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In this paper we present the geological effects induced by the 2012 Emilia seismic sequence in the Po Plain. Extensive liquefaction phenomena were observed over an area of ~ 1200 km2 following the 20 May, ML 5.9 and 29 May, ML 5.8 mainshocks; both occurred on about E–W trending, S dipping blind thrust faults. We collected the coseismic geological evidence through field and aerial surveys, reports from local people and Web-based survey. On the basis of their morphologic and structural characteristics, we grouped the 1362 effects surveyed into three main categories: liquefaction (485), fractures with liquefaction (768), and fractures (109). We show that the quite uneven distribution of liquefaction effects, which appear concentrated and aligned, is mostly controlled by the presence of paleo-riverbeds, out-flow channels and fans of the main rivers crossing the area; these terrains are characterised by the pervasive presence of sandy layers in the uppermost 5 m, a local feature that, along with the presence of a high water table, greatly favours liquefaction. We also find that the maximum distance of observed liquefaction from the earthquake epicentre is ~ 30 km, in agreement with the regional empirical relations available for the Italian Peninsula. Finally, we observe that the contour of the liquefaction observations has an elongated shape almost coinciding with the aftershock area, the InSAR deformation area, and the I ≥ 6 EMS area. This observation confirms the control of the earthquake source on the liquefaction distribution, and provides useful hints in the characterisation of the seismogenic source responsible for historical and pre-historical liquefactions.

The study of the health of a building connects humanistic and scientific research, and a complete characterization can be achieved by integrating all the available historical documentation, architectural and metrological studies, as well as laboratory and in situ analyses of the materials. A contactless, non-invasive surveying technique such as terrestrial laser scanning (TLS) allows the acquisition of dense and accurate geometric and radiometric (electromagnetic measurements such as signal intensity) information about the observed surface of the building, which can be easily integrated with data provided by high-resolution digital imaging. The early Christian Cantalovo church was surveyed for the first time in April 2011, by means of the ILRIS-3D ER very long range scanner. The second and last survey was performed in June 2012, after the main shocks of the Emilia earthquake seismic sequence. A very long range instrument is suitable for fast, simple and independent measurements, due to its technical characteristics and, for this reason, is easily usable for accurate surveying in emergency conditions. The main results are obtained by applying a data analysis strategy based on the creation of TLS-based morphological maps computed as point-to-primitive differences, which allow the creation of a deformation map and its evolution in time.

The aim of this article is to review the potentiality and reliability of the integrated usage of global positioning system (GPS), terrestrial laser scanner (TLS), and total station survey measurements in the geomorphologic studies. Test surveys based on these techniques were done in the area of “Tana della Volpe” blind valley and in the adjacent “Monticino” quarry, near Brisighella, Ravenna, Northern Apennines, Italy. Such sites are characterized by peculiar geomorphologic attributes such as the presence of slope, karst, and anthropic forms. We surveyed about 18,000 GPS points and about 42,200,000 TLS points in a total of 22 scans. The processing of the survey’s whole data set produced three distinct arrays of three-dimensional (3D) coordinates complemented by orthometric heights. Moreover, an integrated multistep procedure was implemented based on the following premises: (1) the removal of points not referred to the bare earth surface; (2) the combination of three coordinate sets into a single one referr...

Aim: Purpose of the study was to evaluate if the circumferential location of colorectal cancer may be identified as a possible prognostic factor. The hypothesis is that tumours located on the antimesenteric (AM) side could have a better prognosis than tumours located on the mesenteric (M) side. Methods: All patients undergoing curative resection for colorectal cancer were enrolled in the study. The specimens were sent to the pathologist to define the exact location of the tumour, the histological type, grading, T, N status as well as lymphatic, vascular and neural invasion, peritumoural lymphoid reaction, desmoplasia and microsatellite instability. Statistical analyses were performed using the test for proportions (with continuity correction), the Pearson Chi-square test and generalised linear models; p

