Recommendations for the management of advanced and metastatic renal cell carcinoma: joint consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology

INTRODUCTION

Kidney cancer, primarily renal cell carcinoma (RCC), ranks among the top 10 most common malignancies in the male population of Hong Kong. In 2019, members of two medical societies in Hong Kong formed an expert panel to establish a set of consensus statements for the management of metastatic RCC. On 22 June 2021, the same panel met to review recent evidence and reassess their positions regarding the management of advanced and metastatic RCC, with the aim of providing recommendations for physicians in Hong Kong.

PARTICIPANTS

The panel included 12 experts (6 clinical oncologists and 6 urologists) who had extensive experience managing patients with RCC in Hong Kong.

EVIDENCE

The panel reviewed randomised controlled trials, observational studies, systematic reviews/meta-analyses, and international clinical guidelines to address key clinical questions that were identified before the meeting.

CONSENSUS PROCESS

In total, 15 key clinical questions were identified before the meeting, covering the surgical and systemic treatment of advanced or metastatic clear cell, sarcomatoid, and non-clear cell RCCs. At the meeting, the panellists voted on these questions, then discussed relevant evidence and practical considerations.

CONCLUSIONS

The treatment landscape for advanced and metastatic RCC continues to evolve. More immune checkpoint inhibitor (ICI)-based combination regimens will be indicated for the treatment of metastatic clear cell RCC. There is increasing evidence concerning the benefit of adjuvant ICI treatment for resected advanced RCC. This article summarises recent evidence and expert insights regarding a series of key clinical questions about the management of advanced and metastatic RCC.

[Disinfection By-products in Drinking Water and Their Control Strategies: A Review]

Disinfection by-products(DBPs) are secondary pollutants generated by the reaction of disinfectants with organic or inorganic precursors during drinking water disinfection. DBPs have received considerable global attention due to their carcinogenic, teratogenic, and mutagenic characteristics. Focusing on drinking water, this paper introduces the main classification and research history of DBPs, and then summarizes the concentration levels of common DBPs in drinking water, and DBPs regulatory compliance in global drinking water standards. Further, the control strategies for DBPs in drinking water, including source control, process control, DBPs removal and integrated control are introduced together with the advantages and disadvantages. Finally, a summary and review of the current level and future trends of DBPs research in China are presented with the proposed control strategies. On the one hand, when evaluating the control effect of a process or technology, the DBPs concentration and comprehensive toxicity should be considered; on the other hand, in order to realize the efficient control of DBPs in drinking water, the focus should be on the integrated methods coupling different DBPs control methods.

Enhancing trace acrylamide analysis by bromine derivatization coupled with direct-immersion solid-phase microextraction in drinking water

Acrylamide is a neurotoxic and genotoxic compound. It is abundant in drinking water because of the usage of polyacrylamide. Its high polarity and small molecular weight characteristics make it difficult to be extracted and analysed. In this study, a novel method was optimized for the determination of trace acrylamide in drinking water. The optimized method, uses bromine derivatization, can avoid false analysis of co-extractives and precursors effectively by transferring acrylamide to 2-bromopropenamide. The 2-bromopropenamide was extracted from water samples using DI-SPME and further analysed by GC-MS. This optimized method uses CAR/PDMS coating SPME fibre to extract at 55°C for 45 min after the addition of 12 g Na₂SO₄, and then desorbs the extractions in GC injector at 260°C for 3 min. The detection limit was 0.05 μg/L with linearity ranging from 0.5 to 500 μg/L. The repeatability and reproducibility relative standard deviation were 7.30% and 8.50%, respectively. The spiking recovery of tap water samples ranged from 100% to 106%. These results confirmed that this novel method was more precise and accurate than the previously reported SPME methods that used to analyse trace acrylamide in drinking water. The concentrations of acrylamide in the collected samples from clarification and filtration units were 0.80 and 0.71 g/L respectively.

Comparison of different disinfection processes for controlling disinfection by-product formation in rainwater

With increasing shortage of clean water, rainwater has been considered as a precious alternative drinking water source. The processes applied to rainwater treatment are responsible for the safety of drinking water. Therefore, we systematically compared different disinfection processes to evaluate the control of disinfection by-product (DBP) formation and integrated cyto- and genotoxicity of the treated rainwater for the first time. The evaluated disinfection processes included chlorination and chloramination, pre-oxidation by potassium permanganate (KMnO₄) and potassium ferrate (K₂FeO₄), ultraviolet/hydrogen peroxide (UV/H₂O₂), and ultraviolet/persulfate (UV/PS) processes. The results revealed that chloramination was effective for controlling the formation of carbonaceous DBPs (C-DBPs), but not nitrogenous DBPs (N-DBPs). Compared to KMnO₄ pre-oxidation, better reduction of almost all DBPs was observed during K₂FeO₄ pre-oxidation. According to the calculation of cytotoxicity index (CTI) and genotoxicity index (GTI), cyto- and genotoxicity of the samples decreased obviously at the dosage of ≥ 2.0 mg/L KMnO₄ and K₂FeO₄. The control of the cyto- and genotoxicity of the formed DBPs from the two UV-related AOPs was more effective at the dosage of ≥ 1.0 mM PS and ≥ 5.0 mM H₂O₂. Moreover, UV/PS was much more powerful to alter the structure of DBP precursors in rainwater.

