Somatosensory evoked potentials(SEPs) are useful for the evaluation of the nervous system from peripheral receptor to cerebral cortex.

SEPs were recorded from 46 normal subjects (male=28, female=18), aged 15∼70 years(mean=41.9) using TECA 42 EMG system. Both median nerves were stimulated at wrist and recording electrodes were placedon C₂(active) and Fz(reference) position of the international 10-20 EEG system. Following results were obtained.

1) The mean latencies of the No, N₁, P₁, N₂, P₂ were 15.4±0.97 msec, 18.7±0.91 msec, 23.5±1.76 msec, 31.7±2.25 msec, 42.6±3.02 msec respectively on the right side.

2) The mean amplitudes, N₁P₁ and N₂P₂ on the right side were 8.06±1.61㎶ and 5.85±1.90㎶ and NP/NP was 72.5%.

3) The N₃ was neglected due to irregularity and inconsistency in shape.

4) Difference between the right and left and between the male and female for the latency and amplitude were not found, but N₂P₂/N₁P₁ of the male and female respectively were 79.8% and 67.9% on the right side.

5) According to aging, mean latencies were increased.

This study was to determine the normal range of the latency and conduction velocity of the F wave of tibial and sciatic nerves in healthy Koreans.

In ten healthy subjects(nine male and one female) 20 tibial and sciatic nerves were examined.

Both tibial and sciatic nerves were examined separately with a TECA-TD 20 EMG system. No subject showed evidence of neuromuscular system abnormality.

The results are as follows:

1) F wave latency and conduction velocity of the tibial nerve were 28.0±1.6 msec, and 55.2±3.0m/sec respectively.

2) F wave latency and conduction velocity of the tibial nerve were 22.9±1.1 msec, and 61.9±5.1m/sec respectively.

3) Conduction velocity of the sciatic nerve between the buttock and popliteal fossa was 55.0±1.6m/sec respectively.

Since isokinetic exercise equipment has made determination of muscle performance with great accuracy objectively, athletic training at high velocity and scientific rehabilitation of the musculoskeletal injuries, it is being more widely used in sports and rehabilitation medicine.

The purpose of this study were to measure the strength, power and endurance of knee extensors and flexors by using the cybex Ⅱ isokinetic dynamometer in the healthy twenties, and to standardize the values obtained.

Twenty subjects were tested, 10 men and 10 women, between the aged of 21 and 28, and mean values of the body weight of 56.5 kg.

The results were as follows;

1) The mean peak torque of quadriceps at speed of 60°/second were 121.0±27.5 ft-lbs in male, and 67.6±5.3 ft-lbs in female. The mean of peak torque of hamstring at speed of 60°/second were 58.5±18.1 ft-lbs in male and 32.4±10.7 ft-lbs in female.

2) The mean torques of quadriceps and hamstring were decreased as the velocity of joint motion increased, and there were no significant differences of quadriceps and hamstring peak torques between dominant and nondominant sides.

3) In male, the ratio of quadriceps peak torque to body weight were 83.9%, and 40.3% for the hamstring. In female, the ratios of quadriceps and hamstrign peak torque to body weight were 56.3% and 27.2%, respectively.

4) The hamstring peak torque to quadriceps peak torque ratios at the speed of 60°/second were 48.8% in male and 47.1% in female.

5) In male, total works of quadriceps and hamstring were 1184.9±289.6 ft-lbs and 256.3±24737 ft-lbs, respectively and 605.0±142.5 ft-lbs for quadriceps and 182.8±99.8 ft-lbs for hamstring in female.

6) The endurance ratio of quadriceps were 65.0±17.3% in male and 72.6±23.8% in female, The Hamstring endurance ratio of male and female were 56.7±20.0% and 54.2±31.0% respectively.

The progressive muscular dystrophy is primarily a disease of the striated muscles of unknown etiology characterized by progressive degeneration and regeneration. Because of the nature of disease, management of patient requires specialized knowledge and skill.

This paper reports total 101 patients registered in the Muscular Dystrophy Association of Korea (4 females and 97 males). The results were obtained by questionnaire sent to patients. They are 52 Duchenne type, 3 Becker type, 27 Limb-gridle type, and 6 Facioscapulohumeral type muscular dystrophy.

