Characterization of novel polysulfide polymer coated fly ash and its application in mitigating diffusion of contaminants

Fly ash consists of a considerable amount of hazardous elements with high mobility, posing substantial environmental risks during storage in surface impoundments and landfills. This hinders its efficient reuse in construction or material industries. To enhance the versatility of fly ash applications, a novel surface modification technique, termed SuMo, has been developed to create a hydrophobic polysulfide polymer coating on the surface of fly ash particles. The physicochemical properties of SuMo fly ash samples were examined using atomic force microscopy (AFM), environmental scanning electron microscopy (ESEM), thermal gravimetric analysis (TGA), Fourier Transform Infrared spectroscopy (FTIR), and leaching of hazardous elements was tested under practical environmental conditions (pH 4-12) based on the EPA's leaching environmental assessment framework (LEAF). The successful coating of polysulfide polymer on fly ash surface was verified through an increased percentage of C, S, and O in elemental mapping, coupled with the identification of S-O, CO, and C-H functional groups consistent with the chemical structure of polysulfide polymer. While the SuMo fly ash particles maintained their spherical shape, they exhibited increased surface roughness, robust hydrophobicity, and thermal stability up to 250 °C. Notably, owing to the coating's resilience against water leaching, the SuMo fly ash demonstrated a substantial reduction (up to 60-fold) in leachate concentrations of multiple concerning elements, including B, Be, Ba, Mn, Zn, As, Cr, Hg, etc., under various pH conditions compared to the uncoated fly ash. Furthermore, the polysulphide polymer coating effectively prevented Hg volatilization from fly ash below 163 °C. This study highlights the efficacy of the developed polysulfide polymer coating in mitigating the diffusion of hazardous elements from fly ash, thereby enhancing its potential reutilization in material, construction, and agriculture industries.

Disseminated Streptococcus pneumoniae infection involving a ventricular assist device

We describe the first reported case, to our knowledge, of disseminated pneumococcal infection involving a left ventricular assist device (LVAD). The management of this infection was extremely challenging, requiring multiple surgical debridements, LVAD removal, and prolonged courses of antibiotics. The Streptococcus pneumoniae isolate was found to be serotype 19F, which is included in both the pneumococcal polysaccharide and conjugate vaccines. This report highlights the importance of routine screening for up-to-date vaccination in patients who undergo LVAD implantation.

Towards simultaneous individual and tissue identification: A proof-of-principle study on parallel sequencing of STRs, amelogenin, and mRNAs with the Ion Torrent PGM

DNA-based individual identification and RNA-based tissue identification represent two commonly-used tools in forensic investigation, aiming to identify crime scene sample donors and helping to provide links between DNA-identified sample donors and criminal acts. Currently however, both analyses are typically performed separately. In this proof-of-principle study, we developed an approach for the simultaneous analysis of forensic STRs, amelogenin, and forensic mRNAs based on parallel targeted DNA/RNA sequencing using the Ion Torrent Personal Genome Machine(®) (PGM™) System coupled with the AmpliSeq™ targeted amplification. We demonstrated that 9 autosomal STRs commonly used for individual identification (CSF1PO, D16S539, D3S1358, D5S818, D7S820, D8S1179, TH01, TPOX, and vWA), the AMELX/AMELY system widely applied for sex identification, and 12 mRNA markers previously established for forensic tissue identification (ALAS2 and SPTB for peripheral blood, MMP10 and MMP11 for menstrual blood, HTN3 and STATH for saliva, PRM1 and TGM4 for semen, CYP2B7P1 and MUC4 for vaginal secretion, CCL27 and LCE1C for skin) together with two candidate reference mRNA markers (HPRT1 and SDHA) can all be successfully combined. Unambiguous mRNA-based tissue identification was achieved in all samples from all forensically relevant tissues tested, and STR sequencing analysis of the tissue sample donors was 100% concordant with conventional STR profiling using a commercial kit. Successful STR analysis was obtained from 1ng of genomic DNA and mRNA analysis from 10ng total RNA; however, sensitivity limits were not investigated in this proof-of-principle study and are expected to be much lower. Since dried materials with noticeable RNA degradation and small DNA/RNA amplicons with high-coverage sequencing were used, the achieved correct individual and tissue identification demonstrates the suitability of this approach for analyzing degraded materials in future forensic applications. Overall, our study demonstrates the feasibility of simultaneously obtaining multilocus STR, amelogenin, and multilocus mRNA information for combined individual and tissue identification from a small sample of degraded biological material. Moreover, our study marks the first step towards combining many DNA/RNA markers for various forensic purposes to increase the effectiveness of molecular forensic analysis and to allow more forensically relevant information to be obtained from limited forensic material.

