Effect of Acupoint Injection at Quyuan (SI13) on the Vibrating Perception Threshold and Its Efficacy in Treating Cervical Spondylosis of Nerve Root Type / 上海针灸杂志

Objective To compare the vibrating perception threshold (VPT) between normal subjects and subjects with cervical spondylosis of nerve root type, and to observe the clinical efficacy of acupoint injection at Quyuan (SI13) in releasing pain in cervical spondylosis of nerve root type.Method Sixty-three patients with cervical spondylosis of nerve root type were recruited and randomized into a treatment group of 35 cases and a control group of 28 cases. The treatment group received acupoint injection at Quyuan, and the control group received acupoint injection at Jiaji (EX-B2) points. The short-form McGill Pain Questionnaire (MPQ) was adopted. From the questionnaire, the Pain Rating Index (PRI), sensory (S), affective (A), and total (T) pain rating indexes, Visual Analogue Scale (VAS), and Present Pain Index (PPI) were used to comprehensively evaluate the pain improvement and to quantify the therapeutic efficacy, and the VPT was also considered. The Clinical Assessment Scale for Cervical Spondylosis (CASCS) by West China Rehabilitation Center was also used to analyze the result in the treatment group.Result After the intervention, the MPQ and VAS scores in the treatment group were significantly lower than those in the control group (P<0.05). The total effective rate of the treatment group was significantly higher than that of the control group (P<0.05). Meanwhile, the VPT was improved after the treatment.Conclusion Acupoint injection at Quyuan can produce a more significant efficacy than at Jiaji (EX-B2) in treating cervical spondylosis of nerve root type.

Comparison of diagnostic method of evaluating vibration induced sensorineural impairment among shipyard’s grinders

The objectives of this study are to investigate diagnostic value of two different tests amongst tests highly recommended and used for diagnosis of HAVS of the sensorineural component; Semmes Weinstein Monofilament (SWM) and Purdue Pegboard (PP) tests using vibrotactile perception threshold (VPT) test as standard objective quantitative test. For the method, a total of 176 grinders as vibration exposed respondent of a shipyard’s fabrication participated in this study. Questionnaire and vibration exposures data were collected for all respondents where 67 respondents further performed the three quantitative sensorineural testing. The result showed that mean acceleration magnitude of grinding tools used were 4.9 ms-2, exceeding recommendation by European Commission. Both cut-off point methods of mean plus two times standard deviation (mean + 2sd) and z-score (at 75th percentile) show significant difference among healthy and HAVS (p < 0.001). Correlation between SWM with VPT and PP with VPT was weak. However, results suggests progressive pathological damage to sensorineural component of the digits starts with fast-adapting II (FA II) mechanoreceptors indicated with significant correlation primarily at 125 Hz. Analyses of sensitivity and specificity found that monofilament at 0.16g force best discriminate HAVS from healthy. In the other hand, Purdue Pegboard test shows best diagnostic value of indicating HAVS at minimum insert of 16 pin and 14 pin respectively for dominant and non-dominant hand. Both Semmes Weinstein Monofilament and Purdue Pegboard tests has limited diagnostic value to be used as screening tools for early detection of HAVS.

Validation of bedside methods in evaluation of diabetic peripheral neuropathy.

Background & objectives: Vibration perception threshold (VPT) is considered as a gold standard for diagnosis of diabetic peripheral neuropathy. However, the data are sparse comparing the VPT with commonly used bedside modalities. This study was carried out to evaluate the usefulness of simple bed side screening modalities for peripheral neuropathy in patients with diabetes mellitus. Methods: A total of 1044 patients with diabetes mellitus attending the Diabetes clinic from January 2007 to May 2008, were included in this study. All subjects had a detailed clinical assessment including Diabetic Neuropathy Symptom (DNS) score, Diabetic Neuropathy Examination (DNE) score, ankle reflex, vibration sensation with a 128 Hz tuning fork, 10g Semmes-Weinstein monofilament and vibration perception threshold (VPT). Results: The prevalence of peripheral neuropathy was 34.9 per cent with VPT. Foot care practices were followed by only 214 (20.5%) of the study population. When compared with VPT, ankle reflex was the most sensitive (90.7%) but least specific (37.3%). The tuning fork and monofilament tests respectively had lower sensitivity (62.5 and 62.8%) but better specificity (95.3 and 92.9%) and accuracy (78.9 and 77.9%). Significant correlations were observed between the VPT score and the DNE (r = 0.532, P<0.001) and DNS (r = 0.546, P<0.001) scores and absent tuning fork sensation (r= 0.590; P<0.001), monofilament sensation (r= 0.573; P<0.001) and ankle reflex (r = 0.377, P= 0.01). Interpretation & conclusions: The present findings show that simple bed side tests are useful for assessing peripheral diabetic neuropathy, even in those subjects in whom foot care practices are not followed.

