Aim. Distal bypass has been considered as a primary choice for the treatment of critical limb ischemia (CLI). When bypass failed with limb threatening ischemia, the amputation rate is high in patients with increased surgical risks and lack of conduit. Percutaneous transluminal angioplasty (PTA) has been shown to be effective and safe in the setting of CLI even in patients with failed bypass graft. The aim of this study was to review our experience and results of extreme endovascular revascularization in patients with CLI following occluded lower limb bypass graft.Methods. Retrospective review from January 2005 to June 2008 of patients with CLI following occluded bypass graft who underwent PTA was performed. All patients were studied by Duplex scanning and dual-energy computed tomographic angiography (DE-CTA) bone removal technique. Stents were used in cases of residual stenosis or dissection. Technical success was defined as a residual stenosis less than 30%. Demographics, comorbidities, functional status, details of the procedure information were recorded. Descriptive, logistic regression and life-table analyses performed.Results. Thirty-six patients with occluded bypass grafts were treated. The mean age was 69 years (range 56-89), 44% were older than 80 years, 83% had diabetes mellitus, 88% of limbs treated had multiple lesions included Tasc C and D lesions. Technical success was achieved in 91%. Mean follow-up was 24 months. At follow-up, there were 19 PTA failures which were followed by subsequent procedures: redo PTA in 16 limbs, redo bypass in 2, amputation in 5. Cumulative primary patency was 60% (+/- 0.08 SE) and 24% (+/- 0.07 SE). Secondary patency was 96% (+/- 0.03 SE) and 83% (+/- 0.08 SE). Limb salvage was 84% (+/- 0.06 SE) and 70% (+/- 0.10 SE). Freedom from surgical revision was 78% (+/- 0.07 SE) and 54% (+/- 0.11 SE). Overall survival was 89% (+/- 0.05 SE) and 58% (+/- 0.11 SE) at 12 and 24 months, respectively.Conclusion. Endovascular revascularization of patients with CLI and occluded bypass graft is a safe and feasible procedure with reasonable technical and clinical success and limb salvage. PTA may be the only alternative to amputation in these patients with extensive comorbidities and limited life expectancy. [Int Angiol 2012;31:163-8]

The observed travel-times of the P-waves for twenty shallow, intermediate, and deep earthquakes, with epicenters in the Mediterranean area, are used in order to analyze some characteristics of the upper mantle. A first- order discontinuity, identifiable as the "20° discontinuity", is found at a depth of 505 ± 16 km in the area underneath the Mediterranean basin. The velocity contrast is equal to 12% (above T'= 8.9 km/sec; below V= 9.97 km/sec). Assuming that this discontinuity gives rise to reflected P-waves (PdP), the travel times of these waves are calculated for various hypocentral depths. The observation of impulses identified as PdP on the seismograms of Messina supports this hypothesis. This result and its implications are discussed in the contest of the conclusions of various authors who locate a P-wave velocity-discontinuity at different depths between 400 and 580 km. Finally, particular emphasis is given to the regional character of the analyzed structures in question.

Starting from the analytic determination of the most important parameters of the Reggio Calabria earthquake, several geostructural hypotheses are analyzed and discussed. The statistical hvpocentre, calculated in two separate phases for (lie epicentral coordinates (q> = 38°04'28"; A = 15°38'55") and for the depth (h = 10.04 km), is consistent with an earlier macroseismic estimation. The travel times for the first arrivals, limited to the distance interval 0 ^ ¿1° ^ 12 can be approximated by means of the three linear equations: which can be interpreted as the travel-time curves of the direct (Pg) and refracted (Pn i , P„2) longitudinal waves. The existence of a focal mechanism, compatible with a couple + oppositely directed force model is deduced from a study of the signs of the first impulses. This model includes faulting and displacement with dislocation plane N 22"K and inclination of ~ 75° towards XI 12°E. Considering the focal location and our geostructural knowledge of the area involved, the Reggio Calabria earthquake can be explained by a process of tectonic distension due to the drift of the Calabrian Arc and to other reliable geostructural elements. The explanation is critically evaluated in relation to the tectonic forces involving the Strait of Messina and the volcanic zone of Etna.

