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Sample records for Autopsy

  1. Needle autopsy

    Philip Davis Marsden

    1997-04-01

    Full Text Available Often in tropical practice there is not time or conditions to do a proper autopsy on a patient who has died. A needle biopsy technique is described for limited closed autopsy examination to clariffy organ histology. In this way the clinician may resolve puzzling fatal disease.Muitas vezes, em clínicas de países tropicais, não há tempo nem condições para se realizar uma necropsia adequada em um paciente que foi a óbito. Um técnica de biópsia por punção é descrita para fins de exame em necropsia limitadamente fechada, para esclarecimento da histologia do órgão. Dessa maneira, o clínico pode resolver enigmas de doenças fatais.

  2. The value of neonatal autopsy.

    Hickey, Leah

    2012-01-01

    Neonatal autopsy rates were in decline internationally at the end of the last century. Our objective was to assess the current value of neonatal autopsy in providing additional information to families and healthcare professionals.

  3. Findings of autopsy imaging

    Described is the outline of autopsy imaging (Ai) by CT, MRI and ultrasonography (US) as the reading of the postmortem images is becoming important for radiologist on site. The present major Ai modality is CT, where the cause of death can be identified in most cases of injuries like that by traffic accident, and of intracranial hemorrhagic lesions. It is difficult for CT alone to determine the cause due to acute heart failure, for which Ai by enhanced CT (2-min heart massage during the intravenous infusion of a contrast agent) has been introduced. CT findings in Ai are varied according to the death cause, anabiotic treatment conducted and postmortem changes. The second item includes the gastrointestinal tract dilation, rib fracture, pneumo- or hemo-thorax, bruise or rupture, and intravascular gas, and the third, the blood hypostasis, which emphasizing the shadow at the gravity-loaded portions in Ai CT. MRI signals vary dependently on the temperature and the inversion time should be shortened to suppress the cerebrospinal signal at Ai of the cold body like that stored in a refrigerator. US can detect clear, macroscopic morphological changes and the portable machine has been in practice at autopsy onsite. As sound speed depends on the temperature in water, Ai US images are obscure relative to living body due to the low temperature. Authors think the problem to identify the cause of death will be mostly solved in Japan when radiological technologists more actively participate in Ai. (K.T.)

  4. Autopsy Tissue Program

    The Autopsy Tissue Program was begun in 1960. To date, tissues on 900 or more persons in 7 geographic regions have been collected and analyzed for plutonium content. The tissues generally consist of lung, liver, kidney, lymph, bone, and gonadal tissue for each individual. The original objective of the program was to determine the level of plutonium in human tissues due solely to fall-out from weapons testing. The baseline thus established was to be used to evaluate future changes. From the first, this program was beset with chemical and statistical difficulties. Many factors whose effects were not recognized and not planned for were found later to be important. Privacy and ethical considerations hindered the gathering of adequate data. Since the chemists were looking for amounts of plutonium very close to background, possible contamination was a very real problem. Widely used chemical techniques introduced a host of statistical problems. The difficulties encountered touch on areas common to large data sets, unusual outlier detection methods, minimum detection limits, problems with Aliquot sizes, and time-trends in the data. The conclusions point out areas to which the biologists will have to devote much more careful attention than was believed

  5. The Autopsy of Squirrel Doe

    Dick, Timothy T.; Watson, Jason

    2005-01-01

    Introductory biology laboratory experiences frequently rely on preserved chordates for anatomical study. Unfortunately, these preserved organisms rarely reflect the appearance of a living creature. Since community colleges are generally prohibited the use of live chordates, this paper describes the autopsy of a "road kill" squirrel to facilitate…

  6. 20 CFR 718.106 - Autopsy; biopsy.

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Autopsy; biopsy. 718.106 Section 718.106... PNEUMOCONIOSIS Criteria for the Development of Medical Evidence § 718.106 Autopsy; biopsy. (a) A report of an autopsy or biopsy submitted in connection with a claim shall include a detailed gross macroscopic...

  7. Medico-legal autopsies in Denmark

    Larsen, Sara Tangmose; Lynnerup, Niels

    2011-01-01

    At 2.7% in 1970, the Danish medico-legal autopsy frequency was lower than recent frequencies observed in the Nordic countries (4-24%). The aim of this study was to analyse trends in the number and frequency of Danish medico-legal autopsies.......At 2.7% in 1970, the Danish medico-legal autopsy frequency was lower than recent frequencies observed in the Nordic countries (4-24%). The aim of this study was to analyse trends in the number and frequency of Danish medico-legal autopsies....

  8. Attitudes of Nigerian Medical Students Towards Autopsy

    EKANEM, Victor James; AKHIGBE, Kingsley O.

    2006-01-01

    The use of autopsy in medical education has been declining although autopsy as an educational experience helps students to correlate clinical findings with basic medical sciences. Students' views in relation to its relevance in medical education are necessary in order to justify its continuous inclusion in medical school curriculum. Two hundred and forty 5th and 6th year medical students who had completed their postings in Anatomical and forensic pathology from two institutions were rand...

  9. Low perinatal autopsy rate in Malaysia: time for a change.

    Tan, Geok Chin; Hayati, Abdul Rahman; Khong, Teck Yee

    2010-01-01

    Our objectives were to determine the perinatal autopsy rate in a tertiary hospital in Malaysia and to quantify the value of the perinatal autopsy. All stillbirths, miscarriages, therapeutic abortions, and neonatal deaths between January 1, 2004, and August 31, 2009, were identified from the archives. The autopsy findings were compared with the clinical diagnoses. The autopsy reports were also reviewed to determine if it would be possible to improve the quality of the autopsies. There were 807 perinatal deaths, of which 36 (4.5%) included an autopsy. There were ethnic differences in the rate of autopsy, with the lowest rate among the Malays. The autopsy provided the diagnosis, changed the clinical diagnosis, or revealed additional findings in 58.3% of cases. Ancillary testing, such as microbiology, chromosomal analysis, and biochemistry, could improve the quality of the autopsy. This study provides further data on the perinatal autopsy rate from an emerging and developing country. It reaffirms the value of the perinatal autopsy. Attempts must be made to improve on the low autopsy rate while recognizing that the performance of autopsies can be enhanced through the use of ancillary testing. PMID:20367214

  10. Adult Hirschsprung's disease diagnosed during forensic autopsy.

    Chatelain, Denis; Manaouil, Cécile; Marc, Bernard; Ricard, Jannick; Brevet, Marie; Montpellier, Dominique; Defouilloy, Christian; Jardé, Olivier

    2006-09-01

    We report a case of fatal Hirschsprung's disease (HD) discovered at autopsy. A 20-year-old man collapsed at home. Emergency medical personnel found him in cardiac arrest and all resuscitative efforts failed. He had a past history of chronic constipation since infancy. Forensic autopsy revealed a megacolon full of gas and stools. Microscopic examination showed absence of ganglion cells in a short segment of the rectum and enterocolitis in the left and transverse colon. HD is rarely described in adults. In many cases, patients complained of constipation since infancy but the affection remained misdiagnosed. The relative good tolerance of the disease is usually due to a short aganglionic bowel segment. Enterocolitis is a frequent and severe complication of HD in children but is rarely described in adults. This case suggests the importance of HD diagnosis in childhood in order to avoid fatal complications with forensic consequences. PMID:17018101

  11. Can postmortem fetal MR imaging replace autopsy?

    The purposes of this study were to compare postmortem fetal MRI findings with autopsy findings and to assess whether postmortem MRI can replace autopsy. The study group consisted of 13 stillborn fetuses, seven that died immediately after birth, and five terminated because of anomalies seen on prenatal sonograms. A total 17 were male, and eight were female, and their gestational ages were from 20 to 41 (average;28.2) weeks. Spin-echo T1-and T2-weighted axial, sagittal, and coronal MR images were obtained, and autopsy findings were divided into major and minor. A major finding was defined as an anomaly or syndrome which caused fetal death or termination of the pregnancy: minor findings were classified, on the basis of gross inspection, as internal or external. MR images were retrospectively analyzed by two radiologists unaware of the autopsy findings, and by comparison with these, the postmortem MRI detection rates for major and minor findings was then determined. In seven of 25 fetuses, MR imaging revealed major findings, a dietction rate of 100%. There were two cases of anencephaly, two of trisomy-18, and one each of hydrops fetalis with large cystic hygroma, diaphragmatic hernia, and Dandy-Walker malformation. Twenty-three of 60 minor findings (38.3%) were detected by MRI. The detection rates for external and internal findings were 29.6%(8/27) and 45.5%(15/33), respectively. Although a limitation of our study is the low detection rate for minor findings, postmortem fetal MRI may help diagnose the major cause of fetal death

  12. Psychological Autopsy: A Psychobiographical Exploration of Suicide

    José Alonso Andrade Salazar; Cesar Humberto Téllez; Laura Angélica Giraldo Blanco

    2013-01-01

    The present work is a conceptual approach on psychosocial factors related to suicidal psychobiography from the exploration of the lives of people who self-eliminate, for which there will be a review of the literature, based on input from journal articles and books published in various sources of documentation. Autopsy psychology is a data collection method that provides light on the psychosocial motivations that drive and reinforce the act of suicide, and is currently used by professionals re...

  13. Can postmortem fetal MR imaging replace autopsy?

    Cho, Jeong Yeon; Song, Mi Jin [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of); Kim, Seoung Hyup [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-02-01

    The purposes of this study were to compare postmortem fetal MRI findings with autopsy findings and to assess whether postmortem MRI can replace autopsy. The study group consisted of 13 stillborn fetuses, seven that died immediately after birth, and five terminated because of anomalies seen on prenatal sonograms. A total 17 were male, and eight were female, and their gestational ages were from 20 to 41 (average;28.2) weeks. Spin-echo T1-and T2-weighted axial, sagittal, and coronal MR images were obtained, and autopsy findings were divided into major and minor. A major finding was defined as an anomaly or syndrome which caused fetal death or termination of the pregnancy: minor findings were classified, on the basis of gross inspection, as internal or external. MR images were retrospectively analyzed by two radiologists unaware of the autopsy findings, and by comparison with these, the postmortem MRI detection rates for major and minor findings was then determined. In seven of 25 fetuses, MR imaging revealed major findings, a dietction rate of 100%. There were two cases of anencephaly, two of trisomy-18, and one each of hydrops fetalis with large cystic hygroma, diaphragmatic hernia, and Dandy-Walker malformation. Twenty-three of 60 minor findings (38.3%) were detected by MRI. The detection rates for external and internal findings were 29.6%(8/27) and 45.5%(15/33), respectively. Although a limitation of our study is the low detection rate for minor findings, postmortem fetal MRI may help diagnose the major cause of fetal death.

  14. The working procedure of human autopsy specimens

    In order to perform the Coordinated Research Program for the Reference Asian Man (phase 2): Ingestion and body content of trace elements of importance in Radiation Protection, study on elemental content in organs of normal Chinese has been worked by China Institute for Radiation Protection and Institute of Radiation Medicine - CAMS in recent two years. Sampling and sample collection of human tissues and the procedures of sample preparation of human autopsy specimens are enlisted

  15. The Challenges in Autopsy Cases Exposed to Animal Attack

    Tokdemir, Murat Bülent; Çetin, Gürsel; Şam, Bülent; Özer, Erdal; Yıldırım, Ali; Bütün, Celal

    2014-01-01

    Abstract Discrimination between antemortem and postmortem lesions inflicted by animals from other traumas, and contribution of these injuries to the cause of death which is often encountered in forensic autopsies may cause some difficulties. Detailed identification, and, evaluation of bite marks which has the depth and shape of the teeth and jaw of the animal interfering to the cadaver, tissue losses, paw and tooth marks nd vital signs must be performed during autopsy. Current autopsy reports...

  16. Autopsy findings in severe malaria – a case report

    Dedi Afandi; Budi Sampurna; Inge Sutanto; J. W. Marwoto; Nurjati Chairani; Sutisna Himawan; Rawina W; Ivan Riyanto

    2008-01-01

    Severe malaria, caused by Plasmodium falciparum infection, has a high mortality rate and is the main cause of death in malaria. Since clinical autopsy is unpopular in Indonesia, autopsy examination in malaria cases is rarely done. We reported a forty three year old woman from non endemic area that was dead because of severe malaria. Diagnosis was concluded from autopsy, histopathology, and toxicology. (Med J Indones 2008; 17: 210-5)Keywords: Plasmodium falciparum, cerebral malaria, black wate...

  17. Autopsy findings in severe malaria – a case report

    Dedi Afandi

    2008-09-01

    Full Text Available Severe malaria, caused by Plasmodium falciparum infection, has a high mortality rate and is the main cause of death in malaria. Since clinical autopsy is unpopular in Indonesia, autopsy examination in malaria cases is rarely done. We reported a forty three year old woman from non endemic area that was dead because of severe malaria. Diagnosis was concluded from autopsy, histopathology, and toxicology. (Med J Indones 2008; 17: 210-5Keywords: Plasmodium falciparum, cerebral malaria, black water fever

  18. Psychological Autopsy: A Psychobiographical Exploration of Suicide

    José Alonso Andrade Salazar

    2013-06-01

    Full Text Available The present work is a conceptual approach on psychosocial factors related to suicidal psychobiography from the exploration of the lives of people who self-eliminate, for which there will be a review of the literature, based on input from journal articles and books published in various sources of documentation. Autopsy psychology is a data collection method that provides light on the psychosocial motivations that drive and reinforce the act of suicide, and is currently used by professionals responsible for investigating the causes of suicide while contributing data produced in the developing programs to promote mental health and prevention of suicidal ideation and behavior.

  19. Autopsy findings of fatal cryptogenic organizing pneumonia

    Terada, Tadashi

    2013-01-01

    Autopsy cases of cryptogenic organizing pneumonia (COP) have been rarely reported. A 73-year-old Japanese man consulted to a hospital because of flu-like sickness. He was diagnosed as pneumonia, and treated by antibiotics. He was referred to our hospital for further treatment. Chest X-P showed pneumonia involving the whole lungs. Blood laboratory test showed leukocytosis, increased CRP, and decreased PaO2. Despite of steroid therapy, he showed a downhill course and died one month after the fi...

  20. An autopsy case of zinc chloride poisoning.

    Kondo, Takeshi; Takahashi, Motonori; Watanabe, Seiya; Ebina, Masatomo; Mizu, Daisuke; Ariyoshi, Koichi; Asano, Migiwa; Nagasaki, Yasushi; Ueno, Yasuhiro

    2016-07-01

    Ingestion of large amounts of zinc chloride causes corrosive gastroenteritis with vomiting, abdominal pain, and diarrhea. Some individuals experience shock after ingesting large amounts of zinc chloride, resulting in fatality. Here, we present the results of an administrative autopsy performed on a 70-year-old man who ingested zinc chloride solution and died. After drinking the solution, he developed vomiting, abdominal pain, and diarrhea, and called for an ambulance. Except for tachycardia, his vital signs were stable at presentation. However, he developed hypotension and severe metabolic acidosis and died. The patient's blood zinc concentration on arrival was high at 3030μg/dL. Liver cirrhosis with cloudy yellow ascites was observed, however, there were no clear findings of gastrointestinal perforation. The gastric mucosa was gray-brown, with sclerosis present in all gastric wall layers. Zinc staining was strongly positive in all layers. There was almost no postmortem degeneration of the gastric mucosal epithelium, and hypercontracture of the smooth muscle layer was observed. Measurement of the zinc concentration in the organs revealed the highest concentration in the gastric mucosa, followed by the pancreas and spleen. Clinically, corrosive gastroenteritis was the cause of death. However, although autopsy revealed solidification in the esophagus and gastric mucosa, there were no findings in the small or large intestine. Therefore, metabolic acidosis resulting from organ damage was the direct cause of death. PMID:27497327

  1. Fetal autopsy and closing the gap.

    Kandasamy, Yogavijayan; Kilcullen, Meegan; Watson, David

    2016-06-01

    Over the past 30 years, the perinatal mortality rate (PMR) in Australia has been reduced to almost a quarter of that observed in the 1970s. To a large extent, this decline in the PMR has been driven by a reduction in neonatal mortality. Stillbirth rates have, however, remained relatively unchanged, and stillbirth rates for Aboriginal or Torres Strait Islander mothers have remained approximately twice that for non-Indigenous women over the last 10 years. The causes for this difference remain to be fully established. Fetal autopsy is the single most important investigative tool to determine the cause of fetal demise. While facilitators and barriers to gaining consent for autopsy have been identified in a non-Indigenous context, these are yet to be established for Indigenous families. In order to address the gap in stillbirths between Indigenous and non-Indigenous mothers, it is essential to identify culturally appropriate ways when approaching Aboriginal and Torres Strait Islander families for consent after fetal death. Culturally safe and appropriate counselling at this time provides the basis for respectful care to families while offering an opportunity to gain knowledge to reduce the PMR. Identifying the cause of preventable stillbirth is an important step in narrowing the disparity in stillbirth rates between Indigenous and non-Indigenous mothers. PMID:27250705

  2. An Autopsy Checklist: A Monitor of Safety and Risk Management.

    Shkrum, Michael James; Kent, Jessica

    2016-09-01

    Any autopsy has safety and risk management issues, which can arise in the preautopsy, autopsy, and postautopsy phases. The London Health Sciences Department of Pathology and Laboratory Medicine Autopsy Checklist was developed to address these issues. The current study assessed 1 measure of autopsy safety: the effectiveness of the checklist in documenting pathologists' communication of the actual or potential risk of blood-borne infections to support staff. Autopsy checklists for cases done in 2012 and 2013 were reviewed. The frequency of communication, as recorded in checklists, by pathologists to staff of previously diagnosed blood-borne infections (hepatitis B/C and human immunodeficiency virus) or the risk of infection based on lifestyle (eg, intravenous drug abuse) was tabulated. These data were compared with medical histories of the deceased and circumstances of their deaths described in the final autopsy reports. Information about blood-borne infections was recorded less frequently in the checklists compared with the final reports. Of 4 known human immunodeficiency virus cases, there was no checklist documentation in 3. All 11 hand injuries were documented. None of these cases had known infectious risks. The Autopsy Checklist is a standardized means of documenting safety and risk issues arising during the autopsy process, but its effectiveness relies on accurate completion. PMID:27356015

  3. Value of postmortem computed tomography in comparison to autopsy; Prospektive Untersuchung zur Wertigkeit der postmortalen Computertomographie im Vergleich zur Autopsie

    Paperno, S.; Krug, B.; Lackner, L. [Klinik und Poliklinik fuer Radiologische Diagnostik, Univ. zu Koeln (Germany); Riepert, T.; Rothschild, M.A.; Schultes, A.; Staak, M. [Inst. fuer Rechtsmedizin des Klinikums der Univ. zu Koeln (Germany)

    2005-01-01

    Purpose: to assess the diagnostic value of postmortem computed tomography (CT) in comparison to autopsy. Materials and methods: twenty-seven cadavers were examined by sequential cranial CT and helical CT through the neck, thorax and abdomen and subsequently underwent an autopsy with histomorphologic examination of the pathologic specimens. The findings of CT, autopsy and histology were registered and compared by three radiologists and one specialist for forensic medicine, using a data entry form. Results: in 19 of 27 cases, the findings explaining the cause of death were concordant for CT and autopsy. Intracranial, intraspinal and intracardiac gas accumulations (n = 12) were registered by CT alone. The detection of skull fractures was equal for both methods (n = 3). CT showed diagnostic problems in the assessment of pneumonic infiltrations (n = 16) and pulmonary edema (n = 21). Conclusion: CT is a useful and complementary method to autopsy. (orig.)

  4. SIRENOMELIA: A DETAILED FETAL AUTOPSY STUDY

    Parimala Sirikonda

    2015-12-01

    Full Text Available Sirenomelia also known as mermaid syndrome, characterized by fused lower limbs, is a lethal and rare congenital abnormality. This is an extreme example of caudal regression syndrome caused by vascular steal of single umbilical artery. Sirenomelia is found approximately one in 100,000 live births and is usually fatal because of complications associated with pulmonary hypoplasia, abnormal development of the kidneys and urinary bladder. Most of the cases are associated with maternal diabetes and single umbilical artery. We report a case of sirenomelia terminated at 21weeks of gestation due to multiple congenital abnormalities. Antenatal scan of a25-year old primi revealed a single live fetus of 21 weeks gestation with severe olighydramnios, non-visualization of kidneys and bladder and lower part of the spine. This pregnancy was terminated and the specimen sent to the department of anatomy for fetal autopsy. On external examination,a tail like rudimentary single midline lower limb without foot was noted. There were no external genitalia and anal orifice. Internal examination revealed hypoplastic lungs, atrial septal and ventricular septal defects, aberrant right subclavian artery, hypoplastic abdominal aorta distal to the single umbilical artery, complete agenesis of urinary system, rectal agenesis and rudimentary indeterminate gonads. We would like to discuss the clinical features, etio- pathogenesis and review of literature of sirenomelia. Early diagnosis and termination of this lethal congenital anomaly results in minimizing the trauma related to the termination of pregnancy at advanced gestation.

  5. An autopsy study of maternal mortality: A tertiary healthcare perspective

    Panchabhai T

    2009-01-01

    Full Text Available Background: An audit of autopsies of maternal deaths is important for the establishment of accurate cause of maternal deaths and to determine the contribution of various etiologies responsible in a given community. Aim: To study the causes of maternal deaths as determined by a pathological autopsy. Settings and Design: A retrospective study of all the cases of maternal deaths that underwent a pathological autopsy in a tertiary healthcare center from January 1998 to December 2006. Materials and Methods: The autopsy records with clinical notes were retrieved; gross and histopathology specimens and slides were studied to establish the accurate cause of maternal deaths. The variables like age (years, stay in the hospital, gravidity, trimester of pregnancy and method of delivery were used to classify and analyze the data from the autopsies. The causes of maternal deaths were divided in to direct and indirect; each being classified into subgroups based on the most evident pathology on autopsy. Results: The Maternal Mortality Rate (MMR over a nine-year period (1998-2006 was 827/100000 live births (471 maternal deaths against 56944 live births. An autopsy was performed in 277 cases (58.8%. In the autopsy group, the most common causes of maternal mortality were pre-ecclampsia/ecclampsia (40 of 277, 14.44% and hemorrhage (32 of 277; 11.55%; However, indirect causes like infectious diseases (27 of 277; 9.75% and cardiac (27 of 277; 9.75% disease also contributed to maternal deaths. Conclusion: Indirect causes like rheumatic heart disease and infections like tuberculosis, malaria or leptospirosis and nutritional anemia are still major causes of maternal mortality in developing countries like India. Intensive efforts need to be taken in these areas to reduce the maternal mortality in developing countries like India.

  6. Minimally invasive autopsies: a promise to revive the procedure

    Paulo Hilário Nascimento Saldiva

    2014-01-01

    Since ancient times, the autopsy has been a relevant source for the improvement of technical and scientific knowledge in the health area. From the first anatomic studies in the Middle Ages to the use of modern molecular techniques for the study of physiopathological processes, the autopsy has proven to be a very rich source of material and inspiration for the advancement of scientific knowledge. However, in recent decades, there has been a marked decline in medical autopsies—a situation that ...

  7. FETAL AUTOPSY STUDY OVER A TWO YEAR PERIOD

    Shailaja

    2015-02-01

    Full Text Available INTRODUCTION: Perinatal death rate is declining in developed and developing countries and so are perinatal autopsies. In the present days due to wider availability and awareness of prenatal scanning more and more congenital malformations are picked up in e arlier weeks of gestation. This helps in counselling of the couple which usually leads to an informed decision on medical termination of pregnancy. Autopsy performed on such fetuses , yields additional information in many cases. AIMS: The study was carried out to determine how well the prenatal ultrasound findings correlate with autopsy findings and also to determine the cause of death where ultrasound was not performed in patients who had spontaneous intrauterine death and abortion. MATERIALS AND METHODS: T his was a prospective study carried out over a period of two years in the department of pathology at Kamineni Academy of Medical Sciences and Research Centre , Hyderabad , from January 2013 to December 2014. A total of 23 fetal autopsies were performed of wh ich one was a twin pregnancy. Brief maternal history , prenatal ultrasound scans , relevant biochemical markers and genetic studies wherever done , were noted. RESULTS : There were 14 male (60.86% and 8 female (34.78% fetuses , and in one case (4.34% gender could not be identified. Nineteen cases (82.60 % were less than 28 weeks of gestation. Medical termination of pregnancy was done in 13 cases (56.52 % whereas , 10 patients (43.47 % had spontaneous intrauterine death of the fetus. Ultrasound scanning was done in 15 cases (65.21 %. In 13 cases (86.66 % the ultrasound and autopsy findings were correlating whereas in two cases (13.33 % there were findings on imaging study which could not be identified on autopsy. Ultrasound was not done in 8 cases (34.78 % out of which 5 cases (62.5 % showed findings on autopsy which could have led to the fetal demise. Twelve cases (52.17 % were referral cases which had come from other hospitals

  8. [Adult autopsies in a French university hospital (CHU Amiens) for the period 1975-2005].

    Chatelain, Denis; Brevet, Marie; Guernou, Malika; Manaouil, Cécile; Leclercq, Fabienne; Bruniau, Alexis; Cordonnier, Carole; Sevestre, Henri

    2007-09-01

    We have reviewed the pathological reports of adult necropsies performed in Amiens hospital during the 1975-2005 period. 1,639 autopsies were performed in 1,049 men and 590 women. We distinguished three periods: 1975-1987 (period 1) with a high number of autopsies (86/year), 1988-1996 (period 2) with a huge decrease of autopsies performed (43/year) and 1997-2005 (period 3) with few autopsies performed (14/year). Patients were younger during period 3, 38% were less than 50 years old versus 26% and 29% during periods 1 and 2. The sex ratio M/F increased during period 3 (2.7 versus 1.7 and 1.9 during periods 1 and 2). Period 3 showed an increase of major diagnoses discovered during autopsies (36% versus 28% of autopsies performed during periods 1 and 2) and showed an increase of autopsies performed after iatrogenic events (20% versus 12% and 13% of autopsies of periods 1 and 2). Period 3 showed an increase of the delay between the death of patients and autopsy and a decrease of the delay of transmission of pathological reports. 2% of autopsies were never answered by the pathologists. In conclusion, our study confirms the major decline of autopsies during the last 30 years. Patients autopsied are currently young men and the autopsies are more frequently performed in potential forensic circumstances. Selection biases explain that major diagnoses are more frequently found at autopsies nowadays than 30 years ago. PMID:18185448

  9. A fetal autopsy case of body stalk anomaly.

    Mathai, Alka Mary; Menezes, Ritesh G; Kumar, Suneet; Pai, Muktha R; Bhandary, Amritha; Fitzhugh, Valerie A

    2009-09-01

    Body stalk anomaly (BSA) is a sporadic polymalformative syndrome incompatible with extrauterine life. In utero detection of BSA by two-dimensional and three-dimensional ultrasonography and magnetic resonance imaging has been well documented. We herein describe a case of body stalk anomaly diagnosed at autopsy. The fetus had a large anterior midline abdominal wall defect with eventration of the visceral organs into the amnio-peritoneal sac and a completely absent umbilical cord. The associated anomalies included club foot, absent diaphragm, genitourinary, and gastrointestinal defects. The observed congenital anomalies supported the theory of embryonic dysgenesis as the etiologic factor. One of the major objectives in the performance of fetal autopsy is to be able to detect abnormalities that can have implications in future pregnancies. Despite the negligible familial recurrence rate of the broad spectrum of anomalies associated with this abdominal wall defect, the present case of fetal autopsy indeed delights to serve the living. PMID:19643652

  10. Clinical diagnosis versus autopsy findings in polytrauma fatalities

    Fakler Johannes K

    2010-10-01

    Full Text Available Abstract Objectives The aim of the study was to determine if differences in clinical diagnosis versus autopsy findings concerning the cause of death in polytrauma fatalities would be detected in 19 cases of fatal polytrauma from a Level 1 trauma centre. Methods Clinical diagnoses determining the cause of death in 19 cases of fatal polytrauma (2007 - 2008 from a Level 1 trauma centre were correlated with autopsy findings. Results In 13 cases (68%, the clinical cause of death and the cause of death as determined by autopsy were congruent. Marginal differences occurred in three (16% patients while obvious differences in interpreting the cause of death were found in another three (16% cases. Five fatalities (three with obvious differences and two with marginal differences were remarked as early death (1-4 h after trauma and one fatality with marginal differences as late death (>1 week after trauma. Obvious and marginal discrepancies mostly occurred in the early phase of treatment, especially when severely injured patients were admitted to the emergency room undergoing continued cardiopulmonary resuscitation, i. e. limiting diagnostic procedures, and thus the clinical cause of death was essentially determined by basic emergency diagnostics. Conclusions Autopsy as golden standard to define the cause of death in fatal polytrauma varies from the clinical point of view, depending on the patient's pre-existing condition, mechanism of polytrauma, necessity of traumatic cardiopulmonary resuscitation, survival time, and thus the possibility to perform emergency diagnostics. An autopsy should be performed at least in cases of early fatal polytrauma to help establishing the definite cause of death. Moreover, autopsy data should be included in trauma registries as a quality assessment tool.

  11. Extraskeletal Osteosarcoma of the Thigh: An Autopsy Case Report

    Akihito Nagano

    2009-01-01

    Full Text Available We report a case of extraskeletal osteosarcoma (ESOS and autopsy findings. A 35-year-old man presented with an ossified tumor in the right thigh and lung metastasis. The lung tumors continued to develop despite multiagent chemotherapy and caused death within 8 months. Autopsy revealed many secondary lesions in the lungs, especially in the left lung. Histopathologically, the primary tumor and one of the secondary tumors showed proliferation of spindle-shaped tumor cells focally forming lace-like osteoid material. Therefore, we made a definite diagnosis of ESOS.

  12. Pierre Robin sequence: case report, the relevance of autopsy

    Cristiano C. Oliveira

    2015-10-01

    Full Text Available ABSTRACTPierre Robin sequence is a neonatal disorder characterized by micrognathism, glossoptosis and cleft palate. We reported an autopsy case of a child whose malformations of the oropharynx were identified only at birth. The child was extremely preterm with severe neonatal depression and poor recovery, and the orofacial alterations prevented the correct treatment. There was facial disorder characterized by micrognathia associated with cleft palate and posterior displacement of the tongue, compressing the vallecula, structurally compatible with glossoptosis. This autopsy surpassed the scientific and epidemiological relevance, allowing the family genetic counseling and close monitoring of a subsequent pregnancy.

  13. An autopsied case of tuberculous meningitis showing interesting CT findings

    A 61-year-old female patient died of a neurological disorder of unknown origin one month after the first visit and was found to have had tuberculous meningitis at autopsy. CT revealed a low density area showing an enlargement of the cerebral ventricle but did not reveal contrast enhancement in the basal cistern peculiar to tuberculous meningitis. (Namekawa, K.)

  14. Psychological Autopsy Provides Insight into Gifted Adolescent Suicide.

    Cross, Tracy

    1996-01-01

    This article highlights findings of a study on the suicides of three academically talented male adolescents. Results of the psychological autopsies are reported in terms of commonalities with adolescent suicide in the general population; commonalities among the three cases related to their giftedness; and themes emerging across the cases,…

  15. Renal arterial aneurysm--an incidental finding at autopsy.

    Vaideeswar P

    1998-01-01

    Full Text Available Herein we describe a rare case of saccular renal artery aneurysm seen as an incidental autopsy finding in an elderly, hypertensive female. The aneurysm was seen as a small exophytic mass with calcified wall and lumen occluded by recanalized thrombus.

  16. Virtopsy versus autopsy in unusual case of asphyxia: case report.

    Aquila, I; Falcone, C; Di Nunzio, C; Tamburrini, O; Boca, S; Ricci, P

    2013-06-10

    We report the case of a 70-year-old woman found dead in her apartment in the South of Italy in February 2011. The detailed data showed that the victim was affected by familiar-type paranoid schizophrenia. This finding was confirmed by the discovery of antipsychotic and tricyclic antidepressant drugs in the house and the deposition of her psychiatric therapist. Before the autopsy, a multislice computed tomography (MSCT) scanning of the thoracic and facial maxillo-cervical area was performed that has allowed anatomical identification and diagnosis of a mechanical obstruction as the cause of death. The autopsy has showed the presence of materials obstructing the trachea totally. Histological and toxicological investigations were carried out on the victim. The toxicological investigation has shown the presence of metabolites of tricyclic antidepressants and antipsychotics in the blood and urine. The histology showed the presence of foreign-origin materials (starch fibres) inside the pulmonary alveolus. The cause of death was asphyxia due to obstruction by food-origin material. In this case the radiological data have been compared with the autopsy and toxicological and histological data. The comparison of results has shown that MSCT scanning may aid in identification of occlusion and then in determination of the cause of death. In conclusion, MSCT scanning can be proposed in the cases of suspected asphyxia, as the screening procedure of first instance to produce preliminary information useful to rapidly develop the successive autopsy performance. PMID:23582265

  17. [A Forensic Autopsy Case Applied for Asbestos-Related Disease].

    Makihara, Kosuke; Hamada, Tetsuo; Kasai, Kentaro; Tanaka, Toshiko; Sato, Hiroaki

    2016-03-01

    We had a forensic autopsy case that required additive pathological examination for the asbestos-related lung disease compensatory application afterwards. A man in his sixties with a history of occupational asbestos inhalation who had neither visited a hospital nor received a physical examination received forensic autopsy because of his death from unknown cause. An inmate said, "He developed cough and dyspnea, and died in the progression of the symptoms." The autopsy revealed widespread pleural plaques on both sides of the parietal pleura and multiple tumors in both sides of the lungs. The cause of death was diagnosed as lung cancer. Additional pathological examination was asked by his family to certify that he had suffered from asbestos-related lung disease in order to apply to the Asbestos-related Damage Relief Law. The Japanese criteria of the compensation law of asbestos-related lung cancer is the detection of more than 5,000 asbestos bodies per gram of dry lung tissue, while his number of asbestos bodies was 4,860. Asbestos bodies were reported to be accumulated in the distal lung parenchyma with no pathological changes. The present lung samples were collected from proximal section around the tumor, which might have made the number of asbestos bodies less than the criteria. Both the number of patients suffering from asbestos-related lung disease and the number of forensic autopsy cases have increased in Japan. Collecting lung samples from the appropriate lung section is essential and should be noted when the lung cancer is suspected at forensic autopsy in order to apply for asbestos-related lung disease compensation. PMID:26972947

  18. [Applications and advantages of a multimedia system for autopsies ].

    Gualco, M; Benzi, D; Fulcheri, E

    2001-10-01

    This work evaluates the benefits and applications of computers and multimedia systems in post-mortem examination practice and, more in particular, in the definition of data collection protocols. We examined issues concerning the different aims of autopsy (e.g. diagnostic, scientific, educational, legal), and found that the pathologist's main duty is to acquire a large amount of data in the best possible way. However, despite the will to carry out detailed post-mortem examinations, many pathologic anatomy services face objective difficulties in doing so, especially due to understaffing, lack of time and high costs. The Institute for Pathologic Anatomy of the University of Genoa has developed software for data handling and for outcome reporting, a particularly important aspect in fetal-perinatal diagnosis. The system consists of a relational database in a client-server environment (Fourth Dimension) with two integrated parts. The first part, with unrestricted access, contains patients' personal data, including gender, age, time and date of death, hospital department of origin, person and department requiring the post-mortem examination, hour and time of autopsy, pathologist's name, and clinical diagnosis of death. Using a scanner, a copy of the autopsy application is also field, together with the patient's medical file and any diagnostic images useful to document the case history. The second part of the information system is accessible by pathologists only, and contains the autopsy report. This part is organized to balance two different needs: it allows sufficient space and freedom for autopsy description while providing guidelines for presentation of the report. The structure of the conventional autopsy protocol has been maintained, with subdivisions for all the organs and apparatuses according to topographic criteria. Before this part, a section is dedicated to external cadaver examination and anthropometric data; weight, shape, volume and texture are described for

  19. Enlarged parietal foramina: a rare forensic autopsy finding.

    Durão, Carlos; Carpinteiro, Dina; Pedrosa, Frederico; Machado, Marcos P; Cunha, Eugénia

    2016-05-01

    Enlarged parietal foramina (EPF) are a quite rare developmental defect of the parietal bone which has to be distinguished from the normal small parietal foramina. We report a forensic case of an individual found in an advanced state of putrefaction in his own house with an undetermined cause of death. No evidence of trauma was observed, and the toxicological exam was negative. The victim was a 40-year-old man with a history of epilepsy. The large biparietal foramina, a rare anatomical variation and unusual autopsy finding, were observed at autopsy. The recognition of anatomical variations is important to avoid false interpretations and conclusions and has a significant potential as an identity factor, thus contributing to positive identification. PMID:26233611

  20. A case of occult intrahepatic cholangiocarcinoma diagnosed by autopsy.

    Oda, Eri; Hashimoto, Daisuke; Shiomi, Yuko; Ohnishi, Koji; Hayashi, Hiromitsu; Chikamoto, Akira; Takeya, Motohiro; Baba, Hideo

    2015-12-01

    Cancer of unknown primary is associated with unknown biology and dismal prognosis. The most common primary sites of cancer of unknown primary were usually the lungs in autopsy studies, and intrahepatic cholangiocarcinoma is rare. We describe the case of a 57-year-old male patient with systemic lymph node metastasis. Imaging examination failed to reveal primary cancer; however, immunostaining of cytokeratins 7, 19, and 20 of a metastatic axillary lymph node suggested a pancreaticobiliary cancer as a primary lesion. He died of liver abscess and sepsis, and then, autopsy indicated occult intrahepatic cholangiocarcinoma. We discuss the clinical course of this rare cholangiocarcinoma including the diagnostic procedure and also present a review of the English literature regarding patients with cancer of unknown primary. PMID:26943425

  1. The Homicide-Suicide Phenomenon: Findings of Psychological Autopsies.

    Knoll, James L; Hatters-Friedman, Susan

    2015-09-01

    Homicide-suicide represents a single episode of violence which may decimate an entire family. This study aimed to further describe motives and context of these tragedies. Psychological autopsies were completed for 18 homicide-suicide cases in Dallas, Texas. This included postevent interviews with surviving family members and review of police and coroner records. Two-thirds of perpetrators had made either verbal or written threats prior to the homicide-suicide. A simplified typology describing victim-perpetrator relationship and motive type is suggested for future studies and clinical ease. Two-thirds of perpetrators fell into the category of Intimate-Possessive, most of whom were depressed men who were abusing substances and undergoing separation. Additional categories included Intimate-Ailing, Filial-Revenge, Familial-Psychotic, and Friend-Psychotic. Further, implications from this psychological autopsy study regarding risk assessment include use of collateral interviews regarding threats and past violence. PMID:26259152

  2. Histomorphology of renal dysplasia--an autopsy study.

    Kakkar, Nandita; Menon, Santosh; Radotra, B D

    2006-01-01

    A retrospective analysis of pediatric autopsies in the past 18 years was done with the aim of studying the histomorphology of renal dysplasia. Renal dysplasia comprised 150 (3.66%) of the 4,099 pediatric autopsies from 20 weeks of gestation to 1 year of life. Primitive ducts with the fibromuscular collar, the sine qua non of renal dysplasia, was seen in all cases. Lobar disorganization and cysts were seen in all cases except for the 7 cases of hypodysplasia. Other elements were seen in varying proportions: cartilage in 33.7%, bone in 1.08%, thickening of basement membrane of the primitive ducts in 64.13%, extramedullary hematopoiesis in 98.9%, nerve twigs in 72.8%, and nodular renal blastema in 2.17% cases. In unilateral multicystic dysplasia/renal agenesis, the contralateral kidney showed abnormalities in 44.45% and 47.37% of cases, respectively. PMID:16908457

  3. Foetal Autopsy-Categories and Causes of Death

    Fatima, Uroos; Sherwani, Rana; Khan, Tamkin; Zaheer, Sufian

    2014-01-01

    Introduction: Intrauterine death(IUD)/ Stillbirth forms a major part of perinatal mortality which thereby is a good indicator of pregnancy wastage as well as quality of healthcare available. The key objectives of autopsy examination are to know the cause(s) of death, elucidation of pathogenic mechanism and quality control of clinical management. The aim of this study was to identify the prevalent causes of IUD, thereby taking appropriate measures to prevent them and decrease the perinatal mor...

  4. Respiratory outcomes among South African coal miners at autopsy

    Naidoo, R.N.; Robins, T.G.; Murray, J. [University of KwaZulu Natal, Durban (South Africa). Center for Occupational & Environmental Health

    2005-09-01

    Studies of dose-response relationships between respiratory outcomes at autopsy and coal dust exposure are limited. The Pathology Automation System (PATHAUT) database of South African miners, is one of the largest autopsy databases of occupational lung disease. This study described the prevalence of respiratory outcomes among South African coal miners at autopsy, and determined whether dose response relationships existed between emphysema and exposure. Autopsies conducted from 1975 to 1997 on coal miners with exclusive coal mining exposure and having exposure duration information (n = 3,167) were analyzed from PATHAUT Logistic regression was used to determine relationships between exposure and outcomes, controlling for race, smoking and age on a subset for whom smoking history was available (n = 725). The prevalence of silicosis, tuberculosis (TB), coal workers' pneumoconiosis (CWP), and moderate and marked emphysema were 10.7%, 5.2%, 7.3%, and 64%, respectively. All diseases, except TB, were associated with exposure duration. Black miners had 8.3 and 1.2 fold greater risks for TB and CWP, respectively, than white miners. White miners had an increased risk of 1.4 and 5.4 for silicosis and moderate to marked emphysema, respectively. In models unadjusted for age, and including smoking, moderate to marked emphysema was strongly associated with exposure duration (OR = 3.4; 95% CI = 1.9-5.9 for highest tercile of exposure duration). Exposure-related risk estimates were reduced when age was introduced into the model. However age and duration of exposure were highly correlated, = 0. 68) suggesting a dilution of the exposure effect by age. There were significant dose related associations of disease, including emphysema, with coal dust exposure.

  5. Suicides among Serbian war veterans: An autopsy study

    Mihailović Zoran

    2015-01-01

    Full Text Available Introduction. The risk of suicide among war veterans is a controversial issue, where findings so far have been contradictory. Objective. This study focusses on suicide in Serbian veterans from the wars in former Yugoslavia in the 1990s in order to create appropriate preventive measures and reduce the number of these fatal cases. Methods. The autopsy protocols of all 44 suicides committed by war veterans in the Belgrade District population over a period between 1992 and 2000 were investigated. Data were obtained from autopsy records, results of toxicological investigations and psychological autopsy protocols. Results. Symptoms of posttraumatic stress disorder were present in 27.3%, major depression in 9.1% and schizophrenia in 6.8% of veterans. The majority of suicides (84.1% were committed by recruits in the Yugoslav National Army, spending between three and eight months in the zone of war operations. Six committed suicide during the first 30 days after their war activities, while the majority of suicides occurred between five and six years after combat. The most frequent manner of suicide was the use of handguns (56.8% and bombs (18.2%. Conclusion. The results of this research may give useful information about the individuals with the highest suicidal risk in order to alleviate the consequences of war psychotraumas in veterans and prevent their growth into a permanent handicap or suicide. [Projekat Ministarstva nauke Republike Srbije, br. OI 175093

  6. The Abbreviated Injury Scale: application to autopsy data.

    Adams, V I; Carrubba, C

    1998-09-01

    Twenty autopsy reports, comprising 1 fall, 1 cutting, 1 burn, 1 drowning, 1 strangulation, 3 gunshot wound, and 13 traffic fatalities, were scored by the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS). The codes were adequate for wounds of skin and long bones, and for most wounds of viscera. The autopsy descriptions were more detailed than the coding criteria for craniocerebral, cervicovertebral and muscular trauma, and less detailed for thoracoabdominal visceral, and long bone trauma. Lung contusions and rib fractures received scores that seemed unduly high, possibly reflecting the greater sensitivity of autopsy diagnosis over clinical diagnosis for these lesions. Complete hinge fractures of the skull base scored 4 (severe), which does not reflect the almost universally lethal nature of the accompanying cerebral concussion, which was itself not codeable. AIS scores were low and did not seem to reflect the lethal outcome when the lethal mechanism was purely physiologic and without a striking morphologic derangement, as in instances of cerebral or cardiac concussion, compression of the neck, occlusive airway hemorrhage, and visceral herniation into an adjacent body cavity. The scores were similarly low when therapy was delayed or adverse. Low AIS and ISS scores in a fatality from blunt or penetrating trauma may be useful retrospective clues to the presence of purely physiologic death mechanisms or therapeutic problems. PMID:9760090

  7. Radiological diagnosis of splenic metastasis and its prevalence at autopsy

    CT and US findings of 7 cases of splenic metastases are described and the prevalence of splenic metastases at autopsy in 641 cases of malignant tumors were evaluated. Metastatic foci in spleen appeared mostly as poorly-defined low density masses on CT. Iodinated contrast material was administered in 2 cases, but no contrast enhancement was observed. US showed both hypoechoic and hyperechoic patterns. These appearances were nonspecific, but were similar to those of metastatic lesions in the liver which were often visible on CT associated with splenic metastases. At autopsy splenic metastases were found in 34 of 641 cases (5.3%). Gastric, colon, lung and ovarian cancers were most common primary tumors. However, the rate of splenic metastasis per tumor was highest in ovarian cancer (50.0%), followed by malignant melanoma (33.3%), colon cancer (16.2%), and gastric cancer (8.2%). Hepatoma which had the largest number of autopsy cases in this series showed the lowest rate of splenic metastases (0.8%). (author)

  8. Autopsy-certified maternal mortality at Ile-Ife, Nigeria

    Dinyain A

    2013-12-01

    Full Text Available Amatare Dinyain,1 G Olutoyin Omoniyi-Esan,2 Olaejirinde O Olaofe,3 Donatus Sabageh,3 Akinwumi O Komolafe,2 Olusegun S Ojo21Department of Anatomic Pathology, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria; 2Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria; 3Department of Morbid Anatomy and Histopathology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, NigeriaAim: Maternal mortality is a major health problem, especially in Nigeria, where accurate autopsy-based data on the prevalent causes are not readily available. The aim of this study was therefore to accurately determine the causes of maternal death as seen in a tertiary health facility in Nigeria.Materials and methods: This was a descriptive, retrospective review of the postmortem autopsy findings from cases of maternal death at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria over a 5-year period. Analyses were performed for differences in proportions using PEPI computer programs for epidemiologists (P is significant at <0.05.Results: A total of 84 cases of maternal deaths were used for the study. Approximately 71.4% of the maternal deaths were due to direct causes and 28.6% were due to indirect causes. The mean age at the time of death was 27.9±7.5 years. Overall, the three leading causes of death were obstetric hemorrhage (30.9%, complications of abortion (23.8%, and nongenital (nonobstetric infections (14.2%. Of the direct causes of maternal death, obstetric hemorrhage (43.3% was the leading cause, with postpartum hemorrhage accounting for most (65.0% of such deaths; other causes included complications of unsafe induced abortion (33.3% and of labor (11.7%. Of the indirect causes, nongenital infections (50.0%, anemia (25.0%, and preexisting hypertension (20.8% accounted for the majority of the maternal deaths. There was disparity between the clinical and

  9. An exploratory study of the pattern of consent for autopsy in a regional hospital setting.

    Kaar, T K

    2012-02-03

    A prospective study of the pattern of responses to requests for autopsy in a general surgical unit was performed. Information on the characteristics of the deceased, of the requestee and of the requester was documented in the case of 66 patients who died while in hospital. Permission to perform autopsy was not requested in 39 out of 66 cases and this was the most frequent contributory factor to the low rate of autopsy. Once a decision to grant or refuse autopsy is made by relatives of the deceased, the decision is unlikely to be reversed. Permission to perform autopsy was more likely to be sought when the deceased was male than when deceased was female. The relatives of patients who had recently undergone surgery were more likely to refuse permission for autopsy than were those of patients who had not had recent surgery.

  10. Differences between postmortem computed tomography and conventional autopsy in a stabbing murder case

    Zerbini, Talita; da Silva, Luiz Fernando Ferraz; Ferro, Antonio Carlos Gonçalves; Kay, Fernando Uliana; Junior, Edson Amaro; Pasqualucci, Carlos Augusto Gonçalves; do Nascimento Saldiva, Paulo Hilario

    2014-01-01

    OBJECTIVE: The aim of the present work is to analyze the differences and similarities between the elements of a conventional autopsy and images obtained from postmortem computed tomography in a case of a homicide stab wound. METHOD: Comparison between the findings of different methods: autopsy and postmortem computed tomography. RESULTS: In some aspects, autopsy is still superior to imaging, especially in relation to external examination and the description of lesion vitality. However, the fi...

  11. Differences between postmortem computed tomography and conventional autopsy in a stabbing murder case

    Talita Zerbini; Luiz Fernando Ferraz da Silva; Antonio Carlos Gonçalves Ferro; Fernando Uliana Kay; Edson Amaro Junior; Carlos Augusto Gonçalves Pasqualucci; Paulo Hilario do Nascimento Saldiva

    2014-01-01

    Objective: The aim of the present work is to analyze the differences and similarities between the elements of a conventional autopsy and images obtained from postmortem computed tomography in a case of a homicide stab wound. Method: Comparison between the findings of different methods: autopsy and postmortem computed tomography. Results: In some aspects, autopsy is still superior to imaging, especially in relation to external examination and the description of lesion vitality. However, th...

  12. Autopsy Findings in Conjoined Twin with Single Heart and Single Liver

    Kar Asaranti; Mohanty Pranati; Kar Tushar; Behera Jagadish; Behera Susmita; Nayak Amarendra

    2012-01-01

    Thoracoomphalopagus is the commonest type of conjoined twin where the bodies are fused from upper chest to lower chest. The autopsy done can help counsil the parents for further pregnancies and determine the prognosis depending upon the type of cardiac anomaly by Seo classification when detected antenatally. We describe the detail pathological autopsy of such a case with single heart and single liver. A detail autopsy was done on the twin fetus. The twins shared a single heart and sometimes t...

  13. Tingkat Pengetahuan Warga Lingkungan 14 Kelurahan Petisah Tengah Tentang Pentingnya Autopsi Forensik

    Daulay, Putri Aini

    2011-01-01

    Autopsy have important role in development of medical practice and science, but number do the autopsy have been decline in the world in a few last decade. Constraint which often faced in field by investigator in expressing cause of death of victim namely public often don't permit to be done by autopsy, along of the minim of knowledge of public concerning the important of forensic autopsy itself. This research aim to know level of knowledge of citizen of area of 14 sub-district of mi...

  14. Significance of External Findings in Hanging Cases during Autopsy

    Sahoo, Niranjan; Kumar, Nityanand; Panda, Bibhuti Bhusana; Dutta, Arunava

    2016-01-01

    The external findings are utmost important in the opinion formation during autopsy of hanging deaths. Thus the current study was done with the aim of studying the significance of external findings in hanging cases during post-mortem examination in the Department of FMT, RIMS, Ranchi prospectively from 1st March, 2013 to 30th May, 2014. Majority of cases of hanging had not received any treatment. In maximum cases the nature of suspension was complete type. Atypical hangings were seen in most c...

  15. The lumbar interspinous bursae and Baastrup's syndrome. An autopsy study.

    Bywaters, E G; Evans, S

    1982-01-01

    This study describes the prevalence, distribution, pathology and pathogenesis of lumbar interspinous bursitis (described as a clinical syndrome by Baastrup in 1933). It is based on an anatomic study of 152 lumbar spines derived from routine and random postmortem material, together with selected specimens from autopsies on patients with various rheumatic diseases. From a statistical study of 50 randomly chosen spines, bursae are found when the interspinous distance is small compared with the total height of the lumbar spine ('bursal index'): nearly all bursal spaces show some sign of inflammation and a few show severe bony erosion. Crystal deposits therein are also described. PMID:7178764

  16. CAUSES OF DEATH IN NEWBORN INFANTS ACCORDING TO AUTOPSY FINDINGS

    Gh.- R. Walizadeh

    1987-12-01

    Full Text Available Autopsy findings in 138 newborn infants which died in a university nursery during 3 years are reviewed and discussed. 80 per cent were premature and small- for- date newborns of up to 2500 g birth weight. Most of these cases showed in addition to general prematurely signs, respiratory tract diseases such as atelectasia, amniotic fluid aspiration and hyaline membrane disease. The full term infants died mostly of malformations. In post neonatal period the cause of death was almost entirely infections such as bronchopneumonia, gastroenteritis and septicemia.

  17. Primary diffuse leptomeningeal gliomatosis: An autopsy case report

    Shaik Afshan Jabeen

    2014-01-01

    Full Text Available Primary diffuse leptomeningeal gliomatosis (PDLG is a rare condition, characterized by infiltration of the meninges by glial cells without evidence of the primary tumor in the brain or spinal cord parenchyma. Glioma arising primarily from the leptomeninges is extremely rare and often diagnosed only in post mortem examination and the diagnosis may be missed in meningeal biopsy. We describe a young female who presented with symptoms of raised intracranial pressure with imaging evidence of diffuse leptomeningeal enhancement in whom autopsy confirmed the diagnosis of PDLG. Our case illustrates the diagnostic difficulties in making the pre-mortem diagnosis even with multiple cerebrospinal fluid cytologies and leptomeningeal biopsy.

  18. An Autopsy of Nanofiltration Membrane Used for Landfill Leachate Treatment

    Ibrahim Demir

    2015-01-01

    Full Text Available Komurcuoda leachate treatment plant, Istanbul, which consists of membrane bioreactor (MBR and nanofiltration (NF system, faced rapid flux decline in membranes after 3-year successful operation. To compensate rapid flux decline in membranes, the fouled membranes were renewed but replacement of the membranes did not solve the problem. To find the reasons and make a comprehensive analysis, membrane autopsy was performed. Visual and physical inspection of the modules and some instrumental analysis were conducted for membrane autopsy. Membranes were found severely fouled with organic and inorganic foulants. Main foulant was iron which was deposited on surface. The main reason was found to be the changing of aerator type of MBR. When surface aerators were exchanged with bottom diffusers which led to increasing of dissolved oxygen (DO level of the basin, iron particles were oxidized and they converted into particulate insoluble form. It was thought that probably this insoluble form of the iron particles was the main cause of decreased membrane performance. After the diagnosis, a new pretreatment alternative including a new iron antiscalant was suggested and system performance has been recovered.

  19. [An Autopsy Case of Abnormal Behaviour Induced by Zolpidem].

    Usumoto, Yosuke; Kudo, Keiko; Sameshima, Naomi; Sato, Kazuo; Tsuji, Akiko; Ikeda, Noriaki

    2015-06-01

    Zolpidem is a widely used ultrashort-acting non-benzodiazepine in clinical practice; compared with benzodiazepines, it does not have side effects such as daytime hangover, rebound insomnia, and development of tolerance. We report an autopsy case of abnormal behaviour induced by zolpidem. A man in his 60's had suffered from postherpetic neuralgia about 2 months ago and had been prescribed zolpidem for insomnia. According to his family, he had no memory of his actions such as striking a wall, taking his futon outside, and eating 5 times a day after he took zolpidem. Because his postherpetic neuralgia did not improve, he was hospitalized and treated with an epidural block. During hospitalization, he took off his clothes, removed the epidural block catheter by himself, and slept on others' beds. He disappeared from the hospital one day; the next day, he was found dead in a narrow water storage tank 10 km away from the hospital. He was thought to have driven a car by himself to reach the place. Forensic autopsy revealed that the cause of death was drowning. Zolpidem and several other drugs were detected by toxicological analysis of his blood; the concentrations of these drugs were within therapeutic range. There are several reports about somnambulism induced by zolpidem such as sleepwalking, sleep driving, and eating. Considering the strange episodes following zolpidem administration, his behaviour on the day of his death was considered abnormal behaviour induced by zolpidem. PMID:26306385

  20. An autopsy case of fatal repellent air freshener poisoning.

    Hitosugi, Masahito; Tsukada, Chie; Yamauchi, Shinobu; Matsushima, Kazumi; Furukawa, Satoshi; Morita, Satomu; Nagai, Toshiaki

    2015-09-01

    We describe a first fatal case of repellent air freshener ingestion. A 79-year-old Japanese man with Alzheimer-type senile dementia orally ingested repellent air freshener containing three surfactants: polyoxyethylene 9-lauryl ether, polyoxyethylene (40) hydrogenated castor oil, and lauric acid amidopropyl amine oxide (weight ratio of 1.3%). About 1h after the collapse, he was in cardiopulmonary arrest and subsequently died 10h after his arrival. The forensic autopsy performed 5.5h after death revealed the 380ml of stomach contents with a strong mint perfume identical to that of the repellent air freshener and the findings of acute death. Toxicologically, 9.1μg/ml and 558.2μg/ml of polyoxyethylene 9-lauryl ether were detected from the serum and stomach contents taken at autopsy. Generally, ingestion of anionic or non-ionic surfactants have been considered as safe. However, because the patient suffered from cardiac insufficiency with a low dose of repellent air freshener ingestion, medical staff members must evaluate the elderly patient for cardiac and circulatory problems regardless of the ingested dose. Not only medical and nursing staff members, but also families who are obliged to care for elderly persons must be vigilant to prevent accidental ingestion of toxic substances generally used in the household. PMID:25982958

  1. An Autopsy of Nanofiltration Membrane Used for Landfill Leachate Treatment

    Demir, Ibrahim; Koyuncu, Ismail; Guclu, Serkan; Yildiz, Senol; Balahorli, Vahit; Caglar, Suphi; Turken, Turker; Pasaoglu, Mehmet E.; Kaya, Recep; Sengur-Tasdemir, Reyhan

    2015-01-01

    Komurcuoda leachate treatment plant, Istanbul, which consists of membrane bioreactor (MBR) and nanofiltration (NF) system, faced rapid flux decline in membranes after 3-year successful operation. To compensate rapid flux decline in membranes, the fouled membranes were renewed but replacement of the membranes did not solve the problem. To find the reasons and make a comprehensive analysis, membrane autopsy was performed. Visual and physical inspection of the modules and some instrumental analysis were conducted for membrane autopsy. Membranes were found severely fouled with organic and inorganic foulants. Main foulant was iron which was deposited on surface. The main reason was found to be the changing of aerator type of MBR. When surface aerators were exchanged with bottom diffusers which led to increasing of dissolved oxygen (DO) level of the basin, iron particles were oxidized and they converted into particulate insoluble form. It was thought that probably this insoluble form of the iron particles was the main cause of decreased membrane performance. After the diagnosis, a new pretreatment alternative including a new iron antiscalant was suggested and system performance has been recovered. PMID:26137593

  2. 20 CFR 410.428 - X-ray, biopsy, and autopsy evidence of pneumoconiosis.

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false X-ray, biopsy, and autopsy evidence of... Pneumoconiosis § 410.428 X-ray, biopsy, and autopsy evidence of pneumoconiosis. (a) A finding of the existence of... shows the existence of pneumoconiosis, or (3) A biopsy (other than a needle biopsy) shows the...

  3. The presence of enterovirus, adenovirus, and parvovirus B19 in myocardial tissue samples from autopsies

    Nielsen, Trine Skov; Hansen, Jakob; Nielsen, Lars Peter;

    2014-01-01

    adenovirus, enterovirus, and parvovirus B19 (PVB) in myocardial autopsy samples from myocarditis related deaths and in non-inflamed control hearts in an effort to clarify their significance as the causes of myocarditis in a forensic material. METHODS: We collected all autopsy cases diagnosed with myocarditis...

  4. Differences between postmortem computed tomography and conventional autopsy in a stabbing murder case

    Talita Zerbini

    2014-12-01

    Full Text Available Objective: The aim of the present work is to analyze the differences and similarities between the elements of a conventional autopsy and images obtained from postmortem computed tomography in a case of a homicide stab wound. Method: Comparison between the findings of different methods: autopsy and postmortem computed tomography. Results: In some aspects, autopsy is still superior to imaging, especially in relation to external examination and the description of lesion vitality. However, the findings of gas embolism, pneumothorax and pulmonary emphysema and the relationship between the internal path of the instrument of aggression and the entry wound are better demonstrated by postmortem computed tomography. Conclusions: Although multislice computed tomography has greater accuracy than autopsy, we believe that the conventional autopsy method is fundamental for providing evidence in criminal investigations.

  5. Correlated study of cerebral infarcts by CAT and autopsy

    The author aims to demonstrate the increased information which can be acquired from a correlated study of the computed tomogram and the pathomorphological patterns of the most common infarctions seen at autopsy. The discussion is divided into two sections: 1. A short bird's-eye view on the laws of distribution of flow in cases of cerebrovascular insufficiency, particularly all the deviations from simple hemodynamics in the process of infarction. 2. A systematic demonstration of the most frequent CT-patterns correlated with the corresponding pathomorphological specimens. This report is based on 6500 cerebral CTs, from which 590, i.e. 9%, showed infarcts. These include mainly cases seen in the neurological ward of the Merheim City Hospital. (Auth.)

  6. Dicephalus dipus dibrachius twins: report of an autopsy case

    Cristiano Claudino Oliveira

    2014-06-01

    Full Text Available Dicephalus dipus dibrachius twins are a rare form of conjoined twins. An autopsy of conjoined dicephalus twins is reported. The diagnosis was performed during the pregnancy and the family received a judicial authorization for termination of pregnancy. The preterm newborn progressed to cardiac arrest and died following a court order to terminate the pregnancy. The conceptus presented two arms, two legs, a trunk, two heads, and a single umbilical cord. The two spinal columns presented vertebral fusion in the sacral region. The heart exhibited complex malformations. The external genitalia were female; and cytogenetic analysis confirmed female sex (46, XX. This analysis also corroborated the etiopathogenic hypotheses described for this abnormality, which proposes failures in embryonic formation rather than specific chromosomal alterations. Current identification of cases by ultrasound permits medical management and multidisciplinary action with the family, enabling the legal termination of pregnancy.

  7. Los Alamos Scientific Laboratory's human autopsy tissue analysis study

    Since 1959, the Health Division, Los Alamos Scientific Laboratory has analyzed the tissues from 81 former employees of the Laboratory for plutonium. Additionally, approximately 700 autopsy cases from the general population have also been analyzed for Pu resulting from fallout. The variation in the distribution of Pu in the bodies of the occupationally exposed individuals suggest that each exposure incident is unique and must be evaluated on the basis of the chemical form, solubility, particle size, mode of entry, and duration of exposure. Particle size distribution of Pu in a lymph node of a long-term chronic exposure case was estimated to have a mass median diameter of 0.32 μm with a geometric standard deviation of 1.5. The baseline concentrations of environmental Pu have been estimated for the general population and the tissue distributions compared with the occupationally exposed cases

  8. Pleural plaques at autopsy, smoking habits, and asbestos exposure

    Andrion, A.; Pira, E.; Mollo, F.

    1984-02-01

    An investigation was made to correlate post-mortem findings of pleural plaques (PP) with the smoking habits and occupational history of asbestos exposure of 898 adults from the general population. A significant association between PP and smoking was found in middle-aged and elderly men (p less than 0.001). When occupational history was considered, such an association was present in both exposed (p less than 0.01) and non-exposed (p less than 0.05) men aged over 50 years. No association was observed in non-exposed women, while in those exposed, the absolute number of cases was too small to evaluate any relationship. The number of cigarettes smoked did not correlate significantly with the frequency of PP. This autopsy study confirms the association between occurrence of PP and the smoking habits.

  9. Primary pleural angiosarcoma associated with pneumoconiosis: An autopsy case.

    Matsuda, Katsuya; Yamaryo, Takeshi; Akazawa, Yuko; Kawakami, Kenji; Nakashima, Masahiro

    2015-11-01

    We report a case of pleural angiosarcoma in an adult male patient confirmed by autopsy and possibly associated with pneumoconiosis. The lesion was characterized by thickened pleura of both lungs with nodular tumors. Histologically, the tumor was composed of spindle-to-polygonal epithelioid cells that were positive for CD31, CD34, vimentin, and cytokeratin on immunohistochemical staining but were negative for calretinin. Further examination revealed mix-dust pathological findings consistent with the existence of pneumoconiosis; dystrophic ossification, anthracosis, and fractal small dust particles were observed in the lung parenchyma and a hilar lymph node. The current case suggests that pneumoconiosis-associated pathologies may be risk factors for the development of angiosarcoma in the pleura. PMID:26314557

  10. Autopsy cases of hepatocellular carcinoma in atomic bomb survivors

    Since 1956, 388 autopsy cases of hepatocellular carcinoma (HCC) have been obtained at the Hiroshima Red Cross and A-Bomb Survivors Hospital, which consisted of those of proximately exposed 52 A-bomb survivors (mean age, 63.8 years), 105 distally exposed A-bomb survivors (mean age, 64.2 years), and the other 231 non-exposed patients (mean age, 60.6 years). Since 1985, the incidence of HCC tended to be higher in both proximately and distally exposed groups than the non-exposed group. There was no consistent tendency for the incidence of HCC by ages at autopsy and A-bombing. The incidence of liver cirrhosis was approximately 2 times higher in males than females in the non-exposed group, although no gender difference existed after 1981. In the exposed group, the incidence was similar in male and female groups. Approximately 90% of HCC patients had coexistent liver cirrhosis. Liver cirrhosis was associated with HCC in 50-60%. No significant differences in these incidences were observed between the exposed and non-exposed groups. The proportion of liver cirrhosis associated with HCC became constant in patients over the age of 40 in the non-exposed group. In the exposed group, on the other hand, the proportion reached the peak in those in their fifties and sixties. Survival time tended to be longer in the exposed group than the non-exposed group. The patients in the non-exposed group tended to have histologically atypical type and metastases, as compared with those in the exposed group. (N.K.)

  11. Performance of the Tariff Method: validation of a simple additive algorithm for analysis of verbal autopsies

    Murray Christopher JL

    2011-08-01

    Full Text Available Abstract Background Verbal autopsies provide valuable information for studying mortality patterns in populations that lack reliable vital registration data. Methods for transforming verbal autopsy results into meaningful information for health workers and policymakers, however, are often costly or complicated to use. We present a simple additive algorithm, the Tariff Method (termed Tariff, which can be used for assigning individual cause of death and for determining cause-specific mortality fractions (CSMFs from verbal autopsy data. Methods Tariff calculates a score, or "tariff," for each cause, for each sign/symptom, across a pool of validated verbal autopsy data. The tariffs are summed for a given response pattern in a verbal autopsy, and this sum (score provides the basis for predicting the cause of death in a dataset. We implemented this algorithm and evaluated the method's predictive ability, both in terms of chance-corrected concordance at the individual cause assignment level and in terms of CSMF accuracy at the population level. The analysis was conducted separately for adult, child, and neonatal verbal autopsies across 500 pairs of train-test validation verbal autopsy data. Results Tariff is capable of outperforming physician-certified verbal autopsy in most cases. In terms of chance-corrected concordance, the method achieves 44.5% in adults, 39% in children, and 23.9% in neonates. CSMF accuracy was 0.745 in adults, 0.709 in children, and 0.679 in neonates. Conclusions Verbal autopsies can be an efficient means of obtaining cause of death data, and Tariff provides an intuitive, reliable method for generating individual cause assignment and CSMFs. The method is transparent and flexible and can be readily implemented by users without training in statistics or computer science.

  12. Simplified Symptom Pattern Method for verbal autopsy analysis: multisite validation study using clinical diagnostic gold standards

    Lozano Rafael

    2011-08-01

    Full Text Available Abstract Background Verbal autopsy can be a useful tool for generating cause of death data in data-sparse regions around the world. The Symptom Pattern (SP Method is one promising approach to analyzing verbal autopsy data, but it has not been tested rigorously with gold standard diagnostic criteria. We propose a simplified version of SP and evaluate its performance using verbal autopsy data with accompanying true cause of death. Methods We investigated specific parameters in SP's Bayesian framework that allow for its optimal performance in both assigning individual cause of death and in determining cause-specific mortality fractions. We evaluated these outcomes of the method separately for adult, child, and neonatal verbal autopsies in 500 different population constructs of verbal autopsy data to analyze its ability in various settings. Results We determined that a modified, simpler version of Symptom Pattern (termed Simplified Symptom Pattern, or SSP performs better than the previously-developed approach. Across 500 samples of verbal autopsy testing data, SSP achieves a median cause-specific mortality fraction accuracy of 0.710 for adults, 0.739 for children, and 0.751 for neonates. In individual cause of death assignment in the same testing environment, SSP achieves 45.8% chance-corrected concordance for adults, 51.5% for children, and 32.5% for neonates. Conclusions The Simplified Symptom Pattern Method for verbal autopsy can yield reliable and reasonably accurate results for both individual cause of death assignment and for determining cause-specific mortality fractions. The method demonstrates that verbal autopsies coupled with SSP can be a useful tool for analyzing mortality patterns and determining individual cause of death from verbal autopsy data.

  13. Autopsy practice in forensic pathology - Evidence-based or experience-based?

    Colville-Ebeling, Bonnie; Freeman, Michael; Banner, Jytte;

    2014-01-01

    Current autopsy practice in forensic pathology is to a large extent based on experience and individual customary practices as opposed to evidence and consensus based practices. As a result there is the potential for substantial variation in how knowledge is applied in each case. In the present case......-gathering and the use of check lists specific to certain injury causes are likely to result in less deviation from evidence-based practices in forensic pathology. Pre-autopsy data-gathering and check lists will help ensure a higher degree of standardization in autopsy reports thus enhancing the quality and...

  14. Utility of Postmortem Autopsy via Whole-Body Imaging: Initial Observations Comparing MDCT and 3.0T MRI Findings with Autopsy Findings

    Cha, Jang Gyu; Kim, Dong Hun; Paik, Sang Hyun [National Institute of Scientific Investigation, Seoul (Korea, Republic of)

    2010-08-15

    We prospectively compared whole-body multidetector computed tomography (MDCT) and 3.0T magnetic resonance (MR) images with autopsy findings. Five cadavers were subjected to whole-body, 16- channel MDCT and 3.0T MR imaging within two hours before an autopsy. A radiologist classified the MDCT and 3.0T MRI findings into major and minor findings, which were compared with autopsy findings. Most of the imaging findings, pertaining to head and neck, heart and vascular, chest, abdomen, spine, and musculoskeletal lesions, corresponded to autopsy findings. The causes of death that were determined on the bases of MDCT and 3.0T MRI findings were consistent with the autopsy findings in four of five cases. CT was useful in diagnosing fatal hemorrhage and pneumothorax, as well as determining the shapes and characteristics of the fractures and the direction of external force. MRI was effective in evaluating and tracing the route of a metallic object, soft tissue lesions, chronicity of hemorrhage, and bone bruises. A postmortem MDCT combined with MRI is a potentially powerful tool, providing noninvasive and objective measurements for forensic investigations

  15. [Some findings of the lung in medicolegal autopsy cases].

    Ohya, I

    1994-12-01

    "At first glance the lungs may seem uncomplicated, but many wise men have gone astray in their labyrinths." These words were written by Dr. A.A. Liebow, a famous pathologist, in a foreword to the first edition of Pathology of the Lung by H. Spencer. This same thought can also be applied to the field of medicolegal autopsies. 1. The gross appearance of the lungs in medicolegal autopsies Plucks consisting of the lungs, neck organs, the esophagus and the aorta were removed from human cadavers and after taking photos of the frontal and rear view, the lungs were carefully examined to reveal whether the lung shows characteristic morphological changes depending on causes of death. Based on their appearance, the lungs were classified into the 3 following types: a collapsed, a non-collapsed and an inflated type, each of these types reflecting the probable cause of death. The collapsed type of lung was seen in cases of death from exanguination, and the lung falling into shrinkage due to traumatic pneumo- and/or hemo-thorax was also classified into the collapsed type. The non-collapsed type of lung was seen in cases whose lungs were thermo-coagulated and in a case of death from a pulmonary embolism. Also, the deflating lungs of drowning victims before falling into collapse, were classified into a non-collapsed type. The inflated type of lung consisted of lungs that showed ballooning soon after death by drowning, and lungs that had inflated due to emphysema or edema from various causes. This lung study has reconfirmed that the lungs show hypostatic changes more clearly than any other organs of the body, and in the absence of skin color changes reflecting hypostasis, the settling of the blood in the lung could be detected in most cases. 2. Early histopathological lung changes induced by shock One hundred and thirty medicolegal cases were reviewed to detect early histopathological changes of the lung induced by shock. In many cases of death from various causes, pulmonary edema

  16. An autopsy study of 74 cases of cut throat injuries

    Dinesh Rao

    2015-12-01

    Full Text Available The present prospective autopsy study was carried out during the period July 2009 to May 2012 in Kingston, Jamaica. A total of 74 cases of cut throat injury were studied. All the cut throat injuries irrespective of those directly or indirectly contributing to the death were studied. Males dominated the list of victims, contributing to 71.62% (n = 53. Majority of those were in the age group 21–30 (n = 25 and 31–40 (n = 26 which contributed to 33.78% and 35.13% respectively. Majority of the cases were homicides contributing to 97.29% (n = 72 of cases, only 2.7% were suicides and accidental cut throat were never reported. Males dominated the homicides category contributing to 72.22% (n = 52 of the cases. Gang and relationship crisis (homosexual and heterosexual were the major motivating factors, each contributing to 39.19% (n = 29 and 32.43% (n = 24 of the cases, respectively. The disease suffered by individuals were the least motivating factors contributing to 1.35% of cases (n = 01. The most common cause of death was exsanguinations in 49.95% (n = 34 of cases followed closely by asphyxia due to aspiration of blood i.e. 36.49% (n = 27 of cases and air embolism was the least cause of death, contributing to 4.05% (n = 03 of cases. Cut throat injury was associated with other injuries like gunshot wound, chop wounds and stab wounds in 13.52% of (n = 10 autopsies. Chop injuries contributed to maximum number of other injuries in homicides (n = 46. The most preferred place for the crime was an open field or farm (n = 26. Majority of the cut throat wounds were situated in zone II level contributing to 66.21% (n = 49 of cases. Majority of the wounds were directed from left to right in 75.68% (n = 56 of cases and the cervical vertebra was affected in 8.11% (n = 06 of cases. Major weapon of choice was machete contributing to 83.78% (n = 62 of injuries. The low income group was the most affected group contributing to 91

  17. Cardiac Channel Molecular Autopsy: Insights From 173 Consecutive Cases of Autopsy-Negative Sudden Unexplained Death Referred for Postmortem Genetic Testing

    Tester, David J.; Medeiros-Domingo, Argelia; Will, Melissa L.; Haglund, Carla M.; Ackerman, Michael J.

