Differences in Analgesia Methods for Open Gastrointestinal Surgery Are Not Associated With Initial Postoperative Ambulation.

Background: A characteristic of modern medical care is the reduction in the length of hospital stay, and several facilities across Japan are working towards this goal. The presence of postoperative pain is correlated with the number of days to hospital discharge. Therefore, this study investigated the relationship between the analgesic methods used in clinical practice and the initial ambulation of postoperative laparotomy patients with severe postoperative worked incisional pain to enable better analgesic management in the future. Methods: This retrospective study collected information from the medical records of 117 patients who underwent laparotomy between December 1, 2019, and October 13, 2020, at the Department of Gastroenterology of the International University of Health and Welfare Mita Hospital. Based on the failure or success of the ambulation process, the patients were divided into the delayed and successful groups, respectively. Results: In the delayed group, patient-controlled epidural analgesia (PCEA) was used in 32 patients, intravenous patient-controlled analgesia (IV-PCA) was used in two patients, continuous worked incisional infiltration anesthesia was used in one patient, and transvenous acetaminophen was used in one patient for postoperative analgesia. In the successful group, PCEA was used in 66 patients, IV-PCA was used in 11 patients, continuous worked incisional infiltration anesthesia was used in three patients, and acetaminophen administered intravenously at patient's request was used in one patient (P = 0.094). Conclusions: No significant differences were observed between different postoperative analgesia methods, suggesting that there may be no association between postoperative ambulation and the postoperative analgesia method.

Predictors of Catheter-Related Bladder Discomfort After Surgery: A Literature Review.

Background: Indwelling bladder catheters are routinely used in clinical practice. Patients may experience postoperative indwelling catheter-related bladder discomfort (CRBD). This study aimed to perform a literature review to identify predictors of postoperative CRBD. Methods: We searched PubMed for relevant articles published between 2000 and 2020 using the search items "CRBD", "catheter-related bladder discomfort", and "prediction". Additionally, we searched for articles that matched the research objectives from the references of the extracted articles. We included only prospective observational studies involving human participants and excluded interventional studies, observational studies that did not report sample sizes, or observational studies that did not research on predictors of CRBD. We narrowed our search to the keyword "prediction" and found five references. We selected five studies that met the objectives of the study as the target literature. Results: Using the keywords "CRBD" and "catheter-related bladder discomfort", we identified 69 published articles. The results were narrowed down by the keyword "prediction", and five studies that recruited 1,147 patients remained. The predictors of CRBD can be divided into four factors: 1) patient factors; 2) surgical factors; 3) anesthesia factors; and 4) device and insertion technique factors. Conclusion: Our study suggests that patients with predictors of CRBD should be closely monitored to reduce postoperative patient suffering, and their quality of life should be improved after anesthesia.

A Literature Review of Factors Related to Postoperative Sore Throat.

Postoperative sore throat can occur as a complication in patients who have undergone surgery under general anesthesia. The incidence of postoperative sore throat ranges from 12.1% to 70%, and its effects include damage to the epithelium and mucosal cells caused by airway securement, damage to the vocal cords, congestion, blood clots, and factors such as an inappropriately large tube, cuff shape, cuff pressure, and airway securement. Notably, there are individual differences in pain thresholds, and the sensation of pain is affected by mental states, such as anxiety, and varies from person to person. Therefore, we conducted a literature review using PubMed to clarify patient factors related to the development of postoperative sore throat. The extracted keywords were "postoperative sore throat," "anesthesia," and "patient factors." We found 16 articles that met our search criteria. We expanded the search period and retrieved 19 cases from 1990 to 2020. We also included references that were judged to be closely related to the list of citations of the retrieved references. The study designs included were randomized controlled trials, clinical trials, meta-analyses, reviews, and systematic reviews. The results showed that female sex, smoking, and age were the most common patient factors. However, we could not find any literature that studied the relationship between postoperative sore throat and mental states such as anxiety.

