• Pediatric Infection and Vaccine
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• v.9 no.1
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• pp.61-66
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• 2002

Purpose : To determine wether varicella can be prevented by administration of oral acyclovir(ACV) during the incubation period of the disease. Methods : Starting 9 days after exposure to the index case in their families, ACV(40 mg/kg/day in four divided doses) was given orally to 20 exposed children for 5 days. Their clinical features was compared with those of 20 control subjects. Antibody titers to VZV were measured in both group 1 week and 4 weeks after finishing the oral ACV administration. Results : The mean age of family members with varicella(51.4 months) were significantly high compared to that of ACV prophylaxis group(28.5 months) and control group(31 months) (P<0.05). Among the 12 children with ACV prophylaxis who completed follow up blood sampling, nine children were diagnosed as VZV infection on the serologic test(75%). Among them six children showed positive VZV IgM on the first blood sample and two children showed serocoversion to positive IgM on the second test after ACV prophylaxis. One child who was negative on both IgM and IgG, showed positive IgG on the second test. The incidence of fever and severity of skin rashes were significantly low in children received oral ACV than in the control group. No or reduced number of maculopapular eruption were observed in the oral ACV group compared to multiple vesicles of the control group. Conclusion : In the present study, we observed that oral ACV prophylaxis to the family contacts is effective in reducing severity of skin lesion. It is likely that oral ACV 9 days after contact prevents or reduces blood dissemination of VZV. Little is known about clinical effect and immunity to the virus in exposed children with no varicella symptom after treatment. We propose the checking up antibody to VZV some period after oral ACV, and considering vaccination to whom with no antibody. But further more studies are needed to practical application of oral ACV for the postexposure prophylaxis of varicella.

• Pediatric Infection and Vaccine
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• v.22 no.2
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• pp.55-62
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• 2015

Purpose: Varicella Zoster Immune Globulin (VZIG) is available in Korea for post-exposure prophylaxis of the Varicella-zoster virus (VZV) in high-risk patients. In July 2013, the United States Centers for Disease Control and Prevention (US CDC) recommended extending the time for administration of VariZIG$^{(R)}$ from within 96 hours up to 10 days after VZV exposure. This study was performed to analyze the effectiveness of VZIG prophylaxis between the two groups of patients who received VZIG within 96 hours and more than 96 hours of exposure to varicella. Methods: A retrospective chart review was performed in pediatric patients who received VZIG at Samsung Medical Center, Seoul, Korea from January 2001 to December 2012. Results: A total of 91 patients were identified. Fifty-seven patients were male (62.6%) and the median age was 5.91 years. Thirty-nine patients (42.9%) were exposed to VZV in the hospital. Underlying diseases were solid tumors (41.8%), hematologic malignancies (40.7%), and others (17.5%). Forty-five patients (49.5%) were hematopoietic cell transplant recipients. Seventy-four patients (81.3%) received VZIG within 96 hours after VZV exposure. There was no significant difference in the development of chickenpox between the two groups (2.7% vs. 5.9%, P=0.4664). In 22 seronegative patients, we also observed no significant difference between the groups in terms of the development of chickenpox (6.6% vs. 0%, P=0.667). Conclusions: This study showed that the effectiveness of VZIG for the prevention of chickenpox was comparable between patients who received VZIG within 96 hours and those who received VZIG more than 96 hours after exposure to VZV.

