Temporary Discharge Research Articles

Lithium Superoxide in Li-O2 Batteries: Performance and Mechanisms

Lithium superoxide (LiO2) is generally regarded as an intermediate formed during the Li-O2 battery discharge and transformed into lithium peroxide (Li2O2). Indeed, its chemical/electrochemical stability is low, making it recognized as a temporary discharge product in Li-O2 battery chemistry. However, in 2016, utilizing an iridium (Ir)-based electrocatalyst, Curtiss and Amine et al. found that LiO2 can be epitaxially grown on the surface of Ir catalyst and can be stable under cycling conditions.1 In the study, a templating mechanism was suggested, where a good lattice matching of LiIr3 surfaces (formed on the Ir catalyst) with that of LiO2 facilitates LiO2 formation as a singular discharge product. Following studies showed some superior electrochemical properties of LiO2 in comparison to Li2O2, including lower charge overpotentials. Meanwhile, some other transition metal compounds have recently exhibited LiO2 formation, where the formation mechanism suggested may not be a templating method. In this case, there could be strong adsorption of LiO2 in specific structures, resulting in suppressed Li2O2 generation. Herein, we will present experimental and computational results on some new catalysts for LiO2 formation and discuss possible underlying mechanisms.AcnowledgementThis work was primarily supported by the US Department of Energy under contract DE-AC02-06CH11357 from the Vehicle Technologies Office, Department of Energy, Office of Energy Efficiency and Renewable Energy.Reference1 Curtiss. L. and Amine. K. et al. A lithium–oxygen battery based on lithium superoxide. Nature 2016, 529, 377-382

Evaluation of the Validity of Endoscopic Transpapillary Gallbladder Drainage for Acute Cholecystitis Based on the Tokyo Guidelines 2018.

We evaluated the validity of endoscopic transpapillary gallbladder drainage (ETGBD) as a bridging therapy prior to elective Lap-C for the patients with acute cholecystitis (AC). The Tokyo Guidelines 2018 recommend early laparoscopic cholecystectomy (Lap-C) for patients with AC, however, some patients require the preoperative drainage because of inadequate for early Lap-C du to background and comorbidities. We performed a retrospective cohort analysis using data from our hospital records from 2018-2021. In total, 71 cases of 61 patients with AC underwent ETGBD. The technical success rate was 85.9%. Patients in the failure group had more complicated branching of the cystic duct. The length of time until feeding was started and until WBC levels normalized, and the length of hospital stay were significantly shorter in the success group. The median waiting period for surgery was 39 days in the ETGBD success cases. The median operating time, amount of bleeding, and length of postoperative hospital stay were 134 min, 83.2g, and 4 days, respectively. In patients who underwent Lap-C, the waiting period for surgery and the operating time were similar between the ETGBD success and failure groups. However, the temporary discharge period after drainage and the length of postoperative hospital stay were significantly longer in the patients with ETGBD failure. Our study revealed that ETGBD has equivalent efficacy prior to elective Lap-C despite some challenges that lower its success rate. Preoperativ ETGBD can improve patient quality of life by eliminating the need for a drainage tube.

Experience of the temporary discharge from the inpatient palliative care unit: A nationwide post-bereavement survey for end-of-life cancer patients

ObjectiveInpatient palliative care units (PCUs) have two roles: place of death and symptom control. In case of symptom control, most patients whose distressing symptoms could be relieved would be temporarily discharged back home. However, the experience of the patient and their family during temporary discharge is unclear. MethodsThis study is a part of the Japan HOspice and Palliative Care Evaluation Study 3, a nationwide cross-sectional post-bereavement survey. We sent questionnaires to bereaved relatives of cancer patients who died in PCUs in 2018. ResultsAmong 968 questionnaires sent, 571 questionnaires were analyzed (59%). Sixteen percent of patients experienced temporary discharge from PCUs. Seventy-two percent of bereaved family members reported that patients said “I am happy to be discharged home.” Overall, 22%–37% of participants reported improvement in the patient's condition after discharge. The caregiver's recognition of better patient's quality of life at home and the doctor's assurance of re-hospitalization, if necessary, were significantly associated with positive experience. ConclusionsBereaved family members recognized temporal discharge as positive experiences for patients and families. Appropriate home palliative care and discharge planning would contribute to positive experience after discharge.

