WorldWideScience

Sample records for autopsies

  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. Informatics and Autopsy Pathology.

    Science.gov (United States)

    Levy, Bruce

    2015-06-01

    Many health care providers believe that the autopsy is no longer relevant in high-technology medicine era. This has fueled a decline in the hospital autopsy rate. Although it seems that advanced diagnostic tests answer all clinical questions, studies repeatedly demonstrate that an autopsy uncovers as many undiagnosed conditions today as in the past. The forensic autopsy rate has also declined, although not as precipitously. Pathologists are still performing a nineteenth century autopsy procedure that remains essentially unchanged. Informatics offers several potential answers that will evolve the low-tech autopsy into the high-tech autopsy. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Assessing the autopsy.

    Science.gov (United States)

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

    1987-08-01

    This study outlines the role of autopsies in medical practice and health policy, details the nature and reason for declining rates, including those in Rochester, Minnesota, and suggests possible remedial measures to halt or reverse this trend. It is concluded that one of the principal impediments to reversing the declining rate of autopsies is what is referred to in Economics as "market failure." In particular, the nature of the spatial and temporal distribution of costs and benefits has precluded the existence of an incentive structure which can lead to a realization of the major net social benefits from the autopsy. Ultimately, it is only the explicit recognition by the medical profession, government agencies, corporate insurers, and the general public of the nature and significance of this market failure and foregone benefits which can lead to remediation.

  4. 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.

  5. Autopsy approach to stroke.

    Science.gov (United States)

    Love, Seth

    2011-02-01

    Stroke is a major cause of morbidity and mortality but the brain and other relevant tissues are often examined only cursorily when stroke patients come to autopsy. The pathological findings and clinical implications vary according to the type of stroke and its location and cause. Large ischaemic strokes are usually associated with atherosclerosis of extracranial or major intracranial arteries but can be caused by dissection. Most small cerebral infarcts are caused by arteriosclerosis or, in the elderly, cerebral amyloid angiopathy (CAA). However, vasculitides and coagulopathies can cause a range of different patterns of ischaemic (and, occasionally, haemorrhagic) stroke. Global brain ischaemia, caused by severe hypotension or raised intracranial pressure, produces damage that is accentuated in certain regions and neuronal populations and may be confused with hypoglycaemic injury. The main cause of subarachnoid haemorrhage is a ruptured berry aneurysm but CAA, arteriovenous malformations and infective aneurysms are occasionally responsible. These can also cause parenchymal brain haemorrhage, although this most often complicates hypertensive small vessel disease. Sometimes the haemorrhage arises from a neoplasm. Performing an adequate autopsy in stroke requires proper preparation, awareness of the likely pathological processes, familiarity with intracranial vascular anatomy, careful gross examination and dissection, and appropriate use of histology. © 2010 Blackwell Publishing Limited.

  6. Findings of autopsy imaging

    International Nuclear Information System (INIS)

    Shiotani, Seiji; Saito, Tsukuru; Itoya, Saori

    2009-01-01

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

  7. MIA : the Minimally Invasive Autopsy

    NARCIS (Netherlands)

    B.M. Blokker (Britt)

    2018-01-01

    textabstractThe autopsy is important to keep up the high quality of modern medicine, by giving clinicians feedback on diagnostics and therapies, and providing for medical training and medical research. Nevertheless, autopsy rates have been declining in many Western countries. From 1977 through 2011,

  8. Family members' experiences of autopsy

    NARCIS (Netherlands)

    Oppewal, F; Meyboom-de Jong, B

    Background. The experiences of family members will teach us how to handle an autopsy, the ultimate quality assessment tool. Objective. The aim of this study was to determine surviving family members' experience of autopsy. Method. Seven GPs were asked to approach surviving family members of

  9. Virtopsy: Touch-free autopsy

    OpenAIRE

    Badam, Raj Kumar; Sownetha, Triekan; Babu, D. B. Gandhi; Waghray, Shefali; Reddy, Lavanya; Garlapati, Komali; Chavva, Sunanda

    2017-01-01

    The word “autopsy” denotes “to see with own eyes.” Autopsy (postmortem) is a process that includes a thorough examination of a corpse noting everything related to anatomization, surface wounds, histological and culture studies. Virtopsy is a term extracted from two words “virtual” and “autopsy.” It employs imaging methods that are routinely used in clinical medicine such as computed tomography and magnetic resonance imaging in the field of autopsy, to find the reason for death. Virtopsy is a ...

  10. 42 CFR 37.203 - Autopsy specifications.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Autopsy specifications. 37.203 Section 37.203... EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Autopsies § 37.203 Autopsy specifications. (a) Every autopsy for which a claim for payment is submitted pursuant to this part: (1) Shall be...

  11. Consented Autopsy and the Middle-East.

    Science.gov (United States)

    Kharoshah, Magdy A; Hussain, Syed Ather; Madadin, Mohammed; Menezes, Ritesh G

    2017-02-01

    Consented autopsy is almost non-existent in the Middle-East where established social and cultural beliefs regarding the procedure might discourage family members from requesting a consented autopsy. Evidence suggests that new information is obtained from consented autopsies. It would not be in the best interest of medicine if social and cultural misconceptions succeed in erasing the existence of consented autopsies entirely.

  12. Inequality in Fetal Autopsy in Canada.

    Science.gov (United States)

    Auger, Nathalie; Tiandrazana, Rémi-Claude; Healy-Profitós, Jessica; Costopoulos, André

    2016-01-01

    Inequality in use of fetal autopsy is poorly understood, despite the importance of autopsy in establishing the cause of stillbirth for future prevention. We examined fetal autopsy rates between linguistic minorities in Quebec, Canada, and assessed trends over three decades. Using registry data on 11,992 stillbirths from 1981-2011, we calculated fetal autopsy rates for Francophones, Anglophones, and Allophones by decade. We found lower fetal autopsy rates for Allophones (54.4%) than Francophones (68.5%) and Anglophones (63.4%), but rates decreased over time for all language groups. After 2000, Allophones had 25% higher risk of non-autopsy relative to Francophones, with 8.8 fewer autopsies for every 100 stillbirths. Allophones who were not autopsied had 32% higher risk of having an undetermined cause of death. Inequality in use of fetal autopsy may be widespread for minorities in Canada. Efforts to decrease stillbirth in minorities may require policies to increase autopsy rates.

  13. Autopsy Tissue Program

    International Nuclear Information System (INIS)

    Fox, T.; Tietjen, G.

    1979-01-01

    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

  14. Hospital autopsy: Endangered or extinct?

    Science.gov (United States)

    Turnbull, Angus; Osborn, Michael; Nicholas, Nick

    2015-08-01

    To determine the hospital autopsy rate for the UK in 2013. A study of data from a 'Freedom of Information' request to all (n=186) acute NHS Trusts within England (n=160), NHS Boards in Scotland (n=14) and Wales (n=7) and Social Care Trusts in Northern Ireland (n=5). Hospital autopsy rates were calculated from the number of hospital autopsies performed in 2013 as a percentage of total inpatient deaths in the Trust that year. The UK response rate was 99% (n=184), yielding a mean autopsy rate of 0.69%. The mean rates were 0.51% (England), 2.13% (Scotland), 0.65% (Wales) and 0.46% (Northern Ireland). 23% (n=38) of all included respondents had a rate of 0% and 86% (n=143) a rate less than 1%. The decline in hospital autopsy has continued relentlessly and, for better or for worse, the practice is on the verge of extinction in the UK. The study highlights to health professionals and policy makers the magnitude of this decline. Further research should investigate the impact of this on patient safety, clinical audit, public health and medical education. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Virtopsy: Touch-free autopsy

    Science.gov (United States)

    Badam, Raj Kumar; Sownetha, Triekan; Babu, D. B. Gandhi; Waghray, Shefali; Reddy, Lavanya; Garlapati, Komali; Chavva, Sunanda

    2017-01-01

    The word “autopsy” denotes “to see with own eyes.” Autopsy (postmortem) is a process that includes a thorough examination of a corpse noting everything related to anatomization, surface wounds, histological and culture studies. Virtopsy is a term extracted from two words “virtual” and “autopsy.” It employs imaging methods that are routinely used in clinical medicine such as computed tomography and magnetic resonance imaging in the field of autopsy, to find the reason for death. Virtopsy is a multi-disciplinary technology that combines forensic medicine and pathology, roentgenology, computer graphics, biomechanics, and physics. It is rapidly gaining importance in the field of forensics. This approach has been recently used by forensic odontologists, but yet to make its own mark in the field. This article mainly deals with “virtopsy” where in various articles were web searched, relevant data was selected, extracted, and summarized here. PMID:28584475

  16. Autopsy prevalence of Wernicke's encephalopathy in alcohol ...

    African Journals Online (AJOL)

    WE) in patients dying from alcohol-related diseases. Design. Prospective postmortem macroscopic and microscopic examination. Setting. Adult autopsies at King Edward VIII Hospital. Methods. Thirty-one consecutive autopsies were performed ...

  17. 49 CFR 831.10 - Autopsies.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Autopsies. 831.10 Section 831.10 Transportation.../INCIDENT INVESTIGATION PROCEDURES § 831.10 Autopsies. The Board is authorized to obtain, with or without reimbursement, a copy of the report of autopsy performed by State or local officials on any person who dies as a...

  18. 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 and...

  19. 32 CFR 935.14 - Autopsies.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Autopsies. 935.14 Section 935.14 National... WAKE ISLAND CODE Civil Administration Authority § 935.14 Autopsies. The medical officer on Wake Island, or any other qualified person under his supervision, may perform autopsies upon authorization of the...

  20. 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…

  1. Verbal Autopsies in Rural Tanzania

    African Journals Online (AJOL)

    Maternal mortality rates in rural Tanzania are high. In preparation for the introduction of an intervention to reduce maternal deaths by distribution of misoprostol and erythromycin to women living in rural Rorya District, Mara Region, Tanzania, we conducted a limited verbal autopsy by surveying family members of women ...

  2. Autopsy experience with a radioactive cadaver

    International Nuclear Information System (INIS)

    Johnston, A.S.; Minarcik, J.; Rossi, R.; Pinsky, S.

    1979-01-01

    A patient who received a 200-mCi dose of 131 I for widespread carcinoma died 10 days after treatment with 50 mCi remaining in the cadaver. An autopsy was required. The radiation levels were sufficiently high that personnel radiation protection was needed. An autopsy procedure was designed that prevented ingestion of radioactivity by the pathologist and his assistants, prevented excessive exposure of any involved personnel, and prevented contamination of the autopsy room or other hospital space. (author)

  3. Comparison of decomposition rates between autopsied and non-autopsied human remains.

    Science.gov (United States)

    Bates, Lennon N; Wescott, Daniel J

    2016-04-01

    Penetrating trauma has been cited as a significant factor in the rate of decomposition. Therefore, penetrating trauma may have an effect on estimations of time-since-death in medicolegal investigations and on research examining decomposition rates and processes when autopsied human bodies are used. The goal of this study was to determine if there are differences in the rate of decomposition between autopsied and non-autopsied human remains in the same environment. The purpose is to shed light on how large incisions, such as those from a thorocoabdominal autopsy, effect time-since-death estimations and research on the rate of decomposition that use both autopsied and non-autopsied human remains. In this study, 59 non-autopsied and 24 autopsied bodies were studied. The number of accumulated degree days required to reach each decomposition stage was then compared between autopsied and non-autopsied remains. Additionally, both types of bodies were examined for seasonal differences in decomposition rates. As temperature affects the rate of decomposition, this study also compared the internal body temperatures of autopsied and non-autopsied remains to see if differences between the two may be leading to differential decomposition. For this portion of this study, eight non-autopsied and five autopsied bodies were investigated. Internal temperature was collected once a day for two weeks. The results showed that differences in the decomposition rate between autopsied and non-autopsied remains was not statistically significant, though the average ADD needed to reach each stage of decomposition was slightly lower for autopsied bodies than non-autopsied bodies. There was also no significant difference between autopsied and non-autopsied bodies in the rate of decomposition by season or in internal temperature. Therefore, this study suggests that it is unnecessary to separate autopsied and non-autopsied remains when studying gross stages of human decomposition in Central Texas

  4. Aerospace Accident - Injury Autopsy Data System -

    Data.gov (United States)

    Department of Transportation — The Aerospace Accident Injury Autopsy Database System will provide the Civil Aerospace Medical Institute (CAMI) Aerospace Medical Research Team (AMRT) the ability to...

  5. 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....

  6. Judicial autopsy of radiation accidents

    International Nuclear Information System (INIS)

    Kannan, P.M.

    1990-01-01

    This paper discusses issues regarding the judicial autopsy of radiation accidents. In the litigation which follows a radiation accident, a claimant calls on the legal system to adjudicate a dispute. Scientific questions are thrust upon the court. The legal system (through attorneys for the parties) then invites scientists to assist the court in resolving such questions. The invitation, however, does not allow the scientist to bring along his full kit. Experimentation, such as repeating the accident with dosimeters to gather more accurate data, is generally not allowed. Also, the scientist must give up his practice of choosing which questions he will pursue

  7. Evaluation of Physicians' Requests for Autopsies.

    Science.gov (United States)

    Kesler, Richard W.; And Others

    1983-01-01

    Chaplains and seminary students enrolled in the University of Virginia Medical Center's Clinical Pastoral Program were asked to judge physicians' performances while requesting autopsies by completing a confidential evaluation form. The results of the evaluations were correlated with the physicians' success in obtaining autopsies. (MLW)

  8. Value of the perinatal autopsy : Critique

    NARCIS (Netherlands)

    Gordijn, SJ; Erwich, JJHM; Khong, TY

    2002-01-01

    In consenting to a perinatal autopsy, the primary motive of parents may be to find the exact cause of death. A critical review on the value of perinatal autopsies was performed to see whether parents could be counseled regarding their main motive. A literature search was performed in MEDLINE,

  9. Utah Youth Suicide Study: Psychological Autopsy

    Science.gov (United States)

    Moskos, Michelle; Olson, Lenora; Halbern, Sarah; Keller, Trisha; Gray, Doug

    2005-01-01

    We conducted a psychological autopsy study to further understand youth suicide in Utah. While traditional psychological autopsy studies primarily focus on the administration of psychometric measures to identify any underlying diagnosis of mental illness for the suicide decedent, we focused our interviews to identify which contacts in the…

  10. [Pediatric autopsy and informed parental consent].

    Science.gov (United States)

    Rambaud, C; Guilleminault, C

    2005-10-01

    In French legal terminology, the definition of autopsy is "organs'withholding". This phrase is ambiguous, meaning both removing the organs for their macroscopic exam and their retention for subsequent histology. The autopsy of a child requires an informed consent from both parents. The issue is that the pathologist who performs the autopsy is not the one who delivers the information and gets the parents' consent: therefore, he does not know what they were told and what they actually agreed upon. A questionnaire was sent to 3 groups of paediatricians (N=891) to approach their knowledge regarding autopsy. Among 362 paediatricians who answered the questionnaire, 57.2% never attended an autopsy and procedures were badly known. They did not know whether or not organs, were systematically sampled especially brain. Regarding the possibility of conservation of organs, a majority thought that one should not solely answer to parents'queries (63.8%) but rather that one should point out every possibility, without giving the ins and outs (60.8%). The majority favoured organs retention and use for research. We make 3 suggestions: to register autopsy in the Natioanal Securite Sociale nomenclature, to establish information and consent forms for organs'removal, retention and disposal, and to offer parents the possibility of an interview with the pathologist before and/or after the autopsy, in association with the paediatrician.

  11. Epidemiology in ovarian carcinoma: Lessons from autopsy.

    Science.gov (United States)

    Güth, Uwe; Arndt, Volker; Stadlmann, Sylvia; Huang, Dorothy Jane; Singer, Gad

    2015-08-01

    We challenge epidemiologic knowledge regarding ovarian carcinoma (OC) by bridging the gap between clinical and autopsy data. Autopsy reports, histological slides and clinical files from 660 patients in whom OC was diagnosed from 1975-2005 were studied (autopsy cohort, n=233; Clinical Cancer Registry from the local gyneco-oncologic center, n=427). Out of the autopsy cohort, we identified four distinct subgroups of patients: 1) OC was diagnosed before autopsy, n=156 (67.0%). 2) OC was an incidental finding, n=16 (6.8%). 3) The ovarian tumors were not primary OC but rather metastases from other primary tumors; this revised diagnosis was first made by using current histopathological knowledge/techniques, n=24 (10.3%). 4) Death was directly due to OC in its final stage and OC was first diagnosed by autopsy, n=37 (15.9%); when these cases were added to the Clinical Cancer Registry to an adjusted OC incidence model, the autopsy cases comprised 8.8% of the adjusted cohort and almost doubled the percentage of oldest patients (≥80 years at diagnosis) from 4.9% to 9.3% (p=0.013). Epidemiological data from the 1970s-1990s may overestimate true incidence because up to 10% of carcinomas in the ovary were not properly classified. Patients who were first diagnosed with OC by autopsy comprise a distinct subgroup. These are patients who have not been seen by specialized oncologists and thus play no role in their perception of the disease. Nevertheless, these cases have impact on prevalence and incidence data of OC and in an era of reduced autopsy rates will probably be overlooked. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Autopsy after transcatheter aortic valve implantation

    DEFF Research Database (Denmark)

    van Kesteren, F; Wiegerinck, E M A; Rizzo, S

    2017-01-01

    Autopsy after transcatheter aortic valve implantation (TAVI) is a new field of interest in cardiovascular pathology. To identify the cause of death, it is important to be familiar with specific findings related to the time interval between the procedure and death. We aimed to provide an overview...... different cause of death as was clinically determined. Autopsy on patients who underwent TAVI reveals specific patterns of cardiovascular pathology that clearly relate to the time interval between TAVI and death and significantly adds to the clinical diagnosis. Our data support the role of autopsy including...

  13. 42 CFR 37.202 - Payment for autopsy.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Payment for autopsy. 37.202 Section 37.202 Public... SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Autopsies § 37.202 Payment for autopsy. (a... in this part and with legal consent: (1) Performs an autopsy on a miner in accordance with this...

  14. 28 CFR 549.80 - Authority to conduct autopsies.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Authority to conduct autopsies. 549.80... MEDICAL SERVICES Authority To Conduct Autopsies § 549.80 Authority to conduct autopsies. (a) The Warden may order an autopsy and related scientific or medical tests to be performed on the body of a deceased...

  15. 77 FR 38179 - Autopsies at VA Expense

    Science.gov (United States)

    2012-06-27

    ... necessary to complete it in a timely fashion. Simplifying the language will help to achieve this goal by... return of the body. Consent for the autopsy will be obtained as stated in paragraph (d) of this section...

  16. Students' Opinions on Autopsy and Death

    African Journals Online (AJOL)

    from the case in real life, with fewer ... determination of the cause of death and ... of medical quality control, the autopsy ... monitoring of possible adverse effects. .... In relation to their professional future .... emotionally well-balanced individuals.

  17. Autopsy after transcatheter aortic valve implantation.

    Science.gov (United States)

    van Kesteren, F; Wiegerinck, E M A; Rizzo, S; Baan, J; Planken, R N; von der Thüsen, J H; Niessen, H W M; van Oosterhout, M F M; Pucci, A; Thiene, G; Basso, C; Sheppard, M N; Wassilew, K; van der Wal, A C

    2017-03-01

    Autopsy after transcatheter aortic valve implantation (TAVI) is a new field of interest in cardiovascular pathology. To identify the cause of death, it is important to be familiar with specific findings related to the time interval between the procedure and death. We aimed to provide an overview of the autopsy findings in patients with TAVI in their medical history divided by the timing of death with specific interest in the added value of autopsy over a solely clinically determined cause of death. In 8 European centres, 72 cases with autopsy reports were available. Autopsies were divided according to the time interval of death and reports were analysed. In 32 patients who died ≤72 h postprocedure, mortality resulted from cardiogenic or haemorrhagic shock in 62.5 and 34.4%, respectively. In 31 patients with mortality >72 h to ≤30 days, cardiogenic shock was the cause of death in 51.6% followed by sepsis (22.6%) and respiratory failure (9.7%). Of the nine patients with death >30 days, 88.9% died of sepsis, caused by infective endocarditis in half of them. At total of 12 patients revealed cerebrovascular complications. Autopsy revealed unexpected findings in 61.1% and resulted in a partly or completely different cause of death as was clinically determined. Autopsy on patients who underwent TAVI reveals specific patterns of cardiovascular pathology that clearly relate to the time interval between TAVI and death and significantly adds to the clinical diagnosis. Our data support the role of autopsy including investigation of the cerebrum in the quickly evolving era of cardiac device technology.

  18. Clinically unrecognized miliary tuberculosis: an autopsy study.

    Science.gov (United States)

    Savic, Ivana; Trifunovic-Skodric, Vesna; Mitrovic, Dragan

    2016-01-01

    Miliary tuberculosis (TB) usually presents with atypical clinical manifestations; thus it is often recognized only at autopsy. Our objectives were to study the frequency of MT diagnosed at autopsy and determine clinical diagnoses that masked TB, as well as causes of death and comorbidities. Retrospective study of all autopsies performed between 2008 and 2014. Institute of Pathology, Belgrade, Serbia. in subjects where autopsy showed the presence of MT that was not recognized clinically, we recorded the clinical diagnoses (presumed causes of death) as reported in autopsy request forms, as well as actual cause of death and comorbidities as determined at autopsy. Clinically unrecognized MT. The total number of autopsies in this period was 6206. thirty-five individuals showed clinically unrecognized MT (0.56% of all autopsies, age: 62.2 [17.2] years, M:F=2:3). Common clinical diagnoses masking pulmonary MT were exacerbation of COPD (25%) and pulmonary thromboembolism (25%), with common radiological presentation of diffuse pulmonary infiltrates (56.3%). Dominant clinical diagnoses in patients with generalized MT were adult respiratory distress syndrome, sepsis, gastrointestinal bleeding and meningoencephalitis. Disseminated MT was often associated with secondary anemia or thrombocytopenia (15.8%) and recent surgery (15.8%). Frequent comorbidities included chronic renal failure and malignancies, whereas MT was a dominant cause of death. Greater awareness of MT is needed to improve recognition in clinical settings. In particular, MT should be considered in patients with atypical clinical presentation and diffuse pulmonary infiltrates on chest X-ray, particularly if they have chronic renal failure, malignancy, hematological disorders or a history of recent surgery. None.

  19. Increasing the efficiency of autopsy reporting.

    Science.gov (United States)

    Siebert, Joseph R

    2009-12-01

    -When autopsy reports are delayed, clinicians and families do not receive information in a timely fashion. -Using lean principles derived from the Toyota Production System, we set out to streamline our autopsy reporting process. -In a formal workshop setting, we identified the steps involved in producing an autopsy report, then sought to eliminate, abbreviate, or reschedule them into a more efficient format. We established intermediate deadlines for each case, taking care to make them visible; we initiated a weekly quality assurance review, giving attention to both scientific issues and approaching deadlines. -By adopting a more standardized approach, eliminating redundancy, and improving the visibility of tasks, we improved the mean completion time of autopsy reports from 53 days (N = 47 cases) to 25 days (N = 47 cases). Previously, 17% of reports were completed by 30 days and 71% by 60 days; in the 15 months following initiation of the program, 72% of reports were completed by 30 days and 100% by 60 days. A follow-up survey of attending physicians revealed continuing appreciation for the autopsy and timely communication, with no perceived diminution in the quality of reports. -This approach was of great benefit in our laboratory and may assist others in reducing the turnaround time of their autopsy reports. It may also benefit other areas of the laboratory.

  20. Pneumonia: Features registered in autopsy material.

    Science.gov (United States)

    Kosjerina, Zdravko; Vukoja, Marija; Vuckovic, Dejan; Kosjerina Ostric, Vesna; Jevtic, Marija

    2017-08-01

    Despite improvements in clinical practice, pneumonia remains one of the leading causes of death worldwide. Pathologic findings from autopsy reports could provide more precise and valid data on characteristics of pneumonia patients. We retrospectively reviewed autopsy reports of deceased patients admitted to the Institute for Pulmonary Diseases of Vojvodina in Sremska Kamenica, Serbia, between 1994 and 2003. The patients were classified into two groups: group 1 (n = 161) comprised patients in whom pneumonia was the main cause of death, while group 2 (n = 165) consisted of patients in whom pneumonia was confirmed at autopsy but had various different causes of death. From 1776 patients who underwent autopsy 326 (18.3%) were diagnosed with pneumonia. The most common underlying diseases were atherosclerosis (29.4%), chronic obstructive pulmonary disease (COPD) (26.7%), and malignancies (20.2%). Pneumonia was the main cause of death in 161 cases (group 1) while in group 2 major causes of death were heart failure (HF) (26.7%), acute myocardial infarction (AMI) (16.4%), and pulmonary embolism (PE) (10.9%). Multilobar involvement (91% vs.27%), pulmonary effusion (29% vs.14%), and lung abscess (23.6% vs.8.5%) were more frequently found in group 1, compared to group 2. In patients with pneumonia who underwent autopsy most common underlying diseases were atherosclerosis, COPD, and malignancies, while major causes of death were: progression of pneumonia, HF, AMI, and PE.

  1. Attitude of nigerian resident doctors towards clinical autopsy.

    Science.gov (United States)

    Ekanem, V J; Gerry, I E

    2007-03-01

    It is to the disadvantage of the doctors in training that there is a decline in the rate of clinical autopsy world wide. This decline may to an extent depend on the attitude of the physicians. To evaluate the attitude of resident doctors towards the practice of clinical autopsy and to determine their role in the decline of clinical autopsy. We carried out a survey of the attitude of resident doctors undergoing training in the various clinical departments of our teaching hospital towards clinical autopsy practice. This survey was by means of a structured randomly distributed questionnaire. Questions were asked on their willingness to request for autopsy, the number of autopsies that they have requested for so far, what hinders them from requesting for autopsy, the level of participation at autopsy and the importance of autopsies in the health care delivery system Eighteen (30%) out of 60 resident doctors attributed their inability to request for autopsy on their not being in direct control of the patients, while 16 (26.7%) found it difficult to get consent from the relatives. Seventeen per cent of them gave reason of not being able to obtain report from the pathologist, 13.3% said it was difficult to get pathologist to perform autopsy on time while only 11% said they knew the diagnosis in most of their cases. Almost all the resident doctors (98.5%) agreed that autopsy is a necessary procedure and is important for their training and health care delivery system Autopsy rate can increase if the resident doctors receive more blessings to request for autopsy from their consultants. Increased exposure to autopsies and education with regards to the benefits of autopsies at both the undergraduate and post graduate level will contribute to improvement in the rate of clinical autopsy.

  2. Unexpected brain finding in pre-autopsy postmortem CT.

    Science.gov (United States)

    Chatzaraki, Vasiliki; Bolliger, Stephan A; Thali, Michael J; Eggert, Sebastian; Ruder, Thomas D

    2017-09-01

    A case is presented in which pre-autopsy postmortem computed tomography (PMCT) revealed an unexpected brain abscess with a related frontal sinusitis and an erosion of the posterior wall of the frontal sinus. PMCT findings enabled the forensic pathologists to adapt protective measures during autopsy and protect their health from infection. Pre-autopsy PMCT has been also useful in the early differential diagnosis procedure. The complementary use of postmortem imaging and autopsy can improve the quality of forensic death investigations.

  3. Autopsy practice in Ghana – reflections of a pathologist | Anim ...

    African Journals Online (AJOL)

    Autopsy practice in Ghana can be said to be far from satisfactory. Most Ghanaians do not know that there are different categories of death, which categories of death require an autopsy and who is required to perform the autopsy. The problems have further been complicated by the fact that, unlike other countries where ...

  4. Attitude and practice of health care providers towards autopsies in ...

    African Journals Online (AJOL)

    Background: Attitude and practice of health care professionals toward autopsy are important as they will give information regarding factors that contribute to the low rate of autopsies in children under five years. Objective: To evaluate the attitude and practice of health care providers towards autopsies in children under five ...

  5. Autopsy rates in the Netherlands: 35 years of decline

    NARCIS (Netherlands)

    B.M. Blokker (Britt); A.C. Weustink (Annick); M.G.M. Hunink (Myriam); Oosterhuis, J.W. (J. Wolter)

    2017-01-01

    textabstractObjective: Although the autopsy still is a valuable tool in health statistics, health care quality control, medical education, and biomedical research, autopsy rates have been declining worldwide. The aim of this study was to examine trends of overall, clinical and forensic autopsy rates

  6. Autopsy rates in the Netherlands: 35 years of decline.

    Science.gov (United States)

    Blokker, Britt M; Weustink, Annick C; Hunink, M G Myriam; Oosterhuis, J Wolter

    2017-01-01

    Although the autopsy still is a valuable tool in health statistics, health care quality control, medical education, and biomedical research, autopsy rates have been declining worldwide. The aim of this study was to examine trends of overall, clinical and forensic autopsy rates among adults in the Netherlands over the last four decades, and trends per sex, age (groups), and hospital type. We performed a retrospective study covering 35 years of Dutch national death counts (1977-2011), the number of in-hospital deceased patients, the number of deaths due to external causes, and the proportion of autopsies performed in these populations. The effects of sex, age and hospital category were analysed by linear and logistic regression and differences were evaluated by chi-square tests. Overall autopsy rates declined by 0.3% per calendar year, clinical autopsy rates by 0.7% per calendar year (from 31.4% to 7.7%), and forensic autopsy rates did not decline. Per calendar year the fraction of in-hospital deceased patients decreased by 0.2%. Autopsy rates were highest among men and younger patients; clinical autopsy rates were highest for patients dying in academic hospitals. In the Netherlands clinical autopsy rates have rapidly declined while at the same time the fraction of in-hospital deaths decreased, both contributing to the overall reduced absolute number of autopsies performed. It is important to improve awareness among both clinicians and general practitioners of the significance of the clinical autopsy.

  7. 76 FR 75509 - Autopsies at VA Expense

    Science.gov (United States)

    2011-12-02

    ... months prior to death. This would accomplish the same effect as the current language, but would do so in... regulation also describes the typical hierarchy for those who may grant permission for an autopsy, but the... director in a State in which this typical hierarchy is not in fact law. Thus, we would remove this list...

  8. Autopsy after transcatheter aortic valve implantation

    NARCIS (Netherlands)

    van Kesteren, F.; Wiegerinck, E. M. A.; Rizzo, S.; Baan, J.; Planken, R. N.; von der Thüsen, J. H.; Niessen, H. W. M.; van Oosterhout, M. F. M.; Pucci, A.; Thiene, G.; Basso, C.; Sheppard, M. N.; Wassilew, K.; van der Wal, A. C.

    2017-01-01

    Autopsy after transcatheter aortic valve implantation (TAVI) is a new field of interest in cardiovascular pathology. To identify the cause of death, it is important to be familiar with specific findings related to the time interval between the procedure and death. We aimed to provide an overview of

  9. 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...

  10. Plutonium in autopsy tissues in Great Britain

    International Nuclear Information System (INIS)

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

    1985-01-01

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

  11. Can postmortem fetal MR imaging replace autopsy?

    International Nuclear Information System (INIS)

    Cho, Jeong Yeon; Song, Mi Jin; Kim, Seoung Hyup

    2001-01-01

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

  12. Radiographic investigations during medico-legal autopsies

    Energy Technology Data Exchange (ETDEWEB)

    Bratzke, H.; Schneider, V.; Dietz, W.

    1982-04-01

    During the last 13 years (1968-1980), 427 radiographic examinations were carried out during the course of medico-legal autopsies at the Institute of Forensic Medicine at the Free University of Berlin. Important problems were the demonstration of retained foreign bodies resulting from shooting, stabbing or blunt trauma, bone injuries, identification, and the question of life in neonates. An historical survey is given and 12 cases with special forensic problems are illustrated and discussed, and further means of investigations are described.

  13. Autopsy findings in small cell lung cancer

    International Nuclear Information System (INIS)

    Jereczek, B.; Jassem, J.; Karnicka-Mlodkowska, H.; Badzio, A.; Mos-Antkowiak, R.; Dziadziuszko, R.; Szczepek, B.; Chojak, E.; Lisowska, B.; Malak, K.

    1996-01-01

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

  14. The working procedure of human autopsy specimens

    International Nuclear Information System (INIS)

    Chen Rusong; Liu Guodong

    2000-01-01

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

  15. Minimally invasive, imaging guided virtual autopsy compared to conventional autopsy in foetal, newborn and infant cases: study protocol for the paediatric virtual autopsy trial

    Science.gov (United States)

    2014-01-01

    Background In light of declining autopsy rates around the world, post-mortem MR imaging is a promising alternative to conventional autopsy in the investigation of infant death. A major drawback of this non-invasive autopsy approach is the fact that histopathological and microbiological examination of the tissue is not possible. The objective of this prospective study is to compare the performance of minimally invasive, virtual autopsy, including CT-guided biopsy, with conventional autopsy procedures in a paediatric population. Methods/Design Foetuses, newborns and infants that are referred for autopsy at three different institutions associated with the University of Zurich will be eligible for recruitment. All bodies will be examined with a commercial CT and a 3 Tesla MRI scanner, masked to the results of conventional autopsy. After cross-sectional imaging, CT-guided tissue sampling will be performed by a multifunctional robotic system (Virtobot) allowing for automated post-mortem biopsies. Virtual autopsy results will be classified with regards to the likely final diagnosis and major pathological findings and compared to the results of conventional autopsy, which remains the diagnostic gold standard. Discussion There is an urgent need for the development of alternative post-mortem examination methods, not only as a counselling tool for families and as a quality control measure for clinical diagnosis and treatment but also as an instrument to advance medical knowledge and clinical practice. This interdisciplinary study will determine whether virtual autopsy will narrow the gap in information between non-invasive and traditional autopsy procedures. Trial Registration ClinicalTrials.gov: NCT01888380 PMID:24438163

  16. Decision influences and aftermath: parents, stillbirth and autopsy.

    Science.gov (United States)

    Horey, Dell; Flenady, Vicki; Conway, Liz; McLeod, Emma; Yee Khong, Teck

    2014-08-01

    Stillbirth, among the most distressing experiences an adult may face, is also a time when parents must decide whether an autopsy or other post-mortem examinations will be performed on their infant. Autopsies can reveal information that might help explain stillbirth, yet little is known about how people make this difficult decision. This study examines the influences on decisions about autopsy after stillbirth among Australian parents. The study involved secondary analysis of transcripts of three focus groups using qualitative content analysis. Seventeen parents of 14 stillborn babies participated in consultations around the revision of a perinatal mortality audit guideline. Parents shared the decision making. Four decision drivers were identified: parents' preparedness or readiness to make decisions; parental responsibility; concern for possible consequences of an autopsy and the role of health professionals. Each decision driver involved reasons both for and against autopsy. Two decision aftermath were also present: some parents who agreed to an autopsy were dissatisfied with the way the autopsy results were given to them and some parents who did not have an autopsy for their infant expressed some form of regret or uncertainty about the choice they made. To make decisions about autopsy after stillbirth, parents need factual information about autopsy procedures, recognition that there might be fear of blame, an environment of trust, and health services and professionals prepared and skilled for difficult conversations. © 2012 John Wiley & Sons Ltd.

  17. 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.

  18. Radiographic investigations during medico-legal autopsies

    International Nuclear Information System (INIS)

    Bratzke, H.; Schneider, V.; Dietz, W.

    1982-01-01

    During the last 13 years (1968-1980), 427 radiographic examinations were carried out during the course of medico-legal autopsies at the Institute of Forensic Medicine at the Free University of Berlin. Important problems were the demonstration of retained foreign bodies resulting from shooting, stabbing or blunt trauma, bone injuries, identification, and the question of life in neonates. An historical survey is given and 12 cases with special forensic problems are illustrated and discussed, and further means of investigations are described. (orig.) [de

  19. Autopsy findings in carcinoma of the esophagus

    International Nuclear Information System (INIS)

    Bosch, A.; Frias, Z.; Caldwell, W.L.; Jaeschke, W.H.

    1979-01-01

    At autopsy of 82 cases of carcinoma of the esophagus over a period of 25 years metastatic tumor was found in 42 cases (51%) and residual tumor in the esophagus in 56 cases (86%). The most frequent site of metastases was in the lymph nodes, followed by liver, lung, and adrenal gland. Direct extension of the tumor to adjacent structures was established in 30 cases (36%), and the most frequent structure involved was the trachea. Five cases had a second primary and two cases a second separate lesion at another level of the esophagus. (Auth.)

  20. Postmortem magnetic resonance imaging: Reproducing typical autopsy heart measurements.

    Science.gov (United States)

    Ampanozi, Garyfalia; Hatch, Gary M; Flach, Patricia M; Thali, Michael J; Ruder, Thomas D

    2015-11-01

    The aim of this study was to evaluate the utility of cardiac postmortem magnetic resonance (PMMR) to perform routine measurements of the ventricular wall thicknesses and the heart valves and to assess if imaging measurements are consistent with traditional autopsy measurements. In this retrospective study, 25 cases with cardiac PMMR and subsequent autopsy were included. The thicknesses of the myocardial walls as well as the circumferences of all heart valves were measured on cardiac PMMR and compared to autopsy measurements. Paired samples T-test and the Wilcoxon-Signed rank test, were used to compare autopsy and cardiac PMMR measurements. For exploring correlations, the Pearson's Correlation coefficient and the Spearman's Rho test were used. Cardiac PMMR measurements of the aortic and pulmonary valve circumferences showed no significant differences from autopsy measurements. The mitral and tricuspid valves circumferences differed significantly from autopsy measurements. Left myocardial and right myocardial wall thickness also differed significantly from autopsy measurements. Left and right myocardial wall thickness, and tricuspid valve circumference measurements on cardiac PMMR and autopsy, correlated strongly and significantly. Several PMMR measurements of cardiac parameters differ significantly from corresponding autopsy measurements. However, there is a strong correlation between cardiac PMMR measurements and autopsy measurements in the majority of these parameters. It is important to note that myocardial walls are thicker when measured in situ on cardiac PMMR than when measured at autopsy. Investigators using post-mortem MR should be aware of these differences in order to avoid false diagnoses of cardiac pathology based on cardiac PMMR. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Parental decision making around perinatal autopsy: a qualitative investigation.

    Science.gov (United States)

    Meaney, Sarah; Gallagher, Stephen; Lutomski, Jennifer E; O'Donoghue, Keelin

    2015-12-01

    Decades of decline in uptake rates of perinatal autopsies has limited investigation into the causes and risk factors for stillbirth. This study aimed to qualitatively explore perinatal autopsy decision-making processes in parents who experienced antepartum and intrapartum stillbirths. A qualitative semi-structured interview format was utilized. The line of questioning centred on how parents came to decide on consenting or declining to have a perinatal autopsy undertaken. Interpretative phenomenological analysis was employed as the analytic strategy. Purposive sampling was used to recruit 10 parents who either consented or declined autopsy from a large tertiary maternity hospital in Cork Ireland, where there were 30 stillbirths in 2011. Findings revealed four superordinate themes influencing parents' decision-making which varied with type of stillbirth experienced. Those parents who experienced antepartum stillbirths were more likely to consent; thus, knowing that the child was stillborn prior to delivery rather than on the day of delivery was associated with consent. In fact, these parents had more time for meaning-making; those consenting wanted to rule out self-blame and were fearful about future pregnancies. Parents who declined autopsy wanted to protect their infant from further harm. Interestingly, parents' knowledge and understanding of the autopsy itself were acquired primarily from public discourse. Parents' decision-making regarding autopsy is profoundly affected by their emotional response to stillbirth; clinicians and other health professionals may play a key role, especially if they can address parental concerns regarding the invasiveness of the autopsy procedure. © 2014 John Wiley & Sons Ltd.

  2. Autopsy pathology revisited | Offiah | Abia State University Medical ...

    African Journals Online (AJOL)

    An autopsy is the examination of the body of a dead person. · It involves systematic dissection of human tissue after death. · It may be restricted to a specific organ region of the body. · Autopsies are performed to determine the cause of death, for legal purposes, and for education and research. · The body is opened in a ...

  3. Correlation between clinincal and autopsy diagnoses in 150 cases ...

    African Journals Online (AJOL)

    Background: Autopsy is a veritable tool for auditing the accuracy of clinincal diagnosis. This study determined the accuracy of clinical diagnosis of diseases using autopsy result. The present report was informed by the unusual presentation of this case and the intent of increasing the index of diagnostic suspicion. A brief ...

  4. Medico Legal Autopsies In Aba, Nigeria | Offiah | Abia State ...

    African Journals Online (AJOL)

    To determine the pattern of medico legal autopsies performed between January 2001 to December 2005 so as to highlight any differences or similarities to the observation of workers in other parts of the country and/or world. A hospital based retrospective analysis of coroner's autopsies in Abia State University Teaching ...

  5. Attitude and Perceptions of Clinicians in Lagos to Autopsy Practice ...

    African Journals Online (AJOL)

    Using pretested questionnaire instrument, a cross sectional survey of clinicians working in the Lagos University Teaching Hospital to obtain their attitudes and perception towards autopsy practice. 230 questionnaires were administered and the response rate was 80.7% . 41.5% of respondents often requested for autopsy.

  6. Plutonium and Cs-137 in autopsy tissues in Great Britain

    International Nuclear Information System (INIS)

    Popplewell, D.S.; Ham, G.J.; Dodd, N.J.; Shuttler, S.D.

    1988-01-01

    Tissues removed at autopsy from members of the general public contain significantly higher concentrations of plutonium and 137 Cs in west Cumbrians than in people from three other regions of Great Britain. Several autopsy cases from Cumbria showed unusually high values of plutonium. Subsequently it was found that the subjects had been former employees of British Nuclear Fuels. 7 refs.; 8 tabs

  7. 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.

  8. Relevance of labor room fetal autopsy in increasing its acceptance.

    Science.gov (United States)

    Kumar, Manisha; Singh, Abha; Gupta, Usha; Anand, Rama; Thakur, Seema

    2015-02-01

    Fetal autopsy is included in the basic protocol of investigating a perinatal death, parental refusal is the main reason for its low rate. To increase acceptance of fetal autopsy and to provide better counselling to the couple regarding risk of recurrence in future pregnancies. All cases with antenatally diagnosed congenital anomaly resulting in stillbirth or termination before 20 weeks were offered fetal autopsy and it was performed in labor room itself by the fetal medicine specialist after consents. External and internal examination, photograph, infantogram and karyotyping were done, and relevant tissue was sent for histopathology. Correlation between the ultrasound and autopsy finding was done. Total 674 cases of antenatally detected major congenital anomaly were included in the study. Out of 403 cases of stillbirth and abortion, consent for autopsy was given in 312. Most common defect was cranio-vertebral defect followed by genitourinary anomaly. The autopsy finding correlated with USG findings fully in 63.5% cases, there were additional findings altering diagnosis in 24.7% cases, the diagnosis completely changed in 11.8% cases. Autopsy if done in labor room increases its acceptance by the couple. Additional findings on autopsy helped in reaching at diagnosis and counseling accordingly.

  9. The perinatal autopsy : Pertinent issues in multicultural Western Europe

    NARCIS (Netherlands)

    Gordijn, Sanne J.; Erwich, Jan Jaap H. M.; Khong, T. Yee

    Western Europe is in a demographic transition with increasing multicultural societies. Health professionals have to understand the background, religious and cultural aspects of parents to counsel them regarding an autopsy in the event of a perinatal loss. Autopsy rates have declined over the past

  10. In Defense of Clinical Autopsy and Its Practice in Cuba.

    Science.gov (United States)

    Espinosa-Brito, Alfredo D; de Mendoza-Amat, José Hurtado

    2017-01-01

    There has been a notable decrease in the global practice of clinical autopsy; the rate has fallen to below 10%, even in high-income countries. This is attributed to several causes, including increased costs, overreliance on modern diagnostic techniques, cultural and religious factors, the emergence of new infectious diseases and negative attitudes on the part of doctors, even pathologists. Alternative methods to autopsy in postmortem studies have been developed based on imaging, endoscopy and biopsy (all quite expensive). These methods have been used in developed countries but never as effectively as the classic autopsy for identifying cause of death and potential medical errors. Although Cuba has also seen a decrease in its autopsy rates, they remain comparatively high. Between 1996 and 2015, there were 687,689 hospital deaths in Cuba and 381,193 autopsies, 55.4% of the total. These autopsies have positively affected medical care, training, research, innovation, management and society as a whole. Autopsies are an important tool in the National Health System's quest for safe, quality patient care based on the lessons learned from studying the deceased. KEYWORDS Autopsy, postmortem examination, postmortem diagnosis, quality of care, patient safety, medical error, Cuba.

  11. Autopsy issues in German Federal Republic transplantation legislation until 1997.

    Science.gov (United States)

    Schweikardt, Christoph

    2014-01-01

    This article analyzes the relevance of autopsy issues for German Federal Republic transplantation legislation until 1997 against the background of legal traditions and the distribution of constitutional legislative powers. It is based on Federal Ministry of Justice records and German Parliament documents on transplantation legislation. Transplantation and autopsy legislation started with close ties in the 1970s. Viewing transplantation legislation as relevant for future autopsy regulation contributed to the decision to stall transplantation legislation, because the interests of the federal government and the medical profession converged to avoid subsequent restrictions on the practice of conducting autopsies and procuring tissues for transplantation. Sublegal norms were insufficient for the prosecution of the organ trade and area-wide transplantation regulation after the reunification of Germany. In contrast to autopsy issues, legislative power for transplantation issues was extended to the federal level by an amendment to the constitution, allowing decision making for Germany as a whole.

  12. Value of postmortem computed tomography in comparison to autopsy

    International Nuclear Information System (INIS)

    Paperno, S.; Krug, B.; Lackner, L.; Riepert, T.; Rothschild, M.A.; Schultes, A.; Staak, M.

    2005-01-01

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

  13. Pediatric medicolegal autopsy in France: A forensic histopathological approach.

    Science.gov (United States)

    Delteil, Clémence; Tuchtan, Lucile; Torrents, Julia; Capuani, Caroline; Piercecchi-Marti, Marie-Dominique

    2018-01-01

    The aim of postmortem medicolegal examination in pediatric death is primarily to establish the circumstances and causes of death and to exclude child abuse. In France, pediatric death is systematically documented by medicolegal or medical autopsy. In case of medicolegal autopsy, the complementary examinations, requested and financed by justice, are rarely limited to a histopathological examination. However in medical autopsies other tools are available to the pathologist as toxicology, biochemistry and molecular biology. The purpose of this article is to evaluate the efficacy of forensic histopathology in pediatric forensic autopsies. We analyze the main causes of pediatric death in a forensic context. Between 2004 and 2015, 157 infant deaths were identified in Marseille university hospital. The forensic histopathology and autopsy reports of all 157 cases were available for systematic review. Medical or surgical causes represented 41,3% of deaths in our center, accidental causes 8.1% and child abuse 28,8%. The definitive diagnosis was made at autopsy in 30% of cases and at histopathological examination in 70% highlighting that forensic histopathology is an indispensable tool in pediatric medicolegal autopsies. Significant histological abnormalities may be detected in selected organs such as the brain, lungs, heart, liver, adrenal glands and kidneys in spite of macroscopically normal appearances. This justifies systematic sampling of all organs. Despite the implementation of the French sudden infant death protocol which recommends medical autopsies, too many pediatric autopsies are carried out in a medicolegal context. 30% of the cases remain without diagnosis at the end of the autopsy and histological examination. This number could be reduced by the contribution of others laboratory investigation. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  14. Stillbirth evaluation: a stepwise assessment of placental pathology and autopsy.

    Science.gov (United States)

    Miller, Emily S; Minturn, Lucy; Linn, Rebecca; Weese-Mayer, Debra E; Ernst, Linda M

    2016-01-01

    The American Congress of Obstetricians and Gynecologists places special emphasis on autopsy as one of the most important tests for evaluation of stillbirth. Despite a recommendation of an autopsy, many families will decline the autopsy based on religious/cultural beliefs, fear of additional suffering for the child, or belief that no additional information will be obtained or of value. Further, many obstetric providers express a myriad of barriers limiting their recommendation for a perinatal autopsy despite their understanding of its value. Consequently, perinatal autopsy rates have been declining. Without the information provided by an autopsy, many women are left with unanswered questions regarding cause of death for their fetus and without clear management strategies to reduce the risk of stillbirth in future pregnancies. To avoid this scenario, it is imperative that clinicians are knowledgeable about the benefit of autopsy so they can provide clear information on its diagnostic utility and decrease potential barriers; in so doing the obstetrician can ensure that each family has the necessary information to make an informed decision. We sought to quantify the contribution of placental pathologic examination and autopsy in identifying a cause of stillbirth and to identify how often clinical management is modified due to each result. This is a cohort study of all cases of stillbirth from 2009 through 2013 at a single tertiary care center. Records were reviewed in a stepwise manner: first the clinical history and laboratory results, then the placental pathologic evaluation, and finally the autopsy. At each step, a cause of death and the certainty of that etiology were coded. Clinical changes that would be recommended by information available at each step were also recorded. Among the 144 cases of stillbirth examined, 104 (72%) underwent autopsy and these cases constitute the cohort of study. The clinical and laboratory information alone identified a cause of death

  15. Improving Autopsy Report Turnaround Times by Implementing Lean Management Principles.

    Science.gov (United States)

    Cromwell, Susan; Chiasson, David A; Cassidy, Debra; Somers, Gino R

    2018-01-01

    The autopsy is an integral part of the service of a large academic pathology department. Timely reporting is central to providing good service and is beneficial for many stakeholders, including the families, the clinical team, the hospital, and the wider community. The current study aimed to improve hospital-consented autopsy reporting times (turnaround time, TAT) by using lean principles modified for a healthcare setting, with an aim of signing out 90% of autopsies in 90 days. An audit of current and historical TATs was performed, and a working group incorporating administrative, technical, and professional staff constructed a value stream map documenting the steps involved in constructing an autopsy report. Two areas of delay were noted: examination of the microscopy and time taken to sign-out the report after the weekly autopsy conference. Several measures were implemented to address these delays, including visual tracking using a whiteboard and individualized tracking sheets, weekly whiteboard huddles, and timelier scheduling of clinicopathologic conference rounds. All measures resulted in an improvement of TATs. In the 30 months prior to the institution of lean, 37% of autopsies (53/144) were signed out in 90 days, with a wide variation in reporting times. In the 30 months following the institution of lean, this improved to 74% (136/185) ( P lean; 63 days post-lean). The application of lean principles to autopsy sign-out workflow can significantly improve TATs and reduce variability, without changing staffing levels or significantly altering scheduling structure.

  16. Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study.

    Science.gov (United States)

    Grabherr, Silke; Heinemann, Axel; Vogel, Hermann; Rutty, Guy; Morgan, Bruno; Woźniak, Krzysztof; Dedouit, Fabrice; Fischer, Florian; Lochner, Stefanie; Wittig, Holger; Guglielmi, Giuseppe; Eplinius, Franziska; Michaud, Katarzyna; Palmiere, Cristian; Chevallier, Christine; Mangin, Patrice; Grimm, Jochen M

    2018-05-01

    Purpose To determine if postmortem computed tomography (CT) and postmortem CT angiography help to detect more lesions than autopsy in postmortem examinations, to evaluate the strengths and weaknesses of each method, and to define their indications. Materials and Methods Postmortem CT angiography was performed on 500 human corpses and followed by conventional autopsy. Nine centers were involved. All CT images were read by an experienced team including one forensic pathologist and one radiologist, blinded to the autopsy results. All findings were recorded for each method and categorized by anatomic structure (bone, organ parenchyma, soft tissue, and vascular) and relative importance in the forensic case (essential, useful, and unimportant). Results Among 18 654 findings, autopsies helped to identify 61.3% (11 433 of 18 654), postmortem CT helped to identify 76.0% (14 179 of 18 654), and postmortem CT angiography helped to identify 89.9% (16 780 of 18 654; P < .001). Postmortem CT angiography was superior to autopsy, especially at helping to identify essential skeletal lesions (96.1% [625 of 650] vs 65.4% [425 of 650], respectively; P < .001) and vascular lesions (93.5% [938 of 1003] vs 65.3% [655 of 1003], respectively; P < .001). Among the forensically essential findings, 23.4% (1029 of 4393) were not detected at autopsy, while only 9.7% (428 of 4393) were missed at postmortem CT angiography (P < .001). The best results were obtained when postmortem CT angiography was combined with autopsy. Conclusion Postmortem CT and postmortem CT angiography and autopsy each detect important lesions not detected by the other method. More lesions were identified by combining postmortem CT angiography and autopsy, which may increase the quality of postmortem diagnosis. Online supplemental material is available for this article.

  17. Study of metastatic foci by CT in autopsied lung cancer

    International Nuclear Information System (INIS)

    Koga, Mitsuru; Nobe, Yoshifumi; Fujii, Kyoichi.

    1983-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-01-01

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

  19. 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. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  20. Meckel Gruber Syndrome: Correlation Between Prenatal Diagnosis and Autopsy Findings

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    Hülya Akgün

    2008-04-01

    CONCLUSION: Ultrasonographic findings of MGS allow for diagnosis of the most cases. However autopsy may be valuable for confirmation of the diagnosis and to evaluate the recurrence risk in future pregnancies.

  1. Coroner Autopsy Findings Among Children and Adolescents of ...

    African Journals Online (AJOL)

    year retrospective study of coroner autopsies carried out on children I adolescents aged between 0-19 years, evaluated the pattern, causes and demographic features of childhood deaths in Rivers state, Nigeria. Methods A retrospective remew of ...

