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1

Needle autopsy  

Directory of Open Access Journals (Sweden)

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.

Philip Davis Marsden

1997-04-01

2

Designing verbal autopsy studies  

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Abstract Background Verbal autopsy analyses are widely used for estimating cause-specific mortality rates (CSMR) in the vast majority of the world without high-quality medical death registration. Verbal autopsies -- survey interviews with the caretakers of imminent decedents -- stand in for medical examinations or physical autopsies, which are infeasible or culturally prohibited. Methods and Findings We introduce methods, simulations, and interpretations that ca...

2010-01-01

3

Lay perceptions of autopsy.  

Science.gov (United States)

The lay public's exposure to information on the purposes and value of the autopsy is sparse. When approached for consent to perform an autopsy, they are often indifferent and uncooperative. If the autopsy is worthy of revitalization as the ultimate medical consultation, pathologists must know what the general public is exposed to, what they think, and what their perceptions about autopsy are. There have been mass media and some specialized media contributions during the years 1977 through 1982. I studied the public's areas of concern regarding the topic and detailed the perceptions and unspoken thoughts of laymen. There are steps that can be taken to join the lay community and pathologists together in renewed efforts to revitalize the role of the autopsy while simultaneously educating the public about the advantages and needs of medical education. PMID:6547294

Brown, H G

1984-06-01

4

[Photodocumentation during autopsy].  

Science.gov (United States)

Photography during autopsy is an important part of forensic imaging and essential for the documentation of autopsy findings. A forensic photograph mainly serves the purpose of providing evidence and should be authentic. But aesthetic artwork may improve both the attractiveness and acceptance of autopsies and thus help to increase the autopsy rate. Different materials were compared to each other as photographic backdrop, particularly with regard to reflection and contrast, stability of exposure measurement and monitoring of colour fidelity. The photofoil 9010 Dove Grey proved to be a material of outstanding quality. In practical application, the foil was scratch-resistant and easy to clean. Furthermore, backdrop boards with a gap, e.g. for head and neck, allow special perspectives without a distracting background. PMID:24683872

Rost, Thomas; Wittig, Holger

2014-01-01

5

Feedwater heater autopsies  

Energy Technology Data Exchange (ETDEWEB)

This paper, extracted from the chapter on feedwater heater autopsies of the authors` forthcoming book, ``Tubular Exchanger, Inspection, Repair and Maintenance,`` discusses what to look for when dissecting a decreased heater and the physical appearances of heater deteriorations. The paper recommends using photography, videography and analysis of specimens for reporting purposes. It advocates using autopsies and reports of post-mortem examinations to train specifiers, operators and maintenance personnel and guide them to avoid repeating past mistakes and misjudgments.

Yokell, S. [MGT Inc., Boulder, CO (United States); Andreone, C.F. [Heat Transfer Consultants, Inc., Reading, MA (United States)

1994-12-31

6

Assessing the autopsy.  

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This study outlines the role of autopsies in medical practice and health policy, details the nature and reason for declining rates, including those in Rochester, Minnesota, and suggests possible remedial measures to halt or reverse this trend. It is concluded that one of the principal impediments to reversing the declining rate of autopsies is what is referred to in Economics as "market failure." In particular, the nature of the spatial and temporal distribution of costs and benefits ...

Nemetz, P. N.; Ludwig, J.; Kurland, L. T.

1987-01-01

7

Congenital hyperthyroidism: autopsy report  

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We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and h...

1999-01-01

8

Findings of autopsy imaging  

International Nuclear Information System (INIS)

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.)

2009-05-01

9

Napoleon's autopsy: new perspectives.  

Science.gov (United States)

In 1821 Napoleon died in exile on the Island of St. Helena. Although the autopsy had suggested stomach cancer as the cause of death, in 1961 an elevated arsenic concentration was found in Napoleon's hair. This finding elicited numerous theories of conspiracy, treachery, and poisoning. Most recent reports even suggested inappropriate medical treatment may have contributed to the exiled Emperor's death. Napoleon's apparent obesity at the time of his demise was interpreted as a strong argument against stomach cancer as the cause of death; however, his weight changes over the course of his life, noticeable from the contemporary iconography, have not been systematically analyzed. To test the hypothesis that Napoleon's weight at death could be compatible with a diagnosis of terminal gastric cancer, we performed several studies to determine: a) Napoleon's weight at death; and b) the changes of his weight during the last 20 years of his life. Our weight modeling was based on the collection of 12 different pairs of trousers worn by Napoleon between 1800 and 1821, the year of his death. Modeling trouser sizes with control data suggested a weight increase from 67 kg to 90 kg by 1820. The trousers worn at the time of death suggested a subsequent weight loss of 11 kg (to 79 kg) during the last year of his life. This weight was confirmed by a second modeling approach based on the subcutaneous fat measurement performed at autopsy (1.5 inches) and a control group of 270 men dying from various causes. This provides a reasonable validation for both weight measurement methods. Napoleon's terminal weight loss of more than 10 kg is suggestive of a severe progressive chronic illness and is highly consistent with a diagnosis of gastric cancer. PMID:15891990

Lugli, A; Lugli, A Kopp; Horcic, M

2005-04-01

10

[Proposals for standardization of autopsy reports].  

Science.gov (United States)

The decline in the number of autopsies not only in Germany has been attributed to several reasons. Complaints of clinicians about a non-uniform layout of autopsy reports may be one important reason. The lack of initiatives concerning standardization of autopsy reports contributes to a poor comparability of autopsy reports from different institutions and even within one institution. In order to promote harmonization of a protocol for autopsy results proposals for a standardization of autopsy protocols are given. These proposals are based on using modules for different parts of the autopsy protocols, thus giving different institutions the possibility to modify these modules. PMID:24619530

Wittekind, C; Habeck, J-O; Gradistanac, T

2014-03-01

11

Autopsy Tissue Program  

International Nuclear Information System (INIS)

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

1979-10-26

12

Congenital hyperthyroidism: autopsy report  

Directory of Open Access Journals (Sweden)

Full Text Available We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and hemorrhagic suffusions in the epicardium. The placenta had infarctions that involved at least 20% of its surface, and the vessels of the umbilical cord were fully exposed due to a decrease in Wharton 's jelly. Hyperthyroidism was confirmed by the maternal clinical data, the fetal findings of exophthalmia, craniosynostosis, and goiter with signs of follicular hyperactivity. Craniosynostosis is caused by the anabolic action of thyroid hormones in bone formation during the initial stages of development. The delayed initiation of treatment in the present case contributed to the severity of fetal hyperthyroidism and consequent fetal death.

Lima Marcus Aurelho de

1999-01-01

13

Maternal mortality: An autopsy audit  

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Full Text Available Background: The process of audit standardizes protocols in departments and has long-term benefits. Maternal autopsies though routinely performed, deserve a special attention. Aims: This study was carried out to calculate the maternal mortality ratio (MMR in a tertiary care hospital and to correlate final cause of death with the clinical diagnosis. An audit of maternal autopsies was carried out to evaluate current practices, identify fallacies and suggest corrective measures to rectify them. Materials and Methods: Eighty-nine autopsies of maternal deaths in the period 2003 to 2007 were studied in detail along with the clinical details. Results: There were 158 maternal deaths and 13940 live births in this five-year period. Maternal mortality rate was found to be very high (1133/ 100000 live births in our institution with a high number of complicated referral cases (68/89 cases, 76%. Of the 89 autopsies, acute fulminant viral hepatitis was the commonest cause of indirect maternal deaths (37 cases, 41.5%. This was followed by direct causes like pregnancy-induced hypertension (12 cases, 13.4% and puerperal sepsis (10 cases, 11.2%. Certain fallacies were noted during the audit process. Conclusion: During the audit it was realized that in maternal mortality autopsies, special emphasis should be given to clinicopathologic correlation, microbiological studies, identification of thromboembolic phenomenon and adequate sectioning of relevant organs. We found difficulty in identification of placental bed in the uterus in postpartum autopsies. A systematic approach can help us for better understanding of the pathophysiology of diseases occurring in pregnancy.

Jashnani K

2009-01-01

14

Death and Teaching Autopsy (review article)  

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At the middle of the 20th century, autopsy has a fundamental role in medical education in Iran, guided by the influential Oslerian philosophy “as is your pathology so is your medical practice”. Students not only attended autopsies, but also had learnt to conduct them. In contrast, today the use of autopsy in medical education is falling down to death. Although this falling is worldwide, but the situation in Iran is much worse. Rarely Iranian medical schools deal with educational autopsy a...

Bahador, M.

2006-01-01

15

Autopsy case of postradiation osteosarcoma  

Energy Technology Data Exchange (ETDEWEB)

An autopsy was made for osteosarcoma arised in the pelvis 15 years after radiation therapy which had been given following radical resection of carcinoma of the cervix in a 52-year-old woman. Literature of post-radiation osteosarcoma was reviewed.

Nojima, T.; Abe, F.; Fujioka, Y.; Inoue, K.; Mizoe, J. (Hokkaido Univ., Sapporo (Japan). School of Medicine)

1982-01-01

16

Psychological Autopsy-A Review  

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Full Text Available The psychological autopsy is thought to be the cornerstone of suicide research, providing more detailed knowledge than other methods. Its prime objective is to retrieve comprehensive information about suicide. Information is collected from key informants, available medical records and personnel and it consists of reconstructing the life style and personality of deceased along with details of circumstances, behaviors and events that led to the death of that individual.

Vasudeva Murthy C R

2010-07-01

17

Death and Teaching Autopsy (review article  

Directory of Open Access Journals (Sweden)

Full Text Available At the middle of the 20th century, autopsy has a fundamental role in medical education in Iran, guided by the influential Oslerian philosophy “as is your pathology so is your medical practice”. Students not only attended autopsies, but also had learnt to conduct them. In contrast, today the use of autopsy in medical education is falling down to death. Although this falling is worldwide, but the situation in Iran is much worse. Rarely Iranian medical schools deal with educational autopsy and some of them are quite unfamiliar with autopsy. There are several reasons for this declining including sophisticated medical education with autopsy, community attitudes ,clinicians’ and pathologist’ reluctance, hospital concern about legal action, religious attitudes, consent from the family and funding priorities. Even with new diagnostic modalities, autopsy remains an important tool for quality and safety assurance. A systematic review of reports on autopsies from USA, European and Australian hospitals, revealed 9 to 40% (on average 23.5% of clinically missed diagnoses and managements involving the principal or underlying cause of death. The key roles of hospital autopsies are Improving safety and quality in diagnosis and treatment, Providing benefits to families, Advancing understand-ing of disease, Allowing good programming for emerging disease and frequently seen disease, and Educating medical and allied health professionals. We have concluded that, reversing the decline of autopsies will require cooperative action at several levels of the healthcare system, particularly including clinicians and pathologists and also governmental and financial bodies and legal authorities.

M. Bahador

2006-08-01

18

Center for Cancer Research - Laboratory of Pathology - Autopsy Pathology  

Science.gov (United States)

 CCR Home   About CCR   CCR Intranet        Laboratory of Pathology LP Home Clinical Services Basic Sciences Training LP Staff Accessibility of Web Site DLM Website Autopsy Pathology Autopsy Pathology Procedure Manual Autopsy Pathology Staff About

19

Medico-legal autopsies in Denmark  

DEFF Research Database (Denmark)

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.

Larsen, Sara Tangmose; Lynnerup, Niels

2011-01-01

20

Autopsy cases of glioblastoma multiforme  

International Nuclear Information System (INIS)

Six autopsy cases of glioblastoma multiforme in cerebral hemisphere were examined by large histological preparations. They were treated by surgery and high-dose fractionated radiation therapy (5 Gy twice weekly). Their morphological changes were compared to the last CT and radiation field and total doses. Four out of six cases showed small residual tumor. One case showed extensive necrosis of the tumor and brain. The other case exhibited no tumor tissue at all. Spongy degeneration of the white matter associated with astrocytosis and macrophage infiltration extended sometimes beyond the local irradiation field. These white matter changes occurred easily in the previous peritumoral edema where tumor cell infiltration was frequently observed. Residual tumor cells consisted of small anaplastic cells, which might be radioresistant and recur. Enhancement effect of CT scan showed tumor tissue and radiation necrosis with vascular proliferation. (author)

1989-01-01

 
 
 
 
21

Autopsy and medical education: a review.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

During the twentieth century there has been a decline in the rate of autopsies performed. A review of the literature reveals reasons for this decline which include: an improvement in the medical diagnostic technology available; inadequate training of doctors as to the importance of autopsy; and difficulties in obtaining consent from relatives and the present use of audit. Recommendations for changes in medical education are made which include: a greater appreciation of the procedure as a usef...

Charlton, R.

1994-01-01

22

Verbal autopsy: methods in transition.  

Science.gov (United States)

Understanding of global health and changing morbidity and mortality is limited by inadequate measurement of population health. With fewer than one-third of deaths worldwide being assigned a cause, this long-standing dearth of information, almost exclusively in the world's poorest countries, hinders understanding of population health and limits opportunities for planning, monitoring, and evaluating interventions. In the absence of routine death registration, verbal autopsy (VA) methods are used to derive probable causes of death. Much effort has been put into refining the approach for specific purposes; however, there has been a lack of harmony regarding such efforts. Subsequently, a variety of methods and principles have been developed, often focusing on a single aspect of VA, and the resulting literature provides an inconsistent picture. By reviewing methodological and conceptual issues in VA, it is evident that VA cannot be reduced to a single one-size-fits-all tool. VA must be contextualized; given the lack of "gold standards," methodological developments should not be considered in terms of absolute validity but rather in terms of consistency, comparability, and adequacy for the intended purpose. There is an urgent need for clarified thinking about the overall objectives of population-level cause-of-death measurement and harmonized efforts in empirical methodological research. PMID:20203105

Fottrell, Edward; Byass, Peter

2010-04-01

23

Results of the Autopsy in Bahrami Children Hospital  

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Background: The aims of this study were to evaluate the trend and clinical utility of the autopsy in Bahrami Childrens Hospital in Tehran, Iran. Methods: In this retrospective descriptive-analytic survey during a six years course from 1998 to 2003, autopsies in the hospital were studied. The clinical and autopsy diagnoses were compared and categorized as follows: 1. Change (Clinical and Autopsy diagnoses discordant), 2. Add (Significant unexpected findings noted on the autopsy, although the c...

Salamati, P.; Abdi-rad, A.; Sarmadi, S.; Sotoudeh, K.; Pourkhosravani, F.

2006-01-01

24

Results of the Autopsy in Bahrami Children Hospital  

Directory of Open Access Journals (Sweden)

Full Text Available Background: The aims of this study were to evaluate the trend and clinical utility of the autopsy in Bahrami Childrens Hospital in Tehran, Iran. Methods: In this retrospective descriptive-analytic survey during a six years course from 1998 to 2003, autopsies in the hospital were studied. The clinical and autopsy diagnoses were compared and categorized as follows: 1. Change (Clinical and Autopsy diagnoses discordant, 2. Add (Significant unexpected findings noted on the autopsy, although the clinical diagnosis was not altered, 3. Confirm (Clinical and Autopsy diagnoses concordant, 4. Autopsy inconclusive Findings: Eighty four autopsies were studied. Out of 350 neonatal deaths, autopsy was performed in 74 neonates (21% and of 249 under 5 year deaths (except neonates autopsy was performed in only 10 cases (4%. The autopsy rate declined during these years. In 61 cases (73% the autopsy diagnoses confirmed the clinical diagnosis, in 10 cases (12% it changed the clinical diagnoses, in 11 cases (13% it significantly added to the clinical diagnoses and in 2 cases (2% it was inconclusive. Conclusions: This study reveals a decline in neonatal and infant autopsy during a six year period. This study also demonstrates that neonatal and infant autopsy continues to provide clinically useful data in 25% of cases and remains a valuable tool in pediatric medicine.

K Sotoudeh

2006-05-01

25

Autopsies in HIV: still identifying missed diagnoses.  

Science.gov (United States)

This study reviews the deaths and autopsies carried out over 23 years, 1983-2005, in a British Infection Unit in HIV patients. Of 115 HIV patients known to have died, we obtained data on 93%. Of this 80% were male, median age 38 (25-68) years; 83% were Caucasian; 12% Black African. Major risk factors were men who have sex with men, 52%; heterosexual in Africa, 17%; and injecting drug use, 8%. The commonest diagnosis pre- and post-autopsy diagnosis was pneumonia. Changes in diagnoses in the 38% who underwent autopsy were high (we requested autopsy in 50%). Primary diagnosis changed in 70%, and 36% of all opportunistic infections were missed. This included six of nine cytomegalovirus, all tuberculosis and 75% of Kaposi's sarcoma. Lymphoma was overdiagnosed. Thus, despite excellent resources, the majority of primary diagnoses were wrong, suggesting inadequacy of current diagnostics. To improve these and improve both epidemiological data and future management autopsy should be considered for all deaths. PMID:19182052

Beadsworth, M B J; Cohen, D; Ratcliffe, L; Jenkins, N; Taylor, W; Campbell, F; Beeching, N J; Azadeh, B

2009-02-01

26

Plutonium in autopsy tissues in Great Britain  

Energy Technology Data Exchange (ETDEWEB)

A summary of the results are presented for plutonium concentrations in autopsy bone, liver and lung tissues obtained from people who had died in Scotland, north-eastern England, Oxfordshire and western Cumbria. Attempts were made to ensure that the subjects had not been occupationally exposed to plutonium in order that these results could be compared with autopsy tissue plutonium concentrations of Sellafield workers. Three cases from west Cumbria showing high tissue concentrations of plutonium were discovered to be former employees of Sellafield Works.

Popplewell, D.S.

1986-07-01

27

Emotionally challenging learning situations: medical students' experiences of autopsies  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objectives: To explore medical students' experiences of an emotionally challenging learning situation: the autopsy. Methods: Qualitative data were collected by means of written accounts from seventeen students after their first and third autopsies and a group interview with seven students after their first autopsy. Data was interpreted using inductive thematic analysis. Results: Students experienced the autopsy in three ways: as an unnatural situation, as a practical exercise, and as a way to...

Maria Weurlander; Max Scheja; Håkan Hult; Annika Wernerson

2012-01-01

28

Emotionally challenging learning situations: medical students' experiences of autopsies  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: To explore medical students' experiences of an emotionally challenging learning situation: the autopsy. Methods: Qualitative data were collected by means of written accounts from seventeen students after their first and third autopsies and a group interview with seven students after their first autopsy. Data was interpreted using inductive thematic analysis. Results: Students experienced the autopsy in three ways: as an unnatural situation, as a practical exercise, and as a way to learn how pathologists work. Most students found the situation unpleasant, but some were overwhelmed. Their experiences were characterised by strong unpleasant emotions and closeness to the situation. The body was perceived as a human being, recently alive. Students who experienced the autopsy as a practical exercise saw it mainly as a part of the course and their goal was to learn anatomy and pathology. They seemed to objectify the body and distanced themselves from the situation. Students who approached the autopsy as a way to learn how pathologists work concentrated on professional aspects of the autopsy. The body was perceived as a patient rather than as a biological specimen. Conclusions: Autopsies are emotionally challenging learning situations. If students attend autopsies, they need to participate in several autopsies in order to learn about procedures and manifestations of pathological changes. Students need opportunities to discuss their experiences afterwards, and teachers need to be aware of how different students perceive the autopsies, and guide students through the procedure. Our findings emphasize the importance of investigating emotional aspects of medical education.

Maria Weurlander

2012-03-01

29

Autopsy findings in botulinum toxin poisoning.  

Science.gov (United States)

In the United States, foodborne botulism is most commonly associated with home-canned food products. Between 1950 and 2005, 405 separate outbreaks of botulism were reported to the Centers for Disease Control and Prevention (CDC). Approximately 8% of these outbreaks were attributed to commercially produced canned food products. Overall, 5-10% of persons ingesting botulinum toxin die. Few reports exist pertaining to autopsy findings in cases of foodborne botulism. Here, we report the autopsy findings of a man who died after a prolonged illness caused by botulinum toxin exposure likely attributable to a commercially prepared food source. Despite extensive testing, our histopathologic findings were nonspecific. We therefore conclude that the forensic pathologist must become familiar with the neurotoxicity syndrome associated with this illness. Maintaining vigilance for botulism by carefully reviewing the decedent's clinical history will aid in the early identification and control of outbreaks, either foodborne or terrorism-related. PMID:20533981

Devers, Kelly G; Nine, Jeffrey S

2010-11-01

30

Plutonium in autopsy tissues in Great Britain  

Energy Technology Data Exchange (ETDEWEB)

From time to time the authors have measured the Pu content of tissues taken at autopsy from people who had worked in the Pu-processing industries including some from Sellafield Works in Cumbria. During the work it became apparent that the results would be more enlightening if they could be compared with the levels of Pu in people who had not worked in the nuclear energy industries. With the objective of making this comparison, the authors commenced a series of Pu analyses on tissues removed at autopsy from members of the general public, who might be expected to have received their body deposits of Pu from fallout from atmospheric nuclear weapons explosions. This note augments some results reported previously in summary form.

Popplewell, D.S.; Ham, G.J.; Johnson, T.E.; Barry, S.F.

1985-08-01

31

Congenital hyperthyroidism: autopsy report Hipertireoidismo Congenital  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and h...

1999-01-01

32

Autopsy findings in small cell lung cancer  

International Nuclear Information System (INIS)

The objective of this study was to assess the pattern of autopsy in 174 small lung cancer patients treated between 1971 and 1991 at seven Polish medical centres. Eighty nine autopsied patients were previously treated with different chemotherapy regimens including 32 patients who also received chest irradiation, 74 received only supportive care and for 11 patients the data on treatment were not available. The age range at diagnosis was 28-81 years (median 57); there were 39 females (22%) and 135 males (78%). Seventy two patients had limited disease at the time of diagnosis, 86 - extensive disease and in 16 the disease extent was not determined. The primary tumor and/or metastases in regional lymph nodes were present in 157 autopsies (90%). There was a significant difference in the rate of locoregional disease found at autopsy in patients given chemotherapy and in those who received only supportive care (85% and 100%, respectively; p = 0.01). Chest radiation therapy given in limited as an adjunct to chemotherapy did not decrease the rate of persistent locoregional disease (primary tumor in the chest was found in 92% of irradiated and in 96% of nonirradiated patients). Locoregional tumor deposit only was found in 28 (16%). Distant metastases were distributed in 143 patients (82%) and were found in 25 different locations, most frequently in liver (49%), supra-renal glands (25%), peripheral lymph nodes (21%), kidneys (18%), brain (17%) and pancreas (12%). In 3 patients no tumor foci were found. The number of organs involved varied between 0 and 10 (median 3). The number of involved organs was not dependent on the disease extent at the time of diagnosis and on the type of treatment. (author)

1996-01-01

33

[Autopsies of the real: resurrecting the dead].  

Science.gov (United States)

The sense of the real, or the material - the dead body - as an inextricable part of the sacred does not disappear in the secular environment of the nineteenth and twentieth centuries. This article analyzes specific humanitarian narratives centered on the practice of autopsy and mummification, in which the traces of Catholicism act as a kind of spectral discourse of the imagination, where the real is configured in forms of the uncanny, the monstrous or the sacred. PMID:22368802

Valis, Noël

2011-01-01

34

Can postmortem fetal MR imaging replace autopsy?  

Energy Technology Data Exchange (ETDEWEB)

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.

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

35

Attitudes of junior medical staff to requesting permission for autopsy.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The attitudes of junior medical staff in a university teaching hospital to requesting postmortem examination were assessed. Following completion of 100 death certificates, autopsy was sought in only 28 cases (and refused in 18). The majority of staff were unaware of the reported benefits of autopsy, despite their inclusion in the local medical handbook and had received no training in how to seek permission for a necropsy. Formal education programmes have been shown to improve hospital autopsy...

Hinchliffe, S. A.; Godfrey, H. W.; Hind, C. R.

1994-01-01

36

Left Paraduodenal Hernia: An Autopsy Case  

DEFF Research Database (Denmark)

We present a case of a left paraduodenal hernia diagnosed at autopsy. A left paraduodenal hernia is an internal hernia of congenital origin due to the abnormal rotation of the midgut during embryonic development. Internal hernias are a rare cause of intestinal obstruction, with the paraduodenal being the most frequent. The clinical course can be asymptomatic, cause chronic or intermittent abdominal pain, or present with acute abdomen. The clinical entity is a diagnostic challenge, which is illustrated in the present case where there patient died during hospital admission. The case also emphasizes the difficulty in diagnosing the disease by plain abdominal radiography.

Omland, Silje Haukali; Hougen, Hans Petter

2011-01-01

37

Verbal autopsy: current practices and challenges  

Directory of Open Access Journals (Sweden)

Full Text Available Cause-of-death data derived from verbal autopsy (VA are increasingly used for health planning, priority setting, monitoring and evaluation in countries with incomplete or no vital registration systems. In some regions of the world it is the only method available to obtain estimates on the distribution of causes of death. Currently, the VA method is routinely used at over 35 sites, mainly in Africa and Asia. In this paper, we present an overview of the VA process and the results of a review of VA tools and operating procedures used at demographic surveillance sites and sample vital registration systems. We asked for information from 36 field sites about field-operating procedures and reviewed 18 verbal autopsy questionnaires and 10 cause-of-death lists used in 13 countries. The format and content of VA questionnaires, field-operating procedures, cause-of-death lists and the procedures to derive causes of death from VA process varied substantially among sites. We discuss the consequences of using varied methods and conclude that the VA tools and procedures must be standardized and reliable in order to make accurate national and international comparisons of VA data. We also highlight further steps needed in the development of a standard VA process.

Soleman Nadia

2006-01-01

38

Autopsy discoveries of death from malaria.  

Science.gov (United States)

Malaria inflicts a huge health care burden in terms of mortality and morbidity worldwide. There has been evidence in the literature where many unexpected/unexplained deaths turned out to be related to malaria on autopsy. The aim of this study is to review autopsy diagnosed malaria related deaths in the literature with due stress to its biologic and forensic aspects. A meticulous literature search was performed for "sudden malaria death", "malaria death postmortem diagnosis" and "unexplained death malaria" across PubMed, SCOPUS, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine, British Nursing Index, CINAHL, EMBASE, Ovid-MEDLINE and Google Scholar. All the literature was thoroughly reviewed and analyzed with reference to the type of study, location, travel history, age, gender, circumstance of death, method of diagnosis, species involved, chemoprophylaxis usage and take home message from the particular study. Plasmodium falciparum was responsible in most of the cases. The symptoms mimicked influenza in most of the case reports. Travel to endemic areas was common to most of the victims. The travelers were from all over the world including USA, France, Switzerland, Spain, Portugal, Germany and Asia (China and Japan). Vascular congestion with the presence of malarial pigment laden RBCs in capillaries of various organs was the major histopathology finding. Such lesions were found in the brains of all subjects (100%), liver of 78% of the cases, spleen in 67%, lungs in 56% and myocardium in 43% of the cases. Peripheral smear and rapid diagnostic test was of great aid to the autopsy in many cases. PCR was used for diagnosis as well as exclusion of possibility of co-infection with other species in case of Plasmodium knowlesi related death. The postmortem and histopathology findings in this case were similar to P. falciparum except for the fact that brain sections were negative for intracellular adhesion molecule-1. Chemoprophylaxis was not taken by the victims except for two in whom history of chloroquine based chemoprophylaxis was mentioned. Given the worldwide prevalence of the disease, increasing international travel and rapidly developing drug resistance, malaria will continue to be an important disease and should be considered in all cases of unexpected deaths particularly in malaria endemic regions or in presence of travel history to endemic regions. PMID:22369777

Menezes, Ritesh G; Pant, Sadip; Kharoshah, Magdy A; Senthilkumaran, Subramanian; Arun, M; Nagesh, K R; Bhat, Nishanth B; Mahadeshwara Prasad, D R; Karki, Raj Kumar; Subba, S H; Fazil, Abul

2012-05-01

39

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

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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.)

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

40

Sudden death in Parkinson's disease: A retrospective autopsy study.  

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The aim of this paper is to reveal the causes of death and to verify sudden death of Parkinson's disease (PD) in an autopsy study. We reviewed the clinical data and the causes of death in 16 PD patients who had postmortem examinations. Prior to autopsy, nine patients died of known causes: five patients died of aspiration pneumonia, two of myocardial infarction, one of asphyxia, and one of dilated cardiomyopathy. Autopsy confirmed that the putative causes of death were compatible with the pathological ones. The remaining seven patients died suddenly of unknown causes. Autopsy revealed that the causes of death were asphyxia in two patients and perforation of a duodenal ulcer in one patient. Autopsy did not determine the causes of unknown death in the remaining four patients. Consequently, autopsy revealed that eight patients died of swallowing problems such as aspiration pneumonia and asphyxia, four of sudden death, three of cardiac problems, and one of a gastrointestinal problem. Although there was a bias that all patients had a postmortem examination, our study revealed that several PD patients died of sudden death without any satisfactory causes of death determined even by autopsy. Therefore, we propose that a non-negligible number of PD patients die of sudden death. PMID:24928079

Matsumoto, Hideyuki; Sengoku, Renpei; Saito, Yuko; Kakuta, Yukio; Murayama, Shigeo; Imafuku, Ichiro

2014-08-15

 
 
 
 
41

Study of metastatic foci by CT in autopsied lung cancer  

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The authors reexamined all of the image diagnoses made during whole hospitalization in 11 lung cancer cases with autopsy. Of 39 metastatic foci observed at autopsy in the liver, kidney, pancreas, adrenal and brain, 12 had been diagnosed on transverse CT images before death. Three foci were missed at initial readings. The period from CT to autopsy was less than 3 months for 9 of 12 correctly diagnosed foci. For 13 of 27 foci undetected by CT, CT was conducted more than 3 months before death.

Koga, Mitsuru; Nobe, Yoshifumi (Kyushu Cancer Center (Japan)); Fujii, Kyoichi

1983-03-01

42

A study of autopsy procedures in Ghana: implications for the use of autopsy data in epidemiological analyses  

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Full Text Available The study of cause of death certification remains a largely neglected field in many developing countries, including Ghana. Yet, mortality information is crucial for establishing mortality patterns over time and for estimating mortality attributed to specific causes. In Ghana, in deaths occurring in homes and those occurring within 48 hours after admission into health facilities, autopsies remain the appropriate option for determining the cause of death. Although these organ-based autopsies may generate convincing results and are considered the ‘gold standard’ tools for ascertainments of causes of death, procedural and practical constraints could limit the extent to which autopsy results can be accepted and/or trusted. The objective of our study was to identify and characterise the procedural and practical constraints as well as to assess their potential effects on autopsy outcomes in Ghana. We interviewed 10 Ghanaian pathologists and collected and evaluated procedural manuals and operational procedures for the conduct of autopsies. A characterisation of the operational constraints and the Delphi analysis of their potential influence on the quality of mortality data led to a quantification of the validity threats as moderate (average expert panel score = 1 in the generality of the autopsy operations in Ghana. On the basis of the impressions of the expert panel, it was concluded that mortality data generated from autopsies in urban settings in Ghana were of sufficiently high quality to guarantee valid use in health analysis.

Alexander Kraemer

2011-03-01

43

Autopsy findings of malignant neoplasms treated with radiation  

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Autopsy findings in 26 cases of malignant neoplasms treated with radiation were analysed and following results were obtained. 1. Causes of death except for neoplastic extension were 58% (15/26) and infection was the single predominant cause of death (73% : 11/15) with 50% (4/8) in lung cancer. 2. Distant metastases were found in 73% (19/26). In 7 cases, no obvious metastasis was found before and after autopsy. On the other hand, the patients with metastases over 2 organs before autopsy revealed metastases in 82% (9/11) to the other organs at autopsy. 3. Radiation therapy was effective and the primary tumor disappeared completely in 71% (10/14) with curative irradiation. In metastatic lesions, tumor cells were almost disappeared with dosage over 40 Gy.

Okazaki, Atsushi; Ito, Jun; Tatezawa, Takashi; Nishimura, Toshinobu; Niibe, Hideo

1984-11-01

44

Statistical analysis of Japanese Thorotrast-administered autopsy cases--1980  

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In 193 cases autopsied between 1945 and 1980, all persons who had been intravascularly injected with Thorotrast in life, the authors found 131 malignant hepatic tumors, 20 liver cirrhoses, 6 myeloid leukemias, 4 erythroleukemias, 5 aplastic anemias, 4 lung cancers, 1 mesothelioma and 1 osteosarcoma. The causes of death in the Thorotrast-administered autopsy group (193 cases) were compared with those of a non-Thorotrast-administered autopsy group (95,000 cases) of the same sex and age at death as recorded in the Annals of Japanese Pathological Autopsy cases from 1958 to 1978. This comparison revealed that the frequencies of malignant hepatic tumors, liver cirrhosis, erythroleukemia, and aplastic anemia were significantly higher in the Thorotrast-administered group than in the non-Thorotrast-administered group.

Mori, T. (National Inst. of Radiological Sciences, Anagawa, Japan); Kato, Y.; Aoki, N.; Hatakeyama, S.

1983-01-01

45

Extraskeletal Osteosarcoma of the Thigh: An Autopsy Case Report  

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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-l...

Akihito Nagano; Takatoshi Ohno; Yutaka Nishimoto; Kazunari Yamada; Katsuji Shimizu

2009-01-01

46

An autopsy case of Adams-Oliver syndrome.  

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We report an autopsy case of a male fetus with Adams-Oliver syndrome. His mother was a healthy, 31-year-old woman and her family and past histories were unremarkable. Therapeutic termination was done at 28(+6) weeks gestational age due to oligohydramnios detected by antenatal ultrasonography. Chromosomal study revealed normal karyotype. On autopsy, characteristic transverse terminal defect of four extremities was found. Both feet were short and broad. All toes were rudimentary with no nails a...

Jun, S. Y.; Khang, S. K.; Park, S. H.

2000-01-01

47

Ovarian leiomyosarcoma: an autopsy case report.  

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Primary non-specific sarcoma of the ovary is extremely rare, and only 22 reported cases of pure leiomyosarcoma (LMS) are known to the authors. We present an autopsy case of a primary ovarian leiomyosarcoma in a 73-year-old woman. She had noticed an abdominal mass after difficulty in defecating for several months. The excision of tumor with bilateral salpingo-oophorectomy and hysterectomy was carried out. A diagnosis of pure leiomyosarcoma of the left ovary was made on pathological examination with immunohistochemistry. Adjuvant radio-chemotherapy was not given. At 18 months' follow up, abdomino-pelvic sonography revealed an abdominal tumor and hepatic metastasis. The patient died 3.5 years after the initial surgery. The post-mortem examination revealed a peritoneal recurrent tumor and extensive distant metastases of the liver, lungs, pancreas, gastric mucosa, muscle and skin. The prognosis of the ovarian LMS is poor from the pertinent literature. Several prognostic indicators on histology including mitotic activity, proliferative activity and p53 status of the tumor are discussed. PMID:10792777

Nasu, M; Inoue, J; Matsui, M; Minoura, S; Matsubara, O

2000-02-01

48

Autopsies of the real: Resurrecting the dead  

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Full Text Available The sense of the real, or the material—the dead body—as an inextricable part of the sacred does not disappear in the secular environment of the nineteenth and twentieth centuries. This article analyzes specific humanitarian narratives centered on the practice of autopsy and mummification, in which the traces of Catholicism act as a kind of spectral discourse of the imagination, where the real is configured in forms of the uncanny, the monstrous or the sacred.

El sentido de lo real, de lo material —el cuerpo sin vida— como una inextricable parte de lo sagrado, no desaparece del ambiente secular de los siglos XIX y XX. En los relatos analizados en este artículo se estudia cómo en determinadas narrativas humanitarias centradas en la práctica de la autopsia y la momificación, las huellas del catolicismo actúan como una suerte de discurso espectral de la imaginación, en que lo real se configura en formas de lo siniestro, lo monstruoso o lo sagrado.

Valis, Noël

2011-12-01

49

Is routine histopathologic examination beneficial in all medicolegal autopsies?  

Science.gov (United States)

Postmortem examinations are performed for a number of reasons. Medical autopsies are performed at the request of and with the consent of the next of kin of a decedent and are often requested to determine the extent of a disease process or to evaluate therapy. In contrast, medicolegal autopsies are performed by a forensic pathologist primarily to determine cause and manner of death but also to document trauma, diagnose potentially infectious diseases and report them to the appropriate agencies, provide information to families about potentially inheritable diseases, provide information to family members and investigative agencies, and testify in court. As medicolegal and hospital autopsies differ in their purpose, so do they differ in procedure. Medicolegal autopsies often include histologic analysis, but not always, as with medical autopsies. We designed a prospective study to address the question of whether or not routine histologic examination is useful in medicolegal cases, defining a routine case as one where histology would not normally be performed and where the cause and manner of death were readily apparent during the gross autopsy. We reviewed brain, heart, liver, kidney, and lung sections on 189 routine forensic cases and compared the results to the gross anatomic findings. Of the 189 cases, in only 1 case did microscopic examination affect the cause of death and in no case did microscopic examination affect the manner of death. Thus, we feel that routine microscopic examination (performing histologic examination in all cases regardless of cause and manner of death) in forensic autopsy is unnecessary. Microscopic examination should be used, as needed, in certain circumstances but is not necessary as a matter of routine. PMID:17325455

Molina, D Kimberly; Wood, Leisha E; Frost, Randall E

2007-03-01

50

Autopsy findings in fatal dengue haemorrhagic fever - 06 Cases  

Science.gov (United States)

Background During recent outbreak of dengue fever in Delhi, there has been a significant increase in dengue-associated admission in hospitals. To better understand the pathology of dengue haemorrhagic fever, we conducted autopsies of dengue infections deaths within our hospital. Method This was an autopsy study of dengue-associated deaths at a large tertiary care hospital. Results From Sep 2009 to Dec 2010, a total of 1032 patients with serological evidence of dengue infection were admitted to our hospital. There were twelve deaths and autopsies were conducted in six. Adult respiratory distress syndrome, bleeding diathesis, hypotension, hepatic failure and acute renal failure were the common causes of death despite early hospitalization, intravenous fluid, and blood-product support. Conclusion Dengue is associated with severe disease, and deaths do occur despite current supportive management. Early predictors of disease severity and better clinical interventions are needed.

Rathi, K.R.; Arora, M.M.; Sahai, K.; Tripathi, S.; Singh, S.P.; Raman, D.K.; Anand, K.B.

2012-01-01

51

Problems in the analysis of cadmium in autopsied tissues  

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A comparison was made between the concentrations of Cd, Zn, Cu, and Fe in the organs at autopsy and after fixation in formalin for anatomicopathological examination. The concentrations of all the metals were lower in the formalin-fixed organs. In particular, the residual rates of Cd in the renal cortex and medulla were 2.3 and 6.1% of those for the fresh organs, respectively. The Cd concentration in the blood collected at autopsy was several hundred times as high as the value measured before death and failed to be an indicator of exposure of Cd. This phenomenon is specific to Cd and is not found with other metals. In determining Cd in the organs collected at autopsy, it is important to avoid contamination with blood, remove water around the organs quickly, and preserve the organs in sealed polyethylene bags. 12 refs., 1 fig., 5 tabs.

Koizumi, Naoko (Hyogo College of Medicine, Nishinomiya (Japan)); Hatayama, Fumikazu; Sumino, Kimiaki (Kobe Univ., Kobe (Japan))

1994-02-01

52

Sudden unexpected death in schizophrenia: Autopsy findings in psychiatric inpatients.  

Science.gov (United States)

Schizophrenia is associated with premature mortality and a high rate of sudden, unexpected deaths. Autopsy data are scant, and in studies using death certificates or root cause assessments, a majority of sudden deaths remained unexplained. In the community, post-mortem data indicate that the most common cause of sudden "natural" death is coronary artery disease. In this study, we used autopsy findings to determine the cause of sudden death in a consecutive cohort of 7189 schizophrenia patients admitted to a free-standing, psychiatric teaching hospital from 1989 to 2013. Medical record review identified 57 patients (0.79%) who died suddenly and unexpectedly during hospitalization. Autopsies were performed in 51 (89.5%) patients (55.9±9.4years, male=56.9%). Autopsy-based causes of sudden death were most commonly cardiovascular disorders (62.8%). Specific causes included myocardial infarction (52.9%), pneumonia (11.8%), airway obstruction (7.8%), myocarditis (5.9%), and dilated cardiomyopathy, hemopericardium, pulmonary embolus, hemorrhagic stroke and brain tumor (2.0% each). The sudden death remained unexplained in 6 (11.8%) patients, 3 of whom had evidence of coronary arteriosclerosis on autopsy. Patients with and without myocardial infarction were similar regarding age, gender, smoking, body mass index and psychotropic treatment (p values?0.10). In conclusion, sudden cardiac death occurs at a 0.8% rate in a psychiatric hospital, well above general population rates. Autopsy findings indicate that sudden death in schizophrenia is caused by structural cardiovascular, respiratory and neurological abnormalities, with most cases due to acute myocardial infarction. Early recognition and treatment of coronary artery disease must become a clinical priority for all adults with schizophrenia. PMID:24704220

Ifteni, Petru; Correll, Christoph U; Burtea, Victoria; Kane, John M; Manu, Peter

2014-05-01

53

Extraskeletal osteosarcoma of the thigh: an autopsy case report.  

Science.gov (United States)

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. PMID:19753130

Nagano, Akihito; Ohno, Takatoshi; Nishimoto, Yutaka; Yamada, Kazunari; Shimizu, Katsuji

2009-01-01

54

Extraskeletal Osteosarcoma of the Thigh: An Autopsy Case Report  

Science.gov (United States)

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.

Nagano, Akihito; Ohno, Takatoshi; Nishimoto, Yutaka; Yamada, Kazunari; Shimizu, Katsuji

2009-01-01

55

A safer method for body restoration following autopsy.  

Science.gov (United States)

Restoration of autopsy incisions can result in inadvertent needle stick injury to the prosector, which can be difficult to prevent even with the use of personal protective equipment such as Kevlar cut resistant gloves. We present a new technique for closure of autopsy incisions using a commonly available commercial hardware tool, a hole punch with a lever enhanced action, combined with blunt probe sewing, which results in an esthetic and leak-proof means of restoring cadavers. This technique is especially useful in cases which may pose blood-borne infection risks to the prosector. PMID:24117624

Duflou, Johan; McNamara, Bradley; Cluney, Robert

2014-01-01

56

An autopsy case of Fabry's disease with cardiac manifestations.  

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We report an autopsy case of Fabry's disease with cardiac manifestations. Electron microscopic examination of rectal biopsy specimens revealed lamellar bodies and osmiophilic irregular bodies. Biochemical analysis showed low enzymatic activity of alpha-galactosidase A in plasma fluid. Microscopic examination on autopsy showed marked hypertrophy and vacuolation of cardiac muscle cells. Intracytoplasmic vacuolation was also found in glomerular epithelial or endothelial cells and smooth muscle cells of renal arteries, Meissner's plexus in the submucosa of small and large intestines, and smooth muscle cells of arterioles in the cerebrum. The diagnosis of Fabry's disease was made. The patient died suddenly of cardiomyopathy. PMID:19907117

Suzuki, Osamu; Abe, Masafumi

2009-11-01

57

Liver scanning in short interval autopsy material of cancer patients  

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The accuracy of liverscanning, alkaline phosphatase and 5'-nucleotidase in the detection of the hepatic metastases was studied in short interval autopsy material of 243 cancer patients. The highest percentage of correct diagnosis was by 5'-nucleotidase, alkaline phosphatase was the second, and scanning third. The overall accuracy of liver scan was 68%. It was the better the shorter the time interval between scanning and autopsy. The higher percentage of incorrect diagnoses of the scan was related to a larger number of false positives, the causes of which were to be verified only in half of the cases.

Appelqvist, P.; Salmo, M.; Kostiainen, S.

1980-12-01

58

Referral for autopsies: analysis of 651 consecutive deaths in one general practice  

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Autopsies represent a key instrument in educating doctors and may aid quality assurance for primary and secondary care. This study shows that only a few patients have an autopsy, of which the majority are carried out at the request of the coroner for medicolegal reasons. Better education and communication between general practitioners, hospital clinicians, pathologists, and coroners may increase the rate of autopsies.???Keywords: deaths; death register; autopsy; coroner

Khunti, K.

2000-01-01

59

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

Science.gov (United States)

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

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

2013-06-10

60

Autopsy case of delayed radiation necrosis of the brain  

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A 48-year-old housewife underwent radiation therapy with 5,000 rad of cobalt following surgery for craniopharyngioma. One year later she developed symptoms of increased intracranial pressure, so that recurrence or occurrence of cerebral tumor was suspected. She died two years after the occurrence of the disease and was found to have had delayed radiation necrosis of the brain at autopsy.

Ihara, Katsuo; Otsutomo, Michinori; Takeshita, Gen (Aomori Rosai Hospital (Japan))

1984-06-01

 
 
 
 
61

An autopsy case of asthmatic death: Usefulness of biochemical examination  

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Full Text Available Background. Asthma is the one of the major causes of sudden death in Japan. Postmortem diagnosis of asthma has been based on morphological findings in lungs, but it histological evidence, was also reported that the biochemical markers such as total and specific immunoglobulin E (IgE are useful. Case report. We present here a case of fatal asthmatic death. A Japanese male in his thirties, complaining of dyspnea, collapsed suddenly. He was taken by ambulance to hospital, but cardiopulmonary resuscitation was ineffective. From autopsy findings, we concluded that the cause of death was asphyxia due to asthma attack. Biochemical findings indicated that the deceased had a severe asthmatic condition. Conclusion. In the presented case, the biochemical examination of the serum obtained at autopsy gave helpful information for the diagnosis that asthmatic attack was a cause of death.

