The removal of heavy metal cations by natural zeolites

In this study, the adsorption behavior of natural (clinoptilolite) zeolites with respect to Co(2+), Cu(2+), Zn(2+), and Mn(2+) has been studied in order to consider its application to purity metal finishing wastewaters. The batch method has been employed, using metal concentrations in solution ranging from 100 to 400 mg/l. The percentage adsorption and distribution coefficients (K(d)) were determined for the adsorption system as a function of sorbate concentration. In the ion exchange evaluation part of the study, it is determined that in every concentration range, adsorption ratios of clinoptilolite metal cations match to Langmuir, Freundlich, and Dubinin-Kaganer-Radushkevich (DKR) adsorption isotherm data, adding to that every cation exchange capacity metals has been calculated. It was found that the adsorption phenomena depend on charge density and hydrated ion diameter. According to the equilibrium studies, the selectivity sequence can be given as Co(2+) > Cu(2+) > Zn(2+) > Mn(2+). These results show that natural zeolites hold great potential to remove cationic heavy metal species from industrial wastewater.

Thermodynamics of Pb2+ and Ni2+ adsorption onto natural bentonite from aqueous solutions

Removal of Pb2+ and Ni2+ from aqueous solutions by sorption onto natural bentonite was investigated. Experiments were carried out as a function of particle size, the amount of bentonite, pH, concentration of metals, contact time, and temperature. The adsorption patterns of metal ions onto followed the Langmuir, Freundlich, and Dubinin-Radushkevich isotherms. This included adsorption isotherms of single-metal solutions at 303 K by batch experiments. The thermodynamic parameters (DeltaH,DeltaS,DeltaG) for Pb2+ and Ni2+ sorption onto bentonite were also determined from the temperature dependence. The adsorptions were endothermic reactions. The results suggested that natural bentonite is suitable as a sorbent material for recovery and adsorption of metal ions from aqueous solutions.

Adsorption characteristic of U(VI) ion onto thermally activated bentonite

In this study, the effect of pH, contact time, temperature, and initial metal concentration on U(VI) adsorption on thermally activated bentonite (TAB) was investigated. Graphical correlation of various adsorption isotherm models like, Freundlich, and Dubinin-Radushkevich have been carried out for TAB. Various thermodynamic parameters, such as, Gibb's free energy, entropy and enthalpy of the on-going adsorption process have been calculated. In order to reveal the adsorptive characteristic of bentonite samples, surface area, FT-IR, and DTA-TG spectra analyses were carried out. The results show that TAB samples can be an alternative low cost adsorbent for removing U(VI) ions from aqueous solutions.

Sperm output of older men

BACKGROUND

Declining fertility of couples from the fourth decade of life is largely attributable to the drop in female fertility. However, increasing numbers of men, whose fertility theoretically lasts until death, are seeking fertility treatment at older ages, yet there is little information on sperm production and function past the age of 50 years. The few studies of such older men have examined men attending fertility clinics, and therefore willing to provide semen samples, but the participation bias of such recruitment hinders extrapolation to the unselected general male population.

METHODS

We have taken the opportunity to study a convenience sample of 55 healthy, non-infertile men ranging in age from 52 to 79 years old who provided semen samples as part of a prostate cancer screening project. They were compared with a control group (n = 409) of younger (< 52 years) men from among 567 volunteers screened as potential sperm donors for an artificial insemination program.

RESULTS

Older men had lower semen volume (mean semen volume 1.8 versus 3.2 ml; P < 0.0001) and total sperm output (median 74 versus 206 million sperm per ejaculate; P < 0.0001), whereas sperm density (median 64 versus 73 million sperm/ml; P = 0.12) was non-significantly decreased. Older men had more abnormal sperm morphology with decreasing numbers of normal forms (mean 14% versus 25%; P < 0.0001) and reduced vitality (mean 51% versus 80%; P < 0.0001), as well as increased numbers of cytoplasmic droplets (median 1 versus 0; P < 0.0001) and sperm tail abnormalities (30% versus 17%; P < 0.0001). Sperm head or neck abnormalities were no different between the groups.