  2. Autopsy findings of malignant neoplasms treated with radiation

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  3. Causes of sudden natural death: A medicolegal (coroner's) autopsy ...

    African Journals Online (AJOL)

    SNDs) that occurred in medical cases in an African referral centre. Design: A descriptive retrospective study. Setting: University of Benin Teaching Hospital, between January 2005 and December 2011. Subjects: Autopsy reports of 626 cases that ...

  4. Review Article AUTOPSY AND THE RELIGIOUS BELIEFS OF ...

    African Journals Online (AJOL)

    FOBUR

    Keywords:Autopsy, religious beliefs, history, christains, muslims, jews. 62. Jos Journal of Medicine, ... 4, 6 thing. Muslims are guided by Shariah (Islamic law) which .... forensic medical practices, however the practice have suffered due to lack ...

  5. The fourth incision: a cosmetic autopsy incision technique.

    Science.gov (United States)

    Patowary, Amarjyoti

    2010-03-01

    Autopsy procedure includes thorough external examination as well as internal examination including opening of all the body cavities for proper visualization of all the visceral organs. As such, there remains incision marks with stitches which harts the sentiment of the already traumatized relatives of the deceased. Moreover, it looks odd especially in cases of otherwise healthy dead bodies. So, autopsy incisions should be such that, we can get maximum possible visualization of the body cavities, particularly the thorax and abdomen, and at the same time the incision as well as the stitch marks are also hidden. This article is aimed to describe few modifications in the autopsy incisions for opening the thorax and abdomen and also proper visualization of the neck structures during autopsy where the incisions and the stitches are kept hidden.

  6. Performance of autopsies in South Africa: Selected legal and ethical ...

    African Journals Online (AJOL)

    2012-02-01

    Feb 1, 2012 ... In South Africa, academic and/or anatomical pathology autopsies are conducted in terms ... She is involved in the co-ordination of the academic programme in the department and teaching of undergraduate ... The incidence.

  7. RESIKO PENULARAN INFEKSI DI RUANG AUTOPSI DAN PENERAPAN KEWASPADAAN UNIVERSAL

    OpenAIRE

    Citra Manela

    2015-01-01

    AbstrakPeningkatan resiko penularan infeksi di ruang autopsi semakin meningkat. Hal ini terjadi karena peningkatan jumlah kasus korban meninggal yang terinfeksi penyakit terutama di negara berkembang. Beberapa studi menyatakan terjadinya peningkatan prevalensi HIV, hepatitis B, C, D dan G, tuberkulosis, penyakit Prion, Hantavirus, campak, infeksi bakteri atau HTCV pada pekerja di ruang autopsi. Penerapan kewaspadaan universal, termasuk standar OSHA, pemilihan disinfektan dan pengolahan limbah...

  8. RESIKO PENULARAN INFEKSI DI RUANG AUTOPSI DAN PENERAPAN KEWASPADAAN UNIVERSAL

    Directory of Open Access Journals (Sweden)

    Citra Manela

    2015-12-01

    Full Text Available AbstrakPeningkatan resiko penularan infeksi di ruang autopsi semakin meningkat. Hal ini terjadi karena peningkatan jumlah kasus korban meninggal yang terinfeksi penyakit terutama di negara berkembang. Beberapa studi menyatakan terjadinya peningkatan prevalensi HIV, hepatitis B, C, D dan G, tuberkulosis, penyakit Prion, Hantavirus, campak, infeksi bakteri atau HTCV pada pekerja di ruang autopsi. Penerapan kewaspadaan universal, termasuk standar OSHA, pemilihan disinfektan dan pengolahan limbah medis sangat penting diperhatikan untuk mencegah resiko terjadinya penularan infeksi. Tujuan penulisan tinjauan pustaka ini adalah mengetahui risiko penularan infeksi pada pekerja di ruang autopsi dan penerapan kewaspadaan universal. Penulisan ini berdasarkan studi kepustakaan yang terkait dengan dua topik ini. Penerapan kewaspadaan universal sangat diperlukan dalam pencegahan penularan penyakit infeksi pada pekerja di ruang autopsi yaitu meliputi penggunaan alat pelindung diri yang tepat, perilaku, tindakan mencegah infeksi, disinfeksi dan penanganan sampah medis yang sesuai aturan.AbstractThe risk of infection transmissions in autopsy room is increasing. This happens because the increase of the number of cases died affected by infectious disease, especially in developing countries. Several studies found an increase on the prevalence of HIV , Hepatitis B , C , D and G, Tuberculosis , Prion Disease , Hantavirus , Measles , Bacterial Infection or HTCV on workers in autopsy room .The application of universal precaution , including OSHA standards , the selection of disinfectant, medical waste management is very important to prevent the risk of the infection transmission. The aim of this review was to explain the risks of infection transmissions on workers in autopsy room and the application of universal precaution. Literatures on these two topics were evaluated. Application of universal precautions are very necessary in the prevention of transmission of

  9. Lung cancer, pulmonary emphysema and pleural effusion: An autopsy study.

    Science.gov (United States)

    Marel, Miloslav; Koubkova, Leona; Kovarikova, Zuzana; Grandcourtova, Alzbeta; Petrik, Frantisek; Hroudova, Hana; Capkova, Linda; Kodet, Roman; Fila, Libor

    2015-12-01

    To determine the exact incidence of lung cancer, pulmonary emphysema and pleural effusion we decided to carry out an autopsy study. In this autopsy study carried out over two years, we compared the results of autopsy findings with the clinical data in accompanying records of the deceased. Among the 708 deceased subjects, there were 398 males and 310 females with a median age of 71 years. At autopsy, 55 cases of lung carcinoma (BCA) were found, of which 24 have not been identified during life (44%). Among the deceased with BCA, emphysema was also observed at autopsy in 40% of the cases. Pulmonary emphysema was described macroscopically in 28% of the full set of 708 deceased, whereas the accompanying records of the deceased described this condition in only 12% of the cases. Microscopic changes compatible with emphysema were identified in 54% of the examined lungs. Pleural effusions were described in the accompanying records of 13% of the deceased, while the autopsies showed this condition in 33% of the deceased. BCA was accompanied by effusion in 25% of the cases. The obtained results show that the studied conditions are present in more cases than are reported by clinicians. The study confirms the commonly accepted association between lung cancer and emphysema.

  10. Childhood neoplasms presenting at autopsy: A 20-year experience.

    Science.gov (United States)

    Bryant, Victoria A; Booth, John; Palm, Liina; Ashworth, Michael; Jacques, Thomas S; Sebire, Neil J

    2017-09-01

    The aims of the review are to establish the number of undiagnosed neoplasms presenting at autopsy in a single centre and to determine the incidence and most common causes of sudden unexpected death due to neoplasia in infancy and childhood (SUDNIC). Retrospective observational study of paediatric autopsies performed on behalf of Her Majesty's Coroner over a 20-year period (1996-2015; n = 2,432). Neoplasms first diagnosed at autopsy were identified from an established database and cases meeting the criteria for sudden unexpected death were further categorised. Thirteen previously undiagnosed neoplasms were identified, including five haematological malignancies, two medulloblastomas, two neuroblastomas, two cardiac tumours and two malignancies of renal origin. Eight cases met the criteria for SUDNIC (0.33% of autopsies), the commonest group of which were haematological malignancies (n = 3). Neoplasms presenting as unexpected death in infancy and childhood and diagnosed at autopsy are rare. The findings suggest that haematological malignancies are the commonest cause of SUDNIC and highlight the importance of specialist autopsy in cases of sudden unexpected death. © 2017 Wiley Periodicals, Inc.

  11. The Molecular Autopsy: Should the Evaluation Continue After the Funeral?

    Science.gov (United States)

    Tester, David J.; Ackerman, Michael J.

    2012-01-01

    Sudden cardiac death (SCD) is one of the most common causes of death in developed countries, with most SCDs involving the elderly, and structural heart disease evident at autopsy. Each year, however, thousands of sudden deaths involving individuals younger than 35 years of age remain unexplained after a comprehensive medicolegal investigation that includes an autopsy. In fact, several epidemiologic studies have estimated that at least 3% and up to 53% of sudden deaths involving previously healthy children, adolescents, and young adults show no morphologic abnormalities identifiable at autopsy. Cardiac channelopathies associated with structurally normal hearts such as long QT syndrome (LQTS), catecholaminergic polymorphic ventricular tachycardia (CPVT), and Brugada syndrome (BrS) yield no evidence to be found at autopsy, leaving coroners, medical examiners, and forensic pathologists only to speculate that a lethal arrhythmia might lie at the heart of a sudden unexplained death (SUD). In cases of autopsy-negative SUD, continued investigation through either a cardiologic and genetic evaluation of first- or second-degree relatives or a molecular autopsy may elucidate the underlying mechanism contributing to the sudden death and allow for identification of living family members with the pathogenic substrate that renders them vulnerable, with an increased risk for cardiac events including syncope, cardiac arrest, and sudden death. PMID:22307399

  12. Diagnostic value of perinatal autopsies: analysis of 486 cases.

    Science.gov (United States)

    Neşe, Nalan; Bülbül, Yeşim

    2018-02-23

    Autopsy is a beneficial procedure to determine the cause of death and the frequency of anomalies in perinatal losses. Even in the event of an autopsy not providing any additional information, completion of the procedure confirming the clinical diagnoses gives reassurance to both clinicians and parents. Here we present a 15-year archival study based on findings of perinatal autopsies. Four hundred and eighty-six cases from our archive were reviewed and according to the findings they were divided into three subcategories; (1) miscarriages (MCF); (2) fetuses terminated (FTA) for vital anomalies detected by prenatal ultrasonography; (3) premature or term newborns died within first month of life (neonates: NN). Autopsies were documented and classified according to week/age of cases, anomalies and causes of abortion or death. Two hundred and twenty-six of 486 cases (46.5%) were in MCF group while 227 (46.7%) and 33 (6.8%) were of them in FTA and NN groups, respectively. In FTA group, the most frequent anomaly detected was neural tube defects. In NN group, prematurity related complications were the most common cause of death. The autopsy process was found valuable in 39.7% of all cases. We suggest that autopsy procedure is diagnostically valuable even in situations when there is USG findings that are confirming FTAs or there is no important major fetal or placental anomaly detected in MCFs.

  13. Acquired immunedeficiency syndrome in forensic autopsies

    Directory of Open Access Journals (Sweden)

    Carlos Delmonte Prints

    Full Text Available From May 1985 to May 1989, 126 necropsies were performed at the São Paulo City Morgue on cadavers of individuals AIDS victims whose unnatural deaths had prompted police investigations. One hundred and nineteen males and 17 females were included. Ages were most commonly in the 20-to-30 year range. Fifty four deaths occurred in penal institutions, 29 deaths resulted from suicides, 17 deaths from manslaughter, 17 deaths were considered suspicious, 5 willful murders and 4 others also considered suspicious because corpses were found in advanced stages of putrefaction. Inmates, except one man who was strangled, died as a consequence of the disease. During all autopsies, special attention was paid to the high rate of extrapulmonary Mycobacterial infections. Suicides were committed in different ways and the majority of the victims were documented to be still in the initial stages of the disease. Suspicious deaths and deteriorated corpses were the result of negligence of the subject's families. Homicidal deaths occurred in subjects in the terminal stages of the disease inside the hospital where these subjects were assisted and the immunedeficiency certainly contributed to aggravate the injuries leading to death. Attention is drawn to both legal and social issues affecting AIDS victims. The authors believe these issues may pose a hindrance for efficient control of the AIDS epidemic.

  14. Autopsies of the real: Resurrecting the dead

    Directory of Open Access Journals (Sweden)

    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.

  15. Virtual autopsy with multiphase postmortem computed tomographic angiography versus traditional medical autopsy to investigate unexpected deaths of hospitalized patients: a cohort study.

    Science.gov (United States)

    Wichmann, Dominic; Heinemann, Axel; Weinberg, Clemens; Vogel, Hermann; Hoepker, Wilhelm Wolfgang; Grabherr, Silke; Pueschel, Klaus; Kluge, Stefan

    2014-04-15

    "Virtual" autopsy by postmortem computed tomography (PMCT) can replace medical autopsy to a certain extent but has limitations for cardiovascular diseases. These limitations might be overcome by adding multiphase PMCT angiography. To compare virtual autopsy by multiphase PMCT angiography with medical autopsy. Prospective cohort study. (ClinicalTrials.gov: NCT01541995) SETTING: Single-center study at the University Medical Center Hamburg-Eppendorf, Hamburg, Germany, between 1 April 2012 and 31 March 2013. Hospitalized patients who died unexpectedly or within 48 hours of an event necessitating cardiopulmonary resuscitation. Diagnoses from clinical records were compared with findings from both types of autopsy. New diagnoses identified by autopsy were classified as major or minor, depending on whether they would have altered clinical management. Of 143 eligible patients, 50 (35%) had virtual and medical autopsy. Virtual autopsy confirmed 93% of all 336 diagnoses identified from antemortem medical records, and medical autopsy confirmed 80%. In addition, virtual and medical autopsy identified 16 new major and 238 new minor diagnoses. Seventy-three of the virtual autopsy diagnoses, including 32 cases of coronary artery stenosis, were identified solely by multiphase PMCT angiography. Of the 114 clinical diagnoses classified as cardiovascular, 110 were confirmed by virtual autopsy and 107 by medical autopsy. In 11 cases, multiphase PMCT angiography showed "unspecific filling defects," which were not reported by medical autopsy. These results come from a single center with concerted interest and expertise in postmortem imaging; further studies are thus needed for generalization. In cases of unexpected death, the addition of multiphase PMCT angiography increases the value of virtual autopsy, making it a feasible alternative for quality control and identification of diagnoses traditionally made by medical autopsy. University Medical Center Hamburg-Eppendorf.

  16. Non-invasive or minimally invasive autopsy compared to conventional autopsy of suspected natural deaths in adults: a systematic review.

    Science.gov (United States)

    Blokker, Britt M; Wagensveld, Ivo M; Weustink, Annick C; Oosterhuis, J Wolter; Hunink, M G Myriam

    2016-04-01

    Autopsies are used for healthcare quality control and improving medical knowledge. Because autopsy rates are declining worldwide, various non-invasive or minimally invasive autopsy methods are now being developed. To investigate whether these might replace the invasive autopsies conventionally performed in naturally deceased adults, we systematically reviewed original prospective validation studies. We searched six databases. Two reviewers independently selected articles and extracted data. Methods and patient groups were too heterogeneous for meaningful meta-analysis of outcomes. Sixteen of 1538 articles met our inclusion criteria. Eight studies used a blinded comparison; ten included less than 30 appropriate cases. Thirteen studies used radiological imaging (seven dealt solely with non-invasive procedures), two thoracoscopy and laparoscopy, and one sampling without imaging. Combining CT and MR was the best non-invasive method (agreement for cause of death: 70 %, 95%CI: 62.6; 76.4), but minimally invasive methods surpassed non-invasive methods. The highest sensitivity for cause of death (90.9 %, 95%CI: 74.5; 97.6, suspected duplicates excluded) was achieved in recent studies combining CT, CT-angiography and biopsies. Minimally invasive autopsies including biopsies performed best. To establish a feasible alternative to conventional autopsy and to increase consent to post-mortem investigations, further research in larger study groups is needed. • Health care quality control benefits from clinical feedback provided by (alternative) autopsies. • So far, sixteen studies investigated alternative autopsy methods for naturally deceased adults. • Thirteen studies used radiological imaging modalities, eight tissue biopsies, and three CT-angiography. • Combined CT, CT-angiography and biopsies were most sensitive diagnosing cause of death.

  17. Two forensic autopsy cases of death due to upper gastrointestinal hemorrhage: a comparison of postmortem computed tomography and autopsy findings.

    Science.gov (United States)

    Suzuki, Hideto; Hasegawa, Iwao; Hoshino, Norio; Fukunaga, Tatsushige

    2015-05-01

    In this report, we describe two autopsy cases of death due to upper gastrointestinal hemorrhage (Case 1: gastric ulcer, Case 2: aortoduodenal fistula). Postmortem computed tomography (CT) images from both cases revealed pooling of gastric fluid, which contained high attenuation areas, although these images also mirrored the different sources of the gastrointestinal hemorrhage. Fluid collection was observed in the small intestine for both cases, although the high attenuation areas were only remarkable in Case 2. The autopsy in Case 1 revealed a peptic ulcer, with small vessels exposed on the surface of the ulcer. Melena was also observed throughout the intestine, although clotting was only observed inside the stomach. The autopsy in Case 2 revealed diffuse massive clotting from the stomach to the upper portion of the ileum, which was due to a primary aortoduodenal fistula. Given our autopsy findings, the extent of the high attenuation areas in the digestive tract during postmortem CT scanning may be correlated with the speed of the gastrointestinal hemorrhage before death. Carefully evaluating the radiodensity of the gastrointestinal contents during postmortem CT scanning may indicate the primary site of the hemorrhage before the autopsy, thereby facilitating the accurate identification of the cause of death during forensic autopsy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Clinical diagnosis versus autopsy diagnosis in head trauma

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    Velnic Andreea-Alexandra

    2017-12-01

    Full Text Available The correct and complete diagnosis is essential for the adequate care and the favourable clinical evolution of the patients with head trauma. Purpose: To identify the error rate in the clinical diagnosis of head injuries as shown in comparison with the autopsy diagnosis and to identify the most common sources of error. Material and method: We performed a retrospective study based on data from the medical files and the autopsy reports of patients with head trauma who died in the hospital and underwent forensic autopsy. We collected: demographic data, clinical and laboratory data and autopsy findings. To quantify the concordance rate between the clinical diagnosis of death and the autopsy diagnosis we used a 4 classes classification, which ranged from 100% concordance (C1 to total discordance (C4 and two classes of partial discordance: C2 (partial discordance in favour of the clinical diagnosis- missing injuries in the autopsy reports and C3 (partial discordance in favor of the necroptic diagnosis- missing injuries in the medical files. Data were analyzed with SPSS version 20.0. Results: We analyzed 194 cases of death due to head injuries. We found a total concordance between the clinical death diagnosis and autopsy diagnosis in 30.4% of cases and at least one discrepancy in 69.6% of cases. Increasing the duration of hospitalization directly correlates with the amount of the imaging investigations and these in turn correlates with an increased rate of diagnosis concordance. Among the patients with stage 3 coma who associated a spinal cord injury, we found a partial diagnosis discordance in 50% of cases and a total discordance in 50% of cases, possibly due to the need for conducting emergency imaging investigation and the need for surgical treatment. In cases with partial and total discordant diagnosis, at least one lesion was omitted in 45.1% of the cases. The most commonly omitted injuries in C2 cases were subdural hematoma, intracerebral

  19. Cadmium Concentration in Human Autopsy Tissues.

    Science.gov (United States)

    Lech, Teresa; Sadlik, Józefa K

    2017-10-01

    The concentration of cadmium in human tissues obtained on the basis of autopsies of non-poisoned Polish people (n = 150), aged from 1 to 80 years, examined between 1990 and 2010, is presented. The following values were found in wet digested samples by flame atomic absorption spectrometry (FAAS) (mean ± SD, median, and range, μg/g of wet weight): brain 0.020 ± 0.031, 0.084, 0-0.120 (n = 41); stomach 0.148 ± 0.195, 0.084, 0-1.25 (n = 89); small intestine 0.227 ± 0.231, 0.130, 0-0.830 (n = 39); liver 1.54 ± 1.55, 1.01, 0.015-9.65 (n = 99); kidney 16.0 ± 13.2, 14.0, 0.62-61.3 (n = 91); lung 0.304 ± 0.414, 0.130, 0-1.90 (n = 25); and heart 0.137 ± 0.107, 0.140, 0.017-0.250 (n = 4). Additionally, results (n = 13 people, aged from 2 to 83 years, 63 samples) obtained by inductively coupled plasma optical emission spectrometry (ICP OES) between 2010 and 2015 are given. The obtained data on Cd concentration in the human body can be used to estimate the amounts occurring in "healthy" people and those occurring in cases of chronic or acute poisonings with Cd compounds, which are examined for forensic purposes or to assess environmental exposure levels.

  20. The Role of Forensic Autopsies in Diagnosis of Cancer

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    Gülden Çengel

    2014-07-01

    Full Text Available Background: Death from cancer is mostly considered as natural deaths. The role of cancer on the cause of death in forensic cases like sudden deaths, negligence or malpractice claims are being investigated. In a small amount of forensic cases, cancer is found incidentally at the autopsy. The aim of this study was to reveal characteristics of the cases in which cancer was diagnosed and types of malignancies in medicolegal autopsies. In addition, the role of forensic autopsies in determining oncological diseases was discussed. Methods: Forensic autopsies were performed in the Morgue Department of Forensic Medicine Council in İzmir for eight years were retrospectively reviewed. Cases that postmortem histopathological examination performed and malignant tumors diagnosed were included in the study. Data about age, sex, location of tumors, immediate causes of death and the potential relation between tumors and the primary cause of death were investigated. Results: In eight year period (between 2001 and 2009, 3722 medicolegal autopsies were done by postmortem histopathological examination. In 86 cases such kind of tumors were observed. In seven of 86 cases the tumors were determined as benign and excluded from the study. The remaining 79 cases with malignant tumors included in the study, 63 (79.7% were male and 16 (20.3% were female, mean age 54.96±20.35 (range: 7-88 years. The tumors were most frequently located in respiratory system (35.4%, gastrointestinal system (19%, genitourinary system (10.1% and central nervous system (8.9%. The males most frequently had tumors in the respiratory system (42.9% and the females in the endocrine system (25%. According to histopathological classification of the tumors, the most frequent tumors were epithelial tumors (65.8%, followed by hemopoetic (12.7%, mesenchymal (7.6%, glial (5.1% and neuroendocrine tumors (2.5% and timoma (1.3%. The tumors could not be histopathologically differentiated in 5.1% of the deaths

  1. Autopsy findings in bodies repatriated to the UK.

    Science.gov (United States)

    Williams, Edward John; Davison, Andrew

    2014-07-01

    Following the death of a British National on foreign soil, a primary investigation is conducted by the authorities of that country; HM Coroner and the United Kingdom police have no jurisdiction to conduct investigations abroad. Upon repatriation of a body, the legal investigation in the UK remains largely unchanged since the publication of the "harmonisation of medico-legal autopsy rules" (1999) and the passing of the Coroners and Justice Act (2009). We identified 44 cases within a 10-year period. An invasive autopsy had been performed abroad in 25 cases; an autopsy report was received prior to UK autopsy in one case. Seven cases showed incomplete evisceration; the absence of part or whole organs was recorded in 11 cases. Toxicology was performed abroad in five cases. Recurring technical difficulties related chiefly to embalming, including difficulty with dissection and noxious fumes. When an autopsy had been performed abroad, the time to UK inquest was prolonged by an average of seven months. A verdict of unlawful killing was returned in nine cases. The discussion expands on these issues, and attempts to offer reasoned explanation where possible. Two cases are used as exemplars to highlight difficulties to both the pathologist and Coroner. This casework remains rare but the potential problems include: absence of tissue; lack of information; technical difficulties; and a disproportionately high number of unlawful killings, making clear the need for experience and caution when making the post mortem examination.

  2. Needle autopsy to establish the cause of death in HIV-infected hospitalized adults in Uganda: a comparison to complete autopsy.

    Science.gov (United States)

    Cox, Janneke A; Lukande, Robert L; Kalungi, Sam; Van Marck, Eric; Van de Vijver, Koen; Kambugu, Andrew; Nelson, Ann M; Manabe, Yukari C; Colebunders, Robert

    2014-10-01

    Minimal invasive but accurate methods to establish the cause of death in HIV-infected patients are needed. We studied the agreement in cause of death between blind and ultrasound-guided needle autopsy and complete autopsy in HIV-infected patients in Uganda. We subsequently performed a blind and ultrasound-guided needle autopsy followed by a complete autopsy in HIV-infected adults who died during hospitalization. Two teams of pathologists reviewed the tissue from either the needle autopsies or the complete autopsy and formulated the major diagnoses, that is, diseases directly contributing to death. The primary outcome was concordance in major diagnosis between needle and complete autopsies. We performed 96 blind needle and complete autopsies and 95 ultrasound-guided needle autopsies. Concordance in major diagnosis between blind needle and complete autopsy was 50%. For the main major diagnosis, tuberculosis (TB) concordance was higher (71%; P autopsy identified at least 1 major diagnosis in 60% of patients; and in 46%, there was complete concordance for all major diagnoses. The main reason for discordance was sampling error of the lesion. Concordance with the addition of ultrasound guidance was 52% for all major diagnoses and 79% for TB. Major diagnoses were mainly identified in tissue cores from the liver (76%) and the spleen (82%). Blind needle autopsy identified half of the major diagnosis. The addition of ultrasound guidance did not significantly improve the performance of needle autopsy. Needle autopsy is a valuable method to confirm causes of death in HIV-infected patients, especially for highly prevalent diseases like TB.

  3. Meckel-Gruber Syndrome: Autopsy Based Approach to Diagnosis

    Directory of Open Access Journals (Sweden)

    Asaranti Kar

    2016-01-01

    Full Text Available Meckel-Gruber syndrome (MGS is a rare lethal congenital malformation affecting 1 in 13,250-140,000 live births. The classical diagnostic triad comprises multicystic dysplastic kidneys, occipital encephalocele, and postaxial polydactyly. It can variably be associated with other malformations such as cleft lip and palate, pulmonary hypoplasia, hepatic fibrosis, and anomalies of central nervous system. A 20 weeks fetus was diagnosed as MGS with classical features along with many other congenital abnormalities such as microcephaly, microphthalmia, hypertelorism, cleft lip and palate, neonatal teeth, and the right side club foot which were detected only after doing autopsy. This case is reported because of its rarity emphasizing the importance of neonatal autopsy in every case of fetal death, especially where the antenatal diagnosis has not been made previously. A systematic approach to accurate diagnosis of MGS based on autopsy will be described here which can allow recurrence risk counseling and proper management in future pregnancies.

  4. [Quo vadis pathologia? An elderly clinicians meditations about autopsies].

    Science.gov (United States)

    Iványi, J

    1998-02-08

    Relying on his own experience and the relevant literature of the past 15 years, the author analyzes the causes of the decrease in the number of autopsies. He disagrees with those who, referring to the application of state-of-the art examination methods, dismiss "the ultimate audit" as unnecessary and only suggest selection. Careful autopsies can still be rendered an authentic and reliable picture of treatment of the deceased on the one hand, and provide information about diagnostic difficulties as well as the possible mistakes and errors on the other. This is especially true of the elderly deceased usually with multimorbidity. As well as several aspects of the cooperation between the pathologist and the clinician there is the didactic importance of autopsies that should also be emphasized.

  5. Clinical diagnosis versus autopsy findings in polytrauma fatalities

    Directory of Open Access Journals (Sweden)

    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.

  6. Should we confirm our clinical diagnostic certainty by autopsies?

    Science.gov (United States)

    Podbregar, M; Voga, G; Krivec, B; Skale, R; Pareznik, R; Gabrscek, L

    2001-11-01

    To evaluate the frequency of diagnostic errors assessed by autopsies. Retrospective review of medical and pathological records in an 11-bed closed medical intensive care unit (ICU) at a 860-bed general hospital. Patients who died in the ICU between January 1998 and December 1999. Medical diagnoses were rated into three levels of clinical diagnostic certainty: complete certainty (group L1), minor diagnostic uncertainty (group L2), and major diagnostic uncertainty (group L3). The patients were divided into three error groups: group A, the autopsy confirmed the clinical diagnosis; group B, the autopsy demonstrated a new relevant diagnosis which would probably not have influenced the therapy and outcome; group C, the autopsy demonstrated a new relevant diagnosis which would probably have changed the therapy and outcome. The overall mortality was 20.3% (270/1331 patients). Autopsies were performed in 126 patients (46.9% of deaths), more often in younger patients (66.6+/-13.9 years vs 72.7+/-12.0 years, p<0.001), in patients with shorter ICU stay (4.7+/-5.6 days vs 6.7+/-8.7 days, p=0.054), and in patients in group L3 without chronic diseases (15/126 vs 1/144, p<0.001). Fatal but potentially treatable errors [group C, 12 patients (9.5%)] were found in 8.7%, 10.0%, and 10.5% of patients in groups L1, L2, and L3, respectively (NS between groups). An ICU length of stay shorter than 24 h was not related to the frequency of group C errors. Autopsies are performed more often in younger patients without chronic disease and in patients with a low clinical diagnostic certainty. No level of clinical diagnostic certainty could predict the pathological findings.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Liver scanning in short interval autopsy material of cancer patients

    International Nuclear Information System (INIS)

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

    1980-01-01

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

  10. The forensic autopsy as a teaching tool: Attitudes and perceptions of ...

    African Journals Online (AJOL)

    known worldwide practice.[1,2] Autopsies are used for teaching anatomical and forensic pathology to under- and postgraduate students. Harris et al.[3] reported that general practitioners regard autopsies as 'being of benefit to education and ...

  11. 78 FR 38735 - Autopsy Performance Criteria: Standards, Guidelines and Best Practices

    Science.gov (United States)

    2013-06-27

    ... DEPARTMENT OF JUSTICE Office of Justice Programs [OJP (NIJ) Docket No. 1626] Autopsy Performance Criteria: Standards, Guidelines and Best Practices AGENCY: National Institute of Justice, DOJ. ACTION... entitled, ``Autopsy Performance Criteria: Standards, Guidelines and Best Practices''. The opportunity to...

  12. An autopsy report of a rare pediatric lung tumor: Pleuropulmonary blastoma

    Directory of Open Access Journals (Sweden)

    Gupta Kirti

    2008-04-01

    Full Text Available An autopsy report of pleuropulmonary blastoma (PPB is described in a two-and-a-half-year-old male child who died within a few days of starting chemotherapy. Autopsy revealed a large tumor almost occupying the whole of left hemithorax with widespread extension to pleura. The diagnosis was confirmed to be PPB, type III on autopsy.

  13. Analysis of maternal death autopsies from the nationwide registration system of maternal deaths in Japan.

    Science.gov (United States)

    Hasegawa, Junichi; Wakasa, Tomoko; Matsumoto, Hiroshi; Takeuchi, Makoto; Kanayama, Naohiro; Tanaka, Hiroaki; Katsuragi, Shinji; Nakata, Masahiko; Murakoshi, Takeshi; Osato, Kazuhiro; Nakamura, Masamitsu; Sekizawa, Akihiko; Ishiwata, Isamu; Ikeda, Tomoaki

    2018-02-01

    To clarify the necessity for and problems related to autopsy for determining the cause of maternal death in Japan. Women who died during pregnancy or within a year after delivery were analyzed by the Maternal Death Exploratory Committee between 2012 and 2015 in Japan. Maternal deaths were analyzed to verify the requirement of autopsy in cases in which autopsy was performed and the need for autopsy in cases in which it was not performed. Among the 49 cases performed autopsy, the final diagnosis was compatible with the clinical course in 24 cases, while the autopsy diagnosis was incompatible with the clinical course in 13 cases. In two cases, the final diagnosis was based on the clinical course, but an autopsy could exclude other possible causes. In three cases, no exact cause of maternal death was identified after autopsy. On the other hand, in cases without an autopsy, the final diagnosis was made using ante-mortem operating findings and surgical specimens in twenty-one cases. Though, thirty-one cases were estimated diagnosis based on post-mortem imaging or ante-mortem examinations, the exact original cause of death was not determined in 25 cases, and the cause of death could not be identified in eight cases without autopsy. Because in most cases the autopsy provides an exact cause of death, the necessity of autopsies should be more widely accepted in Japan.

  14. Psychological Autopsy as a Research Approach for Studying Gifted Adolescents Who Commit Suicide.

    Science.gov (United States)

    Cook, Robert S.; And Others

    1996-01-01

    The psychological autopsy and its use in studying the suicides of three adolescents at a school for gifted students are described in this article. Positive and negative effects of autopsy interviews are discussed, as is the importance of confidentiality. A sample interview protocol is provided for psychological autopsy researchers. (Author/PB)

  15. 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…

  16. [Examination results and autopsy findings in assaults on elderly people].

    Science.gov (United States)

    Bode-Jänisch, Stefanie; Havermann, Robert; Germerott, Tanja; Fieguth, Armin

    2010-01-01

    As the percentage of elderly people in the population grows, violence against persons of advanced age constitutes an increasing social problem. The findings of the clinical forensic examinations (CE group) and autopsies performed on elderly violence victims (> or = 60 years) between 1999 and 2008 at the Institute of Legal Medicine of the Hanover Medical School were retrospectively analysed. In all, the study material comprised 55 victims of the CE group (35 females and 20 males, median age 73.5 years) and 55 autopsies (33 females and 22 males, median age 72.7 years). In most of the autopsy cases, the suspect was a family member or partner. In contrast, the alleged perpetrator was a stranger in most cases of the CE group. Blunt force injuries were most often found in the CE group victims (63.6%). Altogether, 38.2% (CE group) and 20.0% (autopsy cases) of the violent assaults were associated with robbery. In the majority of the CE cases, the victims suffered potentially or acute life-threatening injuries. In summary, the analysis shows that elderly people frequently become victims of robbery and blunt force injury. In most homicides of old people, the perpetrator is familiar to the victim. In surviving elderly violence victims, the assault is more likely to be reported to the police if the suspect is a stranger.

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

    International Nuclear Information System (INIS)

    Abiko, Takashi; Higuchi, Hiroshi; Imada, Ryuichi; Nagai, Kenichi

    1983-01-01

    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. (Namekawa, K.)

  18. Diprosopus tetraophthalmus: CT as a complement to autopsy

    OpenAIRE

    Laor, T; Stanek, J; Leach, J L

    2012-01-01

    Diprosopus is the rarest form of conjoined twinning. This anomaly is characterised by craniofacial duplication to varying degrees and is associated with anomalies of the central nervous, cardiac, respiratory and musculoskeletal systems. We present an infant characterised as diprosopus tetraophthalmus who underwent post-mortem CT, which served as a highly useful complement to autopsy.

  19. Diprosopus tetraophthalmus: CT as a complement to autopsy.

    Science.gov (United States)

    Laor, T; Stanek, J; Leach, J L

    2012-01-01

    Diprosopus is the rarest form of conjoined twinning. This anomaly is characterised by craniofacial duplication to varying degrees and is associated with anomalies of the central nervous, cardiac, respiratory and musculoskeletal systems. We present an infant characterised as diprosopus tetraophthalmus who underwent post-mortem CT, which served as a highly useful complement to autopsy.

  20. Autopsy case of delayed radiation necrosis of the brain

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-06-01

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

  1. Psychological Autopsy Provides Insight into Gifted Adolescent Suicide.

    Science.gov (United States)

    Cross, Tracy

    1996-01-01

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

  2. 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.

  3. Autopsy findings and pattern of mortality in Nigerian sickle cell ...

    African Journals Online (AJOL)

    Introduction: Sickle Cell Disease (SCD) has a high mortality rate in the environment where we practice. There is lack of contemporal autopsy studies describing causes of death among SCD patients at our centre. Methods: This is a retrospective study of SCD patients who died between January 1991 and December 2008 ...

  4. The American Theological Seminary: An Unfamiliar Institutional Autopsy

    Science.gov (United States)

    Lumadue, Richard

    2010-01-01

    Christian educators can learn much from institutional autopsies of Christian schools of higher education that have failed. The untold story of the now-defunct American Theological Seminary (ATS) in St. Augustine, Florida, provides an excellent example of critical errors that Christian educators can learn from to avoid the same fate. An…

  5. An Institutional Autopsy of St. Augustine Junior College

    Science.gov (United States)

    Lumadue, Richard T.

    2009-01-01

    Institutional autopsies can teach much about why learning centers fail the test of time. St. Augustine Junior College in north Florida, the brainchild of Dr. George Apel, was begun in 1942 and ended seven years later in 1949. The purposes of the short-lived college are identified for discussion in this paper. Also identified are the reasons for…

  6. Verbal autopsy in establishing cause of perinatal death | Iriya | East ...

    African Journals Online (AJOL)

    Introduction: Perinatal mortality is a sensitive indicator of health status of a community and is also highly amenable to intervention. The causes of perinatal deaths in developing countries are often difficult to establish. Verbal autopsy has been used in several countries for children and adults, but seldom for perinatal cause.

  7. Opinion: Autopsy practice in northern Nigeria | Malami | Nigerian ...

    African Journals Online (AJOL)

    Nigerian Journal of Surgical Research. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 3 (2002) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Opinion: Autopsy practice in northern Nigeria.

  8. Patterns of malaria related mortality based on verbal autopsy in ...

    African Journals Online (AJOL)

    Patterns of malaria related mortality based on verbal autopsy in Muleba District, north-western Tanzania. G.M Kaatano, F.M Mashauri, S.M Kinung'hi, J.R Mwanga, R.C Malima, C Kishamawe, S.E Nnko, S.M Magesa, L.E.G Mboera ...

  9. The Pattern and Frequency of Drowning Autopsies in Benin City ...

    African Journals Online (AJOL)

    Introduction: Drowning is a form of violent asphyxia death, where in the entry of air into the lungs, is prevented by water or other fluids due to the submersion of mouth and nostril (complex submersion of whole body is not necessary). Aim and objective: To determine profile/patterns of all drowning autopsies in our ...

  10. Psychological Autopsy Studies as Diagnostic Tools: Are They Methodologically Flawed?

    Science.gov (United States)

    Hjelmeland, Heidi; Dieserud, Gudrun; Dyregrov, Kari; Knizek, Birthe L.; Leenaars, Antoon A.

    2012-01-01

    One of the most established "truths" in suicidology is that almost all (90% or more) of those who kill themselves suffer from one or more mental disorders, and a causal link between the two is implied. Psychological autopsy (PA) studies constitute one main evidence base for this conclusion. However, there has been little reflection on the…

  11. Autopsy case of pulmonary aspergilloma. [After long chemotherapy for TB

    Energy Technology Data Exchange (ETDEWEB)

    II, Yohei; Akizuki, S

    1973-01-01

    A 73-year-old female received anti-TB chemotherapy for pulmonary tuberculosis for a long period and died from severe hemoptysis which suddenly developed after recovery from the disease. Autopsy showed a large aspergilloma in the upper lobe of the right lung. This case is reported along with a review of the literature on aspergillosis. (30 refs) (DLC)

  12. A Histological Autopsy Study of the Thyroid gland in Human ...

    African Journals Online (AJOL)

    SITWALA COMPUTERS

    Objective: The aim of the study was to determine the histological appearances of adult thyroid glands in patients who died of HIV related diseases at UTH in the period 2010 to 2012. Materials and Methods: This research was a descriptive retrospective study of adult thyroid glands collected at autopsy during the period 2010 ...

  13. Autopsy findings in sickle cell disease patients in Lagos State ...

    African Journals Online (AJOL)

    Autopsy findings in sickle cell disease patients in Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. ... The study showed that the most common cause of sudden death was anemia-related (50%) while 21% were due to acute infections, 18.4 % were due to cardiovascular events and 4.6% were due to ...

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

    Science.gov (United States)

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

    2016-03-01

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

  15. The medical autopsy as quality assurance tool in clinical medicine: dreams and realities.

    Science.gov (United States)

    van den Tweel, Jan G; Wittekind, Christian

    2016-01-01

    The purpose of medical autopsy has changed to issues of quality assurance today. In addition, autopsies are considered valuable in medical education, e.g., delivering cases for problem-based learning for students. Many studies underscore the need for autopsies also in the era of technical progress emphasizing the continuing discrepancies between antemortem and post mortem diagnoses. Despite these important tasks, we face a decline of autopsy for several reasons with complex interactions. The role of all persons involved in this decline is evaluated and suggestions for changes are proposed. Last but not least, the future of the autopsy is in the hands of pathology itself.

  16. Lethal Congenital Malformations in Fetuses-Antenatal Ultrasound or Perinatal Autopsy.

    Science.gov (United States)

    Grover, Sumit; Garg, Bhavna; Sood, Neena; Arora, Kamaldeep

    2017-06-01

    Congenital malformations (CMF) are major causes of fetal demise which can be detected antenatally by Ultrasonography (USG). We studied 100 perinatal autopsies for CMF. Sensitivity of USG was determined and accuracy of USG with that of autopsy was compared. At Autopsy 134 individual CMF were seen in 40 cases. The sensitivity of USG in detecting major CMF was 54.47%. A complete agreement between autopsy and USG findings was seen in 13/40 (32.5%) and partial agreement in 17/40 (42.5%) fetuses while autopsy completely changed antenatal diagnosis in 10/40 (25%) fetuses. Major findings were added in all 17 fetuses with partial agreement. In 2 cases, CMF suspected on USG were not detected on autopsy due to fetal maceration. Autopsy significantly adds to the prenatal USG diagnosis and may help in predicting the probability of recurrence, and thus counseling the affected couple to prevent any such future event.

  17. Communicating with the coroner: how religion, culture, and family concerns may influence autopsy decision making.

    Science.gov (United States)

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

    2011-04-01

    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 was affected by the further requirement that coroners take into consideration a known religion, culture, and/or raised family concern before making such an order. Preliminary data reveal that the cultural status of the deceased did not affect coronial autopsy decision making. However, a known religion with a proscription against autopsy and a raised family concern appeared to be taken into account by coroners when making autopsy decisions and tended to decrease the invasiveness of the autopsy ordered from a full internal examination to either a partial internal examination or an external-only examination of the body. The impact of these findings is briefly discussed.

  18. An autopsy case of delayed radiation necrosis of the brain

    International Nuclear Information System (INIS)

    Ihara, Katsuo; Otsutomo, Michinori; Takeshita, Gen

    1984-01-01

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

  19. CARDIOVASCULAR CAUSES OF SUDDEN DEATH- AN AUTOPSY STUDY

    Directory of Open Access Journals (Sweden)

    Deepu Thankappan

    2016-10-01

    Full Text Available BACKGROUND Present study “Cardiovascular Causes of Sudden Death- An Autopsy Study” was a cross-sectional study conducted in Department of Forensic Medicine, Government Medical College, Kottayam, during the time period from June 1 st 2013 to June 1 st 2014. The objective of the study was to find out the cardiovascular causes of sudden deaths and to correlate the postmortem findings with the histopathological examination. 57 cases brought for postmortem examination with history suggestive of sudden natural death were taken into the study and those cases observed to have a cardiovascular cause of sudden death during autopsy were further examined and their heart specimens were subjected to histopathological examination. Then, the sociodemographic factors, postmortem findings and histopathological findings were correlated and analysed. MATERIALS AND METHODS 57 cases brought for autopsy at Department of Forensic Medicine, Government Medical College, Kottayam from 01.06.2013 to 31.05.2014 were autopsied and subjected to histopathological examination of the heart. The socio-demographic data were collected; they were analyzed and correlated with the postmortem and histopathological findings. RESULTS Out of the 57 subjects who were taken into the study, maximum number of Sudden natural deaths were in the 36-50 year age group (42.2%, 33.3% in the 51-65 year age group and 14% of cases were in the 66-80 year age group. CONCLUSION Histopathological examination of the samples showed myocardial infarction in 33.3% of cases; chronic ischaemic heart disease in 56.1% of cases and myocarditis in 19.3% of cases. The major cardiovascular cause of sudden death was ascertained as Coronary artery disease.

  20. Phenotype-driven molecular autopsy for sudden cardiac death.

    Science.gov (United States)

    Cann, F; Corbett, M; O'Sullivan, D; Tennant, S; Hailey, H; Grieve, J H K; Broadhurst, P; Rankin, R; Dean, J C S

    2017-01-01

    A phenotype-driven approach to molecular autopsy based in a multidisciplinary team comprising clinical and laboratory genetics, forensic medicine and cardiology is described. Over a 13 year period, molecular autopsy was undertaken in 96 sudden cardiac death cases. A total of 46 cases aged 1-40 years had normal hearts and suspected arrhythmic death. Seven (15%) had likely pathogenic variants in ion channelopathy genes [KCNQ1 (1), KCNH2 (4), SCN5A (1), RyR2(1)]. Fifty cases aged between 2 and 67 had a cardiomyopathy. Twenty-five had arrhythmogenic right ventricular cardiomyopathy (ARVC), 10 dilated cardiomyopathy (DCM) and 15 hypertrophic cardiomyopathy (HCM). Likely pathogenic variants were found in three ARVC cases (12%) in PKP2, DSC2 or DSP, two DCM cases (20%) in MYH7, and four HCM cases (27%) in MYBPC3 (3) or MYH7 (1). Uptake of cascade screening in relatives was higher when a molecular diagnosis was made at autopsy. In three families, variants previously published as pathogenic were detected, but clinical investigation revealed no abnormalities in carrier relatives. With a conservative approach to defining pathogenicity of sequence variants incorporating family phenotype information and population genomic data, a molecular diagnosis was made in 15% of sudden arrhythmic deaths and 18% of cardiomyopathy deaths. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Statistical analysis of Japanese Thorotrast-administered autopsy cases

    International Nuclear Information System (INIS)

    Mori, T.; Kato, Y.; Shimamine, T.; Watanabe, S.

    1979-01-01

    The causes of death of 144 Japanese autopsy cases during 1945-1975, who had been intravascularly injected with Thorotrast in life, were compared with those of non-Thorotrast-administered autopsy cases in the same age bracket, recorded in the Annals of Japanese Pathological Autopsy Cases during 1958-1973. This comparison revealed that the incidence of malignant hepatic tumors was more than 10 times higher in the Thorotrast-administered cases. The increase was attributable to an increased incidence of hemangioendothelioma and cholangiocarcinoma of the liver. The only significant increase of liver cirrhosis found to exist in the Thorotrast group occurred in the female cases. Some of the Thorotrast-administered cases were found to have developed myeloid leukemia and erythroleukemia. There was also a significant increase in the number of cases of aplastic anemia in the Thorotrast group, but clinically and pathologically these were atypical. Lymphatic leukemia was not observed. No significant difference was found in the incidence of either malignant lymphomas or osteosarcomas in the Thorotrast group and the controls. Lung cancer, on the other hand, showed a significantly higher incidence among the controls than among the Thorotrast-administered cases

  2. Carbon Monoxide Poisoning Cases Autopsied in South Marmara Region

    Directory of Open Access Journals (Sweden)

    Filiz Eren

    2014-10-01

    Full Text Available Carbonmonoxide (CO related deaths, which are generally preventable accidents that include accidents due to the coal stoves and water heaters in bath at home, the mining accidents, and other accidents. CO accept as the most common cause of poisoning cases in many countries and its prominent feature is being a colorless, odorless and nonirritant gas. In the period from 2007 until the end of 2011, the autopsy records of the ........ of Turkey were reviewed. Over a period of 5 years a total of 5782 autopsies were done of which 218 involved CO poisoning, constituting 3,8 % of total cases. Information regarding age, sex, month, year, and as well as various aspects were examined. Study data were encoded with computer and Statistical analysis was performed using SPSS for windows program. Of the cases 76 were (34,9% female, 142 were (65,1% male and male/female ratio was 1,9. Of the cases average age was 46.8, range between 1 and 90 years. 57,8% of deaths were in winter markedly. The highest carboxyhemoglobin saturation was 92% in the blood. Poisoning due to CO leaks from coal heaters is an important problem in our country and surrounding regions. The mining accidents should be reduced by increasing safety in the workplace. We must more expend efforts to educate the public and prevent CO poisoning. Key words: Carbon monoxide, poisoning, autopsy.

  3. Perceptions and Attitudes of Romanian People Toward Autopsy Procedures According to the Level of Knowledge.

    Science.gov (United States)

    Marinescu, Daniela; Gyurka, Gellért Attila; Miclăuş, Roxana; Nemet, Codruţa; Rogozea, Liliana

    2017-09-01

    In the last decade, Romanian hospitals have been facing a decline in autopsy rates. This has had a negative impact on medical education and the training of young doctors. Quite a number of caregivers strongly oppose the carrying out of autopsies on their deceased loved ones who have died in hospital. Hence, this study was designed to evaluate how autopsies are perceived by an average person and whether improved knowledge about autopsies would help reduce people's reluctance toward them. The study involved 216 willing participants who had either never had a loved one die in hospital or had never had the power to make a decision about their dead loved ones' body. The method of data collection used was a medical inquiry-based questionnaire. Two questionnaires were used, one before and one after brief information regarding autopsy procedures. Only a small percentage of subjects really knew the meaning of an autopsy. Initially, they accepted that it was easier to consent to their own autopsy than to the autopsy of a loved one. This difference in opinion reduced after they were informed about autopsies. As for arguments against autopsies, the most frequent were integrity of the body and religious reasons. It is extremely useful to ensure people have proper information, in order to help them understand and appreciate the benefits of postmortem examinations. Religious, social, and cultural arguments might be put aside if proper information and new educational programs are put in place.

  4. 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.

  5. Effect of postmortem sampling technique on the clinical significance of autopsy blood cultures.

    Science.gov (United States)

    Hove, M; Pencil, S D

    1998-02-01

    Our objective was to investigate the value of postmortem autopsy blood cultures performed with an iodine-subclavian technique relative to the classical method of atrial heat searing and antemortem blood cultures. The study consisted of a prospective autopsy series with each case serving as its own control relative to subsequent testing, and a retrospective survey of patients coming to autopsy who had both autopsy blood cultures and premortem blood cultures. A busy academic autopsy service (600 cases per year) at University of Texas Medical Branch Hospitals, Galveston, Texas, served as the setting for this work. The incidence of non-clinically relevant (false-positive) culture results were compared using different methods for collecting blood samples in a prospective series of 38 adult autopsy specimens. One hundred eleven adult autopsy specimens in which both postmortem and antemortem blood cultures were obtained were studied retrospectively. For both studies, positive culture results were scored as either clinically relevant or false positives based on analysis of the autopsy findings and the clinical summary. The rate of false-positive culture results obtained by an iodine-subclavian technique from blood drawn soon after death were statistically significantly lower (13%) than using the classical method of obtaining blood through the atrium after heat searing at the time of the autopsy (34%) in the same set of autopsy subjects. When autopsy results were compared with subjects' antemortem blood culture results, there was no significant difference in the rate of non-clinically relevant culture results in a paired retrospective series of antemortem blood cultures and postmortem blood cultures using the iodine-subclavian postmortem method (11.7% v 13.5%). The results indicate that autopsy blood cultures obtained using the iodine-subclavian technique have reliability equivalent to that of antemortem blood cultures.

  6. The Regional Autopsy Center: The University of Alabama at Birmingham Experience.

    Science.gov (United States)

    Atherton, Daniel Stephen; Reilly, Stephanie

    2017-09-01

    Rates of autopsied deaths have decreased significantly for the last several decades. It may not be practical for some institutions to maintain the facilities and staffing required to perform autopsies. In recent years, the University of Alabama at Birmingham (UAB) has established contracts to perform autopsies for several regional institutions including the Alabama Department of Forensic Sciences (ADFS), the United States Veterans Affairs, the local prison system, local community hospitals, and with families for private autopsy services. Contracts and autopsy data from 2004 to 2015 were obtained and reviewed. Since 2004, the number of UAB hospital autopsies trended slightly downward. On average, UAB hospital cases comprised most yearly cases, and the ADFS was the second largest contributor of cases. Income generated from outside autopsies performed from 2006 to 2015 totaled just more than 2 million dollars, and most of the income was generated from referred ADFS cases. This study provides evidence that a centralized institution (regional autopsy center [RAC]) can provide regional autopsy service in a practical, feasible, and economically viable manner, and a RAC can benefit both the referring institutions as well as the RAC itself.

  7. Clinical utility of fetal autopsy and its impact on genetic counseling.

    Science.gov (United States)

    Nayak, Shalini S; Shukla, Anju; Lewis, Leslie; Kadavigere, Rajagopal; Mathew, Mary; Adiga, Prashanth K; Vasudeva, Akhila; Kumar, Pratap; Shetty, Jyothi; Shah, Hitesh; Girisha, Katta M

    2015-07-01

    We aimed to analyze the utility of fetal autopsy in terms of its contribution to establishing a definitive diagnosis and its impact on genetic counseling. Detailed fetal autopsy was carried out in fetuses referred for examination. Clinical utility of fetal autopsy and its impact on counseling were measured by adapting previously published parameters. We performed autopsy in 230 fetuses. There were 106 cases with single system and 92 cases with multisystem involvement. We confirmed prenatal findings in 23% of cases and observed additional findings in 37% of cases. In 23% of cases, autopsy findings differed enough to change the diagnosis. However, in 17% of fetuses, no cause of fetal loss was determined. Risk of recurrence became clear in 30.3% of the fetuses, and risk remained the same, but the diagnosis was different in 4.8% of cases after autopsy. Hence, autopsy led to refinement of the risk of recurrence in 36% of cases. Autopsy aided prenatal counseling of couples in 77% of cases by either confirming the prenatal findings (35%) or providing new information/ruling out a diagnosis (42%). The present study quantifies the utility of fetal autopsy in reproductive genetic counseling in a large cohort. © 2015 John Wiley & Sons, Ltd.

  8. The Decline of the Autopsy in Rhode Island and Nationwide: Past Trends and Future Directions.

    Science.gov (United States)

    Baumgartner, Alex; Anthony, Douglas

    2016-10-04

    The autopsy has long been a fundamental aspect of medical practice and research. However, in the last 50 years, the proportion of deaths for which an autopsy is performed has decreased dramatically. Here we examine some of the reasons for the decline of the autopsy, as well as several interventions that have been proposed to revive it. We also present autopsy utilization data from the Lifespan system, which mirrors nationwide trends. [Full article available at http://rimed.org/rimedicaljournal-2016-10.asp].

