Determination of sixteen polycyclic aromatic hydrocarbons in aqueous and solid samples from an Italian wastewater treatment plant

A robust procedure for the determination of 16 US EPA PAHs in both aqueous (e.g. wastewaters, industrial discharges, treated effluents) and solid samples (e.g. suspended solids and sludge) from a wastewater treatment plant (WWTP) is presented. Recovery experiments using different percentages of organic modifier, sorbents and eluting solvent mixtures were carried out in Milli-Q water (1000 mL) spiked with a mixture of the PAH analytes (100 ng/L of each analyte). The solid phase extraction (SPE) procedures applied to spiked waste water samples (1000 mL; 100 ng/L spiking level) permitted simultaneous recovery of all the 16PAHs with yields >70% (6-13% RSD). SPE clean up procedures applied to sewage and stabilized sludge extracts, showed percent recoveries in the range 73-92% (7-13% RSD) and 71-89% (7-12% RSD), respectively. The methods were used for the determination of PAHs in aqueous and solid samples from the WWTP of Fusina (Venice, Italy). Mean concentrations, as the sum of the 16PAHs in aqueous and suspended solid samples, were found to be approx. in the 1.12-4.62 microg/L range. Sewage and stabilized sludge samples contained mean PAH concentrations, as sum of 16 compounds, in the concentration range of 1.44-1.26 mg/kg, respectively. Extraction and clean up procedures for sludge samples were validated using EPA certified reference material IRM-104 (CRM No. 912). Instrumental analyses were performed by coupling HPLC with UV-diode array detection (UV-DAD) and fluorescence detection (FLD).

Semi-dry thermophilic anaerobic digestion of the organic fraction of municipal solid waste: focusing on the start-up phase

The paper concerns the results of a pilot-scale study of the simulation of the start-up phase of the thermophilic semi-dry anaerobic digestion of the organic fraction of municipal solid wastes. The aim of the study was to aid and shorten the start-up phase of the full-scale plant (500 t/d) in Verona--Ca' del Bue, where the semi-dry anaerobic digestion process is being used. The substrate used in the experimentation was the mechanically sorted organic fraction of municipal solid waste (MS-OFMSW) enriched with the putrescent fraction from the source sorted OFMSW in order to simulate the substrate which is dealt with in the Verona plant. The results of the pilot scale study agreed with literature data and previous work of the authors: it showed a specific gas production of 0.23 m3/kg TVSfeed and a gas production rate of 2.1 m3/m3 d when operating at a specific organic loading rate of 0.135 kgTVSfeed/kgTVSreacter d. No problems regarding process stability were encountered in the gradual acclimation of the biomass. The design organic loading rate of 9 kg TVSfeed/m3reactor d was reached in about 30 days, during which the total solids content in the feedwas increased. Only a partial comparison with the full scale start-up, which is now in progress, is possible: this shows an initial general concordance with the results found in previous work.

Combined oral therapy with sildenafil and doxazosin for the treatment of non-organic erectile dysfunction refractory to sildenafil monotherapy

The purpose of this work was to investigate the efficacy and safety of sildenafil in combination with doxazosin for the treatment of non-organic erectile dysfunction in patients who did not respond to sildenafil. We enrolled 28 patients with non-organic erectile dysfunction, for whom 3 months of sildenafil monotherapy had failed. They were divided in two random and homogeneous groups: 14 were treated with doxazosin (4 mg daily) and sildenafil (100 mg 1 h before sexual intercourse); the other 14 patients received sildenafil and placebo. The results were assessed by means of the IIEF questionnaire before the beginning of the study, after 30 days of therapy and after 60 days. Of the 14 patients treated with doxazosin and sildenafil, 11 (78.6%) showed a statistically significant increase of IIEF; in the placebo group, only one patient (7.1%) recorded a significant IIEF increase. The differences observed in the two groups were statistically very significant (P=0.0016). Blood pressure did not show significant alterations. Side effects were minimal and even present during sildenafil monotherapy. The combination therapy with sildenafil and doxazosin resulted in the safe and effective treatment of men with non-organic erectile dysfunction for whom sildenafil alone had failed.

Effect of donor ethnicity on kidney survival in different recipient pairs: an analysis of the OPTN/UNOS database

BACKGROUND

Previous multivariate analysis performed between April 1, 1994, and December 31, 2000 from the Organ Procurement Transplant Network/United Network for Organ Sharing (OPTN/UNOS) database has shown that kidneys from black donors were associated with lower graft survival. We compared graft and patient survival of different kidney donor-to-recipient ethnic combinations to see if this result still holds on a recent cohort of US kidney transplants.

