• The Journal of the Korean dental association
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• v.48 no.5
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• pp.365-370
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• 2010

Herpes virus family is highly infectious to patients, their families and dentists. The diagnosis of herpes infection is based on the characteristic clinical appearance and the location of the lesions. Herpes Simplex Virus(HSV) usually acquired through direct contact with infected lesions or body fluids, and the prevalence of HSV infection increases progressively from childhood. Primary infections provoke herpetic gingivostomatis typically affects the tongue, lips, gingival, buccal mucosa and palate. Recurrent infections give rise to vesiculo-ulcerative lesions at vermilion border of lip(herpes labialis). In the form of chickenpox, Varicella Zoster Virus(VZV) usually is infected in childhood. VZV spreads in the affected primary afferent nerve to the skin and produces a vesicular rash and pain. Epstein-Barr Virus(EBV) infects B cells and cause infectious mononucleosis. Latent EBV infection has also been implicated in Burkitt lymphoma, nasopharyngeal carcinoma. Cytomegalovirus(CMV) is associated with immune-compromised patient such as organ transplantation and AIDS patients.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.10 no.1
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• pp.349-356
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• 1997

an acute, unilateral, self-limited inflammatory disease of cerebral ganglia and the ganglia of posterior nerve roots and peripheral nerves in a segmented distribution, caused by the chickenpox virus, and characterized by groups of small vesicles in the cutaneous areas along the course of affected nerves, and associated with neuralgic pain. three case of herpes zoster has severe post herpetic neuralgia. these patients has been treated with westernmedicine. But they could not expect to improve condition. We exprienced three cases of herpes zoster that have a result of effect with oriental treatment and lazer threaphy.

• Journal of Acupuncture Research
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• v.18 no.1
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• pp.237-247
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• 2001

Background : infection associated with otalgia, herpetic eruptions, facial palsy, trigeminal pain and cochleovestibular dysfunction such as hearing dishubance, tinnitus, vertigo and other symptoms, and is not frequently encountered in otolaryngologic field. And facial paralysis occured by this syndrome is rapid in onset, usually severe in degree, and poor in prognosis. Objectives : To evaluate the Oriental Medicine's treatment and prognosis of Herpes zoster oticus and to classify of peripheral Facial palsy on Oriental Medicine. Methods : Clinical observation and analysis about a case of Ramsay-Hunt syndrome III type was done, who visited Dongguk University Gangnam Hospital. This case is managed by integrated therapy of oriental and western medicine. In oriental medicine, to treate ear pain, heonggae-yeongoetang(荊芥蓮翹湯) was given and to treat herpetic eruption, 8 constitution acupuncture treatement was done. In western medicine, antiviral agent, acyclovir and steroid hormone, prednisolon were treated. Result : About 6 weeks treatment, this case which has worse prognosis than Bell's palsy, was completed cured without any complication. Conclusion : 1. Futher divided classification about non-infectious and infectious facial palsy include "Ramsay Hunt Syndrome" is needed. 2. In acute state, Jeonyohwadan's (纏腰火丹) treatement can be applied, but the difference of invasion part, primary symptom such as ear pain and herpetic eruption is needed another treatment. 3. Ear pain and herpetic eruption can be treated in part of poongyeol(風熱) and subyeol(濕熱). 4. In Acupuncture treatement, Jeonyohwadan's (纏腰火丹) treatement can be applied in acute stage and guanwasa's treatement can be applied in chronic stage. but futher research is needed. 5. This case, Ramsay Hunt Syndrome IlI type, was managed by integrated therapy such as heonggae-yeongoetang(荊芥蓮翹湯), 8 constitution acupuncture treatement, acyclovir and prednisolon and this treatement was good effect.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.434-438
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• 1996

Epidural abscess is associated with placement of epidural catheter is very rare. We experienced two cases of epidural abscess formation after placement of epidural catheter for pain management. A 63 years old female patient received thoracic epidural catheterization for management of pain due to herpes zoster on right T4 dermatome. Two weeks after catheterization, she complained of paraparesis and anesthesia below $T_4$ dermatome. Four weeks later magnetic resonance images was performed and revealed epidural abscess on $T_2-T_5$. Emergent decompressive laminectomy was performed but neurologic symptoms were not improved. In other case, a 75 years old male patient received lumbar epidural catheterization for management of Buerger's disease. About on month later, pus was aspirated from lumbar epidural space. But further evaluation could not be achieved because he wanted to discharge against advice. We emphasize that epidural abscess results sequele serious and prompt diagnosis and treatment is important.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.52-57
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• 2009

