Simultaneous biodegradation of toluene and p‐xylene was performed in a novel bioreactor, and the performance was analyzed on the basis of both experimental and mathematical simulation results. The novel bioreactor employed a silicon tubing as a supplier of the aromatic solvents to be treated, and the transfer rate of toluene and p‐xylene into the culture broth was easily controlled. Batch, sequencing batch, and continuous mode of operation were carried out in the novel bioreactor to compare the performance of the biodegradation of solvent mixture. Sequencing batch operation worked well, but several operational difficulties were found. Continuous operation was shown to present higher biodegradation rates and operational stability. The continuous biodegradation process was mathematically simulated, and operational conditions were optimized on the basis of the simulation results.

Background: Exacerbations of chronic obstructive pulmonary disease (COPD) are common and can be fatal. However, it is difficult to predict the in-hospital mortality, severity and prognosis of patients. Prognostic tools are needed to assess exacerbations of COPD in the emergency department. Towards this end, we compared DECAF (dyspnea, eosinopenia, consolidation, acidemia, atrial fibrillation) score with other prognostic tools available in the emergency department. Methods: Consecutive patients admitted to the emergency department with exacerbations of COPD were recruited. We compared the DECAF score to CAPS (chronic obstructive pulmonary disease and asthma physiology score), BAP (blood urea nitrogen, altered mental status, pulse)-65 class and CURB (confusion, urea, respiratory rate, blood pressure)-65 score and assessed in-hospital mortality, endotracheal intubation, admission to the intensive care unit and admission to the hospital. Results: The in-hospital mortality rate was 4.9%. The DECAF score showed excellent discrimination for in-hospital mortality (AUROC = 0.72, p = 0.002), endotracheal intubation (AUROC = 0.92, p < 0.001), admission to the intensive care unit (AUROC = 0.90, p < 0.001) and admission to the hospital (AUROC = 0.83, p < 0.001). Conclusions:The DECAF score is a simple and effective prognostic tool for assessing cases involving exacerbation of COPD in the emergency department. Emergency physicians should consider hospital admission if the DECAF score is more than 1 and consider admission to the intensive care unit and endotracheal intubation if the DECAF score is more than 3. 255 서 론만성폐쇄성폐질환은 완전히 가역적이지 않은 기류 제한을 특징으로 하는 질환으로, 높은 유병률을 보이고 있으며 사망률 도 높은 것으로 알려졌다. 국내의 한 연구에서는 45세 초과인 사람 중 GOLD (global initiative for chronic obstructive lung dis-ease) 기준에 의해 forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) 0.7 미만인 기관지 폐색이 17.2%에서 보이는 것으로 나타났다.[1] 만성폐쇄성폐질환 환자 의 급성 악화 시 사망률은 2.5%, 입원을 해야 하는 급성 악화 환자의 병원 내 사망률은 4%에서 30%까지 보고되어 있다.[2-4] 하지만 응급실에 내원하였을 경우 환자의 예후를 알기가 쉽지 않고 입원의 여부, 중환자실에서의 집중치료의 여부를 판단하기가 힘들다. 만성폐쇄성폐질환의 예후를 확인해주는 여러 예측 도구들이 소개됐으나 응급실 환자에서 유용성 여부 를 알 수 없었다. BODE (the body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease) 지수와 같은 도구는 안정된 만성 폐쇄성폐질환 환자의 예후를 예측하는 것이어서 응급실에서 내원한 환자의 예후를 예측하기가 힘들었다.[5] DECAF

No abstract

No abstract

No abstract