Translation and validation of the Korean Version of the Reflux Symptom Score

OBJECTIVES

To assess the validity and reliability of the Korean version of the reflux symptom score (K-RSS).

MATERIALS AND METHODS

The English version of the RSS was translated into Korean and completed by 77 people (44 and 33 people in the patient group and control group, respectively). They completed the K-RSS (K-RSS-1) and reflux symptom index (RSI) questionnaires and answered questions about age, sex, underlying disease, smoking history, and alcohol and coffee consumption. They completed the K-RSS once more (K-RSS-2) after 1 - 2 weeks. Internal consistency was evaluated using Cronbach's α and test-retest reliability using the intraclass correlation coefficient (ICC). External validity was evaluated using the Spearman rank test between the RSI and K-RSS. The Mann-Whitney U test was used to assess internal validity by comparing the K-RSS-1 scores between the patient and control groups.

RESULTS

The most common symptoms were globus sensation, throat clearing, and throat pain. The K-RSS reported high internal consistency (α = 0.894). The ICC for the total score was 0.883, indicating excellent test-retest reliability. According to the Spearman analysis, there was a significant correlation between the total score of the K-RSS and that of the RSI (rs = 0.902; P < 0.001), demonstrating strong external validity. Furthermore, the patient group showed significantly higher values than the control group in all K-RSS scores, suggesting high internal validity.

CONCLUSION

The K-RSS is a patient-reported outcome questionnaire with excellent criterion-referenced validity and ideal reliability.

[Effect of dexmedetomidine on the intraoperative and early postoperative complications of patients undergoing orthotopic liver transplantation]

Objective: To investigate the effect of dexmedetomidine on the intraoperative and early postoperative complications of patients undergoing orthotopic liver transplantation. Methods: This is a retrospective cohort study. The clinical data of 399 patients who underwent orthotopic liver transplantation at the First Affiliated Hospital of Nanjing Medical University from January 2016 to September 2020 were retrospectively collected. There were 319 males and 80 females, aged (50.9±10.2) years (range: 10 to 73 years). These patients were divided into the control group (369 cases) and the dexmedetomidine group (30 cases) according to whether dexmedetomidine was continuously pumped intravenously during the operation until the operation ended. The 1∶2 propensity score matching was used to match the preoperative and intraoperative conditions of the two groups of patients, and the caliper width was 0.2. Outcome indicators included intraoperative postreperfusion syndrome, acute kidney injury and pulmonary complications within 7 days after surgery, length of hospital stay, time of stay in ICU, duration of assisted mechanical ventilation, rate of reintubation, 6-month and 1-year survival and recurrence-free survival rate after surgery. The independent sample t test, χ2 test, Mann-Whitney U test or Fisher exact test was used to statistically analyze the data of the two groups of patients, respectively. Survival curves of overall survival and disease-free-survival were plotted by Kaplan-Meier method, and the survival rate and recurrence-free survival rate were compared by Log-rank test. Results: A total of 78 patients were included after propensity score matching, including 26 in the dexmedetomidine group and 52 in the control group. The incidence of acute kidney injury in the dexmedetomidine group within 7 days after surgery was 0 (0/26), significantly lower than that of the control group (21.2%,11/52)(corrected χ2=4.776, P=0.029). There were no significant differences in the incidence of intraoperative postreperfusion syndrome and pulmonary complications within 7 days after surgery, length of hospital stay, ICU time, the duration of assisted mechanical ventilation, rate of reintubation, 6-month and 1-year survival, and recurrence-free survival rate after surgery between the two groups (all P>0.05). Conclusion: Continuous infusion of dexmedetomidine via intravenous pump during operation may be beneficial in reducing the incidence of acute kidney injury within 7 days after orthotopic liver transplantation.

Empirical assessment of biases in cerebrospinal fluid biomarkers of Alzheimer's disease: an umbrella review and re-analysis of data from meta-analyses

OBJECTIVE

Alzheimer's disease (AD) is a leading cause of years lived with disability in older age, and several cerebrospinal fluid (CSF) markers have been proposed in individual meta-analyses to be associated with AD but field-wide evaluation and scrutiny of the literature is not available.

MATERIALS AND METHODS

We performed an umbrella review for the reported associations between CSF biomarkers and AD. Data from available meta-analyses were reanalyzed using both random and fixed effects models. We also estimated between-study heterogeneity, small-study effects, excess significance, and prediction interval.

RESULTS

A total of 38 meta-analyses on CSF markers from 11 eligible articles were identified and reanalyzed. In 14 (36%) of the meta-analyses, the summary estimate and the results of the largest study showed non-concordant results in terms of statistical significance. Large heterogeneity (I2≥75%) was observed in 73% and small-study effects under Egger's test were shown in 28% of CSF biomarkers.

CONCLUSIONS

Our results suggest that there is an excess of statistically significant results and significant biases in the literature of CSF biomarkers for AD. Therefore, the results of CSF biomarkers should be interpreted with caution.

Increased salivary syndecan-1 level is associated with salivary gland function and inflammation in patients with Sjögren's syndrome

Objectives: Syndecan-1 (SDC-1), a transmembrane heparin sulphate proteoglycan predominantly expressed on epithelial cells, also exists in a soluble form through ectodomain shedding. SDC-1 expression and shedding may be modulated in the inflammatory milieu of primary Sjögren's syndrome (SS). We investigated SDC-1 expression in minor salivary glands (MSGs) and analysed the association between salivary or plasma levels of SDC-1 and clinical parameters in SS.Method: We measured salivary and plasma SDC-1 levels via an enzyme-linked immunosorbent assay and assessed the salivary flow rates (SFRs) in 70 patients with SS and 35 healthy subjects. Disease activity indices, serological markers, salivary gland scintigraphy, and MSG biopsy were evaluated in patients with SS.Results: SDC-1 expression was upregulated on ductal epithelial cells in inflamed salivary glands. Salivary SDC-1 levels in patients significantly exceeded those in healthy subjects [median (interquartile range) 49.0 (20.7-79.1) vs 3.7 (1.7-6.3) ng/mL, p < 0.001] and inversely correlated with SFRs (r = -0.358, p = 0.032) and ejection fractions of the parotid (r = -0.363, p = 0.027) and submandibular (r = -0.485, p = 0.002) glands in salivary gland scintigraphy. Plasma SDC-1 levels were significantly correlated with the EULAR Sjögren's Syndrome Disease Activity Index (r = 0.507, p < 0.001) and EULAR Sjögren's Syndrome Patient Reported Index (r = 0.267, p = 0.033). Focus scores were correlated with salivary SDC-1 levels (r = 0.551, p = 0.004).Conclusion: Salivary and plasma SDC-1 levels may constitute potential biomarkers for salivary gland function and disease activity, respectively, in SS.

