Factors contributing to Korean teachers' attitudes toward students with epilepsy.

We investigated factors contributing to teachers' attitudes toward students with epilepsy. Data were collected from 604 teachers in Korea. The questionnaire included the Scale of Attitudes Toward Persons with Epilepsy (ATPE) and a demographic and teaching experience survey. In stepwise linear regression analysis, ATPE Knowledge scores (P<0.001) and prior experience teaching a student with epilepsy (P=0.001) were identified as significant factors for ATPE Attitude scores. The ATPE Knowledge scores accounted for 50.1% of the variance in the Attitude scores, and experience teaching a student with epilepsy accounted only for 1.0%. Our finding that teachers' knowledge is the most important factor influencing teacher's attitudes toward epilepsy indicates that teachers should be provided with information about epilepsy universally, across geographic settings, educational levels, and experience levels.

Factors contributing to concerns of persons living with epilepsy.

PURPOSE: To describe the concerns of Korean adults living with epilepsy and to compare the concerns of individuals with controlled and uncontrolled seizures. METHODS: Outpatients filled out questionnaires, including the Hospital Anxiety and Depression Scale, the Quality of Life in Epilepsy-10 questionnaire, the stigma scale, and a questionnaire on episodes of discrimination. Patients were asked to fill out the Epilepsy Foundation of America (EFA) Concerns Index and to list their concerns on a blank sheet of paper. RESULTS: Of the 178 participants, 152 described a total of 470 concerns, which could be assorted into 25 distinct concerns. Worrying about the hereditability of their condition was the only concern that differed significantly between individuals with controlled and uncontrolled seizures. Three significant factors were identified on the total EFA Concerns Index score: level of anxiety/depression (34.4%), age (6.3%), and degree of social discrimination (4.3%), resulting in a total explained variance of 45.0%. CONCLUSIONS: Korean adults with epilepsy had various concerns, with some differing from those in Western populations. Anxiety/depression, age and degree of discrimination were significantly associated with the degree of concern in Korean patients with epilepsy.

Factors contributing to Korean adolescents' perceptions of stigma with respect to epilepsy.

We assessed knowledge and perceptions of epilepsy held by Korean adolescents in the general population, and investigated factors important in adolescents' perceptions of stigma with respect to epilepsy. Surveys were distributed to students at 22 schools. A total of 1377 students participated. Fewer than half of all students (45.1%) reported hearing or reading about epilepsy. Overall, students showed a general lack of familiarity with and knowledge of epilepsy. Stigma perception scores were significantly higher in boys than in girls (P<0.05) and in middle school than in high school (P<0.05) students. We also found that stigma perception scores were significantly correlated with both younger age (r=-0.074, P=0.006) and lower knowledge scores (r=-0.404, P=0.000). Linear regression analysis showed that stigma-related perception was associated with lower knowledge scores (P<0.001) and middle school (P<0.05). These results indicate a need for public education of adolescents in the general population to decrease the stigma associated with epilepsy.

Mass balance of nitrogen, and estimates of COD, nitrogen and phosphorus used in microbial synthesis as a function of sludge retention time in a sequencing batch reactor system.

This study investigated characteristics of a sequencing batch reactor (SBR) system which was varied with respect to sludge retention time (SRT) (5.9, 8.2, 10.5, 12.2, and 16.2 days). The removal efficiencies of chemical oxygen demand (COD) were more than 90% under all SRT conditions, and the greatest efficiency (92.2%) occurred with a SRT of 16.2 days. As the SRT increased, the denitrification rate per mixed liquor suspended solids (MLSS) during the anoxic(I) period decreased significantly from 166.3 mg NO(X)(-)-N/g MLSS d to 68.8 mg NO(X)(-)-N/g MLSS d. As the SRT increased, the phosphorus removal efficiency decreased from 47.1% (SRT of 5.9 days) to 31.0% for a SRT of 16.2 days, because active phosphate release and uptake occurred under shorter SRT conditions. The mass balance of nitrogen (with respect to nitrogen in the influent) at a SRT of 16.2 days (the highest nitrogen removal efficiency) showed 14.9% of nitrogen was removed in clarified water effluent, 49.7% was removed by the sludge waste process and 33.3% was removed by denitrification. Nitrogen processing was well accounted for in the SBR system as the nitrogen mass balance was close to 100% (97.9%).

Optimization of nitrogen removal in a sequencing batch reactor system by variation of the time distribution.

