Percutaneous Intradiscal Radiofrequency Thermocoagulation Combined with Sinuvertebral Nerve Ablation for the Treatment of Discogenic Low Back Pain.

BACKGROUND: Percutaneous intervertebral radiofrequency thermocoagulation (PIRFT) and sinuvertebral nerve ablation (SVNA) are commonly used clinical treatments for discogenic low back pain (DLBP). However, they have been reported to have low efficacy rates of approximately 16.5%-26.5%, especially in the medium to long term. OBJECTIVES: To investigate whether PIRFT combined with SVNA can reduce pain and improve clinical outcomes in patients with DLBP. STUDY DESIGN: This is a prospective study. SETTING: All data were from Honghui Hospital in Xi'an. METHODS: Following the inclusion and exclusion criteria, 195 patients were enrolled in this study and randomly divided into 3 groups of 65 patients each and treated with PIRFT+SVNA, PIRFT, or SVNA. Postoperative follow-ups were done at one week, one month, 3 months, 6 months, and 12 months. The demographic characteristics, relevant surgical information, and observed complications of all groups were recorded. The efficacy of the surgeries was evaluated using the visual analog scale (VAS), Oswestry disability index (ODI), and modified Macnab criteria. RESULTS: In total, 167 patients, comprising 81 men and 86 women (aged 28-75 years), were included in this study and completed postoperative follow-ups. There were 54 patients in the combined PIRFT and SVNA (PIRFT+SVNA) group, 58 patients in the PIRFT group, and 55 patients in the SVNA group. All groups were comparable because there were no significant differences in gender, age, disease duration, follow-up time, surgical segments and presence of high-intensity zones of the groups (P > 0.05). In addition, the efficacy of the PIRFT+SVNA group was significantly higher than that of the PIRFT and SVNA groups as assessed by the modified Macnab criteria (P = 0.032). Surgery was successfully completed in all 3 groups, and VAS and ODI improved at all postoperative time points in all 3 groups compared to the preoperative scores. The differences between the VAS and ODI scores preoperation and 12 months postoperation were not statistically significant between all 3 groups. However, at one week, one month, 3 months, and 6 months after surgery, the VAS and ODI scores were lower in the PIRFT+SVNA group compared to the PIRFT and SVNA groups. The difference in VAS scores among the 3 groups was most significant at one week postoperation, and the difference in ODI scores was most significant at one month postoperation. The VAS and ODI improvement rates of the 3 groups showed significant improvement at one week, one month, 3 months, and 6 months postoperation (P < 0.05). There was no significant difference among the 3 groups at 12 months postoperation (P > 0.05). LIMITATIONS: This study was limited by its small sample size in a single-center study. CONCLUSIONS: In DLBP, the sinuvertebral nerve (SVN) is the main nerve involved in the lumbar disc pain signaling pathway, and compared with PIRFT and SVNA alone, combined PIRFT and SVNA treatment may provide more satisfactory pain relief and functional improvement at an early stage.

Effectiveness Analysis of Awake Computed Tomography-Guided Double-Needle Percutaneous Radiofrequency Thermocoagulation for the Treatment of Glossopharyngeal Neuralgia.

BACKGROUND: Percutaneous radiofrequency thermocoagulation (PRT) is an established treatment for glossopharyngeal neuralgia (GPN). However, the effectiveness of conventional single-needle PRT is limited due to the glossopharyngeal nerve's unique anatomical location. OBJECTIVES: A major objective of our study was to evaluate the effectiveness and long-term outcomes of computed-tomography (CT)-guided double-needle PRT for patients with GPN. STUDY DESIGN: Retrospective study. SETTING: Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University. METHODS: Clinical data from 38 postoperative GPN patients who underwent CT-guided double-needle PRT between October 2019 and September 2022 were retrospectively reviewed and analyzed. Pain severity was assessed using the Barrow Neurological Institute Pain Intensity Scale (BNI-P) score, and anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS). RESULTS: Thirty-eight GPN patients were treated with CT-guided double-needle PRT, and 28 patients could be contacted for follow-up. Pain was relieved in 23 patients (82.14%) immediately after the PRT procedure. The percentage of patients who experienced persistent pain relief was 85.71% at T2, 85.71% at T3, 89.28% at T4 and 89.28% at T5. Post-procedure complications included dysesthesia in the throat, dysphagia, choking on drinking water, and hoarseness. No mortality was observed during or after PRT procedures. Twelve patients (42.9%) suffered from anxiety, and 16 patients (57.1%) had depression. Postoperative HADS scores showed notable improvements over the preoperative scores. LIMITATIONS: Because this study was observational and retrospective, there was no detailed evaluation of the patients. Additionally, the study's small sample size and single-center nature may have further contributed to the bias of the results. A multicenter, prospective study with a large sample size should be performed to further investigate the effectiveness of CT-guided double-needle PRT as a GPN treatment. CONCLUSION: This study's findings suggest that CT-guided double-needle PRT is a safe and effective alternative treatment for GPN.

