Background: The spore-forming bacterium Bacillus anthracis causes anthrax, an often-fatal infection in animals. Therefore, a rapid and reliable strategy to decontaminate areas, humans, and livestock from B. anthracis is very critical. Objectives: The aim of this study was performed to evaluate the efficacy of sodium hypochlorite, calcium hypochlorite, and quaternary ammonium compound (QAC) sanitizers, which are commonly used in the food industry, to inhibit spores and vegetative cells of B.anthracis surrogate. Methods: We evaluated the efficacy of sodium hypochlorite, calcium hypochlorite, and a QAC in inhibiting vegetative cells and spores of a B. anthracis surrogate. We treated a 0.1-mL vegetative cell culture or spore solution with 10 mL sanitizer. The samples were serially diluted and cultured. Results: We found that 50 ppm sodium hypochlorite (pH 7), 1 ppm calcium hypochlorite, and 1 ppm QAC completely eliminated the cells in vegetative state. Exposure to 3,000 ppm sodium hypochlorite (pH 7) and 300 ppm calcium hypochlorite significantly eliminated the bacterial spores; however, 50,000 ppm QAC could not eliminate all spores. Conclusions Calcium hypochlorite and QAC showed better performance than sodium hypochlorite in completely eliminating vegetative cells of B. anthracis surrogate. QAC was ineffective against spores of the B. anthracis surrogate. Among the three commercial disinfectants tested, calcium hypochlorite most effectively eliminated both B. anthracis vegetative cells and spores.

OBJECTIVE: To compare the efficacy of ultrasonography guided stellate ganglion block (US-SGB) with that of blind SGB in management of the stroke patients with complex regional pain syndrome (CRPS) type 1. METHOD: Forty-two patients with post-stroke CRPS were randomly assigned to either US-guided SGB (22 patients) or blind SGB group (20 patients). The mean age of US-guided SGB and blind SGB groups was 61.3+/-5.6 years and 59.1+/-4.5 years. We performed two blockades at 7-day intervals on the affected side of patients with CRPS. Pain intensity, using a visual analog score (VAS), score of CRPS clinical severity, and the amounts of affected hand swelling with a hand volumeter were assessed before, 2 weeks and 4 weeks after treatment. RESULTS: In both groups, VAS and the amount of hand swelling were significantly decreased after 2 weeks and after 4 weeks. Between two groups, VAS difference of US-guided SGB group and that of blind SGB group were 2.61+/-1.09, 1.88+/-0.62 at 2 weeks and 3.67+/-1.03, 3.13+/-0.62 at 4 weeks, respectively. US-guided SGB group showed more significant improvement in mean change of VAS compared to the blind SGB group (p-value<0.05). CONCLUSION: Both US-guided SGB and blind SGB techniques were effective in relieving pain in subacute stroke patients with CRPS. US-guided SGB was better in pain relief but has no advantages in reduction of hand swelling in this study.
Hand ; Humans ; Stellate Ganglion ; Stroke

Induction of general anesthesia with tracheal intubation is routine procedure but causes significant tarchycardia and hypertension. Many approaches have been tried to attenuate these circulatory response. The effects of small dose fentanyl on arterial pressure and heart rate increase during intubation were studied in 40 normotensive patients, who were randomly allocated to two groups, receiving saline (Control group) or fentanyl 2ug/kg (Fentanyl group), in a double blind fashion during anesthetic induction with thiopental 5mg/kg. Systolic, diastolic, mean arterial pressure and heart rate were measured and rate pressure product was calculated. All parameters were significantly different between two groups (p<0,05) and control group was significant increase in blood pressure and heart rate compared with pre-induction value but fentanyl group was relatively small changes of blood pressure and heart rate (p<0.01). After tracheal intubation, incresed blood pressure was returned to pre-induction value within two to three minutes in fentanyl group but heart rate was not returned pre-induction value within 5 minutes. Dose of fentanyl that are low enough to cause any side effects of drug itself, no notable side effects were observed during study and recovery.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Fentanyl* ; Heart Rate ; Humans ; Hypertension ; Intubation* ; Thiopental

