Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study.

BACKGROUND: With an increase in the elderly population, the occurrence of hip fractures, femoral neck fractures, and intertrochanteric fractures (ITFs) is also increasing. It is important to establish effective perioperative methods that would help reduce the morbidity and mortality rates associated with ITFs. The purpose of this study was to determine the effects of ITFs according to the AO classification for perioperative hemoglobin drop. METHODS: Seventy-six patients with ITFs classified as AO 31-A1 or A2 and fixated with intramedullary nails participated in this retrospective cohort study. Medical records of these patients were retrospectively reviewed from September 2016 to August 2018. The perioperative hemoglobin drop was chosen as the main outcome measure and calculated as the difference between pre- and postoperative hemoglobin levels. Multivariate linear regression analysis was performed and included the following variables: AO classification (A1.1-A2.1 [stable] vs. A2.2-A2.3 [unstable]), time interval between injury and surgery, age, body mass index, and the use of anticoagulants. RESULTS: Among the 76 patients who met the inclusion criteria, a significantly higher hemoglobin drop was observed in the AO 31 A2.2-A2.3 (unstable) group than in the AO 31 A1.1-A2.1 (stable) group (p = 0.04). The multivariate analysis also showed a greater hemoglobin drop in the unstable group (p < 0.05). CONCLUSIONS: Patients with unstable ITFs exhibited a greater hemoglobin drop and a hidden blood loss was suspected around the fracture site. We believe that this should be taken into consideration when presurgical blood transfusion is being planned for patients with unstable ITFs, to reduce associated postoperative complications, especially in patients with severe anemia or high risk of mortality.

A Feasibility Study of Ammonia Recovery from Coking Wastewater by Coupled Operation of a Membrane Contactor and Membrane Distillation.

More than 80% of ammonia (NH3) in the steel manufacturing process wastewater is contributed from the coking wastewater, which is usually treated by biological processes. However, the NH3 in the coking wastewater is typically too high for biological treatment due to its inhibitory concentration. Therefore, a two-stage process including a hollow fiber membrane contactor (HFMC) and a modified membrane distillation (MD) system was developed and applied to reduce and recover NH3 from coking wastewater. The objectives of this paper are to evaluate different membrane materials, receiving solutions, and operation parameters for the system, remove NH3 from the coking wastewater to less than 300 mg N/L, which is amenable to the biological process, and recover ammonia solution for reuse. As a result, the polytetrafluoroethylene (PTFE) HFMC using sulfuric acid as a receiving solution can achieve a maximum NH3-N transmembrane flux of 1.67 g N/m²·h at pH of 11.5 and reduce NH3 in the coking wastewater to less than 300 mg N/L. The NH3 in the converted ammonium sulfate ((NH4)2SO4) was then recovered by the modified MD using ice water as the receiving solution to produce ≥3% of ammonia solution for reuse.

Innovative sponge-based moving bed-osmotic membrane bioreactor hybrid system using a new class of draw solution for municipal wastewater treatment.

For the first time, an innovative concept of combining sponge-based moving bed (SMB) and an osmotic membrane bioreactor (OsMBR), known as the SMB-OsMBR hybrid system, were investigated using Triton X-114 surfactant coupled with MgCl2 salt as the draw solution. Compared to traditional activated sludge OsMBR, the SMB-OsMBR system was able to remove more nutrients due to the thick-biofilm layer on sponge carriers. Subsequently less membrane fouling was observed during the wastewater treatment process. A water flux of 11.38 L/(m(2) h) and a negligible reverse salt flux were documented when deionized water served as the feed solution and a mixture of 1.5 M MgCl2 and 1.5 mM Triton X-114 was used as the draw solution. The SMB-OsMBR hybrid system indicated that a stable water flux of 10.5 L/(m(2) h) and low salt accumulation were achieved in a 90-day operation. Moreover, the nutrient removal efficiency of the proposed system was close to 100%, confirming the effectiveness of simultaneous nitrification and denitrification in the biofilm layer on sponge carriers. The overall performance of the SMB-OsMBR hybrid system using MgCl2 coupled with Triton X-114 as the draw solution demonstrates its potential application in wastewater treatment.

Applicability of a novel osmotic membrane bioreactor using a specific draw solution in wastewater treatment.

