A case of primary cutaneous aspergillosis in a renal transplant recipient

Opportunistic fungal infections are life-threatening complications which are a major cause of morbidity and mortality in immunocompromized hosts such as those who have undergone organ transplantation. Aspergillosis comprises a spectrum of disease caused by a ubiquitous saprophytic mold. Invasive aspergillus is a serious life-threatening complication in immunocompromised hosts. Primary cutaneous aspergillosis occurs relatively less frequently and is poorly characterized. We report a case of cutaneous aspergillosis in a 51-year-old renal transplant recipient, which was successfully treated with local excision and concomitant antifungal therapy.

CASE

A 51-year-old male renal transplant recipient presented with cutaneous nodules on the dorsum of the right hand. He underwent renal transplantation for end-stage renal disease due to adult dominant polycystic kidney disease (ADPKD) 3 years prior. Initially he suffered an acute rejection episode that was treated with steroid pulse and OKT3 therapy. Eventually he was stabilized on a combination of tacrolimus, prednisone, and mycophenolate mofetil. Three years after transplantation, he developed painless multiple (largest one 5 x 3 cm sized) nodules on the dorsum of his right hand. He was afebrile with no systemic symptoms. A skin biopsy showed a dense solid infiltration of giant cells, histiocytes, and lymphoplasma cells admixed with intra- and extracellular fungal hyphae and spores. The hyphae were septate and acute angle branching, which was consistent with aspergillosis. Oral itraconazole 200 mg/d for 5 weeks was ineffective. Treatment with liposomal amphotericin B for 4 weeks was initiated and MMF was discontinued. The medication was well tolerated with no hepatotoxic effects. Although new lesions did not appear, existing ones did not significantly improve after 4 weeks of treatment. Therefore, most lesions were excised surgically and liposomal amphotericin B continued for 2 weeks followed by treatment with oral fluconazole for 2 months. Ten moths later there was no evidence of recurrence.

Primary immunosuppression with tacrolimus in kidney transplantation: Three-year follow-up in a single center

INTRODUCTION

The 1-year results of the phase III US Multicenter Trial comparing tacrolimus- and cyclosporine (Sandimmun)-based immunosuppressive therapy in kidney transplantation revealed a significant reduction in the incidence and severity of acute rejection episodes among patients maintained on tacrolimus. This retrospective, nonrandomized, single-center study represented 3-year data for patient and graft survival and safety in the tacrolimus-treated patients.

METHODS

Among 97 consecutive kidney transplant recipients 41 who received tacrolimus and 56 cyclosporine-based immunosuppression were followed for 3 years for patient and graft survivals and for the incidence of acute rejection episodes as well as serious adverse events.

RESULTS

The 3-year patient and graft survival rates for tacrolimus and cyclosporine were similar (91.0% vs 90.2%, 96.5% vs 95.0%). However, the incidence of acute rejection episodes was significantly lower in the tacrolimus (17.1%) compared with the cyclosporine group (35.7%, P = .043). There was a higher incidence of headache, posttransplant diabetes, and alopecia reported in the tacrolimus group, whereas hypertension, hypercholesterolemia, and hirsutism were more frequent in the cyclosporine group. The incidences of hand tremor, hyperkalemia, and viral infections were comparable in both groups. Two patients in the tacrolimus group were converted to cyclosporine due to nephrotoxicity and posttransplant diabetes, respectively, whereas 12 patients in the cyclosporine group were converted to tacrolimus as rescue therapy for acute rejection (41.7%), gingival hyperplasia (33.3%), nephrotoxicity (8.3%), neurotoxicity (8.3%), and hirsutism (8.3%), respectively.

CONCLUSION

The 3-year results of tacrolimus treatment show excellent efficacy and safety in kidney transplantation. Due to different side-effect profiles, it is necessary to develop individualized immunosuppressive strategies in kidney transplant recipients.

