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Biomedical subjects

J Gan

Publications and source records attributed to J Gan.

At least 19 recordsLinked to original sources

Dehalogenation of halogenated fumigants by polysulfide salts.

Halogenated fumigants are among the most heavily used pesticides in agriculture. Because of their high mobility and toxicological characteristics, the contamination of air or groundwater by these compounds has been a great environmental concern. In this study, we investigated dehalogenation of several halogenated fumigants by polysulfides. The reaction of polysulfides and methyl iodide (MeI), 1,3-dichloropropene (1,3-D), and chloropicrin (CP) was very rapid. When the initial fumigant and polysulfide concentrations were both 0.2 mM, the observed 50% disappearance time values (DT50) of MeI, cis-1,3-D, and trans-1,3-D were 27.2, 29.6, and 102 h, respectively. When the initial polysulfide concentration was 1.0 mM, the corresponding DT50 values were only 2.2, 1.6, and 3.8 h. Under similar conditions, the reaction with CP was even more rapid than with the other fumigants. In 0.2 mM polysulfide solution, more than 90% of the spiked CP disappeared in 1 h after the initiation of the reaction. The reaction between fumigants and polysulfides also progressed at enhanced rates when the polysulfide solution was initially purged with nitrogen. Analysis of reaction kinetics and initial products suggests that the reaction is SN2 nucleophilic substitution for MeI and 1,3-D but likely reductive dehalogenation for CP. Given the high reactivity of polysulfide salts toward halogenated fumigants, this reaction may be used as a pollution mitigation strategy, such as for disposal of fumigant wastes, treatment of fumigant-containing wastewater, and cleanup of fumigant residues in environmental media.

Allyl Compounds↗

Leaching of N-nitrosodimethylamine (NDMA) in turfgrass soils during wastewater irrigation.

N-nitrosodimethylamine (NDMA) is a carcinogenic by-product of chlorination that is frequently found in municipal wastewater effluent. NDMA is miscible in water and negligibly adsorbed to soil, and therefore may pose a threat to ground water when treated wastewater is used for landscape irrigation. A field study was performed in the summer months under arid Southern California weather conditions to evaluate the leaching potential of NDMA in turfgrass soils during wastewater irrigation. Wastewater was used to irrigate multiple turfgrass plots at 110 to 160% evapotranspiration rate for about 4 mo, and leachate was continuously collected and analyzed for NDMA. The treated wastewater contained relatively high levels of NDMA (114-1820 ng L(-1); mean 930 ng L(-1)). NDMA was detected infrequently in the leachate regardless of the soil type or irrigation schedule. At a method detection limit of 2 ng L(-1), NDMA was only detected in 9 out of 400 leachate samples and when it was detected, the NDMA concentration was less than 5 ng L(-1). NDMA was relatively persistent in the turfgrass soils during laboratory incubation, indicating that mechanisms other than biotransformation, likely volatilization and/or plant uptake, contributed to the rapid dissipation. Under conditions typical of turfgrass irrigation with wastewater effluent it is unlikely that NDMA will contaminate ground water.

Biodegradation, Environmental↗

Loss pathways of N-nitrosodimethylamine (NDMA) in turfgrass soils.

N-nitrosodimethylamine (NDMA) is a potent carcinogen that is often present in municipal wastewater effluents. In a previous field study, it was observed that NDMA did not leach through turfgrass soils following 4 mo of intensive irrigation with NDMA-containing wastewater effluent. To better understand the loss pathways for NDMA in landscape irrigation systems, a mass balance approach was employed using in situ lysimeters treated with 14C-NDMA. When the lysimeters were subjected to irrigation and field conditions after NDMA application, very rapid dissipation of NDMA was observed for both types of soil used in the field plots. After only 4 h, total 14C activity in the lysimeters decreased to 19.1 to 26.1% of the applied amount, and less than 1% of the activity was detected below the 20-cm depth. Analysis of plant materials showed that less than 3% of the applied 14C was incorporated into the plants, suggesting only a minor role for plant uptake in removing NDMA from the vegetated soils. The rapid dissipation and limited downward movement of NDMA in the in situ lysimeters was consistent with the negligible leaching observed in the field study, and suggests volatilization as the only significant loss pathway. This conclusion was further corroborated by rapid NDMA volatilization found from water or a thin layer of soil under laboratory conditions. In a laboratory incubation experiment, prolonged wastewater irrigation did not result in enhanced NDMA degradation in the soil. Therefore, although NDMA may be present at relatively high levels in treated wastewater, gaseous diffusion and volatilization in unsaturated soils may effectively impede significant leaching of NDMA, minimizing the potential for ground water contamination from irrigation with treated wastewater.

