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[Changes in specific sensation in pilots exposed to systematic general vibration].

Helicopter pilots exposed to excessive general vibration demonstrate changes of specific sensation (vibrotactile, vestibular, auditory), that could be signs of occupational disorder. Those changes are increased thresholds of vibrotactile sensation, lower vestibulovegetative stability, changed vestibulospinal reflexes, more common occurrence of consistent deafness for voice frequencies in comparison with jet aircraft pilots. Experimental vibration (50-1,800 (m/s2) 2 hour) caused no changes of the vibrotactile and auditory sensation, and the modified vestibular function could prove the increased vestibular reactivity.

Aerospace Medicine↗

[Sound sensations produced by electric stimulation of the structures of the middle ear and the tympanic chord].

Certain facts must be clearly understood before any attempt is made to analyse the sensations produced by electrical stimulation of the structures of the middle ear. Firstly, when the current passes from an electrode to the skin or to any polarised structure whatsoever, the point at which the electrode is applied and the skin behave like the two plates of a condenser microphone. Electrical vibrations are transformed into ordinary acoustic resonances which can travel through air or bone. These acoustic resonances are fairly pure in comparison with electrical vibrations, judged by the standards under investigation. If a continuous polarisation potential, which gives better distribution of the electrical charges, is added, the capacity of the microphone is increased and greater purity obtained. Consequently, the quality of sound heard in this way depends not only on the quality of this electro-physiological microphone but also on the quality of the internal ear. The acoustic effect produced in this way is called an electrophonic effect. Stevens, Jones and Flottorp described this. Therefore an internal ear which has lost the ability to hear high-pitched sound cannot hear them by means of this electrophonic effect any more than it can by ordinary auditory stimulation. Stimulation of the skin of the mastoid and of the external auditory meatus can be sensed by means of this electrophonic effect. Next, sensations recorded by means of direct stimulation of the acoustic nerve (DJOURNO and EYRIES) or by implantation of intra-cochlear electrodes (SIMMONS, DOYLE, MICHELSON) were studied. Sounds heard through stimulation of the structures of the middle ear should be analysed in the light of these findings and bearing in mind that very strong stimulation of the promontory or of the auditory meatus always causes an auditory sensation without frequency awareness due to global stimulation of the acoustic nerve (faciaestations appeared when experiments, the results of which are described, were carried out, although there is a possibility of episode vestibular irritation. These stimulations were in fact always very weak. Our results were analysed in relation to the quality of the internal ear: completely deaf, serious condition, internal ear normal. The impulses were provided by a direct current battery: these were square with a frequency of between 50 and 900 Hertz, a tension of 0 to 8 volts per 1/10 volt. The electrode was bipolar. The experiments were monitored from time to time by oscilloscope. Mention should be made of the technical and psychological precautions to be observed when stimulation of this kind is carried out if results of any value are to be obtained: a relaxed, sensible patient with whom one can communicate easily. Not much can be gathered from a person deaf in both ears. With the ear opened, the posterior part of the tympanum pulled forward, stimulation of the round window always results in production of a sound at a threshold of 0.5 to 2.5 volts.

Acoustic Stimulation↗

Acoustic rhinometry, rhinomanometry, and the sensation of nasal patency: a correlative study.

Acoustic rhinometry and rhinomanometry were used to evaluate the relationship between nasal cross-sectional areas, nasal resistances, and sensations of nasal patency. These parameters were measured before and after topical application of a nasal decongestant in 78 patients suffering from nasal obstruction. As subjects breathed voluntarily through both nasal cavities, no significant correlation was found between sensation of nasal patency and combined nasal minimum cross-sectional areas (r = .11) or of total airflow resistance (r = -.11) either before or after decongestion. However, when subjects were required to breathe through each nasal cavity separately, a significant correlation was found between ipsilateral sensation of nasal patency and both ipsilateral minimum cross-sectional area pre-decongestion (r = -.53, p < .0001) and post-decongestion (r = -.22, p < .01), and airflow resistance pre-decongestion (r = .42, p < .0001) and post-decongestion (r = .25, p < .01). A significant, negative, nonlinear relationship was also found between nasal minimum cross-sectional area and nasal resistance. Furthermore, acoustic rhinometry demonstrated that small intrusions into the lumen of the nose that might be missed by rhinoscopy produce an exponentially greater increase in nasal resistance measurements by rhinomanometry. The findings were most striking in the valve region. It is concluded that each of these objective and complementary measurement techniques provides a more reliable assessment of nasal patency than subjective evaluation by either patient or clinician and can thus provide valuable guidance in management of the symptom of nasal obstruction.

