• Journal of Korean Neurosurgical Society
• /
• v.61 no.1
• /
• pp.89-96
• /
• 2018

Objective : Morphometric data for the lumbar posterior longitudinal ligament (PLL) was investigated to identify whether there is a difference in the morphometry of the PLL of the lumbar spine at each level with respect to the pattern of intervertebral disc displacement. Methods : In 14 formalin-fixed adult cadavers (12 males and 2 females), from L1 to L5, the authors measured the width and height of the PLL and compared them with other landmarks such as the disc and the pedicle. Results : Horizontally, at the upper margin of the disc, the central portion of the superficial PLL covered 17.8-36.9% of the disc width and the fan-like portion of the PLL covered 63.9-76.7% of the disc width. At the level of the median portion of the disc, the PLL covered 69.1-74.5% of the disc width. Vertically, at the level of the medial margin of the pedicle, the fan-like portion of the PLL covered 23.5-29.9% of the disc height. In general, a significant difference in length was not found in the right-left and male-female comparisons. Conclusion : This study presents the morphometric data on the pattern of intervertebral disc displacement and helps to improve the knowledge of the surgical anatomy of the lumbar PLL.

• Journal of Korean Neurosurgical Society
• /
• v.40 no.5
• /
• pp.363-368
• /
• 2006

Objective : Little is known about the comprehensive molecular and biological mechanism on the development of the degeneration of the intervertebral disc. Many kinds of matrix metalloproteinase[MMP] initiate the degradation of the extracellular matrix including several kinds of collagens and proteoglycans. We compared molecular and immunohistochemical features of degenerated intervertebral disc and normal counterparts in order to investigate the role of MMP-1, 2, 3, 9. Methods : We have evaluated MMP-1, 2, 3, 9 expression in 30 surgically resected lumbar disc from degenerative disc disease patients and 5 normal control cases. RT-PCR[reverse transcriptase-polymerase chain reaction] and immunohistochemistry were performed. Results : By RT-PCR, normal tissue samples showed merely scant expression of MMP-1, 2, 3, 9 mRNA, but degenerated disc samples revealed more pronounced expression. mRNA amplifications were detected in 60%, 63.3%, 70%, 53.3% cases By immunohistochemistry, normal tissue samples showed minimal protein expression of MMP-1, 2, 3, 9, but degenerated disc samples revealed more pronounced expression. Protein expressions were detected in 73.3%, 63.3%, 76.7%, 63.3% cases. Both the mRNA amplification and protein overexpression rates were significantly higher in degenerated disc than in the normal tissue. Concordance between both the mRNA amplification and protein expressions of MMP-1, 3, 9 were not observed, but there is well correlation in MMP-2 expression. Conclusion : We concluded that the over-expressions of the MMP-1, 2, 3, 9 may contribute to the development of degeneration of the intervertebral disc.

• Journal of Korean Medicine Rehabilitation
• /
• v.19 no.2
• /
• pp.203-212
• /
• 2009

Objectives : Spurling test is one of the most widely used physical tests to diagnose herniated cervical intervertebral disc. The purpose of this study is to analyse diagnostic validity of Spurling test. Methods : This study was carried out on 382 subjects who visited Bu-Chun Ja-Seng oriental hospital with the neck pain or radiating pain from neck to upper extremities from November, 2007 to October, 2008. All subjects underwent both Spurling test and cervical magnetic resonance imaging(MRI). The associations between Spurling test and herniated cervical intervertebral disc were analysed. Results : 1. The sensitivity of Spurling test for herniated cervical intervertebral disc was 64%. 2. The specificity of Spurling test for herniated cervical intervertebral disc was 86%. 3. The positive predictive value of Spurling test for herniated cervical intervertebral disc was 93%. 4. The negative predictive value of Spurling test for herniated cervical intervertebral disc was 44%. Conclusions : This study suggests that Spurling test is not useful in screening for herniated cervical intervertebral disc due to the test's relatively low sensitivity. Thus it is necessary to consult advanced tests such as diagnostic imaging to diagnose herniated cervical intervertebral disc.

• Journal of Korean Medicine Rehabilitation
• /
• v.23 no.2
• /
• pp.129-138
• /
• 2013

Objectives : This study investigated the relationship between straight leg raising(SLR), valsalva test and size, position of lumbar disc herniation. Methods : We took SLR and valsalva test on 105 patients with lumbar disc herniation. According to the result of MRI findings, this study classified three groups of 105 patients with lumbar disc herniation, bulging, protrusion and extrusion. According to the position of lumbar disc herniation, 72 patients that were diagnosed protrusion and extrsuion were sorted 4 groups, lateral, lateral postero-lateral, central postero-lateral, central. The association size, position of lumbar disc herniation and SLR, valsalva test were analysed. Results : The bigger size of disc herniation, the more positive result of SLR and valsalva test, the lower angle of SLR test. There was not significant association between the position of lumbar disc herniation and the angle of SLR test. Conclusions : The SLR and valsalva test is an useful physical examination to speculate about the degree of lumbar disc herniation.

