Identifying the origin and fate of dissolved U in the Boeun aquifer based on microbial signatures and C, O, Fe, S, and U isotopes.

The uranium inventory in the Boeun aquifer is situated near an artificial reservoir (40-70 m apart) intended to supply water to nearby cities. However, toxic radionuclides can enter the reservoir. To determine the U mobility in the system, we analyzed groundwater and fracture-filling materials (FFMs) for environmental tracers, including microbial signatures, redox-sensitive elements and isotopes. In the site, U mass flux ranged from only 9.59 × 10-7 µg/L/y to 1.70 × 10-4 µg/L/y. The δ18O-H2O and 14C signatures showed that groundwater originated mainly from upland recharges and was not influenced by oxic surface water. We observed U accumulations (∼157 mg/kg) in shallow FFMs and Fe enrichments (∼226798 mg/kg) and anomalies in the 230Th/238U activity ratio (AR), 230Th/234U AR, δ56Fe and δ57Fe isotopes, suggesting that low U mobility in shallow depths is associated with a Fe-rich environment. At shallow depths, anaerobic Fe-oxidizers, Gallionella was prevalent in the groundwater, while Acidovorax was abundant near the U ore deposit depth. The Fe-rich environment at shallow depths was formed by sulfide dissolution, as demonstrated by δ34S-SO4 and δ18O-SO4 distribution. Overall, the Fe-rich aquifer including abundant sulfide minerals immobilizes dissolved U through biotic and abiotic processes, without significant leaching into nearby reservoirs.

Integrative Magneto-Microfluidic Separation of Immune Cells Facilitates Clinical Functional Assays.

Accurately analyzing the functional activities of natural killer (NK) cells in clinical diagnosis remains challenging due to their coupling with other immune effectors. To address this, an integrated immune cell separator is required, which necessitates a streamlined sample preparation workflow including immunological cell isolation, removal of excess red blood cells (RBCs), and buffer exchange for downstream analysis. Here, a self-powered integrated magneto-microfluidic cell separation (SMS) chip is presented, which outputs high-purity target immune cells by simply inputting whole blood. The SMS chip intensifies the magnetic field gradient using an iron sphere-filled inlet reservoir for high-performance immuno-magnetic cell selection and separates target cells size-selectively using a microfluidic lattice for RBC removal and buffer exchange. In addition, the chip incorporates self-powered microfluidic pumping through a degassed polydimethylsiloxane chip, enabling the rapid isolation of NK cells at the place of blood collection within 40 min. This chip is used to isolate NK cells from whole blood samples of hepatocellular cancer patients and healthy volunteers and examined their functional activities to identify potential abnormalities in NK cell function. The SMS chip is simple to use, rapid to sort, and requires small blood volumes, thus facilitating the use of immune cell subtypes for cell-based diagnosis.

Facet Connectivity-Based Estimation Algorithm for Manufacturability of Supportless Parts Fabricated via LPBF.

Recent advances in additive manufacturing have provided more freedom in the design of metal parts; hence, the prototyping of fluid machines featuring extremely complex geometries has been investigated extensively. The fabrication of fluid machines via additive manufacturing requires significant attention to part stability; however, studies that predict regions with a high risk of collapse are few. Therefore, a novel algorithm that can detect collapse regions precisely is proposed herein. The algorithm reflects the support span over the faceted surface via propagation and invalidates overestimated collapse regions based on the overhang angle. A heat exchanger model with an extremely complex internal space is adopted to validate the algorithm. Three samples from the model are extracted and their prototypes are fabricated via laser powder bed fusion. The results yielded by the fabricated samples and algorithm with respect to the sample domain are compared. Regions of visible collapse identified on the surface of the fabricated samples are predicted precisely by the algorithm. Thus, the supporting span reflected by the algorithm provides an extremely precise prediction of collapse.

