• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.207-212
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• 2013

Objective : Recent studies have shown encouraging progress toward the use of autogenic and allogenic mesenchymal stem cells (MSCs) to arrest, or even lead to partial regeneration in, intervertebral disc (IVD) degeneration. However, this technology is still in its infancy, and further development is required. The aim of this study was to analyze whether rat adipose-derived mesenchymal stem cells (ADMSC) can differentiate towards IVD-like cells after treatment with transforming growth factor ${\beta}3$ (TGF-${\beta}3$) in vitro. We also performed quantitative analysis of gene expression for ADMSC only, ADMSCs treated with TGF-${\beta}3$, and co-cultured ADMSCs treated with TGF-${\beta}3$. Methods : ADMSCs were sub-cultured to homogeneity and used in fluorocytometry assays for CD11, CD45, and CD90/Thy1. ADMSCs were differentiated in spheroid culture towards the chondrogenic lineage by the presence of TGF-${\beta}3$, dexamethasone, and ascorbate. We also co-cultured pure ADMSCs and nucleus pulposus cells in 24-well plates, and performed immunohistochemical staining, western blotting, and RT-PCR for quantitative analysis of gene expression. Results : Results of fluorocytometry were positive for CD90/Thy1 and negative for CD11 and CD45. TGF-${\beta}3$-mediated induction of ADMSCs led to the expression of the differentiation markers of intervertebral disc-like cells, such as aggrecan, collagen II, and sox-9. Co-cultured ADMSCs treated with TGF-${\beta}3$ showed higher expression of differentiation markers and greater extracellular matrix production compared with ADMSCs treated with TGF-${\beta}3$ alone. Conclusion : ADMSC treated with TGF-${\beta}3$ may be an attractive source for regeneration therapy in degenerative IVD. These findings may also help elucidate the pathologic mechanism of MSC therapy in the degeneration of IVD in vivo.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.1
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• pp.585-592
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• 2015

The objective of this study is to determine if when chymopapain is loaded onto a nano-carrier, an injection of it reduces the spreading range of the drug within the discs. The materials for the experiment, which were conducted for three weeks, included fifteen intervertebral discs taken from two cadavers, which were divided according to the types of injected chymopapain solutions as follows: ordinary chymopapain group and nano-carrier system group. The nano-carrier system group was again divided into two subgroups according to the types of pluronics, the basic material for the nano-carriers: Pluronic F 127(DA-PF 127) in the nano-carrier group and Pluronic F 68(DA-PF 68) in the nano-carrier group. The results showed that the action of chymopapain using a pluronic-based nano-carrier system was localized around the center of the injection site instead of broad spreading, compared to that of the ordinary chymopapain group (p<0.01). This characteristic suggests a possible application to effective agents for minimally invasive spinal treatment through which disc lesions were removed selectively.

• Journal of Biomedical Engineering Research
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• v.28 no.4
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• pp.512-519
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• 2007

The purpose of this study is to investigate the potential of a novel tissue engineering approach to regenerate intervertebral disc. In this study, thermosensitive scaffold (chitosan-Pluronic hydrogel) and nanofiber were used to replace the nucleus pulposus (NP) and annulus fibrosus of a degenerated intervertebral disc, leading to an eventual regeneration of the disc using the minimally invasive surgical procedure and organ culture. In preliminary study, disc cells were seeded into the scaffolds and cellular responses were assessed by MTT assay and scanning electron microscopy (SEM). Based on these results, we could know that tissue engineered scaffolds might provide favorable environments for the regeneration of tissues. Organ culture was performed in fresh porcine spinal motion segments with endplates on both sides. These spinal motion segments were classified into three groups: control (Intact), injured NP (Defect), and inserting tissue engineered scaffolds (Insert). The specimens were cultivated for 7 days, subsequently structural stability, cell proliferation and morphological changes were evaluated by the relaxation time, quantity of DNA, GAG and histological examination. In these results, inserting group showed higher relaxation time, reduced decrement of DNA contents, and accumulated GAG amount. Consequently, the tissue engineered scaffolds used in this study seen to be a promising base scaffolds for regenerative intervertebral disc due to its capacity to absorb external dynamic loading and the possible ideal environment provided for disc cell growing.

