Doppler ultrasound-based evaluation of hemodynamic changes in the ophthalmic artery and central retinal artery in patients with type 1 diabetes mellitus without retinopathy and with mild non-proliferative retinopathy.

Aim: Determination of blood flow parameters in the ophthalmic artery and central retinal artery using Doppler ultrasound in patients with type 1 diabetes mellitus without fundus signs of diabetic retinopathy and with mild non-proliferative retinopathy. Material and methods: To eliminate the impact of other systemic factors on vascular flow, the study enrolled a total of 80 patients with type 1 diabetes mellitus, aged between 18 and 45 years. The study participants did not have any diabetic complications or other systemic or ocular comorbidities. The control group comprised 81 healthy individuals within a similar age range. Color Doppler ultrasound examinations of the ophthalmic artery and central retinal artery were performed to evaluate selected blood flow parameters including peak systolic velocity, end-diastolic velocity, and resistance index. Results: Patients with type 1 diabetes mellitus exhibited statistically significant decrease in both systolic and end-diastolic velocities in the central retinal artery, accompanied by an elevation in resistance index, compared to the control group. The study revealed differences in blood flow parameters between the patients without fundus changes and those exhibiting mild non-proliferative retinopathy. Specifically, patients with retinopathy showed a significant decrease in both systolic velocity and end-diastolic velocity in the central retinal artery. No differences were observed for the same parameters in the ophthalmic artery. When analyzing the patients' blood flow parameters in relation to the degree of diabetes control, as determined by glycated hemoglobin levels, a statistically significant reduction in systolic velocity was identified in both the ophthalmic and central retinal arteries in the group with poorly controlled diabetes. Conclusions: Examination of the orbital vessels using Doppler ultrasound in patients with type 1 diabetes mellitus holds promise as an effective method for early detection of vascular abnormalities.

Stainless Steel in Municipal Sewage-How to Recognize Favorable Corrosion Conditions.

While chromium-nickel steel is known to be extremely resistant to corrosion, the occurrence of certain factors can unfortunately initiate an uncontrolled corrosion process. This paper presents samples made of 304 stainless steel containing delta ferrite that have been exposed to wastewater for 18 months. Samples placed above the surface of the wastewater (A-series) were intensively corroded. Samples half-submerged in the wastewater and periodically fully submerged at higher effluent flows through the screenings and grit separator (B-series) only suffered minor mechanical erosion. No significant changes in the tested surface were observed on samples fully submerged in wastewater (C-series). The results indicated that the observed pitting corrosion of samples placed above the surface of the wastewater was a consequence of the presence of bacteria in a wet hydrogen sulfide environment. The fluorescence in situ hybridization method showed that either the sludge taken from the wastewater, or from the surface of samples submerged in wastewater exhibited increased amounts of bacteria from the δ-proteobacteria class, indicating the presence of microorganisms involved in the reduction of sulfur or sulfate compounds. A new approach to microbiological evaluation by determining classes of bacteria may be a promising tool for evaluating wastewater in terms of aggressiveness and recognizing favorable corrosive conditions.

Seasonal prevalence of bacteria in the outflow of two full-scale municipal wastewater treatment plants.

Despite many modern wastewater treatment solutions, the most common is still the use of activated sludge (AS). Studies indicate that the microbial composition of AS is most often influenced by the raw sewage composition (especially influent ammonia), biological oxygen demand, the level of dissolved oxygen, technological solutions, as well as the temperature of wastewater related to seasonality. The available literature mainly refers to the relationship between AS parameters or the technology used and the composition of microorganisms in AS. However, there is a lack of data on the groups of microorganisms leaching into water bodies whose presence is a signal for possible changes in treatment technology. Moreover, sludge flocs in the outflow contain less extracellular substance (EPS) which interferes microbial identification. The novelty of this article concerns the identification and quantification of microorganisms in the AS and in the outflow by fluorescence in situ hybridization (FISH) method from two full-scale wastewater treatment plants (WWTPs) in terms of 4 key groups of microorganisms involved in the wastewater treatment process in the context of their potential technological usefulness. The results of the study showed that Nitrospirae, Chloroflexi and Ca. Accumulibacter phosphatis in treated wastewater reflect the trend in abundance of these bacteria in activated sludge. Increased abundance of betaproteobacterial ammonia-oxidizing bacteria and Nitrospirae in the outflow were observed in winter. Principal component analysis (PCA) showed that loadings obtained from abundance of bacteria in the outflow made larger contributions to the variance in the PC1 factorial axis, than loadings obtained from abundance of bacteria from activated sludge. PCA confirmed the reasonableness of conducting studies not only in the activated sludge, but also in the outflow to find correlations between technological problems and qualitative and quantitative changes in the outflow microorganisms.

