• The Korean Journal of Pain
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• v.3 no.1
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• pp.40-43
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• 1990

Herpes zoster is a common, usually self-limited disease distinguished by pain and a characteristic vesicular rash. The clinical onset of herpes zoster is heralded by pain in the area of the affected segment. So herpetic neuralgia is a major complaint from patients visiting the pain clinic. There are several methods for the treatment of herpetic neuralgia, but there is no method that results in complete remission. In 1988, King introduced the chloroform-aspirin topical application method. This method is known to be a very simple and effective treatment of acute herpetic neuralgia and postherpetic neuralgia. We used diethyl ether instead of chloroform as the solvent and treated 12 patients; 7 patients with herpetic neuralgia and 5 patients with postherpetic neuralgia. The results were follows, 1) The treatment has proved to be highly effective in relieving pain in acute herpetic neuralgia. 2) The application was very simple and safe to use and treatment tolerance has been excellent. 3) There were no effective results in postherpetic neuralgia. 4) The topical treatment seemed to promote the healing of the herpetic skin lesion.

• The Korean Journal of Pain
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• v.30 no.3
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• pp.214-219
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• 2017

Background: As herpes zoster progresses via postherpetic neuralgia (PHN) to well-established PHN, it presents its recalcitrant nature to the treatment. At this point, the well-established PHN is fixed as a non-treatable, but manageable chronic painful neuropathic disorder. This study evaluated the incidence of complete relief from PHN according to PHN duration at their first visit, and the other factors influencing it. Methods: A retrospective chart review was performed on patients with PHN at a university-based pain clinic over 7 years. The responders were defined as patients who had complete relief from pain after 1 year of active treatment. Age, sex, PHN duration at their first visit, dermatomal distribution, and underlying disorders were compared in the responder and non-responder groups. Responders were also compared according to these factors. Results: Among 117 PHN patients (M/F = 48/69), 35 patients (29.9%) had complete relief from PHN. Mean ages were $64.3{\pm}10.6$ and $66.9{\pm}10.7$ years, numbers of male to female patients were 11/24 and 37/45, and mean durations of PHN at their first visit were $8.5{\pm}6.3$ and $15.3{\pm}10.7$ months in the responder and non- responder groups, respectively. In addition, PHN patients who visited the clinic before 9 months showed a better result. Dermatomal distribution and underlying disorders did not show significant differences. Conclusions: Almost 30% of PHN patients received complete relief. Those who sought treatment in a pain clinic before 9 months received a better result.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.3
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• pp.313-317
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• 2000

Return of facial nerve function is important in patients with facial nerve paralysis by trauma. Sometimes, delay in diagnosis of facial nerve paralysis make recovery of facial nerve function difficult. Traumatic facial palsy mostly occur after temporal bone fracture in unilateral. Temporal bone fracture after head trauma are divided into the three group; longitudinal fracture, transverse fracture and mixed fracture. The most common symptoms are hearing impairment, bloody otorrhea, loss of consciousness and facial nerve paralysis. The early care of temporal bone fracture involves facial nerve paralysis. And there has been many discussion and study in the treatment of the immediate or delayed facial palsy ; examply, surgical approach, time and methods. We have managed a patient with unilateral facial nerve paralysis after longitudinal temporal bone fracture in mastoid process and conservative facial nerve decompression was performed. We have obtained good result and report this case with review of literatures.

• Journal of Yeungnam Medical Science
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• v.29 no.2
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• pp.121-124
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• 2012

Valaciclovir is metabolized to acyclovir after ingestion and thereafter exerts its antiviral activity. Because of its superior pharmacokinetic profile, it has quickly replaced acyclovir in the treatment of herpesvirus infection. Neurotoxicity caused by valaciclovir has been reported, however, among patients with pre-existing impaired renal function. This paper reports a case of neurotoxicity of valaciclovir in a patient with end-stage renal disease who was undergoing continuous ambulatory peritoneal dialysis (CAPD). A 67-year-old female on CAPD took 500 mg of valaciclovir twice for herpes zoster. After she took her second dose orally, she developed confusion and disorientation, along with involuntary movements. Her mental confusion progressed to a coma. Discontinuation of valaciclovir showed no rapid improvement. There- fore, hemodialysis was started. After two sessions of hemodialysis, the patient became alert; and after four sessions of hemodialysis, her neurological abnormalities were completely reversed. In conclusion, valaciclovir can induce life-threatening neurotoxicity, especially in CAPD patients, even with appropriate dose reduction, which can be effectively managed by hemodialysis.

• The Korean Journal of Pain
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• v.7 no.2
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• pp.242-248
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• 1994

Postherpetic neuralgia is frequently painful, incapacitating, mood depressing, and sometimes lifelong. We investigated the influence of duration from eruption to nerve blocks in conjunction with patients age on analgesic and preventive effect for postherpetic neuralgia. We retrospectively evaluated 50 outpatient medical records for the above T4 dermatome. Patients had been referred to pain clinic and were treated over 2weeks from Jan. 1988 to Dec. 1993. Fifty patients were divided into 4 groups as follows: Group I (a): less than 4weeks from eruption to nerve block and younger than 65 years old. Group I (b): less than 4weeks from eruption to nerve block and older than 65 years old. Group II (a): more than 4weeks from eruption to nerve block and younger than 65 years old. Group II(b): more than 4weeks from eruption to nerve block and older than 65 years old. Mean number of stellate ganglion blocks were 29.7. Tramadol, amitriptyline, nicardipine were most commonly prescribed. Group I (a): had the most improvement rate(77.8%) as compared with other group(46.6, 52.7, 56.0%). Number of patients who complained of severe pain (VAS > 5) were 0, 3(39%), 2(15.4%), 5(30%) in I (a), I (b), II (a), II (b) group respectively. In conclusion, analgesic effect was best in cases of patients younger than 65 years old whose treatment were started within 4 weeks of eruption. Patients older than 65 yrs, analgesic effect did not vary on the timing of treatment.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.181-185
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• 2007