This study aims to develop a new osmotic membrane bioreactor by combining a moving bed biofilm reactor (MBBR) with forward osmosis membrane bioreactor (FOMBR) to treat wastewater. Ethylenediaminetetraacetic acid disodium salt coupled with polyethylene glycol tert-octylphenyl ether was used as an innovative draw solution in this membrane hybrid system (MBBR-OsMBR) for minimizing the reverse salt flux and maintaining a healthy environment for the microorganism community. The results showed that the hybrid system achieved a stable water flux of 6.94 L/m(2) h and low salt accumulation in the bioreactor for 68 days of operation. At a filling rate of 40% (by volume of the bioreactor) of the polyethylene balls used as carriers, NH4(+)-N and PO4(3-)-P were almost removed (>99%) while producing relatively low NO3(-)-N and NO2(-)-N in the effluent (e.g. <0.56 and 0.96 mg/L, respectively). Furthermore, from analysis based on scanning electron microscopy, Fourier transform infrared spectroscopy, and fluorescence emission-excitation matrix spectrophotometry, there was a thin gel-like fouling layer on the FO membrane, which composed of bacteria as well as biopolymers and protein-like substances. Nonetheless, the formation of these fouling layers of the FO membrane in MBBR-OsMBR was reversible and removed by a physical cleaning technique.

Lens of controllable optical field with thin film metallic glasses for UV-LEDs.

In the exposure process of photolithography, a free-form lens is designed and fabricated for UV-LED (Ultraviolet Light-Emitting Diode). Thin film metallic glasses (TFMG) are adopted as UV reflection layers to enhance the irradiance and uniformity. The Polydimethylsiloxane (PDMS) with high transmittance is used as the lens material. The 3-D fast printing is attempted to make the mold of the lens. The results show that the average irradiance can be enhanced by 6.5~6.7%, and high uniformity of 85~86% can be obtained. Exposure on commercial thick photoresist using this UV-LED system shows 3~5% dimensional deviation, lower than the 6~8% deviation for commercial mercury lamp system. This current system shows promising potential to replace the conventional mercury exposure systems.

Molecular dynamics simulation of the induced-fit binding process of DNA aptamer and L-argininamide.

Aptamers are rare functional nucleic acids with binding affinity to and specificity for target ligands. Recent experiments have lead to the proposal of an induced-fit binding mechanism for L-argininamide (Arm) and its binding aptamer. However, at the molecular level, this mechanism between the aptamer and its coupled ligand is still poorly understood. The present study used explicit solvent molecular dynamics (MD) simulations to examine the critical bases involved in aptamer-Arm binding and the induced-fit binding process at atomic resolution. The simulation results revealed that the Watson-Crick pair (G10-C16), C9, A12, and C17 bases play important roles in aptamer-Arm binding, and that binding of Arm results in an aptamer conformation optimized through a general induced-fit process. In an aqueous solution, the mechanism has the following characteristic stages: (a) adsorption stage, the Arm anchors to the binding site of aptamer with strong electrostatic interaction; (b) binding stage, the Arm fits into the binding site of aptamer by hydrogen-bond formation; and (c) complex stabilization stage, the hydrogen bonding and electrostatic interactions cooperatively stabilize the complex structure. This study provides dynamics information on the aptamer-ligand induced-fit binding mechanism. The critical bases in aptamer-ligand binding may provide a guideline in aptamer design for molecular recognition engineering.

Studies of the binding mechanism between aptamers and thrombin by circular dichroism, surface plasmon resonance and isothermal titration calorimetry.

Thrombin, a multifunctional serine protease, has both procoagulant and anticoagulant functions in human blood. Thrombin has two electropositive exosites. One is the fibrinogen-binding site and the other is the heparin-binding site. Over the past decade, two thrombin-binding aptamers (15-mer and 29-mer) were reported by SELEX technique. Recently, many studies examined the interactions between the 15-mer aptamer and thrombin extensively, but the data on the difference of these two aptamers binding to thrombin are still lacking and worth investigating for fundamental understanding. In the present study, we combined conformational data from circular dichroism (CD), kinetics and thermodynamics information from surface plasmon resonance (SPR) and isothermal titration calorimetry (ITC) to compare the binding mechanism between the two aptamers with thrombin. Special attentions were paid to the formation of G-quadruplex and the effects of ions on the aptamer conformation on the binding and the kinetics discrimination between specific and nonspecific interactions of the binding. The results indicated reasonably that the 15-mer aptamer bound to fibrinogen-binding site of thrombin using a G-quadruplex structure and was dominated by electrostatic interactions, while the 29-mer aptamer bound to heparin-binding site thrombin using a duplex structure and was driven mainly by hydrophobic effects.

Investigation of factors affecting the accumulation of vinyl chloride in polyvinyl chloride piping used in drinking water distribution systems.