Comparison of Surgical Outcomes between Trabeculectomy with Mitomycin C and Ahmed Valve Implantation with Mitomycin C in Eyes with Uveitic Glaucoma.

We compared 1-year outcomes of trabeculectomy with mitomycin C (MMC) and Ahmed valve implantation with MMC as a first surgical procedure in patients with uveitic glaucoma. A total 38 eyes of 38 patients undergoing trabeculectomy (n =16) or Ahmed valve implantation (n = 22) were included. Surgical success was defined as intraocular pressure (IOP) ≤21 mmHg, IOP reduction ≥20% from baseline, no secondary glaucoma surgery, and no loss of light perception. The main outcome measurements including success rate, IOP, and the number of antiglaucoma medications and complications were compared. The overall success rates were comparable between the Ahmed and trabeculectomy groups (81.3 vs. 81.8%, p = 0.987). The mean IOPs were similar as well (p = 0.084), though the number of antiglaucoma medications was significantly lower in the trabeculectomy group than in the Ahmed group (1.0 ± 1.2 vs. 2.2 ± 1.1; p = 0.005). A statistically significant reduction in corneal endothelial cell density was noted in the Ahmed group (p = 0.004). Both treatments offered reasonable IOP control and safety for eyes with uveitic glaucoma. However, significantly fewer antiglaucoma medications were used in the trabeculectomy group. Furthermore, our results suggest that cautious postoperative monitoring with regard to corneal endothelial cell density should be additionally performed after Ahmed valve implantation.

Immobile crystallization of radioactive iodide by redox transformation of a low crystalline copper phase.

Here we show an innovative way to effectively scavenge highly mobile radioiodide and to dramatically reduce its waste volume through a spontaneous phase transformation. Under an anaerobic condition, as metallic copper (II) was favorably associated with bicarbonate (HCO3-) in solution, a cupriferous carbonate compound (malachite) quickly formed, which was redox-sensitive and transformable to a compact crystal of CuI (marshite). The formation of CuI crystal was principally led by the spontaneous Cu-I redox reaction centering around the copper phase over the presence of sulfate (SO42-). The completely transformed CuI crystal was poorly soluble in water and grew to large microcrystals (∼µm) via a remarkable selectivity for I-. Interestingly, this redox-induced iodide crystallization was rather promoted over the existence of anionic competitors (e.g., HCO3- and SO42-), which usually exist in wastewater and natural water. Unlike the conventional methods, these competing anions positively behaved in our system by supporting that the initial malachite was more apt to be reactive to largely attract highly mobile I-. Under practical environments with various anions, such a selective I- uptake and fixation within a compact crystalline space will be a promising way to effectively remove I- in a great capacity.

Comparative study of machine learning models for evaluating groundwater vulnerability to nitrate contamination.

The accurate evaluation of groundwater contamination vulnerability is essential for the management and prevention of groundwater contamination in the watershed. In this study, advanced multiple machine learning (ML) models of Radial Basis Neural Networks (RBNN), Support Vector Regression (SVR), and ensemble Random Forest Regression (RFR) were applied to determine the most accurate performance for the evaluation of groundwater contamination vulnerability. Eight vulnerability factors of DRASTIC-L were rated based on the modified DRASTIC model (MDM) and were used as input data. The adjusted vulnerability index (AVI) with nitrate values was used as output data for the modeling process. The performance of three models was verified using the statistical performance criteria of MAE, RMSE, r2, and ROC/AUC values. The ensemble RFR model showed the highest performance in comparison with standalone SVR and RBNN models. Specifically, ensemble RFR kept all promising solutions during the model performance due to its flexibility and robustness, and the vulnerability map obtained by the RFR model was more accurate for predicting the most vulnerable areas to contamination. It was concluded that ensemble RFR was a robust tool to enhance the evaluation of groundwater contamination vulnerability, and that it could contribute to environmental safety against groundwater contamination.

