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Il presente lavoro mostra le prestazioni del Ground Penetrating Radar (GPR) ultradeep “Loza 2N” di ultima generazione (Voronin et al., 2015) nello studio di faglie sepolte. Questa particolare e innovativa tecnica di prospezione Georadar offre diversi vantaggi rispetto alle tecniche GPR classiche. Attraverso antenne a bassa frequenza (10 MHz), come quelle di cui è dotato il Loza, è possibile eseguire analisi stratigrafiche profonde fino a circa 400 m, differentemente dagli altri GPR che riescono ad indagare, in condizioni ottimali fino ad un massimo di circa 30 m di profondità. Ciò grazie agli ultimi sviluppi del ricevitore del Loza eseguiti da R. Tengler (del Vniismi Institut), con time windows fino a 512000 nsec, scan rate fino a 1000/sec e stacking fino a 100 tracce/sec. Con il GPR Loza è possibile, pertanto, individuare contatti stratigrafici, superfici di falda, faglie e sistemi di fratture di grossa entità in profondità (Reznikov et al., 2003). Un altro vantaggio di questa tecnica, rispetto anche ad altre tecniche geofisiche di prospezione, è che essa fornisce i risultati in tempo reale ed è possibile ottenere delle sezioni del sottosuolo del tutto comparabili con quelle derivanti da altri metodi (come la sismica a riflessione), che però richiedono costi e tempi di acquisizione ed elaborazione di gran lunga superiori. L’unico limite nell’utilizzo dello strumento è l’impossibilità di impiegarlo al di sotto del pelo dell’acqua. Le performance dello strumento vengono, in questo lavoro, illustrate per lo studio delle strutture dell’area di interesse sismotettonico posta in località “Il Lago” (Isernia).

Otitis media secretive is one of the most common ear diseases characterized by frequent sequelae and complications; in particular the authors describe middle ear atelectasis with pocket retraction of tympanic membrane, pocket retraction limited to pars tensa or to pars flaccida, adhesive otitis media, partial or total myringosclerosis and tympanosclerosis. For each disease the Authors comment the best surgical approaches to preserve and restore conductive hearing loss. As for middle ear atelectasis, adhesive otitis media, myringosclerosis and partial tympanosclerosis it was evidenced a significant hearing gain while in total tympanosclerosis there was an initial hearing improvement in a short follow-up even if there are no good long-term results. According to literature data and due to bad long-term hearing results the authors advise against surgical approach to middle ear tympanosclerosis.

L’iperplasia angiolinfoide con eosinofilia (ALHE) è una rara malattia benigna ad eziologia poco chiara, anche se la malattia viene considerata dalla maggior parte degli autori un processo reattivo o di natura vascolare amartomatosa. Colpisce con leggera prevalenza il sesso femminile tra la III e la V decade ed è caratterizzata da lesioni papulose e nodulari con sede elettiva al capo, al collo e al condotto uditivo esterno, senza linfadenopatia e con lieve eosinofilia periferica. Dal punto di vista istologico è presente una proliferazione vascolare dermica e/o ipodermica accompagnata da un infiltrato in gran parte costituito da linfociti, istiociti ed eosinofili. Gli autori descrivono un caso di una paziente di 44 anni che presentava una neoformazione vascolare che interessava il terzo esterno della parete posteriore del condotto uditivo di sinistra e che si continuava con un’altra formazione di consistenza molle elastica, ricoperta da cute roseo-violacea che occupava la regione mastoidea della lunghezza di 2,5 cm x 2 cm. L’audiometria mostrava una modesta ipoacusia di tipo misto a sinistra ed una normoacusia destra. E’ stata eseguita una angio-RMN del capo, che ha messo in evidenza una neoformazione vascolarizzata da due arterie provenienti dalla carotide esterna; la neoformazione proveniente dalla regione mastoidea di sinistra, passando sotto il pavimento del condotto uditivo esterno, si estendeva fino al prolungamento faringeo della parotide, comprimendo la giugulare interna con conseguente stasi del seno sigmoideo. La neoformazione veniva asportata in blocco e l’esame istologico era tipico per ALHE. Il follow-up ad uno e due anni non mostrava recidive. Nel Dicembre 2010 si presentava alla nostra osservazione per la comparsa di una lesione angiomatosa alla radice dell’elice del padiglione auricolare di sinistra, che veniva asportata e che era compatibile per ALHE. Si discutono l’eziopatogenesi ed i rapporti con la malattia di Kimura, che viene considerata un’entità clinico-istologica separata dall’ALHE.

