Definitive Radiotherapy in Patients with Clinical T1N0M0 Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Study

PURPOSE/OBJECTIVE(S)

In this study, we aimed to assess the failure pattern and survival outcomes and to analyze the optimal treatment field of definitive RT for T1N0M0 esophageal squamous cell carcinoma (ESCC).

MATERIALS/METHODS

We performed a retrospective analysis in a multi-institutional cohort of patients with histologically confirmed T1N0M0 ESCC. We included patients who underwent RT with definitive aim from 2010 to 2019. Patterns of failure were demonstrated as in-field locoregional, out-field locoregional and distant metastasis. In the survival analysis, freedom from locoregional recurrence and their association with clinicopathologic risk factors were analyzed. We performed a propensity score matching in the cT1b patients to adjust for the heterogeneity of radiation technique, radiation dose and the use of concurrent chemotherapy.

RESULTS

A total of 168 patients were included with a median follow-up of 34.0 months, and there were 20 cT1a, 94 cT1b and 24 cT1x, (cT1, not otherwise specified) patients. The rates of all and locoregional failure were 26.9% and 23.1% for cT1a and 25.0% and 22.4% for cT1b patients. 10 (10.6%) patients experienced grade ≥ 3 adverse events. Among 116 cT1b patients, 69 patients received elective nodal irradiation (ENI) and 47 patients received involved field irradiation (IFI). After propensity score matching, the 3-year FFLRR rate was 84.5% (95% Confidence Interval, 71.0 - 92.1%). There was no significant difference between the ENI and IFI patients in FFLRR (Log-rank P = 0.831). In the multivariate analysis, the use of concurrent chemotherapy was the only factor marginally associated with FFLRR (Hazard ratio, 0.17; 95% CI, 0.02 - 1.13; P = 0.067).

CONCLUSION

cT1a patients who cannot receive endoscopic resection, showed similar rates of failure compared with cT1b patients, which questioned the accuracy of the staging and raised the need for through treatment such as chemoradiotherapy. In cT1b patients, IFI using dose of 50 to 60 Gy with concurrent chemotherapy could be a reasonable treatment option.

Direct thermal injury to the popliteal artery after total knee arthroplasty

Vascular damage after total knee arthroplasty is rare. However, delayed diagnosis and management may cause adverse outcomes for patients. In particular, direct thermal injury to the popliteal artery after total knee arthroplasty is extremely rare. A 74-year-old woman presented to another institution with a left popliteal artery injury after left total knee arthroplasty. Arteriography revealed total occlusion of the popliteal artery, and emergency surgery was performed. Because of the total occlusion of the popliteal artery due to severe direct thermal injury, anastomosis was performed in an end-to-end fashion with a right great saphenous vein graft. At the time of discharge, she had no specific symptoms other than pain at the surgical site, with a palpable left dorsalis pedis pulse. While performing total knee arthroplasty, the anatomical position of the popliteal artery should be carefully considered to prevent injury.

Anterior resection syndrome: a randomized clinical trial of a 5-HT3 receptor antagonist (ramosetron) in male patients with rectal cancer

BACKGROUND

No effective treatment exists for anterior resection syndrome (ARS) following sphincter-saving surgery for rectal cancer. This RCT assessed the safety and efficacy of a 5-HT3 receptor antagonist, ramosetron, for ARS.

METHODS

A single-centre, randomized, controlled, open-label, parallel group trial was conducted. Male patients with ARS 1 month after rectal cancer surgery or ileostomy reversal were enrolled and randomly assigned (1 : 1) to 5 μg of ramosetron (Irribow®) daily or conservative treatment for 4 weeks. Low ARS (LARS) score was calculated after randomization and 4 weeks after treatment. The study was designed as a superiority test with a primary endpoint of the proportion of patients with major LARS between the groups. Primary outcome analysis was based on the modified intention-to-treat population. Safety was assessed by monitoring adverse events during the study.

RESULTS

: A total of 100 patients were randomized to the ramosetron (49 patients) or conservative treatment group (51 patients). Two patients were excluded, and 48 and 50 patients were analysed in the ramosetron and control groups, respectively. The proportion of major LARS after 4 weeks was 58 per cent (28 of 48 patients) in the ramosetron group versus 82 per cent (41 of 50 patients) in the control group, with a difference of 23.7 per cent (95 per cent c.i. 5.58 to 39.98, P = 0.011). There were minor adverse events in five patients, which were hard stool, frequent stool or anal pain. These were not different between the two groups. There were no serious adverse events.

CONCLUSION

: Ramosetron could be safe and feasible for male patients with ARS.

TRIAL REGISTRATION NUMBER

NCT02869984 (http://www.clinicaltrials.gov).

Deep Learning-Based Cattle Vocal Classification Model and Real-Time Livestock Monitoring System with Noise Filtering

The priority placed on animal welfare in the meat industry is increasing the importance of understanding livestock behavior. In this study, we developed a web-based monitoring and recording system based on artificial intelligence analysis for the classification of cattle sounds. The deep learning classification model of the system is a convolutional neural network (CNN) model that takes voice information converted to Mel-frequency cepstral coefficients (MFCCs) as input. The CNN model first achieved an accuracy of 91.38% in recognizing cattle sounds. Further, short-time Fourier transform-based noise filtering was applied to remove background noise, improving the classification model accuracy to 94.18%. Categorized cattle voices were then classified into four classes, and a total of 897 classification records were acquired for the classification model development. A final accuracy of 81.96% was obtained for the model. Our proposed web-based platform that provides information obtained from a total of 12 sound sensors provides cattle vocalization monitoring in real time, enabling farm owners to determine the status of their cattle.

Changes in facial surface temperature of laying hens under different thermal conditions

OBJECTIVE

The purpose of this study was to identify through infrared thermal imaging technology the facial surface temperature (FST) of laying hens in response to the variations in their thermal environment, and to identify the regional differences in FST to determine the most stable and reliable facial regions for monitoring of thermoregulatory status in chickens.

METHODS

Thirty Hy-Line Brown hens (25-week-old) were sequentially exposed to three different thermal conditions; optimal (OT, 22°C±2°C), low (LT, 10°C±4°C), and high temperature (HT, 30°C±2°C). The mean values of FST in five facial regions including around the eyes, earlobes, wattles, beak and nose, and comb were recorded through infrared thermography. The maximum FST (MFST) was also identified among the five face-selective regions, and its relationship with temperature-humidity index (THI) was established to identify the range of MFST in response to the variations in their thermal environment.

RESULTS

Hens exposed to OT condition at 15:00 displayed a higher temperature at wattles and around the eyes compared to other regions (p<0.001). However, under LT condition at 05:00 to 08:00, around the eyes surface temperature showed the highest value (p<0.01). In HT, wattles temperature tended to show the highest temperature over almost time intervals. Main distribution regions of MFST were wattles (63.3%) and around the eyes (16.7%) in OT, around the eyes (50%) in LT, and wattles (62.2%) and comb (18.3%) in HT. The regression equation between MFST and THI was estimated as MFST = 35.37+ 0.2383×THI (R2 = 0.44; p<0.001).

