• Pediatric Infection and Vaccine
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• v.21 no.2
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• pp.150-156
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• 2014

Despite its rare occurrence, early diagnosis and appropriate treatment for neonatal herpes simplex virus infection are mandatory due to its high morbidity and mortality. In Korea, there has been no epidemiologic data on neonatal herpes simplex virus infection, and even case reports are rare. We observed a 16-day-old neonate who presented with fever and seizures. We diagnosed her with meningoencephalitis caused by herpes simplex virus type 2 based on the polymerase chain reaction test, and treated her with intravenous acyclovir and anticonvulsants. The seroprevalence of herpes simplex virus type 2 sharply increases in women in their 30s, and the average age for childbirth has increased to older than 30 years of age in Korea; we therefore expect that the incidence of neonatal herpes simplex virus type 2 infection will rise in Korea, and more attention should be directed to neonatal herpes simplex virus type 2 infection. We report this newborn patient's case along with a literature review.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.107-118
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• 2007

Background : It is well known that non-rapid eye movement(NREM) sleep activates the occurrence of interictal epileptiform discharges(IED) in many epileptic syndromes. We performed this study to assess the effect of NREM sleep on IED in epileptic patients with organic brain lesions. Materials and Methods : We analyzed awake and sleep electroencephalopathy(EEG) recorded simultaneously after partial sleep deprivation in 50 patients. We calculated the awake and sleep spike index (ASI and SSI, spikes/epoch), and the percentage increase of ASI and SSI during sleep. Results : In the 50 patients, the IEDs were recorded exclusively during the awake state in 1 (2%) patient, and during the sleep state in 13(26%) patients. The SSI was higher in 44 (88%) patients, and the ASI was higher in 5 (10%) patients. The mean ASI and the SSI in patients with organic brain lesions were $0.058{\pm}0.121$ and $0.148{\pm}0.187$, and it was $0.081{\pm}0.150$ and $0.174{\pm}0.226$ in patients without organic brain lesions. There were significant increases in the spike index (P<0.05) during NREM sleep in both groups (n=36), but no significant difference in the percent increase of spike index (P>0.05). Conclusion : The IEDs were activated significantly during NREM sleep both in patients with and without organic brain lesions, but there were no differences in the degree of activation in both groups. The activating effect of NREM sleep was not correlated with clinical factors such as, frequent nocturnal seizures, frequent generalized tonic clonic seizures, type of epilepsy and taking anticonvulsants. We conclude that the routine EEG used to evaluate epileptiform discharges in epileptic patients should include sleep recordings after partial sleep deprivation.

• The Journal of the Korea Contents Association
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• v.15 no.2
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• pp.363-369
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• 2015

Chronic pain is one of the leading causes of hospital visits. It not only affects the patients themselves but also has a major negative impact on their families and society. In this study, we investigated epidemiology of musculoskeletal disorders induced chronic pain among general population based on Korea National Health and Nutrition Examination Survey database and also analysed how it influenced on the use of medical services. This study was done by using the data of 5th Korea National Health and Nutrition Examination Survey (KNHANES V), taking aged 20 years and over adults as research subjects. The EuroQoL-5 Dimension Index(EQ-5D) was used as a survey instrument. T-test, chi-square test and multivariate logistic regression were used for statistical analysis. Subjects with chronic pain had a higher likelihood than control group to use medical services(odds ratio : 5.858, confidence interval 3.636-9.438). Controlling for existence of chronic pain, more women were likely to use medical services than men(1.156, 0.707-1.889). Age, gender and household income level did not affect the use of medical services. Proper control of chronic pain is very helpful in improving patient's quality of life and it also accounts for a large proportion in suppressing excessive consumption of medical services. Anesthesia and pain medicine specialists have superior knowledge about analgesics and anticonvulsants than other physicians do and also have specialized skills to perform procedures like nerve blocks in treating chronic pain. Therefore Anesthesia and pain medicine specialists need to play a leading role in managing chronic pain.

• Journal of Acupuncture Research
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• v.31 no.1
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• pp.177-186
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• 2014