Obstructive sleep apnea: not just a sleep disorder

Obstructive sleep apnea (OSA) has long been recognized as a disorder characterized by snoring and frequent cessations of breathing resulting in fragmentation of sleep, which eventually leads to cumulative sleep debt in affected patients. Until two decades ago, snoring and apneas drew attention mainly as a social curiosity and sleep apnea was not thought of as a serious disorder with multisystem involvement. Impairment of quality of work and high incidence of motor vehicle accidents associated with OSA were recognized toward the end of the last century. Since the turn of this millennium physicians have become increasingly aware of the various cardiovascular complications, metabolic disturbances, and neuropsychologic deficits. It has become very clear in the last decade that patients with OSA have a high recurrence of atrial fibrillation after elective cardioversion if their sleep apnea is not treated with continuous positive airway pressure (CPAP). Poor control of diabetes mellitus and resistant hypertension in the setting of OSA has also been recognized and significant progress in our understanding in this area has been accomplished. Unless physicians include sleep in their system review, many cases will go undiagnosed, which will eventually result in cardiovascular complications. Patients are also not readily forthcoming with the symptoms of sleep apnea, as they often assume that symptoms, such as snoring and daytime sleepiness, are not something serious to be discussed with their physician. In this review, the characteristics, the pathophysiology, and epidemiology of OSA are discussed. Furthermore, the mechanisms by which OSA affects the cardiovascular, endocrine, and metabolic functions have been explored.

Use of cooling tower blow down in ethanol fermentation

Reducing water consumption in bioethanol production conserves an increasingly scarce natural resource, lowers production costs, and minimizes effluent management issues. The suitability of cooling tower blow down water for reuse in fermentation was investigated as a means to lower water consumption. Extensive chemical characterization of the blow down water revealed low concentrations of toxic elements and total dissolved solids. Fermentation carried out with cooling tower blow down water resulted in similar levels of ethanol and residual glucose as a control study using deionized water. The study noted good tolerance by yeast to the specific scale and corrosion inhibitors found in the cooling tower blow down water. This research indicates that, under appropriate conditions, reuse of blow down water from cooling towers in fermentation is feasible.

Differential strain and velocity generation along the right ventricular free wall in pulmonary hypertension

BACKGROUND

In contrast to the homogeneously distributed deformation properties within the left ventricle, the right ventricular (RV) free wall (RVFW) shows a more inhomogeneous distribution. It has been demonstrated that pulmonary hypertension (PH) results in significant RVFW mechanical delay.

OBJECTIVE

To assess the effect of the degree of pulmonary arterial systolic pressure on the RVFW strain gradient and on myocardial velocity generation.

METHODS

Peak longitudinal strain and velocity data were collected from three different segments (basal, mid- and apical) of the RVFW in 17 normal individuals and 31 PH patients.

RESULTS

A total of 144 RV wall segments were analyzed. RVFW strain values in individuals without PH were higher in the mid and apical segments than in the basal segment. In contrast, RVFW strain in PH patients was higher in basal segments and diminished toward the apex. In terms of RVFW velocities, both groups showed decremental values from basal to apical segments. Basal and mid-RVFW velocities were significantly lower in PH patients than in individuals without PH.

CONCLUSIONS

PH results in significant alterations of strain and velocity generation that occurs along the RVFW. Of these abnormalities, the reduction in strain from the mid and apical RVFW segments was most predictive of PH. It is important to be aware of these differences in strain generation when studying the effect of PH on the right ventricle. Additional studies are required to determine whether these differences are due to RV remodelling.

The use of qualitative cultures for detecting infection in open tibial fractures

PURPOSE

To determine the role of qualitative cultures for detecting infection in open tibial fractures.

