Pain and urinary symptoms following colorectal cancer (CRC) surgery are frequent and carry a poor recovery. This study tested the effects of inhalation of Lavandula angustifolia Mill. (lavender) oil or linalyl acetate on pain relief and lower urinary tract symptoms (LUTS) following the removal of indwelling urinary catheters from patients after CRC surgery. This randomised control study recruited 66 subjects with indwelling urinary catheters after undergoing CRC surgery who later underwent catheter removal. Patients inhaled 1% lavender, 1% linalyl acetate, or vehicle (control group) for 20 minutes. Systolic and diastolic blood pressure (BP), heart rate, LUTS, and visual analog scales of pain magnitude and quality of life (QoL) regarding urinary symptoms were measured before and after inhalation. Systolic BP, diastolic BP, heart rate, LUTS, and QoL satisfaction with urinary symptoms were similar in the three groups. Significant differences in pain magnitude and urinary residual sense of indwelling catheters were observed among the three groups, with inhalation of linalyl acetate being significantly more effective than inhalation of lavender or vehicle. Inhalation of linalyl acetate is an effective nursing intervention to relieve pain and urinary residual sense of indwelling urinary catheters following their removal from patients who underwent CRC surgery.
Background Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains were first detected in hospitals in Korea between the late 2000s and early 2010s. However, there is limited information regarding the prevalence of CA-MRSA strains among hospital isolates and their phenotypic changes over the last decade. We investigated the prevalence trend of CA-MRSA strains isolated from different clinical specimens and their phenotypic changes between September 2009 and September 2019. Methods CA-MRSA strains were phenotypically identified by confirming their resistance to penicillin (PCN) and oxacillin (OXA) and evaluating their susceptibility to trimethoprim-sulfamethoxazole, rifampin, fusidic acid, tetracycline, and at least one of the following four antimicrobials: clindamycin (CLI), erythromycin (ERY), ciprofloxacin (CIP), and gentamicin (GEN). A CA-MRSA strain that exhibited resistance to ERY, CLI, CIP, or GEN was classified as having resistance pattern I, II, III, or IV, respectively, regardless of its resistance to other antimicrobial agents. Results Of the 8,278 MRSA isolates identified in specimens obtained two days after admission, 1,385 (16.73%) were CA-MRSA strains. The prevalence of CA-MRSA strains increased from 12.2% to 26.6% (3.21% per period, P =0.05). Resistance type analysis revealed an increasing trend in the prevalence of PCN/OXA-resistant (1.84%; P =0.049) and PCN/OXA/ERY/CLI/CIP-resistant (0.98%; P =0.04) CA-MRSA strains and in resistance pattern III strains (2.08%; P =0.004). Conclusions The prevalence of CA-MRSA strains in Korea has increased significantly over the last decade, and CA-MRSA strains have gained phenotypic diversity beyond PCN/OXA-resistance, including antimicrobial resistance to non-β-lactams, especially CIP.
Background: With development of robotic procedures, there are increasing attempts to apply it to biliary and pancreatic surgery. Previously, we have performed robotic distal pancreatectomy with splenectomy using the daVinci SP system. In this study, we report and share our experiences of robotic spleen preserving distal pancreatectomy using the daVinci SP system. Methods: We reviewed the medical records of four patients who underwent robotic (SP+1) spleen preserving distal pancreatectomy from December, 2021 to December, 2022. Patient demographics, operative time, postoperative hospital stay and complications were obtained and analyzed. Robotic distal pancreatectomy was performed using the daVinci SP Ⓡ Surgical System. One additional 12-mmport was placed on the left side of the daVinci SP Ⓡ port, which was used by the assistant for applying the energy device and endo-GIA stapler. The resected specimen was delivered through umbilicus incision and the drain was inserted through the additional left side port. Results: Robotic (SP+1) spleen preserving distal pancreatectomy was performed in 4 patients, three of whom had splenic vessels preserved. The mean age of the patients was 57.8 ± 12.6 years old, and the mean BMI was 24.9 ± 0.9 kg/m 2 . The mean operation time was 130.0 ± 41.4 minutes and the estimated blood loss was 250.0 ± 173.2 mL. All tumors were located in the tail of pancreas and the pancreas texture was soft in all patients. There were no complications except for POPF grade B in two patients. Patients with POPF grade B were treated with percutaneous abdominal drainage. The mean length of hospital stay was 10.8 ± 4.9 days for after surgery. Conclusions: Robotic spleen preserving distal pancreatectomy using the daVinci SP system is safe and feasible with acceptable perioperative outcomes. Compared to previous robotic single site systems, the daVinci SP system enables more ergonomic with wider range of motion and due to articulating instruments. However, since there is no built in robotic energy device, dissection is less comfortable than the previous robotic systems. Further experiences are necessary to improve techniques and verify the short-and long-term operative outcomes.
Background: Animal venoms and toxins are potential bioresources that have been known to mankind as a therapeutic tool for more than a century through folk and traditional medicine. The present study was an effort to establish the anticancer activity of the purified protein toxin (NN-32) from Indian Spectacled Cobra (Naja naja) venom in human breast cancer cell line. Methods: Isolation and purification of NN-32 was done through CM-cellulose ion exchange chromatography and RP-HPLC. Molecular weight was found out by SDS-PAGE. The anti-leukemic activity using MCF-7 cell line was established through cytotoxicity study.Results: NN-32 was eluted with 0.5M NaCl on CM-cellulose ion exchange chromatography. SDS-PAGE molecular weight was found to be 6.7 KDa. NN-32 produced time and dose dependent cell (MCF-7) growth inhibition. It exhibited DNA fragmentation and comet formation in MCF-7 cells. NN-32 produced membrane disruption, blebbing and nuclear disintegration in MCF-7 cells observed through scanning electron microscopy. Conclusions: NN-32 produced apoptosis, cell cycle arrest at G1 phase. NN-32 induced apoptosis in leukemic cells was followed through caspase 3 and 9 pathway activation. It may be concluded that NN-32, a 6.7 KDa protein purified from Naja naja venom would be a novel pro-apoptotic agent that induced cancer cell killing through p53 and caspase pathway. It is expected that this study may add new information on anticancer effects of Naja naja snake venom, which may be utilized for future drug development clue against cancer.
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