Influence of redox potential on cell growth and metabolism in pH-controlled continuous butanol fermentation

The objectives of this thesis were to characterize the kinetics of acetone-butanol fermentations using Clostridium acetobutylicum and to investigate the relationship of redox potential on the cell growth and metabolism in order to improve the overall performance of this fermentation. The kinetic relationships between the cell growth, product formation and substrate consumption by C. acetobutylicum were characterized using batch and continuous fermentations. The batch fermentation progressed rapidly and was completed in 40 hours and resulted in the production of 3.7 g acetone/liter and 8.6 g butanol/liter. In continuous fermentation, highest yield and productivity of butanol were -1 obtained at a dilution rate of 0.02 hr. However, high butanol concentrations seemed to have an adverse effect on the cell activity. Redox potential was found to be an important indicator of cellular activity and solvent production. The cells consumed much more lactose and resulted into high yield and productivity of butanol at lower redox potential values. It is a useful indicator of the state of the fermentation process.Includes bibliographical references

Long-term evaluation of the prognosis of super hydrophilic surface treated CA implants: a retrospective clinical study

This study was performed to evaluate the long-term clinical efficacy of the CA implants (Osstem Implant, Busan, Korea), calcium-modified surfaced treated implants on acid-etched surfaces sandblasted with alumina. From January 2013 to December 2015, 258 implants of 120 patients placed between 2013 and 2015 were retrospectively studied. Using medical records and periapical radiographs, sex, age, location, fixture width and length of placed implants, presence or absence of bone graft, types of bone substitutes and membrane used for bone grafting, primary and secondary stability, initial and delayed complications, and marginal bone loss were investigated. The success rate and survival rate of the implants in each group were analyzed retrospectively based on the criteria suggested by Albrektsson et al. Between 2013 and 2015, with a follow-up longer than 5years, 258 implants with an average diameter of 4.63mm (3.5–5.5mm) and an average length of 9.94mm (7.0–13.0mm) were placed in a total of 120 patients (61 males and 59 females) with a mean age of 63.7years for an average of 62months of observation period. The survival rate was 97.3%, the success rate was 94.2%, and the average final marginal bone loss was 0.074mm. The CA implants manufactured with the improved surface treatment method exhibited a survival rate of 97.3% and a success rate of 94.2% over an average observation period of 62months. The implants were not affected by most factors and had very high survival and success rates over a long period of observation. In particular, the stability of the implant was excellent, with no cases of failed implants in delayed placement after bone grafting and a healing period

The long-term evaluation of the prognosis of implants with acid-etched surfaces sandblasted with alumina: a retrospective clinical study

Background The aim of this study was to evaluate the long-term clinical stability of implants with acid-etched surfaces sandblasted with alumina using retrospective analyses of the survival rate, success rate, primary and secondary stability, complications, and marginal bone loss of the implants. Methods Patients who had implants placed (TS III SA, SS II SA, SS III SA, and U III SA) with SA surfaces from Osstem (Osstem Implant Co., Busan, Korea) at the Seoul National University Bundang Hospital, from January 2008 to December 2010 were selected for the study. Patients medical records and radiographs (panorama, periapical view) were retrospectively analyzed to investigate sex, age, location of implantation, diameter, and length of the implants, initial and secondary stability, presence of bone grafting, types of bone grafting and membranes, early and delayed complications, marginal bone loss, and implant survival rate. Results Ninety-six implants were placed in 45 patients. Five implants were removed during the follow-up period for a total survival rate of 94.8%. There were 14 cases of complications, including 6 cases of early complications and 8 cases of delayed complications. All five implants that failed to survive were included in the early complications. The survival of implants was significantly associated with the occurrence of complications and the absorption of bone greater than 1 mm within 1 year after prosthetic completion. In addition, the absorption of bone greater than 1 mm within 1 year after prosthetic completion was significantly associated with the occurrence of complications, primary stability, and implant placement method. Five cases that failed to survive were all included in the early complications criteria such as infection, failure of initial osseointegration, and early exposure of the fixture. Conclusions Of the 96 cases, 5 implants failed resulting in a 94.8% survival rate. The failed implants were all cases of early complications such as infection, failure of initial osseointegration, and early exposure of the fixtures. Peri-implantitis was mostly addressed through conservative and/or surgical treatment and resulted in very low prosthetic complications. Therefore, if preventive measures are taken to minimize initial complications, the results can be very stable