A method of "Noninjecting Resection using Bipolar Soft coagulation mode; NIRBS" for superficial non-ampullary duodenal epithelial tumor: a pilot study.

BACKGROUND: Complete endoscopic resection of superficial non-ampullary duodenal epithelial tumors (SNADETs) is technically difficult, especially with an extremely high risk of adverse event (AE), although various endoscopic resection methods including endoscopic mucosal resection (EMR), underwater EMR (UEMR), and endoscopic submucosal dissection (ESD) have been tried for SNADETs. Accordingly, a novel simple resection method that can completely resect tumors with a low risk of AEs should be developed. AIMS: A resection method of Noninjecting Resection using Bipolar Soft coagulation mode (NIRBS) which has been reported to be effective and safe for colorectal lesions is adapted for SNADETs. In this study we evaluated its effectiveness, safety, and simplicity for SNADETs measuring ≤ 20 mm. RESULTS: This study included 13 patients with resected lesions with a mean size of 7.8 (range: 3-15) mm. The pathological distributions of the lesions were as follows: adenomas, 77% (n = 10) and benign and non-adenomatous lesions, 23% (n = 3). The en bloc and R0 resection rate was 100% (n = 13). The median procedure duration was 68 s (32-105). None of the patients presented with major AEs including bleeding and perforation. CONCLUSIONS: Large studies such as prospective, randomized, and controlled trials should be conducted for the purpose of validating effectiveness, safety, and simplicity of the NIRBS for SNADETs measuring ≤ 20 mm suggested in this study.

Optimizing microplastic treatment in the effluent of biological nutrient removal processes using electrocoagulation: Taguchi experimental design.

Microplastics (MPs) have become one of the most critical environmental pollution problems in recent years. Due to the growing abundance of MPs in aquatic environments, extensive research has been conducted and continues to be ongoing to develop effective treatment methods. In this study, the removal of MPs in the effluent of biological wastewater treatment plant (WWTP) was investigated by electrocoagulation (EC) process with aluminum electrodes. Using Taguchi design, the importance of process variables such as pH, current density, and reaction time were evaluated by Analysis of Variance (ANOVA). Statistically, according to F and p values, the most effective parameter for microplastic (MP) removal was current density, followed by pH and reaction time. The R2 value of the created model was found to be above 98%. According to Taguchi results, the optimum process conditions were determined as pH 9, current density 1.905 mA/cm2, and reaction time 15 min and 99% MP removal efficiency was obtained. Under these optimum conditions, the process cost was calculated as 0.049 $/m3 wastewater, considering energy and electrode consumption. As a result of visual analyses, fiber, film, pellet, amorphous, and undefined forms were dominant in WWTP effluent, while only fiber structures were observed after treatment with EC. In this study, it was concluded that the EC process is an alternative treatment method that can be integrated into wastewater treatment plant effluent to achieve MP removal at very low cost and high efficiency. In addition, as a result of this study, it was observed that the EC process can also be used in MP removal by applying it to real wastewater.

A retrospective comparative case series of efficacy and safety of radiofrequency thermocoagulation versus drug therapy in patients with trigeminal neuralgia: A clinical case report.