The definition of some of the standards used for evaluating local effectsand optimizing the relative macroseismic procedures are criticallyconsidered, also from the different interpretative points of view to havecome out of the « Earthquake Catalogue » work group of the Italian GeodynamicsProjetc (PFG). Particular stress has been laid on the significanceand reliability of the main macroseismic parameters which dependmost directly on the investigative criteria used and on their ability tocharacterize efficiently the interaction of earthquakes and environment.Essentially, the analysis is of critical considerations and field-observations,the fruit of macroseismic investigations carried out prevalently inthe Calabro-Peloritan Arc region. The seismic intensity, the use of macroseismicscales, the investigatory criteria, the macroseismic field and its anomalies are the topics chosen for a study which — even if limited fromcertain aspects — it is hoped will stimulate further thought and evaluations.

The application of the statistical analysis to a series of microshocks originating in the Messina area allows to determine the level and the type of interdeDer.den.ee between those events. The investigation aims to identify an "occurrence model" compatible with the series in question, and shows the inadequacy of the simple Poisson process to describe the phenomenon observed; the series of events in question can, instead, be represented as a succession of periods of activity — conforming to a compound Poisson distribution — separated by intervals of seismic inactivity of varying duration. The results reported here seem very correlated with those from an analysis of the spatial distribution of the activity; moreover, they are of interest for comparison with the characteristics of other regions, and constitute data that can be used for a more complete characterization of the structures which originate the activity itself.

Most of the ancient town of Tindari (NE, Sicily) was settled on a plateau the most surficial layer of which was made of unconsolidated material. Ongoing excavations at the archaeological site at Tindari uncovered a large portion of the decumanus which suffered deformations preliminarily assigned to coseismic effects.

The archaeological site of Capo d’Orlando, located in NE Sicily was intensively inhabited during the Roman and Byzantine periods (3rd to the 7th century AD) during which a bath complex probably associated to a large villa extending seawards was built. Archaeoseismological research shows that during the Byzantine period (6th -7th century AD) this complex suffered damage: (1) collapse of the bath, (2) tilting of parallel dry masonry walls in the same direction, and (3) cracking of the floor in the bath. This damage might have been produced by a seismic event, where the level of destruction indicates a strong shaking. The historic record of earthquakes prior to the year 1000 AD is probably not complete. Actually, only four earthquakes are vaguely reported in the seismic literature for this time span. This lack of historical reports on seismic events does not necessarily mean that any earthquakes happened. Archaeoseismic data show that the island was not quiescent but on the contrary suffered several earthquakes. The analysis presented here, based on detailed site surveys, deals principally with seismic causes but it also takes into account other possible causes with regard to the observed damage.

Teleseismic and strong motion data are used to derive the source parameters of the September 9, 1998 Castelluccio earthquake (M5.6). Teleseismic body-wave modeling indicates normal faulting (Plane 1: strike = 328°, dip = 50°, rake = −75°; Plane 2: strike = 126°, dip = 42°, rake = −107°) along NW–SE striking planes. Both nodal planes of the computed focal mechanism are tested for their capability of reproducing the mainshock acceleration time histories at three strong motion stations. Synthetic accelerograms are estimated using the stochastic method for finite sources in combination with the H/V ratios technique for the incorporation of the site effect. Our preferred model, which provided the best fit between synthetic and observed waveforms and corresponding Fourier amplitude spectra, consists of a NE-dipping normal fault with dimensions 8 × 7 km. The rupture nucleation point, which is assumed to coincide with the hypocenter location, was confined to the southeasternmost, deepest part of the fault. Our results are in good agreement with the so far released information regarding the aftershock sequence of the examined event, as well as the general seismotectonic knowledge on the broader epicentral area.

The results of geological and geomorphologic surveys on the salt marsh of Ganzirri (Pantano Grande), combined with geophysical researches and historiographical data, are reported here to define the genesis of the marsh and to evaluate the physical factors that influenced its recent evolution. The genesis of the Pantano Grande may be due to a state of equilibrium reached between differential lowering of the coastal plain, confined by normal faults, and generalized chain uplift. In particular, two normal faults are considered: the first borders the northern shore of the Pantano Grande, and the second bounds the Ionian coastal plain towards the south. Concerning the recent evolution of the Pantano Grande the importance of the sterile conglomerate outcrop, which borders the Ganzirri coastal plain, is stressed. The conglomerate is interposed between sediments that define the Pantano Grande basin, and the Ionian Sea, and influenced the water exchange between the marsh and the sea. Before the excavation of two canals that link up the Pantano Grande with the sea, the conglomerate, limiting the spread of benthic species, has definitively affected the ecological structure of the original marsh.