Acoustics↗

Aberrations in postural control, vibration sensation and some vestibular findings in healthy 64-92-year-old subjects.

To assess changes in postural control among healthy elderly and to correlate with suspected age-related events, 33 women and 16 men were studied. Postural control was evaluated by vibration-induced body sway, measured on a force platform, and vibration sensation was tested with a tuning fork. Occurrence of spontaneous gaze and head-shake-induced nystagmus was observed with infrared charged couple device (CCD) cameras and the subjects' medical history was reviewed. Vibration perception was the major determinant for the magnitude of body sway. Although these senior citizens considered themselves healthy, they had a variety of ailments in their medical history, diminished vibration sensation and a high prevalence of vestibular asymmetry. Age per se was not a determinant factor in any of the findings. The study suggests that interest should also be directed to the status of sensation in the legs and vestibular asymmetry when assessing balance function in the elderly. Furthermore, the term "age concomitant" may be more appropriate than "age dependent" when describing decrements of functions such as postural control in elderly subjects.

Aged↗

[Sensation seeking and anhedonia in risk taking. Study of a population of bungy jumpers].

This study presents the investigation of the relations between sensation seeking (41) and anhedonia in 80 subjects who practice a risk taking sport, bengy jump. These relations were examined according to different variables which characterize the practice of bengy jump: the total number of previous jumps and the motivations to jump (1. personal motivation, 2. professional motivation--working in the jumping organization, and 3. group motivation--for example being leaded to jump by friends). We also assessed the use of psychoactive substances. All jumpers (men and women) have higher scores than control subjects in Thrill and adventure seeking dimension. In men, the more the subjects score on this dimension, the less they score on the physical anhedonia scale (8). In women, Experience Seeking and Boredom Susceptibility dimensions are positively correlated with physical anhedonia and with the number of jumps. Moreover, women with personal motivation are those who score the highest on Thrill and Adventure Seeking and Boredom Susceptibility dimensions. These results suggest that in women, sensation seeking through bengy jumping may be linked to a boredom tendency and driven by a need to compensate for a difficulty in experiencing emotions and sensations from common and mundane stimuli. In men, high frequency of bengy jumping was negatively related to the use of psychoactive substances, suggesting that bengy jump, in a compulsive form recalling an addictive behavior, is a specific and preferential way of stimulation seeking.

Adolescent↗

[Role played in man by myelinated fibers of different diameters for the evocation of a nociceptive flex reflex and the accompanying pain sensation].

Using simultaneous recordings we have made in Man a comparative study of: the sural nerve afferent volley, the nociceptive flexor reflex of a muscle of the lower limb and the associated painful sensation. Two types of stimulations were used, a single short duration electric stimulus, and a train of electric shocks (100/sec). With a single stimulus, the nociceptive flexor reflex and the painful sensation develop only when A delta fibers are recruited. On the other hand, when the stimulations are given by trains the nociceptive flexor reflex and the painful sensation can develop with a stimulus sub-liminar to the threshold of A delta fibers, when A alpha fibers are recruited. When the stimulus activate both A alpha and A delta fibers, the flexion reflex and the pain disappear when a selective blockade of the A delta group is exerted by means of Lidocain.

Adult↗

[Validation of a questionnaire of physical sensations in a French-Canadian population].

The objectives of this study are three-fold. The first objective is to present the aspects of reliability and validity of a self-reported questionnaire that evaluates a specific facet of Panic Disorder with Agoraphobia (PDA) for the francophone population of Quebec, mainly the fear of fear. The Body Sensations Questionnaire (17), translated as the Questionnaire des Sensations Physiques (QSP) evaluates the degree to which individuals fear somatic symptoms commonly associated with panic. A second objective is to determine the factorial validity of the QSP and to investigate the dimensionality of the construct as assessed by the questionnaire. The third objective is to establish a reference database for the agoraphobic (N = 141 and N = 70) and the non-clinical population (N = 223). Results suggest that both questionnaires have similar internal consistency, temporal stability, construct validity, and discriminative validity. While the factorial solution of the present study uncovered a three-factor model (somatic, cardiac, and psychosensorial), which points to the multidimensional nature of the construct evaluated by the QSP, it greatly differs from the one obtained by Arrindel's study (5). Nevertheless, the extraction of the three principal components is supported by the results of the screen test and by two different implementations of parallel analysis, i.e., the computation of random eigen values and the use of an interpolation table of eigen values. Finally, it can be concluded that the psychometric properties of the French-Canadian translation of the BSQ are indications that it is an appropriate instrument to use in clinical research and in clinical practice to assess the fear of bodily sensations associated with the fear of fear.

