Purpose: Problematic late sequelae are common following a calcaneal fracture regardless of the initial treatment. We retrospectively evaluated the painful conditions and reviewed the results of the operative treatment in patients with previously treated calcaneal fractures. Materials and Methods: Between October 1996 and September 2001, forty-three patients who underwent subsequent surgical treatment for late sequelae of calcaneal fracture were reviewed. The initial treatment consisted of only immobilization in a cast in 7 patients, closed reduction with pin fixation (Essex-Lopresti technique) in 22 and open reduction and internal fixation in 14. Painful conditions in the hind foot included subtalar arthritis in 31 patients, calcaneofibular impingement in 13, peroneal tendinitis in 6, displaced posterior bony fragment in 3, sural neuritis in 2, subtalar and midtarsal arthritis in 1 and displaced plantar bony fragment in 1. The surgical procedures for the late complications were performed at a mean of 19 months (range, 6 to 35 months) after the injury and consisted of lateral wall ostectomy and in situ subtalar fusion in 28 patients, only lateral wall ostectomy in 5 patients, lateral wall ostectomy and subtalar distraction arthrodesis in 3, removal of displaced posterior bony fragment in 3, sural nerve transposition in the peroneus brevis in 2, triple arthrodesis in 1 and removal of displaced plantar bony fragment in 1. Mean postoperative follow up period was 57 months (range, 33 to 82 months). The results of treatment were evaluated on the basis of pain, improvement in the ability to perform activities of daily living, to return to work or to a pre-injury level of activity. Results: Pain was partially relieved in 38 patients (88%), but not relieved in 5. Function improved in 34 patients (79%), and 32 (74%) returned to work or to a pre-injury level of activity. There was a trend that the longer the interval between the injury and the operation, the longer the subsequent interval until the patient returned to full activities or work. Conclusion: Meticulous physical examination and intensive prompt treatment for remaining pain after initial treatment of calcaneal fractures are recommended for patient's satisfaction and returning to work.
Kim, Kwang-Jin;Jeon, Byeong-Hwa;Kim, Won-Sik;Park, Kyung-Ran;Choi, Sae-Jin
The Korean Journal of Physiology
/
v.26
no.2
/
pp.143-150
/
1992
The purpose of this study is to obtain the effective concentration of capsaicin to relieve pain with no change in the number of C-fibers and its effective duration for pain relief. Capsaicin has been used extremely as a experimental tool and as topical medications for acute or chronic tissue injuries and partial nerve injury is the main cause of causalgiform pain disorders in humans. Here, the left sciatic nerve was ligated unilaterally at the high level of the thigh to prepare an animal model of this pain condition. The rat developed guarding behavior of the ipsilateral hind paw within a few hours after the operation and this behavior was maintained for several months thereafter, suggesting the possibility of spontaneous pain. These animals were divided into two groups(4-week & 8-week) and each group was subdivided into five groups by different concentration (0.05, 0.1, 0.5, 1.0 & 2.0%). Each capsaicin concentration was treated locally on the spinal cord-side of the ligated nerve and the foot withdrawal latency was measured. Thereafter, the dorsal roots of L5 were removed from both sides immediately after in tracardial perfusion for the counting of C-fibers by the histological procedure. There were no significant differences in the foot-withdrawal latency and the number of C-fibers between the left side treated with 0.05% capsaicin and the right side treated with the vehicle. However, latencies of the left sides treated with 0.1, 0.5, and 1.0% capsaicin increased significantly throughout 4-6 weeks with almost no change in the number of C-fibers, and the latencies showed the trends to approach slowly to those of the conditions after operation. The latency of subgroup treated with 2.0% increased by approximate 10% more than that of the right side throughout 8 weeks, and the number of C-fibers decreased by about 30% or more These results suggest that the elevated latency with capsaicin(0.1-1.0%) treatment is due to the inhibition of impulse transmission throughout the primary afferent fiber and the data from 2.0% are due to partial destruction of C-fibers. Therefore, capsaicin concentrations from 0.1% to 1.0% are probably very effective for the treatment of causalgiform pain with almost no destruction of C-fibers.
