Assessment of activated sludge, membrane bioreactors and vertical flow wetlands for upgrading sewage treatment works.

This paper demonstrates that utilising a vertical flow (VF) wetland after a conventional activated sludge (CAS) delivers equivalent or better effluent quality to a membrane bioreactor (MBR) based on a side-by-side pilot trial. The CAS was operated under the solids retention times (SRT) of 6, 12, and 20 days, with the effluent from each pilot plant fed onto a soil aquifer treatment column to better understand their water reuse application potential. Results showed an upgraded CAS + VF system could deliver effluents with median values of 34 mgO2.L-1, 7 mg.L-1 and 1.9 mg.L-1 for organics, solids and ammonia nitrogen, respectively, which were statistically similar to those from the MBR. Water reuse standards were achieved by the upgraded system for most parameters, with the exception of total coliform removal. The upgraded system delivered superior metal removal when compared to the CAS. An economic analysis showed upgrading a CAS with a VF wetland was more favourable than investing in an MBR system for example works of 5000 and 50,000 population equivalents if the VF system was operated at hydraulic loading rates of 0.03 m.d-1 and 0.08 m.d-1, respectively. This was delivered for a tenth of the carbon footprint of the MBR treatment.

Intragraft mechanisms associated with the immunosuppressive versus the tolerogenic effect of CD3 antibodies in a mouse model of islet allografts.

We previously demonstrated the ability of CD3-specific antibodies (Abs) to induce tolerance of fully mismatched pancreatic islets when administered at the time of effector T-cell priming (day +7). When administered on day -1, CD3 Abs only displayed an immunosuppressive effect with no permanent acceptance. Here we show that rejection correlates with progressive migration of CD4(+) and CD8(+) T cells into the graft. In contrast, the day +7 CD3 Ab tolerogenic effect is associated with absence of de novo accumulation of CD8(+) T cells within the allograft while CD4(+) T-cell migration is not altered. Furthermore, the increased proportion in T-regulatory cells, observed both in the draining lymph nodes and in the transplanted islets, was more pronounced after the delayed (day +7) than the early (day -1) CD3 Ab course. Last, tolerance-promoting (day +7), but not immunosuppressive (day -1) CD3 Ab treatment was associated with an elevated in situ Foxp3/α-1,2-mannosidase gene expression ratio, identified as a biomarker predicting tolerance in renal transplant patients. In conclusion, intragraft-enhanced regulation over effector function after the delayed but not the early CD3 antibody therapy discriminates between the tolerance-promoting and immunosuppressive effect of CD3 Ab treatment and further highlights the importance of the therapeutic window.

[Puberty, fertility and chronic diseases]. / Puberté, fertilité et maladies chroniques.

The onset of puberty is the sum of complex and multifactorial mechanisms resulting from the action of both activating and inhibiting factors, leading to the maturation of the gonads and the ability to reproduce. Many contributors to pubertal development are involved in fat mass acquisition and their action is relayed through the hypothalamus. It is therefore easy to understand how chronic diseases can affect the development of puberty and fertility apart from the specific impact of their molecular alteration. We have chosen cystic fibrosis and chronic renal disease as examples of chronic disorders affecting puberty through distinct mechanisms. As drugs are undistinguishable from chronic diseases, we also describe the impact of corticosteroids and chemotherapy on reproductive function. Last, we describe the surveillance and care of pubertal delay and its consequences (growth and bone mineralization) of patients affected with chronic disorders during adolescence.

[Occurrence of severe cardiac alterations in Amanita proxima poisoning: two original observations]. / Survenue d'une atteinte cardiaque sévère au cours du syndrome proximien : deux observations originales.

Amanita proxima is one species of white mushroom which can induce poisonings called in France "proximien" syndrome. The clinical feature of "proximien" syndrome is mainly characterized by early digestive troubles, mild hepatic cytolysis and late renal impairment. A cardiac insult has never been reported in such a circumstance. The authors describe herein two cases of white mushroom poisoning occurred in the Mediterranean French coast with a typical clinical feature of "proximien" syndrome plus secondary development of severe cardiac alterations. The outcome was good for the two patients thanks to symptomatic treatment. The cases reported here suggest that A. proxima have a potential severe cardiac toxicity leading to include early and precise cardiac examination in the management of patients poisoned by these mushrooms.

Comparison of PPCPs removal on a parallel-operated MBR and AS system and evaluation of effluent post-treatment on vertical flow reed beds.

The presence in the aquatic environment of xenobiotics such as Pharmaceutical and Personal Care Products (PPCPs) has emerged as an issue of concern. Upgrading sewage treatment quality with modern technologies such as Membrane Bioreactors (MBRs) and/or implementing a further posttreatment might mitigate the release of xenobiotics into surface waters. The performance of two processes treating municipal sewage, a MBR and an Activated Sludge (AS) unit, have been compared in terms of PPCPs removal. Moreover, their effluents were treated using vertical flow reed beds. Both systems were operated under similar conditions, more specifically Hydraulic Retention Time (HRT), maintained at 8 hours, and Sludge Retention Time (SRT) set at 6 and 20 days. Pharmaceuticals belong to therapeutic groups such as antiepileptics (carbamazepine) and analgesics (ibuprofen, naproxen, diclofenac), whereas the personal care products are musk fragrances (galaxolide and tonalide). Xenobiotics removals achieved in the MBR showed better results, particularly for the acidic drugs ibuprofen (87% vs. 50%) and naproxen (56% vs. 6%) operating at low SRT. After filtration through vertical flow reed-beds, PPCPs content in effluents was decreased, below 1 ppb in most cases, improving the effluent quality and confirming reed-beds as an interesting low cost alternative in order to attenuate xenobiotics contamination.

