WorldWideScience

Sample records for Autopsy

  1. Needle autopsy

    Directory of Open Access Journals (Sweden)

    Philip Davis Marsden

    1997-04-01

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

  2. The value of neonatal autopsy.

    LENUS (Irish Health Repository)

    Hickey, Leah

    2012-01-01

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

  3. [Autopsy practised in modern China].

    Science.gov (United States)

    Cao, L

    1994-01-01

    It's very difficult for autopsy to develop in modern China. Two autopsy rules issued by Ministry of Internal Affairs were of epochal significance. Although Society on Anatomy had been set up by western medical workers, and there were four people willing to offer their own remains after death for autopsy, it was still very difficult to obtain a cadaver for autopsy actually. The main barrier still lay in the feudal morality. Moreover, incomplete law also contributed a factor. PMID:11639350

  4. Napoleon's autopsy: new perspectives.

    Science.gov (United States)

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

    2005-04-01

    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.

  5. 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

  6. The Autopsy of Squirrel Doe

    Science.gov (United States)

    Dick, Timothy T.; Watson, Jason

    2005-01-01

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

  7. Psychological Autopsies: Methods and Ethics.

    Science.gov (United States)

    Beskow, Jan; And Others

    1990-01-01

    Discusses methodological and ethical issues pertaining to "psychological autopsy," an interview method for reconstruction of suicidal death through interviews with survivors, based on application of method to three studies of suicides and review of other investigations. Emphasizes consideration of integrity of deceased, integrity and health of…

  8. 20 CFR 718.106 - Autopsy; biopsy.

    Science.gov (United States)

    2010-04-01

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

  9. Death and Teaching Autopsy (review article

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    M. Bahador

    2006-08-01

    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.

  10. Medico-legal autopsies in Denmark

    DEFF Research Database (Denmark)

    Larsen, Sara Tangmose; Lynnerup, Niels

    2011-01-01

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

  11. Attitudes of Nigerian Medical Students Towards Autopsy

    OpenAIRE

    EKANEM, Victor James; AKHIGBE, Kingsley O.

    2006-01-01

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

  12. Left Paraduodenal Hernia: An Autopsy Case

    DEFF Research Database (Denmark)

    Omland, Silje Haukali; Hougen, Hans Petter

    2011-01-01

    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...

  13. EDWARDS SYNDROME: AUTOPSY REPORT OF TWO CASES

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    Arpitha Chinnarappa

    2016-03-01

    Full Text Available BACKGROUND The Trisomy 18 syndrome (Edwards syndrome is an autosomal disorder due to the presence of an extra chromosome on chromosome 18. It is a rare genetic disorder involving multiple organ systems. The recognizable features of syndrome include prenatal and postnatal growth retardation, characteristic craniofacial features, distinctive hand posture, short sternum and major malformations of heart & kidney. Ultrasound is useful in the early antenatal detection and helps to minimize the trauma related to the termination of pregnancy at advanced gestation. Autopsy is useful in finding new anomalies and confirming antenatal ultrasonographic findings. Here we illustrate two case reports with phenotypic features, autopsy findings and brief review of literature. Genetic counselling regarding the risk of recurrence in future pregnancies is essential.

  14. Psychological Autopsy: A Psychobiographical Exploration of Suicide

    OpenAIRE

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

    2013-01-01

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

  15. Can postmortem fetal MR imaging replace autopsy?

    International Nuclear Information System (INIS)

    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

  16. [Two autopsy cases of primary pituitary carcinoma].

    Science.gov (United States)

    Negishi, K; Suzuki, T; Masuda, Y; Masugi, Y; Teramoto, A; Ohama, E

    1988-05-01

    We studied two autopsy cases of primary pituitary carcinoma. Case-1. A 45 year old female was admitted on Oct. 4 1978, with a complaint of right homonymous hemianopsia. And diagnosis was pituitary adenoma. Partial removal of pituitary tumor was performed on Oct. 23 1978. She died on Dec. 5 1978 due to bleeding of gastrointestinal tract. Autopsy disclosed a pituitary carcinoma invading the left hypothalamus, mamillary body, optic and V cranial nerves, and mid brain as well as sphenoid bone. No extracranial metastasis was noted. Case-2. A 44 year old female with a history of acromegaly for 6 years was admitted with a complaint of headache on May 8 1976. She was diagnosed as having pituitary adenoma. The subtotal removal of pituitary tumor was performed on May 21 1976 and followed by 4500 rad irradiation. At this time, pathological diagnosis was eosinophilic adenoma. Seven years later, she complained of progressive right hearing disturbance, dysarthria and ataxic gait 1983. The second subtotal removal of pituitary tumor was performed with a diagnosis of recurrence of pituitary adenoma on Oct. 7 1983. After the operation, she complicated sepsis and died on Jan. 14 1984. An autopsy disclosed a pituitary carcinoma from residual pituitary gland, continuously extending to the subarachnoid space of the pons, and invading right cerebello-pontine angle and cerebellum. The histological examination revealed pituitary carcinoma with high pleomorphism and glioblastoma multiform-like feature were within the tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Autopsy findings in severe malaria – a case report

    OpenAIRE

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

    2008-01-01

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

  18. The Challenges in Autopsy Cases Exposed to Animal Attack

    OpenAIRE

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

    2014-01-01

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

  19. Psychological Autopsy: A Psychobiographical Exploration of Suicide

    Directory of Open Access Journals (Sweden)

    José Alonso Andrade Salazar

    2013-06-01

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

  20. An autopsy case of zinc chloride poisoning.

    Science.gov (United States)

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

    2016-07-01

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

  1. Fetal autopsy and closing the gap.

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    Kandasamy, Yogavijayan; Kilcullen, Meegan; Watson, David

    2016-06-01

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

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

    Science.gov (United States)

    Shkrum, Michael James; Kent, Jessica

    2016-09-01

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

  3. Autopsy in Islam and current practice in Arab Muslim countries.

    Science.gov (United States)

    Mohammed, Madadin; Kharoshah, Magdy A

    2014-03-01

    Autopsy, or post-mortem examination, is the dissection of a dead body. It is performed for many reasons. Attitudes toward dead bodies vary with religious beliefs and cultural and geographical backgrounds. We have carried out an extensive literature review to determine the Islamic view and current practice of Autopsy, in at least four Arab countries which published their experiences. Several research articles have studied the history of Islamic Autopsy as well as the current situation and legal debates about it. The overwhelming conclusion is that data is lacking. More must be published from Arabic Muslim countries and more research done to correct misconceptions. We also recommend more application of non-invasive Autopsy.

  4. SIRENOMELIA: A DETAILED FETAL AUTOPSY STUDY

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    Parimala Sirikonda

    2015-12-01

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

  5. Autopsies of the real: Resurrecting the dead

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    Valis, Noël

    2011-12-01

    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.

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

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    Panchabhai T

    2009-01-01

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

  7. FETAL AUTOPSY STUDY OVER A TWO YEAR PERIOD

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    Shailaja

    2015-02-01

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

  8. Neuropathology of supercentenarians - four autopsy case studies.

    Science.gov (United States)

    Takao, Masaki; Hirose, Nobuyoshi; Arai, Yasumichi; Mihara, Ban; Mimura, Masaru

    2016-01-01

    Supercentenarians (aged 110 years old or more) are extremely rare in the world population (the number of living supercentenarians is estimated as 47 in the world), and details about their neuropathological information are limited. Based on previous studies, centenarians (aged 100-109 years old) exhibit several types of neuropathological changes, such as Alzheimer's disease and Lewy body disease pathology, primary age-related tauopathy, TDP-43 pathology, and hippocampal sclerosis. In the present study, we provide results from neuropathological analyses of four supercentenarian autopsy cases using conventional and immunohistochemical analysis for neurodegenerative disorders. In particular, we focused on the pathology of Alzheimer's disease and Lewy body disease, as well as the status of hippocampal sclerosis, TDP-43 pathology, aging-related tau astrogliopathy, and cerebrovascular diseases. Three cases were characterized as an "intermediate" level of Alzheimer's disease changes (NIA-AA guideline) and one was characterized as primary age-related tauopathy. TDP-43 deposits were present in the hippocampus in two cases. Neither Lewy body pathology nor hippocampal sclerosis was observed. Aging-related tau astrogliopathy was consistently observed, particularly in the basal forebrain. Small vessel diseases were also present, but they were relatively mild for cerebral amyloid-beta angiopathy and arteriolosclerosis. Although our study involved a small number of cases, the results provide a better understanding about human longevity. Neuropathological alterations associated with aging were mild to moderate in the supercentenarian brain, suggesting that these individuals might have some neuroprotective factors against aging. Future prospective studies and extensive molecular analyses are needed to determine the mechanisms of human longevity. PMID:27590044

  9. Agenesis of the corpus callosum. An autopsy study in fetuses.

    Science.gov (United States)

    Kidron, Debora; Shapira, Daniel; Ben Sira, Liat; Malinger, Gustavo; Lev, Dorit; Cioca, Andreea; Sharony, Reuven; Lerman Sagie, Tally

    2016-02-01

    Agenesis of the corpus callosum is currently diagnosed prenatally with ultrasound and MRI. While the diagnostic aspects of callosal defects are widely addressed, anatomo-histological data from fetal autopsies are sparse. Callosal defects were present in 50 fetal autopsies. Four distinct groups of complete, partial, hypoplastic, and mixed defects were determined by the gross and histologic details of the corpus callosum. These details helped to rule out other midline defects such as holoprosencephaly. Additional autopsy findings enabled specific diagnoses and suggested etiopathogeneses. Hypoplastic and mixed defects were associated with more abnormalities of the cerebral hemispheres and internal organs. The four groups did not differ according to gender, external dysmorphism, or cerebellar and brainstem anomalies. Defects were classified as syndromic (68 %), encephaloclastic (8 %), undetermined (14 %), or isolated (10 %) based on the autopsy findings. Isolated agenesis of the corpus callosum was diagnosed in only 10 % of the cases in this series, compared to higher numbers diagnosed by prenatal ultrasonography and MRI. Therefore, the autopsy, through its detailed, careful evaluation of external, as well as gross and histological internal features, can elucidate the etiopathogenesis of agenesis of the corpus callosum and suggest specific diagnoses which cannot be ascertained by prenatal imaging. PMID:26573426

  10. Clinical diagnosis versus autopsy findings in polytrauma fatalities

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    Fakler Johannes K

    2010-10-01

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

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

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    Cristiano C. Oliveira

    2015-10-01

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

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

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    Akihito Nagano

    2009-01-01

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

  13. Postmortem whole-body magnetic resonance imaging as an adjunct to autopsy: preliminary clinical experience.

    Science.gov (United States)

    Patriquin, L; Kassarjian, A; Barish, M; Casserley, L; O'Brien, M; Andry, C; Eustace, S

    2001-02-01

    The purpose of this study was to evaluate whole-body magnetic resonance imaging (MRI) of cadavers as an adjunct to autopsy. Eight consecutive patients underwent both whole-body MRI and autopsy [either conventional (six), limited (one), or percutaneous (one)] within 24 hours of death. Comparison was made of major and minor abnormalities and predicted cause of death recorded by independent readers at both MRI and autopsy. Major discrepancies between the recorded primary cause of death at imaging and autopsy occurred in five (5) patients. These included a myocardial infarction found at autopsy alone, bowel infarction and portal venous gas found at MRI alone, and aortic dissection and occipital infarct found at MRI alone in a patient on whom only limited autopsy was performed. Postmortem MRI may represent a useful adjunct to autopsy, particularly in patients in whom autopsy is limited due to patient/family consent, inoculation risks, and ethnic doctrines.

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

    Directory of Open Access Journals (Sweden)

    Vaideeswar P

    1998-01-01

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

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

    Science.gov (United States)

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

    2013-06-10

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

  16. Autopsied case of tuberculous meningitis showing interesting CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Abiko, Takashi; Higuchi, Hiroshi; Imada, Ryuichi; Nagai, Kenichi (Iwate Prefectural Central Hospital (Japan))

    1983-11-01

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

  17. Autopsy findings in patients on postcardiotomy centrifugal ventricular assist.

    Science.gov (United States)

    Curtis, J J; Walls, J T; Boley, T M; Schmaltz, R A; Demmy, T L

    1992-01-01

    Reported experience with ventricular assist devices (VAD) routinely includes the rate of thromboembolic events, which is commonly calculated from clinically evident findings. Fifty-four patients have had postcardiotomy circulatory support with the Sarns centrifugal device at our institution. We have reviewed 43 patients who failed to survive VAD support to compare the thromboembolism rate diagnosed clinically to that determined at autopsy. In the 35 patients who had no autopsy, there was one clinically apparent thromboembolic event (2.3%). In eight similar patients who had autopsy, there was no clinically apparent thromboembolism. Five of these eight patients (63%) had acute thromboembolic infarcts determined at autopsy. Three had evidence of pulmonary thromboembolism, two cerebrovascular infarction, two liver infarcts, two splenic infarcts, two kidney infarcts, and one each gastric, pancreatic, prostate, adrenal, cervical, and ileal infarcts. All had left and/or right ventricular infarctions. It is concluded that patients dying following VAD have commonly suffered perioperative myocardial infarction. When evaluating complications associated with VAD, one should consider that the true incidence of thromboembolic events is underestimated by clinical findings.

  18. Communicating with the Coroner: How Religion, Culture, and Family Concerns May Influence Autopsy Decision Making

    Science.gov (United States)

    Carpenter, Belinda; Tait, Gordon; Adkins, Glenda; Barnes, Michael; Naylor, Charles; Begum, Nelufa

    2011-01-01

    Based on coronial data gathered in the state of Queensland in 2004, this article reviews how a change in legislation may have impacted autopsy decision making by coroners. More specifically, the authors evaluated whether the requirement that coronial autopsy orders specify the level of invasiveness of an autopsy to be performed by a pathologist…

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

    Science.gov (United States)

    Gualco, M; Benzi, D; Fulcheri, E

    2001-10-01

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

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

    Science.gov (United States)

    Knoll, James L; Hatters-Friedman, Susan

    2015-09-01

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

  1. Foetal Autopsy-Categories and Causes of Death

    OpenAIRE

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

    2014-01-01

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

  2. Respiratory outcomes among South African coal miners at autopsy

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-09-01

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

  3. United Kingdom Beryllium Registry: mortality and autopsy study.

    Science.gov (United States)

    Williams, W J

    1996-01-01

    This report is based on 30 deaths from chronic beryllium disease (CBD) in the United Kingdom with details of 19 autopsies. The majority were fluorescent lamp workers and machinists who died from respiratory failure. There were no cases of lung cancer. The survival times ranged from less than 1 to 29 years and was longest in machinists. All of the workers showed interstitial pulmonary fibrosis with varying degrees of cystic change. The majority showed hyalinized, and a few active sarcoid-type, granulomas. Extrathoracic granulomas, as in a U.K. sarcoid autopsy series, were rare. A notable difference was the absence of myocardial involvement in CBD compared to an incidence of 20% in the sarcoid autopsies. The detection of beryllium in the criteria for diagnosis is emphasized and the cases classified as definite include 12 of 19 positive analysis, 6 of 19, negative or unavailable analysis. The remaining case was classified as dubious because, despite a positive analysis, granulomas were absent. The main differential diagnosis is sarcoidosis. Images Figure 1. Figure 2. Figure 3. PMID:8933040

  4. Acute erythroid leukemia: autopsy report of a rare disease

    Directory of Open Access Journals (Sweden)

    Cristiane Rúbia Ferreira

    2011-12-01

    Full Text Available Acute erythroid leukemia (AEL is a rare subtype of acute myeloid leukemia(AML, characterized by predominant erythroid proliferation. The 2008 WorldHealth Organization (WHO classification of AML defined two AEL subtypes:erythroleukaemia (EL, in which erythroid precursors account for 50% or moreof all nucleated bone marrow cells and myeloblasts account for 20% or more ofthe nonerythroid cell population; and pure erythroid leukemia (PEL, in whicherythroid precursors account for 80% or more of all nucleated bone marrowcells. We report the case of an elderly female patient with wasting syndromeand pancytopenia without evidence of blasts in peripheral blood. A diagnosisof PEL was established on the basis of bone marrow biopsy findings. Thepatient died on postadmission day 20, and an autopsy was performed. Wereclassified the disease as EL on the basis of the autopsy findings, whichincluded myeloblasts accounting for more than 20% of the nonerythroid cellsin the bone marrow, as well as leukemic infiltration and myeloid metaplasia insolid organs, such as the liver, spleen, kidneys, adrenal glands, and abdominallymph nodes. A rare disease, AEL accounts for less than 5% of all AMLs and ispractically a diagnosis of exclusion. Autopsy reports of AEL are extremely rarein the literature. We demonstrate that in the case reported here, leukemia cellstended to infiltrate solid organs with myeloid metaplasia. Our findings alsoshow that a larger neoplastic bone marrow sample is crucial to the correctdiagnosis of EL, which is based on morphological and quantitative criteria.

  5. Contrast-enhanced postmortem computed tomography in clinical pathology: enhanced value of 20 clinical autopsies.

    Science.gov (United States)

    Westphal, Saskia E; Apitzsch, Jonas C; Penzkofer, Tobias; Kuhl, Christiane K; Mahnken, Andreas H; Knüchel, Ruth

    2014-09-01

    Postmortem computed tomography (PMCT) is a modern tool that complements autopsy diagnostics. In clinical autopsies, a major cause of death is cardiovascular disease. To improve the performance of PMCT in cardiovascular disease, full body angiography was developed (PMCT angiography [PMCTA]). Twenty PMCTA scans generated before autopsy were compared with native PMCT and clinical autopsy. The objective of the study was to quantify the additional diagnostic value of adding angiography to native imaging and to compare PMCT and PMCTA findings to autopsy findings. The diagnosis of the cause of death was identical or overlapped in 80% of the cases that used PMCTA and 70% that used PMCT. The additional diagnostic yield given by PMCT and PMCTA in combination with autopsy was 55%. PMCT yielded additional diagnoses in the musculoskeletal system. The greatest additional diagnostic value of PMCTA was in association with cardiovascular diagnoses. The accuracy of PMCTA for cardiac causes of death was 80%, and the positive predictive value was 90%. The findings indicate that native PMCT cannot display the cardiovascular system sufficiently clearly for high-quality diagnostic assessment. However, PMCTA is a powerful tool in autopsy cases with a history of cardiovascular disease and/or a suspected cardiovascular cause of death. The combination of PMCTA and clinical autopsy enhances diagnostic quality and completeness of the autopsy report. Furthermore, in cases without consent or with a restricted consent for clinical autopsy, PMCTA has the potential to provide information on cardiovascular causes of death.

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

    Directory of Open Access Journals (Sweden)

    Dinyain A

    2013-12-01

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

  7. Study of various congenital anomalies in fetal and neonatal autopsy

    Directory of Open Access Journals (Sweden)

    V. Siva Sankara Naik

    2015-05-01

    Full Text Available Background: The study of dead is to save the livings. The growing awareness that still births and infant mortalities are unable to reduction has led to a wide spread desire for more information regarding the cause of these deaths. Congenital malformations have become important cause of fetal and neonatal (perinatal mortality in developed countries and would very soon be increasingly important determinants of fetal and neonatal mortality in developing countries like India. In spite of antenatal diagnostic modality still the fetal autopsy plays the vital role in the conformation as well as identification of congenital anomalies and also for the counseling of the parents, to prevent the fetal congenital anomalies in further pregnancies. This study was undertaken with the purpose of finding out cause of death during the perinatal period at government maternity hospital and pediatric department S.V.R.R.G.G.H. and S.V. medical college Tirupati, and to study the clinical and pathological findings (Gross and microscopic in fetal and neonatal death. Methods: The present study of congenital anomalies in fetal and neonatal deaths was done at S.V. medical college, Tirupati, over a time period of 2 years from September 2008 to 2010 August. Consent for autopsy in requested compassionately, respectfully and fully informed. The present study included dead fetus and neonates with gestational age above 20 weeks of intra uterine life and within 7 days of post natal life. All fetuses of gestational age <20 weeks and all neonates above 7 days of age were excluded from the study. The study also obtained clearance from the ethical committee of the institution. Autopsy was performed by standard technique adopted by Edith L. Potter. External and internal findings followed by histopathological examination, and autopsy findings were compared with available ultrasound findings. Results: A total of 46 Autopsies performed, 40 (87% were fetal deaths, 6 (13% were early

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

    LENUS (Irish Health Repository)

    Kaar, T K

    2012-02-03

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

  9. Primary diffuse leptomeningeal gliomatosis: An autopsy case report

    Directory of Open Access Journals (Sweden)

    Shaik Afshan Jabeen

    2014-01-01

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

  10. Autopsy imaging for cardiac tamponade in a Thoroughbred foal

    Science.gov (United States)

    YAMADA, Kazutaka; SATO, Fumio; HORIUCHI, Noriyuki; HIGUCHI, Tohru; KOBAYASHI, Yoshiyasu; SASAKI, Naoki; NAMBO, Yasuo

    2016-01-01

    ABSTRACT Autopsy imaging (Ai), postmortem imaging before necropsy, is used in human forensic medicine. Ai was performed using computed tomography (CT) for a 1-month-old Thoroughbred foal cadaver found in a pasture. CT revealed pericardial effusion, collapse of the aorta, bleeding in the lung lobe, gas in the ventricles and liver parenchyma, and distension of the digestive tract. Rupture in the left auricle was confirmed by necropsy; however, it was not depicted on CT. Therefore, Ai and conventional necropsy are considered to complement each other. The cause of death was determined to be traumatic cardiac tamponade. In conclusion, Ai is an additional option for determining cause of death. PMID:27703406

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

    Directory of Open Access Journals (Sweden)

    Gh.- R. Walizadeh

    1987-12-01

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

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

    Science.gov (United States)

    Bywaters, E G; Evans, S

    1982-01-01

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

  13. Significance of External Findings in Hanging Cases during Autopsy

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  15. Autopsy findings in two siblings with infantile Refsum disease.

    Science.gov (United States)

    Chow, C W; Poulos, A; Fellenberg, A J; Christodoulou, J; Danks, D M

    1992-01-01

    Recognition of adrenal atrophy during a review of autopsy findings in two sisters who died at 8 months and 3 1/2 years prompted estimation of very long chain fatty acids, phytanic acid and pristanic acid on wet liver fixed in formalin for 12 years. These were shown to be markedly increased and defects in multiple peroxisomal functions and decrease in particulate catalase were shown in cultured fibroblasts, confirming an abnormality of peroxisomal biogenesis. The patients had presented with failure to thrive, recurrent diarrhoea and vomiting, poor mental development, retinal pigmentation, blindness and in the older patient deafness, with only mild dysmorphic features. Autopsy in the older patient showed adrenal atrophy, cirrhosis, and foamy histiocytes in multiple organs. The brain showed no demyelination, little cytoarchitectural abnormality, occasional perivascular histiocytes in the grey matter and meninges and prominent Purkinje cells in the molecular layer of the cerebellum. In the younger patient the changes were very subtle in spite of the marked clinical similarity. Despite the young age at death the clinicopathological features are most suggestive of infantile Refsum disease. In many situations anatomical pathology can be very useful in the recognition and study of peroxisomal disorders.

  16. Anatomical Findings in Patients with Infective Endocarditis Diagnosed at Autopsy

    Directory of Open Access Journals (Sweden)

    Miguel Angel Serra Valdés

    2013-12-01

    Full Text Available Background: Infective endocarditis continues to challenge modern medicine despite its rare occurrence in the general population. Its incidence depends on risk groups. Correlation of anatomical and pathological findings with clinical and epidemiological elements may explain the current features of this condition. Objective: to describe the anatomical features of patients with infective endocarditis diagnosed at autopsy. Methods: A descriptive study including cases of infective endocarditis diagnosed at autopsy between 1986 and 2008 was conducted in the Provincial Clinical-Surgical Hospital Celia Sanchez, Granma. The variables analyzed were: age, sex, previous anatomical lesions, location of vegetations, multi-organ embolic infarcts and embolic abscesses, complications, culture of lesions and direct causes of death. Results: frequency of infective endocarditis diagnosed at necropsy ranged annually from 0.4 to 1.5%. Native valve endocarditis without previous damage was the most frequent. The anatomical findings were more common in the left side of the heart. Right-sided nosocomial endocarditis accounted for almost a third of the deceased patients and risk factors were identified. Embolic lesions affecting various organs, systemic complications and direct causes of death showed acute infectious endocarditis. The most common pathogen was Staphylococcus aureus. Conclusion: knowing the anatomical findings may contribute to the understanding of the clinical and epidemiological aspects of this condition. Correlation between anatomical and clinical findings was low; therefore difficulties in establishing the diagnosis during life are inferred.

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

    Science.gov (United States)

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

    2015-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Ibrahim Demir

    2015-01-01

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

  19. 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)

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

    2014-02-01

    Current autopsy practice in forensic pathology is to a large extent based on experience and individual customary practices as opposed to evidence and consensus based practices. As a result there is the potential for substantial variation in how knowledge is applied in each case. In the present case 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.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Talita Zerbini

    2014-12-01

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

  2. Comparison of the clinical diagnosis and subsequent autopsy findings in medical malpractice.

    Science.gov (United States)

    Pakis, Isil; Polat, Oguz; Yayci, Nesime; Karapirli, Mustafa

    2010-09-01

    The rate of diagnostic error has not declined over the last 30 years despite the improvement in diagnosis methods. Today, the probability to encounter a major diagnostic change in autopsy is still high. The special autopsy that provides clinicians the necessary feedback is performed seldom in our country. This study has been started upon the claim that the malpractice cases in scope of forensic cases could be a very useful database. About 525 cases with faulty medical application that resulted in death have been encountered according to the cases that have been sent to the Forensic Medical Institution, which has been the consultative authority of the Ministry of Justice between the years 2001 and 2005. Among these, 375 cases on which autopsies have been conducted are included in the scope of the study. The cases with and without major diagnostic changes have been compared in aspects of gender, age groups, and period spent in health units. When the concordance between autopsy and clinical diagnosis for the 375 cases that were included in the study is examined, it can be seen that clinical diagnosis is verified with autopsy in 49.1% of the cases whereas neither autopsy nor clinical diagnosis was encountered in 14.7% of them. The diseases where diagnostic faults are mostly encountered are ruptured aortic aneurysm, myocardial infarction and pneumonia. The majority of the cases without a clinical diagnosis comprises of complications that occur after operations. In the study, considerable major diagnostic changes were realized after autopsy, which shows that autopsy has an important place in Turkey in spite of the improved methods of diagnosis. Also, in the cases with major diagnostic changes, the medical malpractice rate was high. This shows that autopsy is influential in revealing medical malpractice failures. In the study, we found out that the number of autopsies was high in the cases with a malpractice claim. We aim to increase this number. We are sure that such

  3. Ruptured chordae tendineae in acromegaly. An autopsy case.

    Science.gov (United States)

    Kaku, T; Nakashima, Y; Ichiyasu, H; Soejima, M; Baba, K; Kuroiwa, A

    1991-07-01

    A 57-year-old woman with acromegaly associated with mitral chordal rupture is reported. She was noted to have abnormal development in the size of her hands and feet in childhood. She occasionally suffered from shortness of breath on exertion and nocturnal dyspnea for several years, and was diagnosed and treated as having congestive heart failure due to valvular heart disease. On admission to our hospital, chordal rupture was suspected on the basis of M-mode and two-dimensional echocardiography. Seven years after discharge, she died of congestive heart failure. On autopsy, the heart weight and ventricular wall thickness were increased. Rupture of the posterior chordae was confirmed, but evidence of an old myocardial infarction was not found. There was severe interstitial fibrosis in the left ventricular wall. A possible etiology of the chordal rupture in this case was thought to be the excessive stretching caused by the disproportional visceromegaly of the heart.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-02-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

  6. Rosai - Dorfman disease: a rare entity diagnosed at autopsy

    Directory of Open Access Journals (Sweden)

    João da Costa Veloso Neto

    2013-03-01

    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.

  7. Rapidly aggravated Creutzfeldt-Jacob disease: autopsy-proven case

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-11-15

    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.

  8. Suicidal hanging in Istanbul, Turkey: 1979-2012 Autopsy results.

    Science.gov (United States)

    Taktak, Safak; Kumral, Bahadir; Unsal, Ayla; Ozdes, Taskin; Buyuk, Yalcin; Celik, Safa

    2015-07-01

    A retrospective study was carried out on 4549 which is the total number of hanging cases autopsied at Forensic Medicine Institute in Istanbul, Turkey. 4502 hanging cases of suicidal origin were detected and evaluated in terms of demographic features, the type of hanging material used for ligature, internal findings in neck organs, toxicological findings and microscopic findings. Of these suicides, 3295 (73.2%) were males and 1207 (26.8%) were females. The average age of the victims was 37.8 (SD 1.6). Crude suicidal hanging rate is approximately two-fold increase in women, while it is about five-to six-fold increase in men during 33 years. 1424 of the victims committed suicide by hanging themselves at home, and 441 of them in prison and indoor areas. The alcohol in the blood of all autopsy victims was tested and results were positive for 687 people. A drug active agent was detected in 108 (2.4%) victims: 70 (1.5%) of them were antidepressants, 20 (0.5%) of them were analgesic/anti-inflammatory/anti-histaminic and 18 (0.4%) of them were antipsychotic. In the examination of the psychoactive substances in blood and urine, any of such substances was not detected in 4146 of the victims. However, victims' blood and urine contained a sedative-hypnotic-anxiolytic with 74 (1.6%), a cannabinoid with 16 (0.4%) and an opioid with 12 (0.3%). Psychoactive substance examination was not carried out for 243 victims. Of these cases, 4060 (90.2%), ecchymosis in soft tissues and 2800 (62.1%) fracture in neck organs was found.

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

    Directory of Open Access Journals (Sweden)

    Lozano Rafael

    2011-08-01

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

  10. Thanatophoric dysplasia: case report of an autopsy complemented by postmortem computed tomographic study

    Directory of Open Access Journals (Sweden)

    Éber Emanuel Mayoral

    2014-06-01

    Full Text Available Thanatophoric dysplasia (TD is one of the most common lethal skeletal dysplasias, which was first designated as thanatophoric dwarfism and described in 1967. The authors report a case of a Caucasian girl with TD, born to a 31-year-old woman without comorbidities. The newborn presented respiratory distress immediately after delivery, progressing to death in less than 2 hours. An autopsy was carried out after postmortem tomographic examination. The autopsy findings depicted extensive malformations of the skeletal system and the brain. The aim of this report is to discuss the pathogenesis and correlate the morphologic features of TD that were disclosed at the tomography and the autopsy.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  12. 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)

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

    2010-08-15

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

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

    DEFF Research Database (Denmark)

    Leth, Peter Mygind

    2006-01-01

    Introduction: Can CT-scanning of deceased at the medico legal external examination improve the selection of cases to autopsy? Is CT-scanning a substitute or a supplement to the traditional forensic autopsy? Material: In 2006 60 deceased individuals from Southern Denmark (counties of Fyn and Sønde......Introduction: Can CT-scanning of deceased at the medico legal external examination improve the selection of cases to autopsy? Is CT-scanning a substitute or a supplement to the traditional forensic autopsy? Material: In 2006 60 deceased individuals from Southern Denmark (counties of Fyn...... and Sønderjylland) (15 females and 45 males) were CT-scanned before autopsy. Method: A double-blind prospective investigation of CT-scanning in autopsy cases. A multislice spiral CT-scanner (Siemens Somatom Spirit) was used. Data from the CT-scanning and the autopsy were registered in a computer database...

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

    Science.gov (United States)

    Ohya, I

    1994-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Dinesh Rao

    2015-12-01

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

  16. 78 FR 38735 - Autopsy Performance Criteria: Standards, Guidelines and Best Practices

    Science.gov (United States)

    2013-06-27

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

  17. Prune-belly syndrome: an autopsy case report

    Directory of Open Access Journals (Sweden)

    Marcela Arruda Pereira Silva Vasconcelos

    2014-12-01

    Full Text Available Prune-belly syndrome (PBS is a rare congenital anomaly characterized by a spectrum of mild-to-severe presentations of urinary tract malformations, deficient abdominal wall musculature, and cryptorchidism in male newborns or genital abnormalities in the female newborns. Currently, antenatal diagnosis is feasible with ultrasound examination, and treatment is based on case report experience. More recently, intrauterine management has been undertaken with encouraging results. The authors report a case of PBS diagnosed at the seventeenth gestation week, when ultrasonographic examination revealed the presence of ascites, distended bladder, thickened bladder wall and posterior urethral valve. The fetus was submitted to an intrauterine intervention at the nineteenth gestational week. Delivery occurred at 34 weeks of gestation and the newborn examination was consistent with PBS. On the second day of life, the newborn was submitted to abdominoplasty, colostomy, and orchiopexy. However, the outcome was unfavorable with respiratory failure and death on the fifteenth day of life. The autopsy confirmed the diagnosis of PBS, but the immediate cause of death was attributed to aspiration pneumonia.

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

    Science.gov (United States)

    Quigley, M. A.; Armstrong Schellenberg, J. R.; Snow, R. W.

    1996-01-01

    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. The children were assigned causes of death using data-derived algorithms obtained under logistic regression and using expert algorithms. For most causes of death, the data-derived algorithms and expert algorithms yielded similar levels of diagnostic accuracy. However, a data-derived algorithm for malaria gave a sensitivity of 71% (95% Cl: 58-84%), which was significantly higher than the sensitivity of 47% obtained under an expert algorithm. The need for exploring this and other ways in which the VA technique can be improved are discussed. The implications of less-than-perfect sensitivity and specificity are explored using numerical examples. Misclassification bias should be taken into consideration when planning and evaluating epidemiological studies. PMID:8706229

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-07-01

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

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

    OpenAIRE

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

    1999-01-01

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

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

    OpenAIRE

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

    1999-01-01

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

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

    OpenAIRE

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

    2000-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Megha S Uppin

    2011-01-01

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

  6. Tales from the grave: Opposing autopsy reports from a body exhumed.

    Science.gov (United States)

    Gunasekera, R S; Brown, A B; Costas, E H

    2012-07-01

    We report an autopsy case of a 42-year-old woman who, when discovered, had been dead in her apartment for approximately 1 week under circumstances involving treachery, assault and possible drug overdose. This case is unique as it involved two autopsies of the deceased by two different medical examiners who reached opposing conclusions. The first autopsy was performed about 10 days after death. The second autopsy was performed after an exhumation approximately 2 years after burial. Evidence collected at the crime scene included blood samples from which DNA was extracted and analysed, fingerprints and clothing containing dried body fluids. The conclusion of the first autopsy was accidental death due to cocaine toxicity; the conclusion of the second autopsy was death due to homicide given the totality of evidence. Suspects 1 and 2 were linked to the death of the victim by physical evidence and suspect 3 was linked by testimony. Suspect 1 received life in prison, and suspects 2 and 3 received 45 and 20 years in prison, respectively. This case indicates that cocaine toxicity is difficult to determine in putrefied tissue and that exhumations can be important in collecting forensic information. It further reveals that the combined findings of medical examiners, even though contradictory, are useful in determining the circumstances leading to death in criminal justice. Thus, this report demonstrates that such criminal circumstances require comparative forensic review and, in such cases, scientific conclusions can be difficult.

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

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

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    Sudha M

    2009-10-01

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

  10. Sudden unexpected death in epilepsy: Evaluation of forensic autopsy cases.

    Science.gov (United States)

    Zhuo, Luo; Zhang, Yang; Zielke, H Ronald; Levine, Barry; Zhang, Xiang; Chang, Lin; Fowler, David; Li, Ling

    2012-11-30

    Epilepsy is a common chronic neurological disorder characterized by seizures. Mortality is significantly increased in patients with epilepsy. Sudden unexpected death in epilepsy (SUDEP) is the most common seizure-related category of death. A retrospective study of forensic autopsy cases from 2007 to 2009 at the Office of the Chief Medical Examiner (OCME) yielded a total of 104 sudden unexpected deaths directly or indirectly caused by an epilepsy/seizure disorder in the State of Maryland. Of these deaths, 74 cases met a general accepted definition of SUDEP. The age of SUDEP individuals ranged from 14 to 63 with the majority of subjects in the ages between 21 and 50 years (58 cases, 78.4%). Males were slightly more likely than females to die of SUDEP (male:female=1.5:1 based on the rate). The onset age of epilepsy was documented in 47.3% of cases (35/74) based on investigation and medical records. Of the 35 cases, 12 subjects had early onset epilepsy (onset ages 1-15 years) and 20 subjects had duration of epilepsy for more than 10 years. The majority of deaths (61 of the 74 cases, 82.4%) were unwitnessed. Death scene investigation showed that 71 deaths (95.9%) occurred inside their residence with 50 subjects (70.4%) found either in bed or on the bedroom floor near the bed. Forty-three out of 74 cases (58.1%) showed neuropathological lesions. Per history, 50 subjects were reported as being on anti-epileptic drugs (AEDs). However, postmortem toxicological analysis revealed that only 26 subjects (35.1%) had detectable AEDs. Of the 74 cases, seizure disorder or epilepsy was listed as primary cause of death in 66 cases and the term of SUDEP as official cause of death in only 8 cases. This report focuses on the characteristics of death scene investigation and postmortem examination findings of SUDEP cases.

  11. Tissue microchimerism is increased during pregnancy: a human autopsy study.

    Science.gov (United States)

    Rijnink, Emilie C; Penning, Marlies E; Wolterbeek, Ron; Wilhelmus, Suzanne; Zandbergen, Malu; van Duinen, Sjoerd G; Schutte, Joke; Bruijn, Jan A; Bajema, Ingeborg M

    2015-11-01

    Microchimerism is the occurrence of small populations of cells with a different genetic background within an individual. Tissue microchimerism is considered to be primarily pregnancy-derived and is often studied relative to female-dominant autoimmune diseases, pregnancy complications, malignancies, response to injury, and transplantation outcomes. A particular distribution pattern of chimeric cells across various organs was recently described in a model of murine pregnancies. Our aim was to determine the frequency and distribution of tissue microchimerism across organs during and after pregnancy in humans. We performed in situ hybridization of the Y chromosome on paraffin-embedded autopsy samples of kidneys, livers, spleens, lungs, hearts and brains that were collected from 26 women who died while pregnant or within 1 month after delivery of a son. Frequencies of chimeric cells in various tissues were compared with those of a control group of non-pregnant women who had delivered sons. Tissue microchimerism occurred significantly more frequently in the lungs, spleens, livers, kidneys and hearts of pregnant women compared with non-pregnant women (all P spleen (208 Y+/10(6) nuclei), liver (192 Y+/10(6) nuclei), kidney (135 Y+/10(6) nuclei), brain (85 Y+/10(6) nuclei) and heart (40 Y+/10(6) nuclei). Data from this unique study group of women who died while pregnant or shortly after delivery provide information about the number and physiologic distribution of chimeric cells in organs of pregnant women. We demonstrate that during pregnancy, a boost of chimeric cells is observed in women, with a distribution across organs, that parallels findings in mouse models. PMID:26307194

  12. Unusual productions of endogenous alcohol: report of two autopsy cases.

    Science.gov (United States)

    Moriya, F; Ishizu, H; Miyaishi, S

    1991-10-01

    We experienced two autopsy cases in which endogenous alcohol productions by saprogens had been unusual. Case 1 is a victim found in a mountain stream 3 to 4 weeks after his death. Since ethanol and n-propanol concentrations in the right intrathoracic bloody fluid, pericardial sac fluid, and blood in the right side of the heart were 0.41 mg/g and 0.052 mg/g, 0.42 mg/g and 0.032 mg/g, and 0.45 mg/g and 0.025 mg/g, respectively. The ethanol detected in those specimens appeared to have been produced postmortem. The femoral muscle and urine, however, contained very little n-propanol though the ethanol levels were 0.21 mg/g and 0.05 mg/g, respectively. Thus, we judged the victim might have died soon after drinking a little alcohol. Case 2 is a victim who was stabbed in the abdomen (liver) with a knife and died due to hemorrhagic shock after 26.5 hours in spite of a peritoneotomy. It was probable that metabolic activities of the liver had decreased significantly after getting a wound. Almost 1 mg/g of ethanol and little n-propanol were detected in the heart blood. In the intraabdominal bloody fluid, however, 2.45 mg/g of ethanol and 0.079 mg/g of n-propanol were detected. n-Propanol level in the bloody fluid is equal to that in severely decomposed body and indicates that a large amount of ethanol was endogenously produced. It may be considered that the unusual ethanol production was caused by the severe peritonitis after the operation.

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

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    Jad Saab

    2015-01-01

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

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

    International Nuclear Information System (INIS)

    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.)

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

    LENUS (Irish Health Repository)

    Treacy, A

    2013-03-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    National differences in the legislation on cause and manner of death investigation are reflected in a high autopsy rate in suicides in Finland and a low corresponding rate in Denmark. The consequences for mortality statistics of these different investigation practices on deaths classified...... as suicides in Denmark and Finland, respectively, are not known in detail. The aim of this article was to analyse autopsy rates in deaths classified as suicides, and to identify any differences in investigation practices in deaths with a comparable cause of death, but classified as unnatural deaths other than...... suicide. Data from the mortality registries were summarised for the years 2000, 2005 and 2010. Autopsy rates (total, forensic and medical) were analysed with regard to deaths classified as suicide, and they were compared for three age groups (1-50 years, 51-70 years and ≥71 years) and for causes of death...

  17. An autopsy report of acute myocardial infarction with hypertrophic obstructive cardiomyopathy-like heart.

    Science.gov (United States)

    Ushikoshi, Hiroaki; Okada, Hideshi; Morishita, Kentaro; Imai, Hajime; Tomita, Hiroyuki; Nawa, Takahide; Suzuki, Kodai; Ikeshoji, Haruka; Kato, Hisaaki; Yoshida, Takahiro; Yoshida, Shozo; Shirai, Kunihiro; Toyoda, Izumi; Hara, Akira; Ogura, Shinji

    2015-01-01

    An 84-year-old woman, who was followed up as hypertrophic obstructive cardiomyopathy (HOCM) in a local hospital, was transferred to our center because of anterior chest pain and diagnosed with acute myocardial infarction (MI). Coronary angiography showed total occlusion of the mid-left anterior descending, and flow was restored after endovascular thrombectomy. An autopsy was performed after she died on hospital day 6. At autopsy, there was no significant stenosis in this vessel and the absence of plaque rupture was confirmed. Likewise, it was unclear asymmetric hypertrophy at autopsy, it could not deny that a sigmoid deformity of the basal septum occurs in elderly patients and can mimic the asymmetric septal hypertrophy of hypertrophic cardiomyopathy. MI was thought to be caused by coronary spasm or squeezing in HOCM-like heart. Therefore, it may be necessary antithrombosis therapy in HOCM-like patients with no history of paroxysmal atrial fibrillation.

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

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    Peto Richard

    2004-10-01

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

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

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    Masdalina Pane

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-10-01

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

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

    OpenAIRE

    Subedi, Nuwadatta

    2013-01-01

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

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

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    Ekpo Memfin Dan

    2011-01-01

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

  3. Neurocysticercosis--retrospective study of autopsy reports, a 17-year experience.

    Science.gov (United States)

    de Almeida, Sérgio Monteiro; Torres, Luiz Fernando Bleggi

    2011-10-01

    Neurocysticercosis (NCC) is a common central nervous system (CNS) infection caused by Taenia solium metacestodes. The objective of this study is to describe the incidence of cysticercosis diagnosed at autopsies and describe the epidemiological and clinical characteristics of NCC. Retrospective study analyzing 6,500 reports of autopsies between 1977 and 1994 from a school hospital in Curitiba, PR, southern of Brazil. The following data was obtained, age, gender, site of cysticercosis, NCC as cause of death. The diagnosis of cysticercosis was established in 52 (0.8%) autopsies. From 1977 to 1987 (0.7%) and from 1988 to 1994 (1.1%). In the autopsies with cysticercosis 75% were male; age (mean ± SD) was 43 ± 20. NCC was present in 96% of cases, and seizures was the most frequent clinical manifestation. Asymptomatic cases in 54%. These data classify our area as hiperendemic, according with OMS criteria. The present study reinforces the necessity to develop adequate control programs.

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

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    Elizabeth H. Corder

    2005-01-01

    associated with the APOEε4. 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 ε4 contributes directly to heart valve and myocardial damage.

  5. Search and removal of radioactive seeds: another application of postmortem computed tomography prior to autopsy.

    Science.gov (United States)

    Makino, Yohsuke; Itoda, Nozomi; Ikegaya, Hiroshi; Tanaka, Naoko; Kinoshita, Hiroshi; Motomura, Ayumi; Uno, Takashi; Iwase, Hirotaro

    2016-09-01

    We herein introduce 3 cases illustrating a new application for pre-autopsy postmortem computed tomography (PMCT). In all 3 cases, there was insufficient background information about the victims provided to the forensic pathologists' department. PMCT showed metallic particles in the prostate gland, an indication of metallic seeds containing radioactive isotopes. In 2 of 3 cases, migrated seeds were also detected by CT imaging in the lungs and the heart. Also in 2 of 3 cases, authorities reinvestigated the victim's history before autopsy was completed, which resulted in following appropriate procedure for dealing with the seeds. Although all 3 cadavers were cremated after autopsy, the International Commission on Radiological Protection (ICRP) discourages cremation for deaths soon after radioactive seeds implantation to prevent air pollution by radioactive isotopes in the ash. Our opinion from the present cases is that pre-autopsy PMCT can be recommended for use by forensic pathologists and guidelines for investigating deaths after permanent brachytherapy should include how to deal with cadavers when medical history is limited.

  6. Laryngeal choking on food and acute ethanol intoxication in adults--An autopsy study.

    Science.gov (United States)

    Nikolić, Slobodan; Zivković, Vladimir; Dragan, Babic; Juković, Fehim

    2011-01-01

    The retrospective autopsy study included 98 adults who died because of laryngeal choking on a bolus of food: 67 men and 31 women (χ(2)=6.843, pintoxicated (z=-7.126, pintoxication in individuals without mental disorders, were the most important risk factors for bolus death.

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jason Koshy

    2014-01-01

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

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

    DEFF Research Database (Denmark)

    Hauerberg, Laura; Skibsted, Lillian; Graem, Niels;

    2012-01-01

    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 u...

