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Oral sensations from iron and copper sulfate.

In previous work, retronasal smell was an important cue for perceiving metallic sensations from ferrous sulfate (FeSO4). The purpose of this study was to examine whether FeSO4 produced oral sensations as well as retronasal cues and whether astringency contributed to the oral sensations. In the first study, discrimination of FeSO4 from water was confirmed at concentrations at or above 5 mM without retronasal flow. A second study examined whether FeSO4 and CuSO4 could be detected on a non-gustatory region by tactile sensations. Astringency was perceived when the copper sulfate solution was applied to non-gustatory surfaces between the gum and the upper lip with or without retronasal cues. However, rated astringency for FeSO4 was less than that for CuSO4, and not significantly different from water. Other gustatory or tactile sensations from iron salts may contribute to their oral sensations and the possibility remains that at least one part of metallic sensation may be a metallic taste.

Adult↗

An unusual case of painful phantom-limb sensations during regional anesthesia.

OBJECTIVE: The objective of this article is to describe a late-onset phantom-limb pain during a continuous analgesic popliteal nerve block after foot surgery and its alleviation and recurrence when stopping and resuming the local anesthetic infusion. CASE REPORT: A 29-year-old woman undergoing a left hallux valgus repair received a continuous popliteal sciatic nerve block for postoperative analgesia. Postoperatively, 6 hours after the commencement of a ropivacaine 0.2% infusion, she reported feelings of tingling, clenching pain, and missing-limb sensation below the ankle. The surgical site remained painless. Sensation elicited by touch and propioception were normally perceived. Only sensations for pinprick and heat were impaired. The ropivacaine infusion was stopped, followed 2.5 hours later by the complete regression of any abnormal sensation. Meanwhile, pain at the surgical site was scored at 50 mm on a 100-mm visual analogic scale. As the infusion of ropivacaine was resumed, the abnormal sensations reappeared. The catheter was removed, and abnormal sensations again disappeared. The patient was discharged from hospital without further complications. CONCLUSIONS: This observation suggests that phantom-limb pain can be of late-onset and might occur during a continuous infusion of low-concentration local anesthetic responsible only for an analgesic block, as shown by the fact that only thermal and pinprick sensations, known to depend on Adelta-fibers and C-fibers, were altered. Therefore, this case contradicts the usual belief that a profound block is necessary to elicit phantom-limb pain.

Adult↗

Globus sensation after laser-assisted uvulopalatoplasty.

PURPOSE: To determine the cause of globus sensation following laser-assisted uvulopalatoplasty (LAUP). MATERIALS AND METHODS: Sixty consecutive LAUP patients were questioned regarding globus sensation. Palate sensation on globus patients was mapped and compared with asymptomatic LAUP control patients. Symptomatic patients were tested again 2 months later. RESULTS: There was a 25% incidence of globus with 8% rated severe and 16% rated mild. The globus sensation corresponds to an insensate area of palate (P < .01). Resolution of the symptoms coincides with reemergence of sensation on the palate. CONCLUSION: Sensory dennervation of the central palate is a likely source of post-LAUP globus sensation. As sensation returns, symptoms abate. Palate surgery should be designed with this in mind. It is possible that undiagnosed globus patients may have areas of anesthetic pharynx.

Humans↗

Oral health sensations associated with illicit drug abuse.

