Mindfulness-based Stress Reduction Program for Psychiatric Inpatients / 정신간호학회지

PURPOSE: The purpose of this research was to examine the effects of a Mindfulness-based Stress Reduction (MBSR) program on stress response and power in psychiatric inpatients in a closed ward. METHODS: For this study a quasi-experiment design was used to examine the effects of the intervention. The MBSR program conducted in this study was a six-session program, in which participants were asked to meditate for 45 minutes twice a week for 3 weeks. Homogeneity between the experimental and control group was assessed using χ² test, t-test, and Fisher's exact test. The results of the assessment showed that the variances of the two groups were equal. Demographic variables of the study participants were analyzed using descriptive statistics. The study hypotheses were verified using t-test. Cronbach's α was measured to assess the reliability of each test. RESULTS: Compared with the control group, patients in the experimental group showed significant improvement in scores for stress response (t=3.62, p=.001) and power (t=-3.42, p=.001). CONCLUSION: These results suggest that the mindfulness meditation program can be used as a psychosocial rehabilitation intervention for psychiatric inpatients by capitalizing on its positive effects on emotional reactivity and behavioral regulation.

Early Experience of Laparoendoscopic Single-Site Nephroureterectomy for Upper Urinary Tract Tumors

PURPOSE: We evaluated the feasibility of a laparoendoscopic single-site (LESS) nephroureterectomy for an upper urinary tract tumor. MATERIALS AND METHODS: Between March 2009 and September 2009, 4 patients with upper urinary tract tumors underwent LESS nephroureterectomy. The mean age of the 2 female and 2 male patients was 69 years old, and their mean body mass index was 23.0. We used a homemade single-port device made with a surgical glove and a wound retractor, which were put into a 4 cm periumbilical incision. Operations with articulating and rigid laparoscopic instruments were performed transperitoneally. An open technique with a 4 cm additional midline incision and laparoscopic technique with an endoscopic stapler were used for the treatment of the distal ureter and bladder cuff. RESULTS: All cases were completed successfully, without conversion to conventional laparoscopy or open surgery. The mean operative time was 169.5 minutes. The mean estimated blood loss was 361.4 ml. One patient had transfusion and wound infection. The mean hospital stay was 7.8 days. The mean specimen weight and tumor size were 271.8 g and 2.9 cm. Pathologic results of all cases showed urothelial carcinoma with a negative surgical margin. Three patients were in stage T3N0M0 and 1 was in stage T2N0M0. CONCLUSIONS: Our initial experience shows that LESS nephroureterectomy with a homemade single-port device is technically feasible. However, long term follow-up for the effect on cancer control and technical development for comfortable surgery are needed.

Early Experience of Laparoendoscopic Single-Site Nephroureterectomy for Upper Urinary Tract Tumors

PURPOSE: We evaluated the feasibility of a laparoendoscopic single-site (LESS) nephroureterectomy for an upper urinary tract tumor. MATERIALS AND METHODS: Between March 2009 and September 2009, 4 patients with upper urinary tract tumors underwent LESS nephroureterectomy. The mean age of the 2 female and 2 male patients was 69 years old, and their mean body mass index was 23.0. We used a homemade single-port device made with a surgical glove and a wound retractor, which were put into a 4 cm periumbilical incision. Operations with articulating and rigid laparoscopic instruments were performed transperitoneally. An open technique with a 4 cm additional midline incision and laparoscopic technique with an endoscopic stapler were used for the treatment of the distal ureter and bladder cuff. RESULTS: All cases were completed successfully, without conversion to conventional laparoscopy or open surgery. The mean operative time was 169.5 minutes. The mean estimated blood loss was 361.4 ml. One patient had transfusion and wound infection. The mean hospital stay was 7.8 days. The mean specimen weight and tumor size were 271.8 g and 2.9 cm. Pathologic results of all cases showed urothelial carcinoma with a negative surgical margin. Three patients were in stage T3N0M0 and 1 was in stage T2N0M0. CONCLUSIONS: Our initial experience shows that LESS nephroureterectomy with a homemade single-port device is technically feasible. However, long term follow-up for the effect on cancer control and technical development for comfortable surgery are needed.

Vesicovaginal Fistula Repair Using a Transurethral Pointed Electrode / 대한배뇨장애요실금학회지

The most common cause of vesicovaginal fistulasis injury to the bladder at the time of surgery. The operation most frequently responsible for vesicovaginal fistula formation is hysterectomy. The first successful transvaginal approach to vesicovaginal fistula repair was reported by Sims in 1838. Although many surgical procedures exist, there is no best approach for all patients with vesicovaginal fistula. However, it is an essential surgical principle that the fistulous tract and scar should be excised completely. Here we report our technique using a transurethral pointed electrode for the treatment of multiple, small vesicovaginal fistulas and its outcome.

