Deterioration phenomenon of Pb-contaminated aqueous solution remediation and enhancement mechanism of nano-hydroxyapatite-assisted biomineralization

Modern metallurgical and smelting activities discharge the lead-containing wastewater, causing serious threats to human health. Bacteria and urease applied to microbial-induced carbonate precipitation (MICP) and enzyme-induced carbonate precipitation (EICP) are denatured under high Pb2+ concentration. The nano-hydroxyapatite (nHAP)-assisted biomineralization technology was applied in this study for Pb immobilization. Results showed that the extracellular polymers and cell membranes failed to secure the urease activity when subjected to 60 mM Pb2+. The immobilization efficiency dropped to below 50% under MICP, whereas it due to a lack of extracellular polymers and cell membranes dropped to below 30% under EICP. nHAP prevented the attachment of Pb2+ either through competing with bacteria and urease or promoting Ca2+/Pb2+ ion exchange. Furthermore, CO32- from ureolysis replaced the hydroxyl (-OH) in hydroxylpyromorphite to encourage the formation of carbonate-bearing hydroxylpyromorphite of higher stability (Pb10(PO4)6CO3). Moreover, nHAP application overcame an inability to provide nucleation sites by urease. As a result, the immobilization efficiency, when subjected to 60 mM Pb2+, elevated to above 80% under MICP-nHAP and to some 70% under EICP-nHAP. The findings highlight the potential of applying the nHAP-assisted biomineralization technology to Pb-containing water bodies remediation.

Struvite and ethylenediaminedisuccinic acid (EDDS) enhance electrokinetic-biological permeable reactive barrier removal of copper and lead from contaminated loess

Removal of heavy metals using the electrokinetic (EK) remediation technology is restricted by soils containing a fraction of clay particles above 12%. Furthermore, it is also affected by hydroxide precipitation (focusing phenomenon) close to the cathode. A modified EK reactor containing a permeable reactive barrier (PRB) was proposed herein where the enzyme-induced carbonate precipitation (EICP) treatment was incorporated into the PRB. Despite that, NH4+-N pollution induced by the urea hydrolysis resulting from the EICP treatment causes serious threats to surrounding environments and human health. There were four types of tests applied to the present work, including CP, TS1, TS2, and TS3 tests. CP test neglected the bio-PRB, while TS1 test considered the bio-PRB. TS2 test based on TS1 test tackled NH4+-N pollution using the struvite precipitation technology. TS3 test based on TS2 test applied EDDS to enhance the removal of Cu and Pb. In CP test, the removal efficiency applied to Cu and Pb removals was as low as approximately 10%, presumably due to the focusing phenomenon. The removal efficiency was elevated to approximately 24% when the bio-PRB and the electrolyte reservoir were involved in TS1 test. TS2 test indicated that the rate of struvite precipitation was 40 times faster than the ureolysis rate, meaning that the struvite precipitate had sequestered NH4+ before it started threatening surrounding environments. The chelation between Cu2+ and EDDS took place when EDDS played a part in TS3 test. It made Cu2+ negatively surface charged by transforming Cu2+ into EDDSCu2-. The chelation caused those left in S4 and S4 to migrate toward the bio-PRB, whereas it also caused those left in S1 and S2 to migrate toward the anode. Due to this reason, the fraction of Cu2+ removed by the bio-PRB and the electrolyte reservoir is raised to 32% and 26% respectively, and the fraction of remaining Cu was reduced to 41%. Also, the removal efficiency applied to Pb removal was raised to 50%. Results demonstrate the potential of struvite and EDDS-assisted EK-PRB technology as a cleanup method for Cu- and Pb-contaminated loess.

Applying the first microcapsule-based self-healing microbial-induced calcium carbonate materials to prevent the migration of Pb ions

Lead (Pb) accumulation can lead to serious threats to surrounding environments and damage to the liver and kidneys. In the past few years, microbial-induced carbonate precipitation (MICP) technology has been widely applied to achieve Pb immobilization due to its environmentally friendly nature. However, harsh pH conditions can cause the instability of the carbonate precipitation to degrade or dissolve, increasing the potential of Pb2+ migration into nearby environments. In this study, microcapsule-based self-healing microbial-induced calcium carbonate (MICC) materials were applied to prevent Pb migration. The highest sporulation rate of 95.8% was attained at 7 g/L yeast extract, 10 g/L NH4Cl, and 3.6 g/L Mn2+. In the germination phase, the microcapsule not only prevented the bacterial spores from being threatened by the acid treatment but secured their growth and reproduction. Micro analysis also revealed that cerussite, calcite, and aragonite minerals were present, while extracellular polymeric substances (EPSs) were identified via Fourier transform infrared spectroscopy (FTIR). These results confirm their involvement in combining Pb2+ and Ca2+. The immobilization efficiency of above 90% applied to MICC materials was attained, while it of below 5% applied to no MICC use was attained. The findings explore the potential of applying microcapsule-based self-healing MICC materials to prevent Pb ion migration when the calcium carbonate degrades under harsh pH conditions.

Study on Cu- and Pb-contaminated loess remediation using electrokinetic technology coupled with biological permeable reactive barrier

Although the electrokinetic (EK) remediation has drawn great attention because of its good maneuverability, the focusing phenomenon near the cathode and low removal efficiency remain to be addressed. In this study, a novel EK reactor was proposed to remediate Cu and Pb contaminated loess where a biological permeable reactive barrier (bio-PRB) was deployed to the middle of the EK reactor. For comparison, three test configurations, namely, CG, TG-1, and TG-2, were available. CG considered the multiple enzyme-induced carbonate precipitation (EICP) treatments, while TG-1 considered both the multiple EICP treatments and pH regulation. TG-2 further considered NH4+ recovery based on TG-1. CG not only improved Cu and Pb removals by the bio-PRB but also depressed the focusing phenomenon. TG-1 causes more Cu2+ and Pb2+ to migrate toward the bio-PRB and aggravates Cu and Pb removals by the bio-PRB, depressing the focusing phenomenon. TG-2 depressed the focusing phenomenon the most because Cu2+ and Pb2+ can combine with not only CO32- but PO43-. The removal efficiency of Cu and Pb is 34% and 36%, respectively. A NH4+ recovery of about 100% is attained.

Biopolymer-assisted enzyme-induced carbonate precipitation for immobilizing Cu ions in aqueous solution and loess

Wastewater, discharged in copper (Cu) mining and smelting, usually contains a large amount of Cu2+. Immobilizing Cu2+ in aqueous solution and soils is deemed crucial in preventing its migration into surrounding environments. In recent years, the enzyme-induced carbonate precipitation (EICP) has been widely applied to Cu immobilization. However, the effect of Cu2+ toxicity denatures and even inactivates the urease. In the present work, the biopolymer-assisted EICP technology was proposed. The inherent mechanism affecting Cu immobilization was explored through a series of test tube experiments and soil column tests. Results indicated that 4 g/L chitosan may not correspond to a higher immobilization efficiency because it depends as well on surrounding pH conditions. The use of Ca2+ not only played a role in further protecting urease and regulating the environmental pH but also reduced the potential for Cu2+ to migrate into nearby environments when malachite and azurite minerals are wrapped by calcite minerals. The species of carbonate precipitation that are recognized in the numerical simulation and microscopic analysis supported the above claim. On the other hand, UC1 (urease and chitosan colloid) and UC2 (urea and calcium source) grouting reduced the effect of Cu2+ toxicity by transforming the exchangeable state-Cu into the carbonate combination state-Cu. The side effect, induced by 4 g/L chitosan, promoted the copper-ammonia complex formation in the shallow ground, while the acidic environments in the deep ground prevented Cu2+ from coordinating with soil minerals. These badly degraded the immobilization efficiency. The Raman spectroscopy and XRD test results tallied with the above results. The findings shed light on the potential of applying the biopolymer-assisted EICP technology to immobilizing Cu ions in water bodies and sites.

