Purification capacity of a highly loaded laboratory scale tidal flow reed bed system with effluent recirculation

The purification capacity of a laboratory scale tidal flow reed bed system with final effluent recirculation at a ratio of 1:1 was investigated in this study. In particular, this four-stage reed bed system was highly loaded with strong agricultural wastewater. Under the hydraulic and organic loading rates as high as 0.43 m3/m2d and 1055 gCOD/m2d, respectively, the average removal efficiencies of COD, BOD5, SS, NH4-N and P were 77%, 78%, 66%, 62% and 38%. Even with the high loading rates, approximately 30% of NH4-N was converted into NO2-N and NO3-N from the mid-stage of the system where nitrification took place. The results suggest that the multi-stage reed bed system could be employed to treat strong wastewater under high loading, especially for the substantive mass removal of solids, organic matter and ammoniacal-nitrogen. Tidal flow combined with effluent recirculation is a favourable operation strategy to achieve this objective.

In vitro study of the efficacy of acrylic bone cement loaded with supplementary amounts of gentamicin: Effect on mechanical properties, antibiotic release, and biofilm formation

Background: Infection remains a severe complication following a total hip replacement. If infection is suspected when revision surgery is being performed, additional gentamicin is often added to the cement on an ad hoc basis in an attempt to reduce the risk of recurrent infection.

Methods and results: In this in vitro study, we determined the effect of incorporating additional gentamicin on the mechanical properties of cement. We also determined the degree of gentamicin release from cement, and also the extent to which biofilms of clinical Staphylococcus spp. isolates form on cement in vitro. When gentamicin was added to unloaded cement (1–4 g), there was a significant reduction in the mechanical performance of the loaded cements compared to unloaded cement. A significant increase in gentamicin release from the cement over 72 h was apparent, with the amount of gentamicin released increasing significantly with each additional 1 g of gentamicin added. When overt infection was modeled, the incorporation of additional gentamicin did result in an initial reduction in bacterial colonization, but this beneficial effect was no longer apparent by 72 h, with the clinical strains forming biofilms on the cements despite the release of high levels of gentamicin.

Interpretation: Our findings indicate that the addition of large amounts of gentamicin to cement is unlikely to eradicate bacteria present as a result of an overt infection of an existing implant, and could result in failure of the prosthetic joint because of a reduction in mechanical performance of the bone cement.

Paracetamol-Loaded Poly(ε-caprolactone) Layered Silicate Nanocomposites

The work described in this paper demonstrates a combined novel approach to the preparation of drug loaded poly(e-caprolactone) layered silicate nanocomposites using hot melt extrusion, a continuous process in contrast to the normal batch type processing used to prepare polymeric drug delivery systems, and most significantly the use of high surface area, large aspect ratio inorganic nanoplatelets to retard drug release. The methodology and results described in this article are significant and could equally be applied to the controlled/retarded release of any bio-active molecule (pharmaceutical, nutraceutical, protein, DNA/iRNA, anti-microbial, anti-coagulant, etc.) from biopolymers and the production of medical devices from such composite materials.

Clinical and immunohistochemical assessment of vulval intraepithelial neoplasia following photodynamic therapy using a novel bioadhesive patch-type system loaded with 5-aminolevulinic acid

Background: The work in this study appraised photodynamic treatment (PDT) as a treatment method for vulval intraepithelial neoplasia (VIN) using a novel bioadhesive patch to deliver aminolevulinic acid. An analysis of changes in expression of apoptotic and cell cycle proteins (p53, p21, Mdm2, Blc-2, Bax, Ki-67) in response to PDT was evaluated. Methods: PDT was performed using non-laser light, either as a one or two-cycle treatment, with clinical and pathological assessment following after 6 weeks. Twenty-three patients with 25 VIN lesions underwent 49 cycles of PDT Patches were designed to conform to uneven vulval skin and contained 38 mg cm(-2) aminolevulinic acid. Assessment was carried out at 6 weeks post-treatment. Patient-based treatment assessment, along with clinical and pathological changes, were monitored. Immunohistochemical staining was used to elucidate a possible biomolecular basis for induced cellular changes. Results: Most patients (52%) reported a symptomatic response, with normal pathology restored in 38% of lesions. The patch was easy to apply and remove, causing minimal discomfort. Fluorescence inspection confirmed protoporphyrin accumulation. Pain during implementation of PDT was problematic, necessitating some form of local analgesia. Changes in expression of cell cycle and apoptotic-related proteins suggested involvement of apoptotic pathways. Down regulation of p21 and inverse changes in Bcl-2 and Bax were key findings. Conclusion: Treatment of VIN lesions using a novel bioadhesive patch induced changes in cell cycle and apoptotic proteins in response to PDT with possible utilisation of apoptotic pathways. The efficacy of PDT in treating VIN could be improved by a better understanding of these apoptotic mechanisms, the influence of factors, such as HPV status, and of the need for effective pain management.