Elevated tryptase levels selectively cluster in myeloid neoplasms: a novel diagnostic approach and screen marker in clinical haematology

BACKGROUND

Recent data suggest that tryptase, a mast cell enzyme, is expressed in neoplastic cells in myeloid leukaemias. In several of these patients, increased serum tryptase levels are detectable.

MATERIALS AND METHODS

We have determined serum tryptase levels in 914 patients with haematological malignancies, including myeloproliferative disorders (n = 156), myelodysplastic syndromes (MDS, n = 241), acute myeloid leukaemia (AML, n = 317), systemic mastocytosis (SM, n = 81), non-Hodgkin's lymphoma (n = 59) and acute lymphoblastic leukaemia (n = 26). Moreover, tryptase was measured in 136 patients with non-neoplastic haematological disorders, 102 with non-haematological disorders and 164 healthy subjects.

RESULTS

In healthy subjects, the median serum tryptase was 5.2 ng mL(-1). Elevated serum tryptase levels were found to cluster in myeloid neoplasm, whereas almost all patients with lymphoid neoplasms exhibited normal tryptase. Among myeloid neoplasms, elevated tryptase levels (> 15 ng mL(-1)) were recorded in > 90% of patients with SM, 38% with AML, 34% with CML and 25% with MDS. The highest tryptase levels, often > 1000 ng mL(-1), were found in advanced SM and core-binding-factor leukaemias. In most patients with non-neoplastic haematological disorders and non-haematological disorders analysed in our study, tryptase levels were normal, the exception being a few patients with end-stage kidney disease and helminth infections, in whom a slightly elevated tryptase was found.

CONCLUSIONS

In summary, tryptase is a new diagnostic marker of myeloid neoplasms and a useful test in clinical haematology.

Unusual microbes in asthma exacerbation: Alcaligenes xylosoxidans and Leishmania

Asthma is a chronic inflammatory condition characterised by a variable degree of airflow limitation. Exacerbations during the course of asthma often occur due to environmental factors or infectious, mostly viral, aetiology. The present study reports the case of a 61-yr-old male with severe asthma hospitalised due to increasing respiratory distress. Since recovery was delayed despite anti-obstructive/anti-inflammatory and antibiotic therapy, further diagnostic procedures, including bronchoscopy, were performed in order to attempt to identify the cause of the worsening respiratory condition. The surprising finding consisted of a rare coincidence of concomitant infection with the bacterial pathogen Alcaligenes xylosoxidans, grown from bronchoalveolar lavage fluid, and the protozoan parasite Leishmania spp., revealed by histopathological examination of bronchial mucosal biopsy specimens. This is the first report of an isolated bronchial mucosal involvement of Leishmania in an HIV-negative asthma patient following brief exposure in Leishmania-endemic regions. Further, to the best of the present authors' knowledge, this represents the first description of A. xylosoxidans in asthma, although it is questionable whether it was an infection or colonisation. The present observation identifies previously unreported microbial pathogens associated with asthma exacerbation. Further, the report highlights the importance of obtaining a thorough travel history and applying invasive diagnostic procedures in circumstances of treatment failure, even under unfavourable conditions.

Foam formation on an Austrian-Hungarian lowland river: reasons, methods and solutions

The occurrence of foam in a lowland river in Austria and shortly after the border with Hungary and the consequent protests from Hungarian inhabitants led to investigations concerning the reasons for foam formation. The aims of the study were (i) to specify objectively the scale of appearing of foam, (ii) to evaluate reasons for foam formation, and (iii) to develop abatement measures.

Activated sludge modelling in practice: an international survey

The Good Modelling Practice Task Group (GMP-TG) of the International Water Association (IWA) is developing guidelines for the use of Activated Sludge Models (ASM). As part of this work the group created and sent out a questionnaire to current and potential activated sludge model users in 2007. The objectives of the questionnaire were (i) to better define the profile of ASM users, (ii) to identify the tools and procedures that are actually used and (iii) to highlight the main limitations while building and using ASM-type models. Ninety-six answers were received from all over the world, from several types of organisation. The results were analysed to identify the modellers' perceptions of models depending on their profile. The results also highlighted the main topics of interest for improving modelling procedures which are standardisation of the available modelling guidelines and better experience and knowledge transfer.

