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PubMed1985

Nasal anatomy: the muscles and tip sensation.

The author stresses the importance of columellar sensation, nasal tip sensation, and the role of the nasalis muscles in determining the postoperative results of corrective rhinoplasty, especially as these have an influence on the "drooping tip" and the columellar base. Specific anatomic details of this area are emphasized in order to help the plastic surgeon understand better the "normal" anatomy of this region and the effects that operative procedures have on successful results if the surgeon understands especially the role of the nasalis muscles.

Humans↗

PubMed1995

Absence of effect of nicotine on rectal sensation, rectal compliance, and anal sphincter pressures in healthy subjects.

We examined the effect of nicotine on rectal sensation, rectal compliance, and anorectal sphincter function in healthy volunteers. Eleven healthy (ex-smoker) subjects were randomized in a double-blind, crossover, placebo-controlled study of 12 mg nicotine-containing chewing gum. All treatment periods (nicotine or placebo chewing gum) were preceded by a control period without chewing gum. Crossover study was done after a washout period of more than seven days. The following measurements were made: highest anorectal sphincter tone, highest anorectal sphincter squeeze tone, percentage relaxation of the anorectal sphincter with rectal balloon distension, threshold of rectal sensation, maximal tolerable volume of air inflation of a rectal balloon, and rectal compliance. There was no significant difference in the two control periods. Chewing placebo gum had no significant effect on any of the measurements when compared with control. Compared with placebo, nicotine did not significantly affect on any of the measurements. We conclude that neither nicotine nor the sham-feeding effect of chewing placebo gum appear to have any effect on anorectal sensorimotor function or on rectal compliance in healthy ex-smokers.

Adult↗

PubMed1992

Comparison of rectangular and exponential current pulses for evoking sensation.

There exists a paucity of quantitative information comparing the stimulating currents for different waveforms. Thus, the objectives of this study was to compare the threshold peak current (I) for sensation using rectangular and exponential; that is, capacitor-discharge, cathodal pulses of equivalent pulse duration (d). In 10 human subjects, stimuli were applied to the skin of the forearm, and I was determined alternately for each current waveform at each of several pulse durations (d). Strength-duration curves for sensation were obtained using d of 0.01-50 ms. The threshold peak current (Ir) for a rectangular pulse of duration d was compared to the threshold peak current (Icd) for a capacitor-discharge pulse of duration d, where d was the time constant; that is, the time required for the current to decrease to 1/e, or 37% of its peak value. Chronaxie, the pulse duration at which I is twice the infinite-duration current asymptote (i.e., the rheobase), was calculated for each waveform and subject using the Weiss-Lapicque expression for excitability. Icd was found to be always higher than Ir of equivalent duration. Chronaxie for the capacitor-discharge pulse was, on the average, twice that for the rectangular pulse (p less than 0.01). Moreover, the ratio Icd/Ir increased with decreasing d. These results indicate that these two waveforms are not equivalent on the basis of an equal-charge requirement for excitation, particularly at the short pulse durations. Furthermore, they suggest the need of a better expression to describe the excitability characteristics of tissues.

Adult↗

PubMed1991

Spinal cord injury syndrome with motor sparing in the absence of all sensation.

This paper describes the anatomic basis for the unusual presentation in a spinal cord injured subject of preservation of motor power in the absence of all sensation. The patient was examined at four hours, and daily thereafter, after a motorcycle accident in which he was thrown over the handle bars. He had trace ankle dorsi and plantar flexors, but light touch, pin, position, and vibratory sensation were absent below the level of C4 bilaterally. There was no physical evidence to differentiate whether he suffered a flexion or extension injury. Cervical spine films showed no evidence of fracture or dislocation, but anterior and posterior osteophytes involving C3 to C4, C4 to C5, and C5 to C6 were present. Magnetic resonance imaging showed evidence of cervical cord edema at C3 to C4 with possible hemorrhage and severe spinal stenosis at C3 to C4 and C4 to C5. This patient received a compression injury with resulting classic anterior spinal artery syndrome. Because of his spinal stenosis with a decreased anterior-posterior (AP) diameter of the canal, the posterior circulation was also compromised. The extensive pial anastomotic network provided relative sparing of the most peripheral components of the lateral corticospinal tracts. This case report demonstrates a unique clinical picture that cannot be anatomically classified by current American Spinal Injury Association (ASIA) standards as central cord syndrome. It can be explained by the lamination of the ascending and descending tracts in relation to the vascular supply of the cervical cord in conjunction with the narrowing of the AP diameter of the canal due to spinal stenosis.