Adult↗

Comparison of respiratory sensations induced by J receptor stimulation with lobeline in left handers & right handers.

We examined the hypothesis that right handers and left handers may differ in sensory perceptions and respiratory responses to J receptor stimulation with intravenous injections of lobeline HCl in incremental doses. The comparison was made between 6 right handers and 9 left handers (all males) for (i) the dose of lobeline required to produce sensory threshold (viz., first appearance of respiratory sensations) and cough threshold (first appearance of cough); and (ii) latency and duration of sensations for sensory and cough threshold. All these comparisons were not found to be significant statistically. The sensation of breathlessness, and feelings of drowsiness, giddiness and headache were perceived in 3 of the 9 left handers, and in none of the right handers, but the difference was not significant. Reflex bradycardia was recorded only in left handers (5 of 9). The time (sec) for cough threshold was negatively correlated to threshold dose of lobeline (r = -0.5, and P < 0.05). The left handers perceived cough at the threshold as more distressing as compared with right handers (VAS P < 0.05). In conclusion, handedness did not influence J receptor responses to i.v. lobeline.

Adult↗

[Influences of orthognathic surgery to facial skin sensation--an analysis with a new testing method].

This study introduces an original testing method on facial skin sensation and describes the results obtained by its application to patients after orthognathic surgery. The alterations of skin sensation in lower lip and chin area were examined in 135 patients who had undergone orthognathic surgery, by application of electrical stimulation through an original pencil shaped probe. Detection threshold of the same area before surgery were used as control, and the location and size of the area with thresholds higher than control levels were measured. The control thresholds ranged from 0.13 mA to 0.21 mA. The higher threshold area was found in 86.3% of all the patients in 1 month after surgery, in 27.7% after 1 year. The threshold levels declined with the time, and in none of the patients the threshold level was higher than 1.0 mA more than 2 years after surgery. The patients whose threshold level was more than 1.0 mA in 1 month postoperatively showed a tendency to have the area with a threshold higher than the control level even 1 year later (p < 0.0001). The threshold of the younger patients tended to improve smoothly than the older. In addition, the patients with a shorter set-back or advance distance had a slighter sensory disturbance and recovered more smoothly than those with a longer distance.

Adolescent↗

Sensate radial forearm free flaps in tongue reconstruction.

BACKGROUND: Successful rehabilitation after ablative surgery requires not only the reconstruction of 3-dimensional form but also the restoration of physiologic function. OBJECTIVE: To assess sensory recovery of reinnervated radial forearm flaps used for tongue reconstruction. PATIENTS AND METHODS: Seventeen patients, who underwent reconstruction of glossectomy defects with reinnervated radial forearm free flaps, formed the study group. Recovery of sensation was measured by both subjective and detailed objective tests 8 months after surgery. Sensory function of the flap was compared with that of the normal residual tongue or the adjacent oral mucosa and the contralateral forearm donor site. RESULTS: All patients involved in this study had tongue defects of hemiglossectomy or greater and adjacent floor of the mouth. Sensory recovery was observed in all of the 17 patients within 8 months. Detailed sensory testing showed that median static 2-point discrimination, moving 2-point discrimination, and pressure sensitivity (1.2 cm, 0.8 cm, and 3.7 psi, respectively) were subjectively greater in the innervated forearm flaps than in the contralateral forearm donor site (2.3 cm, 1.7 cm, and 4.6 psi, respectively) (P= .064) and similar to those of the normal tongue (0.9 cm, 0.5 cm, and 3.6 psi). CONCLUSIONS: In all modalities examined, sensate free flaps proved superior in sensory fidelity to the native forearm donor site and closely approached that of the normal tongue. Microsurgical reinnervation of flaps should be considered in tongue reconstruction.

Adult↗

Restoration of laryngopharyngeal sensation by neural anastomosis.