  9. Unusual head and neck injury in elevator: autopsy study.

    Science.gov (United States)

    Eren, B; Türkmen, N; Dokgöz, H

    2012-10-01

    Industrial injuries related to auto-load-carrying vehicles were not frequently reported in the literature. Presented case was, 31-year-old male furniture worker. Deceased was found in awkward position in furniture workshop. Victim was observed on his knees in front of the elevator, head and neck lodged within openings of the elevator, and head and neck structures compressed-guillotined by the lower platform of the elevator were detected. We presented rare case of head and neck compression by elevator. Key words: head - neck - accidents - elevator - autopsy.

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

    International Nuclear Information System (INIS)

    Park, Seung Hyun; Kang, Hyun Koo; Yu, Hyeon; Lee, Sang Chun

    2005-01-01

    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

  11. 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.

  12. Postmortem CT compared to autopsy in children; concordance in a forensic setting.

    Science.gov (United States)

    Sieswerda-Hoogendoorn, Tessa; Soerdjbalie-Maikoe, Vidija; de Bakker, Henri; van Rijn, Rick R

    2014-11-01

    The aim of this study is to assess the accuracy of postmortem CT (PMCT) in determining the cause of death in children who underwent a forensic autopsy because of a suspected nonnatural death. We selected forensic pediatric autopsies at the Netherlands Forensic Institute, whereby the subject underwent PMCT between 1-1-2008 and 31-12-2012. Cause of death was independently scored by a radiologist and a pathologist. Cause of death was classified (1) in categories being natural, unnatural, and unknown; (2) according to the ICD-10; and (3) according to institutional classification. In the study period, 189 pediatric forensic autopsies were performed. Fifteen were excluded because of putrefaction. Of the remaining 174 autopsies, 98 (56%) underwent PMCT. PMCT and autopsy identified the same category in 69/98 cases (70%, kappa 0.49). They identified the same cause of death in 66/98 cases (67%, kappa 0.5) using ICD-10; in 71/98 (72%, kappa 0.62) using a forensic classification. PMCT performed better in unnatural deaths (59-67 % agreement) than in natural deaths (0 % agreement). If no cause of death was detected with autopsy, PMCT failed to identify a cause of death in 98% (39/40). Pediatric PMCT does identify the majority of unnatural causes of death, but does not identify new diagnoses (true positives) if no cause of death is found during autopsy. Diagnostic accuracy in natural deaths is low. • The case mix is an important predictor for the concordance between PMCT and autopsy. • In case of an unnatural death, 72--81% of PMCT results matches autopsy results. • In case of a natural death, 0% of PMCT results matches autopsy results. • If no cause of death is identified with autopsy, 98% of PMCT results concurs.

  13. Concordance between prenatal ultrasound and autopsy findings in a tertiary center.

    Science.gov (United States)

    Rodriguez, M Angeles; Prats, Pilar; Rodríguez, Ignacio; Cusí, Victoria; Comas, Carmina

    2014-08-01

    The aim of this study was to evaluate the ultrasound (US)/autopsy concordance in elective termination of pregnancies (TOP) due to fetal causes. We performed a retrospective evaluation of elective TOP from 2004 to 2012. Inclusion criteria were gestational age at termination autopsy data. Based on the US-autopsy concordance, cases were divided into four groups: Group 1: agreement; Group 2: autopsy confirmed all US findings but provided additional information; Group 3: autopsy didn't confirm all US findings; Group 4: disagreement. One hundred and fifty-one patients fulfilled the inclusion criteria during the study period. Central nervous system malformations (91.5%), cardiovascular anomalies (90.2%) and renal system malformations (91.3%) were confirmed by autopsy. We found less concordance in the abdominal and musculoskeletal anomalies (61.5% and 66.7%, respectively). There were 130 (86%) fetuses in group 1, 7 in group 2 (4.6%), 3 in group 3 (1.9%) and 11 in group 4 (7.2%). In 5.29% of cases, the autopsy added relevant information to the diagnosis and counselling. Diagnosis concordance between US and necropsy is achieved in almost 90% of cases. An autopsy may help to adjust the diagnosis and help in counselling the parents for a future pregnancy. © 2014 John Wiley & Sons, Ltd.

  14. What do parents want to know when considering autopsy for their child with cancer?

    Science.gov (United States)

    Wiener, Lori; Sweeney, Corinne; Baird, Kristin; Merchant, Melinda S; Warren, Katherine E; Corner, Geoffrey W; Roberts, Kailey E; Lichtenthal, Wendy G

    2014-08-01

    Research has suggested that autopsy in pediatrics is a valued way for parents to better understand and process their child's death, yet physicians often express hesitancy in discussing this topic with parents. To better assist clinicians with initiating discussion about this often sensitive topic, the current study examined bereaved parents' preferences about the timing and content of the autopsy discussion as well as reasons for considering autopsy. This study explored the views of 30 parents who lost a child to a variety of malignancies between 6 months and 6 years ago. Results showed that 36.7% of parents recalled having a discussion about autopsy, and the vast majority of those who did not recall a discussion (89.5%) would have considered an autopsy if it had been discussed. The majority of participants in this study indicated their preference to have the first conversation about autopsy when it becomes clear that cure is no longer possible. Findings suggest that educating parents about the clinical, emotional, and potential research benefits of autopsy and tissue procurement will ultimately help them make informed decisions and understand the importance of autopsy in medical progress. The future research and clinical implications of these findings are discussed.

  15. Autopsy study of traumatic/violent deaths in Rivers State of Nigeria ...

    African Journals Online (AJOL)

    Methods: Archived autopsy reports of victims of violent deaths were reviewed for age, gender, circumstances, causes and mechanisms of death between 1998 and 2008. The autopsies were medicolegal cases carried out in different government and privately owned mortuaries located in Rivers state in accordance with the ...

  16. A 23-year review of sudden natural death autopsies in the Niger ...

    African Journals Online (AJOL)

    Background: Death occurring suddenly especially when the victim was active and recently fit, call for attention and thorough investigation to rule out secret homicide. Aim: To study the pattern of sudden natural death in the Niger Delta region of Nigeria. Methodology: The coroner's autopsy reports and hospital autopsy ...

  17. Post-mortem imaging compared with autopsy in trauma victims--A systematic review.

    Science.gov (United States)

    Jalalzadeh, Hamid; Giannakopoulos, Georgios F; Berger, Ferco H; Fronczek, Judith; van de Goot, Frank R W; Reijnders, Udo J; Zuidema, Wietse P

    2015-12-01

    Post-mortem imaging or virtual autopsy is a rapidly advancing field of post-mortem investigations of trauma victims. In this review we evaluate the feasibility of complementation or replacement of conventional autopsy by post-mortem imaging in trauma victims. A systematic review was performed in compliance with the PRISMA guidelines. MEDLINE, Embase and Cochrane databases were systematically searched for studies published between January 2008 and January 2014, in which post-mortem imaging was compared to conventional autopsy in trauma victims. Studies were included when two or more trauma victims were investigated. Twenty-six studies were included, with a total number of 563 trauma victims. Post-mortem computer tomography (PMCT) was performed in 22 studies, post-mortem magnetic resonance imaging (PMMRI) in five studies and conventional radiography in two studies. PMCT and PMMRI both demonstrate moderate to high-grade injuries and cause of death accurately. PMCT is more sensitive than conventional autopsy or PMMRI in detecting skeletal injuries. For detecting minor organ and soft tissue injuries, autopsy remains superior to imaging. Aortic injuries are missed frequently by PMCT and PMMRI and form their main limitation. PMCT should be considered as an essential supplement to conventional autopsy in trauma victims since it detects many additional injuries. Despite some major limitations, PMCT could be used as an alternative for conventional autopsy in situations where conventional autopsy is rejected or unavailable. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Utility of autopsy in medical education--students' opinions and attitudes.

    Science.gov (United States)

    Ioan, Beatrice; Neagu, M; Manoilescu, Irina; Plăieşu, Teodora; Damian, Simona

    2014-01-01

    Autopsy has been for centuries part of medical education, providing benefits to medical students in terms of knowledge, skills, and development of respect, empathy and compassion. To evaluate the utility of autopsy in medical education based on the opinions and attitudes of medical students. A questionnaire was applied to 219 medical students. The answers were grouped according to two main themes: the utility of autopsy in medical education and students' attitudes toward autopsy. Most of the respondents considered that autopsy is useful to society, medical practice and medical education. On average, participants felt "moderately uncomfortable" on exposure to the first autopsy. Our study indicates the need for medical education to emphasize the utility of autopsy in the medical practice. Extracurricular activities to deepen the medico-legal knowledge and skills would be beneficial for the students who are particularly interested in this specialty. It is also necessary to take into account the possible negative psychological reactions of the students caused by the first exposure to autopsy and identify adequate methods to solve them.

  19. Predictors of autopsy following stillbirth in Queensland, Australia: A population-based study.

    Science.gov (United States)

    Ibiebele, Ibinabo; Boyle, Frances M; Horey, Dell; Lourie, Rohan; Wilson, Patricia; Coory, Michael; Flenady, Vicki

    2017-02-01

    Accurate determination of causes of stillbirth is critical to effective prevention. Autopsy remains the gold standard investigation for stillbirth; however, with low autopsy rates many stillbirths are likely to be 'unexplored' rather than 'unexplained'. To determine factors associated with autopsy following stillbirth. Routinely collected population-based data on all singleton stillbirths of at least 400 g birthweight or 20 weeks gestation in Queensland between July 2000 and December 2011 were examined. Adjusted odds ratios (aOR, 99% CI) were calculated accounting for sociodemographic, pregnancy and medical factors. Of interest was initially unexplained stillbirth on the death certificate; analysis was stratified by gestational age group (autopsy performed. Initially unexplained stillbirth was associated with decreased odds of autopsy at late gestation (28-36 weeks, aOR 0.63 (99% CI 0.42-0.93); ≥37 weeks, aOR 0.53 (99% CI 0.35-0.81)) as was intrapartum stillbirth (autopsy following stillbirth. Pregnancy factors are associated with stillbirth autopsy. These findings have implications for development of appropriate information for parents and education of clinical staff. Further research is needed into factors influencing autopsy following stillbirth. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  20. Postmortem CT compared to autopsy in children; concordance in a forensic setting

    NARCIS (Netherlands)

    Sieswerda-Hoogendoorn, Tessa; Soerdjbalie-Maikoe, Vidija; de Bakker, Henri; van Rijn, Rick R.

    2014-01-01

    The aim of this study is to assess the accuracy of postmortem CT (PMCT) in determining the cause of death in children who underwent a forensic autopsy because of a suspected nonnatural death. We selected forensic pediatric autopsies at the Netherlands Forensic Institute, whereby the subject

  1. 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. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  2. 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.

  3. Forensic autopsy costs in the city of São Paulo

    Directory of Open Access Journals (Sweden)

    Fernando Augusto Mardiros Herbella

    Full Text Available CONTEXT: Modern medical practice involves cost analysis of therapeutic and diagnostic procedures. There are no papers dealing with this theme in relation to forensic autopsies in our country. OBJECTIVE: Analysis of direct costs of forensic autopsies. TYPE OF STUDY: Cost analysis. SETTING: São Paulo Medical Examiner's Central Office. SAMPLE: Year 2001 activity. PROCEDURES: Routine forensic autopsies. MEAN MEASUREMENTS: Analysis of direct costs of personnel and material. RESULTS: Cost of personnel represents 90.38% or US$ 93.46. Material expenses comprised 9.62% or US$ 9.95. Total costs were calculated to be US$ 103.41. CONCLUSIONS: Forensic autopsies have a high cost. Cases to be autopsied should be judiciously selected. Our results are similar to international studies if data are rearranged based on the number of annual necropsies.

  4. Role of fetal autopsy as a complementary tool to prenatal ultrasound.

    Science.gov (United States)

    Godbole, Koumudi; Bhide, Vijayshri; Nerune, Savitri; Kulkarni, Aparna; Moghe, Mrinalini; Kanade, Asawari

    2014-11-01

    To correlate and compare prenatal ultrasound with fetal autopsy examination to detect structural births defects and provide specific diagnoses. 141 second trimester fetuses (autopsy findings in 41/141 (29.07%) cases, additional information that did not influence the final diagnosis and/or counseling was obtained by autopsy in 65/1416 (46.09%) cases, while additional information that influenced the final diagnosis and/or counseling was provided by autopsy in 35/141 (24.82%) cases. Fetal autopsy serves as a complementary tool to fetal ultrasound due to its ability to pick up minor anomalies and/or anomalies that were missed on ultrasound. It may be routinely performed as an attempt to reach a specific diagnosis and offer appropriate counseling to couples, following pregnancy termination for fetal anomalies.

  5. The molecular autopsy: an indispensable step following sudden cardiac death in the young?

    Science.gov (United States)

    Boczek, Nicole J.; Tester, David J.; Ackerman, Michael J.

    2013-01-01

    Annually thousands of sudden deaths involving young individuals (autopsy. In fact, epidemiological studies have estimated that over half of sudden deaths involving previously healthy young individuals have no morphological abnormalities identifiable at autopsy. Cardiac channelopathies associated with structurally normal hearts such as long QT syndrome (LQTS), catecholaminergic polymorphic ventricular tachycardia (CPVT), and Brugada syndrome (BrS), leave no evidence to be found at autopsy, leaving investigators to only speculate that a lethal arrhythmia might lie at the heart of a sudden unexplained death (SUD). In cases of autopsy-negative SUD, continued investigation, through the use of a cardiological and genetic evaluation of first- or second-degree relatives and/or a molecular autopsy, may pinpoint the underlying mechanism attributing to the sudden death and allow for the identification of living family members with the pathogenic substrate that renders them vulnerable to an increased risk for cardiac events, including sudden death. PMID:22993115

  6. 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...... ultrasound and autopsy. In 23 fetuses, the main diagnosis was confirmed and additional or more specific findings were observed on autopsy. In five fetuses, there were considerable differences. Discrepancies between ultrasound and autopsy findings were mainly anomalies undetectable by ultrasound and thus...... expected; however, about one-third of the discrepancies were not expected, representing findings that were 'missed' at ultrasound. The main ultrasound diagnoses were confirmed in the majority of the pregnancies, but the additional information obtained at autopsy in more than half of the fetuses clearly...

  7. Is Consent to Autopsy Necessary? Cartesian Dualism in Medicine and Its Limitations.

    Science.gov (United States)

    Lane, Megan; Vercler, Christian J

    2016-08-01

    When a hospitalization ends in death, a request for an autopsy can lead to an emotionally charged encounter between a physician and the deceased patient's family. A case is presented in which a cardiac surgeon, believing he might have made a mistake, requests an autopsy, but members of the deceased patient's family believe that she would not have wanted an autopsy performed. A central question discussed in this commentary is whether and when consent for autopsy is necessary. We discuss two theoretical frameworks that support differing views on this question. Beyond engaging this philosophical discussion, we also highlight a practical approach to discussing an autopsy with a grieving family by using the case presented. © 2016 American Medical Association. All Rights Reserved.

  8. Trends in forensic autopsy in Chiba prefecture over the past decade.

    Science.gov (United States)

    Inokuchi, Go; Ishihara, Kenji; Hayakawa, Mutsumi; Yajima, Daisuke; Makino, Yohsuke; Motomura, Ayumi; Chiba, Fumiko; Torimitsu, Suguru; Iwase, Hirotaro

    2014-09-01

    The death investigation system in Japan is in the midst of a great transformation. As part of efforts to revise this system, in this study we analyzed the reasons the police refer unnatural death cases for forensic autopsy and, from an understanding of the trends of such referrals, we discuss the future direction of handling unnatural deaths in our country. For 1618 forensic autopsy cases handled by the First Investigation Division of Chiba Prefectural Police that were referred to our institution for forensic autopsy between 2003 and 2012, we tallied the number of autopsies by sex, age group, and reason for forensic autopsy for each year and investigated trends in the referrals over time. The results revealed that the number of autopsies increased annually from 2003 to 2012, with a marked increase from 2010. The number of autopsies increased particularly for cases of suspected criminal deaths, where it was unclear to the police before the forensic autopsy whether or not the death resulted from a criminal act. Our findings suggest that the number of forensic autopsies will continue to increase into the future in Chiba prefecture, and is a trend that is inevitable if we are to prevent criminal death cases from being overlooked. Although referrals for forensic autopsy in Japan are made only when criminal activity is suspected, the original purpose of death investigations is not only to avoid overlooking crimes, but also to flag public health issues. Therefore, together with the police, we need to review the original purpose and conduct more in-depth discussions about when referrals are necessary. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Forensic medicine experts' opinion on medico-legal autopsies in hospital deaths: a questionnaire survey.

    Science.gov (United States)

    D'Souza, Deepak Herald; Pant, Sadip; Menezes, Ritesh George

    2013-10-01

    Medico-legal autopsy is conducted routinely in some countries and selectively in others in hospital deaths. This study was conducted to evaluate the views of the forensic medicine experts regarding this matter. A questionnaire pro forma was sent to sixty-five forensic medicine experts practicing in different medical institutions all around India. Designations and experiences of the participants were noted by requests in the same questionnaire. Their specific experience in conducting medico-legal autopsy in hospital deaths was also requested for. Responses were charted in frequency distribution tables and analyzed using SPSS, version 17.0. One-third of the participants felt that a medico-legal autopsy was necessary in all the hospital death cases as defined in the present study. Ten percent of the participants opined that a medico-legal autopsy was unnecessary in hospital deaths. The majority of the experts mentioned finding the cause of death, followed by finding the manner of death and collecting the evidentiary materials, as the reasons for medico-legal autopsy in hospital deaths. Twenty percent of the participants felt that internal findings at autopsy poorly matched with the case records. All the experts agreed that external autopsy findings matched with the hospital case records. Nearly two-third of the participants felt that it was difficult in some cases to interpret the autopsy findings without case records from the hospital where the deceased was treated. Our findings suggest that the exercise of carrying out medico-legal autopsy routinely in every hospital death as evident in the Indian framework is often unnecessary as per the experts' opinion. Autopsy findings in hospital deaths often correlate with hospital case records.

  10. 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.

  11. Coronary atherosclerosis in medico-legal autopsy cases

    Directory of Open Access Journals (Sweden)

    VN Prasad

    2014-09-01

    Full Text Available Background: Coronary atherosclerosis is the major cause of death worldwide. Lifestyle and habits are the major contributory factor in the development of coronary atherosclerosis. Materials and Methods: This is an autopsy-based study in which 45 autopsy cases were randomly selected for study. Proximal one third of all three epicardial coronary arteries (LAD, LCX and RCA were dissected out for study and serial sections were made and stained with H&E method and under the light microscope. Atherosclerosis was graded according to American heart association classification. The risk factors (cigarette smoking, hypertension, diabetes, alcohol consumption, age, sex were also correlated with the grade of atherosclerosis. Results: Seventy-Eight percent of American Heart Association classification grade V lesions were seen in > 70 yrs of age. Almost all cases of > 70 yrs of age had American Heart Association classification grade > IV lesions. Out of all grade IV lesions, 88.9% was seen in male while only 11.1% in female. Similarly out of all grade V lesions, 77.8% was seen in male while 22.2% in female. LAD showed maximum involvement by higher grade lesion, followed by LCX and RCA. American Heart Association classification grade > IV in LAD, LCX and RCA was seen in 25(55.6%, 5(11.1%, and 3(6.7% cases respectively. Conclusion: Higher grade lesion occurs in advancing age. Various cardiovascular risk factors were significantly associated with higher grade of lesions. The multiple risk factors had a synergistic effect on the progression of coronary atherosclerosis. DOI: http://dx.doi.org/10.3126/jpn.v4i8.11492 Journal of Pathology of Nepal; Vol.4,No8(2014 607-611

  12. Autopsy cases of hepatocellular carcinoma in atomic bomb survivors

    International Nuclear Information System (INIS)

    Fujihara, Megumu; Kurihara, Kanji; Aimitsu, Shiomi; Yukaya, Hirofumi; Hamada, Tadao.

    1994-01-01

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

  13. Autopsy cases of hepatocellular carcinoma in atomic bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Fujihara, Megumu; Kurihara, Kanji; Aimitsu, Shiomi; Yukaya, Hirofumi [Hiroshima Red Cross Atomic Bomb Hospital (Japan); Hamada, Tadao

    1994-12-01

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

  14. The role of angiography in the congruence of cardiovascular measurements between autopsy and postmortem imaging.

    Science.gov (United States)

    Troxler, Renaud; Minoiu, Costin; Vaucher, Paul; Michaud, Katarzyna; Doenz, Francesco; Ducrot, Kewin; Grabherr, Silke

    2018-01-01

    Postmortem CT angiography is the method of choice for the postmortem imaging investigations of the cardiovascular (CV) system. However, autopsy still remains the gold standard for CV measurement. Nevertheless, there are not any studies on CV measurements on the multi-phase postmortem angiography (MPMCTA) which includes comparisons with autopsy. Therefore, the aim of this study is to compare CV measurements between the native CT scan and the three phases of the MPMCTA to find out which of these modalities correlate the best with autopsy measurements. For this study, we selected retrospectively 50 postmortem cases that underwent both MPMCTA and autopsy. A comparison was carried out between the CV measurements obtained with imaging (aorta; heart cavities and cardiac wall thicknesses; maximum cardiac diameter and cardiothoracic ratio) and at the autopsy (aorta; cardiac valves, ventricular thicknesses, and weight). Our results show that the dynamic phase displays an advantage for the measurement of the aortas. However, the MPMCTA is not accurate to measure the cardiac wall thicknesses. The measurements of the heart cavities show no correlation with the heart valves. The cardiothoracic ratio measured by the MPMCTA shows no correlation with the heart weight. Nevertheless, the maximum cardiac diameter exhibits a correlation with the latter on the venous and dynamic phase. These results show that only few CV parameters measured with imaging correlate with measurement obtained at the autopsy. These results indicate that in order to better estimate values obtained at the autopsy, we need to define new reference values for the CV measurement on MPMCTA.

  15. The importance of perinatal autopsy. Review of the literature and series of cases.

    Science.gov (United States)

    Şorop-Florea, Maria; Ciurea, Raluca Niculina; Ioana, Mihai; Stepan, Alex Emilian; Stoica, George Alin; Tănase, Florentina; Comănescu, Maria Cristina; Novac, Marius Bogdan; Drăgan, Ioana; Pătru, Ciprian LaurenŢiu; Drăguşin, Roxana Cristina; Zorilă, George Lucian; Cărbunaru, Ovidiu Marian; Oprescu, NuŢi Daniela; Ceauşu, Iuliana; Vlădăreanu, Simona; Tudorache, Ştefania; Iliescu, Dominic Gabriel

    2017-01-01

    Perinatal autopsy remains the gold-standard procedure used to establish the fetal, neonatal or infant abnormalities. Progressively, perinatal pathology has become a specialized field with important roles of audit for fetal prenatal diagnostic tools, in parents counseling regarding future pregnancies, in scientific research, for epidemiology of congenital abnormalities and teaching. The differences between prenatal ultrasound and autopsy reports represent a strong argument for the autopsy examination following termination of pregnancy. The reasons for such discrepancies are related to the ultrasonographic or pathological examination conditions, the type of the anomalies, the expertise and availability of the operators. Several facts led to an undesirable increase of refusals from parents to consent to a conventional invasive autopsy: the centralization of pathology services, the poor counseling provided by non-experts in fetal medicine and the clinicians' over-appreciation of the importance of the ultrasound diagnostic investigation. Although non-invasive alternatives have been tested with promising results, conventional autopsy remains the gold standard technique for the prenatal diagnosis audit. We report and analyze several cases of prenatally diagnosed malformed fetuses with different particularities that underline the necessity of perinatal autopsy. We discuss the antenatal findings and management and post-mortem autopsies in the respective pregnancies.

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

    Directory of Open Access Journals (Sweden)

    Murray Christopher JL

    2011-08-01

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

  17. Performance of post-mortem CT compared to autopsy in children.

    Science.gov (United States)

    Krentz, Beatriz V; Alamo, Leonor; Grimm, Jochen; Dédouit, Fabrice; Bruguier, Christine; Chevallier, Christine; Egger, Coraline; Da Silva, Luiz F F; Grabherr, Silke

    2016-07-01

    Radiological techniques such as non-enhanced post-mortem computed tomography (PMCT) play an increasingly important role in death investigations, especially in cases of non-medicolegal context of death, where the consent of the next of kin is required to perform autopsy. Such consent is often difficult to obtain for deceased children, and radiological methods may be an acceptable alternative. The aim of our study was to evaluate the performance of PMCT explorations compared to medicolegal conventional autopsies in children and its potential usefulness in non-medicolegal situations. We retrospectively reviewed a group of 26 children aged 0-12 years who died of different causes, which were investigated by both conventional autopsy and PMCT. We compared the findings extracted from radiological and autopsy reports. All findings were grouped according to their importance with respect to cause of death and to the anatomical structure they covered: organs, vascular system, soft tissue, and skeletal system. A significantly larger number of findings were detected by autopsy compared to PMCT. Autopsy proved to be superior to PMCT, notably at detecting organ, soft tissue, and vascular findings, while PMCT was superior at detecting bone findings. However, no statistically significant differences were found between the methods concerning the essential findings used to define the cause of death. In children, PMCT was less sensitive than conventional autopsy for detecting general findings. However, most essential findings were detected by both methods. PMCT was superior to autopsy for the detection of bone lesions in children. Up to today, very rare literature exists concerning PMCT in children, especially in a forensic setting. This article investigates the advantages and limitations of PMCT compared to autopsy in a unique study group and discusses possibilities for future developments.

  18. Prospective study of device-related complications in intensive care unit detected by virtual autopsy.

    Science.gov (United States)

    Wichmann, D; Heinemann, A; Zähler, S; Vogel, H; Höpker, W; Püschel, K; Kluge, S

    2018-06-01

    There has been increasing use of invasive techniques, such as extracorporeal organ support, in intensive care units (ICU), and declining autopsy rates. Thus, new measures are needed to maintain high-quality standards. We investigated the potential of computed tomography (CT)-based virtual autopsy to substitute for medical autopsy in this setting. We investigated the potential of virtual autopsy by post-mortem CT to identify complications associated with medical devices in a prospective study of patients who had died in the ICU. Clinical records were reviewed to determine the number and types of medical devices used, and findings from medical and virtual autopsies, related and unrelated to the medical devices, were compared. Medical and virtual autopsies could be performed in 61 patients (Group M/V), and virtual autopsy only in 101 patients (Group V). In Group M/V, 41 device-related complications and 30 device malpositions were identified, but only with a low inter-method agreement. Major findings unrelated to a device were identified in about 25% of patients with a high level of agreement between methods. In Group V, 8 device complications and 36 device malpositions were identified. Device-related complications are frequent in ICU patients. Virtual and medical autopsies showed clear differences in the detection of complications and device malpositions. Both methods should supplement each other rather than one alone for quality control of medical devices in the ICU. Further studies should focus on the identification of special patient populations in which virtual autopsy might be of particular benefit. NCT01541982. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  19. 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.

  20. 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...

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

    International Nuclear Information System (INIS)

    Cha, Jang Gyu; Kim, Dong Hun; Paik, Sang Hyun

    2010-01-01

    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

  2. Attitudes of Nurses and Physicians About Clinical Autopsy in Neonatal and Adult Hospital Care: A Survey in Sweden.

    Science.gov (United States)

    Mjörnheim, Berit; Rosendahl, Anders; Eriksson, Lennart C; Takman, Christina

    2015-01-01

    The rate of autopsies has dropped to low levels in Western countries. The aim of this study was to describe the experiences and attitudes of registered nurses (RNs) and physicians (MD) toward clinical autopsies in neonatal and adult hospital care in Sweden. RNs and MDs in neonatal and adult care specialized clinics at a university-affiliated hospital in Sweden were surveyed. Survey responses were tallied, and free-text comments were assessed with qualitative content analysis. Three hundred thirty-six surveys were distributed; the response rate was 35%. Most RNs and 14% of the MDs had limited or no experience participating in an autopsy. Notably, few RNs and approximately one third of the MDs were familiar with the autopsy processes and the treatment of the deceased person's body after an autopsy. More than one third of RNs had experience with talking to relatives regarding autopsy. Most agreed that an autopsy could be supportive for relatives during the grieving process and beneficial for the quality of healthcare. Most MDs (70%) thought that autopsies should be performed more frequently. Qualitative results emphasized that RNs and MDs thought that autopsy information supported the grieving process of relatives-especially parents who had lost a child. The survey data confirm belief in the value of clinical autopsies in neonatal and adult hospital care. RNs and MDs should receive training about the autopsy process and procedures for obtaining consent for an autopsy. RNs are in a position to support the decision making of relatives about providing consent for autopsy and have an opportunity to take a more active role in the autopsy process.

  3. SUDDEN NATURAL DEATHS IN MEDICOLEGAL CASES- AN AUTOPSY BASED STUDY

    Directory of Open Access Journals (Sweden)

    C. S. Sreedevi

    2017-01-01

    Full Text Available BACKGROUND Death occurring in apparently healthy individual in a case of natural death may arise suspicion of foul play. In these circumstances these cases may be subjected to medicolegal autopsy. The disease condition may be unknown to the individual and the relatives. This study was done to review the exact cause of death in sudden unexpected deaths, and enabling or assisting the legal authorities in detection of crime, to prove or disprove the foul play. Body mass index is the most frequently used indicator of body fatness. An attempt is made to find out whether there is any significant relationship between BMI and the risk for sudden cardiac death. MATERIALS AND METHODS Data of 50 cases of sudden unexpected death brought for medicolegal autopsy at govt. T.D. medical college Alappuzha in the year 2010 were studied and information were collected from the postmortem records. Data was entered in the proforma. The histopathological examination findings of relevant cases were studied. Analysis was done using MS EXCEL and Chi-square test was used as the test of significance in the comparison between two categorical variables. RESULTS In 50 cases, male predominance was observed and 88% were males in which 50% of males died of atherosclerotic occlusive coronary artery disease and among females 33% died of myocardial infarction. While considering the systemic distribution of cause of death, the cardiovascular system was found to be most commonly affected, 33 cases (66% followed by respiratory system 7 cases (14%. In 4 (8% cases gastrointestinal system was affected. In Two cases (4% central nervous system was affected and others were generalized infection, which constituted 2 cases. Out of 33 cases observed in cardiovascular system the commonest cause being the atherosclerotic occlusive coronary artery diseases involving 27 cases (81.81% in which the predominant involvement was seen in left anterior descending artery 21 cases (77.77% followed by right

  4. 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

  5. The forensic autopsy as a teaching tool: Attitudes and perceptions of ...

    African Journals Online (AJOL)

    The strengths, weaknesses, opportunities and threats (SWOT) analysis indicated the following as strengths: record keeping, legislation review and traumatology description; as weaknesses: emotional trauma and nightmares; as opportunities: the attendance of autopsies; and as threats: physical dangers. Conclusion.

  6. Analysis of multiple primary cancer autopsy cases associated with breast cancer: 2002-2010.

    Science.gov (United States)

    Shibahara, Yukiko; Sugawara, Yumi; Miki, Yasuhiro; Hata, Shuko; Takahashi, Hiroaki; Nakamura, Yasuhiro; Suzuki, Takashi; Ohuchi, Noriaki; Tsuji, Ichiro; Sasano, Hironobu

    2016-12-01

    Breast cancer patients have a generally increased risk of developing second cancers. The object of this study was to clarify the increased as well as decreased incidence of cancers in breast cancer patients using autopsy cases. 164 211 autopsy cases in the Annual of Pathological Autopsy Cases in Japan from 2002 to 2010 were analyzed for multiple primary cancer (MPC). Female MPC cases (4222 cases) were selected. We investigated the cancer incidence observed in breast cancer associated MPC. The Chi-squared test was used for analysis. All P-values were two-sided, and differences at P autopsy data on MPC which provide new evidence clinically and pathologically. © 2016 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.

  7. Analysis of Forensic Autopsy in 120 Cases of Medical Disputes Among Different Levels of Institutional Settings.

    Science.gov (United States)

    Yu, Lin-Sheng; Ye, Guang-Hua; Fan, Yan-Yan; Li, Xing-Biao; Feng, Xiang-Ping; Han, Jun-Ge; Lin, Ke-Zhi; Deng, Miao-Wu; Li, Feng

    2015-09-01

    Despite advances in medical science, the causes of death can sometimes only be determined by pathologists after a complete autopsy. Few studies have investigated the importance of forensic autopsy in medically disputed cases among different levels of institutional settings. Our study aimed to analyze forensic autopsy in 120 cases of medical disputes among five levels of institutional settings between 2001 and 2012 in Wenzhou, China. The results showed an overall concordance rate of 55%. Of the 39% of clinically missed diagnosis, cardiovascular pathology comprises 55.32%, while respiratory pathology accounts for the remaining 44. 68%. Factors that increase the likelihood of missed diagnoses were private clinics, community settings, and county hospitals. These results support that autopsy remains an important tool in establishing causes of death in medically disputed case, which may directly determine or exclude the fault of medical care and therefore in helping in resolving these cases. © 2015 American Academy of Forensic Sciences.

  8. Degenerated human articular cartilage at autopsy represents preclinical osteoarthritic cartilage: comparison with clinically defined osteoarthritic cartilage

    NARCIS (Netherlands)

    van Valburg, A. A.; Wenting, M. J.; Beekman, B.; te Koppele, J. M.; Lafeber, F. P.; Bijlsma, J. W.

    1997-01-01

    To investigate whether macroscopically fibrillated human articular knee cartilage observed at autopsy can be considered an early, preclinical phase of osteoarthritis (OA). Histological and biochemical characteristics of 3 types of articular knee cartilage were compared: macroscopically degenerated

  9. Estimating the temporal evolution of Alzheimer's disease pathology with autopsy data.

    Science.gov (United States)

    Royall, Donald R; Palmer, Raymond F

    2012-01-01

    The temporal growth of Alzheimer's disease (AD) neuropathology cannot be easily determined because autopsy data are available only after death. We combined autopsy data from 471 participants in the Honolulu-Asia Aging Study (HAAS) into latent factor measures of neurofibrillary tangle and neuritic plaque counts. These were associated with intercept and slope parameters from a latent growth curve (LGC) model of 9-year change in cognitive test performance in 3244 autopsied and non-autopsied HAAS participants. Change in cognition fully mediated the association between baseline cognitive performance and AD lesions counts. The mediation effect of cognitive change on both AD lesion models effectively dates them within the period of cognitive surveillance. Additional analyses could lead to an improved understanding of lesion propagation in AD.

  10. Perinatal Autopsy Findings in a Case of De Novo Hypohidrotic Ectodermal Dysplasia.

    Science.gov (United States)

    Chikkannaiah, Panduranga; Nagaraju, Smitha; Kangle, Rajit; Gosavi, Mansi

    2015-01-01

    Ectodermal dysplasia are group of inherited disorders involving the developmental defects of ectodermal structures like hair, teeth, nails, sweat glands, and others. X-linked recessive inheritance is most common. Here we describe perinatal autopsy findings in a case of de novo ectodermal dysplasia in a female fetus. To the best of our knowledge, this is the first fetal autopsy description in a case of ectodermal dysplasia.

  11. Necessity of including medico-legal autopsy data in epidemiological surveys of individuals with major trauma.

    Science.gov (United States)

    Bagher, A; Wingren, C J; Ottosson, A; Andersson, L; Wangefjord, S; Acosta, S

    2015-08-01

    It is rare that epidemiological surveys of patients with major trauma include both those admitted to the emergency department and those sent for medico-legal autopsy. The main aim of the present population-based study of major trauma was to examine the importance of medico-legal autopsy data. A new injury severity score (NISS)>15 or lethal outcome was used as criteria for major trauma and to identify patients at the emergency, anaesthesiology and forensic departments and/or being within the jurisdiction of the Malmö police authority and subjected to a medico-legal autopsy between 2011 and 2013. According to Swedish legislation all trauma related deaths should be reported to the police who refer these cases for medico-legal autopsy. Among the 174 individuals included, 92 (53%) died and 81 (47%) underwent medico-legal autopsy. One hundred twenty-six patients were primarily admitted to hospital and 48 died before admission to hospital and were sent directly for medico-legal autopsy. Forty-four in-hospital deaths occurred, of whom 33 (75%) were sent to medico-legal autopsy. In those sent directly to the department of forensic medicine the proportion of accidents was lower (pautopsies among trauma-related deaths at hospital were high age (pautopsy according to legislation, but did not. The high proportion of positive toxicological findings among fatalities examined at medico-legal autopsy implies that toxicology screening should be routine in major trauma patients, in order to improve treatment and prevention. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Contribution Of Autopsy To Medical Practice In Cameroon: A 10 year ...

    African Journals Online (AJOL)

    Of 12.000 bodies received at the mortuary of the Yaounde General Hospital, 126 were autopsied in this 10-year retrospective study from 1997 to 2007, giving a rate of 1 autopsy in 100 deaths. 72.2% of cases were males against 27.8% females. The predominant age group was 20-69 years (57.1%). The main causes of ...

  13. 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.

  14. Postmortem CT versus forensic autopsy: frequent discrepancies of tracheobronchial content findings.

    Science.gov (United States)

    Zech, Wolf-Dieter; Jackowski, Christian; Schwendener, Nicole; Brencicova, Eva; Schuster, Frederick; Lombardo, Paolo

    2016-01-01

    In their daily forensic casework, the authors experienced discrepancies of tracheobronchial content findings between postmortem computed tomography (PMCT) and autopsy to an extent previously unnoticed in the literature. The goal of this study was to evaluate such discrepancies in routine forensic cases. A total of 327 cases that underwent PMCT prior to routine forensic autopsy were retrospectively evaluated for tracheal and bronchial contents according to PMCT and autopsy findings. Hounsfield unit (HU) values of tracheobronchial contents, causes of death, and presence of pulmonary edema were assessed in mismatching and matching cases. Comparing contents in PMCT and autopsy in each of the separately evaluated compartments of the respiratory tract low positive predictive values were assessed (trachea, 38.2%; main bronchi, 40%; peripheral bronchi, 69.1%) indicating high discrepancy rates. The majority of tracheobronchial contents were viscous stomach contents in matching cases and low radiodensity materials (i.e., HU autopsy occur in a considerable number of cases. Discrepancies may be explained by the runoff of contents via nose and mouth during external examination and the flow back of tracheal and main bronchial contents into the lungs caused by upright movement of the respiratory tract at autopsy.

  15. 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 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. © 2016 Wiley Periodicals, Inc.

  16. Tuberculosis among atomic bomb survivors. Study of autopsy cases

    Energy Technology Data Exchange (ETDEWEB)

    Hamada, T [H.ma Atomic Bomb Hospital (Japan); Matsushita, Hiroshi

    1980-03-01

    Effects of atomic bomb on tuberculosis among atomic bomb survivors necropsied after 1956 when Atomic Bomb Hospital was opened were observed statistically and the following results were obtained. The morbidity of tuberculosis in the group exposed within 2 km from the hypocenter was higher than that of the control group, but there was not a significant difference between the groups. The morbidity of all types of tuberculosis was significantly higher in the group exposed within 2 km from the hypocenter than in the control group. The morbidity of tuberculosis tended to decrease in both exposed and non-exposed groups with time. However, the morbidity of miliary or active tuberculosis has tended to rise in the exposed since 1975. The morbidity in young a-bomb survivors exposed within 2 km was higher than that in those of other groups, but there was not a difference in the morbidity among the aged. The higher the rate of complication of active tuberculosis with stomach cancer or acute myelocytic leukemia or liver cirrhosis, the nearer the places of exposure were to the hypocenter. Out of 26 patients with miliary tuberculosis, 6 were suspected to have leukemia while they were alive and were suggested to have leukemoid reaction by autopsy. They all were a-bomb survivors, and 4 of them were exposed within 2 km from the hypocenter.

  17. Prune-belly syndrome: an autopsy case report.

    Science.gov (United States)

    Vasconcelos, Marcela Arruda Pereira Silva; de Lima, Patricia Picciarelli

    2014-01-01

    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. Prune-belly syndrome: an autopsy case report

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    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.

  19. An autopsy case of methanol induced intracranial hemorrhage.

    Science.gov (United States)

    Kim, Hye-Jeong; Na, Joo-Young; Lee, Young-Jik; Park, Jong-Tae; Kim, Hyung-Seok

    2015-01-01

    The major component of car washer fluid is a methanol. Intracranial hemorrhage is a rare but lethal complication in methanol poisoning. We report a case of massive bilateral basal ganglia hematoma in a 32-year-old man with methanol poisoning. He drank car washer solution twice time (about 500 ml), and was admitted to a territorial hospital 10 hours post-ingestion for depressed mental status, lower blood pressure, and high anion gap metabolic acidosis. Computed tomographic (CT) scan showed lesions in both putamen and cerebral deep white matter. Twenty-one days after methanol exposure, he suddenly developed cardiorespiratory arrest. In autopsy, external examination revealed moderate cerebral edema, but no evidence of herniation. Coronal sections of the brain showed softening and about 34 g hematoma in the bilateral putamen and 3rd ventricles. The toxic effect of methanol on the visual system has been noted in the absence of neurologic manifestations; however, there have also been a report of concomitant brain in Korea.

  20. Aspiration-related deaths in 57 consecutive patients: autopsy study.

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    Xiaowen Hu

    Full Text Available Aspiration can cause a diverse spectrum of pulmonary disorders some of which can lead to death but can be difficult to diagnose.The medical records and autopsy findings of 57 consecutive patients in whom aspiration was the immediate cause of death at Mayo Clinic (Rochester, MN, USA over a 9-yr period, from January 1 2004 to December 31 2012 were analyzed.The median age at death was 72 years (range, 13-95 years and included 39 (68% males. The most common symptom before death was dyspnea (63% and chest radiography revealed bilateral infiltrates in the majority (81%. Most common precipitating factors for aspiration were depressed consciousness (46% and dysphagia (44%. Aspiration-related syndromes leading to death were aspiration pneumonia in 26 (46%, aspiration pneumonitis in 25 (44%, and large airway obstruction in 6 patients (11%. Aspiration was clinically unsuspected in 19 (33% patients. Antimicrobial therapy had been empirically administered to most patients (90% with aspiration pneumonia and aspiration pneumonitis.We conclude aspiration-related deaths occur most commonly in the elderly with identifiable risks and presenting bilateral pulmonary infiltrates. One-third of these aspiration-related pulmonary syndromes were clinically unsuspected at the time of death.

  1. Autopsy findings in carcinoma of the esophagus treated with radiotherapy

    International Nuclear Information System (INIS)

    Hishikawa, Yoshio; Kamikonya, Norihiko; Tanaka, Shinichi; Miura, Takashi

    1988-01-01

    Forty autopsied patients with esophageal carcinoma (35 treated with radiotherapy and 5 with conservative treatment) were analyzed by multiple regression analysis. Local recurrence significantly differed with the treatment method. The lowest rate of local recurrence was observed in the patients treated with high-dose-rate intracavitary irradiation following external irradiation. Mediastinal lymph node metastasis was significantly related to the extent of the primary tumor (T) and the lowest rate of metastasis was seen in the patients with T1. Abdominal lymph node metastasis was significantly related to both the disease stage and treatment method. The lowest rate of metastasis was noted in stage 1 patients, whereas, the rate was high in the patients with high-dose-rate intracavitary irradiation following external irradiation. Distant metastasis was significantly related to disease stage, with stage 1 patients showing the lowest rate of metastasis. Prognosis was significantly related to the treatment method. The average of survival was highest in the patients treated with high-dose-rate intracavitary irradiation following external irradiation. (author)

  2. Implications of alcoholic cirrhosis in atherosclerosis of autopsied patients

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    Luciano Alves Matias da Silveira

    Full Text Available Summary Introduction: Alcoholism is a major public health problem, which has a high social cost and affects many aspects of human activity. Liver disease is one of the first consequences of alcohol abuse, and steatosis, liver cirrhosis and hepatitis may occur. Other organs are also affected with pathological changes, such as pancreatitis, cardiomyopathies, dyslipidemias and atherosclerosis. Objective: To identify the occurrence and degree of atherosclerosis in alcohol-dependent individuals with liver cirrhosis, observing macroscopic and microscopic changes in lipid and collagen deposits and in the liver. We also aimed to verify the association of lipid and collagen fiber deposits with gender, age and body mass index, and to relate alcoholism, liver cirrhosis and atherosclerosis. Method: We performed a study based on autopsy reports of patients with alcoholic liver cirrhosis, with analysis of aorta and liver fragments to verify the occurrence and degree of atherosclerosis, as well as collagen contents. Results: Microscopic atherosclerosis was higher in young subjects (early injury and in patients with alcoholic liver cirrhosis. The macroscopic analysis of atherosclerosis in aortas showed that patients in more advanced age groups presented more severe classifications. Atherosclerosis, both micro and macroscopically, and the percentage of fibrosis in the liver and aorta were more expressive in females. Conclusion: Cirrhotic patients presented a higher percentage of fibrosis and lipidosis, and may represent a group susceptible to the accelerated progression of cardiovascular diseases. Investigative studies contribute to targeting health-promoting interventions, reducing the mortality and costs of treating cardiovascular disease.

  3. Autopsy case with malignant liver tumor caused by thorotrast

    Energy Technology Data Exchange (ETDEWEB)

    Sugiwara, T; Katayama, K; Shinta, K [Matsue City Hospital, Shimane (Japan); Yamazaki, I

    1975-03-01

    This paper reported the roentgenographic, laparoscopic and autopsy findings of a patient with thorotrast liver complicated with malignant liver tumor, which was considered to develop 35 years after the infusion of thorotrast. Laboratory findings of a 67-year-old man, who got a war wound before 35 years and received angiography by using thorotrast at that time, indicated marked symptoms of liver parenchymal disturbance, biliary occlusion and malignant liver tumor. X-ray examination revealed arborescent and reticular abnormal shadow in the liver and the spleen and spotted shadow at the liver hilus. Laparoscopic findings revealed reticulate grayish-yellow particles adhered to the recessus of the nodules in the surface of the liver. Liver biopsy showed deposition of thorotrast granules and necrosis and scar formation of the hepatic cells. Microautoradiography revealed ..cap alpha..-track from the region where thorotrast was deposited. Postmortem findings revealed thorotrast liver cirrhosis, primary liver tumor (reticulo-endothelial sarcoma), circular calcium deposit in the hepatic duct, the bile duct and the portal vein, and cholangitis, demonstrating delayed disturbance by thorotrast.

  4. The Significance of Subendocardial Hemorrhages Detected in Forensic Autopsies

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    Nursel Türkmen İnanır

    2015-06-01

    Full Text Available Introduction:In our study, our aim was to reveal the relationship between subendocardial hemorrhage (SEH  which can be seen macroscopically immediately beneath the endocardium, and emerge secondary to many conditions from direct cardiac,  head, and abdominal traumas to hyperemia, and its location with cause of death, its diagnostic value (if any, and whether it can be evaluated as a vital finding.Material and Method :285 autopsy cases diagnosed as SEH which were brought to the Group Presidency of Morgue Specialization Department of the State Institute of Forensic Medicine of Bursa  were included in the studyResults: Study population consisted of 229 (80.4 % male, and 56 (19.6 % female patients. Thity-one cases of death were related to natural causes, while the most frequently detected pathological causes of death were isolated abdominal traumas (32.9 %, followed by isolated head traumas (31.9 %.  While traffic accidents ranked first (35.1% among the events leading to death. Among evaluated cases, SEH was mostly located on septum.Discussion: To fully understand the yet inadequately elucidated pathogenic mechanisms  of SEH , it should be accurately defined by histopathological analysis. Even though various causes of death seen  in association with these lesions suggest more than one underlying pathogenic mechanism, because of their nonspecific characteristics, their possible roles as indicators of vitality (if any should be reinforced  by further studies.

  5. Deaths from abdominal trauma: analysis of 1888 forensic autopsies

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    POLYANNA HELENA COELHO BORDONI

    Full Text Available ABSTRACT Objective: to evaluate the epidemiological profile of deaths due to abdominal trauma at the Forensic Medicine Institute of Belo Horizonte, MG - Brazil. Methods: we conducted a retrospective study of the reports of deaths due to abdominal trauma autopsied from 2006 to 2011. Results: we analyzed 1.888 necropsy reports related to abdominal trauma. Penetrating trauma was more common than blunt one and gunshot wounds were more prevalent than stab wounds. Most of the individuals were male, brown-skinned, single and occupationally active. The median age was 34 years. The abdominal organs most injured in the penetrating trauma were the liver and the intestines, and in blunt trauma, the liver and the spleen. Homicide was the most prevalent circumstance of death, followed by traffic accidents, and almost half of the cases were referred to the Forensic Medicine Institute by a health unit. The blood alcohol test was positive in a third of the necropsies where it was performed. Cocaine and marijuana were the most commonly found substances in toxicology studies. Conclusion: in this sample. there was a predominance of penetrating abdominal trauma in young, brown and single men, the liver being the most injured organ.

  6. Hemorrhagic shock caused by sigmoid colon volvulus: An autopsy case

    Science.gov (United States)

    Sato, Hiroaki; Tanaka, Toshiko; Tanaka, Noriyuki

    2011-01-01

    Summary Background Many reports have described sigmoid volvulus, but fatal hemorrhagic shock resulting from the rupture of the involved artery has not been reported as a complication of a sigmoid volvulus. Case Report A 71-year-old man with slight abdominal pain and obstipation in hypotension died at a nursing home without seeing a doctor. At autopsy, a mesenteric hematoma and hemoperitoneum was observed with approximately 1,000 ml of blood in the abdominal cavity. The sigmoid colon and the mesentery were twisted at an adhesion site of a sigmoid colon to an ileum, and the condition was determined to be a sigmoid volvulus. The volvulus was observed to be loosened. The inferior mesenteric artery was incorporated into the twisted part of the mesentery, but remained patent, and its peripheral branch near the hematoma ruptured without histological abnormality. Conclusions Since ischemic-reperfusion injury occurs with a temporarily occluded artery, the acute re-loading of blood flow may injure the distal vessels after spontaneous reduction of compression by loosening of the volvulus. PMID:22129905

  7. An analysis of autopsied esophageal carcinomas treated with irradiation

    International Nuclear Information System (INIS)

    Yamada, Shogo; Kakuto, Yoshihisa; Sakamoto, Kiyohiko

    1994-01-01

    Ninety-one fresh autopsied esophageal carcinomas treated with a radiation dose of more than 40 Gy were analyzed, because no primary tumor with under 40 Gy was controlled. There were no residual tumors in 6.6% of the patients. Radiation controlled 28.6% of the locoregional tumors. The local control rate was higher in patients with a tumor length under 5 cm. Metastasis was detected in 76.9% of all the patients. Twenty patients (22.0%) had no primary tumor but metastases. The most common sites of metastasis were the lymph node, lung and liver. Multivariate analysis indicated that the primary tumor control correlated directly with the survival period. Some patients with a primary tumor which was easy to control developed lung metastasis more often. Liver metastasis was found more frequently in patients where the primary tumor was located in the lower portion of the esophagus. Patients with a tumor length of more than 10 cm had neck or mediastinal lymph node involvement more often; neck or mediastinal lymph node metastases were not always fatal immediately. Perforations into other organs were observed in 41.8% of the patients. Younger patients, patients with the tumor located in the upper portion of the esophagus, and patients with T4 tumor have a significantly higher risk of perforation. In such a patient, the total radiation dose should be reduced to less than 70 Gy. Nine patients (9.9%) had double cancers. (author)

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

    Science.gov (United States)

    Ylijoki-Sørensen, Seija; Boldsen, Jesper Lier; Boel, Lene Warner Thorup; Bøggild, Henrik; Lalu, Kaisa; Sajantila, Antti

    2014-11-01

    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. Deaths classified as suicide were compared with other unnatural classifications, and comparable causes of death were coded into six subgroups: poisonings, suffocations/strangulations, firearm discharges, drowning/submersions, explosions/flames and other/unspecified causes. The total autopsy rate for suicides was 99.8% in Finland and 13.2% in Denmark. Almost all of these autopsies were conducted as forensic autopsies. In the age group ≥71 years, Danish suicides outnumbered Finnish suicides (410 versus 283). The total autopsy rate was lower in the more senior age group in Denmark (19.5%, 9.9%, 5.6%), whereas it was consistently high in Finland (99.8%, 99.9%, 99.6%). Among Danish deaths due to poisonings, the autopsy rate was 89.5% when these were classified as accidents, but only 20.7% for cases classified as suicides. The number of deaths in the two Danish subgroups was comparable (550 versus 553). In Denmark, the decision regarding the need, if any, for a forensic autopsy is made during the external forensic examination of the body. Our study showed that the limited use

  9. The autopsy and the elderly patient in the hospital and the nursing home: Enhancing the quality of life

    Science.gov (United States)

    Libow, Leslie S.; Neufeld, Richard R.