Applying a nanocomposite hydrogel electrode to mitigate electrochemical polarization and focusing effect in electrokinetic remediation of a Cu- and Pb-contaminated loess

Inappropriate handling of copper (Cu) and lead (Pb)-containing wastewater resulting from metallurgical and smelting industries in Northwest China encourages their migration to surrounding environments. Their accumulation causes damage to liver and kidney function. The electrokinetic (EK) technology is considered to be an alternative to traditional remediation technologies because of its great maneuverability. The EK remediation is accompanied by the electrode polarization and the focusing effect toward affecting removal efficiency. In this study, a nanocomposite hydrogel (NCH) electrode was proposed and applied to the EK remediation of Cu- and Pb-contaminated loess. The mechanical, adsorption capacity, adsorption kinetics, and electrochemical properties of the NCH electrode were investigated in detail, followed by microscopic analyses of Scanning Electron Microscope (SEM), Energy Dispersive X-ray Spectroscopy (EDS), and Raman spectrometer. Results showed that the enhancement of the mechanical properties of the NCH electrode was attributed to the crosslinks of graphene nanoparticles, calcium alginate, and hydrogen bonds, while the Cu or Pb adsorption by the NCH electrode was in a chemisorption manner. The second layer formation might address the increase in adsorption capacity with increasing temperature. These results highlight the relative merits of the NCH electrode and verify the potential of applying the NCH electrode to the EK remediation of Cu- and Pb-contamianted loess.

Evaluating gas breakthrough pressure and gas permeability in a landfill cover layer for mitigation of hazardous gas emissions

The construction of an engineered cover layer over landfills is a common method applied to reduce the emission of hazardous gases into the atmosphere. Landfill gas pressures can reach 50 kPa or even higher in some cases, thus posing a serious threat to nearby properties and human safety. As such, the evaluation of gas breakthrough pressure and gas permeability in a landfill cover layer is of great necessity. In this study, the loess soil that is often applied as a cover layer in landfills in northwestern China was used to conduct gas breakthrough, gas permeability, and mercury intrusion porosimetry (MIP) tests. Resultantly, the smaller the capillary tube diameter, the higher the capillary force, and the more significant the capillary effect. Gas breakthrough could be attained with no difficulty, provided that the capillary effect was minimal or approached zero. A good fit between the experimental gas breakthrough pressure-intrinsic permeability relationship and a logarithmic equation was found. The mechanical effect blew up the gas flow channel. In the worst-case scenario, the mechanical effect could lead to the overall failure of a loess cover layer in a landfill. A new gas flow channel was formed between the rubber membrane and the loess specimen as a result of the interfacial effect. Although both the mechanical and interfacial effects can elevate the gas emission rate, the latter did not play a role in the improvement of the gas permeability; therefore, misleading interference took place in the evaluation of the gas permeability, and an overall failure of the loess cover layer. To tackle this problem, the point at which the large- and small-effective stress asymptotes cross on the volumetric deformation-P_eff diagram may be applied to give early warning signals of the potential overall failure of the loess cover layer in landfills in northwestern China.

Investigating immobilization efficiency of Pb in solution and loess soil using bio-inspired carbonate precipitation

Lead (Pb) metal accumulation in surrounding environments can cause serious threats to human health, causing liver and kidney function damage. This work explored the potential of applying the MICP technology to remediate Pb-rich water bodies and Pb-contaminated loess soil sites. In the test tube experiments, the Pb immobilization efficiency of above 85% is attained through PbCO₃ and Pb(CO₃)₂(OH)₂ precipitation. Notwithstanding that, in the loess soil column tests, the Pb immobilization efficiency decreases with the increase in depth and could be as low as approximately 40% in the deep ground. PbCO₃ and Pb(CO₃)₂(OH)₂ precipitation has not been detected as the majority of Pb²⁺ combines with -OH (hydroxyl group) when subjected to 500 mg/kg Pb²⁺. The alkaline front promotes the chemisorption of Pb²⁺ with CO₃^2- reducing the depletion of quartz mineral close to the surface. However, OH^- is in shortage in the deep ground retarding the Pb immobilization. The Pb immobilization efficiency thus decreases with the increase in depth. Quartz and albite minerals, when subjected to 16,000 mg/kg Pb²⁺, appear not to intervene in the chemisorption with Pb²⁺ where the chemisorption of Pb²⁺ with CO₃^2- plays a major role in the Pb immobilization. Compared to the nanoscale urease applied to the enzyme-induced carbonate precipitation (EICP) technology, the micrometer scale ureolytic bacteria penetrate into the deep ground with difficulty. The 'size' issue remains to be addressed in near future.

Immobilizing lead and copper in aqueous solution using microbial- and enzyme-induced carbonate precipitation

Inappropriate irrigation could trigger migration of heavy metals into surrounding environments, causing their accumulation and a serious threat to human central nervous system. Traditional site remediation technologies are criticized because they are time-consuming and featured with high risk of secondary pollution. In the past few years, the microbial-induced carbonate precipitation (MICP) is considered as an alternative to traditional technologies due to its easy maneuverability. The enzyme-induced carbonate precipitate (EICP) has attracted attention because bacterial cultivation is not required prior to catalyzing urea hydrolysis. This study compared the performance of lead (Pb) and copper (Cu) remediation using MICP and EICP respectively. The effect of the degree of urea hydrolysis, mass and species of carbonate precipitation, and chemical and thermodynamic properties of carbonates on the remediation efficiency was investigated. Results indicated that ammonium ion (NH4+) concentration reduced with the increase in lead ion (Pb2+) or copper ion (Cu2+) concentration, and for a given Pb2+ or Cu2+ concentration, it was much higher under MICP than EICP. Further, the remediation efficiency against Cu2+ is approximately zero, which is way below that against Pb2+ (approximately 100%). The Cu2+ toxicity denatured and even inactivated the urease, reducing the degree of urea hydrolysis and the remediation efficiency. Moreover, the reduction in the remediation efficiency against Pb2+ and Cu2+ appeared to be due to the precipitations of cotunnite and atacamite respectively. Their chemical and thermodynamic properties were not as good as calcite, cerussite, phosgenite, and malachite. The findings shed light on the underlying mechanism affecting the remediation efficiency against Pb2+ and Cu2+.