METHODS

From January 2003 to December 2004, 95 men and 13 women (mean age, 34 years) with open tibial fractures in one or both limbs and without any other sites of infection were prospectively studied. Patients who had been treated with intravenous or oral antibiotics before presentation and/or had undergone debridement or other surgery were excluded.

RESULTS

Infection was not correlated with age, sex, interval from injury to debridement, and cause of fracture. The association of infection with predebridement cultures was stronger (odds ratio=12.5) than that with postdebridement cultures (odds ratio=4.7).

CONCLUSION

Pre- and post-debridement cultures have a role in detecting infection in open tibial fractures. For detecting infection, predebridement cultures have better sensitivity, while postdebridement cultures have better specificity.

Effect of stopper processing conditions on moisture content and ramifications for lyophilized products: comparison of "low" and "high" moisture uptake stoppers

The purpose of this study was to evaluate the effect of processing and storage on the moisture content of two commercially available, 13-mm lyophilization stoppers designated as low moisture (LM) and high moisture (HM) uptake stoppers. The stopper moisture studies included the effect of steam sterilization time, drying time and temperature, equilibrium moisture content, lyophilization and moisture transfer from stopper to a model-lactose lyophilized cake. Results indicated that both stoppers absorbed significant amounts of moisture during sterilization and that the HM stopper absorbed significantly more water than the LM stopper. LM and HM stoppers required approximately 2 and 8 h drying at 105 degrees C, respectively, to achieve final moisture content of not more than 0.5 mg/stopper. Following drying, stopper moisture levels equilibrated rapidly to ambient storage conditions. The apparent equilibrium moisture level was approximately 7 times higher in the HM versus LM stopper. Freeze-drying had minimal effect on the moisture content of dried stoppers. Finally, moisture transfer from the stopper to the lyophilized product is dependent on the initial stopper water content and storage temperature. To better quantify the ramifications of stopper moisture, projections of moisture uptake over the shelf life of a drug product were calculated based on the product-contact surface area of stoppers. Attention to stopper storage conditions prior to use, in addition to processing steps, are necessary to minimize stability issues especially in low-fill, mass lyophilized products.

Benign fibrous histiocytoma of the distal radius with congenital dislocation of the radial head: a case report

Benign fibrous histiocytoma is such a rare tumour that only a few cases have been reported in the literature. A patient with an apparently benign lesion of the distal radius, along with congenital dislocation of the radial head, was presented at St. John's Medical College Hospital in Bangalore, India. Pain was the chief symptom. There were histological features of non-ossifying fibroma in the lesion. Because of its unusual radiological appearance and atypical clinical course, the lesion was diagnosed as fibrous histiocytoma. In this case report, we review similar cases in the literature and discuss an unusual association with congenital dislocation of the radial head.

Respiratory variation of mitral and pulmonary venous Doppler flow velocities in constrictive pericarditis before and after pericardiectomy

The objective of this study was to determine whether Doppler echocardiography is useful in assessing the effects of pericardiectomy in patients with constrictive pericarditis by studying the postoperative change in the respiratory variation of mitral inflow and pulmonary venous Doppler flows. The study population consisted of 35 cases with surgically proven constrictive pericarditis. Thirty-five patients had preoperative Doppler echocardiography, whereas 4 patients died of non-cardiac causes and 1 patient had a heart transplant before follow-up. Postoperative studies were performed at a mean of 1081 +/- 84 days (range 120-2700 days) after pericardiectomy. The mean (+/- SD) respiratory variation changed after surgery from a baseline value of 17% +/- 14% to 8% +/- 8% for peak mitral E velocity (P <.01); from 25% +/- 18% to 7% +/- 13% (P <.001) for pulmonary venous (PV) peak diastolic flow velocity, and from 21% +/- 13% to 11% +/- 13% (P =.009) for PV peak systolic flow velocity. The 23 patients who became asymptomatic after surgery had a significantly lower mean mitral and PV respiratory variation than the 7 patients who were NYHA class II (4% +/- 4% and 6% +/- 4% vs 21% +/- 6% and 19% +/- 10%, respectively, P <.0001 for both). Pulsed Doppler echocardiographic assessment of respiratory variation is useful for evaluating the outcome of pericardiectomy.