    2010-01-01

    The autopsy is the ultimate “peer review.” Yet the autopsy has nearly disappeared from hospitals in the United States and around the world. It is rarely performed in the nursing home or other long-term care (LTC) setting. As a result, all of society has lost much, in terms of quality of health care, the skills of physicians, and insights gained through autopsy-based research. The elderly have the lowest rate of autopsies of any age group. This is a paradox, since the greatest quality and quantity of knowledge would accrue from the often surprising findings revealed at autopsy that reflect the acknowledged ‘multiple simultaneous illnesses’ occurring in older persons. This review and analysis describe why autopsy rates have fallen in hospitals and offer rationales and solutions for reversing this trend in the nursing home and other LTC settings. PMID:19061275

  10. Unexplained Drownings and the Cardiac Channelopathies: A Molecular Autopsy Series

    Science.gov (United States)

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

    2011-01-01

    OBJECTIVE: To determine the prevalence and spectrum of mutations associated with long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT) in a seemingly unexplained drowning cohort. PATIENTS AND METHODS: From September 1, 1998, through October 31, 2010, 35 unexplained drowning victims (23 male and 12 female; mean ± SD age, 17±12 years [range, 4-69 years]) were referred for a cardiac channel molecular autopsy. Of these, 28 (20 male and 8 female) drowned while swimming, and 7 (3 male and 4 female) were bathtub submersions. Polymerase chain reaction, denaturing high-performance liquid chromatography, and DNA sequencing were used for a comprehensive mutational analysis of the 3 major LQTS-susceptibility genes (KCNQ1, KCNH2, and SCN5A), and a targeted analysis of the CPVT1-associated, RYR2-encoded cardiac ryanodine receptor was conducted. RESULTS: Of the 28 victims of swimming-related drowning, 8 (28.6%) were mutation positive, including 2 with KCNQ1 mutations (L273F, AAPdel71-73 plus V524G) and 6 with RYR2 mutations (R414C, I419F, R1013Q, V2321A, R2401H, and V2475F). None of the bathtub victims were mutation positive. Of the 28 victims who drowned while swimming, women were more likely to be mutation positive than men (5/8 [62.5%] vs 3/20 [15%]; P=.02). Although none of the mutation-positive, swimming-related drowning victims had a premortem diagnosis of LQTS or CPVT, a family history of cardiac arrest, family history of prior drowning, or QT prolongation was present in 50%. CONCLUSION: Nearly 30% of the victims of swimming-related drowning hosted a cardiac channel mutation. Genetic testing should be considered in the postmortem evaluation of an unexplained drowning, especially if a positive personal or family history is elicited. PMID:21964171

  11. An autopsy of dead planetary systems with COS

    Science.gov (United States)

    Debes, John

    2014-10-01

    We propose to use HST/COS to conduct autopsies of dead planetary systems around UV bright hydrogen-white dwarfs (WDs), which have dust disks found via their mid-IR emission in excess of that expected from the photosphere. As part of a WISE survey, and followed up with a combination of NASA Keck HIRES/Magellan MIKE optical spectroscopy, we have identified three new systems that are accreting dust. These WDs are bright in the mid-IR and UV, gold-standard targets for studies with HST/COS and later with JWST. The dusty material is debris resulting from the tidal disruption of exo-asteroids that accrete onto the WD surface. Many atomic elements from the accreted and dissociated dust particles are detectable with COS, enabling abundance determinations of exo-asteroidal material. Moreover, the photospheric abundances of this material can be directly compared with a determination of the dust mineralogy obtained with future JWST mid-IR spectroscopy-our proposed UV observations provide complementary constraints on mineralogical compositions of the accreting dust particles. UV spectroscopy is crucial for cataloging elemental abundances for these exo-asteroids. For the majority of WDs, optical spectroscopy reveals only a couple of lines of Ca or Mg, while UV spectroscopy captures lines from Al, Fe, Si, C, Ni, O, S, Cr, P, and Ti. Obtaining the elemental abundances of exo-asteroids is comparable to the spectroscopic characterization of transiting exoplanets or protoplanetary disks-all of these techniques determine how the chemical diversity of planetary systems translate into planetary architectures and the probability of habitable planets around solar-type stars.

  12. 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.

  13. Central nervous system pathology in pediatric AIDS: an autopsy study.

    Science.gov (United States)

    Dickson, D W; Belman, A L; Park, Y D; Wiley, C; Horoupian, D S; Llena, J; Kure, K; Lyman, W D; Morecki, R; Mitsudo, S

    1989-01-01

    The neuropathologic findings of brains and spinal cords removed at autopsy from 26 infants and children with AIDS is described; in two cases, only the spinal cords were available. The most common finding in the brains was dystrophic calcification of blood vessels of all calibers in the basal ganglia and deep cerebral white matter (21 og 24 cases). The next most frequent finding was subacute encephalitis (SE) (15 of 24 cases) with microglial nodules and multinulceated giant cells. Immunocytochemical and in situ hybridization studies showed HIV antigen or genetic sequences only in the brains of cases with SE. Multinucleated giants cells (MGC) were the most frequent cells with reaction products. MGC were labeled with ricinus lectin (RCA), but not with leukocyte common antigen (LCA) or glial fibrillary acidic protein. Many cells in microglial nodules were labeled with RCA, but not LCA; cells in the perivascular compartment were labeled with LCA, but not RCA. Corticospinal tract degeneration was noted in 15 of 20 spinal cords. In six cases tract degeneration was consistent with delayed myelination, and the remaining cases had axonal injury consistent with Wallerian degeneration. Opportunistic infections were rare (three cases). Central nervous system lymphoma occurred in three children and was the most common mass lesion. In two cases lymphoma occurred in the setting of a systemic polyclonal immunoproliferation possibly related to Epstein-Barr virus infection. Cerebrovascular accidents were noted in seven cases. Two cases had hemorrhage associated with immune thrombocytopenia; one hemorrhage was catastrophic. Two children had large vessel arteriopathy with multiple encephalomalacias. Two children had a necrotizing encephalopathy with encephalomalacia and vascular changes suggestive of a mitochondrial cytopathy.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Maternal and pregnancy-related death: causes and frequencies in an autopsy study population.

    Science.gov (United States)

    Buschmann, Claas; Schmidbauer, Martina; Tsokos, Michael

    2013-09-01

    Maternal deaths during pregnancy, both from pregnancy-related or other causes, are rare in Western industrialized countries. In this study we report maternal and pregnancy-related deaths in a large autopsy population focusing on medical history, autopsy findings and histological examinations. Medico-legal autopsy files (n = 11,270) from the Institute of Legal Medicine and Forensic Sciences, University Medical Centre Charité, University of Berlin, and the State Institute of Legal and Social Medicine, Berlin, from 2005 to 2010 were reviewed. All female cases between 15 and 49 years were checked for maternal and pregnancy-related death, and deaths of pregnant women from non-natural causes were also included. Fatalities that met the chosen criteria were classified as "direct gestational death," "indirect gestational death" or "non-gestational death." 13 female fatalities (0.12 %) met the chosen criteria (median age 28 years ± 6.87 SD). Eight (61.5 %) women died in-hospital, four (30.8 %) at home, and one woman died in public. Three cases (23.1 %) were "non-gestational deaths," and one case (7.7 %) remained unclear after autopsy and additional examinations. Of the remaining nine cases, six cases (46.5 %) were "direct gestational deaths," and two cases (15.4 %) were "indirect gestational deaths." One case (7.7 %) was not to be defined as "late maternal death," but the cause of death seemed to be directly related to previous gestation ["(very) late maternal death"]. Maternal deaths during pregnancy, both from pregnancy-related or other causes, remain an uncommon event in routine forensic autopsy practice. We report on the collection and analysis of maternal and pregnancy-related deaths in a large autopsy population, with particular attention to the phenomenology of pregnancy, pathophysiological changes in different organ systems and their detection, and the forensic autopsy assessment.

  15. Postmortem cardiovascular magnetic resonance imaging in fetuses and children: a masked comparison study with conventional autopsy.

    Science.gov (United States)

    Taylor, Andrew M; Sebire, Neil J; Ashworth, Michael T; Schievano, Silvia; Scott, Rosemary J; Wade, Angie; Chitty, Lyn S; Robertson, Nikki; Thayyil, Sudhin

    2014-05-13

    Perinatal and pediatric autopsies have declined worldwide in the past decade. We compared the diagnostic accuracy of postmortem, cardiovascular magnetic resonance (CMR) imaging with conventional autopsy and histopathology assessment in fetuses and children. We performed postmortem magnetic resonance imaging in 400 fetuses and children, using a 1.5-T Siemens Avanto magnetic resonance scanner before conventional autopsy. A pediatric CMR imager reported the CMR images, masked to autopsy information. The pathologists were masked to the information from CMR images. The institutional research ethics committee approved the study, and parental consent was obtained. Assuming a diagnostic accuracy of 50%, 400 cases were required for a 5% precision of estimate. Three cases were excluded from analysis, 2 with no conventional autopsy performed and 1 with insufficient CMR sequences performed. Thirty-eight CMR data sets were nondiagnostic (37 in fetuses ≤24 weeks; 1 in a fetus >24 weeks). In the remaining 359 cases, 44 cardiac abnormalities were noted at autopsy. Overall sensitivity and specificity (95% confidence interval) of CMR was 72.7% (58.2-83.7%) and 96.2% (93.5-97.8%) for detecting any cardiac pathology, with positive and negative predictive values of 72.7% (58.2-83.7%) and 96.2% (93.5-97.8%), respectively. Higher sensitivity of 92.6% (76.6-97.9%), specificity of 99.1% (97.4-99.7%), positive predictive value of 89.3% (72.8-96.3%), and negative predictive value of 99.4% (97.8-99.8%) were seen for major structural heart disease. Postmortem CMR imaging may be a useful alternative to conventional cardiac autopsy in fetuses and children for detecting cardiac abnormalities. http://www.clinicaltrials.gov. Unique identifier: NCT01417962.

  16. Fatal heat stroke in children found in parked cars: autopsy findings.

    Science.gov (United States)

    Adato, Berliz; Dubnov-Raz, Gal; Gips, Hadas; Heled, Yuval; Epstein, Yoram

    2016-09-01

    A common and unfortunate cause for heat stroke-related deaths in children is entrapment in closed vehicles. The aim of this study was to analyze the pathological consequences of such grave events. Autopsy reports of all children that were brought to a national forensic medicine center after being found dead in closed vehicles over a 21-year period (1995-2015) were reviewed. Data extracted were the circumstances of the events, child age, sex, height and weight, time, date and duration of entrapment, and environmental temperatures at the time of entrapment and the autopsy findings. Eight deceased children were brought to the forensic medicine center for autopsy, and seven families consented to the procedure. Autopsy findings included diffuse petechiae and hemorrhages of serosal membranes (n = 7/7) and lung congestion (n = 3/7). Typical autopsy findings following classical heat stroke in children include diffuse petechiae and hemorrhages and lung involvement. These findings are similar to those reported in adults that had died following exertional heat stroke-a very different mechanism of heat accumulation. Prevention of future events can possibly be obtained by public education on the rapid heating of closed vehicles, the vulnerability of children to heat, and the caregiver role in child entrapment. • A common and unfortunate cause for heat stroke-related deaths in children is entrapment in closed vehicles. The pathological consequences of such grave events have not been previously reported. What is New: • This study is the first to describe autopsy findings from children who were found dead in parked cars. • Autopsy findings included diffuse petechiae hemorrhages of serosal membranes and lung congestion. • These findings are identical to those seen in adults following exertional heat stroke.

  17. Traumatic brain injury: Comparison between autopsy and ante-mortem CT.

    Science.gov (United States)

    Panzer, Stephanie; Covaliov, Lidia; Augat, Peter; Peschel, Oliver

    2017-11-01

    The aim of this study was to compare pathological findings after traumatic brain injury between autopsy and ante-mortem computed tomography (CT). A second aim was to identify changes in these findings between the primary posttraumatic CT and the last follow-up CT before death. Through the collaboration between clinical radiology and forensic medicine, 45 patients with traumatic brain injury were investigated. These patients had undergone ante-mortem CT as well as autopsy. During autopsy, the brain was cut in fronto-parallel slices directly after removal without additional fixation or subsequent histology. Typical findings of traumatic brain injury were compared between autopsy and radiology. Additionally, these findings were compared between the primary CT and the last follow-up CT before death. The comparison between autopsy and radiology revealed a high specificity (≥80%) in most of the findings. Sensitivity and positive predictive value were high (≥80%) in almost half of the findings. Sixteen patients had undergone craniotomy with subsequent follow-up CT. Thirteen conservatively treated patients had undergone a follow-up CT. Comparison between the primary CT and the last ante-mortem CT revealed marked changes in the presence and absence of findings, especially in patients with severe traumatic brain injury requiring decompression craniotomy. The main pathological findings of traumatic brain injury were comparable between clinical ante-mortem CT examinations and autopsy. Comparison between the primary CT after trauma and the last ante-mortem CT revealed marked changes in the findings, especially in patients with severe traumatic brain injury. Hence, clinically routine ante-mortem CT should be included in the process of autopsy interpretation. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

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

    International Nuclear Information System (INIS)

    Scholing, M.; Saltzherr, T.P.; Fung Kon Jin, P.H.P.; Ponsen, K.J.; Goslings, J.C.; Reitsma, J.B.; Lameris, J.S.

    2009-01-01

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

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

    International Nuclear Information System (INIS)

    Ullah, K.; Alamgir, W.

    2006-01-01

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

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

    International Nuclear Information System (INIS)

    Martins, N.S.F.; Silva, L.H.C.; Rosa, R.

    1998-01-01

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

  1. Autopsy in Islam: Considerations for Deceased Muslims and Their Families Currently and in the Future.

    Science.gov (United States)

    Sajid, Mohammed Imran

    2016-03-01

    Religious beliefs and cultures have influenced treatment of dead bodies in different ways by nations throughout history, and attitudes toward the deceased individuals have changed across time and so has the role and mechanism of autopsy. Islam has been a part of Europe for a long time; therefore, we would like to emphasize the important issues for Muslims and their families regarding death, autopsy, and funeral and to describe international perspectives of Muslim autopsies. Muslims have expressed their views on autopsy publically and internationally, and there have been claims of violation of the deceased, delays in burial, and nonconsideration of their religious beliefs. In this article, we aim to increase awareness and understanding of doctors about the religious and ethical issues important to Muslims and their families, so that appropriate considerations may be made where possible with regard to respectful treatment of deceased loved ones to decrease tensions presently being faced. Forensic medicine doctors could assist by undertaking autopsy without delay, in a private room by those of the same sex, and covering parts of the body not being worked on at that time.

  2. Discrepancies Between Clinical Diagnoses and Autopsy Findings in Critically Ill Children: A Prospective Study.

    Science.gov (United States)

    Carlotti, Ana P C P; Bachette, Letícia G; Carmona, Fabio; Manso, Paulo H; Vicente, Walter V A; Ramalho, Fernando S

    2016-12-01

    To evaluate the discrepancies between clinical and autopsy diagnoses in patients who died in the pediatric intensive care units (PICUs) of a tertiary care university hospital. A prospective study of all consecutive autopsies discussed at monthly mortality conferences over 5 years. Discrepancies between premortem and autopsy diagnoses were classified according to modified Goldman et al criteria. From January 1, 2011, to December 31, 2015, a total of 2,679 children were admitted to the two PICUs of our hospital; 257 (9.6%) died, 150 (58.4%) underwent autopsy, and 123 were included. Complete concordance between clinical and postmortem diagnoses was observed in 86 (69.9%) patients; 20 (16.3%) had a class I discrepancy, and eight (6.5%) had a class II discrepancy. Comparing 2011 and 2015, the rate of major discrepancies decreased from 31.6% to 15%. Our results emphasize the importance of autopsy to clarify the cause of death and its potential contribution to improvement of team performance and quality of care. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Epidemiology of Zygomycosis: Analysis of National Data from Pathological Autopsy Cases in Japan.

    Science.gov (United States)

    Suzuki, Yuhko; Kume, Hikaru; Togano, Tomiteru; Ohto, Hitoshi

    2017-01-01

    To identify recent trends in the frequency of zygomycosis in autopsy cases, we conducted epidemiological analysis every four years from 1989 to 2009 using national data reported in the "Annual of Pathological Autopsy Cases in Japan." 153,615 cases were autopsied, of which 6622 (4.3%) were found to have had mycosis. Among these, there were 243 cases (3.7%) of zygomycosis, which was the fourth most predominant causative agent of mycoses among the monopathogen mycoses. Of the complicated mycoses, zygomycosis accounted for 56 cases. A total of 299 cases with zygomycoses were observed. The frequency of zygomycosis appeared to be generally stable over the twenty-year period from 1989 to 2009, at around 4% of autopsy cases having mycosis. Younger patients tended to have severe and complicated infections that were characteristic of zygomycosis, compared with non-zygomycosis. The pulmonary and gastrointestinal (GI) systems were the most common foci in our analysis, reflecting the severity of zygomycosis in these sites. Hematological disease was the most frequent underlying disease, but there was a peak of neonatal infections in 2009, which was the first time that this was observed in our studies. These results of the epidemiological analysis of autopsy cases with mycosis demonstrate that clinicians should promptly recognize and treat zygomycosis.

  4. Autopsy histopathology where the prosector is not a histopathologist: a proposal.

    Science.gov (United States)

    Madadin, Mohammed; Molah, Rihab; Cordner, Stephen

    2017-09-01

    Forensic pathology is a specialty that involves death investigation while clinical forensic medicine is the application of the practice of medicine to the requests of the law in relation to the living. Around the world, there is diverse practice for these two disciplines. The forensic physician or forensic doctor (sometimes, called a forensic pathologist but not a forensic histopathologist) in parts of the world such as continental Europe, the Middle East and India, practice both clinical forensic medicine and forensic pathology. This is the specialty, for the purposes of this paper, we will call forensic medicine. The forensic doctor will usually receive training in autopsy dissection, perhaps with a short training of a few months in anatomical pathology or surgical histopathology. When undertaking autopsies (involving internal as well as external examination), if it is thought histological assessment is required, the forensic doctor will sample the organs and tissues required and refer the specimens to the hospital histopathologist for microscopic examination. This division of responsibility could compromise the quality of the autopsy unless handled correctly.Where the histological assessment of the autopsy specimen is undertaken by a pathologist other than the one who dissected the body and collected the samples, standard operating procedures need to be developed to minimize the risk to the overall quality of the autopsy. We are not aware that any such procedures have been published, hence we offer an outline of what a set of such procedures might contain.

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

    International Nuclear Information System (INIS)

    Lange, Charlotte de; Stake, Gunnar; Vege, Aashild

    2007-01-01

    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.)

  6. Comparison of death certificate and autopsy diagnoses - Hiroshima. [Cause of death

    Energy Technology Data Exchange (ETDEWEB)

    Stone, R S; Anderson, Jr, P S

    1960-09-14

    In this report evaluation of the death certificates has been on the basis of comparison with recorded autopsy diagnoses without review of the latter. An attempt has been made to evaluate limitations inherent in this method. The cases analyzed here represent the ABCC Hiroshima autopsy series from 1949 through 1959. Post mortem examinations on stillbirths and neonatal deaths that were collected during the years 1948 through 1953 were excluded from consideration because such cases are not pertinent to the general problems under study. With this limitation 1304 cases were available for matching. In 139 of these cases the death certificates were not available through the mechanisms of the overall study, so 1165 cases remained. Before comparisons are made the most important questions that must be answered about the materials and methods of the present investigation are: (1) is the autopsy-death certificate series a representative sample of all deaths in the population; (2) are the autopsy diagnoses correct; (3) are the death certificates properly understood and coded; and (4) are biologically meaningful groupings chosen for comparison between autopsy cause of death and death certificate cause of death. Because it is not possible to provide exact answers to all of these questions the doubt that they raise must be admitted but evaluated in the perspective of that part of the answer which is known.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Clinicopathological Features and Metastatic Pattern of Hepatocellular Carcinoma: An Autopsy Study of 398 Patients.

    Science.gov (United States)

    Schlageter, Manuel; Quagliata, Luca; Matter, Matthias; Perrina, Valeria; Tornillo, Luigi; Terracciano, Luigi

    2016-01-01

    Analysis of a large local autopsy collective to gather epidemiological and histopathological data on hepatocellular carcinoma (HCC). We examined a large dataset of 44,104 autopsies performed at the Institute of Pathology, Basel, Switzerland, including 2 autopsy collectives (1969-1983 and 1988-2012) to gather current data on HCC in the advanced stage. A total of 398 HCC were diagnosed, accounting for around 1% of all autopsies. As expected, most patients developing HCC had advanced stages of liver fibrosis or cirrhosis (F3/F4). However, in the more recent autopsy collective (1988-2012), our data also show an increase of HCC arising in livers without or with only mild to moderate fibrosis (F0-F2). Extrahepatic metastasis was found in 156 of 398 HCC (39.1%), with lung metastasis (74.5%) being the most common, followed by the bones (24.8%) and adrenal glands (19.1%). Our data therefore seem to suggest that, in the last 2 decades, despite the introduction of new therapeutic modalities for HCC, no significant changes have been observed regarding the metastatic pattern of advanced HCC. © 2016 S. Karger AG, Basel.

  9. Through the lens of the clinician: autopsy services and utilization in a large teaching hospital in Ghana.

    Science.gov (United States)

    Yawson, Alfred E; Tette, Edem; Tettey, Yao

    2014-12-23

    Declining hospital autopsy rates in many countries have generated considerable concern. The survey determined challenges of the autopsy service in a large Teaching Hospital in Ghana, from the perspective of clinicians. This was a cross-sectional study of doctors at the Korle-Bu Teaching Hospital (KBTH) over in 2012. The data was collected using a 69 item self-administered structured questionnaire. In all a total of 215 questionnaires were sent out and 119 doctors responded. Data was collected on the challenges of the autopsy services and barriers to autopsy request from the perspectives of clinicians. Survey data were analyzed by simple descriptive statistics (i.e. proportions, ratios and percentages. Data from survey was analyzed with SPSS version 21. The most common reasons for requesting autopsies were to answer clinical questions, 55 (46.2%) and in cases of uncertain diagnosis, 54 (45.4%). Main demand side barriers to the use of autopsy services by clinicians were reluctance of family to give consent for autopsy 100 (84%), due to cultural and religious objections 89 (74.8%), extra funeral cost to family53 (44.5%) and increased duration of stay of body in the morgue 19 (16%). Health system barriers included delayed feedback from autopsy service 54 (45.4%), difficulties following up the autopsy process 40 (33.6%) due to uncertainties in the timing of particular events in the autopsy process, and long waiting time for autopsy reports 81 (68.1%). More than a third of clinicians 43 (36.2%), received full autopsy report beyond three weeks and 75 (63.1%) clinicians had concerns with the validity of reports issued by the autopsy service (i.e. reports lack specificity or at variance with clinical diagnosis, no toxicological, histological or tissue diagnoses are performed). The autopsy service should restructure itself efficiently and management should support the provision of histological and toxicological services. Strengthening internal and external quality

  10. Layering of stomach contents in drowning cases in post-mortem computed tomography compared to forensic autopsy.

    Science.gov (United States)

    Gotsmy, Walther; Lombardo, Paolo; Jackowski, Christian; Brencicova, Eva; Zech, Wolf-Dieter

    2018-04-24

    In forensic autopsy, the analysis of stomach contents is important when investigating drowning cases. Three-layering of stomach contents may be interpreted as a diagnostic hint to drowning due to swallowing of larger amounts of water or other drowning media. The authors experienced frequent discrepancies of numbers of stomach content layering in drowning cases between post-mortem computed tomography (PMCT) and autopsy in forensic casework. Therefore, the goal of this study was to compare layering of stomach contents in drowning cases between PMCT and forensic autopsy. Drowning cases (n = 55; 40 male, 15 female, mean age 45.3 years; mean amount of stomach content 223 ml) that received PMCT prior to forensic autopsy were retrospectively analyzed by a forensic pathologist and a radiologist. Number of layers of stomach content in PMCT were compared to number of layers at forensic autopsy. In 28 of the 55 evaluated drowning cases, a discrepancy between layering of stomach contents at autopsy compared to PMCT was observed: 1 layer at autopsy (n = 28): 50% discrepancy to PMCT, 2 layers (n = 20): 45% discrepancy, and 3 layers (n = 7): 71.4% discrepancy. Sensitivity of correctly determining layering (as observed at forensic autopsy) in PMCT was 52% (positive predictive value 44.8%). Specificity was 46.6% (negative predictive value 53.8%). In a control group (n = 35) of non-drowning cases, three-layering of stomach contents was not observed. Discrepancies of observed numbers of stomach content layers between PMCT and forensic autopsy are a frequent finding possibly due to stomach content sampling technique at autopsy and movement of the corpse prior to PMCT and autopsy. Three-layering in PMCT, if indeed present, may be interpreted as a hint to drowning.

  11. 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...

  12. Identifying preventable trauma death: does autopsy serve a role in the peer review process?

    Science.gov (United States)

    Scantling, Dane; Teichman, Amanda; Kucejko, Robert; McCracken, Brendan; Eakins, James; Burns, Richard

    2017-07-01

    Missing life-threatening injuries is a persistent concern in any trauma program. Autopsy is a tool routinely utilized to determine an otherwise occult cause of death in many fields of medicine. It has been adopted as a required component of the trauma peer review (PR) process by both the American College of Surgeons and the Pennsylvania Trauma Foundation. We hypothesized that autopsy would not identify preventable deaths for augmentation of the PR process. A retrospective chart review using our institutional trauma registry of all trauma deaths between January 2012 and December 2015 was performed. Per the protocol of our level 1 center, all trauma deaths are referred to the medical examiner (ME) and reviewed as part of the trauma PR process. All autopsy results are evaluated with relation to injury severity score (ISS), trauma injury severity score (TRISS), nature of death, and injuries added by autopsy. ME reports are reviewed by the trauma medical director and referred back to the trauma PR committee if warranted. Trauma injury severity score methodology determines the probability of survival (Ps) given injuries identified. A patient with Ps of ≥0.5 is expected to survive their injuries. Cohorts were created based on when in the hospitalization death occurred: 48 h, or late death. A comparison was conducted between the ISS and Ps calculated during trauma workup and on autopsy using chi-square and Fischer's exact tests. A total of 173 patient deaths were referred to the ME with 123 responses received. Average length of stay was 2.61 d. Twenty-six patients had autopsy declined by the ME, 25 received an external examination only, and 72 received a full autopsy. Autopsy identified one case that was reconsidered in PR (P = 0.603) and added diagnoses, but not injuries, to one patient in the early death group (P = 1) and two in the late death group (P = 0.4921). No preventable cause of death was uncovered, and educational use was minimal. Autopsy did identify

  13. [Soft tissue-cutting law, i.e. the career concept of an autopsy assistant].

    Science.gov (United States)

    Kormos, Timea; Csatai, Tamás; Jäckel, Márta

    2015-03-08

    Practical experience shows that the autopsy assistant society is fairly divided. There are some people who would have needed a thorough basic training, and there are those who - due to their diligence and the close cooperation with physician colleagues - would deserve an opportunity for further progress due to their extensive knowlegde. As regards the autopsy assistant profession the training, and the training system as well has changed significantly, and it requires further changes. Examining the issue in a wide spectrum, the aim of the authors is, as much as possible, to promote the formation of an "Autopsy assistant career," in which they want to create a predictable way for the members of the profession from the phase of becoming a student (competency, training, exams, vocational training, single note) to obtaining the master's degree. The authors would like to provide a summary about their experience and plans regarding this issue.

  14. 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\

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

    International Nuclear Information System (INIS)

    1983-10-01

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

  16. Comparison of clinical causes of death with autopsy diagnosis using discrepency classification.

    Science.gov (United States)

    Ullah, Khalil; Alamgir, Wasim

    2006-12-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  18. [Fall from height--surprising autopsy diagnosis in primarily unclear initial situations].

    Science.gov (United States)

    Schyma, Christian; Doberentz, Elke; Madea, Burkhard

    2012-01-01

    External post-mortem examination and first police assessments are often not consistent with subsequent autopsy results. This is all the more surprising the more serious the injuries found at autopsy are. Such discrepancies result especially from an absence of gross external injuries, as demonstrated by four examples. A 42-year-old, externally uninjured male was found at night time in a helpless condition in the street and died in spite of resuscitation. Autopsy showed severe polytrauma with traumatic brain injury and lesions of the thoracic and abdominal organs. A jump from the third floor was identified as the cause. At dawn, a twenty-year-old male was found dead on the grounds of the adjacent house. Because of the blood-covered head the police assumed a traumatic head injury by strike impact. The external examination revealed only abrasions on the forehead and to a minor extent on the back. At autopsy a midfacial fracture, a trauma of the thorax and abdomen and fractures of the spine and pelvis were detected. Afterwards investigations showed that the man, intoxicated by alcohol, had fallen from the flat roof of a multistoried house. A 77-year-old man was found unconscious on his terrace at day time; a cerebral seizure was assumed. He was transferred to emergency care where he died. The corpse was externally inconspicuous. Autopsy revealed serious traumatic injuries of the brain, thorax, abdomen and pelvis, which could be explained by a fall from the balcony. A 47-year-old homeless person without any external injuries was found dead in a barn. An alcohol intoxication was assumed. At autopsy severe injuries of the brain and cervical spine were found which were the result of a fall from a height of 5 m. On the basis of an external post-mortem examination alone gross blunt force trauma cannot be reliably excluded.

  19. How can we ensure that the coroner's autopsy is not an invasion of human rights?

    Science.gov (United States)

    Leadbeatter, Stephen; James, Ryk

    2018-01-01

    Despite public inquiries, and some changes to legislation following high-profile multiple homicides that were not detected by autopsy, coroners continue to rely largely on the autopsy. Regardless of the extent of quality failings and excess deaths at some hospitals, not detected through the coroner system, the autopsy is scarcely used by hospitals to monitor standards and educate. To explore when a compulsory medicolegal autopsy should, and should not, be used. Two hundred and thirty-six cases referred to a senior coroner were evaluated by pathologists with long experience of forensic, coronial and hospital autopsies, using detailed antecedent medical and circumstantial information: after their advice, the senior coroner decided what kind of autopsy provided sufficient information for his purposes. In nearly 40% (n=88) of deaths where the senior coroner accepted jurisdiction, issues raised could be resolved through analysis of medical records and antecedent information, supplemented only by detailed external examination of the body. Timely provision of sufficient information allows informed decisions about the requirement for, and nature and extent of, medical investigations into a death: unnecessary post mortem dissection is avoided, protecting the rights, under Articles 8 and 9 of the Human Rights Act 1998, of the bereaved to privacy, family life and religious practice. Although improvements in healthcare can undoubtedly result from detailed coroners' inquiries, those deaths where the matters investigated relate only to the accuracy of a natural cause of death or sit with a healthcare provider's internal quality assurance, should be investigated by the healthcare system in collaboration with the bereaved. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Collecting verbal autopsies: improving and streamlining data collection processes using electronic tablets.

    Science.gov (United States)

    Flaxman, Abraham D; Stewart, Andrea; Joseph, Jonathan C; Alam, Nurul; Alam, Sayed Saidul; Chowdhury, Hafizur; Mooney, Meghan D; Rampatige, Rasika; Remolador, Hazel; Sanvictores, Diozele; Serina, Peter T; Streatfield, Peter Kim; Tallo, Veronica; Murray, Christopher J L; Hernandez, Bernardo; Lopez, Alan D; Riley, Ian Douglas

    2018-02-01

    There is increasing interest in using verbal autopsy to produce nationally representative population-level estimates of causes of death. However, the burden of processing a large quantity of surveys collected with paper and pencil has been a barrier to scaling up verbal autopsy surveillance. Direct electronic data capture has been used in other large-scale surveys and can be used in verbal autopsy as well, to reduce time and cost of going from collected data to actionable information. We collected verbal autopsy interviews using paper and pencil and using electronic tablets at two sites, and measured the cost and time required to process the surveys for analysis. From these cost and time data, we extrapolated costs associated with conducting large-scale surveillance with verbal autopsy. We found that the median time between data collection and data entry for surveys collected on paper and pencil was approximately 3 months. For surveys collected on electronic tablets, this was less than 2 days. For small-scale surveys, we found that the upfront costs of purchasing electronic tablets was the primary cost and resulted in a higher total cost. For large-scale surveys, the costs associated with data entry exceeded the cost of the tablets, so electronic data capture provides both a quicker and cheaper method of data collection. As countries increase verbal autopsy surveillance, it is important to consider the best way to design sustainable systems for data collection. Electronic data capture has the potential to greatly reduce the time and costs associated with data collection. For long-term, large-scale surveillance required by national vital statistical systems, electronic data capture reduces costs and allows data to be available sooner.

  1. Usefulness of the Population Health Metrics Research Consortium gold standard verbal autopsy data for general verbal autopsy methods

    Science.gov (United States)

    2014-01-01

    Background Verbal Autopsy (VA) is widely viewed as the only immediate strategy for registering cause of death in much of Africa and Asia, where routine physician certification of deaths is not widely practiced. VA involves a lay interview with family or friends after a death, to record essential details of the circumstances. These data can then be processed automatically to arrive at standardized cause of death information. Methods The Population Health Metrics Research Consortium (PHMRC) undertook a study at six tertiary hospitals in low- and middle-income countries which documented over 12,000 deaths clinically and subsequently undertook VA interviews. This dataset, now in the public domain, was compared with the WHO 2012 VA standard and the InterVA-4 interpretative model. Results The PHMRC data covered 70% of the WHO 2012 VA input indicators, and categorized cause of death according to PHMRC definitions. After eliminating some problematic or incomplete records, 11,984 VAs were compared. Some of the PHMRC cause definitions, such as ‘preterm delivery’, differed substantially from the International Classification of Diseases, version 10 equivalent. There were some appreciable inconsistencies between the hospital and VA data, including 20% of the hospital maternal deaths being described as non-pregnant in the VA data. A high proportion of VA cases (66%) reported respiratory symptoms, but only 18% of assigned hospital causes were respiratory-related. Despite these issues, the concordance correlation coefficient between hospital and InterVA-4 cause of death categories was 0.61. Conclusions The PHMRC dataset is a valuable reference source for VA methods, but has to be interpreted with care. Inherently inconsistent cases should not be included when using these data to build other VA models. Conversely, models built from these data should be independently evaluated. It is important to distinguish between the internal and external validity of VA models. The effects of

  2. Autopsy on an RF-Processed X-band Travelling Wave Structure

    International Nuclear Information System (INIS)

    Le Pimpec, Frederic

    2002-01-01

    In an effort to locate the cause(s) of high electric-field breakdown in x-band accelerating structures, we have cleanly-autopsied (no debris added by post-operation structure disassembly) an RF-processed structure. Macroscopic localization provided operationally by RF reflected wave analysis and acoustic sensor pickup was used to connect breakdowns to autopsied crater damage areas. Surprisingly, the microscopic analyses showed breakdown craters in areas of low electric field. High currents induced by the magnetic field on sharp corners of the input coupler appears responsible for the extreme breakdown damage observed

  3. 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...

  4. 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...

  5. Frequency of tuberculosis at autopsies in a large hospital in Zagreb, Croatia: a 10-year retrospective study

    Science.gov (United States)

    Pavić, Ivana; Radulović, Petra; Bujas, Tatjana; Perić Balja, Melita; Ostojić, Jelena; Baličević, Drinko

    2012-01-01

    Aim To assess the frequency and forms of pulmonary tuberculosis at autopsy in a high-traffic hospital in the capital city of a country with a low tuberculosis incidence. Methods We performed a retrospective search of autopsy data from the period 2000 to 2009 at Sestre Milosrdnice University Hospital Center, Zagreb, Croatia. We also examined patients’ records and histological slides. Results Of 3479 autopsies, we identified 61 tuberculosis cases, corresponding to a frequency of 1.8%. Active tuberculosis was found in 33 cases (54%), 23 of which (70%) were male. Of the 33 active cases, 25 (76%) were clinically unrecognized and 19 (76%) of these were male. Conclusion Clinically undiagnosed tuberculosis accounted for a substantial proportion of active tuberculosis cases diagnosed at autopsy. Autopsy data may be an important complement to epidemiological data on tuberculosis frequency. PMID:22351578

  6. "Blind spots" in forensic autopsy: improved detection of retrobulbar hemorrhage and orbital lesions by postmortem computed tomography (PMCT).

    Science.gov (United States)

    Flach, P M; Egli, T C; Bolliger, S A; Berger, N; Ampanozi, G; Thali, M J; Schweitzer, W

    2014-09-01

    The purpose of this study was to correlate the occurrence of retrobulbar hemorrhage (RBH) with mechanism of injury, external signs and autopsy findings to postmortem computed tomography (PMCT). Six-teen subjects presented with RBH and underwent PMCT, external inspection and conventional autopsy. External inspection was evaluated for findings of the bulbs, black eye, raccoon eyes and Battle's sign. Fractures of the viscerocranium, orbital lesions and RBH were evaluated by PMCT. Autopsy and PMCT was evaluated for orbital roof and basilar skull fracture. The leading manner of death was accident with central regulatory failure in cases of RBH (31.25%). Imaging showed a high sensitivity in detection of orbital roof and basilar skull fractures (100%), but was less specific compared to autopsy. Volume of RBH (0.1-2.4ml) correlated positively to the presence of Battle's sign (pautopsy. PMCT was superior in detecting osseous lesions, scrutinizing autopsy as the gold standard. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. The role of the autopsy in medical malpractice cases, I: a review of 99 appeals court decisions.

    Science.gov (United States)

    Bove, Kevin E; Iery, Clare

    2002-09-01

    Fear that damaging information from autopsy may be introduced as evidence in lawsuits alleging medical malpractice is often cited as one factor contributing to the decline in autopsy rates. To determine how autopsy information influences the outcome of medical malpractice litigation. We studied state court records in 99 cases of medical malpractice adjudicated from 1970 to the present to assess the role of information from autopsies in the outcomes. The 3 largest groups defined by cause of death at autopsy were acute pulmonary embolism, acute cardiovascular disease, and drug overdose/interaction. Findings for defendant physicians outnumbered medical negligence in the original trial proceedings by a 3:1 margin. The appellate courts affirmed 51 acquittals and 19 findings of negligence, and reversed the original trial court decision in 29 cases for technical reasons. We found no significant relationship between accuracy of clinical diagnosis (using the autopsy standard) and outcome of a suit charging medical negligence. Even when a major discrepancy existed between the autopsy diagnosis and the clinical diagnosis, and the unrecognized condition was deemed treatable, defendant physicians were usually exonerated. Moreover, major diagnostic discrepancies were relatively uncommon in suits in which a physician was found to be negligent. Conversely, in about 20% of cases, autopsy findings were helpful to defendant physicians. Our study confirms that a finding of medical negligence is based on standard-of-care issues rather than accuracy of clinical diagnosis. Autopsy findings may appear to be neutral or favorable to either the plaintiff or the defendant, but are typically not the crux of a successful legal argument for either side in a malpractice action. We conclude that fear of autopsy findings has no rational basis and is an important obstacle to uninhibited outcomes analysis.

  8. Air, water, and surface bacterial contamination in a university-hospital autopsy room.

    Science.gov (United States)

    Maujean, Géraldine; Malicier, Daniel; Fanton, Laurent

    2012-03-01

    Today, little is known about the bacteriological environment of the autopsy room and its potential interest for medico-legal practices. Seven hundred fifty microbiological samples were taken from surface (n = 660), air (n = 48), and water (n = 42) to evaluate it in a French University Forensic Department. Median bacterial counts were compared before and during autopsy for air samples, and before and after autopsy for surface samples, using Wilcoxon matched pairs signed ranks test. Bacterial identification relied on traditional phenotypic methods. Bacterial counts in the air were low before autopsy, increased significantly during procedure, and seemed more linked to the number of people in the room than to an important production of aerosol-containing bacteria. Despite cleaning, human fecal flora was omnipresent on surfaces, which revealed insufficient disinfection. Bacteriological sampling is an easy way to monitor cleaning practices in postmortem rooms, but chiefly a way to improve the reliability of medico-legal proofs of infectious deaths. © 2012 American Academy of Forensic Sciences.

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

    DEFF Research Database (Denmark)

    Blaabjerg, Morten; Ruprecht, Klemens; Sinnecker, Tim

    2016-01-01

    , 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...

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

    Science.gov (United States)

    Slater, Greta Yoder

    2011-01-01

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

  11. A Psychological Autopsy of the Suicide of an Academically Gifted Student: Researchers' and Parents' Perspectives.

    Science.gov (United States)

    Cross, Tracy L.; Gust-Brey, Karyn; Ball, P. Bonny

    2002-01-01

    A case study of an academically gifted college student who committed suicide resulted in three sets of findings: those that reflected exclusively on the subject's life, those that compared his life with 3 previous psychological autopsies conducted, and those that reflected the parents' observations and experiences of his life. (Contains…

  12. Perinatal mortality: clinical value of postmortem magnetic resonance imaging compared with autopsy in routine obstetric practice

    NARCIS (Netherlands)

    Alderliesten, Marianne E.; Peringa, Jan; van der Hulst, Victor P. M.; Blaauwgeers, Hans L. G.; van Lith, Jan M. M.

    2003-01-01

    Objective To compare postmortem magnetic resonance imaging (MRI) with autopsy in perinatal deaths. To determine the acceptance and feasibility of postmortem perinatal MRI. Design Cohort study. Setting Large teaching hospital. Population Fetuses and neonates from 16 weeks gestational age until 28

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

    Science.gov (United States)

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

    2011-01-01

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

  14. Demonstration of iron and thorium in autopsy tissues by x-ray microanalysis

    International Nuclear Information System (INIS)

    Landas, S.; Turner, J.W.; Moore, K.C.; Mitros, F.A.

    1984-01-01

    We performed x-ray microanalysis of autopsy specimens using a scanning-transmission electron microscopy mode. Tissues were obtained at necropsy from a patient with history of angiography using thorium dioxide and from a patient with hemochromatosis. X-ray microanalysis confirmed the presence of thorium and iron in their respective tissues. Effects of staining reagents were examined

  15. What Killed This Bank? Financial Autopsy as an Experiential Learning Tool

    Science.gov (United States)

    Hays, Fred H.; DeLurgio, Stephen A.

    2010-01-01

    Finance students today live in the midst of an enormous financial crisis. Institutions both large and small are failing or being rescued through government intervention. This environment presents a host of learning opportunities for instructors as well as students. This paper discusses financial autopsies as a form of experiential learning…

  16. Multiple stab wounds: understanding the manner of death through the psychological autopsy.

    Science.gov (United States)

    Di Vella, G; Grattagliano, I; Curti, S; Catanesi, R; Sullivan, M K; Tattoli, L

    2017-01-01

    A 48-year-old physical therapist with no history of psychiatric disorders or suicidal tendencies was found dead by his relatives inside his apartment. Multiple stab wounds were present on the chest and the abdomen. Several more superficial cuts were also seen on the neck and the left wrist. At the death scene, there was a large pool of blood in the room, with secondary droplets and stains; a kitchen knife was found beside the body, and a suicide note on a table. Especially the number of wounds raised strong suspicion of a homicide in the first instance but some circumstances (the farewell letter, the absence of clothing injuries, no signs of third-party involvement) and autopsy findings (absence of defense or blunt injuries, the localization of the wounds, the presence of hesitation marks) pointed toward a suicide etiology. Because of the many stab injuries and the lack of a psychiatric history, further forensic investigations were required including a so-called psychological autopsy. This case report highlights that only a comprehensive interpretation of all the elements (circumstances, the scene of death, autopsy findings, and psychological autopsy) can lead to the correct solution of atypical cases of suicide.

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

    International Nuclear Information System (INIS)

    Song, Mi Jin; Cho, Jeong Yeon; Lee, Young Ho

    2001-01-01

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

  18. The Autopsy as a Teaching-Learning Tool for Medical Undergraduates

    Science.gov (United States)

    DeRoy, Al K.

    1976-01-01

    The study reported was conducted to identify cognitive, affective, and skill elements that may be transmitted to medical students through the pedagogic autopsy and to determine differences, if any, between student perceptions of the amount of emphasis given these elements and faculty beliefs as to the amount of emphasis given these elements in…

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

    Science.gov (United States)

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

    2012-01-01

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

  20. 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

    . 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...

  1. Autopsy as a tool in the prevention of maternal mortality | Daramola ...

    African Journals Online (AJOL)

    Maternal mortality rates are an index of the state of a nation's health system. Maternal autopsies help to determine these rates, provide information on avoidable/unavoidable causes of mortality, consequently leading to the development of strategies for treatment and prevention ofmaternalmortality andmorbidity. The lesson ...

  2. Autopsy interrogation of emergency medicine dispute cases: how often are clinical diagnoses incorrect?

    Science.gov (United States)

    Liu, Danyang; Gan, Rongchang; Zhang, Weidi; Wang, Wei; Saiyin, Hexige; Zeng, Wenjiao; Liu, Guoyuan

    2018-01-01

    Emergency medicine is a 'high risk' specialty. Some diseases develop suddenly and progress rapidly, and sudden unexpected deaths in the emergency department (ED) may cause medical disputes. We aimed to assess discrepancies between antemortem clinical diagnoses and postmortem autopsy findings concerning emergency medicine dispute cases and to figure out the most common major missed diagnoses. Clinical files and autopsy reports were retrospectively analysed and interpreted. Discrepancies between clinical diagnoses and autopsy diagnoses were evaluated using modified Goldman classification as major and minor discrepancy. The difference between diagnosis groups was compared with Pearson χ 2 test. Of the 117 cases included in this study, 71 of cases (58 class I and 13 class II diagnostic errors) were revealed as major discrepancies (60.7%). The most common major diagnoses were cardiovascular diseases (54 cases), followed by pulmonary diseases, infectious diseases and so on. The difference of major discrepancy between the diagnoses groups was significant (ppay special attention to in practice. This study reaffirmed the necessity and usefulness of autopsy in auditing death in EDs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

    Directory of Open Access Journals (Sweden)

    Kochhar Rakesh K

    2009-12-01

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

  4. How to integrate proxy data from two informants in life event assessment in psychological autopsy.

    Science.gov (United States)

    Zhang, Jie; Wang, Youqing; Fang, Le

    2018-04-27

    Life event assessment is an important part in psychological autopsy, and how to integrate its proxy data from two informants is a major methodological issue which needs solving. Totally 416 living subjects and their two informants were interviewed by psychological autopsy, and life events were assessed with Paykel's Interview for Recent Life Events. Validities of integrated proxy data using six psychological autopsy information reconstruction methods were evaluated, with living subjects' self-reports used as gold-standard criteria. For all the life events, average value of Youden Indexes for proxy data by type C information reconstruction method (choosing positive value from two informants) was larger than other five methods'. For family life related events, proxy data by type 1st information reconstruction method were not significantly different from living subjects' self-reports (P = 0.828). For all other life events, proxy data by type C information reconstruction method were not significantly different from the gold-standard. Choosing positive value is a relatively better method for integrating dichotomous (positive vs. negative) proxy data from two informants in life event assessment in psychological autopsy, except for family life related events. In that case, using information provided by 1st informants (mainly family member) is recommended.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Is the cervical spine clear? Undetected cervical fractures diagnosed only at autopsy.

    Science.gov (United States)

    Sweeney, J F; Rosemurgy, A S; Gill, S; Albrink, M H

    1992-10-01

    Undetected cervical-spine injuries are a nemesis to both trauma surgeons and emergency physicians. Radiographic protocols have been developed to avoid missing cervical-spine fractures but are not fail-safe. Three case reports of occult cervical fractures documented at autopsy in the face of normal cervical-spine radiographs and computerized tomography scans are presented.

  7. An erroneous opinion on a cause of death in a forensic autopsy: a ...

    African Journals Online (AJOL)

    Background: The quality of autopsies is always questioned in courts, especially in developing countries. Wrong decisions or misjudgments are undesirable in medicine, but they are very dangerous in forensic medicine. If a wrong opinion is given, either a culprit can be acquitted or an innocent person can be sentenced.

  8. 20 CFR 410.428 - X-ray, biopsy, and autopsy evidence of pneumoconiosis.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false X-ray, biopsy, and autopsy evidence of pneumoconiosis. 410.428 Section 410.428 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE...) The International Classification of Radiographs of the Pneumoconioses of the International Labour...

  9. 42 CFR 35.16 - Autopsies and other post-mortem operations.

    Science.gov (United States)

    2010-10-01

    ... AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.16 Autopsies and other post-mortem... to in writing by a person authorized under the law of the State in which the station or hospital is... made a part of the clinical record. [25 FR 6331, July 6, 1960] ...

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

    Science.gov (United States)

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

    2009-01-01

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

  11. 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.

  12. Correlation between fetal autopsy and prenatal diagnosis by ultrasound: A systematic review.

    Science.gov (United States)

    Rossi, A Cristina; Prefumo, Federico

    2017-03-01

    The objective of this study was to review literature about the correlation between fetal autopsy and ultrasound findings of fetal malformations. Search in PubMed, Medline, EMBASE, Clinicl trials.org, reference list was performed. Inclusion criteria for studies selection were: fetal autopsy performed after termination of pregnancy (TOP) or stillbirth, TOP for fetal anomalies, prenatal diagnosis of malformations, data reported as proportional rates. case reports, non English language, data reported in graphs or percentage. From each article: sample size, type of malformation, indication for TOP, autopsy findings. Fetal anomalies were grouped in central nervous system (CNS), genitourinary (GU), congenital heart defects (CHD), gastrointestinal (GI), thorax, limbs, skeleton, genetics (TOP for abnormal karyotype), multiples (TOP for multiple severe malformations for which a single indication for TOP/stillbirth could not be identified). Correspondence between autopsy and ultrasound was defined as agreement (same diagnosis), additional (additional findings undetected by ultrasound), unconfirmed (false positive and false negative ultrasound). PRISMA guidelines were followed. From 19 articles, 3534 fetuses underwent autopsy, which confirmed prenatal ultrasound in 2401 (68.0%) fetuses, provided additional information in 794 (22.5%) fetuses, and unconfirmed prenatal ultrasound in 329 (9.2%) fetuses. The latter group consisted of 3.2% false positive and 2.8% false negative cases. The additional findings changed the final diagnosis in 3.8% of cases. The most frequent indication for TOP/stillbirth was CNS anomalies (36.3%), whereas thorax anomalies represented the less frequent indication (1.7%). The highest agreement between autopsy and prenatal ultrasound was observed in CNS (79.4%) and genetics (79.2%), followed by GU anomalies (76.6%), skeleton (76.6%), CHD (75.5%), thorax (69.7%); GI (62.6%), multiple (37.0%), limbs (23.3%). In spite of the high agreement between prenatal

  13. Analysis of Health Facility Based Perinatal Verbal Autopsy of Electoral Constituency 2 of Arghakhanchi District, Nepal.

    Science.gov (United States)

    Manandhar, S R; Manandhar, D S; Adhikari, D; Shrestha, J; Rai, C; Rana, H; Paudel, M

    2015-01-01

    Verbal autopsy is a method to diagnose possible cause of death by analyzing factors associated with death through detailed questioning. This study is a part of the operational research program in electoral constituency no. 2 (EC 2) of Arghakhanchi district by MIRA and HealthRight International. Two day essential newborn care training followed by one day perinatal verbal autopsy training and later one day refresher verbal autopsy training was given for health staff of EC 2 of Arghakhanchi district in two groups. Stillbirths of >22wks or > 500 gms and Early neonatal deaths (newborns died within7 days of life) were included in this study. The Nepal Government approved verbal autopsy forms were used for performing autopsies. Perinatal deaths were classified according to Wigglesworth's Classification. Causes of Perinatal deaths were analyzed. Data were analyzed in the form of frequencies and tabulation in SPSS 16 . There were 41 cases of perinatal deaths (PND) were identified. Among them, 37 PNDs were from Arghakhanchi district hospital, 2 PNDs from Thada PHC, and one PND each from Subarnakhal and Pokharathok HPs. Among the 41 PNDs, 26 were stillbirths (SB) and 15 were early neonatal deaths (ENND). The perinatal mortality rate (PMR) of Arghakhanchi district hospital was 32.2 per 1,000 births and neonatal mortality rate (NMR) was 9.8 per 1,000 live births. Out of 26 stillbirths, 54% (14) were fresh SBs and 46% (12) were macerated stillbirths. The most common cause of stillbirth was obstetric complications (47%) where as birth asphyxia (53%) was the commonest cause of ENND. According to Wigglesworth's classification of perinatal deaths, Group IV (40%) was the commonest cause in the health facilities. Obstetric complication was the commonest cause of stillbirth and birth asphyxia was the commonest cause of early neonatal death. This study highlighted the need for regular antenatal check-ups and proper intrapartum fetal monitoring with timely and appropriate intervention to

  14. Quantification of interstitial fluid on whole body CT: comparison with whole body autopsy.

    Science.gov (United States)

    Lo Gullo, Roberto; Mishra, Shelly; Lira, Diego A; Padole, Atul; Otrakji, Alexi; Khawaja, Ranish Deedar Ali; Pourjabbar, Sarvenaz; Singh, Sarabjeet; Shepard, Jo-Anne O; Digumarthy, Subba R; Kalra, Mannudeep K; Stone, James R

    2015-12-01

    Interstitial fluid accumulation can occur in pleural, pericardial, and peritoneal spaces, and subcutaneous tissue planes. The purpose of the study was to assess if whole body CT examination in a postmortem setting could help determine the presence and severity of third space fluid accumulation in the body. Our study included 41 human cadavers (mean age 61 years, 25 males and 16 females) who had whole-body postmortem CT prior to autopsy. All bodies were maintained in the morgue in the time interval between death and autopsy. Two radiologists reviewed the whole-body CT examinations independently to grade third space fluid in the pleura, pericardium, peritoneum, and subcutaneous space using a 5-point grading system. Qualitative CT grading for third space fluid was correlated with the amount of fluid found on autopsy and the quantitative CT fluid volume, estimated using a dedicated software program (Volume, Syngo Explorer, Siemens Healthcare). Moderate and severe peripheral edema was seen in 16/41 and 7/41 cadavers respectively. It is not possible to quantify anasarca at autopsy. Correlation between imaging data for third space fluid and the quantity of fluid found during autopsy was 0.83 for pleural effusion, 0.4 for pericardial effusion and 0.9 for ascites. The degree of anasarca was significantly correlated with the severity of ascites (p < 0.0001) but not with pleural or pericardial effusion. There was strong correlation between volumetric estimation and qualitative grading for anasarca (p < 0.0001) and pleural effusion (p < 0.0001). Postmortem CT can help in accurate detection and quantification of third space fluid accumulation. The quantity of ascitic fluid on postmortem CT can predict the extent of anasarca.