Association between temporary discharge from the inpatient palliative care unit and achievement of good death in end-of-life cancer patients: A nationwide survey of bereaved family members.

To explore the unclear association between temporary discharge home from the palliative care unit and achievement of good death, in the background of increases in discharge from the palliative care unit. Association between experiences and circumstances of patient and family and duration of temporary discharge was also examined. This study was a secondary analysis of data from a nationwide post-bereavement survey. Among 571 patients, 16% experienced temporary discharge home from the palliative care unit. The total good death inventory score (p < .05) and sum of 10 core attributes (p < .05) were significantly higher in the temporarily discharged and stayed home ≥2 weeks group. Among all attributes, "Independent in daily activities" (p < .001) was significantly better in the temporarily discharged and stayed home ≥2 weeks group. Regarding the experience and circumstance of patient and family, improvement of patient's appetite (p < .05), and sleep (p < .05) and peacefulness (p < .05) of family caregivers, compared to the patient being hospitalized, were associated with longer stay at home after discharge. Patient's achievement of good death was better in the temporarily discharged and stayed home longer group, but this seemed to be affected by high levels of independence of the patient. Temporary discharge from the palliative care unit and staying home longer was associated with improvement of appetite of patients and better sleep and mental health status of family caregivers. Discharging home from palliative care unit is worth being considered even if it is temporary.

Modified PACU Discharge Process During COVID-19 Pandemic

Background InformationCoronavirus disease-2019 (COVID-19) has become a worldwide pandemic that presented challenges and brought extensive changes in the healthcare delivery. Restricting visitation in peri-operative setting is one of the steps adapted by the institution to enhance safety of patients, families and healthcare workers. This had a great impact on the discharge process in the Post-anesthesia Care Unit (PACU).Objectives of ProjectImplement a modified discharge process to ensure safe transfer and continuation of care of post-operative patients.Process of ImplementationVisitor's restriction led to no visitors in perioperative setting except for pediatrics and patients with physical / cognitive limitations. This new process demanded a modified discharge process for outpatients. The two methods used were:•Virtual instruction: Given to family or responsible person by phone before discharging patients from PACU.•Face-to-Face discharge instruction: Provided in one of the four temporary discharge centers created at the entrance to minimize visitation time and exposure to other patients in PACU. Patient families who required one- on -one demonstration and practice identified and escorted to discharge center after COVID screening.Prescriptions for all patients delivered by pharmacy. Copy of after visit summary and patient education provided to family and included in electronic medical record.Statement of Successful PracticeSuccessfully implemented the modified PACU discharge workflow in April 2020. Data collected from 4/1/20 to 1/31/2021 shows that 7,409 patients used the modified discharge process. Out of the 7,409, 86% received instruction through phone call and 14% used the discharge center. Press Ganey patient satisfaction rate with discharge remained high at 96%.Implications for Advancing the PracticeThis project demonstrated the importance of adapting new process to enable safe delivery of care during emergencies. The modified workflow allowed effective transfer of discharge information and patient education for PACU patients while following COVID-19 protocol for visitation. This new model of discharge process can be replicated in similar healthcare environment.

Numerical simulation of freeze-up jamming in a skim ice regime

Freeze-up jamming on regulated rivers is an important aspect of cold regions hydropower operations. The timing and nature of freeze-up jamming has a role in reducing effects to winter discharge conveyance. In northern regions with very mild-sloped rivers, skim ice run is of considerable importance to the formation of a thin and stable cover with low hydraulic resistance. This paper presents a detailed review of skim ice run, including quantitative methods for predicting skim ice formation and a description of its behavior during freeze-up jamming. The review is supplemented by site observations from a large northern regulated river which experiences significant skim ice runs during winter. Following this, a treatment of skim ice run during freeze-up jam simulations is presented for a two-dimensional river ice model (Shen, 2010). The treatment includes implementation of empirical equations to establish skim ice run formation thickness, estimate skim ice floe strength as a function of thermal growth, and facilitate ice cover formation under varying discharge and air temperature conditions. Simulations illustrate the role of temporary discharge reductions on both the formation rate and thickness of ice jams formed mainly by skim ice runs. Further, these simulations highlight that profiles of ice jams formed under cold conditions show smaller final thicknesses relative to those formed under warmer conditions, due to the reduced strength of ice floes formed in warm weather. A brief sensitivity analysis evaluates the cumulative effect of concurrent changes to air temperature and discharge, as well as the impact of varying channel characteristics (i.e., sinuosity and bed slope). Enhancing capabilities of the model to simulate freeze-up jams creates potential for industrial applications, where anticipating the effects of discharge and air temperature on ice jam formation is often of paramount importance for river ice management.

