• Asian Spine Journal
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• v.12 no.6
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• pp.998-1009
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• 2018

Study Design: Olfactory ensheathing cells (OECs) from rat olfactory mucosa were cultured, characterized, and transplanted into a rat model of spinal cord injury (SCI). Purpose: To evaluate different doses of OECs in a rat model of SCI. Overview of Literature: SCI causes permanent functional deficit because the central nervous system lacks the ability to perform spontaneous repair. Cell therapy strategies are being explored globally. The clinical use of human embryonic stem cell is hampered by ethical controversies. Alternatively, OECs are a promising cell source for neurotransplantation. This study aimed to evaluate the efficacy of different doses of allogenic OEC transplantation in a rat model of SCI. Methods: OECs were cultured from the olfactory mucosa of Albino Wistar rats; these cells were characterized using immunohistochemistry and flow cytometry. Rats were divided into five groups (n=6 rats each). In each group, different dosage ($2{\times}10^5$, $5{\times}10^5$, $10{\times}10^5$, and >$10{\times}10^5$) of cultured cells were transplanted into experimentally injured spinal cords of rat models. However, in the SCI group, only DMEM (Dulbecco's modified Eagle's medium) was injected. Rats were followed up upto 8 weeks post-transplantation. The outcome of transplantation was assessed using the Basso, Beattie, Bresnahan (BBB) scale; motor-evoked potential studies; and histological examination. Results: Cultured cells expressed 41% of p75NTR, a marker for OEC, and 35% of anti-fibronectin, a marker for olfactory nerve fibroblast. These cells also expressed $S100{\beta}$ and glial fibrillary acid protein of approximately 75% and 83%, respectively. All the transplanted groups showed promising BBB scores for hind-limb motor recovery compared with the SCI group (p<0.05). A motor-evoked potential study showed increased amplitude in all the treated groups compared with the SCI. Green fluorescent protein-labeled cells survived in the injured cord, suggesting their role in the transplantation-mediated repair. Transplantation of $5{\times}10^5$ cells showed the best motor outcomes among all the doses. Conclusions: OECs demonstrated a therapeutic effect in rat models with the potential for future clinical applications.

• International Journal of Oral Biology
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• v.42 no.3
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• pp.129-135
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• 2017

The present study investigated the role of spinal glutamate recycling in the development of orofacial inflammatory pain or trigeminal neuropathic pain. Experiments were carried out on male Sprague-Dawley rats weighing between 230 and 280 g. Under anesthesia, a polyethylene tube was implanted in the atlanto-occipital membrane for intracisternal administration. IL-$1{\beta}$-induced inflammation was employed as an orofacial acute inflammatory pain model. IL-$1{\beta}$ (10 ng) was injected subcutaneously into one vibrissal pad. We used the trigeminal neuropathic pain animal model produced by chronic constriction injury of the infraorbital nerve. DL-threo-${\beta}$-benzyloxyaspartate (TBOA) or methionine sulfoximine (MSO) was administered intracisternally to block the spinal glutamate transporter and the glutamine synthetase activity in astroglia. Intracisternal administration of TBOA produced mechanical allodynia in naïve rats, but it significantly attenuated mechanical allodynia in rats with interleukin (IL)-$1{\beta}$-induced inflammatory pain or trigeminal neuropathic pain. In contrast, intracisternal injection of MSO produced anti-allodynic effects in rats treated with IL-$1{\beta}$ or with infraorbital nerve injury. Intracisternal administration of MSO did not produce mechanical allodynia in naive rats. These results suggest that blockade of glutamate recycling induced pro-nociception in na?ve rats, but it paradoxically resulted in anti-nociception in rats experiencing inflammatory or neuropathic pain. Moreover, blockade of glutamate reuptake could represent a new therapeutic target for the treatment of chronic pain conditions.