Carbon Isotopes↗

Nitrogen metabolism and excretion in the swamp eel, Monopterus albus, during 6 or 40 days of estivation in mud.

Monopterus albus inhabits muddy ponds, swamps, canals, and rice fields, where it can burrow into the moist earth, and it survives for long periods during the dry summer season. However, it had been reported previously that mortality increased when M. albus was exposed to air for 8 d or more. Thus, the objective of this study was to elucidate the strategies adopted by M. albus to defend against ammonia toxicity during 6 or 40 d of estivation in mud and to evaluate whether these strategies were different from those adopted by fish to survive 6 d of aerial exposure. Ammonia and glutamine accumulations occurred in the muscle and liver of fish exposed to air (normoxia) for 6 d, indicating that ammonia was detoxified to glutamine under such conditions. In contrast, ammonia accumulation occurred only in the muscle, with no increases in glutamine or glutamate contents in all tissues, of fish estivated in mud for 6 d. Similar results were obtained from fish estivated in mud for 40 d. While estivating in mud prevented excessive water loss through evaporation, M. albus was exposed to hypoxia, as indicated by significant decreases in blood P(O(2)), muscle energy charge, and ATP content in fish estivated in mud for 6 d. Glutamine synthesis is energy intensive, and that could be the reason why M. albus did not depend on glutamine synthesis to defend against ammonia toxicity when a decrease in ATP supply occurred. Instead, suppression of endogenous ammonia production was adopted as the major strategy to ameliorate ammonia toxicity when M. albus estivated in mud. Our results suggest that a decrease in O(2) level in the mud could be a more effective signal than an increase in internal ammonia level during aerial exposure to induce a suppression of ammonia production in M. albus. This might explain why M. albus is able to estivate in mud for long periods (40 d) but can survive in air for only <10 d.

Adenosine Triphosphate↗

Distribution and persistence of pyrethroids in runoff sediments.

Pyrethroids are commonly used insecticides in both agricultural and urban environments. Recent studies showed that surface runoff facilitated transport of pyrethroids to surface streams, probably by sediment movement. Sediment contamination by pyrethroids is of concern due to their wide-spectrum aquatic toxicity. In this study, we characterized the spatial distribution and persistence of bifenthrin [BF; (2-methyl(1,1'-biphenyl)-3-yl)methyl 3-(2-chloro-3,3,3-trifluoro-1-propenyl)-2,2-dimethylcyclopropanecarboxylate] and permethrin [PM; 3-(2,2-dichloroethenyl)-2,2-dimethylcyclopropanecarboxylic acid (3-phenoxyphenyl)methyl ester] in the sediment along a 260-m runoff path. Residues of BF and PM were significantly enriched in the eroded sediment, and the magnitude of enrichment was proportional to the downstream distance. At 145 m from the sedimentation pond, BF was enriched by >25 times, while PM isomers were enriched by >3.5 times. Pesticide enrichment along the runoff path coincided with enrichment of organic carbon and clay fractions in the sediment, as well as increases in adsorption coefficient K(d), suggesting that the runoff flow caused selective transport of organic matter and chemical-rich fine particles. Long persistence was observed for BF under both aerobic and anaerobic conditions, and the half-life ranged from 8 to 17 mo at 20 degrees C. The long persistence was probably caused by the strong pesticide adsorption to the solid phase. The significant enrichment, along with the prolonged persistence, suggests that movement of pyrethroids to the surface water may be caused predominantly by the chemically rich fine particles. It is therefore important to understand the fate of sediment-borne pyrethroids and devise mitigation strategies to reduce offsite movement of fine sediment.

Aluminum Silicates↗

Evaluation of Kd underestimation using solid phase microextraction.

Many important environmental pollutants are strongly adsorbing hydrophobic compounds. Because of their potential to adsorb to dissolved organic matter (DOM), their partition coefficient Kd may be underestimated by the conventional approach due to incomplete phase separation. In this study, solid-phase microextraction (SPME) was compared with liquid-liquid partition (LLP) for measuring Kd of bifenthrin and permethrin isomers on sediments. Due to its selective detection of the freely dissolved concentration, SPME gave Kd values 0.6-4.4-fold greater than those obtained by LLP in creek and field sediments and 3.6-21.7-fold greater in nursery runoff sediments. Underestimation by the conventional method was attributed to adsorption to DOM that was not excluded from the aqueous phase by centrifugation. The degree of underestimation was dependent on the source and amount of DOM and may be generally significant for compounds that have DOM adsorption coefficient (KDOM) > 10(4). This study provides evidence that the existing Kd values for many hydrophobic pollutants may be underestimated, and SPME may be a viable, efficacious tool for evaluating the underestimation.

