Video-assisted thoracoscopic surgery for myasthenia gravis with thymoma: A six-year single-center experience.

OBJECTIVES: To investigate clinical and histopathological characteristics of Vietnamese patients with thymoma and myasthenia gravis (MG), and the outcomes of surgical management using video-assisted thoracoscopic surgery (VATS) thymectomy. METHODS: A prospective study was carried out on 61 patients undergoing VATS thymectomy for MG class I, IIA with thymoma in the period from 10/2013 to 5/2019. The WHO histopathological classification, Masaoka's stages and MG grading using the guidelines of the Medical Scientific Advisory Board of the Myasthenia gravis foundation of America (MGFA) were used. All patients were followed up at 1 month, 6 months and over 1 year postoperatively. RESULTS: The average patient age was 47.3 ± 10.8 years (21-70). The female/male ratio was 0.91.80.3% of patients had MG class IIA. Most of the patients were at Masaoka's stage I and stage II (75.4%). Only 1 patient (1.7%) had highly malignant type B3 thymoma. Conversion to open surgery was required in 8 patients. The surgical time was 91.8 ± 49.9 min and blood loss was 37.3 ± 31.5 ml. Most patients (68.9%) were extubated in the operating room. The postoperative hospital stay was 9.8 ± 5.9 days (5-37 days). 22.6% of patients relapsed after one-year. Refractory MG declined to 5.7% after surgical treatment. CONCLUSION: VATS thymectomy for MG with thymoma was safe and effective, with a lower rate of intraoperative complications, shorter hospitalization, and better long-term outcomes. This approach could be applicable for patients of all age groups with thymomas at early Masaoka's stages.

Adsorption Characteristics of Synthesized Polyelectrolytes onto Alumina Nanoparticles and their Application in Antibiotic Removal.

The present study aims to investigate the adsorption of synthesized poly(2-acrylamide-2-methylpropane sulfonic acid) (PAMPs) onto alumina nanoparticles and their application in the removal of ciprofloxacin (CFX) antibiotic from a water environment. The PAMPs were successfully synthesized and characterized by nuclear magnetic resonance and gel-permeation chromatography methods. The number- and weight-average molecular weights of PAMPs were 6.76 × 105 and 7.28 × 106 g/mol, respectively. The charge reversal of nanoalumina after PAMPs modification from positive to -37.5 mV was determined by ζ-potential measurement, while the appearance of C ═ O and N-H functional groups in PAMPs observed by Fourier-transform infrared spectroscopy confirmed them as the main indicators for adsorption of PAMPs onto a nanoalumina surface. The maximum adsorption capacity of PAMPs onto nanoalumina in 100 mg/L KCl was about 10 mg/g. The adsorption isotherms were fitted well by a two-step adsorption model. Application of PAMPs-modified nanoalumina (PAMNA) in CFX removal was also thoroughly studied. The optimum conditions for CFX removal using PAMNA were found to be pH 6, 10 mM NaCl, contact time 90 min, and adsorption dosage 5 mg/mL. The CFX adsorption isotherms and kinetics were in accordance with the two-step and pseudo-second-order models, respectively. The application for CFX removal in actual hospital wastewater was greater than 80%. The results of this study demonstrate that PAMNA is a new and promising material for antibiotic removal from wastewater.

Adsorption Behavior of Polyelectrolyte onto Alumina and Application in Ciprofloxacin Removal.

This study aims to investigate the adsorption behavior of a strong polyelectrolyte poly(styrenesulfonate) (PSS) onto alumina particles. Adsorption of PSS onto positively charged alumina surface increased with increasing ionic strength, indicating that non-electrostatic and electrostatic interaction controlled the adsorption. The removal of an emerging antibiotic ciprofloxacin (CFX) from water environment using PSS-modified alumina (PMA) was also studied. The removal of CFX using PMA was much higher than that using alumina particles without PSS modification in all pH ranges of 2-11. The removal of CFX reached 98% under the optimum conditions of pH 6, contact time of 120 min, adsorbent dosage of five milligrams per milliliter and ionic strength 104-M NaCl. The adsorption isotherms of CFX at different salt concentrations fit well with a two-step adsorption model, while the adsorption kinetic fit well with a pseudo-second-order model with a good correlation coefficient (R2 > 0.9969). The CFX-removal from a hospital wastewater using PMA was more than 75%. Our study demonstrates that adsorption of PSS onto alumina to modify the particle surface is important to form a novel adsorbent PMA for CFX-removal from water environments.

Synthesis, Characterization, and Modification of Alumina Nanoparticles for Cationic Dye Removal.

In the present study, alumina nanoparticles (nano-alumina) which were successfully fabricated by solvothermal method, were characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), Transmission Electron Microscopy (TEM), and Brunauer⁻Emmett⁻Teller (BET) methods. The removal of cationic dye, Rhodamine B (RhB), through adsorption method using synthesized nano-alumina with surface modification by anionic surfactant was also investigated. An anionic surfactant, sodium dodecyl sulfate (SDS) was used to modify nano-alumina surface at low pH and high ionic strength increased the removal efficiency of RhB significantly. The optimum adsorption conditions of contact time, pH, and adsorbent dosage for RhB removal using SDS modified nano-alumina (SMNA) were found to be 120 min, pH 4, and 5 mg/mL respectively. The RhB removal using SMNA reached a very high removal efficiency of 100%. After four times regeneration of adsorbent, the removal efficiency of RhB using SMNA was still higher than 86%. Adsorption isotherms of RhB onto SMNA at different salt concentrations were fitted well by a two-step model. A very high adsorption capacity of RhB onto SMNA of 165 mg/g was achieved. Adsorption mechanisms of RhB onto SMNA were discussed on the basis of the changes in surface modifications, the change in surface charges and adsorption isotherms.

Mechanical Behavior of AZ31B Mg Alloy Sheets under Monotonic and Cyclic Loadings at Room and Moderately Elevated Temperatures.

Large-strain monotonic and cyclic loading tests of AZ31B magnesium alloy sheets were performed with a newly developed testing system, at different temperatures, ranging from room temperature to 250 °C. Behaviors showing significant twinning during initial in-plane compression and untwinning in subsequent tension at and slightly above room temperature were recorded. Strong yielding asymmetry and nonlinear hardening behavior were also revealed. Considerable Bauschinger effects, transient behavior, and variable permanent softening responses were observed near room temperature, but these were reduced and almost disappeared as the temperature increased. Different stress-strain responses were inherent to the activation of twinning at lower temperatures and non-basal slip systems at elevated temperatures. A critical temperature was identified to account for the transition between the twinning-dominant and slip-dominant deformation mechanisms. Accordingly, below the transition point, stress-strain curves of cyclic loading tests exhibited concave-up shapes for compression or compression following tension, and an unusual S-shape for tension following compression. This unusual shape disappeared when the temperature was above the transition point. Shrinkage of the elastic range and variation in Young's modulus due to plastic strain deformation during stress reversals were also observed. The texture-induced anisotropy of both the elastic and plastic behaviors was characterized experimentally.