Kinoshita Hiroshi

2008-01-01

62

[An autopsy case of extraskeletal osteosarcoma arising in the mediastinum].  

Science.gov (United States)

A 90-year-old woman was admitted to our hospital with dyspnea and palpitation. A chest X-ray film showed an enlarged cardiac outline. An enhanced chest CT scan showed a 35-mm tumor in the superior portion of the mediastinum, a large amount of pericardial effusion, and bilateral lung nodules. She showed progressive deterioration and died 2 weeks after admission. At autopsy, there was a solid tumor measuring 35 mm in the anterior mediastinum between the aortic arch and trachea. The tumor invaded the left subclavian artery. The pathological autopsy finding was extraskeletal osteosarcoma arising from the mediastinum. Although extraskeletal osteosarcoma is uncommon and rarely develops in the mediastinum, it should be included in the differential diagnosis of a mediastinal mass. PMID:21485160

Haga, Takahiro; Fukuoka, Mizuki; Morita, Mizuo; Cho, Kouhei; Ozawa, Shirou

2011-03-01

63

My approach to performing a perinatal or neonatal autopsy  

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An opportunity to determine the cause of death, factors that may have a role in it, and the extent and cause of malformations is provided by perinatal autopsy. The family may be assisted in finding closure after the death of their infant by the information obtained. Insight into classifying infants appearing normal into one of three groups, small, appropriate and large for gestational age, has been provided, as each group tends to have specific causes of death. In infants with congenital anom...

2006-01-01

64

Algorithms for verbal autopsies: a validation study in Kenyan children.  

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The verbal autopsy (VA) questionnaire is a widely used method for collecting information on cause-specific mortality where the medical certification of deaths in childhood is incomplete. This paper discusses review by physicians and expert algorithms as approaches to ascribing cause of deaths from the VA questionnaire and proposes an alternative, data-derived approach. In this validation study, the relatives of 295 children who had died in hospital were interviewed using a VA questionnaire. T...

1996-01-01

65

An autopsy case of iatrogenic tracheoesophageal fistula secondary to tracheostomy.  

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Tracheoesophageal fistula (TEF) is an uncommon but life-threatening sequel of prolonged use of a cuffed tracheostomy tube. We describe a patient who developed a TEF after a tracheostomy done for management of head injury due to a road traffic mishap. The patient subsequently died of sepsis after bilateral bronchopneumonia. To the best of our knowledge, this is the first autopsy case of iatrogenic TEF after tracheal intubation reported in forensic literature. PMID:24781407

Menezes, Ritesh G; Pant, Sadip; Prasad, Sampath Chandra; Rao Padubidri, Jagadish; Prabhu, Prashanth; Monteiro, Francis N P; Kanchan, Tanuj; Yallapur Prahalad, Raghavendra Babu; Bhagavath, Prashantha; Sathyanarayan Achar, Manjunath; Lasrado, Savita

2014-06-01

66

Autopsy validation of MRI in central pontine myelinolysis  

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In a fatal case of central pontine myelinolysis (CPM) a low field strength (0.08 Tesla magnetic resonance image revealed reduction of image intensity in the pons with sparing of two central symmetrical areas in the ventral portion. The latter correlated with preservation of centrally located groups of longitudinal myelinated nerve fibres shown at autopsy. Although such sparing is well recognised in pathological studies of CPM it has never previously been demonstrated in life.

Thompson, A.J.; Brown, M.M.; Swash, M.; Thakkar, C.; Scholtz, C.

1988-04-01

67

Respiratory outcomes among South African coal miners at autopsy  

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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.

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

2005-09-01

68

Validation of autopsy data for epidemiologic studies of coal miners  

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South Africa has one of the largest miner autopsy databases, PATHAUT dating back to 1925. The diagnoses recorded on this database have never been evaluated for coal miners. The objective was to determine the validity of the autopsy diagnoses for coal workers, specifically bronchitis, silicosis, tuberculosis, coal workers' pneumoconiosis and emphysema, from 1975 to 1997. Three pathologists experienced in miner respiratory pathology conducted the review. They were blinded to employment and medical histories as well as to previous pathological diagnoses on PATHAUT and reviewed 28 coal miners with mixed mining exposures, and 31 cases with exclusive coal mine exposure-all selected randomly. The reviewers' independent and consensus diagnoses were compared to PATHAUT. An additional 31 cases with available whole mount sections were reviewed for the diagnosis of emphysema. Kappa statistics were used to determine degrees of agreement among reviewers and between reviewers and PATHAUT. This, the first systematic review of PATHAUT autopsy diagnoses made on coal workers, showed that PATHAUT can be used with confidence to establish a diagnosis of moderate to severe grades of coal workers' pneumoconiosis. The grade of emphysema recorded on PATHAUT could be used for epidemiological purposes, when whole mount sections have been prepared.

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

2005-01-01

69

Radiological diagnosis of splenic metastasis and its prevalence at autopsy  

Energy Technology Data Exchange (ETDEWEB)

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).

Imada, Hajime; Nakata, Hajime; Horie, Akio (University of Occupational and Environmental Health, Kitakyushu, Fukuoka (Japan))

1991-05-01

70

Autopsy-certified maternal mortality at Ile-Ife, Nigeria  

Directory of Open Access Journals (Sweden)

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 autopsy diagnoses in 34 of the 84 cases (38.1%.Conclusion: The leading causes of maternal death in this study are similar to those in other developing countries. Autopsy is an invaluable tool in accurately determining the cause of maternal death.Keywords: autopsy, causes, maternal mortality, Nigeria

Dinyain A

2013-12-01

71

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

LENUS (Irish Health Repository)

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.

Kaar, T K

2012-02-03

72

Closing the Loop: Facilitating the Use of Autopsy Information in Medical Decision Making and Managed Care  

Directory of Open Access Journals (Sweden)

Full Text Available This paper advances the somewhat paradoxical hypothesis that the emergence of managed care which threatens to accelerate the decline of the autopsy may, in fact, offer an opportunity for its re-emergence as an important tool of quality and cost control. A simplified autopsy-based management information structure is proposed to close the loop where information currently gleaned from the autopsy is frequently unused or underutilized in medical decision making and managed care.

Peter N. Nemetz

2008-01-01

73

Forensic Techniques in Crime Scene Investigation – The Psychological Autopsy  

Directory of Open Access Journals (Sweden)

Full Text Available Any crime scene investigation is a real challenge for those involved in forensic examination. Especially in those cases where a death ocurred, evidence dynamics and the amount of data colected must lead to an undoubtful conclusion. In some cases investigators have to establish a clear difference between accident, suicide, homicide, and a natural death. It is the case of equivocal death, where is necessary to understand all the psychosocial factors who have contributed to this end in order to clarify the nature of death. The psychological autopsy is the appropriate procedure in these cases. The present article will describe this technique.

Bogdan Tasu

2009-10-01

74

[Congenital anomalies of the central nervous system in autopsy specimens].  

Science.gov (United States)

On the basis of an analysis of 2398 autopsies of infants aged up to 1 year in 194 cases congenital anomalies of the central nervous system were found (8.1%). Most cases of these anomalies were noted in the group of newborns (85%) and the most frequent anomalies were: myelomeningocele (35.6%), multiple anomalies (20.1%), congenital hydrocephalus (17%), anencephaly (14.4%) and corpus callosum malformations (3.6%). Myelomeningocele, congenital hydrocephalus, anencephaly and true microcephaly were more frequent in girls, while multiple anomalies and corpus callosum malformations were more frequent in boys. PMID:2623859

Sobaniec-Lotowska, M; Ostapiuk, H; Sulkowski, S; Sobaniec, W; Sulik, M; Famulski, W

1989-02-01

75

Prenatal diagnosis of absent pulmonary valve confirmed by autopsy.  

Science.gov (United States)

Absent pulmonary valve syndrome (APVS) is a rare congenital cardiac anomaly. This syndrome is comprised of subtotal or total absence of pulmonary valve leaflets, stenosis of the pulmonary artery orifice, aneurysmal dilation of the main pulmonary artery and ventricular septal defect. We report a case of APVS with neural tube defect detected prenatally at 22 weeks of gestation by echocardiography, and subsequently confirmed by autopsy of the still born fetus. The common presentations, means of diagnosis and variants of APVS are discussed in brief. PMID:23371040

Vivek, G; Shetty, Ranjan K; Nayak, Shalini S; Girisha, K M; Naha, Kushal

2013-01-01

76

Voxel-based morphometry in autopsy proven PSP and CBD  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The aim of this study was to compare the patterns of grey and white matter atrophy on MRI in autopsy confirmed PSP and CBD, and to determine whether the patterns vary depending on the clinical syndrome. Voxel-based morphometry was used to compare patterns of atrophy in 13 PSP and 11 CBD subjects and 24 controls. PSP and CBD subjects were also subdivided into those with a dominant dementia or extrapyramidal syndrome. PSP subjects showed brainstem atrophy with involvement of the cortex and unde...

Josephs, Keith A.; Whitwell, Jennifer L.; Dickson, Dennis W.; Boeve, Bradley F.; Knopman, David S.; Petersen, Ronald C.; Parisi, Joseph E.; Jack, Clifford R.

2008-01-01

77

Acute fulminant myocarditis at autopsy: A clinical masquerade?  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Myocarditis is a diagnostic challenge in cardiology. The diagnosis is frequently made post-mortem, with no clinical evidence of myocardial failure. Autopsy studies report a frequency of myocarditis ranging from 0.11-0.55% in the general population. Myocarditis is presents with varied clinical manifestations, ranging from asymptomatic to sudden cardiac death, sometimes mimicking the Myocardial Infarction (MI. Case Summary: A 55 years old male presented with sudden onset of chest pain, breathlessness at rest and flu like symptoms 5-6 days prior to admission. There was tachycardia with low Systolic blood pressure and muffled heart sounds. ECG showed ST segment & T wave changes. CK-MB was moderately raised. Though clinically diagnosed as MI and treated, patient expired the next day. On autopsy, gross examination of heart revealed no significant findings. Histological examination revealed fulminant myocarditis involving right ventricle, interventricular septum, left ventricular wall and A-V Node. Conclusion: It is not uncommon to find Myocarditis patients presenting with manifestations of MI and these cases often misdiagnosed as MI. In such cases, myocarditis should be considered as a differential diagnosis. Endomyocardial biopsies and histological examination of the myocardium is absolutely necessary for reliable diagnosis of the disease.

S.Y. Patil

2012-10-01

78

An autopsy case of pulmonary fissure induced by zygomycosis.  

Science.gov (United States)

For immunodeficient patients, fungi are life-threatening pathogens. In this paper, we present an autopsy case of combined zygomycosis and aspergillosis. A female in her 70s on chronic hemodialysis was admitted to a hospital suffering bloody sputum, dyspnea, and fever, probably due to perinuclear anti-neutrophil cytoplasmic antibody-related vasculitis. Antibiotics were administered and immunosuppressive therapy was started, resulting in an improvement in her condition. Pneumonia later developed, followed by pulmonary bleeding and intractable pneumothorax from which she ultimately died. On autopsy, the upper lobe of the left lung was found to have hemorrhagic necrosis and showed a large longitudinal fissure. Microscopically, Zygomycota were observed in both the lungs and heart, while Aspergillus was found in the middle lobe of the right lung. Zygomycosis, which usually has a poor prognosis, is assumed to have induced hemorrhagic infarction of the lungs, inducing pulmonary bleeding and necrosis, despite the use of lipid formulations of amphotericin B, which are effective medicines against Zygomycota. PMID:23874118

Imai, Yuichiro; Adachi, Yasushi; Kimura, Takashi; Nakano, Chikara; Shimizu, Toshiki; Shi, Ming; Okigaki, Mitsuhiko; Shimo, Tomohiko; Kaneko, Kazunari; Ikehara, Susumu

2013-01-01

79

Occupational exposure to formaldehyde in a medical center autopsy service  

Energy Technology Data Exchange (ETDEWEB)

The formaldehyde exposures occurring in the autopsy service of a medical complex were evaluated as part of a study to detect genetically harmful effects of chemical exposures. Determination of time-weighted average (TWA) exposures and characterization of the patterns of exposure experienced by individuals with different work responsibilities in this occupational setting were sought. Both general area and breathing zone samples were evaluated. Estimated weekly time-weighted average exposures for pathologists, residents and technicians were determined to be between 0.61 and 1.32 parts per million with little difference between work roles. While the averages were similar, the patterns of exposure of technicians and physicians were different. Technicians were exposed to a baseline level of formaldehyde for a prolonged period of time. In contrast, physicians were exposed for shorter times but experienced higher levels during specific tasks, particularly tissue-sectioning and examination. Evaluations of work procedures and environmental conditions in autopsy services are recommended to reduce personnel exposure to formaldehyde vapor.

Coldiron, V.R.; Ward, J.B. Jr.; Trieff, N.M.; Janssen, H.E. Jr.; Smith, J.H.

1983-07-01

80

Autopsy practice in forensic pathology - evidence-based or experience-based? a review of autopsies performed on victims of traumatic asphyxia in a mass disaster.  

Science.gov (United States)

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 series, we describe the variation observed in autopsy reports by five different pathologists of eight victims who died simultaneously from traumatic asphyxia due to compression during a human stampede. We observed that there was no mention of the availability of medical charts in five of the reports, of potentially confounding resuscitation efforts in three reports, of cardinal signs in seven reports and of associated injuries to a various degree in all reports. Further, there was mention of supplemental histological examination in two reports and of pre-autopsy radiograph in six reports. We inferred that reliance on experience and individual customary practices led to disparities between the autopsy reports as well as omissions of important information such as cardinal signs, and conclude that such reliance increases the potential for error in autopsy practice. We suggest that pre-autopsy data-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 accuracy of the report as a legal document as well as rendering it more useful for data-gathering efforts. PMID:24485418

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

2014-02-01

 
 
 
 
81

Autopsy practice in forensic pathology - Evidence-based or experience-based? : A review of autopsies performed on victims of traumatic asphyxia in a mass disaster  

DEFF Research Database (Denmark)

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 series, we describe the variation observed in autopsy reports by five different pathologists of eight victims who died simultaneously from traumatic asphyxia due to compression during a human stampede. We observed that there was no mention of the availability of medical charts in five of the reports, of potentially confounding resuscitation efforts in three reports, of cardinal signs in seven reports and of associated injuries to a various degree in all reports. Further, there was mention of supplemental histological examination in two reports and of pre-autopsy radiograph in six reports. We inferred that reliance on experience and individual customary practices led to disparities between the autopsy reports as well as omissions of important information such as cardinal signs, and conclude that such reliance increases the potential for error in autopsy practice. We suggest that pre-autopsy data-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 accuracy of the report as a legal document as well as rendering it more useful for data-gathering efforts.

Colville-Ebeling, Bonnie; Freeman, Michael

2014-01-01

82

Clinical utility and impact of autopsies on clinical practice among doctors in a large teaching hospital in Ghana  

Directory of Open Access Journals (Sweden)

: Strengthening the interaction between doctors and pathologists is essential in improving the autopsy process and utilization in the hospital. KBTH should create opportunities for doctors to attend autopsy demonstrations and for pathologists to attend clinicopathological meetings in the hospital.

Edem Tette

2014-02-01

83

Correlation between prenatal diagnosis by ultrasound and fetal autopsy findings in second-trimester abortions  

DEFF Research Database (Denmark)

We evaluated the correlation between prenatal diagnosis by ultrasound and autopsy findings, based on 52 second-trimester pregnancies terminated due to fetal malformations or chromosome aberrations diagnosed at a gestational age of 12-25 weeks. In 24 pregnancies, there was full agreement between ultrasound and autopsy. In 23 fetuses, the main diagnosis was confirmed and additional or more specific findings were observed on autopsy. In five fetuses, there were considerable differences. Discrepancies between ultrasound and autopsy findings were mainly anomalies undetectable by ultrasound and thus expected; however, about one-third of the discrepancies were not expected, representing findings that were 'missed' at ultrasound. The main ultrasound diagnoses were confirmed in the majority of the pregnancies, but the additional information obtained at autopsy in more than half of the fetuses clearly shows the value and benefit of postmortem fetal examination following termination of a pregnancy.

Hauerberg, Laura; Skibsted, Lillian

2012-01-01

84

Correlated study of cerebral infarcts by CAT and autopsy  

International Nuclear Information System (INIS)

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.)

1981-09-25

85

Rosai - Dorfman disease: a rare entity diagnosed at autopsy  

Directory of Open Access Journals (Sweden)

Full Text Available Rosai-Dorfman disease (RDD or Sinus histiocytosis with massive lymphadenopathy is a rare and benign histiocytic proliferative disorder first described by Juan Rosai and Ronald Dorfman in 1969, whose etiology remains unknown. Since then, many cases were reported in the literature. The disease primarily involves the lymph nodes, and is characterized by painless, bilateral cervical lymphadenopathy accompanied by fever, night sweats, malaise and weight loss, reason why many patients are clinically misdiagnosed as malignant lymphoma. In some cases, extranodal involvement may be present. Leukocytosis, elevated erythrocyte sedimentation rate, and hypergamaglobulinemia are often present. The authors report a case of a 52-year-old female patient admitted to the hospital with the diagnosis of pneumonia and progressed to multiple organs failure and death. During the hospitalization an attempt to diagnose a lymphoproliferative disease trough an axillary lymph node biopsy was disappointing. The autopsy was crucial for the diagnosis, illustrating a severe and unusual presentation of Rosai-Dorfman disease.

João da Costa Veloso Neto

2013-03-01

86

Size of variables in mandibular movements in autopsy material.  

Science.gov (United States)

Autopsy was performed on the right temporomandibular joint in eleven individuals with a mean age of 71 years. Standard positions indicative for protrusion, laterotrusive border movement and posterior opening movement were photographed in the sagittal plane. Size of movements of the disc and condylar head were recorded, as well as movements of a reference point in the mental region. The slope of the anterior discal movement was estimated and mandibular rotation during posterior opening was registered. Centre of rotation during the hinge movement was in all cases located to the craniodorsal part of the condylar head. Attempt to construct centres of rotation in the eminence and condylar head for the horizontal movements was in vain. The discussion deals with the influence of the specific kind of material on the results and the possible systematic differences to clinical material. PMID:279650

Rasmussen, O C

1978-07-01

87

An autopsy case of miliary tuberculosis in a young adult.  

Science.gov (United States)

A 23-year-old woman who had worked as a hostess at a nightclub was found dead in her house. The cause of death was diagnosed as miliary tuberculosis from the findings of medico-legal autopsy. Recently, tuberculosis (TB) has re-emerged as a health problem due to recurrence in the aged, and infections among health care workers and young adults like the present case. Currently, the common source of TB transmission is recurrence in the aged, but global migration, difficulty to achieve permanent immunity by BCG vaccination, immunodeficiency such as HIV infection, and drug abuse and/or sexual intercourse are also thought to be associated with tuberculosis in young adults. Forensic pathologists should be aware of such connections with TB, and should take care not to become mediators of TB infections. PMID:12935641

Uchigasaki, Seisaku; Kumagai, Tetsuo; Isahai, Isamu; Oshida, Shigemi; Morita, Kaoru

2003-03-01

88

Endocardial Invasion of Lung Cancer Undiagnosable before Autopsy  

Science.gov (United States)

A 59-year-old male patient presented with left chest discomfort on admission. His medical history included encephalitis in childhood and his smoking history was 20 cigarettes per day for 40 years. A physical examination showed an anemic and edematous face with weak respiratory sounds in the left lung. The patient had elevated calcium levels and decreased hemoglobin and potassium. His parathyroid hormone-related protein level was elevated. Thoracic radiography showed cardiomegaly and computed tomography revealed a left lung mass with invasion of the heart and pleural effusion. Magnetic resonance imaging showed endocardial invasion of the tumor mass. Gallium-68 imaging revealed positive accumulation in the region surrounding the heart. No diagnoses were possible upon frequent cytology of his sputum and pleural effusion. The patient died from congestive heart failure with anoxia 38 days after admission. An autopsy revealed tumoral mass occlusion in the left main bronchus and tumoral invasion of the left atrium, left ventricle, and aorta.

Mizuno, T.; Ishigami, K.; Yamada, S.; Tsuchiya, H.; Nakajima, C.; Sangen, R.; Fukushima, M.; Minato, H.; Nojima, N.; Saito, A.; Hayashi, N.; Atsumi, H.; Ito, T.; Iguchi, M.; Usuda, D.; Okamura, H.; Urashima, S.; Asano, M.; Kiyosawa, J.; Fukuda, A.; Takekoshi, N.; Kanda, T.

2014-01-01

89

Rapidly aggravated Creutzfeldt-Jacob disease: autopsy-proven case  

Energy Technology Data Exchange (ETDEWEB)

Creutzfeldt-Jakob disease (DJD) is one of the transmissible spongiform encephalopathies, which is mediated by what has been known as 'prion'. It is a rare and fatal progressive neurodegenerative disease that affects the middle and old aged. There are a number of subtypes of CJD, one of which is the sporadic type characterized by rapidly progressing clinical symptoms, including progressive dementia, myoclonic jerk, and pyramidal or extrapyramidal syndrome. Patients usually end up dying within 1 to 2 years of contacting the disease. We report an autopsy-proven case of sporadic CJD with clinical symptoms that progressed within several days, along with dramatic changes on diffusion weighted magnetic resonance images.

Park, Seung Hyun; Kang, Hyun Koo; Yu, Hyeon; Lee, Sang Chun [Seoul Veterans Hospital, Seoul (Korea, Republic of)

2005-11-15

90

An autopsy case of pulmonary fissure induced by zygomycosis  

Directory of Open Access Journals (Sweden)

Full Text Available Yuichiro Imai,1 Yasushi Adachi,2,3 Takashi Kimura,4 Chikara Nakano,5 Toshiki Shimizu,4 Ming Shi,2 Mitsuhiko Okigaki,6 Tomohiko Shimo,1 Kazunari Kaneko,1 Susumu Ikehara2 1Department of Pediatrics, Kansai Medical University, Osaka, 2Department of Stem Cell Disorders, Kansai Medical University, Osaka, 3Division of Clinical Pathology, Toyooka Hospital, Hyogo, 4First Department of Internal Medicine, Kansai Medical University, Osaka, 5Second Department of Internal Medicine, Kansai Medical University, Osaka, 6Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto, Japan Abstract: For immunodeficient patients, fungi are life-threatening pathogens. In this paper, we present an autopsy case of combined zygomycosis and aspergillosis. A female in her 70s on chronic hemodialysis was admitted to a hospital suffering bloody sputum, dyspnea, and fever, probably due to perinuclear anti-neutrophil cytoplasmic antibody-related vasculitis. Antibiotics were administered and immunosuppressive therapy was started, resulting in an improvement in her condition. Pneumonia later developed, followed by pulmonary bleeding and intractable pneumothorax from which she ultimately died. On autopsy, the upper lobe of the left lung was found to have hemorrhagic necrosis and showed a large longitudinal fissure. Microscopically, Zygomycota were observed in both the lungs and heart, while Aspergillus was found in the middle lobe of the right lung. Zygomycosis, which usually has a poor prognosis, is assumed to have induced hemorrhagic infarction of the lungs, inducing pulmonary bleeding and necrosis, despite the use of lipid formulations of amphotericin B, which are effective medicines against Zygomycota. Keywords: pulmonary fissure, zygomycosis, aspergillosis, lung, immunosuppression

Imai Y

2013-07-01

91

Use of autopsy results in the emergency department quality assurance plan.  

Science.gov (United States)

Traditionally, the autopsy is viewed as the ultimate quality assurance indicator in clinical medicine, yet very few clinical departments actually incorporate autopsy results in their formal quality assurance plans. Consequently, to investigate how autopsy results can be included on our emergency department plan, the clinical and autopsy diagnoses of 244 patients were reviewed retrospectively and compared to identify conditions that were unapparent or misdiagnosed at the time of death. The study period was from January 1984 through June 1988. The average yearly ED census was 33,266. Differences between clinical and autopsy diagnoses were categorized as class 1, 2, 3, or 4 findings. Major unexpected findings (classes 1 and 2) were found in ten patients (4%); the most common missed diagnoses were aortic dissection 3 (1.2%) and pulmonary embolus 2 (0.8%). Minor unexpected findings (classes 3 and 4) were discovered in 14 patients (5.8%). The results clearly identify unexpected findings and point to the need for more aggressive evaluations of certain conditions. Systematic review of autopsy data as presented has led to meaningful changes and delivery of care to emergency patients. Autopsies are a vital source of outcome-based information that should be part of every ED's quality assurance and risk management plan. PMID:2321819

Burke, M C; Aghababian, R V; Blackbourne, B

1990-04-01

92

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-08-15

93

Investigation into the standard of autopsy procedures performed on Irish nationals worldwide.  

Science.gov (United States)

For the purpose of this study twenty cases, involving the deaths of Irish nationals while abroad, were examined. The aims of the report were 1) to observe whether autopsy guidelines are being implemented by countries throughout the world investigating the deaths of foreign citizens, particularly Irish nationals, 2) to compare/contrast the cause(s) of death established in Ireland and the countries where the deaths occurred and 3) where appropriate, suggest improvements to the current system. The results revealed that where a complete autopsy is not performed then the chance of forming a correct cause of death, or any cause of death, decreases from 100% to 0%. The standard of autopsies on foreign nationals varies from country to country and within countries. Currently there are many different autopsy procedure guidelines available. The time may have come to formulate one universal set of guidelines that are to be implemented worldwide. PMID:18557510

McLaughlin, L; Cassidy, M

2008-04-01

94

Autopsy: its role in clinical quality control in the elderly in the 1990s.  

Science.gov (United States)

The accuracy of pre-mortem diagnosis was investigated in 100 patients (age range 65-97 years) undergoing autopsy. Post-mortem rate was 22%. In 32% of cases there were discrepancies between ante- and post-mortem diagnosis; in 14% these may have affected therapy or outcome. We conclude that autopsy remains a useful tool in clinical quality control, and should be part of a quality assurance plan in all geriatric units. PMID:15374215

Hasan, M; Woodhouse, K

1995-01-01

95

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 o...

2011-01-01

96

An autopsy case of hypertrophic cardiomyopathy showing clinical features of dilated cardiomyopathy.  

Directory of Open Access Journals (Sweden)

Full Text Available An autopsy case of hypertrophic cardiomyopathy showing clinical features of dilated cardiomyopathy was reported. The patient was a 60-year-old female complaining of chest discomfort from the age of 40. At autopsy, both ventricles were dilated. Microscopically myocardial loss, fibrosis and disarray of hypertrophic myocardial fibers were observed. The areas showing myocardial disarray were distributed close to the scar-like fibrotic areas. Coronary arteries and intramyocardial arterioles showed minimal stenotic changes.

Yamadori,Ichiro

1985-12-01

97

An autopsy case of hypertrophic cardiomyopathy showing clinical features of dilated cardiomyopathy.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

An autopsy case of hypertrophic cardiomyopathy showing clinical features of dilated cardiomyopathy was reported. The patient was a 60-year-old female complaining of chest discomfort from the age of 40. At autopsy, both ventricles were dilated. Microscopically myocardial loss, fibrosis and disarray of hypertrophic myocardial fibers were observed. The areas showing myocardial disarray were distributed close to the scar-like fibrotic areas. Coronary arteries and intramyocardial arterioles sho...

Yamadori, Ichiro; Murakami, Motomasa

1985-01-01

98

Thorium isotopes in autopsy samples from thorium workers  

Energy Technology Data Exchange (ETDEWEB)

Concentrations of {sup 232}Th and activity ratios of {sup 228}Th to {sup 232}Th and {sup 230}Th to {sup 232}Th were determined in autopsy samples from five former employees of a thorium refinery. The ranges of {sup 232}Th activity concentrations (mBq per gram of wet tissue) were 0.17--94 in lungs, 3.9--1,210 in pulmonary lymph nodes, 0.14--1.19 in bones, 0.015--0.68 in liver, 0.97--5.8 in spleen, and 0.009--0.068 in kidneys. These concentrations are 10 to 1,000 times greater than have been reported for persons not occupationally exposed to thorium. In most of the samples, the ratios of {sup 228}Th to {sup 232}Th and {sup 232}Th to {sup 232}Th activity at death of the subject were 0.2--0.4 and 0.1--0.2, respectively. {sup 228}Th to {sup 228}Ra activity ratios ({+-} standard errors) of 0.86 {+-} 0.11 in lungs and 1.18 {+-} 0.13 in lymph nodes of one subject were obtained by calculation from ratios of {sup 228}Th to {sup 232}Th.

Stehney, A.F.; Lucas, H.F.

2000-01-01

99

Academic autopsies in Brazil - a national survey / Autópsias acadêmicas no Brasil - um inquérito nacional  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Objetivo: Investigar o número e a taxa de autópsias acadêmicas, organização geral, ensino e pesquisa em serviços acadêmicos brasileiros. Métodos: Questionários padronizados enviados para escolas médicas brasileiras (n=177) e programas de resid& [...] #234;ncia em patologia ativos (n=53) de março a junho de 2009. Dados coletados referentes ao período de 2003 a 2008. Resultados: Trinta e dois serviços em 11 estados responderam à pesquisa. Vinte e um (65,6%) realizam menos de cem autópsias de causas naturais e menos de cinquenta autópsias fetais ou pediátricas/ano. Vinte e quatro (75%) realizam menos de cem autópsias de adultos/ano. Muitas instituições (46,9%) relataram queda no número de autópsias em seis anos. A contagem total e a taxa de autópsias em 2008 variaram, respectivamente, de 1 a 632 (mediana=80) e de 0 a 66% (média=10,6%). Foi observada uma redução contínua no total de autópsias em um grupo de 19 instituições (p<0,01). A mediana da taxa de autópsias caiu de 19,3%, em 2003, para 10,6%, em 2008 (p=0,07). Discrepâncias significativas observadas em autópsias levaram a mudanças na prática institucional de saúde em 37,5% dos serviços. O baixo número de autópsias foi limitante no ensino de graduação para 25% dos entrevistados. Um número mínimo de autópsias é necessário para completar o programa de residência em patologia em 34,6% dos serviços. Conclusão: O número total e a taxa de autópsias acadêmicas diminuíram no Brasil entre 2003 e 2008. O número de autópsias e organização geral dos serviços acadêmicos deve ser melhorado para fortalecer a educação médica, pesquisa e controle de qualidade prestado ao paciente. Abstract in english Objective: To investigate the number and rate of academic autopsies, general organization, educational and research in Brazilian academic services. Methods: Standardized questionnaires were sent to Brazilian medical schools (n=177) and active pathology residency programs (n=53) from March to J [...] une 2009. Data were collected for years 2003 to 2008. Results: Thirty-two academic services in 11 Brazilian states answered the survey. Twenty-one (65.6%) perform less than a hundred autopsies for natural causes and less than fifty pediatric or fetal autopsies/year. Twenty-four (75%) perform less than a hundred adult autopsies/year. Many institutions (46.9%) reported a drop in the number of autopsies in a six-year period. The total autopsy count and autopsy rate in 2008 ranged 1-632 (median = 80), and 0-66% (mean = 10.6%), respectively. A steady decrease in the total count of autopsies in a pool of 19 institutions was observed (p<0.01). Median autopsy rates have fallen from 19.3%, in 2003, to 10.6%, in 2008 (p=0.07). Significant discrepancies at autopsies led to changes in institutional healthcare practice in 37.5% of the services. The low number of autopsies was a limiting factor in undergraduate education for 25% of respondents. A minimum number of autopsies is required to complete the pathology residency program in 34.6% of the services. Conclusion: The total number and the rate of academic autopsies have decreased in Brazil between 2003 and 2008. The number of autopsies and the general organization of academic services must be enhanced to improve medical education, research, and the quality control of patient care.

Felipe-Silva, Aloísio; Ishigai, Márcia; Mauad, Thaís.

100

Coronary atherosclerosis in sudden cardiac death: An autopsy study  

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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.

Sudha M

2009-10-01

 
 
 
 
101

Autopsy case of concurrent Huntington's disease and neurofibromatosis type 1.  

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We report here an autopsy case of concurrent Huntington's disease (HD) and neurofibromatosis type 1 (NF1), also known as von Recklinghausen's disease. The patient was a Japanese woman with a significant hereditary burden: seven of her family members within four generations were affected by either NF1 or concurrent HD and NF1. She was diagnosed as having NF1 at age 24. At age 40, she showed signs of irritability, aggressive and childish behaviour, which became progressively worse. At age 48, rigidity and spastic gait were observed. One year later, choreoathetoid involuntary movements became apparent. Diagnosis of HD was made by identification of the abnormally expanded cytosine-adenine-guanine repeats in the Huntington's disease gene. Her condition deteriorated gradually to an apallic state and she died at age 60. Post-mortem examination revealed extensive brain atrophy, which was particularly severe in the frontal and temporal cortices and the striatum. The degree of neurodegenerative change seemed to correspond to grade IV. Polyglutamine positive inclusions were seen frequently in all layers of the cerebral cortex and in the amygdala and hippocampus. Inclusions were also present in the striatum, but there were fewer than in the cortex. Remarkably, neuronal intranuclear inclusions were present in the cerebellum, although they are usually not seen in HD. Features associated with the central nervous system involvement of NF1 were not found in the brain, but HD pathology might have been accelerated by the concurrence of NF1. This is the third report of a case with concurrent HD and NF1 in the world, and the first study in which occurrence of polyglutamine inclusions was confirmed on post-mortem examination. PMID:24528652

Kawakami, Ito; Katsuse, Omi; Aoki, Naoya; Togo, Takashi; Suzuki, Kyoko; Isojima, Daisuke; Kondo, Daizo; Iseki, Eizo; Kosaka, Kenji; Akiyama, Haruhiko; Hirayasu, Yoshio

2014-03-01

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An autopsy case of tuberous sclerosis. Histological and immunohistochemical study.  

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We report an autopsy case of tuberous sclerosis. A 19-year-old Japanese man had shown facial adenoma sebaceum, intractable convulsive seizures and severe mental retardation. Gross inspection of the brain showed a cortical tuber from the orbital frontal lobe to the rhinencephalon of the left side and a few subependymal nodules. Histological examination revealed many cortical tubers in the cerebral hemispheres, a few subependymal nodules with calcification and multifocal clusters of heterotopic cells in the white matter (white matter nodules). In these lesions, massive giant cells with abundant eosinophilic cytoplasm and without Nissl substances were found. Although the size and shape of the giant cells were variable, the majority of them were gemistcytic, ovoid or polygonal. Immunohistochemistry was employed in these lesions using antibodies against neurofilament protein (NFP), glial fibrillary acidic protein (GFAP), vimentin (VM) and myelin basic protein (MBP). In the cortical tuber, the majority of the giant cells were positive for both NFP and VM, but a few were positive for GFAP. All of them were negative for MBP. In the subependymal nodule and white matter nodule, the majority of the giant cells were positive for NFP, but a few were positive for VM, and none were positive for either GFAP and MBP. These findings suggest that the majority of the giant cells may be immature cells toward neuronal series and a few may be those toward astroglial series. These findings also indicate that the giant cells in the subependymal nodule and white matter nodule may be more differentiated than those in the cortical tuber. The nature of the giant cells in tuberous sclerosis is discussed. PMID:1457992

Fukutani, Y; Yasuda, M; Saitoh, C; Kyoya, S; Kobayashi, K; Miyazu, K; Nakamura, I

1992-10-01

103

Verbal autopsy: current practices and challenges / Autopsie verbale: pratiques actuelles et défis à surmonter / Autopsias verbales: práctica y retos  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: English Abstract in spanish Los datos sobre causas de defunción obtenidos a partir de autopsias verbales (AV) son usados con creciente frecuencia con fines de planificación de la salud, establecimiento de prioridades, seguimiento y evaluación en los países con sistemas de registro civil incompletos o inexistentes. En algunas r [...] egiones del mundo es el único método disponible para poder estimar la distribución de las causas de mortalidad. Hoy día el método de las AV se utiliza sistemáticamente en más de 35 lugares, sobre todo en África y Asia. En este artículo presentamos un panorama general del sistema de las AV y los resultados de un análisis de los instrumentos de AV y los procedimientos operativos utilizados en los sitios de vigilancia demográfica y los sistemas de registro de estadísticas vitales por muestreo. Solicitamos información a 36 sitios sobre el terreno acerca de los procedimientos operativos y examinamos 18 cuestionarios de autopsia verbal y 10 listas de causas de defunción usadas en 13 países. El formato y el contenido de los cuestionarios de AV, los procedimientos operativos sobre el terreno, las listas de las causas de defunción y los procedimientos empleados para calcular las causas de mortalidad a partir de las AV diferían sustancialmente de un sitio a otro. Analizamos las consecuencias de utilizar distintos métodos y llegamos a la conclusión de que es necesario normalizar los instrumentos y los procedimientos de AV y hacerlos más fiables si se desea hacer comparaciones más precisas de los datos de AV en los planos nacional e internacional. Ponemos de relieve, además, las medidas adicionales que habría que adoptar para desarrollar un procedimiento de AV normalizado. Abstract in english Cause-of-death data derived from verbal autopsy (VA) are increasingly used for health planning, priority setting, monitoring and evaluation in countries with incomplete or no vital registration systems. In some regions of the world it is the only method available to obtain estimates on the distribut [...] ion of causes of death. Currently, the VA method is routinely used at over 35 sites, mainly in Africa and Asia. In this paper, we present an overview of the VA process and the results of a review of VA tools and operating procedures used at demographic surveillance sites and sample vital registration systems. We asked for information from 36 field sites about field-operating procedures and reviewed 18 verbal autopsy questionnaires and 10 cause-of-death lists used in 13 countries. The format and content of VA questionnaires, field-operating procedures, cause-of-death lists and the procedures to derive causes of death from VA process varied substantially among sites. We discuss the consequences of using varied methods and conclude that the VA tools and procedures must be standardized and reliable in order to make accurate national and international comparisons of VA data. We also highlight further steps needed in the development of a standard VA process.

Soleman, Nadia; Chandramohan, Daniel; Shibuya, Kenji.

104

The value of postmortem computed tomography as an alternative for autopsy in trauma victims: a systematic review  

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The aim of this study was to assess the role of postmortem computed tomography (PMCT) as an alternative for autopsy in determining the cause of death and the identification of specific injuries in trauma victims. A systematic review was performed by searching the EMBASE and MEDLINE databases. Articles were eligible if they reported both PMCT as well as autopsy findings and included more than one trauma victim. Two reviewers independently assessed the eligibility and quality of the articles. The outcomes were described in terms of the percentage agreement on causes of death and amount of injuries detected. The data extraction and analysis were performed together. Fifteen studies were included describing 244 victims. The median sample size was 13 (range 5-52). The percentage agreement on the cause of death between PMCT and autopsy varied between 46 and 100%. The overall amount of injuries detected on CT ranged from 53 to 100% compared with autopsy. Several studies suggested that PMCT was capable of identifying injuries not detected during normal autopsy. This systematic review provides inconsistent evidence as to whether PMCT is a reliable alternative for autopsy in trauma victims. PMCT has promising features in postmortem examination suggesting PMCT is a good alternative for a refused autopsy or a good adjunct to autopsy because it detects extra injuries overseen during autopsies. To examine the value of PMCT in trauma victims there is a need for well-designed and larger prospective studies. (orig.)

Scholing, M.; Saltzherr, T.P.; Fung Kon Jin, P.H.P.; Ponsen, K.J.; Goslings, J.C. [Academic Medical Center, Trauma Unit, Department of Surgery, Amsterdam (Netherlands); Reitsma, J.B. [Academic Medical Center, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam (Netherlands); Lameris, J.S. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands)

2009-10-15

105

The value of postmortem computed tomography as an alternative for autopsy in trauma victims: a systematic review  

International Nuclear Information System (INIS)

The aim of this study was to assess the role of postmortem computed tomography (PMCT) as an alternative for autopsy in determining the cause of death and the identification of specific injuries in trauma victims. A systematic review was performed by searching the EMBASE and MEDLINE databases. Articles were eligible if they reported both PMCT as well as autopsy findings and included more than one trauma victim. Two reviewers independently assessed the eligibility and quality of the articles. The outcomes were described in terms of the percentage agreement on causes of death and amount of injuries detected. The data extraction and analysis were performed together. Fifteen studies were included describing 244 victims. The median sample size was 13 (range 5-52). The percentage agreement on the cause of death between PMCT and autopsy varied between 46 and 100%. The overall amount of injuries detected on CT ranged from 53 to 100% compared with autopsy. Several studies suggested that PMCT was capable of identifying injuries not detected during normal autopsy. This systematic review provides inconsistent evidence as to whether PMCT is a reliable alternative for autopsy in trauma victims. PMCT has promising features in postmortem examination suggesting PMCT is a good alternative for a refused autopsy or a good adjunct to autopsy because it detects extra injuries overseen during autopsies. To examine the value of PMCT in trauma victims there is a need for well-designed and larger prospective studies. (orig.)

2009-10-01

106

Radiation protection measures applied during the autopsies on the casualties of the Goiania accident  

International Nuclear Information System (INIS)

The most seriously affected casualties of the radiological accident caused by the opening of a 137Cs source capsule in Goiania were treated at the Marcilio Dias Naval Hospital (HNMD) in Rio de Janeiro in the period from October to December 1987. Four of the injured died in October. The autopsies were performed at this institution. Due to the external and internal contamination presented by these victims, specific radiation protection procedures were adopted to enable the medical team to perform their duties. The radiation protection staff, under the co-ordination of technicians of the Brazilian Nuclear Energy Commission (CNEN), were responsible for the preparation of the autopsy room and for advising the professionals on duty during these events. The radiation protection staff took specific measures to prevent the spread of contamination throughout the hospital, the contamination of persons attending the autopsies and to minimize any radiation dose to the medical and professional team. The measures aimed at personal control and the preparation of the autopsy room are described as well as the radiation protection steps applied in connection with the performance of the autopsies, the emplacement of the bodies into the coffins and their transport back to Goiania. (author)

1998-12-01

107

Discrepancies between autopsy and clinical findings among patients requiring extracorporeal membrane oxygenator support.  

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Discrepancy between clinical and autopsy diagnosis in children supported on extracorporeal membrane oxygenation (ECMO) has not been previously described. To assess the utility of autopsy examination in children supported on ECMO and assess discrepancies between premortem and postmortem diagnosis in these patients. Retrospective chart review. General pediatric and cardiac intensive care units (ICUs) in a tertiary children's hospital. The hospital's ECMO database was queried for patients supported on ECMO from 2000 through 2010 who died and underwent autopsy examination. Fifty-four autopsies were performed in 139 nonsurvivors (28%) who required ECMO support in the pediatric and cardiac ICU. Major discrepancies between premortem and postmortem diagnoses were found in 29 patients (53.7%). The commonest missed diagnosis was myocardial infarction that occurred in 16 patients, followed by adrenal hemorrhage in three patients. Five patients with a cardiac diagnosis had both major (type 1 discrepancy) and minor (type 2 discrepancy) discrepancies. Surgical complications were noted in four postmortem study with three of them being class 1 discrepancy. We report significant discrepancy between autopsy and clinical findings among ECMO-supported pediatric patients. Our findings underscore the need for enhanced premorbid surveillance in patients supported on ECMO. PMID:24399061

Blanco, Carlos; Steigman, Carmen; Probst, Nathan; Stroud, Michael; Bhutta, Adnan T; Dyamenahalli, Umesh; Imamura, Michiaki; Prodhan, Parthak

2014-01-01

108

Comparison of clinical causes of deth with autopsy diagnosis using discrepancy classification  

International Nuclear Information System (INIS)

To determine the usefulness of autopsy findings in the quality improvement of patients care. The clinical and necropsy findings of all the cases, who died in hospital and had undergone autopsy examination at CMH, Kharian, from January 2001 to December 2003, were retrieved from record of clinical case sheet data and autopsy record of the hospital. The two were analyzed and compared according to the discrepancy classification. The exclusion and inclusion criteria, the international classification of disease (ICD) to code deaths, the global burden of disease (GBD) system to classify and group diseases, and the Goldman discrepancy classification to compare clinical and autopsy diagnosis and classify the discrepancies, were used as described. The death rate varied from 0.94% to 1.29% and autopsy rate from 4.69% to 10.10% annually between January 2001 and December 2003. The number of cases classified according to GBD system was 3 (5%) in Group 1, 26 (43.33 %) in Group 2 and 31 (51.66 %) in Group 3. The discrepancy classes included 9 (15 %) class I major discrepancies and 3 (5 %) class II major discrepancies. Non-discrepant diagnosis was seen in 37 cases (61.66 %) and 11 cases (18.32 %) were non classifiable. (author)

2006-12-01

109

[Documentation of the diagnostic quality of hospitals: evaluation of autopsy reports].  

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Multiple factors have affected the decline in autopsy rates. Discrepancies between clinical diagnoses and findings at autopsy are frequently used as an argument for a high autopsy rate. However, the quality of the diagnosis is independent of the autopsy rate. A long-term study covering the years 1972-2002 in the University Hospital Zurich has documented a significant reduction of diagnostic errors in internal medicine. Major diagnostic errors (class 1) declined from 16% (1972), to 9% (1982), to 7% (1992) to 2% (2002). The main reason is the availability of new diagnostic procedures. In 2010 the analysis of class 1 diagnostic errors throughout the hospital documented class 1 discrepancies in only 1%. This low number of diagnostic errors has been published in the annual quality report of the University Hospital Zurich. The documentation of this improvement in the quality report of the hospital provides the opportunity to convince clinicians, health politicians and the hospital administration to support autopsies in teaching as well as non-teaching hospitals. PMID:21938498

Moch, H

2011-11-01

110

Radiography after unexpected death in infants and children compared to autopsy  

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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.)

