• Title/Summary/Keyword: cases study

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Phenotype-genotype correlations and the efficacy of growth hormone treatment in Korean children with Prader-Willi syndrome (프래더 윌리 증후군의 유전학적 발병 기전에 따른 표현형 및 성장 호르몬 치료 효과에 관한 연구)

  • Bae, Keun Wook;Ko, Jung Min;Yoo, Han Wook
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.315-322
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    • 2008
  • Purpose : Prader-Willi syndrome (PWS) is a complex genetic disorder, caused by the deletion of the paternally derived 15q11-13 region or the maternal uniparental disomy of chromosome 15 (mUPD(15)). In this study, we compared phenotypic differences between those patients whose disease was caused by microdeletion and those caused by mUPD(15). In addition, a comparison of the efficacy of growth hormone (GH) therapy between these two PWS genotypes was analyzed. Methods : Fifty-three patients were diagnosed as having PWS based on molecular and cytogenetic analyses and clinical features. Data that included maternal age, birth weight, a feeding problem in the neonatal period, cryptorchidism, developmental delay or mental retardation, short stature, hypopigmentation, changes in height, weight, and body mass indexes (BMI) before and after GH treatment were obtained by a retrospective review of medical records. The data from the patients with microdeletion were compared with those from the patients with mUPD(15). Results : Of the 53 patients with genetically confirmed PWS, 39 cases had microdeletion and 14 mUPD(15). Maternal ages were significantly higher in the mUPD(15) group, and hypopigmentation and a feeding problem in the neonatal period were more frequent in the microdeletion group. Growth hormone was administered to 20 patients [14 with microdeletion, 6 with mUPD(15)]. There were no differences between the two groups in height velocity, weight and height SDS, and BMI after GH therapy. Conclusion : Phenotype and genotype correlations were observed in Korean PWS patients, such as more advanced maternal ages in the mUPD(15) group and more feeding problems and hypopigmentations in the microdeletion group. Further long-term prospective studies are needed to correlate other aspects of the phenotypes.

Analysis on the association between EEG and 2-deoxy-2-[18F]-D-glucose (FDG)-PET findings in children with epilepsy (소아 간질 환아에서 뇌파와 PET과의 연관성에 대한 분석)

  • Hur, Yun Jung;Lee, Joon Soo;Lee, Jong Doo;Kim, Heung Dong
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.286-292
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    • 2008
  • Purpose : We performed EEG and PET on children with epilepsy concomitantly in order to evaluate the effects of epileptiform and non-epileptiform discharge of EEG on glucose metabolism. Methods : Seventy three children with epilepsy who had PET and EEG simultaneously were included in our study. The subjects were classified in two ways: (1) based on the frequency of epileptiform discharge and (2) the severity of non-epileptiform discharge. We evaluated the clinical aspects of their seizures, the severity of focal slow waves during the interictal period with the frequency of spikes or sharp waves in order to compare with the PET results. Results : The subjects were divided by the frequency of epileptiform discharge, with 13 in the no/rare group, 7 in the occasional group, and 53 children in the frequent group. The concordant rates with PET in each group were 0%, 42.9%, and 67.9%, respectively, showing high correlations with the frequency of epileptiform discharge (P<0.05, r=0.491). The subjects as divided by the severity of non-epileptiform discharge were 15 in the no group, 25 in the infrequent group, 17 in the intermediate group, and 16 in the continuous group. The concurrence rates with PET for each group were 13.3%, 52.0%, 64.7%, and 68.8%, respectively, also showing a high correlation with the severity of non-epileptiform discharge (P<0.05, r= 0.365). Conclusion : Epileptiform discharge and non-epileptiform discharge in EEG showed a certain association with hypometabolism in PET. We recommend EEG to reduce false lateralization and to localize lesions in cases of high frequency and severity.

