Glycogen depletion of type I and type II muscle fiber was studied during exercise with prednisolone treated rat skeletal muscles. Glycogen content in individual fibers were calculated as optical denity of Periodic Acid-Schiff (PAS) stain and structural changes were observed under electron microscope.

The experimental rats were divided into 6 group: In the control group, nothing but injection of distilled water was applied. First group was exercised only without prednisolone treatment. Second, third and fourth groups respectively had, 5, 10, 15 days of prednisolone treatment with exercise and the fifth group had 30 days of recovery after the completion of 15 days prednisolone treatment with exercise.

Glycogen depletion was observed in almost all type I fibers during the short term exercise, and in about 90% of Type II fibers with prolonged exercise. Glycogen restoration was observed more in type II fibers after 30 days rest than in Type I fibers.

In the ultrastructural observations for rats with 5 days exercise without prednisolone treatment the noticeable findings were the disappearance of A and I bands in the myofibrils of both soleus and gastrocnemius.

However, these bands appered to be gradually increased with the exercise of the muscles and prednisolone injection for 5, 10, 15 days (group 2, 3, 4).

In one of the groups exercised for 5 days (gruop I), the glycogen particles of the former, however, decreased successively reaching to the group 4 or 5. And those of the latter were markedly decreased in all groups (group 1∼5).

In both type I and type II fibers, most of mitochondria showed electron lucent area (hydrophilic degeneration) with the 30 days rest after the completion of 15 days treatment of prednisolone with exercise.

The sarcoplasmic reticulum showing marked dilatation of its cistern was not found in the type II fibers but it was found in many areas of myofibril of the I fibers.

From these results, it may suggest that exercise induce the glycogen depletion in prednisolone treated skeletal muscles as well as in normal skeletal muscles in both type I and type II fibers and it may give some organellar changes in the muscles fibers as mentioned above.

The purpose of this study was to demonstrate the predictive value of Vojta's postural reaction and other neurological examinations for early diagnosis of cerebral palsy.

The subjects of this study were 148 infants with motor disturbance who visited the Department of Rehabilitation Medicine, Yonsei University College of Medicine from December, 1987 to October, 1990.

The results are follows:

1) The mean age at initial examination was 4.7 months and the largest group (61 children; 48.0%) was the 1∼3 month of age group.

2) At final examination, 82 children were norma, 47 children were confirmed as cerebral palsy and 21 children had a variety of other diagnosis.

3) Among 10 groups of risk factors the highest prevalence of cerebral palsy was 42.9% in the perinatal asphyxia group, 42.4% in the prematurity group and 40.0% in the seizure group.

4) In the postnatal 0∼6 month period, significant neurological examinations and signs to detect brain dysfunction were Vojta's postural reactions, developmental delay and change of muscle tone (p<0.001).

5) In the groups who showed very light central coordination disturbance at initial examination, only 4.4% were later confirmed as cerebral palsy, but in severe central coordination disturbance group, 92.0% were confirmed as cerebral palsy. The higher the grade of central coordination disturbance, the greater the tendency to be identified as cerebral palsy by the time of final evaluation (p<0.001).

6) The sensitivity of the method used to diagnose cerebral palsy in this study was 95.6% (100% after 4 months) and the specificity was 65.9%.

According to the above results, Vojta's postural reaction method was useful in the early diagnosis of infants younger than 1 year and especially those younger than 6 months of age.

Under the assumpation that the constant biphasic appearance of H-wave is one of the useful parameters in H-reflex study, this study was designed to compare the 3 different recording techniques of H-reflex with surface electrode. The H-reflexes were recorded in 20 normal healthy male subjects from the posterior side of soleus; midpoint between medial malleolus and popliteal crease (methold 1), the medial head of gastrocnemius muscle (method 2), and the soleus, just medial to tibial crest, at the midpoint of tibia (method 3). Also, by usin g the above 3 methods, intrapersonal variations of H-reflexes were compared with one another. The conclusions were as follows.

1) H-latency at the medial gastrocnemius (method 2) was shortest as 28.01 msec and H-latency of posterior soleus was similar with that of medial soleus.

2) H-amplitude and H-area at the medial soleus (method 3) were largest as 5.98 mV and 21.76 ՌVsec, respectively.

3) The shape of H-reflex was biphasic with initial negative deflection in method 3, but triphasic with initial positive deflection in method 1 and method 2.

4) There was no significant difference in intrapersonal variabilities among the above e methods.

So, we think it is better to record H-reflex at the medial side of soleus (method 3) than posterior side. And H-reflex recording at the medial gastrocnemius can be used as useful as that of soleus.

Carpal tunnel syndrome (CTS), median neuropathy at the wrist is the one of the most common entrapment syndrome. Recently, an electrophysiologic study has been widely used as a tool for the diagnosis of neuromuscular disorders such as entrapment neuromuscular disorders such as entrapment neuropathy, polyneuropathy, myopathy, etc.