La crisi che ha colpito tutte le aree del Paese non ha risparmiato il Mezzogiorno le cui difficoltà rischiano di risultare aggravate dalla crisi internazionale.

OBIETTIVI Le indicazioni per una tecnica aperta sono in primo luogo le otomastoiditi colesteatomatose, le neoplasie, alcune complicanze ed alcune forme di otomastoidite granulomatosa diffusa con totale coinvolgimento della catena ossiculare, specialmente quando esiste una mastoide eburmnea. MATERIALI Nel periodo 1975‐2006 sono state eseguite 4875 timpanoplastiche, di cui 3343 con tecnica aperta. In considerazione dell'esperienza maturata è utile distinguere un periodo compreso tra il 1975 e 1990, nel quale, indipendentemente dalla diagnosi, si eseguiva la tecnica chiusa nel 95% dei casi, mentre la tecnica aperta era riservata al 5% dei casi. Nell'85% delle tecniche chiuse veniva eseguito un secondo tempo a distanza di 8 mesi: nel 30% dei casi si trovava una recidiva del colesteatoma, per cui si passava ad una tecnica aperta. Per questi risultati si è deciso di invertire il nostro modo di operare ed abbiamo eseguito la tecnica aperta nel 90% delle otomastoiditi colesteatomatose. RIASSUNTO Abbiamo valutato i risultati a distanza di 4 anni trovando: ‐ recidiva del colesteatoma 5% ‐ risultati anatomici: buona conservazione del neotimpano 40%, perforazione del neotimpano 45%, totale riassorbimento del neotimpano 15%. ‐ risultati funzionali: abbiamo preso in considerazione l'indice GAP (la somma della perdita di udito preoperatoria per le frequenze 250,500,1000,2000 fratto la somma della perdita di udito postoperatoria per le stesse frequenze), nel quale l'indice > di 3 indica risultato ottimo, l'indice > di 2 indica risultato buono, l'indice < di 2 indica risultato insoddisfacente, l'indice < di 1 indica risultato peggiorativo. Nella nostra casistica abbiamo ottenuto GAP > di 3 nel 15% dei casi, GAP > di 2 nel 40%, GAP < di 2 nel 20%,GAP < di 1 nel 5%. CONCLUSIONI In conclusione la migliore visualizzazione della cavità mastoidea consente di prevenire la recidiva di colesteatoma; il paziente può fare il bagno al mare se la guarigione è ben consolidata. Dal punto di vista funzionale non esistono notevoli differenze tra tecnica chiusa e tecnica aperta ed oggi è possibile una corretta protesizzazione anche nei soggetti operati con tecnica aperta. Noi non eseguiamo una ricostruzione della cavità mastoidea prima dei 2 anni dal primo intervento.

English version We present a case of bulky schwannoma arising from the brachial plexus treated by a new surgical device. A 38-year-old man presented with a slow-growing left-sided supraclavicular mass and complained paresthesia of the third and forth fingers of the hand and forearm weakness. Physical examination revealed Tinel's sign. A CT-scan revealed a solid mass situated in the left profound supraclavicular fossa. The tumour was resected with the utilization of bipolar vessel sealing system (Ligasure Precise). This device is very useful in sutureless removal of masses localized in deep supraclavicular fossa. During the operation, care was taken to preserve the nerve function.

