Monitoring individual response to brain-tumour chemotherapy: proton MR spectroscopy in a patient with recurrent glioma after stereotactic radiotherapy.

Since antineoplastic activity varies, sensitive methods for individual assessment of efficacy are needed. We demonstrate the clinical value of MR spectroscopy in monitoring chemotherapy in a patient with recurrent glioma after stereotactic radiotherapy. Diagnostic imaging before and after chemotherapy included contrast-enhanced MRI, single-voxel proton MR spectroscopy ((1)H MRS), (1)H MR spectroscopic imaging ((1)H SI), and fluorodeoxyglucose (FDG) positron-emission tomography (PET). A significant decrease in choline signal intensity was observed 2 months after chemotherapy indicating tumour chemosensitivity, in line with tumour shrinkage on MRI and decreased uptake of FDG. Assessment of early response by MRS may help to improve treatment protocols in other patients.

Population dynamics in wastewater treatment plants with enhanced biological phosphorus removal operated with and without nitrogen removal.

The population dynamics of activated sludge in a pilot plant with two activated sludge systems, both designed for enhanced biological phosphorus removal (EBPR), but one of them with (BNP) and the other without (BP) nitrogen removal, was monitored during a period of 2.5 years. The influent water to the pilot plant was periodically manipulated by external addition of phosphorus (P), acetate and glucose, respectively. The population dynamics and the in situ physiology were monitored by quantitative fluorescence in situ hybridization (FISH) and microautoradiography. Significant P removal was observed in both systems throughout the whole period, with significant increases of the P removal when substrates were dosed. The activated sludge in both systems contained large amounts of dense clusters of gram-negative, methylene-blue staining coccoid rods during the whole period. A large part of the clusters belonged to the beta Proteobacteria, whereas the rest of the clusters belonged either to the Actinobacteria or to the alpha Proteobacteria. The relative abundance of Rhodocyclus-related bacteria in the activated sludge varied significantly in both systems during the whole period (from 6 to 18% in BNP, and from 4 to 28% in BP). However, no statistically significant correlation of the Rhodocyclus-related nor any of the other investigated bacterial groups to the P content of the activated sludge (correlation for all groups investigated was always < 0.5) was observed. A significant 33Pi uptake was observed by the beta Proteobacteria (part of them Rhodocyclus-related, the identity of the rest unknown) and the Actinobacteria. However, not all of the Rhodocyclus-related bacteria showed 33Pi uptake. The P removal in the investigated plants is thus believed to be mediated by a mixed population consisting of a part of the Rhodocyclus-related bacteria, the Actinobacteria and other, yet unidentified bacteria.

Effect of solids retention time and wastewater characteristics on biological phosphorus removal.

The paper deals with the effect of wastewater, plant design and operation in relation to biological nitrogen and phosphorus removal and the possibilities to model the processes. Two Bio-P pilot plants were operated for 2.5 years in parallel receiving identical wastewater. The plants had SRT of 4 and 21 days, the latter had nitrification and denitrification. The plant with 4 days SRT had much more variable biomass characteristics, than the one with the high SRT. The internal storage compounds, PHA, were affected significantly by the concentration of fatty acids or other easily degradable organics in the wastewater, and less by the plant lay-out. The phosphorus removal is mainly dependent on availability in the wastewater of fatty acids but also by the suspended solids in the effluent, which is higher in the plant with nitrification-denitrification, probably due to a higher SVI or denitrification in the settler. The addition of glucose to the influent seems to have an effect on the performance of the plants similar to that of acetic acid. In spite of great load variations over time to the pilot plants and the different operational modes, the study of population dynamics showed less significant variations with time which has importance in relation to modelling. The overall conclusion of the comparison between the two plants is that the biological phosphorus removal efficiency under practical operating conditions is affected by the SRT in the plant and the wastewater composition. Thus great care should be taken when extrapolating results from one type of plant to another. Indirectly the experiments confirm that results from lab-experiments with artificial wastewater are difficult to extrapolate through modelling to real life wastewater and conditions. The 2.5 years time series can be valuable in verification of models for Nitrogen and Enhanced Biological Phosphorus Removal.

