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Burning sensation in the throat--should it be named caloripharyngeus?

A burning sensation in the throat is often complained of by patients, but this symptom has been neglected in the literature. To emphasize its importance, should we give the name 'caloripharyngeus' to the symptom of burning in the throat? A preliminary study of 30 patients with the sensation of burning in the throat is presented in this study. Of the patients studied 73.33 per cent had hyperacidity detected for the first time. Reflux was presented in only one patient; four patients showed oesophagitis in the lower one-third of the oesophagus; 90 per cent of the patients responded to antacids. We suggest that one of the causes of burning in the throat is a referred sensation due to hyperacidity.

Adolescent↗

Foreign body sensation in the throat due to displacement of the superior cornu of the thyroid cartilage: two cases and a literature review.

The sensation of a foreign body in the throat when swallowing is a common and very discomforting symptom for those who experience it. Common causes are gastroesophageal reflux disease and possibly upper oesophageal dysmotility. This complaint may be dismissed as psychogenic when a cause for the problem is not readily apparent. We present two cases in which the patient had a foreign body sensation in the throat, associated with a dry swallow. The most helpful diagnostic procedure was careful examination of the hypopharynx and neck and flexible fibre-optic rhinolaryngoscopy. One case was treated with surgery of the neck and larynx to trim the medially projecting superior cornu of the thyroid cartilage. Surgery was successful in eliminating the symptoms. Although an uncommon finding, our experience is that symptoms due to a medially displaced thyroid cornu should be considered in the differential diagnosis as an important and surgically correctable cause of persistent foreign body sensation at the hyoid level in the neck.

Deglutition Disorders↗

Sensation seeking, augmenting-reducing, and the perceived and preferred effects of drugs.

The following measures were administered to 78 undergraduates: the General and Disinhibition subscales of Zuckerman's (1971) Sensation-Seeking Scale; the Reducer-Augmenter Scale (RAS; Vando, 1970, 1974); self-reported use of alcohol, tobacco, and cannabis; the degree of attribution of stimulant, depressant, and neutral effects to these drugs; and desirability ratings of stimulant and depressant effects ascribed to various drugs. Major findings were as follows: (a) On the RAS, reducing correlated positively with both sensation-seeking measures. (b) Seven of the nine personality-versus-drug-use correlations were positive and significant. (c) Generally, the effects attributed to drugs did not differ by sex, personality, or use. (d) However, frequent drinkers attributed stimulant effects to alcohol more strongly than depressant effects, whereas infrequent drinkers did the opposite. (e) The mean desirability ratings of stimulant and depressant drug effects correlated positively. (f) High disinhibitors rated drug effects of both kinds more favorably than did lows. (g) A similar, more favorable evaluation by high than by low general sensation seekers was significant for male subjects only. (h) Score on the Reducer-Augmenter Scale was not significantly predictive of subjects' desirability ratings.

Alcohol Drinking↗

Influence of sensation seeking on general deviance and specific problem behaviors from adolescence to young adulthood.

Indicators of a Sensation Seeking latent construct were assessed during adolescence and used to predict changes in repeatedly gathered measures of a latent construct of General Deviance. A community sample of 595 male and female Ss was assessed 3 times over a 5-year period from late adolescence to young adulthood. Most Ss reported use of licit drugs, about one half had tried illicit drugs, and a substantial minority had engaged in other delinquent or criminal activities. The General Deviance construct was stable over time, although specific cross-effects were found. Sensation Seeking was moderately correlated with General Deviance at all 3 levels but did not predict directly the General Deviance construct over time; the effects of Sensation Seeking on later deviant behavior and attitudes were specific rather than general.

Adolescent↗

Automatic negative evaluation of suffocation sensations in individuals with suffocation fear.

The current study tested whether "suffocation sensations" (respiratory loads) are automatically evaluated in a negative way by people fearing these sensations. It was found that, after having been primed with a slight respiratory load, participants with high suffocation fear (n=15) reacted more quickly to suffocation words and more slowly to positive words than participants with low suffocation fear (n=21). However, the effect was present only in participants who had noticed the primes. The findings are relevant to the cognitive model of panic disorder because automatic negative appraisal of sensations may play a role in initiating a panic attack.

Adolescent↗

Personality correlates of caffeine dependence: the role of sensation seeking, impulsivity, and risk taking.

The consumption of caffeine has become a growing concern, partially because of the withdrawal properties of the drug. The current study examined personality correlates of caffeine consumption and dependence in 60 university students. Self-report and behavioral measures of sensation seeking, impulsivity, and risk taking were administered to 2 groups, identified as caffeine dependent-high consuming or caffeine nondependent-low consuming. Scores on self-report measures of sensation seeking and impulsivity were related to group status, and only sensation seeking evidenced a significant relationship with group status when both variables were considered in a regression analysis. Implications of these findings and future directions are discussed.

