Stabilization of liquid instabilities with ionized gas jets.

Impinging gas jets can induce depressions in liquid surfaces, a phenomenon familiar to anyone who has observed the cavity produced by blowing air through a straw directly above a cup of juice. A dimple-like stable cavity on a liquid surface forms owing to the balance of forces among the gas jet impingement, gravity and surface tension1,2. With increasing gas jet speed, the cavity becomes unstable and shows oscillatory motion, bubbling (Rayleigh instability) and splashing (Kelvin-Helmholtz instability)3,4. However, despite its scientific and practical importance-particularly in regard to reducing cavity instability growth in certain gas-blown systems-little attention has been given to the hydrodynamic stability of a cavity in such gas-liquid systems so far. Here we demonstrate the stabilization of such instabilities by weakly ionized gas for the case of a gas jet impinging on water, based on shadowgraph experiments and computational two-phase fluid and plasma modelling. We focus on the interfacial dynamics relevant to electrohydrodynamic (EHD) gas flow, so-called electric wind, which is induced by the momentum transfer from accelerated charged particles to neutral gas under an electric field. A weakly ionized gas jet consisting of periodic pulsed ionization waves5, called plasma bullets, exerts more force via electrohydrodynamic flow on the water surface than a neutral gas jet alone, resulting in cavity expansion without destabilization. Furthermore, both the bidirectional electrohydrodynamic gas flow and electric field parallel to the gas-water interface produced by plasma interacting 'in the cavity' render the surface more stable. This case study demonstrates the dynamics of liquids subjected to a plasma-induced force, offering insights into physical processes and revealing an interdependence between weakly ionized gases and deformable dielectric matter, including plasma-liquid systems.

ABO-incompatible kidney transplantation can be successfully conducted by monitoring IgM isoagglutinin titers during desensitization.

BACKGROUND: Recent advances in desensitization techniques and immunosuppressive therapy have led to improved outcomes after ABO-incompatible (ABO-i) kidney transplantation (KT). However, questions remain unanswered, particularly regarding which type of ABO isoagglutinin-immunoglobulin M (IgM) or immunoglobulin M (IgG)-is significantly involved in antibody-mediated rejection (AMR). STUDY DESIGN AND METHODS: We retrospectively analyzed data from 120 patients who underwent ABO-i KT between 2012 and 2014. Preoperative plasma exchange was performed until the IgM isoagglutinin titer was 4 or less, regardless of the IgG titer. Clinical data were compared between patient groups with pre-KT IgG isoagglutinin titer 16 or greater (high IgG; titer range, 16-256; n = 39) and 8 or less (low IgG; titer range, -8; n = 81). RESULTS: The median follow-up periods were 59 (high IgG) and 55 (low IgG) months. Patient survival at 5 years (p = 0.314) was 100% (high IgG) and 97.4% (low IgG). Graft survival at 5 years (p = 0.480) was 100% (high IgG) and 98.7% (low IgG). AMR by anti-ABO antibody occurred in only one patient in the low-IgG group. CONCLUSION: Patients with high pre-KT IgG isoagglutinin titers had equally successful outcomes as those with low IgG titers. ABO-i KT can be successfully performed by reducing the pre-KT IgM isoagglutinin titer to 4 or less, as determined by the immediate spin tube method.

Performance of Norudia Glycated Albumin Assay on Multiple Analytical Platforms and Comparison to Lucica Assay.

BACKGROUND: The Norudia glycated albumin (GA) assay was evaluated for analytical performance and assay applicability on multiple analytical platforms. METHODS: The evaluation included precision, linearity, reference interval, and comparison with Lucica GA assay. A multicenter study was conducted to compare the results of Norudia GA assay on five kinds of widely used automated clinical chemistry analyzers. RESULTS: Within-laboratory imprecisions for GA% presented 1.3 - 3.3% and 0.8 - 2.6% for low- and high-level control materials, respectively, on different analyzers. GA assay was linear from 20.0 to 680.0 µmol/L of GA. The claimed reference range (12 - 16 GA%) was verified. Norudia GA showed a good GA% correlation with Lucica GA (correlation coefficient 0.999). GA% from each analyzer showed good correlation with the consensus mean of the results of five analyzers (correlation coefficient 0.997 - 0.999). CONCLUSIONS: The Norudia GA assay can successfully be implemented in all the tested platforms, with good GA% correlation.