  15. Postmortem computed tomography (PMCT) and autopsy in deadly gunshot wounds--a comparative study.

    Science.gov (United States)

    Kirchhoff, S M; Scaparra, E F; Grimm, J; Scherr, M; Graw, M; Reiser, M F; Peschel, O

    2016-05-01

    Postmortem computed tomography (PMCT) data in gunshot-related death were evaluated by two reader groups and compared to the gold standard autopsy for the determination of forensic pathology criteria. Reader group I consisted of two board-certified radiologists whereas one board-certified radiologist and one board-certified forensic pathologist formed group II. PMCT data of 51 gunshot-related deaths were evaluated for the forensic pathology criteria number of gun shots, localization of gunshot injury, caliber, and direction of the gunshot differentiating between entry and exit wound as well as associated injury to surrounding tissue. The results of both reader groups were compared to the each other and to autopsy findings considered as gold standard. Reader groups I and II and as gold standard the autopsy evaluation showed in general a good correlation between all results. The overall discrepancy rate was 12/51 (23.4%) cases for group I and 8/51 (15.6%) for group II. Ultimately, the designated reader is able to draw the following conclusion from the presented data. At first, physical autopsy is better than PMCT regarding the localization of most gunshot injuries. Second, PMCT presents with better results than physical autopsy in locating fragmented bullets/fragment clouds, and finally, PMCT results of two radiologists were equivalent to the results of one evaluating radiologist and one pathologist with the exception of caliber assessment. However, referring to the pure numbers, the slight but not significant difference in the overall discrepancy rate of both reader groups might indicate the advantage of combining expertise in evaluating imaging in cases of gunshot-related death.

  16. Diagnostic accuracy of postmortem imaging vs autopsy-A systematic review.

    Science.gov (United States)

    Eriksson, Anders; Gustafsson, Torfinn; Höistad, Malin; Hultcrantz, Monica; Jacobson, Stella; Mejare, Ingegerd; Persson, Anders

    2017-04-01

    Background Postmortem imaging has been used for more than a century as a complement to medico-legal autopsies. The technique has also emerged as a possible alternative to compensate for the continuous decline in the number of clinical autopsies. To evaluate the diagnostic accuracy of postmortem imaging for various types of findings, we performed this systematic literature review. Data sources The literature search was performed in the databases PubMed, Embase and Cochrane Library through January 7, 2015. Relevant publications were assessed for risk of bias using the QUADAS tool and were classified as low, moderate or high risk of bias according to pre-defined criteria. Autopsy and/or histopathology were used as reference standard. Findings The search generated 2600 abstracts, of which 340 were assessed as possibly relevant and read in full-text. After further evaluation 71 studies were finally included, of which 49 were assessed as having high risk of bias and 22 as moderate risk of bias. Due to considerable heterogeneity - in populations, techniques, analyses and reporting - of included studies it was impossible to combine data to get a summary estimate of the diagnostic accuracy of the various findings. Individual studies indicate, however, that imaging techniques might be useful for determining organ weights, and that the techniques seem superior to autopsy for detecting gas Conclusions and Implications In general, based on the current scientific literature, it was not possible to determine the diagnostic accuracy of postmortem imaging and its usefulness in conjunction with, or as an alternative to autopsy. To correctly determine the usefulness of postmortem imaging, future studies need improved planning, improved methodological quality and larger materials, preferentially obtained from multi-center studies. Copyright © 2016. Published by Elsevier B.V.

  17. Causes of Mortality for Indonesian Hajj Pilgrims: Comparison between Routine Death Certificate and Verbal Autopsy Findings

    Science.gov (United States)

    Pane, Masdalina; Imari, Sholah; Alwi, Qomariah; Nyoman Kandun, I; Cook, Alex R.; Samaan, Gina

    2013-01-01

    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 (pIndonesian 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 are needed to assess the method’s utility in this setting. PMID:23991182

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

    International Nuclear Information System (INIS)

    Li Hongjun; Zhang Yuzhong; Cheng Jingliang

    2009-01-01

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

  19. AGE DETERMINATION FROM PUBIC SYMPHYSEAL CHANGES- AN AUTOPSY STUDY

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    Jinesh Parambathettu Sasidharan

    2017-02-01

    Full Text Available BACKGROUND Biological identity is one of the first things to be established when analysing skeletal, badly decomposed or otherwise unidentified human remains. The determination of age at death is an important component of identity establishment. Pubic symphysis examination is one of the reliable methods of age estimation. We attempt to determine the age of deceased from pubic symphysis using Suchey-Brooks method and to find the accuracy of Suchey-Brooks method in our population. From among the cases brought for autopsy at Department of Forensic Medicine, Government Medical College, Kottayam, Kerala, from 01/03/2012 to 28/02/2013, 316 cases were included in the study. Their pubic symphysis were harvested. Age determined using SucheyBrooks method and compared with their chronological age. The aim of the study is to- 1. Determine the age of deceased from pubic symphysis using Suchey-Brooks method. 2. Compare the age determined by Suchey-Brooks method and chronological age and find the accuracy of Suchey-Brooks method in our population. MATERIALS AND METHODS Study Design- Descriptive study- Cross-sectional study, Centre of Study- Department of Forensic Medicine, Government Medical College, Kottayam, Study Sample- From the cases brought for medicolegal postmortem examination in the Department of Forensic Medicine, Government Medical College, Kottayam, Kerala, a sample of 316 cases were selected. To make the distribution among various age groups, even the total sample divided for the age group, which resulted in having 60 samples per age group. Age groups were considered as Group 1- Age between 18-25 years; Group 2- Age between 25-35 years; Group 3- Age between 35-45 years; Group 4- Age between 45-55 years; Group 5- Age between 55-65 years. Inclusion Criteria- 1. Cases with known age; 2. Cases whose age between 18 and 65 years. Exclusion Criteria- 1. Unknown cases; 2. Known cases with doubtful age; 3. Individuals having pubic bone trauma involving the

  20. Can virtual autopsy with postmortem CT improve clinical diagnosis of cause of death? A retrospective observational cohort study in a Dutch tertiary referral centre

    Science.gov (United States)

    Sonnemans, Lianne J P; Kubat, Bela; Prokop, Mathias; Klein, Willemijn M

    2018-01-01

    Objective To investigate whether virtual autopsy with postmortem CT (PMCT) improves clinical diagnosis of the immediate cause of death. Design Retrospective observational cohort study. Inclusion criteria: inhospital and out-of-hospital deaths over the age of 1 year in whom virtual autopsy with PMCT and conventional autopsy were performed. Exclusion criteria: forensic cases, postmortal organ donors and cases with incomplete scanning procedures. Cadavers were examined by virtual autopsy with PMCT prior to conventional autopsy. The clinically determined cause of death was recorded before virtual autopsy and was then adjusted with the findings of virtual autopsy. Using conventional autopsy as reference standard, we investigated the increase in sensitivity for immediate cause of death, type of pathology and anatomical system involved before and after virtual autopsy. Setting Tertiary referral centre. Participants 86 cadavers that underwent conventional and virtual autopsy between July 2012 and June 2016. Intervention PMCT consisted of brain, cervical spine and chest–abdomen–pelvis imaging. Conventional autopsy consisted of thoracoabdominal examination with/without brain autopsy. Primary and secondary outcome measures Increase in sensitivity for the immediate cause of death, type of pathology (infection, haemorrhage, perfusion disorder, other or not assigned) and anatomical system (pulmonary, cardiovascular, gastrointestinal, other or not assigned) involved, before and after virtual autopsy. Results Using PMCT, the sensitivity for immediate cause of death increased with 12% (95% CI 2% to 22%) from 53% (41% to 64%) to 64% (53% to 75%), with 18% (9% to 27%) from 65% (54% to 76%) to 83% (73% to 91%) for type of pathology and with 19% (9% to 30%) from 65% (54% to 76%) to 85% (75% to 92%) for anatomical system. Conclusion While unenhanced PMCT is an insufficient substitute for conventional autopsy, it can improve diagnosis of cause of death over clinical diagnosis alone

  1. Can virtual autopsy with postmortem CT improve clinical diagnosis of cause of death? A retrospective observational cohort study in a Dutch tertiary referral centre.

    Science.gov (United States)

    Sonnemans, Lianne J P; Kubat, Bela; Prokop, Mathias; Klein, Willemijn M

    2018-03-16

    To investigate whether virtual autopsy with postmortem CT (PMCT) improves clinical diagnosis of the immediate cause of death. Retrospective observational cohort study. inhospital and out-of-hospital deaths over the age of 1 year in whom virtual autopsy with PMCT and conventional autopsy were performed. forensic cases, postmortal organ donors and cases with incomplete scanning procedures. Cadavers were examined by virtual autopsy with PMCT prior to conventional autopsy. The clinically determined cause of death was recorded before virtual autopsy and was then adjusted with the findings of virtual autopsy. Using conventional autopsy as reference standard, we investigated the increase in sensitivity for immediate cause of death, type of pathology and anatomical system involved before and after virtual autopsy. Tertiary referral centre. 86 cadavers that underwent conventional and virtual autopsy between July 2012 and June 2016. PMCT consisted of brain, cervical spine and chest-abdomen-pelvis imaging. Conventional autopsy consisted of thoracoabdominal examination with/without brain autopsy. Increase in sensitivity for the immediate cause of death, type of pathology (infection, haemorrhage, perfusion disorder, other or not assigned) and anatomical system (pulmonary, cardiovascular, gastrointestinal, other or not assigned) involved, before and after virtual autopsy. Using PMCT, the sensitivity for immediate cause of death increased with 12% (95% CI 2% to 22%) from 53% (41% to 64%) to 64% (53% to 75%), with 18% (9% to 27%) from 65% (54% to 76%) to 83% (73% to 91%) for type of pathology and with 19% (9% to 30%) from 65% (54% to 76%) to 85% (75% to 92%) for anatomical system. While unenhanced PMCT is an insufficient substitute for conventional autopsy, it can improve diagnosis of cause of death over clinical diagnosis alone and should therefore be considered whenever autopsy is not performed. © Article author(s) (or their employer(s) unless otherwise stated in the text of

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

    Science.gov (United States)

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Misganaw Awoke

    2012-08-01

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

  4. Detection of blood aspiration in deadly head gunshots comparing postmortem computed tomography (PMCT) and autopsy.

    Science.gov (United States)

    Scaparra, E; Peschel, O; Kirchhoff, C; Reiser, M; Kirchhoff, S M

    2016-11-01

    The aim of our study was to analyze the reliability of postmortem computed tomography (PMCT) versus autopsy in detecting signs of blood aspiration in a distinct group of patients following deadly head, mouth or floor of mouth gunshot injuries. In this study, in 41 cases PMCT was compared to autopsy reports, the gold standard of postmortem exams, regarding detection of blood aspiration. PMCT was evaluated for the presence and level of typical signs of blood aspiration in the major airways and lung using a semi-quantitative scale ranging from level 0 (no aspiration) to 3 (significant aspiration) also taking density values of the described potential aspiratory changes into account. Overall, in 29 (70.7%) of 41 enrolled cases PMCT and autopsy revealed the same level of aspiration. A difference of one level between PMCT and autopsy resulted for 5 (12.2%) of the remaining 12 cases. More than one level difference between both methods resulted for 7 cases (17.2%). Autopsy described no signs of aspiration in 10 cases, compared to 31 cases with reported blood aspiration. In contrast, PMCT revealed no signs of blood aspiration in 15 cases whereas 26 cases were rated as positive for signs of aspiration in the major airways. In 18 of these 26 cases considered positive for blood aspiration by autopsy and PMCT, clear signs of aspiration signs were also described bilaterally by both methods. The presented study provides evidence for the assumption that PMCT seems to be helpful in the detection of blood aspiration in cases of deadly head gunshots. In conclusion, it seems reasonable to suggest performing PMCT additionally to traditional postmortem exams in cases of suspected aspiration to rule out false-negative cases and to possibly allow for a more detailed and rather evidence based examination reconnoitering the cause of death. However, the adequate use of PMCT in this context needs further evaluation and the definition of an objective scale for aspiration detection on PMCT needs

  5. Relation of radiation to gastric carcinoma observed in autopsy cases in a fixed population, Hiroshima and nagasaki 1961 - 74

    International Nuclear Information System (INIS)

    Yamamoto, Tsutomu; Shimizu, Yukiko

    1978-01-01

    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)

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

    Science.gov (United States)

    Gulczyński, Jacek; Izycka-Swieszewska, Ewa; Grzybiak, Marek

    2009-01-01

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

  7. Can sudden cardiac death in the young be predicted and prevented? Lessons from autopsy for the emergency physician.

    Science.gov (United States)

    White, Jennifer L; Chang, Anna Marie; Cesar, Sergi; Sarquella-Brugada, Georgia

    2018-06-01

    Sudden unexpected death in the young, though rare, is devastating for both the family and the community. Although only 1.3 to 8.5 cases of sudden cardiac death (SCD) occur per 100 000 young people, autopsy is often inconclusive. Many causes of SCD are related to autosomal dominant inherited risk, however; therefore, answers are important for survivors. Causes of autopsy-positive SCD in young patients include hypertrophic cardiomyopathy and arrhythmogenic right ventricular dysplasia. Autopsy-negative SCD has been related to inherited arrhythmogenic causes such as long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, Wolff- Parkinson-White syndrome, and idiopathic ventricular fibrillation. The important question for the emergency physician is how SCD can be predicted and prevented in the young so that there is no need for an autopsy.

  8. 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)

  9. An autopsy case of a primary aortoenteric fistula: A pitfall of the endoscopic diagnosis

    Institute of Scientific and Technical Information of China (English)

    Yoko Ihama; Tetsuji Miyazaki; Chiaki Fuke; Yasushi Ihama; Ryoji Matayoshi; Hiroshi Kohatsu; Fukunori Kinjo

    2008-01-01

    A primary aortoenteric fistula (PAEF), defined as a communication between the native aorta and the gastrointestinal tract, is a rare cause of gastrointes-tinal bleeding. The preoperative diagnosis of PAEF is extremely difficult. Consequently, PAEF may cause sudden and unexpected death. We present an autopsy case of a 68-year-old man who died of massive gastro-intestinal bleeding due to a PAEF. Autopsy revealed a pinhole rupture located on the third part of the duode-nal mucosa and fistulized into the adjacent abdominal aortic aneurysrn (AAA). Our case indicates that the aortoenteric fistula can result in fatal gastrointestinal bleeding. Consequently, a PAEF should be included in the differential diagnosis of gastrointestinal bleeding.

  10. 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...... from 1992 to 2010. Eighty-four suicidal deaths with morphologically normal hearts served as controls. Polymerase chain reaction was used for the detection of the viral genomes (adenovirus, enterovirus, and PVB) in myocardial tissue specimens. The distinction between acute and persistent PVB infection...... was made by the serological determination of PVB-specific immunoglobulins M and G. RESULTS: PVB was detected in 33 of 112 (29 %) myocarditis cases and 37 of 84 (44 %) control cases. All of the samples were negative for the presence of adenovirus and enterovirus. Serological evidence of an acute PVB...

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

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    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.

  12. Autopsy standards of body parameters and fresh organ weights in nonmacerated and macerated human fetuses

    DEFF Research Database (Denmark)

    Maroun, Lisa Leth; Graem, Niels

    2005-01-01

    Standards for body parameters and organ weights are important tools in fetal and perinatal pathology. Previously there has been only a weak emphasis on the effect of maceration on dimensions and weights. This study provides autopsy standards for body weight, body dimensions, and fresh organ weigh...... increased slightly with maceration, whereas body weight and head circumference were unaffected. User-friendly charts and tables of mean values and standard deviations for nonmacerated and macerated fetuses are provided.......Standards for body parameters and organ weights are important tools in fetal and perinatal pathology. Previously there has been only a weak emphasis on the effect of maceration on dimensions and weights. This study provides autopsy standards for body weight, body dimensions, and fresh organ weights...

  13. 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

    AIMS: The targeted genetic screening of Sudden Arrhythmic Death Syndrome (SADS) probands in a molecular autopsy has a diagnostic yield of up to 35%. Exome sequencing has the potential to improve this yield. The primary aim of this study is to examine the feasibility and diagnostic utility...... of targeted exome screening in SADS victims, utilizing familial clinical screening whenever possible. METHODS AND RESULTS: To determine the feasibility and diagnostic yield of targeted exome sequencing deoxyribonucleic acid (DNA) was isolated from 59 SADS victims (mean age 25 years, range 1-51 years...... previously published rare (0.02-0.5%) candidate mutations-a total yield of 29%. Co-segregation fully confirmed two private SCN5A Na channel mutations. Variants of unknown significance were detected in a further 34% of probands. CONCLUSION: Molecular autopsy using targeted exome sequencing has a relatively...

  14. Analysis of the utility of imaging in autopsied patients with abdominal tumor

    International Nuclear Information System (INIS)

    Honma, Mitsuo

    1983-01-01

    The utility of imaging was studied in 10 autopsy cases of abdominal tumor. Examinations strictly concurred with autopsy findings, in 83 (65.9%) of 126 procedures, and they were useful for the process of clinical diagnosis in 106 (74.1%) : 100% for CT, 87.5% and 12.5% for angiography, 80.0% and 20.0% for oral GI sereis, 50% and 36.4% for RI scan, 68.4% and 10.5% for chest X-P and 50.0% and 24.9% for abdominal X-P, respectively. Utility was not so much related to relative difficulty or complexity of diagnostic process. (Chiba, N.)

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

    International Nuclear Information System (INIS)

    Yamada, Shozo; Endo, Yuzo; Takada, Koji; Usui, Masaaki; Hara, Mitsuru; Hirose, Takanori.

    1998-01-01

    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-β. Histological examination confirmed the diagnosis of glioblastoma multiform. He died of accidental head trauma 6.5 years after surgery. Autopsy of the brain detected no evidence of glioblastoma multiform. The only findings were cerebral edema and hematoma caused by head trauma, as well as histological changes due to radiation damage. This case apparently confirms the histological disappearance of tumor tissue in a long-term survivor with glioblastoma multiform. (author)

  16. Automated Peak Picking and Peak Integration in Macromolecular NMR Spectra Using AUTOPSY

    Science.gov (United States)

    Koradi, Reto; Billeter, Martin; Engeli, Max; Güntert, Peter; Wüthrich, Kurt

    1998-12-01

    A new approach for automated peak picking of multidimensional protein NMR spectra with strong overlap is introduced, which makes use of the program AUTOPSY (automatedpeak picking for NMRspectroscopy). The main elements of this program are a novel function for local noise level calculation, the use of symmetry considerations, and the use of lineshapes extracted from well-separated peaks for resolving groups of strongly overlapping peaks. The algorithm generates peak lists with precise chemical shift and integral intensities, and a reliability measure for the recognition of each peak. The results of automated peak picking of NOESY spectra with AUTOPSY were tested in combination with the combined automated NOESY cross peak assignment and structure calculation routine NOAH implemented in the program DYANA. The quality of the resulting structures was found to be comparable with those from corresponding data obtained with manual peak picking.

  17. John Paul Jones: An Overlooked Autopsy Finding that May Explain His Terminal Illness.

    Science.gov (United States)

    Hamrell, Burt B

    2016-03-01

    A finding in the autopsy of John Paul Jones, the American Revolutionary War naval hero, may explain his terminal illness. During his last 2 years, he had a persistent productive cough and dyspnea. Ten days before death, he developed rapidly progressive dependent edema and ascites. He died in France in 1792. His body, preserved in alcohol in a lead coffin, was, in 1905, removed to the United States. Glomerulonephritis was noted on an autopsy, performed in France, but there was no comment then or since about ventricular wall thickness being the same in both ventricles at 5-6 mm. Hypertrophy and dilatation with biventricular failure followed by tissue shrinkage during 113 years in alcohol could have resulted in these ventricular wall findings. Systemic hypertension and left ventricular failure are consistent with his respiratory symptoms complicated perhaps by pulmonary emboli, right ventricular failure with tricuspid regurgitation, peripheral congestion, and jaundice. © 2015 American Academy of Forensic Sciences.

  18. Comparisons between in vivo estimates of systemic Pu deposition and autopsy data

    International Nuclear Information System (INIS)

    Schofield, G.B.

    1982-01-01

    In the UK the radiochemical analyses of autopsy specimens have been undertaken following the death of 30 employees during the period 1964 - 1980 whose work has at some time brought them into contact with plutonium. These workers were routinely monitored during their lifetime and estimates made of their total body content of plutonium. Past experience has shown that the urinary plutonium content bears a marked relationship to the bone and liver deposition levels of plutonium but not to the quantities found in the lungs (1). In this paper therefore the comparisons are made between in vivo estimates of bone and liver plutonium deposition and estimates derived from both the wet and ash weights of autopsy specimens. (author)

  19. The First Survey of Forensically Important Entomofauna Collected from Medicolegal Autopsies in South Korea

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    Sang Eon Shin

    2015-01-01

    Full Text Available Forensic entomology applies insect evidence to legal problems such as the estimation of minimum postmortem interval (mPMI. For this purpose, knowledge of the insect fauna that are attracted to human cadavers in each geographic region is a prerequisite. Despite many studies investigating the insect fauna attracted to meat, there has been no survey of the entomofauna on human cadavers in the East Asian temperate climate zone, particularly in Korea. Therefore, this study reports the entomofauna collected from medicolegal autopsies in northeastern Seoul and its suburbs. Insect samples were collected from 35 medicolegal autopsies in 2010, 2011, and 2013. Molecular and morphological methods were utilized for taxonomic identification. Among 1398 individual samples belonging to 3 orders, 13 families, 18 genera, and 32 species, the dominant family and species were Calliphoridae and Lucilia sericata, respectively. Despite its limited scale, this study provides a snapshot of the general entomofauna that are attracted to human cadavers in this region.

  20. The First Survey of Forensically Important Entomofauna Collected from Medicolegal Autopsies in South Korea

    Science.gov (United States)

    Shin, Sang Eon; Lee, Hyun Ju; Park, Ji Hye; Ko, Kwang Soo; Kim, Yu-Hoon; Kim, Kyung Ryoul

    2015-01-01

    Forensic entomology applies insect evidence to legal problems such as the estimation of minimum postmortem interval (mPMI). For this purpose, knowledge of the insect fauna that are attracted to human cadavers in each geographic region is a prerequisite. Despite many studies investigating the insect fauna attracted to meat, there has been no survey of the entomofauna on human cadavers in the East Asian temperate climate zone, particularly in Korea. Therefore, this study reports the entomofauna collected from medicolegal autopsies in northeastern Seoul and its suburbs. Insect samples were collected from 35 medicolegal autopsies in 2010, 2011, and 2013. Molecular and morphological methods were utilized for taxonomic identification. Among 1398 individual samples belonging to 3 orders, 13 families, 18 genera, and 32 species, the dominant family and species were Calliphoridae and Lucilia sericata, respectively. Despite its limited scale, this study provides a snapshot of the general entomofauna that are attracted to human cadavers in this region. PMID:26185759

  1. Usefulness of post-mortem ophthalmological endoscopy during forensic autopsy: a case report.

    Science.gov (United States)

    Tsujinaka, Masatake; Akaza, Kayoko; Nagai, Atsushi; Nakamura, Isao; Bunai, Yasuo

    2005-01-01

    Post-mortem intraocular findings in two autopsy cases with traumatic intracranial haemorrhage were obtained using an ophthalmological endoscope. The endoscopy results clearly revealed the presence of intraocular haemorrhages and papilledema caused by intracranial haemorrhage. Post-mortem ophthalmological endoscopy offers several benefits. First, post-mortem intraocular findings can be directly observed in corpses with post-mortem clouding of the cornea. Secondly, the endoscopy only requires a 0.9 mm incision in the sclera and does not require the removal of the eye from the corpse, a procedure that should be avoided for ethical and cosmetic reasons. Thus, post-mortem opthalmological endoscopy is a useful method for obtaining intraocular findings in autopsies.

  2. Autopsy consent, brain collection, and standardized neuropathologic assessment of ADNI participants: the essential role of the neuropathology core.

    Science.gov (United States)

    Cairns, Nigel J; Taylor-Reinwald, Lisa; Morris, John C

    2010-05-01

    Our objectives are to facilitate autopsy consent, brain collection, and perform standardized neuropathologic assessments of all Alzheimer's Disease Neuroimaging Initiative (ADNI) participants who come to autopsy at the 58 ADNI sites in the USA and Canada. Building on the expertise and resources of the existing Alzheimer's Disease Research Center (ADRC) at Washington University School of Medicine, St. Louis, MO, a Neuropathology Core (NPC) to serve ADNI was established with one new highly motivated research coordinator. The ADNI-NPC coordinator provides training materials and protocols to assist clinicians at ADNI sites in obtaining voluntary consent for brain autopsy in ADNI participants. Secondly, the ADNI-NPC maintains a central laboratory to provide uniform neuropathologic assessments using the operational criteria for the classification of AD and other pathologies defined by the National Alzheimer Coordinating Center (NACC). Thirdly, the ADNI-NPC maintains a state-of-the-art brain bank of ADNI-derived brain tissue to promote biomarker and multi-disciplinary clinicopathologic studies. During the initial year of funding of the ADNI Neuropathology Core, there was notable improvement in the autopsy rate to 44.4%. In the most recent year of funding (September 1(st), 2008 to August 31(st) 2009), our autopsy rate improved to 71.5%. Although the overall numbers to date are small, these data demonstrate that the Neuropathology Core has established the administrative organization with the participating sites to harvest brains from ADNI participants who come to autopsy. Within two years of operation, the Neuropathology Core has: (1) implemented a protocol to solicit permission for brain autopsy in ADNI participants at all 58 sites who die and (2) to send appropriate brain tissue from the decedents to the Neuropathology Core for a standardized, uniform, and state-of-the-art neuropathologic assessment. The benefit to ADNI of the implementation of the NPC is very clear

  3. Social autopsy: a potential health-promotion tool for preventing maternal mortality in low-income countries.

    Science.gov (United States)

    Mahato, Preeti K; Waithaka, Elizabeth; van Teijlingen, Edwin; Pant, Puspa Raj; Biswas, Animesh

    2018-04-01

    Despite significant global improvements, maternal mortality in low-income countries remains unacceptably high. Increasing attention in recent years has focused on how social factors, such as family and peer influences, the community context, health services, legal and policy environments, and cultural and social values, can shape and influence maternal outcomes. Whereas verbal autopsy is used to attribute a clinical cause to a maternal death, the aim of social autopsy is to determine the non-clinical contributing factors. A social autopsy of a maternal death is a group interaction with the family of the deceased woman and her wider local community, where facilitators explore the social causes of the death and identify improvements needed. Although still relatively new, the process has proved useful to capture data for policy-makers on the social determinants of maternal deaths. This article highlights a second aspect of social autopsy - its potential role in health promotion. A social autopsy facilitates "community self-diagnosis" and identification of modifiable social and cultural factors that are attributable to the death. Social autopsy therefore has the potential not only for increasing awareness among community members, but also for promoting behavioural change at the individual and community level. There has been little formal assessment of social autopsy as a tool for health promotion. Rigorous research is now needed to assess the effectiveness and cost effectiveness of social autopsy as a preventive community-based intervention, especially with respect to effects on social determinants. There is also a need to document how communities can take ownership of such activities and achieve a sustainable impact on preventable maternal deaths.

  4. A team-based approach to autopsy education: integrating anatomic and clinical pathology at the rotation level.

    Science.gov (United States)

    Hébert, Tiffany Michele; Maleki, Sara; Vasovic, Ljiljana V; Arnold, Jeffrey L; Steinberg, Jacob J; Prystowsky, Michael B

    2014-03-01

    Pathology residency training programs should aim to teach residents to think beyond the compartmentalized data of specific rotations and synthesize data in order to understand the whole clinical picture when interacting with clinicians. To test a collaborative autopsy procedure at Montefiore Medical Center (Bronx, New York), linking residents and attending physicians from anatomic and clinical pathology in the autopsy process from the initial chart review to the final report. Residents consult with clinical pathology colleagues regarding key clinical laboratory findings during the autopsy. This new procedure serves multiple functions: creating a team-based, mutually beneficial educational experience; actively teaching consultative skills; and facilitating more in-depth analysis of the clinical laboratory findings in autopsies. An initial trial of the team-based autopsy system was done from November 2010 to December 2012. Residents were then surveyed via questionnaire to evaluate the frequency and perceived usefulness of clinical pathology autopsy consultations. Senior residents were the most frequent users of clinical pathology autopsy consultation. The most frequently consulted services were microbiology and chemistry. Eighty-nine percent of the residents found the clinical pathology consultation to be useful in arriving at a final diagnosis and clinicopathologic correlation. The team-based autopsy is a novel approach to integration of anatomic and clinical pathology curricula at the rotation level. Residents using this approach develop a more holistic approach to pathology, better preparing them for meaningful consultative interaction with clinicians. This paradigm shift in training positions us to better serve in our increasing role as arbiters of outcomes measures in accountable care organizations.

  5. A cause of Sudden Cardiac Deaths on Autopsy Findings; a Four-Year Report.

    Science.gov (United States)

    Rao, Dinesh; Sood, Divya; Pathak, P; Dongre, Sudhir D

    2014-01-01

    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. 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. 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%). 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Takahara, O; Toyoda, S; Tsuno, S; Mukai, H; Uemura, S [Nagasaki Atomic Bomb Hospital (Japan)

    1976-09-01

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

  7. Potentially preventable infant and child deaths identified at autopsy; findings and implications.

    Science.gov (United States)

    Bamber, Andrew R; Mifsud, William; Wolfe, Ingrid; Cass, Hilary; Pryce, Jeremy; Malone, Marian; Sebire, Neil J

    2015-09-01

    The purpose of the study was to determine the proportion of pediatric deaths investigated by HM Coronial autopsy which were potentially preventable deaths due to treatable natural disease, and what implications such findings may have for health policies to reduce their occurrence. A retrospective study of 1779 autopsies of individuals between 7 days and 14 years of age requested by HM Coroner, taking place in one specialist pediatric autopsy center, was undertaken. Cases were included if they involved a definite natural disease process in which appropriate recognition and treatment was likely to have affected their outcome. Strict criteria were used and cases were excluded where the individual had any longstanding condition which might have predisposed them to, or altered the recognition of, acute illness, or its response to therapy. Almost 8% (134/1779) of the study group were potentially preventable deaths as a result of natural disease, the majority occurring in children younger than 2 years of age. Most individuals reported between 1 and 7 days of symptoms before their death, and the majority had sought medical advice during this period, including from general practitioners within working hours, and hospital emergency departments. Of those who had sought medical attention, around one-third had done so more than once (28%, 15/53). Sepsis and pneumonia accounted for the majority of deaths (46 and 34% respectively), with all infections (sepsis, pneumonia and meningitis) accounting for 110/134 (82%). Around 10% of pediatric deaths referred to HM Coroner are potentially preventable, being the result of treatable natural acute illnesses. In many cases medical advice had been sought during the final illness. The results highlight how a review of autopsy data can identify significant findings with the potential to reduce mortality, and the importance of centralized investigation and reporting of pediatric deaths.

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

    International Nuclear Information System (INIS)

    Takahara, Osamu; Toyoda, Shigeki; Tsuno, Sumio; Mukai, Hideaki; Uemura, Seiji

    1976-01-01

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

  9. Evaluation of autopsy imaging (postmortem CT) to presume causes of death

    International Nuclear Information System (INIS)

    Nishihara, Keisuke; Sugihara, Shuji; Morioka, Nobuo; Sato, Shinya; Tsukamoto, Kazumichi; Ogawa, Toshihide

    2010-01-01

    A total of 123 patients arrived at the emergency room in a state of cardiopulmonary arrest were examined by CT after death. Forty one patients (33.3%) were presumed the causes of death by autopsy imaging (Ai). Only 30 patients (24.4%) could be presumed causes of death with postmortem inspection and clinical information. However, presumption rate of cause of death was improved up to 46.3% (22.0 points increase) by adding information provided in Ai. (author)

  10. Perianesthetic Mortality in Domestic Animals: A Retrospective Study of Postmortem Lesions and Review of Autopsy Procedures.

    Science.gov (United States)

    DeLay, J

    2016-09-01

    Autopsy of animals that die in the perianesthetic period allows identification of anesthetic and surgical complications as well as preexisting disease conditions that may have contributed to mortality. In most studies to date investigating perianesthetic mortality in animals, inclusion of autopsy data is very limited. This retrospective study evaluated autopsy findings in 221 cases of perianesthetic death submitted to a veterinary diagnostic laboratory from primary care and referral hospitals. Canine (n = 105; 48%) and feline (n = 90; 41%) cases predominated in the study, involving elective (71%) and emergency (19%) procedures. The clinical history provided to the pathologist was considered incomplete in 42 of 221 cases (19%), but this history was considered essential for evaluating the circumstances of perianesthetic death. Disease had been recognized clinically in 69 of 221 animals (31%). Death occurred in the premedication or sedation (n = 19; 9%), induction (n = 22; 11%), or maintenance (n = 73; 35%) phases or in the 24 hours postanesthesia (n = 93 animals; 45%). Lesions indicative of significant natural disease were present in 130 of 221 animals (59%), mainly involving the heart, upper respiratory tract, or lungs. Surgical or anesthesia-associated complications were identified in 10 of 221 cases (5%). No lesions were evident in 80 of 221 animals (36%), the majority of which were young, healthy, and undergoing elective surgical procedures. Lesions resulting from cardiopulmonary resuscitation were identified in 75 of 221 animals (34%). Investigation of perianesthetic death cases should be done with knowledge of prior clinical findings and antemortem surgical and medical procedures; the autopsy should particularly focus on the cardiovascular and respiratory system, including techniques to identify pneumothorax and venous air embolism. © The Author(s) 2016.

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

    International Nuclear Information System (INIS)

    Pastakia, B.; Horvath, K.; Georgetown Univ., Washington, DC; Lack, E.E.

    1987-01-01

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

  12. Determination of americium and plutonium in autopsy tissue: methods and problems

    International Nuclear Information System (INIS)

    Boyd, H.A.; Eutsler, B.C.; McInroy, J.F.

    1979-01-01

    The current methods used by the tissue analysis program at LASL for the determination of americium and plutonium in autopsy tissue are described. Problems affecting radiochemical yield are discussed. Included are problems associated with sample preparation, separation of plutonium from large amounts of bone ash, and reagent contamination. The average 242 Pu tracer yield for 1800 Pu determinations is 78 +- 12%. The average 242 Am tracer yield is 85 +- 7% for 40 determinations

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

    International Nuclear Information System (INIS)

    Turkmen, N.; Eren, B.; Fedakar, R.; Bulut, M.

    2008-01-01

    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)

  14. 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 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.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.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.

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

    International Nuclear Information System (INIS)

    Santori, G.

    1983-01-01

    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

  16. Validation of verbal autopsy: determination of cause of deaths in Malaysia 2013

    OpenAIRE

    Shubash Shander Ganapathy; Khoo Yi Yi; Mohd Azahadi Omar; Mohamad Fuad Mohamad Anuar; Chandrika Jeevananthan; Chalapati Rao

    2017-01-01

    Abstract Background Mortality statistics by age, sex and cause are the foundation of basic health data required for health status assessment, epidemiological research and formation of health policy. Close to half the deaths in Malaysia occur outside a health facility, are not attended by medical personnel, and are given a lay opinion as to the cause of death, leading to poor quality of data from vital registration. Verbal autopsy (VA) is a very useful tool in diagnosing broad causes of deaths...

  17. HISTOPATHOLOGICAL PROFILE OF LIVER LESIONS IN AUTOPSY EXAMINATION- A HOSPITAL-BASED STUDY

    Directory of Open Access Journals (Sweden)

    Ratan Konjengbam

    2017-06-01

    Full Text Available BACKGROUND Liver is the main site of various primary and secondary diseases including variety of external agents. Most of the chronic liver diseases remained asymptomatic even in the late stage. In apparently healthy persons, many liver lesions are detected incidentally following a postmortem examination. MATERIALS AND METHODS The present study was done for a period of 5 years in a tertiary hospital to evaluate the histopathological profile of liver specimen in autopsy examination. Haematoxylin and Eosin sections of liver specimen were studied. A total of 352 samples were evaluated with male predominates the female sex in the ratio of 5.2:1. RESULTS The most common lesion was fatty liver (19% followed by cirrhosis (11.8%, venous congestion (11.5%, portal triaditis (10.9%, chronic hepatitis (6.2%, granulomatous hepatitis (2.1%, autolysis (16% and others (0.96%. Liver finding was normal in 14% of the cases. CONCLUSION Silent liver diseases are a quite regular finding in autopsy cases and thereby may implicate a common occurrence in general population. Autopsy examination of liver is a must for detection of silent liver diseases like fatty change, cirrhosis and chronic hepatitis.

  18. Explaining suicide in an urban slum of Mumbai, India: a sociocultural autopsy.

    Science.gov (United States)

    Parkar, Shubhangi R; Nagarsekar, Balkrishna; Weiss, Mitchell G

    2009-01-01

    Health demographic mortality studies use verbal autopsies to identify suicide as a cause of death. Psychological autopsies focus almost exclusively on associated high-risk psychiatric disorders. New approaches considering contextual factors are needed for preventing suicide and promoting mental health. This study examined explanations of suicide reported by surviving family members or close friends with reference to social, cultural, and environmental conditions as well as the challenges of life in the Malavani slum of Mumbai. An EMIC (Explanatory Model Interview Catalog) interview based on a cultural epidemiological framework considered underlying problems, perceived causes, and sociocultural contexts. It was administered to survivors of 76 people who had died by suicide (56.6% women). Accounts of underlying problems typically referred to various aspects of tension (73.7%). Perceived causes often identified multiple factors. The sociocultural contexts of suicide included the victimization of women, the personal and social impact of problem drinking, marital problems, physical health problems, mental tension, possession and sorcery. Women were particularly vulnerable to the impact of problem drinking by a spouse or father. This study demonstrates the value of an approach to sociocultural autopsy examining local contexts and explanations of suicide. Findings highlight needs for both mental health services and culturally sensitive social interventions.

  19. Endoscopy and autopsy follow-up of biodegradable oesophageal anastomoses in dogs.

    Science.gov (United States)

    Kovács, T; Németh, T; Orosz, Z; Köves, I

    2001-01-01

    The biofragmentable Anastomosis Ring (BAR) is a mechanical device composed of absorbable material and creates an inverting, atraumatic compressive anastomosis with no foreign material at the anastomotic site after healing. The aim of the present experimental study was to assess the safety of oesophagoscopy in early days after oesophageal anastomoses performed with the BAR and to follow-up the healing of BAR anastomoses by in vivo endoscopy and autopsy examination. Thirty mongrel dogs divided into subgroups according to the time-points of endoscopy and autopsy (4th, 7th, 14th, 28th day) were used. There was no significant difference in the healing of anastomoses performed under or above the tracheal bifurcation. Pleural adhesions helped to cover and seal small subclinical leaks. The mortality was 13.3% (4 dogs) and the overall leakage rate 14.3%. We looked for bleeding, haematoma, erosion, ulceration and granulation tissue in the anastomosis. Due to the high mechanical strength of these anastomoses, oesophagoscopy was a safe, easy and feasible method for follow-up BAR intrathoracic anastomoses, with no significant difference between the number of lesions found with endoscopy as compared to the autopsy data. The overall sensitivity of oesophagoscopy to discover mucosal lesions was 73.1%. Endoscopy had no complications, therefore it is a useful method of follow-up and may help predict the normal or compromised healing of oesophageal anastomoses.

  20. A case series of clinically undiagnosed hematopoietic neoplasms discovered at autopsy.

    Science.gov (United States)

    Podduturi, Varsha; Guileyardo, Joseph M; Soto, Luis R; Krause, John R

    2015-06-01

    In the United States, autopsy rates have diminished to less than 5% during the last half of the 20th century and the beginning of the 21st century for a multitude of reasons. Many believe this results in unrecognized malignancies that could have explained a patient's death. We describe six deaths in which hematopoietic neoplasms were identified at autopsy but were not diagnosed clinically. The six undiagnosed hematopoietic malignancy cases discovered at autopsy include four men and two women ranging from 50 to 78 years of age. One patient was African American and five patients were white, all with multiple comorbidities. The tumors included diffuse large B-cell lymphoma, activated B-cell type, intravascular large B-cell lymphoma, ALK-negative anaplastic large cell lymphoma arising in a setting of human immunodeficiency virus, and a myeloid sarcoma. These cases illustrate the importance of the traditional postmortem examination in not only confirming clinical diagnoses but also identifying previously unknown diagnoses. Hematologic malignancies may present with nonspecific clinical manifestations, and this series of cases also emphasizes the necessity for widening the differential diagnosis in patients with unexplained lactic acidosis and hepatic failure to include hematopoietic malignancies since prompt treatment may be lifesaving. Copyright© by the American Society for Clinical Pathology.

  1. An autopsy case of myelofibrosis seen in a proximally expoed survivor

    International Nuclear Information System (INIS)

    Harada, Tomoyuki; Matsuo, Kakaru; Shikaya, Takao; Takeshita, Kikuo; Toyoda, Shigeki.

    1977-01-01

    An autopsy case of myelofibrosis is reported and is literarily discussed. The patient was a 30-year-old man and was exposed to sublethal dose of radiation at 1.1 km from the hypocenter at the time of the explosion in Nagasaki Prefecture, when he was 10 months old. Serious bone marrow disturbances were suspected. About 25 years after the exposure, clinical symptoms like aplastic anemia were shown and this disease developed. Hepatosplenomegaly was not clinically found until the late period. The liver weighed 3180 g and the spleen weighed 1540 g at autopsy. Blood examination revealed low value of neutrophilic alkaline phosphatase only at the late period, and no abnormal chromosome was seen in the peripheral blood. Reticulum-like cells were not histologically found at biopsy, but were found at autopsy. Extramedullary hematopoiesis, always accompanied with bleeding, was observed not only in the spleen, the liver and the lymphnodes, but also in the dura mater, the stomach, the renal pelves and so on. It was the direct cause of death. (Kanao, N.)

  2. Neuropsychological Profiles Differentiate Alzheimer Disease from Subcortical Ischemic Vascular Dementia in an Autopsy-Defined Cohort.

    Science.gov (United States)

    Ramirez-Gomez, Liliana; Zheng, Ling; Reed, Bruce; Kramer, Joel; Mungas, Dan; Zarow, Chris; Vinters, Harry; Ringman, John M; Chui, Helena

    2017-01-01

    The aim of this study was to assess the ability of neuropsychological tests to differentiate autopsy-defined Alzheimer disease (AD) from subcortical ischemic vascular dementia (SIVD). From a sample of 175 cases followed longitudinally that underwent autopsy, we selected 23 normal controls (NC), 20 SIVD, 69 AD, and 10 mixed cases of dementia. Baseline neuropsychological tests, including Memory Assessment Scale word list learning test, control oral word association test, and animal fluency, were compared between the three autopsy-defined groups. The NC, SIVD, and AD groups did not differ by age or education. The SIVD and AD groups did not differ by the Global Clinical Dementia Rating Scale. Subjects with AD performed worse on delayed recall (p < 0.01). A receiver operating characteristics analysis comparing the SIVD and AD groups including age, education, difference between categorical (animals) versus phonemic fluency (letter F), and the first recall from the word learning test distinguished the two groups with a sensitivity of 85%, specificity of 67%, and positive likelihood ratio of 2.57 (AUC = 0.789, 95% CI 0.69-0.88, p < 0.0001). In neuropathologically defined subgroups, neuropsychological profiles have modest ability to distinguish patients with AD from those with SIVD. © 2017 S. Karger AG, Basel.

  3. Forensic autopsy practice in the Middle East: comparisons with the west.

    Science.gov (United States)

    Al-Waheeb, Salah; Al-Kandary, Nadia; Aljerian, Khaldoon

    2015-05-01

    Autopsies are performed in the majority of Arab, Muslim countries. Several of these countries face social challenges and others do not have well established academic programs to teach the science. In this article we intend to review the history and practice of the forensic part of autopsies in a few Arab, Muslim countries (Egypt, Kingdom of Saudi Arabia (KSA) and Kuwait) and compare it with the United States of America (USA) and the United Kingdom (UK), 2 countries where the practice of forensic science and Forensic pathology is well established. This was achieved by pub med literature search and the distribution of a questionnaire to colleagues in Arab countries. We recommend that Arab countries explore the field of virtual autopsy to overcome some of the social challenges related to dissection of the cadaver. Kuwait can benefit from the introduction of Forensic training given the high workload in the country. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  4. An autopsy case related to a terrorist attack using a ball-bearing bomb.

    Science.gov (United States)

    Takamiya, Masataka; Biwasaka, Hitoshi; Niitsu, Hisae; Saigusa, Kiyoshi; Aoki, Yasuhiro

    2009-03-01

    We encountered an autopsy case related to a terrorist attack using a ball-bearing bomb. The decedent was a 51-year-old male without significant medical histories. During dinner in a restaurant, the perpetrator suddenly exploded a ball-bearing bomb, the blast from which blew the victim off his chair. The victim was found to be unresponsive, and pronounced dead. X-ray photographs taken before autopsy revealed six spherical shadows. Three penetrating wounds in the head, one in the neck and chest, and two in the left upper arm were observed in vivo. Six projectiles recovered from the body were identified as ball-bearings, one of which traveled through the midbrain, diencephalon, and left temporal lobe. Although blast injuries and penetrating wounds are often combined in bomb attack victims, penetrating brain injury would be the cause of death in this case. Lethal injuries to major organs can thus occur even though the destructive force of a ball-bearing bomb is weak. X-ray films were informative for detecting the ball-bearings in this case, suggesting that autopsy imaging is essential in cases of terrorism victims.

  5. Image Guided Virtual Autopsy: An Adjunct with Radiographic and Computed Tomography Modalities - An Important Tool in Forensic Identification

    Directory of Open Access Journals (Sweden)

    Shalu Rai

    2017-01-01

    Full Text Available The forensic examination of dead bodies is very helpful in order to identify the person, cause of death, gender, and solving the mysterious cases. It includes a number of techniques, out of which autopsy is the primary investigation that is performed in every medicolegal case. Because of mutilation technologies, traditional autopsy technique is most disturbing in terms of emotions and rituals of relatives. The use of radiology in forensic science comprises performance, interpretation, and reporting of radiographs that is helpful in detecting those changes that are not clinically visible. Forensic radiology plays an important role for identification of humans in mass disasters, criminal investigations, and evaluation of cause of death. The introduction of radiological modalities in autopsy techniques is a complementary tool for forensic identification and is known as virtual autopsy. The advance imaging techniques such as computed tomography (CT and magnetic resonance imaging (MRI is used in virtual autopsy in order to visualize and reconstruct the internal organs to know the site, type, and depth of injury. This review elaborates the role of maxillofacial imaging in image-guided virtual autopsy.

  6. Back to the Future - Part 1. The medico-legal autopsy from ancient civilization to the post-genomic era.

    Science.gov (United States)

    Cecchetto, Giovanni; Bajanowski, Thomas; Cecchi, Rossana; Favretto, Donata; Grabherr, Silke; Ishikawa, Takaki; Kondo, Toshikazu; Montisci, Massimo; Pfeiffer, Heidi; Bonati, Maurizio Rippa; Shokry, Dina; Vennemann, Marielle; Ferrara, Santo Davide

    2017-07-01

    Part 1 of the review "Back to the Future" examines the historical evolution of the medico-legal autopsy and microscopy techniques, from Ancient Civilization to the Post-Genomic Era. In the section focusing on "The Past", the study of historical sources concerning the origins and development of the medico-legal autopsy, from the Bronze Age until the Middle Ages, shows how, as early as 2000 BC, the performance of autopsies for medico-legal purposes was a known and widespread practice in some ancient civilizations in Egypt, the Far East and later in Europe. In the section focusing on "The Present", the improvement of autopsy techniques by Friedrich Albert Zenker and Rudolf Virchow and the contemporary development of optical microscopy techniques for forensic purposes during the 19th and 20th centuries are reported, emphasizing, the regulation of medico-legal autopsies in diverse nations around the world and the publication of international guidelines or best practices elaborated by International Scientific Societies. Finally, in "The Future" section, innovative robotized and advanced microscopy systems and techniques, including their possible use in the bio-medicolegal field, are reported, which should lead to the improvement and standardization of the autopsy methodology, thereby achieving a more precise identification of natural and traumatic pathologies.

  7. Establishing post mortem criteria for the metabolic syndrome: an autopsy based cross-sectional study.

    Science.gov (United States)

    Christensen, Martin Roest; Bugge, Anne; Malik, Mariam Elmegaard; Thomsen, Jørgen Lange; Lynnerup, Niels; Rungby, Jørgen; Banner, Jytte

    2018-01-01

    Individuals who suffer from mental illness are more prone to obesity and related co-morbidities, including the metabolic syndrome. Autopsies provide an outstanding platform for the macroscopic, microscopic and molecular-biological investigation of diseases. Autopsy-based findings may assist in the investigation of the metabolic syndrome. To utilise the vast information that an autopsy encompasses to elucidate the pathophysiology behind the syndrome further, we aimed to both develop and evaluate a method for the post mortem definition of the metabolic syndrome. Based on the nationwide Danish SURVIVE study of deceased mentally ill, we established a set of post mortem criteria for each of the harmonized criteria of the metabolic syndrome. We based the post mortem (PM) evaluation on information from the police reports and the data collected at autopsy, such as anthropometric measurements and biochemical and toxicological analyses (PM information). We compared our PM evaluation with the data from the Danish health registries [ante mortem (AM) information, considered the gold standard] from each individual. The study included 443 deceased individuals (272 male and 171 female) with a mean age of 50.4 (± 15.5) years and a median (interquartile range) post mortem interval of 114 (84-156) hours. We found no significant difference when defining the metabolic syndrome from the PM information in comparison to the AM information ( P  = 0.175). The PM evaluation yielded a high specificity (0.93) and a moderate sensitivity (0.63) with a moderate level of agreement compared to the AM evaluation (Cohen's κ = 0.51). Neither age nor post mortem interval affected the final results. Our model of a PM definition of the metabolic syndrome proved reliable when compared to the AM information. We believe that an appropriate estimate of the prevalence of the metabolic syndrome can be established post mortem. However, while neither the PM nor the AM information is exhaustive in

  8. Do we still need autopsy in times of modern multislice computed tomography?-Missed diagnoses in the emergency room.

    Science.gov (United States)

    Euler, S A; Kastenberger, T; Attal, R; Rieger, M; Blauth, M; Petri, M

    2017-01-01

    In spite of increasing quality of emergency room (ER) assessment in trauma patients and improved accuracy of modern multislice computed tomography (MSCT), the number of potentially missed diagnoses is still controversial. The aim of this study was to compare the initial findings of ER assessment and MSCT to the findings during autopsy in trauma patients not surviving the first 48 h after admission. We hypothesized that autopsy was more accurate than MSCT in diagnosing potentially fatal diagnoses. Between January 2004 and September 2007, all trauma patients undergoing ER treatment in our institution who deceased within 48 h after admission were analyzed regarding diagnoses from initial ER assessment, including MSCT, and diagnoses from autopsy. Data were prospectively collected and retrospectively analyzed. Autopsy reports were compared to diagnoses of ER assessment and MSCT. Missed diagnoses (MD) and missed potentially fatal diagnoses (MPFD) were analyzed. Seventy-three patients with a mean age of 53.2 years were included into the study. Sixty-three percent were male. Autopsy revealed at least one missed diagnosis in 25% of the patients, with the thoracic area accounting for 67% of these. At least one MPFD was found in 4.1% of the patients, all of them being located in the thorax. Total numbers of MD and MPFD were significantly lower for the newer CT generation (64 MSCT, N = 11), compared to older one (4 MSCT, N = 26). As determined by autopsy, modern multislice computed tomography is an accurate method to diagnose injuries. However, 25% of all diagnoses, and 4.1% of potentially fatal diagnoses are still missed in trauma patients, who deceased within the first 48 h after admission. Therefore, autopsy seems to be necessary to determine potentially missed diagnoses for both academic and medicolegal reasons as well as for quality control.

  9. Minimally invasive autopsy employing post-mortem CT and targeted coronary angiography: evaluation of its application to a routine Coronial service.

    Science.gov (United States)

    Roberts, Ian S D; Traill, Zoe C

    2014-01-01

    Post-mortem imaging is a potential alternative to traditional medicolegal autopsy. We investigate the reduction in number of invasive autopsies required by use of post-mortem CT ± coronary angiography. A total of 120 adult deaths referred to the Coroner were investigated by CT, with coronary angiography employed only for the second series of 60 cases, in order to determine the added value of angiography. The confidence of imaging cause of death was classified as definite (no autopsy), probable, possible or unascertained. Invasive autopsy was not required in 38% of cases without coronary angiography and 70% of cases with angiography. Full autopsy, including brain dissection, was required in only 9% of cases. There was complete agreement between autopsy and radiological causes of death in the cases with a 'probable' imaging cause of death, indicating that cases for which imaging provides an accurate cause of death without autopsy were identified correctly. In two patients, CT demonstrated unsuspected fractures, not detected at subsequent autopsy. A two-thirds reduction in the number of invasive coronial autopsies can be achieved by use of post-mortem CT plus coronary angiography. At the same time, use of post-mortem CT may improve accuracy of diagnosis, particularly for traumatic deaths. © 2013 John Wiley & Sons Ltd.