OBJECTIVES: To investigate oral health sensations (short term oral health effects) associated with illicit drug abuse. In addition, to identify variations in oral health sensations produced by different illicit drugs. SUBJECT: Young adults in a drug rehabilitation programme in Hong Kong, China. METHOD: Self-completed questionnaire about their previous pattern of drug abuse and oral health sensations experienced (recalled). RESULTS: All (119) subjects were poly-drug abusers (abused one or more illicit drugs in the past). Amphetamine-based drugs such as methamphetamine ('speed') and methylenedioxymethamphetine ('ecstasy') were commonly abused. A wide range of oral health sensations were reported on recall of their abuse of illicit drugs; most frequently dry mouth (95%, 113). Types of illicit drugs abused were associated with oral health sensations reported (P < 0.001). 'Ecstasy' abusers more frequently reported chewing (P < 0.001), grinding (P < 0.001), and TMJ tenderness (P < 0.001) compared to non-'ecstasy' abusers. CONCLUSION: Illicit drug abuse produces many oral health sensations. Types of drugs abused were associated with oral sensations produced. and behavioural effects that may manifest as depression, anxiety, memory loss and various neuropsychotic disorders.(8),(9) In some cases drug abuse can result in death by various means: malignant hyperthermia, internal bleeding, fatal overdosing and through allergic reactions.(10),(11) Likewise, there have been reports on the long term clinical effects of illicit drug abused on oral health.

Adolescent↗

Physiological determinants of inspiratory effort sensation during CO2 rebreathing in normal subjects.

1. The physiological basis of inspiratory effort sensation remains uncertain. Previous studies have suggested that pleural pressure, rather than inspiratory muscle fatigue, is the principal determinant of inspiratory effort sensation. However, only a limited range of inspiratory flows and breathing patterns have been examined. We suspected that inspiratory effort sensation was related to the inspiratory muscle tension-time index developed whatever the breathing pattern or load, and that this might explain the additional rise in sensation seen with hypercapnia. 2. To investigate this we measured hypercapnic rebreathing responses in seven normal subjects (six males, age range 21-38 years) with and without an inspiratory resistive load of 10 cm H2O. Pleural and transdiaphragmatic pressures, mouth occlusion pressure and breathing pattern were measured. Diaphragmatic and ribcage tension-time indices were calculated from these data. Inspiratory effort sensation was recorded using a Borg scale at 30s intervals during each rebreathing run. 3. Breathing pattern and inspiratory pressure partitioning were unrelated to changes in inspiratory effort sensation during hypercapnia. Tension-time indices reached pre-fatiguing levels during both free breathing and inspiratory resistive loading. 4. Stepwise multiple regression analysis using pooled mechanical, chemical and breathing pattern variables showed that pleural pressure was more closely related to inspiratory effort sensation than was transdiaphragmatic pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Cenesthetic pain sensations illustrated by an artist suffering from migraine with typical aura.

In addition to attacks with the well-known pulsating characteristics of migrainous headache, migraine patients may experience a variety of peculiar pain sensations which are phenomenologically similar to the spontaneous sensations occurring in patients with thalamic disturbances and to the cenesthesias described as basic symptoms in functional psychoses. A 36-year-old artist with a history of migraine with typical aura provided impressive illustrations of cenesthetic pain sensations experienced during his migraine attacks, including sensations of pressure and sensations of pulling. It is suggested that cenesthetic pain sensations represent aura symptoms of migraine indicative of focal cerebral dysfunction, probably in the thalamic region. The occurrence of cenesthetic pain sensations as a migraine symptom supports the notion of an organic etiology of cenesthesias, as postulated in Huber's concept of basic symptoms of functional psychoses.

Adult↗

Referred phantom sensations and cortical reorganization after spinal cord injury in humans.

To test the hypothesis that cortical remapping supports phantom sensations, we examined referred phantom sensations and cortical activation in humans after spinal-cord injury (SCI) at the thoracic level (T3-T12). Of 12 SCI subjects, 9 reported phantom sensations, and 2 reported referred phantom sensations. In both of these subjects, referred phantom sensations were evoked by contact in reference zones (RZ) that were not adjacent in the periphery and were not predicted to be adjacent in the postcentral gyrus (PoCG), suggesting that representations separated by centimeters of cortical space were simultaneously engaged. This finding was supported by functional MRI (fMRI). In a subject with a T6-level complete SCI, contact in RZ on the left or right forearm projected referred phantom sensations to the ipsilateral chest. During fMRI, contact in either forearm RZ evoked activity in the central PoCG (the position of the forearm representation) and the medial PoCG (the position of the chest representation) with >/=1.6 cm of nonresponsive cortex intervening. In contrast, stimulation in non-RZ forearm and palm regions in this subject and in lesion-matched SCI subjects evoked central but not medial PoCG activation. Our findings support a relation between PoCG activation and the percept of referred phantom sensations. These results, however, present an alternative to somatotopic cortical reorganization, namely, cortical plasticity expressed in coactivation of nonadjacent representations. The observed pattern suggests that somatotopic subcortical remapping, projected to the cortex, can support perceptual and cortical reorganization after deafferentation in humans.

