Evaluation of natural zeolite as microorganism support medium in nitrifying batch reactors: influence of zeolite particle size

An evaluation of natural zeolite as a microorganism carrier in nitrifying reactors operated in batch mode was carried out. Specifically, the influence of zeolite particle sizes of 0.5, 1.0 and 2.0 mm in diameter on microorganism adherence to zeolite, ammonium adsorption capacity and the identification of microbial populations were assessed. The greatest amount of total biomass adhered was observed for a zeolite particle size of 1 mm (0.289 g) which was achieved on the 12th day of operation. The highest ammonium adsorption capacity was observed for a zeolite particle size of 0.5 mm, which was 64% and 31% higher than that observed for particle sizes of 1.0 and 2.0 mm, respectively. The maximum de-sorption values were also found for a zeolite particle size of 0.5 mm, although when equilibrium was reached the ammonium concentrations were similar to those observed for a zeolite particle size of 1.0 mm. It was also found that the experimental data on ammonium adsorption fitted very well to the Freundlich isotherm for the three particle sizes studied. Finally, the nitrifying reactors showed similar microbial populations independently of the particle size used as microorganism carrier. The dominant bacterial community was Gammaproteobacteria making up 80% of the total population found. Betaproteobacteria were also identified and made up 12% approx. of the total population. Ammonium Oxidant Betaproteobacteria and Nitrobacter were also detected.

[Acadione, a new long-term treatment of rheumatoid polyarthritis]

This article summarizes the authors' experience and data from the literature regarding acadione, a medication like D-penicillamine with a thiol radical, in the treatment of rheumatoid arthritis. Two control studies versus placebo and two control trial versus D-penicillamine prove the effectiveness of the treatment and demonstrate a similar activity between 1 g of acadione and 600 mg of D-penicillamine. The side-effects of acadione are similar of those of D-penicillamine, essentially rash, toxic dermatitis, agueusia, proteinuria, which disappear upon discontinuation of the treatment. The fact that the patient exhibited a side effect with D-penicillamine, increases, the risk with acadione, but this is not systematic, which is the main advantage of this product.

Evaluation of a functional index and an articular index in ankylosing spondylitis

We describe an index of functional impairment and a system of scoring joint tenderness for use in the assessment of ankylosing spondylitis. The functional index consists of 20 questions and the articular index is based on the scoring of a total of 10 joint responses after movement or firm digital pressure. These indices are simple to establish and not time consuming. They have a high degree of intra- and interobserver reproducibility. The indices showed changes in short term clinical trials of antiinflammatory drugs; these changes were highly correlated with the patient's overall assessment of his own clinical condition.

Nonathymulin in rheumatoid arthritis: two double blind, placebo controlled trials

Two randomised double blind, placebo controlled trials have been carried out to assess the effectiveness of nonathymulin, a synthetic thymic peptide hormone, in the treatment of rheumatoid arthritis (RA) and to compare three different dosage schedules (1, 5, and 10 mg/day). Nonathymulin 5 mg proved to be the most efficient dose, providing significant clinical improvement as evaluated by the global assessment of all patients who entered the trials (56% v 17% in the placebo group) (p less than 0.02) and by four objective parameters. This effect was accompanied with minimal adverse effects and was not associated with clear changes in immunological parameters. A significant correlation was observed, however, in clinical response to nonathymulin, and T cell subset imbalance was assessed using monoclonal anti-T cell antibodies and a functional suppressor T cell assay.

Indexes of severity for osteoarthritis of the hip and knee. Validation--value in comparison with other assessment tests

The index for hip disease (ISH) was established, validated and appraised as a new assessment test for the trial of new drugs as well as for long-term follow-up of patients, and to help with future indications for surgery. The ISH deals with pain, maximum walking distance, and some activities of daily living. Inter-observer reproducibility is good (mean deviation 0.55 points; p less than 0.05). In a short-term, double-blind crossover trial, the ISH, judged according to its power to distinguish between the active drug period and the placebo period, appears as one of the best assessment tests. In the long term, total hip prosthesis is most often justified when the ISH score reaches 10-12 points. The index of severity for knee disease (ISK) was validated and appraised by the same statistical methods. Its value in non-steroidal anti-inflammatory drug (NSAID) or analgesic trials is lower than the value of the ISH. However, its use is still justified for that purpose, and for long-term follow-up of osteoarthritis of the knee.

[Tiopronine and rheumatoid polyarthritis]

This article summarises the authors' experience and the data of the literature concerning Tiopronine, a drug with a thiol function like D-penicillamine, in the treatment of rheumatoid arthritis. Two controlled trials versus placebo and two controlled trials versus D-penicillamine demonstrated the effectiveness of treatment and the identical action of 1 g of Tiopronine and 600 mg of D-penicillamine. The side effects of Tiopronine are very similar to those of D-penicillamine: essentially rash, toxiderma, aguestia, proteinuria, which resolve when treatment is stopped. Patients with a past history of side effects with D-penicillamine have an increased risk of developing side effects with Tiopronine, but this risk is not systematic, which constitutes the principal value of this drug.