    2012-01-01

    Objective To perform long QT syndrome and catecholaminergic polymorphic ventricular tachycardia cardiac channel postmortem genetic testing (molecular autopsy) for a large cohort of cases of autopsy-negative sudden unexplained death (SUD). Methods From September 1, 1998, through October 31, 2010, 173 cases of SUD (106 males; mean ± SD age, 18.4±12.9 years; age range, 1-69 years; 89% white) were referred by medical examiners or coroners for a cardiac channel molecular autopsy. Using polymerase chain reaction, denaturing high-performance liquid chromatography, and DNA sequencing, a comprehensive mutational analysis of the long QT syndrome susceptibility genes (KCNQ1, KCNH2, SCN5A, KCNE1, and KCNE2) and a targeted analysis of the catecholaminergic polymorphic ventricular tachycardia type 1–associated gene (RYR2) were conducted. Results Overall, 45 putative pathogenic mutations absent in 400 to 700 controls were identified in 45 autopsy-negative SUD cases (26.0%). Females had a higher yield (26/67 [38.8%]) than males (19/106 [17.9%]; P<.005). Among SUD cases with exercise-induced death, the yield trended higher among the 1- to 10-year-olds (8/12 [66.7%]) compared with the 11- to 20-year-olds (4/27 [14.8%]; P=.002). In contrast, for those who died during a period of sleep, the 11- to 20-year-olds had a higher yield (9/25 [36.0%]) than the 1- to 10-year-olds (1/24 [4.2%]; P=.01). Conclusion Cardiac channel molecular autopsy should be considered in the evaluation of autopsy-negative SUD. Several interesting genotype-phenotype observations may provide insight into the expected yields of postmortem genetic testing for SUD and assist in selecting cases with the greatest potential for mutation discovery and directing genetic testing efforts. PMID:22677073

  18. 78 FR 38735 - Autopsy Performance Criteria: Standards, Guidelines and Best Practices

    2013-06-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE Office of Justice Programs Autopsy Performance Criteria: Standards, Guidelines and Best Practices AGENCY... and Best Practices''. The opportunity to provide comments on this document is open to...

  19. Meconium aspiration in the midtrimester fetus: an autopsy study.

    Mortensen, Elin; Kearney, Michael Shelley

    2009-01-01

    We studied the incidence, severity, and significance of intrauterine meconium aspiration (IUMA) in the midtrimester fetus. Lung sections from 219 midtrimester fetuses were examined for meconium, identified by finding meconium corpuscles. There were 21 cases (9.6%) with IUMA. Gestational age ranged from 13 to 23 weeks (mean 18.7 weeks); 11 were female, and 10 were male. Eighteen were spontaneous abortions, 11 of which were macerated, and 1 of these was associated with an intrauterine contraceptive device. There were 3 terminations of pregnancy, 2 for fetal abnormality and 1 for severe preeclampsia. One fetus was conceived by in vitro fertilization. Fifteen cases (71.4%) showed slight IUMA, 5 cases (23.8%) showed moderate IUMA, and in 1 case (4.8%) IUMA was massive. The incidence of IUMA in an autopsy series of midtrimester fetuses was 9.6%. The amount of aspirated meconium was usually small and possibly physiologic. When IUMA was moderate or massive, it was associated with severe abnormality of the umbilical cord or placenta, particularly subchorionic hematoma. PMID:19323599

  20. Intracranial malignant lymphomas. Clinicopathological study of 26 autopsy cases

    Onda, Kiyoshi; Wakabayashi, Koichi; Tanaka, Ryuichi; Takahashi, Hitoshi [Niigata Univ. (Japan). Brain Research Inst

    1999-07-01

    We examined 26 autopsy-proven cases of intracranial malignant lymphoma (IML) in immunocompetent patients to determine the extent of neoplastic involvement of the central nervous system (CNS) and to evaluate the effects of radiation on the tumor and brain tissue. All tumors were identified as diffuse non-Hodgkin's lymphomas of B-cell origin. In six patients who had not received radiotherapy, the clinical course of the disease was short and extensive infiltration of the tumor was seen. The remaining 20 patients were treated with radiotherapy and had a longer survival time. Leptomeningeal involvement was common, but extensive subarachnoid proliferation of the tumor was seen in only two cases. The posterior, but not anterior, lobe of the pituitary was involved in 5 of 22 cases, and choroid plexus involvement was seen in 4 of 21. Direct invasion of the tumor into the spinal cord, which tended to occur in patients with posterior fossa masses, was observed in 5 of 21 cases. Following irradiation, coagulation necrosis was frequently found in the invading zone as well as in the tumor mass, and degeneration of the white matter was also seen. We suggest that IML can extensively infiltrate into the CNS, including the posterior lobe of the pituitary and spinal cord, and that radiation injury to the brain appears to occur relatively easily in this disease. (author)

  1. Autopsy findings in 14 patients with penile squamous cell carcinoma.

    Chaux, Alcides; Reuter, Victor; Lezcano, Cecilia; Velazquez, Elsa; Codas, Ricardo; Cubilla, Antonio L

    2011-04-01

    The aim of this study was to describe pathologic features found at autopsy of 14 patients with penile cancer. Nine patients died from disseminated disease; 5 of them presented local/regional recurrences. Five patients died from other causes, 2 of them postoperatively. Local recurrence sites were corpus cavernosum, Buck's fascia and urethra, regional skin, and prostate. Metastatic sites were lymph nodes (9 cases), liver (7 cases), lungs (6 cases), heart (5 cases), adrenals, bone and skin (3 cases each), thyroid and brain (2 cases each), and pancreas, spleen, and pleura (1 case each). Patients with heart metastasis had arrhythmias. Patients who died and who did not die from penile cancer had different profiles: low-grade superficial tumors with usual and warty subtypes versus high-grade deeply invasive basaloid or hybrid verrucous/sarcomatoid carcinomas. A natural history model for penile cancer routes of spread is proposed: local intrapeneal, regional and systemic nodes, regional skin, liver, lungs, heart, and other multiple sites. PMID:19411278

  2. Epidemiology of Visceral Mycoses: Analysis of Data in Annual of the Pathological Autopsy Cases in Japan

    Yamazaki, Toshikazu; Kume, Hikaru; Murase, Setsuko; Yamashita, Eriko; Arisawa, Mikio

    1999-01-01

    The data on visceral mycoses that had been reported in the Annual of the Pathological Autopsy Cases in Japan from 1969 to 1994 by the Japanese Society of Pathology were analyzed epidemiologically. The frequency of visceral mycoses among the annual total number of pathological autopsy cases increased noticeably from 1.60% in 1969 to a peak of 4.66% in 1990. Among them, the incidences of candidiasis and aspergillosis increased the most. After 1990, however, the frequency of visceral mycoses dec...

  3. A semi-structured interview for psychological autopsy in suicide cases

    Werlang Blanca Guevara; Botega Neury José

    2003-01-01

    OBJECTIVE: To investigate the applicability and the interrater reliability of a Semi-Structured Interview for psychological autopsy in cases of suicide. METHOD: The Semi-Structured Interview for Psychological Autopsy (SSIPA) proposed in this paper consists of four modules which evaluate key-topics associated to suicide. In order to evaluate the instrument's applicability, a sample formed by 42 subjects related to 21 suicide cases was used. The interviews were tape-recorded first and then tran...

  4. One autopsy case of an elderly traffic accident victim with Tetralogy of Fallot

    Kubo, Shinichi; OGATA, Mamoru; Kitamura, Osamu; Nagasono, Ichiro

    1999-01-01

    The case of a61-year-old male traffic accident victem with Tetralogy of Fallot (TOF) is reported. The autopsy revealed massive hemorrhages in the subcutaneous tissue, muscle, and subarachnoidal space. Furthermore, multiple fractures of ribs, sternum and thoracic vertebrae were observed. Histopathological examination revealed changes characteristic of trauma, such as acute lung congestion, acute renal cortical necrosis, and embolization in the lungs and kidney. These autopsy and histological o...

  5. Personality and resilience to Alzheimer's disease neuropathology: A prospective autopsy study

    Terracciano, Antonio; Iacono, Diego; O'Brien, Richard J; Troncoso, Juan C.; An, Yang; Sutin, Angelina R.; Ferrucci, Luigi; Zonderman, Alan B.; Resnick, Susan M.

    2012-01-01

    Alzheimer's disease (AD) neuropathology is found at autopsy in about 30% of cognitively normal older individuals. We examine whether personality traits are associated with such resilience to clinical dementia in individuals with AD neuropathology. Broad factors and specific facets of personality were assessed up to 28 years (M=11, SD=7) before onset of dementia and up to 30 years (M=15, SD=7) before death in a cohort (N=111) evaluated for AD neuropathology at autopsy. Individuals with higher ...

  6. A 2-Year Psychological Autopsy Study of Completed Suicides in the Athens Greater Area, Greece

    Paraschakis, Antonios; Michopoulos, Ioannis; Christodoulou, Christos; Koutsaftis, Filippos; Lykouras, Lefteris; Douzenis, Athanassios

    2015-01-01

    Objective To study the characteristics of a sample of suicide victims from the Athens Greater Area using the psychological autopsy method for the first time in Greece. Methods We studied all recorded cases of completed suicide for the 2-year time period November 2007-October 2009 collecting data from the victims' forensic records as well as from the completion of a psychological autopsy questionnaire. Results 335 persons were recorded as suicide victims. We contacted relatives of 256 victims ...

  7. Invasive fungal disease in university hospital: a PCR-based study of autopsy cases

    Ruangritchankul, Komkrit; Chindamporn, Ariya; Worasilchai, Navaporn; Poumsuk, Ubon; Keelawat, Somboon; Bychkov, Andrey.

    2015-01-01

    Invasive fungal disease (IFD) has high mortality rate, especially in the growing population of immunocompromised patients. In spite of introduction of novel diagnostic approaches, the intravital recognition of IFD is challenging. Autopsy studies remain a key tool for assessment of epidemiology of visceral mycoses. We aimed to determine species distribution and trends of IFD over the last 10 years in unselected autopsy series from a large university hospital. Forty-five cases of visceral mycos...

  8. Multiple organ dysfunction syndrome due to massive wasp stings:an autopsy case report

    ZHANG Ling; TANG Yi; LIU Fang; SHI Yu-ying; CAO Yu; XU Huan; FU Ping

    2012-01-01

    We reported a case of multiple organ dysfunction syndrome (MODS) following about 300 wasp stings.The diagnosis was based on autopsy findings of acute pulmonary edema,acute kidney injury,hepatic and cardiac dysfunction,and cerebral edema.MODS is a life-threatening complication,and should be considered a possibility after multiple wasp stings.Our autopsy helped to establish the cause of unexpected death due to wasp stings and to elucidate a possible mechanism of MODS.

  9. Validation and application of verbal autopsies in a rural area of South Africa

    Kahn, K.; Tollman, S. M.; Garenne, Michel; Gear, J.S.S.

    2000-01-01

    Objective : To validate the causes of death determined with a single verbal autopsy instrument covering all age groups in the Agincourt subdistrict of rural South Africa. Methods : Verbal autopsies (VAs) were conducted on all deaths recorded during annual demogrpahic and health surveillance over a 3-year period (1992-95) in a population of about 63,000 people. Trained field-workers elicited signs and symptoms of the terminal illness from a close caregiver, using a comprehensive questionnaire ...

  10. Fungal infections as a contributing cause of death: An autopsy study

    Megha S Uppin

    2011-01-01

    Full Text Available Context: With the continuing rise in the number of immunocompromised patients, the incidence of invasive mycoses has increased. Various studies have reported the trends of fungal infections in autopsies. Because of limitations in antemortem clinical diagnosis owing to lack of sensitive diagnostic tools, information regarding frequency and pathogenesis of fungal infections is largely dependent on autopsy studies. Aim: To study the prevalence of fungal infections at autopsy spanning a period of 20 years and to document recent trends, prevalence of various fungi over decades along with underlying predisposing factors and pathological findings. Settings and Design: Retrospective study. Materials and Methods:All autopsies between 1988 and 2007 were reviewed and all cases showing fungal infections were analyzed. The clinical details and demographic data were retrieved from medical records. Representative sections from all organs were stained with hematoxylin and eosin stain and special stains including Gomori′s silver methenamine (GMS and per-iodic acid Schiff (PAS. Culture details were noted, wherever available. Results: A total of 401 autopsies were performed during the study period. Fungal infections were identified in 35 (8.7% of these cases. Leukemia was the commonest risk factor. The commonest pathogen in the present study was Aspergillus sp. The commonest single organ involved was brain (n = 18. Culture positivity was seen in 23.8% cases. Conclusion: The study highlights various predisposing factors and organisms in autopsy series. Existing diagnostic modalities are not sensitive to ensure antemortem diagnosis of fungal infections.

  11. Is the diagnostic yield influenced by the indication for fetal autopsy?

    Puri, Ratna Dua; Kotecha, Udhaya; Lall, Meena; Dash, Pratima; Bijarnia-Mahay, Sunita; Verma, Ishwar Chander

    2016-08-01

    The utility of fetal autopsy to corroborate antenatal ultrasound findings and to aid genetic counseling is well known. However, the ability to identify an underlying cause for the common indications for which it is performed is not well studied. This study aimed to determine if the diagnostic yield of fetal autopsy in identifying the underlying cause is determined by the indication of the autopsy. Five groups of fetuses were defined based on the indication for the autopsy performed in 903 cases: (i) malformations, (ii) intrauterine death (IUD), (iii) cystic hygroma and hydrops fetalis, (iv) isolated abnormalities of amniotic fluid, and (v) intrauterine growth restriction (IUGR). The highest diagnostic yield was in fetuses with isolated abnormalities of amniotic fluid (77%), followed by those with IUGR (75%), with IUD (69.6%), those in group five (55.2%) and lowest (45%) in fetuses with malformations (P IUD, IUGR, and oligohydramnios (43.1%; P < 0.003) whereas chromosomal analysis was most useful in cystic hygroma/NIHF (28.9%; P < 0.001). This information on the diagnostic yield in fetal autopsy related its common indications, can be utilized to counsel families of the utility of autopsy to establish cause and recurrence risks and thereby assist then to make an informed decision to consent for the procedure. © 2016 Wiley Periodicals, Inc. PMID:27197608

  12. Reliability of body size measurements obtained at autopsy: impact on the pathologic assessment of the heart.

    McCormack, Carmen A; Lo Gullo, Roberto; Kalra, Mannudeep K; Louissaint, Abner; Stone, James R

    2016-06-01

    Purpose Assessment of body size at autopsy is important for interpreting organ weight measurements and in some cases body identification. The reliability of post-mortem body size measurements, the causes for perturbations in these measurements from their corresponding pre-mortem values, and the impact of such perturbations on heart weight interpretation have not been fully explored. Methods Autopsy body length and weight measurements and pre-mortem height and body weight measurements were compared in 132 autopsies. Clinical records were evaluated for peripheral edema and serum albumin levels. Causes of death, body cavity fluid collections, and heart weights were obtained from the autopsy reports. A subset of patients underwent quantitative post-mortem computed tomography assessment of anasarca. Results At autopsy, body weight differed from the pre-mortem value by 11 ± 1 %, compared with -0.2 ± 0.3 % for body length (P edema (14 ± 2 % vs. 7 ± 2 %, P = 0.01), serum albumin edema/anasarca. Alterations in body weight at autopsy can confound the interpretation of organ weight measurements. PMID:27020890

  13. Diagnostic imaging, preautopsy imaging and autopsy findings of 8 AIDS cases: a comparative study

    LI Hong-jun; GAO Yan-qing; CHENG Jing-liang; ZHANG Yu-zhong

    2009-01-01

    Background Aquired immune deficiency syndrome (AIDS) presents a challenge to medical researchers because of its unique pathological and clinical picture. The clinical data, particularly autopsy evidence, from China have failed to provide enough pathological and etiological evidence for AIDS diagnosis, which impairs the reliability of the diagnosis and our full understanding of the occurrence and development of AIDS complications. The purpose of this study was to investigate the imaging and pathologic characteristics of AIDS.Methods Autopsy, imaging and pathological data from 8 cases of AIDS were retrospectively analyzed. Routine CT scanning of different body parts was performed during their periods of hospitalization. Transverse CT scanning was conducted from the skull to the pelvis immediately after the occurrence of death. After routine formalin fixing, 7 cardevers were cross sectioned for autopsy in freezing state and 1 for gross autopsy. Tissues were obtained from each section and organs for pathological examinations.Results The autopsy data indicated the presence of parasitic infections, bacterial infections, fungal infections, and virus infections in AIDS patients. Pneumocystis pneumonia, pulmonary tuberculosis, coccobacteria pneumonia, Aspergillus pneumonia, cytomegalovirus pneumonia, toxoplasma encephalitis, lymphoma and cerebrovascular diseases were found in these patients.Conclusions During the course of AIDS progression, the concurrent multiple infections as well as tumor development may result in multiple organ pathological changes and clinically complex symptoms that further complicate the imaging and pathological manifestations, thus resulting in difficult differential diagnosis. A combination of imaging data and autopsy data can help to clarify the diagnosis.

  14. Changing times: DNA resequencing and the "nearly normal autopsy".

    Karch, Steven B

    2007-10-01

    No matter how meticulous the autopsy, non-traumatic deaths in the young go unexplained from 5-10% of the time. The percentage is higher in children and young adults. Advances in molecular biology and DNA technology now make it possible to explain many of those deaths. This development is not without irony. At the same time that many clinicians are expressing frustration about the lack of tangible gains provided by the Human Genome Project [Greenhalgh T. The Human Genome Project. J R Soc Med. Dec 2005;98(12):545], and pathologists are wondering about the viability of their field, DNA technology is about to reshape the field of forensic pathology. Emerging evidence suggests that the underlying cause of death in many is genetic, and that both the heart and liver abnormalities can both play a role. The problem is that death from a wide variety of genetic defects may leave no histological markers. The ability to identify these "invisible diseases" with postmortem genetic testing has become a reality far more quickly than anyone had ever imagined. The US Food and Drug Administration is about to place "black box" warnings on warfarin advising doctors screen potential recipients for the ability to metabolize that drug and the American Heart Association has recently editorialized that because of genetic-induced variations in electrical conduction that all newborns should have a screening electrocardiogram before they leave the hospital. The introduction of large-scale genetic screening will have an enormous effect on the practice of forensic pathology, far beyond anything seen in our lifetimes. It will also change the practice of medicine as we know it. This paper reviews the current status of the problem. PMID:17720589

  15. Deaths among women of reproductive age: a forensic autopsy study.

    Padubidri, Jagadish Rao; Menezes, Ritesh G; Pant, Sadip; Shetty, Soumya B

    2013-08-01

    Unnatural deaths in women of reproductive age (range 12-49 years) have a serious psychological and social impact on the family and community. Deaths among women of reproductive age reported as medico-legal cases were investigated to see the trend in terms of cause and manner of death. The study group consisted of a series of 328 consecutive forensic autopsies on women in the reproductive age group, performed between 2009 and 2011 at the Government Wenlock District Hospital, Mangalore, India by qualified specialist forensic medicine experts. Unnatural deaths formed 93.6% of the cohort. The top three causes of death included burns, poisoning and hanging forming 69.5% of the cases. The manner of death was suicide in 45.4% cases, accident in 43.6% cases and homicide in 4.6% cases. The circumstances of death were related to alleged medical negligence in 2.4% cases. Death in 4% cases was natural mannered with a disease being the cause of death. Three-fourths of the victims were married. Married women formed 63.1% of the suicidal victims. Homicidal deaths were not reported among unmarried women. The preponderant method of suicide was by poisoning at 42.3% (63 cases), followed by hanging (34.9%), burns (11.4%) and drowning (9.4%). These four methods comprised 98% of the total suicidal deaths in this study cohort. Accidental deaths were predominantly caused by burns (62.2%) and road traffic accident (23.1%). Two-thirds of the homicidal deaths were due to assault caused by blunt-force trauma, ligature strangulation and sharp-force trauma. One-third of the homicidal victims died due to burns. With a clear understanding of the cause and manner of death, it may be possible to predict, and hopefully prevent, future cases of unnatural deaths in women of reproductive age who form a very important group of society. PMID:23910855

  16. Coronary atherosclerosis in sudden cardiac death: An autopsy study

    Sudha M

    2009-10-01

    Full Text Available Background: The incidence of ischemic heart disease (IHD has markedly increased in India over the past few years. Considering the variations in racial, dietary and lifestyle patterns in our population, it is essential to study the biology of coronary atherosclerosis in our patients. Vulnerable plaques have a large number of foam cells, extracellular lipid, thin fibrous caps and clusters of inflammatory cells and are more prone to rupture. These plaques are nourished by the microvessels arising from the vasa vasorum of the blood vessels and by lumen-derived microvessels through the fibrous cap. This autopsy study was designed to analyse the coronary arterial tree in cases of sudden cardiac death, classify coronary atherosclerotic plaques and to assess the factors contributing to vulnerability of the plaques including inflammation, calcification and microvascular density. Materials and Methods: Seven cases of sudden cardiac death were included in the study. The hearts were perfusion-fixed and the coronary arteries along with their main branches were dissected and studied. The location of the plaques, type of plaques, presence of inflammation and calcification were assessed. The cap thickness and microvessel density per 1000um 2 were assessed. The statistical significance was estimated. Results and Conclusions: Extensive high-grade coronary atherosclerotic disease was seen in all sudden cardiac death cases. Majority of the plaques were vulnerable. High-grade inflammation was seen in most of the vulnerable and ruptured plaques. All the ruptured plaques were uncalcified indicating that calcification probably stabilizes the plaques and protects against rupture. Increased microvessel density was noted in ruptured plaques compared to vulnerable plaques. However, it was not statistically significant.

  17. The use of CT-scanning at the medicolegal external postmortem examination and at the forensic autopsy

    Leth, Peter Mygind

    2006-01-01

    Introduction: Can CT-scanning of deceased at the medico legal external examination improve the selection of cases to autopsy? Is CT-scanning a substitute or a supplement to the traditional forensic autopsy? Material: In 2006 60 deceased individuals from Southern Denmark (counties of Fyn and...... Sønderjylland) (15 females and 45 males) were CT-scanned before autopsy. Method: A double-blind prospective investigation of CT-scanning in autopsy cases. A multislice spiral CT-scanner (Siemens Somatom Spirit) was used. Data from the CT-scanning and the autopsy were registered in a computer database and...... compared. Results: The scanning could be performed in 10 minutes per case. In approximately a third of the cases the cause of death could be established by CT-scanning alone. CT-scanning was found to be most useful in cases of traumatic death, and was superior to autopsy in visualizing fractures...

  18. Evaluating the Cause of Death in Obese Individuals: A Ten-Year Medical Autopsy Study

    Jad Saab

    2015-01-01

    Full Text Available Background. Obesity is a growing public health problem associated with increased morbidity and rate of death. Postmortem examination is imperative to determine the cause of death, to detect clinically unsuspected disease entities, and consequently to determine the actual impact of obesity on patient mortality. Methods. A total of 849 adult autopsies were retrospectively reviewed. Obese (BMI ≥ 30 kg/m2 and nonobese patients were separately studied. The primary cause of death in each group was categorized into malignancy, infection, stroke, ischemic and nonischemic heart disease, pulmonary embolism, hemorrhage, and primary nonneoplastic diseases of different organ systems. Results. Of 849 autopsies, 32.3% were obese. The leading causes of death in the obese population were malignancy (31.4%, infection (25.9%, ischemic heart disease (12.8%, and pulmonary embolism (6.2%. Obese individuals were statistically more likely to die from pulmonary embolism and liver disease and less likely to die from neurologic diseases and nonischemic heart disease. Conclusion. Autopsies on obese individuals constitute a third of all adult medical autopsies in our center. Increased death rates in the obese due to pulmonary embolism and liver disease should receive special clinical attention. Autopsy findings in the obese population should contribute to overall premortem disease detection, prevention, and management.

  19. Radiography after unexpected death in infants and children compared to autopsy

    Postmortem radiography may reveal skeletal and soft-tissue abnormalities of importance for the diagnosis of cause of death. To review the radiographs of children under 3 years of age who had died suddenly and unexpectedly. To compare the radiological and autopsy findings evaluating possible differences in children dying of SIDS and of an explainable cause. A total of 110 consecutive skeletal surveys performed between 1998 and 2002 were reviewed. All but one were performed before autopsy and comprised AP views of the appendicular and axial skeleton and thorax/abdomen, lateral views of the axial skeleton and thorax, and two oblique views of the ribs. Radiography and autopsy findings were compared. Causes of death were classified as SIDS/borderline SIDS (n = 52) and non-SIDS (n = 58), with one case of abuse. In 102 infants there were 150 pathological findings, 88 involving the chest, 24 skeletal, and 38 miscellaneous findings. The radiological-pathological agreement was poor concerning pulmonary findings. Skeletal findings were sometimes important for the final diagnosis. Radiography revealed many skeletal and soft-tissue findings. Pulmonary pathology was most frequently found, but showed poor agreement with autopsy findings. Recognizing skeletal findings related to abuse is important, as these may escape recognition at autopsy. (orig.)

  20. Codeine to morphine concentration ratios in samples from living subjects and autopsy cases after incubation.

    Berg-Pedersen, Riikka Mari; Ripel, Ase; Karinen, Ritva; Vevelstad, Merete; Bachs, Liliana; Vindenes, Vigdis

    2014-03-01

    The codeine to morphine concentration ratio is used in forensic toxicology to assess if codeine has been ingested alone or if morphine and/or heroin have been ingested in addition. In our experience, this interpretation is more difficult in autopsy cases compared with samples from living persons, since high morphine concentrations are observed in cases where only codeine is assumed to have been ingested. We have investigated if codeine and morphine glucuronides are subject to cleavage to the same extent in living and autopsy cases in vitro. We included whole blood samples from eight living subjects and nine forensic autopsy cases, where only codeine ingestion was suspected. All samples were incubated for 2 weeks at 37°C and analyzed for codeine and six codeine metabolites using liquid chromatography tandem mass spectrometry. A reduction in the codeine to morphine concentration ratio was found, both in samples from living subjects (mean 33%, range 22-50%) and autopsy cases (mean 37%, range 13-54%). The increase in the morphine concentrations was greater in the autopsy cases (mean 85%, max 200%) compared with that of the living cases (mean 51%, max 87%). No changes were seen for codeine or codeine-6-glucuronide concentrations. The altered ratios might mislead the forensic toxicologist to suspect morphine or heroin consumption in cases where only codeine has been ingested. PMID:24324229

  1. Sudden unexplained death in childhood. An audit of the quality of Autopsy reporting

    Treacy, A

    2013-03-01

    Cases of sudden unexplained death in childhood (SUDC) in Ireland in children aged >1year and <5 years were examined in order to assess the quality of autopsy reporting. All SUDC cases are notified to and documented by the National Sudden Infant Death Register (NSIDR) in Ireland along with all cases of sudden infant death syndrome (SIDS) referring to sudden infant deaths less than one year of age. The database of the NSIDR in Ireland was interrogated and cases of SIDS and SUDC were compared over a fifteen-year period (1995-2009). SIDS cases whose autopsies were conducted in the same hospital in the same year as the index SUDC case were used for comparison. The autopsy report for each case was examined and modified Rushton(MR) scores 1\\r\

  2. Inventory of ABCC-RERF autopsies Hiroshima and Nagasaki, 1948-1980

    This is the fourth inventory of ABCC-RERF autopsies which covers those performed from 1948-80 (the other three inventories). For general information the introduction of the third inventory (1948-70) is included with some modification, and deaths and autopsy rates for 1971-80 are added. ABCC-RERF performed 10,096 autopsies (6,555 in Hiroshima and 3,541 in Nagasaki) from 1948 to 1980. Protocols, tissues, sections, smears, etc., assembled by the collaborating institutions were examined by members of the ABCC Department of Pathology who completed ABCC records for each case. Copies of all protocols, gross tissues, and histological sections were placed in a designated repository in the Medical School of each city where they are available to all qualified and interested investigators. (J.P.N.)

  3. Causes of mortality for Indonesian Hajj Pilgrims: comparison between routine death certificate and verbal autopsy findings.

    Masdalina Pane

    Full Text Available BACKGROUND: Indonesia provides the largest single source of pilgrims for the Hajj (10%. In the last two decades, mortality rates for Indonesian pilgrims ranged between 200-380 deaths per 100,000 pilgrims over the 10-week Hajj period. Reasons for high mortality are not well understood. In 2008, verbal autopsy was introduced to complement routine death certificates to explore cause of death diagnoses. This study presents the patterns and causes of death for Indonesian pilgrims, and compares routine death certificates to verbal autopsy findings. METHODS: Public health surveillance was conducted by Indonesian public health authorities accompanying pilgrims to Saudi Arabia, with daily reporting of hospitalizations and deaths. Surveillance data from 2008 were analyzed for timing, geographic location and site of death. Percentages for each cause of death category from death certificates were compared to that from verbal autopsy. RESULTS: In 2008, 206,831 Indonesian undertook the Hajj. There were 446 deaths, equivalent to 1,968 deaths per 100,000 pilgrim years. Most pilgrims died in Mecca (68% and Medinah (24%. There was no statistically discernible difference in the total mortality risk for the two pilgrimage routes (Mecca or Medinah first, but the number of deaths peaked earlier for those traveling to Mecca first (p=0.002. Most deaths were due to cardiovascular (66% and respiratory (28% diseases. A greater proportion of deaths were attributed to cardiovascular disease by death certificate compared to the verbal autopsy method (p<0.001. Significantly more deaths had ill-defined cause based on verbal autopsy method (p<0.001. CONCLUSIONS: Despite pre-departure health screening and other medical services, Indonesian pilgrim mortality rates were very high. Correct classification of cause of death is critical for the development of risk mitigation strategies. Since verbal autopsy classified causes of death differently to death certificates, further studies

  4. Verbal autopsy of 80,000 adult deaths in Tamilnadu, South India

    Peto Richard

    2004-10-01

    Full Text Available Abstract Background Registration of the fact of death is almost complete in the city of Chennai and not so in the rural Villupuram district in Tamilnadu, India. The cause of death is often inadequately recorded on the death certificate in developing countries like India. A special verbal autopsy (VA study of 48 000 adult (aged ≥ 25 yrs deaths in the city of Chennai (urban during 1995–97 and 32 000 in rural Villupuram during 1997–98 was conducted to arrive at the probable underlying cause of death to estimate cause specific mortality. Methods A ten day training on writing verbal autopsy (VA report for adult deaths was given to non-medical graduates with at least 15 years of formal education. They interviewed surviving spouse/close associates of the deceased to write a verbal autopsy report in local language (Tamil on the complaints, symptoms, signs, duration and treatment details of illness prior to death. Each report was reviewed centrally by two physicians independently. Random re-interviewing of 5% of the VA reports was done to check the reliability and reproducibility of the VA report. The validity of VA diagnosis was assessed only for cancer deaths. Results Verbal autopsy reduced the proportion of deaths attributed to unspecified and unknown causes from 54% to 23% (p Conclusion A ten day training programme to write verbal autopsy report with adequate feed back sessions and random sampling of 5% of the verbal autopsy reports for re-interview worked very well in Tamilnadu, to arrive at the probable underlying cause of death reliably for deaths in early adult life or middle age (25–69 years and less reliably for older ages (70+. Thus VA is practicable for deaths in early adult life or middle age and is of more limited value in old age.

  5. The spectrum of autopsy in a tertiary referral center in Eastern Nepal

    Subedi, Nuwadatta

    2013-01-01

    Nuwadatta Subedi,1 BN Yadav,2 Shivendra Jha,3 Deepa Shah,3 Utsav Shrestha,3 Anil Sharma,3 Mrityunjay K Rai31Department of Forensic Medicine, College of Medical Sciences, Bharatpur, Chitwan, 2Department of Forensic Medicine, 3BP Koirala Institute of Health Sciences, Dharan, NepalBackground: Autopsy is examination of a body post-mortem, with a view to determining the cause of death. Performing an autopsy has benefits for many parties: the family of the deceased, the clinician and hospital, and ...

  6. Pleural plaques and risk of cancer in Turin, northwestern Italy. An autopsy study

    Mollo, F.; Andrion, A.; Colombo, A.; Segnan, N.; Pira, E.

    1984-10-01

    The relationship between the occurrence of neoplastic diseases and the presence of pleural plaques was studied in a series of 1097 autopsies performed in Turin from the adult general population. In men, pleural plaques showed an association with the presence of laryngeal, pulmonary, esophageal, and colorectal cancer. Only cancer of the larynx was strongly related to the occurrence of such pleural changes. This autopsy investigation confirms previous observations by others based on x-ray findings, and suggests that pleural plaques may be regarded as risk indicators of possibly asbestos-related tumors in the general population.

  7. An Audit of Medical Autopsy: Experience at the University of Uyo Teaching Hospital (UUTH, Niger Delta Region, Nigeria

    Ekpo Memfin Dan

    2011-01-01

    Full Text Available Background: Autopsy is an essential auditing tool in clinical practice. ObjectiveS: The study set out to review all autopsies that were performed over a four-year period in order to determine the rate, indications, as well as the age and sex distribution of dead bodies, which autopsies were performed on them in the Hospital. Setting and Design: This was a retrospective study that was undertaken at the department of Pathology of the University of Uyo Teaching Hospital (UUTH, Uyo, Nigeria between January 2007 and December 2010. Materials and Methods: All the cases of death that underwent pathological autopsies in the UUTH were reviewed. The autopsy records, clinical case notes, gross and histopathological specimens as well as slides were retrieved and examined. Results: A total of 1679 dead bodies were received at the mortuary of the institution studied during the 4-year period. Autopsies were performed in 78 cases giving a request rate of 4.7%. Coroner′s autopsy was commonly performed, and this accounted for 60 (76.9% cases, while the remaining 18 (23.1% were clinical autopsies. Autopsies were commonly performed on male bodies more than females (M: F = 2.6:1.0 with the majority having died at their second decade of life. It was observed that the majority (57.7% of the request for autopsies were from peripheral centers outside the teaching hospital, while the remaining 42.3% cases were drawn from various clinical departments in the teaching hospital. Road traffic accident was the leading indication for coroner′s autopsy (51.7%, while gastroenteritis and chronic liver disease were the two most common indications for clinical autopsy, 27.8% and 22.2% respectively. The concordance rate between clinical diagnosis and autopsy diagnosis was found to be 72.2% (13/18 cases. Conclusion: The rate of request for Autopsy at the University of Uyo Teaching Hospital during the period of this study was low, similar to other previous reports.

  8. The Next Generation of Psychological Autopsy Studies: Part 2. Interview Procedures

    Conner, Kenneth R.; Beautrais, Annette L.; Brent, David A.; Conwell, Yeates; Phillips, Michael R.; Schneider, Barbara

    2012-01-01

    The psychological autopsy (PA) is a systematic method of assessing the psychological and contextual circumstances preceding suicide. The method requires interviews with one or more proxy respondents (i.e., informants) of suicide decedents. Procedural challenges that need to be addressed to conduct PA interviews are described in this article and…

  9. The Next Generation of Psychological Autopsy Studies: Part I. Interview Content

    Conner, Kenneth R.; Beautrais, Annette L.; Brent, David A.; Conwell, Yeates; Phillips, Michael R.; Schneider, Barbara

    2011-01-01

    The psychological autopsy (PA) is a systematic method to understand the psychological and contextual circumstances preceding suicide. The method requires interviews with one or more proxy respondents (i.e., informants) of decedents. The methodological challenges that need to be addressed when determining the content of these research interviews…

  10. Morphological changes in the digestive system of 93 human immunodeficiency virus positive patients: an autopsy study

    Lucinda Calheiros Guimarães

    2012-04-01

    Full Text Available Involvement of the digestive system in patients with acquired immunodeficiency syndrome (AIDS is frequent and many changes in these patients are diagnosed only at autopsy. There are few studies of autopsy with detailed analysis of this system and only one was conducted in Brazil. We evaluated each segment of the digestive system in 93 consecutive autopsies of patients infected with human immunodeficiency virus (HIV and the importance of these lesions to death. Of these, 90 (96.8% patients had AIDS. We reviewed medical records, autopsy reports and histological sections from tongue to rectum stained with hematoxylin-eosin. When necessary, we analyzed special stains and immunohistochemistry to investigate infections. There was damage to the digestive system in 73 (78.5% cases. The most common infections were candidiasis (42%, cytomegalovirus (29%, histoplasmosis (11.8%, toxoplasmosis (9.7% and mycobacterial infection (9.7%. Malignancies were rare, present in four (4.3% cases (two Kaposi's sarcoma, one adenocarcinoma and one metastatic embryonal carcinoma. All segments showed lesions: tongue (48.6%, esophagus (44.8%, stomach (44.7%, colon (43.2% and small intestine (28.9%. The lesions found were immediate cause of death in five (5.4% cases. In another 36 (38.7% cases the basic disease was systemic and also compromised the digestive system.

  11. Embolization of Cyanoacrylate glue in systemic circulation in a case of hepatocellular carcinoma: an autopsy report

    Kochhar Rakesh K; Dutta Usha; Vasishta Rakesh K; Gupta Kirti; Singh Kartar

    2009-01-01

    Abstract We report a case of embolism of the sclerosant dye with subsequent formation of foreign-body giant cell reaction within the veins of pulmonary and portal circulation in an autopsy case of hepatocellular carcinoma developing over an underlying primary biliary cirrhosis.

  12. Embolization of Cyanoacrylate glue in systemic circulation in a case of hepatocellular carcinoma: an autopsy report

    Kochhar Rakesh K

    2009-12-01

    Full Text Available Abstract We report a case of embolism of the sclerosant dye with subsequent formation of foreign-body giant cell reaction within the veins of pulmonary and portal circulation in an autopsy case of hepatocellular carcinoma developing over an underlying primary biliary cirrhosis.

  13. Anaerobiospirillum succiniciproducens sepsis in an autopsy patient: A troublesome diagnostic workup

    Jason Koshy

    2014-01-01

    Full Text Available Anaerobiospirillum succiniciproducens is an uncommon yet potentially lethal gram-negative bacterium typically affecting patients with comorbidities. We report a case of A. succiniciproducens infection in an autopsy patient who had hepatitis C and type 2 diabetes and describe the difficulties in the laboratory identification of this pathogen.

  14. [Autopsies in Switzerland, Germany and Austria: considerations about legal facts and the current situation].

    Tag, B

    2011-11-01

    Significant reasons militate for the implementation of clinical autopsies: On the part of physicians and nurses, there is quality assurance, establishment of legal certainty regarding possible accusations of medical errors and development of treatment methods. On the part of patients and their relatives, there is consolation and relief in cases of unexpected death, insight into genetic dispositions and insurance law concerns, to name only a few. However, a continuing decrease of clinical autopsies can be observed in Switzerland, Germany and Austria. The thesis asserting that the often required informed consent of the deceased during his/her lifetime or of close relatives is a crucial reason for this decrease needs to be called into question due to recent studies. Mainsprings are rather structural reasons, such as the often deficient communication with the patient or close relatives, economic reasons, namely the frequently insufficient remuneration for the clinical autopsy, organizational causes, in particular the repeatedly encountered suboptimal collaboration between the individual departments and the pathology department, the high administrative effort and probably the decreasing appreciation of the clinical autopsy. PMID:21805100

  15. Amended forensic autopsy legal procedures in Turkey during integration with the European Union (EU).

    Celbis, Osman; Aydin, N Engin; Kok, Ahmet Nezih

    2006-12-01

    European Union (EU) is expanding its territories, and Turkey has been making adaptive changes in many aspects for an integration with EU. In this regard, amendments on forensic autopsy procedures have been effective from June 1, 2005. This article delineates these changes, emphasizing the differences between the previous and the current procedures. PMID:17133036

  16. Autopsy rate in suicide is low among elderly in Denmark compared with Finland

    Ylijoki-Sørensen, Seija; Boldsen, Jesper Lier; Boel, Lene Warner Thorup;

    2014-01-01

    . Deaths classified as suicide were compared with other unnatural classifications, and comparable causes of death were coded into six subgroups: poisonings, suffocations/strangulations, firearm discharges, drowning/submersions, explosions/flames and other/unspecified causes. The total autopsy rate for...

  17. Pathological and radiological correlation in an autopsy case of combined pulmonary fibrosis and emphysema

    Karata, Hiroki; Tanaka, Tomonori; Egashira, Ryoko; Tabata, Kazuhiro; Otani, Kyoko; Hayashi, Ryuji; Hori, Takashi; FUKUOKA, JUNYA

    2015-01-01

    We report an educational autopsy case of combined pulmonary fibrosis and emphysema. Radiological patterns of the upper lung were considered as mostly emphysema, but pathological observation revealed significant interstitial fibrosis of usual interstitial pneumonia as a major pathology. The patient eventually developed acute exacerbation of background interstitial pneumonia. Careful radiological and pathological correlation of the current case indicates that regions with distal acinar emphysem...

  18. Schmackhafte Bohnen aus dem Leichenmagen : über den erstaunlichen Erfolg der Fernsehserie "Autopsie"

    Pfohlmann, Oliver

    2009-01-01

    Die Kriminalistik-Reihe "Autopsie" präsentiert Tod, Verwesung und menschliche Abgründe in wohl bislang nicht gesehener Aufdringlichkeit. Rezeptionspsychologisch erklären lässt sich der Erfolg der Serie, wenn man aufzeigt, welch raffiniertes Spiel mit heterogenen Affekten und Lustquellen sie im Zuschauer erzeugt.

  19. Correlation of diagnostic imaging and autopsy findings of eight patients with acquired immune deficiency syndrome

    Objective: To investigate the imaging findings with pathologic correlation in patients with acquired immune deficiency syndrome (AIDS). Methods: Imaging findings, autopsy and pathological data were retrospectively analyzed in eight patients with AIDS. Routine CT scanning of different body parts was performed during their hospitalization. CT scanning was performed from the skull to the pelvis immediately following their death. After routine formalin fixing, 7 cadavers were cross sectioned for autopsy in freezing state and 1 for gross autopsy. Tissues were obtained from each sections and organs for pathological examinations. Results: The autopsy data showed parasitic infections (5 cases), bacterial infections (3 cases), fungal infections (2 cases), virus infections (2 cases), lymphoma (1 case) and cerebrovascular diseases (1 case)in eight patients with AIDS. The CT scanning demonstrated symmetrical ground glass liked shadows with pulmonary hilus as the center in 5 cases of pulmonary PCP infection; pulmonary patchy shadows, scattering distribution of nodular shadows, extensive military nodular shadows with even distribution and tuberculous pleurisy; cloudy shadows for 2 cases of fungi infection with multiple foci of chronic inflammation; pulmonary net-like parenchymal changes for 2 cases of pulmonary CMV infection; thickened intestinal wall and narrowed intestinal lumen for 1 case of intestinal tumor; low density shadows of brain tissue for 1 case of CMV encephalitis and MRI findings of high T1 and high T2 signals as well as MRA findings of broken vascular channels in liquefied areas of brain tissues; patchy low density areas inside a cyst of brain for one case of brain toxoplasmosis infection; multiple small patchy low density areas in cerebral basal ganglia for one case of brain cryptococcus infection. Conclusions: In AIDS patients, infection and tumor may occur in various organs resulting in complex symptoms, which makes it more complicated and difficult to make

  20. Validity of verbal autopsy method to determine causes of death among adults in the urban setting of Ethiopia

    Misganaw Awoke

    2012-08-01

    Full Text Available Abstract Background Verbal autopsy has been widely used to estimate causes of death in settings with inadequate vital registries, but little is known about its validity. This analysis was part of Addis Ababa Mortality Surveillance Program to examine the validity of verbal autopsy for determining causes of death compared with hospital medical records among adults in the urban setting of Ethiopia. Methods This validation study consisted of comparison of verbal autopsy final diagnosis with hospital diagnosis taken as a “gold standard”. In public and private hospitals of Addis Ababa, 20,152 adult deaths (15 years and above were recorded between 2007 and 2010. With the same period, a verbal autopsy was conducted for 4,776 adult deaths of which, 1,356 were deceased in any of Addis Ababa hospitals. Then, verbal autopsy and hospital data sets were merged using the variables; full name of the deceased, sex, address, age, place and date of death. We calculated sensitivity, specificity and positive predictive values with 95% confidence interval. Results After merging, a total of 335 adult deaths were captured. For communicable diseases, the values of sensitivity, specificity and positive predictive values of verbal autopsy diagnosis were 79%, 78% and 68% respectively. For non-communicable diseases, sensitivity of the verbal autopsy diagnoses was 69%, specificity 78% and positive predictive value 79%. Regarding injury, sensitivity of the verbal autopsy diagnoses was 70%, specificity 98% and positive predictive value 83%. Higher sensitivity was achieved for HIV/AIDS and tuberculosis, but lower specificity with relatively more false positives. Conclusion These findings may indicate the potential of verbal autopsy to provide cost-effective information to guide policy on communicable and non communicable diseases double burden among adults in Ethiopia. Thus, a well structured verbal autopsy method, followed by qualified physician reviews could be capable of

  1. Northern and Southern blot analysis of human RNA and DNA in autopsy material

    Larsen, S; Rygaard, K; Asnaes, S; Spang-Thomsen, M

    1992-01-01

    21-118 h postmortem. Extracted RNA and DNA were examined by Northern and Southern blot analysis using oligo-labelled human DNA probes recognizing gene transcripts of 2-5 kb. The results indicated that, in general, Northern blot analysis was feasible with the applied probes when the tissue was......Fresh biopsy material for molecular biological investigations is not obtainable from all relevant normal human tissues. We studied the feasibility of using RNA and DNA from autopsies for Northern and Southern blot analysis. Tissue samples from seven organs were obtained from 10 autopsies performed...... obtained less than two days postmortem. Histological examination showing slight or no autolysis and the presence of ribosomal bands after gel electrophoresis were both indicative parameters of RNA preservation. DNA was appropriate for Southern blotting when the tissue was obtained less than three to five...

  2. Autopsy and clinical findings in case of metastases of the bronchial carcinoma

    Between the years of 1958 to 1980, 1636 patients suffering from histologically demonstrated bronchial carcinomas were submitted to an intensive radiotherapy at the Robert-Roessle Hospital in Berlin-Buch. The tumors received a minimum dose of 5000 Gy. The autopsy reports of 649 cases could be evaluated. The tumor destruction rate determined by autopsy and the distribution of metastases in dependence on the histologic tumor type are described and compared to the frequency of metastases determined by clinical or X-ray examination. With respect to clinical practice, the conclusion is drawn that a prophylactic radiotherapy to the brain, the upper abdominal lymph nodes and the adrenal glands possibly could improved the therapeutic results because of the high rate of metastases of microcellular and non-differentiated bronchial carcinomas found in these regions. (orig.)

  3. CASE REPORT: Papillary Adenoma of Kidney- An Incidental Autopsy Finding: Report of Two Cases

    Bhakti D. Deshmukh

    2012-01-01

    Full Text Available Background: Renal papillary adenoma is usually an incidental finding at autopsy with an incidence of 7% to 23%. The frequency of small papillary tumours of kidney increases with age to approximately 40% of the population over the age of 65. These tumours occur morefrequently in scarred kidneys, acquired renal cystic disease and in children with von Hippel-Lindau syndrome. Case history: In this report we describe renal papillary adenoma incidentally detected during autopsies of two elderly males. Gross examination of kidneyshowed two tiny subcapsular yellowish nodules in one case and single nodule with similar morphology in the other. Microscopic examination in both the cases showed a well circumscribed tumour composed of densely packed tubules and papillae lined by small cuboidal to columnar cells with rounded uniform nuclei. However there was no nuclear atypia, mitosis or necrosis.

  4. Autopsy findings in a long-term survivor with glioblastoma multiforme. Case report

    Autopsy detected no tumor tissues in a patient who died 6.5 years after the diagnosis of glioblastoma multiforme. A 54-year-old male developed left hemiparesis one month prior to admission. Computed tomography demonstrated a cystic lesion in the right frontal region with irregular ring-like enhancement. The tumor was extensively removed together with the surrounding tissues followed by irradiation (whole brain 32.4 Gy, local 28.8 Gy), and intravenous administration of interferon-β. Histological examination confirmed the diagnosis of glioblastoma multiform. He died of accidental head trauma 6.5 years after surgery. Autopsy of the brain detected no evidence of glioblastoma multiform. The only findings were cerebral edema and hematoma caused by head trauma, as well as histological changes due to radiation damage. This case apparently confirms the histological disappearance of tumor tissue in a long-term survivor with glioblastoma multiform. (author)

  5. Malignant Amelanotic Melanoma of the Pleura without Primary Skin Lesion:An Autopsy Case Report

    Nakanishi,Kuniaki

    2009-12-01

    Full Text Available Melanoma metastasizing to the lungs is common, but primary pulmonary or pleural melanoma is extremely rare. We present an autopsy case of malignant melanoma of the pleura without primary skin lesion in a 49-year-old man. A mass found in the right chest was diagnosed as spindle cell sarcoma by antemortem fine-needle aspiration cytology. At autopsy, a yellow-white tumor located primarily in the right visceral pleura (diagnosed as an amelanotic melanoma was found to have invaded into the right lung, right parietal pleura, and right diaphragm, and to have metastasized into the left lung and visceral pleura, thyroid, and left adrenal gland. No primary site was found. The tumor cells were positive for S100 and focally positive for HMB-45, but negative for other markers. Immuno-histochemical examination for S100 and HMB-45 would thus appear to be useful for the diagnosis of an amelanotic melanoma.

  6. Sepsis and meningoencephalitis due to Rhodotorula glutinis in a patient with systemic lupus erythematosus, diagnosed at autopsy

    Pamidimukkala Umabala

    2007-01-01

    Full Text Available Rhodotorula species have been reported as a causative agent of opportunistic mycoses in immunocompromised hosts. We report a case of sepsis and meningoencephalitis caused by Rhodotorula glutinis in a 20-year-old female patient with systemic lupus erythematosus (SLE, which was diagnosed at autopsy. The patient presented with longstanding fever. She was diagnosed with SLE after admission to the hospital and died on day 5 of the hospital stay. Autopsy was performed to confirm the presence of infection. Sepsis and meningoencephalitis due to Rhodotorula glutinis was confirmed by postmortem blood cultures and histopathological examination of biopsies taken from the brain at autopsy. Infection by Rhodotorula spp. is rare but can be fatal in immunocompromised hosts. Infections by such uncommon yeasts may often be difficult to diagnose, especially in the setting of febrile neutropenia. This report also emphasizes the value of autopsy as a powerful educational tool.

  7. ABSENCE OF MUTAGENICITY IN THE URINE OF AUTOPSY SERVICE WORKERS EXPOSED TO FORMALDEHYDE: FACTORS INFLUENCING MUTAGENICITY TESTING OF URINE

    The study examined the effect of exposure to autopsy workers to formaldehyde using urinary mutagenicity testing with Salmonella typhimurium. A matched control group was also studied. Additional studies including the recovery of histidine from urine samples, the determination of h...

  8. Identifying Factors Associated with Maternal Deaths in Jharkhand, India: A Verbal Autopsy Study

    Khan, Nizamuddin; Pradhan, Manas Ranjan

    2013-01-01

    Maternal mortality has been identified as a priority issue in health policy and research in India. The country, with an annual decrease of maternal mortality rate by 4.9% since 1990, now records 63,000 maternal deaths a year. India tops the list of countries with high maternal mortality. Based on a verbal autopsy study of 403 maternal deaths, conducted in 2008, this paper explores the missed opportunities to save maternal lives, besides probing into the socioeconomic factors contributing to m...

  9. Pulmonary Histopathologic Abnormalities and Predictor Variables in Autopsies of Burned Pediatric Patients

    Sousse, Linda E.; Herndon, David N.; Andersen, Clark R.; Zovath, Andrew; Finnerty, Celeste C.; Mlcak, Ronald P.; Cox, Robert A.; Traber, Daniel L.; Hawkins, Hal K.

    2014-01-01

    Pulmonary abnormalities occur in 30–80% of fatalities after burn injury. The objective of our study is to investigate lung pathology in autopsy tissues of pediatric burn patients. METHODS Three scientists with pathology training in pediatric burn care reviewed masked autopsy slides of burned children who died after admission to a burn center from 2002–2012 (n=43). Autopsy lung tissue was assigned scores for histologic abnormalities in 9 categories, including alveolar and interstitial fibrosis, hyaline membranes, and type II epithelial cell proliferation. Scores were then tested for correlation with age, TBSA burn, number of days between burn and death, time between burn and admission, and the presence of inhalation injury using analyses with linear models. RESULTS Type II epithelial cell proliferation was significantly more common in cases with a longer time between burn and admission (p<0.02). Interstitial fibrosis was significantly more severe in cases with longer survival after burn (p<0.01). The scores for protein were significantly higher in cases with longer survival after burn (p<0.03). Enlarged air spaces were significantly more prominent in cases with longer survival after burn (p<0.01), and in cases with the presence of inhalation injury (p<0.01). CONCLUSIONS Histological findings associated with Diffuse Alveolar Damage (DAD), which is the pathological correlate of the Acute Respiratory Distress Syndrome (ARDS), were seen in approximately 42% of autopsies studied. Protein-rich alveolar edema, which is the abnormality that leads to ARDS, may occur from multiple causes, including inhalation injury. PMID:25445004

  10. Statistical observation on autopsy cases of malignancy at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital

    Statistical observation was made as to autopsy cases of atomic-bomb survivors in Nagasaki. The total of autopsy cases at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital from the opening of the hospital, 1968, to December in 1975 was 1,486 cases (autopsy rate, 65.1%) in which 880 cases of atomic bomb survivors (autopsy rate, 68.0%) were contained. Cases of malignancy totaled 829 and 528 cases of those were atomic bomb survivors. Cases of malignancy were divided into three groups, that is, group exposured to atomic bomb at place within 2 km from the explosion place, group exposured at place from more than 2 km or entering after explosion into the city, and not-exposured group. Relationship between main malignancies and exposure was discussed, and the following results were obtained. 1) Obvious relationship was found to exist between exposure and acute and chronic medullary leukemia. 2) Malignant lymphoma was scarecely correlated with exposure, but its occurrence rate was higher than the mean rate in Japan in reflection the region where this disease occurs much geographically. 3) Relationship between exposure and stomach cancer, lung cancer, cancer of the large intestine, and double cancer was not found obviously, but occurrence rate of hepatic cancer was higher than the mean rate in Japan in three groups. The reason was supposed to be geographical factor. 4) Cases of thyroid gland cancer were a small number in female of the group exposured within 2 km, and cases of prostate cancer were a small number in the group within 2 km, but their occurrence rate was high specifically. (Tsunoda, M.)

  11. Interstitial pneumonia induced by sorafenib in a patient with hepatocellular carcinoma: An autopsy case report

    Yamaguchi, Takashi; SEKI, TOSHIHITO; MIYASAKA, CHIKA; INOKUCHI, RYOSUKE; KAWAMURA, RINAKO; SAKAGUCHI, YUUTAKU; Murata, Miki; Matsuzaki, Koichi; NAKANO, YORIKA; Uemura, Yoshiko; Okazaki, Kazuichi

    2015-01-01

    Sorafenib is a multikinase inhibitor currently approved in Japan for the treatment of unresectable hepatocellular carcinoma. Interstitial pneumonia induced by sorafenib may have a fatal outcome, and therefore, has recently been the focus of many studies. The current report presents an autopsy case of diffuse alveolar damage (DAD) that occurred in a 59-year-old male, who had been treated with sorafenib. The patient had been given sorafenib for six months and had exhibited no respiratory sympto...

  12. Prevalence of alcohol-related pathologies at autopsy: Estonian Forensic Study of Alcohol and Premature Death

    Tuusov, J; Lang, K.; Väli, M; Pärna, K; Tõnisson, M; Ringmets, I; McKee, M; Helander, A; Leon, DA

    2014-01-01

    Aims Alcohol can induce diverse serious pathologies, yet this complexity may be obscured when alcohol-related deaths are classified according to a single underlying cause. We sought to quantify this issue and its implications for analysing mortality data. Design, Setting and Participants Cross-sectional study included 554 men aged 25–54 in Estonia undergoing forensic autopsy in 2008–09. Measurements Potentially alcohol-related pathologies were identified following macroscopic and histological...

  13. Memories of an Autopsy: The Effects of Stress Exposure on Suggestibility for a Stressful Event

    Elisa Krackow; Vanessa M. Jacoby; Scotti, Joseph R.

    2013-01-01

    The current study examined the effects of stressful life events on memory for a stressful event. Two groups ofcollege students (N = 61) were formed for analysis based on the presence or absence of particular stressful lifeevents. Participants then viewed a graphic video depicting an autopsy, and received a memory interview fourdays later. Results showed similar group performance on correctly leading questions. However, participants inthe Specific Stressor-Exposed group were less suggestible t...

  14. Association between Cysticercosis and Neoplasia: A Study Based on Autopsy Findings

    Camila Lourencini Cavellani; Aline Cristina Souza da Silva; Grace Kelly Naves de Aquino Ribeiro; Lívia Ferreira Oliveira; Mara Lúcia Fonseca Ferraz; Vicente de Paula Antunes Teixeira

    2013-01-01

    Chronic infections including the cysticercosis induce inflammatory cells to produce free radicals and synthesize carcinogenic toxins. The cells with genetic mutations proliferate in a disorganized manner, leading to the development of neoplasia. The aim of the present study was to demonstrate the relation between cysticercosis and neoplasia. Patients autopsied were divided into 4 groups: patients with neoplasia and cysticercosis (NC), patients with neoplasia only (NN), patients with cysticerc...

  15. Pulmonary tumor thrombotic microangiopathy induced by gastric carcinoma: Morphometric and immunohistochemical analysis of six autopsy cases

    Shinozaki Minoru; Sasai Daisuke; Hiruta Nobuyuki; Abe Fumihito; Yokose Tomoyuki; Nemoto Tetsuo; Kitahara Kanako; Wakayama Megumi; Okubo Yoichiro; Nakayama Haruo; Ishiwatari Takao; Shibuya Kazutoshi

    2011-01-01

    Abstract Background Pulmonary tumor thrombotic microangiopathy (PTTM) has been known as a rare and serious cancer-related pulmonary complication. However, the pathogenesis and pathophysiology of this debilitating condition still remains obscure and no effective management was recommended. The present study aims to elucidate the pathophysiology of PTTM. Methods Autopsy records were searched to extract cases of pulmonary tumor embolism induced by metastasis of gastric carcinoma in the Toho Univ...

  16. Mesenteric volvulus in children: two autopsy cases and review of the literature

    Small bowel mesenteric volvulus when compared with mesocolonic volvulus, have not high incidence. Two autopsy cases of small bowel mesenteric volvulus in infants, highlighting the importance of a suspicion in early recognition of this rare but potentially fatal intra-abdominal emergency are reported. We also review the literature on possible aetiologies and mechanism of small bowel mesenteric volvulus, as well as its management. (author)

  17. Cause of death in 1144 patients with diabetes mellitus: an autopsy study.

    Joron, G. E.; Laryea, E; Jaeger, D.; Macdonald, L

    1986-01-01

    The pathological reports for all patients over 13 years of age who had had an autopsy at one of three university-affiliated hospitals between 1967 and 1976 were reviewed to determine the principal cause of death. The clinical records of the patients with diabetes were reviewed to verify the diagnosis and to determine the known duration of diabetes. There were 1144 patients with diabetes mellitus and 5674 without. The sex distribution was similar in the two groups. The patients with diabetes w...

  18. Creating and validating an algorithm to measure AIDS mortality in the adult population using verbal autopsy.

    Ben A Lopman

    2006-08-01

    Full Text Available BACKGROUND: Vital registration and cause of death reporting is incomplete in the countries in which the HIV epidemic is most severe. A reliable tool that is independent of HIV status is needed for measuring the frequency of AIDS deaths and ultimately the impact of antiretroviral therapy on mortality. METHODS AND FINDINGS: A verbal autopsy questionnaire was administered to caregivers of 381 adults of known HIV status who died between 1998 and 2003 in Manicaland, eastern Zimbabwe. Individuals who were HIV positive and did not die in an accident or during childbirth (74%; n = 282 were considered to have died of AIDS in the gold standard. Verbal autopsies were randomly allocated to a training dataset (n = 279 to generate classification criteria or a test dataset (n = 102 to verify criteria. A rule-based algorithm created to minimise false positives had a specificity of 66% and a sensitivity of 76%. Eight predictors (weight loss, wasting, jaundice, herpes zoster, presence of abscesses or sores, oral candidiasis, acute respiratory tract infections, and vaginal tumours were included in the algorithm. In the test dataset of verbal autopsies, 69% of deaths were correctly classified as AIDS/non-AIDS, and it was not necessary to invoke a differential diagnosis of tuberculosis. Presence of any one of these criteria gave a post-test probability of AIDS death of 0.84. CONCLUSIONS: Analysis of verbal autopsy data in this rural Zimbabwean population revealed a distinct pattern of signs and symptoms associated with AIDS mortality. Using these signs and symptoms, demographic surveillance data on AIDS deaths may allow for the estimation of AIDS mortality and even HIV prevalence.

  19. Studying Suicide with Psychological Autopsy: Social and Cultural Feasibilities of the Methodology in China

    Zhang, Jie; Wieczorek, William F.; JIANG, CHAO; Zhou, Li; Jia, Shuhua; Sun, Yueji; Jin, Shenghua; Conwell, Yeates

    2002-01-01

    As China opens its door to the world, suicide research is making rapid progress using methods and instruments developed in the West. This is a feasibility study of the psychological autopsy methodology applied in China, with its emphasis on the social and cultural environments. With samples of 66 completed suicides and 66 community normal living controls, the authors found that it is feasible to interview at least two informants for each suicide case and each control, between 2 and 6 months a...

  20. Association of pulmonary histopathological findings with toxicological findings in forensic autopsies of illicit drug users

    Todorović Miloš S.

    2011-01-01

    Full Text Available Background/Aim. Drug abuse remains a significant social problem in many countries. The aim of the study was to estimate association between pulmonary histopathological changes and results of toxicological analyses in forensic autopsies of illicit drug users. Methods. This investigation was performed in the Institute of Forensic Medicine, Belgrade, and in the Clinical Center, Department of Forensic Medicine, Kragujevac, from 2000 to 2004, and included 63 medicolegal autopsies of heroin or other drug consumers who suddenly died. Autopsies, postmortem toxicological examination of drugs and serological analyses of anti- HIV/HBV/HCV antibodies were performed. Results. The deceased persons were mostly male, 46/63 (73.01%, ranged in age from 19 to 49 years (mean 31 years and all were whites. Postmortem toxicological examination was performed on all of the deceased persons and drugs in the fatal range were identified in only eight of them (12.7%, in the toxic range in ten (15.87%, and in minimal concentrations in 35 (55.56% of the deceased persons. Drugs identified in the fatal, toxic or minimal range included heroin-morphine (38/53, cocaine (4/53, tramadol (3/53, and lorazepam (1/53. In the 7 remaining subjects, ethanol in combination with heroin was found in 4 cases, and diazepam in combination with heroin in 3 cases. Dominant pathomorphological changes were findings in the lung tissue. Most common histological changes observed in drug users were pulmonary edema - 55/63 (87.3%, acute alveolar hemorrhages - 49/63 (77.78%, hemosiderin-laden macrophages (siderophages - 52/63 (82,54%, and emphysematous changes - 51/63 (80,95%. Conclusion. Pulmonary edema is the frequent non-specific autopsy finding which is associated with virtually all routes of drug administration. The histopatological study is necessary to determinate a cause of death when a deceased person has the history of dependence or abouse of psychoactive drugs with negative toxicological

  1. The relation of antemortem factors to atherosclerosis at autopsy. The Puerto Rico Heart Health Program.

    Sorlie, P. D.; Garcia-Palmieri, M. R.; Castillo-Staab, M. I.; Costas, R.; Oalmann, M. C.; Havlik, R

    1981-01-01

    Among 9824 Puerto Rican men, aged 35-79, participating in a prospective study of cardiovascular risk factors, there were 970 deaths during the period 1965-1977. About 14%, or 139, of these deaths had a protocol autopsy following the procedures of the International Atherosclerosis Project. The percentage of involvement with raised atherosclerotic lesions in the coronary arteries was higher in the urban deceased than in the rural. The coronary heart disease death rate was also found to be highe...

  2. Two forensic autopsy cases of death from unexpected lesions of the pituitary gland.

    Suzuki, Hideto; Hayashi, Kino; Fukunaga, Tatsushige

    2014-01-01

    Herein, we report the findings of 2 forensic autopsy cases, in which unexpected pituitary lesions were the underlying cause of death. Case 1: A 56-year-old woman was found dead at her home during a cold winter spell. Macroscopic autopsy findings included a difference in the color of blood that filled her left and right cardiac chambers (deep red and dark red, respectively), collapse of both lungs, atrophy of the thyroid gland, and a large tumor arising from the sella turcica. Microscopic examination revealed a pituitary adenoma along with extensive bleeding. The cause of death was considered to be hypothermia, resulting from dysregulation of thermogenesis due to the pituitary adenoma. Case 2: An 86-year-old man with a history of pollakiuria was found dead in a bathtub, with his face and chest submerged in bathwater and his legs positioned outside the bathtub. The macroscopic findings of the autopsy included hyper-inflated lungs, fluid collection in the thoracic cavity, and aspiration of gastric contents in the bronchi. The atherosclerotic changes of the man's coronary and cerebral arteries were considered mild for his age. Microscopic examination showed a marked infiltration of lymphocytes and plasma cells in the posterior pituitary gland, as well as in the liver, pancreas, and submandibular gland. Considering the results of the autopsy and the findings from the investigation conducted at the death scene, we concluded that the man probably lost consciousness following a neurally mediated syncope, which was induced by diabetes insipidus (lymphocytic hypophysitis). After losing consciousness, the man likely fell in the filled bathtub and then drowned. These 2 cases highlight the need for a thorough post-mortem investigation, including a microscopic examination of the pituitary gland. In addition, forensic pathologists should carefully study the pituitary gland in cases where the cause of death is thought to be related to dysfunction of thermoregulation or

  3. A STUDY OF LUNG PATHOLOGY IN PEDIATRICS AUTOPSIES: AN 8 YEAR STUDY

    Majethia Nikhil

    2014-11-01

    Full Text Available BACKGROUND: Pneumonia remains the number one killer of children, taking the lives of 1.3 million in 2011 alone. More than 99% of all pneumonia deaths occur in developing countries. The majority of pneumonia cases are preventable and treatable, but clinical diagnosis is highly fallible in many cases and the frequency of morbid state is best assessed by post-mortem examination that may reveal diagnosis which may not be suspected clinically or may, in some way, discredit. AIMS: 1. To ascertain various pulmonary lesions in paediatric deaths. 2. To find incidence of pulmonary lesions. 3. To study the incidence of pulmonary tuberculosis, 4. To find incidence of pulmonary pathology directly and indirectly contributing to the death. SETTINGS: Lokmanya Tilak Municipal General Hospital, Sion, Mumbai. DESIGN: A retrospective observational study. METHODS AND MATERIAL: In this study pediatric age group of (0-15 years admitted in IPCU,NICU and Pediatric, Medicine and Surgery unit are included from the period of 2006-2013. The lung pathology in various diseases entities were studied and co-related with age, sex and clinical history. RESULTS: Of total 3606 autopsies, 642 were pediatric autopsies i.e. 17.8% of all autopsies, and 111 were neonatal autopsies. Of 642, 531(82.7% had primary lung pathology and 157(24.4% had secondary lung pathology. The common age group affected is < 5 years. Bronchopneumonia was the commonest pathology observed as primary lung pathology. Interstitial/viral pneumonia was 2nd most common of primary lung pathology Infective pathology was the most common lesions, of which bronchopneumonia was the most common pathology observed and tuberculosis contributed to 3%of primary lung pathologies. CONCLUSION: The most common lung lesion in pediatric age is infections, which are preventable and curative with appropriate measures. This study will help to improve mother child health services

  4. Jarcho-Levin syndrome--a report of an autopsy case with cytogenetic analysis.

    PARK, Y.; Gong, G.; Choe, G.; Yu, E; Kim, K.S.; I. Lee

    1993-01-01

    Jarcho-Levin syndrome (JLS) is a condition manifested by malformations of vertebral bodes and related ribs. There are two major subtypes spondylocostal dysostosis and spondylothoracic dysostosis, with different survival rates, associated malformations, and inheritance patterns. We have experienced an autopsy case of a premature female fetus with multiple congenital anomalies. She was 30 weeks of gestational age, born as the second baby of twins and expired shortly after birth. A post-mortem e...

  5. Holoprosencephaly with Multiple Anomalies of the Craniofacial Bones-An Autopsy Report

    Aruna, E.; Chakravarthy, V. Kalyan; Rao, D. Naveen Chandar; Rao, D. Ranga

    2013-01-01

    Holoprosencephaly (HPE), a disorder which results from a failure of cleavage or the incomplete differentiation of the forebrain structures at various levels or to various degrees, is related to hereditary factors, chromosomal anomalies, cytogenetic abnormalities, and environmental teratogenic factors. We are reporting a case of a multiparous woman who was G3,P3,L2, who delivered a full term foetus with holoprosencephaly and multiple craniofacial anomalies. An autopsy was conducted. Multiple a...

  6. Causes of childhood deaths in Bangladesh: results of a nationwide verbal autopsy study.

    Baqui, A. H.; Black, R. E.; Arifeen, S.E.; Hill, K.; Mitra, S. N.; al Sabir, A.

    1998-01-01

    While knowledge of causes of deaths is important for health sector planning, little is known from conventional sources about the causes of deaths in Bangladesh. This is partly due to deficiencies in the registration system and partly because few deaths are attended by qualified physicians. The present study was undertaken to update the information available on causes of deaths among under-5-year-olds, taking advantage of advances in verbal autopsy methodology and of the national Bangladesh De...

  7. A prospective study of paediatric autopsies conducted at Bapuji Hospital and Research Centre, Davangere.

    Siddappa, Santhosh Chandrappa; C, Siddesh R; G, Viswanathan K; Gupta, Ashok

    2014-01-01

    Pediatrics is the branch of medicine dealing with children and their diseases. Injury & Violence are major killers of children and adolescents under the age of 18 years throughout the world, and are responsible for about 950000 deaths each year. Unnatural childhood deaths are not only associated with intense trauma and separation distress, but also relate to a sense of self neglect to protect children from harm. Out of 532 autopsies performed during the study period from January 2010 to D...

  8. Atherosclerosis of Coronary Arteries as Predisposing Factor in Myocardial Infarction: An Autopsy Study

    Gauravi A Dhruva,; Amit H Agravat; Hardik K Sanghvi

    2012-01-01

    The incidence of coronary heart disease has markedly increased in India over the past few years. Ischemic heart disease, the largest cause of morbidity and mortality in the developed and developing countries today is overwhelmingly contributed by atherosclerosis. The study highlights the impact of atherosclerotic lesions in the population of Rajkot district. We studied atherosclerotic lesions in coronary arteries in cases subjected to autopsy in last 4 years, to grade and to evaluate the athe...

  9. An analytical method for the determination of plutonium in autopsy samples

    A sensitive method for the determination of plutonium in autopsy samples is described. After a suitable chemical pretreatment of the samples the plutonium is separated by extraction chromatography with tri-n-octylphosphine oxide (TOPO) supported on microporus polyethylene. After electrodeposition of plutonium the activity is counted by alpha spectroscopy. The global yield was 75-80%. The reagent blank activity was such to allow the determination of some femtocuries of plutonium

  10. High-speed documented experimental gunshot to a skull-brain model and radiologic virtual autopsy.

    Thali, Michael J; Kneubuehl, Beat P; Vock, Peter; Allmen, Gabriel v; Dirnhofer, Richard

    2002-09-01

    The authors documented and evaluated experimental gunshots to a skull-brain model with high-speed photography and subsequent radiographic examination for comparison of the morphologic findings in the model. The artificial skull was a polyurethane ball constructed in layers, with a porous diploe sandwiched between a tabula externa and a tabula interna. The brain itself was simulated with gelatin 10% at 4 degrees C, a material well known in wound ballistics. Gunshots were fired at the model from a distance of 10 m and documented with high-speed photography (up to 50 million frames/sec). Subsequently, a complete examination of the artificial skull was performed, including spiral computed tomography (with two-dimensional and three-dimensional reconstructions) and classic skull autopsy. The high-speed photographs clearly showed the dynamic development of the skull fracture system from an external perspective. The subsequent radiographic examination of the entire head volume created two-dimensional reformations in any plane and three-dimensional reconstructions of the gunshot injury of the polyurethane skull-brain model, especially the wound channel and the fracture system. Thanks to the model and high-speed photographs, the dynamic development of the morphology of a gunshot wound could be documented and studied. The data from computed tomography, using two-dimensional and three-dimensional postprocessing with a perspective view, were very similar to those from classic head autopsy, but derived in a hands-off and nondestructive manner. This examination method leads the way to radiographic digital autopsy or virtual autopsy. PMID:12198345

  11. Transcriptional profiling and genotyping of degraded nucleic acids from autopsy tissue samples after prolonged formalin fixation times

    Ferruelo, Antonio; González, Constancio

    2011-01-01

    [Background]: Samples used for genotyping and transcription studies are obtained and conserved in very specific conditions. The possibility to use autopsy tissue samples, which contain nucleic acids of very poor quality, would open new possibilities for genetic studies. [Methods]: We have used liver tissue samples from autopsy cases to (i) determine its quality; (ii) study gene expression of 13 genes involved in different cell processes, before and after cDNA pre-amplification (quantitative r...