  10. Validation of Verbal Autopsy Tool for Ascertaining the Causes of Stillbirth

    Science.gov (United States)

    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

    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. PMID:24130814

  11. Validation of verbal autopsy tool for ascertaining the causes of stillbirth.

    Directory of Open Access Journals (Sweden)

    Sidrah Nausheen

    Full Text Available 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.

  12. Let's talk about death: data collection for verbal autopsies in a demographic and health surveillance site in Malaysia

    Directory of Open Access Journals (Sweden)

    Pascale A. Allotey

    2015-07-01

    Full Text Available Background: Verbal autopsies have gained considerable ground as an acceptable alternative to medically determined cause of death. Unlike with clinical or more administrative settings for data collection, verbal autopsies require significant involvement of families and communities, which introduces important social and cultural considerations. However, there is very little clear guidance about the methodological issues in data collection. The objectives of this case study were: to explore the range of bereavement rituals within the multi-ethnic, multi-faith population of the district; to investigate the preparedness of communities to talk about death; to describe the verbal autopsy process; to assess the effects of collecting verbal autopsy data on data collectors; and to determine the most accurate sources of information about deaths in the community. Methods: A case study approach was used, using focus group discussions, indepth interviews and field notes. Thematic analyses were undertaken using NVivo. Results: Consideration of cultural bereavement practices is importance to acceptance and response rates to verbal autopsies. They are also important to the timing of verbal autopsy interviews. Well trained data collectors, regardless of health qualifications are able to collect good quality data, but debriefing is important to their health and well being. This article contributes to guidance on the data collection procedures for verbal autopsies within community settings.

  13. Indication for resuscitative thoracotomy in thoracic injuries-Adherence to the ATLS guidelines. A forensic autopsy based evaluation

    DEFF Research Database (Denmark)

    Ohrt-Nissen, S; Colville-Ebeling, B; Kandler, K;

    2016-01-01

    of deceased patients with potentially reversible thoracic lesions (PRTL). METHODS: The database at the Department of Forensic Medicine at Copenhagen University was queried for autopsy cases with thoracic lesions indicated by the SNOMED autopsy coding system. Patients were included if thoracic lesions were......%) patients. CONCLUSIONS: Agreement with ATLS guidelines for RT was 63% for intervention and 100% for non-intervention in deceased patients with thoracic trauma. Agreement was higher for penetrating trauma than for blunt trauma. The adherence to guidelines did not improve the ability to predict autopsy...

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

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    Bhakti D. Deshmukh

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-02-01

    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)

  16. Sacrococcygeal chordoma in infancy showing an aggressive clinical course: an autopsy case report.

    Science.gov (United States)

    Shinmura, Yuichiro; Miura, Katsutoshi; Yajima, Shuhei; Tsutsui, Yoshihiro

    2003-07-01

    The autopsy case of a 3-year 6-month-old boy with chordoma arising in the sacrococcygeal region is presented. The primary lesion of the sacrococcygeal area was unresectable and lung metastasis was detected. He was treated with multi-agent systemic chemotherapy and radiation therapy, but the tumor was less responsive to these therapies. He died about one year after first admission. An autopsy revealed a massive sacrococcygeal mass and metastasis in the thoracic and lumbar vertebrae, retroperitoneal and mediastinal lymph nodes, and also in the bilateral lungs and liver. Histologically, the tumor was composed of 'pink' cells and scattered 'physaliphorous' cells with a myxoid matrix. Sacrococcygeal chordoma in infancy is very rare. Our case showed a highly aggressive clinical course.

  17. Myocardial abscess as a complication of an infected arteriovenous fistula: autopsy report

    Directory of Open Access Journals (Sweden)

    Cristiane Rúbia Ferreira

    2011-09-01

    Full Text Available Myocardial abscess is a severe and life-threatening infectious complication thatis commonly but not exclusively associated with infective endocarditis. It mayalso be developed in necrotic myocardial tissue, post trauma, in septic burnpatients, in transplanted heart, in ventricular aneurysm and post angioplasty.Patients on hemodialysis are prone to bacteremia, and infectious complicationsoccur in 48-73% of cases. Myocardial abscess is a rare complication of aninfected arteriovenous fistula. We present an autopsy report of a hemodialysispatient who had an arteriovenous fistula with a polytetrafluoroethylene graftwhere a local infection developed. The patient presented with fever and toxemia.On post-admission day 2, he unexpectedly suffered sudden cardiopulmonaryarrest and died. The autopsy revealed a myocardial abscess, near a branch ofthe left coronary artery, with septic embolism.

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

    Directory of Open Access Journals (Sweden)

    Pamidimukkala Umabala

    2007-01-01

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

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

    Science.gov (United States)

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

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

    OpenAIRE

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

    1986-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Majethia Nikhil

    2014-11-01

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

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

    International Nuclear Information System (INIS)

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

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

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    Todorović Miloš S.

    2011-01-01

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

  8. Measuring Maternal Mortality: Three Case Studies Using Verbal Autopsy with Different Platforms.

    Directory of Open Access Journals (Sweden)

    Siân L Curtis

    Full Text Available Accurate measurement of maternal mortality is needed to develop a greater understanding of the scale of the problem, to increase effectiveness of program planning and targeting, and to track progress. In the absence of good quality vital statistics, interim methods are used to measure maternal mortality. The purpose of this study is to document experience with three community-based interim methods that measure maternal mortality using verbal autopsy.This study uses a post-census mortality survey, a sample vital registration with verbal autopsy, and a large-scale household survey to summarize the measures of maternal mortality obtained from these three platforms, compares and contrasts the different methodologies employed, and evaluates strengths and weaknesses of each approach. Included is also a discussion of issues related to death identification and classification, estimating maternal mortality ratios and rates, sample sizes and periodicity of estimates, data quality, and cost.The sample sizes vary considerably between the three data sources and the number of maternal deaths identified through each platform was small. The proportion of deaths to women of reproductive age that are maternal deaths ranged from 8.8% to 17.3%. The maternal mortality rate was estimable using two of the platforms while obtaining an estimate of the maternal mortality ratio was only possible using one of the platforms. The percentage of maternal deaths due to direct obstetric causes ranged from 45.2% to 80.4%.This study documents experiences applying standard verbal autopsy methods to estimate maternal mortality and confirms that verbal autopsy is a feasible method for collecting maternal mortality data. None of these interim methods are likely to be suitable for detecting short term changes in mortality due to prohibitive sample size requirements, and thus, comprehensive and continuous civil registration systems to provide high quality vital statistics are essential

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

    OpenAIRE

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

    2013-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Ben A Lopman

    2006-08-01

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

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

    OpenAIRE

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

    1981-01-01

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

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

    OpenAIRE

    Khan, Nizamuddin; Pradhan, Manas Ranjan

    2013-01-01

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

  14. Transcriptional profiling of degraded RNA in cryopreserved and fixed tissue samples obtained at autopsy

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    Alhasan Samir

    2006-12-01

    Full Text Available Abstract Background Traditional multiplexed gene expression methods require well preserved, intact RNA. Such specimens are difficult to acquire in clinical practice where formalin fixation is the standard procedure for processing tissue. Even when special handling methods are used to obtain frozen tissue, there may be RNA degradation; for example autopsy samples where degradation occurs both pre-mortem and during the interval between death and cryopreservation. Although specimens with partially degraded RNA can be analyzed by qRT-PCR, these analyses can only be done individually or at low levels of multiplexing and are laborious and expensive to run for large numbers of RNA targets. Methods We evaluated the ability of the cDNA-mediated Annealing, Selection, extension, and Ligation (DASL assay to provide highly multiplexed analyses of cryopreserved and formalin fixed, paraffin embedded (FFPE tissues obtained at autopsy. Each assay provides data on 1536 targets, and can be performed on specimens with RNA fragments as small as 60 bp. Results The DASL performed accurately and consistently with cryopreserved RNA obtained at autopsy as well as with RNA extracted from formalin-fixed paraffin embedded tissue that had a cryopreserved mirror image specimen with high quality RNA. In FFPE tissue where the cryopreserved mirror image specimen was of low quality the assay performed reproducibly on some but not all specimens. Conclusion The DASL assay provides reproducible results from cryopreserved specimens and many FFPE specimens obtained at autopsy. Gene expression analyses of these specimens may be especially valuable for the study of non-cancer endpoints, where surgical specimens are rarely available.

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

    Science.gov (United States)

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

    2002-09-01

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

  16. Coronary Artery Disease and the Profile of Cardiovascular Risk Factors in South South Nigeria: A Clinical and Autopsy Study

    OpenAIRE

    Okon Ekwere Essien; Joseph Andy; Victor Ansa; Akaninyene Asuquo Otu; Alphonsus Udoh

    2014-01-01

    Introduction. Death from coronary artery disease (CAD) has been until recently considered rare in Nigeria. We present a report of a study of CAD with its predisposing cardiovascular (CVD) risk factors in South South Nigeria. Methods. We examined the autopsy reports of 747 coroner cases and 41 consecutive clinically diagnosed cases of ischemic heart disease seen in South South Nigeria. Results. CAD was diagnosed in 13 (1.6%) of 747 autopsies. They were predominantly males, urban residents, and...

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

  20. Fatal firearm injuries in autopsy cases at central Bangkok, Thailand: a 10-year retrospective study.

    Science.gov (United States)

    Myint, Sithu; Rerkamnuaychoke, Budsaba; Peonim, Vichan; Riengrojpitak, Suda; Worasuwannarak, Wisarn

    2014-11-01

    Even though there have been previously published reports on firearm injuries in various countries, the incidence and pattern of death from firearm injuries in Thailand have not been studied before. In present study, 149 fatal firearm injuries from 2002 to 2011 were reviewed. At total of 7126 autopsies, fatal firearm injuries comprised of 2.09% (n = 149) of total autopsies cases. Among those victims, 136 were male (91.3%), 13 (8.7%) were female. The youngest age of victim was 10 years and the oldest was 79 years. Mean age of the victims was 33.79 years and median age was 30 years. Outdoor incident was the most common scene of crime. Night time incident (18:00 PM-05:59 AM) was higher than day time one. Most of the cases occurred in week ends (n = 52). Homicide (77.2%) was the most frequent manner of death. Head/face and chest were the most common sites of entrance. The autopsy report also study on entrance wound, range and types of projectiles. Blood alcohol concentration was examined in 122 cases and 38 victims showed positive results, 11 cases revealed using of illegal substances in blood and urine analysis. This study also included the association between manner of death and other factors. Age group, time of incidence, place of incidence, number of entrance wound and range showed statistically significant association with manner of death.

  1. Risk factor analysis for bone marrow histiocytic hyperplasia with hemophagocytosis: an autopsy study.

    Science.gov (United States)

    Inai, Kunihiro; Noriki, Sakon; Iwasaki, Hiromichi; Naiki, Hironobu

    2014-07-01

    The excessive release of inflammatory cytokines occasionally induces life-threatening hemophagocytosis referred to as hemophagocytic syndrome (HPS). A similar condition, histiocytic hyperplasia with hemophagocytosis (HHH), is often seen in bone marrow collected during autopsy. Unlike HPS, the pathogenesis of HHH remains unclear. Therefore, we performed a clinicopathological analysis of HHH from 70 autopsy cases at the University of Fukui Hospital. HHH was detected in 29 of 70 autopsies (41.4 %) and was significantly complicated with hematological diseases (p HHH (p HHH patients as compared with non-HHH patients. Concentrations of inflammatory mediators including IL-1β, IL-6, and IL-8 were significantly increased in HHH patients. Multivariate risk factor analysis identified hematological diseases (odds ratio (OR), 11.71), ≥ 15 % BM macrophages (OR, 9.42), sepsis (OR, 7.77), and high serum IL-6 levels (OR, 1.00) as independent risk factors for HHH. HHH with hypocellular BM, the most aggressive form of HHH, was recognized in 8 of 29 HHH patients and was associated with ≥ 25 % BM macrophages (p HHH patients fulfilled the diagnostic criteria of HPS. These findings suggest that HHH is a different entity from HPS and that it preferentially develops under conditions of excessive inflammation and its associated risks, such as hematological diseases and sepsis.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

  4. 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.)

  5. Violence against women: A series of autopsy studies from Istanbul, Turkey.

    Science.gov (United States)

    Unal, Esra Ozgun; Koc, Sermet; Unal, Volkan; Akcan, Ramazan; Javan, Gulnaz T

    2016-05-01

    Death is the most severe consequence of violence against women. The purpose of this study was to determine the frequency of violence-related deaths among women and the general characteristics of fatal violence cases against women in Istanbul, Turkey. A total of 20,486 forensic autopsies performed between 2006 and 2010, in Istanbul, were retrospectively analyzed. Of these, 537 violence-related deaths among women were included in the study. The victims were investigated in terms of sociodemographic characteristics, exposed type of violence, and autopsy findings. Out of all female deaths (n = 4165), 12.9% were due to violence against women, which comprised 2.6% of all autopsies (n = 20,456) performed during the study period in Istanbul. The median age of the victims was 43 years, and a significant proportion of victims (49.7%) were between the ages of 21 and 40 years. The deaths occurred most commonly in private residences (51.2%, n = 275), whereas the street was the crime scene for 14.5% (n = 78) of cases. Firearm injuries (50.1%, n = 269) were the most common cause of death, followed by stab wounds (28.3%, n = 152) and strangulation (8.4%, n = 45). Among the identified perpetrators, 52.3% were victims' spouses or boyfriends. The perpetrators were female in 4.4% (n = 16) of cases. Istanbul is the most important and cosmopolitan city of Turkey, representing the country's cultural characteristics. Therefore, the data obtained in this study may be strong indicators of violence against women in Turkey.

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

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    Tettey Yao

    2011-09-01

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

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

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

    2013-01-01

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

  8. The importance of medico-legal autopsies. An analysis of the complex problems regarding damages.

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    Asnaes, S

    1983-01-01

    One hundred forty-four medico-legal autopsies were performed at the University Institute of Forensic Medicine in Copenhagen during the period 1973-77, all requested by the National Office of Social Security in order to estimate whether the cause of death could be related to the work of the deceased. The total number of medico-legal autopsies in the same period was 4050. The material included only four women. One hundred seventeen men died during work, 26 cases were accepted. Clear cases of accidents were always accepted and damages were paid. In cases where the deceased died on his way to or from work damages were rejected. Nineteen men (13%) had died after returning to their homes. Two cases among these were accepted (fall from scaffolding during working hours, arsenic poisoning where death occurred later in hospital). The mean age of the group was about 50 years, which is less than in an average medico-legal population. In all cases but two the autopsy revealed the cause of death, i.e. that unknown causes of death totalled 1.4%. The manner of death was elucidated in all cases. The most frequent cause of death in men turned out to be coronary sclerosis and coronary thrombosis. All such cases were rejected as being due to working conditions, because in no case was extraordinary working stress found to be evident. The two cases of death which occurred at home showed the importance of being aware of injuries due to working conditions, even if death could not be directly related to an industrial accident.

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

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

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    Ohno Summer

    2011-08-01

    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

  11. Cause of Sudden Cardiac Deaths on Autopsy Findings; a Four-Year Report

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    Dinesh Rao

    2014-03-01

    Full Text Available Introduction: Incidence of sudden cardiac death (SCD has been steadily increasing all over the world. While knowing the cause of SCD is one of the favorites of the physicians involved with these cases, it is very difficult and challenging task for the forensic physician. The present report is a prospective study regarding cause of SCDs on autopsy examination in four-year period, Bangalore, India. Methods: The present prospective study is based on autopsy observations, carried out for four-year period from 2008 to 2011, and analyzed for cause of SCDs. The cases were chosen as per the definition of sudden death and autopsied. The material was divided into natural and unnatural groups. Finally, on histopathology, gross examination, hospital details, circumstantial, and police reports the cause of death was inferred. Results: A total of 2449 autopsy was conducted of which 204 cases were due to SCD. The highest SCDs were reported in 50-60 years age group (62.24%; n-127, followed closely by the age group 60-69 (28.43%; n-58. Male to female ratio was around 10:1. The maximum number of deaths (n=78 was within few hours (6 hours after the onset of signs and symptoms. In 24 (11.8% cases major narrowing was noted in both the main coronaries, in 87 (42.6% cases in the left anterior descending coronary artery (LAD, and in 18 (51.5% cases in the right coronary artery (RCA. The major cardiac pathology resulting in sudden death was coronary artery disease (n-116; 56.86% and myocardial infarction (n-104; 50.9%. most of the SCDs occurred in the place of residence (n-80; 39.2% followed closely by death in hospital (n-49; 24.01%. Conclusion: Coronary occlusion was the major contributory cause of sudden death with cardiac origin and the highest number of deaths were reported in the age 50-59 years with male to female ratio of 10:1. 

  12. Perinatal lethal osteogenesis imperfecta in a Thai newborn: the autopsy and histopathogical findings.

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    Himakhun, Wanwisa; Rojnueangnit, Kitiwan; Prachukthum, Sariya

    2012-01-01

    Osteogenesis imperfecta (OI) is an inherited disorder of type I collagen synthesis with an estimate incidence of I in 100,000 live births. Among all types, OI type II is the most severe type with perinatal death. The authors describes a male neonate with characteristic features of osteogenesis imperfect type II, including short crumpling limbs, beaded ribs, poorly bony ossification and blue sclera. Autopsy with histological study revealed not only multiple fractures, but pulmonary hypoplasia and intracerebral hemorrhages were also present. Both are the leading causes of death in the lethal type OI patients. PMID:23964465

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

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    Knudsen, P J; Theilade, P

    1993-01-01

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

  14. The review of autopsy cases of accidental childhood deaths in Istanbul.

    Science.gov (United States)

    Yayci, Nesime; Pakis, Isil; Karapirli, Mustafa; Celik, Sefa; Uysal, Cem; Polat, Oguz

    2011-08-01

    Children are at increased risk for various causes of injury from accidents. Accidents are, by far, the leading cause of death among children and adolescents. The aim of this study is to evaluate the lethal childhood accidents in İstanbul by age groups. Reports of autopsies performed between 2001 and 2005 in the Morgue Department of the Council of Forensic. Medicine in Istanbul (n :16853) are examined retrospectively. 833 deaths from accidents in children aged 0-18 years are investigated into the study. The parameters of age, gender, types of accidents and causes of death are evaluated. The accidents account for 47.3% of the deaths among children aged 0-18 years. Of 833 cases, 601 (73%) are male and 232 (27%) are female. The female to male ratio is 1/2.6. The highest rate of death from accidents is at the group of 15-18 years. The primary causes of accidental childhood deaths are motor vehicle accidents (23.1%), followed by drowning (20,1%), poisoning (15.7%), and fall from height (15.5%). The incidence and types of trauma vary with socio-economic status and culture. İstanbul, where this study is conducted in, has approximately 3000 autopsy number annually. Therefore, it provides an important database.

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

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    Ribeiro C.N.M.

    2004-01-01

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

  16. Pathological spectrum of cytomegalovirus infection of renal allograft recipients-an autopsy study from north India.

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    Joshi, Kusum; Nada, Ritambhra; Radotra, Bishan Das; Jha, Vivekanand; Sakhuja, Vinay

    2004-07-01

    This is a retrospective study of autopsy material to highlight the histo-morphological changes in cytomegalovirus (CMV) infection amongst renal allograft recipients. Nineteen out of 80 patients (23.75%) autopsied during a seventeen-year period (1985-2001) had CMV infection. Pulmonary infection was present in 14 out of 19 cases of which four had isolated lung involvement. Likewise, there were two cases each of isolated oesophageal and renal involvement; one case with isolated colonic involvement. The other 10 cases had multi-organ involvement and the organs involved were kidneys (4), esophagus (6), stomach (1), colon (5), adrenals (3), pancreas (3), liver (1) and spleen (1). Pulmonary infection with CMV was associated with acute pneumonitis in 3 cases and lymphocytic interstitial pneumonitis in 9 instances. Four out of 6 cases had acute tubulo-interstitial nephritis induced by CMV and only two cases had no significant inflammatory response. Glomerular involvement in the form of CMV inclusions in the glomeruli was present in only one case. Gastrointestinal CMV infection (15) presented as acute necrotizing ulceration because of predominant endothelial involvement. Post transplant survival period varied from one month to three years, with majority (14) of the patients having survived for less than one year.

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

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    Gauravi A Dhruva,

    2012-10-01

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

  18. Drug-related deaths with evidence of intracorporeal drug concealment at autopsy: five case reports.

    Science.gov (United States)

    Wilcher, Glenn

    2011-12-01

    Intracorporeal concealment of illicit drugs is a rare observation at coronial autopsy examinations. The article reports 5 cases of accidental drug overdoses at the Westmead Coronial Morgue, Sydney New South Wales, over a 6-year period with evidence of intracorporeal drug concealment known as body packing or body stuffing. Three different forms of anatomic concealment of drugs are illustrated, Case 2 involving therapeutic medication in the form of glass ampoules for parenteral injection not previously reported. Three deaths were the result of acute toxicity due to polydrug abuse rather than as a consequence of the body packing behavior and rupture of the drug packaging, with the intracorporeal drug concealments an adjunct finding at the autopsy examinations. The cause of death in Case 3 was the direct result of acute cocaine intoxication due to rupture of drug packages in the rectum and mucosal absorption. The article details forensic sociological aspects of drug concealment and subcultural group human behavior that can assist in providing information for the initiation of investigations.

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

    Science.gov (United States)

    Soejima, Mikiko; Koda, Yoshiro

    2014-04-01

    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 (5μl) with simple equipment. This semi-quantification method of CRP should be useful for diagnosis during autopsy.

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

    Science.gov (United States)

    Roberts, C S; Roberts, W C

    1990-11-01

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

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

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    Takashi Yuri

    2014-05-01

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

  2. Neoplastic lesions in CADASIL syndrome: report of an autopsied Japanese case.

    Science.gov (United States)

    Hassan, Wael Abdo; Udaka, Naoka; Ueda, Akihiko; Ando, Yukio; Ito, Takaaki

    2015-01-01

    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) is one of the most common heritable causes of stroke and dementia in adults. The gene involved in the pathogenesis of CADASIL is Notch3; in which mutations affect the number of cysteine residues in its extracellular domain, causing its accumulation in small arteries and arterioles of the affected individuals. Besides the usual neurological and vascular findings that have been well-documented in CADASIL patients, this paper additionally reports multiple neoplastic lesions that were observed in an autopsy case of CADASIL patient; that could be related to Notch3 mutation. The patient was a 62 years old male, presented with a past history of neurological manifestations, including gait disturbance and frequent convulsive attacks. He was diagnosed as CADASIL syndrome with Notch3 Arg133Cys mutation. He eventually developed hemiplegia and died of systemic convulsions. Autopsy examination revealed-besides the vascular and neurological lesions characteristic of CADASIL- multiple neoplastic lesions in the body; carcinoid tumorlet and diffuse idiopathic pulmonary neuro-endocrine cell hyperplasia (DIPNECH) in the lungs, renal cell carcinoma (RCC), prostatic adenocarcinoma (ADC) and adenomatoid tumor of the epididymis. This report describes a spectrum of neoplastic lesions that were found in a case of CADASIL patient that could be related to Notch3 gene mutations. PMID:26261665

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

    Science.gov (United States)

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

    2016-01-01

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

  4. Small-cell neuroendocrine carcinoma of the esophagus: an autopsy case report

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    Mariana Bellaguarda de Castro Sepulvida

    2014-03-01

    Full Text Available Small-cell neuroendocrine carcinoma is a well-known aggressive neoplasia, which is usually associated with a poor prognosis. The lung is the most common primary site, but other organs may be involved, especially those of the digestive tract. The authors report the case of a 71-year-old Caucasian, male patient who was admitted because of congestive heart failure and loss of vision accompanied by right proptosis. Skull and sinuses computed tomography showed a tumoral mass involving the posterior region of the right eye, local bones, and paranasal sinuses. Because of severe hemodynamic instability, the patient died and no diagnostic investigation could be performed. Autopsy findings revealed small-cell neuroendocrine carcinoma of the esophagus and metastases to the posterior region of the right ocular globe, which affected the sinuses, the muscles of the ocular region, the orbit bones, the skull, the meninges and the brain, plus the liver, adrenal glands, and the pericardium. This case called the author’s attention to the extent of the metastatic disease in a patient who was firstly interpreted as presenting solely with congestive heart failure. The autopsy findings substantially aid the understanding of the immediate cause of death.

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

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

    2002-07-01

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

  6. 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)

  7. GLUT3 protein and mRNA in autopsy muscle specimens

    Science.gov (United States)

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

    1999-01-01

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

  8. Multiple primary cancers in a case of chronic arsenic poisoning--an autopsy report.

    Science.gov (United States)

    Tanimoto, A; Hamada, T; Kanesaki, H; Matsuno, K; Koide, O

    1990-03-01

    This is an autopsy report of multiple primary cancers observed in a patient who had clinically been diagnosed as chronic arsenic poisoning. An 88-year-old man, non-smoker, had worked in an arsenic mine for 6 years from the age of 47. He had undergone operations for Bowen's disease and gastric cancer at ages 80 and 86, respectively. At autopsy, squamous cell carcinoma of the lung and a polypoid lesion in the piriform recess were found. Furthermore, microscopic examination revealed latent prostatic adenocarcinoma and oncocytoma in the kidney. The polypoid lesion of the piriform recess appeared to originate from the duct of the minor salivary gland in the pharynx, showing an adenoid cystic carcinoma-like pattern with squamous cell carcinoma in part. The cause of death was thought to be respiratory failure due to bronchopneumonia and pulmonary edema as well as hydrothorax, and chronic heart failure following ischemic heart disease. Bowen's disease was followed by four internal malignant tumors, even though the etiological relation between these cancers and arsenic is not clear.

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

    Science.gov (United States)

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

    1987-03-01

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

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

    Directory of Open Access Journals (Sweden)

    B. N. Macharia

    2015-06-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    OpenAIRE

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

    2010-01-01

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

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

    DEFF Research Database (Denmark)

    Leth, Peter Mygind

    2010-01-01

    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...

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

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    Adair Timothy

    2010-03-01

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

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

    Science.gov (United States)

    Uzün, Ibrahim; Büyük, Yalçin; Gürpinar, Kağan

    2007-10-01

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

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

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    Thayyil Sudhin

    2011-12-01

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

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

    LENUS (Irish Health Repository)

    2012-01-31

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

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

    Science.gov (United States)

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

    2016-08-01

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

  19. 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.

  20. Multiorgan gadolinium (Gd) deposition and fibrosis in a patient with nephrogenic systemic fibrosis--an autopsy-based review

    DEFF Research Database (Denmark)

    Sanyal, Soma; Marckmann, Peter; Scherer, Susanne;

    2011-01-01

    tissues of NSF patients, predominantly at the bulk chemical level. The distribution of Gd at the histologic level of organs other than skin has not been reported previously. METHODS: We analysed tissues from an autopsy case with verified advanced NSF by light microscopy and scanning electron microscopy...

  1. 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)

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

    Science.gov (United States)

    Menenteau, Sandra

    2012-01-01

    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.

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

    Science.gov (United States)

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

    2009-01-01

    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

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

    Science.gov (United States)

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

    2009-06-01

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

  5. [Systemic karyomegaly with chronic interstitial nephritis. Discussion of the disease picture based on an autopsy case].

    Science.gov (United States)

    Moch, H; Spöndlin, M; Schmassmann, A; Mihatsch, M J

    1994-02-01

    Systemic karyomegaly associated with interstitial nephritis was first described in 1978 by Mihatsch. Seven cases have been reported to date. We give an account of an autopsy case of systemic karyomegaly in a 30-year-old Italian man. Bizarre enlargement of nuclei was found in renal tubular epithelial cells, Schwann cells and in smooth muscle cells of vessels and bowel and, less obviously, in endothelial and adventitial cells of vessels, in alveolar epithelial cells and in astrocytes of the brain. These findings were associated with chronic interstitial nephritis, nonspecific hepatopathy, adenocarcinoma of the rectum and multiple sclerosis. The clinical course was marked by chronic renal failure, chronic haemodialysis and renal transplantation. The patient died 8 years after diagnosis in septic-toxic shock. The aetiology and pathogenesis of the disease are discussed.

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

    Science.gov (United States)

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

    2012-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Emi Yasuda

    2013-01-01

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

  8. AN APPROACH FOR REMOVAL OF BRAIN, BRAIN STEM WITH SPINAL CORD FOR AUTOPSY AND ANATOMICAL STUDY

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    Nilesh

    2014-10-01

    Full Text Available : After proper preparations of body, removal of brain, brain stem with spinal cord were done. Total thirty (30 cadavers were dissected in a span of three (3 years in Katihar Medical College, Katihar, Bihar, India with good results. The removal of vault of skull, squamous part of occipital bone, posterior arch of atlas, followed by bilateral laminectomy of vertebrae, helps in viewing of brain, brain stem and spinal cord along with spinal nerve roots and cauda equina. This approach helps in total removal of brain, brain stem and spinal cord with its covering with large venous sinuses remaining intact however small venous sinuses are sacrificed in this process. The specimen thus obtained can be used for autopsy or anatomical study.

  9. Wilson's disease: A Clinical autopsy case report with review of literature.

    Science.gov (United States)

    Raju, Kalyani; Bangalore, Gayathri Nagaraj; Thuruvekere, Suresh Nagaraj; Pathavanalli, Venkatarathnamma Narayanappa

    2015-01-01

    Wilson's disease is an autosomal recessive disease resulting in defective copper metabolism, which is usually seen in young adults, predominantly affecting liver and brain. Although it is not uncommon in India, variation in epidemiology, clinical presentation and course are reported. However, community-based incidence and prevalence rates are not available in India and incidences are limited to hospital based reports. Most often, the diagnosis is delayed. We present a clinical autopsy case in a 39 year-old female who had presented with clinical symptoms at 18 years of age. The duration of illness was 21 years. Patient's parent had consanguineous marriage and the younger sibling had died at 5 years of age with similar complaints.

  10. Heterogeneity and compartmentalization of Pneumocystis carinii f. sp. hominis genotypes in autopsy lungs

    DEFF Research Database (Denmark)

    Helweg-Larsen, J; Lundgren, Bettina; Lundgren, Jens Dilling

    2001-01-01

    The extent and importance of genotype heterogeneity of Pneumocystis carinii f. sp. hominis within lungs have not previously been investigated. Two hundred forty PCR clones obtained from respiratory specimens and lung segments from three patients with fatal P. carinii pneumonia were investigated....... Not all genotypes present in the lungs at autopsy were detected in the diagnostic respiratory samples. Compartmentalization of specific ITS and mtLSU rRNA sequence types was observed in different lung segments. In conclusion, the interpretation of genotype data and in particular ITS sequence types...... in the assessment of epidemiological questions should be cautious since genotyping done on respiratory samples cannot a priori be assumed to represent all genotypes present within the lung....

  11. An autopsy case of death due to metabolic acidosis after citric acid ingestion.

    Science.gov (United States)

    Ikeda, Tomoya; Usui, Akihito; Matsumura, Takashi; Aramaki, Tomomi; Hosoya, Tadashi; Igari, Yui; Ohuchi, Tsukasa; Hayashizaki, Yoshie; Usui, Kiyotaka; Funayama, Masato

    2015-11-01

    A man in his 40s was found unconscious on a sofa in a communal residence for people with various disabilities. He appeared to have drunk 800 ml of undiluted citric acid from a commercial plastic bottle. The instructions on the label of the beverage specified that the beverage be diluted 20- to 30-fold before consumption. The patient was admitted to an emergency hospital with severe metabolic acidosis (pH, 6.70; HCO3(-), 3.6 mEq/L) and a low ionized calcium level (0.73 mmol/L). Although ionized calcium and catecholamines were continuously administered intravenously to correct the acidosis, the state of acidemia and low blood pressure did not improve, and he died 20 h later. Citric acid concentrations in the patient's serum drawn shortly after treatment in the hospital and from the heart at autopsy were 80.6 mg/ml and 39.8 mg/dl, respectively (normal range: 1.3-2.6 mg/dl). Autopsy revealed black discoloration of the mucosal surface of the esophagus. Microscopically, degenerated epithelium and neutrophilic infiltration in the muscle layer were observed. In daily life, drinking a large amount of concentrated citric acid beverage is rare as a cause of lethal poisoning. However, persons with mental disorders such as dementia may mistakenly drink detergent or concentrated fluids, as in our case. Family members or facility staff in the home or nursing facility must bear in mind that they should not leave such bottles in places where they are easily accessible to mentally handicapped persons.

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

    Directory of Open Access Journals (Sweden)

    Anita van der Linden

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

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

    Directory of Open Access Journals (Sweden)

    Shinozaki Minoru

    2011-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Braggion-Santos

    2015-02-01

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

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

    Science.gov (United States)

    Obiorah, C C; Amakiri, C N

    2014-01-01

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

  16. Distribution of polybrominated diphenyl ethers in Japanese autopsy tissue and body fluid samples.

    Science.gov (United States)

    Hirai, Tetsuya; Fujimine, Yoshinori; Watanabe, Shaw; Nakano, Takeshi

    2012-09-01

    Brominated flame retardants are components of many plastics and are used in products such as cars, textiles, televisions, and personal computers. Human exposure to polybrominated diphenyl ether (PBDE) flame retardants has increased exponentially during the last three decades. Our objective was to measure the body burden and distribution of PBDEs and to determine the concentrations of the predominant PBDE congeners in samples of liver, bile, adipose tissue, and blood obtained from Japanese autopsy cases. Tissues and body fluids obtained from 20 autopsy cases were analyzed. The levels of 25 PBDE congeners, ranging from tri- to hexa-BDEs, were assessed. The geometric means of the sum of the concentrations of PBDE congeners having detection frequencies >50 % (ΣPBDE) in the blood, liver, bile, and adipose tissue were 2.4, 2.6, 1.4, and 4.3 ng/g lipid, respectively. The most abundant congeners were BDE-47 and BDE-153, followed by BDE-100, BDE-99, and BDE-28+33. These concentrations of PBDE congeners were similar to other reports of human exposure in Japan but were notably lower than concentrations than those reported in the USA. Significant positive correlations were observed between the concentrations of predominant congeners and ΣPBDE among the samples analyzed. The ΣPBDE concentration was highest in the adipose tissue, but PBDEs were distributed widely among the tissues and body fluids analyzed. The PBDE levels observed in the present study are similar to those reported in previous studies in Japan and significantly lower than those reported in the USA. PMID:22544599

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

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    Chow Clara

    2011-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-15

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Madea, Burkhard

    2009-04-01

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

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

    Science.gov (United States)

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

    2002-10-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    International Nuclear Information System (INIS)

    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)

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

    Directory of Open Access Journals (Sweden)

    Bareng AS Nonyane 1,2

    2016-06-01

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

  8. One small scan for radiology, one giant leap for forensic medicine - Post-mortem imaging replaces forensic autopsy in a case of traumatic aortic laceration.

    Science.gov (United States)

    Ruder, Thomas D; Hatch, Gary M; Thali, Michael J; Fischer, Nadja

    2011-01-01

    The questions of cause and manner of death are the most pressing ones in any forensic investigation. Traditionally, autopsy is the means to provide answers to these questions and despite the increasing use of CT and MR in the post-mortem setting, imaging has usually been an adjunct to forensic autopsy. Here we describe a case where post-mortem CT and MR were performed instead of autopsy, at the request of the responsible public prosecutor. The forensic conclusions derived from imaging, including cause and manner of death were accepted by the legal authorities, thereby setting precedence for future cases. This case represents a landmark in forensic medicine and is another step toward the full realization of minimally invasive forensic autopsy.

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

    Directory of Open Access Journals (Sweden)

    Shakeri Bavil Moslem

    2009-10-01

    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.

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

    OpenAIRE

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

    1987-01-01

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

  11. University of Pittsburgh Medical Center remains tracker: A novel application for tracking decedents and improving the autopsy workflow

    Directory of Open Access Journals (Sweden)

    Matthew A Smith

    2011-01-01

    Full Text Available All hospitals deal with patient deaths. Multiple departments and personnel must be coordinated to ensure that decedents are safely managed. Prior to 2004, at the University of Pittsburgh Medical Center (UPMC, when a patient passed away, the process of alerting involved personnel, transporting the decedent, and tracking the completion of clinical documents was cumbersome and inefficient. In order to address these concerns, UPMC Remains Tracker, a web-based application, was developed to improve the efficiency and simplify the logistics related to the management of patient deaths. The UPMC Information Services division developed UPMC Remains Tracker, an application that tracks decedents′ locations, documentation status, and autopsy status within UPMC hospitals. We assessed qualitative improvement in decedent remains tracking, decedent paperwork management, and staff satisfaction and compliance. UPMC Remains Tracker improved the process of tracking decedents′ locations, identifying involved personnel, monitoring autopsy requests, and determining the availability for funeral home transportation. Resident satisfaction with UPMC Remains Tracker was generally positive and scored as "Improved efficiency" and makes identifying and tracking decedents "Much easier". Additionally, the nursing staff reacted favorably to the application. A retrospective review of the use of the application in the management of 100 decedents demonstrated a 93% compliance rate. Among the cases requiring an autopsy, there was a 90% compliance rate. The process of tracking decedents, their paperwork, involved staff, and decedent autopsy status is often inefficient. This assessment suggests that incorporating new technologies such as UPMC Remains Tracker into the management of hospital deaths provides accurate tracking of remains, streamlines the administrative tasks associated with deaths, and increases nursing and resident satisfaction and compliance.

  12. Pattern of homicidal deaths autopsied at Penang Hospital, Malaysia, 2007-2009: a preliminary study.

    Science.gov (United States)

    Bhupinder, S; Kumara, T K; Syed, A M

    2010-12-01

    This article describes the homicide pattern in Penang Island, Malaysia over a three-year period (2007-2009). 65 homicide autopsies were performed at the Department of Forensic Medicine, Penang Hospital over the study period. The homicide rates ranged from 0.01 to 0.09/1000 population, the highest being in the Indian ethnic group. The majority (37%) of victims were in the 20-39 years age group. The male: female ratio was 3:1. The majority of deaths were caused by blunt instruments (46%), followed by stab/slash wounds (25%) and asphyxiation (12%). 63% of homicides occurred in areas served by the police stations at Jalan Patani (23.1%), Sg. Nibong (16.9%), Central (12.3%) and Bayan Lepas (10.9%). 56 (86%) victims were brought in dead to the hospital, while 9 (14%) died after admission. Most (39%) incidences occurred in the morning. The methods of homicide were different from Kuala Lumpur, another highly urbanised area of Malaysia.

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

    Directory of Open Access Journals (Sweden)

    Aramandla Ramesh

    2014-12-01

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

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

    International Nuclear Information System (INIS)

    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)

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

    Science.gov (United States)

    Ishikawa, Takaki; Yuasa, Isao; Endoh, Minoru

    2015-11-01

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

  16. [Benefits of otoscopy in forensic autopsy practice: A prospective study].

    Science.gov (United States)

    Kučerová, Štěpánka; Hejna, Petr; Dobiáš, Martin

    2016-01-01

    The otoscopy is an examination of the external auditory canal, the eardrum, and the middle ear with an instrument called an otoscope. It is a simple, inexpensive, and time-saving endoscopic method typically used by general practitioners and otorhinolaryngologists. Authors present a prospective study of otoscopic findings investigated consecutively at autopsy. Of the 250 examined persons, 50 positive findings were identified: 38 cases with petechial hemorrhages and 12 cases with tympanic membrane perforation or hemotympanon. Hemorrhages of the tympanic membrane detected through the otoscopy may serve as evidence of congestion within head and neck potentially associated with asphyxiation either in the death or in the living (similar to periorbital and conjuctival petechial hemorrhages). In our study, hemorrhages of the tympanic membrane were related to heart failure, hanging and asphyxiation. Perforated tympanic membrane and hemotympanum have been sporadically reported in victims of fatal lightning strike and rarely in strangulation. This findings were in our study associated with craniocerebral injuries: traffic accidents, falls from height and gunshot injuries. The otoscopy may help to reveal various traumatic and pathological changes within the outer and the middle ear, and, thus, provide important forensic evidence. The otoscopy is also highly recommended in the investigation of the sudden deaths in the young. PMID:27221725

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

    Science.gov (United States)

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

    2016-05-01

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

  18. Ethyl glucuronide and ethyl sulfate in autopsy samples 27 years after death.

    Science.gov (United States)

    Politi, Lucia; Morini, Luca; Mari, Francesco; Groppi, Angelo; Bertol, Elisabetta

    2008-11-01

    The unique case of a 50-year-old known alcoholic whose corpse was exhumed 27 years after death is reported. The man apparently committed suicide by hanging, but many years later the case was questioned and homicide-linked to a long-lasting serial killer case-was suspected. Thus, the corpse was exhumed, and at the autopsy it was found to be naturally mummified. This fact permitted the analysis of body tissues with the aim to investigate the persistence of ethanol conjugates in the biological material 27 years after death. Fragments of liver and kidney, a blood clot, and a hair strand were collected and submitted to liquid chromatography tandem mass spectrometry analysis. Ethyl glucuronide (EtG) and ethyl sulfate (EtS) were identified and quantified in the liver, the kidney, and the blood clot. Hair analysis was found to be severely affected by ion suppression even after solid phase extraction. Consequently, EtG was identified in all hair segments (0-3 cm, 3-6 cm, and 6-10 cm), but no reliable quantification could be carried out. In summary, our findings demonstrate that, notwithstanding the expected conjugate degradation, EtG and EtS can be indicative of ante-mortem use of alcohol even many years after death.

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

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    Ariel Barreto Nogueira

    2012-12-01

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

  20. Pattern of suicide: a review of autopsies conducted at the University Hospital, Kuala Lumpur.

    Science.gov (United States)

    Nadesan, K

    1999-12-01

    Suicide is one of the ten leading causes of death in the world, accounting for more than 400,000 deaths annually. The pattern of suicide and the incidence of suicide vary from country to country. Cultural, religious and social values play some role in suicide. Compared to the West and some of the countries in the Asian region the incidence of suicide is low in Malaysia. A three-year retrospective study of all the autopsies performed at the University Hospital, Kuala Lumpur was analysed and the cases that were definitely determined as suicides were further studied. 48.8% of all suicides were ethnic Indians though Indians formed only 8% of the Malaysian population. 38.1% of suicides were Chinese who formed 26% of the population while only 3.6% were Malays, who formed 59% of the population. The preferred methods of suicide were poisoning and hanging. The majority were in the age group 20-40 yr. The study may have missed some cases that would have been wrongly concluded as accidental deaths and a few others where the police would have released the bodies without postmortem examinations.

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

    International Nuclear Information System (INIS)

    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)

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

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    Inci Alacacioglu

    2009-06-01

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

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

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

  5. Pathologic findings in the adrenal glands of autopsied patients with acquired immunodeficiency syndrome.

    Science.gov (United States)

    Rodrigues, Denise; Reis, Marlene; Teixeira, Vicente; Silva-Vergara, Mário; Filho, Dalmo Correia; Adad, Sheila; Lazo, Javier

    2002-01-01

    A morphologic evaluation was carried out on adrenal glands from 128 autopsied patients with the acquired immunodeficiency syndrome (AIDS). The adrenal gland was compromised in 99.2% of the cases, with distinct pathological features and infectious agents. Inflammatory infiltrates were observed in 99.2% of the cases with a predominance of mononuclear cells in 97.4%, affecting mainly the medulla. Necrosis, fibrosis, hemorrhages and neoplasias were observed. We also described 3 (2.3%) cases of calcification located in the adrenal gland central vein (AGCV). This is seldom mentioned in the literature. Cytomegalovirus was the most frequent infectious agent, observed in 48.4% of cases. Balamuthia mandrillaris, a free living ameba, was found in one case affecting the entire gland. We also found a nest of Trypanosoma cruzi in the musculature of the AGCV. The presence of the nest of T cruzi in AGCV may play a role in the reactivation of this infection in immunosuppressed individuals. Pathologic processes and opportunistic infections may contribute to the alterations in the adrenal gland that lead to multiple organ failure observed in terminal AIDS patients.

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

    Directory of Open Access Journals (Sweden)

    Karata H

    2015-07-01

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

  7. Why did ancient people have atherosclerosis?: from autopsies to computed tomography to potential causes.

    Science.gov (United States)

    Thomas, Gregory S; Wann, L Samuel; Allam, Adel H; Thompson, Randall C; Michalik, David E; Sutherland, M Linda; Sutherland, James D; Lombardi, Guido P; Watson, Lucia; Cox, Samantha L; Valladolid, Clide M; Abd El-Maksoud, Gomaa; Al-Tohamy Soliman, Muhammad; Badr, Ibrahem; el-Halim Nur el-Din, Abd; Clarke, Emily M; Thomas, Ian G; Miyamoto, Michael I; Kaplan, Hillard S; Frohlich, Bruno; Narula, Jagat; Stewart, Alexandre F R; Zink, Albert; Finch, Caleb E

    2014-06-01

    Computed tomographic findings of atherosclerosis in the ancient cultures of Egypt, Peru, the American Southwest and the Aleutian Islands challenge our understanding of the fundamental causes of atherosclerosis. Could these findings be true? Is so, what traditional risk factors might be present in these cultures that could explain this apparent paradox? The recent computed tomographic findings are consistent with multiple autopsy studies dating as far back as 1852 that demonstrate calcific atherosclerosis in ancient Egyptians and Peruvians. A nontraditional cause of atherosclerosis that could explain this burden of atherosclerosis is the microbial and parasitic inflammatory burden likely to be present in ancient cultures inherently lacking modern hygiene and antimicrobials. Patients with chronic systemic inflammatory diseases of today, including systemic lupus erythematosus, rheumatoid arthritis, and human immunodeficiency virus infection, experience premature atherosclerosis and coronary events. Might the chronic inflammatory load of ancient times secondary to infection have resulted in atherosclerosis? Smoke inhalation from the use of open fires for daily cooking and illumination represents another potential cause. Undiscovered risk factors could also have been present, potential causes that technologically cannot currently be measured in our serum or other tissue. A synthesis of these findings suggests that a gene-environmental interplay is causal for atherosclerosis. That is, humans have an inherent genetic susceptibility to atherosclerosis, whereas the speed and severity of its development are secondary to known and potentially unknown environmental factors. PMID:25667093

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

    Science.gov (United States)

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

    1984-10-01

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

  9. [Neurocysticercosis: contribution of autopsies in the consolidation of mandatory notification in Ribeiräo Preto-SP,Brazil].