Lange, Charlotte de; Stake, Gunnar [Rikshospitalet-Radiumhospitalet Medical Centre, Department of Paediatric Radiology, Oslo (Norway); Vege, Aashild [Rikshospitalet-Radiumhospitalet Medical Centre, Institute of Forensic Medicine, Oslo (Norway); Norwegian Institute of Science and Technology, Trondheim (Norway)

2007-02-15

111

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

International Nuclear Information System (INIS)

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.)

1983-01-01

112

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

LENUS (Irish Health Repository)

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\

Treacy, A

2013-03-01

113

Clinical setting and extent of premortem evaluation do not predict autopsy discrepancy rates.  

Science.gov (United States)

Autopsy rates have been affected by a number of factors, including technological advances and clinician beliefs of the diminished value of the autopsy. Such factors have resulted in a cultural shift in medicine away from the autopsy. Despite this shift, a number of studies have shown significant differences between antemortem clinical diagnoses and postmortem findings. Surveys of clinician beliefs about the autopsy have pointed toward antemortem diagnostic advancements as an important factor in declining rates. No study to date has addressed the hypothesis that such perceptions in diagnostic certainty have been matched by an actual decay in the yield of valuable or new information obtained by the autopsy. To address this hypothesis, we retrospectively compared the class I and class II discrepancies identified in 284 patients who died in three clinical settings with differing intensities of antemortem diagnostic workup. Despite a significantly different intensity of antemortem workup for patients in each clinical setting, including patients on a medical intensive care unit, patients on a surgical service and patients in an affiliated nursing home, discrepancy rates were found to be similar. Overall discrepancy rates for the medical intensive care unit, surgery service and nursing home patients were 27.8, 32.7 and 31.3%, respectively (P=0.84). In addition, we found no statistical difference in the complexity of workup in discrepant and nondiscrepant cases in each clinical setting. Our study data refute the hypothesis that the intensity of antemortem diagnostic evaluation correlates with an actual decrease in the rate of major diagnostic discrepancies identified at autopsy. PMID:20526285

Scordi-Bello, Irini A; Kalb, Thomas H; Lento, Patrick A

2010-09-01

114

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

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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.

Peto Richard

2004-10-01

115

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

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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 rig...

Ohata, Yuichiro; Haga, Takayuki; Ogata, Sho; Nakanishi, Kuniaki; Kawai, Toshiaki

2009-01-01

116

The lumbosacral ligament. An autopsy study of young black and white people.  

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The lumbosacral ligament (LSL), situated between the L5-vertebra and the sacrum, was studied in autopsy material. Twenty-eight cadaveric specimens from 12 black and 16 white persons aged 17-30 years were studied during routine forensic autopsies. The ligaments were measured and determined in situ. Thereafter, the ligaments were removed for histologic preparation. The ligament in the black subjects was thicker compared with the white (7.5 +/- 1.4 vs. 5.7 +/- 1.2 mm), and wider (11.7 +/- 1.6 mm...

Hanson, P.; Sørensen, Henrik

2008-01-01

117

Autopsy Proven Peripheral Nervous System Neurolymphomatosis Despite Negative Bilateral Sural Nerve Biopsy  

Science.gov (United States)

Neurolymphomatosis (NL) refers to a lymphomatous infiltration of peripheral nerves associated with central nervous system 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 or systemic lymphoma. NL is a rare complication of systemic cancer with heterogeneous clinical presentations and an elusive diagnosis. Diagnosis usually requires the demonstration of infiltrating malignant lymphocytes in the peripheral nerve. Infiltration of brain parenchyma, meninges or Virchow–Robin spaces is characteristic of systemic disease at autopsy. We describe a patient presenting with biopsy negative NL affecting exclusively the peripheral nervous system at autopsy.

Ramirez-Zamora, Adolfo; Morales-Vidal, Sarkis; Chawla, Jasvinder; Biller, Jose

2013-01-01

118

Morphological and virological studies in six autopsies of children with adenovirus pneumonia  

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Full Text Available Pulmonary lesions compatible with adenovirus infection were detected by gross and microscopic examination of autopsy tissues children aged from 5 to 34 months. Hepatic lesions indicative of systemic infection were also found in four of the chisldren. The viral etiology was confirmed in three cases by in-situ hibridization, electro-microscopy and immunofluorescence performed in parafin-embedded tissues, and in one case by cell culture isolation of adenovirus type 2 from nasopharyngeal exudate. Routine testing by methods additional to conventional light microscopy would probably have revealed a larger number of adenovirus infections among the 1.103 autopsy records analyzed in this study.

A. G. P. Garcia

1993-03-01

119

Joachim Oelhaf and the first public autopsy in Gdansk in 1613.  

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The first both in Gdansk and in Central Europe alleged public autopsy was performed by Joachim Oelhaf in February 1613. It was an evidence for Gdansk status as one of the leading anatomical centres in Europe. The aim of the article is to present the history of teaching medicine in Gdansk in early modern era and the eminent anatomists working in Academic Gymnasium of Gdansk. The preserved report of the autopsy of a new-born child with congenital defects is analysed as one of the very first texts in pathological anatomy. The described by Oelhaf case is identified as limb-body wall complex. PMID:24402747

Szarszewski, A; Gulczy?ski, J; Cichorek, M; Kukli?ska, K; Siek, B

2013-11-01

120

Autopsy Study of Metopic Suture Incidence in Human Skulls in Western Rajasthan  

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Introduction: Metopic suture which is placed between frontal bone and usually disappear during infancy and childhood, may persist from nasion to anterior angle of bregma, this is called metopism. Objective: To find the incidence of metopism in western Rajasthan and to compare it with other study in other parts of India and Abroad. Methodology: Present study was autopsy done on 200 dead bodies of all age group who were brought to J L N Medical college, Ajmer for autopsy during the period of 6 ...

Masih, William F.; Sumit Gupta; Saraswat, P. K.; Aggarwal, S. K.

2013-01-01

 
 
 
 
121

An autopsy case of a postirradiation cutaneous angiosarcoma of the hip  

Energy Technology Data Exchange (ETDEWEB)

Presented is the case of 63-year-old woman who developed a cutaneous angiosarcoma of the hip after receiving adjuvant radiation therapy for a squamous cell carcinoma of the uterine cervix after a hysterectomy. The time lapse between radiation therapy and the occurrence of angiosarcoma was 15 years, and its systemic metastasis was seen on autopsy. This autopsy was carried out 26 years after the patient had received the initial irradiation and no recurrence of the uterine cancer was found. Factors involved in the etiology of an angiosarcoma are discussed, and 34 previously reported cases of a postirradiation angiosarcoma are reviewed. (author).

Okada, Hiyoshi; Tsubura, Airo; Senzaki, Hideto; Morii, Sotokichi (Kansai Medical School, Moriguchi, Osaka (Japan))

1990-11-01

122

Systemic burden and body burden of Pu in man: comparison of results from bioassay and autopsy  

Energy Technology Data Exchange (ETDEWEB)

A case of plutonium deposition in man within the range of 190 Bq by inhalation from about 12 yr ago is reported. An estimate of systemic burden was made based on analyses of urine and faeces and the models of Langham, Beach/Dolphin, and Durbin while the individual was alive. This estimate was compared with autopsy finding (spleen, thyroid, blood, lung, pulmonary and tracheobronchial lymph nodes, liver, skeleton). According to autopsy findings, the systemic burden (mainly liver and skeleton) had been overestimated by a factor of 11-16, the body burden (whole body) by a factor of 6-9.

Ohlenschlaeger, L.; Schieferdecker, H.; Schmidt-Martin, W.

1984-04-01

123

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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.

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

2009-01-01

124

Di-George?s syndrome with multiple infections (an autopsy report.  

Directory of Open Access Journals (Sweden)

Full Text Available Di-George?s syndrome is a rare condition of congenital immunodeficiency. An infant presented as hypocalcemic tetany with multiple infections. Autopsy confirmed the hypoplasia of thymus and thyroid associated with other anomalies. A brief of the relevant literature is presented.

Sane S

1989-04-01

125

Limb-body wall complex: Prenatal sonographic findings versus autopsy findings  

International Nuclear Information System (INIS)

To evaluate prenatal ultrasonographic findings of limb-body wall complex and to correlate them with autopsy findings. From October 1995 to June 2000, a retrospectively review of prenatal ultrasonography (US) of 11 patients with pathologically proven limb-body wall complex was done. US findings were then compared with autopsy findings. Prenatal ultrasonography revealed thoraco-abdominoschists (n=7.64%), kyphoscoliosis (n=7.64%), cranial defect (n=5.45%), limb defect (n=4.36%), facial defect (n=1.10%), amniotic band (n=5.45%), and umbilical cord anomaly (n=3.27%). Meanwhile, autopsy findings showed thoraco-abdominoschisis (n=8.72%), limb defect (n=7.64%), facial defect (n=7.64%), kyphoscoliosis (n=5.45%), cranial defect (n=5.45%), amniotic band (n=5.45%) and umbilical cord anomaly (n=4.36%). The most common ultrasonography features of limb-body wall complex were thoraco-abdominoschisis and kyphoscoliosis while the thoraco-abdominoschisis and limb defects were the most frequent findings at autopsy.

2001-06-01

126

Psychosocial and Psychiatric Factors Associated with Adolescent Suicide: A Case-Control Psychological Autopsy Study  

Science.gov (United States)

This study aimed at the investigation of psychosocial and psychiatric risk factors of adolescent suicide by means of a case-control psychological autopsy study. Relatives and other informants of 19 suicide victims and 19 matched psychiatric controls were interviewed by means of a semi-structured interview schedule. Psychiatric controls included…

Portzky, Gwendolyn; Audenaert, Kurt; van Heeringen, Kees

2009-01-01

127

Completed Suicide among Sinhalese in Sri Lanka: A Psychological Autopsy Study  

Science.gov (United States)

Sri Lanka has the one of highest rates of suicide. Important factors associated with suicide were determined via the psychological autopsy approach (which had not been carried out previously in Sri Lanka). Over a 3-month period, in a catchment area, 31 suicides among Sinhalese were identified and 27 were investigated. Males were more likely to…

Samaraweera, Sudath; Sumathipala, Athula; Siribaddana, Sisira; Sivayogan, S.; Bhugra, Dinesh

2008-01-01

128

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

Science.gov (United States)

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…

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

2012-01-01

129

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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.

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

2009-01-01

130

Retrospective study of adenovirus in autopsied pulmonary tissue of pediatric fatal pneumonia in South China  

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Full Text Available Abstract Background Adenovirus are the important pathogen of pediatric severe pneumonia. The aim of this study is to analyze the infection, subtype and distribution of adenovirus in autopsied pulmonary tissue of fatal pneumonia in infants and children, and the relationships between adenovirus infection and respiratory illness in South China. Methods Nested PCR was performed on DNA extracted from autopsied lung tissue from patients who died of severe pneumonia, and the positive nested PCR products were cloned and sequenced. The adenovirus in autopsied pulmonary tissue was also analyzed by immunohistochemistry assay in a blind way. Results In the 175 autopsied pulmonary tissues, the positive percentage of adenovirus was 9.14% (16/175 and 2.29% (4/175 detected with nested PCR and immunohistochemistry, respectively. There are three cases of adenovirus serotype 3, twelve cases of adenovirus serotype 4 and one case of serotype 41 determined by sequencing of the cloned positive nested PCR products. Conclusion Adenovirus is an important cause of severe pneumonia, and these data suggest that adenovirus serotype 4 might be an important pathogen responsible for the fatal pneumonia in Guangzhou, South China.

Gong Si-Tang

2008-09-01

131

The Missing Piece: A Sociological Autopsy of Firearm Suicide in the United States  

Science.gov (United States)

Social, economic, violence, political, and gun access predictors of suicide and gun suicide were examined via sociological autopsy. The model predicting suicide rates overall had the best results, X[superscript 2](9, N = 50) = 5.279 (CMIN, the goodness of fit statistic that represents the minimum discrepancy between the unrestricted sample…

Slater, Greta Yoder

2011-01-01

132

Limb-body wall complex: Prenatal sonographic findings versus autopsy findings  

Energy Technology Data Exchange (ETDEWEB)

To evaluate prenatal ultrasonographic findings of limb-body wall complex and to correlate them with autopsy findings. From October 1995 to June 2000, a retrospectively review of prenatal ultrasonography (US) of 11 patients with pathologically proven limb-body wall complex was done. US findings were then compared with autopsy findings. Prenatal ultrasonography revealed thoraco-abdominoschists (n=7.64%), kyphoscoliosis (n=7.64%), cranial defect (n=5.45%), limb defect (n=4.36%), facial defect (n=1.10%), amniotic band (n=5.45%), and umbilical cord anomaly (n=3.27%). Meanwhile, autopsy findings showed thoraco-abdominoschisis (n=8.72%), limb defect (n=7.64%), facial defect (n=7.64%), kyphoscoliosis (n=5.45%), cranial defect (n=5.45%), amniotic band (n=5.45%) and umbilical cord anomaly (n=4.36%). The most common ultrasonography features of limb-body wall complex were thoraco-abdominoschisis and kyphoscoliosis while the thoraco-abdominoschisis and limb defects were the most frequent findings at autopsy.

Song, Mi Jin; Cho, Jeong Yeon; Lee, Young Ho [Samsung Cheil Hospital, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

2001-06-15

133

Primary (isolated) bilateral pulmonary hypoplasia: A comparative study of radiologic findings and autopsy results  

Energy Technology Data Exchange (ETDEWEB)

Comparative radiologic/pathologic study of 45 newborns with primary and secondary pulmonary hypoplasia is presented and 43 cases were proven at autopsy. From 9 cases with primary pulmonary hypoplasia, 7 could be identified by 3 independent observers on chest radiographs. The roentgen criteria of primary pulmonary hypoplasia are evaluated and should serve in future to diagnose this condition clinically.

Langer, R.; Kaufmann, H.J.

1986-03-01

134

Parathyroid gland tumors in A-bomb survivors, autopsy cases, Hiroshima. Preliminary report  

Energy Technology Data Exchange (ETDEWEB)

Parathyroid gland tumors were observed in 16 of 4,136 autopsy cases (0.4%) based on the life span survey for the population including A-bomb survivors and the control group. All of the cases (5 males and 11 females) had adenoma. The incidence of parathyroid gland tumors tended to increase with increasing the dose.

Takeichi, Nobuo; Fujikura, Toshio (Radiation Effects Research Foundation, Hiroshima (Japan)); Nishida, Toshihiro

1984-03-01

135

Sedimentation level in acute intracerebral hematoma in a patient receiving anticoagulation therapy: an autopsy study  

Energy Technology Data Exchange (ETDEWEB)

We report the first case in which a fluid-blood interface was identified at autopsy in a patient with acute intracerebral hematoma on anticoagulant therapy. Anticoagulation may be one of the major factors contributing to the production of an intracerebral blood sedimentation level. (orig.) With 3 figs., 12 refs.

Ichikawa, K.; Yanagihara, C. [Department of Neurology, Amagasaki, Hygo (Japan)

1998-06-01

136

¿Es útil realmente realizar autopsias? Is it really useful to perform autopsies?  

Directory of Open Access Journals (Sweden)

Full Text Available Motivados por la necesidad de exponer nuevas experiencias en el trabajo con las autopsias, luego de escribir el libro "La autopsia. Garantía de calidad en la Medicina" y concluir la investigación "Evaluación de la calidad de los diagnósticos premortem en autopsias realizadas en Cuba entre 1994 y 2003", se presenta este trabajo con el propósito de que pueda ser útil a los interesados en el tema y acercarse al objetivo final: lograr el máximo aprovechamiento de la autopsia. Se expone la situación de la autopsia en el mundo y en Cuba. Se enfatiza en los logros alcanzados en el país, donde se incluyen los hospitales militares, las dificultades atravesadas y se señala el camino a seguir para disminuir la morbilidad y mortalidad, y lograr el objetivo mayor: aumentar en cantidad y calidad la vida de la población.Motivated by the need to expose new experiences in the work with autopsies, alter writing the book "Autopsy. Guarantee of quality in Medicine" and after concluding the investigation "Evaluation of the quality of the premortem diagnoses in autopsies performed in Cuba between 1994 and 2003", this paper was presented aimed at being useful for those interested in the topic and at approaching the final aim: to take the maximum advantage of autopsy. It was exposed the situation of autopsy in the world and in Cuba. Emphasis was made on the advances attained in the country, including the military hospitals, the difficulties found, and the way to reduce morbidity and mortality and to achieve the major goal: to increase in quantity and quality the life of the population.

José Hurtado de Mendoza Amat

2008-03-01

137

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

International Nuclear Information System (INIS)

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 accurate diagnosis. A correlative study of imaging findings and pathological manifestation of AIDS patients at autopsy could be helpful for clinical diagnosis. (authors)

2009-11-01

138

Validation of Verbal Autopsy Tool for Ascertaining the Causes of Stillbirth  

Science.gov (United States)

Objective To assess performance of the WHO revised verbal autopsy tool for ascertaining the causes of still birth in comparison with reference standard cause of death ascertained by standardized clinical and supportive data. Methods All stillbirths at a tertiary hospital in Karachi, Pakistan were prospectively recruited into study from August 2006- February 2008. The reference standard cause of death was established by two senior obstetricians within 48 hours using the ICD coding system. Verbal autopsy interviews using modified WHO tool were conducted by trained health workers within 2- 6 weeks of still birth and the cause of death was assigned by second panel of obstetricians. The performance was assessed in terms of sensitivity, specificity and Kappa. Results There were 204 still births. Of these, 80.8% of antepartum and 50.5% of intrapartum deaths were correctly diagnosed by verbal autopsy. Sensitivity of verbal autopsy was highest 68.4%, (95%CI: 46-84.6) for congenital malformation followed by obstetric complication 57.6%, (95%CI: 25-84.2). The specificity for all major causes was greater than 90%. The level of agreement was high (kappa=0.72) for anomalies and moderate (k=0.4) for all major causes of still birth, except asphyxia. Conclusion Our results suggest that verbal autopsy has reasonable validity in identifying and discriminating between causes of stillbirth in Pakistan. On the basis of these findings, we feel it has a place in resource constrained areas to inform strategic planning and mobilization of resources to attain Millennium Development Goals.

Nausheen, Sidrah; Soofi, Sajid B.; Sadiq, Kamran; Habib, Atif; Turab, Ali; Memon, Zahid; Khan, M. Imran; Suhag, Zamir; Bhatti, Zaid; Ahmed, Imran; Bahl, Rajiv; Bhutta, Shireen; Bhutta, Zulfiqar A.

2013-01-01

139

Short history of the autopsy. Part I. From prehistory to the middle of the 16th century.  

Science.gov (United States)

We present the first part of work concerning the history of autopsy. During the development of the pathology the role of autopsy was changing. The attitude towards the human body was often a result of struggles between human will to learn and religious beliefs. The knowledge was built upon religious procedures (mummification) through medical and surgical care of the victims of fights and wars and first autopsies. Until the 13th century dissections were seldom performed, sometimes in public. The aims varied from strictly scientific and practical (surgery) to artistic (human body in arts). Later on physicians were learning how to draw conclusions from autopsy results including malformations, pathologies, diseases, causes of death in order to try to put right diagnoses. PMID:20069503

Gulczy?ski, Jacek; Izycka-Swieszewska, Ewa; Grzybiak, Marek

2009-01-01

140

Perivasculitic panencephalitis with relapsing polychondritis: an autopsy case report and review of previous cases.  

Science.gov (United States)

We herein report an autopsy case of relapsing polychondritis encephalitis coexisting with a Lewy body pathology and also review previous autopsy cases. A 59-year-old man exhibited a tremor of the right hand, small-steppage gait and bradykinesia. Five years later, he presented with relapsing auricular chondritis and scleritis and subsequently showed exacerbation of extrapyramidal symptoms. A histological examination revealed perivascular lymphocytic cuffing and infiltration in the small vessels, as well as loss of nerve cells and gliosis in the basal ganglia, insular gyrus and medial temporal lobe. The present case was characterized by perivasculitic panencephalitis and the coexistence of a Lewy body pathology, which may have augmented the patient's parkinsonism. PMID:24881747

Niwa, Atsushi; Okamoto, Yoko; Kondo, Takayuki; Nabatame, Hidehiko; Takahashi, Ryosuke; Tomimoto, Hidekazu

2014-01-01

 
 
 
 
141

Multifocal kaposiform hemangioendothelioma in multiple visceral organs: an autopsy of 9-day-old female baby.  

Science.gov (United States)

Kaposiform hemangioendothelioma is a vascular tumor categorized as intermediate malignancy. We experienced an autopsy of a female baby with kaposiform hemangioendothelioma with Kasabach-Merritt syndrome. She died of systemic bleeding tendency following disseminated intravascular coagulation at the age of 9 days. At autopsy, a huge main tumor, histologically kaposiform hemangioendothelioma, was discovered in the mediastinum between the right chest cavity and pericardium. Furthermore, kaposiform hemangioendothelioma with the same histology involved the lungs, heart, liver, subserosa of cardial part of the stomach, retroperitoneum around the right adrenal gland, broad ligament of the uterus, and muscular tissue around the thyroid. To date, a few previously reported cases of multifocal kaposiform hemangioendothelioma have demonstrated locally aggressive distributions mainly in bone and soft tissues. The present case with extensive distribution including visceral organs implies that kaposiform hemangioendothelioma may have higher potential to spread than considered before. PMID:24931465

Nakaya, Takeo; Morita, Kiyoko; Kurata, Atsushi; Ushiku, Tetsuo; Igarashi, Takashi; Kuroda, Masahiko; Fukayama, Masashi

2014-08-01

142

An autopsy case of suicide by hanging with multiple stab wounds of the neck and chest.  

Science.gov (United States)

We report, from the aspect of 'acting' capability, an autopsy case of suicide by hanging in which multiple deep stab wounds were observed in the neck and chest. A 49-year-old man was found dead in a state typical of hanging. His car was found about 100m away with a blood-stained climber's knife on the seat. Multiple incised and stab wounds were in the neck, with a lesion of the right inner jugular vein. Three penetrating stab wounds of the chest punctured the lungs, with pooling of about 500ml of blood in the left thorax and about 100ml in the right. Two other shallow stab wounds were in the chest. All the above wounds were explainable as self-inflicted. From the autopsy findings and the circumstantial evidence, it was concluded that he walked approximately 100m after stabbing his neck and chest and finally committed suicide by hanging. PMID:8429771

Maeda, H; Imura, M; Higuchi, T; Noguchi, K

1993-01-01

143

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

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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.

Nakanishi,Kuniaki

2009-12-01

144

Photogrammetric documentation of regions of interest at autopsy--a pilot study.  

Science.gov (United States)

In this pilot study, the authors tested whether photogrammetry can replace or supplement physical measurements made during autopsies and, based on such measurements, whether virtual computer models may be applicable in forensic reconstructions. Photogrammetric and physical measurements of markers denoting wounds on five volunteers were compared. Virtual models of the volunteers were made, and the precision of the markers' locations on the models was tested. Twelve of 13 mean differences between photogrammetric and physical measurements were below 1 cm, which indicates that the photogrammetric method has a high accuracy. The precision of the markers' location on the models was somewhat less, although the method is still promising and potentially superior to the current procedures used for reconstructions. The possibility to measure any distance on a body, even after the autopsy is concluded and the corpse is no longer available, is one of the biggest benefits of photogrammetry. PMID:24117866

Slot, Liselott; Larsen, Peter K; Lynnerup, Niels

2014-01-01

145

The value of early autopsy following sudden death occuring at the workstation  

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Full Text Available The authors describe the many medico-legal pitfalls related to sudden death occurring at the workstation. One of these difficulties is the almost constant absence of a precise etiological cause of death, thereby eliminating any possibility, for the insurer or the employer, to irrefutably deny that the cause of death was totally unrelated to conditions of work. The only procedure capable of reducing the incertitude that the event was totally unrelated to work is early autopsy. After describing the different procedures possible, the authors report an experience tested in the region of Lyon, France in which the concerned parties – the courts, the institute of legal medicine and the insurer – rapidly and directly cooperated following each new case. A court-ordered autopsy was instituted every time sudden death occurred at the workplace and a copy of the report was addressed to the insurer at his demand.

Mabriez JC

2000-03-01

146

Autopsy Proven Peripheral Nervous System Neurolymphomatosis Despite Negative Bilateral Sural Nerve Biopsy  

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Full Text Available 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 the demonstration of infiltrating malignant lymphocytes in the peripheral nerve. Infiltration of brain parenchyma, meninges or Virchow-Robin spaces is characteristic of systemic disease at autopsy. We describe a patient presenting with biopsy negative NL affecting exclusively the peripheral nervous system at autopsy.

JoseBiller

2013-12-01

147

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

Energy Technology Data Exchange (ETDEWEB)

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-{beta}. 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)

Yamada, Shozo; Endo, Yuzo; Takada, Koji; Usui, Masaaki; Hara, Mitsuru [Toranomon Hospital, Tokyo (Japan); Hirose, Takanori

1998-02-01

148

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

International Nuclear Information System (INIS)

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-?. 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)

1998-02-01

149

Photogrammetric Documentation of Regions of Interest at Autopsy-A Pilot Study  

DEFF Research Database (Denmark)

In this pilot study, the authors tested whether photogrammetry can replace or supplement physical measurements made during autopsies and, based on such measurements, whether virtual computer models may be applicable in forensic reconstructions. Photogrammetric and physical measurements of markers denoting wounds on five volunteers were compared. Virtual models of the volunteers were made, and the precision of the markers' locations on the models was tested. Twelve of 13 mean differences between photogrammetric and physical measurements were below 1 cm, which indicates that the photogrammetric method has a high accuracy. The precision of the markers' location on the models was somewhat less, although the method is still promising and potentially superior to the current procedures used for reconstructions. The possibility to measure any distance on a body, even after the autopsy is concluded and the corpse is no longer available, is one of the biggest benefits of photogrammetry. © 2013 American Academy of Forensic Sciences.

Slot, Liselott Kristina; Larsen, Peter Kastmand

2014-01-01

150

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

Energy Technology Data Exchange (ETDEWEB)

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 have improved the therapeutic results because of the high rate of metastases of microcellular and non-differentiated bronchial carcinomas found in these regions.

Oehler, W.; Eichhorn, H.J.

1983-11-01

151

Autopsy results of epoxy coated reinforcing steels embedded in test slabs  

Energy Technology Data Exchange (ETDEWEB)

This paper addresses preliminary results of an on-going research project, which is to investigate performance of epoxy coated reinforcing steels (ECRs) exposed to a laboratory testing environment The ECRs acquired from six sources were embedded in 76 chloride contaminated test slabs (two ECRs per slab, in most cases) and connected to bottom mat of {number_sign}5 black rebar. After they were exposed to different environments, some of the slabs were autopsied at three different times (10 months to 3.5 years). According to the autopsy results in terms of degree of coating disbondment, corrosion state at the substrate and macrocell current, it was observed that ECR performance ranged from excellent to poor and key factor was the density and size of coating defects which were initially present or developed during exposure.

Lee, S.K.; Hartt, W.H. [Florida Atlantic Univ., Boca Raton, FL (United States). Dept. of Ocean Engineering

1998-12-31

152

Carcinoma of lung with special reference to adenocarcinoma (an autopsy study of 122 cases).  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We report morphological observations on 122 autopsied cases of lung carcinoma during the years 1974-1989, with emphasis on 44 cases of adenocarcinoma. Adenocarcinoma was the commonest histological type encountered (36%), confirming the trend reported in Western countries. It was also noted that nearly 50% of cases of adenocarcinoma were in the central zone, which is contrary to reported literature. 92% of small cell carcinoma, 87% of epidermoid carcinoma, 64%...

DaCosta N; Sivaraman A; Kinare S

1993-01-01

153

Parity factors and prevalence of fibrocystic breast change in a forensic autopsy series.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The relationship of reproductive factors, such as nulliparous vs ever-parous status, age at first birth, and total parity, with morphologic prevalence of fibrocystic changes were examined using autopsy material from three ethnic/racial groups at varying risks for breast cancer. Although there was a trend toward a protective effect of ever-parous status, there was no statistically significant difference in the prevalence of fibrocystic disease in any group defined by parity status. The ethnic ...

Pathak, D. R.; Pike, M. C.; Key, C. R.; Teaf, S. R.; Bartow, S. A.

1991-01-01

154

Fouling autopsy of hollow-fibre MF membranes in wastewater reclamation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Fouling in membrane filtration processes is problematic but inevitable as it occurs with the retention of contaminants that accumulate on the membrane surface. The causes of fouling are often specific, depending upon feed water constituents, the membrane, and the operation regime. Therefore, it is desirable that a thorough investigation is performed on fouled membrane elements of the affected plant. This technique is known as “membrane autopsy”, which identifies the cause of poor membrane...

Nghiem, Long D.; Scha?fer, Andrea

2006-01-01

155

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

1998-01-01

156

Morphological and virological studies in six autopsies of children with adenovirus pneumonia  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Pulmonary lesions compatible with adenovirus infection were detected by gross and microscopic examination of autopsy tissues children aged from 5 to 34 months. Hepatic lesions indicative of systemic infection were also found in four of the chisldren. The viral etiology was confirmed in three cases by in-situ hibridization, electro-microscopy and immunofluorescence performed in parafin-embedded tissues, and in one case by cell culture isolation of adenovirus type 2 from nasopharyngeal exudate....

Garcia, A. G. P.; Fonseca, M. E. F.; Bonis, M.; Ramos, H. I. B.; Ferro, Z. P. A.; Nascimento, J. P.

1993-01-01

157

"Spontaneous carotid artery dissection-associated medial changes in a selected autopsy population"  

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Spontaneous carotid artery dissection (SCAD) is a major cause of stroke in young adults, yet its pathogenesis remains unclear. Hereditary connective tissue diseases, hormonal influences, sympathomimetic drugs or upper respiratory tract infections may predispose to dissection. Mechanical stress or minimal trauma may also act as a trigger. Various lesions of the arterial wall have been described in association with SCAD, but no prospective autopsy study to evaluate the presence of these lesions...

Frickey, Nathalie Alexandra

2008-01-01

158

Cultural imperatives and the ethics of verbal autopsies in rural Ghana  

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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 t...

Aborigo, Raymond A.; Pascale Allotey; Paulina Tindana; Daniel Azongo; Cornelius Debpuur

2013-01-01

159

Stillbirths and newborn deaths in slum settlements in Mumbai, India: a prospective verbal autopsy study  

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Abstract Background Three million babies are stillborn each year and 3.6 million die in the first month of life. In India, early neonatal deaths make up four-fifths of neonatal deaths and infant mortality three-quarters of under-five mortality. Information is scarce on cause-specific perinatal and neonatal mortality in urban settings in low-income countries. We conducted verbal autopsies for stillbirths and neonatal deaths in Mumbai slum settlements. Our objectives were to cl...

Bapat Ujwala; Alcock Glyn; More Neena; Das Sushmita; Joshi Wasundhara; Osrin David

2012-01-01

160

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

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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 results.

Todorovi? Miloš S.

2011-01-01

 
 
 
 
161

Using verbal autopsy to measure causes of death: the comparative performance of existing methods  

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Background: Monitoring progress with disease and injury reduction in many populations will require widespread use of verbal autopsy (VA). Multiple methods have been developed for assigning cause of death from a VA but their application is restricted by uncertainty about their reliability. Methods: We investigated the validity of five automated VA methods for assigning cause of death: InterVA-4, Random Forest (RF), Simplified Symptom Pattern (SSP), Tariff method (Tariff), and King-Lu (KL), in ...

Murray, Christopher Jl; Lozano, Rafael; Flaxman, Abraham D.; Serina, Peter; Phillips, David; Stewart, Andrea; James, Spencer L.; Vahdatpour, Alireza; Atkinson, Charles; Freeman, Michael K.; Ohno, Summer Lockett; Black, Robert; Ali, Said Mohammed; Baqui, Abdullah H.; Dandona, Lalit

2014-01-01

162

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

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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 c...

Schrader Kerstin; Nguyen-Dobinsky Trong-Nghia; Kayser Klaus; Schrader Thomas

2006-01-01

163

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

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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...

1993-01-01

164

Multiple endocrine tumors in A-bomb survivors, autopsy cases, Hiroshima. Preliminary report  

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Multiple endocrine tumors (MET) were observed in 27 of 4,136 autopsy cases (0.3%) of the fixed population including Hiroshima atomic bomb survivors and the control group. The thyroid was the most common organ in which MET occurred, followed by the ovary. Thirteen cases, including two cases of three MET, had MET in both the tyroid and the ovary, 11 of which had been exposed to one rad or more of atomic bomb.

Takeichi, Nobuo; Fujikura, Toshio (Radiation Effects Research Foundation, Hiroshima (Japan)); Ezaki, Haruo

1984-03-01

165

Seventeen year follow-up and autopsy findings in a case of massive osteolysis  

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Clinical, radiologic, and pathologic findings in an unusual case of massive osteolysis are described. Peculiar clinical episodes of a foul body odor with fever and erythematous skin lesions, presence of radiographic findings such as acro-osteolysis and periarticular erosions, and the absence of angiomatous or lymphangiomatous dysplasias at autopsy, indicate that this is a new form of massive osteolysis rather than a variant of Gorham disease.

Pastakia, B.; Horvath, K.; Lack, E.E.

1987-06-01

166

Liver scanning in cancer patients with short-interval autopsy correlation  

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The correlation between radionuclide liver scan interpretation and autopsy findings in 94 patients is presented. All patients had a known primary malignancy and the postmortem examinations were performed within 28 days of the scan. In 81% of the cases, false-positive readings and a 21% rate of false-negative interpretations. Metastatic deposits less than 2 cm in diameter were the most frequent source of false-negative scans.

Ostfeld, D.A.; Meyer, J.E.

1981-03-01

167

Demographic, etiological, and histological pulmonary analysis of patients with acute respiratory failure: a study of 19 years of autopsies  

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INTRODUCTION: Acute respiratory failure has been one of the most important causes of death in intensive care units, and certain aspects of its pulmonary pathology are currently unknown. OBJECTIVES: The objective was to describe the demographic data, etiology, and pulmonary histopathological findings of different diseases in the autopsies of patients with acute respiratory failure. METHOD: Autopsies of 4,710 patients with acute respiratory failure from 1990 to 2008 were reviewed, and the follo...

Alexandre de Matos Soeiro; Ruppert, Aline D.; Mauro Canzian; Parra, Edwin R.; Cecília Farhat; Capelozzi, Vera L.

2011-01-01

168

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

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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 t...

Pamidimukkala Umabala; Challa Sundaram; Lakshmi Vemu; Tandon Ashwani; Kulkarni Srinivas; Raju Satyanarayana

2007-01-01

169

Efficacy of scintigraphy in the diagnosis of tumor involvement of the liver according to laparotomy and autopsy findings  

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The results of scintigraphy with 198Au (54 patients) and revision of the liver in laparotomy (in 44 of them) were correlated eith autopsy findings. The interval between scintigraphy and autopsy did not exceed 3 months. The accuracy of scintigraphy 77.8%, specificity 85%, sensitivity 57.2%; laparotomy findings were 79.6, 82.4, 70%, respectively. Therefore laparotomy cannot be regarded as an absolutely significant criterion in the evaluation of the accuracy of liver scintigraphy

1982-01-01

170

Efficacy of scintigraphy in the diagnosis of tumor involvement of the liver according to laparotomy and autopsy findings  

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The results of scintigraphy with /sup 198/Au (54 patients) and revision of the liver in laparotomy (in 44 of them) were correlated with autopsy findings. The interval between scintigraphy and autopsy did not exceed 3 months. The accuracy of scintigraphy 77.8%, specificity 85%, sensitivity 57.2%; laparotomy findings were 79.6, 82.4, 70%, respectively. Therefore laparotomy cannot be regarded as an absolutely significant criterion in the evaluation of the accuracy of liver scintigraphy.

Shishkina, V.V.; Tratsevskij, V.V.; Kondratyuk, G.P.; Tashchiev, R.K. (Nauchno-Issledovatel' skij Rentgeno-Radiologicheskij i Onkologicheskij Inst., Kiev (Ukrainian SSR))

1982-02-01

171

[An autopsy case of Sjögren syndrome with organized and fresh subdural hemorrhage (hematoma)].  

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An autopsy case of Sjögren syndrome with organized and fresh subdural hemorrhages (hematoma) is reported. A 49-year-old woman who had been suffering from Sjögren syndrome had gradually lost her consciousness and was taken to the hospital where she died several hours later. Subsequently a doctor found the subdural hematoma of unknown origin on her Brain CT. At autopsy, her skin was dry and all of her teeth were missing. There were sporadic cutaneous purpura and subcutaneous hemorrhages in her trunk and limbs. The histopathological examination revealed that the submandibular gland had no normal acini, and was replaced by fibrous and adipose tissues with numerous lymphocytes. There were signs of fibrosis with inflammation in her liver, kidneys and lungs. The thyroid gland showed thyroiditis. Serological findings showed a significant high level of antinuclear antibody, positive RA factor and high gamma-globulinemia. The autopsy revealed that her cause of death was acute subdural hematoma and uncal herniation. There were no external injuries on her head or face. It is suggested that her acute subdural hematoma according to the hemorrhagic tendency, affected by her Sjögren syndrome. PMID:7861643

Orihara, Y; Kubo, S; Kitamura, O; Tsuda, R; Hirose, W; Matsumoto, H; Nakasono, I

1994-12-01

172

Autopsy as gold standard in FDG-PET studies in dementia.  

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Positron emission tomography (PET) imaging with F18-fluorodeoxyglucose (FDG) is increasingly used as an adjunct to clinical evaluation in the diagnosis of dementia. Considering that most FDG-PET studies in dementia use clinical diagnosis as gold standard and that clinical diagnosis is approximately 80% sensitive or accurate, we aim to review the evidence-based data on the diagnostic accuracy of brain FDG-PET in dementia when cerebral autopsy is used as gold standard. We searched the PubMed and Medline databases for dementia-related articles that correlate histopathological diagnosis at autopsy with FDG-PET imaging and found 47 articles among which there were only 5 studies of 20 patients or more. We were able to conclude that sensitivity and specificity of FDG-PET for Alzheimer's disease are good, but more studies using histopathological diagnosis at autopsy as gold standard are needed in order to evaluate what FDG-PET truly adds to premortem diagnostic accuracy in dementia. PMID:20481267

Durand-Martel, Pascali; Tremblay, Dominic; Brodeur, Catherine; Paquet, Nancy

2010-05-01

173

Congenital malformations in perinatal autopsy: a two-year prospective study.  

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Perinatal autopsy detects the cause of death and also finds the various types of congenital malformation involving one or more than one system. Congenital malformations are one of the leading causes of perinatal deaths and infant mortality. In the present study various visceral malformations were detected in perinatal autopsies and categorised them systemwise. The prospective study was conducted during the period of June 2007 to May 2009 consisting of 32 cases. Out of 32 perinatal deaths studied, 30 were stillborn and in 2 there were early neonatal deaths. In each case, an attempt was made to find out the congenital malformation in perinatal deaths and clinicopathological correlation was attempted after a detailed postmortem and histopathological study. Congenital malformations were seen in 10 cases which accounted for 31.2% of perinatal deaths. A total of 64 congenital malformations were observed in 10 cases. Malformations of the alimentary system (20.31%) were most common followed by genito-urinary system (18.75%), musculoskeletal system (17.18%) and central nervous system (9.37%). There were other 22 congenital anomalies. Two cases of harlequin icthyosis and one case each of Meckel Gruber syndrome, sirenomelia and twin reverse arterial perfusion syndrome were also seen. In many of the perinatal deaths, internal malformations were not suspected clinically. Thus, autopsy is an invaluable tool for detecting visceral malformations, adding to the clinical diagnosis and counselling the parents for subsequent pregnancy. PMID:24003564

Kalyani, R; Bindra, Mandeep S; Mahansetty, Hemalatha

2013-02-01

174

Absent pulmonary valve syndrome: prenatal cardiac ultrasound diagnosis with autopsy correlation.  

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Absent pulmonary valve syndrome (APVS) is a rare conotruncal anomaly consisting of a severely hypoplastic pulmonary valve with annular stenosis, aneurysmal dilatation of main pulmonary artery with dilatation of one or both pulmonary artery branches, and a ventricular septal defect. Here, we report a prenatal echo diagnosis of APVS in a 27-year-old primi gravida at 20 weeks of gestation confirmed on fetal autopsy. A 'bow tie'-like hypoechoic shadow in fetal cardiac ultrasound observed by us in a modified four-chamber view was suggestive of aneurysmal dilatation of branch pulmonary arteries. The consequences of continuation of pregnancy including immediate neonatal complications and possible medical and multistaged surgical interventions were well explained. Parents opted for medical termination of pregnancy. Autopsy findings of the fetus were consistent with the prenatal echo diagnosis of APVS. The presence of patent ductus arteriosus seen in the autopsy may be the cause of severe heart failure evidenced by the abnormally large congested liver, dilated right heart chambers, and tricuspid valve annulus. We infer that the prenatal diagnosis of APVS may be possible with a high degree of accuracy with characteristic fetal echocradiographic findings such as 'bow tie'-like or 'ballooning'-like shadows observed in this case. The presence of ductus confirms definite fetal loss and the parents can be counselled accordingly. However, when the ductus is absent, decision-making is difficult as the fetus is going to survive. PMID:21896574

Philip, S; Varghese, M; Manohar, K; Cherian, K M

2011-12-01

175

Current trend of malignant neoplasms among atomic bomb survivors. Study of admitted patients and autopsy cases in Atomic Bomb Hospital  

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A survey was made on 7,589 admitted patients and 1,965 autopsy cases. The overall incidence of malignant neoplasms tended to decrease in the group exposed to atomic bomb within 2 km in autopsy cases and to increase in admitted patients. The incidence of pulmonary cancer tended to increase in both autopsy cases and admitted patients. The incidence of gastric cancer tended to increase up to 1975, and thereafter tended to decrease. The incidence of liver cancer tended to increase in both autopsy cases and admitted patients, which was marked in males. The incidence of leukemia was high in the group exposed to atomic bomb within 2 km in autopsy cases, and in the group within 1 km and the group which entered the city after the explosion in admitted patients. The incidence of malignant lymphoma tended to decrease, and the incidence of carcinoma of the colon tended to gradually increase in both autopsy cases and admitted patients. The incidence of multiple carcinomas tended to increase in both atomic bomb exposed group and non-exposed group, being higher in atomic bomb group than in non-exposed group. The incidence of breast cancer became constant since 1970. The incidence of carcinoma of the thyroid gland tended to decrease, although it was high in the group exposed near the explosion. (Namekawa, K.).

Hamada, Tadao

1984-03-01

176

Validating physician-certified verbal autopsy and probabilistic modeling (InterVA approaches to verbal autopsy interpretation using hospital causes of adult deaths  

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Full Text Available Abstract Background The most common method for determining cause of death is certification by physicians based either on available medical records, or where such data are not available, through verbal autopsy (VA. The physician-certification approach is costly and inconvenient; however, recent work shows the potential of a computer-based probabilistic model (InterVA to interpret verbal autopsy data in a more convenient, consistent, and rapid way. In this study we validate separately both physician-certified verbal autopsy (PCVA and the InterVA probabilistic model against hospital cause of death (HCOD in adults dying in a district hospital on the coast of Kenya. Methods Between March 2007 and June 2010, VA interviews were conducted for 145 adult deaths that occurred at Kilifi District Hospital. The VA data were reviewed by a physician and the cause of death established. A range of indicators (including age, gender, physical signs and symptoms, pregnancy status, medical history, and the circumstances of death from the VA forms were included in the InterVA for interpretation. Cause-specific mortality fractions (CSMF, Cohen's kappa (? statistic, receiver operating characteristic (ROC curves, sensitivity, specificity, and positive predictive values were applied to compare agreement between PCVA, InterVA, and HCOD. Results HCOD, InterVA, and PCVA yielded the same top five underlying causes of adult deaths. The InterVA overestimated tuberculosis as a cause of death compared to the HCOD. On the other hand, PCVA overestimated diabetes. Overall, CSMF for the five major cause groups by the InterVA, PCVA, and HCOD were 70%, 65%, and 60%, respectively. PCVA versus HCOD yielded a higher kappa value (? = 0.52, 95% confidence interval [CI]: 0.48, 0.54 than the InterVA versus HCOD which yielded a kappa (? value of 0.32 (95% CI: 0.30, 0.38. Overall, (? agreement across the three methods was 0.41 (95% CI: 0.37, 0.48. The areas under the ROC curves were 0.82 for InterVA and 0.88 for PCVA. The observed sensitivities and specificities across the five major causes of death varied from 43% to 100% and 87% to 99%, respectively, for the InterVA/PCVA against the HCOD. Conclusion Both the InterVA and PCVA compared well with the HCOD at a population level and determined the top five underlying causes of death in the rural community of Kilifi. We hope that our study, albeit small, provides new and useful data that will stimulate further definitive work on methods of interpreting VA data.

Tsofa Benjamin

2011-08-01

177

The effect of the postmortem interval on the redistribution of drugs: a comparison of mortuary admission and autopsy blood specimens.  