  12. Transcriptional profiling and genotyping of degraded nucleic acids from autopsy tissue samples after prolonged formalin fixation times

    Ferruelo, Antonio; El-Assar, Mariam; Lorente, José A; Nin, Nicolás; Peñuelas, Oscar; Fernández-Segoviano, Pilar; Gonzalez, Constancio; Esteban, Andrés

    2011-01-01

    Background: Samples used for genotyping and transcription studies are obtained and conserved in very specific conditions. The possibility to use autopsy tissue samples, which contain nucleic acids of very poor quality, would open new possibilities for genetic studies. Methods: We have used liver tissue samples from autopsy cases to (i) determine its quality; (ii) study gene expression of 13 genes involved in different cell processes, before and after cDNA pre-amplification (quantitative rever...

  13. Examination of the Clinicopathologic Continuum of Alzheimer Disease in the Autopsy Cohort of the National Alzheimer Coordinating Center

    Serrano-Pozo, Alberto; Qian, Jing; Monsell, Sarah E; Frosch, Matthew P.; Betensky, Rebecca A.; Hyman, Bradley T.

    2013-01-01

    To test the hypothesis that Alzheimer disease (AD) is a clinical and pathologic continuum between normal aging and end-stage dementia, we selected a convenience sample of subjects from the National Alzheimer Coordinating Center 2005 to 2012 autopsy cohort (n = 2,083) with the last clinical evaluation within 2 years before autopsy and no other primary neuropathologic diagnosis. Demographic and neuropathologic characteristics were correlated with the Clinical Dementia Rating–Sum of Boxes in the...

  14. Aggregate effects of vascular risk factors on cerebrovascular changes in autopsy-confirmed Alzheimer’s disease

    Bangen, Katherine J.; Nation, Daniel A.; Delano-Wood, Lisa; Weissberger, Gali H.; Hansen, Lawrence A.; Galasko, Douglas R.; Salmon, David P.; Bondi, Mark W.

    2014-01-01

    We examined the relationships of ante-mortem vascular risk factors to post-mortem cerebrovascular and AD pathologies. Eighty-four AD patients underwent assessment of vascular risk (blood pressure, cholesterol, smoking, cardiovascular disease, diabetes, atrial fibrillation, transient ischemic attack [TIA] or stroke) and later underwent brain autopsy. Given our aim to examine mild cerebrovascular changes (CVC), individuals were excluded if autopsy revealed large stroke. The most common forms of...

  15. Clinical manifestations and pulmonary histopathological analysis related to different diseases in patients with fatal pulmonary thromboembolism: an autopsy study

    Ruppert, Aline Domingos Pinto; Soeiro, Alexandre de Matos; de Almeida, Maria Carolina Feres; de Oliveira, Múcio Tavares; Serrano, Carlos V; Capelozzi, Vera Luiza

    2014-01-01

    Background To correlate underlying diseases, in autopsies of patients with pulmonary thromboembolism (PTE) to histological findings and manifestations reviewed in the medical records. Methods The autopsy records between 2001 and 2008 of 291 patients whose cause of death was PTE were reviewed. The following data were obtained: age, sex, clinical “in vivo” manifestations, postmortem pathological patterns, and main associated underlying diseases, cancers, and surgeries performed in the last hosp...

  16. Changing patterns of infant death over the last 100 years: autopsy experience from a specialist children's hospital

    Pryce, J. W.; Weber, M A; Ashworth, M T; Roberts, S; Malone, M.; Sebire, N. J.

    2012-01-01

    OBJECTIVES: Infant mortality has undergone a dramatic reduction in the UK over the past century because of improvements in public health policy and medical advances. Postmortem examinations have been performed at Great Ormond Street Hospital for over 100 years, and analysis of cases across this period has been performed to assess changing patterns of infant deaths undergoing autopsy. DESIGN: Autopsy reports from 1909 and 2009 were examined. Age, major pathology and cause of death was reviewed...

  17. Renal pathology in hematopoietic cell transplant recipients: a contemporary biopsy, nephrectomy, and autopsy series.

    Brinkerhoff, Brian T; Houghton, Donald C; Troxell, Megan L

    2016-06-01

    Renal injury in hematopoietic cell transplant recipients may be related to a combination of factors including chemotherapy, radiation, infection, immunosuppressive agents, ischemia, and graft-versus-host disease, and can involve glomerular, tubulointerstitial, and vascular structures. We reviewed renal pathology from 67 patients at a single institution (2009-2014), including 14 patients with biopsy for clinical dysfunction, 6 patients with surgical kidney resection for other causes, and 47 autopsy patients. Kidney specimens frequently contained multiple histopathologic abnormalities. Thrombotic microangiopathy, membranous nephropathy, minimal change disease, and focal segmental glomerulosclerosis were the most common glomerular findings. Pathologies not previously reported in the hematopoietic cell transplant setting included collapsing glomerulopathy, antiglomerular basement membrane disease, fibrillary glomerulonephritis, and in the case of two surgical resections distinctive cellular segmental glomerular lesions that defied classification. Kidney specimens frequently demonstrated acute tubular injury, interstitial fibrosis, arteriolar hyaline, and arteriosclerosis. Other kidney findings at autopsy included leukemia and amyloid (both recurrent), diabetic nephropathy, bacterial infection, fungal invasion, and silver deposition along glomerular and tubular basement membranes. Also in the autopsy cohort, C4d immunohistochemistry demonstrated unexpected membranous nephropathy in two patients, yet C4d also colocalized with arteriolar hyaline. This retrospective hematopoietic cell transplant cohort illustrates multifaceted renal injury in patients with renal dysfunction, as well as in patients without clinically recognized kidney injury. PMID:27015134

  18. Widespread inflammation in CLIPPERS syndrome indicated by autopsy and ultra-high-field 7T MRI

    Blaabjerg, Morten; Ruprecht, Klemens; Sinnecker, Tim; Kondziella, Daniel; Niendorf, Thoralf; Kerrn-Jespersen, Bjørg Morell; Lindelof, Mette; Lassmann, Hans; Kristensen, Bjarne Winther; Paul, Friedemann

    2016-01-01

    Objective: To examine if there is widespread inflammation in the brain of patients with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) syndrome by using histology and ultra-high-field MRI at 7.0T. Methods: We performed a detailed neuropathologic examination in 4 cases, including 1 autopsy case, and studied 2 additional patients by MRI at 7.0T to examine (1) extension of inflammation to areas appearing normal on 3.0T MRI, (2) potential advantages of 7.0T MRI compared to 3.0T MRI in reflecting widespread inflammation, perivascular pathology, and axonal damage, and (3) the possibility of lymphoma. Results: In the autopsy case, perivascular inflammation dominated by CD4+ T cells was not only detected in the brainstem and cerebellum but also in brain areas with normal appearance on 3.0T MRI, including supratentorial regions and cranial nerve roots. There was no evidence of lymphoma in any of the 4 patients. The 7.0T MRI in clinical remission also revealed supratentorial lesions and perivascular pathology in vivo with contrast-enhancing lesions centered around a small venous vessel. Ultra-high-field MRI at 7.0T disclosed prominent T1 hypointensities in the brainstem, which were not seen on 3.0T MRI. This corresponded to neuropathologic detection of axonal injury in the autopsy case. Conclusion: Our findings suggest more widespread perivascular inflammation and postinflammatory axonal injury in patients with CLIPPERS. PMID:27144217

  19. Social autopsy for maternal and child deaths: a comprehensive literature review to examine the concept and the development of the method

    Koffi Alain K; Babille Marzio; Salgado Rene; Kalter Henry D; Black Robert E

    2011-01-01

    Abstract "Social autopsy" refers to an interview process aimed at identifying social, behavioral, and health systems contributors to maternal and child deaths. It is often combined with a verbal autopsy interview to establish the biological cause of death. Two complementary purposes of social autopsy include providing population-level data to health care programmers and policymakers to utilize in developing more effective strategies for delivering maternal and child health care technologies, ...

  20. Mortality pattern according to autopsy findings among traffic accident victims in Yazd, Iran

    Yashar Moharamzad; Hamidreza Taghipour; Nader Hodjati Firoozabadi; Abolfazl Hodjati Firoozabadi; Mojtaba Hashemzadeh; Mehdi Mirjalili; Abed Namavari

    2008-01-01

    Objective: To describe mortality pattern and to deter-mine undiagnosed fatal injuries according to autopsy find-ings among road traffic accident victims in Yazd, Iran. Methods: In this retrospective study, 251 victims of road traffic accidents who were admitted to a tertiary trauma hospital over a two-year period (2006 and 2007) and received medical cares were included. Hospital records were reviewed to gather demographic characteristics, road user type, and medical data. Autopsy records were also reviewed to determine actual causes of death and possible undiagnosed injuries occurred in the initial assessment of the emergency unit or during hospitalization. Results: There were 202 males (80.5%) and 49 females (19.5%). The mean (±SD) age of fatalities was 34.1 (±21.5) years. Pedestrian-vehicle accidents were the most common cause of trauma (100 cases, 39.8%). The most common cause of death was central nervous system injury ( 146 cases, 58.1%). The other causes were skull base fractures (10%), internal bleeding (8%), lower limb hemorrhage (8%), skull vault fractures (4%), cervical spinal cord injury (3.6%), airway com-promise (3.2%), and multifactor cases (5.1%), respectively.Thirtysix fatal injuries in 30 victims (12%) mainly contributed to death according to autopsy, but were not diagnosed in initial assessments. The head (72.2%) and cervical spine (13.8%) regions were the two most common sites for undiagnosed injuries. Conclusion: Training courses for emergency unit medical staff with regard to interpreting radiological findings of head and neck and high clinical suspicion for cervical spine injuries are essential to improve the quality of early hospital care and reduce the mortality and morbidity of traffic accident patients.

  1. Agreement between death-certificate and autopsy diagnoses among atomic-bomb survivors

    Using the Atomic Bomb Casualty Commission/Radiation Effects Research Foundation series of over 5000 autopsies, we examined death-certificate accuracy for several disease categories and assessed the effect of potential modifying factors on this accuracy. For 12 cause-of-death categories, the overall percent agreement between death-certificate and autopsy diagnoses was only 52.5%. Although neoplasms had the highest detection rate (on the death certificate) in the study, still almost 25% of cancers diagnosed at autopsy were missed on the death certificate. Only for neoplasms and external causes of death were confirmation and detection rates above 70%. Confirmation rates were between 50% and 70% for infectious and parasitic diseases and heart and other vascular diseases. Detection rates reached a similar level for infectious and parasitic, cerebrovascular, and digestive diseases. Specificity rates were above 90% for all but the cerebrovascular disease category. Overall agreement decreased with increasing age of the decedents and was lower for deaths occurring outside of hospital vs those occurring in a hospital. There was some suggestion that agreement rates were higher for more-recent deaths but no indication that radiation dose, sex, city of residence, or inclusion in a biennial clinical-examination program influenced agreement. Because the inaccuracy of death-certificate diagnoses can have major implications for many aspects of health research and planning, it is important to be aware that death-certificate accuracy is low and can vary widely depending on the patient's age at death and the place of death. (J.P.N.)

  2. Socio-Demographic Profile of Infant Mortality by Verbal Autopsy in Urban Area of Bhavnagar, Gujarat

    Sanat Rathod, MP Singh, Rahul Damor, Dharmendra Jankar, Vibha Gosalia, Harshad Patel, Devang Raval

    2011-01-01

    Full Text Available Objectives: To study socio-demographic profile of all registered infant deaths in Bhavnagar city. Materials and Method: This was a community based retrospective analytical study carried out in municipal corporation area of Bhavnagar city for which list of all registered infant deaths from 1st January 2009 to 31st December 2009 from municipal corporation, Bhavnagar was obtained. Data collection was carried out between January to May 2010 at respondent’s house with help of restructured verbal autopsy questionnaire developed by WHO. Result: Out of 96 total verbal autopsies 73(76% infant deaths were in neonatal period chiefly focus in early neonatal period (62.5%. Male infant were 57.3% & 42.7% were female. Average family size was 4.9%. 61.5% from socio-economic class IV and 38.5% from classV. Poor housing was reported in 90% cases. Mother age less than 20 years at time of birth of the baby was in 15%. >1/3rd infant deaths in gravida & parity one. In 53.9% cases birth spacing was <2years. Conclusion: By studying verbal autopsy, this study shows how important it is to correctly identify socio-demographic factors responsible for infant deaths. The present study concluded highest chances of infant deaths in ENP( Early Neonatal Period mainly within one hour with significant male infant deaths in ENP. Most deaths were in lower socio-economic strata & first gravida/parity with birth spacing less than two years.

  3. An Autopsy Study of Liver Injuries in a Tertiary Referral Centre of Eastern Nepal

    Subedi, Nuwadatta; Yadav, B.N.; Jha, Shivendra; Gurung, Sharmila; Pradhan, Amshu

    2013-01-01

    Background: Liver is the largest gland in the body and it frequently gets wounded. The objective of this study was to determine the patterns, types and severities of liver injuries which were caused by mechanical trauma and to study the organs associated with liver injuries. Material and Methods: This was a hospital based, cross sectional study which was conducted on the autopsies showing the evidence of liver injuries in the mortuary of a tertiary hospital in eastern Nepal. All consecutive autopsy cases which were handled within one year’s time (n=46) were included in our study. The cases were studied in detail for liver injuries, which included age, sex, severity, associated injuries, site of the injury, description of the injury, etc. Results: The mean age of the victims was 33.87 years and there was a male: female ratio of 3.6:1. The injuries had resulted from blunt trauma in 41 (89.1%) cases, the most common of which was road traffic accidents, constituting 37(80.4%) cases. Grade III injuries were seen in 14 (30.4%) cases. Laceration of the liver was the most frequent finding that was evident in 34 (73.9%) cases. Right lobe of the liver was injured in 30 (74%) cases. The sole presence of liver injuries among abdomino-pelvic organs was seen in 14 (30.4%) cases. In 40 (87%) cases, liver injuries were associated with other regional injuries. Conclusion: Laceration is the most common liver injury among autopsy cases. Right lobe is mostly affected and grade III injuries are the most common ones. Liver injuries are frequently associated with other abdomino-pelvic organs and multiple regional injuries. PMID:24086875

  4. Cause of death among Ghanaian adolescents in Accra using autopsy data

    Tettey Yao

    2011-09-01

    Full Text Available Abstract Background There is limited data on adolescent mortality particularly from developing countries with unreliable death registration systems. This calls for the use of other sources of data to ascertain cause of adolescent mortality. The objective of this study was to describe the causes of death among Ghanaian adolescents 10 to 19 years in Accra, Ghana utilizing data from autopsies conducted in Korle Bu Teaching Hospital (KBTH. Findings Out of the 14,034 autopsies carried out from 2001 to 2003 in KBTH, 7% were among adolescents. Of the 882 deaths among adolescents analyzed, 402 (45.6% were females. There were 365 (41.4% deaths from communicable disease, pregnancy related conditions and nutritional disorders. Non-communicable diseases accounted for 362 (41% cases and the rest were attributable to injuries and external causes of morbidity and mortality. Intestinal infectious diseases and lower respiratory tract infections were the most common communicable causes of death collectively accounting for 20.5% of total deaths. Death from blood diseases was the largest (8.5% among the non-communicable conditions followed by neoplasms (7%. Males were more susceptible to injuries than females (χ2 = 13.45, p = .000. At least five out of ten specific causes of death were as a result of infections with pneumonia and typhoid being the most common. Sickle cell disease was among the top three specific causes of death. Among the females, 27 deaths (6.7% were pregnancy related with most of them being as a result of abortion. Conclusions The autopsy data from the Korle-Bu Teaching Hospital can serve as a useful source of information on adolescent mortality. Both communicable and non-communicable diseases accounted for most deaths highlighting the need for health care providers to avoid complacency in their management of adolescents presenting with these diseases.

  5. Different fractionation schemes tested by histological examination of autopsy specimens from lung cancer patients

    The biological effects of different fractionation schemes have been evaluated by the histological examination of bronchial carcinomas removed at operation or autopsy following radiotherapy. Radiation was given in daily, small fractions (200 cGy (rad)), large fractions (600 cGy (rad)) every fifth day, or a single high dose followed by daily low-dose treatment. The highest proportion of tumours free of viable cells was found in patients who had received small daily fractions in both operable and inoperable tumours. A hypothesis is put forward to explain this apparent change in radio-sensitivity with different fractionation schemes. (author)

  6. Widespread inflammation in CLIPPERS syndrome indicated by autopsy and ultra-high-field 7T MRI

    Blaabjerg, M.; Ruprecht, K.; Sinnecker, T.; Kondziella, D.; Niendorf, T; Kerrn-Jespersen, B.M.; Lindelof, M.; Lassmann, H.; Kristensen, B.W.; F. Paul; Illes, Z.

    2016-01-01

    OBJECTIVE: To examine if there is widespread inflammation in the brain of patients with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) syndrome by using histology and ultra-high-field MRI at 7.0T. METHODS: We performed a detailed neuropathologic examination in 4 cases, including 1 autopsy case, and studied 2 additional patients by MRI at 7.0T to examine (1) extension of inflammation to areas appearing normal on 3.0T MRI, (2) potential ...

  7. Random forests for verbal autopsy analysis: multisite validation study using clinical diagnostic gold standards

    James Spencer L

    2011-08-01

    Full Text Available Abstract Background Computer-coded verbal autopsy (CCVA is a promising alternative to the standard approach of physician-certified verbal autopsy (PCVA, because of its high speed, low cost, and reliability. This study introduces a new CCVA technique and validates its performance using defined clinical diagnostic criteria as a gold standard for a multisite sample of 12,542 verbal autopsies (VAs. Methods The Random Forest (RF Method from machine learning (ML was adapted to predict cause of death by training random forests to distinguish between each pair of causes, and then combining the results through a novel ranking technique. We assessed quality of the new method at the individual level using chance-corrected concordance and at the population level using cause-specific mortality fraction (CSMF accuracy as well as linear regression. We also compared the quality of RF to PCVA for all of these metrics. We performed this analysis separately for adult, child, and neonatal VAs. We also assessed the variation in performance with and without household recall of health care experience (HCE. Results For all metrics, for all settings, RF was as good as or better than PCVA, with the exception of a nonsignificantly lower CSMF accuracy for neonates with HCE information. With HCE, the chance-corrected concordance of RF was 3.4 percentage points higher for adults, 3.2 percentage points higher for children, and 1.6 percentage points higher for neonates. The CSMF accuracy was 0.097 higher for adults, 0.097 higher for children, and 0.007 lower for neonates. Without HCE, the chance-corrected concordance of RF was 8.1 percentage points higher than PCVA for adults, 10.2 percentage points higher for children, and 5.9 percentage points higher for neonates. The CSMF accuracy was higher for RF by 0.102 for adults, 0.131 for children, and 0.025 for neonates. Conclusions We found that our RF Method outperformed the PCVA method in terms of chance-corrected concordance and

  8. A Moessbauer-effect study of autopsied lung tissue of asbestos workers

    A 57Fe Moessbauer-effect study of autopsied lung tissue from Canadian asbestos mine workers is presented. The spectra typically show large quantities of iron storage protein. This exhibits a quadrupole-split doublet at room temperature and both a doublet and a Zeeman-split sextet at 4.2 K, due to a distribution of particle sizes. A comparison is made with Moessbauer spectra of lung tissue from an individual not occupationally exposed to respirable asbestos, and with spectra of respirable chrysotile asbestos taken from Canadian mines. (author)

  9. Efficacy of drug screening in forensic autopsy: retrospective investigation of routine toxicological findings.

    Tominaga, Mariko; Michiue, Tomomi; Inamori-Kawamoto, Osamu; Hishmat, Asmaa Mohammed; Oritani, Shigeki; Takama, Masashi; Ishikawa, Takaki; Maeda, Hitoshi

    2015-05-01

    Toxicological analysis is indispensable in forensic autopsy laboratories, but often depends on the limitations of individual institutions. The present study reviewed routine drug screening data of forensic autopsy cases (n=2996) during an 18.5-year period (January 1996-June 2014) at our institute to examine the efficacy of the procedures and findings in autopsy diagnosis and interpretation. Drug screening was performed using on-site immunoassay screening devices and gas chromatography/mass spectrometry (GC/MS) in all cases, followed by re-examination using GC/MS and liquid chromatography/tandem mass spectrometry (LC/MS/MS) at a cooperating institute in specific cases in the last 4 years. GC/MS detected drugs in 486 cases (16.2%), including amphetamines (n=160), major tranquilizers (n=72), minor tranquilizers (n=294), antidepressants (n=21), cold remedies (n=77), and other drugs (n=19). Among these cases, fatal intoxication (n=123) involved amphetamines (n=73), major tranquilizers (n=37), minor tranquilizers (n=86), antidepressants (n=3), and cold remedies (n=9); most cases involved self-administration, alleged suicide and accidental overdose, while homicide was not included. These drugs were also identified in other manners of death, including homicide (n=40/372), suicide (n=34/226), accidental falls (n=27/129), and natural death (n=72/514). In these cases, on-site immunoassay screening of drugs of abuse showed negative findings in 2440 cases (81.4% in all cases), while GC/MS detected other drugs in 218 cases (7.3% in all cases), including several antipsychotic drugs, acetaminophen and salicylic acid. Further analysis using LC/MS/MS detected low concentrations of benzodiazepines in 32 cases, and also anti-diabetic and hypertensive drugs in a case of fatal abuse. These observations indicate the efficacy of systematic routine toxicological analysis to investigate not only the cause of death but also the background of fatalities in forensic autopsy. The provision of

  10. A psychological autopsy study of suicide among Inuit in Nunavut: methodological and ethical considerations, feasibility and acceptability

    Eduardo Chachamovich

    2013-03-01

    Full Text Available Introduction. The increasing global prevalence of suicide has made it a major public health concern. Research designed to retrospectively study suicide cases is now being conducted in populations around the world. This field of research is especially crucial in Aboriginal populations, as they often have higher suicide rates than the rest of the country. Objective. This article presents the methodological aspects of the first psychological autopsy study on suicide among Inuit in Nunavut. Qaujivallianiq Inuusirijauvalauqtunik (Learning from lives that have been lived is a large case-control study, including all 120 cases of suicide by Inuit that occurred in Nunavut between 1 January 2003 and 31 December 2006. The article describes the research design, ethical considerations and strategies used to adapt the psychological autopsy method to Nunavut Inuit. Specifically, we present local social and cultural issues; data collection procedures; and the acceptability, reliability and validity of the method. Method. A retrospective case-control study using the psychological autopsy approach was carried out in 22 communities in Nunavut. A total of 498 individuals were directly interviewed, and medical and correctional charts were also reviewed. Results. The psychological autopsy method was well received by participants as they appreciated the opportunity to discuss the loss of a family member or friend by suicide. During interviews, informants readily identified symptoms of psychiatric disorders, although culture-specific rather than clinical explanations were sometimes provided. Results suggest that the psychological autopsy method can be effectively used in Inuit populations.

  11. HIV-negative drug addict diagnosed with AIDS and tuberculosis at autopsy: a case report and brief review of literature.

    Ananda, Sunnassee; Shaohua, Zhu; Fan, Yang; Liang, Liu

    2011-04-01

    Human Immunodeficiency Virus (HIV) infection is a true plague and a major health concern globally. It is one of the most significant pandemics in recorded history. Despite worldwide efforts to fight the pandemic, and now with the re-emergence of tuberculosis, those clinicians, personnel performing autopsies and medical caregivers are again at risk in the work place, especially in developing countries. We describe a case where a drug abuser, whose addiction was concealed by his parents, died in hospital. He was tested HIV-negative there. A medical tangle ensued and forensic autopsy was carried out. Autopsy confirmed he was an intravenous drug addict and had tuberculosis. Post-mortem blood was positive for HIV antibodies and he was diagnosed with AIDS. Due to social stigmas, lack of knowledge or inefficient medical laboratory procedures etc, such type of cases can become a hazard to those attending the sick and to autopsy pathologists alike. We provide the case description, autopsy findings and review of pertinent literature. PMID:21420653

  12. Terminal ballistics of the 7.62 mm NATO bullet. Autopsy findings.

    Knudsen, P J; Theilade, P

    1993-01-01

    The 7.62 mm x 51 military rifle bullet (7.62 mm NATO) as manufactured in Denmark, and in some other countries as well, has been claimed to fragment when fired at ranges encountered in forensic practice. All autopsied cases of death due to this bullet in Denmark since 1975 were investigated by studying autopsy reports and the bullets retrieved by the police. With one exception, all bullets that were found in, or known to have passed through the body, had fragmented. This behaviour is assumed to be due to a lack of strength in the jacket causing it to break at the cannelure when hitting the target at high velocity. The fragments will increase the already sizeable lesions and may leave the body through several separate exit wounds, presenting problems both for the surgeon treating survivors and for the forensic scientists when defining the direction of the shot. The legality of this and similar bullets in view of the Hague Declaration of 1899 may be questioned, and we feel that the bullet should be redesigned. A programme to this end has been initiated by the Danish state owned ammunition factory. PMID:8217867

  13. Trousseau's Syndrome Caused by Intrahepatic Cholangiocarcinoma: An Autopsy Case Report and Literature Review

    Yuri, Takashi; Kato, Kouta; Hirohara, y; Kinoshita, Yuichi; Emoto, Yuko; Yuki, Michiko; Yoshizawa, Katsuhiko; Tsubura, Airo

    2014-01-01

    An autopsy case report of Trousseau's syndrome caused by intrahepatic cholangiocarcinoma is presented, and seven previously reported cases are reviewed. A 73-year-old woman experiencing light-headedness and dementia of unknown cause for 6 months developed severe hypotonia. A hypointense lesion compatible with acute cerebral infarction was detected by magnetic resonance imaging. Abdominal computed tomography revealed an ill-defined large liver mass in the right lobe. The mass was not further investigated because of the patient's poor condition. She died of multiple organ failure, and an autopsy was conducted. Postmortem examination revealed intrahepatic cholangiocarcinoma, fibrous vegetations on the mitral valves and multiple thromboemboli in the cerebrum, spleen and rectum. Trousseau's syndrome is defined as an idiopathic thromboembolism in patients with undiagnosed or concomitantly diagnosed malignancy. This syndrome is encountered frequently in patients with mucin-producing carcinomas, while the incidence in patients with intrahepatic cholangiocarcinoma is uncommon. We found that tissue factor and mucin tumor marker (CA19-9, CA15-3 and CA-125) expression in cancer cells may be involved in the pathogenesis of thromboembolism. A patient with unexplained thromboembolism may have occult visceral malignancy; thus, mucin tumor markers may indicate the origin of a mucin-producing carcinoma, and postmortem examination may play an important role in revealing the hidden malignancy. PMID:24987359

  14. Evaluation of Postmortem Drug Concentrations in Bile Compared with Blood and Urine in Forensic Autopsy Cases.

    Tominaga, Mariko; Michiue, Tomomi; Oritani, Shigeki; Ishikawa, Takaki; Maeda, Hitoshi

    2016-06-01

    For drug screening and pharmaco-/toxicokinetic analysis, bile as a major drug excretion route in addition to urine may be used in forensic autopsy cases; however, there are limited published data on correlations between bile and blood or urine drug concentrations. The present study retrospectively investigated drug concentrations in bile, compared with blood and urine concentrations, reviewing forensic autopsy cases during 6 years (January 2009-December 2014). Drugs were analyzed using automated gas chromatography-mass spectrometry following solid-liquid phase extraction. Compared with peripheral blood concentrations, bile concentrations were higher for most drugs; however, caffeine concentrations were similar. Bile concentrations were mostly lower than urine concentrations for amphetamines, caffeine and methylephedrine, but were usually similar to or higher for other drugs. Significant correlations were detected between bile and peripheral blood concentrations for amphetamines, several cold remedies, phenobarbital, phenothiazine derivatives and diazepam, as well as between bile and urine concentrations for amphetamines, caffeine, diphenhydramine, phenobarbital and promethazine derivatives. These findings suggest that bile can provide supplemental data useful in routine forensic toxicology, for the spectrum of drugs mentioned above, as well as for investigating pharmaco-/toxicokinetics and postmortem redistribution when analyzed in combination with drug concentrations at other sites. PMID:27185819

  15. A Century of Germinal Matrix Intraventricular Hemorrhage in Autopsied Premature Infants: A Historical Account.

    Hefti, Marco M; Trachtenberg, Felicia L; Haynes, Robin L; Hassett, Catherine; Volpe, Joseph J; Kinney, Hannah C

    2016-01-01

    The care of premature infants in the 20th century is remarkable for technical advances that have dramatically improved survival, but little is known about temporal changes in the neuropathology of the premature infant over this time frame. We hypothesize that the autopsy rate of germinal matrix hemorrhage changed in the 20th century relative to combined influences of clinical interventions that were both harmful and helpful. We examined germinal matrix hemorrhage with intraventricular hemorrhage (GMH-IVH) in 345 premature infants (gestational age 25-36 weeks) autopsied at Boston Children's Hospital from 1914 to 2015. There was a median of 19 cases/decade (range 7-68). Over the course of the study median gestational age decreased from 33 to 27 gestational weeks (P3-fold around the time of the introduction of positive pressure ventilation into premature intensive care in the mid-1960s. The increased incidence of GMH-IVH in the 1970s-1980s likely reflects respiratory and hemodynamic imbalances complicating mechanical ventilation. We speculate that the subsequent decreased incidence of GMH-IVH likely reflects stabilization of respiratory function with improvements in ventilators and in ventilator management beginning in the 1970s and the use of surfactant and antenatal steroids in the 1980s. PMID:26372101

  16. Aortic dissection with the entrance tear in transverse aorta: analysis of 12 autopsy patients.

    Roberts, C S; Roberts, W C

    1990-11-01

    Clinical and autopsy findings are described in 12 patients who had fatal aortic dissection with the entrance tear in the transverse aorta. The 12 patients represent 7% of 182 autopsies of spontaneous aortic dissection studied by us. The ages of the 12 patients at death ranged from 37 to 87 years (mean, 67 years). Eight were men; 8 had a history of systemic hypertension, and 10 had hearts of increased weight. Diagnosis of aortic dissection was made during life in only 4 of the 12 patients. All 12 patients died of rupture of the false channel within 2 weeks of onset of signs or symptoms compatible with dissection. The direction of aortic dissection from the entrance tear was entirely retrograde in 4 patients, entirely anterograde in 4 patients, and in both directions in 4 patients. Hemopericardium occurred in the first group, left hemothorax in the second group, and either in the last group. Of the 8 patients in whom the ascending aorta was involved, the retrograde dissection in each extended to the aortic root, 6 had pulmonary adventitial hemorrhage, and 4 had involvement of the arch arteries by dissection. In the 4 patients with strictly anterograde dissection, none had dissection in the arch arteries. Thus, tear in the transverse aorta causes a dissection that is usually fata, that often dissects retrogradely, and that may mimic dissection from a tear in ascending aorta. Aortic dissection from a tear in transverse aorta requires early operative intervention. PMID:2241339

  17. Problems in diagnosis and treatment of pancreatic cancer as seen in the autopsy findings

    The results obtained from a pathological study of the cancer spread, postoperative recurrence and intraoperative radiotherapy in 68 autopsy cases of pancreatic cancer were as follows: 1) The study of pancreatic cancer was conducted by classifying the cases according to the location of the cancer; uncus, head, body and tail. Difference was seen in the mode of cancer spread and also in the clinical symptoms among the pancreatic cancers in each location. Especially, it was maintained that cancer in the uncus should be treated independently from the cancer in the head. 2) There was no difference in the mode of cancer spread between postoperative recurrence or intraoperative radiotherapy cases and non-operated or non-intraoperative radiotherapy cases. Moreover, it suggested one side of difficulty of the surgical treatment, that is, all cases considered curative operation were performed through histological study of the resected specimen at operation have had retroperitoneal recurrence. 3) By histological study of autopsy cases of intraoperative radiotherapy, it was suggested that cancer cells remained or regrew in the periphery of the radiotherapy field, which is a meaningful finding for evaluating intraoperative radiotherapy in the future. (author)

  18. GLUT3 protein and mRNA in autopsy muscle specimens

    Stuart, C. A.; Wen, G.; Jiang, J.

    1999-01-01

    GLUT3 is expressed in rat muscle, but this glucose transporter protein has not been identified previously in adult human skeletal muscle. We quantified the rapidity of disappearance of mRNA and protein from human skeletal muscle at room temperature and at 4 degrees C. Fifty percent of the immunologically detectable GLUT3 protein disappeared by 1 hour at 20 degrees C and by 2 hours at 4 degrees C. mRNA for GLUT3 was decreased 50% by 2.2 hours at 20 degrees C and by 24 hours at 4 degrees C. Half of the measurable mRNAs for GLUT4, glyceraldehyde 3-phosphate dehydrogenase (GAPDH), alpha-actin, and beta-myosin disappeared by 0.8 to 2.1 hours at 20 degrees C and by 5.0 to 16.6 hours at 4 degrees C. Previous conclusions that GLUT3 is not expressed in human muscle were likely drawn because of artifacts related to degradation of GLUT3 protein in the specimens prior to study. Because of the rapid degradation of protein and mRNA, autopsy specimens of muscle must be obtained within 6 hours of death, and even then, protein and mRNA data will likely dramatically underestimate their expression in fresh muscle. Some previously published conclusions and recommendations regarding autopsy specimens are not stringent enough to consistently yield useful protein and mRNA.

  19. Cardiovascular Damage in Alzheimer Disease: Autopsy Findings From the Bryan ADRC

    Corder Elizabeth H.

    2005-01-01

    Full Text Available Autopsy information on cardiovascular damage was investigated for pathologically confirmed Alzheimer disease (AD patients (n = 84 and non-AD control patients (n = 60 . The 51 relevant items were entered into a grade-of-membership model to describe vascular damage in AD. Five latent groups were identified “I: early-onset AD,” “II: controls, cancer,” “III: controls, extensive atherosclerosis,” “IV: late-onset AD, male,” and “V: late-onset AD, female.” Expectedly, Groups IV and V had elevated APOE ϵ 4 frequency. Unexpectedly, there was limited atherosclerosis and frequent myocardial valve and ventricular damage. The findings do not indicate a strong relationship between atherosclerosis and AD, although both are associated with the APOE ϵ 4 . Instead, autopsy findings of extensive atherosclerosis were associated with possible, not probable or definite AD, and premature death. They are consistent with the hypothesis that brain hypoperfusion contributes to dementia, possibly to AD pathogenesis, and raise the possibility that the APOE allele ϵ 4 contributes directly to heart valve and myocardial damage.

  20. [Smoldering adult T-cell leukemia complicating severe respiratory failure--an autopsy case report].

    Maekawa, I; Yosida, K; Hirasawa, K; Mayumi, T; Kanda, M

    1987-03-01

    An autopsy case of smoldering adult T-cell leukemia (ATL) is presented. 67 year-old woman was admitted to our hospital with complaints of fever, cough and increasing dyspnea on October 2, 1985. Laboratory findings revealed high LDH, azothermia and slightly leukocytosis with low percentage of flower cells. CRP was strongly positive. Gas disturbance was markedly. Anti-ATLA antibody using indirect immunofluorescence method was X40 positive. Subsets of peripheral lymphocytes showed OKT 4 dominant. (OKT 3; 67.5%, OKT4; 60.6%, OKT8; 8.8%). A chest X-ray film revealed cardiomegaly and fine granular shadows in bilateral lower pulmonary fields. Diagnosis of interstitial pneumonitis was defined in transbronchial lung biopsy (TBLB) specimen. O2 therapy, steroid therapy added antibiotics were ineffective, respiratory failure and renal failure were progressive, she died by septic shock in 39th hospital days. In autopsy, no characteristic histological changes of ATL were found in lymph node, bone marrow, spleen, liver, kidney and lung. Sepsis was the cause was of death. Finally this case diagnosed smoldering ATL and pulmonary fibrosis due to bronchial ectasia with repeated pulmonary bacterial infections. The pulmonary complications of patients with ATL were discussed. PMID:2886412

  1. DNA extraction and quantification from touch and scrape preparations obtained from autopsy liver cells

    Ribeiro C.N.M.

    2004-01-01

    Full Text Available The objective of the present study was to develop a simplified low cost method for the collection and fixation of pediatric autopsy cells and to determine the quantitative and qualitative adequacy of extracted DNA. Touch and scrape preparations of pediatric liver cells were obtained from 15 cadavers at autopsy and fixed in 95% ethanol or 3:1 methanol:acetic acid. Material prepared by each fixation procedure was submitted to DNA extraction with the Wizard® genomic DNA purification kit for DNA quantification and five of the preparations were amplified by multiplex PCR (azoospermia factor genes. The amount of DNA extracted varied from 20 to 8,640 µg, with significant differences between fixation methods. Scrape preparation fixed in 95% ethanol provided larger amount of extracted DNA. However, the mean for all groups was higher than the quantity needed for PCR (50 ng or Southern blot (500 ng. There were no qualitative differences among the different material and fixatives. The same results were also obtained for glass slides stored at room temperature for 6, 12, 18 and 24 months. We conclude that touch and scrape preparations fixed in 95% ethanol are a good source of DNA and present fewer limitations than cell culture, tissue paraffin embedding or freezing that require sterile material, culture medium, laboratory equipment and trained technicians. In addition, they are more practical and less labor intensive and can be obtained and stored for a long time at low cost.

  2. Histopathological change of the metastatic bone marrow. Response for radio- and combination chemotherapy at autopsy cases

    Moriwaki, Shousuke; Mandai, Kouichi; Kataoka, Masaaki; Saeki, Hideyuki; Ohsumi, Syozo [Shikoku Cancer Center Hospital, Matsuyama (Japan)

    2002-07-01

    The purpose of this study was to determine the histopathologic therapeutic effects in metastatic bone marrow for various therapy in cancer patients. Autopsy cases at Shikoku Cancer Center Hospital, mainly cancer of breast, stomach, lung and prostate examined radiotherapy (28-60 Gy) and chemotherapy and/or endocrine chemotherapy (medroxyprogesterone acetate, tamoxifen). Histological evaluation of effects for radio-and chemotherapy have been criteria of UICC and criteria for the evaluation of the clinical and pathological effects by Japan Society for Cancer Therapy. The precise effects for various therapy is difficult to measure objectively in metastatic bone. Histopathologic changes of metastatic bone marrow for radiotherapy revealed decrease and degeneration of tumor cells - swelling, vacuoles of cytoplasm and nuclei, bizarre and giant multinucleated giant cells etc. Stromal reaction was found postnecrotic fresh and/or old granulation-fibrosis and hyalinization, woven bone formation and fatty marrow. Systemic therapy of breast cancer revealed stromal fibrosis and chondroid ossification more than other tumors and therapy. Morphological features of metastatic bone marrow at autopsy cases may be necessary from viewpoint of therapeutic effects. (author)

  3. Validation of Verbal Autopsy in Perinatal Deaths – A Prospective Study in Belgaum District, Karnataka, India

    Mubashir Angolkar

    2012-01-01

    Full Text Available Background: The first goal of National Rural Health Mission (NRHM and the fourth goal of Millennium Development are to reduce under-five mortality rate. In India, data is available for aprox. 3% of the perinatal deaths. The need for good quality data on perinatal deaths is mandatory for public health planning and resources allocation. This has lead to a renewed interest in Verbal autopsy (VA in poor resource settings. Objective: To validate a simplified community-based VA instrument. Materials and Methods: A simplified community-based VA instrument was developed. The sample size of 50 was calculated at power – 80%, significance – 5% and sensitivity – 70%. ANMs were trained to assign COD according to the ICD – 10. Following which they administered Verbal Autopsies for every perinatal death occurring in their area. A panel of 3 Physicians was formed who reviewed the VA data and assigned cause of death according to the ICD–10. Kappa Statistics was used to measure the degree of agreement between the ANM and Physician panel assigned COD. Results: Out of 50 Perinatal Deaths, the COD assigned by ANM and the COD assigned by the Physician panel were same for 40 of the perinatal deaths, which showed the agreement of 80% [Kappa Statistics = 0.838; P = 0.000 (<0.001] which indicates statistically significant agreement. There was agreement of 93% for 14 Stillbirths and 75% agreement for 36 Early Neonatal Deaths.

  4. Atherosclerosis of Coronary Arteries as Predisposing Factor in Myocardial Infarction: An Autopsy Study

    Gauravi A Dhruva,

    2012-10-01

    Full Text Available The incidence of coronary heart disease has markedly increased in India over the past few years. Ischemic heart disease, the largest cause of morbidity and mortality in the developed and developing countries today is overwhelmingly contributed by atherosclerosis. The study highlights the impact of atherosclerotic lesions in the population of Rajkot district. We studied atherosclerotic lesions in coronary arteries in cases subjected to autopsy in last 4 years, to grade and to evaluate the atheromatous plaques; and to assess the cases of myocardial infarction amongst them. The study comprises dissected specimens of heart in total 360 cases subjected for autopsy. The vessels were examined for the presence of atherosclerotic lesions which were graded according to American Heart Association and examined for evidence of myocardial infarction. The study comprises the cases in age group between 20 to 80 years. Commonest type of atherosclerosis seen was grade-4. Left Anterior Descending Coronary was most commonly involved artery. Myocardial infarction was the cause of death in 35 cases (9.72% The data obtained may form a baseline for the forthcoming studies.

  5. Pattern of Suicide: A Review of Autopsies Conducted at Moi Teaching and Referral Hospital in Eldoret Kenya

    B. N. Macharia

    2015-06-01

    Full Text Available Problem statement. Suicide is one of the ten leading causes of death in the world, accounting for more than 400,000 deaths annually. The pattern of suicide and the incidence of suicide vary from country to country. Cultural, religious and social values play some role in suicide. Currently, there is no data regarding the incidence of suicide in Kenya. Setting. Moi Teaching and Referral Hospital Mortuary. Study population. A seven-year retrospective study of all the autopsies performed at the Moi Teaching and Referral Hospital was analysed and the cases that were definitely determined as suicides were further studied. Objective. To characterize the pattern of suicide cases through autopsies conducted at MTRH mortuary between the years 2005 to 2012. Methodology. Retrospective descriptive cross-sectional study. Suicide cases were identified from the MTRH autopsy record books. From these record books, the autopsy number was used to retrieve the pathologists autopsy report. Data regarding age, gender and methods of suicide was retrieved and entered into a data collection form. Data analysis: Data collected was analysed using Stata version 10. Results. There were 213 autopsies performed. Majority were male 180(85%. The subjects had a median age of 29(IQR: 23–37 years. Organophosphate poisoning was the most preferred method followed by hanging. Organophosphate poisoning accounted for 195(91.54% and hanging for 17(7.98% of the subjects. Conclusion. The preferred methods of suicide were poisoning and hanging. The study may have missed some cases where the relatives could have declined for the postmortem procedure and hence the body released without postmortem examinations.

  6. Verbal Autopsy: Reliability and Validity Estimates for Causes of Death in the Golestan Cohort Study in Iran

    Hooman Khademi; Arash Etemadi; Farin Kamangar; Mehdi Nouraie; Ramin Shakeri; Behrooz Abaie; Akram Pourshams; Mohammad Bagheri; Afshin Hooshyar; Farhad Islami; Abnet, Christian C.; Paul Pharoah; Paul Brennan; Paolo Boffetta; Dawsey, Sanford M.

    2010-01-01

    BACKGROUND: Verbal autopsy (VA) is one method to obtain valid estimates of causes of death in the absence of valid medical records. We tested the reliability and validity of a VA questionnaire developed for a cohort study in Golestan Province in northeastern Iran. METHOD: A modified version of the WHO adult verbal autopsy was used to assess the cause of death in the first 219 Golestan Cohort Study (GCS) subjects who died. The GCS cause of death was determined by two internists who independent...

  7. Unusual Development of Pulmonary Tumor Embolism from Controlled Liver Metastases of Transitional Cell Carcinoma: An Autopsy Case.

    Kitayama, Hiromitsu; Yokota, Taro; Kondo, Tomohiro; Sugiyama, Junko; Hirayama, Michiaki; Oyamada, Yumiko; Tsuji, Yasushi

    2016-01-01

    Clinicians generally suspect pulmonary tumor embolism (PTE) with uncontrolled carcinomas which often spread to lungs. We, however, experienced an autopsy case of diffuse microscopic PTE despite controlled liver metastases of transitional cell carcinoma (TCC). A 66-year-old man with progressing respiratory symptoms showed almost normal chest findings on computed tomography. Although liver metastases were successfully shrunk by chemotherapy, the patient died from aggressive respiratory failure. An autopsy revealed small pulmonary vessels showing diffuse tumor emboli. TCC can cause PTE even if liver metastases are controlled. We must therefore be aware that PTE can manifest as respiratory symptoms without any computed tomography findings. PMID:27580549

  8. Review of Handbook of Autopsy Practice, Brenda L. Waters (Ed.). 4th edition, Humana Press (2009). ISBN: 978-1-58829-841-6

    Leth, Peter Mygind

    2010-01-01

    same period the autopsy rate in teaching hospitals has declined. A comprehensive and updated version is therefore most welcome. Part I have six completely new chapters, and contain an assortment of tools of great practical value for the forensic pathologist. There is for example a next-of-kin letter...... specialized techniques used for post-mortem investigation of the cardio-vascular system, the nervous system and eye and adnexa. Autopsy microbiology, chemistry and chromosome analysis and autopsies of bodies containing radioactive material are also among the topics that are addressed in this handbook, as well...... III provides a series of tables providing organ weights and body measurements for foetuses, children and adults. The Handbook of Autopsy Practice fulfils its purpose, and is a very worthwhile purchase for any autopsy facility....

  9. Mortality patterns in Vietnam, 2006: Findings from a national verbal autopsy survey

    Adair Timothy

    2010-03-01

    Full Text Available Abstract Background Accurate nationally representative statistics on total and cause-specific mortality in Vietnam are lacking due to incomplete capture in government reporting systems. This paper presents total and cause-specific mortality results from a national verbal autopsy survey conducted first time in Vietnam in conjunction with the annual population change survey and discusses methodological and logistical challenges associated with the implementation of a nation-wide assessment of mortality based on surveys. Verbal autopsy interviews, using the WHO standard questionnaire, were conducted with close relatives of the 6798 deaths identified in the 2007 population change survey in Vietnam. Data collectors were health staff recruited from the commune health station who undertook 3-day intensive training on VA interview. The Preston-Coale method assessed the level of completeness of mortality reporting from the population change survey. The number of deaths in each age-sex grouping is inflated according to the estimate of completeness to produce an adjusted number of deaths. Underlying causes of death were aggregated to the International Classification of Diseases Mortality Tabulation List 1. Leading causes of death were tabulated by sex for three broad age groups: 0-14 years; 15-59 years; and 60 years and above. Findings Completeness of mortality reporting was 69% for males and 54% for females with substantial regional variation. The use of VA has resulted in 10% of deaths being classified to ill-defined among males, and 15% among females. More ill-defined deaths were reported among the 60 year or above age group. Incomplete death reporting, wide geographical dispersal of deaths, extensive travel between households, and substantial variation in local responses to VA interviews challenged the implementation of a national mortality and cause of death assessment based on surveys. Conclusions Verbal autopsy can be a viable tool to identify cause

  10. Suicidal hanging: fatalities in Istanbul retrospective analysis of 761 autopsy cases.

    Uzün, Ibrahim; Büyük, Yalçin; Gürpinar, Kağan

    2007-10-01

    We retrospectively analyzed the autopsy records of the Institute of Forensic Medicine during the five-year period between 1998 and 2002 to document the characteristics of fatalities resulting from hanging which is the commonest mode of suicide in Istanbul. Upon analysis of death scene investigation and autopsy reports together with the information gathered from the police, the cases of hanging fatalities of suicidal origin were selected. Seven hundred sixty one hanging cases of suicidal origin were detected and evaluated in terms of demographic features, the type of hanging material used for ligature, cause of death, internal findings in neck organs, other traumatic findings suggesting the use of another method for suicide, toxicological findings and microscopic findings in delayed death cases. In 364 of these cases suspension was complete and in 397 incomplete. Five hundred thirty seven of those (70.56%) were male and 224 (29.44%) were female. The preponderance of male cases in our autopsy population was also detected in suicidal hanging cases. There was no case aged lower 10 and the number of the cases in the age group of cases aged over 80 was the lowest (n=3, 0.4%). In 634 of cases, the place of hanging was the subject's own house, most victims selected rope (652 cases) for the ligature with the rest using sheet, belt, cable and necktie. There were traumatic findings showing attempts of suicide other than hanging in 24 cases (tentative marks in 22 cases and non-fatal burning in 2). In 23 of cases, there were bruises of different ages. In these cases females constituted the majority suggesting violence against women that is a social problem in various cultural subgroups of our country. This violence may have played a role in the decision of suicide. Superficial bruises were detected in 56 cases and were attributed to the trauma. Fractures in neck organs were detected in 446 of cases. In fracture-determined cases, fracture in hyoid bone was seen in 177, in

  11. Post mortem magnetic resonance imaging in the fetus, infant and child: A comparative study with conventional autopsy (MaRIAS Protocol

    Thayyil Sudhin

    2011-12-01

    Full Text Available Abstract Background Minimally invasive autopsy by post mortem magnetic resonance (MR imaging has been suggested as an alternative for conventional autopsy in view of the declining consented autopsy rates. However, large prospective studies rigorously evaluating the accuracy of such an approach are lacking. We intend to compare the accuracy of a minimally invasive autopsy approach using post mortem MR imaging with that of conventional autopsy in fetuses, newborns and children for detection of the major pathological abnormalities and/or determination of the cause of death. Methods/Design We recruited 400 consecutive fetuses, newborns and children referred for conventional autopsy to one of the two participating hospitals over a three-year period. We acquired whole body post mortem MR imaging using a 1.5 T MR scanner (Avanto, Siemens Medical Solutions, Enlargen, Germany prior to autopsy. The total scan time varied between 90 to 120 minutes. Each MR image was reported by a team of four specialist radiologists (paediatric neuroradiology, paediatric cardiology, paediatric chest & abdominal imaging and musculoskeletal imaging, blinded to the autopsy data. Conventional autopsy was performed according to the guidelines set down by the Royal College of Pathologists (UK by experienced paediatric or perinatal pathologists, blinded to the MR data. The MR and autopsy data were recorded using predefined categorical variables by an independent person. Discussion Using conventional post mortem as the gold standard comparator, the MR images will be assessed for accuracy of the anatomical morphology, associated lesions, clinical usefulness of information and determination of the cause of death. The sensitivities, specificities and predictive values of post mortem MR alone and MR imaging along with other minimally invasive post mortem investigations will be presented for the final diagnosis, broad diagnostic categories and for specific diagnosis of each system

  12. Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth.

    2012-01-31

    INTRODUCTION: The number of parents agreeing to autopsy following stillbirth is declining, which has undermined clinicians\\' ability to assess causes of intrauterine death and can impact counselling regarding recurrence. Post-mortem radiological imaging is a potential alternative method of investigating perinatal loss. The aim of this study was to assess the role of multi-detector computed tomography (MDCT) in the investigation of stillbirth. STUDY DESIGN: Following ethical approval and written consent, parents were offered MDCT of the stillborn infant. MDCT was performed with 3D reconstruction, and images were analysed for image quality, anthropomorphic measurements and pathologic findings. Body part and organ-specific measurements were performed; including head, chest and abdominal circumferences, and muscle and liver mass was also measured. Findings were correlated with obstetric history, post-mortem skeletal survey (plain radiography), and formal autopsy. RESULTS: Fourteen third-trimester stillborn infants were scanned. Image quality was moderate to excellent for most body structures. CT was better than plain radiography for imaging skeletal structures and large solid organs and demonstrated a range of pathologies including renal vein thrombosis, mesenteric calcification and skeletal hyperostosis that were not seen on plain radiographs. MDCT did not overlook autopsy findings and provided some additional information. CONCLUSION: This study confirms the feasibility of MDCT in the investigation of third trimester stillbirth. MDCT image quality is acceptable and the examination can demonstrate a range of anatomic and pathologic findings. Initially, its value may be as an important adjunct to conventional autopsy.

  13. Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth

    Introduction: The number of parents agreeing to autopsy following stillbirth is declining, which has undermined clinicians’ ability to assess causes of intrauterine death and can impact counselling regarding recurrence. Post-mortem radiological imaging is a potential alternative method of investigating perinatal loss. The aim of this study was to assess the role of multi-detector computed tomography (MDCT) in the investigation of stillbirth. Study design: Following ethical approval and written consent, parents were offered MDCT of the stillborn infant. MDCT was performed with 3D reconstruction, and images were analysed for image quality, anthropomorphic measurements and pathologic findings. Body part and organ-specific measurements were performed; including head, chest and abdominal circumferences, and muscle and liver mass was also measured. Findings were correlated with obstetric history, post-mortem skeletal survey (plain radiography), and formal autopsy. Results: Fourteen third-trimester stillborn infants were scanned. Image quality was moderate to excellent for most body structures. CT was better than plain radiography for imaging skeletal structures and large solid organs and demonstrated a range of pathologies including renal vein thrombosis, mesenteric calcification and skeletal hyperostosis that were not seen on plain radiographs. MDCT did not overlook autopsy findings and provided some additional information. Conclusion: This study confirms the feasibility of MDCT in the investigation of third trimester stillbirth. MDCT image quality is acceptable and the examination can demonstrate a range of anatomic and pathologic findings. Initially, its value may be as an important adjunct to conventional autopsy.

  14. Familial idiopathic basal ganglia calcification: Histopathologic features of an autopsied patient with an SLC20A2 mutation.

    Kimura, Tadashi; Miura, Takeshi; Aoki, Kenju; Saito, Shoji; Hondo, Hiroaki; Konno, Takuya; Uchiyama, Akio; Ikeuchi, Takeshi; Takahashi, Hitoshi; Kakita, Akiyoshi

    2016-08-01

    Idiopathic basal ganglia calcification (IBGC), or Fahr's disease, is a neurological disorder characterized by widespread calcification in the brain. Recently, several causative genes have been identified, but the histopathologic features of the brain lesions and expression of the gene products remain unclear. Here, we report the clinical and autopsy features of a 62-year-old Japanese man with familial IBGC, in whom an SLC20A2 mutation was identified. The patient developed mild cognitive impairment and parkinsonism. A brain CT scan demonstrated abnormal calcification in the bilateral basal ganglia, thalami and cerebellum. An MRI study at this point revealed glioblastoma, and the patient died 6 months later. At autopsy, symmetric calcification in the basal ganglia, thalami, cerebellar white matter and deeper layers of the cerebral cortex was evident. The calcification was observed in the tunica media of small arteries, arterioles and capillaries, but not in veins. Immunohistochemistry using an antibody against type III sodium-dependent phosphate transporter 2 (PiT-2), the SLC20A2 product, demonstrated that astrocytic processes were labeled in several regions in control brains, whereas in the patient, reactivity in astrocytes was apparently weak. Immunoblotting demonstrated a marked decrease of PiT-2 in the patient. There are few autopsy reports of IBGC patients with confirmation of the genetic background. The autopsy features seem informative for better understanding the histogenesis of IBGC lesions. PMID:26635128

  15. Pathology of the heart in AIDS. A study of 60 consecutive autopsies

    Hansen, B F

    1992-01-01

    Cardiac disease and cardiac death in AIDS patients is seldom reported. In recent years minor cardiac abnormalities have been demonstrated, especially by echocardiography. Cardiac pathology in AIDS patients is here reported from 60 consecutive autopsies where the heart was investigated either using...... single samples of ventricular myocardium (the first 21 cases) or by an examination of the whole heart (the last 39 cases). Myocarditis according to the Dallas criteria was seen in 25 of 60 cases (42%), and in seven of these cases a probable pathogen (Toxoplasma gondii, cytomegalovirus, fungi) was...... heart was performed, there was dilation and/or hypertrophy of the right ventricle. This is in agreement with our knowledge that the main diseases and main causes of death in AIDS patients are pulmonary. Survival time in AIDS is increasing due to ever improving symptomatic treatment, and the results of...

  16. Glomerulocystic Kidney Disease and its rare associations: an autopsy report of two unrelated cases

    Sachdeva Man

    2007-04-01

    Full Text Available Abstract Background Glomerulocystic kidney disease is an uncommon type of cystic renal disease. It is characterized by cortical microsysts, which are represented by cystic dilatation of Bowman's spaces. Case presentation We describe a case of glomerulocystic disease in a neonate and another in an abortus associated with tracheo-oesophageal fistula and megacystic-megaureter syndrome. The kidney on autopsy was sponge-like and revealed presence of cysts corresponding to dilatations of Bowman's space microscopically. In these two cases, the Glomerulocystic Kidney Disease in one case corresponded to a sporadic form and, in the other, to a syndromic, non-heritable form of glomerulocystic kidney disease. Conclusion The associated anomalies in Glomerulocystic Kidney disease are well described in the literature. Two more new unrelated associations are described in this article.

  17. G-CSF-producing malignant pleural mesothelioma: an autopsy case report with literature review.

    Oka, Kuniyuki; Sarashina, Gen; Yonekawa, Nobuo; Watanabe, Osamu; Miyao, Yoshiko; Hashimoto, Toshio; Yatabe, Yasushi

    2012-06-01

    This study reports a 54-year-old man who was a carpenter by occupation. He suffered from left chest and back pain and left pleural effusion. Peripheral blood showed granulocytosis and high serum titers of granulocyte-colony stimulating factor (G-CSF) and CYFRA. He died 20 months later. At autopsy, a pleural tumor located around the left lung and thickening of the pericardium, diaphragm, and esophagus by tumor infiltration was seen. The tumor proliferated in papillary and solid alveolar patterns by neoplastic cells. They were positive for calretinin, D2-40, CK5/6, HBME-1, G-CSF, CK19, and E-cadherin. He was diagnosed with G-CSF-producing epithelioid malignant pleural mesothelioma. PMID:21911431

  18. Collecting duct renal cell carcinoma with the syndrome of inappropriate antidiuresis: An autopsy case report

    Emi Yasuda

    2013-01-01

    Full Text Available A 57-year-old Japanese man visited our hospital with a moist cough. Chest radiographic imaging showed a left hilar shadow. Adenocarcinoma cells were found on cytologic screening of fresh sputum. Although multiple metastases including brain were detected, no tumor was observed in the kidneys. The patient underwent whole-brain irradiation and chemotherapy for advanced-stage lung cancer. One month before his death, carcinomatous meningitis was detected. Hyponatremia, hypo-osmolality, and hypertonic urine suggested the syndrome of inappropriate antidiuresis. Restricting water intake improved the hyponatremia; however, he developed fever and hematuria. Despite systemic administration of an antibacterial drug, he died. Primary tumor in the lung was absent, but adenocarcinoma of the right kidney was evident on autopsy. Lectin histochemical analysis of the carcinoma revealed its distal nephron origin, confirming collecting duct carcinoma. Severe carcinomatous meningitis, which is possibly caused the syndrome of inappropriate antidiuresis, was observed, with no cancer involvement of the pituitary gland and hypothalamus.

  19. Sirenomelia with associated systemic anomalies: an autopsy pathologic illustration of a series of four cases.

    Chikkannaiah, Panduranga; Mahadevan, Anita; Gosavi, Manasi; Kangle, Ranjit; Anuradha; Shankar, S K

    2014-07-01

    Sirenomelia, a developmental defect involving the caudal region of the body, is associated with several internal visceral anomalies. We report a detailed spectrum of anomalies in an autopsy study of four fetuses with sirenomelia (gestational ages - 20, 21, 22.4, and 22.5 weeks). Three of the fetuses had single umbilical artery, with genitourinary and gastrointestinal anomalies. Central nervous system anomalies were evident in two of the fetuses, with alobar holoprosencephaly in one and lumbar meningomyelocele in another. The most common gastrointestinal anomaly was blind ended gut (imperforate anus), while esophageal atresia and omphalocele were noted in one case each. Renal hypoplasia was seen in two fetuses, renal agenesis in one and cystic renal dysplasia was noted in one case. Literature regarding pathogenesis of this condition is briefly discussed. PMID:24656289

  20. Fetal Alcohol Syndrome in Sudden Unexpected Death in Infancy: A Case Report in Medicolegal Autopsy.

    Tangsermkijsakul, Aphinan

    2016-03-01

    Fetal alcohol spectrum disorder is a range of birth defects associated with prenatal alcohol exposure. Fetal alcohol syndrome (FAS) is the most serious form of fetal alcohol spectrum disorder. Infants with FAS are prone to death because of various physical abnormalities. Consequently, infants with FAS may be presented in the medicolegal investigation as a form of sudden unexpected death in infancy. The author reported a 6-month-old male infant who was found dead at home. The history of maternal ethanol consumption during pregnancy was obtained. The infant was diagnosed with FAS at the autopsy because he was presented with postnatal growth retardation, multiple facial abnormalities, and abnormal brain structures, which met the criteria of FAS. The cause of death was severe aspiration pneumonia. The purposes of this case report are to show an uncommon manifestation of sudden unexpected death in infancy case for the forensic pathologists and to emphasize on the national healthcare problem. PMID:26730801

  1. [An autopsy case of pulmonary tumor thrombotic microangiopathy complicated with interstitial pneumonia and lipoid pneumonia].

    Ota, Kyoko; Matsuyama, Masashi; Kokuho, Nariaki; Masuko, Hironori; Hayashi, Hiroki; Iizuka, Takashi; Hayashibara, Kenji; Saito, Takefumi; Kawabata, Yoshinori

    2009-06-01

    A 67-year-old woman was admitted to our hospital because of progressive dyspnea, cough, bloody sputum, and backache. Chest radiography and CT scans showed bilateral diffuse interstitial shadows, bilateral pleural effusion and dilatation of the pulmonary artery. Echocardiography indicated pulmonary hypertension, and the serum tumor marker levels were elevated. We performed right cardiac catheterization, and withdrew some blood from a pulmonary artery catheter in the wedge position. We confirmed moderate pulmonary hypertension, and adenocarcinoma-like malignant cells were seen in the aspirated blood. The patient died of progressive respiratory failure despite supportive care. In addition to PTTM and lymphangiosis carcinomatosa, autopsy of the right lung revealed interstitial pneumonia and lipoid pneumonia, both of which were not reported before to be associated with PTTM. PMID:19601530

  2. Men in despair: a qualitative psychological autopsy study of suicide in northern Uganda.

    Kizza, Dorothy; Knizek, Birthe Loa; Kinyanda, Eugene; Hjelmeland, Heidi

    2012-11-01

    The psychosocial circumstances surrounding men's suicide in postconflict Central Northern Uganda were investigated using qualitative psychological autopsy interviews. Records of 17 men who died by suicide were identified through police and local leaders in Internally Displaced Peoples' camps of Amuru and Gulu Districts. Two to five significant others were interviewed around each case. Data were analyzed by interpretative phenomenological analysis (IPA). Lost dignity and social value, lack of hope for the family's future, overwhelming family responsibility, and mental illness were circumstances found to have preceded the suicides. The protracted war in the Northern region of Uganda left men in rural communities feeling disempowered and disenfranchised. This may have contributed to suicidal behavior in some of them. Suicide prevention in this area needs to be multidisciplinary with an emphasis on helping both men and women understand and deal with the many social changes that have evolved over time and affected their traditional roles and responsibilities. PMID:23075801

  3. An autopsy case of peritoneal malignant mesothelioma in a radiation technologist

    A case of peritoneal malignant mesothelioma in a radiation technologist, who had worked in this field for 34 years, is reported. Histopathologically, a biopsy specimen from the retroperitoneal tumor revealed a biphasic type of malignant mesothelioma. Electron microscopy disclosed that the tumor cells contained prominent microvilli, basal laminae adjacent to the stroma, junctional complexes, desmosomes, tonofilaments, clusters of glycogen granules, well developed rough endoplasmic reticulum (RER), confronting cisternae showing direct continuity with the RER and membrane-bound granules suggestive of secretory activity. No increased amount of asbestos was detected in autopsied lung material or the peritoneal mesothelioma. The estimated cumulative dose of occupational irradiation was calculated to be about 40 to 50 rad at most. Irradiation was discussed in relation to the etiology of the peritoneal mesothelioma. (author)

  4. Medico-legal autopsy of abandoned foetuses and newborns in India.

    Behera, C; Sikary, Asit Kumar; Krishna, Karthik; Garg, Aayushi; Chopra, Saurav; Gupta, S K

    2016-06-01

    Foeticide and the abandonment of newborns are important, albeit frequently neglected, issues. Concealment of childbirth is often seen in the setting of unwanted pregnancy which has been recognised as one of the most important factors in both cases. This study highlights the medico-legal autopsy findings of 238 abandoned foetuses and newborns over a period of 17 years (1996-2012) from the region of South Delhi, India. There was no sex predilection. The majority of the cases were full term. Nearly 35% of the foetuses were still born, about 29% were live born and the remainder were non-viable. Among the live born, death by homicide was more common than a natural death and most were left by the roadside. The abandoning and killing of newborns needs urgent attention, and strict measures are needed to save thousands of innocent lives. PMID:26857075

  5. Coroner autopsy study of homicides in Rivers State of Nigeria: 11-year review.

    Obiorah, C C; Amakiri, C N

    2014-01-01

    As most developing countries, including Nigeria, grapple with economic crisis, poor human capital development and high levels of income inequality, violent crimes - especially homicides - continue to be a cause for concern. We studied the pathology and demographic distribution of homicides in Rivers State of Nigeria expecting that the findings would be useful in formulating preventive strategies. Reports of homicide autopsies in the state for 11 years were retrospectively scrutinized for age, gender, type of weapon, site of injury, circumstances, mechanisms and causes of death. The data were analyzed using SPSS version 17. Homicides constituted 50.5% of the medicolegal autopsies. Although the overall male:female ratio was 12.4 : 1, there was variation with weapon. Deaths by firearm had the highest male:female ratio of 24.6 : 1. The mean and peak ages were 29.2 ± 11.4 and 21-30 years, respectively, while the range was 1 to 96 years. Firearms were the most common weapons, at 68.9%, hemorrhagic shock and head injuries at 61.5% and 28.2% respectively were the most common mechanisms and causes of death. Armed robbery incidents were the most common circumstances, while the head was the most common site of injury at 48.8%. The homicide rate is high in our environment and most homicides are committed during armed robberies using firearms. Improving medical care and providing emergency medical services will reduce cases of deaths from homicides, most of which occur due to manageable hemorrhagic shock. Increasing the drive towards controlling illegal arms acquisition and possession will reduce the present carnage in the state. PMID:23945261

  6. Post-mortem tissue biopsies obtained at minimally invasive autopsy: an RNA-quality analysis.

    Anita van der Linden

    Full Text Available Bereaved relatives often refuse to give consent for post-mortem investigation of deceased cancer patients, mainly because of the mutilation due to conventional autopsy (CA. Minimally invasive autopsy (MIA may be a more acceptable alternative and, if implemented in clinical practice, creates an opportunity to more often obtain post-mortem tissue samples of (recurred primary tumors and metastases for molecular research. As a measure for tissue quality for molecular studies, we hereby present a feasibility study, comparing the RNA quality of MIA and CA samples, and fresh frozen samples as reference.Tissue samples of heart, liver and kidney were prospectively collected from 24 MIAs followed by CA, and compared to corresponding archival fresh frozen tissue. After RNA isolation and RT-qPCR, RNA integrity numbers (RIN and GAPDH expression (six amplicon sizes ranging from 71 to 530 base pairs were measured. RIN values and GAPDH Cq values were analyzed and compared between all sample groups and post-mortem intervals (PMI.RIN values in MIA samples were significantly higher than those in CA samples. GAPDH was expressed significantly higher in MIA samples than in CA samples and 530 bp PCR products could be measured in all cases. GAPDH expression was significantly lower in samples with PMI >15 hours. As expected, the samples of the fresh frozen reference standard performed best in all analyses.MIA samples showed better RNA quality than CA samples, probably due to shorter PMI. Both had lower RNA quality and expression levels than fresh frozen tissue, however, remaining GAPDH RNA was still sufficiently intact. Therefore, other highly expressed genes are most likely also detectable. Gene array analysis should be performed to gain insight into the quality of entire post-mortem genomes. Reducing PMI will further improve the feasibility of demanding molecular research on post-mortem tissues, this is most likely more feasible with MIA than CA.

  7. Sudden Cardiac Death in Brazil: A Community-Based Autopsy Series (2006-2010

    Maria Fernanda Braggion-Santos

    2015-02-01

    Full Text Available Background: Sudden cardiac death (SCD is a sudden unexpected event, from a cardiac cause, that occurs in less than one hour after the symptoms onset, in a person without any previous condition that would seem fatal or who was seen without any symptoms 24 hours before found dead. Although it is a relatively frequent event, there are only few reliable data in underdeveloped countries. Objective: We aimed to describe the features of SCD in Ribeirão Preto, Brazil (600,000 residents according to Coroners’ Office autopsy reports. Methods: We retrospectively reviewed 4501 autopsy reports between 2006 and 2010, to identify cases of SCD. Specific cause of death as well as demographic information, date, location and time of the event, comorbidities and whether cardiopulmonary resuscitation (CPR was attempted were collected. Results: We identified 899 cases of SCD (20%; the rate was 30/100000 residents per year. The vast majority of cases of SCD involved a coronary artery disease (CAD (64% and occurred in men (67%, between the 6th and the 7th decades of life. Most events occurred during the morning in the home setting (53.3% and CPR was attempted in almost half of victims (49.7%. The most prevalent comorbidity was systemic hypertension (57.3%. Chagas’ disease was present in 49 cases (5.5%. Conclusion: The majority of victims of SCD were men, in their sixties and seventies and the main cause of death was CAD. Chagas’ disease, an important public health problem in Latin America, was found in about 5.5% of the cases.

