• Title/Summary/Keyword: Spinal Cord Injury

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Neuroprotective Effect of Cyclosporin A on Spinal Cord Ischemic Injury in Rabbits (토끼를 이용한 척수 허혈 손상 모델에서 Cyclosporin A의 척수 손상에 대한 보호 효과)

  • Shin Yoon-Cheol;Choe Ghee-Young;Kim Won-Gon
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.739-748
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    • 2006
  • Background: The purpose of this study is to ascertain the neuroprotective effect of cyclosporin A on the 25-min surgical ischemia model in the spinal cords of rabbits with neuropathological correlation and histoimmunochemical analyses, Material and Method: Thirty-two New Zealand white rabbits were randomly divided into four groups: Rabbits were randomly divided into four groups: the control 12 group (n=8), the control 17 group (n=8), the cyclosporin Cs2 group (n=8), and the cyclosporin Cs7 group (n=8). The 12 group underwent a 25-min aortic cross- clamp without intervention and were sacrificed on the 2nd day postoperatively, while the 17 group underwent a 25- min of aortic cross-clamp without intervention and were sacrificed on the 7th day postoperatively. The Cs2 group received cyclosporin A (25 mg/kg) intravenously 15 min after the 25-min cross-clamp and were sacrificed on the End day postoperatively, while the Cs7 group received cyclosporin A (25 mg/kg) intravenously 15 min after the 25-min cross-clamp and were sacrificed on the 7th day postoperatively. The rabbits underwent 25-min surgical aortic cross-clamp. Neurologic functions were evaluated on the 2nd day and 7th postoperative day using Tarlov scoring system. After scoring neurologic function, all rabbits were sacrificed for histopathologic observation. Result: All rabbits survived the experimental procedure. The values of Tarlov score did not show any differences between the control and cyclosporin groups on the 2nd day. The scores of group Cs7 ($2.75{\pm}0.89$) were significantly higher than those of group 17 ($1.25{\pm}1.39$) on the 7th day (p<0,05). On the histologic exanminations, specimens of the spinal cord showed necrosis and apoptosis. The pathologic scores of group Cs7 ($1,0{\pm}0.53$) was less than those of group 17 ($2.13{\pm}1.36$, p<0.05). TUNEL staing showed apoptosis of the specimen in group 12 and Cs2 but there was no stastically significant difference between groups on the score. There were more overexpression of HSP70 and nNOS in cyclosporine group than in control group. Conclusion: We think that cyclosporin A may decrease neuronal cell death with induced upregulation of HSP70 against 25-min ischemia of the spiral cord in the rabbit.

Case Report of Hemiplegia after apoplexy in a Patient with Monoplegia on Right upper Extremity Treated with Herbal Prescription (우상지(右上肢) 단마비(單痲痺)가 주증(主症)인 풍비 환자의 만금탕가미방(萬金湯加味方) 투여 호전 1례)

  • Jeong, Byeong-Ju;Woo, Sung-Ho;Kim, Byung-Chul;Kim, Yong-Ho;Seo, Ho-Seok;Hwang, Gyu-Dong;Jang, Ha-Jeong;Nam, Hyo-Ick;Kim, Hoi-Young;Kim, Jin-Won
    • The Journal of Internal Korean Medicine
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    • v.27 no.1
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    • pp.288-293
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    • 2006
  • Background : Monoplegia is the paralysis of a limb. It is commonly caused by an injury to the cerebral cortex, and rarely caused by injury to the internal capsule, brain stem, or spinal cord. Most problems with cerebral cortex is derived from the occlusion of a brain cortex blood vessel due to thrombus or embolus. Objectives : This study is to see if there is a significance in thermal differences of acupoints in diagnosis and treatment of monoplegia on an upper extremity to test the validity of acupuncture and herbal treatment for it. Methods : By using Digital Infrared Thermographic Imaging(DITI), thermal differences$({\Delta}T)$ of acupoints on the upper extremity in a patient with monoplegia on the right upper extremity were measured after an attack of the disease. By giving Mangeum-tang(萬金湯) and treating the patient with acupuncture. the temperature changes of the upper extremity were examined through DITI and improvement was observed. Results : Compared with the left arm which suffered no such injury, the right recovered about 80% of sensation, and the grade of monoplegia improved from Grade O to Grade V. Also, the temperatures of right palmar-dorsal hand and the region of Weiguan(外關, Waiguan, TE5) were $1^{\circ}C$ and $1.45^{\circ}C$ higher than the same left region on admission day, but the thermal differences$({\Delta}T)$ narrowed to $0.5^{\circ}C$ by the last day. Conclusions : Results suggest that DITI screening is a reliable method of prognosis and that the time required for treatment can be estimated through this method in cases of monoplegia to an upper extremity. Also, progress in treatment is reflected in thermal differences of acupoints of the monoplegic upper extremity in accordance with the theory of meridian. This supports a role for acupuncture and herbal treatment for monoplegia.