Recruitment of Mycobacterium tuberculosis specific CD4+ T cells to the site of infection for diagnosis of active tuberculosis

Accurate and early diagnosis of active tuberculosis (TB) is problematic as current diagnostic methods show low sensitivity (acid-fast bacilli smears), are time-consuming (culture of biological samples) or show variable results [Mycobacterium tuberculosis (MTB)-specific PCR].

OBJECTIVES

In the course of infection, MTB-specific T cells clonally expand at the site of infection and may thus be used as diagnostic marker for active disease.

DESIGN

In this cohort study, the frequency of MTB-specific, interferon (IFN)-gamma expressing CD4(+) T cells obtained from peripheral blood and the site of disease in 25 patients with suspected TB was assessed (n = 11, bronchoalveolar lavage; n = 7, pleural fluid; n = 1, ascites; n = 1, joint fluid; n = 5, cerebrospinal fluid).

RESULTS

Amongst 15 patients who showed proven active TB infection, a striking increase of MTB-specific T cells was detected at the site of infection compared with peripheral blood (median increase: 28.5-fold, range: 7.25-531 fold; median of IFN-gamma-producing CD4(+) T cells from blood: 0.02%, range: 0-0.52%; median of IFN-gamma-producing CD4(+) T cells from the site of infection: 1.81%, range: 0.29-6.55%, P < 0.001).

MAIN OUTCOME MEASURE

Recruitment of MTB-specific T cells to the site of infection yielded a sensitivity of 100% and specificity of 90%, irrespective of the compartment affected.

CONCLUSIONS

The accumulation of MTB-specific T cells at the site of infection may prove as useful diagnostic marker for an accurate and rapid diagnosis of active TB.

Bilateral subthalamic stimulation in Parkin and PINK1 parkinsonism

OBJECTIVES

To study the frequency of different gene mutations in patients with early-onset parkinsonism and bilateral subthalamic nucleus deep brain stimulation (STN-DBS) and the short- and long-term surgical outcome in mutation-positive (MUT+) and -negative (MUT-) patients.

METHODS

Eighty patients with disease onset at age <or= 45 years and bilateral STN-DBS were screened for mutations in the Parkin gene and PINK1 gene and for the recurrent p.G2019S mutation in the LRRK2 gene. The Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr (H-Y) scale were used to compare the on- and off-medication conditions preoperatively and in the off-medication/on-stimulation condition postoperatively.

RESULTS

We identified 12 mutation carriers (11 Parkin [6 with 2 mutated alleles, 5 with 1 mutated allele], 1 homozygous PINK1). There were no clinical differences between the MUT- and MUT+ patients preoperatively, except for more severe H-Y stage and postural and gait scores in the on-medication state in the MUT+ group. During the first year after surgery, MUT- patients showed better clinical improvement (56% motor UPDRS improvement) compared with MUT+ patients (36%). However, in the long-term follow-up (3-6 years), both groups presented with the same degree of clinical improvement (MUT-: 44% vs MUT+: 42%). Although the MUT+ group showed more severe axial signs preoperatively, MUT- patients developed levodopa- and deep brain stimulation-resistant axial signs within the first 3 to 6 years postoperatively, which diminished the initial benefit soon after surgery.

CONCLUSIONS

Patients with Parkin or PINK1 mutations benefit from subthalamic nucleus deep brain stimulation. However, the clinical response is not superior to non-mutation carriers and might be limited by more advanced axial motor symptoms at a relatively early disease stage.

Intelligent monitoring networks--transformation of data into information for water management

The EU-WFD requires certain monitoring tasks, which yet cannot be fulfilled by automated monitoring devices. Nevertheless, the technical progress of recent years allows monitoring station designs, which enable long-term field application under reasonable maintenance demand. State-of-the-art monitoring stations allow the setup and operation of intelligent monitoring networks, which deliver quality proved and utilisable information to the end-user as opposed to a collection of time-series. Based on a full-scale example monitoring station design, long-term observations and possible ways of (automated) data interpretation are discussed.

Generation of diurnal variation for influent data for dynamic simulation

When using dynamic simulation for fine tuning of the design of activated sludge (AS) plants diurnal variations of influent data are required. For this application usually only data from the design process and no measured data are available. In this paper a simple method to generate diurnal variations of wastewater flow and concentrations is described. The aim is to generate realistic influent data in terms of flow, concentrations and TKN/COD ratios and not to predict the influent of the AS plant in detail. The work has been prepared within the framework of HSG-Sim (Hochschulgruppe Simulation, http://www.hsgsim.org), a group of researchers from Germany, Austria, Luxembourg, Poland, the Netherlands and Switzerland.

