Performance and interpretation of focused right upper quadrant ultrasound by emergency physicians.

The objectives of this study were to determine the accuracy of Emergency Physicians (EP) performing focused right upper quadrant (RUQ) ultrasound, to quantify how sonographic experience affects accuracy for gallbladder pathology, and to establish the time needed to complete a focused RUQ ultrasound. A convenience sample of patients with suspected gallbladder disease received a focused RUQ ultrasound by an EP. Sonographic findings, number of previous RUQ ultrasounds performed, and time for examination completion were recorded. Each patient then had a formal RUQ ultrasound by a sonographer blinded to the focused RUQ ultrasound results. Focused RUQ and formal ultrasound findings were compared, with the exception of the sonographic Murphy sign, which was compared to pathology reports. One hundred nine patients were enrolled. Fifty-one had gallstones. Forty-nine were detected by EPs, yielding a sensitivity of 96% [95% confidence interval (CI).87-.99]. Of the 58 patients without gallstones, 51 were correctly diagnosed by EPs (specificity = 88%, 95% CI.77-.95). The sonographic Murphy sign was present during 54 emergency examinations, but in only 24 formal studies. When compared to pathology reports, the emergency sonographic Murphy sign had a sensitivity of 75% compared to the formal ultrasound sensitivity of 45% for acute cholecystitis. EPs were less accurate for other sonographic findings, and level of experience had little effect on sensitivity or specificity for detecting gallstones. Eighty-three percent of emergency studies were completed in less than 10 min. Gallstones are accurately detected by EPs in a timely fashion. Additionally, compared to the radiologist's interpretation, the EP-detected sonographic Murphy sign was more sensitive for diagnosing acute cholecystitis.

Estimating the removal and biodegradation potential of radiolabeled organic chemicals in activated sludge.

A two-step procedure is described to characterize the removal and biodegradation potential of nonvolatile 14C-labeled organic compounds in activated sludge. In the first step, trace concentrations of radiolabeled test materials are dosed in influent wastewater to continuous-flow activated sludge (CAS) systems which have been previously exposed or acclimated to unlabeled test material. Radiolabel is quantified in influent, effluent, and activated sludge mixed liquor to determine total 14C removal and partitioning of radiolabel in solid and liquid compartments. The 14C data are used to calculate the amount of removal due to sorption and biodegradation and to estimate the apparent sorption coefficients for 14C activity to activated sludge solids. The 14C-labeled CAS studies are followed by biodegradation studies in batch-activated sludge (BAS) systems using sludge derived from the CAS system. The kinetics of biodegradation (defined as mineralization to 14CO2) are measured in the BAS system to confirm the CAS biodegradation results and generate mineralization rate constants for kinetic modeling. The two-step procedure was applied to radiolabeled anionic (linear alkylbenzene sulfonate) and cationic (dodecyltrimethylammonium chloride, distearyldimethylammonium chloride) surfactants which differed greatly in their biodegradation and sorption profiles. Laboratory removal figures for these materials were comparable to values measured in full-scale wastewater treatment systems, although the amount of removal due to sorption and biodegradation varied significantly for the different surfactants. In general, the 14C method has several advantages over standard methods used in the United States and Europe which employ unlabeled materials. These advantages include the use of realistic concentrations and test conditions for acclimating and dosing activated sludge microorganisms and the ability to generate partitioning and kinetic constants that can be used more broadly in environmental fate and exposure models.

Availability of organic chemicals for biodegradation in settled bottom sediments.

Biodegradation rates for dodecyltrimethylammonium chloride (TMAC), a quaternary ammonium compound, and phenol were measured in settled sediments to determine if adsorbed chemicals were directly available for biodegradation by sediment-associated bacteria. In settled sediment cores, biodegradation rates for TMAC, which is charged at environmental pH, was a function of the amount of unadsorbed chemical; adsorbed material was not directly degraded by the sediment-associated bacteria. However, the rate of biodegradation of adsorbed phenol, a relatively hydrophobic and neutral chemical, was apparently a function of the total concentration of material present, suggesting that at least a fraction of the adsorbed material was directly degraded. These results indicate that chemical structure and, possibly, the mechanism of adsorption may influence biodegradation in sediments. Studies on TMAC biodegradation in completely mixed sediment/water slurries (up to 10 g/liter sediment) showed that TMAC biodegradation in slurries differed from that in settled sediments. Biodegradation in slurries was a function of the total amount of material present, both adsorbed and unadsorbed. These results suggest that biodegradation in settled sediments may be influenced by high concentrations of sediment present and/or the lack of mixing. Thus mixed, low-sediment-level slurries may not be realistic surrogates for modeling biodegradation processes in settled bottom sediments.