BACKGROUND: The trigeminal neuralgia (TN) is characterized by a unilateral, episodic, electric shock-like pain in the distribution of the trigeminal nerve. Both drug therapy and radiofrequency thermocoagulation (RT) are used to treat TN. OBJECTIVE: To compare the efficacy and safety of RT and drug therapy in patients with TN. METHODS: Between October 2020 and December 2022, 62 patients with TN were allocated to undergo TN treatment (group A) or drug therapy (group B). In group A, 30 patients received RT treatment, whereas 32 patients in group B receive drug treatment. Pain relief, clinical outcomes, and adverse events in both groups were evaluated. RESULTS: And significantly greater reduction in Visual Analogue Scale scores was noted in group A than in group B in the initial 2-week period (P < .05). The excellent rate was 93.3% (28/30) in group A, whereas it was 68.8% (22/32) in group B during the initial 2-week period (P < .05). A total of 62 patients were followed up at least 12 months, with a mean follow-up time of 14.5 months. But there were no statistically significant differences between the 2 groups at the final follow-up. A total of 24 patients had facial numbness in group A. In contrast, ten patients in group B complained of discomfort including sedation, dizziness, nausea, vomiting. During the follow-up period, 4 patients in group A and 6 patients in group B experienced recurrent pain. CONCLUSION: RT is a safety and effective treatment for patients with classic TN, providing more benefits of quicker pain relief and higher patient's satisfaction, compared with traditional drug therapy.

Does Monopolar Electrocautery Affect the Fetus during Cesarean Section?

Background and Objectives: This study aimed to assess the impact of monopolar electrocautery on the fetus during cesarean section. Materials and methods: A retrospective analysis was conducted with 552 patients delivered by cesarean section. Patients were grouped based on usage of monopolar electrocautery. In 272 patients, monopolar electrocautery was used to separate the tissues before the delivery. In 280 patients, no electrocautery was used. Newborn vital signs, Apgar scores, umbilical cord blood parameters, newborn serum parameters collected within 6th postpartum hour, and rate of newborn intensive care unit admission were compared. Results: The 1st and 5th minute Apgar scores were significantly higher in the electrocautery group; however, this difference lost its significance at the 10th minute. The median newborn pulse rate (148 (7) vs. 146 (6) beats per minute, p = 0.026), umbilical cord blood pH, and partial oxygen pressure were significantly higher in the electrocautery group compared to the no-electrocautery group (7.34 ± 0.06 vs. 7.31 ± 0.06, p < 0.001, and 25.5 (14.77) vs. 23 (16.08) mmHg, p = 0.025, respectively). The median umbilical cord blood serum calcium level was 1.51 (0.64) mmol/L in the electrocautery group, which was significantly lower than 1.9 (0.82) mmol/L in the no-electrocautery group (p = 0.002). The incidence of hypoglycemia was significantly lower in the electrocautery group than in the no-electrocautery group (2.2% vs. 5.7%, p = 0.035). Conclusions: Monopolar electrocautery during cesarean section affects the fetus, but it is safe to use it. Electrocautery is independently associated with umbilical cord blood pH and calcium level. Electrocautery may be associated with a lower incidence of hypoglycemia.

A Case of Colonic Intussusception with Post-polypectomy Electrocoagulation Syndrome and Review of Literature: How to Manage Intussusception Following Colonoscopy?

Colonic intussusception is often reported to be related to malignancy in adults. Colonoscopy itself with or without polypectomy is known to be a rare cause of colonic intussusception. We encountered a case in which an individual was diagnosed with intussusception following colonoscopy. The patient was a 44-year-old female who, on the same day, had undergone a colonoscopy including endoscopic mucosal resection for a polyp in the ascending colon. She visited the emergency room with complaints of right-sided abdominal pain. Abdominal examination revealed peritoneal irritation in the right upper quadrant. Abdominal CT revealed colocolic intussusception near the hepatic flexure. This was suspected to have been induced by post-polypectomy electrocoagulation syndrome. A laparoscopic right hemicolectomy was performed because conducting a reduction trial through colonoscopy involves a high risk of peritonitis, in addition to a low likelihood of spontaneous reduction of intussusception due to the additional edema and ischemia resulting from the polypectomy. The patient was discharged without complications six days after the surgery. Though some cases have been reported, there is no treatment strategy for intussusception following colonoscopy. Therefore, we report this case of colonic intussusception following colonoscopy, which was found to be caused by Post-polypectomy Electrocoagulation Syndrome, with a literature review.

Electrocoagulation process for phosphate recovery of agricultural wastewater: effect of calcium adding, voltage, and time.