• The Korean Journal of Pain
• /
• v.21 no.2
• /
• pp.143-149
• /
• 2008

Background: Traction has often been utilized to treat patients with a herniated lumbar disc. Currently, the most advanced type of traction therapy is non-surgical spinal decompression. Therefore, this study was conducted to evaluate the effectiveness of decompression therapy in patients with a herniated lumbar disc based on clinical findings and symptoms. Methods: Sixty patients with herniated lumbar discs were included in this study. The patients were randomly divided into two groups, a decompression group (n = 30) and a traction group (n = 30). To evaluate the impact of decompression and traction therapy on the herniated disc, the clinical symptoms for each group were evaluated prior to and after treatment using the visual analogue scale (VAS), straight leg raising (SLR), the herniation index, and the disc height. Results: The VAS score was significantly lower in the decompression group ($2.0{\pm}0.2$) than the traction group ($3.9{\pm}0.2$) following treatment. In addition, the SLR angle was significantly higher in the decompression group ($79{\pm}1.5$) than the traction group ($63.3{\pm}1.9$). The herniation index was significantly lower in the decompression group ($217.6{\pm}19.1$) than the traction group ($259.5{\pm}16.4$). Finally, the disc height was not significant differences between pre-treatment and follow-up in two groups. Conclusions: The results of this study suggest that decompression therapy for the treatment of patients suffering from a herniated lumbar disc has an effect on the pain, SLR, and herniation indices, not disc heights.

• Journal of Korean Neurosurgical Society
• /
• v.37 no.5
• /
• pp.336-339
• /
• 2005

Objective: The goal of this study is to establish the anatomical criteria of the normal and stenotic lumbosacral extraforaminal tunnel, and also to determine the effect of the pathologic intervertebral disc on the size of extraforaminal tunnel in the lumbosacral spine. Methods: MRI and CT scans were reviewed and classified into two groups: (1) 40 patients with normal discs at L5- S1 (Group 1) and (2) 43 patients that had undergone successful decompression surgery for extraforaminal entrapment at the lumbosacral region(Group 2). In these two groups, the following parameters were compared are compared: the distance between the disc margin and the ala (lumbosacral tunnel) on the axial MRI, and the posterior disc height at L5-S1 on the mid-sagittal MRI. Results: In the group 1, the mean distance of the lumbosacral tunnel on the axial MRI was $10.1{\pm}2.2mm$. The mean posterior disc height at L5-S1 was $7.4{\pm}1.7mm$ on the mid-sagittal MRI. In the group 2, the mean distance between the disc margin and the ala (costal process) was $1.6{\pm}1.3mm$ on the axial MRI. The average posterior disc height was $4.4{\pm}1.5mm$ on the mid-sagittal MRI. The posterior disc height and the size of the lumbosacral tunnel between the two groups were statistically different on the paired t-test (p<0.0001). However, the posterior disc height was not positively correlated with the size of the extraforaminal tunnel for group 2 (p=0.909). Conclusion: The extraforaminal stenosis was correlated to pathologic disc. However, the posterior disc height was not correlated to the size of the of the extraforaminal tunnel.

• The Korean Journal of Pain
• /
• v.34 no.4
• /
• pp.447-453
• /
• 2021

Background: Provocative discography (PD) is a test that is useful in diagnosing discogenic pain (DP). In this study, to diagnose DP, we used a posterolateral approach of needle placement and followed pressure criteria laid down by the Spine Intervention Society. The aim was to identify the correlation between magnetic resonance imaging (MRI) findings (desiccation, high intensity zone and change in shape and size of the disc) and the results of PD. Methods: Records of 50 patients who underwent PD for DP were analyzed. A total of 109 PDs were performed, with 54 suspect and 55 control discs. Alternate pain generators were ruled out. Results: A total of 35 suspect discs were positive on PD. The mean disc pressure in the suspect disc was 31.9 ± 7.9 psi (range, 15-44). Of the 50 patients who underwent PD, 35 had positive MRI findings. A significant positive correlation was found only between disc desiccation and discography result (r = 0.6, P < 0.001). Logistic regression analysis revealed that only desiccation successfully predicted the result of discography (OR = 26.5, P < 0.001); a high intensity zone and a disc protrusion/extrusion had an OR 2.3 and 1.24, respectively. Disc desiccation of Pfirmann grade 3 or more had a sensitivity and specificity of 0.93 and 0.64 respectively in identifying painful discs; the positive likelihood ratio was 2.58 while the negative likelihood ratio was 0.11. Conclusions: In patients with DP, disc desiccation is the most useful MRI feature that predicts a painful disc on PD.