Acute Seymour fractures in children/adolescents overlooked as a simple nail injury: Reduction without pinning

We retrospectively report the outcomes of several cases in which acute Seymour fractures were treated by open reduction of displaced distal bony fragments with concurrent nail repair, following complete incision and drainage without K-wire fixation. Among 21 patients surgically treated between March 2004 and December 2018, the final 12 were evaluated after at least 2 years of follow-up. All children/adolescents presented more than 24 h after the injury. All injuries were unreduced in the emergency department, with typical features of skin disruption around the eponychium/perionychium. Reduction was maintained without a K-wire after repairing the bone-periosteum-nail bed-nail plate of the distal fragment and the corresponding physis-periosteum-germinal matrix-proximal nail-fold of the proximal stump. Dorsal angulation, finger length, postoperative pain on visual analog scale (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and active range of motion (ROM) were evaluated at the final follow-up. The mean patient age was 9.3 years (range, 3-13 years) and the mean time from injury to surgery was 35 h (range, 28-44 h). Only one child suffered a superficial infection; however, it resolved with 1 week of oral antibiotic treatment. At the final follow-up, mean dorsal angulation was 0.50° ± 1.24°; the length ratio compared with the corresponding contralateral phalanx was 98% (both, P >  0.05). The final pain on VAS, DASH score, and ROM ratio were 0.25 ± 0.45, 0.83 ± 1.34, and 99 ± 2%, respectively. Unreduced Seymour fractures presenting more than 24 h after the injury were treated by proper debridement and reduction of the fracture without the use of a K-wire. However, to determine whether the infection rate is definitively lower, this procedure should be compared with the conventional procedure using a K-wire. Level of Evidence: Therapeutic level IV.

On the mechanism of dendritic fragmentation by ultrasound induced cavitation

A dedicated solidification device and high speed camera were used to capture dendritic fragmentation of pure succinonitrile (SCN) induced by oscillating ultrasonic bubbles. Theoretical analysis of the melting behavior of the dendrite was performed based on local solidification thermodynamics. The dendritic growth or the evolution of the solid-liquid interface is closely related to both thermodynamics of the cavitation bubble and the local geometry of the dendrite. Accordingly, for the first time, a dimensionless scaling formulation was developed by fitting both theoretical and experimental data to determine the variational pressure exerted by the cavitation bubble.

First report of carp oedema virus infection of koi (Cyprinus carpio haematopterus) in the Republic of Korea

Twenty-five koi (Cyprinus carpio haematopterus) bought from a wholesale fish market in Korea, showed lethargic behaviour and 100% mortality within 20 days. Carp oedema virus (CEV) was detected by PCR in all 25 koi. Results of detailed histopathological and clinical examinations of 17 koi indicated loss of body balance, severe infiltration of inflammatory cells into the inter-lamellar spaces of the gills and vacuolization and inclusion bodies in gill epithelial cells. Sequence analysis of PCR products of these koi showed up to 99% identity to the previously reported sequences, suggesting that the observed mass mortality resulted from koi sleepy disease (KSD) due to CEV infection. To the best of our knowledge, this study is the first report of KSD in the Republic of Korea. Partial sequences of 4a protein from the virus indicated that the present CEV detected in koi from Korea is more closely related to that from the UK and Poland than from Japan. The present findings indicate that the prevalence and spread of KSD must be closely monitored in both European and Asian countries to avoid potential economic losses to the global koi industry.

Use of supplemental anti-HBc testing of donors showing non-discriminating reactive results in multiplex nucleic acid testing

BACKGROUND AND OBJECTIVES

The Korean Red Cross began nucleic acid amplification testing (NAT) for HIV and HCV in February 2005, and added HBV NAT beginning in June 2012. The current NAT system utilizes a multiplex assay for simultaneous detection of HBV DNA, HCV RNA and HIV-1 RNA. For samples that are reactive in the multiplex assay, we do specific tests for each virus. However, there have been cases of non-discriminated reactive (NDR) results which appear to be the result of non-specific reactions or cross-contamination, although some cases are considered to arise from the presence of low levels of HBV DNA due to occult hepatitis B infection.

MATERIALS AND METHODS

We examined the incidence of NDR results in previous donations of some NAT-reactive donors. Additionally, for those donors with NDR results, we performed an HBV core antibody (anti-HBc) assay.

RESULTS

From November 2015 to March 2016, there were 408 NAT-reactive donors. Of these, nineteen HBV NAT-reactive donors showed a history of NDR results in the past donations. Seven donors showed NDR results more than once. Of 771 NDR donors, 362 (47·0%) were anti-HBc reactive.

CONCLUSION

The NDR donors had a substantially higher rate of anti-HBc reactivity than other blood donors indicating that some with anti-HBc reactivity represent donors with occult HBV. Therefore, the incorporation of an anti-HBc testing for NDR donors could improve blood safety testing for the Korean Red Cross.

Pathogen inactivation efficacy of Mirasol PRT System and Intercept Blood System for non-leucoreduced platelet-rich plasma-derived platelets suspended in plasma

BACKGROUND AND OBJECTIVES

This study was conducted to evaluate the efficacy of pathogen inactivation (PI) in non-leucoreduced platelet-rich plasma-derived platelets suspended in plasma using the Mirasol PRT System and the Intercept Blood System.

METHODS

Platelets were pooled using the Acrodose PL system and separated into two aliquots for Mirasol and Intercept treatment. Four replicates of each viral strain were used for the evaluation. For bacteria, both low-titre (45-152 CFU/unit) inoculation and high-titre (7·34-10·18 log CFU/unit) inoculation with two replicates for each bacterial strain were used. Platelets with non-detectable bacterial growth and platelets inoculated with a low titre were stored for 5 days, and culture was performed with the BacT/ALERT system.

