In the diagnosis of carpal tunnel syndrome, various techniques have been employed. But there still remains a group of patient, particularly those with minor, intermittent symptoms, who escape confirmation. the sensory innervation to the ring finger is generally shared by the digital branches of median and ulnar nerves. In 150 hand studies on 75 normal adults, all had a recordable response in ring finger uponstimulation of the median and ulnar nerves at wrist, 14cm proximal to the recording electrode. Also we applied this method to the 15 patients of carpal tunnel syndrome.

The results were as follows.

1) The mean sensory latencies of median and ulnar nerves in dominant had were 3.03±0.59 msec, 3.01±0.56 msec respectively, while the mean amplitudes were 56.11±14.05 ㎶ and 50.75±11.23 ㎶ respectively.

2) The mean latencies of median and ulnar nerves in non-dominant hand were 3.15±0.02 msec, 3.06±0.81 msec respectively, while the mean amplitudes were 55.46±6.41 ㎶ and 51.21±16.32 ㎶ respectively.

3) There was no significant difference in latencies of median and ulnar nerves between the dominant and non-dominant hands.

4) There was no significant difference in the latencies of median and ulnar nerves between young and old, both in dominant and non-dominant hands.

5) The difference in latencies of median and ulnar nerves was 0.3 msec or less(95%) in normal subjects and 1.21±0.48 msec in carpal tunnel syndrome.

6) Recording sensory conduction in ring finger seems valuable in the diagnosing of carpal tunnel syndrome, especially of minor and early phase.

Clinical evaluation of the bulbocavernosus reflex is very important in patients with voiding difficulty and sexual dysfunction because the physiologic micturition center is located in the S₂-S₄, spinal cord level which is also associated with the mechanism of sexual reflex, especially of erection.

However, accurate assessment was difficult because: (1) with clinical examination alone, only the presence of reaction could be assessed (2) reaction may not be definite (3) often false negative reactions appeared, and (4) degree of injury could not be assessed in cases with partial nerve injury.

The objectives of this study were to demonstrate the diagnostic value and the clinical usefulness of the electrodiagnostic test in measurement of latency time of the bulbocavernosus reflex.

Thirteen normal adult males served as controls for this study. 119 patients with sexual dysfunction and spinal cord injury who were referred to the EMG laboratory of Rehabilitation Medicine Department, Severance Hospital, Yonsei University, were studied from June 1984 to January 1986.

The results were as follows;

1) The latency time of the bulbocavernosus reflex in normal subjects was 33.9±3.04 msec (normal ranger : 27.9~40.0 msec) and there were no significant difference between right and left sides (P>0.05).

2) The mean bulbocavernosus reflex latency time in cases of functional sexual dysfunction and suprasacral spinal cord injury was not significantly different compared with normal mean values (P<0.01).

3) 46.2% of diabetic patients with sexual dysfunction showed abnormality in latency time and the main cause of sexual dysfunction in this group might be due to diabetic neuropathy. The mean in latency time of the diabetic group showed a significant difference (P<0.01).

4) 36.0% of patients with pelvic and perineal area injury and sexual dysfunction showed an abnormality in latency time and could be diagnosed to have peripheral nerve injury

5) electrodiagnostic study in the patients with conus medullaris and/or cauda equina lesion was useful in classifying th types of sexual dysfunction and neurogenic bladder and the degree of injury.

The authors measured the grip strength and pinch strength and range of motion of the shoulder per 2 weeks in 44 patients of frozen shoulder who were treated at the Department of Rehabilitation Medicine, St. Mary's Hospital during 1 year of period from March 1084 to August 1985.

The results were as follows;

1) Among the 44 cases, female were 15 cases and males were 29 cases and the highest age incidence was fifty to sixth decades.

2) Average duration of symptom at admission was 3.69±2.70 months.

3) The left hand was involved in 17 cases and right hand in 20 cases and both hands in 7 cases

4) The etiology of the frozon shoulders in 26 cases of 44 cases was idiopathic(primary) and 12 cases were associated with direct trauma and 2 cases with mastectomy complication and 3 cases with absolute bed rest due to other site's lesion and 1 case with silicosis.

5) shoulder range of motion at admission was 110.79±25.70⁗in flexion, 84.54±22.77⁗in abduction, 34.36±23.5⁗in internal rotation, 35.12±25.4⁗ in external rotation. The range of motion of the shoulder measured per 2 weeks increased continuously until 8 weeks.

