• The Korean Journal of Physiology
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• v.23 no.1
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• pp.129-138
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• 1989

In an attempt to characterize the ventral root afferent fibers, arterial blood pressure responses to stimulation of the ventral root (VR) were observed in anesthetized cats. Effects of the morphine administered either intravenously or direct spinally and of the spinal lesions on the pressor responses were compared. Followings are the results obtained. 1) Stimulation of the VR with C-strength, high frequency stimuli evoked a marked pressor response. No depressor response, which had been reported during peripheral nerve stimulation, was observed during VR stimulation with low frequency. 2) Acute cervical spinalization abolished the pressor response, indicating the involvement of supraspinal mechanism. 3) The ascending spinal pathways of the pressor response were located in the dorsolateral funiculus bilaterally. 4) Intravenously administered morphine exaggerated the pressor response to VR stimulation, while direct spinally administered morphine suppressed it. From the above results it was concluded that the ventral root afferent fibers have more similar properties to muscular C-afferent fibers than to cutaneous C-fibers.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.186-193
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• 2018

Objective : The purpose of this study was to evaluate pain-related behaviors after bilateral C2 root resection and change in pain patterns in the suboccipital region in rats. Methods : Male Sprague-Dawley rats were randomly assigned to three groups (n=25/group); $n{\ddot{a}}ive$, sham, and C2 resection. Three, 7, 10, and 14 days after surgery, cold allodynia was assessed using $20{\mu}L$ of 99.7% acetone. c-Fos and c-Jun were immunohistochemically stained to evaluate activation of dorsal horn gray matter in C2 segments of the spinal cord 2 hours, 1 day, 7 days, and 14 days after surgery. Results : Three days after surgery, the response to acetone in the sham group was significantly greater than in the $n{\ddot{a}}ive$ group, and this significant difference between the $n{\ddot{a}}ive$ and sham groups was maintained throughout the experimental period (p<0.05 at 3, 7, 10, and 14 days). Seven, 10, and 14 days after surgery, the C2 root resection group exhibited a significantly greater response to acetone than the $n{\ddot{a}}ive$ group (p<0.05), and both the sham and C2 resection groups exhibited significantly greater responses to acetone compared with 3 days after surgery. No significant difference in cold allodynia was observed between the sham and C2 root resection groups throughout the experimental period. Two hours after surgery, both the sham and C2 root resection groups exhibited significant increases in c-Fos- and c-Jun-positive neurons compared with the naive group (p=0.0021 and p=0.0358 for the sham group, and p=0.0135 and p=0.014 for the C2 root resection group, respectively). One day after surgery, both the sham and C2 root resection groups exhibited significant decreases in c-Fos -positive neurons compared with two hours after surgery (p=0.0169 and p=0.0123, respectively), and these significant decreases in c-Fos immunoreactivity were maintained in both the sham and C2 root resection groups 7 and 14 days after surgery. The sham and C2 root resection groups presented a tendency toward a decrease in c-Jun-positive neurons 1, 7, and 14 days after surgery, but the decrease did not reach statistical significance. Conclusion : We found no significant difference in cold allodynia and the early expression of c-Fos and c-Jun between the sham and C2 resection groups. Our results may support the routine resection of the C2 nerve root for posterior C1-2 fusion, but, further studies are needed.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.734-742
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• 2001

Objective : To evaluate the role of anterior lumbar interbody fusion in treatment of failed back surgery syndrome, the authors retrospectively analyzed the result of anterior lumbar interbody fusion performed in our institute. Methods : Fifteen FBSS patients due to variable causes have been treated with anterior lumbar interbody fusion in our institute from April 1994 to June 1999. We analyzed clinical changes in 15 patients who were followed up for an average of 23 months. Results : The etiologies of FBSS were post operative discitis(6 cases), post operative instability(3 cases), post operative adhesion(5 cases), and recurrence(1 case). These fifteen FBSS patients were treated with anterior lumbar interbody fusion. The overall treatment outcome was satisfactory(excellent and good) in 11 cases. Three patients were slightly improved, but post operative low back pain was remained. One patient who had underwent nerve root injury due to pedicle screw insertion showed no improvement. Conclusion : We conclude that the anterior lumbar interbody fusion for FBSS seems to be safe and favorable treatment in selective patients, because low incidence of nerve injury risk and post-operative infection.

