Isolated right atrial appendage (RAA) rupture in blunt trauma – a case report and an anatomic study comparing RAA and right atrium (RA) wall thickness

BACKGROUND: Heart chambers rupture in blunt trauma is uncommon and is associated with a high mortality. The determinant factors, and the incidence of isolated heart chambers rupture remains undetermined. Isolated rupture of the right atrium appendage (RAA) is very rare, with 8 cases reported in the reviewed literature. The thin wall of the RAA has been presumed to render this chamber more prone to rupture in blunt trauma. OBJECTIVE: To report a case of isolated RAA rupture in blunt trauma, and to compare right atrium (RA) and RAA wall thickness in a necropsy study. METHODS: The thickness of RA and RAA wall of hearts from cadavers of fatal penetrating head trauma victims was measured. Our case of isolated RAA rupture is presented. The main findings of the 8 cases reported in the literature, and the findings of our case, were organized in a table. RESULT: The comparison of the data showed that wall thickness of the RAA (0.53 ± 0.33 mm) was significantly thinner than that of RA (1.11 ± 0.42 mm) (p < 0.05). COMMENTS: In all these 9 cases of isolated RAA rupture, cardiac tamponade occurred, RAA rupture was diagnosed intraoperatively and sutured, and the patients survived. Main mechanisms hypothesized for heart chamber rupture include mechanical compression coincident with phases of cardiac cycle, leading to high hydrostatic pressure inside the chamber. Published series include numerous cases of RA rupture, and only a few cases of RAA rupture. CONCLUSION: Thus, our data suggests that wall thickness is not a determinant factor for RA or RAA rupture in blunt trauma

ESR dating of an ancient goat tooth from Nuoro, Sardinia, Italy

The dating of fossil teeth of an ancient goat (Nesogoral melonii) using the electron spin resonance (ESR) technique is reported. This animal was found in the fossiliferous site at Orosei (Nuoro, Sardinia, Italy) and was endemic in the region. Molar teeth were cleaned and enamel was completely removed from dentine. Enamel was irradiated with a 60Co gamma source and measured with an ESR spectrometer (X-band) to obtain the signal vs. dose curve and fitted with an exponential function. The archeological dose obtained by the fitting was 211 ± 34 Gy. Uranium and thorium concentrations were determined by neutron activation analysis. With the software ROSY the age estimates were 195 ± 30 ky for early uptake, 247 ± 40 ky for linear uptake and 243 ± 40 ky for a combination of uptake processes