[Intestinal function tests]

Diagnostic techniques investigating intestinal functions are a main component of gastroenterological diagnostic procedures and are mainly indicated if intestinal motility disturbances or malabsorption syndromes are suspected. H2 breath tests using lactulose or lactitol as substrates measure orocecal transit time. Intestinal manometry allows more detailed analysis of intestinal motility disturbances but is only available at specialized centres. A generalized malabsorption syndrome can be diagnosed by D-xylose test. If it is caused by bacterial overgrowth, the H2 breath test with glucose may be helpful. Lactose intolerance is the most frequently observed intestinal malfunction and affects about 70% of people worldwide. At present, the lactose H2 breath test is the diagnostic procedure of choice to prove lactose malabsorption. Clinically relevant insufficiencies of other intestinal disaccharidases are rare, but may indicate H2 breath tests with specific substrates. Recently developed 13C breath tests using stable, non-radioactive substrates may extend our diagnostic options considerably and may allow more detailed information about intestinal (mal-)functions as a prerequisite for optimized therapy.

Genetic diversity and antibiotic resistance patterns in a campylobacter population isolated from poultry farms in Switzerland

The diversity and genetic interrelation of Campylobacter jejuni and C. coli isolated from Swiss poultry were assessed by three independent typing methods. Samples were derived prior to slaughter from 100 randomly selected flocks (five birds per flock) raised on three different farm types. The observed flock prevalence was 54% in total, with 50% for conventional and 69% for free-range farms. Birds held on farms with a confined roaming area had the lowest prevalence of 37%. Campylobacter isolates were characterized by amplified fragment length polymorphism (AFLP), restriction fragment length polymorphism of flaA PCR fragments (flaA-RFLP), and disk diffusion testing for eight antimicrobial agents that are commonly used in veterinary or human medicine in Switzerland. Analysis of the genotypic results indicates that the Campylobacter population in Swiss poultry is genetically highly diverse. Nevertheless, occasionally, isolates with identical or nearly identical characteristics were isolated from different farms or farm types in different locations. Genetic typing by AFLP and flaA-RFLP was found to be complementary. The majority of isolates (67%) were susceptible to all tested antibiotics; however, single, double, and triple resistances were observed in 7%, 23%, and 2% of the strains, respectively. There was no correlation between genotype and antibiotic resistance. Surprisingly, sulfonamide resistance was frequently found together with streptomycin resistance. Our findings illustrate the results of common genetic exchange in the studied bacterial population.

Characterisation of high-rate acidogenesis processes using a titration and off-gas analysis sensor

The characteristics of the glucose degradation by acidogenesis processes were investigated both in a long-term operating laboratory-scale continuously stirred tank reactor and in short-term experiments utilising a titration and off-gas analysis (TOGA) sensor. The results obtained from continuous-flow experiments in both reactors demonstrated that the TOGA sensor can be applied as a useful tool for the study of acidogenesis processes under steady-state and dynamic conditions. No significant effect from the culture transfer could be detected in the study with the TOGA sensor. Furthermore, the variation of gas production rate could be monitored at real time by the TOGA sensor. The experiments showed that the distribution of acidogenic products in the liquid and the gas phase was significantly influenced by the hydraulic retention time at least in the short term.

Modelling of two-stage anaerobic digestion using the IWA Anaerobic Digestion Model No. 1 (ADM1)

The aim of the study presented was to implement a process model to simulate the dynamic behaviour of a pilot-scale process for anaerobic two-stage digestion of sewage sludge. The model implemented was initiated to support experimental investigations of the anaerobic two-stage digestion process. The model concept implemented in the simulation software package MATLAB/Simulink is a derivative of the IWA Anaerobic Digestion Model No.1 (ADM1) that has been developed by the IWA task group for mathematical modelling of anaerobic processes. In the present study the original model concept has been adapted and applied to replicate a two-stage digestion process. Testing procedures, including balance checks and 'benchmarking' tests were carried out to verify the accuracy of the implementation. These combined measures ensured a faultless model implementation without numerical inconsistencies. Parameters for both, the thermophilic and the mesophilic process stage, have been estimated successfully using data from lab-scale experiments described in literature. Due to the high number of parameters in the structured model, it was necessary to develop a customised procedure that limited the range of parameters to be estimated. The accuracy of the optimised parameter sets has been assessed against experimental data from pilot-scale experiments. Under these conditions, the model predicted reasonably well the dynamic behaviour of a two-stage digestion process in pilot scale.

