High Genetic Diversity in Third-Generation Cephalosporin-Resistant Escherichia coli in Wastewater Systems of Schleswig-Holstein

The spread of multidrug-resistant bacteria from humans or livestock is a critical issue. However, the epidemiology of resistant pathogens across wastewater pathways is poorly understood. Therefore, we performed a detailed comparison of third-generation cephalosporin-resistant Escherichia coli (3GCREC) from wastewater treatment plants (WWTPs) to analyze dissemination pathways. A total of 172 3GCREC isolated from four WWTPs were characterized via whole genome sequencing. Clonal relatedness was determined using multi-locus sequence typing (MLST) and core genome MLST. Resistance genotypes and plasmid replicons were determined. A total of 68 MLST sequence types were observed with 28 closely related clusters. Resistance genes to eight antibiotic classes were detected. In fluoroquinolone-resistant isolates, resistance was associated with three-or-more point mutations in target genes. Typing revealed high genetic diversity with only a few clonal lineages present in all WWTPs. The distribution paths of individual lines could only be traced in exceptional cases with a lack of enrichment of certain lineages. Varying resistance genes and plasmids, as well as fluoroquinolone resistance-associated point mutations in individual isolates, further corroborated the high diversity of 3GCREC in WWTPs. In total, we observed high diversity of 3GCREC inside the tested WWTPs with proof of resistant strains being released into the environment even after treatment processes.

Long time persistence and evolution of carbapenemase-producing Enterobacterales in the wastewater of a tertiary care hospital in Germany

BACKGROUND

Worldwide observations revealed increased frequencies of multi-resistant Enterobacterales and resistance genes in hospital wastewater compared to any other type of wastewater. Despite the description of clonal lineages possibly adapted to hospital wastewater, little is known about long term persistence as well as evolution of these lineages.

METHODS

In this study, wastewater isolates of different Enterobacterales species from a tertiary care hospital were investigated with 2.5 years distance. Whole Genome Sequencing (WGS) and resistance gene identification were performed for E. coli, C. freundii, S. marcescens, K. pneumoniae, K. oxytoca, and E. cloacae isolates (n = 59), isolated in 2022 and compared with strains isolated from the same wastewater pipeline in 2019 (n = 240).

RESULTS

Individual clonal lineages with highly related isolates could be identified in all species identified more than once in 2022 that appear to persist in the wastewater drainage. A common motif of all persistent clonal lineages was the carriage of mobile genetic elements encoding carbapenemase genes with hints for horizontal gene transfer in persistent clones in this environment observed over the 2.5-year period. Multiple plasmid replicons could be detected in both years. In 2022 isolates bla_VIM-1 replaced bla_OXA-48 as the most common carbapenemase gene compared to 2019. Interestingly, despite a similar abundance of carbapenemase genes (>80% of all isolates) at both time points genes encoding extended spectrum β-lactamases decreased over time.

CONCLUSIONS

This data indicates that hospital wastewater continuously releases genes encoding carbapenemases to the urban wastewater system. The evolution of the resident clones as well as the reasons for the selection advantage in this specific ecological niche needs to be further investigated in the future.

Phenotypic Variation in Clinical S. aureus Isolates Did Not Affect Disinfection Efficacy Using Short-Term UV-C Radiation

Pigmentation, catalase activity and biofilm formation are virulence factors that cause resistance of Staphylococcus aureus to environmental stress factors including disinfectants. In recent years, automatic UV-C room disinfection gained greater importance in enhanced disinfection procedures to improve disinfection success in hospitals. In this study, we evaluated the effect of naturally occurring variations in the expression of virulence factors in clinical S. aureus isolates on tolerance against UV-C radiation. Quantification of staphyloxanthin expression, catalase activity and biofilm formation for nine genetically different clinical S. aureus isolates as well as reference strain S. aureus ATCC 6538 were performed using methanol extraction, a visual approach assay and a biofilm assay, respectively. Log₁₀ reduction values (LRV) were determined after irradiation of artificially contaminated ceramic tiles with 50 and 22 mJ/cm² UV-C using a commercial UV-C disinfection robot. A wide variety of virulence factor expression was observed, indicating differential regulation of global regulatory networks. However, no direct correlation with the strength of expression with UV-C tolerance was observed for either staphyloxanthin expression, catalase activity or biofilm formation. All isolates were effectively reduced with LRVs of 4.75 to 5.94. UV-C disinfection seems therefore effective against a wide spectrum of S. aureus strains independent of occurring variations in the expression of the investigated virulence factors. Due to only minor differences, the results of frequently used reference strains seem to be representative also for clinical isolates in S. aureus.