Upgrading of wastewater treatment plants for nutrient removal under optimal use of existing structures

Upgrading of wastewater treatment plants under maximum use of existing structures is often an important requirement, but also useful due to a number of aspects. Because of a change in legal effluent requirements, a number of plants in Austria, typically aged 20+ years, were required to be extended. The two stage activated sludge HYBRID-process often provides an interesting design alternative for such plant upgrades, especially in case an anaerobic sludge treatment stage already exists. It provides high nutrient removal capacity at low area demand. The latter is especially important in cases where no or very limited extension area is available making it the key factor to preserve a site for future use. Based on two full stage case studies the adaptation of the plant layout, first operation results and a synthetic cost comparison to a conventional (single stage) plant extension are given.

Benefits, limitations and uncertainty of in situ spectrometry

In situ spectrometers are comparable robust instruments and can be operated long term with relatively low maintenance demand. The decisive factor for their applicability is the development of a medium and installation location specific correlation model, which estimates the concentration of the requested target parameter from the measured absorption values. In some cases it might turn out, that the development of a single site specific correlation model is not sufficient, due to frequent and substantial variations of the (waste) water composition.In order to assess the total uncertainty of in situ spectrometry, a comprehensive lab test was carried out. It includes a detailed investigation of the uncertainty of CODreference methods (DIN and small tube tests), a precision analysis of the absorption spectra and the impact of those two factors on the total uncertainty of the COD(EQ) correlation model.

Investigative monitoring in the context of detecting anthropogenic impact on an epipotamal river

In the context of an investigative monitoring programme a monitoring system comprising of a water quality monitoring station and a camera station has been installed and operated for more than one year. The monitoring target was to investigate changes of water quality which can be related to a repeated occurrence of foam, observed at a river stretch downstream the monitoring station. The extent and frequency of foam buildup was recorded by means of the camera station. The analysis of the online data clearly showed that some of the measured parameters can be used as indicators for specific discharges, which from additional targeted investigations could be identified as contributors to the foaming problems. The continuous ammonium measurement could be used to detect nitrification problems of WWTPs discharging upstream of the monitoring station. By combining different data sources (emission data, operative and investigative monitoring data) additional information can be gained, which can be used for a comprehensive data assessment as well as a detailed system analysis.

alpha-Synuclein and Parkinson disease susceptibility

BACKGROUND

Mutations in the alpha-synuclein (SNCA) gene have been shown to be responsible for a rare familial form of Parkinson disease (PD). Furthermore, polymorphic variants in multiple regions of the gene have been associated with susceptibility to idiopathic PD in different populations.

OBJECTIVE

To evaluate and to confirm the role of SNCA variants in PD pathogenesis.

METHODS

We included 667 subjects (397 cases with idiopathic PD and 270 healthy, ethnically matched controls) of Northern Central and Southeastern European origin. We analyzed genotypes at 14 markers spanning the SNCA locus and its major haplotype blocks and conducted a haplotype analysis for four promoter markers including the microsatellite marker Rep1.

RESULTS

The three single nucleotide polymorphisms (SNPs) of the promoter region (rs2583988, rs2619364, rs2619363) and a SNP in the 3'UTR (rs356165) of the SNCA gene showed the greatest evidence for an association with PD (p <or= 0.003), with significant pairwise values for linkage disequilibrium (D' >or= 0.74, r (2) >or= 0.29). The promoter haplotype "261-T-G-T" (Rep1-rs2583988-rs2619364-rs2619363) was associated with disease (p = 0.032). The most significant association with PD was generated by excluding Rep1 (p = 0.008). This association remained significant when analyzing the Serbian patients separately and was of borderline significance for the German patients.

CONCLUSIONS

Our findings confirm that genetic variability within the SNCA locus is associated with susceptibility to idiopathic Parkinson disease (PD). We found evidence for disease association with single nucleotide polymorphisms at both the 5' and the 3' end of the gene with pairwise linkage disequilibrium between them. The association was independent of the Rep1 status, and one major SNCA promoter haplotype class seems to be associated with PD susceptibility.