Objectives : In the present study, the effect of Scolopendrid Water-Alcohol Extract (SWAE) applied to acupuncture point BL23 (Shinsu) on the neuropathic pain was examined. A common source of persistent pain in humans is the neuropathic pain. Anti-convulsant drugs are used to treat the neuropathic pain. In the oriental medicine, Scolopendrid was used for long time to treat convulsant syndrome and back pain, etc. Methods : On the bases of the Scolopendrid clinical application, the effect of SWAE applied to the acupuncture point was tested in the rat model of neuropathic pain. Neuropathic pain was induced by tight ligation of L5 spinal nerve. When rats developed pain behaviors, One hundred microliter of SWAE was applied into the ipsilateral BL23 point at a dose of 10 mg/ml under enflurane anesthesia. The foot withdraw latency of the hind limb was measured for an indicator of pain level after each manipulation. Results : SWAE injection increased the mechanical threshold of the foot in the rat model of neuropathic pain significantly for the duration of 4h, suggesting a partial alleviation of pain. SWAE applied to BL23 point produced a significant improvement of mechanical sensitivity of the foot lasting for at least 4h. However, neither contralateral BL23 point, ST25 (Chonchu) point, nor LR3 (Taechung) point produce as much increase of mechanical sensitivity as ipsilateral BL23 point. And, this increase of mechanical sensitivity was dose-dependent. The improvement of mechanical threshold was interpreted as an analgesic effect. In addition, the analgesic effect of Scolopendrid 4 mg/kg injection is equivalent to that of gabapentin 50 mg/kg injection. The relations between SWAE-induced analgesia and endogenous nitric oxide(NO), inducible NO synthase (iNOS)/neuronal NO synthase (nNOS) were also examined. Results were turned out that both NO production and nNOS/iNOS protein expression which are increased by nerve injury were suppressed by SWAE injection applied to BL23 point. Conclusions : The data suggest 1) that SWAE produces a potent analgesic effect on the neuropathic pain model in the rat and 2) that SWAE-induced analgesia modulate endogenous NO through the suppression of nNOS/iNOS protein expression.
The nutria(Myocastor coypus) that is originated from South America is a representative Invasive alien species in Korea. invasive alien species is one of the biggest causes for the loss of biodiversity and it may threaten the conservation and function of ecology as well as the welfare of mankind. Intense habitation has been made around the Nakdong River basin area that this study has analyzed the habitat density of nutria for the subject of 3 survey sites in the Nakdong River basin area. As a result of survey on habitation density in 2011 and 2012, under St.1 it was shown $2.01{\pm}0.21$/ha in 2011 and $0.69{\pm}0.55$/ha in 2012. Under St.2, it was shown $0.91{\pm}0.37$/ha in 2011 and $0.55{\pm}0.39$/ha in 2012. Under St.3, it was shown $5.31{\pm}0.72$/ha in 2011 and $3.99{\pm}2.31$/ha in 2012. The wet survey areas of St.1 and St.3 had shown relatively high habitation density compared to St. 2, the river survey area, and the average annual habitation density of the survey area was $2.74{\pm}2.29$/ha in 2011 and $1.74{\pm}1.18$/ha in 2012 that it has shown slightly reducing trend. As a result of measuring the morphology by capturing the habitation individuals, the average body length of adults is $92.23{\pm}9.41cm$, the length from the head to body for $53.90{\pm}5.15cm$, tail length for $38.33{\pm}4.83cm$, hind foot length for $13.82{\pm}1.00cm$, front foot length for $6.02{\pm}0.56cm$, and weight for $5.48{\pm}1.08kg$. As a result of comparing the types between genders, male showed a slightly higher figure in all parts compared to female and it showed significantly difference in total body length, head-body length, front foot length and total weight. As a result of analysis for each head-body length, other measured parts, weight and relativity for each measured part, all bodily part is shown to have the higher volume of correlations. The condition index of individuals in the survey area was shown in the average of $35.67{\pm}4.78$ with female for an average of $36.60{\pm}5.19$ and male for an average of $34.73{\pm}4.34$. The winter temperature in the southern area of Korea is considered for not greatly impacting on the habitation and development of nutria that, if there is no artificial control, it is considered to have certain concern of showing drastic breeding and territory expansion for the habitation group.
