• 대한물리치료과학회지
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• 제13권4호
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• pp.7-16
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• 2006

The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, ( - ) value was increased between lumbar vertebra segment when was the load on spine. And so stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

• Journal of Korean Neurosurgical Society
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• 제46권4호
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• pp.328-332
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• 2009

Objective : The purpose of this study was to establish new fusion criteria to complement existing Brantigan-Steffee fusion criteria. The primary purpose of intervertebral cage placement is to create a proper biomechanical environment through successful fusion. The existence of a traction spur is an essential predictable radiologic factor which shows that there is instability of a fusion segment. We studied the relationship between the existence of a traction spur and fusion after a posterior lumbar interbody fusion (PLIF) procedure. Methods : This study was conducted using retrospective radiological findings from patients who underwent a PLIF procedure with the use of a cage without posterior fixation between 1993 and 1997 at a single institution. We enrolled 183 patients who were followed for a minimum of five years after the procedure, and used the Brantigan-Steffee classification to confirm the fusion. These criteria include a denser and more mature bone fusion area than originally achieved during surgery, no interspace between the cage and the vertebral body, and mature bony trabeculae bridging the fusion area. We also confirmed the existence of traction spurs on fusion segments and non-fusion segments. Results : The PLIF procedure was done on a total of 251 segments in 183 patients (71 men and 112 women). The average follow-up period was $80.4{\pm}12.7$ months. The mean age at the time of surgery was $48.3{\pm}11.3$ years (range, 25 to 84 years). Among the 251 segments, 213 segments (84.9%) were fused after five years. The remaining 38 segments (15.1%) were not fused. An analysis of the 38 segments that were not fused found traction spur formation in 20 of those segments (52.6%). No segments had traction spur formation with fusion. Conclusion : A new parameter should be added to the fusion criteria. These criteria should be referred to as 'no traction spur formation' and should be used to confirm fusion after a PLIF procedure.

• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.350-358
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• 2012

Objective : Life expectancy for humans has increased dramatically and with this there has been a considerable increase in the number of patients suffering from lumbar spine disease. Symptomatic lumbar spinal disease should be treated, even in the elderly, and surgical procedures such as fusion surgery are needed for moderate to severe lumbar spinal disease. However, various perioperative complications are associated with fusion surgery. The aim of this study was to examine perioperative complications and assess risk factors associated with lumbar spinal fusion, focusing on geriatric patients at least 70 years of age in the Republic of Korea. Methods : We retrospectively investigated 489 patients with various lumbar spinal diseases who underwent lumbar spinal fusion surgery between 2003 and 2007 at our institution. Three fusion procedures and the number of fused segments were analyzed in this study. Chronic diseases were also evaluated. Risk factors for complications and their association with age were analyzed. Results : In this study, 74 patients experienced complications (15%). The rate of perioperative complications was significantly higher in patients 70 years of age or older than in other age groups (univariate analysis, p=0.001; multivariate analysis, p=0.004). However, perioperative complications were not significantly associated with the other factors tested (sex, comorbidities, operation procedures, fusion segments involved). Conclusion : Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery whereas other factors were not significant. We recommend good clinical judgment and careful selection of geriatric patients undergoing lumbar spinal fusion surgery.

• Journal of Korean Neurosurgical Society
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• 제54권4호
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• pp.323-328
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• 2013

