Citations
Method: Ulnar motor nerve conduction studies were performed bilaterally in twenty healthy adult volunteers. For each limb, nerve conduction study was carried out in two different positions. In the first position, shoulder were abducted, elbow and wrist flexed to 90o. For the second position, all joints were kept constant except for the wrist where it was extended. Routine conduction study was performed in both wrist positions. All data were statistically analyzed.
Results: The average conduction velocities in the wrist flexed position were 61.6 m/sec for the forearm segment and 62.3 m/sec across elbow. With the wrist extended, the average was 62.6 m/sec and 64.1 m/sec, respectively. The differences in conduction velocities between two different wrist positions were statistically significant (p＜0.05). In the wrist flexed position, the average measured latencies were 2.3 msec with wrist, 5.4 msec below elbow, and 7.4 msec above elbow stimulation, compared to wrist extended which showed 2.4, 5.4 and 7.2 msec, respectively. The difference of latencies at wrist between the two wrist positions was statistically significant (p＜0.05).
Conclusion: The authors conclude that wrist position affect ulnar nerve conduction velocity.
Method: Twenty one brain injured patients with PEG Foley catheter were studied and divided into three groups by indwelling duration. The balloon of Foley catheter was inflated with 5 ml of normal saline. We calculated the deflating velocity of the balloon by estimating remained amount of normal saline and indwelling duration at the time of replacement.
Results: In 6 patients, the PEG Foley catheter was pulled out easily before aspiration of remained normal saline. In all of these cases, remained amount of normal saline was less than 2 ml. The deflating velocities of the balloons were 0.057⁑0.024 ml/day in cases with 3 to 4weeks of indwelling duration, 0.066⁑0.005 ml/day with 4 to 5 weeks, 0.067⁑0.012 ml/day with above 5weeks. The mean deflating velocity was 0.063⁑0.016 ml/day in human. The deflating velocity was slower than that of the previous study in vitro.
Conclusion: The mean days of deflation of the balloon of total PEG Foley catheter down to 2.5 ml were 42.1 days. We suggest that the PEG Foley catheter would be replaced within 42 days after exchange. (J Korean Acad Rehab Med 2003; 27: 485-488)
Method: Sixty healthy adult men performed five maximal isokinetic knee extension-flexion contractions in each of two contralateral leg stabilization conditions at different angular velocities. In the "Front condition", the test was done with a bar in front of the ankle joint of the non-testing leg. In the Fix condition", the non-testing leg was strapped and induced reciprocally to perform isometric contractions with respect to the testing leg. From the measured values, we calculated the strength difference ratio ([Peak Torque (PT) of "Fix condition"-PT of "Front condition"]⁓100/PT of "Front condition") at each angular velocity.
Results: By comparing the extensor strength, greater PTs were measured at the "Fix condition" in all tested angular velocities (p＜0.01). For the flexor, the PTs of both conditions were similar. The strength difference ratio decreased as angular velocity increased (r=0.48, p＜0.01) in the extensor.
Conclusion: We could infer the crossed extension-flexion reflex is more apparent in the lower angular velocity than in higher one. (J Korean Acad Rehab Med 2003; 27: 255-259)
Objective: The purpose of this study is to find out whether amplitude ratio and area ratio have correlation with nerve conduction velocity in the diabetes mellitus patients.
Method: Median and deep peroneal motor nerve conduction study was performed in thirty-five normal control group and sixty diabetes mellitus patients group. The motor conduction velocity, amplitude ratio, and area ratio of the compound muscle action potential (CMAP) were measured. The experimental subjects were divided into 6 subgroups (in median nerve: M1, M2, M3, in peroneal nerve: P1, P2, P3) according to the median value of conduction velocity of each nerve; group M1 (n=35) and P1 (n=30): normal control group, group M2 (n=25) and P2 (n=30): below the median value of motor nerve conduction velocity in diabetes mellitus patients, group M3 (n=23) and P3 (n=29): above the median value of motor nerve conduction velocity in diabetes mellitus patients.
Results: There was no significant difference of area ratio between the each subgroups in both median and peroneal nerves. There was a significant difference of amplitude ratio between the M1 and M2 subgroups. There was a significant difference of amplitude ratio between the P1 and P2, P3 subgroups.
Conclusion: According to above results, the decrease of amplitude of compound muscle action potential along with the decrease of conduction velocity seems to be helpful in the electrophysiologic diagnosis of diabetic neuropathy.
Objective: Tarsal tunnel syndrome (TTS) is relatively rare and can be difficult to diagnose with conventional electrodiagnostic techniques. To increase the diagnostic sensitivity, we measured transtarsal conduction velocities of medial and lateral plantar nerves recorded by orthodromic near-nerve recording.