Pyridine compounds increase trap capture of Frankliniella occidentalis (Pergande) in a covered crop

The effect of pyridine compounds on the capture of thrips was examined in an Auckland New Zealand capsicum greenhouse in 2004 Yellow sticky traps were positioned just above the crop canopy in a rectangular array with 6 traps per compound and 6 control traps 2024 m apart and left for 24 h Most thrips found on traps were Frankliniella occidentalis (>99) Fourteen times more female F occidentalis were captured on traps with methyl isonicotinate or ethyl isonicotinate than on controls Sticky traps treated with methyl 4pyridyl ketone also caught more female F occidentalis than controls (45) Sticky traps with methyl isonicotinate caught more male F occidentalis (up to 52) than controls Ethyl2chloropyridine4carboxylate and ethyl nicotinate did not increase trap catches of either sex The results demonstrated that selected pyridine compounds have the potential to improve trap capture of F occidentalis in a covered crop

Isolated Endocarditis of the Pulmonary Valve Caused by Pasteurella multocida

We describe the rare case of a patient with an isolated endocarditis of the pulmonary valve caused by Pasteurella multocida. The bacterium was cultured from blood as well as from the excised valve after pulmonary valve replacement. Risk factors were contact with animals and concurrent intravenous drug use.

Comparison of and uncertainties in raw sewage COD measurements by laboratory techniques and field UV-visible spectrometry

A comprehensive investigation of the uncertainty of different COD analysis methods (DIN, small tube tests (STT) and UV-visible spectrometry methods) has been carried out on potassium hydrogen phthalate standard solutions and raw sewage samples from a large wastewater treatment plant. The UV-visible method allows estimating COD equivalent concentration from the measured absorption spectra by means of site specific regression and correlation functions. CODdin and CODstt methods showed equivalent global results but specific calibration relationships are necessary when high accuracy is required. The CODstt method is suitable for immediate COD analysis in the field. Sub-sampling is the main source of uncertainty. Spectrometry is able to estimate CODeq with an uncertainty of the same order of magnitude as the uncertainty in CODdin.

Gef10--the third member of a Rho-specific guanine nucleotide exchange factor subfamily with unusual protein architecture

According to cDNA sequence homologies, Gef10 is related to the Rho-specific guanine nucleotide exchange factors GrinchGEF and p164-RhoGEF. Like these GEFs, Gef10 exhibits only weak homology to known pleckstrin homology domains, but contains a putative WD40-like domain. As detected by RT-PCR, Gef10 is transcribed in at least two splice variants in different human tissues. Although the Gef10 sequence contains two putative transmembrane segments, recombinantly expressed Gef10 displays a cytosolic localisation. As detected by guanine nucleotide exchange activity assay, precipitation assay of GTP-bound Rho proteins and serum response element dependent gene transcription Gef10 activates RhoA-C, but not Rac1 or Cdc42. In the reporter gene assay, Gef10 preferentially activated RhoB. When expressed in NIH3T3 cells, Gef10 induced actin stress fibre, but not lamellipodia or filopodia formation. We conclude that Gef10 is the third member of a Rho-specific GEF family with unusual protein architecture.

RAS gene hot-spot mutations in canine neoplasias

Point mutations in the cellular homologues HRAS, KRAS2, and NRAS of the viral Harvey and Kirsten rat sarcoma virus oncogenes are commonly involved in the onset of malignancies in humans and other species such as dog, mouse, and rat. Most often, three particular hot-spot codons are affected, with one amino acid exchange being sufficient for the induction of tumor growth. While RAS genes have been shown to play an important role in canine tumors such as non-small lung cell carcinomas, data about RAS mutations in canine fibrosarcomas as well as KRAS2 mutations in canine melanomas is sparse. To increase the number of tumors examined, we recently screened 13 canine fibrosarcomas and 11 canine melanomas for point mutations, particularly within the mutational hot spots. The results were compared to the already existing data from other studies about these tumors in dogs.