We performed the clinical study in 70 patients with a clinically suspected carpal tunnel syndrome in the Department of Rehabilitation Medicine, Catholic University Medical College from January 1988 till June 1990.

The summary of the results obtained was as follows:

1) Among 70 persons with a clinically suspected carpal tunnel syndrome, 52 patients were diagnosed as carpal tunnel syndrome and 7 as cervical radiculopathy. Also there is no definite abnormality in 11 persons.

2) Among 52 patients with carpal tunnel syndrome on electromyographic study, 33 patients were diagnosed as bilateral carpal tunnel syndrome.

3) The 31 patients complained the only sensory symptom, 5 patients did the only motor symptom and 16 patients did both symptoms.

4) Physical findings consisted of positive Phalen sign in 42% of the involved hands, positive Tinel sign in 36% of them, and weakness or thenar atrophy in 29% of them.

5) On electromyographyc study, abnormal finding was found I sensory fiber (92%), motor fiber (69%) and needle EMG (63%) in order of frequency.

6) The 4 patients were combined carpal tunnel syndrome with cervical radiculopathy.

7) Among 32 patients with a clinically syspected unilateral carpal tunnel syndrome, 13 (14%) were diagnosed as bilateral carpal tunnel syndrome.

Considering above results, the other hand should be examined in spite of the patients with clinically suspected unilateral carpal tunnel syndrome and cervical radiculopathy be ruled out on electromyographic study.

10ADLs evaluation was done on 64 patients with CVA (cerebrovascular accident), TBI (traumatic brain injury) or SCI (spinal cord injury) during the period 1 May 1988 through 1 May 1991.

10ADLs as a disabled patients evaluation tool was introduced previousely¹⁾.

Following results were obtained:

1) Number of patients in each group were 24 for CVA, 27 for TBI and 13 for SCI (Table 2). The average age was 50.4 years for CVA, 33.7 years for TBI and 41.6 years for SCI. Man was predomint in all 3 group (Table 1)

2) The average improvement score in each group was 6.5 in CVA, 6.4 in TBI and 3.2 in SCI (Table 2).

3) There was significant correlation between ADL improvement and duration of the rehabilitation treatment in all 3 groups.

4) There was no significant correlation between ADL improvement and motivation of the patients in all 3 groups.

5) There was correlation between ADL improvement and how early the initiation of rehabilitation treatment from onset of the illness or injury in TBI group but no significant correlation in CVA and SCI in this study.

6) The improvement was seen all area of ADL in all 3 groups except stair climbing and transfer activity in SCI group.

Clinical applications have been found for lasers in a number of medical and surgical specialties. The high power applications for surgical procedures and hemostasis are well known; however, less dramatic but potentially important biologic effects at powers as low as fractions of milliwatts have also been reported. Although the medical applications of lowpower lasers remain controversial, the clinical use of these devices for a variety of analgesic and wound healing applications is steadily increasing.

Our study was initiated to determine whether low-energy laser stimulation could produce a thermal effect. We used twelve rabbits to examine the tissue temperature change of low-energy infrared laser irradiation. No statistically significant difference between before and after low energy laser irradiation was noted. On the bases of this study, we saw no thermal effect of low-energy infrared laser in skin, subcutaneous tissue, and muscle.

Radiological analysis of bone quality in terms of the pattern of trabecular bone in the proximal end of the femur (Singh index) was performed in 141 patients with hip fractures and 120 control subjects. The incidence of osteoporosis in the fracture group was 34.0% as compared to 0.8% in the control group. The incidence was higher in women(16% in the fracture group and 0% in the control group). The prevalence of osteoporosis increased with advancing age both men and women.¹⁾

The purpose of this study is to investigate the status of the rehabilitation of the residencial stroke patients in a rural community and to evaluate their needs for the rehabilitation and home modification.

The subjects were 41 stroke patients who lived in northern Wanju county.

The results were as follows;

1. Average age of the stroke patients was 65 years old for males (25 cases) and 58 years old for females (16 cases).

2. The most prevalent premorbid disease was hypertension (34.2%) and the second most prevalent was diabetes mellitus (4.95%), 58.9% of the patients who softened from premorbid disease received treatment.

3. Stroke occured most frequently in the spring. Thirteen cases (31.7%) occured in that season.

4. The most frequent initial symptom of stroke was weakness or paralysis of limbs which were experienced in 24 cases. Speech disturbance was the second most frequent symptom and was experienced in 10 cases.

5. Thirty-five cases (85.4%) received primary medical care after onset of the stroke, but only 17 cases (41.5%) received was lack of information about rehabilitation therapy.

6. Only twelve patients (29.3%) had the needs for further rehabilitation therapy.

7. The majority of the patients had barriers in their home structure. The common barriers were stairs, toilets, and floor design. Only 2 patients among them had the needs for home modification to abolish their barriers.

