BACKGROUND: Phantom limb sensation is an unusual position sense of the extremity during nerve block that the position of extremity is misinterpreted as being flexed, or elevated, when actually they are in neutral position. Whether it is from the fixation of proprioceptive input at the time of motor blockade or from unmasking of the pattern which has been already present in the CNS is still controversial. We perfomed this study under the assumption that phantom limb sensation can still be reproduced without the influence of position at the time of nerve blockade. METHODS: Thirty-six patients scheduled for elective orthopedic surgery were randomly assigned. For 26 patients, spinal anesthesia was performed with hyperbaric 0.5% tetracaine or bupivacaine at lateral decubitus position and the position was changed to supine immediately. Existence of phantom limb sensation and the level of anesthesia was recorded at 10 and 20 minutes after injection of local anesthetics. For 10 patients, same local anesthetics were injected after patient's legs were straightened in lateral decubitus position. RESULTS: Forteen out of 26 patients whose position were changed to supine immediately after the injection of local anesthetics experienced phantom limb sensations. Five out of 10 patients whose legs were kept straight before the injection of local anesthetics experienced phantom limb sensations. Previous history of trauma was positively related to the expression of phantom limb sensation. CONCLUSION: Our data showed that the expression of phantom limb sensation is reproducible. And this was not related to the position at the time of spinal anesthesia. Trauma seems to be an important factor related to the expression of phantom limb sensation.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics, Local ; Bupivacaine ; Extremities ; Humans ; Leg ; Nerve Block ; Orthopedics ; Phantom Limb* ; Proprioception ; Sensation* ; Tetracaine

No abstract available.
Cryptococcosis* ; Humans

Avian metapneumovirus (AMPV) is an emerging pathogen causing respiratory and reproductive illness in poultry worldwide. To demonstrate the presence of AMPV in domestic chickens in Korea, we attempted to isolate AMPV from affected chickens. A cytopathic agent was isolated using chicken tracheal ring culture from dead chickens from a broiler breeder farm with reduced egg production in Korea. This agent, termed SC1509 strain, subsequently passed in Vero cells with distinct cytopathic effects. The SC1509 strain was confirmed as avian metapneumovirus (AMPV) using both RT-PCR test and monoclonal antibody-based immunofluorescence assay. Sequence analysis based on the G glycoprotein revealed that the SC1509 strain had 22.5 to 96.0% nucleotide sequence identity and 11.1 to 92.7% predicted amino acid sequence identity with previously published AMPV strains, particularly with the highest sequence homology (95.8 to 96% for nucleotides and 92.2 to 92.7% for amino acids) to European strains belonging to genotype B. The SC1509 strain was phylogenetically clustered with genotype B viruses, confirming that the SC1509 strain belongs to genotype B. This is the first report of genotype B avian metapneumovirus from chickens in Korea.
Amino Acid Sequence ; Base Sequence ; Chickens ; Fluorescent Antibody Technique ; Genotype ; Glycoproteins ; GTP-Binding Proteins ; Herpesvirus 1, Cercopithecine ; Korea ; Metapneumovirus ; Nucleotides ; Ovum ; Poultry ; Sequence Analysis ; Sequence Homology ; Sprains and Strains ; Vero Cells