Effects of Age and Body Mass Index on the Results of Transtrochanteric Rotational Osteotomy for Femoral Head Osteonecrosis

Background: Advanced-stage osteonecrosis and a large area of necrotic bone are known risk factors for failure of transtrochanteric rotational osteotomy of the hip in patients with osteonecrosis. The purpose of this study was to determine whether there are other risk factors for failure of this osteotomy. Methods: One hundred and five patients (113 hips) underwent an anterior transtrochanteric rotational osteotomy for the treatment of femoral head osteonecrosis and were followed for a mean of 51.3 months postoperatively. Radiographic failure was defined as secondary collapse or osteoarthritic change. Multivariate analysis was performed to assess factors associated with secondary collapse and osteophyte formation. The Kaplan-Meier product-limit method was used to estimate survival. Results: Secondary collapse occurred in twenty-seven hips (24%), and fourteen hips (12%) were converted to a total hip arthroplasty. At the time of the most recent follow-up, the hip scores according to the system of Merle d`Aubigne et al. ranged from 6 to 18 points (mean, 15.8 points). Multivariate analysis showed that the stage of the necrosis (III or greater) (hazard ratio = 3.28; 95% confidence interval = 1.49 to 7.24), age of the patient (forty years or older) (hazard ratio = 1.08; 95% confidence interval = 1.02 to 1.14), body mass index ( >= 24 kg/m(2)) (hazard ratio = 1.19; 95% confidence interval = 1.03 to 1.38), and extent of the necrosis (a combined necrotic angle of >= 230 degrees) (hazard ratio = 1.08; 95% confidence interval = 1.04 to 1.11) were associated with secondary collapse. Seven of the eighty-six hips without collapse showed progression to osteoarthritis. The survival rate at 110 months was 63.4% (95% confidence interval 51.1% to 75.7%) with total hip arthroplasty or radiographic failure as the end point and 56.0% (95% confidence interval 44.6% to 67.4%) with total hip arthroplasty, radiographic failure, or loss to follow-up as the end point. Conclusions: Our study showed that age, body mass index, and the stage and extent of the osteonecrosis were determining factors for secondary collapse, unsatisfactory clinical results, and conversion to total hip arthroplasty. These factors should be considered when selecting patients for a transtrochanteric rotational osteotomy. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.Nam KW, 2008, J BONE JOINT SURG AM, V90A, P477, DOI 10.2106/JBJS.F.01582Kearns SR, 2006, CLIN ORTHOP RELAT R, P103, DOI 10.1097/01.blo.0000238868.22852.ddHa YC, 2006, J BONE JOINT SURG AM, V88A, P35, DOI 10.2106/JBJS.F.00535Yoo JJ, 2006, J BIOMED MATER RES B, V78B, P70, DOI 10.1002/jbm.b.30457Jacobsen S, 2004, OSTEOARTHR CARTILAGE, V12, P692, DOI 10.1016/j.joca.2004.05.010.Daniel J, 2004, J BONE JOINT SURG BR, V86B, P177, DOI 10.1302/0301-620X.86B2.14600Hisatome T, 2004, ARCH ORTHOP TRAUM SU, V124, P77, DOI 10.1007/s00402-003-0610-0Flugsrud GB, 2002, ARTHRITIS RHEUM, V46, P675, DOI 10.1002/art.10115Nishii T, 2002, J ORTHOPAED RES, V20, P130Koo KH, 2001, J BONE JOINT SURG BR, V83B, P83HOUGAARD P, 2000, ANAL MULTIVARIATE SUInao S, 1999, CLIN ORTHOP RELAT R, P141Steinberg ME, 1999, CLIN ORTHOP RELAT R, P262Langlais F, 1997, CLIN ORTHOP RELAT R, P110Smith SW, 1996, J BONE JOINT SURG AM, V78A, P1702KIM YH, 1995, CLIN ORTHOP RELAT R, P73HOLMAN AJ, 1995, J RHEUMATOL, V22, P1929HOUGAARD P, 1995, LIFETIME DATA ANAL, V1, P255DEAN MT, 1993, J BONE JOINT SURG BR, V75, P597SUGANO N, 1992, J BONE JOINT SURG BR, V74, P734KATZ RL, 1992, CLIN ORTHOP RELAT R, P145SUGIOKA Y, 1992, CLIN ORTHOP RELAT R, P111SAITO S, 1989, CLIN ORTHOP RELAT R, P198TOOKE SMT, 1987, CLIN ORTHOP RELAT R, P150FICAT RP, 1985, J BONE JOINT SURG BR, V67, P3CORNELL CN, 1985, ORTHOP CLIN N AM, V16, P757PARFITT AM, 1984, CALCIFIED TISSUE INT, V36, pS123TOTTY WG, 1984, AM J ROENTGENOL, V143, P1273SUGIOKA Y, 1978, CLIN ORTHOP RELAT R, P191SWEZEY RL, 1976, RHEUMATOL REHABIL, V15, P10KERBOUL M, 1974, J BONE JOINT SURG BR, VB 56, P291MERLEDAUBIGNE R, 1965, J BONE JOINT SURG B, V47, P612KAPLAN EL, 1958, J AM STAT ASSOC, V53, P457

