Fenomeni di trasporto ed elettrostatici in membrane da Nanofiltrazione

Fenomeni di trasporto ed elettrostatici in membrane da Nanofiltrazione La capacità di predire le prestazioni delle membrane da nanofiltrazione è molto importante per il progetto e la gestione di processi di separazione a membrana. Tali prestazioni sono strettamente legate ai fenomeni di trasporto che regolano il moto dei soluti all’interno della matrice della membrana. Risulta, quindi, di rilevante importanza la conoscenza e lo studio di questi fenomeni; l’obiettivo finale è quello di mettere a punto modelli di trasporto appropriati che meglio descrivano il flusso dei soluti all’interno della membrana. A fianco dei modelli di trasporto ricopre, quindi, una importanza non secondaria la caratterizzazione dei parametri aggiustabili propri della membrana sulla quale si opera. La procedura di caratterizzazione di membrane deve chiarire le modalità di svolgimento delle prove sperimentali e le finalità che esse dovrebbero conseguire. Tuttavia, nonostante i miglioramenti concernenti la modellazione del trasporto di ioni in membrana ottenuti dalla ricerca negli ultimi anni, si è ancora lontani dall’avere a disposizione un modello univoco in grado di descrivere i fenomeni coinvolti in maniera chiara. Oltretutto, la palese incapacità del modello di non riuscire a prevedere gli andamenti sperimentali di reiezione nella gran parte dei casi relativi a miscele multicomponenti e le difficoltà legate alla convergenza numerica degli algoritmi risolutivi hanno fortemente limitato gli sviluppi del processo anche e soprattutto in termini applicativi. Non da ultimo, si avverte la necessità di poter prevedere ed interpretare l’andamento della carica di membrana al variare delle condizioni operative attraverso lo sviluppo di un modello matematico in grado di descrivere correttamente il meccanismo di formazione della carica. Nel caso di soluzioni elettrolitiche, infatti, è stato riconosciuto che la formazione della carica superficiale è tra i fattori che maggiormente caratterizzano le proprietà di separazione delle membrane. Essa gioca un ruolo importante nei processi di trasporto ed influenza la sua selettività nella separazione di molecole caricate; infatti la carica di membrana interagisce elettrostaticamente con gli ioni ed influenza l’efficienza di separazione degli stessi attraverso la partizione degli elettroliti dalla soluzione esterna all’interno dei pori del materiale. In sostanza, la carica delle membrane da NF è indotta dalle caratteristiche acide delle soluzioni elettrolitiche poste in contatto con la membrana stessa, nonché dal tipo e dalla concentrazione delle specie ioniche. Nello svolgimento di questo lavoro sono stati analizzati i principali fenomeni di trasporto ed elettrostatici coinvolti nel processo di nanofiltrazione, in particolare si è focalizzata l’attenzione sugli aspetti relativi alla loro modellazione matematica. La prima parte della tesi è dedicata con la presentazione del problema generale del trasporto di soluti all’interno di membrane da nanofiltrazione con riferimento alle equazioni alla base del modello DSP&DE, che rappresenta una razionalizzazione dei modelli esistenti sviluppati a partire dal modello DSPM, nel quale sono stati integrarti i fenomeni di esclusione dielettrica, per quanto riguarda la separazione di elettroliti nella filtrazione di soluzioni acquose in processi di Nanofiltrazione. Il modello DSP&DE, una volta definita la tipologia di elettroliti presenti nella soluzione alimentata e la loro concentrazione, viene completamente definito da tre parametri aggiustabili, strettamente riconducibili alle proprietà della singola membrana: il raggio medio dei pori all’interno della matrice, lo spessore effettivo e la densità di carica di membrana; in più può essere considerato un ulteriore parametro aggiustabile del modello il valore che la costante dielettrica del solvente assume quando confinato in pori di ridotte dimensioni. L’impostazione generale del modello DSP&DE, prevede la presentazione dei fenomeni di trasporto all’interno della membrana, descritti attraverso l’equazione di Nerst-Planck, e lo