Effects of therapeutic plasma exchange on early allograft dysfunction after liver transplantation.

BACKGROUND: Early allograft dysfunction (EAD) is a serious complication of liver transplantation (LT) and is associated with graft failure, which can result in patient mortality. Due to the shortage of organs for retransplantation, only a small proportion of EAD patients undergo retransplantation. Thus, liver support is needed for most patients with EAD. METHODS: We evaluated the effects of therapeutic plasma exchange (TPE) in EAD patients. EAD was defined as a sustained hyperbilirubinemia (≥10 mg/dL) within 30 days of LT without concurrent biliary complications. In a 13-year period, 107 EAD patients underwent TPE while 36 EAD patients did not. We investigated the laboratory and clinical outcomes of TPE and non-TPE groups. RESULTS: The TPE group showed 1-month and 1-year survival rates of 82.2% and 53.8%, respectively, whereas the non-TPE group showed 58.3% and 22.2%, respectively. In TPE group, statistically significant decreases (P < 0.05) in total bilirubin (15.2 ± 5.2 to 13.1 ± 5.4 mg/dL), and INR (1.72 ± 1.04 to 1.38 ± 1.14), were seen after the final TPE session. TPE responder groups with age <51 years, total bilirubin <11.1 mg/dL, or INR <1.15 after final TPE showed better prognosis. TPE decreased the hazard risk of death in EAD patients whereas older age, male gender, and higher INR on the day of EAD onset increased the risk. CONCLUSIONS: TPE effectively removed plasma bilirubin and improved coagulation function in EAD patients, with higher survival in the TPE group than in the non-TPE group. TPE may be an effective liver support for EAD patients. J. Clin. Apheresis 32:147-153, 2017. © 2016 Wiley Periodicals, Inc.

Effects of minimal exposures to atmospheric pressure plasma on the activity of Salmonella Typhimurium: Deactivation of bacterial motility and suppression of host-cell invasion.

Atmospheric pressure plasma (APP) has been shown effective in sterilization by reducing the number of viable microbes during surface cleaning, food processing, or human tissue treatment. For safe conduct, the majority of previous research focused on complete abolition of microbes, which may require severe treatments. Our aim is to investigate the minimal treatment conditions necessary for effective inactivation of bacteria in such a manner that the APP treated bacteria would not be able to harm the host cells. For this, we ought to identify the objective criteria to make the bacteria dysfunctional. We choose the motile properties and the host-cell invasion capability as two measures to quantify the pathogenic state of bacteria. In this paper, we investigated how the APP treatment in a minimal dosage affects the activity of Salmonella Typhimurium. At 100 W and 15 kHz for 20 s, the APP treatment effectively suppressed active "run and tumble" type motility and induced formation of abnormally long structures. With 20 s exposure, the bacterial cells failed to cause pyroptosis in the host cells with >90% survival after 12 h of co-incubation. Our results suggest novel measures to evaluate the functional pathogenic state for identifying safe APP treatment conditions.

Genetic Polymorphism of CYP2D6 and Clomiphene Concentrations in Infertile Patients with Ovulatory Dysfunction Treated with Clomiphene Citrate.

CYP2D6 is primarily responsible for the metabolism of clomiphene citrate (CC). The purpose of the present study was to investigate the relationship between CYP2D6 genotypes, concentrations of CC and its major metabolites and drug response in infertility patients. We studied 42 patients with ovulatory dysfunction treated with only CC. Patients received a dose of 100 mg/day CC on days 3-7 of the menstrual cycle. CYP2D6 genotyping and measurement of CC and the major metabolite concentrations were performed. Patients were categorized into CC responders or non-responders according to one cycle response for the ovulation. Thirty-two patients were CC responders and 10 patients were non-responders with 1 cycle treatment. The CC concentrations were highly variable within the same group, but non-responders revealed significantly lower (E)-clomiphene concentration and a trend of decreased concentrations of active metabolites compared to the responders. Nine patients with intermediate metabolizer phenotype were all responders. We confirmed that the CC and the metabolite concentrations were different according to the ovulation status. However, our results do not provide evidence for the contribution of CYP2D6 polymorphism to either drug response or CC concentrations.

