Prospective Evaluation of Terminal Ileitis in a Surveillance Population of Patients with Ulcerative Colitis.

BACKGROUND: Ulcerative colitis (UC) is a disease that is normally limited to involvement of the colon. Terminal ileitis in patients with UC with only inactive or mildly active disease has never been investigated. The aim of this prospective study was to determine the prevalence and significance of ileitis among patients with UC enrolled in an endoscopic surveillance program. METHODS: The study consisted of 72 patients with UC and 90 healthy controls who underwent surveillance and screening colonoscopy, respectively. The endoscopic and histologic features of the terminal ileum (both groups) and colon (UC group only) were evaluated in a standardized fashion. Extensive clinical and endoscopic information was obtained from the subjects, and these data were compared between patients with UC either with or without ileitis. RESULTS: Sixteen of 72 patients with UC (22%) had ileitis compared to only 4 of 90 (4%) of the non-UC controls (P < 0.001). None of the patients had features of backwash. Among patients with UC, the presence of ileitis showed a trend towards correlation with extent of disease, but a significant association with involvement of the colonic side of the ileocecal valve (P = 0.02) was noted. Alcohol use in the week before the colonoscopy was also significant (P = 0.02). There were no other features that were significantly related to ileitis in the patients with UC. Only one UC case with ileitis developed Crohn's disease on follow-up. CONCLUSIONS: Ileitis in patients with UC may represent a primary extracolonic manifestation of UC in patients with inactive or mild disease and is not due to backwash.

Inactivation of bacteria from contaminated streams in Limpopo, South Africa by silver- or copper-nanoparticle paper filters.

There is an urgent need for inexpensive point-of-use methods to purify drinking water in developing countries to reduce the incidence of illnesses caused by waterborne pathogens. Previously, our work showed the deactivation of laboratory-cultured bacteria by percolation through a thick paper sheet containing either silver (Ag) or copper (Cu) nanoparticles (NP). In this study, these paper filters containing AgNPs or CuNPs have been tested with water sourced from contaminated streams in Limpopo, South Africa. Following the percolation of the contaminated stream water through the metal nanoparticle (MNP) papers, the water quality of the filtered effluent was evaluated with respect to the colony counts of total coliform and E. coli bacteria, turbidity, and either silver or copper ions. Influent total coliform bacteria concentrations from the stream water in Limpopo ranged from 250 CFU/100 mL to 1,750,000 CFU/100 mL. With the less contaminated stream water (250 - 15,000 CFU/100 mL), both AgNP and CuNP papers showed complete inactivation of the coliform bacteria. With the surface water with higher coliform bacteria levels (500,000 - 1,000,000 CFU/100 mL), both the AgNP and CuNP papers showed similar results with a slightly higher bacteria reduction of log10 5.1 for the AgNP papers than the log10 4.8 reduction for the CuNP papers. E. coli results followed similar trends. For most water purification experiments, the metal release from the sheets was minimal, with values under 0.1 ppm for Ag and 1.0 ppm for Cu (the current US EPA and WHO drinking water limits for Ag and Cu, respectively). These results show good potential for the use of paper embedded with silver and/or copper nanoparticles as effective point-of-use water purifiers.

The finite body triangulation: algorithms, subgraphs, homogeneity estimation and application.

The concept of a finite body Dirichlet tessellation has been extended to that of a finite body Delaunay 'triangulation' to provide a more meaningful description of the spatial distribution of nonspherical secondary phase bodies in 2- and 3-dimensional images. A finite body triangulation (FBT) consists of a network of minimum edge-to-edge distances between adjacent objects in a microstructure. From this is also obtained the characteristic object chords formed by the intersection of the object boundary with the finite body tessellation. These two sets of distances form the basis of a parsimonious homogeneity estimation. The characteristics of the spatial distribution are then evaluated with respect to the distances between objects and the distances within them. Quantitative analysis shows that more physically representative distributions can be obtained by selecting subgraphs, such as the relative neighbourhood graph and the minimum spanning tree, from the finite body tessellation. To demonstrate their potential, we apply these methods to 3-dimensional X-ray computed tomographic images of foamed cement and their 2-dimensional cross sections. The Python computer code used to estimate the FBT is made available. Other applications for the algorithm - such as porous media transport and crack-tip propagation - are also discussed.

CO2 deserts: implications of existing CO2 supply limitations for carbon management.

