Septic systems drive nutrient enrichment of groundwaters and eutrophication in the urbanized Indian River Lagoon, Florida.

Effluent from septic systems can pollute groundwater and surface waters in coastal watersheds. These effects are unknown for the highly urbanized central Indian River Lagoon (CIRL), Florida, where septic systems represent > 50% of wastewater disposal. To better understand these impacts, water quality was assessed along both canals and a tributary that drain into the CIRL. Dissolved nutrient concentrations were higher near septic systems than in natural areas. δ15N values of groundwater (+7.2‰), surface water (+5.5‰), and macrophytes (+9.7‰) were within the range for wastewater (>+3‰), as were surface water concentrations of the artificial sweetener sucralose (100 to 1700 ng/L) and fecal indicator bacteria density. These results indicate that septic systems are promoting eutrophication in the CIRL by contributing nutrient pollution to surface water via groundwater. This study demonstrates the need to reduce reliance on septic systems in urbanized coastal communities to improve water quality and subsequently mitigate harmful algal blooms.

Biotransformation and detoxification of selenite by microbial biogenesis of selenium-sulfur nanoparticles.

This study combines the interaction between the toxic oxyanions selenite and selenate and the plant growth promoting bacterium Azospirillum brasilense with a comprehensive characterization of the formed selenium particles. As selenium is an essential trace element, but also toxic in high concentrations, its state of occurrence in nature is of major concern. Growth of the bacterium was affected by selenite (1-5mM) only, observable as a prolonged growth lag-phase of 3days. Subsequently, selenite reduction occurred under aerobic conditions resulting in extracellularly formed insoluble Se0 particles. Complementary studies by microscopic and spectroscopic techniques revealed the particles to be homogeneous and stable Se8-nSn structured spheres with an average size of 400nm and highly negative surface charge of -18mV in the neutral pH range. As this is the first study showing Azospirillum brasilense being able to biotransform selenite to selenium particles containing a certain amount of sulfur, even if environmental waters supplemented with selenite were used, they may significantly contribute to the biogeochemical cycling of both elements in soil as well as to their soil-plant transfer. Therefore, microbial biotransformation of selenite under certain circumstances may be used for various bio-remediation and bio-technological applications.

[Psychosocial Treatment of Addictive Disorders--An Overview of Psychotherapeutic Options and their Efficacy]. / Psychosoziale Behandlungen bei Suchterkrankungen--Suchtspezifische Psychotherapieformen und ihre Wirksamkeit.

Addictive disorders are chronic relapsing conditions marked by compulsive and often uncontrolled use of psychotropic substances or stimuli. In this review, we present and discuss the current specific psychosocial interventions for addictive disorders and their effectiveness. In particular cognitive behavioral therapy, motivational interviewing, relapse prevention, the community reinforcement approach, and contingency management were found to be effective. For these psychotherapeutic treatments, mostly moderate effect sizes have been found. Their effectiveness seems to be highest in cannabis dependence. Empirical evidence for dependence on "hard" drugs is largest for contingency management, while for alcohol dependence motivational interviewing and the community reinforcement approach show the largest effect sizes. Presumably, combinations of different approaches as well as online interventions will bring further progress in the psychosocial treatment of addictive disorders in the future.

Biosorption of U(VI) by the green algae Chlorella vulgaris in dependence of pH value and cell activity.