• Journal of Acupuncture Research
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• v.24 no.5
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• pp.137-150
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• 2007

Objectives : To find effects of acupuncture, electro-acupuncture, low level He-Ne laser therapy(LLLT) at $TE_5$, $GB_{41}$ in the neuropathic pain. We made experiment on rats ligated L5 spinal nerve like general herniation of nucleus pulposus(HNP). Methods : A model of neuropathic pain was made by isolating Left 5th lumbar spinal nerve of rats. Three days after the neuropathic surgery, acupuncture and LLLT, electro-acupuncture was injected at $TE_5$, $GB_{41}$ one time a day for a week. Each group was divided two. one is opposite side performed the surgery which is right, another is left side performed the surgery. After that, the author examined the withdrawal response of neuropathic rats' legs by van Frey filament and acetone stimulation. And also the author examined c-Fos, Nociceptin and KOR-3 in the midbrain central gray of neuropathic rats. Results : As we have observed the effect of mechanical allodynia, LT-R group were diminished on 6th day compared with control group, EA-L group, EA-R group and LT-L group were diminished on 7th day compared with control group. As we have observed the effect of cold allodynia, EA-R group were diminished on 6th day, 7th day compared with control group. As we have observed the effect of activity of c-Fos in the central gray part, EA-R group and LT-R group were diminished compared with control group. As we have observed the effect of activity of Nociceptin in the central gray part, EA-R group were a little increased compared with control group but it is not reliability. As we have observed the effect of activity of KOR-3 in the central gray part, EA-R group were significantly increased compared with control group. Conclusions : We have noticed that effect of acupuncture at opposite side of sickness and powerful stimulation could be more effective, because of EA-R group have more controllable effect all test we have done on the other hand EA-L group have only effect on mechanical allodynia. This study can be used in clinical therapy for neuropathic pain. But it is not reliability that Nociceptin have effectively to control pain. Therefore We have to follow up about that.

• The Journal of Korea CHUNA Manual Medicine
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• v.6 no.1
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• pp.119-126
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• 2005

The purpose of this study is to report the patients with common peroneal nerve palsy, who improved by motion style treatment.(M.S.T.) The clinical study on 2 case of patients with herniation of nucleus pulposus, L4-5, L5-S1 combined foot drop, who had been hospitalized in Ja-Seng Oriental Hospital. We checked the motor grade and subjective improvement at interval of 3days under the treatment of M.S.T. After 2-3 weeks of treatment, the movement and power of ankle joint improved to nearly normal range. The subjective improvement was 70% compared with Rt. ankle and range of active motion increased from Gr.1-2 to Gr.4

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.1
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• pp.11-23
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• 2016

Objectives : The purpose of this study was to investigate the characteristics and visiting patterns of traffic accident outpatients Methods : In this study, we reviewed the medical charts of 2,048 traffic accident patients who visited Jaseng Hospital of Korean Medicine from January 1st, 2012 to December 31st, 2012. Results : In the distribution of gender and of age patients, the male percentage was 52.3% and the majority of patients were in their thirties(47.2%). In the distribution of the patient's initial visit, most patients visited our clinic from Monday to Wednesday. By monthly distribution, the more patients visited the clinic at the latter half of the year. In the duration of treatment, 1,389 patients(67.8%) finished treatment within four weeks. The most frequently cited sites of pain were neck(82.0%), followed closely by low back(74.0%). In the access route, 746 patients(36.4%) visited our traffic accident clinic as a first choice for primary treatment. We referred patients for radiologic examination in 159 patients(7.9%), of which the exams were mainly lumbar spine MRIs(3.6%) and cervical spine MRIs(2.8%). The most frequent diagnosis were herniated nucleus pulposus. Conclusions : This study shows that most of the patients who visited the traffic accident clinic of a Korean Medical Hospital presented neck and low back pain, and the majority showed improvement without surgical treatment. Following the increasing minor injury rate caused by traffic accidents, we expect the role of Korean Medicine Hospital to become more prominent.

• Journal of Korean Medicine Rehabilitation
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• v.25 no.2
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• pp.135-153
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• 2015

Objectives The purpose of this study was to investigate the characteristics of inpatients who were admitted to Korean medicine hospital due to low back pain. Methods The current study was designed as a retrospective chart review to investigate descriptive characteristics of LBP patients. The clinical records of 601 patients who were hospitalized for treatment of LBP in Cheonan Korean Medicine Hospital, Daejeon University from 1st, January, 2013 to 31th, December, 2013 were analyzed. Results 1. Most frequently given diagnosis was sprain and strain of lumbar (45.93%). 2. Female outnumbered male patients in all disease groups except fracture of lumbar spine. 3. In distribution according to age, sprain and strain of lumbar, HNP of L-spine and lumbago with sciatica were most frequent at 30s, fracture of lumbar spine was most frequent at 50s and spinal stenosis was most frequent at 70s. 4. The most frequently motive for low back pain was traffic accident (35.4%) 5. Patients with no related medical history were 76.95% 6. 0~1week interval between onset and visit to Korean Medicine Hospital was most frequent in all disease groups. 7. 50.85% of patients went through treatment at medical institutions before the admitting to Korean Medicine Hospital. 8. The average admission days of female was higher than male's. And age goes up, average duration of admission was longer. 9. In most (74.59%) of the patients, symptoms were more than improved. 10. Most frequently prescribed examination was X-ray (65.13%). 11. Most frequently prescribed herb medicine was whal-lak-tang (Huoluo-tang). Conclusions In most (74.59%) of the patients, symptoms were more than improved, especially in sprain and strain of lumbar and lumbago with sciatica. But Patients with a local hospital statistic is not be representative of the incidence of the population. In order to obtain more accurate statistics, it is necessary to compare analysis collect statistics from other medical hospitals.