CONCLUSION

The FST and the frequency of MFST in each facial region of laying hens responded sensitively to the variations in the thermal environment. The findings of this experiment provide useful information about the effect of the thermal conditions on the specific facial regions, thus offering an opportunity to stress and welfare assessment in poultry research and industry.

Summer season temperature-humidity index threshold for infrared thermography in Hanwoo (Bos taurus coreanae) heifers

Objective

The study sought to estimate the relationship between body surface temperature (BST) and temperature humidity index (THI) and to present the validity of THI as a heat stress index in the field.

Methods

Eight Hanwoo heifers (20 to 32 month) were examined in a field trial, with a space allowance of 10 m² per head. The BST was measured using an infrared thermographic camera. The BST of five body regions (eyes, hindquarters, nose, part of horns, and ears), ambient temperature (AT), and relative humidity (RH) were measured 7 times daily (07, 09, 11, 13, 15, 17, and 19 h) during each season with three replicates.

Results

The THI ranged 34.0 to 56.9 during spring (AT, −1.0°C to 13.4°C), 75.1 to 84.7 during summer (AT, 24.9°C to 33.6°C), 55.8 to 70.9 during autumn (AT, 13.0°C to 26.0°C) and 17.5 to 39.2 during winter (AT, −10.4°C to 1.0°C). In the regression analysis, the coefficient of determination (R²) between THI and BST was 0.88, 0.72, 0.83, 0.86, and 0.85 for the eyes, hindquarters, nose, part of horn, and ears area, respectively. This indicates that BST has a strong correlation with AT and RH. Expression equations were estimated as Y (THI) = 31.54+0.1085X (BST of eyes) and Y (THI) = 30.48+0.1147X (BST of hindquarters) by simple linear regression analysis in this experiment.

Conclusion

Consequently, the upper bound for heat stress estimation can be specified ranging from THI of 65 (eyes) to 70 (hindquarters). From this we can expect a precise feeding system for Korean native cattle in the field.

Anti-elastase and anti-hyaluronidase activity of phosvitin isolated from hen egg yolk

1. Phosvitin, a major phosphoprotein found in egg yolk, has strong antioxidant activity. Activation of elastase, collagenase, and hyaluronidase by reactive oxygen species are related to the degradation of ECM and skin aging. The objective of this study was to determine the anti-elastase and anti-hyaluronidase activity of phosvitin.2. Elastase from porcine pancreas and hyaluronidase from bovine testes were used to study the inhibitory activity of phosvitin. To elucidate the mechanism of enzyme inhibition, a Lineweaver-Burk plot was constructed.3. Phosvitin inhibited elastase and hyaluronidase activity in a dose-dependent manner. The IC₅₀ value of phosvitin was 31.6 μg/ml and 1,270 μg/ml against elastase and hyaluronidase, respectively. The analysis of elastase and hyaluronidase kinetics indicated that the apparent Michaelis constant (_appK_m) was increased by phosvitin but the V_max value was not affected.4. In conclusion, phosvitin exhibited competitive inhibitory activity against elastase and hyaluronidase. Thus, phosvitin could be used as a natural anti-aging agent in the cosmetics industry.

Cytoprotective effects of taxifolin against cadmium-induced apoptosis in human keratinocytes

Cadmium (Cd) is a heavy metal widely used in industry, and the skin is an important target of this metal. Taxifolin (Tax), a natural source of bioflavonoids found in various conifers, exerts multiple biologic effects on skin cells. However, the mechanisms by which Tax protects keratinocytes against Cd are currently unclear. We investigated the cytoprotective effects of Tax against Cd-induced apoptosis in the human HaCaT keratinocyte. The water-soluble tetrazolium salt (WST-1) assay and Annexin V/propidium iodide double-staining assay results showed that Cd-induced cell death was lower in cells treated with Tax (0–100 μM) than in cells treated with Cd alone. Additionally, a reduction of Cd-induced DNA fragmentation by Tax was shown by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end labeling assay. The levels of reactive oxygen species were also lower in Cd/Tax-treated cells than in Cd-treated cells. We employed a two-dimensional electrophoresis-based proteomic analysis to identify treatment-related alterations in protein expression. Tax downregulated cathepsin B and D and upregulated hsp27, cyclophilin A, and peroxiredowin-1. Western blotting confirmed the downregulation of cathepsin B and D and the upregulation of hsp27. The cytoprotective effects of Tax against Cd-induced apoptosis were also characterized by the changes in the activity of caspase 3, -7, poly ADP-ribose polymerase, the cellular proliferation-related ERK1/2, and AKT. Furthermore, the levels of cell cycle-related proteins, such as SP1 and p21, decreased, whereas p53 level increased. We concluded that Tax reduced Cd cytotoxicity and Cd-induced apoptosis by inhibiting the apoptotic pathway.

Relationship of Success Rate for Balloon Adhesiolysis with Clinical Outcomes in Chronic Intractable Lumbar Radicular Pain: A Multicenter Prospective Study

Combined balloon decompression and epidural adhesiolysis has been reported to be effective in refractory lumbar spinal stenosis. Many cases of intractable stenosis have symptom-related multiple target sites for interventional treatment. In this situation it may not be possible to perform balloon adhesiolysis, or even only epidural adhesiolysis, for all target sites. Therefore, this multicenter prospective observational study aimed to evaluate the relationship of successful ballooning rate for multiple target sites with clinical outcome. Based on the ballooning success rate of multiple target sites, the patients were divided into three groups: below 50%, 50–85%, and above 85% ballooning. A greater ballooning success rate for multiple target sites provided a more decreased pain intensity and improved functional status in patients with chronic refractory lumbar spinal stenosis, and the improvement was maintained for 6 months. The estimated proportions of successful responders according to a multidimensional approach in the below 50%, 50–85%, and above 85% balloon success groups at 6 months after the procedure were 0.292, 0.468, and 0.507, respectively (p = 0.038). Our study suggests the more successful balloon adhesiolysis procedures for multiple target lesions are performed, the better clinical outcome can be expected at least 6 months after treatment.

Characteristics of vocalisation in Hanwoo cattle (Bos taurus coreanae) under different call-causing conditions

The present study provided basic data regarding cattle farming on the basis of animal welfare, by using Hanwoo cattle (Bos taurus coreanae) vocalisations. We collected and analysed cattle-vocalisation data during situations that commonly occur during cattle farming (steer handling call, n = 130; heifer handling call, n = 418; heifer oestrus call, n = 454; heifer feed-anticipation call, n = 124; calf introduction call, n = 212) at a Hanwoo cattle farm and investigated differences in vocalisation parameters (call duration, call intensity, fundamental frequency, first formant, second formant, third formant, fourth formant) according to the type of call. Regarding call duration, intensity and first formant, the heifer oestrus call was significantly (P &lt; 0.05) longer than were the other calls. The calf introduction call was the second longest in duration and first formant. Regarding fundamental frequency, the steer handling call was significantly higher than were the other calls (P &lt; 0.05), with the heifer oestrus call being the lowest by a significant amount (P &lt; 0.05). Regarding the second and third formants, the feed-anticipation call had a significantly higher frequency than did the other calls (P &lt; 0.05). Regarding the fourth formant, the steer and heifer handling calls showed the highest frequency levels by a significant margin (P &lt; 0.05). The calf introduction and heifer oestrus calls scored the lowest for the third formant and fourth formant (P &lt; 0.05). Ultimately, vocalisation-parameter analysis of Hanwoo in different situations enabled the classification of an auditory communication system on the basis of their physiological and emotional states. Such vocalisation research data can be used for animal welfare and to enable more advanced and precise cattle farming.