DNA methylation-based age estimation for adults and minors: considering sex-specific differences and non-linear correlations

DNA methylation patterns change during human lifetime; thus, they can be used to estimate an individual's age. It is known, however, that correlation between DNA methylation and aging might not be linear and that the sex might influence the methylation status. In this study, we conducted a comparative evaluation of linear and several non-linear regressions, as well as sex-specific versus unisex models. Buccal swab samples from 230 donors aged 1 to 88 years were analyzed using a minisequencing multiplex array. Samples were divided into a training set (n = 161) and a validation set (n = 69). The training set was used for a sequential replacement regression and a simultaneous 10-fold cross-validation. The resulting model was improved by including a cut-off of 20 years, dividing the younger individuals with non-linear from the older individuals with linear dependence between age and methylation status. Sex-specific models were developed and improved prediction accuracy in females but not in males, which might be explained by a small sample set. We finally established a non-linear, unisex model combining the markers EDARADD, KLF14, ELOVL2, FHL2, C1orf132, and TRIM59. While age- and sex-adjustments did not generally improve the performance of our model, we discuss how other models and large cohorts might benefit from such adjustments. Our model showed a cross-validated MAD and RMSE of 4.680 and 6.436 years in the training set and of 4.695 and 6.602 years in the validation set, respectively. We briefly explain how to apply the model for age prediction.

High burden and diversity of carbapenemase-producing Enterobacterales observed in wastewater of a tertiary care hospital in Germany

Hospitals are one of the main reservoirs of multi-resistant Enterobacterales (MRE). As MRE are resistant to the most frequently used antibiotics, therapy for patients with MRE infections is challenging. It has been previously described that MRE from hospital wastewater can pass into municipal wastewater and even surface water. In this study, we investigated the diversity and epidemiology of MRE in the wastewater of a large tertiary care hospital. Wastewater samples were collected for a four-day period and tested for the presence of Enterobacterales resistant to 3rd gen. cephalosporins. Representative isolates were further characterized by whole genome sequencing. In 120 β-glucuronidase-producing isolates, 68 Escherichia coli and, interestingly, also 52 Citrobacter freundii were identified. In 120 β-glucosidase-producing isolates 45 Serratia marcescens, 34 Klebsiella oxytoca, 32 Enterobacter cloacae and 9 Klebsiella pneumoniae were observed. For all species various MLST sequence types and different clusters of resistance genes were determined, showing a great diversity within the different Enterobacterales, further corroborated by clonal analysis performed by cgMLST. The most prominent clone was wastewater associated E. coli ST635, which accounted for 47.1% of all E. coli isolates. Interestingly, 45.6% of E. coli, 88.5% of C. freundii, 95.6% of S. marcescens, 91.2% of K. oxytoca, 96.9% of E. cloacae and 88.9% of K. pneumoniae isolates carried a carbapenemase gene, indicating a high burden with carbapenemase-producing Enterobacterales. Comparison with clinical isolates from the same hospital displayed few clonal matches. One wastewater isolate of K. pneumoniae was identified to be closely related compared to a clone that had been introduced into the hospital during an outbreak four years earlier. One E. coli isolate was identified as identical to an isolate from a patient, with inpatient stay during the sampling period. The data obtained in this study highlight the problem of antibiotic resistance of Enterobacterales in hospital wastewater. In particular, the clustered occurrence of carbapenemase genes is of great concern and underscores the problem of increasingly scarce antibiotic options against these bacteria.

