• Korean Journal of Veterinary Research
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• v.58 no.4
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• pp.219-221
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• 2018

A 2-year-old intact female Bengal cat was presented with a 6-month history of visual impairment. The cat manifested bilateral negative menace responses and dazzle reflexes and sluggish pupillary light reflexes. Bilateral fundus changes included generalized tapetal hyperreflectivity, advanced retinal vascular attenuation, and increased pallor of the optic disc. A diagnosis of bilateral retinal degeneration was made. The clinical findings suggest that the investigated Bengal cat was most likely to have an inherited retinal degeneration. Further studies of the Bengal cat breed are needed to determine the prevalence of inherited retinal degeneration in this breed in Korea.

• The Journal of Korea CHUNA Manual Medicine
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• v.3 no.1
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• pp.31-41
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• 2002

Objectives : To study that lateral epicondylitis(tennis elbow) is related with cervical spondylosis. Subjects : The study was composed of 25 patients of lateral epicondylitis(LEP group) and 25 normal control group(CON group). Method : Simple radiologic scale was compared such as cervical lordotic angle, grading for disc degeneration. Pavlov ratio and Intervertebral body Index Results : Cervical lordotic angle and disc degeneration is not significantly different. And Pavlov ratio and intervertebral body index is significantly decrease in the LEP group. Conclusion : The cervical spondylosis is related with ocuuring lateral epicondylitis.

• Journal of International Academy of Physical Therapy Research
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• v.8 no.1
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• pp.1071-1076
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• 2017

The purpose of this study was to determine if a gentle form of manual lumbar traction could reduce painful lumbar motions associated with lumbar disc degeneration (LDD). This clinical trial incorporated 134 participants with painful active lumbar motion. Participants were randomly assigned to an experimental treatment or sham group. 67 participants received sidelying manual lumbar traction while the other 67 participants received a sham treatment. Pre and post treatment NPRS values for the painful active lumbar motion were recorded for each group. There was a statistically significant improvement (P=0.00) for decreased pain intensity during active lumbar motion in the experimental group as compared to the sham treatment group. The average percent decrease in numeric pain rating scale (NPRS) values was 52.1% for the experimental treatment group and 8.1% for the sham group. The results of the study suggest that side-lying manual lumbar traction can improve painful lumbar motion in patients with LDD.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.243-250
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• 2018

Objective : To compare the morphometry of subaxial cervical spine between cerebral palsy (CP) and normal control. Methods : We retrospectively analyzed 72 patients with CP, as well as 72 patients from normal population. The two groups were matched for age, sex, and body mass index. Pedicle, lateral mass (LM), and vertebral foramen were evaluated using computed tomography (CT) imaging. Pedicle diameter, LM height, thickness, width and vertebral foramen asymmetry (VFA) were measured and compared between the two groups. Cervical dynamic motion, disc and facet joint degeneration were investigated. Additionally, we compared the morphology of LM between convex side and concave side with cervical scoliotic CP patients. Results : LM height was smaller in CP group. LM thickness and width were larger in CP group at mid-cervical level. In 40 CP patients with cervical scoliosis, there were no height and width differences between convex and concave side. Pedicle outer diameter was not statistically different between two groups. Pedicle inner diameter was significantly smaller in CP group. Pedicle sclerosis was more frequent in CP patients. VFA was larger in CP group at C3, C4, and C5. Disc/facet degeneration grade was higher in the CP group. Cervical motion of CP group was smaller than those of the control group. Conclusion : LM morphology of CP patients was different from normal population. Sclerotic pedicles and vertebral foramen asymmetry were more commonly identified in CP patients. CP patients were more likely to demonstrate progressive disc/facet degeneration. This data may provide useful information on cervical posterior instrumentation in CP patients.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.153-165
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• 2020

Background: Well-validated risk prediction models help to identify individuals at high risk of diseases and suggest preventive measures. A recent systematic review reported lack of validated prediction models for low back pain (LBP). We aimed to develop prediction models to estimate the 8-year risk of developing LBP and its recurrence. Methods: A population based prospective cohort study using data from 435,968 participants in the National Health Insurance Service-National Sample Cohort enrolled from 2002 to 2010. We used Cox proportional hazards models. Results: During median follow-up period of 8.4 years, there were 143,396 (32.9%) first onset LBP cases. The prediction model of first onset consisted of age, sex, income grade, alcohol consumption, physical exercise, body mass index (BMI), total cholesterol, blood pressure, and medical history of diseases. The model of 5-year recurrence risk was comprised of age, sex, income grade, BMI, length of prescription, and medical history of diseases. The Harrell's C-statistic was 0.812 (95% confidence interval [CI], 0.804-0.820) and 0.916 (95% CI, 0.907-0.924) in validation cohorts of LBP onset and recurrence models, respectively. Age, disc degeneration, and sex conferred the highest risk points for onset, whereas age, spondylolisthesis, and disc degeneration conferred the highest risk for recurrence. Conclusions: LBP risk prediction models and simplified risk scores have been developed and validated using data from general medical practice. This study also offers an opportunity for external validation and updating of the models by incorporating other risk predictors in other settings, especially in this era of precision medicine.