In vitro cytotoxic and ACE-inhibitory activities of promod 278P hydrolysate of ovotransferrin from chicken egg white

Peptides released from egg proteins via enzymatic hydrolysis show various bioactivities such as antimicrobial, antioxidant, antihypertensive, and immunomodulatory properties. The objective of this study was to investigate the cytotoxic and Angiotensin Converting Enzyme (ACE)-inhibitory activities of ovotransferrin and its promod 278P enzyme hydrolysate. Ovotransferrin from egg white was hydrolyzed using promod 278P at 45°C for 3 hours. Using the MTT assay, the cytotoxicity of ovotransferrin and promod 278P hydrolysate of ovotransferrin were evaluated in human cancer cell lines of various tissue origins. The ACE-inhibitory activity was determined using the cleavage of a chromogenic substrate -Hip-His-Leu. The promod 278P hydrolysate of ovotransferrin showed a potent cytotoxicity (>90%) at 20 mg/mL in all cancer cell lines tested, but ovotransferrin did not. The IC50 value of the promod 278P hydrolysate of ovotransferrin against 5 different cancer cells were 10.05 ± 1.55, 3.45 ± 0.94, 4.43 ± 1.87, 4.92 ± 0.63, and 10.43 ± 3.91 mg/mL for MCF-7, HeLa, HepG2, HT-29, and LoVo cells, respectively. The promod 278P hydrolysate of ovotransferrin showed a strong ACE-inhibiting activity: at 10 mg/mL level, the hydrolysate showed 76.82 ± 1.28% inhibition to ACE-inhibitory activity, and 73.33 ± 2.56%, 56.85 ± 1.84%, 50.32 ± 3.71%, 17.30 ± 0.13%, and 4.52 ± 6.83% inhibitory activity at 5, 2.5, 1.25, 0.625, and 0.3125 mg/mL level, respectively. The IC50 value of the promod 278P hydrolysate of ovotransferrin was 1.53 ± 0.20 mg/mL. However, ovotransferrin did not show any inhibitory effect to angiotensin-converting enzyme activity. This result indicated that the promod 278P hydrolysate of ovotransferrin has a great potential as an anticancer and antihypertension agent for humans, but the information on the peptides responsible for the functional activities is not available yet.

Behavioral characteristics of Hanwoo (Bos taurus coreanae) steers at different growth stages and seasons

OBJECTIVE

This research analyzed behavioral characteristics of Hanwoo (Bos taurus coreanae) steers during each season and growth stage to enable measurement of the animals' welfare level for precision livestock farming.

METHODS

A hundred-eight beef steers were divided into three equal groups at a Hanwoo farm according to their growth stage: growing stage (GS), 8 months; early-fattening stage (EFS), 19 months; and late-fattening stage (LFS), 30 months. Twelve behavioral categories were continuously recorded for 13 day-time hours in each four seasons with three replications.

RESULTS

Time spent standing was found to be significantly longer in summer at all growth stages (p<0.05). Hanwoos at the GS spent significantly longer standing time in spring and summer than those at the EFS and LFS (p<0.05). Lying time in summer was the shortest for all growth stages (p<0.05). Steers at the LFS spent significantly longer lying time than that at the GS (p<0.05) in summer. For GS and EFS, time spent eating in spring and autumn were longer than in summer and winter (p<0.05). Eating time was the longest for the GS in spring, autumn, and winter, excluding for the LFS in winter (p<0.05). Regarding ruminating, steers at the LFS spent significantly shorter time than those at other stages in all seasons (p<0.05). GS and EFS steers showed the longest walking time in summer compared with other seasons (p<0.05). At GS and LFS, drinking time in summer was the longest of all seasons (p<0.05). Sleeping time was significantly shorter in summer compared with the other seasons (p<0.05). Self-grooming time was the longest in winter for all growth stages (p<0.05).

CONCLUSION

Steers were found to have more variable behavioral patterns during summer and the GS and less active behaviors during the LFS, thus extra care seems necessary during the GS, LFS, and summer period.

Effects of physically effective neutral detergent fiber content on dry matter intake, digestibility, and chewing activity in Korean native goats (Capra hircus coreanae) fed with total mixed ration

Objective

This experiment was to determine proper physical traits in the diet for goats by investigating the effects of physically effective neutral detergent fiber (peNDF) content on dry matter intake (DMI), digestibility, and chewing activity in black goats fed with total mixed ration (TMR).

Methods

Six growing wethers of Korean native black goats (Capra hircus coreanae) aged 8 months and weighing between 26.9 kg and 27.1 kg (27.03±5.05 kg) were used in this experiment. Three diets of varying peNDF content were obtained by original TMR (T1), 12,000 rpm grinding (T2), and 15,500 rpm grinding (T3) of the same TMR diet. The peNDF_1.18 content of the experimental diets was 23.85%, 21.71%, and 16.22% for T1, T2, and T3, respectively.

Results

Average daily gain (ADG) was higher in T2 group compared to those of the control and T3 groups, but ADG and DMI were not affected by the dietary particle size and peNDF content. Also, there was no difference between apparent nutrient digestibility of dry matter, crude fiber, ether extract, neutral detergent fiber, and acid detergent fiber. Although there was no significant difference, rumination and total chewing time were associated with decreased peNDF content.

Conclusion

The feeding of peNDF-based TMR showed no impact on apparent nutrient digestibility and nitrogen balance. Further studies are required with a wider range of dietary peNDF level and particle size to better identify the effect of dietary peNDF and particle size on chewing activity and performance in goats.

Effects of Physically Effective Neutral Detergent Fiber Content on Intake, Digestibility, and Chewing Activity in Fattening Heifer Fed Total Mixed Ration

The objective of this study was to determine the effects of physically effective neutral detergent fiber (peNDF) content in total mixed ration (TMR) on dry matter intake, digestibility, and chewing activity in fattening Hanwoo (Bos taurus coreanae) heifers. The experiment was designed as a replicated 3×3 Latin square using 12 heifers. Fattening heifers were offered one of three diets [high (T1), medium (T2), and low (T3) peNDF] obtained by different mixing times (3, 10, and 25 min) for the same TMR feed. The peNDF content of TMR was determined by multiplying the proportion of dry matter retained by a 1.18 mm-screen in a Penn State Particle Separator by the dietary NDF content. The peNDF_1.18 content was 30.36%, 29.20%, and 27.50% for the T1, T2, and T3 diets, respectively (p<0.05). Dry matter intake was not affected by peNDF content in TMR. Total weight gain in T1 group was significantly higher (p<0.05) than in T2 and T3 groups. However, weight gain did not differ between T2 and T3 groups. The feed conversion ratio decreased with an increase in the peNDF content (T1: 12.18, T2: 14.17, and T3: 14.01 g/g). An increase in the peNDF content of TMR was associated with a linear increase in the digestibility of dry matter, crude protein, crude fiber, neutral detergent fiber, and acid detergent fiber (p<0.05). Also, an increase in peNDF content of the TMR resulted in a linear increase in the number of chews in eating and ruminating (p<0.05), and consequently in the number of total chews (p<0.05). These results indicate that peNDF content affects digestibility and chewing activity. Consequently, the peNDF content of TMR should be considered for improving feed efficiency, digestibility, body weight gain, and performance in fattening heifers.