RESULTS

The inactivation efficacy expressed as log reduction for Mirasol and Intercept systems for viruses was as follows: human immunodeficiency virus 1, ≥4·19 vs. ≥4·23; bovine viral diarrhoea virus, 1·83 vs. ≥6·03; pseudorabies virus, 2·73 vs. ≥5·20; hepatitis A virus, 0·62 vs. 0·76; and porcine parvovirus, 0·28 vs. 0·38. The inactivation efficacy for bacteria was as follows: Escherichia coli, 5·45 vs. ≥9·22; Staphylococcus aureus, 4·26 vs. ≥10·11; and Bacillus subtilis, 5·09 vs. ≥7·74. Postinactivation bacterial growth in platelets inoculated with a low titre of S. aureus or B. subtilis was detected only with Mirasol.

CONCLUSION

Pathogen inactivation efficacy of Intercept for enveloped viruses was found to be satisfactory. Mirasol showed satisfactory inactivation efficacy for HIV-1 only. The two selected non-enveloped viruses were not inactivated by both systems. Inactivation efficacy of Intercept was more robust for all bacteria tested at high or low titres.

Performance of electron beam irradiation for treatment of groundwater contaminated with acetone

The purposes of this study were to evaluate the efficiency of acetone removal by electron beam irradiation in groundwater and the effect of various conditions. According to the results, the removal kinetics of acetone were pseudo first-order, and the removal efficiencies were expressed to the (%) removal and G-values. By adding sulfite, it was confirmed that acetone was mainly degraded by the reaction with the hydrated electrons. The presence of nitrate caused the removal of acetone to decrease. But there was no significant effect of alkalinity on the removal of acetone. The effect of the initial pH values (pH 5 to 9) on the acetone removal efficiency was negligible, but the pH value decreases due to the formation of acidic compounds after irradiation. Consequently, the radiation-induced removal reactions of acetone followed the pseudo-first-order kinetic model; in addition to the initial concentration of acetone, nitrate and the absorbed dose were important factors in removing acetone from an aqueous solution using electron beam irradiation. The effects of general pH and alkalinity on the degrading acetone were negligible.

Structure and electrochemical performance of Li[Ni(1 -x-y)Co(x)Mn(y)]O2 [0.025 < or = x < or = 0.4, 0.015 < or = y < or = 0.25] as cathodes compound for lithium ion batteries

Li[Ni(1-x-y)Co(x)Mn(y)]O2 (0.025 < or = x < or = 0.4, 0.015 < or = y < or = 0.25) electrode powders were prepared by a solid-state reaction. The phase purity and R-3m layered structure of the synthesized Li[Ni(1-x-y)Co(x)Mn(y)]O2 materials were confirmed by X-ray diffraction analysis. The particle size of the powder/compounds was decreased with increasing Co and Mn contents to a minimum average particle size of 0.2 approximately 0.3 microm for the LiNi0.35Co0.4Mn0.25O2 powder. A specific capacity of 187 mAh/g was obtained for the LiNi0.35Co0.4Mn0.25O2 electrode with good capacity retention when cycled in the potential region of 3.0-4.6 V with a current density of 20 mA/g at room temperature. Although the structural parameters of the LiNi0.35Co0.4Mn0.25O2 cathode material were similar to those of the LiNil/3CO1/3Mn1/3O2 powder, its specific capacity was higher due to the higher Co contents.

Microwave assisted synthesis of nanocrystalline Fe-phosphates electrode materials and their electrochemical properties

LiFePO4 nanocrystalline particles were synthesized using microwave assisted polyol process within a fast reaction time of 20 minutes without any further heating as a post step. The synthesized LiFePO4 nanocrystalline particles showed mono-dispersed rod and orthorhombic-like shapes with a size of 60 approximately 180 nm. The refined X-ray diffraction pattern of the sample was indexed well to the olivine crystal structure (space group: Pnma) without any impurity phases. The LiFePO4 nanocrystalline particles show a capacity of 161 mAh/g in a voltage range of 2.5-4.2 V with a current density of 0.1 mA/cm2 without any observable capacity fading in extended cycles of 100th. A cyclic voltammetry analysis exhibits distinctly sharp peaks corresponding to the typical LiFePO4/FePO4 redox couples and demonstrates a good reversibility of the sample.

A new synthesis route to nanocrystalline olivine phosphates and their electrochemical properties

LiFePO4 nanoparticles were synthesized in various polyol mediums without any further heating. The LiFePO4 samples synthesized in polyol mediums exhibited average sizes of 20, 20, 50, and 50 nm with orthorhombic-like shapes. The XRD patterns were indexed on the basis of an olivine structure (space group : Pnma) except for the sample prepared in EG polyol medium. The LiFePO4 samples prepared in EG, DEG, TEG, and TrEG polyol mediums show the reversible capacity of 120 mA h/g, 144 mA h/g, 159 mA h/g, and 167 mA h/g at current density of 0.1 mA/cm2 with no capacity fading and excellent cycle retentions during extended cycles. Especially, the samples showed the excellent performances at high rate of 30 C and 60 C with high capacity retention. It is a speculation that nanometer size materials (approximately 50 nm) and a uniform size-distribution with highly crystallined phase may affect the excellent performances at high rate current densities.

A polyol-mediated synthesis of titania-based nanoparticles and their electrochemical properties

Ti-based nanoparticles were prepared in polyol mediums of EG (ethylene glycol) and TEG (triethylene glycol), with heating treatment. Ti-based materials of dried power and heated samples showed average sizes of 4, 10, 3, and 8 nm with spherical shapes and monodispersed state, respectively. The XRD patterns of TiO2 and Li4Ti5O12 materials of dried powder and heated samples were indexed to anatase phase TiO2 (space group: I4(1)/amd) and the spinel phase (space group: Fd3m) except for the dried powder sample of Li4Ti5O12, which was corresponded with amorphous-like characteristics from the X-ray diffraction and electron diffraction pattern of Field emission-TEM analysis. The TiO2 and Li4Ti5O12 samples after heat-treated at 500 degrees C exhibited excellent high rate capabilities at a current density of 0.4 mA/cm2 during extended cycles due to their electrochemically beneficial highly crystalline characteristics, nano-sized (approximately 10 nm), and uniform distributions state.

