Effects of the Pringle manoeuvre on the healing of left colonic anastomoses in rats

BACKGROUND

Whether to perform colorectal cancer and liver metastasis resections simultaneously or in separate procedures is controversial. The aim of the present study was to investigate the effect of the Pringle manoeuvre on the healing of left-sided colonic anastomoses in rats.

METHODS

Sixteen rats were randomly separated into two groups. In Groups 1 and 2, 1 cm of descending colon was resected and a primary anastomosis was performed. In Group 2, an intermittent pedicle clamp (the Pringle manoeuvre) was performed. On postoperative day 5, laparotomy was performed and the bursting pressures of all colon anastomoses were determined. Tissues were sampled for assay of hydroxyproline levels. Cultures of intraperitoneal swabs were also performed.

RESULTS

Clostridium was twice as abundant in the Pringle manoeuvre group as in the control group (p < 0.05). Anastomosis-bursting pressures and tissue hydroxyproline levels were significantly lower in the Pringle manoeuvre group than in the control group (p < 0.05).

CONCLUSIONS

The Pringle manoeuvre may compromise the viability of colonic anastomoses.

Effects of tyrosine kinase inhibitor E7080 and eNOS inhibitor L-NIO on colorectal cancer alone and in combination

OBJECTIVE

To investigate the effects of E7080 and N (5)-(1-iminoethyl)-L-ornithine dihydrochloride (L-NIO) on colorectal cancer alone and in combination.

METHODS

HT29 colorectal cancer cell line from Sap Institute was used. Real-time cell analysis (xCELLigence system) was performed to determine the effects of E7080 and L-NIO on colorectal cell proliferation. While apoptosis was determined with Annexin V staining, and the effect of agents on angiogenesis was determined with chorioallantoic membrane (CAM) model.

RESULTS

We found that E7080 has a strong antiproliferative effect with an half maximum inhibition of concentration (IC50) value of 5.60×10(-8) mol/L. Also it has been observed that E7080 showed antiangiogenic and apoptotic effects on HT29 colorectal cancer cells. Antiangiogenic scores of E7080 were 1.2, 1.0 and 0.6 for 100, 10 and 1 nmol/L E7080 concentrations, respectively. Furthermore, apoptosis has been detected in 71% of HT29 colorectal cancer cells after administration of 100 nmol/L E7080 which may indicate strong apoptotic effect. Meanwhile administration of L-NIO alone did not show any effect, but the combination of E7080 with L-NIO increased the antiproliferative, antiangiogenic and apoptotic effects of E7080.

CONCLUSIONS

Results of this study indicate that E7080 may be a good choice in treatment of colorectal tumors. Furthermore the increased effects of E7080 when combined with L-NIO raise the possibility to use a lower dose of E7080 and therefore avoid/minimize the side effects observed with E7080.

Hematological presentation in systemic lupus erythematosus and its relationship with disease activity

Abnormalities of hematological system are very common in systemic lupus erythematosus (SLE). The aim of the study is to evaluate hematological findings in patients with SLE at the time of referral and their relationship with disease activity and organ involvement. The study was carried consecutive 115 patients, including 20 males and 85 females. Most of the cases had anemia at the time of presentation due to various etiologies. Anemia of chronic disease was seen in 46% and it was the most common encountered picture. The rate of hemolytic anemia was 28%, and Coombs' positivity rate was 22% among our patients. Leukopenia ( < 4.0 x 10(9)/l), neutropenia ( < 1.8 x 10(9)/l), and lymphopenia ( < 1.5 x 10(9)/l) rates were 57, 20, and 82%, respectively. Thrombocytopenia was seen in 40% for < 150 x 10(9)/l, 26% for < 100 x 10(9)/l, and 8% for < 50 x 10(9)/l. Of our patients, 10% had antiphospholipid syndrome (APS) at the time of diagnosis. Increased fibrinogen levels were observed in 35% without relating to disease activity. The rates of C3 and C4 hypocomplementemia were 86 and 64%, respectively, and both are closely correlated with the disease activity. Moreover, C3 hypocomplementemia was more prominent in cases with renal or serosal involvement. Leukopenia and hyperfibrinogenemia were more common in patients with skin/mucosal involvements. C3 hypocomplementemia, APS and elevated IgG levels were more common in our patients with renal involvement. SLE should be kept in mind while evaluating patients with mentioned hematological findings, especially in those with accompanying organ involvements.