OBJECTIVE: To demonstrate that sensory nerve transposition may be used to reestablish sensation of the laryngopharynx after central nervous system injury and vagal deficit. DESIGN: Prospective preliminary report of 2 patients following brain-stem stroke with aspiration pneumonia confirmed on chest radiography, severe dysphagia and inability to tolerate oral alimentation, and modified barium swallow that demonstrated cricopharyngeal spasm and impaired laryngeal elevation. Both patients also had severe, bilateral laryngopharyngeal sensory deficits as determined by delivery of air pulse stimuli to the mucosa innervated by the superior laryngeal nerve via a fiberoptic telescope. Each patient underwent surgery as part of management of dysphagia after failure of aggressive nonsurgical treatment. INTERVENTION: During a cricopharyngeal myotomy and laryngeal suspension, a unilateral microneurorrhaphy between the greater auricular nerve and the superior laryngeal nerve was performed. OUTCOME MEASURES: Ability to tolerate oral diet without development of aspiration pneumonia and postoperative laryngopharyngeal sensory capacity. RESULTS: By 12 months after surgery, both patients had ipsilateral restoration of laryngopharyngeal sensation, with no further episodes of aspiration pneumonia. CONCLUSIONS: In select cases of severe dysphagia after central nervous system injury, sensory nerve transposition may be a useful adjunct to the surgical rehabilitation of the patient with dysphagia.

Adult↗

Submucosal versus ligation excision haemorrhoidectomy: a comparison of anal sensation, anal sphincter manometry and postoperative pain and function.

Submucosal (SM) and ligation excision (LE) haemorrhoidectomy were compared to establish whether SM is a less painful procedure and whether anal sensation is better preserved by SM, and, if so, how this relates to postoperative function. There were 18 SM and 22 LE patients. Anal sphincter manometry and anal mucosal electrosensitivity were measured pre-operatively and 6 weeks after surgery. Postoperative pain was assessed by linear analogue scale. Anal sphincter pressures which were high pre-operatively fell to normal after surgery. Neither operation affected functional sphincter length or the recto-anal inhibitory reflex. Forty per cent of patients showed ultraslow waves on sphincter motility studies. These were associated with the highest pressures and in all but three cases disappeared after surgery. There were no differences in postoperative pain scores between the two techniques but there was a wide range from no pain to very severe pain in both groups. Submucosal haemorrhoidectomy preserved anal sensation better than ligation excision but this was not reflected in improved function. There was minor leakage and soiling in 50 per cent of patients from both groups and two SM and LE patients had initial faecal incontinence. All these symptoms had resolved by 6 weeks.

Adult↗

Contribution of the pudendal nerve to sensation of the distal rectum.

BACKGROUND: Anal and rectal sensory mechanisms and pudendal nerve function are important in the control of faecal continence. The contribution of the pudendal nerve to sensation of the distal rectum was investigated. METHODS: Heat thresholds in the anal canal, distal and mid rectum were measured using a specially designed thermoprobe. Rectal sensory threshold volumes were measured using the balloon distension method. Needle electrodes were inserted into the external anal sphincter. Pudendal nerve block was performed through a perineal approach, and completeness assessed by loss of electromyographic activity. Heat and rectal volume thresholds were measured again following unilateral and bilateral pudendal nerve block. RESULTS: The technique was successful in four of six volunteers. Bilateral pudendal nerve block produced complete anaesthesia to heat in the anal canal (P = 0.029), but had no effect on heat thresholds in the distal or mid rectum. Rectal sensory threshold volumes were also unaffected by pudendal nerve anaesthesia. CONCLUSION: Anal canal sensation is subserved by the pudendal nerve, but this nerve is not essential to nociceptive sensory mechanisms in the distal or mid rectum. The transition between visceral control mechanisms in the lower rectum and somatic mechanisms in the anal canal may have functional importance in the initiation of defaecation and the maintenance of continence.

Adult↗

Somatotopic blocking of sensation with navigated transcranial magnetic stimulation of the primary somatosensory cortex.

We demonstrate that spatially accurate and selective stimulation is crucial when cortical functions are studied by the creation of temporary lesions with transcranial magnetic stimulation (TMS). Previously, the interpretation of the TMS results has been hampered by inaccurate knowledge of the site and strength of the induced electric current in the brain. With a Navigated Brain Stimulation (NBS) system, which provides real-time magnetic resonance image (MRI)-guided targeting of the TMS-induced electric field, we found that TMS of a spatially restricted cortical S1 thenar area is sufficient to abolish sensation from a weak electric stimulation of the corresponding skin area. We demonstrate that with real-time navigation, TMS can be repeatably directed at millimeter-level precision to a target area defined on the MRI. The stimulation effect was temporally and spatially specific: the greatest inhibition of sensation occurred when TMS was applied 20 ms after the cutaneous test stimulus and the TMS effect was sensitive to 8-13 mm displacements of the induced electric field pattern. The results also indicate that TMS selectively to S1 is sufficient to abolish perception of cutaneous stimulation of the corresponding skin area.

Adult↗

The milk mucus belief: sensations associated with the belief and characteristics of believers.