Adsorption↗

Effect of planting covers on herbicide persistence in landscape soils.

Recent monitoring shows that the majority of urban streams in the United States are contaminated by pesticide residues, and the contamination is mainly due to runoff from residential landscapes. In this study we evaluated the effect of landscape planting on persistence of the herbicides 2,4-D and dicamba in soil under laboratory conditions. The herbicides exhibited substantially different persistence in the same soil type that had been subjected to different planting practices for about 6 years. In the 0-10 cm surface layer, the half-life of 2,4-D was 30.7 d in soil under trees, which was about 20 times longer than in soil planted with turf grass (1.6 d). The difference in 2,4-D persistence was closely correlated to the number of 2,4-D-degrading bacteria that had evolved in the soils. The half-life of dicamba was much longer in soil under a tree canopy (149 d) than in mulched soil (7.9 d). The rate of dicamba degradation was proportional to soil organic matter content. This study indicates that planting practices can modify soil chemical properties and microbial activity and may further affect pesticide runoff potential by influencing pesticide degradation. Characterizing pesticide behavior as a function of planting covers may improve our understanding of pesticide runoff in urban environments and also help to identify strategies for minimizing pesticide contamination to urban streams.

2,4-Dichlorophenoxyacetic Acid↗

Immunization by particle-mediated transfer of the granulocyte-macrophage colony-stimulating factor gene into autologous tumor cells in melanoma or sarcoma patients: report of a phase I/IB study.

The primary objective of this phase I study was to determine the safety of an autologous tumor vaccine given by intradermal injection of lethally irradiated granulocyte-macrophage colony-stimulating factor (GM-CSF) gene-transfected autologous melanoma and sarcoma cells. Secondary objectives included validation of the gene delivery technology (particle-mediated gene transfer), determining the host immune response to the tumor after vaccination, and monitoring patients for evidence of antitumor response. Sixteen patients were treated with either of two different doses of GM-CSF-treated tumor cells. One patient received treatment with both doses of tumor cells. No treatment-related local or systemic toxicity was noted in any patient. Patients administered 100% treated cells (i.e., with a preparation of tumor cells that had all been exposed to GM-CSF DNA transfection) had a more extensive lymphocytic infiltrate at the vaccine site than did patients given 10% treated cells (a preparation of tumor cells in which 10% had been exposed to GM-CSF transfection) or nontreated tumor. The generation of a systemic immune response to autologous tumor by a delayed-type hypersensitivity response to the intradermal placement of nontransfected tumor cells was noted in one patient. One patient had a transient partial response of metastatic tumor sites. The entire procedure, from tumor removal to vaccine placement, was accomplished in less than 6 hr in all patients. Four of 17 patient tumor preparations produced greater than 3.0 ng of GM-CSF per 10(6) cells per 24 hr in vitro. The one patient with greater than 30 ng of GM-CSF per 10(6) cells per 24 hr in vitro had positive DTH, a significant histologic inflammatory response, and clinically stable disease. This technique of gene transfer was safe and feasible, but resulted in clinically relevant levels of gene expression in only a minority of patients.

Biolistics↗

Microbial response to bensulfuron-methyl treatment in soil.

A laboratory incubation study was conducted to evaluate the effect of bensulfuron-methyl treatment on soil microbial biomass and N-mineralization of a loamy sand soil. The herbicide was applied at 0 (control), 0.01 (field rate), 0.1, and 1.0 microg g(-1), and soil microbial biomass carbon (C(mb)), soil microbial biomass nitrogen (N(mb)), and N-mineralization rate (k) were measured at different times after herbicide treatment. Compared to the untreated soil, C(mb) and N(mb) decreased significantly (p < or = 0.05) within the first 7 days after herbicide treatment at 0.1 and 1.0 microg g(-1), and the impact was greater for N(mb) than for C(mb). Nitrogen mineralization was significantly suppressed during the first 5 days of incubation when the soil was treated with bensulfuron-methyl at 0.1 and 1.0 microg g(-1). The overall impact of bensulfuron-methyl to the soil microbial communities was closely related to the application rate in the range of 0.01-1.0 microg g(-1). This effect, however, was found to be transitory, and significant impact occurred only at high application rates.