Anesthesiologists may have close relationship with muscle relaxants in clinical practice. Fourtunately, a few of the new muscle relaxants were discovered and used in clinic recently. Newly introduced non-depolarizing muscle relaxant: vecuronium has been clinically in use recently. The most suitable method for reversing the neurom uscular blockade caused by vecuronium continues to provoke discussion and differences of opinion. Simultaneous administration of neostigmine and atropine has been considered safe by some authors and dangerous by others. Both slow and rapid administration have been recommended. The general acceptance of the slow administration of neostigmine and atropine has been confirmed. In view of the various data on vecuronium reversal, neostigmine was compared with pyridostigmine and heart rate changes were studied. The results were as follows: 1) Recovery index after i.v. neostigmine 40 ug/kg and atropine 20 ug/kg when first twitch of the "train of four" was appeared during vecuronium 0.1mg/kg relaxation, was 129.9 sec. Heart rate change was decreased to 46.9/min(15%) after i.v. neostigmine during 16 to 20 minutes period(p<0.05). 2) Recovery index after i.v. pyridostigmine 160 ug/kg and atropine 20ug/kg when first twitch of the "train of four" was appeared during vecuronium 0.1mg/kg relaxation, was 134.0sec. Heart rate change was not statistically significant compared with neostigmine.
Atropine ; Heart Rate ; Neostigmine* ; Neuromuscular Blockade ; Pyridostigmine Bromide* ; Rabbits* ; Relaxation ; Vecuronium Bromide*

Clostridium perfringens causes diarrhea and other diseases in animals and humans. We investigated the prevalence, toxin gene profiles, and antibiotic resistance of C. perfringens isolated from diarrheic dogs (DD) and non-diarrheic dogs (ND) in two animal hospitals in Seoul, Korea. Fecal samples were collected from clinically DD (n = 49) and ND (n = 34). C. perfringens was isolated from 31 of 49 DD (63.3%) and 21 of 34 ND dogs (61.8%). All C. perfringens strains were positive for the α toxin gene, but not for the β, ε, or ι toxin genes; therefore, all strains were identified as type A C. perfringens. All isolates were cpe-negative, whereas the β2 toxin gene was identified in 83.9% and 61.9% of isolates from DD and ND, respectively. Most isolates were susceptible to ampicillin (94%), chloramphenicol (92%), metronidazole (100%), moxifloxacin (96%), and imipenem (100%). However, 25.0% and 21.2% of isolates were resistant to tetracycline and clindamycin, respectively. Molecular subtyping of the isolated strains was performed by using pulsed-field gel electrophoresis. Fifty-two isolates were classified into 48 pulsotypes based on more than 90% similarity of banding patterns. No notable differences were observed among the isolates from DD and ND.
Ampicillin ; Animals ; Bacterial Toxins ; Chloramphenicol ; Clindamycin ; Clostridium perfringens ; Clostridium ; Diarrhea ; Dogs ; Drug Resistance ; Drug Resistance, Microbial ; Electrophoresis, Gel, Pulsed-Field ; Hospitals, Animal ; Humans ; Imipenem ; Korea ; Metronidazole ; Prevalence ; Seoul ; Tetracycline

OBJECTIVES: Studies on Clostridium difficile are rare in Korea. We investigated the epidemiological characteristics of C. difficile isolates from patients with C. difficile-associated disease (CDAD) in Korea. METHODS: Multiplex polymerase chain reaction was performed to detect the presence of tcdA and tcdB toxin genes. Antimicrobial susceptibility test was carried out by the disk-dilution method. C. difficile strains were subtyped by automated repetitive-element palindromic PCR (rep-PCR). RESULTS: Among patients with CDAD, 73 (25.8%), 32 (11.3%), 32 (11.3%), and 26 (9.2%) suffered from pneumonia, cancer or neoplasm, diabetes, and colitis, respectively. Of all stool samples, 43 samples (15.2%) were positive for C. difficile strains. We observed two expression patterns of toxin genes: tcdA+/tcdB+ (86% isolates) and tcdA−/tcdB+ (14% isolates), with all isolates expressing tcdB. Furthermore, some isolates were resistant to clindamycin (65%), ampicillin (56%), and cefazolin (40%), but all were susceptible to vancomycin and metronidazole. The tested samples were classified into diverse clusters using automated rep-PCR. CONCLUSION: Our findings revealed the characteristics and antibiotic resistance of C. difficile isolates from patients in Korea. The epidemiological data may provide valuable insight into development of treatment strategies for C. difficile infections in Korea.
Ampicillin ; Cefazolin ; Clindamycin ; Clostridium difficile* ; Clostridium* ; Colitis ; Drug Resistance, Microbial ; Humans ; Korea* ; Methods ; Metronidazole ; Multiplex Polymerase Chain Reaction ; Pneumonia ; Polymerase Chain Reaction ; Vancomycin