Comparative effectiveness of percutaneous epidural adhesiolysis for different sacrum types in patients with chronic pain due to lumbar disc herniation: A propensity score matching analysis

For percutaneous epidural adhesiolysis (PEA) in patients with chronic low back and/or leg pain, comparative efficacy of lumbar PEA between the sacral types has not yet been investigated. This study aimed to determine the comparative efficacy of lumbar PEA between the sacral types in chronic pain with lumbosacral herniated intervertebral disc (L-HIVD).A total of 1158 chronic low back and/or leg pain patients who diagnosed with L-HIVD and underwent PEA between February 2011 and March 2015 were retrospectively examined. All enrolled patients were divided into 2 types: dome-sacral type and flat type. To avoid confounding bias, propensity score analysis was used. Numeric rating scales (NRS) and Patients' Global Impression of Change (PGIC) were compared between the 2 types at baseline and at 3 months post-PEA.After conducting a propensity score matching analysis, 114 patients were included in each type. The mean sacral angle significantly differed between the flat-sacral and dome-sacral types (P < 0.001). A linear mixed effect model analysis showed that the adjusted NRS score at baseline was 7.58 [95% confidence interval (CI): 7.40-7.76] for the flat-sacral type and 7.47 (95% CI: 7.29-7.64) for the dome-sacral type. The adjusted NRS score after 3 months post-PEA was 4.27 (95% CI: 3.77-4.77) for the flat-sacral type and 3.71 (95% CI: 3.21-4.21) for the dome-sacral type. We detected no significant differences in NRS at baseline (P = 0.371) and after 3 months (P = 0.121) between the 2 groups. No significant differences were observed in terms of the NRS score between the 2 groups during the 3 months follow-up (omnibus P = 0.223). There were no significant differences in PGIC between flat-sacral and dome-sacral types at 3 months after the follow-up period (4.40 ± 2.17 and 4.67 ± 1.88, respectively, P = 0.431).PEA provides sufficient pain relief for chronic pain due to L-HIVD at 3 months postprocedure. The sacral type might not affect the outcome of lumbar PEA in chronic pain associated lumbar HIVD.

First Evidence that Sika Deer (Cervus nippon) Velvet Antler Extract Suppresses Migration of Human Prostate Cancer Cells

Deer velvet antler (DVA) is one of the most popular medicines in China. Numerous studies have demonstrated that velvet antler possess biological effects. However, data regarding its anti-migration activity on prostate cancer is scarce. In this study, we investigated the inhibitory effect of top DVA (T-DVA) on the expression of prostate-specific antigen (PSA) and migration-related genes in the human prostate cancer cell, LNCaP. The T-DVA down-regulated the expression of PSA. In addition, the Radius(TM) assay revealed that T-DVA inhibited the migration behavior of prostate cancer cells. Furthermore, the expression of matrix metalloproteinase (MMP)-9 and vascular endothelial growth factor (VEGF) was also decreased with T-DVA. On the contrary, T-DVA increased the tissue inhibition of metalloproteinase (TIMP)-1 and (TIMP)-2. Taken together, our findings indicate that the T-DVA possesses anti-migration activity on prostate cancer cells. This is the first study of DVA to report the anti-migration activity on prostate cancer.

Comparison between a new electronic bidet and conventional sitz baths: a manometric evaluation of the anal resting pressure in normal healthy volunteers

BACKGROUND

A bidet has been proposed as a replacement for the sitz bath. Like a sitz bath, it brings water into contact with the perineum. However, the high force of water from commercially used electronic bidets may harm the anus. We developed a new electronic bidet and evaluated its effects on anal resting pressure compared with a warm sitz bath.

METHODS

Forty volunteers used the electronic bidet and sitz bath on separate days. The electronic bidet was newly designed with warm (38 °C) water and very low force (10 mN) with a fountain type of flow. Anal resting pressure at the high-pressure zone was measured before (control) and after the electronic bidet and sitz bath. Pressure changes after bidet or sitz bath were expressed as percentages compared with control. Water temperatures and rectal temperatures were also recorded.

RESULTS

The anal resting pressures before the electronic bidet and sitz bath were 90.2 ± 24.6 and 88.1 ± 16.8 mmHg, respectively. At 3 min after the electronic bidet and sitz bath, the anal resting pressures were 71.3 ± 23.4 and 69.6 ± 19.8 mmHg, respectively. The pressure changes compared with the control were 78.2 ± 12.9 and 78.1 ± 12.5%, respectively, which were not significantly different. The maximal increase and minimal decrease were not significantly different. The rectal temperature was not elevated, and the water temperature decreased significantly with the sitz bath (p < 0.001).

CONCLUSIONS

Our new electronic bidet may reduce the anal resting pressure much like a warm sitz bath does.

Effects of physically effective neutral detergent fibre content on dry-matter intake, digestibility and chewing activity in beef cattle fed total mixed ration

Our aim in this study was to determine the effects of physically effective neutral detergent fibre (peNDF) in a total mixed ration (TMR) on feed intake, digestibility and chewing activity in beef cattle. The experiment had a replicated 3 × 3 Latin square desig, using three fattening Hanwoo (Bos taurus coreanae) steers with ruminal cannulas. Steers were offered one of three diets (high, medium or low peNDF content) obtained by mixing the same TMR for different periods of time (5, 13 and 25 min). peNDF content of TMR was calculated as [total chewing time/NDF intake (kg)] × dietary NDF content, and the proportion of sample dry matter (DM) collected in a ≥1.18-mm sieve is commonly used as the physical effectiveness factor in the equation. The peNDF1.18 contents of the high, medium and low diets were 25.97%, 21.10% and 17.94% (P < 0.05). In addition, the proportion of particles collected on the 19-mm, 1.18-mm, and pan sieves changed linearly with an increase of TMR mixing time. Mean particle-size distributions of diets were 11.43, 24.11, 30.70 and 33.68 for 19 mm, 8 mm, 1.18 mm and pan, respectively. Eating rate and ruminating and chewing efficiencies were significantly decreased with reduced peNDF content, and DM intake was increased significantly (P < 0.05). Lower peNDF content reduced the total number of chews significantly (P < 0.05). Total time spent chewing associated with eating was not affected by peNDF contents. Digestibility of DM, crude protein and crude fat decreased with reducing peNDF content in the diet, but there was no significant difference among the three groups. These results indicated that peNDF affects intake, digestibility and chewing activity in beef cattle. Therefore, high levels of peNDF appears to improve TMR, as it can increase efficiency and may prevent ruminal disorders in Hanwoo steer.