studio della ripartizione a ridosso dell’interfaccia membrana/soluzione esterna, che tiene in conto di diversi contributi: l’impedimento sterico, la non idealità della soluzione, l’effetto Donnan e l’esclusione dielettrica. Il capitolo si chiude con la presentazione di una procedura consigliata per la determinazione dei parametri aggiustabili del modello di trasporto. Il lavoro prosegue con una serie di applicazioni del modello a dati sperimentali ottenuti dalla caratterizzazione di membrane organiche CSM NE70 nel caso di soluzioni contenenti elettroliti. In particolare il modello viene applicato quale strumento atto ad ottenere informazioni utili per lo studio dei fenomeni coinvolti nel meccanismo di formazione della carica; dall’elaborazione dei dati sperimentali di reiezione in funzione del flusso è possibile ottenere dei valori di carica di membrana, assunta quale parametro aggiustabile del modello. che permettono di analizzare con affidabilità gli andamenti qualitativi ottenuti per la carica volumetrica di membrana al variare della concentrazione di sale nella corrente in alimentazione, del tipo di elettrolita studiato e del pH della soluzione. La seconda parte della tesi relativa allo studio ed alla modellazione del meccanismo di formazione della carica. Il punto di partenza di questo studio è rappresentato dai valori di carica ottenuti dall’elaborazione dei dati sperimentali di reiezione con il modello di trasporto, e tali valori verranno considerati quali valori “sperimentali” di riferimento con i quali confrontare i risultati ottenuti. Nella sezione di riferimento è contenuta la presentazione del modello teorico “adsorption-amphoteric” sviluppato al fine di descrivere ed interpretare i diversi comportamenti sperimentali ottenuti per la carica di membrana al variare delle condizioni operative. Nel modello la membrana è schematizzata come un insieme di siti attivi di due specie: il gruppo di siti idrofobici e quello de siti idrofilici, in grado di supportare le cariche derivanti da differenti meccanismi chimici e fisici. I principali fenomeni presi in considerazione nel determinare la carica volumetrica di membrana sono: i) la dissociazione acido/base dei siti idrofilici; ii) il site-binding dei contro-ioni sui siti idrofilici dissociati; iii) l’adsorbimento competitivo degli ioni in soluzione sui gruppi funzionali idrofobici. La struttura del modello è del tutto generale ed è in grado di mettere in evidenza quali sono i fenomeni rilevanti che intervengono nel determinare la carica di membrana; per questo motivo il modello permette di indagare il contributo di ciascun meccanismo considerato, in funzione delle condizioni operative. L’applicazione ai valori di carica disponibili per membrane Desal 5-DK nel caso di soluzioni contenenti singoli elettroliti, in particolare NaCl e CaCl2 permette di mettere in evidenza due aspetti fondamentali del modello: in primis la sua capacità di descrivere andamenti molto diversi tra loro per la carica di membrana facendo riferimento agli stessi tre semplici meccanismi, dall’altra parte permette di studiare l’effetto di ciascun meccanismo sull’andamento della carica totale di membrana e il suo peso relativo. Infine vengono verificate le previsioni ottenute con il modello dal suddetto studio attraverso il confronto con dati sperimentali di carica ottenuti dall’elaborazione dei dati sperimentali di reiezione disponibili per il caso di membrane CSM NE70. Tale confronto ha messo in evidenza le buone capacità previsionali del modello soprattutto nel caso di elettroliti non simmetrici quali CaCl2 e Na2SO4. In particolare nel caso un cui lo ione divalente rappresenta il contro-ione rispetto alla carica propria di membrana, la carica di membrana è caratterizzata da un andamento unimodale (contraddistinto da un estremante) con la concentrazione di sale in alimentazione. Il lavoro viene concluso con l’estensione del modello ADS-AMF al caso di soluzioni multicomponenti: è presentata una regola di mescolamento che permette di ottenere la carica per le soluzioni elettrolitiche multicomponenti a partire dai valori disponibili per i singoli ioni componenti la miscela.