Review of the Effects of Supplementary Cementitious Materials and Chemical Additives on the Physical, Mechanical and Durability Properties of Hydraulic Concrete.

Supplementary cementitious materials (SCMs) and chemical additives (CA) are incorporated to modify the properties of concrete. In this paper, SCMs such as fly ash (FA), ground granulated blast furnace slag (GGBS), silica fume (SF), rice husk ash (RHA), sugarcane bagasse ash (SBA), and tire-derived fuel ash (TDFA) admixed concretes are reviewed. FA (25-30%), GGBS (50-55%), RHA (15-20%), and SBA (15%) are safely used to replace Portland cement. FA requires activation, while GGBS has undergone in situ activation, with other alkalis present in it. The reactive silica in RHA and SBA readily reacts with free Ca(OH)2 in cement matrix, which produces the secondary C-S-H gel and gives strength to the concrete. SF addition involves both physical contribution and chemical action in concrete. TDFA contains 25-30% SiO2 and 30-35% CaO, and is considered a suitable secondary pozzolanic material. In this review, special emphasis is given to the various chemical additives and their role in protecting rebar from corrosion. Specialized concrete for novel applications, namely self-curing, self-healing, superhydrophobic, electromagnetic (EM) wave shielding and self-temperature adjusting concretes, are also discussed.

Anomalous extraocular muscles in Crouzon syndrome with V-pattern exotropia.

Strabismus associated with Crouzon syndrome is common and often complex. V-pattern strabismus is most commonly reported in this condition and is mainly thought to be due to an excyclorotation of the orbits and rectus muscle pulleys. We report two cases of children with Crouzon syndrome and V-pattern exotropia who had rectus muscle heterotopy on orbital imaging and were also found intraoperatively to have anomalous extraocular muscles. At the time of surgery, bifid insertion, misdirection, and fibrosis of extraocular muscles were noted. This highlights the various causes of V-pattern strabismus associated with Crouzon syndrome, including dysmorphic orbits and extraocular muscle anomalies.

Hyperreflective foci in diabetic macular edema with serous retinal detachment: association with dyslipidemia.

AIMS: Hyperreflective foci (HF), detected in the retina of diabetic patients, suggest the presence of microglial activation and migration, while controversies still remain for the origin of HF to be precursors of hard exudates. We investigated the presence of HF and their association with dyslipidemia in serous retinal detachment (SRD)-type diabetic macular edema (DME). METHODS: Forty-two eyes in 42 patients with diabetic retinopathy (DR) and 22 eyes in 22 patients with branch retinal vascular occlusion (BRVO) showing macular edema were included in this study. The medical records and OCT findings were retrospectively reviewed in patients with SRD-type DME and compared with those with BRVO. The mean number of HF, the mean choroidal thickness, and lipid profiles were analyzed and compared between groups. RESULTS: The mean number of HF was significantly higher in DR group compared to BRVO group. Significant correlation of HF was noted with triglycerides (r = 0.523, P = 0.002). Triglycerides were significantly associated with HF by linear regression (ß = 0.012, 95% CI 0.001-0.024, P = 0.034) and remained significantly associated by multiple linear regression (ß = 0.014, 95% CI 0.003-0.025, P = 0.014). CONCLUSIONS: HF on OCT of DME patients could be indicative of activated microglia. HF are associated with dyslipidemia, especially high triglycerides, suggesting inflammatory reaction from dyslipidemia in diabetic retina.

Studies of aqueous U(iv) equilibrium and nanoparticle formation kinetics using spectrophotometric reaction modeling analysis.

