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Apheresis therapies play an important role in the treatment of many pathologies, both as first-line and rescue therapies after drug failure or drug toxicity and, furthermore, when it is important to reach a therapeutic goal in a short time. Apheresis devices have evolved at an astounding rate over the last decades. Therapeutic apheresis are usually part of a treatment plan, so, a patient-centered approach to select the most appropriate treatment for each patient, balancing personal preferences, medication interferences and technological availability can significantly influence the choice of the protocol to be used. But, if the wide diversity of apheresis treatments may offer a tailored-patient approach, it can also create concerns on the right decision about the most appropriate protocol. Therapeutic apheresis - whose purpose is to cure diseases due to abnormality of blood cells or to toxicity of plasma substances - and, productive apheresis - whose purpose is to produce autologous or allogeneic therapeutic hemocomponents - are widely known as plasma-treatments and cytapheresis. The elementary techniques in apheresis are well represented by three physical separation methods of blood components: 1. differential centrifugation; 2. membrane filtration; 3. adsorption of proteins or cells, from whole blood or from plasma already separated. Starting from these three processes, several apheretic techniques have been developed to ensure, in expert hands, excellent therapeutic efficacy together with a low profile of adverse events., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

In 40% of patients with chronic hepatitis C, standard therapy is unable to eradicate the virus. Since the response to pharmacological treatment depends on the initial viral load, there is a rationale for reducing this load by means of apheretic depletion of the C virus. The aim of this work was to administer cascade filtration (CF) to non responder patients affected by hepatitis C (pts) before resuming the pharmacological treatment. 10 pts underwent 12 sessions of CF, 3 per week (treated plasma volume/session: 3000 mL). After the first week, therapy with PEG-IFN (1.5 ug/Kg/week) plus Ribavirin (1200 mg/day) was added. The viral load was determined before and after each CF session, and at the 1st, 3rd and 6th month. The mean pre-apheresis viral load dropped from 2176275+/-3109997 U/mL at the first session to 1486726+/-2091975 U/mL by the fourth (p<0.001), and 347500+/-637428 U/mL before the last (p<0.001). The mean percentage reduction of the viral load went from a minimum of 29.5% to a maximum of 42%. Early viral response (EVR) was obtained in 70% of these patients as compared with only 10% in an age- and sex-matched control group consisting of 10 patients. Unfortunately, we did not get the same good results in terms of sustained viral response (SVR: 10% in apheretic patients vs 0% in the control group). Efficacious removal of HCV was obtained with CF. However, the successful reduction in the viral load achieved with apheresis in terms of EVR was not confirmed when we considered the SVR.

Composting may present certain technical problems which can negatively influence results in terms of environmental impact as well as of profit and loss account. The aim of this study was to estimate the efficacy of the analytic approach to evaluate the effect of removing the biofilter in a composting system. Results have shown the presence of foul-smelling emissions despite the fact that concentrations of investigated substances were well below the danger threshold or even below the method's detection threshold. Therefore, besides the analytic approach, the most reasonable choice seems to be introducing a reference method for evaluating odour emissions and the efficacy of composting systems.

Among the atmospheric pollutants detectable in the environment, the inhalable airborne particulate (PM10) is regarded with increasing care. Indeed a number of epidemiological studies support the correlation between both acute and chronic adverse health effects and the PM10 pollution in the urban environment. According to recent results the health effects could be related to the physico-chemical characteristics of the particulate itself. With the aim of characterising the individual particles, PM10 samples collected by multi-stage cascade impactor are examined by scanning electron microscopy (SEM) and X-ray microanalysis with energy dispersion spectroscopy (EDS). The obtained data are analysed using multivariate statistical techniques (hierarchical clustering methods, principal factor analysis) to determine the components of the particulate. By these methods a series of studies was carried out by the Istituto Superiore di Sanità to investigate the PM10 pollution in several environmental situations.

The IARC has recently included crystalline silica among substances considered carcinogenic for man. This new evaluation immediately posed the need to measure the exposure levels of the general population. The paper reports the results of measurements of the concentrations of quartz (i.e., the most common form of crystalline silica) in a location in the urban area of Rome. First we studied the respirable fractions of the airborne particles (PM10) sampled in the Spring of 1996 with a cascade impactor, which were characterized using a scanning electron microscope equipped with an X-ray microprobe. Ten components were identified including total silica (crystalline and amorphous), which was present in a percentage of 3.7% on average. On the basis of these data a methodological study was undertaken of the concentration of quartz in the historic series of PM10 sampled daily at the same site by means of an AMP instrument (Airborne Particles Monitor). The filters of mixed cellulose esters on which the PM10 was collected were incinerated at low temperature in oxygen plasma to eliminate the organic component. The residue was deposited on silver filters which were read with a conventional X-ray diffractometer in order to determine the quantity of quartz. We analyzed 28 filters from four representative weeks of the four seasons of 1994, the year in which systematic sampling was initiated. The results showed a mean weekly concentration of airborne quartz of between 0.6 and 1.5 micrograms/Nmc, which gives a percentage over PM10 of 1.7 and 3.4 respectively. These data substantially agree with previous results obtained with electron microscopy and show that the levels of quartz in the urban atmosphere under study were about one hundred times lower than the TLV currently recommended by the ACGIH for working environments (100 micrograms/Nmc) and which are also in force in Italy.

