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A Clinical Study on Transpulmonary Leukostasis and Prophylactic Effects of Steroid in Cardiac Surgery (심장수술시 백혈구의 폐내정체와 스테로이드의 예방적 효과에 관한 연구)

  • 최석철
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.133-151
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    • 1996
  • After cardiac surgery, it has been recognized that various complications were associated with injured humoral and cellular immunity by cardiopulmonary bypass(CPB). Especially, in postoperative pulmonary dysfunction, transpulmonary leukostasis followed complement activation and inflammatory responses are major pathogen. Some studies have showed that pretreated-corticosteroids before CPB protected postoperative pulmonary dysfunction. Corticosteroids may inhibit complement and leukocyte activation. On based previous studies, present investigator determined changes of leukocyte counts and transpulmonary leukostasis during cardiac surgery and postoperative periods. For the evaluation of postoperative pulmonary function and edema, $PaO_2$ and chest X-ray were compared between pre-CPB and post-CPB. Fever and other parameters were also observed postoperatively. The aim of this study was to define for the prophylactic effects of corticosteroid(Solu-Medrol: 30mg/kg) on all the researched parameters. This study was prospectively designed with randomized-blind fashion for 50 patients undergoing cardiac surgery. According to the purpose of study, all patients were divided into placebo and steroid group. : Placebo group was 25 patients received normal saline(not corticosteroid), and steroid group was 25patients received corticosteroid(Solu-Medrol: 30mg/kg) before initiation of CPB. The results of study were summarized as follows. 1. Total peripheral leukocyte counts decreased significantly at 5 minutes of CPB in all patients(P<0.01), and began to increase progressively at later periods of CPB with neutrophilia. The significant rise remained at postoperative 7th day(P<0.05). 2. During partial CPB, transpulmonary leukostasis occurred in placebo group(P<0.001), whereas it was prevented in steroid group. 3. In both groups, peripheral lymphocyte counts were stable during CPB, but began to reduce at time of intensive care unit(ICU) and the lymphocytopenia remained until postoperative 3rd day. The lymphocyte counts recovered on postoperative 7th day. 4. In both groups, peripheral counts of monocyte were relatively stable in the early peroid of CPB, and increased gradually in the later periods of CPB. This significant monocytosis remained throughout postoperlative periods(P<0.05). 5. The mean value of postoperative $paO)_2$ was lower than that of pre-CPB in placebo group(P=0.01) but didn't significant in steroid group(P=0.90). In the incidence of pulmonary edema signs and fever, placebo group was higher than steroid group(P=0.001, p=0.01, respectively). However mechanical respiratory supporting and care periods at intensive care unit were not significant difference between two groups(P>.0.05).With the above results, the investigator concluded that leukocyte activation and pulmonary sequestration were caused by cardiac surgery with CPB and demonstrated that high dose corticosteroid will provide prophylactic effect for pulmonary leukostasis and higher neutrophilia. These effects may ameliorate postoperative pulmonary dysfunction and contribute to postoperative less morbidity. However, further study should be performed because postoperative lymphocytopenia continued for 3 days in both groups, which may suspected damage or suppression of cell-mediated immunity with used corticosteroid.

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Hepatic Oxygen Free Radical and Alcolhol Metabolizing Enzyme Activities in Rats Fed Diets Supplemented with Lycium chinense Ethanol Extract (흰쥐에 있어서 구기자 추출물 첨가식이가 간조직의 유해산소 및 알콜대사 효소활성에 미치는 영향)

  • 윤종국;김현희;채순님;오만진;이규희
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.30 no.4
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    • pp.668-672
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    • 2001
  • To investigate the oxygen free radical and alcohol metabolizing system in liver of rats fed diets with 30% ethanol extract of Lycium chinense (LCEE), Sprague-Dawley male rats weighing 225~235g have been fed a diet supplemented with 2% or 4% LCEE for a month. The rats fed LCEE supplemented diets gained less body weight compared with the control, and had no remarkable changes of liver function. In rats fed 2% LCEE supplemented diet, hepatic cytochrome P450 contents appeared to be increased, but catalase (204.88$\pm$20.06 $H_2O$$_2$nmoles/mg protein/min), and superoxide dismutase (13.18$\pm$0.74 Unit/mg protein) activities were significantly increased compared with control 120.28$\pm$26.99 $H_2O$$_2$nmoles/mg protein/min and 10.49$\pm$0.80 Units/mg protein). There was no difference in hepatic glutathione content, glutathione peroxidase, and glutathione-S-transferase ctivities between the rats fed LCEE suplemented diets and the control diet. On the other hand, hepatic alcohol dehydrogenase activity were not changed by LCEE feeding, but hepatic aldehyde dehydrogenase activities were significantly increased in rats fed both 2 and 4% LCEE diets(5.01$\pm$0.21 and 4.47$\pm$0.06 $\mu$moles NADPH/mg protein/min) compared with control (3.28$\pm$0.21 $\mu$moles NADPH/mg protein/min) and its Vmax value was 1.9 fold increased in rats fed 2% LCEE and 1.5 fold in those fed 4% LCEE compared with control. In conclusion, it is likely that rats receiving a diet supplemented with LCEE may have the oxygen free radicals and alcohol detoxication potential.