6) At admission, average grip strength was 9.50±7.08 kg and average pinch strength was 4.91±2.93 kg. Both grip strength and pinch strength increased statistically significantly until 4 weeks and did not increased after 4 weeks.

A 20-year-old man with a severe, unusual deformity of the trunk and all extremities was diagnosed as muscular dystrophy. The deformity was so severe as to interfere with sitting and even lying on supine or prone and literature search did not reveal any report of such a severe deformity in muscular dystrophy.

We had supplied him with a special brace(occipitothoracolumbosacral orthosis: OTLSO) following which hyperextension of the neck and muscular tension were somewhat decreased so he could return to his previous job of signature seals.

He does this in prone lying with the brace.

The purpose of this article is to present an assessment method, in conjunction with age, sex, and occupation-related normal values, for thoracolumbar spinal range of motion in Korea healthy adults. The thoracolumbar spinal range of motion, flexion, extension, right side lateral flexion, and right and left side rotation were measured on 160 subjects by a goniometry.

The results were as follows;

1) The average thoracolumbar spinal range of motion in healthy adults are 53.1±12.9⁗ in flexion, 39.9±12.2⁗in extension, 46.2±8.9⁗ in lateral flexion, 27.6±7.3⁗and 29.5±8.2⁗ in right and left side rotation.

2) Although there are some exceptions, thoracolumbar spinal range of motion are decreased gradually with increasing age.

3) The female adults shows increased range of motion in flexion, extension, and lateral flexion than male, but no significant difference in both side rotation between sexes.

4) The white coloured shows increased thoracolumbar spinal range of motion to all directions than laboured.

The purpose of this study is to demonstrate the value of peripheral nerve conduction study in diagnosing diabetic neuropathy and the relationship between diabetic neuropathy and age, duration of diabetic mellitus, presence of other complications, and fasting blood sugar.

The subjects of this study were 289 cases with diabetic mellitus aged 17 to 76 years old who were admitted to Severance Hospital, Yonsei University and received electrodiagnostic examination from January 1, 1980 to April 30, 1985.

The summary of results is as follows:

1) Of the total 289 cases, 155 were male and 134 were female with a male to female ratio of 1.16:1.

2) Nerve conduction study revealed abnormal findings in 123 cases(42.6%).

Mean duration of diabetes millitus was 6.95 years in the neuropathy group and 5.10 years in the non-neuropathy group.

3) Diabetic neuropathy significantly increased with increasing age in the 30 years and older group, and wish increasing duration of diabetes mellitus in all age groups.

There was also a significantly higher frequency of diabetic neuropathy in groups with positive clinical signs and symptoms, and in cases with complications.

4) The most frequently involved sensory nerve was the superficial peroneal nerve. Asfor the motor nerve, the tibial and median nerves were involved equally.

In the electrodiagnostic study, 55.2% of the clinically symptomatic cases and 34.1% of the non-symptomatic cases showed abnormality, indicating considerable discrepancy between the clinical symptoms and the electrophysiologic study results.

5) Negative correlation was noted between fasting blood sugar, duration of diabetes mellitus and motor nerve conduction velocities; however, correlation coefficients were statistically nonsignificant.

According to these results, factors associated significantly with diabetic neuropathy were increasing age, long duration of diabetes mellitus, presence of symptoms, positive physical findings and complications.

Objective nerve function measurement by electrodiagnostic examination seems to be a practical method for early detection of diabetic neuropathy.

Carpal tunnel syndrome was the most common entrapment neuropathy with numbness and tingling of the fingers as well as weakness and atrophy of the thenar muscle. The carpal tunnel syndrome has been extensively studied electrophysiologically. When testing a patient for this syndrome. it is customary to measure the sensory latency of the median nerve from the digit to the wrist. More recently, methods have been described to determine the conduction time in the segment across the carpal tunnel. So we compared the diagnostic accuracy of hthis method to that of conventional electrodiagnostic methods.

In this study, an electrodiagnostic study of the carpal tunnel syndrome ws done by the authors from March 1985 to January 1986. Thus we performed the nerve conduction study of the median sensory nerve at index finger and palm upon 56 hands of 34 patients with clinically suspected carpal tunnel syndrome, aged from 25 to 70 years old. Then we compared these results with normal value of our laboratory.

The results were as follows;

1) The median sensory distal latencies measured at index were more than 3.7 msec or not detectable in 92.9%.

