There is no sufficient statistical bases on the diabetic neuropathy, because there has been poor definition and confusion of diagnostic criteria for diabetic neuropathy. We studied sensory nerve conduction(SNC) and scalp-recorded tibial somatosensory evoked potential(SEP) on the lower extremity of diabetic neuropathy.

One hundred and five patients, diagnosed as diabetes mellitus at internal medicine department of SNUH, were examined and results are followings.

1) Of the 105 DM patients, 83(78.1%) patients were diagnosed as diabetic neuropathy; Abnormal SNC was seen in 73(69.5%) patients and abnormal SEP was seen in 69(65.7%) patients.

2) Of the 71 patients with symptom, 95.8%(68 patients) were diagnosed as diabetic neuropathy and only 4.2%(3 patients) were normal by both methods.

3) Of the 34 patients without symptom, 21(61.8%) patients were normal by both methods and 13(38.2%) patients were diagnosed as subclinical neuropathy.

4) In above three groups, difference between SNC and scalp-recorded SEP was statistically significant by chi-square and Fisher test.

5) Of 73 patients showing abnormal SNC, 31 patients had no response and of 69 patients showing abnormal cortical SEP, only 13 patients had no response.

6) Snc and SEP showed tendency of prolonged latency, and decreased amplitude as the duration of DM and symptom of DM neuropathy increased. But the coefficients of correlation were low indicating there is no definite linear correlation.

In order to evaluate the functional levels of 133 disabled patients, the modified Barthel index and the adapted PULSES profile were applied at admission, discharge and follow-up, respectively. Theses methods of evaluation were valuable in monitoring rehabilitation progress over a span of time, as well as in describing individual and group progress in rehabilitation. Various correlational analyses between these evaluation scores and patients age, economic bracket, hospital stay and education level were done.

The major results were as follows: The older the patient, the higher the PULSES profile P score at admission, discharge and follow-up. And there was a tendency for the lower the Barthel score and the higher the PULSES score to have a great number of total hospital days. During admission, the Barthel score and number of hospital days both increased in cases of paraplegia who were in a higher economic bracket. The Barthel and PULSES scores changed significantly during hospital stay in hemiplegic patients with a higher education level regardless of side of involvement.

Ambulater is an equipment designed for training of weight balancing, increasing and activating ambulation, in addition to activating early recognition of body image by visual perceptual stimulation.

The purpose of this study is to evaluate the degree of improvement of weight shifting and ambulation using Ambulater in hemiplegics.

The subjects of this study were 25 hemiplegics who received gait training using Ambulater from August of 1986 to April of 1987.

The results were as follows:

1) Regardless of visual perceptual stimulation, the therapeutic result was significantly effective in the group who trained over 4 weeks.

2) The therapeutic effect in the right hemiplegic group was better than that in the left hemiplegics.

The lateral and medial antebrachial cutaneous nerves are sensory nerves supplying the anterolateral and anteromedial side of the forearm.

They have not been included in the ordinary sensory nerve conduction studies. But they can be used in several clinical cases such as diagnostic study of the peripheral neuropathy of the wrist disarticulated patients, or the polyneuropathy of various etilogies, or determination at the level of the brachial plexus lesion.

The aim of this study lies in determination of normal value that is latency, amplitude, conduction velocity of the lateral and medial antebrachial cutaneous nerves.

Total 111 nerves in 56 healthy Korean ranging in age from 15 to 66 years were examined.

The results are summarized as follows.

1) In the lateral antebrachial cutaneous nerves, the mean value of the distal latency was 2.61±0.12 msec, the mean value of the amplitude was 33.62±13.36 uV, the mean value of the conduction velocity was 53.61±2.61M/sec.

2) In the medial antebrachial cutaneous nerves, the mean value of the distal latency was 2.65±0.15 msec. the mean value of the amplitude was 17.12±6.28 uV, the mean value of the conduction velocity was 52.57±2.74M/sec.

3) There was no significant difference related to the age, the sex and the side of the extremities.

4) The amplitude of the lateral antebrachial cutaneous nerves tends to be larger than that of the medial antebrachial cutaneous nerves, but there was no significant difference in the distal latency and the conduction velocity between the lateral and medial antebrachial cutaneous nerves.

5) In lateral and medial antebrachial cutaneous nerves, there were clearly demarkated sensory nerve action potentials at 14 cm distance recording.

It is generally accepted that depression disorder is significant psychological problem among the patients with spinal cord injury(SCI) who are in the process of adjusting in their rehabilitation treatment.

The subjects conducted in this study was to assess depression tendency among SCI patients where proper social welfare program has not yet been fully established.

The subjects conducted in this study were 72 cases, 69 males and 3 females, ranging age from 18 to 58 years old(mean age 32.8±8.6 years) who were under treatment at rehabilitation clinics.