Enhanced ronidazole degradation by UV-LED/chlorine compared with conventional low-pressure UV/chlorine at neutral and alkaline pH values

Ultraviolet light-emitting diodes (UV-LEDs) are promising alternatives to conventional low-pressure UV (LPUV) lamps, mainly because they contain no toxic mercury and have a potential for less energy consumption and longer lifetime. In this study, UV sources including UV-LEDs (265, 275 and 285 nm) and LPUV (254 nm) were compared in UV/chlorine degradation of an organic contaminant, ronidazole (RNZ). UV-LED/chlorine performed better than LPUV/chlorine at neutral and alkaline pH values for RNZ degradation considering the fluence-based rate constant. However, the wall plug efficiencies of UV-LEDs are relatively low at present and must reach about 20-25% to achieve the same electrical energy per order as the LPUV in UV/chlorine degradation of RNZ at pH 7.5 and 9. Neither the contribution of radical (HO· or Cl·) nor the quantum yield of chlorine could explain the different RNZ degradation rate by UV/chlorine at different wavelengths and pH values, while the chlorine photolysis rate should be the key factor for these phenomena. The effects of common co-existing substances in real water (chloride, bicarbonate and natural organic matter) on UV/chlorine degradation of RNZ were similar at different UV wavelengths. Opposite to other oxidants or reductants, the molar absorption coefficient of chlorine increases when the UV wavelength increases from 254 to 285 nm at neutral and alkaline pH, which makes UV-LED/chlorine one of the best choices for UV-LED-based advanced oxidation/reduction processes.

[Removal Efficiency of Trichloroacetamide by UV/Sodium Sulfite]

Haloacetamides (HAcAms) are an emerging class of nitrogenous disinfection by-products (N-DBPs) with high cytotoxicity and genotoxicity, which are widely detected in drinking water. The toxicity of trichloroacetamide (TCAcAm) is significantly higher than traditional DBPs. In this study, ultraviolet (UV) treatment was combined with sodium sulphite (Na₂SO₃) to remove TCAcAm from water. The effects of different light intensities, different agent dosages (Na₂SO₃), and pH conditions on the removal of TCAcAm by UV/Na₂SO₃ advanced reduction process were investigated. The results showed that TCAcAm could be rapidly degraded by the UV/Na₂SO₃ system. The degradation effect was directly proportional to light intensity, dosage of Na₂SO₃, and pH. Moreover, the pH had a significant effect on the reaction rate and degradation rate. As the pH increased from 6 to 9, the degradation rate of TCAcAm increased from 12.8% to 99.6%, in 120 min. The removal rate of TCAcAm reached 99.4% when the UV light intensity, pH, Na₂SO₃ dosage, and reaction time were 450 μW·cm^-2, 9, 1.00 mmol·L^-1, and 30 min, respectively. The experimental results indicated that the UV/Na₂SO₃ system is an efficient advanced reduction process for the removal of TCAcAm, and it has the potential to reduce other halogenated DBPs. Therefore, it could be used for the degradation of halogenated DBPs in the treatment of drinking water.

Effect of UV wavelength on humic acid degradation and disinfection by-product formation during the UV/chlorine process

The efficiency of the ultraviolet (UV)/chlorine process strongly depends on UV wavelength because chlorine photolysis and its subsequent radical formation are highly wavelength-dependent. This study compared the degradation of humic acid (HA) during the UV/chlorine process by low pressure mercury lamp (LPUV, 254 nm) and ultraviolet light-emitting diode (UV-LED, 275 and 310 nm). The results indicated that HA degradation followed the pseudo-first-order kinetics, and the fluence-based degradation rate constants (k_obs) were significantly affected by UV wavelength and solution pH. HA degradation decreased greatly with increasing solution pH during the UV/chlorine process at 254 nm, while the opposite trend was observed at 275 and 310 nm. In the meantime, k_obs decreased in the order of 275 nm > 254 nm > 310 nm at pH > 7.0. The changes of chlorine molar absorption coefficients at different UV wavelengths resulted in the variation of chlorine photodecay rates (k_{obs, chlorine}), and the synergistic effects of k_{obs, chlorine} and chlorine quantum yields (Φ_chlorine) affected HA reduction. The formation of disinfection by-products (DBPs) during the UV/chlorine process was also evaluated. A significant suppression on DBP formation and DBP-associated calculated theoretical cytotoxicity were observed at 275 nm high UV fluence and alkaline pHs. These findings in this study demonstrate that UV wavelength at 275 nm is more suitable for HA degradation by the UV/chlorine advanced oxidation process in practical applications.