A tectono-sedimentary scenario for the Southern Sardinia (Italy) Cenozoic graben system is proposed using field observations and the interpretation of onshore and offshore seismic profiles. The major structural events are tied to the general geodynamic evolution of the Western Central Mediterranean. Thus, the extensional late Oligocene–Aquitanian event is a consequence of an ‘Apenninic’ westward subduction process associated with a volcanic arc (29–30 to 15–16 My) which is particularly well exposed in Sardinia. Deposition of Sub-aerial clastics, was followed by transgression of the rift depression at the beginning of the Aquitanian. Subduction terminated at the opening of the oceanic Provencal Basin and the rotation of Sardinia–Corsica during Burdigalian time (20–21 to 15–16 My). The Messinian compressional event (NE–SW oriented), documented from microtectonic data, strongly affected the Oligo-Miocene basin. The superimposed Plio-Quaternary Campidano Graben, which is probably related to the formation of the Tyrrhenian Basin, contains more than 600 m of syntectonic deposits. A change in polarity of the master faults bounding the Oligo-Miocene rift created a central horst-type twist zone separating two depocenters in the Oristano and Cagliari regions. Emplacement of large volcanic bodies and inversion of the basin during the Messinian in Cagliari area has reduced the areas with potential for hydrocarbon exploration. The two remaining prospective zones are the Oristano sub-basin and the offshore, south of Cagliari where burial of lower Miocene marine organic matter may have been sufficient to generate hydrocarbons. Potential reservoirs could be pre-rift Mesozoic or Eocene strata but are mainly excellent Miocene sands derived from erosion of the granitic basement in tilted blocks.

Newly hatched specific pathogen-free chicks were dosed with a suspension of Bacillus subtilis spores prior to challenge with Escherichia coli O78:K80, a known virulent strain associated with avian colibacillosis, 24h later. A single oral inoculum of 2.5x10(8) spores was sufficient to suppress all aspects of E. coli O78:K80 infection. Colonisation of deep organs was reduced by a factor of over 2log(10) whilst colonisation of the intestine, as measured by direct caecal count, was reduced over 3log(10). Shedding of E. coli O78:K80 was measured by semi-quantitative cloacal swabbing and was reduced significantly for the duration of the experiment, 35 days. B. subtilis persisted in the intestine although with decreasing numbers over the same period. Challenge with the same dose 5 days after pre-dosing with spores overcame any suppressive effect of the spores.

Scientific investigations in Antarctica are, for many different reasons, a challenging and fascinating task. Measurements, observations and field operations must be carefully planned well in advance and the capacity of successfully meeting the goals of a scientific project is often related to the capacity of forecasting and anticipating the many different potential mishaps. In order to do that, experience and logistic support are crucial. On the scientific side, the team must be aware of its tasks and be prepared to carry out observations in a hostile environment: both technology and human resources have to be suitably selected, prepared, tested and trained. On the logistic side, nations, institutions and any other organisation involved in the expeditions must ensure the proper amount of competence and practical support. The history of modern Italian Antarctic expeditions dates back to the middle 80’s when the first infrastructures of “Mario Zucchelli Station”, formerly Terra Nova Bay Station, were settled at Terra Nova Bay, Northern Victoria Land. Only a few years later, the first geodetic infrastructures were planned and built. Italian geodetic facilities and activities were, ever since, being constantly maintained and developed. Nowadays, the most remarkable geodetic infrastructures are the permanent Global Positioning System (GPS) station (TNB1) installed at Mario Zucchelli and the GPS geodetic network Victoria Land Network for DEFormation control (VLNDEF) entirely deployed on an area extending between 71◦S and 76◦S and 160◦E and 170◦E. These facilities do not only allow carrying out utmost geodetic investigations but also posses interesting capacities on the international multidisciplinary scientific scenario. In order to fully exploit their potentiality, management and maintenance of the infrastructure are crucial; nevertheless, in order to perform high quality scientific research, these abilities must be coupled with the knowledge concerning a proper use and a correct processing of the information that these infrastructures can provide. This work focuses on the different methods that can be applied to process the observations that are performed with GPS technique in Northern Victoria Land, aiming at reaching the highest accuracy of results and assuring the larger significance and versatility of the processing outcomes. Three software were used for the analysis, namely: Bernese v.5.0, Gipsy/Oasis II and Gamit/Globk. The working data sets are: (i) the permanent GPS station TNB1 observations continuously performed since 1998 and (ii) the five episodic campaigns performed on the sites of VLNDEF. The two infrastructures can be regarded as neat examples of standard geodetic installation in Antarctica. Therefore, the technological solutions that were adopted and applied for establishing the GPS permanent station and the VLNDEF geodetic network as well as the data processing strategies and the data analysis procedures that were tested on their observation will be illustrated in detail. The results will be presented, compared and discussed. Furthermore, their potentials and role in geodetic research will be carefully described; their versatility will also be highlighted in the foreground of a multidisciplinary Antarctic international scientific activity.

