• Applied Microscopy
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• 제26권3호
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• pp.329-348
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• 1996

The prenatal development of lateral motor columns in the lumbar spinal cord was studied by electron microscopy in human embryos and fetuses ranging from 9 mm to 260 mm crown-rump length ($5{\sim}30$ weeks of gestational age). At 9 mm embryo, the lateral motor column were developed from ventro-lateral projection into the marginal layer and composed of primitive neuroblasts. At 20 mm embryo the primitive motor neurons were packed closely together and could readly be distinguished from primitive glioblasts by a presence of large nuclei. The primitive multipolar neurons were observed in lateral motor column at 40 mm fetus. At 80 mm fetus multipolar neurons were characterized by their many dendrites and axons in the vicinity of motor neuron perikarya. At 260 mm fetus, the motor neurons were large and contained all intracytoplasmic structures in the cytoplasm which were also found in mature motor neuron in lateral motor column. The first axo-dendritic synapses found at 40 mm fetus and increased in number throughout fetal development. Axo-somatic synapses with spherical vesicles were first observed at 80 mm fetus. A few axo-somatic synapses were found at next prenatal stages. Axo-dendritic and axo-somatic synapses contained mixed populations of spherical and flattened vesicles by 120 mm fetus. These findings indicate that axo-dendritic synapses develop prior to axo-somatic synapses in the spinal cord during neurogenesis.

• Tuberculosis and Respiratory Diseases
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• 제67권6호
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• pp.574-576
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• 2009

An intramedullary spinal cord metastasis (ISCM) rarely develops in systemic cancer but is indicative of a poor prognosis. A 56-year-old man was admitted due to weakness of the lower extremities. He had received radiotherapy 3 months prior for a brain metastasis that had developed 1 year after achieving a complete response from chemotherapy for extended stage small cell lung cancer. Although the brain lesion had improved partially, ISCM from the cervical to lumbar-sacral spinal cords, which was accompanied by a leptomeningeal dissemination, was diagnosed based on magnetic resonance imaging of the spine and cerebrospinal fluid cytology. Finally, he died of sudden cardiac arrest during treatment. This is the first case of ISCM involving the whole spinal segments. Physicians should be aware of the subsequent development of ISCM in lung cancer patients with a previously known brain metastasis who present with new neurological symptoms.

• Journal of Korean Neurosurgical Society
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• 제29권7호
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• pp.877-885
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• 2000

Objective : The NOS inhibitors exhibit antinociceptive activity in rat model of neuropathic pain. NOS activity increases in the dorsal root ganglia(DRG) in neurop-athic pain. However, NOS activity decreases in the dorsal horn of spinal cord in the nerve injury models of neuropathic pain. To investigate whether the mechanism of decrease of NOS expression in the dorsal horn is related to a secondary effect resulting from increased NO production and likewise in the spinal DRG in the spinal nerve ligation model of neuropathic pain. Methods : We conducted behavioral tests for neuropathic pain, and nNOS immunohistochemistry and NADPH-diaphorase histochemistry after tight ligation of the 5th lumbar(L5) and 6th lumbar(L6) spinal nerves and L5 dorsal rhizotomy. Results : Typical neuropathic pain behaviors occurred 7 days after post-ligation in the neuropathic surgery group, but neuropathic pain behaviors in the dorsal rhizotomy group were absent or weak 7 days after post-operation. There was a decrease in the number of nNOS immunoreactive dorsal horn neurons on the both side(especially ipsilateral side) 7 days after post-ligation. The number of nNOS immunoreactive neurons in both side of the dorsal horn was not decreased 7 days after L5 dorsal rhizotomy. Conclusion : These data indicate that the changes in the injured DRG is essential for development and maintenance of neuropathic pain, and mechanism of decrease of nNOS expression in the dorsal horn is a secondary effect against the changes in the DRG including increased NO production in the spinal nerve ligation model of neuropathic pain.