The Scandinavian Sarcoma Group Skeletal Metastasis Register. Survival after surgery for bone metastases in the pelvis and extremities

INTRODUCTION

The assessment of the prognosis for the individual patient is important for the choice of surgical treatment of skeletal metastases. In 1999 the Scandinavian Sarcoma Group (SSG) initiated the Skeletal Metastasis Register as a multicentric, prospective study to provide a scientific basis for treatment recommendations. To improve prognostication we analyzed the survival of patients with skeletal metastases surgically treated at 9 SSG centres.

PATIENTS AND METHODS

460 patients with an average age of 64 years underwent 501 operations for non-spinal skeletal metastases. 7% were operated for more than one metastasis. Carcinoma of the breast, prostate, kidney and lung were the dominating primary tumors.

RESULTS

The survival rate was 0.4 at 1 year, 0.3 at 2 years and 0.2 at 3 years. Univariate analysis showed that survival was related to bone localization, skeletal metastatic load, presence of visceral metastases, Karnofsky performance score, primary tumor type, presence of a complete pathological fracture and preoperative hemoglobin content. Multivariate regression analysis showed that pathological fracture, visceral metastases, haemoglobin content < 7 mmol/L and lung cancer were negative prognostic factors for survival. Myeloma was the sole positive prognostic factor for survival.

The influence of substrate kinetics on the microbial community structure in granular anaerobic biomass

The development of a strong, active granular sludge bed is necessary for optimal operation of upflow anaerobic sludge blanket reactors. The microbial and mechanical structure of the granules may have a strong influence on desirable properties such as growth rate, settling velocity and shear strength. Theories have been proposed for granule microbial structure based on the relative kinetics of substrate degradation, but contradict some observations from both modelling and microscopic studies. In this paper, the structures of four granule types were examined from full-scale UASB reactors, treating wastewater from a cannery, a slaughterhouse, and two breweries. Microbial structure was determined using fluorescence in situ hybridisation probing with 16S rRNA-directed oligonucleotide probes, and superficial structure and microbial density (volume occupied by cells and microbial debris) assessed using scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The granules were also modelled using a distributed parameter biofilm model, with a previously published biochemical model structure, biofilm modelling approach, and model parameters. The model results reflected the trophic structures observed, indicating that the structures were possibly determined by kinetics. Of particular interest were results from simulations of the protein grown granules, which were predicted to have slow growth rates, low microbial density, and no trophic layers, the last two of which were reflected by microscopic observations. The primary cause of this structure, as assessed by modelling, was the particulate nature of the wastewater, and the slow rate of particulate hydrolysis, rather than the presence of proteins in the wastewater. Because solids hydrolysis was rate limiting, soluble substrate concentrations were very low (below Monod half saturation concentration), which caused low growth rates.

Comparison of methods for the determination of K(L)aO2 for respirometric measurements

The mass transfer coefficient for oxygen in water (K(L)aO2) is an important parameter for respirometric studies. But determination of K(L)aO2 in process conditions is not straightforward, In this paper, two distinct procedures for determining K(L)aO2 in process conditions are outlined and tested. The off-gas method relies on a gas mass balance over a bioreactor while the non-steady state methods rely on analysing DO recovery after perturbation. Various means for inducing perturbation are tested and compared. K(L)aO2 values for a bioreactor are determined by the listed methods. It was found that the off-gas method resulted in the highest K(L)aO2 for the given reactor, while the non-steady state method, whereby perturbation is caused by exogenous activity on acetate, resulted in the lowest K(L)aO2. It is shown that the gas mass balancing technique is robust to unexpected exogenous activity (caused by for example, the oxidation of storage polymers formed or nitrite accumulated), while the non-steady state methods that involve inducing perturbations by exogenous activity appear susceptible to such continued exogenous activity in the DO recovery period.

Mass transfer impacts in flocculent and granular biomass from SBR systems

An experimental study was conducted to describe mass transfer impacts within nitrifying aggregates sourced from sequencing batch reactor (SBR) activated sludge systems. Flocculent and granular sludge with high nitrification activity was obtained in two laboratory SBR systems, supplied with a synthetic, ammonium-based feed. The flocculent biomass was fractionated using a sieving procedure, in order to obtain biomass fractions with different particle size distributions. The oxygen uptake rate (OUR) response to changes in dissolved oxygen concentration was measured under highly controlled conditions in a titrimetric and off-gas analysis (TOGA) sensor, and the results used to assess mass transfer effects. As the average particle size of the biomass increased, mass transfer limitations were found to increase significantly. Empirically fitted, apparent K(S,O2) values were demonstrated to be highly dependent on particle size, and reflect the mass transfer limitations occurring in the aggregates within a given system. Such parameters thus have little to do with the actual biokinetic parameter from which they are derived. The results obtained from the TOGA sensor study were consistent with those obtained from a microelectrode study on the same nitrifying granules. Together, these studies add considerable weight to the conclusion that consideration of external and internal mass transfer limitations is vital to the accurate description of activated sludge treatment processes, particularly those with a high oxygen uptake rate.