Humans↗

PubMed1994

The effect of topical anesthetics on skin sensation and soleus motoneuron reflex excitability.

The effect that topical anesthetics has on cutaneous sensation and on soleus motoneuron reflex excitability was studied in a healthy population. Data were obtained from 16 volunteers (7 men and 9 women) between 20 and 47 years of age. The experiment consisted or recording H-reflexes and Achilles tendon reflexes (ATR) before and after administration of a 20% benzocaine spray or a placebo to the skin of the posterior calf. In addition, a sensory evaluation was conducted to determine objectively the actual quality of anesthesia obtained. Subjects served as their own controls, randomly receiving both the active medication and a placebo. The study was conducted in a single blind fashion with only the experimenter being aware of what medication (active/placebo) was being applied during a given experiment. H-reflex amplitudes increased significantly following the application of benzocaine and the placebo spray compared to control (p < .01). This increase was similar whether the active drug or placebo was administered. No significant difference was shown between active benzocaine and the placebo application. The ATR was not significantly affected by any of the treatment techniques used in this study, although some reduction in reflex amplitude was noted. No change in skin sensibility could be attributed to the topical anesthetic in any subject in this study. It was concluded that benzocaine spray did not have an effect on skin sensation and that the increased motoneuron reflex excitability was more likely in response to a stimulatory action upon cutaneous receptors from the spray technique. It is further suggested that topical anesthetics applied to intact skin may not permeate cutaneous tissue in large enough quantities to have a desensitizing effect.

Achilles Tendon↗

PubMed1989

Sensations, cognitions and the perception of cues associated with expected and unexpected panic attacks.

Panic attacks may be perceived by patients as either cued or uncued (spontaneous) and either expected or unexpected. The purpose of the present study was to examine the prevalence and characteristics of these types of panic. Twenty-six panic disorder patients with mild avoidance and 18 with moderate or severe avoidance were instructed to complete a questionnaire during or immediately following each of three consecutive naturally occurring panic attacks they experienced. They were asked to rate the extent to which they expected the panic attack to occur, whether they felt it was associated with an external panic "cue" (e.g. a shopping mall), whether they would expect to panic again in similar circumstances, their mood, present level of life stress, and fear and severity of their body sensations and disturbing cognitions. Results indicated that from a sample of 92 questionnaires, each representing a separate panic, nearly 70% of panic attacks were rated as cued-expected and only one panic was rated as uncued-expected. The other two categories each comprised about 15% of all panic attacks. There were few reported differences in body sensations and cognitions reported as a function of type of panic and no differences with regard to extent of agoraphobic avoidance. Expected panic was associated with a higher expectation of future panic in similar circumstances.

Adult↗

PubMed1992

Individual differences in the perception of bodily sensations: the role of trait anxiety and coping style.