The belief that milk produces mucus is widespread in the community and is associated with a significant reduction in milk consumption. Sensations associated with milk drinking were reported by otherwise healthy believers and non-believers in the milk-mucus effect (N = 169) in an unstructured interview, with further responses prompted about the duration, type and amount of milk causing the effect. The site predominantly affected was the throat, with sensations related to difficulty in swallowing and perceived thickness of mucus and salivary secretions, rather than excessive mucus production. The effect required only a small amount of milk and was reported to be of short duration. The chronic respiratory symptom history and dairy product intake of 130 of these subjects were also assessed. Milk-mucus believers were different from non-believers, reporting more respiratory symptoms and consuming less milk and dairy products. Symptoms consistent with the known effects of food allergy or intolerance were not reported.

Animals↗

Near normoglycaemia improved nerve conduction and vibration sensation in diabetic neuropathy.

Twelve C-peptide deficient Type 1 (insulin-dependent) diabetic patients with abnormal peripheral nerve function were randomly assigned to continuation of conventional insulin therapy (CIT) or to continuous subcutaneous insulin infusion (CSII). There were no statistically significant differences at entry to the study between the two treatment groups in nerve function assessed by neurologic disability score, computer assisted sensation examination and measurements of amplitudes, distal latencies, F-wave latencies and somatosensory evoked potential latencies over the spine and conduction velocities of motor and sensory fibers of ulnar, median, peroneal, tibial, plantar and sural nerves. In addition, mean plasma glucose from 24 h profiles (12.5 vs 10.6 mmol/l, respectively) and HbA1 (11.0 vs 11.6%, respectively) did not differ significantly between the two treatment groups at entry. Despite improved glycaemia from CSII in 5 patients (one dropped out of the study after 2 months) contrasted to CIT in 6 patients (5.3 vs 9.9 mmol/l, respectively, p = 0.002) and HbA1 (8.5 vs 10.7%, respectively, p = 0.002), there were no significant differences in measurements of peripheral nerve function after 4 months. After 8 months of improved glycaemia (4.4 vs 10.2 mmol/l, p = 0.004) and improved HbA1 (8.3 vs 10.5%, p = 0.002), nerve conduction (p = 0.03) and vibratory sensation threshold (p = 0.002) were significantly better in patients treated with CSII than those who received CIT. The improvements in nerve function, although small, provide further evidence that some clinical endpoints of neuropathy are favorably influenced by improved control of glycaemia.

Adolescent↗

Quantitative assessment of anal canal sensation in patients undergoing low anterior resection for rectal cancer.

To determine the influence of anal canal sensation on anal function after low anterior resection (LAR) for rectal cancer, anal canal sensation was quantitatively evaluated before and after LAR by measuring anal mucosal electrosensitivity (AMES), and the relationship between AMES and postoperative and function was explored. Sensory thresholds 1, 2, and 3 cm from the anal margin were recorded in 21 patients who underwent LAR for rectal cancer (LAR-I) before, then 1 and 4 months after their operation. Another 14 patients who had been followed up for more than 1 year (LAR-II) after LAR and 21 control subjects were also studied. The median preoperative sensory thresholds in the LAR-I group were higher than those in the controls, though the differences were not significant. The sensory thresholds in the LAR-I group 4 months after LAR were lower than those preoperatively, but they did not significantly differ from those in the LAR-II and control groups. Although the postoperative sensory thresholds did not correlate with postoperative anal function, the preoperative sensory thresholds were higher in patients who were experiencing episodes of fecal incontinence 4 months after their operation. These results suggests that the preoperative measurement of AMES is useful for identifying patients who are likely to have a poor quality of continence after LAR.

Aged↗

The temporary threshold shift of vibratory sensation induced by composite-band vibration exposure.

Eight healthy subjects were exposed to three 1/3 octave-band vibrations (63, 200, and 500 Hz) by hand clasping a vibrated handle in a soundproof and thermoregulated room. The vibratory sensation threshold at 125 Hz was measured before and after the vibration exposure at an exposed fingertip. According to a preceding study, we first determined the relationship between the acceleration of the vibration and the temporary threshold shift of vibratory sensation immediately after the vibratory exposure (TTSv,0) induced by 1/3 octave-band vibration. We then measured TTSv after the exposure to a composite vibration composed of two 1/3 octave-band vibrations that might induce an equal magnitude of TTSv,0 on the basis of the above relationship. The TTSv,0 induced by the composite vibration was not larger than the TTSv,0 induced by the component vibrations. This result suggests that the component of the vibration inducing the largest TTSv,0 determines the TTSv,0 by broad-band random vibration.

Adult↗