Comparison of OECD and radiolabeled substrate methods for measuring biodegradation in marine environments.

Two methods for assessing biodegradation in marine environments, the OECD method, and a method using radiolabeled test substrate, were compared utilizing a model aromatic compound, benzoic acid. In samples from a relatively unimpacted estuary, Santa Rosa Sound, definitive biodegradation at 20 mg/liter was not detected by either method. However, the radiolabeled substrate method measured rapid biodegradation of the material at 50 micrograms/liter, which approximates expected environmental concentrations. In the Fraser River Estuary, which receives large discharges of municipal wastewater, biodegradation of benzoic acid was rapid at both 20 mg/liter and 50 micrograms/liter, and was detected by both methods. The results of the study illustrate the utility of radiolabeled substrates for determining the biodegradation of synthetic chemicals. Methods such as the OECD technique are very useful screening tools for assessing the overall potential of a chemical to biodegrade. However, such techniques generally cannot measure biodegradation at realistic concentrations. The use of radioisotopes in biodegradation studies can significantly increase the sensitivity of biodegradation measurements. As a result, realistic estimates of biodegradation can be obtained at concentrations which are often outside the scope of screening methods.

Effect of adaptation to phenol on biodegradation of monosubstituted phenols by aquatic microbial communities.

The adaptation of a mixed aquatic microbial community to phenol was examined in microcosms receiving phenol as a sole carbon source. Extended exposure (adaptation) to phenol resulted in adaptation of the microbial community to the structurally related aromatic compounds m-cresol, m-aminophenol, and p-chlorophenol. The increased biodegradation potential of the phenol-adapted microbial community was accompanied by a concurrent increase in the number of microorganisms able to degrade the three test compounds. Thus, adaptation to the three test chemicals was likely a growth-related result of extended exposure to phenol. The results indicate that adaptation to a single chemical may increase the assimilative capacity of an aquatic environment for other related chemicals even in the absence of adaptation-inducing levels of those materials.

Influence of easily degradable naturally occurring carbon substrates on biodegradation of monosubstituted phenols by aquatic bacteria.

The influence of readily degradable, naturally occurring carbon substrates on the biodegradation of several monosubstitued phenols (m-cresol, m-aminophenol, p-chlorophenol) was examined. The natural substrate classes used were amino acids, carbohydrates, and fatty acids. Samples of the microbial community from Lake Michie, a mesotrophic reservoir, were adapted to different levels of representatives from each natural substrate class in chemostats. After an extended adaptation period, the ability of the microbial community to degrade the monosubstituted phenols was determined by using a radiolabeled substrate uptake and mineralization method. Several microbiological characteristics of the communities were also measured. Adaptation to increasing concentrations of amino acids, carbohydrates, or fatty acids enhanced the ability of the microbial community to degrade all three phenols. The stimulation was largest for m-cresol and m-aminophenol. The mechanism responsible for the enhancement of monosubstituted phenol metabolism was not clearly identified, but the observation that adaptation to amino acids also increased the biodegradation of glucose and, to a lesser extent, naphthalene suggests a general stimulation of microbial metabolism. This study demonstrates that prior exposure to labile, natural substrates can significantly enhance the ability of aquatic microbial communities to respond to xenobiotics.

Effects of surface area and flow rate on marine bacterial growth in activated carbon columns.

The colonization of granular activated carbon columns by bacteria can have both beneficial and potentially detrimental consequences. Bacterial growth on the carbon surface can remove adsorbed organics and thus partially regenerate the carbon bed. However, growth can also increase the levels of bacteria in the column effluents, which can adversely affect downstream uses of the treated water. This study of a sand column and several activated carbon columns demonstrated that considerable marine bacterial growth occurred in both sand and carbon columns and that this growth increased the number of bacteria in column effluents. Activated carbon supported approximately 50% more bacteria than did sand. Bacterial growth on activated carbon was reduced by increasing the flow rate through a carbon column and increasing the carbon particle size. Scanning electron micrographs showed that bacteria preferred to attach in the protected crevices on both the sand and carbon surface. The results of this study indicated that the colonization of activated carbon by marine bacteria was enhanced because of carbon's high surface area, its rough surface texture, and its ability to absorb organic materials.