Objectives : The usage of acupuncture has gained popularity for certain chronic pain conditions. However, the efficacy of acupuncture in various diseases has not been fully established and the underlying mechanism is not clearly understood. In the present study, the effect of electroacupuncture (EA) applied to yangno$(SI_6)$ on the neuropathic pain was examined. Methods : A common source of persistent pain in human is a neuropathic pain. Neuropathic pain was induced by tight ligation of L5 spinal nerve. When rats developed pain behaviors, EA was applied for 30 min. under enflurane anesthesia with repeated train stimuli at the intensity of 10X of muscle twitch threshold. The foot withdraw latency of the hind limb was measured for an indicator of pain level after each manipulation. Results : EA increased the mechanical threshold of the foot in the rat model of neuropathic pain significantly for the duration of 1 hr. suggesting a partial alleviation of pain. EA applied to SI6 point produced a significant improvement of mechanical sensitivity of the foot lasting for at least 1 h. However, $ST_{36}$ point did not produce any significant increase of mechanical sensitivity. The improvement of mechanical threshold was interpreted as an analgesic effect. The analgesic effort was specific to the acupuncture point since the analgesic effect on the neuropathic pain model could not be mimicked by EA applied to a point, $ST_{36}$. In addition, this analgesic effect of EA is mediated by a adrenergic mechanism of descending control of spinal cord from the brain. Conclusions : The data suggest that EA produces a potent analgesic effect on the neuropathic pain model in the rat; and 2) that EA-induced analgesia is mediated by a adrenergic mechanism of descending control in a point specific manner.
Kim, Kyoung-Tae;Nam, Taek-Kyun;Park, Yong-Sook;Kim, Young-Baeg;Park, Seung-Won
Journal of Korean Neurosurgical Society
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v.49
no.4
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pp.205-211
/
2011
Objective : We investigated the neuroprotective effect of anthocyanin, oxygen radical scavenger extracted from raspberries, after traumatic spinal cord injury (SCI) in rats. Methods : The animals were divided into two groups : the vehicle-treated group (control group, n=20) received an oral administration of normal saline via stomach intubation immediately after SCI, and the anthocyanin-treated group (AT group, n=20) received 400 mg/kg of cyanidin 3-O-${\beta}$-glucoside (C3G) in the same way. We compared the neurological functions, superoxide expressions and lesion volumes in two groups. Results : At 14 days after SCI, the AT group showed significant improvement of the BBB score by $16.7{\pm}3.4%$, platform hang by $40.0{\pm}9.1%$ and hind foot bar grab by $30.8{\pm}8.4%$ (p<0.05 in all outcomes). The degree of superoxide expression, represented by the ratio of red fluorescence intensity, was significantly lower in the AT group ($0.98{\pm}0.38$) than the control group ($1.34{\pm}0.24$) (p<0.05). The lesion volume in lesion periphery was $32.1{\pm}2.4\;{\mu}L$ in the control and $24.5{\pm}2.3\;{\mu}L$ in the AT group, respectively (p<0.05), and the motor neuron cell number of the anterior horn in lesion periphery was $8.3{\pm}5.1$ cells/HPF in the control and $13.4{\pm}6.3$ cells/HPF in the AT group, respectively (p<0.05). Conclusion : Anthocyanin seemed to reduce lesion volume and neuronal loss by its antioxidant effect and these resulted in improved functional recovery.
Background: Subcutaneous injection of 5% formalin into the hind paw of the rat produces a biphasic nociceptive response. The second phase depends on changes in the dorsal horn cell function that occur shortly after an initial C-fiber discharge, spinal sensitization, or windup phenomenon. This study was performed to investigate the role of glutamate during spinal sensitization. Methods: Sprague-Dawley rats weighing 200 to 250 g were used for this study. Under light anesthesia (0.5% isoflurane) the rats were segregated in a specially designed cage and $50{\mu}l$ 0.5% formalin was injected subcutaneously in the foot dorsum of right hindlimb. Forty minutes after the formalin injection, the rat was quickly decapitated and spinal cord was removed. The spinal segments at the level of L3 (largest area) was collected and stored in a deep freezer ($-70^{\circ}C$). The mRNA gene expression of N-methyl-D-aspartate receptor (NMDAR) and the metabotropic glutamate receptor subtype 5 (mGluR5) were determined by the polymerase chain reaction. Results: The number of flinches was $19.8{\pm}2.3/min$. at one minute after formalin injection and decreased to zero after then. The second peak appeared at 35 and 40 minutes after formalin injection. The values were $17.8{\pm}2.2$ and $17.2{\pm}3.0/min$. The mRNA gene expressions of NMDAR and mGluR5 were increased by $459.0{\pm}46.8%$ (P < 0.01) and $111.1{\pm}4.8%$ (P > 0.05) respectively at 40 minutes after formalin injection. The increased rate of NMDAR was significantly higher than that of mGluR5 (P < 0.01). Conclusions: From these results it suggested that NMDAR partly contributed to the mechanism of central sensitization after the formalin test but mGluR5 did not.