Pancuronium is one of the most available nondepolarizing muscle relaxant. It is primarily eliminat-ed unchanged by the kidney, although a small fraction is metabolized by the liver. On the other hand, calcium channel blocking agents are a chemically heterogeneous group of drugs that inhibit the ionic current carried through the calcium slow channel in cardiac and vascular smooth muscle. This action is the basis of their usefulness in the treatment of cardiovascular disorders. Although the role of calcium in skeletal muscle differs from that in cardiac and vascular smooth muscle, various recent studies have shown that verapamil is able to inhibit neuromuscular function in skeletal muscle preparations. However, it is not well known, yet. Increasing number of patients who are taking calcium channel blockers were reported recently. The present study was undertaken to determine if verapamil could potentiate the effects on pancuronium and how does it affect the cardiovacular response. The results were as follows; 1. Verapamil (1.41 mg) significantly enhanced the recovery index of pancuronium as 226.7 sec compared with control recovery index as 162.5 sec (p<0.025). But tetanic stimulation (50Hz, 5 sec) was sustained in the both group. 2. Hypotensive effect was appeared when 1.41 mg of verapamil was given and it was taken 7.7 min. 3. Signs of cardiovascular response was decreasing the blood pressure especially diastolic first then heart rate was decreased.
Blood Pressure ; Calcium ; Calcium Channel Blockers ; Calcium Channels ; Hand ; Heart Rate ; Humans ; Kidney ; Liver ; Muscle Relaxation* ; Muscle, Skeletal ; Muscle, Smooth, Vascular ; Pancuronium* ; Rabbits* ; Verapamil*

Pancuronium is one of the most available nondepolarizing muscle relaxant. It is primarily eliminat-ed unchanged by the kidney, although a small fraction is metabolized by the liver. On the other hand, calcium channel blocking agents are a chemically heterogeneous group of drugs that inhibit the ionic current carried through the calcium slow channel in cardiac and vascular smooth muscle. This action is the basis of their usefulness in the treatment of cardiovascular disorders. Although the role of calcium in skeletal muscle differs from that in cardiac and vascular smooth muscle, various recent studies have shown that verapamil is able to inhibit neuromuscular function in skeletal muscle preparations. However, it is not well known, yet. Increasing number of patients who are taking calcium channel blockers were reported recently. The present study was undertaken to determine if verapamil could potentiate the effects on pancuronium and how does it affect the cardiovacular response. The results were as follows; 1. Verapamil (1.41 mg) significantly enhanced the recovery index of pancuronium as 226.7 sec compared with control recovery index as 162.5 sec (p<0.025). But tetanic stimulation (50Hz, 5 sec) was sustained in the both group. 2. Hypotensive effect was appeared when 1.41 mg of verapamil was given and it was taken 7.7 min. 3. Signs of cardiovascular response was decreasing the blood pressure especially diastolic first then heart rate was decreased.
Blood Pressure ; Calcium ; Calcium Channel Blockers ; Calcium Channels ; Hand ; Heart Rate ; Humans ; Kidney ; Liver ; Muscle Relaxation* ; Muscle, Skeletal ; Muscle, Smooth, Vascular ; Pancuronium* ; Rabbits* ; Verapamil*

The introduction of musele relaxants was an epoch-making event in the development of clinical anesthesia and their use has hecome essential to anesthesia practice. Vecuronium, one of the newest muscle relaxant, has many advantages; it is rapid and short-acting, noncumulative, has minimal side reactions and is promptly antagonized by anticholinesterases was introduced recently our clinical anesthesia practice. Fortunately, domestic product of vecuronium as vecaron was introduced lately. Therefore, this study was performed to evaluate the effects of vecaron and as compare with vecuronium. The results were as follows: 1) Similar effects of muscle relaxation was observed in both group except the onset time of twitch depression was shorter in vecuronium group than vecaron group. 2) Blood pressure and heart rate was increased during intubation in groups. 3) Recovery index was slightly prolonged in vecuronium group than vecaron group but no significance was observed. However, this recovery index of vecuronium was slightly shorter than previous observations.
Anesthesia ; Blood Pressure ; Cholinesterase Inhibitors ; Depression ; Heart Rate ; Humans* ; Intubation ; Muscle Relaxation ; Vecuronium Bromide