Simultaneous estimation of model parameters and diffuse pollution sources for river water quality modeling

Diffuse pollution sources along a stream reach are very difficult to both monitor and estimate. In this paper, a systematic method using an optimal estimation algorithm is presented for simultaneous estimation of diffuse pollution and model parameters in a stream water quality model. It was applied with the QUAL2E model to the South Han River in South Korea for optimal estimation of kinetic constants and diffuse loads along the river. Initial calibration results for kinetic constants selected from a sensitivity analysis reveal that diffuse source inputs for nitrogen and phosphorus are essential to satisfy the system mass balance. Diffuse loads for total nitrogen and total phosphorus were estimated by solving the expanded inverse problem. Comparison of kinetic constants estimated simultaneously with diffuse sources to those estimated without diffuse loads, suggests that diffuse sources must be included in the optimization not only for its own estimation but also for adequate estimation of the model parameters. Application of the optimization method to river water quality modeling is discussed in terms of the sensitivity coefficient matrix structure.

Disinfection and oxidation of sewage effluent water using ozone and UV technologies

This study was aimed at exploring the reclamation of sewage treatment plant effluent water (SEW) as an alternative water resource. For the oxidation of SEW, an ozone-UV system, based on the results of the combined ozone/UV process performed in our previous study, was set up under practical conditions, including a series type, continuous mode, semi-pilot scale operation (1.5 m3/d). As a result, the serial contact of the ozone and UV reactors showed lower CODCr and TOC removal efficiencies. However, these were greatly enhanced by recycling the water flow of the ozone-UV system at 40Q, as a result of the improvements in the transferred ozone dose in the ozone reactor and the contact efficiency between photons and ozone in the UV reactor, which approached that achieved in the combined ozone/UV process. For the disinfection of SEW, carried out in a syringe-type batch reactor, the increase of instantaneous ozone demand (ozone ID) led to a higher inactivation efficiency, an increased UV transmittance due to ozonation, and an enhanced inactivation rate of E. coli in the UV reactor. Additionally, it was concluded that the ozone/UV process could overcome the limitations of the ozone alone and UV alone processes for the reclamation of sewage effluent water.

Control of disinfection and halogenated disinfection byproducts by the electrochemical process

The aim of this study was to investigate some aspects of the performance of electrochemical process as an alternative disinfection strategy, while minimising DBPs, for water purification. The study of electrochemical processes has shown free chlorine to be produced, but smaller amounts of stronger oxidants, such as ozone, hydrogen peroxide and OH radicals (*OH), were also generated. The formation of mixed oxidants increased with increasing electric conductivity, but was limited at conductivities greater than 0.6 mS/cm. Using several microorganisms, such as E. coli and MS2 bacteriophage, inactivation kinetic studies were performed. With the exception of free chlorine, the role of mixed oxidants, especially OH radicals, was investigated for enhancement of the inactivation rate. Additionally, the formation and reduction of DBPs was studied by monitoring the concentration of haloacetic acids (HAAs) during the process.

Contribution of oligosaccharides to protection of the H,K-ATPaseβ-subunit against trypsinolysis

The proton-pumping H+,K+-adenosinetriphosphatase (H,K-ATPase), responsible for acid secretion by the gastric parietal cell, faces a harshly acidic environment, with some pepsin from neighboring chief cells, at its luminal surface. Its large catalytic alpha-subunit is mostly oriented cytoplasmically. The smaller beta-subunit (HKbeta), is mainly extracellular, with one transmembrane domain and a small cytoplasmic domain. Seven N-linked oligosaccharides in the extracellular domain of HKbeta are thought to contribute to protection of the H,K-ATPase, since previous work has shown that their complete removal, by peptide N-glycosidase F (PNGase F), greatly increased susceptibility of HKbeta to proteolysis. The possibility of graded protection by different numbers of oligosaccharides was investigated here with the use of mutant HKbeta cDNA, having various N-glycosylation sites mutated (Asn to Gln), transfected into HEK-293 cells. Membrane preparations, two days after transfection, were solubilized in 1% Triton X-100 and subjected to trypsinolysis (pH 8, 37 degrees C, trypsin:protein 1:10-1:25). Relative amounts of HKbeta remaining after 20 min trypsin were determined, after sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and probing of Western blots with an antibody to the HKbeta extracellular domain, by chemiluminescent development of blots and densitometry of resulting films. Maturely glycosylated HKbeta was made significantly more susceptible to trypsin than wild type when at least five oligosaccharides were deleted, while the high-mannose form (pre-beta), from the endoplasmic reticulum, became significantly more susceptible than wild-type pre-beta with removal of only two or more oligosaccharides. For each mutant, and wild type, pre-beta was consistently more susceptible than the mature form. While the number, and kind, of oligosaccharides seem to affect protection for HKbeta against trypsinolysis, other aspects of protein maturation, including proper folding of peptide domains and possible subtle alterations of conformation during Golgi processing, are also likely to contribute to this protection.

Catalyzed ozonation process with GAC and metal doped-GAC for removing organic pollutants

The purpose of this study was to investigate the catalytic role of granular activated carbon (GAC), and metal (Mn or Fe) doped-GAC, on the transformation of ozone into more reactive secondary radicals, such as hydroxyl radicals (*OH), for the treatment of wastewater. The GAC doped with Mn showed the highest catalytic performance in terms of ozone decomposition into OH radicals. Likewise, activated carbon alone accelerated the ozone decomposition, resulting in the formation of *OH radicals. In the presence of promoters, the ozone depletion rate was enhanced further by the Mn-GAC catalyst system, even under aqueous acidic pH conditions.

Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures

e analysed the CT scans and radiographs of 76 vertebrae in 49 patients who underwent vertebroplasty for painful osteoporotic compression fractures. Leaks of cement were classified into three types: those via the basivertebral vein (type B), via the segmental vein (type S), and through a cortical defect (type C). More leaks were identified on CT scans than on radiographs by a factor of 1.5 (74/49). Most type-B (93%) and type-S (86%) leaks were missed or underestimated on a lateral radiograph which is usually the only view used during the injection of cement. Of the leaks into the spinal canal, only 7% (2/28) were correctly identified on radiographs. The areas on lateral radiographs where this type of leak may be observed were divided into four zones, and their diagnostic value in predicting a leak into the spinal canal was evaluated. The results showed that cement in the neural foramina had the highest positive predictive value (86%).

Emerging patterns of the cervical cutaneous nerves in Asians

Numerous reports exist upon clinical viewpoints of the four cervical cutaneous nerves. Unfortunately, a detailed description of the cervical cutaneous nerves has not yet been published. For this reason, administering effective anaesthesia to a particular nerve branch is difficult. The aim of this study was to clarify the anatomical knowledge about the emerging patterns of the cervical cutaneous nerves in the superficial neck using 35 Korean cadavers (22 male, 13 female). Four cervical cutaneous nerve branches penetrating the fascia of the posterior border of the sternocleidomastoid muscle (SCM) were classified into seven types based on the locations of their nerve emergence. Among these, the separated type (L-G-T-S) was the most frequent (50%). followed by the L-G x T-S type (20.3%), in which the great auricular nerve (G) and the transverse cervical nerve (T) emerged at the same level on the posterior SCM border.

OH radical monitoring technologies for AOP advanced oxidation process

This study has been conducted to investigate OH radical monitoring technologies for the advanced oxidation process (AOP). OH radicals can be measured directly or indirectly through electron paramagnetic resonance (EPR), hydrogen peroxide method and probe compounds such as pCBA. Among the various AOPs, we focused on the application of EPR technique for *OH monitoring in the ultrasonic irradiation process. EPR method is a valuable tool and has a high sensitivity for radical measuring. Our study was performed with 20 kHz ultrasonic processor in 20 ml DMPO (1 mM) solution. The amount of DMPO-OH adduct with hyperfine constants aN = aH = 1.49 mT and g-value 2.0054, coincided with those of the DMPO-OH adduct depends on the reaction time of the sonication. Also, we have found that at least, *OH was accumulated by 2 x 10(-10) M for 10 min sonication, when 60% of the initial amount was destroyed through *OH monitoring using a probe compound. With these results, we could assume that recombination of *OH to form hydrogen peroxide occurs at the interfacial region.

[Synthesis and electrochemical behavior of new symmetrical porphyrin and cobalt(II) complex]

The synthesis and characterization of mercapto-porphyrin and its cobalt(II) complex are reported. A new method was used to synthesize the porphyrin. These compounds have not been reported previously. Their structural assignment of the porphyrin and its cobalt(II) complex were based on the elemental analysis, UV-Vis, IR and 1H NMR spectra. The elemental analysis data for C44H30N4H4 was C, 69.32(69, 44) H, 4.30(4.24) N, 7.35(7.36). The data of UV-Vis spectra indicated that soret and Q bands of the TMTBP displayed a red-shift in comparison with TPP. The IR spectra of TMTBP showed that the peak of delta (N-H) disappeared, when the cobalt(II) complex was formed. The 1H NMR spectra proved that a new mercapto-porphyrin has been synthesized. This paper also reported electrochemical behavior of new compounds in DMSO by cyclic voltammetry and differential pulse voltammetry.

Effects of genetic polymorphisms of CYP1A1, CYP2E1, GSTM1, and GSTT1 on the urinary levels of 1-hydroxypyrene and 2-naphthol in aircraft maintenance workers

This study was undertaken to investigate the effects of genetic polymorphisms of the cytochrome P450 1A1 (CYP1A1) and 2E1 (CYP2E1), and glutathione S-transferases mu (GSTM1) and theta (GSTT1) on urinary 1-hydroxypyrene and 2-naphthol levels, and to estimate the level of exposure to polycyclic aromatic hydrocarbons (PAHs) in aircraft maintenance workers. In 218 Korean aircraft maintenance workers, the geometric means of urinary 1-hydroxypyrene and 2-naphthol were 0.32 and 3.25 micromol/mol creatinine, respectively. These urinary concentrations were approximately at the upper limit of the general population. Mean urinary 2-naphthol concentrations were significantly different between smokers and non-smokers. CYP1A1 and GSTM1 were statistically significant in analyses on both 1-hydroxypyrene and 2-naphthol levels among smokers. The results suggest that smoking has more profound effects on urinary PAH metabolites than does genetic polymorphisms in this population, and that CYP1A1 and GSTM1 activity might be related to the metabolism of 1-hydroxypyrene and 2-naphthol.

Cloning, sequence analysis, and characterization of the astA gene encoding an arylsulfate sulfotransferase from Citrobacter freundii

Arylsulfate sulfotransferase (ASST) transfers a sulfate group from a phenolic sulfate ester to a phenolic acceptor substrate. In the present study, the gene encoding ASST was cloned from a genomic library copy of Citrobacter freundii, subcloned into the vector pGEM3Zf(-) and sequenced. Sequencing revealed two contiguous open reading frames (ORF1 and ORF2) on the same strand and based on amino acid sequence homology, they were designated as astA and dsbA, respectively. The amino acid sequence of astA deduced from C. freundii was highly similar to that of the Salmonella typhimurium, Enterobacter amnigenus, Klebsiella, Pseudomonas putida, and Campylobacter jejuni, encoded by the astA genes. However, the ASST activity assay revealed different acceptor specificities. Using p-nitrophenyl sulfate (PNS) as a donor substrate, alpha-naphthol was found to be the best acceptor substrate, followed by phenol, resorcinol, p-acetaminophen, tyramine and tyrosine.