METHODS

We included 72,495 recipients of deceased and living donor kidney alone transplants from 2001 to 2005. A multivariate Cox regression method was used to analyze the effect of donor-recipient ethnicity on graft and patient survival within 5 years of transplant, and to adjust for the effect of other donor, recipient, and transplant characteristics. Results are presented as hazard ratios (HR) with the 95% confidence limit (CL) and P values.

RESULTS

Adjusted HRs of donor-recipient patient survival were: white to white (1); and white to black (1.22; P = .001). Graft survival HRs were black to black (1.40; P <.001); black to white (1.35; P <.001); black to Hispanic (0.87; P = .18); and black to Asian (0.69; P =.05).

SUMMARY

Black donor kidneys are associated with significantly lower graft survival when transplanted into whites or blacks and are only associated with lower patient survival when these kidneys are transplanted into white recipients. The graft and patient survival rates for Asian and Latino/Hispanic recipients, however, were not affected by donor ethnicity. This analysis underscores the need for research to better understand the reasons for these disparities and how to improve the posttransplant graft survival rates of black kidney recipients.

Acidogenic fermentation of source separated mixtures of vegetables and fruits wasted from supermarkets

A pilot scale mesophilic anaerobic acidogenic fermenter was fed with mixtures of vegetables and fruits shredded by a hammer mill and mixed in a stock tank, in order to produce a liquid phase suitable as RBCOD source in denitrification and EBPR processes. Different operative conditions were studied working with a HRT in the range 1-12 days. The effluent coming from the fermenter was screw pressed, and the solid phase was recycled adopting different ratios to the fermenter, in order to define its effect on the final liquid phase composition. The variations of the VFA, lactate, methyl and ethyl alcohol concentrations, TCOD, SCOD and pH during more than one year were analysed and discussed both with reference to the fresh feed, and to the content of the fermenter. It was found that almost all the organic matter in the liquid phase inside the fermenter was represented by VFA (mainly acetate), lactate (in particular) and methyl and ethyl alcohols when HRT was longer than 6 days.

Arterial priapism and cycling: a new worrisome reality?

Arterial priapism is a rare condition caused by the traumatic formation of an arteriolacunar fistula. We report 2 cases of arterial priapism after cycling injuries. Both patients sustained a violent perineal trauma against the top tube on the bicycle. In both cases, penile detumescence was obtained by superselective arteriographic embolization of the fistula with gelatin sponge or microcoil. The fistula was monolateral in the first case and bilateral in the second. Cycling should be considered a possible risk factor for arterial priapism as it is for urethritis, prostatitis, hematuria, testicular torsion, scrotal and penile numbness, and erectile dysfunction.

Incidental splenectomy during left radical nephrectomy: reasons and ways to avoid it

INTRODUCTION

Left radical nephrectomy is the second most common cause of incidental splenectomy during transabdominal oncological surgery in the upper left quadrant of the abdomen. The potential sequelae of splenic ablation are often underestimated and generally no systematic planned efforts have been undertaken to avoid a splenic injury.

MATERIAL AND METHODS

We evaluated the incidence of iatrogenic splenectomy in 333 cases of left radical nephrectomy for renal cancer performed at our institute between 1970 and 1999. Two slightly different surgical techniques were adopted and after 1995 particular attention was paid to the possible causes of intraoperative splenic injury and how to avoid it. In the first group of patients (1970-1994) an anterolateral xipho-umbilical-subcostal approach was used, and in the second group (1995-1999) a cruciate "Mercedes-like" incision was always adopted.

RESULTS

The incidence of iatrogenic splenectomy in the first group of patients was 13.2%, and only 2.6% in the second group. The mortality rate in the first group of patients was 6%; no mortality has been recorded in the second group. Postoperative infections averaged 12.1% in the first group and 11.6% in the second, without any difference between the two groups. However, if we consider the incidence of postoperative infections in splenectomy cases, the incidence reaches 24.2% in the first group versus no cases in the second.

CONCLUSIONS

Incidental splenectomy is a potentially severe complication of transabdominal left radical nephrectomy and is often considered a price that has to be paid, particularly in cases of large tumoral masses. A more detailed knowledge of splenic anatomy, a critical consideration of the intraoperative factors that may lead to splenectomy, and the adoption of a surgical tactic borrowed from the techniques of liver transplant significantly lower the incidence of iatrogenic splenectomy.