Biosorption of uranium(VI) by the green alga Chlorella vulgaris was studied at varying uranium concentrations from 5 µM to 1mM, and in the environmentally relevant pH range of 4.4 to 7.0. Living cells bind in a 0.1mM uranium solution at pH 4.4 within 5 min 14.3 ± 5.5 mg U/g dry biomass and dead cells 28.3 ± 0.6 mg U/g dry biomass which corresponds to 45% and 90% of total uranium in solution, respectively. During 96 h of incubation with uranium initially living cells died off and with 26.6 ± 2.1 mg U/g dry biomass bound similar amounts of uranium compared to dead cells, binding 27.0 ± 0.7 mg U/g dry biomass. In both cases, these amounts correspond to around 85% of the initially applied uranium. Interestingly, at a lower and more environmentally relevant uranium concentration of 5 µM, living cells firstly bind with 1.3 ± 0.2 mg U/g dry biomass to 1.4 ± 0.1 mg U/g dry biomass almost all uranium within the first 5 min of incubation. But then algal cells again mobilize up to 80% of the bound uranium during ongoing incubation in the time from 48 h to 96 h. The release of metabolism related substances is suggested to cause this mobilization of uranium. As potential leachates for algal-bound uranium oxalate, citrate and ATP were tested and found to be able to mobilize more than 50% of the algal-bound uranium within 24h. Differences in complexation of uranium by active and inactive algae cells were investigated with a combination of time-resolved laser-induced fluorescence spectroscopy (TRLFS), extended X-ray absorption fine structure (EXAFS) spectroscopy and attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy. Obtained results demonstrated an involvement of carboxylic and organic/inorganic phosphate groups in the uranium complexation with varying contributions dependent on cell status, uranium concentration and pH.

Diagnosis of glutathione synthetase deficiency in newborn screening.

Glutathione synthetase (GSS) deficiency is a rare disorder of glutathione metabolism with varying clinical severity. Patients may present with haemolytic anaemia alone or together with acidosis and central nervous system impairment. Diagnosis is made by clinical presentation and detection of elevated concentrations of 5-oxoproline in urine and low GSS activity in erythrocytes or cultured skin fibroblasts. Diagnosis can be confirmed by mutational analysis. Treatment consists of the correction of acidosis, blood transfusion, and supplementation with antioxidants. The most important determinants for outcome and survival in patients with GSS deficiency are early diagnosis and early initiation of treatment. The case of a newborn with GSS deficiency diagnosed by tandem mass spectrometry (MS/MS)-based newborn screening is described. After onset of clinical symptoms on the 2nd day of life, expanded newborn screening revealed normal results for all disorders included in the German screening programme; however, selective MS/MS screening revealed a >10-fold elevation of 5-oxoproline in dried blood, leading to the presumptive diagnosis of GSS deficiency by the 5th day of life. Diagnosis was later confirmed by detection of markedly reduced glutathione concentration in erythrocytes and mutational analysis of the GSS gene. Presently, GSS deficiency is not included in newborn screening programmes in Europe. As outcome depends significantly on early start of treatment, routine inclusion of this disorder in newborn screening panels should be considered.

Successful UVA1 phototherapy in a patient with scleredema adultorum.

Scleredema adultorum is a rare connective tissue disorder of unknown cause. Both bath-PUVA and cream-PUVA therapy were reported to be effective. We describe a patient with scleredema adultorum who showed a striking clinical improvement with a medium-dose UVA1 phototherapy (single dose, 50 J/cm(2); 35 treatments).

Inter-frame motion correction for MR thermometry.

Noninvasive temperature measurement is feasible with MRI to monitor changes in thermal therapy. Phase shift based MR thermometry gives an estimate of the relative temperature variation between thermal and baseline images. This technique is limited, however, when applied on targets under inter-frame motion. Simple image registration and subtraction are not adequate to recover the temperature properly since the phase shift due to temperature changes is corrupted by an unwanted phase shift. In this work, the unwanted phase shift is predicted from the raw registered phase shift map itself. To estimate the unwanted phase shift, a thin plate smoothing spline is fitted to the values outside the heated region. The spline value in the heated area serves as an estimate for the offset. The estimation result is applied to correct errors in the temperature maps of an ex-vivo experiment.

Kinematical analysis of emotionally induced facial expressions in patients with obsessive-compulsive disorder.