Effect of UV irradiation on iodinated trihalomethane formation during post-chloramination

Ultraviolet (UV) irradiation has been widely used in drinking water treatment processes, but its influence on the formation of disinfection by-products (DBPs), especially the emerging iodinated trihalomethanes (I-THMs) during post-chloramination remains unclear. This study evaluated the impact of low pressure (LP) UV treatment on the formation of I-THMs during post-chloramination through two pathways. The first pathway is through the transition of DOM structure and composition during UV-chloramination, resulting significant increase of I-THM formation with increasing UV dosage in different dissolved organic matter (DOM)-containing water (49.7%-90.5% at 1160 mJ/cm²). With the application of excitation emission matrix-parallel factor analysis (EEM-PARAFAC), we found that I-THM formation in UV-chloraminated water correlated well with two ratios of three PARAFAC humic-like components (C3/C2 and C1/C2, R² = 0.958-1.000), suggesting that the ratios of fluorescent components can be used as reliable indicators for I-THM formation. Moreover, the shift in these fluorescent components is crucial for I-THM formation during UV-chloramination. Another pathway for UV irradiation to affect I-THM formation during post-chloramination is through the transformation of iodine species. Large amounts of reactive iodine species (HOI/I₂ and I₃^-) can be generated directly in the mixed iodine system by UV light, leading to the enhancement of iodine utilization factor (IUF) (up to 0.040) after post-chloramination. These results suggest that UV application to DOM-containing water may induce changes in organic precursors and iodine species so as to enhance I-THM formation during post-chloramination.

Degradation of acrylamide during chlorination as a precursor of haloacetonitriles and haloacetamides

Acrylamide is a monomer of polyacrylamide, which is widely used in the water treatment process as a flocculant. The degradation kinetics and formation of disinfection by-products (DBPs) during acrylamide chlorination were investigated in this study. The reaction between chlorine and acrylamide followed a pseudo-first-order kinetics. A kinetic model regarding acrylamide chlorination was established and the rate constants of each predominant elementary reaction (i.e., the base-catalyzed reaction of acrylamide with ClO^- as well as the reactions of acrylamide with HOCl and ClO^-) were calculated as 7.89×10⁷M^-2h^-1, 7.72×10¹M^-1h^-1, and 1.65×10³M^-1h^-1, respectively. The presence of Br^- in water led to the formation of HOBr and accelerated the rate of acrylamide degradation by chlorine. The reaction rate constant of acrylamide with HOBr was calculated as 1.33×10³M^-1h^-1. The degradation pathways of acrylamide chlorination were proposed according to the intermediates identified using ultra-performance liquid chromatography and electrospray ionization-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS). Five chlorinated DBPs including chloroform (CF), dichloroacetonitrile (DCAN), trichloroacetonitrile (TCAN), dichloroacetamide (DCAcAm), and trichloroacetamide (TCAcAm) were identified during acrylamide chlorination. The formation of CF, DCAN, DCAcAm, and TCAcAm kept increasing, while that of TCAN increased and then decreased with increasing reaction time. As the chlorine dosage increased from 0.75 to 4.5mM, DCAN became the dominant DBP. Large amounts of CF, DCAN, and TCAN were formed at basic pHs. The hydrolysis of DCAN and TCAN led to the formation of DCAcAm and TCAcAm, respectively. The results of this study elucidated that acrylamide can be a precursor for the formation of haloacetonitriles (HANs) and haloacetamides (HAcAms) during drinking water treatment.

Iodinated trihalomethane formation during chloramination of iodate-containing waters in the presence of zero valent iron

Iodide (I^-) and iodinated X-ray contrast media (ICM) are the primary iodine sources for the formation of iodinated disinfection byproducts (I-DBPs), and iodate (IO₃^-) is believed to be a desired sink of iodine in water. This study found that highly cytotoxic iodinated trihalomethanes (I-THMs) also can be generated from iodate-containing waters (without any other iodine sources) in the presence of zero valent iron (ZVI) during chloramination, which could be a big issue in the wide usage of iron pipes. The effect of major factors including ZVI dosage, NH₂Cl and IO₃^- concentrations, initial pH, Br^-/IO₃^- molar ratio, phosphate concentration, iron corrosion scales (goethite and hematite) on the formation of I-THMs were investigated. Formation of I-THMs from IO₃^- increased with the increase of ZVI dosage, IO₃^- and NH₂Cl concentrations. Chloramines can also remarkably accelerate the reduction of IO₃^- by ZVI. Peak I-THM formation was found at pH 8. As the Br^-/IO₃^- molar ratio increased from 0 to 20, I-THM formation considerably enhanced, especially for the bromine-incorporated species. Goethite and hematite enhanced the formation of I-THMs in the presence of ZVI. Additionally, a significant suppression on I-THM formation was observed with the addition of phosphate. Considering that a large number of water distribution networks contain unlined cast iron pipes, transformation of IO₃^- in the presence of ZVI during chloramination may contribute to the formation of I-THMs in such systems.