    Science.gov (United States)

    Chimelli, L; Lovalho, A F; Takayanagui, O M

    1998-09-01

    Neurocysticercosis is a serious public health problem in several countries of Asia, Africa and Latin America. The objective of the present study is to present autopsy findings of neurocysticercosis in the Pathology Division of the University Hospital, Medical School of Ribeirão Preto, University of São Paulo, from 1992 to 1997. Neurocysticercosis was detected in 38 (1.5%) of 2522 autopsies. In twenty two (57.9%) of these, the diagnosis was made post-mortem, while 16 (42.1%) had a previous diagnosis of cysticercosis based on laboratory and imaging studies. Reviewing the medical records, we found that 21 patients (55.2%) were neurologically asymptomatic, while the various clinical manifestations in the others were in accordance with the literature. The high frequency of asymptomatic individuals detected only post-mortem indicates the importance of autopsies as an additional source of data to consolidate the compulsory notification of cysticercosis. Considering the results of this study, the new coefficient of prevalence of cysticercosis in Ribeirão Preto is 67 cases/100,000 inhabitants.

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

    Energy Technology Data Exchange (ETDEWEB)

    Muehler, Matthias R.; Lembcke, Alexander; Fischer, Thomas; Kivelitz, Dietmar [CCM, Department of Radiology, Charite, Berlin (Germany); Rake, Anett; Chaoui, Rabih; Heling, Kay-Sven [CCM, Section for Prenatal Medicine, Department of Gynecology and Obstetrics, Charite, Berlin (Germany); Schwabe, Michael [CCM, Department of Pathology, Charite, Berlin (Germany); Planke, Christiane [Carl-Thiem-Klinikum Cottbus, Department of Pediatrics and Juvenile Medicine, Cottbus (Germany)

    2004-11-01

    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.)

  11. Can post-mortem computed tomography be considered an alternative for autopsy in deaths due to hemopericardium?

    Institute of Scientific and Technical Information of China (English)

    Lorenzo Gitto; Serenella Serinelli; Francesco P Busard; Valeria Panebianco; Giorgio Bolino; Aniello Maiese

    2014-01-01

    Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathologi-cal relationship in causing death is requested. Hemopericardium and cardiac tamponade can be evaluated in living people using radiological techniques, in particular computer tomography (CT). Only a few studies are reported in literature involving post-mortem (PM) cases, where PMCT imaging has been used in order to investigate acute hemopericardium, and they have shown a good accuracy of this technique. Here we report a case involving a 70-year-old white male found dead on the beach, with a medical history of hepatitis C and chronic hypertension with a poor pharmacological response. A PMCT was performed about 3 h after the discovery of the body. The PMCT examination showed an intrapericardial aortic dissection associated to a periaortic hematoma, a sickle-shaped intramural hematoma, a false lumen, and a hemop-ericardium consisting in fluid and clotted blood. In this case, the PMCT was able to identify the cause of death, even though a traditional autopsy was required to confirm the radiological findings. PMCT is a reliable technique, which in chosen cases, can be performed without the need for a traditional autopsy to be carried out.

  12. [Clinico-pathological diagnostic agreement among 429 autopsies from the Instituto Nacional de la Nutrición Salvador Zubirán].

    Science.gov (United States)

    Angeles-Angeles, A; Quintanilla Martínez, L; Muñoz Fernández, L; Espinoza Vázquez, B; Victoría Peralta, P

    1992-01-01

    Comparison of clinical and autopsy findings of the cases studied between 1984 and 1988, were made at the Department of Pathology of the Instituto Nacional de la Nutricion Salvador Zubiran in Mexico City. The goal was to determine the accuracy of clinical diagnoses. The total number of cases was 429. A decreasing number of autopsies as a function of time was observed. Thus, in 1985, 34.65% of the deaths was autopsied, whereas in 1988, the number dropped to 21.16%, overall mean of 27.31%. In 229 autopsies (53.8%), 353 findings of clinical significance were found; of these, 86 were in the main diagnoses and 267 in the causes of death. There were 171 overdiagnoses with therapeutic implications, 38 in the main diagnoses and 133 in the causes of death. Overdiagnoses and underdiagnoses were most common in infectious diseases, followed by respiratory and digestive diseases, while endocrinologic and rheumatologic diseases had the highest diagnostic concordance. It was also found that the diagnostic accuracy did not improve with time of hospitalization. A brief analyses of the probable causes of the decrease in the number of autopsies is made. It is concluded that, in spite of the great advances in clinical and technological knowledge, the high frequency of disagreements between clinical and anatomical diagnoses, indicate that autopsy continues playing a key role in the quality control of medical practice. This justifies by itself the performance of necropsies.

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Koffi Alain K

    2011-08-01

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

  15. A Bacillus anthracis Genome Sequence from the Sverdlovsk 1979 Autopsy Specimens

    Science.gov (United States)

    Sahl, Jason W.; Pearson, Talima; Okinaka, Richard; Schupp, James M.; Gillece, John D.; Heaton, Hannah; Birdsell, Dawn; Hepp, Crystal; Fofanov, Viacheslav; Noseda, Ramón; Fasanella, Antonio; Hoffmaster, Alex; Wagner, David M.

    2016-01-01

    ABSTRACT Anthrax is a zoonotic disease that occurs naturally in wild and domestic animals but has been used by both state-sponsored programs and terrorists as a biological weapon. A Soviet industrial production facility in Sverdlovsk, USSR, proved deficient in 1979 when a plume of spores was accidentally released and resulted in one of the largest known human anthrax outbreaks. In order to understand this outbreak and others, we generated a Bacillus anthracis population genetic database based upon whole-genome analysis to identify all single-nucleotide polymorphisms (SNPs) across a reference genome. Phylogenetic analysis has defined three major clades (A, B, and C), B and C being relatively rare compared to A. The A clade has numerous subclades, including a major polytomy named the trans-Eurasian (TEA) group. The TEA radiation is a dominant evolutionary feature of B. anthracis, with many contemporary populations having resulted from a large spatial dispersal of spores from a single source. Two autopsy specimens from the Sverdlovsk outbreak were deep sequenced to produce draft B. anthracis genomes. This allowed the phylogenetic placement of the Sverdlovsk strain into a clade with two Asian live vaccine strains, including the Russian Tsiankovskii strain. The genome was examined for evidence of drug resistance manipulation or other genetic engineering, but none was found. The Soviet Sverdlovsk strain genome is consistent with a wild-type strain from Russia that had no evidence of genetic manipulation during its industrial production. This work provides insights into the world’s largest biological weapons program and provides an extensive B. anthracis phylogenetic reference. PMID:27677796

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jordana Leitao

    2013-09-01

    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

  18. Recognition memory span in autopsy-confirmed Dementia with Lewy Bodies and Alzheimer's Disease.

    Science.gov (United States)

    Salmon, David P; Heindel, William C; Hamilton, Joanne M; Vincent Filoteo, J; Cidambi, Varun; Hansen, Lawrence A; Masliah, Eliezer; Galasko, Douglas

    2015-08-01

    Evidence from patients with amnesia suggests that recognition memory span tasks engage both long-term memory (i.e., secondary memory) processes mediated by the diencephalic-medial temporal lobe memory system and working memory processes mediated by fronto-striatal systems. Thus, the recognition memory span task may be particularly effective for detecting memory deficits in disorders that disrupt both memory systems. The presence of unique pathology in fronto-striatal circuits in Dementia with Lewy Bodies (DLB) compared to AD suggests that performance on the recognition memory span task might be differentially affected in the two disorders even though they have quantitatively similar deficits in secondary memory. In the present study, patients with autopsy-confirmed DLB or AD, and Normal Control (NC) participants, were tested on separate recognition memory span tasks that required them to retain increasing amounts of verbal, spatial, or visual object (i.e., faces) information across trials. Results showed that recognition memory spans for verbal and spatial stimuli, but not face stimuli, were lower in patients with DLB than in those with AD, and more impaired relative to NC performance. This was despite similar deficits in the two patient groups on independent measures of secondary memory such as the total number of words recalled from long-term storage on the Buschke Selective Reminding Test. The disproportionate vulnerability of recognition memory span task performance in DLB compared to AD may be due to greater fronto-striatal involvement in DLB and a corresponding decrement in cooperative interaction between working memory and secondary memory processes. Assessment of recognition memory span may contribute to the ability to distinguish between DLB and AD relatively early in the course of disease. PMID:26184443

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

    Directory of Open Access Journals (Sweden)

    Straka Lubomir

    2011-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Alexandre de Matos Soeiro

    2011-01-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-15

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

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

    DEFF Research Database (Denmark)

    Jacobsen, Christina; Lynnerup, Niels

    2010-01-01

    Computed tomography (CT) has been used routinely at the Department of Forensic Medicine, University of Copenhagen since 2002. A retrospective study was performed in order to correlate CT-scan based diagnoses of cranial and cerebral lesions with macroscopic autopsy diagnoses in 56 cases. The CT......-scans were performed by a forensic pathologist. They were obtained by using two different CT-scan protocols. The results showed correct skull fracture diagnoses in 34/56 cases. Fractures were diagnosed partially (9) or missed totally (13) on CT-images in 22 cases. The agreement for fracture diagnoses...

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Pattaraarchachai Junya

    2010-05-01

    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

  5. The autopsy was conducted "Under most inauspicious circumstances:" John Turner, Harvey Cushing's case XXXII, and his unwitting contributions to the early understanding of acromegaly.

    Science.gov (United States)

    Pendleton, Courtney; Wand, Gary; Quinones-Hinojosa, Alfredo

    2010-12-01

    Harvey Cushing's monograph The Pituitary Body and Its Disorders describes Case XXXII, a 36-year-old man who presented with gigantism in 1910. The detailed post-mortem exam findings are prefaced with a cryptic statement, describing "inauspicious circumstances" surrounding the autopsy. Although contemporary biographies of Cushing have offered insight into these circumstances, the original surgical file for Case XXXII has not been previously reviewed. The original Johns Hopkins Hospital surgical records were reviewed, and the case of John Turner, who Cushing identified by name in his monograph The Pituitary Body and Its Disorders, was selected for further review. A review of the original surgical file revealed a typewritten note by Dr. Crowe, one of the surgeons who performed the post-mortem exam, with a handwritten addendum by Dr. Cushing. This document provides detail regarding the "inauspicious circumstances" surrounding the autopsy. Namely, the autopsy was conducted without permission of the family, during the funeral service, following a payment to the undertaker. The new information regarding the autopsy of John Turner offers insight into the previously incompletely described circumstances surrounding the autopsy. Additionally, the case illuminates the obligations and ethical quandaries that physician-scientists face. PMID:20607416

  6. The autopsy was conducted "Under most inauspicious circumstances:" John Turner, Harvey Cushing's case XXXII, and his unwitting contributions to the early understanding of acromegaly.

    Science.gov (United States)

    Pendleton, Courtney; Wand, Gary; Quinones-Hinojosa, Alfredo

    2010-12-01

    Harvey Cushing's monograph The Pituitary Body and Its Disorders describes Case XXXII, a 36-year-old man who presented with gigantism in 1910. The detailed post-mortem exam findings are prefaced with a cryptic statement, describing "inauspicious circumstances" surrounding the autopsy. Although contemporary biographies of Cushing have offered insight into these circumstances, the original surgical file for Case XXXII has not been previously reviewed. The original Johns Hopkins Hospital surgical records were reviewed, and the case of John Turner, who Cushing identified by name in his monograph The Pituitary Body and Its Disorders, was selected for further review. A review of the original surgical file revealed a typewritten note by Dr. Crowe, one of the surgeons who performed the post-mortem exam, with a handwritten addendum by Dr. Cushing. This document provides detail regarding the "inauspicious circumstances" surrounding the autopsy. Namely, the autopsy was conducted without permission of the family, during the funeral service, following a payment to the undertaker. The new information regarding the autopsy of John Turner offers insight into the previously incompletely described circumstances surrounding the autopsy. Additionally, the case illuminates the obligations and ethical quandaries that physician-scientists face.

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

    Directory of Open Access Journals (Sweden)

    Raymond A. Aborigo

    2013-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Morild Inge

    2007-10-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-06-01

    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).

  11. An autopsy case of macroglobulinemia complicated with syndrome of inappropriate secretion of ADH (SIADH) like hyponatremia, hypopituitarism and AL amyloidosis.

    Science.gov (United States)

    Yamada, Chika; Yoneda, Chihiro; Ogino, Jun; Fukushima, Sayaka; Kodama, Shoko; Asano, Chihiro; Masuda, Michihiko; Horie-Tajima, Kanako; Toyonaga, Aiko; Hiroshima, Kenzo; Kawamura, Shunji; Hashimoto, Naotake

    2014-01-01

    An 88-year-old male patient with macroglobulinemia was admitted to our hospital because of severe hyponatremia and unconsciousness. Laboratory findings showed decreased inhibition of antidiuretic hormone (ADH) and he was diagnosed with syndrome of inappropriate secretion of ADH (SIADH). Hyponatremia improved with only limitation of water intake and the patient was followed up on a continuing outpatient basis. However, soon after discharge from hospital, his legs started swelling with edema and hyponatremia worsened. He was re-admitted due to a fall at home. Hyponatremia was observed at re-admission. A CRH challenge test showed partial dysfunction of ACTH secretion. Corticosteroid therapy was performed, but the patient subsequently died from pneumonia. Pathological findings at autopsy revealed invasion of plasma cells and amyloid depositions in multiple organs, including the pituitary, adrenal cortex, heart, liver, kidney, lymph nodes and bone marrow. Consistent with these results, fibrosis was observed in the anterior lobe of the pituitary, suggesting that the autopsy findings were related to the clinical observations and diagnosis. This is the first reported case of macroglobulinemia complicated with multiple hormone dysfunction.

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

    Science.gov (United States)

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

    2016-02-01

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

  13. Analyses of cardiac blood cells and serum proteins with regard to cause of death in forensic autopsy cases.

    Science.gov (United States)

    Quan, Li; Ishikawa, Takaki; Michiue, Tomomi; Li, Dong-Ri; Zhao, Dong; Yoshida, Chiemi; Chen, Jian-Hua; Komatsu, Ayumi; Azuma, Yoko; Sakoda, Shigeki; Zhu, Bao-Li; Maeda, Hitoshi

    2009-04-01

    To investigate hematological and serum protein profiles of cadaveric heart blood with regard to the cause of death, serial forensic autopsy cases (n=308, >18 years of age, within 48 h postmortem) were examined. Red blood cells (Rbc), hemoglobin (Hb), platelets (Plt), white blood cells (Wbc), total protein (TP) and albumin (Alb) were examined in bilateral cardiac blood. Blood cell counts, collected after turning the bodies at autopsy, approximated to the clinical values. Postmortem changes were not significant for these markers. In non-head blunt injury cases, Rbc counts, Hb, TP and Alb levels in bilateral cardiac blood were lower in subacute deaths (survival time, 1-12 h) than in acute deaths (survival time blood were significantly higher for non-head injury than for head injury in subacute deaths. In fire fatality cases, Plt count was markedly higher with an automated hematology analyzer than by using a blood smear test, suggesting Rbc fragmentation caused by deep burns, while increases in Wbc count and decreases in Alb levels were seen for subacute deaths. For asphyxiation, Rbc count, Hb, TP and Alb levels in bilateral cardiac blood were higher than other groups, and TP and Alb levels in the right cardiac blood were higher for hanging than for strangulation. These findings suggest that analyses of blood cells and proteins are useful for investigating the cause of death.

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-15

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

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

    Science.gov (United States)

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

    2003-02-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  19. Coronary Artery Disease and the Profile of Cardiovascular Risk Factors in South South Nigeria: A Clinical and Autopsy Study

    Directory of Open Access Journals (Sweden)

    Okon Ekwere Essien

    2014-01-01

    Full Text Available Introduction. Death from coronary artery disease (CAD has been until recently considered rare in Nigeria. We present a report of a study of CAD with its predisposing cardiovascular (CVD risk factors in South South Nigeria. Methods. We examined the autopsy reports of 747 coroner cases and 41 consecutive clinically diagnosed cases of ischemic heart disease seen in South South Nigeria. Results. CAD was diagnosed in 13 (1.6% of 747 autopsies. They were predominantly males, urban residents, and of high social class with combination of CVD risk factors of hypertension, alcohol use, diabetes mellitus, cigarette smoking, poor physical activities, and obesity. The mean serum cholesterol of the clinical subjects was 4.7±1.57 mmol/L and 5.07±1.94 mmol/L for angina and myocardial infarction, respectively, which was higher than the mean total cholesterol for locality of 3.1 mmol/L. Conclusion. CAD and its risk factors are contributing to mortality and morbidity in South South Nigeria. These risk factors include hypertension, alcohol use, diabetes mellitus, cigarette smoking, poor physical activity, and obesity. Nigerians in this locality with CAD have raised serum lipids.

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Luciano Pamplona de Góes Cavalcanti

    2015-12-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

  3. 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)

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

    2013-01-01

    The present study investigated the interobserver variation between a radiologist and a forensic pathologist in 994 injury diagnoses obtained by postmortem computed tomography (CT) of 67 traffic fatality victims, and the results were compared with diagnoses obtained by autopsy. The injuries were...... 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...

  4. 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)

    Grjibovski Andrej M

    2010-10-01

    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

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

    International Nuclear Information System (INIS)

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  8. 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)

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

    2011-06-15

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

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

    International Nuclear Information System (INIS)

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

  10. Novel tubular inclusions in the bone marrow in multiple sclerosis: an ultrastructural study of early autopsy material.

    Science.gov (United States)

    Kirk, J; Dermott, E

    1981-01-01

    Samples of bone marrow taken at early autopsy from patients who died with multiple sclerosis and from control cases, were examined ultrastructurally with the aim of detecting any infectious agents which might be present. No recognizable virus or mycoplasma was detected. However, rare bizarre cellular inclusions were found in 2 cases. The inclusions which are unlike anything previously described in MS consisted of fine (ca 17 nm) sinuous tubules occasionally showing dilated discoid ends. They occurred together with fragmentary electron opaque material in large membrane bound vacuoles in unidentified cells. Despite superficial resemblance to some viral nucleocapsids it is considered more likely that they have been formed as a result of degenerative phagocytic or autolytic activity. The specificity or otherwise of these inclusions to MS remains to be demonstrated. PMID:6939232

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

    Science.gov (United States)

    Watanabe, K; Hasegawa, K; Suzuki, O

    2011-07-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  14. Autopsy in older medical patients: concordance in ante- and post-mortem findings and changing trends.

    Science.gov (United States)

    Swaro, A; Adhiyaman, V

    2010-09-01

    Despite modern diagnostics, the discordance between ante- and post-mortem diagnoses is still around 25%, reiterating the need for high post-mortem rates. In our study, 3.5% had class I errors that, had they been detected during life, would or might have affected short-term outcome. Another 14% had major errors, conditions recorded as primary cause of death that were clinically missed or unrecorded but would not have affected the outcome. There has been an unexplained decline in hospital post mortems and more than a third of UK autopsies are now performed under the instruction of the relevant Coroner's office. The UK Coroners' system is currently under judicial and administrative review to improve the speed of and reduce the need for post-mortem analysis.

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

    Science.gov (United States)

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

    1989-12-01

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

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    for biomechanical trauma analysis by Finite Element Analysis. If CT scan data are to be used for creating individual head models for retrograde trauma analysis in the future we need to ascertain how well cranial fractures are captured by CT scan. The purpose of this study was to compare the diagnostic agreement....... Difficulties remained in the minute diagnosis of hairline fractures. These inconsistencies need to be resolved in order to use CT scan data of victims for individual head modelling and trauma analysis.......BACKGROUND: Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models...

  17. Midbrain-to-pons ratio in autopsy-confirmed progressive supranuclear palsy: replication in an independent cohort.

    Science.gov (United States)

    Kaasinen, Valtteri; Kangassalo, Noora; Gardberg, Maria; Isotalo, Juuso; Karhu, Jari; Parkkola, Riitta; Sonninen, Pirkko

    2015-07-01

    Recent neuropathologically confirmed clinical data suggest that the midbrain-to-pons ratio, as calculated from conventional brain MRI, has high specificity and sensitivity for the diagnosis of progressive supranuclear palsy (PSP). Here, we aimed to replicate these findings in an independent autopsy-confirmed cohort of 6 PSP patients and 23 non-PSP patients. Patients with confirmed PSP had clearly lower midbrain-to-pons ratios compared to non-PSP patients (p midbrain-to-pons ratios higher than 0.50, whereas all but one PSP patient had a ratio lower than 0.50. The positive predictive value (PPV) of the ratio (midbrain-to-brain ratios constitute reliable and clinically useful estimates of diagnostic midbrain atrophy in relation to PSP pathology.

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Hooman Khademi

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

  20. Immunohistochemical Analysis of Brainstem Lesions in the Autopsy Cases with Severe Motor and Intellectual Disabilities Showing Sudden Unexplained Death.

    Science.gov (United States)

    Hayashi, Masaharu; Sakuma, Hiroshi

    2016-01-01

    It is known that patients with severe motor and intellectual disabilities (SMID) showed sudden unexplained death (SUD), in which autopsy failed to identify causes of death. Although the involvement of brainstem dysfunction is speculated, the detailed neuropathological analysis still remains to be performed. In order to clarify pathogenesis, we investigated the brainstem functions in autopsy cases of SMID showing SUD. We immunohistochemically examined expressions of tyrosine hydroxylase, tryptophan hydroxylase, substance P, methionine-enkephalin, and c-fos in the serial sections of the midbrain, pons, and medulla oblongata in eight SUD cases and seven controls, having neither unexplained death nor pathological changes in the brain. Expressions of tyrosine hydroxylase and tryptophan hydroxylase were reduced in two of eight cases, and those of substance P and/or methionine-enkephalin were augmented in the pons and medulla oblongata in seven of eight cases, including the aforementioned two cases, when compared with those in controls. The hypoglossal nucleus and/or the dorsal vagal nucleus demonstrated increased neuronal immunoreactivity for c-fos in seven of eight cases, although there was no neuronal loss or gliosis in both the nuclei. Controls rarely showed immunoreactivity for c-fos in the medulla oblongata. These data suggest the possible involvement of brainstem dysfunction in SUD in patients with SMID, and consecutive neurophysiological evaluation of brainstem functions, such as all-night polysomnography and blink reflex, may be useful for the prevention of SUD, because some parameters in the neurophysiological examination are known to be related to the brainstem catecholamine neurons and the spinal tract nucleus of trigeminal nerve. PMID:27445960

  1. An independent evaluation of plutonium body burdens in populations near Los Alamos Laboratory using human autopsy data.

    Science.gov (United States)

    Gaffney, Shannon H; Donovan, Ellen P; Shonka, Joseph J; Le, Matthew H; Widner, Thomas E

    2013-06-01

    In the mid-1940s, the United States began producing atomic weapon components at the Los Alamos National Laboratory (LANL). In an attempt to better understand historical exposure to nearby residents, this study evaluates plutonium activity in human tissue relative to residential location and length of time at residence. Data on plutonium activity in the lung, vertebrae, and liver of nearby residents were obtained during autopsies as a part of the Los Alamos Tissue Program. Participant residential histories and the distance from each residence to the primary plutonium processing buildings at LANL were evaluated in the analysis. Summary statistics, including Student t-tests and simple regressions, were calculated. Because the biological half-life of plutonium can vary significantly by organ, data were analyzed separately by tissue type (lung, liver, vertebrae). The ratios of plutonium activity (vertebrae:liver; liver:lung) were also analyzed in order to evaluate the importance of timing of exposure. Tissue data were available for 236 participants who lived in a total of 809 locations, of which 677 were verified postal addresses. Residents of Los Alamos were found to have higher plutonium activities in the lung than non-residents. Further, those who moved to Los Alamos before 1955 had higher lung activities than those who moved there later. These trends were not observed with the liver, vertebrae, or vertebrae:liver and liver:lung ratio data, however, and should be interpreted with caution. Although there are many limitations to this study, including the amount of available data and the analytical methods used to analyze the tissue, the overall results indicate that residence (defined as the year that the individual moved to Los Alamos) may have had a strong correlation to plutonium activity in human tissue. This study is the first to present the results of Los Alamos Autopsy Program in relation to residential status and location in Los Alamos.

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

    Directory of Open Access Journals (Sweden)

    Ding Ding

    2011-08-01

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

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

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    Kotsilianou Olympia

    2011-01-01

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

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

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    Jaybhaye, Prasad L.; Shilawant, Santosh S.

    2014-01-01

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

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

    Science.gov (United States)

    Jaybhaye, Prasad L; Shilawant, Santosh S

    2014-01-01

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

  6. An analysis of autopsy cases of non-Hodgkin lymphoma-with special reference to those masquerading as acute febrile illness

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    Sonali Rajesh Saraf

    2016-01-01

    Conclusion: As NHL present with nonspecific symptoms, these tumours may not be detected in early stages and hence may not be treated appropriately. These patients have weakened immunity and hence are prone to infection and sepsis which can be a major cause of mortality. This autopsy study experience has shown that NHL can masquerade as acute febrile illness which if not detected early and treated adequately can turn fatal.

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

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

    2015-10-15

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

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

    Science.gov (United States)

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

    1994-04-01

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

  9. Surface analysis of pilot distribution system pipe autopsies: The relationship of organic and inorganic deposits to input water quality.

    Science.gov (United States)

    Fabris, Rolando; Denman, John; Braun, Kalan; Ho, Lionel; Drikas, Mary

    2015-12-15

    Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS) surface analysis was conducted to characterise deposits in polyethylene pipes used in a novel pilot water distribution system (PDS). The system consisted of four (4) parallel distribution systems receiving water from different treatment processes, ranging from conventional coagulation through to an advanced membrane filtration system. After two years of operation, the distribution system was shut down and samples of pipe were collected for autopsy analysis. Inlet and outlet samples from each PDS were collected for purpose of comparison. ToF-SIMS was used to assess chemical differences in surface biofilm accumulation and particulate deposition, which resulted as a consequence of the treatment method and operational mode of each system. These data supplemented previously collected bacteriological and chemical water quality data. Results from the inorganic analysis of the pipes were consistent with corrosion and contamination events that occurred upstream in the corresponding treatment systems. Principal component analysis of data on organic constituents showed oxygen and nitrogen containing fragments were associated with the treatment inlet and outlet samples. These types of signals can often be ascribed to biofilm polysaccharides and proteins. A trend was observed when comparing samples from the same PDS, showing an association of lower molecular weight (MW) organic fragments with the inlet and higher MW organic fragments with the outlet samples.

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

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    Kenya Nishioka

    2013-01-01

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

  11. Autopsy case of a giant aneurysm of the anterior communicating artery. Correlation of CT findings and angiographic findings

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    Shinmura, Fujio; Takayasu, Kenji; Ohiwa, Yasuyuki; Sakata, Ryuichi; Ariwa, Rokuro

    1983-06-01

    A 64-year-old female was admitted to the hospital with a history of three previous subarachnoid hemorrhages. Neurological examinations revealed incontinentia urinae, gait disturbance, recent memory disturbance and motor weakness on the left side. Plain X-ray films showed a ring-like calcification in the right frontal region. A plain CT scan showed a ring-shaped iso- and high-density area in the intra hemispheric region, the intra bilateral anterior horn of the lateral ventricle, the intra septum pellucidum, and the intra anterior part of the third ventricle. Left carotid angiography showed a large aneurysmal shadow arising from the anterior communicating artery and another from the left middle cerebral artery. In the venous phase the venous angle was supero-posteriorly shifted, and the septal vein was elevated. She died unexpectedly with a status epilepticus of unknown origin. An autopsy specimen revealed that a giant aneurysm occupied the intra ventricular space, the anterior horn of the lateral ventricle, and the right thalamic region. Also, there was a large berry aneurysm arising from the middle cerebral artery. A coronary section through the giant aneurysm showed a markedly compressed left lateral ventricle, right thalamus, and hypothalamus, while the third ventricle had shifted toward the left side.

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

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    Moema Gonçalves Pinheiro Veloso

    2008-08-01

    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.

  13. An autopsy case of neuroleptic malignant syndrome (NMS) and its immunohistochemical findings of muscle-associated proteins and mitochondria.

    Science.gov (United States)

    Kubo, S; Orihara, Y; Kitamura, O; Ikematsu, K; Tsuda, R; Nakasono, I

    2001-01-01

    Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal disorder. In forensic cases, post-mortem diagnosis of NMS is sometimes difficult if ante-mortem information, such as neuroleptic ingestion or signs and symptoms, cannot be obtained. A 39-year-old Japanese male on a neuroleptic treatment regimen suddenly became agitated and died. Autopsy revealed muscle rigidity and hyperthermia. Post-mortem examination of blood revealed elevation of creatine phosphokinase-MM (CK-MM) and lactate dehydrogenase-4 and dehydrogenase-5 (LDH-4 and LDH-5). In renal glomeruli and tubules, myoglobin was stained immunohistochemically. From these findings, the cause of death was considered to be NMS. To support the diagnosis of NMS, both skeletal and cardiac muscles were stained with actin, myoglobin, desmin and mitochondria antibodies immunohistochemically. Actin, myoglobin, desmin, and mitochondria had been lost from skeletal, but not from the cardiac muscle, which suggested that only the skeletal muscle was damaged. Moreover, because mitochondria had disappeared only from the skeletal muscle, it was considered that skeletal muscle degeneration was caused by mitochondrial damage. Therefore, it is suggested that immunostaining of skeletal muscle by antibodies for muscle-associated proteins and mitochondria is useful to corroborate a diagnosis of NMS.

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

    Science.gov (United States)

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

    2009-09-01

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

  15. Evidence for severe atherosclerotic changes in chronic hemodialysis patients: comparative autopsy study against cardiovascular disease patients without chronic kidney disease.

    Science.gov (United States)

    Suzuki, Chigure; Nakamura, Satoko; Ishibashi-Ueda, Hatsue; Yoshihara, Fumiki; Kawano, Yuhei

    2011-02-01

    Atherosclerosis is a major cause of mortality and morbidity among hemodialysis patients, but whether it is more severe in hemodialysis patients than in cardiovascular disease patients without chronic kidney disease is unclear. We examined 46 autopsy patients who had undergone hemodialysis, and age and sex-matched 46 patients with cardiovascular disease and an eGFR of >60 mL/min/1.73 m(2). There was no difference in the prevalence of diabetes or hypertension between the groups. We divided the aorta into four segments: A, ascending artery to arch; B, descending artery to diaphragm; C, suprarenal; and D, infrarenal. We used the classification of the American Heart Association to evaluate atherosclerosis progression. Distribution was scored by the extent to which each segment was damaged: 0, none; 1, less than 1/3; 2, more than 1/3 to less than 2/3; 3, more than 2/3. Histological examination revealed that the progression score (P 60 mL/min/1.73 m(2). Aortic atherosclerosis was aggravated by traditional and chronic kidney disease-related risk factors.

  16. Bone marrow necrosis and fat embolism: an autopsy report of a severe complication of hemoglobin SC disease

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    Fernando Peixoto Ferraz de Campos

    2014-06-01

    Full Text Available Sickle Cell Disease encompasses a group of disorders related with the hemoglobin S and other hemoglobin genotypes. The clinical manifestation and the severity of symptoms are dependent on the specific genotype. In this setting, homozygous genotype (HbSS presents an early onset of symptoms and a low expectancy of lifetime. However, the SC genotype (HbSC, which apparently shows a less severe clinical course, may exhibit the same complications of HbSS. These complications are usually manifested late in the course of life, when compared with the HbSS patients. It is noteworthy that HbSC may present a normal hematocrit, and therefore stays unknown until the first complication, that may be disastrous. The authors report a case of an African-Descendant woman, aging 65 years, with no previous diagnosis of anemia who sought medical attention because of a thoracic back pain followed by fever and altered mental status. The clinical picture deteriorated very fast with multiple organ failure and death. The autopsy findings concluded by generalized vaso-occlusive crisis, bone marrow necrosis and bone marrow and fat embolism, mainly to the lungs and kidney. The authors call attention for the knowledge of this severe life threatening complication, mainly in a country with a high Afro-Descendant population.

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

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    Ro, Ayako

    2016-01-01

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

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

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    María Virginia Bürgesser

    2011-04-01

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

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

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    Peter Byass

    2015-06-01

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

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

    Science.gov (United States)

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

    2008-05-20

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

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

    Science.gov (United States)

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

    2007-12-01

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

  2. Reliability of reporting of HIV status and antiretroviral therapy usage during verbal autopsies: a large prospective study in rural Malawi

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    Estelle M. Mclean

    2016-06-01

    Full Text Available Objective: Verbal autopsies (VAs are interviews with a relative or friend of the deceased; VAs are a technique used in surveillance sites in many countries with incomplete death certification. The goal of this study was to assess the accuracy and validity of data on HIV status and antiretroviral therapy (ART usage reported in VAs and their influence on physician attribution of cause of death. Design: This was a prospective cohort study. Methods: The Karonga Health and Demographic Surveillance Site monitors demographic events in a population in a rural area of northern Malawi; a VA is attempted on all deaths reported. VAs are reviewed by clinicians, who, with additional HIV test information collected pre-mortem, assign a cause of death. We linked HIV/ART information reported by respondents during adult VAs to database information on HIV testing and ART use and analysed agreement using chi-square and kappa statistics. We used multivariable logistic regression to analyse factors associated with agreement. Results: From 2003 to 2014, out of a total of 1,952 VAs, 80% of respondents reported the HIV status of the deceased. In 2013–2014, this figure was 99%. Of those with an HIV status known to the study, there was 89% agreement on HIV status between the VA and pre-mortem data, higher for HIV-negative people (92% than HIV-positive people (83%. There was 84% agreement on whether the deceased had started ART, and 72% of ART initiation dates matched within 1 year. Conclusions: In this population, HIV/ART information was often disclosed during a VA and matched well with other data sources. Reported HIV/ART status appears to be a reliable source of information to help classification of cause of death.

  3. Social Autopsy of maternal, neonatal deaths and stillbirths in rural Bangladesh: qualitative exploration of its effect and community acceptance

    Science.gov (United States)

    Biswas, Animesh; Eriksson, Charli; Halim, Abdul; Dalal, Koustuv

    2016-01-01

    Objectives Social Autopsy (SA) is an innovative strategy where a trained facilitator leads community groups through a structured, standardised analysis of the physical, environmental, cultural and social factors contributing to a serious, non-fatal health event or death. The discussion stimulated by the formal process of SA determines the causes and suggests preventative measures that are appropriate and achievable in the community. Here we explored individual experiences of SA, including acceptance and participant learning, and its effect on rural communities in Bangladesh. The present study had explored the experiences gained while undertaking SA of maternal and neonatal deaths and stillbirths in rural Bangladesh. Design Qualitative assessment of documents, observations, focus group discussions, group discussions and in-depth interviews by content and thematic analyses. Results Each community's maternal and neonatal death was a unique, sad story. SA undertaken by government field-level health workers were well accepted by rural communities. SA had the capability to explore the social reasons behind the medical cause of the death without apportioning blame to any individual or group. SA was a useful instrument to raise awareness and encourage community responses to errors within the society that contributed to the death. People participating in SA showed commitment to future preventative measures and devised their own solutions for the future prevention of maternal and neonatal deaths. Conclusions SA highlights societal errors and promotes discussion around maternal or newborn death. SA is an effective means to deliver important preventative messages and to sensitise the community to death issues. Importantly, the community itself is enabled to devise future strategies to avert future maternal and neonatal deaths in Bangladesh. PMID:27554100

  4. Revealing the burden of maternal mortality: a probabilistic model for determining pregnancy-related causes of death from verbal autopsies

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    Desta Teklay

    2007-02-01

    Full Text Available Abstract Background Substantial reductions in maternal mortality are called for in Millennium Development Goal 5 (MDG-5, thus assuming that maternal mortality is measurable. A key difficulty is attributing causes of death for the many women who die unaided in developing countries. Verbal autopsy (VA can elicit circumstances of death, but data need to be interpreted reliably and consistently to serve as global indicators. Recent developments in probabilistic modelling of VA interpretation are adapted and assessed here for the specific circumstances of pregnancy-related death. Methods A preliminary version of the InterVA-M probabilistic VA interpretation model was developed and refined with adult female VA data from several sources, and then assessed against 258 additional VA interviews from Burkina Faso. Likely causes of death produced by the model were compared with causes previously determined by local physicians. Distinction was made between free-text and closed-question data in the VA interviews, to assess the added value of free-text material on the model's output. Results Following rationalisation between the model and physician interpretations, cause-specific mortality fractions were broadly similar. Case-by-case agreement between the model and any of the reviewing physicians reached approximately 60%, rising to approximately 80% when cases with a discrepancy were reviewed by an additional physician. Cardiovascular disease and malaria showed the largest differences between the methods, and the attribution of infections related to pregnancy also varied. The model estimated 30% of deaths to be pregnancy-related, of which half were due to direct causes. Data derived from free-text made no appreciable difference. Conclusion InterVA-M represents a potentially valuable new tool for measuring maternal mortality in an efficient, consistent and standardised way. Further development, refinement and validation are planned. It could become a routine

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Stefan Kralev

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

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

    DEFF Research Database (Denmark)

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

    1991-01-01

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

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

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    EDITH VALDEZ-MARTÍNEZ

    1998-01-01

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

  10. 51例猝死尸检解剖的临床病理分析%The anatomy of 51 cases of sudden death autopsy clinical pathology analysis

    Institute of Scientific and Technical Information of China (English)

    李晓霞; 卫建平

    2015-01-01

    Objective Through the studying and analyzing the etiology and clinical pathology characteristic of the events of autopsy in basic-level hospitals, it provides some references for the diagnosis and prevention of unexplained cases of the sudden death. Methods Collection 51 cases of pathological autopsy happened in Changzhi people's hospital of Shanxi Province (from 2004 to 2012), to conduct research and analysis the cause of death and the clinical pathology characteristic. Results 49 cases found the exact cause of death during the 51 cases of autopsy, accounting for 96%, of which the most common is the cardiovascular disease, accounting for 52.9%; the followed-by is the central nervous system diseases, accounting for 11.8%; the pulmonary embolism, ac-counting for 10%. Conclusions Through the autopsy cases of etiology and the clinical pathology characteristic analysis of scientific system, not only can clear the cause of death, also can help to improve the level of clinical diagnosis and treatment.%目的:通过对基层医院尸检病例的死亡原因及临床病理学特点进行研究和分析,为不明原因猝死病例的诊断和预防提供一定的依据参考。方法收集山西省长治市人民医院病理科2004年1月—2012年12月发生的51例病理尸体解剖资料,对其死因及临床病理学特点进行研究及分析。结果51例尸检中49例找到了确切死亡的原因,占96%,其中以心血管疾病最常见,占52.9%,其次是中枢系统疾病,占11.8%;再次是肺动脉栓塞,占10%。结论通过对尸检病例的病因和其临床病理学特点进行科学系统的分析,不仅可以明确死因,也可以有助于提高临床诊治水平。

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

    Directory of Open Access Journals (Sweden)

    Laith Hussain-Alkhateeb

    2015-07-01

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

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

    Science.gov (United States)

    Hussain-Alkhateeb, Laith; Fottrell, Edward; Petzold, Max; Kahn, Kathleen; Byass, Peter

    2015-01-01

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

  13. Visualisation of the intact dura mater and brain surface in infant autopsies: a minimally destructive technique for the post-mortem assessment of head injury.

    Science.gov (United States)

    Cheshire, Emma C; Malcomson, Roger D G; Rutty, Guy N; James, Deryk S

    2015-03-01

    During the post-mortem examination of babies and young children, it is important to be able to visualise the brain and its coverings, particularly in cases where a head injury is likely to have occurred. In this paper, we present an improved method for removal of the calvarial bones in infant autopsies to enable viewing of the dura mater and brain. In contrast to the standard post-mortem procedure for observing and removing the brain, this novel technique is minimally disruptive, allowing the dura mater to remain undamaged. Specialised paediatric neurosurgical tools were used to remove the skull bones from 23 neonates, infants and young children during post-mortem examination. In 21 of our 23 cases, the calvarial bones were removed successfully with the dura mater remaining intact. In one case, there was a thickening of the dura mater which created a strong adherence of this membrane to the bone. In another case, the dura mater was slightly damaged due to the inexperience of the operator in using the neurosurgical tools. This method of calvarial bone removal reduces the degree of post-mortem artefact and enhances the ability to observe and photographically document autopsy findings, including the artefact-free detection of signs of injury such as epidural or subdural haematoma, and brain swelling. This technique has now become a routine practise in both of our units to remove the skull bones in infant/young children post-mortem examinations.

  14. A qualitative inquiry into the application of verbal autopsy for a mortality surveillance system in a rural community of southern India.

    Science.gov (United States)

    Mony, Prem K; Vaz, Mario

    2011-01-01

    The aim of this investigation was to identify operational and ethical issues encountered in the application of verbal autopsy (VA) in a rural community in south India. A qualitative study involving semi-structured interviews was conducted with 183 bereaved caregivers in rural Andhra Pradesh, India. Simple descriptive analysis was undertaken. Only 16% of adult deaths and 27% of child deaths occurred in healthcare settings. Healthcare utilization for the terminal illness was reported in two thirds of medical (non-injury) causes of death. Supporting medical evidence was available in <10% of cases to supplement the interpretation of verbal autopsies. About 14% of bereaved caregivers refused to give written consent but provided oral consent. Additional ethical concerns included inability to ensure privacy in 15% of interviews and unsolicited information from unauthorized neighbours in 5% of cases. Such methodological, logistical and ethical issues operate to impact on the quality of VAs. Consideration of these issues would strengthen ongoing efforts in the harmonization of VA procedures.

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

    Science.gov (United States)

    Chen, Jian-Hua; Inamori-Kawamoto, Osamu; Michiue, Tomomi; Ikeda, Sayuko; Ishikawa, Takaki; Maeda, Hitoshi

    2015-09-01

    Previous studies suggested possible application of postmortem biochemistry of myocardial biomarkers to the investigation of sudden cardiac death; however, differences from clinical findings should be considered in autopsy materials. The present study involved a comprehensive investigation of cardiac troponin T and I (cTnT and cTnI), and creatine kinase MB (CK-MB) in cardiac and peripheral external iliac venous blood, pericardial fluid (PCF) and cerebrospinal fluid (CSF) for reassessment, with special regard to the estimated postmortem interval in relation to the cause of death, reviewing a large number of forensic autopsy cases (n=1923). These cardiac biomarkers showed cause-of-death- and postmortem-time-dependent differences: blood and PCF levels of each marker were higher in hyperthermia (heatstroke), bathwater drowning and chronic congestive heart disease in cases of postmortem interval (PMI) PMI of <48h. CSF cTnI and CK-MB showed similar findings. There was no difference between myocardial infarction and other causes of death to be discriminated, including asphyxiation, drowning and fire fatality. These findings are similar to clinical observations in critical ill patients, suggesting that elevated cardiac biomarkers cannot be a specific finding for death from acute ischemic heart disease, but indicate the severity of myocardial injury in postmortem investigation. PMID:26052007

  16. Genetic analysis of ryanodine receptor 1 gene and carnitine palmitoyltransferase II gene: an autopsy case of neuroleptic malignant syndrome related to vegetamin.

    Science.gov (United States)

    Matsusue, Aya; Hara, Kenji; Kageura, Mitsuyoshi; Kashiwagi, Masayuki; Lu, Wang; Ishigami, Akiko; Gotohda, Takako; Tokunaga, Itsuo; Nisimura, Akiyoshi; Sugimura, Tomoko; Kubo, Shin-ichi

    2009-04-01

    We report an autopsy case of a man in his forties who died 2 days after taking an overdose of vegetamin. The autopsy findings were as follows: externally, the upper epidermis of some parts of the body had become loosened. The epidermis was easily detached from the dermis using the fingers. Viscous fluid adhered around the nose and mouth. The brain was edematous and weighed 1520 g. Skeletal muscle was discolored. The urine was a slightly red-tinged yellow. The organs showed congestion. Urine tests: urea nitrogen: 1.95 g/day; creatinine: 0.66 g/day; urine myoglobin: 1100 ng/mL. Blood level of drugs: phenobarbital: 38.2 microg/ml; promethazine: 2.22 microg/ml; chlorpromazine: 0.96 microg/ml. Immunohistochemistry identified myoglobin in the kidney. From these findings, his cause of death was considered to be vegetamin-induced neuroleptic malignant syndrome and rhabdomyolysis. Mutation of the ryanodine receptor 1 gene is associated with malignant hyperthermia. However, there was no mutation which causes amino acid substitution in the three hot-spot regions of the ryanodine receptor 1 gene. Partial deficiency of carnitine palmitoyltransferase II is the commonest cause of recurrent rhabdomyolysis in adults. The subject was found to be heterozygous for an amino acid exchange in exon 4, (1203)G-->A causing a (368)Val-->Ile amino acid substitution. It is necessary to examine other candidate gene mutations. PMID:19269221

  17. [Autopsy case of a patient with Charcot-Marie-Tooth disease type 1A and suspected chronic inflammatory demyelinating polyradiculoneuropathy, which was later diagnosed as amyotrophic lateral sclerosis].

    Science.gov (United States)

    Higuchi, Yujiro; Sakiyama, Yusuke; Nishihira, Yasushi; Endo, Kazuhiro; Suwazono, Shugo; Suehara, Masahito

    2012-01-01

    We report an autopsy case of a 74-year-old man with late onset Charcot-Marie-Tooth disease type 1A (CMT1A) diagnosed by genetic screening, later associated with amyotrophic lateral sclerosis (ALS). At the age of 70 years, the patient was admitted to our hospital because of progressive weakness and dysesthesia in the right upper limb. In the early stages of the illness, he was diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and transient improvement was achieved with intravenous immunoglobulin. However, the symptoms progressively worsened and became refractory. Gene analysis revealed PMP22 gene duplication, which confirmed CMT1A. On sural nerve biopsy, severe demyelinating neuropathy and abundant onion-bulb formations with endoneurial infiltration of inflammatory cells were observed. Thereafter, pseudo-bulbar palsy and respiratory muscle weakness developed insidiously and progressed rapidly along with muscle weakness in the limbs and trunk. The patient died about four years after the onset of this disease. Postmortem examination showed moderate neuronal cell loss, Bunina bodies, and TDP-43-positive inclusions in the anterior horn cells. The spinal cord revealed axonal loss and extensive macrophage permeation in the corticospinal tracts. On the basis of these findings, the final neuropathological diagnosis was ALS. This is the first report of an autopsy case of CMT1A complicated with ALS. We here discuss the significant clinical and neuropathological findings of this case.