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Clinical Comparison of Low-dose and High-dose Steroid in Pediatric Cardiac Surgery with Cardiopulmonary Bypass

  • Choi Seok-Cheol;Kim Song-Myung;Kim Yang-Weon
    • Biomedical Science Letters
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    • v.12 no.3
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    • pp.289-301
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    • 2006
  • Cardiopulmonary bypass (CPB) for cardiac surgery triggers the production and release of numerous chemotactic substances and cytokines, ensuing systemic inflammatory response that leads to postoperative major organ dysfunction. Traditionally, corticosteroids (steroid) have been administered to patients undergoing cardiac surgery to ward off these detrimental physiologic alterations. However, the majority of the studies have been performed on adult patients with high-dose steroid. We carried out a randomized, prospective, double-blind study to compare the efficacy of low-dose steroid with that of high-dose steroid and to determine the adequate dose of pretreated-steroid for prophylactic effects in pediatric cardiac surgery. Thirty pediatric patients scheduled for elective cardiac surgery were randomly assigned to two groups; fifteen patients received low-dose methylprednisolone (10mg/kg intravenously, n=15, low-dose group) and the others received high-dose methylprednisolone (30mg/kg intravenously, n=15, high-dose group) 1 hour prior to CPB. Arterial blood samples were taken before CPB (Pre-CPB), 10 minutes after start of CPB (CPB-10), and immediately after CPB-end (CPB-OFF) for measuring total leukocyte counts (T-WBC) and diff-counts, platelet counts, interleukin-6 (IL-6), myeloperoxidase (MPO), total antioxidant (TAO), neuron-specific enolase (NSE), troponin I (TNI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and blood urea nitrogen (BUN) levels. Other parameters such as volumes of urine output, pulmonary index $(PI,\;PaO_2/FiO_2)$, mechanical ventilating period, intensive care unit (ICU)-staying period, postoperative complications (fever, wound problem), postoperative 24 hrs and total volumes in blood loss, and hospitalized days were also assessed. All parameters were compared between two groups. There were no significant differences in T-WBC counts, monocyte fraction, platelet counts, TA levels, NSE levels, creatinine levels, BUN levels, the volumes of total urine output, PI, the incidences of fever and wound problem, postoperative 24hrs- and total-blood loss volumes and ICU-staying period between two groups (P>0.05). At CPB-OFF, neutrophil fraction, MPO level, TNI level, and AST level were higher in the high-dose group than in the low-dose group (P<0.05). IL-6 level at CPB-10 was higher in the high dose-group than in the low-dose group (P<0.05). Furthermore, mechanical ventilating periods and hospitalized days of the high-dose group were significantly longer than those of low-dose group (P<0.05). The high-dose group had significantly low lymphocyte fi-action at CPB-OFF compared with the low-dose group (P<0.001). These findings suggest that pretreatment of high-dose steroid is not superior to that of low-dose steroid regrading its potential benefits in pediatric cardiac surgery. Therefore, the conventional strategy of steroid treatment, high-dose pretreatment, should be modified in the cardiac surgery with CPB. However, further studies must be performed on the larger number of patients in as much as small number of patients in this study.

