• Journal of Korean Medicine Rehabilitation
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• v.15 no.2
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• pp.183-191
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• 2005

Objectives : The 5th lumbar - 1st sacrum facet joint is unstable area from an anatomical viewpoint, so that it is clinically major causes of low back pain. The purpose of this study is to assess the difference of the Van Akkerveeken measurement and intervertebral disc angle, Ferguson angle betwoon the 5th lumbar - 1st sacrum facet syndrome patients and sample group patients.Methods : Van Akkerveeken measurement, intervertebral disc angle and Ferguson angle were measured in 30 patients who had 5th lumbar - 1st sacrum facet syndrome and 31 sample group patients.Results :1. Van Akkerveeken measurement of 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients.2. Intervertebral disc angle of the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients.3. Ferguson angle is the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger than that of sample group patients.Conclusions : These results suggest that Van Akkerveeken measurement and intervertebral disc angle is able to be used for diagnosis of facet syndrome.

• Korean Journal of Veterinary Research
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• v.37 no.1
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• pp.59-69
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• 1997

The histological and histochemical study of the body of axis and 1st intervertebral disc in the Korean native cattle fetus was attempted to early developmental process. The experimental animals used in this study were collected from fetus of the Korean native cattle ranging from 50mm to 180mm in Crown-Rump length(CR-length). The results were summerized as follows: 1. The ossification centers appeared centrum 1 and centrum 2 of the axis in 110mm CR-length fetus of the Korean native cattle. The centrum 2 was formed little earlier than the centrum 1. 2. The histochemical reactions for collagenous fibers in the axis revealed negative in 50mm CR-length, mild positive in 90mm CR-length, and strong positive in 110mm CR-length, respectively. 3. Dense collagenous fibers were observed in the notochord through the centrum 2, and intervertebral disc developed into cuneiform dorsoventrally, It's contour looks like an annual ring. These fiber bundle arranged lamellar formation. 4. The intervertabral disc of 50mm CR-length fetus was composed mainly mesenchymal cells, and these cell showed aggregation in the central portion. The intervertebral disc of 110mm CR-length fetus was consisted of pricipally fibroblast, and notochordal sheath formed with two layers in the center.

• Journal of Korean Medicine Rehabilitation
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• v.15 no.2
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• pp.169-181
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• 2005

Objectives : The 5th lumbar - 1st sacrum facet joint is unstable area from an anatomical viewpoint, so that it is clinically major causes of low back pain. The purpose of this study is to assess the difference of the Van Akkerveeken measurement and intervertebral disc angle, Ferguson angle between the 5th lumbar - 1st sacrum facet syndrome patients and sample group patients. Methods : Van Akkerveeken measurement, intervertebral disc angle and Ferguson angle were measured in 30 patients who had 5th lumbar - 1st sacrum facet syndrome and 31 sample group patients. Results : 1. Van Akkerveeken measurement of 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients. 2. Intervertebral disc angle of the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients. 3. Ferguson angle is the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger than that of sample group patients. Conclusions : These results suggest that Van Akkerveeken measurement and intervertebral disc angle is able to be used for diagnosis of facet syndrome.

• Journal of Korean Neurosurgical Society
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• v.40 no.5
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• pp.363-368
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• 2006

Objective : Little is known about the comprehensive molecular and biological mechanism on the development of the degeneration of the intervertebral disc. Many kinds of matrix metalloproteinase[MMP] initiate the degradation of the extracellular matrix including several kinds of collagens and proteoglycans. We compared molecular and immunohistochemical features of degenerated intervertebral disc and normal counterparts in order to investigate the role of MMP-1, 2, 3, 9. Methods : We have evaluated MMP-1, 2, 3, 9 expression in 30 surgically resected lumbar disc from degenerative disc disease patients and 5 normal control cases. RT-PCR[reverse transcriptase-polymerase chain reaction] and immunohistochemistry were performed. Results : By RT-PCR, normal tissue samples showed merely scant expression of MMP-1, 2, 3, 9 mRNA, but degenerated disc samples revealed more pronounced expression. mRNA amplifications were detected in 60%, 63.3%, 70%, 53.3% cases By immunohistochemistry, normal tissue samples showed minimal protein expression of MMP-1, 2, 3, 9, but degenerated disc samples revealed more pronounced expression. Protein expressions were detected in 73.3%, 63.3%, 76.7%, 63.3% cases. Both the mRNA amplification and protein overexpression rates were significantly higher in degenerated disc than in the normal tissue. Concordance between both the mRNA amplification and protein expressions of MMP-1, 3, 9 were not observed, but there is well correlation in MMP-2 expression. Conclusion : We concluded that the over-expressions of the MMP-1, 2, 3, 9 may contribute to the development of degeneration of the intervertebral disc.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.4
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• pp.49-60
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• 2014