  18. 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

    Directory of Open Access Journals (Sweden)

    Mandakini M Patel, Bhavna Gamit, R D Patel, Rahul Modi

    2011-01-01

    Full Text Available 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 & took post mortem samples for serologically & HP Examination of tissue. Serological finding showed one patient positive for PCR and second was positive for Leptocheck and IgM ELISA. On HP examination we observed massive intra-alveolar hemorrhage, interstitial nephritis, vasculitis in spleen and kidney, myocarditis & hemorrhage in various organs like heart, suprarenal gland, and subarachnoid space in both our patient. Levaditi’s stain was also performed but results were not conclusive. IHC for kidney tissue was not possible due to lack of facility. Extensive hemorrhage in lung was the cause of death in both patients. Follow up autopsy studies of 30 patients were showing same histopathological findings.

  19. Autopsy statistics on the relative frequency of acute myocardial infarction in the Japanese mental workers and the unemployed during the two oil-crises periods.

    Science.gov (United States)

    Chang, N C; Kawai, S; Okada, R

    1989-03-20

    In order to investigate whether job induced emotional stress, arising from socioenvironmental disasters would act as a trigger for the onset of AMI, the author reviewed all pathological autopsies throughout Japan 15 years old and over. Data was obtained from publications of the "Annual of the Pathological Autopsy Cases in Japan" for the years 1966-1968 (a period of high economic growth), 1973-1975 (1974, the year of the first oil crisis), and 1978-1980 (1979, the year of the second oil crisis). Relative frequencies of AMI were significantly higher during the years of both oil crises than in both the preceding and following years (2.6% in 1973, 3.7% in 1974, 3.0% in 1975; 2.8% in 1978, 3.2% in 1979, and 2.0% in 1980), and in each of three years of the high economic growth period (1.9-2.2% in 1966-1968). The proportions of managers and officials among AMI victims were significantly higher in the years of both oil crises than in both the preceding and following years (13.4% in 1973, 17.5% in 1974, 12.5% in 1975; 11.6% in 1978, 15.8% in 1979, and 11.1% in 1980). Moreover, there was a significantly higher value in the year of first oil crisis than in each of three years of the high economic growth period (11.7-13.1% in 1966-1968). The proportions of "out of job" persons were also significantly higher in the years of both oil crises than in the preceding years (24.0% in 1973, 29.3% in 1974, 27.8% in 1975; 24.1% in 1978, 29.1% in 1979, and 27.4% in 1980). For 11,199 randomly selected autopsies, the proportions of AMI in the above two occupational groups were significantly higher in the years of both oil crises than in the preceding years. Moreover, the proportion of "out of job" persons was significantly higher in the year of first oil crisis than in each of three years of the high economic growth period. A similar trend was noted among professional and technical workers, with more AMI occurring in this group during the years of both oil crises than in both the preceding

  20. Cadmium in kidney cortex, liver, and pancreas from Swedish autopsies. Estimation of biological half time in kidney cortex, considering calorie intake and smoking habits.

    Science.gov (United States)

    Elinder, C G; Lind, B; Kjellström, T; Linnman, L; Friberg, L

    1976-01-01

    Cadmium and zinc have been analyzed in tissues from 292 persons autopsied in Stockholm. In kidney cortex, liver, and pancreas the individual cadmium levels are distributed in a lognormal way. In kidney cortex there is a continuous accumulation of cadmium with age up to 50 years, followed by a decrease. Smokers show a higher cadmium accumulation. For nonsmokers, the biological half time of cadmium in kidney cortex is estimated at 30 years, with an average concentration at age 50 of 11 mug/g wet weight. When smokers are included, the average cadmium concentration at age 50 is 22 mug/g wet weight. Based on the more pronounced cadmium accumulation among smokers than nonsmokers, the respiratory absorption rate of cadmium from tobacco smoke is estimated to be approximately 50%. PMID:999342

  1. Cadmium in kidney cortex, liver, and pancreas from Swedish autopsies. Estimation of biological half time in kidney cortex, considering calorie intake and smoking habits

    Energy Technology Data Exchange (ETDEWEB)

    Elinder, C.G. (Karolinska Inst., Stockholm); Kjellstrom, T.; Friberg, L.; Lind, B.; Linnman, L.

    1976-01-01

    Cadmium and zinc have been analyzed in tissues from 292 persons autopsied in Stockholm. In kidney cortex, liver, and pancreas the individual cadmium levels are distributed in a lognormal way. In kidney cortex there is a continuous accumulation of cadmium with age up to 50 years, followed by a decrease. Smokers show a higher cadmium accumulation. For nonsmokers, the biological half time of cadmium in kidney cortex is estimated at 30 years, with an average concentration at age 50 of 11 ..mu..g/g wet weight. When smokers are included, the average cadmium concentration at age 50 is 22 ..mu..g/g wet weight. Based on the more pronounced cadmium accumulation among smokers than nonsmokers, the respiratory absorption rate of cadmium from tobacco smoke is estimated to be approximately 50 percent.

  2. [Postmortem dismemberment/mutilation--medicolegal and criminalistic evaluation of the autopsies performed by the Institute of Legal Medicine at the Hanover Medical School].

    Science.gov (United States)

    Schulz, Yvonne; Mossakowski, Harald; Albrecht, Knut; Breitmeier, Dirk

    2008-01-01

    Among all the autopsies performed by the Institute of Legal Medicine at the Hanover Medical School between 1978 and 1998. 16 cases of postmortem dismemberment/mutilation were evaluable under criminalistic and medicolegal aspects. In the present study, particular attention was paid to the psychosocial circumstances of the perpetrator's and victim's lives and also to the classification of the different types of postmortem dismemberment/mutilation illustrated by case reports. Apart from an unfavourable personal life situation at the time of the offence, essential predisposing factors were: poor integration in society and family, occupational problems, drug abuse and mental diseases. As the interactions between these factors differ in every single case and may be combined with other factors, the analysis of such homicides should always be based on the assessment of the individual case. PMID:18389859

  3. Anomalous origin of the right coronary artery from the pulmonary artery: an autopsied sudden death case with severe atherosclerotic disease of the left coronary artery.

    Science.gov (United States)

    Nagai, T; Mukai, T; Takahashi, S; Takada, A; Saito, K; Harada, K; Mori, S; Abe, N

    2014-03-01

    Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare anomaly. It may contribute to myocardial ischemia or sudden death, although the lesion is usually asymptomatic. We report a sudden death case of a 58-year-old man with ARCAPA coexisting with severe atherosclerotic coronary artery disease. He had been healthy until he complained of chest pain, several days before death, despite the discovery of heart murmur in childhood and suspicion of valvular heart disease. The autopsy revealed not only typical findings of the right coronary anomaly with well-developed collateral circulations but also severe atherosclerotic lesions of the left coronary artery, and ischemic change of the myocardium in the left and right coronary arterial perfusion territory. In addition to the "coronary steal" phenomenon primarily caused by ARCAPA, the reduced flow of both coronary arteries and further increase of "coronary steal" due to atherosclerotic obstructive coronary disease might have contributed to the patient's death.

  4. Usefulness of postmortem biochemistry in identification of ketosis: Diagnosis of ketoacidosis at the onset of autoimmune type 1 diabetes in an autopsy case with cold exposure and malnutrition.

    Science.gov (United States)

    Tani, Naoto; Michiue, Tomomi; Chen, Jian-Hua; Oritani, Shigeki; Ishikawa, Takaki

    2016-09-01

    A severely malnourished, Japanese female in her twenties was found dead in her apartment. On autopsy, most of the findings from the internal examination were suggestive of hypothermia. Postmortem biochemistry, however, showed severely increased levels of glycated hemoglobin (HbA1c) and blood and urine glucose levels. Levels of acetone, 3-hydroxybutyric acid, and acetoacetate in various body fluids were also highly increased, indicating ketosis. The serum insulin and c-peptide levels were severely low, and subsequent testing was positive for anti-GAD antibodies. Immunohistochemical examination of the pancreatic islet cells revealed few insulin-positive cells but many glucagon-positive cells on staining. Furthermore, slight invasion of CD8-positive lymphocytes in the pancreatic islets of Langerhans was observed. Results of immunostaining of the pancreatic and bronchial epithelial tissues were partly positive for the Influenza A virus. We concluded that severe ketoacidosis associated with rapid-onset hyperglycemia due to autoimmune type 1 diabetes (AT1D) had occurred shortly before death. However, the ketosis was accompanied by hypothermia and malnutrition as well as diabetic ketoacidosis (DKA). Therefore, we retrospectively collected biochemical data on cases of hypothermia and malnutrition and compared them with the present case. Serum glucose, acetone, 3-hydroxybutyric acid, and acetoacetic acid can be used for screening and diagnosis to distinguish DKA from ketosis due to hypothermia and malnutrition. Therefore, in the present case, we diagnosed that the natural cause of death was due to AT1D. In conclusion, screening investigations for relevant biochemical markers can provide essential information for the diagnosis of metabolic disturbances, which fail to demonstrate characteristic autopsy findings. PMID:27591535

  5. Postmortem distribution of flunitrazepam and its metabolite 7-aminoflunitrazepam in body fluids and solid tissues in an autopsy case: Usefulness of bile for their detection.

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    Hasegawa, Koutaro; Wurita, Amin; Minakata, Kayoko; Gonmori, Kunio; Nozawa, Hideki; Yamagishi, Itaru; Watanabe, Kanako; Suzuki, Osamu

    2015-09-01

    We experienced an autopsy case of a woman in her 70s, in which the direct cause of her death was judged as asphyxia due to the occlusion of food in the trachea. The postmortem interval was estimated at about 2days. The specimens dealt with were femoral vein blood, right heart blood, left heart blood, bile, brain, lung, heart muscle, liver, spleen, kidney, pancreas, skeletal muscle, and adipose tissue. By tentative drug screening, we found a high concentration of 7-aminoflunitrazepam in the femoral vein blood, which lead us to examine the postmortem distribution of flunitrazepam and its metabolite 7-aminoflunitrazepam in her body fluids and solid tissues. The extraction of flunitrazepam, 7-aminoflunitrazepam and internal standard nimetazepam was performed by a modified QuEChERS method, followed by the analysis by liquid chromatography-tandem mass spectrometry. Because this study included various kinds of human matrices with quite different properties, we used the standard additional method to overcome the matrix effects. The concentration of 7-aminoflunitrazepam were generally much higher than those of the parent drug flunitrazepam for most specimens except for the adipose tissue, showing that flunitrazepam is readily metabolized to its 7-amino metabolite after absorption into the body both antemortem and postmortem. The outstandingly highest concentration of 7-animoflunitrazepam was found in the bile, followed by the kidney, pancreas, left heart blood, spleen and liver. Although a majority of flunitrazepam was converted to 7-aminoflunitrazepam, the flunitrazepam concentration was highest in the pancreas, followed by the spleen, bile, left heart blood, and brain. In contrast to the results on synthetic cannabinoids, the levels of flunitrazepam and 7-animoflunitrazepam in the adipose tissue were relatively low. The present study showed that the bile may be a useful specimen for detection of unchanged benzodiazepines/their metabolites to be collected at autopsy. PMID

  6. Post-mortem Whole exome sequencing with gene-specific analysis for autopsy-negative sudden unexplained death in the young: a case series.

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    Narula, Nupoor; Tester, David J; Paulmichl, Anna; Maleszewski, Joseph J; Ackerman, Michael J

    2015-04-01

    Annually, thousands of sudden deaths in individuals under 35 years remain unexplained following comprehensive medico-legal autopsy. Previously, post-mortem genetic analysis by Sanger sequencing of four major cardiac channelopathy genes revealed that approximately one-fourth of these autopsy-negative sudden unexplained death in the young (SUDY) cases harbored an underlying mutation. However, there are now over 100 sudden death-predisposing cardiac channelopathy-, cardiomyopathy-, and metabolic disorder-susceptibility genes. Here, we set out to determine whether post-mortem whole exome sequencing (WES) is an efficient strategy to detect ultra-rare, potentially pathogenic variants. We performed post-mortem WES and gene-specific analysis of 117 sudden death-susceptibility genes for 14 consecutively referred Caucasian SUDY victims (average age at death 17.4 ± 8.6 years) to identify putative SUDY-associated mutations. On average, each SUDY case had 12,758 ± 2,016 non-synonymous variants, of which 79 ± 15 localized to these 117 genes. Overall, eight ultra-rare variants (seven missense, one in-frame insertion) absent in three publically available exome databases were identified in six genes (three in TTN, and one each in CACNA1C, JPH2, MYH7, VCL, RYR2) in seven of 14 cases (50 %). Of the seven missense alterations, two (T171M-CACNA1C, I22160T-TTN) were predicted damaging by three independent in silico tools. Although WES and gene-specific surveillance is an efficient means to detect rare genetic variants that might underlie the pathogenic cause of death, accurate interpretation of each variant is challenging. Great restraint and caution must be exercised otherwise families may be informed prematurely and incorrectly that the root cause has been found.

  7. Herpes simplex encephalitis (HSE) and the immunocompromised: a clinical and autopsy study of HSE in the settings of cancer and human immunodeficiency virus-type 1 infection.

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    Schiff, D; Rosenblum, M K

    1998-03-01

    Although herpes simplex encephalitis (HSE) is not regarded as an opportunistic infection, the occurrence of HSE in immunocompromised patients has been documented and the suggestion made that unusual clinical and neuropathologic features characterize the disorder in this population. To further characterize HSE as it affects the immunodeficient, the authors reviewed the clinical and pathological findings in three immunocompromised patients with autopsy-proven HSE. Two patients had cancer (one with lymphoma and another with glioblastoma multiforme), one was known to be human immunodeficiency virus-type 1 (HIV-1)-seropositive and a second was suspected of harboring underlying HIV-1 infection. Two were receiving dexamethasone at onset of HSE. All had fever, mental status changes and new, focal neurological deficits or worsening of established deficits. Cerebrospinal fluid (CSF) pleocytosis was absent or minimal and head computerized tomographic (CT) scans, performed in all cases, were unrevealing. No patient was clinically suspected of having HSE, only one received acyclovir (for concurrent mucocutaneous herpes) and HSE played a major role in all deaths. Autopsy revealed an unusual form of HSE characterized by a noninflammatory, pseudoischemic histological presentation and the unexpected persistence of viral antigens in abundance despite survival beyond the clinical stage during which inflammatory responses usually peak and productive brain infection wanes. The incidence of HSE in the immunocompromised may be underestimated. Preexistent neurological disease, a noninflammatory CSF profile and negative CT scan may confound the diagnosis in this population, a typical clinical presentation notwithstanding. Increased clinical suspicion, the use of magnetic resonance imaging and polymerase chain reaction analysis of CSF for herpes simplex virus nucleic acid sequences may permit more rapid diagnosis and treatment. The absence of inflammatory infiltrates in some fatal cases of

  8. Is Urinary Lipoarabinomannan the Result of Renal Tuberculosis? Assessment of the Renal Histology in an Autopsy Cohort of Ugandan HIV-Infected Adults.

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    Janneke A Cox

    Full Text Available The detection of urinary lipoarabinomannan (LAM, a mycobacterial cell wall component, is used to diagnose tuberculosis (TB. How LAM enters the urine is not known. To investigate if urinary LAM-positivity is the result of renal TB infection we correlated the outcomes of urinary LAM-antigen testing to renal histology in an autopsy cohort of hospitalized, Ugandan, HIV-infected adults.We performed a complete autopsy, including renal sampling, in HIV-infected adults that died during hospitalization after written informed consent was obtained from the next of kin. Urine was collected postmortem through post-mortem catheterisation or by bladder puncture and tested for LAM with both a lateral flow assay (LFA and an ELISA assay. Two pathologists assessed the kidney histology. We correlated the LAM-assay results and the histology findings.Of the 13/36 (36% patients with a positive urinary LAM ELISA and/or LFA, 8/13 (62% had renal TB. The remaining 5 LAM-positive patients had disseminated TB without renal involvement. Of the 23 LAM-negative patients, 3 had disseminated TB without renal involvement. The remaining LAM-negative patients had no TB infection and died mostly of fungal and bacterial infections. LAM LFA had a sensitivity of 81% and specificity of 100% to diagnose TB at any location, and the LAM ELISA a sensitivity of 63% and a specificity of 100%. 54% (7/13 LAM LFA-positive patients were not on anti-TB treatment at the time of death.Renal TB infection explained LAM-positivity in the majority of patients. Patients with disseminated TB without renal involvement can also be diagnosed with LAM. This suggests that other mechanisms that lead to urinary LAM-positivity exist in a minority of patients.

  9. Ability of combined Near-Infrared Spectroscopy-Intravascular Ultrasound (NIRS-IVUS) imaging to detect lipid core plaques and estimate cap thickness in human autopsy coronary arteries

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    Grainger, S. J.; Su, J. L.; Greiner, C. A.; Saybolt, M. D.; Wilensky, R. L.; Raichlen, J. S.; Madden, S. P.; Muller, J. E.

    2016-03-01

    The ability to determine plaque cap thickness during catheterization is thought to be of clinical importance for plaque vulnerability assessment. While methods to compositionally assess cap integrity are in development, a method utilizing currently available tools to measure cap thickness is highly desirable. NIRS-IVUS is a commercially available dual imaging method in current clinical use that may provide cap thickness information to the skilled reader; however, this is as yet unproven. Ten autopsy hearts (n=15 arterial segments) were scanned with the multimodality NIRS-IVUS catheter (TVC Imaging System, Infraredx, Inc.) to identify lipid core plaques (LCPs). Skilled readers made predictions of cap thickness over regions of chemogram LCP, using NIRS-IVUS. Artery segments were perfusion fixed and cut into 2 mm serial blocks. Thin sections stained with Movat's pentachrome were analyzed for cap thickness at LCP regions. Block level predictions were compared to histology, as classified by a blinded pathologist. Within 15 arterial segments, 117 chemogram blocks were found by NIRS to contain LCP. Utilizing NIRSIVUS, chemogram blocks were divided into 4 categories: thin capped fibroatheromas (TCFA), thick capped fibroatheromas (ThCFA), pathological intimal thickening (PIT)/lipid pool (no defined cap), and calcified/unable to determine cap thickness. Sensitivities/specificities for thin cap fibroatheromas, thick cap fibroatheromas, and PIT/lipid pools were 0.54/0.99, 0.68/0.88, and 0.80/0.97, respectively. The overall accuracy rate was 70.1% (including 22 blocks unable to predict, p = 0.075). In the absence of calcium, NIRS-IVUS imaging provided predictions of cap thickness over LCP with moderate accuracy. The ability of this multimodality imaging method to identify vulnerable coronary plaques requires further assessment in both larger autopsy studies, and clinical studies in patients undergoing NIRS-IVUS imaging.

  10. An epidemiological study on pattern of thoraco-abdominal injuries sustained in fatal road traffic accidents of Bangalore: Autopsy-based study

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    N Bayapa Reddy

    2014-01-01

    Full Text Available Background: The statistical profile reflects a global estimate of 5.1 million deaths in 2000, which was due to injuries that accounted for 10% of deaths due to all causes. Out of this, a quarter of injury-related deaths occurred in the South-East Asian region. Road Traffic Accident (RTA is one among the top 5 causes of morbidity and mortality in South-East Asian countries. Most common cause of blunt abdominal trauma in India is road traffic accident followed by pedestrian accidents, abdominal blows, and fall from heights. Aims: To analyze the epidemiology and pattern of fatal thoraco-abdominal injuries in road traffic accidents. Materials and Methods: An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 100 post-mortems of road traffic accident between November 2008 and May 2010 subjected to medico-legal autopsy at the department of Forensic Medicine, KIMS Hospital Bangalore. Results: The majority of the victims were aged 21 to 40 years, 50 (50.0%, most of the victims were male 92 (92.0%; and male/female ratio was 11.5:1. Commonest offending agents in heavy motor vehicles were 54 (54.0%. Bony cage sustained injuries were observed in 71; out of this, fractures of ribs were observed in 45 (63.3% victims, clavicle in 14 (19.7%, sternum was 6 (8.4%, and vertebrae 6 (8.4% of fatal road traffic accidents. Internal thoracic injuries were observed in 26 cases. Among internal thoracic injuries, lungs were the most commonly involved organ 24 (92.3% followed by the heart 2 (7.6%. Lung sustained more lacerations 19 (79.1% than contusions 5 (20.8%. Internal abdominal injuries were observed in 49 cases. In road traffic accidents, the most commonly injured abdominal organs were solid organs such as liver 16 (32.6% followed by spleen 9 (18.3%. Conclusions: Majority of the times in road traffic accidents, young and productive males were injured or lost their life. This study may help the

  11. Adaptation of a probabilistic method (InterVA of verbal autopsy to improve the interpretation of cause of stillbirth and neonatal death in Malawi, Nepal, and Zimbabwe

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    Munjanja Stephan P

    2011-08-01

    Full Text Available Abstract Background Verbal autopsy (VA is a widely used method for analyzing cause of death in absence of vital registration systems. We adapted the InterVA method to extrapolate causes of death for stillbirths and neonatal deaths from verbal autopsy questionnaires, using data from Malawi, Zimbabwe, and Nepal. Methods We obtained 734 stillbirth and neonatal VAs from recent community studies in rural areas: 169 from Malawi, 385 from Nepal, and 180 from Zimbabwe. Initial refinement of the InterVA model was based on 100 physician-reviewed VAs from Malawi. InterVA indicators and matrix probabilities for cause of death were reviewed for clinical and epidemiological coherence by a pediatrician-researcher and an epidemiologist involved in the development of InterVA. The modified InterVA model was evaluated by comparing population-level cause-specific mortality fractions and individual agreement from two methods of interpretation (physician review and InterVA for a further 69 VAs from Malawi, 385 from Nepal, and 180 from Zimbabwe. Results Case-by-case agreement between InterVA and reviewing physician diagnoses for 69 cases from Malawi, 180 cases from Zimbabwe, and 385 cases from Nepal were 83% (kappa 0.76 (0.75 - 0.80, 71% (kappa 0.41(0.32-0.51, and 74% (kappa 0.63 (0.60-0.63, respectively. The proportion of stillbirths identified as fresh or macerated by the different methods of VA interpretation was similar in all three settings. Comparing across countries, the modified InterVA method found that proportions of preterm births and deaths due to infection were higher in Zimbabwe (44% than in Malawi (28% or Nepal (20%. Conclusion The modified InterVA method provides plausible results for stillbirths and newborn deaths, broadly comparable to physician review but with the advantage of internal consistency. The method allows standardized cross-country comparisons and eliminates the inconsistencies of physician review in such comparisons.

  12. A social autopsy of neonatal mortality suggests needed improvements in maternal and neonatal interventions in Balaka and Salima districts of Malawi

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    Alain K. Koffi

    2015-06-01

    Full Text Available Background The Every Newborn Action Plan calls for reducing the neonatal mortality rates to fewer than 10 deaths per 1000 live births in all countries by 2035. The current study aims to increase our understanding of the social and modifiable factors that can be addressed or reinforced to improve and accelerate the decline in neonatal mortality in Malawi. Methods The data come from the 2013 Verbal and Social Autopsy (VASA study that collected data in order to describe the biological causes and the social determinants of deaths of children under 5 years of age in Balaka and Salima districts of Malawi. This paper analyses the social autopsy data of the neonatal deaths and presents results of a review of the coverage of key interventions along the continuum of normal maternal and newborn care and the description of breakdowns in the care provided for neonatal illnesses within the Pathway to Survival framework. Results A total of 320 neonatal deaths were confirmed from the VASA survey. While one antenatal care (ANC visit was high at 94%, the recommended four ANC visits was much lower at 41% and just 17% of the mothers had their urines tested during the pregnancy. 173 (54% mothers of the deceased newborns had at least one labor/delivery complication that began at home. The caregivers of 65% (n = 75 of the 180 newborns that were born at home or born and left a health facility alive perceived them to be severely ill at the onset of their illness, yet only 44% (n = 80 attempted and 36% (n = 65could reach the first health provider after an average of 91 minutes travel time. Distance, lack of transport and cost emerged as the most important constraints to formal care–seeking during delivery and during the newborn fatal illness. Conclusions This study suggests that maternal and neonatal health organizations and the local government of Malawi should increase the demand for key maternal and child health interventions, including the recommended 4

  13. Evaluation of combined near-IR spectroscopic (NIRS)-IVUS imaging as a means to detect lipid-rich plaque burden in human coronary autopsy specimens

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    Su, Jimmy L.; Grainger, Stephanie J.; Greiner, Cherry A.; Hendricks, Michael J.; Goode, Meghan M.; Saybolt, Matthew D.; Wilensky, Robert L.; Madden, Sean P.; Muller, James E.

    2016-02-01

    Intracoronary near-infrared spectroscopy (NIRS) can identify lipid in the coronary arteries, but lacks depth resolution. A novel catheter is currently in clinical use that combines NIRS with intravascular ultrasound (IVUS), which provides depth-resolved structural information via the IVUS modality. A measure designated as lipid-rich plaque burden (LRPB) has been proposed as a means to interpret the combined acoustic and optical information of NIRS-IVUS. LRPB is defined as the area created by the intersection of the NIRS lipid-rich arc with the corresponding IVUS-measured plaque burden. We determined the correlation in human coronary autopsy specimens between LRPB, a measure of lipid presence and extent available via intravascular imaging in patients, and the area of lipid-rich plaque as determined by the gold-standard of histology. Fifteen artery segments from 8 human autopsy hearts were imaged with the NIRS-IVUS system (TVC Imaging System, Infraredx Inc., Burlington, MA). Arteries were imaged in a specialty fixture that assured accurate co-registration between imaging and histology. The arteries were then fixed and divided into 2 mm blocks for histological staining. Pathological contouring of lipid-rich areas was performed on the stained thin sections for 54 lipid-rich blocks. Computation of LRPB was performed on transverse NIRS-IVUS frames corresponding to the histologic sections. The quantified LRPB was frequently higher than the lipid-rich plaque area determined by histology, because the region denoted by the EEL and lumen within the NIRS lipid-rich arc is not entirely comprised of lipid. Overall, a moderate to strong correlation (R = 0.73) was found between LRPB determined by NIRS-IVUS imaging and the lipid-rich plaque area determined by histology. LRPB, which can be measured in patients with NIRS-IVUS imaging, corresponds to the amount of lipid-rich plaque in a coronary artery. LRPB should be evaluated in prospective clinical trials for its ability to

  14. Estudo sobre a contribuição da autópsia como método diagnóstico Study on the contribution of the autopsy as a diagnostic tool

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    Daniel Ribeiro Moreira

    2009-06-01

    Full Text Available INTRODUÇÃO: As taxas hospitalares de autópsias vêm diminuindo mundialmente, atingindo níveis críticos no Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG no que concerne a autópsias não-perinatais. OBJETIVO: Verificar se houve diminuição da relevância da autópsia no HC-UFMG. METODOLOGIA: Realizou-se estudo comparativo entre diagnósticos clínicos e post mortem, estabelecendo taxas de discordância com impacto terapêutico ou prognóstico em duas amostras aleatórias de 80 autópsias realizadas no HC-UFMG nos anos 1970 e outras 80 nos anos 1990, incluindo procedimentos perinatais e não-perinatais. RESULTADOS: Autópsias não-perinatais (adultos e crianças predominaram na década de 1970. As perinatais (natimortos e neomortos predominaram na década de 1990, com discordâncias em 56% dos casos. Discordâncias parciais, com correta classificação de malformações congênitas pela autópsia, foram as mais frequentes. Não houve discordâncias na maioria das autópsias de crianças na década de 1970; entretanto, a maioria destas na amostra da década de 1990 revelou discordâncias. Em relação aos adultos, a frequência de erros diagnósticos não apresentou alterações significativas entre as décadas de 1970 (68% e 1990 (57%. Infecções bacterianas e tromboembolismo pulmonar constituíram frequentes condições não diagnosticadas clinicamente na década de 1970; nos anos 90, os diagnósticos não formulados em vida formaram grupo heterogêneo de doenças. CONCLUSÃO: A autópsia permanece útil como método diagnóstico, apesar de restritamente utilizada na atualidade. É necessária elevação das taxas de autópsias não-perinatas para evitar os efeitos deletérios de sua ausência no ensino, na pesquisa e no controle de qualidade da assistência médica.BACKGROUND: Hospital autopsy rates have declined worldwide and non-perinatal autopsies have reached extremely low numbers at the University Hospital

  15. Suicide or accident? A psychological autopsy study of suicide in youths under the age of 16 compared to deaths labeled as accidents

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    Freuchen Anne

    2012-09-01

    Full Text Available Abstract Objective In the present paper, we describe suicide in youths under 16 years of age and compare their risk factors for suicide to those of older adolescents as described in the literature. Furthermore, we evaluate the possible mislabeling of suicides as accidents, and vice versa. Method We used the data from a nationwide psychological autopsy of youths 15 years and younger who had committed suicide or died in accidents in Norway from 1993 to 2004 (n = 84. We additionally constructed a suicide index to distinguish between the two causes of death. Results The young suicide victims presented, with little gender difference, fewer obvious risk factors and less suicide intent than commonly described for older adolescents. The suicide index distinguished quite well between suicides and accidents, with few cases indicating a possible mislabeling, although some suicide cases could have been labeled as uncertain. Conclusion In line with previous research, suicides in 11-15-year-olds have many similarities to suicides in older adolescents in terms of external circumstances, but they present less apparent warning signs. In our total sample of 84 deaths, there were few indications of incorrect labeling.

  16. Agenesia de vena cava inferior en un caso de autopsia forense Absence of the inferior cava vein in a case of forensic autopsy

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    M. Subirana Domènech

    2011-06-01

    Full Text Available La agenesia de vena cava inferior es una entidad congénita poco frecuente que a menudo se asocia con otras severas anomalías congénitas o malposiciones viscerales. También ha sido descrita como un factor de riesgo de trombosis venosa en pacientes jóvenes. La mayoría de los casos publicados proceden de estudios radiológicos y muy raramente aparece como hallazgo necrópsico. Presentamos un caso de agenesia de vena cava inferior, sin otras anomalías asociadas, que apareció como hallazgo incidental en una autopsia forense.The absence of the inferior vena cava is a rare congenital anomaly, often associated with severe congenital deformities and visceral position abnormalities. It has been described also as a risk factor for deep vein thrombosis in young patients. We present a case of congenital absence of inferior vena cava appeared as an incidental finding in a forensic autopsy.

  17. Detection of Mercury in Human Organs and Hair in a Case of a Homicidal Poisoning of a Woman Autopsied 6 Years After Death.

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    Lech, Teresa

    2015-09-01

    In the described case of the death of a 53-year-old woman, no toxicological examination was performed directly after death (only an anatomopathological autopsy), although symptoms of serious gastrointestinal disturbances had been present (the woman had been hospitalized twice in the course of several months). It was assumed that the cause of death was myocardial infarction. Five years later, some new circumstances came to light which suggested that somebody could have administered some poison (metals, cyanides) to the woman. Toxicological analysis of postmortem samples from the corpse, exhumed 6 years after death by order of the public prosecutor's office, revealed high tissue mercury contents in biological material (cold vapor atomic absorption spectrometry): small intestine, 1516 ng/g; large intestine, 487 ng/g; liver, 1201 ng/g; heart muscle, 1023 ng/g; and scalp hair, 227 ng/g. In samples of soil from places near the coffin, negligible traces of mercury were found (0.5-1.5 ng/g); contamination by mercury from the environment was ruled out. The presented case is a rare example of recognition of mercury poisoning on the basis of the results of analysis of biological material from an exhumed cadaver.

  18. The Experience of ICD Utilization on Verbal Autopsy Data to Obtain Trend of Cause of Death in Indonesian Population (1992–2007

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    Sarimawar Djaja

    2014-11-01

    Full Text Available Background: Cause of death data is necessary for arranging health programs. The needs of these data is not fulfill yet through reporting and recording system from health facilities only,therefore national health survei should be conducted regularly. Objective: To obtain cause of death trends in the populations from VA data. Methods: Material taken from Nasional Health Survey 1992, 1995, 2001, 2007 covering 65,664 households (HH, 206,240 HH, 211,168 HH, 258,366 HH respectively, selected by stratified random sampling technique using core and module sample of Socio Economic National Survey (Susenas and taken with a Probability Proportional to Size method. Cause of death data was collected by structured questionnaire using verbal autopsy (VA technique and was classified based on ICD 9 and ICD 10. Results: The disease patterns of cause of death from 1992 to 2007 showed the non-communicable disease is increasing continuously while communicable disease (infectious, maternal and perinatal, nutritional deficiencies is decreasing; however the burden of disease is still present on both groups of diseases. Conclusions: The little bit less accurate VA data (1992–2007 collected is able to produce national statistic data of cause of death and could be used to suggest health planning program managers in Indonesia

  19. The high prevalence of undiagnosed prostate cancer at autopsy: implications for epidemiology and treatment of prostate cancer in the Prostate-specific Antigen-era.

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    Jahn, Jaquelyn L; Giovannucci, Edward L; Stampfer, Meir J

    2015-12-15

    Widespread prostate-specific antigen (PSA) screening detects many cancers that would have otherwise gone undiagnosed. To estimate the prevalence of unsuspected prostate cancer, we reviewed 19 studies of prostate cancer discovered at autopsy among 6,024 men. Among men aged 70-79, tumor was found in 36% of Caucasians and 51% of African-Americans. This enormous prevalence, coupled with the high sensitivity of PSA screening, has led to the marked increase in the apparent incidence of prostate cancer. The impact of PSA screening on clinical practice is well-recognized, but its effect on epidemiologic research is less appreciated. Before screening, a larger proportion of incident prostate cancers had lethal potential and were diagnosed at advanced stage. However, in the PSA era, overall incident prostate cancer mainly is indolent disease, and often reflects the propensity to be screened and biopsied. Studies must therefore focus on cancers with lethal potential, and include long follow-up to accommodate the lead time induced by screening. Moreover, risk factor patterns differ markedly for potentially lethal and indolent disease, suggesting separate etiologies and distinct disease entities. Studies of total incident or indolent prostate cancer are of limited clinical utility, and the main focus of research should be on prostate cancers of lethal potential.

  20. Reactive Astrocytes Expressing Intense Estrogen Receptor-alpha Immunoreactivities Have Much Elongated Cytoplasmic Processes: An Autopsy Case of Human Cerebellar Tissue with Multiple Genitourinary and Gastrointestinal Anomalies

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    Kim, Eo-Jin; Oh, Chang Seok; Kim, Jaehyup; Kim, Wu Ho; Chung, Yoon Hee

    2007-01-01

    We performed an immunohistochemical study on the estrogen receptor alpha (ER-α) distribution in the cerebellum of a human neonate with multiple congenital anomalies, that had been acquired during autopsy. Although the exact pathology in the brain was not clearly elucidated in this study, an unidentified stressful condition might have induced the astrocytes into reactive states. In this immunohistochemical study on the neonatal cerebellum with multiple congenital anomalies, intense ER-α immunoreactivities (IRs) were localized mainly within the white matter even though ER-α IRs were known to be mainly localized in neurons. Double immunohistochemical staining showed that ER-α IR cells were reactive astrocytes, but not neurons. Interestingly, there were differences in the process length among the reactive astrocytes showing ER-α IRs. Our quantitative data confirmed that among the glial fibrillary acidic protein (GFAP)-expressing reactive astrocytes, the cells exhibiting intense ER-α IRs have much longer cytoplasmic processes and relatively weaker GFAP IRs. Taken together, the elongated processes of reactive astrocytes might be due to decreased expression of GFAP, which might be induced by elevated expression of ER-α even though the elucidation of the exact mechanism needs further studies. PMID:17982251

  1. Comprehensive investigation of postmortem glucose levels in blood and body fluids with regard to the cause of death in forensic autopsy cases.

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    Chen, Jian-Hua; Michiue, Tomomi; Inamori-Kawamoto, Osamu; Ikeda, Sayuko; Ishikawa, Takaki; Maeda, Hitoshi

    2015-11-01

    The serum glucose level is regulated within a narrow range by multiple factors under physiological conditions, but is greatly modified in the death process and after death. The present study comprehensively investigated glucose levels in blood and body fluids, including pericardial fluid (PCF), cerebrospinal fluid (CSF) and vitreous humor, reviewing forensic autopsy cases (n=672). Right heart blood glucose level was often higher than at other sites, and the CSF glucose level was the lowest, showing greater dissociation in acute/subacute death cases. The glucose level was higher in the diabetic (high HbA1c) than in the non-diabetic (low HbA1c) group at each site (pdeath due to ischemic heart disease. Fatal methamphetamine (MA) abuse, sepsis, malnutrition (starvation) and hypoglycemia due to antidiabetics showed markedly lower blood glucose levels. Ketones in bilateral cardiac blood and PCF were increased in diabetic ketoacidosis and fatal alcohol abuse as well as in most cases of hyperthermia (heatstroke), hypothermia (cold exposure) and malnutrition. These findings suggest that combined analysis of glucose, HbA1c and ketones in blood and body fluids is useful to investigate not only fatal diabetic metabolic disorders but also death processes due to other causes, including alcohol and MA abuse, as well as thermal disorders, sepsis and malnutrition. PMID:26593993

  2. Phenotypic patterns of MELAS/LS overlap syndrome associated with m.13513G>A mutation, and neuropathological findings in one autopsy case.

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    Wang, Zhaoxia; Qi, Xiao Kun; Yao, Sheng; Chen, Bin; Luan, Xinghua; Zhang, Wei; Han, Manfu; Yuan, Yun

    2010-12-01

    The 13513G>A mutation in the ND5 gene of mitochondrial DNA (mtDNA) is usually associated with mitochondrial encephalomyopathy with lactate acidosis and stroke-like episodes (MELAS), or Leigh syndrome (LS). In this study, we describe three young Chinese patients with MELAS/LS overlap syndrome who carried the m.13513G>A mutation. Clinical and MRI features were characteristic of both MELAS and LS. Interestingly, the clinical presentation of this overlap syndrome could be variable depending on the degree of relative contribution of MELAS and LS, that is, MELAS as the initial presenting syndrome, LS as the predominant syndrome, or both MELAS and LS appearing at the same time. The final brain MRI showed findings characteristic of both MELAS and LS, with asymmetrical lesions in the cortex and subcortical white matter of the occipital, temporal, and frontal lobes (MELAS), and bilateral and symmetrical lesions in the basal ganglia and brainstem (LS). Brain autopsy in one case revealed infarct-like lesions in the cerebral cortex, basal ganglia and brainstem, providing further insight into the distribution of the pathological lesions in MELAS/LS overlap syndrome. This is the first report of the brain pathological changes in a patient with m.13513G>A mutation. The spatial distribution of infarct-like lesions in the brain could explain the symptoms in MELAS/LS overlap syndrome.

  3. "Whenever they cry, I cry with them": Reciprocal relationships and the role of ethics in a verbal autopsy study in Papua New Guinea.

    Science.gov (United States)

    Gouda, H N; Kelly-Hanku, A; Wilson, L; Maraga, S; Riley, I D

    2016-08-01

    Verbal autopsy (VA) methods usually involve an interview with a recently bereaved individual to ascertain the most probable cause of death when a person dies outside of a hospital and/or did not receive a reliable death certificate. A number of concerns have arisen around the ethical and social implications of the use of these methods. In this paper we examine these concerns, looking specifically at the cultural factors surrounding death and mourning in Papua New Guinea, and the potential for VA interviews to cause emotional distress in both the bereaved respondent and the VA fieldworker. Thirty one semi-structured interviews with VA respondents, the VA team and community relations officers as well as observations in the field and team discussions were conducted between June 2013 and August 2014. While our findings reveal that VA participants were often moved to cry and feel sad, they also expressed a number of ways they benefited from the process, and indeed welcomed longer transactions with the VA interviewers. Significantly, this paper highlights the ways in which VA interviewers, who have hitherto been largely neglected in the literature, navigate transactions with the participants and make everyday decisions about their relationships with them in order to ensure that they and VA interviews are accepted by the community. The role of the VA fieldworker should be more carefully considered, as should the implications for training and institutional support that follow. PMID:27376593

  4. Human cranial vault thickness in a contemporary sample of 1097 autopsy cases: relation to body weight, stature, age, sex and ancestry.

    Science.gov (United States)

    De Boer, H H Hans; Van der Merwe, A E Lida; Soerdjbalie-Maikoe, V Vidija

    2016-09-01

    The relation between human cranial vault thickness (CVT) and various elements of the physical anthropological biological profile is subject of ongoing discussion. Some results seem to indicate no correlation between CVT and the biological profile of the individual, whereas other results suggest that CVT measurements might be useful for identification purposes. This study assesses the correlation between CVT and body weight, stature, age, sex, and ancestry by reviewing data of 1097 forensic autopsies performed at the Netherlands Forensic Institute (NFI). In subadults (younger than 19 years of age at the time of death), all frontal, temporal, and occipital CVT measurements correlated moderately to strongly with indicators of growth (body weight, stature, and age). Neither sex nor ancestry correlated significantly with cranial thickness. In adults, body weight correlated with all CVT measurements. No meaningful correlation was found between CVT and stature or age. Females showed to have thicker frontal bones, and the occipital region was thicker in the Negroid subsample. All correlation in the adult group was weak, with the distribution of cranial thickness overlapping for a great deal between the groups. Based on these results, it was concluded that CVT generally cannot be used as an indicator for any part of the biological profile.

  5. The relationship between impulsivity and suicide among rural youths aged 15-35 years: a case-control psychological autopsy study.

    Science.gov (United States)

    Lin, Lin; Zhang, Jie; Zhou, Li; Jiang, Chao

    2016-01-01

    In China, the gender ratio of suicide rates did not match the Western patterns, which was higher for females than males. However, the rural men were at relatively high risk of suicide in Liaoning province. Impulsivity was an important factor of suicide behaviors, but there was a lack of studies in China. This research aimed to study the relationship between impulsive personality traits and suicidal behavior among Chinese rural youths. Suicides were consecutively sampled from six randomly selected counties in Liaoning Province in China. Between 2005 and 2007, a total of 162 suicide victims were enrolled in the study along with 162 community controls matched for age, gender, and location. The psychological autopsy method was used to collect data from informants knowledgeable about the selected suicide victims and controls. The results showed the suicide victims in the study were more likely to demonstrate dysfunctional impulsivity and less likely to demonstrate functional impulsivity compared with the controls. Mental disorders, acute negative life events, and dysfunctional impulsivity contributed to the risk of suicide; educational and functional impulsivity were protective factors. Suicide prevention efforts in rural China may address impulsivity.

  6. In-depth analyses of organic matters in a full-scale seawater desalination plant and an autopsy of reverse osmosis membrane

    KAUST Repository

    Jeong, Sanghyun

    2016-02-17

    In order to facilitate the global performance of seawater reverse osmosis (SWRO) systems, it is important to improve the feed water quality before it enters the RO. Currently, many desalination plants experience production losses due to incidents of organic and biofouling. Consequently, monitoring or characterizing the pretreatment step using more advanced organic and biological parameters are required for better operation to lessen fouling issues. In this study, the performance of pretreatment processes (including coagulation, dual media filtration (DMF), polishing with cartridge filter (CF) coupled with anti-scalant) used at Perth Seawater Desalination Plant (PSDP) located in Western Australia were characterized in terms of organic and biological fouling parameters. These analyses were carried out using liquid chromatography with organic carbon detector (LC-OCD), three dimensional-fluorescence excitation emission matrix (3D-FEEM) and assimilable organic carbon (AOC). Furthermore, the used (exhausted) RO membrane and CF were autopsied so that the fates and behaviors of organic foulants in these treatment systems could be better understood.

  7. The late Greco-Roman and Byzantine contribution towards the evolution of laboratory examinations of bodily excrement. Part 2: sputum, vomit, blood, sweat, autopsies.

    Science.gov (United States)

    Diamandopoulos, Athanasios A; Goudas, Pavlos C

    2005-01-01

    Although the establishment of medical laboratory institutions was a continuous process that matured only after the 16th century, several attempts had already been made to attain a diagnosis by investigating bodily excrement. In the first part of our work, published in a previous issue of this journal, we presented data on urine, sperm, menses and stools. In this paper we present data on sputum, vomit, blood, sweat, and autopsies, thus completing the list of human materials used for laboratory examinations. All the data used are extracted from codices of Late Antiquity and Byzantium and translated by us. We did not study medical texts from the other great ancestors of Western medicine, namely Arabic and Jewish writings. From the texts cited, it is apparent that the lack of technological means was no obstacle for the doctor to create an "examinational" mind, i.e., to try to correlate the macroscopic findings in the excrement with the pathophysiological mechanism that induced them, solely with the use of the senses. This not only applies to the examination of urine, as is commonly assumed, but also to many other excrements of the upper and lower orifices of the body, as well as the human body as a whole. PMID:15653449

  8. Tattoo types and frequencies in New Mexican white hispanics and white non-hispanics: autopsy data from homicidal and accidental deaths, 2002-2005.

    Science.gov (United States)

    Komar, Debra; Lathrop, Sarah

    2008-12-01

    Tattoos serve as a form of forensic personal identification and providing evidence of possible gang affiliation, incarceration history, and high-risk lifestyle factors such as drug use. Despite their forensic applications, tattoo typology and frequencies in specific ethnic and racial groups are underreported and poorly understood. This study examined autopsy records from the New Mexico Office of the Medical Investigator from 2002 to 2005. A total of 3430 individuals (1666 white Hispanics; 1764 white non-Hispanics), aged 18 to 100 years, with homicidal or accidental manners of death were included in the study. In addition to demographic information, data were recorded on the presence/absence of tattoos, singular or multiple tattoos, and the language of text tattoos. Tattoos depicting gang or religious symbolism were also recorded. Results indicate statistically significant differences in tattoo frequencies by ethnicity (52% Hispanic vs. 29.5% non-Hispanic), sex (46.8% men vs. 25.9% women) and age cohort. Hispanics were more likely to have multiple tattoos than non-Hispanics (41% and 19%, respectively), and were 4.67 times more likely to have a religious tattoo and 7.13 times more likely to have a gang tattoo than non-Hispanics. Significant patterns in language of text tattoos and correlations with manner of death were also noted. PMID:19259010

  9. Human cranial vault thickness in a contemporary sample of 1097 autopsy cases: relation to body weight, stature, age, sex and ancestry.