  8. Pulmonary tumor thrombotic microangiopathy induced by gastric carcinoma: Morphometric and immunohistochemical analysis of six autopsy cases

    Shinozaki Minoru

    2011-03-01

    Full Text Available Abstract Background Pulmonary tumor thrombotic microangiopathy (PTTM has been known as a rare and serious cancer-related pulmonary complication. However, the pathogenesis and pathophysiology of this debilitating condition still remains obscure and no effective management was recommended. The present study aims to elucidate the pathophysiology of PTTM. Methods Autopsy records were searched to extract cases of pulmonary tumor embolism induced by metastasis of gastric carcinoma in the Toho University Omori Medical Center from 2000 to 2006. And then, tissue sections of extracted cases were prepared for not only light microscopic observation but morphometric analysis with the use of selected PTTM cases. Results Six autopsies involved PTTM and clinicopathological data of them were summarized. There was a significant negative association between pulmonary arterial diameter and stenosis rate in four cases. Although all cases showed an increase of stenosis rate to some degree, the degree of stenosis rate varied from case to case. Significant differences were found for average stenosis rate between the under 100 micrometer group or the 100 to 300 micrometer group and the 300 micrometer group in four cases. However, no significant differences were found for average stenosis rate between the under 100 micrometer group and the 100 to 300 micrometer group in all cases. Meanwhile, all cases showed positive reactivity for tissue factor (TF, five showed positive reactivity for vascular endothelial growth factor (VEGF, and three showed positive reactivity for osteopontin (OPN. Conclusions In the present study, we revealed that the degree of luminal narrowing of the pulmonary arteries varied from case to case, and our results suggested that pulmonary hypertension in PTTM occurs in selected cases which have a widespread pulmonary lesion with severe luminal narrowing in the smaller arteries. Furthermore, our immunohistochemical examination indicated that gastric

  9. A comparative analysis of coronary adventitial T-lymphocytes - an autopsy study

    Background: Recent clinical and histopathologic data suggests that inflammation plays a key role in coronary artery plaque instability and subsequent occlusive thrombosis. The intima has received much attention as a site of inflammation, while the adventitia has remained relatively unexplored. The aim of the present study was to investigate the frequency of inflammatory activity in the cap and shoulder region of un ruptured, atherosclerotic lesions in coronary arteries and to correlate these findings with distribution of inflammatory cells in adventitia. Methods: The study was carried out in Histopathology Department, Army Medical College, Rawalpindi and National University of Sciences and Technology (NUST), from August 2008 to July 2009. Sixty-seven autopsy cases performed at Military Hospital Rawalpindi, Pakistan were selected. The cases were divided into study group and control group. Case group (n=35) included those where cause of death was ischemic heart disease. Those coronary arteries were taken as control (n=32) where atherosclerotic changes were found by chance (death without history of ischemic heart disease). Plaques in each group were assessed by light microscopy and by immunohistochemistry. Results: The ages of the deceased ranged from 38 to 49 years. Within study group, adventitial lymphocytes exhibited strong correlation with erosion, thrombus formation in culprit plaque (p=0.001). No correlation was found between adventitial T-lymphocytes and erosion of plaque (p=0.700) in control group. In 72% of culprit plaques moderate staining for T-lymphocytes was observed in adventitia as well as intima. In control group, most of the cases contained scattered cells. Few cases of stable plaques revealed lymphocytes as clusters, both in adventitia and in intima. Conclusion: Adventitial inflammation may play a pivotal role for atherosclerotic lesion histology and atheroma instability. With the help of these autopsy findings, we hope to be able to reduce the

  10. Mobile education in autopsy conferences of pathology: presentation of complex cases

    Kayser Klaus

    2006-11-01

    Full Text Available Abstract Background MeduMobile was a project to develop and evaluate learning scenarios for medical students and teachers by use of video communication and notebooks. Its core part was assigned to various medical routines, conferences or meetings such as doctor-patient bedside conversation. These were filmed by video teams and broadcasted live via the WLAN of the Charité campus to course participating students. One type of the learning arrangements was the autopsy conference as an on-call scenario. Materials and methods The MeduMobile project consisted of two main compartments: the regular seminar event which took place every week or month, and the on-call event. For an on-call event the students were informed two hours before the lesson's start. A mobile video team organised the video conference via a specific MeduMobile seminar system. This software offered the students to log. The MeduMobile seminar system is based on the Windows operating system and realises an extended video communication via WLAN. Thirteen access points were implemented at the Charité Campus Virchow Klinikum and Campus Mitte. A questionnaire was developed to investigate in the response and learning effect of the mobile seminar system. Results During the MeduMobile project 42 video conferences with (cumulative 145 participating students took place. Four autopsy conferences could be organised as on-call scenarios within this project. A prospective, not randomised follow-up study was included 25 students of the 1st – 6th clinical semester. According to the answers, professional reasoning, professional performance, sustainability, and the complexity were broadly accepted by the students. Discussion In principle, the MeduMobile realised an interdisciplinary case presentation using video conference and web page. The evaluation indicates a high acception of such complex case presentation with multidisciplinary settings. The use of the notebooks in mobile learning enables an

  11. Effects on the estimated cause-specific mortality fraction of providing physician reviewers with different formats of verbal autopsy data

    Chow Clara

    2011-08-01

    Full Text Available Abstract Background The process of data collection and the methods used to assign the cause of death vary significantly among different verbal autopsy protocols, but there are few data to describe the consequences of the choices made. The aim of this study was to objectively define the impact of the format of data presented to physician reviewers on the cause-specific mortality fractions defined by a verbal autopsy-based mortality-surveillance system. Methods Verbal autopsies were done by primary health care workers for all deaths between October 2006 and September 2007 in a community in rural Andhra Pradesh, India (total population about 180,162. Each questionnaire had a structured section, composed of a series of check boxes, and a free-text section, in which a narrative description of the events leading to death was recorded. For each death, a physician coder was presented first with one section and then the other in random order with a 20- to 40-day interval between. A cause of death was recorded for each data format at the level of ICD 10 chapter headings or else the death was documented as unclassified. After another 20- to 40-day interval, both the structured and free-text sections of the questionnaire were presented together and an index cause of death was assigned. Results In all, 1,407 verbal autopsies were available for analysis, representing 94% of all deaths recorded in the population that year. An index cause of death was assigned using the combined data for 1,190 with the other 217 remaining unclassified. The observed cause-specific mortality fractions were the same regardless of whether the structured, free-text or combined data sources were used. At the individual level, the assignments made using the structured format matched the index in 1,012 (72% of cases with a kappa statistic of 0.66. For the free-text format, the corresponding figures were 989 (70% and 0.64. Conclusions The format of the verbal autopsy data used to assign

  12. Medico-legal autopsies as a source of information to improve patient safety.

    Madea, Burkhard

    2009-04-01

    Clear data on the epidemiology of medical malpractice are missing, at least for Germany. Especially data on the frequency of malpractice claims in penal and civil law are not available. However, from epidemiological and healthcare research some data on the frequency of adverse events (AE), preventable adverse events (PAE) and negligent adverse events (NAE) are available. According to a review of the German Alliance of Patient Safety adverse events can be expected in 5-10%, preventable adverse events in 2-4%, negligent adverse events in about 1% and lethal outcome in about 0.1% of hospitalized patients. However, these data are not compatible with figures from civil and penal law and there seems to be a great "litigation gap". Data on malpractice cases are available from the files of the arbitration committees on medical malpractice, files of liability insurance companies and files of the institutes of forensic medicine. However, these files are not complete and data sources may have some interferences. The arbitration committees are, however, mainly dealing with living patients. Lethal cases are a special subgroup and the best available data source are the files of the institutes of forensic medicine. This subgroup is of special importance since death is the most severe outcome of medical malpractice and the reproach to have caused the death of a patient by medical negligence is the most severe malpractice claim. From a retrospective multicentre study on autopsies performed in cases of medical malpractice claims (altogether 101.358 autopsies, 4450 due to medical malpractice claims) the most important data will be presented (disciplines concerned, cause of accusation, classification of accusation, causes of preliminary proceedings, occupational group and number of approved medical malpractice, outcome of medical malpractice proceedings). However, these data are not only of a descriptive value but have utmost importance also for risk analysis and to increase patient

  13. Immunohistochemistry panel segregates molecular types of hepatocellular carcinoma in Brazilian autopsy cases

    Felipe-Silva, Aloísio; Wakamatsu, Alda; dos Santos Cirqueira, Cinthya; Alves, Venâncio Avancini Ferreira

    2016-01-01

    AIM: To assess the distribution of proteins coded by genes reported as relevant for the molecular classification of hepatocellular carcinoma (HCC). METHODS: In this retrospective cross-sectional study, the following clinicopathological data were analyzed in 80 autopsied HCC patients: sex, age, ethnicity, alcohol intake, infection with hepatitis B and/or C virus, infection with human immunodeficiency virus, prior treatment, basic and immediate causes of death, liver weight, presence of cirrhosis, number and size of nodules, gross pattern, histological grade and variants, architectural pattern, invasion of large veins, and presence and location of extrahepatic metastases. The protein products of genes known to be involved in molecular pathogenesis of HCC, including epidermal growth factor receptor (EGFR), MET, keratin 19 (K19), vimentin, beta-catenin, mechanistic target of rapamycin (mTOR), extracellular signaling-related kinase (ERK)1, ERK2, Ki67, cyclin D1, caspase 3 and p53, were detected by immunohistochemistry on tissue microarrays. The expression levels were scored and statistically assessed for correlation with HCC parameters. RESULTS: Infection with hepatitis C virus was identified in 49% of the 80 autopsy patients, cirrhosis in 90%, advanced tumors in 95%, and extrahepatic metastases in 38%. Expression of K19, p53 and ERK1 correlated to high-grade lesions. Expression of ERK1, nuclear beta-catenin, cyclin D1 and ERK2 correlated to higher rates of cell proliferation as determined by Ki67. Expression of MET, EGFR (> 0) and caspase 3 correlated with lower histological grades. Expression of EGFR correlated to that of caspase 3, and overexpression of EGFR (≥ 200/300) was observed in low-grade tumors more frequently (grades 1 and 2: 67% vs grade 3: 27% and grade 4: 30%). Expression of ERK1 was associated with that of K19 and vimentin, whereas expression of ERK2 was associated with that of cyclin D1, MET and membrane beta-catenin. Expression of vimentin was

  14. Racking the brain: Detection of cerebral edema on postmortem computed tomography compared with forensic autopsy

    Graphical abstract: -- Highlights: •Postmortem swelling of the brain is a typical finding on PMCT and occurs concomitant with potential antemortem or agonal brain edema. •Cerebral edema despite normal postmortem swelling is indicated by narrowed temporal horns and symmetrical herniation of the cerebral tonsils on PMCT. •Cases with intoxication or asphyxia demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units) and a ratio >1.58 between the gray and white matter. •The Hounsfield measurements of the white and gray matter help to determine the cause of death in cases of intoxication or asphyxia. -- Abstract: Purpose: The purpose of this study was to compare postmortem computed tomography with forensic autopsy regarding their diagnostic reliability of differentiating between pre-existing cerebral edema and physiological postmortem brain swelling. Materials and methods: The study collective included a total of 109 cases (n = 109/200, 83 male, 26 female, mean age: 53.2 years) and were retrospectively evaluated for the following parameters (as related to the distinct age groups and causes of death): tonsillar herniation, the width of the outer and inner cerebrospinal fluid spaces and the radiodensity measurements (in Hounsfield Units) of the gray and white matter. The results were compared with the findings of subsequent autopsies as the gold standard for diagnosing cerebral edema. p-Values <0.05 were considered statistically significant. Results: Cerebellar edema (despite normal postmortem swelling) can be reliably assessed using postmortem computed tomography and is indicated by narrowed temporal horns and symmetrical herniation of the cerebellar tonsils (p < 0.001). There was a significant difference (p < 0.001) between intoxication (or asphyxia) and all other causes of death; the former causes demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units), and the gray to

  15. Assessing the quality of evidence for verbal autopsy diagnosis of stroke in Vietnam

    Sachin Gupta

    2012-01-01

    Full Text Available Background: Information on the leading causes of mortality will continue to rely on verbal autopsy (VA in developing countries. The accuracy of VA methods in correctly ascertaining the cause for each individual death is crucial in order to have confidence in the data collected through the procedure. Accuracy of the VA procedure is generally established by carrying out validation studies involving a comparison of the underlying cause of death derived from the VA with a reference underlying cause from medical records. Such validation is only possible in cases for which clinical records are available, and this is clearly not the case for most deaths in developing countries. We attempt to verify the accuracy of VA evidence by reviewing the responses to specific symptom questions and other information recorded in verbal autopsy questionnaires that were assigned cerebrovascular conditions (stroke as causes of death upon physician review in Vietnam. Materials and Methods: A national sample mortality surveillance activity identified deaths and causes of death that had occurred during 2008 in selected communes in 16 provinces distributed across Vietnam. All cases from the northern provinces of Hanoi, Hai Duong, Quang Ninh and Thanh Hoa with ICD codes pertaining to cerebrovascular diseases were identified. A total of 326 VA questionnaires for deaths from cerebrovascular diseases were reviewed and analysed in detail for the presence of symptoms pertaining to stroke. The respondents′ narration of the chronological disease history and the hospital diagnosis was also examined with an aim to explore supporting signs for diagnosis and to verify the quality of VA interview. Differences between responses among cases with and without hospital admission were examined using Chi-squared test of statistical significance. Results: Ninty percent of the cases diagnosed as stroke were found to have positive response to the key symptoms; viz., paralysis (in structured

  16. Racking the brain: Detection of cerebral edema on postmortem computed tomography compared with forensic autopsy

    Berger, Nicole [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Ampanozi, Garyfalia; Schweitzer, Wolf; Ross, Steffen G.; Gascho, Dominic [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Ruder, Thomas D. [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital of Bern, Freiburgstrasse, 3010 Bern (Switzerland); Thali, Michael J. [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Flach, Patricia M., E-mail: patricia.flach@irm.uzh.ch [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2015-04-15

    Graphical abstract: -- Highlights: •Postmortem swelling of the brain is a typical finding on PMCT and occurs concomitant with potential antemortem or agonal brain edema. •Cerebral edema despite normal postmortem swelling is indicated by narrowed temporal horns and symmetrical herniation of the cerebral tonsils on PMCT. •Cases with intoxication or asphyxia demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units) and a ratio >1.58 between the gray and white matter. •The Hounsfield measurements of the white and gray matter help to determine the cause of death in cases of intoxication or asphyxia. -- Abstract: Purpose: The purpose of this study was to compare postmortem computed tomography with forensic autopsy regarding their diagnostic reliability of differentiating between pre-existing cerebral edema and physiological postmortem brain swelling. Materials and methods: The study collective included a total of 109 cases (n = 109/200, 83 male, 26 female, mean age: 53.2 years) and were retrospectively evaluated for the following parameters (as related to the distinct age groups and causes of death): tonsillar herniation, the width of the outer and inner cerebrospinal fluid spaces and the radiodensity measurements (in Hounsfield Units) of the gray and white matter. The results were compared with the findings of subsequent autopsies as the gold standard for diagnosing cerebral edema. p-Values <0.05 were considered statistically significant. Results: Cerebellar edema (despite normal postmortem swelling) can be reliably assessed using postmortem computed tomography and is indicated by narrowed temporal horns and symmetrical herniation of the cerebellar tonsils (p < 0.001). There was a significant difference (p < 0.001) between intoxication (or asphyxia) and all other causes of death; the former causes demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units), and the gray to

  17. Autopsy features relevant for discrimination between suicidal and homicidal gunshot injuries.

    Karger, B; Billeb, E; Koops, E; Brinkmann, B

    2002-10-01

    A total of 624 consecutive gunshot autopsies from the Institutes of Legal Medicine in Münster and Hamburg was investigated retrospectively. In a subsample of 284 suicides and 293 homicides (n=577), a large variety of features such as firearm, ammunition, number and site of entrance wounds, shooting distance and direction of the internal bullet path were recorded and binary logistic regression analysis performed in the case of bullet paths. Females constituted 26.3% of the homicide victims and 10.6% of the suicides. Short-barrelled firearms outnumbered long arms in homicides by 6:1 and in suicides by 2:1. More than 1 gunshot injury was found in 5.6% of the suicides (maximum 5 gunshots) and in 53.9% of the homicides (maximum 23 gunshots). The suicidal gunshots were fired from contact or near contact range in 89% while this was the case in only 7.5% of the homicides. The typical entrance wound sites in suicides were the temple (36%), mouth (20%), forehead (11%) and left chest (15%) but uncommon entrance wound sites such as the eye, ear, and back of the neck and head were also encountered. In suicidal gunshots to the right temple (n=107), only 6% of the bullet paths were directed downwards and only 4% were directed from back-to-front. In gunshots to the left chest (n=130), bullet paths running right-to-left or parallel occurred frequently in suicides (75%) and infrequently in homicide victims (19%). From 61 suicides who fired the gun inside their mouth, only 1 pointed the gun downwards. Consequently, some bullet path directions cannot be considered indicative of suicide: downwards and back-to-front in gunshots to the temple, left-to-right in gunshots to the left chest and downwards in mouth shots. The isolated autopsy findings can only be indicative of suicide or homicide but the combined analysis of several findings can be associated with a high probability. PMID:12376836

  18. [On the value of tattoos for identifying unknown bodies - a retrospective study of forensic autopsy cases from Giessen, Germany].

    Birngruber, Christoph G; Görner, Nicole; Ramsthaler, H Frank

    2016-01-01

    The number of tattooed people in Germany has constantly grown over the past few years. The present study deals with the question if this social trend can be seen in foren- sic autopsy cases as well. In a retrospective study, forensic autopsy cases of two periods (1990-1994 and 2010-2014) have been reviewed and statistically analyzed. Comparison of the two periods revealed a significant increase in tattooed individuals, especially in the female subgroup. Between 2010 and 2014, 14.2 % of the deceased showed tattoos. There are significant differences in the frequency and localization of tattoos dependent on age and sex. About 50 % of the tattooed deceased showed tattoos on body sites that are visible for other persons in everyday life. The resulting value of tattoos for the purpose of identifying unknown bodies is discussed and illustrated. PMID:26934763

  19. Assessment of a Sudden Death Case due to Coronary Artery Disease Based on the PMCT and Forensic Autopsy

    WAN Lei; ZHANG Jian-hua; HUANG Ping; YING Chong-liang; LIU Ning-guo; ZHU Guang-you

    2012-01-01

    It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography (PMCT).This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification (CAC) was clearly displayed using PMCT scan.The entire coronary artery system was almost reconstructed via multiplanar reformation (MPR) and volume-rendering reconstruction (VR),and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software.The results showed that CAC was conspicuous; the total calcium score was 640.3,considerably higher than 400.The pulmonary ground-glass opacity (GGO) and small amount of fluid both in the subglottic trachea and main bronchi were also found.The imaging results confirmed those of autopsy.In addition,the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure.

  20. Relation of radiation to gastric carcinoma observed in autopsy cases in the life span study sample, Hiroshima and Nagasaki, 1961-74

    A study was made of the relation to atomic bomb radiation of 535 cases of gastric carcinoma among 4,694 deaths occurring in a fixed population of Hiroshima and Nagasaki who were autopsied between 1961 and 1974. The proportion of all autopsies with gastric carcinoma as autopsy diagnosis tended to be high in the high dose group, but it could not be concluded with the present amount of information that there is a relation between gastric carcinoma and radiation in this autopsy study. Although no specific distribution of the histological types of gastric carcinoma was noted by radiation dose, the data indicated increases in the degree of extension of tumor cells in the gastric wall and the degree of metastasis to the lymph nodes seemed to be high in the high dose group. (author)

  1. Factors associated with delay in care–seeking for fatal neonatal illness in the Sylhet district of Bangladesh: results from a verbal and social autopsy study

    Bareng AS Nonyane 1,2

    2016-06-01

    Full Text Available We conducted a social and verbal autopsy study to determine cultural–, social– and health system–related factors that were associated with the delay in formal care seeking in Sylhet district, Bangladesh.

  2. Distribution of α-synuclein in the spinal cord and dorsal root ganglia in an autopsy cohort of elderly persons

    Sumikura, Hiroyuki; Takao, Masaki; Hatsuta, Hiroyuki; Ito, Shinji; Nakano, Yuta; Uchino, Akiko; Nogami, Akane; Saito, Yuko; Mochizuki, Hideki; Murayama, Shigeo

    2015-01-01

    Background Lewy body–related α-synucleinopathy (LBAS, the abnormal accumulation of pathologic α-synuclein) is found in the central and peripheral nervous systems, including the spinal cord, dorsal root ganglia, and sympathetic ganglia, of Parkinson’s disease patients. However, few studies have focused on the distribution of LBAS in the spinal cord, primary sensory neurons, and preganglionic sympathetic nerves. Results We analyzed 265 consecutive subjects with LBAS who underwent autopsy at a g...

  3. Strategies for searching medical natural language text. Distribution of words in the anatomic diagnoses of 7000 autopsy subjects.

    Moore, G. W.; Hutchins, G M; Miller, R. E.

    1984-01-01

    Computerized indexing and retrieval of medical records is increasingly important; but the use of natural language versus coded languages (SNOP, SNOMED) for this purpose remains controversial. In an effort to develop search strategies for natural language text, the authors examined the anatomic diagnosis reports by computer for 7000 consecutive autopsy subjects spanning a 13-year period at The Johns Hopkins Hospital. There were 923,657 words, 11,642 of them distinct. The authors observed an av...

  4. A comparative study of cranial, blunt trauma fractures as seen at medicolegal autopsy and by Computed Tomography

    Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechanical trauma analysis by Finite Element Analysis. If CT scan data are to be used for creating individual head models for retrograde trauma analysis in the future we need to ascertain how well cranial fractures are captured by CT scan. The purpose of this study was to compare the diagnostic agreement between CT and autopsy regarding cranial fractures and especially the precision with which cranial fractures are recorded. The autopsy fracture diagnosis was compared to the diagnosis of two CT readings (reconstructed with Multiplanar and Maximum Intensity Projection reconstructions) by registering the fractures on schematic drawings. The extent of the fractures was quantified by merging 3-dimensional datasets from both the autopsy as input by 3D digitizer tracing and CT scan. The results showed a good diagnostic agreement regarding fractures localised in the posterior fossa, while the fracture diagnosis in the medial and anterior fossa was difficult at the first CT scan reading. The fracture diagnosis improved during the second CT scan reading. Thus using two different CT reconstructions improved diagnosis in the medial fossa and at the impact points in the cranial vault. However, fracture diagnosis in the anterior and medial fossa and of hairline fractures in general still remained difficult. The study showed that the forensically important fracture systems to a large extent were diagnosed on CT images using Multiplanar and Maximum Intensity Projection reconstructions. Difficulties remained in the minute diagnosis of hairline fractures. These inconsistencies need to be resolved in order to use CT scan data of victims for individual head modelling and trauma analysis

  5. A comparative study of cranial, blunt trauma fractures as seen at medicolegal autopsy and by computed tomography

    Jacobsen, Christina; Bech, Birthe H; Lynnerup, Niels

    2009-01-01

    BACKGROUND: Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechani...... reconstructions. Difficulties remained in the minute diagnosis of hairline fractures. These inconsistencies need to be resolved in order to use CT scan data of victims for individual head modelling and trauma analysis....

  6. A psychological autopsy study of suicide among Inuit in Nunavut: methodological and ethical considerations, feasibility and acceptability

    Chachamovich, Eduardo; Haggarty, Jack; Cargo, Margaret; Hicks, Jack; Kirmayer, Laurence J.; Turecki, Gustavo

    2013-01-01

    Introduction: The increasing global prevalence of suicide has made it a major public health concern. Research designed to retrospectively study suicide cases is now being conducted in populations around the world. This field of research is especially crucial in Aboriginal populations, as they often have higher suicide rates than the rest of the country. Objective: This paper presents the methodological aspects of the first psychological autopsy study on suicide among Inuit in Nunavut. Qaujiva...

  7. Causes of death in diarrhoeal diseases after rehydration therapy: an autopsy study of 140 patients in Bangladesh

    T. Butler; Islam, M; Azad, A K; M. R. Islam; Speelman, P

    1987-01-01

    The cause of death (besides dehydration) for 140 diarrhoeal patients who died in hospital following rehydration was determined by autopsy examination. Children under 5 years comprised 74% of the patients. Diarrhoeal pathogens were identified as Shigella spp. in 27%, enterotoxigenic Escherichia coli in 17%, Entamoeba histolytica in 16%, Campylobacter jejuni in 12%, Salmonella spp. in 4%, Vibrio cholerae in 4%, and Giardia lambliain 4% of cases. The most frequent underlying causes of death were...

  8. Pattern of Suicide: A Review of Autopsies Conducted at Moi Teaching and Referral Hospital in Eldoret Kenya

    B. N. Macharia; Iddah, M. A.; F. M. Ndiangui; Keter, A.

    2015-01-01

    Problem statement. Suicide is one of the ten leading causes of death in the world, accounting for more than 400,000 deaths annually. The pattern of suicide and the incidence of suicide vary from country to country. Cultural, religious and social values play some role in suicide. Currently, there is no data regarding the incidence of suicide in Kenya. Setting. Moi Teaching and Referral Hospital Mortuary. Study population. A seven-year retrospective study of all the autopsies performed at the M...

  9. Autopsy findings of the first and second filial generations of atomic bomb survivors

    Autopsy findings of 652 fetuses whose parents or one parent were exposed to the Atomic Bomb (F1) and 115 fetuses which had one or two grandparents exposed (F2) were compared with that of 8570 fetuses whose parents were not exposed (control). The F1 fetuses have been collected since 1963 and F2 fetuses since 1971 voluntarily in Hiroshima. The findings were classified according to the types of delivery and to the distances away from the hypocenter where the parents and grandparents were exposed. Many normal cases in the group of artificial abortions and many malformations and pathological findings in the group of spontaneous abortions were found in both groups of F1 and F2. The malformations were cardiovascular, central nervous and urogenital system, quantitatively in that order, in both groups of F1 and F2. Although there were a few cases of cystic kidney and chondrodystrophy which belong to autosomal dominant and osteogenesis imperfecta which belong to autosomal recessive, these cases were not correlated with the distance. Most cases of malformation which belong to the multifactorial inheritance were found in each organ. No peculiar malformation was found in the groups of F1 and F2. (author)

  10. Autopsy features in a newborn baby affected by a central congenital diaphragmatic hernia.

    Bolino, Giorgio; Gitto, Lorenzo; Serinelli, Serenella; Maiese, Aniello

    2015-03-01

    Congenital diaphragmatic hernia is a congenital malformation of the diaphragm, resulting in the herniation of the abdominal organs into the thoracic cavity. The most common types of congenital diaphragmatic hernia are Bochdalek hernia (postero-lateral hernia), Morgagni hernia (anterior defect), and diaphragm eventration (abnormal displacement of part or all of an otherwise intact diaphragm into the chest cavity). Congenital diaphragmatic hernia is a life-threatening pathology in infants, and a major cause of death due to pulmonary hypoplasia and pulmonary hypertension. We present a fatal case of congenital diaphragmatic hernia in a newborn. At the autopsy, a central defect of the diaphragm was found, 8 × 5 cm in size, that led to a herniation of the small intestine, the right lobe of the liver, and the right adrenal gland into the thorax. An esophageal atresia was associated with the congenital diaphragmatic hernia. The lungs showed severe hypoplasia and atelectasia. Physicians should pay attention to a prenatal diagnosis of congenital diaphragmatic hernia in order to prevent newborn fatalities. PMID:25573226

  11. Pathological and radiological correlation in an autopsy case of combined pulmonary fibrosis and emphysema

    Karata H

    2015-07-01

    Full Text Available Hiroki Karata,1 Tomonori Tanaka,1 Ryoko Egashira,2 Kazuhiro Tabata,1 Kyoko Otani,3 Ryuji Hayashi,4 Takashi Hori,5 Junya Fukuoka1 1Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; 2Department of Radiology, Faculty of Medicine, Saga University, Saga, Japan; 3Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan; 4Department of Internal Medicine, University of Toyama, Faculty of Medicine, Toyama, Japan; 5Laboratory of Pathology, Toyama University Hospital, Toyama, Japan Abstract: We report an educational autopsy case of combined pulmonary fibrosis and emphysema. Radiological patterns of the upper lung were considered as mostly emphysema, but pathological observation revealed significant interstitial fibrosis of usual interstitial pneumonia as a major pathology. The patient eventually developed acute exacerbation of background interstitial pneumonia. Careful radiological and pathological correlation of the current case indicates that regions with distal acinar emphysema on computed tomography image may possess histologically marked dense fibrosis of lethal interstitial pneumonia. Keywords: interstitial pneumonia, CPFE, AEF, smoking, CT

  12. Measurement of asbestos bodies in lung tissue of autopsy cases diagnosed with primary lung cancer

    To investigate the relation between asbestos-related lung cancer and the concentration of asbestos bodies in lung tissue, we analyzed the concentration in 24 autopsy cases diagnosed with primary lung cancer, with regard to the gender, age, histological type of lung cancer and occupation of each case. The asbestos bodies were measured according to Kohyama's method. Positive cases (more than 5,000 bodies per 1 g of dry lung tissue) were further analyzed for asbestosis and pleural plaques by chest X-ray and chest CT. Two cases exhibited more than 5,000 bodies, five cases between 1,000 and 5,000, and seventeen cases less than 1,000. The occupation of the two positive cases was not informative: one demonstrated neither asbestosis nor pleural plaques, and the other showed only pleural plaques. Although the number of cases of asbestos-related lung cancer is minimal among all lung cancer cases, the number of the former may exceed that of mesothelioma patients. Not only physicians but also radiologists, surgeons and pathologists need to collaborate in the diagnosis of asbestos-related lung cancer. (author)

  13. Cardiac Tropism of Borrelia burgdorferi: An Autopsy Study of Sudden Cardiac Death Associated with Lyme Carditis.

    Muehlenbachs, Atis; Bollweg, Brigid C; Schulz, Thadeus J; Forrester, Joseph D; DeLeon Carnes, Marlene; Molins, Claudia; Ray, Gregory S; Cummings, Peter M; Ritter, Jana M; Blau, Dianna M; Andrew, Thomas A; Prial, Margaret; Ng, Dianna L; Prahlow, Joseph A; Sanders, Jeanine H; Shieh, Wun Ju; Paddock, Christopher D; Schriefer, Martin E; Mead, Paul; Zaki, Sherif R

    2016-05-01

    Fatal Lyme carditis caused by the spirochete Borrelia burgdorferi rarely is identified. Here, we describe the pathologic, immunohistochemical, and molecular findings of five case patients. These sudden cardiac deaths associated with Lyme carditis occurred from late summer to fall, ages ranged from young adult to late 40s, and four patients were men. Autopsy tissue samples were evaluated by light microscopy, Warthin-Starry stain, immunohistochemistry, and PCR for B. burgdorferi, and immunohistochemistry for complement components C4d and C9, CD3, CD79a, and decorin. Post-mortem blood was tested by serology. Interstitial lymphocytic pancarditis in a relatively characteristic road map distribution was present in all cases. Cardiomyocyte necrosis was minimal, T cells outnumbered B cells, plasma cells were prominent, and mild fibrosis was present. Spirochetes in the cardiac interstitium associated with collagen fibers and co-localized with decorin. Rare spirochetes were seen in the leptomeninges of two cases by immunohistochemistry. Spirochetes were not seen in other organs examined, and joint tissue was not available for evaluation. Although rare, sudden cardiac death caused by Lyme disease might be an under-recognized entity and is characterized by pancarditis and marked tropism of spirochetes for cardiac tissues. PMID:26968341

  14. Statistical analysis of a LASL study of plutonium in US autopsy tissue

    The Autopsy Tissue Program was begun in 1960. To date, tissues on 900 or more persons in 7 geographic regions have been collected and analyzed for plutonium content. The tissues generally consist of lung, liver, kidney, lymph, bone, and gonadal tissues for each individual. The original objective of the program was to determine the level of plutonium in human tissues due solely to fallout from weapons testing. The baseline thus established was to be used to evaluate future changes. From the first, this program was beset with chemical and statistical difficulties. Many factors whose effects were not recognized and not planned for were found later to be important. Privacy and ethical considerations hindered the gathering of adequate data. Since the chemists were looking for amounts of plutonium very close to background, possible contamination was a very real problem. Widely used chemical techniques introduced a host of statistical problems. The difficulties encountered touch on areas common to large data sets, unusual outlier detection methods minimum detection limits, problems with aliquot sizes, and time-trends in the data. The conclusions point out areas to which the biologists will have to devote much more careful attention than was believed

  15. Non specific drug distribution in an autopsy case report of fatal caffeine intoxication.

    Ishikawa, Takaki; Yuasa, Isao; Endoh, Minoru

    2015-11-01

    Caffeine has long been recognized as an addictive substance that causes autonomic nerve effect, and is known to increase catecholamine secretion from the adrenal glands. In recent years, the risk of ingesting toxic levels of caffeine has increased because of the easy availability of analgesics, CNS (Central Nervous System) stimulant medicine and dietary supplements at shops, health stores and through online purchases. We report the death of a young female resulting from the ingestion for suicide of an online purchased sleepiness-preventing medicine containing caffeine. The autopsy findings included pulmonary edema and congestion plus cutaneous emphysema. The stomach contents included a dark-brown viscous fluid without tablet or food residue. Toxicological examination revealed the presence of caffeine in the right heart blood (154.2 μg/mL) and stomach contents (197.5 μg/mL) (lethal blood level, >80 μg/mL). The highest caffeine content was in the bile (852.3 μg/mL). Biochemical findings showed that catecholamine concentration in the peripheral blood in the iliac vein was elevated. Immunostaining of catecholamine was weak in the adrenal medulla. We recommend highlighting the toxicity risk of ingesting substances with a high caffeine concentration, and we propose that caffeine concentrations should be included in the comprehensive routine forensic toxicological tests for all cases. PMID:26594005

  16. Polycyclic Aromatic Hydrocarbon Residues in Serum Samples of Autopsied Individuals from Tennessee

    Aramandla Ramesh

    2014-12-01

    Full Text Available This study reports the concentrations of Polycyclic Aromatic Hydrocarbons (PAHs in human blood sera samples (n = 650 obtained at autopsy from individuals who died of drug abuse, alcohol toxicity, homicide, suicide and other unknown causes. The analyzed samples from decedents revealed the presence of PAHs of which B(aP was the most predominant one, followed by benzo(bfluoranthene and benzo(kfluoranthene. The other PAHs detected sporadically and measured were benzo(g,h,iperylene, acenaphthene, anthracene, phenanthrene, and fluoranthene The mean concentrations of PAHs were greater in the twenties to fifties age groups compared to others. The PAH residue levels detected were high in African Americans compared to Caucasians, Asians, and Hispanics. It appears that environmental exposure, dietary intake and in some cases occupational exposure may have contributed to the PAH body burden. While the PAH residue concentrations measured fall within the range of those reported for healthy adults elsewhere, in isolated cases, the concentrations detected were high, calling the need for a reduction in PAH emissions and human biomonitoring studies for purposes of risk assessment.

  17. Five years audit for presence of toxic agents/drug of abuse at autopsy

    Objective: To know the frequency of fatal poisoning in Peshawar regarding the toxic agents mostly involved and year wise percentage. To know the age group and the gender that is most vulnerable to fatal poisoning. Results: Poisoning was the cause of death in 1.48% of the total autopsies conducted during the five years. Males were more involved than the females, 90.38%. Suicidal poisoning was present in 17.30% of the total cases and accidental poisoning was found in 80.72% cases, while homicidal cases were 1.29% only. Diacetylmorphine (heroin) was the most commonly involved agent, 65.38%, of the total cases. The incidence of poisoning was more during the third and fourth decades of life. Conclusion: Diacetylmorphine (heroin) was the main causative agent involved in young males due to accidental over-dosage. Accidental and suicidal deaths should not be considered as inevitable. More elaborative studies are required in this area of recent research to adopt appropriate and adequate measures to save precious lives.(author)

  18. Fatal disseminated mucormycosis in a patient with mantle cell non-hodgkin's lymphoma: an autopsy case

    Inci Alacacioglu

    2009-06-01

    Full Text Available A patient with mantle cell non-Hodgkin's lymphoma presented herself with fever, nausea, right upper quadrant pain on the 7th day of R-CHOP chemotherapy. After hospitalization with the suspicion of acute cholecystitis, she received antibiotherapy with G-CSF because of emerging neutropenia at the 10th day of chemotherapy. Abdominal computed tomography revealed small infarcts in the spleen and kidneys. The echymotic lesion which developed on her right lateral malleolus, became bullous in the following days and treated as ecthyma gangrenosum. Altough the patient was afebrile with a normal neutrophil count on the third day of antibiotherapy, she developed acute renal failure and deteriorated rapidly. The patient underwent hemodialysis but expired on the 10th day of hospitalization. Post mortem autopsy findings showed ischemic infarction and necrosis of parenchyma due to mycotic thrombosis of arteries and veins of many organs (heart, lung, diaphgram, kidneys, spleen, gut mucosa as well as invasion of vessel walls and parenchyma by mucor. We reviewed mucormycosis in the light of this case.

  19. An autopsy report on a ruptured rudimentary horn (uterine anomaly) with ectopic pregnancy.

    Hirose, Izumi; Harada, Kazuki; Kuroda, Ryohei; Ishii, Yasuhiro; Nakajima, Makoto; Kamei, Yoshimasa; Takazawa, Yutaka; Yoshida, Ken-ichi

    2013-01-10

    The rudimentary horn is a rare developmental anomaly of the Müllerian duct. Ectopic pregnancy in the rudimentary horn is estimated to occur in one out of 76,000-150,000 pregnancies. A 30-year-old primigravida suddenly collapsed after 3 days of continuous abdominal pain. Emergency laparotomy revealed a massive intraperitoneal hemorrhage and fetal demise. The growth of the fetus after 19 weeks of gestation is believed to have caused the rudimentary horn rupture, thereby rapidly leading to hemorrhagic shock in the mother and ischemic death in the fetus. This is the first autopsy report on maternal death due to the rudimentary horn or other Müllerian duct anomalies, which emphasizes the need for forensic pathologists to consider this condition as a possible cause of unexpected death in fertile women. In addition, it is very important for clinicians to detect Müllerian duct anomalies by sonography during routine obstetric examinations, and promptly diagnose anomaly related ectopic pregnancies in women displaying symptoms of an acute abdomen, intraperitoneal hemorrhage, or shock in the emergency practice. PMID:23265443

  20. Laser radiation at various wavelengths for decompression of intervertebral disk. Experimental observations on human autopsy specimens.

    Choy, D S; Altman, P A; Case, R B; Trokel, S L

    1991-06-01

    The interaction of laser radiation with the nucleus pulposus from autopsy specimens of human intervertebral disks was evaluated at different wavelengths (193 nm, 488 nm & 514 nm, 1064 nm, 1318 nm, 2150 nm, 2940 nm, and 10600 nm). A significant correlation of linear least squares fit of the mass ablated as a function of incident energy was found for all lasers used except the Excimer at 193 nm. The 2940-nm Erbium:YAG laser was most efficient in terms of mass of disk ablated per joule in the limited lower range where this wavelength was observed. At higher energy levels, the CO2 laser in the pulsed mode was most efficient. However, the Nd:YAG 1064-nm and 1318-nm lasers are currently best suited for percutaneous laser disk decompression because of the availability of usable waveguides. Carbonization of tissue with the more penetrating Nd:YAG 1064-nm laser increases the efficiency of tissue ablation and makes it comparable to the Nd:YAG 1318-nm laser. PMID:1904334

  1. Renal tubular dysgenesis with hypocalvaria and ileocecal valve agenesis: an autopsy report

    Ariel Barreto Nogueira

    2012-12-01

    Full Text Available Renal tubular dysgenesis (RTD is a rare, lethal, autosomal recessive disorder characterized by non-differentiation of the renal proximal convoluted tubules, resulting in oligohydramnios. It is usually diagnosed in the second trimester of pregnancy, following the oligohydramnios sequence, pulmonary hypoplasia and hypocalvaria. The prognosis is poor, and death usually occurs in utero or within the first few days of life. The pathogenesis of RTD is associated with the perinatal use of drugs, such as angiotensin- converting enzyme inhibitors, angiotensin II receptor antagonists, and anti- inflammatory drugs, as well as with fetal transfusion syndrome, genetic mutations in the pathway of the renin-angiotensin system pathway, cocaine snorting, or other pathological mechanisms that reduce renal blood flow. Here, we report the autopsy of a neonate born to consanguineous parents at 38 weeks of gestation, with RTD, decreased amniotic fluid, oligohydramnios sequence, hypocalvaria, pulmonary hypoplasia, and ileocecal valve agenesis. To our knowledge, the latter has never been reported associated with RTD.

  2. Causes of childhood deaths in Bangladesh: results of a nationwide verbal autopsy study.

    Baqui, A. H.; Black, R. E.; Arifeen, S. E.; Hill, K.; Mitra, S. N.; al Sabir, A.

    1998-01-01

    While knowledge of causes of deaths is important for health sector planning, little is known from conventional sources about the causes of deaths in Bangladesh. This is partly due to deficiencies in the registration system and partly because few deaths are attended by qualified physicians. The present study was undertaken to update the information available on causes of deaths among under-5-year-olds, taking advantage of advances in verbal autopsy methodology and of the national Bangladesh Demographic and Health Survey conducted in 1993-94. About 25% of the deaths were associated with acute lower respiratory infections (ALRI) and about 20% with diarrhoea. Neonatal tetanus and measles remained important causes of death, and drowning was a major cause for 1-4-year-olds. Research and programmes to enable mothers to identify ALRI cases, particularly pneumonia, and to encourage timely and appropriate care-seeking and strengthening of ALRI case management at the primary care facilities are important priorities. While promotion of oral rehydration for watery diarrhoea and antibiotic treatment for dysentery should continue, broader preventive interventions including provision of safe water and sanitation, and improvements in personal hygiene require more attention. Further intensification of immunization programmes and innovative experimental interventions to reduce childhood from drowning should be designed and tested. PMID:9648357

  3. Understanding the Unique Characteristics of Suicide in China: National Psychological Autopsy Study

    GONG-HUAN YANG; MICHAEL R. PHILLIPS; MAI-GENG ZHOU; LI-JUN WANG; YAN-PING ZHANG; DONG XU

    2005-01-01

    Objective To compare the characteristics of suicides in the four main demographic groups: urban males, urban females,rural males and rural females in order to help clarify the demographic pattern of suicides in China. Methods A detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country. Results Pesticide ingestion accounted for 58% (519) of all suicides and 61% (318/519) of deaths were due to unsuccessful medical resuscitation. A substantial proportion (37%) of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13%(76/563) received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion (79%), the lowest prevalence of mental illness (39%), and the highest acute stress from precipitating life events just prior to the suicide. Conclusion Many suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.

  4. Autopsy study correlating degree of osteoarthritis, synovitis and evidence of articular calcification.

    Gordon, G V; Villanueva, T; Schumacher, H R; Gohel, V

    1984-10-01

    Inflammation has been suggested as a component in the osteoarthritic process. We have examined 150 knees at autopsy to correlate the degree of osteoarthritis (OA) with synovial inflammation, and with radiographic or pathologic evidence of calcification as a possible source of crystal induced inflammation. Roentgenographic evidence of calcification and histologic finding of synovial reaction (proliferation or inflammation) were seen more frequently (p less than .05) in the knees of patients with more advanced OA. Perichondrocytic staining for calcium and phosphorus was seen in 93% of patients with severe OA and in only 24% of those with normal or minimal OA. Calcium hydroxyapatite crystals were identified by electron microscopy in perichondrocytic and other areas in 8 of 15 cartilage samples with moderate to severe OA and in none with normal appearing cartilage. In advanced OA, there were bone fragments embedded in cartilage and synovium. Although the pathogenetic sequences are uncertain, we speculate that calcium hydroxyapatite (and pyrophosphate) crystals and/or bone shards can contribute to both synovitis and cartilage degeneration. PMID:6096542

  5. A nationwide, retrospective analysis of symptoms, comorbidities, medical care and autopsy findings in cases of fatal pulmonary embolism in younger patients

    Haunsø, S; Theilade, J; Winkel, B G; Holst, A G; Tfelt-Hansen, J; Svendsen, J H; Haunsø, Stig

    2010-01-01

    Our objective was to provide a comprehensive description of fatal pulmonary embolism (PE) in younger persons. Specifically, we recorded information on symptoms, comorbidity, medical contact, if this had been required, and subsequent autopsy findings.......Our objective was to provide a comprehensive description of fatal pulmonary embolism (PE) in younger persons. Specifically, we recorded information on symptoms, comorbidity, medical contact, if this had been required, and subsequent autopsy findings....

  6. Transcriptional profiling and genotyping of degraded nucleic acids from autopsy tissue samples after prolonged formalin fixation times

    Ferruelo, Antonio; El-Assar, Mariam; Lorente, José A; Nin, Nicolás; Peñuelas, Oscar; Fernández-Segoviano, Pilar; Gonzalez, Constancio; Esteban, Andrés

    2011-01-01

    Background: Samples used for genotyping and transcription studies are obtained and conserved in very specific conditions. The possibility to use autopsy tissue samples, which contain nucleic acids of very poor quality, would open new possibilities for genetic studies. Methods: We have used liver tissue samples from autopsy cases to (i) determine its quality; (ii) study gene expression of 13 genes involved in different cell processes, before and after cDNA pre-amplification (quantitative reverse transcriptase polymerase chain reaction); and (iii) analyze the presence of 2 common polymorphisms of relevance for illness (ACE I/D genotype by PCR amplification, and TNF-α promoter gene polymorphism, by DNA sequencing). Results: Samples were grouped according to different buffered formalin fixation times (group 1, <15 days; group 2, 60-90 days; group 3, 150-180 days; group 4, 240-270 days). Nucleic acids showed a time-dependent degradation. The expression of 13 genes could be studied in all cases from groups 1 and 2, only 7 from group 3 and none from group 4. cDNA preamplification allowed the study of all genes in all samples. DNA genotyping for ACE and TNF-α promoter region was possible in all cases. Conclusions: We conclude that nucleic acids extracted from autopsy specimens after prolonged periods of time in formalin were of sufficient quality to study gene expression and genotyping using currently available methodology and cDNA pre-amplification. PMID:21326810

  7. Prevalence rate of thyroid diseases among autopsy cases of the atomic bomb survivors in Hiroshima, 1951-1985

    To examine the radiogenic risk of latent thyroid cancer, thyroid adenoma, colloid/adenomatous goiter and chronic thyroiditis, the date for 3821 subjects collected in the course of autopsies of atomic bomb survivors in Hiroshima from 1951 to 1985 by the Radiation Effects Research Foundation (RERF) were analyzed using a logistic model. About 80% of the autopsies were performed at RERF and the remainder at local hospitals. The frequencies of the above diseases were not associated with whether the underlying cause of death was cancer. However, note that our results may be influenced by potentially biasing factors associated with autopsy selection. The relative frequency of latent thyroid cancer (greatest dimension ≤1.5 cm but detectable on a routine microscopic slide of the thyroid gland) increased as the radiation dose increased and was about 1.4-fold greater at 1 Gy than in the 0-Gy dose group. The relative occurrence of thyroid adenoma also increased as radiation dose increased, and was about 1.5-fold greater at 1 Gy than in the 0-Gy dose group. Sex, age at the time of the bombing or period of observation did not significantly modify the radiogenic risks for thyroid adenoma or latent thyroid cancer. No statistically significant association was found between radiation exposure and the rates of colloid/adenomatous goiter and chronic thyroiditis. The possible late effect of atomic bomb radiation on the frequency of benign thyroid diseases is discussed on the basis of these data. 38 refs., 2 figs., 5 tabs

  8. Biodistribution Analysis of Oncolytic Adenoviruses in Patient Autopsy Samples Reveals Vascular Transduction of Noninjected Tumors and Tissues.

    Koski, Anniina; Bramante, Simona; Kipar, Anja; Oksanen, Minna; Juhila, Juuso; Vassilev, Lotta; Joensuu, Timo; Kanerva, Anna; Hemminki, Akseli

    2015-10-01

    In clinical trials with oncolytic adenoviruses, there has been no mortality associated with treatment vectors. Likewise, in the Advanced Therapy Access Program (ATAP), where 290 patients were treated with 10 different viruses, no vector-related mortality was observed. However, as the patient population who received adenovirus treatments in ATAP represented heavily pretreated patients, often with very advanced disease, some patients died relatively soon after receiving their virus treatment mandating autopsy to investigate cause of death. Eleven such autopsies were performed and confirmed disease progression as the cause of death in each case. The regulatory requirement for investigating the safety of advanced therapy medical products presented a unique opportunity to study tissue samples collected as a routine part of the autopsies. Oncolytic adenoviral DNA was recovered in a wide range of tissues, including injected and noninjected tumors and various normal tissues, demonstrating the ability of the vector to disseminate through the vascular route. Furthermore, we recovered and cultured viable virus from samples of noninjected brain metastases of an intravenously treated patient, confirming that oncolytic adenovirus can reach tumors through the intravascular route. Data presented here give mechanistic insight into mode of action and biodistribution of oncolytic adenoviruses in cancer patients. PMID:26156245

  9. VALIDATION TEST FOR VERBAL AUTOPSY TOOL IN CAPTURING TB DEATH IN THE COMMUNITY IN METRO CITY, LAMPUNG PROVINCE

    Sarimawar Djaja

    2012-11-01

    Full Text Available The TB death rate and the TB prevalence are considered two indicators of infectious diseases measured  to asses treatment progress to reach the MDGs target in 2015. Verbal autopsy is used to captured TB death cases happened  at home. The sample of " true” TB and "non” TB tests were selected from three gold standard hospital in Metro city. Verbal autopsy was conducted by well trained nurses/midwives from Puskesmas, interviewing  families having the death cases. Two reviewers  set up diagnoses based on the results of the VA. A referee team would decide the final cause of death (COD if the two diagnoses made by these two reviewers were unmatched. To avoid bias in this study, the blind technique was applied. The result of validation test shows out of 95 cases picked out from the three hospitals, only 65 of them were available for interview, 16 were defined to be TB cases and the other 49 cases were non TB, based as gold standard. There were 13 cases of well matched diagnoses between VA result and gold standard with Sensitivity value of 81 per cent (13 per 16. Twenty one death cases were defined TB through VA, the Positive Predictive Value was then 62 per cent (13 per 21. Those result is not much difference with the other place. The quality to determine the cause of death should be improved based on the /CD-10 mortality coding.   Key words: Validation, verbal autopsy, tuberculosis

  10. Alcohol and premature death in Estonian men: a study of forensic autopsies using novel biomarkers and proxy informants

    Ringmets Inge

    2012-02-01

    Full Text Available Abstract Background Alcohol makes an important contribution to premature mortality in many countries in Eastern Europe, including Estonia. However, the full extent of its impact, and the mechanisms underlying it, are challenging issues to research. We describe the design and initial findings of a study aimed at investigating the association of alcohol with mortality in a large series of forensic autopsies of working-age men in Estonia. Methods 1299 male deaths aged 25-54 years were subject to forensic autopsy in 2008-2009. The routine autopsy protocol was augmented by a more systematic inspection of organs, drug testing, assay of liver enzymes and novel biomarkers of alcohol consumption (EtG, EtS and PEth, together with proxy interviews with next of kin for deaths among men who lived in or close to a major town. Results 595 augmented autopsies were performed. Of these, 66% were from external causes (26% suicide, 25% poisoning. 17% were attributed to circulatory system diseases and 7% to alcoholic liver disease. Blood alcohol concentrations (BAC of ≥ 0.2 mg/g were found for 55% of deaths. Interviews were conducted with proxy informants for 61% of the subjects who had resided in towns. Of these, 28% were reported in the previous year to have been daily or almost daily drinkers and 10% had drunk non-beverage alcohols. Blood ethanol and the liver enzyme GGT were only associated with daily drinking. However, the novel biomarkers showed a more graded response with recent consumption. In contrast, the liver enzymes AST and ALT were largely uninformative because of post-mortem changes. The presence of extremely high PEth concentrations in some samples also suggested post-mortem formation. Conclusion We have shown the feasibility of deploying an extended research protocol within the setting of routine forensic autopsies that offer scope to deepen our understanding of the alcohol-related burden of premature mortality. The most unique feature of the

  11. Social autopsy for maternal and child deaths: a comprehensive literature review to examine the concept and the development of the method

    Koffi Alain K

    2011-08-01

    Full Text Available Abstract "Social autopsy" refers to an interview process aimed at identifying social, behavioral, and health systems contributors to maternal and child deaths. It is often combined with a verbal autopsy interview to establish the biological cause of death. Two complementary purposes of social autopsy include providing population-level data to health care programmers and policymakers to utilize in developing more effective strategies for delivering maternal and child health care technologies, and increasing awareness of maternal and child death as preventable problems in order to empower communities to participate and engage health programs to increase their responsiveness and accountability. Through a comprehensive review of the literature, this paper examines the concept and development of social autopsy, focusing on the contributions of the Pathway Analysis format for child deaths and the Maternal and Perinatal Death Inquiry and Response program in India to social autopsy's success in meeting key objectives. The Pathway Analysis social autopsy format, based on the Pathway to Survival model designed to support the Integrated Management of Childhood Illness approach, was developed from 1995 to 2001 and has been utilized in studies in Asia, Africa, and Latin America. Adoption of the Pathway model has enriched the data gathered on care seeking for child illnesses and supported the development of demand- and supply-side interventions. The instrument has recently been updated to improve the assessment of neonatal deaths and is soon to be utilized in large-scale population-representative verbal/social autopsy studies in several African countries. Maternal death audit, starting with confidential inquiries into maternal deaths in Britain more than 50 years ago, is a long-accepted strategy for reducing maternal mortality. More recently, maternal social autopsy studies that supported health programming have been conducted in several developing countries

  12. Social autopsy for maternal and child deaths: a comprehensive literature review to examine the concept and the development of the method.

    Kalter, Henry D; Salgado, Rene; Babille, Marzio; Koffi, Alain K; Black, Robert E

    2011-01-01

    "Social autopsy" refers to an interview process aimed at identifying social, behavioral, and health systems contributors to maternal and child deaths. It is often combined with a verbal autopsy interview to establish the biological cause of death. Two complementary purposes of social autopsy include providing population-level data to health care programmers and policymakers to utilize in developing more effective strategies for delivering maternal and child health care technologies, and increasing awareness of maternal and child death as preventable problems in order to empower communities to participate and engage health programs to increase their responsiveness and accountability.Through a comprehensive review of the literature, this paper examines the concept and development of social autopsy, focusing on the contributions of the Pathway Analysis format for child deaths and the Maternal and Perinatal Death Inquiry and Response program in India to social autopsy's success in meeting key objectives. The Pathway Analysis social autopsy format, based on the Pathway to Survival model designed to support the Integrated Management of Childhood Illness approach, was developed from 1995 to 2001 and has been utilized in studies in Asia, Africa, and Latin America. Adoption of the Pathway model has enriched the data gathered on care seeking for child illnesses and supported the development of demand- and supply-side interventions. The instrument has recently been updated to improve the assessment of neonatal deaths and is soon to be utilized in large-scale population-representative verbal/social autopsy studies in several African countries. Maternal death audit, starting with confidential inquiries into maternal deaths in Britain more than 50 years ago, is a long-accepted strategy for reducing maternal mortality. More recently, maternal social autopsy studies that supported health programming have been conducted in several developing countries. From 2005 to 2009, 10 high

  13. Verbal autopsy of 48 000 adult deaths attributable to medical causes in Chennai (formerly Madras, India

    Kanaka Santhanakrishnan

    2002-05-01

    Full Text Available Abstract Background In the city of Chennai, India, registration of the fact of death is almost complete but the cause of death is often inadequately recorded on the death certificate. A special verbal autopsy (VA study of 48 000 adult deaths in Chennai during 1995–97 was conducted to arrive at the probable underlying cause of death and to measure cause specific mortality rates for Chennai. Methods Trained non-medical graduates with at least 15 years of formal education interviewed the surviving family members or an associate of the deceased to write a report on the complaints, symptoms, signs, duration and treatment details of illness prior to death. Each report was reviewed centrally by two physicians independently. The reliability was assessed by comparing deaths attributed to cancer by VA with records in Vital Statistics Department and Chennai Cancer Registry. Results The VA reduced the proportion of deaths attributed to unspecified medical causes and unknown causes from 37% to 7% in early adult life and middle age (25–69 yrs and has yielded fewer unspecified causes (only 10% than the death certificate. The sensitivity of VA to identify cancer was 94% in the age group 25–69. Conclusion VA is practicable for deaths in early adult life or middle age and is of more limited value in old age. A systematic program of VA of a representative sample of deaths could assign broad causes not only to deaths in childhood (as has previously been established but also to deaths in early adult life and middle age.

  14. Fatal alcohol intoxication in women: A forensic autopsy study from Slovakia

    Straka Lubomir

    2011-12-01

    Full Text Available Abstract Background Plenty of information related to alcoholism can be found in the literature, however, the studies have mostly dealt with the predominance of male alcoholism and data related to addiction in women are desperately scarce and difficult to find. Basic demographic data focusing on the impact of acute alcohol intoxication on the circumstances of death and social behaviour in the alcohol addicted female population are needed especially in the prevention of alcohol related mortality. Methods A retrospective forensic autopsy study of all accidental deaths due to alcohol intoxication over a 12-year period was performed in order to evaluate the locations, circumstances, mechanisms and causes of death. Results A sample of 171 cases of intoxicated women who died due to blood alcohol concentration (BAC equal to or higher than 2 g/kg was selected. Among them 36.26% (62/171 of women died due to acute alcohol intoxication (AAI. We noted an increase in the number of deaths in women due to AAI from 2 in 1994 up to 5 in 2005 (an elevation of 150% between the years 1994-2005. The age structure of deaths in women due to BAC and AAI followed the Gaussian distribution with a dominant group of women aged 41-50 years (45.16% and 35.09% respectively. The most frequent place of death (98% among women intoxicated by alcohol was their own home. The study suggests a close connection between AAI and violence against women. Conclusions The increasing number of cases of death of women suffering from AAI has drawn attention to the serious problem of alcoholism in women in the Slovak Republic during the process of integration into "western" lifestyle and culture.

  15. Evaluation of additional head of biceps brachii: a study with autopsy material.

    Ballesteros, L E; Forero, P L; Buitrago, E R

    2014-05-01

    Additional head of the biceps brachii (AHBB) has been reported in different population groups with a frequency of 1-25%. The purpose of this study was to determine the incidence and morphologic expression of the AHBB as determined in a sample of the Colombian population. An exploration was conducted with 106 arms corresponding to unclaimed corpses autopsied at Institute of Legal and Forensic Medicine of Bucaramanga, Colombia. Using medial incision involvingskin, subcutaneous tissue, and brachial fascia, the heads of the biceps and their innervating branches were visualised. One AHBB was observed in 21 (19.8%) of the arms evaluated, with non-significant difference (p = 0.568) per side of presentation: 11 (52.4%) cases on the right side and 10 (47.6%) on the left side. All AHBBs were originated in the infero-medial segment of the humerus, with a mean thickness of 17.8 ± 6.8 mm. In 4 (19%) cases the fascicle was thin, less than 10 mm; in 7 (33.3%) cases it was of medium thickness, between 11 and 20 mm, whereas in 47.6% it was longer than 20 mm. The length of the AHBB was 118.3 ± 26.8 mm; its motor point supplied by the musculocutaneous nerve was located at 101.3 ± 20.9 mm of the bi-epicondylar line. The incidence of AHBB in this study is located at the upper segment of what has been reportedin the literature and could be a morphologic trait of the Colombian population; in agreement with prior studies, the origin was the infero-medial surface of the humerus. PMID:24902098

  16. Median ulnar nerves communication in the forearm: a study with autopsy material.

    Ballesteros, Luis E; Forero, Pedro L; Quintero, Iván D

    2014-01-01

    The incidence of median-ulnar communication in the forearm presents variability in different population groups. The aim of this study was to determine the incidence and morphologic expression of the median-ulnar communication in a sample of the Colombian population. One hundred and eight forearms of autopsy material at the National Institute of Forensic Medicine of Bucaramanga, Colombia were studied. Using an approach of the flexor compartment of forearm the median and ulnar nerves were dissected and the communications between these two structures were characterized. The communicating branch occurred in 28 (25.9%) forearms. It occurred unilaterally in 12 specimens and bilaterally in 8, with statistically significant difference (P=0.01). The communication between the anterior interosseous and ulnar nerves was most frequent, observed in 13 (46.4%) forearms. The length of the communicating branch was 56.9 +/- 8.3 mm. The distance of the proximal and distal points of the communicating branch to the bi- epicondylar line was 59.6 +/- 15.4 mm and 102.7 +/- 23.5 mm respectively. The length of the forearm was 269.8 +/- 15.9 mm. A projection of the communicating branch from the upper third to the midthird of the forearm was observed. The incidence of the median-ulnar communication in the present study is in the high rank reported in the literature; there is an agreement with prior studies in finding more numerous communicating branches in the right forearm. The median-ulnar communication should be taken into account for surgical approach of the forearm. PMID:26749683

  17. Custody and prison deaths autopsied in Istanbul between 2010 and 2012.

    Ünal, Volkan; Özgün Ünal, Esra; Çetinkaya, Zafer; İmalı, Murat; Gürler, Selçuk; Koç, Sermet

    2016-04-01

    The occurred death of a convict in prison, police custody cell or in a hospital always attracts public attention and can be considered as a complex phenomenon. The aim of this study is to evaluate the data obtained from autopsies performed to the custody and prison deaths in Istanbul and to discuss the possible solutions by comparing with the literature. It is also aimed to discuss the postponement of the sentence and presidential amnesty facts in Turkey. Deaths of inmates, which occurred in hospitals, prisons, prison medical rooms, police vans and police custody cells between 2010 and 2012 in Istanbul, Turkey were included in the study. Totally 125 cases were found and 98.4% of them were male. Natural deaths accounted for a great majority of deaths (83.2%). The most common natural cause was cardiovascular diseases. Unnatural deaths accounted for 15.2% of the deaths. Death reason cannot be determined for 1.6% of the cases. More than half of the cases (56%) were died at the hospital, 34.4% were died at the prison, 4% of them at the police van, 3.2% were died under police custody and 2.4% were died at the prison medical room. Moreover, twelve of these cases had applied to Third Specialization Board previously for postponement of the sentence or Presidential amnesty. Totally five of these cases found suitable for postponement of the sentence. Prison conditions should be improved, prisoners with chronic diseases should be examined periodically and if appropriate their sentences should be postponed until they heal. PMID:26807995

  18. Metastatic breast cancer patients: attitudes toward tissue donation for rapid autopsy.

    Achkar, Tala; Wilson, John; Simon, Jacqueline; Rosenzweig, Margaret; Puhalla, Shannon

    2016-01-01

    Rapid autopsy (RA) offers a unique opportunity to obtain a large amount of metastatic tissue at death in order to deepen existing understanding of cancer evolution and heterogeneity. In breast cancer, understanding metastasis is particularly valuable given that treatment regimens are based on the traditional hormone and HER2 receptor status as well as evolving genomic data of the primary tumor. We aimed to elucidate the attitudes and interests of patients with metastatic breast cancer (MBC) toward RA, and to identify associated demographic or disease characteristics that may influence patient attitudes and interest. Ninety-seven patients with MBC were surveyed over the course of 12 months at a large, urban comprehensive cancer center's breast cancer outpatient clinic. 93/97 patients completed the survey sufficiently to be included in the analysis. Fisher's exact test was employed for categorical variables, and t test and rank-sum tests for continuous variables. p values ≤0.05 were considered statistically significant. Of the 93 patients with MBC analyzed, 87 % were willing to donate tissue at death. Marital status and younger age were associated with willingness to donate (p = 0.000, p = 0.025, respectively). Race, employment status, religion/spirituality, and cancer subtype were not associated with likelihood of donating. Forty-five percent of patients felt that doctors should ask about RA at diagnosis of early-stage breast cancer rather than during late-stage disease. These data provide evidence that an RA program would be welcomed by patients and requires initiative by providers. PMID:26705147

  19. Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring

    Leitao, Jordana; Chandramohan, Daniel; Byass, Peter; Jakob, Robert; Bundhamcharoen, Kanitta; Choprapawon, Chanpen; de Savigny, Don; Fottrell, Edward; França, Elizabeth; Frøen, Frederik; Gewaifel, Gihan; Hodgson, Abraham; Hounton, Sennen; Kahn, Kathleen; Krishnan, Anand; Kumar, Vishwajeet; Masanja, Honorati; Nichols, Erin; Notzon, Francis; Rasooly, Mohammad Hafiz; Sankoh, Osman; Spiegel, Paul; AbouZahr, Carla; Amexo, Marc; Kebede, Derege; Alley, William Soumbey; Marinho, Fatima; Ali, Mohamed; Loyola, Enrique; Chikersal, Jyotsna; Gao, Jun; Annunziata, Giuseppe; Bahl, Rajiv; Bartolomeus, Kidist; Boerma, Ties; Ustun, Bedirhan; Chou, Doris; Muhe, Lulu; Mathai, Matthews

    2013-01-01

    Objective Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it feasible for application on a larger scale such as in routine civil registration and vital statistics (CRVS) systems. Methods A literature review of existing VA instruments was undertaken. The World Health Organization (WHO) then facilitated an international consultation process to review experiences with existing VA instruments, including those from WHO, the Demographic Evaluation of Populations and their Health in Developing Countries (INDEPTH) Network, InterVA, and the Population Health Metrics Research Consortium (PHMRC). In an expert meeting, consideration was given to formulating a workable VA CoD list [with mapping to the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) CoD] and to the viability and utility of existing VA interview questions, with a view to undertaking systematic simplification. Findings A revised VA CoD list was compiled enabling mapping of all ICD-10 CoD onto 62 VA cause categories, chosen on the grounds of public health significance as well as potential for ascertainment from VA. A set of 221 indicators for inclusion in the revised VA instrument was developed on the basis of accumulated experience, with appropriate skip patterns for various population sub-groups. The duration of a VA interview was reduced by about 40% with this new approach. Conclusions The revised VA instrument resulting from this consultation process is presented here as a means of making it available for widespread use and evaluation. It is envisaged that this will be used in conjunction with automated models for assigning CoD from VA data, rather than involving physicians. PMID

  20. Risk factors, organ weight deviation and associated anomalies in neural tube defects: A prospective fetal and perinatal autopsy series

    Asaranti Kar

    2015-01-01

    Full Text Available Introduction: Neural tube defects (NTD are a group of serious birth defects occurring due to defective closure of neural tube during embryonic development. It comprises of anencephaly, encephalocele and spina bifida. We conducted this prospective fetal autopsy series to study the rate and distribution of NTD, analyze the reproductive factors and risk factors, note any associated anomalies and evaluate the organ weights and their deviation from normal. Materials and Methods: This was a prospective study done over a period of 6 years from August, 2007 to July, 2013. All cases of NTDs delivered as abortion, still born and live born were included. The reproductive and risk factors like age, parity, multiple births, previous miscarriage, obesity, diabetes mellitus, socioeconomic status and use of folic acid during pregnancy were collected.Autopsy was performed according to Virchow′s technique. Detail external and internal examination were carried out to detect any associated anomalies. Gross and microscopic examination of organs were done. Results: Out of 210 cases of fetal and perinatal autopsy done, 72 (34.28% had NTD constituting 49 cases of anencephaly, 16 spina bifida and 7 cases of encephalocele. The mothers in these cases predominantly were within 25-29 years (P = 0.02 and primy (P = 0.01. Female sex was more commonly affected than males (M:F = 25:47, P = 0.0005 There was no history of folate use in majority of cases. Organ weight deviations were >2 standard deviation low in most of the cases. Most common associated anomalies were adrenal hypoplasia and thymic hyperplasia. Conclusion: The authors have made an attempt to study NTD cases in respect to maternal reproductive and risk factors and their association with NTD along with the organ weight deviation and associated anomalies. This so far in our knowledge is an innovative study which was not found in literature even after extensive search.

  1. Post-mortem computed tomography findings of the lungs: Retrospective review and comparison with autopsy results of 30 infant cases

    Highlights: •Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). •In this study, twenty-two of the thirty sudden infant death cases showed increasing concentration in the entire lung field. •Based on the autopsy results, the lungs simply collapsed and no other abnormal lung findings were identified. •The radiologist should not consider increasing concentration in all lung fields as simply a pulmonary disorder when diagnosing the cause of infant death using PMCT. -- Abstract: Objectives: Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). However, the lungs often show simply atelectasis at autopsy in the absence of any other abnormal changes. Thus, we retrospectively reviewed the PMCT findings of lungs following sudden infant death and correlated them with the autopsy results. Materials and methods: We retrospectively reviewed infant cases (0 year) who had undergone PMCT and a forensic autopsy at our institution between May 2009 and June 2013. Lung opacities were classified according to their type; consolidation, ground-glass opacity and mixed, as well as distribution; bilateral diffuse and areas of sparing. Statistical analysis was performed to assess the relationships among lung opacities, causes of death and resuscitation attempt. Results: Thirty infant cases were selected, which included 22 sudden and unexplained deaths and 8 other causes of death. Resuscitation was attempted in 22 of 30 cases. Bilateral diffuse opacities were observed in 21 of the 30 cases. Of the 21 cases, 18 were sudden and unexplained deaths. Areas of sparing were observed in 4 sudden and unexplained deaths and 5 other causes of death. Distribution of opacities was not significantly associated with causes of death or resuscitation attempt. The 21 cases with bilateral diffuse opacities included 6 consolidations (4 sudden and unexplained

  2. Post-mortem computed tomography findings of the lungs: Retrospective review and comparison with autopsy results of 30 infant cases

    Kawasumi, Yusuke, E-mail: ssu@rad.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Usui, Akihito, E-mail: t7402r0506@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosokai, Yoshiyuki, E-mail: hosokai@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Igari, Yui, E-mail: igari@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosoya, Tadashi [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hayashizaki, Yoshie, E-mail: yoshie@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Saito, Haruo, E-mail: hsaito@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Ishibashi, Tadashi, E-mail: tisibasi@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Funayama, Masato, E-mail: funayama@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan)

    2015-04-15

    Highlights: •Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). •In this study, twenty-two of the thirty sudden infant death cases showed increasing concentration in the entire lung field. •Based on the autopsy results, the lungs simply collapsed and no other abnormal lung findings were identified. •The radiologist should not consider increasing concentration in all lung fields as simply a pulmonary disorder when diagnosing the cause of infant death using PMCT. -- Abstract: Objectives: Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). However, the lungs often show simply atelectasis at autopsy in the absence of any other abnormal changes. Thus, we retrospectively reviewed the PMCT findings of lungs following sudden infant death and correlated them with the autopsy results. Materials and methods: We retrospectively reviewed infant cases (0 year) who had undergone PMCT and a forensic autopsy at our institution between May 2009 and June 2013. Lung opacities were classified according to their type; consolidation, ground-glass opacity and mixed, as well as distribution; bilateral diffuse and areas of sparing. Statistical analysis was performed to assess the relationships among lung opacities, causes of death and resuscitation attempt. Results: Thirty infant cases were selected, which included 22 sudden and unexplained deaths and 8 other causes of death. Resuscitation was attempted in 22 of 30 cases. Bilateral diffuse opacities were observed in 21 of the 30 cases. Of the 21 cases, 18 were sudden and unexplained deaths. Areas of sparing were observed in 4 sudden and unexplained deaths and 5 other causes of death. Distribution of opacities was not significantly associated with causes of death or resuscitation attempt. The 21 cases with bilateral diffuse opacities included 6 consolidations (4 sudden and unexplained

  3. Craniocerebral trauma--congruence between post-mortem computed tomography diagnoses and autopsy results: a 2-year retrospective study

    Jacobsen, Christina; Lynnerup, Niels

    anterior, medial and posterior cranial fossae was 20%, 52% and 60%, respectively. Fractures involving bilateral bones were diagnosed correctly more frequently. The diagnostic agreement regarding brain injuries varied from 0% to 79%. Both the autopsy-reports and CT-scan descriptions need to be standardized......-scans were performed by a forensic pathologist. They were obtained by using two different CT-scan protocols. The results showed correct skull fracture diagnoses in 34/56 cases. Fractures were diagnosed partially (9) or missed totally (13) on CT-images in 22 cases. The agreement for fracture diagnoses of the...

  4. Mercury in human brain, blood, muscle and toenails in relation to exposure: an autopsy study

    Morild Inge

    2007-10-01

    Full Text Available Abstract Background The main forms of mercury (Hg exposure in the general population are methylmercury (MeHg from seafood, inorganic mercury (I-Hg from food, and mercury vapor (Hg0 from dental amalgam restorations. While the distribution of MeHg in the body is described by a one compartment model, the distribution of I-Hg after exposure to elemental mercury is more complex, and there is no biomarker for I-Hg in the brain. The aim of this study was to elucidate the relationships between on the one hand MeHg and I-Hg in human brain and other tissues, including blood, and on the other Hg exposure via dental amalgam in a fish-eating population. In addition, the use of blood and toenails as biological indicator media for inorganic and organic mercury (MeHg in the tissues was evaluated. Methods Samples of blood, brain (occipital lobe cortex, pituitary, thyroid, abdominal muscle and toenails were collected at autopsy of 30 deceased individuals, age from 47 to 91 years of age. Concentrations of total-Hg and I-Hg in blood and brain cortex were determined by cold vapor atomic fluorescence spectrometry and total-Hg in other tissues by sector field inductively coupled plasma-mass spectrometry (ICP-SFMS. Results The median concentrations of MeHg (total-Hg minus I-Hg and I-Hg in blood were 2.2 and 1.0 μg/L, and in occipital lobe cortex 4 and 5 μg/kg, respectively. There was a significant correlation between MeHg in blood and occipital cortex. Also, total-Hg in toenails correlated with MeHg in both blood and occipital lobe. I-Hg in both blood and occipital cortex, as well as total-Hg in pituitary and thyroid were strongly associated with the number of dental amalgam surfaces at the time of death. Conclusion In a fish-eating population, intake of MeHg via the diet has a marked impact on the MeHg concentration in the brain, while exposure to dental amalgam restorations increases the I-Hg concentrations in the brain. Discrimination between mercury species is

  5. Cultural imperatives and the ethics of verbal autopsies in rural Ghana

    Raymond A. Aborigo

    2013-09-01

    Full Text Available Background: Due to a paucity of statistics from vital registration systems in developing countries, the verbal autopsy (VA approach has been used to obtain cause-specific mortality data by interviewing lay respondents on the signs and symptoms experienced by the deceased prior to death. In societies where the culture of mourning is adhered to, the use of VA could clash with traditional norms, thus warranting ethical consideration by researchers. Objective: The study was designed to explore the ethics and cultural context of collecting VA information through a demographic and health surveillance system in the Kassena-Nankana District (KND of Ghana. Study Design: Data were collected through qualitative in-depth interviews (IDIs with four field staff involved in the routine conduct of VAs, four physicians who code VAs, 20 selected respondents to the VA tool, and eight opinion leaders in the KND. The interviews were supplemented with observation by the researchers and with the field notes of field workers. Interviews were audio-recorded, and local language versions transcribed into English. Thematic analysis was performed using QSR NVivo 8 software. Results: The data indicate that cultural sensitivities in VA procedures at both the individual and family levels need greater consideration not only for ethical reasons but also to ensure the quality of the data. Discussions of some deaths are culturally prohibited and therefore lead to refusal of interviews. Families were also concerned about the confidentiality of information because of the potential of blame for the death. VA teams do not necessarily engage in culturally appropriate bereavement practices such as the presentation of tokens. The desire by families for feedback on the cause of death, which is currently not provided by researchers, was frequently expressed. Finally, no standard exists on the culturally acceptable time interval between death and VA interviews. Conclusion: Ethical issues

  6. Plasma homocysteine, Alzheimer and cerebrovascular pathology: a population-based autopsy study

    Polvikoski, Tuomo; Kivipelto, Miia; Tanskanen, Maarit; Myllykangas, Liisa; Erkinjuntti, Timo; Mäkelä, Mira; Oinas, Minna; Paetau, Anders; Scheltens, Philip; van Straaten, Elizabeth C. W.; Sulkava, Raimo; Solomon, Alina

    2013-01-01

    Elevated plasma total homocysteine is associated with increased risk of dementia/Alzheimer’s disease, but underlying pathophysiological mechanisms are not fully understood. This study investigated possible links between baseline homocysteine, and post-mortem neuropathological and magnetic resonance imaging findings up to 10 years later in the Vantaa 85+ population including people aged ≥85 years. Two hundred and sixty-five individuals had homocysteine and autopsy data, of which 103 had post-mortem brain magnetic resonance imaging scans. Methenamine silver staining was used for amyloid-β and modified Bielschowsky method for neurofibrillary tangles and neuritic plaques. Macroscopic infarcts were identified from cerebral hemispheres, brainstem and cerebellum slices. Standardized methods were used to determine microscopic infarcts, cerebral amyoloid angiopathy, and α-synuclein pathology. Magnetic resonance imaging was used for visual ratings of the degree of medial temporal lobe atrophy, and periventricular and deep white matter hyperintensities. Elevated baseline homocysteine was associated with increased neurofibrillary tangles count at the time of death: for the highest homocysteine quartile, odds ratio (95% confidence interval) was 2.60 (1.28–5.28). The association was observed particularly in people with dementia, in the presence of cerebral infarcts, and with longer time between the baseline homocysteine assessment and death. Also, elevated homocysteine tended to relate to amyloid-β accumulation, but this was seen only with longer baseline-death interval: odds ratio (95% confidence interval) was 2.52 (0.88–7.19) for the highest homocysteine quartile. On post-mortem magnetic resonance imaging, for the highest homocysteine quartile odds ratio (95% confidence interval) was 3.78 (1.12–12.79) for more severe medial temporal atrophy and 4.69 (1.14–19.33) for more severe periventricular white matter hyperintensities. All associations were independent of

  7. Investigation of a fatal airplane crash: autopsy, computed tomography, and injury pattern analysis used to determine who was steering the plane at time of accident. A case report

    Høyer, Christian Bjerre; Nielsen, Trine Skov; Nagel, Lise Loft;

    2012-01-01

    A fatal accident is reported in which a small single-engine light airplane crashed. The airplane carried two persons in the front seats, both of whom possessed valid pilot certificates. Both victims were subject to autopsy, including post-mortem computed tomography scanning (PMCT) prior to the...... autopsy. The autopsies showed massive destruction to the bodies of the two victims but did not identify any signs of acute or chronic medical conditions that could explain loss of control of the airplane. PMCT, histological examination, and forensic chemical analysis also failed to identify an explanation...... for the crash. A detailed review of an airplane identical to the crashed airplane was performed in collaboration with the Danish Accident Investigation Board and the Danish National Police, National Centre of Forensic Services. The injuries were described using the abbreviated injury scale, the injury...