• Investigative Magnetic Resonance Imaging
• /
• v.15 no.2
• /
• pp.123-129
• /
• 2011

Purpose : To compare lumbar disc changes between initial lumbar spine (L-spine) MRI and follow-up (f/u) MRI that were performed due to recurred backaches. Materials and Methods : A total 50 patients who had undergone f/u L-spine MRI were retrospectively reviewed. Five discs (L1-S1) were surveyed in each f/u MRI. Lumbar disc changes were defined as no change, aggravations, or improvements compared to initial disc states. These states were defined on the basis of morphologic status and disc levels. Results : In a total of 250 discs in 50 patients, 31 discs (12.4%) showed morphologic changes of disc lesions, whereas 219 discs (87.6 %) showed no changes. Among the 31 disc lesions, 24 were aggravated and 7 were partially improved. And on the basis of disc status, initially abnormal discs revealed any morphologic changes of the degree of disc herniation. A total of 33.3% of the morphologic changes are noted in initially extruded discs. Fifteen morphologic changes of disc lesions were located at the L4-5 level. Conclusion : Our results suggest that correlations between lumbar disc herniations and back pain symptoms are limited, and that evaluations of extra disc lesions are required.

• Korean Journal of Head & Neck Oncology
• /
• v.19 no.1
• /
• pp.25-33
• /
• 2003

Background and Objectives: The Herpes Simplex type 2 Defective Infectious Single Cycle virus (DISC virus) is attenuated virus originally produced as viral vaccines but are also efficient gene transfer vehicle. The main goals of this study were to examine the efficiencies of the gene transfer using DISC vectors for various head and neck squamous cell carcinoma cell lines and to evaluate the efficacy of vaccination with DISC virus carrying a immunomodulatory genes (GM-CSF) as cancer therapy in a organotopic oral cavity squamous cell cancer model. Materials and Methods : We determinated the gene transfer efficiency of DISC virus by x-gal stain method and proved gene and protein expression of DISC-GMCSF transfected SCCVII cells by RT-PCR and ELISA method. Also we evaluated the ex vivo vaccination effects of SCCVII/GMCSF (DISC-GMCSF transfected SCCVII vaccine) vaccine on preventing the recurrence of micro-residual tumor. After the vaccination of SCCVII/GMCSF, specific cytotoxic T-cell responses was evaluated by CTL assay. Results: At an MOI of 10 DISC virus showed 64-88% of transfection rates in various head and neck squamous cancer cell lines. SCCVII cells transduced by DISC virus vector (MOI=10) carrying the GM-CSF gene, produced 4.5 nanogram quantities of GM-CSF per $10^6$ cells. In vivo vaccination using tumor cells transduced ex vivo with DISC-GMCSF resulted in better protection rate against subsequent tumor recurrence in organotopic oral cavity cancer model. Although tumor free survival rate was not statistically significantly increased in vaccination group (p=0.078), tumor specific cytotocic T-cell responses were significantly increased in SCCVII/GMCSF vaccination group. Conclusion: These data demonstrate that; 1) The DISC virus vector is capable of efficient gene transfer to various head and neck squamous cancer cell lines, 2) GM-CSF secreting genetically modified tumor vaccine (SCCVII/GMCSF) efficiently protected against tumor recurrence in organotopic micro-residual oral cavity cancer model and produced tumor specific cytotoxic T-cell response. DISC virus-mediated, cytokine gene transfer may prove to be useful as a clinical therapy for head and neck cancers.

• Journal of the Korean Society of Safety
• /
• v.23 no.3
• /
• pp.25-29
• /
• 2008

In automotive disc brake system, friction heat is not uniformly distributed due to various reasons such as thermal expansion and imperfections in geometry. It is well known that thermoelastic distortion due to fictional heating affects the contact pressure distribution and can lead to thermoelastic instability, where the contact load is concentrated in one or more small regions on the brake disc surface. These regions then take very high temperatures and passage of hot spots moving under the brake pads can cause low frequency vibration called brake judder. This paper presents the FEM(finite element method) result for the temperature distribution of ventilated disc brake. A steady state two-dimensional model of disc brake system predicts the surface temperatures during a multi-stop driving schedule.