Efforts to mitigate the impacts of climate change will require deep reductions in anthropogenic CO2 emissions on the scale of gigatonnes per year. CO2 capture and utilization and/or storage technologies are a class of approaches that can substantially reduce CO2 emissions. Even though examples of this approach, such as CO2-enhanced oil recovery, are already being practiced on a scale >0.05 Gt/year, little attention has been focused on the supply of CO2 for these projects. Here, facility-scale data newly collected by the U.S. Environmental Protection Agency was processed to produce the first comprehensive map of CO2 sources from industrial sectors currently supplying CO2 in the United States. Collectively these sources produce 0.16 Gt/year, but the data reveal the presence of large areas without access to CO2 at an industrially relevant scale (>25 kt/year). Even though some facilities with the capability to capture CO2 are not doing so and in some regions pipeline networks are being built to link CO2 sources and sinks, much of the country exists in "CO2 deserts". A life cycle analysis of the sources reveals that the predominant source of CO2, dedicated wells, has the largest carbon footprint further confounding prospects for rational carbon management strategies.

Contrast videofluoroscopic assessment of dysphagic cats.

The diagnostic utility of contrast-enhanced videofluoroscopic esophagography in dysphagic cats has been rarely studied relative to dogs. Current literature regarding feline dysphagia typically consists of individual case reports or small case series. This retrospective study analyzed the imaging findings in 11 cats undergoing 15 videofluoroscopic swallow studies. Hiatal hernia (n = 5), esophageal stricture (n = 3), and esophageal dysmotility (n = 7) were the most common diagnoses (some cats having more than 1 diagnosis) in dysphagic cats that underwent videofluoroscopic swallow studies. Esophageal dysmotility appeared to be associated with a higher percentage of swallows from which no peristaltic waves were generated. Oropharyngeal and cricopharyngeal causes of dysphagia were not identified in any cat and quantitative assessment of the swallowing reflex (pharyngeal constriction ratio = 0.17 ± 0.09; time to maximum pharyngeal contraction = 0.13 ± 0.02 s; time to proximal esophageal sphincter opening = 0.07 ± 0.02 s; time to proximal esophageal sphincter closed = 0.23 ± 0.05 s; time to opening of the epiglottis = 0.27 ± 0.04 s) was similar to quantitative swallowing parameters previously reported in healthy dogs. In conclusion, videofluoroscopy is a diagnostic tool that can identify esophageal abnormalities that are not readily apparent on survey radiographs. Limitations include the potential need for multiple studies, and the possibility of poor compliance in the feline patient. Results of this study are intended to help veterinarians define a prioritized differential diagnosis list for dysphagic cats.

Relative permeability experiments of carbon dioxide displacing brine and their implications for carbon sequestration.

To mitigate anthropogenically induced climate change and ocean acidification, net carbon dioxide emissions to the atmosphere must be reduced. One proposed option is underground CO2 disposal. Large-scale injection of CO2 into the Earth's crust requires an understanding of the multiphase flow properties of high-pressure CO2 displacing brine. We present laboratory-scale core flooding experiments designed to measure CO2 endpoint relative permeability for CO2 displacing brine at in situ pressures, salinities, and temperatures. Endpoint drainage CO2 relative permeabilities for liquid and supercritical CO2 were found to be clustered around 0.4 for both the synthetic and natural media studied. These values indicate that relative to CO2, water may not be strongly wetting the solid surface. Based on these results, CO2 injectivity will be reduced and pressure-limited reservoirs will have reduced disposal capacity, though area-limited reservoirs may have increased capacity. Future reservoir-scale modeling efforts should incorporate sensitivity to relative permeability. Assuming applicability of the experimental results to other lithologies and that the majority of reservoirs are pressure limited, geologic carbon sequestration would require approximately twice the number of wells for the same injectivity.

Extraintestinal manifestations of inflammatory bowel disease.

Extraintestinal manifestations of inflammatory bowel disease are prevalent in both ulcerative colitis and Crohn's disease. The most common manifestations involve the musculoskeletal and dermatologic systems. Other manifestations involve the hepatopan-creatobiliary system (eg, primary sclerosing cholangitis) as well as the ocular, renal, and pulmonary systems. A multidisciplinary team approach is often needed for effective management, and emergency situations require prompt evaluation.

Chemoprophylaxis of colorectal cancer in inflammatory bowel disease: current concepts.

Ulcerative colitis and Crohn's disease both confer an increased risk of developing colorectal cancer. The use of 5-aminosalicylate as a remission-inducing agent has been long accepted. Its use as a potential chemoprophylactic agent has been proposed and is used by some practitioners. This review examines the most recent data on 5-aminosalicylate as a chemoprophylactic drug as well as ursodeoxycholic acid, folic acid, azathioprine, and 6-mercaptopurine.