Antitumoral effects of Melissa officinalis on breast cancer in vitro and in vivo

BACKGROUND

There is a long standing interest in the identification of medicinal plants and derived natural products for developing cancer therapeutics. Here we investigated the antiproliferative properties of Melissa officinalis (MO) from Turkey on breast cancer.

METHODS

MO extracts were studied for cytotoxicity against breast cancer cell lines (MCF-7, MDA-MB-468 and MDA-MB-231). In vitro apoptosis studies were performed by annexin V staining and flow cytometry analyses. Immunohistochemistry for Ki-67 and caspase 7 in the tumoral tissue sections of DMBA-induced mammary tumors in rats was also performed, along with TUNEL assays to detect apoptotic cells. In vivo anticancer activity testing was carried out with reference to inhibition of growth of DMBA induced mammary tumors in rats.

RESULTS

MO showed cytotoxicity against three cancer cell lines, inducing increase in Annexin-positive cells. Expression of caspase-7 protein and TUNEL positive cells were much higher in rats treated by MO, compared with the untreated control group, while expression of Ki-67 was decreased. Furthermore, in vivo studies showed that mean tumor volume inhibition ratio in MO treated group was 40% compared with the untreated rats.

CONCLUSION

These results indicated that MO extrcts have antitumoral potential against breast cancer.

Antitumor effects of Origanum acutidens extracts on human breast cancer

PURPOSE

There has been a long-standing interest in the identification of medicinal plants and derived natural products for developing anticancer agents. This work aimed at investigating the antiprolipherative properties of Origanum acutidens (OA) on breast cancer.

METHODS

OA water extracts were studied for cytotoxicity against the breast cancer cell lines MCF-7, MDA-MB-468 and MDA-MB-231. In vitro apoptosis studies of these cancer cell lines were performed by annexin V staining in flow cytometry analyses. Immunohistochemistry studies for Ki-67 and caspase-7 of tumor tissue sections of dimethylbenzanthracene (DMBA) -induced mammary cancer in rats were also performed. TUNEL assay was used to detect apoptotic cells of tumor tissue. In vivo anticancer activity testing was carried out by inhibiting the growth of DMBA-induced mammary cancer in rats.

RESULTS

OA showed cytotoxicity on all 3 cancer cell lines. Annexin-positive cells level in OA-treated cell lines were significantly higher compared with untreated control cells (p=0.002). The expressions of caspase-7 protein and TUNEL-positive cells were much higher for the rats treated by OA, compared with the untreated control group (p<0.05). The expressions of the Ki-67 decreased in the treated groups compared with the control group (p<0.05). In vivo studies showed that the mean tumor volume inhibition ratio in OA-treated group was 41 % compared with the untreated rats (p<0.05).

CONCLUSION

These results indicate that OA has antitumor activity against breast cancer cell lines.

Effects of cannabinoid agonists on sheep sphincter of oddi in vitro

BACKGROUND/AIMS

According to recent studies, the endocannabinoid system plays an important role in both physiological and pathophysiological situations. The purpose of the present study was to investigate the effects of cannabinoid (CB) agonists on isolated sheep sphincter of Oddi (SO)in vitro.

METHODS

The isolated sheep SO tissues were mounted in organ baths and tested for isometric tension and cyclic GMP levels (cGMP) in response to the non-selective CB receptor agonist WIN 55,212-2 and the potent CB1 receptor agonist methanandamide in the presence and absence of the selective CB1 antagonist SR 141716A, the selective CB2 antagonist SR 144528 and the nonspecific inhibitor of nitric oxide (NO) synthase L-NAME.

RESULTS

CB agonists relaxed SO in a concentration-dependent manner. These relaxations did not reduce in the presence of SR 144528 but were significantly reduced by SR 141716A and L-NAME. Carbachol significantly increased the cGMP levels compared with the control group and both of the CB receptor agonists significantly increased the cGMP levels compared with the control and carbachol groups. On the other hand, L-NAME prevented the increase in cGMP levels caused by CB agonists.

CONCLUSION

These results show that the relaxation by the agonists may be through CB1 receptors. The decrease of CB relaxation responses by L-NAME, a nonspecific inhibitor of NO synthase, and the increase of cGMP levels in the SO tissues by CB agonists which decreased by L-NAME show that the relaxation effects of these agonists may also partially be via increasing the NO synthesis or release.

