Occurrence, distribution, and fate evaluation of endocrine disrupting compounds in three wastewater treatment plants with different treatment technologies in Türkiye.

Nowadays, two of the endocrine disrupting compounds (EDCs) in the group of alkylphenols (APs), nonylphenol (4-NP) and octylphenol (4-t-OP), have attracted great scientific and regulatory attention mainly due to concerns about their aquatic toxicity and endocrine disrupting activity. This paper investigated the occurrence, distribution behavior, fate, and removal of 4-NP and 4-t-OP in liquid and solid phases of three full-scale wastewater treatment plants (WWTPs) with different treatment technologies comparatively. In this context, (i) advanced biological WWTP, (ii) wastewater stabilization pond (WSP), and (iii) constructed wetland (CW) were utilized. In all three investigated WWTPs, the concentrations of 4-NP (219.9-19,354.4 ng/L) in raw wastewater were higher than those of 4-t-OP (13.9-2822.4 ng/L). Within the scope of annual average removal efficiencies, 4-NP was treated highly in advanced biological WWTP (93.5 %), while it was almost not treated in WSP (3.1 %) and treated with negative removal (<0 %) in CW. While 4-t-OP was treated at a similar removal rate (93.5 %) to 4-NP in advanced biological WWTP, it was treated moderately in WSP (52.5 %) and very poorly in CW (12.4 %). It has been determined that the most important removal mechanism of both 4-NP and 4-t-OP in WWTPs is biodegradation, followed by sorption onto sewage sludge. According to the mass balance performed in advanced biological WWTP, the biodegradation rates for 4-NP and 4-t-OP were found to be 70.4 % and 86.6 %, respectively, while the sorption onto sewage sludge were determined to be 23.3 % and 6.8 %. One of the critical findings obtained within the scope of the study is that while the concentrations of both metabolites, especially 4-NP, in wastewater and sewage sludge, decreased considerably under aerobic conditions, on the contrary, their concentrations increased significantly under anaerobic conditions. Both compounds were detected at higher concentrations in primary sludge compared to secondary sludge in advanced biological WWTP, while in WSP, they were determined at higher concentrations in anaerobic stabilization pond sludge compared to facultative stabilization pond sludge. Besides, it was also determined that the sorption behavior of these alkylphenols is much more dominant than desorption.

Evaluation of occurrence, fate and removal of priority phthalate esters (PAEs) in wastewater and sewage sludge by advanced biological treatment, waste stabilization pond and constructed wetland.

Phthalate Esters (PAEs), detected in high concentrations generally in treated wastewater discharged from wastewater treatment plants (WWTPs), are important pollutants that restrict the reuse of wastewater. Investigating the fate of these endocrine-disrupting chemicals in WWTPs is crucial in order to protect both receiving environments and ecosystems. For this purpose, di(2-ethylhexyl) phthalate (DEHP), di-n-octyl phthalate (DNOP) and benzyl butyl phthalate (BBP) in the group of PAEs were monitored in simultaneously both in wastewater and sludge lines of selected two nature-based WWTPs and one advanced biological WWTP. Although it was frequently stated that phthalates were significantly removed in WWTPs in many studies found in literature, negative removal efficiencies of selected phthalates in investigated WWTPs during the sampling period were observed generally in this study. One of the reasons for this concentration increase could be releasing of phthalates from microplastics in wastewater during the treatment process or the desorption of PAEs from treatment sludge. DNOP was the compound with the highest concentration increase at almost each treatment unit of the three WWTPs. On the other hand, total PAEs load was 1997 g d-1 in advanced biological WWTP and adsorption onto sludge of PAEs were determined as 90%. The side-stream total load returned from the decanter supernatant was 0.02% of the total PAEs load coming to advanced biological WWTP from the sewer system. As a result of detailed statistical analysis, the correlation between raw wastewater and primary clarifier (PC) effluent was determined as an increasing linear relation for DEHP and DNOP. On the other hand, moderate and strong correlations were observed both between septic tank and constructed wetland (CW) processes with raw wastewater. In the waste stabilization pond (WSP), while a significant correlation was not found between the sludge line data, homogeneous variance, strong and moderate correlations were obtained in the wastewater line data. However, while mean differences for all investigated PAEs were not significant (p > 0.05) in the wastewater line, mean differences of DEHP (p < 0.05) were significant in the sludge line according to ANOVA analysis.

Occurrence, loadings and removal of EU-priority polycyclic aromatic hydrocarbons (PAHs) in wastewater and sludge by advanced biological treatment, stabilization pond and constructed wetland.