UNLABELLED: BACKGROUND; Motor function is deficient in many patients with obsessive-compulsive disorder (OCD), especially in the face. To investigate subtle motor dysfunction, kinematical analysis of emotional facial expressions can be used. Our aim was to investigate facial movements in response to humorous film stimuli in OCD patients. METHOD: Kinematical analysis of facial movements was performed. Ultrasound markers at defined points of the face provided exact measurement of facial movements, while subjects watched a humorous movie ('Mr Bean'). Thirty-four OCD patients (19 male, 15 female; mean (S.D.) age: 35.8 (11.5) years; mean (S.D.) total Y-BOCS score: 25.5 (5.9)) were studied in unmedicated state and after a 10-week treatment with the SSRI sertraline. Thirty-four healthy controls (19 male, 15 female; mean (S.D.) age: 37.5 (13.1) years) were also investigated. RESULTS: At baseline, OCD patients showed significantly slower velocity at the beginning of laughing than healthy controls and a reduced laughing frequency. There was a significant negative correlation between laughing frequency and severity of OCD symptoms. Ten weeks later a significant increase of laughing frequency and initial velocity during laughing was found. CONCLUSIONS: Execution of adequate facial reactions to humour is abnormally slow in OCD patients. Susceptibility of OCD patients with regard to emotional stimuli is less pronounced than in healthy subjects. This phenomenon is closely correlated to OCD symptoms and is state-dependent.

CHO expression of a novel human recombinant IgG1 anti-RhD antibody isolated by phage display.

Replacement of the hyperimmune anti-Rhesus (Rh) D immunoglobulin, currently used to prevent haemolytic disease of the newborn, by fully recombinant human anti-RhD antibodies would solve the current logistic problems associated with supply and demand. The combination of phage display repertoire cloning with precise selection procedures enables isolation of specific genes that can then be inserted into mammalian expression systems allowing production of large quantities of recombinant human proteins. With the aim of selecting high-affinity anti-RhD antibodies, two human Fab libraries were constructed from a hyperimmune donor. Use of a new phage panning procedure involving bromelin-treated red blood cells enabled the isolation of two high-affinity Fab-expressing phage clones. LD-6-3 and LD-6-33, specific for RhD. These showed a novel reaction pattern by recognizing the D variants D(III), D(IVa), D(IVb), D(Va), D(VI) types I and II. D(VII), Rh33 and DFR. Full-length immunoglobulin molecules were constructed by cloning the variable regions into expression vectors containing genomic DNA encoding the immunoglobulin constant regions. We describe the first, stable, suspension growth-adapted Chinese hamster ovary (CHO) cell line producing a high affinity recombinant human IgG1 anti-RhD antibody adapted to pilot-scale production. Evaluation of the Fc region of this recombinant antibody by either chemiluminescence or antibody-dependent cell cytotoxicity (ADCC) assays demonstrated macrophage activation and lysis of red blood cells by human lymphocytes. A consistent source of recombinant human anti-RhD immunoglobulin produced by CHO cells is expected to meet the stringent safety and regulatory requirements for prophylactic application.

Efficacy and safety of teicoplanin plus rifampicin in the treatment of bacteraemic infections caused by Staphylococcus aureus.

An open study was carried out on 16 patients with hospital-acquired, bacteraemic Staphylococcus aureus infections to evaluate the safety and efficacy of teicoplanin plus rifampicin. Patients received teicoplanin 400 mg bd for the first 24 h followed by 400 mg od thereafter, and rifampicin 600 mg bd. Both agents were given intravenously. Serum samples were collected to determine trough and peak antibiotic concentrations. The MIC of teicoplanin and rifampicin and the MBC of teicoplanin were determined for all S. aureus isolates. Time-kill curves were performed for the drugs individually and in combination. Clinical efficacy was assessed by the APACHE II scoring system. Bacteriological success was evaluated by elimination, persistence or recurrence of S. aureus. Safety was carefully monitored by regular biochemical and haematological testing and recording of adverse events. Fifteen patients were evaluable, of whom 13 (86.7%) were clinically cured with elimination of S. aureus. One patient died, but death was not attributed to the study drugs. Treatment failed in another patient who relapsed with a high fever. S. aureus was recovered from blood cultures from this patient, and resistance to rifampicin had developed. Time-kill curves all showed adequate killing of S. aureus at the drug concentrations measured in vivo. Neither synergy nor antagonism between teicoplanin and rifampicin was demonstrated. The combination of teicoplanin and rifampicin is an effective and well-tolerated treatment for bacteraemic S. aureus infections, but in deep-seated foci of infection resistance to rifampicin may develop.