The most common causes of disability were industrial and traffic accidents(92.8%), the average treatment length was 2 year and 0.7 month. The levels of injury were 20 cervicals(26.4%), 20 thoracics(27.8%) and 33 lumbars(45.8%) and the extents of injury were (70.8%) complete and rest of were incomplete. The average Barthel index score was 33.35.

The administered method of depression scales were MMPI and SCL-90-R, and the scores were compared with the level of cord injured, the extent of injury, the marriage status and sports and outdoor activities.

The results obtained were summarized as follows.

1) The average depression score with MMPI on 72 SCI subjects was 59.41, 57.43 with the SCL-90-R.

2) 16.7% of subjects had depression reaction with MMPI and 15.3% with SCL-90-R.

3) There was no significant relationship between the level of injured cord or extent of injury and the depression score was observed.

4) The depression scale who were not participated in sports program was significantly higher than that of those who did participate.

5) The depression scale of married subjects was significantly higher than that of not married.

6) Those who are not married, short duration from injury, participants in sports activities and youger age cases were observed higher scores of Barthel index with lower depression scores.

Shoulder pain, stiffness and limited shoulder range of motion are unfortunately frequent complications in hemiplegia. Pain and limited shoulder range of motion in hemiplegia interfere with self-care activities, impede balance, and create difficulty with transfers and ambulation.

The clinical similarity between the frozen shoulder and the painful, contracted shoulder of the hemiplegic patient was found through several studies.

To analyze therapeutic effect between frozen shoulder in hemiplegia and non-hemiplegia, the authors applied traditional physical therapy and followed up for 1 months. The results were summarized as follows.

1) Among the 68 cases, the hemiplegic patients were 19 cases and the non-hemiplegic patients were 49 cases.

2) Among the 68 cases, males were 27 cases and females were 41 cases and the highest age incidence was fifth to sixth decades.

3) duration of symptom was 2 to 4 month in 58% of hemiplegia and 59% of non-hemiplegia.

4) The left side was involved in 30 cases and the right side in 27 cases and both sides in 11 cases.

5) The causative factors of frozen shoulder in 19 hemiplegic patients were; spasticity and subluxation respectively in 13 cases, shoulder-hand syndrome in 7 cases, myofascial syndrome in 2 cases.

6) shoulder range of motion in hemiplegia at first visit was 92.3±24.4° in forward flexion, 76.2±24.7° in abduction, 1.3±15.2° in external rotation and 169.7±52.7° in total.

Shoulder range of motion in non-hemiplegia at first visit was 115.5±32.9° in forward flexion, 89.3±33.8° in abduction, 19.0±22.3° in external rotation, and 222.0±70.0° in total.

7) In hemiplegia shoulder range of motion 1 month after physical therapy was 121.0±28.1° in forward flexion, 107.0±26.4° in abduction, 11.3±15.2°in external rotation, and 239.2±57.5^o in total; increase in range of motion being 28.8±24.1^o, 30.8±22.8^o, 10.0±10.5^o, and 69.5±53.0^o respectively. In non-hemiplegia shoulder range of motion 1 month after physical therapy was 142.5±29.2^o in forward flexion, 124.6±33.0^o in abduction, 35.3±21.8^o in external rotation, and 302.4±74.9^o in total; increase in range of motion being 26.9±13.7^o, 35.3±18.4^o, 18.2±17.4^o, and 80.3±36.3^o respectively.

8) The range of shoulder external rotation in hemiplegic patients revealed significant resistance to physical therapy.

85 men with spinal cord injury were evaluated for sexual problem using questionaire. Following Findings were obtained:

1) Average age was 33.0 years old, the oldest was 53, the youngest was 24.

2) Level of SCI: 8 persons(12.9%) had cervical cord, 56 persons(65.8%) had thoracic cord 18 persons(21.1%) had lumbar cord level.

3) Lesion of SCI was classified into incomplete and complete. Incomplete lesion in 23(27%), complete lesions was in 62(73%).

4) Sexual interst and desire are developed within 1 year in 28 persons and are developed within 1 month after spinal cord injury in 20 persons.

5) Over 10 minutes erection was seen in 7 persons, most of them had cervical cord level, only one person had lower thoracic cord lesion.

6) The ejaculation was possible in 30 person. Among them cervical cord lesion was 8, thoracic cord lesion was 8, lumbar cord lesion was 14.

7) Orgasm was fel only 3 out of 85 spinal cord injuried. Those who had cervical cord lesion.

Ankylosing spondylitis is a chronic progressive inflammatory disease of unknown etiology involving principally the axial joints of the spine, chiefly the sacro-iliac apophyseal and costovertebral articulations resulting in not only deformity but also functional disability in terms of cardiopulmonary dysfunction and activities of daily living.