Background: The first pain clinic opened in korea in 1973 at Yonsei University Hospital, however, since then the number of pain clinics has gradually increased, as has the number of patients visiting them. This increase in patient has caused concerns about the way in which pain is managed, therefore, we conducted a retrospective review of data according to the sex, age and disease in an attept to aid us in planning for the future of our pain clinic. Methods: We analyzed 1,282 new patients who had visited our pain clinic and 828 inpatients who were admitted to our pain clinic between March 2006 and February 2007. Results: The most frequent age group was in the sixties in outpatient and in the seventies in inpatient. In addition, the incidence of disease in new patients and inpatients was as follows: in new patients, lumbar herniated intervertebral disc 16.5%, hyperhidrosis 12.3%, cervical disc disorder 10.5%, acute herpes zoster 8.2%, postherpetic neuralgia 7.9%, and trigeminal neuralgia 7.0%; in admitted patients, acute herpes zoster 17.6%, trigeminal neuralgia 15.6%, lumbar herniated intervertebral disc 13.0%, postherpetic neuralgia 11.2%, hyperhidrosis 9.8%, and complex regional pain syndrome 7.0%. Conclusions: The patients visiting our pain clinic have presented with a wide variety of diseases. This improved care reflects an effort to expand our fields not only to the management of outpatients but also inpatients, as well as to the treatment of new fields of disease. In the future, We need to manage various pain patients not only in outpatients but also in inpatients to expand our field even through pain clinic is rapidly growing in Korea.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.15 no.2
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• pp.289-301
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• 2002

Background: It is axiomatic that average life span is prolonged in proportion to the advance of socio-economic improvements and medical science. Consequently, the number of elderly patients with skin diseases is increasing. Objective: This study was performed to examine the patterns of skin diseases in elderly patients that had visited Dongguk Oriental Medical hospital, Dept. of Dermatology. We also compared these patients to the young generational groups. Methods: We studied 67 elderly patients with complaints of skin diseases who had visited our hospital from March 2000 to February 2002. We analysed their skin diseases and compared them with the younger group's. Results: The results were as follows; 1. The common disease groups were eczema(32.8$\%$); pruritus(23.9$\%$); viral infections (13.4$\%$); psoriasis(9.0$\%$); fungal infections and urticaria(6.0$\%$). 2. The disorders prevalent in men were eczema(30.0$\%$); herpes zoster & pruritus(23.3$\%$); fungal infection(13.3$\%$); psoriasis (3.3$\%$); melasma(6.7$\%$). 3. The common diseases of women's group were observed in the following order; eczema(35.l$\%$); pruritus(24.3$\%$); psoriasis(13.5$\%$); urticaria(10.8$\%$); other dermatoses(8.1$\%$); herpes zoster(5.4$\%$). 4. The most frequent skin disease for those in their 50's was eczema(32.3$\%$); 60's, pruritus(36.8$\%$); 70's, eczema(50.0); and over eighties., eczema and pruritus(40.0$\%$). Conclusion: This study suggests that dermatologic problems in the elderly are very common, especially eczema, pruritus. It is a very different pattern from the younger group's. And we have to better consider more effective management and treatment for them; especially further dermatologic studies including substantial medical care. Usually Oriental medicine is good at treating chronic diseases and less harmful. So we expect it to be generally better for elderly patients than western medicine.

• 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.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.380-384
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• 2009

Acute transverse myelitis (ATM) in most patients is characterized by an abrupt onset of progressive weakness and sensory disturbance in the lower extremities with a preceding viral infection such as Epstein-Barr, herpes simplex, influenza, mumps and Varicella-zoster viruses (VZV). Although less frequent, some residual deficits including bladder dysfunction or weakness in the lower extremities may follow ATM, from which recovery usually begins within the first week of the onset of symptoms. In this report, we describe the case of a 9-year-old girl who experienced ATM following chickenpox and had bladder dysfunction as a sequela.

• Clinical and Experimental Pediatrics
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• v.46 no.10
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• pp.1047-1050
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• 2003

Maternal varicella resulting in viremia may transmit the virus to the fetus by either transplacental spread, or by ascending infection from lesion in the birth canal. The characteristic symptoms consist of skin lesions in dermatomal distribution, eye diseases, neurological defects, and limb hypoplasia. Varicella of the newborn is a life-threatening illness that may occur when a newborn is delivered either within five days of the onset of the illness or after postdelivery exposure to varicella. The severity of neonatal disease is dependent upon the timing of maternal illness. The clinical approach to varicella of newborns should emphasize prevention. Our patient was the first child of a 31-year-old mother who had varicella-zoster ten days before delivery. The child showed muscular hypotonia, poor feeding but no skin lesions.