Nonspecific binding of IgE to allergens.

Nonspecific IgE binding to allergens was observed in testing myeloma IgEs, namely, IgE-VL and IgE-PS, chimeric IgE (IgE-JW8), and the recombinant IgE Fc epsilon peptide CH1-CH4, in two different immunoassays. This binding was concentration-dependent but detectable only at higher IgE concentration. In RAST inhibition, IgE-allergen interactions could be reduced by using either matching or nonmatching allergens. In order to test whether the nonspecific binding of IgE to allergens was due to carbohydrate interaction, myeloma IgEs and the chimeric IgE were desialized with neuraminidase. Desialized samples were equally well recognized by xenogenic antibodies as native IgEs, but binding of IgE to Fc epsilon receptors on basophils was affected by the treatment, as shown in the histamine-release assay. Desialization of IgE affected also its binding capacity to allergens in RAST: binding of chimeric IgE was reduced, but nonspecific binding of myeloma IgE-VL was enhanced. Hence, nonspecific allergen-IgE binding may be partly due to a lectin-like interaction, but may depend mostly on the tertiary structure of IgE. Thus, nonspecific IgE-allergen interactions might present a problem 1) at high IgE concentration, and 2) depend on the grade of sialization of IgE, which might affect its conformation. This may explain why patients with elevated total IgE levels often have multiple weak positive RASTs with non-cross-reactive allergens.

Anti-IgE autoantibodies mistaken for specific IgG.

During isolation of specific IgE by affinity chromatography, we obtained IgG acting as "specific IgG" in dot immunoassay and RAST. Further analysis of this fraction revealed that this specific IgG was indeed an immune complex consisting of IgG anti-IgE autoantibodies and specific IgE that falsely appeared as specific IgG in the immunoassays. After disruption of complexes, more IgE became accessible, resulting in increased counts per minute in the RAST. Thus, anti-IgE autoantibodies may hinder determination of specific IgE in in vitro immunoassays, since they hide specific IgE immunologically. To demonstrate the isotope specificity of such immune complex-derived IgG, the purified anti-IgE autoantibodies were radiolabeled and used as detection antibodies in immunoblotting. These autoantibodies recognized different IgE preparations, including a recombinant IgE peptide.

Calcium-dependent and calcium-independent gelatinolytic proteinase activities of the rat ventral prostate and its secretion: characterization and effect of castration and testosterone treatment.

Calcium-dependent and calcium-independent proteinase activities were detected in extracts of rat ventral prostate and its secretion by use of gelatin-containing SDS-PAGE zymography. Ca(2+)-independent proteinase activities of 22, 26, and 73-79 kDa and Ca(2+)-dependent activities of 58, 63, and 66 kDa were found in the adult gland. The 26- (most intense activity of gland) and 22-kDa activities were present in secretion and were not expressed in the undifferentiated gland of the 10-day-old animal. The Ca(2+)-dependent activities were also present in the secretion, where the 63-kDa form was more prominently expressed than the 58- and 66-kDa bands. The Ca(2+)-dependent and Ca(2+)-independent proteinase activities both responded to a broad range of pH values in the incubation media. The 73-79-kDa Ca(2+)-independent activities were sensitive to benzamidine and the Ca(2+)-dependent activities were inhibited by EDTA and EGTA. Both Ca(2+)-dependent and Ca(2+)-independent proteinase activities responded to androgenic manipulations. Castration was followed by the appearance of a 35-kDa Ca(2+)-independent proteinase (at 2 days) and a 43-kDa Ca(2+)-dependent proteinase (at 4 days). In the Ca(2+)-independent proteinase group, the 73-79-kDa activities were increased somewhat and the 22- and 26-kDa activities decreased after castration. The Ca(2+)-dependent proteinases of 58, 63, and 66 kDa increased in activity with castration, but activity of the 58-kDa form decreased again at 7 days after castration. Treatment of animals upon castration for 4 days with hydrocortisone prevented these changes in proteinase activities whereas treatment with actinomycin D or tranexamic acid did not. Testosterone propionate replacement therapy of rats castrated for 16 days stimulated the activities of the 22- and 26-kDa and 73-79-kDa Ca(2+)-independent and the 58- and 63-kDa Ca(2+)-dependent proteinases with 4 days of therapy. The activities of the 35-kDa Ca(2+)-independent and the 43-kDa Ca(2+)-dependent proteinases were repressed with 8 days of testosterone treatment. Thus, individual proteinases show differential changes in activity during development and in response to androgenic manipulation: this suggests that in addition to proteinases which are secreted, others may be involved in intracellular functions or in mediating tissue organization changes.

