No abstract available.
Erythrocytes*

OBJECTIVE: To study the changes of magnetic evoked potentials by thinking of simple motion without actual muscle action of that motion. METHOD: We use H-reflex to test the excitability of relevant pools of spinal motor neurons and Magnetic Evoked Potentials (MEPs) to study the core of brain motor activity. The H-reflex and MEPs were obtained in three different conditions. 1) non-facilitation (NF), that is, resting state without actual motion and without thinking of that motion. 2) volitional-faciliation (VF), with actual motion which is usual manner of facilitation of MEPs. 3) thinking-facilitation (TF), without actual motion but with imaginary thinking of that motion. We evaluate the thresholds, amplitudes and latencies of H-reflex and MEPs in each three condition. RESULTS: Comparing with the parameters in NF condition as a baseline, there were no significant changes in any parameters of H-reflex in TF condition, but there were significant changes in threshold and amplitude of H-reflex in VF. On the while there were significant changes both in VF and TF of MEPs. The amount of facilitation of MEPs were greater in VF than in TF; the amount threshold decrement, amplitude increment and latency decrement of MEPs were greater in VF than in TF. CONCLUSION: Thinking of simple motion without actual muscle action of that motion could facilitate the MEPs, and this facilitation is induced by increasing activity of brain motor cortex not by that of spinal cord level.
Brain ; Evoked Potentials* ; H-Reflex ; Motor Activity ; Motor Cortex ; Motor Neurons ; Spinal Cord ; Thinking*

OBJECTIVE: This study was designed to evaluate the usefulness of stretch reflex threshold speed (SRTS) in biomechanical assesment of spasticity of hemiplegic patients. METHOD: Thirty-eight hemiplegic patients and twenty-seven control subjects were studied. The spasticity of ankle plantar flexor muscles were assessed both clinically and biomechanically. Modified Ashworth scale (MAS) and Brunnstrom stage were used in clinical assessment. For biomechanical assessment, ankle plantar flexor muscles were stretched isokinetically while EMG signals were recorded simultaneously. SRTS was defined as a minimum angular velocity in which EMG signals evoked by stretch reflex were recorded. RESULTS: SRTSs of ankle plantar flexors were 128.1 47.1o/sec in control group, 163.7 79.7o/sec in intact legs, and 83.4 69.1o/sec in involved legs of hemiplegic group. STRS was significantly lower in involved legs of hemiplegic group than in intact legs of hemiplegic group and control group. Significant reverse correlation was observed between SRTS and MAS. There was significant difference in SRTS between MAS 0 group and other groups. The patients with Brunnstrom stage 3 and 4 groups showed decreased SRTS compared to the patients with other groups. CONCLUSION: SRTS is thought to reflect increased excitability of stretch reflex and seems to be one of useful parameters in quantitative assessment of spasticity.
Ankle ; Equidae ; Hemiplegia ; Humans ; Leg ; Muscle Spasticity* ; Muscles ; Reflex, Stretch*

OBJECTIVE: To observe changes in reflex threshold and gain in spastic muscles and to find useful parameters in biomechanical assessment of spasticity. METHOD: Ankle plantar flexor muscles of twenty two hemiplegic patients were stretched by isokinetic dynamometer. Stretching was done at the velocities of 10degrees/sec, 300degrees/sec, and at the threshold velocity (e.g. lowest velocity at which electromyographic evidence of stretch reflex was recorded). Peak eccentric torque, torque at joint angle of 20degrees, torque threshold angle, and stiffness index were measured. RESULTS: Peak eccentric torque and stiffness index were increased and torque threshold angle was decreased in hemiplegic side. Peak eccentric torque and stiffness index were increased at 300degrees/sec compared to 10degrees/sec. Stiffness index showed significant correlation with modified Ashworth scale at 300degrees/sec and threshold velocity. CONCLUSION: Both reflex threshold and reflex gain were changed in spastic muscles. Stiffness index was thought to be one of useful parameters in biomechanical assessment of spasticity.
Ankle ; Hemiplegia ; Humans ; Joints ; Muscle Spasticity* ; Muscles ; Reflex ; Reflex, Stretch ; Torque*