Isolation and characterisation of collagen from elk antler velvet

Collagen was extracted from the antler velvet of elk (Cervus elaphus). Two types of collagen were prepared namely, acetic acid-soluble collagen and pepsin-soluble collagen. The electrophoretic patterns of both of the collagens showed that they were heterotrimeric, i.e. they consisted of α1α2α3. The total yield of the collagen obtained from the elk antler velvet was 12.1%. Amino acid analysis of the collagen by high-performance liquid chromatography showed that imino acid content such as that of proline and hydroxyproline was high, which might contribute to better visco-elastic properties. The peptide mapping of the collagens showed their similarity with porcine Type I collagen, thereby suggesting that the primary structure of both collagens is identical to that of porcine skin Type I collagen. The thermal denaturation temperature was 37°C, which is comparable to porcine Type I collagen and may also be as a result of high imino acid content.

Establishing the Origin of Elevated Uranium Concentrations in Groundwater near the Central Ogcheon Metamorphic Belt, Korea

We examined the origin of the U-enriched groundwater in Daejeon, near the Ogcheon U zone in Korea. For this study, groundwater ionic species and C, S, and Sr isotopic compositions were analyzed. The U-enriched groundwater occurred only in the Daejeon granite region, while all the groundwater in the Ogcheon Supergroup showed very low U concentrations. In the granite region, the pedospheric or atmospheric origin of dissolved C and S means that the aquifer has been well connected to the oxidized surface environment. The Sr/Sr ratios indicated a lithospheric origin of Sr. Groundwater isotopic compositions in the Ogcheon belt varied greatly, indicating their complex sources. In this region, dissolved C originated from graphite-rich slate and limestone. The broad range of δS suggested that the composite sources included atmospheric SO for most groundwater, lithogenic SO for mine drainage and quarry water, and anthropogenic SO for polluted groundwater. This study indicates that the U-enriched groundwater is not related to the present U ores in the Ogcheon belt but is genetically associated with the granite body itself. The varying but considerable U contents within the granite body can be present as isolated groups. We infer that locally high U contents in the Daejeon granite might inherently be due to assimilation of the Ogcheon U-mineralized zone into granitic melt during the Mesozoic; however, the pH and Eh conditions except aquifer geology were very important factors in developing highly enriched U groundwater in the Daejeon granite region. Thermodynamic modeling highlights the importance of dissolved Ca and (bi-)carbonate in U geochemistry.

Volumetric response evaluation after intensity modulated radiotherapy in patients with supratentorial gliomas

Radiotherapy is frequently indicated to treat cerebral gliomas. Accurate response evaluation after radiotherapy is essential to determine the efficacy of treatment. We retrospectively analyzed the volumetric tumor response after simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) in patients with gliomas. Thirty-five patients (Grade II, 7 patients; Grade III, 12; and Grade IV, 16) were treated with SIB-IMRT with a median total dose of 55.9 Gy/26 fractions for Grade II and 60 Gy/25 fractions for Grade III-IV tumors. Tumor responses were evaluated for enhancing volume on post-gadolinium T1-weighted images (Vgd) and hyper-intensity volume on T2-weighted FLAIR images (V(fl)) on serial MRIs. With the median follow-up of 24.0 months, overall response rates (RRs) were 57% for V(gd) and 51% for V(fl). Tumor grade was predictive of response favoring the lower grade in Vfl with RRs of 86% for Grade II, 75% for Grade III, and 19% for Grade IV tumors (p = 0.004). Time to 50% or greater volume reduction (T50) in Vgd was 8 months for grade III. The T50 in V(fl) was approximately 24 months both for Grade II and III tumors. Majority of Grade IV tumors continued to progress and never reached the T50 in Vgd or Vfl. Responders survived longer than non-responders for V(gd) and V(fl). Volume response after radiotherapy was dependent upon tumor grade and time. LGGs are very responsive to radiotherapy with the RRs of 86% in V(fl). The response of Vfl is more protracted compared to V(gd). Further investigation is needed to determine the clinical significance of volumetric response evaluation.

Fungal peri-prosthetic joint infection after primary total knee replacement

We retrospectively reviewed 30 two-stage revision procedures in 28 patients performed for fungal peri-prosthetic joint infection (PJI) after a primary total knee replacement. Patients were followed for at least two years or until the infection recurred. The mean follow-up for patients who remained free of infection was 4.3 years (2.3 to 6.1). Overall, 17 patients were assessed as American Society of Anesthesiologists grade 3 or 4. The surgical protocol included removal of the infected implant, vigorous debridement and insertion of an articulating cement spacer. This was followed by at least six weeks of antimicrobial treatment and delayed reimplantation in all patients. The mean interval between removal of the prosthesis and reimplantation was 9.5 weeks (6 to 24). After reimplantation, patients took antifungal agents orally for a maximum of six months. Two knees became reinfected at one and two months post-operatively, respectively: one of these subsequently required arthrodesis because of uncontrolled infection. Fungal PJIs can be treated successfully by removal of all infected material, appropriate antimicrobial treatment and delayed reimplantation.

Antibiotic resistance of microbial strains isolated from Korean acne patients

Over several decades, topical and systemic antibiotics have been the mainstay of treatment for acne vulgaris. The widespread and long-term use of antibiotics in the treatment of acne has resulted in the spread of resistant bacterial strains and treatment failure. We aimed to examine the bacteriology of acne vulgaris and to evaluate its susceptibility to the antibiotics widely used for acne in Korea. We examined the species of bacteria aerobically and anaerobically isolated from 100 Korean acne patients. Among the bacteria isolated, Staphylococcus epidermidis (36 patients) was the most common, followed by Propionibacterium acnes (30 patients). Eleven strains of P. acnes (36.7%) and 25 strains of S. epidermidis (69.4%) were resistant to one or other of the antibiotics tested. A higher proportion of P. acnes isolates were resistant to clindamycin (30%) and erythromycin (26.7%), than to any other antibiotics tested (P = 0.0003). Some S. epidermidis isolates were resistant to tetracycline and doxycycline in addition to clindamycin and erythromycin. In the previous studies, few strains of P. acnes were found to be resistant to any of the antibiotics, but this study shows that antibiotic-resistant strains have been increasing in Korea acne patients.

Effects of growth stage and position within the beam in the structure and chemical composition of sika deer (Cervus nippon) antlers

The purpose of the present study was to investigate the changes in structural and chemical properties of sika deer antler at different stages of its growth in order to improve scientific assessment of antler’s quality. Eighteen antler samples, harvested on 40, 50 and 60 days after casting were collected from randomly selected deer farms, and the structural properties of antlers were examined. The chemical composition of each antler was determined in the upper, middle and basal section. Our results showed that the crude protein, crude fat (ether extract), uronic acid and sialic acid increased markedly from the base to the upper section, but the ash was higher in the basal section. Collagen content increased significantly from the upper to the basal section in all groups. The structural factors, including length and girth were positively or negatively correlated with the chemical composition such as glycosaminoglycans, ether extract-fat, ash, uronic acid, sialic acid, total sugar and collagen content. These findings may provide useful basic information and identify biomarkers for the association between structural properties and chemical composition during antler growth period, which should facilitate efficient production of high quality antlers for food consumption and as pharmaceutical agents.