Application of Integrated Fixed-Film Activated Sludge in a Conventional Wastewater Treatment Plant.

It is often only at the operation stage of a wastewater treatment plant that there is a need to adjust the treatment process in terms of variable hydraulic capacity, increased pollutant load, high/low concentration of suspended biomass, or the unfavorable phenomenon of reduced sedimentation capacity of the activated sludge. One of the ways to improve the treatment process efficiency is to increase the biologically active surface by using bio-carriers in the form of fibers, materials, or bio-balls. This paper presents the results of a wastewater treatment plant operation during the period of six months after the implementation of the integrated fixed-film activated sludge (IFAS) technology. The research showed that microorganisms developed both in the activated sludge and on the fibers, positively influencing the activated sludge condition. During the start-up of the IFAS process, ciliates predominated over the other species. However, as oxygen content was high (2 mg/dm3 and more) and textile beds were used, the protozoan population developed intensively, and small metazoans became increasingly common. Throughout the research period, nitrifying and phosphorus-accumulating bacteria were observed both in the activated sludge and on the fibers. Between the 59th and 184th day of operation, numerous microorganisms were detected on the fibers and in the activated sludge, testifying to low biological oxygen demand, good aerobic conditions for nitrification, and long sludge age. However, the process seemed to break down after day 72, when the occurrence of metazoan led to reduced sludge production; after day 88, chemical oxygen demand and total suspended solids in the outflow increased, and oligochaetes and rotifers dominated the suspended sludge and fibers. Results also showed that the textile bed and low ammonia concentration became an excellent substrate for the development of Stentor sp. With regard to chemical and biological oxygen demand, total nitrogen- and total phosphorus-effluent concentrations were mostly within the legally permissible limits throughout the 184 days of operation.

Analysis of the Bacterial Biocenosis of Activated Sludge Treated with Leachate from Municipal Landfills.

The influx of toxic pollutants into wastewater treatment plants can negatively affect the quality of the activated sludge (AS). One source is landfill leachate. The identification of microorganisms present in AS is very important, e.g., while improving wastewater treatment technology. Therefore, the aim of the study was to investigate the effect of raw leachate and after purification of Phragmites australis and Ceratophyllum demersum on the composition of the AS bacterial biocenosis. In addition, AS status was assessed by LIVE/DEAD BacLight ™ fluorescent staining. The obtained results showed that the leachate did not significantly affect the cell membranes of AS bacteria, and even a slight improvement was noted. The research carried out using the next-generation sequencing method shows that the origin of the samples (active and closed storage) and the method of processing do not significantly affect the composition of the AS bacterial biocenosis at higher taxonomic levels. However, at the species level, the appearance of bacteria not previously present in AS was observed, namely: Flavobacterium luticocti, Candidimonas nitroreducens and Nitrobacter hamburgensis. The obtained results suggest that the leachate may be a source of microorganisms positively influencing the condition of AS bacteria.

Doppler imaging of orbital vessels in the assessment of the activity and severity of thyroid-associated orbitopathy.

