Comparison of Stress Hormone Response, Interleukin-6 and Anaesthetic Characteristics of Two Anaesthetic Techniques: Volatile Induction and Maintenance of Anaesthesia using Sevoflurane versus Total Intravenous Anaesthesia using Propofol and Remifentanil

This prospective randomized study compared the effects of two types of anaesthesia on peri-operative anaesthetic profiles from induction to recovery and on immunological and neurohormonal responses to anaesthesia and surgical stress. Forty patients were assigned to undergo either volatile induction and maintenance of anaesthesia (VIMA) with sevoflurane or total intravenous anaesthesia (TIVA) with propofol and remifentanil. Plasma adrenaline, noradrenaline, cortisol, glucose and interleukin-6 (IL-6) levels were measured at baseline, induction, incision and extubation. TIVA produced a significantly lower intubation score, shorter time to intubation and faster waking time than VIMA, but recovery profiles did not differ. Adrenaline, noradrenaline, cortisol and glucose levels were significantly lower with TIVA than VIMA, but there was no difference in IL-6 levels between the two groups. TIVA with propofol and remifentanil may be preferable to VIMA with sevoflurane alone because it leads to smoother, more rapid induction, more rapid awakening and lower stress responses to surgical stimuli.

Two-dimensional modelling of benzene transport and biodegradation in a laboratory-scale aquifer

In this study biodegradation of aqueous benzene during transport in a laboratory-scale aquifer model was investigated by conducting a 2-D plume test and numerical modelling. Benzene biodegradation and transport was simulated with the 2-D numerical model developed for solute transport coupled with a Haldane-Andrews type function for inclusion of an inhibition constant which is effective for high concentrations. Experimental data revealed that in the early stages the benzene plume showed a rather clear shape but lost its shape with increased travel time. The mass recoveries of benzene at 9, 16, and 22 h were 37, 13 and 8%, respectively, showing that a significant mass reduction of aqueous benzene occurred in the model aquifer. The major processes responsible for the mass reduction were biodegradation and irreversible sorption. The modelling results also indicated that the simulation based on the microbial parameters from the batch experiments slightly overestimated the mass reduction of benzene during transport. The sensitivity analysis demonstrated that the benzene plume was sensitive to the maximum specific growth rate and slightly sensitive to the half-saturation constant of benzene but almost insensitive to the Haldane inhibition constant. The insensitivity to the Haldane inhibition constant was due to the rapid decline of the benzene peak concentration by natural attenuation such as hydrodynamic dispersion and irreversible sorption. An analysis of the model simulation also indicated that the maximum specific growth rate was the key parameter controlling the plume behaviour, but its impact on the plume was affected by competing parameter such as the irreversible sorption rate coefficient.

Can a warning leak in a patient with unruptured aneurysm mask an underlying gastrointestinal pathology? A case report

Aggravating headache accompanied by nausea and epigastric discomfort suggesting a warning leak in a 39-year-old woman with a giant thrombosed intracranial aneurysm prompted us to undertake coiling of the aneurysm. After uneventful coil embolization of the aneurysm, collapse of the lung related to bronchospam developed, and was found to have a gastrointestinal pathology which had gone undetected before the procedure. Despite its rarity, gastrointestinal pathology mimicking warning leak should have been considered in a patient with a warning leak sign.

Comparison of Three Warming Devices for the Prevention of Core Hypothermia and Post-Anaesthesia Shivering

The efficacy of forced air warming with a surgical access blanket in preventing a decrease in core temperature during anaesthesia and post-anaesthesia shivering (PAS) was compared with two widely used interventions comprising forced air warming combined with an upper body blanket, and a circulating water mattress, in a prospective, randomized double-blind study. A total of 90 patients undergoing total abdominal hysterectomy were studied, 30 in each group. Core temperature was measured 15, 30, 45, 60, 90 and 120 min after induction of anaesthesia. PAS was evaluated every 5 min after emergence from anaesthesia over a period of 1 h. Core temperature fell in all three groups compared with the baseline, but forced air warming using a surgical access blanket was more effective than the other warming methods in ameliorating the temperature decrease. The surgical access blanket was also superior to the circulating water mattress in reducing PAS.