Use of phosphorus release batch tests for modelling an EBPR pilot plant.

The aim of this study was to evaluate how routinely performed phosphorus release tests could be used when modelling enhanced biological phosphorus removal (EBPR) using activated sludge models such as ASM2d. A pilot plant with an extensive analysis programme was used as basis for the simulations. Without any calibration the prediction of phosphorus removal was poor and the initial release rates from the simulations were not similar to those found from the laboratory tests. A period with low organic loading was chosen as a calibration period. In this period averages of daily influent measurements were used as influent parameters. First, calibration was performed in order to fit effluent COD and MLVSS in the sludge. Next, the phosphorus content in the sludge was decreased to the measured level by decreasing the fermentation rate. Finally, the initial phosphorus release rate was calculated from a simulated batch test and the PHA uptake rate was increased to fit this release rate with the average initial rates from laboratory batch tests performed during the period. The calibrated model was verified with data from the subsequent period where acetate was dosed.

Possible complication regarding phosphorus removal with a continuous flow biofilm system: diffusion limitation.

Diffusion limitation of phosphate possibly constitutes a serious problem regarding the use of a biofilm reactor for enhanced biological phosphorus removal. A lab-scale reactor for simultaneous removal of phosphorus and nitrate was operated in a continuous alternating mode of operation. For a steady-state operation with excess amounts of carbon source (acetate) during the anaerobic phase, the same amount of phosphate was released during the anaerobic phase as was taken up during the anoxic phase. The measured phosphorus content of the biomass that detached during backwash after an anoxic phase was low, 2.4 +/- 0.4% (equal to 24 +/- 4 mg P/g TS). A simplified computer model indicated the reason to be phosphate diffusion limitation and the model revealed a delicate balance between the obtainable phosphorus contents of the biomass and operating parameters, such as backwash interval, biofilm thickness after backwash, and phase lengths. The aspect of diffusion is considered of crucial importance when evaluating the performance of a biofilter for phosphate removal.

[Mucoepidermoid carcinoma of the salivary glands after high dosage radiotherapy]. / Mukoepidermoid-Karzinom der Speicheldrüsen nach hochdosierter Radioiodtherapie.

BACKGROUND: High-dose radioiodine therapy following total thyroidectomy is standard for patients suffering from differentiated thyroid carcinoma and contributes significantly to their favourable prognosis. Due to active iodine accumulation, high focal radiation doses are received by the salivary glands. PATIENTS/RESULT: Report on two patients, who received multiple high-dose radioiodine treatments because of a differentiated metastatic thyroid carcinoma. A few years later, they developed a mucoepidermoid carcinoma of the salivary glands. Due to the high cumulative radiation dose, radiation-induced secondary malignancies following radiation-induced sialadenitis appears likely, although no causal connection could be proven. CONCLUSION: Consistent protection of the salivary glands during radioiodine therapy as well as the follow-up of the many long-term survivors of differentiated thyroid carcinomas is desirable to further lower the salivary gland-related side effects and to detect secondary malignancies as early as possible.

[Mucoepidermoid carcinoma of the submandibular gland after high-dose radioiodine therapy: case report and review of the literature]. / Mukoepidermoid-Karzinom der Glandula Submandibularis nach hochdosierter Radioiodtherapie: Fallpräsentation und Literaturübersicht.

Case report of a 42 year old female, who received 14th-20th year of life six radioiodine therapies with altogether 19.2 GBq131I because of a papillary thyroid carcinoma. 17 years after the last therapy, she developed a histologically proven chronic radiogenic sialadenitis of the left submandibular gland. Further four years later, the right submandibular gland has been extirpated because of a mucoepidermoid carcinoma with infiltration of a regionary lymphatic node. Review of the previous published secondary-malignancies of the salivary glands after high-dose radioiodine therapies.