Recovery of volatile fatty acids from fermentation of sewage sludge in municipal wastewater treatment plants.

This work investigated the pilot scale production of short chain fatty acids (SCFAs) from sewage sludge through alkaline fermentation and the subsequent membrane filtration. Furthermore, the impact of the fermentation liquid on nutrient bioremoval was examined. The addition of wollastonite in the fermenter to buffer the pH affected the composition of the carbon source produced during fermentation, resulting in higher COD/NH4-N and COD/PO4-P ratios in the liquid phase and higher content of propionic acid. The addition of wollastonite decreased the capillary suction time (CST) and the time to filter (TTF), resulting in favorable dewatering characteristics. The sludge dewatering characteristics and the separation process were adversely affected from the use of caustic soda. When wollastonite was added, the permeate flux increased by 32%, compared to the use of caustic soda. When fermentation liquid was added as carbon source for nutrient removal, higher removal rates were obtained compared to the use of acetic acid.

Neoadjuvant chemotherapy with accelerated CNF plus G-CSF in patients with breast cancer tumors larger than three centimeters: a pilot study.

From February 1992 to November 1993, forty patients with operable breast cancer tumors larger than three centimeters were enrolled in this study of accelerated neo-adjuvant chemotherapy. Thirty-seven patients are evaluable: one patient was excluded from the protocol and two refused to continue treatment after the first cycle. Chemotherapy consisted of three presurgical cycles of CNF [cyclophosphamide at 600 mg/m2, mitoxantrone (Novantrone) at 10 mg/m2 and 5-fluorouracil at 600 mg/m2] administered every 2 weeks, plus G-CSF (5 microg/kg s.c./day on days 7-12). Twenty-six of 37 patients (70%) achieved objective tumor response and were submitted to quadrantectomy. Toxicity was easily manageable. After a median 55-month follow-up (range 48-70), no locoregional recurrences were observed. Distant metastases occurred in 12/37 (32%) patients. The five-year disease-free (DFS) and overall (OS) survival were 58% and 80%, respectively. Accelerated CNF plus G-CSF proved to be a safe and tolerable regimen yielding a good clinical response thereby increasing the possibility of breast conservation surgery for patients otherwise candidates for mastectomy.

Randomised clinical trial of adjuvant chemotherapy in patients with node-negative, fast-proliferating breast cancer.

A prospective randomised clinical trial in patients with node-negative, fast-proliferating breast cancer was initiated in January 1990 to verify the feasibility and reliability of a 3H-thymidine (3H-Tdr) autoradiographic assay in a prospective and consecutive series of node-negative patients and the therapeutic effect of adjuvant chemotherapy in patients with node-negative breast cancer and high tumour proliferative activity. Node-negative patients with a high 3H-Tdr Labelling Index (3H-Tdr-LI) were randomised to receive either no further treatment or combination chemotherapy consisting of fluorouracil, epirubicin plus cyclophosphamide (FEC) for 6 cycles. The autoradiographic assay was performed in 307 of 317 patients (97%) and was evaluable in 291 of 317 patients (92%). A total of 176 patients with a high 3H-Tdr-LI entered the clinical randomised study: 91 in the FEC arm and 85 in the control arm. Patient groups were fairly well balanced regarding the most important clinical and pathological characteristics. In total, 530 FEC cycles have been administered with an actual dose intensity of 90%. Patients receiving FEC demonstrated leucopenia in 35% of cases, alopecia in 70%, and loss of menses in premenopausal patients in an age-dependent manner. Patients are still being entered into the study.

Voluntary immunomodulation: a preliminary study.

This study explored the effects of relaxation and imagery procedures on the voluntary self-regulation of immune responses. Immune studies of 19 adults were made before and after a 45 minute intervention consisting of relaxation with imagery aimed at enhancing immune activity. A self-report measure of psychological distress was completed before each blood sample. Results indicate that the seven blood measures of immune functioning were measured with adequate reliability and consisted of two sets of immune parameters. A statistically significant increase in one of the mitogen measures and a marginally significant increase in one of the blood count measures was found following the relaxation/imagery procedure. Age, hypnotizability, and their interaction significantly predicted change on the set of blood count measures but not on the set of mitogen measures. As expected, level of subjective psychological distress generally decreased following the intervention. The methodological limitations of this study included limited sample size and absence of a control group.