Autonomic Function in Chronic Alcoholic Patients

OBJECTIVE: To investigate the relationship among the alcohol drinking history, autonomic symptom scores (ASS), and the autonomic functions measured with sympathetic skin response (SSR) and heart rate variability (HRV) of alcoholic patients, and to assess the difference between the values from the autonomic function tests of patients and normal controls. METHOD: SSR and HRV were measured in 44 patients and 26 controls. ASS and Toronto clinical neuropathy scoring system (TCNSS) scores were also assessed. For the HRV, the mean heart rate, standard deviation of the NN intervals (SDNN), total power (TP), very low frequency (VLF), low frequency (LF), and high frequency (HF) in both the supine and standing positions were evaluated. For the SSR, the onset latency and amplitude of both the palm and sole were measured. RESULTS: There were no significant relationships among the alcohol history, the TCNSS, and the results of the autonomic function tests. There were, however, significant relationships among their ASS and some values from autonomic function tests [i.e., the sole amplitudes, the SDNNs (supine), and the TPs (standing)]. There were significant differences between the sole amplitudes of the patients and controls. In HRV, there were significant differences between the patients and controls with respect to their SDNNs and TPs at a standing position. CONCLUSION: Autonomic function tests such as SSR and HRV are related to ASS, but not to alcohol history and TCNSS. Moreover, the values from the autonomic function tests of the alcoholic patients decreased, unlike the normal controls.

Usefulness of Infrared Thermography in Diagnosis of Unilateral Carpal Tunnel Syndrome

OBJECTIVE: To evaluate the usefulness of infrared thermography in the diagnosis of unilateral carpal tunnel syndrome (CTS). METHOD: Thirty six patients confirmed electrodiagnostically as CTS and fifteen adults with normal electrodiagnostic study were included in this study. For the thermographic diagnosis, we measured the skin temperature of the palmar area of all 5 fingers, thenar area, hypothenar area and volar area of forearm bilaterally. We compared the interside peak temperature difference between median nerve innervated area and noninnervated area in three different groups (normal control, mild CTS and moderate to severe CTS groups). RESULTS: Thermography of the CTS patients showed significant temperature differences in more than one area of the median vasomotor nerve territory, and no significant temperature difference in all the areas that were not innervated by the median vasomotor nerve. When we considered interside temperature differences of more than 0.3 degrees C as abnormal findings, the sensitivity of thermography was 2.7% and the specificity was 86.6%. With more than 0.6 degrees C as abnormal, the sensitivity was 25% and the specificity was 66.6%. With more than 1.0 degrees C, the sensitivity was 8.3% and the specificity was 73.3%. There was no significant interside peak temperature difference in all groups. CONCLUSION: This study suggests that infrared thermography has low sensitivity and specificity, which implies that it is not useful for the diagnosis of CTS.