In this study, we investigated the variations of the nitrogen removal and mass balance of a sequencing batch reactor (SBR) system with the duration of the second anoxic period (the anoxic (II) period); durations of 0, 70, 100, and 130 minutes were tested in one cycle of SBR operation to determine the optimum conditions for the operation of the SBR and increase its nitrogen removal efficiency. The SBR system was operated under the conditions as follows: a sludge retention time (SRT) of 17.5 days, an operation time of 6 hours per cycle, a hydraulic retention time (HRT) of 12 hours, an influent COD loading of 0.4 kg/m3/day, and an influent nitrogen loading of 0.068 kgT-N/m3/day. For anoxic (II) phase duration times of 0, 70, 100, and 130 minutes, the amounts of nitrogen removed in the clarified water effluent for the synthetic wastewater were 73.1, 64.9, 59.0, and 49.3 mg/cycle, with nitrogen removal percentages of 59.7, 65.4, 68.8, and 73.8%, respectively. The amounts of nitrogen removed during the sludge waste process were 21.8, 22.0, 22.4, and 22.3 mg/cycle, respectively, indicating that the amount of nitrogen removed during the sludge waste process is not affected by changes in the time allotted to the anoxic (II) period. The amounts of nitrogen removed by denitrification were 76.5, 83.0, 90.5, and 96.5 mg/cycle, respectively indicating that increasing the duration of the anoxic (II) period increases the efficiency of nitrogen removal. The nitrogen mass balances were calculated as the percentages of nitrogen removed in the clarified water effluent or by denitrification and sludge waste processing in each cycle of SBR operation and were found to be excellent: 96.8%, 96.3%, 96.8%, and 95.2% for anoxic (II) phase durations of 0, 70, 100, and 130 minutes, respectively.

Protective effect of glycyrrhizin on 1-methyl-4-phenylpyridinium-induced mitochondrial damage and cell death in differentiated PC12 cells.

Defects in mitochondrial function have been shown to participate in the induction of neuronal cell injury. The aim of the present study was to assess the preventive effect of licorice compounds glycyrrhizin and 18beta-glycyrrhetinic acid against the toxicity of parkinsonian neurotoxin 1-methyl-4-phenylpyridinium (MPP+) in relation to the mitochondria-mediated cell death process and role of oxidative stress. MPP+ induced the nuclear damage, the changes in the mitochondrial membrane permeability, leading to the cytochrome c release and caspase-3 activation, the formation of reactive oxygen species, and the depletion of glutathione (GSH) in differentiated PC12 cells. Glycyrrhizin up to 100 microM significantly attenuated cell death and depletion of GSH due to MPP+ concentration-dependently. Meanwhile, 18beta-glycyrrhetinic acid showed a maximal inhibitory effect at 10 microM; beyond this concentration, the inhibitory effect declined. The protective effect of licorice compounds was also detected in the rotenone-treated PC12 cells. Glycyrrhizin and 18beta-glycyrrhetinic acid prevented the MPP+-induced formation of the mitochondrial permeability transition. The results show that both glycyrrhizin and a metabolite, 18beta-glycyrrhetinic acid, exhibit a depressant effect against the MPP+ toxicity. Glycyrrhizin and 18beta-glycyrrhetinic acid may prevent the cytotoxicity of MPP+ by suppressing the mitochondrial permeability transition formation. The preventive effect seems to be ascribed to the inhibitory effect on the formation of reactive oxygen species and depletion of GSH.

Phosphorus removal characteristics in hydroxyapatite crystallization using converter slag.

This study was performed to investigate the phosphorus removal characteristics in hydroxyapatite (HAP) crystallization using converter slag as a seed crystal and the usefulness of a slag column reactor system. The effects of alkalinity, and the isomorphic-substitutable presence of ionic magnesium, fluoride, and iron on HAP crystallization seeded with converter slag, were examined using a batch reactor system. The phosphorus removal efficiencies of the batch reactor system were found to increase with increases in the iron and fluoride ion concentrations, and to decrease with increases in the alkalinity and magnesium ion concentration. A column reactor system for HAP crystallization using converter slag was found to achieve high, stable levels of phosphorus elimination: the average PO4-P removal efficiency over 414 days of operation was 90.4%, in which the effluent phosphorus concentration was maintained at less than 0.5 mg/L under the appropriate phosphorus crystallization conditions. The X-ray diffraction (XRD) patterns and Fourier transform infrared (FTIR) spectra of the crystalline material deposited on the seed particles exhibited peaks consistent with HAP. Scanning electron micrograph (SEM) images showed that finely distributed crystalline material was formed on the surfaces of the seed particles. Energy dispersive X-ray spectroscopy (EDS) mapping analysis revealed that the molar Ca/P composition ratio of the crystalline material was 1.72.

Factors predicting seizure outcome of anterior temporal lobectomy for patients with mesial temporal sclerosis.

PURPOSE: To investigate the factors, including those associated with ictal scalp EEG results, related to surgical outcome in patients with pathologically proven mesial temporal sclerosis. METHODS: We studied 51 consecutive patients who underwent anterior temporal lobectomy and had at least 4 years of follow-up. Surgical outcome was classified as being seizure-free or not seizure-free during the first two and the subsequent two postoperative years. Clinical variables and scalp EEG parameters were subjected to statistical analysis. RESULTS: Of the 51 patients, 36 (70.6%) were seizure-free during postoperative years 3 and 4. Logistic regression analysis revealed that seizure remission for the first 2 years (p = 0.002) and contralateral propagated ictal discharges (p = 0.015) were independently related to seizure outcome at 4 years. Patients who were seizure-free at 2 years had an 86.5% chance of remaining seizure-free at 4 years. Of the patients without bitemporal asynchrony or switch of lateralization, 88.9% were seizure free at 4 years, compared with 54.5% of patients with asynchrony or switch of lateralization (p = 0.007). These two factors, however, were not predictive of seizure outcome at 2 years. CONCLUSIONS: Contralateral propagated ictal discharges, including bitemporal asynchrony and switch of lateralization, unfavorably influence long-term seizure outcome. Long-term seizure control is best when the patient has no such propagation patterns of ictal discharges and is seizure-free during the first 2 years after temporal lobectomy.