Rate of nitrate production during a two-stage nitrification batch reaction

The two steps of nitrification, namely the oxidation of ammonia to nitrite and nitrite to nitrate, often need to be considered separately in process studies. It has been assumed that these two reactions can be described by single Monod models. In this paper, the suitability of the single Monod model for describing nitrite oxidation to nitrate is discussed. The measured rate of nitrate production during a batch reaction is presented. For the system studied it was found that nitrate production actually increased after the completion of ammonia oxidation. It is suggested that the reason for the increase was a combination of: (i) likely competition for oxygen when both substrates were present, and (ii) a decrease in ammonia inhibition of nitrite oxidisers with the removal of ammonia. The result is that a single Monod expression (based on nitrite as the substrate) could not be used to describe nitrate production. In these types of systems the consequence of oxygen limitation and substrate inhibition should also be considered.

Integration of titrimetric measurement, off-gas analysis and NOx- biosensors to investigate the complexity of denitrification processes

The denitrification process, namely the reduction of nitrate (NO3-) to nitrogen gas (N2), often cannot be simply modelled as a single step process. For a more complete and comprehensive model the intermediates, particularly nitrite (NO2-) and nitrous oxide (N2O), need to be investigated. This paper demonstrates the integration of titrimetric measurements and off-gas analysis with on-line nitrite plus nitrate (NOx-) biosensors, highlighting the necessity of measuring process intermediates with high time-scale resolution to study and understand the kinetics of denitrification. Investigation of activated sludge from a full-scale treatment plant showed a significant accumulation of NO2-, which appeared to impact on the overall denitrification rate measured as NOx- reduction or N2 production. A different sludge obtained from a lab-scale bioreactor produced N2O instead of N2 as the end product of denitrification. The two examples both illustrate the complexity of denitrification and stress the need for the more versatile and detailed measurement procedures, as presented in this paper.

International evaluation of current and future requirements for environmental engineering education

The field of environmental engineering is developing as a result of changing environmental requirements. In response, environmental engineering education (E3) needs to ensure that it provides students with the necessary tools to address these challenges. In this paper the current status and future development of E3 is evaluated based on a questionnaire sent to universities and potential employers of E3 graduates. With increasing demands on environmental quality, the complexity of environmental engineering problems to be solved can be expected to increase. To find solutions environmental engineers will need to work in interdisciplinary teams. Based on the questionnaire there was a broad agreement that the best way to prepare students for these future challenges is to provide them with a fundamental education in basic sciences and related engineering fields. Many exciting developments in the environmental engineering profession will be located at the interface between engineering, science, and society. Aspects of all three areas need to be included in E3 and the student needs to be exposed to the tensions associated with linking the three.

Structure and microbial composition of nitrifying microbial aggregates and their relation to internal mass transfer effects

This paper presents an analysis of the structure and microbial composition of nitrifying aggregates, formed as either flocs or granules, in sequencing batch reactors (SBR) operated with a high ammonium load. The structure and microbial community of the aggregates was determined by fluorescence in situ hybridisation (FISH). The aggregate structure and size was related to mass transfer limitations observed by measurements of OURs measured by either a titrimetric and off-gas analysis sensor (TOGA) or by microsensors. The FISH analysis showed that the spatial arrangement of the microbial consortia correlated well with the oxygen gradients inside the aggregates. In the larger aggregates, the ammonium- and nitrite-oxidising bacteria were mainly concentrated to the outer 100-200 microm, whereas in the floc system, the bacteria were distributed throughout the entire aggregate. This indicates that the internal mass transfer resistance is considerably larger when the aggregate size increases which is directly supported by TOGA measurements.