• Asian Spine Journal
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• v.12 no.6
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• pp.1092-1099
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• 2018

Study Design: In-vitro biomechanical investigation. Purpose: To evaluate the biomechanical effects of the degeneration of the biodegradable cervical plates developed for anterior cervical discectomy and fusion (ACDF) on fusion and adjacent levels. Overview of Literature: Biodegradable implants have been recently introduced for cervical spine surgery. However, their effectiveness and safety remains unclear. Methods: A linear three-dimensional finite element (FE) model of the lower cervical spine, comprising the C4-C6 vertebrae was developed using computed tomography images of a 46-year-old woman. The model was validated by comparison with previous reports. Four models of ACDF were analyzed and compared: (1) a titanium plate and bone block (Tita), (2) strong biodegradable plate and bone block (PLA-4G) that represents the early state of the biodegradable plate with full strength, (3) weak biodegradable plate and bone block (PLA-1G) that represents the late state of the biodegradable plate with decreased strength, and (4) stand-alone bone block (Bloc). FE analysis was performed to investigate the relative motion and intervertebral disc stress at the surgical (C5-C6 segment) and adjacent (C4-C5 segment) levels. Results: The Tita and PLA-4G models were superior to the other models in terms of higher segment stiffness, smaller relative motion, and lower bone stress at the surgical level. However, the maximal von Mises stress at the intervertebral disc at the adjacent level was significantly higher in the Tita and PLA-4G models than in the other models. The relative motion at the adjacent level was significantly lower in the PLA-1G and Bloc models than in the other models. Conclusions: The use of biodegradable plates will enhance spinal fusion in the initial stronger period and prevent adjacent segment degeneration in the later, weaker period.

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.180-187
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• 2000

Objective : A number of evidence have suggested a pivotal role of matrix metalloproteinases(MMP) on the degeneration of intervertebral disc. Proteins of intervertebral disc mainly consist of collagen and proteoglycan. These proteins can be destructed by MMP, resulting in changes of main collagen type and degeneration of matrix proteins. The present study was to determine the different effects of MMP-1 and MMP-2 on the degenerative spinal diseases, resulting from aging process. Clinical Materials & Methods : Thirty-one patients were randomly selected among 350 patients whose discs were resected during operation from March 1997 to February 1999. Patients were divided into two groups: group I with spinal stenosis and group II with herniated intervertebral disc. Group II was subdivided into the ruptured(Group Iia) and unruptured(Group Iib). Increases in MMP-1 immunopositive cells were observed in both groups, as evidenced by immunocytochemical staining. However, in marked contrast, the number of MMP-2 immunopositive cells were only seen in group II. There was no significant difference between Group IIa and Group IIb. The MMP-2 immunopositive cells were increased in the anulus fibrosus of ruptured(Group Iia) more than unruptured(Group Iib), but statistically it was not significant. In addition, the immunopositivity of MMP-1 and MMP-2 was proportional to patients's age. Conclusion : These results strongly suggests the possible involvement of MMP-2, but not MMP-1 in progressive herniated intervertevral disc.

• Journal of Korean Neurosurgical Society
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• v.47 no.1
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• pp.30-35
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• 2010