Plastic piping made of polyvinyl chloride (PVC), and chlorinated PVC (CPVC), is being increasingly used for drinking water distribution lines. Given the formulation of the material from vinyl chloride (VC), there has been concern that the VC (a confirmed human carcinogen) can leach from the plastic piping into drinking water. PVC/CPVC pipe reactors in the laboratory and tap samples collected from consumers homes (n = 15) revealed vinyl chloride accumulation in the tens of ng/L range after a few days and hundreds of ng/L after two years. While these levels did not exceed the EPA's maximum contaminant level (MCL) of 2 µg/L, many readings that simulated stagnation times in homes (overnight) exceeded the MCL-Goal of 0 µg/L. Considerable differences in VC levels were seen across different manufacturers, while aging and biofilm effects were generally small. Preliminary evidence suggests that VC may accumulate not only via chemical leaching from the plastic piping, but also as a disinfection byproduct (DBP) via a chlorine-dependent reaction. This is supported from studies with CPVC pipe reactors where chlorinated reactors accumulated more VC than dechlorinated reactors, copper pipe reactors that accumulated VC in chlorinated reactors and not in dechlorinated reactors, and field samples where VC levels were the same before and after flushing the lines where PVC/CPVC fittings were contributing. Free chlorine residual tests suggest that VC may be formed as a secondary, rather than primary, DBP. Further research and additional studies need to be conducted in order to elucidate reaction mechanisms and tease apart relative contributions of VC accumulation from PVC/CPVC piping and chlorine-dependent reactions.

Daunomycin interaction with DNA: microcalorimetric studies of the thermodynamics and binding mechanism.

Nucleic acids are an important target for many therapeutics. Small molecules that bind to nucleic acids are important in many aspects of medicines, particularly in cancer chemotherapy. In recent years, many studies have utilized polynucleic acids with various sequences to demonstrate the binding mechanism of daunomycin, a potent anticancer drug. This study describes that isothermal titration calorimetry is a useful tool for studying the fundamental binding mechanism systemically. The results suggest that the binding free energy is more favorable when the temperature is increased. The binding entropy contributes to this effect. Furthermore, the amine group on daunomycin contributes electrostatic interaction that induces the binding process. In addition, enthalpy-entropy compensation is also exhibited in the daunomycin-DNA binding mechanism. This study used an easy, convenient method of performing a systemic study in a recognition system. The results from this study provide additional information about microscopic mechanisms for molecular design and molecular recognition.

Novel application of parameters in waveform contour analysis for assessing arterial stiffness in aged and atherosclerotic subjects.

OBJECTIVE: Although contour analysis of pulse waves has been proposed as a non-invasive means in assessing arterial stiffness in atherosclerosis, accurate determination of the conventional parameters is usually precluded by distorted waveforms in the aged and atherosclerotic objects. We aimed at testing reliable indices in these patient populations. METHODS: Digital volume pulse (DVP) curve was obtained from 428 subjects recruited from a health screening program at a single medical center from January 2007 to July 2008. Demographic data, blood pressure, and conventional parameters for contour analysis including pulse wave velocity (PWV), crest time (CT), stiffness index (SI), and reflection index (RI) were recorded. Two indices including normalized crest time (NCT) and crest time ratio (CTR) were also analysed and compared with the known parameters. RESULTS: Though ambiguity of dicrotic notch precluded an accurate determination of the two key conventional parameters for assessing arterial stiffness (i.e. SI and RI), NCT and CTR were unaffected because the sum of CT and T(DVP) (i.e. the duration between the systolic and diastolic peak) tended to remain constant. NCT and CTR also correlated significantly with age, systolic and diastolic blood pressure, PWV, SI and RI (all P<0.01). CONCLUSION: NCT and CTR not only showed significant positive correlations with the conventional parameters for assessment of atherosclerosis (i.e. SI, RI, and PWV), but they also are of particular value in assessing degree of arterial stiffness in subjects with indiscernible peak of diastolic wave that precludes the use of conventional parameters in waveform contour analysis.

Recent trends and some applications of isothermal titration calorimetry in biotechnology.

