The value of flexible sigmoidoscopy for patients with bright red rectal bleeding

Objective. To review the diagnostic yield of flexible sigmoidoscopy in patients presenting with bright red rectal bleeding. Design. Retrospective study. Setting. University teaching hospital, Hong Kong. Subjects and methods. Patients who underwent flexible sigmoidoscopy between January 1995 and April 1996 for investigation of bright red rectal bleeding were recruited. The extent of the endoscopic examination, complications, and endoscopic findings were recorded. Results. A total of 1052 patients were included in the study. The mean length of endoscopic examination was 55 cm. There were no complications attributed to the procedure. Thirteen (1.2%) patients aged from 41 to 87 years were found to have malignant tumours that were not palpable on digital examination. All the tumours were moderately differentiated adenocarcinoma. Two patients had synchronous liver metastasis at presentation. Adenomatous polyps were detected in 81 (7.7%) patients, of whom 76 were older than 40 years. The majority of polyps were tubular adenomas associated with mild or moderate dysplasia. Other endoscopic findings included hyperplastic and juvenile polyps, proctocolitis, diverticulosis, irradiation colitis, ischaemic colitis, rectal ulcers, and infective colitis. The overall diagnostic yield was 21.1%. No mucosal lesion was detected by flexible sigmoidoscopy in 78.9% of patients in whom the rectal bleeding was due to either haemorrhoids or anal fissure. Conclusions. Cancer was detected in 1.2% and adenomatous polyps in 7.7% of patients with bright red rectal bleeding using flexible sigmoidoscopy. All cancers and 94% of adenomatous polyps were detected in patients older than 40 years. Flexible sigmoidoscopy appears to be a valuable initial investigation for bright red rectal bleeding in patients older than 40 years.published_or_final_versio

Value of gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment: A prospective evaluation

Aim: Gastrografin is a hyperosmolar water-soluble contrast medium. Besides its predictive value for the need for operative treatment, a potential therapeutic role of this agent in adhesive small bowel obstruction has been suggested. This study aimed at evaluating the effectiveness of gastrografin in adhesive small bowel obstruction when conservative treatment failed. Methods: Patients with adhesive small bowel obstruction were given trial conservative treatment unless there was fear of bowel strangulation. Those responded in the initial 48 h had conservative treatment continued. Patients who showed no improvement in the initial 48 h were given 100 mL of gastrografin through nasogastric tube followed by serial abdominal radiographs. Patients with the contrast appeared in large bowel within 24 h were regarded as having partial obstruction and conservative treatment was continued. Patients in which the contrast failed to reach large bowel within 24 h were considered to have complete obstruction and laparotomy was performed. Results: Two hundred and twelve patients with 245 episodes of adhesive obstruction were included. Fifteen patients were operated on soon after admission due to fear of strangulation. One hundred and eighty-six episodes of obstruction showed improvement in the initial 48 h and conservative treatment was continued. Two patients had subsequent operations because of persistent obstruction. Forty-four episodes of obstruction showed no improvement within 48 h and gastrografin was administered. Seven patients underwent complete obstruction surgery. Partial obstruction was demonstrated in 37 other cases, obstruction resolved subsequently in all of them except one patient who required laparotomy because of persistent obstruction. The overall operative rate in this study was 10%. There was no complication that could be attributed to the use of gastrografin. Conclusion: The use of gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment is safe and reduces the need for surgical intervention. © 2005 The WJG Press and Elsevier Inc. All rights reserved.published_or_final_versio

A novel dual-layer bicomponent electrospun nanofibrous membrane for desalination by direct contact membrane distillation