    Science.gov (United States)

    De Boer, H H Hans; Van der Merwe, A E Lida; Soerdjbalie-Maikoe, V Vidija

    2016-09-01

    The relation between human cranial vault thickness (CVT) and various elements of the physical anthropological biological profile is subject of ongoing discussion. Some results seem to indicate no correlation between CVT and the biological profile of the individual, whereas other results suggest that CVT measurements might be useful for identification purposes. This study assesses the correlation between CVT and body weight, stature, age, sex, and ancestry by reviewing data of 1097 forensic autopsies performed at the Netherlands Forensic Institute (NFI). In subadults (younger than 19 years of age at the time of death), all frontal, temporal, and occipital CVT measurements correlated moderately to strongly with indicators of growth (body weight, stature, and age). Neither sex nor ancestry correlated significantly with cranial thickness. In adults, body weight correlated with all CVT measurements. No meaningful correlation was found between CVT and stature or age. Females showed to have thicker frontal bones, and the occipital region was thicker in the Negroid subsample. All correlation in the adult group was weak, with the distribution of cranial thickness overlapping for a great deal between the groups. Based on these results, it was concluded that CVT generally cannot be used as an indicator for any part of the biological profile. PMID:26914798

  10. Suicidal single gunshot injury to the head: differences in site of entrance wound and direction of the bullet path between right- and left-handed--an autopsy study.

    Science.gov (United States)

    Nikolić, Slobodan; Zivković, Vladimir; Babić, Dragan; Juković, Fehim

    2012-03-01

    The aim of this study was to determine the differences in the anatomical site of a gunshot entrance wound and the direction of the bullet path between right- and left-handed subjects who committed a suicide by a single gunshot injury to the head. The retrospective autopsy study was performed for a 10-year period, and it included selected cases of single suicidal gunshot head injury, committed by handguns. We considered only contact or near-contact wounds. The sample included 479 deceased, with average age 47.1 ± 19.1 years (range, 12-89 years): 432 males and 47 females, with 317 right-handed, 25 left-handed, and 137 subjects with unknown dominant hand. In our observed sample, most cases involved the right temple as the site of entrance gunshot wound (about 67%), followed by the mouth (16%), forehead (7%), left temple (6%), submental (2%), and parietal region (1%). The left temple, right temple, and forehead were the sites of the gunshot entrance wounds, which were the best predictors of the handedness of the deceased (Spearman ρ = 0.149, P = 0.006). Our study showed that the direction of the bullet intracranial path in cases of suicide was even a more potent predictor of the handedness of the deceased (Spearman ρ = 0.263, P = 0.000; Wald = 149.503, P = 0.000).

  11. The Research of DSM - IV SCID in Psychological Autopsy.%DSM - IV临床定式访谈(SCID)在心理解剖诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    许俊亭; 姜潮; 高岩; 刘启贵; 贾树华; 周莉

    2011-01-01

    目的 本研究主要评估SCID在心理解剖中进行精神疾病诊断时的可靠性、灵敏度和特异度问题.方法 对精神疾病住院患者进行SCID访谈(为患者SCID诊断),对患者亲属进行SCID访谈(为心理解剖SCID诊断).计算两种SCID诊断的重测信度,评分者信度以及心理解剖SCID诊断的灵敏度和特异度.结果 患者SCID诊断,除焦虑障碍外,临床常见精神障碍的重测信度及评分者信度都高于0.75;心理解剖SCID诊断的酒精相关障碍、精神病性障碍、双相障碍、抑郁障碍及焦虑障碍的重测信度及评分者信度都大于0.75;在所有轴Ⅰ的疾病中,除酒精滥用和恶劣心境外,心理解剖SCID诊断与患者SCID诊断一致性系数均大于0.6.心理解剖SCID诊断的特异度都大于88%,但敏感度都低于特异度.结论 研究表明SCID诊断具有较高的重测信度和评分者信度.心理解剖SCID诊断具有较好的灵敏度和特异度,与患者SCID诊断的一致性良好.%Objective The reliability, sensitivity, specificity and adoption of the Structured Clinical Interview for DSM - IV Axis I (SCID) in psychological autopsy were investigated. Method All subjects were the psychiatric patients in the No. 7 people * s hospital of Dalian. Diagnosis was made by patients SCID interview and by psychological autopsy SCID interview. Inter - rater reliability and test - retest reliability were assessed in 30 and 35 patients SCID diagnosis and psychological autopsy SCID diagnosis, respectively. Chi - square and kappa analysis were used to determine agreement of diagnoses. Results Kappa coefficients were above 0. 75 for alcohol - related disorders, psychiatric disorders, bipolar disorders and depression disorders for inter - rater and test -retest reliability in patients SCID diagnosis. Kappa coefficients were above 0. 75 for alcohol - related disorders, psychiatric disorders, bipolar disorders, depression disorders and anxiety disorders for inter

  12. O decréscimo vertiginoso das autópsias em um hospital universitário do Brasil nos últimos 20 anos The dramatic decline of the autopsies at a Brazilian university hospital in the last 20 years

    Directory of Open Access Journals (Sweden)

    Fabiana Resende Rodrigues

    2011-08-01

    Full Text Available INTRODUÇÃO: O declínio no número de autópsias em hospitais e instituições universitárias é evento amplamente reportado, inicialmente em países do primeiro mundo e posteriormente em muitos países em desenvolvimento, como o Brasil. As causas para essa tendência são múltiplas e complexas, incluindo aspectos religiosos, familiares e médicos. Entre estes últimos, salientam-se razões diagnósticas, caracterizadas pelo significativo avanço tecnológico na imagenologia, com a suposição de que todos os diagnósticos agora podem ser feitos em vida, e a crescente ansiedade de processos judiciais contra médicos por má prática. OBJETIVO: Demonstrar o decréscimo vertiginoso e drástico do número de autópsias em um hospital universitário no Brasil. MATERIAL E MÉTODO: Avaliou-se o número de registros nos livros de autópsias consecutivas realizadas no Departamento de Patologia do Hospital Universitário Antonio Pedro da Universidade Federal Fluminense (HUAP/UFF, Niterói, Rio de Janeiro, criando um banco dados em tabela do programa Microsoft Excel. RESULTADOS: Durante os anos 1966 a 2009, foram realizadas 23.813 necrópsias, sendo 12.702 de adultos e 11.111 de fetos. Entre os anos 1966 e 1998, foram realizadas mais necrópsias, no total de 23.321, sendo 12.482 de adultos e 10.839 de fetos. Já entre os anos 1999 e 2009, foi observado o declínio acentuado e drástico das mesmas, totalizando apenas 492 necrópsias, sendo 220 de adultos e 272 de fetos. CONCLUSÃO: Acreditamos que a principal causa para esse declínio é a pouca informação da população, que desconhece que o saber é fruto de estudo, pesquisa, prática e aprimoramento.INTRODUCTION: The decline in the number of autopsies at hospitals and university hospitals has been widely reported, initially in developed countries and afterwards in several developing countries including Brazil. The causes for this trend are multiple and complex, encompassing religious, family and

  13. An autopsy case of superficial siderosis of the central nervous system accompanied by anterior sacral polycystic meningocele in neurofibromatosis type 1.

    Science.gov (United States)

    Matsumoto, Arifumi; Suzuki, Hiroyoshi; Tobita, Muneshige; Hisanaga, Kinya

    2016-07-28

    A 74-year-old female patient, who was diagnosed with neurofibromatosis type 1 (NF1) at the age of 40, was admitted with complaints of flickering vision and gait disturbance for the last 2 years. On admission, neurological examination revealed mild bilateral hearing loss and ataxia in the limb and trunk. Laboratory tests revealed anti-hepatitis C virus (HCV) antibody positivity and elevated HCV RNA by real-time polymerase chain reaction. The cerebrospinal fluid examination revealed a slightly yellowish appearance with elevated total protein levels. Gradient echo T2*-weighted brain magnetic resonance imaging (MRI) demonstrated a rim of hypointense lesions surrounding the surface of the cerebellum, brainstem, frontal and temporal lobes, and thalamus, which was considered as hemosiderin depositions. From these MRI findings, she was diagnosed as having superficial siderosis of the central nervous system. Cerebral angiography revealed an aneurysm-like dilatation at the bifurcation of the right internal carotid-posterior communicating artery. (99m)Tc-ethyl cysteinate dimer single-photon emission computed tomography revealed hypoperfusion in the bilateral frontal and temporal lobes. Pelvic plain X-ray, pelvic computed tomography, and lumbosacral MRI revealed a sacral defect and an anterior sacral polycystic meningocele communicating with the spinal subarachnoid space. The patient's symptoms gradually worsened, and she died of septic shock because of pyelonephritis at the age of 77. An autopsy was performed; on pathological examination, we did not observe any findings associated with rupture of the aneurysm-like dilatation in the bifurcation of the right internal carotid-posterior communicating artery and cerebral amyloid angiopathy. Because duropathies-a new neurological disease concept-have been implicated as a cause of bleeding in the superficial siderosis, the anterior sacral polycystic meningocele, a type of duropathies, was presumed to be the most probable bleeding

  14. Evaluation of a teaching strategy based on integration of clinical subjects, virtual autopsy, pathology museum, and digital microscopy for medical students

    Directory of Open Access Journals (Sweden)

    Julio A Diaz-Perez

    2014-01-01

    Full Text Available Background: Learning pathology is fundamental for a successful medical practice. In recent years, medical education has undergone a profound transformation toward the development of an integrated curriculum incorporating both basic science and clinical material. Simultaneously, there has been a shift from a magisterial teaching approach to one centered around problem-based learning. Now-a-days, informatics tools are expected to help better implement these strategies. Aim: We applied and evaluated a new teaching method based on an active combination of clinical problems, gross pathology, histopathology, and autopsy pathology, all given through informatics tools, to teach a group of medical students at the Universidad de Santander, Colombia. Design: Ninety-four medical students were followed in two consecutive semesters. Students were randomized to receive teaching either through traditional methodology or through the new integrated approach. Results: There was no significant difference between the intervention group and the control group at baseline. At the end of the study, the scores in the intervention group were significantly higher compared to the control group (3.91/5.0 vs. 3.33/5.0, P = 0.0008. Students and tutors endorsed the benefits of the integrated approach. Participants were very satisfied with this training approach and rated the program an 8.7 out of 10, on average. Conclusion: This study confirms that an integrated curriculum utilizing informatics systems provides an excellent opportunity to associate pathology with clinical medicine early in training of medical students. This can be possible with the use of virtual microscopy and digital imaging.

  15. [Massive pulmonary thromboembolism found at autopsy in a patient with a 14-year history of polymyositis-associated nonspecific interstitial pneumonia].

    Science.gov (United States)

    Takagi, Yusuke; Hagiwara, Kiyofumi; Sato, Takeo; Akiyama, Osamu; Ogura, Takashi; Tsugata, Mikiko; Takemura, Tamiko

    2008-10-01

    A 64-year-old woman with a 14-year history of refractory nonspecific interstitial pneumonia (NSIP) associated with polymyositis was admitted urgently to our hospital due to acute exacerbation of dyspnea. The first episode of dyspnea had occurred 14 years earlier and the diagnosis of cellular and fibrotic NSIP had been made by radiographic examinations and open lung biopsy. Her NSIP initially responded well to high-dose prednisolone therapy (40mg/day), but flared when the dose of prednisolone was tapered. Three years after the diagnosis of NSIP, a diagnosis of polymyositis was made based on her elevated serum level of creatinine phosphokinase and muscle biopsy findings. Her polymyositis was controlled well by prednisolone therapy, but her NSIP gradually worsened, despite treatment with several courses of methylprednisolone pulse therapy and immunosuppressive agents. She was brought to our hospital by ambulance due to acute progression of dyspnea and was admitted. Chest X-ray film revealed diffuse interstitial shadows and marked enlargement of the right atrium and bilateral pulmonary arteries. Transthoracic echocardiogram revealed severe dilatation of the right atrium and right ventricle with an estimated pulmonary artery systolic pressure of 84mmHg. She died of progressive respiratory failure on day 4 of hospitalization. Autopsy revealed massive thrombi that completely obstructed the bilateral pulmonary trunks. Histological examination revealed that these thrombi were organized, and her interstitial lung disease (ILD) was specified as fibrotic NSIP with microscopic honeycomb. Massive pulmonary thromboembolism is extremely rare in patients with polymyositis-associated NSIP, but it should be considered as a possible cause of acute exacerbation of respiratory failure. This case provides valuable information on the clinical and pathological course of polymyositis-associated NSIP. PMID:19044031

  16. Unnatural deaths in Shanghai from 2000 to 2009: a retrospective study of forensic autopsy cases at the Shanghai Public Security Bureau.

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    Meng He

    Full Text Available Shanghai is the most developed city in China and has a soaring population. This study uses forensic epidemiology to determine the relationship between unnatural deaths and the development in Shanghai, based on recently released forensic autopsy cases from the 2000s at the Shanghai Public Security Bureau (SPSB. There were 5425 accidental deaths, 2696 homicides, 429 suicides, 186 natural deaths, and 1399 deaths of undetermined cause. There was a male-to-female ratio of 2.02:1, and the average age was 40.9±18.7 years. Traffic accidents (84.2% were the number one cause of accidental deaths, which decreased during the study period. Sharp force injury (50.6% was the leading cause of homicides, different from Western countries, where firearms are the leading cause. Hanging (24.5% was the leading cause of suicides, whereas drug and chemical intoxication was the leading cause in the previous decade; pesticide ingestion decreased in the 2000s. In addition to traffic accidents, manual strangulation was the leading cause of death in childhood fatalities. Children under age 2 were vulnerable to homicides. In the 2000s, there were a large number of drug overdoses, and illegal medical practices and subway-related deaths first appeared in Shanghai. A new type of terrorist attack that involved injecting people with syringes in public places was reflected in the SPSB archives. The forensic epidemiology and changes in unnatural deaths in this decade reflected their relationship with the law, policy and changes in Shanghai. Illegal medical practices, subway-related deaths and terrorist attacks were closely related to the development in Shanghai. Identifying the risks of unnatural deaths will improve public health.

  17. Association of the formiminotransferase N-terminal sub-domain containing gene and thrombospondin, type 1, domain-containing 7A gene with the prevalence of vertebral fracture in 2427 consecutive autopsy cases.

    Science.gov (United States)

    Zhou, Heying; Mori, Seijiro; Kou, Ikuyo; Fuku, Noriyuki; Naka Mieno, Makiko; Honma, Naoko; Arai, Tomio; Sawabe, Motoji; Tanaka, Masashi; Ikegawa, Shiro; Ito, Hideki

    2013-02-01

    We previously reported 2 osteoporosis-susceptibility genes--formiminotransferase N-terminal sub-domain containing gene (FONG) and thrombospondin, type 1, domain-containing 7A (THSD7A)--in which we identified two common single-nucleotide polymorphisms, rs7605378 (FONG) and rs12673692 (THSD7A). The former was associated with a predisposition to osteoporosis and the latter with bone mineral density. To further elucidate the importance of these polymorphisms in the pathogenesis of osteoporosis, we examined their association with the incidence of vertebral fracture. DNA extracted from the renal cortex of 2427 consecutive Japanese autopsies (1331 men, mean age: 79 years; 1096 women, mean age: 82 years) were examined in this study. The presence or absence of vertebral fracture during each subject's lifetime was determined by a thorough examination of the clinical records, as well as autopsy reports. After adjustments for sex and age at autopsy, logistic regression analysis revealed that homozygotes for the risk alleles of rs7605378 (A-allele) or rs12673629 (A-allele) possess an increased risk of vertebral fracture. The subjects simultaneously homozygous for both the risk alleles of rs7605378 (AA genotype) and rs12673629 (AA genotype) showed significantly higher risk of vertebral fracture (odds ratio 2.401, 95% confidence interval 1.305-4.416, P = 0.0048) than those who had at least one non-risk allele of either rs7605378 (AC/CC genotypes) or rs12673629 (AG/GG genotypes). The results suggest that Japanese subjects homozygous for the risk alleles of rs7605378 and rs12673629 have a higher risk of vertebral fracture.

  18. Social autopsy study identifies determinants of neonatal mortality in Doume, Nguelemendouka and Abong–Mbang health districts, Eastern Region of Cameroon

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    Alain K. Koffi

    2015-06-01

    Full Text Available Background Reducing preventable medical causes of neonatal death for faster progress toward the MGD4 will require Cameroon to adequately address the social factors contributing to these deaths. The objective of this paper is to explore the social, behavioral and health systems determinants of newborn death in Doume, Nguelemendouka and Abong–Mbang health districts, in Eastern Region of Cameroon, from 2007–2010. Methods Data come from the 2012 Verbal/Social Autopsy (VASA study, which aimed to determine the biological causes and social, behavioral and health systems determinants of under–five deaths in Doume, Nguelemendouka and Abong–Mbang health districts in Eastern Region of Cameroon. The analysis of the data was guided by the review of the coverage of key interventions along the continuum of normal maternal and newborn care and by the description of breakdowns in the care provided for severe neonatal illnesses within the Pathway to Survival conceptual framework. Results One hundred sixty–four newborn deaths were confirmed from the VASA survey. The majority of the deceased newborns were living in households with poor socio–economic conditions. Most (60–80% neonates were born to mothers who had one or more pregnancy or labor and delivery complications. Only 23% of the de ceased newborns benefited from hygienic cord care after birth. Half received appropriate thermal care and only 6% were breastfed within one hour after birth. Sixty percent of the deaths occurred during the first day of life. Fifty–five percent of the babies were born at home. More than half of the deaths (57% occurred at home. Of the 64 neonates born at a health facility, about 63% died in the health facility without leaving. Careseeking was delayed for several neonates who became sick after the first week of life and whose illnesses were less serious at the onset until they became more severely ill. Cost, including for transport, health care and other expenses

  19. Deriving causes of child mortality by re–analyzing national verbal autopsy data applying a standardized computer algorithm in Uganda, Rwanda and Ghana

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    Li Liu

    2015-06-01

    Full Text Available Background To accelerate progress toward the Millennium Development Goal 4, reliable information on causes of child mortality is critical. With more national verbal autopsy (VA studies becoming available, how to improve consistency of national VA derived child causes of death should be considered for the purpose of global comparison. We aimed to adapt a standardized computer algorithm to re–analyze national child VA studies conducted in Uganda, Rwanda and Ghana recently, and compare our results with those derived from physician review to explore issues surrounding the application of the standardized algorithm in place of physician review. Methods and Findings We adapted the standardized computer algorithm considering the disease profile in Uganda, Rwanda and Ghana. We then derived cause–specific mortality fractions applying the adapted algorithm and compared the results with those ascertained by physician review by examining the individual– and population–level agreement. Our results showed that the leading causes of child mortality in Uganda, Rwanda and Ghana were pneumonia (16.5–21.1% and malaria (16.8–25.6% among children below five years and intrapartum–related complications (6.4–10.7% and preterm birth complications (4.5–6.3% among neonates. The individual level agreement was poor to substantial across causes (kappa statistics: –0.03 to 0.83, with moderate to substantial agreement observed for injury, congenital malformation, preterm birth complications, malaria and measles. At the population level, despite fairly different cause–specific mortality fractions, the ranking of the leading causes was largely similar. Conclusions The standardized computer algorithm produced internally consistent distribution of causes of child mortality. The results were also qualitatively comparable to those based on physician review from the perspective of public health policy. The standardized computer algorithm has the advantage of

  20. Causes of death in two rural demographic surveillance sites in Bangladesh, 2004–2010: automated coding of verbal autopsies using InterVA-4

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    Nurul Alam

    2014-10-01

    Full Text Available Objective: Population-based information on causes of death (CoD by age, sex, and area is critical for countries with limited resources to identify and address key public health issues. This study analysed the demographic surveillance and verbal autopsy (VA data to estimate age- and sex-specific mortality rates and cause-specific mortality fractions in two well-defined rural populations within the demographic surveillance system in Abhoynagar and Mirsarai subdistricts, located in different climatic zones. Design: During 2004–2010, the sample demographic surveillance system registered 1,384 deaths in Abhoynagar and 1,847 deaths in Mirsarai. Trained interviewers interviewed the main caretaker of the deceased with standard VA questionnaires to record signs and symptoms of diseases or conditions that led to death and health care experiences before death. The computer-automated InterVA-4 method was used to analyse VAs to determine probable CoD. Results: Age- and sex-specific death rates revealed a higher neonatal mortality rate in Abhoynagar than Mirsarai, and death rates and sex ratios of male to female death rates were higher in the ages after infancy. Communicable diseases (CDs accounted for 16.7% of all deaths in Abhoynagar and 21.2% in Mirsarai – the difference was due mostly to more deaths from acute respiratory infections, pneumonia, and tuberculosis in Mirsarai. Non-communicable diseases (NCDs accounted for 56.2 and 55.3% of deaths in each subdistrict, respectively, with leading causes being stroke (16.5–19.3%, neoplasms (13.2% each, cardiac diseases (8.9–11.6%, chronic obstructive pulmonary diseases (5.1–6.3%, diseases of the digestive system (3.1–4.1%, and diabetes (2.8–3.5%, together accounting for 49.2–51.2% points of the NCD deaths in the two subdistricts. Injury and other external causes accounted for another 7.5–7.7% deaths, with self-harm being higher among females in Abhoynagar. Conclusions: The computer

  1. Moving from data on deaths to public health policy in Agincourt, South Africa: approaches to analysing and understanding verbal autopsy findings.

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    Peter Byass

    Full Text Available BACKGROUND: Cause of death data are an essential source for public health planning, but their availability and quality are lacking in many parts of the world. Interviewing family and friends after a death has occurred (a procedure known as verbal autopsy provides a source of data where deaths otherwise go unregistered; but sound methods for interpreting and analysing the ensuing data are essential. Two main approaches are commonly used: either physicians review individual interview material to arrive at probable cause of death, or probabilistic models process the data into likely cause(s. Here we compare and contrast these approaches as applied to a series of 6,153 deaths which occurred in a rural South African population from 1992 to 2005. We do not attempt to validate either approach in absolute terms. METHODS AND FINDINGS: The InterVA probabilistic model was applied to a series of 6,153 deaths which had previously been reviewed by physicians. Physicians used a total of 250 cause-of-death codes, many of which occurred very rarely, while the model used 33. Cause-specific mortality fractions, overall and for population subgroups, were derived from the model's output, and the physician causes coded into comparable categories. The ten highest-ranking causes accounted for 83% and 88% of all deaths by physician interpretation and probabilistic modelling respectively, and eight of the highest ten causes were common to both approaches. Top-ranking causes of death were classified by population subgroup and period, as done previously for the physician-interpreted material. Uncertainty around the cause(s of individual deaths was recognised as an important concept that should be reflected in overall analyses. One notably discrepant group involved pulmonary tuberculosis as a cause of death in adults aged over 65, and these cases are discussed in more detail, but the group only accounted for 3.5% of overall deaths. CONCLUSIONS: There were no differences

  2. Autopsy profiles of malpractice cases.

    Science.gov (United States)

    Pakis, Isil; Yayci, Nesime; Karapirli, Mustafa; Gunce, Elif; Polat, Oguz

    2009-01-01

    Claims for medical malpractice and the number of lawsuits filed thereafter are increasing in Turkey as is the case throughout the world. In the present study all files issued by the associated boards of the Council of Forensic Medicine between 2001 and 2005 were studied and of those, 525 death cases in which there was a medical malpractice claim were included. 303 of the cases (57.7%) were male, 215 (41%) were female, while no gender was mentioned in seven cases (1.3%). The age of the subjects ranged between 0 and 90, with an average of 26.8. 147 cases (28%) were related to Emergency Units. 92% of the cases (482 cases) were resolved in the Council of Forensic Medicine, Ministry of Justice. 167 of the resolved cases were concluded as medical malpractice.

  3. Comparação entre os diagnósticos clínicos e os achados de necropsia: análise retrospectiva de 680 pacientes Correlation between clinical and autopsy diagnoses: a retrospective analysis of 680 patients

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    Marcos Emanuel de Alcântara Segura

    2006-12-01

    Full Text Available OBJETIVO: Analisar a concordância entre os diagnósticos clínicos e os achados anatomopatológicos obtidos por meio do exame necroscópico, a fim de determinar a freqüência com que a necropsia revela diagnósticos principais inesperados, que são relevantes para a causa do óbito. MÉTODOS: Foram analisadas retrospectivamente 680 necropsias realizadas no Hospital de Base do Distrito Federal (HBDF, de janeiro de 1997 a dezembro de 2002. Para a comparação entre os achados clínicos e anatomopatológicos utilizou-se a classificação de Goldman, e fez-se a correlação segundo o sexo, a idade do paciente, a unidade de internação e o tempo de permanência hospitalar. Foram utilizados, como fonte de dados, os pedidos de necropsia, preenchidos pelos médicos-assistentes, e os laudos finais de necropsia. RESULTADOS: A necropsia confirmou os diagnósticos principais formulados pela clínica em 69% das amostras. Em relação aos casos discordantes, 18% foram classificados como classe I (com potencial impacto na sobrevida do paciente e 13% como classe II (sem o questionável impacto na sobrevida do paciente. Os principais diagnósticos discordantes mais freqüentes foram doenças do aparelho circulatório (acidente vascular cerebral, insuficiência cardíaca congestiva e miocardiopatia hipertrófica, moléstias infecciosas (meningite bacteriana, tuberculose miliar e neurotoxoplasmose e neoplasias (linfomas. CONCLUSÕES: Evidenciou-se significativa discordância entre os diagnósticos clínicos e anatomopatológicos post mortem, mostrando que a necropsia ainda é um procedimento importante para o esclarecimento diagnóstico, bem como para a melhoria dos serviços de saúde.OBJECTIVE: To analyze the discrepancies between clinical and postmortem diagnoses in order to determine the frequency of relevant missed diagnoses detected at autopsy. METHOD: Six hundred and eighty patients autopsied at the Hospital de Base do Distrito Federal, Brazil, between

  4. 3014例法医尸检资料的回顾性分析%Retrospective studies on forensic autopsy data of 3 014 cases

    Institute of Scientific and Technical Information of China (English)

    杨明; 李剑波; 唐任宽; 赵鹏; 朱英; 李永国

    2011-01-01

    目的:分析非正常死亡与猝死案件尸体年龄、性别差异、死因和动机等特点.方法:川东北9个县市区2005年至2009年间3014例非正常死亡与猝死案件的法医尸检资料进行统计分析.结果:男女比例为1.9∶1;年龄以15~45岁为主;死亡时间以夏、冬季和10时~13时居多;猝死的高发年龄段呈现年轻化的趋势,死因以心血管系统和中枢神经系统为主;他杀案件的致伤工具以单刃锐器最多见,杀人动机以纠纷为主;自杀案件的死因以农药中毒、缢颈和溺死为主.结论:为减少非正常死亡与猝死案件的发生,应重点关注青少年的心理健康与中青年人群的健康隐患;同时加强重点时间段、管制刀具的监管,加强青少年人群的法律意识.%Objective:To analyze the sex difference, age, cause and motivation of unnatural death and sudden death. Methods:Forensic autopsy data of 3014 cases of unnatural death and sudden death in nine counties of Northeast Sichuan Province during 2005~2009 were studied. Results:The male and female proportion was 1.9:1, and the peak age was 15~45 years. The major death time was at 10~13 h in summer and winter. The peak age of sudden death was moving to younger groups. The major causes of sudden death were cardiovascular system disease and central nervous system disease. The major injury instruments for murder were single-bladed sharp tools, and dispute was the major motivation of murder. The major causes of suicide death were pesticide intoxication, hanging and drowning. Conclusion:In order to decrease the occurrence of unnatural death and sudden death, we should pay particular attention to adolescent psychological health, and young and middle-aged people's health hazard, and should strengthen supervision for focal period of time and controlled knives, and enhance the legal consciousness of adolescents.

  5. Twenty Autopsy Cases of Anaphylactic Shock Induced by Cephalosporins%头孢类药物致过敏性休克死亡20例分析

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    杜中波; 朱宇; 覃虹; 官大威; 吴旭; 李如波; 高卫民; 毛瑞明; 朱宝利

    2011-01-01

    Objective To explore the characteristics of autopsy cases of anaphylactic shock induced by cephalosporins and provide the evidences in forensic medicine. Methods Twenty cases of anaphylactic shock induced by cephalosporins were collected from April 2005 to August 2009 in judicial expertise center of China Medical University, and the characteristics of the cases were analyzed retrospectively. Results The age of decedents ranged from 40 to 60 years. Ninety percent of cases were from local medical centers and private clinics. The symptoms of the shock appeared 30s-150min after the administration of the drug,and death occurred 10min-210min after the appearance of the shock symptoms. In all cases, various degrees of eosinophil infiltration were observed in trachea and the lungs. Serum IgE detected by ELISA method was normal value in 14 cases. Conclusion In fatal anaphylactic cases, little specific findings are detected during postmortem and microscope examination. For this reason, the determination of cause of death in these cases requires comprehensive analysis combined with clinic information and excludes other diseases leading to the sudden death.%目的 探讨头孢类药物所致过敏性休克死亡案件的病理学特点,为法医学鉴定提供依据.方法 对中国医科大学法医司法鉴定中心2005年4月-2009年8月受理的20头孢类药物致过敏性休克死亡鉴定案件进行回顾性分析.结果 死者年龄主要集中在40~60岁,90%的案例发生在基层医疗机构.用药后至休克症状出现在30s~150min,休克症状出现至死亡在10~210min.显微镜检见所有案例气管、肺组织中存在不同程度的嗜酸性粒细胞浸润.ELISA法检测结果显示14例血液IgE值在临床参考值正常范围以内.结论 在头孢类药物致过敏性休克死亡案例中,尸体检验和显微镜观察较少发现特异性的改变,因此,此类案例的死亡原因推断需要在排除其他致死性疾病的基础上结合临床过程综合分析.

  6. 607例不同年份中毒尸检资料对比分析%Comparative Analysis of 607 Autopsy Cases of Poisoning Death

    Institute of Scientific and Technical Information of China (English)

    梁曼; 郑娜; 周兰; 刘茜; 张海东; 卓荦; 刘艳; 黄光照; 刘良

    2011-01-01

    目的 研究不同年份中毒案例的毒物种类、中毒途径、中毒方式等相关问题,为此类案例的法医学鉴定提供参考.方法 对华中科技大学同济医学院法医学系(湖北同济法医学司法鉴定中心)1957-2008年鉴定的607例中毒案例尸检资料进行对比分析.结果 1999-2008年218例中毒案例中死者男性居多,30~49岁占50%,中毒以口服方式为主,意外中毒居首位,毒物种类以杀鼠剂、有毒气体、农药类位居前三位.与1983-1998年及1957-1982年的中毒尸检资料对比,不同年份间毒物种类明显变化,近年农药、氰化物中毒减少,杀鼠药、有毒气体及醇类中毒增加,毒品滥用激增.结论 农药中毒是长期威胁公众健康的一类毒物,须对此提高防范意识;对联合中毒日益增多的趋势应引起关注.%Objective To provide references for forensic expertise by investigating the kinds of toxicant, routes of exposure and manners of poisoning deaths, etc. Methods Six hundred and seven autopsy cases of poisoning deaths from 1957 to 2008 in Department of Forensic Medicine, Tongji Medical College(Tongji Forensic Science Identification Center of Hubei), were comparatively reviewed. Results In 218 cases from 1999 to 2008, more than 50% of decedents were male in the ages of 30-49. The toxicants are usually taken orally and the most common manner of death was accidental. The common substances involved in poisoning death were rodenticide, poisoning gas and insecticide. Compared to the data of 1983-1998 and 1957-1982, the common toxic agents had changed significantly. The number of cases involving insecticide and cyanide poisoning decreased in recent years, and the number of cases of rodenticide, poisoning gas, alcohols poisoning displayed an increase tendency, especially for drugs abuse. Conclusion Poisoning deaths of pesticides remain a major public health problem for a long time and the awareness of prevention need to be raised, especially for

  7. Alterações histopatológicas pulmonares em pacientes com insuficiência respiratória aguda: um estudo em autopsias Pulmonary histopathological alterations in patients with acute respiratory failure: an autopsy study

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    Alexandre de Matos Soeiro

    2008-02-01

    Full Text Available OBJETIVOS: Apresentar alterações histopatológicas pulmonares encontradas em autopsias de pacientes falecidos por insuficiência respiratória aguda (IRA e verificar se doenças de base e específicos fatores de risco associados aumentam a incidência dessas alterações. MÉTODOS: Foram revisados laudos finais de autopsias e selecionadas 3.030 autopsias de pacientes > 1 ano de idade, com infiltrado pulmonar radiológico, portadores de doença de base e fatores de risco associados, que morreram por alterações pulmonares decorrentes de IRA. RESULTADOS: As principais alterações histopatológicas pulmonares causadoras de morte imediata foram: dano alveolar difuso (DAD; edema pulmonar; pneumonia intersticial linfocítica (PIL e hemorragia alveolar. As principais doenças de base encontradas foram: AIDS; broncopneumonia; sepse; cirrose hepática; tromboembolismo pulmonar; infarto agudo do miocárdio (IAM; acidente vascular cerebral; tuberculose; câncer; insuficiência renal crônica e leucemia. Os principais fatores de risco associados foram: idade > 50 anos; hipertensão arterial; insuficiência cardíaca congestiva; doença pulmonar obstrutiva crônica e diabetes mellitus. Pacientes com esses fatores de risco e AIDS apresentaram alta probabilidade de desenvolver PIL; pacientes com esses mesmos fatores, de desenvolver DAD, se portadores de sepse ou cirrose hepática; pacientes com tromboembolismo e os mesmos fatores de risco, de desenvolver hemorragia alveolar; pacientes com esses fatores de risco e IAM, de desenvolver edema pulmonar. CONCLUSÕES: Os achados pulmonares em pacientes com óbito por IRA apresentaram quatro padrões histopatológicos: DAD, edema pulmonar, PIL e hemorragia alveolar. Doenças de base e específicos fatores de risco associados correlacionaram-se positivamente com determinados padrões histopatológicos detectados à autópsia.OBJECTIVE: To present the pulmonary histopathological alterations found in the autopsies of

  8. Achados clínicopatológicos na tromboembolia pulmonar: estudo de 24 anos de autópsias Clinicopathological findings in pulmonary thromboembolism: a 24-year autopsy study

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    Hugo Hyung Bok Yoo

    2004-10-01

    Full Text Available INTRODUÇÃO: Tromboembolia pulmonar (TEP é ainda uma afecção enigmática em diversos aspectos clínicos e epidemiológicos e frequentemente erroneamente diagnosticada. OBJETIVO: Descrever a prevalência e os achados anatomopatológicos de TEP em uma série de 5261 autópsias realizadas em um hospital universitário de nível terciário, correlacionar estes achados com as doenças de base e verificar a freqüência de suspeita clínica antemortem de TEP. MÉTODO: Revisão dos registros das autópsias consecutivas realizadas de 1979 a 2002 para um estudo retrospectivo. Dos prontuários e dos relatórios de autópsias dos pacientes que tiveram TEP documentada, macro e/ou microscopicamente, foram extraídos dados demográficos, doenças de base, suspeita antemortem de TEP, localização dos trombos nos pulmões e provável local de origem da TEP. RESULTADOS: A freqüência de autópsias foi de 42,0% e TEP foi encontrada em 544 pacientes, sendo a principal causa da morte (TEP fatal em 225 casos. Doenças infecciosas (p=0,0003 foram associadas com TEP não fatal e trauma (p=0,007 com TEP fatal. A taxa de não suspeita antemortem de TEP foi 84,6% e 40,0% destes pacientes apresentaram TEP fatal. Doenças do sistema circulatório (p=0,0001, infecções (pBACKGROUND: Pulmonary thromboembolism (PTE is still an enigmatic disorder in many epidemiological and clinical features, remaining one of the most commonly misdiagnosed disorders. OBJECTIVE: To describe the prevalence and pathological findings of PTE in a series of autopsies, to correlate these findings with underlying diseases, and to verify the frequency of PTE clinically suspected before death. METHOD: The reports on 5261 consecutive autopsies performed from 1979 to 2002 in a Brazilian tertiary referral medical school were reviewed for a retrospective study. From the medical records and autopsy reports of the patients found with macroscopically and/or microscopically documented PTE, were gathered

  9. Propuesta de un protocolo para la ejecución de autopsia psicológica empleando sociometría conductual/Proposal of a protocol for the implementation of psychological autopsy using sociometry behavioral

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    Jacobo Herrera Rodríguez (México

    2013-08-01

    Full Text Available Se realiza en este documento una propuesta metodológica para la ejecución siguiendo un protocolo de la técnica de autopsia psicológica, empleando técnicas pertenecientes a la sociometría conductual. Dentro de este artículo, inicialmente se hace una revisión histórica-conceptual de la técnica de autopsia psicológica, para ubicar sus alcances, así como para delimitar su campo de aplicación y utilidades. Enseguida se exponen algunas cuestiones fundamentales de la sociometría conductual. Finalmente se describe el diseño metodológico propuesto, pretendiendo que esta propuesta sea útil para el trabajo de esclarecimiento de casos suicidas y criminales, así como un apoyo para la labor investigativa policial y la conformación de bases de datos de tipo epidemiológico. It is carried out in this document a methodological proposal for the execution using a protocol of the psychological autopsy technique applying social-behavioral and social-cognitive maps. This article initially shows a historic-conceptual review of the technique of psychological autopsy in order to locate its reaches, as well as for delimit its field of application and utilities. After that the article exposes some sociometrics behavioral basics. Finally the proposed methodological design is described. The design looks to be useful for the clarification work in suicide and criminal cases and can also help the police work and the configure of epidemiological data base.

  10. Clinical and Autopsy Features of 9 Children with Enterovirus 71 Infection%肠道病毒71型感染9例临床及尸体解剖特点

    Institute of Scientific and Technical Information of China (English)

    郑伟华; 杨方源; 李雄; 李运千; 欧维琳

    2012-01-01

    目的 了解肠道病毒71型( EV71)感染的危重病例的临床特点及尸体解剖病理特点.方法 收集2010年3-6月桂林市7家医院收治的9例EV71感染死亡病例的临床资料,并对患儿尸体系统解剖,对脑、肺、肠、心、肝、胃、脾、肾等脏器行组织常规HE染色,光镜下观察.结果 患儿年龄7个月~3岁.临床特点为病程短、进展快.6例病程中手足口或肛周有手足口样皮疹,3例无皮疹.9例患儿均在发病第1-2天出现神经系统症状,表现为精神差,呕吐,肌张力下降,抬头不稳、行走不稳,肢体抖动;3例在病程中有抽搐.病程第3-4天,9例患儿均出现肺水肿、肺出血而死亡.尸解结果显示其脑、肺部病变明显.脑部主要累及蛛网膜、脑干、软脑膜、脊髓、大脑、脊髓膜等处,表现为水肿、炎症、坏死,有明显的软化灶、出血灶形成;肺部主要为肺淤血、肺水肿及肺出血;心脏无炎症及心肌炎的表现;肝、脾、胃肠道、肾等器官病理改变不明显.结论 EV71感染危重病例的病变主要累及中枢神经系统,呼吸系统为继发病变;严重的脑干脑炎和神经源性肺水肿、肺出血是死亡的主要病因.%Objective To recognize the clinical and autopsy pathologic features of the fatal enterovirus 71 ( EV7I) infection in autopsy cases. Methods The clinical data were analyzed and the autopsy was performed in 9 children with EV71 infection who were treated in the hospitals in Guilin from Mar. to Jun. 2010. Tissue samples of major organs such as brains,lungs,intestines,hearts,livers,kidneys,spleens and stomachs were collected,HE stained and examined under light microscopy. Results The ages of the 9 patients were from 7 months to 3 years.The clinical course was short and rapidly progressive. Vesicular rashes were found in 6 cases, and 3 cases had no rashes. The 9 patients had clinical manifestations of central nervous system and they had dispirited

  11. Analysis of mortality causes for 165 type 2 diabetics:an autopsy study%死亡2型糖尿病患者165例临床及病理分析

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    李琳; 李春霖; 田慧; 韦立新

    2011-01-01

    Objective To analyze the main mortality causes and pathological characteristics of type 2 diabetics with autopsy findings.Methods A total of 165 autopsy reports of type 2 diabetics were retrospectively reviewed and summarized at our institution.And 165 non-diabetics during the same period were analyzed similarly.Results The clinical data showed that type 2 diabetics had a higher risk for coronary heart disease,hypertension,stroke,hyperlipidemia and renal diseases than non-diabetics(P0.05).The three major mortality causes were malignant neoplasms(39.4%,n=65),circulatory system diseases(35.2%,n=58)and respiratory system diseases(9.1%,n=15).Conclusion The onset of malignant tumors,especially gastrointestinal one,should be monitored closely during the prevention and treatment of cardiocerebrovascular diseases and complications.%目的 分析尸体解剖糖尿病患者死亡的主要原因及主要病理改变特点.方法 对1988--2000年在解放军总医院死亡并行尸体解剖的165例糖尿病患者进行回顾性分析,并与同期死亡并行尸体解剖的165例非糖尿病患者进行比较.结果 临床诊断提示糖尿病患者冠心病、高血压、脑卒中、血脂异常、肾脏疾病的发生率均显著高于非糖尿病患者(P0.05).糖尿病患者的前3位主要病理死亡原因依次是恶性肿瘤39.4%(n=65),循环系统疾病35.2%(n=58)及呼吸系统疾病9.1%(n=15).结论 恶性肿瘤及循环系统疾病是糖尿病患者死亡的主要原因.

  12. Síndrome da imunodeficiência adquirida: descrição anátomo-patológica de dois casos de necropsia Acquired immunodeficiency syndrome: pathologic description of two autopsy cases

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    Vera L. C. Delmonte

    1984-08-01

    Full Text Available Os Autores apresentam dois casos de Síndrome de Imunodeficiência Adquirida com ênfase aos achados de necropsia. A criptococose generalizada de padrão miliar, infreqüente, e a pneumocistose foram infecções oportunísticas de curso fatal pela destruição parenquimatosa de órgãos vitais que acarretaram. É destacado o papel etiopatogênico do citomegalovírus, pela concomitância de infecção em ambos os casos e associação aos órgãos mais afetados. Extensa necrose de supra-renal foi constatada, possivelmente secundária à destruição celular viral pelo CMV.Two autopsy cases of acquired immunodeficiency disease syndrome are reported. One case showed widespread miliar cryptococcosis, with scarce inflammatory response. The other developed respiratory failure due to pulmonary infection by P. carinii. In both cases we could observe generalized cytomegalic infection, with striking adrenal involvement. Special emphasis is given to the pathologic changes and the possible etiopathogenic role of cytomegaloviroses in the acquired immunodeficiency cases.

  13. Autopsy report of two cases with enterovirus type 71 infection brainstem encephalitis and literature review%肠道病毒71型脑干脑炎二例尸检报道及文献复习

    Institute of Scientific and Technical Information of China (English)

    韦丹; 李坤雄; 陈娥

    2010-01-01

    Objective To understand clinicopathologic characteristics of hand-foot-and-mouth disease.Methods The data of two autopsy cases with brainstem encephalitis caused by enterovirus type 71 infection were analyzed.Results The age of the two patients was younger(≤3 age).The clinical course was rapidly progressive,vesicular rashes were found in one case and the other case had no rashes.Both patients had clinical manifestations of central nervous system.Rapid progression to death were preceded by the development of pulmonary edema and hemorrhage.The results of the autopsy showed that the brain and brain stem were most severely involved and there were inflammation and necrosis.There were lung edema and hemorrhage.The myocardium and other organs were not infiltrated by inflammatory cells.Conclusion Hand-foot-and-mouth disease with enterovirus type 71 infection often affected central nervous system,rapid progression to death was preceded by the development of brain stem encephalitis and pulmonary edema.%目的 探讨手足口病的临床与病理特征.方法 分析2例肠道病毒71型(EV71)脑干脑炎死亡病例尸检结果及临床资料,并复习相关文献.结果 死者年龄≤3岁,病程短,进展快,1例有典型皮疹,1例皮疹不明显,2例均有不同程度的神经系统症状,最终出现肺水肿和肺出血死亡.尸检显示:病变主要在大脑和脑干,可见明显水肿、炎症、坏死等;肺脏主要为水肿和出血;心肌无炎细胞浸润及心肌炎的改变,肝、脾、肾、胰腺及胃肠道病理改变不明显.结论 本组2例尸解结果显示神经系统、呼吸系统病变明显.支持EV71感染的手足口病,常并发中枢神经系统损害;严重的脑干脑炎和神经源性肺水肿、肺出血是死亡的主要原因;也可以解释患儿以咳嗽、气促、抽搐、昏迷为主的临床表现.

  14. Metallographic autopsies of full-scale ITER prototype cable-in-conduit conductors after full cyclic testing in SULTAN: II. Significant reduction of strand movement and strand damage in short twist pitch CICCs

    Science.gov (United States)

    Sanabria, Carlos; Lee, Peter J.; Starch, William; Devred, Arnaud; Larbalestier, David C.

