Nationwide evaluation of microplastic properties in municipal wastewater treatment plants in South Korea.

Wastewater treatment plants (WWTPs) are considered a significant microplastic discharge source. To evaluate the amount and characteristics of microplastics discharged from WWTPs in South Korea, we selected 22 municipal WWTPs nationally and investigated microplastics at each treatment stage. The mean microplastic removal efficiency by WWTPs was >99%, and most of the microplastics were removed by sedimentation with the second clarifier during wastewater treatment. Consequently, the microplastic removal efficiency of WWTPs did not significantly differ from that of the adopted wastewater treatment technology because a second clarifier was applied in most WWTPs. However, for WWTPs operating a tertiary treatment process, the removal efficiency was enhanced compared with that of WWTPs discharging after a second clarifier. Although the microplastic removal efficiency was high by WWTP, the discharge contribution to the water environment could not be ignored because of the amount of treated wastewater, resulting in an increase of 5.8-270.9 items/m3 of microplastics in the receiving water. The characteristics of microplastics in WWTPs, including their components, shape, and size, were also evaluated. The most detected components included polytetrafluoroethylene and polyester. Most microplastics detected were categorized as fragments and fibers, while other types were hardly detected. The size of more than 70% of the microplastics detected in WWTPs was under 300 µm, implying that the size of microplastics required to control in WWTPs was much smaller than the defined size of microplastics. An evaluation of the correlation between other pollution factors and microplastic abundance did not reveal positive correlations, and microplastic occurrence was not affected by changing seasons, which may need to be evaluated with further studies. Research should also be performed on the effect of influent sources on the level of microplastic abundance and fate of ultrafine plastics in WWTPs.

Detection of microplastic traces in four different types of municipal wastewater treatment plants through FT-IR and TED-GC-MS.

Large amounts of microplastics are discharged into wastewater treatment plants (WWTPs), from where some of them are released into natural waterbodies on account of their not being fully eliminated by WWTPs. To investigate the behavior and emission of microplastics from WWTPs, we selected four WWTPs with different treatment technologies, including anaerobic-anoxic-aerobic (A2O), sequence batch reactor (SBR), media, and membrane bioreactor (MBR). The number of microplastics detected using Fourier transform infrared (FT-IR) spectroscopy ranged from 520 to 1820 particles/L in influent and from 0.56 to 2.34 particles/L in effluent. The microplastic removal efficiencies of four WWTPs were over 99%, indicating that the type of treatment technologies did not significantly affect the removal rate of microplastics. In the unit process for each WWTP, the major stages relating to microplastic removal were the secondary clarifier and tertiary treatment processes. Most microplastics detected were categorized as fragments and fibers, while other types were hardly detected. The size of more than 80% of microplastic particles detected in WWTPs ranged between 20 and 300 µm, indicating that they were significantly smaller than the size threshold defined for microplastics. Therefore, we used thermal extraction-desorption coupled with gas chromatography-mass spectroscopy (TED-GC-MS) to evaluate the microplastic mass content in all four WWTPs, and the results were compared with those of the FT-IR analysis. In this method, only four components, namely polyethylene, polypropylene, polystyrene, and polyethylene terephthalate, were analyzed because of the analysis limitation, and the total microplastic concentration represented the sum of four components concentrations. The influent and effluent microplastic concentrations estimated by TED-GC-MS ranged from not detectable to 160 µg/L and 0.04-1.07 µg/L, respectively, indicating a correlation coefficient of 0.861 (p < 0.05) between the TED-GC-MS and FT-IR results, when compared to the combined abundance of the four microplastic components by FT-IR analysis.

Determination of pharmaceuticals in solid samples in municipal wastewater treatment plants by online SPE LC-MS/MS using QuEChERS extraction.

