The salinity levels of wastewater and sludge are relatively high in some coastal cities as they may use saline water for toilet flushing, and as such,the sludge dewaterability can be affected by it. ...The salinity effect on sludge dewaterability was therefore investigated through experimental testing of specific resistance in filtration (SRF), time to filter (TTF), and final solid content of sludge. SRF and TTF were determined using Buchner funnel tests. The final solid content was estimated by centrifuging the sludge at four levels of rotational speed. Sludge with three salinity levels (5,000, 10,000 and 20,000 ppm) were considered in this study. Coagulants such as alum, iron(II) sulfate, and organic polyelectrolytes were added to the sludgetostudythe dewaterability of such sludge with chemical conditioning. Experimental results show that doubling the salinity level of the sludge from 10,000 to 20,000 ppm shows not much change in SRF and TTF. Compared with the sludge without chemical conditioning, the addition of the coagulants to the sludge at a salinity level of 5,000 ppm drastically reduces its SRF and TTF. However, sludge with and without chemical conditioning at a salinity of 20,000 ppm has similar SRF and TTF. The final solid content of sludge increases almost linearly with salinity. Among the coagulants used in this study, the cationic polyelectrolyte is found to be better in improving sludge dewaterability, while iron(II) sulfate performs slightly better in enhancing the final solid content of the sludge.
The management of colonic epithelial changes indefinite for dysplasia (IND) in patients with inflammatory bowel disease (IBD) remains controversial because of a paucity of published outcome data.
We ...analyzed data from 93 patients with IBD who were IND and 52 IBD patients without dysplasia (controls) from the Department of Anatomic Pathology database at the Cleveland Clinic from 1989 to 2004. Pathology reports, histologic slides, clinical features, and outcomes were reviewed.
Twenty-two patients (23.7%) had surgical resections within 6 months of the IND assignment; of these, 6 had dysplasia (27.3%; 1 low-grade dysplasia and 5 high-grade dysplasia HGD). The remaining 71 patients received regular colonoscopy examinations for a mean period of 98.6 months; 18 patients developed dysplasia or carcinoma (25.2%; 10 low-grade dysplasia, 5 HGD, and 3 colorectal cancer). There was a mean interval of 53.9 months between an IND assignment and identification of dysplasia or carcinoma. Histology review of 59 cases revealed 3.2 cases per 100 person-years for neoplasia (low-grade dysplasia, HGD, or colorectal cancer) and 1.5 cases per 100 person-years for advanced neoplasia (HGD or colorectal cancer); these values were higher than those for controls (1.9 cases per 100 person-years for neoplasia and 0.7 cases per 100 person-years for advance neoplasia; P = 0.1 and P = 0.2, respectively, for IND versus controls). Patients aged more than 44 years when they were found to be IND were more likely than younger patients to develop neoplasia (hazard ratio, 6.7; P = 0.01).
Patients with IBD and IND are at significant risk for colorectal dysplasia and cancer. These patients should be closely followed.
Abstract Diarrhea is a very common complaint among immunocompromised patients, and the most common causes of this and other gastrointestinal complaints in this population differ from those commonly ...seen in immunocompetent patients. Underlying immunodeficiencies may be associated with particular patterns of gastrointestinal tract injury, and particular immunodeficiencies may lead to increased susceptibility to infection by specific organisms depending upon the etiology of the immune compromise. It is important to become familiar with the causes of gastrointestinal disease in the immunocompromised patient population because prompt and proper treatment is of the essence in this patient group. This review focuses on common causes of enterocolitis in the immunocompromised with attention to primary immunodeficiency disorders, the post-transplant setting, chemotherapy-related injury, and a select group of common or emerging infections.
Congenital scoliosis (CS) is a lateral curvature of the spine resulting from congenital vertebral malformations (CVMs) and affects 0.5-1/1000 live births. The copy number variant (CNV) at chromosome ...16p11.2 has been implicated in CVMs and recent studies identified a compound heterozygosity of 16p11.2 microdeletion and
variant/haplotype causing CS in multiple cohorts, which explains about 5-10% of the affected cases. Here, we studied the genetic etiology of CS by analyzing CNVs in a cohort of 67 patients with congenital hemivertebrae and 125 family controls. We employed both candidate gene and family-based approaches to filter CNVs called from whole exome sequencing data. This identified 12 CNVs in four scoliosis-associated genes (
,
,
, and
) as well as eight recessive and 64 novel rare CNVs in 15 additional genes. Some candidates, such as
,
,
, and
, have been found to be associated with syndromes with scoliosis or implicated in bone/spine development. In particular, the
mutant mouse showed spinal deformities. Our findings suggest that, in addition to the 16p11.2 microdeletion, other CNVs are potentially important in predisposing to CS.
