PURPOSE: It is thought that neurological disorders are one of the main causes of organic female sexual dysfunction. However, it is difficult to diagnose due to the lack of measuring tools for assessing genital neural function. Sensory nerve tests on external genitalia is a new challenge for diagnosing female sexual dysfunction. In this study, we aimed to evaluate the clinical significance of the quantitative measurement of the genital sensory threshold in female sexual dysfunction. MATERIALS AND METHODS: Forty women with complaints of sexual dysfunction were evaluated with physical and vagina examination, serum hormonal tests, routine urinalysis and a questionnaire (the brief index of sexual function for women). A genitosensory analyzer (GAS, Medoc, Israel) was used to quantitative measure the vaginal and clitoral warm, cold and vibratory sensory thresholds. RESULTS: Of the 40 women, an arousal disorder was reported in 40%, orgasmic disorder in 82.5%, sexual pain disorder in 17.5% and a decreased libido in 17.5%. Of the 40 women, 86.4 and 91.2% showed impairment of vaginal cold (A-delta fiber) and warm (unmyelinated C fiber) sensations, respectively. However, the touch and vibratory sensations (A-beta fiber) showed relatively lower impairments; vagina and clitoris in 20.0 and 89.2% of the patients, respectively. CONCLUSIONS: In this study, most of the patients with sexual problems had significant vaginal and clitoral sensory nerve fiber impairments. The results support the significance of organic origins in female sexual dysfunction and the usefulness of quantitative analysis of genital sensation in diagnosing the etiology. (Korean J Urol 2005;46:610-615)
Arousal ; Clitoris ; Diagnosis* ; Female* ; Genitalia* ; Humans ; Libido ; Nerve Fibers ; Nervous System Diseases ; Surveys and Questionnaires ; Sensation ; Sensation Disorders ; Sensory Thresholds ; Sexual Dysfunctions, Psychological ; Sexuality ; Somatoform Disorders ; Urinalysis ; Vagina

The present study was done to validate the two-site Semmes-Weinstein (SW) monofilament test in identifying patients at risk of lower-extremity complications in clinical setting. The SW monofilament test and nerve conduction study were conducted on type 2 diabetic patients (n=37) at Pusan National University Hospital in Korea. As the duration of diabetes mellitus was longer, neuropathy identified by nerve conduction study and complications of diabetes were more severe (p<0.01). The number of sites unable to perceive SW monofilament (p<0.001) was larger in patients with lower-extremity neuropathy symptoms than those without symptoms. Sensitivity and specificity at two sites (the third and fifth metatarsal head sites) were 93% and 100%, respectively. In conclusion, the two-site SW monofilament test was a sensitive, specific, simple, and inexpensive screening tool for identifying diabetic peripheral neuropathy in clinical setting.
Aged ; Comparative Study ; Diabetes Mellitus, Type II/complications* ; Diabetic Neuropathies/diagnosis* ; Female ; Human ; Male ; Middle Aged ; Neural Conduction ; Neurologic Examination/instrumentation* ; Neurologic Examination/methods ; Pressure ; Sensation Disorders/diagnosis* ; Sensation Disorders/etiology ; Sensitivity and Specificity ; Touch

Lingual osseous lesion can be classified as one of three types: osteoma, chondroma and osteochondroma. Osteoma is a benign neoplasms consisting of mature normal osseous tissue. Osseous growths within the oral cavity, but it is especially rare to find it in the tongue. The majority of the lesions occur in the posterior third of the tongue at or in close proximity to the foramen cecum and the circumvallate papillae. Clinically, tongue osteomas are benign, slow- growing tumors made up of densely sclerotic, well-formed bone. Symptoms include foreign body sensation, dysphagia, nausea, and choking. However, most patients tend to be asymptomatic, and histologic studies can confirm the diagnosis. Treatment of the oral osteoma is by surgical excision, preferably by a transoral approach. This should give complete resolution and there were rare recurrences with good prognosis. Recently, we experienced a 25 year old woman with asymptomatic hard mass on the base of the tongue. A surgical resection was performed and pathologic analysis confirmed tongue osteoma for the patient. Now we report this case with a review of literature.
Adult ; Airway Obstruction ; Cecum ; Chondroma ; Deglutition Disorders ; Diagnosis ; Female ; Foreign Bodies ; Humans ; Mouth ; Nausea ; Osteochondroma ; Osteoma* ; Prognosis ; Recurrence ; Sensation ; Tongue*

