Lorenzo Nigro

The key role of micro-Raman spectroscopy in the study of ancient pottery: the case of pre-classical Jordanian ceramics from the archaeological site of Khirbet al-Batrawy

Micro-Raman (μ-Raman) spectroscopy has been used, as a preliminary and non-destructive technique, in order to investigate the mineralogical composition and to define the maximum firing temperature and redox state of the firing atmosphere of ancient ceramic materials. The studied ceramics come from the archaeological site of Khirbet al-Batrawy (north-central Jordan), dating back to the Early Bronze Age (3000–2000 B.C.). The results show that the ceramic body is composed mainly by quartz and calcite, and minor amount of feldspars and hematite. In addition, apatite and zircon, important markers to identify the provenance of raw materials, have been detected. Furthermore, the occurrence of gypsum has been related to both rehydration of anhydrite and burial alteration processes. Micro-Raman spectroscopy was helpful to investigate the nature of the pigments of these ceramics: the red colour was obtained by hematite, the dark pigment by amorphous carbon. Mineral assemblage allowed estimating the maximum firing temperature of these pottery vessels between 850 and 950 °C. The comparison of the results of μ-Raman spectroscopy and of X-ray diffraction analysis suggests that μ-Raman spectroscopy could have a key role in the study of ceramic materials, especially the characterization of archaeological ceramic samples for which manipulation and/or consumption are not allowed.

Surgery of intradural extramedullary tumors: Retrospective analysis of 107 cases

BACKGROUND Intradural extramedullary tumors (IDEMTs) are uncommon lesions that cause pain and neurological deficits. OBJECTIVE To evaluate the effects of surgery for IDEMTs. METHODS This cohort study recruited all patients operated on for IDEMTs at the Department of Neurology and Psychiatry of Sapienza University of Rome from January 2003 to January 2013. The analysis was conducted on clinical records evaluation over a 1-year follow-up. The Graphic Rating Scale was used to assess pain. Neurological deficits were detected through neurological examination. Quality of life was evaluated with the EuroQol (EQ-5D). Statistical interpretation of the data was performed with SPSS version 19 software. RESULTS One hundred seven patients were recruited. Three were lost to follow-up. Patients reported lower level of pain 1 year after surgery (before surgery, 6.05; after surgery, 3.65). Mean comparison showed a significant decrease of -2.400 (P < .001). Ninety-two patients (88.5%) were neurologically asymptomatic 1 year after surgery. Only 12 patients (11.5%) presented with a deficit, with a global decrease of 39% (χ(2) = 27.6; P < .005). The quality of life in patients was middle to high (mean rating of EQ-5D visual analog score, 61.78%). The lowest levels of quality of life were found in patients with sphincter dysfunctions (mean, 33.4). CONCLUSION Surgery for IDEMTs has a good outcome. Patients reported lower levels of pain and a drastic reduction in neurological symptoms 1 year after surgery. The quality of life is middle to high. It is influenced mainly by the neurological outcome.

Is Khirbet Kerak Ware from Khirbet al-Batrawy (Jordan) local or imported pottery?

A multi-analytical approach has been applied to characterize Khirbet Kerak Ware from the archaeological site of Khirbet al-Batrawy (Jordan), a highly distinctive pottery production of Early Bronze III Levant. Sherds of Khirbet Kerak Ware vessels, dating back to 2750–2500 B.C., show peculiar shapes and a highly polished red/black coating, alien to other Levantine ceramic traditions. Micro-Raman, infrared spectroscopic and petrographic data have been obtained with the aim of defining the fabric, tracing the origin of the raw material used in the manufacturing process and exploring the technological aspects. The results on Khirbet Kerak Ware are then compared with those of ceramics of the same period found at that site in order to highlight possible differences or similarities in the manufacturing process. All these pottery productions reveal similar mineralogical composition, compatible with a local sourcing of the raw materials; moreover, the identification of a specific mineral assemblage allows to estimate a firing temperature ranging from 850 °C to 900 °C. In spite of the marked differences observed between macroscopic appearances of Khirbet Kerak Ware and those of other coeval and local pottery productions, the results are indicative of overall local manufacturing.

