Systematic review and meta-analysis of cardiac neurosis for development of clinical practice guidelines of Korean medicine.

Background: The development of clinical practice guidelines in traditional medicine requires evidence that sufficiently reflects the medical field. Cardiac neurosis is a disease that occurs because of problems in the autonomic nervous system and is characterized by symptoms of the circulatory system that are representative of autonomic dysfunction. In traditional medicine, the heart is considered to be involved in mental health problems, and cardiac neurosis is accompanied by a variety of mental symptoms. Furthermore, there is a categorized diagnosis for cardiac neurosis, and active empirical research is being conducted in China. Objective: This study aimed to systematically review and quantitatively synthesize the effects of Korean medicine treatments in patients with cardiac neurosis to develop evidence-based clinical practice guidelines for the treatment of autonomic dysfunction. Methods: Nine databases were searched for articles published before September 13, 2022. The methodological quality of the studies was assessed using the RoB tool. The primary outcomes were somatization, depression, anxiety, and effectiveness rate. The secondary outcome was the rate of adverse effects. Results: Based on a systematic literature review, 151 randomized controlled trials were selected and analyzed. For patients with cardiac neurosis, herbal medicine, combined treatment of herbal medicine and Western medicine, combined treatment of herbal medicine and acupuncture, acupuncture, and combined treatment of acupuncture and Western medicine showed better overall effects than Western medicine alone. Furthermore, the combined treatment of herbal medicine and psychotherapy and that of herbal medicine, psychotherapy, and Western medicine showed an overall better effect than the combined treatment of Western medicine and psychotherapy. Conclusion: A meta-analysis of articles revealed the effectiveness of Korean medicine treatments and verified the effectiveness of a Korean medicine treatment alone, Korean medicine combined treatment, and combined treatment of Korean medicine and Western medicine on cardiac neurosis. Limitations included the inability to verify the cause of high heterogeneity between studies and the poor quality of the included studies. Nevertheless, this systematic review and meta-analysis of cardiac neurosis showed that the disease concept of traditional medicine can also be organized based on the latest research. Future research related to traditional diseases such as these should be conducted. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022347992, identifier CRD42022347992.

Mercury distribution characteristics in primary manganese smelting plants.

The mercury (Hg) distribution characteristics were investigated in three primary manganese smelting plants in Korea for the assessment of anthropogenic Hg released. Input and output materials were sampled from each process, and Hg concentrations in the samples were analyzed. Among the input materials, the most mercury was found in the manganese ore (83.1-99.7%) and mercury was mainly released through fly ash or off gas, depending on the condition of off gas cleaning system. As off gas temperature decreases, proportion and concentration of emitted gaseous elemental mercury (Hg0) in off gas decreases. Based on mass balance study from these three plants and national manganese production data, the total amount of mercury released from those Korean plants was estimated to 644 kg/yr. About half of it was emitted into the air while the rest was released to waste as fly ash. With the results of this investigation, national inventory for Hg emission and release could be updated for the response to Minamata Convention on Mercury.

Emission of bisphenol analogues including bisphenol A and bisphenol F from wastewater treatment plants in Korea.

Due to the regulation on bisphenol A (BPA) in several industrialized countries, the demand for other bisphenol analogues (BPs) as substitutes for BPA is growing. Eight BPs were determined in sludge from 40 representative wastewater treatment plants (WWTPs) in Korea. Total concentrations of BPs (ΣBP) in sludge ranged from

A nationwide survey and emission estimates of cyclic and linear siloxanes through sludge from wastewater treatment plants in Korea.

Siloxanes are widely used in various industrial applications as well as in personal care products. Despite their widespread use and potential toxic effects, few studies have reported on the occurrence of siloxanes in the environment. In this study, we determined the concentrations of 5 cyclic and 15 linear siloxanes in sludge collected from 40 representative wastewater treatment plants (WWTPs) in Korea. Total concentrations of 20 siloxanes (Σsiloxane) in sludge ranged from 0.05 to 142 (mean: 45.7) µg/g dry weight, similar to the concentrations reported in European countries but higher than those reported in China. The concentrations of siloxanes in sludge from domestic WWTPs were significantly (p<0.01) higher than those from industrial WWTPs, indicating higher consumption of siloxanes in various personal care products (e.g. shampoos and conditioners). The major siloxane compounds found in sludge were decamethylcyclopentasilane (D5), docosamethyldecasiloxane (L10) and dodecamethylcyclohexasilane (D6), which collectively accounted for, on average, 62% of the Σsiloxane concentrations. Non-parametric multidimensional scaling ordination of the profiles of siloxanes indicated the existence of different usage patterns of siloxanes between industrial and household activities. Multiple linear regression analysis of siloxane concentrations and WWTP characteristics suggested that D5, D6 and linear siloxane concentrations in sludge were positively correlated with population served by a WWTP. Environmental emission fluxes of cyclic and linear siloxanes through sludge disposal in Korea were 14,800 and 18,500 kg/year, respectively. This is the first report describing occurrence and environmental emission of siloxanes through sludge in Korea.