Immobilizing of lead and copper using chitosan-assisted enzyme-induced carbonate precipitation

Enzyme-induced carbonate precipitation (EICP) is considered as an environmentally friendly method for immobilizing heavy metals (HMs). The fundamental of the EICP method is to catalyze urea hydrolysis using the urease, discharging CO₃^2- and NH₄⁺. CO₃^2- helps to form carbonates that immobilize HMs afterwards. However, HMs can depress urease activity and reduce the degree of urea hydrolysis. Herein, the potential of applying the chitosan-assisted EICP method to Pb and Cu immobilization was explored. The chitosan addition elevated the degree of urea hydrolysis when subjected to the effect of Cu²⁺ toxicity where the protective effect, flocculation and adsorption, and the formation of precipitation, play parts in improving the Cu immobilization efficiency. The use of chitosan addition, however, also causes the side effect (copper-ammonia complex formation). Two calcium source additions, CaCl₂ and Ca(CH₃COO)₂, intervened in the test tube experiments not only to prevent pH from raising to values where Cu²⁺ complexes with NH₃ but also to separate the urease enzyme and Cu²⁺ from each other with the repulsion of charges. The FTIR spectra indicate that the chitosan addition adsorbs Cu²⁺ through its surface hydroxyl and carboxyl groups, while the SEM images distinguish who the mineral are nucleating with. The findings shed light on the potential of applying the chitosan-assisted EICP method to remedy lead- and copper-rich water bodies.

Immobilizing copper in loess soil using microbial-induced carbonate precipitation: Insights from test tube experiments and one-dimensional soil columns

Biomineralization as an alternative to traditional remediation measures has been widely applied to remediate copper (Cu)-contaminated sites due to its environmental-friendly nature. Immobilizing Cu is, however, a challenging task as it inevitably causes inactivation of ureolytic bacteria. In the present work, a series of test tube experiments were conducted to derive the relationships of Cu immobilization efficiency versus pH conditions. The Cu speciation transformation that is invisible in the test tube experiments was investigated via numerical simulations. Apart from that, the one-dimensional soil column tests, accompanied by the X-ray diffraction (XRD) and Raman spectroscopy analysis, mainly aimed not only to investigate the variations of Cu immobilization efficiency with the depth but to reveal the underlying mechanisms affecting the Cu immobilization efficiency. The results of the test tube experiments highlight the necessity of narrowing pH ranges to as close as 7 by introducing an appropriate bacterial inoculation proportion. The coordination adsorption of Cu, while performing the one-dimensional soil column tests, is encouraged by alkaline environments, which differs from the test tube experiments where Cu²⁺ is capsulized by carbonate precipitates to prevent their migration. The findings highlight the potential of applying the microbial-induced carbonate precipitation (MICP) technology to Cu-rich water bodies and Cu-contaminated sites remediation.

Catalyzing urea hydrolysis using two-step microbial-induced carbonate precipitation for copper immobilization: Perspective of pH regulation

Microbial induced carbonate precipitation (MICP) has recently applied to immobilize heavy metals toward preventing their threats to public health and sustainable development of surrounding environments. However, for copper metallurgy activities higher copper ion concentrations cause the ureolytic bacteria to lose their activity, leading to some difficulty in forming carbonate precipitation for copper immobilization (referred to also as “biomineralization”). A series test tube experiments were conducted in the present work to investigate the effects of bacterial inoculation and pH conditions on the copper immobilization efficiency. The numerical simulations mainly aimed to compare with the experimental results to verify its applicability. The copper immobilization efficiency was attained through azurite precipitation under pH in a 4–6 range, while due to Cu²⁺ migration and diffusion, it reduced to zero under pH below 4. In case pH fell within a 7–9 range, the immobilization efficiency was attained via malachite precipitation. The copper-ammonia complexes formation reduced the immobilization efficiency to zero. The reductions were attributed either to the low degree of urea hydrolysis or to inappropriate pH conditions. The findings shed light on the necessity of securing the urease activity and modifying pH conditions using the two-step biomineralization approach while applying the MICP technology to remedy copper-rich water bodies.

Effect of seepage conditions on the microstructural evolution of loess across north-west China

Loess features metastable microstructure and is deemed susceptible to chemical contaminant permeation. However, studies on the loess permeability evolution under water and chemical environments are remarkably limited. In this study, the response of the loess to the water and sodium sulfate seepages was analyzed using the temporal relationship of cations concentration, X-ray diffraction and fluorescence (XRD and XRF), mercury intrusion porosimetry (MIP), and scanning electron microscope (SEM) tests. The permeability evolution characteristics were identified, and its underlying mechanisms were revealed from aspects of the diffuse double layer (DDL) theory and physiochemical actions. The discharge of Mg²⁺ and precipitation of calcium carbonate, referred also to as the dedolomitization, degraded the macro permeability when subjected to the water seepage test. The salt-induced swelling, induced by the intrusion of Na⁺ into the DDL, caused an increase in the micropore fraction under the sodium sulfate seepage test, thereby increasing the macro permeability.

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The k evolution of the loess under the water and Na₂SO₄ seepages is investigated

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The dedolomitization takes part in the k degradation under the water seepage

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The Na⁺ intrusion into the double layer enhances the k under the Na₂SO₄ seepage

Effects of Bacterial Culture and Calcium Source Addition on Lead and Copper Remediation Using Bioinspired Calcium Carbonate Precipitation

Lead and copper ions from wastewater induced by metallurgical processes are accumulated in soils, threatening plant and human health. The bioinspired calcium carbonate precipitation is proven effective in improving the cementation between soil particles. However, studies on capsulizing heavy metal ions using the bioinspired calcium carbonate precipitation are remarkably limited. The present study conducted a series of test tube experiments to investigate the effects of bacterial culture and calcium source addition on the remediation efficiency against lead and copper ions. The calcium carbonate precipitation was reproduced using the Visual MINTEQ software package to reveal the mechanism affecting the remediation efficiency. The degradation in the remediation efficiency against lead ions relies mainly upon the degree of urea hydrolysis. However, higher degrees of urea hydrolysis cause remediation efficiency against copper ions to reduce to zero. Such high degree of urea hydrolysis turns pH surrounding conditions into highly alkaline environments. Therefore, pursuing higher degrees of urea hydrolysis might not be the most crucial factor while remedying copper ions. The findings shed light on the importance of modifying pH surrounding conditions in capsulizing copper ions using the bioinspired calcium carbonate precipitation.

Effects of the Urease Concentration and Calcium Source on Enzyme-Induced Carbonate Precipitation for Lead Remediation

Heavy metal contamination during the rapid urbanization process in recent decades has notably impacted our fragile environments and threatens human health. However, traditional remediation approaches are considered time-consuming and costly, and the effect sometimes does not meet the requirements expected. The present study conducted test tube experiments to reproduce enzyme-induced carbonate precipitation applied to lead remediation under the effects of urease concentration and a calcium source. Furthermore, the speciation and sequence of the carbonate precipitation were simulated using the Visual MINTEQ software package. The results indicated that higher urease concentrations can assure the availability of CO₃²⁻ during the enzyme-induced carbonate precipitation (EICP) process toward benefiting carbonate precipitation. The calcium source determines the speciation of carbonate precipitation and subsequently the Pb remediation efficiency. The use of CaO results in the dissolution of Pb(OH)₂ and, therefore, discharges Pb ions, causing some difficulty in forming the multi-layer structure of carbonate precipitation and degrading Pb remediation. The findings of this study are useful in widening the horizon of applications of the enzyme-induced carbonate precipitation technology to heavy metal remediation.