Is self-expandable metallic stents superior to transanal decompression tubes for the treatment of malignant large-bowel obstruction: a meta-analysis.

Preoperative intestinal decompression, such as self-expandable metallic stents (SEMS) and transanal decompression tubes (TDT), has been widely used for patients with malignant large-bowel obstruction (MLBO). The aim of this study is to evaluate the clinical outcomes of SEMS for MLBO as a bridge to surgery compared to TDT. We searched three databases, including PubMed, Embase, and Web of Science from inception until June 12, 2019. Risk ratio (RR) or weight mean difference (WMD) with 95% CIs was used to calculate the data extracted from included studies. Five studies with 226 participants were included in this review. SEMS insertion showed significantly higher clinical success rate (RR =1.30, 95% CI: 1.06, 1.60; P=0.012) and technical success rate (RR =1.33, 95% CI: 1.07, 1.65; P=0.011), as well as higher rates of solid food intake (RR =27.15, 95% CI: 8.73, 84.45; P<0.001) and temporal discharge (RR =64.47, 95% CI: 9.10, 456.57; P<0.001), as compared with TDT insertion. Moreover, SEMS insertion significantly reduced the blood loss (WMD =-69.73 mL, 95% CI: -81.61, -57.85; P<0.001), and prolonged the operative time (WMD =93.49 minutes, 95% CI: 14.24, 172.75; P=0.021) in the treatment of MLBO. Duration of hospital stay, complication rate and mortality rate were comparable between the two treatments. Preoperative SEMS insertion offered better effects for MLBO, including higher success rate, and higher rates of solid food intake and temporary discharge, compared with TDT.

ANALISIA HIDROGRAF SATUAN DAN WIND ROSE PLOTS PADA DAERAH ALIRAN SUNGAI SEKANAK

Sekanak watershed is a basin in Palembang which is often affected by flood during the rainy season. The characteristics of the watershed by the impact of changes in land-use by economic and settlement developments. Sekanak watershed has 3 retention ponds which have the function of accommodating temporary discharge during floods. The catchment capacity of the watershed soil type, storage conditions etc. Therefore we need an analysis of the transformation of rainfall data in the watershed into a flow at the watershed control point and an analysis of the transformation of runoff volume (effective rain) into a surface runoff hydrograph (unit hydrograph). Hydrographs measured at a watershed control point are the response or output from rain that falls on a watershed system. The size of the watershed depend on the watershed system. This is closely related in analyzing the availability of water that occurs in the watershed system.

The analogue experiment of small space debris impact inducing solar array discharge

High density and conductivity plasma will be induced when space debris impacts with spacecraft. The plasma can lead to a temporary discharge tunnel and triggering discharge. This has been reported as the mechanism of space debris impact inducing discharge and might be a big threat to spacecraft. The solar array is of vital importance to spacecraft and is regarded as vulnerable to space debris impact inducing discharge. Research of space debris larger than 1 mm impact solar array discharge has already carried out. Space debris smaller than 1 mm are predominant and will impact with spacecraft more frequently compared to space debris larger than 1 mm. If the impact of such debris with solar array can induce discharge, the threat will be more serious. However, the study of space debris smaller than 1 mm impacting solar array inducing discharge has not been reported. In this paper, the analogue experiment of smaller than 1 mm space debris impact solar array inducing discharge is carried out. Our results show that the space debris with 200 μm in diameter can trigger solar array discharge. If the voltage is high and the discharge current is large enough, secondary discharge can be triggered too. The discharge can make noticeable mechanical damage on the surface of solar cells.