[Aconitine analogues in wild Aconitum plants: contents toxicity to mice and decrease by boiling].

Simultaneous determination of four aconitine analogues (ACs) (AC; aconitine, HA; hypaconitine, JA; jesaconitine, MA; mesaconitine) in leaves and roots of wild Aconitum plants (Aconitum japonicum THUNBERG, Aconitum okuyamae Nakai) was carried out to elucidate the relation between toxicity to mice and ACs content determind by liquid chromatography tandem mass spectrometry. The total amounts of ACs in leaves, roots, petals and nectaries of Aconitum japonicum collected at Sagae-shi Tashiro were 5.9 µg/g, 928.1 µg/g, 46.1 µg/g, and 69.8 µg/g, respectively. Despite the high contents in nectary, commercial honey contained no ACs. Extract of wild Aconitum japonicum roots which contained ACs (2.69 mg/g) was administered to 5 mice orally at 1.0 g/kg (fresh root equivalent), and 2 mice died. On the other hand, 3 of 5 mice died after being given the standard AC (3.0 mg/kg, p.o.). These findings confirmed good coincidence between toxicity and quantitative values. Mice given extract of Aconitum okuyamae root (100 g/kg, p.o.) without ACs showed no toxic symptoms. Residual ACs in Aconitum leaves were examined after boiling. The remaining percentage of ACs in leaves after 0.5 minutes boiling was 31.6%, and the amount in the boiling water was 54.5%. MA is converted into benzoylmesaconine by hydrolysis (by boiling). Therefore food poisoning caused by Aconitum plants is explained by detection of benzoylmesaconine formed during food preparation.

Laboratory investigation of an Escherichia coli O157:H7 strain possessing a vtx2c gene with an IS1203 variant insertion sequence isolated from an asymptomatic food handler in Japan.

We isolated an Escherichia coli O157:H7 strain that was negative for verocytotoxin production, but positive for the vtx2 gene using commercial kits, from an asymptomatic food handler. The laboratory investigations revealed that a 1310-bp insertion sequence, IS1203 variant, was present in the B subunit-coding region of the vtx2c gene.

Multimodal image registration using IECC as the similarity measure.

PURPOSE: The registration of images from positron emission tomography (PET) to those from magnetic resonance imaging (MRI) using mutual information is usually effective, but fails occasionally because of small region of overlap, low-activity defects in the PET image, difference in spatial resolution, etc. In this article, the authors propose the pixel-based individual entropy correlation coefficient (IECC) as a new, more accurate and more robust registration criterion. METHODS: The authors compare it to the current criteria: Mutual information (MI), normalized mutual information (NMI), and the entropy correlation coefficient (ECC). The anatomical region to be registered was the head. A rigid-body registration was used; no deformation was employed. The authors established the effectiveness of IECC by both simulated data and clinical studies using brain fluorodeoxyglucose (FDG) PET and MRI. Both a normal-activity FDG model and a FDG model with a perfusion defect were used for the PET image. Reconstruction by both filtered backprojection and by ordered subset-expectation maximization was investigated. RESULTS: The mean errors and SDs of IECC were 1.17 +/- 0.85 mm for translation and 1.04 +/- 1.28 degrees for rotation in clinical PET. Those of MI, NMI, and ECC were 1.86 +/- 1.22, 1.86 +/- 0.96, and 1.68 +/- 4 1.05 mm for translations and 1.52 +/- 1.84 degrees, 1.74 +/- 1.68 degrees, and 1.70 +/- 1.90 degrees for rotations. The mean errors and SDs of IECC were 1.56 +/- 0.58 mm for translation and 1.46 +/- 1.66 degrees for rotation in clinical PET model with a 30% perfusion defect. Those of MI, NMI, and ECC were 2.81 +/- 1.41, 2.98 +/- 1.80, and 3.29 +/- 2.08 mm for translations and 3.34 +/- 3.800, 2.87 +/- 3.25 degrees, and 3.04 +/- 3.44 degrees for rotations. The mean errors and SDs of IECC were 1.79 +/- 1.04 mm for translation and 1.64 +/- 1.62 degrees for rotation in clinical PET model with a 50% perfusion defect. Those of MI, NMI, and ECC were 3.49 +/- 1.92, 3.57 +/- 2.22, and 3.49 +/- 1.89 mm for translations and 4.12 +/- 4.24 degrees, 3.62 +/- 4.87 degrees, and 3.44 +/- 3.80 degrees for rotations. The significant differences between IECC and each of the other three criteria were found for displacement misregistration in almost all parameters (p < 0.01). CONCLUSIONS: Accuracy of the IECC criterion was higher than that of the other criteria, usually in a statistically significant way.