Movement building responses to COVID-19: lessons from the JASS mobilisation fund

This article draws on the work of Just Associates (JASS), a feminist movement support organisation that strengthens the leadership and organising capacity of community-based women networks in Southern Africa, Southeast Asia, and Mesoamerica, to transform the structures that perpetuate inequality and violence. We analyse qualitative interviews and surveys drawn from recipients of the JASS mobilisation fund (JMF), an innovative financial crisis support mechanism for feminist movements. We argue that localisation strategies deployed by women's networks supported by the JMF in response to COVID-19, challenge dominant humanitarian responses that de-centre feminist movements, local knowledge, and expertise. By accounting for local knowledge generated from long histories of movement building, building collective power, and challenging racialised and gendered responses to humanitarian crises, women's collectives and networks supported through the JMF developed contextually relevant responses that challenge patriarchal structural barriers heightened by COVID-19.

Activated Carbons from Miscanthus Straw for Cleaning Water Bodies in Kazakhstan

Pollution of water bodies by heavy metals is an acute problem in Kazakhstan. Hence, search for and implementation of sustainable environmental technologies for water purification is of high priority. Activated carbon appears as an appropriate material as reflected in a number of previous studies. Due to a growing interest in low-cost active coals from renewable, rapidly recovering raw materials, especially for the purification of drinking water and wastewater, special attention has been in recent years been paid to the preparation activated carbons from some types of agricultural by-products. Along these lines a technology for producing new carbon-containing sorbents, i.e., activated carbon from Miscanthus straw (Мiscanthus × giganteus) is reported. The method of preparation, type of reactor, experimental conditions and the influence of the selected initial material on the properties of the resulting activated carbons are discussed. The activation of the primarily carbonized material in super-heated steam creates an activated coal material with a specific surface area of 541.9 m2/g and a specific pore volume of 0.232 cm3/g. The possible application for purification of water bodies from selected heavy metals was studied by estimation of the sorption capacity of the generated active coal material towards selected metal ions. The adsorption capacity for copper, zinc and lead ions is 90, 100, 500 mg/L, which allows to consider obtained by this method AC as an attractive alternative to traditional coal sorbents.

On a Possible Sustainable Petroleum Asssociated Gas Utilization in the Kashagan and Tengiz Regions, Kazakhstan

Associated petroleum gas (APG) is a form of natural gas, which is found associated with oil deposits. These gasses have traditionally been considered as unwanted byproducts in connection with oil exploitation. For decades the practice of flaring has been applied. However, this practice is highly controversial as it is environmentally polluting and economically unfavorable. Throughout the oil market this problem has high priority, and specifically in Kazakhstan. In the present paper possible ways to significantly reduce or eventually eliminate petroleum associated gas flaring in the Atyrau region, Kazakhstan are discussed. A particular focus is given to the Kashagan and Tengiz oilfields, which have high priority and potential for further growth in<br />the near future, and thus have a specific value for Kazakhstan both from political and economic points of view. It is concluded that despite a rush for short-term profit by Kazakhstan’s oil producers, an appropriate long-term strategy could not only be environmentally friendly but also financially beneficial. It is, however, also concluded that this requires a coordinated action involving the different players in the region as well as the Kazakh government. As an alternative it is suggested that a private consortium is formed being responsible for creating a unified system for processing and distribution of the APGs. The current flaring situation in Kashagan and Tengiz areas has been assessed applying the integrated environmental assessment framework DPSIR discussing the single elements: Driving forces, Pressures (on the environment), State (of the environment), Impact (on environmental and human helath) and Responses, respectively.

A combined QSAR and partial order ranking approach to risk assessment

QSAR generated data appear as an attractive alternative to experimental data as foreseen in the proposed new chemicals legislation REACH. A preliminary risk assessment for the aquatic environment can be based on few factors, i.e. the octanol-water partition coefficient (Kow), the vapour pressure (VP) and the potential biodegradability of the compound in combination with the predicted no-effect concentration (PNEC) and the actual tonnage in which the substance is produced. Application of partial order ranking, allowing simultaneous inclusion of several parameters leads to a mutual prioritisation of the investigated substances, the prioritisation possibly being further analysed through the concept of linear extensions and average ranks. The ranking uses endpoint values (log Kow and log VP) derived from strictly linear 'noise-deficient' QSAR models as input parameters. Biodegradation estimates were adopted from the BioWin module of the EPI Suite. The population growth impairment of Tetrahymena pyriformis was used as a surrogate for fish lethality.