Patients with lung metastasis from colorectal cancer (CRC) may benefit from surgical resection. Chest computed tomography (CT) is often included in the preoperative staging. Interpretation of the nature of pulmonary lesions is not always easy and many question its clinical value.Clinical data for all patients treated at our institution for CRC have been collected prospectively in a dedicated database. Since August 2008 chest CT has been routinely performed for preoperative staging. The outcome of 147 patients operated on since then (Group A) was compared with a numerically equal group of patients (147) (Group B) treated before the introduction of preoperative routine chest CT.Pulmonary lesions were identified in 45 (30%) patients in Group A and 10 (6.8%) in Group B. Ten and nine lesions, respectively, were interpreted as metastases. In 28 (19%) patients in Group A, the lesions were considered to be indeterminate and only four were confirmed as malignant. Overall metastases were present after 1 year of follow-up in 5 (50%) of 10 patients in Group A and 5 (55%) of 9 in Group B. The global incidence of synchronous and metachronous metastases was 6.8%, with no statistical difference between the two groups.This study shows that chest CT reveals a higher number of pulmonary lesions, only a small proportion of which were malignant. The investigation does not add value to routine staging methods in patients with CRC.

The main purpose of the Italian Society of Colorectal Surgery (SICCR) is to enhance the science and standard of care of patients with colorectal diseases in our Country. The Annual Report (AR) from the Coloproctology Units (UCP) affiliated to the Society was introduced in 1993 in order to monitor their activity and includes four sections covering the most important colo-rectal diseases and their different possibilities of care. From its introduction, it has been improved, being now more articulated and including not only simply the figures of surgical procedures but also alternative treatments, the ratio between observed and operated patients, the percentage of the most common complications (i.e. anastomotic dehiscence). The overall data are analysed and compared with those from the previous years, and results are presented at the annual UCP Club meeting, where co-ordinators of the UCP are requested to attend. This meeting, that is considered very important in the society-life, aims to favour discussion and comparison amongst UCP co-ordinators, to highlight possible differences amongst centres and to address possible issues of wrong practice. The goal is to recall the attention of the coordinators on the standard of the surgical management of their patients. In the same direction, debating at the conclusion of the 2011 UCP meeting, which was held last May in Venice, we thought that a judgment given by some international experts in colo-rectal surgery would have been beneficial. Pasquale Giordano was then asked to comment the Proctology section (condylomata, fissures, haemorrhoids and fistulae), Andrew Zbar commented the Functional Diseases section (megacolon, obstructed defecation, proctalgia, entero-rectocele, rectal prolapse), Steven Wexner the IBD section (ulcerative colitis, Crohn’s disease and also diverticular disease) and Francis Seow-Choen the Cancer section (anal cancer, colon and rectal carcinoma and polyps).

The aim of the study was to define risk factors for perineal wound complications after abdominoperineal resection (APR), with particular reference to preoperative radiotherapy.Patients undergoing APR at our institution between 1985 and 2009 were reviewed. Wound complications were classified according to the Center for Disease Control and Prevention classification of surgical site infection (SSI). Perineal complications were identified in patients who had preoperative long-course radiotherapy (Group 1) and those who had surgery alone (Group 2).One hundred and fifty-seven patients met the inclusion criteria. Preoperative radiotherapy was performed in 68 (44.7%) patients (Group 1), and 89 (65.3%) patients (Group 2) underwent surgery alone. The overall rate of perineal wound complications was 14.8%. The wound infection rate was similar in each group (Group 1, 10/68, 14.7%; Group 2, 13/89, 14.9%; P = 0.9). An elevated BMI (30) was the only factor correlated with perineal morbidity on univariate analysis (P = 0.01).Preoperative radiotherapy does not influence perineal healing other than in patients with obesity.

