• Journal of Korean Academy of Nursing
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• v.42 no.7
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• pp.1009-1018
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• 2012

Purpose: This study was done to evaluate effectiveness of home healthcare services (HHCS) specialized for elders who received spinal surgeries. Methods: A non-equivalent control group pre-post test quasi-experimental study was performed. HHCS was developed based on the Rice model of dynamic self-determination for self-care. For data collection, a control group (n=23) and an experimental group (n=23) were selected by matching age, BMI, pain, general characteristics and type of spine surgery. Measurement tools to evaluate uncertainty and knowledge were developed by the authors. The Numeric Rating Scale (NRS) and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were used to evaluate pain levels. Muscular strength in the legs was measured using a digital muscle tester and tape ruler. Questionnaires were used to evaluate disability in performing ADL and psychological distress levels. Results: The experimental group showed significant decrease in uncertainty (p=.028), increased knowledge (p=.038), and partially decreased pain (p=.003-.331). Partial muscle strength increased significantly (p=.021-.644). Disability in performing ADL and psychological distress in the experimental group decreased significantly compared to control group (p=.002, p=.004). Conclusion: Results indicate HHCS is an efficient home care nursing program for these elders. Further experimental studies with larger samples are required to confirm effects of HHCS.

• Molecules and Cells
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• v.25 no.2
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• pp.242-246
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• 2008

To assess the role of $\alpha_{1G}$ T-type $Ca^{2+}$ channels in neuropathic pain after L5 spinal nerve ligation, we examined behavioral pain susceptibility in mice lacking $Ca_{V}3.1$ (${\alpha}_{1G}{^{-/-}}$), the gene encoding the pore-forming units of these channels. Reduced spontaneous pain responses and an increased threshold for paw withdrawal in response to mechanical stimulation were observed in these mice. The ${{\alpha}_{1G}}^{-/-}$ mice also showed attenuated thermal hyperalgesia in response to both low-(IR30) and high-intensity (IR60) infrared stimulation. Our results reveal the importance of ${\alpha}_{1G}$ T-type $Ca^{2+}$ channels in the development of neuropathic pain, and suggest that selective modulation of ${\alpha}_{1G}$ subtype channels may provide a novel approach to the treatment of allodynia and hyperalgesia.

• Journal of Magnetics
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• v.20 no.4
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• pp.377-380
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• 2015

Muscle contusion has a negative effect on muscle function. Although several studies showed that pain control and muscle recovery is facilitated by pulsed electromagnetic fields (PEMF), there has not been much research regarding the specific effects of PEMF on them. The aim of the present study is to investigate effects of PEMF on pain and muscle recovery following extensor digitorum longus (EDL) contusion injury through measuring the expression of the c-fos proto-oncogene and nerve growth factor (NGF). Significantly reduced c-fos expression in the spinal cord was shown in PEMF groups compared with control (CON) groups. There was no significant difference between PEMF1 and CON1, but significantly increased NGF expression was shown in PEMF3 and PEMF5 compared with in CON groups, where the numbers in the group names are the days from contusion. In conclusion, PEMF could be used to not only reduce pain in muscle injuries by down-regulating c-fos expression in the spinal cord, but it could also influence muscle healing through increasing NGF expression in the injured muscle.

• The Journal of Korean Academic Society of Nursing Education
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• v.16 no.1
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• pp.140-149
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• 2010

Purpose: This follow up study was performed to survey the problem in performing ADLs at home after surgery. Method: Twenty elderly patients were assessed 3 times; from the time of hospitalization for surgery until 3 weeks after discharge. Measuring tools are numeric rating scales (NRS) for pain and 3 questionnaires developed by the authors to measure difficulties in ambulation, performing indoor ADLs, and emotional status. Pearson correlation, variance analysis and descriptive statistics were used to analyze the data. Result: The level of pain significantly decreased after surgery, but the difference between pain at the time of discharge and that of 3 weeks after discharge were not significant. Pain showed a positive relationship with emotional difficulties. Elderly with a higher education, family caregiver, and regular exercise showed a lower level of emotional difficulties. Conclusion: Comprehensive approaches for chronic pain including physical, psychological, and social aspects should be considered when caring for the elderly with spinal surgery. In addition, home care nursing interventions should include an exercise program to promote adaptation and rehabilitation after discharge.