Mode transition induced by low-frequency current in dual-frequency capacitive discharges

The mode transition induced by varying the low-frequency current in low-pressure dual-frequency discharges in argon is found through particle-in-cell or Monte Carlo simulations. As the low-frequency (2 MHz) current increases for the fixed high-frequency (27 MHz) current, the electron distribution function (EDF) changes from Druyvesteyn to bi-Maxwellian (in alpha mode) or Maxwellian-type (in gamma mode), along with the significant drop in the effective electron temperature. It is shown that this EDF evolution is attributed to the transition from collisional to collisionless property (but not stochastic heating) of the low-energy electrons as well as the alpha-gamma transition.

Selegiline potentiates the effects of EGb 761 in response to ischemic brain injury

We evaluated whether combined treatment with selegiline, a selective MAO-B inhibitor, and EGb 761, a standard extract of Ginkgo biloba, has synergistic effects against ischemic reperfusion injury (IRI) in gerbils. Interestingly, we observed that pretreatment with EGb 761 significantly attenuated selegiline-induced hyperactivity. This finding paralleled striatal fos-related antigen immunoreactivity (FRA-IR) in mice. Four minutes of bilateral carotid artery occlusion caused substantial cell loss in the CA1 of the hippocampus 5 days post-ischemic insult. Pretreatment with EGb 761, with or without selegiline, significantly attenuated this neuronal loss. Combined treatment with EGb 761 plus selegiline was more efficacious in preventing this loss. Synaptosomal formations of protein carbonyl, lipid peroxidation (malondialdehyde (MDA) + 4-hydroxyalkenal (4-HDA)), and reactive oxygen species (ROS) in the hippocampus remained elevated 5 days post-ischemic insult. The antioxidant effects appeared to be most significant in the group treated with EGb 761 plus selegiline. This combined treatment produced more significant attenuation of IRI-induced alterations in intramitochondrial calcium accumulation, the mitochondrial transmembrane potential, and mitochondrial Mn-superoxide dismutase-like immunoreactivity (Mn-SOD-IR) than either treatment alone. Our results suggest that co-administration of EGb 761 and selegiline produces significant neuroprotective effects via suppression of oxidative stress and mitochondrial dysfunction without affecting neurological function.

Expression of the hepatitis B surface S and preS2 antigens in tubers of Solanum tuberosum

In an attempt to develop an edible vaccine, we transformed a recombinant hepatitis B virus (HBV) gene encoding the middle protein of HBV that contains the surface S and preS2 antigen into potato by Agrobacterium-mediated transformation. The HBV gene was under control of either the CaMV 35S promoter, the double 35S promoter with the AlMV 5' non-translated leader sequence, or the tuber-specific patatin promoter. HBV mRNA levels were higher with the 35S promoter than with the double 35S and patatin promoters; however, the levels of the S and preS2 antigen in the transformed tubers were higher with the patatin promoter than with the CaMV 35S and double promoters. The levels of preS2 antigen produced are the highest reported to date. Transgenic potato tubers were fed to mice, and the mice showed an immune response against the HBV S antigen.

Systemic-to-pulmonary venous shunt in superior vena cava obstruction: depiction on computed tomography venography

PURPOSE

To describe computed tomography (CT) venographic appearances of systemic-to-pulmonary venous shunts with CT venography and three-dimensional reconstruction images from patients with superior vena cava obstruction.

MATERIAL AND METHODS

From January 1994 to April 2002, CT venography was performed in 45 patients with superior vena cava obstruction using a single-detector helical CT scanner (n=38) and four-detector row CT scanner (n=7). Analysis of CT scan data included the cause and degree of venous obstruction, the presence of pleural thickening and enhancement, and the attenuation of pulmonary veins. The causative factor for systemic-to-pulmonary venous shunt was evaluated using the Fisher exact test.