Thirty young women participated in an experiment in which heart rate, blood pressure, respiration rate, skin conductance level and palmar sweat index were monitored at rest and during the administration of mental arithmetic, mirror drawing and cold pressor tasks. The accuracy of perception of somatic states was estimated by calculating within-subject correlations between four bodily sensations (racing heart, high blood pressure, shortness of breath and sweaty hands) and corresponding physiological parameters, assessed on eight occasions during the experiment. The accuracy of heart rate perception was highest, with a mean correlation between actual heart rate and ratings of racing heart of 0.76 and 66% of participants showing significant within-subject effects. The mean accuracy was 0.55 for systolic blood pressure, 0.48 for respiration rate, 0.47 for skin conductance level, and 0.64 for palmar sweat index. Accurate perception across physiological parameters did not cluster within individuals, and was not dependent on the range either of physiological changes or sensation ratings. Trait anxiety was not significantly associated with accuracy of somatic perception. Subjects with high trait anxiety reported larger increases in shortness of breath during tasks than did low anxious subjects, but this was not reflected in objective physiological measures. Information-seeking coping style, indexed by the monitoring scale of the Miller Behavioral Style Scale, was related to the accuracy of perception of skin conductance level and heart rate. The use of within-subject correlational strategies for assessing individual differences in perception of bodily states is discussed.

Adaptation, Psychological↗

PubMed1992

Motility and sensation of the rectosigmoid and the rectum in patients with anorectal malformations.

Motility of the rectosigmoid and rectum and reservoir function of the rectum after surgery for anorectal malformations were investigated in 32 patients (17 with high type, 6 with intermediate type, and 9 with low type anomaly) aged 5 to 16 years. All 32 patients were examined manometrically as well as with a newly devised myoelectrical method. Manometry showed that the values of maximum anal pressure and anorectal pressure difference in the high type were significantly lower than those in the low type. However, the incidence of contractile activity of the rectosigmoid was not significantly different between these two groups. The threshold sensation pressure and the maximum tolerable pressure in the high type were significantly higher than those in the low type, and the rectal compliance in the high type was significantly lower than that in the low type. Electromyography was recorded at 8 cm and 5 cm from the anal verge. Two types of slow waves were observed, a faster rhythm and a slower rhythm. Their frequency was similar in the three groups. However, the numbers of spike bursts in the high type and intermediate type were significantly higher than those in the low type. These results indicate that in addition to an inadequate anal resting pressure a loss of optimal rectal sensation or rectal reservoir function might be associated with fecal incontinence in the high type and that increased spike bursts might play some role in rectal motility.

Adolescent↗

PubMed1993

Effects of subcutaneous bethanechol on bladder sensation during cystometry.

Bethanechol has been shown to produce a pharmacologic effect on the urinary bladder, although the clinical efficacy of this response is controversial. The measured response has been an increase in detrusor pressure, although sensory effects may occur also. In this study, 10 neurologically intact men had cystometry before subcutaneous administration of 5 mg bethanechol chloride and thirty minutes after bethanechol. The sensation of desire to void and the maximum cystometric capacity occurred at a higher intravesical pressure and a smaller bladder capacity following bethanechol. Subcutaneous bethanechol appears to alter the bladder pressure and capacity at which the perception of desire to void and the sensation of maximum fullness occurs.

Aged↗

PubMed1992

The recovery of sensation and function after cross-finger flaps for fingertip injury.

Over a five-year period, 54 patients had cross-finger flaps at Mount Vernon Hospital for single fingertip injuries. A retrospective study was carried out to evaluate the recovery of sensation and function. 92% of the patients were satisfied with the result although 53% suffered cold sensitivity. All the cross-finger flaps tested had diminished sweating and a raised threshold for electrical stimulation. Despite the presence of protective sensation, dynamic sensory discrimination and the return of advanced A beta fibre innervation, none of the cross-finger flaps was found to have recovered tactile gnosis.

Adolescent↗

PubMed1990

The sensational contributions of Erik Moberg.

Erik Moberg is the father of functional sensory testing. During the past three decades, his research into quantitative testing of hand sensibility has provided the insight to bring us from classic academic tests (permitting localisation of lesions within the central nervous system) to clinical capability of restoring sensation to the hand. He introduced the Ninhydrin test to document objectively innervation. He defined hand function as precision-sensory and gross-sensory grips. He correlated Weber two-point discrimination with hand function. He introduced the pick-up test to document hand function. He coined the term "tactile gnosis". He hypothesised that proprioception is principally due to skin, not joint, afferents. He classified the tetraplegic hand according to its combined sensory and motor capacity. He set the standard for sensory recovery after primary nerve repair, relating recovered two-point discrimination to age (Onne's line) and he inspired the present generation of researchers to quantify their own studies of sensation.