BACKGROUND: There is good evidence that radiotherapy is beneficial in advanced rectal cancer, but its application in Italy has not been investigated. METHODS: We conducted a nationwide survey among members of the Italian Society of Colo-Rectal Surgery (SICCR) on the use of radiation therapy for rectal cancer in the year 2005. Demographic, clinical and pathologic data were retrospectively collected with an online database. Italy was geographically divided into 3 regions: north, center and south which included the islands. Hospitals performing 30 or more surgeries per year were considered high volume. Factors related to radiotherapy delivery were identified with multivariate analysis. RESULTS: Of 108 centers, 44 (41%) responded to the audit. We collected data on 682 rectal cancer patients corresponding to 58% of rectal cancers operated by SICCR members in 2005. Radiotherapy was used in 307/682 (45.0%) patients. Preoperative radiotherapy was used in 236/682 (34.6%), postoperative radiotherapy in 71/682 (10.4%) cases and no radiotherapy in 375 (55.0%) cases. Of the 236 patients who underwent preoperative radiotherapy, only 24 (10.2%) received short-course radiotherapy, while 212 (89.8%) received long-course radiotherapy. Of the 339 stage II-III patients, 159 (47%) did not receive any radiotherapy. Radiotherapy was more frequently used in younger patients (P < 0.0001), in patients undergoing abdominoperineal resection (APR) (P < 0.01) and in the north and center of Italy (P < 0.001). Preoperative radiotherapy was more frequently used in younger patients (P < 0.001), in large volume centers (P < 0.05), in patients undergoing APR (P < 0.005) and in the north-center of Italy (P < 0.05). CONCLUSION: Our study first identified a treatment disparity among different geographic Italian regions. A more systematic audit is needed to confirm these results and plan adequate interventions.

Scientific investigations in Antarctica are, for many different reasons, a challenging and fascinating task. Measurements, observations and field operations must be carefully planned well in advance and the capacity of successfully meeting the goals of a scientific project is often related to the capacity of forecasting and anticipating the many different potential mishaps. In order to do that, experience and logistic support are crucial. On the scientific side, the team must be aware of its tasks and be prepared to carry out observations in a hostile environment: both technology and human resources have to be suitably selected, prepared, tested and trained. On the logistic side, nations, institutions and any other organisation involved in the expeditions must ensure the proper amount of competence and practical support.

Mechanical and thermo‐physical properties of composites materials with thermoplastic matrix (PEEK/IM7, TPI/IM7 and PPS/IM7) used for aerospace applications have been analyzed as function of two different process techniques: compression molding and fiber placement process “hot gas assisted.”

Preoperative chemoradiotherapy has demonstrated to improve resectability and local control in locally advanced rectal cancer (LARC). 5-fluorouracil (5FU) has traditionally been the drug of choice in combination with radiation therapy. Early studies of capecitabine (CAP) have shown its potential to replace 5FU. Between March 2002 and April 2005, 31 patients with newly diagnosed LARC (T2 N+ 2 cases, T3 N0-N+ 25 cases, T4 N0-N+ 4 cases) received the combined treatment. Surgery was planned 6-8 weeks after chemoradiation. Adjuvant chemotherapy with 5FU plus leucovorin for 6 courses was given in pN+ patients. All patients completed the planned treatment. Grade 3 acute toxicity was observed in 5 patients (16%). Nineteen patients (61%) had a downstaging. A complete pathological remission was observed in 3 cases (10%). Median follow-up is of 23 months (range; 6-36 months). The results of this experience confirm the data of the literature about the feasibility and efficacy of a neoadjuvant treatment with radiation and CAP in LARC.

The aim of this study was to define the role of endorectal ultrasound in the evaluation of transphincteric fistula-in-ano treated with a seton.Fifty-one patients affected by complex fistula-in-ano and treated with the application of a drain seton at the Second Unit of General Surgery of the University of Cagliari were recruited for the study. Clinical and ultrasonographic (US) evaluation, with transanal scans, were performed in each case before operation. Intraoperative demonstration of a transphincteric track was an indication for a partial fistulotomy with the application of a seton, tied up loosely around the external sphincter. If clinical and US evaluation, during follow-up, revealed a good drainage of the fistula by the seton and its superficialization, definitive fistulotomy was performed.Endoanal US had an 88.2% accuracy. Sclerosis around the seton was observed in 9 patients (17.6%); in other 9 cases a surgical toilette of the track was necessary because of the bad drainage carried out by the seton. Definitive fistulotomy was performed in 35 patients, whilst 16 are still bearer of the seton. After a mean follow-up of 39.5 months, 1 recurrence (2.9%) has occurred. Functional results were satisfactory: 55.9% of the patients has a perfect continence and 88.2% has a Wexner's incontinence score of up to 5.At skilled institutions, endoanal ultrasound allows to optimize the therapy of transphincteric fistula-in-ano treated with a seton and contribute to obtain good results in terms of recurrence and functional outcomes.