The results of these studies were as follows;

1) Korean floor Ondol style classification(Kang's method) for functional stage in the home bound patients is more practical than Swinyard, Price, Ueda method especially in questionnaire.

2) The familial genetic history reveals 30.7% and the nonfamilial mutation history reveals 69.3%.

3) The 76.9% of Duchenne type patients need special education program rather than ordinary school program.

4) The diagnostic criteria included history and physical examination, serum enzyme study, eletromyography and muscle biopsy.

5) It seemed to be considered the factors related in our psycosocial background, parents counseling and active patients care should be focused effectively in Rehabilitation Program in the Rehabilitation institute.

6) For further investigation in the subject, Muscle Study Group is to be suggested. Muscular Dystrophy Association needs support by civilian as well as governmental base.

The electroretinogram, a sensitive indicator of the mass retinal integrity and early central nervous system action, has significant value in the diagnosis of visual disorders as well as broad application in clinical and basic research.

The purpose of this study is to establish the normative data of this laboratory.

With Cadwell 7400 Ganzfeld stimulation ERG system, photopic, scotopic and flicker fusion photopic ERG are recorded from 60 normal eyes of 30 healthy Koreans who showed no evidence of abnormality in ocular and retinal regions.

The subjects ranged in age from 7 to 55 years with a mean age of 30.5.

The results are as follows.

1) Latencies and amplitudes of ERP, a_p, a_s, b_p and b_s in photopic stimulation are 5.35±0.05 msec, 5.89±3.06Ռv, 12.5±2.00 msec, 14.92±5.16Ռv, 16.92±3.00 msec, 12.95±5.53Ռv, 21.09±2.48 msec, 22.23±5.68㎶, 35.57±2.33 msec, 35.57±2.33Ռv, 35.83±8.77Ռv, respectively.

2) Latencies and amplitudes of ERP, a_p, a_s, b_p and b_s in scotopic stimulation are 5.7±1.38 msec, 5.67±2.09Ռv, 14.19±2.25 msec, 19.38±4.36Ռv, 17.99±2.27 msec, 17.48±4.21Ռv, 21.71±2.78 msec, 30.03±7.25Ռv, and 36.65±1.85 msec, 62.27±8.47Ռv, respectively.

3) Maximal latency differences between right and left eye in ERP, a_p, a_s, b_p and b_s are 2.96 msec, 2.55 msec, 1.73 msec, 2.07 msec and 2 msec, respectively, by photopic stimulation.

4) Maximal latency differences between right and left eye in ERP, a_p, a_s, b_p and b_s are 2.61 msec, 2.37 msec, 1.8 msec, 1.62 msec and 1.98 msec, respectively, by photopic stimulation.

5) There is no significant latency difference between left and right ERG.

The wheelchair is the adjuvant to rehabilitation of the disabled. Whenever a person has to spend much of his time in a wheelchair, an appropriate must be prescribed. Wheelchair should be fitted to each patient rather than fitting the patient to the wheelchair. Therefore a rehabilitation facility should have available sample chairs of different sizes with various special features including detachable armrests, detachable footrests, reclining backs, etc.

The authors have studied 120 Korean disabled adults who were wheelchair users and 466 normal adults as a control group in order to provide basic data for making standard wheelchairs for Korean disabled adults.

The results are as follows:

In the disabled group, 60% were paraplegia, 25.8% quadriplegia, 9.2% hemiplegia, 2.5% amputee with paraplegia and 2.5% were cerebral palsy.

All of the disabled adults in our study did not possess an appropriate wheelchair in terms of their disability and body size. There was a statistical significance between male and female body dimension measurements in the normal as well as in the disabled group(p<0.05). Standard dimensions included seat width 40.8 cm for Korean male adults; and seat width 40.1 cm, seat depth 43.3 cm, back height 37,8 cm, arm height 28.7 cm and seat height 44.6 cm for Korean female adults.

Computerized tomography(CT) of the brain allows the clinical diagnosis of intracerebral hemorrhage or cerebral infarction. The size, location and extension of lesion are acurately portrayed.

At Kyung Hee medical center in this year, prognosis of 71 cases with cerebral infarction and 71 cases with cerebral hemorrhage has been studied in relation to the lesion on CT scan. It has been important prognostic index whether to involve or not to involve posterior limb of internal capsule. The results were summerized as follows.