The anisotropic modelling of intensity distribution, affected by the construction of macroseismic planes, allows an analysis of the influence of each point of observed intensity on the analytical determination of epicenter and of the principal attenuation directions. Such a procedure is a vital aid in the cases in which the observed intensity points, that, for location or joined intensity level, are not consistent with an anisotropic model of intensity attenuation. A suitable filtering on intensity levels associated with the points of the intensity map, for a better modelling of observed intensity distribution, is proposed with the aim of a better seismic hazard evaluation.

A methodology of urban and territorial vulnerability analysis related both to engineering studies and social priority levels is presented. Modelling an urban system as a set of elements and relations, the evaluation of seismic vulnerability is carried out through suitable functions that characterize the seismic reliability of the site in terms of the geotechnical reliability of the ground and a structural reliability of buildings regarding the importance of activities referable to each element of the system. The results of the study, represented in map form, allow a full characterization of the distribution of urban and territorial vulnerability aimed at a seismic risk mitigation.

The Author's report the case of the simple form of Caroli's disease, a rare malformation, and review literature pointing out the difficulty of an early diagnosis, because disease can be silent for a long time too and it is identified for complication. Today, imaging, endoscopy and interventionist radiology are the most valid tools for a correct diagnosis and treatment, above all in a case of emergency, when other therapeutic solutions are not possible.

125.5 m B025 Analysis of the dynamic response of the archaeological site of Tindari (NE Sicily) Abstract 1 The first results of the dynamic modelling of the ground of the archaeological site of Tindari are presented with the aim of explaining the coseismic deformations recently discovered along the decumanus floor. Dynamic modelling of the site The phenomenon of amplification of the seismic waves between the bedrock and the top of the Tindari promontory where the homonymous archaeological site is located. In particular the analysis has been focused in the area of the decumanus of which recent excavations have emphasized the

In this paper a characterization of seismic site response is proposed, taking into consideration geo-morphological conditions, geotechnical and geophysical parameters such as slope, average shear-wave velocity, maximum expected acceleration on bedrock, depth of ground water table. An empirical relationship is presented between these parameters and applied, with the objective of determining ground motion amplification coefficients to be used in specific programs of land use or town planning dedicated to the mitigation of seismic risk.

Seismic hazard evaluation is proposed by a methodological approach that allows thestudy of the influence of different modelling assumptions relative to the spatial andtemporal distribution of earthquakes on the maximum values of expected intensities.In particular, we show that the estimated hazard at a fixed point is very sensitive tothe assumed spatial distribution of epicentres and their estimators. As we will see, theusual approach, based on uniformly distributing the epicentres inside each seismogeniczone is likely to be biased towards lower expected intensity values. This will be mademore precise later. Recall that the term ``bias'' means, that the expectation of theestimated quantity (taken as a random variable on the space of statistics) is differentfrom the expectation of the quantity itself. Instead, our approach, based on an estimatorthat takes into account the observed clustering of events is essentially unbiased, as shownby a Monte-Carlo simulation, and is configured on a 11011-isotropic macroseismicattenuation model which is independently estimated for each zone.

We present our experience in the nonoperative management of iatrogenic lesions of celiac branches by using transcatheter arterial embolization. We treated 6 pseudoaneurysms (5 intrahepatic and 1 of the gastroduodenal artery), 6 vessel lacerations (1 common hepatic artery, 1 right hepatic artery, 1 gastroduodenal artery, 2 pancreatoduodenal, 1 polar intrasplenic artery), 1 arterioportal fistula, and 1 arteriobiliary fistula; all the bleeding lesions were secondary to surgical, endoscopic, or interventional radiologic procedures.

—A study of the intensity distribution of the earthquake of December 5th 1456, which affected a large area of central and southern Italy was carried out, verifying, through a recently proposed methodology, the two hypotheses assumed by different authors for one single seismic event and three distinct and close ones. This methodology is based on a vectorial modelling of the macroseismic intensity distribution which aims at determining the epicentre and the principal (minimum and maximum) attenuation directions.The study was structured, considering each of the two assumed hypotheses, in a set of tests obtained for the macroseismic field and the intensity map, by analysing different configurations of the observed intensity distribution.The results obtained are in agreement with the hypothesis of the time coexistence of three distinct seismic events, for which the calculated epicentres and the principal attenuation directions are compatible with the observed intensity distribution and with the tectonic trend of the Apennine region, respectively.

The Authors report a case of spontaneous large gastric phytobezoar in an unoperated stomach and describe this pathology especially with regards to pathogenesis, diagnosis and endoscopic treatment.