2) The median sensory distal latencies across the carpal tunnel were more than 1.7 msec or not detectable in 96.4%.

3) As the duration of syndrome became longer, sensory distal latency was more prolonged.

4) The amplitude of the median sensory verve was decreased to 50% of normal value or below it in index and across the carpal tunnel.

5) Above results imply us this method(measurement of latency of median sensory across the carpal tunnel) is a clinically sensitive technique for diagnosis of carpal tunnel syndrome.

Acute transverse myelitis is a well known clinical entity, but little is known about its etilology and epidermiological characteristics. It has rarely been reported to occur as a complication of typhoid fever.

Recently, we have seen a patient with acute transverse myelitis as a complication of typhoid fever. In the course of typhoid fever treatment, be became paraplegic with urinary difficulty.

After 2 months rehabilitation program including bowel and neurogenic bladder care and physical therapy, muscle strength of both lower extremities improved progressively and he was able to ambulate with support of a right ankle-foot orthoses, a left knee-ankle-foot orthoses and bilateral crutches.

Autonomic hyperreflexia is a life-threatening syndrome it is not promptly recognized and properly treated.

We treated an intractable autonomic hyperreflexia in a 35 years old C5 quadriplegic male by intrathecal phenol injection using 10 ml of 7% phenol solution. No recurrence of autonomic hyperreflexia for more than one year was noted.

The effect of specific EMG Biofeedback treatment was determined with 14 cases of 4 muscles(3 muscles on upper limb and one lower limb) which recieved 12 feedback training sessions. The assesment of result was performed 4 periods; biweekly and weekly with APA (Action potential analyzer: APA) of TECA 42 EMG system.

These data were compared with changes measured by control group(6 patients) of routine P.T only.

The results were as follows;

1) Pre-expermental base line differences of resting action potential and active action potential revealed statistically not significant(P>0.1)

2) Comparison oof mean amplitude of active action potentials of difference first and last assesment(4th week) between experimental and control group resulted in significant increase of mean amplitude(P<0.001), eventhough not homogenous variance in m. Triceps brachii and Tibialis auticus in F-distribution.

3) Comparison of mean amplitude of active action potentials within experimental group between 9 sessions of EMGBF(3rd week) and 12 sessions are statistically significant(P<0.001)

4) The comparison of proportion of independent values between experimantal(EMGBF+PT) and control(PT only) group by chi-square test 4 muscle of tested revealed statistically significant differences.(P<0.04 in m Deltoideus, P<0.02 m, biceps brachii, p≦0.006 m, Triceps Brachii and p<0.01 in Tibialis Anterior muscle).

Fourty shoulders in 26 normal Korean male and female and 14 painful shoulders and 14 spastic hemiplegic shoulders were used for measurement of scapulohumeral rhythm by plain X-ray, This is thought that this method is simple but acurate and good for the documentation.

The first replantation of an arm in the Western world was performed by Malt in 1962 and Komatsu and Tamai reported the successful replantation of a completely amputed thumb in 1965.

Without accurate repair of bones, nerves and tendons in addition to vascular anastomosis, however, it is impossible to gain functional success when replanting a digit or limbs.

Although there have been many reports of microvascular surgical technique for successful replantation involving digit, hand and upper extremities. little has been mentioned about 속 functional results in these patients.

The authours have examined electrodiagnostic study and analyzed the functional results of replanted patients (21 cases), transfered from OS department for physical therapy and occupational therapy.

The results were as follows;

1) The average age was 29.7 years and the male to female sex ratio was 10:1.

2) The level of amputation in 21 rehabilitation was as follows: Arm, 1 case; forearm, 3 cases; wrist, 2 cases; palm, 2 cases; thigh, 1 case; all fingers, 2 cases in each except index 3 cases.

3) Type of injuries was incomplete injury in 19 cases, and complete injury in 8 cases.

4) Patient assessment of replanted limbs was relatively satisfied with replanted limbs, but objective assessment of limbs was moderately satisfied.

5) Range of motion in replanted limbs was very poor results.

6) Motor nerve conduction study was gradually regenerated and, so only 2 cases were not conducted after 2 years and sensory nerve conduction study only 5 cases were conducted with decreased amplitude and delayed latendy after 2 years.

7) Electrophysiologic findings were gradually increased motor unit and amplitude with polyphasic motor unit and only a few museles were no motor unit.