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Postmortem redistribution (PMR) is an accepted toxicological phenomenon that may affect the interpretation of postmortem blood concentrations. The extent of PMR is not well understood for some drugs. This report describes the PMR of selected substances resulting from the analysis of 149 cases comparing blood specimens taken at admission of the deceased to the mortuary and then at autopsy. Blood was collected in preserved tubes containing 1 % sodium fluoride/potassium oxalate. All cases were subject to a full autopsy and blood extracts were analyzed using a targeted screen by LC-MS/MS. 30 drug or drug metabolites that were detected with an incidence of 6 or more were included in this study. The pre-autopsy interval ranged from 0.5 to 164 h (6.4 days) with an average of 64 h for the cases analyzed. The increase in drug concentration from mortuary admission to autopsy ranged from 30 % for drugs such as citalopram, mirtazapine, and sertraline to 300 % for doxylamine. Only 7 drugs of the 30 studied showed increases of greater than 20 % when comparing autopsy to mortuary admission blood irrespective of the length of the postmortem interval. Drugs including methadone, EDDP, fluoxetine, mirtazapine, and sertraline all showed statistically significant increases during the pre-autopsy interval (p < 0.05) while 6-acetylmorphine, 9-hydroxy-risperidone, and caffeine showed significant decreases (p < 0.05) from mortuary admission to autopsy. While femoral blood is thought to reduce PMR, this data shows that for some drugs significant redistribution can occur even when taking peripheral specimens irrespective of the delay in the postmortem interval. PMID:22618455

Gerostamoulos, Dimitri; Beyer, Jochen; Staikos, Voula; Tayler, Penny; Woodford, Noel; Drummer, Olaf H

2012-12-01

178

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

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"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 incre...

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

2011-01-01

179

Population Health Metrics Research Consortium gold standard verbal autopsy validation study: design, implementation, and development of analysis datasets  

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Full Text Available Abstract Background Verbal autopsy methods are critically important for evaluating the leading causes of death in populations without adequate vital registration systems. With a myriad of analytical and data collection approaches, it is essential to create a high quality validation dataset from different populations to evaluate comparative method performance and make recommendations for future verbal autopsy implementation. This study was undertaken to compile a set of strictly defined gold standard deaths for which verbal autopsies were collected to validate the accuracy of different methods of verbal autopsy cause of death assignment. Methods Data collection was implemented in six sites in four countries: Andhra Pradesh, India; Bohol, Philippines; Dar es Salaam, Tanzania; Mexico City, Mexico; Pemba Island, Tanzania; and Uttar Pradesh, India. The Population Health Metrics Research Consortium (PHMRC developed stringent diagnostic criteria including laboratory, pathology, and medical imaging findings to identify gold standard deaths in health facilities as well as an enhanced verbal autopsy instrument based on World Health Organization (WHO standards. A cause list was constructed based on the WHO Global Burden of Disease estimates of the leading causes of death, potential to identify unique signs and symptoms, and the likely existence of sufficient medical technology to ascertain gold standard cases. Blinded verbal autopsies were collected on all gold standard deaths. Results Over 12,000 verbal autopsies on deaths with gold standard diagnoses were collected (7,836 adults, 2,075 children, 1,629 neonates, and 1,002 stillbirths. Difficulties in finding sufficient cases to meet gold standard criteria as well as problems with misclassification for certain causes meant that the target list of causes for analysis was reduced to 34 for adults, 21 for children, and 10 for neonates, excluding stillbirths. To ensure strict independence for the validation of methods and assessment of comparative performance, 500 test-train datasets were created from the universe of cases, covering a range of cause-specific compositions. Conclusions This unique, robust validation dataset will allow scholars to evaluate the performance of different verbal autopsy analytic methods as well as instrument design. This dataset can be used to inform the implementation of verbal autopsies to more reliably ascertain cause of death in national health information systems.

Ohno Summer

2011-08-01

180

Feasibility and validation of virtual autopsy for dental identification using the Interpol dental codes.  

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Virtual autopsy is a medical imaging technique, using full body computed tomography (CT), allowing for a noninvasive and permanent observation of all body parts. For dental identification clinically and radiologically observed ante-mortem (AM) and post-mortem (PM) oral identifiers are compared. The study aimed to verify if a PM dental charting can be performed on virtual reconstructions of full-body CT's using the Interpol dental codes. A sample of 103 PM full-body CT's was collected from the forensic autopsy files of the Department of Forensic Medicine University Hospitals, KU Leuven, Belgium. For validation purposes, 3 of these bodies underwent a complete dental autopsy, a dental radiological and a full-body CT examination. The bodies were scanned in a Siemens Definition Flash CT Scanner (Siemens Medical Solutions, Germany). The images were examined on 8- and 12-bit screen resolution as three-dimensional (3D) reconstructions and as axial, coronal and sagittal slices. InSpace(®) (Siemens Medical Solutions, Germany) software was used for 3D reconstruction. The dental identifiers were charted on pink PM Interpol forms (F1, F2), using the related dental codes. Optimal dental charting was obtained by combining observations on 3D reconstructions and CT slices. It was not feasible to differentiate between different kinds of dental restoration materials. The 12-bit resolution enabled to collect more detailed evidences, mainly related to positions within a tooth. Oral identifiers, not implemented in the Interpol dental coding were observed. Amongst these, the observed (3D) morphological features of dental and maxillofacial structures are important identifiers. The latter can become particularly more relevant towards the future, not only because of the inherent spatial features, yet also because of the increasing preventive dental treatment, and the decreasing application of dental restorations. In conclusion, PM full-body CT examinations need to be implemented in the PM dental charting protocols and the Interpol dental codes should be adapted accordingly. PMID:23622469

Franco, Ademir; Thevissen, Patrick; Coudyzer, Walter; Develter, Wim; Van de Voorde, Wim; Oyen, Raymond; Vandermeulen, Dirk; Jacobs, Reinhilde; Willems, Guy

2013-05-01

 
 
 
 
181

Cardiovascular involvement in systemic lupus erythematosus: An autopsy study of 27 patients in India  

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Full Text Available Background: Although cardiovascular disease (CVD is recognized as a leading cause of death in patients with systemic lupus erythematosus (SLE in western countries, there is hardly any data regarding Indian subjects with SLE. Aims: To determine the incidence of cardiac abnormalities and vascular lesions at autopsy and to assess their contribution to the mortality in patients with SLE Settings and Design: Retrospective retrieval of reports of autopsies performed on 35 patients with SLE over a 11 year period and analysis of 27 cases with cardiac and/or vascular lesions. Materials and Methods: Gross and microscopic features in 27 autopsies were analyzed with special attention to the heart and the vasculature of all organs. Findings were correlated with clinical features and ante-mortem investigations. Their contribution towards mortality was assessed. Results: Valvar lesions were the commonest cardiac lesions noted with non-bacterial thrombotic endocarditis in nine (33.33%, valvar thickening in two (7.41%, Libman-Sacks endocarditis and infective endocarditis in one (3.70% each. Myocarditis and myocardial scarring were seen in 10 (37.03% and seven (25.92% cases, respectively. Fibrinous pericarditis was noted in seven (25.92%. Thromboses/ embolism, vasculitis and severe coronary atherosclerosis were seen in nine (33.33%, five (18.52% and one (3.70% subjects, respectively. Renal disease [13, 48.14%] and cardiovascular manifestations [8, 29.62%] were the leading causes of death in our patient population. Conclusion: CVD contributes significantly to the mortality in patients with SLE in India. It is second only to renal disease in this regard

Panchal L

2006-01-01

182

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

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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.).

Ron, E.; Carter, R.L.; Jablon, S.; Mabuchi, Kiyohiko

1993-11-01

183

Sudden cardiac death in younger adults: autopsy diagnosis as a tool for preventive medicine.  

Science.gov (United States)

Sudden death in children and younger adults can be caused by potentially heritable cardiovascular disorders, and the fatal outcome is often the first symptom in apparently healthy subjects. In these cases, a careful autopsy becomes the sole diagnostic tool to guide the clinical screening of the families. The aims of the present study were (1) to assess the pathological substrate of sudden cardiac death in children and younger adults (age, 1-40 years) in a large prospective series using strict morphological criteria; and (2) to perform cardiological assessment of the relatives of the deceased subjects with cardiomyopathies or structurally normal hearts, potentially consistent with a heritable cardiac disease. We studied 100 consecutive cases. Autopsy findings included coronary artery disease (30%, atherosclerotic in the majority of cases), cardiomyopathies (22%), and various cardiac abnormalities (28%). In the remaining 20% of cases, the presence of significant morphological abnormalities of the heart was ruled out. Twenty of 42 families in which the heart of the proband was either affected by a cardiomyopathy or failed to show significant structural abnormalities could be contacted and provided informed consent to cardiological assessment. A potentially inherited cardiac disease was diagnosed in 4 (20%). Molecular genetic analysis was restricted to 3 of these families and revealed a mutation in the ryanodine receptor type 2 gene (RyR2) in 1. Our results underline the implication of autopsy findings for relatives and the importance of cardiological screening of family members to uncover familial cardiomyopathies or genetic arrhythmias and to adopt the proper therapeutic and preventive strategies. Genetic testing is still time consuming and costly: accordingly, it should be restricted only to selected cases. PMID:16784977

di Gioia, Cira Rosaria Tiziana; Autore, Camillo; Romeo, Daniela Maria; Ciallella, Costantino; Aromatario, Maria Rosaria; Lopez, Annunziata; Pagannone, Erika; Giordano, Carla; Gallo, Pietro; d'Amati, Giulia

2006-07-01

184

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

International Nuclear Information System (INIS)

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.)

1993-01-01

185

Autopsy findings in 40 cases of esophageal cancer treated with radiation therapy  

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We analyzed local control, lymph node metastases and distant metastases for autopsy cases of esophageal cancer treated with radiation therapy alone. Thirty-eight patients had squamous cell carcinoma, one had adenosquamous carcinoma and one had undifferentiated carcinoma. Sixteen patients received a total dose less than 60 Gy and 24 received 60 Gy or more. The 1-year, 3-year, 5-year overall survival rates by Kaplan-Meier method were 45.8%, 16.7%, 8.3%, respectively. Four patients (10%) were free of tumors, and another six (15%) had no primary tumor but metastases. Thirty patients had persistent or recurrent primary tumors. Local tumor control rates were 25% for all patients and 34% for patients who survived more than 3 months and 33% for patients irradiated with 60 Gy or more. Tumor type, tumor length and survival times were significantly related with tumor control rates. Perforations into neighboring organs were observed in eighteen patients (45%); 12 were perforated into respiratory systems, 4 into vascular systems, 1 into the mediastinum and 1 into the pleural cavity. Thirty-two patients (80%) had lymph node metastases. Twenty-seven patients (68%) had distant metastases; 20 in the lung, 19 in the liver, 10 in the stomach, 8 in the pancreas and the adrenal gland, 7 in the pleura, 6 in the bone and the heart and the diaphragm. Concurrent double cancer was observed at autopsy in six patients; 2 early gastric cancers, 2 latent hepatomas, 1 lung cancer, 1 latent thyroid cancer. Three patients had a history of resection of other cancer before radiation therapy to esophageal cancer; 2 had gastric cancer and 1 had submandibular cancer. One patient who had another esophageal cancer apart from the first esophageal cancer received radiation therapy 12 years ago. In conclusion, the local control rate was 33% for autopsy cases of esophageal cancer treated with radiation therapy of 60 Gy or more. (J.P.N.).

Yamakawa, Michitaka; Shiojima, Kazumi; Hasegawa, Masatoshi [Gunma Univ., Maebashi (Japan). School of Medicine] [and others

1995-09-01

186

French retrospective multicentric study of neonatal hemochromatosis: importance of autopsy and autoimmune maternal manifestations.  

Science.gov (United States)

Neonatal hemochromatosis is a rare disease that causes fetal loss and neonatal death in the 1st weeks of life and is one of the most common causes of liver failure in the neonate. The diagnosis is mostly made retrospectively, based on histopathologic features of severe liver fibrosis associated with hepatic and extrahepatic siderosis. Several etiologies may underlie this phenotype, including a recently hypothesized gestational alloimmune disease. Fifty-one cases of liver failure with intrahepatic siderosis in fetuses and neonates were analyzed retrospectively. Maternal and infant data were collected from hospitalization and autopsy reports. All available slides were reviewed independently by 3 pathologists. Immunologic studies were performed on maternal sera collected immediately after delivery. The diagnosis of neonatal haemochromatosis was retained in 33 cases, including 1 case with Down syndrome and 1 case with myofibromas. Liver siderosis was inversely proportional to fibrosis progression. In fetuses, iron storage was more frequent in the thyroid than in the pancreas. Perls staining in labial salivary glands was positive in 1 of 5 cases. Abnormal low signal intensity by magnetic resonance imaging was detected in the pancreas in 2 of 7 cases. Renal tubular dysgenesis was observed in 7 of 23 autopsy cases. Chronic villitis was seen in 7 of 15 placentas. Half of the mothers presented with an autoimmune background and/or autoantibodies in their sera. Our work highlights the importance of autopsy in cases of neonatal hemochromatosis and marshals additional data in support of the hypothesis that neonatal hemochromatosis could reflect maternal immune system dysregulation. PMID:22901025

Collardeau-Frachon, Sophie; Heissat, Sophie; Bouvier, Raymonde; Fabre, Monique; Baruteau, Julien; Broue, Pierre; Cordier, Marie-Pierre; Debray, Dominique; Debiec, Hanna; Ronco, Pierre; Guigonis, Vincent

2012-01-01

187

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

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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.

Eduardo Chachamovich

2013-03-01

188

Clinical evaluation of gallium-67 scintigraphy in comparison with autopsy findings in the older ages  

International Nuclear Information System (INIS)

A correlative study of autopsy findings and retrospective review of gallium scintigrams were performed in 106 older ages cases. Of these cases studied, 57 % demonstrated positive gallium study in the present series. Histological correlation was undertaken in cases of lung cancer. Among them, squamous cell carcinoma showed the highest incidence of positive results (83 %), whereas adenocarcinoma was the lowest (35 %). There is no apparent correlation between subtypes of histological classification of adenocarcinoma and abnormal accumulation of gallium. However, abnormal accumulation of the nuclide seems to be rather related with interstitial reactions, namely fibrotic changes, lymphocyte infiltration and vascularization. (author)

1987-01-01

189

Parity factors and prevalence of fibrocystic breast change in a forensic autopsy series.  

Science.gov (United States)

The relationship of reproductive factors, such as nulliparous vs ever-parous status, age at first birth, and total parity, with morphologic prevalence of fibrocystic changes were examined using autopsy material from three ethnic/racial groups at varying risks for breast cancer. Although there was a trend toward a protective effect of ever-parous status, there was no statistically significant difference in the prevalence of fibrocystic disease in any group defined by parity status. The ethnic differences in the prevalence of fibrocystic changes were not explained by the differences in parity status distribution for the three ethnic/racial groups. PMID:2069834

Pathak, D R; Pike, M C; Key, C R; Teaf, S R; Bartow, S A

1991-06-01

190

[Peptic ulcer and liver pathology (an analysis of 6456 autopsy observations during 1983-1992)].  

Science.gov (United States)

The incidence of various forms of stomach ulcer, their combination with liver diseases and pathogenetic relationships of these two pathological types have been studied on the material of 6456 autopsy cases for 1983-1992. High incidence of nonspecific reactive hepatitis in both gastric and duodenal ulcer and that of liver cirrhosis and cirrhosis-carcinoma in the pyloro-duodenal ulcer is established. A role of gastrin as a promoter in the development of liver cirrhosis and carcinoma in pyloroduodenal ulcer is suggested. The role of nonspecific reactive hepatitis in chronization of the hepatic pathological process is not excluded. PMID:9139591

Lapina, T L; Serov, V V; Severgina, L O

1996-01-01

191

The caudal mandibular reconstruction plate: a radiographic and histologic study of an autopsy specimen.  

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During autopsy, a reconstructed partial mandibular resection was recovered and subjected to histological examination. The mandible had been reconstructed 12 weeks earlier with a caudal plate and autologous cancellous bone from the iliac crest. Undecalcified microsections showed that the plate was firmly anchored by screws on both sides and on one side there was bony union. However, most of the free transplant bone had undergone 'unreplaced resorption.' Nevertheless, this method offers advantages over the conventional method of seating the plate on the buccal aspect and has interesting potential for further development. PMID:1622963

Schuller-Götzburg, P; Krenkel, C; Falkensammer, G; Plenk, H

1992-06-01

192

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

International Nuclear Information System (INIS)

A "5"7Fe 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)

1987-01-01

193

Autopsy case report of thoracic myelopathy after /sup 60/Co irradiation for esophageal cancer  

Energy Technology Data Exchange (ETDEWEB)

The patient, a 61-year-old male, noticed he had dysphagea in October 1975. He visited a radiologist and his illness was diagnosed as an esophageal cancer. Irradiation therapy was given; a dose of 6000 rad to the region of Th3-Th12, another 1000 rad to Th6-Th9. The patient progressed well until he noticed a sensory disturbance on the right toe. He entered our clinic in July 1979. He had Brown-Sequard syndrome at left thoracic level. His condition grew worse and resulted in complete paraplegia. He died in 1980. Autopsy revealed neither reccurrence nor metastasis. Spinal cord was atrophied from Th5 to Th10.

Shimauchi, T.; Tomishige, M.; Okuda, T.; Nishiyama, Y.; Matsuo, Y. (Hiroshima Red Cross Hospital (Japan))

1981-06-01

194

Acute respiratory distress syndrome due to systemic lupus erythematosus with hemophagocytic syndrome: an autopsy report.  

Science.gov (United States)

This report concerns a patient with systemic lupus erythematosus (SLE) who died of acute respiratory distress syndrome (ARDS) 1 day after the onset of pulmonary symptoms. Autopsy demonstrated severe hemophagocytosis in the bone marrow and histopathology indicating a marked increase in vascular permeability in both lungs and kidneys. In this patient, active SLE and associated hemophagocytic syndrome may have induced an increase in the production of inflammatory cytokines, which immediately induced ARDS. Since fatal ARDS can occur as a life-threatening complication of SLE, careful observation is necessary, particularly when there are clinical findings suggestive of associated hemophagocytic syndrome. PMID:15338452

Kaneko, Kazuma; Matsuda, Masayuki; Sekijima, Yoshiki; Hosoda, Waki; Gono, Takahisa; Hoshi, Kenichi; Shimojo, Hisashi; Ikeda, Shu-ichi

2005-04-01

195

Comparison of organochlorine residues in human adipose tissue autopsy samples from two Ontario municipalities  

Energy Technology Data Exchange (ETDEWEB)

Human adipose tissue samples obtained during autopsies in a Canadian Great Lakes community, Kingston, Ontario, and a second community, Ottawa, Ontario, were analyzed for organochlorine pesticides, polychlorobiphenyls, chlorobenzenes, and chlorophenols. Significantly different levels of Dichlorodiphenyl-dichlorethane, mirex, hexachlorobenzene, and 2,3,4,6-tetrachlorophenol were found in Kingston adipose tissues compared to Ottawa tissues. Residue levels of oxychlordane, mirex, and polychlorinated biphenyls were significantly different in Kingston males versus Kingston females. The means and ranges of residue levels were contrasted with those reported in previous Canadian surveys.

Williams, D.T.; LeBel, G.L.; Junkins, E.

1984-01-01

196

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

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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 CSMF accuracy for adult and child VA with and without HCE and for neonatal VA without HCE. It is also preferable to PCVA in terms of time and cost. Therefore, we recommend it as the technique of choice for analyzing past and current verbal autopsies.

James Spencer L

2011-08-01

197

Detection of pathological zinc accumulation in neurons: methods for autopsy, biopsy, and cultured tissue  

DEFF Research Database (Denmark)

It has been repeatedly shown that synaptically released zinc contributes to excitotoxic neuronal injury in ischemia, epilepsy, and mechanical head trauma. Such zinc-induced injury leaves an unmistakable "footprint" in the injured neurons, allowing an easy and unambiguous postmortem diagnosis. This footprint is the presence of weakly bound, histochemically reactive zinc in the cytoplasm of the perikaryon and proximal dendrites. Such staining appears to be a necessary and sufficient marker for zinc-induced neuronal injury. Here we show how to prepare and stain tissue from biopsy, autopsy, or experimental animal sources for maximal contrast and visibility of zinc-injured neurons.

Suh, S W; Listiack, K

1999-01-01

198

Moessbauer-effect study of autopsied lung tissue of asbestos workers  

Energy Technology Data Exchange (ETDEWEB)

A /sup 57/Fe 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.

Stroink, G.; Lim, D.; Dunlap, R.A.

1987-02-01

199

Evaluation of point-of-care testing of C-reactive protein in forensic autopsy cases.  

Science.gov (United States)

We assessed the technical performance and robustness of the point-of-care test for C-reactive protein (CRP) NycoCard CRP for use in forensic autopsy cases. The results of 17 of 39 cadaver blood samples that had CRP in the range effectively measured by the NycoCard (5-120mg/l) correlated well (r=0.99) with those of quantitative latex agglutination immunoassay (turbidimetry), and the out-of-range NycoCard results were fully consistent with those obtained by turbidimetry. For the ten sera whose CRP >120mg/l according to NycoCard, a significant correlation (r=0.98) was observed between values multiplied by the dilution ratio and those of turbidimetry. No significant differences were observed after a freeze-thaw procedure. In addition, CRP results using recombinant human CRP spiked with hemoglobin up to 80g/l were not significantly different from the unspiked results in PBS. The test allows reliable and cost-effective on-site measurement of CRP from a small volume of serum (5?l) with simple equipment. This semi-quantification method of CRP should be useful for diagnosis during autopsy. PMID:24530941

Soejima, Mikiko; Koda, Yoshiro

2014-04-01

200

The burden of disease in Maputo City, Mozambique: registered and autopsied deaths in 1994  

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Full Text Available OBJECTIVE: To classify the causes of death in Maputo City, Mozambique, using the methods of the Global Burden of Disease study, in order to provide information for health policy-makers and to obtain a baseline for future studies in Maputo City and provincial capitals. METHODS: Data were taken from the Maputo City death register and autopsy records for 1994. FINDINGS: A total of 9011 deaths were recorded in the death register, representing a coverage of approximately 86%. Of these, 8114 deaths (92% were classified by cause. Communicable, maternal, perinatal, and nutritional disorders accounted for 5319 deaths; noncommunicable diseases for 1834; and injuries for 961. The 10 leading causes of registered deaths were perinatal disorders (1643 deaths; malaria (928; diarrhoeal diseases (814; tuberculosis (456; lower respiratory infections (416; road-traffic accidents (371; anaemia (269; cerebrovascular diseases (269; homicide (188; and bacterial meningitis (178. CONCLUSIONS: Infectious diseases of all types, injuries, and cerebrovascular disease ranked as leading causes of death, according to both the autopsy records and the city death register. AIDS-related deaths were underreported. With HIV infection increasing rapidly, AIDS will add to the already high burden of infectious diseases and premature mortality in Maputo City. The results of the study indicate that cause of death is a useful outcome indicator for disease control programmes.

Dgedge Martinho

2001-01-01

 
 
 
 
201

An autopsy case of preclinical multiple system atrophy (MSA-C).  

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Multiple system atrophy (MSA) is divided into two clinical subtypes: MSA with predominant parkinsonian features (MSA-P) and MSA with predominant cerebellar dysfunction (MSA-C). We report a 71-year-old Japanese man without clinical signs of MSA, in whom post mortem examination revealed only slight gliosis in the pontine base and widespread occurrence of glial cytoplasmic inclusions in the central nervous system, with the greatest abundance in the pontine base and cerebellar white matter. Neuronal cytoplasmic inclusions (NCIs) and neuronal nuclear inclusions (NNIs) were almost restricted to the pontine and inferior olivary nuclei. It was noteworthy that most NCIs were located in the perinuclear area, and the majority of NNIs were observed adjacent to the inner surface of the nuclear membrane. To our knowledge, only four autopsy cases of preclinical MSA have been reported previously, in which neuronal loss was almost entirely restricted to the substantia nigra and/or putamen. Therefore, the present autopsy case of preclinical MSA-C is considered to be the first of its kind to have been reported. The histopathological features observed in preclinical MSA may represent the early pattern of MSA pathology. PMID:23581648

Kon, Tomoya; Mori, Fumiaki; Tanji, Kunikazu; Miki, Yasuo; Wakabayashi, Koichi

2013-12-01

202

Autopsy findings in carotid arterial rupture following radiotherapy of head and neck advanced carcinoma  

International Nuclear Information System (INIS)

The influence of radiotherapy in advanced head and neck cancer was investigated by autopsy of head and neck patients who had had carotid artery rupture. Twenty-five cases of head and neck cancer revealed carotid artery rupture among the 255 head and neck cases autopsied from 1972 to 1985. The rate of carotid artery rupture in hypopharyngeal cancer was 8/32 (25%); in oral cancer 8/55 (14.5%), and in other cancers 9/165 (5.4%). In localization of ruptured arteries there were 9 cases of common carotid artery, 14 cases of external carotid artery, one case of internal carotid artery, and one unknown. These cases were irradiated using more than 70 Gy. The following reasons for carotid artery rupture were suspected: 1. There was a tumor with deep ulceration and necrosis near the vessel. 2. The wall of the artery had radiation angitis. 3. The artery wall was necrotic because of invasion by the tumor. 4. Thrombosis developed with ensuant rupture of the artery. Radiotherapy for advanced cancer of the head and neck is necessary to control pain and as palliative treatment, but to avoid rupture of the carotid artery, pain clinic techniques and chemotherapy as palliative treatment for this kinds of terminal condition should also be considered. (author)

1989-01-01

203

A rare case of adult T cell leukemia/lymphoma: clinicopathological correlation with autopsy confirmation.  

Science.gov (United States)

Adult T cell leukaemia/lymphoma (ATLL) is a rare T lymphoproliferative disorder which is etiologically linked with human T cell lymphotropic virus type-1 (HTLV-1). HTLV-1 is endemic in Japan, Caribbean and Africa. The highest incidence of ATLL is in Japan although sporadic cases have been reported elsewhere in the world. We describe a case of ATLL with an unusual presentation with clinic-pathological correlation and autopsy confirmation. A 56 year old male was referred to Command Hospital (Southern Command) for an incidental finding of lymphocytosis on a routine Hemogram. Clinical examination did not reveal hepatosplenomegaly, lymphadenopathy, jaundice or skin lesions. Laboratory investigations showed lymphocytosis with predominance of atypical lymphomonocytoid cells. Immunophenotyping of the bone marrow mononuclear cells showed positivity for CD45, CD2, CD3, CD4, CD5 and negative for CD7, CD8, CD13, CD33, CD19, which is characteristic of ATLL phenotype. Clonality was confirmed by PCR for TCR gene rearrangement on post mortem tissue. He succumbed to his illness after 40 days of initial presentation and 16 days of being diagnosed as ATLL. Here, we discuss the pathogenesis and characteristics of ATLL with clinico-pathological correlation and autopsy confirmation. PMID:24839359

Manoj, M G; Kotwal, J; Dutta, V

2014-06-01

204

Causes and Severity of Fatal Injuries in Autopsies of Victims of Fatal Traffic Accidents  

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Full Text Available Introduction: In this retrospective study, we decided to determine the death causes and severity of injuries in traffic accidents according to reports of the forensic medical center of Yazd. Methods: A total of 251 fatalities due to traffic accidents that had undergone autopsy examinations at the Yazd forensic medicine center from2006 till 2008 were included in the study by census method. Data regarding gender, road user type, type of vehicle (car, motorcycle, autobus or minibus, consciousness level, and intensive care unit (ICU admission was gathered. For evaluation of injury severity, we used Injury Severity Score (ISS. Results: The population under study consisted of 202 men (80.5% and 49 women (19.5% with an average age of 34.1 years (range: 1-89 years. Motorcycle-pedestrian accidents were the most common type of injury (100, 39.8%. Head (220, 87.6% and face (169, 67.3% were the two most common sites of injuries. Mean (±SD of ISS was 23.2 (±10.4. According to autopsy records, the main cause of death was head trauma (146, 58.1%. Conclusion: Public awareness in terms of primary prevention of road accidents should be considered important. Also, regarding the high prevalence of brain injuries and complications associated with skull fractures, accessibility to neurosurgeons and availability of imaging devices have an important role in decreasing the mortality rate of traffic accidents.

F Panahi

2010-03-01

205

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

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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.

Corder Elizabeth H.

2005-01-01

206

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

International Nuclear Information System (INIS)

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)

1984-01-01

207

Autopsy findings in carotid arterial rupture following radiotherapy of head and neck advanced carcinoma  

Energy Technology Data Exchange (ETDEWEB)

The influence of radiotherapy in advanced head and neck cancer was investigated by autopsy of head and neck patients who had had carotid artery rupture. Twenty-five cases of head and neck cancer revealed carotid artery rupture among the 255 head and neck cases autopsied from 1972 to 1985. The rate of carotid artery rupture in hypopharyngeal cancer was 8/32 (25%); in oral cancer 8/55 (14.5%), and in other cancers 9/165 (5.4%). In localization of ruptured arteries there were 9 cases of common carotid artery, 14 cases of external carotid artery, one case of internal carotid artery, and one unknown. These cases were irradiated using more than 70 Gy. The following reasons for carotid artery rupture were suspected: 1. There was a tumor with deep ulceration and necrosis near the vessel. 2. The wall of the artery had radiation angitis. 3. The artery wall was necrotic because of invasion by the tumor. 4. Thrombosis developed with ensuant rupture of the artery. Radiotherapy for advanced cancer of the head and neck is necessary to control pain and as palliative treatment, but to avoid rupture of the carotid artery, pain clinic techniques and chemotherapy as palliative treatment for this kinds of terminal condition should also be considered. (author).

Satake, Bunsuke; Matsuura, Shizumu; Sakaino, Kouji; Maehara, Yasunobu (Gunma Cancer Center Hospital, Ota (Japan))

1989-12-01

208

GLUT3 protein and mRNA in autopsy muscle specimens  

Science.gov (United States)

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.

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

1999-01-01

209

An autopsy case of microencephaly, bizarre putaminal lesion, and cerebellar atrophy with heart and liver diseases.  

Science.gov (United States)

We reported a 64-year-old autopsy case, showing a unique combination of disorders in visceral organs and brain. She had developmental delay, microencephaly, and facial dysmorphism. She developed sick sinus syndrome and liver cirrhosis. There were no abnormalities in laboratory tests for congenital metabolic errors or anomaly syndromes, including activities of lysosomal enzymes, isoelectric focusing of serum transferrin or array comparative genomic hybridization. She died of cardiorespiratory failure. At autopsy she showed liver cirrhosis and mesangial proliferation. The brain weighed 710g. Bizarre putaminal changes were found, in which the size of area of putamen in coronal sections was small, aberrant fiber running was increased, and immunoreactivity for tyrosine hydroxylase was reduced. Loss of Purkinje cells was found throughout the cerebellar cortex. She had unreported combination of developmental delay, facial dysmorphism, small brain, bizarre putaminal lesion, cerebellar atrophy, cardiac disease, liver cirrhosis and renal disease. Although the exact cause of disease still remains to be investigated, it will be a clue for the establishment of new disease entity to accumulate subjects having the similar phenotype. PMID:24491944

Okoshi, Yumi; Hayashi, Masaharu; Kanda, Sachiko; Yamamoto, Toshiyuki

2014-09-01

210

“CORONARY ARTERY DISEASE ON AUTOPSY”: A FIVE YEARS CLINICOPATHOLOGICAL STUDY (NOVEMBER-2007 TO OCTOBER-2012  

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Full Text Available BackgroundThis study was done to investigate the cause of death due to coronary artery pathology found on autopsies received between November 2007 to October 2012. The study was conducted at the Histopathology laboratory, Pathology Department, P. D. U. Medical College, Rajkot, Gujarat, India.MethodsIn the present study, total 350 postmortem cases with coronary artery specimen received from Saurashtra region(formed by seven districts of Gujarat,India from November 2008 to October 2012 were considered. Histopathological sectioning of these specimens was done & slides were prepared & stained by Hematoxylin & Eosin stains, examined microscopically for coronary artery pathology. Each and every autopsy cases received irrespective of natural, unnatural or sudden death were considered for this study. Patients’ relatives were approached and detailed history about the life style, habit & clinical complains of the patient was noted for further evaluation.ResultsA direct relationship was observed between death due to coronary artery disease and personal history including risk factors like sedentary life style, smoking, alcohol, obesity, diabetes & also with particular age groups viz. 45-65 years.ConclusionsOur study confirms that coronary artery diseases are more common among the population with sedentary life style, habit of smoking, alcohol & obesity. Also relationships with diabetes & hypertension were observed. These signify, increasing incidence of coronary artery diseases with modernization & adaptation of western lifestyle in the developing countries as emphasized by this study in our study population. These informations are valuable in policy formation for the control of coronary as artery diseases.

Dr Kalpesh G Rathod

2013-03-01

211

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

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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.

Gauravi A Dhruva,

2012-10-01

212

Central nervous system malformations in a perinatal/neonatal autopsy series.  

Science.gov (United States)

Congenital malformations of the central nervous system (CNS) are among the most common anomalies, but data on the incidence of CNS malformations in autopsy populations are scant. We examined 4122 autopsies between the years 1958 and 1995. There were 363 cases (8.8%) with CNS malformations; 235 were neonates and 128 stillborns. The overall gender ratio was 1:1, although more male neonates and more female stillborns had malformations. The body weights ranged from 24 to 6440 g. Neural tube defects were the most common types of malformations (45.5%) and included anencephaly, meningoencephalocele, meningocele/meningomyelocele, craniospinal rachischisis, and spina bifida occulta. The incidences of other malformations were: congenital hydrocephalus (12.4%), neuronal/glial proliferation disorders such as micro- and macrocephaly (8.8%), neuronal migration disorders (8.8%), prosencephalon growth disorders such as holoprosencephaly and arhinencephaly (8.5%), abnormalities of the midline structures such as agenesis of corpus callosum (4.1%), developmental cysts (3.3%), cerebellar malformations (3%), and vascular malformations (2%). Miscellaneous malformations (3%) consisted of acephalia in four cases with twin reversed arterial perfusion (TRAP), two cases of hydranencephaly, and four cases of rare degenerative and metabolic encephalopathies. PMID:10463270

Pinar, H; Tatevosyants, N; Singer, D B

1998-01-01

213

Late onset GM2 gangliosidosis presenting with motor neuron disease: An autopsy case.  

Science.gov (United States)

Adult-onset GM2 gangliosidosis is very rare and only three autopsy cases have been reported up to now. We report herein an autopsy case of adult-onset GM2 gangliosidosis. The patient developed slowly progressive motor neuron disease-like symptoms after longstanding mood disorder and cognitive dysfunction. He developed gait disturbance and weakness of lower limbs at age 52 years. Because of progressive muscle weakness and atrophy, he became bed-ridden at age 65. At age of 68, he died. His neurological findings presented slight cognitive disturbance, slight manic state, severe muscle weakness, atrophy of four limbs and no extrapyramidal signs and symptoms, and cerebellar ataxia. Neuropathologically, mild neuronal loss and abundant lipid deposits were noted in the neuronal cytoplasm throughout the nervous system, including peripheral autonomic neurons. The most outstanding findings were marked neuronal loss and distended neurons in the anterior horn of the spinal cord, which supports his clinical symptomatology of lower motor neuron disease in this case. The presence of lipofuscin, zebra bodies and membranous cytoplasmic bodies (MCB) and the increase of GM2 ganglioside by biochemistry led to diagnosis of GM2 gangliosidosis. PMID:24354582

Yokoyama, Teruo; Nakamura, Seigo; Horiuchi, Emiko; Ishiyama, Miyako; Kawashima, Rei; Nakamura, Kazuo; Hasegawa, Kazuko; Yagishita, Saburo

2014-06-01

214

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

Energy Technology Data Exchange (ETDEWEB)

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)

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

2002-07-01

215

Las autopsias en el hospital "Comandante Manuel Fajardo Rivero" Autopsies in "Comandante Manuel Fajardo Rivero" hospital  

Directory of Open Access Journals (Sweden)

Full Text Available Objetivos: mostrar los principales resultados obtenidos de la autopsia y utilizarlos en la mejora continua de la calidad asistencial. Métodos: se realizó un estudio retrospectivo, longitudinal, de la base de datos de autopsias del SARCAP, realizadas en el Hospital Militar "Comandante Manuel Fajardo Rivero" entre los años 1991-2011. Se analizaron el sexo, la edad, las especialidades de egreso, la estadía hospitalaria, las principales enfermedades, causas de muerte y evaluación de sus diagnósticos premortem. Resultados: se estudiaron 2 480 autopsias. Predominó el sexo masculino con el 51,7 % y las edades de 75-84 años con el 31 %. El 79,65 % de los casos fallecidos ocurrieron en el área de atención al grave y el 47,8 % de ellos fallecieron con una estadía de hasta 48 horas. La bronconeumonía y el infarto cardíaco fueron las principales causas directas de muerte, mientras en las básicas lo fueron la aterosclerosis coronaria, cerebral y generalizada. La hipertensión arterial y la diabetes mellitus fueron las principales causas contribuyentes. Las discrepancias para las causas directas y básicas de muerte fueron de una cada cuatro autopsias. Conclusiones: el estudio multicausal de la muerte permite caracterizar los principales problemas de salud. La aplicación del SARCAP y el diagnóstico del DMO han sido logros importantes de la especialidad alcanzados en esta institución. La metodología de trabajo obtenida en el estudio de la autopsia y su empleo en la mejora continua de la calidad de la asistencia médica en este centro constituye referencia para otros hospitales.Objectives: to show the main results of autopsy and to use tehm in the continuous improvement of care quality. Methods: a retrospective, longitudinal study was conducted in SARCAP autopsy database at "Comandante Manuel Fajardo Rivero" Military Hospital from 1991 to 2011. Different items were analyzed such as sex, age, specialties of discharge, the hospital stay, major diseases, causes of death and its premortem diagnostic evaluation. Results: 2 480 autopsies were studied; most of them were male (51.7 % and the mean age rate of 75-84 years (31 %. 79,65 % of the died cases happened in the area of attention to the serious patients and 47,8 % of the cases died with up to 48 hours of hospital stay. Bronchopneumonia and heart attacks were the main direct causes of death, while coronary, cerebral and generalized atherosclerosis were the basic causes of death. Hypertension and diabetes mellitus were the main contributing causes. Discrepancies for basic and direct causes of death were one in four autopsies. Conclusions: this multicausal-death study allowed characterizing those major health problems. Applying SARCAP and BMD diagnosis have been an important achievement in the specialty of this institution. The gained methodology during this autopsy study and its use in the continuous improvement of medical care quality in this center is a reference to other hospitals.

Ygnacio Ygualada Correa

2013-03-01

216

Las autopsias en el hospital "Comandante Manuel Fajardo Rivero" / Autopsies in "Comandante Manuel Fajardo Rivero" hospital  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Objetivos: mostrar los principales resultados obtenidos de la autopsia y utilizarlos en la mejora continua de la calidad asistencial. Métodos: se realizó un estudio retrospectivo, longitudinal, de la base de datos de autopsias del SARCAP, realizadas en el Hospital Militar "Comandante Manuel Fajardo [...] Rivero" entre los años 1991-2011. Se analizaron el sexo, la edad, las especialidades de egreso, la estadía hospitalaria, las principales enfermedades, causas de muerte y evaluación de sus diagnósticos premortem. Resultados: se estudiaron 2 480 autopsias. Predominó el sexo masculino con el 51,7 % y las edades de 75-84 años con el 31 %. El 79,65 % de los casos fallecidos ocurrieron en el área de atención al grave y el 47,8 % de ellos fallecieron con una estadía de hasta 48 horas. La bronconeumonía y el infarto cardíaco fueron las principales causas directas de muerte, mientras en las básicas lo fueron la aterosclerosis coronaria, cerebral y generalizada. La hipertensión arterial y la diabetes mellitus fueron las principales causas contribuyentes. Las discrepancias para las causas directas y básicas de muerte fueron de una cada cuatro autopsias. Conclusiones: el estudio multicausal de la muerte permite caracterizar los principales problemas de salud. La aplicación del SARCAP y el diagnóstico del DMO han sido logros importantes de la especialidad alcanzados en esta institución. La metodología de trabajo obtenida en el estudio de la autopsia y su empleo en la mejora continua de la calidad de la asistencia médica en este centro constituye referencia para otros hospitales. Abstract in english Objectives: to show the main results of autopsy and to use tehm in the continuous improvement of care quality. Methods: a retrospective, longitudinal study was conducted in SARCAP autopsy database at "Comandante Manuel Fajardo Rivero" Military Hospital from 1991 to 2011. Different items were analyze [...] d such as sex, age, specialties of discharge, the hospital stay, major diseases, causes of death and its premortem diagnostic evaluation. Results: 2 480 autopsies were studied; most of them were male (51.7 %) and the mean age rate of 75-84 years (31 %). 79,65 % of the died cases happened in the area of attention to the serious patients and 47,8 % of the cases died with up to 48 hours of hospital stay. Bronchopneumonia and heart attacks were the main direct causes of death, while coronary, cerebral and generalized atherosclerosis were the basic causes of death. Hypertension and diabetes mellitus were the main contributing causes. Discrepancies for basic and direct causes of death were one in four autopsies. Conclusions: this multicausal-death study allowed characterizing those major health problems. Applying SARCAP and BMD diagnosis have been an important achievement in the specialty of this institution. The gained methodology during this autopsy study and its use in the continuous improvement of medical care quality in this center is a reference to other hospitals.

Ygnacio, Ygualada Correa; José, Hurtado de Mendoza Amat; Teresita de J, Montero González.

217

Breast cancer and atypia among young and middle-aged women: a study of 110 medicolegal autopsies.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In 110 consecutive, medicolegal autopsies of young and middle-aged women (range 20-54 years) the breasts were examined by an extensive histopathologic method and by correlative specimen radiography. Malignancy was found in 22 women (20%) of which only one was known to have had clinical invasive breast cancer (IBC). At autopsy 2 women had IBC (2%), the remaining in situ carcinoma (in situ BC) of microfocal type (18%), i.e. 15 (14%) intraductal carcinomas (DCIS), 4 (3%) lobular carcinoma in sit...

Nielsen, M.; Thomsen, J. L.; Primdahl, S.; Dyreborg, U.; Andersen, J. A.

1987-01-01

218

Autopsy case of opsoclonus-myoclonus-ataxia and cerebellar cognitive affective syndrome associated with small cell carcinoma of the lung.  

Science.gov (United States)

We report an autopsy case of paraneoplastic opsoclonus-myoclonus-ataxia syndrome associated with small cell carcinoma of the lung. Chemotherapy and lung lobectomy resulted in complete tumor remission and disappearance of myoclonus. However, emotional and behavioral disturbances relapsed and remitted associated with exacerbation of truncal ataxia and ocular flutter, which responded favorably to prednisolone. At autopsy, after 2 years and 11 months of illness, there was no recurrence of cancer. Neuropathologically, only the cerebellum was affected, with diffuse loss of Purkinje cells and dentate neurons, suggesting that the paraneoplastic cerebellar involvement may be responsible for the cognitive affective symptoms in our patient. PMID:17534981

Ohara, Shinji; Iijima, Naoko; Hayashida, Kensuke; Oide, Takashi; Katai, Satoshi

2007-07-15

219

Concentration of sup(239,240)Pu in human autopsy tissues. Preliminary report of a comparative study on different populations  

Energy Technology Data Exchange (ETDEWEB)

Concentrations of sup(239,240)Pu in human autopsy tissue samples from the general population in Japan are reported for 1970. The mean plutonium concentration was determined to be 0.23 +- 0.63, 0.57 +- 0.37, and 1.10 +- 0.63 pCi/kg for the lung, liver and vertebrae samples, respectively; no appreciable concentration of plutonium was found in the kidney samples. These results are being compared with the data obtained from autopsy cases from the general population in the United States for the same year.

Kawamura, H.; Tanaka, G. (National Inst. of Radiological Sciences, Nakaminato, Ibaraki (Japan). Nakaminato Lab. Branch Office); McInroy, J.F.; Eutsler, B.C.

1981-12-01

220

Discrepancy between clinical criteria for diagnosing acute respiratory distress syndrome secondary to community acquired pneumonia with autopsy findings of diffuse alveolar damage.  