1) Motor deficit was mild in patients with the brain lesion, which is not involving internal capsule(Motor function 73%), whereas patients with lesion in the posterior limb of internal capsule had much more marked motor involvement(Mf. 12%).

2) In the case involving internal capsule, nearly all of the patients with cerebral infarction had complete hemiplegia(Mf. 15%), whereas there was slight improvement in the patients with cerebral hemorrhage(Mf. 30%). On the other hand, the patients with the lesion not involving internal capsule had a good recovery(Mf. 86%).

3) The prognosis of hemiparesis was unfavorable in patients with the lesion involving internal capsule than the other lesion by CT scan.

The success in the control of neurogenic bladder is very important in management of the spinal cord injured. The Foley cather drainage method had been most prevaled before the intermittent catheter drainage method was introduced. In Korea, there are many spinal cord injured whose management of neurogenic bladder be maintained by the use of the Foley catheter drainage. Also at prsent time, there are considerable hospitals where the Foley catheter drainage are used as a method provided for the control of neurogenic bladder.

But the Foley catheter drainage have incurred many serious complication, such as urinary tract infection, vesicoureteral reflux, pyelonephritis and chronic renal failure.

The source of infection in the Foley cathered was considered as ascending infection through the catheter.

In 1966, Guttman reported the new method for the control of neurogenic bladder, namely intermittent catheterization. The method has shown very remarkable reduction in urinary tract infection and other complication such as vesicoureteral fistula, which appeared frequently in Foley catheter drainage. Also, it provide physiologic drainage of bladder with benefit of the maintaince of bladder wall contractility, which is very important in acquiring the balanced bladder. But in Korea, there are many spinal cord injured who do not know the risk of Foley catheterization and thebenefit of intermittent catheterization.

An attempt to find out the efficacy of intermittent catheterization and to find out the dangerosity of Foley catherization is conducted using 40 bladder trainee with intermittent catheterization and 80 Foley catheterized men.

Comparison of some selected attributes such as age, education, back ground, socioeconomic status and clinical laboratory findings such as urine culture and identification of bacteria is made between bladder-trained group and Foley cathetered group. Also the willingness of bladder training with intermittent catheterization in Foley cathetered group was investigated.

The results and findings obtained were as followed.

1) The bladder trained group showed very significantly lower urinary tract infection rate than Foley cathetered group.

2) In the distribution of organism of the urinary tract, the exogenous bacteria was found much more frequently in Foley cathetered group.

And this finding showed that Foley cathetered is major reason of urinary tract infection.

3) Whether the spinal cord injured receive bladder training or not is totally dependent on the hospital where the patient was admitted.

4) Most of the Foley cathetered spinal cord injured wanted to receive the bladder training. So, bladder training technique must be educated and transmitted rapidly to the non-bladder training hospital and Foley cathetered spinal injured.

Pudendal SEP study is a useful method of evaluating the patients with sexual dysfunction due to lesion is the course of afferent sensory tract from peripheral nerve to cerebral cortex.

The objectives of this study are to obtain the normal value of short latency of pudendal SEP and to show the clinical usefulness of pudendal SEP in the evaluation of sexual dysfunction.

Twenty normal adults and 74 patients with sexual dysfunction were studied.

The results are as follows:

1) The short latency of pudendal SEP in normal adult was 40.3±2.36 msec with normal range of 35.6~45.0 msec.

2) All of the patients with functional sexual dysfunction showed normal values.

3) Pudendal SEP study showed high incidence of abnormality in patients with spinal cord and pelvic trauma.

The purpose of this study is to measure and compare the sensory conduction velocity of median nerve measured by conventional method and somatosensory evoked potentials.

The subjects conducted in this study were 25 cases, 13 males and 12 females, ranging age from 15 to 41 years old(mean age: 27.5 years) who were healthy free from neurologic diseases.

The results obtained were summarized as follows.

1) The conventional Sensory nerve conduction study of the median nerve in the forearm 67.50 M/sec in average, 67.80±4.24 M/sec in the right and 67.21±3.62 M/sec in the left. There is no significant difference noticed between the right and left side.