Anaerobic rumen SBR for degradation of cellulosic material

Hydrolysis of organic particulates under anaerobic conditions is generally regarded as the rate limiting step in solid digestion processes. Rumen-based ecosystems appear to achieve very high hydrolysis rates for cellulosic organic material. This study aimed at the development and demonstration of an anaerobic sequencing batch reactor (SBR) process operating with a rumen-based microbial inoculum. Fibrous alpha cellulose was used as sole carbon substrate and the use of an SBR operating cycle allowed the utilisation of a high liquid flow rate (hydraulic retention time of 0.67 d) while maintaining a much longer solids retention time of 7 d. Complete mass balances for carbon and nitrogen, as well as COD balancing allowed the full characterisation of the process stoichiometry and kinetics. Elemental analysis of the biomass revealed a composition of C5H4.8O2.4N0.7, which is quite different from other generic biomass compositions used in the literature. The anaerobic rumen SBR was compared with another rumen-based reactor system in the literature which used a continuous filtration process for solid/liquid separation. This comparison showed that the volatile fatty acid production rate from cellulose in the anaerobic SBR was comparable with the performance achieved in the continuous system, although loading, substrate type and media composition were quite different between these two studies. Further evaluation of the anaerobic rumen SBR is required to determine its practical application for other substrates and to demonstrate the scale-up potential of this concept.

Effects of acetate and propionate on the performance of a photosynthetic biofilm reactor for sulfide removal

The effects of acetate and propionate on the performance of a recently proposed and characterized photosynthetic biological sulfide removal system have been investigated with a view to predicting this concept's suitability for removing sulfide from wastewater undergoing or having undergone anaerobic treatment. The concept relies on substratum-irradiated biofilms dominated by green sulfur bacteria (GSB), which are supplied with radiant energy in the band 720-780 nm. A model reactor was fed for 7 months with a synthetic wastewater free of volatile fatty acids (VFAs), after which time intermittent dosing of the wastewater with acetate or propionate was begun. Such dosing suppressed the areal net sulfide removal rate by approximately 50%, and caused the principal net product of sulfide removal to switch from sulfate to elemental-S. Similarly suppressed values of this rate were observed when the wastewater was dosed continuously with acetate, and this rate was not significantly affected by changes in the concentration of ammonia-N in the feed. The main net product of sulfide removal was again elemental-S, which was scarcely released into the liquid, however. Sulfate reduction and sulfur reduction were observed when the light supply was interrupted and were inferred to be occurring within the irradiated biofilm. A preexisting conceptual model of the biofilm was augmented with both of these reductive processes, and this augmented model was shown to account for most of the observed effects of VFA dosing. The implications of these findings for the practicality of the technology are considered.

Nitrogen removal of high strength wastewater via nitritation/denitritation using a sequencing batch reactor

The sequencing batch reactor (SBR) process concept was applied to achieve efficient ammonium removal via nitrite under both laboratory and pilot-scale conditions. Both sets of experimental results show that without pH control or carbon addition the nitritation process consistently converted approximately 50% of the ammonium from biosolids dewatering liquids to nitrite with hydraulic retention times (HRT) as short as 10 h. The results from the pilot-scale study also indicate that the selective oxidation of ammonium to nitrite is a reliable process as the accumulation of nitrate was never an issue during a 330-day trial. The SBR process concept was extended to achieve complete nitrogen removal through nitritation and denitritation in the laboratory scale. The experimental results indicate that a total reduction of 96-98% of the ammonium nitrogen from biosolids dewatering liquids (influent concentration typically 1,200 g m(-3)) was achieved with a short HRT of 1.1 d and a removal rate of 1.05 kgNm(-3)d(-1). This process concept was tested at pilot scale where the nitritation process could be started up without temperature control in a short period of time. Nitrogen removal rates up to 1.2 kgNm(-3)d(-1) at an HRT of 0.88 d have been obtained. COD to nitrogen ratios required in the pilot plant were consistently in the range 1.6-1.9 kgCOD kg(-1)N removed.

Short-term effects of carbon source on the competition of polyphosphate accumulating organisms and glycogen accumulating organisms

The effectiveness of enhanced biological phosphorus removal (EBPR) systems is directly affected by the competition of polyphosphate accumulating organisms (PAOs) and glycogen accumulating organisms (GAOs). This study investigated the short-term effects of carbon source on PAO and GAO performance. The tests were designed to clearly determine the impact of volatile fatty acid (VFA) composition on the performance of two types of biomass, one enriched for PAOs and the other for GAOs. The two populations were enriched in separate reactors using identical operating conditions and very similar influent compositions with acetate as the sole carbon source. The only difference was that a very low level of phosphorus was present in the influent to the GAO reactor. The abundance of PAOs and GAOs was quantified using fluorescence in-situ hybridisation. The results clearly show that there are some very distinctive differences between PAOs and GAOs in their ability to utilise different carbon substrates. While both are able to take up acetate rapidly and completely, the GAOs are far slower at consuming propionate than the PAOs during short-term substrate changes. This provides a potentially highly valuable avenue to influence the competition between PAOs and GAOs. Other VFAs studied seem to be less usable in the short term by both PAOs and GAOs, as indicated by their much lower uptake rates.