Recovery of valuable resources, such as phosphate recovery from wastewater, can help close the nutrient cycle and is interesting to investigate. This study aims to evaluate phosphate recovery and set aside TOC, OC, and IC in agricultural wastewater using electrocoagulation with a helix electrode configuration. This study employed the Response Surface Methodology (RSM) for statistical analysis and modeling, utilizing a central composite design (CCD). Variation of calcium concentration (2-7 mg/L), voltage (15-45 V), and electrocoagulation time (5-15 min) was applied in an electrocoagulation reactor with a helix-shaped stainless steel cathode and a solid cylindrical Mg anode. Based on RSM analysis, electrocoagulation with a helical electrode configuration significantly affects phosphate recovery and the removal of TOC, OC, and IC when treating agricultural wastewater. Under operating conditions of 15 V, 15 min time, and 2 mg/L calcium concentration, we achieved the lowest phosphate concentration of 0.003 mg/L (99.74% reduction). The highest TOC allowance is > 100% of the initial concentration, the TC allowance is 55.79%, and the IC allowance is 30.91%. The formation of metal hydroxides affects the efficiency of TOC removal in the electrocoagulation process, and higher electrolysis times lead to higher TOC removal efficiency. Higher voltages also improve the coagulation and flotation processes in the reactor. Calcium concentration plays a role in enhancing the flocculation process and binding phosphonates from wastewater.

Use of Advanced Energy Devices and Fiberoptic Retractors in Single-Incision Breast-Conserving Surgery for Breast Cancer.

PURPOSE: The use of advanced energy devices for mastectomy and axillary lymph node dissection can reduce perioperative blood loss, seroma formation, and drainage duration/volume. Retraction using fiberoptic retractors can help visualize deep and narrow surgical fields. We aimed to compare the postoperative outcomes between single-incision breast-conserving surgery (SIBCS) and conventional breast-conserving surgery (CBCS) with axillary staging using advanced energy devices and conventional equipment, respectively. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 244 patients who underwent BCS with axillary surgery between March 2018 and September 2019 at Severance Hospital. The patients were grouped based on the device used to aid in axillary staging: CBCS group (n=117) used conventional electrocautery; and SIBCS group (n=127) used advanced energy devices and fiberoptic retractors. The two groups were compared for postoperative outcomes. RESULTS: The mean patient age was 55.9 and 53.1 years in the CBCS and SIBCS groups, respectively. Incision size was significantly smaller in the SIBCS group than in the CBCS group (6.3±2.1 cm vs. 7.5±2.5 cm, p=0.044). There were no significant differences between the two groups in terms of operating time (126.0±40.0 min vs. 127.0±63.0 min, p=0.828), operative blood loss (11.0±31.0 mL vs. 7.0±18.0 mL, p=0.100), drainage duration (7.0±3.0 d vs. 8.0±4.0 d, p=0.288), and complications (1.70% vs. 2.36%, p=0.523). CONCLUSION: Using advanced energy devices for SIBCS with axillary staging reduced incision size and provided better cosmetic outcomes compared to those using the conventional method. Advanced energy devices may offer better surgical outcomes in patients who undergo BCS with axillary staging.

Stereo-electroencephalography-guided radiofrequency thermocoagulation restricted to periventricular nodular heterotopias in patients with drug-resistant epilepsy: A single center experience.