Hydrolysis of tetravalent uranium (U(iv)) and U(iv)-nanoparticle formation kinetics were examined over a wide range of temperatures using spectrophotometric reaction modeling analysis. The characteristic absorption bands representing U4+, U(OH)3+, and a proposed oxohydroxo species were newly identified in the UV region (190-300 nm). Dynamic absorption band changes in the UV and visible regions (360-800 nm) were explored to reevaluate the binary ion interaction coefficients for U(iv) ions and the thermodynamic constants of the primary hydrolysis reaction, including complexation constants, enthalpy, and entropy. No further hydrolysis equilibrium beyond the formation of U(OH)3+ was identified. Instead, an irreversible transformation of U(iv) ions to U(iv)-nanoparticles (NPs) was found to occur exclusively via the formation of a new intermediate species possessing characteristic absorption bands. The kinetic analysis, based on a two-step, pseudo-first-order reaction model, revealed that the rate of the initial step producing the intermediates is highly temperature-dependent with the measured kinetic energy barrier of ∼188 kJ mol-1. With additional experimental evidence, we conclude that the intermediates are oligomeric oxohydroxo U(iv) species occurring from the condensation of U(iv) ions and simultaneously participating in the nucleation and growth process of UO2(cr)-NPs.

Does Combining a Suprascapular Nerve Block With an Intra-articular Corticosteroid Injection Have an Additive Effect in the Treatment of Adhesive Capsulitis? A Comparison of Functional Outcomes After Short-term and Minimum 1-Year Follow-up.

BACKGROUND: No therapeutic intervention is universally accepted as the most effective treatment for adhesive capsulitis. An intra-articular corticosteroid injection (IAI) with a suprascapular nerve block (SSNB), a common treatment for this disease, is a safe and effective method for the resolution of pain and restoration of shoulder range of motion (ROM). PURPOSE: To compare the efficacy of combined SSNB and IAI with that of IAI alone in the treatment of adhesive capsulitis. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We performed a retrospective review of 102 patients with adhesive capsulitis who were treated at an outpatient clinic from July 2016 to January 2017. A combined SSNB with IAI was performed in 48 patients (SSNB + IAI group), and an IAI alone was performed in 54 patients (IAI group). Patients were assessed before the intervention and at 2 weeks and 2 months after the intervention. ROM and pain and function visual analog scales (PVAS and FVAS, respectively), the American Shoulder and Elbow Surgeons (ASES) score, the Korean Shoulder Scoring System (KSS), the Constant score, the Simple Shoulder Test (SST), and the Shoulder Pain and Disability Index (SPADI) were used for clinical assessments. PVAS, FVAS, and ASES scores at a minimum of 1 year after the intervention were assessed for 82 patients. RESULTS: At the 2-month assessment, all parameters significantly improved in both the SSNB + IAI and IAI groups (P < .05), however, improvements in forward flexion (FF) and abduction (ABD) between the 2-week and 2-month assessments were better in the SSNB + IAI group. At the 2-month assessment, improvements in the FVAS, ASES, SST, and SPADI scores and FF and ABD values were statistically significantly greater in the SSNB + IAI group compared with the IAI group. Improvements in FVAS and ASES scores were significantly greater in the SSNB + IAI group at a minimum of 1 year. CONCLUSION: Both a combined SSNB and IAI and an IAI alone significantly improved pain and functional outcomes in patients with adhesive capsulitis. The use of an SSNB with an IAI further increased treatment efficacy, as per the FVAS, ASES, SST, and SPADI scores and FF and ABD values. Patients who underwent SSNB combined with an IAI showed better improvements in the FVAS and ASES scores compared with IAI alone at a minimum of 1 year after the intervention. Therefore, an SSNB combined with an IAI may be a good treatment choice for adhesive capsulitis.

Insights into the pathogenesis of cystoid macular edema: leukostasis and related cytokines.

Cystoid macular edema (CME) is the abnormal collection of intraretinal fluid in the macular region, especially in the inner nuclear and outer plexiform layers. CME leads to severe visual impairment in patients with various retinal diseases, such as diabetic retinopathy, retinal vascular occlusion, choroidal neovascularization, and uveitis. Although various retinal conditions lead to CME, a shared pathogenesis of CME is involved in these diseases. Accordingly, the pathogenesis of CME based on vasogenic mechanisms is first discussed in this review, including vascular hyperpermeability, leukostasis, and inflammation. We then describe cytotoxic mechanisms based on retinal Müller cell dysfunction. This comprehensive review will provide an understanding of the pathogenesis of CME for potential therapeutic strategies.