Balneotherapy in fibromyalgia: a single blind randomized controlled clinical study

We aimed to evaluate the effectiveness of balneotherapy in fibromyalgia management. Fifty women with fibromyalgia under pharmacological treatment were randomly assigned to either the balneotherapy (25) or the control (25) group. Four patients from the balneotherapy group and one patient from the control group left the study after randomization. The patients in the balneotherapy group (21) had 2 thermomineral water baths daily for 2 weeks in Tuzla Spa Center. The patients in the control group (24) continued to have their medical treatment and routine daily life. An investigator who was blinded to the study arms assessed the patients. All patients were assessed four times; at the beginning of the study, at the end of the 2nd week, the 1st month, and the 3rd month after balneotherapy. Outcome measures of the study were pain intensity, Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), patient's global assessment, investigator's global assessment, SF-36 scores, and tender point count. Balneotherapy was found to be superior at the end of the cure period in terms of pain intensity, FIQ, Beck Depression Inventory, patient's global assessment, investigator's global assessment scores, and tender point count as compared to the control group. The superiority of balneotherapy lasted up to the end of the 3rd month, except for the Beck Depression Inventory score and the investigator's global assessment score. Significant improvements were observed in PF, GH, and MH subscales of SF-36 during the study period in the balneotherapy group; however, no such improvement was observed in the control group. Balneotherapy was superior only in VT subscale at the end of therapy and at the end of the third month after the therapy as compared to the controls. It was concluded that balneotherapy provides beneficial effects in patients with fibromyalgia.

A destructive urban transformation project resulting with a social transformation process in Ankara-Turkey

Introduction

Dikmen Valley is a slum district where the Municipality of Ankara intended to start an urban transformation project. Dikmen neighborhood includes nearly 1000 houses which the Municipiality attempted to pull down suddenly at night in the winter of 2007.

Residents of Dikmen Valley resisted and managed to stop this attempt. Whole event was experienced as an acute trauma as well as a continuous experience of anxiety because of ongoing risk of another attack.

Aim

The aim of the present study was to investigate the psychological consequences of the whole process.

Methods

The study sample consisted of 201 individuals from 106 households, and a total of 178 individuals from 102 households was taken as comparison group from another slum neighborhood where residents did not experience any threat to their houses. The Beck Depression Inventory, the Spielberger Trait Anxiety Scale, and the General Self-Efficacy Scale were used for assessment.

Results

Dikmen sample was found to have a statistically significant higher mean score of anxiety and depression compared to the comparison group. Dikmen had a higher level of general self-efficacy belief than the comparison group after controlling for depression and anxiety scores.

Conclusions

Although the traumatic process after an attack of pulling down and the threat of losing one's house resulted with a depressive state and anxiety in Dikmen residents, unexpectedly they had a high level of general self-efficacy. To the researchers’ observations, a social transformational process has been realized resulting with an overall high general self-efficacy level in Dikmen neighborhood.

Small bowel tumors in emergency surgery

BACKGROUND

The aim of the present study was to describe the clinical presentation, diagnostic work-up, surgical therapy, and prognosis of 13 patients with small bowel tumor admitted for surgical procedures in an emergency setting.

METHODS

From 1996 to 2008, 13 consecutive surgical cases of small bowel tumors were treated at the Cumhuriyet University Faculty of Medicine, Department of General Surgery, and Kütahya State Hospital, Department of General Surgery. Clinical and radiological charts of these patients were reviewed retrospectively from the department database.

RESULTS

Intestinal obstruction (7 cases) and perforation (5 cases) were the most common clinical presentations, followed by intussusception (1 case). Adenocarcinoma was the most frequent histologic type (4 cases), while small bowel sarcoma was seen in three cases and non-Hodgkin lymphoma in two cases. The remaining cases had carcinoid tumor, small bowel angioleiomyoma, Brunner's gland adenoma, and inflammatory pseudotumor of the small intestine.

CONCLUSION

Small bowel tumors are rare, the symptoms often non-specific, and the accuracy of different diagnostic tests remains to be improved. Timing and type of the intervention to the process and biological behavior of the pathological cells predict the prognosis.