BACKGROUND: The 5-hydroxytryptamine 3 receptor (5-HT3R) is a member of a superfamily of ligand-gated ion channels which has structural similarities and common evolutionary origin to those of the nicotinic acetylcholine receptor (nAChR). 5-hydroxytryptamine (5-HT) and muscle relaxants may have cross reaction. Rocuronium is a non-depolarizing neuromuscular blocking agent which has a rapid onset. The aim of this study was to examined the effects of 5-HT on rocuronium-induced neuromuscular blockade in a rat phrenic nerve-hemidiaphragm preparation. METHODS: Institutional approval was obtained for the experimental procedure. Fifty male Sprague-Dawley rats (150-200 g) were divided into 5 groups; the control, and 0.1, 1, 10, and 20microgram/ml of 5-HT. The animals were injected with phentobarbital at 40 mg/kg into the peritoneal cavity. The hemidiaphragm with the phrenic nerve was dissected and then mounted in a bath containing 100 ml Krebs solution at room temperature. The phrenic nerve was stimulated at the supramaximal intensity using a Grass(R) S88 stimulator via an SIU5 isolation unit. The twitch height was measured and recorded using a precalibrated Grass(R) FT88 force displacement transducer and recorded with a Grass(R) 79 polygraph, respectively. In the cumulative dose-response study, the rocuronium 100microgram/dl and each dose of 5-HT were administered simultaneously administered, with additional 50microgram/dl incremental doses of rocuronium were added to obtain grteater than 95% neuromuscular twitch inhibition. The ED5, ED50, ED90, and ED95 of rocuronium in each group were calculated using a probit model. RESULTS: The ED50, ED90, and ED95 of rocuronium were significantly reduced in 5-HT 20microgram/ml group (P < 0.05), but no differences were observed with the other 5-HT groups compared to the control groups. CONCLUSIONS: 5-HT at 20microgram/ml enhanced the neuromuscular blockade of rocuronium.
Animals ; Baths ; Cross Reactions ; Humans ; Ligand-Gated Ion Channels ; Male ; Neuromuscular Blockade* ; Peritoneal Cavity ; Phrenic Nerve ; Rats* ; Rats, Sprague-Dawley ; Receptors, Nicotinic ; Serotonin* ; Transducers

The isolation rate of Escherichia (E.) coli in poultry litter was investigated at 44 broiler farms, 20 that used fresh litter and 24 that used recycled litter. The patterns of resistance to antibiotics of the E. coli isolates were compared. In litter sampled before the rearing period, the isolation rate of E. coli was higher at farms that used fresh litter; E. coli was present in the litter in 94.5% (35 out of 37 flocks tested) of the farms that used fresh litter vs. 51.2% (21 out of 41 flocks) of the farms that used recycled litter. The susceptibility of the 93 isolates of E. coli to 13 antibiotics was studied. Before the rearing period, E. coli isolates from the farms that recycled litter showed higher resistance rates than isolates from farms that replaced litter with fresh litter. Comparing the antibiotic resistance patterns of isolates from litter sampled before and at the end of the rearing period, the antibiotic resistance rates at the end of the rearing period increased dramatically compared with rates before the rearing period.
Agriculture ; Anti-Bacterial Agents ; Drug Resistance, Microbial* ; Escherichia coli* ; Escherichia* ; Poultry*

BACKGROUND: Helicobacter pylori(H. pylori) is a major risk factor for chronic gastritis, peptic ulcer, and low grade gastric lymphoma of mucosa-associated lymphoid tissue(MALT). Eradication of H. pylori can induce prevention of peptic ulcer relapse and regression of gastric MALT lymphoma. Smoking has also been knawn to be a mapr risk factor for peptic ulcer. The purpose of this study is to evaluate the effects of smoking on eradication of H. pylori according to smoking status, amount of smoking, and smoking cessation. METHODS: We studied 132 patients with H. pylori-positive gastroduodenal diseases. Diseases composed of gastritis in 36.4%, peptic ulcer 62.1%, gastric MALT lymphoma 1.5%. Patients were treated with amoxacillin 1.0g, clarithromycin 500mg, omeprazole 20mg bid for a period of 7 days. Patients underwent a follow-up gastroendoscopy 6 weeks later after eradication treatment. H. pylori status was confirmed by initial and follow up biopsies of gastric antrum and corpus using Hematoxylin-Eosin stain and Wharthin-Starry silver stain. At the begining of treatment, 66.7% of 132 patients were smokers, 9.8% ex-smokers, 23.5% non-smokers. Smokers were advised to stop smoking through education and counseling at each office visit. RESULTS: H. pylori eradication was achieved in 111 patients(84.1%). The number of smokers who had quit smoking sucessfully during treatment were 25(28.4%). The rate of eradication did not seem to influenced by initial smoking status and total amount of smoking(pack-years). Hawever, during treatment, success group for smoking cessation(100%) had a higher rate of eradication than non-cessation group. Daily amount of smoking had an effect on eradication with significant statistical difference ; Non-smokers showed 89.9% eradication rate, mild smokers(<20 cigarettes/day) 81.8%, and heavy smokers ( >20/day) 50%. CONCLUSIONS: These results suggest that current smoking status and daily amount of smoking during treatment seem to influence the rate of eradication of H. pylori rather than past smoking history alone. There was some improvement in the eradication rate by quitting or reducing smoking together with H. pylori eradication treatment.
Biopsy ; Clarithromycin ; Counseling ; Education ; Follow-Up Studies ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Office Visits ; Omeprazole ; Peptic Ulcer ; Pyloric Antrum ; Recurrence ; Risk Factors ; Silver ; Smoke* ; Smoking Cessation ; Smoking*