In this study, a pretreatment method based on the QuEChERS method has been applied for simultaneously extracting 27 residual pharmaceuticals from wastewater solids. The extracted compounds have been analyzed using online solid-phase extraction (SPE) coupled to liquid chromatography with tandem mass spectrometry (LC-MS/MS). A recovery test was conducted according to the absorbent type, and buffers were added in the sample extraction step. The highest recovery efficiency could be observed when Na2SO4 was used as an absorbent and Na2EDTA was injected during the extraction process; the recovery efficiencies of the proposed method for the target compounds ranged from 61.3 to 137.2%, and the repeatability was 6.8%. These recovery and repeatability data showed that the proposed method could reliably analyze the 27 target residual pharmaceuticals. The concentrations of the target compounds were all below the limits of quantification: 830 ng g-1 for the target compounds in suspended solids, 2353 ng g-1 in activated sludge, and 1929 ng g-1 in waste sludge. The analytical method established in this study can be applied to quantify residual pharmaceuticals in solid samples and to investigate their behaviors in a municipal wastewater treatment plant.

Spatial variation of pharmaceuticals in the unit processes of full-scale municipal wastewater treatment plants in Korea.

Several reports have elucidated the removal of pharmaceutical residues in municipal wastewater treatment plants (WWTPs). However, there remains a need to determine the spatial distribution of pharmaceuticals in the unit processes of full-scale municipal WWTPs. Herein, spatial variations of fifteen pharmaceuticals in the unit processes of four full-scale municipal WWTPs were assessed by analyzing both solid and liquid samples. Furthermore, different pathways of each pharmaceutical such as biodegradation, adsorption, deconjugation, and electrostatic interaction were investigated. Pharmaceutical mass loading were measured at various points for the different unit process and evaluated using liquid chromatography-tandem mass spectrometry. The average mass loading of acetaminophen and caffeine decreased tremendously in the first biological treatment process regardless of the process configuration. In contrast, a temporary increase was observed in the mass loading of ibuprofen in the anaerobic and/or anoxic processes, which was presumably caused by deconjugation. Additionally, the adverse effect of coagulation on ibuprofen removal was validated. The major removal mechanism for the selected antibiotics, except for sulfamethoxazole, was the adsorption by biosolids due to electrostatic interaction. Subsequently, a drastic decrease was observed in their mass loadings in the solid-liquid separation process of the WWTPs. The membrane bioreactor (MBR) shows excellent capability for mitigation of pharmaceuticals in municipal wastewater because it comprises a high concentration of biosolids that act as adsorbents. The evaluation of the spatial variations of the selected pharmaceuticals in different unit processes provides valuable information on their behavior and removal mechanisms.

A Simple and Practical Scoring System for Radiosurgical Treatment in Patients with Brain Metastases.

BACKGROUND: The study aimed to investigate the prognostic factors for patients with brain metastases undergoing radiosurgical treatment and to introduce a simple and practical scoring system for the prediction of survival time. METHODS: We retrospectively analyzed data for 311 patients treated with Gamma Knife radiosurgery at a single institute. The mean age at time of treatment was 60 years (range 23-86 years), and the median Karnofsky performance status (KPS) score was 90 (range 60-100). Using a new prognostic index, the prognostic index for brain metastases (PIBM), the patients were categorized into 3 groups according to the primary tumor status and KPS score. We performed survival analysis and compared the prognostic ability of the PIBM with other published indices. RESULTS: During the median follow-up duration of 8.2 months (range 0.1-109 months), the median overall survival time was 9.1 months. Stable primary tumor status (hazard ratio [HR] 0.497, 95% confidence interval [CI] 0.321-0.769, p = 0.002) and KPS score ≥90 (HR 1.407, 95% CI 1.018-1.946, p = 0.039) significantly predicted longer overall survival. The PIBM showed the lowest Akaike information criterion value and the highest integrated area under the curve value compared with other prognostic indices. CONCLUSIONS: The PIBM may be a more accurate prognostic indicator than other published indices. Although this new and practical prognostic index requires further validation in larger cohort studies, we suggest that the PIBM could be useful to predict survival time and inform appropriate management of patients with brain metastases.

National Reconnaissance Survey of Microplastics in Municipal Wastewater Treatment Plants in Korea.