Performances of serum creatinine, C-reactive protein and white blood cell to predict urinary tract infection in febrile children younger than 24 months of age

Purpose Differentiation of urinary tract infection (UTI) from viral infection is a critical challenge in febrile children in emergency departments (EDs). This study aimed to assess the predicting performances of creatinine, C-reactive protein (CRP), and white blood cell (WBC) for predicting UTI in the children. Methods This study was a retrospective analysis of a prospectively enrolled cohort of febrile children who presented to our children’s hospital ED from August 2016 through February 2018. We included previously healthy, febrile (≥ 38。C) children younger than 24 months whose urine cultures were obtained. Accuracy of creatinine, CRP, and WBC were assessed by optimal cutoffs, which were calculated using receiver operating characteristic curves. Results Among the total 33,013 children to the ED, 7,847 (23.8%) febrile children were registered to the fever registry. Finally, 506 children were included, and UTI was diagnosed in 127 (25.1%). The areas under the curve of creatinine, CRP, and WBC to predict UTI were 0.41 (95% confidence interval [CI], 0.35-0.46), 0.71 (95% CI, 0.66-0.77), and 0.66 (95% CI, 0.60-0.72), respectively. The cutoffs were 0.26 mg/dL for creatinine, 2.3 mg/dL for CRP, and 14.4 × 103 cells/μL for WBC. Creatinine showed worse performance than the other variables. The application of creatinine added to the other variables led to an increase only in the sensitivity, but at the expense of a lower specificity, positive predictive value, and negative predictive value. Conclusion Serum creatinine showed a poor performance in predicting UTI in the febrile young children. Since a single biomarker can neither rule in nor rule out UTI in the children, the prediction of UTI can be achieved by the interpretation of both clinical and laboratory findings

Alumina-on-Alumina Total Hip Arthroplasty A Concise Follow-up, at a Minimum of Ten Years, of a Previous Report

We previously reported the five-to-six-year results of the use of third-generation alumina-on-alumina bearings in a consecutive series of 100 primary cementless total hip arthroplasties. This report presents the longer-term outcomes of these same bearings, at a minimum of ten years postoperatively. Eighty-six of eighty-eight hips available for the study retained the original bearings at the time of the latest follow-up. Thirteen hips were associated with noise, and six hips demonstrated fretting of the femoral neck on radiographs. Two hips required a change of the bearings because of a ceramic head fracture. The ten-year survival rate of the alumina-on-alumina total hip prostheses, with revision of any implant for any reason as the end point, was 99.0%. On the basis of those results, we concluded that the rate of survival of primary cementless total hip prostheses with third-generation alumina-on-alumina bearings is excellent at ten years. However, the risk of ceramic fracture, noise, and impingement between the metal neck and the ceramic liner should be a concern to surgeons, and patients should be informed of these risks before surgery.Koo KH, 2008, J BONE JOINT SURG AM, V90A, P329, DOI 10.2106/JBJS.F.01489Sugano N, 2007, J BONE JOINT SURG BR, V89B, P455Yoo JJ, 2005, J BONE JOINT SURG AM, V87A, P530, DOI 10.2106/JBJS.D01753Allain J, 1998, J BONE JOINT SURG AM, V80A, P1355Joshi RP, 1998, J BONE JOINT SURG BR, V80B, P585MARTELL JM, 1993, J BONE JOINT SURG AM, V75A, P554MALONEY WJ, 1990, J BONE JOINT SURG AM, V72A, P1025BELLAMY N, 1988, J RHEUMATOL, V15, P1833ENGH CA, 1987, J BONE JOINT SURG BR, V69, P45SARMIENTO A, 1985, J BONE JOINT SURG AM, V67A, P48GRUEN TA, 1979, CLIN ORTHOP RELAT R, P17DELEE JG, 1976, CLIN ORTHOP RELAT R, P20HARRIS WH, 1969, J BONE JOINT SURG AM, VA 51, P737KAPLAN EL, 1958, J AM STAT ASSOC, V53, P457