Choroidal Thickness Indicates Subclinical Ocular and Systemic Inflammation in Eyes with Behçet Disease without Active Inflammation.

PURPOSE: To investigate whether subfoveal choroidal thickness, measured using enhanced depth imaging optical coherence tomography (EDI-OCT), is an indicator of subclinical ocular or systemic inflammation in eyes with Behçet disease (BD) without active ocular inflammation. METHODS: A retrospective analysis was used to examine clinical features of non-uveitic patients with BD (NUBD group), patients with a previous history of Behçet uveitis in an inactive state (IUBD group), and healthy controls were evaluated from October 2014 to September 2015. Subfoveal choroidal thickness was measured using EDI-OCT. RESULTS: The NUBD group included 46 eyes in 24 patients; the IUBD group included 16 eyes in 11 patients; and the control group included 35 eyes in 23 individuals. The mean subfoveal choroidal thicknesses differed significantly among these groups. Choroidal thickness was significantly greater in the NUBD (310.5 ± 81.0 µm) than in the IUBD (263.1 ± 56.6 µm, p = 0.013) and control (256.9 ± 67.9 µm, p = 0.002) groups. The disease activity score was significantly higher in the NUBD than in the IUBD group (p < 0.001), while the use of cyclosporine was significantly associated with choroidal thickness in eyes with NUBD (p = 0.039). CONCLUSIONS: Subfoveal choroidal thickness, as measured by EDI-OCT, may be a clinical indicator of subclinical ocular inflammation and systemic inflammation in BD patients without active ocular inflammation.

Factors controlling groundwater quality in the Yeonjegu District of Busan City, Korea, using the hydrogeochemical processes and fuzzy GIS.

The hydrogeochemical processes and fuzzy GIS techniques were used to evaluate the groundwater quality in the Yeonjegu district of Busan Metropolitan City, Korea. The highest concentrations of major ions were mainly related to the local geology. The seawater intrusion into the river water and municipal contaminants were secondary contamination sources of groundwater in the study area. Factor analysis represented the contamination sources of the mineral dissolution of the host rocks and domestic influences. The Gibbs plot exhibited that the major ions were derived from the rock weathering condition. Piper's trilinear diagram showed that the groundwater quality was classified into five types of CaHCO3, NaHCO3, NaCl, CaCl2, and CaSO4 types in that order. The ionic relationship and the saturation mineral index of the ions indicated that the evaporation, dissolution, and precipitation processes controlled the groundwater chemistry. The fuzzy GIS map showed that highly contaminated groundwater occurred in the northeastern and the central parts and that the groundwater of medium quality appeared in most parts of the study area. It suggested that the groundwater quality of the study area was influenced by local geology, seawater intrusion, and municipal contaminants. This research clearly demonstrated that the geochemical analyses and fuzzy GIS method were very useful to identify the contaminant sources and the location of good groundwater quality.

Microbial copper reduction method to scavenge anthropogenic radioiodine.

Unexpected reactor accidents and radioisotope production and consumption have led to a continuous increase in the global-scale contamination of radionuclides. In particular, anthropogenic radioiodine has become critical due to its highly volatile mobilization and recycling in global environments, resulting in widespread, negative impact on nature. We report a novel biostimulant method to effectively scavenge radioiodine that exhibits remarkable selectivity for the highly difficult-to-capture radioiodine of >500-fold over other anions, even under circumneutral pH. We discovered a useful mechanism by which microbially reducible copper (i.e., Cu(2+) to Cu(+)) acts as a strong binder for iodide-iodide anions to form a crystalline halide salt of CuI that is highly insoluble in wastewater. The biocatalytic crystallization of radioiodine is a promising way to remove radioiodine in a great capacity with robust growth momentum, further ensuring its long-term stability through nuclear I(-) fixation via microcrystal formation.