RESULTS

Systemic-to-pulmonary venous shunts were observed in four patients (9%) who had high-attenuated pulmonary veins and pleural enhancement on CT venography. Pleural thickening (P=0.01) and a history of pulmonary tuberculosis (P=0.034) are statistically significant risk factors.

CONCLUSION

CT venography showed strong pleural enhancement and high-attenuated pulmonary veins indicating systemic-to-pulmonary venous shunts. Radiologists should study the earlier enhancement of pulmonary veins in patients with superior vena cava obstruction.

Hydrocele of the canal of Nuck in a girl: ultrasound and MR appearance

Hydrocele of the canal of Nuck is a rare condition in females. A small evagination of parietal peritoneum forms the canal of Nuck. Failure of complete obliteration of the canal results in either an indirect inguinal hernia or a hydrocele of the canal of Nuck. We present a case in a 7-year-old girl. On ultrasound, there was a comma-shaped cyst with the tail directed cranially toward the inguinal canal. The cyst had no internal echoes and demonstrated increased through transmission. Coronal and axial MR showed a thin walled cystic mass.

The clinicopathological significance of inferior mesenteric lymph node metastasis in colorectal cancer

AIMS

There are few studies reporting survival or recurrence patterns in colorectal cancer patients with inferior mesenteric lymph node metastasis (IMLN+). The present study evaluated the prognostic significance of patients being IMLN+ or IMLN- in colorectal cancer.

METHODS

Survival, recurrence pattern and treatment protocols were compared between 63 IMLN+ patients and 108 IMLN- patients with stage III and IV rectal and sigmoid cancer undergoing curative surgery. Lymph node sampling was routinely performed prior to inferior mesenteric artery ligation and excision flush with aorta. Limited principal node dissection including IMLN was performed in cases of identified node metastasis.

RESULTS

The 5-year disease-free survival rates were 50% in IMLN- and 31% in IMLN+ patients (P=0.004). The 5-year disease-free survival rate was greater in the N1 group than the N2 group (P=0.038). Cox regression analysis showed IMLN+, lymphovascular tumour invasion, T4, M1, and pre-operative serum CEA level over 6 ng/ml were independently associated with unfavorable disease-free survival. The prognostic significance of M category was greater when the IMLN+ was included in the M1 as opposed to the N category. In patients undergoing absolute curative surgery, post-operative recurrence rates were 34% for IMLN- and 57% for IMLN+ patients (P=0.009; OR, 2.611; 95% CI, 1.313-5.194). For IMLN+ patients, post-operative adjuvant treatment independently correlated with disease-free survival (P=0.029).

CONCLUSIONS

IMLN+ is an independent survival factor enhancing the prognostic significance of the M category in the AJCC staging. Curative radical surgery and post-operative chemoradiotherapy appears to be warranted for IMLN+ colorectal cancer patients as it resulted in 5-year disease-free survival rates of up to 31% compared to 50% in IMLN- patients.

Three-dimensional reconstructed images using multidetector computed tomography in evaluation of the biliary tract

The recent development of multidetector computed tomography (MDCT) and the parallel escalation in the capabilities of the workstation allow the use of high-quality multiplanar and three-dimensional reconstruction images. As a noninvasive technique, MDCT dedicated to the biliary tract represents an alternative to magnetic resonance cholangiography. The usefulness of three-dimensional reconstructed images using MDCT in evaluating biliary tract abnormality is illustrated.

Nutrient removal and microbial granulation in an anaerobic process treating inorganic and organic nitrogenous wastewater