Enhancement of antioxidant effects of naringin after atmospheric pressure dielectric barrier discharge plasma treatment.

Naringin is the natural chief bitter flavonoid found in Citrus species. Herein, bitter naringin was treated with atmospheric pressure plasma to afford two new converted flavonoids, narinplasmins A (2) and B (3), along with the known compound, 2R-naringin. The structures of the two new naringin derivatives were elucidated on the basis of spectroscopic methods. The antioxidant activity of all isolates was evaluated based on 1,1-diphenyl-2-picrylhydrazyl and peroxynitrite (ONOO(-)) scavenging assays. The new flavanone glycoside 2 containing a methoxyalkyl group exhibited significantly improved antioxidant properties in these assays relative to the parent naringin.

Flexible thin-layer dielectric barrier discharge plasma treatment of pork butt and beef loin: effects on pathogen inactivation and meat-quality attributes.

The effects of a flexible thin-layer dielectric barrier discharge (DBD) plasma system using a sealed package on microbial inactivation and quality attributes of fresh pork and beef were tested. Following a 10-min treatment, the microbial-load reductions of Listeria monocytogenes, Escherichia coli O157:H7, and Salmonella Typhimurium were 2.04, 2.54, and 2.68 Log CFU/g in pork-butt samples and 1.90, 2.57, and 2.58 Log CFU/g in beef-loin samples, respectively. Colorimetric analysis showed that DBD-plasma treatment did not significantly affect L* values (lightness) of pork and beef samples, but lowered a* values (redness) significantly after 5- and 7.5-min exposures. The plasma treatment significantly influenced lipid oxidation only after a 10-min exposure. The texture of both types of meat was unaffected by plasma treatment. All sensory parameters of treated and non-treated samples were comparable except for taste, which was negatively influenced by the plasma treatment (P < 0.05). This thin-layer DBD-plasma system can be applied to inactivate foodborne pathogens. The observed minor deterioration of meat quality might be prevented by the use of hurdle technology.

Evaluation of pathogen inactivation on sliced cheese induced by encapsulated atmospheric pressure dielectric barrier discharge plasma.

Pathogen inactivation induced by atmospheric pressure dielectric barrier discharge (DBD) (250 W, 15 kHz, air discharge) produced in a rectangular plastic container and the effect of post-treatment storage time on inactivation were evaluated using agar plates and cheese slices. When agar plates were treated with plasma, populations of Escherichia coli, Salmonella Typhimurium, and Listeria monocytogenes showed 3.57, 6.69, and 6.53 decimal reductions at 60 s, 45 s, and 7 min, respectively. When the pathogens tested were inoculated on cheese slices, 2.67, 3.10, and 1.65 decimal reductions were achieved at the same respective treatment times. The post-treatment storage duration following plasma treatment potently affected further reduction in pathogen populations. Therefore, the newly developed encapsulated DBD-plasma system for use in a container can be applied to improve the safety of sliced cheese, and increasing post-treatment storage time can greatly enhance the system's pathogen-inactivation efficiency.

Effect of atmospheric pressure plasma jet on the foodborne pathogens attached to commercial food containers.