Criminal procedure powers of the President of the Russian Federation

In article powers of the President of the Russian Federation in the sphere of criminal trial are considered. The Criminal Procedure Code of the Russian Federation stipulates the following similar powers of the head of state: the announcement of pardon, temporary discharge from a position of the highest public official of the territorial subject of the Russian Federation, discharge from a position of the Prosecutor General of the Russian Federation and the Chairman of Investigative Committee of the Russian Federation at the solution of situation of excitement concerning them criminal case. In work the procedural order of realization by the President of the Russian Federation of appropriate authority is analyzed. By results of a research the author formulates a conclusion according to which investment of the President of the Russian Federation with some powers in the sphere of criminal trial allows to balance criminal procedure activity. At the same time further expansion of powers of the President of the Russian Federation is not required.

Comparative study between colonic metallic stent and anal tube decompression for Japanese patients with left-sided malignant large bowel obstruction

BackgroundSurgical management of malignant bowel obstruction carries with high morbidity and mortality. Placement of a trans-anal decompression tube (TDT) has traditionally been used for malignant bowel obstruction as a bridge to surgery. Recently, colonic metallic stent (CMS) as a bridge to surgery for malignant bowel obstruction, particularly left-sided malignant large bowel obstruction (LMLBO) caused by colorectal cancer, has been reported to be both a safe and feasible option. The aim of this retrospective study is to evaluate the clinical effects of CMS for LMLBO as a bridge to surgery compared to TDT.MethodsBetween January 2000 and December 2015, we retrospectively evaluated outcomes of 59 patients with LMLBO. We compared the outcomes of 26 patients with CMS for LMLBO between 2013 and 2015 (CMS group) with those of 33 patients managed with TDT between 2003 and 2011 (TDT group) by the historical study. LMLBO was defined as a large bowel obstruction due to a colorectal cancer that was diagnosed by computed tomography and required emergent decompression.ResultsAll patients in the CMS group were successfully decompressed (p = 0.03) and could initiate oral intake after the procedure (p < 0.01). Outcomes in the CMS group were superior to the TDT group in the following areas: duration of tube placement (p < 0.01), surgical approach (p < 0.01), operation time (p < 0.01), number of resected lymph nodes (p < 0.001), and rate of curative resection (p < 0.01). However, no significant differences were found in the overall postoperative complication rate (p = 0.151), surgical site infection rate (p = 0.685), hospital length of stay (p = 0.502), and the need for permanent ostomy (p = 0.745). The 3-year overall survival rate of patients in the CMS and TDT groups was 73.0% and 80.9%, respectively, and this was not significant (p = 0.423).ConclusionsTreatment with CMS for patients with LMLBO as a bridge to surgery is safe and demonstrated higher rates of resumption of solid food intake and temporary discharge prior to elective surgery compared to TDT. Oncological outcomes during mid-term were equivalent.

Substance P Regulation in Epilepsy.

Background: Epilepsy is a common neurological disease characterized by abnormal temporary discharge of neurons in the central nervous system. In recent years, studies have revealed the localization and changes in the density of neuropeptides, such as substance P (SP) in the pathogenesis of epilepsy. This review is a concise overview of SP and their physiologic and pathologic functions on regulating epilepsy, and the underline mechanisms.Methods: We research and collect relative online content for reviewing the effects of SP in Epilepsy.Results: The SP/NK-1 receptor system may induce seizures and play an important role in status epilepticus and in experimental animal models of epilepsy. Newest studies show that several mechanisms may explain the excitatory effects of the SP/NK-1 receptor signaling pathway in epilepsy. By binding to the NK-1 receptor, NK-1 receptor antagonists may block the pathophysiological effects of SP, and further studies are needed to confirm the possible anti-epileptic activity of NK-1 receptor antagonists.Conclusion: SP plays crucial roles on through binding with NK-1 receptor during epilepsy pathologic processing, and the NK-1 receptor is receiving a great attention as a therapeutic target for treating epilepsy. Thus, the use of NK-1 receptor antagonists for the treatment of epilepsy should be investigated in further studies.