• Journal of Yeungnam Medical Science
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• v.38 no.2
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• pp.152-156
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• 2021

Diplopia is a rare complication of spine surgery. The abducens nerve is one of the cranial nerves most commonly related to diplopia caused by traction injury. We report a case of a 71-year-old woman who presented with diplopia developing from abducens nerve palsy after C1-C2 fixation and fusion due to atlantoaxial subluxation with cord compression. As soon as we discovered the symptoms, we suspected excessive traction by the instrument and subsequently performed reoperation. Subsequently, the patient's symptoms improved. In other reported cases we reviewed, most were transient. However, we thought that our rapid response also helped the patient's fast recovery in this case. The mechanisms by which postoperative diplopia develops vary and, thus, remain unclear. We should pay attention to the fact that the condition is sometimes an indicator of an underlying, life-threatening condition. Therefore, all patients with postoperative diplopia should undergo thorough ophthalmological and neurological evaluations as well as careful observation by a multidisciplinary team.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.311-317
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• 1996

Background: Following peripheral nerve injury, rats will show a tactile allodynia and hyperalgesia. But the mechanism of allodynia is still obscure. Previous studies have shown this allodynia was reversed by intrathecal alpha-2 agonists and NMDA antagonists, but not by morphine. In formalin test, either the pretreatment of NMDA antagonist or morphine prevents the hyperalgesia. The present studies, using rats rendered allodynic by ligation of the left L5 and L6 nerves, aimed to investigate the effects of pretreatment of MK-801 and morphine on the development of tactile allodynia. Methods and Material: Male Sprague-Dawley rats (100~150g) were anesthetized with halothane, the left L5 and L6 spinal nerves were ligated tightly by 6-0 black silk. For sham operation muscle dissection was performed but the spinal nerve was not ligated. For pretreatment of drugs, MK-801 (NMDA antagonist; 0.3 mg/kg). CNQX (non-NMDA) antagonist; 0.3 mg/kg), morphine (1 mg/kg) or saline (placebo) was administered subcutaneously 30 minutes before operation. A second dose was administered subcutaneously 24 hours after operation and further doses were given daily for 2 days further. The volume of injection was 5 ml/kg. To assess the mechanical allodynia, paw withdrawal thresholds of ipsilateral limb were determined using 8 von Frey hairs. Results: Within 2 days saline, CNQX or morphine injected rats developed tactile allodynia (paw withdrawal threshold was about 2g), and persisted for over 2 weeks. Pretreatment of MK-801 delayed the development of tactile allodynia for 3 days comparing to that of saline injected rat. Conclusion: NMDA receptor in the central nerve system plays an important role in the development of tactile allodynia induced by peripheral nerve injury. But the mechanism may be different from hyperalgesia developed in formalin test.

• Journal of Korean Neurosurgical Society
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• v.52 no.2
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• pp.114-119
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• 2012

Objective : The purpose of this study was 1) to analyze clinically-executed cervical lateral mass screw fixation by the Kim's technique as suggested in the previous morphometric and cadaveric study and 2) to examine various complications and bicortical purchase that are important for b-one fusion. Methods : A retrospective study was done on the charts, operative records, radiographs, and clinical follow up of thirty-nine patients. One hundred and seventy-eight lateral mass screws were analyzed. The spinal nerve injury, violation of the facet joint, vertebral artery injury, and the bicortical purchases were examined at each lateral mass. Results : All thirty-nine patients received instrumentations with poly axial screws and rod systems, in which one hundred and seventy-eight screws in total. No vertebral artery injury or nerve root injury were observed. Sixteen facet joint violations were observed (9.0%). Bicortical purchases were achieved on one hundred and fifty-six (87.6%). Bone fusion was achieved in all patients. Conclusion : The advantages of the Kim's technique are that it is performed by using given anatomical structures and that the complication rate is as low as those of other known techniques. The Kim's technique can be performed easily and safely without fluoroscopic assistance for the treatment of many cervical diseases.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.101-103
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• 2006

Oral prostaglandin E1 (PGE1) is a medicine that is clinically applied during a treatment of patients suffering with vascular disease with chronic arterial obstruction because it has vasodilation and anti-platelet effects. The mechanisms of lumbosacral symptoms associated with spinal stenosis probably include vascular insufficiency with hypoxic injury to the cauda equina and the nerve roots. Thus, increasing the blood supply would be beneficial to improve the pathophysiologic condition. Several studies on the improvement of clinical symptoms of spinal stenosis by PGE1 treatment have been reported on. In this case, 47-year old female underwent posterior compression and posterolateral fusion with a cage at L2-4 due to L3 compression fracture, and she did not show improvement of the radiating pain of her right leg after the operation. Therefore, she received repetitive epidural catheterization and adhesiolysis, epidural block and physical therapy, but her symptoms deteriorated after temporary improvement. Finally, she was given PGE1 and the radiculopathy was completely improved, although some muscle weakness still remained.