  8. The problem with medical research on tissue and organ samples taken in connection with forensic autopsies in France.

    Rougé-Maillart, C; Dupont, V; Jousset, N

    2016-02-01

    Currently, in France, it is legally impossible to conduct scientific research on tissue and organ samples taken from forensic autopsies. In fact, the law schedules the destruction of such samples at the end of the judicial investigation, and the common law rules governing cadaver research cannot be applied to the forensic context. However, nothing seems in itself to stand in the way of such research since, despite their specific nature, these samples from forensic autopsies could be subject, following legislative amendments, to common law relating to medical research on samples taken from deceased persons. But an essential legislative amendment, firstly to allow the Biomedicine Agency to become authorized to issue a research permit and secondly, to change the research conditions in terms of the non-opposition of the deceased to said research. Such an amendment would be a true breakthrough because it would allow teams to continue to move forward calmly in research, and allow this research to be placed within a legal framework, which would promote international exchanges. PMID:26694871

  9. Bronchopulmonary arterial anastomosis at the precapillary level in human lung. Visualization using CT angiography compared with microangiography of autopsied lung

    To investigate the interrelationships between the bronchial and pulmonary circulations including the existence of precapillary bronchopulmonary arterial anastomoses, CT of bronchial arteriography (BAG-CT) was performed in 10 patients and BAG-CT during a pulmonary artery block test (PA-block) in 5 patients with lung cancer. Bronchial and pulmonary circulations were evaluated in 5 autopsied normal lungs by injecting silicone rubber with different colors into the bronchial and pulmonary arteries. BAG-CT correlated well with the findings at silicone rubber injection into lung autopsy samples. BAG-CT demonstrated inflow of contrast medium into the pulmonary artery during PA-block in all cases, while no inflow was observed before and following reversal of PA-block. Mixed silicone rubber was observed in the lobar to subsubsegmental bronchial arteries in all cases and in the subsubsegmental pulmonary artery in one case. Precapillary bronchopulmonary arterial anastomoses may exist at the level of the lobar bronchi to the periphery. If either the pulmonary or bronchial circulation is disturbed, flow occurs inside the anastomoses to supplement the other flow, especially flow from the bronchial to the pulmonary arteries via the anastomoses, which occurs within 30 min

  10. Bronchopulmonary arterial anastomosis at the precapillary level in human lung. Visualization using CT angiography compared with microangiography of autopsied lung

    Purpose: To investigate the interrelationships between the bronchial and pulmonary circulations including the existence of precapillary bronchopulmonary arterial anastomoses. Material and Methods: CT of bronchial arteriography (BAG-CT) was performed in 10 patients and BAG-CT during a pulmonary artery block test (PA-block) in 5 patients with lung cancer. Bronchial and pulmonary circulations were evaluated in 5 autopsied normal lungs by injecting silicone rubber with different colors into the bronchial and pulmonary arteries. Results: BAG-CT correlated well with the findings at silicone rubber injection into lung autopsy samples. BAG-CT demonstrated inflow of contrast medium into the pulmonary artery during PA-block in all cases, while no inflow was observed before and following reversal of PA-block. Mixed silicone rubber was observed in the lobar to subsubsegmental bronchial arteries in all cases and in the subsubsegmental pulmonary artery in one case. Conclusion: Precapillary bronchopulmonary arterial anastomoses may exist at the level of the lobar bronchi to the periphery. If either the pulmonary or bronchial circulation is disturbed, flow occurs inside the anastomoses to supplement the other flow, especially flow from the bronchial to the pulmonary arteries via the anastomoses, which occurs within 30 min. (orig.)

  11. An autopsy case of acute pancreatitis with a high serum IgG4 complicated by amyloidosis and rheumatoid arthritis

    Tatsuki Ichikawa; Kazuhiko Nakao; Keisuke Hamasaki; Kazuaki Ohkubo; Kan Toriyama; Katsumi Eguchi

    2005-01-01

    We report an autopsy case of acute pancreatitis with a high serum IgG4 concentration complicated by systemic amyloid A amyloidosis and rheumatoid arthritis (RA). The patient was a 42-year-old Japanese female with a 22-year history of rheumatoid arthritis. She was diagnosed with myasthenia gravis when she was 31-year old. At the onset of pancreatitis, the patient was anti-nuclear antibody-positive,and had high serum gamma globulin and IgG4 levels.Dexamethasone and conventional therapy induced clinical remission and significantly decreased the serum IgG4 and gamma globulin. However, despite the decreased disease parameters, the patient developed a bleeding pseudocyst and died of cardiac failure. In the autopsy examination, it was determined that pancreatitis was probably caused by ischemia due to vascular obstruction caused by amyloid deposition in the pancreas. Even though acute pancreatitis is a rare complication in RA patients, we speculate that an autoimmune pancreatitis-related mechanism and ischemia due to vascular obstruction by amyloid deposition might be attributable to a single source that leads to acute pancreatitis in our particular case.

  12. Examination of the clinicopathologic continuum of Alzheimer disease in the autopsy cohort of the National Alzheimer Coordinating Center.

    Serrano-Pozo, Alberto; Qian, Jing; Monsell, Sarah E; Frosch, Matthew P; Betensky, Rebecca A; Hyman, Bradley T

    2013-12-01

    To test the hypothesis that Alzheimer disease (AD) is a clinical and pathologic continuum between normal aging and end-stage dementia, we selected a convenience sample of subjects from the National Alzheimer Coordinating Center 2005 to 2012 autopsy cohort (n = 2,083) with the last clinical evaluation within 2 years before autopsy and no other primary neuropathologic diagnosis. Demographic and neuropathologic characteristics were correlated with the Clinical Dementia Rating-Sum of Boxes in the 835 subjects meeting these criteria. Both neuritic plaques and neurofibrillary tangles independently predicted Clinical Dementia Rating-Sum of Boxes. Severe small-vessel disease, severe amyloid angiopathy, and hippocampal sclerosis were also independently associated with the degree of cognitive impairment. By contrast, education was a strong independent protective factor against cognitive deficits. The cause of mild to moderate dementia remained uncertain in 14% of the patients. Inverse probability weighting suggests the generalizability of these results to nonautopsied cohorts. These data indicate that plaques and tangles independently contribute to cognitive impairment, that concurrent vascular disease strongly correlates with cognitive dysfunction even in a sample selected to represent the AD pathologic continuum, and that education further modifies clinical expression. Thus, multiple concomitant etiologies of brain damage and premorbid characteristics contribute to the uncertainty of AD clinicopathologic correlations based only on tangles and plaques. PMID:24226270

  13. The correlation of epicardial adipose tissue on postmortem CT with coronary artery stenosis as determined by autopsy.

    Sequeira, Damien I; Ebert, Lars C; Flach, Patricia M; Ruder, Thomas D; Thali, Michael J; Ampanozi, Garyfalia

    2015-06-01

    The goal of this study was to assess whether epicardial and paracardial adipose tissue volumes, as determined by computed tomography (CT), correlate with coronary artery stenosis as determined by autopsy. The postmortem CT data and autopsy findings of 116 adult human decedents were retrospectively compared. Subjects were classified into three groups according to their degree of coronary artery stenosis: ≥50, segmentation after threshold based masking. In addition, epicardial adipose tissue thickness was measured using a caliper. All three parameters (thickness of epicardial fat and volumes of both epicardial and paracardial fat) were compared among the three groups and correlated with the degree of coronary artery stenosis. The group with no coronary artery stenosis showed the lowest mean values of epicardial adipose tissue volume, while the coronary artery stenosis ≥50 % group showed the highest volume. All measured variables (thickness of epicardial fat and volumes of both epicardial and paracardial fat) correlated significantly with the grade of coronary artery stenosis, even after controlling for BMI, however, epicardial adipose tissue volume exhibited the strongest correlation. This study reveals that there is an association between the degree of coronary artery stenosis and the amount of epicardial fat tissue: The larger the volume of epicardial fat, the higher the degree of coronary artery stenosis. PMID:25711291

  14. Spectrum of pediatric developmental and genetic renal lesions and associated congenital malformations--an autopsy study from north India.

    Kakkar, Nandita; Menon, Santosh; Radotra, B D

    2006-01-01

    Pediatric developmental and genetic renal lesions are a known cause of mortality in the perinatal/neonatal period. These lesions are associated with a wide range of extrarenal congenital malformations that influence the outcome of the patients. In this autopsy study, we have analyzed the spectrum of pediatric developmental and genetic renal lesions and their associated congenital malformations. A total of 4,099 autopsies (20 weeks of gestation to 1 year of life) were reviewed, of which 158 cases (3.85%) of pediatric developmental (143 cases) and genetic renal lesions (15 cases) were found. Autosomal recessive polycystic kidney disease was the commonest genetic lesion. Primitive ducts with cuffing of immature mesenchyme--the sine qua non of renal dysplasia--was found in all cases of dysplasia. Associated congenital malformations were seen in all cases and thus a thorough search for them is mandatory. Ductal plate malformation was found in all cases of autosomal recessive polycystic kidney disease and in 1 case of bilateral multicystic dysplasia. PMID:16754487

  15. Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

    Winklhofer, Sebastian; Stolzmann, Paul [University of Zurich, Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, Zurich (Switzerland); University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Surer, Eddie; Ampanozi, Garyfalia; Thali, Michael; Schweitzer, Wolf [University of Zurich, Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, Zurich (Switzerland); Ruder, Thomas [University of Zurich, Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, Zurich (Switzerland); University Hospital Bern, Institute of Diagnostic, Interventional and Pediatric Radiology, Bern (Switzerland); Elliott, Marina [Simon Fraser University, Department of Archaeology, Burnaby, BC (Canada); Oestreich, Andrea; Kraemer, Thomas [University of Zurich, Department of Forensic Pharmacology and Toxicology, Institute of Forensic Medicine, Zurich (Switzerland); Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland)

    2014-06-15

    To investigate frequent findings in cases of fatal opioid intoxication in whole-body post-mortem computed tomography (PMCT). PMCT of 55 cases in which heroin and/or methadone had been found responsible for death were retrospectively evaluated (study group), and were compared with PMCT images of an age- and sex-matched control group. Imaging results were compared with conventional autopsy. The most common findings in the study group were: pulmonary oedema (95 %), aspiration (66 %), distended urinary bladder (42 %), cerebral oedema (49 %), pulmonary emphysema (38 %) and fatty liver disease (36 %). These PMCT findings occurred significantly more often in the study group than in the control group (p < 0.05). The combination of lung oedema, brain oedema and distended urinary bladder was seen in 26 % of the cases in the study group but never in the control group (0 %). This triad, as indicator of opioid-related deaths, had a specificity of 100 %, as confirmed by autopsy and toxicological analysis. Frequent findings in cases of fatal opioid intoxication were demonstrated. The triad of brain oedema, lung oedema and a distended urinary bladder on PMCT was highly specific for drug-associated cases of death. (orig.)

  16. Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

    To investigate frequent findings in cases of fatal opioid intoxication in whole-body post-mortem computed tomography (PMCT). PMCT of 55 cases in which heroin and/or methadone had been found responsible for death were retrospectively evaluated (study group), and were compared with PMCT images of an age- and sex-matched control group. Imaging results were compared with conventional autopsy. The most common findings in the study group were: pulmonary oedema (95 %), aspiration (66 %), distended urinary bladder (42 %), cerebral oedema (49 %), pulmonary emphysema (38 %) and fatty liver disease (36 %). These PMCT findings occurred significantly more often in the study group than in the control group (p < 0.05). The combination of lung oedema, brain oedema and distended urinary bladder was seen in 26 % of the cases in the study group but never in the control group (0 %). This triad, as indicator of opioid-related deaths, had a specificity of 100 %, as confirmed by autopsy and toxicological analysis. Frequent findings in cases of fatal opioid intoxication were demonstrated. The triad of brain oedema, lung oedema and a distended urinary bladder on PMCT was highly specific for drug-associated cases of death. (orig.)

  17. Metastatic hepatocellular carcinoma of the maxillary sinus: a rare autopsy case without lung metastasis and a review.

    Okada, H; Kamino, Y; Shimo, M; Kitamura, E; Katoh, T; Nishimura, H; Akimoto, Y; Kaneda, T; Hinata, M; Yamamoto, H

    2003-02-01

    A rare case of metastatic hepatocellular carcinoma (HCC) of the maxillary sinus in a 67-year-old man is reported along with the findings at autopsy. A fine needle aspiration biopsy specimen revealed a characteristic tumour structure resembling primary HCC. At autopsy, metastatic lesions were recognized in the bilateral adrenals, spleen, sternum, vertebrae and lymph node at the lesser curvature of the stomach, but not in the lung, suggesting that the HCC had metastasized to the maxillary sinus via the plexus venous vertebralis and/or the azygos vein, or lymph duct. In our reviewed 29 cases of metastatic HCC in the oro-maxillofacial region, most patients were men in the 50- to 70-year age range. At least 11 cases did not have lung metastasis, and in 18, metastasis to the oro-maxillofacial region was the first sign of HCC. One should be aware of the possibility to encounter the oral lesion as first sign of metastatic HCC. PMID:12653243

  18. Evaluation of the World Health Organization 2009 classification of dengue severity in autopsied individuals, during the epidemics of 2011 and 2012 in Brazil

    Luciano Pamplona de Góes Cavalcanti

    2015-12-01

    Full Text Available Abstract: INTRODUCTION: The dengue classification proposed by the World Health Organization (WHO in 2009 is considered more sensitive than the classification proposed by the WHO in 1997. However, no study has assessed the ability of the WHO 2009 classification to identify dengue deaths among autopsied individuals suspected of having dengue. In the present study, we evaluated the ability of the WHO 2009 classification to identify dengue deaths among autopsied individuals suspected of having dengue in Northeast Brazil, where the disease is endemic. METHODS: This retrospective study included 121 autopsied individuals suspected of having dengue in Northeast Brazil during the epidemics of 2011 and 2012. All the autopsied individuals included in this study were confirmed to have dengue based on the findings of laboratory examinations. RESULTS: The median age of the autopsied individuals was 34 years (range, 1 month to 93 years, and 54.5% of the individuals were males. According to the WHO 1997 classification, 9.1% (11/121 of the cases were classified as dengue hemorrhagic fever (DHF and 3.3% (4/121 as dengue shock syndrome. The remaining 87.6% (106/121 of the cases were classified as dengue with complications. According to the 2009 classification, 100% (121/121 of the cases were classified as severe dengue. The absence of plasma leakage (58.5% and platelet counts <100,000/mm3 (47.2% were the most frequent reasons for the inability to classify cases as DHF. CONCLUSIONS: The WHO 2009 classification is more sensitive than the WHO 1997 classification for identifying dengue deaths among autopsied individuals suspected of having dengue.

  19. Postmortem computed tomography and magnetic resonance imaging facilitates forensic autopsy in a fatal case of poisoning with formic acid, diphenhydramine, and ethanol.

    Berger, Florian; Steuer, Andrea E; Rentsch, Katharina; Gascho, Dominic; Stamou, Stamatios; Schärli, Sarah; Thali, Michael J; Krämer, Thomas; Flach, Patricia M

    2016-09-01

    A case of fatal poisoning by ingesting formic acid, diphenhydramine, and ethanol by a 25-year-old woman who committed suicide is presented. Prior to autopsy, postmortem computed tomography and postmortem magnetic resonance tomography were performed and revealed severe damage to the stomach, the left thoracic wall, and parts of the liver. Imaging detected acid-induced fluid-fluid level within the thoracic cavity (fat-equivalent fluid and necrotic pleural effusion). This case report illustrates that postmortem cross-sectional imaging may facilitate dissection of severely damaged or complex regions, and may provide additional information compared to autopsy and toxicological examinations alone. PMID:27427196

  20. Remodeling of the pulmonary artery induced by metastatic gastric carcinoma: a histopathological analysis of 51 autopsy cases

    Gastric carcinoma remains the second commonest cause of cancer deaths worldwide. Presence of the carcinoma cell in the pulmonary artery is serious condition that might cause remodeling of the pulmonary artery. The present study conducted detailed histopathological analyses to elucidate how gastric carcinoma cells may affect the structure and hemodynamics of pulmonary arteries. Remodeling of the pulmonary artery was assessed based on measurements of arterial diameters and stenosis rates from the autopsies, and their correlation were also validated. We additionally calculated 95 percent confidential intervals (CIs) for the rate of stenosis in groups of pulmonary arteries of different caliber zones (under 100, 100 to 300, and over 300 micrometer). The right ventricular thickness was measured and examined whether it correlated with the rate of pulmonary arterial stenosis. A total of 4612 autopsy cases were recorded at our institute, among which 168 had gastric carcinoma. Finally, 51 cases of the gastric carcinoma were employed for the study which had carcinoma cells in the lumen of the pulmonary artery. The mean right ventricular wall thickness of these cases was 3.14 mm. There were significant positive associations between the rates of pulmonary arterial stenosis and right ventricular thickness from pulmonary arteries of diameter under 100, 100 to 300, and over 300 micrometer. In these zones, 31, 31, and 33 cases had rates of pulmonary arterial stenosis that were below the lower limit of the 95 percent CI values, respectively. On the other hand, among cases with significant pulmonary stenosis, 17 of 18 cases with stenosis in the over 300 micrometer zone involved pulmonary arteries of both in the under 100 and 100 to 300 micrometer zones. One-third of autopsy with advanced gastric carcinoma had carcinoma cells in lumen of pulmonary artery, but implantation and proliferation may be essential to induce intimal thickening that causes an increasing of pulmonary arterial

  1. A state-of-the-art pipeline for postmortem CT and MRI visualization: from data acquisition to interactive image interpretation at autopsy

    The importance of autopsy procedures leading to the establishment of the cause of death is well-known. A recent addition to the autopsy work flow is the possibility of conducting postmortem imaging, in its 3D version also called virtual autopsy (VA), using multidetector computed tomography (MDCT) or magnetic resonance imagining (MRI) data from scans of cadavers displayed with direct volume rendering (DVR) 3D techniques. The use of the data and their workflow are presented. Data acquisition was performed and high quality data-sets with submillimeter precision were acquired. New data acquisition techniques such as dual-energy CT (DECT) and quantitative MRI, then were implemented and provided additional information. Particular findings hardly visualized in conventional autopsy can rather easy be seen at the full body CT, such as air distribution, e.g. pneumothorax, pneumopericardium, air embolism, and wound channels. MRI shows natural deaths such as myocardial infarctions. Interactive visualization of these 3D data-sets can provide valuable insight into the corpses and enables non-invasive diagnostic procedures. In postmortem CT imaging, not being limited by a patient depending radiation dose limit the data-sets can, however, be generated with such a high resolution that they become difficult to handle in today's archive retrieval and interactive visualization systems, specifically in the case of full body scans. To take full advantage of these new technologies the postmortem workflow needs to be tailored to the demands and opportunities that the new technologies allow

  2. A state-of-the-art pipeline for postmortem CT and MRI visualization: from data acquisition to interactive image interpretation at autopsy

    Persson, Anders (Center for Medical Image Science and Visualization (CMIV), Univ. of Linkoeping, Linkoeping (Sweden); Dept. of Radiology of Medical and Health Sciences (IMH), Linkoeping Univ. Hospital, Linkoeping (Sweden)), email: anders.persson@cmiv.liu.se; Lindblom, Maria (Dept. of Radiology of Medical and Health Sciences (IMH), Linkoeping Univ. Hospital, Linkoeping (Sweden)); Jackowski, Christian (Inst. of Legal Medicine, Univ. of Zurich, Zurich (Switzerland))

    2011-06-15

    The importance of autopsy procedures leading to the establishment of the cause of death is well-known. A recent addition to the autopsy work flow is the possibility of conducting postmortem imaging, in its 3D version also called virtual autopsy (VA), using multidetector computed tomography (MDCT) or magnetic resonance imagining (MRI) data from scans of cadavers displayed with direct volume rendering (DVR) 3D techniques. The use of the data and their workflow are presented. Data acquisition was performed and high quality data-sets with submillimeter precision were acquired. New data acquisition techniques such as dual-energy CT (DECT) and quantitative MRI, then were implemented and provided additional information. Particular findings hardly visualized in conventional autopsy can rather easy be seen at the full body CT, such as air distribution, e.g. pneumothorax, pneumopericardium, air embolism, and wound channels. MRI shows natural deaths such as myocardial infarctions. Interactive visualization of these 3D data-sets can provide valuable insight into the corpses and enables non-invasive diagnostic procedures. In postmortem CT imaging, not being limited by a patient depending radiation dose limit the data-sets can, however, be generated with such a high resolution that they become difficult to handle in today's archive retrieval and interactive visualization systems, specifically in the case of full body scans. To take full advantage of these new technologies the postmortem workflow needs to be tailored to the demands and opportunities that the new technologies allow

  3. Improved discrimination of autopsy-confirmed Alzheimer's disease (AD) from non-AD dementias using CSF P-tau181P

    Koopman, Karen; Le Bastard, Nathalie; Martin, Jean Jacques; Nagels, Guy; De Deyn, Peter P.; Engelborghs, Sebastiaan

    2009-01-01

    To establish diagnostic accuracy (acc) and optimal cut-off levels of CSF tau phosphorylated at threonine 181 (P-tau(181P)) for discriminating Alzheimer's disease (AD) from non-AD dementias in autopsy-confirmed dementia patients, CSF levels of beta-amyloid peptide (A beta(1-42)). total tau protein (T

  4. Characteristics of cirrhosis undiagnosed during life: a comparative analysis of 73 undiagnosed cases and 149 diagnosed cases of cirrhosis, detected in 4929 consecutive autopsies

    Graudal, Niels; Leth, Peter Mygind; Mårbjerg, Lone;

    1991-01-01

    In 4929 consecutive autopsies performed during a period of 4 years, 222 cases (4.5%) of cirrhosis were found, of which 149 (3%) were detected while the patients were alive (diagnosed cirrhosis) and 73 (1.5%) were not detected while the patients were living (undiagnosed cirrhosis). Fifty-three of...

  5. An autopsy case of acute multiple sclerosis with multifocal low density areas in the cerebral white matter on CT scans

    A 34-year-old woman presented with urination difficulty and consciousness disturbance, followed by persistent neurologic findings, such as semicomatose mental status and bilateral optic neuritis, and monophasic clinical course. Cranial CT showed multifocal low density areas in cerebral white matter. The patient was clinically diagnosed as having acute disseminated encephalomyelitis. She died of sepsis four months later. Autopsy revealed multifocal large demyelinating lesions confined to the cerebral white matter, shown as low density areas on CT scans, and demyelinating plaques scattered in the optic nerves and chiasm, and cerebral peduncle. The final diagnosis was acute multiple sclerosis. The CT appearance of multifocal low density areas was most likely due to demyelinating lesions causing edema and tissue necrosis. (Namekawa, K.)

  6. Biomechanical and histologic investigation of cemented total hip arthroplasties. A study of autopsy-retrieved femurs after in vivo cycling.

    Maloney, W J; Jasty, M; Burke, D W; O'Connor, D O; Zalenski, E B; Bragdon, C; Harris, W H

    1989-12-01

    Eleven whole anatomic specimens of the femur were retrieved at autopsy from patients who previously had cemented total hip arthroplasty. Implant duration ranged from 0.5 to 210 months. Clinically and roentgenographically the implants were stable. A detailed biomechanical analysis evaluated bone strains and implant stability in both the single-limb stance and stair-climbing positions using a 100-pound spinal load. The stability offered by cement in these well-fixed prostheses was remarkable, with the maximum axial micromotion being 40 mu. This is a reflection of intimate osseointegration at the bone-cement interface with only rare intervening fibrous tissue. The strain gauge and photoelastic strain-coating studies revealed that marked stress shielding in the proximal medial femoral cortex persists long after a cemented femoral component is inserted. Even 17 years after surgery, the strain in the calcar region did not normalize. PMID:2582664

  7. An autopsy study of cerebrovascular disease in Japanese men who lived in Hiroshima, Japan and Honolulu, Hawaii

    Evidence of cerebrovascular disease at autopsy was compared in two groups of men, 186 long time residents of Hiroshima, Japan and 253 men of Japanese ancestry long resident in Honolulu, Hawaii. They were from 45 to 71 years of age at death. Atherosclerosis of the circle of Willis and its major branches, sclerosis of the intraparenchymal arteries and the frequency of cerebral hemorrhage and cerebral infarct were compared in the two populations. The Honolulu subjects had significantly more atherosclerosis of the circle of Willis, but less intraparenchymal artery sclerosis and less cerebral infarction. Cerebral hemorrhage was equally frequent in the two cities. It was concluded that cerebral infarction is more frequent in Japanese men in Hiroshima than Honolulu, and that men of Japanese ancestry in Honolulu are spared an appreciable risk of cerebral infarction through decreased frequency of intraparenchymal arterial sclerosis despite higher levels of atherosclerosis of large intracranial arteries. (author)

  8. A double-suicide autopsy case of potassium poisoning by intravenous administration of potassium aspartate after intake of some psychopharmaceuticals.

    Watanabe, K; Hasegawa, K; Suzuki, O

    2011-07-01

    We report a curious double-suicide autopsy case of both male and female who died of potassium poisoning by intravenous administration of concentrated potassium aspartate solution. The plasma concentrations of potassium of the male and female subjects were as high as 49.7 and 62.8 mEq/L, respectively. In addition to the high concentrations of potassium, toxic levels of phenobarbital, promethazine and chlorpromazine, and relatively low levels of etizolam and brotizolam were also detected from whole blood and urine specimens of both cadavers. Twenty empty plastic bottles (10-mL capacity) labeled 'ASPARA® Potassium Injection 10 mEq' were found at the suicide spot. To our knowledge, this is the first description for suicidal death by potassium aspartate; in all of the previous literature, they used potassium chloride intravenously or per os. PMID:20670988

  9. An escape from agony: A qualitative psychological autopsy study of women's suicide in a post-conflict Northern Uganda

    Dorothy Kizza

    2012-09-01

    Full Text Available We set out to investigate suicide among women in a post-conflict context in Northern Uganda using qualitative psychological autopsy interviews. Three to five relatives and friends for each of the three suicides recruited were interviewed (N=11. Through interpretative phenomenological analysis (IPA we found that the women all had been through traumatic experiences attributable to the protracted war/conflict between the rebel groups and Ugandan Government armed forces. Nevertheless, the decision of self-inflicted death seemed to have been due to a combination of unpleasant experiences/events that prevailed within the last 3 months prior to the suicide. These experiences are summarized in two broad themes: No control in life and No care. Changes in the traditional gender roles, men's quest for their lost masculinity, and women's attempt to fight for their rights that was perceived as a cultural transgression contributed to the women's suicides.

  10. Primary management of esophageal carcinoma with radiation therapy and surgery and correlation of failure pattern based on autopsy findings

    This paper reports a study of forty-seven patients with esophageal carcinoma who were treated definitively with radiation therapy (n = 18) and radical surgery (n = 18) or received palliative treatment (n = 11) at the Medical College of Virginia between 1967 and 1982. The average intervals between diagnosis and death were 5, 7, and 4 months, respectively. Autopsy revealed that 80% with radiation therapy and 50% in the surgery group had persistent local-regional disease. Eleven of 36 had adrenal metastasis and eight of 36 had a second primary in the head, neck, lung or prostate. The data show a significant incidence of persistent disease in spite of negative surgical margins. Additional treatment with chemotherapy or postoperative radiation therapy should be considered

  11. An autopsy case of multiple myeloma with veno-occlusive disease of the liver induced by ionizing radiation

    An autopsy case of multiple myeloma which accompanied radiation-induced veno-occlusion of the liver is presented. A 62-year-old woman with a chief complaint of low back pain was diagnosed as having multiple myeloma. Approximately one year later, the patient was treated with chemotherapy, consisting of VCR, MCNU, ADR, PSL, and CPA, and X-irradiation of 30 Gy to the bilateral trunk for medically intractable rib pain. The irradiation field included the entire liver. Six months later, she was admitted to the hospital due to abdominal distention and massive amounts of ascites. Various examinations failed to make a qualitative diagnosis. Postmortem examination revealed fibrotic occlusion of the central vein which is typical for veno-occlusion disease of the liver. This finding was restricted to the area that was not shielded, irrespective of anatomical structure, strongly suggesting radiation-induced veno-occlusion of the liver. (N.K.)

  12. An autopsy case of Hermansky-Pudlak syndrome: a case report and review of the literature on treatment.

    Harada, Tatsuhiko; Ishimatsu, Yuji; Nakashima, Shota; Miura, Shiro; Tomonaga, Masaomi; Kakugawa, Tomoyuki; Hara, Shintaro; Sakamoto, Noriho; Yoshii, Chiharu; Mukae, Hiroshi; Kawabata, Yoshinori; Kohno, Shigeru

    2014-01-01

    Hermansky-Pudlak syndrome (HPS) is a rare genetic disorder, the most common complication of which influencing the prognosis is pulmonary fibrosis. In the present report, we describe an autopsy case of a Japanese woman with HPS. The patient was diagnosed at 50 years of age based on the presence of oculocutaneous albinism, hemorrhagic diathesis, ceroid-lipofuscin accumulation and pulmonary fibrosis. Although systemic steroids, immunosuppressants and pirfenidone were administered for pulmonary involvement, she died from respiratory failure two years later. Obtaining an early diagnosis and taking into consideration the need for lung transplantation is necessary in order to improve the prognosis of HPS. We herein report this very rare Japanese case of HPS with a review of the treatment approaches for HPS complicated with pulmonary fibrosis. PMID:25447654

  13. Strategies for searching medical natural language text. Distribution of words in the anatomic diagnoses of 7000 autopsy subjects.

    Moore, G W; Hutchins, G M; Miller, R E

    1984-04-01

    Computerized indexing and retrieval of medical records is increasingly important; but the use of natural language versus coded languages (SNOP, SNOMED) for this purpose remains controversial. In an effort to develop search strategies for natural language text, the authors examined the anatomic diagnosis reports by computer for 7000 consecutive autopsy subjects spanning a 13-year period at The Johns Hopkins Hospital. There were 923,657 words, 11,642 of them distinct. The authors observed an average of 1052 keystrokes, 28 lines, and 131 words per autopsy report, with an average 4.6 words per line and 7.0 letters per word. The entire text file represented 921 hours of secretarial effort. Words ranged in frequency from 33,959 occurrences of "and" to one occurrence for each of 3398 different words. Searches for rare diseases with unique names or for representative examples of common diseases were most readily performed with the use of computer-printed key word in context (KWIC) books. For uncommon diseases designated by commonly used terms (such as "cystic fibrosis"), needs were best served by a computerized search for logical combinations of key words. In an unbalanced word distribution, each conjunction (logical and) search should be performed in ascending order of word frequency; but each alternation (logical inclusive or) search should be performed in descending order of word frequency. Natural language text searches will assume a larger role in medical records analysis as the labor-intensive procedure of translation into a coded language becomes more costly, compared with the computer-intensive procedure of text searching. PMID:6546837

  14. Quantification of immunohistochemical findings of neurofibrillary tangles and senile plaques for a diagnosis of dementia in forensic autopsy cases.

    Takayama, Mio; Kashiwagi, Masayuki; Matsusue, Aya; Waters, Brian; Hara, Kenji; Ikematsu, Natsuki; Kubo, Shin-Ichi

    2016-09-01

    We report the quantification of immunohistochemical findings for a diagnosis of dementia in autopsy cases among older decedents. Autopsy cases were selected with the following requirements: >65yo; no head injuries, thermal injuries, or heat stroke; no intracranial lesions; and within 48h of death. Among cases that met all requirements, 10 had a clinical diagnosis of dementia were included in dementia group. Non-dementia group consisted of 38 cases without any record of dementia. To compare these groups, immunohistochemically, beta-amyloid, tau protein, gephyrin, and IL-33 were examined in five regions. Quantitative analysis was performed by collecting with image data analyzed using analysis software. Image data on tau-immunopositive neurofibrillary tangles (NFT) and beta-amyloid-positive senile plaques (SP) were photographed. Criteria for dementia were made by counting and measuring NFT and SP from image data using software. Differences in SP and NFT were effective for discriminating between the two groups. These criteria may reveal the presence and progression of dementia. Total of tau-positive NFT in Ammon's horn (AH) may be useful for diagnosing dementia. When the total is more than 41 in approximately 6mm(2) of AH, the possibility of dementia is considered. Total of beta-amyloid-positive SP in the parahippocampal gyrus (PHG) may be useful for diagnosing dementia. When the total in approximately 5mm(2) of PHG is more than 47, the possibility of dementia is considered. Immunohistochemical staining may be more useful for obtaining image data for quantification than conventional staining techniques, such as Bielschowsky-Hirano's silver staining. PMID:27591545

  15. Verbal autopsy: reliability and validity estimates for causes of death in the Golestan Cohort Study in Iran.

    Hooman Khademi

    Full Text Available BACKGROUND: Verbal autopsy (VA is one method to obtain valid estimates of causes of death in the absence of valid medical records. We tested the reliability and validity of a VA questionnaire developed for a cohort study in Golestan Province in northeastern Iran. METHOD: A modified version of the WHO adult verbal autopsy was used to assess the cause of death in the first 219 Golestan Cohort Study (GCS subjects who died. The GCS cause of death was determined by two internists who independently reviewed all available medical records. Two other internists ("reviewers" independently reviewed only the VA answers and classified the cause of death into one of nine general categories; they repeated this evaluation one month later. The reliability of the VA was measured by calculating intra-reviewer and inter-reviewer kappa statistics. The validity of the VA was measured using the GCS cause of death as the gold standard. RESULTS: VA showed both good validity (sensitivity, specificity, PPV, and NPV all above 0.81 and reliability (kappa>0.75 in determining the general cause of death independent of sex and place of residence. The overall multi-rater agreement across four reviews was 0.84 (95%CI: 0.78-0.89. The results for identifying specific cancer deaths were also promising, especially for upper GI cancers (kappa = 0.95. The multi-rater agreement in cancer subgroup was 0.93 (95%CI: 0.85-0.99. CONCLUSIONS: VA seems to have good reliability and validity for determining the cause of death in a large-scale adult follow up study in a predominantly rural area of a middle-income country.

  16. Performance of InterVA for assigning causes of death to verbal autopsies: multisite validation study using clinical diagnostic gold standards

    Flaxman Abraham D

    2011-08-01

    Full Text Available Abstract Background InterVA is a widely disseminated tool for cause of death attribution using information from verbal autopsies. Several studies have attempted to validate the concordance and accuracy of the tool, but the main limitation of these studies is that they compare cause of death as ascertained through hospital record review or hospital discharge diagnosis with the results of InterVA. This study provides a unique opportunity to assess the performance of InterVA compared to physician-certified verbal autopsies (PCVA and alternative automated methods for analysis. Methods Using clinical diagnostic gold standards to select 12,542 verbal autopsy cases, we assessed the performance of InterVA on both an individual and population level and compared the results to PCVA, conducting analyses separately for adults, children, and neonates. Following the recommendation of Murray et al., we randomly varied the cause composition over 500 test datasets to understand the performance of the tool in different settings. We also contrasted InterVA with an alternative Bayesian method, Simplified Symptom Pattern (SSP, to understand the strengths and weaknesses of the tool. Results Across all age groups, InterVA performs worse than PCVA, both on an individual and population level. On an individual level, InterVA achieved a chance-corrected concordance of 24.2% for adults, 24.9% for children, and 6.3% for neonates (excluding free text, considering one cause selection. On a population level, InterVA achieved a cause-specific mortality fraction accuracy of 0.546 for adults, 0.504 for children, and 0.404 for neonates. The comparison to SSP revealed four specific characteristics that lead to superior performance of SSP. Increases in chance-corrected concordance are attained by developing cause-by-cause models (2%, using all items as opposed to only the ones that mapped to InterVA items (7%, assigning probabilities to clusters of symptoms (6%, and using empirical

  17. Epidemiologic application of verbal autopsy to investigate the high occurrence of cancer along Huai River Basin, China

    Ding Ding

    2011-08-01

    Full Text Available Abstract Background In 2004, the media repeatedly reported water pollution and "cancer villages" along the Huai River in China. Due to the lack of death records for more than 30 years, a retrospective survey of causes of death using verbal autopsy was carried out to investigate cancer rates in this area. Methods An epidemiologic study was designed to compare numbers of deaths and causes of death between the study areas with water pollution and the control areas without water pollution in S County and Y District in 2005. The study areas were selected based on the distribution of the Huai River and its tributaries. Verbal autopsy was used to assist cause of death (COD diagnoses and to verify mortality rates. The standard mortality rates (SMRs of cancer in the study area were compared with those in the control areas. In order to verify the difference between mortality rates due to cancers in the study and the control areas, patients who reported having cancer in the survey received a second diagnosis by national and provincial oncologists with pathological and laboratory examinations. Comparisons were made to determine if differential cancer prevalence rates in the study and control areas were similar to the difference in mortality due to cancer in these study and control areas. Mortality rates of cancers in study and control areas were also compared with national statistics for the rural population of China. Results Over five years, 3,301 deaths were identified, including 1,158 cancer deaths. The annual average SMRs of cancer in the study areas of S County and Y District were 277.8/100,000 and 223.6/100,000, respectively, which is three to four times higher than those in the control areas. In addition, a total of 626 cases of cancer in the study and control areas were confirmed. The prevalence rates of cancer were 545/100,000 and 128.1/100,000 per year in the study and control areas in S County, respectively, and 440.9/100,000 and 200/100,000 per

  18. Verbal/social autopsy study helps explain the lack of decrease in neonatal mortality in Niger, 2007–2010

    Kalter, Henry D; Yaroh, Asma Gali; Maina, Abdou; Koffi, Alain K; Bensaïd, Khaled; Amouzou, Agbessi; Black, Robert E

    2016-01-01

    Background This study was one of a set of verbal/social autopsy (VASA) investigations undertaken by the WHO/UNICEF–supported Child Health Epidemiology Reference Group to estimate the causes and determinants of neonatal and child deaths in high priority countries. The study objective was to help explain the lack of decrease in neonatal mortality in Niger from 2007 to 2010, a period during which child mortality was decreasing. Methods VASA interviews were conducted of a random sample of 453 neonatal deaths identified by the 2010 Niger National Mortality Survey (NNMS). Causes of death were determined by expert algorithm analysis, and the prevalence of household, community and health system determinants were examined along the continuum of maternal and newborn care, the Pathway to Survival for newborn illnesses, and an extended pathway for maternal complications. The social autopsy findings were compared to available data for survivors from the same cohort collected by the NNMS and the 2012 Niger Demographic and Health Survey. Findings Severe neonatal infection and birth asphyxia were the leading causes of early neonatal death in the community and facilities. Death in the community after delayed careseeking for severe infection predominated during the late neonatal period. The levels of nearly all demographic, antenatal and delivery care factors were in the direction of risk for the VASA study decedents. They more often resided rurally (P < 0.001) and their mothers were less educated (P = 0.03) and gave birth when younger (P = 0.03) than survivors’ mothers. Their mothers also were less likely to receive quality antenatal care (P < 0.001), skilled attendance at birth (P = 0.03) or to deliver in an institution (P < 0.001). Nearly half suffered an obstetric complication, with more maternal infection (17.9% vs 0.2%), antepartum hemorrhage (12.5% vs 0.5%) and eclampsia/preeclampsia (9.5% vs 1.6%) than for all births in Niger. Their mothers also

  19. Social determinants of child mortality in Niger: Results from the 2012 National Verbal and Social Autopsy Study

    Koffi, Alain K; Maina, Abdou; Yaroh, Asma Gali; Habi, Oumarou; Bensaïd, Khaled; Kalter, Henry D

    2016-01-01

    Background Understanding the determinants of preventable deaths of children under the age of five is important for accelerated annual declines – even as countries achieve the UN’s Millennium Development Goals and the target date of 2015 has been reached. While research has documented the extent and nature of the overall rapid decline in child mortality in Niger, there is less clear evidence to provide insight into the contributors to such deaths. This issue is the central focus of this paper. Methods We analyzed a nationally representative cross–sectional sample of 620 child deaths from the 2012 Niger Verbal Autopsy/Social Autopsy (VASA) Survey. We conducted a descriptive analysis of the data on preventive and curative care, guided by the coverage of proven indicators along the continuum of well child care and illness recognition and care–seeking for child illnesses encompassed by the BASICS/CDC Pathway to Survival model. Results Six hundred twenty deaths of children (1–59 months of age) were confirmed from the VASA survey. The majority of these children lived in households with precarious socio–economic conditions. Among the 414 children whose fatal illnesses began at age 0–23 months, just 24.4% were appropriately fed. About 24% of children aged 12–59 months were fully immunized. Of 601 children tracked through the Pathway to Survival, 62.4% could reach the first health care provider after about 67 minutes travel time. Of the 306 children who left the first health care provider alive, 161 (52.6%) were not referred for further care nor received any home care recommendations, and just 19% were referred to a second provider. About 113 of the caregivers reported cost (35%), distance (35%) and lack of transport (30%) as constraints to care–seeking at a health facility. Conclusion Despite Niger’s recent major achievements in reducing child mortality, the following determinants are crucial to continue building on the gains the country has made

  20. Distribution of pseudoexfoliation material on anterior segment structures in human autopsy eyes after cataract surgery with intraocular lens implantation.

    Schmack, Ingo; Auffarth, Gerd Uwe

    2016-06-01

    The purpose of the study was to evaluate the distribution and amount of pseudoexfoliation material (PXM) on anterior segment structures in pseudophakic human autopsy eyes with pseudoexfoliation (PEX) syndrome and to study its impact on fixation and decentration of posterior chamber intraocular lenses (IOLs). Sixteen human autopsy eyes (donor age [mean ± SD] 77.5 ± 8.6 years; range, 70-90 years) with history of cataract surgery and PEX syndrome were analyzed for distribution and accumulation of PXM on structures of the anterior segment by light microscopy. Quantitative IOL decentration measurements were performed using the Miyake-Apple posterior view technique. All 16 eyes displayed IOLs which were either fixed symmetrically in the capsular bag (n = 8) or asymmetrically with one haptic in the sulcus and one in the bag (n = 7) or at the pars plicata of the ciliary body (n = 1). In the majority, PXM was found around the pars plicata (average grade: 1.6 ± 0.53 µm) and the lens capsule (average grade: 1.05 ± 0.46 µm). Minor amounts were detected at the pars plana and the trabecular meshwork. IOL decentration measurements ranged from 0.51 ± 0.35 (symmetrical-fixation) to 0.61 ± 0.43 mm (asymmetrical-fixation). There was only a weak statistically not significant correlation in regard to the amount of PXM and IOL decentration and between PXM distribution and the IOL fixation site. PXM contributes to weakening of the suspensory apparatus of the crystalline lens. Although PXM induced tissue alterations predispose for a broad spectrum of intra- and postoperative complications, the amount and distribution of PXM on different anterior segment structures showed only a weak correlation to IOL decentration or fixation location. PMID:26307751

  1. Patients with pelvic fractures due to falls: A paradigm that contributed to autopsy-based audit of trauma in Greece

    Kotsilianou Olympia

    2011-01-01

    Full Text Available Abstract Background Evaluation of the pelvic fractures (PFx population in auditing effective components of trauma care is the subject of this study. Methods A retrospective, case-control, autopsy-based study compared a population with PFx to a control-group using a template with trauma outcome variables, which included demographics, ICD-9, intention, mechanisms, toxicology, Abbreviated Injury Scale (AIS-90, Injury Severity Score (ISS, causes of haemorrhage, comorbidity, survival time, pre-hospital response, in hospital data, location of death, and preventable deaths. Results Of 970 consecutive patients with fatal falls, 209 (21.5% had PFx and constituted the PFx-group while 761 (78.5% formed the control-group. Multivariate analysis showed that gender, age, intention, and height of fall were risk factors for PFx. A 300% higher odds of a psychiatric history was found in the PFx-group compared to the control-group (p The median ISS was 50 (17-75 for the PFx-group and 26 (1-75 for the control-group (p Associated injuries were significantly more common in the PFx-group than in the control-group. Potentially preventable deaths (ISS A subset of 126 (60.3% potentially preventable deaths in the PFx-group had at least one AIS-90 code other than the PFx, denoting major haemorrhage. Deaths directly attributed to PFx were limited to 6 (2.9%. The median survival time was 30 minutes for the PFx-group and 20 hours for the control-group (p Pre-hospital mortality was significantly higher in the PFx-group i.e. 70.3% of the PFx-group versus 42.7% of the control-group (p Conclusions The PFx-group shared common causative risk factors, high severity and multiplicity of injuries that define the PFx-group as a paradigm of injury for audit. This reduced sample of autopsies substantially contributed to the audit of functional, infrastructural, management and prevention issues requiring transformation to reduce mortality.

  2. Interobserver agreement of the injury diagnoses obtained by postmortem computed tomography of traffic fatality victims and a comparison with autopsy results

    Leth, Peter Mygind; Struckmann, Henrik; Lauritsen, Jens

    2013-01-01

    The present study investigated the interobserver variation between a radiologist and a forensic pathologist in 994 injury diagnoses obtained by postmortem computed tomography (CT) of 67 traffic fatality victims, and the results were compared with diagnoses obtained by autopsy. The injuries were...... coded according to the abbreviated injury scale (AIS). We found a low interobserver variability for postmortem CT injury diagnoses, and the variability was the lowest for injuries with a high AIS severity score. The radiologist diagnosed more injuries than the pathologist, especially in the skeletal...... system, but the pathologist diagnosed more organ injuries. We recommend the use of a radiologist as a consultant for the evaluation of postmortem CT images. Training in radiology should be included in forensic medicine postgraduate training. CT was superior to autopsy in detecting abnormal air...

  3. [External and internal post mortem examination according to the german code of criminal procedure (StPO)--review of section 87 StPO with special emphasis on the forensic autopsy].

    Parzeller, Markus; Dettmeyer, Reinhard; Bratzke, Hansjürgen

    2009-01-01

    Section 87 subs. 2 of the German Code of Criminal Procedure stipulates that a forensic or court-ordered autopsy shall be performed by two physicians. One of them must be a "forensic medical officer" (in German "Gerichtsarzt") or the head of a public forensic or pathology institute or a physician of such an institute entrusted with this task and having specialist knowledge of forensic medicine. Recently, it has been suggested to amend Section 87 subs. 2 StPO to the effect that self-employed specialists in forensic medicine can also be entrusted with court-ordered autopsies. The authors object to such privatization of forensic autopsies for legal and factual reasons and recommend to keep the present regulation according to which one of the physicians conducting the autopsy is not only required to have the necessary professional qualification, but must also hold a public position as defined in the law. PMID:19323147

  4. Myocardial contrast defect associated with thrombotic coronary occlusion: Pre-autopsy diagnosis of a cardiac death with post-mortem CT angiography

    We report the case of a female who died of suspected acute myocardial infarction. Post-mortem CT angiography (PMCTA) was performed with intravascular contrast infusion before the standard autopsy, and it successfully demonstrated the complete thrombotic occlusion of a coronary artery and also a corresponding perfusion defect on myocardium. We herein describe the PMCTA findings of a cardiac death with special emphasis on the potential benefits of this novel CT technique in forensic practice

  5. Fatal Case of Hydrocarbon Aspiration and Use of Lipoid Cells as Corroborative Finding for Rapid Autopsy Diagnosis in Cases of Delayed Death

    Jaybhaye, Prasad L.; Shilawant, Santosh S.

    2014-01-01

    Accidental aspiration of diesel can cause consolidation, atelectasis, and abscess formation. Aspiration of diesel usually results into pneumonitis, which resolves completely within 5–7 days of treatment. Diesel aspiration resulting in bilateral pneumonia and death is rare and is scarcely documented in literature. Finding of lipoid cells in lung autopsy specimen is one of the important features of hydrocarbon aspiration. Unfortunately this important finding is not mentioned in most of the toxi...

  6. Fatal case of hydrocarbon aspiration and use of lipoid cells as corroborative finding for rapid autopsy diagnosis in cases of delayed death.

    Jaybhaye, Prasad L; Shilawant, Santosh S

    2014-01-01

    Accidental aspiration of diesel can cause consolidation, atelectasis, and abscess formation. Aspiration of diesel usually results into pneumonitis, which resolves completely within 5-7 days of treatment. Diesel aspiration resulting in bilateral pneumonia and death is rare and is scarcely documented in literature. Finding of lipoid cells in lung autopsy specimen is one of the important features of hydrocarbon aspiration. Unfortunately this important finding is not mentioned in most of the toxicology textbooks. Hence, we are reporting this case. PMID:25948973

  7. Myocardial contrast defect associated with thrombotic coronary occlusion: Pre-autopsy diagnosis of a cardiac death with post-mortem CT angiography

    Lee, Heon; Cha, Jang Gyu [Dept. of Radiology, Soonchunhyang University Hospital, Bucheon (Korea, Republic of); Park, Hye Jin; Lee, Soo Kyoung; Yang, Kyung Moo [Dept. of Forensic Medicine, National Forensic Service, Wonju (Korea, Republic of)

    2015-10-15

    We report the case of a female who died of suspected acute myocardial infarction. Post-mortem CT angiography (PMCTA) was performed with intravascular contrast infusion before the standard autopsy, and it successfully demonstrated the complete thrombotic occlusion of a coronary artery and also a corresponding perfusion defect on myocardium. We herein describe the PMCTA findings of a cardiac death with special emphasis on the potential benefits of this novel CT technique in forensic practice.

  8. Sclerosing encapsulating peritonitis (abdominal cocoon) associated with liver cirrhosis and diffuse large B-cell lymphoma: autopsy case.

    Yamada, Sohsuke; Tanimoto, Akihide; Matsuki, Yasumasa; Hisada, Yuji; Sasaguri, Yasuyuki

    2009-09-01

    A case of sclerosing encapsulating peritonitis (SEP) associated with liver cirrhosis (LC) and complicated by diffuse large B-cell lymphoma (DLBCL) is reported herein. A 49-year-old Japanese man had undergone peritoneo-venous shunt against refractory ascites due to hepatitis C virus-positive uncompensated LC for 2 years. After he received a diagnosis of DLBCL of the left neck lymph node 3 months before his death, palliative care was given because of his poor general condition. He developed severe abdominal distention and pain over 1 week and was found to have marked ascites and whole bowel lumped together on abdominal CT. At autopsy, the peritoneum was covered with a thick white membrane and the bowel could not be distinguished, which was macroscopically characterized by a cocoon-like appearance. Histology indicated a proliferation of diffusely thickened or hyalinized fibrocollagenous tissue in the entire peritoneum with a slight chronic inflammatory infiltrate and without remarkable change of mucosa. A diagnosis of SEP, also known as abdominal cocoon, was established based on these features. Additionally, in the abdominal cavity, a large amount of serous ascites and multiple peritoneal nodules or masses involved by DLBCL were recognized. To the authors' knowledge this is the first case report of SEP associated with LC and complicated by the invasion of DLBCL in the abdominal cavity. PMID:19712139

  9. Autopsy findings of human fetuses of descendant (F1, F2) of the A-bomb survivors

    An analysis was made of autopsy population of human fetuses and neonates (652 cases for F1 and 115 cases for F2 ) obtained from A-bomb exposed and non-exposed groups. In a study of delivery mode, the incidence of abnormal findings, including congenital anomaly, was found higher in the group of spontaneous delivery than the group of artificial delivery. Anomaly of the heart or great vessels was the most common, followed by anomaly of the central nervous system and urinary system in both F1 and F2 groups. Abnormal findings in the group of spontaneous delivery were observed in a total of 148 cases. For evaluable 32 cases in which the exposure distance was confirmed, these abnormalities were not related to distance from the hypocenter. Anomaly in this group was seen in 74 cases, in which autosomal dominant inheritance had induced chondrodystrophy (two cases) and polycystic kidney disease (one). For F2, anomaly was observed in 22 cases in the group of spontaneous delivery. Polycystic kidney disease was seen in each one case exposed at ≤2,000 m or 2,000-4,000 m from the hypocenter. The incidence of other anomalies was independent of exposure distance or either paternal or maternal exposure to A-bombing. Nor was correlation between the incidence of macerated fetuses and exposure distance or either paternal or maternal exposure. (N.K.)

  10. Distribution of volumes of individual glomeruli in kidneys at autopsy: association with physical and clinical characteristics and with ethnic group.

    Hoy, Wendy E; Hughson, Michael D; Diouf, Boucar; Zimanyi, Monika; Samuel, Terence; McNamara, Bridgette J; Douglas-Denton, Rebecca N; Holden, Libby; Mott, Susan A; Bertram, John F

    2011-01-01

    We have demonstrated considerable variability in the volumes of different glomeruli in given individuals (individual glomerular volume: IGV) in a stereologic study of kidneys at forensic autopsy performed to investigate sudden or unexpected death in people without manifest kidney disease. We review some important associations of IGV by subject characteristics and by ethnic groups. IGVs were measured by the Cavalieri method in 30 glomeruli in each of 111 adult males who belonged to 4 ethnic groups, i.e. US Whites, African-Americans, Africans from Senegal, and Australian Aborigines. Correlations of pooled IGV values with certain subject characteristics were evaluated in the US Whites. Pooled IGV data were compared in subjects across the 4 ethnic groups. In US Whites, mean IGV and its variance were greater with higher age, lower nephron number, lower birth weight, and with gross obesity, hypertension and cardiovascular death. In comparisons by ethnic group, mean IGV and IGV ranges were higher in African-Americans and Australian Aborigines than in US Whites and African Senegalese subjects. We conclude that glomerular enlargement with volume heterogeneity marks more advanced age, relative nephron deficiency, lower birth weight, obesity, hypertension, and advanced cardiovascular disease. The findings in African-Americans and Australian Aborigines suggest that larger IGVs and volume heterogeneity might mark populations with accentuated susceptibility to hypertension and kidney disease, but the data need to be further examined in the context of the determining characteristics defined in the US Whites. PMID:21659730

  11. Pathomorphology of the brain at autopsy in patients treated with radiation-chemoimmunotherapy (RAFP therapy) for malignant glioblastoma

    Fifteen patients with malignant glioblastoma (MGB) were treated with radiation and chemoimmunotherapy, consisting of ACNU + FT 207 + PSK, (RAFP therapy). Autopsy findings of the brain were examined pathomorphologically in these patients, and were compared with those in the other 15 MGB patients not treated with RAFP therapy. Viable tumor tissues massively remained in the primary tumor site in only three patients in the FAFP group; however, this finding was common in the control group (10/15). Tumor infiltration into the other cerebral lobes, contralateral cerebral hemisphere, and tumor tissues below the tentorium was infrequent and slight in the RAFP group, as compared with that in the control group. Radiation necrosis in the brain tissues surrounding the tumor was more noticeable in the FAFP group than in the control group. Widespread edema, which was considered due to radiation, was seen in association with damage in the brain parenchyma. Major causes of increased intracranial pressure were tumor necrotic lesions, their surrounding radiation-induced necrosis, and edema in the RAFP group, and an increase and infiltration of residual tumor tissues in the control group. The results suggest that radiation, as well as tumor size and infiltration, may have been responsible for severe failure of central nervous system function. (Namekawa, K.)

  12. Longitudinally Extensive Transverse Myelitis with Intramedullary Metastasis of Small-Cell Lung Carcinoma: An Autopsy Case Report

    Kenya Nishioka

    2013-01-01

    Full Text Available Background. Longitudinally extensive transverse myelitis (LETM is characterized by spinal cord inflammation extending vertically through three or more vertebral segments. The widespread use of MRI revealed LETM more frequency than ever. We report the case of a patient with pathologically confirmed small-cell lung carcinoma metastasis into the spinal cord presenting as LETM. Case Presentation. A 74-year-old man developed rapidly progressive sensorimotor disturbance and vesicorectal dysfunction. T2-weighted magnetic resonance imaging of the spine revealed LETM at the level of from T3 to conus medullaris; gadolinium enhancement showed concurrent tumor in the thoracic spinal cord from T10 to T11. Systemic survey identified a nodular mass in the lung that was verified as small-cell carcinoma. Following initial failed treatment by high-dose steroid, the patient underwent an emergent microsurgical tumor resection. Histological examination was identical with the lung carcinoma. The patient died of tumor progression at the 47th day after admission. At autopsy, only changes of edema were found in the gray matter of the cord, while tumor cells were not noted in it. Conclusion. Metastasis may rarely present symptoms of LETM. Prompt identification of underlying etiology by contrast examination and systemic survey is crucial for the patient assumed as LETM.

  13. GC-MS identification of MIC trimer: a constituent of tank residue in preserved autopsy blood of Bhopal gas victims.

    Chandra, H; Rao, G J; Saraf, A K; Sharma, V K; Jadhav, R K; Sriramachari, S

    1991-10-01

    Based on the external and internal findings of Bhopal gas disaster victims, it was apparent that the gases and particulate matter came out as an aerosol. This was possibly the pyrolysed, reformulated, reconjugated suspension of constituents of the tank E-610 of Union Carbide India Limited, Bhopal, while it was claimed to be methyl isocyanate (MIC) only. It was postulated by the manufacturer of MIC, that the material inhaled by the victims of the Bhopal gas disaster does not cross the lung barrier (UCC press conference on 14th December 1984). It was observed that the more the victims ran, the more aerosol they inhaled and the fatalities were observed in such victims. The tissues, which were preserved in the deep freeze, were randomly selected and analysed by GC coupled with MS (ITD) Finnigan MAT, UK. 14 out of 34 autopsy cases showed MIC trimer peak in extracts of blood. This was one of the constituents of the aerosol and was also located in the tank residue, thereby proving that the trimer had passed the lung barrier. PMID:1795611

  14. Streptococcus agalactiae infective endocarditis complicated by large vegetations at aortic valve cusps along with intracoronary extension: An autopsy case report.

    Ro, Ayako

    2016-01-01

    Streptococcus agalactiae infective endocarditis is a rare condition with high mortality owing to complications of large vegetations and systemic emboli. A 49-year-old man was found dead in his house. He had a history of hepatic cirrhosis and had been diagnosed with type 2 diabetes 2years previously. He had presented with a high fever 10days before his death. An autopsy revealed 50mL of purulent pericardial effusion, and S. agalactiae was detected from the culture of this pericardial effusion. Two slender rope-like vegetations were present at the right aortic valve cusp and noncoronary aortic valve cusp. The vegetation at the right aortic valve cusp extended into the right coronary artery. The right coronary artery was broadly occluded by white rod-like material. The mitral valves were also affected, and the posterior papillary muscle was ruptured. Myocardial infarction was not observed. Systemic microscopic Gram-positive bacterial masses were observed in several organs. The death was attributed to acute myocardial ischemia caused by occlusive intracoronary extension of the vegetation at the proximal right coronary artery. PMID:26926519

  15. Pulmonary alveolar proteinosis and glomerulonephritis in lysinuric protein intolerance: case reports and autopsy findings of four pediatric patients.

    Parto, K; Kallajoki, M; Aho, H; Simell, O

    1994-04-01

    Lysinuric protein intolerance is an autosomal recessive disease caused by defective transport of cationic amino acids. Of the 38 lysinuric protein intolerance patients diagnosed in Finland since 1965, four pediatric patients have died. We describe the clinical courses and autopsy findings for these patients. All patients developed acute respiratory insufficiency. In addition to pulmonary hemorrhages, three of the patients had pulmonary alveolar proteinosis and one had cholesterol granulomas. Three patients had a clinically obvious renal insufficiency, but all four showed histologic signs of immune complex-mediated glomerulonephritis. The patients also developed hepatic insufficiency with fatty degeneration or cirrhosis. All patients showed anemia, thrombocytopenia, and a severe bleeding tendency. The bone marrow of three patients was hypercellular, but the amount of megakaryocytes was decreased in two cases. Amyloid was present in the lymph nodes and the spleen. Bone specimens showed osteoporosis. We conclude that pediatric patients with lysinuric protein intolerance are predisposed to develop pulmonary alveolar proteinosis and glomerulonephritis. They are also at risk of protein malnutrition in the active growth phase, probably due to higher requirements for total nitrogen and amino acids. PMID:8163273

  16. A semi-structured interview for psychological autopsy in suicide cases Entrevista semi-estruturada para autópsia psicológica em casos de suicídio

    Blanca Guevara Werlang; Neury José Botega

    2003-01-01

    OBJECTIVE: To investigate the applicability and the interrater reliability of a Semi-Structured Interview for psychological autopsy in cases of suicide. METHOD: The Semi-Structured Interview for Psychological Autopsy (SSIPA) proposed in this paper consists of four modules which evaluate key-topics associated to suicide. In order to evaluate the instrument's applicability, a sample formed by 42 subjects related to 21 suicide cases was used. The interviews were tape-recorded first and then tran...

  17. Ovarian small cell carcinoma of pulmonary type appearing in ante-mortem ascites: An autopsy case and review of the literature

    Hirotsugu Hashimoto, MD

    2015-09-01

    Full Text Available Ovarian small cell carcinoma of pulmonary type (OSCCPT is an extremely rare and aggressive disease. The diagnostic significance of cytology of ascites for OSCCPT, however, has not been shown so far. Here, we report the diagnosis of this carcinoma in an autopsy case with ante-mortem cytology of ascites. A 75 year-old woman was detected with bilateral ovarian cancer by radiological imaging. Although operation was planned, massive ascites was discovered a few weeks later. Ascites was removed with abdominocentesis, which cytologically diagnosed presence of carcinoma, suspicious of adenocarcinoma. A few days later, she died. From autopsy samples, we diagnosed this case as bilateral OSCCPT, showing neuroendocrine differentiation by immunohistochemistry. We reviewed ante-mortem cytology of ascites and found scattered small atypical cells. Immunocytochemical study of the cell block of the ascites showed neuroendocrine differentiation of the atypical cells in an identical manner as the autopsy specimens. Since small atypical cells of OSCCPT often exist with other histological tumor components, careful screening of all cells on the preparation is advisable to accurately diagnose OSCCPT by cytology of ascites.

  18. Discrepancias entre diagnósticos clínicos y hallazgos de autopsia Discrepancies between clinical diagnoses and autopsy findings

    María Virginia Bürgesser

    2011-04-01

    Full Text Available El objetivo principal del presente trabajo fue identificar las discrepancias clínico-patológicas en las autopsias realizadas en la institución. Se revisaron 53 autopsias de casos clínicos en adultos en el período comprendido entre enero de 2005 y junio de 2009, realizadas en el servicio de Anatomía Patológica del Hospital Privado de Córdoba, Argentina. Se excluyeron seis debido a información insuficiente. Se aplicó la clasificación de Goldman y col. para establecer las discrepancias clínico-patológicas entre los diagnósticos pre y post-mortem. Los diagnósticos clínicos más frecuentes fueron las infecciones respiratorias y el tromboembolismo pulmonar agudo. Los hallazgos de autopsia más frecuentes fueron las infecciones respiratorias y el infarto agudo de miocardio. Se detectaron 17 discrepancias mayores y 30 concordancias, no se detectaron discrepancias menores. Las infecciones respiratorias fueron la principal causa de error, seguidas por el infarto agudo de miocardio. Concluimos que en 17/47 (37% de los casos se realizó un diagnóstico clínico diferente al post-mortem, y que las infecciones respiratorias constituyen el principal tipo de error. Se sugiere adoptar estrategias informativas y educativas, revalorizar la autopsia y las prácticas clínicas tradicionales.The main objective of this study was to identify the clinical-pathological discrepancies in autopsies performed in the institution. We reviewed autopsies of clinical cases in 53 adults in the period between January 2005 and June 2009, carried out in the Pathology Service at the Hospital Privado de Córdoba, Argentina. Six autopsies were excluded due to insufficient information. The Goldman et al. classification was applied to establish clinico-pathologic discrepancies between clinical diagnoses and autopsy findings. Frequently clinical diagnoses were respiratory infections and acute pulmonary embolism. The most frequently reported postmortem diagnoses were

  19. Traumatic brain injury as a risk factor for Alzheimer disease. Comparison of two retrospective autopsy cohorts with evaluation of ApoE genotype

    Wrocklage Christian

    2001-07-01

    Full Text Available Abstract Background and Purpose The impact of traumatic brain injury (TBI on the pathogenesis of Alzheimer disease (AD is still controversial. The aim of our retrospective autopsy study was to assess the impact of TBE and ApoE allele frequency on the development of AD. Material and Methods We examined 1. the incidence of AD pathology (Braak stageing, CERAD, NIA-Reagan Institute criteria in 58 consecutive patients (mean age ± SD 77.0 ± 6.8 years with residual closed TBI lesions, and 2. the frequency of TBI residuals in 57 age-matched autopsy proven AD cases. In both series, ApoE was evaluated from archival paraffin-embedded brain material. Results 1. TBE series: 12.1 % showed definite and 10.3% probable AD (mean age 77.6 and 75.2 years, only 2/13 with ApoEε3/4. From 45 (77.6% non-AD cases (mean age 78.2 years, 3 had ApoEε3/4. The prevalence of 22.4% AD in this small autopsy cohort was significantly higher than 3.3% in a recent large clinical series and 14% in the general population over age 70. 2. In the AD cohort with ApoEε4 allele frequency of 30% similar to other AD series, residuals of closed TBI were seen in 4 brains (7% (mean age ± SD 78.2 ± 6.4, all lacking the ApoEε4 allele. TBI incidence was slightly lower than 8.5% in the clinical MIRAGE study. Conclusions The results of this first retrospective autopsy study of TBI, ApoEε allele frequency, and AD confirm clinical studies suggesting severe TBI to be a risk factor for the development AD higher in subjects lacking ApoEε4 alleles. Further studies in larger autopsy series are needed to elucidate the relationship between TBI, genetic predisposition, and AD.

  20. Comparing verbal autopsy cause of death findings as determined by physician coding and probabilistic modelling: a public health analysis of 54 000 deaths in Africa and Asia

    Peter Byass

    2015-06-01

    Full Text Available Background: Coverage of civil registration and vital statistics varies globally, with most deaths in Africa and Asia remaining either unregistered or registered without cause of death. One important constraint has been a lack of fit–for–purpose tools for registering deaths and assigning causes in situations where no doctor is involved. Verbal autopsy (interviewing care–givers and witnesses to deaths and interpreting their information into causes of death is the only available solution. Automated interpretation of verbal autopsy data into cause of death information is essential for rapid, consistent and affordable processing. Methods: Verbal autopsy archives covering 54182 deaths from five African and Asian countries were sourced on the basis of their geographical, epidemiological and methodological diversity, with existing physician–coded causes of death attributed. These data were unified into the WHO 2012 verbal autopsy standard format, and processed using the InterVA–4 model. Cause–specific mortality fractions from InterVA–4 and physician codes were calculated for each of 60 WHO 2012 cause categories, by age group, sex and source. Results from the two approaches were assessed for concordance and ratios of fractions by cause category. As an alternative metric, the Wilcoxon matched–pairs signed ranks test with two one–sided tests for stochastic equivalence was used. Findings: The overall concordance correlation coefficient between InterVA–4 and physician codes was 0.83 (95% CI 0.75 to 0.91 and this increased to 0.97 (95% CI 0.96 to 0.99 when HIV/AIDS and pulmonary TB deaths were combined into a single category. Over half (53% of the cause category ratios between InterVA–4 and physician codes by source were not significantly different from unity at the 99% level, increasing to 62% by age group. Wilcoxon tests for stochastic equivalence also demonstrated equivalence. Conclusions: These findings show strong concordance

  1. Elements in autopsy liver tissue samples from Greenlandic Inuit and Danes. V. Selenium measured by X-ray fluorescence spectrometry.

    Milman, Nils; Laursen, Jens; Byg, Keld-Erik; Pedersen, Henning Sloth; Mulvad, Gerd; Hansen, Jens Christian

    2004-01-01

    The content of selenium in normal liver tissue samples from Greenlandic Inuit was measured and the results compared with those obtained in normal liver tissue samples from Danes. Normal liver tissue samples were obtained at autopsy from 50 Greenlandic Inuit (27 men, 23 women) with a median age of 61 years (range 23-83) and from 74 Danes (44 men, 30 women) with a median age of 60 years (range 15-87). Total liver selenium content was measured by X-ray fluorescence spectrometry. The content of selenium (median) was in Inuit 26.6 micromol/kg dry liver (5-95 percentile: 15.2-49.4) and in Danes 17.7 micromol/kg dry liver (5-95 percentile: < 3.8-36.5) (p < 0.0001). Liver selenium content displayed no significant gender difference, either in Inuit or Danes. In Inuit men, there was a negative correlation between liver selenium content and age (rs = -0.39, p < 0.05), whereas Danish men displayed a positive correlation between liver selenium content and age (rs = 0.37, p = 0.02). There was no correlation in Inuit or Danish women. In Inuit, the median hepatic selenium index (liver selenium content divided by age) was 0.48 and in Danes 0.33 (p = 0.001). There was an inverse correlation between hepatic selenium index and age both in Inuit (rs = -0.77, p < 0.0001) and in Danes (rs = -0.47, p < 0.0001). In conclusion, Inuit had a higher liver content of selenium and a higher hepatic selenium index compared with Danes. The more favourable selenium status is due to a higher nutritional selenium intake with fish and meat from sea mammals. PMID:15139392

  2. Elements in autopsy liver tissue samples from Greenlandic Inuit and Danes. III. Zinc measured by X-ray fluorescence spectrometry.

    Laursen, J; Milman, N; Pedersen, H S; Mulvad, G; Saaby, H; Byg, K E

    2001-01-01

    The aim of the study was to measure the content of zinc (Zn) in liver tissue samples from Greenlandic Inuit using X-ray fluorescence spectrometry, and compare the results with those obtained in liver samples from Danes. Normal liver tissue samples was obtained at autopsy from 50 Greenlandic Inuit (27 men) with a median age of 61 years (range 23-83) and from 74 Danes (44 men) with a median age of 60 years (range 15-87). In the entire series, liver zinc content in Inuit was not significantly different compared with Danes. There was no significant gender difference in liver zinc content either in Inuit or in Danes. The content of zinc given as median (5-95 percentile) was in Inuit 3.809 mmol/kg dry liver (2.355-7.406), and in Danes 3.992 mmol/kg dry liver (2.499-8.645). There was a significant, positive correlation between liver zinc content and age in Danish women (r(s) = 0.43, p = 0.02), which could not be demonstrated in Danish men or in Inuit. Median hepatic zinc index (zinc content in mmol/kg dry weight divided by age in years) in Inuit was 0.073, and in Danes 0.080 (p = 0.3) without any significant difference between the two genders. In Inuit and Danes there was an inverse correlation between hepatic zinc index and age both in the two genders and in the entire series: Inuit: r(s) = -0.62, p < 0.0001; Danes: r(s) = -0.70, p < 0.0001. The results indicate that Inuit have liver zinc levels, which are similar to those found in Danes. PMID:11846009

  3. Influence of ballistic and autopsy parameters on the manner of death in case of long firearms fatalities.

    de la Grandmaison, Geoffroy Lorin; Fermanian, Christophe; Aegerter, Philippe; Durigon, Michel

    2008-05-20

    A retrospective study was carried out on 132 fatalities due to gunshot wounds secondary to long firearms. One group of suicide (n=72) and one group of homicide (n=60) were statistically compared regarding age and sex of the victim, number of shots, range of fire, direction of the projectile(s), anatomical distribution of entrance sites, weapon and ammunition types and the nature of eventual associated traumatic lesions. The frequency of suicide was higher when the victim's age increased. Females constituted about 43% of the homicide victims and about 8% of the suicide victims. 51.5% of the homicide victims and about 10% of the suicide victims had sustained more than one gunshot wound. Close range was respectively found in 53.5% of the homicide cases and in all suicide cases. Most of the suicide cases (85% of the cases) showed typical entrance sites. Entrance sites in the limbs and lateral or posterior wall of the chest were only encountered in homicide cases. Associated traumatic lesions were found in about 23% of the homicide cases and in 18% of the suicide cases. In case of suicidal gunshots to the left chest, both upwards and downwards directions, and also both right-to-left and left-to-right directions can occur. From 22 suicide cases showing entrance wound in the mouth, a downwards direction was found in only one. This study underlines the importance but also the limits of the autopsy findings (including direction of the projectile(s) related to the entrance site) for giving an indication of the manner of death (homicide vs. suicide). PMID:18282673

  4. Hemorrhagic small intestine cancer with solitary pulmonary metastasis initially presented as suspected primary lung cancer: an autopsy report.