Occurrence of PBDEs and other alternative brominated flame retardants in sludge from wastewater treatment plants in Korea.

Studies on the occurrence of polybrominated diphenyl ethers (PBDEs) and other alternative brominated flame retardants in the environment are scarce. In this study, PBDEs and non-PBDE brominated flame retardants (NBFRs), including decabromodiphenyl ethane (DBDPE) and 1,2-bis(2,4,6-tribromophenoxy)ethane (BTBPE), were measured in sludge collected from three types of wastewater treatment plants (WWTPs) in Korea. Total concentrations of PBDEs (∑PBDE) in sludge ranged from 298 to 48,000 (mean: 3240) ng/g dry weight. Among 10 NBFRs analyzed, DBDPE and BTBPE were the only ones detected in sludge samples. Concentrations of DBDPE and BTBPE ranged from 1) of DBDPE/BDE 209 were found in sludge from I-WWTPs, reflecting a shift in the usage pattern of BFRs by the Korean industry. The nationwide annual emission fluxes of ∑PBDE, DBDPE and BTBPE via WWTPs to the environment were estimated to be 7400, 480, and 3.7 kg/year, respectively. This is the first study on the occurrence of alternative brominated flame retardants in sludge from Korea.

Enrichment of PCDDs/PCDFs in peripheral utilities of the municipal solid waste incineration facility.

This study was performed to suggest the improvements through measuring the amounts of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs), re-synthesized in peripheral utilities (PUs) of a commercial-scale municipal solid waste incineration facility (MSWIF) where a few research results existed. The PUs examined in this study consisted of air pre-heaters (APHs) and gas/gas re-heater (GGRH) and kerosene-fired duct burner for selective catalytic reduction (SCR) process. PCDDs/PCDFs in flue gas were simultaneously measured at the inlet and outlet of PUs. Flue gas was cooled down from 380 °C to 249 °C by exchanging the heat with fresh air in APHs, and then heated up to 383 °C by GGRH and duct burner from 164 °C at the outlet of bag filter. The results showed that PCDDs/PCDFs were 3-4 times higher within this temperature range of PUs. In comparison of PCDDs/PCDFs concentrations at the inlet with those at the outlet of PUs, particulate-phase PCDDs/PCDFs were about 9.5-10 times enriched while gaseous-phase ones were decreased by about 33-41%. The PCDDs/PCDFs re-synthesized in the PUs, where PCDDs were relatively higher than PCDFs, showed somewhat different patterns compared to those formed at incinerators and emitted at stack. Through the investigations for PUs, we conclude that the PUs used in MSWIFs was a potential source for de novo synthesis of PCDDs/PCDFs.

Characteristics of gas and residues produced from electric arc pyrolysis of waste lubricating oil.

An attempt has been made to recover high-calorific fuel gas and useful carbonaceous residue by the electric arc pyrolysis of waste lubricating oil. The characteristics of gas and residues produced from electric arc pyrolysis of waste lubricating oil were investigated in this study. The produced gas was mainly composed of hydrogen (35-40%), acetylene (13-20%), ethylene (3-4%) and other hydrocarbons, whereas the concentration of CO was very low. Calorific values of gas ranged from 11,000 to 13,000 kcal kg(-1) and the concentrations of toxic gases, such as NO(x), HCl and HF, were below the regulatory emissions limit. Gas chromatography-mass spectrometry (GC/MS) analysis of liquid-phase residues showed that high molecular-weight hydrocarbons in waste lubricating oil were pyrolyzed into low molecular-weight hydrocarbons and hydrogen. Dehydrogenation was found to be the main pyrolysis mechanism due to the high reaction temperature induced by electric arc. The average particle size of soot as carbonaceous residue was about 10 microm. The carbon content and heavy metals in soot were above 60% and below 0.01 ppm, respectively. The utilization of soot as industrial material resources such as carbon black seems to be feasible after refining and grinding.

Dechlorination and destruction of PCDDs/PCDFs in fly ashes from municipal solid waste incinerators by low temperature thermal treatment.