QSARs for identifying and prioritizing substances with persistence and bioconcentration potential

From the 8511 chemicals with 1998 production volumes reported to the U.S. Environmental Protection Agency (U.S. EPA), the TSCA Interagency Testing Committee's (ITC's) Degradation Effects Bioconcentration Information Testing Strategies (DEBITS) was used to identify 56 chemicals. The DEBITS Quantitative Structure-Activity Relationships (QSARs) and the U.S. EPA's PBT profiler QSARs were used to predict the persistence and bioconcentration factors of these 56 chemicals. Partial order ranking was used to prioritise the chemicals based on persistence and bioconcentration potential.

Global government applications of analogues, SARs and QSARs to predict aquatic toxicity, chemical or physical properties, environmental fate parameters and health effects of organic chemicals

Faced with the need to predict physical and chemical properties, environmental fate, ecological effects and health effects of organic chemicals in the absence of experimental data, several Government organizations have been applying analogues, Structure Activity Relationships (SARs) and Quantitative Structure Activity Relationships (QSARs) to develop those predictions. To establish some benchmarks for monitoring future increases in applications of analogues, SARs and QSARs by global Government organizations, this paper describes the current applications of analogues, SARs and QSARs by Australian, Canadian, Danish, European, German, Japanese, Netherlands, and United States Government organizations to predict physical and chemical properties, environmental fate, ecological effects and health effects of organic chemicals.

Evaluation of empirical versus non-empirical descriptors

In this case study, based on the notorious PCBs, the performance of selected empirical (EM) versus non-empirical and quantum chemical (NEM-QC) descriptors in multivariate QSARs have been evaluated. The informational content of the EM descriptors has been evaluated with respect to the physical understandable NEM-QC descriptors. Models for estimating key parameters for risk assessment have been developed, based on two-dimensional EM and three-dimensional NEM-QC descriptors, respectively. In spite of the simplicity of the two-dimensional descriptors, no evidence of lower predictive ability of the EM descriptors compared to the NEM-QC descriptors was observed. Homogeneity of variance within and between experimental methods, species and PCB congeners has been analysed, disclosing the importance for the need for handling uncertainty aspects of the results obtained by different laboratories and methods. The latter appears crucial for the model developments when using data from more than one source.

QSAR's based on partial order ranking

The development of Quantitative Structure Activity Relationships (QSAR's) often relies heavily on the application of statistical methods such as multi-linear regression (MLR) or principal component analysis/partial least square (PCA/PLS). Partial order ranking (POR), which from a mathematical point of view is based on elementary methods of Discrete Mathematics, appears as an attractive and operationally simple and more general alternative since the method does not require specific functional relationships between the single descriptors or the end-points. The POR method allows ranking of a series of compounds, based on selected descriptors characterizing their structural and/or electronic nature (model diagram). The ranking of the compounds based on their end-points (experimental ranking) can then be compared to the model diagram. If the model diagram resembles the experimental ranking of the end-points under investigation, other compounds, not being experimentally investigated, can be assigned a rank in the model and hereby obtain an identity based on the known compounds. The present study elucidates the applicability of POR as a simple tool for QSAR modeling. Based on illustrative examples the POR approach to QSAR modeling will be presented with special focus on the precision and the uncertainties of the method, which will be discussed in terms of the number of descriptors and compounds involved. The advantageous interplay between POR and PCA, the latter being applied in order to reduce a possible large number of descriptors into a limited number of latent descriptors will be discussed.