General Surgery↗

PubMed1987

A mechanism of new pain following cordotomy; reference of sensation.

An antero-lateral cordotomy was performed on a 62-year-old man who had been suffering from intractable right chest pain caused by lung cancer. Six hours after the cordotomy a new pain occurred in an analogous part of the body on the opposite side; the intensity increased gradually and it became as severe as the original within 1 week. Reference of sensation from analgesic area of cordotomy to the opposite side of the body was induced by noxious stimuli. Intrathecal phenol block to the nerves conveying the cancer pain abolished the new pain and the reference of sensation from this blocked area, though it remained unchanged in other analgesic areas of cordotomy. This substantiates that the new pain was a reference of the original cancer pain.

Electrocoagulation↗

PubMed1991

Comparison of human pain sensation and flexion withdrawal evoked by noxious radiant heat.

The purpose of this study was to determine the reliability of flexion withdrawal magnitude as an indicator of pain sensation. In 10 healthy human volunteers, we compared the magnitude and latency of integrated biceps EMG with the subjects' rating of pain, using a visual analog scale, elicited by noxious radiant heat stimuli applied to the dorsal forearm. The magnitude and inverse latency of withdrawal, although variable, increased exponentially as a functions of stimulus temperature. The stimulus response functions for mean withdrawal magnitude and mean pain intensity were similar for lower stimulus temperatures, but at higher temperatures the withdrawal continued to increase exponentially whereas pain intensity reached a plateau. The pain intensity and withdrawal magnitude for each stimulus were poorly correlated. Under the conditions of this experiment, mean pain intensity and mean withdrawal magnitude were both well correlated with stimulus temperature, but the magnitude of withdrawal did not reliably reflect the intensity of pain sensation.

Adult↗

PubMed1996

A parsimonious set of verbal descriptors of pain sensation derived from the McGill Pain Questionnaire.

In view of some recent disagreements about the vocabulary of pain as suggested in the McGill Pain Questionnaire (MPQ), the present study re-examined all MPQ pain descriptors with regard to their appropriateness as descriptors of pain sensation. A sample of 70 undergraduate students (whose first language was English) assigned descriptors to individual sensory subcategories and then rated them in terms of implied intensity of pain. Data were evaluated using three criteria related to the absolute frequency, relative frequency, and unimodality of word assignments to each subcategory. Results revealed that about 40% of the supposed MPQ sensory descriptors could not be classified within any of the sensory subcategories because of incomprehension, underuse, or ambiguity of usage. The majority of the words, however, were classified in the same subcategories and given similar intensity ratings as in the MPQ. These words constitute a parsimonious subset of MPQ descriptors of pain sensation. Such words promise more diagnostic specificity in the assessment of pain. Further research could serve to replicate these findings as part of the ongoing refinement of the MPQ.

Adolescent↗

PubMed1992

Vascular anatomy of the finger dorsum and a new idea for coverage of the finger pulp defect that restores sensation.

The cutaneous vascular anatomy of the finger dorsum was studied by dissection under loupe magnification of 71 fingers from 19 preserved cadaver hands. All specimens were injected with red latex or epoxy resin through a cannula in the brachial artery to identify the small vessels. The finger dorsum was supplied by the terminal branches from the dorsal metacarpal artery around the metacarpophalangeal joint. Other areas were nourished by the dorsal cutaneous branch from the proper palmar digital artery. There were two or three dorsal branches in the proximal phalangeal region and two in the middle phalangeal region. On the basis of these findings, we have developed a new method for one-stage reconstruction of finger pulp defect that restores sensation. Our innervated reverse vascular pedicle digital island flap includes the dorsal digital nerve and the proper palmar digital artery as a retrograde vascular pedicle. We have used the technique in three patients, with excellent results. The advantage of this procedure is that it provides a one-stage reconstruction of the pulp defect and restores sensation. The disadvantage is that the procedure requires neurorrhaphy.