Ankylosing spondylitis is one of the most responsive disease among arthritides to comprehensive rehabilitation, physical modality such as postural and strengthening exercise and chest physical therapy.

Since comparatively excellent treatment results were gained subjectively as well as objectively by administering intensive comprehensive rehabilitation for short period of admission, 5 diagnosed cases along with importance of patient education and home therapy maintenance program are stated for the first time in Korea.

The electromyographic study was undertaken to assess the peripheral nervous system in patients with complete spinal cord injury due to trauma above lumbar cord level.

Ten patients were studied. In 6 patients the paraplegic was of the spastic type, while 4 had flaccid paraplegia, in 5 patients the paraplegia was of atrophic type, while 5 had non-atrophic paraplegia.

E.M.G. abnormalities consisting of denervation potentials, slowed conduction and inexcitability of nerve were demonstrated in the lower limb of all patients at Peroneal nerve. Superficial peroneal nerve. Tibial nerve. Sural nerve. Femoral nerve and Saphenous nerve.

This involvement was more apparent in atrophy group of paraplegic patients compared to non-atrophic ones and more involved nerves were Peroneal nerve, Superficial and Saphenous nerve in Nerve Conduction Studies.

Pulmonary embolism is one of the acute pulmonary diseases and often results in sudden death.

Furthermore, it is known as a major cause of death at the acute phase of the spinal cord injured patients.

It's incidence is reported to be about 15.3% in Western societies, but it is believed to be rare in Korea.

We report that an acute pulmonary embolism complicated to a chronic C6 quadriplegic patient has been successfully treated by adequate heparinization and supportive therapy.

Heterotopic ossification is a true ossification that occurs para-articularly in soft tissue and only involves neurologically affected joints. The extensive heterotopic ossification is a cause of limitation of active or passive joint motion and ultimately bony ankylosis which interferes independency in activities of daily living and ability of maximum rehabilitation

The purpose of this study is to define the various clinical, laboratory and radiologic findings of heterotopic ossification and to help early diagnosis, understanding of clinical progression and early treatment of heterotopic ossification. This study reports the 7 cases in 6 men with heterotopic ossification who were admitted to the Institute of Rehabilitation Medicine of the Presbyterian Medical Center from April, 1982 through September, 1986 with the review of literatures.

The effects of ultra-short acting barbiturate (thiopental sodium) on short latency potential of somatosensory evoked potential have been studied in twenty two patients without neurological disease.

The results were as follows:

1) The men values of P₄₀ potential latencies were 36.7±2.09 msec for the pre-anesthetic state, and 36.7±1.65 msec, 37.0±2.30 msec and 37.7±2.48 msec correspondingly for the post-anesthetic state after serial thiopental sodium infusion of 0.5mg/kg, 1.5mg/kg and 3.0mg/kg.

2) There was no statistical difference of P₄₀ potential latencies between pre-anesthetic and post-anesthetic states(P>0.05).

Fifteen spinal cord injured patient with neurogenic bladder dysfunction were treated with intermittent catheterization and pharmacotherapy. Clinical approach of pharmacotherapy for neurovesical disorders is aimed to promote bladder emptying and storage.

Six patients showed neurogenic bladder dysfunction of detrusor sphincter dyssynergia. There of them were treated with pharmacological inhibition of the smooth sphincter and one patient was treated with pharmacological inhibition of both sphincters. Mean duration of bladder retraining of the 6 patients was 13.8 days with 100 percent succesful bladder retraining with 150cc of acceptable maximal residual urine volume.

Rest of patients showed incontinence. Eight of 9 patients were treated with pharmacological combination of inhibition of bladder contractility and increase of outlet resistence. One patient was treated with only pharmacological increase of outlet resistence. Mean duration of bladder retraining for incontinence was 11.5 days with good results.

Jebsen hand function test in children was administered without modification from the adult test with the exception of using table and chair heights appropriate to the size of the child, and excluding writing for the 6-7 age group. This extension of the hand function test to children should be of value in helping to differentiate those improvements in hand function which are due to maturation from those which are due to particular therapy in children with impaired hand function.

To provide the clinician with the data from normal Korean children when test is given to Korean subjects, and to encourage the clinician to give this test for better hand rehabilitation, the authors report the result of Jebsen hand function test in 300 normal Korean children with the statistical analysis.

Sturge-Weber syndrome consists essentially of a vascular anomaly of the skin of the face, in the area served by the trigeminal nerve, associated with a presumed intracranial vascular anomaly. Frequent associated clinical findings are focal or generalized convulsion, ocular anomaly, contralateral hemiplegia, and mental retardation.

This is a case report of four typical Sturge-Weber syndrome in which data were sufficient establish the diagnosis.