Potentially toxic metal contamination and microbial community analysis in an abandoned Pb and Zn mining waste deposit.

Bioindicators have been widely used to assess the contamination of lead/zinc (Pb/Zn) in smelter areas, mining waste disposal areas and in areas containing slags from Pb ore smelting. In this context, the analysis involving microorganisms has gained prominence as a complementary tool in studies aimed at assessing contaminated sites. Therefore, the objective of this study was to assess the contamination of Pb, Zn and cadmium (Cd) in an area where a PbZn smelter operated, using the integration of geochemical and microbial data. The experimental analysis was conducted to characterize the soil collected at three different sites (samples NS, EW and EP). The analysis conducted was physicochemical, metal concentration, metal speciation and analysis of the microbial community through high-throughput sequencing technique. Through the results it was observed that the high concentrations of metals altered the bacterial community present in the soil. Differences were noted between the microbial communities according to the sampling site, especially in sample EP, collected at the margin of the dirt road, which presented higher metal concentrations and microbial diversity. The main phyla detected in the samples were: Proteobacteria, Bacteroidetes and Acidobacteria. Bacteria tolerant to the presence of potentially toxic metals (PTM), such as Rhodoplanes, Kaistobacter, Sphingomonas and Flavisolibacter were identified in the analyzed samples. The phylogenetic groups identified in the study area are similar to those obtained in other studies in metal contaminated areas. The differences between the bacterial communities in each sample indicate that the concentration of PTM may have influenced the microbial community in the soil. Thus, it is noted the importance of the integration of geochemical and microbial data to evaluate the impact of the improper disposal of high PTM concentrated slags in natural soils.

A two-year follow-up of surgical and non-surgical treatments in patients with masticatory muscle tendon-aponeurosis hyperplasia.

This study re-examined the usefulness of surgery for the management of masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) through a comparison of the outcomes between patients who underwent surgery and those who did not. The duration of follow-up was 2 years. Twenty-eight patients who attended the study hospital and were given a diagnosis of MMTAH were included. Nineteen patients underwent surgery (surgical group) and nine patients were instructed to open their mouths wide once a day and did not undergo surgery (non-surgical group). Maximum mouth opening, impairment of daily activities, satisfaction, and the status of mouth opening training were evaluated after surgery. The mean increase in mouth opening after 2 years was 20.2mm in the surgical group and 2.4mm in the non-surgical group. Adequate mouth opening training led to satisfactory results 2 years postoperative, and sustained mouth opening training for 6 months after surgery was a key factor for obtaining good outcomes. The general condition and personality of individual patients should be evaluated carefully before surgery to estimate whether or not they can endure the pain associated with postoperative mouth opening training. The results of this study suggest that the surgical procedure is useful for the management of MMTAH.

Microbial diversity and the implications of sulfide levels in an anaerobic reactor used to remove an anionic surfactant from laundry wastewater.

The objective of this study was to evaluate the removal of linear alkylbenzene sulfonate (LAS) from commercial laundry wastewater using an expanded granular sludge bed (EGSB) reactor with two specific LAS loading rates (SLLRs), 1.0 and 2.7 mg LAS gVS(-1)d (-1). The biomass was characterized using denaturing gradient gel electrophoresis (DGGE) and 16S Ion Tag sequencing. Higher LAS removal (92.9%) was observed in association with an SLLR of 1.0 mg LAS gVS(-1) d(-1) than with an SLLR of 2.7 mg LAS gVS(-1) d(-1) (58.6%). A relationship between the S(-2) concentration in the effluent and the surfactant removal efficiency was observed. This result is indicative of the inhibition of LAS-removing microbiota at S(-2) concentrations greater than 20 mg SL(-1). By using DGGE, microbial stratification was observed in the reactor in association with granule size, even though the reactor is considered to be a completely mixed regime. The RDP-classifier identified 175 genera, 33 of which were related to LAS degradation.