Objective : The purpose of this study was to examine the efficacy and perioperative complications associated with lumbar spinal fusion surgery, focusing on geriatric patients in the Republic of Korea. Methods : We retrospectively investigated 485 patients with degenerative spinal diseases who had lumbar spinal fusion surgeries between March 2006 and December 2010 at our institution. Age, sex, comorbidity, American Society of Anesthesiologists (ASA) class, fusion segments, perioperative complications, and outcomes were analyzed in this study. Risk factors for complications and their association with age were analyzed. Results : In this study, 81 patients presented complications (16.7%). The rate of perioperative complications was significantly higher in patients 70 years or older than in other age groups (univariate analysis, p=0.015; multivariate analysis, p=0.024). The perioperative complications were not significantly associated with the other factors tested (sex, comorbidity, ASA class, and fusion segments). Post-operative outcomes of lumbar spinal fusion surgeries for the patients were determined on the basis of MacNab's criteria (average follow up period : 19.7 months), and 412 patients (85.0%) were classified as having "excellent" or "good" results. Conclusion : Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery, whereas other factors were not significant. However, patients' satisfaction or return to daily activities when compared with younger patients did not show much difference. We recommend good clinical judgment as well as careful selection of geriatric patients for lumbar spinal fusion surgery.

• Animal cells and systems
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• 제4권4호
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• pp.353-359
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• 2000

Location of the neurons in the lateral reticular nucleus projecting to dorsal horn of the cervical, thoracic, or lumbar spinal cord was investigated in the rat using the technique of retrograde transport of horseradish peroxidase. The projection was bilateral with ipsilateral predominance. Neurons projecting to the cervical spinal cord were located near the medial, dorsal, and lateral perimeter of the magnocellular division of the lateral reticular nucleus, whereas cells projecting to the thoracic and lumbar spinal cord were localized in the medial and dorsal boundaries of the magnocellular division. The labeled neurons were distinctly multipolar in shape and measured approximately 10-15 $\mu m$ in their greatest transverse diameter. A few neurons were also observed in the subtrigeminal nucleus, whereas few cells were in the parbocellular division. These observations provide an anatomical substrate for the functional implication of the lateral reticular nucleus in the regulation of spinal nociceptive transmission and vascular hemodynamics via the descending pathway into the spinal cord.

• The Korean Journal of Physiology
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• 제30권2호
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• pp.289-297
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• 1996

Excitatory amino acids (EAA) are thought to play an important role in producing cell death associated with ischemic and traumatic spinal cord injury. The present study was carried out to determine if the response characteristics of spinal sensory neurons in segments adjacent to degeneration sites induced by EAA are altered following these morphological changes. Intraspinal injections of quisqualic acid (QA) produced neuronal degeneration and spinal cavitation of gray matter. The severity of lesions was significantly attenuated by pretreatment with a non-NMDA antagonist NBQX. In extracellular single unit recordings, dorsal horn neurons in QA injected animal showed the increased mechanosensitivity, which included a shift to the left in the stimulus-response relationship, an increased background activity and an increase in the duration of after-discharge responses. Neuronal responses, especially the C-fiber response, to suprathreshold electrical stimulation of sciatic nerve also increased in most cases. These results suggest that altered functional states of neurons may be responsible for sensory abnormalities, e.g. allodynia and hyperalgesia, associated with syringomyolia and spinal cord injury.

• Journal of Acupuncture Research
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• 제15권2호
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• pp.117-133
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• 1998

The purpose of this morphological study was to investigate the relationship to facial nerve and LI4 related to the large intestine meridian. The common locations of the spinal cord and brain projecting to the LI4 and facial nerve were observed fallowing injection of transsynaptic neurotropic virus, pseudorabis virus(PRV), into the LI4 and facial nerve of the rat. After survival times of 96 hours following injection of PRV, the rats were perfused, and their spinal cord and brain were frozen sectioned(30${\mu}m$). These sections were stained by PRV immunohistochemical staining method, and observed with light microscope The results were as follows: 1. The PRV labeled spinal cord segments projecting to the LI4 and facial nerve were founded in cervical, thoracic, lumbar and sacral segments. Dense labeled areas of each spinal cord segment were founded in lamina IV, V, X, lateral spinal nucleus, intermediolateral nucleus and dorsal nucleus. 2. The PRV labeled medulla oblongata projecting to the LI4 and facial nerve were founded in the A1 noradrenalin cells/C1 adrenalin cells/caudoventrolateral reticular nucleus, rostroventrolateral reticular nucleus, medullary reticular nucleus, nucleus tractus solitarius, raphe obscurus nucleus, raphe pallidus nucleus, raphe magnus nucleus, gigantocellular nucleus, lateral paragigantocellular nucleus, and spinal trigeminal nucleus.