Association between Cancer and Selenium Concentration in Blood and Toenails (혈액과 발톱의 셀레니움 농도와 암과의 관련성)

  • Rhee, Jung-Kil;Chung, Jong-Hak;SaKong, Jun;Kang, Pock-Soo;Kim, Chang-Yoon;Lee, Kyeong-Soo;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.29-43
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    • 1992
  • A case-control study was conducted to investigate the association between the risk of cancer and selenium concentration in blood and toenails. Seventy three patients and two hundreds eighty three controls were, selected at the Yeungnam University Hospital between May and September in 1991. The selected cases were patients who had been hospitalized for stomach or colon cancer at the Depertment of General Surgery. The controls were people who visited to check physical examination at the Automated Mediscreening Center. The selenium concentration in whole blood and toenails were measured by atomic absorption spectrophotometer equipped with graphite furnace atomizer. The following information was ascertained for all cancer patients and controls : sex, age, body mass index, blood pressure, total serum cholesterol, and history of smoking and drinking. The mean selenium concentration in blood and toenail for all cancer patients were $143.6{\pm}10.8{\mu}g/l$ and $1.04{\pm}0.62{\mu}g/g$ and for the controls, $167.0{\pm}14.5{\mu}g/l$ and $1.15{\pm}0.55{\mu}g/g$, respectively. The difference in blood and toenail selenium concentrations of the two cancer sites was not statistically significant. Metastasis did not influence the concentration of selenium in blood and toenails. In the multiple logistic regression analysis, the blood selenium concentration($_aOR$: 0.888, 95% CI : 0.860-0.918), age, BMI and total serum cholesterol were significant variables for risk of cancer, but the selelenium concentration in toenail was not shown to be a significant variable in this regression analysis. The coefficient for blood selenium concentration adjusted for age, sex, diastolic blood pressure, total serum cholesterol, body mass index and smoking was -0.1184(p<0.01). These findings suggest that low selenium concentration is associated with gastrointestinal cancers. Further epidemiologic studies including important variables such as other antioxidant micronutrients will be necessary.

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A Study on Anxiety-Depression and Psycnoticism in Hospitalized Patients (종합병원 입원 환자의 정신 건강 평가)

  • Kim, Jin-Sung
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.54-67
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    • 1992
  • The author studied the mental status of 497 patients admitted in non-psychiatric wards and 42 patients diagnosed as mental disorders by DSM-III-R criteria and admitted in three general hospitals located in Pusan city, using NADS and PSCS. The assessment were obtained from October, 1991 to March, 1992 and the results as follows: The mean ${\pm}$ SD of Anxiety-Depression scores were $34.4{\pm}10.4$ in non-psychiatric patients and $50.0{\pm}18.3$ in psychiatric patients. The psychiatric group had significantly higher scores than non-psychiatric group. The mean ${\pm}$ SD of Psychosis scores were $3.9{\pm}4.4$ in non-psychiatric patients and $20.3{\pm}9.8$ in psychiatric patients. The psychiatric group had significantly higher scores than non-psychiatric group. In the psychosocial factors, dissatisfaction in family atmosphere and acquaintanceship with parellts(P<0.001, relatively), pessimistic in future, present and past self-images(P<0.001, relatively), and yes in previous psychiatric treatment of admission(P<0.01, relatively) had common significant relationships to Anxiety-Depression and Psychosis scores. There were correlationships between NADS scores and PSCS scores(${\gamma}$ = 0.74), past and present self-images(${\gamma}$ = 0.45), present and future self images(${\gamma}$ = 0.45), past and future self-images(${\gamma}$ = 0.34) and family atmosphere and acquaintanceship with parents(${\gamma}$ = 0.49). The regression analysis revealed that present self-image, acquaintanceship with parents, future self-image, past self-image, and family atmosphere, in order of significance were to be descriptive or predicable variances for Anxiety-Depression status. The discriminant analysis according to Anxiety-Depression scores showed that the cases of incorrect classification were 22 for non-psychiatric patient group and 2 for psychiatric patient group.

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Studies on the Fracture Healing in the Alloxan treated Rabbits (Alloxan 투여 가토(家兎)에 대한 골절치유 실험)