• The Korean Journal of Pain
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• v.2 no.1
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• pp.30-35
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• 1989

Two hundred patients with acute and chronic pain were treated with a low power laser and 115 patients among them were divided into several groups by their pathology and evaluated their response rate to the laser therapy was evaluated through follow-up study. 1) The ages of patients were between the early twenties and late sixties, and there was no differences between sexes. 2) Degenerative spondylosis and chronic lumbar sprain were the most common diseases among those patients. 3) The average duration of therapy was about 16 days and response to the therapy appeared from the fourth day of laser therapy. 4) Acute lumbar sprain and acute spinal compression fracture showed rapid response to laser therapy. 5) The spinal pathology group was the most common at 37.5% of cases and the response rate to laser therapy was the lowest at 58.7%. 6) The articular pathology group occupied 24.6% and the response rate was the highest at 81.3%. 7). The response rate of the posttraumatic and postsurgical pathology group was 76.5%. 8) The response rate of the tendinous and sports pathology group was 75%. 9) The response rate of the miscellaneous group was 66.7%. 10) The mean response rate of all patients was 71.6%.

• Journal of Korean Biological Nursing Science
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• v.4 no.1
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• pp.101-112
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• 2002

Peripheral nerve injury results in plastic changes in the dorsal ganglia (DRG) and spinal cord, and is often complicated with neuropathic pain. The mechanisms underlying these changes are not known, but these changes seem to be most likely related to the neurotrophic factors. This study investigated the effects of mechanical peripheral nerve injury on expression of brain-derived neurotrophic factor(BDNF) in the DRG and spinal cord in rats. 1) Bennett model and Chung model groups showed significantly increased percentage of small, medium and large BDNF-immunoreactive neurons in the ipsilateral $L_4$ DRG compared with those in the contralateral side at 1 and 2 weeks of the injury. 2) In the ipsilateral $L_5$ DRG of the Chung model, percentage of medium and large BDNF-immunoreactive neurons increased significantly at 1 week, whereas that of large BDNF-immunoreactive neurons decreased at 2 week when compared with those in the contralateral side. The intensity of immunoreactivity of each neuron was lower in the ipsilateral than in the contralateral DRG. 3) In the spinal cord, the Bennett and Chung model groups showed a markedly increased BDNF-immunoreactivity in axonal fibers of both superficial and deeper laminae. The present study demonstrates that peripheral nerve injury in neuropathic models altered the BDNF expression in the DRG and spinal cord. This may suggest important roles of BDNF in sensory abnormalities after nerve injury and in protecting the large-sized neurons in the damaged DRG.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.106-110
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• 2011

In the patient who has intradural mass associated with spinal stenosis, if the operation for spinal stenosis is performed alone, the symptom may remain. We report with literature review that we achieved the successful outcome after simultaneous decompression of spinal stenosis and space occupying mass removal in the case of intradural and extradural compression. A 71-year-old female patient suffering from low back pain and radiating pain of both lower extremities admitted. In magnetic resonance imaging, spinal stenosis on L4-5 and spondylolisthesis on L5-S1 compressed dural sac and intradural space occupying mass on L4 level compressed. By posterior approach, decompression and interbody fusion were carried out. Then mass was removed with median durotomy. Pathologic diagnosis was schwannoma and the symptom was improved remarkably.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1080-1084
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• 2000

Spinal neurenteric cyst results from the persistence of an abnormal communication between endodermal and ne-uroectodermal layer. Embryologically, neurenteric cyst is derived from endoderm that is fused with the developing notochord during the third week of gestation. It is a rare malformation that lead to spinal cord compression. The patient is 19-year-old male presented with chest pain, paresthesia and progressive weakness in his low extremities(grade II/II). Preoperative MR imaging revealed intradural extramedullary cyst with intracystic hemorrhage in T1 and T2 level that is ventrally located and compressed the spinal cord. Involved vertebral bodies were scalloped and fused. The cystic tumor were totally removed through costotransversectomy approach. Postoperatively, motor weakness of the low extremities were improved to the level of grade IV/V. And chest pain and paresthesia were gradually disappeared. Postoperative MR imaging showed the decompression of the thoracic spinal cord. Histologic examination revealed a ciliated columnar epithelial neurenteric cyst. The pre- and postoperative clinical, radiological features of a case of upper thoracic neurenteric cyst is described with review of literature.