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

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    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. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

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

    International Nuclear Information System (INIS)

    Yamakawa, Michitaka; Shiojima, Kazumi; Hasegawa, Masatoshi

    1995-01-01

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

  13. 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.

  14. Haloperidol and sudden cardiac death in dementia: autopsy findings in psychiatric inpatients.

    Science.gov (United States)

    Ifteni, Petru; Grudnikoff, Eugene; Koppel, Jeremy; Kremen, Neil; Correll, Christoph U; Kane, John M; Manu, Peter

    2015-12-01

    Treatment with haloperidol has been shown, in studies using death certificates and prescription files, to be associated with an excess of sudden cardiac deaths, and regulatory warnings highlight this risk in patients with dementia. We used autopsy findings to determine whether the rate of sudden cardiac death is greater in cases of unexpected deaths of patients with dementia treated with haloperidol. From 1989 through 2013, 1219 patients with a primary diagnosis of dementia with behavioral disturbance were admitted to a psychiatric hospital, and 65 (5.3%) died suddenly. Sixty-five patients (5.3%) died unexpectedly. Complete post-mortem examinations after the sudden death were performed in 55 (84.6%) patients. Twenty-seven of the autopsied cases (49.1%) had been treated with haloperidol orally (2.2 mg ± 2.1 mg/day), the only antipsychotic used in this cohort. Univariable comparisons and multivariable regression analyses compared the groups of patients with or without sudden cardiac death. The leading causes of death were sudden cardiac death (32.7%), myocardial infarction (25.5% of patients), pneumonia (23.6%), and stroke (10.9%). Patients with sudden cardiac death and those with anatomically established cause of death were similar regarding the use of haloperidol (p = 0.5). Sudden cardiac death patients were more likely to suffer from Alzheimer's dementia (p = 0.027) and to have a past history of heart disease (p = 0.0094), and less likely to have been treated with a mood stabilizer (p = 0.024), but none of these variables were independent predictors of sudden cardiac death. Autopsy data suggest that oral haloperidol is not associated with increased risk of sudden cardiac death in psychiatric inpatients with dementia. Copyright © 2015 John Wiley & Sons, Ltd.

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

    International Nuclear Information System (INIS)

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

    1993-11-01

    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.)

  16. [Autopsy and blood testing for alcohol and drugs/medicine after traffic fatalities is not routinely conducted].

    Science.gov (United States)

    Uhrenholt, Lars; Schumacher, Bente; Freeman, Michael

    2010-09-27

    In some road traffic crashes with fatal outcome, the police investigations lead to charges against and prosecution of a person. The police can request a medico-legal autopsy as well as a toxicological examination, but the extent to which this is done, and the role here of in the legal setting is unknown. Information concerning traffic crashes with fatal outcome in the period 2000-2004 in Aarhus Police District was retrieved and compared. The information included comprised crash specific and legal information, as well as medical data concerning autopsy, examination for alcohol, drugs and/or medicine. In all, 81 traffic crashes had a fatal outcome for 92 persons, of whom 17 (18%) were autopsied, 55 (60%) were tested for alcohol, and five (5%) were examined for drugs/medicine. Twenty-six were charged with negligent homicide, of which 18 were convicted. Autopsy was performed in four of these cases, 19 were tested for alcohol and one was tested for drugs/medicine. This study shows that the police requests few medico-legal autopsies following road traffic fatalities, and that testing for alcohol as well as drugs/medicine is not conducted routinely. As a consequence, important information may not come to the knowledge of the police in cases of negligent homicide. We recommend that postmortem examination be conducted routinely in traffic-related homicide cases to secure the best possible conditions for a legal evaluation.

  17. [Grading the level of suspicion in criminal proceedings, restrictions of the proportionality principle and veto options in forensic autopsies].

    Science.gov (United States)

    Czerner, Frank

    2010-01-01

    The article deals with two topics: determination of the necessary level of suspicion for an internal post-mortem examination pursuant to Section 87 (German) Code of Criminal Procedure and options of the family to object to the forensic autopsy. The level of suspicion required in this case is to be regarded as very low, even below that of the initial suspicion, because a detailed opinion as to any third-party fault can only be given after completion of the autopsy. The individual concerned does not have a right to oppose a forensic autopsy while still alive. The same applies to the family. Other than in clinical autopsies, the interest in prosecution is to be considered the higher good to be protected, because at the time of deciding a homicide cannot be ruled out and only an internal examination can furnish the necessary evidence. Consequently, it is appropriate. Contrary to the opinion often expressed in the literature, one cannot infer from the provisions of Sections 87 subs. 4, 33 subs. 3 Code of Criminal Procedure and Section 103 subs. 3 Basic Law that the family of the deceased has a right to be informed or heard. This can only be changed by the legislator in an amendment to the autopsy law.

  18. Added Diagnostic Value of Cerebrospinal Fluid Biomarkers for Differential Dementia Diagnosis in an Autopsy-Confirmed Cohort.

    Science.gov (United States)

    Niemantsverdriet, Ellis; Feyen, Bart F E; Le Bastard, Nathalie; Martin, Jean-Jacques; Goeman, Johan; De Deyn, Peter Paul; Bjerke, Maria; Engelborghs, Sebastiaan

    2018-01-01

    Differential dementia diagnosis remains a challenge due to overlap of clinical profiles, which often results in diagnostic doubt. Determine the added diagnostic value of cerebrospinal fluid (CSF) biomarkers for differential dementia diagnosis as compared to autopsy-confirmed diagnosis. Seventy-one dementia patients with autopsy-confirmed diagnoses were included in this study. All neuropathological diagnoses were established according to standard neuropathological criteria and consisted of Alzheimer's disease (AD) or other dementias (NONAD). CSF levels of Aβ1 - 42, T-tau, and P-tau181 were determined and interpreted based on the IWG-2 and NIA-AA criteria, separately. A panel of three neurologists experienced with dementia made clinical consensus dementia diagnoses. Clinical and CSF biomarker diagnoses were compared to the autopsy-confirmed diagnoses. Forty-two patients (59%) had autopsy-confirmed AD, whereas 29 patients (41%) had autopsy-confirmed NONAD. Of the 24 patients with an ambiguous clinical dementia diagnosis, a correct diagnosis would have been established in 67% of the cases applying CSF biomarkers in the context of the IWG-2 or the NIA-AA criteria respectively. AD CSF biomarkers have an added diagnostic value in differential dementia diagnosis and can help establishing a correct dementia diagnosis in case of ambiguous clinical dementia diagnoses.

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

    Science.gov (United States)

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

    2013-01-01

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

  20. 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. 

  1. An Autopsy Case of Fulminant Amebic Colitis in a Patient with a History of Rheumatoid Arthritis

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    Naoko Kawabe

    2016-01-01

    Full Text Available Generally, amebic colitis is localized around the mucosal membrane and often accompanied by diarrhea and abdominal pain. We describe a patient with a history of rheumatoid arthritis who had received prolonged steroid therapy. The patient complained of breathing difficulties because of rheumatoid lung disease. Although the patient was given antibacterial agent, the symptoms did not improve until death. We did an autopsy and found that he had fulminant amebic colitis, although the patient was not previously examined. Histochemical analysis revealed severe inflammation and full-thickness necrosis of the colon by ameba, suggesting the involvement of ameba in the progression of the overall condition.

  2. A Novel Method of Macropathologic and Arteriographic Examination of Carotid Specimens Obtained from Autopsy

    International Nuclear Information System (INIS)

    Schulte-Altedorneburg, Gernot; Droste, Dirk W.; Kollar, Jozsef; Hegedues, Csaba; Gomba, Szabolcs; Ringelstein, E. Bernd; Csiba, Laszlo

    2000-01-01

    Twenty carotid bifurcations were examined. During autopsy, carotid bifurcations were removed in toto. Unfixed carotids were ligated and cannulated for injection of an angiographic contrast medium followed by injection of a tissue-embedding medium at physiologic pressure and temperature. The carotid bifurcation was frozen and cut manually in 3-mm cross-sections. Photographs were then taken of every slice. Angiography, filling with tissue-embedding material, and sectioning were successful in all cases. In the macropathologic sections, the extent, configuration and location of atherosclerotic lesions could be identified

  3. Autopsy validation of 123I-FP-CIT dopaminergic neuroimaging for the diagnosis of DLB.

    Science.gov (United States)

    Thomas, Alan J; Attems, Johannes; Colloby, Sean J; O'Brien, John T; McKeith, Ian; Walker, Rodney; Lee, Lean; Burn, David; Lett, Debra J; Walker, Zuzana

    2017-01-17

    To conduct a validation study of 123 I-N-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl) nortropane ( 123 I-FP-CIT) SPECT dopaminergic imaging in the clinical diagnosis of dementia with Lewy bodies (DLB) with autopsy as the gold standard. Patients >60 years of age with dementia who had undergone 123 I-FP-CIT imaging in research studies and who had donated their brain tissue to the Newcastle Brain Tissue Resource were included. All had structured clinical research assessments, and clinical diagnoses were applied by consensus panels using international diagnostic criteria. All underwent 123 I-FP-CIT imaging at baseline, and scans were rated as normal or abnormal by blinded raters. Patients were reviewed in prospective studies and after death underwent detailed autopsy assessment, and neuropathologic diagnoses were applied with the use of standard international criteria. Fifty-five patients (33 with DLB and 22 with Alzheimer disease) were included. Against autopsy diagnosis, 123 I-FP-CIT had a balanced diagnostic accuracy of 86% (sensitivity 80%, specificity 92%) compared with clinical diagnosis, which had an accuracy of 79% (sensitivity 87%, specificity 72%). Among patients with DLB, 10% (3 patients) met pathologic criteria for Lewy body disease but had normal 123 I-FP-CIT imaging. This large autopsy analysis of 123 I-FP-CIT imaging in dementia demonstrates that it is a valid and accurate biomarker for DLB, and the high specificity compared with clinical diagnosis (20% higher) is clinically important. The results need to be replicated with patients recruited from a wider range of settings, including movement disorder clinics and general practice. While an abnormal 123 I-FP-CIT scan strongly supports Lewy body disease, a normal scan does not exclude DLB with minimal brainstem involvement. This study provides Class I evidence that 123 I-FP-CIT dopaminergic neuroimaging accurately identifies patients with DLB. Copyright © 2016 The Author(s). Published by Wolters Kluwer

  4. Ebstein′s anomaly--an autopsy study of 28 cases.

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    Madiwale C

    1997-01-01

    Full Text Available Twenty eight autopsy specimens of Ebstein′s anomaly were studied in order to evaluate the morphologic features of the abnormal tricuspid valve. All cases showed marked dilatation of the original tricuspid annulus, a normally positioned anterior leaflet and variable downward displacement of the posterior and septal leaflets. Sixteen cases showed a very large anterior leaflet. All three leaflets showed dysplastic features and a wide range of anatomic abnormalities in the valve and valve apparatus. A thin walled atrialised right ventricle was present in nine cases. Associated cardiac anomalies were seen in 21 cases, the commonest being an atrial septal defect (17 cases.

  5. Pasteurella multocida Septicemia in a Patient with Cirrhosis: An Autopsy Report

    Directory of Open Access Journals (Sweden)

    Takuma Yamamoto

    2015-01-01

    Full Text Available More people are keeping pets in their homes but may not be sufficiently aware of the potential danger from infections. We report an autopsy case of a 57-year-old man affected by cirrhosis. Septic shock with Pasteurella multocida pneumonia was the cause of his death. P. multocida was the source of infection via the respiratory tract and caused pneumonia. Cirrhosis is one of the risk factors for P. multocida infection. A detailed patient history about animal exposure should be obtained and a differential diagnosis of P. multocida infection must be kept in mind.

  6. Sudden Unexpected Death in Epilepsy: A Retrospective Autopsy Study of 112 Epileptic Patients.

    Science.gov (United States)

    Esen Melez, İpek; Arslan, Murat Nihat; Melez, Deniz Oğuzhan; Şanli, Ahmet Necati; Koç, Sermet

    2017-09-01

    Sudden unexpected deaths comprise the most important and worthy investigation case profiles in both neurology and forensic medicine. Epilepsy, which is one of the neuropathological causes of sudden unexpected deaths, is an important disorder having mysterious aspects. The aim of this study is to make common the points of view between neurology and forensic medicine experts and to discuss the features of the findings together with the related clinical hypotheses, leading to the differential diagnosis of sudden unexpected death in epilepsy (SUDEP) by presenting autopsy findings and available medical data of patients who had a prior diagnosis of epilepsy. In Istanbul, the cases of 20334 autopsied patients who were referred to The Ministry of Justice Council of Forensic Medicine between 2007 and 2011 were identified from the complete forensic autopsy data of the city and were retrospectively reviewed. Patients who had a prior diagnosis of epilepsy were included. Both descriptive and inferential statistical analyses were performed through the parameters of demographical data, physical properties, incident features, macroscopic-microscopic autopsy findings, and cause of death initially for all cases and then separately for SUDEP cases. Among the 20334 patients, 112 were determined to have a prior diagnosis of epilepsy. A possible macroscopic and/or microscopic epileptic focus was present in 23 (20.5%) of these 112 cases. The cause of death was determined to be SUDEP in 40 (35.7%) cases, while it could not be determined in 28 (25%) cases. Among patients whose death cause was considered as SUDEP, the male-to-female ratio was 1.1:1, while the mean age was 31.5±13.9 years in males and 29.6±12.9 years in females. The presence of hypertrophy and myocardial scar tissue findings in the microscopic examination were significantly more frequent among patients determined to have died from cardiovascular diseases compared to patients in the SUDEP group (p=0.001 for each finding

  7. Dandy Walker Syndrome with Unusual Associated Findings in a Fetal Autopsy Study

    Directory of Open Access Journals (Sweden)

    Surekha U Arakeri

    2015-01-01

    Full Text Available Dandy Walker Syndrome (DWS is a congenital brain malformation characterized by hypoplasia or absence of cerebellar vermis, cystic dilatation of fourth ventricle and hydrocephalus. It is frequently associated with other congenital anomalies. Associated central nervous system anomalies such as agenesis of corpus callosum and vermis are associated with poor prognosis. Association of DWS with congenital absence of spleen is life threatening condition and has been reported very rarely. Autopsy findings of DWS with association of congenital absence of corpus callosum, vermis and spleen are reported in a stillborn fetus of 28 weeks gestation and review of relevant literature was done

  8. An autopsy case of right ventricular cardiac metastasis from squamous cell carcinoma of the left hand

    Directory of Open Access Journals (Sweden)

    T. Kondo

    2016-12-01

    Full Text Available We here report a 60-year-old woman in whom autopsy revealed a metastasis in the right cardiac ventricle from a well-differentiated squamous cell carcinoma (SCC of the left hand. The tumors in the myocardium and left hand were both well-differentiated SCCs with keratinization and sporadic keratin pearls. High concentrations of heart failure markers together with a pericardial effusion suggested antemortem chronic heart failure. Our case is particularly unusual because there were no regional lymph node metastases and the cardiac metastasis was not one of multiple metastases; thus, hematogenous metastasis to the right side of the heart alone had occurred.

  9. [3H]muscimol binding sites increased in autopsied brains of chronic schizophrenics

    International Nuclear Information System (INIS)

    Hanada, S.; Mita, T.; Nishino, N.; Tanaka, C.

    1987-01-01

    [ 3 H]muscimol binding and glutamic acid decarboxylase (GAD) activity in the prefrontal cortex and caudate nucleus of autopsied brains from 19 chronic schizophrenics and 17 control subjects were investigated. In the schizophrenics, saturation analysis with varying concentrations of [ 3 H]muscimol revealed an increase in the number GABA/sub A/ receptors, but there was no significant difference in the affinity. In addition, the enhancement of [ 3 H]muscimol binding by diazepam was significantly greater in schizophrenics than in controls. GAD activity did not differ between controls and schizophrenics. The possibility that GABAergic mechanisms might play a role in case of chronic schizophrenia should be given further attention

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

    International Nuclear Information System (INIS)

    Shimohara, Yasuaki; Tanno, Munehiko; Yamada, Hideo; Kimura, Yuji; Nishino, Hideo; Ide, Hiroshi; Kurihara, Norimitsu; Chiba, Kazuo.

    1987-01-01

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

  11. Classification of forensic autopsy reports through conceptual graph-based document representation model.

    Science.gov (United States)

    Mujtaba, Ghulam; Shuib, Liyana; Raj, Ram Gopal; Rajandram, Retnagowri; Shaikh, Khairunisa; Al-Garadi, Mohammed Ali

    2018-06-01

    Text categorization has been used extensively in recent years to classify plain-text clinical reports. This study employs text categorization techniques for the classification of open narrative forensic autopsy reports. One of the key steps in text classification is document representation. In document representation, a clinical report is transformed into a format that is suitable for classification. The traditional document representation technique for text categorization is the bag-of-words (BoW) technique. In this study, the traditional BoW technique is ineffective in classifying forensic autopsy reports because it merely extracts frequent but discriminative features from clinical reports. Moreover, this technique fails to capture word inversion, as well as word-level synonymy and polysemy, when classifying autopsy reports. Hence, the BoW technique suffers from low accuracy and low robustness unless it is improved with contextual and application-specific information. To overcome the aforementioned limitations of the BoW technique, this research aims to develop an effective conceptual graph-based document representation (CGDR) technique to classify 1500 forensic autopsy reports from four (4) manners of death (MoD) and sixteen (16) causes of death (CoD). Term-based and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) based conceptual features were extracted and represented through graphs. These features were then used to train a two-level text classifier. The first level classifier was responsible for predicting MoD. In addition, the second level classifier was responsible for predicting CoD using the proposed conceptual graph-based document representation technique. To demonstrate the significance of the proposed technique, its results were compared with those of six (6) state-of-the-art document representation techniques. Lastly, this study compared the effects of one-level classification and two-level classification on the experimental results

  12. Unusually extensive head trauma in a hydraulic elevator accident: post-mortem MSCT findings, autopsy results and scene reconstruction.

    Science.gov (United States)

    Jacobsen, Christina; Schön, Corinna A; Kneubuehl, Beat; Thali, Michael J; Aghayev, Emin

    2008-10-01

    Accidental or intentional falls from a height are a form of blunt trauma and occur frequently in forensic medicine. Reports describing elevator accidents as a small subcategory of falls from heights are rare in the medical literature and no report on injury patterns or scene reconstruction of such an accident was found. A case of an accident in a hydraulic elevator with a man falling 3m was examined using post-mortem multi-slice computed tomography (MSCT) and autopsy. The man suffered an unusually extensive trauma and died at the scene. Post-mortem MSCT examination showed a comminute fracture of the skull, the right femur and the first lumbar vertebra. Severe lacerations of the brain with epidural, subdural and subarachnoidal haemorrhages over both hemispheres were diagnosed. Autopsy confirmed these findings. To reconstruct the accident we used radiological and autopsy results as well as findings at the scene.

  13. Foulant analysis of hollow fine fiber (HFF) membranes in Red Sea SWRO plants using membrane punch autopsy (MPA)

    KAUST Repository

    Green, Troy N.

    2017-06-12

    Membrane punch autopsy (MPA) is a procedure for quantitative foulant analysis of hollow fine fiber (HFF) permeators. In the past, quantitative autopsies of membranes were restricted to spiral wound. This procedure was developed at SWCC laboratories and tested on permeators of two commercial Red Sea reverse osmosis plants. For membrane autopsies, stainless steel hollow bore picks were penetrated to membrane cores and fibers extracted for foulant analysis. Quantitative analysis of extracted materials contained inorganic and organic foulants including bacteria. Fourier transform infrared spectroscopy analysis confirmed the presence of organic fouling functional groups and scanning electron microscopy with energy dispersive X-ray spectroscopy in the presence of diatoms and silica most likely not from particulate sand. API analysis revealed the presence of Shewanella and two Vibrio microbial species confirmed by 16S rDNA sequence library. It was observed that fouling content of HFF cellulose triacetate (CTA) membranes were more than 800 times than polyamide spiral wound membranes.

  14. Post-mortem magnetic resonance foetal imaging: a study of morphological correlation with conventional autopsy and histopathological findings.

    Science.gov (United States)

    Vullo, Annamaria; Panebianco, Valeria; Cannavale, Giuseppe; Aromatario, Mariarosaria; Cipolloni, Luigi; Frati, Paola; Santurro, Alessandro; Vullo, Francesco; Catalano, Carlo; Fineschi, Vittorio

    2016-11-01

    The aim of the present study is to offer our experience concerning post-mortem magnetic resonance (PMMR) in foetal death cases and an evaluation of the differences between the findings acquired by PMMR and by forensic autopsy. Fifteen foetuses were recruited from July 2014 to December 2015. These had suffered intrauterine death in women in the 21st to 38th week of gestation who were treated in the emergency department for non-perception of foetal movements. We performed a PMMR on foetuses, 3 ± 1 days on average from the time of death, and then a complete forensic autopsy was performed. All 15 foetuses were examined with a whole-body study protocol, starting from the skull, down to and including the lower limbs. The total time of examination ranged from 20 to 30 min in each case. The external evaluation and description of post-mortem phenomena (maceration), record of the weight and detection and the various measurements of foetal diameters were evaluated before performing autopsy. A complete histopathological study was performed in each case. Out of 15 cases examined, eight were negative for structural anatomical abnormalities and/or diseases, both in the preliminary radiological examination and the traditional autopsy. In the remaining seven cases, pathological findings were detected by PMMR with corresponding results at autopsy. PMMR can provide useful information on foetal medical conditions and result in improved diagnostic classification. It may enable the planning of a more suitable technique before proceeding to autopsy, including focusing on certain aspects of organ pathology otherwise not detectable. The association between PMMR, post-mortem examination and related histological study of the foetus-placenta unit could help reduce the percentage of cases in which the cause of foetal death remains unexplained. Lastly, it may allow a selective sampling of the organ in order to target histological investigations.

  15. The use of human samples obtained during medicolegal autopsies in research: An introduction to current conditions and initiatives in Japan.

    Science.gov (United States)

    Tsujimura-Ito, Takako; Inoue, Yusuke; Muto, Kaori; Yoshida, Ken-Ichi

    2017-04-01

    Background Leftover samples obtained during autopsies are extremely important basic materials for forensic research. However, there are no established practices for research-related use of obtained samples. Objective This study discusses good practice for the secondary use of samples collected during medicolegal autopsies. Methods A questionnaire was posted to all 76 departments of forensic medicine performing medicolegal autopsies in Japan, and 48 responses were received (response rate: 63.2%). As a secondary analysis, we surveyed information provided on department websites. Results Ethical reviews conducted when samples were to be used for research varied greatly among departments, with 21 (43.8%) departments reporting 'fundamentally, all cases are subject to review', eight (16.7%) reporting 'only some are subject to review' and 17 (39.6%) reporting 'none are subject to review'. Information made available on websites indicated that 11 departments had a statement of some type to bereaved families about the potential research use of human samples obtained during autopsies. Nine of these included a notice stating that bereaved families may revoke their consent for use. Several departments used an opt-out system. Conclusion There is no common practice in the field of legal medicine on the ethical use for medical research of leftover samples from medicolegal autopsies. The trust of not only bereaved families but also society in general is required for the scientific validity and social benefits of medical studies using leftover samples from medicolegal autopsies through the use of opt-out consenting and offline and online dissemination and public-relations activities.

  16. Autopsy case of acute myelocytic leukemia preceded by hemopoietic dysplasia found in an atomic bomb survivor

    Energy Technology Data Exchange (ETDEWEB)

    Sonoda, Y; Edagawa, J; Taniwaki, M; Ide, T; Misawa, S [Kyoto Prefectural Univ. of Medicine (Japan)

    1981-03-01

    An autopsy case of acute myelocytic leukemia preceded by hemopoietic dysplasia, presumably on a sequela to the atomic bomb in Hiroshima is reported. On admission, severe anemia and thrombocytosis were found and the bone marrow aspiration showed myeloid hyperplasia without definite maturation arrest. Mild to moderate eosinophilia and basophilia continued during the course of the disease, accompaning mild monocytosis 2 years later. Furthermore, he had the radical operation for the early gastric cancer in this preleukemic stage. After the administration of methenolone acetate (25 mg/day), severe anemia has dramatically improved, but leukocytosis with profound monocytosis persisted, and subsequently acute myelocytic leukemia developed. He died from an intracerebral bleeding due to an accidental trauma on the head. Autopsy findings disclosed the systemic leukemic infiltration. Repeated chromosome analyses revealed the mosaic karyotype of 46, XY/45, XY, -16 on admission, but it was 46, XY/46, XY, del (8) (p 12) in the overt leukemic phase. The granulopoietic colony forming capacity of bone marrow cells was already low one year before the onset of overt leukemia. This finding suggested that the existence of an abnormal clone could be predictable. In addition, the possible causative effect of the exposure to the atomic bomb in leukemogenesis in this case is discussed.

  17. [Autopsy case of Lissauer's general paresis with rapidly progressive left hemiparesis].

    Science.gov (United States)

    Kato, Hiroko; Yoshida, Mari; Ando, Tetsuo; Sugiura, Makoto; Hashizume, Yoshio

    2009-06-01

    A 48-years-old man presented with slowly progressive bradykinesia, personality change and rapidly progressive left hemiparesis. On admission, he presented dementia, poor judgment, left hemiparesis. MRI revealed a widespread high intensity area in right hemisphere and MRA was almost normal. Serological tests of serum and CSF demonstrated high titers of antibodies to Treponema pallidum. He was treated for syphilis with daily penicillin injections without improvement. He died of sepsis eight months after admission. At autopsy, the brain weighed 1,100 g and the right cerebral hemisphere was atrophic, especially in frontal base, temporal, parietal, angular, and posterior regions covered by thickened, fibrotic leptomeninges. Microscopically, chronic meningoencephalitis was observed. Severe neuronal loss with gliosis was seen in the right cerebral cortices. Scattered rod-shaped microglia and inflammatory cell infiltration were visible in the cerebral parenchyma. The dorsal column of the spinal cord was not involved and meningovascular syphilis was unclear. The distribution of the encephalitic lesions was well correlated with the clinical and neuroradiological findings. This was a rare autopsy case presenting Lissauer's general paresis, clinically manifesting as rapidly progressive stroke-like episode.

  18. An autopsy case of cerebral radiation necrosis simulating recurrent malignant glioma

    Energy Technology Data Exchange (ETDEWEB)

    Shibuya, Tadashi; Kushi, Hidehiko; Miyagi, Atsushi; Miyagami, Mitsusuke; Tsubokawa, Takashi (Nihon Univ., Tokyo (Japan). School of Medicine)

    1993-01-01

    The present case was a 60-year-old man. After removal of a malignant glioma (astrocytoma grade 3), radiation therapy was performed. From 1 year and 2 months after radiation therapy, disturbance of consciousness and right hemiparesis appeared. An abnormal shadow was noted on CT scan in the region from which the tumor had been extracted. Recurrence of the tumor was thus suspected. The symptoms were not relieved by steroid therapy or ACNU chemotherapy. The disturbance of consciousness gradually became aggravated and was complicated with respiration disorder. The patient died after a total course of 3 years and 6 months from the initial treatment. The findings of CT scans suggested a polymorphological tumor mass occupying the left frontal lobe with invasion to the right hemisphere via the corpus callosum. The gross and histological findings at autopsy mainly consisted of an extensive coagulation necrosis focus. There was also extensive vascular disturbance probably ascribable to radiation damage. Extensive investigations for residual tumor cells yielded negative results. The findings of CT scans were therefore considered to reflect changes in radiation necrosis with time. In the present case, autopsy findings, clinical course and image findings resembled those of recurrent malignant glioma but no residual tumor cells at the histological level. (author).

  19. A Histomorphological Pattern Analysis of Pulmonary Tuberculosis in Lung Autopsy and Surgically Resected Specimens

    Directory of Open Access Journals (Sweden)

    Mamta Gupta

    2016-01-01

    Full Text Available Background. Tuberculosis (TB is a major cause of morbidity and mortality globally. Many cases are diagnosed on autopsy and a subset of patients may require surgical intervention either due to the complication or sequelae of TB. Materials and Methods. 40 cases of resected lung specimens following surgery or autopsy in which a diagnosis of pulmonary tuberculosis was made were included. Histopathological pattern analysis of pulmonary tuberculosis along with associated nonneoplastic changes and identification of Mycobacterium tuberculosis bacilli was done. Results. The mean age of diagnosis was 41 years with male predominance (92.5%. Tuberculosis was suspected in only 12.1% of cases before death. Seven cases were operated upon due to associated complications or suspicion of malignancy. Tubercular consolidation was the most frequent pattern followed by miliary tuberculosis. The presence of necrotizing granulomas was seen in 33 cases (82.5%. Acid fast bacilli were seen in 57.5% cases on Ziehl-Neelsen stain. Conclusion. Histopathology remains one of the most important methods for diagnosing tuberculosis, especially in TB prevalent areas. It should be considered in the differential diagnosis of all respiratory diseases because of its varied clinical presentations and manifestations.

  20. Statistical study of autopsy cases in Hiroshima Atomic Bomb Hospital 1956-1975

    Energy Technology Data Exchange (ETDEWEB)

    Hamada, T; Ishida, S [H.ma Atomic Bomb Hospital (Japan); Matsushita, Hiroshi

    1976-03-01

    In order to study the differences in the incidence of a variety of disease (excluding tumors), between the cases exposed to the atomic bomb and those who were unexposed, main lesions were studied statistically by autopsy. The subjects were 1230 cases autopsied at the Hiroshima Atomic Bomb Hospital or the Hiroshima Red-Cross Hospital. They were divided into 318 cases exposed at a short distance from the bombed area (within 2 km), and 420 cases exposed at a long distance from that area (more than 2 km), including those who had come to Hiroshima later. Four hundred twenty nine unexposed cases were selected as controls. The incidence of tumor, disturbance of circulation, disturbance of the blood vessels in the brain, blood disease, and respiratory disease was higher in the exposed cases than in the unexposed cases. The incidence of cirrhosis of the liver was higher in females than in males, and was lower in cases farther from the bombed area. Cardiac infarction, valvular disease, and endocarditis were more often seen in the cases exposed near the bombed area. The incidence of the blood vessels in the brain was highest in the exposed cases near the bombed area. The incidence of disturbance of circulation, and disturbance of the blood vessels in the brain had a tendency to be higher in the exposed cases than in the unexposed cases. This is considered to be due to the advanced age in the exposed cases.

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

    Directory of Open Access Journals (Sweden)

    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. Validity of proxy data obtained by different psychological autopsy information reconstruction techniques.

    Science.gov (United States)

    Fang, L; Zhang, J

    2010-01-01

    Two informants were interviewed for each of 416 living controls (individuals sampled from the normal population) interviewed in a Chinese case-control psychological autopsy study. The validity of proxy data, obtained using seven psychological autopsy information reconstruction techniques (types 1, 2 and A - E), was evaluated, with living controls' self reports used as the gold-standard. Proxy data for reconstruction technique types 1, 2 and D on the Impulsivity Inventory Scale (total impulsivity score) were no different from the living controls' self report gold standard, whereas data for types A and E were smaller than data from living controls. On the 'acceptance or resignation' sub-scale of the avoidance coping dimension of the Moos Coping Response Inventory, information obtained by reconstruction technique types 1 and D was not significantly different from the living controls' self reports, whereas proxy data from types 2, A and E were smaller than those from the living controls. No statistically significant differences were identified for other proxy data obtained by reconstruction technique types 1, 2, A, D and E. These results indicate that using a second informant does not significantly enhance information reconstruction for the target.

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

    International Nuclear Information System (INIS)

    Satake, Bunsuke; Matsuura, Shizumu; Sakaino, Kouji; Maehara, Yasunobu

    1989-01-01

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

  4. The autopsy-correlation of computed tomography in acute severe head injuries

    International Nuclear Information System (INIS)

    Tomita, Shin; Kim, Hong; Mikabe, Toshio; Karasawa, Hideharu; Watanabe, Saburo

    1981-01-01

    We discuss the importance of Contrast-Enhanced CT (C.E.CT) in establishing the variety of the intracranial pathological process in acute severe head injuries. During a two-and-a-half-year period (June, 1977 - December, 1979) thirty-three patients with acute severe head injuries were autopsied, all of whom had been scanned on admission. Among them, 14 patients had undergone both plain CT and C.E.CT on admission. Brain slices were examined macroscopically in three categories; brain contusion, subarachnoid hemorrhage, and intracerebral hemorrhage. Each category was then compared retrospectively with the plain CT and C.E.CT findings. C.E.CT was found to correspond much better to the autopsy finding than plain CT in the following three points: (1) C.E.CT clearly enhances the contusion areas and reveals occult contusion areas. (2) C.E.CT enhances the areas corresponding to the subarachnoid space due to the breakdown of brain-surface blood vessels. (3) C.E.CT reveals the enlargement and formation of the intracerebral hematoma by the extravasation of the intravenous contrast material from injured arterial vessels. (author)

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

    International Nuclear Information System (INIS)

    Goseki, Norihide; Okamoto, Atsutake; Onodera, Tokio; Tabata, Ikuo; Takizawa, Toichiro; Koike, Morio; Matsuda, Tadayoshi; Kamimae, Goro

    1984-01-01

    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)

  6. Discoveries about tubercolosis from autopsies: topographical and morphological profiles of lesions in dakar (Senegal).

    Science.gov (United States)

    Thiam, I; Dial, C; Doh, K; Gaye, A M; Woto-Gaye, G

    2016-11-01

    Tuberculosis is endemic in Senegal. It is rate of increase and high mortality rate make it a major public health problem. The aim of this study was to describe the topographic, macroscopic, and microscopic aspects of tuberculosis lesions responsible for deaths in Dakar. This is a retrospective study of 158 autopsy reports, collected over 10 years, of deaths due to tuberculosis. The diagnosis of tuberculosis was essentially macroscopic; only equivocal cases had histological analysis. The average age at death was 47 years, and nearly all patients were men (all but 5). The largest percentage of deaths were in the 56-60 year old age group (21.6%, n = 34). Cachexia (70.3%), pallor (44.3%), and hemoptysis (20.9%) were found in the external examination of these corpses. Autopsy of the viscera showed pulmonary disease in 98.7% of cases (n = 156), both bilateral and extensive. Renal and pericardial disease were rare, found in respectively 3.8% and 2.5% of cases. Macroscopic aspects of tuberculosis were various and often related. Miliary tuberculosis (81%), small nodule tuberculosis (76.6%), and tuberculomas (62%) were the lesions most commonly encountered. Histologic analysis showed these lesions were of different ages. Tubercles (Koster follicles) were found consistently. Caseous necrosis was pathognomonic. Tuberculosis remains a deadly disease in Dakar, it mainly affects men and older individuals.

  7. A Ten Year Analysis of Fatal Peripheral Vascular Injuries Autopsy Study

    Directory of Open Access Journals (Sweden)

    Salim Tuncer

    2016-04-01

    Full Text Available Aim: Peripheral vascular injuries are usually associated with fatal injuries. Early diagnosis and intervention are so vital for improving a favorable outcome for traumatic vascular injuries. As a preventable cause of death, we aimed to evaluate peripheral vascular injuries in overall deaths in ten year period, 2003-2012. Material and Method: A retrospective evaluation was made of 2845 death cases which had post-mortem examination and autopsy from the 10-year period of 2003-2012 in Eskisehir, Turkey. The mean age of the cases included in the study was 32.5±7.9 years with the highest rate of cases occurring in the 30-39 years age group. Males constituted 89.2% of the victims. The most frequent manner of death was homicide 83.8%.The femoral artery was the most commonly injured vessel 29 cases (78.4%. In this study it was identified that, 33 patients (89.3% died before any medical intervention could be performed. Discussion: Our study shows that, peripheral vascular injuries most commonly caused by sharp objects. The injuries have a low mortality rate when early intervention is made. Autopsies are conducted is very important to explain not only the cause of death but also the treatment process, which would clear the cases of any potential malpractice or negligence claims.

  8. An autopsy case of cerebral radiation necrosis simulating recurrent malignant glioma

    International Nuclear Information System (INIS)

    Shibuya, Tadashi; Kushi, Hidehiko; Miyagi, Atsushi; Miyagami, Mitsusuke; Tsubokawa, Takashi

    1993-01-01

    The present case was a 60-year-old man. After removal of a malignant glioma (astrocytoma grade 3), radiation therapy was performed. From 1 year and 2 months after radiation therapy, disturbance of consciousness and right hemiparesis appeared. An abnormal shadow was noted on CT scan in the region from which the tumor had been extracted. Recurrence of the tumor was thus suspected. The symptoms were not relieved by steroid therapy or ACNU chemotherapy. The disturbance of consciousness gradually became aggravated and was complicated with respiration disorder. The patient died after a total course of 3 years and 6 months from the initial treatment. The findings of CT scans suggested a polymorphological tumor mass occupying the left frontal lobe with invasion to the right hemisphere via the corpus callosum. The gross and histological findings at autopsy mainly consisted of an extensive coagulation necrosis focus. There was also extensive vascular disturbance probably ascribable to radiation damage. Extensive investigations for residual tumor cells yielded negative results. The findings of CT scans were therefore considered to reflect changes in radiation necrosis with time. In the present case, autopsy findings, clinical course and image findings resembled those of recurrent malignant glioma but no residual tumor cells at the histological level. (author)

  9. 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.

  10. Mutational profiles of breast cancer metastases from a rapid autopsy series reveal multiple evolutionary trajectories.

    Science.gov (United States)

    Avigdor, Bracha Erlanger; Cimino-Mathews, Ashley; DeMarzo, Angelo M; Hicks, Jessica L; Shin, James; Sukumar, Saraswati; Fetting, John; Argani, Pedram; Park, Ben H; Wheelan, Sarah J

    2017-12-21

    Heterogeneity within and among tumors in a metastatic cancer patient is a well-established phenomenon that may confound treatment and accurate prognosis. Here, we used whole-exome sequencing to survey metastatic breast cancer tumors from 5 patients in a rapid autopsy program to construct the origin and genetic development of metastases. Metastases were obtained from 5 breast cancer patients using a rapid autopsy protocol and subjected to whole-exome sequencing. Metastases were evaluated for sharing of somatic mutations, correlation of copy number variation and loss of heterozygosity, and genetic similarity scores. Pathological features of the patients' disease were assessed by immunohistochemical analyses. Our data support a monoclonal origin of metastasis in 3 cases, but in 2 cases, metastases arose from at least 2 distinct subclones in the primary tumor. In the latter 2 cases, the primary tumor presented with mixed histologic and pathologic features, suggesting early divergent evolution within the primary tumor with maintenance of metastatic capability in multiple lineages. We used genetic and histopathological evidence to demonstrate that metastases can be derived from a single or multiple independent clones within a primary tumor. This underscores the complexity of breast cancer clonal evolution and has implications for how best to determine and implement therapies for early- and late-stage disease.

  11. A statistical study of autopsy cases in Hiroshima Atomic Bomb Hospital 1956-1975

    International Nuclear Information System (INIS)

    Hamada, Tadao; Ishida, Sadamu; Matsushita, Hiroshi.

    1976-01-01

    In order to study the differences in the incidence of a variety of disease (excluding tumors), between the cases exposed to the atomic bomb and those who were unexposed, main lesions were studied statistically by autopsy. The subjects were 1230 cases autopsied at the Hiroshima Atomic Bomb Hospital or the Hiroshima Red-Cross Hospital. They were divided into 318 cases exposed at a short distance from the bombed area (within 2 km), and 420 cases exposed at a long distance from that area (more than 2 km), including those who had come to Hiroshima later. Four hundred twenty nine unexposed cases were selected as controls. The incidence of tumor, disturbance of circulation, disturbance of the blood vessels in the brain, blood disease, and respiratory disease was higher in the exposed cases than in the unexposed cases. The incidence of cirrhosis of the liver was higher in females than in males, and was lower in cases farther from the bombed area. Cardiac infarction, valvular disease, and endocarditis were more often seen in the cases exposed near the bombed area. The incidence of the blood vessels in the brain was highest in the exposed cases near the bombed area. The incidence of disturbance of circulation, and disturbance of the blood vessels in the brain had a tendency to be higher in the exposed cases than in the unexposed cases. This is considered to be due to the advanced age in the exposed cases. (Serizawa, K.)

  12. Death following the ingestion of detergent: an autopsy case with special regard to the histochemical findings.

    Science.gov (United States)

    Kawamoto, Osamu; Ishikawa, Takaki; Oritani, Shigeki; Kuramoto, Yuko; Michiue, Tomomi; Maeda, Hitoshi

    2013-06-01

    We report an autopsy case of death due to accidental ingestion of a liquid laundry detergent with special regard to the histochemical findings. A female inpatient suffering from schizophrenia in a psychiatric institution, was found unconscious lying on the floor of her room, with a container of detergent nearby, and died despite intensive life-support measures. At autopsy, the stomach and duodenum contained whitish translucent foamy viscous fluid, and the mucous membranes, from the esophagus to the duodenum, had diffuse erosions with congestion and edema. There was otherwise no significant pathology other than signs of acute death and hemolysis. Toxicological investigations detected 1-methyl-4-prop-1-en-2-ylcyclohexene (detergent additive) in the gastric contents using headspace-gas chromatography/mass spectrometry, and a nonionic surfactant by a color identification test. Although these substances could not be detected in the blood, body fluid or viscera, histochemical examination using Oil red O demonstrated droplet-like staining in the pulmonary alveoli, suggesting aspiration of detergent, and similar staining in the vasculature of the lung, Kupffer cells of the liver, Bowman capsules of the kidney, and capillaries of the brain, suggesting the systemic effect of ingested/aspirated detergent. These findings were in keeping with death from ingestion of detergent and demonstrated the importance of preventing accidents such as this in healthcare facilities for elderly people.

  13. Measuring mortality due to HIV-associated tuberculosis among adults in South Africa: Comparing verbal autopsy, minimally-invasive autopsy, and research data

    Science.gov (United States)

    Tlali, Mpho; Fielding, Katherine L.; Charalambous, Salome; Chihota, Violet N.; Churchyard, Gavin J.; Hanifa, Yasmeen; Johnson, Suzanne; McCarthy, Kerrigan; Martinson, Neil A.; Omar, Tanvier; Kahn, Kathleen; Chandramohan, Daniel; Grant, Alison D.

    2017-01-01

    Background The World Health Organization (WHO) aims to reduce tuberculosis (TB) deaths by 95% by 2035; tracking progress requires accurate measurement of TB mortality. International Classification of Diseases (ICD) codes do not differentiate between HIV-associated TB and HIV more generally. Verbal autopsy (VA) is used to estimate cause of death (CoD) patterns but has mostly been validated against a suboptimal gold standard for HIV and TB. This study, conducted among HIV-positive adults, aimed to estimate the accuracy of VA in ascertaining TB and HIV CoD when compared to a reference standard derived from a variety of clinical sources including, in some, minimally-invasive autopsy (MIA). Methods and findings Decedents were enrolled into a trial of empirical TB treatment or a cohort exploring diagnostic algorithms for TB in South Africa. The WHO 2012 instrument was used; VA CoD were assigned using physician-certified VA (PCVA), InterVA-4, and SmartVA-Analyze. Reference CoD were assigned using MIA, research, and health facility data, as available. 259 VAs were completed: 147 (57%) decedents were female; median age was 39 (interquartile range [IQR] 33–47) years and CD4 count 51 (IQR 22–102) cells/μL. Compared to reference CoD that included MIA (n = 34), VA underestimated mortality due to HIV/AIDS (94% reference, 74% PCVA, 47% InterVA-4, and 41% SmartVA-Analyze; chance-corrected concordance [CCC] 0.71, 0.42, and 0.31, respectively) and HIV-associated TB (41% reference, 32% PCVA; CCC 0.23). For individual decedents, all VA methods agreed poorly with reference CoD that did not include MIA (n = 259; overall CCC 0.14, 0.06, and 0.15 for PCVA, InterVA-4, and SmartVA-Analyze); agreement was better at population level (cause-specific mortality fraction accuracy 0.78, 0.61, and 0.57, for the three methods, respectively). Conclusions Current VA methods underestimate mortality due to HIV-associated TB. ICD and VA methods need modifications that allow for more specific

  14. Varied autopsy findings in five treated patients with Gaucher disease and parkinsonism include the absence of Gaucher cells.

    Science.gov (United States)

    Monestime, Gianina; Borger, Daniel K; Kim, Jenny; Lopez, Grisel; Allgaeuer, Michael; Jain, Dhanpat; Vortmeyer, Alexander; Wang, Hao-Wei; Sidransky, Ellen

    2016-05-01

    Enzyme replacement therapy is standard of care for patients with Gaucher disease, as it significantly improves skeletal, visceral, and hematological symptoms. Few pathological studies have documented the extent of pathological findings in treated patients. Autopsy findings in five treated patients, who ultimately developed parkinsonism, ranged from the complete absence of Gaucher pathology to extensive involvement of multiple tissues, without correlation to age, genotype, spleen status, or dose/duration of therapy. Additional autopsies may elucidate modifiers and biomarkers contributing to disease burden and response to therapy. Published by Elsevier Inc.

  15. 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......), kidney, lymph node, skeletal muscle, dura mater and cerebellum of the NSF autopsy case, primarily in vascular walls. Some, but not all, Gd deposits were seen in fibrotic areas. Literature review highlighted that non-specific tissue fibrosis and calcification are frequent findings in tissues of patients...

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

    International Nuclear Information System (INIS)

    Sugibayashi, Keiichi; Abe, Yoshiteru; Suga, Yutaka

    1996-01-01

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

  17. 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

    This 4th edition of Handbook of Autopsy Practice is a thoroughly updated version. Autopsy practice has undergone significant changes in recent time due to technological advancements such as molecular diagnostics, immunohistochemisty and the introduction of post-mortem imaging techniques. In the s...

  18. Medical Student Attitudes to the Autopsy and Its Utility in Medical Education: A Brief Qualitative Study at One UK Medical School

    Science.gov (United States)

    Bamber, Andrew R.; Quince, Thelma A.; Barclay, Stephen I. G.; Clark, John D. A.; Siklos, Paul W. L.; Wood, Diana F.

    2014-01-01

    Attending postmortems enables students to learn anatomy and pathology within a clinical context, provides insights into effects of treatment and introduces the reality that patients die. Rates of clinical autopsies have declined and medical schools have cut obligatory autopsy sessions from their curricula making it difficult to assess medical…

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

    Directory of Open Access Journals (Sweden)

    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

  20. Characterization of RNA isolated from eighteen different human tissues: results from a rapid human autopsy program.

    Science.gov (United States)

    Walker, Douglas G; Whetzel, Alexis M; Serrano, Geidy; Sue, Lucia I; Lue, Lih-Fen; Beach, Thomas G

    2016-09-01

    Many factors affect the integrity of messenger RNA from human autopsy tissues including postmortem interval (PMI) between death and tissue preservation and the pre-mortem agonal and disease states. In this communication, we describe RNA isolation and characterization of 389 samples from 18 different tissues from elderly donors who were participants in a rapid whole-body autopsy program located in Sun City, Arizona ( www.brainandbodydonationprogram.org ). Most tissues were collected within a PMI of 2-6 h (median 3.15 h; N = 455), but for this study, tissue from cases with longer PMIs (1.25-29.25 h) were included. RNA quality was assessed by RNA integrity number (RIN) and total yield (ng RNA/mg tissue). RIN correlated with PMI for heart (r = -0.531, p = 0.009) and liver (r = -558, p = 0.0017), while RNA yield correlated with PMI for colon (r = -485, p = 0.016) and skin (r = -0.460, p = 0.031). RNAs with the lowest integrity were from skin and cervix where 22.7 and 31.4 % of samples respectively failed to produce intact RNA; by contrast all samples from esophagus, lymph node, jejunum, lung, stomach, submandibular gland and kidney produced RNA with measurable RINs. Expression levels in heart RNA of 4 common housekeeping normalization genes showed significant correlations of Ct values with RIN, but only one gene, glyceraldehyde-3 phosphate dehydrogenase, showed a correlation of Ct with PMI. There were no correlations between RIN values obtained for liver, adrenal, cervix, esophagus and lymph node and those obtained from corresponding brain samples. We show that high quality RNA can be produced from most human autopsy tissues, though with significant differences between tissues and donors. The RNA stability and yield did not depend solely on PMI; other undetermined factors are involved, but these do not include the age of the donor.

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

    Directory of Open Access Journals (Sweden)

    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

  2. Child homicide victims in forensic autopsy in Taiwan: A 10-year retrospective study.

    Science.gov (United States)

    Hwa, Hsiao-Lin; Pan, Chih-Hsin; Shu, Guang-Ming; Chang, Chin-Hao; Lee, Tsui-Ting; Lee, James Chun-I

    2015-12-01

    Child homicides are critical medico-legal issues worldwide. Data on the characteristics of these cases in Asia are limited. This study aimed to describe the characteristics of child homicides in Taiwan. A retrospective analysis of forensic autopsy records of child homicide victims (aged 0-17 years) in Taiwan, during a 10-year period between 2001 and 2010, was carried out. The age, sex, relationship with the perpetrator(s), injury patterns of the victims, and causes of death were analyzed. In all, 193 child homicide autopsies were identified. There were 38 (19.7%), 82 (42.5%), 25 (13.0%), and 48 (24.9%) homicide victims aged under 1, 1-5, 6-12, and 13-17 years, respectively. One-hundred boys (mean age: 8.4±7.0) and 93 girls (mean age: 3.7±4.3) were included. A female predominance was noted among the victims aged 0-5. Blunt force (53.4%) was the most frequent method of injury, followed by suffocation/strangulation (20.2%) and sharp force (13.0%). Bruise (64.8%) and brain injury (45.1%) were the most common types of injuries. The cranium (62.2%) and face (60.6%) were the most frequently injured body regions. The distribution of fatal injuries varied among victims in different age groups. Neurogenic shock, asphyxia, and hemorrhagic shocks were most common in victims aged 0-5, 6-12, and 13-17, respectively. The most frequent causes of death included blunt force head injury (40.4%), suffocation/strangulation (20.2%), and sharp force lung trauma (7.3%). The type of offenders, injury methods, types of injuries, distribution of injuries, mechanism of death, and causes of death were significantly different among victims of different age groups. Eighteen (9.33%) victims displayed no external evidence of trauma. The patterns of injuries, mechanism of death, and causes of death were different among victims of different age groups. A female predominance was noted among the victims aged 0-5. Complete forensic autopsy is necessary to identify child homicide. This report will

  3. [Hospital maternal mortality: causes and consistency between clinical and autopsy diagnosis at the Northeastern Medical Center of the IMSS, Mexico].

    Science.gov (United States)

    Calderón-Garcidueñas, Ana Laura; Martínez-Salazar, Griselda; Fernández-Díaz, Héctor; Cerda-Flores, Ricardo M

    2002-02-01

    The aim was to study the causes of maternal mortality (MM) and the percent of concordance between the clinical diagnosis and the autopsy findings. The autopsies of maternal death (1980-1999) from the Hospital de Especialidades, Centro Médico del Noreste, IMSS in Monterrey, México, were analyzed. The cases were classified in directly obstetric maternal mortality (DOM) and indirectly obstetric maternal mortality (IOM), the causes were studied and the percent of concordance between pre- and post-mortem diagnosis was determined. There were 124 deaths. Autopsy was performed in 61 (49.1%) women. In 55 cases the clinical file and the autopsy protocol were available. This was our sample for study. Sixty percent of the cases were DO. Causes of DOM were: specific hypertensive pregnancy disease (SHPD) (51.6%), sepsis (35.5%), hypovolemic shock (9.7%), anesthetic accidents (3%); causes of IOM were: sepsis (41.7%), malignancies (16.7%), hematological diseases (12.5%), cardiopathy and systemic arterial hypertension (12.5%), hepatic disorders (12.5%), and Superior Longitudinal Sinus thrombosis (4%). A 100% clinical-pathological concordance was observed in DOM cases, while only a 41.6% was found in IOM cases. In those cases of sepsis (IOM), the etiologic agents were identified only in 20% before death. The early detection and treatment of SHPD and the prevention of sepsis should decrease the MM. This study showed some weakness in the Health Services that should be improved.

  4. 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.

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

    NARCIS (Netherlands)

    Scholing, M.; Saltzherr, T. P.; Fung Kon Jin, P. H. P.; Ponsen, K. J.; Reitsma, J. B.; Lameris, J. S.; Goslings, J. C.

    2009-01-01

    The aim of this study was to assess the role of postmortem computed tomography (PMCT) as an alternative for autopsy in determining the cause of death and the identification of specific injuries in trauma victims. A systematic review was performed by searching the EMBASE and MEDLINE databases.

  6. What Does Psychological Autopsy Study Tell Us about Charcoal Burning Suicide--A New and Contagious Method in Asia?

    Science.gov (United States)

    Chan, Sandra S. M.; Chiu, Helen F. K.; Chen, Eric Y. H.; Chan, Wincy S. C.; Wong, Paul W. C.; Chan, Cecilia L. W.; Law, Y. W.; Yip, Paul S. F.

    2009-01-01

    Charcoal burning suicides in Hong Kong between 2002-2004 in the 15 to 59-year-old age group were investigated using the psychological autopsy method. The psychopathological profiles of charcoal burning suicides (N = 53) were compared against "other suicides" (N = 97). The two groups did not differ significantly in the prevalence of…

  7. 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-sc...

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

    International Nuclear Information System (INIS)

    Nakayama, Masafumi; Mashima, Saburo; Ohkawa, Shin-ichiro; Tanno, Munehiko; Yamada, Hideo.