Biomass↗

Environmental fate of metalaxyl and chlorothalonil applied to a bentgrass putting green under southern California climatic conditions.

Putting greens usually receive high inputs of fertilizers and pesticides to meet the high demand for visual quality and to overcome the stress from close mowing and traffic. In this study, two commonly used fungicides, metalaxyl (methyl N-(methoxyacetyl)-N-(2,6-xylyl)-DL-alaninate) and chlorothalonil (2,4,5,6-tetrachloro-1,3-benzenedicarbonitrile), were evaluated for their partitioning and persistence in a bentgrass (Agrostis palustris Huds) putting green under southern California climatic conditions. The putting green site was constructed according to the US Golf Association (USGA) specifications. Lysimeter assemblies installed at the center of each plot were used to monitor the leachate, flux chambers were used to measure volatilization, clippings were collected to determine the residues on grass, and soil cores were sampled to determine residues in the soil profile. Results showed that cumulative volatilization loss accounted for 0.10 and 0.02%, clipping removal 0.11 and 0.13%, and cumulative leaching 0.71 and 0.002% of the applied metalaxyl and chlorothalonil, respectively. The two fungicides were mainly found in the top 10 cm of the soil profile due to the high organic carbon content in the thatch and mat layers. The dissipation half-life was 1.4 days for metalaxyl and 4.9 days for chlorothalonil on grass, shorter than those found in agricultural fields. This study showed that, under normal turf management practices, the offsite transport of the parent fungicides was minimal. Future research should focus on investigating the fate and mobility of the metabolites of the fungicides.

Adsorption↗

An approach for estimating the permeability of agricultural films.

Plastic tarps currently used during soil fumigation to control emissions have been shown to be permeable to fumigant vapors, resulting in appreciable losses to the atmosphere. New low-permeability films are being developed to reduce fumigant emissions and increase efficacy. A rapid, reliable, and sensitive method is required to measure the permeability of various films that may be used in new management practices. This manuscript presents an approach for estimating the mass transfer coefficient (h) of fumigant compounds across agricultural films. The h is a measure of the resistance to diffusion which, unlike other measures of permeability, is a property of the film-chemical combination and independent of the concentration gradient across the film. This method uses static sealed cells; fumigant vapor is spiked to one side of the film and the concentrations on both sides of the film are monitored until equilibrium. An analytical model is fitted to the data to obtain h. This model relies on a mass balance approach and includes sorption to and diffusion across the film membrane. The method was tested using two polyethylene films and a very low-permeability film and showed that the method produces a sensitive and reproducible measure of film permeability.

Agriculture↗

Evaluation of propargyl bromide for control of barnyardgrass and Fusarium oxysporum in three soils.

With the scheduled phasing out of methyl bromide, there is an urgent need for alternatives. We evaluated the efficacy of propargyl bromide as a potential replacement for methyl bromide for the control of barnyardgrass (Echinochloa crus-galli) and Fusarium oxysporum in an Arlington sandy loam, a Carsitas loamy sand and a Florida muck soil. Soil was mixed with barnyardgrass seeds or F oxysporum colonized on millet seeds, and treated with propargyl bromide at a range of concentrations. The mortality of the fungi and weed seeds was determined after 24 h of exposure at 30 degrees C. The concentrations required to inhibit 50% barnyard seed germination (LC50) were 2.8, 2.4 and 48.5 micrograms g-1 in the sandy loam, loamy sand and muck soil, respectively. In contrast, the LC50 values for F oxysporum were 11.2, 10.8 and 182.1 micrograms g-1 in the sandy loam, loamy sand and muck soil, respectively. The low efficacy of propargyl bromide in the muck soil was a result of the rapid degradation and high adsorption of the compound in the soil. The degradation half-life (t1/2) was only 7 h in the muck soil at an initial concentration of 6.8 micrograms g-1, compared to 60 and 67 h in the sandy loam and loamy sand, respectively. The adsorption coefficients (Kd) were 0.96, 0.87 and 5.6 cm3 g-1 in the sandy loam, loamy sand and muck soil, respectively. These results suggest that registration agencies should consider site-specific properties in recommending application rates for propargyl bromide.

