• Journal of Acupuncture Research
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• v.24 no.5
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• pp.197-205
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• 2007

Objectives : Herniation of Nucleus Pulposus(HNP) of Lumbar is the most important that causes low back pain. The aim of this study is to compare several therapies about Lumbar spine Hearniated Nucleus Pulposus in oriental Medecine which are Bee-venom Acpuncture and Ouhyul Herbal Acpuncture. Methods: Subjects of this research were 60 inpatients complaining Herniation of Nucleus Pulposus, and who were diagnosed as bulging disc, disc protrusion or extrusion with CT & MRI. 20 patients in each, 3 groups; Acpuncture therapy only, Bee-venom Acpuncture, and Ouhyul Herbal Acpuncture, were divided and the conclusions for treatment are as follows. Results : 1. Regarding alleviation of pain by VAS, Ouhyul Herbal Acpuncture Group III showed significant decrease of VAS in the early period of admission(5days), while Bee-venom Acpuncture Group II showed higher score of VAS compared to Acpuncture therapy only Group I. 2. On contrary, in the latter period of admission($5{\sim}9days$), Bee-venom Acpuncture Group II showed significantly higher rate of improvement than the other groups. 3. On the 9th admission day, Bee-venom Acpuncture Group II and Ouhyul Herbal Acpuncture Group III showed higher improvement than Acpuncture therapy only Group I. Between group II and III, Group II showed higher improvement rate. Conclusions : In this study, there were different effects among three groups according to period of treatment. Further study on various traatment for Herniation of Nucleus Pulposus required.

• The Journal of Korea CHUNA Manual Medicine
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• v.6 no.1
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• pp.189-196
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• 2005

Objectives : This report intended to estimate effect taken by using Sacro-Occipital Technique on the patient with Herniation of Nucleus Pulposus(Central type). Method : From 11 May, 2005 to 30 June, 2005. The patient recived Sacro-Occipital Technique and Acupuncture therapy. Result : After being hospitalized for 50 days. the patient's Motor Grade, ODI, VAS, ROM were improved each from IV to IV+. from 26 to 20, from 10 to 2, and ROM with flexion/entension, rotation were improved each from 70'/0' to 90'/12', from 30'/40' to 45'/55'. Conclusion : We considered Sacro-Occipital Technique has an useful effect on Herniation of Nucleus Pulposus

• The Journal of Korean Physical Therapy
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• v.24 no.3
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• pp.208-215
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• 2012

Purpose: We attempt to assess the differences in the degree of lumbar lordosis in patients with lower back pain caused by the herniation of the nucleus pulposus and in normal people (divided into male and female groups). Methods: This study was conducted with 14 patients (7 males, 7 females) diagnosed with, and being treated for, lumbar herniated nucleus pulposus and 14 normal people (7 males, 7 females). In order to examine the degree of lumbar lordosis in these subjects, hip flexor lengthening tests were conducted and the lumbar curves were measured in three postures (supine, sitting, and prone) and the results were compared. Results: The measured values of the curves for the standing and prone postures showed statistically significant differences between the normal group and the patient group, between the normal male group and the male patient group, and between the normal female group and the female patient group (p<0.05). Conclusion: The measurement method that uses flexible curve rulers in the standing or prone postures can be usefully utilized in assessing the lumbar lordosis of patients with lumbar herniation of the nucleus pulposus.

• The Journal of Korean Physical Therapy
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• v.21 no.3
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• pp.95-102
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• 2009