• The Korean Journal of Pain
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• v.14 no.1
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• pp.1-6
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• 2001

Background: Subcutaneous injection of 5% formalin into the hind paw of the rat produces a biphasic nociceptive response. The second phase depends on changes in the dorsal horn cell function that occur shortly after an initial C-fiber discharge, spinal sensitization, or windup phenomenon. This study was performed to investigate the role of glutamate during spinal sensitization. Methods: Sprague-Dawley rats weighing 200 to 250 g were used for this study. Under light anesthesia (0.5% isoflurane) the rats were segregated in a specially designed cage and $50{\mu}l$ 0.5% formalin was injected subcutaneously in the foot dorsum of right hindlimb. Forty minutes after the formalin injection, the rat was quickly decapitated and spinal cord was removed. The spinal segments at the level of L3 (largest area) was collected and stored in a deep freezer ($-70^{\circ}C$). The mRNA gene expression of N-methyl-D-aspartate receptor (NMDAR) and the metabotropic glutamate receptor subtype 5 (mGluR5) were determined by the polymerase chain reaction. Results: The number of flinches was $19.8{\pm}2.3/min$. at one minute after formalin injection and decreased to zero after then. The second peak appeared at 35 and 40 minutes after formalin injection. The values were $17.8{\pm}2.2$ and $17.2{\pm}3.0/min$. The mRNA gene expressions of NMDAR and mGluR5 were increased by $459.0{\pm}46.8%$ (P < 0.01) and $111.1{\pm}4.8%$ (P > 0.05) respectively at 40 minutes after formalin injection. The increased rate of NMDAR was significantly higher than that of mGluR5 (P < 0.01). Conclusions: From these results it suggested that NMDAR partly contributed to the mechanism of central sensitization after the formalin test but mGluR5 did not.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.317-325
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• 2007

Objective : The purpose of the study was to determine the clinical effects of anterior radical debridement on a series of patients with spontaneous spinal infection. Methods : We retrospectively analyzed the clinical characteristics of 32 patients who underwent surgical treatment from January 2000 to December 2005 in our department. The average follow-up Period was 33.4 months (range, 6 to 87 months). Thirty-two patients presented with the following : 23 cases with pyogenic spondylitis, eight with tuberculous spondylitis and one with fungal spondylitis. The indications for surgery were intractable pain, failure of medical management, neurological impairment with or without an associated abscess, vertebral destruction causing spinal instability and/or segmental kyphosis. Results : The study included 15 (46.9%) males and 17 (53.1%) females ranging in age from 26 to 75 years (mean, 53.1 years). Diabetes mellitus (DM) and pulmonary Tbc were the most common predisposing factors for pyogenic spondylitis and tuberculous spondylitis. Staphylococcus aureus (13%) was the main organism isolated. The most prevalent location was the lumbar spine (75%). Changes in the pain score, Frankel's classification, and laboratory parameters demonstrated a significant clinical improvement in all patients. However, there were recurrent infections in two patients with tuberculous spondylitis and inappropriate debridement and intolerance of medication and noncompliance. Autologous rib, iliac bone and allograft(fibular) were performed in most patients. However, 10 patients were grafted using a titanium mesh cage after anterior radical debridement. There were no recurrent infections in the 10 cases using the mesh cage with radical debridement. Conclusion : The findings of this study indicate that surgery based on appropriate surgical indications is effective for the control of spinal infection and prevention of recurrence with anterior radical debridement, proper drug use and abscess drainage.