Method: Twenty normal subjects (aged 24∼59) were studied. For below flexor retinaculum (BFR) recordings, near-nerve needle recording electrodes were positioned posteriorly to the flexor digitorum longus tendon in medial plantar nerve and anteriorly to the calcaneus in lateral plantar nerve at the level of lower border of medial malleolus. For above flexor retinaculum (AFR) recordings, near-nerve needle recording electrodes were positioned anteriorly to the Achilles tendon 4 cm proximal to the BFR recording electrodes in medial and lateral plantar nerves. Stimulating ring electrodes were placed to the digit I and V.
Results: Transtarsal latencies and conduction velocities for medial plantar nerve were 0.7⁑0.1 msec, 56⁑6 m/sec, respectively. Transtarsal latencies and conduction velocities for lateral plantar nerve were 0.8⁑0.1 msec, 54⁑6 m/sec, respectively.
Conclusion: This approach may improve the diagnostic sensitivity in TTS.
Objective: To find out the incidence of reduced median conduction velocity of forearm (MNCV-F) in carpal tunnel syndrome (CTS) and to compare clinical and electrophysiologic characteristics of CTS with reduced MNCV-F and to observe the changes of reduced MNCV-F after carpal tunnel release.
Method: One hundred and fifty nine hands with CTS are divided into two groups; MNCV-F of 50 m/sec and above as group I and that of below 50 m/sec as group II. For the electrophysiologic comparison, median sensorimotor distal latency, peak-to-peak amplitudes and abnormal spontaneous activity of abductor pollicis brevis were observed and for clinical comparison, sensorimotor symptoms, Phalen and Tinel sign were observed. Twenty four hands which had successful carpal tunnel release were examined for the changes of MNCV-F.
Results: The hands with reduced MNCV-F were 29 among 159 hands. Sensorimotor distal latency were significantly prolonged and sensorimotor amplitudes also significantly reduced in group II. Sensory change and Phalen signs were more frequently observed in group II. MNCV-F in group I had not changed after carpal tunnel release, but MNCV-F in group II was improved significantly. The changes MNCV-F in group II were much delayed than the improvement of parameters of distal conduction studies.
Conclusion: The incidence of reduced MNCV-F in CTS was 18.24%. Patients with reduced MNCV-F had more severe CTS both electrophysiologically and clinically. Reduced MNCV-F had improved significantly, but there was significant time gap between the electrophysiologic improvements of distal and proximal portions of nerve. This findings may suggest that retrograde degeneration may play a partial role in reduced forearm motor nerve conduction velocity of the median nerve in CTS.
Objective: The purpose of this study was to evaluate hemodynamics for diabetes mellitus (DM) by transcranial Doppler sonography (TCD) and to evaluate the influences of risk factors to cerebral hemodynamics in DM.
Method: We examined 54 normal persons, 17 patients with DM without risk factors, and 15 patients with DM and risk factors. The risk factors were hypertension, smoking, and hyper lipidemia (total cholesterol ＞240 mg/dl, low density lipoprotein ＞160 mg/dl). Mean blood flow velocity (MBFV) was also analyzed by Angiodine 2 Doppler system operating at 2 MHz frequency from each subjects.
Results: There was a significant decrease of MBFV in the diabetes in comparison to control groups (p＜0.05). There was a significant decrease of MBFV in the diabetic risk group as compared to diabetic non-risk group (p＜0.05). There was significantly increased total cholesterol, low density lipoprotein, low density lipoprotein/high density lipoprotein ratio in the diabetic risk group as compared to diabetic non-risk group (p＜0.05). MBFV significantly decreased with increasing concentration of HbA1C and duration of DM (p＜0.05).
Conclusion: We suggest that transcranial Doppler sonography can be used as one of the useful screening tests for early detection of cerebrovascular diseases in DM.
Objective: To investigate the muscle fiber conduction velocity and histopathologic changes in skeletal muscle after 7% phenol solutions intramuscular injection.
Method: Forty-five Sprague Dawley rats were divided into two groups: Experimental group, 30; Control group, 15. Experimental and control groups were injected with 0.1 cc of 7% phenol solution and 0.9% saline in right gastrocnemius, respectively. The histopathologic findings and muscle fiber conduction velocity were evaluated at 0, 1, 5, 14, and 28 days after each injection.
Results: In the light microscopic examination of experimental groups, vacuolar change, atrophy of myofibers, and intermyofiber cell proliferation were shown. The expression of synaptophysin began to be seen at 5 days and S-100 protein was increased 14 days after injection. In the electron microscopic examination of experimental groups, vacuolar change and denuded postsynaptic membrane were shown. In muscle fiber conduction study of experimental groups, the mean velocity were significantly slowed at 1, 5, 14, and 28 days after injection than those of control groups (p＜0.05).
Conclusion: On the basis of histopathologic findings, it is presumed that the mechanisms of paralysis following intramuscular injection of 7% phenol solutions were both myogenic and neurogenic. The slowing of muscle fiber conduction velocity tended to be related with the histopathologic changes of skeletal muscles after intramuscular injection with 7% phenol solution.