Establishment of a Cell Line Derived from a Canine Prostate Carcinoma with a Highly Rearranged Karyotype

Akin to the situation in humans, dogs are frequently affected by tumors of the prostate. The malignancies share many similarities between both species, for example, median age at the onset of the disease and metastatic behavior. In human prostatic tumor samples, investigations of prepared metaphase spreads showed a variety of chromosomal aberrations, with trisomies of chromosomes 7, 8, and 17 as the leading cytogenetic abnormalities. In this article we present one case of a canine adenocarcinoma of the prostate, including clinical examination and establishment of a cell line from a tumor sample obtained from the affected 10-year-old male Briard. Searching for similarities between both species in respect to chromosomal changes within the tumor samples, we investigated prepared metaphases of the canine cell line cytogenetically. These investigations presented a highly rearranged karyotype showing a large biarmed marker consisting of material from chromosomes 1 and 2 in addition to centromeric fusions between dog chromosomes 1 and 5 that both could be identified in every metaphase investigated, while centric fusions of chromosomes 4 and 5 occurred in up to 50% of the metaphases. The cell line grew very well and showed evidence of being spontaneously immortalized when it crossed the 20th passage.

Parasitism of tomato fruitworm larvae in process tomatoes at Pukekohe

A process tomato trial was undertaken at Pukekohe to investigate the interactions between tomato fruitworm Helicoverpa armigera and its larval parasitoids the accidentally introduced generalist Meteorus pulchricornis and the introduced specialists Cotesia kazak and Microplitis croceipes Total mortality of larvae caused by parasitism was 75 with M pulchricornis the dominant parasitoid reared from 54 of parasitised larvae and C kazak and M croceipes reared from 33 and 13 respectively Cotesia kazak attacked smaller larvae than the other two species and was able to survive in the presence of the entomopathogenic fungus Zoophthora radicans late in the crop These results contrast with those for corresponding parasitism in Hawkes Bay where C kazak is very dominant It is concluded that the availability of alternative hosts in areas like Pukekohe is causing the displacement of C kazak there but that this is having little impact on biocontrol of this pest in tomatoes

"Best friends" sharing the HMGA1 gene: comparison of the human and canine HMGA1 to orthologous other species

HMGA1 nonhistone proteins are reported to participate in various cellular processes including regulation of inducible gene transcription, integration of retroviruses into chromosomes, and the induction of neoplastic transformation and promotion of metastatic progression of cancer cells. Overexpression of HMGA1 was shown to be characteristic for various malignant tumors, suggesting a relation between the neoplastic phenotype and a high titer of the protein. Also chromosomal aberrations affecting the human HMGA1 gene at 6p21 were described in several tumors, e.g., uterine leiomyomas, pulmonary chondroid hamartomas, and follicular thyroid adenomas. We characterize the molecular structure of the canine HMGA1 cDNA, its splice variants, and predicted proteins HMGA1a and HMGA1b. Furthermore, we compared the CDS of both splice variants for 12 different breeds, screened them for SNPs, characterised a basic expression pattern, and mapped the gene via FISH. Additionally, we compared the known human, canine, murine, rat, hamster, bovine, pig, Xenopus, and chicken HMGA1 transcripts.

Continuous monitoring in sewer networks an approach for quantification of pollution loads from CSOs into surface water bodies

Different approaches for quantification of pollution loads discharged from combined sewer networks into surface water bodies have been observed over the last few years and decades, but a large number of unresolved problems still remain. Many monitoring campaigns have been based on manual or automated spot sampling - with the long known limitations of this method such as sampling errors and errors due to sample conservation, transport and preparation. On the other hand, only recently have sensors became available which are suitable for continuous application in sewer networks. A large number of practical problems still have to be solved before continuous monitoring in sewer networks will be successful. Additionally, most of the applicable sensors are based on surrogate methods which results in a considerable effort for reference measurements for sensor calibration. Finally, it has to be considered that, depending on the sewer network topography, deposition and remobilisation of pollutants varies considerably, which limits the generality of monitoring results and, subsequently, their applicability as a base for the design of storm water tanks or combined sewer overflows (CSO). A monitoring station for continuous monitoring of load discharges from a CSO has been installed and operated for more than one year. The design and equipment of the measurement station, operational experiences and results are given in this paper.

In vitro activity and interaction of clindamycin combined with dihydroartemisinin against Plasmodium falciparum

Combination regimens are considered a valuable tool for the fight against drug-resistant falciparum malaria. This study was conducted to evaluate the antimalarial potential of clindamycin in combination with dihydroartemisinin in continuously cultured and in freshly isolated Plasmodium falciparum parasites, measuring the inhibition of Plasmodium falciparum histidine-rich protein II synthesis. Interaction analysis revealed a synergistic or additive mode of interaction at various concentration ratios in all continuously cultured parasites at the 50% effective concentration (EC(50)) level. Antagonism was not found for any of the culture-adapted parasites. In fresh P. falciparum isolates, a fixed clindamycin-dihydroartemisinin combination exhibited additive activity at the EC(50) and EC(90) levels. The drug mixture showed no significant activity correlation to other commonly used antimalarials. The clindamycin-dihydroartemisinin combination appears to be a promising candidate for clinical investigation.