Comparison of new Doppler echocardiographic methods to differentiate constrictive pericardial heart disease and restrictive cardiomyopathy

This study assesses how the newer modalities of tissue Doppler echocardiography and color M-mode flow propagation compare with respiratory variation of Doppler flow in distinguishing between constrictive pericarditis and restrictive cardiomyopathy. We studied 30 patients referred for further evaluation of diastolic function who had a diagnosis of constrictive pericarditis or restrictive cardiomyopathy established by diagnostic tests, including clinical assessment, magnetic resonance imaging, cardiac catheterization, endomyocardial biopsy, and surgical findings. Nineteen patients had constrictive pericarditis and 11 had restrictive cardiomyopathy. We performed 2-dimensional transesophageal echocardiography combined with pulsed-wave Doppler of the pulmonary veins and mitral inflow with respiratory monitoring, tissue Doppler echocardiography of the lateral mitral annulus, and color M-mode flow propagation of left ventricular filling. Respiratory variation of the mitral inflow peak early (peak E) velocity of > or =10% predicted constrictive pericarditis with 84% sensitivity and 91% specificity and variation in the pulmonary venous peak diastolic (peak D) flow velocity of > or =18% distinguished constriction with 79% sensitivity and 91% specificity. Using tissue Doppler echocardiography, a peak early velocity of longitudinal expansion (peak Ea) of > or =8.0 cm/s differentiated patients with constriction from restriction with 89% sensitivity and 100% specificity. A slope of > or =100 cm/s for the first aliasing contour in color M-mode flow propagation predicted patients with constriction with 74% sensitivity and 91% specificity. Thus, the newer methods of tissue Doppler echocardiography and color M-mode flow propagation are equivalent and complimentary with Doppler respiratory variation in distinguishing between constrictive pericarditis and restrictive cardiomyopathy. The additive role of the new methods needs to be established in difficult cases of constrictive pericarditis where respiratory variation may be absent or decreased.

Role of transesophageal echocardiography in assessing diastolic dysfunction in a large clinical practice: a 9-year experience

BACKGROUND

Two-dimensional transthoracic echocardiography with respiratory monitoring has been used to characterize diseases that impair diastolic function. Transesophageal echocardiography (TEE) has emerged as a complementary technique to evaluate patients with these diseases. The purpose of this study was to evaluate in a large clinical practice the utility of TEE with respiratory monitoring for classification of patients with diastolic dysfunction.

METHODS

Over a 9-year period TEE was used to examine 192 patients referred to an echocardiography laboratory for additional evaluation of abnormal diastolic function. We performed pulsed-wave Doppler TEE of the left ventricular inflow and pulmonary veins and respiratory monitoring to categorize patients as showing restrictive physiologic features, constriction with or without effusion, mixed constriction and restriction, abnormal relaxation, pseudonormalization, large pericardial effusion or tamponade, or normal diastolic function.

RESULTS

Patients with diastolic dysfunction underwent 3% of the total number of transesophageal studies conducted during the study period. Among the 192 patients referred for TEE, abnormal diastolic function was found in 181 (94%); 11 (6%) had normal diastolic function. Seventy-one (39%) of the 181 patients had restrictive physiologic features. Constrictive pericarditis was found in 54 (30%) of the patients and was confirmed for all 31 patients who underwent pericardiectomy. Mixed constriction and restriction was present in 21 (12%) of the patients. The other 35 patients (19%) had abnormal relaxation, pseudonormalization, or large pericardial effusion or tamponade. The cause of diastolic dysfunction was idiopathic for 32% of the patients, previous cardiac operation for 26%, cardiac amyloidosis for 23%, radiation therapy for 11%, and hypertension or advanced ischemic heart disease for 8%.

CONCLUSION

Two-dimensional and Doppler TEE with respiratory monitoring is useful in categorizing patients with impaired diastolic function, primarily into those with restrictive physiologic features or constrictive pericarditis.

Cloud point of nonionic surfactants: modulation with pharmaceutical excipients

PURPOSE

To determine the cloud point of a variety of nonionic surfactants and to search for means to raise the surfactant cloud point in liquid formulations.

METHODS

Cloud points of nonionic surfactants were determined visually in a water bath. Organic compounds, many of which have been used as pharmaceutical excipients, were tested initially for effect on the cloud point of poloxamine 908. Four effective cloud point boosters (CPBs) from different structural classes were further tested on additional surfactants.