Versatility of right gastroepiploic and gastroduodenal arteries for arterial reconstruction in adult living donor liver transplantation

BACKGROUND

In cases where there is severe intimal dissection in the recipient hepatic artery (HA), or if the HA has been used already and additional operations are needed due to graft rejection or arterial occlusion, an alternative is necessary. In the present study, we have reported the feasibility of using the right gastroepiploic artery (RGEA) and gastroduodenal artery (GDA) in various situations where the HA is not a feasible option.

METHODS

Among 463 patients who underwent primary adult-to-adult living donor liver transplantation from January 2002 to July 2010, eight subjects required alternative vessels. Four recipients displayed severe intimal injury associated with previous transarterial chemoembolization (TACE); two, required a salvage operation due to hepatic artery thrombosis (HAT); and two, retransplantations due to chronic rejection. The RGEA was used in five and the GDA in three patients.

RESULTS

Postoperative Doppler ultrasonography and three-dimensional computed tomography showed patent arterial flow in all patients. However, HAT recurred in one patient who underwent a salvage operation with the RGEA; she died 2 months later. Two other patients died due to wound infection and respiratory failure within 3 months despite intact hepatic arterial flow. Four patients had no further complications during follow-up (mean = 33 months).

CONCLUSION

Although there was a discrepancy in the diameter of the HA and the RGEA (or GDA), there was no problem with mobilization and microanastomosis. We therefore believe that these vessels can be good alternatives when the hepatic artery is unavailable.

A parametric study ot protease production in batch and fed-batch cultures of Bacillus firmus

Proteolytic enzymes produced by Bacillus species find a wide variety of applications in brewing, detergent, food, and leather industries. Owing to significant differences normally observed in culture conditions promoting cell growth and those promoting production of metabolites such as enzymes, for increased efficacy of bioreactor operations it is essential to identify these sets of conditions (including medium formulation). This study is focused on formulation of a semidefined medium that substantially enhances synthesis and secretion of an alkaline protease in batch cultures of Bacillus firmus NRS 783, a known superior producer of this enzyme. The series of experiments conducted to identify culture conditions that lead to improved protease production also enables investigation of the regulatory effects of important culture parameters including pH, dissolved oxygen, and concentrations of nitrogen and phosphorous sources and yeast extract in the medium on cell growth, synthesis and secretion of protease, and production of two major nonbiomass products, viz., acetic acid and ethanol. Cell growth and formation of the three nonbiomass products are hampered significantly under nitrogen, phosphorous, or oxygen limitation, with the cells being unable to grow in an oxygen-free environment. Improvement in protease production is achieved with respect to each culture parameter, leading in the process to 80% enhancement in protease activity over that attained using media reported in the literature. Results of a few fed-batch experiments with constant feed rate, conducted to examine possible enhancement in protease production and to further investigate repression of protease synthesis by excess of the principal carbon and nitrogen sources, are also discussed. The detailed investigation of stimulatory and repressory effects of simple and complex nutrients on protease production and metabolism of Bacillus firmus conducted in this study will provide useful guidelines for design of bioreactors for production of protease and bulk chemicals by this bacterium.

Availability of brain serotonin transporters in patients with restless legs syndrome

BACKGROUND

Selective serotonin reuptake inhibitors have been associated with the risk of restless legs syndrome (RLS), suggesting that dysregulation of serotonergic neurotransmission may provoke or exacerbate RLS.

METHODS

We compared the availability of serotonin transporter (SERT) between 16 drug-naïve patients with RLS and 16 healthy controls. SERT was measured in the pons and medulla via [(123)I]-2beta-carbomethoxy-3beta-(4-iodophenyl) tropane (beta-CIT) SPECT. A ratio of specific to nonspecific brain uptake (V(3)'') was used for all comparisons. RLS was diagnosed according to the criteria proposed by the National Institute of Health, and its severity was measured using the International RLS Study Group (IRLSSG) Severity Scale.

RESULTS

The availability of SERT was similar in the RLS group and the control group with regards to the pons (1.24 +/- 0.31 vs 1.24 +/- 0.25, p > 0.1) and the medulla (0.99 +/- 0.25 vs 1.00 +/- 0.23, p > 0.1). However, IRLSSG Severity Scale scores increased with decrease of SERT availability in both the pons (beta = -0.50, t = -3.19, p = 0.009) and the medulla (beta = -0.42, t = -2.44, p = 0.03).

CONCLUSIONS

Although serotonin transporter (SERT) availability in pons and medulla was similar in the restless legs syndrome (RLS) group and the control group, the severity of RLS symptoms increased as the availability of SERT decreased. These data partially support the hypothesis that an increase of serotonergic neurotransmission in the brainstem may exacerbate RLS, possibly via dual modulations on striatal dopaminergic neurotransmission and on the activities of spinal motor and sensory neurons.

Strong tunable slow and fast lights using a gain-clamped semiconductor optical amplifier

Previously demonstrated slow light is still far from applications, particularly due to the limited bandwidth and control speed. Although semiconductor-based slow light has the high bandwidth and sub-nanosecond control speed, slow light was observed only in the absorption regime with attenuation, while fast light observed in the gain regime with amplification. The large power difference in two regimes makes the use of the optical delay impractical. We report novel slow light in the gain regime, with a high power comparable to that of fast light, utilizing the anomalous gain characteristic in a gain-clamped semiconductor optical amplifier. The slow light is tunable to fast light with the current as the only variable. Additional high speed operation, fast delay control, and wide range of operation wavelength make the present approach practical.

Discoloration characteristics of 3 major muscles from cattle during cold storage

Discoloration characteristics of 3 major muscles (LD, Longissimus dorsi; PM, Psoas major; SM, Semimemebranosus) from Korean native cattle (Hanwoo) were monitored during 7 d of cold storage at 4 degrees C. The muscles were obtained from 12 Hanwoo carcasses at 24 h postmortem. Meat color (CIE L*, a*, b*), myoglobin (Mb) concentration, chemical form, metmyoglobin (MetMb) reducing ability (MRA), mitochondria concentration, and thiobarbituric acid reactive substance (TBARS) were measured at 1, 3, 5, and 7 d of storage. Although there were no significant differences in CIE a* and b*-values between the 3 muscles at day 1, the values of PM muscle were significantly (P < 0.05) lower than those of LD and SM muscles at day 5 and 7. PM muscle showed a rapid decrease in the oxymyoglobin (OxyMb) and an increase in MetMb, which resulted in a significantly (P < 0.05) higher percentage of MetMb in PM muscle compared to LD and SM muscles. Also, the Mb and mitochondria concentration of PM muscle was significantly (P < 0.05) higher than those of LD and SM muscles. However, there were no significant differences in MRA, pH, or TBARS between the 3 muscles during 7 d of cold storage. It was concluded that rapid discoloration (that is, MetMb accumulation) in PM muscle of Hanwoo could be due to its higher contents of Mb and mitochondria.

