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Membrane distillation (MD) is an emerging thermally-driven technology that poses a lot of promise in desalination, and water and wastewater treatment. Developments in membrane design and the use of alternative energy sources have provided much improvement in the viability of MD for different applications. However, fouling of membranes is still one of the major issues that hounds the long-term stability performance of MD. Membrane fouling is the accumulation of unwanted materials on the surface or inside the pores of a membrane that results to a detrimental effect on the overall performance of MD. If not addressed appropriately, it could lead to membrane damage, early membrane replacement or even shutdown of operation. Similar with other membrane separation processes, fouling of MD is still an unresolved problem. Due to differences in membrane structure and design, and operational conditions, the fouling formation mechanism in MD may be different from those of pressure-driven membrane processes. In order to properly address the problem of fouling, there is a need to understand the fouling formation and mechanism happening specifically for MD. This review details the different foulants and fouling mechanisms in the MD process, their possible mitigation and control techniques, and characterization strategies that can be of help in understanding and minimizing the fouling problem.

Percutaneous endoscopic lumbar discectomy (PELD) for migrated disc herniations is technically demanding due to the absence of the technical guideline. The purposes of this study were to propose a radiologic classification of disc migration and surgical approaches of PELD according to the classification. A prospective study of 116 consecutive patients undergoing single-level PELD was conducted. According to preoperative MRI findings, disc migration was classified into four zones based on the direction and distance from the disc space: zone 1 (far up), zone 2 (near up), zone 3 (near down), zone 4 (far down). Two surgical approaches were used according to this classification. Near-migrated discs were treated with "half-and-half" technique, which involved positioning a beveled working sheath across the disc space to the epidural space. Far-migrated discs were treated with "epiduroscopic" technique, which involved introducing the endoscope into the epidural space completely. The mean follow-up period was 14.5 (range 9-20) months. According to the Macnab criteria, satisfactory results were as follows: 91.6% (98/107) in the down-migrated discs; 88.9% (8/9) in the up-migrated discs; 97.4% (76/78) in the near-migrated discs; and 78.9% (30/38) in the far-migrated discs. The mean VAS score decreased from 7.5 +/- 1.7 preoperatively to 2.6 +/- 1.8 at the final follow-up (P < 0.0001). There were no recurrence and no approach-related complications during the follow-up period. The proposed classification and approaches will provide appropriate surgical guideline of PELD for migrated disc herniation. Based on our results, open surgery should be considered for far-migrated disc herniations.

Percutaneous endoscopic interlaminar discectomy is a safe, effective, and minimally invasive procedure for the treatment of intracanalicular disc herniations at the L5-S1 level in properly selected cases, especially when the transforaminal approach is not possible because of anatomic constraints.

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