[Determination of illudin S in Omphalotus guepiniformis and foods that caused food poisoning by liquid chromatography with tandem mass spectrometry].

A simple method was developed for determination of illudin S in fungi (Omphalotus guepiniformis: poisonous mushroom) and a food that caused food poisoning, using liquid chromatography tandem mass spectrometry (LC/MS/MS). Illudin S in fungi and the food that caused food poisoning was extracted with methanol and then cleaned up with an Oasis HLB cartridge. LC separation was performed with an octadecylated silica column (Inertsil ODS-3, 2.1 mm i.d. x 150 mm) and a mobile phase of 0.1% formic acid-methanol (7 : 3) at a flow rate 0.2 mL/min. Mass spectral acquisition was performed in the positive mode and illudin S was targeted using multiple reaction monitoring (MRM) with electrospray ionization (ESI). The recoveries of illudin S were 84-94% from edible fungi (Lentinula edodes, Pleurotus ostreatus and Panellus serotinus). The detection limits of illudin S in the fungi (L. edodes, P. ostreatus and P. serotinus) were 0.08-0.10 microg/g respectively. Illudin S was detected in the food that caused food poisoning at the level of 2.0 and 15.1 microg/g in the soup and fungi, respectively. The recovery of illudin S from a mushroom soup (cooked at 100 degrees C for 10 min) sample which simulated food poisoning was 74.8%. These results indicate that the developed method is suitable for the determination of illudin S in fungi (O. guepiniformis) and foods that caused food poisoning.

[Simultaneous determination of aconitine analogues in Aconitum plants and foods that caused food poisoning by liquid chromatography with tandem mass spectrometry].

A simple method for the simultaneous determination of four aconitine analogues (AC; aconitine, HA; hypaconitine, MA; mesaconitine, JA; jesaconitine) in Aconitum plants (Aconitum subcuneatum NAKAI) and a food that caused food poisoning was developed, using liquid chromatography tandem mass spectrometry (LC/MS/MS). Aconitine analogues were extracted with 1 mmol/L HCl and then cleaned up with an Oasis HLB cartridge. The LC separation was performed with an octadecylated silica column (Develosil ODS-HG-5, 2.0 mm i.d. x 50 mm) at a flow rate of 0.2 mL/min, using A solution (5 mmol/L ammonium acetate dissolved in 0.1% acetic acid) and B solution (acetonitrile-THF=1 : 3), 90%A (0 min)-->60%A (15 min)-->const. (2 min). Mass spectral acquisition was performed in the positive mode and the analogues were targeted using multiple reaction monitoring (MRM) with electrospray ionization (ESI). The recoveries of aconitine analogues were 93-99% from Aconitum plants. The detection limits of AC, HA, MA and JA were 0.4, 0.4, 0.3 and 0.5 ng/g, respectively. The aconitine analogues, except JA, were detected in food that caused food poisoning at the level of 2.6-29.7 microg/g. These results indicate that the developed method is suitable for the determination of aconitine analogues in Aconitum plants and foods that cause food poisoning.