CONCLUSIONS

While neither study group may be representative of the general male population, these findings suggest that sperm production, reflected in sperm output but not sperm density, as well as sperm morphology and viability are diminished in this population of healthy, non-infertile older men.

The incidence of cystic fibrosis gene mutations in patients with congenital bilateral absence of the vas deferens in Scotland

OBJECTIVE

To examine the incidence of cystic fibrosis transmembrane-conductance regulator (CFTR) gene mutations in Scottish patients with congenital bilateral absence of the vas deferens (CBAVD).

PATIENTS AND METHODS

Thirty patients with CBAVD presenting consecutively to the Edinburgh infertility clinic were examined for CFTR gene mutations. All patients were assessed clinically and tested for 15 gene mutations using a single-tube polymerase chain-reaction multiplex system.

RESULTS

All patients were in good health and without clinical evidence of cystic fibrosis. CFTR gene mutations were found in 70% of patients with CBAVD.

CONCLUSION

CFTR gene-testing and genetic counselling are important in all men with CBAVD.

Prospective study of the aetiology of infusion phlebitis and line failure during peripheral parenteral nutrition

Four techniques of administering peripheral parenteral nutrition (PPN) were examined prospectively to investigate the role of mechanical trauma in the development of infusion phlebitis. Patients in group 1 (n = 15) were fed via a standard 18-G Teflon cannula which was removed on completion of the infusion and was rotated to the contralateral arm every day. Group 2 patients (n = 15) had a similar catheter sited in each forearm simultaneously, with rotation of the side of infusion each day. Patients in group 3 (n = 17) had a 15-cm Silastic rubber catheter inserted into a forearm vein and a standard cannula sited in the contralateral forearm, with alternation of infusion each day. Those in group 4 (n = 13) had a fine-bore 23-G silicone catheter sited in one arm only. Patients in groups 1, 2 and 3 were fed over 12-h cycles and those in group 4 for a 24-h continuous cycle. A total of 408 patient-days of PPN were given. Mean duration of PPN in groups 1-4 was 7.5, 9, 5.5 and 5 days respectively. Infusion phlebitis was not recorded in patients who had a daily change of cannula (group 1), but occurred in four patients in group 2, eight in group 3 and eight in group 4. Phlebitis scores were 0, 9, 15 and 12 for groups 1-4 respectively. Severe phlebitis and line occlusion occurred more frequently in patients with a 15-cm catheter (group 3) and in those fed continuously over 24 h (group 4). These results suggest that mechanical trauma is an important factor in the aetiology of infusion phlebitis. This can be minimized by reducing the time for which the vein wall is exposed to nutrient infusion and by reducing the amount of prosthetic material within the vein.

BabyLux device: a diffuse optical system integrating diffuse correlation spectroscopy and time-resolved near-infrared spectroscopy for the neuromonitoring of the premature newborn brain

The BabyLux device is a hybrid diffuse optical neuromonitor that has been developed and built to be employed in neonatal intensive care unit for the noninvasive, cot-side monitoring of microvascular cerebral blood flow and blood oxygenation. It integrates time-resolved near-infrared and diffuse correlation spectroscopies in a user-friendly device as a prototype for a future medical grade device. We present a thorough characterization of the device performance using test measurements in laboratory settings. Tests on solid phantoms report an accuracy of optical property estimation of about 10%, which is expected when using the photon diffusion equation as the model. The measurement of the optical and dynamic properties is stable during several hours of measurements within 3% of the average value. In addition, these measurements are repeatable between different days of measurement, showing a maximal variation of 5% in the optical properties and 8% for the particle diffusion coefficient on a liquid phantom. The variability over test/retest evaluation is < 3 % . The integration of the two modalities is robust and without any cross talk between the two. We also perform in vivo measurements on the adult forearm during arterial cuff occlusion to show that the device can measure a wide range of tissue hemodynamic parameters. We suggest that this platform can form the basis of the next-generation neonatal neuromonitors to be developed for extensive, multicenter clinical testing.