INTRODUCTION: Periventricular nodular heterotopias (PVNH) are developmental abnormalities with neurons abnormally clustered around the cerebral ventricles. Patients frequently present with focal drug-resistant epilepsy (DRE). However, the relationship between PVNH and the seizure onset zone (SOZ) is complex. Stereo-electroencephalography (SEEG) is an invasive diagnostic procedure for patients with DRE. In selected patients, the SEEG may be converted into a therapeutic procedure, lesioning the probable (SOZ) with pulsed radiofrequency thermocoagulation (RFTC). The aim of our study was to evaluate the efficacy and safety of SEEG-RFTC in a series of DRE patients with PVNH. METHODS: Twenty-four patients with focal DRE related to PVNH and treated with SEEG-guided-RFTC restricted to nodules were prospectively collected between 2016 and 2023 and retrospectively analyzed after a follow-up of at least 12 months. RESULTS: Seventeen patients (71 %) responded (ILAE class 1-4) after SEEG-guided RFTC of whom eleven (46 %) became seizure-free (class 1) at last follow up, nine (45 %) despite residual PVNH tissue on MRI. SEEG seizure onset was restricted to PVNH in eleven patients (class 1 in 45 %) and simultaneously in PVNH and other cortical areas in thirteen patients (class 1 in 46 %). Out of 31 SEEG-RFTC procedures in twenty-four patients, adverse events, related to RFTC, were recorded in eight (26 %), of which two patients (8 %) had predicted permanent visual complaints whilst the other five had transient complaints. SIGNIFICANCE: This study demonstrates that a considerable percentage of patients, even with bilateral, multiple PVNH and involvement of adjacent cortical regions can be rendered seizure-free with SEEG-guided-RFTC restricted to the nodules. Furthermore, this study delivers evidence that the complete destruction of the entire nodule is not necessary to render a patient seizure free. This justifies the use of SEEG in patients with single, multiple or bilateral PVNHs to provide insight into the epileptogenic organization in and around these lesions.

Alternative sequential combinations of electrocoagulation with electrooxidation and peroxi-coagulation for effective treatment of adhesive production industry wastewater.

Adhesive production industry wastewater can be characterized by high chemical oxygen demand (COD) sourced from high refractory organic contaminants and high total suspended solids (TSS) concentration. Biodegradability of the wastewater is low and wastewater quality is unstable. Various treatment processes have limited applicability in such characterized wastewater. In this study, the treatment performance of electrochemical processes was investigated. Because it is not possible to meet the discharge standards by application of only one process for high refractory organic content, sequential electrochemical processes were studied in this work. In the first step of the sequential process, electrocoagulation (EC) using Al electrodes by which better performance was achieved was applied. In the second step, electrooxidation (EO) and peroxi-coagulation (PC) processes were applied to the EC effluent. In EO, Ti/MMO was selected as the most effective anode whereas in PC, Fe was used as the anode, and graphite was used as the cathode. Box-Behnken Design was applied to optimize the operating conditions of EO and PC processes and to obtain mathematical model equations. In the EC process, 77% COD, 78.5% TSS, and 85% UV254 removal efficiency were obtained under the optimum conditions (pH 7.2, reaction time 35 min, and current density 0.5 mA/cm2). With the EO and PC processes applied to the effluent of EC, 68.5% COD, 77% TSS, and 83% UV254 removal and 77.5% COD, 87% TSS, and 86.5% UV254 removal were obtained, respectively. The specific energy consumption of EC-EO and EC-PC processes was 16.08 kWh/kg COD and 15.06 kWh/kg COD, respectively. Considering the treatment targets and process operating costs, it was concluded that both sequential electrochemical systems could be promising alternative systems for the treatment of adhesive production industry wastewater.

Accurate prediction and intelligent control of COD and other parameters removal from pharmaceutical wastewater using electrocoagulation coupled with catalytic ozonation process.

In this study, we employed the response surface method (RSM) and the long short-term memory (LSTM) model to optimize operational parameters and predict chemical oxygen demand (COD) removal in the electrocoagulation-catalytic ozonation process (ECOP) for pharmaceutical wastewater treatment. Through RSM simulation, we quantified the effects of reaction time, ozone dose, current density, and catalyst packed rate on COD removal. Then, the optimal conditions for achieving a COD removal efficiency exceeding 50% were identified. After evaluating ECOP performance under optimized conditions, LSTM predicted COD removal (56.4%), close to real results (54.6%) with a 0.2% error. LSTM outperformed RSM in predictive capacity for COD removal. In response to the initial COD concentration and effluent discharge standards, intelligent adjustment of operating parameters becomes feasible, facilitating precise control of the ECOP performance based on this LSTM model. This intelligent control strategy holds promise for enhancing the efficiency of ECOP in real pharmaceutical wastewater treatment scenarios. PRACTITIONER POINTS: This study utilized the response surface method (RSM) and the long short-term memory (LSTM) model for pharmaceutical wastewater treatment optimization. LSTM predicted COD removal (56.4%) closely matched experimental results (54.6%), with a minimal error of 0.2%. LSTM demonstrated superior predictive capacity, enabling intelligent parameter adjustments for enhanced process control. Intelligent control strategy based on LSTM holds promise for improving electrocoagulation-catalytic ozonation process efficiency in pharmaceutical wastewater treatment.