Characterization of raw water for the ozone application measuring ozone consumption rate

This study was conducted to illustrate an ideal method for characterizing natural waters for ozonation processes in drinking water treatment plants. A specific instrument designed with the flow injection analysis (FIA) technique enabled us to measure accurately the ozone decomposition rate, which was found to consist of two stages: the instantaneous ozone consumption stage and the slower ozone decay stage. The ozone consumption rate was measured at the initial and secondary stages by determining certain parameters called the instantaneous ozone demand (ID) and the pseudo first-order decay rate constant (k(c)). Using the OH*-probe, the yield of OH* per consumed ozone was also measured to determine its potential to produce OH* for the oxidation of micropollutants during the ozonation process. The ozone consumption of the ID values was significant in most natural waters, and substantial amounts of OH* were found to generate during the instantaneous ozone consumption stage. This study also investigated the effects of particulates, ozone doses, and sequential ozone injection on ozone decomposition kinetics and OH* formation yield.

Analysis of vancomycin and related impurities by micellar electrokinetic capillary chromatography. Method development and validation

A fast and highly selective micellar electrokinetic capillary chromatography (MEKC) method for quantitative analysis of vancomycin and related impurities is described. Among the tested surfactants, cetyltrimethylammonium chloride (CTAC) offered the best selectivity. Another important parameter, which strongly influenced the selectivity, was buffer pH. It was found that the selectivity increased with buffer pH decreasing from 9 to 5. Using Tris-phosphate buffer containing CTAC, satisfactory separation could be obtained in the pH range from 5.0 to 5.5. Excellent repeatability in terms of migration time and peak area could be obtained when the capillary was carefully washed between two runs. In order to obtain optimal conditions and to evaluate the method robustness, a central composite experimental design was carried out. The optimal conditions were: 44 cm length of fused-silica capillary with 50 microm ID, 120 mM Tris-phosphate buffer (pH 5.2) containing 50 mM CTAC, -15 kV applied voltage, UV detection at 210 nm, and a column temperature of 25 degrees C. Under the optimal conditions, more than 20 peaks could be separated within 8 min. The method has a linearity range from 0.004 to 1.2 mg/ml (concentration of vancomycin B, active component). The limit of detection (LOD) and limit of quantitation (LOQ) were 0.4 microg/mL vancomycin, equivalent to 0.3 microg/mL vancomycin B (0.04%) and 1.1 microg/mL vancomycin, equivalent to 0.9 microg/mL vancomycin B (0.1%), respectively.

Down modulation of IL-18 expression by human papillomavirus type 16 E6 oncogene via binding to IL-18

To understand modulation of a novel immune-related cytokine, interleukin-18, by human papillomavirus type (HPV) 16 oncogenes, HaCaT, normal keratinocyte cell line, and C-33A, HPV-negative cervical cancer cell line, were prepared to establish stable cell lines expressing E6, E6 mutant (E6m), E6E7, or E7 constitutively. Expressions of various HPV oncogene transcripts were identified by RT-PCR. Expression of HPV oncogene E6 was reversely correlated to the expression of interleukin-18, a novel pro-inflammatory cytokine. The expression of E6 in C-33A, independent of E6 splicing, resulted in decreased IL-18 expression and that of IL-18 was also significantly reduced in HaCaT cells expressing E6. The level of p53 was reduced in C-33A cells expressing E6 whereas not altered in HaCaT cells expressing E6, suggesting that E6 downregulated IL-18 expression via an independent pathway of p53 degradation in HaCaT cells which have a mutated p53 form. However, E7 did not affect IL-18 expression significantly in both C-33A and HaCaT cells. Cotransfection experiments showed that E6 oncogene did not inhibit the activities of IL-18 promoter P1 and P2, suggesting that E6 oncogene indirectly inhibited IL-18 expression. Taken together, E6, E6m and E6/E7 inhibited IL-18 expression with some variation, assuming that cells expressing E6 oncogene can evade immune surveillance by downregulating the expression of immune stimulating cytokine gene, IL-18, and inhibiting the cascade of downstream effects that follow activation of the IL-18 receptor.

Effects of occupation, lifestyle and genetic polymorphisms of CYP1A1, CYP2E1, GSTM1 and GSTT1 on urinary 1-hydroxypyrene and 2-naphthol concentrations

This study was undertaken to determine the effects of occupation, lifestyle and the genetic polymorphisms of cytochrome P450 1A1 (CYP1A1), cytochrome P450 2E1 (CYP2E1) and glutathione S-transferases micro1 (GSTM1) and 1 (GSTT1) on the concentrations of urinary 1-hydroxypyrene (1-OHP) and 2-naphthol among Korean coke oven workers and university students. The study subjects included 90 coke oven workers and 128 university students. A questionnaire was used to obtain detailed data about the work area, smoking habits and food intake of subjects. Associations between urinary polycyclic aromatic hydrocarbon (PAH) concentrations and occupation, smoking status, total airborne PAH level and genetic polymorphisms were tested. Urinary 1-OHP and 2-naphthol concentrations were higher in coke oven workers than in students and correlated significantly with work area. Urinary 2-naphthol concentrations increased with an increase in the level of cigarette smoking in students. Total airborne PAH level correlated with urinary 1-OHP concentration in coke oven workers. Urinary 1-OHP and 2-naphthol concentrations were higher in coke oven workers with the c1/c2 or c2/c2 genotype of CYP2E1 than in those with the c1/c1 genotype. Urinary 2-naphthol concentrations were higher in GSTM1-null workers than in GSTM1-positive workers. In multiple regression analysis CYP2E1 was a significant factor determining urinary 1-OHP concentrations in coke oven workers. CYP2E1 and GSTM1 were significant determinants for urinary 2-naphthol concentrations in coke oven workers and GSTM1 and smoking were prognosticators among university students. Urinary 1-OHP is a better indicator of occupational exposure to PAH in coke oven workers than 2-naphthol, whereas urinary 2-naphthol may be more sensitive for non-occupational inhalation exposure to PAH. In occupationally exposed populations CYP2E1 and GSTM1 appear to play an important role in the metabolism of pyrene and naphthalene. In individuals not occupationally exposed to PAHs GSTM1 and smoking seem to influence the urinary concentration of 2-naphthol.