Effects of bacterial inoculation and calcium source on microbial-induced carbonate precipitation for lead remediation

Heavy metal contamination has caused serious threats to surrounding fragile environments and human health. While the novel microbial-induced carbonate precipitation (MICP) technology in the recent years has been proven effective in improving material mechanical and durability properties, the mechanisms remedying heavy metal contamination still remain unclear. In this study, the potential of applying the MICP technology to the lead remediation under the effects of urease activity and calcium source was explored. The values of OD₆₀₀ corresponding to the ureolytic bacterial activity, electrical conductivity (EC), urease activity (UA) and pH were applied to monitor the degree of urea hydrolysis. Further, the carbonate precipitations that possess different speciations and cannot be distinguished through test tube experiments were reproduced using the Visual MINTEQ software package towards verifying the validity of the proposed simulations, and revealing the mechanisms affecting the lead remediation efficiency. The findings summarised in this work give deep insights into lead-contaminated site remediation engineering.

The Effect of Calcium Source on Pb and Cu Remediation Using Enzyme-Induced Carbonate Precipitation

Heavy metal contamination not only causes threat to human health but also raises sustainable development concerns. The use of traditional methods to remediate heavy metal contamination is however time-consuming, and the remediation efficiency may not meet the requirements as expected. The present study conducted a series of test tube experiments to investigate the effect of calcium source on the lead and copper removals. In addition to the test tube experiments, numerical simulations were performed using Visual MINTEQ software package considering different degrees of urea hydrolysis derived from the experiments. The remediation efficiency degrades when NH4+ and OH− concentrations are not sufficient to precipitate the majority of Pb2+ and Cu2+. It also degrades when CaO turns pH into highly alkaline conditions. The numerical simulations do not take the dissolution of precipitation into account and therefore overestimate the remediation efficiency when subjected to lower Pb(NO3)2 or Cu(NO3)2 concentrations. The findings highlight the potential of applying the enzyme-induced carbonate precipitation to lead and copper remediations.

Revealing the Enhancement and Degradation Mechanisms Affecting the Performance of Carbonate Precipitation in EICP Process

Given that acid-rich rainfall can cause serious damage to heritage buildings in NW China and subsequently accelerate their aging problem, countermeasures to protect their integrity and also to preserve the continuity of Chinese culture are in pressing need. Enzyme-induced carbonate precipitation (EICP) that modifies the mechanical properties of the soil through enhancing the interparticle bonds by the precipitated crystals and the formation of other carbonate minerals is under a spotlight in recent years. EICP is considered as an alternative to the microbial-induced carbonate precipitation (MICP) because cultivating soil microbes are considered to be challenging in field applications. This study conducts a series of test tube experiments to reproduce the ordinary EICP process, and the produced carbonate precipitation is compared with that of the modified EICP process subjected to the effect of higher MgCl₂, NH₄Cl, and CaCl₂ concentrations, respectively. The modified EICP, subjected to the effect of higher MgCl₂ concentrations, performs the best with the highest carbonate precipitation. The enhancement mechanism of carbonate precipitation is well interpreted through elevating the activity of urease enzyme by introducing the magnesium ions. Furthermore, the degradation of carbonate precipitation presents when subjected to the effect of higher NH₄Cl concentration. The decreasing activity of urease enzyme and the reverse EICP process play a leading role in degrading the carbonate precipitation. Moreover, when subjected to the effect of higher CaCl₂ concentrations, the slower rate of urea hydrolysis and the decreasing activity of urease enzyme are primarily responsible for forming the "hijacking" phenomenon of carbonate precipitation. The findings of this study explore the potential use of the EICP technology for the protection of heritage buildings in NW China.

Effect of straw reinforcement on the shearing and creep behaviours of Quaternary loess

In addition to the shearing behavior of soil, the creep character is also considered crucial in determining the long-term shear strength. This especially holds true for the loess that possesses the metastable microstructure and is prone to landslide hazards. This study explored the potential application of straw reinforcement to enhance the shearing and creep properties of the Quaternary loess. The mechanism responsible for the straw reinforcement to elevate the peak shear strength was revealed. Furthermore, three creep characters, namely attenuating creep, non-attenuating creep, and viscous flow were identified in this study. The unreinforced and reinforced specimen behaved in a different manner under identical shear stress ratio condition. The reinforced specimen was superior in limiting the particle relative movement within the shear plane than the unreinforced specimen. The chain reaction of interparticle contact loss, accompanied with excessive viscous displacement, rapid weakening of creep resistance, and eventually accelerated creep displacement, provided an evidence for the formation mechanism of slow-moving landslide. The long-term shear strength using the isochronal stress-strain relationship may be used for optimising the design of high-fill embankment works.

[Clinical characteristics and risk factors analysis of intracranial and extracranial arterial dissection]

Objective: To compare and analyze the clinical features and potential risk factors of intracranial and extracranial arterial dissection. Methods: A total of 241 consecutive patients with cervicocerebral artery dissection (CAD) in the First Affiliated Hospital of Zhengzhou University from 2010 to 2019 were observed. The 241 CAD patients were divided into extracranial artery dissection group (EAD) (n=81) and intracranial artery dissection group (IAD) (n=160), clinical characteristics and risk factors were compared between the two groups. Results: Compared with EAD, the National Institute of Health Stroke Scale (NIHSS) score was higher in patients with ischemic stroke in the IAD group (P=0.015). Patients with IAD were more likely to present with headache (58.8% vs 37.0%, P<0.001), and dissection Aneurysms (76.3% vs 38.3%, P<0.001). Patients with EAD more likely to have a history of mild head and neck injuries (11.1% vs 4.4%, P=0.047) and often involved the anterior circulation (77.8% vs 20.0%, P<0.001). Multivariate Logistic regression analysis showed differences in a history of minor head and neck trauma (OR=3.53, 95%CI 1.04-11.97, P=0.042), anterior circulation involvement (OR=0.09, 95%CI 0.05-0.19, P<0.001), dissection aneurysms (OR=4.98, 95%CI 2.80-8.84, P<0.001), headache (OR=2.42, 95%CI 1.39-4.20, P=0.002) remained significant, and the NHISS score lost its significance. Conclusions: EAD often involves the anterior circulation and a history of mild injury to the head and neck. IAD is more prone to exhibit headache symptoms, and it is more likely to form a dissection aneurysm, and the symptoms of ischemic stroke are more severe.

A medical cost estimation with fuzzy neural network of acute hepatitis patients in emergency room

Taiwan is an area where chronic hepatitis is endemic. Liver cancer is so common that it has been ranked first among cancer mortality rates since the early 1980s in Taiwan. Besides, liver cirrhosis and chronic liver diseases are the sixth or seventh in the causes of death. Therefore, as shown by the active research on hepatitis, it is not only a health threat, but also a huge medical cost for the government. The estimated total number of hepatitis B carriers in the general population aged more than 20 years old is 3,067,307. Thus, a case record review was conducted from all patients with diagnosis of acute hepatitis admitted to the Emergency Department (ED) of a well-known teaching-oriented hospital in Taipei. The cost of medical resource utilization is defined as the total medical fee. In this study, a fuzzy neural network is employed to develop the cost forecasting model. A total of 110 patients met the inclusion criteria. The computational results indicate that the FNN model can provide more accurate forecasts than the support vector regression (SVR) or artificial neural network (ANN). In addition, unlike SVR and ANN, FNN can also provide fuzzy IF-THEN rules for interpretation.