Ansiedade, medo e sinais vitais dos pacientes infantis / Anxiety, fear and vital signs of the child signs of the child patients

Este estudo o objetivo de determinar os sinais vitais dos pacientes infantis, especificamente, presão arterial e frequencia cardíaca antes, durante e após os procedimentos odontológicos, relacionando-os com ansiedade e medo, avaliados através do Venham Picture Test (teste VPT), realizado antes e após o atendimento. A amostra constou de 44 pacientes inscritos nas Clínicas de Odontopediatria da Universidade Federal de Pernambuco, no período de fevereiro a julho de 2008. O teste VPT foi associado com gênero, idade, história médica e odontológica das crianças. A anáise dos dados foi realizada pelo Test de Friedman e a associação do test VPT com as demais variáveis foi estudada, estimulando-se odds-ratio e intervalos de confiança de 95%. Os resultados não revelaram associações estatisticamente significantes entre sinais vitais e reações emocionais. Porém o teste VPT mostrou-se um instrumento de avaliação de ansiedade infantil eficiente, especialmente em idade pré-escolar, das quais a maioria apresentou ansiedade. Quando associado à história odontológica, mostrou que criança com experiência negativa em consultas odontológicas são mais ansiosas, mas não apresentou relação com história médica e gênero. A adoção do teste VPT pelos odontopediatras parece ser uma sugestão plausível para avaliar a ansiedade e o medo nos pacientes, especialmente em idade pré-escolar.

This study has the objective to determinate the vital signs of the childlike patients, specifically, blood pressure and cardiac frequency, before, during and after the dental proceeding, and connected them with the anxiety and the fear valued through the Venham Picture Test (VPT) carried out before and after the proceedings. The sample was composed by 44 patients registered in the Clinics of Odontopediatric of the Federal University of Pernambuco, in the period of February to July 2008. The VPT test was also connected with genre, age, medical and odontologic history of the children. Data analysis was performed by Friedman test and the test VPT association with the other variables were studied with an estimated odds-ratio and confidence intervals of 95%. The result did not reveal statistically significant associations between the vital signs and the emotional reactions. However, the test VPT was shown a very efficient instrument of evaluation of anxiety in children, especially in pré-school age, which majority presented anxiety. When associated with odontologic history, it showed that the children with negative experience in odontologic consultations are more anxious, however doesn 't shown relations with the medical history and with the genre. The adoption of the VPT test for the odontopediatrics it seems to be a credible suggestion to value the anxiety and the fear on his patients, especially in pre-school age.

Temporary Threshold Shift of Vibration Sensation by Dental Handpiece / 예방의학회지

This study was performed to investigate the possibility of temporary threshold shift (TTS) of vibration sense could induced by exposure to high-frequency vibration or by work position taking by dentists in drilling or polishing. The vibratory perception thresholds (VPT) of 28 healthy men were measured on the index fingertip pulp of dominant hand at 250Hz. The vibrating tool used in test was a low-speed handpiece of 34,000 rpm. For the TTS test, the dominant hand was exposed to high-frequency vibration and to work position for five minutes, respectively. The VPTs before and after vibratory exposure were 23.5+/-3.5 dB, 30.8+/-4.2 dB, respectively and VPT after work position was 23.7+/-4.6 dB. The difference between before and after vibartory exposure was statistically significant (P<0.001). The correlation of height, weight and BMl with baseline VPTs was not statistically significant. Also, there was no difference of VPTs by smoking. These results suggest that high-frequency vibration from dental handpieces might cause the impairment of vibration sensation.

Selection of Testing Frequency in Bone Vibrator of Audiometer for Measurement of Vivration Perception Threshold / 대한산업의학회지

Both to determine testing frequency in bone vibrator of audiometer for measurement of vibration perception threshold(VPT) and to evaluate factors influencing VPT, ninty seven healthy adults were tested on their second metacarpal head of both hands, at 250Hz, 500Hz, 1,000Hz and so on. Measures of the VPTs at 1,000Hz were excluded in analysis because frequency 1,000Hz was not recognized as a vibration sense. Mean and standard deviation(S.D.) of the VPTs in the both hands measured at 250Hz were 19.9+/-6.7dB, 21.0+/-7.3dB, respectively and at 500Hz were 33.6+/-8.3dB, 34.9+/-8.1dB, respectively. Both mean and S.D. tended to be lower at 250Hz than 500Hz, and mean differences of VPTs between the left and the right hand at the both frequencies appeared statistically significant (p<0.01). VPTs were significantly correlated with each other (p<0.01). Age was positively correlated(p<0.001) with VPTs and education was negatively(p<0.01). Multiple regression analysis showed that age was the only factor influenced on VPT. These results suggest that, when using the bone vibrator of audiometer for measurement of VPT, the frequency 250Hz as a testing frequency may be more useful than frequency 500Hz, and VPT should be measured on both hands.