• Journal of Korean Neurosurgical Society
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• v.47 no.4
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• pp.271-277
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• 2010

Objective : The purpose of this study is to evaluate the clinical characteristics and surgical outcome of cerebellopontine angle (CPA) epidermoids presenting with trigeminal neuralgia. Methods : Between 1996 and 2004, 10 patients with typical symptoms of trigeminal neuralgia were found to have cerebellopontine angle epidermoids and treated surgically at our hospital. We retrospectively analyzed the clinico-radiological records of the patients. Results : Total resection was done in 6 patients (60%). Surgical removal of tumor and microvascular decompression of the trigeminal nerve were performed simultaneously in one case. One patient died due to postoperative aseptic meningitis. The others showed total relief from pain. During follow-up, no patients experienced recurrence of their trigeminal neuralgia (TN). Conclusion : The clinical features of TN from CPA epidermoids are characterized by symptom onset at a younger age compared to TN from vascular causes. In addition to removal of the tumor, the possibility of vascular compression at the root entry zone of the trigeminal nerve should be kept in mind. If it exists, a microvascular decompression (MVD) should be performed. Recurrence of tumor is rare in both total and subtotal removal cases, but long-term follow-up is required.

• The Korean Journal of Pain
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• v.1 no.2
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• pp.181-187
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• 1988

Since the introduction of epidural corticosteroid injections for the management of sciatica, lumbosacral radiculopathy has become one of the most common pain problems encountered by anesthesiologists. In order to function effectively, anesthesiologists should be able to: (1) recognize those syndromes which may respond to nerve block; (2) understand the pathophysiology of the conditions being treated and (3) be familiar with alternate therapeutic pathways for patients not responding to merre block. There are many etiologic factors of low back pain and lumbosacral radiculopathy. Particularly, Nerve root compression caused by a protruding disc, a osteophyte or tumors are usually responsible for pain. Neural inflammation, therefore, is considered to play a major role in pain production. The use of local anesthetics in mixture with steroids is believed to break down neural inflammation. Steroids and local anesthetics were injected lumbar or caudal epidmal to 106 patients for the purpose of relieving low back pain and lumbosacral radiculopathy. The results are as follows: Excellent pain relieved group: 27 patients (25.5%) Good pain relieved group: 49 patients (46.1%) Fair pain relieved group: 15 patients(14.2%) Not effective group: 15 patients(14.2%).

• The Korean Journal of Pain
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• v.12 no.1
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• pp.148-151
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• 1999

This report is a case of 62-year-old man with anterior chest pain and pin pricking pain with allodynia affecting left T5 sensory dermatome for 3 months without history of vesicular skin eruption. He had a history of diabetes mellitus for 10 years and insulin therapy for recent 1 year. EKG, chest PA and rib series were normal. Serologic evaluation of IgG antibody to varicella-zoster virus was positive and was diagnosed as post herpetic neuralgia after zoster sine herpete. He was treated with left T5 nerve root block followed by thoracic epidural blockade and intercostal nerve block for 2 weeks. His VAS score decreased from 10 to 2 after 2 weeks of treatment. After 3 months, he revisited our clinic complaining right side chest pain followed by vesicular skin eruption 8 days after the onset of pain. He was treated as herpes zoster and tolerates well after 4 months.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.465-473
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• 2004

Purpose : The essential triad for nerve regeneration is nerve conduit, supporting cell and neurotrophic factor. In order to improve the peripheral nerve regeneration, we used polyglycolic acid(PGA) tube and brain-derived neurotrophic factor(BDNF) gene transfected Schwann cells in sciatic nerve defects of SD rat. Materials and methods : Nerve conduits were made with PGA sheet and outer surface was coated with poly(lactic-co-glycolic acid) for mechanical strength and control the resorption rate. The diameter of conduit was 1.8mm and the length was 17mm Schwann cells were harvested from dorsal root ganglion(DRG) of SD rat aged 1 day. Schwann cells were cultured on the PGA sheet to test the biocompatibility adhesion of Schwann cell. Human BDNF gene was obtained from cDNA library and amplified using PCR. BDNF gene was inserted into E1 deleted region of adenovirus shuttle vector, pAACCMVpARS. BDNF-adenovirus was multiplied in 293 cells and purified. The BDNF-Adenovirus was then infected to the cultured Schwann cells. Left sciatic nerve of SD rat (250g weighing) was exposed and 14mm defects were made. After bridging the defect with PGA conduit, culture medium(MEM), Schwann cells or BDNF-Adenovirus infected Schwann cells were injected into the lumen of conduit, respectively. 12 weeks after operation, gait analysis for sciatic function index, electrophysiology and histomorphometry was performed. Results : Cultured Schwann cells were well adhered to PGA sheet. Sciatic index of BDNF transfected group was $-53.66{\pm}13.43$ which was the best among three groups. The threshold of compound action potential was between 800 to $1000{\mu}A$ in experimental groups which is about 10 times higher than normal sciatic nerve. Conduction velocity and peak voltage of action potential of BDNF group was the highest among experimental groups. The myelin thickness and axonal density of BDNF group was significantly greater than the other groups. Conclusion : BDNF gene transfected Schwann cells could regenerate the sciatic nerve gap(14mm) of rat successfully.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.1
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• pp.83-92
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• 2014