Incidence of thromboembolism after transurethral resection of the prostate (TURP)--a study on TED stocking prophylaxis and literature review

OBJECTIVE

To assess the incidence of clinically evident pulmonary emboli and deep vein thromboses in patients undergoing transurethral resection of the prostate (TURP) with the routine use of graduated elastic compression stockings (TED) in all patients and the addition of low-dose heparin in selected high-risk patients.

PATIENTS AND METHOD

A retrospective analysis of clinically evident thromboembolic complications within 4 weeks of operation in 883 patients operated in a single hospital during a 4-year period.

RESULTS

Four patients (0.45%) developed pulmonary emboli (PE), of which two (0.23%) were fatal. There was one clinically evident deep vein thrombosis (DVT) in a high-risk patient (0.11%). None of the 14 high-risk patients receiving additional low-dose heparin required a blood transfusion.

CONCLUSION

Clinical thromboembolic complications following TURP are rare. TURP patients have a low risk for DVT, but an intermediate risk for pulmonary emboli. Pulmonary emboli may occur without identifiable risk factors and despite TED stocking prophylaxis.

Transportation and kinetic analysis of Mo(VI) ions through a MDLM system containing TNOA as carrier

In this report, Mo(VI) ions are transported from an aqueous donor phase into an aqueous acceptor phase by a newly designed method called as multi dropped liquid membrane (MDLM) system prepared by dissolving TNOA as carrier in kerosene. During the extraction of Mo(VI) ions by the liquid membrane system; 100ppm Mo(VI) solutions as donor phase, buffer solution(pH:9.5) and Na2CO3 in different concentrations as acceptor phase and TNOA diluted by kerosen as organic phase are used.In our experimental work, the effect of temperature by using buffer solution and Na2CO3 in the acceptor phase and effect of concentration of acceptor phase on the extraction of Mo(VI) ions were investigated. Appropriate conditions for Mo(VI) transportation were as follows: pH of donor phase is 2.00, concentration of TNOA is 0.005M, 1.00M Na2CO3 as acceptor phase, and flux rate is 50mL/min. Besides, Mo(VI) ion transportation is consecutive first order irreversible reaction and the transportation of Mo(VI) ions is diffusion controlled process. The kinetic parameters (k1, k2, Rm(max), tmax, Jd(max), Ja(max)) were calculated for the interface reactions assuming two consecutive, irreversible first-order reactions.

Estrogen secretion from a malignant sex cord stromal tumor in a patient with complete androgen insensitivity

We report on a 68-year-old patient with complete androgen insensitivity syndrome (testicular feminization syndrome) in whom an estrogen-secreting malignant sex cord stromal tumor developed in an intraabdominal testis. We believe this to be the first such case to document estrogen secretion by the tumor.

Surgical management of breast cancer liver metastases

We analyzed the treatment results in patients who underwent hepatic resection for breast cancer liver metastases(BCLM).Between 1/2003 and 12/2012, 15 patients underwent hepatic resection for BCLM. All primary breast tumors were diagnosed as invasive breast cancer. Synchronous BCLM ocurred in 2 patients and 13 patients presented with metachronous BCLM. Median age of patients at the time of BCLM diagnosis was 51 years(range from 31 to 73 years). All resections were considered as R0. From among 15 resections we performed 10 major hepatic resections according to Couinaud classification(≥3 segments) and the rest were minor ones. There was no postoperative mortality within 60 days . All postoperative complications were managed conservatively. Median hospital stay was 10,5 days, ranging from 7-14 days.Standard therapy for patients with BCLM remains systemic chemo- and hormonal therapy. Hepatic resection as a part of multimodal treatment in tertiary HPB centers can offer in a selected group of patients a safe option for improved survival. Keywords: breast cancer, liver metastases, hepatic resection.