Efficacy of Mind-Regulating and Depression-Reliving Acupuncture in Combination with Radiofrequency Thermocoagulation of Dorsal Root Ganglion for Post-herpetic Neuralgia.

PURPOSE: This study is aimed at evaluating the efficacy of mind-regulating and depression-relieving acupuncture in combination with radiofrequency thermocoagulation of dorsal root ganglion (DRG) for post-herpetic neuralgia (PHN). METHODS: PHN patients who presented to the Pain Department of Affiliated Hospital of Jiaxing University from November 2021 to June 2023 were included. The participants were assigned into 2 groups using a random number table: Acupuncture + RFTC (group H, n = 44) group and RFTC (group C, n = 44) group. The pain numerical rating score (NRS), visual analogue scale scores (VAS), IL-6, Gal-3, oral dose of tramadol and gabapentin capsules levels were recorded before and after 1, 2, 4, 8 and 12 weeks of the treatment. RESULTS: After treatment, NRS scores in both groups were significantly lower than pretreatment scores at each time point. Compared with before treatment, the VAS scores at all time points after treatment was increased in both groups. Compared with before treatment, the doses of oral gabapentin capsules and tramadol were reduced in both groups after treatment. Compared with group C, the doses of oral gabapentin capsules and tramadol after the end of the treatment course were significantly reduced in group H. Compared with before treatment, the blood levels of Gal-3 and IL-6 were reduced at all points after treatment in both groups. Compared with group C, the blood Gal-3 and IL-6 levels were significantly reduced in group H. CONCLUSIONS: Compared with RFTC alone, acupuncture combined with RFTC of DRG has a better therapeutic effect for PHN.

Cold versus hot snare endoscopic mucosal resection for large (≥15 mm) flat non-pedunculated colorectal polyps: a randomised controlled trial.

BACKGROUND AND AIMS: Conventional hot snare endoscopic mucosal resection (H-EMR) is effective for the management of large (≥20 mm) non-pedunculated colon polyps (LNPCPs) however, electrocautery-related complications may incur significant morbidity. With a superior safety profile, cold snare EMR (C-EMR) of LNPCPs is an attractive alternative however evidence is lacking. We conducted a randomised trial to compare the efficacy and safety of C-EMR to H-EMR. METHODS: Flat, 15-50 mm adenomatous LNPCPs were prospectively enrolled and randomly assigned to C-EMR or H-EMR with margin thermal ablation at a single tertiary centre. The primary outcome was endoscopically visible and/or histologically confirmed recurrence at 6 months surveillance colonoscopy. Secondary outcomes were clinically significant post-EMR bleeding (CSPEB), delayed perforation and technical success. RESULTS: 177 LNPCPs in 177 patients were randomised to C-EMR arm (n=87) or H-EMR (n=90). Treatment groups were equivalent for technical success 86/87 (98.9%) C-EMR versus H-EMR 90/90 (100%); p=0.31. Recurrence was significantly greater in C-EMR (16/87, 18.4% vs 1/90, 1.1%; relative risk (RR) 16.6, 95% CI 2.24 to 122; p<0.001).Delayed perforation (1/90 (1.1%) vs 0; p=0.32) only occurred in the H-EMR group. CSPEB was significantly greater in the H-EMR arm (7/90 (7.8%) vs 1/87 (1.1%); RR 6.77, 95% CI 0.85 to 53.9; p=0.034). CONCLUSION: Compared with H-EMR, C-EMR for flat, adenomatous LNPCPs, demonstrates superior safety with equivalent technical success. However, endoscopic recurrence is significantly greater for cold snare resection and is currently a limitation of the technique. TRIAL REGISTRATION NUMBER: NCT04138030.

Evaluation of the regeneration process of the sciatic nerve of a mouse animal model after application of freezing, crushing or electrocoagulation damage / Ocena procesu regeneracji nerwu kulszowego mysiego modelu zwierzecego po zastosowaniu uszkodzenia metoda mrozenia, zmiazdzenia i elektrokoagulacji.