Adsorption↗

Effect of temperature, organic amendment rate and moisture content on the degradation of 1,3-dichloropropene in soil.

1,3-Dichloropropene (1,3-D), which consists of two isomers, (Z)- and (E)-1,3-D, is considered to be a viable alternative to methyl bromide, but atmospheric emission of 1,3-D is often associated with deterioration of air quality. To minimize environmental impacts of 1,3-D, emission control strategies are in need of investigation. One approach to reduce 1,3-D emissions is to accelerate its degradation by incorporating organic amendments into the soil surface. In this study, we investigated the ability of four organic amendments to enhance the rate of degradation of (Z)- and (E)-1,3-D in a sandy loam soil. Degradation of (Z)- and (E)-1,3-D was well described by first-order kinetics, and rates of degradation for the two isomers were similar. Composted steer manure (SM) was the most reactive of the organic amendments tested. The half-life of both the (Z)- and (E)-isomers in unamended soil at 20 degrees C was 6.3 days; those in 5% SM-amended soil were 1.8 and 1.9 days, respectively. At 40 degrees C, the half-life of both isomers in 5% SM-amended soil was 0.5 day. Activation energy values for amended soil at 2, 5 and 10% SM were 56.5, 53.4 and 64.5 kJ mol-1, respectively. At 20 degrees C, the contribution of degradation from biological mechanisms was largest in soil amended with SM, but chemical mechanisms still accounted for more than 58% of the (Z)- and (E)-1,3-D degradation. The effect of temperature and amendment rate upon degradation should be considered when describing the fate and transport of 1,3-D isomers in soil. Use of organic soil amendments appears to be a promising method to enhance fumigant degradation and reduce volatile emissions.

Air Pollutants↗

Oxidation of 2,6-dimethylaniline by recombinant human cytochrome P450s and human liver microsomes.

2,6-Dimethylaniline (2,6-DMA) is classified as a rodent nasal cavity carcinogen and a possible human carcinogen. The major metabolite of 2,6-DMA in rats and dogs is 4-amino-3,5-dimethylphenol (DMAP) but oxidization of the amino group to produce metabolites such as N-(2,6-dimethylphenyl)hydroxylamine (DMHA) is also indicated by the occurrence of hemoglobin adducts of 2,6-DMA in human and rats. Previous studies have shown a large interindividual variability in human 2,6-DMA hemoglobin adduct levels. In the present study, 2,6-DMA oxidation in vitro by human liver microsomes and recombinant human P450 enzymes was investigated to assess whether the hemoglobin adduct variability could be attributed to metabolic differences. At micromolar concentrations, the only product detectable (UV) was DMAP, while at 10 nM, DMHA was a substantial product. 2E1 and 2A6 were identified as the major P450s in human liver microsomes responsible for the production of DMAP by using P450-specific chemical inhibitors and mouse monoclonal antibodies that selectively inhibit human P450 2E1 and 2A6. 2A6 was identified as the major P450 responsible for the N-hydroxylation. Native P450 2E1 and human liver microsomes catalyzed the rearrangement of DMHA to DMAP independent of NADPH. Consistent with a mechanism involving oxygen rebound to the heme iron center, labeled oxygen was not incorporated into DMAP from either 18O2 gas or H2 18O in this rearrangement. Results presented here suggest much of the observed interindividual variability of 2,6-DMA hemoglobin adduct levels could be due to differences in the relative amounts of hepatic 2E1 and 2A6.

Aniline Compounds↗

Microcosm enrichment of 1,3-dichloropropene-degrading soil microbial communities in a compost-amended soil.

AIMS: A microcosm-enrichment approach was used to investigate bacterial populations that may represent 1,3-dichloropropene (1,3-D)-degrading micro-organisms in compost-amended soil. METHODS AND RESULTS: After 8 weeks of incubation, with repeated application of 1,3-D, volatilization fluxes were much lower for compost-amended soil (CM) than with the unamended soils, indicating accelerated degradation due to addition of compost, or development of new microbial populations with enhanced degradation capacity. Denaturing gradient gel electrophoresis (DGGE) profiles of the PCR-amplified region of 16S rDNA genes were used to identify dominant bacterial populations in the fumigant-degrading soil. The DGGE results indicated that specific bacterial types had been enriched, and a more diverse fingerprint was observed in the community derived from the compost-amended soil compared with the unamended soil. Fragments from 16 different DGGE bands were cloned, sequenced and compared with published 16S rDNA sequences. Two clones, designated E1 and E4, were unique to all soils to which compost was added, and corresponded to strains of Pseudomonas and Actinomadura, respectively. CONCLUSIONS: The results show that the addition of compost to soil increases specific microbial populations and results in the accelerated degradation of fumigants. SIGNIFICANCE AND IMPACT OF THE STUDY: Application of compost manure to soil can help degrade soil fumigants at a faster rate.