Quantification of Lung Perfusion Blood Volume by Dual-Energy CT in Patients With and Without Chronic Obstructive Pulmonary Disease.

Purpose: In chronic obstructive pulmonary disease (COPD), pulmonary vascular alteration is one of the characteristic features. Recently, software has been used for the quantification of lung iodine perfusion blood volume (iPBV) using dual-energy CT, allowing objective evaluation. The purpose of this study was to evaluate the quantification of lung PBV with and without COPD. Materials and Methods: This study was approved by the Institutional Review Board. Sixty-two subjects who had undergone a respiratory function test within one month underwent dual-energy CT angiography. The subjects were divided into two groups: with (n = 14) and without (n = 48) COPD. We evaluated the quantification of lung iPBV in the early phase and late phase using Syngo softwarepost contrast. Associations between lung iPBV and respiratory function (forced expiratory volume in 1 second/forced vital capacity; FEV1/FVC) and the percentage area of emphysema (%LAA-950) were also evaluated. Results: In the early phase, lung iPBV values were 20.1 ± 5.5 and 30.6 ± 7.6 Hounsfield Unit (HU) in those with and without COPD, respectively, with a significant difference between them (p < 0.0001). In the late phase, the values were 12.3 ± 3.7 and 15.3 ± 4.6 HU, respectively, with no significant difference (p = 0.051). However, this could be noticed as a trend. In the early phase, there was a weak significant correlation between lung iPBV value and FEV1/FVC (R = 0.26, p = 0.047). There were significant and moderate negative correlations between lung iPBV value and %LAA-950 in early and late phases (R = -0.57, p = 0.0002; R = -0.45, p = 0.005, respectively). Conclusions: Quantification of lung iPBV reflects reduced pulmonary perfusion in patients with COPD. It may be useful for objective evaluation of the pulmonary blood flow in patients with COPD.

Efficacy and safety of systemic chemotherapy and intra-arterial chemotherapy with/without radiotherapy for bladder preservation or as neo-adjuvant therapy in patients with muscle-invasive bladder cancer: a single-centre study of 163 patients.

INTRODUCTION: Patients with muscle-invasive bladder cancer (MIBC) often undergo various preoperative treatments to improve survival; however, their efficacy and safety remain unclear. MATERIALS AND METHODS: The anti-tumour effects and adverse events were evaluated in 163 MIBC patients who received systemic chemotherapy (SC, n = 34), intra-arterial chemotherapy (IAC, n = 50), or combined IAC and radiotherapy (IAC + R, n = 79). RESULTS: Pathological complete responses were observed in 17.6%, 22.0%, and 43.0% of patients in the SC, IAC, and IAC + R groups, respectively, with respective 5-year overall survival rates of 42.0%, 46.7%, and 50.3%. Multivariate analysis showed that successful IAC + R protocol administration was a significant predictor for survival (hazard ratio = 0.16, p = 0.028). The incidence of severe adverse events was higher in the IAC + R group (36.7%) than in the SC (9.8%) and IAC groups (16.0%). CONCLUSIONS: IAC + R was useful for patients with MIBC. Successful completion and optimal patient selection were important for this treatment strategy.

Analysis of a microbial community associated with polychlorinated biphenyl degradation in anaerobic batch reactors.

The degradation of polychlorinated biphenyls (PCBs) was investigated under fermentative-methanogenic conditions for up to 60 days in the presence of anaerobic biomass from a full-scale UASB reactor. The low methane yields in the PCBs-spiked batch reactors suggested that the biomass had an inhibitory effect on the methanogenic community. Reactors containing PCBs and co-substrates (ethanol/sodium formate) exhibited substantial PCB reductions from 0.7 to 0.2 mg mL(-1). For the Bacteria domain, the PCBs-spiked reactors were grouped with the PCB-free reactors with a similarity of 55 %, which suggested the selection of a specific population in the presence of PCBs. Three genera of bacteria were found exclusively in the PCB-spiked reactors and were identified using pyrosequencing analysis, Sedimentibacter, Tissierela and Fusibacter. Interestingly, the Sedimentibacter, which was previously correlated with the reductive dechlorination of PCBs, had the highest relative abundance in the RCS-PCB (7.4 %) and RCS-PCB-PF (12.4 %) reactors. Thus, the anaerobic sludge from the UASB reactor contains bacteria from the Firmicutes phylum that are capable of degrading PCBs.

