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Pescara, Italy

Currently the therapeutic gold standard for medium and low rectal tumours is the "en-bloc" excision of the rectum and total mesorectal excision (TME) preserving the autonomous nerve plexus. In very distal tumours, complex procedures such as very low anterior resections and intersphincteric resections are used where possible. These procedures can avoid incapacitating operations such as abdominoperineal amputation. The possibilities to perform these procedures even by laparoscopic means, with regard to it's advantages, are still under evaluation. The authors describe their own clinical experiences using such methods. From 2005 to 2010, we performed by laparoscopic procedure 3 anterior resections and 3 inter-sphincteric resections for cancer of the low rectum . Medium age of patients was 70 years (range 52-80 years) and male to female ratio was 4/2. Mean operative time was 260 min ( range 220 - 360 min). No laparoscopic procedure was converted to the traditional open surgery. We noted 2 anastomotic leakages of which one required re-operation. Two patients were classified T2 (1 N0 and 1 N1); four patients T3 (3 N0 and 1 N2). In all the cases, resection margins were free. The mean distance from the anal verge was 3,8 cm (range 2,8 - 6 cm). In a mean followup of 48 months ( range 6-54 months), 1 patient developed hepatic metastasis and no local recurrence was noted. Two patients had urinary retention, resolved spontaneously. One patient presented erectile dysfunction. At 12 months from the operation, one patient had slight incontinence for gas and liquids. We believe that total mesorectal resection, even associated with sphincter preserving procedures, such as intersphincteric resection, in case of very low rectal tumours, can also be performed by laparoscopic approach with the same oncological and surgical principles of open surgery. However it is necessary to have broad based studies and randomised clinical trials in order to confirm the safety of such procedure and the results obtained.


Biasone A.,Valagro SpA | Cianci G.,Valagro SpA | Di Tommaso D.,Valagro SpA | Piaggesi A.,Valagro SpA | D'Alessandro N.,University Gdannunzio
Journal of Chromatography A | Year: 2013

Among the commercial ethylenediamine-N,N'-bis(2-hydroxy)phenylacetic acid/iron(III) derivatives, ethylenediamine-N,N'-bis(2-hydroxy-5-sulphophenylacetic) acid/iron(III) (EDDHSA/Fe) represents one of the promising chelates for the treatment of chlorotic plants. Industrial synthesis of EDDHSA/Fe leads to relevant amounts of o,o-EDDHSA condensation products (o,o-EDDHSAcps) and other secondary products that might have important relevance from the agronomic point of view. However, their chemical structures have remained unknown to date. Analysis of iron complexes by ion-pair reversed-phase chromatography, coupled with electrospray tandem mass spectrometry revealed the presence of the meso-o,o-EDDHSA/Fe, rac-o,o-EDDHSA/Fe, o,p-EDDHSA/Fe regioisomers, the hydroxyl derivative of o,o-EDDHSA/Fe, and the three main EDDHSA condensation products chelating the iron(III) (EDDHSAcps/nFe). However, the chromatographic peaks of EDDHSAcps/Fe are not well resolved due to the large numbers of stereoisomers and the poor efficiency of the ion-pair reversed-phase separation method. An alternative chromatographic method is based on porous graphitic carbon (PGC) separation after pre-column decomplexation of the chelates with trifluoracetic acid, which was developed to allow detection of EDDHSA stereo/regioisomers, EDDHSAcps, and low-molecular-weight by-products. This extensive PGC-HPLC-ESI-MS/MS investigation provides quantitative determination of meso-o,o-EDDHSA, rac-o,o-EDDHSA and o,p-EDDHSA, in addition to characterisation of EDDHSAcps and the low-molecular-weight by-products. PGC separation coupled to a triple quadrupole ESI-MS detector allowed characterisation of free ligands using collision-induced dissociation experiments in positive and negative ionisation mode, providing comparative evaluation of EDDHSAcps in three commercial samples. For detection, the PGC-HPLC-ESI-MS/MS is the best method according to the limit of quantification and limit of detection (picomolar and sub-picomolar detection, respectively) for determination of meso-EDDHSA and rac-o,o-EDDHSA. Synthesis, purification and quantification of o,o-EDDHSA and o,p-EDDHSA by 1H-nuclear magnetic resonance are also reported. © 2013 Elsevier B.V.


Sepe V.,University of Chieti Pescara | Spacone E.,University of Chieti Pescara | Verazzo C.,University Gdannunzio
COST ACTION C26: Urban Habitat Constructions under Catastrophic Events - Proceedings of the Final Conference | Year: 2010

This paper presents the early results of thework carried out by a group of researchers in support of the reconstruction efforts in the municipality of Poggio Picenze (near L'Aquila), where the April 6, 2009 L'Aquila earthquake severely damaged the historical center. The research group is interdisciplinary and includes structural engineers, architectural designers, city planners, architectural conservation experts, geologists and industrial designers. The main objectives of the proposed activities are to define reference guidelines for the conservation, rehabilitation, and safety enhancement of the built environment of the historical center of Poggio Picenze. These guidelines are the results of consultations with the regional reconstruction authorities, that supervise the postemergency activities in the L'Aquila region. Together with the local authorities, the reconstruction scenarios consider the gradual old town reopening within a more general scheme of social and economic revitalization of the town and the surrounding areas. The following pages present the results of the first year of work, that was basically spent gathering information regarding the town before the earthquake and the damage assessment primarily in the historical center. © 2010 Taylor & Francis Group, London.


Campli P.,University Gdannunzio
Leibniz International Proceedings in Informatics, LIPIcs | Year: 2011

In this paper a general framework (based on soft constraints) to model and solve the fair allocation problem is proposed. Our formal approach allows to model different allocation problems, ranging from goods and resources allocation to task and chore division. Soft constraints are employed to find a fair solution by respecting the agents's preferences; indeed these can be modeled in a natural fashion by using the Semiring-based framework for soft constraints. The fairness property is considered following an economical point of view, that is, taking into account the notions of envy-freeness (each player likes its allocation at least as much as those that the other players receive, so it does not envy anybody else) and efficiency (there is no other division better for everybody, or better for some players and not worse for the others).


Eboli M.,University Gdannunzio
Intelligent Systems Reference Library | Year: 2015

This contribution focuses on the methodology applied in papers that investigate the dynamics of contagion in financial networks using numerical simulations. In these papers, a propagation of losses and defaults in a financial system is modeled as a direct balance-sheet contagion (a.k.a. counterparty contagion), that is the direct transmission of losses from financially distressed debtors to their creditors. The researchers in this field perform their simulations with three different methods: (i) basic linear threshold algorithms, (ii) the graph-theoretic approach, where contagion is modeled as a propagation process in directed and weighted graphs, (iii) the lattice-theoretic approach, where contagion is modeled as a ‘fictitious default algorithm’, that computes the vector of payments that clears a net of financial obligations. Some of the results obtained by this stream of literature raised doubts about the assumptions used in such simulations. We discuss this issue and present some methodological recommendations that may improve the realism and the generality achievable in numerical investigations of financial contagion. © Springer International Publishing Switzerland 2015.

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