Traumatic autonephrectomy due to explosion: a case report and literature review

A 47-year-old man presented 33 years after major trauma resulting from an explosion with asymptomatic microhaematuria. An IVU, showed a completely calcified non-functioning right kidney with hypertrophic left kidney. Investigations for other causes of haematuria were negative. The results of long-term conservative management of traumatic renal infarction are reviewed.

[Study of dental attrition in a medieval adult population from Southwest France]

INTRODUCTION

The aim of the authors was to study dental attrition in a medieval sample of paired mandibles and maxillas from the Southwest France (IX to XV century).

MATERIALS AND METHODS

We selected 58 adult individuals with maxillas and mandibles in good state of conservation, 29 women and 29 men from the medieval collection of Vilarnau-d'Amont (Western Pyrenees, France). Attrition was graded according to the Brabant index.

RESULTS

We found a high prevalence of attrition in this sample. The first molars (M1) were the maxillary and mandibular teeth most concerned by attrition. The most frequent attrition level was level 2, with dentin exposure. We did not find any significant difference of tooth wear between maxillary and mandibular teeth, even if maxillary teeth seemed to be more worn. There was symmetry of attrition between the left and right side. There was no significant difference between men and women.

DISCUSSION

Working on paired mandibles and maxillas showed that attrition in the middle age was a global phenomenon, intermaxillary and symmetric. It was much more severe than today, rapidly evolving and generalized because of the abrasive quality of food, cooking, chewing habits, and intensity of chewing pressure.

Ampullary cancer in a patient with familial adenomatous polyposis - a rare case report and current status of management

Familial adenomatous polyposis (FAP) is an inherited autosomal dominant disorder. Extracolonic manifestations are seen quite often. As prophylactic colectomy has become a standard care in FAP patients, the concerns over the development of associated extracolonic malignancies have become more prevalent. The authors report a case of a patient with the history of subtotal colectomy because of FAP with the development of adenocarcinoma of papilla of Vater twenty-six years later. A radical procedure in form of proximal pancreaticoduodenectomy was indicated. Variable endoscopic surveillance protocols and treatment strategies have been proposed concerning the management of duodenal and periampullary lesions. In case of periampullary malignancies, the radical surgical resection offers the only chance for cure and the only option that may safeguard the long‑term survival (Fig. 2, Ref. 30). Keywords: ampulla of Vater, bile duct, obstructive jaundice, pancreatoduodenectomy, periampullary tumors.

Bilateral ureteric obstruction secondary to the prolonged use of tiaprofenic acid

There is increasing awareness that the long-term use of the non-steroidal anti-inflammatory agent tiaprofenic acid (Surgam) is associated with a severe form of cystitis. The condition is usually reversible with complete resolution of symptoms on stopping the drug. We present a case of tiaprofenic acid-induced cystitis resulting in bilateral hydronephrosis suggesting ureteric obstruction. The previous reported cases are reviewed and the risks of delay in withdrawal of the drug and of permanent ureteric damage are discussed.

Postoperative pancreatic fistula after pancreatic resection

BACKGROUND

The failure of pancreatic anastomosis after the proximal pancreaticoduodenectomy (PD) and the failure of pancreatic stump after the distal pancreatectomy with a resulting postoperative pancreatic fistula remain the most feared complications after pancreatic resection. Surgeons have been trying to find a reliable reconstructive technique of pancreatic anastomosis for decades.

METHODS

A literature search was performed to January 2020. Studies giving a detailed description of the pancreatic anastomosis after open PD and pancreatic stump closure techniques after the distal pancreatectomy were included. The aim of this study was review reported data derived from meta-analyses concerning the incidence of POPF according to the International Study Group of Pancreatic Surgery. A comparison of various surgical techniques and their impact on POPF incidence was made.