Introduction: We applied the new technique of virtual endoscopy to the middle ear because this anatomical area is characterized by favorable contrast., Materials and Methods: CT examinations of the petrous bone were obtained using 1.5 mm thick 1 coronal axis slices, with 1 mm or 1.5 mm table feed, 120 kV, 140-170 mA and 2 s scan time. The images were reconstructed with the high resolution algorithm for bony structures and a small field of view (9.6 cm), separately for the right and left petrous bone. The images were then transferred on a workstation and processed with the Navigator virtual endoscopic software (General Electric). A threshold value ranging -350 to -600 HU was applied., Results: A series of images is acquired as the virtual endoscope moves from the external auditory canal to the middle ear cavity. Images of the anterior, medial, and posterior surfaces of the middle ear are presented. Different views of the ossicles are also presented. High quality images were always obtained for the middle ear structures, including the ossicles. CT endoscopy of the middle ear provides a new view of the anatomy of this complex area. It has some advantages and disadvantages; the former can be summarized as follows: -demonstration of areas which are difficult to show with endoscopy because of the presence of membrana tympani; -the virtual endoscope can be placed in several positions and therefore it can be inserted in all sites and tortuous places of anatomical cavity; -nice and effective demonstration of the ossicular chain including the stapes. The disadvantages are related to the fact that the endoscopic reconstruction (such as any other three-dimensional reconstruction) is a representation of surfaces where different densities are necessarily homogenized., Conclusions: CT virtual endoscopy of the middle ear can currently be considered a complementary technique to conventional CT because it permits better anatomical detailing of this complex region.

Reversible binding of pertechnetate (95mTcO-4) by human serum albumin (HSA) has been investigated by "wash-in" experiments, in the presence of a large excess of HSA. Equilibrium constants have been determined in the range of temperature between 5 and 37 C. Thermodynamic parameters of the process have been calculated. The marked influence of temperature on the association reaction should be taken into consideration when carrying out investigations on the metabolism of technetium in poikilotherms.

Authors studied red blood cell filtrability by means of an original apparatus. The red blood cells were suspended in 0,9% NaCl and Teitel solutions. Teitel solution was the most usefullness in filtrability studies.

Recent studies shown that patients receiving more than 20% of their total blood volume through 170 mu standard blood filters, may occur in severe organic damage such as pulmonary, cerebral, renal embolism due to microaggregates contained in stored blood. Microaggregate size varies from 10-200 mu; they are composed of platelets, leucocytes, red cells debris and fibrin strands, which take form few hours after blood storage begins and whose number progressively increases. In this study we analyzed microaggregate composition, factors causing their formation, side effects due to massive transfusion and blood filtration techniques capable to prevent a direct blood infusion. There is a variety of available filters, but screen filters seem to offer more important and practical advantages than depth filters do. The use fine pore filters is recommended when more than three blood units are to be infused during only one administration.

Erythrocyte deformability is one of the most important factors on determining blood viscosity. Many microcirculation damages are caused by alteration of viscosity. We propose a method for evaluate erythrocyte filtration using Nucleopore membranes, to study erythrocyte deformability. Normal ranges are calculated in young healthy subjects. Mean filtration time is determined on 5 filtrations for every subject. Filtration rate is expressed by sec/ml and correlated whit haematocrit. The method is not easily utilizable, but it can be useful in the knowledge of the role of the erythrocyte deformability in the altered microcirculation.

The main particles present in solutions for parenteral use are potentially harmful. Current industrial technologies are not yet capable of supplying products that are entirely free of corpusculated substances. In addition, the latter increase in direct proportion to the number of handlings that are carried out by hospital staff in the preparation of infusion treatments. Filters capable of cutting down the number of infused particles are suggested for application to defluxion devices. Three such filters currently available on the Italian market are examined. The filter with 0.45 mu diameter holes proved capable of minimising the amount for particles without provoking an appreciable interference with the defluxion times of the solutions used in the experiments.

The Author summarizes the basic routine procedure for blood cultures first examining different factors that can influence it (blood coagulation, antimicrobial agents, natural bacterial inhibitors of blood cell wall deficient bacteria) and then describing culture media, atmospheric conditions, incubation time, and modalities for inspection, staining of cultures and subcultures. Finally new rapid automated methods are briefly pointed out.