Modeling of growth kinetics for Pseudomonas putida during toluene degradation

Glucose has been often used as a secondary substrate to enhance the degradation of primary substrate as well as the increase of biomass, especially for the inhibitory range of substrate concentration. In this study, we investigated the effect of glucose concentration on growth kinetics of Pseudomonas putida during toluene degradation for a wide concentration range (60-250 mg/l). Batch microcosm studies were conducted in order to monitor bacterial growth for three different initial concentrations (2, 5, 10 mg/ml) of glucose for a given toluene concentration. Modeling of growth kinetics was also performed for each growth curve of glucose dose using both Monod and Haldane kinetics. Batch studies revealed that bacterial growth showed a distinct inhibitory phase above some limit (approximately 170 mg/l) for the lowest (2 mg/ml) glucose dose, but the degree of inhibition decreased as the glucose dose increased, leading to three different growth patterns. The bacterial growth followed each of the modified Wayman and Tseng, Wayman and Tseng, and Luong model as the glucose dose increased from 2 to 10 mg/ml. This indicates that glucose has a prominent influence on bacterial growth during toluene degradation and that different kinetics should be adopted for each broth condition.

Intracranial stenting of severe symptomatic intracranial stenosis: results of 100 consecutive patients

BACKGROUND AND PURPOSE

There are a few reports regarding the outcome evaluation of balloon-expandable intracranial stent placement (BEICS). The purpose of our study was to evaluate the outcome and factors related to the adverse events (AEs) of BEICS.

MATERIALS AND METHODS

We evaluated 100 consecutive patients who underwent BEICS. We assessed the procedural success (residual stenosis < 50%), AEs (minor strokes, major strokes, and death), clinical outcome, and restenosis (> 50%) at 6 months. We also analyzed 18 factors including symptom patterns related to AE rate. Symptom patterns revealed 1) stable patients (n = 73) with improving, stationary, or resolved symptoms; and 2) unstable patients (n = 27) with gradual worsening or fluctuating symptoms (National Institutes of Health Stroke Scale [NIHSS] > or = 4) within 2 days before stent placement.

RESULTS

The procedural success rate was 99%. Overall, there were 10 (10%) AEs within the 6 months: 4 (4%) minor strokes, 3 (3%) major strokes, and 3 (3%) deaths including a death from myocardial infarction. AE rate was 4.1% in stable and 25.9% in unstable patients. Restenosis at 6 months revealed 0% (0/59). Good outcome (modified Rankin Scale < or = 2) at 6 months was 97% (71/73) in stable and 67% (18/27) in unstable patients. Stepwise logistic regression model revealed that symptom pattern (unstable versus stable) was the only significant risk factor (OR, 8.167; 95% CI, 1.933-34.500; P = .004).

CONCLUSION

BEICS revealed a low AE and good outcome rate at 6 months, especially in the stable patients. Midterm outcome was also favorable in the unstable patient group.

Method of assessing involved facial areas: rule of fours

BACKGROUND

Disease extent or affected area is probably the most easily and most frequently measured index of patient disability in dermatological disorders such as psoriasis. However, no standard method is available for assessing involved facial areas.

OBJECTIVES

To devise a method for assessing involved facial areas and to examine its validity and reliability.

METHODS

In study 1, the facial areas of 26 healthy adults were analysed and a new method for assessing facial areas was devised. In study 2, the validity and reliability of the devised method were investigated by 10 dermatologists using 30 photographs of patients with facial psoriasis.

RESULTS

In study 1, facial regions were defined to have percentage areas that were multiples of 4% of the total facial area (which we refer to as the rule of fours), i.e. forehead 24%, one cheek 20%, perioral area 8%, one aspect of an ear 4%, one periorbital area 4%, and nose 4%. In study 2, a comparison of values obtained using the rule of fours with those obtained using an image analysis system showed excellent intrarater and inter-rater reliability when using the rule of fours.

CONCLUSIONS

The rule of fours is useful for assessing involved facial areas. The application of this rule was found to provide an accurate and reliable method as compared with image analysis.

Dissecting aneurysm of the basilar arterial trunk presenting with pontine infarction. Coil obliteration of the dissecting aneurysm including the diseased basilar arterial segment

SUMMARY

Dissecting basilar aneurysms have rarely been reported but are associated with high morbidity and mortality. Therefore, controversy exists as to the proper management of such lesions because their natural course is not well understood. We describe a 50-year-old man with a dissecting aneurysm involving the lower basilar trunk who presented with pontine infarction corresponding to the aneurysmal sac location. We obliterated the dissecting basilar aneurysm by coil embolization of the aneurysmal sac as well as the diseased segment of the basilar trunk after confirmation of collateral filling of the basilar artery through the posterior communicating artery. The patient recovered without any procedural complication. Eight month follow-up revealed complete disappearance of the aneurysm without symptom recurrence together with preservation of collateral flow in the distal basilar artery. Obliteration of the parent artery as well as the aneurysmal sac with coils could be considered in a lower basilar aneurysm of a dissecting nature.