Bacterial biofilms are associated with numerous infections and problems in the health care and food industries. The aim of this study was to evaluate the bactericidal effect of an atmospheric pressure plasma (APP) jet on Escherichia coli O157:H7, Listeria monocytogenes, and Salmonella Typhimurium biofilm formation on collagen casing (CC), polypropylene (PP) and polyethylene terephthalate (PET), which are widely used food container materials. The samples were treated separately with the APP jet at a 50-W input power for 5 and 10 min, and nitrogen (6 l per minute) gas combined with oxygen (10 standard cubic centimeters per minute) was used to produce the APP. The APP jet reduced the number of bacterial cells in a time-dependent manner. All pathogens attached to CC, PP, and PET were reduced by 3-4 log CFU/cm(2) by the 10-min APP treatment. The developed APP jet was effectively reduced biofilms on CC, PP, and PET.

Significance of isoagglutinin titer in ABO-incompatible kidney transplantation.

ABO-incompatible (ABO-i) kidney transplantation (KT) has emerged for overcoming the shortage of organ donors. Although this technique initially achieved only low graft survival due to isoagglutinin, recently developed desensitization protocols have improved survival to levels that are comparable to ABO-compatible KT. However, isoagglutinin is still regarded as a major obstacle to ABO-i KT. In this study, we evaluate the impact of isoagglutinin titer on clinical outcomes as well as factors that may influence isoagglutinin titers. In total, data from 95 patients who underwent ABO-i KT were analyzed. Preoperatively, rituximab administration and plasmapheresis were performed until the titer was reduced to ≤1:4. Retrospective analysis included blood group; timing and dosage of rituximab; isoagglutinin titer; number of plasmapheresis; and clinical outcomes including graft survival and serum creatinine. Graft survival was 95.8% (n = 91) and average serum creatinine at 1- and 1.5-year post-ABOi-KT was 1.3. Three patients died of sepsis. The identified predictors of titer-rebound after transplant were short interval (<7 days) between rituximab and first plasmapheresis (P = 0.004); high initial titer (≥256) (P = 0.023); low titer-reduction rate (P < 0.001); and blood group O (P < 0.001). One patient who experienced a rebound developed antibody-mediated rejection. With low-dose (200 mg) rituximab, the change in isoagglutinin titer-rebound was not significant and the infection rate was significantly decreased (P = 0.001). In conclusion, isoagglutinin titer-rebound within the first 2 weeks after KT may be a risk factor for rejection. The factors identified as affecting titer-rebound after KT were high initial isoagglutinin titer, low titer-reduction rate, short interval, and blood group O.

Evaluation of the URiSCAN super cassette ACR semiquantitative urine dipstick for microalbuminuria screening.

BACKGROUND: Microalbuminuria tests are used as screening tools for diseases, such as diabetic nephropathy, cardiovascular disease, and hypertension. The purpose of this study was to evaluate the utility of a newly introduced semiquantitative urine dipstick, URiSCAN Super cassette ACR (URiSuper-ACR [where ACR is albumin/creatinine ratio]; YD Diagnostics Corp., Korea), as a screening tool for microalbuminuria. METHODS: Albumin and creatinine levels in randomly selected spot urine samples of 1,040 patients were semiquantitatively measured using URiSuper-ACR. Results using URiSuper-ACR system were compared to measurements obtained by quantitative analyzer. We also calculated diagnostic sensitivity, specificity, precision, linearity, and categorical concordance rates for the diagnosis of microalbumiuria using this system. Furthermore, we performed interference tests using standard controls to evaluate possible influence of various factors. RESULTS: URiSuper-ACR test showed 88.8% and 86.3% sensitivity and 90.1% and 93.8% specificity for albumin concentration and ACR, respectively. It also showed 91.1% and 92.6% positive predictive values and 87.6% and 88.5% negative predictive values, respectively. The concordance rate between URiSuper-ACR and quantitative method for albumin and creatinine concentration within the same category were 78.4% and 67.1%, respectively, and for the ±1 category were 98.8% and 99.5%, respectively. For ACR, an 80.0% concordance rate was seen within the same category. The within-run coefficients of variation (CVs) were 3.0∼15.4% and 5.2∼23.5% for albumin and creatinine, respectively, showing good linearity. In interference tests, no interference was observed except for cases with high specific gravity. CONCLUSIONS: URiSuper-ACR showed good diagnostic performance for the detection of microalbuminuria and may be a useful screening test in clinical laboratories.