Science.gov (United States)

Diffuse alveolar damage (DAD) is the underlying pathological finding in most cases of acute respiratory distress syndrome (ARDS). The objective of this study was to compare clinical criteria for ARDS secondary to community acquired pneumonia with autopsy findings of DAD and to determine the discrepancy rate between the two. We compared prospectively obtained clinical diagnosis of ARDS secondary to community acquired pneumonia with autopsy findings of DAD and pneumonia. Forty nine patients dead with a clinical diagnosis of ARDS secondary to pneumonia who underwent autopsy between 1986 and 2004 in our ICU were included with systematic histopathological analysis of all lung lobes. The discrepancy rate between the premortem clinical diagnosis of ARDS secondary to pneumonia and DAD at autopsy was determined. Seven patients were found to have neither infection nor DAD at autopsy. Six patients showed pathologic signs of DAD without evidence of infection. Out of 38 patients meeting clinical criteria for ARDS secondary to pneumonia and proven pneumonia at autopsy, 25 met criteria for DAD at autopsy. Therefore, 18 out of 49 patients who were clinically diagnosed with ARDS did not actually show pathological signs of DAD, resulting in a discrepancy rate of 37%. Despite an acceptable correspondence between clinical criteria for ARDS secondary to pneumonia and autopsy findings of DAD a significant number of patients had neither signs of DAD nor infection. PMID:21570273

Sarmiento, Xavier; Guardiola, Juan J; Almirall, Jordi; Mesalles, Eduard; Mate, Jose Luis; Soler, Manuel; Klamburg, Jordi

2011-08-01

 
 
 
 
221

Accuracy of unfolded map method for determining the left ventricular border. Evaluation of the cut-off value from autopsy finding  

Energy Technology Data Exchange (ETDEWEB)

To improve the quantification of the left ventricular surface area (LVSA) by unfolded map method, we evaluated the cut-off value for determining the left ventricular border. The LVSA measured by unfolded map was compared with those measured using myocardial phantom and autopsy findings. The relative error (RE) was calculated as difference between LVSA in phantom and area of unfolded map. In phantom study, the cut-off value was calculated as 73.3{+-}0.5% when the RE was zero. In autopsy study, the cut-off value was 74.0{+-}7.2%. The area of unfolded map had good correlation with LVSA at autopsy when the cut-off value was 74% (r=0.83, p<0.003). The diameter of left ventricle at autopsy was compared with that of beating heart obtained by two-dimensional echocardiography, because the area of unfolded map was greater than LVSA at autopsy. The ratio of LVSA at autopsy to beating heart was calculated as 1.37. The suitable cut-off value was evaluated as 55.6% when the unfolded map area obtained by autopsy was increased 1.37 magnifications. There was a good correlation between LVSA of unfolded map (cut-off=56%) and the LVSA at autopsy (r=0.90, p<0.001). These results suggest that the cut-off value for determining the left ventricular border in vivo is 56%. (author)

Sugibayashi, Keiichi; Abe, Yoshiteru; Suga, Yutaka [Kansai Medical Univ., Moriguchi, Osaka (Japan)] [and others

1996-09-01

222

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

Directory of Open Access Journals (Sweden)

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. Clinical Trial Registration NCT01417962 NIHR Portfolio Number: 6794

Thayyil Sudhin

2011-12-01

223

Partitioning of 238Pu, 239Pu, and 241Am in skeleton and liver of United States transuranium registry autopsy cases  

International Nuclear Information System (INIS)

The distribution and concentration of the transuranic elements in humans was studied through analysis of tissues collected from occupationally exposed persons at autopsy. This report describes the results of the evaluation of data from registrants with measurable concentrations of plutonium and americium who had contributed bone and liver specimens to the United States Transuranium Registry

1986-07-03

224

Myocardial viability in cases with persistent perfusion defects on the dipyridamole thallium-201 scintigram. A comparative study with autopsy findings  

International Nuclear Information System (INIS)

The aim of this study was to assess the incidence of myocardial infarction among persistent perfusion defects in dipyridamole-stress thallium scintigraphy by inspecting autopsied hearts and to evaluate whether the regional thallium activity of a scintigraphic defect can predict the presence of infarction. Autopsied hearts were compared with dipyridamole myocardial scintigrams undertaken during life in 27 patients (mean age 85±8 years). The time interval from stress testing until death was 428±351 days. Regional thallium uptake of delayed perfusion defect was calculated on the short axis images. The grade of regional myocardial fibrosis in autopsy specimens was also quantified to correlate with the corresponding regional thallium uptake. In 6 of 15 (40%) regions with persistent defects on the scintigram, myocardial infarction was not found at autopsy. Regional thallium-201 uptake of delayed defects < 50% diagnosed infarction with a sensitivity of 82% and a specificity of 80%. A linear correlation (r=-0.67) was observed between percent thallium-201 uptake and the degree of myocardial fibrosis. In conclusion, perfusion defects at 4-hour imaging in dipyridamole-stress testing may overestimate the presence of myocardial infarction and regional thallium-201 activity is helpful in distinguishing between defects with and without infarction. (author)

1996-05-01

225

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

LENUS (Irish Health Repository)

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.

2012-01-31

226

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

International Nuclear Information System (INIS)

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.

2012-07-01

227

Myocardial viability in cases with persistent perfusion defects on the dipyridamole thallium-201 scintigram. A comparative study with autopsy findings  

Energy Technology Data Exchange (ETDEWEB)

The aim of this study was to assess the incidence of myocardial infarction among persistent perfusion defects in dipyridamole-stress thallium scintigraphy by inspecting autopsied hearts and to evaluate whether the regional thallium activity of a scintigraphic defect can predict the presence of infarction. Autopsied hearts were compared with dipyridamole myocardial scintigrams undertaken during life in 27 patients (mean age 85{+-}8 years). The time interval from stress testing until death was 428{+-}351 days. Regional thallium uptake of delayed perfusion defect was calculated on the short axis images. The grade of regional myocardial fibrosis in autopsy specimens was also quantified to correlate with the corresponding regional thallium uptake. In 6 of 15 (40%) regions with persistent defects on the scintigram, myocardial infarction was not found at autopsy. Regional thallium-201 uptake of delayed defects < 50% diagnosed infarction with a sensitivity of 82% and a specificity of 80%. A linear correlation (r=-0.67) was observed between percent thallium-201 uptake and the degree of myocardial fibrosis. In conclusion, perfusion defects at 4-hour imaging in dipyridamole-stress testing may overestimate the presence of myocardial infarction and regional thallium-201 activity is helpful in distinguishing between defects with and without infarction. (author)

Nakayama, Masafumi; Mashima, Saburo [Showa Univ., Yokohama (Japan). Fujigaoka Hospital; Ohkawa, Shin-ichiro; Tanno, Munehiko; Yamada, Hideo

1996-05-01

228

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

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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.

Sachdeva Man

2007-04-01

229

Membranoproliferative glomerulonephritis in a carcinoma with unknown primary: An autopsy study  

Directory of Open Access Journals (Sweden)

Full Text Available Kidney disease frequently complicates malignancy and its treatment. Although many solid and hematologic cancers may involve the renal parenchyma, clinical sequelae are usually not prominent. Published reports cite membranous nephropathy as the most common malignancy-associated glomerulopathy, occurring with many carcinomas and occasionally with leukemia and lymphoma followed by minimal change disease. Rarely membranoproliferative glomerulonephritis (MPGN has been reported in patients with malignancy. The mechanism by which malignancy induces disease remains unproved, but may involve deposition of tumor antigen in the subepithelial space with in situ immune complex formation and subsequent complement activation. Treatment of the underlying malignancy may lead to resolution of nephrotic syndrome, lending indirect support to this theory. We report a rare autopsy case of a patient with metastatic carcinoma (with unknown primary associated with MPGN. The association between MPGN and metastatic carcinoma with unknown primary is uncommon and has not been previously reported in the literature.

Gupta Kirti

2008-04-01

230

Recurrent primary central nervous system lymphoma mimicking neurodegenerative disease--an autopsy case report.  

Science.gov (United States)

A 42-year-old female presented with recurrent primary central nervous system lymphoma mimicking the roentgenographic appearance of diffuse brain degeneration. Betamethazone was administered, but her condition worsened. Biopsy of a swollen neck lymph node demonstrated lymphoma cells. Computed tomography and magnetic resonance (MR) imaging showed no contrast-enhanced lesions. T2-weighted MR imaging revealed diffuse, high intensity areas in the white matter of the bilateral cerebrum, basal ganglia, and brainstem. Despite chemotherapy for systemic lymphoma, she died of respiratory arrest. Histological examination of autopsy specimens showed diffuse infiltration of lymphoma cells in the perivascular space of the cerebral cortex, but little neovascularization. The absence of contrast enhancement may have been due to preservation of the blood-brain barrier. Histological confirmation of roentgenographic findings of brain degeneration is important in patients treated for primary central nervous system lymphoma. PMID:7566377

Matsumoto, K; Kohmura, E; Fujita, T; Tsuruzono, K; Tsujimura, T; Kawano, K

1995-06-01

231

[The art of improvising. The practice of medico-legal autopsies in the 19th century].  

Science.gov (United States)

Murder is perpetrated, suicide is committed and lethal accidents happen everywhere, even in the heart of the French country. In the 19th century, law often appealed to the lights of experts. During criminal investigation, improvisation and men's adaptation were important, although forensic autopsy was official and necessary. Sometimes the magistrates appealed to young people, not used to that kind of reports, who could only remind some bits of the forensic courses they had followed when they were students. As for the specialists, the circumstances often led them to examine--as Baudelaire would say--the "decaying carcass," in a dark and suffocating ruined house, on the kitchen table, and with a simple scapel. PMID:23038869

Menenteau, Sandra

2012-01-01

232

An autopsy case report of thoracic myelopathy after _6_0Co irradiation for esophageal cancer  

International Nuclear Information System (INIS)

The patient, a 61-year-old male, noticed he had dysphagea in October 1975. He visited a radiologist and his illness was diagnosed as an esophageal cancer. Irradiation therapy was given; a dose of 6000 rad to the region of Th3-Th12, another 1000 rad to Th6-Th9. The patient progressed well until he noticed a sensory disturbance on the right toe. He entered our clinic in July 1979. He had Brown-Sequard syndrome at left thoracic level. His condition grew worse and resulted in complete paraplegia. He died in 1980. Autopsy revealed neither reccurrence nor metastasis. Spinal cord was atrophied from Th5 to Th10. (author)

1981-01-01

233

An autopsy case of peritoneal malignant mesothelioma in a radiation technologist  

International Nuclear Information System (INIS)

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)

1990-01-01

234

Metastatic CNS lymphoma presenting with periventricular dissemination - MRI and neuropathological findings in an autopsy case.  

Science.gov (United States)

Metastatic CNS lymphoma usually manifests as pachymeningeal or leptomeningeal infiltrates, and periventricular dissemination is rare. A 70-year old man first noticed a mass in the left supraclavicular fossa, and then presented with bilateral parkinsonism, followed by consciousness disturbance. Fluid attenuated inversion recovery (FLAIR) image of brain MRI demonstrated hyperintensities at the parenchyma around the lateral ventricle, third ventricle, and fourth ventricle. Gadolinium-enhanced T1-weighted image demonstrated enhancement along the whole wall of the ventricle. Biopsy of the left supraclavicular lymph nodes established a diagnosis of diffuse large B-cell lymphoma. The patient died of multiple organ failure about 5 months after the onset. Autopsy disclosed periventricular dissemination of lymphoma cells that was most severe around the lateral ventricle. We considered that the lymphoma cells entered the ventricular system through the choroid plexus of the lateral ventricle, followed by dissemination of the periventricular parenchyma. PMID:19041988

Kobayashi, Zen; Tsuchiya, Kuniaki; Machida, Akira; Goto, Jun; Yokota, Osamu; Miake, Hirotomo; Watabiki, Sadakiyo; Taki, Kazuhiro; Ishizu, Hideki; Haga, Chie; Arai, Tetsuaki; Akiyama, Haruhiko; Mizusawa, Hidehiro

2009-02-15

235

Severe cortical involvement in MV2 Creutzfeldt-Jakob disease: an autopsy case report.  

Science.gov (United States)

MV2 type sporadic Creutzfeldt-Jakob disease (sCJD) is reported to have a long duration and marked involvement of the cerebral deep gray matter. We describe an autopsied long-surviving sCJD case of MV2. In the early stages, the patient exhibited memory impairment, attention deficit and semantic memory disorder. Diffusion-weighted MRI showed abnormal hyperintensity signals along the cerebral cortex, sparing the thalami and basal ganglia. Pathological observations included: severe spongiosis throughout the cerebral cortex, several kuru plaques and plaque-like PrP deposits in the cerebellum, with only minimal degeneration in the thalami and basal ganglia. Our case suggests that MV2 has a wide clinicopathological spectrum, which ranges from "VV2" to "MM2" type. PMID:17080721

Ishihara, Kenji; Sugie, Masayuki; Shiota, Jun-Ichi; Kawamura, Mitsuru; Kitamoto, Tetsuyuki; Nakano, Imaharu

2006-10-01

236

Hepatobiliary alterations in massive biliary ascariasis. Histopathological aspects of an autopsy case.  

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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 Cholangio-hepatitis, 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. PMID:2095631

Gayotto, L C; Muszkat, R M; Souza, I V

1990-01-01

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Clinical, pathological and mineralogical features in two autopsy cases of workers exposed to agalmatolite dust.  

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An agalmatolite miner and processor showed large shadows at the bilateral hila accompanied by surrounding emphysematous changes and irregular shadows on chest X-ray films. Chest CT scans were characterized by a mixture of tiny irregular structures and small round opacities. Histopathological examination revealed massive fibrosis, which corresponded to large shadows, but only a small number of typical silicotic nodules, indicating mixed dust pneumoconiosis. Mineralogical examination of the autopsy lungs showed quartz, pyrophyllite, mica, and kaolinite. Quartz accounted for 70% of the amount of all mineral dust in both patients, but pyrophyllite accounted for 10.8% and 14.4%. The pulmonary mineral dust composition in the two patients was well consistent with the mineral composition of the raw clays in the agalmatolite mine. In the two patients, chest X-ray findings and histopathological findings of the lungs also suggested agalmatolite pneumoconiosis, which was confirmed by mineral analysis of the lungs. PMID:10547959

Kishimoto, T; Yamamoto, H; Morinaga, K; Yamawaki, Y; Yoshimoto, T; Miyashita, T; Kohyama, N; Shinohara, Y

1999-10-01

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Lobed spleen: an autopsy case report with emphasis on surgical anatomy.  

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During the medico-legal autopsy of a male aged 45 years, a bilobed morphology of the spleen was observed. An oblique fissure was located longitudinally at the mid-region of the diaphragmatic surface of the spleen. The fissure was partially deep and observed throughout the diaphragmatic surface. The clinician should be aware of the developmental anomalies of the spleen; as such anomalies may cause confusion during the procedures like splenic biopsy and splenectomy. We believe that, the present case report is important to the radiologists and clinicians involved in the diagnosis and management of splenic pathology. The knowledge is also enlightening to the morphologists and embryologists. The radiologist and clinician should make sure that the fissure in a spleen is not misinterpreted as a laceration or rupture. PMID:24999567

Menezes, R G; Murlimanju, B V; Kharoshah, M A; Madadin, M; Naik, R; Senthilkumaran, S

2014-01-01

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Autopsy report on pseudo-Bartter syndrome with renal calcification induced by diuretics and diet pills.  

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A woman in her mid-forties had repeated vomiting and diarrhoea accompanied by muscle weakness soon after she started taking seven different diet pills imported from Thailand. After she had taken the pills for 8 days, respiratory depression progressed rapidly to arrest. Blood tests at the Emergency Department showed severe hypokalaemia with metabolic alkalosis. We diagnosed that she had developed pseudo-Bartter syndrome from the findings based on ionic abnormalities and high renin and aldosterone levels, and hyperplasia of the juxtaglomerular apparatus. A postmortem blood analysis indicated subtherapeutic levels of furosemide. We concluded that the patient died from pseudo-Bartter syndrome, which was triggered by chronic self-administration of furosemide and aggravated by the diet pills. This is the first pseudo-Bartter syndrome autopsy report to show histological localisation of calcification in the kidneys. PMID:21686346

Unuma, Kana; Tojo, Akihiro; Harada, Kazuki; Saka, Kanju; Nakajima, Makoto; Ishii, Takeshi; Fujita, Toshiro; Yoshida, Ken-Ichi

2009-01-01

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Using verbal autopsy to assess the prevalence of HIV infection among deaths in the ART period in rural Uganda: a prospective cohort study, 2006-2008  

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Full Text Available Abstract Background Verbal autopsy is important for detecting causes of death including HIV in areas with inadequate vital registration systems. Before antiretroviral therapy (ART introduction, a verbal autopsy study in rural Uganda found that half of adult deaths assessed were in HIV-positive individuals. We used verbal autopsy to compare the proportion of HIV-positive adult deaths in the periods before and after ART introduction. Methods Between 2006 and 2008, all adult (? 13 years deaths in a prospective population-based cohort study were identified by monthly death registration, and HIV serostatus was determined through annual serosurveys. A clinical officer interviewed a relative of the deceased using a verbal autopsy questionnaire. Two clinicians independently reviewed the questionnaires and classified the deaths as HIV-positive or not. A third clinician was the tie-breaker in case of nonagreement. The performance of the verbal autopsy tool was assessed using HIV serostatus as the gold standard of comparison. We compared the proportions of HIV-positive deaths as assessed by verbal autopsy in the early 1990s and the 2006-2008 periods. Results Of 333 deaths among 12,641 adults of known HIV serostatus, 264 (79.3% were assessed by verbal autopsy, of whom 59 (22.3% were HIV-seropositive and 68 (25.8% were classified as HIV-positive by verbal autopsy. Verbal autopsy had a specificity of 90.2% and positive predictive value of 70.6% for identifying deaths among HIV-infected individuals, with substantial interobserver agreement (80.3%; kappa statistic = 0.69. The HIV-attributable mortality fraction estimated by verbal autopsy decreased from 47.0% (pre-ART period to 25.8% (ART period, p Conclusions In resource-limited settings, verbal autopsy can provide a good estimate of the prevalence of HIV infection among adult deaths. In this rural population, the proportion of deaths identified by verbal autopsy as HIV-positive declined between the early 1990s and the 2006-2008 period. Verbal autopsy findings can inform policy on HIV health care needs.

Mugisha Joseph O

2011-08-01

 
 
 
 
241

Induction of pluripotent stem cells from autopsy donor-derived somatic cells.  

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Human induced pluripotent stem cells (iPSCs) have become an intriguing approach for neurological disease modeling, because neural lineage-specific cell types that retain the donors' complex genetics can be established in vitro. The statistical power of these iPSC-based models, however, is dependent on accurate diagnoses of the somatic cell donors; unfortunately, many neurodegenerative diseases are commonly misdiagnosed in live human subjects. Postmortem histopathological examination of a donor's brain, combined with premortem clinical criteria, is often the most robust approach to correctly classify an individual as a disease-specific case or unaffected control. In this study, we describe iPSCs generated from a skin biopsy collected postmortem during the rapid autopsy of a 75-year-old male, whole body donor, defined as an unaffected neurological control by both clinical and histopathological criteria. These iPSCs were established in a feeder-free system by lentiviral transduction of the Yamanaka factors, Oct3/4, Sox2, Klf4, and c-Myc. Selected iPSC clones expressed both nuclear and surface antigens recognized as pluripotency markers of human embryonic stem cells (hESCs) and were able to differentiate in vitro into neurons and glia. Statistical analysis also demonstrated that fibroblast proliferation was significantly affected by biopsy site, but not donor age (within an elderly cohort). These results provide evidence that autopsy donor-derived fibroblasts can be successfully reprogrammed into iPSCs, and may provide an advantageous approach for generating iPSC-based neurological disease models. PMID:21839145

Hjelm, Brooke E; Rosenberg, Jon B; Szelinger, Szabolcs; Sue, Lucia I; Beach, Thomas G; Huentelman, Matthew J; Craig, David W

2011-09-20

242

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

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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 interconnective training and promotes a complex learning.

Kayser Klaus

2006-11-01

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The influence of gender and of AIDS on the immunity of autopsied patients' esophagus.  

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Previous studies have shown that males who have AIDS are more frequently affected by infectious diseases than females. The esophagus is the organ in the digestive tube that is more commonly affected by opportunistic infections during the syndrome. The aim of this study was to assess the influence of AIDS and of gender on local immunity of the esophageal epithelium. Fragments of the esophagus from 29 autopsied women and 37 autopsied men were collected at a university hospital from 1980 to 2009 and were divided in groups with and without AIDS. The IgA-, IgG-, and IgM-positive cells and Langerhans cells (LCs) were immunostained, respectively, with anti-IgA, anti-IgG, anti-IgM, and anti-S100. The software Image J was used to measure the esophageal epithelium and to count the epithelium cellular layers. Patients with AIDS, apart from gender, showed an increase in IgA-, IgG-, and IgM-positive cells and a reduction of Langerhans cells, in thickness and in number of cellular layers in the esophageal epithelium. However, among individuals with AIDS, men presented lower secretory expression of IgA-, IgG-, and IgM-positive cells than women and more intense reduction of LCs. Women have naturally presented better local esophageal immunity than men. Although AIDS possibly causes immunological and morphological alterations in the esophageal epithelium in both genders, women have better esophageal immunity, which may explain a greater frequency of hospital admissions due to infection of men with AIDS when compared with women. PMID:20858138

Rocha, Laura Penna; de Melo E Silva, Ana Teresa; Gomes, Nayara Cândida; Faria, Humberto Aparecido; Silva, Renata Beatriz; Olegário, Janaínna Grazielle Pacheco; Corrêa, Rosana Rosa Miranda; de Paula Antunes Teixeira, Vicente; Cavellani, Camila Lourencini

2011-05-01

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

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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

Obiorah, C C; Amakiri, C N

2014-01-01

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Hereditary leiomyomatosis and renal cell carcinoma (HLRCC): a rapid autopsy report of metastatic renal cell carcinoma.  

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Rapid ("warm") autopsies of patients with advanced metastatic cancer provide invaluable insight into the natural history, pathobiology, and morphology of advanced and treatment-resistant tumors. Here, we report a rapid autopsy case of a hereditary leiomyomatosis and renal cell carcinoma (HLRCC) patient with advanced metastatic renal cell carcinoma (RCC)-the first such case described for either a primary renal tumor or HLRCC-related cancer. Mutations in the fumarate hydratase (FH) gene underlie HLRCC, a rare syndrome involving cutaneous and uterine leiomyomata and aggressive kidney tumors. Loss of heterozygosity at the wild-type FH gene locus results in profound cellular metabolic derangement, "pseudohypoxic" upregulation of hypoxia-inducible factor 1? (HIF-1?)-dependent transcription, and aberrant protein succination; these molecular changes drive oncogenesis of kidney tumors in HLRCC patients. The current index patient had a high-grade RCC with classic morphologic features of HLRCC, including large nuclei with prominent eosinophilic nucleoli and perinucleolar clearing. In addition, this patient's RCC demonstrated extensive sarcomatoid and rhabdoid features-morphologies not previously well described in HLRCC-associated kidney tumors. Here, we report the extent of metastatic dissemination and supplement this unique tumor morphology with mitochondrial enzyme histochemistry and extended immunohistochemical analysis. Tumor cells strongly expressed PAX8, vimentin, CD10, and the HIF target GLUT1 and showed increased nuclear p53 accumulation; the expression of other RCC markers was negative. We also detail microscopic tubular epithelial changes in the grossly uninvolved ipsilateral renal parenchyma and demonstrate sporadic, aberrant upregulation of the HIF targets GLUT1 and CAIX in dysplastic peritumoral tubules. PMID:24625422

Udager, Aaron M; Alva, Ajjai; Chen, Ying-Bei; Siddiqui, Javed; Lagstein, Amir; Tickoo, Satish K; Reuter, Victor E; Chinnaiyian, Arul M; Mehra, Rohit

2014-04-01

246

Saccade abnormalities in autopsy-confirmed frontotemporal lobar degeneration and Alzheimer's disease  

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Objective Deficits in the generation and control of saccades have been described in clinically-defined frontotemporal dementia (FTD) and Alzheimer’s disease (AD). Because clinical FTD syndromes can correspond to a number of different underlying neuropathologic FTD and non-FTD diagnoses, we sought to determine the saccade abnormalities associated with autopsy-defined cases of FTLD and AD. Participants and design An infrared eye tracker was used to record visually guided saccades to ten degree targets and antisaccades in 28 autopsy-confirmed FTD and 10 AD subjects, an average of 35.6 ± 10 months prior to death and 27 age-matched normal controls (NC). 12 FTD subjects had FTLD-TDP pathology, 15 had FTLD-tau pathology and one showed FTLD-FUS pathology. Receiver operating curve (ROC) statistics were used to determine diagnostic value of oculomotor variables. Neuroanatomical correlates of oculomotor abnormalities were investigated using voxel-based morphometry (VBM). Results All FTD and AD subjects were impaired relative to NC on the antisaccade task. However, only FTLD-tau and AD cases displayed reflexive visually-guided saccade abnormalities. AD cases displayed prominent increases in horizontal saccade latency that differentiated them from FTD cases. Impairments in velocity and gain were most severe in individuals with Progressive Supranuclear Palsy (PSP) but were also present in other tauopathies. Vertical and horizontal saccade velocity and gain were able to differentiate PSP cases from other patients. Vertical saccade velocity was strongly correlated with dorsal midbrain volume. Conclusion Decreased visually-guided saccade velocity and gain are suggestive of underlying tau pathology in FTD, with vertical saccade abnormalities most diagnostic of PSP.

Boxer, Adam L.; Garbutt, Siobhan; Seeley, William W.; Jafari, Aria; Heuer, Hilary W.; Mirsky, Jacob; Hellmuth, Joanna; Trojanowski, John Q.; Huang, Erik; DeArmond, Steven; Neuhaus, John; Miller, Bruce L.

2012-01-01

247

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

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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 carcinoma indicating PTTM shows a higher TF-positive rate than typical gastric carcinoma. However, it remains still obscuring whether gastric carcinoma indicating PTTM shows a higher VEGF or OPN-positive rate as determined by immunohistochemistry.

Shinozaki Minoru

2011-03-01

248

Leptospirose de evolução fulminante: um caso de autópsia Fulminant Leptospirosis: an autopsy case  

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Full Text Available A leptospirose é uma doença febril aguda septicêmica que afeta humanos e/ou animais com alta incidência mundial principalmente em países tropicais em desenvolvimento.É uma doença de ocorrência na zona rural e urbana com algumas características próprias ocupacionais ou recreativas. Os indivíduos mais acometidos na grande maioria das vezes são jovens ou adultos jovens. Aproximadamente 5% - 15% dospacientes apresentam a forma grave da doença conhecida como doença de Weill que pode se associar a síndrome da hemorragia pulmonar da leptospirose. Apresentamosum relato de autópsia de uma paciente octogenária, residente na zona urbana do município de São Paulo, internada no Hospital Universitário da Universidade de São Paulo, que apresentou quadro de evolução fulminante. A autópsia revelou comprometimento dos pulmões com hemorragia alveolar difusa e infiltração mononuclear dos septos alveolares. A histologia do fígado apresentava destrabeculação dos hepatócitos, alargamento dos sinusóides e hiperplasia das células de Kupfer. Necrose tubular aguda e nefrite intersticial caracterizaram a histologia dos rins. Leptospirosis is an acute febrile illness affecting humans and/or animals, with a high global incidence mainly in the tropical developing countries. Outbreaks are frequently related to rainy season, floods and the presence of reservoirs animals more commonly rodents and dogs. The disease occurs in the rural and urban areas linked to some occupational and recreational activities. The younger population is at higher risk of infection. Approximately 5% - 15% of the patients develop the severemanifestations of the disease known as Weill’s disease that can be associated with leptospirosis pulmonary hemorrhage syndrome. We present an autopsy case of an octogenarian patient, resident of the urban area of the city of São Paulo, admitted to the Hospital Universitário da Universidade de São Paulo, who presented a fulminant outcome. The autopsy revealed pulmonary involvement characterized by diffuse alveolar hemorrhage and interstitial mononuclear infiltration. The liver histology presented disorganization of the liver cell plates, congested sinusoids and Kupfer cells hyperplasia. Acute tubular necrosis and interstitial nephritis was the hallmark of kidneys involvment.

Fernando Peixoto Ferraz de Campos

2012-08-01

249

Limitations of cadaveric organ donation on judicial cases and problems confronted in autopsy: Istanbul data in comparative perspective.  

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Organ transplantation is one of the most important services of modern medicine to the humanity. In judicial death cases the interaction between judicial needs and transplantation needs is inevitable and both should be provided in a short time before the decomposition of the body. Thus, the description of this interaction and the algorithm which should be carried out to manage these cases are important. Aim of this study is to determine the problems confronted in forensic autopsies and to determine what to do for both judicial processes' and cadaveric organ donations' not becoming limited due to each other. With these aims, autopsy case archive of the Council of Forensic Medicine Istanbul Morgue Department was reviewed, between the years 2009 and 2011, to reveal the number of organ donors among autopsy cases and also to find out the judicial problems confronted during autopsies. Among 12,016 judicial death cases referred to Istanbul Morgue Department in 3 years, 35 cases were found to have undergone cadaveric solid organ harvesting procedure and 307 cases cornea-only harvesting procedure. Manner of deaths for organ donor cases were blunt trauma due to traffic accident in 20 cases, firearm injury in 3 cases, stabbing in 2 cases, suspicious criminal battery in 4 cases and fatal falls in 5 cases. Only 1 case was suspected to have died due to high dose insulin administration. Through the whole data presented in this study, it can be concluded that consulting with the Forensic Medicine Expert not only for the autopsies but also during the clinical process of a judicial case, who is a candidate to be an organ donor, is absolutely important. The early contribution of the Forensic Medicine Expert would provide help to plan both the judicial process and the transplantation process which needs urgent decisions. A Forensic Medicine Expert may be an organ harvest team member performing initial investigations on the cause of death and collecting some of the toxicological screening samples when needed. PMID:24581395

Arslan, M N; Esen Melez, I; Melez, D O; Cavlak, M; Gur, A

2014-04-01

250

An autopsy case of osteosarcoma of right mandibula developed after irradiation to the right cervical region for treatment of Hodgkin's disease  

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An autopsy case of osteosarcoma derived from the right mandible was reported. The case was a 64 year-old-female who received radiotherapy (60Co) for Hodgkin's disease in the right neck 15 years prior to the development of her osteosarcoma. By autopsy findings, large nodular growths in the right facial region and the lung metastases of the osteosarcoma were remarkable. No recurrence of Hodgkin's disease was revealed by autopsy. The authors considered that right mandibular osteosarcoma were suspected to be radiation-induced according to the long latent interval and the development of the sarcoma derived from the same location of the irradiation field. (author)

1989-01-01

251

CMV quantitative PCR in the diagnosis of CMV disease in patients with HIV-infection – a retrospective autopsy based study  

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Full Text Available Abstract Background Patients with advanced HIV infection at the time of diagnosis and patients not responding to antiretroviral therapy are at risk of cytomegalovirus (CMV disease. Earlier studies of patients with HIV infection have demonstrated that the diagnosis is often first made post-mortem. In recent years new molecular biological tests have become available for diagnosis of CMV disease. Although clinical evaluation of tests for diagnosis of CMV disease in HIV-infected individuals is suboptimal without autopsy, no results from such studies have been published. The aim of this study was to explore the diagnostic utility of CMV quantitative polymerase chain reaction (PCR in plasma from HIV and CMV seropositive patients who died during the period 1991–2002 and in whom autopsy was performed. Methods Autopsy was performed in all cases, as part of routine evaluation of HIV-infected cases followed at Ullevaal University Hospital. Of 125 patients included, 53 had CMV disease, 37 of whom were first diagnosed at autopsy. CMV disease was diagnosed either by ophthalmoscopic findings typical of CMV retinitis, biopsy or autopsy. One or two plasma samples taken prior to the first diagnosis of CMV disease (alive or at autopsy or death without CMV disease were analysed by CMV quantitative PCR. Sensitivity, specificity, positive and negative predictive values were calculated for different CMV viral load cut-offs and according to detection of viraemia in one versus two samples. Results Twenty-seven of 53 patients with CMV disease (51% and 10 of 72 patients without CMV disease (14% had detectable viraemia in at least one sample. Sensitivity and negative predictive value (NPV of the test, maximised with a cut-off at the test's limit of detection of CMV viraemia (400 copies/mL, were 47% and 70%, respectively. With cut-off at 10 000 copies/mL, specificity and positive predictive value (PPV were 100%. With a requirement for CMV viraemia in two samples, specificity and PPV were 100% in patients with CMV viraemia above the limit of detection. Conclusion Our results indicate that quantitative CMV PCR is best used to rule in, rather than to rule out CMV disease in HIV-infected individuals at high risk.

Goplen Anne K

2007-11-01

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Anatomopathological aspects of neurocysticercosis in autopsied patients Aspectos anatomopatológicos da neurocisticercose em pacientes autopsiados  

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Full Text Available The aim of this paper was to describe the occurrence and morphology of neurocysticercosis (NCC in autopsies. We revised 2218 autopsies performed at the School Hospital from Federal Unversity of Triangulo Mineiro, 1970-2003. Data referring to age, gender and color of patients were reported and NCC was microscopically and macroscopically analyzed. We found 53 (2.4% NCC cases. The mean age was 50 years old, 34 (64.1% individuals were male and 36 (67.9% white. Macroscopically, 17 cysticerci were analyzed. The most frequent location was meningocortical in 12 (70.6% cases. Microscopically, the cysticerci presented an ovoid shape, containing the larvae preserved in 4 (23.5% cases or in destruction degrees in 13 (76.5% cases. Therefore, in NCC was found several general pathologic processes (necrosis, interstitial deposits, fibrosis, gliosis, inflammation amongst which are highlighted beta-fibrillose in 13 (76.5% cases associated to inflammatory process in 16 (94.1% cases caused by the parasite, not yet related to NCC, and calcification present in viable and destruction parasites.O objetivo desse trabalho foi descrever ocorrência e morfologia da neurocisticercose (NCC autópsias. Revisou-se 2218 autópsias realizadas no Hospital Escola da Universidade Federal do Triângulo Mineiro (UFTM, 1970-2003. Registrou-se idade, gênero e cor dos pacientes, analisou-se macroscopia e microscopia da NCC. Encontrou-se 53 (2,4% casos de NCC. A média das idades foi 50 anos, sendo 34 (64,1% do sexo masculino e 36 (67,9% brancos, não havendo diferença significante na comparação da idade, gênero e cor dos pacientes. Analisou-se macroscopicamente 17 cisticercos. A localização mais comum foi a meningo-cortical em 12 (70,6% casos. Microscopicamente, os cisticercos apresentaram forma oval contendo a larva íntegra em 4 (23,5% casos ou em grau de destruição em 13 (76,5% casos. Portanto, na NCC foram verificados vários processos patológicos gerais (necrose, depósitos intersticiais, fibrose, gliose, inflamação destacando-se: beta-fibrilose em 13 (76,5% casos associada ao processo inflamatório em 16(94,1% casos causado pelo parasito, ainda não relatada na NCC, e calcificação presente no parasito viável e em destruição.

Ruy de Souza Lino-Junior

2007-03-01

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Anatomopathological aspects of neurocysticercosis in autopsied patients / Aspectos anatomopatológicos da neurocisticercose em pacientes autopsiados  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese O objetivo desse trabalho foi descrever ocorrência e morfologia da neurocisticercose (NCC) autópsias. Revisou-se 2218 autópsias realizadas no Hospital Escola da Universidade Federal do Triângulo Mineiro (UFTM), 1970-2003. Registrou-se idade, gênero e cor dos pacientes, analisou-se macroscopia e micr [...] oscopia da NCC. Encontrou-se 53 (2,4%) casos de NCC. A média das idades foi 50 anos, sendo 34 (64,1%) do sexo masculino e 36 (67,9%) brancos, não havendo diferença significante na comparação da idade, gênero e cor dos pacientes. Analisou-se macroscopicamente 17 cisticercos. A localização mais comum foi a meningo-cortical em 12 (70,6%) casos. Microscopicamente, os cisticercos apresentaram forma oval contendo a larva íntegra em 4 (23,5%) casos ou em grau de destruição em 13 (76,5%) casos. Portanto, na NCC foram verificados vários processos patológicos gerais (necrose, depósitos intersticiais, fibrose, gliose, inflamação) destacando-se: beta-fibrilose em 13 (76,5%) casos associada ao processo inflamatório em 16(94,1%) casos causado pelo parasito, ainda não relatada na NCC, e calcificação presente no parasito viável e em destruição. Abstract in english The aim of this paper was to describe the occurrence and morphology of neurocysticercosis (NCC) in autopsies. We revised 2218 autopsies performed at the School Hospital from Federal Unversity of Triangulo Mineiro, 1970-2003. Data referring to age, gender and color of patients were reported and NCC w [...] as microscopically and macroscopically analyzed. We found 53 (2.4%) NCC cases. The mean age was 50 years old, 34 (64.1%) individuals were male and 36 (67.9%) white. Macroscopically, 17 cysticerci were analyzed. The most frequent location was meningocortical in 12 (70.6%) cases. Microscopically, the cysticerci presented an ovoid shape, containing the larvae preserved in 4 (23.5%) cases or in destruction degrees in 13 (76.5%) cases. Therefore, in NCC was found several general pathologic processes (necrosis, interstitial deposits, fibrosis, gliosis, inflammation) amongst which are highlighted beta-fibrillose in 13 (76.5%) cases associated to inflammatory process in 16 (94.1%) cases caused by the parasite, not yet related to NCC, and calcification present in viable and destruction parasites.

Ruy de Souza, Lino-Junior; Ana Carolina Guimarães, Faleiros; Marina Clare, Vinaud; Flávia Aparecida de, Oliveira; Janaína Valadares, Guimarães; Marlene Antônia dos, Reis; Vicente de Paula Antunes, Teixeira.

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Morphological changes in aorto-coronary vein graft: The analysis of autopsy and biopsy material  

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Full Text Available Background. Patients with implanted aortic coronary grafts have different survival time, which raises the question why the efficacy of graft implants is so poor. The aim of this study was to present the results of the analysis of morphological changes in the vein grafts taken after the death of patients who died after surgery in different time intervals, as well to present the analysis of the grafts obtained after surgical reintervention. Methods. The total number of 656 grafts of 308 dead patients was analyzed, as well as 76 grafts from 40 patients who underwent surgical reintervention. According to the duration of the graft since surgical intervention until death, all the analyzed changes were divided into two groups: a early changes and complications, and b late changes and complications in aorto-coronary vein grafts. Results. After the autopsy, 518 vein grafts from the first group were evaluated histopathologically. Changes were found in the form of small or large areas with peeled endothelium in 266 grafts, with the insudation of fibrin and thrombocytes in such places, subendothelial edema, and occlusive thrombosis of the graft lumen. Significant stenosis, which occurred distally from the anastomoses, was present in 118 grafts without changes in the walls of the graft, and there was significant narrowing of the graft lumen in 134 vein grafts due to intimal hyperplasia. In the second group, 138 grafts were histopathologically analyzed after autopsy. Significant hyperplasia was present in 117 grafts with the migration of smooth muscle cells from media into intima, and in 21 grafts there were atheromatous plaques. In 120 veins analyzed before the graft implantation, the lesion or the lack of endothelium was found, as well as the penetration of fibrin and blood elements and intimal hyperplasia. In 46 veins analyzed before the graft implantation, significant intimal hyperplasia with the elevated number of smooth muscle cells was found. Conclusion. The most frequent lesions in the grafts were the lesions of the endothelium, which caused thrombosis formation and lumen occlusion. Intimal hyperplasia in patients with longer survival time occurred due to the migration of smooth muscle cells from the media, or due to the formation of atherosclerotic plaques, which caused graft lumen stenosis or thrombosis.

Tati? Vujadin

2004-01-01

255

Stillbirths and newborn deaths in slum settlements in Mumbai, India: a prospective verbal autopsy study  

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Full Text Available Abstract Background Three million babies are stillborn each year and 3.6 million die in the first month of life. In India, early neonatal deaths make up four-fifths of neonatal deaths and infant mortality three-quarters of under-five mortality. Information is scarce on cause-specific perinatal and neonatal mortality in urban settings in low-income countries. We conducted verbal autopsies for stillbirths and neonatal deaths in Mumbai slum settlements. Our objectives were to classify deaths according to international cause-specific criteria and to identify major causes of delay in seeking and receiving health care for maternal and newborn health problems. Methods Over two years, 2005–2007, births and newborn deaths in 48 slum areas were identified prospectively by local informants. Verbal autopsies were collected by trained field researchers, cause of death was classified by clinicians, and family narratives were analysed to investigate delays on the pathway to mortality. Results Of 105 stillbirths, 65 were fresh (62% and obstetric complications dominated the cause classification. Of 116 neonatal deaths, 87 were early and the major causes were intrapartum-related (28%, prematurity (23%, and severe infection (22%. Bereavement was associated with socioeconomic quintile, previous stillbirth, and number of antenatal care visits. We identified 201 individual delays in 121/187 birth narratives (65%. Overall, delays in receiving care after arrival at a health facility dominated and were mostly the result of referral from one institution to another. Most delays in seeking care were attributed to a failure to recognise symptoms of complications or their severity. Conclusions In Mumbai’s slum settlements, early neonatal deaths made up 75% of neonatal deaths and intrapartum-related complications were the greatest cause of mortality. Delays were identified in two-thirds of narratives, were predominantly related to the provision of care, and were often attributable to referrals between health providers. There is a need for clear protocols for care and transfer at each level of the health system, and an emphasis on rapid identification of problems and communication between health facilities. Trial registration ISRCTN96256793

Bapat Ujwala

2012-05-01

256

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

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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)

1978-01-01

257

Histopathologic Abnormalities of the Sinus Node Compared with Electrocardiographic Evidence of Sinus Node Dysfunction after the Modified Fontan Operation: An Autopsy Study of 14 Cases  

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Autopsy specimens from 14 patients who had undergone a modified Fontan operation were evaluated to correlate the extent of histopathologic disruption of the sinus node with electrocardiographic findings of sinus node dysfunction.

Chan, David P.; Bartmus, Dietmar A.; Edwards, William D.; Porter, Co-burn J.

1992-01-01

258

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

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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.

Theilade, J; Winkel, B G

2010-01-01

259

[Porencephalia vera in autopsy specimens from the Department of Pathological Anatomy, Medical Academy, in Bia?ystok 1976-1985].  

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Morphological and statistical analysis of true porencephaly based on 2793 autopsies of children aged up to 18 years showed 12 cases of porencephaly, accounting for 0.43% of the autopsy material, and 5.2% of all anomalies of the central nervous system in this age group. The greatest number of porencephaly cases (6) was in the age group 3-18 years. The anomaly was twice as frequent in boys (8 cases) than girls (4 cases). Nine cases of porencephaly showed coexistence of other developmental anomalies (75%) mainly with those of central nervous system, especially microecephaly, congenital hydrocephalus, which could indicate a genetic determination of the anomaly. The most frequent associated neurological singn in porencephaly was psychomotor underdevelopment. PMID:3226475

Sobaniec-Lotowska, M; Sobaniec, W; Ostapiuk, H

1988-01-01

260

Systemic accumulation of undigested lysosomal metabolites in an autopsy case of mucolipidosis type II; autophagic dysfunction in cardiomyocyte.  

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Mucolipidosis type II is an autosomal recessive lysosomal storage disease caused by N-acetylglucosamine-1-phosphotransferese deficiency. We report here pathological findings of an autopsy case of mucolipidosis type II. The patient was an 8-year-old boy with mucolipidosis type II and was complicated with hypertrophic cardiomyopathy. He suddenly developed progressive respiratory failure and finally died. At autopsy, systemic accumulation of undigested lysosomal metabolites was prominent, particularly in the heart, lungs, and dorsal root ganglion. In cardiomyocyte, LC3, an autophagy marker, was positive in the cytoplasm. Ubiquitin, p62, K48 polyubiquitin, and K63 polyubiquitin were also positive in the cytoplasm. Our findings suggest that autophagic dysfunction might be associated with the cardiomyopahty of mucolipidosis type II. PMID:24857410

Sato, Yohei; Kobayashi, Hiroshi; Sato, Shun; Shimada, Yohta; Fukuda, Takahiro; Eto, Yoshikatsu; Ohashi, Toya; Ida, Hiroyuki

2014-07-01

 
 
 
 
261

Autopsy Findings of Brainstem in Head Trauma in Comparison with CT Scan Findings in Brain Trauma Ward in Tabriz, Iran  

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Full Text Available Computed tomography (CT is now the primary diagnostic method for head trauma because of its ability to demonstrate the nature, extent, sites, and multiplicity of brain injuries. Although there have been numerous reports on the CT findings of most types of intracranial injury, the findings in brainstem injury have not been well described. This study aimed at comparing the autopsy findings of brainstem in head trauma in comparison with CT scan results. Two hundred patients with head trauma, who expired after a period of time of hospitalization, were assessed in a diagnostic value study. Brain stem involvement was determined by autopsy as well as CT scanning of the brain during their hospitalization. The results of the two methods were compared with each other, emphasizing on the type and location of probable lesions in the brain stem. Considering the autopsy as the method of the choice, sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV of CT scan in brain stem lesions of patients with head trauma were calculated. The effect of primary cause of head trauma, survival time and Glasgow Coma Scale (GCS were evaluated, as well. Brain stem lesions were detected in 39 (19.5% patients in autopsy. However, CT scan revealed brain stem lesions in 23(11.5% cases. The sensitivity, specificity, PPV and NPV of CT scan was 59%, 100%, 100% and 91% respectively. The most common lesions of the brain stem region were as contusion of pons (8.5%, medulla (5% and midbrain (4.5%. There were 6 (3% cases of ponto-medullary junction tearing and 1 (0.5% case of cervico-medullary junction tearing. CT scan is a specific method of evaluating patients with probable brain stem injuries after head trauma, but low sensitivity limits its efficacy. Our results are in conformity with the reports in the literature.

Shakeri Bavil Moslem

2009-10-01

262

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

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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...

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

1987-01-01

263

Leptomeningeal carcinomatosis as initial presentation in adenocarcinoma of lung with signet ring cell features: an autopsy case report  

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Signet ring cell (SRC) features are rare but well-recognized cytological changes of pulmonary adenocarcinoma (PA). PA with SRC features (PA-SRC) is frequently associated with anaplastic lymphoma kinase (ALK) gene rearrangement, and recognition of PA-SRC may be important for the administration of targeted treatment. To the authors’ knowledge, leptomeningeal carcinomatosis (LMC) as an initial presentation of PA-SRC has not yet been reported. We report an autopsy case from a 59-year-old female...