Caffeine↗

Sensation seeking and the aversive motivational system.

Sensation seeking (SS) has traditionally been viewed as a phenomenon of the appetitive motivational system. The limited SS research exploring contributions from the aversive motivational system reveals greater anxious reactivity to dangerous activities among low sensation seekers. The present study extends this line of work by comparing levels of fear and anxiety during anticipation of predictable and unpredictable aversive stimuli across high- and low-SS groups. Low sensation seekers displayed greater fear-potentiated startle (FPS) to predictable aversive stimuli, and only those low on SS showed FPS and skin conductance response effects during experimental contexts in which aversive stimuli were delivered unpredictably. Findings implicate enhanced apprehensive anticipation among those low on SS as a potential deterrent for their participation in intense and threatening stimulus events.

Adult↗

A thalamic nucleus specific for pain and temperature sensation.

The existence of a posterolateral thalamic relay nucleus for pain and temperature sensation was postulated in 1911, on the basis of the stroke-induced analgesia and thermanaesthesia found paradoxically in patients with thalamic pain syndrome. Pain or temperature sensations can be evoked in humans by electrical stimulation in a vaguely defined region of the posterolateral thalamus. Here we use anterograde tracing and single unit recordings to demonstrate that there is a distinct nucleus in the posterior thalamus of the macaque monkey that receives a dense, topographic input from spinothalamic lamina I neurons and in which almost all neurons are nociceptive- or thermoreceptive-specific. Immunohistochemical staining showed that this nucleus is defined by a dense calbindin-positive fibre plexus in the macaque, so we applied the same staining method to sections of human thalamus. We found a nearly identical fibre plexus localized within a distinct nucleus that is cytoarchitectonically homologous to the lamina I relay nucleus in the macaque thalamus. The stereotaxic coordinates of this nucleus and its location relative to the main somatosensory representation fit clinical descriptions of the pain-producing region in humans. We conclude that this is a specific thalamic nucleus for pain and temperature sensation in both monkey and human.

Animals↗

Appetite sensations and eating behaviors to complete fasting in obese and non-obese individuals.

OBJECTIVE: To investigate the response of appetite sensations and eating behaviors to fasting in obese and non-obese individuals. DESIGN: Prospective study on inpatients enrolled in weight loss program including fasting at the obesity clinic, an oriental medical center in Seoul, Korea. SUBJECTS AND MEASUREMENTS: For seven obese (body mass index BMI> or =30) and 11 non-obese (BMI<30) patients, the modified visual analog scale (VAS) was administered three times per day throughout 9 days of complete fasting. Three-Factor Eating Questionnaire (TEEQ) was administered before and 18 days after the complete fasting period. RESULTS: After treatment, average weight losses were 7.4 kg (3.0 BMI) for the obese group and 6.7 kg (2.6 BMI) for the non-obese. TFEQ scales did not differ by weight status at both before and after treatments. Eighteen days after the fasting, an increase of restraint of eating was found only for the non-obese. There was a decrease of disinhibition of eating regardless of weight status. During fasting, desire to eat, hunger and prospective consumption decreased for the non-obese, while these appetite sensations tended to increase slightly for the obese. CONCLUSIONS: BMI, independent of dieting status, appeared to be related to appetite sensations except for satiety during fasting, but not before and 18 days after fasting.

Adult↗

Distressing upper extremity phantom limb sensation during intravenous regional anesthesia.

BACKGROUND AND OBJECTIVES: The objective of this article is to describe a case of distressing upper extremity phantom limb sensation during intravenous regional anesthesia (IVRA). CASE REPORT: A 33-year-old American Society of Anesthesiologists (ASA) status I female with an uncomplicated intrauterine gestation presented for endoscopic carpal tunnel release. Following gravity-assisted exsanguination of the vertically positioned left upper extremity, she underwent an IVRA. Within minutes of her arm being repositioned for surgery she remarked that the arm felt as if it was still in the vertical position. This sensory disturbance was described as fatiguing and exhausting. Despite reassurance and medication with intravenous narcotics, her symptoms became intolerable. Her phantom sensation disappeared upon dissipation of the IVRA. CONCLUSIONS: There are no previous reports regarding the development of phantom phenomena during an IVRA. The occurrence of distressing phantom sensations during an otherwise adequate IVRA may be interpreted as block failure and may lead to conversion to general anesthesia. Practitioners are encouraged to consider these phenomena when performing IVRA.