Chlor(am)ination of iopamidol: Kinetics, pathways and disinfection by-products formation

The degradation kinetics, pathways and disinfection by-products (DBPs) formation of iopamidol by chlorine and chloramines were investigated in this paper. The chlorination kinetics can be well described by a second-order model. The apparent second-order rate constants of iopamidol chlorination significantly increased with solution pH. The rate constants of iopamidol with HOCl and OCl^- were calculated as (1.66 ± 0.09) × 10^-3 M^-1 s^-1 and (0.45± 0.02) M^-1 s^-1, respectively. However, the chloramination of iopamidol fitted well with third-order kinetics and the maximum of the apparent rate constant occurred at pH 7. It was inferred that the free chlorine (i.e., HOCl and OCl^-) can react with iopamidol while the combined chlorine species (i.e., NH₂Cl and NHCl₂) were not reactive with iopamidol. The main intermediates during chlorination or chloramination of iopamidol were identified using ultra performance liquid chromatography - electrospray ionization-mass spectrometry (UPLC-ESI-MS), and the destruction pathways including stepwise deiodination, hydroxylation as well as chlorination were then proposed. The regular and iodinated DBPs formed during chlorination and chloramination of iopamidol were measured. It was found that iodine conversion from iopamidol to toxic iodinated DBPs distinctly increased during chloramination. The results also indicated that although chloramines were much less reactive than chlorine toward iopamidol, they led to the formation of much more toxic iodinated DBPs, especially CHI₃.

Formation of organic chloramines during chlor(am)ination and UV/chlor(am)ination of algae organic matter in drinking water

Surface water are frequently subjected to problems of algal blooms and release of algae organic matter (AOM) from the algae cells, which cause many water quality issues. This study investigated the formation of organic chloramines and nitrogenous disinfection by-products (N-DBPs) during chlor(am)ination and UV/chlor(am)ination of AOM in drinking water. AOM caused higher organic chloramine formation than humic acid and fulvic acid during chlor(am)ination. The formation of organic chloramines increased first and then decreased with the increase of free chlorine dosage, but kept increasing with the increase of NH2Cl dosage. During AOM chlorination, the formation of organic chloramines kept decreasing as the reaction time went by, and the maximum organic chloramine proportion (79.1%) in total chlorine occurred at 8 h. However, during AOM chloramination, the formation of organic chloramines increased first, decreased in the following and then increased again as the reaction time went by, and the maximum organic chloramine proportion (22.1%) in total chlorine occurred at 24 h. UV irradiation pretreatment did not effectively influence organic chloramine formation during AOM chlor(am)ination, but accelerated the degradation of organic chloramines during chloramination. Besides, UV pretreatment enhanced the formation of N-DBPs during the subsequent chlor(am)ination of AOM, especially dichloroacetonitrile.

[Composition of NOM in raw water of Danjiangkou Reservoir of South-to-North Water Diversion Project and comparison of efficacy of enhanced coagulation]

The best enhanced coagulation conditions for the raw water of Danjiangkou Reservoir of South-to-North Water Diversion Project and the molecular weights as well as hydrophobicity composition of Natural organic matter (NOM) in the water were investigated in this study. The results showed that the NOM in the raw water of Danjiangkou Reservoir of South-to-North Water Diversion Project was mainly composed of the fraction with a molecular weight of < 1 000 and transphilic components. Dissolved organic carbon (DOC, 39.98%) and UV254 (39.10%) were the major components. And the fraction with a molecular weight of < 1 000 had the highest contents of THMFP and N-DBPFP. In the raw water of Danjiangkou Reservoir, the sum of transphilic and hydrophobic fractions was up to 80%, and the hydrophobic fraction was the minimum contributor of the NOM, but the THMFP of the hydrophobic fraction had the highest percentage. And when the raw water of Danjiangkou Reservoir was treated using polymeric ferric sulfate (PFS, 4 mg x L(-1)) and poly-acrylamide (PAM, 0.4 mg x L(-1)) , the optimal removal rates of turbidity, DOC, UV254 and THMFP were 76.33%, 25.57%, 37.78% and 23.16%, respectively. The results of this paper can provide theoretical and technological basis for upgrading of the process and operation optimization of original drinking water treatment plants in the intake area of South-to-North Water Diversion Project.

