Characterization, management and treatment of wastewater from white wine production.

During a 16 months period, the characteristics of the wastewaters generated in a Rias Baixas winery (Spain) producing white wine were determined: The characterization study showed that white wine wastewater had an average CODt and TSS values of 7.3 and 5.2 kg/m3, respectively being the ratio wastewater/wine produced of about 1.6-2.0 L/L and the ratio between load pollution and produced wine of 9.7 kg(CODt)/m3(WINE). A strategy for the management of wastes and wastewaters allowed for an important reduction of a 55% of wastewater generation to be achieved. In order to select a suitable technology for the treatment of wastewaters two configurations were tested at pilot scale: i) An Anaerobic Filter (AF) of 430 L followed by an activated sludge unit of 510 L and: ii) one activated sludge unit of 510 L. The results showed that the anaerobic/aerobic configuration was more flexible as it adapted quickly to the different loads and flows produced during the different phases through the year. Besides it allowed higher COD removals (98.5-99.2%) to be achieved and proved to permit a quicker re-start up after starvation periods.

Rhinocerebral mucormycosis and internal carotid artery thrombosis in a previously healthy patient.

Mucormycosis is a very serious fungal infection caused by habitual saprophytes of the human organism, in many cases concomitant with various pathological conditions marked by immunodepression. The rhinocerebral variant habitually accompanies ketoacidotic diabetes. We report a case of rhinocerebral mucormycosis in a subject free from immunodepression and non-diabetic, in apparently normal health. Following treatment with amphotericin B combined with 5-fluorocytosine and surgery, remission of the disease was finally secured and about one year after the last operation there are no sign of resumption.

Diazepam binding inhibitor-like immunoreactivity (DBI-LI) in human CSF. Correlations with neurological disorders.

Cerebrospinal fluid (CSF) levels of the anxiogenic neuropeptide diazepam binding inhibitor (DBI) were determined by radioimmunoassay in 281 patients who underwent evaluation for neurological problems. Serial dilution curves and reverse-phase high pressure liquid chromatography showed that the immunoreactive material in CSF behaved just as authentic DBI extracted from human brain. Furthermore in the assay there was no evidence of interference from CSF samples deprived of DBI by immunoaffinity. In 82 patients with no evidence of major lesions in the central nervous system, who acted as controls, the CSF DBI content was shown to be age- and sex-related. No correlation was observed with the CSF protein concentration. In patients with different types of dementia, the levels of CSF DBI were significantly increased in a group with normal pressure hydrocephalus. No significant differences were found between Alzheimer's disease, multi-infarct dementia, or dementia with Parkinson's disease and controls. In non-demented patients with Parkinson's disease the levels of DBI were increased in a subgroup with depressive disturbances whereas no differences was observed in the non-depressed cases. The content of DBI was markedly reduced in 5 cases with olivopontocerebellar atrophy and in 4 with spinocerebellar ataxia. In all the other disorders studied the levels of DBI were similar to or slightly lower (multiple sclerosis) than those of the controls. The origin of DBI in cerebrospinal fluid is uncertain; a number of various possibilities are discussed concerning the proposed role of DBI as modulator of brain GABAergic transmission.

Perioperative changes in functional residual capacity in morbidly obese patients.

Functional residual capacity (FRC) was measured before and after induction of anaesthesia for jejunoileal bypass surgery in 30 morbidly obese patients. The onset of anaesthesia was associated with a 51% reduction in FRC from 2.2 litre to 1.0 litre. Eighteen of the patients were investigated more extensively; in these subjects FRC was reduced below the control values of residual volume (RV) with the onset of anaesthesia, but recovered towards baseline after laparotomy incision. Reduction in FRC is related to baseline vital capacity (VC) and FRC and is much greater than that reported for patients of normal weight.

Orthotopic transplantation of partially hepatectomized liver in the pig.

One of the major technical obstacles to liver transplantation in children is to find a liver of appropriate size because of the rarity of child donors. To overcome this difficulty an experimental study was carried out using only a portion of the donor liver (right liver) transplanted orthotopically in pigs. A group of 15 allotransplants were performed. A left hepatectomy of the liver graft was performed ex situ and the right liver amounted to 55% of the whole liver. A total of 13 animals survived for more than 5 days (5 to 30 days, with an average of 16). Upon killing, the liver weight was considerably more than that of the part transplanted. The absence of technical complications suggests that this procedure is safe and feasible.

A case of cortical blindness due to carbon monoxide poisoning.

We report a case of cortical blindness occurring 7 days after acute CO poisoning with no other neurological or psychic deficits apart from denial of the blindness with visual confabulation and slight loss of retentive memory. There was scant correlation between the course of the clinical pattern, which cleared completely within 6 days, and the electroencephalographic pattern with marked and diffuse slowing, which did not recede completely during 3 months observation. CT scanning of the skull, initially within normal limits, displayed 2 weeks later a faint but diffuse hypodensity of the white substance, more marked in the occipital region, which was no longer present 80 days after the first scan.

Veno-venous bypass without heparin in orthotopic liver allotransplantation in the pig.