A novel wastewater treatment process: simultaneous nitrification, denitrification and phosphorus removal

Simultaneous nitrification and denitrification (SND) via the nitrite pathway and anaerobic-anoxic enhanced biological phosphorus removal (EBPR) are two processes that can significantly reduce the COD demand for nitrogen and phosphorus removal. The combination of these two processes has the potential of achieving simultaneous nitrogen and phosphorus removal with a minimal requirement for COD. A lab-scale sequencing batch reactor (SBR) was operated in alternating anaerobic-aerobic mode with a low dissolved oxygen concentration (DO, 0.5 mg/L) during the aerobic period, and was demonstrated to accomplish nitrification, denitrification and phosphorus removal. Under anaerobic conditions, COD was taken up and converted to polyhydroxyalkanoates (PHA), accompanied with phosphorus release. In the subsequent aerobic stage, PHA was oxidized and phosphorus was taken up to less than 0.5 mg/L at the end of the cycle. Ammonia was also oxidised during the aerobic period, but without accumulation of nitrite or nitrate in the system, indicating the occurrence of simultaneous nitrification and denitrification. However, off-gas analysis found that the final denitrification product was mainly nitrous oxide (N2O) not N2. Further experimental results demonstrated that nitrogen removal was via nitrite, not nitrate. These experiments also showed that denitrifying glycogen-accumulating organisms rather than denitrifying polyphosphate-accumulating organisms were responsible for the denitrification activity.

Fluorescence in situ hybridization analysis of nitrifiers in piggery wastewater treatment reactors

Fluorescence in situ hybridization (FISH) was performed to analyze the nitrifying microbial communities in an activated sludge reactor (ASR) and a fixed biofilm reactor (FBR) for piggery wastewater treatment. Heterotrophic oxidation and nitrification were occurring simultaneously in the ASR and the COD and nitrification efficiencies depend on the loads. In the FBR nitrification efficiency also depends on ammonium load to the reactor and nitrite was accumulated when free ammonia concentration was higher than 0.2 mg NH3-N/L. FISH analysis showed that ammonia-oxidizing bacteria (NSO1225) and denitrifying bacteria (RRP1088) were less abundant than other bacteria (EUB338) in ASR. Further analysis on nitrifying bacteria in the FBR showed that Nitrosomonas species (NSM156) and Nitrospira species (NSR1156) were the dominant ammonia-oxidizing and nitrite-oxidizing bacteria, respectively, in the piggery wastewater nitrification system.

[Esophageal 24 hour-pH metry. Recommendations of the German Society of Neurogastroenterology and Motility and the Study Group for Gastrointestinal Functional Disorders and Function Diagnostics of the Austrian Society of Gastroenterology and Hepatology]

This article presents the recommendations for 24-hour oesophageal pH-metry of the German Society of Neurogastroenterology and Motility and the Study Group for Gastrointestinal Functional Disorders and Function Diagnostics of the Austrian Society of Gastroenterology and Hepatology. Indications for the examination, the procedures to be followed, the analysis of the obtained data and the conclusions to be drawn are delineated. The literature on which the recommendations are based is reviewed.

Implant surface roughness affects osteoblast gene expression

The transcription factor Cbfa1 regulates osteoblast differentiation and expression of genes necessary for the development of a mineralized phenotype. The purpose of this study was to determine if Cbfa1 and BSPII gene expression are influenced by implant surface microtopography. Osteoblasts were cultured on 600-grit (grooved) or sandblasted (roughened) cpTi implant discs. Mineralization was evaluated by Alizarin-Red-S staining. Real Time PCR was used for quantitative analysis of Cbfa1 and BSPII gene expression. Enhanced mineralization was seen in osteoblasts grown on roughened implant surfaces relative to tissue culture plastic. Real Time PCR showed significant (P < 0.05) increases in Cbfa1 gene expression in cells grown on roughened, as compared with grooved, implant surfaces. BSPII gene expression was also increased on rough surfaces in the UMR cells, but was reduced in the rat calvarial osteoblast cultures. These results suggest that osteoblast gene expression and mineralization are affected by roughened implant surface microtopographies during osseointegration of dental implants.

A sclerocorneal electrode for the study of the characteristics of primate vision under condition of space flight

We describe here a physiologically nonirritating sclerocorneal lens electrode of special design for making reproducible, low noise electroretinographic recordings on frogs and the rhesus monkey. The apparatus should be particularly useful in studying the effect of space flight factors on these responses in man.