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Sample records for brain death

  1. Diagnosis of brain death

    Directory of Open Access Journals (Sweden)

    Calixto Machado

    2010-06-01

    Full Text Available Brain death (BD should be understood as the ultimate clinical expression of a brain catastrophe characterized by a complete and irreversible neurological stoppage, recognized by irreversible coma, absent brainstem reflexes, and apnea. The most common pattern is manifested by an elevation of intracranial pressure to a point beyond the mean arterial pressure, and hence cerebral perfusion pressure falls and, as a result, no net cerebral blood flow is present, in due course leading to permanent cytotoxic injury of the intracranial neuronal tissue. A second mechanism is an intrinsic injury affecting the nervous tissue at a cellular level which, if extensive and unremitting, can also lead to BD. We review here the methodology of diagnosing death, based on finding any of the signs of death. The irreversible loss of cardio-circulatory and respiratory functions can cause death only when ischemia and anoxia are prolonged enough to produce an irreversible destruction of the brain. The sign of such loss of brain functions, that is to say BD diagnosis, is fully reviewed.

  2. Whole-brain death reconsidered.

    OpenAIRE

    Browne, A.

    1983-01-01

    The author, a philosopher, suggests that the concept of death should be left as it is 'in its present indeterminate state', and that we ought to reject attempts to define death in terms of whole-brain death or any other type of brain death, including cerebral death and 'irreversible coma'. Instead of 'fiddling with the definition of death' clear rules should be established specifying 'what can be appropriately done to whom when'.

  3. Scintigraphic evaluation of brain death

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    Park, C. H.; Bai, M. S.; Cho, K. K.; Kim, S. J.; Yoon, S. N.; Cho, C. W. [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1997-07-01

    A law recognizing brain death is a life saving legal measure in patients suffering from badly diseased organs such as kidney, liver, heart, and lung. Such law is being discussed for legalization at the Korean National Assembly. There are various criteria used for brain death in western world and brain scintiscan is one of them. However, the scintiscan is not considered in establishing brain death in the draft of the law. The purpose of this report is to spread this technique in nuclear medicine society as well as in other medical societies. We evaluated 7 patients with clinical suspicion of brain death by various causes. The patient's age ranged from 5 to 39 years. We used 5-20mCi {sup 99m}Tc-HMPAO (d.1-hexamethyl propylene amine oxime) or ECD (Ethyl Cysteinate Dimer), lipophilic agents that cross BBB (blood brain barrier). A dynamic study followed by static or SPECT (single photon emission tomography) was performed. Interpretive criteria used for brain death were 1) no intracranial circulation 2) no brain uptake. The second criteria is heavily used. Five of 7 patients were scintigraphically brain dead and the remaining 2 had some brain uptake excluding the diagnosis of scintigraphic brain death. In conclusion, cerebral perfusion study using a lipophilic brain tracer offers a noninvasive, rapid, easy, accurate and reliable mean in the diagnosis of brain death. We believe that this modality should be included in the criteria of brain death in the draft of the proposed Korean law.

  4. Brain Death,Concept and Criteria

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The concept of brain death originated in France. In 1959, the French scholars P. Mollaret and M. Goulon proposed the concept of "coma de- passe" or "brain death" for the first time and reported 23 cases with such symptoms. The first guidelines (the Harvard criteria) for diagnosing brain death was established in 1968, defining brain death

  5. Clinical and ethical perspectives on brain death

    OpenAIRE

    Nair-Collins, Michael

    2015-01-01

    Michael Nair-Collins Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA Abstract: Death determined by neurological criteria, or brain death, is an accepted legal standard for death throughout much of the world. However, brain death has also been a source of controversy ever since its inception, and recently it has been subjected to increased scrutiny, both in academia and in the public domain. The purpose of this paper is to provide an...

  6. [Brain death: biological and ethical aspects].

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    Roczeń, R; Bohatyrewicz, R

    2001-01-01

    The article presents briefly historical development of death criteria from the modern times to the present. The criteria which are used for identification and diagnosing death on the base of respiratory and circulatory death definition are described. This work underlines the inadequacy of the definition of the brain death in relation to patients with persistent vegetative state and in relation to anencephalic newborns. The author describes the pathology and clinical and laboratory evidence of the brain stem death, which gave the possibility to justify the thesis that in case of the brain stem death ontological arguments are sufficient for diagnosing the death of a human being. The attention of the ethic of the life sanctity (on the base of halachic's law) and its opposing influence on the evolution of the medical definition of death has been paid. The recognition of the brain as the death of an individual is a cultural shock, which from scientific point of view changed the ways of thinking, almost immediately but did not in the awareness of the society. The work also underlies the fact that utilitarian argumentation can not be a criterion for making a decision concerning the life of an individual.

  7. Notification of brain death in the hospital

    Directory of Open Access Journals (Sweden)

    Bruna Soares de Jesus Souza

    2015-05-01

    Full Text Available Objective: to identifying brain death in the hospital. Methods: it is a cross sectional and quantitative study which analyzed secondary data extracted from the notified brain death registers and from the medical records of the eligible patients. The data were processed and analyzed through descriptive statistics and comparisons. Results: of the 64 cases of notifications, the male gender predominated (67.2% within the age range from 40 to 59 years (64.1%. There was a greater proportion (71.8% of causes of death related to Hemorrhagic Cerebral Vascular Accident and Traumatic Brain Injury caused by motorcycle accident, showing statistically significant difference (p<0.05 regarding the gender, age and location. Conclusion: the Hemorrhagic Cerebral Vascular Accident was the most prevalent cause of notification of brain death and the Intensive Therapy Unit was the most notified venue.

  8. Notification of brain death in the hospital

    OpenAIRE

    Bruna Soares de Jesus Souza; Gerlene Grudka Lira; Rachel Mola

    2015-01-01

    Objective: to identifying brain death in the hospital. Methods: it is a cross sectional and quantitative study which analyzed secondary data extracted from the notified brain death registers and from the medical records of the eligible patients. The data were processed and analyzed through descriptive statistics and comparisons. Results: of the 64 cases of notifications, the male gender predominated (67.2%) within the age range from 40 to 59 years (64.1%). There was a greater proportion (71.8...

  9. Magnetic resonance imaging of brain death

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    Lee, D.H.; Nathanson, J.A.; Fox, A.J.; Pelz, D.M.; Lownie, S.P.

    1995-06-01

    In order to demonstrate the magnetic resonance imaging (MRI) appearance of the brain in patients with clinical brain death, high-field MRI was performed on 5 patients using conventional T1-weighted and T2-weighted imaging. The study showed MRI exhibited similar features for all of the patients, features which were not found in MRI of comatose patients who were not clinically brain dead. It was stated that up to now the most important limitation in MRI of patients with suspected brain death has been the extreme difficulty of moving them out of the intensive care setting. If this problem can be overcome, and it appears possible with with the advent of MRI-compatible ventilators and noninvasive monitoring, MRI could become an excellent alternative for confirming clinical diagnosis of brain death for such patients. 15 refs., 3 figs.

  10. A Response to the Legitimacy of Brain Death in Islam.

    Science.gov (United States)

    Rady, Mohamed Y; Verheijde, Joseph L

    2016-08-01

    Brain death is a novel construct of death for the procurement of transplantable organs. Many authoritative Islamic organizations and governments have endorsed brain death as true death for organ donation. Many commentators have reiterated the misconception that the Quranic text does not define death. We respond by clarifying: (1) the Quran does define death as biologic disintegration and clearly distinguishes it from the dying process, (2) brain death belongs scientifically within the spectrum of neurologic disorders of consciousness and should not be confused with death, and (3) religious and legal discord about brain death has grown in jurisdictions worldwide. We urge for public transparency and truthfulness about brain death and the accommodation and respect of religious objection to the determination of death by neurologic criteria.

  11. A Response to the Legitimacy of Brain Death in Islam.

    Science.gov (United States)

    Rady, Mohamed Y; Verheijde, Joseph L

    2016-08-01

    Brain death is a novel construct of death for the procurement of transplantable organs. Many authoritative Islamic organizations and governments have endorsed brain death as true death for organ donation. Many commentators have reiterated the misconception that the Quranic text does not define death. We respond by clarifying: (1) the Quran does define death as biologic disintegration and clearly distinguishes it from the dying process, (2) brain death belongs scientifically within the spectrum of neurologic disorders of consciousness and should not be confused with death, and (3) religious and legal discord about brain death has grown in jurisdictions worldwide. We urge for public transparency and truthfulness about brain death and the accommodation and respect of religious objection to the determination of death by neurologic criteria. PMID:27010462

  12. Approach of Complex Networks for the Determination of Brain Death

    Institute of Scientific and Technical Information of China (English)

    SUN Wei-Gang; CAO Jian-Ting; WANG Ru-Bin

    2011-01-01

    In clinical practice, brain death is the irreversible end of all brain activity. Compared to current statistical methods for the determination of brain death, we focus on the approach of complex networks for real-world electroencephalography in its determination. Brain functional networks constructed by correlation analysis are derived, and statistical network quantities used for distinguishing the patients in coma or brain death state, such as average strength, clustering coefficient and average path length, are calculated. Numerical results show that the values of network quantities of patients in coma state are larger than those of patients in brain death state. Our Sndings might provide valuable insights on the determination of brain death.%@@ In clinical practice, brain death is the irreversible end of all brain activity.Compared to current statistical methods for the determination of brain death, we focus on the approach of complex networks for real-world electroencephalography in its determination.Brain functional networks constructed by correlation analysis axe derived, and statistical network quantities used for distinguishing the patients in coma or brain death state, such as average strength, clustering coefficient and average path length, are calculated.Numerical results show that the values of network quantities of patients in coma state are larger than those of patients in brain death state.Our findings might provide valuable insights on the determination of brain death.

  13. Brain death in neonates: a case report

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    Georgios Mitsiakos

    2014-06-01

    Full Text Available Brain death (BD is the permanent and complete loss of cerebral and brainstem function. It is relatively uncommon in newborns with its percentage among deaths being 1-6.3%. BD leads to debate for medical, ethical and philosophical issues. It is a challenging condition in neonatal intensive care units (NICUs since difficulties for BD diagnosis in neonates and ever more so in preterm neonates do arise. Revised guidelines for BD diagnosis definition include history with known etiology, clinical examination, apnea testing and neurological evaluation often assisted by ancillary tests. We present the case of a near term female baby that was born with brain death due to hypoxic ischemic encephalopathy. We conclude that BD in newborns is a challenge to NICUs and there is a need for establishing and implementing new guidelines and checklists on national basis. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  14. Temperature and brain death determination: need for updated criteria

    Directory of Open Access Journals (Sweden)

    Michael A. Meyer

    2010-08-01

    Full Text Available For an excellent review on the diagnosis of brain death, the interested reader is directed to the review of Machado appearing in this journal; the author reviews all aspects of brain death and cites nine different references where the minimum temperature for brain death exams appear to have been at least 32°C. Given the new data listed above, it is clearly time for a reconsideration of the how we approach the exam for diagnosis of brain death – normal or near normal temperatures of 36°C and above are very reasonable starting points.

  15. Assessment of brain death in the neurocritical care unit.

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    Hwang, David Y; Gilmore, Emily J; Greer, David M

    2013-07-01

    This article reviews current guidelines for death by neurologic criteria and addresses topics relevant to the determination of brain death in the intensive care unit. The history of brain death as a concept leads into a discussion of the evolution of practice parameters, focusing on the most recent 2010 update from the American Academy of Neurology and the practice variability that exists worldwide. Proper transition from brain death determination to possible organ donation is reviewed. This review concludes with a discussion regarding ethical and religious concerns and suggestions on how families of patients who may be brain dead might be optimally approached. PMID:23809039

  16. Confounding factors in diagnosing brain death: a case report

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    Login Ivan S

    2002-06-01

    Full Text Available Abstract Background Brain death is strictly defined medically and legally. This diagnosis depends on three cardinal neurological features: coma, absent brainstem reflexes, and apnea. The diagnosis can only be made, however, in the absence of intoxication, hypothermia, or certain medical illnesses. Case presentation A patient with severe hypoxic-ischemic brain injury met the three cardinal neurological features of brain death but concurrent profound hypothyroidism precluded the diagnosis. Our clinical and ethical decisions were further challenged by another facet of this complex case. Although her brain damage indicated a hopeless prognosis, we could not discontinue care based on futility because the only known surrogate was mentally retarded and unable to participate in medical planning. Conclusion The presence of certain medical conditions prohibits a diagnosis of brain death, which is a medicolegal diagnosis of death, not a prediction or forecast of future outcome. While prognostication is important in deciding to withdraw care, it is not a component in diagnosing brain death.

  17. Brain death diagnosis in misleading conditions.

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    de Tourtchaninoff, M; Hantson, P; Mahieu, P; Guérit, J M

    1999-07-01

    The necessity of defining brain death (BD) arose from technological development in medical science. The definition of this concept had practical consequences and opened the way to organ donation from BD patients. Nowadays, the imbalance between the number of organs available for transplantation and the size of the demand is becoming critical. In most laboratories, a BD diagnosis is made according to precise criteria and in a well-defined process. BD diagnosis should be improved, not only to assure the safety and to preserve the human dignity of the patient, but also in order to increase the rate of organ donation. By analysing some epidemiological parameters in BD diagnosis and organ donation, it appears that BD diagnoses can be made more often and more rapidly if one has a reliable, accurate, and safe confirmatory test, especially under misleading conditions (hypothermia, drugs, metabolic disturbances). In our experience, the use of multimodality evoked potentials (MEPs) to confirm a BD diagnosis has many advantages: MEPs can be rapidly performed at the patient's bedside, assess the brain stem as well as the cerebral cortex, and are innocuous for the patient. Moreover, their insensitivity to the aforementioned misleading factors is sufficient to distinguish BD from clinical and EEG states that mimic BD. They give an immediate diagnosis, and no delay is required in BD confirmation if there is sufficient cause to account for BD. MEPs are a safe, accurate, and reliable tool for confirming a BD diagnosis, and their use can improve the organ donation rate while preserving the safety of the patient. PMID:10627891

  18. Brain death and care of the organ donor

    OpenAIRE

    Lakshmi Kumar

    2016-01-01

    Brain death has specific implications for organ donation with the potential for saving several lives. Awareness on maintenance of the brain dead has increased over the last decade with the progress in the field of transplant. The diagnosis of brain death is clinical and can be confirmed by apnea testing. Ancillary tests can be considered when the apnea test cannot be completed or is inconclusive. Reflexes of spinal origin may be present and should not be confused against the diagnosis of brai...

  19. Diagnosis of brain death: confirmatory tests after clinical test

    Institute of Scientific and Technical Information of China (English)

    Su Yingying; Yang Qinglin; Liu Gang; Zhang Yan; Ye Hong; Gao Daiquan; Zhang Yunzhou

    2014-01-01

    Background The brain death confirmation tests occupy a different position in each country's diagnostic criteria (or guideline); the choices of tests are also different.China brain death criteria include clinical judgment and confirmation tests.This study aimed to confirm the preferred confirmatory test and complementary confirmatory tests.Methods We did a clinical brain death determination on deep coma patients,and then divided them into brain death group and non-brain death group.According to the Chinese standards for determining brain death,both the groups accepted confirmatory tests including electroencephalograph (EEG),somatosensory evoked potentials (SEP),and transcranial Doppler (TCD).The sensitivity,specificity,false positive rate,and false negative rate were calculated to evaluate the accuracy of the confirmatory tests.Results Among the 131 cases of patients,103 patients met the clinical criteria of brain death.Respiratory arrest provocation test was performed on 44 cases and 32 cases (73%) successfully completed and confirmed that they have no spontaneous breathing.Of the three confirmation tests,EEG had the highest completion rate (98%) and good sensitivity (83%) and specificity (97%); TCD had followed completion rate (54%) and not good sensitivity (73%) and specificity (75%); SEP had the lowest completion rate (49%),good sensitivity (100%),and not good specificity (78%).After the combination of SEP or TCD with EEG,the specificity can increase to 100%.Conclusions The completion rate of respiratory arrest provocation test remains a problem in the clinical diagnosis of brain death.If the test cannot be completed,whether to increase a confirmatory test is debatable.SEP had an ideal sensitivity,and the specificity will reach 100% after combining with TCD or EEG.When a confirmed test was uncertain,we suggest increasing another confirmatory test.

  20. Outcome of kidney transplantation between controlled cardiac death and brain death donors: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Ming Yingzi; Shao Mingjie; Tian Tingting; She Xingguo; Liu Hong; Ye Shaojun; Ye Qifa

    2014-01-01

    Background Our goal was to evaluate the outcomes of kidney transplants from controlled cardiac death donors compared with brain death donors by conducting a meta-analysis of cohort studies.Methods The PubMed database and EMBASE were searched from January 1980 to July 2013 to identify studies that met pre-stated inclusion criteria.Reference lists of retrieved articles were also reviewed.Two authors independently extracted information on the designs of the studies,the characteristics of the study participants,and outcome assessments.Results Nine cohort studies involving 84 398 participants were included in this meta-analysis; 3 014 received kidneys from controlled cardiac death donors and 80 684 from brain death donors.Warm ischemia time was significantly longer for the controlled cardiac death donor group.The incidence of delayed graft function was 2.74 times (P <0.001) greater in the controlled cardiac death donor group.The results are in favor of the brain death donor group on short-term patient and graft survival while this difference became nonsignificant at mid-term and long term.Sensitivity analysis yielded similar results.No evidence of publication bias was observed.Conclusion This meta-analysis of retrospective cohort studies suggests that the outcome after controlled cardiac death donors is comparable with that obtained using kidneys from brain death donors.

  1. Similar liver transplantation survival with selected cardiac death donors and brain death donors

    NARCIS (Netherlands)

    Dubbeld, J.; Hoekstra, H.; Farid, W.; Ringers, J.; Porte, R. J.; Metselaar, H. J.; Baranski, A. G.; Kazemier, G.; van den Bere, A. P.; van Hoek, B.

    2010-01-01

    Background: The outcome of orthotopic liver transplantation (OLT) with controlled graft donation after cardiac death (DCD) is usually inferior to that with graft donation after brain death (DBD). This study compared outcomes from OLT with DBD versus controlled DCD donors with predefined restrictive

  2. CT Angiography in the Diagnosis of Brain Death

    International Nuclear Information System (INIS)

    Summary Brain death is defined as the irreversible cessation of functioning of the entire brain, including the brainstem. Brain death is principally established using clinical criteria including coma, absence of brainstem reflexes and loss of central drive to breathe assessed with apnea test. In situations in which clinical testing cannot be performed or when uncertainty exists about the reliability of its parts due to confounding conditions ancillary tests (i.a. imaging studies) may be useful. The objective of ancillary tests in the diagnosis of brain death is to demonstrate the absence of cerebral electrical activity (EEG and evoked potentials) or cerebral circulatory arrest. In clinical practice catheter cerebral angiography, perfusion scintigraphy, transcranial Doppler sonography, CT angiography and MR angiography are used. Other methods, like perfusion CT, xenon CT, MR spectroscopy, diffusion weighted MRI and functional MRI are being studied as potentially useful in the diagnosis of brain death. CT angiography has recently attracted attention as a promising alternative to catheter angiography – a reference test in the diagnosis of brain death. Since 1998 several major studies were published and national guidelines were introduced in several countries (e.g. in France, Austria, Switzerland, the Netherlands and Canada). This paper reviews technique, characteristic findings and criteria for the diagnosis of cerebral circulatory arrest in CT angiography

  3. Imaging Findings of Brain Death on 3-Tesla MRI

    International Nuclear Information System (INIS)

    To demonstrate the usefulness of 3-tesla (3T) magnetic resonance imaging (MRI) including T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), time-of-flight (TOF) magnetic resonance angiography (MRA), T2*-weighted gradient recalled echo (GRE), and susceptibility weighted imaging (SWI) in diagnosing brain death. Magnetic resonance imaging findings for 10 patients with clinically verified brain death (group I) and seven patients with comatose or stuporous mentality who did not meet the clinical criteria of brain death (group II) were retrospectively reviewed. Tonsilar herniation and loss of intraarterial flow signal voids (LIFSV) on T2WI were highly sensitive and specific findings for the diagnosis of brain death (p < 0.001 and < 0.001, respectively). DWI, TOF-MRA, and GRE findings were statistically different between the two groups (p = 0.015, 0.029, and 0.003, respectively). However, cortical high signal intensities in T2WI and SWI findings were not statistically different between the two group (p = 0.412 and 1.0, respectively). T2-weighted imaging, DWI, and MRA using 3T MRI may be useful for diagnosing brain death. However, SWI findings are not specific due to high false positive findings.