Evaluation of the treatment of both sides of raw chicken breasts with an atmospheric pressure plasma jet for the inactivation of Escherichia coli.

Atmospheric pressure plasma (APP) is an emerging nonthermal microbial inactivation technique. In this study, agar and raw chicken breast were inoculated with Escherichia coli and treated with an APP jet based on cold arc plasma. The aim of this study was to investigate the optimum conditions for the plasma treatment of an APP jet in order to maximize the efficiency of E. coli inactivation. The combination of N2+O2 (10 standard cubic centimeters per minute) and a longer treatment time (10 min) resulted in the highest inactivation of E. coli on agar plates with an optimum treatment distance of 20 mm. The samples in dry and wet conditions showed similar reductions in E. coli count when one side of the samples was treated at a given treatment time. Treating both sides-2.5 min on each side-resulted in a higher growth inhibition of E. coli than treatment of a single side only for 5 min. However, there was no significant difference between one-side treated samples (10 min) and both-sides treated samples (5+5 min). When the concentration of E. coli in the chicken breast sample was 10(4) colony-forming units (CFU)/g, the reduction rate of the E. coli was the highest, followed by 10(5), 10(6), and 10(7) CFU/g; however, no difference was found between 10(3) and 10(4) CFU/g. In conclusion, various treatment conditions may affect the inactivation efficiency of E. coli. In the present study, the optimum condition was determined as the treatment distance of 20 mm and longer treatment time (10 min) with the addition of oxygen to the nitrogen gas flow. Furthermore, the cell concentration of sample was an important parameter for the efficacy of the inactivation process.

Efficacy of a novel channel-cleaning ball brush for endoscope reprocessing: a randomized controlled trial.

BACKGROUND/AIMS: Endoscopic channels are difficult to clean and can cause infection transmission. We examined the effectiveness of a newly developed channel-cleaning ball brush (BB), which is sucked into the endoscopic channel and scrapes and cleans the lumen as it passes through. METHODS: The upper and lower gastrointestinal endoscopes used for patient examinations were randomly selected as the conventional brush (CB) or BB group. After manual cleaning, the presence or absence of carbohydrates, proteins, adenosine triphosphate, and hemoglobin was assessed. RESULTS: Fifty-six and 58 endoscopes were cleaned with the CB and BB, respectively. Carbohydrate and protein were detected in one (1.8%) and two endoscopes (3.4%) in the CB and BB groups, respectively (p=1.000). Hemoglobin was observed in one (1.8%) and three endoscopes (5.2%) in the CB and BB groups, respectively (p=0.636). The adenosine triphosphate levels were 10.6±15.9 and 12.5±14.3 relative light units in the CB and BB groups, respectively (p=0.496). Twenty-seven (48.2%) and 19 (32.8%) endoscopes were positive for microbial cultures in the CB and BB groups, respectively (p=0.136). CONCLUSION: The efficacy of BB was not significantly different from that of CB in the endoscopic channel-cleaning process.

Improvement of osseointegration efficacy of titanium implant through plasma surface treatment.

A novel plasma treatment source for generating cylindrical plasma on the surface of titanium dental implants is developed herein. Using the titanium implant as an electrode and the packaging wall as a dielectric barrier, a dielectric barrier discharge (DBD) plasma was generated, allowing the implant to remain sterile. Numerical and experimental investigations were conducted to determine the optimal discharge conditions for eliminating hydrocarbon impurities, which are known to degrade the bioactivity of the implant. XPS measurement confirmed that plasma treatment reduced the amount of carbon impurities on the implant surface by approximately 60%. Additionally, in vitro experiments demonstrated that the surface treatment significantly improved cell adhesion, proliferation, and differentiation. Collectively, we proposed a plasma treatment source for dental implants that successfully removes carbon impurities and facilitate the osseointegration of SLA implants.

Effect of atmospheric pressure plasma on inactivation of pathogens inoculated onto bacon using two different gas compositions.