Prospects of X-ray imaging spectrometers for impurity transport: Recent results from the stellarator Wendelstein 7-X (invited)

This paper reports on the design and the performance of the recently upgraded X-ray imaging spectrometer systems, X-ray imaging crystal spectrometer and high resolution X-ray imaging spectrometer, installed at the optimized stellarator Wendelstein 7-X. High resolution spectra of highly ionized, He-like Si, Ar, Ti, and Fe as well as H-like Ar have been observed. A cross comparison of ion and electron temperature profiles derived from a spectral fit and tomographic inversion of Ar and Fe spectra shows a reasonable match with both the spectrometers. The also measured impurity density profiles of Ar and Fe have peaked densities at radial positions that are in qualitative agreement with the expectations from the He-like impurity fractional abundances, given the measured temperature profiles. Repeated measurements of impurity decay times have been demonstrated with an accuracy of 1 ms via injection of non-recycling Ti, Fe, and Mo impurities using a laser blow-off system.

Visual representation of natural language scene descriptions

We are mainly interested in the development of CAD systems for interior design. An effective use of such systems relies to a large extent on the characteristics of their user interface. This paper describes NALIG, a system able to "understand" and "reason about" high level descriptions of spatial scenes. The user interacts with the system by using a natural language interface which, though very simple, is expressive enough to allow the description of complex configurations of objects. NALIG replies by drawing on the screen an image mirroring its own "understanding" of the scene described. The comprehension process has required the integration of different AI-techniques (e.g., natural language understanding, spatial reasoning, default and common sense reasoning).

The removal of pathogens in surface-flow constructed wetlands and its implications for water reuse

Microbiological quality represents the biggest concern to the reuse of treated wastewater. This paper reports and discusses the results of an international survey on the removal of indicators of microbiological contamination in surface-flow constructed wetlands. Constructed wetlands consistently provide a reduction of 90-99% (1-2 log-removal) in the concentration of indicators such as coliform bacteria and faecal streptococci. This removal is found in wetlands treating water from different types of pretreatment (primary sedimentation, activated sludge, trickling filter, maturation ponds). On the other hand, when the influent is of high microbiological quality, wetlands act as sources of pathogenic contamination. The final water quality, however, is still compatible with medium to no-contact recreational activities and other final water uses. High variability in the effluent quality and seasonality might limit the opportunities for reuse. The role of constructed wetlands in different treatment schemes and the remaining open questions concerning removal mechanisms and reference pathogens are discussed.

In situ wavelength calibration system for the X-ray Imaging Crystal Spectrometer (XICS) on W7-X

An in situ wavelength calibration system for the X-ray Imaging Crystal Spectrometer (XICS) on W7-X has been developed to provide routine calibration between plasma shots. XICS is able to determine plasma flow profiles by measuring the Doppler shift of x-ray line emission from highly charged impurity species. A novel design is described that uses an x-ray tube with a cadmium anode placed in front of the diffracting spherically bent crystal. This arrangement provides calibration lines over the full detector extent for both the Ar¹⁶⁺ and Ar¹⁷⁺/Fe²⁴⁺ spectrometer channels. This calibration system can provide a relative wavelength accuracy of 3 × 10^-7 Å across the full spatial extent of the detector, which corresponds to 50 m/s in the W7-X system. An absolute wavelength calibration of 1 × 10^-5 Å is expected, corresponding to 1 km/s, based on the current known accuracy of the calibration wavelength and the achievable measurement of the absolute positioning of the hardware. This calibration system can be used to independently calibrate XICS systems on both stellarators and tokamaks, without the need for special plasma conditions often used for calibration, such as locked modes on tokamaks. Experimental and simulated results are shown along with expected results, and the complete design of the calibration hardware that is to be installed in the W7-X XICS system.

[Transvestibular urethrolysis]

OBJECTIVE

Bladder outlet obstruction with obstructive and irritative urinary symptoms may be a complication of surgery for female urinary incontinence. In presence of persistent symptoms, the therapy is surgical and usually consists in an accurate urethrolysis. The way of approach is generally transvaginal. In this paper we propose and describe our experience with a transvestibular approach.

MATERIAL AND METHODS

18 women who had undergone anti-incontinence surgery (TVT 12 pts, TOT 3 pts, Burch retropubic colposuspension 3 pts) with obstruction and/or irritative symptoms underwent to a transvestibular urethrolysys. Five patients had urinary retention and the rest of patients had post voiding residual urine>100 ml. Using a scalpel blade a circum-meatal incision was performed and the urethra was progressively freed, dissecting just below the os pubis upwards and on the vaginal wall downwards, untethering it under direct vision in order to abtain a complete circular freeing of the urethra. In the end, the urethral meatus is repositioned with circular stiches.

RESULTS

The operation lasts between 20 and 40 minutes. An urethral catheter was left in place for 24-48 hours and no complications were observed. The post-voiding residual urine decreased in all of the cases and the irritative symptoms were reduced.

