• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.1-11
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• 2016

PURPOSE: This study was conducted to assess the effects of local vibration on ankle plantarflexion spasticity and clonus in patients with spinal cord injury. METHODS: The subjects were 14 inpatients with complete or incomplete spinal cord injury (SCI) whose scores were higher than 1 on the Modified Ashworth Scale (MAS) and Spinal Cord Assessment Tool for Spastic Reflexes (SCATS) scale of paraplegia. A randomized single-blind cross-over design was used. Vibration treatment involved a single application of vibration for 10 min in the sitting position, and placebo treatment involved the patient remaining in the sitting position for 10 min. One day after treatment, vibration and placebo treatments were crossed over. Spasticity was measured by using the MAS, and resistance force, by using a hand-held dynamometer; clonus was gauged by using the SCATS scale and clonus burst duration. Additionally, the burst maximal frequency and voluntary ankle dorsiflexion angle of the triceps surae were measured. RESULTS: The application of vibration treatment in the sitting position significantly reduced the MAS scores and resistance force, but significantly increased the dorsiflexion angle of the ankle joint (p<0.05). Furthermore, the vibration treatment diminished the clonus burst duration and SCATS score significantly (p<0.05). Although it reduced the burst maximal frequency of the lateral gastrocnemius and medial soleus, this was significant only for the lateral gastrocnemius. The placebo treatment did not significantly affect any of the test parameters. CONCLUSION: Vibration treatment in the sitting position was effective in cases of spasticity and clonus caused by SCI.

• Journal of Trauma and Injury
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• v.25 no.2
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• pp.57-62
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• 2012

Gunshot wounds are rare in Korea, but they have tended to increase recently. We experienced an interesting case of penetrating gunshot injuries to the cervical spine with migration the fragments of the bullet within the dural sac of the cervical spine, so discuss the pathomechanics, treatment and complications of gunshot wounds to the spine and present a review of the literature. A 38-year-old man who had tried to commit suicide with a gun was admitted to our hospital with a penetrating injury to the anterior neck. the patient had quadriplegia. A Computed tomography (CT) scan and 3-dimensional CT of the spine showed destruction of the left lateral mass and lamina of the 5th cervical vertebra; the bullet and fragments were found at the level of the 5th cervical vertebra. The posterior approach was done. A total laminectomy and removal of the lateral mass of the 5th cervical vertebrae were performed, and bone fragments and pellets were removed from the spinal canal, but an intradurally retained pellets were not totally removed. A dural laceration was noted intraoperatively, and CSF leakage was observed, so dura repair was done watertightly with prolene 6-0. The dura repair site was covered with fibrin glue and Tachocomb$^{(R)}$. Immediately, a lumbar drain was done. Radiographs included a postoperative CT scan and X-rays. The postoperative neurological status of the patient was improved compared with the preoperative neurological status. however, the patients developed symptoms of menigitis. He received lumbar drainage(200~250 cc/day) and ventilator care. After two weeks, panperitonitis due to duodenal ulcer perforation was identified. Finally, the patient died because of sepsis.

• The Journal of Internal Korean Medicine
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• v.22 no.4
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• pp.557-565
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• 2001

Objectives : This study was carried out to examine toxic effect of Sintongchukeo-tang on cultured mouse spinal sensory neurons inhibited by neurotoxicity induced by hydrogen peroxide. Methods : MTT assay, NR assay, LDH and neurofilament assay were performed after spinal sensory neurons were preincubater with various concentrations of Sintongchukeo-tang water extract before treatment of cells with hydrogen peroxide. Results : Hydrogen peroxide induced ceil degeneration such as the decrease of cell viability was measured by MTT and NR assay in the cultured mouse spinal sensory neurons. Sintongchukeo-tang water extract was effective in the decrease of LDH activities of neurons produced by hydrogen peroxide. Sintongchukeo-tang water extract was effective in the increase of amount of neurofilaments damaged by hydrogen peroxide. Conclusions : From the above results, it is suggested that hydrogen peroxide induces the inhibition of cell viability in cultured mouse spinal sensory neurons and Sintongchukeo-tang water extract was effective in cultured neurons damaged by hydrogen peroxide.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.182-193
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• 1998