Objectives To evaluate the clinical usefulness between muscle energy techniques (MET) and transcutaneous electrical nerve stimulator (TENS), we performed both on elector spinae muscle of acute low back pain patients. Methods After performing MET and TENS, we compared both in terms of electrical activity. We performed MET or TENS on elector spinae muscle of acute low back pain patients in each group (n=15,15). After performing MET or TENS, we analyzed root mean square (RMS), median edge frequency (MEF) and asymmetry index (AI). Results 1. After performing MET on elector spinae muscle of acute low back pain patients, RMS was significantly decreased compared with before (p<0.005). 2. After performing TENS on elector spinae muscle of acute low back pain patients, RMS was significantly decreased compared with before (p<0.005). 3. After performing MET on elector spinae muscle of acute low back pain patients, asymmetric index was significantly decreased compared with before (p<0.05). Conclusions According to above results, performing MET on elector spinae muscle of acute low back pain patients has effect in terms of RMS and asymmetric index. And performing TENS on elector spinae muscle of acute low back pain patients also has similar effect in terms of RMS but has not in terms of asymmetric index.

• The Journal of Pediatrics of Korean Medicine
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• v.14 no.1
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• pp.197-204
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• 2000

Neuromuscular disorders are common causes of weakness and hypotonia in the infantile period and in childhood. Accurate diagnosis of specific neuromuscular disorders depends first on identification of which aspect of the peripheral neuromuscular system is affected-the motor neuron in the spinal cord, the nerve root or peripheral nerve, the neuromuscular junction, or the muscle-and then on the determination of the etiology and specific clinical entity. Spinal muscular atrophy(SMA) is the most common autosomal-recessive genetic disorder lethal to infants. The three major childhood-onset forms of SMA are now usually called type I, type II and typeⅢ. Progression of the disease is due to loss of anterior horn cells, thought to be caused by apoptosis. Diagnosis is based on the course of the illness, as well as certain changes seen on nerve and muscle biopsy and electrodiagnostic studies. More recently, our understanding of the genetics of this disorder has provided a noninvasive approach to diagnosis. We report on a 3-year-old male patient with spinal muscular atrophy type II. He had progressive muscular weakness since 18 months of age. The upper arms were slightly, and the thighs moderately atrophic. There was muscle weakness of both the upper and lower limbs, being more proximal in distribution. Electromyogram revealed a neurogenic pattern.

• Journal of Korean Neurosurgical Society
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• v.40 no.3
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• pp.148-153
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• 2006

Objective : The authors conducted this study to present the long-term treatment outcomes [minimum 2 years] of Gamma knife radiosurgery[GKS] for trigeminal neuralgia[TN] and to demonstrate the correlation of treatment outcomes and the anatomical characteristics of TN. Methods : From 1997 to 2003, 44 consecutive patients suffering from medically intractable pain underwent GKS for TN. A single 4mm collimator was used with a median maximum dose of 80Gy [range $75{\sim}80Gy$] prescribed to the root entry zone of the trigeminal nerve. Median follow up duration was 30 months [range $24{\sim}78\;months$]. Anatomical measurements of trigeminal nerve in magnetic resonance images during GKS planning were correlated with clinical outcome. Results : Twenty-two patients [50%] achieved an excellent outcome [BNI grade I & II], 20 patients [45.5%] a good outcome [grade IIIa & IIIb], and only 2 patients [4.5%] a poor outcome [grade IV & V]. Eleven patients [25.0%] experienced pain recurrence after initial pain relief. Smaller volume of trigeminal nerve area irradiated more than 40Gy was significantly correlated with excellent outcome in both univariate and multivariate analyses respectively [P=0.033 and 0.040]. Conclusion : Anatomical considerations during the planning of GKS would be helpful for predicting clinical outcome in TN.