• Polymer(Korea)
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• v.37 no.6
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• pp.669-676
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• 2013

Demineralized bone particle (DBP) is a biomaterial used widely in the field of tissue engineering. In this study, in order to study the effect of DBP/poly(lactic-co-glycolic acid) (PLGA) scaffold on disc regeneration in vivo environment, we prepared the porous DBP/PLGA hybrid scaffold. Disc defect was induced by removing the nucleus pulposus tissue after incision the annulus fibrosus tissue in half and scaffolds were transplanted. After 1, 2 and 3 months later, the extracted discs were confirmed by collagen synthesis and glycosaminoglycan (sGAG). We conducted histology (H&E, Safranin-O, Alcian blue, Type I Collagen, Type II Collagen). From the results, it was confirmed that collagen and sGAG content were high in DBP/PLGA scaffold, and the regeneration of intervertebral disc was possible.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.211-218
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• 2019

Herniation of the intervertebral disc is a medical disease manifesting as a bulging out of the nucleus pulposus or annulus fibrosis beyond the normal position. Most lumbar disc herniation cases have a favorable natural course. On the other hand, surgical intervention is reserved for patients with severe neurological symptoms or signs, progressive neurological symptoms, cauda equina syndrome, and those who are non-responsive to conservative treatment. Numerous surgical methods have been introduced, ranging from conventional open, microscope assisted, tubular retractor assisted, and endoscopic surgery. Among them, microscopic discectomy is currently the standard method. Biportal endoscopic spinal surgery (BESS) has several merits over other surgical techniques, including separate and free handling of endoscopy and surgical instruments, wide view of the surgical field with small skin incisions, absence of the procedure of removing fog from the endoscope, and lower infection rate by continuous saline irrigation. In addition, existing arthroscopic instruments for the extremities and conventional spinal instruments can be used for this technique and surgery for recurred disc herniation is applicable because delicate surgical procedures are performed under a brightness of 2,700 to 6,700 lux and a magnification of 28 to 35 times. Therefore, due to such advantages, BESS is a novel technique for the surgical treatment of lumbar disc herniation.

• Korean Journal of Radiology
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• v.23 no.6
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• pp.638-648
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• 2022

Objective: The study aimed to investigate the diurnal variation in cervical disc hydration and its relationship with cervical degeneration. Materials and Methods: C3-C7 discs of 86 prospectively enrolled participants (37 males, 49 females; mean age ± standard deviation, 23.5 ± 2.5 years) were assessed using T2 mapping in the morning and evening. All discs were stratified by Miyazaki grade or C2-C7 Cobb angle and T2 values (T2). The degree of diurnal T2 variation (T2-DDV), defined as (morning T2 - evening T2)/morning T2 x 100%, was measured for the entire disc, annulus fibrosus (AF), nucleus pulposus (NP), and endplate zones. Results: T2 of the entire disc decreased significantly after the daytime load (p < 0.001), with a T2-DDV of 13.3% for all discs and 16.0%, 12.2%, and 13.0% for healthy (grade I), mild degenerative (grade II), and advanced degenerative (grade III/IV) discs, respectively. T2 of regional NPs and AFs decreased significantly from morning to evening (p ≤ 0.049) except in the healthy anterior inner AF (p = 0.092). Compared with healthy discs, mild degenerative discs displayed lower T2 and T2-DDV in regional NPs (p < 0.001). Advanced degenerative discs showed higher T2-DDV in the anterior inner AF compared with healthy discs (p = 0.050). Significant diurnal T2 changes in the endplate zones were observed only in healthy discs (p = 0.013). Cervical discs in the low Cobb angle group showed higher T2-DDV in the anterior AFs and anterior NP and lower T2-DDV in the posterior AF than those in the high Cobb angle group (p ≤ 0.041). Conclusion: This study characterized the diurnal variation in hydration of the cervical discs as assessed using T2 mapping and revealed early chemo-mechanical coupling dysfunction in degenerating discs. Cervical sagittal alignment on MRI can affect the diurnal stress patterns of the cervical discs. T2 mapping is sensitive to disc biomechanical dysfunction and offers translational potential from biomechanical research to clinical application.