• Annals of Clinical Neurophysiology
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• v.25 no.1
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• pp.45-49
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• 2023

Neurolymphomatosis is the direct endoneurial infiltration of lymphoma cells. Bone marrow biopsy is a widely practiced procedure that is generally considered to be relatively safe. However, bone marrow biopsy can also result in pain and long-term consequences such as nerve injury. Here we report a case of a 68-year-old male who presented with lumbosacral plexopathy due to neurolymphomatosis that was superimposed on a probable traumatic lumbosacral plexopathy mostly involving the sciatic nerve immediately after a bone marrow biopsy.

• Biomolecules & Therapeutics
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• v.27 no.4
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• pp.414-422
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• 2019

There is accumulating evidence that microRNAs are emerging as pivotal regulators in the development and progression of neuropathic pain. MicroRNA-15a/16 (miR-15a/16) have been reported to play an important role in various diseases and inflammation response processes. However, whether miR-15a/16 participates in the regulation of neuroinflammation and neuropathic pain development remains unknown. In this study, we established a mouse model of neuropathic pain by chronic constriction injury (CCI) of the sciatic nerves. Our results showed that both miR-15a and miR-16 expression was significantly upregulated in the spinal cord of CCI rats. Downregulation of the expression of miR-15a and miR-16 by intrathecal injection of a specific inhibitor significantly attenuated the mechanical allodynia and thermal hyperalgesia of CCI rats. Furthermore, inhibition of miR-15a and miR-16 downregulated the expression of interleukin-$1{\beta}$ and tumor-necrosis factor-${\alpha}$ in the spinal cord of CCI rats. Bioinformatic analysis predicted that G protein-coupled receptor kinase 2 (GRK2), an important regulator in neuropathic pain and inflammation, was a potential target gene of miR-15a and miR-16. Inhibition of miR-15a and miR-16 markedly increased the expression of GRK2 while downregulating the activation of p38 mitogen-activated protein kinase and $NF-{\kappa}B$ in CCI rats. Notably, the silencing of GRK2 significantly reversed the inhibitory effects of miR-15a/16 inhibition in neuropathic pain. In conclusion, our results suggest that inhibition of miR-15a/16 expression alleviates neuropathic pain development by targeting GRK2. These findings provide novel insights into the molecular pathogenesis of neuropathic pain and suggest potential therapeutic targets for preventing neuropathic pain development.

• The Korean Journal of Physiology
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• v.26 no.2
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• pp.143-150
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• 1992

The purpose of this study is to obtain the effective concentration of capsaicin to relieve pain with no change in the number of C-fibers and its effective duration for pain relief. Capsaicin has been used extremely as a experimental tool and as topical medications for acute or chronic tissue injuries and partial nerve injury is the main cause of causalgiform pain disorders in humans. Here, the left sciatic nerve was ligated unilaterally at the high level of the thigh to prepare an animal model of this pain condition. The rat developed guarding behavior of the ipsilateral hind paw within a few hours after the operation and this behavior was maintained for several months thereafter, suggesting the possibility of spontaneous pain. These animals were divided into two groups(4-week & 8-week) and each group was subdivided into five groups by different concentration (0.05, 0.1, 0.5, 1.0 & 2.0%). Each capsaicin concentration was treated locally on the spinal cord-side of the ligated nerve and the foot withdrawal latency was measured. Thereafter, the dorsal roots of L5 were removed from both sides immediately after in tracardial perfusion for the counting of C-fibers by the histological procedure. There were no significant differences in the foot-withdrawal latency and the number of C-fibers between the left side treated with 0.05% capsaicin and the right side treated with the vehicle. However, latencies of the left sides treated with 0.1, 0.5, and 1.0% capsaicin increased significantly throughout 4-6 weeks with almost no change in the number of C-fibers, and the latencies showed the trends to approach slowly to those of the conditions after operation. The latency of subgroup treated with 2.0% increased by approximate 10% more than that of the right side throughout 8 weeks, and the number of C-fibers decreased by about 30% or more These results suggest that the elevated latency with capsaicin(0.1-1.0%) treatment is due to the inhibition of impulse transmission throughout the primary afferent fiber and the data from 2.0% are due to partial destruction of C-fibers. Therefore, capsaicin concentrations from 0.1% to 1.0% are probably very effective for the treatment of causalgiform pain with almost no destruction of C-fibers.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.347-353
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• 2010