Application of ion-sensitive sensors in water quality monitoring

Within the last years a trend towards in-situ monitoring can be observed, i.e. most new sensors for water quality monitoring are designed for direct installation in the medium, compact in size and use measurement principles which minimise maintenance demand. Ion-sensitive sensors (Ion-Sensitive-Electrode--ISE) are based on a well known measurement principle and recently some manufacturers have released probe types which are specially adapted for application in water quality monitoring. The function principle of ISE-sensors, their advantages, limitations and the different methods for sensor calibration are described. Experiences with ISE-sensors from applications in sewer networks, at different sampling points within wastewater treatment plants and for surface water monitoring are reported. An estimation of investment and operation costs in comparison to other sensor types is given.

Sewage-treatment under substantial load variations in winter tourism areas--a full case study

The sewage-load variations in winter tourism areas are characterized by sudden increases--in the range of a factor two to three--within only a few days at the start and the end of the tourist season, especially at Christmas. The sudden load increases occur during periods of low wastewater temperatures, which is an additional demanding factor with respect to nitrogen removal. A full case study was carried out at WWTP Saalfelden, which is located near one of Austria's largest skiing resorts. The plant is designed for 80,000 PE and built according to the HYBRID-concept, which is a special two stage activated sludge process for extensive nutrient removal.

In-line river monitoring--new challenges and opportunities

Water management becomes a complex issue when considering the large number of water-rights-of-use like drinking water production, recreation, receiving water, transport on and ecological quality of the water bodies. Recent changes in the legal requirements concerning water management on European scale (EC Water Framework Directive, 2000/60/EC) highlighted the need for appropriate means for monitoring water quality and exchange of water quality data. Indirect measurement of water quality using surrogate parameters (chemical and physical-chemical parameters) can be automated at a high accuracy level. This was shown over the past years by national and international research projects. In 2001 such a research project has started in Austria focusing on the installation and operation of a pilot water quality network, which is suitable for application at several points of interest of water management, i.e. sewer networks, wastewater treatment plants and receiving water bodies. The paper describes the operational problems and experiences of collecting data over a period of one year in the Danube River downstream of Vienna. The sensors are installed in situ, directly in the river, without any bypass system. The first evaluation of the measurements shows that the values are reliable and therefore applicable to further interpretations.

Quantification of pollution loads from CSOs into surface water bodies by means of online techniques

Based on novel technologies, a modular online monitoring station suitable for continuous application in sewer networks, wastewater treatment plants and receiving water bodies has been designed. The monitoring station serves as the backbone of a water quality pilot network. As one part of this network a sewer monitoring station has been installed at a combined sewer overflow in Graz to quantify pollution concentrations and loads in the combined sewer and into the receiving water and is operated since October 2002. The design and equipment of the measurement station and first operating experiences and results are given in this paper.

Nutrient removal process development and full scale implementation at the 4 million p.e. main treatment plant of Vienna, Austria

The Main Treatment Plant of Vienna is in extension for 4 million p.e. and very stringent nutrient removal requirements. The existing high rate BOD removal activated sludge plant (in operation since 1980) is extended by a second stage activated sludge plant and a newly developed flow scheme for nitrogen removal optimisation adaptable to the temperature variations over the year. For this plant pilot investigations have been performed for the development of a specific mathematical model (ASMV) and a specific aeration control strategy. The civil work of the extension is already finished and the installation of the equipment has started. Operation should start in 2004. The whole project will cost about [see symbol in text]264 million of which about one half is for civil work. The effluent standards correspond to the requirements for sensitive areas in EU Directive for Municipal Waste Water. The raw primary and excess sludge are incinerated after thickening and dewatering. This paper tries to condense the already existing literature with the construction progress and the cost situation.