A case of cervical tuberculosis with severe kyphosis treated with a winged expandable cage after double corpectomy

In this case report, we demonstrate that the use of a winged expandable cage was able to obtain good clinical and radiological results in a case of cervical tuberculosis with severe kyphosis. However, case series will be necessary to affirm its validity as a stand-alone device for similar cases with high risk of instability.

Delayed surgery in neurologically intact patients affected by thoraco-lumbar junction burst fractures: to reduce pain and improve quality of life

Background This is a retrospective study on 18 patients affected by thoraco-lumbar junction burst fractures (TLJBF) A3 or A4 at computed tomography (CT) scan who referred to our hospital. To assess the surgical results in terms of pain and quality of life in a series of neurologically intact patients affected by TLJBF who underwent surgery after 3-4 months from the injury. In literature there is controversy if pain could be an indication for surgery in TLJBF and series of patients conservatively managed with success have been reported. Methods A retrospective study on 18 patients is reported. Patients included in this series were neurologically intact and affected by a TLJBF A3 or A4 at CT scan, the height of the burst vertebral body was >50%, spinal canal invasion was <30% and kyphosis deformity <30 degrees. Pain and quality of life were evaluated using graphic rating scale (GRS) and EuroQol (EQ-5D) scores on admission, at the clinical follow-up and in post-surgical period. Results Comparing pre- and post-operative EQ-5D, the scores had a statistically significant decrease after the operation (P<0.001) [pre-surgery EQ-5D was 2.60 (SD =0.67), post-surgery EQ-5D was 1.37 (SD =0.41)]. Also analyzing the EQ5D-VAS scores, the t-test revealed that surgery (P<0.01) improved the quality of life with statistically significance (EQ5D-VAS pre =43.89, SD =12.43 and EQ5D-VAS post =73.33, SD =10.84). Analyzing pre- and post-surgical GRS scores, the pain decreased significantly with the maximum mean difference among the 2nd and 3rd month before surgery and at 12 months after surgery (respectively D =5.444, P<0.001 and D =5.167, P<0.001). Conclusions Conservatively managed patients affected by TLJBF require a strict clinical follow-up since pain sometimes is present in the following months and it affects the quality of life. Surgery should be considered for these cases.

A hoard of Nilotic nacreous shells from Egypt to Jericho (Early Bronze II, 3000–2800 BCE): Their finding, content and historical archaeological implications

ABSTRACT The Tell es-Sultan, ancient Jericho, is amongst the earliest “cities” that rose in the Southern Levant between the end of 4th and the beginning of the 3rd millennium BCE. The site is being excavated, studied and rehabilitated for tourism by Sapienza University of Rome and the Palestinian Ministry of Tourism and Antiquities since 1997. In 2017, during the 13th season of excavation, an unexpected discovery occurred: five Chambardia rubens shells have been found piled up in a dwelling unit dating back to the Early Bronze Age IB-II. The discovery is a tangible evidence of trade and cultural interconnections between the Southern Levant and Egypt, as these shells belong to a species that is only been found to live in the Nile. Moreover, chemical analysis, and thorough Scanning Electron Microscopy examination revealed that the shells contained Manganese Dioxide, an inorganic compound used as make-up ingredient in ancient Egypt, and available in the ores of the Sinai. These findings strongly support the existence of a link between the urban rise in EB IB-II through international trade of luxury goods, and are suggestive of the emergence at Jericho of a ruling elite that was influenced by Egypt.

Protecting and rehabilitating the archaeology of Bethlehem

Rescue excavations in Bethlehem undertaken by the Sapienza University of Rome and the Palestinian Ministry of Tourism and Antiquities—Department of Archaeology and Cultural Heritage—have revealed four Bronze Age necropolises. These newly discovered sites illuminate the development of pre-Classical Bethlehem.