    2015-12-01

    Prototype cable-in-conduit-conductors (CICCs) destined for use in the toroidal field and central solenoid coils of the ITER experimental fusion reactor underwent severe cyclic loading in the SULTAN facility. Their autopsies revealed significant and permanent transverse strand migration due to the large Lorentz forces of the SULTAN test. The movement resulted in a 3%-7% void fraction increase on the low pressure (LP) side of the longer twist pitch CICCs. However, short twist pitch conductors exhibited less than 1% void fraction increase in the LP side, as well as a complete absence of the Nb3Sn filament fractures observed in the longer twist pitch conductors. We report here a detailed strand-to-cable analysis of short and longer ‘baseline’ twist pitch CICCs. It was found that the use of internal tin (IT) strands in the longer ‘baseline’ twist pitch CICCs can be beneficial possibly because of their superior stiffness—which better resist strand movement—while the use of bronze process strands showed more movement and poorer cyclic test performance. This was not the case for the short twist pitch CICC. Such conductor design seems to work well with both strand types. But it was found that despite the absence of filament fractures, the short twist pitch CICC made from the IT strands studied here developed severe strand distortion during cabling which resulted in diffusion barrier breaks and Sn contamination of the Cu stabilizer during the heat treatment. Conversely, the short twist pitch CICC made from bronze process strands preserved diffusion barrier integrity.

  15. Autopsy and postmortem examination case study on genetic risk factors for cardiac death: Polymorphisms of endothelial nitric oxide synthase gene Glu298asp variant and T-786c mutation, human paraoxonas

    Directory of Open Access Journals (Sweden)

    Ameno Kiyoshi

    2006-01-01

    Full Text Available Background/Aim. The Glu298Asp variant in exon 7 and T-786C mutation in the 5'-flanking region of the endothelial nitric oxide synthase (eNOS gene, paraoxonase I gene (PON1, and α2β- adrenergic receptor gene (α2β-AR have been reported to be genetic risk factors for coronary heart disease (CHD. The aim of this study was to investigate the effects of these four genetic polymorphisms on the probability of death due to CHD, using data obtained from medico-legal autopsies. Methods. Blood samples from three groups: healthy controls, dead cases with CHD and without CHD (the latter as a control for dead cases were used. After DNA extraction, genotyping was performed by polymerase chain reaction − restriction fragment length polymorphism (PCR-RFLP test. Results. The frequency of the T allele in Glu298Asp variant in the dead cases with CHD was significantly higher than that in the healthy control (p < 0.001, OR = 4.47 and that in the dead cases without CHD (p < 0.001, OR = 7.62. The gene frequency of PON1 was significantly different (p = 0.007 between dead cases with and without CHD, and was also significantly different (p = 0.025 between the healthy control and dead cases without CHD. The gene frequency of PON1 was not significantly different (p = 0.401 between the healthy controls and dead cases with CHD. Hence this gene was not associated with death due to CHD. The other polymorphisms (T- 786C mutation, α2β-AR also showed no effect on death due to CHD. Conclusion. The polymorphism of Glu298Asp eNOS gene in dead cases may be useful for determining the cause of death in CHD cases in the Japanese population.

  16. Metallographic autopsies of full-scale ITER prototype cable-in-conduit conductors after full cyclic testing in SULTAN: III. The importance of strand surface roughness in long twist pitch conductors

    Science.gov (United States)

    Sanabria, Charlie; Lee, Peter J.; Starch, William; Devred, Arnaud; Larbalestier, David C.

    2016-07-01

    As part of the ITER conductor qualification process, 3 m long cable-in-conduit conductors (CICCs) were tested at the SULTAN facility under conditions simulating ITER operation so as to establish the current-sharing temperature, T cs, as a function of multiple full Lorentz force loading cycles. After a comprehensive evaluation of both the toroidal field (TF) and the central solenoid (CS) conductors, it was found that T cs degradation was common in long twist pitch TF conductors while short twist pitch CS conductors showed some T cs increase. However, one kind of TF conductors containing superconducting strand fabricated by the Bochvar Institute of Inorganic Materials (VNIINM) avoided T cs degradation despite having long twist pitch. In our earlier metallographic autopsies of long and short twist pitch CS conductors, we observed a substantially greater transverse strand movement under Lorentz force loading for long twist pitch conductors, while short twist pitch conductors had negligible transverse movement. With help from the literature, we concluded that the transverse movement was not the source of T cs degradation but rather an increase of the compressive strain in the Nb3Sn filaments possibly induced by longitudinal movement of the wires. Like all TF conductors this TF VNIINM conductor showed large transverse motions under Lorentz force loading, but T cs actually increased, as in all short twist pitch CS conductors. We here propose that the high surface roughness of the VNIINM strand may be responsible for the suppression of the compressive strain enhancement (characteristic of long twist pitch conductors). It appears that increasing strand surface roughness could improve the performance of long twist pitch CICCs.

  17. Evaluation of image quality and spatial resolution of low-dose high-pitch multidetector-row helical high-resolution CT in 11 autopsy lungs and a wire phantom

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate whether low-dose high-pitch (6:1) multidetector-row helical high-resolution CT is appropriate for the evaluation of various pulmonary abnormalities, including faint opacities. Eleven autopsy lungs were scanned with a multidetector-row CT scanner using 2.5 mm x 4 beam collimation, effective slice thickness 3 mm, 6:1 pitch, 0.8 second gantry rotation speed, 20 cm Display Fov, high spatial frequency (bone) algorithm, and various radiation doses (120 kVp; 160, 80, 40, 24, and 8 mAs). The image quality of each CT set was assessed as adequate or inadequate for diagnosis by two independent observers. In addition, a wire phantom was scanned with the same parameters in order to describe the modular transfer function (MTF) curves. There was excellent agreement between the observers for the evaluation of image quality (kappa statistic, 0.84). The ratio of images evaluated as inadequate for 8 mAs and 24 mAs was significantly higher than that for 160, 80, and 40 mAs (p<0.01: chi-square test). MTF curves of both 8 and 24 mAs were significantly inferior to those of 40, 80, and 160 mAs (p<0.01, Friedman test), while the MTF curve of 40 mAs was relatively inferior to that of 160 mAs (p<0.05, Friedman test). More than 40 mAs in combination with 120 kVp is preferable for the evaluation of details of lung parenchyma by high-pitch. multidetector-row helical high-resolution CT. (author)

  18. Evaluation of image quality and spatial resolution of low-dose high-pitch multidetector-row helical high-resolution CT in 11 autopsy lungs and a wire phantom

    Energy Technology Data Exchange (ETDEWEB)

    Johkoh, Takeshi; Honda, Osamu; Yamamoto, Shuji [Osaka Univ., Suita (Japan). Medical School] (and others)

    2001-12-01

    The aim of this study was to evaluate whether low-dose high-pitch (6:1) multidetector-row helical high-resolution CT is appropriate for the evaluation of various pulmonary abnormalities, including faint opacities. Eleven autopsy lungs were scanned with a multidetector-row CT scanner using 2.5 mm x 4 beam collimation, effective slice thickness 3 mm, 6:1 pitch, 0.8 second gantry rotation speed, 20 cm Display Fov, high spatial frequency (bone) algorithm, and various radiation doses (120 kVp; 160, 80, 40, 24, and 8 mAs). The image quality of each CT set was assessed as adequate or inadequate for diagnosis by two independent observers. In addition, a wire phantom was scanned with the same parameters in order to describe the modular transfer function (MTF) curves. There was excellent agreement between the observers for the evaluation of image quality (kappa statistic, 0.84). The ratio of images evaluated as inadequate for 8 mAs and 24 mAs was significantly higher than that for 160, 80, and 40 mAs (p<0.01: chi-square test). MTF curves of both 8 and 24 mAs were significantly inferior to those of 40, 80, and 160 mAs (p<0.01, Friedman test), while the MTF curve of 40 mAs was relatively inferior to that of 160 mAs (p<0.05, Friedman test). More than 40 mAs in combination with 120 kVp is preferable for the evaluation of details of lung parenchyma by high-pitch. multidetector-row helical high-resolution CT. (author)

  19. 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

    Directory of Open Access Journals (Sweden)

    Alberto Antonio Terrabuio Junior

    2007-02-01

    Full Text Available 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 autopsies (3.28% from patients aged 15 years or more with primary underlying diseases who developed radiologically diffuse infiltrates of the lung during their hospital course and died after secondary interstitial pneumonia (bronchopneumonia, lobar pneumonia, interstitial pneumonia, diffuse alveolar damage, pulmonary recurrence of underlying disease, drug-induced lung disease, cardiogenic pulmonary edema, or pulmonary embolism. Histology slides were reviewed by experienced pathologists to confirm or not the presence of secondary interstitial pneumonia. Statistical analysis included the Fisher exact test to verify any association between histopathology and the cause of immunocompromise; a logistic regression was used to predict the risk of death for specific histological findings for each of the independent variables in the model. RESULTS: Secondary interstitial pneumonia was histologically represented by diffuse interstitial pneumonitis ranging from mild nonspecific findings (n = 213 to a pattern of diffuse alveolar damage (n = 273. The principal causes of immunocompromise in patients with diffuse alveolar damage were sepsis (136 cases, neoplasia (113 cases, diabetes mellitus (37 cases, and transplantation (48 cases. A high risk of death by pulmonary edema was found for patients with carcinoma of colon. Similarly, in patients with lung cancer or cachexia, A high risk of death by bronchopneumonia (OR = 3.6; OR = 2.6, respectively was found. Pulmonary

  20. Autópsias psicológicas e psicossociais de idosos que morreram por suicídio no Brasil Psychological and psychosocial autopsies of the elderly who committed suicide in Brazil

    Directory of Open Access Journals (Sweden)

    Fátima Gonçalves Cavalcante

    2012-08-01

    Full Text Available Analisam-se 51 casos de suicídio de idosos em dez municípios brasileiros, visando a conhecer a interação de variáveis associadas ao fenômeno. Uma revisão sobre o tema dá suporte teórico ao estudo. Tendo como base o método da autópsia psicológica, o estudo parte de um roteiro de entrevista semiestruturada, aplicada e analisada por pares de pesquisadores, mediante um mesmo procedimento de coleta, organização e análise dos dados. O conjunto foi reexaminado através de uma meta-análise de enfoque psicossocial e qualitativo sobre dados dos familiares entrevistados, interpretações dos pesquisadores, contextualização socioantropológica e categorias de relevância. Foram estudadas formas de perpetração e letalidade por sexo, faixa etária, perfil socioeconômico; fatores associados; e motivos atribuídos. Analisou-se a interação de fatores precipitantes relevantes. As conclusões apontam convergências entre estudos epidemiológicos e qualitativos. Doenças graves, deficiências e transtornos mentais juntos formam as principais causas, seguidas de depressão, conflitos familiares e conjugais. Recomenda-se atenção à qualidade de vida dos idosos, especialmente dos homens, que constituem o grupo de maior risco para suicídio.The authors analyze 51 cases of suicide among the elderly from ten Brazilian municipalities. The objective is to understand the interaction of variables associated with suicide among the elderly. A bibliographic review gives theoretical support to this study. Based on psychological autopsy, the study begins with a semi-structured interview format, which was applied and analyzed by peer researchers, using the same procedure for gathering, organizing and analyzing the data. This material was reviewed using a psychosocial and qualitative meta-analysis approach based on family interview data, researchers' interpretations, socio-anthropological contextualization and relevance categories. Ways of committing

  1. Autópsia psicológica e psicossocial sobre suicídio de idosos: abordagem metodológica Psychological and psychosocial autopsy on suicide among the elderly: a methodological approach

    Directory of Open Access Journals (Sweden)

    Fátima Gonçalves Cavalcante

    2012-08-01

    Full Text Available O artigo analisa a qualidade e a consistência de um roteiro de entrevista semiestruturada, adaptado para o estudo do suicídio de pessoas idosas e apresenta o método das autópsias psicossociais que resultou da aplicação desse instrumento. O objetivo é demonstrar como o uso da entrevista em profundidade e sua forma de organização e análise de dados foram testados e aperfeiçoados por uma rede de pesquisadores de vários centros de pesquisa do Brasil. O método envolveu a aplicação do instrumento em que se socializou um manual de instruções sobre a coleta, sistematização e análise de dados. A metodologia foi aplicada no estudo de 51 casos de idosos que faleceram por suicídio em dez municípios brasileiros, e permitiu a verificação da consistência do instrumento usado e a aplicabilidade do seu método, durante o processo e ao final, por meio de uma avaliação em rede. O roteiro aperfeiçoado e as instruções para replicá-lo e analisá-lo são aqui apresentados. Os resultados apontam o rigor e a credibilidade dessa abordagem metodológica testada e qualificada de um modo interdisciplinar e interinstitucional.The article analyzes the quality and consistency of a semi-structured interview script, adapted for the study on suicide among elderly people, and presents the psychological and psychosocial autopsy method, which is the result of application of this instrument. The objective is to demonstrate how the in-depth interview and subsequent data organization and analyses were tested and improved by a network of researchers from eight regions in Brazil. Evaluation of the method was conducted before and after the application of the instruments to collect, systematize and analyze the data. This methodology was applied in 51 cases of elderly people who committed suicide in ten Brazilian municipalities. The study did more than just collect data with scientific rigor, since it also verified the consistency of the instrument used and

  2. Misoprostol como abortivo en España: A propósito de un caso de autopsia judicial Misoprostol as an abortive in Spain: Report of a judicial autopsy case

    Directory of Open Access Journals (Sweden)

    PM. Garamendi González

    2004-10-01

    Full Text Available El Misoprostol es un agente farmacológico introducido en el mercado español bajo la forma de un fármaco protector gástrico y comercializado actualmente en asociación con un antinflamatorio. Desde hace varios años, se desarrolla un debate internacional sobre el hecho de que este mismo producto cumple las características de un abortivo extremadamente eficaz. No obstante, el uso inadecuado del Misoprostol puede causar daños severos a la madre y al feto, tanto si el producto se usa con fines abortivos como si se administra accidentalmente durante una gestación, incluso a las dosis recomendadas. Por otra parte, el Misoprostol tiene un rápido metabolismo y no es fácilmente identificable por los laboratorios toxicológicos de referencia, limitando su posible identificación en casos de uso inadecuado, voluntario o accidental. Se presenta un caso de autopsia médico legal tras un posible episodio de aborto inducido por la administración de Misoprostol.Misoprostol is a drug commercialized in Spain as a gastric protector. Nowadays it is sold in our country also associated with diclofenac to prevent gastric damages produced by anti-inflammatories. During the last few years, there has been a public debate in medical press about the fact that Misoprostol has also proved to be an excellent abortive. Nevertheless, when it is not properly used Misoprostol can be the cause of severe damages to the fetus and the mother. This Prostaglandin E1 analog is a drug rapidly metabolized in humans and it is not easy to identify in toxicological analyses. This is the main bias when trying to identify it in forensic cases of accidental damages after using it as a gastric protector or voluntary administration as an abortive. We present a case report about a forensic autopsy following a possible Misoprostol induced abortion.

  3. 类胰蛋白酶在冠心病患者尸检心脏组织中的表达%Expression of tryptase in patiens with coronary heart disease autopsy heart tissue

    Institute of Scientific and Technical Information of China (English)

    付立平; 张付瑶; 王涛; 王慧君

    2012-01-01

    Objective To investigate the relationship between tryptase expression in patients with coronary heart disease and severity of the coronary artery disease. Methods Autopsy heart samples (n =70) collected during 2008-2011 were divided into 4 groups..Group A (20 cases) died of sudden death with coronary heart disease (SCD) ;group B (20 cases) , non-sudden death with coronary heart disease; group C (10 cases) died of anaphylaxis sudden death;group D (20 cases) ,died of any cause without atherosclerosis. Tryptase was detected by immunohistochemistry ( SP method) and image analysis system. Results OD in ischemic myocardium were significantly higher in SCD, CHD, sudden death of hypersensi-tivity up than that in the control group, and comparison among the groups showed statistically significantly differences (P<0.05). Conclusions Tryptase expression is increased in ischemic myocardium of SCD patients. Increased expression of tryptase in ischemic myocardium is closely related to the occurrence of SCD, providing new ways for SCD diagnosis and clinical research of prevention and treatment of coronary heart disease.%目的 探讨类胰蛋白酶(tryptase)与冠心病病情及与冠状动脉病变程度的关系.方法 从本教研室2008~2011年尸检档案中挑选病例及心脏标本共70例.分为四组:A组:冠心病猝死(SCD,20例);B组:冠心病非猝死者(CHD,20例);C组:过敏性猝死(10例);D组:阴性对照(无明显动脉粥样硬化病变的死者,20例).应用免疫组化染色(SP法)和图像定量分析法,观察每例左心室缺血心肌的类胰蛋白酶染色情况和光密度.结果 SCD组、CHD组、过敏性猝死组光密度值均高于阴性对照组,各组间比较均有显著差异(P<0.01).结论 缺血心肌中类胰蛋白酶的表达增加与SCD的发生密切相关,为SCD的诊断和临床对冠心病防治的研究提供新的途径.

  4. Tay Sachs disease: an autopsy case report.

    Science.gov (United States)

    Jadhav, Meenal Vitthal; Landge, Meenal P; Sawaimoon, Satyakam K; Harke, Arun B; Deshmukh, Sanjay D

    2005-10-01

    This report describes a case report of a postmortem performed on a 5-year old patient of Tay-Sachs disease, presenting with failure to thrive, muscular flaccidity, and cherry-red spots on macula on fundoscopy. There was no history of similarly affected sibling or any other family member. The diagnosis was confirmed by enzyme studies. At postmortem, there was no organomegaly. The brain, on microscopy, showed vacuolated swollen neurons. PMID:16366100

  5. 76 FR 75509 - Autopsies at VA Expense

    Science.gov (United States)

    2011-12-02

    ... procedure; Alcohol abuse; Alcoholism; Claims; Day care; Dental health; Drug abuse; Government contracts...; Health records; Homeless; Mental health programs; Nursing homes; Philippines, Reporting and recordkeeping... outside of a facility while undergoing post-hospital care under the provisions of 38 U.S.C. 1712 and...

  6. 42 CFR 37.203 - Autopsy specifications.

    Science.gov (United States)

    2010-10-01

    ... shall be measured directly above the insertion of the anterior papillary muscle; (v) Size, number... block of tissue; a minimum of three stained slides and three blocks of tissue shall be submitted. When...-impregnated blocks of tissue shall be submitted. (b) Needle biopsy techniques shall not be used....

  7. Anthrax Meningitis - Report Of An Autopsied Case

    Directory of Open Access Journals (Sweden)

    Mahadevan A

    1999-01-01

    Full Text Available Anthrax is a rare cause of hemorrhagic meningitis in man. This report illustrates the characteristic hemorrhagic manifestations in the brain of a patient dying of anthrax meningitis secondary to overwhelming bacteremia. Gross examination of the brain revealed a thick dense subarachnoid hemorrhage with numerous petechial hemorrhages in the cortex. Histologically, meningoencephalitis with vascular necrosis, edema, perivascular cortical hemorrhages and clumps of Gram positive bacilli in the vascular lumen and invading vessel wall were the salient features. The anthrax bacillus was isolated from CSF and brain tissue and further its pathogenecity was confirmed by animal inoculation.

  8. Anthrax Meningitis - Report Of An Autopsied Case

    OpenAIRE

    Mahadevan A; Panda K. M; Khanna N; Swamy H S; Yasha T. C

    1999-01-01

    Anthrax is a rare cause of hemorrhagic meningitis in man. This report illustrates the characteristic hemorrhagic manifestations in the brain of a patient dying of anthrax meningitis secondary to overwhelming bacteremia. Gross examination of the brain revealed a thick dense subarachnoid hemorrhage with numerous petechial hemorrhages in the cortex. Histologically, meningoencephalitis with vascular necrosis, edema, perivascular cortical hemorrhages and clumps of Gram positive bacilli in the v...

  9. Diagnóstico del origen y la causa de la muerte después de la autopsia médico-legal (Parte I Diagnosis of the origin and cause of death after the medico-legal autopsy (Part I

    Directory of Open Access Journals (Sweden)

    J.L. Palomo Rando

    2010-12-01

    Full Text Available Una de las tareas más difíciles en patología forense puede ser determinar, después de la autopsia, el origen y la causa de la muerte cuando dichos extremos no están claros o son discutibles. Una autopsia técnicamente perfecta es condición necesaria pero no suficiente para cumplir adecuadamente esta decisión. En el presente trabajo se delimitan claramente los conceptos de causa y mecanismo de muerte, muerte natural y muerte violenta. Se revisan muchos de los aspectos relacionados con el diagnóstico del origen y la causa de la muerte; especialmente el enfoque actual del valor de la autopsia en el diagnóstico, la interacción entre traumatismo y enfermedad, la doctrina de la causalidad, la utilización de la CIE-10, la llamada etiología médico-legal, la autopsia psicológica, la "autopsia blanca" o negativa y el origen de la muerte por complicaciones de la terapéutica, etc., todos ellos se ilustran con ejemplos de casos representativos. Se discute el limitado papel del patólogo forense en España en la determinación de la denominada etiología médico-legal. Las conclusiones constituyen un conjunto de recomendaciones para el mejor cumplimiento de este trabajo, entre ellas el abandono de las denominadas causas de muerte inaceptables como parada cardiaca, parada cardiorrespiratoria o muerte cerebral, etc., la utilización siempre que sea posible de los diagnósticos de la CIE-10 y del formato del apartado de la causa de la muerte (parte I y II del modelo internacional de certificado médico de causa de defunción de la OMS. Todo ello como guía breve que facilite un resultado judicial adecuado y aumente la credibilidad del patólogo forense.One of the most difficult tasks in forensic pathology is deciding the origin and the cause of death after the autopsy when those issues are unclear or debatable. A technically perfect autopsy is a necessary but not a sufficient condition to adequately fulfil this decision. The present paper clearly

  10. Diagnóstico del origen y la causa de la muerte después de la autopsia médico-legal (Parte II Diagnosis of the origin and cause of death after the medico-legal autopsy (Part II

    Directory of Open Access Journals (Sweden)

    J.L. Palomo Rando

    2011-03-01

    Full Text Available Una de las tareas más difíciles en patología forense puede ser determinar, después de la autopsia, el origen y la causa de la muerte cuando dichos extremos no están claros o son discutibles. Una autopsia técnicamente perfecta es condición necesaria pero no suficiente para cumplir adecuadamente esta decisión. En el presente trabajo se delimitan claramente los conceptos de causa y mecanismo de muerte, muerte natural y muerte violenta. Se revisan muchos de los aspectos relacionados con el diagnóstico del origen y la causa de la muerte; especialmente el enfoque actual del valor de la autopsia en el diagnóstico, la interacción entre traumatismo y enfermedad, la doctrina de la causalidad, la utilización de la CIE-10, la llamada etiología médico-legal, la autopsia psicológica, la "autopsia blanca" o negativa y el origen de la muerte por complicaciones de la terapéutica, etc., todos ellos se ilustran con ejemplos de casos representativos. Se discute el limitado papel del patólogo forense en España en la determinación de la denominada etiología médico-legal. Las conclusiones constituyen un conjunto de recomendaciones para el mejor cumplimiento de este trabajo, entre ellas el abandono de las denominadas causas de muerte inaceptables como parada cardiaca, parada cardiorrespiratoria o muerte cerebral, etc., la utilización siempre que sea posible de los diagnósticos de la CIE-10 y del formato del apartado de la causa de la muerte (parte I y II del modelo internacional de certificado médico de causa de defunción de la OMS. Todo ello como guía breve que facilite un resultado judicial adecuado y aumente la credibilidad del patólogo forense.One of the most difficult tasks in forensic pathology is deciding the origin and the cause of death after the autopsy when those issues are unclear or debatable. A technically perfect autopsy is a necessary but not a sufficient condition to adequately fulfil this decision. The present paper clearly

  11. Cause Analysis of 3 Misdiagnosed Cases of Autopsy-Proven Waterhouse-Friederichsen Syndrome%尸检确诊的华佛综合征三例误诊原因分析

    Institute of Scientific and Technical Information of China (English)

    穆娇; 屈希良; 张吉; 邓姣娟; 谢静茹; 徐层; 曾飞; 董红梅

    2015-01-01

    目的:探讨华佛综合征的临床诊治要点,以避免误诊误治。方法对我院尸检法医鉴定的华佛综合征3例的临床及尸检资料进行回顾性分析。结果2例以皮肤淤点或淤斑就诊,误诊为过敏性紫癜及过敏性休克;1例以咳嗽、喘息及呼吸困难为主要表现,误诊为呼吸系统感染。3例均发病急骤,病情危重,很快死亡,尸检并法医病理诊断为流行性脑膜炎并急性肾上腺功能衰竭(华佛综合征)2例,急性肾上腺功能衰竭(华佛综合征)1例。结论本病临床少见,病情进展快,易误诊。临床上一旦明确华佛综合征诊断,治疗应争分夺秒,若发现弥漫性血管内凝血应尽早使用肝素及抗纤维蛋白原溶解药物,积极抗休克治疗是关键。%Objective To explore the key factors in diagnoses and treatment of Waterhouse-Friederichsen syndrome to avoid misdiagnosis and mistreatment. Methods The clinical and autopsy data of 3 cases of Waterhouse-Friederichsen syn-drome in the Department of Forensic Medicine, Tongji Medical College were reviewed. Results 2 cases presented with pete-chiasis or ecchymosis, and both were misdiagnosed as allergic purpura and anaphylactic shock. However, cough, asthma and dyspnea were complained as main clinical manifestations in 1 case, which was misdiagnosed as respiratory tract infection. All the patients with acute onset died soon. The forensic pathological diagnosis was acute adrenal function failure ( Waterhouse-Friederichsen syndrome) due to epidemic meningitis in 2 cases and acute adrenal function failure ( Waterhouse-Friederichsen syndrome) in 1 case. Conclusion This disease is rare, rapidly progressive and tends to be misdiagnosed. When diagnosis of Waterhouse-Friederichsen syndrome is definite, the patient should be treated as soon as possible. The effective strategy for treatment would be anti-coagulation with Heparin and anti-fibrinolytic drug and anti-shock remedy.

  12. Neurocisticercose: contribuição da necrópsia na consolidação da notificação compulsória em Ribeirão Preto-SP, Brazil Neurocysticercosis: contribution of autopsies to consolidation of the compulsory notification in Ribeirão Preto-SP, Brazil

    Directory of Open Access Journals (Sweden)

    LEILA CHIMELLI

    1998-09-01

    Full Text Available O presente estudo tem como objetivo a apresentação dos achados de cisticercose nas necrópsias realizadas no Serviço de Patologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP, no período de 1992 a 1997. Das 2522 necrópsias, a neurocisticercose foi detectada em 38 (1,5% dos casos. Destes, 22 (57,9% foram diagnosticados apenas na necrópsia enquanto 16 (42,1% apresentavam exames complementares consistentes com cisticercose. A análise dos prontuários médicos evidenciou que 21 (55,2% eram neurologicamente assintomáticos e a frequência das diversas manifestações clínicas estava de acordo com os dados da literatura. A elevada frequência de indivíduos assintomáticos detectados apenas através da necrópsia demonstra a importância desta como fonte complementar de dados para a consolidação da notificação compulsória da cisticercose. Embasado nos dados do presente estudo, o atual coeficiente de prevalência da cisticercose no município de Ribeirão Preto é 67 casos/100000 habitantes.Neurocysticercosis is a serious public health problem in several countries of Asia, Africa and Latin America. The objective of the present study is to present autopsy findings of neurocysticercosis in the Pathology Division of the University Hospital, Medical School of Ribeirão Preto, University of São Paulo, from 1992 to 1997. Neurocysticercosis was detected in 38 (1.5% of 2522 autopsies. In twenty two (57.9% of these, the diagnosis was made post-mortem, while 16 (42.1% had a previous diagnosis of cysticercosis based on laboratory and imaging studies. Reviewing the medical records, we found that 21 patients (55.2% were neurologically asymptomatic, while the various clinical manifestations in the others were in accordance with the literature. The high frequency of asymptomatic individuals detected only post-mortem indicates the importance of autopsies as an additional source of data to consolidate the compulsory

  13. Autopsia bucal post-exhumación en víctimas de un desastre masivo: Masacre de la Cárcel de Sabaneta, Maracaibo, Venezuela Post-exhumation buccal autopsy in victims of a massive disaster: the Sabaneta Jail Massacre, Maracaibo, Venezuela

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    J.L. Fereira Paz

    2002-10-01

    Full Text Available Ante la solicitud presentada por los parientes de víctimas no identificadas de la Masacre de la Cárcel de Sabaneta, Maracaibo, Venezuela, un tribunal ordenó la exhumación de cuatro cadáveres, quince días después de haber sido sepultados. Se observó una buena conservación de los restos con apreciable mantenimiento de las estructuras y contornos faciales. Se evidenció que el método de acceso a la cavidad oral empleado en la autopsia bucal pre-inhumación facilitó el abordaje para la autopsia post-exhumación, sin provocar mayor destrucción de los tejidos blandos y permitiendo la correcta manipulación tanto de las estructuras orales como de los dispositivos protésicos aportados como evidencias. En todos los casos se verificó la coincidencia de los datos obtenidos durante la autopsia pre-sepultura. Se concluye que cuando el proceso de inhumación se lleva a cabo siguiendo una adecuada planificación, se facilita una futura recuperación del cadáver cuando esta es requerida para completar el procedimiento de identificación.In view of the petition presented by the relatives of the unidentified victims of the Sabaneta Jail Massacre, Maracaibo, Venezuela, a court ordered the exhumation of four corpses, fifteen days after they were buried. The remains were well preserved, the structure and facial outline were well conserved. It was evidenced that the method of access to the oral cavity employed in the pre-inhumation buccal autopsy facilitated the approach to the post-inhumation autopsy, without causing major destruction of the soft tissues and allowing for the correct manipulation of the oral structures as well as of the prosthetic appliances presented as evidence. In all cases, the coincidence of the data obtained during the pre-burial autopsy was verified. It was concluded that adequate planning of the inhumation process facilitates future recuperation of the bodies when this is required to complete the identification procedure.

  14. Estudo das malformações congênitas do aparelho urinário: análise de 6.245 necropsias pediátricas Study of urinary tract congenital malformations: analysis of 6,245 pediatric autopsies

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    Lucia de Noronha

    2003-09-01

    Full Text Available O presente estudo tece investigações sobre os aspectos epidemiológicos de malformações do aparelho urinário de uma população de natimortos, neomortos, lactentes, pré-escolares e escolares de uma amostra representativa da população de Curitiba e região metropolitana - análise de 40 anos de necropsias na Unidade de Patologia Pediátrica e Perinatal (UPPP do Serviço de Anatomia Patológica do Hospital de Clínicas de Curitiba da Universidade Federal do Paraná (UFPR. Variáveis como sexo, idade, faixa etária e causas de morte são correlacionadas, estratificando a amostra em grupos específicos de indivíduos, apontando anormalidades epidemiológicas, doenças raras e a relação das doenças com o processo de morte. Foram encontrados 182 casos com malformações do aparelho urinário, correspondendo a 2,9% do número de necropsias avaliadas. Não foram observadas diferenças entre os sexos, e houve maior prevalência de recém-natos com tais anormalidades. A classe mais prevalente foi a de malformações renais e de trato urinário superior, com 150 casos.The presented study investigates epidemiologic aspects regarding congenital malformations of the urinary tract in a representative sample of stillborns, newborns, infants and children from Curitiba, analising autopsies from the Pediatric and Perinatal Pathology Unit (Service of the Clinical Hospital - Curitiba, Paraná in a 40-year period. Sex, age groups and death causes are correlated, dividing the cases in specific groups of study, revealing epidemiologic abnormalities, rare diseases and diseases related to the death process. Out of 6,245 autopsies, 182 cases (2.9% presented urinary tract congenital malformations. There was no difference between sex, and the group of newborns was the most prevalent. The group of malformations of the kidney and upper urinary tract contributed with 150 abnormalities.

  15. Muerte inesperada súbita en el Servicio de Urgencias, de paciente tratada por neurosis de ansiedad, portadora de un feocromocitoma descubierto durante la autopsia. Sudden unexpected death at the medical Emergency Service of a patient, treated for anxiety neurosis, who had a heochromocytoma, found at forensic autopsy.

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    A. Serratosa

    2002-07-01

    unexpected death, which took place at the Medical Emergency Service, of a patient diagnosed with anxiety neurosis. The forensic autopsy discovered the existence of a pheochromocytoma of the left suprarenal medulla.

  16. Identificação de agentes infecciosos pulmonares em autópsias de pacientes com a síndrome da imunodeficiência adquirida Identification of infectious agents in the lungs in autopsies of patients with acquired immunodeficiency syndrome

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    Sanivia Aparecida de Lima Pereira

    2002-12-01

    Full Text Available As afecções pulmonares são freqüentes em indivíduos infectados pelo vírus da imunodeficiência humana. Neste trabalho, procurou-se identificar através de histoquímica e imunohistoquímica, agentes infecciosos nos pulmões de indivíduos portadores da síndrome da imunodeficiência adquirida (SIDA, autopsiados entre março de 1990 e julho de 2000 na FMTM. Fragmentos de pulmão de 40 indivíduos com SIDA autopsiados foram analisados histologicamente. Foram identificados agentes infecciosos em 34 (85% casos dos 40 analisados, sendo que bactérias foram encontradas em 22 (55% casos. Entre os agentes fúngicos o Pneumocystis carinii foi encontrado em oito (19,1% casos; Cryptococcus sp em quatro (9,5%, Histoplasma sp em dois (4,8% e Candida sp em um (2,4% caso. Detectou-se também associação entre Pneumocystis carinii, Citomegalovirus e Cryptococcus sp; CMV e Toxoplasma gondii. Em cinco casos, Candida sp, CMV e Pneumocystis carinii estiveram associados a bactérias. Entre as infecções não bacterianas, os fungos foram os agentes infecciosos mais isolados dos pulmões em autópsias de indivíduos com SIDA, sendo o Pneumocystis carinii o mais freqüente.Lung diseases are frequently observed in individuals infected with HIV. The aim of this study was to identify infectious agents in the lungs in the autopsied individuals with AIDS performed between march 1990 and july 2000 at the school of medicine (Uberaba- Brazil, using histochemical and immunohistochemical techniques. Analysis was made on lungs obtained from 40 individuals with AIDS. Infectious agents were observed in 34 (85% cases of the 40 analyzed. Regarding fungis, Pneumocystis carinii was found in 8 (19.1%cases; Cryptococcus sp in 4 (9.5%cases, Histoplasma sp in 2 (4.8%cases and Candida sp in 1 (2.4%case. Association of Pneumocystis carinii, Citomegalovirus and Cryptococcus sp, was observed in one case, and in another, the association of CMV, and Toxoplasma gondii. There were 5 cases

  17. Gastro-intestinal ascariasis--an unusual autopsy case report.

    Science.gov (United States)

    Kanchan, Tanuj; Wasti, Harihar; Acharya, Jenash

    2015-09-01

    Ascaris lumbricoides or roundworms' propensity to produce large number of eggs that are resistant to extremes of environmental conditions have made them one of the highly prevalent and geographically well distributed nematodes among poor socio-economic regions throughout the world. We present an unusual case of fatal gastro-intestinal ascariasis where general neglect, and firm and prolonged reliance on traditional healing methods led to aggregation of roundworms to such an extent that otherwise seems improbable in modern times and, hence, is worth reporting.

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

    OpenAIRE

    Dinyain A; Omoniyi-Esan GO; Olaofe OO; Sabageh D; Komolafe AO; Ojo OS

    2013-01-01

    Amatare Dinyain,1 G Olutoyin Omoniyi-Esan,2 Olaejirinde O Olaofe,3 Donatus Sabageh,3 Akinwumi O Komolafe,2 Olusegun S Ojo21Department of Anatomic Pathology, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria; 2Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria; 3Department of Morbid Anatomy and Histopathology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, NigeriaAim: Maternal mortality is a maj...

  19. AN AUTOPSY OF THE SOUTH KOREAN MARKET: DYNAMICS AND CONTRADICTIONS

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    You-Il Lee

    2003-01-01

    Full Text Available The most dynamic feature of the South Korean economy in the late 20th century is the emergence of the country as a major destination for foreign investors. However, because the market has been closed to outsiders, for almost two decades, except for certain industries, Korea is as yet an unknown entity among the global business community. This acts as a deterrent to market entry. It is evident that among the economic and business literature there has been limited emphasis on the cultural and other complications such as the position and influence of the chaebol (a group of mostly family owned conglomerates in Korea that exists for foreign businesses in the Republic of Korea. This paper attempts to crystallize some of the key cultural issues, examine their relevance and highlight some consequences of the lack of understanding of these cultural issues for the world's leading multinational corporations wishing to enter the Korean market.

  20. The Chemical Adventures of Sherlock Holmes: Autopsy in Blue

    Science.gov (United States)

    Waddell, Thomas G.; Rybolt, Thomas R.

    2004-01-01

    A chemical mystery with an emphasis on qualitative inorganic analysis, forensic chemistry and medicinal substances is discussed. The mystery is solved by Sherlock Holmes with the help of clues provided.

  1. An autopsy case of multiple psychotropic drug poisoning.

    Science.gov (United States)

    Tanaka, Naoko; Kinoshita, Hiroshi; Nishiguchi, Minori; Jamal, Mostofa; Kumihashi, Mitsuru; Takahashi, Motonori; Nishio, Hajime; Ameno, Kiyoshi

    2011-07-01

    A fatal poisoning case involving etizolam, phenobarbital, promethazine and chlorpromazine is presented. Quantitative toxicological analysis showed that the concentrations of etizolam, phenobarbital, promethazine and chlorpromazine in the femoral blood were 86 ng/ml, 5082 microg/ml, 0.107 microg/ml and 0.144 microg/ml, respectively, and large amounts of drugs were also detected in the stomach contents. We conclude that the cause of death was due to the interaction of multiple psychotropic drugs. PMID:21887897

  2. Surveillance of abused drugs in forensic autopsy cases in Norway

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    Svetlana V. Konstantinova-Larsen

    2011-12-01

    Full Text Available High drug related mortality has been registered in Norway. Although comparison between countries relies on a standard international coding system of diseases, different practices in verifying cause of death and applying codes could lead to variation. The comparison gives no information on drug findings or drug patterns underlying the cause of deaths. To evaluate deaths involving illicit drugs in Norway, we examined drug patterns in 2735 forensically examined post-mortem samples collected from 15-64 year-old individuals from 2000 to 2009. There were four times as many men as women among the deceased illicit drug users, and the majority were in the age group 25-44 years. The number of deceased showing signs of illicit drug use has gradually declined during the study period. The decline was found among younger individuals, while a larger proportion of the deceased were above 45 years of age in 2009, compared to 2000. Cases positive for heroin, ethanol, ecstasy and flunitrazepam were fewer in 2009, while the prevalence of amphetamine, cannabis, methadone and other opioids has increased. The prevalence of methamphetamine has increased ten fold, and the prevalence of benzodiazepines doubled. Thus, the drug pattern and age of the deceased has changed markedly during the last 10 years. Heroin and ethanol use has partly been substituted by use of amphetamines, cannabis, benzodiazepines and other opioids. This change could possibly be explained by the prolonged survival of drug users on substitution treatment and by the reduced toxicity of consumed drugs.

  3. Autopsy report for chemical burns from cresol solution.

    Science.gov (United States)

    Emoto, Yuko; Yoshizawa, Katsuhiko; Shikata, Nobuaki; Tsubura, Airo; Nagasaki, Yasushi

    2016-01-01

    Cresol, which is used as a disinfectant and insecticide, has erosive effects on epidermal and epithelial tissues in the body. Oral exposure causes gastrointestinal corrosive injuries as a direct chemical burn. We report herein a case of suicidal poisoning by ingestion of cresol solution. An octogenarian man with depression was found dead approximately 14 h after exposure to less than 500 mL of saponated cresol solution. Macroscopically, corrosive lesions such as red-to-brown-colored epithelium and edematous thickening of walls were seen in the skin, mouth, oral cavity, esophagus, and stomach. Histopathologically, coagulative necrosis and vascular dilatation were detected from mucosal to muscular layers in the esophagus, stomach, and duodenum. Congestive edema of the lungs, edematous changes in the brain, and proximal tubular necrosis of the kidneys were seen, suggesting acute circulatory disturbance due to shock. This human case offers valuable information on the direct irritation and shock induced by systemic exposure to corrosive substances.

  4. Citalopram concentrations in samples from autopsies and living persons

    DEFF Research Database (Denmark)

    Worm, Karen; Dragsholt, Claus; Simonsen, Kirsten Wiese;

    1998-01-01

    Retskemi,Citalopram,fatal concentrations,toxic concentrations,therapeutic concentrations,metabolites......Retskemi,Citalopram,fatal concentrations,toxic concentrations,therapeutic concentrations,metabolites...

  5. Autopsy-proven determinants of immediate fire death in lungs.

    Science.gov (United States)

    de Paiva, Luiz A S; Parra, Edwin R; da Rosa, Danieli C; Farhat, Cecília; Delmonte, Carlos; Capelozzi, Vera L

    2008-12-01

    In immediate fire deaths, pulmonary injury may be the main source of mortality, being important to document the histologic findings for the purpose of excluding other modes of death, such as from asphyxia with no gross findings. In this context, a group of morphologic determinants have been targeted with useful makers of pulmonary injury. To facilitate the determination of whether an individual was deceased before the start of a fire and validate the importance of parenchymal alterations in pulmonary injury in fire deaths, we studied lungs in victims of fire (N = 28) and suffocation (N = 40), creating a mathematical model using cluster analysis. For this purpose, a semiquantitative analysis of the distal parenchyma was performed to evaluate the amount of bronchiolar dilatation, overinsufflation (ductal and alveolar), collapse (ductal and alveolar), passive congestion, alveolar edema, and hemorrhage (interstitial and alveolar). These 7 histologic determinants were useful to discriminate fire (bronchiolar dilatation, ductal overinsuflation, alveolar overinsuflation, alveolar hemorrhage) from suffocation lung injuries (alveolar collapse, congestion, and edema). We conclude that these determinants should be included in the routine of forensic pathology.

  6. The injured France: autopsy of a climatic catastrophe; La France blessee: autopsie d'une catastrophe climatique

    Energy Technology Data Exchange (ETDEWEB)

    Desbois, M.; Pouradier, G.

    2000-07-01

    Using the storms that ravaged the French territory in December 1999 as a starting point, this book takes stock of the climatic and ecological situation of the Earth: greenhouse effect, pollution, oceanic circulation and climates regulation, global warming, deforestation and carbon recycling, land use etc.. (J.S.)

  7. Utilidad de la determinación de la fracción I de la Troponina cardíaca (cTnI, en el diagnóstico de la muerte súbita de origen cardíaco en autopsias forenses Usefulness of cardiac troponin I (cTnI in the diagnosis of sudden cardiac death in forensic autopsies

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    E. Navarro

    2007-07-01

    Full Text Available Objetives: To evaluate practical usefulness of cardiac Troponin analysis (cTnI in peripheral blood levels, in order to improve diagnosis of sudden cardiac death in routine forensic cases. Comparing these levels with Myoglobin and MB-CK blood levels in the same type of samples. Material and methods: We have studied 97 medico legal autopsies performed in the Pathology Service of the Institute of Legal Medicine (Alicante. In every case we analyzed sample of serum from peripheral blood (femoral, by Microparticle Enzyme Immunoassay (MEIA Axsym system (Abbott Diagnostics. Causes of death were classified into 6 groups according: 1 Death of cardiac origin (n=42; 2 Traumatic deaths (n=19; 3 Death by asphyxia (n=12; 4 Natural deaths of non-cardiac origin (n=8; 5 Miscellaneous group (n=6, and 6 Traumatic death with Thoracic trauma (n=10. Data was analysed by means of SPSS 14.0 statistical software program (SPSS Inc, 2005. Results: cTnI levels were significantly high in cases of sudden cardiac death, but it were also high in the group of thoracic trauma, which could raise diagnosis problems between these groups, as was shown previously in the literature. Conclusions: The determination of cTnI is more efficient than CKMB and Myoglobine in the diagnosis of sudden cardiac death. However, the elevation of mean levels of this marker in cases of severe thoracic traumatism limits its diagnostic usefulness in these situations.

  8. La causa y la manera de la muerte indeterminada: a propósito de un caso de muerte súbita en adolescente, portador de una tumoración quística intestinal, descubierta durante la autopsia Cause and Manner of Death Undetermined: regarding a case of sudden death in an adolescent with an intestinal cystic tumour, discovered during autopsy

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    A. Garfia

    2002-04-01

    and death. During the forensic autopsy the existence of a mesenteric tumour was discovered in the distal ileum. The corpse gave off a peculiar smell which reminded the pathologist of the typical smell of some organophosphorous pesticides. The following diagnoses for the cause of death were put forward in the pathologists report: 1 Septic shock due to intestinal abscess. 2 Mortal poisoning by pesticides. 3 Sudden cardiac death. The chemical-toxicological investigation resulted negative. The histopathologic study did not show cardiac lesions which could justify the death, and the study of the mesenteric tumour showed that it was a cystic intestinal duplication, with discreet chronic inflammation of the wall; ulcerations, haemorrhage, vascular or ischaemic intestinal lesions which could have justified sudden death with digestive causes, were not seen. The cause and manner of death were considered undetermined.