Fate of aorta and clinical outcomes in patients with chronic type B aortic dissection: over 20-year experience.

AIM: In type B double-barrel aortic dissection (AD), the fate of the affected aorta, causes of death, and very long-term clinical outcomes have not been completely elucidated. The purpose of this study was to clarify the fate of the affected aorta and long-term clinical outcomes in patients with type B AD during the chronic phase. MEHODS: One hundred and four patients were entered into this study, and regular follow-up CT studies (mean; 87.6 months) were performed. Also, clinical data including AD-related events (including aneurysm formation, rupture, ischemia, and re-dissection), AD-related deaths, and long-term survival were retrospectively reviewed. RESULTS: Forty-six of 104 patients (44.2%) had one more AD-related event during the follow-up period. The actuarial event-free rates for any AD-related events of all patients were 95±2%, 75±5%, 53±6%, and 13±7% at 1, 5, 10, and 20 years, respectively. Initial aortic diameter ≥40 mm and blood flow in the false lumen were significant risk factors for AD-related events in univariate and multivariate analysis. CONCLUSION: In type B chronic aortic dissection, the affected aortas have a high incidence of AD-related events during the follow-up period. Prophylactic surgery or endovascular treatment for patients at high risk may reduce the AD-related events.

Microbial characterization and removal of anionic surfactant in an expanded granular sludge bed reactor.

This study evaluated linear alkylbenzene sulfonate removal in an expanded granular sludge bed reactor with hydraulic retention times of 26 h and 32 h. Sludge bed and separator phase biomass were phylogenetically characterized (sequencing 16S rRNA) and quantified (most probable number) to determine the total anaerobic bacteria and methanogenic Archaea. The reactor was fed with a mineral medium supplemented with 14 mg l(-1)LAS, ethanol and methanol. The stage I-32 h consisted of biomass adaptation (without LAS influent) until reactor stability was achieved (COD removal >97%). In stage II-32 h, LAS removal was 74% due to factors such as dilution, degradation and adsorption. Higher HRT values increased the LAS removal (stage III: 26 h - 48% and stage IV: 32 h - 64%), probably due to increased contact time between the biomass and LAS. The clone libraries were different between samples from the sludge bed (Synergitetes and Proteobacteria) and the separator phase (Firmicutes and Proteobacteria) biomass.

Double-balloon endoscopy versus magnet-imaging enhanced colonoscopy for difficult colonoscopies, a randomized study.

BACKGROUND AND STUDY AIMS: Studies have estimated that failure of cecal intubation occurs with conventional colonoscopy in up to 10 % of cases. Double-balloon endoscopy (DBE) systems, magnetic endoscope imaging (MEI), and transparent cap have been shown to improve success rates for colonoscopy. This study evaluated the utility of DBE for complete examination of the colon compared with MEI plus cap (MEI-Cap) after incomplete or technically difficult colonoscopy in a randomized comparative manner. PATIENTS AND METHODS: A total of 94 patients with incomplete or technically difficult colonoscopy were randomly assigned to receive either DBE (n = 47) or colonoscopy with MEI-Cap (n = 47). The primary end point was cecal intubation rate within 30 minutes. Secondary end points included intubation time, pain score using a visual analog scale, abdominal pressure attempts, doses of sedative medication, and changes in patient position during colonoscopy. RESULTS: Patient characteristics were comparable in both groups. Cecal intubation rate within 30 minutes was significantly higher for DBE (45 /47, 95.7 %) than for MEI-Cap (34 /47, 72.3 %) (P = 0.0049). Mean time to reach the cecum was significantly lower in the DBE group (13.0 ±â€Š5.3 minutes) than in the MEI-Cap group (16.4 ±â€Š4.8 minutes; P = 0.0003). No complications were encountered in either group.   CONCLUSION: DBE is more useful for complete examination of the colon than MEI-Cap in patients with incomplete or technically difficult colonoscopy.

