Enhanced adsorption of fluoride from aqueous solution using an iron-modified attapulgite adsorbent.

Attapulgite modified with iron was used as an adsorbent for fluoride removal from aqueous solutions. The pristine attapulgite and the iron-modified attapulgite composite were characterized by X-ray powder diffraction (XRD), Fourier transform infrared (FT-IR) techniques, and the pH point of zero charge measurement. The XRD analysis indicates the existence of iron oxide hydroxide (FeO[OH]) in the iron-modified attapulgite composite. The FT-IR spectra of the iron-modified attapulgite composite before and after adsorption indicate that the involvement of the hydroxide radical in the fluoride adsorption. The effects of pH, contact time, initial concentration, and temperature on fluoride adsorption by the adsorbent were studied in a batch system. Kinetics studies show that the fluoride adsorption kinetics over the adsorbent is well-described by the pseudo-second-order kinetic model. The fluoride adsorption isotherm is well-fitted by the Langmuir model. Desorption studies show that the iron-modified attapulgite adsorbent can be easily regenerated at pH 12.5. The adsorption mechanism is discussed in detail.

Haemorrhoidectomy by vessel sealing system under local anaesthesia in an outpatient setting: preliminary experience.

AIM: This prospective study was designed to assess the feasibility of local anaesthesia for LigaSure haemorrhoidectomy in an outpatient setting. METHOD: From April 2006 to March 2007, 207 consecutive patients (median age 42, 126 males) with grade III (147) and grade IV (60) haemorrhoids, underwent Milligan-Morgan haemorrhoidectomy with LigaSure under local anaesthesia (lidocaine 1%, mean dose 27 +/- 1.7 ml) in an outpatient setting. Postoperative pain was assessed by a visual analogue scale (VAS). RESULTS: Two, three and four files were removed in 120, 51 and 36 patients. Mean operative time was 12 +/- 5.2 min and mean blood loss was 3.4 +/- 3.9 ml. The mean postoperative pain scores were 6.2 +/- 2.1 for the maximal pain intensity and 6.1 +/- 2.5 for the pain on defecation. All patients left hospital after surgery within 2 h and 33 (15.9%) required analgesics. They returned to normal daily activity after 12.2 +/- 7.9 days including work (12.1 +/- 7.8 days). The wounds had healed by 32.2 +/- 9.1 days. At a follow-up of at least 6 months, only six cases of major bleeding had occurred and 24 patients had skin tags. The median satisfaction score was +2 (-2 to +3). CONCLUSION: LigaSure haemorrhoidectomy under local anaesthesia in the outpatient setting is safe and effective.

Decline of serum levels of free testosterone in aging healthy Chinese men.

OBJECTIVE: To investigate the age-related change of serum androgen levels in healthy men and to define a cut-off value of serum testosterone for the diagnosis of androgen deficiency in the aging male. METHOD: 1080 healthy men aged 20 to 70 years old were enrolled in Beijing, Shanghai, Xian and Chongqing. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (T), calculated free testosterone (cFT), sex hormone binding globulin (SHBG), 17beta-oestradiol (E2), the T/LH ratio, and T/SHBG as a free testosterone index (FTI) were all determined. RESULTS: Serum total T did not significantly decline, but the cFT, T/LH and FTI progressively decreased with aging. To determine androgen deficiency, the 10th percentile value of men < 40 years was defined as the lower cut-off value for cFT, T/LH or FTI, which were 0.3 nmol/L, 2.8 nmol/IU, and 0.4 nmol/IU respectively. With the median value of cFT of men aged between 20 and 49 years as the criterion, the level of cFT was lower in 2.82% of men from 40 to 49 years, in 19.53% from 50 to 59 years, in 22.57% from 60 to 69 years, and in 33.19% of men > or = 70 years. Taking the above value of cFT as the cut-off point, the prevalence of androgen deficiency in men 40-49 years was 13.0%, 31.8% in men 50-59 years, 30.1% in men 60 to 69 years, and 46.7% in men > 70 years. CONCLUSIONS: (i). While serum total T values do not decline with aging, the levels of cFT gradually decline with aging; (ii) when using the value of cFT of the 10th percentile of men aged 20 to 39 years as the cut-off point, the prevalence of androgen deficiency was < 15% before the age of 50 years, and about 30% thereafter, approaching 45% after the age of 70 years; and (iii) in this study the values of T/LH paralleled those of cFT closely; therefore, T/LH could serve as a surrogate for cFT.

Reassessment of conservative management for stage T1N0M0 transitional cell carcinoma of the bladder.

PURPOSE: We evaluated the outcome of stage T1 transitional cell carcinoma of the bladder treated with local tumor resection and intravesical therapies. MATERIALS AND METHODS: Of 42 patients with stage T1 bladder cancer seen at our clinic during a 10-year period 38 were treated conservatively with local tumor resection, intravesical therapy and long-term followup. Bacillus Calmette-Guerin (BCG) was used as the primary intravesical agent since 1986. RESULTS: Of the 38 patients 15 had initial grade 2 or 2 to 3 tumors, including 9 (60%) who had at least 1 or more local recurrences but without disease progression. The remaining 23 patients had grade 3 or grades 3 to 4 stage T1 tumors, with local recurrence in 17 (74%) and disease progression in 8 (35%). Furthermore, 5 patients (22%) died of the metastasis despite salvage therapies. CONCLUSIONS: For patients with initial grade 2 or grades 2 to 3, stage T1 disease the risk of disease progression is low. Current management with local tumor resection and intravesical BCG is appropriate and should be continued. Patients with high grade, stage T1 disease are at particularly high risk for disease progression and BCG does not seem to decrease this risk effectively. Therefore, immediate cystectomy is appropriate and should be recommended.