ß-lapachone suppresses the proliferation of human malignant melanoma cells by targeting specificity protein 1.

ß-lapachone (ß-lap), a novel natural quinone derived from the bark of the Pink trumpet tree (Tabebuia avellanedae) has been demonstrated to have anticancer activity. In this study, we investigated whether ß-lap exhibits anti-proliferative effects on two human malignant melanoma (HMM) cell lines, G361 and SK-MEL-28. The effects of ß-lap on the HMM cell lines were investigated using 3-(4,5-dimethylthiazol-2-yl)­5-(3-carboxymethoxyphenyl)­2-(4-sulfophenyl-2H-tetrazolium (MTS) assay, 4',6-diamidino-2-phenylindole (DAPI) staining, Annexin V and Dead cell assay, mitochondrial membrane potential (MMP) assay and western blot analysis. We demonstrated that ß-lap significantly induced apoptosis and suppressed cell viability in the HMM cells. Intriguingly, the transcription factor specificity protein 1 (Sp1) was significantly downregulated by ß-lap in a dose- and time-dependent manner. Furthermore, ß-lap modulated the protein expression level of the Sp1 regulatory genes including cell cycle regulatory proteins and apoptosis-associated proteins. Taken together, our findings indicated that ß-lap modulates Sp1 transactivation and induces apoptotic cell death through the regulation of cell cycle- and apoptosis-associated proteins. Thus, ß-lap may be used as a promising anticancer drug for cancer prevention and may improve the clinical outcome of patients with cancer.

Esculetin Induces Apoptosis Through EGFR/PI3K/Akt Signaling Pathway and Nucleophosmin Relocalization.

Esculetin, a coumarin compound, has anti-proliferative effects on various types of human cancer cells, but its effect on oral squamous cell carcinoma (OSCC) is unknown. In this study, we determined whether esculetin had anti-proliferative effects on two oral squamous cell lines, HN22, and HSC2. We found that esculetin inhibited cell viability by inducing apoptosis, as evinced by apoptotic cell morphologies, nuclear fragmentation, and the multi-caspase/MMP activity. Furthermore, proteomic analysis was used to identify the target-specific proteins involved in esculetin treatment. Intriguingly, apoptotic cell death by esculetin was associated with significant inhibition of the EGFR/PI3K/Akt signaling pathway. We also demonstrated that the expression of nucleophosmin (NPM) markedly decreased after esculetin treatment, and relocalization of NPM from the nucleous to the cytoplasm, together with p65, potentiated apoptotic stimulation. Additionally, our data indicated that NPM expression was markedly higher in OSCC tissues than in normal tissues. Our results collectively indicated that esculetin inhibited the proliferation of OSCC through EGFR-mediated signaling pathways and down-regulation of NPM as well as the perturbation of NPM trafficking from the nucleolus to the cytoplasm resulted in apoptosis.

Lumbar Stenosis: A Recent Update by Review of Literature.

Degeneration of the intervertebral disc results in initial relative instability, hypermobility, and hypertrophy of the facet joints, particularly at the superior articular process. This finally leads to a reduction of the spinal canal dimensions and compression of the neural elements, which can result in neurogenic intermittent claudication caused by venous congestion and arterial hypertension around nerve roots. Most patients with symptomatic lumbar stenosis had neurogenic intermittent claudication with the risk of a fall. However, although the physical findings and clinical symptoms in lumbar stenosis are not acute, the radiographic findings are comparatively severe. Magnetic resonance imaging is a noninvasive and good method for evaluation of lumbar stenosis. Though there are very few studies pertaining to the natural progression of lumbar spinal stenosis, symptoms of spinal stenosis usually respond favorably to non-operative management. In patients who fail to respond to non-operative management, surgical treatments such as decompression or decompression with spinal fusion are required. Restoration of a normal pelvic tilt after lumbar fusion correlates to a good clinical outcome.