Objective : Iliac screw fixation has been used to prevent premature loosening of sacral fixation and to provide more rigid fixation of the sacropelvic unit. We describe our technique for iliac screw placement and review our experience with this technique. Methods : Thirteen consecutive patients who underwent spinopelvic fixation using iliac screws were enrolled. The indications for spinopelvic fixation included long segment fusions for spinal deformity and post-operative flat-back syndrome, symptomatic pseudoarthrosis of previous lumbosacral fusions, high-grade lumbosacral spondylolisthesis, lumbosacral tumors, and sacral fractures. Radiographic outcomes were assessed using plain radiographs, and computed tomographic scans. Clinical outcomes were assessed using the Oswestry Disability Index (ODI) and questionnaire about buttock pain. Results : The median follow-up period was 33 months (range, 13-54 months). Radiographic fusion across the lumbosacral junction was obtained in all 13 patients. The average pre- and post-operative ODI scores were 40.0 and 17.5, respectively. The questionnaire for buttock pain revealed the following : 9 patients (69%) perceived improvement; 3 patients (23%) reported no change; and 1 patient (7.6%) had aggravation of pain. Two patients complained of prominence of the iliac hardware. The complications included one violation of the greater sciatic notch and one deep wound infection. Conclusion : Iliac screw fixation is a safe and valuable technique that provides added structural support to S1 screws in long-segment spinal fusions. Iliac screw fixation is an extensive surgical procedure with potential complications, but high success rates can be achieved when it is performed systematically and in appropriately selected patients.

• Korean Journal of Acupuncture
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• v.37 no.2
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• pp.104-121
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• 2020

Objectives : Since neuropathic pain shows a variety of symptoms via various mechanisms, there are many difficulties in treatment and various treatments have been tried. This study was conducted to investigate the effects of Araliae Continentalis Radix pharmacopuncture (ACR) on neuropathic pain. Methods : After dividing the white rats into six groups, the sciatic nerves of five groups except the normal group were excised to induce neuropathic pain. Except normal and control group, the other four groups were given: saline (Saline group), ACR 1.100 mg/kg (ACR 1 group), ACR 2.743 mg/kg (ACR 2 group), and ACR 5.486 mg/kg (ACR 3 group) at GB30, twice a week for a total of six times in three weeks. Withdrawal response react time and force intensity, c-Fos, TNF-α, IL-6, and IFN-γ were observed to investigate the efficacy of ACR in each group. Body weight, WBC, RBC, HGB, PLT, AST, ALT, BUN, and Cr changes were observed to check the safety of ACR. Results : Both withdrawal response react time & force intensity were significantly increased in the ACR2 and ACR3 groups at 3 weeks. C-Fos tended to decrease in all ACR groups and significantly decreased in ACR3 group. In blood serum, TNF-α showed a tendency to decrease in all ACR groups and a significant decrease in ACR3 group. But IL-6 and IFN-γ did not change significantly in all experimental groups. In the spinal cord, IFN-γ was significantly decreased in the ACR3 group. But TNF-α and IL-6 were not significantly changed in all experimental groups. Body weight was not changed significantly in all experimental groups. RBC increased significantly in ACR2 group, HGB increased in ACR3 group, and PLT increased significantly in all experimental groups. ALT significantly decreased in ACR1 group, and there were no significant changes in AST, BUN, and Cr in all experimental groups. Conclusions : At high concentrations, ACR pharmacopuncture reduced c-Fos, and TNF-α in the blood serum and IFN-γ in the spinal cord thereby suppressed allodynia. More in-depth studies about pharmacopuncture concentration or mechanism are needed.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.33-39
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• 2017

Purpose: Surgical risks associated with the resection of osteochondroma around the proximal tibia and fibula, as well as the proximal humerus have been well established; however, the clinical presentation and optimal surgical approach for osteochondroma around the lesser trochanter have not been fully addressed. Materials and Methods: Thirteen patients with osteochondroma around the lesser trochanter underwent resection. We described the chief complaint, duration of symptom, location of the tumor, mass protrusion pattern on axial computed tomography image, tumor volume, surgical approach, iliopsoas tendon integrity after resection, and complication according to the each surgical approach. Results: Pain on walking or exercise was the chief complaint in 7 patients, and numbness and radiating pain in 6 patients. The average duration of symptom was 19 months (2-72 months). The surgical approach for 5 tumors that protruded postero-laterally was postero-lateral (n=3), anterior (n=1), and medial (n=1). All 4 patients with antero-medially protruding tumor underwent the anterior approach. Two patients with both antero-medially and postero-laterally protruding tumor received the medial and anterior approach, respectively. Two patients who underwent medial approach for postero-laterally protruded tumor showed extensive cortical defect after resection. One patient who received the anterior approach to resect a large postero-laterally protruded tumor developed complete sciatic nerve palsy, which was recovered 6 months after re-exploration. Conclusion: For large osteochondromas with posterior protrusion, we should not underestimate the probability of sciatic nerve compression. When regarding the optimal surgical approach, the medial one is best suitable for small tumors, while the anterior approach is good for antero-medial or femur neck tumor. For postero-laterally protruded large tumors, posterior approach may minimize the risk of sciatic nerve palsy.