Humic complexes of diethyl phthalate: molecular modelling of the sorption process

The sorption mechanisms and complex formation between humic acid (HA) and a successively increasing number of diethyl phthalate (DEP) molecules have been studied theoretically using molecular mechanics, the number (n) of DEP molecules being varied from 1 to 30. The energy components of the single HA x nDEP complexes have been used as explanatory variables in a principal component analysis for exploring the presence of similarities/dissimilarities in the energetic properties of the individual xenobiotic complexes. The sorption can be explained in terms of a two-step mechanism. Absorption takes place as long as the host humic acid structure offers (a) enough internal docking space and (b) favorable interactions (energy release) with the guest molecule. This takes place for up to 7 DEP molecules. Further increase in the number to 30 DEP molecules will, due to the lack of free available internal voids, lead to surface controlled adsorption. The two-step sorption process apparently results in (a) a linear increase in energy gain by DEP bonds, and similarly (b) a constant incremental rise in molecular properties of the complexes such as volume and surface area. Three outstanding observations emerge: (1) Structural features at the atomic level (nanochemistry), such as partial atomic charges and high aromaticity of the humic acid, are observed to be dominating the intermolecular interactions in the complexes at the specific sorption sites. (2) Torsional relief and favorable changes in bonding energy also prevail for the growing complex. The latter indicates both the structural flexibility of the HA host and the stabilizing effect of DEP on the complex, by filling of the voids within the HA molecule. (3) The intermolecular forces are described mainly by hydrogen bonds (electrostatic energy) and interactions between dipole-dipole, such as carboxylic functions and uncharged moieties such as aromatic rings (van der Waals energy).

Solubility of nonylphenol and nonylphenol ethoxylates. On the possible role of micelles

The water solubility of nonylphenol (NP) has been estimated to be 4.9 +/- 0.4 mg/l corresponding to (2.22 +/- 0.18) x 10(-5) mol/l at 25 degrees C using shake flask and surface tension techniques. The low solubility in combination with an observed rather slow dissolution process will limit the leachability of NP in the terrestrial environment. Based on indirect evidence, it is suggested that NP, in contrast to nonylphenol ethoxylate (NPEO) with, e.g., 12 ethoxylate moieties, is not subject to micelle formation, and as such does not constitute a potential vehicle for the transport of hydrophobic pollutants in the environment. For NPEOs with a very high number of ethoxy moieties, e.g., 100, the compounds appear water soluble without micelle formation.

Partial order ranking-based QSAr's: estimation of solubilities and octanol-water partitioning

Partial order ranking appears as an attractive alternative to conventional Quantitative Structure Activity Relationships (QSAR) methods, the latter typically relying on the application of statistical methods. The method seems attractive as a priori knowledge of specific functional relationships is not required. In the present study, it is demonstrated that QSAR models based on a partial order ranking approach can be used satisfactorily to predict solubilities and octanol-water partitioning for a selection of organic compounds exhibiting different structural and electronic characteristics. The uncertainty is validated using well-established LSER descriptors. Two requirements to the model with regard to precision prevail, i.e., the model must be able to rank the single compounds in the basis set correctly compared to the experimental data, and the model should be based on a basis set of compounds large enough to secure a satisfactorily fine-meshed net, taking the number of descriptors into account. In the present study, the model was able to rank 318 out of 319 comparisons correctly in the case of solubilities. The corresponding figures for the octanol-water partitioning were 407 out of 408. The precision and the uncertainties of the method which, were found closely related to the mutual interplay between the number of compounds and the number of descriptors is discussed in terms of the number of descriptors and compounds involved. The limitations of the method are discussed.