Adult↗

Rehabilitation of somatic sensation and related deficit of motor control in patients with pure sensory stroke.

OBJECTIVE: To assess the effectiveness of a rehabilitative training program for deficits in somatic sensation and motor control of the hand in patients with pure sensory stroke. DESIGN: Multiple baseline and before-after follow-up trial with behavioral analysis of single cases. SETTING: Rehabilitation unit of a university hospital in Italy. PARTICIPANTS: Four patients were studied: 2 had a unilateral lesion confined to the parietal lobe (patients 1, 2), and 2 had a unilateral lesion of the thalamus (patients 3, 4) that also lapped the posterior limb of the internal capsule. All 4 patients had chronic deficits in somatic sensation and motor control of the contralesional hand. INTERVENTION: Behavioral training consisting of exercises aimed at improving somatic sensation and motor control of the affected, contralesional hand. Thirty treatment sessions, each lasting 50 minutes, were performed. MAIN OUTCOME MEASURES: Somatic deficit was evaluated with 5 tests, and motor control deficit was assessed with 4 tests. One functional test estimated the influence of somatic deficit on daily activities. A visual analog scale (VAS) was also submitted to the patients' relatives to evaluate the amount of use of the affected arm in daily life activities. A baseline was obtained by recording each measure, except for the VAS, 4 times at the first evaluation session. Evaluation sessions were conducted before, after, and 6 months after the end of the experimental treatment. RESULTS: All patients showed a stable baseline in at least 8 of the outcome measures. Patients 1 and 2 significantly improved in 9 and 7 outcome measures, respectively. Patients 3 and 4 improved in 4 and 7 outcome measures, respectively. With the exception of case 3, all patients considerably increased their use of the affected arm during daily life. The improvement was generally stable over a 6-month period, suggesting that the treatment had a long-term effect. CONCLUSIONS: Results suggest the possible effectiveness of our training program for treating somatic and motor control deficits of the hand in patients with cortical or subcortical pure sensory stroke.

Adult↗

"Phantom" sensations following intraspinal injury.

The sensations associated at times with neural lesions in the spinal canal may have the following features and phases: 1) early anosognosia, i.e. lack of awareness of disability; 2) initial stimulation; 3) illusion of amputation; 4) disappearance of that illusion and 5) grotesque sensations. Detailed features of the phantoms such as changes in their size, position, and vividness as well as tactics evoking changes in the sensations are recorded. The special situations are described in which paraplegia is accompanied by actual amputation, or there is a phantom of an upper limb after avulsion of the brachial plexus or after extensive posterior rhizotomy. Finally phantoms associated with incomplete lesions of the cord are analyzed and the basis presented for concluding that a lesion of an ipsilateral posterior column is responsible for the phantom experience in cord lesion.

Amputation, Surgical↗

Usefulness of free sensate osteofasciocutaneous forearm and fibula flaps for neophallus construction.

Female-to-male transsexuals have been treated by the authors since the 1970's, using different operative methods. Since 1981, these patients have received neophallus construction with free sensate osteofasciocutaneous forearm flaps and, since 1993, with free sensate osteofasciocutaneous fibula flaps. In order to evaluate the usefulness of these flaps, the authors performed, in 24 patients (12 with forearm and 12 with fibula flaps), the following examinations: clinical and radiologic evaluations of the neophallus and its donor site, as well as patient questionnaires. In all patients, subjective findings and clinical examinations showed no significant variations in neophallus size and form. Patients with fibula flaps had better sexual intercourse, although their neophallus sensibility was minor, when compared to the forearm flap patients. Donor-site morbidity was moderate in both groups. On radiologic examination, robust, calcified bone structure, and no fracture of the neophallus bone and its donor site, as well as no instability of the ankle joint (in the fibula flap patients) were found. These findings further support the use of these free sensate osteofasciocutaneous flaps for neophallus construction. In the authors' opinion, it is the patient who must decide which method should be used for neophallus construction.

Female↗

Beyond re-membering: phantom sensations of congenitally absent limbs.