Epigenetic inactivation of tumor suppressor SFRP2 and point mutation in KRAS proto-oncogene in fistula-associated mucinous type anal adenocarcinoma: report of two cases

The secreted frizzled-related proteins (SFRPs) genes are unmethylated in normal colorectal mucosa tissue but aberrant methylation profiles can be detected in colorectal cancer (CRC), adenomas, and in aberrant crypt foci. The aim of the current study was to clarify whether SFRP2 methylation and K-ras structural mutation in fecal DNA can be found in stool and tumoral tissues of individuals with fistula-associated mucinous type anal adenocarcinomas (MTAA).Two man patients (68 and 56 years old) were treated for anorectal fistula in the surgical department. Patients were evaluated for clinical findings, tumoural tissue samples were examined histopathologically and DNA from fecal and tumoral tissue samples were isolated. K-ras mutation and promoter hypermethylation of SFRP2 gene in tumoral tissues were assessed by methylation-specific PCR based stripAssay hybridisation technique (Me-PCR) and compared to the healthy controls. Fecal and tumoural tissue samples from both patients were found to be fully hypermethylated profiles for SFRP2 gene and combined point mutations were detected in codon 12 and 13 of K-ras proto-oncogene. The current results showed that the combined effects of somatic mutations in K-ras and epigenetic alterations in SFRP2 genes may play an active role in the development of mucinous type anal adenocarcinoma.

Levothyroxine versus ketotifen in the treatment of patients with chronic urticaria and thyroid autoimmunity

BACKGROUND

Thyroid hormone replacement therapy has previously been discussed as a feasible therapeutic approach in patients with chronic urticaria and/or angio-oedema (CUA) and thyroid autoimmunity (TA).

OBJECTIVE

The efficacy of levothyroxine was investigated in patients with CUA and TA by comparing it with ketotifen treatment.

METHODS

A total of 60 patients with CUA and TA were included in the study. Patients were divided into two groups, which were matched with respect to sex, age and symptom score. Each group consisted of 30 patients. Patients in one group were treated with ketotifen and the other with levothyroxine. After completion of the treatment periods, the pre- and post-treatment symptom scores, onset time of drug effects, duration of symptom-free period, recurrence ratios, recurrence times and side effects were evaluated for each drug. The two drugs were compared with each other according to these parameters.

RESULTS

Ketotifen treatment provided significant relief of symptoms. However, these beneficial effects were observed only in ongoing treatment. Symptoms reappeared in all patients during the drug-free follow-up period. On the other hand, 18 of 30 patients were completely improved and three patients partially improved with levothyroxine treatment. Symptoms did not recur in the completely improved patients.

CONCLUSION

Levothyroxine is an important and inexpensive treatment alternative in patients with CUA and TA.

Feasibility analysis of color removal from textile dyeing wastewater in a fixed-bed column system by surfactant-modified zeolite (SMZ)

In this study, the ability of surfactant-modified zeolite (SMZ) to remove color from real textile wastewater was investigated. Tests were performed in a fixed-bed column reactor and the surface of natural zeolite was modified with a quaternary amine surfactant hexadecyltrimethylammonium bromide (HTAB). The zeolite bed that was modified at 1 g L(-1) HTAB concentration and HTAB flow rate of 0.015 L min(-1) showed good performance in removing color. Effects of wastewater color intensity, flow rates and bed heights were also studied. Wastewater was diluted several times in the ratios of 25%, 50% and 75% in order to assess the influence of wastewater strength. The breakthrough curves of the original and diluted wastewaters are dispersed due to the fact that breakthrough came late at lower color intensities and saturation of the bed appeared faster at higher color intensities. The column had a 3-cm diameter and four different bed heights of 12.5, 25, 37.5 and 50 cm, which treated 5.25, 19.50, 35.25 and 51 L original textile wastewater, respectively, at the breakthrough time at a flow rate of 0.025 L min(-1). The theoretical service times evaluated from bed depth service time (BDST) approach for different column variables. The calculated and theoretical values of the exchange zone height were found with a difference of 27%. The various design parameters obtained from fixed-bed experimental studies showed good correlation with corresponding theoretical values, under different bed heights. The regeneration of the SMZ was also evaluated using a solution consisting of 30 g L(-1) NaCl and 1.5 g L(-1) NaOH at pH 12 and temperature 30 degrees C. Twice-regenerated SMZ showed the best performance compared with the others while first- and thrice-regenerated perform lower than the original SMZ.