The sustainable anaerobic nitrogen removal and microbial granulation were investigated by using a laboratory anaerobic granular sludge bed reactor, treating synthetic (inorganic and organic) wastewater and piggery waste. From inorganic synthetic wastewater, lithoautotrophic ammonium oxidation to nitrite/nitrate was observed by an addition of hydroxylamine. Also, the results revealed that the Anammox intermediates (particularly, hydrazine) contents in the substrate would be one of the important parameters for success of the anaerobic nitrogen removal process. The results from organic synthetic wastewater show that if the Anammox organism were not great enough in the startup of the process, denitritation and anaerobic ammonification would be a process prior to the Anammox reaction. The anaerobic ammonium removal from the piggery waste was performed successfully, probably due to the Anammox intermediates contained in the substrate. This reactor shows a complex performance including the Anammox reaction and HAP crystallization, as well as having partial denitritation occurring simultaneously. From the activity test, the maximum specific N conversion rate was 0.1 g NH4-N/g VSS/day (0.77 g T-N/g VSS/day), indicating that potential denitritation is quite high. The NO2-N/NH4-N ratio to Anammox is 1.17. The colour of the biomass treating the piggery waste changed from black to dark red. It was also observed that the red-colored granular sludge had a diameter of 1-2 mm. The settleability assessment of the granular sludge revealed that the granular sludge had a good settleability even though it was worse than that of seed granular sludge.

Afferent loop obstruction after gastric cancer surgery: helical CT findings

BACKGROUND

We reviewed the computed tomographic (CT) findings of afferent loop obstruction and assessed the value of helical CT in determining the underlying cause.

METHODS

Helical CT scans of 18 patients (12 men and six women; age range = 35-67, mean age = 50 years) with afferent loop obstruction were reviewed. All patients had gastric cancer. Ten patients had undergone radical subtotal gastrectomy with Billroth II gastrojejunostomy, and eight had undergone total gastrectomy with Roux-en-Y esophagojejunostomy. CT images were analyzed retrospectively, and the presumed cause of obstruction on CT was compared with surgical findings (n = 8) and clinical courses (n = 10).

RESULTS

Local recurrence (n = 15), peritoneal seeding (n = 1), internal hernia (n = 1), and adhesion (n = 1) were the presumed causes of obstruction on CT. In all eight patients who underwent a second operation, the cause of afferent loop obstruction was correctly suggested on CT (local recurrence in six patients and adhesion and internal hernia in one patient). In 10 patients who were not re-explored, the clinical findings or biopsy indicated recurrent tumor as suggested on CT.

CONCLUSION

Recurrent tumors and other potential causes of afferent loop obstruction can be correctly predicted with CT in most cases.

Characterization of B cell membrane receptors of polysaccharide isolated from the root of Acanthopanax koreanum

We investigated the immunomodulatory activity of polysaccharide isolated from the root of Acanthopanax koreanum (AK) at the cellular level. AK directly increased B cell proliferation and antibody production, but did not affect the expression of IL-2, IFN-gamma or IL-4 by T cells, or T cell proliferation in vitro. Since AK cannot penetrate cells due to its large molecular mass, B cell activation may be caused by the surface binding of AK to B cell-specific receptors. The role of TLR4 as an AK receptor was shown by the fact that AK activity in B cells from C3H/HeJ mice, which are known to have a defective Toll-like receptor (TLR)-4, was found to be reduced compared with that in control cells from C3H/HeN mice. AK activity was also reduced by antibodies blocking TLR2, TLR4, CD19 or CD79b, but not by an antibody blocking CD38, which suggests AK receptor profiling in B cells. Two main differences between AK and lipopolysaccharide (LPS) were observed. First, LPS activity was inhibited by antibodies to either TLR2 or TLR4, but not by antibodies to CD19, CD79b or CD38. Another was that LPS-induced B cell proliferation was inhibited by polymyxin B (PMB), a specific inhibitor of LPS, whereas AK activity was not affected. Taken together, our results demonstrate that AK directly activates B cells, but not T cells, and suggest that AK has a broader receptor profile than LPS in B cells.

hMLH1 and hMSH2 mutations in families with familial clustering of gastric cancer and hereditary non-polyposis colorectal cancer