In this study, a bicomponent nanofibrous composite membrane was fabricated by electrospinning and was tested for desalination by direct contact membrane distillation (DCMD). The nanofibrous membrane was composed of a dual-layered structure of poly(vinylidene fluoride-co-hexafluoropropylene) (PH) nanofibers and polyacrylonitrile (PAN) microfibers. Morphological characterization showed slightly beaded cylindrical PH nanofibers with porosity of about 90%. The contact angles of PH and PAN nano/microfibers were 150° and 100°, respectively. The nanofibrous membranes were tested by DCMD and a high water flux of 45 and 30Lm-2h-1 was obtained for distilled water and 35gL-1 NaCl solutions as feed, respectively using DL2 membrane (i.e., 25/75 PH/PAN thickness ratio). The present dual-layer membrane showed better flux performance compared to a commercial flat-sheet membrane. The results suggest the potential of the dual-layer nanofibrous membrane for DCMD applications. © 2014 Elsevier B.V

Environmental and economic assessment of hybrid FO-RO/NF system with selected inorganic draw solutes for the treatment of mine impaired water

© 2017 Elsevier B.V. A hybrid forward osmosis (FO) and reverse osmosis (RO)/nanofiltration (NF) system in a closed-loop operation with selected draw solutes was evaluated to treat coal mine impaired water. This study provides an insight of selecting the most suitable draw solution (DS) by conducting environmental and economic life cycle assessment (LCA). Baseline environmental LCA showed that the dominant components to energy use and global warming are the DS recovery processes (i.e. RO or NF processes) and FO membrane materials, respectively. When considering the DS replenishment in FO, the contribution of chemical use to the overall global warming impact was significant for all hybrid systems. Furthermore, from an environmental perspective, the FO-NF hybrid system with Na2SO4 shows the lowest energy consumption and global warming with additional considerations of final product water quality and FO brine disposal. From an economic perspective, the FO-NF with Na2SO4 showed the lowest total operating cost due to its lower DS loss and relatively low solute cost. In a closed-loop system, FO-NF with NaCl and Na2SO4 had the lowest total water cost at optimum NF recovery rates of 90 and 95%, respectively. FO-NF with Na2SO4 had the lowest environmental and economic impacts. Overall, draw solute performances and cost in FO and recovery rate in RO/NF play a crucial role in determining the total water cost and environmental impact of FO hybrid systems in a closed-loop operation

Mechanism of Cisplatin-Induced Cytotoxicity Is Correlated to Impaired Metabolism Due to Mitochondrial ROS Generation

The chemotherapeutic use of cisplatin is limited by its severe side effects. In this study, by conducting different omics data analyses, we demonstrated that cisplatin induces cell death in a proximal tubular cell line by suppressing glycolysis-and tricarboxylic acid (TCA)/mitochondria-related genes. Furthermore, analysis of the urine from cisplatin-treated rats revealed the lower expression levels of enzymes involved in glycolysis, TCA cycle, and genes related to mitochondrial stability and confirmed the cisplatin-related metabolic abnormalities. Additionally, an increase in the level of p53, which directly inhibits glycolysis, has been observed. Inhibition of p53 restored glycolysis and significantly reduced the rate of cell death at 24 h and 48 h due to p53 inhibition. The foremost reason of cisplatin-related cytotoxicity has been correlated to the generation of mitochondrial reactive oxygen species (ROS) that influence multiple pathways. Abnormalities in these pathways resulted in the collapse of mitochondrial energy production, which in turn sensitized the cells to death. The quenching of ROS led to the amelioration of the affected pathways. Considering these observations, it can be concluded that there is a significant correlation between cisplatin and metabolic dysfunctions involving mROS as the major player.116224Ysciescopu

Fouling and its control in membrane distillation-A review

© 2014 Elsevier B.V. Membrane distillation (MD) is an emerging thermally-driven technology that poses a lot of promise in desalination, and water and wastewater treatment. Developments in membrane design and the use of alternative energy sources have provided much improvement in the viability of MD for different applications. However, fouling of membranes is still one of the major issues that hounds the long-term stability performance of MD. Membrane fouling is the accumulation of unwanted materials on the surface or inside the pores of a membrane that results to a detrimental effect on the overall performance of MD. If not addressed appropriately, it could lead to membrane damage, early membrane replacement or even shutdown of operation. Similar with other membrane separation processes, fouling of MD is still an unresolved problem. Due to differences in membrane structure and design, and operational conditions, the fouling formation mechanism in MD may be different from those of pressure-driven membrane processes. In order to properly address the problem of fouling, there is a need to understand the fouling formation and mechanism happening specifically for MD. This review details the different foulants and fouling mechanisms in the MD process, their possible mitigation and control techniques, and characterization strategies that can be of help in understanding and minimizing the fouling problem