BACKGROUND: This study provides up-to-date survival data on cardiac resuscitation in adult in-patients. The main objectives of the study were to evaluate the incidence, causes, and outcomes of perioperative cardiac arrest. Objective data might encourage more meaningful attitude in anesthesiologists, surgeons, and patients. METHODS: We retrospectively reviewed patients who experienced perioperative cardiac arrest while receiving noncardiac surgery between January 2004 and December 2012. Collected data included patient characteristics, preoperative evaluations, American Society of Anesthesiologists Physical Status (ASA PS) classification, surgical status (e.g., elective or emergency), type of surgery, and outcomes. RESULTS: We identified 30 cases of perioperative cardiac arrest that occurred in 457,529 anesthetized patients (incidence = 0.66 per 10,000 anesthetized patient; all-cause mortality = 0.21 per 10,000 anesthetic cases). Two-thirds of patients (19 of 30) were emergency cases (21% survival rate; 4 of 19 patients). Most cardiac arrest patients (60%; 18 of 30 patients) were ASA PS IV-V, and only 40% patients were ASA PS I, II and III. Four cases were associated with anesthesia and the patient recovered, and 3 patients recovered after resuscitation. The main causes of cardiac arrest were respiratory- (75%) and medication-related events (25%). CONCLUSIONS: In accordance with anesthetic management guidelines and the development of anesthetic agents, anesthesia-related cardiac arrests decreased in terms of incidence and mortality. However, we recommend that clinicians cautiously keep in mind airway management and the administration of medications, which are important preventative factors.
Adult ; Airway Management ; Anesthesia ; Anesthetics ; Classification ; Emergencies ; Heart Arrest* ; Hospitals, Teaching* ; Humans ; Incidence ; Korea ; Mortality ; Resuscitation ; Retrospective Studies* ; Survival Rate

Newcastle disease (ND) caused by virulent Newcastle disease virus (NDV) is a highly contagious viral disease of poultry. Virulent NDVs characteristically have a multibasic amino acid sequence (virulence motif) such as (112)RRQKRF(117) at the cleavage site of the precusor fusion (F0) protein. The antigenic and immunogenic characteristics of the virulence motif (112)RRQKRF(117) in the F0 protein of virulent NDVs were investigated. Epitope mapping analysis revealed that a RRQKRF-specific monoclonal antibody 4G2 recognized the KRF section of the motif. A synthetic peptide bearing the RRQKRF motif reacted strongly with sera from virulent NDV (with RRQKRF motif)-infected chickens. These sera also showed reactivity to peptides bearing other virulence motifs ((112)KRQKRF(117), (112)RRQRRF(117) and (112)RRRKRF(117)) but not an avirulence motif ((112)GRQGRL(117)) by ELISA. The synthetic bearing RRQKRF motif reacted with 60% to 91% of sera taken from surviving chickens on ND outbreak farms but not with sera from vaccinated birds, even though most of the sera had antibody to NDV due to vaccination. This indicates that the virulence motif has the potential to differentiate virulent NDV infected birds from vaccinated birds.
Amino Acid Motifs/*immunology ; Amino Acid Sequence ; Animals ; Chickens ; Enzyme-Linked Immunosorbent Assay/veterinary ; Epitope Mapping/veterinary ; Newcastle Disease/*immunology ; Newcastle disease virus/*genetics/pathogenicity ; Poultry Diseases/*immunology/*virology ; Serologic Tests/veterinary ; Viral Fusion Proteins/*genetics/immunology ; Virulence/genetics