Adult↗

Does Deqi (needle sensation) exist?

The mechanism, by which acupuncture works is not yet clear, therefore there is no unequivocal consensus about styles and sensations of needling. To enhance the scientific base of acupuncture, needling somehow should be objectified. The term Deqi is understood to represent all or at least the main form of phenomena to acupuncture stimulation. The characteristics of Deqi, however, have always been based on a translation of original Chinese description. Hoping to find a clue to develop sham (placebo) method for subject blinding, we investigated which sensations are frequently expected and experienced, and whether or not these expectations and experiences of sensations are similar in naive subjects. The acupuncture sensation scale developed by Vincent et al. (1989) was translated into Korean. Thirty-eight healthy acupuncture naïve female volunteers (mean age 29.1, range 25-39) were asked to complete the sensation scale of acupuncture according to what they expected needling to feel like before needling. Needling was done on left Hegu (LI4) point in the hand and consisted of insertion, stimulation for 30 seconds, and removal. Directly after needling, the subjects were asked to complete the same sensation scale according to what they experienced. The subjects expected to feel hurting, penetrating, sharp, tingling, pricking and stinging, and actually experienced aching, spreading, radiating, pricking and stinging more than 60% of the time. Comparison between expectation and experience, the subjects expected more penetrating, tingling, pricking and burning than they experienced, and on the contrary experienced more aching, pulling, heavy, dull, electric and throbbing than they expected. Traditionally described sensations of Deqi are something beyond just a general pain dimension in the Korean population. Further study involving acupuncture experienced subjects or subjects from other cultures need to confirm this finding. Moreover, sham acupuncture should be studied.

Acupuncture↗

Deqi sensation between the acupuncture-experienced and the naïve: a Korean study II.

Previous experience of acupuncture is believed to affect people's expectation of future treatments. Therefore, subjects who have had acupuncture are generally excluded from sham-controlled acupuncture clinical trials. However, this assumption has not been proven, but just accepted because of the lack of evidence to the contrary. To investigate the difference in frequency and intensity of acupuncture sensation between subjects who have had acupuncture and those who have not, 36 acupuncture-experienced subjects were invited to take part in the study. After informed consent was obtained, participants were asked to complete the acupuncture sensation scale (ASS) according to what they expected needling to feel like. The needling was done at the left Hegu (LI 4) point and consisted of insertion, stimulation for 30 seconds and removal. After needling, the subjects were asked to complete the same ASS according to what they actually experienced. Adverse events were monitored. The frequency of each sensation expected and experienced, as well as acupuncture sensation scores were compared. More than 60% of the subjects expected to feel sensations of penetrating (87.6% to 100%), aching (71.2% to 95.5%), tingling (87.6% to 100%), pricking (79.7% to 99.2%) and throbbing (64.2% to 91.4%). In fact, the subjects experienced sharp (60.9% to 89.1%), intense (60.9% to 89.1%), radiating (71.2% to 95.5%) and heavy (74.8% to 97.4%) sensations just as much. The subjects expected more hurting (p = 0.001), tingling (p < 0.001), pricking (p = 0.010), stinging (p = 0.012), burning (p = 0.001) and pulsing (p = 0.009) than they experienced, while more heaviness (p = 0.011) was experienced than expected. The same outcome measures were also compared between experienced and naive groups. Apart from the fact that the acupuncture-experienced participants expected to feel pricking (p = 0.030) and stinging (p = 0.002), and experienced hurting (p = 0.022) and stinging (p = 0.028) significantly less than those who had not had acupuncture before, there was no significant difference between first time and experienced subjects. The results indicate that previous experience does not affect the people's expectation and does not hinder people from experiencing Deqi. In addition, a constellation of Deqi-related acupuncture-specific sensations is more than just a general pain intensity dimension, which requires a biochemical and physiological exploration.