The use of Hasse diagrams as a potential approach for inverse QSAR

Quantitative structure-activity relationships are often based on standard multidimensional statistical analyses and sophisticated local and global molecular descriptors. Here, the aim is to develop a tool helpful to define a molecule or a class of molecules which fulfills pre-described properties, i.e., an Inverse QSAR approach. If highly sophisticated descriptors are used in QSAR, the structure and then the synthesis recipe may be hard to derive. Thus, descriptors, from which the synthesis recipe can be easily derived, seem appropriate to be included within this study. However, if descriptors simple enough to be useful for defining syntheses recipes of chemicals were used, the accuracy of a numeric expression may fail. This paper suggests a method, based on very simple elements of the theory of partially ordered sets, to find a qualitative basis for the relationship between such fairly simple descriptors on the one side and a series of ecotoxicological properties, on the other side. The partial order ranking method assumes neither linearity nor certain statistical distribution properties. Therefore the method may be more general compared to many standard statistical techniques. A series of chlorinated aliphatic compounds has been used as an illustrative example and a comparison with more sophisticated descriptors derived from quantum chemistry and graph theory is given. Among the results, it was disclosed that only for algae lethal concentration, as one of the four ecotoxicological properties, the synthesis specific predictors seem to be good estimators. For all other ecotoxicological properties quantum chemical descriptors appear as the more suitable estimators.

Solubilities and surface activities of phthalates investigated by surface tension measurements

Aqueous solutions of DEP (di-ethyl), DnBP (di-n-butyl), DnH(6)P (di-n-hexyl), and DEHP (di-[2-ethyl-hexyl]) phthalates have been investigated by use of surface tension measurements at temperatures between 10 and 35 degrees C. A tensiometric approach allows for the determination of unimeric solubilities and delta G degree, which is the standard Gibbs free energy change, for the dissolution of phthalates in water. The unimeric solubility of the phthalates increase with decreasing temperature. The delta G degree shows a linear increase with increasing phthalate alkyl chain length. The contribution of enthalpy (delta H degree) and entropy (delta S degree) to delta G degree were calculated from the temperature-dependent solubilities. The contributions of both delta H degree and delta S degree are negative and increase in magnitude with increasing alkyl chain length, suggesting hydrophobic interactions between phthalates and water. The ability of different phthalates to lower the surface tension decreases with increasing alkyl chain length, whereas the relative affinity for adsorption in the air-water interface increases drastically for long-chain phthalates. Despite the low surface activity of phthalates compared with that of common surfactants, they show significant affinity for adsorption in air-water interfaces of natural surface waters. This property, combined with their low solubilities, may affect the fate of these compounds within the natural environment, because they form emulsions above unimeric saturation in aqueous media.

The influence on partial order ranking from input parameter uncertainty. Definition of a robustness parameter

The method of partial order ranking has been used within the environmental area for a variety of purposes as an attractive way of handling complex information. However, the environmental data are often associated with a significant degree of uncertainty. In this investigation the general nature of the influence from data uncertainty on the partial order ranking is analyzed. A Monte Carlo type analysis is performed in which a series of randomly formed data are used to test the influence of data uncertainty. The partial order ranking is interpreted, where the results are transferred to a one-dimensional ranking scale taking into account that not all elements are ranked with the same certainty. A simple general robustness parameter (E) in form of the expected number of comparisons for each ranking element is defined and correlated to the uncertainty analysis results. A simple equation relates E to the number of elements and the number of parameters, respectively. The magnitude of the ranking uncertainty is shown to increase rapidly when the E value decreases below 4-5 comparisons per element. When the E value exceeds 5 the ranking uncertainty becomes nearly constant and independent on the actual E value.

The effect of humic acids on the water solubility and water-organic carbon partitioning of fluorene and its NSO-heteroanalogues: carbazole, dibenzofuran, and dibenzothiophene

The solubilizing effect of humic acids on fluorene and its NSO analogues carbazole, dibenzofuran and dibenzothiophene has been studied. The interaction between these substances and humic acids was found to depend significantly on the actual humic acid concentration. A pronounced decrease in the interaction constant, as well as in the water-organic matter partitioning coefficient was observed with increasing humic acid concentration. The effects are discussed in terms of concentration dependent macromolecular structural changes in the humic acids. A linear free energy relation for the interaction is suggested.