CONCLUSIONS

The transvestibular approach for urethrolysis is safe and effective regardless of the previous anti-incontinence surgery carried out. This procedure has the advantage of working in a relatively unscarred tissue, allows for a complete untethering of the urethra even in the retropubic space and leaves the vaginal wall intact.

Linfomi non Hodgkin ad Esordio Apparentemente Urologico: Presentazione di due Casi

We present the cases two patients with non-Hodgkin's lymphoma to illustrate the variety of urological problems that can occur in this group of malignancies. Most cases with urogenital involvement are in an advanced state of the disease and cannot be cured by operation alone. Surgery is most useful to obtain tissue for diagnosis and to preserve renal function while chemotherapy and or radiotherapy dissolves the tumour.

Surgery for Peyronie'S Disease: Comparison of Results

Many, varied techniques have been used over the years in the surgical treatment of Induratio Penis Plastica (IPP). From December 1994 to March 1998, 83 patients were operated for IPP and assessed with an average follow-up of 20 months (range 2–24). Results were analysed, the overall assessment taking into consideration not only the objective clinical finding by the doctor, but also the degree of satisfaction expressed by patients. The patients were given a subjective self-assessment test considering the pre and post-operative changes in the following parameters: rigidity, curvature, glandular sensitivity, length of penis and satisfaction with general result. Another doctor in the department (not the operator) clinically assessed the same parameters during follow-up. Results showed that the above parameters were more favourable in patients operated for plaque and incision of the same than in those who had undergone removal. The subjective version of almost all patients and the clinical follow-up assessment were, however, in disagreement with these results. Moreover, only 60% of patients reported that they were generally satisfied. The subjective and objective assessment by the patients and doctor respectively are not always in agreement, highlighting the fact that patient satisfaction is sometimes unrelated to the clinical evaluation of “success” of the surgical option. In IPP therapy, results for the patient would seem to be better when less aggressive surgery is carried out on the plaque as described, i.e. with minimum dissection of the anatomical structures of the penis.

Disease Progression in Bladder Cancer: Which Developments since 1994

Objectives

The introduction of PSA in clinical practice has resulted in decreasing the death rate form prostate cancer and in a downward shift of the pathological stage in radical prostatectomy specimens. This seems not to be the case for bladder cancer. In order to verify this assumption, we have reviewed the charts of the patients operated on of radical prostatectomy and radical cystectomy between 1994 and 2006.

Methods

456 and 491 consecutive patients, respectively, underwent radical cystectomy and radical prostatectomy with bilateral lymph nodes dissection. We excluded all the patients who had received neoadjuvant treatment or did not undergo node dissection. The patients were divided into two consecutive groups according to the year of treatment: group 1 included pts treated from 1994 to 2000, and group 2 pts from 2001 to 2006. The histopathological findings of the two groups of pts were compared. The difference among TNM systems has been balanced evaluating histopathological reports critically and converting them to the 2002 edition.

Results

For patients with prostate cancer, those in group 2 had a decrease in the incidence of extracapsular extension and lymph nodes invasion. The bladder cancer patients belonging to group 2 had a greater number of T2, but there was an increased number of pN+ in this group.

Conclusions

Even if there is a decline in locally advanced disease in patients with bladder cancer, our retrospective analysis did not show a comparable success in early diagnosis as it did for prostate cancer. There is undoubtedly an increase in the lymph node dissemination, whether this is due to a more extended lymph node dissection or to a premature dissemination remains questionable. Public awareness regarding bladder cancer and its risk factors is limited, but several studies have reported that a delay in diagnosis of invasive bladder cancer is an adverse prognostic factor. A higher care in the development of new diagnostic markers for bladder tumors and especially in the screening protocols together with an earlier radical therapy could hopefully improve the management of such a pathology, as it happened for prostate cancer.

Elettrovaporizzazione transuretrale della prostata: Risultati a un anno di distanza

Transurethral vaporisation of the prostate plays a leading role among the techniques for BPH treatment. Between April and December 1995 the authors treated 49 patients with BPH, all of whom benefited immediately. Assessment at the 12-month follow-up highlighted a reduction in IPSS to 7 and an increase in mean PFR to 23 ml/s. Complications were minimal. The immediate advantages of EVAP are widely acknowledged: little bleeding, absence of TUR syndrome, short catheter drainage, shorter hospitalisation and lower costs. The good PFR and IPSS values at 12 months confirm the effectiveness and safety of this technique, making it, in our opinion, even more interesting and less invasive for the surgical management of BPH.