Objective: The purpose of this study is to explain the effect and reciprocal action among tumor necrosis factor (TNF) like weak inducer of apoptosis (TWEAK), fibroblast growth factor-inducible 14 (Fn14), and transforming growth factor-$\beta1$ (TGF-$\beta1$) on degeneration of human intervertebral disc (IVD). Methods: Human intervertebral disc tissues and cells were cultured with Dulbecco's Modified Eagle's Medium/Nutrient F-12 Ham (DMEM/F-12) media in $37^{\circ}C$, 5% $CO_2$ incubator. When IVD tissues were cultured with TWEAK, Fn14 that is an antagonistic receptor for TWEAK and TGF-$\beta1$, the level of sulfated glycosaminoglycan (sGAG) was estimated by dimethyl methyleneblue (DMMB) assay and sex determining region Y (SRY)-box 9 (Sox9) and versican messenger ribonucleic acid (mRNA) levels were estimated by reverse transcriptase polymerase chain reaction (RT-PCR). Results: When human IVD tissue was cultured for nine days, the sGAG content was elevated in proportion to culture duration. The sGAG was decreased significantly by TWEAK 100 ng/mL, however, Fn14 500 ng/mL did not change the sGAG production of IVD tissue. The Fn14 increased versican and Sox9 mRNA levels decreased with TWEAK in IVD tissue TGF-$\beta1$ 20 ng/mL elevated the sGAG concentration 40% more than control. The sGAG amount decreased with TWEAK was increased with Fn14 or TGF-$\beta1$ but the result was insignificant statistically. TGF-$\beta1$ increased the Sox9 mRNA expression to 180% compared to control group in IVD tissue. Sox9 and versican mRNA levels decreased by TWEAK were increased with TGF-$\beta1$ in primary cultured IVD cells, however, Fn14 did not show increasing effect on Sox9 and versican. Conclusion: This study suggests that TWEAK would act a role in intervertebral disc degeneration through decreasing sGAG and the mRNA level of versican and Sox9.

• Journal of Korean Neurosurgical Society
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• v.59 no.6
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• pp.559-563
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• 2016

Objective : Low back pain, caused intervertebral disc degeneration has been treated by thermal annuloplasty procedure, which is a non-surgical treatement. The theoretical backgrounds of the annuloplasty are thermal destruct of nociceptor and denaturization of collagen fiber to induce contraction, to shrink annulus and thus enhancing stability. This study is about temperature and its distribution during thermal annuloplasty using 1414 nm Nd : YAG laser. Methods : Thermal annuloplasty was performed on fresh human cadaveric lumbar spine with 20 intact intervertebral discs in a $37^{\circ}C$ circulating water bath using newly developed 1414 nm Nd : YAG laser. Five thermocouples were attached to different locations on the disc, and at the same time, temperature during annuloplasty was measured and analyzed. Results : Thermal probe's temperature was higher in locations closer to laser fiber tip and on lateral locations, rather than the in depth locations. In accordance with the laser fiber tip and the depth, temperatures above $45.0^{\circ}C$ was measured in 3.0 mm depth which trigger nociceptive ablation in 16 levels (80%), in accordance with the laser fiber end tip and laterality, every measurement had above $45.0^{\circ}C$, and also was measured temperature over $60.0^{\circ}C$, which can trigger collagen denaturation at 16 levels (80%). Conclusion : When thermal annuloplasty is needed in a selective lesion, annuloplasty using a 1414 nm Nd : YAG laser can be one of the treatment options.

• Journal of Acupuncture Research
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• v.18 no.2
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• pp.237-244
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• 2001

Back pain has plagued humans for many thousands of years. The treatment of back pain is divided into operative treatment and conservative treatment. It is reported that cure rate of conservative treatment is 80~90 percent. Generally, the treatment of oriental medicine is mostly conservative treatment. But, surgery should not be used as a last resort in treatment; it is just one of many treatment options for various spinal conditions. In some instance, it can be to preferred choice; in other situations, alternative therapies may be superior. Selections of the operation in HIVD 1. Acute disc herniations with a protracted significant component af back pain. 2. Chronic disc degeneration with significant back pain and degeneration limited to one or two disc levels. 3. Sugical instability created during decompression. 4. The presence of neural arch defects coincident with disc disease. 5. Symptamatic and radiographically demonstrable segmental instability. Selections of the operation in stenosis 1. If it does not slowly progress in physical therapy and other nonoperative measures, many of these patients may ultimately need surgical decompression. 2. Absolute stenosis in an impression of CT, MRI.(under 10mm) 3. In patients with established symptoms of .neurogenic claudication. 4. In patients with bad influence of neurogenic derangement.(strength, sensory) Selections of the operation in spondylolisthesis 1. Persistence or recurrence of major symptoms for at least one year despite activity modification and physical therapy. 2. Tight hamstrings, persistently abnormal gait, or postural deformities unrelieved by physical therapy. 3. Sciatic scoliosis. 4. Progressive neurologic deficit. 5. Progressive slipping beyond 25 or 50 percent, even when asymptomatic. 6. A high slip angle (40 to 50 degrees) in a growing child, since it is likely to be associated with further progression and deformity. 7. Psychologic problems attributed to shortness of trunk, abnormal gait, and postural deformities characteristic of more severe slips.