The efficacy of the combination of teicoplanin or flucloxacillin with netilmicin in the treatment of Staphylococcus aureus bacteraemia.

Twenty one patients with serious Staphylococcus aureus infection and bacteraemia were randomized prospectively to receive either teicoplanin and netilmicin or flucloxacillin and netilmicin. After at least 48 h of treatment serum samples were collected for the determination of trough and peak antibiotic concentrations, the serum killing level and the serum bactericidal rate. With the help of a severity-of-disease scoring system (APACHE II) the clinical efficacy of antimicrobial therapy was assessed. Eighteen patients were evaluable. The clinical results and the results of the serum assays suggest that treatment with teicoplanin or flucloxacillin, combined with netilmicin, is a safe approach in patients with bacteraemia caused by S. aureus.

[Laser trabeculoplasty in glaucoma chronicum simplex. Results of a prospective, clinical study]. / Lasertrabekuloplastik bei Glaucoma chronicum simplex. Ergebnisse einer prospektiven, klinischen Studie.

Between 1984 and 1986, 104 patients with open-angle glaucoma of various etiologies were treated by laser trabeculoplasty (LTP) in a prospective clinical study. In order to ensure that the group of patients studied was homogeneous, only the 85 consecutive patients (85 eyes) with primary open-angle glaucoma were included, using a specially designed software program. The number of patients with pseudoexfoliation glaucoma, aphakic glaucoma, and congenital glaucoma was too small to allow statistical comparison with those who had chronic open-angle glaucoma. Criteria for success were defined as follows: no progression of disk cupping or visual field defects, mean intraocular pressure below 24 mm Hg as calculated by a day profile, and no increase in medication. These conditions were satisfied by 76% of the patients after six months and by 64% after 12 months. Initially, coagulations were performed over 180 degrees in the inferior circumference. If this did not suffice, the upper 180 degrees were also coagulated. If LTP is to be effective, thorough coagulation with tender blanching effects is mandatory. Average preoperative pressure values of over 22 mm Hg and a postoperative pressure increase of between 5 and 14 mm Hg are favorable prognostic signs. None of the parameters age, sex, duration, intensity of glaucomatous disease, or preoperative medication had any influence on the efficacy of LTP. In 14 of the 45 patients in whom only one eye was treated a simultaneous decrease in pressure was also observed in the untreated eye. The side effects of LTP bear no relation to its benefits, so that LTP is very suitable as a therapy between medication and surgery. Careful follow-ups of the patients are necessary because of possible increases in intraocular pressure in the course of time.

Type A behavior and coronary heart disease.

Coronary-prone (Type A) behavior is an independent risk factor for ischemic heart disease (coronary heart disease). Recent investigations indicate that modification of Type A behavior is possible and that such treatment reduces the likelihood of subsequent coronary events. Type A behavior is not difficult to recognize in day-to-day family practice. By recognizing and responding to coronary-prone behavior, family physicians can play an active role in the prevention and treatment of coronary heart disease.

[Treatment of band keratopathy with EDTA (author's transl)]. / Medikamentöse Behandlung der bandförmigen Hornhautdegeneration mit EDTA.

Six eyes with band keratopathy were treated with ethylenediamintetraacetacid (EDTA). The treatment is simple, shows no harmful complications and may replace corneal grafting. EDTA treatment can not be successful if a pannus or hyalin deposits impede contact between EDTA and the calcium deposition. Histopathologic examination suggests that the basement membrane of the corneal epithelium is the primary focus of cristallisation of the calcium salt. Even in long standing cases of band keratopathy only the most superficial layers of the cornea are involved.