• Archives of Plastic Surgery
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• 제35권1호
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• pp.13-19
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• 2008

Purpose: Human adipose tissue-derived mesenchymal stem cells(hATSCs) can be differentiated into multiple mesenchymal lineages, including bone, cartilage, and muscle. And growth hormone play important roles in the normal growth and development of the CNS. In this study, we explored whether the transplanted hATSCs and growth hormones could improve functional recoveries from rats with contusive spinal cord injury. Methods: We divided 30 female rats, which were subjected to a weight driven implant spinal cord injury, into 3 groups with 10 rats each; Group A as a control group, group B with hATSCs transplantation on injured region, and group C with hATSCs transplantation and GH administration for 7 days. Then, we researched their neurologic functional recoveries before and 2, 4, and 8 weeks after transplantation using Basso-Beattie-Bresnahan (BBB) locomotor rating scale. And we checked Y-chromosome positive cells by FISH(Fluorescent in situ hybridization) to identify the survival of transplanted mesenchymal stem cells. Results: After 4 weeks of transplantation, the group B and group C showed significant improvement of neurologic function on BBB locomotor rating scale in comparison with the group A(Group A: $13.1{\pm}0.58$, Group B: $14.6{\pm}0.69$, Group C: $14.9{\pm}0.56$). Moreover, the group C displayed meaningful recovery of neurologic function after 8 weeks in comparison with group B (Group B: $15.7{\pm}0.63$, Group C: $16.5{\pm}1.14$). The group A, the control one, improved for 5 weeks after injury, and had no more recovery. On the other hand, Group B and C showed the improvement of neurologic function continuously for 9 weeks after injury. Conclusion: In this study, we found out that hATSCs transplantation have an effect on neurologic functional recovery of spinal cord injured rat and GH injection seems to bring the synergistic results on this good tendency.

• 재활치료과학
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• 제9권4호
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• pp.107-120
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• 2020

목적 : 척수손상환자를 대상으로 한 무작위 대조군 연구의 체계적 고찰과 메타분석을 통해 척수손상환자의 재활 중재의 효과성과 근거를 알아보고자 한다. 연구방법 : 국외 논문데이터베이스에서 검색어를 사용하여 학술지에 게재된 연구를 2명의 연구자가 독립적으로 검색하여 선정하였다. 선정기준에 부합한 연구는 총 21편이었고, PEDro Scale을 사용하여 연구의 질적 평가를 실시하였다. 메타분석은 Comprehensive Meta-Analysis 3.0 프로그램을 사용하였다. 결과 : 분석된 연구에 참여한 연구대상자는 총 713명이었고, 메타분석을 실시한 결과 신체활동을 이용한 중재는 0.406(95.0% 신뢰구간: 0.221~0.591), 전기 자극 치료중재는 0.505(95.0% 신뢰구간: 0.449~1.528)로 중간크기(Medium)의 효과를 보이는 것으로 나타났고 교육적 방법 중재는 0.248(95.0% 신뢰구간: 0.033~0.464), 복합 중재는 0.280(95.0% 신뢰구간: 0.122~0.438)로 작은 크기(Small)의 효과를 보이는 것으로 나타났다. 통계적 이질성 검정에서 유의미한 이질성이 있어 연구결과 통합 시 랜덤효과 모형을 선택하여 분석하였고, 출판편견은 유의미하지 않아 신뢰할만한 연구결과였다. 결론 : 분석된 결과 척수손상환자를 대상으로한 재활 중재는 효과적임을 알 수 있었다. 척수손상환자를 대상으로한 재활분야에서 임상가들이 대상자의 라이프 스타일을 개선하기 위한 프로그램을 구성할 때 기여할 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.242-247
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• 2015