It is now widely accepted that a veno-venous bypass is required to minimize the problems of the anhepatic phase in orthotopic liver transplantation. A technique that does not require systemic anticoagulation is needed to prevent damage by heparinization in hepatic patients. The use of heparin-bonded cannulas offers low risks of thromboembolic complication. Fourteen orthotopic liver transplantation were performed in pigs, including 7 with a roller pump and 7 with a centrifugal pump, without systemic anticoagulation and with heparin-bonded circuits except for the portal cannula, connectors, centrifugal pump head and the tract of the circuit on which the roller moves. All the circuits were previously utilized in clinical liver transplantation and repeatedly washed in saline solution and sterilized for each experiment. The haemodynamic control of the anhepatic state was excellent without hypotension and venous engorgement. In only one case a thromboembolic complication was noted. Arterial pressure, heart rate, urine flow, creatinine, arterial pH and thromboelastographic data did not change significantly while on bypass. No difference was found in the use of either a roller or a centrifugal pump even when the blood flow fell to less than 1000 ml/min to 500 ml/min.

Heterotopic liver allograft in acute hepatic failure in pigs.

Seven heterotopic liver allotransplantations were performed in pigs with total, acute hepatic necrosis, induced by arterial and portal vein devascularization. Six pigs survived for 4, 6, 7, 7, 23 and 90 days respectively. Good results can be obtained only with intensive perenteral postoperative support lasting the first three days. The viability of the graft is shown by the biochemical indices and the survival of the animals. These results confirm that a heterotopic liver transplantation provides a viable substitute when the host liver is affected by acute irreversible hepatic necrosis.

Primary dementias: epidemiological and sociomedical aspects.

An epidemiological survey of primary dementia syndromes was conducted in the city of Bra (26287 residents) in the Piedmont region. All the patients for whom a diagnosis of senile dementia had already been recorded together with the cases coming to light as a result of a questionary circulated to general practitioners and neuropsychiatrists were subjected to a broad battery of neuropsychological tests. The prevalence rate proved to be 255 (+/- 61) per 100 000 of the population and 2028 (+/- 476) per 100 000 of the over 65s. Close attention was paid to dements living in nursing facilities. Factors favoring institutionalisation were: advanced age, severe motor impairment and female sex. No correlation between severity or dementia and institutionalisation was found.

Prevalence of Eikenella corrodens in dental plaque.

The prevalence of Eikenella corrodens in dental plaque and saliva samples of 282 volunteers was determined by a semiquantitative method with a selective medium. E. corrodens was recovered in 58.9% of plaque samples and 0.3% of saliva samples. This prevalence rate was not significantly altered (P greater than 0.05) by variables of sex, race, smoking habits, clinic attended by the patient, general health status, or age; however, patients 7 to 14 years old had a significantly higher prevalence rate (90.5%; P less than 0.05). E. corrodens should be considered as a potential pathogen in infections associated with and wounds inoculated by the human gingival flora.

A pathologic study of malignant gliomas operated after radio- and chemotherapy.

Fifteen biopsies of malignant gliomas, treated before surgery by radio- and chemotherapy, have been studied. The aim of the study was to ascertain if the tissue changes, which have already been observed in autopsy samples and are related to the above mentioned treatments, occur also in biopsy samples. Even taking into due account the limitations imposed by the small number of cases, a positive correlation was found between macrophages, vessel degenerations, endothelial proliferations and radiation therapy as well as between monster cell increase and chemotherapy. These findings are consistent with those obtained with autopsy material and demonstrate that tumors after radio- and chemotherapy are more quiescent and contained.

Radio- and chemotherapy of malignant gliomas. Pathological changes in the normal nervous tissue.

The pathological effects of radio- and chemotherapy on the normal nervous tissue have been studied in 42 brains with malignant gliomas. The brains have been examined by means of the complete study technique. In seven cases the picture of delayed radionecrosis has been found. Apart from this, many histological features have been related to post-operative survival, radiation dose, interval between radiation and death, chemotherapy, steroids, size and activity of the tumour. Some alterations, such as peritumoural necroses, macrophage areas, vessel wall degenerations etc. result from radiotherapy. The relations and pathogenesis are discussed.

Tissue alterations induced by radio- and chemotherapy in brain with malignant gliomas.

35 brains with malignant gliomas treated by surgery, radiotherapy and chemotherapy and processed by means of the "complete study" technique have been studied. The preliminary results are reported. Many types of changes have been observed. Areas of coagulative necrosis with vessel alterations and teleangectasias are present around the tumor in many cases. Different pathologic aspects are observed distant from the tumor. Edema both in the homo - and contralateral hemisphere is constantly present. Severe edema with demyelination, axon disappearance and loss of cells is frequently found associated with prolonged survival. Often it is accompanied by wide or small areas filled with macrophages. Spongio-necrosis in the white matter of contralateral temporal lobe has been observed in two cases and telangiectasias areas have been found in another one. The relation between changes and treatment is discussed.

Hemodynamics and renal function during low frequency positive pressure ventilation with extracorporeal CO2 removal. A comparison with continuous positive pressure ventilation.

Six lambs were anesthetized and connected venovenous mode to a Membrane Lung for Extracorporeal CO2 removal. The animals underwent several hours periods of continuous positive pressure ventilation (CPPV), at 5 cmH2O positive end expiratory pressure (PEEP), alternated with several hours periods of low frequency positive pressure ventilation (5 cmH2O PEEP, 2 b.p.m.) with extracorporeal CO2 removal (LFPPV-ECCO2R). During LFPPV-ECCO2R compared with CPPV, cardiac output increased by 26%, pulmonary vascular resistances and systemic vascular resistances decreased by 28% and 22% respectively. The renal function improved significantly during LFPPV-ECCO2R compared with CPPV, i.e. urinary flow, creatinine clearance and osmolar clearance increased by 50%, 37% and 52% respectively. In these experiments LFPPV-ECCO2R, a form of completely artificial ventilation, seems to prevent hemodynamic and renal complications of CPPV.