Objective: The purpose of this study is to prove protective action of melatonin on the development of neuropathy in diabetic rat.
Method: The experimental rats (Sprague-Dawley) were divided into 3 groups: Group 1, streptozotocin-induced diabetic rats with trial of melatonin; Group 2, streptozotocin-induced diabetic rats without trial of melatonin; Group 3, normal control. Streptozotocin was injected intraperitoneally in group 1 and 2. Melatonin was administered per orally in group 1 from 1 week after the injection of streptozotocin. The melatonin effect on diabetic neuropathy was evaluated by the measurement of conduction velocities and amplitudes of rat tail mixed nerve action potentials. The electrophysiologic examinations were performed before and 2, 4, and 6 weeks after administration of streptozotocin.
Results: The rat tail mixed nerve conduction velocities were decreased at 4 weeks in group 1 and 2, and showed significant improvement at 6 weeks in group 1 as compared with those of group 2 (p＜0.05). The amplitudes of the compound nerve action potentials did not show difference before and after streptozotocin and melatonin trials, neither among groups.
Conclusion: In this experimental study, we observed the inhibitory effect of melatonin on the progression of polyneuropathy in early stage of diabetic rat. For the clinical application to human beings, further study is required.
Objective: To investigate the conduction velocity of sympathetic skin response(SSR) in normal adults.
Method: The latency of SSR was measured in 41 normal healthy subjects by the simultaneous recordings from three sites of the hand. And we also measured the distance and conduction time between the recording sites of the hand. The conduction velocity of SSR was calculated by dividing the distance by conduction time.
Results: The SSR was obtainable in all subjects from three sites of the hand. The mean latencies of SSR recorded from wrist, midpalm and index finger were 1.29, 1.40 and 1.54 seconds respectively. And the mean latency showed a significant increase from wrist to index finger(p＜0.05). The conduction velocity of the SSR from wrist to index was 0.57 m/sec, and segmental conduction velocities from wrist to palm and palm to index were 0.62 and 0.66 m/sec respectively. The conduction velocity of SSR in the distal segment was slightly faster than in the proximal segment with no statistical significance.
Conclusion: The conduction velocity of SSR by the simultaneous recordings at two or more sites of the hand can be easily obtained and offers a useful parameter along with the amplitude and latency of SSR.
Objective: To establish the normal values of the transcranial doppler sonography in healthy Korean adults according to the increasing age and sex.
Method: We examined 68 healthy adult volunteers who had no history of diabetes mellitus, hypertension, cerebrovascular disease or other neurological illness. The study included 54 subjects from whom good doppler signals from the middle, anterior, and posterior cerebral arteries could be obtained. Mean blood flow velocity (MBFV), Resistance index (RI), and Pulsatility index (PI) were analyzed by Angiodine 2 Doppler System operating at 2 MHz frequency.
Results: MBFV significantly decreased with the increasing age in the middle, anterior and posterior cerebral arteries (p＜0.05). There was a significantly decreased MBFV of the middle cerebral artery in the 4 th, 5 th, 6 th, and 7 th decades compared to the 3 rd decade (p＜0.05). RI and PI were significantly increased with the increasing age (p＜0.05). MBFV of the female subjects were greater than the male subjects (p＞0.05). There was no significant difference in the RI and PI between the male and female subjects.
Conclusion: We suggest that the transcranial doppler sonography can be used as one of the useful screening tools for the diagnosis of cerebrovascular diseases.
The purpose of this study was to obtain the normative values for variable parameters of lumbar function with the isoinertial triaxial dynamometer in normal subjects and to compare these values with those of the patients with chronic low back pain.
In 82 normal subjects and 27 patients with chronic low back pain, the variable parameters including lumbar range of motion (ROM), maximum isometric torques, and maximum isoinertial velocities were measured with the isoinertial triaxial dynamometer in three axes (rotation, flexion-extension, and lateral flexion). In normal subjects, all parameters except lumbar ROM of all three axes were significantly higher in the male group than the female group. However, other anthropometric variables such as age, height, weight, and body mass index were little correlated with each parameter. Therefore, the normative values were obtained only in consideration of the gender. In patients with chronic low back pain, all parameters except the maximum isometric torques in the female group were significantly lower than those in normal subjects. In addition, the decrease of maximum velocities during the isoinertial exercise was highly correlated to verbal rating scales (VRS) in most axes, especially in the female patient group, but the duration of low back pain was little correlated with the various parameters measured with the isoinertial triaxial dynamometer.
In conclusion, all parameters measured with the isoinertial triaxial dynamometer in all three axes were significantly lower in patients with chronic low back pain than those in normal subjects except maximum isometric torques of female group. It was suggested that maximum isoinertial velocities were more reliable and significant than maximum isometric torques for the objective assessment of chronic low back pain.
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