Objectives The purpose of this study is to research current trends of acupuncture treatment of lumbar herniated intervertebral disc using the PubMed database. Methods We set up the search strategy and investigated clinical trials on acupuncture treatment of lumbar herniated intervertebral disc through PubMed search. This study analyzed previous researched papers published from January 1st, 2000 to April 30th, 2014, and classified them by publication year, journal names, types of literature, treatment methods and evaluation scales. To assess the quality of the reviewed literature, randomized controlled trial (RCT) studies were assessed by Cochrane's risk of bias (ROB) tool and non-RCT studies were assessed by risk of bias for non-randomized studies (RoBANS). Results We found 35 studies on the acupuncture treatment of lumbar herniated intervertebral disc. Papers on this topic have been published, on average, three to four times annually in 9 journals since the mid-2000's. The journal with the largest number of publications was Chinese Acupuncture & Moxibustion, and most of articles were classified as RCT. Acupuncture treatment was performed individually or together with other treatments. The most frequently used pain evaluation index was visual analogue scale (VAS). The index of effective rate was used frequently but there was a lack of objectivity. In regards to the quality of the studies, outcome assessment in RCT showed that random sequence generation, allocation concealment, and the blinding of participants and personnel increase potential of risk of bias. For non-RCT assessment, outcome showed that confounding variable, measurement of intervention were at high risk of bias. Conclusions In order to obtain objective clinical evidence of acupuncture treatment of lumbar herniated intervertebral disc, further clinical studies should be designed to minimize the risk of bias, using STRICTA with larger sample sizes.

• Polymer(Korea)
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• v.39 no.1
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• pp.144-150
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• 2015

Gellan gum as a natural polysaccharide has good heat resistance, acid resistance and enzymes resistance. However, one of the drawbacks of gellan gum might be the lower mechanical strength. In this work, gellan gum scaffolds were mixed with poly(lactic-co-glycolic acid) (PLGA) microsphere in order to improve mechanical properties. The gellan gum scaffolds with various contents of PLGA microsphere were prepared for the regeneration of disc tissues. To evaluate the mechanical strength of hybrid structure of gellan gum and PLGA microsphere, compression strength of the fabricated scaffolds was measured. MTT analysis, SEM observation, histological evaluation and RT-PCR were performed to confirm the effect on the cell growth and extracellular matrix secretion. As a result, it showed the best cell proliferation and extracellular matrix secretion in gellan gum sponge containing 50% PLGA microspheres. In conclusion, this study confirmed that the hybrid structure of gellan gum and PLGA microspheres was found suitable in regeneration of the intervertebral disc.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.52-56
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• 2013

Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.

• Journal of Acupuncture Research
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• v.30 no.4
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• pp.169-173
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• 2013

Objectives : The purpose of this study is to report the effect of Dochim & Gwanchim therapy combined with Korean medicine treatment in patients of herniated lumbar disc. Methods : Clinical study was conducted to 103 patients who were treated in Department of Acupuncture and Moxibustion Medicine, Korean Medicine Hospital, Daejeon University from 1st september, 2011 th 31th July, 2013. We divided into two groups. The group A(n=80) was treated with Gwanchim therapy combined with Korean medicine treatment, and the group B(n=23) was treated only Korean medicine treatment. We evaluated the treatment effect with the verbal numerical rating scale(VNRS), and compared admission day and one day after admission. Results : 1. In both two groups VNRS was decreased and this therapy is safety. 2. In group A, VNRS was decreased 10 to 5.68 and in group B, VNRS was decreased 10 to 8.7 Conclusion : This study demonstrates that Gwan acupuncture therapy has significant effect reducing pain for HIVD(herniated lumbar intervertebral disc) patients.