Large quantities of microplastics are thought to be emitted to freshwater environments via wastewater treatment plants (WWTPs). To evaluate the occurrence of microplastics in Korean WWTPs, a nationwide study was conducted for the first time in 50 representative WWTPs with large treatment capacities. Grab sampling and laboratory filtration were used for influents, whereas in situ filtration using a custom-made sampling device was used for effluents. The filtrates were pretreated using wet peroxidation and density separation prior to the identification of microplastics with a dissection microscope and Fourier-transform infrared spectroscopy. Pooled analyses of the microplastics revealed that they were predominantly fragment-shaped, and thermoplastics and synthetic fibers were the dominant microplastic materials in WWTPs. The concentration ranged from 10 to 470 L-1 in influents and 0.004 to 0.51 L-1 in effluents. The removal efficiency of microplastics during wastewater treatment was calculated to be 98.7-99.99% in 31 WWTPs. Additionally, WWTPs using advanced phosphorus removal processes exhibited higher removal efficiency than those not implementing such processes. Power-law distribution was successful in describing microplastic particle sizes down to 100 µm, although it was not applicable for smaller particles. This comprehensive monitoring study provides information on the current level and characteristics of microplastics in WWTPs in Korea.

Distribution and Removal of Pharmaceuticals in Liquid and Solid Phases in the Unit Processes of Sewage Treatment Plants.

In this study, we analyzed 27 pharmaceuticals in liquid and solid phase samples collected from the unit processes of four different sewage treatment plants (STPs) to evaluate their distribution and behavior of the pharmaceuticals. The examination of the relative distributions of various categories of pharmaceuticals in the influent showed that non-steroidal anti-inflammatory drugs (NSAIDs) were the most dominant. While the relative distribution of antibiotics in the influent was not high (i.e., 3%-5%), it increased to 14%-30% in the effluent. In the four STPs, the mass load of the target pharmaceuticals was reduced by 88%-95% mainly in the biological treatment process, whereas the ratio of pharmaceuticals in waste sludge to those in the influent (w/w) was only 2%. In all the STPs, the removal efficiencies for the stimulant caffeine, NSAIDs (acetaminophen, naproxen, and acetylsalicylic acid), and the antibiotic cefradine were high; they were removed mainly by biological processes. Certain compounds, such as the NSAID ketoprofen, contrast agent iopromide, lipid regulator gemfibrozil, and antibiotic sulfamethoxazole, showed varying removal efficiencies depending on the contribution of biodegradation and sludge sorption. In addition, a quantitative meta-analysis was performed to compare the pharmaceutical removal efficiencies of the biological treatment processes in the four STPs, which were a membrane bioreactor (MBR) process, sequencing batch reactor (SBR) process, anaerobic-anoxic-oxic (A2O) process, and moving-bed biofilm reactor (MBBR) process. Among the biological processes, the removal efficiency was in the order of MBR > SBR > A2O > MBBR. Among the tertiary treatment processes investigated, powdered activated carbon showed the highest removal efficiency of 18%-63% for gemfibrozil, ibuprofen, ketoprofen, atenolol, cimetidine, and trimethoprim.

Occurrence of microplastics in municipal sewage treatment plants: a review.

Municipal sewage treatment plants (STPs) are thought to be important point sources of microplastics in freshwater systems and many peer-reviewed articles have been published on this issue since mid-2010s. In this review, we summarize existing literature on the occurrence of microplastics in STPs and experimental methods used for isolation and identification of microplastics. The number concentrations of microplastics in STP influents were 15.1-640 L-1 , whereas those in the STP effluents were highly variable and ranged from not detectable to 65 L-1 . For most of cases, conventional STPs are removing microplastics very effectively. Fragments and fibers are dominant shapes of microplastics. Thermoplastics (polyethylene and polypropylene) and polyester are the predominant materials recovered. Although further research is needed, size distribution of microplastics in STPs is likely to follow a power law, implying that different studies using different size cutoffs may be compared after establishing a power law relationship.