A bacteria injection scheme for in situ bioaugmentation

This article presents an innovative design for inoculating the desired organisms to stratified geological layers at desired rates during in-situ bioaugmentation. The new delivery system consists of intermittent porous tubes connected in series with impermeable polyethylene tubes that run horizontally in each stratified layer of a contaminated aquifer. A bioaugmentation test using the new delivery system was conducted to inject an enriched culture of Escherichia coli (E. coli). Results of the test indicated that the distribution of E. coli through each porous tube was fairly uniform. A mathematical model previously developed to calculate the distribution of water flow through each porous tube was modified to calculate the distribution of E. coli. Geological layers often have different hydraulic conductivities. By controlling the permeability and the length of porous tubes placed in stratified layers, the new design provides a means to selectively deliver aqueous bacteria to various layers at desired rates according to aquifer heterogeneity.

Differentiation of bacteria cell wall using Raman scattering enhanced by nanoparticle array

We have fabricated surface-enhanced Raman scattering (SERS) substrates based on arrays of silver nanoparticles grown on porous anodic alumina templates. Using this nanotechnology platform, label-free and high-speed detection of bacteria are achieved. SERS spectra of various bacteria including Staphylococcus Aureus (Gram-positive bacterium), Klebsiella Pneumoniae (Gram-negative bacterium), and Mycobacterium Smegmatis (Mycobacterium) were recorded. The highly reproducible SERS-based technological platform is capable of differentiating different kinds of bacteria by PCA, LDA, clustering analysis, and SVM methods, which provides promising opportunity for biosensing of clinical microbes.

The association of clinical findings and exposure profiles with melamine associated nephrolithiasis

BACKGROUND

Little is known about the exposure profiles of melamine in children. We evaluated the association of clinical findings, exposure patterns and biomarkers with nephrolithiasis in children with potential exposure to melamine.

METHODS

A case-control study was conducted in children aged 0-16 years with potential exposure to contaminated dairy products. Cases were defined as nephrolithiasis detected by renal ultrasonography. On the basis of different brands of contaminated dairy products consumed, subjects were classified into high exposure, low exposure and control groups with estimated melamine exposure levels of higher than 2.5 ppm, 0.05-2.5 ppm and lower than detection limits <0.05 ppm. We measured urine melamine for those with nephrolithiasis and age-matched and gender-matched controls within the subset of the study population.

RESULTS

The duration of consumption of contaminated products was longer in children with nephrolithiasis in the high exposure group than in controls (median (IQR) 12.0 (3.3-24.0) vs 6.0 (4.0-7.0) months; p = 0.048). High melamine exposure levels were significantly associated with nephrolithiasis (OR 61.04 (95% CI 12.73 to 292.84)). The risk was found to increase with estimate melamine exposure levels (p for trend <0.001). Two among 10 affected subjects with nephrolithiasis showed elevated urine melamine levels. In comparison, levels of all 20 controls were lower than the detection limit.

CONCLUSIONS

The risk of melamine-associated nephrolithiasis was related to duration of consumption of contaminated products and estimated melamine exposure levels. Though urine melamine was not a sensitive test, it might serve as an exposure biomarker in melamine-associated nephrolithiasis.

Anomalous scaling and refined similarity of an active scalar in a shell model of homogeneous turbulent convection

Anomalous scaling in the statistics of an active scalar is studied in a shell model of homogeneous turbulent convection. We extend refined similarity ideas for homogeneous and isotropic turbulence to homogeneous turbulent convection and attribute the origin of the anomalous scaling to variations of the entropy transfer rate. We verify the consequences and thus the validity of our hypothesis by showing that the conditional statistics of the active scalar and the velocity at fixed values of entropy transfer rate are not anomalous but have simple scaling with exponents given by dimensional considerations, and that the intermittency corrections are given by the scaling exponents of the moments of the entropy transfer rate.

Reaction of cyanoacetylene HCCCN(XΣ+1) with ground-state carbon atoms C(P3) in cold molecular clouds

The reaction of the simplest cyanopolyyne, cyanoacetylene [HCCCN(X (1)Sigma(+))], with ground-state atomic carbon C((3)P) is investigated theoretically to explore the probable routes for the depletion of the famed interstellar molecule HCCCN, and the formation of carbon-nitrogen-bearing species in extraterrestrial environments particularly of ultralow temperature. Six collision complexes (c1-c6) without entrance barrier as a result of the carbon atom addition to the pi systems of HCCCN are located. The optimized geometries and harmonic frequencies of the intermediates, transition states, and products along the isomerization and dissociation pathways of each collision complex are obtained by utilizing the unrestricted B3YLP6-311G(d,p) level of theory, and the corresponding CCSD(T)/cc-pVTZ energies are calculated. Subsequently, with the facilitation of Rice-Ramsperger-Kassel-Marcus (RRKM) and variational RRKM rate constants at collision energy of 0-10 kcal/mol, the most probable paths for the titled reaction are determined, and the product yields are estimated. Five collision complexes (c1-c3, c5, and c6) are predicted to give the same products, a chained CCCCN (p2)+H, via the linear and most stable intermediate, HCCCCN (i2), while collision complex c4 is likely to dissociate back to C+HCCCN. The study suggests that this class of reaction is an important route to the destruction of cyanoacetylene and cyanopolyynes in general, and to the synthesis of linear carbon-chained nitriles at the temperature as low as 10 K to be incorporated in future chemical models of interstellar clouds.

Multiobjective water resources systems analysis using genetic algorithms--application to Chou-Shui River Basin, Taiwan

Multipurpose operation is adopted by most reservoirs in Taiwan in order to maximize the benefits of power generation, water supply, irrigation and recreational purposes. A multiobjective approach can be used to obtain trade-off curves among these multipurpose targets. The weighting method, in which different weighting factors are used for different purposes, was used in this research work. In Taiwan, most major reservoirs are operated by rule curves. Genetic algorithms with characteristics of artificial intelligence were applied to obtain the optimal rule curves of the multireservoir system under multipurpose operation in Chou-Shui River Basin in central Taiwan. The model results reveal that different shapes of rule curves under different weighting factors on targets can be efficiently obtained by genetic algorithms. Pareto optimal solutions for a trade-off between water supply and hydropower were obtained and analyzed.

Effects of buyang huanwu decoction on peripheral nerve regeneration using silicone rubber chambers

This study investigated the effect of buyang huanwu decoction on the regeneration of a 10-mm gap of rat sciatic nerve created between the proximal and distal nerve stumps, which were sutured into silicone rubber tubes. Empty silicone rubber tubes with no further treatment were used as controls. Six weeks after implantation, 89% of the animals orally administered the buyang huanwu decoction exhibited regeneration across the nerve gaps, whereas only 70% had regenerated in the control group. Both qualitative and quantitative histology of the regenerated nerves revealed a more mature ultrastructural organization with significantly higher numbers of myelinated axons, larger endoneurial areas, higher axon densities and a larger percentage of axon area per total nerve area in the buyang huanwu group than in the controls. These results showed that the buyang huanwu decoction had a growth-promoting effect on the regenerated nerves.

Small cell carcinoma of the endometrium with concomitant pelvic inflammatory disease

BACKGROUND

Small cell carcinoma of the endometrium is a rare disease entity characterized by bulkiness and predisposition to necrosis. Clinical presentations include postmenopausal bleeding, lower abdominal mass, chronic abdominal pain and menorrhagia. We present a case of small cell carcinoma of the endometrium with concomitant pelvic inflammatory disease. The literature is also reviewed.