• International Journal of Oral Biology
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• v.32 no.4
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• pp.153-160
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• 2007

The superficial dorsal horn, particularly substantia gelatinosa (SG) in the spinal cord, receives inputs from small-diameter primary afferents that predominantly convey noxious sensation. Reactive oxygen species (ROS) are toxic agents that may be involved in various neurodegenerative diseases. Recent studies indicate that ROS are also involved in persistent pain through a spinal mechanism. In the present study, whole cell patch clamp recordings were carried out on SG neurons in spinal cord slice of young rats to investigate the effects of hydrogen peroxide on neuronal excitability and excitatory synaptic transmission. In current clamp condition, tert-buthyl hydroperoxide (t-BuOOH), an ROS donor, depolarized membrane potential of SG neurons and increased the neuronal firing frequencies evoked by depolarizing current pulses. When slices were pretreated with phenyl-N-tert-buthylnitrone (PBN) or ascorbate, ROS scavengers, t-BuOOH did not induce hyperexcitability. In voltage clamp condition, t-BuOOH increased the frequency and amplitude of spontaneous excitatory postsynaptic currents (sEPSCs), and monosynaptically evoked excitatory postsynaptic currents (eEPSCs) by electrical stimulation of the ipsilateral dorsal root. These data suggest that ROS generated by peripheral nerve injury can modulate the excitability of the SG neurons via pre- and postsynaptic actions.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.3-12
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• 2024

One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

• The Korean Journal of Physiology and Pharmacology
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• v.16 no.6
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• pp.405-411
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• 2012

The spontaneous axon regeneration of damaged neurons is limited after spinal cord injury (SCI). Recently, mesenchymal stem cell (MSC) transplantation was proposed as a potential approach for enhancing nerve regeneration that avoids the ethical issues associated with embryonic stem cell transplantation. As SCI is a complex pathological entity, the treatment of SCI requires a multipronged approach. The purpose of the present study was to investigate the functional recovery and therapeutic potential of human MSCs (hMSCs) and polymer in a spinal cord hemisection injury model. Rats were subjected to hemisection injuries and then divided into three groups. Two groups of rats underwent partial thoracic hemisection injury followed by implantation of either polymer only or polymer with hMSCs. Another hemisection-only group was used as a control. Behavioral, electrophysiological and immunohistochemical studies were performed on all rats. The functional recovery was significantly improved in the polymer with hMSC-transplanted group as compared with control at five weeks after transplantation. The results of electrophysiologic study demonstrated that the latency of somatosensory-evoked potentials (SSEPs) in the polymer with hMSC-transplanted group was significantly shorter than in the hemisection-only control group. In the results of immunohistochemical study, ${\beta}$-gal-positive cells were observed in the injured and adjacent sites after hMSC transplantation. Surviving hMSCs differentiated into various cell types such as neurons, astrocytes and oligodendrocytes. These data suggest that hMSC transplantation with polymer may play an important role in functional recovery and axonal regeneration after SCI, and may be a potential therapeutic strategy for SCI.

• Journal of Trauma and Injury
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• v.27 no.3
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• pp.79-83
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• 2014

The brachial plexus is a network of nerves that provides movement and feeling to the shoulder, arm and hand. The majority of acute brachial plexus injuries occur when the plexus is stretched violently or torn. This happens as result of the shoulder being pressed down forcefully while the head is pushed up and away from that shoulder. Such injuries frequently result from automobile or motor-cycle accidents or from falls and usually affect one side. Nerve injuries vary in severity from a mild stretching of the nerve to a tearing of the nerve root away from the spinal cord. We experienced a 50-year-old woman with weakness in both upper extremities after an attempted hanging. A consecutive workup revealed bilateral brachial plexus injuries. Six months after the incident, she had fully recovered. This is a very rare case of bilateral brachial plexus injuries after an attempted hanging.