Choi, Eunice; Lewis, Annisa L.; Takei, Hidehiro; Ro, Jae Y.

2012-01-01

264

A dynamic magnetic shift method to increase nanoparticle concentration in cancer metastases: a feasibility study using simulations on autopsy specimens  

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A nanoparticle delivery system termed dynamic magnetic shift (DMS) has the potential to more effectively treat metastatic cancer by equilibrating therapeutic magnetic nanoparticles throughout tumors. To evaluate the feasibility of DMS, histological liver sections from autopsy cases of women who died from breast neoplasms were studied to measure vessel number, size, and spatial distribution in both metastatic tumors and normal tissue. Consistent with prior studies, normal tissue had a higher v...

Nacev, Alek; Kim, Skye H.; Rodriguez-canales, Jaime; Tangrea, Michael A.; Shapiro, Benjamin; Emmert-buck, Michael R.

2011-01-01

265

The prevalence of opportunistic infections and malignancies in autopsied patients with human immunodeficiency virus infection in Japan  

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Background Opportunistic infections and malignancies such as malignant lymphoma and Kaposi sarcoma are significant complications of human immunodeficiency virus (HIV) infection. However, following the introduction of antiretroviral therapy in Japan in 1997, the incidence of clinical complications has decreased. In the present study, autopsy cases of HIV infection in Japan were retrospectively investigated to reveal the prevalence of opportunistic infections and malignancies. Methods A total of 225 autopsy cases of HIV infection identified at 4 Japanese hospitals from 1985–2012 were retrospectively reviewed. Clinical data were collected from patient medical records. Results Mean CD4 counts of patients were 77.0 cells/?L in patients who received any antiretroviral therapy during their lives (ART (+) patients) and 39.6 cells/?L in naïve patients (ART (?) patients). Cytomegalovirus infection (142 cases, 63.1%) and pneumocystis pneumonia (66 cases, 29.3%) were the most frequent opportunistic infections, and their prevalence was significantly lower in ART (+) patients than ART (?) patients. Non-Hodgkin lymphoma and Kaposi sarcoma were observed in 30.1% and 16.2% of ART (?) patients, and 37.9% and 15.2% of ART (+) patients, respectively. Malignant lymphoma was the most frequent cause of death, followed by cytomegalovirus infection regardless of ART. Non-acquired immunodeficiency syndrome (AIDS)-defining cancers such as liver and lung cancer caused death more frequently in ART (+) patients (9.1%) than in ART (?) patients (1.5%; P?=?0.026). Conclusions The prevalence of infectious diseases and malignancies were revealed in autopsy cases of HIV infection in Japan. The prevalence of cytomegalovirus infection and pneumocystis pneumonia at autopsy were lower in ART (+) patients than ART (?) patients. Higher prevalence of non-AIDS defining malignancies among ART (+) patients than ART (?) patients suggests that onsets of various opportunistic infections and malignancies should be carefully monitored regardless of whether the patient is receiving ART.

2014-01-01

266

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

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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 haemo...

Papadopoulos Iordanis N; Kanakaris Nikolaos K; Bonovas Stefanos; Konstantoudakis George; Petropoulou Konstantina; Christodoulou Spyridon; Kotsilianou Olympia; Leukidis Christos

2011-01-01

267

Diffuse large B-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms  

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A 78-year-old Japanese male noticed a difficulty in the beginning of standing up, followed by 7a progressive numbness of extremities with pain, Bell’s palsy, dysarthria, and difficulty in swallowing. A clinician had suspected cancer of unknown primary origin, accompanied by the diverse and elusive neurological symptoms, likely presenting as painful mononeuropathy simplex and cranial neuropathy. He developed dysbasia over weeks and died 1?month after the symptom onset. At autopsy, an ill-d...

Yamada, Sohsuke; Tanimoto, Akihide; Nabeshima, Atsunori; Tasaki, Takashi; Wang, Ke-yong; Kitada, Shohei; Noguchi, Hirotsugu; Sasaguri, Yasuyuki

2012-01-01

268

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

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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...

1984-01-01

269

Autopsy-proven causes of death in lungs of patients immunocompromised by secondary interstitial pneumonia Causas de óbito por pneumonia intersticial secundária em autópsias pulmonares de pacientes imunocomprometidos  

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PURPOSE: To present the more frequent associations found in autopsies of immunocompromised patients who developed secondary interstitial pneumonia as well as the risk of death (odds ratio) in having specific secondary interstitial pneumonia according to the cause of immunocompromise. METHOD: From January 1994 to March 2004, 17,000 autopsies were performed at Hospital das Clínicas, São Paulo University Medical School. After examining the pathology report review, we selected 558 of these auto...

Alberto Antonio Terrabuio Junior; Edwin Roger Parra; Cecília Farhat; Vera Luiza Capelozzi

2007-01-01

270

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

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This 4th edition of Handbook of Autopsy Practice is a thoroughly updated version. Autopsy practice has undergone significant changes in recent time due to technological advancements such as molecular diagnostics, immunohistochemisty and the introduction of post-mortem imaging techniques. In the 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 for the family of the deceased and a quality assurance worksheet. The text is written in a well-formulated language, and is not too long. The illustrations and photos are of a high quality. All photos are black-and-white. The book covers a broad area of relevance to autopsy practice, including 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 as post-mortem imaging techniques. Part II begins with a list of special histologic stains, but the bulk is devoted to an alphabetic listing of major diseases with possible or expected findings and recommended procedures. This part has also been updated with new diseases and recent references. Part 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.

Leth, Peter Mygind

2010-01-01

271

Ostium secundum atrial septal defect-related post-partum death of an adult: An autopsy case  

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Full Text Available Atrial Septal Defect (ASD is the most common type ofcongenital heart disease in adolescents and adults with afrequency of 10-15 %. Ostium secundum type ASD has amultifactorial heredity pattern and is almost always sporadic.Herein, we presented a maternal mortality case of ASDthat died after nine days after delivery. She applied to thehospital three times with non-specific symptoms but diedwithout an accurate diagnosis. At autopsy, there was evidenceof episiotomy in recent delivery in genital region.The weight of the heart was 380 grams, hypertrophy ofpapillary muscles and an ostium secundum type ASDwith 1,6 x 1,1 cm dimensions were detected. Microscopicexamination of heart sections revealed hypertrophy, hyperemia,and focal, minimal colliquative myocytolysis.Electrocardiogram findings and autopsy findings wereevaluated together and in conclusion, our opinion on thecause of death was circulatory disturbance resulting fromchronic heart disease.Because of this, congenital heart disease which is a rarepathology and a cause of death in adult population, wepresented the findings of this case.Key words: Congenital heart disease, atrial septal defect,ostium secundum, maternal mortality, autopsy.

Eyyüp Y?lmaz

2012-09-01

272

Truncus arteriosus communis in a midtrimester fetus: Comparison of prenatal ultrasound and MRI with postmortem MRI and autopsy  

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Different techniques are used in fetal cardiology, and their accuracy has been demonstrated on several occasions. Color Doppler US has proved to be a reliable and valuable tool in the diagnosis of fetal cardiac abnormalities. Magnetic resonance imaging (MRI) of the fetal heart has, so far, played no role in prenatal diagnostics. We report on a truncus arteriosus communis diagnosed prenatally during a screening ultrasound at 22 weeks of gestation. In addition to real-time ultrasound and color Doppler echocardiography, fetal MRI was performed. Fetal echocardiography arose suspicion of a type I common trunk. Fetal MR showed solely a widened vessel coursing retrocardially and additionally an inhomogeneous fluid distribution of the lung not shown on prenatal US. After termination of pregnancy at 23 weeks of gestation, MR fetography and autopsy were performed, and both found a type II common trunk. MR autopsy of the heart was very reliable in this case and could be an alternative when fetal pathology is not available for different reasons. Postmortem MRI was also able to demonstrate the inhomogeneous fluid distribution in the lung, which was confirmed by autopsy. Fetal and postmortem MR was reliable in the detection of an inhomogeneous fluid distribution in the lung not shown on prenatal US, providing a relevant additional finding to US. Therefore, MRI should be used more often in fetal cardiology, although it still must be further developed. (orig.)

2004-11-01

273

Trends in the prevalence of invasive fungal infections from an analysis of annual records of autopsy cases of Toho University.  

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Clinical diagnosis of invasive fungal infections (IFIs) is sometimes difficult, and obtaining an accurate assessment of trends concerning the prevalence of IFIs is a challenge. The aim of this study was to determine trends in the prevalence of IFIs from an autopsy survey. The retrospective review of autopsy records stored in Toho University was performed on all documented cases with fungal infection from 1955 to 2006. A total of 411 cases of IFIs were detected among 10 297 autopsies. The prevalence of candidiasis decreased from 3.6% (1981-93) to 2.0% (1994-2006), and that of aspergillosis increased throughout the 52-year period and reached 2.0% (1994-2006). The prevalence of IFIs in the patient group comprising haematological disorders was significantly higher (19.9%) than in other patient groups (2.9%), of which the odds ratio was 18.4 for mucormycosis and 10.0 for aspergillosis. The lung was the most common organ involved irrespective of major fungal species, and most cases with candidiasis showed multiple-organ infection. Results confirmed the increasing prevalence of aspergillosis and high risk of IFIs in the patient group with haematological disorders. IFIs were also detected in an immunocompromised state caused not only by primary disease but also by treatment with anti-tumour drugs and corticosteroids. PMID:22320199

Shimodaira, Kayoko; Okubo, Yoichiro; Nakayama, Haruo; Wakayama, Megumi; Shinozaki, Minoru; Ishiwatari, Takao; Sasai, Daisuke; Nemoto, Tetsuo; Takahashi, Kei; Ishii, Toshiharu; Saji, Tsutomu; Shibuya, Kazutoshi

2012-09-01

274

The effect of ionizing radiation on epidermal Langerhans cells; A quantitative analysis of autopsy cases with radiation therapy  

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Langerhans cells (LCs) are dendritic cells located in the epiderm with antigen-presenting capacities. We performed a quantitative analysis of LC density in the anterior chest skin of 286 autopsy cases, including 31 cases treated with radiation therapy. Skin specimens were stained by immunoperoxidase technique (PAP method) with an anti-S-100 protein antiserum. S-100 positive LCs were counted for comparison between non-irradiated and irradiated cases. In this study we noted the followings: (1) The decline in density of the LCs was age-related and dendritic processes were more prominent in younger groups; (2) The cases irradiated within one month before autopsy showed a reduction in LC density compared with age-matched controls; (3) The cases irradiated more than one month before autopsy demonstrated no consistent or definite tendency. It is suggested that ionizing irradiation as well as ultraviolet light may deplete the LC density in an acute phase. The possibility that radiation therapy alters immunological surveillance in the human skin is discussed. (author).

Kawase, Yoshihisa; Naito, Shinji; Ito, Masahiro; Sekine, Ichiro (Nagasaki Univ. (Japan). School of Medicine); Fujii, Hideharu

1990-09-01

275

Corroboration of in utero MRI using post-mortem MRI and autopsy in foetuses with CNS abnormalities  

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AIMS: To corroborate the findings of in utero magnetic resonance imaging (MRI) with autopsy and post-mortem MRI in cases of known or suspected central nervous system (CNS) abnormalities on ultrasound and to compare the diagnostic accuracy of ante-natal ultrasound and in utero MRI. METHODS: Twelve pregnant women, whose foetuses had suspected central nervous system abnormalities underwent in utero MRI. The foetuses were imaged using MRi before autopsy. The data were used to evaluate the diagnostic accuracy of in utero MRI when compared with a reference standard of autopsy and post-mortem MRI in 10 cases and post-mortem MRI alone in two cases. RESULTS: The diagnostic accuracy of antenatal ultrasound and in utero MRI in correctly characterizing brain and spine abnormalities were 42 and 100%, respectively. CONCLUSION: In utero MRI provides a useful adjuvant to antenatal ultrasound when assessing CNS abnormalities by providing more accurate anatomical information. Post-mortem MRI assists the diagnosis of macroscopic structural abnormalities.

Whitby, E.H. E-mail: e.whitby@sheffield.ac.uk; Variend, S.; Rutter, S.; Paley, M.N.J.; Wilkinson, I.D.; Davies, N.P.; Sparey, C.; Griffiths, P.D

2004-12-01

276

Non-atherosclerotic aorto-arterial thrombosis: A study of 30 cases at autopsy.  

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Full Text Available BACKGROUND: Aorto-arterial thrombosis is very often associated with atherosclerotic and/or aneurysmal changes. Thrombosis, unrelated to these changes is infrequent. AIMS: To evaluate the clinical presentation and aetiopathogenesis of aorto-arterial thrombosis, unrelated to atherosclerosis and aneurysms. SUBJECTS AND METHODS: A retrospective study of 30 autopsied cases of non-atherosclerotic and non-aneurysmal aorto-arterial thrombosis collected over a period of 14 years was carried out. RESULTS: There were 23 males and seven females and majority presented in the third to fourth decades of life with clinical features of acute abdomen or lower limb gangrene. Abdominal aorta as the site of thrombosis was observed in 46.5% cases. The causes were attributed to hypercoagulable states and changes in the aortic wall. No aetiology could be identified in 5 patients (16.6%. Associated tuberculosis was seen in six cases. CONCLUSIONS: Non-atherosclerotic aortic thrombosis is a heterogeneous group of disorders. Young and even elderly patients with symptoms related to abdominal ischaemia or peripheral vascular disease should be investigated thoroughly for hypercoagulable states and aortic pathology.

Vaideeswar P

2001-01-01

277

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

DEFF Research Database (Denmark)

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 demonstrated. Diffuse myocardial fibrosis was seen in 40 of 60 cases (67%) and is considered to be partly due to repair after myocyte necrosis/myocarditis. A myocardium thus weakened might not be able to meet an increase in functional demand, and in 15 of the 39 cases (38%) where an examination of the whole 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 this study indicate that the prevalence of especially right-sided heart failure will increase.

Hansen, B F

1992-01-01

278

LA AUTOPSIA PSICOLÓGICA COMO INSTRUMENTO DE INVESTIGACIÓN PSYCHOLOGYCAL AUTOPSY AS AN INVESTIGATION TOOL  

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Full Text Available Se define el concepto de autopsia psicológica desde su origen en los años cincuenta en California cuando empezó a utilizarse buscando un acercamiento a la comprensión de las circunstancias que rodearon la muerte de un individuo, investigando retrospectivamente sus características de personalidad y las condiciones que tuvo en vida. Se establecen las características del método y su utilidad en psiquiatría clínica y en psiquiatría forense, siendo relevante su aplicación en psiquiatría forense, siendo relevante su aplicaci ón potencial en el diseño de políticas de promoción de la salud y prevención de suicidio, homicidio o accidentes. Finalmente se resumen algunos resultados obtenidos mediante su aplicación en el Instituto Nacional de Medicina Legal y Ciencias Forenses de Colombia.From its origins in California, in the fifties, the concept of psychological autopsy is defined. Understand of circunstances around the death of an individual, along with the study of his or her distinctive personality traits and life condition constitute its aim. Method characteristics and its usefulness in clinical forensic psychiatry, and accidents programs in suicide, homicide and accidents are established. Finally, some results in the National Institute of Legal Medicine and Forensic of Colombia are here presented.

IVÁN ALBERTO JIMÉNEZ ROJAS

2001-09-01

279

An autopsy case of clear cell adenocarcinoma of the urinary bladder.  

Science.gov (United States)

Clear cell adenocarcinoma of the urinary bladder is rare. A 73-year-old woman presented with chronic renal and cardiac failure. Blood tests showed elevated carcinoembryonic antigen and CA19-9 levels. Imaging techniques showed bilateral hydronephrosis and hydroureter. Cystoscopy showed a bladder tumor, and the biopsy showed malignant cells. The patient died 4 months later. Autopsy showed an elevated tumor of the bladder. Metastases to the liver, lungs, adrenal glands, spleen and bones were observed. The kidney showed chronic active pyelonephritis with hydronephrosis. The cause of death was chronic renal and cardiac failure and/or carcinomatosis. Histologically, the bladder tumor consisted of malignant clear cells arranged in solid nests and tubules. Histochemical stains for glycogen and mucins were negative. Metastases also showed similar histology. Immunohistochemically, the tumor cells were positive for carcinoembryonic antigen, CA19-9, CA125, CD10, pancytokeratins (AE1/3, CAM5.2), cytokeratin (CK) 34?E12, CK7, CK8, CK18, CK19, EMA, MUC1, p53, and Ki-67 (labeling=40%). They were negative for CK5/6, CK14, CK20, estrogen receptor, progesterone receptor, ?-methylacyl-CoA-racemase, p63, CDX2, MUC2, MUC5AC, MUC6, CD45, CD34, vimentin, neuron-specific enolase, S100 protein, desmin, HMB45, AFP, ?-smooth muscle actin, MDM2, HER2/neu, synaptophysin, and CD56. Metastases showed the same immunohistochemical findings. PMID:22024991

Terada, Tadashi

2013-07-01

280

[An autopsied case of giant cell myocarditis and myositis associated with invasive thymoma].  

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A 75-year-old man was given a diagnosis of invasive thymoma (WHO type B3, stage IVa) in 2004. He received 8 cycles of chemotherapy with doxorubicin, vincristin, cyclophosphamide and cisplatin from November 2004 to May 2005, combined thoracic radiotherapy (total dosage 60 Gy) in April 2006, and 2 cycles of chemotherapy with carboplatin and paclitaxel from July 2008 to August 2008. He was readmitted to our hospital complaining of fever and neck pain in September 2008. Laboratory data on admission revealed elevated serum levels of CRP, GOT, GPT, LDH, CK, and troponin-I with hypo gamma-globulinemia. Although he received immunoglobulin and antibiotic therapy, he suddenly died of cardiac shock on the 9th hospital day. On postmortem examination of the myocardium, the skeletal muscles of the neck and iliopsoas muscle showed inflammatory cell infiltration containing multinucleated giant cells with degeneration and necrosis of the muscle tissues. These findings were consistent with giant cell myocarditis with polymyositis. Autopsy findings suggested that sudden death was caused by giant cell myocarditis, probably associated with invasive thymoma. PMID:20608087

Isobe, Kazutoshi; Gocho, Kyoko; Kaburaki, Kyohei; Sugino, Keishi; Akasaka, Yoshikiyo; Homma, Sakae

2010-06-01

 
 
 
 
281

Polymorphism of SERPINE2 gene is associated with pulmonary emphysema in consecutive autopsy cases  

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Full Text Available Abstract Background The SERPINA1, SERPINA3, and SERPINE2 genes, which encode antiproteases, have been proposed to be susceptible genes for of chronic obstructive pulmonary disease (COPD and related phenotypes. Whether they are associated with emphysema is not known. Methods Twelve previously reported single nucleotide polymorphisms (SNPs in SERPINA1 (rs8004738, rs17751769, rs709932, rs11832, rs1303, rs28929474, and rs17580, SERPINA3 (rs4934, rs17473, and rs1800463, and SERPINE2 (rs840088 and rs975278 were genotyped in samples obtained from 1,335 consecutive autopsies of elderly Japanese people. The association between these SNPs and the severity of emphysema, as assessed using macroscopic scores, was determined. Results Emphysema of more than moderate degree was detected in 189 subjects (14.1% and showed a significant gender difference (males, 20.5% and females, 7.0%; p SERPINE2 gene was positively associated with emphysema. Unlike the major alleles, homozygous minor alleles of rs975278 were associated with emphysema (odds ratio (OR = 1.54; 95% confidence interval (CI = 1.02-2.30; p = 0.037 and the association was very prominent in smokers (OR = 2.02; 95% CI = 1.29-3.15; p = 0.002. Conclusions SERPINE2 may be a risk factor for the development of emphysema and its association with emphysema may be stronger in smokers.

Kida Kozui

2010-11-01

282

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

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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

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

1991-06-01

283

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

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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)

2007-07-01

284

Analysis of the scalp of women with AIDS subjected to autopsy: epithelial, follicular, and immunologic aspects.  

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Hair keeps the scalp warmer and slightly moister than the rest of the skin, which contributes to a favorable environment for mycotic, bacterial, and parasitic infections. It is well established that AIDS makes the patient more susceptible to opportunistic infections and cutaneous manifestations. Because of this, the aim of this study was to analyze scalp fragments of autopsied women with AIDS. Twenty-eight scalp samples of women aged between 18 and 46 years were observed. These women were divided into 2 groups: with AIDS (n = 14) and without AIDS (n = 14). We conducted histochemical (hematoxylin-eosin, Picrosirius, and Verhoeff), morphometric (Image J; National Institutes of Health, Hamilton, ON, Canada and KS-300 Kontron-Zeiss; Kontron Elektronik, Carl-Zeiss, Germany), and immunohistochemical (S-100) analyses of the scalp. In patients with AIDS, epithelial thickness, number of epithelial cell layers, number of immature Langerhans cells in the epidermis, and percentages of elastic fibers in the dermis were significantly lower, whereas telogen hair follicles were significantly higher. The percentage of collagen fibers in the dermis and the diameter of the epithelial cells were smaller in patients with AIDS, without significant difference. AIDS possibly causes immunologic and morphologic alterations in the scalp. This study may establish parameters for better clinical and morphologic diagnostic in patients with AIDS. PMID:22921727

Faria, Humberto Aparecido; Farnese, Mauricio; Rocha, Laura Penna; Olegário, Janaínna Grazielle Pacheco; Cavellani, Camila Lourencini; de Oliveira Guimarães, Camila Souza; dos Reis, Marlene Antônia; Miranda Corrêa, Rosana Rosa

2013-02-01

285

Transjugular Intrahepatic Portosystemic Shunt: Histologic and Immunohistochemical Study of Autopsy Cases  

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Purpose: To assess the histologic findings associated with stenosed and occluded transjugular intrahepatic portosystemic shunt (TIPS) tracts. Methods: Four TIPS tracts within three autopsy livers were histologically studied for vascular components by routine staining and immunohistochemical staining. TIPS had been performed for bleeding from esophageal varices in patients with cirrhosis of the liver. Results: Two TIPS, examined on days 4 and 53, showed occlusion by fibrin thrombus. In the former, no endothelial cells were detected, but coagulative necrosis of hepatocytes was found in the surrounding liver. In the latter, bile pigments were seen on the luminal surface. In the two other TIPS without tract occlusion, examined on days 49 and 293, a layer of endothelial cells, proliferation of smooth muscle cells, and deposition of an extracellular matrix such as collagen were confirmed. In the tract examined on day 293, there was protrusion of hepatocytes into the lumen through the stent wires. Conclusion: Short- and midterm TIPS occlusions were caused by thrombus forming after necrosis of hepatocytes and bile leakage, respectively. Long-term TIPS stenosis was associated with a combination of pseudointimal hyperplasia and ingrowth of hepatocytes

1997-11-01

286

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

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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)

287

Intramuscular metastatic squamous cell carcinoma of the cervix: autopsy case report  

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Full Text Available Cancer of the uterine cervix is the fourth leading cause of death in women in Brazil, accounting for 4800 fatal cases per year. The histology of this neoplasia is mainly represented by squamous cell carcinoma (80-85%, adenocarcinomas (10-15%, and, more rarely, mixed carcinomas. The Papanicolaou (Pap smear test is the method of excellence in detecting incipient or pre-malignant lesions. Since its implementation, the Pap test has been reducing the incidence of this neoplasia worldwide, despite its lack of high sensitivity and specificity. Both incidence and mortality from cervical cancer have sharply decreased following the introduction of well-run screening programs. The cervical cancer typically spreads to adjacent structures by contiguity; pelvic and para-aortic lymph nodes are involved by lymphatic dissemination. Less frequently, hematogenic spread is observed, and when it occurs, the brain, breast, and skeletal muscle are rarely involved. The authors report a case of a young woman who underwent periodical gynecological examination with negative Pap tests and presented to the hospital with an advanced cervical metastatic disease involving thyroid, muscles, lymph nodes, and breast (among others sites. The diagnosis of the primary site was not elucidated during life. The patient died, and at autopsy an endophytic squamous cell carcinoma of the cervix was diagnosed.

Cristiane Rúbia Ferreira

2012-12-01

288

Cardiac arrhythmia and death of teenager linked to rare genetic disorder diagnosed at autopsy.  

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A 17-year-old male adolescent sustained cardiac arrest after participating in a wrestling match, where he was thrown down. He had no pulse, and cardiopulmonary resuscitation was immediately initiated along with application of an automatic external defibrillator. Upon arrival of emergency medical services, an electrocardiogram showed the patient to be in ventricular tachycardia, torsades, and ventricular fibrillation. The patient was ultimately transported to the hospital and, with ACLS protocol being performed, was resuscitated to a junctional rhythm with bradycardia and borderline prolonged QT. His hospital stay was characterized by refractory cardiac failure, and 2 days after the incident, a decision was made to remove him from life support. At autopsy, there were no external or internal injuries that could be considered a contributing cause of death. On external examination, observations were made about the decedent's facial features including his nose, eyes, ears, fingers, and toes. A careful review of the decedent's medical history was initiated to reveal birth defects including syndactyly of the third and fourth digit of the upper extremity as well as complete lack of dental enamel. A tentative diagnosis of oculodentodigital dysplasia was made and confirmed by genetic testing of heart muscle taken from the decedent. This case report examines the rare association of oculodentodigital dysplasia with cardiac arrhythmia as well as places emphasis on the features of the disorder that can aid in its diagnosis. PMID:24781393

Quick, Jennifer Sue; Dobersen, Michael

2014-06-01

289

Histopathological and cytological examination of autopsy cases with multiple organ dysfunction syndromes.  

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To evaluate the role of small scavenger receptor A (SRA)-positive (SRA(+)) cells and large SRA(+) cells in the peripheral blood (PB) in the pathophysiological mechanisms underlying multiple organ dysfunction syndromes (MODS), 24 autopsy cases with MODS were examined. In addition to histopathological and immunohistochemical examination, cytokine levels of cardiac blood, the SRA index (number of small SRA(+) cells in 10 high power fields, upper limit <30), and appearance of large SRA(+) cells in PB were examined. The SRA index exceeded 30 in all cases. Large SRA(+) cells and tumor necrosis factor (TNF)-alpha(+) cells were detected in PB in all cases. Macrophage colony stimulating factor (M-CSF), interleukin (IL)-6 and IL-8 levels exceeded the normal level in all cases, and 18 and 15 cases had TNF-alpha and IL-1beta levels above the normal threshold, respectively. Lung injury and necrosis of cardiac myocyte were observed in all cases. Neutrophils and platelets accumulated in the capillaries of injured organs and endothelial cells were extensively injured. From these results, large SRA(+) cells differentiated from monocytes in PB were considered to play an important role in the development of MODS, and necrosis of cardiac myocytes together with lung injury might be the leading cause of death in MODS patients. PMID:20518899

Emura, Iwao; Usuda, Hiroyuki

2010-06-01

290

Histological analysis of esophageal muscular layers from 27 autopsy cases with mixed connective tissue disease (MCTD).  

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Esophageal symptoms in mixed connective tissue disease (MCTD) have been investigated radiologically. We investigated the esophageal lesions in MCTD histopathologically, and analyzed relationships between these lesions and autoantibodies extracted from the serum of MCTD patients. Esophageal tissues from 27 MCTD patients submitted to autopsy were examined. We compared histopathological features of the esophagus in different wall layers from the mucosa, submucosa, and muscular layer to the adventitia, and in the upper, middle, and lower portions of esophagus. The most striking change observed was severe atrophy and occasional loss of smooth muscle cells in the muscular layer, followed by fibrosis. These muscular changes were particularly prominent in the inner layer of the lower esophagus. Immunohistochemically, degenerated muscular tissues of the esophagus were positive for anti-IgG and anti-C3 antibodies, but not for anti-IgM antibodies. IgG fractions extracted from three MCTD patients were immunohistochemically used to examine whether some antibodies in MCTD patients showed reactivity for esophageal components. The IgG fractions isolated from MCTD patients reacted with smooth muscle from non-connective tissue disease cases, suggesting that some serum antibodies may trigger esophageal changes. These findings suggest that esophageal lesions associated with clinical dysphagia in MCTD may be related to autoantibodies. PMID:21620578

Uzuki, Miwa; Kamataki, Akihisa; Watanabe, Mika; Sasaki, Nobuhito; Miura, Yasuhiro; Sawai, Takashi

2011-06-15

291

Distal humeral migration as a component of multidirectional shoulder instability. An anatomical study in autopsy specimens.  

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The object of the present study of autopsy specimens was to evaluate distal humeral migration during abduction allowed by sequential severance of capsular and ligamentous structures stabilizing the shoulder joint. A kinesiologic testing device continuously registered distal humeral migration, abduction angle, rotation, and flexion-extension. No distally directed force was applied to the humerus except the weight of the apparatus. Significant distal migration was recorded in the entire range of abduction (0 degrees -60 degrees) after solitary severance of the coracohumeral ligament as well as the proximal part of the anterior joint capsule. Further sectioning of the proximal part of the posterior capsule did not significantly increase distal humeral migration. Maximum distal migration (25 mm) was measured at 20 degrees of abduction. Applying an internal torque to the humerus significantly prevented distal migration as long as the posterior capsule was kept intact. Clinical testing for distal humeral migration should be performed with the shoulder joint at 20 degrees of abduction and neutral rotation. Furthermore, distal humeral migration can be significantly reduced by internal rotation of the humerus when the posterior joint capsule is intact. PMID:2302878

Helmig, P; Søjbjerg, J O; Kjaersgaard-Andersen, P; Nielsen, S; Ovesen, J

1990-03-01

292

The pathology and pathogenesis of fatal hepatic amoebiasis--A study based on 79 autopsy cases.  

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The present study is based on a retrospective analysis of 79 autopsy cases of hepatic amoebiasis. An attempt has been made to reconstruct the sequence of events starting from intestinal infection to invasion and transport of amoebae along the radicles of the portal veins, the formation of early Zahn's infarct and the proliferation of amoebae in such foci leading to the formation of small abscesses. The coalescence of small abscesses gives rise to the apparently large abscesses. Apart from direct contiguity, more distant extension leading to a satellite abscess is due to involvement of the hepatic and/or portal venous radicles. It seems that obstruction of the hepatic vein contributes substantially towards the enlargement of the liver and its exaggerated nutmeg appearance. Signs and symptoms of hepatic vein obstruction sometimes overshadow the abscess pathology. Thrombosis or pressure of a neighbouring abscess over the portal vein obstruction sometimes overshadow the abscess pathology. Thrombosis or pressure of a neighbouring abscess over the portal vein and bile-duct lead to development of portal hypertension and jaundice. Both cell-mediated and humoral immunity are depressed in fatal cases of hepatic amoebiasis. PMID:473308

Aikat, B K; Bhusnurmath, S R; Pal, A K; Chhuttani, P N; Datta, D V

1979-01-01

293

Relationship of red splenic arteriolar hyaline with rapid death: a clinicopathological study of 82 autopsy cases  

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Full Text Available Abstract Background Little is known about the relationship between splenic arteriolar hyaline and cause of death. The purpose of this retrospective study was to evaluate the clinicopathological significance of splenic arteriolar hyaline in autopsy cases and estimate the applicability of hyaline for diagnosing the cause and rapidity of death. Methods Archival data and histological slides from 82 cases were reviewed retrospectively. One section of each spleen was evaluated microscopically. The tinctorial pattern of splenic arteriolar hyaline was examined with Heidenhain’s Azan trichrome stain, and the relationships between this pattern and age, cause of death, and rapidity of death were investigated. Results Fifty-four cases demonstrated hyaline change, with 3 different tinctorial patterns: red, blue, and a combination of red and blue. The 3 patterns coexisted in various proportions in each tissue section. Frequency of the blue pattern increased with age (P?P? Conclusions Estimation of splenic arteriolar hyaline with Heidenhain’s Azan trichrome stain is useful for assessment of the cause and rapidity of death. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1132441651796836

Kotani Hirokazu

2012-12-01

294

Autopsy studies of Hashimoto's thyroiditis in Hiroshima and Nagasaki (1954-1974)  

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The authors examined 155 autopsy cases of Hashimoto's thyroiditis in the Life Span Study sample including both A-bomb survivors and controls in Hiroshima and Nagasaki (1954 to 1974). Hashimoto's thyroiditis was classified into lymphoid, diffuse and fibrous types and the following results were obtained. No difference existed in the effects of A-bomb radiation in the incidence and ATB (At the time of the A-bomb). The ration of males to females did not reveal statistical significance, even though reversed ratio was noted in the high dose group. The variation of thyroid gland weight in T65 dose or by variant showed no significant pattern, even though the smallest average weight was found in the highest radiation exposure group. The complication in the patients with Hashimoto's thyroiditis were noted to have high prevalance of ovarian cancer and low prevalence of stomach cancer and total cancer. Only two patients with Hashimoto's thyroiditis were found to be complicated with thyroid carcinoma. Among collagen diseases, the prevalence of rheumatic fever and rheumatoid arthritis was high as complication. And the prevance of combined diseases suggested that no late effect of A-bomb radiation existed. (author)

1978-01-01

295

Coexistence of CJD and Alzheimer's disease: an autopsy case showing typical clinical features of CJD.  

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The present report concerns an autopsy case of CJD showing typical clinical features of CJD. The patient was a Japanese woman without hereditary burden or dementing disorder anamnesis who was 70-years-old at the time of death. She developed gait disturbance at age 68, followed by memory impairment, visual disturbance, and myoclonus. A neurological examination approximately 2 months after the disease onset revealed akinetic mutism, in addition to periodic synchronous discharges on electroencephalogram. Serial neuroradiological examinations disclosed progressive atrophy of the brain. She died of bronchopneumonia 25 months after the disease onset. The brain weighed 560 g (cerebrum 490 g, brainstem with cerebellum 70 g). Macroscopically, neuropathological examination showed prominent atrophy of the cerebrum, caudate nucleus, and cerebellum, in addition to necrosis of the cerebral white matter, compatible with panencephalopathic CJD. Histologically, there was neuronal loss with or without spongiform change in the cerebral cortex, parahippocampal gyrus, amygdala, striatum, pallidum, thalamus, pontine nucleus, and cerebellar granule cells, in addition to diffuse synaptic-type prion staining in the cerebrum and cerebellum. Furthermore, senile plaques, compatible with definite Consortium to establish a registry for Alzheimer's disease rank Alzheimer's disease, and neurofibrillary changes of the limbic system, consistent with stage IV of Braak's classification, were found. Based on these clinicopathological findings and a review of the published literature, it is concluded that there were two forms of coexistence of CJD and Alzheimer's disease in the same patient. PMID:15068172

Tsuchiya, Kuniaki; Yagishita, Saburo; Ikeda, Kenji; Sano, Michio; Taki, Kazuhiro; Hashimoto, Keisuke; Watabiki, Sadakiyo; Mizusawa, Hidehiro

2004-03-01

296

Clinicopathological study of diffuse type brainstem gliomas: analysis of 40 autopsy cases.  

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Diffuse type brainstem glioma is one of the most malignant types of brain tumors and the prognosis is extremely poor. The proliferative potential of these tumors is presumed to be very high, but there is little information about the cell kinetics of brainstem glioma because surgical resection is rarely performed. The histological grade, tumor spread, growth potential, and prognosis were evaluated in 40 autopsy cases of diffuse type brainstem glioma. To quantify the growth potentials of individual tumors, the proliferating cell indices of Ki-67 (MIB-1) and proliferating cell nuclear antigen (PCNA) monoclonal antibodies were measured. Mean MIB-1 and PCNA proliferating cell indices were 20.4% (24 cases) and 37.0% (28 cases), respectively, in 34 glioblastomas. The median survival time was 40 weeks in 22 treated patients. The mean PCNA proliferating cell index was 10.8% in four of five anaplastic astrocytomas and the median survival time in four treated patients was 91 weeks. The MIB-1 and PCNA proliferating cell indices of one astrocytoma were 2.9% and 20.3%, respectively, and the survival time was 56 weeks. The overall median survival time was 32 weeks. There was a significant difference in PCNA proliferating cell indices between glioblastomas and anaplastic astrocytomas (p astrocytomas plus astrocytoma (74 weeks) among the treated patients (p astrocytomas (p astrocytoma or astrocytoma is rarer and less infiltrative and proliferative, and carries a slightly better prognosis than glioblastoma. PMID:12968803

Yoshimura, Junichi; Onda, Kiyoshi; Tanaka, Ryuichi; Takahashi, Hitoshi

2003-08-01

297

An autopsy case of primary pericardial mesothelioma in arc cutter exposed to asbestos through talc pencils.  

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An autopsy case of a primary pericardial mesothelioma in a 53-year-old arc cutter is reported. He had often had the chance to inhale dust generated by sharpening the slate pencils composed of talc. He was admitted for heart failure due to pericardial tumor, but later died. The tumor was mainly located on the pericardium with a thickness of about 2.5 cm. Small nodular disseminations were observed in the left parietal pleura. Microscopically, tumor cells were epithelial-like and rich in histochemical demonstrable hyaluronic acid. Findings of immunohistochemical markers revealed keratin (+), EMA (+), calretinin (+), and CEA (-), which were characteristics of mesothelioma of epithelial type. The number of asbestos bodies (AB) in the lung parenchyma was increased (2026 AB/gram dry lung tissue). Subsequent transmission electron microscopic examination equipped with an energy dispersive X-ray analyzer revealed that the fibers identified in the lungs were fibrous talc and actinolite. These findings suggested that this patient had been occupationally exposed to asbestos contaminated in the talc pencils, which induced the development of primary pericardial mesothelioma. PMID:15895852

Fujiwara, Hiroshi; Kamimori, Takao; Morinaga, Kenji; Takeda, Yoshiki; Kohyama, Norihiko; Miki, Yoshihiro; Inai, Kouki; Yamamoto, Satoru

2005-04-01

298

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

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Full Text Available SciELO Brazil | Language: English Abstract in english 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.

Inci, Alacacioglu; Aydanur, Kargi; Mehmet Ali, Ozcan; Ozden, Piskin; Cilem, Solak; Mustafa, Secil; Mehtat, Unlu; Fatih, Demirkan; Guner Hayri, Ozsan; Bulent, Undar.

299

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

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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.

Inci Alacacioglu

2009-06-01

300

[Case of benign asbestos pleurisy with diffuse pleural thickening confirmed on autopsy].  

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We report a 65-year-old man with a 35-year history of occupational asbestos exposure. He presented at a nearby hospital with a complaint of dyspnea in 2002. Bilateral pleural effusion was revealed on a chest x-ray film. Chest CT revealed diffuse thickening of the pleura, bilateral pleural effusions and cardiac effusion, but no abnormal findings in the lung fields. Both pleural effusions were exudative, and lymphocytes were predominant. Antituberculous chemotherapy had no effect on the exudates. Thoracoscopic pleural biopsy was conducted to exclude malignant mesothelioma. No evidence of malignancy was found in pleural samples. The patient's condition was diagnosed as benign asbestos pleurisy with diffuse pleural thickening. He was referred to our hospital in June 2008. Bilateral pleural effusions continued to progress despite pleurodesis and frequent drainage of his pleural effusion. He suffered from respiratory failure and died in December 2008. We investigated the concentration of asbestos bodies in his lung tissue. There were 462 asbestos bodies per 1 g of dry lung tissue, which was relatively low considering the time of asbestos exposure. We report a rare case of benign asbestos pleurisy with diffuse pleural thickening confirmed by autopsy. PMID:21141060

Haga, Takahiro; Nakajima, Yuki; Kitamura, Atsushi; Kuroda, Fuminobu; Takiguchi, Yuichi; Tatsumi, Koichiro

2010-11-01

 
 
 
 
301

Membranous lipodystrophy (Nasu-Hakola disease) with thalamic degeneration: report of an autopsied case.  

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An autopsied case of membranous lipodystrophy (Nasu-Hakola disease, NHD) with thalamic degeneration was reported. A 34-year-old Japanese man was diagnosed as having NHD by bone biopsy prior to the onset of clinical symptoms. His maternal grandfather and paternal grandmother are cousins, but this family history is negative for NHD. He developed frontal lobe syndrome at the age of 35 with progressive dementia, and died of acute renal failure at the age of 46. Gross inspection of the brain detected atrophy and softening of the cerebral white matter, predominantly in the frontal lobe. Microscopically, numerous spheroids, predominant fibrillary gliosis with less prominent demyelination "dissociation glio-myélinique" and scanty sudanophilic lipid droplets were observed, indicating the sclerosing type of NHD. An unusual patholgoical finding in this case was selective involvement of the thalamic nuclei with preservation of the other gray matter except for focal cortical necrosis. The topography of the affected thalamic nuclei is similar to that of systemic thalamus degeneration. An association with thalamic degeneration in NHD has not been previously reported. The present case suggests that NHD also affects the thalamus. PMID:1722609

Miyazu, K; Kobayashi, K; Fukutani, Y; Nakamura, I; Hasegawa, H; Yamaguchi, N; Saitoh, T

1991-01-01

302

High-resolution molecular genomic autopsy reveals complex sudden unexpected death in epilepsy risk profile.  

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Advanced variant detection in genes underlying risk of sudden unexpected death in epilepsy (SUDEP) can uncover extensive epistatic complexity and improve diagnostic accuracy of epilepsy-related mortality. However, the sensitivity and clinical utility of diagnostic panels based solely on established cardiac arrhythmia genes in the molecular autopsy of SUDEP is unknown. We applied the established clinical diagnostic panels, followed by sequencing and a high density copy number variant (CNV) detection array of an additional 253 related ion channel subunit genes to analyze the overall genomic variation in a SUDEP of the 3-year-old proband with severe myoclonic epilepsy of infancy (SMEI). We uncovered complex combinations of single nucleotide polymorphisms and CNVs in genes expressed in both neurocardiac and respiratory control pathways, including SCN1A, KCNA1, RYR3, and HTR2C. Our findings demonstrate the importance of comprehensive high-resolution variant analysis in the assessment of personally relevant SUDEP risk. In this case, the combination of de novo single nucleotide polymorphisms (SNPs) and CNVs in the SCN1A and KCNA1 genes, respectively, is suspected to be the principal risk factor for both epilepsy and premature death. However, consideration of the overall biologically relevant variant complexity with its extensive functional epistatic interactions reveals potential personal risk more accurately. PMID:24372310

Klassen, Tara L; Bomben, Valerie C; Patel, Ankita; Drabek, Janice; Chen, Tim T; Gu, Wenli; Zhang, Feng; Chapman, Kevin; Lupski, James R; Noebels, Jeffrey L; Goldman, A M

2014-02-01

303

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

International Nuclear Information System (INIS)

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)

2003-09-01

304

Spectrum of pulmonary adenocarcinoma with ultrastructural correlation: An autopsy study from northern India  

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Full Text Available Background: In the present study, we have evaluated the use of electron microscopy in subtyping pulmonary adenocarcinomas, comparing the ultrastructural findings with the diagnosis rendered by light microscopy. Materials and Methods: The gross and histologic features of 16 autopsy cases of pulmonary adenocarcinoma were analyzed and compared with electron microscopic features. The cytologic phenotypes of these cases of well-differentiated pulmonary adenocarcinoma were determined by electron microscopic examination. More than 200 cells in each case were examined, and the tumors were classified according to the predominant feature noted. Results: Eight cases were of Clara cell origin and one case each of type II pneumocyte and bronchial surface cell type. The remaining 6 cases lacked definite discernible features of differentiation towards any specific cell type, other than presence of small nuclear clefts in occasional nuclei. Tumors with Clara cell differentiation were low cuboidal with apical snouts. Type II pneumocyte tumor failed to reveal any characteristic definable as light microscopic feature. Conclusion: Ultrastructural examination is the only definite means of identification of various cell types in the respiratory epithelium and hence forms an invaluable tool in classification of pulmonary adenocarcinoma.

Gupta Kirti

2008-07-01

305

Diffuse alveolar hemorrhage as a fatal adverse effect of bevacizumab: an autopsy case.  

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A 71-year-old female with Stage IIIB primary adenocarcinoma was administered a three-drug combination therapy consisting of docetaxel, cisplatin and bevacizumab as a first-line treatment based on the Phase II clinical trial. On the 32nd day after the fourth course of chemotherapy, the patient developed bloody sputum. She was found dead at home on the 34th day. Autopsy revealed a diffuse alveolar hemorrhage without diffuse alveolar damage. Endothelial cells of the small arteries and capillaries were swollen and desquamated, indicating that alveolar capillaries were injured. The similar pathological changes in blood vessels were also observed in the kidney and the digestive tract. Because diffuse alveolar hemorrhage caused by cisplatin and docetaxel has never been reported apart from interstitial pneumonitis, bevacizumab is the most suspicious drug for diffuse alveolar hemorrhage in our case. Chest physicians and oncologists should be aware that although it is very rare, diffuse alveolar hemorrhage can develop during any course of chemotherapy with bevacizumab. PMID:24683198

Ikeda, Satoshi; Sekine, Akimasa; Kato, Terufumi; Yoshida, Masahiro; Ogata, Ryo; Baba, Tomohisa; Nagahama, Kiyotaka; Okudela, Koji; Ogura, Takashi

2014-05-01

306

Suicide among adults aged 30–49: A psychological autopsy study in Hong Kong  

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Full Text Available Abstract Background A surge in suicide rates in middle age people in Hong Kong and many Asian countries was recently observed. However, there is a paucity of suicide research on this subgroup of people in Asia. Methods The next-of-kin of 85 suicide cases and 85 community subjects aged 30–49 years were interviewed by a psychological autopsy approach. Information was triangulated by interview notes, coroner's court files, and police investigation reports. Results A multiple logistic regression analysis identified the following risk factors for suicide among the middle age people in Hong Kong: the presence of at least one psychiatric disorder (OR = 37.5, 95% CI 11.5–121.9, p Conclusion The data show that socio-economical factors had a strong impact on suicide in the target group. Further research is needed to explore any positive qualities that protect the middle-aged from suicide. The prevention of suicide in the middle-aged requires multiple strategies.