RESULTS

A number of compounds can raise the cloud point of nonionic surfactants. These cloud point boosters are classified into two categories: nonionic and ionic. The nonionic CPBs include poly(ethylene glycols), propylene glycol, methanol, ethanol, isopropanol, and 2-hydroxypropyl-beta-cyclodextrin. They are effective at molar concentrations. The ionic CPBs include anionic and cationic surfactants, charged phospholipids, long chain fatty acids, and bile salts. They are effective at millimolar concentrations.

CONCLUSIONS

The cloud point of nonionic surfactants used in liquid formulations can be modulated through the proper choice of excipient.

Physical stability of ethyl diatrizoate nanocrystalline suspension in steam sterilization

PURPOSE

To study the effects of formulation variables on the physical stability of a submicron crystal (nanocrystal) suspension under steam sterilization conditions.

METHODS

Suspensions of ethyl diatrizoate nanocrystals were prepared by wet milling in the presence of the surfactant poloxamine 908. Particle size distribution and zeta potential were measured by photon correlation spectroscopy.

RESULTS

On heating, the mean particle size of the nanocrystal suspension remained essentially unchanged up to 110 degrees C, the cloud point of the stabilizing surfactant, but increased significantly above that temperature. The increase in particle size was a result of particle aggregation rather than crystal growth. Adding a cloud point booster to the suspension significantly minimized the particle aggregation at high temperatures. The purity of poloxamine 908 and the tonicity agent and buffer salt used also affected the heat stability of the suspension, the latter agents apparently through altering the surfactant cloud point.

CONCLUSIONS

The aggregation of the ethyl diatrizoate nanocrystalline suspension under steam sterilization conditions was a result of phase separation of the stabilizing surfactant at its cloud point. When formulated with a cloud point booster to prevent the phase-separation, the suspension maintained its physical stability under steam sterilization without any significant change in particle size distribution.

Cytolytic therapy for the treatment of bronchiolitis obliterans syndrome following lung transplantation

Bronchiolitis obliterans syndrome (BOS) is a common occurrence following lung transplantation and is one of the most important impediments to long-term graft viability. Cytolytic therapy has been used as treatment for BOS, but there is little data documenting efficacy. Furthermore, these agents have been associated with significant adverse effects. Charts of 15 patients who received an antilymphocyte preparation (ALP) for BOS were reviewed. Forced expiratory volume-1 second (FEV1) and stage of BOS were compared before and after treatment. Complications of ALP were recorded from the charts. Two of 15 patients had an improvement in FEV1, 5/15 exhibited no change, and 8/15 continued to decline. There was no pattern associating stage of BOS with likelihood of response to ALP. All patients received antimicrobial prophylaxis and did not experience infectious complications following administration of the ALP. ALP for the treatment of BOS results in an arrest or improvement of FEV1 in approximately 50% of patients. Infectious complications are uncommon when antimicrobial prophylaxis is administered.

Bronchodilator response at low lung volumes predicts bronchiolitis obliterans in lung transplant recipients

BACKGROUND

Bronchiolitis obliterans syndrome (BOS) is the major obstacle to long-term lung allograft viability. The diagnosis often occurs after significant organ dysfunction is present, and BOS is often unresponsive to standard immunosuppressive agents. We have observed bronchodilator responses (BRs) at low lung volumes in many of our patients who have developed BOS. We therefore assessed whether BR could predict the development of BOS.

METHODS

We conducted a retrospective review of the clinical and pulmonary function laboratory records of 146 patients who underwent transplantation between March 1983 and November 1993. BR was defined as 25% or more increase in forced expiratory flow at 50% of vital capacity or 30% or more increase in forced expiratory flow at 75% of vital capacity. BOS was defined according to recently published FEV1 criteria. Bronchiolitis obliterans was defined histologically according to criteria of the Lung Rejection Study Group.

RESULTS

Of the total population, 52 were excluded because of death or insufficient information. BRs of the small airways were seen in 31 patients (33%), 25 of whom developed BOS (83%). Approximately half of those with BR who developed BOS had evidence of acute rejection in the month prior to the onset of BR. Two thirds (four of six) of patients with BR not developing BOS had acute rejection in the previous month. The sensitivity of BR in predicting BOS was 51% with a specificity of 87%. The positive predictive value was 81%.

