As you know, we have met with the patients suffered from cervical spondylosis with so to speak paresthesia in daily living. We planned, this time, to search for how clinical assessment about like that kind of paresthesia was to be in practical scene.
The subjects of this studies, they were cared in the out-patient programs, the department of rehabilitation medicine at Teikyo University, 26 cervical spondylosis patients complained of any paresthesia on their arms.
In the first place, to clarify the differences between the normal and patient groups clinicaly, we were planing to check and count sensory and motor conduction velocity, somato-sensory evoked potential and latency of each component. And then, plethysmogram was also checked but decidedly, there was no significant difference between the normal and innormal group statistically.
Accordingly, it has become clear that we had so many items which was to be solved scientifically in these investigations. And that we got to know its difficulities and possibilities to put like this clinical assessment in practice.

Inserting a tangusten microelectrode into the peroneous nerve of the conscious human subject, the authors recorded the discharge of primary afferent C and A δ fibers. Most of the C fibers belonged to the polymodal group, as these were excited by both mechanical and thermal stimulations. These units responded to painful mechanical or thermal stimuli, as well as to non-painful stimuli of these modalities. These polymodal receptors were capable of responding to a wide range of stimulation intensity.
Only some of the Aδ fibers responded to mechanical stimulation of a high intensity and painful thermal stimulation. These units increased their discharge to repeated heat administration showing a marked sensitization. This sensitization corresponded to the sense of increased heat experience by the human subjects who had hyperalgesia from the increasing heat. These findings indicate that these Aδ afferent fibers transmit sensation of hyperalgesia from the hairy skin to the higher centers.

Muscle tenderness or stiffness is generally attributed to local muscle spasm or aggravated tonus however electro-myographic studies have indicated no spontaneous discharge as usual and any kind of change of N M U weve patterns, certainly. There is a great deal of uncertainty about the fundamental chracter, identified factor of these conditions.
To analize (_??_-S curves) -the mean inteerval (_??_) of the single unit NMU discharges and the standard deviation (S) of the same it was learned that these phenomena could be classified into two types of muscle activities, the one is kinetic activity (K-curve) and the other is tonic one (T-curve) so to speak. We conducted examinations concerning about the character of the notor unit activity of the trigger point in low back pain patient with _??_-S relation. In comparison with the distribution of (_??_-S) of the low back pain patient group (14 patients, 295 units) and that of the control group most (_??_) was up to about 120 msec. with (S) relatively stable, an almost horizontal distribution along the x-axis with an increase when (_??_) was any larger.
As compared to this, in most examples in the lumbago group (_??_) was horizontally up to 120 msec. after which a gradual rise xas indicated. The various distributions showed that that of the lumbago group was moved to the right of the awis of co-ordination as was the recovery line. Consequently, we observed that the NMU discharges of the trigger point in low back pain patients showed more tonic activity than that of normal subjects. And this finding strongly indicates that voluntary muscular activity in trigger points is under the predominant influence of spinal motoneuron than homonymous neuron segmentally.

We report a case of transposition of the great arteries (TGA) with severe pulmonary hypertension from the right to left shunt in the right modified Blalock-Taussig shunt. The patient was diagnosed with TGA with a small ventricular septal defect, restrictive patent foramen ovale, and patent ductus arteriosus. Balloon atrial septostomy was performed, and an arterial switch operation (ASO) was planned. However, ASO was delayed during the neonatal period due to cerebral bleeding. Moreover, left outflow tract obstruction was noted ; hence, the surgical strategy was shifted to an atrial switch operation or Rastelli type operation. The patient was palliated at the age of 5 months with a right 4-mm Gore-Tex modified Blalock-Taussig shunt. After this procedure, he was followed up at the outpatient clinic with good saturation level. However, at 9 months, he revisited the hospital due to septic shock. His SpO2 was 60% in the upper right limbs and 40% in the upper left and lower limbs. Nitric oxide inhalation and 100% oxygen were administered to improve pulmonary hypertension and subsequent differential cyanosis. Pulmonary hypertension decreased from over-systemic to 70% of the systemic arterial pressure. The Senning procedure with a fenestration in an atrial baffle was successfully performed at the age of 1 year.