  4. Imaging Findings of Brain Death on 3-Tesla MRI

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    Sohn, Chul Ho [Dept. of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Lee, Hwa Pyung [Dept. of Occupational and Environmental Medicine, CHA Gumi Medical Center, CHA University, Gumi (Korea, Republic of); Park, Jun Beom [Dept. of Radiology, Korean Armed Force Daejeon Hospital, Daejeon (Korea, Republic of); Chang, Hyuk Won; Kim, Easlmaan; Park, Ui Jun; Kim, Hyoung Tae [Keimyung University College of Medicine, Dongsan Medical Center, Daegu (Korea, Republic of); Kim, Eun Hee [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Ku, Jeong Hun [Dept. of Biomedical Engineering, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2012-09-15

    To demonstrate the usefulness of 3-tesla (3T) magnetic resonance imaging (MRI) including T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), time-of-flight (TOF) magnetic resonance angiography (MRA), T2*-weighted gradient recalled echo (GRE), and susceptibility weighted imaging (SWI) in diagnosing brain death. Magnetic resonance imaging findings for 10 patients with clinically verified brain death (group I) and seven patients with comatose or stuporous mentality who did not meet the clinical criteria of brain death (group II) were retrospectively reviewed. Tonsilar herniation and loss of intraarterial flow signal voids (LIFSV) on T2WI were highly sensitive and specific findings for the diagnosis of brain death (p < 0.001 and < 0.001, respectively). DWI, TOF-MRA, and GRE findings were statistically different between the two groups (p = 0.015, 0.029, and 0.003, respectively). However, cortical high signal intensities in T2WI and SWI findings were not statistically different between the two group (p = 0.412 and 1.0, respectively). T2-weighted imaging, DWI, and MRA using 3T MRI may be useful for diagnosing brain death. However, SWI findings are not specific due to high false positive findings.

  5. Some historical notes on the diagnosis of death--the emergence of the brain death concept.

    Science.gov (United States)

    Kinnaert, P

    2009-01-01

    This paper demonstrates that discussions about the diagnosis of death and the meaning of states of suspended animation existed long before the publication of the Harvard criteria in 1968. The surgeons who started retrieving kidneys from heart beating cadavers have been accused to redefine death in order to obtain high quality organs. In fact, they were not aware of modifying a definition. They did not view death as a philosophical concept but considered that it was a biological phenomenon of which brain death was merely a new expression resulting from the development of resuscitation and intensive care procedures. PMID:19943608

  6. Pitfalls in brain death diagnosis: a case report.

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    Ruess, Daniel; Rieger, Bernhard; Goldbrunner, Roland; Schlacke, Hans-Peter

    2013-05-01

    Although there are distinct guidelines in nearly all countries, a reliable secure assessment of brain death in cases with open head injury can be challenging. We present a case of a 32-year-old man with severe head injury after intracranial penetration of a grindstone fragment. As the injury led to destruction of nearly the whole greater wing of the right sphenoid bone and parts of the right orbit, the examination of brainstem reflexes and the confirmation of brain death was unfeasible. On day 2, all clinical criteria of brain death (coma, absence of brainstem reflexes, apnea) were fulfilled. In addition, there was an extinction of brainstem auditory (BAEP) and cerebral (N20) components of median nerve somatosensory evoked potentials, while electroencephalogram (EEG) activity was still present. In the following days, a persisting EEG activity was obtained. Thus, an irreversible loss of whole brain functions could not be proved. As the patient had agreed to organ donation in case of brain death several years ago, ancillary methods to test the cessation of cerebral blood flow were mandatory. However, in this patient these methods turned out either to be doubtful or unavailable. For example, values of transcranial Doppler ultrasonography are not reliable in cases with open head injury. Due to a progressive septic state, time was running out to get the radiopharmaceutical agent for a cerebral scintigraphy (delivery time about 7 days, as the radiopharmaceutical agent was not in stock). Referring to the actual German guidelines, we had no legitimating indication for a cerebral angiography. Finally, the patient died of sepsis. We discuss the widening of the German guidelines in assessing brain death with the fast and low-risk method of cerebral computed tomography-angiography (CTA) to confirm diagnosis of brain death. PMID:22899230

  7. 99mTc HM-PAO brain perfusion SPECT in brain death

    International Nuclear Information System (INIS)

    We have easily carried out and interpreted 99mTc HM-PAO SPECT in a consecutive series of 40 comatose patients with brain damage, without discontinuing therapy. Brain death was diagnosed in 7 patients, by recognising absence of brain perfusion, as shown by no intracranial radionuclide uptake. In patients in whom perfusion was seen on brain scans, HM-PAO SPECT improved assessment of the extent of injury, which in general was larger than suggested by CT. (orig.)

  8. Brain death in ICU patients: Clinical significance of endocrine changes

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2014-01-01

    Full Text Available Numerous studies have been carried out among patients admitted in intensive care unit (ICU having primary endocrine pathology, endocrine manifestations of systemic diseases or post-endocrine tissue surgery. However, minimal literary evidence is available highlighting the endocrine changes occurring during brain death in critically ill patients. A precise and timely diagnosis of brain death is required to convey the relatives about the prognosis and also to possibly plan for organ retrieval for transplantation purposes. The diagnosis of this condition as of today remains largely a clinical one. Brain death is associated with a multitude of endocrinological alterations which are yet to be completely unraveled and understood. Evaluating these endocrinological modifications lends us an added vista to add to the existing clinical parameters which might help us to confirm the diagnosis of brain death with a higher degree of precision. Moreover, since the efficacy of hormone replacement therapy to benefit in organ retrieval remains yet unproven, newer diagnostic modalities and research studies are definitely called for to strategize the optimal dosage and duration of such therapies.

  9. Gadolinium-enhanced magnetic resonance angiography in brain death

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    Luchtmann, M.; Beuing, O.; Skalej, M.; Kohl, J.; Serowy, S.; Bernarding, J.; Firsching, R.

    2014-01-01

    Confirmatory tests for the diagnosis of brain death in addition to clinical findings may shorten observation time required in some countries and may add certainty to the diagnosis under specific circumstances. The practicability of Gadolinium-enhanced magnetic resonance angiography to confirm cerebral circulatory arrest was assessed after the diagnosis of brain death in 15 patients using a 1.5 Tesla MRI scanner. In all 15 patients extracranial blood flow distal to the external carotid arteries was undisturbed. In 14 patients no contrast medium was noted within intracerebral vessels above the proximal level of the intracerebral arteries. In one patient more distal segments of the anterior and middle cerebral arteries (A3 and M3) were filled with contrast medium. Gadolinium-enhanced MRA may be considered conclusive evidence of cerebral circulatory arrest, when major intracranial vessels fail to fill with contrast medium while extracranial vessels show normal blood flow.

  10. An empirical EEG analysis in brain death diagnosis for adults.

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    Chen, Zhe; Cao, Jianting; Cao, Yang; Zhang, Yue; Gu, Fanji; Zhu, Guoxian; Hong, Zhen; Wang, Bin; Cichocki, Andrzej

    2008-09-01

    Electroencephalogram (EEG) is often used in the confirmatory test for brain death diagnosis in clinical practice. Because EEG recording and monitoring is relatively safe for the patients in deep coma, it is believed to be valuable for either reducing the risk of brain death diagnosis (while comparing other tests such as the apnea) or preventing mistaken diagnosis. The objective of this paper is to study several statistical methods for quantitative EEG analysis in order to help bedside or ambulatory monitoring or diagnosis. We apply signal processing and quantitative statistical analysis for the EEG recordings of 32 adult patients. For EEG signal processing, independent component analysis (ICA) was applied to separate the independent source components, followed by Fourier and time-frequency analysis. For quantitative EEG analysis, we apply several statistical complexity measures to the EEG signals and evaluate the differences between two groups of patients: the subjects in deep coma, and the subjects who were categorized as brain death. We report statistically significant differences of quantitative statistics with real-life EEG recordings in such a clinical study, and we also present interpretation and discussions on the preliminary experimental results.

  11. Death Associated Protein Kinases: Molecular Structure and Brain Injury

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    Claire Thornton

    2013-07-01

    Full Text Available Perinatal brain damage underlies an important share of motor and neurodevelopmental disabilities, such as cerebral palsy, cognitive impairment, visual dysfunction and epilepsy. Clinical, epidemiological, and experimental studies have revealed that factors such as inflammation, excitotoxicity and oxidative stress contribute considerably to both white and grey matter injury in the immature brain. A member of the death associated protein kinase (DAPk family, DAPk1, has been implicated in cerebral ischemic damage, whereby DAPk1 potentiates NMDA receptor-mediated excitotoxicity through interaction with the NR2BR subunit. DAPk1 also mediate a range of activities from autophagy, membrane blebbing and DNA fragmentation ultimately leading to cell death. DAPk mRNA levels are particularly highly expressed in the developing brain and thus, we hypothesize that DAPk1 may play a role in perinatal brain injury. In addition to reviewing current knowledge, we present new aspects of the molecular structure of DAPk domains, and relate these findings to interacting partners of DAPk1, DAPk-regulation in NMDA-induced cerebral injury and novel approaches to blocking the injurious effects of DAPk1.

  12. On asking the right questions: personal death vs. brain death in Japan.

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    Brannigan, M

    1998-01-01

    This article addresses methodological concerns encountered during the author's recent fellowship tenure at the University of Tokyo's School for International Health. His research addressed matters relating to Japanese views of personal death within the context of the relationship between self and body. He was also interested in learning more about the extent to which these same views influence issues in medical ethics, particularly the ongoing debate over brain death and heart transplantation, which, until June 1997, was legally prohibited. One critical component in methodology involved interviews and discussions with prominent scholars representing various disciplines. The key feature in these meetings centered around specific core questions. The author describes how these questions underwent significant modifications, and discusses how these methodological adjustments in effect reveal notions that are substantive and relevant to the research design pertaining to Japanese views of death, self, and embodiment.

  13. Brain Swelling and Death in Children with Cerebral Malaria

    Science.gov (United States)

    Seydel, Karl B.; Kampondeni, Samuel D.; Valim, Clarissa; Potchen, Michael J.; Milner, Danny A.; Muwalo, Francis W.; Birbeck, Gretchen L.; Bradley, William G.; Fox, Lindsay L.; Glover, Simon J.; Hammond, Colleen A.; Heyderman, Robert S.; Chilingulo, Cowles A.; Molyneux, Malcolm E.; Taylor, Terrie E.

    2015-01-01

    BACKGROUND Case fatality rates among African children with cerebral malaria remain in the range of 15 to 25%. The key pathogenetic processes and causes of death are unknown, but a combination of clinical observations and pathological findings suggests that increased brain volume leading to raised intracranial pressure may play a role. Magnetic resonance imaging (MRI) became available in Malawi in 2009, and we used it to investigate the role of brain swelling in the pathogenesis of fatal cerebral malaria in African children. METHODS We enrolled children who met a stringent definition of cerebral malaria (one that included the presence of retinopathy), characterized them in detail clinically, and obtained MRI scans on admission and daily thereafter while coma persisted. RESULTS Of 348 children admitted with cerebral malaria (as defined by the World Health Organization), 168 met the inclusion criteria, underwent all investigations, and were included in the analysis. A total of 25 children (15%) died, 21 of whom (84%) had evidence of severe brain swelling on MRI at admission. In contrast, evidence of severe brain swelling was seen on MRI in 39 of 143 survivors (27%). Serial MRI scans showed evidence of decreasing brain volume in the survivors who had had brain swelling initially. CONCLUSIONS Increased brain volume was seen in children who died from cerebral malaria but was uncommon in those who did not die from the disease, a finding that suggests that raised intracranial pressure may contribute to a fatal outcome. The natural history indicates that increased intracranial pressure is transient in survivors. (Funded by the National Institutes of Health and Wellcome Trust U.K.) PMID:25785970

  14. Danish ethics council rejects brain death as the criterion of death -- commentary 1: wanting it both ways.

    OpenAIRE

    Lamb, David

    1990-01-01

    In this commentary on the recommendations of the Danish Council of Ethics (DCE) concerning criteria for death it is argued that whilst the DCE is correct in stressing the cultural aspects of death, its adoption of cardiac-oriented criteria raises several problems. There are problems with its notion of a 'death process', which purportedly begins with brain death and ends with cessation of cardiac function, and there are serious problems regarding its commitment to a cardiac-oriented definitio...

  15. Brain Death and Human Organismal Integration: A Symposium on the Definition of Death.

    Science.gov (United States)

    Moschella, Melissa

    2016-06-01

    Does the ability of some brain dead bodies to maintain homeostasis with the help of artificial life support actually imply that those bodies are living human organisms? Or might it be possible that a brain dead body on life support is a mere collection of still-living cells, organs and tissues which can coordinate with one another, but which lack the genuine integration that is the hallmark of a unified human organism as a whole? To foster further study of these difficult and timely questions, a Symposium on the Definition of Death was held at The Catholic University of America in June 2014. The Symposium brought together scholars from a variety of disciplines-law, medicine, biology, philosophy and theology-who all share a commitment to the dead donor rule and to a biological definition of death, but who have differing opinions regarding the validity of neurological criteria for human death. The papers found in this special issue are among the fruits of this Symposium.

  16. Brain Death and Human Organismal Integration: A Symposium on the Definition of Death.

    Science.gov (United States)

    Moschella, Melissa

    2016-06-01

    Does the ability of some brain dead bodies to maintain homeostasis with the help of artificial life support actually imply that those bodies are living human organisms? Or might it be possible that a brain dead body on life support is a mere collection of still-living cells, organs and tissues which can coordinate with one another, but which lack the genuine integration that is the hallmark of a unified human organism as a whole? To foster further study of these difficult and timely questions, a Symposium on the Definition of Death was held at The Catholic University of America in June 2014. The Symposium brought together scholars from a variety of disciplines-law, medicine, biology, philosophy and theology-who all share a commitment to the dead donor rule and to a biological definition of death, but who have differing opinions regarding the validity of neurological criteria for human death. The papers found in this special issue are among the fruits of this Symposium. PMID:27107428

  17. Apnoea testing to confirm brain death in clinical practice.

    Science.gov (United States)

    van Donselaar, C A; Meerwaldt, J D; van Gijn, J

    1986-09-01

    In six patients an apnoea test was carried out to confirm brain death according to a protocol recommended in the USA. After ten minutes' apnoea the pCO2 did not reach the target value of 7.98 kPa (60 mm Hg) in any of these patients. This was caused by the low initial value and the slow increase of the pCO2. Moreover, we could not confirm the belief that the necessary duration of the apnoea test can be predicted by assuming a rise of the pCO2 of 0.33 kPa (2.5 mm Hg) per minute.

  18. Apnoea testing to confirm brain death in clinical practice.

    Science.gov (United States)

    van Donselaar, C A; Meerwaldt, J D; van Gijn, J

    1986-01-01

    In six patients an apnoea test was carried out to confirm brain death according to a protocol recommended in the USA. After ten minutes' apnoea the pCO2 did not reach the target value of 7.98 kPa (60 mm Hg) in any of these patients. This was caused by the low initial value and the slow increase of the pCO2. Moreover, we could not confirm the belief that the necessary duration of the apnoea test can be predicted by assuming a rise of the pCO2 of 0.33 kPa (2.5 mm Hg) per minute. PMID:3093640

  19. EEG guidelines in the diagnosis of brain death.

    Science.gov (United States)

    Szurhaj, W; Lamblin, M-D; Kaminska, A; Sediri, H

    2015-03-01

    In France, for the determination and diagnostic validation of brain death the law requires either two EEG recordings separated by a 4-hour observation period, both showing electrocerebral inactivity; or cerebral angiography examination. Since EEG is available in most hospitals and clinics, it is often used in this indication, at the patient's bedside, especially in the context of organ donation. However, very precise methodology must be followed. The last French guidelines date back to 1989, before the development of digital EEG recording. We present the new guidelines from the Société de Neurophysiologie Clinique de Langue Française. Electrocerebral inactivity may be confirmed when a 30-minute good quality EEG recording shows complete electrocerebral silence, defined as no cerebral activity greater than 2 uV, having first ruled out the possible influence of sedative drugs, metabolic disorders or hypothermia. In the presence of sedative drugs, CT brain angiography will be the gold standard test for this diagnosis. In the newborn, the utmost caution is indicated since electrocerebral inactivity can be observed in the absence of cerebral death. In the infant, the criterion for the observation period to be respected between both EEG recordings needs to be more clearly refined.

  20. Paradoxical effects of brain death and associated trauma on rat mesenteric microcirculation: an intravital microscopic study

    OpenAIRE

    Rafael Simas; Paulina Sannomiya; José Walber M. C Cruz; Cristiano de Jesus Correia; Fernando Luiz Zanoni; Maurício Kase; Laura Menegat; Isaac Azevedo Silva; Moreira, Luiz Felipe P.

    2012-01-01

    OBJECTIVE: Experimental findings support clinical evidence that brain death impairs the viability of organs for transplantation, triggering hemodynamic, hormonal, and inflammatory responses. However, several of these events could be consequences of brain death–associated trauma. This study investigated microcirculatory alterations and systemic inflammatory markers in brain-dead rats and the influence of the associated trauma. METHOD: Brain death was induced using intracranial balloon inflatio...

  1. Development and validation of the Communicating with Family about Brain Death Scale.

    Science.gov (United States)

    Bresnahan, Mary; Zhuang, Jie

    2016-07-01

    This study reports development of a scale assessing communication with family about brain-dead organ donation. Two cross-sectional studies demonstrated scale validity. Tests of internal, external, and predictive validity were conducted using confirmatory factor analysis. In both studies, the same 6 items were shown to be unidimensional with acceptable reliability. Parallelism was shown between the Brain Death Scale and a measure of communication with family. Predictive validity was exhibited between participants' donor status and the Brain Death Scale. The scale was associated with knowledge about brain death confirming misconceptions about brain-dead organ donation. PMID:25253626

  2. Determination of Death and the Dead Donor Rule: A Survey of the Current Law on Brain Death.

    Science.gov (United States)

    Nikas, Nikolas T; Bordlee, Dorinda C; Moreira, Madeline

    2016-06-01

    Despite seeming uniformity in the law, end-of-life controversies have highlighted variations among state brain death laws and their interpretation by courts. This article provides a survey of the current legal landscape regarding brain death in the United States, for the purpose of assisting professionals who seek to formulate or assess proposals for changes in current law and hospital policy. As we note, the public is increasingly wary of the role of organ transplantation in determinations of death, and of the variability of brain death diagnosing criteria. We urge that any attempt to alter current state statutes or to adopt a national standard must balance the need for medical accuracy with sound ethical principles which reject the utilitarian use of human beings and are consistent with the dignity of the human person. Only in this way can public trust be rebuilt. PMID:27097648

  3. Revisiting the Persisting Tension Between Expert and Lay Views About Brain Death and Death Determination: A Proposal Inspired by Pragmatism.

    Science.gov (United States)

    Racine, Eric

    2015-12-01

    Brain death or determination of death based on the neurological criterion has been an enduring source of controversy in academic and clinical circles. The controversy chiefly concerns how death is defined, and it also bears on the justification of the proposed criteria for death determination and their interpretation. Part of the controversy on brain death and death determination stems from disputed crucial medical facts, but in this paper I formulate another hypothesis about the nature of ongoing controversies. At stake is a misunderstood relationship between, on the one hand, the nature of our lay (or our "manifest image") views about death and, on the other hand, the nature of scientific insights (and related conceptual refinements) into death and its determination (the "scientific image"). The misunderstanding of this relationship has partly anchored the controversy and continues to fuel it. Based on a perspective inspired by pragmatism, which stresses the positive contribution of science to ethical and policy debates but also challenges different forms of scientism in science and philosophy found in foundationalist interpretations, I scrutinize three different stances regarding the relationship between lay and scientific perspectives about the definition of death: (1) foundational lay views, (2) foundational expert views, and (3) co-evolving views. I argue that only the latter is sustainable given recent challenges to foundationalist interpretations. PMID:26626067

  4. How important is the duration of the brain death period for the outcome in kidney transplantation?

    NARCIS (Netherlands)

    Nijboer, Willemijn N.; Moers, Cyril; Leuvenink, Henri G. D.; Ploeg, Rutger J.