Photochemical degradation of ciprofloxacin in UV and UV/H₂O₂ process: kinetics, parameters, and products

Photochemical degradation of fluoroquinolone ciprofloxacin (CIP) in water by UV and UV/H₂O₂ were investigated. The degradation rate of CIP was affected by pH, H₂O₂ dosage, as well as the presence of other inorganic components. The optimized pH value and H₂O₂ concentration were 7.0 and 5 mM. Carbonate and nitrate both impeded CIP degradation. According to liquid chromatography-tandem mass spectrometry analysis, four and 16 products were identified in UV and UV/H₂O₂ system, respectively. Proposed degradation pathways suggest that reactions including the piperazinyl substituent, quinolone moiety, and cyclopropyl group lead to the photochemical degradation of CIP. Toxicity of products assessed by Vibrio qinghaiensis demonstrated that UV/H₂O₂ process was more capable on controlling the toxicity of intermediates in CIP degradation than UV process.

Giant urethral diverticulum calculus presenting as scrotal abscess

We report herein a patient with a urethral calculus associated with urethral diverticulum. A 39-year-old man presented with scrotal swelling and acute retention of urine. Computed tomography of the pelvis and cystoscopy demonstrated a giant calculus in the proximal penile urethra. Emergency in-situ lithotripsy was performed. Complete stone clearance was achieved and a large urethral diverticulum was encountered. The rare occurrence of urethral diverticulum and associated stone disease were discussed.

Beyond-limit light focusing in the intermediate zone

We experimentally verify that a new nanolens of a designed plasmonic aperture can focus visible light to a single line with its width smaller than the limit of half the wavelength in the intermediate zone. The experimental measurement indicates that while the near field plays a role to increase the spot size in the near zone, it is negligible at the beyond-limit focused region; i.e., the focused light is dominated by the radiative fields. The image taken by the optical microscope shows that the fields focused have propagated to the far zone. Besides being of academic interest, the nanolens capable in achieving a lower diffraction limit in the intermediate zone is important for application possibilities.

Formation of nitrogenous disinfection by-products from pre-chloramination

A sampling survey investigated the formation of nitrogenous disinfection by-products (N-DBPs) and carbonaceous DBPs (C-DBPs) from pre-chloramination, an increasingly common treatment strategy in China for regulated C-DBP control, followed by subsequent conventional water treatment processes, i.e., coagulation, sedimentation, and filtration. Dihalogenated N-DBPs typically peaked in the summer and early autumn with a relatively higher temperature, with the maximum levels of dichloroacetamide (DCAcAm), dichloroacetonitrile (DCAN), bromochloroacetonitrile, dibromoacetonitrile and dichloroacetone at 1.8, 6.3, 6.0, 2.6 and 1.8μgL(-1) in the finished water, respectively. Also, the levels of all the dichlorinated N-DBPs were correlated with the ratio of dissolved organic nitrogen (DON) to dissolved organic carbon, implying autochthonous DON played an essential role in the formation of these DBPs. In contrast, the yields of trihalogenated DBPs [chloroform (CF), trichloronitromethane (TCNM) and trichloroacetone (TCAce)] appeared not to be significantly affected by seasons. CF and DCAN were the dominant species in trihalomethanes (THMs) and dihaloacetonitriles (DHANs), respectively. Bromine was more readily incorporated into DHANs to form brominated DBPs than THMs during pre-chloramination. Although pre-chloramination can ensure the finished water to meet with the current Chinese THM regulatory limits, the increased levels of TCNM and TCAce may be a new water quality concern.

Comparison of inclined plate sedimentation and dissolved air flotation for the minimisation of subsequent nitrogenous disinfection by-product formation

The formation of disinfection by-products (DBPs), including both nitrogenous disinfection by-products (N-DBPs) and carbonaceous disinfection by-products (C-DBPs), was investigated upon chlorination of water samples following two treatment processes: (i) coagulation-inclined plate sedimentation (IPS)-filtration and (ii) coagulation-dissolved air flotation (DAF)-filtration. The removal of algae, dissolved organic nitrogen (DON), dissolved organic carbon (DOC) and UV(254) by coagulation-DAF-filtration was superior to coagulation-IPS-filtration. On average, 53%, 53% and 31% of DOC, DON and UV(254) were removed by coagulation-DAF-filtration process, which were higher than 47%, 31% and 27% of that by coagulation-IPS-filtration process. Additionally, coagulation-IPS-filtration performed less well at removing the low molecular weight organics than coagulation-DAF-filtration process. The concentrations of chloroform, dichloroacetamide (DCAcAm) and dichloroacetonitrile (DCAN) formed during chlorination after coagulation-DAF-filtration reached their maximum values of 13, 1.5 and 4.7μgL(-1), respectively, and were lower than those after coagulation-IPS-filtration with the maximum detected levels of 17, 2.9 and 6.3μgL(-1). However, the trichloronitromethane (TCNM) concentration after the two processes was similar, suggesting that DON may have less of a contribution to TCNM formation than DCAcAm and DCAN.