Cloning and sequencing of the astA gene encoding arylsulfate sulfotransferase from Salmonella typhimurium

Arylsulfate sulfotransferase (ASST) transfers a sulfate group from a phenolic sulfate ester to a phenolic acceptor substrate. In the present study, the gene encoding ASST was cloned from a genomic library of Salmonella typhimurium. The gene was subcloned into the vector pKF3 and was sequenced. A recombinant clone harboring the gene was directly identified using a fluorescent assay. Sequencing revealed two contiguous open reading frames (ORFs) on the same strand. Based on amino acid sequence homology, ORF1 and ORF2 are designated as astA and dsbA, respectively. The deduced amino acid sequence of astA from S. typhimurium was highly similar to those of the Enterobacter amnigenus, Klebsiella, and Campylobacter jejuni ASSTs, encoded by the astA genes. However, an ASST activity assay revealed a different acceptor specificity. Using p-nitrophenyl sulfate (PNS) as a donor substrate, phenol is the best acceptor substrate, followed by alpha-naphthol, resorcinol, tyramine, acetaminophen, and tyrosine.

Analysis of bacitracin by micellar electrokinetic capillary chromatography with mixed micelle in acidic solution

A method used for quantitative analysis of bacitracin with micellar electrokinetic capillary chromatography (MEKC) is described. As capillary zone electrophoresis gave poor separation selectivity, MEKC was preferable. It was found that a zwitterionic surfactant, 3-(N,N-dimethylhexadecylammonium)-propanesulfonate (PAPS) gave the best selectivity among the several surfactants studied. As the analytes tend to adsorb onto the capillary wall due to their positive charge, an acidic solution composed of Tris-phosphate buffer at pH 2.5 was necessary to diminish such adsorption. The peak tailing caused by relatively strong ion pair interaction between the analyte and PAPS micelle could be reduced by adding nonionic surfactant Brij 35 to the PAPS solution. This phenomenon is possibly explained by a mixed micelle mechanism. In order to obtain the optimal conditions and to test the method robustness, a central composite experimental design was performed. The optimal conditions are as follows: 44 cm length of fused-silica capillary with 50 microm inner diameter, 90 mM Tris-phosphate buffer (pH 2.5) containing 17 mM PAPS and 0.3% w/v-Brij 35, 18 kV applied voltage, UV detection at 192 nm and 25 degrees C column temperature. Under the optimal conditions, more than 50 peaks could be obtained in 30 min. The method had a linearity range from 1 to 0.05 mg/mL (concentration of bacitracin A). The limit of quantitation (LOQ) and limit of detection (LOD) were 0.005 and 0.0012 mg/mL, respectively.

Urinary 1-hydroxypyrene and 2-naphthol concentrations in male Koreans

OBJECTIVE

Urinary 1-hydroxypyrene (1-OHP) has been used as a biological marker of exposure to polycyclic aromatic hydrocarbons (PAHs), and urinary 2-naphthol is suggested as a new marker for route-specific exposure to airborne PAHs. We analyzed urinary 1-OHP and 2-naphthol concentrations in 292 male Koreans (129 university students and 163 shipyard workers) to define the distribution pattern in Koreans with no or low occupational exposure to PAHs.

METHOD

Histories of cigarette smoking and the eating of PAH-containing foods were obtained by a self-administered structured questionnaire. Urine samples were collected and urinary 1-OHP and 2-naphthol concentrations were measured using high-performance liquid chromatography (HPLC).

RESULTS

The arithmetic (geometric) means of urinary 1-OHP and 2-naphthol concentrations for all students, expressed as micromoles per mole of creatinine, were 0.04 (0.04) and 3.12 (2.22), for non-smokers 0.03 (0.03) and 1.78 (1.30) and for smokers 0.05 (0.03) and 4.36 (3.62), respectively. Among shipyard workers, the arithmetic (geometric) means of urinary 1-OHP and 2-naphthol concentrations were 0.69 (0.31) and 4.37 (2.62) for all, 0.27 (0.18) and 2.46 (1.16) for nonsmokers, and 0.97 (0.44) and 5.60 (4.44) for smokers, respectively. Mean urinary 1-OHP and 2-naphthol concentrations differed significantly between nonsmokers and smokers both in students and in shipyard workers. In smokers, some variables related to smoking habit were positively correlated with urinary 1-OHP and with 2-naphthol concentrations. The latter showed better correlations with the variables related to smoking amount than the former. None of the food-related factors was significantly correlated with urinary 1-OHP or 2-naphthol concentration.

CONCLUSION

These results suggest that urinary 2-naphthol concentration is more sensitively affected by smoking status than urinary 1-OHP concentration and that urinary 2-naphthol is a sensitive marker for low-level inhalation of PAHs.

Oxidation of polycyclic aromatic hydrocarbons by ozone in the presence of sand

A series of soil slurry experiments was performed to investigate the characteristics of PAHs removal by ozone in various conditions. Gaseous ozone was bottled into the aqueous phase in the presence of soil contaminated by PAHs. The effects of soil media, OH radical scavengers, ozone dosage, and humic acid were examined at the given experimental conditions. There exists a substantial difference in the removal of PAH according to the types of soil media tested. Baked sand showed the highest removal efficiency compared to the others. The descending order of removal rate was: BS > S > GB. This is considered to be due to the OH radical effect produced by catalytic reactions of ozone with the reactive site on the and. This is qualitatively proved by the experiment of scavenging OH radicals using tert-butanol. The comparison of half-lives of ozone in sand and glass bead columns further supports this hypothesis. It was found that about 22% of enhancement of phenanthrene destruction was accomplished by OH radicals produced by the catalytic ozone decomposition. The rate of ozone consumption for the phenanthrene oxidation was obtained as 1.88 mg/mgO3/min.

Analysis of polymyxin B sulfate by capillary zone electrophoresis with cyclodextrin as additive. Method development and validation

A capillary zone electrophoresis method for analysis of polymyxin B sulfate is described. In this method, triethanolamine (TEA)-phosphate buffer at pH 2.5 was employed to reduce the adsorption of analyte onto the capillary wall. Methyl-beta-cyclodextrin (M-beta-CD) and 2-propanol (IPA) were found to be necessary for selectivity enhancement. In order to optimize the method and to control its robustness, a central composite design was performed with four parameters, i.e. concentration of M-beta-CD, TEA, IPA and buffer pH. The optimal separation conditions were as follows: capillary, 55 cm (50 microm I.D., 47 cm effective length); 130 mM TEA-phosphate buffer (pH 2.5) containing 5 mM M-beta-CD and 5% IPA; 24 kV (51 microA) applied voltage; column temperature, 20 degrees C. Further, linearity and limits of detection quantification were examined. Three commercial samples were analyzed quantitatively.