Procedura di progettazione di protesi a basso costo per l'arto inferiore

L'attività di ricerca descritta in questa tesi fornisce linee guida per la progettazione di arti protesici inferiori, con particolare riferimento alla progettazione di protesi a basso costo. La necessità di efficienti protesi a basso costo risulta infatti sentita nei Paesi in via di sviluppo ma anche dalle fasce meno abbienti dei paesi occidentali. Al fine di comprendere le strategie adottate dall'apparato locomotorio per muoversi con le protesi sono analizzati il cammino fisiologico, le protesi presenti sul mercato ed infine le modalità con cui le loro prestazioni sono valutate. Con il presente lavoro, dopo aver osservato la presenza di una scarsa strutturazione della metodologia di progettazione che riguarda specialmente il settore del basso costo, si propone una metodologia il più possibile oggettiva e ripetibile tesa ad individuare quali sono gli aspetti essenziali di una protesi per garantire al paziente una buona qualità di vita. Solo questi aspetti dovranno essere selezionati al fine di ottenere la massima semplificazione della protesi e ridurre il più possibile i costi. Per la simulazione delle attività di locomozione, in particolare del cammino, è stato elaborato un apposito modello spaziale del cammino. Il modello proposto ha 7 membri rigidi (corrispondenti a piedi, tibie, femori e bacino) e 24 gradi di libertà. Le articolazioni e l'appoggio dei piedi al suolo sono modellati con giunti sferici. La pianta del piede consente tre possibili punti di appoggio. I criteri di realizzazione delle simulazioni possono comprendere aspetti energetici, cinematici e dinamici considerati come obiettivo dall'apparato locomotorio. In questa tesi vengono trattati in particolare gli aspetti cinematici ed è mostrata un'applicazione della procedura nella quale vengono dapprima identificati i riferimenti fisiologici del cammino e quindi simulato il cammino in presenza di una menomazione al ginocchio (eliminazione della flessione in fase di appoggio). Viene quindi lasciato a sviluppi futuri il completamento della procedura e la sua implementazione in un codice di calcolo.

The Integrated European Project "GEHA - GEnetics of Healthy Aging": recruitment, health status assessment and survival of the Italian 90+ sibpairs