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Systematic Review of Driving Rehabilitation for Improving On-Road Driving (도로 주행 능력을 향상시키기 위한 운전재활의 체계적 고찰)

  • Park, Jin-Hyuck;Heo, Seo-Yoon;Seo, Jun;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.5 no.2
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    • pp.35-47
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    • 2016
  • Objective: The aim of this study was to identify the driving rehabilitation for on-road driving through a systematic review. Methods: We systematically examined papers published in journals from December 2014 to January 2015, using CINAH, Embase, Pubmed, PsycINFO, and The Cochrane Library. Eventually, 15 studies were included in the analyses. Results: The evidence of 15 studies was from levels I, III, and V. The subjects included in the analyses were patients with stroke(40.0%), older driver(20.0%), traumatic brain injury(20.0%), acquired brain injury(13.3%) and spinal cord injury(6.7%). The intervention types were driving simulator training(53.3%), cognitive skills training(26.6%), off-road educational training(6.7%), adaptation of assistive device(6.7%), and behind-the-wheel training(6.7%). The effects of driving rehabilitation were different depending on the types of intervention. However, driving simulator training showed significant improvement of on-road assessments in all studies included this study. Conclusions: Driving rehabilitation for on-road driving has been used in various types. Specially, the effect of the driving simulator training has been proved by many studies. Future studies are to be required with client from a range of diagnostic groups to establish evidence-based interventions and determine their effectiveness in improving on-road driving.

Microsurgical DREZotomy for Deafferentation Pain (구심로 차단 동통에서의 미세 후근 진입부 절제술)

  • Kim, Seong-Rim;Lee, Kyung Jin;Cho, Jeong Gi;Rha, Hyung Kyun;Park, Hae Kwan;Kang, Joon Ki;Choi, Chang Rak
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.85-90
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    • 2001
  • Objective : DREZotomy is effective for the treatment of deafferentation pain as a consequence of root avulsion, postparaplegic pain, posttraumatic syrinx, postherpetic neuralgia, spinal cord injury, and peripheral nerve injury. We performed microsurgical DREZotomy to the patients with deafferentation pain and relieved pain without any serious complication. The purpose of this study is to evaluate the usefulness of the microsurgical DREZotomy for deafferentation pain. Methods : We evaluated 4 patients with deafferntation pain who were intractable to medical therapy. Two of them were brachial plexus injury with root avulsion owing to trauma, one was axillary metastasis of the squamous cell carcinoma of the left forearm, and the last was anesthesia dolorosa after surgical treatment(MVD and rhizotomy) of trigeminal neuralgia. Preoperative evaluation was based on the neurologic examination, radiologic imaging, and electrophysiological study. In the case of anesthesia dolorosa, we produced two parallel lesions in cephalocaudal direction, 2mm in distance, from the C2 dorsal rootlet to the 5mm superior to the obex including nucleus caudalis, after suboccipital craniectomy and C1-2 laminectomy, with use of microelectrode. In the others, we confirmed lesion site with identification of the nerve root after hemilaminectomy. We performed arachnoid dissection along the posterolateral sulcus and made lesion with microsurgical knife and microelectrocoagulation, 2mm in depth, 2mm in distance, to the direction of 30-45 degrees in the medial portion of the Lissauer's tract and the most dorsal layers of the posterior horn at the one root level above and below the lesion. Results : Compared with preoperative state, microsurgical DREZotomy significantly diminished dosage of the drugs and relieved pain meaningfully. One patient showed tansient ipsilateral ataxia, but recovered soon. There was not any serious complication. Conclusion : It may be concluded that microsurgical DREZotomy is very useful and safe therapeutic modality for deafferentation pain, especially segmentally distributed intermittent or evoke pain. Complete preoperative evaluation and proper selection of the patients and lesion making device are needed to improve the result.

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A Study of Effect of Disability Prevention Program Acquired by People with Disabilities are Performed : centered on Elementary School Students (휠체어 장애인과 함께하는 장애예방교육의 융·복합 효과에 관한 연구 : 초등학생을 중심으로)

  • Kim, Yeon-Jung
    • Journal of Digital Convergence
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    • v.14 no.5
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    • pp.369-376
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    • 2016
  • The purpose of this study was to identify the effect the disability prevention program by spinal cord injury lecturer for elementary school students. 1,167 students participated and data were analyzed using Wilcoxon signed-rank test by SPSS 22.0 program and qualitative analysis. The disability prevention program was a 40minutes, program composed of cause of disability, watching cases of accidents, story of disabled lecturer. The result showed that there were significant improvements in self-efficacy(Z=-26.109, p<.01) and awareness for the disabled. This study suggests that the disability prevention program by disabled lecturer had a positive effect on elementary school students. So the program should be expanded for children.