Long-term results of surgical therapy for masticatory muscle tendon-aponeurosis hyperplasia accompanied by limited mouth opening.

Masticatory muscle tendon-aponeurosis hyperplasia is a new disease entity characterized by limited mouth opening due to contracture of the masticatory muscles, resulting from hyperplasia of tendons and aponeuroses. In the case of masseter muscle type, the face displays a square mandible configuration. Pharmacotherapy, occlusal splints and physical therapy are ineffective. This study evaluated the long-term results of aponeurectomy of the masseter muscle with coronoidectomy to release the temporal muscle tendon. The subjects were 10 patients who underwent surgery between 2000 and 2005. Mean maximum mouth opening before surgery was 21.8mm (range 17-29 mm). All patients received bilateral aponeurectomy of the masseter muscle and coronoidectomy. Three patients additionally underwent bilateral anglectomy for esthetic reasons. After discharge, one patient did not return to the hospital. Data from the other nine patients were analyzed. The mean duration of follow-up was 4 years. At final follow-up, the maximum mouth opening was >44 mm in four patients, 40-44 mm in three patients, and 35-39 mm in two patients. Overall satisfaction was excellent or good in all patients.

Evaluation of the anaerobic degradation of black liquor from a Kraft pulp plant with addition of organic co-substrates.

The purpose of this study was to assess the anaerobic degradation of black liquor with and without additional carbon sources. Batch experiments were conducted using black liquor, from an integrated pulp and paper mill adding ethanol, methanol and nutrients. The PCR/DGGE technique was used to characterize the structure of the microbial community. The addition of extra sources of carbon did not significantly influence the degradation of black liquor under the conditions evaluated and the microbial community was similar in all experiments. It was observed an increase in some members of the archaeal in reactors that had the best efficiencies for removal of black liquor (around 7.5%). Either ethanol or methanol can be used as co-substrates because the produce the same quantitative and qualitative effect.

Myocardial delayed contrast-enhanced MRI: relationships between various enhancing patterns and myocardial diseases.

The concentration of MR contrast agents is relatively high in abnormal myocardial tissue, with increased extravascular space and/or abnormal contrast wash-in and wash-out characteristics. Based on this mechanism, myocardial delayed contrast-enhanced MRI has been increasingly used to detect myocardial damage. Delayed enhancement (DE) can be seen in various components, such as fibrosis, protein infiltration or possibly myocardial disarray with disorganized myocardial fibre packing. Therefore, DE can be seen in various myocardial diseases, each of which has a characteristic DE pattern. Knowledge of the relationships among various DE patterns and myocardial diseases is useful for differential diagnosis and management.

Biofilm adaptation to sulfate reduction in anaerobic immobilized biomass reactors sujected to different COD/sulfate ratios.

Various aspects of biofilm adaptation to sulfate reduction in horizontal-flow anaerobic immobilized biomass (HAIB) reactors subjected to increasing sulfate concentrations and different COD/sulfate ratios are presented and discussed. Four bench-scale HAIB reactors filled with vegetal carbon (R1 and R2) and polyurethane foam matrices (R3 and R4) were utilized. Influent sulfate concentrations ranging from 500 to 3000 mg/L were applied at COD/sulfate ratios ranging from 5.0 to 1.7. Reactors R1 and R4 were operated with higher sulfate loads than those applied to R2 and R3. For the same COD/sulfate ratio, the highest sulfate reduction efficiency (approximately 80%) was displayed by the vegetal carbon reactor (R2) subjected to low sulfate loads. According to the results of our molecular biology analyses, the different support materials provided different biomass colonization conditions. The lowest diversity of sulfate-reducing bacteria was found in the HAIB filled with polyurethane foam matrices operating with high sulfate loads.