  • Kim, Sung-Joon
    • The Korean Journal of Pharmacology
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    • v.7 no.1
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    • pp.53-65
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    • 1971
  • It is well known that diabetes mellitus is associated with metabolic derangements, such as hyper-glycemia, ketosis, glycosuria, and also widespread alterations in the blood vessels, kidneys, eyes, peripheral nerves and heart. It is also recognized that healing of skin wound is delayed in diabetics. In bone, according to Aegerter, osteopenia develops in diabetes mellitus and it is chiefly ascribed to overutilization of protein. Shim claims that total blood flow to the entire skeletal system is approximately 4 to 8 percent of resting cardiac output and blood supply to the skeletal system would be decreased on account of secondary arteriosclerotic changes in the diabetics. An adequate blood supply is an essential factor in the healing process of fracture, and disturbed blood flow, either local or systemic, will invariably delay union of the fragments or the fragments from being fused. As the author has encountered several cases of diabetics in whom healing of fracture was delayed or incomplete, this experimental study was undertaken to elucidate the effects of hyperglycemia and diabetes mellitus on the healing process of fracture. In this experiment adult albino rabbits, weighing about 2 kg. were used and divided into 6 groups. The femur of each animal was fractured surgically, and then the healing process of fracture was periodically checked by radiography at an interval of one week for a period of 6 weeks. Thereafter, all the rabbits were killed to obtain tissue preparation of the femur. The experimental groups were as follows; 1) Control group: Six rabbits sustained a surgical fracture to the femur, without being given any other treatment or drug. 2) Alloxan-treated group: For inducing diabetes, alloxan was given intravenously to 17 rabbits in various dose as follows; to 7 of them 40 mg/kg, to 6 rabbits 80 mg/kg and to 4 rabbits 120 mg/kg of body weight, respectively. 3) Insulin-treated group: Protamine-zinc insulin was injected subcutaneously to each of 6 rabbits in a daily dose of 1 unit per kilogram of body weight. 4) Group treated with insulin after alloxan: Four rabbits were given 80 mg of alloxan once and than 1 unit of insulin per kilogram of body weight daily. Another 5 rabbits were injected 1 unit of insulin per kg of body weight daily following administration of alloxan in a dose of 120 mg/kg. 5) Homotransplantation group: Following intravenous injection of alloxan in a dose of 120 mg/kg, 10 rabbits underwent homotransplantation of a short bone segment to the femur. Five of them were subsequently given 1 unit/kg of insulin daily. 6) Sugar-treated group: six rabbits were fed $15{\sim}20$ gm of sugar daily throughout the period of experiment. The results obtained are summarized as follows; 1. Blood sugar level and damage to the pancreatic islet increased proportionately when alloxan was given to the rabbits in various doses. No appreciable change could be observed in the islets when the blood sugar level was altered by either oral administration of sugar or subcutaneous injection of insulin. 2. Comparing with the control group, healing of fracture was delayed in the alloxan-treated group, while callus formation and periosteal reaction were shown to be more prominent in this group and subsequently, the ultimate osseous tissue formed at the fracture site was significantly smaller in amount and less compact. These findings were more marked as the amount of alloxan increased. 3. Administration of insulin prevented the delay in healing process of fracture in the rabbits with alloxan-induced hyperglycemia. In this case, the course and progression of fracture healing were almost similar to those of control group. 4. Union between the host bone and the fragment transplanted from other rabbit of the same species was more delayed in the group treated with alloxan alone than in the group to which insulin was administered after development of alloxan-induced diabetes. In both groups periosteal new bone developed from the ends of the host bone, above and below the transplanted fragment, and directly fused with failure of periosteal callus to bridge the adjacent ends of the host bone and the transplanted fragment. 5. The healing process of fracture was not inhibited by alteration in blood sugar level when the blood sugar was abnormally increased by excessive sugar intake or lowered by administration of insulin alone. The healing of fracture in these groups progressed similarly as in the control group. In brief summary, it appears that the healing process of fracture would be definitely disturbed in diabetic state brought about by damage to the pancreatic islet. As such an inhibition could be overcome with insulin, it seems that insulin plays an important role in healing of fracture, but alteration in blood sugar level alone does not modify healing process of fracture to significant degree.