CASE

A 64 year old female presented was admitted with the principal complaints of fever, lower abdominal pain and malodorous vaginal discharge. Bimanual examination revealed cervical motion tenderness with a WBC of 9400 cells/microL and increased levels of neutrophils, band cells and C-reactive protein. Sonography revealed an adnexal echocomplex compatible with tubo-ovarian abscess. Culture of the vaginal discharge revealed the presence of E. coli. Symptoms persisted despite three days of antibiotics administration so a laparotomy was performed with a friable hemorrhagic uterus revealed and an area of necrosis evident in the left adnexa. Malignancy was confirmed from frozen section. Total abdominal hysterectomy, with bilateral salpingooophorectomy and optimal debulking, was performed. The final pathology report confirmed small cell carcinoma of the endometrium.

CONCLUSION

Malignancy and pelvic inflammatory disease have overlapping clinical characteristics. Once pelvic inflammatory disease is suspected in a postmenopausal patient, malignancy should also be suspected, and a thorough examination and a tumor-marker analysis performed.

Raloxifene versus continuous combined estrogen/progestin therapy: densitometric and biochemical effects in healthy postmenopausal Taiwanese women

We treated 116 healthy postmenopausal women (age 47-66 years, mean 57 years) in Taiwan with either raloxifene (RLX) 60 mg (n = 92) or 0.625 mg conjugated equine estrogen plus 5 mg medroxyprogesterone acetate (CCEP, n = 24) daily for 12 months in a randomized, double-masked, active-controlled fashion. The results showed that both regimens increased bone mineral density (BMD) at hip sites (means: RLX 2.5-4.9%, CCEP 4.6-7.9%, all p<0.005 compared with baseline), and the difference between the two regimens was not significant. The spinal BMD increased significantly in both groups (1.4% with RLX and 6.0% with CCEP, both p<0.01), and more with CCEP (p<0.003). Osteocalcin levels and urinary type I collagen C-telopeptide/creatinine ratios decreased significantly in both regimens, but the decreases were significantly larger with CCEP. Compared with baseline, both RLX and CCEP decreased the total cholesterol (median 4.9% and 8.6% respectively, p<0.001) and LDL-cholesterol (median 11% and 19% respectively, p<0.001), and increased HDL-cholesterol (median 8.6% and 10.7% respectively, p<0.01). Both regimens increased triglyceride levels (median 3.2% and 18.9% respectively, both p<0.05), although to a lesser extent with RLX than with CCEP (p<0.05). Only 3 subjects (3.3%) reported vaginal bleeding in the RLX group, as compared with 31% (7/22) with CCEP (p<0.05). We conclude that in healthy, postmenopausal Taiwanese women, RLX 60 mg given daily has favorable results in BMD, bone turnover and serum lipids, although the dosage we used showed a potency less than that of conventional CCEP.

Long-lived immune response to early secretory antigenic target 6 in individuals who had recovered from tuberculosis

We sought to understand the persistence and relevance of the long-lived immune response to early secretory antigenic target (ESAT-6) of Mycobacterium tuberculosis in humans. ESAT-6 is recognized by memory cells involved in protection of animals against tuberculosis (TB). Recent reports also showed that ESAT-6 response can be recovered in patients with TB and in those soon after anti-TB therapy. We chose 18 individuals who had recovered from pulmonary TB (some in remission for >5 years), and 14 bacille Calmette-Guérin-vaccinated healthy individuals for this study. The results showed that peripheral blood mononuclear cells of 10 (55.6%) of 18 patients with TB remission responded to ESAT-6 with stimulation indices >3.0, whereas none of the healthy controls responded. Functional analysis showed that 13 (72.2%) of 18 patients with TB remission produced significant amounts of IFN-gamma in response to ESAT-6, whereas only 1 (7.1%) of the 14 healthy control subjects did so. It appears that responses to ESAT-6 can persist in individuals who had recovered from pulmonary TB.

Vinyl sulfones in solid-phase synthesis: preparation of 4,5,6,7-tetrahydroisoindole derivatives

The preparation of functionalized 4,5,6,7-tetrahydroisoindole via a traceless solid-phase sulfone linker strategy is described. Thermolytic extrusion of SO(2) from polymer-bound 3-(phenylsulfonyl)-3-sulfolene (7) generated polymer-bound 2-(phenylsulfonyl)-1,3-butadiene (9) in situ which underwent Diels--Alder cycloaddition with various dienophiles to furnish vinyl sulfone resins 10-14. To complete a traceless linker cleavage strategy, (p-tolysulfonyl)methyl isocyanide or ethyl isocyanoacetate was employed to react with the vinyl sulfone moiety to liberate functionalized 4,5,6,7-tetrahydroisoindole products from the resin. Using this chemistry, nine tetrahydroisoindole derivatives (6, 15-22) were prepared in 32-41% overall yields from polystyrene/divinylbenzene sulfinate 1.

Effects of gender and age differences on the distribution of bone content in the third lumbar vertebra

STUDY DESIGN

A cross-sectional study on the distribution of bone mineral content in the third lumbar vertebrae.

OBJECTIVES

To evaluate the effects of age and gender on the distribution of bone mineral content in the third lumbar vertebrae.

SUMMARY OF BACKGROUND DATA

Compression fractures occur mainly at the vertebral body. Variations in the distribution of bone mass in a vertebra, if undefined, may bias the ability of the acquired bone mineral density values, which was usually measured posteroanteriorly, to predict the risk of fractures.

METHODS

The bone mineral content of the whole L3, including the L3 vertebral body and the posterior segment, was measured using a lateral approach with a dual energy radiograph absorptiometer on 177 healthy Taiwanese adults including 65 men and 55 premenopausal and 57 postmenopausal women.

RESULTS

The proportion of bone mineral content in the vertebral body was significantly lower in premenopausal women than in age-matched men (39.1 +/- 0.9% vs. 50.0 +/- 1.7%, P < 0.0001). Furthermore, whereas postmenopausal women showed a decreased proportion of bone mineral content in the vertebral body with increased age (about -0.0022 per year, P = 0.0001), premenopausal women and men showed a sustained proportion.

CONCLUSIONS

The proportion of bone mineral content distributed in the body of L3 vertebrae was lower in women than in men. The discrepancy of this parameter between the genders was even larger with increased ages.

[Distribution of bacteria and analysis of their sensibility to antibiotics in patients with hospital-acquired pneumonia]

OBJECTIVES

This study was explore the distribution of the bacteria and their sensibility to antibiotics in hospital-acquired pneumonia.

METHODS

One hundred and ninety-six bacterium species were collected in patients with the hospital-acquired pneumonia to make sputum culture. The sensibility of the bacteria to antibiotics were examined by KB paper method and the minimal-inhibitory-concentration by gel double multiple dilute method.

RESULTS

Most of the G- bacteria were pseudomonas aeruginosa (30%) and klebsiella bacillus (22%). Most of the G+ bacteria were staphylococcus epidermidis (14%) and staphylococcus aureus (12%). G- bacteria were sensitive to impienem(98%), cefoperazone(90%), ceftriaxone(90%), leftazidime(92%), ciprofloxacin(90%), and amikacin(89%). The sensibility of vancomycin to G+ bacteria was 100%.