Spigelian hernia (SH) is a rare partial abdominal wall defect; its manifestation is rare. Seven cases were observed--4 females and 3 males with mean age of 56.5 years (range 38-65)--in 857 patients operated for hernia (0.8%) between 1995 and 2003. Ultrasound examination avoid the diagnosis and marked the fascial defect, measuring diameter and sac contents. In all cases a surgical approach with an epicritic incision has be done and the fascia defect closed with properitoneal and subfascial polypropylene mesh (Prolene Hernia System, PHS). All patients underwent to follow-up demonstrating no recurrences or complications like mesh suppuration or dislocation.

Pilonidal sinus is a considerable source of problems in young patients both in terms of discomfort and in time off to work. Many procedures have been proposed for its treatment but most of them present substantial persistence/recurrence rates. Surgical procedures avoiding a wound in the midline are most likely to succeed. Bascom's technique is the simplest and successful method. The aim of this study is to retrospectively evaluate the results of the Bascom's procedure performed by the authors as to healing time and recurrence rate. All patients with chronic pilonidal disease, treated with Bascom's technique were re-viewed. Complications, healing time and long-term follow-up were considered.A total of 74 patients (52 males, and 22 females), were admitted to the study. The mean age was 26 years; 69 had a small sinus with 1-2 tracks. Three patients (4%) had postoperative bleeding or wound infection. Mean healing time was 39 days but all patients were able to return to work within 1 week from the operation. The mean period of follow-up was 45 months. Six patients developed recurrence (9,2%). Only 3 of them, (because symptomatic) required a second operation.Bascom's technique is simple and suitable for one-day surgery with local anesthesia. It also gives favorable results as to return to work and rate of recurrence. Therefore, it is suggested as the procedure of choice in the initial treatment of symptomatic pilonidal disease.

To determine the results of elective surgical treatment for colo-rectal cancer in the elderly.A total of 746 patients were consequently operated on in elective conditions for colorectal cancer. Patients were divided into 4 groups, according to patient's age: Group Aor =80; Group B=70-79; Group C=60-69; Group Dor = 60.Between older patients there was a higher percentage of right colon cancers (A: 26.3%; B: 13.9%; C: 16.6%; D: 20.6%) and stage D tumors (A: 34.4%; B: 28.3%; C: 21.4%; D: 26%), explaining the greater proportion of palliative surgical treatment in this group of patients (A: 34.7%; B: 28.2%; C: 28.6%; D: 25.7%). There were no differences in term of morbidity (A: 12.6%; B: 9.2%; C: 5.1%; D: 6.4%), mean hospital stay (A: 18.9+/-16.2 days; B: 17.2+/-15.8; C: 15.2+/-8.6; D: 16.8+/-21.8) and postoperative mortality (A: 3.1%; B: 2.3%; C-D: 0.4%); on the contrary, survival curve in group A was significantly shorter than in the other groups.Advanced age is not per se a negative prognostic factor and consequently does not represent a contraindication to surgery. In fact, long-term results have been proved to be similar both in young and old patients. Nevertheless, elderly patients have a lower capacity to react to postoperative complications; this needs an accurate evaluation of single patient, considering different parameters such as disease stage, possibility of cure or palliation, quality and expectancy of life.

A prospective phase II study was conducted to evacuate toxicity and results of preoperative radiochemotherapy in locoregionally advanced rectal cancer (LARC). A total of 33 patients entered the study and received 45 Gy to the pelvis plus a supplemental boost of 5.4-9 Gy concurrently with 5 FU c.i. at a dose of 225-275 mg/m2. Thirty patients were operated after 5-7 weeks (20 anterior resection and 10 abdominoperineal excision). In 14 patients (47%) a downstaging was observed, 5 patients experienced a complete clearance of the primary tumor. After a median of 14 months (range, 5-27), 23 patients, are alive and well. And 8 patients experienced a disease progression (4 local-regional and 4 distant). Our results provide further evidence of the utility and effectiveness of preoperative radiochemotherapy in LARC.