• Korean Journal of Poultry Science
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• v.35 no.1
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• pp.39-55
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• 2008

Like the other herpesviruses, the virion of MDV consists of an envelope, which surrounds an amorphous tegument. Within the tegument, and icosahedral capsid encloses a linear double-stranded DNA core. Although the genome structure of MDV indicates that it is an ${\alpha}-herpesvirus$ like herpes simplex and varicella-zoster viruses, biological properties indicate MDV is more akin to the ${\gamma}-herpesvirus$ group, which includes Epstein-Barr and Kaposi's sarcoma herpesviruses. These herpesviruses replicate lytically in lymphocytes, epithelial and fibroblastic cells, and persist in lymphoblastoid cells. MDV has a complex life cycle and uses two means of replication, productive and non-productive, to exist and propagate. The method of reproduction changes according to a defined pattern depending on changes in virus-cell interactions at different stages of the disease, and in different tissues. Productive (lytic) interactions involve active invasion and take-over of the host cell, resulting in the production of infectious progeny virions. However, some herpesviruses, including MDV, can also establish a non-productive (abortive) infection in certain cell types, resulting in production of cell-associated progeny virus. Non-productive interactions represent persistent infection, in which the viral genome is present but gene expression is limited, there is no structural or regulatory gene translation, no replication, no release of progeny virions and no cell death. Reactivation of the virus is rare, and usually the infectious virus can be re-isolated only after cultivation in vitro. MDV establishes latency in lymphoid cells, some of which are subsequently transformed. In this review article, recent knowledges of the pathogenesis mechanisms followed by MDV infection to sensitive cells and chickens are discussed precisely.

• The Journal of the Korean Society for Microbiology
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• v.35 no.2
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• pp.191-201
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• 2000

The viruses of Herpes Simplex Virus 1 (HSV-1), Herpes Simplex Virus 2 (HSV-2) and Varicella-Zoster virus (VZV) which belong to the alpha herpes subfamily are important human pathogens. When eruptions were not fully developed from these viral infections, clinical diagnosis was not always easy and required virological confirmation test. The above viruses were reactivated in individuals who were compromised in immune competence for one reason or another. Polymerase chain reaction (PCR) enables rapid and sensitive detection of HSV and VZV DNAs. Its sensitivity was largely influenced by choice of primers. Authors conducted a study to detect of those three viruses in human specimens including vesicle fluid and joint fluid and serum using PCR methods. Primers used for this study were the general primer pair GPHV-RU which was known to amplify within the genes enjoying the highest degree of homology between UL15 of HSV and UL42 of VZV. PCR with primers hybridized pair GPHV-RU amplifies a 396 bp with THP-1 and HSV-2 standard strain DNA and 405 bp with VZV standard strain DNA. Restriction enzyme cleavage with HpaII and DdeI were used to detect and distinguish DNAs of THP-1 and HSV-2 and VZV. The purpose of this study was a rapid and easy detection of VZV and THP-1 or HSV-2 from various clinical specimens (vesicle fluid, serum and joint fluid) by PCR method. Used methods were: HSV PCR with primer 1, 2 and HpaII RE digestion; VZV nested PCR; HSV PCR with primer A, Band BssHII RE digestion. 1) In 33 cases (33/42, 78.6%) VZV was detected single or mixed infection from 42 clinical specimens which included vesicle fluid (5), serum form respiratory infected children (10), serum from immune suppressed adult cancer patients (7) and joint fluid from arthritis patients (20). 2) In 20 cases (20/42, 47.6%) HSV was detected singly or mixed infection and 19 of those cases were HSV-2 and 1 case was THP-1. 3) In 19 cases (19/42, 45.2%) VZV was singly detected which included serum from respiratory infected children (6 cases), joint fluid from arthritis patients (9 cases), vesicle fluid (2 cases) and serum form immunosuppressed cancer patients (2 cases). 4) HSV was singly detected in 6 cases (6/42, 14.3%) which included joint fluid from arthritis patients (5 cases) and serum form respiratory infected children (1 cases). 5) 14 cases of VZV and HSV mixed infection (14/42, 33.3%) were detected. They included vesicle fluid (3 cases), serum form immunosuppressed cancer patients (4 cases), serum from respiratory infected children (2 cases) and joint fluid from arthritis patients (5 cases). 6) HSV-1 and HSV-2 detection and typing by HSV PCR with primer A, Band BssHII RE digestion method was more sensitive and the results were easier to detect than on other method.