Background: Transforaminal epidural injection (TEI) may be useful to treat unilateral pain that has a dermatomal distribution. In this approach, the needle tip can be placed closer to the dorsal root ganglion and ventral aspect of the nerve root. However many studies have reported that serious complications following TEI occurred more frequently when it was conducted at the cervical level. One of the presumptive mechanisms of the complication is intravascular injection. Therefore this study was conducted to identify the incidence of complications in response to intravascular injections at cervical segments. Methods: This study included all patients, who visited our pain clinic and had radicular symptoms or herpes zoster associated pain. All procedures were conducted under fluoroscopic guidance with contrast enhancement by one of the authors. After the ideal needle position was confirmed by biplanar fluoroscopy, the blood aspiration through the needle hub was evaluated, and a 3 ml mixture of nonionic contrast (2 ml) with normal saline (1 ml) was injected at a rate of 0.3-0.5 ml/sec continuously under real time fluoroscopic visualization. We then classified the contrast spreading pattern as neural, simultaneous neural and vascular, or vascular. Results: A total 71 cervical TEIs were performed. In 26 cases (36.6%), the contrast only spread to the nerve sheath. However, 45 cases (63.4%) showed an intravascular spreading pattern, 37 (52.1%) of which showed a neural and vascular pattern and 8 (11.3%) of which showed only a vascular pattern. Conclusions: Approximately two thirds of the cases of cervical TEI were found to lead to intravascular spreading, which is much higher than the incidence reported in previous studies.

• The Korean Journal of Pain
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• v.21 no.3
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• pp.217-223
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• 2008

Background: Lumbar transforaminal epidural injections (LTEIs) have been utilized in the treatment of radicular pain, and LTEIs have the advantage of target-specificity. However, there have not been enough studies on the contrast patterns in LTEIs with using fluoroscopy. The purpose of this study was to evaluate the spreading epidural contrast patterns that are seen during real-time fluoroscopic guided LTEIs. Methods: A total of 131 patients who underwent fluoroscopic guided LTEIs were studied. The inclusion criteria were those patients with low back pain and/or lower extremity pain that was caused by a herniated nucleus pulposus, lumbar spinal stenosis, failed back surgery syndrome, and herpes zoster-associated pain. We classified the contrast patterns in regard to the contrast flow spreading to the nerve root and/or the unilateral, bilateral or cylinderic type of epidural spreading on the AP view of the fluoroscopy and the ventral or dorsal epidural filling on the lateral view. In addition to the pattern analysis, we evaluated the range of contrast spreading from the cranial to the caudal epidural filling and the incidence of an intravascular flow pattern. Results: Epidural spreading was seen in 126 cases (96.2%) of the total patients through the nerve root. Ventral spreading occurred in 120 cases (95.2%). On the AP view, a nerve root with unilateral, bilateral and cylinderic epidural filling was noted for 108 (85.7%), 9 (7.1%) and 9 (7.1%) cases, respectively. The contrast spreading to vertebral segments was smaller for the patients with lumbar spinal stenosis and failed back surgery syndrome than for the other groups (P < 0.0083). The incidence of intravascular injection was 11.1% (14/126). Conclusions: LTEIs using fluoroscopic visualization provided excellent assessment of the ventral epidural filling as well as nerve root filling. However, unilateral epidural spreading was prominent for the LTEIs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.75-79
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• 2008

Blunt trauma, drugs, infection, congenital anomalies of the pancreaticobiliary system, and multisystem diseases are the main causes of acute pancreatitis in children. Various viruses can cause acute pancreatitis, but varicella-induced pancreatitis is unusual and generally observed in adults or immunocompromised patients. We report a rare case of acute pancreatitis associated with varicella-zoster virus infection in a 6-year-old immunocompetent girl. The patient initially presented complaining of severe abdominal pain and repetitive vomiting. The patient had multiple cutaneous crusts that has been caused by preceding varicella infection and had elevated values of serum amylase and lipase. Abdominal ultrasonography demonstrated swelling of the pancreas and pancreatic duct dilatation, findings which were compatible with acute pancreatitis. The patient's clinical and laboratory abnormalities were completely normalized through conservative treatment consisting of fasting, total parenteral nutrition, and analgesic therapy.

• 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.

• The Journal of Internal Korean Medicine
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• v.24 no.4_2
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• pp.1007-1013
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• 2003

Ramsay Hunt Syndrome is caused by infection of herpes zoster and associated with otalgia, herpetic eruptions, facial palsy, trigerminal pain and cochleovestibular dysfunction such as deafness, tinnitus, vertigo and so on. A 60-year old female, who has tinnitus, peripheral facial palsy, deafness, vertigo, postauricular pain and herpetic eschar, had been admitted to Wonkwang University Oriental Jeonju Medicine Hospital. We treated this patient with Daehwangchijahwangbaeg-byung and Yongdamsagantang-gami, and the patients showed improvement in the symptoms. So we describe the process and contents about the way the patient was cured.