    1996-01-01

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

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

    International Nuclear Information System (INIS)

    O’Donoghue, Keelin; O’Regan, Kevin N.; Sheridan, Carmel P.; O’Connor, Owen J.; Benson, Jodie; McWilliams, Sebastian; Moore, Niamh; Murphy, Mary J.; Chopra, Raj; Higgins, John R.; Maher, Michael M.

    2012-01-01

    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.

  10. Prevalence of HCV, HBV, and HIV Seropositivity among Cadavers Referred to Autopsy Hall of Legal Medicine Bureau of Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Jaber Gharehdaghi

    2017-01-01

    Full Text Available A large number of dead bodies are referred to forensic autopsy halls for medicolegal examination. They can be a source of transmission of infectious diseases through direct contact or autopsy tools. The main aim of this study was to estimate the virus infection rates in the dead bodies. One thousand consecutive dead bodies that had been referred to autopsy hall of Legal Medicine Bureau of Tehran, Iran, during 2016, were included. The blood samples were analyzed in the laboratory for detection of HBs Ag, HBs Ab, HIV Ab, and HCV Ab, after providing informed consent from legal next of kin of the dead bodies. The general characteristics of the dead bodies were also collected by a checklist. Forty-seven cases of HIV seropositivity, 80 cases of HBs Ag seropositivity, and 97 cases for HCV Ab seropositivity were found. Among them, 27 cases of HIV, 40 cases of anti-HBC positive, and 94 cases of RIBA testing positive for HCV were proved through confirmatory tests. In other words, 2.6% of the dead bodies were infected with HIV, 3.8% with HBV, and 9% with HCV. The total infection rate was 15.5%. This is a worrying risk for pathologist and autopsy technicians.

  11. Prevalence of HCV, HBV, and HIV Seropositivity among Cadavers Referred to Autopsy Hall of Legal Medicine Bureau of Tehran, Iran.

    Science.gov (United States)

    Gharehdaghi, Jaber; Abedi Khorasgani, Mohammad Hassan; Ghadiani, Mohammad Hassan; Kazemifar, Amir Mohammad; Solhi, Hassan; Solhi, Sadra

    2017-01-01

    A large number of dead bodies are referred to forensic autopsy halls for medicolegal examination. They can be a source of transmission of infectious diseases through direct contact or autopsy tools. The main aim of this study was to estimate the virus infection rates in the dead bodies. One thousand consecutive dead bodies that had been referred to autopsy hall of Legal Medicine Bureau of Tehran, Iran, during 2016, were included. The blood samples were analyzed in the laboratory for detection of HBs Ag, HBs Ab, HIV Ab, and HCV Ab, after providing informed consent from legal next of kin of the dead bodies. The general characteristics of the dead bodies were also collected by a checklist. Forty-seven cases of HIV seropositivity, 80 cases of HBs Ag seropositivity, and 97 cases for HCV Ab seropositivity were found. Among them, 27 cases of HIV, 40 cases of anti-HBC positive, and 94 cases of RIBA testing positive for HCV were proved through confirmatory tests. In other words, 2.6% of the dead bodies were infected with HIV, 3.8% with HBV, and 9% with HCV. The total infection rate was 15.5%. This is a worrying risk for pathologist and autopsy technicians.

  12. Causes of and contributors to infant mortality in a rural community of North India: evidence from verbal and social autopsy.

    Science.gov (United States)

    Rai, Sanjay Kumar; Kant, Shashi; Srivastava, Rahul; Gupta, Priti; Misra, Puneet; Pandav, Chandrakant Sambhaji; Singh, Arvind Kumar

    2017-08-11

    To identify the medical causes of death and contribution of non-biological factors towards infant mortality by a retrospective analysis of routinely collected data using verbal and social autopsy tools. The study site was Health and Demographic Surveillance System (HDSS), Ballabgarh, North India PARTICIPANTS: All infant deaths during the years 2008-2012 were included for verbal autopsy and infant deaths from July 2012 to December 2012 were included for social autopsy. Cause of death ascertained by a validated verbal autopsy tool and level of delay based on a three-delay model using the INDEPTH social autopsy tool were the main outcome measures. The level of delay was defined as follows: level 1, delay in identification of danger signs and decision making to seek care; level 2, delay in reaching a health facility from home; level 3, delay in getting healthcare at the health facility. The infant mortality rate during the study period was 46.5/1000 live births. Neonatal deaths contributed to 54.3% of infant deaths and 39% occurred on the first day of life. Birth asphyxia (31.5%) followed by low birth weight (LBW)/prematurity (26.5%) were the most common causes of neonatal death, while infection (57.8%) was the most common cause of post-neonatal death. Care-seeking was delayed among 50% of neonatal deaths and 41.2% of post-neonatal deaths. Delay at level 1 was most common and occurred in 32.4% of neonatal deaths and 29.4% of post-neonatal deaths. Deaths due to LBW/prematurity were mostly followed by delay at level 1. A high proportion of preventable infant mortality still exists in an area which is under continuous health and demographic surveillance. There is a need to enhance home-based preventive care to enable the mother to identify and respond to danger signs. Verbal autopsy and social autopsy could be routinely done to guide policy interventions aimed at reduction of infant mortality. © Article author(s) (or their employer(s) unless otherwise stated in the text

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

    Directory of Open Access Journals (Sweden)

    Gupta Kirti

    2008-04-01

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

  14. An unusual autopsy case of pyogenic liver abscess caused by periodontal bacteria.

    Science.gov (United States)

    Ohyama, Hideki; Nakasho, Keiji; Yamanegi, Koji; Noiri, Yuichiro; Kuhara, Ayako; Kato-Kogoe, Nahoko; Yamada, Naoko; Hata, Masaki; Nishimura, Fusanori; Ebisu, Shigeyuki; Terada, Nobuyuki

    2009-09-01

    Pyogenic liver abscess (PLA) formation is thought to originate from the transmission of infection via three major routes including the biliary tract, portal vein and hepatic artery. However, about 50% of PLA cases are considered to be cryptogenic. Here we report an unusual autopsy case of PLA associated with periodontopathic bacterial infection. A 59-year-old female suddenly developed cardiopulmonary arrest and died. Despite macroscopic and microscopic examinations, the infectious routes and source of infection were unidentified, and the case appeared to be cryptogenic. Since this patient had suffered severe periodontitis for a long period of time, we investigated the involvement of periodontal infection in PLA formation by performing immunohistochemical analyses. We identified several periodontopathic bacterial species in the PLA of this patient, including Fusobacterium nucleatum, Treponema denticola, Prevotella intermedia and Porphyromonas gingivalis. Thus, we demonstrate here that periodontal infection is a potential source of infection in the formation of PLA.

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

    DEFF Research Database (Denmark)

    Hansen, B F

    1992-01-01

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

  16. Completed suicide in an autopsy-confirmed case of early onset Alzheimer's disease.

    Science.gov (United States)

    Hartzell, Jennifer Wiener; Geary, Richard; Gyure, Kymberly; Chivukula, Venkata Ravi; Haut, Marc W

    2018-04-01

    We report a case of a 57-year-old male with clinically diagnosed and autopsy-confirmed early onset Alzheimer's disease who completed suicide by gunshot wound to the chest. This case has several unique aspects that have not been discussed in previous case reports of completed suicide in Alzheimer's disease. In particular, our patient's death was highly planned with successful compensation for his cognitive deficits. After all firearms had been removed from the home as a safety precaution, he obtained a new weapon, hid it and left himself cues to find and use it. The case is discussed in the context of literature differentiating the neural circuitry propagating impulsive versus planned suicidal acts.

  17. Liver cirrhosis and primary carcinoma of the liver among atomic bomb survivors. Study of autopsy cases

    Energy Technology Data Exchange (ETDEWEB)

    Hamada, T [Hiroshima Atomic Bomb Hospital (Japan)

    1980-11-01

    Liver cirrhosis and primary carcinoma of the liver were investigated in 1699 autopsies of atomic bomb survivors carried out in Hiroshima from 1956 to 1980. Liver cirrhosis, hepatocellular carcinoma and intrahepatic biliary carcinoma were observed in 116, 111, and 17 cases respectively, the ratios of man to woman and were 2.3, 3.9, and 1.8 with a mean age of 56, 60, and 67 years respectively. There was no evidence that exposure to a-bomb increased the risk of these diseases significantly. About 90% of the hepatocellular carcinomas was combined with liver cirrhosis. Weight of liver and spleen, amount of ascites, hemorrhage from the digestive canals, esophageal varix, combination with other diseases, and histologic correlation with the activities of HBs antigen and ..cap alpha..-fetoprotein were discussed with the relation to the exposure.

  18. 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.

  19. Fatal air embolism in hospital confirmed by autopsy and postmortem computed tomography.

    Science.gov (United States)

    Edler, Carolin; Klein, Anke; Püschel, Klaus; Schröder, Ann Sophie

    2018-06-01

    Vascular air embolism is caused by penetration of air into veins or arteries through a surgical wound or other connection between the external and internal aspects of the body. Vascular air embolism has various causes, and iatrogenic air embolisms are the most frequently described. We report a case of fatal air embolism in an 83-year-old woman who was admitted to hospital. At the time of the incident, she was alone in her ward receiving an intravenous infusion of antibiotics via a peripheral line in her right forearm. She was also inhaling air through a mask, which was connected via a tubing system to a compressed air connection in the wall behind her bed. Autopsy and postmortem computed tomography (PMCT) findings are presented. The case illustrates the high diagnostic value of PMCT, which is an effective procedure for detecting the presence of air or gas.

  20. Autopsy case of undiagnosed gangliocytoma in the medulla oblongata complicated with cerebral palsy.

    Science.gov (United States)

    Takahashi, Motonori; Kondo, Takeshi; Morichika, Mai; Kuse, Azumi; Nakagawa, Kanako; Asano, Migiwa; Ueno, Yasuhiro

    2016-03-01

    A Japanese man in his 30s who had congenital cerebral palsy was found unresponsive in bed. His death was confirmed after resuscitation attempts. He had a history of occasional falling (despite the use of walking sticks and a wheelchair) owing to a slowly progressive gait disturbance, and had a medical examination without full neurological re-examination. Autopsy revealed gangliocytoma in the medulla oblongata, which was diagnosed as the cause of death. Although gangliocytoma is a well-differentiated benign tumor, the almost total replacement of the medulla oblongata by the tumor cells was assumed to result in ataxia via the olivocerebellar tract and secondary cerebellar atrophy, followed by central hypoventilation and death of the patient. The symptoms caused by gangliocytoma may be overlooked owing to long-standing cerebral palsy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Autopsy findings in surgical-radiotherapeutically treated bladder carcinoma - conclusions for optimization of radiotherapy

    International Nuclear Information System (INIS)

    Fueller, J.; Kob, D.; Fritzsche, V.

    1989-01-01

    Autopsy findings in patients with bladder carcinoma, treated by combined operation and radiotherapy, revealed tendencies of tumor spread as well as complications and late effects of radiotherapy. In 24.5% of the cases tumor tissue was found within the bladder and in 30.5% within the minor pelvis. Metastases were found in 24.1% in iliac lymph nodes, in 21.3% in abdominal lymph nodes. Liver, lungs, bones, and kidneys are main organs for hematological metastasizing. Little or undifferentiated carcinomas and squamous cell carcinomas showed a greater tendency to metastasize than highly and medium-differentiated ureteral carcinomas. The least radiotherapeutical complications and late effects were found in a fractionation with daily 1.5 Gy and a total dose of 60 Gy. (author)

  2. The importance of microbiological testing for establishing cause of death in 42 forensic autopsies

    DEFF Research Database (Denmark)

    Christoffersen, Søren

    2015-01-01

    postmortem. With this study we aim to review the use of microbiological procedures at our forensic institute. In a retrospective study including 42 autopsies performed at our Institute, where microbiological test had been applied, analyses were made with regard to: type of microbiological tests performed......Microorganisms have always been one of the great challenges of humankind, being responsible for both high morbidity and mortality throughout history. In a forensic setting microbiological information will always be difficult to interpret due to lack of antemortem information and changes in flora......, microorganisms found, histological findings, antemortem information, C-reactive protein measurement and cause of death. Fiftyone different microorganisms were found distributed among 37 cases, bacteria being the most abundant. Nineteen of the cases were classified as having a microbiological related cause...

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

    Science.gov (United States)

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

    2014-07-01

    Sirenomelia, a developmental defect involving the caudal region of the body, is associated with several internal visceral anomalies. We report a detailed spectrum of anomalies in an autopsy study of four fetuses with sirenomelia (gestational ages - 20, 21, 22.4, and 22.5 weeks). Three of the fetuses had single umbilical artery, with genitourinary and gastrointestinal anomalies. Central nervous system anomalies were evident in two of the fetuses, with alobar holoprosencephaly in one and lumbar meningomyelocele in another. The most common gastrointestinal anomaly was blind ended gut (imperforate anus), while esophageal atresia and omphalocele were noted in one case each. Renal hypoplasia was seen in two fetuses, renal agenesis in one and cystic renal dysplasia was noted in one case. Literature regarding pathogenesis of this condition is briefly discussed. Copyright © 2014 Elsevier GmbH. All rights reserved.

  4. Human fatality due to thallium poisoning: autopsy, microscopy, and mass spectrometry assays.

    Science.gov (United States)

    Li, Shangxun; Huang, Wen; Duan, Yijie; Xing, Jingjun; Zhou, Yiwu

    2015-01-01

    Thallium has been responsible for many intoxications since its discovery; however, toxicological profiles for thallium in human fatalities have not been updated recently. Autopsy, microscopic investigations, and toxicological analyses were performed on a married couple who died from thallium sulfate intended homicidal poisoning. The distribution of thallium was established by inductively coupled plasma mass spectrometry with hair samples showing the highest thallium concentration. Electron microscopy revealed a dystrophic condition of hair with disorganized cuticle and atrophy of the hair bulb. Thallium interacts with cells at different levels, with prominent ultrastructural injuries in the mitochondria and endoplasmic reticulum, and high concentration of electron dense granules observed in the cytoplasm and mitochondria of several organs. Alopecia, toxic encephalopathy, and peripheral neuropathy were diagnosed in the victims and suggested to be crucial implications for thallium poisoning. The analytical procedures used in this case are of considerable forensic importance in the diagnosis of thallium poisoning. © 2014 American Academy of Forensic Sciences.

  5. Complications in autopsy cases of Hashimoto's disease with special reference to A-bomb exposure

    International Nuclear Information System (INIS)

    Asano, Masahide; Kato, Hiroo

    1978-01-01

    To clarify a relationship between A-bomb exposure and Hashimoto's disease and that between Hashimoto's disease and carcinoma of the thyroid gland, autopsy cases of Hashimoto's disease (112 cases in Hiroshima and 43 cases in Nagasaki) were examined. Incidence of Hashimoto's disease was not related to exposure doses and ages at the time of exposure. Incidence of carcinoma of the thyroid gland from Hashimoto's disease was 1.3% (2 cases), and there was no relationship between them. Incidence of ovarian cancer as cancer accompanied with Hashimoto's disease was significantly high, but that of stomach cancer was significantly low. Incidence of total cancer from Hashimoto's disease was also significantly low. Incidences of rheumatic fever and rheumatoid arthritis which were collagen diseases and diseases similar to them complicated by Hashimoto's disease was significantly high. (Tsunoda, M.)

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

    International Nuclear Information System (INIS)

    Horie, Akio; Hiraoka, Katsumi; Yamamoto, Osamu; Haratake, Joji; Tsuchiya, Takehiko; Sugimoto, Hidekatsu.

    1990-01-01

    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)

  7. 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....

  8. 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.

  9. Stainable hepatic iron in 341 African American adults at coroner/medical examiner autopsy

    Directory of Open Access Journals (Sweden)

    Acton Ronald T

    2005-01-01

    Full Text Available Abstract Background Results of previous autopsy studies indicate that increased hepatic iron stores or hepatic iron overload is common in African Americans dying in hospitals, but there are no reports of hepatic iron content in other cohorts of African Americans. Methods We investigated the prevalence of heavy liver iron deposition in African American adults. Using established histochemical criteria, we graded Perls' acid ferrocyanide-reactive iron in the hepatocytes and Kupffer cells of 341 consecutive African American adults who were autopsied in the coroner/medical examiner office. Heavy staining was defined as grade 3 or 4 hepatocyte iron or grade 3 Kupffer cell iron. Results There were 254 men and 85 women (mean age ± 1 SD: 44 ± 13 y vs. 48 ± 14 y, respectively; p = 0.0255; gender was unstated or unknown in two subjects. Approximately one-third of subjects died of natural causes. Heavy staining was observed in 10.2% of men and 4.7% of women. 23 subjects had heavy hepatocyte staining only, six had heavy Kupffer cell staining only, and one had a mixed pattern of heavy staining. 15 subjects had histories of chronic alcoholism; three had heavy staining confined to hepatocytes. We analyzed the relationships of three continuous variables (age at death in years, hepatocyte iron grade, Kupffer cell iron grade and two categorical variables (sex, cause of death (natural and non-natural causes in all 341 subjects using a correlation matrix with Bonferroni correction. This revealed two positive correlations: hepatocyte with Kupffer cell iron grades (p Conclusions The present results confirm and extend previous observations that heavy liver iron staining is relatively common in African Americans. The pertinence of these observations to genetic and acquired causes of iron overload in African Americans is discussed.

  10. 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.

  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. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    International Nuclear Information System (INIS)

    Zubair, A.; Mubarik, A.; Jamal, S.; Naz, S.

    2010-01-01

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

  13. 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.

  14. Prediction of cause of death from forensic autopsy reports using text classification techniques: A comparative study.

    Science.gov (United States)

    Mujtaba, Ghulam; Shuib, Liyana; Raj, Ram Gopal; Rajandram, Retnagowri; Shaikh, Khairunisa

    2018-07-01

    Automatic text classification techniques are useful for classifying plaintext medical documents. This study aims to automatically predict the cause of death from free text forensic autopsy reports by comparing various schemes for feature extraction, term weighing or feature value representation, text classification, and feature reduction. For experiments, the autopsy reports belonging to eight different causes of death were collected, preprocessed and converted into 43 master feature vectors using various schemes for feature extraction, representation, and reduction. The six different text classification techniques were applied on these 43 master feature vectors to construct a classification model that can predict the cause of death. Finally, classification model performance was evaluated using four performance measures i.e. overall accuracy, macro precision, macro-F-measure, and macro recall. From experiments, it was found that that unigram features obtained the highest performance compared to bigram, trigram, and hybrid-gram features. Furthermore, in feature representation schemes, term frequency, and term frequency with inverse document frequency obtained similar and better results when compared with binary frequency, and normalized term frequency with inverse document frequency. Furthermore, the chi-square feature reduction approach outperformed Pearson correlation, and information gain approaches. Finally, in text classification algorithms, support vector machine classifier outperforms random forest, Naive Bayes, k-nearest neighbor, decision tree, and ensemble-voted classifier. Our results and comparisons hold practical importance and serve as references for future works. Moreover, the comparison outputs will act as state-of-art techniques to compare future proposals with existing automated text classification techniques. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  15. Assessing the use of magnetic resonance imaging virtopsy as an alternative to autopsy: a systematic review and meta-analysis.

    Science.gov (United States)

    Ahmad, Mohammad Usman; Sharif, Kamal Ali; Qayyum, Haisum; Ehsanullah, Bushra; Balyasnikova, Svetlana; Wale, Anita; Shanmuganandan, Arun; Siddiqui, Muhammed Rafay Sameem; Athanasiou, Thanos; Kemp, Graham John

    2017-11-01

    The post mortem examination or autopsy is a trusted method of identifying the cause of death. Patients and their families may oppose an autopsy for a variety of reasons, including fear of mutilation or owing to religious and personal beliefs. Imaging alternatives to autopsy have been explored, which may provide a viable alternative. To explore the possibility of using MRI virtopsy to establish the cause of death as an alternative to the traditional post mortem examination or autopsy. Systematic review was carried out of all studies, without language restriction, identified from Medline, Cochrane (1960-2016) and Embase (1991-2016) up to December 2016. Further searches were performed using the bibliographies of articles and abstracts. All studies reporting the diagnosis of the cause of death by both MRI virtopsy and traditional autopsy were included. Five studies with 107 patients, contributed to a summative quantitative outcome in adults. The combined sensitivity of MRI virtopsy was 0.82 (95% CI 0.56 to 0.94) with a diagnostic odds ratio (DOR) of 11.1 (95% CI 2.2 to 57.0). There was no significant heterogeneity between studies (Q=1.96, df=4, p=0.75, I 2 =0). Eight studies, with 953 patients contributed to a summative quantitative outcome in children. The combined sensitivity of MRI virtopsy was 0.73 (95% CI 0.59 to 0.84) with a DOR of 6.44 (95% CI 1.36 to 30.51). There was significant heterogeneity between studies (Q=34.95, df=7, pautopsy. By using MRI virtopsy, a potential cost reduction of at least 33% is feasible, and therefore ought to be considered in eligible patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. AUTOPSY-BASED STUDY OF SILENT LIVER DISEASES IN MEDICOLEGAL CASES IN A TERTIARY CARE CENTRE OF EASTERN ODISHA

    Directory of Open Access Journals (Sweden)

    Bidyut Prava Das

    2017-05-01

    Full Text Available BACKGROUND An autopsy is a medical procedure that consists of a thorough examination of corpse to determine the cause of death and to evaluate any diseases that maybe present. Most of the chronic liver diseases even in advanced stages may cause no signs and symptoms and may go undiagnosed or are found coincidently during general health checkup, investigation being done for some other disease, surgery or autopsy. The underlying cause of chronic liver diseases vary in different geographic areas and are based on various factors such as socioeconomic status, lifestyle, diet, local and other endemic diseases. Hence, we have conducted this study to unearth the silent liver diseases in medicolegal cases. MATERIALS AND METHODS The study was carried out in Department of Pathology and Forensic Medicine and Toxicology of SCB Medical College, Cuttack, during 2012 to 2015. All medicolegal cases received for autopsy are included in the study. Routine HE stain and special stain like reticulin, Masson trichrome stain was used wherever necessary and results were analysed. RESULTS Autopsy was done in 139 cases. Portal inflammation and fibrosis was found in 35 (25.18% cases. Sinusoidal dilatation and congestion in 29 cases (20.86%, cirrhosis and bridging fibrosis was found in 16 cases (11.5%, steatohepatitis in 27 cases (19.42%, cholestasis in 3 cases (2.16%, hepatitis 1 case (0.72% and hepatocellular carcinoma in 1 case (0.72%. The others include autolytic changes and normal liver. CONCLUSION Autopsy and histopathological study of liver is the best method to determine the clinically latent liver diseases.

  17. Marks of autopsy and identification of victims of human rights violations exhumed from cemeteries: the case of the Spanish Civil War (1936-1939).

    Science.gov (United States)

    Ríos, Luis; Martínez, Berta; García-Rubio, Almudena; Herrasti, Lourdes; Etxeberria, Francisco

    2014-09-01

    The presence of autopsy marks in human skeletal remains indicates a medicolegal procedure related to ascertaining the cause and manner of death. We present here four cases where signs of autopsy were observed in the remains recovered from mass graves and cemeteries of prisoners from the Spanish Civil War (1936-1939), victims of extrajudicial executions, and of death in prison, respectively. With respect to the former, historical evidence indicate that during the first weeks after the coup, official removal of cadavers and autopsy procedures were carried out to the first victims of extrajudicial killings, whose corpses were found abandoned in the road. Once the civil war was established and systematic extrajudicial killings were systematic, official military orders were issued to stop standard forensic proceedings. Therefore, autopsy marks observed in the remains exhumed from mass graves located in cemeteries may be indicative of an earlier chronology of the killings, and this information proved to be relevant for the identification process in one of the cases presented. In a cemetery of political prisoners, autopsy signs were also observed in two skeletal remains and in the official records of two prisoners, a corroboration of information also relevant for the identification process. These findings indicate that autopsy marks can be found in the remains of victims of human rights violations exhumed from cemeteries. Skeletal and archival information could be useful for the identification process in other cases of large-scale violence, where the first victims of extrajudicial executions were buried unidentified in cemeteries after autopsy procedures.

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

    Directory of Open Access Journals (Sweden)

    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

  19. Intraepithelial lymphocytes in relation to NIH category IV prostatitis in autopsy prostate.

    Science.gov (United States)

    Dikov, Dorian; Bachurska, Svitlana; Staikov, Dimitri; Sarafian, Victoria

    2015-07-01

    Quantitative analysis of the number, normal and pathologic ratios between lymphocytes and epithelial cells (ECs), and the significance of intraepithelial lymphocytes (IELs) in normal prostatic epithelium, benign prostatic hyperplasia (BPH), and high grade prostatic intraepithelial neoplasia (PIN) in relation to NIH category IV prostatitis (histologic prostatitis: HP) was studied in autopsy prostate. IELs were analysed in 59 autopsy prostates, which was routinely embedded in paraffin and immunohistochemically stained for CD3. An average of 300-500 ECs were counted per case. The number of IELs was calculated as the mean/100 ECs. Category IV prostatitis was evaluated using NIH consensus grading system in terms of anatomical localization and grade. In healthy individuals the mean number of IELs/100 ECs was 0.61 ± 0.34% or ≤1 lymphocyte/100 ECs, which is considered as the normal basal level of prostate IELs. In category IV prostatitis, the mean number of IELs/100 ECs was 8.53 ± 3.25% or 5-11 lymphocytes/100 ECs. The number of IELs in both around and inside inflammation areas correlated to the grade and location of HP (P prostatic inflammation (P prostatic IELs in normal prostate and in relation to category IV prostatitis. The detected normal upper limit of CD3+ IELs is 1 lymphocyte/100 ECs in the normal prostate epithelium. This is considered as an organ specific characteristic of the prostate-associated lymphoid tissue (PALT). Values >5 IELs/100 ECs indicate the presence of category IV prostatitis. The severity of inflammation correlates to the number of IELs. There is an intimate link between the quantity of the IELs, the degree of the severity and the localization of category IV prostatitis. HP is a chronic and dynamic inflammatory process affecting the whole prostate gland. The increased number of IELs suggests the immune or autoimmune character of category IV prostatitis, BPH and inflammatory preneoplastic (PIN) lesions in the prostatic tumor

  20. An autopsy study of combined pulmonary fibrosis and emphysema: correlations among clinical, radiological, and pathological features

    Science.gov (United States)

    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 an autopsy cases of CPFE patients. Methods Experts retrospectively reviewed the clinical charts and examined chest computed tomography (CT) images and pathological findings of an autopsy series of 22 CPFE patients, and compared these with findings from 8 idiopathic pulmonary fibrosis (IPF) patients and 17 emphysema-alone patients. Results All patients had a history of heavy smoking. Forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC%) was significantly lower in the emphysema-alone group than the CPFE and IPF-alone groups. The percent predicted diffusing capacity of the lung for carbon monoxide (DLCO%) was significantly lower in the CPFE group than the IPF- and emphysema-alone groups. Usual interstitial pneumonia (UIP) pattern was observed radiologically in 15 (68.2%) CPFE and 8 (100%) IPF-alone patients and was pathologically observed in all patients from both groups. Pathologically thick-cystic lesions involving one or more acini with dense wall fibrosis and occasional fibroblastic foci surrounded by honeycombing and normal alveoli were confirmed by post-mortem observation as thick-walled cystic lesions (TWCLs). Emphysematous destruction and enlargement of membranous and respiratory bronchioles with fibrosis were observed in the TWCLs. The cystic lesions were always larger than the cysts of honeycombing. The prevalence of both radiological and pathological TWCLs was 72.7% among CPFE patients, but no such lesions were observed in patients with IPF or emphysema

  1. 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

  2. CSF tau and β-amyloid predict cerebral synucleinopathy in autopsied Lewy body disorders.

    Science.gov (United States)

    Irwin, David J; Xie, Sharon X; Coughlin, David; Nevler, Naomi; Akhtar, Rizwan S; McMillan, Corey T; Lee, Edward B; Wolk, David A; Weintraub, Daniel; Chen-Plotkin, Alice; Duda, John E; Spindler, Meredith; Siderowf, Andrew; Hurtig, Howard I; Shaw, Leslie M; Grossman, Murray; Trojanowski, John Q

    2018-03-20

    To test the association of antemortem CSF biomarkers with postmortem pathology in Lewy body disorders (LBD). Patients with autopsy-confirmed LBD (n = 24) and autopsy-confirmed Alzheimer disease (AD) (n = 23) and cognitively normal (n = 36) controls were studied. In LBD, neuropathologic criteria defined Lewy body α-synuclein (SYN) stages with medium/high AD copathology (SYN + AD = 10) and low/no AD copathology (SYN - AD = 14). Ordinal pathology scores for tau, β-amyloid (Aβ), and SYN pathology were averaged across 7 cortical regions to obtain a global cerebral score for each pathology. CSF total tau (t-tau), phosphorylated tau at threonine 181 , and Aβ 1-42 levels were compared between LBD and control groups and correlated with global cerebral pathology scores in LBD with linear regression. Diagnostic accuracy for postmortem categorization of LBD into SYN + AD vs SYN - AD or neocortical vs brainstem/limbic SYN stage was tested with receiver operating curves. SYN + AD had higher CSF t-tau (mean difference 27.0 ± 8.6 pg/mL) and lower Aβ 1-42 (mean difference -84.0 ± 22.9 g/mL) compared to SYN - AD ( p CSF t-tau ( R 2 = 0.15-0.16, p CSF Aβ 1-42 ( R 2 = 0.31, p CSF t-tau/Aβ 1-42 ratio ( R 2 = 0.27, p = 0.01). CSF t-tau/Aβ 1-42 ratio had 100% specificity and 90% sensitivity for SYN + AD, and CSF Aβ 1-42 had 77% specificity and 82% sensitivity for neocortical SYN stage. Higher antemortem CSF t-tau/Aβ 1-42 and lower Aβ 1-42 levels are predictive of increasing cerebral AD and SYN pathology. These biomarkers may identify patients with LBD vulnerable to cortical SYN pathology who may benefit from both SYN and AD-targeted disease-modifying therapies. © 2018 American Academy of Neurology.

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

    International Nuclear Information System (INIS)

    Berger, Nicole; Ampanozi, Garyfalia; Schweitzer, Wolf; Ross, Steffen G.; Gascho, Dominic; Ruder, Thomas D.; Thali, Michael J.; Flach, Patricia M.

    2015-01-01

    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

  4. ABCC-JNIH pathology studies, Hiroshima and Nagasaki. Report III. The autopsy program and the life span study, January 1951--December 1970

    Energy Technology Data Exchange (ETDEWEB)

    Steer, A; Moriyama, I M; Shimizu, K

    1973-01-01

    Of the 19,701 deaths in the Life Span cohort between 1951--70, 22% came to autopsy. The autopsy procurement rate reached 45% in 1963 and declined thereafter. Problems and bias are discussed; autopsy rates were directly associated with radiation dose, especially in Hiroshima. Favorable autopsy procurement rates did not result from the rapport with survivors in the Adult Health Study. A study was made of stroke, ischemic heart disease, and cancer. The occurrence of cancer by site and cell type agrees with other data from Japan except for those cancers associated with prior ionizing radiation. Estimated radiation exposure data reveals no significant association for any disease other than some forms of cancer. (45 tables) (DLC)

  5. 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.

  6. Current (1986) status of the Japanese follow-up study of the Thorotrast patients, and its relationships to the statistical analysis of the autopsy series

    International Nuclear Information System (INIS)

    Mori, T.; Kumatori, T.; Hatakeyama, S.

    1989-01-01

    Although the Japanese Thorotrast study was limited by the number of cases that could be followed or autopsied, (286 and 333) the following conclusions were made:- 1. Shortening of the lifespan occurred in the intravascular Thorotrast follow-up cases as compared with their controls. 2. The incidence of malignant hepatic tumours, liver cirrhosis, blood diseases and carcinoma of the gall-bladder was significantly higher in the intravascular Thorotrast cases than in their controls. 3. A chronological change occurred in the distribution of histological types of Thorotrast-induced malignant hepatic tumours during the 42-year period from 1945 to 1986. 4. A significantly higher rate of malignant peritoneal tumours was proved in the intravascular Thorotrast autopsy series as compared with the control autopsy series. 5. From the relationship between the follow-up study and the autopsy series, the authors estimated that 2000-3000 Japanese lived more than 3 years after intravascular injection of Thorotrast. (author)

  7. Whole-Body MRI Virtual Autopsy Using Diffusion-weighted Imaging With Background Suppression (DWIBS) at 3 T in a Child Succumbing to Chordoma.

    Science.gov (United States)

    Andronikou, Savvas; Kemp, Marnie L; Meiring, Michelle

    2017-03-01

    We report the use of diffusion-weighted imaging with background suppression (DWIBS) in pediatric virtual magnetic resonance imaging (MRI) autopsy of a child who succumbed to chordoma. A 10-year-old girl who succumbed to relapse of a chordoma underwent whole-body virtual MRI autopsy 12 hours postmortem with short Tau inversion recovery (STIR) and DWIBS on 3 T, which demonstrated the primary mass, local and cardiac invasion, and metastatic disease to the thorax, abdomen, head/neck, and musculoskeletal system. Postmortem virtual MRI autopsy including DWIBS successfully demonstrated the transthoracic spread of chordoma and invasion of the heart, resulting in blood-borne metastases. Motion and respiratory artifact were not factors during virtual autopsy using DWIBS on 3 T, making ideal use of this technology.

  8. Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

    Science.gov (United States)

    Addison, S; Arthurs, O J

    2014-01-01

    Although post-mortem MRI (PMMR) was proposed as an alternative to conventional autopsy more than a decade ago, the lack of systematic validation has limited its clinical uptake. Minimally invasive autopsy (MIA) using PMMR together with ancillary investigations has now been shown to be as accurate as conventional autopsy in foetuses, newborns and infants and is particularly useful for cerebral, cardiac and genitourinary imaging. Unlike conventional autopsy, PMMR provides a permanent three-dimensional auditable record, with accurate estimation of internal organ volumes. MIA is becoming highly acceptable to parents and professionals, and there is widespread political support and public interest in its clinical implementation in the UK. In the short to medium term, it is desirable that a supraregional network of specialist centres should be established to provide this service within the current National Health Service framework. PMID:24288400

  9. [The coroner's autopsies in the Great Britain: the problems related to the quality of the studies, standardization, auditing, financial support and the approaches to their solution].

    Science.gov (United States)

    Makarov, I Yu; Fetisov, V A; Filimonov, B A; Gusarov, A A

    The objective of the present study was to analyze the experience of the coroners and pathologists in the Great Britain based on the results of the coroner's autopsies and recommendations of the experts involved in the activities carried out in the framework of the National Confidential Enquiry into Patient Outcome and Death program (NCEPOD). The recommendations are designed to reform the country's medical examiner system, improve the equipment of the mortuary facilities, and optimize funding for the autopsy studies. The authors consider in the chronological order the following issues of the coroners and pathologists' activities: organization of their work and its procedural aspects, ordering coroner's autopsies, preparation for their performance, analysis of the relevant documentation (autopsy reports) and medical case histories (discharge summaries). Also discussed are the recommendations of the NCEPOD experts for the improvement of the said studies with the detailed analysis of the causes underlying the aforementioned problems and concise comments of the authors.

  10. 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)

    Yamamoto, Tsutomu; Shimizu, Yukiko.

    1978-11-01

    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)

  11. Epidemiologic evaluation ABCC and Nagasaki University School of Medicine autopsies and ABCC surgical specimens: Nagasaki 1950-59

    Energy Technology Data Exchange (ETDEWEB)

    Samther, T G; Hrubec, Zdenek; Brown, W J; Thomas, G D

    1962-08-22

    This epidemiologic evaluation covered autopsies performed at ABCC Nagasaki and at the Nagasaki University School of Medicine, as well as surgical pathology specimens examined at ABCC Nagasaki during 1950-59. The material was related to the ABCC Master Sample population. Bias was demonstrated with respect to symptom status, exposure, age, death certificate diagnosis, male occupations, and history of previous medical examinations at ABCC. In addition the ABCC autopsy series was found to be biased with regard to sex. Comparison with data from Hiroshima indicated similar bias which is possibly more pronounced in Hiroshima. On the basis of these findings, it was concluded that at this time the material is not suitable for broad epidemiologic studies of clinically manifest disease. The material, however, does lend itself to a number of studies of clinically occult disease and other problems which were discussed. 19 references, 32 tables.

  12. Correlation of scintigraphy with short interval autopsy in malignant focal liver disease. A study of 59 cases

    International Nuclear Information System (INIS)

    Ruiter, D.J.; Byck, W.; Pauwels, E.K.J.; Taconis, W.K.; Spaander, P.J.

    1977-01-01

    The accuracy of scintigraphy in focal liver disease was evaluated by comparing the scintigraphic and autopsy findings in 59 patients. The interval between scintigraphy and autopsy was not more than a few weeks. The overall agreement rate was 49 in 59 (83 percent), with four out of 26 (15 percent) false positive and six out of 33 (18 percent) false negative reports. Defects smaller than 2 1 / 2 cm were the principal source of false negative reports. The accuracy of interpretation in cases with liver weights up to 2000 g was significantly (P less than 0.025) lower than for higher weights. Detection of a single focal lesion by scintigraphy was found to be unreliable (only two out of 13 correct). Estimation of spleen weights by scintigraphy was disappointing. Liver weight estimates were somewhat more satisfactory

  13. A clinicopathological study on gastric cancer of the atomic-bomb survivors in Nagasaki, by autopsy cases

    International Nuclear Information System (INIS)

    Takahara, Osamu; Yoshida, Kuniko; Nakatani, Akira; Nakano, Masato.

    1986-01-01

    Autopsy findings of gastric cancer were examined in 265 patients consisting of those exposed at ≤ 2,000 m from the hypocenter (group 1), those exposed at > 2,000 m or those entering the city after the bombing (group 2), and non-exposed controls (group 3). The largest number of patients was in their sixties and seventies, irrespective of exposure status. Overall, the ratio of men to women was 1.6 : 1. The incidence of gastric cancer decreased up to 1975 in all groups. Thereafter, it began to increase, especially in group 1. The most common site of cancer was the pyloric antrum in all groups. Histologically, poorly differentiated type was observed most frequently in group 1; however, this was not statistically significant. Multiple primaries, which were unlikely to be related to exposure, were observed in 22 autopsy cases. (Namekawa, K.)

  14. An audit of the toxicology findings in 555 medico-legal autopsies finds manner of death changed in 5 cases.

    Science.gov (United States)

    Langlois, Neil E I; Gilbert, John D; Heath, Karen J; Winskog, Calle; Kostakis, Chris

    2013-03-01

    An audit of toxicological analysis in Coronial autopsies performed at Forensic Science South Australia was conducted on the cases of three pathologists. Toxicological analysis had been performed in 555 (68 %) from a total of 815 autopsies. It was found that the proffered manner of death was changed from the provisional report (provided immediately after the post-mortem examination) in five cases (just under 1 %) as a consequence of the toxicological findings. This is a limited study as it is retrospective, not all cases had toxicological analysis and the findings are constrained by the range of the substances that could be detected. Nonetheless, the audit supports the application of toxicological analysis in medico-legal death investigation and suggests that an inclusive policy should be adopted.

  15. [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.

  16. Comparison of whole-body post mortem 3D CT and autopsy evaluation in accidental blunt force traumatic death using the abbreviated injury scale classification.

    Science.gov (United States)

    Daly, Barry; Abboud, Samir; Ali, Zabiullah; Sliker, Clint; Fowler, David

    2013-02-10

    Although 3D CT imaging data are available on survivors of accidental blunt trauma, little similar data has been collected and classified on major injuries in victims of fatal injuries. This study compared the sensitivity of post mortem computed tomography (PMCT) with that of conventional autopsy for major trauma findings classified according to the trauma Abbreviated Injury Scale (AIS). Whole-body 3D PMCT imaging data and full autopsy findings were analyzed on 21 victims of accidental blunt force trauma death. All major injuries were classified on the AIS scale with ratings from 3 (serious) to 6 (unsurvivable). Agreement between sensitivity of autopsy and PMCT for major injuries was determined. A total of 195 major injuries were detected (mean per fatality, 9.3; range, 1-14). Skeletal injuries by AIS grade included 37 grade 3, 45 grade 4, 12 grade 5, and 2 grade 6 major findings. Soft tissue injuries included 10 grade 3, 68 grade 4, 16 grade 5, and 5 grade 6 major findings. Of these, PMCT detected 165 (88 skeletal, 77 soft tissue), and autopsy detected 127 (59 skeletal, 68 soft tissue). PMCT agreed with autopsy in 86% and 76% of skeletal and soft tissue injuries, respectively. PMCT detected an additional 37 skeletal and 31 soft tissue injuries that were not identified at autopsy. Autopsy detected 8 skeletal and 22 soft tissue injuries that were not detected by PMCT. PMCT was more sensitive for skeletal (P=0.05) and head and neck region injury (P=0.043) detection. PMCT showed a trend for greater sensitivity than autopsy, but this did not reach statistical significance (P=0.083). 3D PMCT detected significantly more skeletal injuries than autopsy and a similar number of soft tissue injuries to autopsy and promises to be a sensitive tool for detection and classification of skeletal injuries in fatal blunt force accidental trauma. Use of the AIS scale allows standardized categorization and quantification of injuries that contribute to death in such cases and allows more

  17. Autopsy of Adult Patients Deceased in an Academic Hospital: Considerations of Doctors and Next-of-Kin in the Consent Process.

    Science.gov (United States)

    Blokker, Britt M; Weustink, Annick C; Hunink, M G Myriam; Oosterhuis, J Wolter

    2016-01-01

    Hospital autopsies, vanishing worldwide, need to be requested by clinicians and consented to by next-of-kin. The aim of this prospective observational study was to examine how often and why clinicians do not request an autopsy, and for what reasons next-of-kin allow, or refuse it. Clinicians at the Erasmus University Medical Centre were asked to complete a questionnaire when an adult patient had died. Questionnaires on 1000 consecutive naturally deceased adults were collected. If possible, missing data in the questionnaires were retrieved from the electronic patient record. Data from 958 (96%) questionnaires was available for analysis. In 167/958 (17·4%) cases clinicians did not request an autopsy, and in 641/791 (81·0%) cases next-of-kin did not give consent. The most important reason for both clinicians (51·5%) and next-of-kin (51·0%) to not request or consent to an autopsy was an assumed known cause of death. Their second reason was that the deceased had gone through a long illness (9·6% and 29·5%). The third reason for next-of-kin was mutilation of the deceased's body by the autopsy procedure (16·1%). Autopsy rates were highest among patients aged 30-39 years, Europeans, suddenly and/or unexpectedly deceased patients, and tissue and/or organ donors. The intensive care and emergency units achieved the highest autopsy rates, and surgical wards the lowest. The main reason for not requesting or allowing an autopsy is the assumption that the cause of death is known. This is a dangerous premise, because it is a self-fulfilling prophecy. Clinicians should be aware, and communicate with the next of kin, that autopsies not infrequently disclose unexpected findings, which might have changed patient management. Mutilation of the deceased's body seems a minor consideration of next-of-kin, though how it really affects autopsy rates, should be studied by offering minimally or non-invasive autopsy methods.

  18. Analysis of death in major trauma: value of prompt post mortem computed tomography (pmCT) in comparison to office hour autopsy.

    Science.gov (United States)

    Schmitt-Sody, Markus; Kurz, Stefanie; Reiser, Maximilian; Kanz, Karl Georg; Kirchhoff, Chlodwig; Peschel, Oliver; Kirchhoff, Sonja

    2016-03-29

    To analyze diagnostic accuracy of prompt post mortem Computed Tomography (pmCT) in determining causes of death in patients who died during trauma room management and to compare the results to gold standard autopsy during office hours. Multiple injured patients who died during trauma room care were enrolled. PmCT was performed immediately followed by autopsy during office hours. PmCT and autopsy were analyzed primarily regarding pmCT ability to find causes of death and secondarily to define exact causes of death including accurate anatomic localizations. For the secondary analysis data was divided in group-I with equal results of pmCT and autopsy, group-II with autopsy providing superior results and group-III with pmCT providing superior information contributing to but not majorly causing death. Seventeen multiple trauma patients were enrolled. Since multiple trauma patients were enrolled more injuries than patients are provided. Eight patients sustained deadly head injuries (47.1%), 11 chest (64.7%), 4 skeletal system (23.5%) injuries and one patient drowned (5.8%). Primary analysis revealed in 16/17 patients (94.1%) causes of death in accordance with autopsy. Secondary analysis revealed in 9/17 cases (group-I) good agreement of autopsy and pmCT. In seven cases autopsy provided superior results (group-II) whereas in 1 case pmCT found more information (group-III). The presented work studied the diagnostic value of pmCT in defining causes of death in comparison to standard autopsy. Primary analysis revealed that in 94.1% of cases pmCT was able to define causes of death even if only indirect signs were present. Secondary analysis showed that pmCT and autopsy showed equal results regarding causes of death in 52.9%. PmCT is useful in traumatic death allowing for an immediate identification of causes of death and providing detailed information on bony lesions, brain injuries and gas formations. It is advisable to conduct pmCT especially in cases without consent to

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

    DEFF Research Database (Denmark)

    Theilade, J; Winkel, B G; Holst, A G

    2010-01-01

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

  20. Diagnostic accuracy of WHO verbal autopsy tool for ascertaining causes of neonatal deaths in the urban setting of Pakistan: a hospital-based prospective study.

    Science.gov (United States)

    Soofi, Sajid Bashir; Ariff, Shabina; Khan, Ubaidullah; Turab, Ali; Khan, Gul Nawaz; Habib, Atif; Sadiq, Kamran; Suhag, Zamir; Bhatti, Zaid; Ahmed, Imran; Bhal, Rajiv; Bhutta, Zulfiqar Ahmed

    2015-10-05

    Globally, clinical certification of the cause of neonatal death is not commonly available in developing countries. Under such circumstances it is imperative to use available WHO verbal autopsy tool to ascertain causes of death for strategic health planning in countries where resources are limited and the burden of neonatal death is high. The study explores the diagnostic accuracy of WHO revised verbal autopsy tool for ascertaining the causes of neonatal deaths against reference standard diagnosis obtained from standardized clinical and supportive hospital data. All neonatal deaths were recruited between August 2006 -February 2008 from two tertiary teaching hospitals in Province Sindh, Pakistan. The reference standard cause of death was established by two senior pediatricians within 2 days of occurrence of death using the International Cause of Death coding system. For verbal autopsy, trained female community health worker interviewed mother or care taker of the deceased within 2-6 weeks of death using a modified WHO verbal autopsy tool. Cause of death was assigned by 2 trained pediatricians. The performance was assessed in terms of sensitivity and specificity. Out of 626 neonatal deaths, cause-specific mortality fractions for neonatal deaths were almost similar in both verbal autopsy and reference standard diagnosis. Sensitivity of verbal autopsy was more than 93% for diagnosing prematurity and 83.5% for birth asphyxia. However the verbal autopsy didn't have acceptable accuracy for diagnosing the congenital malformation 57%. The specificity for all five major causes of neonatal deaths was greater than 90%. The WHO revised verbal autopsy tool had reasonable validity in determining causes of neonatal deaths. The tool can be used in resource limited community-based settings where neonatal mortality rate is high and death certificates from hospitals are not available.

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

    International Nuclear Information System (INIS)

    Kojiro, Masamichi; Ito, Yuji

    1989-01-01

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

  2. [Consequences of autopsies for the living : Causes of death in the clinical diagnosis "septic and toxic shock"].

    Science.gov (United States)

    Ozretić, L; Schwindowski, A; Dienes, H-P; Büttner, R; Drebber, U; Fries, J W U

    2017-09-01

    There is reason to believe that the diagnosis of septic and toxic shock, as indicated on the death certificate, cannot be confirmed as the cause of death without autopsy and subsequent histological analysis. The external examination of the corpse can therefore not represent the sole basis for a reliable statement about the infection status of a corpse, e. g. as a prerequisite for embalming. The validity of autopsy in determining septic and toxic shock as the cause of death is demonstrated in 7 exemplary cases. Decades of experience in a university pathology institute have shown that an external examination of the corpse alone is not suitable for certifying the cause of death if an infectious disease is suspected. Consequently, only autopsy with subsequent histological analysis provides reliable statements on the etiopathogenesis of the underlying process. Possible problems and discrepancies between clinical and pathological diagnoses are discussed on the basis of several cases with or without autoptic confirmation of the septic shock. The case of a missionary from Africa infected with Lassa virus serves to point out the seriousness of the threat an undiagnosed infection may represent to the attending staff. During the treatment of patients suspected to have an infectious cause of fever of unknown origin, compliance with the usual safety regulations, including adequate disinfecting measures, is essential. In cases with fatal outcome, not infrequently under the clinical picture of a septic and toxic shock, autopsy should be regularly performed to confirm the type of infection and the infectious cause of death. Rapid and open communication between the professional groups involved plays a crucial role in this process.

  3. Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study

    Science.gov (United States)

    Castillo, Paola; Martínez, Miguel J.; Ussene, Esperança; Jordao, Dercio; Lovane, Lucilia; Ismail, Mamudo R.; Carrilho, Carla; Lorenzoni, Cesaltina; Ferreira, Luiz; Lacerda, Marcus; Mandomando, Inacio; Vila, Jordi; Munguambe, Khátia; Maixenchs, Maria; Quintó, Llorenç; Macete, Eusebio; Alonso, Pedro; Bassat, Quique; Menéndez, Clara; Ordi, Jaume

    2016-01-01

    Background There is an urgent need to identify tools able to provide reliable information on the cause of death in low-income regions, since current methods (verbal autopsy, clinical records, and complete autopsies) are either inaccurate, not feasible, or poorly accepted. We aimed to compare the performance of a standardized minimally invasive autopsy (MIA) approach with that of the gold standard, the complete diagnostic autopsy (CDA), in a series of adults who died at Maputo Central Hospital in Mozambique. Methods and Findings In this observational study, coupled MIAs and CDAs were performed in 112 deceased patients. The MIA analyses were done blindly, without knowledge of the clinical data or the results of the CDA. We compared the MIA diagnosis with the CDA diagnosis of cause of death. CDA diagnoses comprised infectious diseases (80; 71.4%), malignant tumors (16; 14.3%), and other diseases, including non-infectious cardiovascular, gastrointestinal, kidney, and lung diseases (16; 14.3%). A MIA diagnosis was obtained in 100/112 (89.2%) cases. The overall concordance between the MIA diagnosis and CDA diagnosis was 75.9% (85/112). The concordance was higher for infectious diseases and malignant tumors (63/80 [78.8%] and 13/16 [81.3%], respectively) than for other diseases (9/16; 56.2%). The specific microorganisms causing death were identified in the MIA in 62/74 (83.8%) of the infectious disease deaths with a recognized cause. The main limitation of the analysis is that both the MIA and the CDA include some degree of expert subjective interpretation. Conclusions A simple MIA procedure can identify the cause of death in many adult deaths in Mozambique. This tool could have a major role in improving the understanding and surveillance of causes of death in areas where infectious diseases are a common cause of mortality. PMID:27875530

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  6. Enzyme studies with human and hen autopsy tissue suggest omethoate does not cause delayed neuropathy in man.

    Science.gov (United States)

    Lotti, M; Ferrara, S D; Caroldi, S; Sinigaglia, F

    1981-11-01

    Levels of acetylcholinesterase and neurotoxic esterase were measured in brain autopsy material. In tissue from a fatal human poisoning and from hens given 4-8 x unprotected LD50 AChE was highly inhibited and neurotoxic esterase uninhibited. The findings correlate with the inhibitory power of omethoate against these enzymes in vitro. It is concluded that omethoate has negligible potential to cause delayed neuropathy and a published report of human neuropathy due to omethoate is criticised.

  7. Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study.

    Directory of Open Access Journals (Sweden)

    Paola Castillo

    2016-11-01

    Full Text Available There is an urgent need to identify tools able to provide reliable information on the cause of death in low-income regions, since current methods (verbal autopsy, clinical records, and complete autopsies are either inaccurate, not feasible, or poorly accepted. We aimed to compare the performance of a standardized minimally invasive autopsy (MIA approach with that of the gold standard, the complete diagnostic autopsy (CDA, in a series of adults who died at Maputo Central Hospital in Mozambique.In this observational study, coupled MIAs and CDAs were performed in 112 deceased patients. The MIA analyses were done blindly, without knowledge of the clinical data or the results of the CDA. We compared the MIA diagnosis with the CDA diagnosis of cause of death. CDA diagnoses comprised infectious diseases (80; 71.4%, malignant tumors (16; 14.3%, and other diseases, including non-infectious cardiovascular, gastrointestinal, kidney, and lung diseases (16; 14.3%. A MIA diagnosis was obtained in 100/112 (89.2% cases. The overall concordance between the MIA diagnosis and CDA diagnosis was 75.9% (85/112. The concordance was higher for infectious diseases and malignant tumors (63/80 [78.8%] and 13/16 [81.3%], respectively than for other diseases (9/16; 56.2%. The specific microorganisms causing death were identified in the MIA in 62/74 (83.8% of the infectious disease deaths with a recognized cause. The main limitation of the analysis is that both the MIA and the CDA include some degree of expert subjective interpretation.A simple MIA procedure can identify the cause of death in many adult deaths in Mozambique. This tool could have a major role in improving the understanding and surveillance of causes of death in areas where infectious diseases are a common cause of mortality.