Rehabilitation for bariatric patients

Morbidly obese patients can achieve functional improvement1 but they often experience increased post-acute rehabilitation length of stay due to the limitations of the healthcare system.2 This study aims to develop targeted interventions to optimise rehabilitation care delivery for bariatric patients. We reviewed the medical records of two inpatients at the rehabilitation ward in Sunshine Hospital, Victoria. The patients were morbidly obese (weight of 180 and 196 kg respectively) and had a few months of complicated acute hospital stay (10 and 12 weeks respectively). On admission to the rehabilitation ward, both patients required full nursing care and were non-ambulant. Factors related to the patients, staff and environment which posed challenges to the rehabilitation and discharge planning were recorded. Multiple factors account for the difficulties in rehabilitating bariatric patients. Morbidly obese patients tend to develop more frequent and severe medical complications during their subacute stay.3 It also takes longer for them to recover from the illnesses. Increased number of nursing staff is required to provide the appropriate care needs. Occupational health and safety issues are frequent, with multiple nursing staff having to take sick leave due to musculoskeletal injuries. A room with larger space and bariatric-specific equipment are essential for patient comfort, effective nursing care and physical therapies. Discharge planning process can be complex as extensive home modification and support are often required. Temporary discharge destination options need to be explored early on as bariatric patients take longer time to achieve functional improvement. Multiple factors contribute to challenges in bariatric rehabilitation. Prior to admitting morbidly obese patients into the rehabilitation ward, it is prudent to educate staff,4 involve the occupational health and safety department, and ensure the availability of the required equipment3 and room. To reduce the length of stay at the rehabilitation ward, the treating team needs to explore the available support options and assess home environment early on during admission. While increasing the number of nursing staff imposes a financial strain to the hospital, it will not only reduce the physical and psychological burden of the nursing team, but also allow the patient to have extra therapies. Close monitoring of the medical condition and provision of weight loss programme may potentially prevent hospital-related and obesity-related complications, and subsequently improve the patient’s functional gains during therapy sessions. Surmounting obstacles relating to rehabilitation of bariatric patients should commence at the earliest possible time and continue throughout the admission to optimise the outcome of the patients.

Comparison between metallic stent and transanal decompression tube for malignant large-bowel obstruction

BackgroundThe short-term safety and efficacy of a self-expandable metallic colonic stent (SEMS) insertion followed by elective surgery, “bridge to surgery (BTS)”, for malignant large-bowel obstruction (MLBO) have been well described comparing with emergency surgery. The aim of this study was to compare short-term outcomes of endoscopic decompression using a SEMS versus a transanal decompression tube (TDT). Materials and methodsFrom January 2005 to November 2014, a total of 101 patients with MLBO underwent surgery at our single institution were retrospectively identified. Among them, 73 patients who underwent preoperative complete insertion of a decompression device (TDT, n = 45; SEMS, n = 28) were finally included in this study. Six patients with incomplete insertion of a decompression device (TDT, n = 5; SEMS, n = 1) were also excluded. The primary endpoints of this study were the postoperative morbidity and mortality rates. The secondary endpoints were decompression-related outcomes. Additionally, propensity score matched (PSM) analysis was conducted in short-term outcomes between the groups. ResultsThe SEMS group had significantly higher proportion of right-sided tumor and bigger tumor size compared with those of the TDT group. The SEMS group had a significantly higher proportion of patients who underwent laparoscopic surgery, and consequently, a longer surgical duration than did the TDT group. Higher rates of insertion failure and perforation were recognized in the TDT group than in the SEMS group (10.0% versus 3.6% and 8.9% versus 0.0%, respectively), although these differences were not statistically significant (P = 0.406 and 0.291, respectively). The two groups showed similar occurrences of anastomotic leakage, bowel obstruction, overall complications, and mortality. Compared with the TDT group, the SEMS group had a significantly lower rate of surgical site infection (24.4% versus 3.6%, respectively; P = 0.023 and P = 0.025 after PSM) and a shorter length of hospital stay (median, 21 d [interquartile range, 18-29 d] versus 38 d [interquartile range, 28-45 d], respectively; P = 0.015 and P = 0.003 after PSM). Solid food intake after decompression and preoperative temporary discharge occurred only in the SEMS group. ConclusionsPreoperative SEMS insertion for MLBO is effective with at least equivalent short-term outcomes and superior preoperative quality of life compared with decompression using TDT.

