There have been discrepancies to difficulties to assess a subjective experience such as mood or pain. The difficulties will remain constant from one measurement interval to the next, and especially from one person to another. As for within-subject comparisons, VAS was suited to experimental designs, and Ohnhaus and Adler (1975) and Joyce et al. (1975) found the VAS-pain were more sensitive than the other verbal rating scales (ex. 5-point scales). However, its suitability for between-subject comparisons has been questioned for the reasons that the equivalent positioning of marks on lines by different people does not necessarily convey that they experienced the same pain.
Although VAS provide easily the numerical values for statistical analysis, there have been some problems underlying the use of VAS as a sophisticated statistical technique.
There have been two ways to treat the length of the line as the evaluation of pain intensity in statistical analysis. The one equates the length of the line produced by the subject's mark with the estimation of pain as though the subjects were able to effect one-to-one correspondence between VAS and the pain intensity (parametric or cardinal). The other prefers to treat as the data so obtained non-parametrically (ordinal).
It should be noted that subjects did not necessarily attach the same meanings to the same absolute scores.
Subjective estimates like the VAS do not qualify as interval level scores and are thus not suited for the operations of addition and subtraction and calculations of averages. (Chapman 1976)
The use of rank based non-parametric statistical procedures helps to overcome some of the difficulties associated betwwn-subject comparisons with the VAS, as procedures are based on the assumptions that the data cannot be classified into particular distributions and that its scaling can be represented by ranks.
VAS pain scores obtained in our patients with Herpes Zoster or RSD were treated as ordinal scales and statistical analyses were carried out by use of non-parametric method (Wilcoxon signed rank test, Kruskal Wallis test or Friedman 2 way-ANOVA).
These results have been presented.

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The focus of this brief review is treatments that are effective for patients with neuropathic pain. We will discuss these treatments in the context of neural mechanisms that are thought to contribute to pain following peripheral nervous system injury or dysfunction. Although some mechanisms come into play only when the nervous system is damaged others are operative under physiological conditions and contribute to pain even when there is no neural damage or dysfunction. Regardless of whether pathological or physiological, each mechanism offers a potential point for treatment. In this chapter, we will relate therapeutic interventions to particular pain mechanisms, and review the available clinical evidence for the efficacy of such treatments. Finally, current therapeutic options will be discussed in the context of a treatment trials algorithm for peripheral neuropathic pain.

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In certain instances it can be demonstrated that pain is dependent on sympathetic innervation of the painful area. Sympathetically maintained pain (SMP) is the term that has been coined to describe this circumstance. Sympathetically independent pain (SIP) is the phrase used to refer to those patients whose pain is independent of sympathetic innervation of the painful area.

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Aim of Investigation: The aim of this study is to determine whether an oblique radiograph can visualize inappropriate spread of solution in the performance of thoracic sympathetic block (TSB).
Methods: Forty-two TSBs at 83 vertebral levels were included in this study. TSB was performed with patients prone on the fluoroscopic table. Three directional radiographs which consisted of P-A, lateral and oblique views were taken after placement of needles and administration of contrast solution. For an oblique radiograph, direction of X-ray was angled at 15-20 degrees from the saggital plane to the affected side.
Results: In the oblique radiograph, untoward spread of the contrast solution into the intervertebral foramen and the epidural space could be clearly identified without any overlap of the contrast mass located against the anterolateral aspect of the vertebral body. Such inappropriate flow was seen at 16 vertebral levels (19%), out of which, at 10 levels (63%), it could be identified only in the oblique view.
Conclusion: The oblique contrast radiograph could visualize inappropriate epidural flow of the injected solution and was helpful to prevent complications of TSB.

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Aim of this investigation: The cause of Trigeminal neuralgia (TN) and Hemi facial spasm (HFS) was reported to be a vascular compression with the root exit zone (REZ) of the 5th or 7th cranial nerve. Microvascular decompression (MVD) was generally performed. Current preoperative studies, CT, MRI, angiography, are not able to demonstrate the detail of the relationship between cranial nerve and offending vessels in REZ. Thus, we investigated the relationship, using spoiledGRASS MRI (SPGR-MRI) with 3 dimensional-time of fly-magnetic resonance angiography (3D-TOF-MRA).
Method and Result: Thirtynine patients with TN and HFS were investigated by imaging SPGR-MRI combined with 3D-TOF-MRA. Sixteen of 24 (67%) with TN had ipsilateral vascular compression of 5th cranial nerve, and twelve of 17 (71%) with HFS had similar compression of the 7th and 8th nerve complex.
Conclusion: This method combining SPGR-MRI with 3D-TOF-MRA is very useful to identify the offending vessels in TN and HFS.

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Background: The present study investigates the effect of superior cervical ganglionectomy to increase weight with natural growth on rats. We also studied them under conditions of stress.
Method: The first group (10 male Wister rats) underwent ganglionectomy followed by producing stress in water for 4 hours a week. The 2nd group (10 rats) underwent ganglionectomy only. The 3rd group (10 rats) underwent a sham operation in water as same as the 1st group. The 4th group (10 rats) underwent only the sham operation. Control group (9 rats) did not undergo any procedures.
Result: After eight weeks of experiments, body weights in the 3rd group were significantly less than those in other groups.
Conclusions: Superior cervical ganglionectomy does not result in an increase in body weight, but under the conditions of stress, the ganglionectomy may affect to protect the inhibition of natural growth as a stress response in rats.

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The sensory innervation of the human stellate ganglion (SG) was investigated using immunohistocemistry with antibodies to substance P (SP) and calcitonin gene related peptide (CGRP). The distribution and number of SP immunoreactive (SP-IR) fibers in the SG were compared with those of calcitonin gene related peptide (CGRP). A number of fine varicose CGRP immunoreactive (CGRP-IR) fibers were observed, and the density exceeded that of the SP-IR fibers. Some fine varicosed SP and CGRP-IR fibers lie close to the postganglionic cells. In most places which are in contact with principal cell bodies, terminal axonal branches of CGRP-IR fibers are swollen. Some CGRP-IR cell bodies were observed, but no SP-IR cell bodies were recognized.
These results suggest that the SG are innervated by sensory nerves from spinal ganglia.

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The patient, a 54-year-old woman who had been treated with prednisolone for mixed connective tissue disease for 14 years, developed herpes zoster. She was treated with intravenous acyclovir and repeated epidural blocks, she recovered without showing cutaneous dissemination or postherpetic neuralgia. The relationship between mixed connective tissue disease and herpes zoster is also discussed.

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We have reported two rare cases of facial nerve palsy. Case 1: A 17-year-old female underwent a right sagittal split osteotomy (SSO) to correct her prognathism. Six days after the operation a right facial palsy was noted and remained moderate over 3 months. To improve it stellate ganglion blocks were performed, and the palsy remitted completely. We suppose that the cause might be due to the traction and hypoxia of the tissues induced by postoperative swelling. Case 2: A 63-year-old man has had a bilateral recurrent type of facial palsy for 6 years. The palsy had worsened attack by attack and was in severe condition (facial palsy score=3) at the fourth attack. At this time, His serum Epstein-Barr (EB) virus titers were x1280 (VCA IgG) and x640 6 months later. We suspected that the etiologies might be Sarcoidosis, Guillain-Barré syndrome, Melkersson-Rosenthal syndrome and EB virus infection. But the definitive findings were not found. We thus conjectured the etiology to be idiopathic.

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