The present study is part of the EU Integrated Project “GEHA – Genetics of Healthy Aging” (Franceschi C et al., Ann N Y Acad Sci. 1100: 21-45, 2007), whose aim is to identify genes involved in healthy aging and longevity, which allow individuals to survive to advanced age in good cognitive and physical function and in the absence of major age-related diseases. Aims The major aims of this thesis were the following: 1. to outline the recruitment procedure of 90+ Italian siblings performed by the recruiting units of the University of Bologna (UNIBO) and Rome (ISS). The procedures related to the following items necessary to perform the study were described and commented: identification of the eligible area for recruitment, demographic aspects related to the need of getting census lists of 90+siblings, mail and phone contact with 90+ subjects and their families, bioethics aspects of the whole procedure, standardization of the recruitment methodology and set-up of a detailed flow chart to be followed by the European recruitment centres (obtainment of the informed consent form, anonimization of data by using a special code, how to perform the interview, how to collect the blood, how to enter data in the GEHA Phenotypic Data Base hosted at Odense). 2. to provide an overview of the phenotypic characteristics of 90+ Italian siblings recruited by the recruiting units of the University of Bologna (UNIBO) and Rome (ISS). The following items were addressed: socio-demographic characteristics, health status, cognitive assessment, physical conditions (handgrip strength test, chair-stand test, physical ability including ADL, vision and hearing ability, movement ability and doing light housework), life-style information (smoking and drinking habits) and subjective well-being (attitude towards life). Moreover, haematological parameters collected in the 90+ sibpairs as optional parameters by the Bologna and Rome recruiting units were used for a more comprehensive evaluation of the results obtained using the above mentioned phenotypic characteristics reported in the GEHA questionnaire. 3. to assess 90+ Italian siblings as far as their health/functional status is concerned on the basis of three classification methods proposed in previous studies on centenarians, which are based on: • actual functional capabilities (ADL, SMMSE, visual and hearing abilities) (Gondo et al., J Gerontol. 61A (3): 305-310, 2006); • actual functional capabilities and morbidity (ADL, ability to walk, SMMSE, presence of cancer, ictus, renal failure, anaemia, and liver diseases) (Franceschi et al., Aging Clin Exp Res, 12:77-84, 2000); • retrospectively collected data about past history of morbidity and age of disease onset (hypertension, heart disease, diabetes, stroke, cancer, osteopororis, neurological diseases, chronic obstructive pulmonary disease and ocular diseases) (Evert et al., J Gerontol A Biol Sci Med Sci. 58A (3): 232-237, 2003). Firstly these available models to define the health status of long-living subjects were applied to the sample and, since the classifications by Gondo and Franceschi are both based on the present functional status, they were compared in order to better recognize the healthy aging phenotype and to identify the best group of 90+ subjects out of the entire studied population. 4. to investigate the concordance of health and functional status among 90+ siblings in order to divide sibpairs in three categories: the best (both sibs are in good shape), the worst (both sibs are in bad shape) and an intermediate group (one sib is in good shape and the other is in bad shape). Moreover, the evaluation wanted to discover which variables are concordant among siblings; thus, concordant variables could be considered as familiar variables (determined by the environment or by genetics). 5. to perform a survival analysis by using mortality data at 1st January 2009 from the follow-up as the main outcome and selected functional and clinical parameters as explanatory variables. Methods A total of 765 90+ Italian subjects recruited by UNIBO (549 90+ siblings, belonging to 258 families) and ISS (216 90+ siblings, belonging to 106 families) recruiting units are included in the analysis. Each subject was interviewed according to a standardized questionnaire, comprising extensively utilized questions that have been validated in previous European studies on elderly subjects and covering demographic information, life style, living conditions, cognitive status (SMMSE), mood, health status and anthropometric measurements. Moreover, subjects were asked to perform some physical tests (Hand Grip Strength test and Chair Standing test) and a sample of about 24 mL of blood was collected and then processed according to a common protocol for the preparation and storage of DNA aliquots. Results From the analysis the main findings are the following: - a standardized protocol to assess cognitive status, physical performances and health status of European nonagenarian subjects was set up, in respect to ethical requirements, and it is available as a reference for other studies in this field; - GEHA families are enriched in long-living members and extreme survival, and represent an appropriate model for the identification of genes involved in healthy aging and longevity; - two simplified sets of criteria to classify 90+ sibling according to their health status were proposed, as operational tools for distinguishing healthy from non healthy subjects; - cognitive and functional parameters have a major role in categorizing 90+ siblings for the health status; - parameters such as education and good physical abilities (500 metres walking ability, going up and down the stairs ability, high scores at hand grip and chair stand tests) are associated with a good health status (defined as “cognitive unimpairment and absence of disability”); - male nonagenarians show a more homogeneous phenotype than females, and, though far fewer in number, tend to be healthier than females; - in males the good health status is not protective for survival, confirming the male-female health survival paradox; - survival after age 90 was dependent mainly on intact cognitive status and absence of functional disabilities; - haemoglobin and creatinine levels are both associated with longevity; - the most concordant items among 90+ siblings are related to the functional status, indicating that they contain a familiar component. It is still to be investigated at what level this familiar component is determined by genetics or by environment or by the interaction between genetics, environment and chance (and at what level). Conclusions In conclusion, we could state that this study, in accordance with the main objectives of the whole GEHA project, represents one of the first attempt to identify the biological and non biological determinants of successful/unsuccessful aging and longevity. Here, the analysis was performed on 90+ siblings recruited in Northern and Central Italy and it could be used as a reference for others studies in this field on Italian population. Moreover, it contributed to the definition of “successful” and “unsuccessful” aging and categorising a very large cohort of our most elderly subjects into “successful” and “unsuccessful” groups provided an unrivalled opportunity to detect some of the basic genetic/molecular mechanisms which underpin good health as opposed to chronic disability. Discoveries in the topic of the biological determinants of healthy aging represent a real possibility to identify new markers to be utilized for the identification of subgroups of old European citizens having a higher risk to develop age-related diseases and disabilities and to direct major preventive medicine strategies for the new epidemic of chronic disease in the 21st century.