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Increased Carboxyhemoglobin and Serum Iron Concentration as an Indicator of increased Red Cell Turnover in Preeclampsia (임신성 고혈압 환자에서 적혈구교체의 지표로서 일산화탄소 혈색소와 혈청 철의 임상적 의의)

  • Kim, Sang-Heon;Lee, Kwang-Hee;Kim, Mi-Sook;Lee, Young-Gi;Park, Yoon-Kee;Lee, Tae-Hyung;Lee, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.68-76
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    • 1993
  • Pregnancy induced hypertension is multifaceted syndrome with variable involvement of several key organ systems, so sensitive and specific laboratory tests for predicting severity and prognosis, and early diagnosis of this disease are required. Because heme catabolism results in equimolar production of carboxyhemoglobin, iron and bilirubin, a concomittant rise of these parameters would provide confirmation of increased heme catabolism. Microangiopathic hemolytic anemia may occurs in severe preeclampsia, but it is not known whether increased red cell turnover occurs with mild preeclampsia as complication. The purpose of this study was to confirm that increased heme catabolism also occurs in patients with mild preeclampsia. The analysis of data was done on 23 cases with mild preeclampsia and 35 normal pregnant women, who were admitted to Yeungnam University Hospital from October 1992 to March 1993. The results were as follows. 1. The mean antepartum serum iron concentration was significantly higher in the group with mild preeclampsia($86.5{\pm}6.1{\mu}g/dl$) than in the controls($53.2{\pm}5.3{\mu}g/dl$). 2. The mean antepartum and postpartum carboxyhemoglobin concentrations were significantly higher in the group with mild preeclampsia(antepartum : $2.55{\pm}0.42{\mu}g/dl$, postpartum : $1.21{\pm}0.4{\mu}g/dl$) than the controls(antepartum : $0.61{\pm}0.2{\mu}g/dl$, postpartum $0.53{\pm}0.2{\mu}g/dl$) 3. During postpartum, carboxyhemoglobin concentration in preeclampsia reduced significantly from antepartum level, but, there was no difference between antepartum and postpartum carboxyhemoglobin concentrations among controls. 4. Bilirubin concentrations were similar in both groups.

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ATHEROSCLEROSIS, CHOLESTEROL AND EGG - REVIEW -

  • Paik, I.K.;Blair, R.
    • Asian-Australasian Journal of Animal Sciences
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    • v.9 no.1
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    • pp.1-25
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    • 1996
  • The pathogenesis of atherosclerosis can not be summarized as a single process. Lipid infiltration hypothesis and endothelial injury hypothesis have been proposed and investigated. Recent developments show that there are many points of potential interactions between them and that they can actually be regarded as two phases of a single, unifying hypothesis. Among the many risk factors of atherosclerosis, plasma homocysteine and lipoprotein(a) draw a considerable interest because they are independent indicators of atherogenicity. Triglyceride (TG)-rich lipoproteins (chylomicron and VLDL) are not considered to be atherogenic but they are related to the metabolism of HDL cholesterol and indirectly related to coronary heart disease (CHD). LDL can of itself be atherogenic but the oxidative products of this lipoprotein are more detrimental. HDL cholesterol has been considered to be a favorable cholesterol. The so-called 'causalist view' claims that HDL traps excess cholesterol from cellular membranes and transfers it to TG-rich lipoproteins that are subsequently removed by hepatic receptors. In the so-called 'noncausalist view', HDL does not interfere directly with cholesterol deposition in the arterial wall but instead reflects he metabolism of TG-rich lipoproteins and their conversion to atherogenic remnants. Approximately 70-80% of the human population shows an effective feedback control mechanism in cholesterol homeostasis. Type of dietary fat has a significant effect on the lipoprotein cholesterol metabolism and atherosclerosis. Generally, saturated fatty acids elevate and PUFA lower serum cholesterol, whereas MUFA have no specific effect. EPA and DHA inhibit the synthesis of TG, VLDL and LDL, and may have favourable effects on some of the risk factors. Phospholipids, particularly lecithin, have an antiatherosclerotic effect. Essential phospholipids (EPL) may enhance the formation of polyunsaturated cholesteryl ester (CE) which is less sclerotic and more easily dispersed via enhanced hydrolysis of CE in the arterial wall. Also, neutral fecal steroid elimination may be enhanced and cholesterol absorption reduced following EPL treatment. Antioxidants protect lipoproteins from oxidation, and cells from the injury of toxic, oxidized LDL. The rationale for lowering of serum cholesterol is the strong association between elevation of plasma or serum cholesterol and CHD. Cholesterol-lowing, especially LDL cholesterol, to the target level could be achieved using diet and combination of drug therapy. Information on the link between cholesterol and CHD has decreased egg consumption by 16-25%. Some clinical studies have indicated that dietary cholesterol and egg have a significant hypercholesterolemic effect, while others have indicated no effect. These studies differed in the use of purified cholesterol or cholesterol in eggs, in the range of baseline and challenge cholesterol levels, in the quality and quantity of concomitant dietary fat, in the study population demographics and initial serum cholesterol levels, and clinical settings. Cholesterol content of eggs varies to a certain extent depending on the age, breed and diet of hens. However, egg yolk cholesterol level is very resistant to change because of the particular mechanism involved in yolk formation. Egg yolk contains a factor of factors responsible for accelerated cholesterol metabolism and excretion compared with crystalline cholesterol. One of these factors could be egg lecithin. Egg lecithin may not be as effective as soybean lecithin in lowering serum cholesterol level due probably to the differences of fatty acid composition. However, egg lecithin may have positive effects in hypercholesterolemia by increasing serum HDL level and excretion of fecal cholesterol. The association of serum cholesterol with egg consumption has been widely studied. When the basal or control diet contained little or no cholesterol, consumption of 1 or 2 eggs daily increased the concentration of plasma cholesterol, whereas that of the normolipemic persons on a normal diet was not significantly influenced by consuming 2 to 3 eggs daily. At higher levels of egg consumption, the concentration of HDL tends to increase as well as LDL. There exist hyper-and hypo-responders to dietary (egg) cholesterol. Identifying individuals in both categories would be useful from the point of view of nutrition guidelines. Dietary modification of fatty acid composition has been pursued as a viable method of modifying fat composition of eggs and adding value to eggs. In many cases beneficial effects of PUFA enriched eggs have been demonstrated. Generally, consumption of n-3 fatty acids enriched eggs lowered the concentration of plasma TG and total cholesterol compared to the consumption of regular eggs. Due to the highly oxidative nature of PUFA, stability of this fat is essential. The implication of hepatic lipid accumulation which was observed in hens fed on fish oils should be explored. Nutritional manipulations, such as supplementation with iodine, inhibitors of cholesterol biosynthesis, garlic products, amino acids and high fibre ingredients, have met a limited success in lowering egg cholesterol.