RESULTS

In the group of clinically relevant POPF (CR- POPF), a well established difference between the patients undergoing POPF-associated interventional drainage or reoperation was observed. Meta-analyses showed that the patients with CR- POPF were statistically more likely to have a small duct size, soft gland texture, particular pancreatic neoplasms and an excessive intraoperative blood loss.

CONCLUSION

Grade C POPF following PD, although uncommon, occurs with a defined incidence and is associated with a substantial morbidity, prolonged hospitalization, delayed recovery and a significant mortality. According to the results of various meta-analyses, pancreatogastrostomy and pancreatojejunostomy seemed to be comparable anastomotic techniques following PD (Ref. 54).

Recurrence after sentinel lymph node biopsy in cutaneous melanoma: a single-center experience in Slovak patients

The standard approach in the management of cutaneous malignant melanoma is considered to be a complete excision of the primary lesion with an appropriate margin of the normal tissue according to Breslow thickness. Usually sentinel lymph node biopsy (SLNB) can help to determine the nodal status, and thus improve the accuracy of staging of the disease. However, the role of SLNB in melanoma treatment remains controversial. NCCN guidelines strongly support routine performance of therapeutic lymphadenectomy in all melanoma patients with clinically positive nodes without radiographic evidence of distant metastases. Patients with positive SLNB should have had completion lymph node dissection (CLND) for regional disease control. Between 2012 and 2016, 168 consecutive patients underwent surgery for primary cutaneous malignant melanoma at St. Elisabeth Cancer Institute in Bratislava. The indication for SLNB and the procedure was made according to international guidelines. In this retrospective study, a cohort of 78 patients was analyzed (35 women and 43 men). Inclusion criteria comprised patients with cutaneous melanoma with no evidence of distant metastases or clinical lymphadenopathy. SLNB comprised a dual labelling method (Tc-99m Nanocolloid / blue dye) in a one-day protocol. Median follow-up was 657 days. The primary composite outcome was the time to the first disease-related event (death, reintervention, worsening of symptoms). Primary outcome measures were overall (disease-specific) and disease-free survival. The overall identification rate of SLN in melanoma patients by dual labelling method was 98.5%. All patients with positive SLNB on frozen section underwent complete regional lymphadenectomy. Using multivariable analysis Breslow thickness of the lesion (p=0.00004, HR 4.03 on logarithmic scale) was identified as the strongest independent predictor of the disease-free survival (DFS) and male gender was significant predictor of DFS. An increase in tumor thickness was associated with significantly higher risk of an event. Neither SLN positivity nor initial S-100 level proved to be significant predictors of the event at the 0.05 level of probability. Multidisciplinary approach represents the gold standard of care for melanoma patients and surgery remains the best option for most localized cases. Although the usefulness of SLNB procedure has been questioned, it provides an excellent staging method, moreover, it can identify high-risk patients. The routine use of completion lymphadenectomy after a positive SLNB is still controversial. It is not clear whether CLND following a positive SLN biopsy improves survival but it could provide regional disease control.

Surgical management of breast cancer liver metastases

We analyzed the treatment results in patients who underwent hepatic resection for breast cancer liver metastases(BCLM).Between 1/2003 and 12/2012, 15 patients underwent hepatic resection for BCLM. All primary breast tumors were diagnosed as invasive breast cancer. Synchronous BCLM ocurred in 2 patients and 13 patients presented with metachronous BCLM. Median age of patients at the time of BCLM diagnosis was 51 years(range from 31 to 73 years). All resections were considered as R0. From among 15 resections we performed 10 major hepatic resections according to Couinaud classification(≥3 segments) and the rest were minor ones. There was no postoperative mortality within 60 days . All postoperative complications were managed conservatively. Median hospital stay was 10,5 days, ranging from 7-14 days.Standard therapy for patients with BCLM remains systemic chemo- and hormonal therapy. Hepatic resection as a part of multimodal treatment in tertiary HPB centers can offer in a selected group of patients a safe option for improved survival.