The Ultrasonographic Findings of the Median Nerve in the CarpalTunnel According to Age and Sex of Normal Korean Adults

OBJECTIVE: To define the ultrasonographic findings of the median nerve within the carpal tunnel and to verify the differences of the median nerve according to age, sex and the wrist in the normal Korean adults. METHOD: We studied 152 hands of 76 normal Korean adults who had no symptoms of carpal tunnel syndrome such as hand numbness, pain, dysesthesia or hand weakness. All subjects were examined with a real-time ultrasonography. We evaluated the flattening ratio (FR) and cross-sectional area (CSA) of the median nerve within the carpal tunnel. RESULTS: The CSA of the median nerve was 6.44+/-0.02 mm2 (at distal radioulnar joint), 6.34+/-0.02 mm2 (at pisiform) and 6.31+/-0.02 mm2 (at hamate). The FR at distal radioulnar joint is 2.36+/-0.02, at pisiform is 2.33+/-0.01 and at hamate is 2.33+/-0.01. Men have a larger cross-sectional area and flattening ratio of the median nerve than women. The older group over age 50 years has a smaller cross-sectional area and flattening ratio than the younger group. There were differences between men and women in body mass index (BMI) as well as between the older and the younger. There was also a linear relationship with CSA and FR in weight and height. CONCLUSION: The ultrasonographic finding of the normal Korean adult's median nerve in the carpal tunnel were different according to age and sex. Weight, height and BMI might be important factors to bring different results according to race, sex and age.

Current Status of Pediatric Rehabilitation Services for Children with Disabilities

OBJECTIVE: To survey the current status of rehabilitation programs for disabled children in Korea. METHOD: Questionnaires were distributed to hospitals and rehabilitation centers around the country which provides pediatric rehabilitation services to disabled children. Questions included the number of physiatrists, therapists specialized in managing children, frequency and duration of therapeutic session, waiting period required to receive the therapy, and burden of costs, etc. RESULTS: Survey found 2.2 mean number of physiatrists in 45 hospitals and only one rehabilitation center had full time physiatrist among 21 rehabilitation centers. These institutions had mean number of 2.3 physical therapists, 1.4 occupational therapists, and 1.1 speech therapists. According to parents, these children received average of 16 times of therapeutic sessions in a month. For most of patients, they had to wait 6.8 months to start the physical therapy, 9.4 months for occupational therapy, and 13.8 months for speech therapy. The whole cost of receiving the treatment was found to be 586,000 won in a month. CONCLUSION: Survey found the medical health system and human resources related to pediatric rehabilitation were not enough and they have to be supported to satisfy the needs of appropriate pediatric rehabilitation program around the country.

Segmental Spinal Dysgenesis: Case report

Segmental spinal dysgenesis (SSD) is a rare congenital abnormality in which a segment of the spine and spinal cord fails to develop properly. Segmental vertebral anomalies involve the thoracolumbar, lumbar, or lumbosacral spine. We report two cases of SSD associated with other spinal dysraphism. Radiologic investigations revealed segmental dysgenesis of thoracic spinal cord without an associated vertebral bony anomaly in one case and segmental dysgenesisof the cervico-thoracic cord with diastematomyelia in the other case. The neurologic picture depends on the severity of the malformation and on its segmental level along the longitudinal embryonic axis. The pathogenesis of SSD syndrome is not clear but its cause is probably related to a segmental maldevelopment of the neural tube.

The Effects of Plastic Ankle-foot Orthosis on Elderly Stroke Patients

BACKGROUND: Retraining elderly patients with hemiparesis to walk is a major goal of any stroke rehabilitation program. In particular, an plastic ankle-foot orthosis (AFO) is used to correct a spastic drop foot or equinus foot, which are both commonly seen in spastic stroke related hemiparesis and hemiplegia. This study was performed to investigate the gait pattern with or without plastic AFO in elderly stroke patients. METHOD: The subjects of this study were 20 elderly ambulatory hemiplegic patients. We measured time to walk 10 meters and Berg balance scale (BBS) with or without plastic AFO at the time of admission, 4th week and 12th week. RESULTS: Time to walk and BBS of the stroke patients with plastic AFO significantly improved on transfer and 4 weeks later. But 12 weeks later, time to walk and BBS with plastic AFO did not improve. CONCLUSION: The plastic AFO is helpful for the elderly sroke patients to improve walking speed and BBS in early period of in-patient rehabilitation management.