Adult reference levels in diagnostic and interventional radiology for temporary use in Switzerland.

This work aims at establishing a set of diagnostic reference levels (DRLs) for various types of examinations performed in diagnostic and interventional radiology. The average doses for 257 types of radiological examinations were established during the 1998 nationwide survey on the exposure of the Swiss population by radiodiagnostics. They were calculated using appropriate dosimetric models and average technical parameters. The DRLs were derived from the average doses using a multiplying factor of 1.5. The DRLs obtained were rounded and compared to the data reported in the literature. The results are in most cases comparable to the DRLs determined by the 3rd-quartile method. These discrepancies registered in some cases, particularly for complex examinations, can be explained by significant differences in the protocols and/or the technical parameters used. A set of DRLs is proposed for a large number of examinations to be used in Switzerland as temporary values until a national dosimetric database is set up.

First trimester prenatal diagnosis of metachromatic leukodystrophy on chorionic villi by 'immunoprecipitation-electrophoresis'.

Prenatal diagnosis of metachromatic leukodystrophy (MLD) due to arylsulphatase A (ASA) deficiency can be performed by amniocentesis with the disadvantage of a late pregnancy termination. Whether chorionic villi (CV) obtained by trophoblast biopsy during the first trimester of pregnancy can be useful for diagnosis depends on the reliability of results. The complexity of arylsulphatase expression in CV and the existence of several isozymes make diagnosis difficult. However, the use of an anti-ASA antiserum enabled us to discriminate between ASA and a comigrating contaminant isozyme, and the antigen-antibody (Ag-Ab) complex gave better evidence of the presence or absence of ASA after enhancement of activity with 4-methylumbelliferyl sulphate (4-MUS). We propose that immunoprecipitation followed by electrophoresis could be a valuable method of MLD prenatal diagnosis on chorionic villi.

Prenatal diagnosis of glycogenosis type II (Pompe's disease) using chorionic villi biopsy.

Glycogenosis type II (Pompe's disease) has been diagnosed using cultured amniotic cells for several years. In this paper, we present three prenatal diagnoses based on chorionic villi biopsy in three families at risk for Pompe's disease juvenile form: a normal fetus that was diagnosed and confirmed by enzymatic assay on amniotic cells; two affected fetuses that were diagnosed and confirmed on post-abortion fetal tissues. In one case a residual acid alpha-glucosidase activity was found; we concluded that the residual activity was due to maternal contamination. Prenatal diagnosis of Pompe's disease is therefore possible using chorionic villi biopsy.

[Early prenatal diagnosis of lysosomal enzymopathies from biopsies of trophoblasts]. / Diagnostic prénatal précoce des enzymopathies lysosomiales à partir de biopsies de trophoblastes.

This study was undertaken to assess the reliability of trophoblastic biopsy for early ante-natal diagnosis (10 weeks) of lysosomal diseases, including glycogenoses, sphingolipidoses and mucopolysaccharidoses. The sensitivity and specificity were excellent. In addition, cell cultures of the trophoblastic material enable further confirmation of the diagnosis. The possibility of a diagnosis and a medical decision with regards to the outcome of pregnancy at the 10th week of gestation is a considerable advance compared to diagnostic amniocentesis between the 17th and 20th weeks. In our opinion, if a total deficit is observed, the decision to terminate the pregnancy can be taken; in partial deficits or in cases with normal activity, it is wise to confirm the diagnosis by amniocentesis.

Prenatal diagnosis of atypical Tay-Sachs disease by chorionic villi sampling.

We studied a family at risk for atypical TSD in which the index case showed, clinically, a late onset and a gradual psychomotor deterioration and biochemically, a residual hex. A activity in leucocytes. Two prenatal diagnoses of affected fetuses were made in this family. The first one on amniotic cells, the second one on trophoblast biopsy samples. Both of them were confirmed after abortion on cultured cells. Prenatal diagnosis of TSD, even of some atypical forms is possible using trophoblast biopsy, but formal confirmation should be obtained on cultured trophoblasts.

Effects of antisera raised against native and denatured human alpha-glucosidase and beta-hexosaminidases on native enzyme activity.

Antisera were raised in rabbits against native and sodium dodecylsulfate denatured forms of human acid alpha-glucosidase and beta-hexosaminidases A and B. Anti-native enzyme antisera were able to precipitate all or nearly all enzyme activity from cell extracts, and to eliminate all stainable activity on electrophoresis. Antisera prepared against denatured enzymes precipitated only a minor part of enzyme activity. Electrophoretic analysis showed that these antisera were able to bind to the enzyme molecule. The result was a slowing down of the anodic migration but not immobilization. The use of variants with hexosaminidase deficiencies helped to clarify the action of the antisera on the various hexosaminidase isozymes.