Review on persistent organic pollutants in the environment of Greenland and Faroe Islands

The literature concerning persistent organic pollutants (POPs) in the environment of Greenland and the Faroe Islands covering the period up to 1995 has been revisited. It is difficult to compare data from earlier studies with those from more recent investigations. Thus as the former quantified the content of CBs by comparison to a technical mixture of CBs (e.g. Aroclor 1254), the latter analyses typically are quantified on a single congener level. Single CB congeners have in some cases been determined, but the results were subsequently expressed as total PCB related to an Aroclor standard. For studies based on single CB congener determinations, the highest levels are reported for porpoise blubber from Greenland (700-4500 micrograms/kg wet weight), the conclusion, however being based on two determinations only. In Greenlandic seal blubber and peregrine falcon plasma equal levels of CBs (130-750 micrograms/kg ww) and of DDTs (150-860 micrograms/kg ww) were found. Levels of CBs and DDTs in fish liver were found to be around 40-75 micrograms/kg ww. In sediment samples the CBs were almost all below the detection limit (< 0.02-0.1 microgram/kg dry weight), and thereby being the matrix with the lowest CBs concentration levels. Earlier data based on Aroclor standards showed DDT levels in Greenlandic whale blubber in the range of 2700-4100 micrograms/kg ww and PCB levels of 3700 micrograms/kg-5400 micrograms/kg ww. DDT levels for seal blubber were at the same level (2700-4500 micrograms/kg ww) whereas the PCB level was lower (900-3900 micrograms/kg ww). The PCB level corresponds to the level found in human adipose tissue determined with a similar quantification technique. The lowest levels reported for mammals correspond to walrus blubber, the sum of PCBs and DDTs being in the ranges of 180-360 micrograms/kg ww and 50-90 micrograms/kg ww, respectively. The content of PCBs in scallops was found to be 3 micrograms/kg ww near the Thule Air base.

The Allergen Bank: a source of extra contact allergens for the dermatologist in practice

The Allergen Bank was established to give dermatologists easy access to special test materials in order to make early diagnoses of special cases of allergic contact dermatitis. The Allergen Bank comprises a computer system to register several hundred contact allergens in appropriate patch test concentrations available at the allergy laboratory and the patch test results. At the request of dermatologists in practice for Allergen Bank may supply special contact allergens for aimed patch testing of contact dermatitis patients. The organization of the Allergen Bank and the procedure of its use are described. During its first 23 months 28 dermatologists asked for 2,209 allergen samples for testing of 386 patients, an average of 6 allergens per patient and 14 patients per dermatologist. A total number of 164 positive reactions have been registered, and 440 of the 540 allergens have been in use. One third of the positive reactions were caused by the 16 most frequently ordered allergens, which amounted to 340 allergen samples. The allergens included plant chemicals, acrylates, animal feed additives, fragrance chemicals and preservatives. Selected allergens were investigated for stability during handling and shipping under varying conditions relevant to the function of the Allergen Bank. The possible inhomogeneity of petrolatum based allergen preparations is discussed in relation to diagnostic patch testing.

Contact allergy to 2-hydroxy-5-tert-butyl benzylalcohol and 2,6-bis(hydroxymethyl)-4-tert-butylphenol, components of a phenolic resin used in marking pens

2-hydroxy-5-tert-butyl benzylalcohol and 2,6-bis(hydroxymethyl)-4-tert-butylphenol were identified as contact allergens in a phenolic resin used as a tackifier in the ink of a marking pen, which, after being used directly on the skin, caused an acute contact dermatitis on the hand of a 13-year-old boy. The patient also reacted to 4-tert-butylphenol-formaldehyde resin (BPF resin) 1% pet. included in the European standard series.

Carvone: an overlooked contact allergen cross-reacting with sesquiterpene lactones?

The terpene l-carvone is one of the main constituents of spearmint oil. The sensitizing potential of l-carvone has been considered low, but it has occasionally caused contact allergy in users of spearmint toothpaste and chewing gum. l-Carvone is also an oxidation product of d-limonene that occurs in solvents used increasingly in industry. We included l-carvone 5% pet. in the standard patch test series. In the 1st year, 541 patients were tested and 15 (2.77%) had positive, and 12 doubtful positive (?+) reactions to l-carvone. The strongest reactions were observed in 9 patients with concomitant Compositae sensitivity. The key clinical features and other contact allergies of the patients are presented. When re-testing with l-carvone in the same or lower concentrations, only 2 out of 8 patients had positive reactions. Possible reasons for this discrepancy are discussed in terms of cross-reactions, concomitant sensitization, excited skin syndrome, irritancy and facilitated immunological response.