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Distribution Characteristic of Exploitable Macrobenthic Invertebrates of Beach Sediments in the Southern Coastal Water of Jeju Island (제주남부해역 사질대 유용생물 분포특성)

  • Ko, Jun-Cheol;Ko, Hyuck-Joon;Kim, Bo-Yeon;Cha, Hyung-Kee;Chang, Dae-Su
    • The Korean Journal of Malacology
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    • v.28 no.3
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    • pp.197-213
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    • 2012
  • This study was performed to know the community structure of macrobenthos and environmental factors at each 16 stations in the subtidal sandy bottoms of the southern coastal water of Jeju Island from July to November, 2011. Mean temperature and mean salinity were $20.2-22.7^{\circ}C$, 33.7-34.9 psu which shows stable water messes. Chlorophyll a concentrations of phytoplankton ranged from 0.71 to 1.71 mg/L (1.11 mg/L), showing higher July than September and November with a blooming in summer. The mean concentration values (the ranges in parentheses) of nitrate, phosphate, and silicate are 0.029-0.206 mg/L (0.101 mg/L), 0.001-0.027 mg/L (0.007 mg/L), 0.024-0.682 mg/L (0.454 mg/L), respectively. However, the values higher coastal zone due to influxes from the land. A total of 37 species was identified. of these mollusca comprised 29 secies (78.4%); Echinodermata 5 (13.5%); Arthropoda 3 (8.1%). density and biomass were estimated to be 550 ind./$m^2$ and 20,951.8 gwwt/$m^2$, respectively. Mollusca were the most dominant faunal group in terms of abundance (481 ind./$m^2$) and number of species as well, whereas bivalves were predominant in biomass (16,647.6 gwwt/$m^2$). The dominant species were Vasticardium burchardi, Oblimopa japonica, Mactar achatina, Bornatemishistrioiw akawai, Paphia vernicosa, Amusium japonicum, Glycymeris albolineata, Astriclypeus manni in 15-30 m. The seasonal variation appeared as distinct, Mollusca of individual and biomass. When summer was make a slow increase, after the highest decrease in autumn. The abundance of macrobenthic invertebrates showed significant correlation with environmental factors (Chlorophyll a, DIN, $SiO_2$, Fine sand, Very fine sand) in almost all sampling depths. The biodiversity, evenness richness index were appeared 1.56-2.50 (H'), 0.49-0.80 (E'), 4.12-4.67 (R) in each stations. The dominace index were appeared Highest in November and lowest in September.

Quality Characteristics of Kochujang Prepared with Paecilomyces japonica from Silkworm (누에 동충하초(Paecilomyces japonica)를 첨가하여 제조한 고추장의 품질특성 변화에 관한 연구)

  • Bang, Hye-Yeol;Park, Moo-Hyun;Kim, Gun-Hee
    • Korean Journal of Food Science and Technology
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    • v.36 no.1
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    • pp.44-49
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    • 2004
  • Changes in quality properties of Kochujang prepared with Paecilomyces japonica powder and extract using different solvents were investigated during 90 days of fermentation at $20^{\circ}C$. Although moisture contents were not significantly different, pH of P. japonica-added Kochujang was lower than that of control group without P. japonica, and decreased with increasing fermentation time. Amino nitrogen content increased up to 60 days of fermentation and decreased slightly after 90 days, with that of P. japonica-added Kochujang showing highest on 30 and 60 days at 179.2 and 282.2 mg%, respectively, higher than control gruup. L, a, and b values decreased in proportion to fermentation period, with P. japonica-added Kochujang, particularly P. japonica powder-added Kochujang, lower than those of control g개up. Sensory evaluation test showed color of control group was 'clear red', whereas that of P. japonica powder-added Kochujang was 'dark reddish brown' and P. japonica extract-added Kochujang was darker than control group; consumer preference for dark color was low, Textures of all samples were 'glossy and smooth', showing high consumer preference. Salt content of P. japonica-added Kochujang was higher than that of control group, with P. japonica extract-added Kochujang higher than that made with powder Hot taste or P. japonica-added Kochujang was weaker, whereas its flavor higher, than control group, with P. japonica powder-added Kochujang showing highest flavor score. Overall preference was higher for P. japonica-added Kochujang than control group, with P. japonica water extract-added Kochujang showing the highest score.