Acupuncture Therapy↗

Estimation of thermal sensation during varied air temperature conditions.

Seven male students were exposed to four varied air temperature environments: hot (37 degrees C) to neutral (27 degrees C) (HN), neutral to hot (NH), cool (17 degrees C) to neutral (CN), and neutral to cool (NC). The air temperature was maintained at the first condition for 20 min, then was changed to the second condition after 15 min and was held there for 20 min. Each subject wore a T-shirt, briefs, trunks, and socks. Each sat on a chair and was continuously evaluated for thermal sensation, thermal comfort, and air velocity sensation. Some physiological and thermal parameters were also measured every 5 s during the experiment. The correlation between thermal sensation and skin temperature at 15 sites was found to be poor. The subjects felt much warmer during the rising phase of the air temperature (CN, NH) than during the descending phase (HN, NC) at a given mean skin temperature. However, thermal sensation at the same heat flux or at the same value of the difference between skin and air temperature (delta(Tsk - Ta)) was not so different among the four experimental conditions, and the correlation between thermal sensation and heat flux or delta(Tsk - Ta) was fairly good. The multiple regression equation of the thermal sensation (TS) on 15 sites of skin temperature (Tsk; degrees C) was calculated and the coefficient of determination (R*2) was found to be 0.656. Higher coefficients of determination were found in the equations of thermal sensation for the heat flux (H; kcal.m-2.h-1) at the right and left thighs of the subjects and on delta(Tsk - Ta) (degrees C) at 4 sites. They were as follows: TS = 2.04 - 0.016 Hright - 0.036 Hleft; R*2 = 0.717, TS = 1.649 + 0.013 delta(Tsk - Ta)UpperArm - 0.036 delta(Tsk - Ta)Chest - 0.223 delta(Tsk - Ta)Thigh-0.083 delta(Tsk - Ta)LowerLeg; R*2 = 0.752, respectively.

Adult↗

Relating sensation seeking and the von Restorff Isolation Effect.

Sensation seeking was examined in a short-term memory task involving the serial recall of a 10-item list of consonants with (isolated) and without (non-isolated) a distinctively larger item in the fifth position. 126 students were given the Sensation Seeking Scale Form-V and 32 10-item lists to memorize in a 1 by 3 mixed design. Sensation seeking was a between-subject factor and Blocks (Trials 1-16 and 17-32), Isolation (isolated and nonisolated), and Duration (2 sec. and 10 sec.) were within-subject factors. Generally nonisolated lists and the larger letters (the von Restorff Isolation Effect) were better recalled, with the latter being stronger at the shorter duration. Only the high sensation-seeking group showed a Blocks effect for lists with an isolated item such that there was a greater number of items correct per list in Block 1 than in Block 2. This finding is consistent with the argument that higher scores on sensation seeking are associated with greater cortical arousal and better memory for newness and change. Students with high sensation-seeking scores showed superior memory for the isolated list when it contained an isolate if allowed more processing time. It is argued that high sensation-seeking scores were associated with more effective transfer of items from shorter to longer-term memory. A rapid nontime-dependent perceptual process was used to explain the isolation effect. The poorer overall list performance for the lists with the isolate was explained in terms of the intense nature of the isolate.

Adult↗

Measurement of palatal surface sensation by neuro-sensory tests in the postoperative cleft palate patients.

