Viruses are obligate intracellular parasites which cause infection by invading and replicating within cells. The immune system has mechanisms which can attack the virus in extracellular and intracellular phase of life cycle, and which involve both non-specific and specific effectors. The survival of viruses depends on the survival of their hosts, and therefore the immune system and viruses have evolved together. Immune responses to viral infection may be variable depending on the site of infection, the mechanism of cell-to-cell spread of virus, physiology of the host, host genetic variation, and environmental condition. Viral infection of cells directly stimulates the production of interferons and they induce antiviral state in the surrounding cells. Complement system is also involved in the elimination of viruses and establishes the first line of defence with other non-specific immunity. During the course of viral infection, antibody is most effective at an early stage, especially before the virus enters its target cells. The virus- specific cytotoxic T lymphocytes are the principal effector cells in clearing established viral infections. But many viruses have resistant mechanism to host immune responses in every step of viral infection to cells. Some viruses have immune evasion mechanism and establish latency or persistency indefinitely. Furthermore antibodies to some viruses can enhance the disease by the second infection. Immune responses to viral infection are very different from those to bacterial infection.
Antibodies ; Antibodies, Neutralizing ; Antibody-Dependent Enhancement ; Bacterial Infections ; Complement System Proteins ; Genetic Variation ; Immune Evasion ; Immune System ; Immunity, Innate ; Immunity, Mucosal ; Interferons ; Life Cycle Stages ; Parasites ; Physiology ; T-Lymphocytes, Cytotoxic

No abstract available.
Curcumin ; Pain Management

No abstract available.
Ascorbic Acid ; Neuralgia ; Vitamins

No abstract available.
Pain Management

Sacral nerve stimulation through the retrograde approach has been used for peroneal or irritable bowel syndrome through the retrograde approach. However, several reasons, lead could not be advanced down ward. In this case, anterograde sacral nerve stimulation through the sacral hiatus could be used. The aim of this report is to present of technique of sacral nerve root stimulation through the sacral hiatus approach.
Irritable Bowel Syndrome ; Spinal Cord Stimulation

Tarlov or perineural cysts are nerve root cysts found most commonly at the sacral spine level arising between covering layers of the perineurium and the endoneurium near the dorsal root ganglion and are usually asymptomatic. Symptomatic sacral perineural cysts are uncommon but sometimes require surgical treatment. A 69-year-old male presented with pain in the buttock. He was diagnosed as having a sacral cyst with magnetic resonance imaging. For the nonoperative diagnosis and treatment, caudal peridurography and block were performed. After the treatment, the patient's symptom was relieved. We suggest a caudal peridural block is effective in relieving pain from a sacral cyst.
Aged ; Buttocks ; Ganglia, Spinal ; Humans ; Magnetic Resonance Imaging ; Male ; Peripheral Nerves ; Spine ; Tarlov Cysts

Kikuchi's disease (KD) is an idiopathic and self-limiting necrotizing lymphadenitis that predominantly occurs in young females. It is common in Asia, and the cervical lymph nodes are commonly involved. Generally, KD has symptoms and signs of lymph node tenderness, fever, and leukocytopenia, but there are no reports on treatment for the associated myofacial pain. We herein report a young female patient who visited a pain clinic and received a trigger point injection 2 weeks before the diagnosis of KD. When young female patients with myofascial pain visit a pain clinic, doctors should be concerned about the possibility of KD, which is rare but can cause severe complications.
Asia ; Facial Pain ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Leukopenia ; Lymph Nodes ; Lymphadenitis ; Myofascial Pain Syndromes ; Neck Pain ; Pain Clinics ; Trigger Points

The use of fluoroscopy guidance together with the loss of resistance technique during epidural injections has been advocated lately; moreover, epidural injections in the absence of fluoroscopic guidance have a high rate of inaccurate needle-tip placement during the injections. However, the approach to the lower cervical and upper thoracic epidural space may be challenging due to its obscure lateral fluoroscopic views from overlying normal tissue structures. In this case, we report an alternative oblique C-arm fluoroscopy guided view approach to supplement the standard anterior-posterior and lateral fluoroscopic views to facilitate successful needle placement and precise anatomical localization of the epidural space.
Epidural Space ; Fluoroscopy ; Injections, Epidural ; Needles

BACKGROUND: Fibromyalgia (FM) is characterized by chronic widespread pain with a low pain threshold. The aim of this study was to compare two criteria for the diagnosis and assessment of FM and to analyze the correlation and agreement between the 1990 and 2010 American College of Rheumatology (ACR) preliminary diagnostic criteria for FM. METHODS: We studied 98 patients who had already been diagnosed as having FM using the 1990 criteria or 2010 preliminary criteria. Tender point examination, FM impact questionnaire (FIQ) and pain visual analog scale (VAS) were obtained. According to the preliminary criteria, FM was quantified as WPI (widespread pain index) and the SS scale (symptom severity) and the two criteria were compared. RESULTS: Among 98 patients, 78.6% of the patients were diagnosed with the 1990 ACR criteria and 93.9% of the patients were diagnosed with the ACR preliminary diagnostic criteria, and there was also significant agreement between the two criteria (P < 0.01). There was a correlation with the WPI and the tender point, with the SS and the FIQ, and with the sum of the WPI and SS and the FIQ. CONCLUSIONS: The ACR preliminary diagnostic criteria for FM were in agreement with the 1990 ACR criteria during the disease course. The preliminary criteria were the more sensitive method than the 1990 criteria. In addition, the 2010 criteria might have advantages since it is easy to assess the physical and psychological symptoms and can be quantified. Therefore, the ACR preliminary diagnostic criteria for FM could be used more conveniently for clinical diagnosis and follow up evaluation after starting management of FM.
Fibromyalgia ; Follow-Up Studies ; Humans ; Pain Threshold ; Surveys and Questionnaires ; Rheumatology

BACKGROUND: The aim of the study was to investigate the feasibility of fluoroscopy-guided anterior approach for suprascapular nerve block (SSNB). METHODS: Twenty patients with chronic shoulder pain were included in the study. All of the nerve blocks were performed with patients in a supine position. Fluoroscopy was tilted medially to obtain the best view of the scapular notch (medial angle) and caudally to put the base of coracoid process and scapular spine on same line (caudal angle). SSNB was performed by introducing a 100-mm, 21-gauge needle to the scapular notch with tunnel view technique. Following negative aspiration, 1.0 ml of contrast was injected to confirm the scapular notch, and 1 % mepivacaine 2 ml was slowly injected. The success of SSNB was assessed by numerical rating scale (NRS) before and after the block. RESULTS: The average NRS was decreased from 4.8 +/- 0.6 to 0.6 +/- 0.5 after the procedure (P < 0.05). The best view of the scapular notch was obtained in a medial angle of 15.1 +/- 2.2 (11-19degrees) and a caudal angle of 15.4 +/- 1.7degrees (12-18degrees). The average distance from the skin to the scapular notch was 5.8 +/- 0.6 cm. None of the complications such as pneumothorax, intravascular injection, and hematoma formation was found except one case of partial brachial plexus block. CONCLUSIONS: SSNB by fluoroscopy-guided anterior approach is a feasible technique. The advantage of using a fluoroscopy resulted in an effective block with a small dose of local anesthetics by an accurate placement of a tip of needle in the scapular notch while avoiding pneumothorax.
Anesthetics, Local ; Brachial Plexus ; Contrast Media ; Fluoroscopy ; Hematoma ; Humans ; Imidazoles ; Mepivacaine ; Needles ; Nerve Block ; Nitro Compounds ; Pneumothorax ; Shoulder Pain ; Skin ; Spine ; Supine Position