The pattern of hMLHI and hMSH2 mutations was assessed to identify the genetic correlation between hereditary gastric and colorectal cancers. Four disease groups and their healthy family members were assembled according to the presentation of gastric cancer: FG, familial clustering of gastric cancer (n = 32); CG, family with one or more colorectal and gastric cancers in first-degree relatives (n = 22); HS, seven HNPCC families corresponding to the Amsterdam criteria (AMS+) and 12 suspected HNPCC families which did not satisfy one of the criteria (AMS-), but no gastric cancer among first- and second-degree relatives (n = 19); and SG, sporadic gastric cancer (n = 33). In the CG group, three were included in AMS + and six in AMS- criteria. Peripheral blood was obtained from them to detect hMLHI and hMLH2 mutations using PCR-SSCP analysis and direct sequencing. The incidence of mutations was 9.4% in the FG group, 54.5% in the CG group, 31.6% in the HS group, and none in the SG group. The incidence, type, and number of the mutation were not different between the CG and HS groups. Thirty-four different mutations included 19 in hMLH1 and 15 in hMSH2. Gastric cancer was the most common extracolonic malignancy in HNPCC and suspected HNPCC families (9/28, 32.1%). The hMLH1 or hMSH2 mutation occurred in seven of 10 families with AMS+, whereas it occurred in four of 18 with AMS- (70% vs. 22.2%, P = .013). Five mutations in the hMLH1 and six mutations in the hMSH2 were exclusively found in families with gastric cancer. All three mutations in the FG group were in hMLHI and there was no mutation in their healthy family members. This study demonstrates that some familial clustering type of gastric cancer appears to be associated with hMLHI mutations thereby indicating a difference from the hereditary gastric cancer studies previously reported. In addition, hMLHI and hMSH2 mutations may impact the gastric cancer carcinogenesis in HNPCC or suspected HNPCC.

A direct sandwich ELISA to detect antibodies against the C-terminal region of merozoite surface protein 1 could be a useful diagnostic method to identify Plasmodium vivax exposed persons

We expressed a C-terminal 108-aa region of the Plasmodium vivax merozoite surface protein 1 (PvMSP1c) excluding the C-end transmembrane region in Escherichia coli in order to evaluate the antibody level to MSP in Korean malaria patients. We optimized a direct sandwich enzyme-linked immunosorbent assay (ELISA) method to simultaneously determine the total antibody levels, including IgG and IgM, to PvMSP1c. If the cut-off for seropositivity was determined as the mean+3SD of the antibody levels of the negative control group, the antibody levels were positive in 99.5% of the patient group (sensitivity 199/200). The antibody levels were negative in 99.4% of the negative control group (specificity 504/507). The positive reactions in the negative control group came from non-specific reactions, as confirmed by a competition assay. This direct sandwich ELISA for PvMSP1c antibody could prove to be a useful tool for the diagnosis of malaria patients and for blood screening in blood banks.

Effects of pine bark extract administered to immunosuppressed adult mice infected with Cryptosporidium parvum

The treatment of cryptosporidiosis using pine bark extract (Pycnogenol) in immunosuppressed adult C57BL/6N mice infected with Cryptosporidium parvum was investigated. Five groups of 10 mice/group were used. Groups 1, 2, 3, and 5 served as normal, toxicity, placebo, and positive controls, respectively. Mice in groups 2-5 were immunosuppressed with dexamethasone phosphate administered ad libitum in drinking water at a dosage level of 12 microg/ml. Mice in groups 3-5 were inoculated per os with 10(6) C. parvum oocysts on the day immunosuppression was started. Mice in groups 2 and 4 were treated by administering Pycnogenol orally at 30 mg/kg/day. In group 4, Pycnogenol was first administered on day 3 postinoculation. Of the four groups of mice immunosuppressed with DEXp (groups 2-5), the two groups treated with Pycnogenol (groups 2 and 4) had no premature deaths. The other two groups (groups 3 and 5) had 3 and 4 mice die, respectively, before the experiment ended. Consequently, Pycnogenol was judged to be non-toxic at the dosage level used and even afforded mice some positive health benefits. Fecal oocyst shedding in groups 3-5 was initially detected on day 3 postinoculation. These mice continued to shed oocysts throughout the duration of the 28-day experiment. Oocyst shedding intensities were greater in group 3 and 5 than in group 4. However, histological examination of infected intestinal tissues in groups 3-5 revealed no significant difference with regard to parasite colonization and villus/crypt (V/C) length ratios. As a result, Pycnogenol was determined to be therapeutically effective against C. parvum at 30 mg/kg/day only when measured by fecal oocyst shedding intensity. There was no effect on parasite tissue colonization and V/C ratios in infected mice. We conclude that Pycnogenol is a useful dietary supplement for C. parvum-infected patients by affording some positive health benefits, significantly reduces fecal oocyst shedding, but does not decrease parasite colonization of intestinal tissue.