Detection of CSF leak in spinal CSF leak syndrome using MR myelography: correlation with radioisotope cisternography

BACKGROUND AND PURPOSE

Spinal CSF leak syndrome is a unique disorder caused by spinal CSF leak. In this study, we attempted to determine whether MR myelography (MRM) can detect the leakage site in the spine.

MATERIALS AND METHODS

We performed both MRM and radioisotope cisternography (RIC) in 15 patients with spinal CSF leak syndrome. Patients were included in this study if they had at least 2 of the following criteria: 1) orthostatic headache, 2) low CSF opening pressure, and 3) diffuse pachymeningeal enhancement on brain MR imaging. For comparison, we performed MRM in 15 subjects without symptoms of spinal CSF leak syndrome. MRM was performed with the 2D turbo spin-echo technique in the entire spine by using a 1.5T scanner. Two blinded radiologists evaluated the MRM findings in a total of 30 cases, composed of patient and control groups, with regard to the presence of leakage and the level of leakage if present. RIC was performed only in the patient group and was assessed by consensus among 3 physicians experienced in nuclear medicine. The diagnostic performance of MRM and RIC was evaluated on the basis of the clinical diagnosis of spinal CSF leak syndrome.

RESULTS

The sensitivity, specificity, and accuracy of MR myelography for detecting CSF leak was 86.7%, 86.7%, and 86.7% for reader 1, respectively, and 80.0%, 93.3%, and 86.7% for reader 2, respectively. The sensitivity of RIC was 93.3%. Agreement between the 2 techniques for the detection of CSF leak was substantial in reader 1 and moderate in reader 2 (kappa = 0.634 and 0.444, respectively).

CONCLUSION

MRM is an effective tool for detecting CSF leak in the spine in patients with spinal CSF leak syndrome.

Semi-automated disk-type solid-phase extraction method for polychlorinated dibenzo-p-dioxins and dibenzofurans in aqueous samples and its application to natural water

A disk-type solid-phase extraction (SPE) method was used for the extraction of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in natural water and tap water. Since this SPE system comprised airtight glass covers with a decompression pump, it enabled continuous extraction with semi-automation. The disk-type SPE method was validated by comparing its recovery rates of spiked internal standards with those of the liquid-liquid extraction (LLE). The recovery ranges of both methods were similar in terms of (13)C-labeled internal standards: 64.3-99.2% for the LLE and 52.4-93.6% for the SPE. For the native spike of 1,3,6,8-tetrachlorinated dibenzo-p-dioxin (TCDD) and octachlorinated dibenzo-p-dioxin (OCDD), the recoveries in the SPE were in the normal range of 77.9-101.1%. However, in the LLE, the recoveries of 1,3,6,8-TCDD decreased significantly. One of the reasons for the low recovery is that the solubility of this congener is high. The semi-automated SPE method was applied to the analysis of different types of water: river water, snow, sea water, raw water for drinking purposes, and tap water. PCDD/F congeners were found in some sea water and snow samples, while their concentrations in the other samples were below the limits of detection (LODs). This SPE system is appropriate for the routine analysis of water samples below 50L.

Electrochemical detection of pathogen infection using cell chip

The immobilized cell using self-assembled synthetic oligopeptide was applied to the electrochemical detection of pathogen infection. Thin films based on cysteine-terminated synthetic oligopeptides were fabricated for the immobilization of HeLa cell on gold (Au) substrate. Layer formation and immobilization of the cell were investigated with surface plasmon resonance (SPR) and electrochemical impedance spectroscopy (EIS). Experimental results showed that the thin film of cysteine-terminated synthetic oligopeptide was successfully fabricated and it could be applied for the immobilization of HeLa cells. The adhered living cell was exposed to E. coli O157:H7, which induced the change of SPR angle and electrochemical impedance signal. The proposed cell immobilization method using self-assembly technique can be applied to construct the cell microarray for on-site pathogen monitoring.

