Acute Werdnig-Hoffmann disease, the most common cause of hypotonic infants, is progressive degenerative disease of anterior spinal neuron, and characterized by flaccid paralysis of extremities and fasciculation of tongue.

We experienced 3 cases of Werding-Hoffmann disease confirmed by electrodiagnostic examination and muscle biopsy.

They revealed generalized hypotonia with frog leg position, fasciculation of tongue, decreased or absent deep tendon reflexes without pathologic reflexes suggesting upper motor neuron diseases.

The clinical manifestations, values of laboratory examination including electrodiagnostic examination and muscle biopsy for diagnosis and differential diagnosis of Werding-Hoffmann disease were reviewed.

A peroneal nerve palsy is one of the most common peripheral nerve injuries. A retrospective analysis of 275 peroneal nerve palsies was carried out from 11 years experience (since 1972 to 1982) in the Department of Rehabilitation Medicine, Yonsei University College of Medicine.

The third decade was involved most frequently and the females were more prevalant than the males with the ratio of 3.3:1. The most frequent site of the lesions was the common peroneal nerve(51.8%). For the cause of lesions, the fracture was most common(32.2%). A complete and an incomplete lesions were 47.9% and 52.1% of all cases respectively.

Confirmation of sensory changes in clinical neurologic examination by somatosensory evoked potential examination is the main purpose of this article.

Twenty eight patients who were undertaken an operation for herniated lumbar disc were analysed in clinical neurological symptoms, electromyographic findings, operative findings and somatosensory evoked potential findings in superficial peroneal and sural nerve stimulation.

The results were as follows.

1) The latency of somatosensory evoked potential in superfical peroneal and sural nerve of normal Korean subjects were 39.81±1.71 msec, 38.95±1.80 msec, each.

2) The accuracy of level localization in electromyography was 85.7% in this study.

3) The accuracy of somatosensory evoked potential examination in patients who have sensory symptoms was 82.6%.

4) Two cases among four cases of negative electromyographic finding were positive in somatosensory evoked potential examination and the accuracy was raised to 92.8% with combinations of the electromyography and somatosensory evoked potential examination.

5) The somatosensory evoked potential examination seems be to a good supportive measure in diagnosis of herniated lumbar disc patients with electromyography, expecially who have sensory change symptoms.

In diagnosis of patients with postoperative recurrence of back pain evaluation becomes much more difficult since postoperative scarring distorts the myelogram and the operative trauma may cloud the significance of electromyographic abnormalities, especially in the paraspinal musculature. It is important to evaluate these patients who have no evidence of motor root involvement but continue to complain of apin and are related to medico-legal problems from traffic accidents.

This paper discusses the usefulness of somatosensory evoked potentials(SEP) study in diagnosis of sensory radiculopathy developing after laminectomy.

An interdisciplinary method of functional assessment is presented utilizing the Modified Patient Evaluation Conference System^Ⰳ or PECS^Ⰳ taken from Harvey and Jellinek's PECS^Ⰳ, which has been applied in a medical rehabilitation setting to guide treatment and to assess program effectiveness.

The subjects of this study were 17 patients who were presented in Rehabilitation Patient Evaluation Conference twice or more in the Department of Rehabilitation Medicine, Presbyterian Medical Center in Chonju, during 6 months period since March 1983.

The method required that functional performance items be evaluated by each professional in particular functional areas and that rehabilitation goals be set by these professionals.

The key concept in the use of this method is that the goal setting is the essence of rehabilitation. Data are presented to demonstrate level of gain, goal-setting effectiveness, and degree of independent function.

Cerebral palsy is a nonprogressive disorder of motion and posture due to brain insult or injury during the period of early brain growth, and the incidence has not reduced in spite of improvement in social, medical and economic status.

Vojta treatment is a recently developed method of C.P. treatment which can be applied earlier than the other traditional methods by early diagnosis.

We analysed the effect of treatment by motor quotient in 32 cerebral palsied who was treated continuously for over 8 months in accordance with the neuromotor type, severity, mentality, age of initial treatment, and the number of treatment per day.

The results were as follows,

1) Spastic type was higher in initial M.Q. but the effect of treatment was similar to other types.

2) Cerebral palsied with good mentality and of mild degree had noticeably higher M.Q. initially than that of poor mentality or more severe degree, but the effect was only slightly superior to the others.

3) The better was the effect of treatment when the earlier the initial treatment.

4) The effect of treatment was much better in cases treated over twice per day than the cases treated only once.

The standard short leg brace is attached to and exerts its forces through the patient's shoe. Because of the motion that occurs between the shoe and foot this is an inefficient arrangement and therefore requires the application of strong forces, necessitating metal components that are heavy and have a poor cosmetic appearance. The weight, furthermore, is fatiguing to weak muscles and tends to cause rotational gait disturbances.

In an effort to decrease brace weight and improve cosmesis, a molded plastic brace has been devised that acts directly on the extremity rather than by exerting its forces indirectly through the shoe. It has been used successfully for both flaccid and spastic lower extremities, providing both medial-lateral and plantar-flexion control.