Short-Term Efficacy of Steroid and Immunosuppressive Drugs in Patients with Idiopathic Pulmonary Fibrosis and Pre-treatment Factors Associated with Favorable Response (특발성폐섬유화증에서 스테로이드와 면역억제제의 단기 치료효과 및 치료반응 예측인자)

  • Kang, Kyeong-Woo;Park, Sang-Joon;Koh, Young-Min;Lee, Sang-Pyo;Suh, Gee-Young;Chung, Man-Pyo;Han, Jung-Ho;Kim, Ho-Joong;Kwon, O-Jung;Lee, Kyung-Soo;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.685-696
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    • 1999
  • Background : Idiopathic pulmonary fibrosis (IPF) is a diffuse inflammatory and fibrosing process that occurs within the interstitium and alveolus of the lung with invariably poor prognosis. The major problem in management of IPF results from the variable rate of disease progression and the difficulties in predicting the response to therapy. The purpose of this retrospective study was to evaluate the short-term efficacy of steroid and immunosuppressive therapy for IPF and to identify the pre-treatment determinants of favorable response. Method : Twenty patients of IPF were included. Diagnosis of IPF was proven by thoracoscopic lung biopsy and they were presumed to have active progressive disease. The baseline evaluation in these patients included clinical history, pulmonary function test, bronchoalveolar lavage (BAL), and chest high resolution computed tomography (HRCT). Fourteen patients received oral prednisolone treatment with initial dose of 1mg/kg/day for 8 to 12 weeks and then tapering to low-dose prednisolone (0.25mg/kg/day). Six patients who previously had experienced significant side effects to steroid received 2mg/kg/day of oral cyclophosphamide with or without low-dose prednisolone. Follow-up evaluation was performed after 6 months of therapy. If patients met more than one of followings, they were considered to be responders : (1) improvement of more than one grade in dyspnea index, (2) improvement in FVC or TLC more than 10% or improvement in DLco more than 20% (3) decreased extent of disease in chest HRCT findings. Result : One patient died of extrapulmonary cause after 3 month of therapy, and another patient gave up any further medical therapy due to side effect of steroid. Eventually medical records of 18 patients were analyzed. Nine of 18 patients were classified into responders and the other nine patients into nonresponders. The histopathologic diagnosis of the responders were all nonspecific interstitial pneumonia (NSIP) and that of nonresponders were all usual interstitial pneumonia (UIP) (p<0.001). The other significant differences between the two groups were female predominance (p<0.01), smoking history (p<0.001), severe grade of dyspnea (p<0.05), lymphocytosis in BAL fluid ($23.8{\pm}16.3%$ vs $7.8{\pm}3.6%$, p<0.05), and less honeycombing in chest HRCT findings (0% vs $9.2{\pm}2.3%$, p<0.001). Conclusion : Our results suggest that patients with histopathologic diagnosis of NSIP or lymphocytosis in BAL fluid are more likely to respond to steroid or immunosuppressive therapy. Clinical results in large numbers of IPF patients will be required to identify the independent variables.

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Species Diversity of Riparian Vegetation by Soil Chemical Properties and Water Quality in the Upper Stream of Mankyeong River (만경강 상류 수질 및 식생분포와 토양환경에 따른 하천식생의 종 다양성)

  • Lee, Kyeong-Bo;Kim, Chang-Hwan;Lee, Deog-Bae;Kim, Jong-Gu;Park, Chan-Won;Na, Seoung-Yong
    • Korean Journal of Environmental Agriculture
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    • v.22 no.2
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    • pp.100-110
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    • 2003
  • This study was conducted to evaluate influence of chemical properties in the riparian on the species diversity and to get plant information for enhancement of natural purification in Mankyeong River. The concentration of total nitrogen was high in Jeonju and Sam stream, while that of total nitrogen showed the highest peak in Winter. Concentrations of $NH_4-N$ was $0.01{\sim}0.06\;mg/L$ in Gosan and Soyang stream. The water quality of upstream along with Mankyeong River was suitable for the irrigation source. The riparian vegetation was investigated by Zurich-Montpellier school's method from June, 2001 to September, 2002. The number of riparian plants were 59 families, 129 genera, 165 species, 20 varieties in Gosancheon, on the while 53 families, 111 genera, 141 species, 19 varieties in Soyangcheon. The number of riparian plants in Bari basin was higher than that of other sites namely, 73 families, 134 genera, 218 species, 33 varieties. Riparian vegetation was consisted of 12 plant communities. The contents of organic matter, total nitrogen and electrical conductivity had negative relationship with species diversity (Species richness index, Heterogeneity index, Species evenness index Species number). On the while, species diversity had positive relationship with soil pH. Species diversify of the plant communities were affected by topography and disturbance.