The safety, tolerability and immunogenicity of an oral cholera vaccine (OCV) was assessed in adult Korean male through an open-label, non-comparative clinical study. Two doses of vaccine with an interval of 2 weeks were given to 20 healthy subjects. A total of 7 adverse events occurred in 6 subjects. However, no clinically significant change was observed in electrocardiograms, vital signs, physical examinations, and clinical laboratory tests. The immunogenicity of OCV was evaluated by serum vibriocidal assay where anti-Vibrio cholerae O1 and O139 antibodies were measured at day 0, 14, and 28 of vaccine administration. The antibody titers ranged from < 2.5-5,120 for V. cholerae O1 Inaba, < 2.5-10,240 for V. cholerae O1 Ogawa and < 2.5-480 for V. cholerae O139. In addition, the fold increase in antibody titers ranged from 1-4,096 for O1 Inaba, 1-8,192 for O1 Ogawa, and 1-384 for O139. The seroconversion rate was 95% and 45% for O1 and O139 antibodies, respectively. Our study clearly shows that administration of two doses of OCV at a 2 week-interval increases an appropriate level of antibody titer in the serum of healthy Korean adult males (Clinical Trial Number, NCT01707537).
Administration, Oral ; Adult ; Antibodies, Bacterial/*blood/immunology ; Antibody Formation ; Cholera/*prevention & control ; Cholera Vaccines/adverse effects/*immunology ; Creatine Kinase/blood ; Humans ; Male ; Republic of Korea ; Toothache/etiology ; Vibrio cholerae O1/immunology

BACKGROUND: Phenytoin and carbamazepine may augment a neuromuscular block from nondepolarizing muscle relaxants. The potency of rocuronium is increased after the administration of an acute high dose of phenytoin. We investigated the effects of phenytoin and carbamazepine on rocuronium-induced neuromuscular blockade. METHODS: Male Sprague Dawley rats (n = 80) were randomly allocated into a control group, phenytoin group, carbamazepine group, and phenytoin with carbamazepine group. The phrenic nerve was stimulated with supramaximal intensity and twitch responses were measured. After a stabilization period, 300microg rocuronium was added. After 10 minutes, in the pheytoin group of rats, phenytoin in Krebs solution was administered at a concentration of 1microg/ml (P1), 10microg/ml (P10) and 100microg/ml (P100). In the carbamazepine group of rats, carbamazepine in Krebs solution was administered at a concentration of 0.5microg/ml (C0.5), 5microg/ml (C5) and 50microg/ml (C50). In the phenytoin with carbamazepine group of rats, phenytoin simultaneously with carbamazepine was administered in Krebs solution at a phenytoin concentration of 10microg/ml (P10) and a carbamazepine concentration of 5microg/ml (C5). We measured twitch responses at 10 minutes after rocuronium administration and 10 minutes after the administration of the anticonvulsants. RESULTS: There were significant depressions in the twitch response of rocuronium in the 100microg/ml phenytoin group of rats, 5microg/ml and 50microg/ml carbamazepine group of rats, and the 10microg/ml phenytoin with 5microg/ml carbamazepine group of rats. CONCLUSIONS: The potency of rocuronium increased with phenytoin and carbamazepine administration. Phenytoin and carbamazepine can cause recurarization perioperatively.
Animals ; Anticonvulsants ; Carbamazepine* ; Depression ; Humans ; Male ; Neuromuscular Blockade* ; Phenytoin* ; Phrenic Nerve ; Rats ; Rats, Sprague-Dawley