Objectives : The aim of this study is to report a case of a 51-year-old patient with Herpes zoster, whose symptoms were relieved within five weeks after the East-west medical combined treatment. Methods : A Herpes zoster patient with extreme pain around the right lower ribs and lower back was admitted into the Korean medicine hospital. Bee venom acupuncture was applied directly onto the site of pain and electroacupuncture was applied on $GV_6-BL_{20}$, inferior site of spinous process of the 12th thoracic vertebra-$BL_{21}$, $GV_5-BL_{22}$, $GV_4-BL_{23}$ six times a week. Moxibustion was applied on $BL_{49}$, $BL_{50}$, $BL_{51}$, $BL_{52}$, $GB_{25}$, $LR_{13}$ six times a week, and the patient took daily doses of herbal medicine and western medicines such as anticonvulsants, analgesics, antiepileptics. The patient's symptoms were evaluated with numeric rating scale(NRS) and neuropathic pain scale(NPS). Results : The results were as follows: 1. After the East-west medical combined treatment, the NRS grade decreased from 8 to 1. 2. On the neuropathic pain scale, the patient's symptoms changed from deep sharp pain and burning sensation to superficial dull pain and coldness. Sensitivity to touch, discomfort, and itchiness also decreased. Sudden attacks of pain appeared 14 to 21 days after onset, but disappeared after final treatment. Conclusions : The results of the above patient suggests that the East-west medical combined treatment may be effective for total remission of herpes zoster. Further research is needed to confirm such effects.

• Tuberculosis and Respiratory Diseases
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• v.57 no.1
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• pp.55-60
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• 2004

Anticonvulsant hypersensitivity syndrome (AHS) is an uncommon, but potentially fatal and mutilsystemic disorder that occurs after exposure to the arene oxide-producing anticonvulsants-carbamzepine, phenobarbital and phenytoin. The multisystemic reactions include fever, skin eruptions, lymphadenopathy, hematologic abnormality and hepatitis. The diagnosis of AHS is made by history of drug exposure and clinical course. No specific treatments are proved as benefit except discontinuing the offending drug and trying the steroids in some severe cases. We report a case of carbamazepine induced anticonvulsant hypersensitivity syndrome characterized by skin rash, eosinophilia, subcarinal lymphadenopathy and eosinophilic pneumonia. The patient was resolved completely after only discontinuing carbamazepine.

• The Journal of Internal Korean Medicine
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• v.44 no.2
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• pp.231-243
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• 2023

Background: Diabetic polyneuropathy is the most common complication in diabetics, occurring in 50% of all cases. About 10-20% of all diabetics are accompanied by neurological pain, showing a tendency to increase with age. Clinical aspects are very diverse, from mild abnormalities on nerve conduction tests to severe abnormalities in all sensory, motor, and autonomic nerves; however, sensory symptoms usually precede motor symptoms. Patients typically express sensory symptoms, such as positive and negative symptoms, which decrease the quality of life and have marked clinical implications, such as increased morbidity and mortality. Although Western medical drugs, such as tricyclic antidepressants, anticonvulsants, and narcotic analgesics, are used for diabetic polyneuropathy, a standard treatment has not been established. Case report: A 65-year-old male with paresthesia and pain due to diabetic polyneuropathy was treated with Uchashinki-hwan, acupuncture, electroacupuncture, moxibustion, and Jungsongouhyul pharmacopuncture for 10 days. We used the Toronto Clinical Neuropathy Scoring System, EuroQol-5 Dimension, and Visual Analog Scale to evaluate symptoms. Subsequently, the Neuropathy Scoring System, EuroQol-5 Dimension, and subjective discomfort improved. Conclusion: The present case report suggests that combined Korean medicine treatment might be an effective treatment for paresthesia and pain with diabetic polyneuropathy. Several follow-up studies should be conducted to clarify the effectiveness of the treatment.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.705-710
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• 2001

Objective : Postoperative seizure is a well documented complication of aneurysm surgery. The purpose of the present study was to analyze risk factors for postoperative seizure. Methods : Between January 1990 and December 1996, we performed craniotomy for ruptured cerebral aneurysms in 321 patients. Among them 206 patients who could be followed up for more than 1 year(range, 1 to 4.6 years) were enrolled to present study. All patients were treated with anticonvulsants for 3 to 18 months postoperatively. We analyze the incidence of postoperative seizure in different sex and age groups, and risk factors associated with postoperative seizures following aneurysm rupture. For statistical processing chi-square test and Fisher's exact test were used. Results : In the follow-up period of 1 to 4.6 years(mean, 1.8 years) postoperative seizure appeared in 18 out of 206 patients(8.7%). Mean latency between the operation and the first seizure was 6 months(range, 3 weeks to 18 months). The age of the patients has significant influence on the risk of seizure, it occurred more often in younger patients(p =0.0014). Aneurysm location in the MCA was associated with a significantly a higher risk of seizure(p = 0.042). Eight patients(19%) out of 42 patients who suffered delayed ischemic neurologic deficit(DID) developed seizure. Delayed ischemic neurologic deficit was associated with significantly a higher risk of seizure(p =0.019). Infarct and hypertension were associated with significantly a higher risk of seizure(p <0.05). pre- or postoperative intracranial hematoma(intracerebral or epidural hematoma) was associated with significantly a higher risk of seizure(p <0.0001). H-H grade, Fisher grade, Glasgow Outcome Scale of patients and timing of operation after subarachnoid hemorrhage had no significant relation with the risk of seizure. Conclusion : Factors associated with the development of postoperative seizure were middle cerebral artery aneurysm, delayed ischemic neurologic deficit, infarct on late postoperative CT scan, hypertension, pre or postoperative intracranial hematoma(intracerebral or epidural hematoma). Identification of the risk factors may be help to focus the antiepileptic drug threapy in cases prone to develop seizures. Prospective evaluation is indicated.