    2011-01-01

    P>In kidney transplantation, graft survival using grafts from donation after brain death (DBD) donors is inferior to results after living donation. However, little is known about the effect of the duration of brain death (BDdur) on outcome after transplantation. This is a retrospective Organ Procure

  5. Guideline of procedures 2003 for the gammagraphic study of brain death

    International Nuclear Information System (INIS)

    The diagnosis of brain death is a clinical diagnosis that is sometimes made with the help of cerebral perfusion scintigraphy. It is important that all physicians be knowledgeable about the clinical requirements for the diagnosis of brain death, especially the need to establish irreversible cessation of all function of the cerebrum and brain stem. Institutions performing scintigraphy for the evaluation of possible brain death should develop clinical guidelines and procedures for the clinical diagnosis that incorporate both clinical evaluations and the integration of ancillary tests such as perfusion scintigraphy. (Author)

  6. "Brain Death" and dead donor rule. Discussion and proposals on the thesis of Truog.

    Science.gov (United States)

    Bruzzone, Paolo

    2015-01-01

    The introduction in 1968 by the "ad hoc" Harvard committee of the concept of "Brain Death" gave birth to the worldwide diffusion of organ transplantation. Recently "Total Brain Failure" has been proposed as preferred term, instead of "Brain Death", by the President's Council on Bioethics. The concepts of "brain death" and of "dead donor rule" remain the ethical and moral support of organ transplantation. However both criteria has been questioned , either separately or all together , by many authors and particularly by Dr. Robert D. Truog.

  7. Brain death: the challenges of translating medical science into Islamic bioethical discourse.

    Science.gov (United States)

    Padela, Aasim I; Basser, Taha A

    2012-09-01

    Islamic ethico-legal assessments of brain death are varied and controversial. Some Islamic ethico-legal bodies have concluded that brain death is equivalent to cardiopulmonary death; others regard it as an intermediate state between life and death, and a few opine that it does not meet the standards for legal death according to Islamic law. Yet this translation of the concept of brain death into the Islamic ethico-legal domain has generated multiple ethical complexities that receive insufficient attention within the extant medical and fiqh literature. How do Islamic legists understand brain death as a clinical phenomenon? How does the Islamic ethico-legal system treat medical uncertainty? What Islamic ethico-legal principles should apply to bioethical questions about life and death? In this paper, we analyze the arguments for, and against, the acceptance of brain death within the context of the deliberation of a representative juridical council. In our discussion we focus on areas in which the legists' ethico-legal reasoning hinges upon clinical conceptions of the state of the individual when diagnosed as brain dead. As Islamic ethics continues to engage scientific and technological advancements in these areas, such exploration of internal workings is necessary if we wish to better understand how Islamic ethical principles can contribute to bioethical deliberation. PMID:23248843

  8. Brain death and organ transplant legislation:analysis of 969 respondents by classroom questionnaire

    Institute of Scientific and Technical Information of China (English)

    Ru-Liang Song; Xiao-Hua Cui; Zhan Gao; Shao-Lin Deng; You-Ping Li

    2009-01-01

    BACKGROUND: China has the largest potential market for organ transplants in the world, but it has not yet established brain death and organ transplant laws. We aimed to investigate the attitudes and suggestions of doctors, pharmacists, and civil servants concerning brain death, organ transplantation, and their respective legislation. METHODS: A questionnaire with 10 sections and 44 questions was designed and distributed. The effective questionnaire data were then recorded and checked for descriptive analysis. RESULTS: In 1400 questionnaires distributed, 1063 were responded and 969 of them were valid and analyzed. The respondents showed an incomplete understanding of brain death and organ transplantation laws. Seventy-four percent of the respondents recognized and accepted the standard of brain death. They agreed that legislation should be involved in the removal of organs for transplantation, the future use of organs, and insurance and compensation for the donor for possible health risks induced by organ removal. Of the 969 respondents, 92%considered it necessary to have legislation in brain death and organ transplantation, and 61% thought that it is time to legislate. CONCLUSIONS: Legislation for brain death and organ transplantation is urgent and timely in China. The laws must include the respective rights and obligations of patients, close relatives, and medical institutions. Educating the public about brain death and organ transplantation should also be encouraged in a variety of ways.

  9. Danish ethics council rejects brain death as the criterion of death -- commentary 2: return to Elsinore.

    OpenAIRE

    Pallis, Christopher

    1990-01-01

    No discussion of when an individual is dead is meaningful in the absence of a definition of death. If human death is defined as the irreversible loss of the capacity for consciousness combined with the irreversible loss of the capacity to breathe spontaneously (and hence to maintain a spontaneous heart beat) the death of the brainstem will be seen to be the necessary and sufficient condition for the death of the individual. Such a definition of death is not something radically new. It is m...

  10. Single-photon emission computed tomography imaging for brain death donor counseling

    Science.gov (United States)

    Palaniswamy, Vijayanand; Sadhasivam, Suganya; Selvakumaran, Cibi; Jayabal, Priyadharsan; Ananth, S. R.

    2016-01-01

    Organ donation awareness is very poor in India. We have a high demand for transplant organs with poor supply. Apnea test is the confirmatory test for brain death in our country. The Transplantation of Human Organs Act does not support any ancillary testing for the confirmation of brain death in our country. Radionuclide scan is used widely in western countries as a confirmatory test. We in our institution used this as a tool for family counseling with successful conversion rate. PMID:27630461

  11. Correlation between heat shock protein 70 expression in the brain stem and sudden death after experimental traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    ZHAO Lian-xu; XU Xiao-hu; LIU Chao; PAN Su-yue; ZHU Jia-zhen; ZHANG Cheng

    2001-01-01

    Objective: The aim of this study was to determine the patterns of heat-shock protein 70 (HSP70) biosynthesis following traumatic brain injury, and observe the effect of HSP70 induction on the function of the vital center in the brain stem. Methods: Rat models of sudden death resulted form traumatic brain injury were produced, and HSP70 expression in the rat brain stem was determined by immunohistochemistry, the induction of HSP70 mRNA detected by RT-PCR. Results: The level of HSP70 mRNA was prominently elevated in the brain stem as early as 1 5 min following the impact injury, while HSP70 expression was only observed 3 to 6 h after the injury. It was also observed that the levels of HSP70 mRNA but not the protein were elevated in the brain stem of sudden death rats. Conclusion: The synthesis of HSP70 was significantly enhanced in the brain stem following traumatic injury, and the expression of HSP70 is beneficial to eliminate the stress agents, and to sustain the cellular protein homeostasis. When the injury disturbs the synthesis of HSP70 to disarm the protective mechanism of heat-shock proteins, dysfunction of the vital center in the brain stem, and consequently death may occur. Breach in the synchronization of HSP70 mRNA-protein can be indicative of fatal damage to the nerve cells.

  12. Paradoxical effects of brain death and associated trauma on rat mesenteric microcirculation: an intravital microscopic study

    Directory of Open Access Journals (Sweden)

    Rafael Simas

    2012-01-01

    Full Text Available OBJECTIVE: Experimental findings support clinical evidence that brain death impairs the viability of organs for transplantation, triggering hemodynamic, hormonal, and inflammatory responses. However, several of these events could be consequences of brain death-associated trauma. This study investigated microcirculatory alterations and systemic inflammatory markers in brain-dead rats and the influence of the associated trauma. METHOD: Brain death was induced using intracranial balloon inflation; sham-operated rats were trepanned only. After 30 or 180 min, the mesenteric microcirculation was observed using intravital microscopy. The expression of Pselectin and ICAM-1 on the endothelium was evaluated using immunohistochemistry. The serum cytokine, chemokine, and corticosterone levels were quantified using enzyme-linked immunosorbent assays. White blood cell counts were also determined. RESULTS: Brain death resulted in a decrease in the mesenteric perfusion to 30%, a 2.6-fold increase in the expression of ICAM-1 and leukocyte migration at the mesentery, a 70% reduction in the serum corticosterone level and pronounced leukopenia. Similar increases in the cytokine and chemokine levels were seen in the both the experimental and control animals. CONCLUSION: The data presented in this study suggest that brain death itself induces hypoperfusion in the mesenteric microcirculation that is associated with a pronounced reduction in the endogenous corticosterone level, thereby leading to increased local inflammation and organ dysfunction. These events are paradoxically associated with induced leukopenia after brain damage

  13. Effect of Transient Maternal Hypotension on Apoptotic Cell Death in Foetal Rat Brain

    OpenAIRE

    Özyürek, Hamit; Bayrak, Sibel; Pehlivanoğlu, Bilge; Atilla, Pergin; Balkancı, Zeynep Dicle; Çakar, Nur; Anlar, Banu

    2014-01-01

    Background: Intrauterine perfusion insufficiency induced by transient maternal hypotension has been reported to be associated with foetal brain malformations. However, the effects of maternal hypotension on apoptotic processes in the foetal brain have not been investigated experimentally during the intrauterine period. Aims: The aim of this study was to investigate the effects of transient maternal hypotension on apoptotic cell death in the intrauterine foetal brain. Study...

  14. Brain death and Islam: the interface of religion, culture, history, law, and modern medicine.

    Science.gov (United States)

    Miller, Andrew C; Ziad-Miller, Amna; Elamin, Elamin M

    2014-10-01

    How one defines death may vary. It is important for clinicians to recognize those aspects of a patient's religious beliefs that may directly influence medical care and how such practices may interface with local laws governing the determination of death. Debate continues about the validity and certainty of brain death criteria within Islamic traditions. A search of PubMed, Scopus, EMBASE, Web of Science, PsycNet, Sociological Abstracts, DIALOGUE ProQuest, Lexus Nexus, Google, and applicable religious texts was conducted to address the question of whether brain death is accepted as true death among Islamic scholars and clinicians and to discuss how divergent opinions may affect clinical care. The results of the literature review inform this discussion. Brain death has been acknowledged as representing true death by many Muslim scholars and medical organizations, including the Islamic Fiqh Academies of the Organization of the Islamic Conference and the Muslim World League, the Islamic Medical Association of North America, and other faith-based medical organizations as well as legal rulings by multiple Islamic nations. However, consensus in the Muslim world is not unanimous, and a sizable minority accepts death by cardiopulmonary criteria only.

  15. Experimental study on the establishment and maintenance of brain death model with pigs

    Institute of Scientific and Technical Information of China (English)

    ZHANG Shuijun; SHI Jihua; ZHAI Wenlong; SONG Yan; CHEN Shi

    2007-01-01

    It remains controversial that after the transplantation of using grafts from brain-dead donors,organs injury and rejection can influence the effects of transplantation.This study sought to explore methods of establishing a stable brain death(BD)model using Bama mini pigs and to maintain the brain-dead state for a comparatively long period to provide a model for investigating changes in brain death.Sixteen anesthetized Bama mini pigs were randomized into a control group(n=5)and a BD group(n=11).Intracranial pressure (ICP)was increased in a modified,slow,and intermittent way to establish BD.Respiration and circulation were sustained during the brain-dead state.Hemodynamic changes were monitored during the experiment.In the BD group,10 pigs met the requirements for brain death and 1 died of cardiopulmonary complications following an increase in ICP.Brain death was maintained for more than 48 hours with artificial life support.During the experiment,the heart rate and blood pressure showed characteristic changes due to increased ICP.Prior to BD being established,a"tic reaction"inevitably occurred.We used an improved method of increasing ICP to establish a stable BD model.The BD state could be maintained for more than 48 hours with effective respiratory and circulatory support.Disappearance of the tic reaction was considered to be one of the verified indexes for BD via encephalic pressure increase.

  16. [Determination of irreversibility of clinical brain death. Electroencephalography and evoked potentials].

    Science.gov (United States)

    Buchner, H; Ferbert, A

    2016-02-01

    Principally, in the fourth update of the rules for the procedure to finally determine the irreversible cessation of function of the cerebrum, the cerebellum and the brainstem, the importance of an electroencephalogram (EEG), somatosensory evoked potentials (SEP) and brainstem auditory evoked potentials (BAEP) are confirmed. This paper presents the reliability and validity of the electrophysiological diagnosis, discusses the amendments in the fourth version of the guidelines and introduces the practical application, problems and sources of error.An EEG is the best established supplementary diagnostic method for determining the irreversibility of clinical brain death syndrome. It should be noted that residual brain activity can often persist for many hours after the onset of brain death syndrome, particularly in patients with primary brainstem lesions. The derivation and analysis of an EEG requires a high level of expertise to be able to safely distinguish artefacts from primary brain activity. The registration of EEGs to demonstrate the irreversibility of clinical brain death syndrome is extremely time consuming.The BAEPs can only be used to confirm the irreversibility of brain death syndrome in serial examinations or in the rare cases of a sustained wave I or sustained waves I and II. Very often, an investigation cannot be reliably performed because of existing sound conduction disturbances or failure of all potentials even before the onset of clinical brain death syndrome. This explains why BAEPs are only used in exceptional cases.The SEPs of the median nerve can be very reliably derived, are technically simple and with few sources of error. A serial investigation is not required and the time needed for examination is short. For these reasons SEPs are given preference over EEGs and BAEPs for establishing the irreversibility of clinical brain death syndrome. PMID:26785843

  17. Donor pretreatment with carbamylated erythropoietin in a brain death model reduces inflammation more effectively than erythropoietin while preserving renal function

    NARCIS (Netherlands)

    Nijboer, Willemijn N.; Ottens, Petra J.; van Dijk, Antony; van Goor, Harry; Ploeg, Rutger J.; Leuvenink, Henri G. D.

    2010-01-01

    Objective: We hypothesized that donor treatment of deceased brain dead donors would lead to a decrease in inflammatory responses seen in brain death and lead to a restoration of kidney function. Design: A standardized slow-induction rat brain death model followed by evaluation of kidney function in

  18. Donor pretreatment with carbamylated erythropoietin in a brain death model reduces inflammation more effectively than erythropoietin while preserving renal function.

    NARCIS (Netherlands)

    Nijboer, W.N.; Ottens, P.J.; Dijk, A.P.J. van; Goor, H. van; Ploeg, R.J.; Leuvenink, H.G.

    2010-01-01

    OBJECTIVE: We hypothesized that donor treatment of deceased brain dead donors would lead to a decrease in inflammatory responses seen in brain death and lead to a restoration of kidney function. DESIGN: A standardized slow-induction rat brain death model followed by evaluation of kidney function in

  19. IS BRAIN DEATH REVERSAL POSSIBLE IN NEAR FUTURE: INTRATHECAL SODIUM NITROPRUSSIDE (SNP SUPERFUSION IN BRAIN DEATH PATIENTS = THE 10,000 FOLD EFFECT

    Directory of Open Access Journals (Sweden)

    Vinod

    2014-05-01

    Full Text Available BACKGROUND: Primary or secondary brain death is accompanied with vasospasm of the perforators & further exaggerating the anoxic damage, in the form of neuropraxia. In normal conditions the excitatory impulse propagates as anterograde neurotransmission (ANT and at the level of synapse, glutamate activates NMDA receptors on postsynaptic membrane. Nitric oxide (NO is produced by Nitric oxide Synthetase (NOS in postsynaptic dendride or cell body and travels backwards across a chemical synapse to bind to the axon terminal of a presynaptic neuron for regulation of ANT this process is called as the retrograde neurotransmission (RNT. Thus the primary function of NO is RNT and the purpose of RNT is regulation of chemical neurotransmission at synapse. For this reason, RNT allows neural circuits to create feedback loops. The haem is the ligand binding site of NO receptor (sGC at presynaptic membrane. The affinity of haem exhibits >10, 000- fold excess for NO than Oxygen (THE 10, 000 FOLD EFFECT. In pathological conditions ANT, normal synaptic activity including RNT is absent. NO donors like sodium nitroprusside (SNP releases NO by activating NOS at the level of postsynaptic area. NO now travels backwards across a chemical synapse to bind to the haem of NO receptor at axon terminal of a presynaptic neuron as in normal condition. NO now acts as impulse generator (at presynaptic membrane thus bypasses the normal ANT. Also the arteriolar perforators are having Nitric Oxide Synthetase (NOS at the adventitial side (outer border on which sodium nitroprusside (SNP acts; causing release of Nitric Oxide (NO which vasodilates the perforators causing gush of blood in brain’s tissue and reversal of brain death. OBJECTIVE: In brain death cases we only think for various transplantations but this study being a pilot study reverses some criteria of brain death by vasodilating the arteriolar perforators. To study the effect of intrathecal sodium nitroprusside (IT SNP in

  20. Cell death in the injured brain: roles of metallothioneins

    DEFF Research Database (Denmark)

    Pedersen, Mie Ø; Larsen, Agnete; Stoltenberg, Meredin;

    2009-01-01

    oxygen species (ROS). ROS promote oxidative stress, which leads to neurodegeneration and ultimately results in programmed cell death (secondary injury). Since this delayed, secondary tissue loss occurs days to months following the primary injury it provides a therapeutic window where potential......, and caspase inhibitors. However, most of the scientific efforts have failed in translating the experimental results into clinical trials. Despite intensive research, effective neuroprotective therapies are lacking in the clinic, and TBI continues to be a major cause of morbidity and mortality. This paper...

  1. The profile of head injuries and traumatic brain injury deaths in Kashmir

    Directory of Open Access Journals (Sweden)

    Tabish Amin

    2008-06-01

    Full Text Available Abstract This study was conducted on patients of head injury admitted through Accident & Emergency Department of Sher-i-Kashmir Institute of Medical Sciences during the year 2004 to determine the number of head injury patients, nature of head injuries, condition at presentation, treatment given in hospital and the outcome of intervention. Traumatic brain injury (TBI deaths were also studied retrospectively for a period of eight years (1996 to 2003. The traumatic brain injury deaths showed a steady increase in number from year 1996 to 2003 except for 1999 that showed decline in TBI deaths. TBI deaths were highest in age group of 21–30 years (18.8%, followed by 11–20 years age group (17.8% and 31–40 years (14.3%. The TBI death was more common in males. Maximum number of traumatic brain injury deaths was from rural areas as compared to urban areas. To minimize the morbidity and mortality resulting from head injury there is a need for better maintenance of roads, improvement of road visibility and lighting, proper mechanical maintenance of automobile and other vehicles, rigid enforcement of traffic rules, compulsory wearing of crash helmets by motor cyclist and scooterists and shoulder belt in cars and imparting compulsory road safety education to school children from primary education level. Moreover, appropriate medical care facilities (including trauma centres need to be established at district level, sub-divisional and block levels to provide prompt and quality care to head injury patients

  2. The profile of head injuries and traumatic brain injury deaths in Kashmir.

    Science.gov (United States)

    Yattoo, Gh; Tabish, Amin

    2008-01-01

    This study was conducted on patients of head injury admitted through Accident & Emergency Department of Sher-i-Kashmir Institute of Medical Sciences during the year 2004 to determine the number of head injury patients, nature of head injuries, condition at presentation, treatment given in hospital and the outcome of intervention. Traumatic brain injury (TBI) deaths were also studied retrospectively for a period of eight years (1996 to 2003).The traumatic brain injury deaths showed a steady increase in number from year 1996 to 2003 except for 1999 that showed decline in TBI deaths. TBI deaths were highest in age group of 21-30 years (18.8%), followed by 11-20 years age group (17.8%) and 31-40 years (14.3%). The TBI death was more common in males. Maximum number of traumatic brain injury deaths was from rural areas as compared to urban areas.To minimize the morbidity and mortality resulting from head injury there is a need for better maintenance of roads, improvement of road visibility and lighting, proper mechanical maintenance of automobile and other vehicles, rigid enforcement of traffic rules, compulsory wearing of crash helmets by motor cyclist and scooterists and shoulder belt in cars and imparting compulsory road safety education to school children from primary education level. Moreover, appropriate medical care facilities (including trauma centres) need to be established at district level, sub-divisional and block levels to provide prompt and quality care to head injury patients.