Color removal from textile dyebath effluents in a zeolite fixed bed reactor: determination of optimum process conditions using Taguchi method

Taguchi method was applied as an experimental design to determine optimum conditions for color removal from textile dyebath house effluents in a zeolite fixed bed reactor. After the parameters were determined to treat real textile wastewater, adsorption experiments were carried out. The breakthrough curves for adsorption studies were constructed under different conditions by plotting the normalized effluent color intensity (C/C(0)) versus time (min) or bed volumes (BV). The chosen experimental parameters and their ranges are: HTAB concentration (C(htab)), 1-7.5 gL(-1); HTAB feeding flowrate (Q(htab)), 0.015-0.075 L min(-1); textile wastewater flowrate (Q(dye)), 0.025-0.050 L min(-1) and zeolite bed height (H(bed)), 25-50 cm, respectively. Mixed orthogonal array L(16) (4(2)x2(2)) for experimental plan and the larger the better response category were selected to determine the optimum conditions. The optimum conditions were found to be as follows: HTAB concentration (C(htab))=1g L(-1), HTAB feeding flowrate (Q(htab))=0.015 L min(-1), textile wastewater flowrate (Q(dye))=0.025 L min(-1) and bed height (H(bed))=50 cm. Under these conditions, the treated wastewater volume reached a maximum while the bed volumes (BV) were about 217. While HTAB concentration, gL(-1) (A); zeolite bed height, cm (D) and wastewater flowrate, L min(-1) (C) were found to be significant parameters, respectively, whereas, HTAB flowrate, L min(-1) (B) was found to be an insignificant parameter.

Performance of emergency medicine residents in the interpretation of radiographs in patients with trauma

BACKGROUND

Radiographs are vital diagnostic tools that complement physical examination in trauma patients. A study was undertaken to assess the performance of residents in emergency medicine in the interpretation of trauma radiographs.

METHODS

348 radiographs of 100 trauma patients admitted between 1 March and 1 May 2007 were evaluated prospectively. These consisted of 93 cervical spine (C-spine) radiographs, 98 chest radiographs, 94 radiographs of the pelvis and 63 computed tomographic (CT) scans. All radiological material was evaluated separately by five emergency medicine residents and a radiology resident who had completed the first 3 years of training. The same radiographs were then evaluated by a radiologist whose opinion was considered to be the gold standard. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated.

RESULTS

The mean (SE) age of the patients was 29 (2) years (range 2-79). There were no statistically significant differences in terms of pathology detection between the emergency medicine residents and the radiologist. The agreement between the emergency medicine residents and the radiology resident was excellent for radiographs of the pelvis and the lung (kappa (kappa) = 0.928 and 0.863, respectively; p<0.001) and good for C-spine radiographs and CT scans (kappa = 0.789 and 0.773, respectively; p<0.001).

CONCLUSIONS

Accurate interpretation of radiographs by emergency medicine residents who perform the initial radiological and therapeutic interventions on trauma patients is of vital importance. The performance of our residents was found to be satisfactory in this regard.

Reduced dose of lenograstim is as efficacious as standard dose of filgrastim for peripheral blood stem cell mobilization and transplantation: a randomized study in patients undergoing autologous peripheral stem cell transplantation

In vitro studies have demonstrated a 27% increased efficacy of lenograstim over filgrastim. However, equal doses of 10 microg/kg/day of filgrastim and lenograstim have been recommended for mobilization of CD34+ cells without associated chemotherapy. In this study, we investigated whether a 25% reduced dose of lenograstim at 7.5 microg/kg/day is equavalent to 10 microg/kg/day filgrastim for autologous peripheral blood stem cell (PBSC) mobilization and transplantation. A total of 40 consecutive patients were randomized to either filgrastim (n = 20) or lenograstim (n = 20). The two cohorts were similar in regard to disease, sex, body weight, body surface area, conditioning regimens, previous chemotherapy cycles and radiotherapy. Each growth factor was administered for 4 consecutive days. The first PBSC apheresis was done on the 5th day. In the posttransplant period, the same G-CSF was given at 5 microg/kg/day until leukocyte engraftment. Successful mobilization was achieved in 95% of patients. Successful mobilization with the first apheresis, was achieved in 10/20 (50%) patients in the filgrastim group versus 9/20 (46%) patients in the lenograstim group. No significant difference was seen in the median number of CD34+cells mobilized, as well as the median number of apheresis, median volume of apheresis, percentage of CD34+ cells, and CD34+ cell number. Leukocyte and platelet engraftments, the number of days requiring G-CSF and parenteral antibiotics, the number of transfusions were similar in both groups in the posttransplant period. Lenograstim 7.5 microg/kg/day is as efficious as filgrastim 10 microg/kg/day for autologous PBSC mobilization and transplantation.