Correlation between Time Usage and Hope in 20s and 30s the Disabled (20대 및 30대 장애인의 시간사용과 희망의 관계)

  • Lee, Chun-Yeop;Chang, Moon-Young
    • The Journal of Korean society of community based occupational therapy
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    • v.4 no.1
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    • pp.11-21
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    • 2014
  • Objective : This study was aimed to survey the correlation between time usage and hope in 20s and 30s the disabled. Methods : From November to December 2012, 52 the disabled who have therapy in rehabilitation hospital in Busan and Gyeongnam, being diagnosed with spinal cord injury and stroke, were chosen. Semi-structured interview was carried out using a questionnaire involved time usage and hope. Results : The followings are the results of this study. First, the participants spent most time sleeping (10:47) and using media (3:41) on weekends. In additions, they spent most time sleeping (9:43) and health management (5:12) on weekdays. Second, doing household chores were positive correlation (.688) between time usage and hope (p<.05). However, no significant differences in time usage and hope. Conclusion : The results of this study would contribute to propose various activities for 20s and 30s the disabled.

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The Effects of Daeyeoung-jeon on the Prevention of Disuse Muscle Atrophy in Rats (대영전(大營煎)이 불용성 근위축에서의 apoptosis 관련 단백질들의 발현변화에 미치는 영향)

  • Kim, Bum Hoi
    • Herbal Formula Science
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    • v.25 no.4
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    • pp.499-508
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    • 2017
  • Objectives : Skeletal muscle atrophy occurs in response to a variety of conditions. The unloading to muscle occurs clinically in limb immobilization, bed rest, spinal cord injury and peripheral nerve damage, resulting in significant loss of muscle mass and force production. Muscle disuse is accompanied by an increase in apoptotic signaling, which mediates some of the responses to unloading in the muscle. In this study we tested the hypothesis that Daeyeoung-jeon extract would improve muscle recovery after reloading following disuse. Method : Twenty young male Sprague-Dawley rats were used for the studies. The hindlimb immobilization was performed with casting tape to keep the left ankle joint in a fully extended position. No intervention was performed on the right leg and used as intact region. The Rats in Daeyeoung-jeon treated group (DYJ) were orally administrated Daeyeoung-jeon water extract, and rats of Control group were given with saline only. After 2 weeks of immobilization, all animals were sacrificed, and the whole gastrocnemius muscles were dissected from both legs. The morphology of right and left gastrocnemius muscles in both DYJ and Control groups were assessed by hematoxylin and eosin staining. Moreover, to investigate the immobilization-induced muscular apoptosis, the immunohistochemical analysis of Bax and Bcl-2 was carried out. Results : Daeyeoung-jeon represented the significant protective effects against the reductions of the left gastrocnemius muscles weight and average cross section area to compared with Control group. The treatment with Daeyeoung-jeon extract significantly reduced the immunoreactivity of BAX and increased the immunoreactivity of Bcl-2 in gastrocnemius muscle compared with Control group. Conclusion : Daeyeoung-jeon has protective effects against immobilization-induced muscle atrophy by regulating the activities of apoptosis-associated BAX/Bcl-2 proteins in gastrocnemius muscle.

Treatment of Recurrent Ischial Pressure Sore Using Sclerotherapy with Absolute Ethanol (순수 에탄올을 이용한 재발된 좌골부위 압박궤양의 경화요법적 치료)

  • Song, Hoon;Park, Sang Keun;Kim, Jong Whan;Hong, In Pyo
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.627-631
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    • 2006
  • Purpose: Ischial region is common site of pressure sore as well as greater trochanteric area. In general, ischial pressure sore associated with a large subcutaneous bursa often requires radical surgical treatment. The authors performed sclerotherapy using absolute ethanol which was considered as an alternative in treating recurrent ischial pressure sore. Methods: From may 2005 to February 2006, 11 ischial pressure sore patients were treated sclerotherapy using absolute ethanol. The authors performed sclerotherapy using absolute ethanol in 11 patients in whom the ischial sore has recurred despite of multiple radical surgical treatment. The patients' original disorders were spinal cord injury in 9 patients, cerebral palsy in 1 patient and giant cell tumor in thoracic vertebrae 1 patient. Results: Recurrence of pressure sore was not found in any patient during the follow-up period. The swap of the bursa taken before the surgery was germ cultured and compared with the discharge from an end of the inserted drain tube. The germ cultured results after the surgery were tested negative in all patients. Conclusion: This method involves causing the bursa to become scarred and closing it up by sterilizing, fixing, and denaturing by the pharmacologic effect of absolute ethanol instead of surgical excision of the bursa. We felt that aforementioned treatment modality may be considered as an alternative in treating recurrent ischial pressure sore.