Dimethoxycurcumin, a Structural Analogue of Curcumin, Induces Apoptosis in Human Renal Carcinoma Caki Cells Through the Production of Reactive Oxygen Species, the Release of Cytochrome c, and the Activation of Caspase-3

PURPOSE: Curcumin (Cur) has been reported to induce apoptosis in human renal carcinoma Caki cells. Dimethoxycurcumin (DMC), one of several synthetic Cur analogues, has been reported to have increased metabolic stability over Cur. We determined whether DMC, like Cur, induces apoptosis in Caki cells and also compared the apoptosis-inducing activity of DMC with that of Cur. MATERIALS AND METHODS: Caki cells were treated with DMC possessing four methoxy groups, Cur possessing two methoxy groups, or bis-demethoxycurcumin (BMC), which lacks a methoxy group. Cell viability was measured by using a methyltetrazolium assay. Flow cytometry and the caspase-3 activity assay were used to detect apoptosis. The release of cytochrome-c (Cyt c) was detected by Western blot analysis. The production of reactive oxygen species (ROS) was measured by flow cytometry. RESULTS: DMC, Cur, and BMC reduced cell viability and induced apoptosis, but the potency varied; DMC was the most potent compound, followed by Cur and BMC. ROS production, Cyt c release, and caspase-3 activity were increased, again in the order DMC>Cur>BMC. N-Acetylcysteine, a potent antioxidant, inhibited ROS production, Cyt c release, caspase-3 activation, and apoptosis induction in DMC-treated cells. CONCLUSIONS: These results indicate that DMC, like the original form of Cur, may induce apoptosis in human renal carcinoma Caki cells through the production of ROS, the release of mitochondrial Cyt c, and the subsequent activation of caspase-3. In addition, DMC is more potent than Cur in the ability to induce apoptosis.

The Reliability of 1-Day Frequency-Volume Charts in Assessing Lower Urinary Tract Symptoms in Patients with Benign Prostate Hyperplasia

PURPOSE: The aim of this study was to evaluate the reliability of 1-day frequency-volume charts in assessing lower urinary tract symptoms (LUTS) in patients with benign prostate hyperplasia (BPH). MATERIALS AND METHODS: Between Jan. 2006 and Dec. 2006, we retrospectively analyzed the medical records of men with LUTS due to BPH who visited our out-patient department. All of 70 men completed 3-days frequency-volume chart for the initial evaluation of their LUTS. We compared mean values of variables with values from respective days. Test-retest reliability was evaluated by calculating intraclass correlation coefficient. RESULTS: The mean age was 66.7 years, mean prostate size was 33.6ml, mean IPSS was 18, and mean maximal flow rate was 13.8ml/s. The mean total voided volume was 1716.3ml/day, mean number of voids was 9.2/day, mean number of daytime voids was 7.1, and mean number of nocturnal voids was 2.0. No significant differences were found between the three 24-hr periods for the variables from the charts by ANOVA test. The intraclass correlation coefficients were mostly 0.7-0.9. But nocturnal bladder capacity was slightly less reliable than other variables, 0.557. Mean voiding volume, total voiding number, and daytime frequencyhad the high reliability. CONCLUSIONS: A 1-day frequency-volume charts can be sufficiently reliable to provide an insight into a patient's voiding behavior. But more research of high quality is required, especially into the relationship of frequency-volume charts duration with compliance.

Laparoscopic Partial Nephrectomy without Renal Arterial Clamping

PURPOSE: Renal vascular clamping during a laparoscopic partial nephrectomy is a time-consuming procedure with a risk of renal ischemia. To study the feasibility of laparoscopic partial nephrectomy without renal arterial clamping, we compared the procedure with laparoscopic partial nephrectomy with vascular clamping. MATERIALS AND METHODS: Seventeen patients underwent laparoscopic partial nephrectomy without renal arterial clamping (group 1) from February 2004 to June 2008. The operative results were reviewed retrospectively and compared with those of 16 patients who underwent laparoscopic partial nephrectomy with arterial clamping (group 2). Patient characteristics did not differ significantly between the 2 groups. However, exophytic tumors were detected in 13 patients in group 1 and 3 patients in group 2 (p=0.001). Scores on the preoperative aspects and dimensions used for an anatomical (PADUA) classification were 6.9 in group 1 and 7.7 in group 2 (p=0.037). All surgeries by the transperitoneal approach were performed by a single surgeon. RESULTS: The mean operative times were 103 and 130 minutes in groups 1 and 2, respectively (p=0.312). The mean renal arterial clamping time of group 2 was 27.6 minutes (range, 20-42 minutes). The mean estimated blood loss was 327 ml in group 1 and 315 ml in group 2 (p=0.971). The mean postoperative change in the glomerular filtration rate was 20.11 ml/min/1.73 m2 in group 1 and 18.95 ml/min/1.73 m2 in group 2 (p=0.748). The mean times to postoperative initiation of ambulation and of oral intake were 1.6 and 1.7 days (p=0.486) and 1.3 and 1.6 days (p=0.811) in groups 1 and 2, respectively. The mean length of hospital stay was 7.4 and 7.9 days in groups 1 and 2, respectively (p=0.9). The mean tumor size was 2.1 cm (range, 1-7 cm) in group 1 and 3.3 cm (range, 1.5-9 cm) in group 2. CONCLUSIONS: Laparoscopic partial nephrectomy without renal arterial clamping is feasible for a localized renal tumor. However, patients should be selected carefully, such as those with an exophytic tumor.