• The Journal of Korean Society of Virology
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• v.30 no.3
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• pp.171-178
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• 2000

Herpes simplex virus, Varicella zoster virus and Human herpes virus-6 caused central nervous system infections and latent infections but there is no data of the 3 viruses being tested from the same cerebrospinal fluid samples with aseptic meningitis or encephalitis in adults patients. These viruses produced similar neurologic symptoms but difficulties existed in differentiating of etiologic agents and therefore the viruses needed to be detected in the early state. Herpes simplex virus encephalitis (HSVE) in adults, if not treated promptly was fatal. If treated with antiviral drugs in the early phase of encephalitis, neurologic sequales decreased by 65%. Recently, a PCR method for detection of HSVE with CSF was developed. VZV primary and secondary infections caused neurologic symptoms of encephalitis or meningitis. The second frequency of adult encephalitis that caused VZV were reported. HHV-6 caused CNS latent infection that was studied with normal adults brains. But there is no data of HSV, VZV and HHV-6 for aseptic meningitis and encephalitis of Korean adults through etiologic study. We cultured CSFs on HEp-2 cells and simultaneously tested for HSV PCR, VZV nested PCR and HHV-6 PCR with 8 specific primers. The PCR results of CSF from meningitis Korean adults were 13/19 (68.4%) for HSV, 10/19 (52.6%) for VZV and 12/19 (63.2%) for HHV-67/19 (36.8%) cases were triple infected HSV PCR, VZV PCR and HHV-6 PCR positive; 3/19 (15.8%) cases were dual infected HSV PCR and HHV-6 PCR positive; 1119 (0.5%) cases was VZV PCR positive. Strong viral DNA amplification of CSF means a causative virus may be present in aseptic meningitis or encephalitis patients and may cause clinical neurologic symptoms. HSV and HHV-6 viruses detection rate were higher than VZV by PCR with CSFs.

• Pediatric Infection and Vaccine
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• v.4 no.2
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• pp.298-302
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• 1997

Ramsay Hunt syndrome is a viral associated disease with severe otalgia, vertigo, fever, herpetic eruptions on either side of the external auditory meatus and cavum concha, ipsilateral facial nerve palsy and cochleovestibular dysfunction. This syndrome may be the most common cause of unilateral facial paralysis and involvement of both the vestibular and cochlear branch of 8th cranial nerve. And loss of taste sensation may be developed in same involement site. This syndrome affects adults in most cases, and a samll number of children with herpes zoster oticus have been reported. And concomittantly CNS invlovement of this snydrome is very rare. We experienced a 7 years old aged patient of Ramsay Hunt syndrome who had evidence of aseptic meningitis, and this patient showed well reponses with Acyclovir and symptomatic therapy. So, we report this case with brief review of related literatures.

• Journal of Acupuncture Research
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• v.40 no.1
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• pp.16-34
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• 2023

Herpes zoster (HZ) results from the reactivation of a varicella-zoster virus infection and is accompanied by moderate-to-severe pain in most patients. The most common treatment is medication; however, there are still limitations. Acupuncture reportedly has meaningful therapeutic effects and is a possible alternative option in HZ. However, no systematic reviews examining the use of acupuncture and electro-acupuncture (EA) alone have been published; in this study, we therefore aimed to systematically review those techniques. We searched for clinical trials of acupuncture and EA treatment for HZ up to October 2022. Trials that used acupuncture were included. Outcomes were visual analog scale (VAS) and effective rate. Secondary outcomes were time to pain relief, time to pain elimination, incrustation, decrustation, lastly incidence of post-herpetic neuralgia (PHN). In total, 22 randomized controlled trials were included in this research. Compared with conventional medication therapy, acupuncture was associated with a significant improvement in VAS, effective rate, and times to pain relief and elimination. Times to new blister cessation, incrustation, and decrustation (days) were significantly improved. Furthermore, the incidence rate of PHN was lower in acupuncture groups. The results suggest that acupuncture could be a reasonable treatment option for patients with HZ who suffer from pain and accompanying symptoms.