CONCLUSIONS

BR appears to be useful as an early marker of BOS. The development of BR in selected patients should lead to closer monitoring and possibly a trial of augmented immunosuppression to arrest the establishment of BOS.

Astrocytoma presenting with apnea and sinus arrest

Although some vascular lesions of the central nervous system are known to cause abnormalities in the control of breathing, association between astrocytoma and combined cardiorespiratory abnormalities in the adult is distinctly unusual. We present a case of a 52-year-old man whose only features of astrocytoma consisted of episodes of apnea and sinus arrest followed by prolonged alveolar hypoventilation. These abnormalities resolved after resection of the tumor. We conclude that in patients presenting with respiratory and sinus arrest, the search for a cause should not be limited to the cardiac and pulmonary systems, but it must include a possibility of a brain tumor.

Hemothorax following uncomplicated sclerotherapy for esophageal varices

Although pleural effusion as a complication of esophageal manipulation is well described in the literature, the fluid is usually nonhemorrhagic. We describe the first patient who had uncomplicated sclerotherapy with ethanolamine for esophageal varices, and on two occasions this patient developed left-sided bloody pleural effusion within 12-72 h after sclerotherapy. The effusion resolved spontaneously within 4 weeks. This case illustrates that hemothorax should be included in the pulmonary complications of sclerotherapy for esophageal varices.

Properties of some alkali fluoride–chloride salt mixtures I. Primary crystallization and density measurements

The primary crystallization and density of the fluoride–chloride salt systems (i) NaF–LiCl and (ii) NaF–(LiCl + KCl) eutectic were determined experimentally using thermal analysis and the Archimedean technique, respectively. The corresponding liquidus curves for the two systems were constructed and compared. Molar volume and excess volume functions were computed from density data at different compositions and temperatures. The positive values of the excess volumes correspond to volume expansion that increases with temperature for both systems. The results suggest that as far as the primary crystallization and density behaviours are concerned, it is possible to replace the component, pure LiCl, in the fluoride–chloride salt system by the eutectic mixture of (LiCl + KCl) for the system's use as a potential electrolyte for aluminium electrolysis.

Pneumocystis carinii pneumonia in thymoma with hypogammaglobulinaemia: successful outcome of therapy including i.v. IgG replacement

A 66-year-old patient presented with Pneumocystis carinii Pneumonia (PCP) and was found to have hypogammaglobulinaemia, associated with a thymoma that had been resected 17 months earlier. Only one previous case of PCP in association with a thymoma and hypogammaglobulinaemia has been reported, in which the patient died. We report another such patient who was successfully treated with a combination of intravenous immunoglobulin and high dose cotrimoxazole.

Torticollis and blepharospasm in systemic lupus erythematosus

A case of torticollis and blepharospasm as the major manifestation of neurological involvement in systemic lupus erythematosis (SLE) is presented. A 56-year-old woman presented with blepharospasm in February 1985 and with torticollis in April 1985. She was diagnosed as having SLE in 1966, on the basis of positive LE cells, when she presented with fever and joint pains. There was no evidence that she had ever been on major tranquilizers. An attempt has been made to correlate the level of antibody titres and exacerbation of these movements with response to steroids. The possibility of an association between blepharospasm, torticollis, and autoimmune disorders has recently been considered.

Kinetics and thermodynamics of dissolution of lecithin by bile salts

The kinetics of dissolution of dispersions of egg phosphatidylcholine (lecithin) by bile salts was studied by observing the decrease in turbidity as mixed micelles of lecithin and bile salts were formed. The rate of dissolution of lecithin corresponding to formation of mixed micelles was studied in the presence of dihydroxy bile salts, sodium deoxycholate, sodium chenodeoxycholate, sodium ursodeoxycholate and one trihydroxy bile salt, sodium cholate. The rate of dissolution of lecithin and mixed micelle formation decreased in the order: chenodeoxycholate greater than deoxycholate greater than cholate greater than ursodeoxycholate. Kinetic solvent isotope studies in D2O, along with measurement of enthalpies of mixed micelle formation both in H2O and D2O, suggest that formation and stabilization of mixed micelles are related to "hydrophobicity" as estimated by high performance liquid chromatography retention factors.