  9. Renal involvement in human rabies: clinical manifestations and autopsy findings of nine cases from northeast of Brazil Envolvimento renal na raiva em humanos: manifestações clínicas e achados de autópsia de nove casos do nordeste do Brasil

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    Elizabeth De Francesco Daher

    2005-12-01

    Full Text Available A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 ± 34 days. The time until death ranged from one to nine days (mean 3.3 ± 5.5 days. The signs and symptoms presented were fever, hydrophobia, aerophobia, agitation, disorientation, dyspnea, sialorrhea, vomiting, oliguria, sore throat, pain and hypoesthesia in the site of the bite, headache, syncope, cough, hematemesis, mydriasis, hematuria, constipation, cervical pain and priapism. In three out of six patients, there was evidence of acute renal failure, defined as serum creatinine > 1.4 mg/dL. The post-mortem findings in the kidneys were mild to moderate glomerular congestion and mild to intense peritubular capillary congestion. Acute tubular necrosis was seen in only two cases. This study shows some evidence of renal involvement in rabies. Histopathologic findings are nonspecific, so hemodynamic instability, caused by autonomic dysfunction, hydrophobia and dehydration must be responsible for acute renal failure in rabies.Foi realizado estudo retrospectivo de nove casos de raiva internados em um hospital de Fortaleza, Brasil. Autópsia foi realizada em todos os casos. As idades variaram de 3 a 81 anos. Todos foram agredidos por cães. O tempo entre o acidente e a admissão hospitalar variou de 20 a 120 dias (média de 45 ± 34 dias. O tempo de internamento variou de 1 a 9 dias (média de 5.5 ± 3.1 dias. Os sinais e sintomas observados foram febre, hidrofobia, aerofobia, agitação, desorientação, dispnéia, sialorréia, vômitos, oligúria, faringite, dor e hipoestesia no local da mordida, cefaléia, síncope, tosse, hematêmese, midríase, hematúria, constipação, dor cervical e priapismo. Em três de seis pacientes

  10. Relationship between the morphologic alterations of vocal cords from adult autopsies and the cause of death Avaliação morfológica da membrana basal das cordas vocais de adultos autopsiados e sua correlação com as causas de óbito

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    Ana Karina Marques Salge

    2004-01-01

    Full Text Available PURPOSE: The purpose of this study was to identify the possible alteration in the thickness of the epithelium basal membrane of the vocal cords and correlate it with the cause of death. METHOD: Larynxes collected from adult autopsies during the period of 1993 to 2001 were utilized. We used the hematoxylin-eosin and periodic acid-Schiff staining methods for the morphological and morphometric analysis. RESULTS: Sixty-six vocal cords were analysed; increased thickness was identified in 14 cases (21.2%, with equal proportions between the genders. Increased vocal-cord thickness was more frequent in patients of the white ethnicity (12 cases, 85.7%. Respiratory alterations were found in 10 (71.4% of the cases with increased vocal-cord thickness. Of the patients that were maintained with mechanical ventilation before death, 7 (18.4% had thickening of the basal membrane. Among the smokers, 9 (19.63% had basal membrane thickening. CONCLUSION: No statistically significant differences were found between the cases in which the cause of death was related to respiratory diseases as compared to non-respiratory diseases and the thickening of the basal membrane of the vocal cords. However, new studies are needed in order to verify the etiopathogenesis of this thickening.OBJETIVO: O objetivo deste trabalho foi identificar as possíveis alterações na espessura da membrana basal das cordas vocais e relacionar estas com a causa de morte. MÉTODO: Foram utilizadas laringes coletadas de adultos autopsiados, no período de 1993 até 2001. Realizamos as colorações da Hematoxilina- Eosina e Ácido Periódico de Schiff, onde foi medido o diâmetro da membrana basal. RESULTADOS: Foram analisadas 66 cordas vocais, o espessamento foi identificado em 14 casos (21,2%, sendo encontrado em proporções iguais entre os sexos, sendo freqüente em pacientes da cor branca (12 casos, 85,7%. Foram encontradas alterações respiratórias em 10 (71,4% dos casos com espessamento

  11. Psychological autopsy study of gender-specific psychological characteristics of rural young suicides%农村青年男女自杀死亡者心理状态和心理特征的心理解剖研究

    Institute of Scientific and Technical Information of China (English)

    孔媛媛; 张杰

    2011-01-01

    目的:比较农村青年男女自杀死亡者的心理状态和心理特征,比较心理因素指标相关的自杀危险程度在农村青年男女间的差异.方法:在山东、辽宁、湖南随机抽取16个县/市,采用心理解剖方法对392例15~34岁自杀死亡者进行研究;并就心理因素指标相关的自杀危险程度与从调查地点随机抽取的416例同年龄段对照进行两水平多层非线性模型分析.结果:自杀死亡者中,男性相对于女性具有更高的绝望感、抑郁水平及特质焦虑程度(均P<0.05),冲动性和应对技能的性别差异没有统计学意义.心理因素指标相关的自杀危险程度比较,"问题解决"和"寻求代偿"能力对女性自杀死亡风险的降低作用显著高于男性(均P<0.05),"认知回避"和"发泄情绪"应对方式对男性自杀死亡风险的增加作用显著高于女性(均P<0.05).结论:自杀死亡心理危险因素在农村青年男性自杀死亡者中评分更高,心理因素指标相关的自杀危险程度的性别比较多数没有显著性差异.%Objective: To compare the psychological characteristics between rural young male and female suicides, and compare the influences of the psychological factors on suicide between rural young men and women. Methods: Sixteen counties or county-level cities in Shandong, Liaoning and Hunan provinces were randomly selected. Totally 392 suicides aged 15 ~ 34 years old were studied by using psychological autopsy method. Hierarchical Linear and Nonlinear Modeling (HLM) was applied to calculate the OR values of psychological factors by using 392 suicides and 416 controls with the same age range which were randomly selected from the 16 selected sites. Results: Rural young male suicides had more severe hopelessness, depression, and trait anxiety (Ps < 0. 05). There was no significant gender difference in neither impulsivity nor coping skills. The comparison of odds ratio values of the psychological factors showed that

  12. Peso dos ventrículos cardíacos determinado em necropsia de indivíduos saudáveis mortos por causas externas Cardiac ventricular weights recorded at the autopsy of healthy subjects who died of external causes

    Directory of Open Access Journals (Sweden)

    Sérgio Lamêgo Rodrigues

    2007-11-01

    Full Text Available OBJETIVO: Determinar o peso dos ventrículos cardíacos em necropsia de indivíduos sadios vítimas de morte acidental, visando determinar padrões de normalidade em nossa população. MÉTODOS: Foram examinados 94 corações no Instituto Médico Legal de Vitória. Após remoção do coração e ressecção dos átrios e gordura epicárdica, os ventrículos direito (VD e esquerdo (VE, incluindo o septo, foram separados e pesados e a massa indexada pela altura. O teste de Kolmogorov-Smirnov foi usado para testar normalidade da distribuição. Os dados são apresentados como média ± desvio padrão. RESULTADOS: Após 12 exclusões (doença cardiovascular possível detectada após a morte foram analisados 82 corações (52 homens e 30 mulheres, 16-68 anos, média 31±12 anos. O peso do VE foi de 181±25 g e 125±15 g, do VD foi de 54±7 g e 38±6 g e a massa de VE indexada pela altura foi de 105±14 g/m e 78±8 g/m para homens e mulheres, respectivamente. O P95 do peso do VE foi de 218 g e 128 g/m em homens e 148 g e 88 g/m em mulheres. Não detectamos correlação significante entre a massa ventricular e idade. CONCLUSÃO: O peso do ventrículo esquerdo do coração dos homens da nossa amostra foi superior aos relatados na literatura contemporânea. Nossos resultados sugerem que a presença de hipertrofia de VE pode ser inferida em presença de massa de VE superior a 218 g ou 128 g/m nos homens e 148 g ou 88 g/m nas mulheres.OBJECTIVE:To establish cardiac ventricular weights recorded during the autopsy of healthy individuals who died of external causes, aiming at determining normality patterns in our population. METHODS:A total of 94 hearts were evaluated at the Forensics Department of the city of Vitória, Espírito Santo. After the heart removal and resection of the atria and epicardial fat, the right ventricle (RV and the left ventricle (LV, including the septum, were separated and weighed and the mass was indexed by the height. The Kolmogorov

  13. Prevalência e padrão de distribuição das doenças cerebrovasculares em 242 idosos, procedentes de um hospital geral, necropsiados em Belo Horizonte, Minas Gerais, no período de 1976 a 1997 Prevalence and types of cerebrovascular diseases in 242 hospitalized elderly patients, autopsied in Belo Horizonte, Minas Gerais, Brazil, from 1976 to 1997

    Directory of Open Access Journals (Sweden)

    José Eymard H. Pittella

    2002-03-01

    Full Text Available OBJETIVO: Descrever a prevalência e os tipos das doenças cerebrovasculares (DCVs em indivíduos idosos necropsiados. MÉTODO: Foram consultados os laudos neuropatológicos de 242 pacientes com idade igual ou superior a 61 anos, procedentes em sua maioria do Hospital das Clínicas da Universidade Federal de Minas Gerais, em Belo Horizonte, Minas Gerais, e necropsiados consecutivamente no período 1976 a 1997. RESULTADO: Os principais grupos de doenças do sistema nervoso central (SNC foram representados por DCVs (71,9%, infecções (12,4%, neoplasias (7,1%, traumatismos crânio-encefálicos (3,7%, doenças nutricionais (2,5% e doenças degenerativas (1,7%. As DCVs mais frequentes foram: aterosclerose (61,2%, doença cerebrovascular hipertensiva (25,6% e infarto cerebral (14,9%. Observou-se aumento da frequência e da gravidade da aterosclerose e da frequência da doença cerebrovascular hipertensiva com o avançar da idade. Houve associação significativa entre doença cerebrovascular hipertensiva e aterosclerose. As DCVs foram clinicamente sintomáticas e as responsáveis diretas pelo óbito em 42,7% e 17,3% dos pacientes, respectivamente. CONCLUSÃO: As DCVs constituíram o principal grupo de doenças do SNC no idoso. A aterosclerose e a doença cerebrovascular hipertensiva foram as principais doenças deste grupo, notando-se aumento de sua frequência com o avançar da idade e associação significativa entre ambas.OBJECTIVE: To describe the prevalence and the types of cerebrovascular diseases (CVDs in autopsied elderly individuals. METHOD: Consecutive clinical charts and neuropathological reports of 242 patients aged 61 years or older were reviewed. The patients died in Hospital das Clínicas, Federal University of Minas Gerais, in Belo Horizonte, Minas Gerais, Brazil, from 1976 to 1997. RESULTS: The prevalent diseases of the central nervous system (CNS found in decreasing order were: CVDs (71.9%, infections (12.4%, neoplasms (7.1%, head

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

    DEFF Research Database (Denmark)

    Hansen, B F

    1992-01-01

    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...

  15. Autopsy case of lymphangiosarcoma arising from the postoperative and postirradiated site of lymphangioma of the thigh

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Tomotsugu; Fujiwara, Masayuki; Yoshie, Haruhiko; Hotchi, Masao (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

    1983-01-01

    A 25-year-old man had undergone resection of lymphangioma on the anterior aspect of left thigh and postoperative irradiation at the age of seven. About ten years later, lymphangiosarcoma developed at the postoperative site and he died despite wide resection, chemotherapy and irradiation. Microscopically, the malignant cells were arranged in an angiomatous pattern with endthelial lining. Ultrastructural examination of the tumor suggested the dual origin from blood and lymphatic capillaries. The pathogenesis of the tumor was considered to be closely related to local disturbances in lymph circulation at the postoperative site although no lymphedema was present.

  16. Acute Placental Villitis as Evidence of Fetal Sepsis: An Autopsy Case Report.

    Science.gov (United States)

    Bae, Go Eun; Yoon, Nara; Choi, Misun; Hwang, Soohyun; Hwang, Hyewon; Kim, Jung-Sun

    2016-01-01

    Acute placental villitis is very rare and believed to reflect overwhelming fetal sepsis in utero, commonly caused by Escherichia coli or group B streptococci. We present a case of intrauterine fetal death associated with acute placental villitis and acute necrotizing chorioamnionitis by early-onset group B streptococcal infection. A 36-year-old woman presented with decreased fetal movement and fever at 21 weeks of gestation. Ultrasound demonstrated intrauterine fetal death. After delivery, the placenta revealed multifocal neutrophilic infiltration in chorionic villi, most prominently beneath the trophoblast basement membrane, which was also accompanied by acute necrotizing chorioamnionitis. Gram-positive microorganisms were detected in villous vessels as well as in the major organs of the fetus, which was consistent with Streptococcus agalactiae (group B) cultured from maternal blood. Acute placental villitis should be recognized as evidence of fetal sepsis that often has lethal clinical outcome, as compared to intra-amniotic infection associated with acute chorioamnionitis alone. PMID:26457860

  17. 20 CFR 410.428 - X-ray, biopsy, and autopsy evidence of pneumoconiosis.

    Science.gov (United States)

    2010-04-01

    ... according to: (i) The ILO-U/C International Classification of Radiographs of Pneumoconioses, 1971; or (ii... ILO Classification (1958) or Short Form (1968) will be reclassified as Category 0 or Category 1...

  18. From Autopsy to Biopsy: A Metacognitive View of Lesson Planning and Teacher Trainees in ELT

    Science.gov (United States)

    Liyanage, Indika; Bartlett, Brendan John

    2010-01-01

    Lesson planning and implementation of those plans are complex and cognitively demanding for English Language Teacher trainees preparing for the profession. Many find it difficult to develop a lesson holistically and to maintain alignment across aims, procedural steps, and evaluation when planning and implementing a lesson. We attempted to address…

  19. The Pathological Features of Dissemination of Lymphoma in the Heart in 42 Autopsy Cases

    Institute of Scientific and Technical Information of China (English)

    Siqing Feng; Wenchen Huang; Limei Liu; Yanqin Liu; Fan Zhou; Xuemei Zhang

    2005-01-01

    OBJECTIVE To study the pathological features of dissemination of lymphoma in the heart and understand its influence on cardiac function.METHODS Forty-two patients who died of lymphoma were autoposied and the gross and microscopic pathological changes of the heart observed.RESULTS Eight (19.05%) out of 42 cases had heart dissemination in the pericardium and heart wall. The dissemination features noted were of a nodular type, diffuse type and mixed type, leading to neoplastic myocarditis.CONCLUSION The pathological features of dissemination of lymphoma in the heart are varied, and the different types can produce dissimilar influences in heart function.

  20. 尸检教学的衰亡%Death of the teaching autopsy

    Institute of Scientific and Technical Information of China (English)

    Gregory O' Grady

    2004-01-01

    尸检不再在医学教学中扮演主要角色,在奥克兰已禁止尸检用于教学;以尸检为基础的教学传授了有用的技能,有些是从其他地方难以学到的;那些在校期间未接受过尸检教学的医生不太可以在今后的工作中要求尸检

  1. Unsuspected meningioma in a patient with pituitary gigantism. Case report with autopsy findings

    Energy Technology Data Exchange (ETDEWEB)

    Stock, J.M.; Ghatak, N.R.; Oppenheimer, J.H.

    1975-06-01

    A unique example of a clinically unsuspected large parasellar meningioma is described in a 36-yr-old pituitary giant who had been treated initially with conventional irradiation, subsequently by surgical excision of an acidophil adenoma, and ultimately with medroxyprogesterone acetate (MPA) prior to his demise. The patient died of increased intracranial pressure resulting from a combined mass effect of the meningioma and recurrent tumor. The relationship between radiation and the development of the meningioma is discussed, as well as the fine ultrastructure of a highly functioning acidophil adenoma.

  2. Sudden death due to an unrecognized cardiac hydatid cyst: three medicolegal autopsy cases.

    Science.gov (United States)

    Pakis, Isil; Akyildiz, Elif Ulker; Karayel, Ferah; Turan, Arzu Akcay; Senel, Berna; Ozbay, Mehmet; Cetin, Gursel

    2006-03-01

    Echinococcosis is a human infection caused by the larval stage of Echinococcocus granulosus. The most common sites of infection are the liver and the lungs. Cardiac hydatid cysts are very rare, even in regions where hydatic cysts are endemic (the Mediterranean, South America, Africa, and Australia). It has been reported that cardiac involvement is seen in about 0.5-3% of human echinococcosis cases. Three cases of cardiac hydatid disease that caused sudden death and which were histopathologically diagnosed are reported. Cardiac echinococcosis is rare, but due to its insidious presentation and affinity to cause sudden death, it is important that it be identified in the histopathological examination.

  3. Cardiac injuries caused by blunt trauma: an autopsy based assessment of the injury pattern.

    Science.gov (United States)

    Turan, Arzu Akcay; Karayel, Ferah Anik; Akyildiz, Elif; Pakis, Isil; Uzun, Ibrahim; Gurpinar, Kagan; Atilmis, Umit; Kir, Ziya

    2010-01-01

    Nonpenetrating chest trauma with injury to the heart and aorta has become increasingly common, particularly as a result of rapid deceleration in high-speed vehicular accidents, over the past 2-3 decades. The high mortality rate of cardiac injuries and possible late onset complications make blunt cardiac injuries an important challenging point for legal medicine. One hundred and ninety cases with blunt cardiac injuries in a period of 3 years were analyzed retrospectively in terms of patterns of cardiac injury, survival times, and demographic profiles of the cases in this study.

  4. Oral autopsy: A simple, faster procedure for total visualization of oral cavity.

    Science.gov (United States)

    Charan Gowda, Boregowda Kadaiah; Mohan, C V; Hemavathi

    2016-01-01

    Identification of humans, especially in mass disaster is a challenging aspect for team members of the disaster victim identification (DVI) unit. Identification is necessary for humanitarian and emotional reasons and for many legal issues, particularly for family members. In the modern day, all possible methods have been applied for establishing the identification of deceased individuals. The DVI team comprises specialists from different disciplines. The forensic dentist plays a major role in the identification of victims in disaster. To establish a simple, faster and time saving procedure for Postmortem dental identification in mass disaster. In this article, we present a simpler and faster method, which helps in gaining access into the oral cavity that helps in the recording of postmortem oral findings where required. PMID:27555728

  5. Diagnostic yield of molecular autopsy in patients with sudden arrhythmic death syndrome using targeted exome sequencing

    DEFF Research Database (Denmark)

    Nunn, Laurence M; Lopes, Luis R; Syrris, Petros;

    2016-01-01

    ). Targeted exome sequencing of 135 genes associated with cardiomyopathies and ion channelopathies was performed on the Illumina HiSeq2000 platform. Non-synonymous, loss-of-function, and splice-site variants with a minor allele frequency

  6. Performing a stellar autopsy using the radio-bright remnant of SN 1996cr

    CERN Document Server

    Meunier, C; Dwarkadas, V V; Koribalski, B; Emonts, B; Hunstead, R W; Campbell-Wilson, D; Stockdale, C; Tingay, S J

    2013-01-01

    We present archival radio observations of SN1996cr from ATCA and MOST, and model its radio lightcurves using X-ray constrained hydrodynamical simulations of the interaction between the SN ejecta and the CSM. The early radio data show signs of free-free absorption (FFA), which decreases gradually and is minimal above 1.4 GHz after day ~3000. FFA optical depth constraints provide estimates of the CSM free electron density, which allows insight into the ionisation of SN1996cr's CSM and offers a test on the density distribution adopted by the hydrodynamical simulation. The intrinsic spectral index of the radiation shows evidence for spectral flattening, which is characterised by alpha = 0.852 +/- 0.002 at day 3000 and a decay rate of d_alpha = -0.014 +/- 0.001 yr^-1. The similarity in the spectral flattening of SN1987A, SN1993J, and SN1996cr suggests this may be a relatively common feature of SNe/CSM shocks. We adopt this spectral index variation to model the synchrotron radio emission of the shock, and consider ...

  7. An autopsy case of meningeal carcinomatosis with parenchymal invasion through the cranial and spinal nerve roots.

    Science.gov (United States)

    Kon, Tomoya; Funamizu, Yukihisa; Miki, Yasuo; Tomiyama, Masahiko; Baba, Masayuki; Kurotaki, Hidekachi; Wakabayashi, Koichi

    2014-10-01

    Meningeal carcinomatosis is a well-known complication of malignant neoplasms. We report a case of meningeal carcinomatosis of 2 months' duration in a 22-year-old man, in whom the initial symptom was gradually worsening headache. Postmortem examination revealed infiltrating adenocarcinoma of the stomach. Carcinoma cells showed diffuse spread to the subarachnoid space of the brain and spinal cord. In many places, subarachnoid tumor cells had infiltrated to the cranial and spinal nerves. Moreover, carcinoma cells in the nerve roots extended to the parenchyma of the brain and spinal cord beyond the CNS-peripheral nervous system junction. These findings suggest that cranial and spinal nerve roots can be a possible route of parenchymal invasion in meningeal carcinomatosis. PMID:24779918

  8. Suicidal insulin poisoning with nine day survival: recovery in bile at autopsy by radioimmunoassay

    International Nuclear Information System (INIS)

    The discovery of insulin fifty years ago enabled doctors to successfully treat an eleven year old boy dying from diabetes mellitus and thereby ushered in a new medical era. While millions of subsequent patients were thus able to lead productive lives, others turned this miraculous substance into self-destructive purposes, while a few attempted (and possibly succeeded in) carefully concealed homicidal undertakings. The first ''murder by insulin'' case, prosecuted with a conviction in Great Britain fifteen years ago, employed a laborious bioassay method to demonstrate the hormone at the site of injection. A recent series of insulin poisonings in California was dependent on pathological changes in the brain from anoxia (hypoglycemia) coupled with history and investigation rather than chemical measurements, although an immunoassay method was used for confirmation in the final case. Instances of suicidal attempts by self-administered insulin have been reported with analyses performed by radioimmunoassay, now employed in clinical laboratories to measure many hormonal and therapeutic substances. We have applied this principle from pathologic and toxicologic aspects in an effort to enhance the diagnostic capability of the forensic pathologist, who must examine and properly certify such deaths

  9. Mobile autopsy teams in the investigation of war crimes in Kosovo 1999

    DEFF Research Database (Denmark)

    Sprogøe-Jakobsen, S; Eriksson, A; Hougen, H P;

    2001-01-01

    On request of the International Criminal Tribunal for the former Yugoslavia (ICTY), the Danish-Swedish forensic teams worked in Kosovo during the summer and the fall of 1999. The teams worked mainly as "mobile teams" at sites with few graves. Only two larger sites were examined. Most of the bodies...

  10. Autopsy on the AMA: An Analysis of Healthcare Delivery Systems in America [1970

    Directory of Open Access Journals (Sweden)

    Joe Woodard

    2009-02-01

    Full Text Available Prepared by: Cy Schoenfield, Janet Brown, Joe Woodard, Jeff Brown, Martin Brown, Charles Turner, Jill Hill Published in 1970 by Student Research Facility, Berkeley, California Reproduced from the US Heath Activism History Collection Rare Book and Manuscript Library, University of Pennsylvania "The United States (has a quality of medical care unsurpassed anywhere," said Dr. Milford O. Rouse, President of the American Medical Association (the AMA in 1967. His position at the pinnacle of the most powerful country's most powerful medical organization certainly gave him the authority to say that with confidence. "People respect doctors. In fact, 92% of the public feels most doctors can be trusted. People in the medical therapy professions are admired and the communities they serve reward them well for their work. Doctors averaged $31,400 a year in 1967 and their median income was $32,170 in 1968. These figures are approximately five times the average and median incomes for the general population. "Medically speaking, things seem to be going well. The drama of headlines about organ transplants and new medical advances in the laboratory also serve to indicate that the System that provides health care for Americans does its job splendidly. But does it, really?"

  11. Briançon, 24 juillet 1995: autopsie et enseignements d'une catastrophe naturelle

    Directory of Open Access Journals (Sweden)

    Philippe LAHOUSSE

    1998-06-01

    Full Text Available L'épisode pluvio-orageux du 24 juillet 1995 dans le Briançonnais est à l'origine d'une série de crues torrentielles et de coulées de débris dévastatrices. L'approche cartographique, combinée à l'enquête historique, permet de mesurer l'ampleur du phénomène et contribue à une meilleure évaluation des dangers. Elle permet de mieux fonder la politique de prévention des risques.

  12. [Acute edematous encephalopathy presenting with refractory generalized status epilepticus: an autopsy case].

    Science.gov (United States)

    Yamashita, M; Yamamoto, T; Yasuda, T

    2001-11-01

    A previously healthy, 29-year-old man developed generalized convulsion with disturbed consciousness 3 days after the flu-like symptoms. On the next day, his convulsion evolved into generalized status epilepticus (GSE) that was unresponsive to administration of various anticonvulsants. Then, intravenous anesthetic agents, including midazolam, propofol and vecuronium sodium, were continuously infused. During the following 9 days, despite of high-dose infusion of these anesthetic agents, his GSE could not be suppressed, and complex partial seizure with secondary generalization frequently occurred. The patient was comatose and mechanically ventilated, whereas the brainstem reflexes were preserved. Electroencephalogram revealed a diffuse slowing of the background activity and occasional focal spike and wave complexes with secondary generalization. Cerebrospinal fluid analysis showed pleocytosis and elevated protein concentration. Cranial CT scans obtained on day 8 demonstrated brain edema. On day 10, his GSE ceased with abolition of the brainstem reflexes, and he lapsed into brain death resulting from the progressive brain edema. Over the following six days, his systemic circulation gradually worsened, and he died on day 16. On postmortem examination, the brain was markedly edematous and showed the findings consistent with acute anoxic encephalopathy with extensive circulatory stasis. Mild gliosis was observed in the insular cortex, yet no evidence of inflammatory disease was found throughout the brain. This patient was characterized by acutely progressive severe brain edema without inflammatory changes, suggesting that his primary disease was acute toxic encephalopathy presumably induced by viral infection. His GSE was refractory and unresponsive to the intensive treatment with the intravenous anesthetic agents. This case epitomizes the difficulties in controlling refractory seizures in some patients with encephalopathy or encephalitis.

  13. An "Autopsy" Approach to Frontier Press History: The Ghost Town Newspaper.

    Science.gov (United States)

    Burd, Gene

    An assessment of newspapers from ghost towns in the United States is proposed in this paper as a means of improving the definitions of frontier journalism beyond national time periods, expansion over geographical space, and primitive policy and practices. It is suggested that an evaluation be made by measurement and appraisal of those newspapers'…

  14. A multitude of variations in the configuration of the circle of Willis: an autopsy study.

    Science.gov (United States)

    Klimek-Piotrowska, Wiesława; Rybicka, Monika; Wojnarska, Aleksandra; Wójtowicz, Agnieszka; Koziej, Mateusz; Hołda, Mateusz K

    2016-09-01

    The circle of Willis (CW) is an anastomotic system of arteries located at the base of the brain. The aim of the study was to evaluate the anatomic configuration of the CW in the Polish population and to compare results with previously conducted research. Brains were obtained from 100 recently deceased human adults, and the diameters of cerebral vessels were measured using a slide caliper. Cerebral vessels were observed, paying attention to their origin, diameter, typical configuration and variations. Twenty-seven percent of cases presented the typical literature pattern. The remaining 73 % of all cases were atypical; in 16 % the CW was incomplete and in 57 % complete. Atypical findings involved the posterior communicating artery (PcomA), 62 %; anterior communicating artery (AcomA), 22 %; anterior cerebral artery (ACA), 14 %; posterior cerebral artery (PCA), 8 %. The most common variations were bilateral hypoplastic PcomAs (27 % of cases) and unilateral hypoplastic PcomAs (19 % of cases). Only 9 of the 22 types of CW variations classified previously in the literature were observed, and 26 variations (36 cases) in our study were labeled as 'other' type. Mean diameter values for typical CW patterns were internal carotid artery = 3.6 mm, ACA = 2.3 mm, AcomA = 1.9 mm, PCA = 2.2 mm and PcomA = 1.4 mm. Circle of Willis variations have a large impact on clinical practice. This study shows many rare variations that should be taken into consideration to avoid any unexpected complications during surgical procedures involving cerebral vessels. PMID:26439730

  15. Hepatosplenomegaly Associated with Transient Abnormal Myelopoiesis in Down Syndrome: An Autopsy Case of a Stillborn Fetus

    Directory of Open Access Journals (Sweden)

    Michiko Yuki

    2015-06-01

    Full Text Available A 38-year-old primiparous mother (gravida 1, para 0 at 27 weeks and 6 days' gestation reported that fetal movements had been absent for 6 days. All serological markers for infection were negative. Chorionic villus sampling at stillbirth delivery revealed trisomy 21 (47, XX, +21, indicative of Down syndrome. The macerated baby was female and weighed 1,290 g. There was no evidence of hydrops fetalis. Proliferating blast cells expressing megakaryoblastic/megakaryocytic antigen CD61 were mainly seen within the vessels, and some cells infiltrated outside of the vessels in almost all organs. Vessels of the umbilical cord and chorionic villi were filled with proliferating blast cells, but the blast cells were not apparent in the bone marrow. The diagnosis of transient abnormal myelopoiesis in Down syndrome was made. Hepatomegaly (64.5 g was due to congestion and infiltration of CD61-positive blast cells within the vascular lumina and expanding outside the lumina accompanied by fibrotic change. The cause of death was attributed to liver insufficiency caused by liver fibrosis. An umbilical cord and chorionic villi examination may be helpful in the diagnosis of transient abnormal myelopoiesis when post-mortem examination is not permitted.

  16. Autopsy Report with Clinical and Pathophysiologic Discussion of Autosomal Dominant Adult Polycystic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Anup Hazra

    2014-01-01

    Full Text Available The average weight of a kidney is approximately 135 gm, measuring on average 10 × 6 × 4 cm. In hereditary conditions, autosomal dominant and autosomal recessive polycystic kidney disease, the shape, size, and the weight can be significantly abnormal, causing progressive renal failure, often necessitating dialysis or renal transplant for survival. We report a case of adult polycystic kidney disease in a 50-year-old female without a family history, who died of complications of the disease which included accelerated hypertension, and renal and cardiac failure.

  17. Autopsy results of a case of ingestion of sodium hydroxide solution

    OpenAIRE

    EMOTO, Yuko; Yoshizawa, Katsuhiko; SHIKATA, NOBUAKI; Tsubura, Airo; Nagasaki, Yasushi

    2015-01-01

    Sodium hydroxide is a strongly corrosive alkali. We describe herein a case of suicide by ingestion of sodium hydroxide. A man in his 80s was found dead with a mug and a bottle of caustic soda. Macroscopically, liquefaction and/or disappearance of esophagus, trachea and lung tissue and a grayish discoloration of the mucosa of the stomach were seen along with blackish brown coloration of the skin, mouth, and oral cavity. The contents of the gastrointestinal tract showed a pH level of 7–8 on pH ...

  18. Autopsy results of a case of ingestion of sodium hydroxide solution.

    Science.gov (United States)

    Emoto, Yuko; Yoshizawa, Katsuhiko; Shikata, Nobuaki; Tsubura, Airo; Nagasaki, Yasushi

    2016-01-01

    Sodium hydroxide is a strongly corrosive alkali. We describe herein a case of suicide by ingestion of sodium hydroxide. A man in his 80s was found dead with a mug and a bottle of caustic soda. Macroscopically, liquefaction and/or disappearance of esophagus, trachea and lung tissue and a grayish discoloration of the mucosa of the stomach were seen along with blackish brown coloration of the skin, mouth, and oral cavity. The contents of the gastrointestinal tract showed a pH level of 7-8 on pH indicator strips. Histopathologically, liquefactive necrosis of remnant lung tissue and the stomach were seen. As biological reactions such as vasodilatation and inflammation were not detected in these organs, only a short number of hours must have passed between ingestion and death. This human case provides valuable information concerning the direct irritation induced by systemic exposure to corrosive substances. PMID:26989301

  19. Lung Postmortem Autopsy Revealing Extramedullary Involvement in Multiple Myeloma Causing Acute Respiratory Distress Syndrome

    Directory of Open Access Journals (Sweden)

    Aurélie Ravinet

    2014-01-01

    Full Text Available Pulmonary involvement with multiple myeloma is rare. We report the case of a 61-year-old man with past medical history of chronic respiratory failure with emphysema, and a known multiple myeloma (Durie and Salmon stage III B and t(4;14 translocation. Six months after diagnosis and first line of treatment, he presented acute dyspnea with interstitial lung disease. Computed tomography showed severe bullous emphysema and diffuse, patchy, multifocal infiltrations bilaterally with nodular character, small bilateral pleural effusions, mediastinal lymphadenopathy, and a known lytic lesion of the 12th vertebra. He was treated with piperacillin-tazobactam, amikacin, oseltamivir, and methylprednisolone. Finally, outcome was unfavourable. Postmortem analysis revealed diffuse and nodular infracentimetric infiltration of the lung parenchyma by neoplastic plasma cells. Physicians should be aware that acute respiratory distress syndrome not responding to treatment of common causes could be a manifestation of the disease, even with negative BAL or biopsy and could be promptly treated with salvage therapy.

  20. SOCIAL AUDIT AND VERBAL AUTOPSY ON MATERNAL DEATHS IN PRAKASAM DISTRICT, ANDHRA PRADESH

    Directory of Open Access Journals (Sweden)

    Sapna

    2014-07-01

    Full Text Available TITLE: Ultrasound guided fine needle aspiration cytology (FNAC in diagnosis of space occupying lesions (SOL of liver. INTRODUCTION: Liver is an important organ for metabolism of body and is also a drainage site for many organs, therefore it becomes affected in many benign, malignant and inflammatory conditions and performing ultrasound guided FNA helps to diagnose cases with 90-95% accuracy and minimizing the requirement of biopsy. AIMS: To evaluate the efficacy of ultrasound guided FNA and to look for spectrum of diseases affecting liver. MATERIAL AND METHODS: The study is performed on patients who came with lump abdomen and had SOL in liver on ultrasonography in SMS hospital, Jaipur. Ultrasonography guided FNAC was performed on 360 patients in one year period from January 2013 to December 2013. Majority of the patients were males and most of them were middle to elderly age group. Samples were adequate in 324 (90% and inadequate in 36 (10%. Out of 360 patients 7 had benign lesions, rest all had malignant tumors. Of all the malignant tumors, metastatic tumors were commonest accounting for 68% cases, hepatocellular carcinoma accounted for 15% and the rest 17% were unclassified malignancies. CONCLUSION: Ultrasonography guided FNAC is a simple, safe, cost effective and accurate diagnostic method for cytological diagnosis of hepatic lesions. It can be practiced in any centre where ultrasound facility and specialist pathologists are available. Cell blocks can be prepared from FNAC material which is of great help especially in cases who have unknown primaries and present with metastasis in liver

  1. Secondary skull fractures in head wounds inflicted by captive bolt guns: autopsy findings and experimental simulation.

    Science.gov (United States)

    Perdekamp, Markus Grosse; Kneubuehl, Beat P; Ishikawa, Takaki; Nadjem, Hadi; Kromeier, Jan; Pollak, Stefan; Thierauf, Annette

    2010-11-01

    Apart from one article published by Rabl and Sigrist in 1992 (Rechtsmedizin 2:156-158), there are no further reports on secondary skull fractures in shots from captive bolt guns. Up to now, the pertinent literature places particular emphasis on the absence of indirect lesions away from the impact point, when dealing with the wounding capacity of slaughterer's guns. The recent observation of two suicidal head injuries accompanied by skull fractures far away from the bolt's path gave occasion to experimental studies using simulants (glycerin soap, balls from gelatin) and skull–brain models. As far as ballistic soap was concerned, the dimensions of the bolt's channel were assessed by multi-slice computed tomography before cutting the blocks open. The test shots to gelatin balls and to skull-brain models were documented by means of a high-speed motion camera. As expected, the typical temporary cavity effect of bullets fired from conventional guns could not be observed when captive bolt stunners were discharged. Nevertheless, the visualized transfer of kinetic energy justifies the assumption that the secondary fractures seen in thin parts of the skull were caused by a hydraulic burst effect. PMID:20393855

  2. CHANGES IN LIVER IN CASE OF INSECTICIDAL AND ALCOHOL POISONING: AN AUTOPSY STUDY

    Directory of Open Access Journals (Sweden)

    Subhasish

    2015-03-01

    Full Text Available Poison is a substance introduced in the body to produce ill - effect, disease or death. It may be of any origin like synthetic, mineral, animal or vegetable. Death due to poisoning is mostly prevalent in the developing countries, of the total burden of acute pesticide poisoning; the majority of deaths are from deliberate self - poisoning with organophosphorus pesticides, aluminium phosphide and paraquat. Exposure to pesticides is usually occupational, accidental or suicidal. In India very few research works hav e been undertaken on histopathological changes of liver in different poisoning. In this part of our country a sizable number of cases of poisoning due to insecticides & alcohol are reported. So this current study intends to find out different histopatholog ical changes of liver in insecticidal & alcohol poisoning with regards to time interval between poisoning and death. In our 1 year (November 2012 - October 2013 of study we got 143 victims who died due to insecticidal and alcohol poisoning, out of which 132 cases show significant histopathological changes in liver. In this study male subjects (60.83% outnumber female (39.17% victims and most common age group affected in this study is between 20 - 40 years. This study show 29.37% victims died due to organopho sphorus poisoning, 25.17% cases of organochlorine poisoning, 11.88% study subjects from carbamate poisoning, 18.88% cases died due to combined alcohol and insecticidal poisoning, and 14.68% victims died due to alcohol poisoning. On microscopically 25.87% o f cases show centrilobular necrosis(CN, sinusoidal dilatation(SD found in 22.37%, fatty changes(FC in 11.88%, both venous congestion(VC, combined sinusoidal dilatation and degenerative change in 1.39% of cases, each 2.09% of cases show degenerative cha nge(DC , centrilobular necrosis and venous congestion , and sinusoidal dilatation and venous congestion respectively, each 3.49% show combined centrilobular necrosis and sinusoidal dilatation, fatty change and degenerative change respectively, 08.39% of cas es show centrilobular necrosis and fatty change, 06.99% cases show sinusoidal dilatation and fatty change, 07.69% have no significant histopathological changes, 0.69% case show centrilobular necrosis and degenerative change.

  3. Churg-Strauss Syndrome: a syndrome described on clinical observation and autopsy findings

    Directory of Open Access Journals (Sweden)

    Fernando Peixoto Ferraz de Campos

    2013-06-01

    Full Text Available Dr. Jacob Churg (1910-2005 was born in Dolhinow, a Belarusian city that later became a part of Poland and in 1939 was ceded to Russia during the partition of Poland by Russia and Germany. Churg’s father, Wolf, was a physician, and his mother, Gita, a dentist. Jacob recalled reading his father’s medical books and pestering him with many questions. He graduated with a medical degree from the University of Wilno (Poland in 1933 and started working at the Department of Internal Medicine. He realized that he was less confident dealing with patients than with “tissues.” In 1936, at the same university, he began his studies in experimental pathology.

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

    OpenAIRE

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

    2013-01-01

    Background: Liver is the largest gland in the body and it frequently gets wounded. The objective of this study was to determine the patterns, types and severities of liver injuries which were caused by mechanical trauma and to study the organs associated with liver injuries.

  5. An autopsy study of combined pulmonary fibrosis and emphysema: correlations among clinical, radiological, and pathological features

    OpenAIRE

    Inomata, Minoru; Ikushima, Soichiro; Awano, Nobuyasu; Kondoh, Keisuke; Satake, Kohta; Masuo, Masahiro; Kusunoki, Yuji; Moriya, Atsuko; Kamiya, Hiroyuki; Ando, Tsunehiro; Yanagawa, Noriyo; Kumasaka, Toshio; Ogura, Takashi; Sakai, Fumikazu; Azuma, Arata

    2014-01-01

    Background Clinical evaluation to differentiate the characteristic features of pulmonary fibrosis and emphysema is often difficult in patients with combined pulmonary fibrosis and emphysema (CPFE), but diagnosis of pulmonary fibrosis is important for evaluating treatment options and the risk of acute exacerbation of interstitial pneumonia of such patients. As far as we know, it is the first report describing a correlation among clinical, radiological, and whole-lung pathological features in a...

  6. Concentration of organochlorines in human brain, liver, and adipose tissue autopsy samples from Greenland

    DEFF Research Database (Denmark)

    Dewailly, Éric; Mulvad, Gert; Pedersen, Henning S.;

    1999-01-01

    Organochlorines are persistent lipophilic compounds that accumulate in Inuit people living in circumpolar countries. Organochlorines accumulate as a result of the Inuits' large consumption of sea mammal fat; however, available data are limited to blood lipids, milk fat, and adipose tissue. We...... report results of organochlorine determination in liver, brain, omental fat, and subcutaneous abdominal fat samples collected from deceased Greenlanders between 1992 and 1994. Eleven chlorinated pesticides and 14 polychlorinated biphenyl congeners were measured in tissue lipid extracts by high......-resolution gas chromatography with electron capture detection. Mean concentrations of polychlorinated biphenyls, 2, 2'-bis(4-chlorophenyl)-1,1-dichloroethylene, ss-hexachlorocyclohexane, hexachlorobenzene, mirex, trans-nonachlor, and oxychlordane in adipose tissue samples from Greenlanders were 3-34-fold higher...

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

    OpenAIRE

    Adolfo eRamirez-Zamora; Sarkis Gibran eMorales Vidal; Jasvinder eChawla; Jose eBiller

    2013-01-01

    ABSTRACT. Neurolymphomatosis (NL) refers to a lymphomatous infiltration of peripheral nerves associated with central nervous system (CNS) or systemic lymphoma, or alternatively, neurodiagnostic evidence of nerve enhancement and/or enlargement beyond the dural sleeve in the setting of primary central nervous system lymphoma (PCNSL) or systemic lymphoma. NL is a rare complication of systemic cancer with heterogeneous clinical presentations and an elusive diagnosis. Diagnosis usually requires ...

  8. Estimation of stature from anthropometry of hand: an interesting autopsy based study in Madhya Pradesh, India

    Directory of Open Access Journals (Sweden)

    Rajesh Ban Goswami

    2016-06-01

    Results: The mean age of the male and female study subjects was38.472+/-13.28 years and 34.728+/-10.33 years respectively. Male to female ratio was 1:1. Mean stature in male subjects was 163.5+/-5.21 cm. Mean stature in female subjects was 155.69+/-10.12 cm. In male study subjects, mean hand length on right side was more than mean hand length on left side. In female study subjects, mean hand length on right side was more than on left side. In male study subjects, hand breadth (HB on right side was more than on left side. Average HB in male subjects was 8.39+/-0.203 cm. In female study subjects, hand breadth on right side was more than on left side. Conclusions: The findings of the present study can be used as baseline information for other population based studies in the study area. [Int J Res Med Sci 2016; 4(6.000: 1873-1878

  9. Liberté ou sécurité: autopsie d'un faux dilemme

    OpenAIRE

    Tavaglione, Nicolas

    2013-01-01

    Le président Barack Obama cherche le «juste équilibre» entre les besoins de sécurité de la société américaine et la protection de la liberté du citoyen. L’exercice est précaire, des travaux académiques ont montré les limites de l’image de la balance.

  10. Fatty infiltration of the liver in severely burned pediatric patients : Autopsy findings and clinical implications

    NARCIS (Netherlands)

    Barret, JP; Jeschke, MG; Herndon, DN

    2001-01-01

    Background. Trauma induces hypermetabolic responses that are characterized by the mobilization of all available substrates. The marked increase of peripheral lipolysis after a burn can lead to the development of fatty liver, which has been associated with immunodepression and increased mortality. Me

  11. Modeling GRB 050904: Autopsy of a Massive Stellar Explosion at z=6.29

    CERN Document Server

    Gou, L J; Mészáros, P

    2006-01-01

    GRB 050904 at redshift z=6.29, discovered and observed by Swift and with spectroscopic redshift from the Subaru telescope, is the first gamma-ray burst to be identified from beyond the epoch of reionization. Since the progenitors of long gamma-ray bursts have been identified as massive stars, this event offers a unique opportunity to investigate star formation environments at this epoch. Apart from its record redshift, the burst is remarkable in two respects: first, it exhibits fast-evolving X-ray and optical flares that peak simultaneously at t~470 s in the observer frame, and may thus originate in the same emission region; and second, its afterglow exhibits an accelerated decay in the near-infrared (NIR) from t~10^4 s to t~3 10^4 s after the burst, coincident with repeated and energetic X-ray flaring activity. We make a complete analysis of available X-ray, NIR, and radio observations, utilizing afterglow models that incorporate a range of physical effects not previously considered for this or any other GRB...

  12. Exploring vulnerability to suicide in the developmental history of young men: a psychological autopsy study.

    Science.gov (United States)

    Rasmussen, Mette L; Haavind, Hanne; Dieserud, Gudrun; Dyregrov, Kari

    2014-01-01

    This study explores the developmental history of ten young men who completed suicide in the transition to adulthood. The young men, aged 18-30, had no previous history of suicide attempts or treatment in mental health. In-depth interviews with four to eight informants for each suicide were analyzed using Interpretative Phenomenological Analysis. Three developmental issues from early age onwards emerged: (a) unsuccessful in becoming independent; (b) weakened competence to deal with shame; and (c) trapped in anger. The capacity to regulate emotions like shame and anger could make certain men vulnerable to suicide when facing adult challenges and defeats.

  13. Autopsy study of small cardiac scars in Japanese men who lived in Hiroshima, Japan and Honolulu, Hawaii

    International Nuclear Information System (INIS)

    Japanese men long resident in Honolulu, Hawaii have significantly more ischemic heart disease, but significantly fewer small cardiac scars than men in Hiroshima, Japan. These scars occur in three forms: 1) small scars in the mural myocardium which account for the difference in frequency of small lesions in the two cities, and are of uncertain etiology; 2) areas of diffuse fibrosis in the papillary muscles. These are equally frequent in the two cities, and are associated with advancing age and sclerosis of papillary muscle arteries; and 3) focal scars in the papillary muscles. These are more frequent in Honolulu than Hiroshima. They are healed infarcts due to ischemic heart disease and are associated with a severe degree of extramural coronary artery sclerosis. Small mural myocardial scars, when present, are usually found in multiple sites, and are not related to age at death or heart weight. They are more common in the presence of sclerosis of intramural small arteries, but this association does not explain their more frequent occurrence in Hiroshima. There is no evidence that they are related to A-bomb radiation exposure. (author)

  14. Malignant tumors and multiple primary malignant tumors of the atomic-bombed survivors in Nagasaki by autopsy cases

    International Nuclear Information System (INIS)

    Out of 10,674 bodies necropsied in Nagasaki district during 32 years period after World War II, 9,302 were selected, and their malignant tumors and multiple primary malignant tumors were discussed. They were divided into 4 groups, the group exposed within 1,000 m from the hypocenter, the group exposed within 2,000 m, the group exposed over 2,000 m + the group who entered the city after the explosion, and the non-exposed group who were born before the explosion. The percentage of cases of malignant tumors (4,784) was 51.4%, which was almost the same as the average in Japan. The incidence of multiple malignant tumors (112 cases of double cancer and 7 cases of triple cancer) was 2.48% of all malignant tumors, and it did not increase particularly. The incidence of malignant tumors and multiple malignant tumors tended to increase with the age. The incidence of malignant tumors was a little high in the group exposed within 1,000 m, and the incidence of leukemia and thyroid cancer was high in the group exposed near the hypocenter in Nagasaki as same as in Hiroshima. The incidence of multiple malignant tumors was markedly high in the group exposed near the hypocenter. This tendency was also shown in Hiroshima. The incidence of multiple malignant tumors was also high in women. In the group exposed near the hypocenter, there were many cases of digestive cancer or thyroid cancer combined with cancers of other organs. Multiple malignant cancer combined with leukemia was found only in one case. There were many combinations of cancer with cancer, but there was not a relation between a-bomb exposure and cancer or sarcoma. The time of onset of multiple malignant tumors was different in many cases of the exposed. (Tsunoda, M.)