Characteristic of algogenic organic matter and its effect on UF membrane fouling

Algogenic organic matter (AOM) was extracted from blue-green algae (cyanobacteria) and its characteristic was determined by various methods including high-pressure size-exclusion chromatography (HP-SEC), hydrophobic and hydrophilic fractionation, molecular weight (MW) fractionation and fluorescence excitation emission matrix (EEM). The results revealed that AOM was hydrophilic fractionation predominantly, accounting for 78%. The specific ultraviolet absorbance of AOM was 1.1 L/(mg m) only. The analysis for MW distribution demonstrated that organic matter greater than 30,000 MW accounted for over 40% and was composed of mostly neutral hydrophilic compound. EEM analyses revealed that protein-like and humic-substances existed in AOM. A test for membrane filtration exhibited that AOM could make ultrafiltration membrane substantial flux decline, which can be attributed to membrane pore clog caused by neutral hydrophilic compound with larger MW.

Precursors of dichloroacetamide, an emerging nitrogenous DBP formed during chlorination or chloramination

Haloacetamides (HAcAms) are an emerging class of nitrogenous disinfection byproducts (N-DBPs). However, there is a limited understanding about the precursors of HAcAms. In this study, we screened the precursors of dichloroacetamide (DCAcAm), the most commonly identified HAcAm in chlorinated or chloraminated drinking water. DCAcAm formation potential (FP) of raw water samples collected in different months from a reservoir in China was determined during chlorination, and the highest DCAcAm FP typically occurred in the summer samples. Dissolved organic matter (DOM) in a representative summer raw water sample was separated into six fractions by a series of resin elutions. Among them, hydrophilic acid (HiA) DOM showed the maximum DCAcAm FP, followed by hydrophilic bases (HiB) and, to a much lower extent, hydrophobic acids (HoA). Fluorescence excitation-emission matrix (EEM) spectra revealed that a mass of protein-like substances in the HiA fraction, made up of amino acids (AAs), were the likely DCAcAm precursors. Finally, we investigated the DCAcAm yields of 20 AAs during chlorination. Among them, seven AAs (aspartic acid, histidine, tyrosine, tryptophan, glutamine, asparagine, phenylalanine) could form DCAcAm during chlorination, with the corresponding DCAcAm yields of 0.231, 0.189, 0.153, 0.104, 0.078, 0.058, and 0.050 mmol/mol AA.

Effect of oral immunization with Aeromonas hydrophila ghosts on protection against experimental fish infection

AIMS

To investigate whether oral immunization with Aeromonas hydrophila ghosts (AHG) vaccine can elicit mucosal and systemic immune responses of Carp (Carassius auratus gibelio) compared to conventional formalin-killed bacteria (FKC).

METHODS AND RESULTS

Fish were fed diets coated with AHG, FKC or phosphate buffered saline (PBS) alone, after immunization, more antigen-specific antibody was significantly detected in serum and intestinal mucus in AHG group than FKC group and PBS group. In addition, after challenged with the parent strain J-1, the survival of bacterial ghost-vaccinated fish was higher than PBS group and FKC group, the relative per cent survival (RPS) being 76.8%, 58.9%, respectively.

CONCLUSIONS

Oral immunization with A. hydrophila ghosts can elicit systemic and mucosal adaptive immune responses and has higher potential to induce protective adaptive immunity than normal vaccine.

SIGNIFICANCE AND IMPACT OF THE STUDY

Oral immunization with bacterial ghosts is a promising new solution with potential application to prevent diseases in fish.

Formation of chloroform during chlorination of alanine in drinking water

Currently, dissolved nitrogenous organic matters in water, important precursors of disinfection by-products (DBPs), are of significant concern. This study was to explore the formation of chloroform (CF) during chlorination of alanine (Ala), an important nitrogenous organic compound commonly present in water sources. Our results indicated that the CF yield reached a maximum value of 0.143% at the molar ratio of chlorine atom to nitrogen atom (Cl/N)=1.0 over a Cl/N range of 0.2-5.0 (pH=7.0, reaction time=5d, and initial Ala=0.1mM). At an acidic-neutral condition (pH 4-7), the formation of CF was suppressed. However, the highest CF yield (0.227%) occurred at weakly alkaline condition (pH 8.0) (initial Ala=0.1mM, and Cl/N=1.0). The increase of Br(-) in water can increase total trihalomethanes (THMs) and bromo-THMs. However, the bromo-THMs level reached a plateau at Br(-)/Cl>0.04. Finally, based on the computation of frontier electron density and identification and measurement of key intermediates during Ala chlorination, we proposed a formation pathway of CF from Ala chlorination: Ala-->monochloro-N-alanine (MC-N-Ala)-->acetaldehyde (AAld)-->monochloroacetaldehyde acetaldehyde (MCAld)-->dichloroacetaldehyde (DCAld)-->trichloroacetaldehyde (TCAld)-->CF.