Epithelial reattachment after gingivectomy in the rat

It is known that an epithelial reattachment occurs a few days after gingivectomy. Depending upon the surgical procedure and the animal species used, different times have been proposed to obtain a complete reattachment. Nevertheless, it is not known whether there is a correlation between the time required and the sequence of morphologic events involved in this process. To investigate this matter, gingivectomies were performed in the maxillary molars of rats. Specimens were taken 1 to 14 days after the operation and processed for light and electron microscopy. The new junctional epithelium appeared at the 5th day, but the earliest signs of reattachment complex formation were evident at the 8th day. Rudimentary hemidesmosomes and lamina lucida appeared in epithelial cells bordering remnants of fibrin. Anchoring filaments that formed between the earliest hemidesmosomes and the subjacent fibrin crossed the lamina lucida. Simultaneously, segments of lamina densa appeared. At the 11th day insertion of tonofilaments into the attachment plaques and insertion of anchoring filaments in the lamina densa were observed. At the 14th day, full development of the reattachment complex was evident.

Tiopronin (N-[2-mercaptopropionyl] glycin) in rheumatoid arthritis

Two controlled trials have demonstrated that tiopronin, a new sulfhydryl compound, is active as a slow-acting antirheumatic drug in rheumatoid arthritis. One trial compared 10 patients receiving placebos and 20 receiving tiopronin, 1 gm/day; the second compared two groups of 16 patients who received either placebos or tiopronin, 1.5 gm/day. In addition, 80 patients (56 from the 2 trials plus 24 other patients) were followed up for a long period. Dropout rate for intolerance or inefficacy was comparable to that fund with D-penicillamine. Secondary toxic reactions resembled those of other sulfhydryl compounds.

Autoantibody formation in D-penicillamine-treated rheumatoid arthritis

One hundred and two rheumatoid arthritis patients were tested before treatment for the presence of 16 autoantibodies. Low titers of antinuclear factors appeared, but there were no antitissue antibodies. At different intervals during the treatment of a 2nd series of 176 patients, elevations of antinuclear factors were observed that correlated slightly with either autoimmune or toxic side effects. Antitissue antibodies were seen only in pemphigus and myasthenia after the onset of these complications. The practical value of systematic evaluation for autoantibodies in penicillamine-treated rheumatoid patients is questionable.

[Tiopronine, new anti-rheumatic drug, has slow action in rheumatoid arthritis]

2 mercapto propionyl glycine (tiopronine) has, like D-penicillamine, a thiol radicle; it is a powerful chelating agent of heavy metals. This analogy suggests that it may be used in rheumatoid arthritis. A preliminary double blind study lasting four months comparing 1g./day in 20 patients and a placebo in 10 patients showed slight (non significant) efficacy concerning all parameters. An open study using 1.5 g. daily is being carried out in 32 patients, and we note a beneficial effect on the morning stiffness, the joint index, the functional index, the prehension strength, the E.S.R., and the joint swelling. The side effects are similar to those of D-penicillamine: loss of taste, proteinuria, mucous ulceration, which required stopping treatment. The therapeutic effect within 4 months and was maintained for 18 months in the 15 patients under treatment. A new double blind trial comparing placebo and tiopronine at a dose of 1.5 g. daily is in progress.

[The contour of the normal foot. A statistical study]

The authors, thanks to a statistical study on 292 young adults with healthy feet, have established the common occurrence, that has been suspected clinically, of the arched foot in the classical sense of the term. If one makes an exception of the black race where the flat foot is rather frequent, the white population normally has an arched foot (incipiens, of the 1st or 2nd degree) in 58.2 per cent of cases in men, which increases to 78.8 per cent in women. As for the classically " normal " foot which rather deserves the term " intermediary ", it is found in the white race in 1/3 of subjects.

[Evaluation of the long term effect of antirheumatic drugs with the survey rate method]

In the long term study of antirheumatic drugs, drop out of patients (for failure of effect or side effects) can analysed with "survey rate" methods. Survey rates become in drug tests "treatment continuation rates". With this method D-penicillamine and levamisole have been compared. Penicillamine has better "continuation rate" not because of better tolerance, but because of better long term effectiveness compared with levamisole.