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

    International Nuclear Information System (INIS)

    Whitby, E.H.; Variend, S.; Rutter, S.; Paley, M.N.J.; Wilkinson, I.D.; Davies, N.P.; Sparey, C.; Griffiths, P.D.

    2004-01-01

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

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

    International Nuclear Information System (INIS)

    Muehler, Matthias R.; Lembcke, Alexander; Fischer, Thomas; Kivelitz, Dietmar; Rake, Anett; Chaoui, Rabih; Heling, Kay-Sven; Schwabe, Michael; Planke, Christiane

    2004-01-01

    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.)

  10. The importance of post-mortem computed tomography (PMCT) in confrontation with conventional forensic autopsy of victims of motorcycle accidents.

    Science.gov (United States)

    Moskała, Artur; Woźniak, Krzysztof; Kluza, Piotr; Romaszko, Karol; Lopatin, Oleksij

    2016-01-01

    Since traffic accidents are an important problem in forensic medicine, there is a constant search for new solutions to help with an investigation process in such cases. In recent years there was a rapid development of post-mortem imaging techniques, especially post-mortem computed tomography (PMCT). In our work we concentrated on a potential advantage of PMCT in cases of motorcycle accident fatalities. The results of forensic autopsy were compared with combined results of the autopsy and PMCT to check in which areas use of these two techniques gives statistically important increase in number of findings. The hypothesis was confirmed in case of pneumothorax and fractures of skull, spine, clavicle, scapula, lower leg bones. As for majority of other bone fractures locations and brain injures there were single cases with pathologies visible only in PMCT, but too few to reach expected level of p-value. In case of injuries of solid organs and soft tissues statistical analysis did not confirmed any advantage of unenhanced PMCT use. On the whole it has been shown that PMCT used as an adjunct to forensic autopsy can cause an increase in information about vitally important regions in case of motorcycle accident fatalities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Usefulness of post mortem computed tomography versus conventional forensic autopsy of road accident victims (drivers and passengers).

    Science.gov (United States)

    Moskała, Artur; Woźniak, Krzysztof; Kluza, Piotr; Romaszko, Karol; Lopatin, Oleksiy

    2017-01-01

    Aim of the study: Deaths of in-vehicle victims (drivers and passengers) of road accidents represent a significant group of issues addressed by forensic medicine. Expressing opinions in this regard involves first of all the determination of the cause of death and the forensic pathologist's participation in the process of road accident reconstruction through defining the mechanism of bodily harm. The scope of the opinion as well as its accuracy and degree of detail largely depend on the scope of forensic autopsy. In this context, techniques that broaden the capabilities of standard autopsy are of particular importance. This paper compares the results of post mortem computed tomography (PMCT) of road accident victims (drivers and passengers) against the results of standard examination in order to determine the scope to which PMCT significantly enhances autopsy capabilities. Material and methods: The analysis covers 118 in-vehicle victims (drivers and passengers) examined from 2012 to 2014. In each case, post-mortem examination was preceded by PMCT examination using Somatom Emotion 16 (Siemens AG, Germany). Results: The results are presented in a tabular form. Conclusions: In most road accident victims (drivers and passengers), post mortem computed tomography significantly increases the results' degree of detail, particularly with regard to injuries of bones and gas collections.

  12. Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach.

    Directory of Open Access Journals (Sweden)

    Paola Castillo

    Full Text Available Complete diagnostic autopsies (CDA remain the gold standard in the determination of cause of death (CoD. However, performing CDAs in developing countries is challenging due to limited facilities and human resources, and poor acceptability. We aimed to develop and test a simplified minimally invasive autopsy (MIA procedure involving organ-directed sampling with microbiology and pathology analyses implementable by trained technicians in low- income settings.A standardized scheme for the MIA has been developed and tested in a series of 30 autopsies performed at the Maputo Central Hospital, Mozambique. The procedure involves the collection of 20 mL of blood and cerebrospinal fluid (CSF and puncture of liver, lungs, heart, spleen, kidneys, bone marrow and brain in all cases plus uterus in women of childbearing age, using biopsy needles.The sampling success ranged from 67% for the kidney to 100% for blood, CSF, lung, liver and brain. The amount of tissue obtained in the procedure varied from less than 10 mm2 for the lung, spleen and kidney, to over 35 mm2 for the liver and brain. A CoD was identified in the histological and/or the microbiological analysis in 83% of the MIAs.A simplified MIA technique allows obtaining adequate material from body fluids and major organs leading to accurate diagnoses. This procedure could improve the determination of CoD in developing countries.

  13. Macroscopy predicts tumor progression in gastric cancer: A retrospective patho-historical analysis based on Napoleon Bonaparte's autopsy report.

    Science.gov (United States)

    Dawson, Heather; Novotny, Alexander; Becker, Karen; Reim, Daniel; Langer, Rupert; Gullo, Irene; Svrcek, Magali; Niess, Jan H; Tutuian, Radu; Truninger, Kaspar; Diamantis, Ioannis; Blank, Annika; Zlobec, Inti; Riddell, Robert H; Carneiro, Fatima; Fléjou, Jean-François; Genta, Robert M; Lugli, Alessandro

    2016-11-01

    The cause of Napoleon Bonaparte's death remains controversial. Originally suggested to be gastric cancer, whether this was truly neoplastic or a benign lesion has been recently debated. To interpret findings of original autopsy reports in light of the current knowledge of gastric cancer and to highlight the significance of accurate macroscopy in modern-day medicine. Using original autopsy documents, endoscopic images and data from current literature, Napoleon's gastric situation was reconstructed. In a multicenter collection of 2071 gastric cancer specimens, the relationship between tumor size and features of tumor progression was assessed. Greater tumor size was associated with advanced pT, nodal metastases and Borrmann types 3-4 (pNapoleon's autopsy with present-day knowledge to support gastric cancer as his terminal illness and emphasizes the role of macroscopy, which may provide valuable information on gastric cancer progression and aid patient management. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. Observations on self-incineration characteristics in 24 years (1993-2016) of autopsies in the city of Milan.

    Science.gov (United States)

    Amadasi, Alberto; Boracchi, Michele; Gentile, Guendalina; Maciocco, Francesca; Maghin, Francesca; Zoja, Riccardo

    2018-01-01

    Self-incineration is one of the most dramatic and lethal suicide methods. It is rarely reported in Western countries and is more frequent in developing regions. We illustrate the forensic cases of self-immolation occurring over 24 years in the city of Milan, Italy, highlighting the main issues of such a complex and rare suicide. We selected 33 cases of self-incineration among 23,417 autopsies (4022 suicides) performed at the Department of Legal Medicine of the University of Milan over a period of 24 years (1993-2016). Several parameters were included and analysed: gender and age of the victims, pathological history, previous suicide intentions/attempts, duration of burning, place of death or discovery of the corpse, circumstantial data of fatal events and autopsy findings, with particular attention to thermal injuries. Self-incineration was found in 0.8% of total suicides and 0.14% of total autopsies. One of these cases involved a complex modality (association with plastic-bag suffocation). The typical characteristics of the victim were an Italian man with psychiatric illness, frequently moved by passion, existential discomfort and economic problems. During the 24-year period, the number of cases of self-incineration progressively reduced. This study provides a general overview in one of the biggest metropolitan Italian areas and is one of the few works performed on this topic. It may be helpful in understanding and studying such an unusual manner of suicide.

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

    International Nuclear Information System (INIS)

    Yoshimoto, Yasuhiko; Ezaki, Haruo; Etoh, Ryozo; Hiraoka, Toshio; Akiba, Suminori

    1995-01-01

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

  16. Attitudes toward clinical autopsy in unexpected patient deaths in Japan: a nation-wide survey of the general public and physicians.

    Science.gov (United States)

    Kamishiraki, Etsuko; Maeda, Shoichi; Starkey, Jay; Ikeda, Noriaki

    2012-12-01

    Autopsy is a useful tool for understanding the cause and manner of unexpected patient death. However, the attitudes of the general public and physicians in Japan about clinical autopsy are limited. To describe the beliefs of the general public about whether autopsy should be performed and ascertain if they would actually request one given specific clinical situations where patient death occurred with the additional variable of medical error. To compare these attitudes with previously obtained attitudes of physicians practising at Japanese teaching hospitals. We conducted a cross-sectional study of the general public. We sent standardised questionnaires in 2010 to a randomly selected non-physician adult population using a survey company for participant selection. Respondents gave their opinions about the necessity of autopsy and how they might act given various clinical scenarios of patient death. We compared these results with those of a previous survey of Japanese physicians conducted in 2009. Of the 2300 eligible general adult population, 1575 (68.5%) responded. The majority of the general public indicated they believed an autopsy was necessary. However, in cases of unclear medical error or unclear cause and effect relationship of medical care and patient death, the general public were much less likely to indicate they would actually request an autopsy than were physicians (pcase of error related to death is underway. The results from this study will be important in informing related decisions.

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

    Science.gov (United States)

    Saraf, Sonali Rajesh; Naphade, Nilesh S; Kalgutkar, Alka D

    2016-01-01

    As in any medical disorder, in non-Hodgkin lymphomas (NHLs) also, precise analysis of causes of death is needed to focus research efforts and improve morbidity and mortality. The aim of this study was to review the clinical presentation, mode of death and the immunophenotype of the autopsy cases of NHL. Autopsy cases wherein NHL was diagnosed, were selected for study. Autopsy cases which were diagnosed as NHL, either antemortem or after autopsy during a 7 years period at a tertiary care referral centre were studied and reviewed. Descriptive statistical analysis used. The autopsy findings seen in eight cases of NHL were reviewed. Except one, all cases were above 40 years age. Infective etiology (62%) followed by cardiorespiratory failure (38%) was the cause of death observed in these patients. In three cases, the antemortem diagnosis of NHL was missed as the patients were being treated for acute febrile illness and were referred late to the Tertiary Care Centre. One of these was a case of extra-nodal primary splenic lymphoma. 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.

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

    Science.gov (United States)

    Banyini, Audrey V.; Rees, David; Gilbert, Leah

    2013-01-01

    Context In the South African mining sector, cardiorespiratory-specific autopsies are conducted under the Occupational Diseases in Mines and Works Act (ODMWA) on deceased mineworkers to determine eligibility for compensation. However, low levels of autopsy utilisation undermine the value of the service. Objective To explore enablers and barriers to consent that impact on ODMWA autopsy utilisation for posthumous monetary compensation. Methods In-depth interviews were conducted with mineworkers, widows and relatives of deceased mineworkers as well as traditional healers and mine occupational health practitioners. Results A range of socio-cultural barriers to consent for an autopsy was identified. These barriers were largely related to gendered power relations, traditional and religious beliefs, and communication and trust. Understanding these barriers presents opportunities to intervene so as to increase autopsy utilisation. Conclusions Effective interventions could include engagement with healthy mine-workers and their families and re-evaluating the permanent removal of organs. The study adds to our understanding of utilisation of the autopsy services. PMID:23364088

  19. [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.

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

    International Nuclear Information System (INIS)

    Idei, Yuka; Kamada, Satoe; Matsumoto, Shoji; Ohnishi, Kazuo; Kitazawa, Riko; Kitazawa, Sohei

    2007-01-01

    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)

  1. An autopsy case of fatal acute peritonitis complicated by illegal acupuncture therapy.

    Science.gov (United States)

    Kim, DongJa; Lee, SangHan

    2017-07-01

    Acupuncture is an alternative medical therapy and widely practiced in Northeast Asia. Although it is known as a safe procedure, complications including infection, pneumothorax, hemorrhage, and cardiac tamponade have been reported. The authors present a rare case of fatal acute peritonitis due to penetration of acupuncture needles directly into the abdominal and pelvic cavity. The victim was a 55-year-old woman who had a recent history of chemo-radiotherapy due to breast cancer. She was collapsed three days after receiving acupuncture. She had symptoms of fever and chilling sensation, general myalgia, and vomiting during three days. The autopsy revealed several needle marks in the lower abdomen and 180ml of bloody exudate in the abdominal cavity. There was no visible intestinal perforation, but hemorrhagic foci in the mesentery and paracolic area of sigmoid colon were noted. The deepest portion was 13.5cm from the needle marks on the abdominal skin. The practitioner had not a Chinese medical license. He was accused of illegal medical practice and manslaughter. Acute peritonitis associated with acupuncture might be caused by inadequate sterilization of skin and needle itself and/or direct mesentery injury. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Nonbacterial thrombotic endocarditis in a Japanese autopsy sample. A review of eighty cases

    Energy Technology Data Exchange (ETDEWEB)

    Chino, F; Kodama, A; Otake, M; Dock, D S

    1974-01-01

    A study of nonbacterial thrombotic endocarditis was carried out in a series of 3404 autopsies performed upon A-bomb survivors in Hiroshima in the period 1953--70. The prevalence of the lesion was 2.4%, with a greater frequency among the elderly and among females, and with a significant relationship to malignant neoplasms. There was a great prevalence among cancers of the colon and rectum and female genitourinary tract. No relationship was noted between nonbacterial thrombotic endocarditis and radiation exposure. Histologic findings in the heart valve leaflets in close proximity to the verrucae suggest that in association with severe systemic disease, there appears a process consisting of degenerative changes in valve collagen and ground substance, with subsequent denudation of endothelium, localized almost entirely to the apposing leaflet surfaces of the left-heart valves. The verrucae of nonbacterial thrombotic endocarditis are then formed upon this abnormal leaflet surface. There is no doubt that this lesion represents a clinically important complication of severe systemic disease. It also seems likely that in some cases nonbacterial thrombotic endocarditis may complicate an illness which may otherwise be curable. Increasing awareness of this pathologic entity, coupled with echocardiographic techniques, will permit more frequent diagnosis in living

  3. Statistical studies on heart disease of the pathological autopsy cases in the Atomic Bomb Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Matushita, H [Hiroshima Red Cross Hospital (Japan); Hamada, T; Ishida, S

    1976-03-01

    Of 1230 autopsied cases in the Atomic Bomb Hospital and in the Red-Cross Hospital from 1956 to March, 1975, a statistical study was made on 118 cases in which primary or secondary heart disease had been found. The results are as follows. The incidence of myocardial infarction was 2.4 times higher in the group exposed to the atomic bomb within 2 km distance from the bombed area than that it was in the unexposed group. The incidence of acquired valvular disease was 4.1 times higher in the exposed group than in the unexposed group. From the standpoint of the incidence of myocardiosis, there was no difference between the groups. The incidence of pericarditis was 1.5 times higher in the exposed group than in the unexposed group. The incidence of cor pulmonale was 1.8 times higher in the exposed group than in the unexposed group. The incidence of other heart disease including congenital disease was, however, 1.6 times higher in the unexposed group than in the exposed group. The incidence of general heart disease was 1.7 times higher in the exposed group than in the unexposed group. The incidence of hypertrophy of the heart (more than 400 g) was 1.2 times higher in the exposed group than in the unexposed group.

  4. Statistical studies on heart disease of the pathological autopsy cases in the Atomic Bomb Hospital

    International Nuclear Information System (INIS)

    Matushita, Hiroshi; Hamada, Tadao; Ishida, Sadamu.

    1976-01-01

    Of 1230 autopsied cases in the Atomic Bomb Hospital and in the Red-Cross Hospital from 1956 to March, 1975, a statistical study was made on 118 cases in which primary or secondary heart disease had been found. The results are as follows. The incidence of myocardial infarction was 2.4 times higher in the group exposed to the atomic bomb within 2 km distance from the bombed area than that it was in the unexposed group. The incidence of acquired valvular disease was 4.1 times higher in the exposed group than in the unexposed group. From the standpoint of the incidence of myocardiosis, there was no difference between the groups. The incidence of pericarditis was 1.5 times higher in the exposed group than in the unexposed group. The incidence of cor pulmonale was 1.8 times higher in the exposed group than in the unexposed group. The incidence of other heart disease including congenital disease was, however, 1.6 times higher in the unexposed group than in the exposed group. The incidence of general heart disease was 1.7 times higher in the exposed group than in the unexposed group. The incidence of hypertrophy of the heart (more than 400 g) was 1.2 times higher in the exposed group than in the unexposed group. (Namekawa, K.)

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

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    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

  6. A rare autopsy case of traumatic rhabdomyolysis associated with intermittent assault.

    Science.gov (United States)

    Chiba, Fumiko; Makino, Yohsuke; Motomura, Ayumi; Inokuchi, Go; Ishii, Namiko; Torimitsu, Suguru; Hoshioka, Yumi; Abe, Hiroko; Yamaguchi, Rutsuko; Hashimoto, Mari; Sakuma, Ayaka; Nagasawa, Sayaka; Saito, Hisako; Yajima, Daisuke; Iwase, Hirotaro

    2016-05-01

    Traumatic rhabdomyolysis generally occurs after severe blunt trauma and is acute in onset, associated with severe disease, and potentially lethal. Accordingly, diagnosis of traumatic rhabdomyolysis in patients without massive subcutaneous or intramuscular hemorrhage is difficult, especially in the postmortem period, which is limited in terms of the availability of biochemical examination tools and accurate history of illness. To the best of our knowledge, there are no previous reports of death from traumatic rhabdomyolysis among individuals who did not pursue medical consultation. A previously healthy man in his early sixties had been punched and kicked several times in the previous 2months, but he had not gone to a hospital. He suddenly lost consciousness at his workplace approximately 5days after the most recent assault, and cardiopulmonary arrest occurred when the emergency service arrived. He died the same day, and a medicolegal autopsy was performed. Although several sites of minor subcutaneous and muscle hemorrhage were observed, the cause of death was unclear upon macroscopic assessment. Immunohistochemical staining revealed acute renal failure caused by rhabdomyolysis. We herein report a rare case of fatal traumatic rhabdomyolysis, seemingly associated with minor and apparently nonlethal muscle injury. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Characteristics of Mexican children and adolescents who died by suicide: A study of psychological autopsies.

    Science.gov (United States)

    González-Castro, Thelma Beatriz; Tovilla-Zárate, Carlos Alfonso; Hernández-Díaz, Yazmín; Juárez-Rojop, Isela E; León-Garibay, Alejandra Giovanna; Guzmán-Priego, Crystell Guadalupe; López-Narváez, Lilia; Frésan, Ana

    2017-11-01

    In recent years, suicide in children and adolescents has increased considerably, becoming the second cause of death in this age group. Therefore, the aim of this study was to identify characteristics and factors that could precipitate deaths by suicide in children and adolescents. Using the psychological autopsy method, we studied 28 suicide cases of children and adolescents between 10 and 17 years old. Socio-demographic factors, characteristics of the suicide and family history were documented. The proportion of deaths by suicide was the same in females and males (50% each). Most of the suicides were performed at the child/adolescent's home (78.6%) and no history of previous suicide attempts were registered (85.7%). Also, the majority of suicidal individuals came from a dysfunctional family (60.7%). Our results identified characteristics of children and adolescents that had died by suicide, such as dying at their homes and coming from dysfunctional families. Knowing the characteristics of children and adolescents that had ended their lives by suicide should be considered in future studies to help developing preventive programs and strategies for treating suicidal behaviors in Mexican children and adolescents. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  8. Review of autopsy reports of deaths relating to fire in South Australia 2000-2015.

    Science.gov (United States)

    Sully, Claire J; Walker, G Stewart; Langlois, Neil E I

    2018-06-01

    It has been noted there are gaps and inconsistencies in data pertaining to fire related deaths in Australia, which poses difficulties for analysis of national statistics. A search of post-mortem examination reports at Forensic Science SA from 2000 to 2015 revealed 275 cases regarded as fire related in which the body had been involved in a fire. The autopsy reports were evaluated to determine parameters including the location of the fire event, age and sex of victim, as well as the presence of soot in the airways and cherry-red coloration to the blood and/or organs, in addtion to toxicological levels of carboxyhemoglobin and alcohol. Fire events were clasified as structural, transportation or open air in type. Males were more commonly victims than females, especially in transportation fires, where males aged below 50 years were most at risk of death. Carboxyhemoglobin levels tended to be lower in victims of transportation fires. This study has confirmed that presence of soot in the respiratory tract and cherry-red coloration of a body retrieved from a fire are both linked to an increased level of blood carboxyhemoglobin. These findings significantly contribute to the documentation of fire deaths in Australia.

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

    International Nuclear Information System (INIS)

    Terayama, Noboru; Matsui, Osamu; Kadoya, Masumi; Yoshikawa, Jun; Gabata, Toshifumi; Miyayama, Shiro; Takashima, Tsutomu; Kobayashi, Kenichi; Nakanishi, Isao; Nakanuma, Yasuni

    1997-01-01

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

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

    International Nuclear Information System (INIS)

    Fox, T.; Tietjen, G.L.; McInroy, J.F.

    1979-01-01

    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

  11. Medicolegal Investigation of Medical Negligence in India: A Report of Forensic Autopsy Case

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    Raktim Pratim Tamuli

    2016-01-01

    Full Text Available In general negligence means failure to take proper care over something and according to law negligence means breach of a duty of care which results in damage. Medical negligence is not very uncommon; every now and then cases of medical negligence are reported in the electronic media. Medical Negligence is doing something that one is not supposed to do, or failing to do something that one is supposed to do. Role of Forensic Pathologist in cases of Medical Negligence is always unquestionable. Forensic Pathologists need to explore and maintain a high degree of transparency between the doctors, patients and the law enforcing agencies. In the present case, a person was attacked by a wild animal and he fell down on a rough surface. Immediately he was rushed to a local hospital. The treating doctor stitched the external injury and allowed him to go home; he neither advised any investigation nor kept him under observation to rule out any internal injury. After 12 hours the victim succumbed to death. At autopsy a fractured skull with underlying subdural haemorrhage was noticed. Was not the treating doctor negligent in this case? Were the protocols followed? What should be the role of a Forensic Pathologist in such kind of cases?

  12. Mental disorders and suicide in Japan: a nation-wide psychological autopsy case-control study.

    Science.gov (United States)

    Hirokawa, Seiko; Kawakami, Norito; Matsumoto, Toshihiko; Inagaki, Akiko; Eguchi, Nozomi; Tsuchiya, Masao; Katsumata, Yotaro; Akazawa, Masato; Kameyama, Akiko; Tachimori, Hisateru; Takeshima, Tadashi

    2012-10-01

    The purpose of the present nationwide psychological autopsy case-control study is to identify the association between mental disorders and suicide in Japan, adjusting for physical conditions. A semi-structured interview was conducted of the closest family members of 49 suicide completers and 145 gender-, age-, and municipality-matched living controls. The interview included sections of socio-demographic characteristics, physical conditions, and a psychiatric interview producing DSM-IV diagnoses of mental disorders prior to suicide (or at survey). We compared prevalences of mental disorders between the two groups, using conditional logistic regression. A significantly higher proportion with any mental disorder was found in the suicide group (65.3%) compared to the control group (4.8%) (p=0.003, odds ratio [OR]=7.5). The population attributable risk proportion associated with mental disorder was 0.24. Mood disorder, particularly major depressive disorder, was the most strongly associated with suicide (pmental disorders, particularly mood disorder, were significantly associated with a greater risk of suicide in Japan, independent of physical conditions. Mental disorders are a major target of suicide prevention programs in Japan. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Idiopathic mitral valve prolapse with tricuspid, aortic and pulmonary valve involvement: An autopsy case report

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    Heena M Desai

    2015-01-01

    Full Text Available Mitral valve prolapse (MVP is usually asymptomatic, but can be associated with complications such as infective endocarditis, mitral regurgitation, thromboembolism and sudden cardiac death. It has been very rarely reported to occur in association with other valvular involvement. A 55-year-old male patient was brought dead and at autopsy the mitral valve orifice was stenotic and the leaflets were enlarged, myxoid and bulging suggestive of MVP and chordae tendinae were thickened, stretched and elongated. Similar changes were seen in the tricuspid valve. The pulmonary and aortic valves also showed myxomatous degeneration of their cusps. Myxomatous degeneration is the most common cause of MVP and it can be associated with involvement of the other valves. Concomitant involvement of the aortic valve has been reported, however it is very rare and simultaneous involvement of the pulmonary valve has not been reported in the literature so far. We report a case of MVP associated with myxomatous degeneration of the tricuspid, pulmonary and aortic valves.

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

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    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.

  15. A hospital based autopsy study of 50 cases at combined military hospital (cmh), sialkot

    International Nuclear Information System (INIS)

    Asif, N.

    2014-01-01

    To analyze the pattern of deaths on autopsy carried out on Armed Forces personnel in CMH Sialkot. Study Design: Retrospective analytical study Place and Duration of Study: Combined Military Hospital Sialkot (CMH), from 2009 to 2012 Materials and Methods: In a total of fifty (50) cases detailed postmortems were carried out and gross features on external examination and different systemic examinations were recorded. Histopathology of various organs was done in all cases. Chemical and toxicological examination of various abdominal viscera was carried out in all sudden and suspicious deaths. Results: Ischemic Heart Disease (IHD) was most common cause of death (38%) followed by road traffic accidents (14%) and electrocution (8%). Sudden adult death syndrome accounted for 4 cases of deaths. Other causes were drowning, cerebral malaria, heat stroke, gunshot wounds, myocarditis, brain hemorrhage, meningitis and diabetic ketoacidosis. Most of these cases were young soldiers (n=30) followed by Non-Commissioned Officers (n=17). Conclusion: A large number of our young soldiers dying of heart problems is an alarming situation. Awareness among the troops of various risk factors is most important. Precautionary measures against preventable causes should be taken. (author)

  16. [An autopsy case of brain candidiasis in premature infant: morphology and intraparenchymal distribution of Candida foci].

    Science.gov (United States)

    Yamaguchi, K; Goto, N

    1993-07-01

    An autopsy case of brain candidiasis occurring in a premature infant is presented, and the morphology and intraparenchymal distribution of Candida foci are described in detail with the aid of serial sections of the affected brain. The patient was a boy, who was born after 25 weeks of gestation and died on day 15. Candida foci were composed of two infectious forms of Candida (yeasts and pseudohyphae) and various inflammatory reactions of the host. They were widely disseminated in the brain parenchyma, leptomeninges and ventricular system. In view of their morphology, they were classified into the acute and chronic inflammatory types. The acute type foci, characterized by microabscess of infiltration of neutrophils, were large and localized predominantly in the cerebral white matter, fiber tracts, central grey matter of the midbrain, reticular formation, floor of fourth ventricle and subependymal germinal layer; most of the acute type foci were found in the watershed zones where the blood supply was considered to be poorer than the other parts of the brain parenchyma. In contrast, the chronic type foci, characterized by nodular proliferation of astrocytes, were small and localized in the grey matter (the cerebral cortex, basal ganglia and brainstem nuclei) and the leptomeninges. This study suggests that Candida infection to the brain may occur by different two kinds of way correlating with the proper vasoarchitecture of brain. In addition, it is recommended to make a close examination of the maternal vagina, placenta and umbilical cord after delivery to detect the risk of Candida infection.

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

    International Nuclear Information System (INIS)

    Satow, Yukio

    1992-01-01

    Autopsy findings of 652 fetuses whose parents or one parent were exposed to the Atomic Bomb (F 1 ) and 115 fetuses which had one or two grandparents exposed (F 2 ) were compared with that of 8570 fetuses whose parents were not exposed (control). The F 1 fetuses have been collected since 1963 and F 2 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 F 1 and F 2 . The malformations were cardiovascular, central nervous and urogenital system, quantitatively in that order, in both groups of F 1 and F 2 . 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 F 1 and F 2 . (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    Satow, Yukio (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology)

    1992-01-01

    Autopsy findings of 652 fetuses whose parents or one parent were exposed to the Atomic Bomb (F[sub 1]) and 115 fetuses which had one or two grandparents exposed (F[sub 2]) were compared with that of 8570 fetuses whose parents were not exposed (control). The F[sub 1] fetuses have been collected since 1963 and F[sub 2] 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 F[sub 1] and F[sub 2]. The malformations were cardiovascular, central nervous and urogenital system, quantitatively in that order, in both groups of F[sub 1] and F[sub 2]. 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 F[sub 1] and F[sub 2]. (author).

  19. TECHNOLOGICAL INNOVATION AND FIRM DEVELOPMENT: THE CASE OF INFOVALLEY DIGITAL AUTOPSY SYSTEM COMMERCIALISATION

    Directory of Open Access Journals (Sweden)

    Khairul Akmaliah Adham

    2008-01-01

    Full Text Available Current research emphasises the importance of the successful commercialisation of technology in the development of small firms and the need to address unique contextual dimensions when examining the concept of commercialisation. Guided by product and venture development lifecycle models as well as a structuration perspective, this case study examines how an entrepreneurial venture called Infovalley Life Sciences develops and commercialises the firm's digital human autopsy system despite the fact that the firm operates within an underdeveloped innovation system context. In-depth interviews were conducted with key individuals involved in the innovation and venture development processes. Analysis indicates that the entrepreneur and his or her team co-evolve with their business contexts in creating a favourable nvironment for themselves. This process requires the entrepreneur to integrate his or her broad knowledge of technology applications and the market with his or her team's highly specialised knowledge in the core technology domain; this process results in a successful product launch. This leads to the creation of internal core capability, which supports the commercialisation of new products and thereby contributes to the firm's development and growth. This link between structuration and resource-based perspectives of entrepreneurship augments the conceptualisation of entrepreneurship, technological innovation and firm's development.

  20. Lung and heart pathology in fatal drug addiction. A consecutive autopsy study.

    Science.gov (United States)

    Kringsholm, B; Christoffersen, P

    1987-01-01

    Lung and heart sections from 33 drug addicts submitted for medico-legal autopsy at the Institute of Forensic Medicine in Copenhagen were studied together with tissue sections from 20 'normal' persons. In the drug addict cases focal bleedings in lung tissue were found in 94%, signs of earlier bleedings, haemosiderin containing histiocytes, were seen in 91%, and focal fibrosis in 46%. The bleeding episodes may be due to hypoxia in connection with heroin intake. In 94% of the drug addicts birefringent material in lung tissue was demonstrated, in 58% in granulomas and giant cells, in 27% in giant cells only and in 9% in isolated histiocytes. The material was localized in the wall of pulmonar arteries and/or in the interstitial tissue, undoubtedly depending on the duration of the abuse. In 18% angiothrombosis was seen, in all cases granulomas/giant cells were observed in the wall of the vessel concerned. The results indicate periodical intravenous injection of dissolved tablets in addition to heroin. Histological signs of pulmonary hypertension were not seen, possibly due to the fact that abuse of central stimulants is very rare in Denmark. Regarding heart alterations no significant differences were demonstrated between drug addicts and controls. The only note-worthy finding was focal infiltration of lymphocytes in the atrio-ventricular bundle in two drug addicts, the meaning of which is uncertain.

  1. Intestinal/Peritoneal Tuberculosis in Children: An Analysis of Autopsy Cases

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    Cecilia Ridaura-Sanz

    2012-01-01

    Full Text Available Infection by Mycobacterium bovis is not infrequently identified in Mexico. Its relation to nonpasteurized milk products ingestion is well recognized with primary infection usually in the intestinal tract. The term “abdominal tuberculosis” includes peritoneal as well as primary and secondary intestinal tuberculosis. The clinical differentiation of these conditions is difficult. In this work, we reviewed the clinical and pathological features of 24 cases of children dying with tuberculosis in whom autopsy revealed abdominal disease in a referral hospital in Mexico City. We identified 8 cases of primary intestinal tuberculosis, with documentation of M. bovis in 6 of them, and 9 cases of secondary intestinal tuberculosis (primary pulmonary disease, all negative to M. bovis. Seven patients had peritoneal tuberculosis without intestinal lesions and with active pulmonary disease in 4 of them, and of the remaining three, two had mesenteric lymph node involvement suggesting healed intestinal disease. In this approach to abdominal tuberculosis, postmortem analysis was able to differentiate primary from secondary intestinal tuberculosis and to define the nature of peritoneal involvement. This discrimination gives rise to different diagnostic approaches and epidemiological and preventive actions, particularly in countries where tuberculosis is endemic and infection by M. bovis continues to be identified.

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

    International Nuclear Information System (INIS)

    Asano, Masahide; Norman, J.E. Jr.; Kato, Hiroo; Yagawa, Kanichi.

    1978-01-01

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

  3. Infectious diseases in atomic bomb survivors. Statistical study on autopsy cases, 1965--1975

    Energy Technology Data Exchange (ETDEWEB)

    Hamada, T; Ishida, S [Hiroshima Atomic Bomb Hospital (Japan); Matsushita, H

    1976-09-01

    Incidences of various infectious diseases in 986 autopsy cases at Hiroshima Atomic Bomb Hospital and Hiroshima Red Cross Hospital from 1965 to 1975 were compared according to the distance from the explosion place, and the following results were obtained. There was not a significant difference at incidences of most infectious diseases between each exposured group and not-exposured group. Incidence of old tuberculosis focus was a little higher in exposured groups, but incidences of main lesions such as tuberculosis, active tuberculosis, and miliary tuberculosis were lower in exposured groups and effect of exposure was negative. Out of urinary tract infections, the nearer the distance to the explosion place was, the higher incidence of cistitis in female was. Incidence of cystitis of female was higher than that of male in the group exposured near to the explosion place. With respect to stomach cancer, leukemia, malignant lymphoma, and cerebrovascular disorder, the nearer the distance to the explosion place was, the higher incidences of various infectious diseases were.

  4. Comparative Analytical Utility of DNA Derived from Alternative Human Specimens for Molecular Autopsy and Diagnostics

    Science.gov (United States)

    Klassen, Tara L.; von Rüden, Eva-Lotta; Drabek, Janice; Noebels, Jeffrey L.; Goldman, Alica M.

    2013-01-01

    Genetic testing and research have increased the demand for high-quality DNA that has traditionally been obtained by venipuncture. However, venous blood collection may prove difficult in special populations and when large-scale specimen collection or exchange is prerequisite for international collaborative investigations. Guthrie/FTA card–based blood spots, buccal scrapes, and finger nail clippings are DNA-containing specimens that are uniquely accessible and thus attractive as alternative tissue sources (ATS). The literature details a variety of protocols for extraction of nucleic acids from a singular ATS type, but their utility has not been systematically analyzed in comparison with conventional sources such as venous blood. Additionally, the efficacy of each protocol is often equated with the overall nucleic acid yield but not with the analytical performance of the DNA during mutation detection. Together with a critical in-depth literature review of published extraction methods, we developed and evaluated an all-inclusive approach for serial, systematic, and direct comparison of DNA utility from multiple biological samples. Our results point to the often underappreciated value of these alternative tissue sources and highlight ways to maximize the ATS-derived DNA for optimal quantity, quality, and utility as a function of extraction method. Our comparative analysis clarifies the value of ATS in genomic analysis projects for population-based screening, diagnostics, molecular autopsy, medico-legal investigations, or multi-organ surveys of suspected mosaicisms. PMID:22796560

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

    International Nuclear Information System (INIS)

    Ali, S.M.A.; Khalil, I.R.; Saeed, A.; Hussain, Z.

    2003-01-01

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

  6. Malignant Pleural Mesothelioma with Marked Lymphatic Involvement: A Report of Two Autopsy Cases

    Directory of Open Access Journals (Sweden)

    Reiko Ideguchi

    2017-01-01

    Full Text Available We herein report two cases of malignant pleural mesothelioma with marked lymphangiosis. The patients included a 68-year-old man and a 67-year-old man who both had a history of exposure to asbestos. Computed tomography (CT on admission showed pleural effusion with pleural thickening. In both cases, a histopathological examination of the pleura confirmed the diagnosis of epithelioid malignant mesothelioma. They received chemotherapy, but the treatment was only palliative. The chest CT assessments during admission revealed marked pleural effusion and mediastinal lymphadenopathy. CT also showed a consolidative mass with bronchovascular bundle and septal thickening in the lungs suggesting pulmonary parenchymal involvement and the lymphangitic spread of the tumor. These CT findings mimicked lung cancer with pleuritis and lymphangitic carcinomatosis. Autopsy was performed in both cases. Macroscopically, the tumor cells infiltrated the lung with the marked lymphatic spread of the tumor. Microscopy also revealed that the tumor had invaded the pulmonary parenchyma with the marked lymphatic spread of the tumor. Although this growth pattern is unusual, malignant pleural mesothelioma should be considered as the differential diagnosis, especially in patients with pleural lesions.

  7. [Forensic analysis of death caused by fat embolism: A study of 20 autopsy cases].

    Science.gov (United States)

    Zhou, Lan; Mu, Jiao; Dong, Hong-Mei; Zhang, Ji

    2013-12-01

    To analyze the general and forensic pathological characteristics of death due to fat embolism syndrome (FES) and to provide reference data for forensic identification. Twenty autopsy cases due to FES were selected from the forensic center of a medical college from 1999 to 2012. The general and forensic pathological characteristics such as the ways and types of injuries, clinical manifestation and the pathological changes were summarized. Fat embolism mainly occurred after long bone fracture or a large area of soft tissue injury with the majority of cases being fat embolism of lung and occasional cases being combined embolisms of lung and brain as well. The onset of symptoms appeared shortly after the injury or surgery. Lipid droplets could be observed within small pulmonary vessels and verified by special staining. There are particular characteristics in death due to FES in concern with types of injuries, onset of symptoms and pathological findings. In order to find out the direct evidence of FES, special staining (oil red O staining) can be used in the forensic identification.

  8. Changes in autopsy rates among cancer patients and their impact on cancer statistics from a public health point of view: a longitudinal study from 1980 to 2010 with data from Cancer Registry Zurich.

    Science.gov (United States)

    Bieri, Uwe; Moch, Holger; Dehler, Silvia; Korol, Dimitri; Rohrmann, Sabine

    2015-06-01

    During the last decades, autopsy rates have dramatically decreased in many countries. The Cancer Registry Zurich, which exists since 1980, provides the opportunity to address to what extent the number of autopsies in cancer patients has changed over a longer period of time and how often autopsies provide a diagnosis of clinically undetected cancer. Data from the Cancer Registry Zurich consisting of 102,434 cancer cases among 89,933 deceased patients between 1980 and 2010 were analyzed by means of descriptive statistics. The autopsy rate declined from 60 % in 1980 to 7 % in 2010. The total number of autopsies performed decreased from 1179 in 1986 to 220 in 2010. Furthermore, there was also a decline in the rate of newly detected tumours based on autopsy information. In 1980, the rate of newly detected tumours through autopsy was 42 % compared with 2010, when the rate had declined to 17 %. A consequence of the reduced autopsy rate is the reduction of incidental findings at autopsy in cancer registration. However, this reduction has not negatively affected the total incidence of cancer. It seems that the state-of-the-art diagnostic tools used for tumour detection are sufficiently reliable, allowing the scientific community to trust the quality of data provided by cancer registries in spite of decreasing autopsy rates.

  9. Social autopsy: INDEPTH Network experiences of utility, process, practices, and challenges in investigating causes and contributors to mortality

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    Yevoo Lucy

    2011-08-01

    Full Text Available Abstract Background Effective implementation of child survival interventions depends on improved understanding of cultural, social, and health system factors affecting utilization of health care. Never the less, no standardized instrument exists for collecting and interpreting information on how to avert death and improve the implementation of child survival interventions. Objective To describe the methodology, development, and first results of a standard social autopsy tool for the collection of information to understand common barriers to health care, risky behaviors, and missed opportunities for health intervention in deceased children under 5 years old. Methods Under the INDEPTH Network, a social autopsy working group was formed to reach consensus around a standard social autopsy tool for neonatal and child death. The details around 434 child deaths in Iganga/Mayuge Health and Demographic Surveillance Site (HDSS in Uganda and 40 child deaths in Dodowa HDSS in Ghana were investigated over 12 to 18 months. Interviews with the caretakers of these children elicited information on what happened before death, including signs and symptoms, contact with health services, details on treatments, and details of doctors. These social autopsies were used to assess the contributions of delays in care seeking and case management to the childhood deaths. Results At least one severe symptom had been recognized prior to death in 96% of the children in Iganga/Mayuge HDSS and in 70% in Dodowa HDSS, yet 32% and 80% of children were first treated at home, respectively. Twenty percent of children in Iganga/Mayuge HDSS and 13% of children in Dodowa HDSS were never taken for care outside the home. In both countries most went to private providers. In Iganga/Mayuge HDSS the main delays were caused by inadequate case management by the health provider, while in Dodowa HDSS the main delays were in the home. Conclusion While delay at home was a main obstacle to prompt and

  10. Diagnostic accuracy of post-mortem CT with targeted coronary angiography versus autopsy for coroner-requested post-mortem investigations: a prospective, masked, comparison study.

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    Rutty, Guy N; Morgan, Bruno; Robinson, Claire; Raj, Vimal; Pakkal, Mini; Amoroso, Jasmin; Visser, Theresa; Saunders, Sarah; Biggs, Mike; Hollingbury, Frances; McGregor, Angus; West, Kevin; Richards, Cathy; Brown, Laurence; Harrison, Rebecca; Hew, Roger

    2017-07-08

    England and Wales have one of the highest frequencies of autopsy in the world. Implementation of post-mortem CT (PMCT), enhanced with targeted coronary angiography (PMCTA), in adults to avoid invasive autopsy would have cultural, religious, and potential economic benefits. We aimed to assess the diagnostic accuracy of PMCTA as a first-line technique in post-mortem investigations. In this single-centre (Leicester, UK), prospective, controlled study, we selected cases of natural and non-suspicious unnatural death referred to Her Majesty's (HM) Coroners. We excluded cases younger than 18 years, known to have had a transmittable disease, or who weighed more than 125 kg. Each case was assessed by PMCTA, followed by autopsy. Pathologists were masked to the PMCTA findings, unless a potential risk was shown. The primary endpoint was the accuracy of the cause of death diagnosis from PMCTA against a gold standard of autopsy findings, modified by PMCTA findings only if additional substantially incontrovertible findings were identified. Between Jan 20, 2010, and Sept 13, 2012, we selected 241 cases, for which PMCTA was successful in 204 (85%). Seven cases were excluded from the analysis because of procedural unmasking or no autopsy data, as were 24 cases with a clear diagnosis of traumatic death before investigation; 210 cases were included. In 40 (19%) cases, predictable toxicology or histology testing accessible by PMCT informed the result. PMCTA provided a cause of death in 193 (92%) cases. A major discrepancy with the gold standard was noted in 12 (6%) cases identified by PMCTA, and in nine (5%) cases identified by autopsy (because of specific findings on PMCTA). The frequency of autopsy and PMCTA discrepancies were not significantly different (p=0·65 for major discrepancies and p=0·21 for minor discrepancies). Cause of death given by PMCTA did not overlook clinically significant trauma, occupational lung disease, or reportable disease, and did not significantly affect

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

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    Koffi Alain K

    2011-08-01

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

  12. Analysis of the symmetric configuration of the circle of Willis in a series of autopsied corpses

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    Stojanović Nebojša

    2015-01-01

    Full Text Available Introduction. The forming of the blood vessels network configuration at the base of the brain and interconnecting of blood vessels during the embryogenesis is directly related to the phylogenetic development of the brain and brain structures. A blood vessel configuration at the brain base, in the form of a ring or a hexagon, stands in direct relation to the perfusion needs of certain parts of the brain during its primary differentiation. The aim of this paper was to determine the incidence of certain blood vessel configurations at the base of the brain and understanding their symmetry or asymmetry. Methods. Analysis of the blood vessels at the base of the brain was performed on the autopsied subjects. The object of observation was the anterior segment of the circle of Willis consisting of C1- a. carotis interna (ICA, above a. communicaus posterior (PcoA, the segment A1 a. cerebri anterior (ACA from a. carotis interna bifurcation to the a. communicans anterior (AcoA and a. communicans anterior itself, as well as the posterior segment consisting of PcoA and the segment P1 - a. cerebri posterior (PCA from the a. basilaris bifurcation to the PcoA. For the purpose of grouping the findings, the four basic configuration types of the circle of Willis were identified based on its symmetry or asymmetry. Type-A (symmetric circle of Willis, type-B (asymmetric circle of Willis' due to the unilateral hypoplastic A1-ACA; type-C (symmetric circle of Willis with bilateral symmetric changes on PcoA and type-D (asymmetric circle of Willis due to the asymmetric changes on PcoA. Results. Autopsy was performed on 56 corpses. A total of 41 (73.2% subjects were recorded with a symmetric configuration of the circle of Willis', of which 27 (48.2% subjects had type A and 14 (25% type C. The asymmetric configuration was present in 15 (26.8% subjects, of whom 9 (16% had type B and 6 (10.8% type D. The symmetric Willis group (73.2% did not have a homogeneous finding that

  13. Developing a Social Autopsy Tool for Dengue Mortality: A Pilot Study

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    Arauz, María José; Ridde, Valéry; Hernández, Libia Milena; Charris, Yaneth; Carabali, Mabel; Villar, Luis Ángel

    2015-01-01

    Background Dengue fever is a public health problem in the tropical and sub-tropical world. Dengue cases have grown dramatically in recent years as well as dengue mortality. Colombia has experienced periodic dengue outbreaks with numerous dengue related-deaths, where the Santander department has been particularly affected. Although social determinants of health (SDH) shape health outcomes, including mortality, it is not yet understood how these affect dengue mortality. The aim of this pilot study was to develop and pre-test a social autopsy (SA) tool for dengue mortality. Methods and Findings The tool was developed and pre-tested in three steps. First, dengue fatal cases and ‘near misses’ (those who recovered from dengue complications) definitions were elaborated. Second, a conceptual framework on determinants of dengue mortality was developed to guide the construction of the tool. Lastly, the tool was designed and pre-tested among three relatives of fatal cases and six near misses in 2013 in the metropolitan zone of Bucaramanga. The tool turned out to be practical in the context of dengue mortality in Colombia after some modifications. The tool aims to study the social, individual, and health systems determinants of dengue mortality. The tool is focused on studying the socioeconomic position and the intermediary SDH rather than the socioeconomic and political context. Conclusions The SA tool is based on the scientific literature, a validated conceptual framework, researchers’ and health professionals’ expertise, and a pilot study. It is the first time that a SA tool has been created for the dengue mortality context. Our work furthers the study on SDH and how these are applied to neglected tropical diseases, like dengue. This tool could be integrated in surveillance systems to provide complementary information on the modifiable and avoidable death-related factors and therefore, be able to formulate interventions for dengue mortality reduction. PMID:25658485

  14. Characterizing measles transmission in India: a dynamic modeling study using verbal autopsy data.

    Science.gov (United States)

    Verguet, Stéphane; Jones, Edward O; Johri, Mira; Morris, Shaun K; Suraweera, Wilson; Gauvreau, Cindy L; Jha, Prabhat; Jit, Mark

    2017-08-10

    Decreasing trends in measles mortality have been reported in recent years. However, such estimates of measles mortality have depended heavily on assumed regional measles case fatality risks (CFRs) and made little use of mortality data from low- and middle-income countries in general and India, the country with the highest measles burden globally, in particular. We constructed a dynamic model of measles transmission in India with parameters that were empirically inferred using spectral analysis from a time series of measles mortality extracted from the Million Death Study, an ongoing longitudinal study recording deaths across 2.4 million Indian households and attributing causes of death using verbal autopsy. The model was then used to estimate the measles CFR, the number of measles deaths, and the impact of vaccination in 2000-2015 among under-five children in India and in the states of Bihar and Uttar Pradesh (UP), two states with large populations and the highest numbers of measles deaths in India. We obtained the following estimated CFRs among under-five children for the year 2005: 0.63% (95% confidence interval (CI): 0.40-1.00%) for India as a whole, 0.62% (0.38-1.00%) for Bihar, and 1.19% (0.80-1.75%) for UP. During 2000-2015, we estimated that 607,000 (95% CI: 383,000-958,000) under-five deaths attributed to measles occurred in India as a whole. If no routine vaccination or supplemental immunization activities had occurred from 2000 to 2015, an additional 1.6 (1.0-2.6) million deaths for under-five children would have occurred across India. We developed a data- and model-driven estimation of the historical measles dynamics, CFR, and vaccination impact in India, extracting the periodicity of epidemics using spectral and coherence analysis, which allowed us to infer key parameters driving measles transmission dynamics and mortality.

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

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    Muramatsu Masaaki

    2008-08-01

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

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

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

    2013-01-01

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

  17. Differential distribution patterns in cerebellar irrigation. A study with autopsy material

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    Hernando Yesid Estupiñan

    2018-02-01

    Full Text Available Aim: The aim of this investigation was characterize morphologically the cerebellar artery and its branches in a specimen of autopsy material. Methods: This descriptive cross-sectional study evaluated the anatomical characteristics of the cerebellar arteries and their branches in 93 brain stem and cerebellum blocks obtained from fresh cadavers. The specimens were perfused bilaterally channeling the proximal segments of the internal carotid and vertebral arteries with a semi-synthetic resin (Palatal GP40L 85%; styrene 15% impregnated with mineral red dye. We evaluated the distribution patterns of the cerebellar artery and its branches. Results: The calibers of the superior cerebellar artery (SCA, anterior inferior cerebellar artery (AICA and posterior inferior cerebellar artery (PICA were 1.46 ± 0.2 mm, 1.02 ± 0.35 mm and 1.45 ± 0.37 mm, respectively. Agenesis of the SCA was observed in six specimens (3.2%, AICA in 30 (16.1%, and PICA in 14 (7.5% specimens. Usual irrigation was observed in 44 (47.3% cerebellar blocks, whereas 49 (52.7% specimens showed irrigation variants, 23 (46.9% of which appeared bilaterally. The dominant distribution of the cerebellar arteries corresponded to SCA in 9 (12.5% cases, AICA in 46 (63.9% and PICA in 7 (9.7% specimens; shared dominance was found in 10 (13.9% specimens. Conclusion: The high variability of the cerebellar arteries observed in the present study is consistent with previous reports. The diverse anatomic expressions of the cerebellar arteries were typified in relation to their dominance and territories irrigated, useful for the diagnosis and clinical-surgical management of the cerebellum blood supply.

  18. What caused the 2012 dengue outbreak in Pucallpa, Peru? A socio-ecological autopsy.

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    Charette, Margot; Berrang-Ford, Lea; Llanos-Cuentas, Elmer Alejandro; Cárcamo, César; Kulkarni, Manisha

    2017-02-01

    Dengue is highly endemic in Peru, with increases in transmission particularly since vector re-infestation of the country in the 1980s. Pucallpa, the second largest city in the Peruvian Amazon, experienced a large outbreak in 2012 that caused more than 10,000 cases and 13 deaths. To date, there has been limited research on dengue in the Peruvian Amazon outside of Iquitos, and no published review or critical analysis of the 2012 Pucallpa dengue outbreak. This study describes the incidence, surveillance, and control of dengue in Ucayali to understand the factors that contributed to the 2012 Pucallpa outbreak. We employed a socio-ecological autopsy approach to consider distal and proximal contributing factors, drawing on existing literature and interviews with key personnel involved in dengue control, surveillance and treatment in Ucayali. Spatio-temporal analysis showed that relative risk of dengue was higher in the northern districts of Calleria (RR = 2.18), Manantay (RR = 1.49) and Yarinacocha (RR = 1.25) compared to all other districts between 2004 and 2014. The seasonal occurrence of the 2012 outbreak is consistent with typical seasonal patterns for dengue incidence in the region. Our assessment suggests that the outbreak was proximally triggered by the introduction of a new virus serotype (DENV-2 Asian/America) to the region. Increased travel, rapid urbanization, and inadequate water management facilitated the potential for virus spread and transmission, both within Pucallpa and regionally. These triggers occurred within the context of failures in surveillance and control programming, including underfunded and ad hoc vector control. These findings have implications for future prevention and control of dengue in Ucayali as new diseases such as chikungunya and Zika threaten the region. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Factors Associated with Pneumonia-caused Death in Older Adults with Autopsy-confirmed Dementia.

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    Manabe, Toshie; Mizukami, Katsuyoshi; Akatsu, Hiroyasu; Hashizume, Yoshio; Ohkubo, Takayoshi; Kudo, Koichiro; Hizawa, Nobuyuki

    2017-01-01

    Objective A better understanding of risk factors for pneumonia-caused death may help to improve the clinical management of dementia. Methods A retrospective observational study was conducted by reviewing the medical charts and autopsy reports of 204 patients who were admitted to hospital, underwent a post-mortem examination, and who were neuropathologically diagnosed with dementia. The risk factors for pneumonia-caused death were examined both as underlying and immediate causes of death using logistic regression models. Results A high frequency of pneumonia-caused death was observed both in underlying- (37.3%) and immediate- (44.1%) cause of death, but varied according to the subtypes of dementia. The factors related to pneumonia-caused death (underlying) were subtypes of dementia; Alzheimer's disease (odds ratio [OR], 2.891; 95% confidence interval [CI], 1.459-5.730); argyrophilic grain disease (OR, 3.148; 95% CI, 0.937-10.577); and progressive supranuclear palsy (OR, 34.921; 95% CI, 3.826-318.775), dysphagia (OR, 2.045; 95% CI, 1.047-3.994), diabetes mellitus (OR, 3.084; 95% CI, 1.180-8.061) and conversely related with heart failure (OR, 0.149; 95% CI, 0.026-0.861). Factors relating to pneumonia-caused death (immediate) were incidence of pneumonia during hospitalizations (OR, 32.579; 95%CI, 4.308-246.370), gender-male (OR, 2.060; 95% CI, 1.098-3.864), and conversely related with malignant neoplasm (OR, 0.220; 95% CI, 0.058-0.840). Conclusion The different factors relating to the pneumonia-caused death were evaluated depending on whether pneumonia was the underlying- or immediate-cause of death. Strengthening clinical management on dysphagia and diabetes mellitus, and preventing incidence of pneumonia during hospitalization appear to be the important for the terminal stage of hospitalized patients with dementia.

  20. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.