To clarify the effects of abnormal sensation on the palatal surface on speech sounds in postoperative cleft palate patients, we measured palatal surface sensation in these patients. Tactile and vibratory sensation were measured quantitatively using a SW sensemeter and a vibrometer. The obtained values were compared with those in controls. The following results were obtained. In both the postoperative cleft palate patients and controls, the sensation in the anterior region of the hard palate was more numb than that in the anterior region of the soft palate or the premolar alveolar region. The tactile sensation in the postoperative cleft palate patients was more numb than that in the controls. In particular, a marked difference was observed in the premolar alveolar mucosa. The vibratory sensation in the postoperative cleft palate patients, however, did not clearly differ from that in the controls. There was a positive correlation between the tactile sensory threshold and the vibratory sensory threshold in the controls. No association between the two thresholds was observed in the postoperative cleft palate patients. The authors concluded that the tactile sensation at premolar alveolar region in the postoperative cleft palate patients was more numb than in the controls. This abnormality may affect speech development.

Adolescent↗

High-risk sexual behaviour & sensation seeking among heavy alcohol users.

BACKGROUND & OBJECTIVES: An association has been shown between alcohol use and high-risk sexual behaviour. One of the important variables that might mediate risky sexual behaviour among alcohol users is the sensation-seeking dimension of personality. This study was undertaken with the aim to assess the relationship between sensation seeking and sexual risk taking among heavy alcohol users admitted to a De-addiction centre. METHODS: To study the above association, sensation seeking was compared between subjects admitted for treatment of alcohol dependence with (n = 30) and without (n = 30) reported high-risk sexual behaviour. RESULTS: Subjects reporting high-risk sexual behaviour were found to have higher sensation seeking scores in all the domains of the sensation seeking scale compared to those without high-risk sexual behaviour. Scores on the subscale disinhibition, of the sensation seeking scale seemed to be associated with higher sexual risk taking. INTERPRETATION & CONCLUSION: Sensation seeking as a personality variable was significantly associated with sexual risk taking behaviour among heavy alcohol users. The study indicates the need for careful assessment of personality in these individuals and emphasizes the need for further studies on a larger sample.

Adult↗

[Dyspnea sensation during resistive loading].

To examine the relationship among the sensation of dyspnea, the respiratory muscle oxygen consumption (VO2 resp), minute ventilation and occlusion pressure, seven normal volunteers were studied during incremental dead space loading induced hyperventilation with and without inspiratory resistive load. Although the sensation of dyspnea and VO2 resp at the same level of minute ventilation increased with an increase in resistance, there appeared to be a unique relationship among the sensation of dyspnea, VO2 resp and occlusion pressure, which was not affected by inspiratory resistive loading from 0 to 20 cmH2O/l/sec. These results show that the ventilatory command signal is closely related to the dyspnea sensation. We also found that during incremental dead space loading the quality of the sensation changed relatively quickly at some point, where tidal volume was maximum with each resistive loading and the breathing pattern changed. In the other experiment, the functional residual capacity (FRC) decreased during inspiratory resistive and elastic loading. Because the decreased FRC was associated with the decrease in the dyspnea sensation, it was speculated that the subject decreased his FRC through a cortical response so that the sensation of dyspnea during loading decreased.

Airway Resistance↗

Are hot-burning sensations produced by the axonal damage of afferent unmyelinated fibres?

AIM: Pain resulting from nerve lesions is classically referred to as a ''burning pain''. Both the axonal damage and sensitization of unmyelinated C-fibres have been considered as the possible generators of this sensation. The aim of this study was to verify the hypothesis that hot-burning sensations are produced by the axonal damage of afferent unmyelinated fibres in peripheral nerves. METHODS: A total of 122 patients with pain localised in the distal parts of the upper limbs (hand, forearm) and lower limbs (leg or foot) were enrolled in the study. The intensity of pain and hot-burning sensations was measured using a numerical scale (range 0-10). The relationship between the presence of warm hypoesthesia (related to the loss of afferent unmyelinated fibres) and hot-burning sensations was assessed. Warm hypoesthesia was identified by Quantitative Sensory Testing employing thermal stimulation (QST-t) and the patients were divided into 2 groups: group A, with hypoesthesia and group B with normoesthesia. Patients with a central nervous impairment were excluded. RESULTS: No significant differences in the intensity of pain and hot-burning sensations was observed between the group of patients with warm hypoesthesia and that with warm normoesthesia. CONCLUSIONS: This study does not confirm the hypothesis that hot-burning sensations are produced by the axonal damage of afferent amyelinated fibres in peripheral nerves. It agrees with clinical evidence suggesting that patients with different clinical conditions can complain of hot-burning sensations, independently of the presence of a nerve lesion.