Effect of chilling temperature of carcass on breast meat quality of duck

An experiment was carried out to investigate whether variations in chill water temperature affect muscle shortening and meat quality in duck breast. Three chill water temperatures were applied to duck carcasses at 20 min postmortem for 30 min, including in ice water at 0 degrees C, in cold water at 10 degrees C, and in water at 20 degrees C. Results revealed that carcass temperatures were different (P < 0.05) at 50 and 120 min of postmortem with lower temperatures at the 0 degrees C treatment (P < 0.05). The pH over the first 24 h postmortem was not different (P > 0.05) among treatments, with the exception of 50 min postmortem. The pH of breast meat in the 0 degrees C treatment was higher (P < 0.05) than that of 20 degrees C treatment at 50 min postmortem (just after chilling). No other differences (P > 0.05) in pH existed among treatments. Drip loss, cooking loss, and moisture content were not different for breast meat samples that were chilled at different temperatures. Differences (P < 0.05) were found in CIE (L, a, and b) color values. Lightness (L) increased, whereas redness (a) decreased as the chill water temperature increased. Lower yellowness (b) was found in the breast meat samples at the 10 degrees C chill water temperature. However, shear force, sarcomere length, and protein solubility were not different (P > 0.05) among the breast meat samples chilled at different chill water temperatures. It may be concluded that chilling duck carcasses at different temperature ranges from 0 to 20 degrees C did not influence muscle shortening or meat quality, except in regard to breast meat color.

Giant vascular eccrine spiradenoma: report of a case with immunohistochemical study

We report a rare case of giant vascular eccrine spiradenoma (GVES) which developed in 56-yr-old Korean woman. It is a rare variant of eccrine spiradenoma (ES), which might be mistaken for angiomatous lesions in view of its florid vascularity and hemorrhagic features. Histogenesis of GVES is not clearly elucidated although it is known that ES presumably originates in the eccrine glands. To clarify the histogenesis of GVES, immunohistochemical stainings using various monoclonal antibodies were also performed. The tumor was composed of three types of cells, namely pale epithelial cells, small basal cells, and myoepithelial cells. Therefore, we conclude that GVES originated from eccrine gland and mainly differentiates toward secretory portion of secretory coil.

Characterization of heparan sulfate from the unossified antler of Cervus elaphus

The antler is the most rapidly growing tissue in the animal kingdom. According to previous reports, antler glycosaminoglycans (GAGs) consist of all kinds GAGs except for heparan sulfate (HS). Chondroitin sulfate is the major antler GAG component comprising 88% of the total uronic acid content. In the current study, we have isolated HS from antler for the first time and characterized it based on both NMR spectroscopy and disaccharide composition analysis. Antler GAGs were isolated by protease treatment and followed by cetylpyridinium chloride precipitation. The sensitivity of antler GAGs to heparin lyase III showed that this sample contained heparan sulfate. After incubation of antler GAGs with chondroitin lyase ABC, the HS-containing fraction was recovered by ethanol precipitation. The composition of HS disaccharides in this fraction was determined by its complete depolymerization with a mixture of heparin lyase I, II, and III and analysis of the resulting disaccharides by the reversed-phase (RP) ion pairing-HPLC, monitored by the fluorescence detection using 2-cyanoacetamide as a post-column labeling reagent. Eight unsaturated disaccharides (DeltaUA-GlcNAc, DeltaUA-GlcNS, DeltaUA-GlcNAc6S, DeltaUA2S-GlcNAc, DeltaUA-GlcNS6S, DeltaUA2S-GlcNS, DeltaUA2S-GlcNAc6S, DeltaUA2S-GlcNS6S) were produced from antler HS by digestion with the mixture of heparin lyases. The total content of 2-O-sulfo disaccharide units in antler HS was higher than that of heparan sulfate from most other animal sources.

Clinical features of Plasmodium vivax malaria

BACKGROUND

Since its reemergence in 1993, a number of cases of Plasmodium vivax malaria have been reported in Korea. We analyzed the cases of malaria patients living in Chuncheon and its neighboring communities, to characterize its clinical manifestations and laboratory findings, and to identify any differences between our clinical findings and those of previous studies.

METHODS

We reviewed the clinical records of cases that were confirmed as malaria by peripheral blood smear at Chuncheon Sacred Heart Hospital from July 1998 to September 2001.

RESULTS

Forty-four cases were included in the study. All patients were infected with Plasmodium vivax, and presented with high fever; however, tertian fever developed in only 15 patients (35.7%). A number of cases showed various symptoms, which included headache, abdominal pain, nausea and vomiting. Of the 44 cases identified, 41 (93.2%) developed malaria between June and September. Thrombocytopenia was a prominent finding in 75% of the cases at diagnosis, but resolved during or after therapy. Other laboratory abnormalities such as, anemia, elevated transamines, coagulopathies, and elevated lactose dehydrogenase (LDH) were also noted. Cerebrospinal fluid (CSF) studies were performed in five cases, one of which showed pleocytosis in the CSF.

CONCLUSION

We noted only 15 patients (35.7%) with tertian fever; the other patients showed variable fever patterns. Thrombocytopenia was the most prominent laboratory finding. Therefore, we suggest that malaria should be included in the differential diagnosis of febrile diseases with an onset between June to and September, regardless of the pattern of the fever.

Unique properties of four lactobacilli in amino acid production and symbiotic mixed culture for lactic acid biosynthesis

With four Lactobacilli--L. delbrueckii subsp. lactis (ATCC 12315), L. casei (NRRL-B1445), L. delbrueckii (NRRL-B445), and L. heveticus (NRRL-B1937)--the characteristics of cell growth and production of lactate and amino acids were investigated. Especially, the time-course variation in concentration of amino acids (classified into alanine, serine, aspartate, glutamate, aromatic amino acid, and histidine families) was estimated in detail, and the results were systematically compared. It was elucidated that L. delbrueckii (NRRL-B445) and L. helveticus (NRRL-B1937) had quite different characteristics in growth, lactic acid synthesis, and amino acid production. L. helveticus (NRRL-B1937) was superior in the production of amino acids as well as in cell growth, but showed very poor ability in lactic acid production. However, L. delbrueckii (NRRL-B445) showed higher yield of lactic acid despite repressed cell growth, but suffered from severe amino acid deficiency in culture. By modulating the initial concentration of each strain in the mixed culture containing both L. delbrueckii (NRRL-B445) and L. helveticus (NRRL-B1937), the lactic acid production (i.e., the amount of lactic acid produced and lactic acid yield to glucose consumed) was significantly improved, presumably via symbiotic interaction between the two strains.

Removal of chromium from water and wastewater by ion exchange resins

Removal of chromium from water and wastewater is obligatory in order to avoid water pollution. Batch shaking adsorption experiments were carried out to evaluate the performance of IRN77 and SKN1 cation exchange resins in the removal of chromium from aqueous solutions. The percentage removal of chromium was examined by varying experimental conditions viz., dosage of adsorbent, pH of the solution and contact time. It was found that more than 95% removal was achieved under optimal conditions. The adsorption capacity (k) for chromium calculated from the Freundlich adsorption isotherm was found to be 35.38 and 46.34 mg/g for IRN77 and SKN1 resins, respectively. The adsorption of chromium on these cation exchange resins follows the first-order reversible kinetics. The ion exchange resins investigated in this study showed reversible uptake of chromium and, thus, have good application potential for the removal/recovery of chromium from aqueous solutions.