Accessibility Factors to Health Check-Ups for People with Disability: A Qualitative Study (장애인 건강검진 접근성 저해요인과 개선방안 도출에 대한 질적 연구)

  • Hong, Hye-Su;Lim, Myung Joon;Kim, Oi-Sook;Choi, Eun-Sook;Kim, Jung Hwan
    • Health Policy and Management
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    • v.30 no.3
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    • pp.335-344
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    • 2020
  • Background: The purpose of this study was to identify factors inhibiting access of people with disability to health check-ups as well as identify pertinent solutions for improvement. Methods: Twenty-three people with disability older than the age of 19 who took respective health check-ups within the last 3 years were selected as participants. For the data collection, the 1:1 intensive interview was used. The data were analyzed by the grounded theory by Corbin and Strauss. Results: The results comprised nine categories, 23 subcategories, and 179 concepts. The central phenomenon was 'failure to obtain check-ups.' Causal conditions were observed as a 'lack of communication method,' 'physical difficulties,' and 'staff unfamiliar with people with disability,' Interventional conditions comprised 'physical accessibility,' 'staffs' competency,' and 'assistant manpower.' The active strategy was included 'to investigate the professional medical institution,' 'to find the medical institution of convenient traffic accessibility,' 'to overcome communication difficulties through equipment,' and 'to overcome linguistic barriers through sufficient communication.' Whereas, 'utilization of ancillary equipment,' 'the education of staffs on people with disability,' 'universal design manual,' and 'customized check-ups' were included in the passive strategy. Such processes arose in the contextual conditions of 'lack of expectations for daily lives' and 'lack of government support.' As a consequence, the subjects participated experienced the 'disadvantages,' 'discrimination,' and 'reduced reliability of the health check-ups.' Conclusion: The subjects who participated in this study emphasized 'staffs familiar with people with disability' and 'systems customized for people with disability' are mandatory to secure complete health check-ups for people with disability.

DNA Microarray Analysis of Methylprednisolone Inducible Genes in the PC12 Cells

  • Choi, Woo-Jin;Choi, Seung-Won;Kim, Seon-Hwan;Kim, Youn;Kwon, O-Yu
    • Biomedical Science Letters
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    • v.15 no.3
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    • pp.261-263
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    • 2009
  • Methylprednisolone is a synthetic glucocorticoid which is usually taken intravenously for many neurosurgical diseases which cause edema including brain tumor, and trauma including spinal cord injury. Methylprednisolone reduces swelling and decreases the body's immune response. It is also used to treat many immune and allergic disorders, such as arthritis, lupus, psoriasis, asthma, ulcerative colitis, and Crohn's disease. To identify genes expressed during methylprednisolone treatment against neurons of rats (PC12 cells), DNA microarray method was used. We have isolated 2 gene groups (up- or down-regulated genes) which are methylprednisolone differentially expressed in neurons. Lipocalin 3 is the gene most significantly increased among 772 up-regulated genes (more than 2 fold over-expression) and Aristaless 3 is the gene most dramatically decreased among 959 down-regulated genes (more than 2 fold down-expression). The gene increased expression of Fgb, Thbd, Cfi, F3, Kngl, Serpinel, C3, Tnfrsf4 and Il8rb are involved stress-response gene, and Nfkbia, Casp7, Pik3rl, I11b, Unc5a, Tgfb2, Kitl and Fgf15 are strongly associated with development. Cell cycle associated genes (Mcm6, Ccnb2, Plk1, Ccnd1, E2f1, Cdc2a, Tgfa, Dusp6, Id3) and cell proliferation associated genes (Ccl2, Tnfsf13, Csf2, Kit, Pim1, Nr3c1, Chrm4, Fosl1, Spp1) are down-regulated more than 2 times by methylprednisolone treatment. Among the genes described above, 4 up-regulated genes are confirmed those expression by RT-PCR. We found that methylprednisolone is related to expression of many genes associated with stress response, development, cell cycle, and cell proliferation by DNA microarray analysis. However, We think further experimental molecular studies will be needed to figure out the exact biological function of various genes described above and the physiological change of neuronal cells by methylprednisolone. The resulting data will give the one of the good clues for understanding of methylprednisolone under molecular level in the neurons.

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