A guideline for simulation studies of wastewater treatment plants

A guideline for simulation studies of wastewater treatment plants is proposed. The aim of the HSG-guideline is to define a reference quality level that helps to make the results of simulation studies comprehensible and comparable and therefore increases the quality and reliability of mathematical modelling in wastewater treatment. The paper gives a summary of the HSG-guideline, written by a group of university members from Germany, Austria and Switzerland.

Antibody cross-linking of myelin oligodendrocyte glycoprotein leads to its rapid repartitioning into detergent-insoluble fractions, and altered protein phosphorylation and cell morphology

Myelin oligodendrocyte glycoprotein (MOG) is, quantitatively, a relatively minor component of the myelin membrane. Nevertheless, peritoneal administration of MOG evokes potent cellular and humoral immunoreactivity, resulting in an experimental allergic encephalitis with immunopathology similar to multiple sclerosis. Moreover, antibodies against MOG cause myelin destruction in situ. Therefore, it appears that MOG-related demyelination is dependent on anti-MOG antibody, but the mechanism(s) by which it occurs is unclear. Of potential significance are observations that some proteins are selectively partitioned into specialized plasma membrane microdomains rich in glycosphingolipids and cholesterol ("lipid rafts"). In particular, during ligand or antibody cross-linking, various plasma membrane receptors undergo enhanced partitioning into rafts as an obligatory first step toward participation in early signal transduction events. In contrast to mature myelin, in oligodendrocytes (OLs) in culture MOG is not raft associated [Triton X-100 (TX-100) soluble, 4 degrees C]. However, in this study we show that antibody cross-linking (anti-MOG plus secondary antibody) of MOG on the surface of OLs results in the repartitioning of approximately 95% of MOG into the TX-100-insoluble fraction. This repartitioning of MOG is rapid (<or=1 min), antibody dose dependent, requires an intact cytoskeleton, leads to phosphorylation or dephosphorylation of tyrosine, serine, and threonine residues in specific proteins (e.g., beta-tubulin, Gbeta1-2), and invokes a rapid retraction of OL processes. After removal of the cross-linking antibodies, these events are reversed. We hypothesize that antibody-mediated repartitioning of MOG into TX-100-insoluble glycosphingolipid-cholesterol-rich microdomains initiates specific cellular signaling that could be related to initial steps of MOG-mediated demyelination.

Cellular profile of cytokine production in a patient with visceral leishmaniasis: gammadelta+ T cells express both type 1 cytokines and interleukin-10

The cytokine profile of CD4+, CD8+ T cells, gammadelta+ T cells and natural killer (NK) cells (CD94+CD3-) was studied in a patient with visceral leishmaniasis (VL). The otherwise healthy, human immunodeficiency virus-negative patient acquired the disease in Tuscany, Italy. Diagnosis was made by demonstration of high concentrations of antibodies against Leishmania antigens in serum. Flow cytometry for the detection of intracellular interferon-gamma (IFN-gamma), interleukin (IL)-2, IL-4, IL-6, IL-10, IL-13 and tumour necrosis factor (TNF)-alpha expression in peripheral blood mononuclear cells stimulated with phorbol 12-myristate 13-acetate and ionomycin was performed, followed by treatment with liposomal amphotericin B. CD4+ cells were identified as major cytokine-expressing cells, capable of producing both type 1 and type 2 cytokines. A high frequency of IL-4- and IL-13-expressing CD8+ cells was noted. NK cells and gammadelta+ T cells, thought to be involved in innate host defences against Leishmania, expressed IFN-gamma and TNF-alpha. Ten per cent of gammadelta+ T cells expressed IL-10, predominantly together with IFN-gamma, suggesting additional immune-regulatory roles for this T-cell subset in VL.

Serum thrombopoietin levels and anti-thrombopoietin antibodies in systemic lupus erythematosus