CONCLUSIONS

The pseudomonas aeruginosa, klebsiella bacillus, staphylococcus epidermidis, and staphylococcus aureus are the most important bacteria in patients with hospital-acquired pneumonia. Imipenem, cefoperazone, ceftriazone, leftazidime, ciprofloxacin, amikacin, and vancomycin are effective antibiotics for treating hospital-acquired pneumonia.

Effects of alendronate on osteopenic postmenopausal Chinese women

To evaluate the effects of alendronate on postmenopausal Chinese women with osteopenia, we treated 46 subjects daily with either 10 mg alendronate (N = 24) or placebo plus 500 mg calcium supplement (N = 22), and measured their bone mineral density (BMD) at the lumbar spine and hip, and urinary bone resorption markers before, during, and after the 1 year treatment period. The bone markers included N-telopeptide of type I collagen (NTx) and deoxypyridinoline (Dpd); both were corrected by the concentration of creatinine in the same sample (NTx/Cr and Dpd/Cr). Both NTx/Cr and Dpd/Cr decreased significantly by 44% and 28%, respectively (p < 0.05 for both), in 1 month in the active treatment group but did not change in the placebo group. BMD at the spine, femoral neck, trochanter, and Ward's triangle increased significantly by 6 months and showed a further increase through month 12 at the spine in the alendronate-treated group. Relative to the placebo group, BMD changes at various sites in the alendronate-treated group were higher at 12 months by 6%-11%. Thus, our data suggest that 10 mg alendronate daily resulted in significant increases in spine and hip BMD, and decreases of urinary resorption markers in the osteopenic postmenopausal Chinese women studied. The amplitude of responses was higher than in previous reports in the USA and Europe.

Prenatal diagnosis of meconium peritonitis in a twin pregnancy after intracytoplasmic sperm injection. A case report

BACKGROUND

Meconium peritonitis occurring in pregnancies following artificial reproductive techniques (ART) is rare. We report the first case of meconium peritonitis following intracytoplasmic sperm injection (ICSI).

CASE

A 37-year-old woman attended our in vitro fertilization (IVF) program because her husband suffered from hypospermatogenetic azoospermia due to cancer surgery and radiotherapy. The patient achieved a twin pregnancy through ICSI from testicular sperm extraction at our IVF center. Meconium peritonitis, fetal ascites, polyhydramnios, bowel dilatation, hydrocele and intraabdominal calcification were noted in one of the twins on ultrasound at 30 weeks' gestation. Cesarean section due to breech presentation in labor was performed at 36 weeks' gestation. A normal female and male infant with a distended abdomen were delivered. Emergency laparotomy was performed on the male twin because of dyspnea. A 0.2-cm perforation was found in the terminal ileum. Ileotomy was performed and closed after 27 days.

CONCLUSION

Prenatal diagnosis of meconium peritonitis is possible through careful ultrasonographic examination, and early surgical intervention and intensive postoperative support are required to improve the prognosis.

Rapid prenatal diagnosis of chromosome abnormalities

The aim of the present work was to examine the efficacy of using FISH for the rapid prenatal diagnosis of common chromosome aneuploidies. A total of 100 analyses over a six month period were included in the study. Diagnosis was possible in all cases. A mosaic for trisomy 21 proved, by comparison with an extensive analysis of long term cultures, to be an apparent false positive. Otherwise the technique was reliable, accurate and relatively straightforward to perform. Results could be available within 24 hrs. In most cases an additional long term full analysis was also done, so as to exclude rarer aneuploidies and structural rearrangements. This methodology is seen as a useful addition to the prenatal diagnostic repertoire.

Methotrexate for cesarean scar pregnancy after in vitro fertilization and embryo transfer. A case report

BACKGROUND

Cesarean scar pregnancy is an exceedingly rare occurrence. We present the first case of cesarean scar pregnancy following in vitro fertilization-embryo transfer (IVF-ET).

CASE

A 40-year-old woman with a history of a previous cesarean section presented with five years of unexplained infertility. The patient complained of abdominal pain 16 days after embryo transfer. Ultrasonography revealed a gestational sac with cardiac activity located outside the lower segment of the uterus. Dilatation and curettage was performed due to misdiagnosis of inevitable abortion. Two weeks later, repeated sonography demonstrated a sacculus, 4.07 x 4.07 cm, within the uterine isthmus with only 7.1 mm of thickness separating the sac from the urinary bladder. Normal cervical length without ballooning was noted. Cesarean scar pregnancy was diagnosed. Local injection of methotrexate (MTX) under ultrasound guidance was performed. Plasma beta-hCG levels declined from 23,328 to 8 mlU/mL within two months.

CONCLUSION

For women with cesarean scar pregnancy who desire fertility, conservative treatment using MTX is an excellent choice.

Peripheral nerve regeneration using silicone rubber chambers filled with collagen, laminin and fibronectin

A 10 mm gap of rat sciatic nerve was created between the proximal and distal nerve stumps, which were sutured into silicone rubber tubes filled with an extracellular gel containing collagen, laminin and fibronectin. Empty silicone rubber tubes were used as controls. Six weeks after implantation, all extracellular elements were completely degraded and absorbed, and 90% of the animals from the extracellular gel group exhibited regeneration across the nerve gaps, whereas only 60% in the control group. Both qualitative and quantitative histology of the regenerated nerves revealed a more mature ultrastructural organization with 28% larger cross-sectional area and 28% higher number of myelinated axons in the extracellular gel group than the controls. These results showed that the gel mixture of collagen, laminin and fibronectin could offer a suitable growth medium for the regeneration of axons.

The effectiveness of cyclic and continuous oral clodronate therapy on bone density and markers in osteopenic postmenopausal women

Bisphosphonates have been used effectively to treat established osteoporosis and prevent postmenopausal bone loss. However, the optimal manner of its administration-whether cyclic or continuous-has not been well established. This study investigated the efficacy of cyclic and continuous oral administration of clodronate in 54 newly identified osteopenic postmenopausal women in a randomized, double-blind, crossover fashion. The participants were randomly separated into two groups. The cyclic group (n = 29) received 800 mg twice daily of oral clodronate for 2 weeks every 3 months for the first 12 months followed by placebo for the second 12 months. The continuous group (n = 25) received placebo in the first 12 months and ingested 400 mg of clodronate once daily for the second 12 months. The urinary amino-terminal (NTXtrade mark) and carboxy-terminal (CrossLapstrade mark) cross-linked fragments of type I collagen, both markers of bone resorption, showed a marked decrease (25-50%) with both regimens during the period of active treatment. In the cyclic group, the levels of these two markers increased in the second 12 months with placebo, but did not return to the baseline completely. However, bone mineral density (BMD), determined by dual-energy X-ray absorptiometry (DXA), showed no significant change of BMD at various sites after 1 year of active treatment in both groups. Thoracic and lumbar spine X-ray showed no new vertebral fracture in either group after 2 years of treatment. With the two treatment protocols in this study, oral clodronate was effective in decreasing postmenopausal bone resorption, causing no significant changes in BMD at various sites.