Effect of xylazine hydrochloride on histamine release (Xylazine이 histamine 유리에 미치는 영향)

  • 김영환;박준형
    • Korean Journal of Veterinary Service
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    • v.25 no.1
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    • pp.53-73
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    • 2002
  • It has been reported that degranulation of mast cells in rats, rabbits and dog was observed after dosing xylazine hydrochloride(Xh) which has been widely used as sedative, analgesic and muscular relaxant. Therefore, this experiment was conducted to examine the relations between Xh and histamine release and to identify the action of ${\alpha}$-adrenoceptors which exists on the suface of mast cells. 1. The content of histamine within serum was measured with HPLC by performing the O-phthalaldehyde(OPA) fluorescent derivation. The pretreatment method had a little modification from the conventional method. The pretreament was carried out in the following method. 0.2$m\ell$ of serum and 1$m\ell$ of butanol were added to mixed together and then the liquid was centrifugally separated at 4$^{\circ}C$ and 2,000 rpm for 3 minutes. 0.4$m\ell$ of 0.1N HCl and 1.6$m\ell$ of heptane were added to 0.8$m\ell$ of supernatant taken from the liquid, and they were mixed together. This mixture was also centrifugally separated at 4$^{\circ}C$ and 2,000 rpm for 5 minutes. The supernatant was thrown away and the OPA fluorescent derivation was carried out with 0.2$m\ell$ of the lower liquid then, 5 minutes after mixing 400${\mu}\ell$ of 0.1N HCl, 120${\mu}\ell$ of 1N NaOH and 40${\mu}\ell$ of 0.1% OPA in the 0.2$m\ell$ of the lower liquid,120${\mu}\ell$ of 3.57N H$_3$PO$_4$ was added to the mixed liquid, and the liquid, was mixed again and syringe-filtered. Then, the measurement was done with HPLC in the 30 : 70(ν/ν) ratio of 0.004M KH$_2$PO$_4$: CH$_3$CN, flow rate of 1.0$m\ell$/min., and a wavelength of λex= 350nm and λem=444nm at the column temperature of 27$^{\circ}C$, using the fluorescence detector. 2. The content of histamine in each laboratory animal appeared to be higher in such an order as rabbit, rat, guinea pig, dog, Korean indigenous goat, swine, Korean indigenous cattle, Holstein, and mouse, of which the individual mean values${\pm}$standard deviation were 2.0668 ${\pm}$ 0.6049. 0.4999 ${\pm}$ 0.2278, 0.4241 ${\pm}$ 0.1974, 0.1054 ${\pm}$ 0.0556, 0.1028 ${\pm}$ 0.0276, 0.0972 ${\pm}$ 0.0513, 0.0872 ${\pm}$ 0.0373, 0.0717 ${\pm}$ 0.0379, and 0.0706 ${\pm}$ 0.0366, respectively. 3. The content of histamine was measured at the moments of 15-, 30-, 60-, 120-minutes after inoamuscular injection of 20mg/100kg Xh into two to 4 years old Holstein weighing 600∼700kg. The result showed that there was a significant increase at the times of 30- and 90-minutes after injection(p<0.05). 4. Intramuscular injection of 3mg/10kg Xh was given to crossbred pug dogs weighing 2.5∼4.3kg. The content of histamine was measured at the times of 30-, 60-, 90- and 120-minutes after injection. The result revealed that there was a significant increase at the times of 60-and 90-minutes after injection(p<0.05). 5. Intramuscular injection of 10mg/$m\ell$∼25mg/$m\ell$ Xh in concentration of 0.1$m\ell$ was applied to Korean indigenous goat over 5 months old. Then, the content of histamine was measured at the times of 15-, 30-, 60- and 90-minutes after injection. A significant increase was shown at the times of 30- and 60-minutes after injection(p<0.05). 6. The content of histamine was measured at the moments of 30- and 60-minutes after intramuscular injection of 0.1-0.2$m\ell$ Xh (20mg/$m\ell$) into male rabbits weighting 2.5-4kg. A significant increase was found at the moment of 60 minutes after injection(p<0.001). 7. After administering Xh to the mast cell taken from the abdominal cavity of mouse, the content of histamine was measured. The result showed that the higher the concentration, the more significantly the content of histamine was increased(p<0.05). 8. Compound 48/80 was administered in concentration of 5$\mu\textrm{g}$/$m\ell$ and 10$\mu\textrm{g}$/$m\ell$ to the mast cell picked from the abdominal cavity of mouse. The result showed that there was a significant increase in the content of histamine in case of the concentration of 10$\mu\textrm{g}$/$m\ell$(p<0.05). It was found to be about 10,000 to 500,000 times stronger than the Xh. 9. After premedication of 1mg/kg of yohimbine hydrochloride as ${\alpha}$$_2$-adrenergic antagonist to rabbits, the Xh was administered to them. The result was that the value of histamine within serum was decreased significantly(p<0.001). 10. After premeditation of 1mg/kg of prazosin hydrochloride as ${\alpha}$$_1$-adrenergic antagonist to rabbits, the Xh was administered to them. It was found that the value of histamine within serum was decreased significantly(p<0.005). 11, Prazosin hydrochloride and yohimbine hydrochloride as ${\alpha}$$_1$-adrenergic antagonist, respectively, and ${\alpha}$$_2$-adrenergic antagonist were administerd. In this case, the value of histamine within serum was decreased significantly(p<0.0001). As the results, when the Xh is administered to various kinds of animals, the amount of histamine release within serum is increased. In view of the results so far achieved, it is concluded that Xh acted on both a$_1$-adrenoreceptor and ${\alpha}$$_2$-adrenoreceptor induces the degranulation of mast cell.