Econazole attenuates cytotoxicity of 1-methyl-4-phenylpyridinium by suppressing mitochondrial membrane permeability transition.

Defects in mitochondrial function have been shown to participate in the induction of neuronal cell injury. The effect of econazole against the cytotoxicity of 1-methyl-4-phenylpyridinium (MPP(+)) in differentiated PC12 cells was assessed in relation to the mitochondrial membrane permeability changes. Treatment of PC12 cells with MPP(+) resulted in the nuclear damage, decrease in the mitochondrial transmembrane potential, cytosolic accumulation of cytochrome c, activation of caspase-3, increase in the formation of reactive oxygen species (ROS) and depletion of GSH. Econazole (0.25-2.5 microM) inhibited the cytotoxicity of MPP(+) or rotenone. The addition of econazole (0.5 microM) significantly attenuated the MPP(+)-induced mitochondrial damage, elevation of intracellular Ca(2+) level and cell death. However, because of the cytotoxicity, econazole at 5 microM did not attenuate the toxicity of MPP(+). The results show that econazole at the low concentrations may reduce the MPP(+)-induced viability loss in PC12 cells by suppressing the mitochondrial permeability transition, leading to activation of caspase-3 and the elevation of intracellular Ca(2+) levels, which are associated with the increased formation of ROS and depletion of GSH.

Hydroxyapatite crystallization from a highly concentrated phosphate solution using powdered converter slag as a seed material.

A system for recovering phosphorus from membrane-filtrate from a sludge reduction process containing high phosphorus concentrations was developed. In this system, referred to as the completely mixed phosphorus crystallization reactor, powdered converter slag was used as a seed material. In a preliminary experiment, the optimal pH range for metastable crystallization of phosphorus from membrane-filtrate containing about 100mg/L PO(4)-P was found to be 6.6-7.0. The laboratory scale completely mixed phosphorus crystallization reactor, actually operated in pH range of 6.8-7.6 for influent 72.9 mg/L PO(4)-P, achieved an average efficiency of phosphorus removal from the membrane-filtrate of 52.4% during a 30-day experiment. Mixed-liquor suspended solids (MLSS) measurements revealed that, out of 0.24 kg PO(4)-P in the original membrane-filtrate fed into the reactor, 0.12 kg PO(4)-P was recovered on the seed particles after 30 days. X-ray diffraction (XRD) pattern and Fourier transform infrared (FT-IR) spectra of the crystalline material deposited on the seed particles showed peaks consistent with hydroxyapatite. Scanning electron micrograph (SEM) images exhibited that finely distributed crystalline material was formed on the surfaces of seed particles. Energy dispersive X-ray spectroscopy (EDS) mapping analysis revealed that the molar composition ratio of Ca/P of the crystalline material was 1.84. The Ca/P molar ratio>1.67 for crystalline substance might result from the presence of CaCO(3) on the crystalline surfaces. A particle size distribution analysis showed that the average particle size increased from 22 microm for the original converter slag seed particles, to 94 microm after 30 days of phosphorus crystallization. Collectively, the present results suggest that the proposed phosphorus crystallization recovery system is an effective tool for recycling phosphorus from phosphate solution.

Factors contributing to clinical seizure lateralization in patients with mesial temporal lobe epilepsy.

Clinical seizure semiology can provide important information on the lateralization of the epileptogenic zone. We investigated factors associated with clinical seizure lateralization in patients with pathologically proven mesial temporal sclerosis. We reviewed 243 seizures of 58 patients. Clinical lateralization was possible in 155 (63.8%) of 243 seizures. Lateralization was correct in 144 (92.9%) of 155 lateralized seizures. Logistic regression analysis showed that age at onset (p = 0.001; odds ra tio = 1.089, 95% confidence interval = 1.035-1.145) and the contralateral propagation pattern of ictal discharges (p = 0.001; odds ratio = 3.544, 95% confidence interval = 1.723-7.289) correlated with clinical seizure lateralization. The patient group with clinically lateralized seizures had a younger age at onset of habitual seizures compared to the clinically nonlateralized group (11.1 +/- 6.3 vs. 15.6 +/- 8.4 years; p < 0.001). Of seizures without bitemporal asynchrony or switch of lateralization, 70.7% were clinically lateralized compared with only 46.4% of seizures with asynchrony or lateralization switch. The present results suggest that the age of epilepsy onset and the ictal scalp EEG propagation pattern affect clinical seizure lateralization in patients with mesial temporal sclerosis.