It is well known that mucosal concentrations of many pro and anti-inflammatory cytokines are elevated in diseased segments of colon in Crohn's colitis. The present study, showing preliminary results, aims to determine whether the IL-1beta, IL-6 and IL-8 levels are increased throughout the entire colon in patients with Crohn's colitis.Five patients with active Crohn's colitis and five controls were studied by mucosal biopsies. In the diseased patients IL-1beta, IL-6 and IL-8 levels have been measured in both pathologic and normal appearing colonic mucosa. The concentration of these cytokines was assessed using ELISA and compared. Histological sections were also performed to confirm diseased segment of colon.The concentrations IL-1beta and IL-8 were much more higher in patients with Crohn's colitis when compared to controls. Moreover IL-1beta and IL-8 were more elevated in uninvolved colonic segments than on diseased segments.Our results confirm the finding of other authors that, although Crohn's colitis is a segmental disease, the concentration of IL-1beta and IL-8 in mucosal biopsies is increased throughout the entire colon. In particular our study shows that the concentrations of IL-1b and IL-8 is higher in uninvolved than involved colonic segments. These appearances favour the physio-pathologic hypothesis that Crohn's colitis involves the entire colon even when is not clinically or histologically apparent, and they suggest that uninvolved parts of colon may not be free of disease. Further studies are required to better understand the higher levels of cytokines found in macroscopically normal when compared to pathological mucosal in patients with Crohn's colitis.

The aim of the study was to evaluate the clinical relevance of isolated metastases (MII) in unusual sites (different from liver and lung), synchronous and metachronous, in patients operated on for colorectal carcinoma (CCR).The study was performed on 655 patients who underwent surgery for CCR during the period 1985-2000. Work out for distance metastases was performed (both during preoperative evaluation and follow-up) with physical examination and other few exams (CEA, chest X-ray, abdominal US scan). Other investigations were carried out if requested by clinical features. Metastases localized in sites different from liver and lungs were considered unusual.Metastases in unusual sites usually are observed in patients with terminal neoplastic disease. MII was found in only 7 (1.07%) patients, all submitted to resection of the primary tumor. Sites of unusual metastases were bones (3), CNS (2), adrenal gland and anus; such lesions were easily diagnosed by clinical features or by few examinations. Curative treatment was feasible in only three patients, and actually it did improve neither survival, nor quality of life.Extra-abdominal MII are rare, generally they cannot be treated; therefore particular tests for early diagnosis of such lesions appear useless. Potentially curative surgery for splenic and adrenal metastases is described in the literature; anyhow these lesions are usually shown by routine investigations.

We present the case of a 50-year old patient, operated on for three adjoining annular strictures in the jejunum with proximal dilatation. He presented with a one-year history of recurrent cramping in the upper abdomen and vomiting, with two episodes of intestinal obstruction. Microscopic examination of the stricture revealed, in the submucosa, disorganised fascicles of smooth muscle derived from the muscularis mucosae, bundles of non-myelinated nerve fibres with scattered abnormal ganglion cells and haemangiomatous vessels. The pathological findings observed were similar to those described as neuromuscular and vascular hamartoma, a rare stricturing condition of the small intestine. Many authors have questioned the hamartomatous nature of this disorder, since identical features may be seen in Crohn's disease, in ischaemic enteritis, in radiation enteritis and in non-steroidal antiinflammatory drug-induced small intestinal strictures. On the basis of a review of the 5 previously described cases and of our own experience, we believe that neuro muscular and vascular hamartoma of the small bowel should be considered as a distinct entity if histological hallmarks of Crohn's disease are absent, in patients with no history of gastrointestinal disease, or of chronic ingestion of non-steroidal antiinflammatory drugs.