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.
Carpal Tunnel Syndrome* ; Forearm* ; Hand ; Humans ; Incidence ; Median Nerve* ; Neural Conduction ; Retrograde Degeneration

OBJECTIVE: This study was designed to evaluate the correlation of periventricular leukomalacia (PVL) on brain MRI and Denver II and Capute developmental test. METHOD: Thirty children with PVL on brain MRI showing delayed development were included. The severity of PVL was graded as localized/generalized lesion in three fields; periventricular hyperintensity in T2 weighted image (PVHI in T2WI), reduced volume of cerebral white matter (RV of CWM), ventriculomegaly with periventricular wall irregula rity (VM with PVWI). Development quotients were obtained by Denver II and Capute test, and assessed according to the severity of PVL. RESULTS: Although language, fine motor-adaptive, personal- social scale of Denver II and cognitive-adaptive and clinical linguistic and auditory milestone of Capute test had little correlation with severity of PVL, gross motor developmental scale assessed by Denver II had a certain degree of correlation with severity of PVL which was not significant statistically. The gross motor developmental scale of the nineteen preterm births had a significant correlation with VM with PVWI, but the other developmental scales still had no significant correlation with PVL. CONCLUSION: As for the children with delayed development the degree of motor development was a significant predictor of the PVL on brain MRI, but those of language and cognitive development were not.
Brain* ; Child ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular* ; Linguistics ; Magnetic Resonance Imaging* ; Premature Birth ; Weights and Measures

OBJECTIVE: This study was designed to evaluate the effect of stretching on decreasing spasticity of ankle plantar flexor muscles by biomechanical assessments. METHOD: Twenty two ankle joints of nineteen patients with upper motor neuron lesion were included. The spasticity was assessed both clinically and biomechanically before and after stretching of ankle plantar flexor muscles by tilt table. For clinical assessment modified Ashworth scale (MAS) was used. For biomechanical assessment, ankle plantar flexor muscles were stretched isokinetically while EMG signals were recorded simultaneously and peak eccentric torque, stiffness index and stretch reflex threthold speed (SRTS) were measured. RESULTS: Two cases showed improvement in MAS after stretching but the others did not. SRTS of ankle plantar flexor was increased significantly while peak eccentric torque and stiffness index were unchanged. CONCLUSION: Passive stretching of ankle plantar flexor muscles decreased the stretch threshold, that is a neural component of spasticity but it did not decrease the mechanical component of spasticity.
Ankle Joint ; Ankle* ; Humans ; Motor Neurons ; Muscle Spasticity* ; Muscle Stretching Exercises* ; Muscles* ; Reflex, Stretch ; Torque

OBJECTIVE: It is a widely accepted belief that paraspinal muscles tend to show spontaneous activity on needle electromyography early on in a radiculopathy and distal muscles become abnormal later on. But most studies have shown the limitations of using symptom duration when interpreting electrodiagnostic findings in radiculopathy. The purpose of this study was to determine the relationship between symptom duration and abnormal spontaneous activity in S1 radiculopathy confined to abnormal H-reflex. METHOD: A retrospective study that collected the informations on symptom duration and spontaneous activity in paraspinal muscle and gastrocnemius for 112 patients with S1 radiculopathy diagnosed by unilateral H-reflex abnormality was undertaken. RESULTS: Abnormal spontaneous activity in paraspinal muscle had shown a significant negative correlation with symptom duration, that is a tendency to decrease its expression over symptom duration. On the contrary abnormal spontaneous activity in gastrocnemius muscle was rare at first a few weeks and became to show after 7 weeks. Patients with symptom duration over 1 year had higher incidence of having no abnormal spontaneous activities both in paraspinal and gastrocnemius muscle. CONCLUSION: These results suggested that symptom duration had a potential role in the diagnosis of S1 radiculopathy when H-reflex were abnormal unilaterally.
Diagnosis ; Electromyography ; H-Reflex ; Humans ; Incidence ; Muscle, Skeletal ; Muscles ; Needles ; Paraspinal Muscles ; Radiculopathy* ; Retrospective Studies