2-stage revision of 120 deep infected hip and knee prostheses using gentamicin-PMMA beads

Background and purpose — A 2-stage revision is the most common treatment for late deep prosthesis-related infections and in all cases of septic loosening. However, there is no consensus about the optimal interval between the 2 stages.Patients and methods — We retrospectively studied 120 deep infections of total hip (n = 95) and knee (n = 25) prostheses that had occurred over a period of 25 years. The mean follow-up time was 5 (2–20) years. All infections had been treated with extraction, 1 or more debridements with systemic antibiotics, and implantation of gentamicin-PMMA beads. There had been different time intervals between extraction and reimplantation: median 14 (11–47) days for short-term treatment with uninterrupted hospital stay, and 7 (3–22) months for long-term treatment with temporary discharge. We analyzed the outcome regarding resolution of the infection and clinical results.Results — 88% (105/120) of the infections healed, with no difference in healing rate between short- and long-term treatment. 82 prostheses were reimplanted. In the most recent decade, we treated patients more often with a long-term treatment but reduced the length of time between the extraction and the reimplantation. More reimplantations were performed in long-term treatments than in short-term treatments, despite more having difficult-to-treat infections with worse soft-tissue condition.Interpretation — Patient, wound, and infection considerations resulted in an individualized treatment with different intervals between stages. The 2-stage revision treatment in combination with local gentamicin-PMMA beads gave good results even with difficult prosthesis infections and gentamicin-resistant bacteria.

Treatment with continuous intrasynovial antimicrobial infusion for septic synovitis in horses: 31 cases (2000–2003)

OBJECTIVE-To determine clinical findings, complications, and outcome of septic synovitis in which continuous intrasynovial antimicrobial infusion (CIAI) was used for local antimicrobial delivery in horses. DESIGN-Retrospective case series. Animals-22 adult horses and 9 foals (horses<1 year of age). PROCEDURES-Records of horses with septic synovitis that had CIAI during treatment were reviewed. The association between clinical variables and whether horses performed their intended use following treatment was determined. RESULTS-42 synovial cavities were treated via CIAI. Twenty-nine cases were chronic (>7 days) in nature, 15 had been refractory to standard treatments, and 13 synovial infections had associated osteomyelitis. Mean duration from infection to initiation of CIAI was 19.7 days, and mean duration of CIAI was 6.1 days. Temporary discharge from the catheter site at the time of removal was evident in 8 horses. Dysfunction of the infusion system occurred in 2 horses and was corrected during the course of treatment. No long-term complications were reported. Thirty-nine (93%) synovial infections in 29 (94%) horses were resolved. Twenty adult horses and 8 foals were discharged from the hospital, and 19 of 24 horses with long-term follow-up performed their intended use. CONCLUSIONS AND CLINICAL RELEVANCE-CIAI was a useful adjunctive treatment for septic synovitis and allowed intrasynovial antimicrobial delivery into a variety of synovial cavities.

Discharge regime and the effect of drying on macroinvertebrate communities in a temporary karst stream in East Westphalia (Germany)

The special hydrological situation of temporary streams has a great influence on the abiotic processes and other habitat conditions for organisms. To monitor possible impacts of stream drying on the composition of lotic communities, streamflow measurements and collections of the macrozoobenthos were conducted in a temporary and an adjacent upstream permanent section of the karst stream Sauer (East Westphalia, Germany) in 1996. The Sauer has a summer-dry temporary flow regime. The seasonal dry phase can last from spring to early autumn, so the duration of the dry phase varies from one to several months, increasing with distance downstream from the upstream permanent section. The number of invertebrate taxa and individuals decreases with increasing duration of the dry phase. The permanent section is characterized by taxa typical of montane and submontane streams, whereas the fauna of the temporary section is quite different, composed of representatives of various zonal areas. Limnephilid caddisflies are particularly characteristic of this section. Life cycle strategies and specific adaptations with respect to habitat drying are discussed for several species. It can be concluded that the temporary discharge regime of the karst stream Sauer has a clear effect on the invertebrate communities. They mainly consist of species which can be seen as characteristic faunal elements of temporary streams.