OBJECTIVE: We evaluated if interstitial laser photocoagulation (ILP) under ultrasound (US) guidance of intraparenchymal small HCC (

The authors evaluate the role of surgery in the treatment of primary adrenocortical cancer. They describe a case-report of a "giant" surrenalic cancer in a young woman affected by chronic hepatitis B related, submitted to "en bloc" surgical resection, locoregional lumphectomy and omolateral nefropexy. The adjuvant post-operative therapy consisted in six cicles of chemioterapy with Mitotane (op'DDD) at conventional dose. Postoperative course was unevenful and the patient was discharged after four days. Postoperative adjuvant therapy was well tolerated and after one year the patient is disease free. In Italy adrenocortical cancer represents about the 10% of adrenal neoplasms and causes a mortality--cancer related--about of 0.1% among all cancers. The incidence of relapse is about 25% after "en bloc" resection with 5 years survival of 54% in stage I-II, 21.4% in stage III, 6.5% in stage IV, respectively. The age < 40 years a functional activity of the mass, stage and resecability of neoplasm represent the most important prognostic factors. The use of mitotane in the postoperative adjuvant therapy is still controversry with variable results. Surgery represents the treatment of choice in case of primary adrenocortical cancer and is well indicated also for patients with advanced stage and recurrent loco-regional disease. The authors evaluate the role of surgery in the treatment of primary adrenocortical cancer. They describe a case-report of a "giant" surrenalic cancer in a young woman affected by chronic hepatatis B related, submitted to "en bloc" surgical resection, locoregional lumphectomy and omolateral nefropexy. The adjuvant post-operative therapy consisted in six cicles of chemioterapy with Mitotane (op'DDD) at conventional dose. Postoperative course was unevenful and the patient was discharged after four days. Postoperative adjuvant therapy was well tolereted and after one year the patient is disease free. In Italy adrenocortical cancer represents about the 10% of adrenal neoplasms and causes a mortality - cancer related - about of 0.1% among all cancers. The incidence of relapse is about 25% afier "en bloc" resection with 5 years survival of 54% in stage I-II, 21.4% in stage III, 6.5% in stage IV, respectively. The age

Cannabinoids modulate nitric oxide (NO) levels in cells of the central nervous system. Here we studied the effect of cannabinoid CB(1) and CB(2) receptor agonists on the release of NO and cell toxicity induced by the human immuno-deficiency virus-1 Tat protein (HIV-1 Tat) in rat glioma C6 cells. The CB(1) and CB(2) agonist WIN 55,212-2 inhibited the expression of inducible NO synthase (iNOS) and NO release caused by treatment of C6 cells with HIV-1 Tat and interferon-gamma (IFN-gamma). The effect of WIN 55,212-2 was uniquely due to CB(1) receptors, as shown by experiments carried out with selective CB(1) and CB(2) receptor agonists and antagonists. CB(1) receptor stimulation also inhibited HIV-1 Tat + IFN-gamma-induced and NO-mediated cell toxicity. Moreover, cell treatment with HIV-1 Tat + IFN-gamma induced a significant inhibition of CB(1), but not CB(2), receptor expression. This effect was mimicked by the NO donor GSNO, suggesting that the inhibition of CB(1) expression was due to HIV-1 Tat + IFN-gamma-induced NO overexpression. HIV-1 Tat + IFN-gamma treatment also induced a significant inhibition of the uptake of the endocannabinoid anandamide by C6 cells with no effect on anandamide hydrolysis. These findings show that the endocannabinoid system, through the modulation of the l-arginine/NO pathway, reduces HIV-1 Tat-induced cytotoxicity, and is itself regulated by HIV-1 Tat.