Subsquamous intestinal metaplasia (SSIM) in the setting of Barrett's esophagus (BE) is a technically challenging diagnosis. While the risk for progression of BE involving the surface mucosa is well ...documented, the potential risk for development of advanced neoplasia associated with SSIM has been controversial. This study aimed to determine the effects of specimen adequacy, presence of dysplasia, and interobserver agreement for SSIM interpretation. Adult patients (n = 28) who underwent endoscopic therapy for BE with high-grade dysplasia or intramucosal carcinoma (HGD/IMC) between October 2005 and June 2013 were included. Initial evaluation (n = 140 slides) by an experienced gastrointestinal pathologist was followed by an interobserver study by 8 pathologists. Forty-seven (34%) slides had insufficient subsquamous tissue to assess for SSIM. SSIM was found in 19% of all slides and 29% of slides with sufficient subsquamous tissue. At least one slide had SSIM in 54% to 64% of patients. Subsquamous low grade dysplasia (LGD) was found in 4 (15%) slides with SSIM and subsquamous HGD/IMC was found in 5 (19%) slides with SSIM. At the patient level, 8 (53%) had no dysplasia, 4 (27%) had LGD and 3 (20%) had HGD/IMC. Overall agreement for SSIM by slide was 92% to 94% (κ = 0.73 to κ = 0.82, moderate to strong agreement), and by patient was 82% to 94% (κ = 0.65 to κ = 0.87, moderate to strong agreement). This study confirms the need for assessing specimen adequacy and assessing the prevalence of SSIM and is the first to assess interobserver agreement for SSIM and dysplasia within SSIM.
•Biopsy adequacy essential for assessing subsquamous intestinal metaplasia•Assess per slide and per patient to understand biopsy adequacy•Strong to moderate interobserver agreement for subsquamous intestinal metaplasia•Dysplasia can be graded within subsquamous intestinal metaplasia.•Presence of subsquamous intestinal metaplasia can be indeterminate.
The application of zero-valent iron
(
Fe0
)
in the funnel-and-gate permeable reactive barrier (PRB) installed at the Vapokon site, Denmark, was conducted in 1999 to remediate the groundwater ...contaminated by chlorinated aliphatic hydrocarbons (CAHs). Over the past
4
years
, except in September 2002 and January 2003, about 92.4–97.5% CAH removal could be achieved with the PRB. Although there was a continuous decrease in total alkalinity (90.3%), calcium (81.7%), and sulfate (69.2%) ions in the groundwater crossing the PRB, probably caused by mineral precipitation and resulting in 0.88% porosity loss per year, no noticeable deterioration of the barrier’s performance was observed between March 2000, and August 2003. Instead, climatic variation in the barrier’s performance on CAH dechlorination was examined. The dechlorination rates in the cold season (January 2003 and March 2000) were generally smaller than those in the hot season (August 2003, September 2000, and September 2001). Besides, 1,2-dichloroethane and dichloromethane, which were proven to be not treatable by
Fe0
, could also be removed with the PRB, thereby suggesting enhancement from
Fe0
adsorption or microbial degradation.
Fiber bundle microendoscopic imaging of colorectal tissue has shown promising results, for both qualitative and quantitative analysis. A quantitative image quality control and image feature ...extraction algorithm was previously designed for quantitative image feature analysis of proflavine-stained
colorectal tissue. We investigated fluorescein as an alternative topical stain. Images of
porcine, caprine, and human colorectal tissue were used to compare microendoscopic images of tissue topically stained with fluorescein and proflavine solutions. Fluorescein was shown to be comparable for automated crypt detection, with an average crypt detection sensitivity exceeding 90% using a combination of three contrast limit pairs.
Background and aims: We previously demonstrated a significant colorectal neoplasia risk in inflammatory bowel disease (IBD) patients with mucosal changes indefinite for dysplasia (IND) and the ...potential diagnostic utility of p53 and cytokeratin 7 immunohistochemistry in IBD-associated neoplasia. The primary aim of this exploratory study was to determine the predictive value of the two markers for neoplasia risk in the IBD-IND population.
Methods: We identified 44 eligible cases with IBD and IND in colon biopsy from our pathology database. We semi-quantified the expression of p53 and cytokeratin 7 in the colon biopsies by immunohistochemistry and correlated their expression, demographic information, and clinical features with colorectal neoplasia outcome.
Results: The mean age of the cohort was 46.6 ± 15.1 years, with 25 (56.8%) being male. The median follow-up was 101 months (range: 6–247) after IND diagnosis. Among these 44 patients, 11 (25%) progressed to neoplasia (low-grade dysplasia = 6; high-grade dysplasia = 2; cancer 3) at a median follow-up of 66 months (range: 19–145). Univariate analysis demonstrated that age and p53 overexpression were associated with progression to neoplasia.
Conclusions: Twenty-five percent of patients with IBD and IND developed colorectal dysplasia or cancer. Overexpression of p53 and age are associated with neoplastic progression.
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