Eight polycyclic aromatic hydrocarbon (PAH) compounds which have been accepted as priority micropollutants by European Union (EU) were analyzed both in wastewater and sludge lines throughout three full scale (located in city, sub-province and village) WWTPs during 12-month sampling period. Investigated WWTPs have different treatment types including advanced biological treatment, stabilization pond (SP) and constructed wetland (CW). Removal efficiencies for total PAH compounds varied from 48% in CW to 85% in advanced biological treatment plant. The maximum concentrations of 360-2282 ng/L observed for naphthalene in raw wastewater were decreased to 103-370 ng/L by treatment processes. Minimum concentration were detected for benzo(k)fluoranthene (B[k]F) and benzo(g,h,i)perylene (B[g,h,i]P) ranged between 8 and 12 ng/L and 19-33 ng/L, respectively. While minimum removal efficiencies were obtained for B[k]F and B[g,h,i]P maximum removal efficiencies were obtained for naphthalene in all WWTPs. PAHs present in minimum and maximum levels in the sludge samples were detected as 54 and 6826 ng/g for the B[g,h,I]P and naphthalene, respectively. Considering the removal mechanisms, PAHs have been determined to be removed by biodegradation or vaporization up to 84% and by settling (adsorption onto sludge) up to 2%. The greatest portion (99%) of naphthalene and anthracene were determined to be biodegraded or vaporized in biological treatment due to their low molecular weights. On the other hand, mechanism of adsorption onto sludge was determined as negligible for these two compounds. In addition, approximately 14% of PAHs were discharged to the receiving environment. Among the different WWTP types investigated, advanced biological treatment was found to be the most efficient plant for the removal of PAH compounds.

Removal of PAHs from leachate using a combination of chemical precipitation and Fenton and ozone oxidation.

In this study, six emerging pollutants, belonging to the polycyclic aromatic hydrocarbons (PAHs) group, found in landfill leachate were investigated for their removal by sequential treatment processes including chemical precipitation (CP), Fenton oxidation (FO) and ozone oxidation (OO). Each treatment process was run under different conditions using an experimental design program. Optimization of both CP and FO processes was designed based on the measured values of the residual chemical oxygen demand (COD) of the samples analyzed. The analysis of variance test was applied to the obtained results for determination of statistical significance of the model. Removal efficiencies of micropollutants were determined in the optimal conditions both for CP and FO processes. Samples obtained after these processes were treated with different pH and ozonation times for observing the performances of ozonation on micropollutant removal under different operating conditions. In this study, the removal of acenaphthylene, acenaphthene, fluorene, phenanthrene, fluoranthene and pyrene micropollutants was investigated. The values obtained for PAHs in leachate were determined to be above 10 ppb. In the CP process, the removal efficiencies for PAHs were ranged between 6% and 40% except for pyrene. Removal efficiencies of all micropollutants with FO were over 70% except for fluorene (55%). The removal efficiencies of the investigated micropollutants were 80-100% as a result of consecutive treatment processes including CP, FO and OO respectively.

Early onset marfan syndrome: Atypical clinical presentation of two cases.

Early onset Marfan Syndrome (eoMFS) is a rare, severe form of Marfan Syndrome (MFS). The disease has a poor prognosis and most patients present with resistance to heart failure treatment during the newborn period. This report presents two cases of eoMFS with similar clinical features diagnosed in the newborn period and who died at an early age due to the complications related to the involvement of the cardiovascular system.

Melatonin and amfenac modulate calcium entry, apoptosis, and oxidative stress in ARPE-19 cell culture exposed to blue light irradiation (405 nm).

PURPOSE: Under conditions of oxidative stress, cell apoptosis is triggered through the mitochondrial intrinsic pathway. Increased levels of reactive oxygen species (ROS) are linked to excess cell loss and mediate the initiation of apoptosis in a diverse range of cell types. The aims of this study were to assess intracellular Ca(2+) release, ROS production, and caspase-3, and -9 activation in ARPE-19 cells during the blue light-mediated cell death, and to examine a potential protective effect of melatonin and amfenac, in the apoptotic cascade. METHODS: ARPE-19 cells were cultured in their medium. First, MTT tests were performed to determine the protective effects of amfenac and melatonin. Cells were then exposed to blue light irradiation in an incubator. Intracellular Ca(2+) release experiments, mitochondrial membrane depolarization, apoptosis assay, glutathione (GSH), glutathione peroxidase (GSH-Px), and ROS experiments were done according to the method stated in the Materials and methods section. RESULTS: Cell death was clearly associated with increased levels of ROS production, as measured by 2',7'-dichlorofluorescein fluorescence, and associated increase in Ca(2+) levels, as measured by Fura-2-AM. Blue light-induced cell death was associated with an increased level of caspase-3 and 9, suggesting mediation via the apoptotic pathway. Cell death was also associated with mitochondrial depolarization. Melatonin was shown to delay these three steps. CONCLUSION: Melatonin, amfenac, and their combination protect ARPE-19 cells against blue light-triggered ROS accumulation and caspase-3 and -9 activation. The antiapoptotic effect of melatonin and amfenac at doses inhibiting caspase synthesis modified Ca(2+) release and prevented excessive ROS production, suggesting a new therapeutic approach to age-related macular degeneration.