Quantification of toxigenic Microcystis spp. in freshwaters by quantitative real-time PCR based on the microcystin synthetase A gene.

A method to estimate the abundance of toxigenic Microcystis in environmental samples by using quantitative real-time PCR was developed and optimized. The basis of this method is the amplification of a highly conserved region of the mcyA gene within the microcystin synthetase gene cluster. Using this method, the average copy number of mcyA gene per cell in toxigenic Microcystis strains was estimated. The molecular markers and method developed in this study can be used to monitor toxigenic strains of Microcystis in Korean freshwaters, in which harmful cyanobacterial blooms are routinely found.

Posterior C2-C3 Fixation for Unstable Hangman's Fracture.

OBJECTIVE: This is a retrospective review of 13 unstable Hangman's fractures who underwent posterior C2-3 fixation to describe clinical outcomes with a literature review. METHODS: Thirteen patients for unstable Hangman's fracture were enrolled between July 2007 and June 2010 were included in this study. The medical records of all patients were reviewed. Concurrently, clinical outcomes were evaluated using Neck Disability Index (NDI) scores and Visual Analogue Scale (VAS) scores during preoperative and postoperative follow up period. Plain radiographs were obtained on postoperative 1day, 1week, and then at 1, 2, 6, and 12 months. CT was done at postoperative 12 months in all patients for evaluation of bone fusion. The mean period of clinical follow-up was 17 months. RESULTS: Mean age were 43 years old. Bone fusion was recognized in all cases at the final follow-up. The average preoperative VAS score for neck pain was 8.3±1.1, while the final follow-up VAS score was 2.07±0.8 (p<0.001). The average immediate postoperative NDI was 84% points and final NDI was 22% points (p<0.001). There were one case of infection and 1 case of screw loosening. CONCLUSION: In the treatment of the patients with unstable Hangman's fracture, posterior C2-C3 fusions is effective and curative treatments to achieve cervical spinal stability.

Primary spinal cord melanoma in thoracic spine with leptomeningeal dissemination and presenting hydrocephalus.

Primary spinal cord melanoma is a rare central nervous system malignant tumor. Usually it resembles an intradural extramedullary (IDEM) nerve sheath tumor or melanoma. We experienced a patient with upper thoracic primary IDEM spinal cord melanoma who was diagnosed to be with hydrocephalus and without intracranial lesions. Initial symptoms of the patient were related to the hydrocephalus and the primary spinal cord melanoma was diagnosed eight months later. At the first operation, complete resection was impossible and the patient refused additional radiotherapy or chemotherapy. At 22 months after surgery, the patient revisited our institution with recurrent both leg weakness. Leptomeningeal dissemination was present in the whole spinal cord and only partial resection of tumor was performed. The symptoms slightly improved after surgery. Primary spinal cord melanoma is extremely rare but complete resection and additional radiotherapy or chemotherapy can prolong the disease free interval. Hydrocephalus or signs of increased intracranial pressure may be the diagnostic clue of spinal cord malignancy and progression.

Simultaneous quantification of cyanobacteria and Microcystis spp. using real-time PCR.

In order to develop a protocol to quantify cyanobacteria and Microcystis simultaneously, the primers and probe were designed from the conserved regions of 16S rRNA gene sequences of cyanobacteria and Microcystis, respectively. Probe match analysis of the Ribosomal Database Project showed that the primers matched with over 97% of cyanobacterial 16S rRNA genes, indicating these can be used to amplify cyanobacteria specifically. The TaqMan probe, which is located between two primers, matched with 98.2% of sequences in genus GpXI, in which most Microcystis strains are included. The numbers of cyanobacterial genes were estimated with the emission of SYBR Green from the amplicons with two primers, whereas those of Microcystis spp. were measured from the fluorescence of CAL Fluor Gold 540 emitted by exonuclease activity of Taq DNA polymerase in amplification. It is expected that this method enhances the accuracy and reduces the time to count cyanobacteria and potential toxigenic Microcystis spp. in aquatic environmental samples.