• Applied Microscopy
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• v.21 no.2
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• pp.39-56
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• 1991

The development of notochordal cells of nucleus pulposus was studied with electron microscope in human fetuses ranging from 30 mm to 260 mm crown-rump length. At 30 mm fetus, primitive notochordal cells were large with central nucleus, few organelles, and their cytoplasm usually contained dense glycogen and fine filaments. Notochordal cells at all ages contained bundles of fine filaments of indeterminate nature. One unusual feature of fetal notochordal cells was the consistent presense of rough endoplasmic reticulum surrounding poorly developed mitochondria. At 50 mm fetus, notochordal cells formed dense masses with interdigitating cell membranes connected by a variety of cell to cell junctions. With increasing age, the cell connections became slender threaded cytoplamic extending from cell and enclosed large extracellular space. Chondrocyte-like cells appeared to be separated by large volumes of extracellular matrix. Viable notochordal and condrocyte-like cells existed in specimen from all age. The extracellular spaces were filled with fibrillar and granular material by 90 mm fetus. Necrotic cells were distinguished by loss of their membrane integrity, vacuolization of their organelles, and the presence of dense osmiophilic masses. In adult tissue, notochordal cells became rounded or irregular in shape and developed a pericellular matrix consisting of collagen fibrile, and dense particle. The structure of notochordal cells and their persistance in the nucleus pulposus after fetal life suggested that they may have a significant role in the formation and maintenance of the nucleus pulposus. The presence of Golgi complex and well-developed endoplasmic reticulum in chondrocyte-like cells suggested that they are capable of producing and maintaining the extracellular matrix.

• 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.

• 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.

• 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 the Korean Orthopaedic Association
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• v.56 no.4
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• pp.283-293
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• 2021

Degenerative disc disease has traditionally been thought of as low back pain caused by changes in the nucleus pulposus and annulus fibrous, in recent studies, however, changes in the upper and lower endplates cause degeneration of the disc, resulting in mechanical pressure, inflammatory reactions and low back pain. Recently, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous were considered as a single unit, and the relationship was explained. Once the endplate is damaged, it eventually aggravates the degeneration of the bone marrow, nucleus pulposus, and annulus fibrosus. In this process, the compression force of the annulus fibrosus increases, and an inflammatory reaction occurs due to inflammatory mediators. Hence, the sinuvertebral nerves and the basivertebral nerves are stimulated to cause back pain. If these changes become chronic, degenerative changes such as Modic changes occur in the bone marrow in the vertebrae. Finally, in the case of degenerative intervertebral disc disease, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous need to be considered as a single unit. Therefore, when treating patients with chronic low back pain, it is necessary to consider the changes in the nucleus pulposus and annulus fibrosus and a lesion of the endplate.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.1 no.1
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• pp.99-104
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• 1995

Markolf and Morris suggests that the deranged disk and torn annulus have an exellent recovery ability from the position of spine extension, where the posterior annulus is not under stress and the gel can move anterioly. McKenzie explains side gliding as a combination of rotation and side bending, his clinical studies indicate that side-gliding can gel laterally. In conclusion, the prone unilateral traction on the opposite side from the patient's pain along with the other treatment appered to have helped reduce those patient's pain. The method of treatment described in this report is suggested for Korean physical therapists who treat patients suspected of posterolateral herniated nucleus pulposus.

• Journal of Korean Physical Therapy Science
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• v.2 no.2
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• pp.481-486
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• 1995

Markolf and Morris suggests that the deranged disk and torn annulus have an exellent recovery ability from the position of spine extension, where the posterior annulus is not under stress and the gel can move anterioly. McKenzie explains side gliding as a combination of rotation and side bending, his clinical studies indicate that side-gliding can gel laterally. In conclusion, the prone unilateral traction on the opposite side from the patient's pain along with the other treatment appered to have helped reduce those patient's pain. The method of treatment described in this report is suggested for Korean physical therapists who treat patients suspected of posterolateral herniated nucleus pulposus.

• The Journal of Korean Physical Therapy
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• v.2 no.1
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• pp.103-112
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• 1990

The intervertebral disc in the anterior portion of the function unit gives the spine its flexibility. The disc is attached closely to the vertebral endplates. Between these endplates and the annulus fibrosus, the nucleus pulposus of the lumbar disc is enclosed in a circle of unyielding tissues. Compressive pressure placed on the disc is dissipated circumferentially in a passive manner In response to the greater axial forced exerted on the lumbar spine in comparison to the cervical and thoracic spines, the nucleus pulposus has its greatest surface area in the lumbar spine. The intervertebral disc is not only structure that helps diss pate stresses placed on the spine. With flexion, extension, rotation, or shear stress, the load distribution on the function unit is shared by the intervertebral disc, anterior and posterior longitudinal ligaments, the facet joints and capsules, and other ligamentous structures like the ligamentum flavum, interspinous and supraspinous ligaments, which attach to the posterior elements of the functional unit.

• 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.

• Molecules and Cells
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• v.42 no.9
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• pp.661-671
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• 2019

Adipose tissue-derived mesenchymal stem cells (ADSCs) are promising for regenerating degenerated intervertebral discs (IVDs), but the low efficiency of nucleus pulposus (NP)-specific differentiation limits their clinical applications. The Sonic hedgehog (Shh) signaling pathway is important in NP-specific differentiation of ADSCs, and Smoothened Agonist (SAG) is a highly specific and effective agonist of Shh signaling. In this study, we proposed a new differentiation strategy with the use of the small molecule SAG. The NP-specific differentiation and extracellular matrix (ECM) synthesis of ADSCs were measured in vitro, and the regenerative effects of SAG pretreated ADSCs in degenerated IVDs were verified in vivo. The results showed that the combination of SAG and transforming growth factor-${\beta}3$ ($TGF-{\beta}3$) is able to increase the ECM synthesis of ADSCs. In addition, the gene and protein expression levels of NP-specific markers were increased by treatment with SAG and $TGF-{\beta}3$. Furthermore, SAG pretreated ADSCs can also improve the disc height, water content, ECM content, and structure of degenerated IVDs in vivo. Our new differentiation scheme has high efficiency in inducing NP-specific differentiation of ADSCs and is promising for stem cell-based treatment of degenerated IVDs.