Historically, Eagle syndrome is a term that has been used to describe radiating pain in the orofacial region, foreign body sensation, and/or dysphagia due to a unilateral or bilateral elongated styloid process impinging upon the tonsillar region. Because elongated styloid processes–with or without associated Eagle syndrome–can present with various symptoms and radiographic findings, it can be challenging for healthcare practitioners to formulate an accurate diagnosis. Abnormal styloid anatomy can lead to a multitude of symptoms, including chronic orofacial/neck pain, thus masquerading as more commonly diagnosed conditions. In this report, we describe a patient who presented to our department with styloid process elongation and fracture. A careful history, physical examination, and a conebeam computed tomography (CBCT) investigation led to the diagnosis. The patient was then referred for appropriate care. This case report demonstrates the utilization of CBCT in differentiating a fracture site from a pseudo-joint that might mimic a fracture.
Cone-Beam Computed Tomography ; Deglutition Disorders ; Delivery of Health Care ; Diagnosis ; Eagles ; Foreign Bodies ; Humans ; Neck Pain ; Neck ; Physical Examination ; Sensation

Restless legs syndrome (RLS) is a neurological disorder characterized by an irresistible urge to move one's body to stop uncomfortable or odd sensations. It most commonly affects the legs. Moving the affected body part, such as walking or stretching provide relief the urge to move the legs and any accompanying unpleasant sensation partially or totally. RLS is relatively common, affecting 5 to 15 % of the general population, with prevalence rates increasing alongside age. Restless legs syndrome can lead to sleep-onset or sleep-maintenance insomnia, and occasionally excessive daytime sleepiness, all leading to significant morbidity. Dopaminergic systems are known to be strongly related with RLS that are closely linked to CNS iron homeostasis. Besides defective dopaminergic system that is closely related with iron metabolism, genetic factors play a role in early-onset individual with a positive family history. The diagnosis can be made based on the symptom characteristics, differential diagnosis is important because many conditions could mimic RLS symptoms. Dopamine agonists (DAs) have been considered the first-line therapy, but with the growing appreciation of problems associated with long-term treatment, particularly augmentation and impulse control disorder, alpha-2-delta drugs, such as gabapentin, are now considered the first line of treatment in patients with troublesome RLS. In more severe cases, a combination therapy may be required.
Diagnosis* ; Diagnosis, Differential ; Dopamine Agonists ; Homeostasis ; Humans ; Iron ; Leg ; Metabolism ; Nervous System Diseases ; Prevalence ; Restless Legs Syndrome* ; Sensation ; Sleep Initiation and Maintenance Disorders ; Walking

The aim of this study is to elucidate the clinical spectrum and frequency of non-motor symptoms during off periods (NMOS) in Parkinson's disease (PD) patients with motor fluctuation. We compared clinical characteristics between PD patients with motor symptoms only (M-off) and those with both motor and non-motor symptoms (NM-off) during off periods. The association of NMOS with parkinsonian clinical characteristics was also investigated. Sixty-seven consecutive PD patients of both M-off and NM-off groups were included in this study. We reviewed medical records, interviewed the patients, and administered a structured questionnaire. NMOS is classified into three categories: autonomic, neuropsychiatric and sensory. The frequency of NMOS and their individual manifestations were assessed. Of 67 patients with off symptoms, 20 were M-off group and 47 NM-off group. Among NMOS, diffuse pain was the most common manifestation, followed by anxiety and sweating. There were no significant differences between M-off and NM-off groups with regard to age, duration of disease and treatment, interval between onset of parkinsonian symptoms and off symptoms and off periods. Patients taking higher dosage of levodopa had fewer NMOS. NMOS is frequent in PD. Comprehensive recognition of NMOS can avoid unnecessary tests and is important for optimal treatment in PD.
Aged ; Female ; Humans ; Interviews as Topic ; Levodopa/therapeutic use ; Male ; Middle Aged ; Parkinson Disease/*diagnosis/etiology ; Prospective Studies ; Questionnaires ; Sensation Disorders/diagnosis ; Severity of Illness Index

Hearing loss is one of the most common sensory disorders and has numerous environmental and genetic factors that influence its onset and development. Hearing loss can be classified by either the affected anatomic or functional lesion of hearing loss, or as conductive or sensorineural hearing loss (SNHL). Genetic factors account for about 50% of congenital SNHL, and are therefore the most common cause. Molecular genetics research has identified more than 100 genes related to hearing and hearing loss, and shown that the risk of hearing loss caused by non-genetic factor is modified by genetic susceptibility. About 30% of genetic hearing loss is syndromic related and has affected phenotypic markers in other organs that make it easier to correctly diagnose the etiology of the hearing loss. In some cases, hearing loss can precede the pathologies of other organs and in these cases, hearing loss acts as a predictor of the syndrome associated pathologies of other organs. Inheritance of nonsyndromic hearing loss follows common inheritance patterns such as autosomal dominant, autosomal recessive, sex chromosome related, and mitochondrial inheritances. The paucity of predominant phenotypes and ethnic specificity of the prevalence and types of mutations may hinder the genetic diagnosis in nonsyndromic hearing loss. However, progress in elucidating the causal mutations is going forward using stratified genetic diagnostic strategies of candidate genes identified by hearing phenotypes and patterns of inheritance.
Diagnosis ; Fibrinogen ; Genetic Predisposition to Disease ; Genetics ; Hearing ; Hearing Loss* ; Hearing Loss, Sensorineural ; Inheritance Patterns ; Molecular Biology ; Pathology ; Phenotype ; Prevalence ; Risk Factors ; Sensation Disorders ; Sensitivity and Specificity ; Sex Chromosomes ; Wills

Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis(DISH). Large osteophytes can produce otolaryngological symptoms such as dysphagia, dysphonia, and foreign body sensation. We describe a DISH patient with giant anterior cervical osteophyte causing chronic dysphagia and dysphonia. A 56-year-old man presented with increasing dysphagia, dysphonia, neck pain and neck stiffness. Physical examination of the neck showed a non-tender and hard mass on the left side at the level of C4-5. Radiography showed extensive ossification of anterior longitudinal ligament along the left anterolateral aspect of vertebral bodies from C2 to T1. The ossification was espe cially prominent at the level of C4-5 and linear breakage was noted at same level. Esophagogram revealed a filling defect along the pharynx and lateral displacement of the esophagus. Giant anterior cervical osteophyte was removed through the leftsided anterolateral cervical approach to the spine. Anterior cervical interbody fusion at C4-5 was followed by posterior cervical fixation using lateral mass screws from C3 to C6. After surgery, dysphagia and dysphonia improved immediately. One year later, cervical CT showed bone fusion at C4-5 bodies and no recurrence of osteophyte. DISH is a common cause of anterior cervical osteophyte leading to progressive dysphagia. Keeping this clinical entity in the differential diagnosis is important in patients with progressive neck stiffness, dysphagia or dysphonia. And surgical treatment of symptomatic anterior cervical osteophyte due to DISH should be considered with a solid fusion procedure preventing postoperative instability or osteophyte progress.
Deglutition Disorders* ; Diagnosis, Differential ; Dysphonia ; Esophagus ; Foreign Bodies ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal ; Longitudinal Ligaments ; Middle Aged ; Neck ; Neck Pain ; Osteophyte* ; Pharynx ; Physical Examination ; Recurrence ; Sensation ; Spine

Peripheral neuropathies occur in lymphoma patients. Causes of neuropathy include chemotherapy, opportunistic infections, and the lymphoma itself. We report a patient with lymphoma whose chief complaint was a sensory loss in the hands and feet. Electrophysiologic studies and sural nerve biopsy showed sensory polyneuropathies. We hypothesize that this neuropathy is associated with lymphoma-related ganglionopathy, and among the possible causes, we suspect that a systemic cause such as a paraneoplastic syndrome is the most likely pathogenic etiology. However, further follow-up will be necessary to see whether sensory symptoms change with lymphoma treatment.
Adult ; Biopsy ; Electrophysiology ; Hodgkin Disease/*complications/*diagnosis ; Human ; Lymphatic Metastasis ; Lymphoma/*metabolism ; Male ; Peripheral Nervous System Diseases/*complications/*pathology ; Sensation Disorders/complications/pathology

Eagle's syndrome is a disease caused by an elongated styloid process or calcified stylohyoid ligament. Eagle defined the disorder in 1937 by describing clinical findings related to an elongated styloid process, which is one of the numerous causes of pain in the craniofacial and cervical region. The prevalence of individuals with this anatomic abnormality in the adult population is estimated to be 4% with 0.16% of these individuals reported to be symptomatic. Eagle's syndrome is usually characterized by neck, throat, or ear pain; pharyngeal foreign body sensation; dysphagia; pain upon head movement; and headache. The diagnosis of Eagle's syndrome must be made in association with data from the clinical history, physical examination, and imaging studies. Patients with increased symptom severity require surgical excision of the styloid process, which can be performed through an intraoral or an extraoral approach. Here, we report a rare case of stylohyoid ligament bilaterally elongated to more than 60 mm in a 51-year-old female. We did a surgery by extraoral approach and patient's symptom was improved.
Adult ; Deglutition Disorders ; Diagnosis ; Eagles ; Ear ; Female ; Foreign Bodies ; Head Movements ; Headache ; Humans ; Ligaments ; Middle Aged ; Neck ; Pharynx ; Physical Examination ; Prevalence ; Sensation