Neuromuscular adaptations to a submaximal static contraction for a period of one minute were investigated using healthy adult as frequency components of the electromyogram. Spectral analysis of the EMG signal revealed a shift to lower frequency components and a concurrent increase in the amplitude as a response to fatigue.

The magnitude of this SEMG frequency content shifts to lower values has been related to the intensity and duration of contraction.

The frequency shift and increase amplitude for the EMG signal were discussed in light of evidence for recruitment and synchronization of motor units and changes in muscle fiber conduction velocity as possible mechanisms.

Transmission of trains of stimuli were investigated in human sensory and motor median nerves. We studied the effect of prolonged high-frequency stimulation in normal median nerves. Nerves could conduct impulses at 50 Hz for 30 minutes without complete conduction block. However, there was a statistically significant increase in latencies of the compound muscle action potential and sensory action potential. These change were reversible upon cessation of stimulation.

Dissecting aneurysm is the most common acute disease of the aorta. Classification of the types of nervous system involvement I cases of dissecting aortic aneurysm usually includes three types, depending on whether ischemic changes involve the peripheral nerves, spinal cord, or brain.

Ischemic spinal cord lesions with aortic dissecting aneurysm are rare and clinically they present flaccid paraplegia.

We have seen one case of complete paraplegia due to aortic dissecting aneurysm and report the case of complete paraplegia due to aortic dissecting aneurysm and report the case here with its clinical manifestations, laboratory data, radiologic findings and rehabilitation management.

We describe the clinical features and electromyographic findings of two patients who had childhood onset nemaline myopathies, confirmed by muscle biopsy. This autosomal dominantly inherited myopathy is characterized by the presence of rod-shaped bodies within muscle fibers and the predominance of type I fibers with concomitant atrophy. In addition to diffuse weakness and hypotonia, the clinical features include and elongated face, a highached palate, kypho-scoliosis, pes caves and talipes equinovarus. This myopathy can present at any age and can be divided into three groups, such as the severe neonatal form, a milder childhood form and an adult form. EMG findings in nemaline myopathy has usually show "myopathic" features, but normal or even patterns compatible with "neuropathy" are also shown. Electromicroscopic features consist of the accumulation of nemaline bodies under the sarcolemma and between the myofibrils, and enlargement and streaming of the Z disks. The rods appear to originate from the Z disks and the weakness seems to be related not to the nemaline bodies but to the Z disk alteration.

Posterior interosseous syndrome is a neuropathy of the deep muscular branch of the radial nerve. Just distal to the elbow the posterior interosseous nerve can be compressed by tumors, ganglia, or fibrous of joint capsule, or by a spontaneous compression that may occur at the point of passage through the arcade.

We reports the 4 cases of posterior interosseous syndrome which was not related to trauma.

Fecal incontinence in patients with myelomeningocele is a serious psychosocial problem and often is considered an obstacle to the child attending an ordinary school. This bowel management programs play an important role in the rehabilitation of these children.

We report that an fecal incontinence in 8 years old myelomeningocele child had been successfully treated by EMG biofeedback after reconstruction of anal sphincter with gracilis muscle.

Isolated axillary nerve injury following blunt trauma to the shoulder without associated fracture or dislocation is very rare and failure to recover is common.

This is a review of 4 cases about type of trauma, clinical and electrodiagnostic examination, assessment, management and their prognosis.

Of the various entrapment neuropathies, we can meet the Carpal Tunnel Syndrome most frequently in clinic. And the development of electrophysiological study enables us to diagnose Tarsal Tunnel Syndrome more easily, so we can experience these cases occasionally.

Generally, entrapment neuropathies are classified into two main causes, the one is localized problem and the other is systemic one. The systemic causes have been said that they are accompanied with various diseases such as rhumatoid arthritis, ankylosing spondylitis, diabetes mellitus, etc. So special and precise studies for their differential diagnosis are required.

In addition, entrapment neuropathies combined with hyperlipidemia has been hardly reported yet, and the reports for these cases are very rare at home and abroad. Now, this paper reports two cases which had been diagnosed as Tarsal Tunnel Syndrome accompanying hyperlipidemia and diabetes mellitus, and also reports for the relationship between hyperlipidemia and entrapment neuropathies, their pathology, and book review.

Iontophoresis, the process of increasing the penetration of drugs into surface tissues by the application of an electric current, has been applied to a great many disease conditions, such as multiple cutaneous, musculoskeletal, and neurological conditions. A 24-year-old female patient exhibited significant hyperhidrosis of palms, which was defined as excessive sweating of the palms resulting in a social or occupational handicap, was treated by tap water iontophoresis. This symptom abated upon daily treatment method for four weeks, only to return upon its inadvertent discontinuation. This treatment method was well tolerated without serious side effect. Although further experience is needed, tap water iontophoresis may be an effective treatment option in idiopathic hyperhidrosis.