Cleaning strategies for flux recovery of an ultrafiltration membrane fouled by natural organic matter

One of the most common problems encountered in water treatment applications of membranes is fouling. Natural organic matter (NOM) represents a particularly problematic foulant. Membranes may be fouled by relatively hydrophilic and/or hydrophobic NOM components, depending on NOM characteristics, membrane properties, and operating conditions. To maximize flux recovery for an NOM-fouled ultrafiltration membrane (NTR 7410), chemical cleaning and hydraulic rinsing with a relatively high cross-flow velocity were investigated as cleaning strategies. The modification of the membrane surface with either an anionic or a cationic surfactant was also evaluated to minimize membrane fouling and to enhance NOM rejection. Foulants from a hydrophobic NOM source (Orange County ground water (OC-GW)) were cleaned more effectively in terms of permeate flux by acid and caustic cleanings than foulants from a relatively hydrophilic NOM source (Horsetooth surface water (HT-SW)). An anionic surfactant (sodium dodecyl sulfate (SDS)) was not effective as a cleaning agent for foulants from either hydrophobic or hydrophilic NOM sources. High ionic strength cleaning with 0.1 M NaCl was comparatively effective in providing flux recovery for NOM-fouled membranes compared to other chemical cleaning agents. Increased cross-flow velocity and longer cleaning time influenced the efficiency of caustic cleaning, but not high ionic strength cleaning. The membrane was successfully modified only with the cationic surfactant; however, enhanced NOM rejection was accompanied by a significant flux reduction.

A study on hexachromic ion selective electrode based on supported liquid membranes

An ion selective electrode (ISE) for determining Cr(VI) using supported liquid membranes (SLMs) containing trioctylphosphine oxide (TOPO) was investigated in this study. TOPO, as a carrier, had a high selectivity for Cr(VI) against interfering ions such as sulfate, nitrate, nitrite, and chloride. The composition of the SLM was optimized as 0.193 g TOPO/1 mL NPOE (o-nitrophenyl octyl ether)/0.5 g poly (vinyl chloride) for detection of Cr(VI). The Cr(VI) concentration was measured in the range of 1 x 10(-3) to 1 x 10(-6) M with the SLM prepared in the study. It seemed that Cr(VI) was transported in the SLM as a triply charged ion indicated by the slope of the emf response. Selectivity coefficients and detection limits of Cr(VI) in the presence of interfering ions were determined experimentally using the fixed interference method.

Comparison between posterolateral fusion with pedicle screw fixation and anterior interbody fusion with pedicle screw fixation in adult spondylolytic spondylolisthesis

There have been many reports regarding various operative methods for spondylolytic spondylolisthesis. However, there have been no reports regarding the comparison between posterolateral fusion (PLF) with pedicle screw fixation (PSF) and anterior lumbar interbody fusion (ALIF) with PSF. The purpose of the current study was to compare the clinical outcomes of PLF with PSF and ALIF with PSF, and to help in the selection of treatment options. Fifty-six patients with spondylolytic spondylolisthesis who underwent PLF with PSF (group 1, 35 patients) or who underwent ALIF with PSF (group 2, 21 patients) were studied. Minimum follow-up was 2 years. Demographic variables and disease state were similar for the two groups. We studied operating time, amount of blood loss, duration of hospital stay, clinical outcomes, complications, time at which fusion was complete, fusion rate, and radiological measurements. There were no significant differences between the two groups in terms of the amount of blood loss, duration of hospital stay, back pain, radiating pain, fusion rate, or complication rate. However, in group 2, the operation time and the time at which fusion became complete was longer, and in group 1 there was significant radiological reduction loss. In conclusion, PLF with PSF was just as effective as ALIF with PSF in terms of clinical outcomes, but ALIF with PSF was superior to PLF with PSF in terms of the prevention of reduction loss. Anterior support would be helpful for preventing reduction loss in cases of spondylolytic spondylolisthesis of the lumbar spine.

Pathological findings in cumulative irritation induced by SLS and croton oil in hairless mice

It is known that the pathological features of acute irritant contact dermatitis are specific according to the irritant. However, in chronic irritant contact dermatitis, it is not clear whether specific patterns exist. To investigate whether the specific pathology of acute irritant contact dermatitis is sustained in chronic irritant contact dermatitis, sodium lauryl sulfate (SLS) and croton oil were applied 3x a week for 2 weeks on the dorsal skin of hairless mice using Finn Chambers. The pathologic changes induced by irritants at various concentrations were evaluated using H&E and Luna's staining, as well as immunohistochemistry for 5-bromo-2-deoxyuridine (BrdU), keratin 6 and loricrin. Our results showed that epidermal hyperplasia and inflammatory infiltration were relatively marked in the groups treated with higher concentrations of irritants. These features were more prominent in the 1% croton oil treated group than in the 0.25% SLS treated group. However, lower concentrations of irritants resulted in very similar histological changes, characterized by epidermal hyperplasia with minimal inflammatory infiltration, irrespective of the chemical. Our results suggest that the histological responses to irritants vary with concentration in cumulative irritation, as in acute irritation, but repetitive mild irritation may evoke common histological changes, characterized by epidermal hyperplasia with minimal inflammatory infiltration, irrespective of the chemical used.

Recurrent lumbar disc herniation: results of operative management

STUDY DESIGN

A retrospective evaluation of 28 patients with recurrent lumbar disc herniation.

OBJECTIVES

To analyze the outcome of the revisions (repeat discectomy), the risk factors of recurrent disc herniation, and the factors that influenced the outcomes of repeat discectomy.

SUMMARY OF BACKGROUND DATA

Recurrent herniation following disc excision has been reported in 5-11% of patients. There have been many studies on recurrent disc herniation, but these studies have analyzed mixed patient populations.

METHODS

Recurrent lumbar disc herniation was defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, with a pain-free interval greater than 6 months. Eight women and 20 men were studied. The levels of disc herniation were L4-L5 (19 cases) and L5-S1 (9 cases). Gadolinium-enhanced magnetic resonance imaging was performed in all patients. Revision surgery was performed in all patients by using conventional open discectomy. The pain-free interval, side and degree of herniation, operation time, duration of hospital stay, and clinical improvement rate were recorded.

RESULTS

The mean pain-free interval was 60.8 months. There were 21 cases of ipsilateral herniation and 7 cases of contralateral herniation. The degrees of herniation in revision were protrusion (14 cases), subligamentous extrusion (3 cases), transligamentous extrusion (8 cases), and sequestration (3 cases). The degrees of herniation in the previous discectomy were protrusion (17 cases), subligamentous extrusion (10 cases), and transligamentous extrusion (1 case). The length of surgery was significantly different (P = 0.003) between the revision surgery and the previous discectomy. There were no significant differences between revision and previous surgery in terms of hospital stay or clinical improvement rates. Age, gender, smoking, professions, traumatic events, level and degree of herniation, and pain-free interval did not affect the clinical outcomes.

CONCLUSION

Conventional open discectomy as a revision surgery for recurrent lumbar disc herniation showed satisfactory results that were comparable with those of primary discectomy. Based on the results of this study, repeat discectomy can be recommended for the management of recurrent lumbar disc herniation.