Adolescent↗

Quantitative assessment of facial sensation in leprosy.

The trigeminal and great auricular nerves which supply sensation to the face are affected in leprosy. No objective sensory testing methods have been devised for testing sensation in the face. Testing for corneal sensation to ascertain trigeminal nerve or visualization and palpation of the great auricular nerve alone may not be enough to establish the involvement of these nerves. In a sample of leprosy patients, face sensation threshold measurements were done using a set of three Semmes-Weinstein (SW) monofilaments that gave a force of 0.05-0.07, 0.2 and 2 g. Sensation was tested by three examiners and intra- and inter-observer testing was used as a means to validate the findings. Within the limitations of this study, the results indicate that use of SW monofilaments is a fairly reliable and repeatable method for sensory testing in the face. During follow up, a single filament with a force of 0.5-0.7 g (2.83 marking number in SW filament or any other filament with a corresponding gram force) could be used to assess sensation. A simple procedure of quantifying sensation in these nerves is suggested. A method to incorporate trigeminal or great auricular nerve sensory testing into the existing sensory assessment charts is also discussed.

Face↗

Effect of hinge width on corneal sensation and dry eye after laser in situ keratomileusis.

PURPOSE: To investigate the effect of hinge width on corneal sensation and dry-eye syndrome after laser in situ keratomileusis (LASIK). SETTING: TLC Laser Eye Center, Garden City, New York, USA. METHODS: Fifty-four patients at least 18 years of age had bilateral LASIK with a narrow nasal hinge microkeratome flap in 1 eye and a wider nasal hinge microkeratome flap in the other eye. In all eyes, the flaps were 160 microm in thickness with a diameter of 9.5 mm. Masked Cochet-Bonnet esthesiometry was performed in the central cornea preoperatively and at 1 week and 1, 3, and 6 months. Dry eye was evaluated at the same intervals by lissamine green corneal and conjunctival staining, Schirmer test with anesthesia, and tear-film breakup time. RESULTS: Corneal sensation was significantly reduced from preoperative levels through 6 months in the narrow-hinge group and through 3 months in the wider-hinge group (P< or =.002). The mean corneal sensation was greater in corneas with a wider hinge flap than in those with a narrow hinge flap at all postoperative examinations; the difference was significant at 1 and 3 months (P< or =.002). The loss of sensation was greatest at 1 week and improved at all subsequent examinations. Overall, dry-eye signs and symptoms were greatest immediately postoperatively and improved at subsequent intervals. CONCLUSIONS: Corneal sensation and dry-eye signs and symptoms improved at all intervals between 1 week and 6 months. The loss of corneal sensation and presence of dry-eye syndrome were greater in eyes with a narrow hinge flap than in eyes with a wider hinge flap.

Adult↗

Loss of urinary voiding sensation due to herpes zoster.

A case of sacral herpes zoster infection in a 56-year-old man with the complication of loss of urinary voiding sensation is presented. He had typical herpes zoster eruption on the left S2 dermatome, hypalgesia of the S1-S4 dermatomes, and absence of urinary voiding sensation. There was no other urinary symptom at the first medical examination. Urinary complications associated with herpes zoster are uncommon, but two types, acute cystitis and acute retention, have been recognized. No cases of loss of urinary voiding sensation due to herpes zoster have been reported. In this case, hypalgesia of the sacral dermatomes was mild compared to the marked loss of urethral sensation. This inconsistency is explained by the hypothesis that the number of urethral fibers is very small as compared to that of cutaneous fibers, therefore, urethral sensation would be more severely disturbed than cutaneous sensation.

Defecation↗