Many studies in the literature have confirmed the role of combined therapy in the treatment of rectal neoplasms. Aim of the Authors' study was to evaluate the efficacy of preoperative neoadjuvant radiochemotherapy in these patients. The study group consisted of 15 patients, affected by rectal adenocarcinoma T < 4 M0 with age < 75 years, observed from January to August 1998, who underwent to RT of pelvis with three fields--total dose 32 Gy- in ten days associated with 5 FU(500 mg/m2) during the first five. After restaging the patients were operated on. Anterior resections (AR) were followed by mechanical colorectal anastomosis in 10 patients, coloendoanal anastomosis in 4, while in 1 case an abdominoperineal resection (APR) was performed. The protocol was well tolerated in every patient and perioperative complications were similar to those in the control group. A considerable reduction of the mass was obtained in a great percentage of patients studied, confirmed by pathologic examination like "down staging" of cancer. In no case a complete response to the therapy was observed (pT0N0). Survival in the patients operated on for rectal adenocarcinoma in about 50% and local relapse is the most important site of recurrent disease. The aim of neoadjuvant protocol is the control of lymphatic spread and reduction rectal neoplasm allowing coloanal anastomosis in the treatment of the 1/3 inferior rectal cancer. Literature data confirm a significant decrease of local relapse, probably with a better survival. The Authors study confirms that combined preoperative therapy is well tolerated in most of the cases and it represents the protocol of choice in the patient affected by rectal cancer. Many studies in the literature have confirmed the role of combined therapy in the treatment of rectal neoplasms. Aim of the Authors' study was to evaluate the efficacy of preoperative neoadjuvant radiochemotherapy in these patients. The study group consisted of 15 patients, affected by rectal adenocarcinoma T < 4 M0 with age < 75 years, observed from January to August 1998, who underwent to RT of pelvis with three fields--total dose 32 Gy- in ten days associated with 5 FU(500 mg/m2) during the first five. After restaging the patients were operated on. Anterior resections (AR) were followed by mechanical colorectal anastomosis in 10 patients, coloendoanal anastomosis in 4, while in 1 case an abdominoperineal resection (APR) was performed. The protocol was well tolerated in every patient and perioperative complications were similar to those in the control group. A considerable reduction of the mass was obtained in a great percentage of patients studied, confirmed by pathologic examination like "down staging" of cancer. In no case a complete response to the therapy was observed (pT0N0). Survival in the patients operated on for rectal adenocarcinoma in about 50% and local relapse is the most important site of recurrent disease. The aim of neoadjuvant protocol is the control of lymphatic spread and reduction rectal neoplasm allowing coloanal anastomosis in the treatment of the 1/3 inferior rectal cancer. Literature data confirm a significant decrease of local relapse, probably with a better survival. The Authors study confirms that combined preoperative therapy is well tolerated in most of the cases and it represents the protocol of choice in the patient affected by rectal cancer.

Our study first objective is the evaluation of the attachment to partner and affective temperamental traits in alcohol addicted patients; the second objective is the evaluation of differences between alcohol addicted patients of type 1 and 2 according to Cloninger and Sullivan.The sample is composed of 40 adult patients with a alcohol addiction diagnosis enrolled at the Alcoholic Service of the Viterbo "Villa Rosa" Nursing Home. Patients have been submitted the semistructured interviews SCID I and SCID II and the self submitted TCI-R test. Furthermore they have completed the TEMPS-A (Temperament Evaluation Memphis, Pisa, Paris and San Diego) and the ECR (Experiences in Close Relationships).The attachment profile shows that 50% of patients have an insecure type of attachment so distributed: 25.5% of patients show a preoccupied type of attachment, 17.5% appear dismissing and 7.5% fearful. As for the affective temperament we observed a major frequency of elevated scores of Hyperthymic TEMPS-A (OR = 1.68; p0.01) compared to controls. At last type 2 compared to type 1 is characterized by a more elevated mid scores presence at the Avoiding dimension of Scale ECR.The alcohol addicted patients sample mainly show an attachment of insecure type and, with major frequency, a hyperthymic temperament. Moreover in type 2 patients there is a prevalence of the avoiding dimension in intimate relationships.

Rapporto di ricerca N°2010.11.23.0284, "“Ruolo del settore edilizio sul cambiamento climatico: Genius Loci "– Rapporto tecnico annuale sulle attività svolte e i risultati ottenuti (periodo di riferimento: 11 luglio 2009 – 11 luglio 2010)