Cardiovascular changes in children with coarctation of the aorta treated by endovascular stenting.

The aim of this study was to investigate the echocardiographic, biochemical short- and mid-term effects of the stenting procedure on left ventricular function, aortic stiffness, elasticity and systemic hypertension in children with coarctation of the aorta (CoA). Fifteen patients with native or recurrent CoA and 30 healthy controls who were sex and age matched were included in the study. The blood pressure values, echocardiographic measurements, elastic functions of ascending aorta and serum N-Terminal ProBNP (NT-ProBNP) levels were recorded prospectively before and at the first and sixth month after stenting. The mean arterial pressure recorded before stenting was 134.4±16.3 mm Hg; at the sixth month it was 115.5±9.5 mm Hg and in the control group it was 107.3±9.4 mm Hg. Although blood pressure levels were lower compared with the pre-stenting measurements (P<0.05), they were still significantly higher compared with the control group (P<0.05). Although a significant reduction was detected in the LVMIz at the end of the sixth month (50.4±14.3 g m(-2.7)) compared with the baseline (66.6±17.9 g m(-2.7); P<0.05), it was still higher compared with the control group (35.7±6.2 g m(-2.7); P<0.05). The baseline aortic elasticity (6.4±3.4 cm(2) dyn(-1) 10(-6)) was lower compared with the control group (10.0±1.7 cm(2) dyn(-1) 10(-6); P<0.05), and prestenting aortic stiffness was higher than that of the control group (5.6±1.6 dyn(-1) 10(-6); 2.5±0.45 dyn(-1) 10(-6); P<0.05). A statistically significant negative correlation was detected between the pressure gradient at the lesion site and aortic elasticity (r: -0.53, P: 0.04). Although resolution of the coarctation by endovascular stenting led to a reduction in the arteriopathy that had already begun before treatment, it was demonstrated that these children did not completely return to normal.

Scoliosis, blindness and arachnodactyly in a large Turkish family: is it a new syndrome?

In this report we have described an affected sib in a large Turkish family who appears to have a new distinct dominantly-inherited blindness, scoliosis and arachnodactyly syndrome. The combination of clinical abnormalities in these patients did not initially suggest Marfan syndrome or other connective tissue disorders associated with ectopia lentis. The proband was a 16-year-old boy who was referred to our clinics for scoliosis. He had arachnodactyly of both fingers and toes. He had been suffering from progressive visual loss and strabismus since he was eight-years-old. His 20-year-old brother had severe kyphoscoliosis, and arachnodactyly of fingers and toes. He was 130 cm tall and was bilaterally blind. His 23-year-old sister had only eye findings but no arachnodactyly or scoliosis. His 60-year-old father had mild scoliosis, blindness and arachnodactyly and mother was normal. We performed routine mutation analyses in the genes FBN1, TGFBR1 and TGFBR2, but no mutation has been detected. Our Turkish patients are most likely affected by a hitherto unrecorded condition which is caused by an autosomal dominant gene defect with variable expression but we can not exclude multigenic inheritance. Further studies are needed to assess the contribution of sex influence to the syndrome because the female relative is less affected.

Magnesium, zinc and copper status in osteoporotic, osteopenic and normal post-menopausal women.

Serum concentrations of magnesium, zinc and copper were measured in postmenopausal women with osteoporosis (n = 40), osteopenia (n = 40) or normal bone mineral density (n = 40) as classified on the basis of the T-score of the femur neck and dual energy X-ray absorptiometry results. Mean concentrations of magnesium and zinc were significantly lower in osteoporotic women than in both osteopenic women and normal women. In addition, magnesium and zinc concentrations in osteopenic women were significantly lower than in normal women. There were no statistically significant differences observed between the osteopenic, osteoporotic and control groups with respect to copper levels. The clinical significance of these changes needs further elucidation, but trace element supplementation, especially with magnesium and zinc and perhaps copper, may have beneficial effects on bone density.

Nickel adsorption on the modified pine tree materials.