Expression of multidrug resistance-associated protein1,P-glycoprotein, and thymidylate synthase in gastric cancer patients treated with 5-fluorouracil and doxorubicin-based adjuvant chemotherapy after curative resection

Both 5-fluorouracil and doxorubicin are commonly used agents in chemotherapy of gastric cancer in adjuvant setting as well as metastatic disease. In a variety of malignancies, high expression of multidrug resistance-associated protein1 and P-glycoprotein has been associated with resistance to doxorubicin, whereas 5-fluorouracil resistance has correlated with the level of thymidylate synthase expression. We evaluated the expression of multidrug resistance-associated protein1, P-glycoprotein, and thymidylate synthase using immunohistochemistry in 103 locally advanced gastric cancer patients (stage IB-IV) who underwent 5-fluorouracil and doxorubicin-based adjuvant chemotherapy after curative resection and investigated the association between their expression and clinicopathologic characteristics including prognosis of the patients. While high expression (> or =5% of tumour cells positive) of multidrug resistance-associated protein1 and P-glycoprotein was observed in 70 patients (68%) and 42 patients (41%), respectively, 65 patients (63%) had primary tumours with high expression (> or =25% of tumour cells positive) of thymidylate synthase. There was a significant association between multidrug resistance-associated protein1 and P-glycoprotein expression (P<0.0001) as well as P-glycoprotein and thymidylate synthase expression (P<0.0001). High multidrug resistance-associated protein1 and P-glycoprotein expressions were associated with well and moderately differentiated histology (P<0.0001 and P=0.03, respectively) and intestinal type (P<0.0001 and P=0.009, respectively). High multidrug resistance-associated protein1 expression correlated with lymph node metastasis (P=0.037), advanced stage (P=0.015), and older age (P=0.021). Five-year disease-free survival and overall survival of total patients were 55.2% and 56.2%, respectively, with a median follow-up of 68 months. There were no significant differences in disease-free survival and overall survival according to the expression of multidrug resistance-associated protein1 (P=0.902 and P=0.975, respectively), P-glycoprotein (P=0.987 and P=0.955, respectively), and thymidylate synthase (P=0.604 and P=0.802, respectively). Concurrent high expression of these proteins (high multidrug resistance-associated protein1/P-glycoprotein, high multidrug resistance-associated protein1/thymidylate synthase, high P-glycoprotein/thymidylate synthase) did not correlate with disease-free survival or overall survival. Even high expression of all three proteins was not associated with poor disease-free survival (P=0.919) and overall survival (P=0.852). In conclusion, high expression of multidrug resistance-associated protein1, P-glycoprotein, and thymidylate synthase did not predict poor prognosis of gastric cancer patients treated with 5-fluorouracil and doxorubicin-based adjuvant chemotherapy. A larger study including patients treated with surgical resection alone would be necessary.