  3. Control of adult neurogenesis by programmed cell death in the mammalian brain.

    Science.gov (United States)

    Ryu, Jae Ryun; Hong, Caroline Jeeyeon; Kim, Joo Yeon; Kim, Eun-Kyoung; Sun, Woong; Yu, Seong-Woon

    2016-04-21

    The presence of neural stem cells (NSCs) and the production of new neurons in the adult brain have received great attention from scientists and the public because of implications to brain plasticity and their potential use for treating currently incurable brain diseases. Adult neurogenesis is controlled at multiple levels, including proliferation, differentiation, migration, and programmed cell death (PCD). Among these, PCD is the last and most prominent process for regulating the final number of mature neurons integrated into neural circuits. PCD can be classified into apoptosis, necrosis, and autophagic cell death and emerging evidence suggests that all three may be important modes of cell death in neural stem/progenitor cells. However, the molecular mechanisms that regulate PCD and thereby impact the intricate balance between self-renewal, proliferation, and differentiation during adult neurogenesis are not well understood. In this comprehensive review, we focus on the extent, mechanism, and biological significance of PCD for the control of adult neurogenesis in the mammalian brain. The role of intrinsic and extrinsic factors in the regulation of PCD at the molecular and systems levels is also discussed. Adult neurogenesis is a dynamic process, and the signals for differentiation, proliferation, and death of neural progenitor/stem cells are closely interrelated. A better understanding of how adult neurogenesis is influenced by PCD will help lead to important insights relevant to brain health and diseases.

  4. Cell proliferation and cell death are disturbed during prenatal and postnatal brain development after uranium exposure.

    Science.gov (United States)

    Legrand, M; Elie, C; Stefani, J; N Florès; Culeux, C; Delissen, O; Ibanez, C; Lestaevel, P; Eriksson, P; Dinocourt, C

    2016-01-01

    The developing brain is more susceptible to neurotoxic compounds than adult brain. It is also well known that disturbances during brain development cause neurological disorders in adulthood. The brain is known to be a target organ of uranium (U) exposure and previous studies have noted that internal U contamination of adult rats induces behavioral disorders as well as affects neurochemistry and neurophysiological properties. In this study, we investigated whether depleted uranium (DU) exposure affects neurogenesis during prenatal and postnatal brain development. We examined the structural morphology of the brain, cell death and finally cell proliferation in animals exposed to DU during gestation and lactation compared to control animals. Our results showed that DU decreases cell death in the cortical neuroepithelium of gestational day (GD) 13 embryos exposed at 40mg/L and 120mg/L and of GD18 fetuses exposed at 120mg/L without modification of the number of apoptotic cells. Cell proliferation analysis showed an increase of BrdU labeling in the dentate neuroepithelium of fetuses from GD18 at 120mg/L. Postnatally, cell death is increased in the dentate gyrus of postnatal day (PND) 0 and PND5 exposed pups at 120mg/L and is associated with an increase of apoptotic cell number only at PND5. Finally, a decrease in dividing cells is observed in the dentate gyrus of PND21 rats developmentally exposed to 120mg/L DU, but not at PND0 and PND5. These results show that DU exposure during brain development causes opposite effects on cell proliferation and cell death processes between prenatal and postnatal development mainly at the highest dose. Although these modifications do not have a major impact in brain morphology, they could affect the next steps of neurogenesis and thus might disrupt the fine organization of the neuronal network. PMID:26506049

  5. Beacon signal in transcranial color coded ultrasound: A sign for brain death

    OpenAIRE

    Mehmet Akif Topçuoğlu; Ethem Murat Arsava

    2014-01-01

    A widely under-recognized brain-death confirming transcranial ultrasonography pattern resembling the red-blue beacon signal was demonstrated. Familiarity to this distinct and characteristic ultrasonic pattern seems to be important in the perspective of point-of-care neurological ultrasound use and knobology.

  6. Beacon signal in transcranial color coded ultrasound: A sign for brain death

    Directory of Open Access Journals (Sweden)

    Mehmet Akif Topçuoğlu

    2014-04-01

    Full Text Available A widely under-recognized brain-death confirming transcranial ultrasonography pattern resembling the red-blue beacon signal was demonstrated. Familiarity to this distinct and characteristic ultrasonic pattern seems to be important in the perspective of point-of-care neurological ultrasound use and knobology.

  7. Furan fatty acids efficiently rescue brain cells from cell death induced by oxidative stress

    NARCIS (Netherlands)

    Teixeira, A.; Cox, R.C.; Egmond, M.R.

    2013-01-01

    Treatment of rat brain C6 astroglioma cells with furan fatty acid F6 prior to exposure to hydrogen peroxide shows a strong protective effect of F6 against cell death resulting from oxidative stress. This protective effect is obtained only for F6 administered as a free fatty acid and with an intact f

  8. Donor treatment after pronouncement of brain death: a neglected intensive care problem.

    Science.gov (United States)

    Wijnen, R M; van der Linden, C J

    1991-09-01

    The need for cadaveric organs for transplantation is increasing. To decrease the shortage of organs, identification of potential donors and conditioning of these donors must improve. We present a review of relevant data on body and tissue alterations due to brain death and summarize the recent literature covering experimental and clinical studies on optimal donor management.

  9. Human Traumatic Brain Injury Results in Oligodendrocyte Death and Increases the Number of Oligodendrocyte Progenitor Cells.

    Science.gov (United States)

    Flygt, Johanna; Gumucio, Astrid; Ingelsson, Martin; Skoglund, Karin; Holm, Jonatan; Alafuzoff, Irina; Marklund, Niklas

    2016-06-01

    Oligodendrocyte (OL) death may contribute to white matter pathology, a common cause of network dysfunction and persistent cognitive problems in patients with traumatic brain injury (TBI). Oligodendrocyte progenitor cells (OPCs) persist throughout the adult CNS and may replace dead OLs. OL death and OPCs were analyzed by immunohistochemistry of human brain tissue samples, surgically removed due to life-threatening contusions and/or focal brain swelling at 60.6 ± 75 hours (range 4-192 hours) postinjury in 10 severe TBI patients (age 51.7 ± 18.5 years). Control brain tissue was obtained postmortem from 5 age-matched patients without CNS disorders. TUNEL and CC1 co-labeling was used to analyze apoptotic OLs, which were increased in injured brain tissue (p number of single-labeled Olig2, A2B5, NG2, and PDGFR-α-positive cells, numbers of Olig2 and A2B5 co-labeled cells were increased in TBI samples (p < 0.05); this was inversely correlated with time from injury to surgery (r = -0.8, p < 0.05). These results indicate that severe focal human TBI results in OL death and increases in OPCs postinjury, which may influence white matter function following TBI.

  10. Legal Standards for Brain Death and Undue Influence in Euthanasia Laws.

    Science.gov (United States)

    Pope, Thaddeus Mason; Okninski, Michaela E

    2016-06-01

    A major appellate court decision from the United States seriously questions the legal sufficiency of prevailing medical criteria for the determination of death by neurological criteria. There may be a mismatch between legal and medical standards for brain death, requiring the amendment of either or both. In South Australia, a Bill seeks to establish a legal right for a defined category of persons suffering unbearably to request voluntary euthanasia. However, an essential criterion of a voluntary decision is that it is not tainted by undue influence, and this Bill falls short of providing adequate guidance to assess for undue influence. PMID:27048423

  11. The prolongation of somatic support in a pregnant woman with brain-death: a case report

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    Amaral Eliana

    2006-04-01

    Full Text Available Abstract Background Medical literature has increasingly reported cases of maternal brain death during pregnancy. This is a rare situation which demands the decision and, depending on the gestational age, the implementation of a set of measures to prolong the homeostasis of the human body after brain death for the purpose of maintaining the foetus alive until its viability. Case presentation A 40 year old woman suffered an intracranial haemorrhage during the 25th week of pregnancy. Despite neurosurgical drainage of a gross intraparenchymatous haematoma, the patient developed brain death. Upon confirmation of this diagnosis, she received full ventilatory and nutritional support, vasoactive drugs, maintenance of normothermia, hormone replacement and other supportive measures required to prolong gestation and improve the survival prognosis of her foetus. All decisions regarding the patient's treatment were taken in consensus with her family. She also received corticosteroids to accelerate foetal lung maturity. During the twenty-five days of somatic support, the woman's condition remained stable; however, during the last seven days the foetus developed oligohydramnios and brain-sparring, which led the medical team to take the decision to perform a Caesarean section at that moment. After delivery, the patient's organs were removed for donation. The male infant was born weighing 815 g, with an Apgar score of 9 and 10 at the first and fifth minutes, respectively. The infant was admitted to the neonatal intensive care unit, but did not require mechanical ventilation and had no major complications. He was discharged at 40 days of life, with no sequelae and weighing 1850 g. Conclusion These results are in accordance with findings from previous studies and case reports suggesting the appropriateness and safety of extended somatic support during pregnancy under certain circumstances. They also suggest the need for prompt diagnosis of brain death before the

  12. Neurotoxin envenomation mimicking brain death in a child: A case report and review of literature

    OpenAIRE

    Madhu Dayal; Smita Prakash; Verma, Pradeep K; Mridula Pawar

    2014-01-01

    The spectrum of presentation of a victim of neurotoxic snake bite can range from mild ptosis to complete paralysis and ophthalmoplegia. We report a case of snake bite in a 10-year-old child who was comatosed with bilateral fixed dilated pupils and absent doll′s eye movement that was interpreted as brain death. Physicians need to be aware of the likelihood of snakebite presenting as locked in syndrome.

  13. Neurotoxin envenomation mimicking brain death in a child: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Madhu Dayal

    2014-01-01

    Full Text Available The spectrum of presentation of a victim of neurotoxic snake bite can range from mild ptosis to complete paralysis and ophthalmoplegia. We report a case of snake bite in a 10-year-old child who was comatosed with bilateral fixed dilated pupils and absent doll′s eye movement that was interpreted as brain death. Physicians need to be aware of the likelihood of snakebite presenting as locked in syndrome.

  14. Complications associated with the apnea test in the determination of the brain death

    Institute of Scientific and Technical Information of China (English)

    WU Xiao-liang; FANG Qiang; LI Li; QIU Yun-qing; LUO Ben-yan

    2008-01-01

    Background An apnea test is essentialin the clinical determination of brain death.This study was conducted to analyse complications associated with the apnea test in the determination of the brain death.Methods On 93 adult patients In coma in Zhejiang Province of China from January 2003 to December 2006,179 apnea tests were performed as a part of the determination of brain death.Potential risk conditions and complications were analysed during apnea tests.Results During apnea,sedous cardiac arrhythmia did not occur in all patients.Complications occurred in 37 of 179 (21%)apnea tests.Hypotension occurred in 30 patients(17%)and it was obsewed in 8/94(9%)tests with baseline value of systolic arterial blood pressure not less than 120 mmHg,and 22/85(26%)lass than 120 mmHg(P<0.05).Severe hypoxaemia occurred in 10 patients(6%)of which 3/138(2%)tests with baseline value of arterial oxygen pressure not less than 200 mmHg,and 7/41(17%)less than 200 mmHg(P<0.05).Conclusions This study demonstrated that complications occurred mostly in patients with inadequate baseline systolic arterial blood pressure and preoxygenation.Adequate precautions during the apnea tests may reduce the risk of cardiovascular and oxygenation complication.

  15. Motricidade reflexa na morte cerebral The reflex activity in the brain death

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    Wilson L. Sanvito

    1972-03-01

    Full Text Available O diagnóstico de morte cerebral está baseado em critérios clínicos, eletrencefalográficos e angiográficos. Do ponto de vista clínico deve ser evidenciado o seguinte quadro: coma profundo, midríase paralítica bilateral, ausência de reação a qualquer estímulo externo, apnéia, arreflexia superficial e profunda. Do ponto de vista eletrencefalográfico são necessários dois registros, separados por um intervalo de 24 horas, evidenciando traçados iselétricos. No presente trabalho são estudados 15 pacientes com morte cerebral comprovada do ponto de vista clínico e eletrencefalográfico. Em 8 pacientes havia persistência de atividade reflexa durante a fase de morte cerebral (reflexos profundos e/ou superficiais. Fenômenos de automatismos medulares também foram verificados em 3 pacientes.The diagnosis of brain death is based in clinical, electroencephalographic and angiographic data. The criteria for diagnosis of brain death are: deep coma with unreceptivity and unresponsiveness, no movements or breathing (the patient's respiration must be maintained artificially, bilateral dilated and fixed pupils, absence of corneal reflexes, no response to caloric test, absence of deep tendon reflexes and of the superficial abdominal and plantar reflexes, isoelectric EEG maintained for twenty-four hours. The purpose of this study was to observe the natural clinical courses of 15 patients with brain death, specially the data concerning the deep and superficial reflexes. From 15 patients fulfilling the criteria of brain death, 8 maintained spinal reflexes up to the time of cardiac arrest; in five of these patients the superficial abdominal reflexes were present and the reflexes of spinal automatism could be elicited. These results show that the absence of deep and superficial reflexes can't be considered as essencial for the diagnosis of brain death.

  16. [Report of Sata Clinical Fellowship; brain death and organ donation in hospital for sick children, Toronto, Canada].

    Science.gov (United States)

    Tanaka, M

    2000-04-01

    I have experienced two cases of pediatric organ donation from the brain dead patients in Hospital for Sick Children in three months. First case was a 9-year-old boy after a traffic accident. Second case was an 11-year-old boy with intracranial hemorrhage. Brain death is diagnosed by clinical criteria alone in Canada, as in many of developed countries. EEG or brain flow studies are not mandatory. In the first case, brain death was confirmed after additional brain flow study, EEG, and SSEP because of cervical spinal injury. Second case was diagnosed as brain death by clinical criteria alone, and cardiopulmonary resuscitation was performed after brain death diagnosis. MORE (multiple organ receival and exchange program of Ontario), Organ Donation Team (critical care physicians, nurses, organ donation coordinators, social workers and chaplains) in HSC, and volunteers play the important role to help the family and to make the organ transplantation successful. In Canada, pediatric brain death and organ donation are widely accepted, but there remains an imbalance between the demand for transplantation and the number of organs available. PMID:10793535

  17. Redefining Death

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The results of 20 years of research on brain death will be released to the public, the Chinese Ministry of Health reported in early April. A special ministry team has drafted the criteria for brain death in Criteria for the Diagnosis of Brain Death in Adults (Revised Edition) and Technical Specifications for the Diagnosis

  18. Problems associated with the apnea test in the diagnosis of brain death

    Directory of Open Access Journals (Sweden)

    Saposnik Gustavo

    2004-07-01

    Full Text Available Background: Brain death is the absence of all cortical functions, including the brainstem. The apnea test (AT is a necessary requisite to complete this diagnosis. Anecdotal reports describing hypotension and acidosis due to apnea test have been reported. However, there are few studies that evaluate complications or difficulties related to this procedure. Objective: To analyze medical problems associated with the apnea test. Methods and Patients: We analyzed clinical features, potential risk conditions, and problems in 129 brain dead patients during the apnea test. The diagnosis of brain death was made according to the American Academy of Neurology recommendations. Results: Clinical problems during the apnea test were detected in more than two thirds of patients, including: arterial hypotension (12%, acidosis (68%, and hypoxemia (23%. Four patients developed major complications, including: pneumothorax, cardiac arrest, bradycardia, atrial fibrillation and myocardial infarction. Conclusion: The apnea test is not an innocuous procedure. Complications during the AT are more common than reported and limit organ procurement for transplantation. Guidelines for performing the AT should be followed in order to avoid clinical complications.

  19. Endoplasmic Reticulum Stress Instigates the Rotenone Induced Oxidative Apoptotic Neuronal Death: a Study in Rat Brain.

    Science.gov (United States)

    Goswami, Poonam; Gupta, Sonam; Biswas, Joyshree; Sharma, Sharad; Singh, Sarika

    2016-10-01

    The present study was conducted to evaluate the involvement of endoplasmic reticulum stress in rotenone-induced oxidative neuronal death in rat brain. Rotenone (6 μg/3 μl) was administered intranigrally, unilaterally (right side) in SD rat brain. Neuronal morphology, expression level of tyrosine hydroxylase (TH) and endoplasmic reticulum (ER) stress markers like glucose-regulated protein 78 (GRP78), growth arrest and DNA damage-inducible gene 153 (GADD153), eukaryotic translation initiation factor 2α (p-eIF2α/eIF2α) and cleaved caspase-12 were estimated in the rat brain. Levels of reactive oxygen species (ROS), reduced glutathione (GSH) and enzymatic activities of glutathione peroxidase (GPx) and glutathione reductase (GRd) were estimated to assess the rotenone induced oxidative stress. Apoptotic death of neurons was assessed by estimating the mRNA level of caspase-3. Rotenone administration caused altered neuronal morphology, decreased expression of TH, augmented ROS level, decreased level of GSH and decreased activities of GPx and GRd enzymes which were significantly attenuated with the pretreatment of ER stress inhibitor, salubrinal (1 mg/kg, intraperitoneal). Significantly increased levels of GRP78, GADD, dephosphorylated eIF2α and cleaved caspase-12 was also observed after rotenone administration, which was inhibited with the pretreatment of salubrinal. Rotenone-induced increased mRNA level of caspase-3 was also attenuated by pretreatment of salubrinal. Findings suggested that salubrinal treatment significantly inhibited the rotenone-induced neurotoxicity implicating that ER stress initiates the rotenone-induced oxidative stress and neuronal death. PMID:26446018

  20. Transgenic over-expression of slit2 enhances disruption of blood-brain barrier and increases cell death after traumatic brain injury in mice.

    Science.gov (United States)

    Li, Shuai; Li, Hang; He, Xiao-Fei; Li, Ge; Zhang, Qun; Liang, Feng-Ying; Jia, Huan-Huan; Li, Jiang-Chao; Huang, Ren; Pei, Zhong; Wang, Li-Jing; Zhang, Yu

    2016-09-19

    Traumatic brain injury (TBI) is the leading cause of mortality and disability among male adolescents and young adults; and mild traumatic brain injury is the most common type of traumatic brain injury. The disruption of blood-brain barrier (BBB) plays an important role in brain trauma. Previously, we have found that slit2, a member of slit protein family, increases permeability of BBB. In the present study, we examined the role of slit2 in the pathogenesis of mild TBI in a mouse model of micro TBI. Rhodamine BandPI (PropidiumIodide) staining were used to detect the permeability of BBB and cell death, respectively. The leakage of Rhodamine B and cell death were significantly increased in Slit2-Tg mice than in C57 control mice after micro TBI. The present results suggest that over expression of slit2 plays a detrimental role in the pathophysiology of mild TBI.

  1. Arguments against promoting organ transplants from brain-dead donors, and views of contemporary Japanese on life and death.

    Science.gov (United States)

    Asai, Atsushi; Kadooka, Yasuhiro; Aizawa, Kuniko

    2012-05-01

    As of 2009, the number of donors in Japan is the lowest among developed countries. On July 13, 2009, Japan's Organ Transplant Law was revised for the first time in 12 years. The revised and old laws differ greatly on four primary points: the definition of death, age requirements for donors, requirements for brain-death determination and organ extraction, and the appropriateness of priority transplants for relatives. In the four months of deliberations in the National Diet before the new law was established, various arguments regarding brain death and organ transplantation were offered. An amazing variety of opinions continue to be offered, even after more than 40 years have elapsed since the first heart organ transplant in Japan. Some are of the opinion that with the passage of the revised law, Japan will finally become capable of performing transplants according to global standards. Contrarily, there are assertions that organ transplants from brain-dead donors are unacceptable because they result in organs being taken from living human beings. Considering the current conditions, we will organize and introduce the arguments for and against organ transplants from brain-dead donors in contemporary Japan. Subsequently, we will discuss the primary arguments against organ transplants from brain-dead donors from the perspective of contemporary Japanese views on life and death. After introducing the recent view that brain death should not be regarded as equivalent to the death of a human being, we would like to probe the deeply-rooted views on life and death upon which it is based.

  2. Quality of Care of Nursing from Brain Death Patient in ICU Wards

    Directory of Open Access Journals (Sweden)

    Seyedeh Toktam Masoumian Hoseini

    2015-04-01

    Full Text Available Introduction: Nowadays, Intensive Care Unit (ICU nurses play a significant and key role in the care of brain dead patients and their families, therefore their Practice extremely important to the success of organ donation. To assess ICU nurse's practice in relation to nurse's role in the organ donation process from brain dead patients in Iran. Materials and Methods:In a cross-sectional analytical study 90 ICU nurses in Ghaem and Imam Reza Hospitals in Mashhad through stratified random sampling allocation method were selected. Data collection tools included a questionnaire on demographic information, factors influencing nurse's practice during the organ donation process and surveying "nurse's practice in relation to their roles in the organ donation process." Results: 90 nurses participated in this study. (70.0% of the research subjects had spoken with their own families about organ donation, and (20.0% had organ donation cards. Practice scores were calculated on a scale of 100. The mean score of nurses' practice was (6.04± 3.66. 96.7% of nurses’ weak practice in terms of their roles in the organ donation process. Conclusion: As a result, they do not have adequate practice regard nurse's role in organ donation process and in relation to brain death patient and their families. Therefore it is suggested to include nursing courses in the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the process to improve their practice by different training methods.