Early voiding difficulty after colposuspension

To determine the incidence of post-operative voiding dysfunction (POVD) after colposuspension and to identify pre-operative risk factors. A retrospective study of 100 women having colposuspension to determine the preoperative clinical assessment (history, physical examination, symptom-specific questionnaire and visual analogue score assessment of urological symptoms), pre-operative urodynamic investigations (uroflowmetry, twin-channel subtracted cystometry and video-cystourethrography), information on post-operative catheter management and the presence and management of any POVD. Twenty-one women experienced significant POVD attributable to their colposuspension. This resolved within 6 months in 19, but persisted beyond 6 months in two. Women experiencing POVD were significantly older and were more likely to have previously undergone a hysterectomy. The risk of POVD was 12% for those aged < 50 years, 25% at age 50-64, and 50% for those over 65 years. The duration of post-operative catheterization was related to the presence of symptoms of voiding difficulty. The risk of POVD after colposuspension increases with age. In women over 65 years old, consideration should be given to an elective temporary discharge home with a suprapubic catheter in situ for 7-10 days before initiating a catheter-clamping regimen.

ROLE OF PHOTOTHERAPY, LASER THERAPY, BRACHYTHERAPY, AND PROSTHETIC STENTS IN THE MANAGEMENT OF LUNG CANCER

The short-term safety and efficacy of a self-expandable metallic colonic stent (SEMS) insertion followed by elective surgery, “bridge to surgery (BTS)”, for malignant large-bowel obstruction (MLBO) have been well described comparing with emergency surgery. The aim of this study was to compare short-term outcomes of endoscopic decompression using a SEMS versus a transanal decompression tube (TDT).From January 2005 to November 2014, a total of 101 patients with MLBO underwent surgery at our single institution were retrospectively identified. Among them, 73 patients who underwent preoperative complete insertion of a decompression device (TDT, n = 45; SEMS, n = 28) were finally included in this study. Six patients with incomplete insertion of a decompression device (TDT, n = 5; SEMS, n = 1) were also excluded. The primary endpoints of this study were the postoperative morbidity and mortality rates. The secondary endpoints were decompression-related outcomes. Additionally, propensity score matched (PSM) analysis was conducted in short-term outcomes between the groups.The SEMS group had significantly higher proportion of right-sided tumor and bigger tumor size compared with those of the TDT group. The SEMS group had a significantly higher proportion of patients who underwent laparoscopic surgery, and consequently, a longer surgical duration than did the TDT group. Higher rates of insertion failure and perforation were recognized in the TDT group than in the SEMS group (10.0% versus 3.6% and 8.9% versus 0.0%, respectively), although these differences were not statistically significant (P = 0.406 and 0.291, respectively). The two groups showed similar occurrences of anastomotic leakage, bowel obstruction, overall complications, and mortality. Compared with the TDT group, the SEMS group had a significantly lower rate of surgical site infection (24.4% versus 3.6%, respectively; P = 0.023 and P = 0.025 after PSM) and a shorter length of hospital stay (median, 21 d [interquartile range, 18-29 d] versus 38 d [interquartile range, 28-45 d], respectively; P = 0.015 and P = 0.003 after PSM). Solid food intake after decompression and preoperative temporary discharge occurred only in the SEMS group.Preoperative SEMS insertion for MLBO is effective with at least equivalent short-term outcomes and superior preoperative quality of life compared with decompression using TDT.

Various Urinary Properties in Bladder Tumor Patients

Urinary electrolytes, pH, urea nitrogen, creatinine, uric acid and osmolarity were measured in patients with bladder tumors and compared with those of a control group. There were 41 bladder tumor patients ranging in age from 29 to 87 (average 64) years with a male:female ratio of 32:9. According to histopathological classification of the bladder tumors, there were 34 transitional cell carcinomas (TCC) (21 G1, 10 G2, 3 G3), four squamous cell carcinomas, two adenocarcinomas and one inverted papilloma. The control group comprised 29 patients ranging in age from 35 to 80 (average 63) years with a male:female ratio of 26:3. Four urine samples were collected from each patient: early morning on the day of admission, just after admission, early morning on the day of return to hospital after temporary discharge, immediately after return to hospital after temporary discharge. The results indicated that the urinary Ca2+ and uric acid values were significantly lower in the bladder tumor group than in the control group. The urinary pH tended to be somewhat higher than in the control group, and the pH values tended to be especially high in the TCC G3 patients. There were differences in the various urinary properties between the TCC G1 and G2 and the TCC G3 patients.