    Iwata, Takashi; Inoue, Kiyotoshi; Kiriike, Sachiko; Izumi, Nobuhiro; Mizuguchi, Shinjiro; Tsukioka, Takuma; Morita, Ryuhei; Nishiyama, Noritoshi; Takemura, Masashi; Osugi, Harusi; Wakasa, Kenichi; Suehiro, Shigefumi

    2007-12-01

    Cancer of the small intestine presenting with a solitary pulmonary metastasis is rare. Diagnosis and treatment of hemorrhagic small intestinal disease is clinically problematic due to its anatomic aspect, especially after multiple laparotomies. The case that we present here was a 79-year-old man who was initially diagnosed with suspected T2N2M0 lung cancer. After non-diagnostic results on two bronchoscopic biopsies and computed tomography-guided needle biopsy, he was admitted for thoracoscopic biopsy and possible curative operation. The patient had a history of multiple laparotomies for gastric ulcer and had no abdominal symptoms. A fecal occult blood test was positive; this was thought to be because of persistent bloody sputum. During the preoperative evaluation period, massive intestinal hemorrhage occurred. Intestinal tumor was identified by double-balloon enteroscopy and emergency laparotomy was performed to control the bleeding. The histopathological diagnosis was metastatic adenocarcinoma. However, intestinal bleeding started again. His systemic status deteriorated progressively, resulting in death. Autopsy revealed a large polypoid tumor with hemorrhagic necrosis in the jejunum that was histologically and immunohistochemically diagnosed as primary poorly differentiated adenocarcinoma in the small intestine. Multiple small submucosal tumors with central ulceration were confirmed as intramural metastases. A lung mass in the right lower lobe was diagnosed as a metastatic lesion. In the diagnosis and treatment of the disease, we faced several clinically difficult problems. We here describe in detail the clinical course and the diagnostic and therapeutic difficulties of this rare case, with some references to the literature. PMID:18432067

  5. [An autopsy case of neuronal type Charcot-Marie-Tooth disease (HMSN type II) with nerve deafness and psychiatric symptoms].

    Yoshimura, I; Yoshimura, N; Hanazono, T; Usutani, S; Muramoto, Y; Fukushima, Y

    1992-06-01

    The clinical and pathological findings of a 41-year-old male patient with atypical Charcot-Marie-Tooth disease were reported. There were 3 cases of subarachnoid haemorrhage, 2 nerve deafness and 2 hereditary motor and sensory neuropathy (HMSN) in his family. He had suffered from progressive nerve deafness since 5 years old and gait disturbance since 37 years old. He had been admitted to the psychiatric hospital 3 times because of hallucinatory-delusional state and behavior abnormalities. Neurological examinations at 39 years old revealed that he had mental deterioration (IQ 66), nerve deafness, diffuse muscle atrophy, most marked distally, sensory disturbance, areflexia, positive Romberg's sign, orthostatic hypotension, dysphagia and slurred speech. MCV of median nerve was 27.8 m/sec, and SCV was not evoked. EEG revealed nonspecific dysfunction of the brain. He died of ileus-like condition at 41 years old. General autopsy showed haemorrhagic infarction of the jejunum and ileum due to compression of the superior mesenteric artery and vein by an adhesion band of connective tissue formed after previous appendectomy. Neuropathological examinations revealed axonal degeneration and loss of myelinated fibers with schwannosis of anterior and posterior spinal nerve roots as well as peripheral nerves. The posterior roots were more severely affected than the anterior ones. Ganglion cells of the posterior root ganglia showed remarkable degeneration and loss. There was severe degeneration of the posterior columns, especially in the gracilis, of the spinal cord. Nerve cells in the anterior horns and Clarke's columns also displayed conspicuous atrophy or central chromatolysis followed by gliosis. There was slight degeneration of the posterior spinocerebellar tracts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1389565

  6. Atherosclerosis in coronary artery and aorta in a semi-urban population by applying modified American Heart Association classification of atherosclerosis: An autopsy study

    Thej, Mothakapalli Jagadish; Kalyani, Raju; Kiran, Jayaramaiah

    2012-01-01

    Background: Ischemic heart disease (IHD) following atherosclerosis is a giant killer and the incidence of atherosclerosis in coronary arteries is rapidly increasing among Indians. The study was formulated to assess the histomorphological atherosclerotic changes in aorta and coronary arteries at autopsy by applying the modified American Heart Association classification of atherosclerosis based on morphological descriptions to find out the age and sex related prevalence of atherosclerosis in the semi-urban population of Kolar, a district in Southern India. Materials and Methods: Autopsy was conducted on 113 cases whose age ranged from 8-85 years. Autopsy was conducted by the conventional technique; heart and the aorta were removed and fixed in 10% formalin. The heart was dissected along the direction of flow of blood and aorta along the posterior surface. Microscopic assessment of the three main coronary arteries and aorta was done using the modified American Heart Association classification of atherosclerosis. Proportions were analyzed using Chi-square test. Results: The number of males was 78 (69%) and number of females was 35 (31%). Mean age was 37.11 ± 15.69 years. Increased incidence of intermediate lesions was noted in young individuals (15-34 yrs). Atherosclerotic lesions were more in left anterior descending artery compared to other coronary arteries and in abdominal aorta compared to thoracic and ascending aorta. Vulnerable plaques were more in right coronary artery. Conclusion: With cardiovascular disease attaining pandemic proportions, the study of subclinical atherosclerosis is the need of the hour to estimate the disease burden in the asymptomatic population. The increased amount of atherosclerosis (advanced and intermediate lesions) found in the young population in this study gives an indication that anti-atherogenic preventive measures need to be implemented in young individuals, so as to prevent coronary artery disease from causing premature death

  7. Combining diagnostic categories to improve agreement between death certificate and autopsy classifications of cause of death for atomic bomb survivors, 1950-87

    Several investigators have observed less-than-desirable agreement between death certificate diagnoses and autopsy diagnoses for most specific causes of death, and even for some causes grouped by major disease category. Our results from data on 5130 autopsies of members of the Life Span Study cohort of atomic bomb survivors in Hiroshima and Nagasaki conducted prior to September 1987 were equally discouraging. Among diseases with more than 10 cases observed, confirmation rates ranged from 13 % to 97 % and detection rates from 6 % to 90 %. Both rates were greater than 70 % for only 6 of 60 disease categories studied and for only 1 of 16 categories defined by major International Classification of Disease categories (neoplasms). This deficiency suggests cautious interpretation of results from studies based on death certificate diagnoses. To determine whether any groupings of diagnoses might meet acceptable accuracy requirements, we applied a hierarchical clustering method to data from these 5130 cohort members. The resulting classification system had 10 categories: breast cancer; other female cancers; cancers of the digestive organs; cancer of the larynx; leukemia; nasal, ear, or sinus cancer; tongue cancer; external causes; vascular disease; and all other causes. Confirmation and detection rates for each of these categories were at least 66 %. Although the categories are broad, particularly for nonneoplastic diseases, further divisions led to unacceptable accuracy rates for some of the resulting diagnostic groups. Using the derived classification system, there was 72 % agreement overall between death certificate and autopsy diagnoses compared to 53 % agreement for a second system obtained by grouping strictly by major disease category. Eighty-seven percent agreement was observed for a similar classification system with vascular disease grouped with all other nonneoplastic diseases. Further agglomeration achieved very little additional improvement. (J.P.N.)

  8. Expansion of the Multi-Link Frontier™ coronary bifurcation stent: micro-computed tomographic assessment in human autopsy and porcine heart samples.

    Stefan Kralev

    Full Text Available BACKGROUND: Treatment of coronary bifurcation lesions remains challenging, beyond the introduction of drug eluting stents. Dedicated stent systems are available to improve the technical approach to the treatment of these lesions. However dedicated stent systems have so far not reduced the incidence of stent restenosis. The aim of this study was to assess the expansion of the Multi-Link (ML Frontier™ stent in human and porcine coronary arteries to provide the cardiologist with useful in-vitro information for stent implantation and selection. METHODOLOGY/PRINCIPAL FINDINGS: Nine ML Frontier™ stents were implanted in seven human autopsy heart samples with known coronary artery disease and five ML Frontier™ stents were implanted in five porcine hearts. Proximal, distal and side branch diameters (PD, DD, SBD, respectively, corresponding opening areas (PA, DA, SBA and the mean stent length (L were assessed by micro-computed tomography (micro-CT. PD and PA were significantly smaller in human autopsy heart samples than in porcine heart samples (3.54±0.47 mm vs. 4.04±0.22 mm, p = 0.048; 10.00±2.42 mm(2 vs. 12.84±1.38 mm(2, p = 0.034, respectively and than those given by the manufacturer (3.54±0.47 mm vs. 4.03 mm, p = 0.014. L was smaller in human autopsy heart samples than in porcine heart samples, although data did not reach significance (16.66±1.30 mm vs. 17.30±0.51 mm, p = 0.32, and significantly smaller than that given by the manufacturer (16.66±1.30 mm vs. 18 mm, p = 0.015. CONCLUSIONS/SIGNIFICANCE: Micro-CT is a feasible tool for exact surveying of dedicated stent systems and could make a contribution to the development of these devices. The proximal diameter and proximal area of the stent system were considerably smaller in human autopsy heart samples than in porcine heart samples and than those given by the manufacturer. Special consideration should be given to the stent deployment procedure (and to the follow

  9. The 2002 results of the first series of follow-up studies on Japanese Thorotrast patients and their relationships to autopsy series

    Mori, T.; Aoki, I. [Yokohama City Univ. School of Medicine, Yokohama (Japan); Machinami, R. [Kawakita General Hospital, Tokyo (Japan); Hatakeyama, S. [Tokyo Medical and Dental Univ., Tokyo (Japan); Fukutomi, K. [National Inst. of Public Health, Tokyo (Japan); Kato, Y.; Akashi, M. [National Inst. of Radiological Sciences, Chiba (Japan); Fukumoto, M. [Tohoku Univ. School of Medicine, Sendai (Japan)

    2005-07-01

    In 1963, a follow-up study was started on 262 war-wounded Japanese ex-servicemen who had been injected with thorotrast into blood vessels between 1931 and 1945. This first series of our follow-up studies on thorotrast patients covered a total of 71 years from 1931 to the present 2002 survey. It was supplemented in 1979 by another follow-up study called the second or Aichi series performed on other thorotrast-injected war-wounded persons. The 2002 survey of the first series indicated that 5 (1.9%) of 262 thorotrast cases were still alive, while 257 (98.1%) had died. Among 1,630 control war-wounded persons not treated with thorotrast, 348 (21.3%) were still alive and 1,282 (78.7%) had died. In an age-matched control population of 3,999,000 persons, 837,175 (20.9%) were alive and 3,161,825 (79.1%) had died. The life span of thorotrast patients was; thus, markedly shorten (about 18 years, P< 0.001) than that of controls. The main causes of death in the thorotrast patients were: 81 liver malignancies (30.9%), 19 liver cirrhoses (7.3%), 5 cancers of the extrahepatic bile duct (1.9%), 11 hematopoietic malignancies (4.2%). Statistical analyses by the {chi} {sup 2} test showed that the incidence of these disorders was significantly higher in the thorotrast group than the control group. From 1945 to 2002, autopsies have been performed on 404 thorotrast-treated-patients - 392 injected with thorotrast by vascular route and 12 injected by other routes. In vascularly injected autopsy cases, 266 liver malignancies (67.9%), 28 liver cirrhoses (7.1%), 12 cancers of extrahepatic bile duct (3.1%), 30 hematopoietic malignancies (7.7%); 2 bone sarcomas (0.5%), 16 lung cancers (4.1%), one hemangiosarcoma of the spleen (0.3%), 4 malignant peritoneal tumors (1.0%), and 7 sarcomas at the injection site (1.8%) were found. The relative risk estimate of liver malignancies and hematopoietic malignancies was significantly higher in the autopsied thorotrast patients than in the autopsied

  10. Instability of the hindfoot after lesion of the lateral ankle ligaments: investigations of the anterior drawer and adduction maneuvers in autopsy specimens

    Kjaersgaard-Andersen, P.; Frich, Lars Henrik; Madsen, F.;

    1991-01-01

    The mobility patterns in the tibiotalocalcaneal joint complex with a solitary lesion of the anterior talofibular ligament (ATL) and a combined lesion of the ATL and calcaneofibular ligament (CFL) were studied in 22 human lower-extremity autopsy specimens mounted in a kinesiologic testing device. A...... solitary lesion of the ATL increased the anteroposterior (AP) laxity in the ankle joint in the entire range of flexion, with a maximum median of 3.1 mm in neutral flexion. Further cutting of the CFL increased AP laxity most obviously in dorsiflexion. A solitary lesion of the ATL resulted in a minor...

  11. Concordancia entre el diagnóstico clínico y el patológico por necropsias Clinico-pathological concordance at autopsies

    EDITH VALDEZ-MARTÍNEZ

    1998-01-01

    Full Text Available Objetivo. Determinar la concordancia entre diagnósticos clínicos y patológicos con base en los resultados de necropsias. Material y métodos. Se revisaron 67 protocolos de necropsia y expedientes clínicos de niños y adultos del servicio de patología del Centro de Especialidades Médicas del Estado de Veracruz Doctor Rafael Lucio, durante 1995 y 1996. Se obtuvieron las frecuencias simples de las variables de estudio, y la concordancia se calculó con el estadístico kappa simple. Resultados. En general la cifra de necropsias fue de 10.5%. Correspondió a la población infantil la mayor frecuencia (17.5%. El 59% de diagnósticos clínicos en niños y el 57% en adultos presentaron algún tipo de error La concordancia del diagnóstico principal ante y postmortem fue de 26% (infantes y 41% (adultos. Conclusiones. La alta cifra de errores diagnósticos y la consecuente baja concordancia clínicopatológica apoyan el hecho de que, a pesar del avance tecnológico en los procedimientos diagnósticos, es necesario realizar necropsias con el fin de documentar de manera más definitiva el control de calidad del ejercicio de la medicina.Objective. To determine the degree of concordance between clinical and autopsy diagnosis. Material and methods. The records of 67 autopsies and clinical files of children and adults, comprising the years 1995 to 1996, from a third level hospital in the State of Veracruz, Mexico, were revised. The concordance score was calculated with the statistical kappa. Results. In general, the rate of autopsy was 10.5%, with higher frequency for children (17.5%. In children, 59% of clinical diagnoses revealed mistakes and in adults, 57%. The degree of agreement in the underlying cause ante and postmortem was 6% in children and 41% in adults. Conclusions The high rate of diagnostic error and low concordance score between clinical and autopsy diagnosis strongly suggests that, in spite of increased availability of modern diagnostic

  12. Metals in lung tissue from autopsy cases in Mexico City residents: comparison of cases from the 1950s and the 1980s.

    Fortoul, T. I.; Osorio, L S; Tovar, A T; Salazar, D; Castilla, M E; Olaiz-Fernández, G

    1996-01-01

    In autopsies performed on residents of Mexico City during the 1950s and 1980s (45 males and 24 females and 42 males and 42 females, respectively), concentrations of cadmium, copper, cobalt, nickel, and lead in the lungs were studied by atomic absorption spectrometry. Sharp increases were noted in samples taken in the 1980s compared to those from the 1950s. In samples from both time periods, the concentrations were influenced by gender. Smoking was not associated with higher levels of the meta...

  13. Local perceptions of causes of death in rural South Africa: a comparison of perceived and verbal autopsy causes of death

    Laith Hussain-Alkhateeb

    2015-07-01

    Full Text Available Background: Understanding how lay people perceive the causes of mortality and their associated risk factors is important for public health. In resource-limited settings, where verbal autopsy (VA is used as the most expedient method of determining cause of death, it is important to understand how pre-existing concepts of cause of death among VA-informants may influence their VA-responses and the consequential impact on cause of death assessment. This study describes the agreement between VA-derived causes of death and informant-perceived causes and associated influential factors, which also reflects lay health literacy in this setting. Method: Using 20 years of VA data (n=11,228 from the Agincourt Health and Demographic Surveillance System (HDSS site in rural South Africa, we explored the agreement between the causes of death perceived by the VA-informants and those assigned by the automated Inter-VA tool. Kappa statistics and concordance correlation coefficients were applied to measure agreement at individual and population levels, respectively. Multivariable regression models were used to explore factors associated with recognised lay perceptions of causes of mortality. Results: Agreement between informant-perceived and VA-derived causes of death at the individual level was limited, but varied substantially by cause of death. However, agreement at the population level, comparing cause-specific mortality fractions was higher, with the notable exception of bewitchment as a cause. More recent deaths, those in adults aged 15–49 years, deaths outside the home, and those associated with external causes showed higher concordance with InterVA. Conclusion: Overall, informant perception of causes of death was limited, but depended on informant characteristics and causes of death, and to some extent involved non-biomedical constructs. Understanding discordance between perceived and recognised causes of death is important for public health planning; low

  14. Association of the apolipoprotein E {epsilon}4 allele with clinical subtypes of autopsy-confirmed Alzheimer`s Disease

    Zubenko, G.S.; Stiffler, S.; Kopp, U. [Univ. of Pittsburgh School of Medicine, PA (United States)] [and others

    1994-09-15

    Consistent with previous reports, we observed a significant association of the APOE {epsilon}4 allele with Alzheimer`s Disease (AD) in a series of 91 autopsy-confirmed cases. The {epsilon}4 allele frequency was higher in cases with a family history of AD-like dementia (0.54 {+-} 0.07), although the {epsilon}4 allele frequency in the AD cases with a negative family history (0.38 {+-} 0.05) remained significantly greater than that for the non-AD control group (0.13 {+-} 0.03). A similar increase in {epsilon}4 allele frequency (0.54 {+-} 0.07) was observed in the AD cases with amyloid angiopathy, compared to those who did not have amyloid angiopathy (0.35 {+-} 0.04). Contrary to previous reports, no effect of the dosage of the {epsilon}4 allele was found on the age of onset of dementia among the AD cases and, contrary to reports suggesting an association of {epsilon}4 and atherosclerosis, the {epsilon}4 allele frequency was similar in cases with or without concurrent brain infarcts. Modest but consistent correlations were observed between the dosage of {epsilon}4 alleles and the cortical density of senile plaques, but not neurofibrillary tangles. The last finding suggests that the pathogenic events mediated by the {epsilon}4 allele may be more directly involved in the formation of senile plaques, the identifying lesions in AD, than neurofibrillary tangles. A robust association of both the presence of an {epsilon}4 allele and a family history of AD-like dementia with concurrent amyloid angiopathy occurred within our sample of AD cases. This association arose from an interaction of the {epsilon}4 allele with a separate familial factor for which a family history of dementia served as a surrogate. These results suggest that amyloid angiopathy may be a common or central feature of a form of familial AD that is associated with the transmission of the APOE {epsilon}4 allele. 22 refs., 2 figs., 5 tabs.

  15. Using verbal autopsy to track epidemic dynamics: the case of HIV-related mortality in South Africa

    Mee Paul

    2011-08-01

    Full Text Available Abstract Background Verbal autopsy (VA has often been used for point estimates of cause-specific mortality, but seldom to characterize long-term changes in epidemic patterns. Monitoring emerging causes of death involves practitioners' developing perceptions of diseases and demands consistent methods and practices. Here we retrospectively analyze HIV-related mortality in South Africa, using physician and modeled interpretation. Methods Between 1992 and 2005, 94% of 6,153 deaths which occurred in the Agincourt subdistrict had VAs completed, and coded by two physicians and the InterVA model. The physician causes of death were consolidated into a single consensus underlying cause per case, with an additional physician arbitrating where different diagnoses persisted. HIV-related mortality rates and proportions of deaths coded as HIV-related by individual physicians, physician consensus, and the InterVA model were compared over time. Results Approximately 20% of deaths were HIV-related, ranging from early low levels to tenfold-higher later population rates (2.5 per 1,000 person-years. Rates were higher among children under 5 years and adults 20 to 64 years. Adult mortality shifted to older ages as the epidemic progressed, with a noticeable number of HIV-related deaths in the over-65 year age group latterly. Early InterVA results suggested slightly higher initial HIV-related mortality than physician consensus found. Overall, physician consensus and InterVA results characterized the epidemic very similarly. Individual physicians showed marked interobserver variation, with consensus findings generally reflecting slightly lower proportions of HIV-related deaths. Aggregated findings for first versus second physician did not differ appreciably. Conclusions VA effectively detected a very significant epidemic of HIV-related mortality. Using either physicians or InterVA gave closely comparable findings regarding the epidemic. The consistency between two

  16. Genotyping of Toxoplasma gondii: DNA extraction from formalin-fixed paraffin-embedded autopsy tissues from AIDS patients who died by severe disseminated toxoplasmosis.

    Bastos da Silva, Inara; Batista, Tatiana Pimental de Andrade; Martines, Roosecelis Brasil; Kanamura, Cristina Takami; Ferreira, Isabelle Martins Ribeiro; Vidal, Jose Ernesto; Pereira-Chioccola, Vera Lucia

    2016-06-01

    This study investigated the genetic features of Toxoplasma gondii isolated directly in autopsies of HIV-infected patients who died with severe disseminated toxoplasmosis. This retrospective analysis was conducted in a cohort of 15 HIV-infected patients with clinical and laboratory data. They had previous cerebral toxoplasmosis at least 6 months before the disseminated toxoplasmosis episode. The hypothesis was that they were infected with highly virulent parasites due to the condition in which they died. T. gondii genotyping was done directly in DNA extracted from 30 autopsy brain and lung samples (2 per patient) and mutilocus PCR-RFLP genotyping was done using 12 molecular markers. The 30 clinical samples were genotyped successfully in 8 or more loci and six suggestive genotypes were identified. One of them was Toxo DB #11, previously identified in different domestic animals and virulent in experimental animals. The other five suggestive genotypes identified in 14 patients were not described. TgHuDis1 was the most frequent and was determined in 8 patients. TgHuDis3 and TgHuDis5 were identified in two patients each. TgHuDis2 and TgHuDis4 have been identified in one patient each. These suggestive genotypes could be considered as virulent, since they caused severe tissue damage and had similar characteristics as Toxo # DB 11. PMID:26969767

  17. Cardiac biomarkers in blood, and pericardial and cerebrospinal fluids of forensic autopsy cases: A reassessment with special regard to postmortem interval.

    Chen, Jian-Hua; Inamori-Kawamoto, Osamu; Michiue, Tomomi; Ikeda, Sayuko; Ishikawa, Takaki; Maeda, Hitoshi

    2015-09-01

    Previous studies suggested possible application of postmortem biochemistry of myocardial biomarkers to the investigation of sudden cardiac death; however, differences from clinical findings should be considered in autopsy materials. The present study involved a comprehensive investigation of cardiac troponin T and I (cTnT and cTnI), and creatine kinase MB (CK-MB) in cardiac and peripheral external iliac venous blood, pericardial fluid (PCF) and cerebrospinal fluid (CSF) for reassessment, with special regard to the estimated postmortem interval in relation to the cause of death, reviewing a large number of forensic autopsy cases (n=1923). These cardiac biomarkers showed cause-of-death- and postmortem-time-dependent differences: blood and PCF levels of each marker were higher in hyperthermia (heatstroke), bathwater drowning and chronic congestive heart disease in cases of postmortem interval (PMI) PMI of <48h. CSF cTnI and CK-MB showed similar findings. There was no difference between myocardial infarction and other causes of death to be discriminated, including asphyxiation, drowning and fire fatality. These findings are similar to clinical observations in critical ill patients, suggesting that elevated cardiac biomarkers cannot be a specific finding for death from acute ischemic heart disease, but indicate the severity of myocardial injury in postmortem investigation. PMID:26052007

  18. Death by 'ice': fatal methamphetamine intoxication of a body packer case detected by postmortem computed tomography (PMCT) and validated by autopsy.

    Bin Abdul Rashid, Saiful Nizam; Rahim, Amir Saad Abdul; Thali, Michael J; Flach, Patricia M

    2013-03-01

    Fatal acute methamphetamine (MA) poisoning in cases of internal drug trafficking is rarely described in the literature. This case study reports an MA 'body packer' who died from fatal methamphetamine intoxication due to leaking drug packages in the alimentary tract. The deceased was examined by postmortem computed tomography (PMCT), and the results were correlated to subsequent autopsy and toxicological findings. The deceased was arrested by the police when he was found disoriented in the city of Kuala Lumpur. He was transferred to the emergency department on suspicion of drug abuse. The initial drug screening was reactive for amphetamines. Shortly after admission to the hospital, he died despite rigorous resuscitation attempts. The postmortem plain chest and abdominal radiographs revealed multiple suspicious opacities in the gastrointestinal tract attributable to body packages. An unenhanced whole body PMCT revealed twenty-five drug packages, twenty-four in the stomach and one in the transverse colon. At least two were disintegrating, and therefore leaking. The autopsy findings were consistent with the PMCT results. Toxicology confirmed the diagnosis of fatal methamphetamine intoxication. PMID:23404531

  19. [Postmortem dismemberment/mutilation--medicolegal and criminalistic evaluation of the autopsies performed by the Institute of Legal Medicine at the Hanover Medical School].

    Schulz, Yvonne; Mossakowski, Harald; Albrecht, Knut; Breitmeier, Dirk

    2008-01-01

    Among all the autopsies performed by the Institute of Legal Medicine at the Hanover Medical School between 1978 and 1998. 16 cases of postmortem dismemberment/mutilation were evaluable under criminalistic and medicolegal aspects. In the present study, particular attention was paid to the psychosocial circumstances of the perpetrator's and victim's lives and also to the classification of the different types of postmortem dismemberment/mutilation illustrated by case reports. Apart from an unfavourable personal life situation at the time of the offence, essential predisposing factors were: poor integration in society and family, occupational problems, drug abuse and mental diseases. As the interactions between these factors differ in every single case and may be combined with other factors, the analysis of such homicides should always be based on the assessment of the individual case. PMID:18389859

  20. Cadmium in kidney cortex, liver, and pancreas from Swedish autopsies. Estimation of biological half time in kidney cortex, considering calorie intake and smoking habits.

    Elinder, C G; Lind, B; Kjellström, T; Linnman, L; Friberg, L

    1976-01-01

    Cadmium and zinc have been analyzed in tissues from 292 persons autopsied in Stockholm. In kidney cortex, liver, and pancreas the individual cadmium levels are distributed in a lognormal way. In kidney cortex there is a continuous accumulation of cadmium with age up to 50 years, followed by a decrease. Smokers show a higher cadmium accumulation. For nonsmokers, the biological half time of cadmium in kidney cortex is estimated at 30 years, with an average concentration at age 50 of 11 mug/g wet weight. When smokers are included, the average cadmium concentration at age 50 is 22 mug/g wet weight. Based on the more pronounced cadmium accumulation among smokers than nonsmokers, the respiratory absorption rate of cadmium from tobacco smoke is estimated to be approximately 50%. PMID:999342

  1. Cadmium in kidney cortex, liver, and pancreas from Swedish autopsies. Estimation of biological half time in kidney cortex, considering calorie intake and smoking habits

    Elinder, C.G. (Karolinska Inst., Stockholm); Kjellstrom, T.; Friberg, L.; Lind, B.; Linnman, L.

    1976-01-01

    Cadmium and zinc have been analyzed in tissues from 292 persons autopsied in Stockholm. In kidney cortex, liver, and pancreas the individual cadmium levels are distributed in a lognormal way. In kidney cortex there is a continuous accumulation of cadmium with age up to 50 years, followed by a decrease. Smokers show a higher cadmium accumulation. For nonsmokers, the biological half time of cadmium in kidney cortex is estimated at 30 years, with an average concentration at age 50 of 11 ..mu..g/g wet weight. When smokers are included, the average cadmium concentration at age 50 is 22 ..mu..g/g wet weight. Based on the more pronounced cadmium accumulation among smokers than nonsmokers, the respiratory absorption rate of cadmium from tobacco smoke is estimated to be approximately 50 percent.

  2. Diagnostic post-mortem des intoxications chez les carnivores domestiques‎ : intérêts et limites de l’autopsie. Etude de 23 cas d’intoxication

    Goube, Anaïs

    2015-01-01

    diagnostic des intoxications chez les carnivores domestiques repose sur la confrontation d’éléments épidémiologiques, cliniques, nécropsiques et analytiques après exclusion d’autres étiologies. Une autopsie rigoureuse et méthodique suivie d’une description lésionnelle est essentielle et à portée de tout praticien qui choisit alors les prélèvements pertinents pour l’analyse toxicologique. Basée sur des données épidémiologiques et l’étude de 23 cas recueillis auprès des ENV, cette thèse présent...

  3. Lung cancer at autopsy in A-bomb survivors and controls, Hiroshima and Nagasaki, 1961--1970. II. Smoking, occupation and A-bomb exposure

    The apparent effect of ionizing radiation on lung cancer in A-bomb survivors has not been large enough to still doubts as to its validity. It has seemed essential to determine whether the apparent radiation effect could have resulted from a confounding of heavy smoking and high radiation dose, or if the occupational exposure of high-dose subjects with lung cancer was suggestive of the influence of environmental hazards other than radiation. The available series consists of 204 subjects with lung cancer verified by autopsy, 61 of whom were low-dose (less than 1 rad) and 13 high-dose (200+ rads) subjects. No evidence could be found that the influence of either smoking or occupational exposure upon lung cancer was exerted so as to suggest that the apparent radiation effect is other than real. The study also provides additional evidence of the relationship between lung cancer and smoking in Japan

  4. The autopsy archive of former uranium miners of the East German WISMUT company - a valuable resource for research on ionizing radiation in interaction with other carcinogens and cancer

    In East Germany, uranium mining was undertaken on a large scale for the Soviet nuclear industry from 1946 to 1989. Poor working conditions especially in the early years led to a high level of occupational diseases, in particular lung cancer. For WISMUT miners, comprehensive data is available on working histories and exposure to radiation and quartz dust. After German reunification, the autopsy archive of the Institute of Pathology in Stollberg was opened for research as part of the WISMUT Health Data Archive of the Bundesanstalt fuer Arbeitsschutz und Arbeitsmedizin. It contains protocols of about 30,000 persons (including 17,000 miners), 400,000 slides, 66,000 tissue blocks, and 200 whole lungs. Now, the tissue repository is held in trust at BGFA and Institute of Pathology in Bochum, Germany. The source population of the cases is not defined. The archive contains tissues from many - but not from all - former WISMUT miners as well as from local people. For 12,923 miners, median radon exposure was 621 WLM, including about 800 workers with exposure above 1800 WLM. Smoking information is poor, but prevalence of smoking was high. A leading diagnosis was lung cancer in about 5,300 persons, mainly underground miners. A database has been developed at Deutsches Krebsforschungszentrum to document relevant autopsy information on the cases. Histopathological classification of 5,270 lung cancer cases has been re-assessed by three pathologists. U.S. NIOSH conducted a study on the feasibility of research on pathologic types of lung cancer. Laboratory studies on the quality of the material for molecular-biological investigations are under way. A project is ongoing to investigate the interaction of radiation and crystalline silica on lung cancer development. A workshop was scheduled December 10, 2004 to discuss the resources, the findings, the pitfalls and challenges presented by the material and the future use of that archive in research. (orig.)

  5. Ability of combined Near-Infrared Spectroscopy-Intravascular Ultrasound (NIRS-IVUS) imaging to detect lipid core plaques and estimate cap thickness in human autopsy coronary arteries

    Grainger, S. J.; Su, J. L.; Greiner, C. A.; Saybolt, M. D.; Wilensky, R. L.; Raichlen, J. S.; Madden, S. P.; Muller, J. E.

    2016-03-01

    The ability to determine plaque cap thickness during catheterization is thought to be of clinical importance for plaque vulnerability assessment. While methods to compositionally assess cap integrity are in development, a method utilizing currently available tools to measure cap thickness is highly desirable. NIRS-IVUS is a commercially available dual imaging method in current clinical use that may provide cap thickness information to the skilled reader; however, this is as yet unproven. Ten autopsy hearts (n=15 arterial segments) were scanned with the multimodality NIRS-IVUS catheter (TVC Imaging System, Infraredx, Inc.) to identify lipid core plaques (LCPs). Skilled readers made predictions of cap thickness over regions of chemogram LCP, using NIRS-IVUS. Artery segments were perfusion fixed and cut into 2 mm serial blocks. Thin sections stained with Movat's pentachrome were analyzed for cap thickness at LCP regions. Block level predictions were compared to histology, as classified by a blinded pathologist. Within 15 arterial segments, 117 chemogram blocks were found by NIRS to contain LCP. Utilizing NIRSIVUS, chemogram blocks were divided into 4 categories: thin capped fibroatheromas (TCFA), thick capped fibroatheromas (ThCFA), pathological intimal thickening (PIT)/lipid pool (no defined cap), and calcified/unable to determine cap thickness. Sensitivities/specificities for thin cap fibroatheromas, thick cap fibroatheromas, and PIT/lipid pools were 0.54/0.99, 0.68/0.88, and 0.80/0.97, respectively. The overall accuracy rate was 70.1% (including 22 blocks unable to predict, p = 0.075). In the absence of calcium, NIRS-IVUS imaging provided predictions of cap thickness over LCP with moderate accuracy. The ability of this multimodality imaging method to identify vulnerable coronary plaques requires further assessment in both larger autopsy studies, and clinical studies in patients undergoing NIRS-IVUS imaging.

  6. [Civil and criminal laws regarding the donation, removal and transfer of organs (Transplantation Law) in Germany with respect to administrative and clinical autopsies].

    Dufková, J

    2000-07-01

    In the Federal Republic of Germany, transplantation medicine, which is relatively young and still developing, is now regulated by the law governing the donation, removal and transfer of organs (Transplantation Law--TPG) of 05. 11. 1997 and has been given a legal basis which satisfies even present-day standards. By evaluating the highly personal rights to potential organ donor and of his next-of-kin against the interests of maintaining life and health of others, the law works along the lines of the so-called extended consent solution. The basic civil law stipulations of sections 3 + 4 TPG, while protecting the donor's individual freedom of decision, give his next-of-kin or trusted confidant at or immediately following death the right to communicate his presumes wishes. In addition, it must be stated that through recent decisions handed down by the Federal Constitutional Court (Bundesverfassungsgericht) in response to various complaints, this regulation has been recognised as conforming to constitutional laws. The basic content of the penal regulations states that violations of civil law rules and trafficking in organs are an offence. Current disclosed requirements for suitable donor organs, in particular for 1998, make it appear likely that the current deficit can be eliminated by the introduction of the organisational measures contained in the law. In conclusion, the situation with regard to autopsy should be addressed since, in contrast to the federal transplantation law which applies to all states, autopsy is regulated differently and, from a legal-political standpoint, unsatisfactorily by each individual state. It is desirable that this legal ambiguity be corrected by standardising the inconsistent and at times non-existent legal stipulations. PMID:10974752

  7. Postmortem volumetric CT data analysis of pulmonary air/gas content with regard to the cause of death for investigating terminal respiratory function in forensic autopsy.

    Sogawa, Nozomi; Michiue, Tomomi; Ishikawa, Takaki; Kawamoto, Osamu; Oritani, Shigeki; Maeda, Hitoshi

    2014-08-01

    Postmortem CT (PMCT) is useful to investigate air/gas distribution and content in body cavities and viscera. The present study investigated the procedure to estimate total lung air/gas content and aeration ratio as possible indices of terminal respiratory function, using three-dimensional (3-D) PMCT data analysis of forensic autopsy cases without putrefactive gas formation (within 3 days postmortem, n=75), and analyzed the volumetric data with regard to the cause of death. When 3-D bilateral lung images were reconstructed using an image analyzer, combined lung volume was larger in drowning (n=12) than in alcohol/sedative-hypnotic intoxication (n=8) and sudden cardiac death (SCD; n=10), and intermediate in other cases, including mechanical asphyxiation (n=12), fire fatalities due to burns (n=6) and carbon monoxide intoxication (n=7), fatal methamphetamine abuse (n=7), hyperthermia (heatstroke; n=6) and fatal hypothermia (cold exposure; n=7). Air/gas content of the lung as detected using HU interval between -2000 and -400 ('effective' lung aeration areas) and between -2000 and -191 (total lung aeration areas) as well as the ratios to total lung volume ('effective' and total lung aeration ratios, respectively) was higher in mechanical asphyxiation, drowning, fatal burns and hypothermia (cold exposure) than in SCD, and was intermediate in other cases. 'Effective' and total lung aeration ratios may be useful for comparisons between specific causes of death to discriminate between hypothermia (cold exposure) and drug intoxication, and between SCD and other causes of death, respectively. These findings provide interesting insights into potential efficacy of PMCT data analyses of lung volume and CT density as well as lung air/gas content and aeration ratio with regard to the cause of death, as possible indicators of terminal respiratory function, as part of virtual autopsy of the viscera in situ. PMID:24905153

  8. Usefulness of postmortem biochemistry in identification of ketosis: Diagnosis of ketoacidosis at the onset of autoimmune type 1 diabetes in an autopsy case with cold exposure and malnutrition.

    Tani, Naoto; Michiue, Tomomi; Chen, Jian-Hua; Oritani, Shigeki; Ishikawa, Takaki

    2016-09-01

    A severely malnourished, Japanese female in her twenties was found dead in her apartment. On autopsy, most of the findings from the internal examination were suggestive of hypothermia. Postmortem biochemistry, however, showed severely increased levels of glycated hemoglobin (HbA1c) and blood and urine glucose levels. Levels of acetone, 3-hydroxybutyric acid, and acetoacetate in various body fluids were also highly increased, indicating ketosis. The serum insulin and c-peptide levels were severely low, and subsequent testing was positive for anti-GAD antibodies. Immunohistochemical examination of the pancreatic islet cells revealed few insulin-positive cells but many glucagon-positive cells on staining. Furthermore, slight invasion of CD8-positive lymphocytes in the pancreatic islets of Langerhans was observed. Results of immunostaining of the pancreatic and bronchial epithelial tissues were partly positive for the Influenza A virus. We concluded that severe ketoacidosis associated with rapid-onset hyperglycemia due to autoimmune type 1 diabetes (AT1D) had occurred shortly before death. However, the ketosis was accompanied by hypothermia and malnutrition as well as diabetic ketoacidosis (DKA). Therefore, we retrospectively collected biochemical data on cases of hypothermia and malnutrition and compared them with the present case. Serum glucose, acetone, 3-hydroxybutyric acid, and acetoacetic acid can be used for screening and diagnosis to distinguish DKA from ketosis due to hypothermia and malnutrition. Therefore, in the present case, we diagnosed that the natural cause of death was due to AT1D. In conclusion, screening investigations for relevant biochemical markers can provide essential information for the diagnosis of metabolic disturbances, which fail to demonstrate characteristic autopsy findings. PMID:27591535

  9. The autopsy archive of former uranium miners of the East German WISMUT company - a valuable resource for research on ionizing radiation in interaction with other carcinogens and cancer

    Pesch, B.; Taeger, D. [Berufsgenossenschaftliches Forschungsinstitut fuer Arbeitsmedizin (BGFA), Univ. of Bochum (Germany); Wiethege, T. [Inst. of Pathology of Ruhr Univ., Kliniken Bergmannsheil, Bochum (Germany)

    2005-07-01

    In East Germany, uranium mining was undertaken on a large scale for the Soviet nuclear industry from 1946 to 1989. Poor working conditions especially in the early years led to a high level of occupational diseases, in particular lung cancer. For WISMUT miners, comprehensive data is available on working histories and exposure to radiation and quartz dust. After German reunification, the autopsy archive of the Institute of Pathology in Stollberg was opened for research as part of the WISMUT Health Data Archive of the Bundesanstalt fuer Arbeitsschutz und Arbeitsmedizin. It contains protocols of about 30,000 persons (including 17,000 miners), 400,000 slides, 66,000 tissue blocks, and 200 whole lungs. Now, the tissue repository is held in trust at BGFA and Institute of Pathology in Bochum, Germany. The source population of the cases is not defined. The archive contains tissues from many - but not from all - former WISMUT miners as well as from local people. For 12,923 miners, median radon exposure was 621 WLM, including about 800 workers with exposure above 1800 WLM. Smoking information is poor, but prevalence of smoking was high. A leading diagnosis was lung cancer in about 5,300 persons, mainly underground miners. A database has been developed at Deutsches Krebsforschungszentrum to document relevant autopsy information on the cases. Histopathological classification of 5,270 lung cancer cases has been re-assessed by three pathologists. U.S. NIOSH conducted a study on the feasibility of research on pathologic types of lung cancer. Laboratory studies on the quality of the material for molecular-biological investigations are under way. A project is ongoing to investigate the interaction of radiation and crystalline silica on lung cancer development. A workshop was scheduled December 10, 2004 to discuss the resources, the findings, the pitfalls and challenges presented by the material and the future use of that archive in research. (orig.)

  10. Estudo sobre a contribuição da autópsia como método diagnóstico Study on the contribution of the autopsy as a diagnostic tool

    Daniel Ribeiro Moreira

    2009-06-01

    Full Text Available INTRODUÇÃO: As taxas hospitalares de autópsias vêm diminuindo mundialmente, atingindo níveis críticos no Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG no que concerne a autópsias não-perinatais. OBJETIVO: Verificar se houve diminuição da relevância da autópsia no HC-UFMG. METODOLOGIA: Realizou-se estudo comparativo entre diagnósticos clínicos e post mortem, estabelecendo taxas de discordância com impacto terapêutico ou prognóstico em duas amostras aleatórias de 80 autópsias realizadas no HC-UFMG nos anos 1970 e outras 80 nos anos 1990, incluindo procedimentos perinatais e não-perinatais. RESULTADOS: Autópsias não-perinatais (adultos e crianças predominaram na década de 1970. As perinatais (natimortos e neomortos predominaram na década de 1990, com discordâncias em 56% dos casos. Discordâncias parciais, com correta classificação de malformações congênitas pela autópsia, foram as mais frequentes. Não houve discordâncias na maioria das autópsias de crianças na década de 1970; entretanto, a maioria destas na amostra da década de 1990 revelou discordâncias. Em relação aos adultos, a frequência de erros diagnósticos não apresentou alterações significativas entre as décadas de 1970 (68% e 1990 (57%. Infecções bacterianas e tromboembolismo pulmonar constituíram frequentes condições não diagnosticadas clinicamente na década de 1970; nos anos 90, os diagnósticos não formulados em vida formaram grupo heterogêneo de doenças. CONCLUSÃO: A autópsia permanece útil como método diagnóstico, apesar de restritamente utilizada na atualidade. É necessária elevação das taxas de autópsias não-perinatas para evitar os efeitos deletérios de sua ausência no ensino, na pesquisa e no controle de qualidade da assistência médica.BACKGROUND: Hospital autopsy rates have declined worldwide and non-perinatal autopsies have reached extremely low numbers at the University Hospital

  11. An epidemiological study on pattern of thoraco-abdominal injuries sustained in fatal road traffic accidents of Bangalore: Autopsy-based study

    N Bayapa Reddy

    2014-01-01

    Full Text Available Background: The statistical profile reflects a global estimate of 5.1 million deaths in 2000, which was due to injuries that accounted for 10% of deaths due to all causes. Out of this, a quarter of injury-related deaths occurred in the South-East Asian region. Road Traffic Accident (RTA is one among the top 5 causes of morbidity and mortality in South-East Asian countries. Most common cause of blunt abdominal trauma in India is road traffic accident followed by pedestrian accidents, abdominal blows, and fall from heights. Aims: To analyze the epidemiology and pattern of fatal thoraco-abdominal injuries in road traffic accidents. Materials and Methods: An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 100 post-mortems of road traffic accident between November 2008 and May 2010 subjected to medico-legal autopsy at the department of Forensic Medicine, KIMS Hospital Bangalore. Results: The majority of the victims were aged 21 to 40 years, 50 (50.0%, most of the victims were male 92 (92.0%; and male/female ratio was 11.5:1. Commonest offending agents in heavy motor vehicles were 54 (54.0%. Bony cage sustained injuries were observed in 71; out of this, fractures of ribs were observed in 45 (63.3% victims, clavicle in 14 (19.7%, sternum was 6 (8.4%, and vertebrae 6 (8.4% of fatal road traffic accidents. Internal thoracic injuries were observed in 26 cases. Among internal thoracic injuries, lungs were the most commonly involved organ 24 (92.3% followed by the heart 2 (7.6%. Lung sustained more lacerations 19 (79.1% than contusions 5 (20.8%. Internal abdominal injuries were observed in 49 cases. In road traffic accidents, the most commonly injured abdominal organs were solid organs such as liver 16 (32.6% followed by spleen 9 (18.3%. Conclusions: Majority of the times in road traffic accidents, young and productive males were injured or lost their life. This study may help the

  12. A social autopsy of neonatal mortality suggests needed improvements in maternal and neonatal interventions in Balaka and Salima districts of Malawi

    Alain K. Koffi

    2015-06-01

    Full Text Available Background The Every Newborn Action Plan calls for reducing the neonatal mortality rates to fewer than 10 deaths per 1000 live births in all countries by 2035. The current study aims to increase our understanding of the social and modifiable factors that can be addressed or reinforced to improve and accelerate the decline in neonatal mortality in Malawi. Methods The data come from the 2013 Verbal and Social Autopsy (VASA study that collected data in order to describe the biological causes and the social determinants of deaths of children under 5 years of age in Balaka and Salima districts of Malawi. This paper analyses the social autopsy data of the neonatal deaths and presents results of a review of the coverage of key interventions along the continuum of normal maternal and newborn care and the description of breakdowns in the care provided for neonatal illnesses within the Pathway to Survival framework. Results A total of 320 neonatal deaths were confirmed from the VASA survey. While one antenatal care (ANC visit was high at 94%, the recommended four ANC visits was much lower at 41% and just 17% of the mothers had their urines tested during the pregnancy. 173 (54% mothers of the deceased newborns had at least one labor/delivery complication that began at home. The caregivers of 65% (n = 75 of the 180 newborns that were born at home or born and left a health facility alive perceived them to be severely ill at the onset of their illness, yet only 44% (n = 80 attempted and 36% (n = 65could reach the first health provider after an average of 91 minutes travel time. Distance, lack of transport and cost emerged as the most important constraints to formal care–seeking during delivery and during the newborn fatal illness. Conclusions This study suggests that maternal and neonatal health organizations and the local government of Malawi should increase the demand for key maternal and child health interventions, including the recommended 4

  13. Over-representation of the APOE*4 allele in autopsy confirmed early- and late-onset sporadic Alzheimer`s disease

    Kamboh, M.I.; DeKosky, S.T.; Ferrell, R.E. [Univ. of Pittsburgh, PA (United States)

    1994-09-01

    Apolipoprotein E binds to {beta}-amyloid peptide in senile plaques and neurofibrillary tangles in Alzheimer`s disease (AD). Recent studies have identified the APOE*4 allele as a major predisposing genetic factor for late-onset familial AD as well as in sporadic AD. Most of these association studies are based on clinically diagnosed AD cases with little data available on autopsy confirmed, definite AD. To characterize the distribution of APOE polymorphism in autopsy confirmed sporadic AD cases, we determined APOE genotypes in 111 DNA samples (aged 51-101 years) extracted from brain tissues which were available from the University of Pittsburgh Alzheimer`s Disease Research Center. The APOE data was compared between the AD group and 3 samples of population controls from Western Pennsylvania consisting of a young cohort (N=473, aged 18-48 years), middle cohort (N=473, aged 42-50 years) and an old cohort (N=870, aged 65-90 years). The frequency of the APOE*4 allele was similar in the young and middle cohorts (0.12) and slightly lower in the old cohort (0.10). However, the frequency of the APOE*4 allele was three times higher in both early-onset (<65 years; 0.36) and late-onset ({ge}65 years; 0.38) sporadic AD cases compared to the control groups (p<0.0001). In the AD cohort the frequency of the APOE*4 allele was similar across all age groups (<65, 65-75, 76-85, 86+) and so was in men and women (0.40 vs. 0.37). The E*4 homozygosity was observed in 18% of AD cases compared to 1% in each of the three control groups. The E*4 heterozygosity was present in 50% of AD cases compared to 17% in the control old cohort and 22% in both the young and middle control cohorts. These data confirm that the APOE*4 allele is a major risk factor for AD regardless of age-at-diagnosis or family history.

  14. In-depth analyses of organic matters in a full-scale seawater desalination plant and an autopsy of reverse osmosis membrane

    Jeong, Sanghyun

    2016-02-17

    In order to facilitate the global performance of seawater reverse osmosis (SWRO) systems, it is important to improve the feed water quality before it enters the RO. Currently, many desalination plants experience production losses due to incidents of organic and biofouling. Consequently, monitoring or characterizing the pretreatment step using more advanced organic and biological parameters are required for better operation to lessen fouling issues. In this study, the performance of pretreatment processes (including coagulation, dual media filtration (DMF), polishing with cartridge filter (CF) coupled with anti-scalant) used at Perth Seawater Desalination Plant (PSDP) located in Western Australia were characterized in terms of organic and biological fouling parameters. These analyses were carried out using liquid chromatography with organic carbon detector (LC-OCD), three dimensional-fluorescence excitation emission matrix (3D-FEEM) and assimilable organic carbon (AOC). Furthermore, the used (exhausted) RO membrane and CF were autopsied so that the fates and behaviors of organic foulants in these treatment systems could be better understood.

  15. Pulmonary hypoplasia on preterm infant associated with diffuse chorioamniotic hemosiderosis caused by intrauterine hemorrhage due to massive subchorial hematoma: report of a neonatal autopsy case.

    Yamada, Sohsuke; Marutani, Takamitsu; Hisaoka, Masanori; Tasaki, Takashi; Nabeshima, Atsunori; Shiraishi, Mika; Sasaguri, Yasuyuki

    2012-08-01

    A male infant born prematurely at 31 weeks of gestation weighed 789 g and had mildly brown-colored oral/tracheal aspirates at delivery. The amniotic fluid was also discolored, and its index was below 5. The patient died of hypoxemic respiratory and cardiac failure 2 hours after birth. The maternal profiles showed placenta previa and intrauterine growth restriction (IUGR) at 22 weeks of gestation, and revealed recurrent episodes of antenatal and substantial vaginal bleeding and oligohydramnios, indicating chronic abruption-oligohydramnios sequence. The thickened placenta, weighing 275 g, grossly displayed unevenness and diffuse opacity with green to brown discoloration in the chorioamniotic surface, and revealed chronic massive subchorial hematomas (Breus' mole) with old peripheral blood clot, circumvallation, and infarction. Microscopically, diffuse Berlin-blue staining-positive hemosiderin deposits were readily encountered in the chorioamniotic layers of the chorionic plate, consistent with diffuse chorioamniotic hemosiderosis (DCH) due to Breus' mole, accompanied by diffuse amniotic necrosis. At autopsy, an external examination showed several surface anomalies and marked pulmonary hypoplasia, 0.006 (less 0.012) of lung:body weight ratio. Since Breus' mole has a close relationship with intrauterine hemorrhage, resulting in DCH, IUGR, and/or pulmonary hypoplasia of the newborn, the present features might be typical. PMID:22827763

  16. Verbal/Social Autopsy in Niger 2012–2013: A new tool for a better understanding of the neonatal and child mortality situation

    Bensaïd, Khaled; Yaroh, Asma Gali; Kalter, Henry D; Koffi, Alain K; Amouzou, Agbessi; Maina, Abdou; Kazmi, Narjis

    2016-01-01

    Niger, one of the poorest countries in the world, recently used for the first time the integrated verbal and social autopsy (VASA) tool to assess the biological causes and social and health system determinants of neonatal and child deaths. These notes summarize the Nigerien experience in the use of this new tool, the steps taken for high level engagement of the Niger government and stakeholders for the wide dissemination of the study results and their use to support policy development and maternal, neonatal and child health programming in the country. The experience in Niger reflects lessons learned by other developing countries in strengthening the use of data for evidence–based decision making, and highlights the need for the global health community to provide continued support to country data initiatives, including the collection, analysis, interpretation and utilization of high quality data for the development of targeted, highly effective interventions. In Niger, this is supporting the country’s progress toward achieving Millennium Development Goal 4. A follow–up VASA study is being planned and the tool is being integrated into the National Health Management Information System. VASA studies have now been completed or are under way in additional sub–Saharan African countries, in each through the same collaborative process used in Niger to bring together health policy makers, program planners and development partners. PMID:26955472

  17. A comparison of long-term retention of plutonium oxide in lung based on excretion data with observed lung burdens at autopsy

    Experience in the nuclear industry has shown that the most FR-equent route for significant plutonium deposition in man is by inhalation. After an accidental inhalation exposure to plutonium oxide has occurred, an attempt is usually made to determine the lung burden using in-vivo measurement techniques. However, this will not be possible if the amount deposited is less than the detection capability of the counter. Likewise, it may not be possible for even larger intakes if they are first discovered as a results of a routine examination after much of the plutonium has transferred out of the lungs. Under these conditions, the initial lung burden and dose assessment may, of necessity, be based entirely on excretion date. This paper discusses three plutonium inhalation cases for which autopsy data are available to demonstrate the difficulties and uncertainties of such assessments and to emphasize the need for enhanced routine surveillance of the worker and work place to assure that intakes are detected at the time they occur. An in-depth review of the findings for these three cases suggests that the use of urine excretion data applied to ICRP lung model assumption will result in large uncertainties in estimates of the pulmonary burden and lung dose. These estimates will be improved if the material inhaled can be better characterized and by using clearance half times developed for the individual rather than the default values for Class Y material recommended by the ICRP

  18. Atypical amyotrophic lateral sclerosis with dementia mimicking frontal Pick's disease: a report of an autopsy case with a clinical course of 15 years.

    Tsuchiya, K; Ikeda, K; Haga, C; Kobayashi, T; Morimatsu, Y; Nakano, I; Matsushita, M

    2001-06-01

    This report concerns an autopsy case of atypical amyotrophic lateral sclerosis (ALS) with dementia mimicking frontal Pick's disease. The patient was a Japanese woman without hereditary burden who was 45 years old at the time of death. She developed abnormal behavior and amnesia at age 30, followed by disinhibition, aspontaneity, urinary incontinence, abulia, and rectal incontinence. Neurological signs compatible with ALS developed about 14 years after the disease onset. No respirator was used throughout the clinical course. Macroscopically, neuropathological examination showed atrophy of the frontotemporal lobes with accentuation in the convexities of the frontal lobes. Histologically, there was neuronal loss in the cerebral cortex, parahippocampal gyrus, amygdala, caudate nucleus, substantia nigra, brain stem motor nuclei, and anterior horns of the spinal cord, in addition to marked degeneration of the pyramidal tracts. Ubiquitin-immunoreactive neuronal inclusions were present in the frontotemporal cortical layer II neurons and motor neurons in the brain stem and spinal cord. In the hippocampal dentate granular cells, many ubiquitin-immunoreactive neurites were present without ubiquitin-immunoreactive intraneuronal inclusions. Based on these clinicopathological findings and a review of the literature, we concluded that our case was atypical ALS with dementia of long disease duration. We also note the possibility that motor neuron disease-inclusion dementia with a long clinical course may develop into ALS in the final stage of the illness. PMID:11515792

  19. Verbal/Social Autopsy in Niger 2012-2013: A new tool for a better understanding of the neonatal and child mortality situation.

    Bensaïd, Khaled; Yaroh, Asma Gali; Kalter, Henry D; Koffi, Alain K; Amouzou, Agbessi; Maina, Abdou; Kazmi, Narjis

    2016-06-01

    Niger, one of the poorest countries in the world, recently used for the first time the integrated verbal and social autopsy (VASA) tool to assess the biological causes and social and health system determinants of neonatal and child deaths. These notes summarize the Nigerien experience in the use of this new tool, the steps taken for high level engagement of the Niger government and stakeholders for the wide dissemination of the study results and their use to support policy development and maternal, neonatal and child health programming in the country. The experience in Niger reflects lessons learned by other developing countries in strengthening the use of data for evidence-based decision making, and highlights the need for the global health community to provide continued support to country data initiatives, including the collection, analysis, interpretation and utilization of high quality data for the development of targeted, highly effective interventions. In Niger, this is supporting the country's progress toward achieving Millennium Development Goal 4. A follow-up VASA study is being planned and the tool is being integrated into the National Health Management Information System. VASA studies have now been completed or are under way in additional sub-Saharan African countries, in each through the same collaborative process used in Niger to bring together health policy makers, program planners and development partners. PMID:26955472

  20. Development of proton-induced x-ray emission techniques with application to multielement analyses of human autopsy tissues and obsidian artifacts

    A method of trace element analysis using proton-induced x-ray emission (PIXE) techniques with energy dispersive x-ray detection methods is described. Data were processed using the computer program ANALEX. PIXE analysis methods were applied to the analysis of liver, spleen, aorta, kidney medulla, kidney cortex, abdominal fat, pancreas, and hair from autopsies of Pima Indians. Tissues were freeze dried and low temperature ashed before analysis. Concentrations were tabulated for K, Ca, Ti, Mn, Fe, Co, Ni, Cu, Zn, Pb, Se, Br, Rb, Sr, Cd, and Cs and examined for significant differences related to diabetes. Concentrations of Ca and Sr in aorta, Fe and Rb in spleen and Mn in liver had different patterns in diabetics than in nondiabetics. High Cs concentrations were also observed in the kidneys of two subjects who died of renal disorders. Analyses by atomic absorption and PIXE methods were compared. PIXE methods were also applied to elemental analysis of obsidian artifacts from Campeche, Mexico. Based on K, Ba, Mn, Fe, Rb, Sr and Zr concentrations, the artifacts were related to several Guatemalan sources. (Diss. Abstr. Int., B)

  1. "Whenever they cry, I cry with them": Reciprocal relationships and the role of ethics in a verbal autopsy study in Papua New Guinea.

    Gouda, H N; Kelly-Hanku, A; Wilson, L; Maraga, S; Riley, I D

    2016-08-01

    Verbal autopsy (VA) methods usually involve an interview with a recently bereaved individual to ascertain the most probable cause of death when a person dies outside of a hospital and/or did not receive a reliable death certificate. A number of concerns have arisen around the ethical and social implications of the use of these methods. In this paper we examine these concerns, looking specifically at the cultural factors surrounding death and mourning in Papua New Guinea, and the potential for VA interviews to cause emotional distress in both the bereaved respondent and the VA fieldworker. Thirty one semi-structured interviews with VA respondents, the VA team and community relations officers as well as observations in the field and team discussions were conducted between June 2013 and August 2014. While our findings reveal that VA participants were often moved to cry and feel sad, they also expressed a number of ways they benefited from the process, and indeed welcomed longer transactions with the VA interviewers. Significantly, this paper highlights the ways in which VA interviewers, who have hitherto been largely neglected in the literature, navigate transactions with the participants and make everyday decisions about their relationships with them in order to ensure that they and VA interviews are accepted by the community. The role of the VA fieldworker should be more carefully considered, as should the implications for training and institutional support that follow. PMID:27376593

  2. Tattoo types and frequencies in New Mexican white hispanics and white non-hispanics: autopsy data from homicidal and accidental deaths, 2002-2005.

    Komar, Debra; Lathrop, Sarah

    2008-12-01

    Tattoos serve as a form of forensic personal identification and providing evidence of possible gang affiliation, incarceration history, and high-risk lifestyle factors such as drug use. Despite their forensic applications, tattoo typology and frequencies in specific ethnic and racial groups are underreported and poorly understood. This study examined autopsy records from the New Mexico Office of the Medical Investigator from 2002 to 2005. A total of 3430 individuals (1666 white Hispanics; 1764 white non-Hispanics), aged 18 to 100 years, with homicidal or accidental manners of death were included in the study. In addition to demographic information, data were recorded on the presence/absence of tattoos, singular or multiple tattoos, and the language of text tattoos. Tattoos depicting gang or religious symbolism were also recorded. Results indicate statistically significant differences in tattoo frequencies by ethnicity (52% Hispanic vs. 29.5% non-Hispanic), sex (46.8% men vs. 25.9% women) and age cohort. Hispanics were more likely to have multiple tattoos than non-Hispanics (41% and 19%, respectively), and were 4.67 times more likely to have a religious tattoo and 7.13 times more likely to have a gang tattoo than non-Hispanics. Significant patterns in language of text tattoos and correlations with manner of death were also noted. PMID:19259010

  3. Suicide or accident? A psychological autopsy study of suicide in youths under the age of 16 compared to deaths labeled as accidents

    Freuchen Anne

    2012-09-01

    Full Text Available Abstract Objective In the present paper, we describe suicide in youths under 16 years of age and compare their risk factors for suicide to those of older adolescents as described in the literature. Furthermore, we evaluate the possible mislabeling of suicides as accidents, and vice versa. Method We used the data from a nationwide psychological autopsy of youths 15 years and younger who had committed suicide or died in accidents in Norway from 1993 to 2004 (n = 84. We additionally constructed a suicide index to distinguish between the two causes of death. Results The young suicide victims presented, with little gender difference, fewer obvious risk factors and less suicide intent than commonly described for older adolescents. The suicide index distinguished quite well between suicides and accidents, with few cases indicating a possible mislabeling, although some suicide cases could have been labeled as uncertain. Conclusion In line with previous research, suicides in 11-15-year-olds have many similarities to suicides in older adolescents in terms of external circumstances, but they present less apparent warning signs. In our total sample of 84 deaths, there were few indications of incorrect labeling.

  4. The late Greco-Roman and Byzantine contribution towards the evolution of laboratory examinations of bodily excrement. Part 2: sputum, vomit, blood, sweat, autopsies.

    Diamandopoulos, Athanasios A; Goudas, Pavlos C

    2005-01-01

    Although the establishment of medical laboratory institutions was a continuous process that matured only after the 16th century, several attempts had already been made to attain a diagnosis by investigating bodily excrement. In the first part of our work, published in a previous issue of this journal, we presented data on urine, sperm, menses and stools. In this paper we present data on sputum, vomit, blood, sweat, and autopsies, thus completing the list of human materials used for laboratory examinations. All the data used are extracted from codices of Late Antiquity and Byzantium and translated by us. We did not study medical texts from the other great ancestors of Western medicine, namely Arabic and Jewish writings. From the texts cited, it is apparent that the lack of technological means was no obstacle for the doctor to create an "examinational" mind, i.e., to try to correlate the macroscopic findings in the excrement with the pathophysiological mechanism that induced them, solely with the use of the senses. This not only applies to the examination of urine, as is commonly assumed, but also to many other excrements of the upper and lower orifices of the body, as well as the human body as a whole. PMID:15653449

  5. Comprehensive investigation of postmortem glucose levels in blood and body fluids with regard to the cause of death in forensic autopsy cases.

    Chen, Jian-Hua; Michiue, Tomomi; Inamori-Kawamoto, Osamu; Ikeda, Sayuko; Ishikawa, Takaki; Maeda, Hitoshi

    2015-11-01

    The serum glucose level is regulated within a narrow range by multiple factors under physiological conditions, but is greatly modified in the death process and after death. The present study comprehensively investigated glucose levels in blood and body fluids, including pericardial fluid (PCF), cerebrospinal fluid (CSF) and vitreous humor, reviewing forensic autopsy cases (n=672). Right heart blood glucose level was often higher than at other sites, and the CSF glucose level was the lowest, showing greater dissociation in acute/subacute death cases. The glucose level was higher in the diabetic (high HbA1c) than in the non-diabetic (low HbA1c) group at each site (pdeath due to ischemic heart disease. Fatal methamphetamine (MA) abuse, sepsis, malnutrition (starvation) and hypoglycemia due to antidiabetics showed markedly lower blood glucose levels. Ketones in bilateral cardiac blood and PCF were increased in diabetic ketoacidosis and fatal alcohol abuse as well as in most cases of hyperthermia (heatstroke), hypothermia (cold exposure) and malnutrition. These findings suggest that combined analysis of glucose, HbA1c and ketones in blood and body fluids is useful to investigate not only fatal diabetic metabolic disorders but also death processes due to other causes, including alcohol and MA abuse, as well as thermal disorders, sepsis and malnutrition. PMID:26593993

  6. The Experience of ICD Utilization on Verbal Autopsy Data to Obtain Trend of Cause of Death in Indonesian Population (1992–2007

    Sarimawar Djaja

    2014-11-01

    Full Text Available Background: Cause of death data is necessary for arranging health programs. The needs of these data is not fulfill yet through reporting and recording system from health facilities only,therefore national health survei should be conducted regularly. Objective: To obtain cause of death trends in the populations from VA data. Methods: Material taken from Nasional Health Survey 1992, 1995, 2001, 2007 covering 65,664 households (HH, 206,240 HH, 211,168 HH, 258,366 HH respectively, selected by stratified random sampling technique using core and module sample of Socio Economic National Survey (Susenas and taken with a Probability Proportional to Size method. Cause of death data was collected by structured questionnaire using verbal autopsy (VA technique and was classified based on ICD 9 and ICD 10. Results: The disease patterns of cause of death from 1992 to 2007 showed the non-communicable disease is increasing continuously while communicable disease (infectious, maternal and perinatal, nutritional deficiencies is decreasing; however the burden of disease is still present on both groups of diseases. Conclusions: The little bit less accurate VA data (1992–2007 collected is able to produce national statistic data of cause of death and could be used to suggest health planning program managers in Indonesia

  7. Human cranial vault thickness in a contemporary sample of 1097 autopsy cases: relation to body weight, stature, age, sex and ancestry.

    De Boer, H H Hans; Van der Merwe, A E Lida; Soerdjbalie-Maikoe, V Vidija

    2016-09-01

    The relation between human cranial vault thickness (CVT) and various elements of the physical anthropological biological profile is subject of ongoing discussion. Some results seem to indicate no correlation between CVT and the biological profile of the individual, whereas other results suggest that CVT measurements might be useful for identification purposes. This study assesses the correlation between CVT and body weight, stature, age, sex, and ancestry by reviewing data of 1097 forensic autopsies performed at the Netherlands Forensic Institute (NFI). In subadults (younger than 19 years of age at the time of death), all frontal, temporal, and occipital CVT measurements correlated moderately to strongly with indicators of growth (body weight, stature, and age). Neither sex nor ancestry correlated significantly with cranial thickness. In adults, body weight correlated with all CVT measurements. No meaningful correlation was found between CVT and stature or age. Females showed to have thicker frontal bones, and the occipital region was thicker in the Negroid subsample. All correlation in the adult group was weak, with the distribution of cranial thickness overlapping for a great deal between the groups. Based on these results, it was concluded that CVT generally cannot be used as an indicator for any part of the biological profile. PMID:26914798

  8. The Research of DSM - IV SCID in Psychological Autopsy.%DSM - IV临床定式访谈(SCID)在心理解剖诊断中的应用

    许俊亭; 姜潮; 高岩; 刘启贵; 贾树华; 周莉

    2011-01-01

    目的 本研究主要评估SCID在心理解剖中进行精神疾病诊断时的可靠性、灵敏度和特异度问题.方法 对精神疾病住院患者进行SCID访谈(为患者SCID诊断),对患者亲属进行SCID访谈(为心理解剖SCID诊断).计算两种SCID诊断的重测信度,评分者信度以及心理解剖SCID诊断的灵敏度和特异度.结果 患者SCID诊断,除焦虑障碍外,临床常见精神障碍的重测信度及评分者信度都高于0.75;心理解剖SCID诊断的酒精相关障碍、精神病性障碍、双相障碍、抑郁障碍及焦虑障碍的重测信度及评分者信度都大于0.75;在所有轴Ⅰ的疾病中,除酒精滥用和恶劣心境外,心理解剖SCID诊断与患者SCID诊断一致性系数均大于0.6.心理解剖SCID诊断的特异度都大于88%,但敏感度都低于特异度.结论 研究表明SCID诊断具有较高的重测信度和评分者信度.心理解剖SCID诊断具有较好的灵敏度和特异度,与患者SCID诊断的一致性良好.%Objective The reliability, sensitivity, specificity and adoption of the Structured Clinical Interview for DSM - IV Axis I (SCID) in psychological autopsy were investigated. Method All subjects were the psychiatric patients in the No. 7 people * s hospital of Dalian. Diagnosis was made by patients SCID interview and by psychological autopsy SCID interview. Inter - rater reliability and test - retest reliability were assessed in 30 and 35 patients SCID diagnosis and psychological autopsy SCID diagnosis, respectively. Chi - square and kappa analysis were used to determine agreement of diagnoses. Results Kappa coefficients were above 0. 75 for alcohol - related disorders, psychiatric disorders, bipolar disorders and depression disorders for inter - rater and test -retest reliability in patients SCID diagnosis. Kappa coefficients were above 0. 75 for alcohol - related disorders, psychiatric disorders, bipolar disorders, depression disorders and anxiety disorders for inter

  9. [Massive pulmonary thromboembolism found at autopsy in a patient with a 14-year history of polymyositis-associated nonspecific interstitial pneumonia].

    Takagi, Yusuke; Hagiwara, Kiyofumi; Sato, Takeo; Akiyama, Osamu; Ogura, Takashi; Tsugata, Mikiko; Takemura, Tamiko

    2008-10-01

    A 64-year-old woman with a 14-year history of refractory nonspecific interstitial pneumonia (NSIP) associated with polymyositis was admitted urgently to our hospital due to acute exacerbation of dyspnea. The first episode of dyspnea had occurred 14 years earlier and the diagnosis of cellular and fibrotic NSIP had been made by radiographic examinations and open lung biopsy. Her NSIP initially responded well to high-dose prednisolone therapy (40mg/day), but flared when the dose of prednisolone was tapered. Three years after the diagnosis of NSIP, a diagnosis of polymyositis was made based on her elevated serum level of creatinine phosphokinase and muscle biopsy findings. Her polymyositis was controlled well by prednisolone therapy, but her NSIP gradually worsened, despite treatment with several courses of methylprednisolone pulse therapy and immunosuppressive agents. She was brought to our hospital by ambulance due to acute progression of dyspnea and was admitted. Chest X-ray film revealed diffuse interstitial shadows and marked enlargement of the right atrium and bilateral pulmonary arteries. Transthoracic echocardiogram revealed severe dilatation of the right atrium and right ventricle with an estimated pulmonary artery systolic pressure of 84mmHg. She died of progressive respiratory failure on day 4 of hospitalization. Autopsy revealed massive thrombi that completely obstructed the bilateral pulmonary trunks. Histological examination revealed that these thrombi were organized, and her interstitial lung disease (ILD) was specified as fibrotic NSIP with microscopic honeycomb. Massive pulmonary thromboembolism is extremely rare in patients with polymyositis-associated NSIP, but it should be considered as a possible cause of acute exacerbation of respiratory failure. This case provides valuable information on the clinical and pathological course of polymyositis-associated NSIP. PMID:19044031

  10. An autopsy case of superficial siderosis of the central nervous system accompanied by anterior sacral polycystic meningocele in neurofibromatosis type 1.

    Matsumoto, Arifumi; Suzuki, Hiroyoshi; Tobita, Muneshige; Hisanaga, Kinya

    2016-07-28

    A 74-year-old female patient, who was diagnosed with neurofibromatosis type 1 (NF1) at the age of 40, was admitted with complaints of flickering vision and gait disturbance for the last 2 years. On admission, neurological examination revealed mild bilateral hearing loss and ataxia in the limb and trunk. Laboratory tests revealed anti-hepatitis C virus (HCV) antibody positivity and elevated HCV RNA by real-time polymerase chain reaction. The cerebrospinal fluid examination revealed a slightly yellowish appearance with elevated total protein levels. Gradient echo T2*-weighted brain magnetic resonance imaging (MRI) demonstrated a rim of hypointense lesions surrounding the surface of the cerebellum, brainstem, frontal and temporal lobes, and thalamus, which was considered as hemosiderin depositions. From these MRI findings, she was diagnosed as having superficial siderosis of the central nervous system. Cerebral angiography revealed an aneurysm-like dilatation at the bifurcation of the right internal carotid-posterior communicating artery. (99m)Tc-ethyl cysteinate dimer single-photon emission computed tomography revealed hypoperfusion in the bilateral frontal and temporal lobes. Pelvic plain X-ray, pelvic computed tomography, and lumbosacral MRI revealed a sacral defect and an anterior sacral polycystic meningocele communicating with the spinal subarachnoid space. The patient's symptoms gradually worsened, and she died of septic shock because of pyelonephritis at the age of 77. An autopsy was performed; on pathological examination, we did not observe any findings associated with rupture of the aneurysm-like dilatation in the bifurcation of the right internal carotid-posterior communicating artery and cerebral amyloid angiopathy. Because duropathies-a new neurological disease concept-have been implicated as a cause of bleeding in the superficial siderosis, the anterior sacral polycystic meningocele, a type of duropathies, was presumed to be the most probable bleeding

  11. Unnatural deaths in Shanghai from 2000 to 2009: a retrospective study of forensic autopsy cases at the Shanghai Public Security Bureau.

    Meng He

    Full Text Available Shanghai is the most developed city in China and has a soaring population. This study uses forensic epidemiology to determine the relationship between unnatural deaths and the development in Shanghai, based on recently released forensic autopsy cases from the 2000s at the Shanghai Public Security Bureau (SPSB. There were 5425 accidental deaths, 2696 homicides, 429 suicides, 186 natural deaths, and 1399 deaths of undetermined cause. There was a male-to-female ratio of 2.02:1, and the average age was 40.9±18.7 years. Traffic accidents (84.2% were the number one cause of accidental deaths, which decreased during the study period. Sharp force injury (50.6% was the leading cause of homicides, different from Western countries, where firearms are the leading cause. Hanging (24.5% was the leading cause of suicides, whereas drug and chemical intoxication was the leading cause in the previous decade; pesticide ingestion decreased in the 2000s. In addition to traffic accidents, manual strangulation was the leading cause of death in childhood fatalities. Children under age 2 were vulnerable to homicides. In the 2000s, there were a large number of drug overdoses, and illegal medical practices and subway-related deaths first appeared in Shanghai. A new type of terrorist attack that involved injecting people with syringes in public places was reflected in the SPSB archives. The forensic epidemiology and changes in unnatural deaths in this decade reflected their relationship with the law, policy and changes in Shanghai. Illegal medical practices, subway-related deaths and terrorist attacks were closely related to the development in Shanghai. Identifying the risks of unnatural deaths will improve public health.