BACKGROUND: In Korea, cerebrovascular accident (CVA) is the most significant cause of death among older people, and the incidence of cerebral hemorrhage is much higher than that of developed countries. There have been many investigations about the risk factors for CVA in both Korea as well as developed countries. A few papers reported various risk factors for cerebral hemorrhage in developed countries:however, well-designed studies of risk factors for the various causes of CVA were rare in Korea. Therefore, the purpose of this study was to compare the risk factors for the various causes of CVA and to evaluate the risk factors compared with age- and sex-matched control groups. In addition, duplex sonographic findings of the carotid artery were evaluated in patients with cerebral infarction. METHODS: One hundred and sixty-four patients admitted to the hospital in 1996 were enrolled. The four groups were divided based on the following states: cerebral infarction (n-63), cerebral hemorrhage (n-64), cerebral infarction with atrial fibrillation (n-19), and lacunar infarction (n-18). Major risk factors were compared with age- and sex-matched control groups and among CVA groups. Duplex sonography of the carotid artery was done in 14 patients with cerebral infarction. RESULTS: In multiple logistic regression analysis, patients with cerebral infarction had higher prevalence of diabetes mellitus and lower high density lipoprotein-cholesterol level than the control group, and hypertension showed borderline significance. Patients with cerebral hemorrhage had higher prevalence of hypertension, higher high density lipoprotein-cholesterol level, and more frequent prevalence of smoking compared with the control group. Patients with cerebral infarction showed lower high density lipoprotein-cholesterol, higher low density lipoprotein-cholesterol levels, more frequent diabetes mellitus, lower prevalence of hypertension and older age than patients with cerebral hemorrhage. Patients with cerebral infarction and atrial fibrillation showed only older age than patients with cerebral infarction only. There were no differences in risk factors between patients with cerebral infarction and lacuna infarction. Atheromatous plaque was found in 71% of patients with cerebral infarction. CONCLUSION: Metabolic abnormalities played more important role in the development of cerebral infarction and hemodynamic abnormalities in cerebral infarction. Sonographic examination of the carotid artery may be useful for predicting the occurrence of cerebrovascular accident in high risk patients.
Atrial Fibrillation ; Carotid Arteries* ; Cause of Death ; Cerebral Hemorrhage ; Cerebral Infarction* ; Developed Countries ; Diabetes Mellitus ; Hemodynamics ; Humans ; Hypertension ; Incidence ; Infarction ; Korea ; Logistic Models ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar ; Ultrasonography*

BACKGROUND: Core hypothermia during the first hour after induction of anesthesia results primarily from a redistribution of body heat. Propofol in low doses provides reliable sedation and is associated with fast recovery. However, propofol-induced peripheral vasodilation is likely to facilitate core-to-peripheral heat redistribution. This study was designed to evaluate the effects of low dose propofol on core and peripheral temperatures during spinal anesthesia. METHODS: Fifty patients of ASA status I or II, aged 20 to 60, undergoing lower extremity surgery under spinal anesthesia were studied. Spinal anesthesia was administered to all patients, who were assigned sedation as follows: 1) control (n = 25), 2) propofol (n = 25); propofol infusion rates were, 8 mg/kg/h for the first 3 min, 4 mg/kg/h for the next 10 min, and 2 mg/kg/h for the next 15 min. Temperatures were recorded after beginning surgery at 5-min intervals for 30 min. RESULTS: Core temperature was significantly decreased after 15, 20, 30 min of surgery in the propofol group, and this result was statistically different between the two groups. Forearm skin temperature decreased in the control group and increased in the propofol group, without significance. Fingertip skin temperature did not changed significantly in the control group, but increased significantly after 15 min in the propofol group and continued to increasing to 30 min. Forearm minus finger skin temperature gradients were not changed significantly in control group, but decreased between 5 and 30 min in the propofol group, which was statistically significant. CONCLUSIONS: Low dose propofol may induce a degree of hypothermia during spinal anesthesia. Close monitoring is needed to prevent core hypothermia, if sedation is induced using propofol during spinal anesthesia.
Anesthesia ; Anesthesia, Spinal* ; Fingers ; Forearm ; Hot Temperature ; Humans ; Hypothermia ; Lower Extremity ; Propofol* ; Skin Temperature ; Vasodilation