Dechlorination and destruction characteristics of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDDs/PCDFs) in fly ashes from commercial-scale municipal solid waste incinerators by low temperature thermal treatment using a laboratory-scale heating system were investigated. Experiments were carried out in reducing atmosphere at temperatures of 300 degrees C, 450 degrees C and 600 degrees C respectively, for the treatment time of 1h and 3h. Concentrations of PCDDs/PCDFs in raw fly ashes ranged from 35.5 to 107.3 microg kg(-1) (1.5-3.4 microg TEQ kg(-1)) and treated fly ashes ranged from 0.34 to 45.3 microg kg(-1) (0.012-1.63 microg TEQ kg(-1)). Concentrations of PCDDs/PCDFs in fly ashes treated at the different temperatures and times were observed to decrease with increase of treatment temperature and time by dechlorination or destruction. The distribution of octa- and hepta-chlorinated congeners were decreased and tetra-, penta- and hexa-chlorinated congeners were increased at 300 degrees C and 450 degrees C, but the distribution of octa- and hepta-chlorinated congeners were increased and tetra-, penta- and hexa-chlorinated congeners were again decreased at 600 degrees C. Total destruction efficiencies of PCDDs/PCDFs in fly ashes showed above 95% at the treatment temperature of 450 degrees C for 3h. However, removal efficiency of each congener in fly ashes varied, especially, 2,3,7,8-TeCDD and 1,2,3,7,8-PeCDD in fly ash A increased. And the dechlorination and destruction characteristics of PCDDs/PCDFs in fly ash A and B was different due to difference in contents of Ca-compounds and metal oxides such as CuO and PbO in fly ashes.

Enrichment of PCDDs/PCDFs in the cooling system of municipal solid waste incineration plants.

This study measured the levels of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDDs/PCDFs), destroyed or formed in combustors and re-synthesized in cooling systems. For the proper control of PCDDs/PCDFs in municipal solid waste (MSW) incinerators, three grate-type MSW incinerators were selected, two of which had boilers, and one of which had a water spray tower (WST) as a cooling system. At the combustor outlets, dusts were in the range of 1640-4270 mg/Sm3 and PCDDs/PCDFs were in the range of 0.103-2.619 ng-TEQ/Sm3, showing the different values according to the grate structure of combustor and the flow direction of flue gas. After the flue gases passed through the cooling system, PCDDs/PCDFs at the waste heat boiler (WHB) outlets were enriched to levels that were 10.8-13.6 times higher than those at the furnace outlets, but PCDDs/PCDFs at the WST outlet was reduced to 5% of the level found at the furnace outlet. The emission patterns, such as the ratio of PCDFs to PCDDs, the ratio of gaseous-phase to particulate-phase PCDDs/PCDFs, and the compositional percentiles of each 2,3,7,8-substituted congener varied according to the types of air pollution control devices (APCDs). Reducing re-synthesis in the cooling system rather than enhancing the removal efficiencies of the APCDs seems to be more effective for lowering the levels of PCDDs/PCDFs in MSW incineration plants.

Characteristics of ashes from different locations at the MSW incinerator equipped with various air pollution control devices.

The characteristics of ashes from different locations at a municipal solid waste incinerator (MSWI) equipped with a water spray tower (WST) as a cooling system, and a spray dryer adsorber (SDA), a bag filter (BF) and a selective catalytic reactor (SCR) as air pollution control devices (APCD) was investigated to provide the basic data for further treatment of ashes. A commercial MSWI with a capacity of 100 tons per day was selected. Ash was sampled from different locations during the normal operation of the MSWI and was analyzed to obtain chemical composition, basicity, metal contents and leaching behavior of heavy metals. Basicity and pH of ash showed a broad range between 0.08-9.07 and 3.5-12.3, respectively. Some major inorganics in ash were identified and could affect the basicity. This could be one of the factors to determine further treatment means. Partitioning of hazardous heavy metals such as Pb, Cu, Cr, Hg and Cd was investigated. Large portions of Hg and Cd were emitted from the furnace while over 90% of Pb, Cu and Cr remained in bottom ash. However 54% of Hg was captured by WST and 41% by SDA/BF and 3.6% was emitted through the stack, while 81.5% of Cd was captured by SDA/BF. From the analysis data of various metal contents in ash and leach analysis, such capturing of metal was confirmed and some heavy metals found to be easily released from ash. Based on the overall characteristics of ash in different locations at the MSWI during the investigation, some considerations and suggestions for determining the appropriate treatment methods of ash were made as conclusions.