  12. An autopsy case of frontotemporal lobar degeneration with the appearance of fused in sarcoma inclusions (basophilic inclusion body disease) clinically presenting corticobasal syndrome.

    Matsumoto, Arifumi; Suzuki, Hiroyoshi; Fukatsu, Reiko; Shimizu, Hiroshi; Suzuki, Yasushi; Hisanaga, Kinya

    2016-02-01

    We describe an autopsy case of basophilic inclusion body disease (BIBD), a subtype of frontotemporal lobar degeneration (FTLD) with the appearance of fused in sarcoma (FUS) inclusions (FTLD-FUS), clinically presenting corticobasal syndrome (CBS). A 54-year-old man initially developed worsening of stuttering and right hand clumsiness. Neurological examinations revealed rigidity in the right upper and lower extremities, buccofacial apraxia, and right-side dominant limb-kinetic and ideomotor apraxia. Neuroimaging showed asymmetric left-dominant brain atrophy and a cerebral blood flow reduction in the ipsilateral frontal region. At 56 years, his apraxia had advanced, and ideational apraxia was observed. Furthermore, the asymmetry in the limb-kinetic and ideomotor apraxia had disappeared, and both conditions had become bilateral. He had a new onset of aphasia. His symptoms progressed and he died 9 years after the initial symptoms. The brain weighed 955 g. Diffuse brain atrophy was most obvious in the bilateral frontotemporal regions. The atrophy of the left superior frontal and precentral gyri and bilateral basal ganglia was remarkable. Histologically, there was a marked loss of neurons with gliosis in the affected areas, where basophilic neuronal cytoplasmic inclusions were observed. The inclusions were immunoreactive for FUS, p62, and TATA-binding protein-associated factor 15 (TAF15), but not for phosphorylated tau, transactive response DNA-binding protein of 43 kDa (TDP-43), neurofilament protein, or Ewing sarcoma (EWS). From these pathological findings, this case was diagnosed as having BIBD as an FTLD-FUS variant. Spinal cord lower motor neurons were spared in number, similar to primary lateral sclerosis. Mutations in FUS were undetectable. Common background pathologies for CBS include corticobasal degeneration, Alzheimer's disease, PSP, FTLD with phosphorylated TDP-43 inclusions (FTLD-TDP), Pick's disease, Lewy body disease and CJD. However, FTLD-FUS (BIBD

  13. Social autopsy study identifies determinants of neonatal mortality in Doume, Nguelemendouka and Abong–Mbang health districts, Eastern Region of Cameroon

    Alain K. Koffi

    2015-06-01

    Full Text Available Background Reducing preventable medical causes of neonatal death for faster progress toward the MGD4 will require Cameroon to adequately address the social factors contributing to these deaths. The objective of this paper is to explore the social, behavioral and health systems determinants of newborn death in Doume, Nguelemendouka and Abong–Mbang health districts, in Eastern Region of Cameroon, from 2007–2010. Methods Data come from the 2012 Verbal/Social Autopsy (VASA study, which aimed to determine the biological causes and social, behavioral and health systems determinants of under–five deaths in Doume, Nguelemendouka and Abong–Mbang health districts in Eastern Region of Cameroon. The analysis of the data was guided by the review of the coverage of key interventions along the continuum of normal maternal and newborn care and by the description of breakdowns in the care provided for severe neonatal illnesses within the Pathway to Survival conceptual framework. Results One hundred sixty–four newborn deaths were confirmed from the VASA survey. The majority of the deceased newborns were living in households with poor socio–economic conditions. Most (60–80% neonates were born to mothers who had one or more pregnancy or labor and delivery complications. Only 23% of the de ceased newborns benefited from hygienic cord care after birth. Half received appropriate thermal care and only 6% were breastfed within one hour after birth. Sixty percent of the deaths occurred during the first day of life. Fifty–five percent of the babies were born at home. More than half of the deaths (57% occurred at home. Of the 64 neonates born at a health facility, about 63% died in the health facility without leaving. Careseeking was delayed for several neonates who became sick after the first week of life and whose illnesses were less serious at the onset until they became more severely ill. Cost, including for transport, health care and other expenses

  14. Deriving causes of child mortality by re–analyzing national verbal autopsy data applying a standardized computer algorithm in Uganda, Rwanda and Ghana

    Li Liu

    2015-06-01

    Full Text Available Background To accelerate progress toward the Millennium Development Goal 4, reliable information on causes of child mortality is critical. With more national verbal autopsy (VA studies becoming available, how to improve consistency of national VA derived child causes of death should be considered for the purpose of global comparison. We aimed to adapt a standardized computer algorithm to re–analyze national child VA studies conducted in Uganda, Rwanda and Ghana recently, and compare our results with those derived from physician review to explore issues surrounding the application of the standardized algorithm in place of physician review. Methods and Findings We adapted the standardized computer algorithm considering the disease profile in Uganda, Rwanda and Ghana. We then derived cause–specific mortality fractions applying the adapted algorithm and compared the results with those ascertained by physician review by examining the individual– and population–level agreement. Our results showed that the leading causes of child mortality in Uganda, Rwanda and Ghana were pneumonia (16.5–21.1% and malaria (16.8–25.6% among children below five years and intrapartum–related complications (6.4–10.7% and preterm birth complications (4.5–6.3% among neonates. The individual level agreement was poor to substantial across causes (kappa statistics: –0.03 to 0.83, with moderate to substantial agreement observed for injury, congenital malformation, preterm birth complications, malaria and measles. At the population level, despite fairly different cause–specific mortality fractions, the ranking of the leading causes was largely similar. Conclusions The standardized computer algorithm produced internally consistent distribution of causes of child mortality. The results were also qualitatively comparable to those based on physician review from the perspective of public health policy. The standardized computer algorithm has the advantage of

  15. Causes of death in two rural demographic surveillance sites in Bangladesh, 2004–2010: automated coding of verbal autopsies using InterVA-4

    Nurul Alam

    2014-10-01

    Full Text Available Objective: Population-based information on causes of death (CoD by age, sex, and area is critical for countries with limited resources to identify and address key public health issues. This study analysed the demographic surveillance and verbal autopsy (VA data to estimate age- and sex-specific mortality rates and cause-specific mortality fractions in two well-defined rural populations within the demographic surveillance system in Abhoynagar and Mirsarai subdistricts, located in different climatic zones. Design: During 2004–2010, the sample demographic surveillance system registered 1,384 deaths in Abhoynagar and 1,847 deaths in Mirsarai. Trained interviewers interviewed the main caretaker of the deceased with standard VA questionnaires to record signs and symptoms of diseases or conditions that led to death and health care experiences before death. The computer-automated InterVA-4 method was used to analyse VAs to determine probable CoD. Results: Age- and sex-specific death rates revealed a higher neonatal mortality rate in Abhoynagar than Mirsarai, and death rates and sex ratios of male to female death rates were higher in the ages after infancy. Communicable diseases (CDs accounted for 16.7% of all deaths in Abhoynagar and 21.2% in Mirsarai – the difference was due mostly to more deaths from acute respiratory infections, pneumonia, and tuberculosis in Mirsarai. Non-communicable diseases (NCDs accounted for 56.2 and 55.3% of deaths in each subdistrict, respectively, with leading causes being stroke (16.5–19.3%, neoplasms (13.2% each, cardiac diseases (8.9–11.6%, chronic obstructive pulmonary diseases (5.1–6.3%, diseases of the digestive system (3.1–4.1%, and diabetes (2.8–3.5%, together accounting for 49.2–51.2% points of the NCD deaths in the two subdistricts. Injury and other external causes accounted for another 7.5–7.7% deaths, with self-harm being higher among females in Abhoynagar. Conclusions: The computer

  16. Alterações histopatológicas pulmonares em pacientes com insuficiência respiratória aguda: um estudo em autopsias Pulmonary histopathological alterations in patients with acute respiratory failure: an autopsy study

    Alexandre de Matos Soeiro

    2008-02-01

    Full Text Available OBJETIVOS: Apresentar alterações histopatológicas pulmonares encontradas em autopsias de pacientes falecidos por insuficiência respiratória aguda (IRA e verificar se doenças de base e específicos fatores de risco associados aumentam a incidência dessas alterações. MÉTODOS: Foram revisados laudos finais de autopsias e selecionadas 3.030 autopsias de pacientes > 1 ano de idade, com infiltrado pulmonar radiológico, portadores de doença de base e fatores de risco associados, que morreram por alterações pulmonares decorrentes de IRA. RESULTADOS: As principais alterações histopatológicas pulmonares causadoras de morte imediata foram: dano alveolar difuso (DAD; edema pulmonar; pneumonia intersticial linfocítica (PIL e hemorragia alveolar. As principais doenças de base encontradas foram: AIDS; broncopneumonia; sepse; cirrose hepática; tromboembolismo pulmonar; infarto agudo do miocárdio (IAM; acidente vascular cerebral; tuberculose; câncer; insuficiência renal crônica e leucemia. Os principais fatores de risco associados foram: idade > 50 anos; hipertensão arterial; insuficiência cardíaca congestiva; doença pulmonar obstrutiva crônica e diabetes mellitus. Pacientes com esses fatores de risco e AIDS apresentaram alta probabilidade de desenvolver PIL; pacientes com esses mesmos fatores, de desenvolver DAD, se portadores de sepse ou cirrose hepática; pacientes com tromboembolismo e os mesmos fatores de risco, de desenvolver hemorragia alveolar; pacientes com esses fatores de risco e IAM, de desenvolver edema pulmonar. CONCLUSÕES: Os achados pulmonares em pacientes com óbito por IRA apresentaram quatro padrões histopatológicos: DAD, edema pulmonar, PIL e hemorragia alveolar. Doenças de base e específicos fatores de risco associados correlacionaram-se positivamente com determinados padrões histopatológicos detectados à autópsia.OBJECTIVE: To present the pulmonary histopathological alterations found in the autopsies of

  17. Achados clínicopatológicos na tromboembolia pulmonar: estudo de 24 anos de autópsias Clinicopathological findings in pulmonary thromboembolism: a 24-year autopsy study

    Hugo Hyung Bok Yoo

    2004-10-01

    Full Text Available INTRODUÇÃO: Tromboembolia pulmonar (TEP é ainda uma afecção enigmática em diversos aspectos clínicos e epidemiológicos e frequentemente erroneamente diagnosticada. OBJETIVO: Descrever a prevalência e os achados anatomopatológicos de TEP em uma série de 5261 autópsias realizadas em um hospital universitário de nível terciário, correlacionar estes achados com as doenças de base e verificar a freqüência de suspeita clínica antemortem de TEP. MÉTODO: Revisão dos registros das autópsias consecutivas realizadas de 1979 a 2002 para um estudo retrospectivo. Dos prontuários e dos relatórios de autópsias dos pacientes que tiveram TEP documentada, macro e/ou microscopicamente, foram extraídos dados demográficos, doenças de base, suspeita antemortem de TEP, localização dos trombos nos pulmões e provável local de origem da TEP. RESULTADOS: A freqüência de autópsias foi de 42,0% e TEP foi encontrada em 544 pacientes, sendo a principal causa da morte (TEP fatal em 225 casos. Doenças infecciosas (p=0,0003 foram associadas com TEP não fatal e trauma (p=0,007 com TEP fatal. A taxa de não suspeita antemortem de TEP foi 84,6% e 40,0% destes pacientes apresentaram TEP fatal. Doenças do sistema circulatório (p=0,0001, infecções (pBACKGROUND: Pulmonary thromboembolism (PTE is still an enigmatic disorder in many epidemiological and clinical features, remaining one of the most commonly misdiagnosed disorders. OBJECTIVE: To describe the prevalence and pathological findings of PTE in a series of autopsies, to correlate these findings with underlying diseases, and to verify the frequency of PTE clinically suspected before death. METHOD: The reports on 5261 consecutive autopsies performed from 1979 to 2002 in a Brazilian tertiary referral medical school were reviewed for a retrospective study. From the medical records and autopsy reports of the patients found with macroscopically and/or microscopically documented PTE, were gathered

  18. Autópsias psicológicas sobre suicídio de idosos no Rio de Janeiro Psychogical autopsies into suicide among the elderly in Rio de Janeiro

    Maria Cecília de Souza Minayo

    2012-10-01

    Full Text Available Esse estudo analisa autópsias psicológicas e contextualiza problemas e fatores que levaram algumas pessoas idosas a acabar com a própria vida na cidade do Rio de Janeiro, entre 2004 e 2007. O estudo parte de 26 laudos periciais de homens e mulheres que cometeram suicídios no centro, na zona norte e na zona sul da cidade. As famílias desses idosos foram contatadas por carta e telefone e depois, pessoalmente. Foram oito autópsias psicológicas, por meio das quais foram coletados dados de identificação, genograma da família e uma entrevista que reconstituiu o modo de vida e as razões da violência autoinfligida. Os entrevistados foram familiares, amigos e conhecidos das vítimas. Os suicídios estão associados a depressão, a enfermidades físicas e mentais graves e a fatores socioculturais como decadência profissional e socioeconômica. Esses eventos ocorreram com e sem apoio familiar, com e sem acompanhamento médico. A fragilização cumulativa de recursos pessoais e sociais no ciclo vital revela que o risco do suicídio em idosos exige cuidados permanentes de saúde pública.This study analyses psychological autopsies and contextualizes problems and issues that led to elderly people taking their own lives in the city of Rio de Janeiro between 2004 and 2007. The study began with an analysis of 26 expert findings of elderly men and women who committed suicide in the central, northern and southern areas of Rio de Janeiro. The sample was contacted by letter and telephone and after that, by a one-on-one conversation. Eight psychological autopsies were conducted, in which identification data and family genograms were collected followed by an interview to profile the life style and the reasons for the self-inflicted violence. The interviewees were family members, friends and acquaintances of the victims. The suicides are associated with depression, serious physical and mental illness, as well as socio-cultural factors related to

  19. Síndrome da imunodeficiência adquirida: descrição anátomo-patológica de dois casos de necropsia Acquired immunodeficiency syndrome: pathologic description of two autopsy cases

    Vera L. C. Delmonte

    1984-08-01

    Full Text Available Os Autores apresentam dois casos de Síndrome de Imunodeficiência Adquirida com ênfase aos achados de necropsia. A criptococose generalizada de padrão miliar, infreqüente, e a pneumocistose foram infecções oportunísticas de curso fatal pela destruição parenquimatosa de órgãos vitais que acarretaram. É destacado o papel etiopatogênico do citomegalovírus, pela concomitância de infecção em ambos os casos e associação aos órgãos mais afetados. Extensa necrose de supra-renal foi constatada, possivelmente secundária à destruição celular viral pelo CMV.Two autopsy cases of acquired immunodeficiency disease syndrome are reported. One case showed widespread miliar cryptococcosis, with scarce inflammatory response. The other developed respiratory failure due to pulmonary infection by P. carinii. In both cases we could observe generalized cytomegalic infection, with striking adrenal involvement. Special emphasis is given to the pathologic changes and the possible etiopathogenic role of cytomegaloviroses in the acquired immunodeficiency cases.

  20. Autopsy report of two cases with enterovirus type 71 infection brainstem encephalitis and literature review%肠道病毒71型脑干脑炎二例尸检报道及文献复习

    韦丹; 李坤雄; 陈娥

    2010-01-01

    Objective To understand clinicopathologic characteristics of hand-foot-and-mouth disease.Methods The data of two autopsy cases with brainstem encephalitis caused by enterovirus type 71 infection were analyzed.Results The age of the two patients was younger(≤3 age).The clinical course was rapidly progressive,vesicular rashes were found in one case and the other case had no rashes.Both patients had clinical manifestations of central nervous system.Rapid progression to death were preceded by the development of pulmonary edema and hemorrhage.The results of the autopsy showed that the brain and brain stem were most severely involved and there were inflammation and necrosis.There were lung edema and hemorrhage.The myocardium and other organs were not infiltrated by inflammatory cells.Conclusion Hand-foot-and-mouth disease with enterovirus type 71 infection often affected central nervous system,rapid progression to death was preceded by the development of brain stem encephalitis and pulmonary edema.%目的 探讨手足口病的临床与病理特征.方法 分析2例肠道病毒71型(EV71)脑干脑炎死亡病例尸检结果及临床资料,并复习相关文献.结果 死者年龄≤3岁,病程短,进展快,1例有典型皮疹,1例皮疹不明显,2例均有不同程度的神经系统症状,最终出现肺水肿和肺出血死亡.尸检显示:病变主要在大脑和脑干,可见明显水肿、炎症、坏死等;肺脏主要为水肿和出血;心肌无炎细胞浸润及心肌炎的改变,肝、脾、肾、胰腺及胃肠道病理改变不明显.结论 本组2例尸解结果显示神经系统、呼吸系统病变明显.支持EV71感染的手足口病,常并发中枢神经系统损害;严重的脑干脑炎和神经源性肺水肿、肺出血是死亡的主要原因;也可以解释患儿以咳嗽、气促、抽搐、昏迷为主的临床表现.

  1. Metallographic autopsies of full-scale ITER prototype cable-in-conduit conductors after full cyclic testing in SULTAN: III. The importance of strand surface roughness in long twist pitch conductors

    Sanabria, Charlie; Lee, Peter J.; Starch, William; Devred, Arnaud; Larbalestier, David C.

    2016-07-01

    As part of the ITER conductor qualification process, 3 m long cable-in-conduit conductors (CICCs) were tested at the SULTAN facility under conditions simulating ITER operation so as to establish the current-sharing temperature, T cs, as a function of multiple full Lorentz force loading cycles. After a comprehensive evaluation of both the toroidal field (TF) and the central solenoid (CS) conductors, it was found that T cs degradation was common in long twist pitch TF conductors while short twist pitch CS conductors showed some T cs increase. However, one kind of TF conductors containing superconducting strand fabricated by the Bochvar Institute of Inorganic Materials (VNIINM) avoided T cs degradation despite having long twist pitch. In our earlier metallographic autopsies of long and short twist pitch CS conductors, we observed a substantially greater transverse strand movement under Lorentz force loading for long twist pitch conductors, while short twist pitch conductors had negligible transverse movement. With help from the literature, we concluded that the transverse movement was not the source of T cs degradation but rather an increase of the compressive strain in the Nb3Sn filaments possibly induced by longitudinal movement of the wires. Like all TF conductors this TF VNIINM conductor showed large transverse motions under Lorentz force loading, but T cs actually increased, as in all short twist pitch CS conductors. We here propose that the high surface roughness of the VNIINM strand may be responsible for the suppression of the compressive strain enhancement (characteristic of long twist pitch conductors). It appears that increasing strand surface roughness could improve the performance of long twist pitch CICCs.

  2. Evaluation of image quality and spatial resolution of low-dose high-pitch multidetector-row helical high-resolution CT in 11 autopsy lungs and a wire phantom

    The aim of this study was to evaluate whether low-dose high-pitch (6:1) multidetector-row helical high-resolution CT is appropriate for the evaluation of various pulmonary abnormalities, including faint opacities. Eleven autopsy lungs were scanned with a multidetector-row CT scanner using 2.5 mm x 4 beam collimation, effective slice thickness 3 mm, 6:1 pitch, 0.8 second gantry rotation speed, 20 cm Display Fov, high spatial frequency (bone) algorithm, and various radiation doses (120 kVp; 160, 80, 40, 24, and 8 mAs). The image quality of each CT set was assessed as adequate or inadequate for diagnosis by two independent observers. In addition, a wire phantom was scanned with the same parameters in order to describe the modular transfer function (MTF) curves. There was excellent agreement between the observers for the evaluation of image quality (kappa statistic, 0.84). The ratio of images evaluated as inadequate for 8 mAs and 24 mAs was significantly higher than that for 160, 80, and 40 mAs (p<0.01: chi-square test). MTF curves of both 8 and 24 mAs were significantly inferior to those of 40, 80, and 160 mAs (p<0.01, Friedman test), while the MTF curve of 40 mAs was relatively inferior to that of 160 mAs (p<0.05, Friedman test). More than 40 mAs in combination with 120 kVp is preferable for the evaluation of details of lung parenchyma by high-pitch. multidetector-row helical high-resolution CT. (author)

  3. Evaluation of image quality and spatial resolution of low-dose high-pitch multidetector-row helical high-resolution CT in 11 autopsy lungs and a wire phantom

    Johkoh, Takeshi; Honda, Osamu; Yamamoto, Shuji [Osaka Univ., Suita (Japan). Medical School] (and others)

    2001-12-01

    The aim of this study was to evaluate whether low-dose high-pitch (6:1) multidetector-row helical high-resolution CT is appropriate for the evaluation of various pulmonary abnormalities, including faint opacities. Eleven autopsy lungs were scanned with a multidetector-row CT scanner using 2.5 mm x 4 beam collimation, effective slice thickness 3 mm, 6:1 pitch, 0.8 second gantry rotation speed, 20 cm Display Fov, high spatial frequency (bone) algorithm, and various radiation doses (120 kVp; 160, 80, 40, 24, and 8 mAs). The image quality of each CT set was assessed as adequate or inadequate for diagnosis by two independent observers. In addition, a wire phantom was scanned with the same parameters in order to describe the modular transfer function (MTF) curves. There was excellent agreement between the observers for the evaluation of image quality (kappa statistic, 0.84). The ratio of images evaluated as inadequate for 8 mAs and 24 mAs was significantly higher than that for 160, 80, and 40 mAs (p<0.01: chi-square test). MTF curves of both 8 and 24 mAs were significantly inferior to those of 40, 80, and 160 mAs (p<0.01, Friedman test), while the MTF curve of 40 mAs was relatively inferior to that of 160 mAs (p<0.05, Friedman test). More than 40 mAs in combination with 120 kVp is preferable for the evaluation of details of lung parenchyma by high-pitch. multidetector-row helical high-resolution CT. (author)

  4. Metallographic autopsies of full-scale ITER prototype cable-in-conduit conductors after full cyclic testing in SULTAN: II. Significant reduction of strand movement and strand damage in short twist pitch CICCs

    Sanabria, Carlos; Lee, Peter J.; Starch, William; Devred, Arnaud; Larbalestier, David C.

    2015-12-01

    Prototype cable-in-conduit-conductors (CICCs) destined for use in the toroidal field and central solenoid coils of the ITER experimental fusion reactor underwent severe cyclic loading in the SULTAN facility. Their autopsies revealed significant and permanent transverse strand migration due to the large Lorentz forces of the SULTAN test. The movement resulted in a 3%-7% void fraction increase on the low pressure (LP) side of the longer twist pitch CICCs. However, short twist pitch conductors exhibited less than 1% void fraction increase in the LP side, as well as a complete absence of the Nb3Sn filament fractures observed in the longer twist pitch conductors. We report here a detailed strand-to-cable analysis of short and longer ‘baseline’ twist pitch CICCs. It was found that the use of internal tin (IT) strands in the longer ‘baseline’ twist pitch CICCs can be beneficial possibly because of their superior stiffness—which better resist strand movement—while the use of bronze process strands showed more movement and poorer cyclic test performance. This was not the case for the short twist pitch CICC. Such conductor design seems to work well with both strand types. But it was found that despite the absence of filament fractures, the short twist pitch CICC made from the IT strands studied here developed severe strand distortion during cabling which resulted in diffusion barrier breaks and Sn contamination of the Cu stabilizer during the heat treatment. Conversely, the short twist pitch CICC made from bronze process strands preserved diffusion barrier integrity.

  5. Hepatobiliary alterations in massive biliary ascariasis: histopathological aspects of an autopsy case Lesões hepatobiliares em ascaridíase biliar maciça: aspectos histopatológicos em um caso de autópsia

    Luiz Carlos da Costa Gayotto

    1990-04-01

    Full Text Available Hepatobiliary alterations found in an autopsy case of massive Biliary Ascariasis, are reported on histological grounds. Severe cholangitis was the main finding, but other changes were also detected, such as pyloric and intestinal metaplasia, hyperplasia of the epithelial lining, with intraductal papillomas and adenomatous proliferation. Remnants of the worm were observed tightly adhered to the epithelium, forming microscopic intrahepatic calculi. Mucopolysaccharides, especially acid, showed to be strongly positive on the luminal border, and in proliferated glands around the ducts. The authors discuss the similarity between such findings and Oriental Cholangiohepatitis, and suggest that inflammation and the presence of the parasitic remnants are responsible for the hyperplastic and metaplastic changes, similarly with what occurs in chlonorchiasis, fascioliasis and schistosomiasis.Os autores apresentam os aspectos histopatológicos encontrados no fígado de um caso de autópsia de Ascaridíase Biliar maciça. A intensa colangite foi o aspecto predominante, mas outras lesões também foram encontradas, tais como metaplasia pilórica e intestinal, hiperplasia epitelial com papilomas intraductais, e por vezes padrão adenomatoso. Restos do helminto foram encontrados fortemente aderidos ao epitélio, sendo intensa a positividade de mucopolissacárides, principalmente ácidos, na borda luminal do epitélio ductal e em glândulas proliferadas ao redor dos ductos. Os autores discutem a semelhança da Ascaridíase Biliar com a Colangio Hepatite Oriental, e sugerem que o processo inflamatório e a presença de restos do verme são responsáveis pelas alterações hiperplásicas e metaplásicas, analogamente ao que ocorre na clonorquíase, fasciolíase e esquistossomose.

  6. Causas de óbito em pacientes com síndrome da imunodeficiência adquirida, necropsiados na Fundação de Medicina Tropical do Amazonas Causes of death among patients with acquired immunodeficiency syndrome autopsied at the Tropical Medicine Foundation of Amazonas

    Sílvia Leopoldina Santos de Souza

    2008-06-01

    Full Text Available O objetivo deste estudo foi verificar em 129 pacientes com AIDS, necropsiados na Fundação de Medicina Tropical do Amazonas de 1996 a 2003, as causas do óbito, observando o grau de concordância entre os diagnósticos necroscópicos com os diagnósticos clínicos. A doença mais freqüente que causou o óbito foi tuberculose 28%, seguida de pneumonia bacteriana 17%, histoplasmose 13%, toxoplasmose 10%, pneumocistose 8%, criptococose 5%, sepse bacteriana 4% e 15% outras causas. A concordância entre o diagnóstico clínico antemortem e a necropsia foi de 51,9%. O principal órgão acometido foi o pulmão 82,2%. O tempo de sobrevivência após o diagnóstico laboratorial até o óbito variou entre um mês e 120 meses. A média de sobrevivência foi 15 dias e 56% morreram menos de um mês após o diagnóstico, 15 pacientes morreram na mesma data do diagnóstico. Esses resultados demonstram a importância da necropsia na causa mortis em pacientes com AIDS.The aim of this study was to investigate the causes of death among 129 AIDS patients that were autopsied at the Tropical Medicine Foundation of Amazonas between 1996 and 2003. The degree of concordance between the autopsy diagnoses and the clinical diagnoses was observed. The disease that most frequently caused death was tuberculosis (28%, followed by bacterial pneumonia (17%, histoplasmosis (13%, toxoplasmosis (10%, pneumocystosis (8%, cryptococcosis (5%, bacterial sepsis (4% and other causes (15%. The concordance between the clinical diagnosis before death and the autopsy was 51.9%. The main organ involved was the lungs (82.2%. The length of survival from the time of the laboratory diagnosis to death ranged from one month to 120 months. The mean length of survival was 15 days and 56% died less than one month after the diagnosis, while 15 patients died on the same day that they were diagnosed. These results show the importance of autopsies in elucidating the causes of death among AIDS patients.

  7. Autópsias psicológicas e psicossociais de idosos que morreram por suicídio no Brasil Psychological and psychosocial autopsies of the elderly who committed suicide in Brazil

    Fátima Gonçalves Cavalcante

    2012-08-01

    Full Text Available Analisam-se 51 casos de suicídio de idosos em dez municípios brasileiros, visando a conhecer a interação de variáveis associadas ao fenômeno. Uma revisão sobre o tema dá suporte teórico ao estudo. Tendo como base o método da autópsia psicológica, o estudo parte de um roteiro de entrevista semiestruturada, aplicada e analisada por pares de pesquisadores, mediante um mesmo procedimento de coleta, organização e análise dos dados. O conjunto foi reexaminado através de uma meta-análise de enfoque psicossocial e qualitativo sobre dados dos familiares entrevistados, interpretações dos pesquisadores, contextualização socioantropológica e categorias de relevância. Foram estudadas formas de perpetração e letalidade por sexo, faixa etária, perfil socioeconômico; fatores associados; e motivos atribuídos. Analisou-se a interação de fatores precipitantes relevantes. As conclusões apontam convergências entre estudos epidemiológicos e qualitativos. Doenças graves, deficiências e transtornos mentais juntos formam as principais causas, seguidas de depressão, conflitos familiares e conjugais. Recomenda-se atenção à qualidade de vida dos idosos, especialmente dos homens, que constituem o grupo de maior risco para suicídio.The authors analyze 51 cases of suicide among the elderly from ten Brazilian municipalities. The objective is to understand the interaction of variables associated with suicide among the elderly. A bibliographic review gives theoretical support to this study. Based on psychological autopsy, the study begins with a semi-structured interview format, which was applied and analyzed by peer researchers, using the same procedure for gathering, organizing and analyzing the data. This material was reviewed using a psychosocial and qualitative meta-analysis approach based on family interview data, researchers' interpretations, socio-anthropological contextualization and relevance categories. Ways of committing

  8. Misoprostol como abortivo en España: A propósito de un caso de autopsia judicial Misoprostol as an abortive in Spain: Report of a judicial autopsy case

    PM. Garamendi González

    2004-10-01

    Full Text Available El Misoprostol es un agente farmacológico introducido en el mercado español bajo la forma de un fármaco protector gástrico y comercializado actualmente en asociación con un antinflamatorio. Desde hace varios años, se desarrolla un debate internacional sobre el hecho de que este mismo producto cumple las características de un abortivo extremadamente eficaz. No obstante, el uso inadecuado del Misoprostol puede causar daños severos a la madre y al feto, tanto si el producto se usa con fines abortivos como si se administra accidentalmente durante una gestación, incluso a las dosis recomendadas. Por otra parte, el Misoprostol tiene un rápido metabolismo y no es fácilmente identificable por los laboratorios toxicológicos de referencia, limitando su posible identificación en casos de uso inadecuado, voluntario o accidental. Se presenta un caso de autopsia médico legal tras un posible episodio de aborto inducido por la administración de Misoprostol.Misoprostol is a drug commercialized in Spain as a gastric protector. Nowadays it is sold in our country also associated with diclofenac to prevent gastric damages produced by anti-inflammatories. During the last few years, there has been a public debate in medical press about the fact that Misoprostol has also proved to be an excellent abortive. Nevertheless, when it is not properly used Misoprostol can be the cause of severe damages to the fetus and the mother. This Prostaglandin E1 analog is a drug rapidly metabolized in humans and it is not easy to identify in toxicological analyses. This is the main bias when trying to identify it in forensic cases of accidental damages after using it as a gastric protector or voluntary administration as an abortive. We present a case report about a forensic autopsy following a possible Misoprostol induced abortion.

  9. Autópsia psicológica e psicossocial sobre suicídio de idosos: abordagem metodológica Psychological and psychosocial autopsy on suicide among the elderly: a methodological approach

    Fátima Gonçalves Cavalcante

    2012-08-01

    Full Text Available O artigo analisa a qualidade e a consistência de um roteiro de entrevista semiestruturada, adaptado para o estudo do suicídio de pessoas idosas e apresenta o método das autópsias psicossociais que resultou da aplicação desse instrumento. O objetivo é demonstrar como o uso da entrevista em profundidade e sua forma de organização e análise de dados foram testados e aperfeiçoados por uma rede de pesquisadores de vários centros de pesquisa do Brasil. O método envolveu a aplicação do instrumento em que se socializou um manual de instruções sobre a coleta, sistematização e análise de dados. A metodologia foi aplicada no estudo de 51 casos de idosos que faleceram por suicídio em dez municípios brasileiros, e permitiu a verificação da consistência do instrumento usado e a aplicabilidade do seu método, durante o processo e ao final, por meio de uma avaliação em rede. O roteiro aperfeiçoado e as instruções para replicá-lo e analisá-lo são aqui apresentados. Os resultados apontam o rigor e a credibilidade dessa abordagem metodológica testada e qualificada de um modo interdisciplinar e interinstitucional.The article analyzes the quality and consistency of a semi-structured interview script, adapted for the study on suicide among elderly people, and presents the psychological and psychosocial autopsy method, which is the result of application of this instrument. The objective is to demonstrate how the in-depth interview and subsequent data organization and analyses were tested and improved by a network of researchers from eight regions in Brazil. Evaluation of the method was conducted before and after the application of the instruments to collect, systematize and analyze the data. This methodology was applied in 51 cases of elderly people who committed suicide in ten Brazilian municipalities. The study did more than just collect data with scientific rigor, since it also verified the consistency of the instrument used and

  10. 42 CFR 37.203 - Autopsy specifications.

    2010-10-01

    ... Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND...) Shall include: (i) Gross and microscopic examination of the lungs, pulmonary pleura, and... under this subparagraph shall be in the metric system); (iii) Circumference of each cardiac valve...

  11. Tay Sachs disease: an autopsy case report.

    Jadhav, Meenal Vitthal; Landge, Meenal P; Sawaimoon, Satyakam K; Harke, Arun B; Deshmukh, Sanjay D

    2005-10-01

    This report describes a case report of a postmortem performed on a 5-year old patient of Tay-Sachs disease, presenting with failure to thrive, muscular flaccidity, and cherry-red spots on macula on fundoscopy. There was no history of similarly affected sibling or any other family member. The diagnosis was confirmed by enzyme studies. At postmortem, there was no organomegaly. The brain, on microscopy, showed vacuolated swollen neurons. PMID:16366100

  12. SIRENOMELIA: A DETAILED FETAL AUTOPSY STUDY

    Parimala Sirikonda; Nalluri Himabindu

    2015-01-01

    Sirenomelia also known as mermaid syndrome, characterized by fused lower limbs, is a lethal and rare congenital abnormality. This is an extreme example of caudal regression syndrome caused by vascular steal of single umbilical artery. Sirenomelia is found approximately one in 100,000 live births and is usually fatal because of complications associated with pulmonary hypoplasia, abnormal development of the kidneys and urinary bladder. Most of the cases are associated with maternal diabetes an...

  13. Anthrax Meningitis - Report Of An Autopsied Case

    Mahadevan A

    1999-01-01

    Full Text Available Anthrax is a rare cause of hemorrhagic meningitis in man. This report illustrates the characteristic hemorrhagic manifestations in the brain of a patient dying of anthrax meningitis secondary to overwhelming bacteremia. Gross examination of the brain revealed a thick dense subarachnoid hemorrhage with numerous petechial hemorrhages in the cortex. Histologically, meningoencephalitis with vascular necrosis, edema, perivascular cortical hemorrhages and clumps of Gram positive bacilli in the vascular lumen and invading vessel wall were the salient features. The anthrax bacillus was isolated from CSF and brain tissue and further its pathogenecity was confirmed by animal inoculation.

  14. Anthrax Meningitis - Report Of An Autopsied Case

    Mahadevan A; Panda K. M; Khanna N; Swamy H S; Yasha T. C

    1999-01-01

    Anthrax is a rare cause of hemorrhagic meningitis in man. This report illustrates the characteristic hemorrhagic manifestations in the brain of a patient dying of anthrax meningitis secondary to overwhelming bacteremia. Gross examination of the brain revealed a thick dense subarachnoid hemorrhage with numerous petechial hemorrhages in the cortex. Histologically, meningoencephalitis with vascular necrosis, edema, perivascular cortical hemorrhages and clumps of Gram positive bacilli in the v...

  15. 76 FR 75509 - Autopsies at VA Expense

    2011-12-02

    ... issuing any rule that may result in expenditure by State, local, or Tribal governments, in the aggregate... public inspection in the Office of Regulation Policy and Management, Room 1063B, between the hours of 8 a... INFORMATION CONTACT: Kristin J. Cunningham, Director, Business Policy, Chief Business Office, Department...

  16. Diagnóstico del origen y la causa de la muerte después de la autopsia médico-legal (Parte I Diagnosis of the origin and cause of death after the medico-legal autopsy (Part I

    J.L. Palomo Rando

    2010-12-01

    Full Text Available Una de las tareas más difíciles en patología forense puede ser determinar, después de la autopsia, el origen y la causa de la muerte cuando dichos extremos no están claros o son discutibles. Una autopsia técnicamente perfecta es condición necesaria pero no suficiente para cumplir adecuadamente esta decisión. En el presente trabajo se delimitan claramente los conceptos de causa y mecanismo de muerte, muerte natural y muerte violenta. Se revisan muchos de los aspectos relacionados con el diagnóstico del origen y la causa de la muerte; especialmente el enfoque actual del valor de la autopsia en el diagnóstico, la interacción entre traumatismo y enfermedad, la doctrina de la causalidad, la utilización de la CIE-10, la llamada etiología médico-legal, la autopsia psicológica, la "autopsia blanca" o negativa y el origen de la muerte por complicaciones de la terapéutica, etc., todos ellos se ilustran con ejemplos de casos representativos. Se discute el limitado papel del patólogo forense en España en la determinación de la denominada etiología médico-legal. Las conclusiones constituyen un conjunto de recomendaciones para el mejor cumplimiento de este trabajo, entre ellas el abandono de las denominadas causas de muerte inaceptables como parada cardiaca, parada cardiorrespiratoria o muerte cerebral, etc., la utilización siempre que sea posible de los diagnósticos de la CIE-10 y del formato del apartado de la causa de la muerte (parte I y II del modelo internacional de certificado médico de causa de defunción de la OMS. Todo ello como guía breve que facilite un resultado judicial adecuado y aumente la credibilidad del patólogo forense.One of the most difficult tasks in forensic pathology is deciding the origin and the cause of death after the autopsy when those issues are unclear or debatable. A technically perfect autopsy is a necessary but not a sufficient condition to adequately fulfil this decision. The present paper clearly

  17. Diagnóstico del origen y la causa de la muerte después de la autopsia médico-legal (Parte II Diagnosis of the origin and cause of death after the medico-legal autopsy (Part II

    J.L. Palomo Rando

    2011-03-01

    Full Text Available Una de las tareas más difíciles en patología forense puede ser determinar, después de la autopsia, el origen y la causa de la muerte cuando dichos extremos no están claros o son discutibles. Una autopsia técnicamente perfecta es condición necesaria pero no suficiente para cumplir adecuadamente esta decisión. En el presente trabajo se delimitan claramente los conceptos de causa y mecanismo de muerte, muerte natural y muerte violenta. Se revisan muchos de los aspectos relacionados con el diagnóstico del origen y la causa de la muerte; especialmente el enfoque actual del valor de la autopsia en el diagnóstico, la interacción entre traumatismo y enfermedad, la doctrina de la causalidad, la utilización de la CIE-10, la llamada etiología médico-legal, la autopsia psicológica, la "autopsia blanca" o negativa y el origen de la muerte por complicaciones de la terapéutica, etc., todos ellos se ilustran con ejemplos de casos representativos. Se discute el limitado papel del patólogo forense en España en la determinación de la denominada etiología médico-legal. Las conclusiones constituyen un conjunto de recomendaciones para el mejor cumplimiento de este trabajo, entre ellas el abandono de las denominadas causas de muerte inaceptables como parada cardiaca, parada cardiorrespiratoria o muerte cerebral, etc., la utilización siempre que sea posible de los diagnósticos de la CIE-10 y del formato del apartado de la causa de la muerte (parte I y II del modelo internacional de certificado médico de causa de defunción de la OMS. Todo ello como guía breve que facilite un resultado judicial adecuado y aumente la credibilidad del patólogo forense.One of the most difficult tasks in forensic pathology is deciding the origin and the cause of death after the autopsy when those issues are unclear or debatable. A technically perfect autopsy is a necessary but not a sufficient condition to adequately fulfil this decision. The present paper clearly

  18. Guías para la práctica de la autopsia en casos de muerte súbita cardíaca Guidelines for autopsy investigation of sudden cardiac death

    C. Basso

    2009-01-01

    there is considerable variation in the way in which they approach this increasingly complex task. The Association for European Cardiovascular Pathology developed guidelines, which represent the minimum standard that is required in the routine autopsy practice for the adequate assessment of sudden cardiac death, including not only a protocol for heart examination and histological sampling, but also for toxicology and molecular investigation. Our recommendations apply to university medical centres, regional and district hospitals and all types of forensic medicine institutes. If a uniform method of investigation is adopted throughout the European Union, this will lead to improvements in standards of practice, allow meaningful comparisons between different communities and regions and, most importantly, permit future trends in the patterns of disease causing sudden death to be monitored.

  19. Autopsia bucal post-exhumación en víctimas de un desastre masivo: Masacre de la Cárcel de Sabaneta, Maracaibo, Venezuela Post-exhumation buccal autopsy in victims of a massive disaster: the Sabaneta Jail Massacre, Maracaibo, Venezuela

    J.L. Fereira Paz

    2002-10-01

    Full Text Available Ante la solicitud presentada por los parientes de víctimas no identificadas de la Masacre de la Cárcel de Sabaneta, Maracaibo, Venezuela, un tribunal ordenó la exhumación de cuatro cadáveres, quince días después de haber sido sepultados. Se observó una buena conservación de los restos con apreciable mantenimiento de las estructuras y contornos faciales. Se evidenció que el método de acceso a la cavidad oral empleado en la autopsia bucal pre-inhumación facilitó el abordaje para la autopsia post-exhumación, sin provocar mayor destrucción de los tejidos blandos y permitiendo la correcta manipulación tanto de las estructuras orales como de los dispositivos protésicos aportados como evidencias. En todos los casos se verificó la coincidencia de los datos obtenidos durante la autopsia pre-sepultura. Se concluye que cuando el proceso de inhumación se lleva a cabo siguiendo una adecuada planificación, se facilita una futura recuperación del cadáver cuando esta es requerida para completar el procedimiento de identificación.In view of the petition presented by the relatives of the unidentified victims of the Sabaneta Jail Massacre, Maracaibo, Venezuela, a court ordered the exhumation of four corpses, fifteen days after they were buried. The remains were well preserved, the structure and facial outline were well conserved. It was evidenced that the method of access to the oral cavity employed in the pre-inhumation buccal autopsy facilitated the approach to the post-inhumation autopsy, without causing major destruction of the soft tissues and allowing for the correct manipulation of the oral structures as well as of the prosthetic appliances presented as evidence. In all cases, the coincidence of the data obtained during the pre-burial autopsy was verified. It was concluded that adequate planning of the inhumation process facilitates future recuperation of the bodies when this is required to complete the identification procedure.

  20. Neurocisticercose: contribuição da necrópsia na consolidação da notificação compulsória em Ribeirão Preto-SP, Brazil Neurocysticercosis: contribution of autopsies to consolidation of the compulsory notification in Ribeirão Preto-SP, Brazil

    LEILA CHIMELLI

    1998-09-01

    Full Text Available O presente estudo tem como objetivo a apresentação dos achados de cisticercose nas necrópsias realizadas no Serviço de Patologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP, no período de 1992 a 1997. Das 2522 necrópsias, a neurocisticercose foi detectada em 38 (1,5% dos casos. Destes, 22 (57,9% foram diagnosticados apenas na necrópsia enquanto 16 (42,1% apresentavam exames complementares consistentes com cisticercose. A análise dos prontuários médicos evidenciou que 21 (55,2% eram neurologicamente assintomáticos e a frequência das diversas manifestações clínicas estava de acordo com os dados da literatura. A elevada frequência de indivíduos assintomáticos detectados apenas através da necrópsia demonstra a importância desta como fonte complementar de dados para a consolidação da notificação compulsória da cisticercose. Embasado nos dados do presente estudo, o atual coeficiente de prevalência da cisticercose no município de Ribeirão Preto é 67 casos/100000 habitantes.Neurocysticercosis is a serious public health problem in several countries of Asia, Africa and Latin America. The objective of the present study is to present autopsy findings of neurocysticercosis in the Pathology Division of the University Hospital, Medical School of Ribeirão Preto, University of São Paulo, from 1992 to 1997. Neurocysticercosis was detected in 38 (1.5% of 2522 autopsies. In twenty two (57.9% of these, the diagnosis was made post-mortem, while 16 (42.1% had a previous diagnosis of cysticercosis based on laboratory and imaging studies. Reviewing the medical records, we found that 21 patients (55.2% were neurologically asymptomatic, while the various clinical manifestations in the others were in accordance with the literature. The high frequency of asymptomatic individuals detected only post-mortem indicates the importance of autopsies as an additional source of data to consolidate the compulsory

  1. Estudo das malformações congênitas do aparelho urinário: análise de 6.245 necropsias pediátricas Study of urinary tract congenital malformations: analysis of 6,245 pediatric autopsies

    Lucia de Noronha

    2003-09-01

    Full Text Available O presente estudo tece investigações sobre os aspectos epidemiológicos de malformações do aparelho urinário de uma população de natimortos, neomortos, lactentes, pré-escolares e escolares de uma amostra representativa da população de Curitiba e região metropolitana - análise de 40 anos de necropsias na Unidade de Patologia Pediátrica e Perinatal (UPPP do Serviço de Anatomia Patológica do Hospital de Clínicas de Curitiba da Universidade Federal do Paraná (UFPR. Variáveis como sexo, idade, faixa etária e causas de morte são correlacionadas, estratificando a amostra em grupos específicos de indivíduos, apontando anormalidades epidemiológicas, doenças raras e a relação das doenças com o processo de morte. Foram encontrados 182 casos com malformações do aparelho urinário, correspondendo a 2,9% do número de necropsias avaliadas. Não foram observadas diferenças entre os sexos, e houve maior prevalência de recém-natos com tais anormalidades. A classe mais prevalente foi a de malformações renais e de trato urinário superior, com 150 casos.The presented study investigates epidemiologic aspects regarding congenital malformations of the urinary tract in a representative sample of stillborns, newborns, infants and children from Curitiba, analising autopsies from the Pediatric and Perinatal Pathology Unit (Service of the Clinical Hospital - Curitiba, Paraná in a 40-year period. Sex, age groups and death causes are correlated, dividing the cases in specific groups of study, revealing epidemiologic abnormalities, rare diseases and diseases related to the death process. Out of 6,245 autopsies, 182 cases (2.9% presented urinary tract congenital malformations. There was no difference between sex, and the group of newborns was the most prevalent. The group of malformations of the kidney and upper urinary tract contributed with 150 abnormalities.

  2. Muerte inesperada súbita en el Servicio de Urgencias, de paciente tratada por neurosis de ansiedad, portadora de un feocromocitoma descubierto durante la autopsia. Sudden unexpected death at the medical Emergency Service of a patient, treated for anxiety neurosis, who had a heochromocytoma, found at forensic autopsy.

    A. Serratosa

    2002-07-01

    unexpected death, which took place at the Medical Emergency Service, of a patient diagnosed with anxiety neurosis. The forensic autopsy discovered the existence of a pheochromocytoma of the left suprarenal medulla.

  3. Identificação de agentes infecciosos pulmonares em autópsias de pacientes com a síndrome da imunodeficiência adquirida Identification of infectious agents in the lungs in autopsies of patients with acquired immunodeficiency syndrome

    Sanivia Aparecida de Lima Pereira

    2002-12-01

    Full Text Available As afecções pulmonares são freqüentes em indivíduos infectados pelo vírus da imunodeficiência humana. Neste trabalho, procurou-se identificar através de histoquímica e imunohistoquímica, agentes infecciosos nos pulmões de indivíduos portadores da síndrome da imunodeficiência adquirida (SIDA, autopsiados entre março de 1990 e julho de 2000 na FMTM. Fragmentos de pulmão de 40 indivíduos com SIDA autopsiados foram analisados histologicamente. Foram identificados agentes infecciosos em 34 (85% casos dos 40 analisados, sendo que bactérias foram encontradas em 22 (55% casos. Entre os agentes fúngicos o Pneumocystis carinii foi encontrado em oito (19,1% casos; Cryptococcus sp em quatro (9,5%, Histoplasma sp em dois (4,8% e Candida sp em um (2,4% caso. Detectou-se também associação entre Pneumocystis carinii, Citomegalovirus e Cryptococcus sp; CMV e Toxoplasma gondii. Em cinco casos, Candida sp, CMV e Pneumocystis carinii estiveram associados a bactérias. Entre as infecções não bacterianas, os fungos foram os agentes infecciosos mais isolados dos pulmões em autópsias de indivíduos com SIDA, sendo o Pneumocystis carinii o mais freqüente.Lung diseases are frequently observed in individuals infected with HIV. The aim of this study was to identify infectious agents in the lungs in the autopsied individuals with AIDS performed between march 1990 and july 2000 at the school of medicine (Uberaba- Brazil, using histochemical and immunohistochemical techniques. Analysis was made on lungs obtained from 40 individuals with AIDS. Infectious agents were observed in 34 (85% cases of the 40 analyzed. Regarding fungis, Pneumocystis carinii was found in 8 (19.1%cases; Cryptococcus sp in 4 (9.5%cases, Histoplasma sp in 2 (4.8%cases and Candida sp in 1 (2.4%case. Association of Pneumocystis carinii, Citomegalovirus and Cryptococcus sp, was observed in one case, and in another, the association of CMV, and Toxoplasma gondii. There were 5 cases

  4. Autopsy-certified maternal mortality at Ile-Ife, Nigeria

    Dinyain A; Omoniyi-Esan GO; Olaofe OO; Sabageh D; Komolafe AO; Ojo OS

    2013-01-01

    Amatare Dinyain,1 G Olutoyin Omoniyi-Esan,2 Olaejirinde O Olaofe,3 Donatus Sabageh,3 Akinwumi O Komolafe,2 Olusegun S Ojo21Department of Anatomic Pathology, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria; 2Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria; 3Department of Morbid Anatomy and Histopathology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, NigeriaAim: Maternal mortality is a maj...

  5. Primary diffuse leptomeningeal gliomatosis: An autopsy case report

    Shaik Afshan Jabeen; Arikapadu Haritha Chowdary; Rukmini Mridula Kandadai; Uppin, Megha S.; Angamattu Kanikannan Meena; Rupam Borgohain; Challa Sundaram

    2014-01-01

    Primary diffuse leptomeningeal gliomatosis (PDLG) is a rare condition, characterized by infiltration of the meninges by glial cells without evidence of the primary tumor in the brain or spinal cord parenchyma. Glioma arising primarily from the leptomeninges is extremely rare and often diagnosed only in post mortem examination and the diagnosis may be missed in meningeal biopsy. We describe a young female who presented with symptoms of raised intracranial pressure with imaging evidence of diff...

  6. The Chemical Adventures of Sherlock Holmes: Autopsy in Blue

    Waddell, Thomas G.; Rybolt, Thomas R.

    2004-01-01

    A chemical mystery with an emphasis on qualitative inorganic analysis, forensic chemistry and medicinal substances is discussed. The mystery is solved by Sherlock Holmes with the help of clues provided.

  7. Autopsy report for chemical burns from cresol solution.

    Emoto, Yuko; Yoshizawa, Katsuhiko; Shikata, Nobuaki; Tsubura, Airo; Nagasaki, Yasushi

    2016-01-01

    Cresol, which is used as a disinfectant and insecticide, has erosive effects on epidermal and epithelial tissues in the body. Oral exposure causes gastrointestinal corrosive injuries as a direct chemical burn. We report herein a case of suicidal poisoning by ingestion of cresol solution. An octogenarian man with depression was found dead approximately 14 h after exposure to less than 500 mL of saponated cresol solution. Macroscopically, corrosive lesions such as red-to-brown-colored epithelium and edematous thickening of walls were seen in the skin, mouth, oral cavity, esophagus, and stomach. Histopathologically, coagulative necrosis and vascular dilatation were detected from mucosal to muscular layers in the esophagus, stomach, and duodenum. Congestive edema of the lungs, edematous changes in the brain, and proximal tubular necrosis of the kidneys were seen, suggesting acute circulatory disturbance due to shock. This human case offers valuable information on the direct irritation and shock induced by systemic exposure to corrosive substances. PMID:26404918

  8. An autopsy case of multiple psychotropic drug poisoning.

    Tanaka, Naoko; Kinoshita, Hiroshi; Nishiguchi, Minori; Jamal, Mostofa; Kumihashi, Mitsuru; Takahashi, Motonori; Nishio, Hajime; Ameno, Kiyoshi

    2011-07-01

    A fatal poisoning case involving etizolam, phenobarbital, promethazine and chlorpromazine is presented. Quantitative toxicological analysis showed that the concentrations of etizolam, phenobarbital, promethazine and chlorpromazine in the femoral blood were 86 ng/ml, 5082 microg/ml, 0.107 microg/ml and 0.144 microg/ml, respectively, and large amounts of drugs were also detected in the stomach contents. We conclude that the cause of death was due to the interaction of multiple psychotropic drugs. PMID:21887897

  9. Pathological examinations of an enterovirus 71 infection: an autopsy case

    Gao, Lulu; Lin, Peixin; Liu, Shuguang; Lei, Bin; Chen, Qing; Yu, Shouyi; SHEN Hong

    2014-01-01

    We report an 8-month-old female infant with the fatal enterovirus 71 infection here. Clinically, she developed respiratory failure and severe pulmonary edema rapidly. Histologically, the lung specimen showed diffuse, severe pulmonary congestion and edema with focal intra-alveolar hemorrhage and typical features of acute encephalitis were easily identified under light microscope. Immunohistochemically, enterovirus 71 antigen was positive in the cerebella and brainstem. We measured the viral lo...

  10. Citalopram concentrations in samples from autopsies and living persons

    Worm, Karen; Dragsholt, Claus; Simonsen, Kirsten Wiese;

    1998-01-01

    Retskemi,Citalopram,fatal concentrations,toxic concentrations,therapeutic concentrations,metabolites......Retskemi,Citalopram,fatal concentrations,toxic concentrations,therapeutic concentrations,metabolites...

  11. Problem in twin pregnancy: Findings of prenatal sonography and autopsy

    Kim, Jeong Ah; Cho, Jeong Yeon; Song, Mi Jin; Min, Jee Yeon; Lee, Young Ho; Lee, Hak Jong; Chun, Yi Kyeong; Kim, Yee Jeong; Hong, Sung Ran [Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2001-12-15

    Multifetal gestations are high risk pregnancies with higher perinatal morbidity and mortality. Multifetal gestations are subject to unique complications including conjoined twins, twin-to-twin transfusion syndrome (TTTS), acardiac twins, twin embization of co-twin demise and heterotopic pregnancies. Prenatal sonographic diagnosis of types and complications of multifetal gestations is important for antenatal care and prediction of fetal outcome. This study was performed to present the prenatal ultrasonographic findings and pathologic findings of the unique complications of twin pregnancy. Acardia is a lethal anomaly occurring in 1% of monozygotic twin. The acardiac twin has a parasitic existence and depends on the donor (pump) twin for its blood supply via placental anastomoses and retrograde perfusion of umbilical cord. This twin reversed arterial perfusion (TRAP) sequence is a most extreme manifestation on the TTTS. Doppler verification reversed flow in umbilical cord of the acardiac twin confirms the diagnosis.

  12. Problem in twin pregnancy: Findings of prenatal sonography and autopsy

    Multifetal gestations are high risk pregnancies with higher perinatal morbidity and mortality. Multifetal gestations are subject to unique complications including conjoined twins, twin-to-twin transfusion syndrome (TTTS), acardiac twins, twin embization of co-twin demise and heterotopic pregnancies. Prenatal sonographic diagnosis of types and complications of multifetal gestations is important for antenatal care and prediction of fetal outcome. This study was performed to present the prenatal ultrasonographic findings and pathologic findings of the unique complications of twin pregnancy. Acardia is a lethal anomaly occurring in 1% of monozygotic twin. The acardiac twin has a parasitic existence and depends on the donor (pump) twin for its blood supply via placental anastomoses and retrograde perfusion of umbilical cord. This twin reversed arterial perfusion (TRAP) sequence is a most extreme manifestation on the TTTS. Doppler verification reversed flow in umbilical cord of the acardiac twin confirms the diagnosis.

  13. Gastro-intestinal ascariasis--an unusual autopsy case report.

    Kanchan, Tanuj; Wasti, Harihar; Acharya, Jenash

    2015-09-01

    Ascaris lumbricoides or roundworms' propensity to produce large number of eggs that are resistant to extremes of environmental conditions have made them one of the highly prevalent and geographically well distributed nematodes among poor socio-economic regions throughout the world. We present an unusual case of fatal gastro-intestinal ascariasis where general neglect, and firm and prolonged reliance on traditional healing methods led to aggregation of roundworms to such an extent that otherwise seems improbable in modern times and, hence, is worth reporting. PMID:25748290

  14. Histo-morphology of age of contusions: An autopsy study

    A K Unmesh

    2012-06-01

    Full Text Available Background : During forensic evaluation the determination of age of contusions play a very important role. Age of contusions is normally determined based on their colour. Different authors have different interpretations of age of contusions based on colour. Objective : The aim of the present study is to have a first hand information regarding the colour changes occurring in contusions with the passage of time, in our population and also to compare the aging process of contusions in our population with the standard data available Methods: Contusions were classified into small, medium and large. Both naked eye examination of colour of contusions and microscopic examination of contusions were done. Perl’s staining was also done to confirm the presence of pigments. Results: 65 male and 15 female patients were included in the study. Majority of the cases the contusions were due to road traffic accidents. It was observed that in contusions of 24 hrs duration it was red in colour,followed by blue colour for two to three days. Contusions of four to six days were bluish black coloured and green in colour by seventh day. Microscopic examination revealed the presence of RBC in injuries less than 24 hrs duration. Lymphocytes and polymorphs were prominent in third and fourth day of injury. Perl’s stain was positive from the fifth day onwards. Conclusion : The observations of colour tone of injury and histopathological findings including special staining techniques like Perl’s stain can help the forensic pathologist to a certain extent in dating the age of medium sized contusion in moderately nourished adult subjects during the initial phases of injury. [National J of Med Res 2012; 2(3.000: 339-342

  15. SURVEI KEMATIAN NEONATAL (STUDI AUTOPSI VERBAL DI KABUPATEN CIREBON, 2004

    Sarimawar Djaja

    2012-09-01

    Full Text Available In its attempt to realize the intervention program to saving newborn babies with asphyxia, the Ministry of Health will initiate to train midwives in the village in order to that they know how to operate resuscitation equipment to save neonatal baby with asphyxia. The intervention program his dubbed successful if the mortality proportion due if asphyxia decreased to half as targeted. The survey was conducted in the rural area of Cirebon district. The sample was 200 neonatal death babies, calculated using the hypothesis test with different proportion; p1 0.3 (30% neonatal death cause of asphyxia, according household health survey 2001, p2 0.15, α 0.05, β 0.2, (l-β 0.8. Neonatal dead cases happened within 12 months prior to the survey were identified by rural midwives out of their personal records. The death cases were followed up by interviewing the mother of the neonatal baby concerning its birth, illness or disorder histories before death. The diagnosis of the diseases were based on the International Classification of Diseases 10 and Wigglesworth classification, determined in union by NIHRD researchers and neonatologists. The neonatal mortality rate was 13 out of 1,000 live births. The major cause of early neonatal mortality was respiration disorder mainly caused by birth asphyxia (45%, of which 90 percent could be intervened by doing resuscitation (for babies weighed more than 1.000 gram. The second and third order of the mortality causes was infection (22% and congenital disorders (11% respectively. The major cause of late neonatal mortality was infection (56%, followed by low birth weight and prematurely born, as well as neonatal jaundice (14 percent each, and congenital disorder comes in the third place. The option to handle asphyxia with the early neonatal babies is the right effort to decrease the neonatal mortality rate. And to achieve the utmost result, it is necessary that the rural midwives maintain their standard performance (in terms of quantity and quality in their basic midwifery services, i.e. providing pregnancy health care and detecting as early as possible maternal diseases/complication. Besides, there must be continuous monitoring and adequate guidance from the counselor team from referral hospital.

  16. Cardiac injuries--a clinical and autopsy profile.

    Kulshrestha, P; Das, B; Iyer, K S; Sampath, K A; Sharma, M L; Rao, I M; Venugopal, P

    1990-02-01

    One hundred two patients sustaining cardiac injuries over a 4-year period were analysed to highlight the natural history of the cardiac injuries. There were 45 blunt, 36 stab, and 21 gunshot injuries. The injury involved the ventricle in 85, atrium in seven, pulmonary artery in five cases, and resulted in crush injury to the heart in the remaining five cases. Thirty-three patients (32.3%) died on the scene and 58 (56.9%) died during the transportation. Only 11 patients (10.8%) reached the hospital alive, and ten of these patients survived following thoracotomy and repair of the cardiac injury. The factors influencing the natural course of cardiac injury were analysed: 2.2% of patients with blunt cardiac trauma reached the hospital alive compared to 19.4% with stab and 14.3% with gunshot injuries; ventricular injuries had a greater prehospital mortality compared to atrial or pulmonary artery injuries; 11.3% of patients sustaining injury to right ventricle reached the hospital alive compared to 3% of those with left ventricular injuries. These data emphasize the need for rapid transport, immediate recognition, and aggressive surgical management, to make a favourable impact on the natural history of cardiac injuries. PMID:2304116

  17. Correlation between surgical lung biopsy and autopsy findings and clinical data in patients with diffuse pulmonary infiltrates and acute respiratory failure Correlação entre achados de biópsia pulmonar cirúrgica e de autópsia e dados clínicos em pacientes com infiltrados pulmonares difusos e insuficiência respiratória aguda

    Mauro Canzian

    2006-10-01

    Full Text Available INTRODUCTION: Surgical lung biopsy is an invasive procedure performed when other procedures have failed to provide an urgent and specific diagnosis, but there may be reluctance to perform it in critically ill patients with diffuse pulmonary infiltrates. PURPOSE: To evaluate the diagnostic accuracy, the changes in therapy and survival of patients with diffuse lung infiltrates, mostly presenting acute respiratory failure, who underwent surgical biopsy. METHODS: We retrospectively examined medical records and surgical lung biopsies from 1982 to 2003 of 63 patients older than 18 years with diffuse infiltrates. Clinical diagnoses were compared to histopathological ones, from biopsies and autopsies. Laboratory and epidemiological data were evaluated, and their relationship to hospital survival was analyzed. RESULTS: All histological specimens exhibited abnormalities, mostly presenting benign/inflammatory etiologies. Fifteen patients had an etiologic factor determined in biopsy, most commonly Mycobacterium tuberculosis. The preoperative diagnosis was rectified in 37 patients. Autopsies were obtained in 25 patients and confirmed biopsy results in 72% of cases. Therapy was changed for 65% of patients based on biopsy results. Forty-nine percent of patients survived to be discharged from the hospital. Characteristics that differed significantly between survivors and nonsurvivors included sex (P = 0.05, presence of comorbidity (P = 0.05, SpO2 (P = 0.05, and presence of diffuse alveolar damage in the biopsy (P = 0.004. CONCLUSION: Surgical lung biopsy provided a specific, accurate etiologic diagnosis in many patients with diffuse pulmonary infiltrates when clinical improvement did not occur after standard treatment. Surgical lung biopsy may reveal a specific diagnosis that requires distinct treatment, and it would probably have an impact in lowering the mortality of these patients.INTRODUÇÃO: A biópsia pulmonar cirúrgica é um procedimento invasivo

  18. The injured France: autopsy of a climatic catastrophe; La France blessee: autopsie d'une catastrophe climatique

    Desbois, M.; Pouradier, G.

    2000-07-01

    Using the storms that ravaged the French territory in December 1999 as a starting point, this book takes stock of the climatic and ecological situation of the Earth: greenhouse effect, pollution, oceanic circulation and climates regulation, global warming, deforestation and carbon recycling, land use etc.. (J.S.)

  19. Utilidad de la determinación de la fracción I de la Troponina cardíaca (cTnI, en el diagnóstico de la muerte súbita de origen cardíaco en autopsias forenses Usefulness of cardiac troponin I (cTnI in the diagnosis of sudden cardiac death in forensic autopsies

    E. Navarro

    2007-07-01

    Full Text Available Objetives: To evaluate practical usefulness of cardiac Troponin analysis (cTnI in peripheral blood levels, in order to improve diagnosis of sudden cardiac death in routine forensic cases. Comparing these levels with Myoglobin and MB-CK blood levels in the same type of samples. Material and methods: We have studied 97 medico legal autopsies performed in the Pathology Service of the Institute of Legal Medicine (Alicante. In every case we analyzed sample of serum from peripheral blood (femoral, by Microparticle Enzyme Immunoassay (MEIA Axsym system (Abbott Diagnostics. Causes of death were classified into 6 groups according: 1 Death of cardiac origin (n=42; 2 Traumatic deaths (n=19; 3 Death by asphyxia (n=12; 4 Natural deaths of non-cardiac origin (n=8; 5 Miscellaneous group (n=6, and 6 Traumatic death with Thoracic trauma (n=10. Data was analysed by means of SPSS 14.0 statistical software program (SPSS Inc, 2005. Results: cTnI levels were significantly high in cases of sudden cardiac death, but it were also high in the group of thoracic trauma, which could raise diagnosis problems between these groups, as was shown previously in the literature. Conclusions: The determination of cTnI is more efficient than CKMB and Myoglobine in the diagnosis of sudden cardiac death. However, the elevation of mean levels of this marker in cases of severe thoracic traumatism limits its diagnostic usefulness in these situations.

  20. La causa y la manera de la muerte indeterminada: a propósito de un caso de muerte súbita en adolescente, portador de una tumoración quística intestinal, descubierta durante la autopsia Cause and Manner of Death Undetermined: regarding a case of sudden death in an adolescent with an intestinal cystic tumour, discovered during autopsy

    A. Garfia

    2002-04-01

    and death. During the forensic autopsy the existence of a mesenteric tumour was discovered in the distal ileum. The corpse gave off a peculiar smell which reminded the pathologist of the typical smell of some organophosphorous pesticides. The following diagnoses for the cause of death were put forward in the pathologists report: 1 Septic shock due to intestinal abscess. 2 Mortal poisoning by pesticides. 3 Sudden cardiac death. The chemical-toxicological investigation resulted negative. The histopathologic study did not show cardiac lesions which could justify the death, and the study of the mesenteric tumour showed that it was a cystic intestinal duplication, with discreet chronic inflammation of the wall; ulcerations, haemorrhage, vascular or ischaemic intestinal lesions which could have justified sudden death with digestive causes, were not seen. The cause and manner of death were considered undetermined.

  1. Renal involvement in human rabies: clinical manifestations and autopsy findings of nine cases from northeast of Brazil Envolvimento renal na raiva em humanos: manifestações clínicas e achados de autópsia de nove casos do nordeste do Brasil

    Elizabeth De Francesco Daher

    2005-12-01

    Full Text Available A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 ± 34 days. The time until death ranged from one to nine days (mean 3.3 ± 5.5 days. The signs and symptoms presented were fever, hydrophobia, aerophobia, agitation, disorientation, dyspnea, sialorrhea, vomiting, oliguria, sore throat, pain and hypoesthesia in the site of the bite, headache, syncope, cough, hematemesis, mydriasis, hematuria, constipation, cervical pain and priapism. In three out of six patients, there was evidence of acute renal failure, defined as serum creatinine > 1.4 mg/dL. The post-mortem findings in the kidneys were mild to moderate glomerular congestion and mild to intense peritubular capillary congestion. Acute tubular necrosis was seen in only two cases. This study shows some evidence of renal involvement in rabies. Histopathologic findings are nonspecific, so hemodynamic instability, caused by autonomic dysfunction, hydrophobia and dehydration must be responsible for acute renal failure in rabies.Foi realizado estudo retrospectivo de nove casos de raiva internados em um hospital de Fortaleza, Brasil. Autópsia foi realizada em todos os casos. As idades variaram de 3 a 81 anos. Todos foram agredidos por cães. O tempo entre o acidente e a admissão hospitalar variou de 20 a 120 dias (média de 45 ± 34 dias. O tempo de internamento variou de 1 a 9 dias (média de 5.5 ± 3.1 dias. Os sinais e sintomas observados foram febre, hidrofobia, aerofobia, agitação, desorientação, dispnéia, sialorréia, vômitos, oligúria, faringite, dor e hipoestesia no local da mordida, cefaléia, síncope, tosse, hematêmese, midríase, hematúria, constipação, dor cervical e priapismo. Em três de seis pacientes

  2. Relationship between the morphologic alterations of vocal cords from adult autopsies and the cause of death Avaliação morfológica da membrana basal das cordas vocais de adultos autopsiados e sua correlação com as causas de óbito

    Ana Karina Marques Salge

    2004-01-01

    Full Text Available PURPOSE: The purpose of this study was to identify the possible alteration in the thickness of the epithelium basal membrane of the vocal cords and correlate it with the cause of death. METHOD: Larynxes collected from adult autopsies during the period of 1993 to 2001 were utilized. We used the hematoxylin-eosin and periodic acid-Schiff staining methods for the morphological and morphometric analysis. RESULTS: Sixty-six vocal cords were analysed; increased thickness was identified in 14 cases (21.2%, with equal proportions between the genders. Increased vocal-cord thickness was more frequent in patients of the white ethnicity (12 cases, 85.7%. Respiratory alterations were found in 10 (71.4% of the cases with increased vocal-cord thickness. Of the patients that were maintained with mechanical ventilation before death, 7 (18.4% had thickening of the basal membrane. Among the smokers, 9 (19.63% had basal membrane thickening. CONCLUSION: No statistically significant differences were found between the cases in which the cause of death was related to respiratory diseases as compared to non-respiratory diseases and the thickening of the basal membrane of the vocal cords. However, new studies are needed in order to verify the etiopathogenesis of this thickening.OBJETIVO: O objetivo deste trabalho foi identificar as possíveis alterações na espessura da membrana basal das cordas vocais e relacionar estas com a causa de morte. MÉTODO: Foram utilizadas laringes coletadas de adultos autopsiados, no período de 1993 até 2001. Realizamos as colorações da Hematoxilina- Eosina e Ácido Periódico de Schiff, onde foi medido o diâmetro da membrana basal. RESULTADOS: Foram analisadas 66 cordas vocais, o espessamento foi identificado em 14 casos (21,2%, sendo encontrado em proporções iguais entre os sexos, sendo freqüente em pacientes da cor branca (12 casos, 85,7%. Foram encontradas alterações respiratórias em 10 (71,4% dos casos com espessamento

  3. Peso dos ventrículos cardíacos determinado em necropsia de indivíduos saudáveis mortos por causas externas Cardiac ventricular weights recorded at the autopsy of healthy subjects who died of external causes

    Sérgio Lamêgo Rodrigues

    2007-11-01

    Full Text Available OBJETIVO: Determinar o peso dos ventrículos cardíacos em necropsia de indivíduos sadios vítimas de morte acidental, visando determinar padrões de normalidade em nossa população. MÉTODOS: Foram examinados 94 corações no Instituto Médico Legal de Vitória. Após remoção do coração e ressecção dos átrios e gordura epicárdica, os ventrículos direito (VD e esquerdo (VE, incluindo o septo, foram separados e pesados e a massa indexada pela altura. O teste de Kolmogorov-Smirnov foi usado para testar normalidade da distribuição. Os dados são apresentados como média ± desvio padrão. RESULTADOS: Após 12 exclusões (doença cardiovascular possível detectada após a morte foram analisados 82 corações (52 homens e 30 mulheres, 16-68 anos, média 31±12 anos. O peso do VE foi de 181±25 g e 125±15 g, do VD foi de 54±7 g e 38±6 g e a massa de VE indexada pela altura foi de 105±14 g/m e 78±8 g/m para homens e mulheres, respectivamente. O P95 do peso do VE foi de 218 g e 128 g/m em homens e 148 g e 88 g/m em mulheres. Não detectamos correlação significante entre a massa ventricular e idade. CONCLUSÃO: O peso do ventrículo esquerdo do coração dos homens da nossa amostra foi superior aos relatados na literatura contemporânea. Nossos resultados sugerem que a presença de hipertrofia de VE pode ser inferida em presença de massa de VE superior a 218 g ou 128 g/m nos homens e 148 g ou 88 g/m nas mulheres.OBJECTIVE:To establish cardiac ventricular weights recorded during the autopsy of healthy individuals who died of external causes, aiming at determining normality patterns in our population. METHODS:A total of 94 hearts were evaluated at the Forensics Department of the city of Vitória, Espírito Santo. After the heart removal and resection of the atria and epicardial fat, the right ventricle (RV and the left ventricle (LV, including the septum, were separated and weighed and the mass was indexed by the height. The Kolmogorov

  4. Prevalência e padrão de distribuição das doenças cerebrovasculares em 242 idosos, procedentes de um hospital geral, necropsiados em Belo Horizonte, Minas Gerais, no período de 1976 a 1997 Prevalence and types of cerebrovascular diseases in 242 hospitalized elderly patients, autopsied in Belo Horizonte, Minas Gerais, Brazil, from 1976 to 1997

    José Eymard H. Pittella

    2002-03-01

    Full Text Available OBJETIVO: Descrever a prevalência e os tipos das doenças cerebrovasculares (DCVs em indivíduos idosos necropsiados. MÉTODO: Foram consultados os laudos neuropatológicos de 242 pacientes com idade igual ou superior a 61 anos, procedentes em sua maioria do Hospital das Clínicas da Universidade Federal de Minas Gerais, em Belo Horizonte, Minas Gerais, e necropsiados consecutivamente no período 1976 a 1997. RESULTADO: Os principais grupos de doenças do sistema nervoso central (SNC foram representados por DCVs (71,9%, infecções (12,4%, neoplasias (7,1%, traumatismos crânio-encefálicos (3,7%, doenças nutricionais (2,5% e doenças degenerativas (1,7%. As DCVs mais frequentes foram: aterosclerose (61,2%, doença cerebrovascular hipertensiva (25,6% e infarto cerebral (14,9%. Observou-se aumento da frequência e da gravidade da aterosclerose e da frequência da doença cerebrovascular hipertensiva com o avançar da idade. Houve associação significativa entre doença cerebrovascular hipertensiva e aterosclerose. As DCVs foram clinicamente sintomáticas e as responsáveis diretas pelo óbito em 42,7% e 17,3% dos pacientes, respectivamente. CONCLUSÃO: As DCVs constituíram o principal grupo de doenças do SNC no idoso. A aterosclerose e a doença cerebrovascular hipertensiva foram as principais doenças deste grupo, notando-se aumento de sua frequência com o avançar da idade e associação significativa entre ambas.OBJECTIVE: To describe the prevalence and the types of cerebrovascular diseases (CVDs in autopsied elderly individuals. METHOD: Consecutive clinical charts and neuropathological reports of 242 patients aged 61 years or older were reviewed. The patients died in Hospital das Clínicas, Federal University of Minas Gerais, in Belo Horizonte, Minas Gerais, Brazil, from 1976 to 1997. RESULTS: The prevalent diseases of the central nervous system (CNS found in decreasing order were: CVDs (71.9%, infections (12.4%, neoplasms (7.1%, head

  5. Concentration of organochlorines in human brain, liver, and adipose tissue autopsy samples from Greenland

    Dewailly, Éric; Mulvad, Gert; Pedersen, Henning S.;

    1999-01-01

    Organochlorines are persistent lipophilic compounds that accumulate in Inuit people living in circumpolar countries. Organochlorines accumulate as a result of the Inuits' large consumption of sea mammal fat; however, available data are limited to blood lipids, milk fat, and adipose tissue. We...... report results of organochlorine determination in liver, brain, omental fat, and subcutaneous abdominal fat samples collected from deceased Greenlanders between 1992 and 1994. Eleven chlorinated pesticides and 14 polychlorinated biphenyl congeners were measured in tissue lipid extracts by high...... than those measured using the same analytical method in samples from Canadians in Quebec City, Quebec. Brain lipids contained lower concentrations of all organochlorines than lipids extracted from other tissues. Organochlorine residue levels in lipid extracts from liver, omental fat, and subcutaneous...