Chan Sandra SM

2008-05-01

307

Molecular autopsy in young sudden cardiac death victims with suspected cardiomyopathy  

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The aim of this investigation was to identify and characterise pathogenic mutations in a sudden cardiac death (SCD) cohort suspected of cardiomyopathy in persons aged 0-40 years. The study material for the genetic screening of cardiomyopathies consisted of 41 cases and was selected from the case database at the Institute of Forensic Medicine. Mutational screening by DNA sequencing was performed to detect mutations in DNA samples from deceased persons suspected of suffering from hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), and arrhythmogenic right ventricle cardiomyopathy (ARVC). A total of 9 of the examined 41 cases had a rare sequence variant in the MYBPC3, MYH7, LMNA, PKP2 or TMEM43 genes, of which 4 cases (9.8%) were presumed to be pathogenic mutations. The presumed pathogenic mutations were distributed with one case of suspected HCM and DCM (MYH7; p.R442H), one case of suspected DCM (LMNA; p.R471H), and two cases of suspected ARVC (PKP2; p.R79X and LMNA; p.R644C). The presented data adds important information on the genetic elements of SCD in the young, and calls for expert pathological evaluation and molecular autopsy in the post-mortem examination of SCD victims with structural anomalies of the heart.

Larsen, Maiken Kudahl; Nissen, P H

2011-01-01

308

Hiperinfecção por Strongyloides stercoralis: relato de caso autopsiado Strongyloides stercoralis hyperinfection: autopsy case report  

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Full Text Available Infecção assintomática por Strongyloides stercoralis pode resultar em doença potencialmente fatal em pacientes imunodeprimidos. Os autores relatam caso de hiperinfecção por Strongyloides stercoralis descoberto à autópsia, enfatizando aspectos clinicopatológicos, em homem de 55 anos, em tratamento para mieloma múltiplo. Apresentava, havia um dia, cefaléia intensa, dor abdominal e oligúria desenvolvendo insuficiência respiratória aguda e choque séptico. Devido à dificuldade no diagnóstico, o tratamento empírico antes do início da terapia imunossupressora pode ser a melhor estratégia para prevenir a hiperinfecção pelo verme.Asymptomatic infection due to Strongyloides stercoralis may result in potentially fatal disease in immunodepressed patients. A case of Strongyloides stercoralis hyperinfection discovered at autopsy in a 55-year-old man who had been undergoing treatment for multiple myeloma is reported, emphasizing the clinical and pathological findings. One day earlier, he presented severe headache, abdominal pain and oliguria, from which he developed acute respiratory failure and septic shock. Because of difficulty in reaching this diagnosis, empirical treatment before starting immunosuppressive therapy may be the best strategy for preventing hyperinfection by this worm.

Moema Gonçalves Pinheiro Veloso

2008-08-01

309

“Even if I were to consent, my family will never agree”: exploring autopsy services for posthumous occupational lung disease compensation among mineworkers in South Africa  

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Full Text Available Context: In the South African mining sector, cardiorespiratory-specific autopsies are conducted under the Occupational Diseases in Mines and Works Act (ODMWA on deceased mineworkers to determine eligibility for compensation. However, low levels of autopsy utilisation undermine the value of the service. Objective: To explore enablers and barriers to consent that impact on ODMWA autopsy utilisation for posthumous monetary compensation. Methods: In-depth interviews were conducted with mineworkers, widows and relatives of deceased mineworkers as well as traditional healers and mine occupational health practitioners. Results: A range of socio-cultural barriers to consent for an autopsy was identified. These barriers were largely related to gendered power relations, traditional and religious beliefs, and communication and trust. Understanding these barriers presents opportunities to intervene so as to increase autopsy utilisation. Conclusions: Effective interventions could include engagement with healthy mine-workers and their families and re-evaluating the permanent removal of organs. The study adds to our understanding of utilisation of the autopsy services.

Audrey V. Banyini

2013-01-01

310

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

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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 study is the information on a wide range of informative alcohol biomarkers, several of which have not been used previously in this sort of post-mortem research study. We have demonstrated, for the first time, the epidemiological value and validity of these novel alcohol biomarkers in post-mortem samples.

Ringmets Inge

2012-02-01

311

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

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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. From 2005 to 2009, 10 high-mortality states in India conducted community-based maternal verbal/social autopsies with participatory data sharing with communities and health programs that resulted in the implementation of numerous data-driven maternal health interventions. Social autopsy is a powerful tool with the demonstrated ability to raise awareness, provide evidence in the form of actionable data and increase motivation at all levels to take appropriate and effective actions. Further development of the methodology along with standardized instruments and supporting tools are needed to promote its wide-scale adoption and use.

Koffi Alain K

2011-08-01

312

[An autopsied case of Fabry's disease presenting with parkinsonism and cardiomegaly as a cardinal clinical manifestation].  

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A 68-year-old male had been followed up under a clinical diagnosis of parkinsonism for 5 years. He was admitted to the Kanto Teishin Hospital with a chief complaint of difficulty in swallowing. Physical findings were almost normal. Neurological examination showed parkinsonism including mask-like face, positive Myerson's sign, mild rigidity, marche à petit pas, and retropulsion, and pyramidal signs including mild right hemiparesis, generalized hyperreflexia and positive Babinski's sign on both sides. Routine blood analysis was normal, except for elevated LDH level. He was found to have cardiac enlargement (CTR 58.7%) in chest roentogenogram, left ventricular hypertrophy (LVH), right bundle branch block and myocardial ischemia in electrocardiogram, as well as LVH, asymmetrical septal hypertrophy, mild MR and AR in echocardiogram. A T2 weighted brain MRI disclosed multiple high signal intensities in the basal ganglia and deep white matter regions which suggest parkinsonism resulting from multiple cerebral infarctions. An upper gastrointestinal endoscopic examination revealed esophageal and gastric carcinomas. He died of ventricular fibrillation 14 days after an operation of these carcinomas. Autopsy showed severe cardiomegaly (800 g) and vacuolar change of myocardium with lamellar body on electron microscopic examination. A definite biochemical diagnosis of Fabry's disease was made by demonstration of deposition of a large amount of trihexosylceramide in the myocardium, kidney, and liver. This case presented parkinsonism and cardiomegaly without typical signs of Fabry's disease. Therefore, Fabry's disease should be considered as one of possible underlying diseases, when a patient has cardiomegaly or ischemic cerebrovascular disease without risk factors, even if he has no typical signs of Fabry's disease. PMID:7834942

Orimo, S; Iwasaki, T; Yoshino, H; Arai, M; Hiyamuta, E

1994-10-01

313

[Differential diagnosis of congenital lipidoses by lipid analyses of body fluids, biopsy and autopsy tissue].  

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1. Presentation of the commomly used procedures for the extraction and separation of total lipids, glycolipids and phosholipids from fresh and formalin-fixed organs tissues (brain, liver, spleen, kidney) as well as from serum, CSF and urine. II. Description of the qualitative and quantitative analysis of individual lipid fractions (glycolipids, gangliosides, phospholipids, neutral lipids) by thin-layer chromatograhy and photodensitometry. III. Results of investigations performed on biopsy material, autopsy material, serum and urine in the following diseases: 1. Infantile, juvenile and adult Gaucher's disease: accumulation of glucocerebroside in liver and spleen. 2. Infantile and adult Niemann-Pick disease: accumulation of sphingomyelin in liver, spleen, kidney and lung. 3. Fabry's disease: increased urinary excretion of trihexosyl-ceramide and dihexosyl-ceramide. 4. Infantile and adult metachromatic leukodystrophy: accumulation of sulfatides in the central and peripheral nervous system and kidney, increased urinary excretion of sulfatides. 5. Austin's variant of metachromatic leukodystrophy: besides an increase of sulfatides in the white matter of brain accumulation of glycolipids in the cerebral cortex. 6. Tay-Sachs disease (GM2-gangliosidosis): cerebral accumulation of GM2-ganglioside and trihexosylceramide (enzyme variant B), additional visceral accumulation (liver, spleen, kidney) of tetrahexosyl-ceramide = globoside (enzyme variant 0). 7. Infantile generalized GM1-gangliosidosis: cerebral (and visceral) accumulation of GM1-ganglioside and tetrahexosyl-ceramide. 8. Late infantile GM1-gangliosidosis: Cerebral accumulation of GM1-ganlioside and tetrahexosylceramide. 9. GM3-gangliosidosis (lactosyl-ceramidosis): neuronal accumulation of lactosyl-ceramide, GM2-ganglioside and GM3-ganglioside. 10. Refsum's disease: demonstration of phytanic acid esters of cholesterol in serum. PMID:53174

Pilz, H; Heipertz, R

1975-11-01

314

Strengthening standardised interpretation of verbal autopsy data: the new InterVA-4 tool  

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Full Text Available Background: Verbal autopsy (VA is the only available approach for determining the cause of many deaths, where routine certification is not in place. Therefore, it is important to use standards and methods for VA that maximise efficiency, consistency and comparability. The World Health Organization (WHO has led the development of the 2012 WHO VA instrument as a new standard, intended both as a research tool and for routine registration of deaths. Objective: A new public-domain probabilistic model for interpreting VA data, InterVA-4, is described, which builds on previous versions and is aligned with the 2012 WHO VA instrument. Design: The new model has been designed to use the VA input indicators defined in the 2012 WHO VA instrument and to deliver causes of death compatible with the International Classification of Diseases version 10 (ICD-10 categorised into 62 groups as defined in the 2012 WHO VA instrument. In addition, known shortcomings of previous InterVA models have been addressed in this revision, as well as integrating other work on maternal and perinatal deaths. Results: The InterVA-4 model is presented here to facilitate its widespread use and to enable further field evaluation to take place. Results from a demonstration dataset from Agincourt, South Africa, show continuity of interpretation between InterVA-3 and InterVA-4, as well as differences reflecting specific issues addressed in the design and development of InterVA-4. Conclusions: InterVA-4 is made freely available as a new standard model for interpreting VA data into causes of death. It can be used for determining cause of death both in research settings and for routine registration. Further validation opportunities will be explored. These developments in cause of death registration are likely to substantially increase the global coverage of cause-specific mortality data.

Peter Byass

2012-09-01

315

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

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Full Text Available 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.

Jordana Leitao

2013-09-01

316

Parkinson's disease mimicking senile dementia of the Alzheimer type: a clinicopathological study of four autopsy cases.  

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This report concerns four Japanese autopsy cases of Parkinson's disease (PD) mimicking senile dementia of the Alzheimer type. Three patients with a clinical diagnosis of senile dementia of the Alzheimer type developed memory disturbance as the initial sign, and a patient with a clinical diagnosis of atypical senile dementia presented with hallucination and delusion as the initial sign. Dementia was evident in all four patients, and slight parkinsonism appeared in the middle to late stages of the disease in two patients. Macroscopical examination of the brain disclosed slight depigmentation of the substantia nigra and prominent depigmentation of the locus ceruleus in all four cases. Histological examination of the four patients showed neuronal loss with astrocytosis and the appearance of Lewy bodies in the substantia nigra, locus ceruleus, and dorsal vagal nucleus. The nucleus basalis of Meynert was involved in three cases, in which this structure was examined. The total Lewy body scores of the four cases were 1 in three cases and 0 in the other, compatible with PD. Massive appearance of senile plaques, consistent with Braak stage C, was found in one case, and the slight appearance of senile plaques, consistent with Braak stage A, was evident in two cases. One case had no evidence of senile plaques. In all four cases, slight neurofibrillary changes were present in the limbic areas, compatible with Braak stages II to III. Based on these clinicopathological findings and a review of the literature, we concluded that PD simulating Alzheimer's disease without overt parkinsonism rarely exists. Furthermore, we postulate that the clinical features of PD are more widespread than previously believed. PMID:12075939

Tsuchiya, Kuniaki; Ikeda, Kenji; Niizato, Kazuhiro; Watabiki, Sadakiyo; Anno, Midori; Taki, Kazuhiro; Haga, Chie; Iritani, Shuji; Matsushita, Masaaki

2002-06-01

317

Lymphotoxin-alpha polymorphisms and presence of cancer in 1,536 consecutive autopsy cases  

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Full Text Available Abstract Background Lymphotoxin-alpha (LTA is a pro-inflammatory cytokine with anti-tumor activity. The objective of this study was to determine whether LTA polymorphisms influence the presence of cancer. Methods LTA polymorphisms C804A (rs1041981, T60N and T495C (rs2229094, C13R were determined in 1,536 consecutive autopsy cases and were registered in the Japanese single-nucleotide polymorphisms (SNPs for geriatric research (JG-SNP Internet database. Tumors were systematically reviewed, pathologically confirmed, and assessed in relation to LTA genotype. Results The study population consisted of 827 males and 709 females, with a mean age of 80 years. Altogether, we studied 606 subjects without cancer and 930 subjects with cancer of the stomach (n = 183, lung (n = 164, colon or rectum (n = 143, or other sites. The presence of cancer was higher in males than in females. The C804A and T495C polymorphisms were associated with cancer in males (CA + AA: CC, adjusted OR = 0.72, 95% CI = 0.53 – 0.99; TC + CC: TT, adjusted OR = 1.45, 95% CI = 1.04 – 2.02; respectively but not in females. In males, the C804A polymorphism was associated with lung cancer (CA + AA: CC, adjusted OR = 0.60, 95% CI = 0.37 – 0.97, whereas the T495C polymorphism was associated with gastric cancer (TC + CC: TT, adjusted OR = 1.68, 95% CI = 1.06 – 2.65. Conclusion We found some evidence of an association between LTA polymorphisms and cancer risk in elderly Japanese men. Further studies in larger populations should examine this hypothesis.

Muramatsu Masaaki

2008-08-01

318

Morphologic evaluation of the renal veins: a study with autopsy material from Colombian subjects.  

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Renal venous drainage presents a large degree of variability. The purpose of this study was to determine the morphological expression of the renal veins. Renal vein formation patterns, their morphometry, and frequency of additional veins were studied in a sample of 156 pairs of kidneys, the vascular beds of which were subjected to an injection-corrosion technique, taken from cadaver specimens autopsied at National Institute of Legal Medicine and Forensics Sciences in Bucaramanga, Colombia. A single renal vein (RV) was found bilaterally in 122 (78.2%) samples, whereas 34 (21.8%) kidneys had additional RVs (left side 33 cases, right side one case). Of the specimens with multiple right renal veins (RRV), 28 (17.9%) had two RVs and five (3.2%) had three RVs. Of the left kidneys, 99.4% had one LRV and 0.6% had two LRVs. The lengths of the left and right renal veins were 56.5±12.7 mm and 23.6±8.21 mm, respectively; the caliber of the left renal vein (LRV) was 12.3±1.41 mm, whereas the caliber of the RRV was 10.9±1.56 mm, a statistically non-significant difference (p=0.262). 82.7% of the LRVs and the 73.1% of the RRVs (p=0.768) originated at the extra-hilum level. Renal vein formation pattern characterized by the confluence of upper and lower tributaries was found in 61.6% of the cases, whereas 16.3% of the specimens had upper, medium, and lower tributaries. Variation patterns found in this study point towards a wide morphological expression of these vessels that needs to be taken into account for both imaging and surgical procedures. PMID:24715169

Ballesteros, Luis Ernesto; Saldarriaga, Vladimir; Ramirez, Luis Miguel

2014-01-01

319

An autopsy case of granulocyte-colony-stimulating-factor-producing extrahepatic bile duct carcinoma  

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Full Text Available A 79-year-old man was referred to this department due to the presence of extrahepatic bile duct carcinoma with a tumor at the left chest wall. The lesion was suspected to be a metastasis of bile duct carcinoma to the left wall, however, computed tomography (CT revealed no regional lymph node or liver metastases. In addition, cytological and pathological examinations did not show malignancy. At the time of admission, the white blood cell count was 21 460 cells/?L (neutrophils, 18 240 cells/?L and this elevated to 106 040 before death. In addition, serum granulocyte colony-stimulating factor (G-CSF was elevated. At 28 d after admission, the patient died. An autopsy showed a poorly differentiated adenocarcinoma with sarcomatous change, which had slightly invaded into the pancreas around the bile duct, and was found in the distal bile duct with multiple metastases to the chest wall, lung, kidney, adrenal body, liver, mesentery, vertebra and mediastinal and para-aortic lymph nodes, without locoregional lymph node and liver metastasis. The cancer cells showed positive immunohistochemical staining for anti-G-CSF antibody. This is believed to be the first report of an extrahepatic bile duct carcinoma that produces G-CSF. Since G-CSF-producing carcinoma and sarcomatous change of the biliary tract leads to poor prognosis, early diagnosis and treatment are needed. When infection is ruled out, the G-CSF in serum should be examined. In addition, examinations such as bone scintigraphy and chest CT should also be considered for distant metastasis.

Satoru Matsuyama, Tomonori Shimonishi, Hirofumi Yoshimura, Kensaku Higaki, Kenji Nasu, Mariko Toyooka, Shigehisa Aoki, Keiko Watanabe and Hajime Sugihara

2008-05-01

320

Demographic, etiological, and histological pulmonary analysis of patients with acute respiratory failure: a study of 19 years of autopsies  

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Full Text Available SciELO Brazil | Language: English Abstract in english INTRODUCTION: Acute respiratory failure has been one of the most important causes of death in intensive care units, and certain aspects of its pulmonary pathology are currently unknown. OBJECTIVES: The objective was to describe the demographic data, etiology, and pulmonary histopathological findings [...] of different diseases in the autopsies of patients with acute respiratory failure. METHOD: Autopsies of 4,710 patients with acute respiratory failure from 1990 to 2008 were reviewed, and the following data were obtained: age, sex, and major associated diseases. The pulmonary histopathology was categorized as diffuse alveolar damage, pulmonary edema, alveolar hemorrhage, and lymphoplasmacytic interstitial pneumonia. The odds ratio of the concordance between the major associated diseases and specific autopsy findings was calculated using logistic regression. RESULTS: Bacterial bronchopneumonia was present in 33.9% of the cases and cancer in 28.1%. The pulmonary histopathology showed diffuse alveolar damage in 40.7% (1,917) of the cases. A multivariate analysis showed a significant and powerful association between diffuse alveolar damage and bronchopneumonia, HIV/AIDS, sepsis, and septic shock, between liver cirrhosis and pulmonary embolism, between pulmonary edema and acute myocardial infarction, between dilated cardiomyopathy and cancer, between alveolar hemorrhage and bronchopneumonia and pulmonary embolism, and between lymphoplasmacytic interstitial pneumonia and HIV/ AIDS and liver cirrhosis. CONCLUSIONS: Bronchopneumonia was the most common diagnosis in these cases. The most prevalent pulmonary histopathological pattern was diffuse alveolar damage, which was associated with different inflammatory conditions. Further studies are necessary to elucidate the complete pathophysiological mechanisms involved with each disease and the development of acute respiratory failure.

Alexandre de Matos, Soeiro; Aline D., Ruppert; Mauro, Canzian; Edwin R., Parra; Cecília, Farhat; Vera L., Capelozzi.

 
 
 
 
321

Demographic, etiological, and histological pulmonary analysis of patients with acute respiratory failure: a study of 19 years of autopsies  

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Full Text Available INTRODUCTION: Acute respiratory failure has been one of the most important causes of death in intensive care units, and certain aspects of its pulmonary pathology are currently unknown. OBJECTIVES: The objective was to describe the demographic data, etiology, and pulmonary histopathological findings of different diseases in the autopsies of patients with acute respiratory failure. METHOD: Autopsies of 4,710 patients with acute respiratory failure from 1990 to 2008 were reviewed, and the following data were obtained: age, sex, and major associated diseases. The pulmonary histopathology was categorized as diffuse alveolar damage, pulmonary edema, alveolar hemorrhage, and lymphoplasmacytic interstitial pneumonia. The odds ratio of the concordance between the major associated diseases and specific autopsy findings was calculated using logistic regression. RESULTS: Bacterial bronchopneumonia was present in 33.9% of the cases and cancer in 28.1%. The pulmonary histopathology showed diffuse alveolar damage in 40.7% (1,917 of the cases. A multivariate analysis showed a significant and powerful association between diffuse alveolar damage and bronchopneumonia, HIV/AIDS, sepsis, and septic shock, between liver cirrhosis and pulmonary embolism, between pulmonary edema and acute myocardial infarction, between dilated cardiomyopathy and cancer, between alveolar hemorrhage and bronchopneumonia and pulmonary embolism, and between lymphoplasmacytic interstitial pneumonia and HIV/ AIDS and liver cirrhosis. CONCLUSIONS: Bronchopneumonia was the most common diagnosis in these cases. The most prevalent pulmonary histopathological pattern was diffuse alveolar damage, which was associated with different inflammatory conditions. Further studies are necessary to elucidate the complete pathophysiological mechanisms involved with each disease and the development of acute respiratory failure.

Alexandre de Matos Soeiro

2011-01-01

322

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

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Full Text Available Aline Domingos Pinto Ruppert,1 Alexandre de Matos Soeiro,2 Maria Carolina Feres de Almeida,2 Múcio Tavares de Oliveira Jr,2 Carlos V Serrano Jr,2 Vera Luiza Capelozzi1 1Department of Pathology, 2Heart Institute, University of São Paulo Medical School, São Paulo, Brazil 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 hospitalization. The pulmonary histopathological changes were categorized as diffuse alveolar damage, pulmonary edema, alveolar hemorrhage, and lymphoid interstitial pneumonia. Odds ratios of positive relations were obtained by logistic regression and were considered significant when P<0.05. Results: The median age was 64 years old. About 64% of patients presented cardiovascular illness associated with PTE. The most prevalent pulmonary finding was pulmonary edema. Only 13% of cases had clinical suspicion of PTE. Acute respiratory failure was positively related to pulmonary edema, alveolar hemorrhage, and diffuse alveolar damage as well as hemodynamic instability to alveolar hemorrhage and diffuse alveolar damage. Conclusion: We found important relations between clinical data and histological findings of patients with fatal PTE. A greater understanding of the pulmonary physiopathological mechanisms involved with each disease associated to PTE could improve its diagnosis and treatment. Keywords: pulmonary embolism, autopsy, pathology, acute respiratory failure, pulmonary edema, fatal

Ruppert ADP

2014-03-01

323

[Incidence and structure of pediatric pathology according to autopsy files at the University Hospital "St. George" Plovdiv, Bulgaria during 1985-2001].  

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The present study is aiming at sharing our problems and experience with pediatric autopsy cases. The incidence of pediatric cases as part of total autopsy activity is estimated. Criteria such as coincidence between pediatricians' and final pathological diagnosis are considered. The research is retrospective and it is made for the period from 1985 to 2001. It includes review of 5663 autopsy files from which only pediatric cases were extracted, divided into separate age groups. Main disease, causes of death and complications are recorded for each separate age group. The first two age groups constitute the major part of pediatric mortality with the substantial participation of the neonate group--771 cases, followed by the second period (30 days-1 year)--563 cases. They show a similar rate of causes of death and hemorrhagic complications prevail either as isolated or in the context of DIC-syndrome. The vast majority of pediatric cases belong to neonatal period and the first year of life. A rapid decline in autopsy rates is observed concerning early school age (5-7) and the teenager group (7-11 yrs). In the era of a definite autopsy rate decline, Bulgarian pathologists meet with fewer pediatric cases. PMID:17974180

Staribratova, D; Zaprianov, Z; Milchev, N; Belovezhdov, V; Batashki, I

2007-01-01

324

A neuropatologia no período neonatal: análise de 1616 casos de necropsia / The neuropathology of neonatal period: analysis of 1616 autopsies  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese As lesões do sistema nervoso central, resultantes da vulnerabilidade do encéfalo às condições adversas durante a gestação e após o nascimento, representam uma importante causa de morbimortalidade no período neonatal. Este estudo visa analisar a prevalência e os padrões das lesões neuropatológicas em [...] neomortos do Hospital de Clínicas de Curitiba. Utilizou-se como fonte de dados o Banco de Necropsia da Unidade de Patologia Perinatal e Pediátrica do Hospital de Clínicas da Universidade Federal do Paraná - Curitiba, que registra 5743 necropsias realizadas entre os anos de 1960 e 1995. Foram selecionados 2049 casos correspondentes aos laudos de necropsia dos neomortos, os quais foram classificados segundo a faixa etária e o padrão de lesão neuropatológica. Caracterizou-se lesão neuropatológica em 1616 casos (78,87%), observando-se maior prevalência das hemorragias intracranianas (73,39%), malformações congênitas (4,27%) e infecções (3,59%). As hemorragias hipóxicas representaram a lesão neuropatológica mais freqüente entre os neomortos, especialmente entre os prematuros. Houve diferença na prevalência quanto ao gênero apenas nas malformações, que foram mais comuns no sexo feminino. Abstract in english The lesions of the central nervous system represent an important cause of morbid-mortality in the neonatal period. This is due to the vulnerability of the brain to several adverse conditions during gestation and after birth. This study analyses the prevalence and pattern of central nervous system le [...] sions in neonates autopsied at Hospital de Clínicas - Curitiba. There were 5743 pediatric autopsies performed in the Sector of Anatomic Pathology from 1960 to 1995 with 2049 cases corresponding to death during neonatal period. These later autopsies were reviewed and all cases with central nervous system lesions were selected and classified according to sex, age and pattern of central nervous system lesion. The central nervous system was affected in 1616 (78,87%) of neonatal autopsies and there was predominance of intracerebral hemorrhages (73,39%), congenital malformations (4,27%) and infections (3,59%). The hypoxic hemorrhages are the most prevalent central nervous system lesions in the neonatal period, affecting mainly premature babies. There was predominance of central nervous system malformations in the female neonates.

Noronha, Lúcia de; Medeiros, Fabiola; Martins, Vanessa D. M.; Nones, Rodrigo B.; Sepulcri, Rodrigo P.; Prevedello, Luciano M. S.; Sampaio, Gilberto A.; Serapião, Maria J.; Torres, Luiz F. Bleggi.

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A neuropatologia no período neonatal: análise de 1616 casos de necropsia The neuropathology of neonatal period: analysis of 1616 autopsies  

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Full Text Available As lesões do sistema nervoso central, resultantes da vulnerabilidade do encéfalo às condições adversas durante a gestação e após o nascimento, representam uma importante causa de morbimortalidade no período neonatal. Este estudo visa analisar a prevalência e os padrões das lesões neuropatológicas em neomortos do Hospital de Clínicas de Curitiba. Utilizou-se como fonte de dados o Banco de Necropsia da Unidade de Patologia Perinatal e Pediátrica do Hospital de Clínicas da Universidade Federal do Paraná - Curitiba, que registra 5743 necropsias realizadas entre os anos de 1960 e 1995. Foram selecionados 2049 casos correspondentes aos laudos de necropsia dos neomortos, os quais foram classificados segundo a faixa etária e o padrão de lesão neuropatológica. Caracterizou-se lesão neuropatológica em 1616 casos (78,87%, observando-se maior prevalência das hemorragias intracranianas (73,39%, malformações congênitas (4,27% e infecções (3,59%. As hemorragias hipóxicas representaram a lesão neuropatológica mais freqüente entre os neomortos, especialmente entre os prematuros. Houve diferença na prevalência quanto ao gênero apenas nas malformações, que foram mais comuns no sexo feminino.The lesions of the central nervous system represent an important cause of morbid-mortality in the neonatal period. This is due to the vulnerability of the brain to several adverse conditions during gestation and after birth. This study analyses the prevalence and pattern of central nervous system lesions in neonates autopsied at Hospital de Clínicas - Curitiba. There were 5743 pediatric autopsies performed in the Sector of Anatomic Pathology from 1960 to 1995 with 2049 cases corresponding to death during neonatal period. These later autopsies were reviewed and all cases with central nervous system lesions were selected and classified according to sex, age and pattern of central nervous system lesion. The central nervous system was affected in 1616 (78,87% of neonatal autopsies and there was predominance of intracerebral hemorrhages (73,39%, congenital malformations (4,27% and infections (3,59%. The hypoxic hemorrhages are the most prevalent central nervous system lesions in the neonatal period, affecting mainly premature babies. There was predominance of central nervous system malformations in the female neonates.

Lúcia de Noronha

2001-06-01

326

Cause-of-death ascertainment for deaths that occur outside hospitals in Thailand: application of verbal autopsy methods  

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Full Text Available Abstract Background Ascertainment of cause for deaths that occur in the absence of medical attention is a significant problem in many countries, including Thailand, where more than 50% of such deaths are registered with ill-defined causes. Routine implementation of standardized, rigorous verbal autopsy methods is a potential solution. This paper reports findings from field research conducted to develop, test, and validate the use of verbal autopsy (VA methods in Thailand. Methods International verbal autopsy methods were first adapted to the Thai context and then implemented to ascertain causes of death for a nationally representative sample of 11,984 deaths that occurred in Thailand in 2005. Causes of death were derived from completed VA questionnaires by physicians trained in ICD-based cause-of-death certification. VA diagnoses were validated in the sample of hospital deaths for which reference diagnoses were available from medical record review. Validated study findings were used to adjust VA-based causes of death derived for deaths in the study sample that had occurred outside hospitals. Results were used to estimate cause-specific mortality patterns for deaths outside hospitals in Thailand in 2005. Results VA-based causes of death were derived for 6,328 out of 7,340 deaths in the study sample that had occurred outside hospitals, constituting the verification arm of the study. The use of VA resulted in large-scale reassignment of deaths from ill-defined categories to specific causes of death. The validation study identified that VA tends to overdiagnose important causes such as diabetes, liver cancer, and tuberculosis, while undercounting deaths from HIV/AIDS, liver diseases, genitourinary (essential renal, and digestive system disorders. Conclusions The use of standard VA methods adapted to Thailand enabled a plausible assessment of cause-specific mortality patterns and a substantial reduction of ill-defined diagnoses. Validation studies enhance the utility of findings from the application of verbal autopsy. Regular implementation of VA in Thailand could accelerate development of the quality and utility of vital registration data for deaths outside hospitals.

Pattaraarchachai Junya

2010-05-01

327

Verbal autopsy-based cause-specific mortality trends in rural KwaZulu-Natal, South Africa, 2000-2009  

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Full Text Available Abstract Background The advent of the HIV pandemic and the more recent prevention and therapeutic interventions have resulted in extensive and rapid changes in cause-specific mortality rates in sub-Saharan Africa, and there is demand for timely and accurate cause-specific mortality data to steer public health responses and to evaluate the outcome of interventions. The objective of this study is to describe cause-specific mortality trends based on verbal autopsies conducted on all deaths in a rural population in KwaZulu-Natal, South Africa, over a 10-year period (2000-2009. Methods The study used population-based mortality data collected by a demographic surveillance system on all resident and nonresident members of 12,000 households. Cause of death was determined by verbal autopsy based on the standard INDEPTH/WHO verbal autopsy questionnaire. Cause of death was assigned by physician review and the Bayesian-based InterVA program. Results There were 11,281 deaths over 784,274 person-years of observation of 125,658 individuals between Jan. 1, 2000 and Dec. 31, 2009. The cause-specific mortality fractions (CSMF for the population as a whole were: HIV-related (including tuberculosis, 50%; other communicable diseases, 6%; noncommunicable lifestyle-related conditions, 15%; other noncommunicable diseases, 2%; maternal, perinatal, nutritional, and congenital causes, 1%; injury, 8%; indeterminate causes, 18%. Over the course of the 10 years of observation, the CSMF of HIV-related causes declined from a high of 56% in 2002 to a low of 39% in 2009 with the largest decline starting in 2004 following the introduction of an antiretroviral treatment program into the population. The all-cause age-standardized mortality rate (SMR declined over the same period from a high of 174 (95% confidence interval [CI]: 165, 183 deaths per 10,000 person-years observed (PYO in 2003 to a low of 116 (95% CI: 109, 123 in 2009. The decline in the SMR is predominantly due to a decline in the HIV-related SMR, which declined in the same period from 96 (95% CI: 89, 102 to 45 (95% CI: 40, 49 deaths per 10,000 PYO. There was substantial agreement (79% kappa = 0.68 (95% CI: 0.67, 0.69 between physician coding and InterVA coding at the burden of disease group level. Conclusions Verbal autopsy based methods enabled the timely measurement of changing trends in cause-specific mortality to provide policymakers with the much-needed information to allocate resources to appropriate health interventions.

Newell Marie-Louise

2011-08-01

328

Pathomorphological study on 106 autopsy cases of Thorotrast-related hepatic malignancies with comparison to non-Thorotrast-related cases  

International Nuclear Information System (INIS)

The pathomorphological features of 106 autopsy case of Thorotrast (TH)-related malignant tumours of the liver were studied and compared to those of non-Thorotrast-related cases. Among the 106 cases, 44 (41.5%) were cholangiocarcinoma (CHC), 42(39.6%) were angiosarcoma (AGS), 17(16.0%) were hepatocellular carcinoma (HCC), and three (2.8%) were double cancers. In contrast, in non-Thorotrast-related cases about 90% of the cases were hepatocellular and angiosarcoma was extremely rare. (author)

1988-10-03

329

The unexpected finding of a benign mature teratoma in a forensic pathology autopsy : a rare cause for sudden, unexpected death  

DEFF Research Database (Denmark)

Intracranial teratomas are rare tumors that are usually discovered in infancy due to progressive symptoms. We describe a case of a 38-year-old man who was found dead 9 hours after the last sign of life. The deceased's medical history could not explain the sudden, unexpected death. A forensic autopsy revealed an asymptomatic, mature teratoma in the left frontal and temporal lobes. We concluded that the cause of death must have been a generalized epileptiform seizure originating in the tumor site(s) leading to aspiration of the stomach contents and unfavorable positioning, resulting in asphyxia.

Høyer, Christian Bjerre; Ulhøi, Benedicte Parm

2013-01-01

330

Robust metrics for assessing the performance of different verbal autopsy cause assignment methods in validation studies  

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Full Text Available Abstract Background Verbal autopsy (VA is an important method for obtaining cause of death information in settings without vital registration and medical certification of causes of death. An array of methods, including physician review and computer-automated methods, have been proposed and used. Choosing the best method for VA requires the appropriate metrics for assessing performance. Currently used metrics such as sensitivity, specificity, and cause-specific mortality fraction (CSMF errors do not provide a robust basis for comparison. Methods We use simple simulations of populations with three causes of death to demonstrate that most metrics used in VA validation studies are extremely sensitive to the CSMF composition of the test dataset. Simulations also demonstrate that an inferior method can appear to have better performance than an alternative due strictly to the CSMF composition of the test set. Results VA methods need to be evaluated across a set of test datasets with widely varying CSMF compositions. We propose two metrics for assessing the performance of a proposed VA method. For assessing how well a method does at individual cause of death assignment, we recommend the average chance-corrected concordance across causes. This metric is insensitive to the CSMF composition of the test sets and corrects for the degree to which a method will get the cause correct due strictly to chance. For the evaluation of CSMF estimation, we propose CSMF accuracy. CSMF accuracy is defined as one minus the sum of all absolute CSMF errors across causes divided by the maximum total error. It is scaled from zero to one and can generalize a method's CSMF estimation capability regardless of the number of causes. Performance of a VA method for CSMF estimation by cause can be assessed by examining the relationship across test datasets between the estimated CSMF and the true CSMF. Conclusions With an increasing range of VA methods available, it will be critical to objectively assess their performance in assigning cause of death. Chance-corrected concordance and CSMF accuracy assessed across a large number of test datasets with widely varying CSMF composition provide a robust strategy for this assessment.

Vahdatpour Alireza

2011-08-01

331

Cultural imperatives and the ethics of verbal autopsies in rural Ghana  

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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 need to be given greater consideration in the collection of cause of death data, and this can be achieved through the establishment of processes that allow active engagement with communities, authorities of civil registrations, and Institutional Review Boards to take greater account of local contexts.

Raymond A. Aborigo

2013-09-01

332

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

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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 ?g/L, and in occipital lobe cortex 4 and 5 ?g/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 necessary to evaluate the impact on Hg in the brain of various sources of exposure, in particular, dental amalgam exposure.

Morild Inge

2007-10-01

333

[The analysis of neonatal deaths based on autopsy protocols of the Department of Forensic Medicine in Bialystok in the years 1955-2009].  

Science.gov (United States)

The authors performed an analysis of the causes of deaths of newborns with special emphasis placed on cases when neonaticide was suspected. In the discussed period, 17838 medico-legal autopsies were performed, 124 of them (0.695 per cent of all postmortem examinations) involved children who meet the WHO criteria for newborn - children under 28th day of life. The newborns were divided into two groups according to their exact age at the time of death - newborns who died within a short time after birth and newborns who died after the perinatal period. Their sex, body length and body weight were also taken into consideration. A total of 108 autopsies (87.1 per cent of all autopsied newborns) involved cases of suspected criminal infanticide within the first score of hours postnatally. In the majority of these cases, the cause of death was suffocation, rarely mechanical trauma. The case of death of older newborns was broadly understood trauma. PMID:22715681

Ptaszy?ska-Sarosiek, Iwona; Niemcunowicz-Janica, Anna; Filimoniuk, Marcin; Ok?ota, Magdalena; Wardaszka, Zofia; Szeremeta, Micha?; Sackiewicz, Adam

2011-01-01

334

Autopsy case of osteosarcoma of right mandibula developed after irradiation to the right cervical region for treatment of Hodgkin's disease  

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An autopsy case of osteosarcoma derived from the right mandible was reported. The case was a 64 year-old-female who received radiotherapy (/sup 60/Co) for Hodgkin's disease in the right neck 15 years prior to the development of her osteosarcoma. By autopsy findings, large nodular growths in the right facial region and the lung metastases of the osteosarcoma were remarkable. No recurrence of Hodgkin's disease was revealed by autopsy. The authors considered that right mandibular osteosarcoma were suspected to be radiation-induced according to the long latent interval and the development of the sarcoma derived from the same location of the irradiation field. (author).

Satoh, Masanobu; Suzuki, Atsumi; Obata, Kazuo; Yuki, Katsuhiko; Sekiyama, Saburo (Iwate Medical Coll., Morioka (Japan). School of Dentistry)

1989-06-01

335

Metabolic autopsy with postmortem cultured fibroblasts in sudden unexpected death in infancy: diagnosis of mitochondrial respiratory chain disorders.  

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Mitochondrial respiratory chain disorders are the most common disorders among inherited metabolic disorders. However, there are few published reports regarding the relationship between mitochondrial respiratory chain disorders and sudden unexpected death in infancy. In the present study, we performed metabolic autopsy in 13 Japanese cases of sudden unexpected death in infancy. We performed fat staining of liver and postmortem acylcarnitine analysis. In addition, we analyzed mitochondrial respiratory chain enzyme activity in frozen organs as well as in postmortem cultured fibroblasts. In heart, 11 cases of complex I activity met the major criteria and one case of complex I activity met the minor criteria. In liver, three cases of complex I activity met the major criteria and four cases of complex I activity met the minor criteria. However, these specimens are susceptible to postmortem changes and, therefore, correct enzyme analysis is hard to be performed. In cultured fibroblasts, only one case of complex I activity met the major criteria and one case of complex I activity met the minor criteria. Cultured fibroblasts are not affected by postmortem changes and, therefore, reflect premortem information more accurately. These cases might not have been identified without postmortem cultured fibroblasts. In conclusion, we detected one probable case and one possible case of mitochondrial respiratory chain disorders among 13 Japanese cases of sudden unexpected death in infancy. Mitochondrial respiratory chain disorders are one of the important inherited metabolic disorders causing sudden unexpected death in infancy. We advocate metabolic autopsy with postmortem cultured fibroblasts in sudden unexpected death in infancy cases. PMID:22658691

Yamamoto, Takuma; Emoto, Yuko; Murayama, Kei; Tanaka, Hidekazu; Kuriu, Yukiko; Ohtake, Akira; Matoba, Ryoji

2012-08-01

336

An autopsy study of histopathological changes in the urinary bladder transitional epithelium of atomic bomb survivors, 1960 - 1983  

International Nuclear Information System (INIS)

From the ABCC-RERF Life Span Study extended sample, there were 4,499 cases in the Pathology Study sample of atomic bomb survivors who had come to autopsy in the period 1960 - 83. Among 370 subjects who were heavily exposed with an estimated dose (T65D) of 100 rad or more, 72 (about 20 %) of them, whose urinary bladder epithelia had been preserved satisfactorily to suit the purpose of this study, were sampled as the index group. An equal number of control subjects were selected from the unexposed group individually, matched with the index cases by city, sex, age at death, and year of death. However, cases with marked epithelial autolysis and those pathologically diagnosed as urinary bladder cancer were previously excluded from both the index group and control subjects. These 72 pairs of autopsy cases were pathologically studied for the presence or absence of epithelial lesions of the urinary bladder, namely, hyperplasia, dysplasia and carcinoma-in-situ, and the frequencies of appearance of these lesions were compared statistically by ?2 test based on a case-control study design. Carcinoma-in-situ and severe dysplasia were detected in neither the index cases nor the control cases. The risk was relatively higher in the index group than in the control subjects for both hyperplasia and dysplasia (mild and moderate), in particular the relative risk of papillary hyperplasia being about 4.0, but as the total number of cases were small, this was not statistically significant. (author)

1988-01-01

337

Líneas guía en autopsias por sospecha de mala praxis asistencial Guidelines of autopsy in cases of suspected clinical malpractice  

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Full Text Available El presente trabajo revisa las líneas seguidas en casos de autopsia por sospecha de mala praxis. Se revisan las indicaciones, propósitos generales, técnicas de disección, exámenes complementarios, junto con los problemas éticos, de acuerdo con la experiencia del autor y la literatura. Un grado significativo de entrenamiento y experiencia tanto clínica como patológica es requerido en estos casos. Esta necesidad puede contrastar con la relativa falta de expertizatión de los médicos forenses en España, y con las limitaciones de la autopsia médico-legal. Algunas guías para solucionar este problema, como consulta con especialistas independientes, o con los comités de las especialidades médicas, son consideradas. Existen importantes problemas éticos en estos fallecimientos. En consecuencia, hay una necesidad de enfoque correcto de estos problemas. Se consideran algunas orientaciones en este sentido.The present paper reviews the guidelines for autopsy in cases of suspected clinical malpractice. Indications, general purposes, dissection techniques, laboratory and complementary examinations, as well as ethical problems are revised, according to the author's experience and literature review. A significant degree of training and skill, both clinical and pathologically, are required. This needing can contrast with the relative lack of specialization of Forensic Pathologists in Spain, and limitations of the judicial autopsy in these cases. Some guidelines to solve this problem, like independent expert consultation or advise by the Specialties Boards, are considered. Important ethical issues can arise from these deaths, therefore, a needing of correct address of these issues is perceived. Some orientations in this subject are considered.

J. Aso Escario

2011-12-01

338

Constant involvement of the Betz cells and pyramidal tract in multiple system atrophy: a clinicopathological study of seven autopsy cases.  

Science.gov (United States)

We investigated clinicopathologically the pyramidal signs, including spasticity, hyperreflexia, and Babinski's sign, and the involvement of the pyramidal tract and primary motor cortex, in seven Japanese autopsy cases of multiple system atrophy (MSA). Pyramidal signs were observed in six (86%) of the seven autopsy cases. Hyperreflexia and Babinski's sign were each evident in five patients, but spasticity was observed in only one patient. Loss of Betz cells and presence of glial cytoplasmic inclusions in the primary motor cortex were noticed in all seven cases. Astrocytosis in the fifth layer of the primary motor cortex was noticed in five cases, but its presence was not related to the duration of the disease. Involvement of the pyramidal tract in the spinal cord, particularly of the small myelinated fibers, was observed in all seven cases, but no involvement of the pyramidal tract in the midbrain was evident in any of the six cases in which this structure was examined. In MSA, pyramidal signs were shown to be present more frequently than believed before, and the clinicopathological correlation between pyramidal signs and involvement of the pyramidal tract was obvious. Constant involvement of Betz cells in MSA has not been reported. Our clinicopathological findings may also make a contribution to the understanding of the clinicopathological hallmarks of MSA. PMID:10867796

Tsuchiya, K; Ozawa, E; Haga, C; Watabiki, S; Ikeda, M; Sano, M; Ooe, K; Taki, K; Ikeda, K

2000-06-01

339

Unique morphologic and clinical features of liver predominant/primary small cell carcinoma-autopsy and biopsy case series.  