Relationship between modic changes and facet joint degeneration in the cervical spine.

PURPOSE: Given that the disc moves simultaneously with facet joints, there would be a relationship between Modic changes and facet joint degeneration in the cervical spine. However, there is no literature investigating the relationship. The purpose is to evaluate the relationship between Modic changes and facet joint degeneration in the cervical spine. METHODS: Ninety-eight patients underwent both computed tomography (CT) and magnetic resonance images (MRI) of the cervical spine. They consisted of fifty-one males and forty-eight females and their mean age was 60.1 years (ranged from 40 years to 81 years). We compared the degree of facet joint degeneration based on CTs with Modic changes based on MRIs from C2-C3 to C6-C7. The degree of facet joint degeneration was classified into four categories and Modic changes were classified into four types. Disc degeneration was determined with Miyazaki's grading system. RESULTS: Facet joint degeneration was most common at C2-C3 and C4-C5 and rarest at C6-C7. Modic changes were most common at C2-C3 and rarest at C6-C7. However, there was no relationship between facet joint degeneration and any Modic changes at the same level. However, the presence of facet joint degeneration and the presence of Modic change are common in high grades of disc degeneration at the same level of the cervical spine. CONCLUSION: Modic changes and facet joint degeneration are most common at C2-C3 in the cervical spine. However, there were no relationships between the presence of Modic changes and facet joint degeneration at the same level of the cervical spine.

Panax ginseng aqueous extract prevents pneumococcal sepsis in vivo by potentiating cell survival and diminishing inflammation.

BACKGROUND: More than 50% of sepsis cases are caused by Streptococcus pneumoniae, and hospital mortality related to sepsis comprises 52% of all hospital deaths. Therefore, sepsis is a medical emergency, and any treatment against the agent that produces it, is welcome. PURPOSE: The role of Panax ginseng C.A. Meyer (Araliaceae) aqueous extract in bacterial infection in vivo is not well understood. Here, the protective effect of Korean red ginseng (KRG) extract against pneumococcal infection and sepsis was elucidated. STUDY DESIGN: In this study, mice were administrated KRG (25, 50, 100 mg/kg) for 15 days, and then infected with a lethal S. pneumoniae strain. Survival rate, body weight, and colonization were determined. METHODS: The RAW 264.7 macrophage cells were infected with S. pneumoniae and cell viability was assessed using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Inflammation was examined using an enzyme-linked immunosorbent assay (ELISA) and hematoxylin and eosin (HE) staining while gene expression was determined using western blotting. RESULTS: KRG-pre-treated mice (100 mg/kg of KRG) had significantly higher survival rates and body weights than those of the non-treated controls; KRG-pre-treated mice had lower bacterial number and morbidity than those of the non-treated controls. 100 mg/kg of KRG administration decreased cytokine levels including tumor necrosis factor (TNF)-α (897 and 623 pg/ml, control and KRG groups, respectively, P < 0.05) and interleukin (IL)-1ß (175 and 127 pg/ml, control and KRG groups, respectively, P = 0.051), nitric oxide level (149 and 81 nM, control and KRG groups, respectively, P < 0.05), and neutrophil infiltration 48 h post-infection, in vivo. In pneumococcal infection, KRG pre-treatment downregulated toll-like receptor (TLR) 4 and TNF-ɑ expressions in RAW 264.7 macrophage cells and increased cell survival by activating phosphoinositide 3-kinase (PI3K)/AKT signaling. CONCLUSION: Taken together, 100 mg/kg of KRG appeared to protect host cells from lethal pneumococcal sepsis by inhibiting inflammation as well as by enhancing bacterial clearance thereby reinforcing cell survival against pneumococcal infection.