Ideal chest compression site for cardiopulmonary resuscitation in fontan circulation patients with dextrocardia

Background We aimed to identify the ideal chest compression site for cardiopulmonary resuscitation (CPR) in patients with a single ventricle with dextrocardia corrected by Fontan surgery. Methods The most recent stored chest computed tomography images of all patients with a single ventricle who underwent Fontan surgery were retrospectively analysed. We reported that the ideal chest compression site is the largest part of the compressed single ventricle. To identify the ideal chest compression site, we measured the distance from the midline of the sternum to the point of the maximum sagittal area of the single ventricle as a deviation and calculated the area fraction of the compressed structures. Results 58 patients (67.2% male) were analysed. The mean right deviation from the midline of the sternum to the ideal compression site was similar to the mean sternum width (32.85 ± 15.61 vs. 31.05 ± 6.75 mm). When chest compression was performed at the ideal site, the area fraction of the single ventricle significantly increased by 7%, which was greater than that of conventional compression (0.15 ± 0.10 vs. 0.22 ± 0.11, P < 0.05). Conclusions When performing CPR on a patient with Fontan circulation with dextrocardia, right-sided chest compression may be better than the conventional location

Cardiac Autonomic Neuropathy as a Predictor of Deterioration of the Renal Function in Normoalbuminuric, Normotensive Patients with Type 2 Diabetes Mellitus

Our study was performed to determine whether cardiac autonomic neuropathy can predict deterioration of the renal function in normoalbuminuric, normotensive people with type 2 diabetes mellitus (DM). One hundred and fifty-six normoalbuminuric, normotensive people with type 2 DM were included in our retrospective longitudinal study. We categorized normal patterns, early patterns, and definite or severe patterns according to the results of the cardiac autonomic function test. Of 156 patients included, 54 had normal patterns, 75 had early patterns, 25 had definite or severe patterns, and 2 had atypical patterns. During a median follow-up of nine years, glomerular filtration rates (GFR) remained stable in the normal and early pattern groups (mean changes, 4.50% and 0.77%, respectively) but declined in those with definite or severe patterns (mean change, -10.28%; p=0.047). An abnormal heart response to the deep breathing test of the cardiac autonomic function tests was an independent predictor of GFR decline. Our data suggest that cardiac autonomic neuropathy, especially with a definite or severe pattern, might be associated with a subsequent deterioration in renal function in normoalbuminuric, normotensive people with type 2 DM

Development of a clinical scoring system for appendicitis in children with presumed appendicitis

Purpose To develop a clinical scoring system for children with presumed appendicitis who visit the emergency department. Methods A registry based-retrospective study was conducted in the pediatric emergency department between September 2015 and December 2016. Patients aged 4 to 17 years who had a > 1 of 5 Likert scale for possibility of appendicitis were included. Multiple logistic regressions based on Akaike information criterion were performed using variables regarding clinical features and inflammatory markers to develop the clinical scoring system. Results A total of 233 patients were included, and 93 (39.9%) had the final diagnosis of appendicitis. The final model with the lowest Akaike information criterion (171.7) consisted of 5 variables, including vomiting (1 point), absence of watery diarrhea (1 point), duration of symptoms ≤ 3 days (1 point), rebound tenderness (1 point), and white blood cell count > 10.0 × 109/L (2 points). If the clinical score was ≥ 4 of 6 points, the area under the receiver operating characteristic curve was 0.78 (95% confidence interval, 0.71-0.86) with a 78.9% sensitivity, 66.7% specificity, positive and negative predictive values of 70.0% and 76.2%, respectively, and positive and negative likelihood ratios of 2.4 and 0.3, respectively. Conclusion The 5-item clinical scoring system shows a fair performance for prediction of pediatric appendicitis. This simple tool could be applied to predict the pediatric appendicitis, and to avoid the use of potentially unnecessary computed tomography