  3. Dido mutations trigger perinatal death and generate brain abnormalities and behavioral alterations in surviving adult mice.

    Science.gov (United States)

    Villares, Ricardo; Gutiérrez, Julio; Fütterer, Agnes; Trachana, Varvara; Gutiérrez del Burgo, Fernando; Martínez-A, Carlos

    2015-04-14

    Nearly all vertebrate cells have a single cilium protruding from their surface. This threadlike organelle, once considered vestigial, is now seen as a pivotal element for detection of extracellular signals that trigger crucial morphogenetic pathways. We recently proposed a role for Dido3, the main product of the death inducer-obliterator (dido) gene, in histone deacetylase 6 delivery to the primary cilium [Sánchez de Diego A, et al. (2014) Nat Commun 5:3500]. Here we used mice that express truncated forms of Dido proteins to determine the link with cilium-associated disorders. We describe dido mutant mice with high incidence of perinatal lethality and distinct neurodevelopmental, morphogenetic, and metabolic alterations. The anatomical abnormalities were related to brain and orofacial development, consistent with the known roles of primary cilia in brain patterning, hydrocephalus incidence, and cleft palate. Mutant mice that reached adulthood showed reduced life expectancy, brain malformations including hippocampus hypoplasia and agenesis of corpus callosum, as well as neuromuscular and behavioral alterations. These mice can be considered a model for the study of ciliopathies and provide information for assessing diagnosis and therapy of genetic disorders linked to the deregulation of primary cilia. PMID:25825751

  4. Infrequent near death experiences in severe brain injury survivors - A quantitative and qualitative study

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    Yongmei Hou

    2013-01-01

    Full Text Available Background: Near death experiences (NDE are receiving increasing attention by the scientific community because not only do they provide a glimpse of the complexity of the mind-brain interactions in ′near-death′ circumstances but also because they have significant and long lasting effects on various psychological aspects of the survivors. The over-all incidence-reports of NDEs in literature have varied widely from a modest Figure of 10% to around 35%, even up to an incredible Figure of 72% in persons who have faced close brush with death. Somewhat similar to this range of difference in incidences are the differences prevalent in the opinions that theorists and researchers harbor around the world for explaining this phenomena. None the less, objective evidences have supported physiological theories the most. A wide range of physiological processes have been targeted for explaining NDEs. These include cerebral anoxia, chemical alterations like hypercapnia, presence of endorphins, ketamine, and serotonin, or abnormal activity of the temporal lobe or the limbic system. In spite of the fact that the physiological theories of NDEs have revolved around the derangements in brain, no study till date has taken up the task of evaluating the experiences of near-death in patients where specific injury has been to brain. Most of them have evaluated NDEs in cardiac-arrest patients. Post-traumatic coma is one such state regarding which the literature seriously lacks any information related to NDEs. Patients recollecting any memory of their post-traumatic coma are valuable assets for NDE researchers and needs special attention. Materials and Methods: Our present study was aimed at collecting this valuable information from survivors of severe head injury after a prolonged coma. The study was conducted in the head injury department of Guangdong 999 Brain hospital, Guangzhou, China. Patients included in the study were the ones Recovered from the posttraumatic

  5. Analysis on the training effect of criteria and practical guidance for determination of brain death: electroencephalogram

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    Wei-bi CHEN

    2015-12-01

    Full Text Available Objective To analyze the training results of electroencephalogram (EEG for brain death determination and to improve the training program. Methods A total of 114 trainees received theoretical training, simulation skills training, bedside skills training and test analysis. The composition of the trainees and the results of EEG tests were analyzed. The error rates of 5 knowledge points of EEG tests were calculated. Univariate and multivariate backward Logistic regression analyses were used to analyze the influence of factors including sex, age, specialty, professional category, professional qualification and hospital level on the error rates. Results All of 114 trainees came from 72 hospitals. Among them, 91 trainees (79.82% were between 30-49 years old, 108 trainees (94.74% came from third grade, grade A hospitals, and most of them were from Department of Neurology (57.89% , 66/114 and Electrophysiology (19.30% , 22/114. There were 98 clinicians (85.96% and 52 trainees (45.61% had intermediate certificate. Of the 5 knowledge points, the total error rate was 9.19% (204/2221. Among them, the error rate of parameter setting was the highest (11.40% , 26/228, followed by those of result determination (10.44%, 80/766, recording techniques (10.25%, 69/673, environmental requirements (7.46%, 17/228 and pitfalls (3.68%, 12/326. The error rate of trainees who were older than 50 was significantly higher than that in other ages (P = 0.000, for all. The error rate of technicians was higher than that of clinicians (P = 0.039. Univariate and multivariate Logistic regression analyses showed that age was independent risk factor associated with high error rates (OR = 1.382, 95%CI: 1.156-1.652; P = 0.000. Conclusions Among the trainees, degree of mastering the knowledge points is different. The training program should be optimized according to the trainees. More attention should be paid to the difference of EEG between brain death determination and routine check to

  6. Brain stem death as the vital determinant for resumption of spontaneous circulation after cardiac arrest in rats.

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    Alice Y W Chang

    Full Text Available BACKGROUND: Spontaneous circulation returns to less than half of adult cardiac arrest victims who received in-hospital resuscitation. One clue for this disheartening outcome arises from the prognosis that asystole invariably takes place, after a time lag, on diagnosis of brain stem death. The designation of brain stem death as the point of no return further suggests that permanent impairment of the brain stem cardiovascular regulatory machinery precedes death. It follows that a crucial determinant for successful revival of an arrested heart is that spontaneous circulation must resume before brain stem death commences. Here, we evaluated the hypothesis that maintained functional integrity of the rostral ventrolateral medulla (RVLM, a neural substrate that is intimately related to brain stem death and central circulatory regulation, holds the key to the vital time-window between cardiac arrest and resumption of spontaneous circulation. METHODOLOGY/PRINCIPAL FINDINGS: An animal model of brain stem death employing the pesticide mevinphos as the experimental insult in Sprague-Dawley rats was used. Intravenous administration of lethal doses of mevinphos elicited an abrupt cardiac arrest, accompanied by elevated systemic arterial pressure and anoxia, augmented neuronal excitability and enhanced microvascular perfusion in RVLM. This period represents the vital time-window between cardiac arrest and resumption of spontaneous circulation in our experimental model. Animals with restored spontaneous circulation exhibited maintained neuronal functionality in RVLM beyond this critical time-window, alongside resumption of baseline tissue oxygen and enhancement of local blood flow. Intriguingly, animals that subsequently died manifested sustained anoxia, diminished local blood flow, depressed mitochondrial electron transport activities and reduced ATP production, leading to necrotic cell death in RVLM. That amelioration of mitochondrial dysfunction and

  7. [Deceased organ donors, legal regulations governing diagnosis of brain death, overview of donors and liver transplants in the Czech Republic].

    Science.gov (United States)

    Pokorná, E

    2013-08-01

    The key restriction of transplantation medicine globally, as well as in the Czech Republic, concerns the lack of organs. The number of deceased donors, and thus the availability of organ transplants, has been stagnating in our country. The paper describes current legal regulations governing the dia-gnosis of brain death and primary legal and medical criteria for the contraindication of the deceased for organ explantation, gives an overview of the number of liver transplants, age structure, and diagnosis resulting in brain death of the deceased liver donors in the Czech Republic.

  8. Complement mediated renal inflammation induced by donor brain death : role of renal C5a-C5aR interaction

    NARCIS (Netherlands)

    van Werkhoven, M. B.; Damman, J.; van Dijk, M. C. R. F.; Daha, M. R.; de Jong, I. J.; Leliveld, A.; Krikke, C.; Leuvenink, H. G.; van Goor, H.; van Son, W. J.; Olinga, P.; Hillebrands, J. -L.; Seelen, M. A. J.

    2013-01-01

    Kidneys retrieved from brain-dead donors have impaired allograft function after transplantation compared to kidneys from living donors. Donor brain death (BD) triggers inflammatory responses, including both systemic and local complement activation. The mechanism by which systemic activated complemen

  9. Potential brain death organ donors - challenges and prospects: A single center retrospective review

    Directory of Open Access Journals (Sweden)

    Yousef Al-Maslamani

    2014-01-01

    Full Text Available Organ donation after brain death (BD is a major source for obtaining transplantable organs for patients with end-stage organ disease (ESOD. This retrospective, descriptive study was carried out on all potential BD patients admitted in different intensive care units (ICUs of the Hamad medical Corporation (HMC, Doha, Qatar during a period from January 2011 to April 2012. Our aim was to evaluate various demographic criteria and challenges of organ donation among potential BD organ donors and plan a strategy to improve the rate of organ donation in Qatar. Various aspects of BD patients in the ICUs and their possible effects on organ donation were studied. The time intervals analyzed to determine the possible causes of delay of organ retrieval were: time of diagnosing fixed dilated pupils in the ICU, to performing the first BD test, then to the second BD test, to family approach, to organ retrieval and/or circulatory death (CD without organ retrieval. There were a total of 116 potential BD organ donors of whom 96 (82.75% were males and 20 (17.25% were females. Brain hemorrhage and head injury contributed to 37 (31.9% and 32 (27.6% BD cases, respectively. Time interval between diagnosing fixed dilated pupil and performing the first test of BD was delayed >24 h in 79% of the cases and between the first and second BD tests was >6 h in 70.8% of the cases. This delay is not compatible with the Hamad Medical Corporation (HMC policy for BD diagnosis and resulted in a low number of organs retrieved. BD organ donation, a potential source for organs to save patients with ESOD has several pitfalls and every effort should be made to increase the awareness of the public as well as medical personnel to optimize donation efficacy.

  10. FoxP3 T cells and the pathophysiologic effects of brain death and warm ischemia in donor kidneys

    NARCIS (Netherlands)

    C.C. Baan (Carla); A. Peeters (Anna); M.W.H.J. Demmers (Martijn); W.M. Mol (Wendy); K. Boer (Karin); J.N. Samsom (Janneke); A.T. Rowshani (Ajda); J.N.M. IJzermans (Jan); W. Weimar (Willem)

    2012-01-01

    textabstractBackground and objectives Forkhead box P3 regulatory T cells control inflammatory responses, but it remains unclear whether they inhibit brain death-initiated inflammation and tissue injury in deceased kidney donors. Design, setting, participants, & measurement To study the actions of re

  11. Integrated But Not Whole? Applying an Ontological Account of Human Organismal Unity to the Brain Death Debate.

    Science.gov (United States)

    Moschella, Melissa

    2016-10-01

    As is clear in the 2008 report of the President's Council on Bioethics, the brain death debate is plagued by ambiguity in the use of such key terms as 'integration' and 'wholeness'. Addressing this problem, I offer a plausible ontological account of organismal unity drawing on the work of Hoffman and Rosenkrantz, and then apply that account to the case of brain death, concluding that a brain dead body lacks the unity proper to a human organism, and has therefore undergone a substantial change. I also show how my view can explain hard cases better than one in which biological integration (as understood by Alan Shewmon and the President's Council) is taken to imply ontological wholeness or unity.

  12. Guideline of procedures 2003 for the gammagraphic study of brain death; Guia de procedimientos 2003 para el estudio gammagrafico de muerte cerebral

    Energy Technology Data Exchange (ETDEWEB)

    Mora R, R.A. [Instituto Nacional de Pediatria, Mexico D.F. (Mexico)

    2003-07-01

    The diagnosis of brain death is a clinical diagnosis that is sometimes made with the help of cerebral perfusion scintigraphy. It is important that all physicians be knowledgeable about the clinical requirements for the diagnosis of brain death, especially the need to establish irreversible cessation of all function of the cerebrum and brain stem. Institutions performing scintigraphy for the evaluation of possible brain death should develop clinical guidelines and procedures for the clinical diagnosis that incorporate both clinical evaluations and the integration of ancillary tests such as perfusion scintigraphy. (Author)

  13. Liver transplant outcomes using ideal donation after circulatory death livers are superior to using older donation after brain death donor livers.

    Science.gov (United States)

    Scalea, Joseph R; Redfield, Robert R; Foley, David P

    2016-09-01

    Multiple reports have demonstrated that liver transplantation following donation after circulatory death (DCD) is associated with poorer outcomes when compared with liver transplantation from donation after brain death (DBD) donors. We hypothesized that carefully selected, underutilized DCD livers recovered from younger donors have excellent outcomes. We performed a retrospective study of the United Network for Organ Sharing database to determine graft survivals for patients who received liver transplants from DBD donors of age ≥ 60 years, DBD donors  60 years old. Careful donor organ and recipient selection can lead to excellent results, despite previous reports suggesting otherwise. Increased acceptance of these DCD livers would lead to shorter wait list times and increased national liver transplant rates. Liver Transplantation 22 1197-1204 2016 AASLD.

  14. Brain iron accumulation in unexplained fetal and infant death victims with smoker mothers-The possible involvement of maternal methemoglobinemia

    Directory of Open Access Journals (Sweden)

    Corna Melissa F

    2011-07-01

    Full Text Available Abstract Background Iron is involved in important vital functions as an essential component of the oxygen-transporting heme mechanism. In this study we aimed to evaluate whether oxidative metabolites from maternal cigarette smoke could affect iron homeostasis in the brain of victims of sudden unexplained fetal and infant death, maybe through the induction of maternal hemoglobin damage, such as in case of methemoglobinemia. Methods Histochemical investigations by Prussian blue reaction were made on brain nonheme ferric iron deposits, gaining detailed data on their localization in the brainstem and cerebellum of victims of sudden death and controls. The Gless and Marsland's modification of Bielschowsky's was used to identify neuronal cell bodies and neurofilaments. Results Our approach highlighted accumulations of blue granulations, indicative of iron positive reactions, in the brainstem and cerebellum of 33% of victims of sudden death and in none of the control group. The modified Bielschowsky's method confirmed that the cells with iron accumulations were neuronal cells. Conclusions We propose that the free iron deposition in the brain of sudden fetal and infant death victims could be a catabolic product of maternal methemoglobinemia, a biomarker of oxidative stress likely due to nicotine absorption.

  15. Characteristic of brain perfusion imaging in children brain death patients%儿童脑死亡患者脑血流灌注显像特点

    Institute of Scientific and Technical Information of China (English)

    杨吉刚; 庄红明

    2012-01-01

    Objective To investigate characteristics of brain perfusion imaging of patients with brain death. Methods 77 pediatric patients with clinical suspicion brain death were received brain perfusion imaging, Eventually, 77 patients were died within twenty four hours after last brain perfusion imaging. These data were retrospectively analyzed. Results In the 15 patients (19.5%), the images revealed minimal radioactivity in the brain, which can be seen clearly part of the brain of patients with radioactive distribution. The other patients can be seen a small number of radioactivity distribution. While 62 patients (80.5%) with cerebral perfusion imaging showed brain no radioactive distribution. Conclusion Patients with brain perfusion imaging of the brain no radioactive distribution is the performance of the typical brain-dead, brain no radioactive distribution must not survive. However, the brain radioactivity distribution of patients is not indicative of patient survival.%目的 研究儿童脑死亡患者脑血流灌注显像特点.方法 77例临床怀疑脑死亡的患者行脑血流灌注显像,最终77例患者全部于最后一次脑血流灌注显像后24 h内死亡.本研究回顾性分析脑血流灌注显像的特点.结果 15例(19.5%)患者脑血流灌注显像示脑内可见放射性分布,其中部分患者脑内可见明显放射性分布,其余患者可见少量放射性分布;62例(80.5%)患者脑血流灌注显像示脑内未见放射性分布.临床随访证实77例患者最终全部死亡.结论 脑血流灌注显像示脑内未见放射性分布是典型脑死亡的表现,脑内未见放射性分布的患者一定不能存活,但脑内有放射性分布的患者并不预示患者存活.

  16. Computationally Prediction of Candidate Agents for Preventing Organ Dysfunction After Brain Death.

    Science.gov (United States)

    Liu, Qianwen; Ye, Qifa

    2016-01-01

    BACKGROUND Our aim was to explore the mechanism of post-transplant organ function decrease induced by brain death (BD) and discover a potential candidate drug for improving the survival and organ function after BD. MATERIAL AND METHODS The microarray data developed from the liver tissues after BD were further analyzed by bioinformatics methods. The differentially expressed genes (DEGs) were computationally predicted and the DEGs that involved biological functions were explored by gene ontology (GO) analysis. The candidate agents that could induce the reverse gene signature were predicted based on the Connectivity Map (CMap) database. RESULTS There were total 1374 DEGs, including 589 up-regulated genes and 785 down-regulated genes. Function analysis showed that DEGs were mainly enriched in biological process-related GO terms, such as regulation of transcription, DNA-dependent, inflammatory response, and regulation of phosphorus metabolic process. The down-regulated genes were significantly enriched in transcription factor activity and transcription regulator activity-related molecular function. The down-regulated GO terms exhibited close interaction with each other. CONCLUSIONS The organ function decrease may be attributed by transcription alteration, inflammation response, and metabolic alteration in liver after BD. Spaglumic acid and halcinonide may be potential drugs for preventing organ damage during the BD process. PMID:27170053

  17. Effect of Polyphenols on Oxidative Stress and Mitochondrial Dysfunction in Neuronal Death and Brain Edema in Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Richard A. Anderson

    2011-11-01

    Full Text Available Polyphenols are natural substances with variable phenolic structures and are elevated in vegetables, fruits, grains, bark, roots, tea, and wine. There are over 8000 polyphenolic structures identified in plants, but edible plants contain only several hundred polyphenolic structures. In addition to their well-known antioxidant effects, select polyphenols also have insulin-potentiating, anti-inflammatory, anti-carcinogenic, anti-viral, anti-ulcer, and anti-apoptotic properties. One important consequence of ischemia is neuronal death and oxidative stress plays a key role in neuronal viability. In addition, neuronal death may be initiated by the activation of mitochondria-associated cell death pathways. Another consequence of ischemia that is possibly mediated by oxidative stress and mitochondrial dysfunction is glial swelling, a component of cytotoxic brain edema. The purpose of this article is to review the current literature on the contribution of oxidative stress and mitochondrial dysfunction to neuronal death, cell swelling, and brain edema in ischemia. A review of currently known mechanisms underlying neuronal death and edema/cell swelling will be undertaken and the potential of dietary polyphenols to reduce such neural damage will be critically reviewed.

  18. Ruta 6 selectively induces cell death in brain cancer cells but proliferation in normal peripheral blood lymphocytes: A novel treatment for human brain cancer.

    Science.gov (United States)

    Pathak, Sen; Multani, Asha S; Banerji, Pratip; Banerji, Prasanta

    2003-10-01

    Although conventional chemotherapies are used to treat patients with malignancies, damage to normal cells is problematic. Blood-forming bone marrow cells are the most adversely affected. It is therefore necessary to find alternative agents that can kill cancer cells but have minimal effects on normal cells. We investigated the brain cancer cell-killing activity of a homeopathic medicine, Ruta, isolated from a plant, Ruta graveolens. We treated human brain cancer and HL-60 leukemia cells, normal B-lymphoid cells, and murine melanoma cells in vitro with different concentrations of Ruta in combination with Ca3(PO4)2. Fifteen patients diagnosed with intracranial tumors were treated with Ruta 6 and Ca3(PO4)2. Of these 15 patients, 6 of the 7 glioma patients showed complete regression of tumors. Normal human blood lymphocytes, B-lymphoid cells, and brain cancer cells treated with Ruta in vitro were examined for telomere dynamics, mitotic catastrophe, and apoptosis to understand the possible mechanism of cell-killing, using conventional and molecular cytogenetic techniques. Both in vivo and in vitro results showed induction of survival-signaling pathways in normal lymphocytes and induction of death-signaling pathways in brain cancer cells. Cancer cell death was initiated by telomere erosion and completed through mitotic catastrophe events. We propose that Ruta in combination with Ca3(PO4)2 could be used for effective treatment of brain cancers, particularly glioma.