New fast preparation of 123I labelled radiopharmaceuticals

A new fast kit preparation of 123I labelled radiopharmaceuticals such as IMP, HIPDM, MIBG and Hippuran is proposed. A radiochemical yield greater than 99% is obtained at 100 degrees C within 10-30 min. The new labelling procedure is based on the nucleophilic exchange in presence of Cu(I) and an excess of reducing agents. The four kit prepared 123I-radiopharmaceuticals have been used with success in clinical studies involving 400 patients. The proposed method is also compared with earlier described methods which, yielding labelled side products and 123I2, do not fulfill the requirements for kit labelling.

Triphenyl phosphate allergy from spectacle frames

A case of triphenyl phosphate allergy from spectacle frames is reported. Patch tests with analytical grade triphenyl phosphate, tri-m-cresyl phosphate, and tri-p-cresyl phosphate in the concentrations 5%, 0.5% and 0.05% pet. showed positive reactions to 0.05% triphenyl phosphate and 0.5% tri-m-cresyl phosphate, but no reaction to tri-p-cresyl phosphate. Gas chromatography of the tricresyl phosphate 5% pet. patch test material supplied from Trolab showed that it contained a mixture of a wide range of triaryl phosphates, including 0.08% triphenyl phosphate which is above the threshold for detecting triphenyl phosphate allergy in our patient.

Contact sensitivity and bioavailability of chlorocresol

Chlorocresol sensitization from 5 topical preparations was determined in guinea pigs using the cumulative contact enhancement test. Chlorocresol 5% in olive oil/acetone (4/1), and 5% in aqueous suspension stabilized with carbomer 941 were more sensitizing (55% and 60% of the animals positive, respectively) than chlorocresol 5% in propylene glycol with or without carbomer 941 (20% positive). The sensitization from a saturated aqueous chlorocresol solution (about 0.38% w/v) was comparable to that of a 5% propylene glycol solution containing 13 times more chlorocresol. The fraction of the applied dose (from each preparation) that remained in the bandage material and the patch test skin site was determined by combined gas chromatography-mass spectrometry using an isotopic dilution technique. From 0.2% to 1.6% of the applied doses remained at the patch test skin sites as free chlorocresol. 75% of the chlorocresol in aqueous suspension permeated the skin in contrast to 34% and 35% of the chlorocresol in olive oil/acetone (4/1) and propylene glycol, respectively. In spite of the same amount of chlorocresol absorption from the 2 latter preparations, they showed a significant difference in sensitizing capacity. No simple relationship between the sensitization rates and the calculated bioavailability was observed with the preparations tested.

N-Nitrosodiethanolamine revisited

N-nitrosodiethanolamine is believed to be a weakly carcinogenic chemical, and as it occurs widely--in consumer products for example--it may constitute a significant hazard to humans. However, the chemical evidence concerning the identity, purity and properties of N-nitrosodiethanolamine is incomplete, and this casts some doubt on the basis of the current interest in this substance. In the present paper a purification procedure of synthetic N-nitrosodiethanolamine based on high-performance liquid chromatography is given. Other fractionation procedures such as gas liquid chromatography, ambient pressure column chromatography and distillation are shown to be inadequate. The purity and identity of purified N-nitrosodiethanolamine is established by means of electron impact and field ionization mass spectrometry, including metastable defocusing and collision induced decomposition techniques. Furthermore, 1H and 13C nuclear magnetic resonance and, to a lesser extent, infrared and ultraviolet spectroscopy are used. Deuterium labelled analogues of N-nitrosodiethanolamine and the parent diethanolamine are employed in rationalizing the results obtained.

A variation of the Biesenberger technique of reduction mammaplasty

A variation of the Biesenberger technique of reduction mammaplasty is presented. The medial and lateral blood supply is preserved in a "cut as you go" technique. The results in 68 widely varying cases have been most satisfactory.