Two-dimensional imaging of edge-localized modes in KSTAR plasmas unperturbed and perturbed by n=1 external magnetic fields

The temporal evolution of edge-localized modes (ELMs) has been studied using a 2-D electron cyclotron emission imaging system in the KSTAR tokamak. The ELMs are observed to evolve in three distinctive stages: the initial linear growth of multiple filamentary structures having a net poloidal rotation, the interim state of regularly spaced saturated filaments, and the final crash through a short transient phase characterized by abrupt changes in the relative amplitudes and distance among filaments. The crash phase, typically consisted of multiple bursts of a single filament, involves a complex dynamics, poloidal elongation of the bursting filament, development of a fingerlike bulge, and fast localized burst through the finger. Substantial alterations of the ELM dynamics, such as mode number, poloidal rotation, and crash time scale, have been observed under external magnetic perturbations with the toroidal mode number n = 1. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.3694842]X1125sciescopu

Membrane capacitive deionisation as an alternative to the 2nd pass for seawater reverse osmosis desalination plant for bromide removal

© 2018 Elsevier B.V. Most Australian surface and ground waters have relatively high concentration of bromide between 400 and 8000 μg/L and even higher concentration in seawater between 60,000–78,000 μg/L. Although bromide is not regulated, even at low concentrations of 50–100 μg/L, it can lead to the formation of several types of harmful disinfection by-products (DBPs) during the disinfection process. One of the major concerns with brominated DBPs is the formation of bromate (BrO3−), a serious carcinogen that is formed when water containing a high concentration of bromide is disinfected. As a result, bromate is highly regulated in Australian water standards with the maximum concentration of 20 μg/L in the drinking water. Since seawater reverse osmosis (SWRO) desalination plays an important role in augmenting fresh water supplies in Australia, SWRO plants in Australia usually adopt 2nd pass brackish water reverse osmosis (BWRO) for effective bromide removal, which is not only energy-intensive to operate but also has higher capital cost. In this study, we evaluated the feasibility of membrane capacitive deionisation (MCDI) as one of the alternatives to the 2nd pass BWRO for effective bromide removal in a more energy efficient way

First report of Perkinsus honshuensis in the variegated carpet shell clam Ruditapes variegatus in Korea

The recent discovery of Perkinsus honshuensis, a new Perkinsus species infecting Manila clams Ruditapes philippinarum (Sowerby, 1852), in Japan, suggested that, based on proximity, P. honshuensis could also be in Korean waters, where to date, P. olseni was believed to be the only Perkinsus species present. Perkinsus sp. infections consistently occurred among Ruditapes variegatus clams on a pebble beach on Jeju Island, off the south coast of Korea. The typical \u27signet ring\u27 morphology of the parasite was observed in the connective tissue of the digestive gland, and infection intensity was comparatively low (3.3 x 10(3) +/- 1.2 x 10(4) to 1.3 x 10(4) +/- 6.1 x 10(4) cells g(-1) gill weight). Further DNA analyses of internal transcribed spacer (ITS-1, 5.8S and ITS-2) and non-transcribed spacer (NTS) regions of the parasite showed 98.9-99.8 and 98.5-99.5% similarity to those of P. honshuensis from Japan, respectively. Phylogenetic analyses using ITS and NTS sequences indicated that Perkinsus sp. from Jeju formed a highly supported clade with P. honshuensis. This is the first report of P. honshuensis infections in clams in Korean waters and the first report of R. variegatus as a host for that parasite