  19. Ammonium accumulation and cell death in a rat 3D brain cell model of glutaric aciduria type I.

    Directory of Open Access Journals (Sweden)

    Paris Jafari

    Full Text Available Glutaric aciduria type I (glutaryl-CoA dehydrogenase deficiency is an inborn error of metabolism that usually manifests in infancy by an acute encephalopathic crisis and often results in permanent motor handicap. Biochemical hallmarks of this disease are elevated levels of glutarate and 3-hydroxyglutarate in blood and urine. The neuropathology of this disease is still poorly understood, as low lysine diet and carnitine supplementation do not always prevent brain damage, even in early-treated patients. We used a 3D in vitro model of rat organotypic brain cell cultures in aggregates to mimic glutaric aciduria type I by repeated administration of 1 mM glutarate or 3-hydroxyglutarate at two time points representing different developmental stages. Both metabolites were deleterious for the developing brain cells, with 3-hydroxyglutarate being the most toxic metabolite in our model. Astrocytes were the cells most strongly affected by metabolite exposure. In culture medium, we observed an up to 11-fold increase of ammonium in the culture medium with a concomitant decrease of glutamine. We further observed an increase in lactate and a concomitant decrease in glucose. Exposure to 3-hydroxyglutarate led to a significantly increased cell death rate. Thus, we propose a three step model for brain damage in glutaric aciduria type I: (i 3-OHGA causes the death of astrocytes, (ii deficiency of the astrocytic enzyme glutamine synthetase leads to intracerebral ammonium accumulation, and (iii high ammonium triggers secondary death of other brain cells. These unexpected findings need to be further investigated and verified in vivo. They suggest that intracerebral ammonium accumulation might be an important target for the development of more effective treatment strategies to prevent brain damage in patients with glutaric aciduria type I.

  20. Absence of Doppler signal in transcranial color-coded ultrasonography may be confirmatory for brain death: A case report

    Directory of Open Access Journals (Sweden)

    Mehmet Akif Topçuoğlu

    2015-08-01

    Full Text Available Transcranial Doppler ultrasonography (TCD is a valuable tool for demonstrating cerebral circulatory arrest (CCA in the setting of brain death. Complete reversal of diastolic flow (to-and-fro flow and systolic spikes in bilateral terminal internal carotid arteries and vertebrobasilar circulation are considered as specific sonogram configurations supporting the diagnosis of CCA. Because of the possibility of sonic bone window impermeability, absence of any waveform in TCD is not confirmatory for CCA unless there is documentation of disappearance of a previously well detected signal by the same recording settings. Transcranial color-coded sonography (TCCS with B-mode imaging can reliably detect adequacy of bone windows with clarity contralateral skull and ipsilateral planum temporale visualization. Therefore, absence of detectable intracranial Doppler signal along with available ultrasound window in TCCS can confirm clinical diagnosis of brain death. We herein discuss this entity from the frame of a representative case.

  1. Systemic LPS administration induces brain inflammation but not dopaminergic neuronal death in the substantia nigra

    OpenAIRE

    Jeong, Hey-Kyeong; Jou, Ilo; Joe, Eun-hye

    2010-01-01

    It has been suggested that brain inflammation is important in aggravation of brain damage and/or that inflammation causes neurodegenerative diseases including Parkinson's disease (PD). Recently, systemic inflammation has also emerged as a risk factor for PD. In the present study, we evaluated how systemic inflammation induced by intravenous (iv) lipopolysaccharides (LPS) injection affected brain inflammation and neuronal damage in the rat. Interestingly, almost all brain inflammatory response...

  2. An international comparison of the effect of policy shifts to organ donation following cardiocirculatory death (DCD on donation rates after brain death (DBD and transplantation rates.

    Directory of Open Access Journals (Sweden)

    Aric Bendorf

    Full Text Available During the past decade an increasing number of countries have adopted policies that emphasize donation after cardiocirculatory death (DCD in an attempt to address the widening gap between the demand for transplantable organs and the availability of organs from donation after brain death (DBD donors. In order to examine how these policy shifts have affected overall deceased organ donor (DD and DBD rates, we analyzed deceased donation rates from 82 countries from 2000-2010. On average, overall DD, DBD and DCD rates have increased over time, with the proportion of DCD increasing 0.3% per year (p = 0.01. Countries with higher DCD rates have, on average, lower DBD rates. For every one-per million population (pmp increase in the DCD rate, the average DBD rate decreased by 1.02 pmp (95% CI: 0.73, 1.32; p<0.0001. We also found that the number of organs transplanted per donor was significantly lower in DCD when compared to DBD donors with 1.51 less transplants per DCD compared to DBD (95% CI: 1.23, 1.79; p<0.001. Whilst the results do not infer a causal relationship between increased DCD and decreased DBD rates, the significant correlation between higher DCD and lower DBD rates coupled with the reduced number of organs transplanted per DCD donor suggests that a national policy focus on DCD may lead to an overall reduction in the number of transplants performed.

  3. Liver transplant outcomes using ideal donation after circulatory death livers are superior to using older donation after brain death donor livers.

    Science.gov (United States)

    Scalea, Joseph R; Redfield, Robert R; Foley, David P

    2016-09-01

    Multiple reports have demonstrated that liver transplantation following donation after circulatory death (DCD) is associated with poorer outcomes when compared with liver transplantation from donation after brain death (DBD) donors. We hypothesized that carefully selected, underutilized DCD livers recovered from younger donors have excellent outcomes. We performed a retrospective study of the United Network for Organ Sharing database to determine graft survivals for patients who received liver transplants from DBD donors of age ≥ 60 years, DBD donors liver transplants were performed in the United States. Of these, 41,181 (78.8%) underwent transplantation with livers from DBD donors of age livers from DCD donors livers of age livers ≥ age 60 years (P livers; of these, 111 (83.4%) were from donors livers (age livers > 60 years old. Careful donor organ and recipient selection can lead to excellent results, despite previous reports suggesting otherwise. Increased acceptance of these DCD livers would lead to shorter wait list times and increased national liver transplant rates. Liver Transplantation 22 1197-1204 2016 AASLD. PMID:27314220

  4. Region-specific vulnerability to endoplasmic reticulum stress-induced neuronal death in rat brain after status epilepticus

    Indian Academy of Sciences (India)

    Jing Chen; Hu Guo; Guo Zheng; Zhong-Nan Shi

    2013-12-01

    We sought to clarify the involvement and the intra-cerebral distribution variability of C/EBP homologous protein (CHOP), a representative molecule related to endoplasmic reticulum (ER) stress-induced cell death signalling pathways, in neuronal death resulting from status epilepticus in rats. The expression patterns of CHOP and glucose-regulated protein (GRP) 78, a good marker of ER stress, were assessed by Western blotting, real-time PCR, Hoechst and immunohistochemistry in the hippocampus, cortex and striatum on a status epilepticus (SE) model. Double-fluorescent staining of CHOP and the terminal deoxynucleotidyl transferase-mediated DNA nick-end labelling (TUNEL) method were performed to clarify the involvement of CHOP in cell death. SE resulted in a time-dependent increase in the expression of GRP78 and CHOP. The expression of GRP78 protein was increased at 3, 6 and 12 h after SE and no brain region variability was found. The expression of CHOP protein was also increased, reached its peak at 24 h and remained high at 48 h. CHOP protein expression, however, showed brain region variability with highest expression noted in the hippocampus followed by the striatum, and lowest in the cortex. The up-regulation of CHOP occurring at the transcriptional level was demonstrated by real-time PCR. Double fluorescence showed that CHOP expression strongly correlated with neurons undergoing apoptosis. The results indicated that SE compromises the function of the ER and that the hippocampus is more vulnerable than the cortex and the striatum.

  5. Near-death-like experiences without life-threatening conditions or brain disorders: a hypothesis from a case report

    Directory of Open Access Journals (Sweden)

    Enrico eFacco

    2012-11-01

    Full Text Available Near-death experiences (NDEs are profound psychic experiences commonly occurring in life-threatening conditions. They include feeling a sense of peace, of seeing a bright light, encountering deceased relatives or religious figures, and of transcending space and time. To explain them, it has been suggested that they stem from brain disorders and/or psychological reactions to approaching death, a sort of wishful thinking in response to the perceived threat.This is a report on a case with most of the features typical of NDEs except that it occurred entirely without any life-threatening conditions. This evidence is theoretically incompatible with either of the above hypotheses, suggesting that a broader interpretation of the phenomenon is needed.

  6. B-Amyloid Precursor Protein Staining of the Brain in Sudden Infant and Early Childhood Death

    DEFF Research Database (Denmark)

    Jensen, Lisbeth Lund; Banner, Jytte; Ulhøi, Benedicte Parm;

    2013-01-01

    To develop and validate a scoring method for assessing β-amyloid precursor protein (APP) staining in cerebral white matter and to investigate the occurrence, amount and deposition pattern based on the cause of death in infants and young children.......To develop and validate a scoring method for assessing β-amyloid precursor protein (APP) staining in cerebral white matter and to investigate the occurrence, amount and deposition pattern based on the cause of death in infants and young children....

  7. Lived Experiences of Iranian Nurses Caring for Brain Death Organ Donor Patients: Caring as “Halo of Ambiguity and Doubt”

    Science.gov (United States)

    Keshtkaran, Zahra; Sharif, Farkhondeh; Navab, Elham; Gholamzadeh, Sakineh

    2016-01-01

    Background: Brain death is a concept in which its criteria have been expressed as documentations in Harvard Committee of Brain Death. The various perceptions of caregiver nurses for brain death patients may have effect on the chance of converting potential donors into actual organ donors. Objective: The present study has been conducted in order to perceive the experiences of nurses in care-giving to the brain death of organ donor patients. Methods: This qualitative study was carried out by means of Heidegger’s hermeneutic phenomenology. Eight nurses who have been working in ICU were interviewed. The semi-structured interviews were recorded by a tape-recorder and the given texts were transcribed and the analyses were done by Van-Mannen methodology and (thematic) analysis. Results: One of the foremost themes extracted from this study included ‘Halo of ambiguity and doubt’ that comprised of two sub-themes of ‘having unreasonable hope’ and ‘Conservative acceptance of brain death’. The unreasonable hope included lack of trust (uncertainty) in diagnosis and verification of brain death, passing through denial wall, and avoidance from explicit and direct disclosure of brain death in patients’ family. In this investigation, the nurses were involved in a type of ambiguity and doubt in care-giving to the potentially brain death of organ donor patients, which were also evident in their interaction with patients’ family and for this reason, they did not definitely announce the brain death and so far they hoped for treatment of the given patient. Such confusion and hesitance both caused annoyance of nurses and strengthening the denial of patients’ family to be exposed to death. Conclusion: The results of this study reveal the fundamental perceived care-giving of brain death in organ donor patients and led to developing some strategies to improve care-giving and achievement in donation of the given organ and necessity for presentation of educational and

  8. Analysis on the training effect of criteria and practical guidance for determination of brain death: evoked potentials

    Directory of Open Access Journals (Sweden)

    Yan ZHANG

    2015-12-01

    Full Text Available Objective To analyze the training results of short-latency somatosensory-evoked potential (SLSEP for brain death determination and to improve the training program. Methods A total of 101 trainees received theoretical training, simulation skills training, bedside skills training and test analysis for SLSEP in brain death determination. The composition of trainees was analyzed and the error rates of 6 knowledge points were calculated. Univariate and multivariate backward Logistic regression analyses were used to analyze the influence of factors including sex, age, specialty, professional category, professional qualification and hospital level, on the error rates. Results Among them, trainees of 30-49 years old occupied 76.24% (77/101, most of them were from third grade, grade A hospitals (98.02%, 99/101, and 78 trainees (77.23% were from Department of Neurology. There were 82 clinicians (81.19%, 31 (30.69% had senior certificate and 42 (41.58% had intermediate certificate. Total error rate of 6 knowledge points was 4.50% (91/2020. Of the 6 knowledge points, the error rate of pitfalls was the highest (9.41%, 19/202, followed by result determination (5.94% , 12/202, recording techniques (4.75% , 24/505, procedures (3.96%, 32/808, sequence of confirmatory tests (1.98%, 2/101 and environmental conditions (0.99%, 2/202. Univariate and multivariate Logistic regression analyses showed that age (OR = 1.566, 95% CI: 1.116-2.197; P = 0.009 and professional qualification (OR = 1.669, 95% CI: 1.163-2.397; P = 0.005 were independent risk factors associated with high error rates. Conclusions The differences between brain death determination and routine check of SLSEP should be paid more attention to improve the quality of determination for brain death by SLSEP.  DOI: 10.3969/j.issn.1672-6731.2015.12.007

  9. Brazilian guidelines for the application of transcranial ultrasound as a diagnostic test for the confirmation of brain death

    Directory of Open Access Journals (Sweden)

    Marcos C. Lange

    2012-05-01

    Full Text Available Neurosonological studies, specifically transcranial Doppler (TCD and transcranial color-coded duplex (TCCD, have high level of specificity and sensitivity and they are used as complementary tests for the diagnosis of brain death (BD. A group of experts, from the Neurosonology Department of the Brazilian Academy of Neurology, created a task force to determine the criteria for the following aspects of diagnosing BD in Brazil: the reliability of TCD methodology; the reliability of TCCD methodology; neurosonology training and skills; the diagnosis of encephalic circulatory arrest; and exam documentation for BD. The results of this meeting are presented in the current paper.

  10. A Comparative Study of Organ Donation after Brain Death in Japan and Australia

    OpenAIRE

    TERAO, Kaori; FUJIWARA, Yoshirou

    2013-01-01

    Objective : (1) To compare the status of organ donation from brain-dead donors in Japan and Australia. (2) To identify the possible reasons for the low rates of organ donation from brain-dead donors. Background : The shortage of available organs for transplantation has prompted many countries to develop a system for the use of organs from brain-dead donors, including Japan and Australia. Yet, there is a wide range of organ donation rates and policies between Japan and Australia in the current...

  11. The Effect of Early Detection of Occult Brain Metastases in HER2-Positive Breast Cancer Patients on Survival and Cause of Death

    International Nuclear Information System (INIS)

    Purpose: The aim of the study is to evaluate disease-free survival, survival from the detection of brain metastases, overall survival, and cause of death in patients with occult brain metastases (Group I) vs. patients with symptomatic brain metastases (Group II). Methods and Materials: In 80 HER2-positive breast cancer patients, treated with trastuzumab and cytostatic agents for metastatic disease, magnetic resonance imaging screening of the brain was performed, and in 29 patients (36%) occult brain metastasis was detected (Group I). Whole-brain radiotherapy was delivered to Group I. This first group was compared with 52 patients who had symptomatic brain metastases (Group II) and was treated the same way, at the same clinic, during the same time period. Results: Median disease-free survival was 17 months in Group I and 19.9 months in Group II (p = 0.58). The median time interval between the dissemination of the disease and the detection of occult or symptomatic brain metastases was 9 and 15 months, respectively (p = 0.11). When the brain metastases were detected, the median survival was 9 and 8.78 months, respectively (p = 0.80). The median overall survival was 53 and 51 months, respectively (p = 0.94). In the group with occult brain metastases (Group I) 16% of patients died because of progression within the brain. In the group with symptomatic brain metastases (Group II) the rate of cerebral death was 48% (p = 0.009). Conclusions: Whole-brain radiotherapy of occult brain metastases in HER2-positive breast cancer patients with visceral dissemination produces a three-fold decrease in cerebral deaths but does not prolong survival.

  12. Analysis on the training effect of criteria and practical guidance for determination of brain death: transcranial Doppler

    Directory of Open Access Journals (Sweden)

    Lin-lin FAN

    2015-12-01

    Full Text Available Objective To analyze the training effects of transcranial Doppler (TCD for brain death determination conducted by Brain Injury Evaluation Quality Control Centre of National Health and Family Planning Commission to optimize the training program and improve the training effects. Methods A total of 106 trainees received theoretical training, simulation skill training, bedside skill training and test analysis on TCD confirmatory test for brain death determination. The composition of trainees was analyzed and the error rates of 6 knowledge points were calculated. Univariate and multivariate backward Logistic regression analyses were used to analyze the influence of factors including sex, age, specialty, professional category professional qualification and hospital level on the error rates. Results The trainees including 42 males and 64 females, came from 69 hospitals. Trainees of 30-49 years old occupied 77.36% (82/106. In the trainees, 96.23% (102/106 were from third grade, grade A hospitals, and most of them were from Department of Neurology (64.15% , 68/106 and Ultrasound (19.81% , 21/106. There were 82 clinicians (77.36%. Thirty four (32.08% trainees had senior certificate and 49 (46.23% had intermediate certificate. Total error rate of 6 knowledge points was 7.26% (149/2052. Of the 6 knowledge points, the error rate of parameter setting was the highest (9.43%, 10/106, followed by checking position (8.73%, 37/424, artery recognition (8.67%, 43/496, result determination (7.41%, 55/742, equipment (1.89%, 2/106 and pitfalls (1.12%, 2/178. Univariate and multivariate Logistic regression analyses showed that specialty (OR = 1.313, 95% CI: 1.072-1.610; P = 0.009 and hospital level (OR = 2.943, 95% CI: 1.623-5.338; P = 0.000 were independent risk factors associated with high error rates. Conclusions Among the trainees, degree of mastering the knowledge points is different, and the characteristics of trainees influence the training effect. The training

  13. Dialysis Disequilibrium Syndrome: Brain death following hemodialysis for metabolic acidosis and acute renal failure – A case report

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    Bagshaw Sean M

    2004-08-01

    Full Text Available Abstract Background Dialysis disequilibrium syndrome (DDS is the clinical phenomenon of acute neurologic symptoms attributed to cerebral edema that occurs during or following intermittent hemodialysis (HD. We describe a case of DDS-induced cerebral edema that resulted in irreversible brain injury and death following acute HD and review the relevant literature of the association of DDS and HD. Case Presentation A 22-year-old male with obstructive uropathy presented to hospital with severe sepsis syndrome secondary to pneumonia. Laboratory investigations included a pH of 6.95, PaCO2 10 mmHg, HCO3 2 mmol/L, serum sodium 132 mmol/L, serum osmolality 330 mosmol/kg, and urea 130 mg/dL (46.7 mmol/L. Diagnostic imaging demonstrated multifocal pneumonia, bilateral hydronephrosis and bladder wall thickening. During HD the patient became progressively obtunded. Repeat laboratory investigations showed pH 7.36, HCO3 19 mmol/L, potassium 1.8 mmol/L, and urea 38.4 mg/dL (13.7 mmol/L (urea-reduction-ratio 71%. Following HD, spontaneous movements were absent with no pupillary or brainstem reflexes. Head CT-scan showed diffuse cerebral edema with effacement of basal cisterns and generalized loss of gray-white differentiation. Brain death was declared. Conclusions Death is a rare consequence of DDS in adults following HD. Several features may have predisposed this patient to DDS including: central nervous system adaptations from chronic kidney disease with efficient serum urea removal and correction of serum hyperosmolality; severe cerebral intracellular acidosis; relative hypercapnea; and post-HD hemodynamic instability with compounded cerebral ischemia.