• Journal of Life Science
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• v.16 no.2 s.75
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• pp.206-212
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• 2006

In order to synthesize novel anticonvulsants, we researched that the reactions of diamines with 2,5-dimethoxytetrahydrofuran and 1,3-acetonedicarboxylic acid. The reaction of ethylenediamine with 2,5-dimethoxytetrahydrofuran and 1,3-acetonedicarboxylic acid afforded 8-(2-pyrrol-1-yl-ethyl)-8-aza-bicyclo[3,2,1]octan-3-one (yield; 5.0%) and 1,2-di-(8-aza-bicyclo[3,2,1]octan3-onyl)ethane (yield; 17.0%). In case of 1,3-diaminopropane, 8-(3-pyrrol-1-yl-propyl)-8-aza-bicyclo[3,2,1]octan-3-one(yield; 6.0%) and 1,3-di-(8-aza-bicyclo[3,2,1]octan-3-onyl)propane (yield; 21.0%) were obtained. In case of 1,8-diaminooctane, 8-(8-pyrrol-1-yl-octyl)-8-aza-bicyclo-[3,2,1]octan-3-one (yield; 2.6 %) and 1,8-di-(8-aza-bicyclo[3,2,1]octan-3-onyl)octane (yield; 24.9%) were obtained. In diaminobenzene reactions, synthetic yields of 8-aza-bicyclo-[3,2,1]octan-3-one derivatives were higher than those of pyrrole derivatives because re actions were done under room temperature. The longer the carbon chain of diaminoalkane is, the more reactive N atom is due to more electron donating effect, and the less steric hindrance around the carbon gave the higher chemical yields. The reaction of p-phenylenediamine as a diaminobenzene with 2,5-dimethoxyte-trahydrofuran and 1,3-acetonedicarboxylic acid produced p-dipyrrolylbenzene (yield; 4.0%), 8-(4-pyrrol-1-yl-phenyl)-8-aza-bicyclo[3,2,1]octan-3-one (yield; 12.0%), and 1,4-di-(8-aza-bicyclo[3,2,1]octan-3-onyl)benzene (yield; 59.0%). In case of m-phenylenediamine, 8-(3-pyrrol-1-yl-phenyl)-8-aza-bicyclo[3,2,1]octan-3-one(yield; 2.0%) and 1,3-di-(8-aza-bicyclo[3,2,1]octan-3-onyl)benzene (yield ; 28.0%) were obtained. But, synthesis of 1,2-di-(8-aza-bicyclo[3,2,l]octan-3-onyl)benzene by treatment of o-phenylenediamine was not successful, presumably due to the steric hindrance of 8-aza-bicyclo-[3,2,1]octan-3-one rings.

• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1225-1231
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• 2005

Purpose : This study compares the first epileptic seizures between preterm and term-born children with periventricular leukomalacia and epilepsy. Methods : From 108 cases having lesions of high signal intensity around the ventricles in T2 weighted imaging of a brain magnetic resonance study, we selected 37 cases that showed epileptic seizures two times or more and divided them into the group of preterm-born(27 cases) and term-born children(10 cases). A retrospective study was made by comparing the two groups with regard to age, type of the first epileptic seizures, EEG findings and responsiveness to anticonvulsants. Results : The age of the first epileptic seizure was $22.2{\pm}18.3$ months in the preterm-born group and $26.9{\pm}21.1$ months in the term-born group(P=0.505). As for the first epileptic seizure, 11 out of the 27 cases in the preterm-born group had infantile spasms. Out of the 10 cases in the term-born group, 7 had complex partial seizures. In the preterm group, hypsarrhythmias were found in 11 cases, focal epileptiform discharges in 6 cases. In term-born group, focal epileptiform discharges were found in 5 cases but no epileptiform discharge was found in 3 cases. Intractable epilepsies were diagnosed in 6 cases and all of them belonged to the preterm-born group. Conclusion : More severe epilepsies such as infantile spasm and intractable epilepsies seem to be more common in preterm-born epileptic children with PVL as well as more severely abnormal EEG finding compared to term-born epileptic children.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.327-336
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• 2011

Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.