Clinical evaluation of magnetic resonance imaging flowmetry of portal and hepatic veins in patients following hepatectomy.

BACKGROUND: Hepatic blood flow was associated with degree of hepatic damage. Measurements of blood flow using ultrasonography (US) may vary due to any observer's and patient's conditions. The utility of magnetic resonance imaging (MRI) flowmetry in portal and hepatic veins was assessed. PATIENTS AND METHODS: Using the phase-contrast method, the mean flow velocity of portal (PVF) and hepatic vein (HVF) were determined by MRI and US in 75 consecutive patients with liver diseases, including 58 patients undergoing hepatectomy. The correlations between these parameters and clinicopathological findings were examined. RESULTS: PVF and HVF measured by MRI flowmetry were 12.8+/-4.5 and 14.7+/-5.3 cm/s, respectively. There was no significant correlation of both flows between MRI and US. PVF correlated significantly with portal pressure (r = -0.722; P < 0.05). There was a negative correlation between HVF and histological activity index score (r = -0.366; P < 0.05). PVF and HVF were lower in patients with cirrhosis and higher staging score (2-4) and PVF was lower in patients with higher grading score (2-3; P < 0.05). PVF and HVF were not significantly associated with postoperative complications. CONCLUSIONS: Our results suggest that MRI flowmetry is a potentially useful tool for measurement of hepatic blood flow and recommend its use for estimation of liver cirrhosis-associated impairment.

The comparison between pains, difficulties in function, and associating factors of patients in subtypes of temporomandibular disorders.

The aim of this study was to compare the multidimensional properties among subtypes of painful temporomandibular disorders (TMD): myofascial pain (group I), disc displacement (group II), arthralgia (group IIIa) and osteoarthritis (group IIIb). A total of 511 patients answered a battery of questionnaires, which included questions relating to intensity and duration of pain, the Japanese version of the McGill Pain Questionnaire, limitation of daily functions, the Hospital Anxiety and Depression Scale, the Eysenck Personality Questionnaire short-form and 34 items of behavioural contributing factors. Group IIIb showed significantly the highest age in all subtypes. Those in group I had higher depression scores than those in group II (P = 0.005). Group IIIa had a lower women's ratio than in group II (P = 0.001) and the patients showed a shorter pain duration than those in groups I (P = 0.000) and II (P = 0.001). Group IIIa patients also showed lower visual analogue scale (VAS) ratings for pain descriptors 'heavy' (P = 0.002) and 'tiring' (P = 0.004) than those of group I, and 'dull' (P = 0.005), 'heavy' (P = 0.001) and 'tiring' (P = 0.005) than those of group II. Group IIIa showed lower ratios of contributing factors of 'an awareness of grinding/clenching during sleep' (P = 0.000) and 'an awareness of clenching sensation when waking up at night' (P = 0.002) than those of group I, and also showed a higher ratio of 'a liking for a hard food' (P = 0.000) and lower ratio of 'talking for a long time on the telephone' (P = 0.001) than those of group II. In conclusion, although several properties were different between subtypes, the majority of them were similar in the four subtypes of TMD.

Intramucosal adenocarcinoma of the appendix: how to find and how to treat.

A colonoscopic examination of a 58-year-old man revealed a small elevated lesion inside the orifice of the appendix. Using a polypectomy snare, a nodular polypoid lesion with a diameter of ca. 20 mm was removed from the lumen of the appendix. Histopathology showed that it was a well-differentiated adenocarcinoma. This is the first report of an intramucosal adenocarcinoma of the appendix diagnosed preoperatively; laparoscopy-assisted colectomy with a D2 lymph-node dissection was carried out. Endoscopists should consider an appendiceal tumor when an erosion, elevation, or deformity is seen in the head of the cecum.