Methoden und Modelle zur Phytoplanktonanalyse am Beispiel einer Restaurierungsmaßnahme an der Bleiloch Talsperre

Methoden und Modelle zur Phytoplanktonanalyse am Beispiel einer Restaurierungsmaßnahme an der Bleiloch Talsperre Zusammenfassung An der hypertrophen Bleiloch Talsperre (Thüringen, BRD) werden die Auswirkungen der 1997 in Betrieb genommenen partiellen Destratifikation (0- 20m) untersucht. Ziel der Maßnahme war die Hemmung des Phytoplanktonwachstums durch Lichtlimitation.Da es nicht gelang, auch die Oberflächenlammelle in die Durchmischung einzubeziehen, wurde auch keine Reduktion des Phytoplanktons beobachtet. Seine zeitliche Dynamik nahm deutlich zu und es traten neben typischen Längsgradienten auch extreme, kleinräumige Konzentrationsunterschiede auf. Die vorher häufigen Cyanobakterien spielten jedoch keine quantitativ bedeutsame Rolle mehr. Es wird diskutiert, wie die Belüftung die Saisonalität des Planktons stört und zu Verschiebungen der Zusammensetzung führt. Der Zusammenhang zwischen der Chlorophyll a Menge und der Stabilität der Wassersäule sowie der Einfluß wachstumsbestimmender Größen werden modelliert. Methodische Schwerpunkte umfassen die Auswertung von Phytoplankton-Pigmentdaten (HPLC-Analyse) und die Entwicklung einer Durchflußzytometer-Methode. Bei letzerer werden an lebenden Phytoplanktern die Vorwärtsstreuung sowie vier Fluoreszenzen (2 Phycoerythrine, Phycocyanin und Chlorophyll a, 514nm Anregungswellenlänge) gemessen. Zur Klassifizierung von Algen anhand von Referenzen werden zwei Methoden entwickelt, Möglichkeiten des Sortierens aufgezeigt und es wird ein Vergleich mit Mikroskopie und HPLC- Pigmentanalyse durchgeführt. Anhand von Modellrechnungen wird demonstriert, wie sich systematische bzw. zufällige Abweichungen der Pigmentstöchiometrien auf die Berechnung von Algengruppenanteilen auswirken. Strategien zur Auswertung von Pigmentdaten werden empfohlen.

Thin nanostructured crystalline TiO 2 films and their applications in solar cells

Research on thin nanostructured crystalline TiO2 films has attracted considerable interests because of their intriguing physical properties and potential applications in photovoltaics. Nanostructured TiO2 film plays an important role in the TiO2 based dye-sensitized solar cells because they act as a substrate for the adsorption of dye molecules and a matrix for the transportation of electrons as well. Thus they can influence the solar cell performance significantly. Consequently, the control of the morphology including the shape, size and size distribution of the TiO2 nanostructures is critical to tune and optimize the performance of the solar cells. To control the TiO2 morphology, a strategy using amphiphilic block copolymer as templating agent coupled with sol-gel chemistry has been applied. Especially, a good-poor solvent pair induced phase separation process has been developed to guide the microphase separation behavior of the block copolymers. The amphiphilic block copolymers used include polystyrene-block-poly (ethylene oxide) (PS-b-PEO), poly (methyl methacrylate)-block-poly (ethylene oxide) (PMMA-b-PEO), and poly (ethylene oxide)-block-polystyrene-block-poly (ethylene oxide) (PEO-b-PS-b-PEO). The block copolymer undergoes a good-poor-solvent pair induced phase separation in a mixed solution of 1, 4-dioxane or N, N’-dimethyl formamide (DMF), concentrated hydrochloric acid (HCl) and Titanium tetraisopropoxide (TTIP). Specifically, in the system of PS-b-PEO, a morphology phase diagram of the inorganic-copolymer composite films was mapped by adjusting the weight fractions among 1, 4-dioxane, HCl, and TTIP in solution. The amorphous TiO2 within the titania-block copolymer composite films was crystallized by calcination at temperatures above 400C, where the organic block copolymer was simultaneously burned away. This strategy is further extended to other amphiphilic block copolymers of PMMA-b-PEO and PEO-b-PS-b-PEO, where the morphology of TiO2 films can also be controlled. The local and long range structures of the titania films were investigated by the combination of imaging techniques (AFM, SEM) and x-ray scattering techniques (x-ray reflectivity and grazing incidence small-angle x-ray scattering). Based on the knowledge of the morphology control, the crystalline TiO2 nanostructured films with different morphologies were introduced into solid state dye-sensitized solar cells. It has been found that all of the morphologies help to improve the performance of the solar cells. Especially, clustered nanoparticles, worm-like structures, foam-like structures, large collapsed nanovesicles show more pronounced performance improvement than other morphologies such as nanowires, flakes, and nanogranulars.