Purpose: This study evaluates MCP-1 expression in the dorsal horn of a rat model of lumbar disc herniation by an autograft of the nucleus pulposus to the spinal nerve. Methods: After a coccygeal nucleus pulposus graft to the left $5^{th}$ lumbar spinal nerve, proximal to dorsal root ganglion, mechanical allodynia and thermal hyperalgesia were assessed 1 day before surgery, and 1, 10, 20, 30 days after surgery. The mRNA of MCP-1 in the dorsal horn was assessed by real time PCR to compare the temporal pattern of neuropathic pain of the lumbar disc herniation model. Results: In the ipsilateral side of the lumbar disc herniation models, mechanical allodynia and thermal hyperalgesia reached a maximum at 10 days after surgery with significant difference from the control group. Pain was also provoked in the contralateral side of the lumbar disc herniation models with less intensity than the ipsilateral side. The level of MCP-1 mRNA expression in the dorsal horn reached a peak at 20 days after surgery. Conclusion: Mechanical allodynia and thermal hyperalgesia was induced by nucleus pulposus in a rat lumbar disc herniation model, similar to a previously reported peripheral nerve injury model. The level of MCP-1 expression was higher in the dorsal horn of the ipsilateral and contralateral sides. These results suggest that MCP-1 might play a role in the maintenance of neuropathic pain.

• Korean Journal of Occupational Health Nursing
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• v.16 no.2
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• pp.168-176
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• 2007

Purpose: This study was to investigate the factors influencing on the quality of life (QOL) among herniation of nucleus pulposus (HNP) patients caused by occupational accidents. Method: 203 patients of HNP were recruited. 106 patients were occupationally injured workers who benefited from workmen's compensation scheme (PWCS group), and 43 patients were non-occupationally injured workers benefiting from national health insurance (PNHI group). Questions of QOL items were used by Korean version of SBQOL (SmithKlein Beecham's Qality of Life). Result: The quality of life of PWCS group measured by SBQOL was significantly lower than that of PNHI group. In PWCS group, SBQOL was significantly lower in patients with 40s of their age, 5 years or longer of treatment duration, no expectation of return to work, no expectation of recovering subject's health, and with loss of employment than rest of the patients in each category. Expectations of recovering subject's health showed to be affect factors on QOL both the PWCS and PNHI groups. Conclusion: It suggested that betterment of expectation of recovering patient's health and an administrative system for returning to work of the occupationally injured HNP patients during treatment be necessary for improvement of their quality of life.

• Journal of Acupuncture Research
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• v.26 no.1
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• pp.59-66
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• 2009

Objectives : This study was designed to evaluate clinical effects of Hua-Tuo-Jia-Ji-Xue acupuncture to the patients with herniation of nucleus pulposus(HNP) of lumbar. Methods : Total of 40 patients with HNP of lumbar were participated in this study. We divided them into two group; A group using conventional acupuncture and B group using conventional acupuncture and Hua-Tuo-Jia-Ji-Xue acupuncture at the same time. All the subjects were asked to complete the VAS(visual analogue scale) and ODI(Oswestry disability index) before and after treatment. Results : Both A and B group represented effective improvement in VAS and ODI. And, B group is more effective than A group statistically. Conclusions : A comparision of VAS and ODI results of the two groups show that Hua-Tuo-Jia-Ji-Xue acupuncture trement can give be more effective method on lumbago patients, if it is added conventional acupuncture. Further clinical studies are needed to verify these findings.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.6 no.2
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• pp.109-119
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• 2011

Objective : The aim of this study is to investigate the effectiveness of ShinBaro Pharmacopuncture in the treatment of patients with Lumbar spine Herniated Nucleus Pulposus. Methods : We investigated 20 cases of patients with lumbar disc herniation and devided into two groups. Experimental group were treated with ShinBaro Pharmacopuncture with integrated package treatment and control group were treated the same therapies without ShinBaro Pharmacopuncture. To evaluate the treatment effects of two groups, we used numeric rating scale(NRS), oswestry disability index(ODI). Results : In NRS of lumbar and sciatica pain and ODI, that of experimental group was much more improved than control group, and decrement of NRS of lumbar pain showed statistical significance along with the duration of treatment. Conclusions : ShinBaro Pharmacopuncture was thought to be effective for relieving symptoms of lumbar spine herniated nucleus pulposus, although further study is needed.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.71-77
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• 2010