Prediction on lengths of stay in the postanesthesia care unit following general anesthesia: preliminary study of the neural network and logistic regression modelling

The length of stay in the postanesthesia care unit (PACU) following general anesthesia in adults is an important issue. A model, which can predict the results of PACU stays, could improve the utilization of PACU and operating room resources through a more efficient arrangement. The purpose of study was to compare the performance of neural network to logistic regression analysis using clinical sets of data from adult patients undergoing general anesthesia. An artificial neural network was trained with 409 clinical sets using backward error propagation and validated through independent testing of 183 records. Twenty-two inputs were used to find determinants and to predict categorical values. Logistic regression analysis was performed to provide a comparison. The neural network correctly predicted in 81.4% of situations and identified discriminating variables (intubated state, sex, neuromuscular blocker and intraoperative use of opioid), whereas the figure was 65.0% in logistic regression analysis. We concluded that the neural network could provide a useful predictive model for the optimization of limited resources. The neural network is a new alternative classifying method for developing a predictive paradigm, and it has a higher classifying performance compared to the logistic regression model.

[Separation and determination of nycodenz and its impurities by capillary electrophoresis]

Separation and determination of nycodenz (a new radiography reagent) and its impurities by capillary electrophoresis was investigated. Since the analytes were polyols, Na2B4O7-H3BO3 was chosen as the buffer system. The analytes were negatively charged by complexing with borate. Then cetyltrimethylammonium bromide was used to reverse electroosmotic mobility in order to shorten the analysis time. 2-Propanol was added to optimize the separation further. Acceptable results of linearity, precision of corrected peak area and migration time were obtained. The RSD(n = 6) of corrected peak area and migration time were 0.73% and 1.4% respectively. The results obtained by CE were directly compared to those obtained by high performance liquid chromatography.

Comparison of three analytical methods for 1-hydroxypyrene glucuronide in urine after non-occupational exposure to polycyclic aromatic hydrocarbons

Urinary pyrene metabolites, 1-OHP and 1-OHPG, have been used as biomarkers for the assessment of occupational and environmental exposure to PAHs. This study compares the sensitivity and applicability of the different analytical methods of 1-OHPG for human biomonitoring of low level exposure to PAHs. Three analytical methods were compared: (1) HPLC method from that reported by Singh et al. (Singh, R., Tucek, M., Maxa, K., Tenglerova, J., Weyand, E.H., 1995. A rapid and simple method for the analysis of 1-hydroxypyrene glucuronide: a potential biomarker for polycyclic aromatic hydrocarbon exposure. Carcinogenesis 16, 2909-2915); (2) IAC-SFS method: the rapid and simple assay using IAC purification using monoclonal antibody specific for PAH-DNA adduct and PAH metabolites and SFS quantitation; and (3) IAC-HPLC method: IAC and HPLC separation and quantitation. The correlation between the IAC-SFS method, HPLC method, and the IAC-SFS method was determined in 20 first year-grade junior high school students (age 12-13) from Yochon, Korea who participated in a nationwide survey for the environmental disease surveillance projects in Korea. Chromatograms obtained by the IAC purification and HPLC quantitation method were clear with no interfering peaks adjacent to 1-OHPG, thus 1-OHPG could be easily quantitated. However, the HPLC method produced chromatogram profiles with many interfering peaks adjacent to 1-OHPG peak. The concentrations of 1-OHPG in 20 urine samples were similar when analyzed by all three analytical methods. The correlation coefficient between the IAC-HPLC and IAC-SFS methods was 0.915, and between the IAC-HPLC and HPLC methods was 0.844, and between the IAC-SFS and HPLC methods was 0.805. The analytical methods for 1-OHPG compared in this study showed a good correlation with one another. These results suggest that any of the methods can be applied to human biomonitoring of PAH exposure. However, SFS quantitation after IAC purification is rapid and simple because this method does not need HPLC separation of 1-OHPG.

The cytotoxic effect of neonatal lupus erythematosus and maternal sera on keratinocyte cultures is complement-dependent and can be augmented by ultraviolet irradiation

To elucidate the role of autoantibodies and ultraviolet (UV) exposure in the pathogenesis of the skin lesions in neonatal lupus erythematosus (NLE), keratinocytes were cultured, as the target cells, from a patient with NLE and from a normal neonate. We demonstrated that the expression of nuclear/cytoplasmic Ro/SSA and La/SSB molecules on to the surface of NLE keratinocytes occurred to a much greater extent than that on normal keratinocytes. A dose of 200 mJ/cm2 UVB irradiation on NLE keratinocytes induced a 2.5-3-fold increase in Ro/SSA and La/SSB expression compared to non-irradiated cells. Sera derived from both the NLE patient and from his mother exhibited a cytotoxic effect on NLE keratinocytes, but not on control cells, in the presence of complement. Furthermore, the cytotoxicity of the sera was enhanced on UVB-irradiated NLE keratinocytes, whereas it had no cytotoxic effects on UVB-irradiated control cells. This suggests that the abnormal expression of both Ro/SSA and La/SSB on the surface membrane of NLE keratinocytes induces the autoantibodies and complements to injure the cells. This complement-mediated cytotoxic effect can be augmented by UV irradiation, a concept not incompatible with the exacerbation of the skin eruption in sun-exposed skin sites.

Successful Rastelli operation in infant with complete transposition of great arteries, levoposition of aorta, and subaortic ventricular septal defect

A 10-month-old infant with complete transposition of the great arteries (TGA) [S,D,L] and large ventricular septal defect (VSD) without left ventricular outflow tract obstruction underwent successful Rastelli operation utilizing a 16 mm Hancock graft. The VSD was subaortic, and an internal conduit was placed easily. Postoperative hemodynamic conditions were satisfactory, and the patient was doing well eighteen months after operation. The feasibility of primary Rastelli operation for TGA and VSD in young infants is described.