Science.gov (United States)

Liver predominant small cell carcinoma is rare but often presents as hyperacute liver failure with unknown primary and is a medical emergency. We present 2 autopsy and 7 biopsy cases of liver predominant small cell carcinoma and demonstrate that these patients present with liver failure and identifiable hepatomegaly but lack discrete lesions on imaging as well as no mass lesions identified in other organs including lung. Compared with the multiple nodules of metastatic small cell carcinoma in the liver, unique morphologic feature of liver predominant/primary small cell carcinoma in autopsy and biopsy specimens was a diffuse infiltration of small blue neoplastic cells predominantly in the sinusoidal space in the liver parenchyma. Before diagnosing liver predominant/primary small cell carcinoma, other infiltrating small blue cell neoplasms including lymphoma and peripheral neuroectodermal tumor need to be ruled out through immunohistochemistry. We, therefore, demonstrate that liver biopsy together with a rapid panel of immunostains is necessary to firmly establish a diagnosis of liver predominant small cell carcinoma and allow clinicians to immediately implement potentially lifesaving chemotherapy. PMID:24667053

Lo, Amy A; Lo, Edward C; Li, Haonan; Zhang, Wanying; Liao, Jie; Rao, M Sambasivia; Miller, Frank; Yang, Guang-Yu

2014-06-01

340

Inference of uptake and retention of plutonium from its cumulative urinary excretion and post mortem autopsy data  

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A method of interpreting plutonium in urine monitoring data in conjunction with subsequent estimates of organ contents of plutonium from autopsy measurements is illustrated using published data for one person who had been occupationally exposed to plutonium. This indicates a specific urinary excretion function for that person with about double the amplitude of the function that can be derived from data on human subjects injected with plutonium. If this is substantiated for other occupationally exposed persons there would be significant implications in the estimation of plutonium uptakes from plutonium in urine measurements. The retention half-lives of plutonium in bone and liver, which are inferred from the present data, are considerably shorter than those adopted in ICRP Publication 30 but these changes in half-life would cause little if any increase in the ALI of /sup 239/Pu calculated using the procedures in ICRP Publication 30. The method can also provide a robust estimate of committed dose equivalent to cells near bone surfaces from a person's intake of plutonium when using ICRP Publication 30 models with parameters adjusted on the basis of that person's monitoring and autopsy data.

Adams, N.

1986-01-01

 
 
 
 
341

Histopatología del daño múltiple de órganos en autopsias pediátricas / Histopathology of multiple organ damage in paediatric autopsies  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Introducción: el daño múltiple de órganos es el conjunto de alteraciones morfológicas, frecuentes en pacientes críticos, diagnosticadas en las autopsias como respuesta a la inflamación sistémica. En estudios realizados, las personas con edades jóvenes de la vida se han visto particularmente afectada [...] s por esta entidad. Objetivo: analizar el comportamiento del diagnóstico del daño múltiple de órganos en autopsias pediátricas procedentes de dos unidades de terapia intensiva e identificar las manifestaciones histopatológicas, la edad y el sexo de los niños fallecidos. Métodos: se revisaron 13 autopsias de niños fallecidos en el Hospital Militar Central "Dr. Luis Díaz Soto" en 5 años (2003-2007) y 42 correspondientes al Hospital Pediátrico Docente de San Miguel del Padrón en un periodo de 7 años (2000-2006), y se extrajeron las que cumplieron los criterios diagnósticos del daño múltiple de órganos. Resultados: se destacó la elevada frecuencia del daño múltiple de órganos en las autopsias de la terapia pediátrica en ambos centros estudiados. Los primeros periodos de vida fueron los más afectados, mientras el sexo mostró variaciones entre ambos centros estudiados. Conclusiones: el diagnóstico del daño múltiple de órganos es expresión de la calidad del trabajo que se realiza con las autopsias y la preparación del personal médico, lo cual se muestra en las elevadas cifras de coincidencias diagnósticas. Modular la respuesta inflamatoria incontrolada, es prevenir que se establezca el referido daño y, por lo tanto, es salvar la vida de un niño. Abstract in english Introduction: multiple organ damage is a group of morphological alterations, frequent in critical patients, which are diagnosed in autopsies as a response to systemic inflammation. Different studies report that the youngest people have been particularly affected by this disease. Objective: to analyz [...] e the behaviour of the diagnosis of multiple organ damage in paediatric autopsies from two Intensive Care Units and identify the histopathological manifestations, the age, and the sex in dead children. Methods: 13 autopsies of dead children were checked in "Dr. Luis Diaz Soto" Central Military Hospital during 5 years (2003-2007). Other 42 corresponding to the Paediatric Teaching Hospital of San Miguel del Padrón were also checked over a period of 7 years (2000-2006). The ones that reported diagnostic criteria of multiple organ damage were selected. Results: a high frequency of multiple organ damage in autopsies of paediatric therapies in both cases under study was emphasized. The first periods of life were the most affected ones and the sex showed some variations in the two centres under study. Conclusions: the diagnosis of multiple organ damage is the reflection of both the quality of work carried out with autopsies and the training of the medical staff. It is shown in the high levels of diagnostic coincidences. To regulate the uncontrolled inflammatory response means preventing the referred damage, thus saving a child's life.

Teresita, Montero González; Yanira Noalis, Díaz Valdés; José, Hurtado de Mendoza Amat; Cecilia, Toledo Veja; Arturo, Delgado Delgado; Sonia, Pujol Olivares.

342

Characterization of autopsy-proven fatal asthma patients in São Paulo, Brazil Caracterización de los pacientes fallecidos por asma certificada por autopsia en São Paulo, Brasil  

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Few data are available on autopsy-proven fatal asthma patients in São Paulo, Brazil. We characterized 73 asthma patients who were autopsied at the Serviço de Verificação de Óbitos da Universidade de São Paulo between 1996 and 2004. An interview with the next of kin assessed socioeconomic status, history, and treatment of asthma. There were 42 women and 31 men. Fifty-six (76.7%) of them were older than 34 years. Sixty-three percent were Caucasians, 77.3% had < 8 years of schooling, and t...

Thais Mauad; Ferreira, Diogenes S.; Costa, Maria Beatriz G.; Araujo, Bianca B.; Silva, Luiz Fernando F.; Martins, Milton A.; Wenzel, Sally E.; Marisa Dolhnikoff

2008-01-01

343

Characteristics of prostate cancer among atomic bomb exposure obtained from autopsy specimen at Data and Specimens Center of Atomic Bomb Disaster at Research Institute for Nuclear Medicine and Biology of Hiroshima University  

Energy Technology Data Exchange (ETDEWEB)

Fifty-four cases of prostate cancer received autopsy at hospitals in Hiroshima city between 1954 and 1981 were compared with 34 cases of prostate cancer of non-exposed, received autopsy at Hiroshima University. They are classified by age, histology and distance from the hypocenter. (J.P.N.).

Matsuda, Masahiro; Okamoto, Taro; Watanabe, Hiromitsu; Ito, Akihiro; Hayakawa, Norihiko; Munaka, Masaki (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology); Terada, Yoritaka; Sakata, Masayuki

1992-12-01

344

Deaths of infants subject to forensic autopsy in Estonia from 2001 to 2005: what can we learn from additional information?  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Deaths from childhood injury are a public health problem worldwide. A relatively high proportion of child deaths of undetermined manner in Estonia raises concerns about potential underestimation of intentional deaths, especially in infants. This suggests that more information on the circumstances surrounding death is needed to establish the manner of death correctly and, more importantly, to prevent these deaths. The objective of this study was to detect, describe, and analyze the circumstances around deaths of infants subject to forensic autopsy in Estonia to reveal hidden cases of child abuse and more accurately determine causes of death. Methods Study cases included all infant deaths in Estonia from 2001 to 2005 subject to forensic autopsy at the Estonian Bureau of Forensic Medicine. Additional information was obtained from a series of visits to general practitioners, including characteristics of infant health, family composition, parents' education and employment, living conditions, and circumstances around death as perceived by medical staff in charge of outpatient services for these families. Results The total number of infant deaths in Estonia between 2001 and 2005 subject to forensic autopsy was 98, with 40 (40.8% deaths attributed to a disease and 58 deaths (59.2% resulting from injury. Elements of child abuse were involved in as many as 57.7% (95% CI 46.9-68.1 of the deaths for which medical records were available (n = 90. At death, the majority of these cases were registered as diseases or deaths from unintentional injury. Average annual mortality from external causes in Estonian infants, 2001-2005, previously reported by us as 88.1 per 100,000 (95% CI 68.1-113.6 would decrease to 41.0 (95% CI 26.9-57.8. Many infants in the studied group had faced multiple threats and were living in poor hygienic conditions. In a number of cases, they were left alone or looked after by older siblings. Parents' alcohol abuse played an important role in a considerable number of cases. Conclusions Using additional sources of information revealed new information about child abuse not reflected in the cause of death diagnosis. Effective interventions aimed at parent education and improved follow-up of children by medical staff may reduce mortality from external causes among Estonian infants by more than half.

Grjibovski Andrej M

2010-10-01

345

What a pity the master cannot admire his pupil's work: the autopsy of the anatomist Antonio Cocchi (1695-1758) performed by his pupil Saverio Manetti.  

Science.gov (United States)

Antonio Cocchi (1695-1758) was a physician, sanitary administrator, and Professor of Anatomy at the University of Florence. Wide-ranging in his interests, he was also a philologist, botanist, and a cultured traveler through 18th-century Europe. After Cocchi died, his pupil Saverio Manetti (1723-1785) reported, in a private letter on the state of health of his renowned master, the circumstances of his death and the autopsy findings. In an endeavour to determine the cause of death, Manetti accurately described the symptoms and clinical signs preceding the exitus of Antonio Cocchi and related them to the autopsy results. Interestingly, his lifestyle habits, past medical history, and family diseases were all considered when making the diagnosis. This handling of the matter clearly proceeds from Cocchi's teachings. As an anatomist, Cocchi believed autopsy to be a fundamental tool in achieving new insights into medicine while, as a professor, he emphasized the didactic relevance of autopsy in medical education. Manetti's letter appears as a surprisingly modern example of clinicopathological practice. Based on this informative document, we present an interpretation of the possible cause of the death of Antonio Cocchi, namely, congestive heart failure. PMID:20619688

Santi, Raffaella; Conti, Andrea A; Nesi, Gabriella

2011-01-01

346

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

International Nuclear Information System (INIS)

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

2011-06-01

347

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

Energy Technology Data Exchange (ETDEWEB)

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

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

348

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

DEFF Research Database (Denmark)

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 accumulations, but autopsy was superior to CT in the detection of organ injuries and aortic ruptures. We recommend a combination of CT and autopsy for the postmortem investigation of traffic fatality victims.

Leth, Peter Mygind; Struckmann, Henrik

2013-01-01

349

Partitioning of /sup 238/Pu, /sup 239/Pu, and /sup 241/Am in skeleton and liver of United States transuranium registry autopsy cases  

Energy Technology Data Exchange (ETDEWEB)

The distribution and concentration of the transuranic elements in humans was studied through analysis of tissues collected from occupationally exposed persons at autopsy. This report describes the results of the evaluation of data from registrants with measurable concentrations of plutonium and americium who had contributed bone and liver specimens to the United States Transuranium Registry. (ACR)

Kathren, R.L.

1986-06-01

350

An Autopsy Case Involving a 12-year History of Amyotrophic Lateral Sclerosis with CIDP-like Polyneuropathy.  

Science.gov (United States)

Demyelinating polyneuropathy associated with amyotrophic lateral sclerosis (ALS) is quite rare. We herein present the case of a woman patient with a 12-year history of chronic inflammatory demyelinating polyneuropathy (CIDP)-like polyneuropathy who later developed bulbar palsy and respiratory failure. The autopsy findings revealed neuronal loss in the anterior horn and primary motor cortex with degeneration of the corticospinal tracts. Diffuse phosphorylated TAR DNA-binding protein of 43 kDa inclusions were observed in the anterior horn and cerebral cortices, including the temporal lobe. The final diagnosis was ALS with CIDP-like polyneuropathy. Compared with other reports of ALS with CIDP-like polyneuropathy, the present patient was younger and followed a relatively long clinical course, with no upper motor neuron signs. PMID:24930660

Akaishi, Tetsuya; Tateyama, Maki; Kato, Kazuhiro; Miura, Emiko; Izumi, Rumiko; Endo, Kaoru; Sugeno, Naoto; Suzuki, Naoki; Baba, Toru; Misu, Tatsuro; Kikuchi, Akio; Hasegawa, Takafumi; Konosu-Fukaya, Sachiko; Fujishima, Fumiyoshi; Suzuki, Hiroyoshi; Nakashima, Ichiro; Aoki, Masashi

2014-01-01

351

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

Science.gov (United States)

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. PMID:22989691

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

2012-01-01

352

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

Directory of Open Access Journals (Sweden)

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.

Dorothy Kizza

2012-09-01

353

Autopsy findings in a case of a small cell lung cancer complicated by radiotherapy induced acute interstitial pneumonia  

Energy Technology Data Exchange (ETDEWEB)

The authors describe the case of a 71-year-old man who had been referred to his hospital because of a dry cough and an associated abnormality that had been detected by x-ray. Based on chest x-ray evaluations and the endoscopic bronchial biopsy findings the diagnosis was a small cell lung cancer. The patient thus received a 2 time regimen of cisplatin chemotherapy and subsequent radiotherapy (40 Gy). Two weeks after this radiotherapy, however the patient complained of an increasing dyspnea. Two days later, he was readmitted to hospital because of pneumonia and severe dyspnea, but died of respiratory failure on the same day. The autopsy findings revealed diffuse organized alveolar duct damage that had been induced by radiotherapy directed toward a relatively large area that included the right lower lung and the mediastinum. (author).

Umeki, Shigenori; Hirokawa, Mitsuyoshi (Kawasaki Medical School, Kurashiki, Okayama (Japan))

1993-09-01

354

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

International Nuclear Information System (INIS)

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.)

1988-01-01

355

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

Science.gov (United States)

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

Watanabe, K; Hasegawa, K; Suzuki, O

2011-07-01

356

Detection of Epstein-Barr virus DNA in tongue tissues from AIDS autopsies without clinical evidence of oral hairy leukoplakia.  

Science.gov (United States)

Epstein-Barr virus (EBV) DNA was detected by in situ hybridization at 3 sites of 30 samples taken from clinically normal lateral border of tongue mucosa from 15 AIDS autopsies and in none of 20 samples from 10 controls. The first positive case showed a thin layer of parakeratosis correlated with positive signals for EBV in one area and an adjacent area without obvious parakeratosis was also positive for EBV. These findings were present on both sides of the tongue. The second case was unilaterally positive for EBV and parakeratosis was absent. The hybridization signals were localised to koilocyte-like cells in the stratum spinosum, as in oral hairy leukoplakia (OHL). These observations suggest that the in situ hybridization technique can detect very early or subclinical OHL, and supports the role of EBV in the pathogenesis of this lesion. PMID:7776261

Mabruk, M J; Flint, S R; Toner, M; Leonard, N; Sheils, O; Coleman, D C; Atkins, G J

1995-03-01

357

Determinantes morfológicos de prognóstico em pneumonia nosocomial: um estudo em autópsias Morphological prognostic factors in nosocomial pneumonia: an autopsy study  

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Full Text Available OBJETIVO: Determinar a prevalência de pneumonia nosocomial nas autópsias em um hospital público universitário; identificar os fatores de risco relacionados à pneumonia nosocomial e os potenciais fatores prognósticos relacionados à ocorrência de pneumonia nosocomial fatal; e correlacionar os achados anatomopatológicos com a ocorrência de pneumonia nosocomial e/ou pneumonia aspirativa. MÉTODOS: Estudo retrospectivo de 199 pacientes autopsiados, maiores de 1 ano de idade, internados no Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista entre 1999 e 2006, cuja causa de morte (causa básica ou associada foi pneumonia nosocomial. Testou-se a associação dos dados demográficos, clínicos e anatomopatológicos com os desfechos pneumonia nosocomial fatal e pneumonia aspirativa fatal. As variáveis significativas entraram na análise multivariada. RESULTADOS: A idade média foi de 59 ± 19 anos. A prevalência de pneumonia nosocomial em autópsias foi 29%, e essa foi a causa mortis de 22,6% dos pacientes autopsiados. A pneumonia nosocomial fatal correlacionou-se com os achados anatomopatológicos de alterações estruturais tabágicas (OR = 3,23; IC95%: 1,26-2,95; p = 0,02 e acometimento pulmonar bilateral (OR = 3,23; IC95%: 1,26-8,30; p = 0,01. Não houve associações significativas entre as variáveis e pneumonia aspirativa fatal. CONCLUSÕES: Em nossa amostra, a pneumonia nosocomial teve prevalência elevada e foi responsável por quase 25% das mortes. A mortalidade é favorecida por alterações estruturais tabágicas e pneumonia bilateral. Esses achados corroboram os resultados de diversos estudos clínicos sobre pneumonia nosocomial.OBJECTIVE: To determine the prevalence of nosocomial pneumonia in autopsies at a public university hospital; to identify the risk factors for nosocomial pneumonia and the potential prognostic factors associated with fatal nosocomial pneumonia and with fatal aspiration pneumonia; and to determine whether anatomopathological findings correlate with nosocomial pneumonia or aspiration pneumonia. METHODS: A retrospective study involving 199 autopsied patients, older than 1 year of age, who had been admitted to the São Paulo State University Botucatu School of Medicine Hospital das Clínicas and died of nosocomial pneumonia (underlying or contributing cause, between 1999 and 2006. Demographic, clinical and anatomopathological variables were tested regarding their association with the outcomes (fatal nosocomial pneumonia and fatal aspiration pneumonia. The significant variables were analyzed using multivariate analysis. RESULTS: The mean age was 59 ± 19 years. The prevalence of nosocomial pneumonia in autopsies was 29%, and the disease was the cause of death in 22.6% of the autopsied patients. Fatal nosocomial pneumonia correlated with the following anatomopathological findings: tobacco-associated structural lesions (OR = 3.23; 95% CI: 1.26-2.95; p = 0.02 and bilateral pneumonia (OR = 3.23; 95% CI: 1.26-8.30; p = 0.01. None of the variables were found to be significantly associated with fatal aspiration pneumonia. CONCLUSIONS: In our sample, there was a high prevalence of nosocomial pneumonia, which was responsible for almost 25% of all of the deaths. Smoking-related structural lesions and bilateral pneumonia all favored mortality. These findings corroborate the results of various clinical studies on nosocomial pneumonia.

Luiz Mário Baptista Martinelli

2010-02-01

358

Statistical analysis of a Los Alamos Scientific Laboratory study of plutonium in U.S. autopsy tissue  

International Nuclear Information System (INIS)

The autopsy Tissue Program at the Los Alamos Scientific Laboratory was begun in 1959. To date, tissues from 900 or more persons in 7 geographic regions throughout the U.S. have been collected and analyzed for plutonium content. The tissues generally consist of lung, liver, kidney, lymph node, bone, spleen, thyroid and gonadal tissues for each individual. The present objective of the program is to determine the level of plutonium in human tissues due solely to fall-out from weapons testing. The baseline thus established is to be used to evaluate future changes. Geographical comparisons are made, but require adjustment because of outliers, and time and age trends present in the data. (author)

1980-01-01

359

An autopsy case report of suicide by multiple self-cutting and self-stabbing over the chest and neck.  

Science.gov (United States)

A 27-year-old male with a clinical history of acquired immunodeficiency syndrome committed suicide by cutting and stabbing himself in his bedroom. During the scene investigation, the knife was recovered below his body and the room was not ransacked The external examination revealed one deep incised wound with one superficial incised wound over the anterior aspect of the neck, three horizontal stab wounds with five superficial small incised wounds over the chest and two superficial incised wounds over the ventral aspect of the left wrist. They showed multiple hesitation wounds. Subsequent autopsy showed a cut wound of the thyroid cartilage penetrating trachea and a penetrating wound of the left lower lung with 500 ml fresh blood hemothorax. All findings lead to suspicion of suicide by multiple sharp forces. PMID:19530594

Srisont, Smith; Peonim, A V M Vichan; Chirachariyavej, Thamrong

2009-06-01

360

Distribution of cerebellar cortical lesions in multiple system atrophy: a topographic neuropathological study of three autopsy cases in Japan.  

Science.gov (United States)

We investigated neuropathologically the distribution of the cerebellar cortical lesions in three Japanese autopsy cases of multiple system atrophy (MSA) using hemisphere specimens. The lesions were classified as mild, moderate or severe. The distribution of cerebellar cortical lesions in all three cases were uniform: the cerebellar cortical lesions were more conspicuous in the vermis than in the hemisphere. These neuropathological findings differ from the established theory that cerebellar lesions of MSA are more pronounced in the hemisphere than in the vermis. The degree of cerebellar cortical lesions in our cases increased in relation to the duration of the disease. Our pathological data may contribute to the morphological differential diagnosis in various neurodegenerative disorders including late cortical cerebellar atrophy. Our neuropathological findings may also make a contribution to the neuroradiological progress in the differential diagnosis of spinocerebellar disease. PMID:9562327

Tsuchiya, K; Watabiki, S; Sano, M; Iobe, H; Shiotsu, H; Taki, K; Hashimoto, K

1998-02-18

 
 
 
 
361

Post-mortem imaging in traffic fatalities: from autopsy to reconstruction of the scene using freely available software.  

Science.gov (United States)

CT scan coupled with autopsy is the gold standard for the forensic investigation of fatal road traffic accidents. The objective of the present paper is to demonstrate that from this, it is possible to reconstruct elements of an accident with minimal human and material resources using basic knowledge of three-dimensional imaging software. This is illustrated by a case implicating a pedestrian and a motor vehicle in which the impact areas were matched using freely available computer-aided design software. Such an approach aims to improve the visualisation of forensic elements, which is crucial for the understanding of all parties involved in the legal implications of such accidents and which could become the standard practice in many institutes. PMID:23334320

Benali, Larbi; Gromb, Sophie; Bou, Christophe

2013-09-01

362

Infective endocarditis caused by multidrug-resistant Streptococcus mitis in a combined immunocompromised patient: an autopsy case report.  

Science.gov (United States)

An autopsy case of infective endocarditis caused by multidrug-resistant Streptococcus mitis was described in a patient with a combination of factors that compromised immune status, including autoimmune hemolytic anemia, post-splenectomy state, prolonged steroid treatment, and IgA deficiency. The isolated S. mitis strain from blood culture was broadly resistant to penicillin, cephalosporins, carbapenem, macrolides, and fluoroquinolone. Recurrent episodes of bacterial infections and therapeutic use of several antibiotics may underlie the development of multidrug resistance for S. mitis. Because clinically isolated S. mitis strains from chronically immunocompromised patients have become resistant to a wide spectrum of antibiotics, appropriate antibiotic regimens should be selected when treating invasive S. mitis infections in these compromised patients. PMID:22965841

Matsui, Natsuko; Ito, Makoto; Kuramae, Hitoshi; Inukai, Tomomi; Sakai, Akiyoshi; Okugawa, Masaru

2013-04-01

363

Leptomeningeal carcinomatosis as initial presentation in adenocarcinoma of lung with signet ring cell features: an autopsy case report.  

Science.gov (United States)

Signet ring cell (SRC) features are rare but well-recognized cytological changes of pulmonary adenocarcinoma (PA). PA with SRC features (PA-SRC) is frequently associated with anaplastic lymphoma kinase (ALK) gene rearrangement, and recognition of PA-SRC may be important for the administration of targeted treatment. To the authors' knowledge, leptomeningeal carcinomatosis (LMC) as an initial presentation of PA-SRC has not yet been reported. We report an autopsy case from a 59-year-old female who presented with intractable headache for 6 weeks and died of LMC as a result of metastatic PA-SRC. Premortem brain MRI showed nonspecific leptomeningeal enhancement. At autopsy, a tan rubbery mass was found in the hilar area of the right lung, which also surrounded the lower trachea and carotid arteries. A right posteromedial middle lobe mass was also found. Leptomeninges were slightly thickened, without discrete masses. Microscopic examination of the lung mass and leptomeninges showed solid sheets and nests of malignant cells with pleomorphic nuclei and frequent SRC features which comprised 50% of the mass. Immunohistochemically, the tumor cells demonstrated strong diffuse expression of cytokeratin (CK)-7, TTF-1, and napsin-A. Immunostains for CK-20 and ALK were negative. These features were consistent with PA-SRC. It has been reported that approximately 70% of PAs demonstrate ALK gene rearrangement when SRCs comprised >10% of the tumor cells. The presence of SRCs can be indicative of a lung primary and, because of frequent ALK gene rearrangement in PA-SRC, proper recognition of PA-SRC may be important in determining whether further testing is advisable (e.g., ALK immunostaining and/or ALK gene rearrangement). PMID:23119115

Choi, Eunice; Lewis, Annisa L; Takei, Hidehiro; Ro, Jae Y

2012-01-01

364

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

Directory of Open Access Journals (Sweden)

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.

Kotsilianou Olympia

2011-01-01

365

Verbal autopsy coding: are multiple coders better than one? / Codage des autopsies verbales: est-il préférable qu'il soit effectué par plusieurs codeurs au lieu d'un ? / Codificación de las autopsias verbales: ¿varios codificadores mejor que uno?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: English Abstract in spanish OBJETIVO: Evaluar el impacto en los perfiles de causas de defunción notificadas de una estrategia de codificación de las autopsias verbales basada en el uso de uno o varios agentes codificadores para examinar cada caso de defunción. MÉTODOS: A lo largo de 12 meses durante 2003-2004 se documentaron l [...] as defunciones registradas en 45 aldeas (población total: 180 162 habitantes) del sur de la India, rellenándose para cada fallecimiento un cuestionario de autopsia verbal estándar. Dos codificadores médicos, sin conocer cada uno las decisiones del otro, asignaron las causas de defunción basándose en las causas enumeradas en los títulos de los capítulos de la décima revisión de la Clasificación Internacional de Enfermedades y Problemas de Salud Conexos (CIE-10). Para los tres títulos de capítulos que se aplicaron a más de 100 defunciones, se analizó también el grado de coincidencia para subconjuntos de causas de defunción dentro del capítulo. En caso de discrepancia, un tercer codificador intervenía para dirimirla. La medición del grado de acuerdo entre los dos codificadores médicos se realizó mediante el estadístico kappa de Cohen (K). RESULTADOS: En total se documentaron 1354 defunciones, realizándose una autopsia verbal en 1329 (98%) de ellas. En lo que respecta a los títulos de los capítulos de la CIE-10, los codificadores médicos asignaron la misma causa a 1255 defunciones (94%) (K = 0,93; intervalo de confianza del 95%: 0,92-0,94). Los perfiles de mortalidad derivados de las causas asignadas por cada médico fueron muy similares a los perfiles obtenidos mediante el proceso de consenso, hasta el punto de que el orden de importancia de las 10 causas principales de defunción fue el mismo con los tres métodos de codificación. CONCLUSIÓNS: La duplicación de la codificación de los resultados de las autopsias verbales no ofrece grandes ventajas respecto al sistema de codificador único en el contexto de la vigilancia de la mortalidad o la identificación de perfiles demográficos de la mortalidad. Se podrían desviar recursos hacia otros aspectos del proceso de vigilancia de la mortalidad, como por ejemplo la validación. Abstract in english OBJECTIVE: To assess the impact on the reported cause-of-death patterns of a verbal autopsy coding strategy based on a review of every death by multiple coders versus a single coder. METHODS: Deaths in 45 villages (total population 180 162) in southern India were documented during 12 months in 2003- [...] 2004, and a standard verbal autopsy questionnaire was completed for each death. Two physician coders, each unaware of the other's decisions, assigned an underlying cause of death in accordance with the causes listed in the chapter headings of the International classification of diseases and related health problems, 10th revision (ICD-10). For the three chapter headings that applied to more than 100 of the deaths, agreement for subsets of causes of death within the chapter was also analysed. In the event of discrepancies, a third coder was used to finalize a cause of death. Cohen's kappa statistic (K) was used to measure levels of agreement between the two physician coders. FINDINGS: In total, 1354 deaths were documented, and a verbal autopsy was completed for 1329 (98%) of them. At the chapter heading level of the ICD-10, physician coders assigned the same cause to 1255 deaths (94%) (K = 0.93; 95% confidence interval: 0.92-0.94). The patterns of death derived from the causes assigned by each physician were all very similar to the patterns obtained through the consensus process, with the rank order of the 10 leading causes of death being the same for all three coding methods. CONCLUSION: Duplicate coding of verbal autopsy results has little advantage over a single-coder system for mortality surveillance or for identifying population patterns of death. Resources could be better diverted to other parts of the mortality surveillance process, such as validation.

Rohina, Joshi; Alan D, Lopez; Stephen, MacMahon; Srinath, Reddy; Rakhi, Dandona; Lalit, Dandona; Bruce, Neal.

366

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

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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 the 73 undiagnosed patients appeared to be completely without signs of cirrhosis (silent cirrhosis). In the diagnosed group, 70% of patients died from hepatic causes, in contrast to 16% in the undiagnosed group. At autopsy, the following complications of cirrhosis were found more frequently in the diagnosed group than in the undiagnosed group: ascites (41% vs. 8%), oesophageal varices (44% vs. 10%), splenomegaly (52% vs. 29%). The prevalence of hepatocellular carcinoma did not differ significantly in the two groups (12% vs. 8%). It is concluded that cirrhosis without obvious signs occurs relatively frequently, and that no sensitive non-invasive screening methods are available at present.

Graudal, Niels; Leth, Peter Mygind

1991-01-01

367

Total anomalous pulmonary vein drainage: Report of an autopsy case associated with atresia of the common pulmonary vein and left superior pulmonary vein  

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We describe the clinicopathological features of a case of total anomalous pulmonary vein drainage (TAPVD) associated with atresia of the common pulmonary vein (ACPV). A male Japanese infant born at 37 weeks of gestation demonstrated apnea and severe respiratory acidosis immediately after delivery. The patient died of hypoxemic respiratory failure 6 days after birth despite the initiation of artificial ventilation and administration of a surfactant. Autopsy showed the bilateral inferior pulmon...

Yamada, Sohsuke; Hisaoka, Masanori; Wang, Ke-yong; Ding, Yan; Guo, Xin; Shimajiri, Shohei; Matsumoto, Hayato; Shirakawa, Yoshitsugu; Sasaguri, Yasuyuki

2011-01-01

368

Malaria-related mortality based on verbal autopsy in an area of low endemicity in a predominantly rural population in Ethiopia  

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Abstract Background Although malaria is one of the most important causes of death in Ethiopia, measuring the magnitude of malaria-attributed deaths at community level poses a considerable difficulty. Nevertheless, despite its low sensitivity and specificity, verbal autopsy (VA) has been the most important technique to determine malaria-specific cause of death for community-based studies. The present study was undertaken to assess the magnitude of malaria mortality in a predom...

Deressa Wakgari; Fantahun Mesganaw; Ali Ahmed

2007-01-01

369

A report of two cases: post flood autopsy findings in urban patients with an unusual presentation of leptospirosis with hemorrhagic pneumonia in government medical college, Surat  

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South Gujarat is endemic zone for leptospirosis in paddy workers but recently we have post flood plenty of urban patients who were presented with high grade fever, dyspnea & haemoptysis with rapid deterioration. Clinicians were suspecting an outbreak of Hantavirus or leptospirosis. Both our patients were serologically negative for leptospirosis ante mortem, but alveolar hemorrhage & raised urea was the only finding. Both our patient rapidly deteriorated. We performed autopsy & too...

Mandakini M Patel, Bhavna Gamit

2011-01-01

370

Atomic force microscopy of paired helical filaments isolated from the autopsied brains of patients with Alzheimer's disease and immunolabeled against microtubule-associated protein tau.  

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Atomic force microscopy was employed to study the structural features of paired helical filaments isolated from autopsied brains of Alzheimer's disease patients. The identity of paired helical filaments was confirmed following a specific immunogold labeling using antibodies directed against the microtubule-associated protein tau, which is the main constituent of paired helical filaments. Computer-assisted analysis of high resolution, three-dimensional images allowed us to study the longitudin...

Ikonomovic, M. D.; Armstrong, D. M.; Yen, S. H.; Obcemea, C.; Vidic, B.

1995-01-01

371

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

International Nuclear Information System (INIS)

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, P2 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 controls. (orig.)

372

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  

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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 t...

1990-01-01

373

Postmortem interval alters the water relaxation and diffusion properties of rat nervous tissue – Implications for MRI studies of human autopsy samples  

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High-resolution imaging of human autopsy tissues may improve our understanding of in vivo MRI findings, but interpretation is complicated because samples are obtained by immersion fixation following a postmortem interval (PMI). This study tested the hypotheses that immersion fixation and PMI's from 0 - 24 hours would alter the water relaxation and diffusion properties in rat cortical slice and spinal cord models of human nervous tissue. Diffusion data collected from rat cortical slices at mul...

Shepherd, Timothy M.; Flint, Jeremy; Thelwall, Peter E.; Stanisz, Greg J.; Mareci, Thomas H.; Yachnis, Anthony T.; Blackband, Stephen J.

2009-01-01

374

The effects of aging on biceps brachii muscle fibers: a morphometrical study from biopsies and autopsies Efeitos do envelhecimento sobre as fibras do músculo biceps braquial: estudo morfométrico em biópsias e autópsias  

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OBJECTIVES: In order to study the morphology and size of muscle fibers, cross sections of biceps brachii samples from autopsies, up to 9 hours after death, and biopsies of 72 subjects were compared. The subjects aged 13 to 84 years in both sexes. METHODS: The samples obtained from autopsies (n=47) were from subjects with sudden death, or who died after acute disease without evidence of neuromuscular involvement. The biopsies (n=25) were from patients with symptoms suggestive of inflammatory o...

Ana Cláudia Mattiello-Sverzut; Leila Chimelli; Maria Silvia de Assis Moura; Silvia Teixeira; José Alberto Mello de Oliveira

2003-01-01

375

Comparative study of abnormalities of central nervous system in children and adults autopsied after bone marrow transplantation Estudo comparativo das alterações no sistema nervoso central de crianças e adultos autopsiados após transplante de medula óssea  

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BACKGROUND: We compare neuropathological abnormalities in children and adults after bone marrow transplantation (BMT) by means of autopsy in the Department of Medical Pathology, Universidade Federal do Paraná (UFPR), Brazil. METHODS: Autopsy reports of 180 patients were reviewed. They were divided in two groups: patients under 15 years old and those 15 or older. Age, gender, clinical diagnosis at time of BMT, survival time, neuropathological abnormalities and cause of death were analyzed. RE...

Benites Filho, Paulo R.; Pinto Almeida, Luis G. M.; José Zanis Neto; Ricardo Pasquini; Bleggi-torres, Luiz F.

2007-01-01

376

An autopsied case of human chorionic gonadotropin (HCG)-producing lung cancer accompanied by bilateral radiation pneumonitis due to small doses of irradiation  

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An autopsied case of human chorionic gonadotropin (HCG)-producing lung cancer accompanied by bilateral radiation pneumonitis is reported. A 68 year-old male was admitted to our hospital because of an abnormal shadow in his chest x-ray. Lung cancer was diagnosed and treated with radiotherapy. The radiotherapy (1,200 cGy) was discontinued, however because his general condition deteriorated. Chest x-rays then showed a pneumonia-like shadow in the projected field of irradiation. The same shadow was observed in the contralateral lung field one month later. Gynecomastia and an elevated level of serum HCG were noticed during hospitalization. The patient died and an autopsy was performed. Histopathological examination upon autopsy confirmed a large cell carcinoma of the lung which stained positively for HCG with an immunoenzyme labelling technique using the PAP method. Marked fibrosis and thickening of the alveolar septae were histologically demonstrated in the projected field of irradiation and the contralateral field where chest x-rays showed the pneumonia-like shadow. (author).

Tano, Yoshihiko; Adachi, Michifumi; Kimura, Makoto; Matsushima, Toshiharu; Torii, Takashi (Kawasaki Medical School, Kawasaki Hospital, Okayama (Japan))

1990-07-01

377

An autopsied case of human chorionic gonadotropin (HCG)-producing lung cancer accompanied by bilateral radiation pneumonitis due to small doses of irradiation  

International Nuclear Information System (INIS)

An autopsied case of human chorionic gonadotropin (HCG)-producing lung cancer accompanied by bilateral radiation pneumonitis is reported. A 68 year-old male was admitted to our hospital because of an abnormal shadow in his chest x-ray. Lung cancer was diagnosed and treated with radiotherapy. The radiotherapy (1,200 cGy) was discontinued, however because his general condition deteriorated. Chest x-rays then showed a pneumonia-like shadow in the projected field of irradiation. The same shadow was observed in the contralateral lung field one month later. Gynecomastia and an elevated level of serum HCG were noticed during hospitalization. The patient died and an autopsy was performed. Histopathological examination upon autopsy confirmed a large cell carcinoma of the lung which stained positively for HCG with an immunoenzyme labelling technique using the PAP method. Marked fibrosis and thickening of the alveolar septae were histologically demonstrated in the projected field of irradiation and the contralateral field where chest x-rays showed the pneumonia-like shadow. (author)

1990-01-01

378

A clinical, genetic, neuropathological study in a Japanese family with SCA 6 and a review of Japanese autopsy cases of autosomal dominant cortical cerebellar atrophy.  

Science.gov (United States)

This report concerns a Japanese family with genetically confirmed SCA 6, including an autopsy case, and a review of Japanese autopsy cases of autosomal dominant cortical cerebellar atrophy (ADCCA). The proband (Case 1) was a Japanese woman. She developed gait disturbance at age 62. The father and younger sister (Case 2) had the same disorder. She died at age 67 due to subarachnoid hemorrhage. Neuropathological examination revealed severe loss of Purkinje cells in the cerebellum, prominently in the dorsal vermis, and absence of neuronal loss in the inferior olives. Molecular genetic study showed the CAG-repeat expansion of SCA 6 gene. The younger sister (Case 2) developed gait disturbance at age 62. Neurological examination at age 66 revealed cerebellar signs without sensory disturbance. Neuroimaging at this time showed cerebellar atrophy, prominently in the vermis. She died of multiple myeloma at age 66. A neuropathological review of Japanese autopsy cases of ADCCA showed that there are two patterns in the distribution of cerebellar cortical lesions of Japanese patients with ADCCA. The distribution of cerebellar cortical lesions in genetically confirmed Japanese patients with SCA 6 is more prominent in the vermis than in the hemisphere. PMID:9804117

Tsuchiya, K; Ishikawa, K; Watabiki, S; Tone, O; Taki, K; Haga, C; Takashima, M; Ito, U; Okeda, R; Mizusawa, H; Ikeda, K

1998-09-18

379

Postmortem virtual volumetry of the heart and lung in situ using CT data for investigating terminal cardiopulmonary pathophysiology in forensic autopsy.  

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Postmortem CT (PM-CT) is useful to investigate the viscera in situ before opening the body cavity at autopsy. The present study investigated heart and lung volumes in situ with regard to the cause of death as possible indexes of terminal cardiopulmonary dysfunction by means of PM-CT data analysis of forensic autopsy cases within 3days postmortem (n=70). Estimated heart volume was larger in sudden cardiac death (SCD; n=10) and fatal methamphetamine abuse (n=5) than in other groups, including mechanical asphyxiation (n=12), drowning (n=11), acute alcohol/sedative-hypnotic intoxication (n=8), fire fatality (n=12), hyperthermia (heatstroke; n=6) and fatal hypothermia (cold exposure; n=6). Estimated combined lung volume was larger in drowning, smaller in fire fatality due to carbon monoxide intoxication and SCD, and intermediate in other groups. Volume ratio of the lung to heart was higher in drowning, lower in SCD, and intermediate or varied in other groups; high and low ratios can indicate predominant/antecedent pulmonary and cardiac dysfunctions, respectively. These findings provide quantitative data that are not available at conventional autopsy or by routine two-dimensional CT morphology to assess three-dimensional gross heart and lung morphologies for interpreting terminal cardiopulmonary pathophysiology, detecting significant difference between SCD and other causes of death, especially mechanical asphyxiation and drowning. PMID:24703760

Sogawa, Nozomi; Michiue, Tomomi; Kawamoto, Osamu; Oritani, Shigeki; Ishikawa, Takaki; Maeda, Hitoshi

2014-07-01

380

[Medico-legal autopsy case of an infant suffering anaphylactic shock during dental treatment. Potential hazards in the use of a rubber-dam-sheet for infants].  

Science.gov (United States)

We report a medico-legal autopsy of a 4-year-old girl without any history of allergies, who died following anaphylactic shock due to local anesthesia with lidocaine during dental treatment. The shock symptoms were overlooked due to a rubber-dam-sheet covering her face. The autopsy revealed laryngeal edema, secretory fluid filling the trachea, severe pulmonary congestion and edema. An immunohistochemical investigation showed numerous mast cells releasing histamine in lungs, and the fluids in the pulmonary alveoli and veins also showed positive staining. In addition, the plasma concentration of histamine in the heart blood showed a high value. From these findings, the cause of death was determined to be respiratory failure due to anaphylactic shock induced by lidocaine. In this case, her death was considered to be due to medical malpractice; adequate life support had not been performed, because anaphylactic shock was overlooked until the rubber-dam-sheet removed. In addition, due to two previous autopsy case reports that described infantile fatalities involved with the misusage of a rubber-dam-sheet for the patients under local anesthesia, we therefore recommend immediate improvements in rubber-dam-sheets and/or better applications of them in pediatric dentistry. PMID:17134013

Masuda, Tomoo; Murayama, Takako; Takada, Yuzo; Mukaida, Masahiro

2006-10-01

 
 
 
 
381

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

Science.gov (United States)

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

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

2009-09-01

382

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

Science.gov (United States)

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

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

1994-04-01

383

Prevalence of benign, atypical, and malignant breast lesions in populations at different risk for breast cancer. A forensic autopsy study.  

Science.gov (United States)

A forensic autopsy series of 519 women more than 14 years old was studied for prevalence of benign, atypical, and occult malignant breast lesions. The women included Anglos (non-Hispanic whites), Hispanics, and American Indians from New Mexico and Eastern Arizona. These three ethnic/racial groups are at markedly different risk for the development of breast cancer (Anglo 89 of 100,000 women per year, Hispanic 45.5, and American Indian 24.9. There were striking ethnic/racial and age-related differences in both the prevalence and magnitude of all forms of nonproliferative and proliferative fibrocystic disease. The various subsets of fibrocystic disease were highly associated with each other. Such lesions as apocrine metaplasia, sclerosing adenosis, and lobular microcalcification showed as much difference according to ethnic/racial background and age as the more common cystic change and duct epithelial hyperplasia. Atypical lobular and ductal hyperplasia, carcinoma in situ, and occult invasive carcinoma were uncommon and also occurred in ethnic/racial groups in a pattern that parallels the cancer risk in those groups. PMID:3677009

Bartow, S A; Pathak, D R; Black, W C; Key, C R; Teaf, S R

1987-12-01

384

Assessing a new approach to verbal autopsy interpretation in a rural Ethiopian community: the InterVA model  

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Full Text Available OBJECTIVE: Verbal autopsy (VA- the interviewing of family members or caregivers about the circumstances of a death after the event- is an established tool in areas where routine death registration is non-existent or inadequate. We assessed the performance of a probabilistic model (InterVA for interpreting community-based VA interviews, in order to investigate patterns of cause-specific mortality in a rural Ethiopian community. We compared results with those obtained after review of the VA by local physicians, with a view to validating the model as a community-based tool. METHODS: Two-hundred and eighty-nine VA interviews were successfully completed; these included most deaths occurring in a defined community over a 1-year period. The VA interviews were interpreted by physicians and by the model, and cause-specific mortality fractions were derived for the whole community and for particular age groups using both approaches. FINDINGS: The results of the two approaches to interpretation correlated well in this example from Ethiopia. Four major cause groups accounted for over 60% of all mortality, and patterns within specific age groups were consistent with expectations for an underdeveloped high-mortality community in sub-Saharan Africa. CONCLUSION: Compared with interpretation by physicians, the InterVA model is much less labour intensive and offers 100% consistency. It is a valuable new tool for characterizing patterns of cause-specific mortality in communities without death registration and for comparing patterns of mortality in different populations.

Fantahun Mesganaw

2006-01-01

385

Polymorphisms of the formylpeptide receptor gene (FPR1) and susceptibility to stomach cancer in 1531 consecutive autopsy cases.  

Science.gov (United States)

Formylpeptide receptor (FPR1) is involved in inflammation, which is important in the pathogenesis of diverse conditions, including common diseases and cancers. To date, little is known about the relationships between FPR1 and such diseases, aside from the fact that FPR1 is related to periodontitis, which is implicated in systemic diseases such as stomach cancer. We hypothesized that FPR1 polymorphisms related to periodontal disease may confer susceptibility to stomach cancer. Two single nucleotide polymorphisms (SNPs) in the second extracellular region and C-terminus of the formylpeptide receptor gene were analyzed in 1531 consecutive autopsy cases in the Japanese elderly. The tri-allelic SNP of rs1042229 was detected by modified melting temperature analysis. Homozygous K alleles of rs1042229 were associated with stomach cancer (Odds ratio [OR]=1.62, confidence interval [CI]=1.05-2.48, p=0.028). In the analysis of the recessive model of the K allele, FPR1 was associated with a high risk of stomach cancer (OR=1.73, CI=1.15-2.55, p=0.0075). The risk allele for stomach cancer pointed in the same direction as periodontitis. This is the first study to evaluate polymorphisms of the FPR1 gene in stomach cancer to find a positive association between these polymorphisms and stomach cancer. Further studies on the relationship between stomach cancer and the FPR1 gene are warranted. PMID:21216225

Otani, Tatsuro; Ikeda, Shinobu; Lwin, Htay; Arai, Tomio; Muramatsu, Masaaki; Sawabe, Motoji

2011-02-18

386

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

International Nuclear Information System (INIS)

Fifteen patients with malignant glioblastoma (MGB) were treated with radiation and chemoimmunotherapy, consisting of ACNU + FT 207 + PSK, (RAFP therapy). Autopsy findin