Allyl Compounds↗

Impact of fumigants on soil microbial communities.

Agricultural soils are typically fumigated to provide effective control of nematodes, soilborne pathogens, and weeds in preparation for planting of high-value cash crops. The ability of soil microbial communities to recover after treatment with fumigants was examined using culture-dependent (Biolog) and culture-independent (phospholipid fatty acid [PLFA] analysis and denaturing gradient gel electrophoresis [DGGE] of 16S ribosomal DNA [rDNA] fragments amplified directly from soil DNA) approaches. Changes in soil microbial community structure were examined in a microcosm experiment following the application of methyl bromide (MeBr), methyl isothiocyanate, 1,3-dichloropropene (1,3-D), and chloropicrin. Variations among Biolog fingerprints showed that the effect of MeBr on heterotrophic microbial activities was most severe in the first week and that thereafter the effects of MeBr and the other fumigants were expressed at much lower levels. The results of PLFA analysis demonstrated a community shift in all treatments to a community dominated by gram-positive bacterial biomass. Different 16S rDNA profiles from fumigated soils were quantified by analyzing the DGGE band patterns. The Shannon-Weaver index of diversity, H, was calculated for each fumigated soil sample. High diversity indices were maintained between the control soil and the fumigant-treated soils, except for MeBr (H decreased from 1.14 to 0.13). After 12 weeks of incubation, H increased to 0.73 in the MeBr-treated samples. Sequence analysis of clones generated from unique bands showed the presence of taxonomically unique clones that had emerged from the MeBr-treated samples and were dominated by clones closely related to Bacillus spp. and Heliothrix oregonensis. Variations in the data were much higher in the Biolog assay than in the PLFA and DGGE assays, suggesting a high sensitivity of PLFA analysis and DGGE in monitoring the effects of fumigants on soil community composition and structure. Our results indicate that MeBr has the greatest impact on soil microbial communities and that 1,3-D has the least impact.

Allyl Compounds↗

Isomeric effects on thiosulfate transformation and detoxification of 1,3-dichloropropene.

The fumigant 1,3-dichloropropene (1,3-D) is one of the most heavily used pesticides but also a suspected carcinogen. Previous research has shown that 1,3-D was rapidly transformed and detoxified by ammonium thiosulfate (ATS), a sulfur and nitrogen fertilizer. As common formulations contain cis and trans isomers at roughly equivalent ratios, this study was conducted to understand isomeric differences in thiosulfate transformation and detoxification of 1,3-D. Under the same conditions, reaction of cis-1,3-D with thiosulfate was more than three times faster than trans-1,3-D, which was correlated with a lower reaction activation energy for the cis isomer. The trans isomer was considerably more toxic to the luminescent bacteria Vibrio fisheri than the cis isomer, but the toxicity was reduced by 14 times after thiosulfate transformation. Mutagenic activity to strains of Salmonella typhimurium was observed for trans-1,3-D but was not detected after thiosulfate transformation. These results suggest that thiosulfate transformation detoxifies 1,3-D primarily by deactivating the trans isomer, and the reaction is toxicologically beneficial, as it negates the potential harmful effects of 1,3-D to the environment and human health.

Allyl Compounds↗

Retrospective study of mechanical ventilation in treating multiple trauma accompanied with craniocerebral injury.

OBJECTIVE: To explore the importance of mechanic al ventilation (MV) in treating multiple trauma mainly accompanied with cerebral injury and improve the treatment level. METHODS: All 116 patients who suffered from multiple trauma accompanied with mainly cerebral injury were analyzed. Rank correlation and Chi-square test were made between MV with GCS, ISS, and whether shock or not. RESULTS: The MV was correlated with GCS, ISS scores, and whether shock or not markedly. Furthermore, when GCS or=35, the ratio of MV was about 85%. CONCLUSIONS: During the treatment of multiple trauma accompanied with cerebral injury, the principle of "early MV, early withdraw" and "individualism" should be insisted on. For patients accompanied with shock, the optimum PEEP is very important. Proper and active MV is of great importance and can improve the treatment level markedly.

Adolescent↗