The Study on the Effects of the Economical Use of Irrigation Water by Different Irrgation Periods and Its Methods on the Growth, Yield and the Factors of Rice Plants. (절수의 시기 및 방법의 차이가 수도생육 수량과 기타 실용형태질 미치는 영향)

  • 이창구
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.10 no.1
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    • pp.1388-1393
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    • 1968
  • Higher yield in rice paddies is greatly dependent on adequately balanced and timely supply of water. A majority of rice paddy in Korea is generally irrigated by rainfall, but in many cases it has to be supplemented by artificial irrigation for optimum rice culture. Although the water requirement of rice plant is far higher than that of other crops, submerged condition of rice paddy is not necessarily required. The moisture requirement of rice plant varies with its growing stages, and it is possible to increase the irrigation efficiency through reduction of water loss due to percolation in rice paddies. An experiment was conducted on the effectiveness of economical use of water by different irrigation period and different method of cultivation. The experimental plots were set up by means of randomized block design with three duplications; (a) Alltime submerged (b) Economically controlled, and (c) Extremely controlled. Three different irrigation periods were (a) Initial stage (b) Inter-stage, and (c) last stage. The topsoil of the three plots were excavated to the depth of 30cm and then compacted with clay of 6 cm thickness. Thereafter, they were piled up with the excavated top soils, leveled and cored with clay of 6cm thickeness arround footpath in order to prevent leakage. The results obtained frome the experiments are as follows; (1) There is no difference among the three experiment plots in terms of physical and chemical contditions, soil properties, and other characteristics. (2) Colulm length and ear length are not affected by different irrigation methdos. (3) There is no difference in the mature rate and grain weight of rice for the three plots. (4) The control plot which was irrigated every three days shows an increased yield over the all the time submerged plot by 17 persent. (5) The clay lined plot whose water holding capacity was held days long, needs only to be irrigated every 7 days. (6) The clay lined plot showes an increased yield over the untreated plot; over all the time submerged plot by 18 percent, extremely controlled plot by 18 percent, and economically controled plot by 33 percent.