Atmospheric pressure plasma (APP) is an emerging non-thermal pasteurization method for the enhancement of food safety. In this study, the effect of APP on the inactivation of pathogens inoculated onto bacon was observed. Sliced bacon was inoculated with Listeria monocytogenes (KCTC 3596), Escherichia coli (KCTC 1682), and Salmonella Typhimurium (KCTC 1925). The samples were treated with APP at 75, 100, and 125 W of input power for 60 and 90 s. Two gases, helium (10 lpm) or a mixture of helium and oxygen, (10 lpm and 10 sccm, respectively) were used for the plasma generation. Plasma with helium could only reduce the number of inoculated pathogens by about 1-2 Log cycles. On the other hand, the helium/oxygen gas mixture was able to achieve microbial reduction of about 2-3 Log cycles. The number of total aerobic bacteria showed 1.89 and 4.58 decimal reductions after plasma treatment with helium and the helium/oxygen mixture, respectively. Microscopic observation of the bacon after plasma treatment did not find any significant changes, except that the L∗-value of the bacon surface was increased. These results clearly indicate that APP treatment is effective for the inactivation of the three pathogens used in this study, although further investigation is needed for elucidating quality changes after treatment.

Inactivation of Listeria monocytogenes on agar and processed meat surfaces by atmospheric pressure plasma jets.

An apparatus for generating atmospheric pressure plasma (APP) jet was used to investigate the inactivation of Listeria monocytogenes on the surface of agar plates and slices of cooked chicken breast and ham. He, N2 (both 7 L/min), and mixtures of each with O2 (0.07 L/min) were used to produce the plasma jets. After treatment for 2 min with APP jets of He, He + O2, N2, or N2 + O2, the numbers of L. monocytogenes on agar plates were reduced by 0.87, 4.19, 4.26, and 7.59 log units, respectively. Similar treatments reduced the L. monocytogenes inoculated onto sliced chicken breast and ham by 1.37 to 4.73 and 1.94 to 6.52 log units, respectively, according to the input gas used with the N2 + O2 mixture being the most effective. Most APP jets reduced the numbers of aerobic bacteria on the meat surfaces to <10² CFU/g, and the numbers remained below that level of detection after storage at 10 °C for 7 days. The results indicate that APP jets are effective for the inactivation of L. monocytogenes on sliced meats and for prolonging the shelf-life of such foods.

Surface plasma with an inkjet-printed patterned electrode for low-temperature applications.

The global health crisis caused by the recent pandemic has led to increasing social demand for 'new normal' sanitizing and disinfecting facilities to fit our 'new normal' lives. Here, we introduce an inkjet-printed, thin-film plasma source applicable to dry disinfection processes. In contrast to conventional plasma reactors, the merits of plasma produced on a film include disposability, cost-effectiveness, and applicability to high-dimensional objects such as the human body. The developed flexible plasma film can be applied to a wide variety of shapes via origami-remaining plasma stable even when bent. However, electrode degradation has been a practical issue in the long-term operation of inkjet-printed plasma sources, which is troublesome from application perspectives. We focus on making the inkjet-printed electrode more plasma stress-resistant, thereby increasing its lifespan from a few minutes to two hours of continuous operation with optimal inkjet printing and passivation, thus increasing the practicality of the source. Considering the fact that ozone and nitrogen oxides are selectively produced by plasma, we implement a disposable pouch-type plasma source and examine its usefulness in extending the shelf life of food.

Forced convective heating for low-temperature sterilization.

A novel impermeable sterile pouch is developed to allow the forced convective heating mechanism for improving the sterilization cycle. The heating process is parametrically investigated to obtain an optimized condition in which a sterilization load is heated from 20 to 45 °C within 2 min, and the forced convection is experimentally and numerically analyzed to find that the convection coefficient is dramatically increased to 450 W/m2 K when compared with the conventional natural convection coefficient of 80 W/m2 K. The optimized heating process is applied to a sterilization cycle using the impermeable pouch, and the overall sterilization cycle is found to be completed within 7.5 min whose performance is validated by using a process challenge device.