Polarization observables in virtual compton scattering

Virtual Compton Scattering (VCS) is an important reaction for understanding nucleon structure at low energies. By studying this process, the generalized polarizabilities of the nucleon can be measured. These observables are a generalization of the already known polarizabilities and will permit theoretical models to be challenged on a new level. More specifically, there exist six generalized polarizabilities and in order to disentangle them all, a double polarization experiment must be performed. Within this work, the VCS reaction p(e,e p)gamma was measured at MAMI using the A1 Collaboration three spectrometer setup with Q2=0.33 (GeV/c)2. Using the highly polarized MAMI beam and a recoil proton polarimeter, it was possible to measure both the VCS cross section and the double polarization observables. Already in 2000, the unpolarized VCS cross section was measured at MAMI. In this new experiment, we could confirm the old data and furthermore the double polarization observables were measured for the first time. The data were taken in five periods between 2005 and 2006. In this work, the data were analyzed to extract the cross section and the proton polarization. For the analysis, a maximum likelihood algorithm was developed together with the full simulation of all the analysis steps. The experiment is limited by the low statistics due mainly to the focal plane proton polarimeter efficiency. To overcome this problem, a new determination and parameterization of the carbon analyzing power was performed. The main result of the experiment is the extraction of a new combination of the generalized polarizabilities using the double polarization observables.

Toward cell therapy using placenta-derived cells: disease mechanisms, cell biology, preclinical studies, and regulatory aspects at the round table

Among the many cell types that may prove useful to regenerative medicine, mounting evidence suggests that human term placenta-derived cells will join the list of significant contributors. In making new cell therapy-based strategies a clinical reality, it is fundamental that no a priori claims are made regarding which cell source is preferable for a particular therapeutic application. Rather, ongoing comparisons of the potentiality and characteristics of cells from different sources should be made to promote constant improvement in cell therapies, and such comparisons will likely show that individually tailored cells can address disease-specific clinical needs. The principle underlying such an approach is resistance to the notion that comprehensive characterization of any cell type has been achieved, neither in terms of phenotype nor risks-to-benefits ratio. Tailoring cell therapy approaches to specific conditions also requires an understanding of basic disease mechanisms and close collaboration between translational researchers and clinicians, to identify current needs and shortcomings in existing treatments. To this end, the international workshop entitled "Placenta-derived stem cells for treatment of inflammatory diseases: moving toward clinical application" was held in Brescia, Italy, in March 2009, and aimed to harness an understanding of basic inflammatory mechanisms inherent in human diseases with updated findings regarding biological and therapeutic properties of human placenta-derived cells, with particular emphasis on their potential for treating inflammatory diseases. Finally, steps required to allow their future clinical application according to regulatory aspects including good manufacturing practice (GMP) were also considered. In September 2009, the International Placenta Stem Cell Society (IPLASS) was founded to help strengthen the research network in this field.

Nanomechanics to drive stem cells in injured tissues: insights from current research and future perspectives

Stem cells reside within tissue, ensuring its natural ability to repair an injury. They are involved in the natural repair of damaged tissue, which encompasses a complex process requiring the modulation of cell survival, extracellular matrix turnover, angiogenesis, and reverse remodeling. To date, the real reparative potential of each tissue is underestimated and noncommittal. The assessment of the biophysical properties of the extracellular environment is an innovative approach to better understand mechanisms underlying stem cell function, and consequently to develop safe and effective therapeutic strategies replacing the loss of tissue. Recent studies have focused on the role played by biomechanical signals that drive stem cell death, differentiation, and paracrinicity in a genetic and/or an epigenetic manner. Mechanical stimuli acting on the shape can influence the biochemistry and gene expression of resident stem cells and, therefore, the magnitude of biological responses that promote the healing of injured tissue. Nanotechnologies have proven to be a revolutionary tool capable of dissecting the cellular mechanosensing apparatus, allowing the intercellular cross-talk to be decoded and enabling the reparative potential of tissue to be enhanced without manipulation of stem cells. This review highlights the most relevant findings of stem cell mechanobiology and presents a fascinating perspective in regenerative medicine.