Background: Ciliary neurotrophic factor (CNTF), identified as a survival factor for developing peripheral neurons is upregulated by reactive astrocytes in the traumatized tissue and in areas of terminal degeneration after a brain lesion. But in the spinal cord, CNTF is expressed in the non-astrocytic phenotypic, maybe oligodendrocytes. The present study was undertaken to determine the upregulation of CNTF expression in reactive astrocytes following spinal cord lesion in the rat. Methods: Unilateral incision of the dorsal funiculus at the thoracic level was performed and rats were sacrificed on days 3, 7, 14 and 28 postlesion. Western blot analysis, immunocytochemical analysis and double immunofluorescence for CNTF and glial fibrillary acidic protein (GFAP) were performed after spinal cord lesion. Results: A major band with 24 kDa and additional band of higher molecular weight form were detectable, and the intensity of the 24 kDa immunoreactive band increased up to 14 days postlesion and decreased toward laminectomized control values. CNTF immunoreactivity was markedly upregulated in the injured dorsal funiculus and adjacent gray matter. The time course of CNTF expression is coincident with the appearance of reactive astrocytes in the injured spinal cord. Moreover, double immunofluorescence for CNTF and glial fibrillary acidic protein (GFAP) revealed that CNTF immunoreactivity was in GFAP immunoreactive astrocytes. Conclusions: These results show that CNTF upregulation occurred in reactive astrocytes following spinal cord lesion, and suggest a role for CNTF in the regulation of astrocytic responses after spinal cord injury.

• Physical Therapy Korea
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• v.8 no.4
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• pp.81-89
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• 2001

There are two independent mechanisms to control the segmental reflex gain in humans during gait. They are presynaptic inhibition and homosynaptic depression. Through the mechanism of the presynaptic inhibition, the muscle spindle afferent feedback can be properly gated during eccentric phase of gait. The modulation of the presynaptic inhibition is reflected in the level of H-reflex at a constant EMG level. During the eccentric muscle activation presynaptic inhibition should increase to account for the lower amplitude level of H-reflex at a constant level of EMG. Homosynaptic depression is another mechanism responsible for regulating the effectiveness of the muscle spindle afferent feedback. Both the presynaptic inhibition and the monosynaptic depression are responsible for modulating reflex gain during gait initiation. Reflex modulation is influenced not only as a passive consequence of the alpha motor neuron excitation level, but also through supraspinal mechanisms. Spastic paretic patients show the impaired soleus H-reflex modulation either during the initial stance phase, or during the swing phase. This abnormal modulatory mechanism can partially and artificially be restored by the application of peripheral stimulus to the sole of the foot, provided that the segmental circuitry remains functional.

• Physical Therapy Korea
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• v.10 no.2
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• pp.71-84
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• 2003

The purpose of this study was to provide information on driving characteristics in persons with spinal cord injury through basic statistic analysis of the survey results. The survey was administered to 44 drivers with spinal cord injury. The subjects' general, neurologic and driving characteristics were analyzed, as well as the degree of difficulty in using their vehicles between tetraplegia and paraplegia. The results were as follows: thirty-five (79.6%) of forty-four respondents was men. The average age was 35.0 years old and the age at the time of injury was 29.0 years old. Their neurologic characteristics were tetraplegics 12 (27.3%) and paraplegics 32 (72.2%). Among complete lesions, the highest level those who could drive independently was C7. All the vehicles were equipped with special devices, including "power steering", "automatic transmission" and "hand controls". The vehicles for cervical cord injury were equipped with "grip bars" as well as for the degree of difficulty in using their vehicles, all the subjects felt that "moving the wheelchair in and out of their vehicles" was too difficult for them to do. We suggest that the driver training should be an essential part of the rehabilitation program for patients with spinal cord injuries to maximize their mobility in the community. This training seems to be essential in order to modify the standards of the Handicapped Drivers Ability Test and to aid the driver rehabilitation program in the health insurance payment system. Also, the driver rehabilitation training program should include instruction in that moving wheelchairs in and out of vehicles.

• The Journal of Internal Korean Medicine
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• v.41 no.2
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• pp.122-131
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• 2020

Background: This study aimed to determine the effects of complex Korean medicine treatments on a patient suffering from tetraplegia caused by spinal cord injury. Case Summary: A 64-year-old female patient diagnosed with tetraplegia was treated using acupuncture, electroacupuncture, pharmacopuncture, knee joint motion style treatment (MST), and herbal medicine. Clinical symptoms were measured using the numeric rating scale (NRS) and manual muscle test (MMT). After 67 days of treatment, the NRS score for lower back pain and knee pain decreased from 7 to 3. For the shoulder joint the MMT grade improved from 3+/4+(Rt./Lt.) to 4/5-; in the hip joint, it improved from 3-/3+ to 4/4+. No side effects were observed from the treatments used in this case report. Conclusion: The complex Korean Medicine treatments appeared to be effective in recovering muscle strength and reducing pain in patients with tetraplegia caused by spinal cord injury.