Ramosetron for the prevention of cisplatin-induced acute emesis: a prospective randomized comparison with granisetron

Control of nausea and vomiting is very important in determining patient compliance with cisplatin chemotherapy. A multicentre, randomized, single-blind study was conducted to compare the tolerability and efficacy of ramosetron with those of granisetron over 24 h following cisplatin administration to cancer patients. In eight study centres, a total of 194 adult patients were randomly assigned to receive either intravenous ramosetron 0.3 mg or intravenous granisetron 3.0 mg. The anti-emetic effect of ramosetron determined from the no-vomiting rate lasted longer, but there was no significant difference in the number of acute vomiting episodes or the severity of nausea between the two groups. In the tolerability evaluation, there were no statistically significant differences between the two groups, except for a higher incidence of dull headache in the granisetron group. Ramosetron and granisetron appear to have equivalent efficacy and tolerability profiles, but the effects of ramosetron on the prevention of acute vomiting in patients undergoing cisplatin chemotherapy were longer lasting.

An insight into the genetic pathway of adenocarcinoma of the small intestine

BACKGROUND

Although the adenoma to carcinoma pathway in colorectal cancer is well described, the mechanisms of carcinogenesis in the small intestine remain unclear.

AIMS

The aim of this study was to investigate candidate genes in the genetic pathway of adenocarcinoma of the small intestine.

SUBJECTS AND METHODS

A total of 21 non-familial, non-ampullary adenocarcinomas of the small intestine were analysed. DNA was extracted from formalin fixed paraffin wax embedded tissue using standard techniques. The replication error (RER) status was determined by amplification of BAT26. The mutation cluster region (MCR) of the adenomatous polyposis coli (APC) gene was screened using polymerase chain reaction single strand conformational polymorphism and direct sequencing. Immunohistochemistry was performed on formalin fixed paraffin wax embedded tissue using monoclonal antibodies for hMLH1, hMSH2, beta-catenin, E-cadherin, and p53.

RESULTS

Fourteen male and seven female patients with a median age of 64 years (range 21-85) presented with adenocarcinoma of the duodenum (10), jejunum (7), and ileum (4). One cancer (5%) was found to be RER+, and all tumours stained positive for hMLH1 and hMSH2. No mutations were detected in the MCR of the APC gene. beta-Catenin showed increased nuclear expression with loss of membranous staining in 10 cancers (48%). Absent or decreased membrane expression of E-cadherin was found in eight cancers (38%). Strong staining of p53 was found in the nucleus of five cancers (24%).

CONCLUSION

We did not detect mutations in the MCR of the APC gene, and this suggests that adenocarcinoma of the small intestine may follow a different genetic pathway to colorectal cancer. Abnormal expression of E-cadherin and beta-catenin was common and reflects an early alternative to APC in this pathway in which mutations may be found in adenocarcinoma of the small intestine.

Ozonation of Han River humic substances

This study investigated the characteristics of extracted humic substances (HS) which are ubiquitous in river waters and affect the treatment of the water. HS were extracted from the Han River and the samples obtained were analyzed before/after oxidation with the following analytical methods: DOC, THMFP, UV-abs, chemical composition, molecular weight distribution, IR. Ozonation experiments were conducted in batch-type reactors. Ozone dose was 1 mg/L and contact time was varied from 0 to 20 minutes. The fraction of hydrophobic matter was 56.0% of total organic carbon in the Han River and the ratio of humic/fulvic acids was 22.4/77.6, showing high fractions of aromatic and/or double carbon bond functional groups and high fractions of saturated aliphatic carbons. Oxygen fraction of Han HS was relatively high compared with other humic substances (Suwannee River humic and fulvic acids), which are consistent with the results of IR spectra. The IR spectra showed the increase in aliphatic groups by ozonation of the Han HS. Humic substances could not completely be oxidized to CO2, H2O etc., but were partly oxidized to low molecular weight matter (aliphatics, aldehydes, carboxylics, polysaccharides etc.), so low removal efficiencies in terms of DOC (31-35% with 5 minute contact) were observed. For UV254, 5 minute or shorter contact showed more than 80% removal efficiencies.