  14. Inflammatory responses are not sufficient to cause delayed neuronal death in ATP-induced acute brain injury.

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    Hey-Kyeong Jeong

    Full Text Available BACKGROUND: Brain inflammation is accompanied by brain injury. However, it is controversial whether inflammatory responses are harmful or beneficial to neurons. Because many studies have been performed using cultured microglia and neurons, it has not been possible to assess the influence of multiple cell types and diverse factors that dynamically and continuously change in vivo. Furthermore, behavior of microglia and other inflammatory cells could have been overlooked since most studies have focused on neuronal death. Therefore, it is essential to analyze the precise roles of microglia and brain inflammation in the injured brain, and determine their contribution to neuronal damage in vivo from the onset of injury. METHODS AND FINDINGS: Acute neuronal damage was induced by stereotaxic injection of ATP into the substantia nigra pars compacta (SNpc and the cortex of the rat brain. Inflammatory responses and their effects on neuronal damage were investigated by immunohistochemistry, electron microscopy, quantitative RT-PCR, and stereological counting, etc. ATP acutely caused death of microglia as well as neurons in a similar area within 3 h. We defined as the core region the area where both TH(+ and Iba-1(+ cells acutely died, and as the penumbra the area surrounding the core where Iba-1(+ cells showed activated morphology. In the penumbra region, morphologically activated microglia arranged around the injury sites. Monocytes filled the damaged core after neurons and microglia died. Interestingly, neither activated microglia nor monocytes expressed iNOS, a major neurotoxic inflammatory mediator. Monocytes rather expressed CD68, a marker of phagocytic activity. Importantly, the total number of dopaminergic neurons in the SNpc at 3 h (∼80% of that in the contralateral side did not decrease further at 7 d. Similarly, in the cortex, ATP-induced neuron-damage area detected at 3 h did not increase for up to 7 d. CONCLUSIONS: Different cellular

  15. Muerte cerebral en una embarazada y sobrevida del feto Brain death in a pregnant woman and fetus survival

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    Raúl Mejía

    2008-12-01

    Full Text Available Se presenta el caso de una mujer de 29 años de edad que a consecuencia de una hemorragia cerebelosa presentó un cuadro de muerte cerebral mientras cursaba la 17 semana de su embarazo. Durante 56 días se mantuvo con sostén vital artificial, corrección de déficit hormonal, nutrición enteral y tratamiento de las infecciones. Durante la 25 semana de embarazo, por paro cardíaco se debió practicar una cesárea, naciendo un niño de 450 gramos. Se realizó una revisión de los casos similares publicados y se discuten algunos aspectos médicos, éticos y legales derivados de esta situación.A 29 year old woman suffered massive brain injury after a cerebellum hemorrhage at 17 weeks' gestation. Several hours later, and after brainstem test, she was declared brain dead. She was supported with intensive care during 56 days. After a cardiac arrest, on week 25, a 450 g infant was delivered through a cesarean section. The somatic support of mother and fetus according to the expected physiologic changes after brain death and its ethical implications are discussed.

  16. Analysis on the training effect of criteria and practical guidance for determination of brain death: clinical diagnosis

    Directory of Open Access Journals (Sweden)

    Ying-ying SU

    2015-12-01

    Full Text Available Objective Clinical diagnosis is the most predominant in the criteria for determination of brain death. This paper aims to analyze the training results of clinical diagnosis for brain death determination and to improve the training program. Methods A total of 461 trainees received theoretical training, simulation skills training, bedside skills training and test analysis. The composition of trainees was analyzed and the error rates of knowledge points were calculated. Univariate and multivariate backward Logistic regression analyses were used to analyze the influence of factors including sex, age, specialty, professional qualification and hospital level, on the error rates. Results Four hundred and sixty-one trainees came from 161 hospitals. Among them, trainees of 30-49 years old occupied 77.87% (359/461, and most of them came from third grade, grade A hospitals (88.29%, 407/461. There were 200 trainees (43.39% from Department of Neurology, 109 trainees (23.64% from Department of Neurosurgery, and 88 trainees (19.09% from Intensive Care Unit. Most of them (66.59%, 307/461 had senior certificate. Total error rate of 13 knowledge points was 5.81% (1054/18 128. The error rate of corneal reflex was the highest (24.64% , 104/422, followed by deep coma (11.59% , 365/3149, oculocephalogyric reflex (9.48%, 40/422, step and time of determination (7.48%, 138/1844, and pupillary light reflex (5.10% , 90/1766. Univariate and multivariate Logistic regression analyses showed that age (OR = 1.558, 95%CI: 1.435-1.693; P = 0.000, specialty (OR = 1.080, 95%CI: 1.021-1.143; P = 0.007 and hospital level (OR = 1.395, 95%CI: 1.174-1.659; P = 0.000 were independent risk factors associated with high error rates. Conclusions The training patterns and methods of clinical diagnosis for brain death determination should be further improved, especially the individual training, to rise the training quality. DOI: 10.3969/j.issn.1672-6731.2015.12.006

  17. Caffeic acid phenethyl ester prevents apoptotic cell death in the developing rat brain after pentylenetetrazole-induced status epilepticus.

    Science.gov (United States)

    Yiş, Uluç; Topçu, Yasemin; Özbal, Seda; Tuğyan, Kazım; Bayram, Erhan; Karakaya, Pakize; Yilmaz, Osman; Kurul, Semra Hız

    2013-11-01

    Population-based studies suggest that seizure incidence is highest during the first year of life, and early-life seizures frequently result in the development of epilepsy and behavioral alterations later in life. The early-life insults like status epilepticus often lead to epileptogenesis, a process in which initial brain injury triggers cascades of molecular, cellular, and network changes and eventually spontaneous seizures. Caffeic acid phenethyl ester is an active component of propolis obtained from honeybees and has neuroprotective properties. The aim of this study was to investigate whether caffeic acid phenethyl ester exerts neuroprotective effects on the developing rat brain after status epilepticus. Twenty-one dams reared Wistar male rats, and 21-day-old rats were divided into three groups: control group, pentylenetetrazole-induced status epilepticus group, and caffeic acid phenethyl ester-treated group. Status epilepticus was induced on the first day of experiment. Caffeic acid phenethyl ester injections (30 mg/kg intraperitoneally) started 40 min after the tonic phase of status epilepticus was reached, and the injections of caffeic acid phenethyl ester were repeated over 5 days. Rats were sacrificed, and brain tissues were collected on the 5th day of experiment after the last injection of caffeic acid phenethyl ester. Apoptotic cell death was evaluated. Histopathological examination showed that caffeic acid phenethyl ester significantly preserved the number of neurons in the CA1, CA3, and dentate gyrus regions of the hippocampus and the prefrontal cortex. It also diminished apoptosis in the hippocampus and the prefrontal cortex. In conclusion, this experimental study suggests that caffeic acid phenethyl ester administration may be neuroprotective in status epilepticus in the developing rat brain.

  18. Repeated exposure of the developing rat brain to magnetic resonance imaging did not affect neurogenesis, cell death or memory function

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Changlian [Center for Brain Repair and Rehabilitation, University of Gothenburg (Sweden); Department of Pediatrics, The Third Affiliated Hospital, Zhengzhou University (China); Gao, Jianfeng [Center for Brain Repair and Rehabilitation, University of Gothenburg (Sweden); Department of Pediatrics, The Third Affiliated Hospital, Zhengzhou University (China); Department of Physiology, Henan Traditional Medical University (China); Li, Qian; Huang, Zhiheng; Zhang, Yu; Li, Hongfu [Center for Brain Repair and Rehabilitation, University of Gothenburg (Sweden); Department of Pediatrics, The Third Affiliated Hospital, Zhengzhou University (China); Kuhn, Hans-Georg [Center for Brain Repair and Rehabilitation, University of Gothenburg (Sweden); Blomgren, Klas, E-mail: klas.blomgren@neuro.gu.se [Center for Brain Repair and Rehabilitation, University of Gothenburg (Sweden); Department of Pediatric Oncology, The Queen Silvia Children' s Hospital, Gothenburg (Sweden)

    2011-01-07

    Research highlights: {yields} The effect of MRI on the developing brain is a matter of debate. {yields} Repeated exposure to MRI did not affect neurogenesis. {yields} Memory function was not affected by repeated MRI during development. {yields} Neither late gestation nor young postnatal brains were affected by MRI. {yields} Repeated MRI did not cause cell death in the neurogenic region of the hippocampus. -- Abstract: The effect of magnetic fields on the brain is a matter of debate. The objective of this study was to investigate whether repeated exposure to strong magnetic fields, such as during magnetic resonance imaging (MRI), could elicit changes in the developing rat brain. Embryonic day 15 (E15) and postnatal day 14 (P14) rats were exposed to MRI using a 7.05 T MR system. The animals were anesthetized and exposed for 35 min per day for 4 successive days. Control animals were anesthetized but no MRI was performed. Body temperature was maintained at 37 {sup o}C. BrdU was injected after each session (50 mg/kg). One month later, cell proliferation, neurogenesis and astrogenesis in the dentate gyrus were evaluated, revealing no effects of MRI, neither in the E15, nor in the P14 group. DNA damage in the dentate gyrus in the P14 group was evaluated on P18, 1 day after the last session, using TUNEL staining. There was no difference in the number of TUNEL-positive cells after MRI compared with controls, neither in mature neurons, nor in newborn progenitors (BrdU/TUNEL double-labeled cells). Novel object recognition was performed to assess memory function 1 month after MRI. There was no difference in the recognition index observed after MRI compared with the control rats, neither for the E15, nor for the P14 group. In conclusion, repeated exposure to MRI did not appear to affect neurogenesis, cell death or memory function in rats, neither in late gestation (E15-E18) nor in young postnatal (P14-P17) rats.

  19. Heart murmur and N-terminal pro-brain natriuretic peptide as predictors of death in 2977 consecutive hospitalized patients

    DEFF Research Database (Denmark)

    Iversen, Kasper; Nielsen, O.W.; Kirk, V.;

    2008-01-01

    -pro-BNP, discovery of valvular heart disease by echocardiography yielded no additional prognostic information. Conclusions: Detection of a cardiac murmur during routine medical examination of hospitalized patients is associated with increased risk of death within a year. A blood test for NT-pro-BNP gives significant...... valvular heart disease. We wanted to test whether murmur predicts mortality in unselected patients admitted to the hospital and whether NT-pro-BNP is capable of distinguishing between innocent and significant murmurs. Methods: Consecutive patients (n = 2977) older than 40 years admitted to a local hospital......Background: Little is known about the prognostic importance of murmur in unselected patients. It is difficult to distinguish between innocent and significant murmurs. N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and BNP have recently been shown to be useful in small series of patients with...

  20. Death and survival of neuronal and astrocytic cells in ischemic brain injury: a role of autophagy

    Institute of Scientific and Technical Information of China (English)

    Min XU; Hui-ling ZHANG

    2011-01-01

    Autophagy is a highly regulated cellular mechanism that leads to degradation of long-lived proteins and dysfunctional organelles. The process has been implicated in a variety of physiological and pathological conditions relevant to neurological diseases. Recent studies show the existence of autophagy in cerebral ischemia, but no consensus has yet been reached regarding the functions of autophagy in this condition. This article highlights the activation of autophagy during cerebral ischemia and/or reperfusion, especially in neurons and astrocytes, as well as the role of autophagy in neuronal or astrocytic cell death and survival. We propose that physiological levels of autophagy, presumably caused by mild to modest hypoxia or ischemia, appear to be protective. However, high levels of autophagy caused by severe hypoxia or ischemia and/or reperfusion may cause self-digestion and eventual neuronal and astrocytic cell death. We also discuss that oxidative and endoplasmic reticulum (ER) stresses in cerebral hypoxia or ischemia and/or reperfusion are potent stimuli of autophagy in neurons and astrocytes. In addition, we review the evidence suggesting a considerable overlap between autophagy on one hand, and apoptosis, necrosis and necroptosis on the other hand, in determining the outcomes and final morphology of damaged neurons and astrocytes.

  1. Kidney ischemic injury genes expressed after donor brain death are predictive for the outcome of kidney transplantation.

    Science.gov (United States)

    Kamińska, D; Kościelska-Kasprzak, K; Drulis-Fajdasz, D; Hałoń, A; Polak, W; Chudoba, P; Jańczak, D; Mazanowska, O; Patrzałek, D; Klinger, M

    2011-10-01

    The results of deceased donor kidney transplantation largely depend on the extent of organ injury induced by brain death and the transplantation procedure. In this study, we analyzed the preprocurement intragraft expression of 29 genes involved in apoptosis, tissue injury, immune cell migration, and activation. We also assessed their influence on allograft function. Before flushing with cold solution we obtained 50 kidney core biopsies of deceased donor kidneys immediately after organ retrieval. The control group included 18 biopsies obtained from living donors. Gene expression was analyzed with low-density arrays (Taqman). LCN2/lipocalin-2 is considered a biomarker of kidney epithelial ischemic injury with a renoprotective function. HAVCR1/KIM-1 is associated with acute tubular injury. Comparison of deceased donor kidneys to control organs revealed a significantly higher expression of LCN2 (8.0-fold P=.0006) and HAVCR1 (4.7-fold, PKidneys displaying delayed graft function and/or an acute rejection episode in the first 6 months after showed higher LCN2 expression compared to event-free ones (1.7-fold, P=.027). A significantly higher increase in expression of TLR2 (5.2-fold), Interleukin (IL) 18 (4.6-fold), HMGB1 (4.1-fold), GUSB (2.4-fold), CASP3 (2.0-fold) FAS (1.8-fold), and TP53 (1.6-fold) was observed among deceased donor kidneys compared with the control group. Their expression levels were not related to clinical outcomes: however, they showed significant correlations with one another (r>.6, Pkidneys after donor brain death were hallmarks of the organ injury process. LCN2 expression level in retrieved kidneys can predict kidney transplantation outcomes. PMID:21996181

  2. Up-regulation of K{sub ir}2.1 by ER stress facilitates cell death of brain capillary endothelial cells

    Energy Technology Data Exchange (ETDEWEB)

    Kito, Hiroaki [Department of Molecular and Cellular Pharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya (Japan); Yamazaki, Daiju [Department of Molecular and Cellular Pharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya (Japan); Department of Biological Chemistry, Kyoto University, Graduate School of Pharmaceutical Sciences, Kyoto (Japan); Department of Molecular Neurobiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya (Japan); Ohya, Susumu; Yamamura, Hisao [Department of Molecular and Cellular Pharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya (Japan); Asai, Kiyofumi [Department of Molecular Neurobiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya (Japan); Imaizumi, Yuji, E-mail: yimaizum@phar.nagoya-cu.ac.jp [Department of Molecular and Cellular Pharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya (Japan)

    2011-07-29

    Highlights: {yields} We found that application of endoplasmic reticulum (ER) stress with tunicamycin to brain capillary endothelial cells (BCECs) induced cell death. {yields} The ER stress facilitated the expression of inward rectifier K{sup +} channel (K{sub ir}2.1) and induced sustained membrane hyperpolarization. {yields} The membrane hyperpolarization induced sustained Ca{sup 2+} entry through voltage-independent nonspecific cation channels and consequently facilitated cell death. {yields} The K{sub ir}2.1 up-regulation by ER stress is, at least in part, responsible for cell death of BCECs under pathological conditions. -- Abstract: Brain capillary endothelial cells (BCECs) form blood brain barrier (BBB) to maintain brain homeostasis. Cell turnover of BCECs by the balance of cell proliferation and cell death is critical for maintaining the integrity of BBB. Here we found that stimuli with tunicamycin, endoplasmic reticulum (ER) stress inducer, up-regulated inward rectifier K{sup +} channel (K{sub ir}2.1) and facilitated cell death in t-BBEC117, a cell line derived from bovine BCECs. The activation of K{sub ir} channels contributed to the establishment of deeply negative resting membrane potential in t-BBEC117. The deep resting membrane potential increased the resting intracellular Ca{sup 2+} concentration due to Ca{sup 2+} influx through non-selective cation channels and thereby partly but significantly regulated cell death in t-BBEC117. The present results suggest that the up-regulation of K{sub ir}2.1 is, at least in part, responsible for cell death/cell turnover of BCECs induced by a variety of cellular stresses, particularly ER stress, under pathological conditions.

  3. Topiramate attenuates early brain injury following subarachnoid haemorrhage in rats via duplex protection against inflammation and neuronal cell death.

    Science.gov (United States)

    Tian, Yong; Guo, Song-Xue; Li, Jian-Ru; Du, Hang-Gen; Wang, Chao-Hui; Zhang, Jian-Min; Wu, Qun

    2015-10-01

    Early brain injury (EBI) following aneurysmal subarachnoid haemorrhage (SAH) insults contributes to the poor prognosis and high mortality observed in SAH patients. Topiramate (TPM) is a novel, broad-spectrum, antiepileptic drug with a reported protective effect against several brain injuries. The current study aimed to investigate the potential of TPM for neuroprotection against EBI after SAH and the possible dose-dependency of this effect. An endovascular perforation SAH model was established in rats, and TPM was administered by intraperitoneal injection after surgery at three different doses (20mg/kg, 40mg/kg, and 80mg/kg). The animals' neurological scores and brain water content were evaluated, and ELISA, Western blotting and immunostaining assays were conducted to assess the effect of TPM. The results revealed that TPM lowers the elevated levels of myeloperoxidase and proinflammatory mediators observed after SAH in a dose-related fashion, and the nuclear factor-kappa B (NF-κB) signalling pathway is the target of neuroinflammation regulation. In addition, TPM ameliorated SAH-induced cortical neuronal apoptosis by influencing Bax, Bcl-2 and cleaved caspase-3 protein expression, and the effect of TPM was enhanced in a dose-dependent manner. Various dosages of TPM also upregulated the protein expression of the γ-aminobutyric acid (GABA)-ergic signalling molecules, GABAA receptor (GABAAR) α1, GABAAR γ2, and K(+)-Cl(-) co-transporter 2 (KCC2) together and downregulated Na(+)-K(+)-Cl(-) co-transporter 1 (NKCC1) expression. Thus, TPM may be an effective neuroprotectant in EBI after SAH by regulating neuroinflammation and neuronal cell death.

  4. Relationship between duration of brain death and hemodynamic (in)stability on progressive dysfunction and increased immunologic activation of donor kidneys

    NARCIS (Netherlands)

    van der Hoeven, JAB; Molema, G; Ter Horst, GJ; Freund, RL; Wiersema, J; van Schilfgaarde, R; Leuvenink, HGD; Ploeg, RJ

    2003-01-01

    Background. Consistent difference in graft survival after renal transplantation has been shown when cadaveric transplants are compared to the living related donor situation, in favor of the latter. Recently, evidence has been put forward that brain death has significant effects on the donor organ qu

  5. Myocardial protective effects of a c-Jun N-terminal kinase inhibitor in rats with brain death.

    Science.gov (United States)

    Guo, Wenzhi; Cao, Shengli; Yan, Bing; Zhang, Gong; Li, Jie; Zhao, Yongfu; Zhang, Shuijun

    2016-07-01

    To investigate whether the mitochondrial apoptotic pathway mediates myocardial cell injuries in rats under brain death (BD), and observe the effects and mechanisms of the c-Jun N-terminal kinase (JNK) inhibitor SP600125 on cell death in the heart. Forty healthy male Sprague-Dawley (SD) rats were randomized into four groups: sham group (dural external catheter with no BD); BD group (maintain the induced BD state for 6 hrs); BD + SP600125 group (intraperitoneal injection of SP600125 10 mg/kg 1 hr before inducing BD, and maintain BD for 6 hrs); and BD + Dimethyl Sulphoxide (DMSO) group (intraperitoneal injection of DMSO 1 hr before inducing BD, and maintain BD for 6 hrs). Real-time quantitative PCR was used to evaluate mRNA levels of Cyt-c and caspase-3. Western blot analysis was performed to examine the levels of mitochondrial apoptosis-related proteins p-JNK, Bcl-2, Bax, Cyt-c and Caspase-3. TUNEL assay was employed to evaluate myocardial apoptosis. Compared with the sham group, the BD group exhibited increased mitochondrial apoptosis-related gene expression, accompanied by the elevation of p-JNK expression and myocardial apoptosis. As the vehicle control, DMSO had no treatment effects. The BD + SP600125 group had decreased p-JNK expression, and reduced mitochondrial apoptosis-related gene expression. Furthermore, the apoptosis rate of myocardial cells was reduced. The JNK inhibitor SP600125 could protect myocardial cells under BD through the inhibition of mitochondrial apoptosis-related pathways. PMID:27072084

  6. Original Protocol Using Computed Tomographic Angiography for Diagnosis of Brain Death: A Better Alternative to Standard Two-Phase Technique?