[Therapeutic approach in the rehabilitation of chronic lower back pain. Comparative study of 3 techniques of lumbar reeducation]

The short-term therapeutic effect of 3 techniques of rehabilitation of the lumbar spine (cyphosis gymnastics, kinebalneotherapy and differenciated rehabilitation) was studied out of 87 chronic lumbalgias selected at random and using one of the three techniques administered by 3 physical therapists. A comparison of these 9 couples (technique, technician) was based on criteria evaluated on a blind basis using the traditional unidimensional analysis and also multidimensional analysis. The cyphosis gymnastic reeducation gives less satisfactory results using 26 criteria out of 27. There is an underlying physical therapy factor. A certain number of prognostic factors with implications for any rehabilitation method and for all of the techniques, were disclosed. The comparative testing methods used in the study of drugs are applicable to rehabilitation techniques. However, it was not possible to carry out a comparative study of a reeducation method with a reeducation placebo.

[Criteria for the evaluation of the antirheumatic (antiinflammatory) drugs in man]

Comparison of 5 antiinflammatory drugs and placebo in a double blind, short term, cross-over trial conducted in patients suffering from rheumatoid arthritis. 15 measurements were used and studied. With classical unidimensional statistical tests it was not possible to discriminate active drugs between them. Multidimensional analysis (correspondance analysis and discriminant analysis) are more sensitive and allow us to distinguish active drugs with only 11 criterion.

Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc

The findings are reported of a controlled clinical trial comparing in 66 rheumatoid arthritis patients 0 g (placebo), and 0.50 g a day and 1 g a day of penicillamine. Each of these groups has been subdivided into two, one part receiving 5 mg a day of zinc metal supplement, the other a placebo. The trial was planned to be double-blind, and for each patient to take part for 4 months. The results prove the effectiveness of penicillamine in rheumatoid arthritis. 0.50 g a day has the same effect as 1 g a day but gives less side effects. Zinc supplement inhibits the clinical effects of penicillamine but does not prevent the side effects.

[4 cases of osteomalacia during anticonvulsant or sedative treatment]

The authors report osteomalacia in 3 cases of epilepsy and one case of coronary heart disease treated with phenobarbitone, either alone or associated with other anticonvulsants. There were clinical signs in all cases and typical radiological signs in 3 cases, a characteristic laboratory syndrome in 4 cases. In the 3 cases where it was estimated, serum levels of parathormone were high. Finally, in 3 cases where it was measured, daily urinary excretion of glucaric D acid was increased. The bony histological signs studied in 3 cases, were similar to those in deficiency osteomalacia. A study of Ca45 metabolism in one case, showed the characteristic changes found in osteomalacia. Finally, a study of the metabolism of tritiated vitamin D, or tritiated 25 OH CC, carried out in 3 cases, gave 3 different patterns; only one of them was characteristic of enzyme induction under the dependency of anticonvulsant. Started in 2 cases, treatment with 125 OH2CC, brought about a rapid fall in blood PTH levels which then rose again before falling progressively in one case, under treatment with 25 OH CC. The bony histological signs of hyperparathyroidism then regressed whilst serum PTH levels remained high. Phosphorous and calcium balance improved in only one case. Treatment with 25 OH CC in high dosage brought about clinical, radiological and laboratory cure of osteomalacia in both cases, reducing the frequency of fits in the epileptic patient.

[Radiographic study of the hand in 50 cases of primary articular chondrocalcinosis. Comparison with a control series of 100 subjects]

The authors analysed radiograms of the hands of 50 patients suffering from primary articular chondrocalcinosis (ACC) and compared them with those of 100 control subjects of similar sex and age. There were 40 women and 10 men, with an average age of 69.6 years (plus or minus 9.82). A chalky incrustation of the semilunar pyramidal interspace was observed in 40 percent of cases. The frequency of this incrustation was next in order of importance to incrustation of the triangular ligament which occurred in 52 percent of cases. The difference from the controls was highly significant (p less than 0.001). Voluminous geodes affecting one or more of the bone of the wrist were present in 20 percent of the patients with ACC and in 5 percent of the controls. The difference was significant (p less than 0.01). Chalky deposits were found in the soft tissues immediately next to a metacarpo-phalangeal articulation in 22 percent of the ACC patients but not in any of the controls. The difference was highly significant (p less than 0.001). These chalky deposits next to metacarpo-phalangeal articulations were always associated with chalky incrustation of the radio-carpal joint. As regards the radiological lesions, considered as being typical images of arthrosis and affecting the trapezo-metacarpal, metacarpo-phalangeal, and interphalangeal articulations, the chondrocalcinosis patients appeared to be more frequently affected than the controls, but the difference was not significant. On the other hand, a type of arthropathy occurs in ACC patients which also resembles an arthrosis radiologically but which was 5 times more frequent in them than in the controls and which in this series occurred without nearby trapezo-metacarpal arthropathy only in ACC patients (16 percent as against 0 percent in the controls: p less than 0.001); this was scapho-trapezial arthropathy. The finding of this kind of radiological lesion, particularly when it is not associated with lesions in the trapezo-metacarpal articulations should indicate the possibility of a diagnosis of ACC and should lead to radiological investigation of other sites.