The vitamin D receptor start codon polymorphism (Fok1) and bone mineral density in premenopausal women in Taiwan

The vitamin D receptor gene (VDRG) polymorphism as a factor of bone turnover rate or bone mineral density (BMD) is a controversial issue, especially in different ethnic populations. In addition to intron 8 (Bsm1, Taq1) and exon 9 (Apa1), VDRG polymorphism is present at its translation initiation site on exon 2. The VDRG has two translation initiation sites. The first shows a thymine/cytosine polymorphism and can be detected by restriction fragment length polymorphism (RFLP) using the endonuclease Fok1. This start codon polymorphism (SCP) of the VDRG was detected by polymerase chain reaction and then by RFLP with Fok1. While the f allele was assigned for the presence of the restriction site, the F allele was assigned for the absence of the restriction site, and the encoded vitamin D receptor is shorter by three amino acids. We examined the association between this SCP of the VDRG and bone turnover as well as BMD in 101 premenopausal Taiwanese women aged 40-53 years. Total body bone mineral content and BMD of proximal femur and lumbar spine were measured by dual-energy X-ray absorptiometry. We found a prevalence of 39.6% for the f allele of the VDRG. The frequencies of FF, Ff and ff genotypes were 35.6%, 49.5% and 14.9%, respectively. There was no statistically significant difference in BMD at any site or bone turnover markers among the three Fok1 genotypes (FF, Ff and ff). The SCP is independent of Bsm1, Apa1 or Taq1 polymorphisms of the VDRG at intron 8 and exon 9. In conclusion, the SCP polymorphism detected by endonuclease Fok1 does not significantly influence BMD or bone turnover in premenopausal women in Taiwan.

A simple program to calculate codon bias index

A computer program (PCBI) was developed to quickly calculate codon bias index (CBI). PCBI can analyze a gene containing introns. The 22 preferred codons defined from Saccharomyces cerevisiae were used in PCBI as the standard to measure the CBI values. However, users can modify the preferred codons to suit each organism. The data PCBI provides include DNA sequence of open reading frame without introns, amino acid sequence of gene product, a table of amino acid composition, a table of codon usage and (G + C) content, parameters for calculating CBI, and the value of CBI. PCBI runs on a DOS or Windows environment, but results can be saved in ASCII text format.

Effect of bone area on spine density in Chinese men and women in Taiwan

Areal bone mineral density (BMD), the quotient of bone mineral content (BMC) divided by the projectional bone area (BA), measured with dual-energy X-ray absorptiometers (DXA), is the most common parameter used today to evaluate spinal osteoporosis. To evaluate whether gender, age, weight, and height can determine spinal BA, and to compare BA and analyze its effects on spinal density in the two genders, we measured BA and BMC, and calculated areal BMD, and the bone mineral apparent density (BMAD = BMD/the square root of BA) of the L-2 to L-4 vertebrae of 604 female and 223 male Chinese volunteers from 20 to 70 years of age using a Norland XR-26 DXA. Standardized for height and weight, BA showed a relatively large variation and a significant increase with increasing age in both genders. On the other hand, BMC stayed unchanged in men > 50 years of age and decreased with aging in postmenopausal women. Younger men (< 51 years) had a much larger mean BA (by 15.5%) and larger mean BMC (only 10%) than that of age-matched women. As a result, younger men had a slightly and significantly lower areal BMD (by 7.1%) and a much lower BMAD (by 16%) (p < 0.0001 for both) than premenopausal women of similar age. Men had higher areal BMD and BMAD values than age-matched women only after age 50 years. Although taller body height, heavier weight, and increasing age were associated with a larger BA, these factors could not explain most of the interindividual variations in BA in both genders. Thus anteroposterior BA of lumbar vertebrae measured with DXA seems to affect the areal BMD and BMAD readings in the two genders. The larger BA caused a low BMAD and probably underestimated the true volumetric spine density in men.

Effect of exercise and exogenous glucocorticoid on serum level of intact parathyroid hormone

Most previous studies suggest that physical exercise, or physiological response to exercise such as cortisol and adrenaline secretion regulate parathyroid hormone (PTH) secretion in humans. To investigate the effects and possible interaction of exercise and excessive glucocorticoid on PTH secretion, we examined the serum of levels of intact-PTH, cortisol, adrenocorticotrophic hormone (ACTH), calcium, magnesium and phosphorus before and during one-hour of bicycle-ergometric exercise at 60% of maximal oxygen uptake. These exercise tests were performed on eight Chinese male volunteers aged between 20 and 25 years, once with and once without pretreatment with 0.5 mg of dexamethasone taken orally 9.5 hours in advance. The results showed that dexamethasone pretreatment significantly lowered basal levels of cortisol and ACTH, but intact PTH did not change. After 60 minutes of bicycling, intact PTH level increases by 50% of baseline both with and without dexamethasone pretreatment. Serum levels of calcium, corrected for changes in serum albumin concentration, phosphorus and magnesium also increased in both cases. This study demonstrated an increase of intact-PTH with exercise which was not associated with hypocalcemia or hypomagnesemia, and was not altered in the presence of mild exogenous glucocorticoid excess and suppressed endogenous cortisol secretion.

Reoperation for recurrent trigeminal neuralgia after microvascular decompression

BACKGROUND

Microvascular decompression (MVD) is an effective technique for those who have trigeminal neuralgia (TN) but cannot tolerate, or show no response to medicine. Though the initial success rate is high, some patients may develop severe recurrent neuralgia, especially after a longer period of follow-up. The efficacy of reoperation needs to be evaluated. To know the possible risk factors of recurrence after initial MVD is mandatory to the management of recurrent TN.

METHODS

Among the 80 cases of TN treated with MVD, five cases showed severe recurrent symptoms within a follow-up period from 9 months-4 years. The symptoms recurred on the same side of the face, and were unresponsive to medical treatment. Brain computed tomography (CT) and magnetic resonance imaging (MRI) may reveal the etiology of recurrence. Repeat decompression of the trigeminal nerve was the main goal of reoperation, which was done via a suboccipital approach.

RESULTS

Over the past 17 years, 80 MVDs for TN have been performed at Chang Gung Memorial Hospital. There were five cases of serious postoperative recurrence, which could not be relieved by medicine. Recurrence occurred 1 day-12 months after the initial surgery. Three cases were due to vascular compression, while two were caused by the local effect of Teflon felt. Reoperation produced complete remission in four patients, and partial remission in one.

CONCLUSIONS

An increasing number of patients may experience severe recurrent TN after initial MVD during a long period of follow-up. Reoperation is safe and beneficial for these patients, but the results are dependent on the etiology of the recurrence. Further vascular compression of the trigeminal nerve can be relieved by MVD. Otherwise, in cases of severe adhesion caused by Teflon, complete microneural lysis can achieve satisfactory results.

Bone densitometry of proximal femur in Chinese subjects: gender differences in bone mass and bone areas

Bone mineral content (BMC), bone areas (BA), and bone mineral density (BMD) of the proximal femur were measured in 202 healthy Chinese men and 507 healthy Chinese women, aged 21-70 years, to investigate gender differences in densitometry of the femur. Densitometric values measured at the femoral neck, trochanter, and Ward's triangle were generally greater in men than women of the same age, except at Ward's triangle. While BMD decreased with aging with similar slopes of -0.2 approximately -1% per year, the actual readings were 10%-15% lower than those of Caucasian subjects of the same age and gender for Chinese men and women. Furthermore, with increasing age, trochanteric BA increased in women but not in men, and femoral neck BA increased in men but not in women. These different trends of change in bone dimensions were independent of weight or height. They may reflect a structural difference at the proximal femur and imply differences in mechanical strength, and thus may have played some roles in the different incidence of hip fractures between the elderly men and women.