Colonoscopic screening has been recommended in asymptomatic first-degree relatives of patients with colorectal cancer. In fact this population is believed to have an increased risk in developing colorectal neoplasia. The purpose of this study is to report the impact of colonoscopy in a series of completely asymptomatic first-degree relatives of patients operated on for colorectal cancer at our institution. A total of 480 individuals was requested to participate in a screening program based on faecal occult blood testing (FOBT) and colonoscopy in those with positive FOBT. Colonoscopy was also suggested to persons with negative FOBT. After the first 195 examined relatives, FOBT was abandoned because of continuously increasing acceptance of colonoscopy.Two hundred fifty four subjects (52.4%) accepted to participate at the screening program. After the first 195 examined relatives, FOBT was abandoned because of continuously increasing acceptance of colonoscopy. A total of 142 colonoscopies was performed. Colonoscopy was completed in 112 relatives (78.9%). Thirty-three subjects (23.2%) had a positive colonoscopy: one had invasive adenocarcinoma, one had large villous adenoma and 31 had 54 polyps. Twenty-three lesions (40.3%) were located proximal to the splenic flexure. Of the 54 polyps, 45 (83.3%) were less than 1 cm in size. These findings confirm the utility of colonoscopic screening in asymptomatic first-degree relatives of patients with colorectal cancer. However, its feasibility with the current endoscopic facilities remains an unsolved question.

Herniation of small bowel trough a defect of the broad ligament is an extremely rare event, more over in women never had surgical operations. Pathogenetic hypothesis are considered. Differential diagnosis may be difficult. The Authors report a recent observation of such small bowel herniation trough the left mesosalpynx.

Total large bowel evaluation remains an essential step in the treatment of patients with colorectal cancer (CRC). Colonoscopy is the gold standard in the evaluation of the colon for colorectal tumors, but may be incomplete due to tumor obstruction, which is a frequent event in distal cancers. Double-contrast barium enema has a lower accuracy and is not ideal in the presence of signs of obstruction. In theory, intraoperative colonoscopy is a valid alternative, but its routine use is impeded by various practical limitations. Preoperative survey of the colon in 521 consecutive patients treated for CRC in our department was based on colonoscopy (92.5%). Our series was characterised by a high percentage of distal lesions (76.4%) and therefore by a high percentage of incomplete preoperative colonoscopies (50.4%) due to tumor obstruction. In the presence of an incomplete preoperative colonoscopy, we evaluated the entire colon with a double-contrast barium enema in selected cases (36.7%) and with a postoperative colonoscopy within 3 months of surgery in almost all patients (93.4%). The overall rate of complete endoscopic evaluation, either pre- or postoperatively, was 96.7%. The incidence of adenomas was significantly higher in the preoperative examinations as compared to early postoperative colonoscopy. This means that in distal cancer the vast majority of polyps will be located in the distal colon and therefore included in a standard resection. Four patients (0.8%), required a second operation for treatment of a missed lesion (2 benign and 2 malignant). The need for a repeat surgery apparently did not affect the therapeutic results in these four patients. On the basis of our experience, intraoperative colonoscopy would not appear to be a mandatory procedure in all cases of incomplete preoperative evaluation of the colon. However, in the absence of prospective, randomised trials comparing intraoperative vs early postoperative colonoscopy, the dilemma as to the strategy of choice remains.

In this study, we present the results of the application of non-destructive acoustic techniques to analyse the state of preservation of a colonnade of an antient church in the central Sardinia (Italy) aimed at planning its restoration and preservation.

In May 1994 a first comparison campaign between a superconducting and the IMGC absolute gravimeter has been performed in Brasimone, near Bologna in Italy. The superconducting gravimeter was previously calibrated by means of a moving ring, the mass of which has been measured with the highest accuracy allowed by the actual technology. During the three days of observation with the absolute gravity meter, a maximum, a complete semidiurnal curve and a minimum of the tidal effect have been observed. These data have been used to compute the calibration factor of the superconducting gravity meter; it agrees in a rather satisfactory way with the results of the calibration with the moving mass.