[Factors affecting formation of THMs during dissolved organic nitrogen acetamide chlorination in drinking water]

Chlorination disinfection greatly reduced bacteria and virus in drinking water. However, there is an unintended consequence of disinfection, the generation of chemical disinfection by-products (DBPs). Dissolved organic nitrogen (DON) as the important precursor of DBPs is of current concern. As acetamide (AcAm) occur in important bimolecular, we studied formation pathways for THMs during chlorination of model AcAm. The experiments are designed by Plackett-Burman and Box-Behnken methods. Factors affecting formation of THMs such as AcAm initial concentration, chlorine dosage, pH, temperature, Br(-) concentration and contact time were investigated. The results indicate that AcAm initial concentration, pH and temperature have little effects on formation of THMs. On the contrary, three other factors have important effects on formation of THMs, especially Br(-) concentration. The capacity of THMs generation varies very little when Br(-) has a constant concentration. Generation amount of THMs attach maximum under the condition that dosage of active chlorine, Br(-) concentration and contact time is 8.77 mg/L, 0.77 mg/L and 6.20 h respectively. Bromine ion plays a catalysis role on THMs formation. Controlling the concentration of bromine ion can reduce total generation amount of THMs via AcAm. Bromine partition coefficient tends to increasing along with contact time lapse. Controlling chlorination reaction time can lower the cancer risk. At last, the pathway is proposed for THMs formation via AcAm, and the catalysis mechanism of Br(-) was addressed.

[Emergent treatment process for raw water polluted by heavy metal Pb (II)]

Based on two common coagulants-polyferric sulfate (PFS) and polyaluminum chloride (PACl), some measurements and processes in the background of Pb (II) concentration sudden increase in water were studied. The removal efficiency of Pb(II) was compared between PAC and diatomite absorption with coagulation. The effect of coagulant dosage, initial concentration of Pb(II), pH value and KMnO4 preoxidation on coagulation were investigated. The results showed that using PFS was better than PACl for the removal of Pb(II). The regulating pH value up to 9 could improve the removal efficiency of Pb(II) up to 95% by coagulation under the optimum dosage of coagulant PFS of 10 mg/L. KMnO4 preoxidation could improve the removal efficacy of Pb(II) by coagulation of PACl only. The Pb(II) removal efficiency of PAC and diatomite absorption with coagulation were almost equal. Pb(II) concentration could be lowered from 402 microg/L to below 10 microg/L under the condition that dosages of PAC or diatomite were 10 mg/L or 25 mg/L by using PFS. The same effect could be got under the condition that dosages of PAC or diatomite were 20 mg/L or 50 mg/L by using PACl. KMnO4 and diatomite are dosed at the same time would weaken their function each other. Therefore, diatomite adsorption coupled with coagulation is the simplest and most effective method for removing Pb(II).

Microfabricated biocapsules provide short-term immunoisolation of insulinoma xenografts

This study examines the viability and functionality of two insulinoma cell lines, RIN (1048) and betaTC6F7, encapsulated within microfabricated biocapsules. Surface and bulk micromachining are integrated in the biocapsule fabrication process, resulting in a diffusion membrane with uniform pore size distribution as well as mechanical and chemical stability, surrounded by an anisotropically-etched silicon wafer, which serves as the encapsulation cavity. Insulinoma cells (4500 cells/biocapsule) were enclosed within these microfabricated biocapsules and subjected to a static incubation study after either implantation in BALB-C mice or incubation in vitro. Examination of retrieved microfabricated biocapsules revealed an insulin stimulatory index of approximately 1.5 for encapsulated RIN cells and 3.6 for encapsulated betaTC6F7 cells for biocapsules with 18 nm pore sized microfabricated membranes, similar to indices of biocapsules incubated in vitro. There was an 80% decrease in cell stimulatory response between in vitro and in vivo 66 nm-biocapsules as compared to 20% for 18 nm-biocapsules, indicating that the immunoisolatory effectiveness depends greatly on achieving uniform pore sizes in the size range of 18 nm or smaller. The present study demonstrates the feasibility of using microfabricated biocapsules for the immunoisolation of insulinoma cells lines. The microfabricated biocapsule may serve as an alternative to conventional polymeric based biocapsules for possible use as in vivo insulin secreting bioreactor.

Role of Microfilaments and Microtubules in the Invasion of EPC Cells by Aeromonas hydrophila

The influence of the cytoskeleton on the invasion of Aeromonas hydrophila strain AhJ-1, isolated from diseased fish, in the monolayer cell of epithelioma papillosum cells of carp (EPC) was evaluated by the recovery of gentamicin-resistant bacteria from Triton X-100 cell lysates. The depolymerization of microfilaments (MF) by cytochalasin B and D inhibited the uptake of A. hydrophila in a dose-dependent manner and that of microtubules (MT) by colchicines and nocodazole did not affect the invasion of A. hydrophila in EPC cells significantly. The invasion frequency decreased approximately 62% with the addition of 0.1 microg/ml cytochalasin D and nearly 86% by the addition of 5.0 microg/ml. Invasion decreased approximately 49% and 83% by addition of cytochalasin B in a concentration of 2.5 microg/ml and 10.0 microg/ml. Colchicine and nocodazole, inhibitors of MT formation appears to have little effect on the invasion of EPC cells by strain Ah J-1. Thus MF formation, but not MT formation seems to play an important role in the internalization of A. hydrophila J-1.