Patients with symptoms of thyroid-associated orbitopathy are classified on the basis of the clinical activity score (CAS) proposed by Mourits in 1989. Despite its undoubted clinical usefulness, it has several limitations which can decide about the success or failure of the implemented treatment. Numerous reports mention the presence of hemodynamic changes in orbital and bulbar vessels in the course of an orbitopathy called Graves' disease. The usage of Doppler sonography in the diagnosis of numerous ophthalmologic vascular diseases suggests that changes in thyroid-associated orbitopathy can correlate with the activity and severity of the disease. This paper presents the overview of the state-of-the-art concerning the usefulness of Doppler imaging in patient selection for the treatment of thyroid-associated orbitopathy. It has been shown that the velocity of blood flow in the superior ophthalmic vein, which is the most susceptible to changes in anatomical conditions in the enclosed orbital space, decreases in a statistically significant way. A decrease in blood flow velocity is closely associated with the active stage of the disease whereas reverse flow or its absence attest to severe orbitopathy and constitute a risk factor of ocular neuropathy. The activity of the inflammatory process in the eyeball is also confirmed by an increase in peak systolic velocity (PSV) in the ophthalmic artery and central retinal artery as well as end-diastolic velocity (EDV) in the ophthalmic artery. Resistance index values decrease in the ophthalmic artery and increase in the central retinal artery mainly in cases with considerable expansion of the extraocular muscles.

Color Doppler imaging of the retrobulbar vessels in diabetic retinopathy.

Diabetes is a metabolic disease characterized by elevated blood glucose level due to impaired insulin secretion and activity. Chronic hyperglycemia leads to functional disorders of numerous organs and to their damage. Vascular lesions belong to the most common late complications of diabetes. Microangiopathic lesions can be found in the eyeball, kidneys and nervous system. Macroangiopathy is associated with coronary and peripheral vessels. Diabetic retinopathy is the most common microangiopathic complication characterized by closure of slight retinal blood vessels and their permeability. Despite intensive research, the pathomechanism that leads to the development and progression of diabetic retinopathy is not fully understood. The examinations used in assessing diabetic retinopathy usually involve imaging of the vessels in the eyeball and the retina. Therefore, the examinations include: fluorescein angiography, optical coherence tomography of the retina, B-mode ultrasound imaging, perimetry and digital retinal photography. There are many papers that discuss the correlations between retrobulbar circulation alterations and progression of diabetic retinopathy based on Doppler sonography. Color Doppler imaging is a non-invasive method enabling measurements of blood flow velocities in small vessels of the eyeball. The most frequently assessed vessels include: the ophthalmic artery, which is the first branch of the internal carotid artery, as well as the central retinal vein and artery, and the posterior ciliary arteries. The analysis of hemodynamic alterations in the retrobulbar vessels may deliver important information concerning circulation in diabetes and help to answer the question whether there is a relation between the progression of diabetic retinopathy and the changes observed in blood flow in the vessels of the eyeball. This paper presents the overview of literature regarding studies on blood flow in the vessels of the eyeball in patients with diabetic retinopathy.

[Diagnostics and pharmacological treatment of ocular cicatrical pemphigoid]. / Diagnostyka i leczenie zachowawcze ocznego pemfigoidu bliznowaciejacego.

Ocular cicatricial pemphigoid (OCP) is an autoimmune disease characterize by mucous membrane fibrosis and skin changes resulting with scarring. The pathogenic mechanisms of ocular cicatricial pemphigoid are incompletely understood. Antibasement membrane antibodies which lead to subepithelial blistering, granulation tissue and inflammatory infiltrate formation in the substantia propria are thought to be the main pathophysiological mechanisms in cicatricial pemphigoid. It has been found eosinophils and increased collagen type I and III. Human leukocyte antigen HLA-DR2, HLA-DR4 and DQw7 genotypes have been identified as conferring increased susceptibility to the development of this disease. Ocular cicatrical pemphigoid (OCP) is one of the forms of bullous pemphigoid. Initial symptoms of ocular pemfigoid are not characteristic. Conjunctival fibrosis may cause severe entropion, trichiasis, symblepharon, dry eye syndrome, corneal epithelial erosions or ulceration. Secondary glaucoma is one of the most frequent complications. Ocular cicatricial pemphigoid may be chronic, acute, or subacute disease with periodic exacerbation of conjunctival inflammation. The treatment in this disease are topical drops or ointment (lubricants, corticosteroids, antibiotics, antiglaucomatous). Oral dapsone and corticosteroids may control the activity of the disease. In other progressive cases immunosuppressive drugs must be used (azathioprine, cyclophosphamide, methotrexate, mycophenolan mofetil, daclizumab, intravenous immunoglobulin therapy). To make an early diagnosis of ocular cicatricial pemphigoid, biopsy and immunohistochemical analysis of conjunctiva should be performed in every case of persistent conjunctival inflammation.