Evaluation of the Immune Response Following Exposure of Mice to Bisphenol A: Induction of Th1 Cytokine and Prolactin by BPA Exposure in the Mouse Spleen Cells

  • Youn, Ji-Youn;Park, Hyo-Young;Lee, Jung-Won;Jung, In-Ok;Choi, Keum-Hwa;Kim, Kyung-Jae;Cho, Kyung-Hea
    • Archives of Pharmacal Research
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    • v.25 no.6
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    • pp.946-953
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    • 2002
  • Bisphenol A [2, 2 bis (4-hydoxyphenyl) propane; BPA] is a widely used endocrine disruptors and has estrogenic: activities. Although interests on biological effect of BPA are rising, evidences of its effect on immune system are lacking. We investigated that the effect of BPA on immune parameters to postulate the mechanism, and BPA interruptions between neuroendocrine and immune system. BPA was administrated to mice by p.o. (as a drinking water) dose on 0.015, 1.5 and 30 mg/ml for 4 weeks. The BPA treatment did not result in any change in body weight, spleen weight and distribution of lymphocyte subpopulation collected from spleen. BPA induced prolactin production in spleen, and exposure of SPA increased the activity of splenocyte proliferation in response to Con A (p<0.001). The production of a strong Th-1 type cytokine ($IFN-{\gamma}$) was induced while Th-2 type (IL-4) was suppressed by SPA treatment. These were consistent with RT-PCR results of transcription factor GATA-3 and IRF-1. These findings suggested that stimulation of prolactin production by estrogenic effects of SPA would affect cytokine profiles, and lead to imbalanced cellular immune response. In addition, we could speculate that prolactin and cytokine is important mediator involved in network between neuroendocrine and immune system by BPA.

Comparison of nitrogen removal efficiency on process stability for granular and immobilized anammox bacteria (공정 안정성에 대한 입상 및 고정화 혐기성 암모늄 산화균의 질소제거효율 비교)

  • Choi, Daehee;Bae, Hyokwan;Jung, Jinyoung;Kim, Sang-Hyoun
    • Journal of Korean Society of Water and Wastewater
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    • v.28 no.2
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    • pp.195-206
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    • 2014
  • Immobilization of anaerobic ammonium oxidizing bacteria has been studied to enhance the biomass retention of the slowly growing bacteria and the process stability. The purpose of this study was to compare the nitrogen removal efficiency of granular and immobilized anammox bacteria with poly vinyl alcohol and alginate. The specific anammox activity of the granular, homoginized and immobilized anammox bacteria were $0.016{\pm}0.0002gN/gVSS/d$, $0.011{\pm}0.001gN/gVSS/d$ and $0.007{\pm}0.0005gN/gVSS/d$, respectively. Although the activity decreased to 43.7 % of the original one due to low pH and $O_2$ exposure during the homogination and the immobilization, it was rapidly recovered within 7 days in the following continuous culture. When synthetic T-N concentrations of 100, 200, 400, 800 mg/L were fed, the immobilized anammox bacteria showed higher nitrogen removal efficiencies at all operational conditions than those of granular anammox bacteria. When the sludge retention time was shorten below 30.7 days and the reject water was fed, the nitrite removal efficiency of the granular anammox bacteria dropped to 8 % of the initial value, while that of the immobilized anammox bacteria was maintained over 95 % of the initial one. The immobilization with poly vinyl alcohol and alginate would be a feasible method to improve the performance and stability of the anammox process.