Magnesium, Zinc, Copper, Manganese, and Selenium Levels in Postmenopausal Women with Osteoporosis. Can Magnesium Play a Key Role in Osteoporosis?

Introduction: There has been a resurgence of interest in studies concerning the role of elements in the development and maintenance of the skeleton. The aim of the study was to assess the plasma and red blood concentrations of some elements in postmenopausal women with osteoporosis. Materials and Methods: Seventy-seven postmenopausal women with osteoporosis aged 61 years (median interquartile range, 7.5; range, 46 to 74) and 61 age- and BMI-matched healthy postmenopausal women aged 60 years (median interquartile range, 8.0; range, 44 to 76) were included in the study. Element concentrations in plasma and red blood cells including magnesium (Mg), zinc, copper, manganese, and selenium were measured by atomic absorption spectrophotometry in both postmenopausal women with osteoporosis and healthy postmenopausal women. Results: Only statistically significant difference between the osteoporotic (51.51 [15.40] μg/mL) and healthy subjects (54.54 [15.42] μg/mL) was observed in red blood cell (RBC) magnesium concentration (Z = -2.07, P = 0.039). However, no significant difference was found between patient and control groups, both in plasma and in red blood concentrations, for zinc, copper, manganese, and selenium. Conclusion: Mg levels in red blood cells are significantly lower in postmenopausal women with osteoporosis. It is concluded that Mg transport mechanism(s) into the cell could be affected in patients with osteoporosis. Key words: Copper, Magnesium, Manganese, Osteoporosis, Selenium, Zinc

Magnesium, zinc, copper, manganese, and selenium levels in postmenopausal women with osteoporosis. Can magnesium play a key role in osteoporosis?

INTRODUCTION

There has been a resurgence of interest in studies concerning the role of elements in the development and maintenance of the skeleton. The aim of the study was to assess the plasma and red blood concentrations of some elements in postmenopausal women with osteoporosis.

MATERIALS AND METHODS

Seventy-seven postmenopausal women with osteoporosis aged 61 years (median interquartile range, 7.5; range, 46 to 74) and 61 age- and BMI-matched healthy postmenopausal women aged 60 years (median interquartile range, 8.0; range, 44 to 76) were included in the study. Element concentrations in plasma and red blood cells including magnesium (Mg), zinc, copper, manganese, and selenium were measured by atomic absorption spectrophotometry in both postmenopausal women with osteoporosis and healthy postmenopausal women.

RESULTS

Only statistically significant difference between the osteoporotic (51.51 [15.40] microg/mL) and healthy subjects (54.54 [15.42] microg/mL) was observed in red blood cell (RBC) magnesium concentration (Z=-2.07, P=0.039). However, no significant difference was found between patient and control groups, both in plasma and in red blood concentrations, for zinc, copper, manganese, and selenium.

CONCLUSION

Mg levels in red blood cells are significantly lower in postmenopausal women with osteoporosis. It is concluded that Mg transport mechanism(s) into the cell could be affected in patients with osteoporosis.

Ammonium removal from sanitary landfill leachate using natural Gördes clinoptilolite

Removal of ammonium ion (NH(4)(+)) from leachate from Odayeri sanitary landfill, located in the European part of Istanbul, was examined using Gördes (Turkish) clinoptilolite. The effects of pH, flow rate, ammonium concentration and competitive cations on the removal efficiency were investigated in both batch and column studies. Thomas model were used to analyze the breakthrough data. Nonlinear least square method was applied for fitting the column data. The competitive effect was observed more effective in lower ammonium concentration and higher cation concentrations. Conditioning and regeneration using NaCl improved removal efficiency of ammonium from leachate.