Characteristics and management of ruptured distal middle cerebral artery aneurysms

OBJECTIVE

Distal middle cerebral artery (dMCA) aneurysms are very rare with a reported frequency of 2-6%. Typically, patients with ruptured distal MCA aneurysms have poor clinical outcomes because often there is both a subarachnoid haemorrhage (SAH) and an intracerebral haematoma (ICH). The goals of this study were to identify the characteristics of the distal MCA aneurysms and evaluate the optimal treatment for a good outcome.

METHODS

The clinical, neuroradiological and operative records of 8 patients with a ruptured distal MCA aneurysm who underwent surgical management were reviewed retrospectively. The outcomes were presented according to the Glasgow Outcome Scale (GOS).

RESULTS

The clinical characteristics of the patients with ruptured dMCA aneurysms included the following: (1) a fusiform appearance in five out of eight (63%) patients. (2) Mean aneurysm size of 9.4 mm (range 2-35 mm). (3) The location being M2 (insular segment) in three, M2-3 junction in three, and M3 (opercular segment) in two patients. (4) Brain CT images revealed both SAH and an ICH in six of eight (75%) patients with the mean size of the ICH being 10 cc (range 5-25 cc). (5) Re-bleeding occurred in four out of eight (50%) of patients. All patients underwent early surgical treatment and the procedures used for surgical repair were, clipping in five patients, trapping in two, and trapping with end-to-end bypass surgery in one patient. Clinical outcomes were poor in two patients (death) due to severe brain swelling.

CONCLUSIONS

In this study, dMCA aneurysms had a fusiform shape and a high re-bleeding rate; if ruptured, there was generally ICH and SAH. A good clinical outcome was associated with adequate control of brain swelling and early surgery to prevent re-bleeding.

A promoter nucleotide variant of the dendritic cell-specific DCNP1 associates with serum IgE levels specific for dust mite allergens among the Korean asthmatics

Dendritic cells (DCs), the most abundant antigen-presenting cells in the lung, have been drawing attention for their roles in specific allergic responses to aeroallergens with support of Th lymphocytes, and in persistent inflammatory changes in allergic asthma. To identify genetic factors that may be involved in the asthma susceptibility and development of the disease phenotypes, we examined association of DC-specific DCNP1 polymorphisms with the disease risk. The case-control study revealed association of the nucleotide variants with serum immunoglobulin E (IgE) levels specific for Dermatophagoides farinae (Der f 1) and Dermatophagoides pteronyssinus (Der p 1), major aeroallergens of dust mites, among subjects with asthma. In particular, the T-allele-carrying genotype frequencies for one of the variants (c.-1289C>T) located in the promoter region were found increased in the asthmatic group with low levels of the mite-specific IgE (odds ratio (OR)=0.63 (0.48-0.83) for Der p 1). Results from functional analyses indicated that the promoter variant would affect the gene expression by modulating DNA-protein interaction. We propose that the genetic polymorphism of DCNP1 may influence production of specific IgE by altering DC functions in the mite allergen presenting and/or processing. The functional relevance of the genetic variation would provide an important insight into the genetic basis of allergic response to the mite antigens.

Desorption kinetics of benzene in a sandy soil in the presence of powdered activated carbon

Desorption kinetics of benzene was investigated with a modified biphasic desorption model in a sandy soil with five different powdered activated carbon (PAC) contents (0, 1, 2, 5, 10% w/w) as sorbents. Sorption experiments followed by series dilution desorption were conducted for each sorbent. Desorption of benzene was successively performed at two stages using deionized water and hexane. Modeling was performed on both desorption isotherm and desorption rate for water-induced desorption to elucidate the presence of sorption-desorption hysteresis and biphasic desorption and if present to quantify the desorption-resistant fraction (q (irr)) and labile fraction (F) of desorption site responsible for rapid process. Desorption isotherms revealed that sorption-desorption exhibited a severe hysteresis with a significant fraction of benzene being irreversibly adsorbed onto both pure sand and PAC, and that desorption-resistant fraction (q (irr)) increased with PAC content. Desorption kinetic modeling showed that desorption of benzene was biphasic with much higher (4-40 times) rate constant for rapid process (k (1)) than that for slow process (k (2)), and that the difference in the rate constant increased with PAC content. The labile fraction (F) of desorption site showed a decreasing tendency with PAC. The experimental results would provide valuable information on remediation methods for soils and groundwater contaminated with BTEX.