• Journal of Physiology & Pathology in Korean Medicine
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• v.30 no.1
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• pp.66-72
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• 2016

This retrospective observational study was aimed to assess that Shinchubogun-tang (Shenzhuibujian-tang ; SBT) improves the symptoms related to lumbar disc herniation. We analyzed the medical records of 36 patients, who were satisfied with inclusion and exclusion criteria. The patients were diagnosed with lumbar disc herniation and prescribed with SBT in addition to Korean medical common treatments at Dunsan Korean Medicine Hospital of Daejeon University from January 1st, 2013 to November 30th, 2015. The effects of SBT was evaluated by comparing before and after taking SBT through 0-10 visual analogue scale(VAS) of the symptoms including lower back pain, radiating pain, and lower extremity numbness. The average period of common Korean medicine treatment before SBT prescription was 9.78 days and then the patients received SBT along with common Korean medicine treatment for 13.17 days on average. SBT plus common korean medicine treatment group significantly decreased VAS score of lower back pain from 5.40±1.62 to 3.28±1.70 (p<0.01), radiating pain from 5.60±1.42 to 2.35±1.79 (p<0.01), lower extremity numbness from 5.77±1.52 to 2.55±1.85(p<0.01). These results demonstrated that SBT might have a potential on improvement of lumbar disc herniation by reducing the symptoms of lower back pain, radiating pain, and lower extremity numbness.

• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.352-357
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• 2010

Objective : This retrospective study was performed to evaluate the clinical and radiological results of anterior lumbar interbody fusion (ALIF) using two different stand-alone cages in the treatment of lumbar intervertebral foraminal stenosis (IFS). Methods : A total of 28 patients who underwent ALIF at L5-S1 using stand-alone cage were studied [Stabilis$^{(R)}$ (Stryker, Kalamazoo, MI, USA); 13, SynFix-LR$^{(R)}$ (Synthes Bettlach, Switzerland); 15]. Mean follow-up period was 27.3 ${\pm}$ 4.9 months. Visual analogue pain scale (VAS) and Oswestry disability index (ODI) were assessed. Radiologically, the change of disc height, intervertebral foraminal (IVF) height and width at the operated segment were measured, and fusion status was defined. Results : Final mean VAS (back and leg) and ODI scores were significantly decreased from preoperative values (5.6 ${\pm}$ 2.3 ${\rightarrow}$ 2.3 ${\pm}$ 2.2, 6.3 ${\pm}$ 3.2 ${\rightarrow}$1.6 ${\pm}$ 1.6, and 53.7 ${\pm}$ 18.6 ${\rightarrow}$ 28.3 ${\pm}$ 13.1, respectively), which were not different between the two devices groups. In Stabilis$^{(R)}$ group, postoperative immediately increased disc and IVF heights (10.09 ${\pm}$ 4.15 mm ${\rightarrow}$ 14.99 ${\pm}$ 1.73 mm, 13.00 ${\pm}$ 2.44 mm ${\rightarrow}$ 16.28 ${\pm}$ 2.23 mm, respectively) were gradually decreased, and finally returned to preoperative value (11.29 ${\pm}$ 1.67 mm, 13.59 ${\pm}$ 2.01 mm, respectively). In SynFix-LR$^{(R)}$ group, immediately increased disc and IVF heights (9.60 ${\pm}$ 2.82 mm ${\rightarrow}$ 15.61 ${\pm}$ 0.62 mm, 14.01 ${\pm}$ 2.53 mm ${\rightarrow}$ 21.27 ${\pm}$ 1.93 mm, respectively) were maintained until the last follow up (13.72 ${\pm}$ 1.21 mm, 17.87 ${\pm}$ 2.02 mm, respectively). The changes of IVF width of each group was minimal pre- and postoperatively. Solid arthrodesis was observed in 11 patients in Stabilis group (11/13, 84.6%) and 13 in SynFix-LR$^{(R)}$ group (13/15, 86.7%). Conclusion : ALIF using stand-alone cage could assure good clinical results in the treatment of symptomatic lumbar IFS in the mid-term follow up. A degree of subsidence at the operated segment was different depending on the device type, which was higher in Stabilis$^{(R)}$ group.