Thrombocytopenia is a common phenomenon in patients suffering from systemic lupus erythematosus (SLE). The cause of thrombocytopenia in SLE, however, is poorly understood. In this study, 100 patients with SLE were evaluated for serum thrombopoietin levels, anti-thrombopoietin antibodies and routine laboratory parameters such as peripheral blood counts, parameters of blood chemistry and immunologic parameters of SLE. The median platelet count of SLE patients was 230 g/l and 19 were thrombocytopenic (range 8-148 g/l). Thrombopoietin levels in SLE patients were found to be significantly higher than in healthy controls (n = 96; median, 117 pg/ml vs 64 pg/ml, P < 0.01). When excluding thrombocytopenic SLE patients, thrombopoietin levels in SLE were still above controls (111 pg/ml, P < 0.01). The thrombopoietin levels were correlated to erythrocyte sedimentation rate and ECLAM score of disease activity, and inversely correlated to complement factor C4, but not to the platelet count. Anti-thrombopoietin antibody reactivity was found in 23% of SLE patients. Interestingly, these patients had lower platelet counts than SLE patients without anti-thrombopoietin antibodies (median 174 g/l and 253 g/l, respectively, P < 0.01), but thrombopoietin levels were not significantly different. Taken together, thrombopoietin levels are significantly higher in the sera of SLE patients than in healthy controls and anti-thrombopoietin antibodies are frequently found.

An overview of the Lew attachment: clinical reports

Although the Lew attachment was originally developed to provide retention for overdentures fabricated in conjunction with subperiosteal implants, these attachments can also be used with other types of implants. Two cases are presented to describe the use of Lew attachments, one with a conventional subperiosteal implant, and the other with 4 endosteal implants and an implant connecting bar.

A new implant designed to maximize contact with trabecular bone: survival to 18 months

PROBLEM

A roughened, commercially pure titanium (CP-Ti) implant design has been developed that features a different length and pitch for each screw thread to direct functional stresses away from cortical bone and to the more resilient trabecular bone. Abutment-implant connection is made using a conical taper to provide a seal against invasion by microorganisms.

PURPOSE

To assess short-term (18 months) clinical performance of this innovative implant design.

METHODS

A total of 1,419 implants were placed in 313 patients to support 419 prostheses in a multidisciplinary, multicentered, prospective clinical study conducted by the Ankylos Implant Clinical Research Group (AICRG). More than 100 dentists at 32 centers in the United States, 1 in Korea, and 1 in Taiwan are involved in the study. Failure was defined as implant removal for any reason. The influence of mobility at placement, implant length and diameter, incision type, augmentation, crestal bone reduction, bone density, and the use of the operating room or dental clinic on survival were evaluated over 18 months. Crestal bone loss between placement and uncovering was also determined.

RESULTS

Crestal bone loss ranged from 0.2 to 0.5 mm. The overall success rate from placement to 18 months was 96.6%. Implants mobile at placement failed more frequently (16.9%) compared with stable implants (3.1%). Wide-diameter implants and longer implants exhibited higher survival rates. Incision design and surgery location did not influence survival. Bone density was important to clinical survival.

Stability of implants and natural teeth as determined by the Periotest over 60 months of function

Various methods for evaluating tooth mobility have been developed throughout the years, but their acceptance has been limited because of the subjectivity associated with their use. In recent years, the Periotest has been studied and used to evaluate the mobility of natural teeth and is claimed to b e potentially reliable in assessing the stability of the implant-bone interface. Few clinical implant studies have used natural teeth as controls to monitor changes in mobility associated with dental implants. The Dental Implant Clinical Research Group initiated a long-term clinical study in 1991 to assess the influence of design, application, and site of placement on clinical success and crestal bone height. As part of the study, Periotest values (PTVs) were recorded for 2,623 of the 2,998 implants placed and uncovered. For the statistical analysis, 2,623 implants were tested at second-stage surgery, with the number of implants tested varying at each follow-up visit. Data were collected from investigators at 32 study centers for periods ranging up to 60 months. A total of 975 natural teeth from 409 partially edentulous study subjects served as controls. FPVs on natural teeth and implants were combined, and the overall average Periotest values (OA-PTVs) were compared with values for individual subjects. The effect of implant and natural tooth locations on mobility were evaluated and compared with each other. The combined OA-PTV for all natural teeth was +1.8 and the OA-PTV for all implants was -3.4 PTVs. Compared with those in the maxillae, mandibular teeth and implants were found to be more stable Implants were found to be significantly more stable as compared with natural teeth. The recorded variations in PTVs for natural teeth and implants over the entire evaluation period were not found to be significantly different. This study developed the following conclusions: (1) implants were found to be significantly less mobile as compared with natural teeth for individual subjects; (2) the PTVs for natural teeth and implants did not exhibit significant variation over the evaluation period; (3) the Periotest can provide reproducible assessment of stability in a long-term clinical study; and (4) changes in PTVs may be helpful in evaluating improvement or degradation of the implant-bone complex.