2) The somatosensory evoked potential of the median nerve in the forearm showed the sensory nerve conduction velocity to be 70.91 M/sec in average, 69.59±8.35 M/sec in the right and 70.23±10.15 M/sec in the left. There is no significant difference noticed between right and left side.

3) The conduction velocity of median nerve by conventional measurement in forearm was 69.50 M/sec in average and 70.91 M/sec using somatosensory evoked potential measurement and there was no significant difference between them.

Some patients undergoing shoulder arthrography with a stiff and painful joint have a small volume capsule or a frozen shoulder. In the past, treatment of frozen shoulder has included watchful waiting, physical therapy, range of motion exercise, systemic antiinflammatory medication, analgesics, and intraarticular injection of local anesthetic and steroids. In certain cases, the arthrographic procedure has been therapeutic and joint distension has effected a return to normal function.

After arthrography, improved range of motion will occur immediately, but this improvement must me maintained by active range of motion, and heat therapy for several days after arthrography.

In 18 patients with frozen shoulder, we applied shoulder arthrography and physical therapy, and followed up 18 patients for 1 months.

The results were summerized as follows.

1) Shoulder range of motion at prearthrogram was 90.38±29.73° in forward flexion, 69.44±21.47° in abduction, 10.28±10.47° in external rotation, 170.56±51.10° in total.

2) Shoulder range of motion at 1 week after arthrogram was 116.67±24.94° in forward flexion, 92.94±30.10° in abduction, 21.39±14.98° in external rotation, 230.83±62.26° in total, each range of motion were increased 25.84^o, 23.5^o, 11.11^o, and 60.27^o than range of motion at preathrogram.

3) Shoulder range of motion at 1 month after arthrogram was 131.67+31.84^o in forward flexion, 117.92+37.08^o in abduction, 30.83+15.92^o in external rotation, 266.67+84.91^o in total, each range of motion were increased 40.84^o, 48.48^o, 20.55^o, and 96.11^o than range of motion at preathrogram.

4) In frozen shoulder, shoulder arthrogram with continued physical therapy seem to acquire not only increased range of motion but also short duration of treatment.

Persistent pain is the most frequent complaint of patients, yet it is one of the most difficult symptoms to treat, because of complex nature. Psychological testing, especially using self administered forms, has become a more and more popular adjunct to diagnosis.

Twenty-eight chronic pain patients, 15 organic pain group and 13 functional pain group, have completed the Minnesota Multiphasic Personality Inventory(MMPI) and the results were as follows:

1) Mean MMPI t-score of Hypochondriasis was 62.0±12.0, that of Depression was 55.0±11.4, and that of Hysteria was 61.8;12.6. And those of other scales were within normal range near to 50.

2) There was no significant difference between male and female groups on MMPI scales.

3) The MMPI t-score of functional group was significantly higher than that of organic group on Hypochondriasis scale.

Biofeedback is autoregulation or self-control technique that improve the patient to control a wide range of internal physiologic process shown through visual or auditory signal of the equipment. In this experiment, we used the EMG biofeedback treatment, one of the biofeedback methods, and confirmed the effect of EMGBF in the paretic patients caused by hemiplegia mainly and the other nerve injuries. Biofeedback training using TECA EMG system was practiced 3 times per week for 4~6 weeks and total 33 patients were assessed the amplitude, frequency, mean rectified amplitude weekly or biweekly with action potential analyzer.

The result were followings:

1) In CNS disorders, there was no difference between experimental and control groups in the incipient stage of EMGBF training on mean rectified amplitude(MRA) and significant difference was shown after 3 weeks. MRA of active action potential increased significantly in the last assessment of the experiment. The results were approved statistically by chisquare test.

2) In cases of facial palsy, monoparesis due to spinal cord compression, peripheral nerve injuries including radiculopathy and common peroneal nerve palsy, rheumatoid myopathy, EMGBF training brought about increase of the MRA in proportion to the duration of treatment. EMGBF was terminated when MRA on the involved muscle reached to the level of normal side.

3) In case of foreign body in brain, spinal cord stroke and early peripheral nerve injury, EMGBF treatment had no effects.

Long thoracic nerve palsy involving serratus anterior muscle is rare.

This paper will report the case of a 10 yr boy who has developed winging of the scapula after fall down. Manual muscle examination and electrodiagnostic examination indicated the long thoracic nerve palsy.