Adult↗

PubMed2005

Recovery of sensation in the skin of non-innervated radial flaps after subfascial and suprafascial dissection.

We compared the extent of recovery of sensation in 40 non-innervated radial free flaps, 20 of which had been raised subfascially and 20 suprafascially. We found no significant difference in sensory recovery between the two groups. The mean extent of sensory recovery was light touch (68%); sharp touch (84%); warm (29%) and cold (40%) temperature; and static (25%) and moving (31%) two-point discrimination. Nearly all the flaps responded to at least one stimulus (excluding two-point discrimination) and half of them to three or more. Sharp touch sensation in the flap was similar to that in the surrounding tissues and light touch was less sensitive. There was no dysaesthesia. Recovery was not related to sex, age, alcohol consumption, or site of reconstruction. Smoking and radiotherapy had a slight effect.

Aged↗

PubMed2026

Prediction of alcohol consumption: The role of genetics, impulsivity, and sensation seeking from adolescence to adulthood.

BACKGROUND: There are well-known phenotypic and genetic associations among impulsivity, sensation seeking (SS), and alcohol consumption, but whether they vary between adolescence and early adulthood remains unclear. PURPOSE/HYPOTHESES: We hypothesized that adolescent alcohol consumption would be better predicted by polygenic indices (PGIs) of impulsivity and SS than PGIs of adult alcohol consumption (drinks per week; DPW), but that the reverse would be observed in young adulthood (i.e., stronger associations for DPW PGIs). METHODS: N = 733-754 twins of European genetic ancestry from the Colorado Longitudinal Twin Study were assessed at age 17 and/or 23 years using structural equation modeling. RESULTS: The SS PGIs were associated with alcohol consumption in adolescence (β=0.16), whereas DPW PGIs were associated with alcohol consumption in early adulthood (β=0.15). Additionally, phenotypic measures of impulsivity and SS are associated with alcohol consumption at both ages (β=.13-.21) and mediated some PGI-alcohol associations. DISCUSSION: These findings suggest that genetic influences on alcohol consumption change from adolescence to early adulthood, with genetic influences on sensation seeking most relevant to alcohol consumption in adolescence.

Humans↗

PubMed2005

Effect of neonatal circumcision on penile neurologic sensation.

OBJECTIVES: To evaluate penile sensory thresholds in neonatally circumcised and uncircumcised men. METHODS: We evaluated 125 patients, 62 uncircumcised men and 63 neonatally circumcised men. All patients completed the Erectile Function domain of the International Index of Erectile Function questionnaire. Of the 125 patients, 29 (International Index of Erectile Function score of between 25 and 30) were placed in the functional group, and 96 in the dysfunctional group. The patients were tested on the dorsal midline glans of the penis (foreskin retracted). Quantitative somatosensory testing was performed and included vibration, pressure, spatial perception, and warm and cold thermal thresholds. RESULTS: In the functional group, t-test analysis demonstrated a significant (P <0.001) difference, with worse vibration and better pressure sensation for uncircumcised men. When controlling for age, hypertension, and diabetes, all t-test significance was lost. In the dysfunctional group, circumcised men (49 +/- 16 years) were significantly younger (P <0.01) than uncircumcised men (56 +/- 13 years). For the dysfunctional group, t-test analysis also demonstrated worse vibration sensation for uncircumcised men (P <0.01). Again, when controlling for age, hypertension, and diabetes, all t-test significance was lost. CONCLUSIONS: We present a comparative analysis of uncircumcised and circumcised men using a battery of quantitative somatosensory tests that evaluate the spectrum of small to large axon nerve fiber function. Our study controlled for factors, including age, erectile function status, diabetes, and hypertension, that have been shown to alter neurologic testing. In our study of neonatally circumcised men, we demonstrated that circumcision status does not significantly alter the quantitative somatosensory testing results at the glans penis.

Adult↗