  15. High Prevalence of Human Parvovirus B19 DNA in Myocardial Autopsy Samples from Subjects without Myocarditis or Dilative Cardiomyopathy▿

    OpenAIRE

    Schenk, Thomas; Enders, Martin; Pollak, Stefan; Hahn, Ralph; Huzly, Daniela

    2008-01-01

    Human parvovirus B19 has been linked to a variety of cardiac diseases, as well as to erythema infectiosum, acute arthropathy, and fetal hydrops. A causal association between viral infection and cardiac disease was frequently postulated following the detection of B19 DNA by PCR in endomyocardial biopsy specimens. Since the lifelong persistence of B19 DNA in bone marrow, skin, synovia, tonsils, and liver was previously reported, the aim of our study was to investigate the possibility of asympto...

  16. Psychological Autopsy and Its Limitation in Application%心理解剖及其运用限制

    Institute of Scientific and Technical Information of China (English)

    涂文强; 赵虎

    2009-01-01

    长期以来,中国对自杀的判断仅依靠死亡现场和尸体特征,忽视了心理解剖对死亡方式的区分作用.心理解剖与传统的自杀风险评估和自杀流行病学调查有明显区别.心理解剖的目的 主要是了解死者个性特征、行为方式、自杀动机;心理解剖的方法 是全面调查、收集和分析死者有关的资料.心理解剖也存在很多限制,其中缺乏标准方案是主要原因.最近Bermanr提出了一个较为完善的标准,但这个标准在我国应用之前还有许多问题需要解决.

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

    OpenAIRE

    Kenya Nishioka; Ryota Tanaka; Satoshi Tsutsumi; Hideki Shimura; Yutaka Oji; Harumi Saeki; Yukimasa Yasumoto; Masanori Ito; Nobutaka Hattori; Takao Urabe

    2013-01-01

    Background. Longitudinally extensive transverse myelitis (LETM) is characterized by spinal cord inflammation extending vertically through three or more vertebral segments. The widespread use of MRI revealed LETM more frequency than ever. We report the case of a patient with pathologically confirmed small-cell lung carcinoma metastasis into the spinal cord presenting as LETM. Case Presentation. A 74-year-old man developed rapidly progressive sensorimotor disturbance and vesicorectal dysfunctio...

  18. Criteria for cure in acromegaly: report of a case apparently cured in which persisting tumor was found at autopsy.

    Science.gov (United States)

    Wrightson, P; Holdaway, I M; Synek, B J

    1984-06-01

    A 49-year-old man with acromegaly underwent the apparently complete removal of a pituitary microadenoma by the transsphenoidal route. There was complete remission of the biochemical abnormalities for 2 1/2 years, with basal plasma growth hormone (GH) levels of less than 1 ng/ml and normal somatomedin levels. The patient then died after the rupture of a cerebral aneurysm. Serial sections of the pituitary fossa showed persistent tumor with a volume of about 6% of the remaining normal gland. It is concluded that current endocrine tests are limited in their ability to detect residual GH-secreting tumor. Their sensitivity is likely to depend on the mass of tumor and on the GH secretion rate. Predictions of long term cure based on these tests are only tentative.

  19. An autopsied case of primary malignant lymphoma of the central nervous system presenting an unusual clinical course and CT findings

    International Nuclear Information System (INIS)

    A case of primary malignant lymphoma of the central nervous system was reported. A 58-year-old man was admitted because of diplopia in March, 1986. Last year in June he lost consciousness, accompanied by headache, vertigo, a floating sensation, and tinnitus, though his symptoms disappeared the next day. Last year in October and November, he complained of weakness of the left hand, but it soon disappeared. A neurological examination on admission revealed left trochlear nerve palsy, a decreased sensitivity to pain on the left side of the face and the opposite side of the body, and a mild left-side lack of coordination. A head CT scan and angiography showed no abnormalities. An examination of the CSF revealed increased protein with mild pleocytosis and IgG, but cytology was negative. After admission, he complained of left trigeminal neuralgia, but it disappeared upon steroid pulse therapy. When the steroids were tapered off, however, peripheral facialnerve palsy developed. Therefore, a second course of steroid pulse therapy was done, with some effect. In June, however, the patient became unconscious while the orally administered steroid was being tapered off. A head CT scan showed isodensity masses in the basal ganglia, the thalamus, and the periventricular white matter on a plain scan, and homogeneous masses with ring enhancement and edema on the use of a contrast medium. A histopathological examination showed primary cerebral malignant lymphoma (large-cell type). (author)

  20. An autopsy case of hepatoid carcinoma of the ovary with PIVKA-II production: immunohistochemical study and literature review.

    Science.gov (United States)

    Senzaki, H; Kiyozuka, Y; Mizuoka, H; Yamamoto, D; Ueda, S; Izumi, H; Tsubura, A

    1999-02-01

    A case of hepatoid carcinoma of the ovary in a 61-year-old Japanese woman, who showed high serum levels of alpha-fetoprotein and CA125, is reported. Grossly, the left ovarian tumor, which measured 12 x 9 cm, was solid and multinodular. Histologically, the tumor resembled hepatocellular carcinoma by its architectural and cytological features. Liver cell differentiation was indicated functionally by the immunohistochemical detection of alpha-fetoprotein and protein induced by vitamin K absence or antagonist II (PIVKA-II) and by positive bile production, and the hepatocellular differentiation was structurally in accord with keratin 7, 8 and 18 expression. CA125 expression, commonly present in ovarian surface epithelial carcinomas, suggested that this neoplasm originated from ovarian common epithelial cells. There are only nine such cases in the literature. A review of these cases reveals that hepatoid carcinoma of the ovary occurs exclusively in postmenopausal women (mean age, 62.7 years) and that the prognosis is poor.

  1. Students Who Wish to Specialize in Forensic Medicine vs. Their Fellow Students: Motivations, Attitudes and Reactions during Autopsy Practice

    Science.gov (United States)

    Papadodima, Stavroula A.; Sergentanis, Theodoros N.; Iliakis, Roussos G.; Sotiropoulos, Konstantinos C.; Spiliopoulou, Chara A.

    2008-01-01

    Purpose: To investigate the particular features of students who express the desire to follow a forensic career. Methods and materials: Three hundred and four 6th-year students attending the compulsory practice in forensic medicine in the academic year 2005-2006 were asked to fill in a self-administered questionnaire at the end of the course.…

  2. Autopsied case of primary malignant lymphoma of the central nervous system presenting an unusual clinical course and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, Kazuya; Kobayashi, Shotai; Yamaguchi, Shuhei and others

    1987-08-01

    A case of primary malignant lymphoma of the central nervous system was reported. A 58-year-old man was admitted because of diplopia in March, 1986. Last year in June he lost consciousness, accompanied by headache, vertigo, a floating sensation, and tinnitus, though his symptoms disappeared the next day. Last year in October and November, he complained of weakness of the left hand, but it soon disappeared. A neurological examination on admission revealed left trochlear nerve palsy, a decreased sensitivity to pain on the left side of the face and the opposite side of the body, and a mild left-side lack of coordination. A head CT scan and angiography showed no abnormalities. An examination of the CSF revealed increased protein with mild pleocytosis and IgG, but cytology was negative. After admission, he complained of left trigeminal neuralgia, but it disappeared upon steroid pulse therapy. When the steroids were tapered off, however, peripheral facialnerve palsy developed. Therefore, a second course of steroid pulse therapy was done, with some effect. In June, however, the patient became unconscious while the orally administered steroid was being tapered off. A head CT scan showed isodensity masses in the basal ganglia, the thalamus, and the periventricular white matter on a plain scan, and homogeneous masses with ring enhancement and edema on the use of a contrast medium. A histopathological examination showed primary cerebral malignant lymphoma (large-cell type).

  3. A dwarf galaxy's transformation and a massive galaxy's edge: autopsy of kill and killer in NGC 1097

    CERN Document Server

    Amorisco, N C; Schedler, J

    2015-01-01

    (abridged) We present a dynamical analysis of the extended stellar stream encircling NGC 1097. Within a statistical framework, we model its surface brightness using mock streams as in Amorisco (2015) and deep imaging data from the CHART32 telescope (Stellar Tidal Stream Survey). We reconstruct the post-infall evolution of the progenitor, which has experienced 3 pericentric passages and lost more than 2 orders of magnitude in mass. At infall, $5.4\\pm0.6$ Gyr ago, the progenitor was a disky dwarf with mass of $\\log_{10}[m(<3.4\\pm1 {\\rm kpc})/ M_\\odot]=10.35\\pm0.25$. We illustrate how the 90$^\\circ$ turn in the stream, identifying the `dog leg', is the signature of the progenitor's prograde rotation. Today, the remnant is a nucleated dwarf, with a LOS velocity of $v_{\\rm p, los}^{\\rm obs}=-30\\pm 30$ kms$^{-1}$, and a luminosity of $3.3\\times 10^7 L_{V,\\odot}$ (Galianni et al. 2010). Our independent analysis predicts $v_{\\rm p, los}=-51^{-17}_{+14}$ kms$^{-1}$, and measures $\\log_{10}(m/ M_\\odot)=7.4^{+0.6}_{-...

  4. Maternal deaths in a tertiary health care centre of Odisha: An in-depth study supplemented by verbal autopsy

    Directory of Open Access Journals (Sweden)

    Biswajit Paul

    2011-01-01

    Full Text Available Background: Maternal mortality is a reflection of the care given to women by its society. It is tragic that deaths occur during the natural process of child birth and most of them are preventable. Objectives: The present study was undertaken to find out the causes and contributing factors of maternal deaths. Materials and Methods: All maternal deaths occurring in a year in the medical college and hospital were traced and interviews were taken from the relatives as well as the health care providers who were present at the time of death of the woman. Results: Out of the total maternal deaths, 72% belonged to 20-30 yrs age group, also 46.5% were illiterate, and majority deaths (60.5% were from low socio-economics status. Direct causes were responsible for 76.7% of maternal deaths. Hypertensive disorders of pregnancy were most common (32.6% cause of direct deaths, while malaria (9.3% and anemia (7% were most common indirect causes. Most of the women had to use their own resources to travel to health care facilities. Delays at different levels, often in combination, contributed to the maternal deaths. Conclusions: The study will serve as an eye-opener to the bottlenecks present in the community as well as in the health facility so as to take appropriate measures to prevent maternal deaths.

  5. Meaning-Making through Psychological Autopsy Interviews: The Value of Participating in Qualitative Research for Those Bereaved by Suicide

    Science.gov (United States)

    Dyregrov, Kari Madeleine; Dieserud, Gudrun; Hjelmeland, Heidi Marie; Straiton, Melanie; Rasmussen, Mette Lyberg; Knizek, Birthe Loa; Leenaars, Antoon Adrian

    2011-01-01

    Too often ethical boards delay or stop research projects with vulnerable populations, influenced by presumed rather than empirically documented vulnerability. The article investigates how participation is experienced by those bereaved by suicide. Experiences are divided into 3 groups: (a) overall positive (62%), (b) unproblematic (10%), and (c)…

  6. Central nervous system granulomastous phlebitis with limited extracranial involvement of the heart and lungs: An autopsy case.

    Science.gov (United States)

    Mlakar, Jernej; Zorman, Jerneja Videčnik; Matičič, Mojca; Vrabec, Matej; Alibegović, Armin; Popović, Mara

    2016-02-01

    Primary angiitis of the central nervous system is a rare condition, usually with an insidious onset. There is a wide variety of histological types (granulomatous, lymphocytic or necrotizing vasculitis) and types of vessel involved (arteries, veins or both). Most cases are idiopathic. We describe a first case of idiopathic granulomatous central nervous system phlebitis with additional limited involvement of the heart and lung, exclusively affecting small and medium sized veins in a 22-year-old woman, presenting as a sub acute headache. The reasons for this peculiar limitation of inflammation to the veins and the involvement of the heart and lungs are unknown.

  7. An autopsy case of lymphangiosarcoma arising from the posotoperative and postirradiated site of lymphangioma of the thigh

    International Nuclear Information System (INIS)

    A 25-year-old man had undergone resection of lymphangioma on the anterior aspect of left thigh and postoperative irradiation at the age of seven. About ten years later, lymphangiosarcoma developed at the postopeative site and he died despite wide resection, chemotherapy and irradiation. Microscopically, the malignant cells were arranged in an angiomatous pattern with endthelial lining. Ultrastructural examination of the tumor suggested the dual origin from blood and lymphatic capillaries. The pathogenesis of the tumor was considered to be closely related to local disturbances in lymph circulation at the postoperative site although no lymphedema was present. (author)

  8. Expansion of the Multi-Link Frontier™ Coronary Bifurcation Stent: Micro-Computed Tomographic Assessment in Human Autopsy and Porcine Heart Samples

    OpenAIRE

    Kralev, Stefan; Haag, Benjamin; Spannenberger, Jens; Lang, Siegfried; Brockmann, Marc A.; Bartling, Soenke; Marx, Alexander; Haase, Karl-Konstantin; Borggrefe, Martin; Süselbeck, Tim

    2011-01-01

    Background Treatment of coronary bifurcation lesions remains challenging, beyond the introduction of drug eluting stents. Dedicated stent systems are available to improve the technical approach to the treatment of these lesions. However dedicated stent systems have so far not reduced the incidence of stent restenosis. The aim of this study was to assess the expansion of the Multi-Link (ML) Frontier™ stent in human and porcine coronary arteries to provide the cardiologist with useful in-vitro ...

  9. MSCT容积再现在并腿畸形尸检中的应用%Application of MSCT with volume rendering in sirenomelia autopsy

    Institute of Scientific and Technical Information of China (English)

    马慧静; 徐来; 邵剑波; 杨小红

    2014-01-01

    目的:探讨胎儿并腿畸形的骨骼异常及尸检胎儿 MSCT容积再现对产前B超的提示作用。方法:对8例疑似并腿畸形胎儿行 MRI检查,引产后行 MSCT检查。结果:8例并腿畸形胎儿中,7例为单胎,1例为臀部联体双胎之一。8例中,1例表现为单个下肢,7例为形式各异的下肢融合畸形。8例均有髂骨异常、尾椎部分或全部缺失。7例伴有各种各样的胸腰椎和肋骨畸形,2例并左上肢畸形融合。结论:MSCT容积再现可以提供胎儿详细立体的影像学资料,提高对并腿畸形骨骼异常的认识及产前诊断水平。%Objective:To discuss the skeletal anomalies of sirenomelia of fetus and the value of post-natal MSCT with volume rendering technique for fetal prenatal ultrasound.Methods:8 fetuses suspected of sirenomelia underwent MRI exami-nation and these fetuses after induced labor underwent MSCT examination.Results:Of the 8 cases of sirenomelia,7 cases were monocyesis,and one case was one of coxal conjoined twins,one of the twins had sirenomelia.Of the 8 cases,one case had single lower limb,7 cases had various fusion of the lower limbs.There were iliac bone anomalies and complete or partial caudal vertebra defects in 7 cases.There were various deformities of thoracic and lumbar vertebrae and ribs deformities in 7 cases and fusion of the upper limbs in 2 cases.Conclusion:MSCT with volume rendering can provide significant and clear im-aging information of the entire fetus,which can improve the understanding and prenatal diagnostic level of skeletal anomalies of sirenomelia.

  10. Radiation doses to members of the U.S. population from ubiquitous radionuclides in the body: Part 1, autopsy and in vivo data.

    Science.gov (United States)

    Watson, David J; Strom, Daniel J

    2011-04-01

    This paper is Part 1 of a three-part series investigating steady-state effective dose rates to residents of the United States from intakes of ubiquitous radionuclides, including radionuclides occurring naturally, radionuclides whose concentrations are technologically enhanced, and anthropogenic radionuclides. This series of papers explicitly excludes intakes from inhaling (222)Rn, (220)Rn, and their short-lived decay products; it also excludes intakes of radionuclides in occupational and medical settings. In this work, it is assumed that instantaneous dose rates in target organs are proportional to steady-state radionuclide concentrations in source regions. The goal of Part 1 of this work was to review, summarize, and characterize all published and some unpublished data for U.S. residents on ubiquitous radionuclide concentrations in tissues and organs. Forty-five papers and reports were obtained and their data reviewed, and three data sets were obtained via private communication. The 45 radionuclides of interest are the (238)U series (14 nuclides), the actinium series (headed by (235)U; 11 nuclides), and the (232)Th series (11 nuclides); primordial radionuclides (87)Rb and (40)K; cosmogenic and fallout radionuclides (14)C and (3)H; and purely anthropogenic radionuclides (137)Cs-(137m)Ba, (129)I, and (90)Sr-(90)Y. Measurements judged to be relevant were available for only 15 of these radionuclides: (238)U, (235)U, (234)U, (232)Th, (230)Th, (228)Th, (228)Ra, (226)Ra, (210)Pb, (210)Po, (137)Cs, (87)Rb, (40)K, (14)C, and (3)H. Recent and relevant measurements were not available for (129)I and (90)Sr-(90)Y. A total of 11,741 radionuclide concentration measurements were found in one or more tissues or organs from 14 states. Data on age, gender, geographic locations, height, and weight of subjects were available only sporadically. Too often authors did not provide meaningful values of uncertainty of measurements, so that variability in data sets is confounded with measurement uncertainty. The following papers detail how these shortcomings are overcome to achieve the goals of the three-part series.

  11. 医疗纠纷处理中的法医病理尸检%The forensic pathological autopsy in malpractice

    Institute of Scientific and Technical Information of China (English)

    张益鹄

    1999-01-01

    @@ 医疗纠纷中最后需医疗事故鉴定委员会鉴定或向各级人民法院起诉的,绝大多数是导致死亡的医疗纠纷,如果处理不好可能影响正常的医疗秩序和社会安定.

  12. [An autopsy case of amyotrophic lateral sclerosis with prominent muscle cramps, fasciculation, and high titer of anti-voltage gated potassium channel (VGKC) complex antibody].

    Science.gov (United States)

    Sato, Aki; Sakai, Naoko; Shinbo, Junsuke; Hashidate, Hideki; Igarashi, Shuichi; Kakita, Akiyoshi; Yamazaki, Motoyoshi

    2014-01-01

    The patient was a 55-year-old male who had prominent fasciculation and muscle cramps. Muscle weakness and atrophy of the trunk, respiratory system, and extremities gradually progressed. On the basis of these features, we diagnosed this patient as having amyotrophic lateral sclerosis (ALS), however, the upper motor neuron signs were not significant. Following the detection of the anti-voltage gated potassium channel (VGKC) complex antibody at 907.5 pM (normal VGKC complex antibody in the development of cramp-fasciculation syndrome has been speculated. In this ALS patient, the antibodies might be associated with pathomechanisms underlying the characteristic symptoms.

  13. Laryngeal teflonoma identified by Fourier-transform infrared microspectroscopy after forensic autopsy: An interesting tool for foreign material identification in forensic cases

    OpenAIRE

    Duband, Sébastien; Govin, Alexandre; Dumollard, Jean-Marc; Forest, Fabien; Basset, Thierry; Peoc'h, Michel

    2012-01-01

    Forensic pathologists are sometimes confronted with microscopic foreign bodies mixed in with soft tissues surrounding wounds and which are thus difficult to identify. This identification, however, could be primordial in investigating a crime and in determining the weapon used. A case of a fatal respiratory distress syndrome due to conjoining suicidal drug intoxication and laryngeal obstruction by a voluminous foreign body giant cell granuloma is presented. The classical histological examinati...

  14. (13)Carbon and (15)nitrogen isotopes in autopsy liver tissue samples from Greenlandic Inuit and Danes: consumption of marine versus terrestrial food

    DEFF Research Database (Denmark)

    Milman, N.; Laursen, J.; Mulvad, G.;

    2010-01-01

    . Results: Inuit: median delta C-13 was -21.2 parts per thousand in cellular and -20.0 parts per thousand in connective tissue fractions (P = 001). Median delta N-15 was 10.6 parts per thousand in both cellular and connective tissue fractions. Body mass index was negatively correlated with delta C-13...... in the connective tissue fraction (r(s) = -0.42, P = 0.057). Danes: median delta C-13 was -27.0% in cellular and -24.3% in connective tissue fractions (P = 0.11). Median delta N-15 was 9.5 parts per thousand in cellular and 8.9 parts per thousand in connective tissue fractions (P = 0.5). Inuit had higher delta C-13...

  15. GAMMA KNIFE RADIOSURGERY OF BRAIN METASTASIS FROM MALIGNANT PLEURAL MESOTHELIOMA – REPORT OF THREE CASES WITH AUTOPSY STUDY IN A CASE –

    OpenAIRE

    Kobayashi, Tatsuya; TSUGAWA, TAKAHIKO; Hashizume, Chisa; Toriyama, Takanobu; Asai, Masami; Mori, Yoshimasa; Shibamoto, Yuta

    2014-01-01

    ABSTRACT The median survival time of malignant pleural mesothelioma (MPM) has been 9 months. Given the short survival, there have been only few cases in which brain metastases have been diagnosed and treated before death. Three cases of brain metastases treated by gamma knife radiosurgery (GKR) are reported. Case 1 showed a metastatic lesion in the right frontal lobe which was treated by GKR two years after diagnosis of MPM. The lesion markedly reduced and the symptoms were improved, But the ...

  16. Moving from data on deaths to public health policy in Agincourt, South Africa : approaches to analysing and understanding verbal autopsy findings

    OpenAIRE

    Byass, Peter; Kahn, Kathleen; Fottrell, Edward; Collinson, Mark A.; TOLLMAN, STEPHEN M.

    2010-01-01

    Editors' Summary Background Whenever someone dies in a developed country, the cause of death is determined by a doctor and entered into a “vital registration system,” a record of all the births and deaths in that country. Public-health officials and medical professionals use this detailed and complete information about causes of death to develop public-health programs and to monitor how these programs affect the nation's health. Unfortunately, in many developing countries dying people are not...

  17. Effects of androgen deprivation therapy and bisphosphonate treatment on bone in patients with metastatic castration-resistant prostate cancer: results from the University of Washington Rapid Autopsy Series.

    Science.gov (United States)

    Morrissey, Colm; Roudier, Martine P; Dowell, Alex; True, Lawrence D; Ketchanji, Melanie; Welty, Christopher; Corey, Eva; Lange, Paul H; Higano, Celestia S; Vessella, Robert L

    2013-02-01

    Qualitative and quantitative bone features were determined in nondecalcified and decalcified bone from 20 predetermined bone sites in each of 44 patients who died with castration-resistant prostate cancer (CRPC), some of which received bisphosphonate treatment (BP) in addition to androgen-deprivation therapy (ADT). Thirty-nine of the 44 patients (89%) had evidence of bone metastases. By histomorphometric analysis, these bone metastases were associated with a range of bone responses from osteoblastic to osteolytic with a wide spectrum of bone responses often seen within an individual patient. Overall, the average bone volume/tissue volume (BV/TV) was 25.7%, confirming the characteristic association of an osteoblastic response to prostate cancer bone metastasis when compared with the normal age-matched weighted mean BV/TV of 14.7%. The observed new bone formation was essentially woven bone, and this was a localized event. In comparing BV/TV at metastatic sites between patients who had received BP treatment and those who had not, there was a significant difference (28.6% versus 19.3%, respectively). At bone sites that were not invaded by tumor, the average BV/TV was 10.1%, indicating significant bone loss owing to ADT that was not improved (11%) in those patients who had received BPs. Surprisingly, there was no significant difference in the number of osteoclasts present at the metastatic sites between patients treated or not treated with BPs, but in bone sites where the patient had been treated with BPs, giant osteoclasts were observed. Overall, 873 paraffin-embedded specimens and 661 methylmethacrylate-embedded specimens were analyzed. Our results indicate that in CRPC patients, ADT induces serious bone loss even in patients treated with BP. Furthermore, in this cohort of patients, BP treatment increased BV and did not decrease the number of osteoclasts in prostate cancer bone metastases compared with bone metastases from patients who did not receive BP.

  18. Combined coagulation-disk filtration process as a pretreatment of ultrafiltration and reverse osmosis membrane for wastewater reclamation: an autopsy study of a pilot plant.

    Science.gov (United States)

    Chon, Kangmin; Kim, Seung Joon; Moon, Jihee; Cho, Jaeweon

    2012-04-15

    The effects of the combined coagulation-disk filtration (CC-DF) process on the fouling characteristics and behavior caused by interactions between effluent organic matter (EfOM) and the membrane surfaces of the ultrafiltration (UF) and reverse osmosis (RO) membranes in a pilot plant for municipal wastewater reclamation (MWR) were investigated. The feed water from secondary effluents was treated by the CC-DF process used as a pretreatment for the UF membrane to mitigate fouling formation and the permeate from the CC-DF process was further filtered by two UF membrane units in parallel arrangement and fed into four RO modules in a series connection. The CC-DF process was not sufficient to mitigate biofouling but the UF membrane was effective in mitigating biofouling on the RO membrane surfaces. Fouling of the UF and RO membranes was dominated by hydrophilic fractions of EfOM (e.g., polysaccharide-like and protein-like substances) and inorganic scaling (e.g., aluminum, calcium and silica). The desorbed UF membrane foulants included more aluminum species and hydrophobic fractions than the desorbed RO membrane foulants, which was presumably due to the residual coagulants and aluminum-humic substance complexes. The significant change in the surface chemistry of the RO membrane (a decrease in surface charge and an increase in contact angle of the fouled RO membranes) induced by the accumulation of hydrophilic EfOM onto the negatively charged RO membrane surface intensified the fouling formation of the fouled RO membrane by hydrophobic interaction between the humic substances of EfOM with relatively high hydrophobicity and the fouled RO membranes with decreased surface charge and increased contract angle.

  19. Mise au point sur les méthodes de dépistage des parasitoses chez les bovins (autopsies exclues)

    OpenAIRE

    Fourcade, Raphaël

    2012-01-01

    Face à des éléments de suspicion de parasitose bovine, l’expérience du vétérinaire, ainsi qu’une analyse épidémio-clinique, peuvent parfois suffire à mettre en place une stratégie de lutte, mais ne seront jamais aussi précises que les informations apportées par des examens complémentaires. Cette étude vise à présenter les différents outils de laboratoire à la disposition d’un praticien afin d’objectiver, parfois de confirmer, une hypothèse diagnostique, à l’échelle individuelle ou collective,...

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

    DEFF Research Database (Denmark)

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

    1991-01-01

    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...

  1. 昆明学院医学院解剖室通风设计%Ventilation Design of Autopsy for Medical School of Kunming University

    Institute of Scientific and Technical Information of China (English)

    胡鑫

    2013-01-01

    结合昆明学院医学院解剖室通风设计,分析了解剖室通风系统设计特点,介绍了在充分利用当地气候条件的前提下,根据工程实际情况以及通风需求后,解剖室通风系统可采取的方案设计.

  2. Achados clínicopatológicos na tromboembolia pulmonar: estudo de 24 anos de autópsias Clinicopathological findings in pulmonary thromboembolism: a 24-year autopsy study

    OpenAIRE

    Hugo Hyung Bok Yoo; Fabiana Guandalini Mendes; Christine Elisabete Rubio Alem; Alexandre Todorovic Fabro; José Eduardo Corrente; Thais Thomaz Queluz

    2004-01-01

    INTRODUÇÃO: Tromboembolia pulmonar (TEP) é ainda uma afecção enigmática em diversos aspectos clínicos e epidemiológicos e frequentemente erroneamente diagnosticada. OBJETIVO: Descrever a prevalência e os achados anatomopatológicos de TEP em uma série de 5261 autópsias realizadas em um hospital universitário de nível terciário, correlacionar estes achados com as doenças de base e verificar a freqüência de suspeita clínica antemortem de TEP. MÉTODO: Revisão dos registros das autópsias consecuti...

  3. Degeneração hepatolenticular: conteúdos de ferro e cobre em tecidos de material de autópsia Hepatolenticular degeneration: iron and copper contents of tissues of autopsy material

    Directory of Open Access Journals (Sweden)

    Francisco Bastos De Jorge

    1970-03-01

    Full Text Available Os autores apresentam os resultados das dosagens de ferro e cobre nos tecidos de um paciente com degeneração hepatolenticular, no qual a moléstia teve curso fulminante. Parece que o curso da moléstia foi agravado pela administração de drogas tranqüilizantes quando foi iniciado o tratamento com penicilamina. Esta observação pode ser de interesse clínico. Os teores de cobre e ferro estavam muito aumentados nos tecidos cerebrais, no fígado, nos pulmões, nos rins, no baço, na suprarenal e em outros órgãos.Iron and copper contents in tissues of one patient with hepatolenticular degeneration, with fulminating course, are reported. It seems that the disease's course was aggravated by tranquilizer drugs, when treatment with penicillamine was started. This observation may be of clinical interest. Copper and iron contents were increased in the brain tissues, in the liver, lungs, kidneys, spleen, suprarenal gland and in other organs.

  4. Two-gun suicide by simultaneous shots to the head: interdisciplinary reconstruction on the basis of scene investigation, autopsy findings, GSR analysis and examination of firearms, bullets and cartridge cases.

    Science.gov (United States)

    Grosse Perdekamp, Markus; Nadjem, Hadi; Merkel, Joachim; Braunwarth, Roland; Pollak, Stefan; Thierauf, Annette

    2011-07-01

    Suicidal shots fired simultaneously to the head from two handguns are rare. The authors report about a recent case in which a Smith & Wesson cal. 9 mm pistol and a Smith & Wesson cal. .357 Magnum revolver were used. Sitting on a sofa, a 33-year-old man (member of a shooting club) fired two simultaneous shots to the head; the pistol held in the left hand was discharged into the left temple, and the revolver held in the right hand was fired into the mouth. Both weapons remained in the respective hands. An upside-down muzzle imprint in the left temporal region and recoil injuries of a mandibular incisor, and the lower lip indicated that both the pistol and the revolver had been held in an inverted manner at the time of discharge. Blood stains (backspatter) and gunshot residues were present on both firing hands, whereas forward spatter originating from the exit wounds was deposited on the wall behind the suicide's head.

  5. Clinical and pathological assessment of 82 patients with cardiovascular diseases undergoing autopsy at the Hospital das Clínicas of the Faculdade de Medicina de Botucatu from 1988 to 1993

    Directory of Open Access Journals (Sweden)

    Reinaldo Ayer de Oliveira

    2000-10-01

    Full Text Available OBJECTIVE: To evaluated the clinical diagnostic, efficiency for basic death causes in patients dying of circulatory disease and de relative frequency of those diseases. METHODS: Analysis of medical record data of 82 patients, ages from 16 to 84 years old (68 over 40 years old, whose died of circulatory disease and had undergone necropsy in the period from 1988 to 1993 years in the University Hospital of Medicine Faculty of Botucatu-UNESP, Br. RESULTS: The functional class of patients were III or IV, in 78%, and 81.7% needed urgent hospitalization. By the clinical judgment the death were by ischemic heart disease in 32 (21 acute myocardial infarction, Chagas'disease in 12, valvopathy in 11, cardiomyopathy in 7, heart failure with no specification of cardiopathy in 11 and other causes in 9. At the necropsy the death cause was ischemic heart disease in 34 patients, valvopathy in 10, Chagas'disease in 10, cardiomyopathy in 5, and heart failure with no specification of cardiopathy in 2.The concordance taxes were in thhe same order: 94,6%, 90,0%, 83.3%, 71.4% and 28.5%. CONCLUSION: There was a great efficiency of clinical diagnosis for death cause in a general university hospital. The ischemic heart disease were the main causes of death.

  6. Right lung agenesis and dextrocardia: one autopsy case report and review of literature%右肺缺如并右位心尸体解剖1例及文献复习

    Institute of Scientific and Technical Information of China (English)

    韩林; 张兆祥; 杨大富

    2014-01-01

    目的 探讨先天性肺缺如和右位心的发病率、病因及发病机制、临床病理所见及诊断.方法 报告经尸检证实的右肺缺如并右位心1例,并复习近期相关文献.结果 患儿为出生32天女婴.因口吐白沫、呼吸急促伴口唇发绀1天入院,经抢救无效死亡.尸检主要病变包括:①先天性右肺缺如(包括右肺动脉分支和右肺静脉)并新生儿肺炎(左肺);②伴内脏正位的真性(镜像)右位心.结论 婴幼儿肺缺如并右位心是一种极其罕见的先天性畸形.肺缺如临床表现为典型的呼吸道症状,极易误(漏)诊.右位心需与模拟右位心、假性右位心等鉴别.X线、CT、MRI、支气管镜和超声心动图检查有助于肺缺如和右位心的诊断.

  7. 新生儿先天性心脏病围手术期死因的尸检病理分析%An autopsies analysis of perioperative death in newborns with congenital heart deseases

    Institute of Scientific and Technical Information of China (English)

    刘蕾; 王红月

    2006-01-01

    目的 从病理学角度分析新生儿先天性心脏病围手术期的死亡原因.方法 收集15例围手术期死亡的新生儿先天性心脏病尸检病例,复查病理资料,分析其死亡原因.结果 先天性心脏病新生儿围手术期病死率为28.6%,尸检率为62.5%.临床与尸检病理诊断符合率为86.67%,主要死因包括心脏原因(9例),肺部感染(4例)及应激性肾上腺出血(2例).结论 加强新生儿先天性心脏病围手术期的心肺保护,加强尸检意识,有助提高手术成功率.

  8. Virtual autopsy in forensic sciences and its applications in the forensic odontology = A autópsia virtual nas ciências forenses e sua aplicação na Odontologia forense

    OpenAIRE

    Rosário Junior, Ademir Franco do

    2012-01-01

    Atualmente os avanços tecnológicos se fazem cada vez mais importantes nas ciências forenses. Por outro lado a autópsia ainda é uma abordagem tradicional na prática médica-odontológica, na qual evidências são coletadas por meio fotográfico e radiológico. Neste contexto, a Autópsia Virtual surge como uma ferramenta útil e complementar para o exame cadavérico. Através da alta tecnologia radiológica a Autópsia Virtual fornece uma visão eficiente e precisa do caso a ser analisado. Esta revisão crí...

  9. Virtual autopsy in forensic sciences and its applications in the forensic odontology = A autópsia virtual nas ciências forenses e sua aplicação na Odontologia forense

    Directory of Open Access Journals (Sweden)

    Rosário Junior, Ademir Franco do

    2012-01-01

    Full Text Available Atualmente os avanços tecnológicos se fazem cada vez mais importantes nas ciências forenses. Por outro lado a autópsia ainda é uma abordagem tradicional na prática médica-odontológica, na qual evidências são coletadas por meio fotográfico e radiológico. Neste contexto, a Autópsia Virtual surge como uma ferramenta útil e complementar para o exame cadavérico. Através da alta tecnologia radiológica a Autópsia Virtual fornece uma visão eficiente e precisa do caso a ser analisado. Esta revisão crítica tem o objetivo de atualizar os Cirurgiões-dentistas apresentando o primeiro trabalho com o conteúdo voltado a Autópsia Virtual

  10. Sipuleucel-T (Provenge(®))-Autopsy of an Innovative Paradigm Change in Cancer Treatment: Why a Single-Product Biotech Company Failed to Capitalize on its Breakthrough Invention.

    Science.gov (United States)

    Jarosławski, Szymon; Toumi, Mondher

    2015-10-01

    Approved by the US Food and Drug Administration (FDA) in 2010, sipuleucel-T (Provenge(®)) was the first 'personalized' cancer vaccine for the treatment of prostate cancer in a metastatic, non-symptomatic population of 30,000 men in the USA. Sipuleucel-T is prepared individually for each patient and infused in three sessions over a period of 1 month. However, in 2015, Dendreon, the owner of sipuleucel-T, filed for bankruptcy. This opinion paper reviews the probable reasons this innovative product failed to achieve commercial success. PubMed and internet searches were performed focused on pricing, reimbursement, and market access. We found that sipuleucel-T's FDA approval was delayed by 3 years, reportedly because of the vaccine's new mechanism of action. Sipuleucel-T was cleared by the European Medicines Agency 2 years later, but other national agencies were not approached. It was priced at $US93,000 for a course of treatment, and this high price combined with the company's late securement of reimbursement for the vaccine by the US Centers for Medicare and Medicaid Services (CMS) resulted in another year's delay in accessing the market. Despite a positive recommendation by the National Comprehensive Cancer Network, sipuleucel-T's complex administration, high price, and uncertainty about the reimbursement status deterred doctors from prescribing the product. Furthermore, the vaccine's supply was limited during the first year of launch due to limited manufacturing capacity. In addition, two oral metastatic prostate cancer drugs with similar survival benefits reached the US market 1 and 2 years after sipuleucel-T. Also, even though Dendreon's market capitalization topped $US7.5 billion following the FDA's approval of sipuleucel-T, this value degraded gradually until the firm's bankruptcy 5 years later. We conclude that the bankruptcy of Dendreon was largely due to the delay in securing FDA approval and CMS coverage, as well as the high cost that had to be incurred by providers up-front. Licensing sipuleucel-T to a pharmaceutical company more experienced in the market access pathway may have saved the company and the product.

  11. Hepatocellular carcinoma (Letter to the editor)

    DEFF Research Database (Denmark)

    Békássy, Albert N.; Garwicz, Stanislaw; Jensen, O.A.

    1994-01-01

    Øjenpatologi, Alagill's syndrome, hepatic carcinoma, biliary atresia, histopathology, liver, child, liver cirrhosis, autopsy, eyes, AFP......Øjenpatologi, Alagill's syndrome, hepatic carcinoma, biliary atresia, histopathology, liver, child, liver cirrhosis, autopsy, eyes, AFP...

  12. Experience with post-mortem computed tomography in Southern Denmark 2006-11

    DEFF Research Database (Denmark)

    Leth, Peter Mygind

    2013-01-01

    . Materials: PMCT and autopsy were performed in 900 forensic cases from Southern Denmark. 4547 diagnoses were registered. Methods: This was a prospective, double-blind investigation. Results: In twothirds of all cases, PMCT and autopsy agreed on the cause of death. The agreement was highest for injury deaths...... in this study could have been substituted by PMCT. Histology yielded important new information in onefourth of the cases, but this proportion was much smaller among cases for which we estimated that the autopsy could have been substituted by PMCT. Conclusion: PMCT is a valuable supplement to autopsy and may......Objectives: (1) To explore the ability of post-mortem computed tomography (PMCT) to establish the cause of death. (2) To investigate the inter-method variation between autopsy and PMCT. (3) To investigate whether PMCT can select cases for autopsy. (4) To investigate the importance of histology...

  13. Differences in investigations of sudden unexpected deaths in young people in a nationwide setting

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Holst, Anders Gaarsdal; Theilade, Juliane;

    2012-01-01

    differences exist in the investigation of young persons dying suddenly and unexpectedly. METHODS AND RESULTS: All deaths in persons aged 1-35 years in Denmark in 2000-2006 were included. Death certificates were read independently by two physicians. External examination as well as autopsy status was retrieved....... Significant regional differences were found regarding external examinations and autopsy frequencies. Ratios of conducted external examinations varied between 63% and 93% (p¿=¿0.004). Autopsy ratios varied between 60% and 88% (p¿=¿0.001). In urban areas, external examinations and autopsies were more often...... conducted than in rural areas. In East Denmark, there were more external examinations resulting in a forensic autopsy, and there was a higher overall autopsy rate compared to West Denmark. CONCLUSION: Despite operating under the same set of laws, we document significant regional differences in forensic...

  14. Computerized tomography used as a routine procedure at postmortem investigations

    DEFF Research Database (Denmark)

    Leth, Peter Mygind

    2009-01-01

    This is a prospective investigation of a consecutive series of 250 deceased individuals who were computerized tomography (CT)-scanned and autopsied. In 13% of patients, important findings at the CT-scanning were not found at the autopsy, and in 48% of patients, important autopsy findings were not...... and allows fractures and inner organs to be seen "in situ." CT provides documentation in digital form - easily stored - permits review by others and provides pictures that may be more suitable for presentation in court than autopsy photos....

  15. La causa y la manera de la muerte indeterminada: a propósito de un caso de muerte súbita en adolescente, portador de una tumoración quística intestinal, descubierta durante la autopsia Cause and Manner of Death Undetermined: regarding a case of sudden death in an adolescent with an intestinal cystic tumour, discovered during autopsy

    OpenAIRE

    A. Garfia; M. Salguero; Martínez, M.C.; J.C. Pimentel

    2002-01-01

    Presentamos un caso de muerte inesperada súbita, acaecida en un sujeto de 19 años, el cual presentó, en las horas previas al fallecimiento, un cuadro de mareos, náuseas y vómitos que fue tratado en el Centro de Atención Primaria con analgésicos y antiespasmódicos. Después de pocas horas de evolución el indivíduo fue trasladado de nuevo, por los familiares, al Centro Médico, en estado de inconsciencia. A pesar de la aplicación de maniobras de resucitación el sujeto presentó parada cardiorrespi...

  16. Neurocisticercose: contribuição da necrópsia na consolidação da notificação compulsória em Ribeirão Preto-SP, Brazil Neurocysticercosis: contribution of autopsies to consolidation of the compulsory notification in Ribeirão Preto-SP, Brazil

    OpenAIRE

    LEILA CHIMELLI; ADRIANA F. LOVALHO; Osvaldo M. Takayanagui

    1998-01-01

    O presente estudo tem como objetivo a apresentação dos achados de cisticercose nas necrópsias realizadas no Serviço de Patologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP, no período de 1992 a 1997. Das 2522 necrópsias, a neurocisticercose foi detectada em 38 (1,5%) dos casos. Destes, 22 (57,9%) foram diagnosticados apenas na necrópsia enquanto 16 (42,1%) apresentavam exames complementares consistentes com cisticercose. A análise dos prontuários médicos evidencio...

  17. 电感耦合等离子体质谱法测定人尸体10种器官组织样品中15种痕量稀土元素的研究%Determination of 15 trace rare earth elements in 10 kinds of human autopsy organ tissue by ICP-MS

    Institute of Scientific and Technical Information of China (English)

    欧阳荔; 诸洪达; 王京宇; 刘雅琼; 王小燕; 王耐芬; 刘虎生

    2004-01-01

    采用ICP-MS法对人尸体10种器官组织样品中痕量稀土元素测定进行了研究,选择了最佳仪器工作参数,用铑(Rh)为内标元素补偿基体效应和灵敏度漂移,检出限为0.005(89Y)~0.023(172Yb)ng/mL,肝样品的加标回收率为81%~118%,相对标准偏差为1.6%~14%.在严格质量控制的基础上用HNO3+HClO4混合酸消解样品,不须分离富集,直接对人尸体的肺、肝、骨、甲状腺、小肠、胃、肌肉、肾、脾和心中15种痕量稀土元素进行测定.

  18. Mortalidad asociada con la contaminación atmosférica por SO2: A propósito de un caso de autopsia médico legal tras un episodio de polución atmosférica Mortality associated with atmospheric pollution by SO2: A medical legal case of autopsy after an episode of atmospheric pollution

    Directory of Open Access Journals (Sweden)

    P.M. Garamendi González

    2003-07-01

    Full Text Available Se presenta un caso de muerte súbita de origen respiratorio en un paciente afecto de broncopatía previa en el entorno de un episodio de contaminación atmosférica por SO2. Se exponen los resultados del estudio histopatológico y toxicológico, así como las conclusiones de las encuestas clínicas en la población expuesta y de los análisis de concentraciones ambientales por SO2 durante el episodio. Se presentan los datos de revisión bibliográfica sobre la mortalidad asociada con exposición ambiental al SO2. Se analizan los criterios de causalidad de la posible muerte relacionada con la exposición a tóxicos y se valoran los posibles factores de confusión en la interpretación de los resultados del estudio forense.We present a case report on a sudden pulmonary death in an asthmatic subject exposed to sulphur dioxide air pollution. We present the results of histopathological and toxicological investigations and those of the epidemiological survey on the general population exposed to a sulphur dioxide pollution episode. Air concentrations of sulphur dioxide during the pollution episode are summarised. We also developed a short bibliographic review on sudden death associated with sulphur dioxide pollution. Finally, we analyse causality criteria about the relationship between sudden death in this case and the sulphur dioxide exposure episode and we point out some possible misinterpretation factors related to forensic evaluation of the episode and its relation with sudden death.

  19. The value of postmortem experience in undergraduate medical education: current perspectives

    Directory of Open Access Journals (Sweden)

    Bamber AR

    2015-03-01

    Full Text Available Andrew R Bamber,1 Thelma A Quince2 1UCL Institute of Child Health, London, UK; 2Department of Public Health and Primary Care, Primary Care Unit, School of Clinical Medicine, University of Cambridge, School of Clinical Medicine, Cambridge, UK Abstract: The autopsy has traditionally been used as a tool in undergraduate medical education, but recent decades have seen a sharp decline in their use for teaching. This study reviewed the current status of the autopsy as a teaching tool by means of systematic review of the medical literature, and a questionnaire study involving UK medical schools. Teachers and students are in agreement that autopsy-based teaching has many potential benefits, including a deeper knowledge of basic clinical sciences, medical fallibility, end of life issues, audit and the “hidden curriculum”. The reasons underlying the decline in teaching are complex, but include the decreasing autopsy rate, increasing demands on teachers' time, and confusion regarding the law in some jurisdictions. Maximal use of autopsies for teaching may be achieved by involvement of anatomical pathology technologists and trainee pathologists in teaching, the development of alternative teaching methods using the principles of the autopsy, and clarification of the law. Students gain most benefit from repeated attendance at autopsies, being taught by enthusiastic teachers, when they have been effectively prepared for the esthetic of dissection and the mortuary environment. Keywords: medical education, autopsy, postmortem 

  20. Cranial thickness in relation to age, sex and general body build in a Danish forensic sample

    DEFF Research Database (Denmark)

    Lynnerup, N

    2001-01-01

    The cranial thickness was measured in 64 individuals (43 males, 21 females) autopsied at our institute. The thickness was measured by taking a biopsy with a trephine at four specific locations on the skull. Complete medical records and pathologic autopsy results were available. While none of the ...