A simplified risk-based approach for process screening in municipal wastewater reclamation and reuse

Reuse of municipal wastewater has become a promising solution to relieve the tension of increasing fresh water demand in many metropolitans. Although different advanced technologies are available to reclaim wastewater into premium quality, associated health effects are usually not properly assessed in reclamation process selection. A simplified risk-based approach developed for process screening and adaptation of health impacts as a consideration in reclamation process selection is discussed in this paper. This approach can be used to screen out unqualified processes and those with poor cost benefits. As a result, the design of wastewater reclamation could be enhanced to control the associated health impacts in wastewater reuse.

Microfabricated immunoisolating biocapsules

A microfabricated silicon-based biocapsule for the immunoisolation of cell transplants is presented. The biocapsule-forming process employs bulk micromachining to define cell-containing chambers within single crystalline silicon wafers. These chambers interface with the surrounding biological environment through polycrystalline silicon filter membranes. The membranes are surface micromachined to present a high density of uniform pores, thus affording sufficient permeability to oxygen, glucose, and insulin. The pore dimensions, as small as 20 nm, are designed to impede the passage of immune molecules and graft-borne viruses. The underlying filter-membrane nanotechnology has been successfully applied in controlled cell culture systems (Ferrari et al., 1995), and is under study for viral elimination in plasma fractionation protocols. Here we report the encouraging results of in vitro experiments investigating the biocompatibility of the microfabricated biocapsule, and demonstrate that encapsulated rat neonatal pancreatic islets significantly outlive and outperform controls in terms of insulin-secretion capability over periods of several weeks. These results appear to warrant further investigations on the potential of cell xenografts encapsulated within microfabricated, immunoisolating environments for the treatment of insulin-dependent diabetes.

Prostatein C3-mRNA: a sensitive marker of androgen-responsiveness in prostate explant cultures

Prostatein is an androgen-dependent protein which is secreted by the rat ventral prostate. To determine if prostatein or its mRNA were responsive to androgen in vitro, prostate explants were cultured in media containing 0 or 25 nM dihydrotestosterone (DHT), estradiol (E2), or cortisol (F). Prostatein concentrations in medium were measured by radioimmunoassay at 2 and 4 days and in homogenates at 4 days. They were not changed significantly by any of these steroids. The concentration of the mRNA for the C3-subunit of prostatein was determined by dot hybridization at 0, 2, 4, 6, and 8 days. It was decreased significantly by 2 days when compared with explants cultured in the presence of DHT and significant differences persisted through 8 days. In conclusion, quantitation of the mRNA for the C3-subunit of prostatein in short-term cultures of ventral prostate explants appears to be more sensitive to changes in androgen concentration than does measurement of prostatein, per se. Prostatein C3-mRNA may be a useful marker for in vitro studies of androgen agonists and antagonists.

Maternal cell contamination in cultured chorionic villi: comparison of chromosome Q-polymorphisms derived from villi, fetal skin, and maternal lymphocytes

Maternal cell contamination of chorionic villi (CV) samples used for first trimester prenatal diagnosis can cause obvious and/or unrecognized diagnostic dilemmas. The purpose of this investigation is to assess the frequency of maternal cell contamination (MCC) in chorionic villus samples and to evaluate selected parameters which might predict where contamination is more likely to have occurred. Maternal lymphocytes, chorionic villi from ultrasonically directed transcervical catheter aspiration, and fetal tissue were obtained at 8-11 weeks gestation from 45 patients undergoing elective termination. Quinacrine (Q) banded metaphases were compared from duplicate direct preparations of chorionic villi; cultured chorionic villi, fetal fibroblast tissue cultures, and maternal lymphocyte cultures. Q-polymorphisms in metaphase chromosomes were 100 per cent concordant between fetal tissue and direct CV preparation. However, evidence for maternal cell contamination occurred in 13.1 per cent of cultured chorionic villi preparations where polymorphisms were found to be identical between maternal and cultured CV and both distinct from fetal tissue preparations. Where MCC was identified, it was noted that CV cell cultivation interval was prolonged (24.2 +/- 6.8 days) compared with non-contaminated cultures (14.1 +/- 4.4 days) (p less than 0.05). We conclude that maternal cell contamination is a significant problem with chorionic villus sampling. Where direct preparations are not employed or when cultures are 'slow growing', MCC may be a significant and unrecognized complication re: fetal diagnosis. Direct preparations, multiple cultures, quinacrine banding, and maternal Q-polymorphism comparisons can minimize diagnostic dilemmas secondary to maternal cell contamination.(ABSTRACT TRUNCATED AT 250 WORDS)