• Molecules and Cells
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• 제21권1호
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• pp.76-81
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• 2006

Tubulin is synthesized in the cell body and must be delivered to the axon to support axonal growth. However, the exact form in which these proteins, in particular tubulin, move within the axon remains contentious. According to the "polymer transport model", tubulin is transported in the form of microtubules. In an alternative hypothesis, the "short oligomer transport model", tubulin is added to existing, stationary microtubules along the axon. In this study, we measured the translocation of microtubule plus ends in soma segments, the middle of axonal shafts and the growth cone areas, by expressing GFP-EB3 in cultured Xenopus embryonic spinal neurons. We found that none of the microtubules in the three compartments were transported rapidly as would be expected from the polymer transport model. These results suggest that microtubules are stationary in most segments of the axon, thus supporting the model according to which tubulin is transported in nonpolymeric form in rapidly growing Xenopus neurons.

• The Korean Journal of Pain
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• 제19권2호
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• pp.146-151
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• 2006

Background: Spinal cord stimulation is a well-established method for the management of several types of chronic and intractable pain. This form of stimulation elicits a tingling sensation (paresthesia) in the corresponding dermatomes. The goal of this study was to establish a correlation between the spinal levels of the implanted epidural electrodes and the paresthesia elicited due to stimulation of the neural structures. Methods: Thirty five patients, who received trial spinal cord stimulation, were evaluated. After the insertion of the lead to the selected position, the areas of paresthesia evoked by stimulation were evaluated. Results: Seventy-one percent of cases showed paresthesia in the shoulder area when the tip of the electrode was located between the C2⁣-C4 levels. At the upper extremities, paresthesia was evoked in 86⁣-93% of cases, regardless of the location of the electrode tip within the cervical spinal segments. The most common tip placement of the leads eliciting hand stimulation was at the C5 level. The most common level of electrode tip placement eliciting paresthesia of the anterior and posterior thigh and the foot were at the T7-⁣T12, T10⁣-L1 and T11-⁣L1 vertebral segments, respectively. Conclusions: Detailed knowledge of the patterns of stimulation induced paresthesia in relation to the spine level of the implanted electrodes has allowed the more consistent and successful placement of epidural electrodes at the desired spine level.

• 한방재활의학과학회지
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• 제18권4호
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• pp.13-24
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• 2008

Objectives : The purpose of this study was to investigate the effect of Poncirus Trifoliata(PT) on improvement of fecal impaction in spinal cord injured(SCI) rats. Methods : Fifteen adult Sprague-Dawley female rats were used weighing 200~250 g. A complete spinal cord transection was performed surgically at the T10 cord level. Experimental groups were assigned into 3 groups: Control(n=5), SCI+vehicle(n=5) and SCI+PT(n=5). PT was administered 100mg/kg in 0.5ml every 24 hours from 1st operation day to 7th day. We measured the body weight and food intake as well as the number and the weight of fecal pellet every morning. After 1 week of operation, whole colon was divided into proximal and distal segments under anesthesia. Each segment of colon was mounted with longitudinal direction in a organ bath. We measured spontaneous contraction and compared the area under the curve in each segments. Enhanced responses were observed by acetylcholine($10^{-6}M$), 40 mM KCl solution, L-NAME($10^{-4}M$). Results : The fecal number and weights were significantly higher in the group of SCI+PT than SCI+vehicle group(p<0.05). In organ bath study, area under the curves of the spontaneous contraction in SCI+vehicle and SCI+PT groups were significantly increased compared to control group. Contractility of distal colon in response to acetylcholine or KCl in SCI+vehicle group was significantly decreased compared to other groups(p<0.05). Conclusions : These results suggest that PT might be useful to promote bowel emptying in spinal cord injured rats.