Considerations regarding supplementary motor area syndrome after surgery for parasagittal meningiomas

Dear Editor, We read with great interest the paper by Berg-Johnsen et al. about the supplementary motor area syndrome after surgery for parasagittal meningiomas (Berg-Johnsen J, Høgestøl EA (2018) Supplementary motor area syndrome after surgery for parasagittal meningiomas. Acta Neurochir (Wien). 160(3):583– 587) [2]. After the removal of a parasagittal meningioma, the event to have a hemiplegic or hemiparetic patient is unexpected for the surgeon who has operated an extrinsic tumor without the use of brain retractors and no evidence of electrophysiological alteration during the cortical and subcortical stimulation. On the same time the finding that the patient is aphasic is unpleasant. So as stated by the authors, we know that these findings can be related to the supplementary motor cortex and these disturbances go under the name of supplementary motor area (SMA) syndrome. After the resection of low-grade gliomas, this syndrome is diffusely reported but it is rarely reported in high-grade gliomas or meningiomas. This is due to the different growth of the tumors in the white matter. The high grades and meningiomas, differently from low-grade gliomas, tend to dissociate the white matter fibers without growing into them. For this reason, it is possible to preserve the SMA during the removal of the tumor. We would like to enhance the importance of SMA for its multiple white matter tracts which are present in this area. Moreover, it is particularly important to preserve this area in parasagittal meningiomas. The SMA has been demonstrated to have connections with the precentral gyrus, prefrontal cortex, basal ganglia (striatum and claustrum), limbic system, spinal cord, contralateral SMA complex, superior parietal cortex, and inferior frontal cortices (pars opercularis) [3]. Herein, we report the postoperative tractography reconstruction of a patient who developed dysphasia after the removal of a left parasagittal meningioma (Fig. 1). After the operation, the left SMA showed a minor representation of white matter tracts if compared to the right SMA. Moreover the right SMA demonstrated the presence of crossing fibers through the corpus callosum. So as demonstrated by some authors, the hyper-activation of the contralateral SMA is responsible for recovery since the crossing fibers are able to supply the deficit [1]. We agree with the authors that the SMA is usually preserved after the removal of parasagittal meningiomas. For this reason, this syndrome is rarely present in the postoperative period. Nevertheless, it can result in cases of extensive meningiomas, grade II WHO tumors, extensive postoperative edema. It can manifest in these cases for the involvement of the surrounding cortex and white matter of SMA. In order to preserve the SMA, the resection of parasagittal meningiomas requires a microsurgical technique, the preservation of the cortical veins, a careful dissection from the SMA cortex and white matter without the use of brain retractors. It is extremely important to preserve the superior sagittal sinus in order to avoid venous ischemia to the pre-motor area. In case of complete sinus occlusion, it may be possible to ligate the sinus, but it is necessary to preserve the draining veins. In these cases, the sinus may be sacrificed since the draining veins are supplying its function. The sinus occlusion must be carefully demonstrated preoperatively (angiography) and intraoperatively (micro-Doppler). Moreover, its closure may determine a risk of bilateral SMA injury and a subsequent This article is part of the Topical Collection on Tumor Meningioma

Total en-bloc spondylectomy through a posterior approach: technique and surgical outcome in thoracic metastases

BackgroundIn 1981, Roy-Camille et al. have firstly reported the total en-bloc spondylectomy (TES) through a posterior approach for cases of malignant spine tumors in order to reduce the local recurrence and to increase the patient’s survival. By then, this surgery has been increasingly gaining recognition. However, it requires a high level of technical ability and knowledge of spinal anatomy, physiology, and biomechanics.MethodHerein, we report the patient’s selection and technique to execute the TES for cases of thoracic metastasis.ConclusionThis surgery is technically demanding so the patient’s selection requires a careful pre-operative evaluation. However, it can be suggested for patients affected by intracompartmental lesions with a good prognosis since the tumor’s progression is “limited” by local barriers as demonstrated by histological studies.

The Manubriotomy is a safe option for the anterior approach to the cervico-thoracic junction

The cervicothoracic junction (CTJ) is defined as the area extending from vertebral segments C7 to T4. Because most pathological processes occur in the anterior segment of the vertebrae, the anterior approach is usually the best surgical option, allowing neural decompression, stabilization and restoration of anatomical spinal alignment. Nevertheless, it represents a big challenge for the spinal surgeon for the presence of important anatomical structures of the upper mediastinum: manubrium, thymus gland, left and right brachiocephalic veins (or innominate veins), right brachiocephalic artery, left common carotid artery, aortic arc, esophagus, trachea and thoracic duct. Varied approaches to the CTJ have been described in literature [low lateral anterior cervical approach (LACA), full sternotomy, lateral parascapular thoracotomy, clavicular dissection]. Among them, the low LACA combined with manubriotomy is the most used and safe (1).