The problem of regeneration of damaged peripheral nerves is an ongoing topic and has long been the subject of intensive research worldwide. This study examined the morphological and functional evaluation of the regeneration process within the damaged sciatic nerve, a mouse animal model. The effect of impaired expression of the TSC-1 gene on the process of nerve regeneration was evaluated, depending on the mode of damage. The research object consisted of 48, 2-month-old male TSC lines. The test group consisted of animals that underwent damage to the sciatic nerve by crushing, freezing and electrocoagulation, while the control group includes mice whose sciatic nerve was not damaged. Behavioral tests were conducted to evaluate the functional return of the limb, after 3,5,7 and 14 days. The first changes in the regeneration process of the damaged neurite are observed as early as day 3 after the injury, while on day 14 after the injury the functional return of the damaged limb was noted.

Efficiency enhancement of electrocoagulation, ion-exchange resin and reverse osmosis (RO) membrane filtration by prior organic precipitation for treatment of anaerobically-treated palm oil mill effluent.

Anaerobically-treated palm oil mill effluent (POME) still has unacceptable properties for water recycling and reuse, with an unpleasant appearance due to the brownish color caused by tannins and phenolic compounds. This study proposes an approach for treating anaerobically-treated POME for water recycling by combining organic precipitation, electrocoagulation (EC), and ion-exchange resin, followed by reverse osmosis (RO) membrane filtration in series. The results indicated that the organic precipitation enhanced the efficiency of EC treatment in reducing the concentrations of tannins, color, and chemical oxygen demand (COD) of the anaerobically-treated POME effluent, with reductions of 95.73%, 96.31%, and 93.96% for tannin, color, and COD, respectively. Moreover, organic precipitation affected the effectiveness of Ca2+ and Mg2+ ion removal using ion exchange resin and RO membrane filtration. Without prior organic precipitation, the ion-exchange resin process required a longer contact time, and the RO membrane filtration treatment was hardly effective in removing total dissolved solids (TDS). The combined process gave a water quality that meets the criteria set by the Thailand Ministry of Industry for industrial boiler use (COD 88 mg/L, TDS <0.001 mg/L, water hardness <5 mg-CaCO3/L, and pH 6.9).

Importance of iron complexation and floc formation towards phosphonate removal with Fe-electrocoagulation.

Phosphonates are widely used scale inhibitors, but the residual phosphonates in drainage are challenging to remove because of their chelating capacity and resistance to biodegradation. Here, we reported a highly efficient and robust Fe-electrocoagulation (Fe-EC) system for phosphonate removal. Surprisingly, we found for the first time that phosphonates like NTMP were more efficiently removed under anoxic conditions (80% of total soluble phosphorus (TSP) in 4 min) than oxic conditions (0% of TSP within 6 min) in NaCl solution. A similar phenomenon was observed when other phosphonates, such as EDTMP and DTPMP, were removed, highlighting the importance of iron complexation and floc formation toward phosphonate removal with Fe-EC. We also showed that the removal efficiency of NTMP by electrochemically in-situ formed flocs (97%) was much higher than post-adsorption systems (ex-situ, 40%), revealing that the growth of flocs consumed the active site for NTMP adsorption. Beyond the removal of TSP, 10 % of NTMP-P was also degraded after the electrolysis phase, evidenced by the evolution of phosphate-P. However, this did not happen in anoxic or chemical coagulation processes, which confirms the formation of reactive oxygen species via Fe(II) oxidation in the oxic Fe-EC system. The primary removal mechanism of phosphonates is due to their complexation with iron (hydr)oxide generated in the Fe-EC system by forming a Fe-O-P bond. Encouragingly, the Fe-EC system exhibits comparable or even better performance in treating phosphonate-laden wastewater (i.e., cooling water). Our preliminary cost calculation suggests the proposed system (€ 0.009/m3) has a much lower OPEX under oxic conditions than existing approaches. This study sheds light on the removal mechanism of phosphonate and the treatment of phosphonate-laden wastewater by playing with the iron complexion and flocs formation in classical Fe-EC systems.

Defluoridation by positive single-pulse current electrocoagulation from photovoltaic wastewater: Energy consumption assessment and mechanism analysis.