• Journal of Acupuncture Research
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• v.19 no.5
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• pp.234-246
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• 2002

Background: Herpes Zoster Oticus, which can be caused from infection by Varicella-zoster virus, is known to be expected poor prognosis, since it has higher possibility of complete injury of facial nerve. Conservative therapy of the Western medicine is effective on the treatment for the herpes zoster and pain. However, its effectiveness on the facial verve palsy has not been proven. Objective : This study was performed to evaluate the treatment of oriental medicine and an analyze prognosis of the facial nerve palsy in Herpes Zoster Oticus. Methods : This retrospctive study was conducted to observe the clinical manifestation of Herpes Zoster Oticus, and the result of electrical diagnostic study on the patients with the facial nerve palsy in Herpes Zoster Oticus who were diagnosed and treated at the Department of Acupuncture & Moxibustion in Kyung Hee Oriental Medical Hospital. Results : 1. According to the six clinical types of Herpes Zoster Oticus, the patients in this study can be grouped as 7 cases of the type II, 2 cases of the type V, and one case of the type IV and the type VI. 2. The shorter the period from onset to the first visit to a hospital, the prognosis of facial nerve palsy in Herpes Zoster Oticus was the better. 3. According to the follow up study, the H-B grades of all cases were improved. 4. According to the follow up study, the result of electrical diagnostic study was improved. Conclusions : We found in our study that the treatment of oriental medicine, such as acupuncture, herbal medicine and aroma therapy, helps the recovery of facial nerve palsy in Herpes Zoster Oticus. The further clinical study about the more cases of facial nerve palsy in Herpes Zoster Oticus and comparative study between the group of oriental medicine and that of western medicine are needed.

• Investigative Magnetic Resonance Imaging
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• v.25 no.3
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• pp.197-200
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• 2021

Ramsay Hunt syndrome (RHS) is a disease caused by varicella-zoster virus (VZV) infection that can be diagnosed through clinical symptoms with or without imaging evaluations. The typical features of RHS on imaging evaluation include signal changes and enhancement in the internal auditory canal (IAC) nerves, and the labyrinthine segment of cranial nerve VII (CN VII) and cranial nerve VIII (CN VIII). In some patients, inner ear structure (cochlear and vestibular apparatus) is involved in RHS. Neurologic complications, such as encephalitis and meningitis, are rare in RHS, but are known to occur. Therefore, magnetic resonance imaging (MRI) is necessary to detect both abnormal signal intensity in the IAC, CN VII, CN VIII, inner and ear structure, and CNS complications. We report an RHS patient with CN VII, VIII, and leptomeningeal enhancement within the cerebellar folia on 10-min delayed, contrast-enhanced (CE), three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.669-676
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• 2004

Post-herpetic neuralgia(PHN) is a chronic pain syndrome associated with the reactivation of a primary infection with varicella zoster virus(chinken pox), which leads to a chronic infection of dorsal root ganglia. The most common risk factor for shingles and its potential sequela, PHN, is advanced age. For a significant number of patients, the pain following healing of shingles can persist for months to years. If this pain, classified as PHN, persists longer than one month. PHN often leads to depression, disrupted sleep, decreased productivity, and utilization of health care. We treated a 60 year-old female patient who suffered pain and headache after Stellate Ganglion Blocks(SGB). In identifying points for differentiation of syndrom(辨證), this subject was diagnosed as Yangmyeong Merdian wind-heat syndrom(陽明經風熱證) and was administered Seungmagalgeuntanggamibang(revised Shengmagalgen-tang, 升麻葛根湯加味方). To ease pain, Western medication was administered as well. After fourteen days of treatment, pain and other symptoms improved.