Purpose: To determine whether upregulation of inducible nitric oxide synthase (iNOS) transcription and translation is related to radicular pain in a model of lumbar disc herniation. Also, to investigate the temporal changes of mRNA expression of iNOS and the identity of iNOS and transient receptor potential vanilloid (TRPV) 1 channel expression cells in dorsal root ganglion (DRG) of a model of lumbar disc herniation. Methods: A lumbar disc herniated rat model was developed by implantation of the autologous nucleus pulposus, harvested from the coccygeal vertebra of each tail, on the left L5 nerve root just proximal to the DRG. Rats were tested for mechanical allodynia of the plantar surface of both hind paws 2 days before surgery and 1, 5, 10, 20 and 30 days postoperatively. Reverse transcription polymerase chain reaction (RT-PCR) was used to follow iNOS mRNA expression. To stain iNOS and TRPV1 in DRG, an immunohistochemical study was done 10 days after surgery. Results: A significant drop in mechanical withdrawal threshold on the ipsilateral and contralateral hind paws was observed 1 day after surgery and was prolonged to 30 days in rats with lumbar disc herniation. The expression of mRNA for iNOS peaked at postoperative day 10 on both sides of the DRG. iNOS-positive sensory neurons in the DRG varied in size from large to small diameter cells. A majority of small and intermediate sensory neurons were TRPV1-positive cells. Double immunofluorescence staining for TRPV1 and iNOS revealed that most intermediate TRPV1-positive sensory neurons co-localized with iNOS-positive neurons. Conclusion: Nucleus pulposus-induced mechanical allodynia can be generated without mechanical compression. This pain is related to temporal changes in expression of iNOS mRNA in the DRG. Co-localization of TRPV1 and iNOS in intermediate neurons of the DRG is correlated with pain modality and intensity.

• The Korean Journal of Pain
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• v.34 no.1
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• pp.47-57
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• 2021

Background: Lumbar disc herniation (LDH) is a common cause of radicular pain, but the mechanism is not clear. In this study, we investigated the engagement of toll-like receptor 4 (TLR4) and the nuclear factor-kappa B (NF-κB) in radicular pain and its possible mechanisms. Methods: An LDH model was induced by autologous nucleus pulposus (NP) implantation, which was obtained from coccygeal vertebra, then relocated in the lumbar 4/5 spinal nerve roots of rats. Mechanical and thermal pain behaviors were assessed by using von Frey filaments and hotplate test respectively. The protein level of TLR4 and phosphorylated-p65 (p-p65) was evaluated by western blotting analysis and immunofluorescence staining. Spinal microglia activation was evaluated by immunofluorescence staining of specific relevant markers. The expression of proand anti-inflammatory cytokines in the spinal dorsal horn was measured by enzyme linked immunosorbent assay. Results: Spinal expression of TLR4 and p-NF-κB (p-p65) was significantly increased after NP implantation, lasting up to 14 days. TLR4 was mainly expressed in spinal microglia, but not astrocytes or neurons. TLR4 antagonist TAK242 decreased spinal expression of p-p65. TAK242 or NF-κB inhibitor pyrrolidinedithiocarbamic acid alleviated mechanical and thermal pain behaviors, inhibited spinal microglia activation, moderated spinal inflammatory response manifested by decreasing interleukin (IL)-1β, IL-6, tumor necrosis factor-α expression and increasing IL-10 expression in the spinal dorsal horn. Conclusions: The study revealed that TLR4/NF-κB pathway participated in radicular pain by encouraging spinal microglia activation and inflammatory response.

• The Journal of Korean Physical Therapy
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• v.20 no.3
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• pp.69-74
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• 2008

Purpose: The majority of patients with radiculopathy caused by a herniated nucleus pulposus (HNP) heal spontaneously without surgery. The aim of this report is to describe the spontaneous regression of lumbar disc herniation and the results of clinical follow-up. Methods: Three patients with radiating low back pain presented with an extruded intervertebral disc on magnetic resonance imaging (MRI). We performed follow-up with conservative treatment (epidural injection, medication, physical therapy, exercise) and clinical assessments on the 6th, 10th and 22nd months. Results: The extruded intervertebral disc almost complete regressed, and correlated with clinical improvement and follow-up MRI. Conclusion: Conservative treatment can be an effective approach for a herniated lumbar discs if no neurological deficits are present.