The presence of fluoride ions (F-) in photovoltaic (PV) wastewater significantly affects the integrity of the ecological environment. In contrast to direct current electrocoagulation (DC-EC), positive single-pulse electrocoagulation (PSPC-EC) shows a significant reduction in both the formation of passivation films on electrodes and the consumption of electrical energy. Under the experimental conditions of an Al-Al-Al-Al electrode combination, an electrode spacing of 1.0 cm, a NaCl concentration of 0.05 mol L-1, an initial pH of 5.6, an initial F- concentration of 5 mg L-1, a current density of 5 A m-2, a pulse frequency of 500 Hz, and a 40 % duty cycle, the achieved equilibrium F- removal efficiencies were 84.0 % for DC-EC and 88.0 % for PSPC-EC, respectively, accompanied by power consumption of 0.0198 kWh·mg-1 and 0.0073 kWh·mg-1. The flocs produced in the PSPC-EC process were characterized using scanning electron microscopy, X-ray diffraction, Fourier transform infrared spectroscopy, and X-ray photoelectron spectroscopy and it is revealed that the F- removal mechanisms in the PSPC-EC process include co-precipitation, hydrogen bond complexation, and ion exchange. When the actual PV wastewater was finally subjected to treatment under the optimal PSPC-EC conditions, the F- concentration in the wastewater was reduced from 4.6 mg L-1 to 1.4 mg L-1. This paper provides both a theoretical framework and a technological basis for the application of PSPC-EC in the advanced treatment of PV wastewater.

Adverse events related to suction electrocautery devices in adenotonsillectomy: Analysis of the MAUDE database.

OBJECTIVE: To identify adverse events (AEs) related to suction electrocautery use during adenotonsillectomy. METHODS: The US Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database was searched using the terms "suction cautery," "suction electrocautery," "suction Bovie," and "suction coagulator" from January 2014 to December 2023. RESULTS: 165 AE reports were gathered from the MAUDE database medical device reports (MDRs). 36 met inclusion criteria. Patient injuries were found in 22 (61.1 %) reports and device malfunction events were found in 14 (38.9 %) reports. All patient injuries were thermal burns (N = 22, 100 %). Location of burn injuries included the lip (N = 6, 27.3 %), oral commissure (N = 5, 22.7 %), and tongue (N = 4, 18.2 %). The most common cause of an AE was inadequate device insulation (N = 7, 19.4 %). CONCLUSION: The suction electrocautery apparatus may malfunction and cause patient burn injuries. Device failures mainly result from inadequate device insulation, coagulation problems, and detachment of device components. Surgeons must be aware of these potential complications and counsel parents and patients regarding AEs.

SEEG-RFTC in patients with refractory focal epilepsy: real-world outcomes from 121 cases.

OBJECTIVE: Radiofrequency thermocoagulation (RFTC) has emerged as an effective and safe treatment method for patients with refractory focal epilepsy, when stereo-electroencephalography (SEEG) is implanted. Although real-world research results are still limited, a considerable number of patients have shown favorable outcomes with this less invasive method. This study aims to describe the outcomes and predictive factors of SEEG-RFTC in real-world research. METHODS: A retrospective observational study was conducted on patients in the authors' epilepsy center. In total, 121 patients who underwent RFTC were included in the study. Post-RFTC outcomes were evaluated using the seizure-free rate and response rate (seizure frequency reduction more than 50%). Predictive factors influencing post-RFTC outcome were considered by comparing different variables. RESULTS: The mean follow-up period was 18.3 months. Eighty-two patients (67.8%) were responders and 54 (44.6%) were seizure free. In 36 patients with malformation of cortical development, the seizure-free rate and the response rate were 69.44% and 83.33%, respectively. In 20 patients with hippocampal sclerosis, 19 patients were responders and 14 (70%) patients were seizure free at the last follow-up. The MRI feature and etiology of epilepsy are correlated with the outcome. MR-positive is a predictive factor for seizure freedom (p < 0.01) and responders (p < 0.01). Other factors have no predictive value for post-RFTC outcome. INTERPRETATION: SEEG-RFTC is a safe procedure and yields favorable outcomes in numerous cases of focal DRE. The MRI feature and etiology of epilepsy are correlated with the seizure-free rate and response rate. And MRI positivity is the predictor for good RFTC outcome.