An experience of surgical non-thoracic emergencies in patients admitted for chronic lung disease is herein presented. Fifty-four patients out of 10457 admitted in the four Departments of Pneumology of the Binaghi Hospital (Cagliari) between 1-1-1985 and 31-3-1993, were referred to our Department of General Surgery due to non-thoracic surgical emergencies. There was a considerable delay in the referral (only 25% of patients within 12 hours from the onset of symptoms): indeed predominant respiratory symptoms, hypoxia and hypercapnia made these patients no responsive to symptoms of surgical emergency. Surgical emergencies in causal correlation with respiratory disease (intestinal occlusion due to abdominal metastases of lung carcinoma, complicated peptic ulcer) had the worst prognosis (mortality: 52.9%). Those in chance connection, such as acute limb ischemia and preexisting abdominal disease, had a less adverse outcome. Mortality, however, was 37.5%: this datum outlines the role of chronic lung disease in defining operative risk. The authors call attention to three groups of observed patients: 1) three patients were operated on for intestinal occlusion due to unrecognized abdominal neoplasia, that showed itself in the course of hospitalization in the Department of Pneumology for lung metastases; 2) in 3 cases symptoms and signs of acute abdomen were observed without abdominal disease. The cause of acute pseudoabdomen was diaphragmatic pleural or basal pulmonary inflammation; 3) the eight patients with pulmonary embolism were all admitted in the Department of Pneumology with a wrong diagnosis of bronchopneumonia.

Two ideal lithologic sections representing a tidal bar system and a fluvial complex were drawn in order to run seismic modeling programs developed by OGS on behalf of the European Community. The simulations allowed an accurate analysis of the seismic expressions of the two sections. The tidal bar system is formed by a number of sandstone lenses interlayered with siltstone and mudstone deposits. These lenses meet together on an erosion surface, while they thin and vanish in the other direction. The fluvial complex is fonned by a limestone basement overlain by coarse alluvial plain sediments which in turn are transgressed by finer flood plain sediments, including sandstone lenses stacking towards the top in a meandering belt. These lithofacies associations represent potential multi-pool reservoirs in which the mudstone layers constitute the plugs. As a function of the granulometric and depositional features of each lithological unit, together with fluid content, wave velocities and densities were evaluated. A 2D modeling for elastic plane wave propagation in these hypothesized geologic sections was run on a Cray supercomputer. The numerical scheme is based on solving the full wave equation by pseudospectral methods.

The efficacy of two methods of orthograde lavage preparation in elective colorectal surgery was tested in 133 consecutive patients: the results obtained with whole gut irrigation (50 patients, group A) were compared with the results of oral lavage solution (83 patients, group B). All patients received a parenteral association of antibodies (clindamycin in combination with a broad spectrum antibiotic, mainly II or III generation cephalosporins). Bacterial cultures were carried out at the end of the lavage in the rectal effluent (no statistically significant differences between the two groups) and in the intraoperative aspirate from the colon (the bacterial concentration was higher in group B). The total number of infections was 12 (9%), with 6 (12%) in group A and 6 (7.2%) in group B. The infectious complications involved perineal wound in 9 cases (in 2 patients in combination with abdominal wound infection), abdominal drainage in 2 and abdominal wound in 1. The type of broad spectrum antibiotic did not affect the infection rate significantly. Perioperative and infection site bacteriological cultures grew the same type of organism only in one case. The surgeons' judgement of the adequacy of the cleansing favored whole gut irrigation, although the results of the study revealed that both methods were safe and provided equally adequate bowel cleansing.

The Authors report two cases of sub-peritoneal rupture of the duodenum following blunt abdominal trauma. The diagnostic difficulties are explained in detail. Emphasis is placed on the importance of prompt recognition of the duodenal injury and early surgical treatment to ensure a successful outcome.

A case of single splenic metastasis from large cell anaplastic carcinoma of the lung is described. The patient first underwent pulmonary lobectomy and then splenectomy. He is still alive 42 months after the first operation and 41 after the second. The case herein described is rather uncommon, due to the rarity of single splenic metastases, and the long survival of the patient. The latter point strongly suggests an aggressive surgical approach to single metastases, even if primary tumor has extremely poor prognosis.

In arteriosclerotic obstruction of the main tibial arteries, the tibial collateral vessels are usually patent, and about 70% of these arteries are potentially suitable for surgical revascularization. The present study aimed at investigating the practical feasibility of a selective revascularization procedure on these tibial muscular arteries (ultraperipheral revascularization). Six lower limbs amputated at thigh level for arteriosclerotic gangrene with complete obstruction of the main tibial arteries, were studied: the tibial collateral muscular vessels showed patency in 65% of cases. The authors propose a surgical technique for the revascularization of these peripheral vessels with the use of a vascular prosthesis. The "post-operative" angiographic studies showed that revascularization of these peripheral muscular arteries was possible.