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Risk Assessment of Agricultural Worker's Exposure to Fungicide Thiophanate-methyl during Treatment in Green Pepper, Cucumber and Apple Fields (고추, 오이 및 사과 재배 중 살균제 Thiophanate-methyl 살포 시 농작업자의 노출 및 위해 평가)

  • Choi, Hoon;Kim, Jeong-Han
    • Journal of Applied Biological Chemistry
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    • v.57 no.1
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    • pp.73-81
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    • 2014
  • The present study was carried out to assess exposure and risk to thiophanate-methyl wettable powder for agricultural worker during mixing/loading and application with power sprayer in green pepper, cucumber and apple fields. Dermal exposure was measured with patches, gloves, socks and masks, while inhalation exposure was evaluated with personal air pump and solid sorbent. Those methods were full validated before experiment. During mixing/loading, dermal exposure amount in green pepper, cucumber and apple fields was $24.0{\pm}6.7$, $4.5{\pm}1.5$ and $18.5{\pm}0.6mg$, corresponding to mean 0.007, 0.001 and 0.005% of prepared active ingredient, respectively. The major exposed part for mixer/loader was hands (78-92%). Dermal exposure amount for applicator in green pepper, cucumber and apple fields was $84.9{\pm}14.0$, $34.0{\pm}20.8$ and $30.7{\pm}9.1mg$, corresponding to mean 0.024, 0.016 and 0.013% of applied active ingredient, respectively. The main body parts of exposure in apple field were hands, while thighs and shins in other fields. Inhalation exposure amount in green pepper, cucumber and apple fields was $1.5{\pm}2.2$, $52.7{\pm}48.9$ and $4.0{\pm}4.9{\mu}g$ during mixing/loading and $0.2{\pm}0.1$, $23.2{\pm}12.4$ and $0.4{\pm}0.6{\mu}g$ for applicator, respectively. These results were suggested that main factors affecting dermal exposure were contact frequency to the plants, foliage density, hygienic behavior, work type, and working environment, while inhalation exposure was affected mainly by working environment, especially wind. In risk assessment, margin of safety for thiophanate-methyl in all cases was over 1. However, during application in green pepper field, margin of safety was close to 1.

Production of Alternative Coagulant Using Waste Activated Alumina and Evaluation of Coagulation Activity (폐촉매 부산물로부터 대체 응집제 제조 및 응집성능 평가)

  • Lee, Sangwon;Moon, Taesup;Kim, Hyosoo;Choi, Myungwon;Lee, Deasun;Park, Sangtae;Kim, Changwon
    • Journal of Korean Society of Environmental Engineers
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    • v.36 no.7
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    • pp.514-520
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    • 2014
  • In this study, the production potential of alternative coagulant ($Al_2(SO_4)_3$ solution) having the identical coagulation activity with respect to the commercial coagulant was investigated. The raw material of alternative coagulant was a spent catalyst including aluminium (waste activated alumina) generated in the manufacturing process of the polymer. The alternative coagulant was produced through a series of processes: 1) intense heat and grinding, 2) chemical polymerization and substitution with $H_2SO_4$ solution, 3) dissolution and dilution and 4) settling and separation. To determine the optimal operating conditions in the lab-scale autoclave and dissolver, the content of $Al_2O_3$ in alternative coagulant was analyzed according to changes of the purity of sulfuric acid, reaction temperature, injection ratio of sulfuric acid and water in the dissolver. The results showed that the alternative coagulant having the $Al_2O_3$ content of 7~8% was produced under the optimal conditions such as $H_2SO_4$ purity of 50%, reaction temperature of $120^{\circ}C$, injection ratio of $H_2SO_4$ of 5 times and injection ratio of water of 2.3 times in dissolver. In order to evaluate the coagulation activity of the alternative coagulant, the Jar-test was conducted to the effluent in aerobic reactor. As a result, in both cases of Al/P mole of 1.5 and 2.0, the coagulation activity of the alternative coagulant was higher than that of the existing commercial coagulant. When the production costs were compared between the alternative and commercial coagulant through economic analysis, the production cost reduction of about 50% was available in the case of the alternative coagulant. In addition, it was identified that the alternative coagulant could be applied at field wastewater treatment plant without environmental problem through ecological toxicity testing.