Hypersensitivity and oral tolerance in the absence of a secretory immune system

Mucosal immunity protects the epithelial barrier by immune exclusion of foreign antigens and by anti-inflammatory tolerance mechanisms, but there is a continuing debate about the role of secretory immunoglobulins (SIgs), particularly SIgA, in the protection against allergy and other inflammatory diseases. Lack of secretory antibodies may cause immune dysfunction and affect mucosally induced (oral) tolerance against food antigens.

A case of homicidal intraoral gunshot and review of the literature

Determination of the manner of death in case of intraoral firearm wounds can be a challenge, especially if the circumstances of the incident are unclear and crime scene investigation is inadequate. It is a well-known fact that the mouth is one of the selected sites for suicide with firearms. Homicidal shooting through the mouth is said to be rare, but does occur, and can be mistaken for a suicide. For discrimination between suicide and homicide in cases of intraoral firearm wounds, some useful points are the site of entry wound, the direction of the internal bullet path, the range of fire and the circumstances of death. We demonstrate these points in a case of a homicidal gunshot to the mouth assessed by both classical autopsy and post-mortem CT (PMCT).

Pros and cons of post-mortem CT imaging on aspiration diagnosis

Recently, the field of forensics has experienced a rapid increase in the use of modern cross-sectional imaging in forensic investigations. We examined the value of post-mortem computed tomography (CT) imaging relative to autopsy for distinguishing aspiration into the lungs from airways, from lung alterations due to other causes, and for identifying the aspirated material. We selected 54 bodies submitted to whole-body CT scanning prior to autopsy. All cases had autopsy findings of blood (31 cases), fresh water (12 cases), or gastric content (11 cases) aspiration. The radiological images were retrospectively analyzed for airway and lung aspiration. In all cases, CT imaging detected pulmonary abnormalities suggestive of aspiration. Nevertheless, analysis of the CT images alone was not able to identify the aspirated material or to distinguish pulmonary findings of aspiration from lung changes due to other causes, except for a few cases of hemo-aspiration. However, due to its ability to visualize the entire parenchyma, CT imaging was superior to autopsy in providing additional data about the distribution and severity of the aspiration as well as in detecting small abnormalities. Post-mortem CT imaging should be considered as a superior tool for forensic investigations of aspiration due to its ability to document diagnostic conclusions and to guide the forensic pathologist during lung tissue examination.

Laser-guided lumbar medial branch kryorhizotomy

The authors describe a modification of the medial branch kryorhizotomy technique for the treatment of lumbar facet joint syndrome using a fluoroscopy-based laser-guided method. A total of 32 patients suffering from lumbar facet joint syndrome confirmed by positive medial nerve block underwent conventional or laser-guided kryorhizotomy. The procedural time (20.6 +/- 1.0 vs 16.3 +/- 0.9 minutes, p < 0.01), fluoroscopy time (54.1 +/- 3.5 vs 28.2 +/- 2.4 seconds, p < 0.01), radiation dose (407.5 +/- 32.0 vs 224.1 +/- 20.3 cGy/cm(2), p < 0.01), and patient discomfort during the procedure (7.1 +/- 0.4 vs 5.2 +/- 0.4 on the visual analog scale, p < 0.01) were significantly reduced in the laser-guided group. There was a tendency for a better positioning accuracy when the laser guidance method was used (3.0 +/- 0.3 vs 2.2 +/- 0.3 mm of deviation from the target points, p > 0.05). No difference in the outcome was observed between the 2 groups of patients (visual analog scale score 3.5 +/- 0.2 vs 3.3 +/- 0.3, p > 0.05). This improved minimally invasive surgical technique offers advantages to conventional fluoroscopy-based kryorhizotomy.