The effects of container materials and buffer additives on decreasing the iodide concentration in a disposal vault for spent nuclear fuel

To retard the migration of iodine released from a spent fuel after the break of a container, the reducing effects on the concentration of the iodide by container corrosion products and some buffer additives were examined in a solution with bentonite. Iron and copper, and their corrosion products scarcely reduced the iodide concentration. And kaolinite, chalcopyrite, pyrite, copper ore and galena, known as having a sorption property for iodine, did not noticeably sorb the iodide. However, palm active carbon, silver metal and Ag2O lowered the iodide concentration. Especially, Ag2O put into a disposal container would effectively hinder the migration of iodine to the outside of a disposal vault without a great loss if the pore size of the compacted buffer layer is maintained below 1 mu m.

Biological responses of anodized titanium implants under different current voltages

The oxide layer of a titanium surface is very stable, and seems to result in excellent biocompatibility and successful osseointegration. The purpose of this study was to investigate the effects of high anodic oxidation voltages on the surface characteristics of titanium implants and the biologic response of rabbit tibiae. Bone tissue responses were evaluated by removal torque tests and histomorphometric analysis. Screw-shaped implants with microthreads were made of commercially pure titanium (Grade II). We prepared anodized implants under 300 V (group I), 400 V (group II), 500 V (group III) and 550 V (group IV). The surface characteristics of specimens were inspected according to three categories: surface morphology, surface roughness and oxide layer thickness. The screw-shaped implants were installed in rabbit tibiae. The removal torque values were measured and histomorphometric analysis was done after 1- and 3-month healing periods. Data indicate that as anodic oxidation voltage increased above 300 V, oxide layer thickness increased rapidly and pore size also increased. The roughness values of the implants increased with voltage up to 500 V, but decreased at 550 V. In the removal torque test, group III showed higher values than groups I and II at a statistically significant level (P < 0.05) after a 1-month healing period. In histomorphometric analysis, groups III and IV, after a 3-month healing period, showed greater bone to implant contact ratios for the total implant surface than did group I (P < 0.05).

Effect of dissolved oxygen regime on growth dynamics of Pseudomonas spp during benzene degradation

We investigated the effect of different oxygen regimes on growth patterns of Pseudomonas spp. during benzene degradation in microcosm batch studies. Benzene degradation was induced by limiting oxygen available for microbial activity, which consists of three initial-dissolved oxygen (DO) levels of oxic, hypoxic, and anoxic conditions. Batch experiments were performed for cell growth and benzene degradation by inoculating three strains of Pseudomonas spp. (Pseudomonas aeruginosa, Pseudomonas fluorescens, Pseudomonas putida) in mineral salt medium containing aqueous benzene. Results showed that all strains were capable to grow and degrade benzene under all oxygen regimes but in a different manner. The highest cell growth of P. aeruginosa and P. fluorescens was achieved under oxic and anoxic condition, respectively, but there was no substantial difference on benzene degradation between the oxygen treatments with about 25% reduction for both strains. P. putida showed a facultative process for both cell growth and benzene degradation. This reveals that care should be taken in selection of microorganisms with regard to environmental studies since they exhibit different responses for given environmental conditions such as DO levels.

Peripheral T-cell lymphoma in the neck: CT findings of lymph node involvement

OBJECTIVE

To describe the CT findings of lymph nodes of the neck involved in peripheral T-cell lymphomas (PTCL).

MATERIALS AND METHODS

Twenty-seven patients with pathologically proved PTCL with involvement of the lymph nodes of the neck were enrolled in this study. We retrospectively evaluated the lymph nodes on CT images with special attention to nodal necrosis, the margin, and enhancement patterns.

RESULTS

In the 27 patients studied, nodal necrosis and ill-defined margin were seen in 11 (41%) and 19 (70%), respectively. Heterogeneous enhancement of enlarged lymph nodes was noted on CT images in 19 (70%) of 27 patients. Homogeneous enhancement without ill-defined margin and/or nodal necrosis was only seen in 6 of 27 patients (22%).

CONCLUSION

Necrosis, an ill-defined margin, and heterogeneous enhancement of enlarged lymph nodes in the neck are relatively common CT features of PTCL. For patients with cervical lymph node enlargement, the presence of these findings may suggest high-grade non-Hodgkin's lymphoma, including PTCL.