Mutations in the ST7/RAY1/HELG locus rarely occur in primary colorectal, gastric, and hepatocellular carcinomas.

Human cancers frequently show a loss of heterozygosity on chromosome 7q31, which indicates the existence of broad-range tumour-suppressor gene(s) at this locus. Truncating mutations in the ST7 gene at this locus are seen frequently in primary colon cancer and breast cancer cell lines. Therefore, the ST7 gene represents a novel candidate gene for the tumour suppressor at this locus. However, more recent studies have reported that ST7 mutations are infrequent or absent in primary cancer and cell lines. To ascertain the frequency of mutations of the ST7 gene in cancer cells, we examined mutations in the ST7 coding sequence in 48 colorectal, 48 gastric, and 48 hepatocellular carcinomas using polymerase chain reaction-single-strand conformational polymorphism and direct sequencing. We detected somatic mutations, which were located near the exon-intron junction in intron 8, in only three out of 144 cases. We conclude that mutations in the ST7 gene are rare in primary colorectal, gastric, and hepatocellular carcinomas.

Anomalous systemic arterial supply to normal basal segments of left lower lobe: characteristic imaging findings.

PURPOSE: The purpose of this study was to describe the characteristic findings in each imaging modality of anomalous systemic arterial supply to normal basal segments of the left lower lobe of the lung. METHOD: Five patients with anomalous systemic arterial supply to normal basal segments of the left lower lobe were retrospectively reviewed. Chest radiography, contrast-enhanced CT scan, angiography, and other imaging modalities were analyzed. RESULTS: The imaging findings of this anomaly were characterized by three issues as follows: an anomalous systemic artery arising from the thoracic aorta, absence of pulmonary arterial supply, and normal bronchial system as well as normal pulmonary parenchyma in the affected segments. The anomalous systemic artery was demonstrated on chest radiography, contrast-enhanced CT scan, MRI, and thoracic aortography. Absence of pulmonary arterial supply was revealed by pulmonary angiography, radiolabeled perfusion scan, and CT scan. Normal bronchial system was confirmed by radiolabeled ventilation scan, bronchography, and CT scan. CONCLUSION: CT is useful in making the correct diagnosis of this anomaly because it is the only diagnostic method that can demonstrate the anomalous systemic artery, absence of pulmonary arterial supply, and normal bronchial system in the affected segments.

Immunohistochemical and electron microscopic study of extrinsic hepatic reinnervation following orthotopic liver transplantation in rats.

BACKGROUND/AIMS: Because little has been known about the morphological and functional consequences of liver transplantation on hepatic autonomic nerves, we examined the time-course of extrinsic hepatic innervation at the level of the porta hepatis of liver allografts. METHODS: Orthotopic liver transplantation was performed using male Lewis rats. Crosscut tissue specimens were obtained postoperatively for up to 6 months from the porta hepatis of transplanted livers, and processed for immunohistochemical staining for protein gene product 9.5 (PGP 9.5) and growth-associated protein 43 (GAP-43), and for transmission electron microscopy (TEM). RESULTS: Extrinsic nerve fibers at the porta hepatis stained positively for PGP 9.5 throughout the entire study period. In contrast, the immunoreactivity of GAP-43 was negative at postoperative day (POD) 1 and 2. GAP-43-positive nerves were first observed to appear in the porta hepatis at POD 3. The immunoreactivity of GAP-43 remained positive thereafter until 3 months post-OLT, and became negative in all the specimens at 4 months post-OLT. Transmission electron microscopy demonstrated a small number of regenerating axons existing among many degenerating axons at POD 3. At 3 months post-OLT, most regenerating axons had been fully ensheathed by the cytoplasm of Schwann cells, although their density remained at a lower level compared with normal. CONCLUSION: The results of this study suggest that liver allografts become extrinsically reinnervated, with the regenerating axons reaching the hepatic hilus 3 days after transplantation. The process of extrinsic hepatic reinnervation is considered to almost terminate 4 months after transplantation in rats.