• The Korean Journal of Physiology and Pharmacology
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• v.8 no.5
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• pp.237-243
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• 2004

Glial cells are activated in neuropathy and play a key role in hyperalgesia and allodynia. This study was performed to determine whether minocycline could attenuate heat hyperalgesia and mechanical allodynia, and how glial cell activation and nuclear factor kappa B (NF-kappaB) were regulated by minocycline in a model of chronic constriction of sciatic nerve (CCl). When minocycline (50 mg/kg, oral) was daily administered from 1 day before to 9 days after ligation, heat hyperalgesia and mechanical allodynia were attenuated. Furthermore, when minocycline treatment was initiated 1 or 3 days after ligation, attenuation of the hypersensitive behavior was still robust. However, the effect of attenuation was less when minocycline was started from day 5. In order to elucidate the mechanism of pain attenuation by minocycline, we examined the changes of glia and NF-kappaB, and found that attenuated hyperalgesia and allodynia by minocycline was accompanied by reduced microglial activation. Furthermore, the number of NF-kappaB immunoreactive cells increased after CCI treatment and this increase was attenuated by minocycline. We also observed translocation of NF-kappaB into the nuclei of activated glial cells. These results suggest that minocycline inhibits activation of glial cells and NF-kappaB, thereby attenuating the development of behavioral hypersensitivity to stimuli.

• Journal of Korean Physical Therapy Science
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• v.2 no.4
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• pp.749-761
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• 1995

The purpose of this study was to analyze the effects of V-trac on the clinical characteristics of patients who suffered from HIVD. The data were collected from 500 cases who had lumbar disc problems, from August, 1993 to July, 1995. The results of study were as follows; 1. Total patients statistics; mean age is 38 years, average duration of symptom is 5.4 years. 2. Symptomatic effects; HNP is 89.5 %, spinal stenosis is 55.1 %, and mean effects of total symptom is 80.0 %. 3. Pain relief effects; 1st session is 85.0 %, 7 th sessions are 89.3 %. 4. Back muscle improved effects; 10 sessions are 25.6 % rather than 1st session patients. 5. Sciatic scoliosis correction effect; Corrected scoliosis is improved 86.6 % by the 14 sessions V-trac. 6. Psychological effects; mental vigour is 51.2 %, emotional stability is 57.4 %, well-being is 72.5 %, comfortable sleeping is 60.2 %. 7. Follow-up states after V-trac therapy; Good conditions are 72.0 %, less conditions are 28.0 % after 1 month.

• Korean Journal of Acupuncture
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• v.23 no.2
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• pp.79-88
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• 2006

Objectives : Yogaktong is the genernal term of lowback and sciatic pain. Simpley this is not for the syndrom or illiness but for the symptoms. In this study, the effect of Acupuncture and Moxibustion Treatment by Analysing Su-point(背兪穴) compared with X-ray measuring for three patients with Yogaktong(腰脚痛) were evaluated. Methods : After treatment with the Acupuncture and Moxibustion Treatment by Analysing Su-point(背兪穴) compared with X-ray measuring for one time, we evaluated the effect by the figure of x-ray measuring and complaints of patients. Results : In three cases, the change in the figure declined dramatically and symptoms of patients got better after one treatment. Conclusions : Acupuncture and Moxibustion Treatment by Analysing Su-point(背兪穴) compared with X-ray measuring was effective. It will be attempted to the patients with it.

• The Korean Journal of Physiology and Pharmacology
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• v.12 no.5
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• pp.253-258
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• 2008

Somatostatin (SOM) is a widely distributed peptide in the central nervous system and exerts a variety of hormonal and neural actions. Although SOM is assumed to play an important role in spinal nociceptive processing, its exact function remains unclear. In fact, earlier pharmacological studies have provided results that support either a facilitatory or inhibitory role for SOM in nociception. In the current study, the effects of SOM were investigated using anesthetized cats. Specifically, the responses of rostrally projecting spinal dorsal horn neurons (RPSDH neurons) to different kinds of noxious stimuli (i.e., heat, mechanical and cold stimuli) and to the $A{\delta}$ -and C-fiber activation of the sciatic nerve were studied. Iontophoretically applied SOM suppressed the responses of RPSDH neurons to noxious heat and mechanical stimuli as well as to C-fiber activation. Conversely, it enhanced these responses to noxious cold stimulus and $A{\delta}$-fiber activation. In addition, SOM suppressed glutamate-evoked activities of RPSDH neurons. The effects of SOM were blocked by the SOM receptor antagonist cyclo-SOM. These findings suggest that SOM has a dual effect on the activities of RPSDH neurons; that is, facilitation and inhibition, depending on the modality of pain signaled through them and its action site.