• The Journal of Korean Physical Therapy
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• v.13 no.3
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• pp.569-578
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• 2001

The purpose of the present study was to examine the functional recovery of the crushed sciatic nerve of rats after low-power laser irradiation applied to the corresponding segments of the spinal cord. After a crushed injury on the left sciatic nerve in rats. low-power laser irradiation was applied transcutaneously to corresponding segments of the spinal cord immediately after suture the wound by using 2000 mW, 2000Hz, 830 nm CaAIAs(Gallium-aluminum-arsenide) semiconductor diode laser. The laser treatment was performed with 10 minutes daily for 4 successive weeks. Functional recovery was evaluated per weekly following injury by sciatic function index(SFI),using data obtained by walking track analysis. For four weeks after crush injury, experimental group had significantly greater functional improvement than control group(${\alpha}$=0.05). In a experimental group, SFI was significantly increased for three weeks, but control group not increased for two weeks. This study suggests that low-power laser irradiation applied directly to the spinal cord can improve functional recovery of the crushed sciatic nerve in rats.

• The Journal of Korean Physical Therapy
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• v.18 no.1
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• pp.65-73
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• 2006

Purpose: The purpose of this study was to identify the effect of electroacupuncture(EA) and transcutaneous electric nerve stimulation(TENS) after sciatic nerve crush injury in rats. Methods: The EA for experimental group I (Exp I, n=15) and TENS for experimental group II (Exp II, n=15) was applied from post-injury day(PD) 1 to PD 14 after sciatic nerve injury using low frequency stimulator that gave electrical stimulation(15min/60Hz). In order observe the effect of EA and TENS, this study examined GAP-43 expression in rat lumbar spinal cord at the PD 1, PD 7 and PD 14. In addition, the stride length(SL) and toe out angle(TOA) were measured at the PD 7 and PD 4. Results; Exp I and Exp II had higher GAP-43 immunoreactivity than control group(PD 1, 7, 14). The SL of Exp I and Exp II were significantly higher than control group(PD 7, 14). The TOA of Exp I and Exp II were significantly lower than control group(PD 7, 14). Conclusion: EA and TENS application increased motor nerve recovery and expression of GAP-43 immunoreactivity after sciatic nerve crush injury. Therefore effect of TENS and EA had similar effect on nerve regeneration and functional recovery.

• Journal of Oriental Neuropsychiatry
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• v.11 no.1
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• pp.1-18
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• 2000

To study the effects of Ramulus et Uncus Uncariae (REUU) on oxygen free radical-mediated damage by hydrogen peroxide $(H_{2}O_{2})$ on cultured spinal sensory neurons, in vitro assays such as MTT assay, NR assay, neurofilament enzymeimmuno assay (EIA), sulforhodamine B (SRB) assay, assay for lactate dehydrogenase (LDH) activity and assay for lipid peroxidation were used in cultured spinal dorsal root ganglion neurons derived from mice, Spinal dorsal root ganglion neurons were cultured in media containing various concentrations of $H_{2}O_{2}$ for 5 hours, after which the neurotoxic effect of $H_{2}O_{2}$ was measured by in vitro assay. The protective effect of the herb extract, Ramulus et Uncus Uncariae (REUU) against H2O2-induced neurotoxicity was also examined. The results are as follows. 1. In NR assay and MTT assay, $H_{2}O_{2}$ significantly decreased the cell viability of cultured mouse spinal dorsal root ganglion neurons according to exposure concentration in these cultures. An additional time course study was done on these cultures. 2. Cultured spinal dorsal root ganglion neurons which were exposed to various concentrations of $H_{2}O_{2}$ showed a quantitative decrease of neuronal cells by EIA and of total protein by sulforhodamine B (SRB) assay, while they showed an increase of both lipid peroxidation and LDH activity. 3. The effect of Ramulus et Uncus Uncariae (REUU) on $H_{2}O_{2}$ induced neurotoxicity showed a quantitative increase in both neurofilament and total protein, but showed a decrease of lipid peroxidation and LDH activity. These results suggest that $H_{2}O_{2}$ has a neurotoxic effect on cultured spinal dorsal root ganglion neurons from mice and that the herb extract, Ramulus et Uncus Uncariae (REUU), was very effective in protecting $H_{2}O_{2}$ induced neurotoxicity by decreasing lipid peroxidation and LDH activity.