Comparison of the amount of nuclides released from the spent fuel in contact with and without a compacted bentonite block

A spent LWR fuel specimen between Ca-bentonite blocks was leached in a simulated bentonite-saturated granitic water (SBGW) for 165 days and its results were compared with those of a specimen leached without a bentonite block. The amounts of Cs, Sb, Sr, Eu, Am, U and Pu released from a 4.3 mm thickness of a fuel pellet with a 50,400 MWD/MTU burn-up in the SBGW without a bentonite block were 2.2, 0.25, 0.15, 0.02, 0.01, 0.01 and approximately 5 x 10(-4)% of their inventories, respectively. However, the amounts of nuclides released from the specimen between the 1.4 Mg/m(3) bentonite blocks were decreased by three times at least. Moreover, the concentrations of the nuclides in the leachate were very low because most of them were retained in the bentonite blocks.

Unusual renal cell carcinomas: a pictorial essay

Renal cell carcinoma (RCC) is the most common solid renal neoplasm. Clear cell (conventional) carcinoma is the most common pathologic subtype of RCC. Usually RCC is a hypervascular, solid, solitary mass with contour bulging. However, RCC can manifest different features according to the pathologic tumor subtypes. Preoperative diagnosis of cyst-associated RCC is very difficult, especially in cases of RCC originating in a cyst. Multiple or bilateral presentation of RCC occurs in fewer than 5% of cases. In addition, RCCs may demonstrate unusual findings such as infiltrative growth mimicking transitional cell carcinoma, fatty component mimicking angiomyolipoma, severe perinephric infiltration, and extensive calcifications mimicking inflammation or other tumor. RCCs can be associated with hereditary diseases such as von Hippel-Lindau disease. Familiarity with these radiologic features of unusual RCCs can help ensure correct diagnosis and proper management.

Relationships between tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) and hematopoietic activity in healthy adults

To investigate the relationship between hematopoiesis and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), we measured soluble TRAIL concentrations, reticulocytes, hemograms, and anthropometric variables in 156 healthy subjects. Serum TRAIL concentrations were analyzed by an enzyme immunoassay. Serum ferritin, thyroid hormone, total cholesterol, creatinine, and blood glucose levels were determined. There were no significant differences in blood cell counts and biochemical parameters between the subjects with TRAIL less than 63.5 pg/ml and TRAIL at least 63.5 pg/ml, nor between those with TRAIL at most 47.5 pg/ml (20th percentile) and TRAIL > or =80.9 pg/ml (80th percentile). However, hemoglobin, mean corpuscular hemoglobin (MCH), and MCH concentration (MCHC) averaged 15.6+/-0.8 g/dl, 31.9+/-1.1 pg, and 34.5+/-0.9 g/dl in the subjects with TRAIL at most 47.5 pg/ml, which were significantly above the values in those with TRAIL at least 80.9 pg/ml (14.7+/-0.9 g/dl, 30.4+/-1.3 pg, and 33.2+/-1.2 g/dl, P<0.05, respectively). Serum TRAIL levels were significantly higher in the subjects with decreased MCH than in those with elevated MCH. Soluble TRAIL concentrations were significantly correlated with hemoglobin (r=-0.25, P<0.05), MCH (r=-0.32, P<0.05), and MCHC (r=-0.29, P<0.05), but not correlated with leukocyte differentials and platelet counts. In conclusion, soluble TRAIL does not seem to influence leukocyte and platelet production but has an important relationship to erythropoiesis in healthy adults.

Optimization of submerged culture condition for the production of mycelial biomass and exopolysaccharides by Agrocybe cylindracea

The optimization of submerged culture conditions and nutritional requirements was studied for the production of exopolysaccharide (EPS) from Agrocybe cylindracea ASI-9002 using the statistically based experimental design in a shake flask culture. Both maximum mycelial biomass and EPS were observed at 25 degrees C. The optimal initial pH for the production of mycelial biomass and EPS were found to be pH 4.0 and pH 6.0, respectively. Subsequently, optimum concentration of each medium component was determined using the orthogonal matrix method. The optimal combination of the media constituents for mycelial growth was as follows: maltose 80 g/l, Martone A-1 6 g/l, MgSO4 x 7H2O 1.4 g/l, and CaCl2 1.1 g/l; for EPS production: maltose 60 g/l, Martone A-1 6 g/l, MgSO4 x 7H2O 0.9 g/l, and CaCl2 1.1 g/l. Under the optimal culture condition, the maximum EPS concentration achieved in a 5-l stirred-tank bioreactor indicated 3.0 g/l, which is about three times higher than that at the basal medium.