  6. [An autopsied case of corticobasal degeneration with onset of nonfluent aphasia revealing symmetrical cerebral involvement].

    Ishihara, Kenji; Mimura, Masaru; Ishigaki, Seiichirou; Shiota, Jun-ichi; Nakano, Imaharu; Kawamura, Mitsuru

    2012-08-01

    Herein we describe a patient with established corticobasal degeneration with onset of nonfluent aphasia and showing symmetrical cerebral involvement. A 64-year-old man with a speech disorder for 2 years visited our hospital. He had nonfluent aphasia (reduced spontaneous speech, loss of intonation, anomia, repetition disorder, and difficulty in speaking short sentences). He also showed right-sided motor neglect, hypertonus of the left lower limb, a mask-like facial expression, and difficulty in closing his eyes. He was restless and walked around even during examination, suggesting frontotemporal dementia (FTD). Single-photon emission computed tomography (SPECT) revealed symmetrical reduction of cerebral blood flow in the bilateral fronto-temporo-parietal lobes. His neurological condition deteriorated gradually and a year later he could not speak comprehensive sentences. Magnetic resonance imaging (MRI) of the head at age 70 showed symmetrical atrophy of the bilateral fronto-temporal lobes. He died of respiratory failure after clinical problems lasting ten years. On pathological examination, the fixed brain weighed 1,010 g and showed bilateral symmetrical atrophy of the frontal lobes. Histopathological examination revealed neuronal loss and gliosis in the frontal lobes, especially in the frontal convexity, superior frontal gyrus and precentral gyrus. Gallyas-Braak silver staining showed astrocytic plaques, argyrophilic threads and coiled bodies mainly in the frontal lobes. The substantia nigra showed severe neuronal loss on both sides and presence of free melanin. Pathological diagnosis was corticobasal degeneration (CBD). We believe that the patient had nonfluent aphasia and FTD reflected in bilateral degeneration of the frontal lobes. Some cases of CBD may present with symmetrical degeneration of the brain, even though left-hemisphere symptoms such as aphasia reveal themselves at an early stage. PMID:22868886

  7. A geostatistical autopsy of the Austrian indoor radon survey (1992-2002)

    Indoor radon (Rn) concentrations have been measured intensively in many countries to assess the burden of diseases associated with exposure to this radioactive gas. So-called radon-risk maps have consequently been produced to delineate areas with high levels. Geostatistical techniques are commonly used nowadays to map a range of environmental variables, in particular to generate probability maps of exceeding a given threshold. However, very few case studies in which indoor radon measurements have been investigated using geostatistical techniques have been published so far. By analyzing around 12,000 Rn measurements made in Austrian ground floors during a 10-year survey, we aim here to review and discuss the potential of geostatistics for mapping an environmental variable that shows very strong local variability. In particular, we show how kriging of the scale components can shed new light on various factors that affect the very high spatial variability of the variable

  8. SOCIAL AUDIT AND VERBAL AUTOPSY ON MATERNAL DEATHS IN PRAKASAM DISTRICT, ANDHRA PRADESH

    Sapna

    2014-07-01

    Full Text Available TITLE: Ultrasound guided fine needle aspiration cytology (FNAC in diagnosis of space occupying lesions (SOL of liver. INTRODUCTION: Liver is an important organ for metabolism of body and is also a drainage site for many organs, therefore it becomes affected in many benign, malignant and inflammatory conditions and performing ultrasound guided FNA helps to diagnose cases with 90-95% accuracy and minimizing the requirement of biopsy. AIMS: To evaluate the efficacy of ultrasound guided FNA and to look for spectrum of diseases affecting liver. MATERIAL AND METHODS: The study is performed on patients who came with lump abdomen and had SOL in liver on ultrasonography in SMS hospital, Jaipur. Ultrasonography guided FNAC was performed on 360 patients in one year period from January 2013 to December 2013. Majority of the patients were males and most of them were middle to elderly age group. Samples were adequate in 324 (90% and inadequate in 36 (10%. Out of 360 patients 7 had benign lesions, rest all had malignant tumors. Of all the malignant tumors, metastatic tumors were commonest accounting for 68% cases, hepatocellular carcinoma accounted for 15% and the rest 17% were unclassified malignancies. CONCLUSION: Ultrasonography guided FNAC is a simple, safe, cost effective and accurate diagnostic method for cytological diagnosis of hepatic lesions. It can be practiced in any centre where ultrasound facility and specialist pathologists are available. Cell blocks can be prepared from FNAC material which is of great help especially in cases who have unknown primaries and present with metastasis in liver

  9. Atherosclerosis and myocardial bridging: Not a benign combination. An autopsy case report

    Thej, M. J.; Kalyani, R.; Kiran, J

    2012-01-01

    Myocardial bridging is a congenital coronary anomaly with a variety of clinical manifestations. Traditionally, myocardial bridging has been considered a benign condition, but some cases of myocardial ischemia, infarction and sudden cardiac death due to myocardial bridging have been reported. Various studies have suggested that in their intramyocardial segments, these vessels are protected from obstructive atherosclerosis, with atherosclerosis being present in the proximal part of the artery. ...

  10. An autopsied case of cardiomyopathy demonstrated specific findings by thallium-201 myocardial scintigraphy

    A few cases showing dilatation and decreased contraction of the left ventricle at the terminal stage of hypertrophic cardiomyopathy (dilated-HCM) have been reported. Recently, we experienced a case of dilated-HCM and compared thallium-201 myocardial scintigraphic findings with histological findings. Thallium-201 myocardial scintigraphic findings resembled that of dilated cardiomyopathy (dilated biventricle and large perfusion defect). But, histological findings revealed large fibrosis and disarray of myocardial cells. These observation from thallium-201 myocardial scintigraphy was useful for the assessment of myocardial fibrosis of hypertrophic cardiomyopathy. (author)

  11. Briançon, 24 juillet 1995: autopsie et enseignements d'une catastrophe naturelle

    Philippe LAHOUSSE

    1998-06-01

    Full Text Available L'épisode pluvio-orageux du 24 juillet 1995 dans le Briançonnais est à l'origine d'une série de crues torrentielles et de coulées de débris dévastatrices. L'approche cartographique, combinée à l'enquête historique, permet de mesurer l'ampleur du phénomène et contribue à une meilleure évaluation des dangers. Elle permet de mieux fonder la politique de prévention des risques.

  12. Lead content in autopsy liver tissue in samples from Greenlandic Inuit and Danes

    Milman, Nils; Laursen, Jens; Byg, Keld-Erik; Pedersen, Henning Sloth; Mulvad, Gert; Hansen, Jens Carl

    2005-01-01

    Objectives. To measure the quantity of lead (Pb) in liver tissue samples from Greenlandic Inuit, and compare the results with those obtained in Caucasian Danes. Study design. Observational, descriptive survey on environmental pathology. Methods. The setting was related to forensic medicine and hospitalised care in Nuuk, Ilulissat and Copenhagen. Participants were 50 Greenlandic Inuit (27 men) with a median age of 61 years (range 23-83) and 74 Danes (44 men) with a median age of 60 years (rang...

  13. Oral autopsy: A simple, faster procedure for total visualization of oral cavity.

    Charan Gowda, Boregowda Kadaiah; Mohan, C V; Hemavathi

    2016-01-01

    Identification of humans, especially in mass disaster is a challenging aspect for team members of the disaster victim identification (DVI) unit. Identification is necessary for humanitarian and emotional reasons and for many legal issues, particularly for family members. In the modern day, all possible methods have been applied for establishing the identification of deceased individuals. The DVI team comprises specialists from different disciplines. The forensic dentist plays a major role in the identification of victims in disaster. To establish a simple, faster and time saving procedure for Postmortem dental identification in mass disaster. In this article, we present a simpler and faster method, which helps in gaining access into the oral cavity that helps in the recording of postmortem oral findings where required. PMID:27555728

  14. Autopsy results of a case of ingestion of sodium hydroxide solution

    EMOTO, Yuko; Yoshizawa, Katsuhiko; SHIKATA, NOBUAKI; Tsubura, Airo; Nagasaki, Yasushi

    2015-01-01

    Sodium hydroxide is a strongly corrosive alkali. We describe herein a case of suicide by ingestion of sodium hydroxide. A man in his 80s was found dead with a mug and a bottle of caustic soda. Macroscopically, liquefaction and/or disappearance of esophagus, trachea and lung tissue and a grayish discoloration of the mucosa of the stomach were seen along with blackish brown coloration of the skin, mouth, and oral cavity. The contents of the gastrointestinal tract showed a pH level of 7–8 on pH ...

  15. Autopsy results of a case of ingestion of sodium hydroxide solution.

    Emoto, Yuko; Yoshizawa, Katsuhiko; Shikata, Nobuaki; Tsubura, Airo; Nagasaki, Yasushi

    2016-01-01

    Sodium hydroxide is a strongly corrosive alkali. We describe herein a case of suicide by ingestion of sodium hydroxide. A man in his 80s was found dead with a mug and a bottle of caustic soda. Macroscopically, liquefaction and/or disappearance of esophagus, trachea and lung tissue and a grayish discoloration of the mucosa of the stomach were seen along with blackish brown coloration of the skin, mouth, and oral cavity. The contents of the gastrointestinal tract showed a pH level of 7-8 on pH indicator strips. Histopathologically, liquefactive necrosis of remnant lung tissue and the stomach were seen. As biological reactions such as vasodilatation and inflammation were not detected in these organs, only a short number of hours must have passed between ingestion and death. This human case provides valuable information concerning the direct irritation induced by systemic exposure to corrosive substances. PMID:26989301

  16. Churg-Strauss Syndrome: a syndrome described on clinical observation and autopsy findings

    Fernando Peixoto Ferraz de Campos

    2013-06-01

    Full Text Available Dr. Jacob Churg (1910-2005 was born in Dolhinow, a Belarusian city that later became a part of Poland and in 1939 was ceded to Russia during the partition of Poland by Russia and Germany. Churg’s father, Wolf, was a physician, and his mother, Gita, a dentist. Jacob recalled reading his father’s medical books and pestering him with many questions. He graduated with a medical degree from the University of Wilno (Poland in 1933 and started working at the Department of Internal Medicine. He realized that he was less confident dealing with patients than with “tissues.” In 1936, at the same university, he began his studies in experimental pathology.

  17. Renal cell carcinoma treated with stereotactic radiotherapy with histological change confirmed on autopsy: a case report

    Onishi, Hiroshi; Kawasaki, Tomonori; Zakoji, Hidenori; Yoshida, Takashi; Komiyama, Takafumi; Kuriyama, Kengo; Araya, Masayuki; Saito, Ryo; Aoki, Shinichi; Maehata, Yoshiyasu; Tominaga, Licht; Marino, Kan; Watanabe, Iori; Oguri, Mitsuhiko; Araki, Tsutomu

    2014-01-01

    Background Treatment of primary renal cell carcinoma using radiotherapy with curative intent is rare, because renal cell carcinoma is generally regarded as a radiation-resistant tumor. Recently, stereotactic body radiation therapy has been radically applied for cancers in various organs including renal cell carcinoma. However, there were few reports describing pathological changes of renal cell carcinoma post stereotactic body radiation therapy. This is the first report we are aware of docume...

  18. Diagnostic yield of molecular autopsy in patients with sudden arrhythmic death syndrome using targeted exome sequencing

    Nunn, Laurence M; Lopes, Luis R; Syrris, Petros;

    2016-01-01

    ). Targeted exome sequencing of 135 genes associated with cardiomyopathies and ion channelopathies was performed on the Illumina HiSeq2000 platform. Non-synonymous, loss-of-function, and splice-site variants with a minor allele frequency

  19. Autopsy case of lymphangiosarcoma arising from the postoperative and postirradiated site of lymphangioma of the thigh

    Nakamura, Tomotsugu; Fujiwara, Masayuki; Yoshie, Haruhiko; Hotchi, Masao (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

    1983-01-01

    A 25-year-old man had undergone resection of lymphangioma on the anterior aspect of left thigh and postoperative irradiation at the age of seven. About ten years later, lymphangiosarcoma developed at the postoperative site and he died despite wide resection, chemotherapy and irradiation. Microscopically, the malignant cells were arranged in an angiomatous pattern with endthelial lining. Ultrastructural examination of the tumor suggested the dual origin from blood and lymphatic capillaries. The pathogenesis of the tumor was considered to be closely related to local disturbances in lymph circulation at the postoperative site although no lymphedema was present.

  20. Estimation of stature from anthropometry of hand: an interesting autopsy based study in Madhya Pradesh, India

    Rajesh Ban Goswami

    2016-06-01

    Results: The mean age of the male and female study subjects was38.472+/-13.28 years and 34.728+/-10.33 years respectively. Male to female ratio was 1:1. Mean stature in male subjects was 163.5+/-5.21 cm. Mean stature in female subjects was 155.69+/-10.12 cm. In male study subjects, mean hand length on right side was more than mean hand length on left side. In female study subjects, mean hand length on right side was more than on left side. In male study subjects, hand breadth (HB on right side was more than on left side. Average HB in male subjects was 8.39+/-0.203 cm. In female study subjects, hand breadth on right side was more than on left side. Conclusions: The findings of the present study can be used as baseline information for other population based studies in the study area. [Int J Res Med Sci 2016; 4(6.000: 1873-1878

  1. Acute Placental Villitis as Evidence of Fetal Sepsis: An Autopsy Case Report.

    Bae, Go Eun; Yoon, Nara; Choi, Misun; Hwang, Soohyun; Hwang, Hyewon; Kim, Jung-Sun

    2016-01-01

    Acute placental villitis is very rare and believed to reflect overwhelming fetal sepsis in utero, commonly caused by Escherichia coli or group B streptococci. We present a case of intrauterine fetal death associated with acute placental villitis and acute necrotizing chorioamnionitis by early-onset group B streptococcal infection. A 36-year-old woman presented with decreased fetal movement and fever at 21 weeks of gestation. Ultrasound demonstrated intrauterine fetal death. After delivery, the placenta revealed multifocal neutrophilic infiltration in chorionic villi, most prominently beneath the trophoblast basement membrane, which was also accompanied by acute necrotizing chorioamnionitis. Gram-positive microorganisms were detected in villous vessels as well as in the major organs of the fetus, which was consistent with Streptococcus agalactiae (group B) cultured from maternal blood. Acute placental villitis should be recognized as evidence of fetal sepsis that often has lethal clinical outcome, as compared to intra-amniotic infection associated with acute chorioamnionitis alone. PMID:26457860

  2. Lung Postmortem Autopsy Revealing Extramedullary Involvement in Multiple Myeloma Causing Acute Respiratory Distress Syndrome

    Aurélie Ravinet

    2014-01-01

    Full Text Available Pulmonary involvement with multiple myeloma is rare. We report the case of a 61-year-old man with past medical history of chronic respiratory failure with emphysema, and a known multiple myeloma (Durie and Salmon stage III B and t(4;14 translocation. Six months after diagnosis and first line of treatment, he presented acute dyspnea with interstitial lung disease. Computed tomography showed severe bullous emphysema and diffuse, patchy, multifocal infiltrations bilaterally with nodular character, small bilateral pleural effusions, mediastinal lymphadenopathy, and a known lytic lesion of the 12th vertebra. He was treated with piperacillin-tazobactam, amikacin, oseltamivir, and methylprednisolone. Finally, outcome was unfavourable. Postmortem analysis revealed diffuse and nodular infracentimetric infiltration of the lung parenchyma by neoplastic plasma cells. Physicians should be aware that acute respiratory distress syndrome not responding to treatment of common causes could be a manifestation of the disease, even with negative BAL or biopsy and could be promptly treated with salvage therapy.

  3. Performing a stellar autopsy using the radio-bright remnant of SN 1996cr

    Meunier, C; Dwarkadas, V V; Koribalski, B; Emonts, B; Hunstead, R W; Campbell-Wilson, D; Stockdale, C; Tingay, S J

    2013-01-01

    We present archival radio observations of SN1996cr from ATCA and MOST, and model its radio lightcurves using X-ray constrained hydrodynamical simulations of the interaction between the SN ejecta and the CSM. The early radio data show signs of free-free absorption (FFA), which decreases gradually and is minimal above 1.4 GHz after day ~3000. FFA optical depth constraints provide estimates of the CSM free electron density, which allows insight into the ionisation of SN1996cr's CSM and offers a test on the density distribution adopted by the hydrodynamical simulation. The intrinsic spectral index of the radiation shows evidence for spectral flattening, which is characterised by alpha = 0.852 +/- 0.002 at day 3000 and a decay rate of d_alpha = -0.014 +/- 0.001 yr^-1. The similarity in the spectral flattening of SN1987A, SN1993J, and SN1996cr suggests this may be a relatively common feature of SNe/CSM shocks. We adopt this spectral index variation to model the synchrotron radio emission of the shock, and consider ...

  4. An autopsy case of a charred body which committed suicide after arson.

    Tatsumi, S; Noda, H; Sugiyama, S

    2000-08-01

    A severely burned body was found lying on its right side at the scene of the fire in a 2-story wooden apartment house. The presence of a ligature (an electrical cord) running horizontally around the neck aroused suspicion of arson after homicidal strangulation (murder-arson). The entire body was severely burned and partly charred. The head and neck were severely charred, and the left temporal bone had been consumed exposing the brain. Around the neck was looped an electrical cord, which ran horizontally and canted downward toward the nape, leaving a furrow resulting from the knot being tightened up. No other injuries or pathologic lesions suggestive of the cause of death were noted. No drug, poison or alcohol was detectable in the blood or urine. The peculiar method of making a noose of the ligature around the neck is called clove hitch, which makes the noose tighten further with increased load. The fallen curtain rod had a bend with an acute angle, which was considered to have been the point of suspension in hanging. In addition, a lighter was found under the corpse, which was presumably used to ignite the gasoline that the deceased sprinkled. We speculate, therefore, that the deceased hanged himself by placing the electrical cord around his neck (by clove hitch), suspending it from the curtain rod, sprinkling gasoline in his room, igniting it with a lighter, executing suicidal hanging after the start of the fire. Probably the body was wrapped in flames while dangling, then fell to the floor together with the collapsing curtain rod. PMID:12935453

  5. An autopsy case of meningeal carcinomatosis with parenchymal invasion through the cranial and spinal nerve roots.

    Kon, Tomoya; Funamizu, Yukihisa; Miki, Yasuo; Tomiyama, Masahiko; Baba, Masayuki; Kurotaki, Hidekachi; Wakabayashi, Koichi

    2014-10-01

    Meningeal carcinomatosis is a well-known complication of malignant neoplasms. We report a case of meningeal carcinomatosis of 2 months' duration in a 22-year-old man, in whom the initial symptom was gradually worsening headache. Postmortem examination revealed infiltrating adenocarcinoma of the stomach. Carcinoma cells showed diffuse spread to the subarachnoid space of the brain and spinal cord. In many places, subarachnoid tumor cells had infiltrated to the cranial and spinal nerves. Moreover, carcinoma cells in the nerve roots extended to the parenchyma of the brain and spinal cord beyond the CNS-peripheral nervous system junction. These findings suggest that cranial and spinal nerve roots can be a possible route of parenchymal invasion in meningeal carcinomatosis. PMID:24779918

  6. Suicidal insulin poisoning with nine day survival: recovery in bile at autopsy by radioimmunoassay

    The discovery of insulin fifty years ago enabled doctors to successfully treat an eleven year old boy dying from diabetes mellitus and thereby ushered in a new medical era. While millions of subsequent patients were thus able to lead productive lives, others turned this miraculous substance into self-destructive purposes, while a few attempted (and possibly succeeded in) carefully concealed homicidal undertakings. The first ''murder by insulin'' case, prosecuted with a conviction in Great Britain fifteen years ago, employed a laborious bioassay method to demonstrate the hormone at the site of injection. A recent series of insulin poisonings in California was dependent on pathological changes in the brain from anoxia (hypoglycemia) coupled with history and investigation rather than chemical measurements, although an immunoassay method was used for confirmation in the final case. Instances of suicidal attempts by self-administered insulin have been reported with analyses performed by radioimmunoassay, now employed in clinical laboratories to measure many hormonal and therapeutic substances. We have applied this principle from pathologic and toxicologic aspects in an effort to enhance the diagnostic capability of the forensic pathologist, who must examine and properly certify such deaths

  7. From Autopsy to Biopsy: A Metacognitive View of Lesson Planning and Teacher Trainees in ELT

    Liyanage, Indika; Bartlett, Brendan John

    2010-01-01

    Lesson planning and implementation of those plans are complex and cognitively demanding for English Language Teacher trainees preparing for the profession. Many find it difficult to develop a lesson holistically and to maintain alignment across aims, procedural steps, and evaluation when planning and implementing a lesson. We attempted to address…

  8. 尸检教学的衰亡%Death of the teaching autopsy

    Gregory O' Grady

    2004-01-01

    尸检不再在医学教学中扮演主要角色,在奥克兰已禁止尸检用于教学;以尸检为基础的教学传授了有用的技能,有些是从其他地方难以学到的;那些在校期间未接受过尸检教学的医生不太可以在今后的工作中要求尸检

  9. An Autopsy Study of Liver Injuries in a Tertiary Referral Centre of Eastern Nepal

    Subedi, Nuwadatta; Yadav, B.N.; Jha, Shivendra; Gurung, Sharmila; Pradhan, Amshu

    2013-01-01

    Background: Liver is the largest gland in the body and it frequently gets wounded. The objective of this study was to determine the patterns, types and severities of liver injuries which were caused by mechanical trauma and to study the organs associated with liver injuries.

  10. An autopsy study of combined pulmonary fibrosis and emphysema: correlations among clinical, radiological, and pathological features

    Inomata, Minoru; Ikushima, Soichiro; Awano, Nobuyasu; Kondoh, Keisuke; Satake, Kohta; Masuo, Masahiro; Kusunoki, Yuji; Moriya, Atsuko; Kamiya, Hiroyuki; Ando, Tsunehiro; Yanagawa, Noriyo; Kumasaka, Toshio; Ogura, Takashi; Sakai, Fumikazu; Azuma, Arata

    2014-01-01

    Background Clinical evaluation to differentiate the characteristic features of pulmonary fibrosis and emphysema is often difficult in patients with combined pulmonary fibrosis and emphysema (CPFE), but diagnosis of pulmonary fibrosis is important for evaluating treatment options and the risk of acute exacerbation of interstitial pneumonia of such patients. As far as we know, it is the first report describing a correlation among clinical, radiological, and whole-lung pathological features in a...

  11. The prevalence and abundance of internal parasites in working horses autopsied in Poland.

    Gawor, J J

    1995-05-01

    The digestive tracts of 50 working horses from private farms in Poland were examined. Thirty-seven nematode species, two tapeworm species and one species of botfly were recovered. The most prevalent small strongyle species were Cyathostomum catinatum, Cylicocyclus nassatus, Cylicostephanus goldi, Cylicostephanus longibursatus, Cyathostomum coronatum, Cylicostephanus calicatus, Cylicocyclus leptostomus and Cylicostephanus minutus. Thirteen cyathostome species showed a site preference in the ventral colon, five in the dorsal colon and three in the caecum. One species, Cylicocyclus triramosus, was new for Poland. Delafondia vulgaris was the most common large strongyle, with 74% prevalence, but low abundance. Parascaris equorum (26%) and Oxyuris equi (36%) were common. Strongyloides westeri (4%), Habronema majus (16%) and Habronema muscae (8%) were less prevalent. Both Habronema species were new for Poland. Tapeworm infection were not prevalent (Anoplocephala magna (4%) and Anoplocephala perfoliata (4%)). Botfly larvae were found in 40% of the horses examined. It was stated that no anthelmintics had been used on the farms. PMID:7676606

  12. Widespread inflammation in CLIPPERS syndrome indicated by autopsy and ultra-high-field 7T MRI

    Blaabjerg, Morten; Ruprecht, Klemens; Sinnecker, Tim; Kondziella, Daniel; Niendorf, Thoralf; Kerrn-Jespersen, Bjørg Morell; Lindelof, Mette; Lassmann, Hans; Kristensen, Bjarne Winther; Paul, Friedemann; Illes, Zsolt

    2016-01-01

    OBJECTIVE: To examine if there is widespread inflammation in the brain of patients with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) syndrome by using histology and ultra-high-field MRI at 7.0T. METHODS: We performed a detailed neuropath...

  13. Mobile autopsy teams in the investigation of war crimes in Kosovo 1999

    Sprogøe-Jakobsen, S; Eriksson, A; Hougen, H P;

    2001-01-01

    On request of the International Criminal Tribunal for the former Yugoslavia (ICTY), the Danish-Swedish forensic teams worked in Kosovo during the summer and the fall of 1999. The teams worked mainly as "mobile teams" at sites with few graves. Only two larger sites were examined. Most of the bodies...

  14. Autopsy Proven Peripheral Nervous System Neurolymphomatosis Despite Negative Bilateral Sural Nerve Biopsy

    Adolfo eRamirez-Zamora; Sarkis Gibran eMorales Vidal; Jasvinder eChawla; Jose eBiller

    2013-01-01

    ABSTRACT. Neurolymphomatosis (NL) refers to a lymphomatous infiltration of peripheral nerves associated with central nervous system (CNS) or systemic lymphoma, or alternatively, neurodiagnostic evidence of nerve enhancement and/or enlargement beyond the dural sleeve in the setting of primary central nervous system lymphoma (PCNSL) or systemic lymphoma. NL is a rare complication of systemic cancer with heterogeneous clinical presentations and an elusive diagnosis. Diagnosis usually requires ...

  15. The Pathological Features of Dissemination of Lymphoma in the Heart in 42 Autopsy Cases

    Siqing Feng; Wenchen Huang; Limei Liu; Yanqin Liu; Fan Zhou; Xuemei Zhang

    2005-01-01

    OBJECTIVE To study the pathological features of dissemination of lymphoma in the heart and understand its influence on cardiac function.METHODS Forty-two patients who died of lymphoma were autoposied and the gross and microscopic pathological changes of the heart observed.RESULTS Eight (19.05%) out of 42 cases had heart dissemination in the pericardium and heart wall. The dissemination features noted were of a nodular type, diffuse type and mixed type, leading to neoplastic myocarditis.CONCLUSION The pathological features of dissemination of lymphoma in the heart are varied, and the different types can produce dissimilar influences in heart function.

  16. Liberté ou sécurité: autopsie d'un faux dilemme

    Tavaglione, Nicolas

    2013-01-01

    Le président Barack Obama cherche le «juste équilibre» entre les besoins de sécurité de la société américaine et la protection de la liberté du citoyen. L’exercice est précaire, des travaux académiques ont montré les limites de l’image de la balance.

  17. A multitude of variations in the configuration of the circle of Willis: an autopsy study.

    Klimek-Piotrowska, Wiesława; Rybicka, Monika; Wojnarska, Aleksandra; Wójtowicz, Agnieszka; Koziej, Mateusz; Hołda, Mateusz K

    2016-09-01

    The circle of Willis (CW) is an anastomotic system of arteries located at the base of the brain. The aim of the study was to evaluate the anatomic configuration of the CW in the Polish population and to compare results with previously conducted research. Brains were obtained from 100 recently deceased human adults, and the diameters of cerebral vessels were measured using a slide caliper. Cerebral vessels were observed, paying attention to their origin, diameter, typical configuration and variations. Twenty-seven percent of cases presented the typical literature pattern. The remaining 73 % of all cases were atypical; in 16 % the CW was incomplete and in 57 % complete. Atypical findings involved the posterior communicating artery (PcomA), 62 %; anterior communicating artery (AcomA), 22 %; anterior cerebral artery (ACA), 14 %; posterior cerebral artery (PCA), 8 %. The most common variations were bilateral hypoplastic PcomAs (27 % of cases) and unilateral hypoplastic PcomAs (19 % of cases). Only 9 of the 22 types of CW variations classified previously in the literature were observed, and 26 variations (36 cases) in our study were labeled as 'other' type. Mean diameter values for typical CW patterns were internal carotid artery = 3.6 mm, ACA = 2.3 mm, AcomA = 1.9 mm, PCA = 2.2 mm and PcomA = 1.4 mm. Circle of Willis variations have a large impact on clinical practice. This study shows many rare variations that should be taken into consideration to avoid any unexpected complications during surgical procedures involving cerebral vessels. PMID:26439730

  18. Autopsy Report with Clinical and Pathophysiologic Discussion of Autosomal Dominant Adult Polycystic Kidney Disease

    Anup Hazra

    2014-01-01

    Full Text Available The average weight of a kidney is approximately 135 gm, measuring on average 10 × 6 × 4 cm. In hereditary conditions, autosomal dominant and autosomal recessive polycystic kidney disease, the shape, size, and the weight can be significantly abnormal, causing progressive renal failure, often necessitating dialysis or renal transplant for survival. We report a case of adult polycystic kidney disease in a 50-year-old female without a family history, who died of complications of the disease which included accelerated hypertension, and renal and cardiac failure.

  19. Unsuspected meningioma in a patient with pituitary gigantism. Case report with autopsy findings

    Stock, J.M.; Ghatak, N.R.; Oppenheimer, J.H.

    1975-06-01

    A unique example of a clinically unsuspected large parasellar meningioma is described in a 36-yr-old pituitary giant who had been treated initially with conventional irradiation, subsequently by surgical excision of an acidophil adenoma, and ultimately with medroxyprogesterone acetate (MPA) prior to his demise. The patient died of increased intracranial pressure resulting from a combined mass effect of the meningioma and recurrent tumor. The relationship between radiation and the development of the meningioma is discussed, as well as the fine ultrastructure of a highly functioning acidophil adenoma.

  20. The importance of microbiological testing for establishing cause of death in 42 forensic autopsies

    Christoffersen, Søren

    2015-01-01

    Microorganisms have always been one of the great challenges of humankind, being responsible for both high morbidity and mortality throughout history. In a forensic setting microbiological information will always be difficult to interpret due to lack of antemortem information and changes in flora...... circumstances, all findings should be compared to anamnestic antemortem information, before conclusions are drawn. A definite list of true pathogens is nearly impossible to compile....

  1. Multiple cerebral artery occlusion due to non-bacterial thrombotic endocarditis: an autopsy case report.

    Nagakane, Yoshinari; Takezawa, Hidesato; Katsura, Kanade; Yamamoto, Yasumasa

    2016-03-30

    A 60-year-old man was admitted to our hospital because of vertigo and repeated vomiting, which suddenly occurred 25 hours before admission. Neurologic examination revealed Wallenberg syndrome on the left side, and brain MRI showed acute infarcts in the left lateral medulla as well as in the left internal carotid artery (ICA) territory. MR angiography did not depict the left vertebral artery (VA) and the left ICA. Despite antithrombotic treatment, he developed bulbar palsy, and then, brain herniation due to infarct growth in the left middle cerebral artery territory. He died on day 9. Histopathlogical examination found verruca involving the mitral leaflet, which was consistent with non-bacterial thrombotic endocarditis (NBTE). Atherosclerosis was also found in the systemic arteries, and there was sclerotic stenosis with calcification at the portion of piercing dulla matter in the left VA and at the cavernous segment of the left ICA. Because the cerebral emboli in the narrowed lumen presented a histologic appearance similar to that of the verruca, the diagnosis of brain embolism due to NBTE was confirmed. PMID:26960272

  2. Development of paradigm for the study of amino acid neurotransmitter release in human autopsy brain samples

    Full text: This study attempted to establish a release protocol to characterize both the vesicular and cytoplasmic components of amino acid transmitter release in human synaptosomes. Experiments with rat synaptosomes showed that, with depolarizing concentrations of K+ ions, vesicular release could be successfully differentiated from cytoplasmic release for preloaded L-[3H ]glutamate and [14C ]GABA. However, human tissue studies did not give clear-cut results. Experiments were carried out to optimize the release paradigm as well as to improve the vesicular uptake of labeled transmitters. A 'pulse- chase' protocol, with an unlabelled D-aspartate chase, was performed in human tissue samples in order to enhance the L-[3H ] glutamate release signal derived from exocytosis by removing the cytoplasmic pool of L-[3H ] glutamate first. However, the results showed that total release was not enhanced effectively in comparison with the non-pulse-chase protocol. In brief, the pulse-chase protocol did not build up the vesicular pool of L-[3H ]glutamate, though the cytoplasmic L- [3H ] glutamate pool was effectively depressed by D-aspartate. Further studies applied 4- aminopyridine (4-AP) to trigger release, to circumvent the problem of the reversal of plasma membrane transporters caused by raised K+ ion concentrations. The results showed that the application of 4-AP elicited the release of amino acid transmitters from rat synaptosomes, but failed to produce successful release signals in the human tissue experiments. Our findings suggest that the vesicular compartment may be impaired by freezing and affected by post-mortem delay (PMD). Rat studies showed that the freezing step had a major effect on Ca 2+-dependent release, as less L- [3 H ]glutamate and [14C ]GABA were released from the frozen rat tissue preparations. Moreover, there was an indication of a decline in L-[3H ]glutamate release with increasing PMD. Copyright (2001) Australian Neuroscience Society

  3. Fatty infiltration of the liver in severely burned pediatric patients : Autopsy findings and clinical implications

    Barret, JP; Jeschke, MG; Herndon, DN

    2001-01-01

    Background. Trauma induces hypermetabolic responses that are characterized by the mobilization of all available substrates. The marked increase of peripheral lipolysis after a burn can lead to the development of fatty liver, which has been associated with immunodepression and increased mortality. Me

  4. Argyrophilic Grain Disease: Demographics, Clinical, and Neuropathological Features From a Large Autopsy Study.

    Rodriguez, Roberta Diehl; Suemoto, Claudia Kimie; Molina, Mariana; Nascimento, Camila Fernandes; Leite, Renata Elaine Paraizo; de Lucena Ferretti-Rebustini, Renata Eloah; Farfel, José Marcelo; Heinsen, Helmut; Nitrini, Ricardo; Ueda, Kenji; Pasqualucci, Carlos Augusto; Jacob-Filho, Wilson; Yaffe, Kristine; Grinberg, Lea Tenenholz

    2016-07-01

    Argyrophilic grain disease (AGD) is a frequent late-onset, 4-repeat tauopathy reported in Caucasians with high educational attainment. Little is known about AGD in non-Caucasians or in those with low educational attainment. We describe AGD demographics, clinical, and neuropathological features in a multiethnic cohort of 983 subjects ≥50 years of age from São Paulo, Brazil. Clinical data were collected through semistructured interviews with an informant and included in the Informant Questionnaire on Cognitive Decline in the Elderly, the Clinical Dementia Rating, and the Neuropsychiatric Inventory. Neuropathologic assessment relied on internationally accepted criteria. AGD was frequent (15.2%) and was the only neuropathological diagnosis in 8.9% of all cases (mean, 78.9 ± 9.4 years); it rarely occurred as an isolated neuropathological finding. AGD was associated with older age, lower socioeconomic status (SES), and appetite disorders. This is the first study of demographic, clinical, and neuropathological aspects of AGD in different ethnicities and subjects from all socioeconomic strata. The results suggest that prospective studies of AGD patients include levels of hormones related to appetite control as possible antemortem markers. Moreover, understanding the mechanisms behind higher susceptibility to AGD of low SES subjects may disclose novel environmental risk factors for AGD and other neurodegenerative diseases. PMID:27283329

  5. Creating and Validating an Algorithm to Measure AIDS Mortality in the Adult Population using Verbal Autopsy

    Lopman, BA; Barnabas, RV; Boerma, JT; Chawira, G; Gaitskell, K; Harrop, T; Mason, P.; Donnelly, CA; Garnett, GP; Nyamukapa, C; S. Gregson

    2006-01-01

    Editors' Summary Background. The worldwide epidemic of HIV/AIDS is at its most severe in poor countries—for example, in Africa, where over 25 million people are estimated to have been infected with HIV. Such countries generally lack the kind of health system that is able to record the cause of death for each person who dies. This makes it very hard to know the number of people whose deaths are related to AIDS. The uncertainty over the AIDS death rates in these countries causes many problems. ...

  6. Using autopsy brain tissue to study alcohol-related brain damage in the genomic age

    Sutherland, Greg T.; Sheedy, Donna; Kril, Jillian J.

    2013-01-01

    The New South Wales Tissue Resource Centre (NSW TRC) at the University of Sydney, Australia is one of the few human brain banks dedicated to the study of the effects of chronic alcoholism. The bank was affiliated in 1994 as a member of the National Network of Brain Banks and also focuses on schizophrenia and healthy control tissue. Alcohol abuse is a major problem worldwide, manifesting in such conditions as fetal alcohol syndrome, adolescent binge drinking, alcohol dependency and alcoholic n...

  7. Using autopsy brain tissue to study alcohol-related brain damage in the genomic age.

    Sutherland, Greg T; Sheedy, Donna; Kril, Jillian J

    2014-01-01

    The New South Wales Tissue Resource Centre at the University of Sydney, Australia, is one of the few human brain banks dedicated to the study of the effects of chronic alcoholism. The bank was affiliated in 1994 as a member of the National Network of Brain Banks and also focuses on schizophrenia and healthy control tissue. Alcohol abuse is a major problem worldwide, manifesting in such conditions as fetal alcohol syndrome, adolescent binge drinking, alcohol dependency, and alcoholic neurodegeneration. The latter is also referred to as alcohol-related brain damage (ARBD). The study of postmortem brain tissue is ideally suited to determining the effects of long-term alcohol abuse, but it also makes an important contribution to understanding pathogenesis across the spectrum of alcohol misuse disorders and potentially other neurodegenerative diseases. Tissue from the bank has contributed to 330 peer-reviewed journal articles including 120 related to alcohol research. Using the results of these articles, this review chronicles advances in alcohol-related brain research since 2003, the so-called genomic age. In particular, it concentrates on transcriptomic approaches to the pathogenesis of ARBD and builds on earlier reviews of structural changes (Harper et al. Prog Neuropsychopharmacol Biol Psychiatry 2003;27:951) and proteomics (Matsumoto et al. Expert Rev Proteomics 2007;4:539). PMID:24033426

  8. Modeling GRB 050904: Autopsy of a Massive Stellar Explosion at z=6.29

    Gou, L J; Mészáros, P

    2006-01-01

    GRB 050904 at redshift z=6.29, discovered and observed by Swift and with spectroscopic redshift from the Subaru telescope, is the first gamma-ray burst to be identified from beyond the epoch of reionization. Since the progenitors of long gamma-ray bursts have been identified as massive stars, this event offers a unique opportunity to investigate star formation environments at this epoch. Apart from its record redshift, the burst is remarkable in two respects: first, it exhibits fast-evolving X-ray and optical flares that peak simultaneously at t~470 s in the observer frame, and may thus originate in the same emission region; and second, its afterglow exhibits an accelerated decay in the near-infrared (NIR) from t~10^4 s to t~3 10^4 s after the burst, coincident with repeated and energetic X-ray flaring activity. We make a complete analysis of available X-ray, NIR, and radio observations, utilizing afterglow models that incorporate a range of physical effects not previously considered for this or any other GRB...

  9. Fracture-associated and idiopathic subchondral vertebral lesions: a magnetic resonance study in autopsy specimens with histologic correlation

    Peters, C.A.; Berg, B.C. vande; Lecouvet, F.E.; Malghem, J. [Cliniques Universitaires St Luc, Universite Catholique de Louvain, Department of Radiology, Brussels (Belgium); Galand, C. [Cliniques Universitaires St Luc, Universite Catholique de Louvain, Department of Pathology, Brussels (Belgium)

    2009-03-15

    The aim of this study was to describe and compare the magnetic resonance (MR) and histological appearance of subchondral vertebral lesions that are idiopathic or that develop with vertebral fractures. T1- and T2-weighted spin-echo images and radiographs were obtained in 81 cadaveric spine specimens. All subchondral vertebral lesions that were considered to be idiopathic or associated with vertebral end plate fractures were selected. Lesions due to growth disturbance were excluded. Radiographs and MR images were analyzed in consensus by two radiologists, and sampled specimens were analyzed by a pathologist. Eleven idiopathic and ten fracture-associated vertebral lesions were available. On T1-weighted images, all lesion signal intensity was low and homogeneous. On T2-weighted images, all idiopathic lesions showed a heterogeneous signal with a central low or intermediate signal component and a peripheral high or intermediate component. All but one fracture-related lesions showed a homogeneous intermediate to high signal intensity. Histological analysis of idiopathic lesions showed a central acellular fibrous connective tissue in all cases surrounded by loose connective tissue in nine cases. Herniated disk material and cartilage metaplasia were found in one lesion only. Fracture-associated lesions contained herniated disk material, necrotic tissue, and loose connective tissue with a peripheral component of loose fibrovascular connective tissue in four cases only. MR and histological appearance of idiopathic and fracture-associated subchondral vertebral lesions differ, suggesting that they might have a different origin. (orig.)

  10. Meaning-Making through Psychological Autopsy Interviews: The Value of Participating in Qualitative Research for Those Bereaved by Suicide

    Dyregrov, Kari Madeleine; Dieserud, Gudrun; Hjelmeland, Heidi Marie; Straiton, Melanie; Rasmussen, Mette Lyberg; Knizek, Birthe Loa; Leenaars, Antoon Adrian

    2011-01-01

    Too often ethical boards delay or stop research projects with vulnerable populations, influenced by presumed rather than empirically documented vulnerability. The article investigates how participation is experienced by those bereaved by suicide. Experiences are divided into 3 groups: (a) overall positive (62%), (b) unproblematic (10%), and (c)…

  11. High Prevalence of Human Parvovirus B19 DNA in Myocardial Autopsy Samples from Subjects without Myocarditis or Dilative Cardiomyopathy▿

    Schenk, Thomas; Enders, Martin; Pollak, Stefan; Hahn, Ralph; Huzly, Daniela

    2008-01-01

    Human parvovirus B19 has been linked to a variety of cardiac diseases, as well as to erythema infectiosum, acute arthropathy, and fetal hydrops. A causal association between viral infection and cardiac disease was frequently postulated following the detection of B19 DNA by PCR in endomyocardial biopsy specimens. Since the lifelong persistence of B19 DNA in bone marrow, skin, synovia, tonsils, and liver was previously reported, the aim of our study was to investigate the possibility of asympto...

  12. A Heart with Multiple Coronaries Anomalies: Myocardial Bridging, Left Dominance and High Takeoff of Ostia-An Autopsy Case

    Haswani, Lokesh; M.L, Harendra Kumar; Kiran, J

    2014-01-01

    Myocardial bridging is a segment of coronary artery that runs intramurally through the myocardium. Though it is commonly seen in the anterior interventricular artery and less commonly in right coronary artery, it can cause limitation in the blood flow, which leads to myocardial ischaemia. Left dominance increases cardiac mortality because of association with the congenital bicuspid aortic valve and myocardial infarction. An earlier study has shown the correlation of myocardial bridging with l...

  13. A dwarf galaxy's transformation and a massive galaxy's edge: autopsy of kill and killer in NGC 1097

    Amorisco, N C; Schedler, J

    2015-01-01

    (abridged) We present a dynamical analysis of the extended stellar stream encircling NGC 1097. Within a statistical framework, we model its surface brightness using mock streams as in Amorisco (2015) and deep imaging data from the CHART32 telescope (Stellar Tidal Stream Survey). We reconstruct the post-infall evolution of the progenitor, which has experienced 3 pericentric passages and lost more than 2 orders of magnitude in mass. At infall, $5.4\\pm0.6$ Gyr ago, the progenitor was a disky dwarf with mass of $\\log_{10}[m(<3.4\\pm1 {\\rm kpc})/ M_\\odot]=10.35\\pm0.25$. We illustrate how the 90$^\\circ$ turn in the stream, identifying the `dog leg', is the signature of the progenitor's prograde rotation. Today, the remnant is a nucleated dwarf, with a LOS velocity of $v_{\\rm p, los}^{\\rm obs}=-30\\pm 30$ kms$^{-1}$, and a luminosity of $3.3\\times 10^7 L_{V,\\odot}$ (Galianni et al. 2010). Our independent analysis predicts $v_{\\rm p, los}=-51^{-17}_{+14}$ kms$^{-1}$, and measures $\\log_{10}(m/ M_\\odot)=7.4^{+0.6}_{-...

  14. Students Who Wish to Specialize in Forensic Medicine vs. Their Fellow Students: Motivations, Attitudes and Reactions during Autopsy Practice

    Papadodima, Stavroula A.; Sergentanis, Theodoros N.; Iliakis, Roussos G.; Sotiropoulos, Konstantinos C.; Spiliopoulou, Chara A.

    2008-01-01

    Purpose: To investigate the particular features of students who express the desire to follow a forensic career. Methods and materials: Three hundred and four 6th-year students attending the compulsory practice in forensic medicine in the academic year 2005-2006 were asked to fill in a self-administered questionnaire at the end of the course.…

  15. An autopsied case of corticobasal degeneration showing severe cerebral atrophy over a protracted disease course of 16 years.

    Kondo, Daizo; Hino, Hiroaki; Shibuya, Katsuhiko; Fujisawa, Koshiro; Kosaka, Kenji; Hirayasu, Yoshio; Yamamoto, Ryoko; Kasanuki, Koji; Minegishi, Michiko; Sato, Kiyoshi; Hosokawa, Masato; Arai, Tetsuaki; Arai, Heii; Iseki, Eizo

    2015-06-01

    The patient was a 72-year-old Japanese woman. At the age of 57, she started having difficulty performing daily work and developed agraphia. She also exhibited restlessness and loss of interest, and began to speak less. Thereafter, stereotypical behavior, gait disturbance and dysphagia were noted. CT scan demonstrated left-dominant frontal and temporal lobe atrophy. She died at the age of 72, about 16 years after the onset of symptoms. Neuropathologically, the brain weighed 867 g, and showed remarkable cerebral atrophy with degeneration of the white matter, predominantly in the left dorsal frontal lobe and anterior temporal lobe. Microscopically, severe neuronal loss and gliosis with rarefaction were found in the cerebral cortex, and severe destruction of myelin and axons was observed in the cerebral white matter. Moderate neuronal loss with gliosis was also found in the pallidum and substantia nigra. Gallyas-Braak staining and tau immunostaining revealed pretangle neurons, NFTs, ballooned neurons and astrocytic plaques in the cerebral cortex, subcortical nuclei and brainstem, and argyrophilic threads and coiled bodies in the subcortical white matter. Tau isoform-specific immunostaining revealed that most tau-immunoreactive structures were positive for 4-repeat (4R) tau, but some of the NFTs were positive for 3-repeat (3R) tau in the cerebral neocortex. Immunoblotting demonstrated an accumulation of 4R tau in the cerebral cortex and subcortical white matter. The patient was pathologically diagnosed as having corticobasal degeneration. Her long survival course likely accounts for the severe white matter degeneration and accumulation of 3R tau in NFTs. PMID:25516199

  16. Multiorgan gadolinium (Gd) deposition and fibrosis in a patient with nephrogenic systemic fibrosis--an autopsy-based review

    Sanyal, Soma; Marckmann, Peter; Scherer, Susanne;

    2011-01-01

    BACKGROUND: Nephrogenic systemic fibrosis (NSF) is a systemic disorder of patients with severe renal insufficiency who have received gadolinium (Gd)-based magnetic resonance contrast agents (GBCAs). The causative association with Gd exposure was strengthened by the demonstration of Gd in various ...

  17. Autopsy study of small cardiac scars in Japanese men who lived in Hiroshima, Japan and Honolulu, Hawaii

    Japanese men long resident in Honolulu, Hawaii have significantly more ischemic heart disease, but significantly fewer small cardiac scars than men in Hiroshima, Japan. These scars occur in three forms: 1) small scars in the mural myocardium which account for the difference in frequency of small lesions in the two cities, and are of uncertain etiology; 2) areas of diffuse fibrosis in the papillary muscles. These are equally frequent in the two cities, and are associated with advancing age and sclerosis of papillary muscle arteries; and 3) focal scars in the papillary muscles. These are more frequent in Honolulu than Hiroshima. They are healed infarcts due to ischemic heart disease and are associated with a severe degree of extramural coronary artery sclerosis. Small mural myocardial scars, when present, are usually found in multiple sites, and are not related to age at death or heart weight. They are more common in the presence of sclerosis of intramural small arteries, but this association does not explain their more frequent occurrence in Hiroshima. There is no evidence that they are related to A-bomb radiation exposure. (author)

  18. Malignant tumors and multiple primary malignant tumors of the atomic-bombed survivors in Nagasaki by autopsy cases

    Out of 10,674 bodies necropsied in Nagasaki district during 32 years period after World War II, 9,302 were selected, and their malignant tumors and multiple primary malignant tumors were discussed. They were divided into 4 groups, the group exposed within 1,000 m from the hypocenter, the group exposed within 2,000 m, the group exposed over 2,000 m + the group who entered the city after the explosion, and the non-exposed group who were born before the explosion. The percentage of cases of malignant tumors (4,784) was 51.4%, which was almost the same as the average in Japan. The incidence of multiple malignant tumors (112 cases of double cancer and 7 cases of triple cancer) was 2.48% of all malignant tumors, and it did not increase particularly. The incidence of malignant tumors and multiple malignant tumors tended to increase with the age. The incidence of malignant tumors was a little high in the group exposed within 1,000 m, and the incidence of leukemia and thyroid cancer was high in the group exposed near the hypocenter in Nagasaki as same as in Hiroshima. The incidence of multiple malignant tumors was markedly high in the group exposed near the hypocenter. This tendency was also shown in Hiroshima. The incidence of multiple malignant tumors was also high in women. In the group exposed near the hypocenter, there were many cases of digestive cancer or thyroid cancer combined with cancers of other organs. Multiple malignant cancer combined with leukemia was found only in one case. There were many combinations of cancer with cancer, but there was not a relation between a-bomb exposure and cancer or sarcoma. The time of onset of multiple malignant tumors was different in many cases of the exposed. (Tsunoda, M.)

  19. Autopsied case of primary malignant lymphoma of the central nervous system presenting an unusual clinical course and CT findings

    Yamashita, Kazuya; Kobayashi, Shotai; Yamaguchi, Shuhei and others

    1987-08-01

    A case of primary malignant lymphoma of the central nervous system was reported. A 58-year-old man was admitted because of diplopia in March, 1986. Last year in June he lost consciousness, accompanied by headache, vertigo, a floating sensation, and tinnitus, though his symptoms disappeared the next day. Last year in October and November, he complained of weakness of the left hand, but it soon disappeared. A neurological examination on admission revealed left trochlear nerve palsy, a decreased sensitivity to pain on the left side of the face and the opposite side of the body, and a mild left-side lack of coordination. A head CT scan and angiography showed no abnormalities. An examination of the CSF revealed increased protein with mild pleocytosis and IgG, but cytology was negative. After admission, he complained of left trigeminal neuralgia, but it disappeared upon steroid pulse therapy. When the steroids were tapered off, however, peripheral facialnerve palsy developed. Therefore, a second course of steroid pulse therapy was done, with some effect. In June, however, the patient became unconscious while the orally administered steroid was being tapered off. A head CT scan showed isodensity masses in the basal ganglia, the thalamus, and the periventricular white matter on a plain scan, and homogeneous masses with ring enhancement and edema on the use of a contrast medium. A histopathological examination showed primary cerebral malignant lymphoma (large-cell type).

  20. An autopsy case of lymphangiosarcoma arising from the posotoperative and postirradiated site of lymphangioma of the thigh

    A 25-year-old man had undergone resection of lymphangioma on the anterior aspect of left thigh and postoperative irradiation at the age of seven. About ten years later, lymphangiosarcoma developed at the postopeative site and he died despite wide resection, chemotherapy and irradiation. Microscopically, the malignant cells were arranged in an angiomatous pattern with endthelial lining. Ultrastructural examination of the tumor suggested the dual origin from blood and lymphatic capillaries. The pathogenesis of the tumor was considered to be closely related to local disturbances in lymph circulation at the postoperative site although no lymphedema was present. (author)

  1. Genetic characterization of Toxoplasma gondii from autopsy proven cases of AIDS associated cerebral toxoplasmosis in South India.

    Vijaykumar, B R; Lekshmi, Swathi U; Sai Kant, R; Vaigundan, D; Mahadevan, Anita; Rajendran, C; Shankar, S K; Jayshree, R S

    2016-04-01

    Toxoplasma gondii (T.gondii) infection can be devastating in the immunodeficient causing high morbidity and mortality. Due to limited availability of both diagnostic facilities and Highly Active Antiretroviral Therapy (HAART), toxoplasmosis continues to be a significant problem amongst Acquired Immuno Deficiency Syndrome (AIDS) patients in India. While scanty literature is available on T. gondii isolates in animals in India, little is known about the genetic diversity of the parasite in humans. Therefore, the present study investigated the genetic diversity of T. gondii in 25 confirmed cases of cerebral toxoplasmosis developing on the background of human immunodeficiency virus (HIV) infection/AIDS. PCR DNA sequencing was performed at four important genetic loci of T. gondii: BTUB, GRA6, alternative SAG2 (alt SAG2) and SAG3 on DNA from tissues obtained at postmortem. The amplified products from all the cases were successfully sequenced except at one locus for one case. Results of the present study suggest that majority of the patients (22/25; 88%) in South India are infected with strains that are recombinants of type II/III and/or strains representing T. gondii different from the archetypal lineages I, II, and III. In addition, clonal types III, MAS, and MAS variant genotypes were encountered. No clonal type I or II was seen in the present study. In addition, variants were observed at alt SAG2 and SAG3 but BTUB and GRA6 were highly conserved. Single nucleotide polymorphisms were observed mainly at two loci which are coding for surface antigens at alt SAG2 and SAG3. In conclusion, the present study reveals genetic diversity in India amongst strains of T. gondii from clinical cases of toxoplasmosis which is in accordance with other recent studies showing a high rate of genetic diversity in this parasite across the globe. There is a need to genotype T. gondii from different forms of toxoplasmosis in humans in India. PMID:26802459

  2. An autopsied case of primary malignant lymphoma of the central nervous system presenting an unusual clinical course and CT findings

    A case of primary malignant lymphoma of the central nervous system was reported. A 58-year-old man was admitted because of diplopia in March, 1986. Last year in June he lost consciousness, accompanied by headache, vertigo, a floating sensation, and tinnitus, though his symptoms disappeared the next day. Last year in October and November, he complained of weakness of the left hand, but it soon disappeared. A neurological examination on admission revealed left trochlear nerve palsy, a decreased sensitivity to pain on the left side of the face and the opposite side of the body, and a mild left-side lack of coordination. A head CT scan and angiography showed no abnormalities. An examination of the CSF revealed increased protein with mild pleocytosis and IgG, but cytology was negative. After admission, he complained of left trigeminal neuralgia, but it disappeared upon steroid pulse therapy. When the steroids were tapered off, however, peripheral facialnerve palsy developed. Therefore, a second course of steroid pulse therapy was done, with some effect. In June, however, the patient became unconscious while the orally administered steroid was being tapered off. A head CT scan showed isodensity masses in the basal ganglia, the thalamus, and the periventricular white matter on a plain scan, and homogeneous masses with ring enhancement and edema on the use of a contrast medium. A histopathological examination showed primary cerebral malignant lymphoma (large-cell type). (author)

  3. Longitudinally Extensive Transverse Myelitis with Intramedullary Metastasis of Small-Cell Lung Carcinoma: An Autopsy Case Report

    Kenya Nishioka; Ryota Tanaka; Satoshi Tsutsumi; Hideki Shimura; Yutaka Oji; Harumi Saeki; Yukimasa Yasumoto; Masanori Ito; Nobutaka Hattori; Takao Urabe

    2013-01-01

    Background. Longitudinally extensive transverse myelitis (LETM) is characterized by spinal cord inflammation extending vertically through three or more vertebral segments. The widespread use of MRI revealed LETM more frequency than ever. We report the case of a patient with pathologically confirmed small-cell lung carcinoma metastasis into the spinal cord presenting as LETM. Case Presentation. A 74-year-old man developed rapidly progressive sensorimotor disturbance and vesicorectal dysfunctio...

  4. Indication for resuscitative thoracotomy in thoracic injuries-Adherence to the ATLS guidelines. A forensic autopsy based evaluation

    Ohrt-Nissen, S; Colville-Ebeling, B; Kandler, K; Hornbech, K; Steinmetz, J; Ravn, J; Lehnert, P

    2016-01-01

    BACKGROUND: The appropriate indications for Resuscitative Thoracotomy (RT) are still debated in the literature and various guidelines have been proposed. This study aimed to evaluate whether Advanced Trauma Life Support (ATLS) guidelines for RT were applied correctly and to evaluate the proportion...

  5. Expansion of the Multi-Link Frontier™ Coronary Bifurcation Stent: Micro-Computed Tomographic Assessment in Human Autopsy and Porcine Heart Samples

    Kralev, Stefan; Haag, Benjamin; Spannenberger, Jens; Lang, Siegfried; Brockmann, Marc A.; Bartling, Soenke; Marx, Alexander; Haase, Karl-Konstantin; Borggrefe, Martin; Süselbeck, Tim

    2011-01-01

    Background Treatment of coronary bifurcation lesions remains challenging, beyond the introduction of drug eluting stents. Dedicated stent systems are available to improve the technical approach to the treatment of these lesions. However dedicated stent systems have so far not reduced the incidence of stent restenosis. The aim of this study was to assess the expansion of the Multi-Link (ML) Frontier™ stent in human and porcine coronary arteries to provide the cardiologist with useful in-vitro ...

  6. Systemic IgG4-related disease with extensive peripheral nerve involvement that progressed from localized IgG4-related lymphadenopathy: an autopsy case

    Fujii, Masayoshi; Sato, Yasuharu; Ohara, Nobuya; Hashimoto, Kenji; KOBASHI, HARUHIKO; Koyama, Yoshinobu; Yoshino, Tadashi

    2014-01-01

    A 77-year-old man, with a lengthy medical history of chronic dysuria, constipation, hypertension, myocardial infarction, and a submandibular lymphadenopathy that was excised 3 years ago, was hospitalized due to elevated liver enzyme levels. He demonstrated hypergammaglobulinemia, hyperproteinemia, high levels of IgG and IgG4, eosinophilia, sclerosing cholangitis, and retroperitoneal fibrosis. He was diagnosed with IgG4-related disease (IgG4-RD). While hospitalized, he had several episodes of ...

  7. Propagande française en Irlande  pendant la Première Guerre mondiale : autopsie d’un échec

    Wiel, Jérôme aan de

    2009-01-01

    This article deals with French propaganda efforts in Ireland during the First World War, a theme hitherto unexplored. In 1914, Ireland was in the grip of war fever like other European countries. In the early months of the conflict, thousands of Irishmen (nationalists and unionists) enlisted in the British army. Soon, however, the number of recruits dropped dramatically as various British recruitment organisations blundered and as British propaganda was rather useless. The French government de...

  8. Laryngeal teflonoma identified by Fourier-transform infrared microspectroscopy after forensic autopsy: An interesting tool for foreign material identification in forensic cases

    Duband, Sébastien; Govin, Alexandre; Dumollard, Jean-Marc; Forest, Fabien; Basset, Thierry; Peoc'h, Michel

    2012-01-01

    Forensic pathologists are sometimes confronted with microscopic foreign bodies mixed in with soft tissues surrounding wounds and which are thus difficult to identify. This identification, however, could be primordial in investigating a crime and in determining the weapon used. A case of a fatal respiratory distress syndrome due to conjoining suicidal drug intoxication and laryngeal obstruction by a voluminous foreign body giant cell granuloma is presented. The classical histological examinati...

  9. GAMMA KNIFE RADIOSURGERY OF BRAIN METASTASIS FROM MALIGNANT PLEURAL MESOTHELIOMA – REPORT OF THREE CASES WITH AUTOPSY STUDY IN A CASE –

    Kobayashi, Tatsuya; TSUGAWA, TAKAHIKO; Hashizume, Chisa; Toriyama, Takanobu; Asai, Masami; Mori, Yoshimasa; Shibamoto, Yuta

    2014-01-01

    ABSTRACT The median survival time of malignant pleural mesothelioma (MPM) has been 9 months. Given the short survival, there have been only few cases in which brain metastases have been diagnosed and treated before death. Three cases of brain metastases treated by gamma knife radiosurgery (GKR) are reported. Case 1 showed a metastatic lesion in the right frontal lobe which was treated by GKR two years after diagnosis of MPM. The lesion markedly reduced and the symptoms were improved, But the ...

  10. Moving from data on deaths to public health policy in Agincourt, South Africa : approaches to analysing and understanding verbal autopsy findings

    Byass, Peter; Kahn, Kathleen; Fottrell, Edward; Collinson, Mark A.; TOLLMAN, STEPHEN M.

    2010-01-01

    Editors' Summary Background Whenever someone dies in a developed country, the cause of death is determined by a doctor and entered into a “vital registration system,” a record of all the births and deaths in that country. Public-health officials and medical professionals use this detailed and complete information about causes of death to develop public-health programs and to monitor how these programs affect the nation's health. Unfortunately, in many developing countries dying people are not...

  11. Majnün Performing Autopsy: Exposing the Ugliness of Dictatorship in Ṭā’ir al-Kharāb

    Sami Alkyam

    2015-06-01

    Full Text Available Trauma and the experience of it is only one of the ways open for victims to speak and/or testify for the horror done to them. My argument in this paper focuses on the use of the verbal (i.e. words and the nonverbal (i.e. the body testimonies as modes of remembering and disclosure. Through the reading of the heart breaking love story of Ṭā’ir al-kharāb by ᶜabd al-RRab Sarūrī, the paper shows how the novel gives a voice and space to Ilhām to recounts her individual and collective past and expose the traumatic impact of the dictatorship on the female body, and by a means of allegory on the body of the nation, as exemplified by the character Ilhām. The juxtaposition of both the story of the raped female body and the rape of the nation by the dictator, who is referred to throughout the novel as Ṭā’ir al-Kharāb (the bird of destruction as well as Sheikh al-qabīlah (the tribal sheikh, is read as an anguished cry for normalcy sought by not only women in Yemen but all the nation. Srūrī’s representation of the body may be looked at, and this is what this paper is doing, as an index of his position on dictatorship, its nature, the relationship of the individual to state and society in it, and the place of authoritarianism within the decaying body of Ilhām which he uses as an allegory to the body of the nation. Thus, the transformation of the trauma of the past, this paper suggests, is treated less as a source of knowledge than as a means of assigning a human-like quality to texts where they become able to speak, even if it is allegoric, to and of the present.

  12. Neuronal nicotinic receptor subtypes in normal ageing, Alzheimer's disease and schizophrenia : Influences of neuropathological mechanisms as studied in human autopsy brain and transgenic mice

    Marutle, Amelia

    2002-01-01

    Neuronal nicotinic acetylcholine receptors (nAChRs) are transmitter-gated ion channel receptors which are widely distributed in the brain. They mediate the effects of several neurotransmitters including ACh, DA, 5-HT and NA and are important for many normal physiological functions in the brain and are also implicated in a number of CNS disorders, such as AD, PD, schizophrenia, Tourette's syndrome and familial epilepsy. The overall aim of this thesis was to characterise chang...

  13. Regulatory changes in presynaptic cholinergic function assessed in rapid autopsy material from patients with Alzheimer disease: Implications for etiology and therapy

    Brain regions from patients with or without Alzheimer disease (AD) were obtained within 2 hr of death and examined for indices of presynaptic cholinergic function. Consistent with loss of cholinergic projections, cerebral cortical areas involved in AD exhibited decreased choline acetyltransferase activity. However, remaining nerve terminals in these regions displayed marked up-regulation of synaptosomal high affinity [3H]choline uptake, a result indicative of relative cholinergic hyperactivity. As choline uptake is also rate-limiting in acetylcholine biosynthesis, these findings have implications for both therapy and identification of causes contributing to neuronal death in AD

  14. Alterações histopatológicas pulmonares em pacientes com insuficiência respiratória aguda: um estudo em autopsias Pulmonary histopathological alterations in patients with acute respiratory failure: an autopsy study

    Alexandre de Matos Soeiro; Edwin Roger Parra; Mauro Canzian; Cecília Farhat; Vera Luiza Capelozzi

    2008-01-01

    OBJETIVOS: Apresentar alterações histopatológicas pulmonares encontradas em autopsias de pacientes falecidos por insuficiência respiratória aguda (IRA) e verificar se doenças de base e específicos fatores de risco associados aumentam a incidência dessas alterações. MÉTODOS: Foram revisados laudos finais de autopsias e selecionadas 3.030 autopsias de pacientes > 1 ano de idade, com infiltrado pulmonar radiológico, portadores de doença de base e fatores de risco associados, que morreram por alt...

  15. Achados clínicopatológicos na tromboembolia pulmonar: estudo de 24 anos de autópsias Clinicopathological findings in pulmonary thromboembolism: a 24-year autopsy study

    Hugo Hyung Bok Yoo; Fabiana Guandalini Mendes; Christine Elisabete Rubio Alem; Alexandre Todorovic Fabro; José Eduardo Corrente; Thais Thomaz Queluz

    2004-01-01

    INTRODUÇÃO: Tromboembolia pulmonar (TEP) é ainda uma afecção enigmática em diversos aspectos clínicos e epidemiológicos e frequentemente erroneamente diagnosticada. OBJETIVO: Descrever a prevalência e os achados anatomopatológicos de TEP em uma série de 5261 autópsias realizadas em um hospital universitário de nível terciário, correlacionar estes achados com as doenças de base e verificar a freqüência de suspeita clínica antemortem de TEP. MÉTODO: Revisão dos registros das autópsias consecuti...

  16. 新生儿先天性心脏病围手术期死因的尸检病理分析%An autopsies analysis of perioperative death in newborns with congenital heart deseases

    刘蕾; 王红月

    2006-01-01

    目的 从病理学角度分析新生儿先天性心脏病围手术期的死亡原因.方法 收集15例围手术期死亡的新生儿先天性心脏病尸检病例,复查病理资料,分析其死亡原因.结果 先天性心脏病新生儿围手术期病死率为28.6%,尸检率为62.5%.临床与尸检病理诊断符合率为86.67%,主要死因包括心脏原因(9例),肺部感染(4例)及应激性肾上腺出血(2例).结论 加强新生儿先天性心脏病围手术期的心肺保护,加强尸检意识,有助提高手术成功率.

  17. Clinical and pathological assessment of 82 patients with cardiovascular diseases undergoing autopsy at the Hospital das Clínicas of the Faculdade de Medicina de Botucatu from 1988 to 1993

    Reinaldo Ayer de Oliveira

    2000-10-01

    Full Text Available OBJECTIVE: To evaluated the clinical diagnostic, efficiency for basic death causes in patients dying of circulatory disease and de relative frequency of those diseases. METHODS: Analysis of medical record data of 82 patients, ages from 16 to 84 years old (68 over 40 years old, whose died of circulatory disease and had undergone necropsy in the period from 1988 to 1993 years in the University Hospital of Medicine Faculty of Botucatu-UNESP, Br. RESULTS: The functional class of patients were III or IV, in 78%, and 81.7% needed urgent hospitalization. By the clinical judgment the death were by ischemic heart disease in 32 (21 acute myocardial infarction, Chagas'disease in 12, valvopathy in 11, cardiomyopathy in 7, heart failure with no specification of cardiopathy in 11 and other causes in 9. At the necropsy the death cause was ischemic heart disease in 34 patients, valvopathy in 10, Chagas'disease in 10, cardiomyopathy in 5, and heart failure with no specification of cardiopathy in 2.The concordance taxes were in thhe same order: 94,6%, 90,0%, 83.3%, 71.4% and 28.5%. CONCLUSION: There was a great efficiency of clinical diagnosis for death cause in a general university hospital. The ischemic heart disease were the main causes of death.

  18. Virtual autopsy in forensic sciences and its applications in the forensic odontology = A autópsia virtual nas ciências forenses e sua aplicação na Odontologia forense

    Rosário Junior, Ademir Franco do

    2012-01-01

    Atualmente os avanços tecnológicos se fazem cada vez mais importantes nas ciências forenses. Por outro lado a autópsia ainda é uma abordagem tradicional na prática médica-odontológica, na qual evidências são coletadas por meio fotográfico e radiológico. Neste contexto, a Autópsia Virtual surge como uma ferramenta útil e complementar para o exame cadavérico. Através da alta tecnologia radiológica a Autópsia Virtual fornece uma visão eficiente e precisa do caso a ser analisado. Esta revisão crí...

  19. Degeneração hepatolenticular: conteúdos de ferro e cobre em tecidos de material de autópsia Hepatolenticular degeneration: iron and copper contents of tissues of autopsy material

    Francisco Bastos De Jorge

    1970-03-01

    Full Text Available Os autores apresentam os resultados das dosagens de ferro e cobre nos tecidos de um paciente com degeneração hepatolenticular, no qual a moléstia teve curso fulminante. Parece que o curso da moléstia foi agravado pela administração de drogas tranqüilizantes quando foi iniciado o tratamento com penicilamina. Esta observação pode ser de interesse clínico. Os teores de cobre e ferro estavam muito aumentados nos tecidos cerebrais, no fígado, nos pulmões, nos rins, no baço, na suprarenal e em outros órgãos.Iron and copper contents in tissues of one patient with hepatolenticular degeneration, with fulminating course, are reported. It seems that the disease's course was aggravated by tranquilizer drugs, when treatment with penicillamine was started. This observation may be of clinical interest. Copper and iron contents were increased in the brain tissues, in the liver, lungs, kidneys, spleen, suprarenal gland and in other organs.

  20. Sipuleucel-T (Provenge(®))-Autopsy of an Innovative Paradigm Change in Cancer Treatment: Why a Single-Product Biotech Company Failed to Capitalize on its Breakthrough Invention.

    Jarosławski, Szymon; Toumi, Mondher

    2015-10-01

    Approved by the US Food and Drug Administration (FDA) in 2010, sipuleucel-T (Provenge(®)) was the first 'personalized' cancer vaccine for the treatment of prostate cancer in a metastatic, non-symptomatic population of 30,000 men in the USA. Sipuleucel-T is prepared individually for each patient and infused in three sessions over a period of 1 month. However, in 2015, Dendreon, the owner of sipuleucel-T, filed for bankruptcy. This opinion paper reviews the probable reasons this innovative product failed to achieve commercial success. PubMed and internet searches were performed focused on pricing, reimbursement, and market access. We found that sipuleucel-T's FDA approval was delayed by 3 years, reportedly because of the vaccine's new mechanism of action. Sipuleucel-T was cleared by the European Medicines Agency 2 years later, but other national agencies were not approached. It was priced at $US93,000 for a course of treatment, and this high price combined with the company's late securement of reimbursement for the vaccine by the US Centers for Medicare and Medicaid Services (CMS) resulted in another year's delay in accessing the market. Despite a positive recommendation by the National Comprehensive Cancer Network, sipuleucel-T's complex administration, high price, and uncertainty about the reimbursement status deterred doctors from prescribing the product. Furthermore, the vaccine's supply was limited during the first year of launch due to limited manufacturing capacity. In addition, two oral metastatic prostate cancer drugs with similar survival benefits reached the US market 1 and 2 years after sipuleucel-T. Also, even though Dendreon's market capitalization topped $US7.5 billion following the FDA's approval of sipuleucel-T, this value degraded gradually until the firm's bankruptcy 5 years later. We conclude that the bankruptcy of Dendreon was largely due to the delay in securing FDA approval and CMS coverage, as well as the high cost that had to be incurred by providers up-front. Licensing sipuleucel-T to a pharmaceutical company more experienced in the market access pathway may have saved the company and the product. PMID:26403092