Objective : The purpose of this study is to determine whether the changes of contralateral sensorimotor cortical activation on functional magnetic resonance imaging (fMRI) can predict the neurological outcome among spinal cord injury (SCI) patients when the great toes are stimulated without notice. Methods : This study enrolled a total of 49 patients with SCI and investigated each patient's preoperative fMRI, postoperative fMRI, American Spinal Injury Association (ASIA) score, and neuropathic pain occurrence. Patients were classified into 3 groups according to the change of blood oxygenation level dependent (BOLD) response on perioperative fMRI during proprioceptive stimulation with repetitive passive toe movements : 1) patients with a response of contralateral sensorimotor cortical activation in fMRI were categorized; 2) patients with a response in other regions; and 3) patients with no response. Correlation between the result of fMRI and each parameter was analyzed. Results : In fMRI data, ASIA score was likely to show greater improvement in patients in group A compared to those belonging to group B or C (p<0.001). No statistical significance was observed between the result of fMRI and neuropathic pain (p=0.709). However, increase in neuropathic pain in response to the signal change of the ipsilateral frontal lobe on fMRI was statistically significant (p=0.030). Conclusion : When there was change of BOLD response at the contralateral sensorimotor cortex on perioperative fMRI after surgery, relief of neurological symptoms was highly likely for traumatic SCI patients. In addition, development of neuropathic pain was likely to occur when there was change of BOLD response at ipsilateral frontal lobe.

• The Korean Journal of Pain
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• 제29권2호
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• pp.86-95
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• 2016

Background: The present study was designed to examine the functional recovery following spinal cord injury (SCI) by adjusting the parameters of impact force and dwell-time using the Infinite Horizon (IH) impactor device. Methods: Sprague-Dawley rats (225-240 g) were divided into eight injury groups based on force of injury (Kdyn) and dwell time (seconds), indicated as Force-Dwell time: 150-4, 150-3, 150-2, 150-1, 150-0, 200-0, 90-2 and sham controls, respectively. Results: After T10 SCI, higher injury force produced greater spinal cord displacement (P < 0.05) and showed a significant correlation (r = 0.813) between the displacement and the force (P < 0.05). In neuropathic pain-like behavior, the percent of paw withdrawals scores in the hindpaw for the 150-4, 150-3, 150-2, 150-1 and the 200-0 injury groups were significantly lowered compared with sham controls (P < 0.05). The recovery of locomotion had a significant within-subjects effect of time (P < 0.05) and the 150-0 group had increased recovery compared to other groups (P < 0.05). In addition, the 200-0 and the 90-2 recovered significantly better than all the 150 kdyn impact groups that included a dwell-time (P < 0.05). In recovery of spontaneous bladder function, the 150-4 injury group took significantly longer recovery time whereas the 150-0 and the 90-2 groups had the shortest recovery times. Conclusions: The present study demonstrates SCI parameters optimize development of mechanical allodynia and other pathological outcomes.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2004년도 학술대회 논문집 정보 및 제어부문
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• pp.6-8
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• 2004

The objective of this paper is to develop a powered wheelchair controller based on EMG for users with high-level spinal cord injury using a proportional control scheme. An advantage of EMG is relative convenience of acquisition by a surface electrode to users. Direction information can be easily extracted from two EMG channels and force information can be acquired by proportional relationship between the amplitude of EMG and user's power, respectively. Pattern classification algorithm is a threshold method with a supervised learning process. Furthermore, the emergency situation can be avoided using an interrupt function. We evaluated the performance of powered wheelchair controller by navigating a pre-defined path with three non-handicapped people. The results show the feasibility of EMG as an input interface for powered wheelchair and other devices for the seriously disabled.

• 제어로봇시스템학회논문지
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• 제16권9호
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• pp.860-865
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• 2010

This paper deals with gait assisting rehabilitation robot which helps SCI patient walk again. We propose new concept of orthotic for robot considering motions of Hip and Knee Joints, and how to fit the robot to a user in terms of weight balance and comfortable standing. Then we describe our first engineering sample being designed based on the passive orthotic and show how to make the robot work for SCI patient in basic operation.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 2001년도 ICCAS
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• pp.84.5-84
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• 2001

The objective of this paper is to develop a powered wheelchair controller based on EMG for users with high-level spinal cord injury. EMG is very naturally measured when the user Indicating a certain direction, and the force information which will be used for the speed of wheelchair is easily extracted from EMG. Furthermore, the emergency situation based on EMG will be checked relatively ease. We classified the pre-defined motions such as rest case, forward movement, left movement, and right movement by Fuzzy Min-Max Neural Networks (FMMNN). This classification results shows the feasibility of EMG as an input interface for powered wheelchair. To make the system low cost and small size, we developed EMG AMP and its controller ...