Removal of nickel ions from aqueous solutions containing 1-100 mg l(-1), using pine tree (Pinus nigra) materials modified with HCl, was investigated on a laboratory scale. For this purpose, two natural adsorbents such as the modified pine bark (MPB) and the modified pine cone (MPC) materials with HCl solution were studied. At first, the required concentration level of the HCl solution for the modification was observed, and then this was followed by the determinations of optimum levels of adsorbent amount, stirring rate, contact time and pH values. Various adsorption isotherms were also obtained by using different concentrations of the heavy metal cations tested in the experiment. As a result, the maximum removal efficiency levels obtained were as follows; 97% for the modified pine bark at pH 8 and 80% for the modified pine cone at pH 8.

Effect of MnSO4 on the chromium removal from the leather industry wastewater.

Chromium (VI) is one of the heavy metals in water and wastewater that has the most toxic characteristic. Consequently, it is dangerous for human and environmental health. Various methods are used for removal of the chromium from wastewater, and new methods have been developed in recent years. Recent studies and investigations on the removal of environmental pollution selected methods that were economical, of optimum efficiently and could be carried out easily. In this study, the removal of Cr6+ in the leather industry wastewater is investigated using MnSO4 that was used easily and economically. Experimental studies are performed in two phases. In the first phase, the optimum MnSO4 dose for removal of Cr6+ was determined. In the second phase, the optimum pH was studied. About 96% removal of chromium was launched with 530 mg l(-1) MnSO4 dose at pH value 9 in the wastewater sample.

The callotasis method of limb lengthening.

Limb lengthening by the callotasis technique of De Bastiani and use of the Orthofix external fixator was performed on 25 femurs and tibias of 23 patients between June 1989 and March 1995 in our clinic. Twenty femoral and five tibial segments were lengthened. Simultaneous lengthening of the femur and tibia was performed in two limbs. The mean duration of follow-up was 35.4 months (range, 12 to 81 months). Age at surgery ranged from 9 to 25 years (16.4 years on average). Poliomyelitis was the most common cause (69.6%) of the leg length discrepancy. The maximal achieved lengthening was 8 cm and the shortest 4 cm, with an average of 5.11 cm (13.6% of original bone length). The mean healing index was 38.6 days/cm; the complication rate was 36%. We conclude that limb lengthening by the De Bastiani method is a satisfactory procedure for pediatric and adult patients with moderate limb-length discrepancies.

One-stage treatment of congenital dislocation of the hip in older children.

We reviewed the results of a primary one-stage combined operation in 47 patients (55 hips) who were > or = 4 years and had congenital dislocation of the hip. At a mean follow-up of 7.5 years (2-16 years), 67% of the whole series had good or excellent clinical results, and 65% were good or excellent radiologically. Avascular necrosis occurred in four patients, and redislocation also occurred in four patients. We concluded that most of the children who are > or = 4 years and who have congenital dislocation of the hip can successfully be treated with an extensive one-stage operation consisting of open reduction combined with innominate osteotomy and femoral varus, derotation, and shortening osteotomy.

The chondrogenic potential of free autogenous periosteal and fascial grafts for biological resurfacing of major full-thickness defects in joint surfaces (an experimental investigation in the rabbit).

In the present study, 40 rabbits were used, 30 of them for the experiment and 10 as controls. Full layer defects of 7-14 mm which were produced on knee joint cartilage were repaired with free autogenous periosteal and fascial grafts. The defects were made on the weight bearing areas of the medial condyles of the femurs of rabbits. The full layer periosteal grafts which were taken from the upper parts of the anterior tibia of 15 rabbits were located so that the combium layer faced the joint, and sutured to synovial membrane with 6.0 vicryl. The defects of the other rabbits were covered with fascial grafts obtained from fascia lata and were sutured to synovial membrane with 6.0 vicryl. No grafting was performed on the 10 rabbits in the control group after production of defects. The rabbits were immobilized for two hours postoperatively, and then allowed to be active. The rabbits in the experimental group were sacrificed in the third, sixth and ninth weeks respectively, and the rabbits of the control group were sacrificed in the ninth week. The distal femurs of 40 rabbits were removed and examined both macroscopically and histologically. The collagen phenotype was determined biochemically. When the assessments were made, it was noticed that the joint faces of the rabbits which were repaired with periosteal grafts were smooth, a tissue resembling hyaline joint cartilage had developed, and the synthesis of collagen of type II increased. On the other hand, the joint faces of the rabbits which were repaired with fascial grafts were not smooth, immature cartilage had with fibrous tissue developed, and the synthesis of type II collagen accounted for 50 per cent. The joint faces of the control group were course and covered with fibrous tissue, and the collagen synthesized was type I. According to these findings, we suggest that the biological repair of joint cartilage defects is possible with free autogenous periosteal grafts.