Isothermal titration calorimeters (ITCs) are thermodynamic instruments used for the determination of enthalpy changes in any physical/chemical reaction. This can be applied in various fields of biotechnology. This review explains ITC applications, especially in bioseparation, drug development and cell metabolism. In liquid chromatography, the separation/purification of specific proteins or polypeptides in a mixture is usually achieved by varying the adsorption affinities of the different proteins/polypeptides for the adsorbent under different mobile-phase conditions and temperatures. Using ITC analysis, the binding mechanism of proteins with adsorbent solid material is derived by elucidating enthalpy and entropy changes, which offer valuable guidelines for designing experimental conditions in chromatographic separation. The binding affinity of a drug with its target is studied by deriving binding enthalpy and binding entropy. To improve the binding affinity, suitable lead compounds for a drug can be identified and their affinity tested by ITC. Recently ITC has also been used in studying cell metabolism. The heat produced by animal cells in culture can be used as a primary indicator of the kinetics of cell metabolism, which provides key information for drug bioactivity and operation parameters for process cell culture.

Thermodynamic basis of chiral recognition in a DNA aptamer.

Chiral separation is an important issue in pharmaceutical research and industries, because most organic compounds and biological molecules, including many drugs and food additives, are chiral compounds. DNA aptamers are a new group of chiral selectors; however, there still exists deficiencies in the understanding of the molecular basis of their chiral recognition. Herein, a comparative study of the DNA aptamer binding with L-argininamide (L-Arm) and its enantiomer (D-Arm) is investigated by spectroscopic and calorimetric methods. The effect of various experimental conditions such as temperature, pH and salt concentration on the L-Arm and D-Arm binding properties was studied in order to provide information about the chiral recognition mechanism of the DNA aptamer. An isothermal titration calorimetry study reveals that both L-Arm and D-Arm binding with the aptamer are enthalpy driven and entropy cost processes. The protonated amino group of both L-Arm and D-Arm participates in electrostatic interaction and this interaction is stronger for D-Arm than L-Arm binding with the aptamer. From the opposite behavior of the heat capacity change of the two enantiomers, we could suggest that L-Arm and D-Arm bind at different binding sites of the aptamer, resulting in different conformations of the binding complexes. In the binding mechanism, electrostatic interaction provided by the protonated amino group with the aptamer and the conformational change of the nucleic acid upon binding are major processes involved for chiral recognition in the DNA aptamer. This study provides information on chiral separation of D- and L-argininamide by the aptamer, which can be successfully achieved by varying the operation temperature based on the opposite heat capacity dependence of the enantiomers binding with the DNA.

Microcalorimetrics studies of the thermodynamics and binding mechanism between L-tyrosinamide and aptamer.

In recent years, several high-resolution structures of aptamer complexes have shed light on the binding mode and recognition principles of aptamer complex interactions. In some cases, however, the aptamer complex binding behavior and mechanism are not clearly understood, especially with the absence of structural information. In this study, it was demonstrated that isothermal titration calorimetry (ITC) and circular dichroism (CD) were useful tools for studying the fundamental binding mechanism between a DNA aptamer and L-tyrosinamide (L-TyrNH2). To gain further insight into this behavior, thermodynamic and conformational measurements under different parameters such as salt concentration, temperature, pH value, analogue of L-TyrNH2, and metal ion were carried out. The thermodynamic signature along with the coupled CD spectral change suggest that this binding behavior is an enthalpy-driven process, and the aptamer has a conformational change from B-form to A-form. The results showed that the interaction is an induced fit binding, and the driving forces in this binding behavior may include electrostatic interactions, hydrophobic effects, hydrogen bonding, and the binding-linked protonation process. The amide group and phenolic hydroxyl group of the L-TyrNH2 play a vital role in this binding mechanism. In addition, it should be noted that Mg(2+) not only improves binding affinity but also helps change the structure of the DNA aptamer.

The ARID domain of the H3K4 demethylase RBP2 binds to a DNA CCGCCC motif.

The histone H3 lysine 4 demethylase RBP2 contains a DNA binding domain, the AT-rich interaction domain (ARID). We solved the structure of ARID by NMR, identified its DNA binding motif (CCGCCC) and characterized the binding contacts. Immunofluorescence and luciferase assays indicated that ARID is required for RBP2 demethylase activity in cells and that DNA recognition is essential to regulate transcription.

Evaluation of perinephric, retroperitoneal schwannomas: case report and review of the literature.

Schwannomas are tumors arising from the nerve sheath. Because of their infrequent occurrence, nonspecific symptoms, and lack of distinguishing radiologic features, schwannomas are most often diagnosed histologically after surgical excision. We report herein a case of a perinephric, retroperitoneal schwannoma which, after evaluation by computed tomography, magnetic resonance, and angiography, appeared to be a renal cell carcinoma arising from the left kidney. The diagnosis of benign retroperitoneal schwannoma was made by histologic examination and immunohistochemical staining of the excised mass. A practical algorithm for perinephric, retroperitoneal schwannomas is proposed.