The morphometrical characteristics such as external measurements and mandible size assessment in mice and rats have to be highly heritable and sufficiently variable between strains in order to calculate a strain specific profiles. The coat color of Korean wild rats were observed and morphometric analysis of external measurements were carried out on Korean wild rats compared to laboratory strains in order to clarify the genetic characteristics of Korean wild rats and to establish background data as a domestication of Korean wild rats for new laboratory strain. Korean wild rats were captured from Chunchon and Hoengsong. 4 inbred and 1 outbred strains of rats were used in this study for the comparison of genetic characteristic of Korean wild rats. Total body length, head length, tail length, hind foot length and ear length were measured and then statistical analysis were carried out by discrimiant analysis. The coat color of Korean wild rat showed golden white in ventral portion and dark agouti in dorsal portion. Korean wild rats could be distinguished from the other laboratory strains distinctly by morphogenetical analysis. There was significant variations among Korean wild rat compared to those of the other laboratory strains of rat. This study may provide that Korean wild rats have a unique genetic characterization compared to those of other inbred strains of rats based on morphogenetical characteristics by external measurements.
Objectives This study was to investigate the effects of Yuhyangjeongtong-san on the carrageenin-induced acute inflammation and adjuvant-induced arthritis in rats. Methods Acute inflammation was induced by injection of 2% carrageenin 0.15 ml into right hind foot of rats. Control group was carrageenin injected and taken distilled water, treated group was carrageenin injected and taken Yuhyangjeongtong-san by orally once. 2 hours after injection, plantar temperature and paw volume were measured. 3 hours after, counts of white blood cell (WBC) were performed. Arthritis was induced by injection of complete freund's adjuvant (CFA) into base of tail. Control group was CFA injected and taken distilled water, treated group was CFA injected and taken Yuhyangjeongtong-san by orally for 10 days. 0,5,10 day, body weight, thickness of ankle joint and paw edema were measured. 10 day, counts of WBC, $interleukin-1{\beta}$ ($IL-1{\beta}$) and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) level were analysed. Histochemical study of NADPH-d and immunohistochemical study of c-fos were performed. Results In the carrageenin-induced acute inflammation, neutrophils of treated group were significantly decreased compared with control group. In the adjuvant-induced arthritis, paw edema, total counts of WBC and TNF-${\alpha}$ level in paw exudates were significantly decreased compared with control group, and the number of c-fos positive neurons of treated group was significantly decreased compared with control group. Conclusions On the basis of these results, we concluded that Yuhyangjeongtong-san have anti-arthritic and anti-inflammatory effects.
Objectives : The aim of this study was to observe the dose-dependent effects of bee venom (BV) pharmacopuncture on the serious ankle sprain in rats. Methods : The grade III ankle sprain was produced by surgically damaging the lateral ligaments complex of Sprague-Dawley rats. BV pharmacopuncture with the different doses($5{\mu}g/kg$, $10{\mu}g/kg$, $50{\mu}g/kg$) were treated on the different acupoints(GB34, GB39 and GB42) of the affected hind limb, respectively. By measuring foot weight bearing force ratio(FWBFR), the pain levels by ankle sprain and the pain recovery for 7 days were observed under BV pharmacopuncture on each acupoint. Results : In the normal and ankle sprained rat, the BV single administration decreased FWBFR in a dose - dependent pattern. The higher the BV dose, the higher the pain resulted in the normal and the sprained ankles. Especially, the dose - dependent effects of BV resulted in the most pronounced decrease in FWBFR in GB34. The recovery of FWBFR was shown at the low dose($5{\mu}g/kg$) BV and the effect was most remarkable in the BV of GB34, but the others showed no recovery effect compared with the control group. Conclusions : BV pharmacopuncture does not exhibit analgesic effects in acute phase of ankle sprain. However, the recovery of ankle sprain was more effective than the natural recovery in the case of low dose of BV repeated over time. Considering this, it is presumed that it would be important to select appropriate clinic guidelines for acute phase of ankle sprain.
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