The clinical experience with plastic AFO for 20 hemiplegics, in the Department of Rehabilitation Medicine, Presbyterian Medical Center in Chonju for 15 months since Feb. 1983, is presented with the method of fabrication and modifications and the review of the related literature.

The usefulness of performing late response studies for the detection of uremic polyneuropathy has been demonstrated. It has been shown that significant prolongation of the minimal latencies of the H-reflexes and the F-responses and significant correlation with conventional method of motor and sensory conduction. The 30 cases of uremic polyneuropathies are studies, as possible as, with conventional and late response study comparing to 25 cases of normal controls.

The conclusions are as followings.

1) Statistically significant(p<0.001) prolongation of motor and sensory conduction velocities of tibial nerve in uremic polyneuropathies.

2) The late response study performing on uremic polyneuropathies revealed statistically significant (p<0.005 in F-reponses and p<0.001 in H-reflex) prolongation of latency and slowing of their conduction velocities compared to normal controls.

3) The H-reflex latency and conduction velocity of its pathway would be taken significant role in the effect of treatment(Hemodialysis) and prognosis of uremic polyneuropathies.

4) The significant prolongation of minimal latencies of H-reflex is present at a time of when conventional methods of motor and sensory conduction do not show an abnormality in individual patients.

Since March 1980 to Jan, 1984, 111 cases of L5 and S1 radiculopathies who were diagnosed by electromyography at Dept. of Rehabilitation Medicine, Seoul National University Hospital, was analaysed in retrospective study.

Our aim in this study was the usefulness of tibialis posterior muscle in radiculopathies.

Our results obtationed were as follows.

1) Among the 111 cases, 65 cases (58.6%) were electromyographically positive findings in both anterior and posterior rami, 46 cases(41.4%) were positive findings in only anterior rami.

2) L5 radiculopathies were markedly predominant than S1 radiculopathies in spite of pure or mixed pattern.

3) In L5 radiculopathies, tibialis posterior muscle was the most sensitive muscle in electromyographic findings and in S1 radiculopathies, abductor hallucis muscle was the most sensitive one.

4) The tibialis posterior muscle was more sensitive in pure L5 radiculopathies compared to pure S1 radiculopathies.

920 cases with peripheral nerve injuries those who were seen in Hanyang University Hospital EMG laboratory during a period January 1972 -October 1983 were evaluated for the causes.

This study revealed that the causes were traumatic, occupational and pathological factors locally or systemically. And many of them could be prevented if a certain caution was made.

3 nerves of upper extremity and 2 nerves of lower extremity those nerves most frequently affected were evaluated and the causes were discussed.

In 204 median nerve injuries evaluated (Table 1-1), laceration and penetration injuries was most common cause(51.5%) and the next common cause was compression and traction injuries (33.8%). The later group(69 cases) was evaluated again for the details. As table 1-2 shown the carpal tunnel syndrome was most frequent cause(76.8%) and 5 other various causes were encountered.

In 219 ulnar nerve injuries evaluated(table 2-1), laceration was most frequent(46.6$) and the next frequent causes were compression and traction injury(15.1%). The later group (33 cases) was evaluated again for the details. As the table 2-2 shown simple compression at the elbow was in 60.6% and 4 other causes were encountered.

In 162 radial nerve injuries evaluated(table 3-1), fracture of the humerus was the most frequent(37.0%), and the next frequent cause were compression and traction injuries(19.8%). The later group(32 cases) was evaluated again for the details. As the table 3-2 shown simple compression at the humerus was in 62.5% and 5 other causes were encountered.

In 303 peroneal nerve injuries evaluated(table 4-1), compression & traction injury and IM injection the gluteal region were the 2 most frequent causes(16.8%, 16.8%). The former group(51 cases) was evaluated again for the details. As the table 4-2 shown compression at the fibular neck was in 54.9% and 6 other causes encountered.

In tibial nerve injuries evaluated(table 5-1), IM injection injury was the most frequent causes(25.0%) and compression injury was in 9.4%. The later group(3 cases) was evaluated again for the details. As the table 5-2 shown massive edema of leg with CO intoxication in 66.6% and the other was due to a prolonged cramp of calf.

Using Polgon goniometer, the time ratio between stride and height, and the maximal angle of knee and hip joint angles in gait cycle were observed in 10 normal Korean man. And in a few groups of patients who have gait diturbances, the gait pattern was noted and compared.

The results were following;

1) The ratio between stride and height in normal subjects was 60.6% in average stride, 54.3% in short stride, 71.8% in long stride.

2) The time during 1 gait cycle was 1.47 sec. in average speed walking, 1.68 sec, in slow speed walking, 1.25 sec, in fast speed walking.

3) The maximal flexion and extension of hip & knee joint angle in average stride and slow speed walking was 32.4', 11.6', 51.5', -2.1' each.

4) The smaller the stride, the maximal flexion & extension of hip joint was reduced and the maximal flexion of the knee joint was relatively unchanged but the maximal extension was reduced compared with average speed.

5) The angle-angle diagram seems to be a useful objective criteria in gait analysis in patients who have gait disturbances.