Phantom limbs are traditionally conceptualized as the phenomenal persistence of a body part after deafferentation. Previous clinical observations of subjects with phantoms of congenitally absent limbs are not compatible with this view, but, in the absence of experimental work, the neural basis of such "aplasic phantoms" has remained enigmatic. In this paper, we report a series of behavioral, imaging, and neurophysiological experiments with a university-educated woman born without forearms and legs, who experiences vivid phantom sensations of all four limbs. Visuokinesthetic integration of tachistoscopically presented drawings of hands and feet indicated an intact somatic representation of these body parts. Functional magnetic resonance imaging of phantom hand movements showed no activation of primary sensorimotor areas, but of premotor and parietal cortex bilaterally. Movements of the existing upper arms produced activation expanding into the hand territories deprived of afferences and efferences. Transcranial magnetic stimulation of the sensorimotor cortex consistently elicited phantom sensations in the contralateral fingers and hand. In addition, premotor and parietal stimulation evoked similar phantom sensations, albeit in the absence of motor evoked potentials in the stump. These data indicate that body parts that have never been physically developed can be represented in sensory and motor cortical areas. Both genetic and epigenetic factors, such as the habitual observation of other people moving their limbs, may contribute to the conscious experience of aplasic phantoms.

Adult↗

Corticosterone in the range of stress-induced levels possesses reinforcing properties: implications for sensation-seeking behaviors.

In both humans and animals certain individuals seek stimuli or situations that are considered stressful and consequently avoided by others. A common feature of such situations is an activation of the hypothalamo-pituitary-adrenal axis leading to secretion of glucocorticoids. Since glucocorticoids have euphoric effects in some individuals and have been shown to potentiate the reinforcing properties of drugs of abuse in animals, we hypothesized that corticosterone secretion during stress-like situations may have reinforcing effects and that a higher sensitivity to the reinforcing effects of glucocorticoids might be a biological basis of sensation seeking. In this report we show that (i) corticosterone has reinforcing properties, as evidenced by the development of intravenous self-administration, (ii) self-administration of corticosterone is observed at plasma levels that are comparable to those induced by stress, and (iii) there are individual differences in corticosterone self-administration, which are related to individual reactivity to novelty and sensitivity to drugs of abuse, behavioral features akin to certain traits of high-sensation seekers. These findings provide insight into the physiological role of glucocorticoids and the biology of sensation seeking and may have clinical implications.

Analysis of Variance↗

Images and sensations of war: a common theme in the history of military nursing.

We analyzed interviews with 22 military nurses who had served in wars or conflicts since World War II, up to and including Operation Desert Storm. Using a method of hermeneutic phenomenology, we found several common themes in the interviews. In this article, we report on the theme Images and Sensations of War. Within that theme, the subcategories sights, sounds, and other sensations (climate and weather, taste, smell, and comfort) were discovered. We categorized the images and sensations as pleasant, unpleasant, and horrible. The findings from this analysis may be useful to professionals who recruit military nurses, provide ongoing military training, help military nurses return to civilian life, and treat posttraumatic stress syndrome. Furthermore, the findings could be used as a basis for future quantitative studies to determine how widespread this theme is in larger groups of military nurses.

Female↗

The effects of heat-induced pain on the detectability, discriminability, and sensation magnitude of vibrotactile stimuli.

The effects of heat-induced pain on absolute thresholds, sensation magnitudes and amplitude-difference thresholds were measured at 10 and 100 Hz. Consistent with previous results, heat-induced pain elevated the absolute thresholds by approximately 8.0 dB and lessened the magnitudes of tactile sensations during pain as compared to the non-painful condition. In contrast to these effects, the discriminability of change in the intensity of the vibrotactile stimuli was unaffected by the presence of pain indicating that the effect of pain on tactile sensations is more likely due to sensory rather than cognitive processes (i.e., attention) and that the mechanisms underlying tactile sensitivity as compared to discriminability are different.

Acoustic Stimulation↗

Effects of hydration on tactile sensation.

The routine tasks of washing usually necessitates the immersion of parts of the body in water, which causes hydration and changes in the mechanical properties of the superficial layer of skin. To determine how hydration affects tactile sensations, the hydration and skin-surface temperature of glabrous and hairy skin was first measured under normal conditions (air), after submersion in distilled water alone and after submersion in a surfactant-water solution. In these experiments, measurements were made of the time to achieve complete hydration and the recovery time to normal levels. The uptake of water in hairy skin was found to be considerably greater than in glabrous skin, and retention was significantly prolonged by the surfactant additive. Subsequent experiments on glabrous skin, based on the results of the preceding hydration studies, measured in-air and hydrated tactile thresholds and sensation magnitudes to vibratory stimuli and to the roughness of textured surfaces. Vibrotactile detection thresholds were not affected by skin hydration, nor were sensation magnitudes to suprathreshold vibratory stimuli. However, suprathreshold perceptions of roughness were substantially altered by hydration. It is concluded that hydration and the mechanics of the skin play a major role in the perception of spatiotemporal (i.e., textured) surfaces and, thus, must be taken into account in any physiological/psychophysical model based on using such stimuli. This may not be required for models based on predominantly temporal (i.e., vibratory) stimuli.

Adult↗