    Science.gov (United States)

    Sawicki, Marcin; Sołek-Pastuszka, Joanna; Jurczyk, Krzysztof; Skrzywanek, Piotr; Guziński, Maciej; Czajkowski, Zenon; Mańko, Witold; Burzyńska, Małgorzata; Safranow, Krzysztof; Poncyljusz, Wojciech; Walecka, Anna; Rowiński, Olgierd; Walecki, Jerzy; Bohatyrewicz, Romuald

    2015-01-01

    BACKGROUND The application of computed tomographic angiography (CTA) for the diagnosis of brain death (BD) is limited because of the low sensitivity of the commonly used two-phase method consisting of assessing arterial and venous opacification at the 60th second after contrast injection. The hypothesis was that a reduction in the scanning delay might increase the sensitivity of the test. Therefore, an original technique using CTA was introduced and compared with catheter angiography as a reference. MATERIAL AND METHODS In a prospective multicenter trial, 84 clinically brain-dead patients were examined using CTA and catheter angiography. The sensitivities of original CTA technique, involving an arterial assessment at the 25th second and a venous assessment at the 40th second, and the standard CTA, involving an arterial and venous assessment at the 60th second, were compared to catheter angiography. RESULTS Catheter angiography results were consistent with the clinical diagnosis of BD in all cases. In comparison to catheter angiography, the sensitivity of original CTA technique was 0.93 (95%CI, 0.85-0.97; p<0.001) and 0.57 (95%CI, 0.46-0.68; p<0.001) for the standard protocol. The differences were statistically significant (p=0.03 for original CTA and p<0.001 for standard CTA). Decompressive craniectomy predisposes to a false-negative CTA result with a relative risk of 3.29 (95% CI, 1.76-5.81; p<0.001). CONCLUSIONS Our original technique using CTA for the assessment of the cerebral arteries during the arterial phase and the deep cerebral veins with a delay of 15 seconds is a highly sensitive test for the diagnosis of BD. This method may be a better alternative to the commonly used technique. PMID:26250464

  7. Computed tomographic angiography criteria in the diagnosis of brain death - comparison of sensitivity and interobserver reliability of different evaluation scales

    Energy Technology Data Exchange (ETDEWEB)

    Sawicki, Marcin; Walecka, A. [Pomeranian Medical University, Department of Diagnostic Imaging and Interventional Radiology, Szczecin (Poland); Bohatyrewicz, R.; Solek-Pastuszka, J. [Pomeranian Medical University, Clinic of Anesthesiology and Intensive Care, Szczecin (Poland); Safranow, K. [Pomeranian Medical University, Department of Biochemistry and Medical Chemistry, Szczecin (Poland); Walecki, J. [The Centre of Postgraduate Medical Education, Warsaw (Poland); Rowinski, O. [Medical University of Warsaw, 2nd Department of Clinical Radiology, Warsaw (Poland); Czajkowski, Z. [Regional Joint Hospital, Szczecin (Poland); Guzinski, M. [Wroclaw Medical University, Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw (Poland); Burzynska, M. [Wroclaw Medical University, Department of Anesthesiology and Intensive Therapy, Wroclaw (Poland); Wojczal, J. [Medical University of Lublin, Department of Neurology, Lublin (Poland)

    2014-08-15

    The standardized diagnostic criteria for computed tomographic angiography (CTA) in diagnosis of brain death (BD) are not yet established. The aim of the study was to compare the sensitivity and interobserver agreement of the three previously used scales of CTA for the diagnosis of BD. Eighty-two clinically brain-dead patients underwent CTA with a delay of 40 s after contrast injection. Catheter angiography was used as the reference standard. CTA results were assessed by two radiologists, and the diagnosis of BD was established according to 10-, 7-, and 4-point scales. Catheter angiography confirmed the diagnosis of BD in all cases. Opacification of certain cerebral vessels as indicator of BD was highly sensitive: cortical segments of the middle cerebral artery (96.3 %), the internal cerebral vein (98.8 %), and the great cerebral vein (98.8 %). Other vessels were less sensitive: the pericallosal artery (74.4 %), cortical segments of the posterior cerebral artery (79.3 %), and the basilar artery (82.9 %). The sensitivities of the 10-, 7-, and 4-point scales were 67.1, 74.4, and 96.3 %, respectively (p < 0.001). Percentage interobserver agreement in diagnosis of BD reached 93 % for the 10-point scale, 89 % for the 7-point scale, and 95 % for the 4-point scale (p = 0.37). In the application of CTA to the diagnosis of BD, reducing the assessment of vascular opacification scale from a 10- to a 4-point scale significantly increases the sensitivity and maintains high interobserver reliability. (orig.)

  8. Protective Effects of Salubrinal on Liver Injury in Rat Models of Brain Death

    Directory of Open Access Journals (Sweden)

    Tao Wang

    2015-01-01

    Full Text Available Background: Previous studies have indicated that endoplasmic reticulum stress participates in and mediates liver injury and apoptosis in brain-dead (BD rats. In this study, we observed the effect of salubrinal (Sal, Sigma, USA on liver cells in BD rats and explored its relevant mechanisms. Methods: Thirty Sprague-Dawley rats were equally randomized into three groups: BD group, Sal group, and DMSO group. The BD models were established by increasing intracranial pressure in a modified, slow, and intermittent way. In the drug groups, Sal was administered 1 h before the induction of BD. After modeling was completed, the blood and liver samples were harvested. CHOP and Caspase-12 mRNA expression was detected using quantitative polymerase chain reaction. PKR-like ER kinase (PERK, P-eukaryotic translation initiation factor 2α (eIF2α, eIF2α, CHOP and caspase-12 expression was detected using western blotting (WB. CHOP and caspase-12 distribution and expression in liver tissues were determined using immunohistochemistry (IHC. Alanine aminotransferase and aspartate aminotransferase level were detected using an automatic biochemical analyzer. Hepatic cell apoptosis was detected using TUNEL. The results were analyzed using Quantity-one v4.62 software (Bio-Rad, USA. Results: CHOP and caspase-12 expression and PERK, eIF2α, and P-eIF2α protein expression showed no significant difference between BD group and DMSO group. Compared with BD group, Sal group had a significantly higher P-eIF2C level and a lower P-PERK level 2 h and 6 h after BD (P 0.05. After the Sal treatment, CHOP and caspase-12 mRNA expression significantly decreased 4 h after BD (P < 0.05. WB and IHC indicated that CHOP and caspase-12 expression also significantly decreased after Sal treatment. Sal was associated with improved liver function and decreased hepatic cell apoptosis. Conclusions: Sal can significantly reduce apoptosis in hepatic cells of BD rats. This protective effect may be

  9. Protective Effects of Salubrinal on Liver Injury in Rat Models of Brain Death

    Institute of Scientific and Technical Information of China (English)

    Tao Wang; Shui-Jun Zhang; Sheng-Li Cao; Wen-Zhi Guo; Bing Yan; Hong-Bo Fang

    2015-01-01

    Background:Previous studies have indicated that endoplasmic reticulum stress participates in and mediates liver injury and apoptosis in brain-dead (BD) rats.In this study,we observed the effect ofsalubrinal (Sal,Sigma,USA) on liver cells in BD rats and explored its relevant mechanisms.Methods:Thirty Sprague-Dawley rats were equally randomized into three groups:BD group,Sal group,and DMSO group.The BD models were established by increasing intracranial pressure in a modified,slow,and intermittent way.In the drug groups,Sal was administered l h before the induction of BD.After modeling was completed,the blood and liver samples were harvested.CHOP and Caspase-12 mRNA expression was detected using quantitative polymerase chain reaction.PKR-like ER kinase (PERK),P-eukaryotic translation initiation factor 2α (eIF2α),eIF2α,CHOP and caspase-12 expression was detected using western blotting (WB).CHOP and caspase-12 distribution and expression in liver tissues were determined using immunohistochemistry (IHC).Alanine aminotransferase and aspartate aminotransferase level were detected using an automatic biochemical analyzer.Hepatic cell apoptosis was detected using TUNEL.The results were analyzed using Quantity-one v4.62 software (Bio-Rad,USA).Results:CHOP and caspase-12 expression and PERK,eIF2α,and P-eIF2α protein expression showed no significant difference between BD group and DMSO group.Compared with BD group,Sal group had a significantly higher P-eIF2C level and a lower P-PERK level 2 h and 6 h after BD (P < 0.05).However,eIF2α expression showed no significant difference (P > 0.05).After the Sal treatment,CHOP and caspase-12 mRNA expression significantly decreased 4 h after BD (P < 0.05).WB and IHC indicated that CHOP and caspase-12 expression also significantly decreased after Sal treatment.Sal was associated with improved liver function and decreased hepatic cell apoptosis.Conclusions:Sal can significantly reduce apoptosis in hepatic cells of BD rats

  10. Head Trauma with or without Mild Brain Injury Increases the Risk of Future Traumatic Death: A Controlled Prospective 15-Year Follow-Up Study.

    Science.gov (United States)

    Vaaramo, Kalle; Puljula, Jussi; Tetri, Sami; Juvela, Seppo; Hillbom, Matti

    2015-10-15

    Patients who have recovered from traumatic brain injury (TBI) show an increased risk of premature death. To investigate long-term mortality rates in a population admitted to the hospital for head injury (HI), we conducted a population-based prospective case-control, record-linkage study, All subjects who were living in Northern Ostrobothnia, and who were admitted to Oulu University Hospital in 1999 because of HI (n=737), and 2196 controls matched by age, gender, and residence randomly drawn from the population of Northern Ostrobothnia were included. Death rate and causes of death in HI subjects during 15 years of follow-up was compared with the general population controls. The crude mortality rates were 56.9, 18.6, and 23.8% for subjects having moderate-to-severe traumatic brain injury (TBI), mild TBI, and head injury without TBI, respectively. The corresponding approximate annual mortality rates were 6.7%, 1.4%, and 1.9%. All types of index HI predicted a significant risk of traumatic death in the future. Subjects who had HI without TBI had an increased risk of both death from all causes (hazard ratio 2.00; 95% confidence interval 1.57-2.55) and intentional or unintentional traumatic death (4.01, 2.20-7.30), compared with controls. The main founding was that even HI without TBI carries an increased risk of future traumatic death. The reason for this remains unknown and further studies are needed. To prevent such premature deaths, post-traumatic therapy should include an interview focusing on lifestyle factors.

  11. Deletion of apolipoprotein E receptor-2 in mice lowers brain selenium and causes severe neurological dysfunction and death when a low-selenium diet is fed.

    Science.gov (United States)

    Burk, Raymond F; Hill, Kristina E; Olson, Gary E; Weeber, Edwin J; Motley, Amy K; Winfrey, Virginia P; Austin, Lori M

    2007-06-01

    Selenoprotein P (Sepp1) is a plasma and extracellular protein that is rich in selenium. Deletion of Sepp1 results in sharp decreases of selenium levels in the brain and testis with dysfunction of those organs. Deletion of Sepp1 also causes increased urinary selenium excretion, leading to moderate depletion of whole-body selenium. The lipoprotein receptor apolipoprotein E receptor-2 (apoER2) binds Sepp1 and facilitates its uptake by Sertoli cells, thus providing selenium for spermatogenesis. Experiments were performed to assess the effect of apoER2 on the concentration and function of selenium in the brain and on whole-body selenium. ApoER2-/- and apoER2+/+ male mice were fed a semipurified diet with selenite added as the source of selenium. ApoER2-/- mice had depressed brain and testis selenium, but normal levels in liver, kidney, muscle, and the whole body. Feeding a selenium-deficient diet to apoER2-/- mice led to neurological dysfunction and death, with some of the characteristics exhibited by Sepp1-/- mice fed the same diet. Thus, although it does not affect whole-body selenium, apoER2 is necessary for maintenance of brain selenium and for prevention of neurological dysfunction and death under conditions of selenium deficiency, suggesting an interaction of apoER2 with Sepp1 in the brain.

  12. Comparing Outcomes of Donation After Cardiac Death Versus Donation After Brain Death in Liver Transplant Recipients with Hepatitis C: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Malcolm Wells

    2014-01-01

    Full Text Available BACKGROUND: Liver transplantation (LT using organs donated after cardiac death (DCD is increasing due, in large part, to a shortage of organs. The outcome of using DCD organs in recipients with hepatits C virus (HCV infection remains unclear due to the limited experience and number of publications addressing this issue.

  13. Brain

    Science.gov (United States)

    ... will return after updating. Resources Archived Modules Updates Brain Cerebrum The cerebrum is the part of the ... the outside of the brain and spinal cord. Brain Stem The brain stem is the part of ...

  14. Inflammation Following Traumatic Brain Injury in Humans: Insights from Data-Driven and Mechanistic Models into Survival and Death

    Science.gov (United States)

    Abboud, Andrew; Mi, Qi; Puccio, Ava; Okonkwo, David; Buliga, Marius; Constantine, Gregory; Vodovotz, Yoram

    2016-01-01

    Inflammation induced by traumatic brain injury (TBI) is a complex mediator of morbidity and mortality. We have previously demonstrated the utility of both data-driven and mechanistic models in settings of traumatic injury. We hypothesized that differential dynamic inflammation programs characterize TBI survivors vs. non-survivors, and sought to leverage computational modeling to derive novel insights into this life/death bifurcation. Thirteen inflammatory cytokines and chemokines were determined using Luminex™ in serial cerebrospinal fluid (CSF) samples from 31 TBI patients over 5 days. In this cohort, 5 were non-survivors (Glasgow Outcome Scale [GOS] score = 1) and 26 were survivors (GOS > 1). A Pearson correlation analysis of initial injury (Glasgow Coma Scale [GCS]) vs. GOS suggested that survivors and non-survivors had distinct clinical response trajectories to injury. Statistically significant differences in interleukin (IL)-4, IL-5, IL-6, IL-8, IL-13, and tumor necrosis factor-α (TNF-α) were observed between TBI survivors vs. non-survivors over 5 days. Principal Component Analysis and Dynamic Bayesian Network inference suggested differential roles of chemokines, TNF-α, IL-6, and IL-10, based upon which an ordinary differential equation model of TBI was generated. This model was calibrated separately to the time course data of TBI survivors vs. non-survivors as a function of initial GCS. Analysis of parameter values in ensembles of simulations from these models suggested differences in microglial and damage responses in TBI survivors vs. non-survivors. These studies suggest the utility of combined data-driven and mechanistic models in the context of human TBI. PMID:27729864

  15. Protective efficacy of mitochondrial targeted antioxidant MitoQ against dichlorvos induced oxidative stress and cell death in rat brain.

    Science.gov (United States)

    Wani, Willayat Yousuf; Gudup, Satish; Sunkaria, Aditya; Bal, Amanjit; Singh, Parvinder Pal; Kandimalla, Ramesh J L; Sharma, Deep Raj; Gill, Kiran Dip

    2011-12-01

    Dichlorvos is a synthetic insecticide that belongs to the family of chemically related organophosphate (OP) pesticides. It can be released into the environment as a major degradation product of other OPs, such as trichlorfon, naled, and metrifonate. Dichlorvos exerts its toxic effects in humans and animals by inhibiting neural acetylcholinesterase. Chronic low-level exposure to dichlorvos has been shown to result in inhibition of the mitochondrial complex I and cytochrome oxidase in rat brain, resulting in generation of reactive oxygen species (ROS). Enhanced ROS production leads to disruption of cellular antioxidant defense systems and release of cytochrome c (cyt c) from mitochondria to cytosol resulting in apoptotic cell death. MitoQ is an antioxidant, selectively targeted to mitochondria and protects it from oxidative damage and has been shown to decrease mitochondrial damage in various animal models of oxidative stress. We hypothesized that if oxidative damage to mitochondria does play a significant role in dichlorvos induced neurodegeneration, then MitoQ should ameliorate neuronal apoptosis. Administration of MitoQ (100 μmol/kg body wt/day) reduced dichlorvos (6 mg/kg body wt/day) induced oxidative stress (decreased ROS production, increased MnSOD activity and glutathione levels) with decreased lipid peroxidation, protein and DNA oxidation. In addition, MitoQ also suppressed DNA fragmentation, cyt c release and caspase-3 activity in dichlorvos treated rats compared to the control group. Further electron microscopic studies revealed that MitoQ attenuates dichlorvos induced mitochondrial swelling, loss of cristae and chromatin condensation. These results indicate that MitoQ may be beneficial against OP (dichlorvos) induced neurodegeneration. PMID:21784090

  16. Death and Death Anxiety

    OpenAIRE

    Gonca Karakus; Zehra Ozturk; Lut Tamam

    2012-01-01

    Although death and life concepts seem so different from each other, some believe that death and life as a whole that death is accepted as the goal of life and death completes life. In different cultures, societies and disciplines, there have been very different definitions of death which changes according to personality, age, religion and cultural status of the individual. Attitudes towards death vary dramatically according to individuals. As for the death anxiety, it is a feeling which start...

  17. Mitochondrial division inhibitor 1 (Mdivi-1) offers neuroprotection through diminishing cell death and improving functional outcome in a mouse model of traumatic brain injury.

    Science.gov (United States)

    Wu, Qiong; Xia, Shui-Xiu; Li, Qian-Qian; Gao, Yuan; Shen, Xi; Ma, Lu; Zhang, Ming-Yang; Wang, Tao; Li, Yong-Sheng; Wang, Zu-Feng; Luo, Cheng-Liang; Tao, Lu-Yang

    2016-01-01

    Mitochondria dysfunction, an enormous potential crisis, has attracted increasing attention. Disturbed regulation of mitochondrial dynamics, the balance of mitochondrial fusion and fission, has been implicated in neurodegenerative diseases, such as Parkinson׳s disease and cerebral ischemia/reperfusion. However the role of mitochondrial dynamics in traumatic brain injury (TBI) has not been illuminated. The aim of the present study was to investigate the role of Mdivi-1, a small molecule inhibitor of a key mitochondrial fission protein dynamin-related protein 1 (Drp1), in TBI-induced cell death and functional outcome deficits. Protein expression of Drp1 was first investigated. Outcome parameters consist of motor test, Morris water maze, brain edema and lesion volume. Cell death was detected by propidium iodide (PI) labeling, and mitochondrial morphology was assessed using transmission electron microscopy. In addition, the expression of apoptosis-related proteins cytochrome c (cyt-c) and caspase-3 was investigated. Our findings showed that up-regulation of Drp1 expression started at 1h post-TBI and peaked at 24 h, but inhibition of Drp1 by Mdivi-1 significantly alleviated TBI-induced behavioral deficits and brain edema, reduced morphological change of mitochondria, and decreased TBI-induced cell death together with lesion volume. Moreover, treatment with Mdivi-1 remarkably inhibited TBI-induced the release of cyt-c from mitochondria to cytoplasm, and activation of caspase-3 at 24 h after TBI. Taken together, these data imply that inhibition of Drp1 may help attenuate TBI-induced functional outcome and cell death through maintaining normal mitochondrial morphology and inhibiting activation of apoptosis.

  18. 无心跳脑死亡兔模型的建立及生命体征变化%The changes of vital signs from establishment of gradual onset brain death rabbit model to cardiac death

    Institute of Scientific and Technical Information of China (English)

    范晓礼; 叶啟发; 钟自彪; 张远; 乔兵兵; 赵杰

    2013-01-01

    Objective To observe changes of vital signs from brain death to cardiac death through establishing gradual onset brain death rabbit models.Methods A total of 15 New Zealand rabbits were randomly divided into control group (group A),brain death 4 h group (group B1),and brain death 8-h group (group B2),with 5 rabbits in each group.In group A Foley balloon catheter was placed in intracalvarium only,and no brain-dead model was established.Brain-dead model was established in group B1 and group B2 by increasing intracranial pressure in a modified,slow,and intermittent way.The changes of mean arterial pressure (MAP),heart rate (HR),radical resection (RR) before pressurization and those of MAP and HR after stopping salvage were observed.Heart living time after stopping salvage was recorded.Results After intracalvarium pressurization,MAP was upgraded (P < 0.01).MAP,HR of brain death group at 0.5,3.0,6.0 min after the salvage was stopped were lower than that of the control,the difference was statistically significant.The cardiac survival time of B1,B2,groups were (16.20 ±5.80) min,(15.20 ±3.11) min after life support withdrew,the difference didn't have statistical significance.Conclusion When gradual onset brain death rabbit models were established,hemodynamics could be kept steady for relatively long time.Cardiac function was not deteriorated with prolongation of time after brain death.MAP and HR were descending gradually after stopping salvage.%目的 建立渐进性颅内加压脑死亡模型,观察撤除抢救措施后脑死亡至心脏死亡过程中的生命体征变化.方法 将新西兰兔15只随机分为实验对照组(A组)、脑死亡4h组(B1组)及脑死亡8h组(B2组),每组5只.A组维持麻醉8h,开颅置入10号Foley球囊导管后不加压,B1、B2组加压复制脑死亡后分别维持4、8h,监测脑死亡建立过程中平均动脉压(MAP)、心率(HR)、呼吸频率(RR)变化及撤除抢救措施后MAP、HR值变化,记录停止抢

  19. Does β-APP staining of the brain in infant bed-sharing deaths differentiate these cases from sudden infant death syndrome?

    DEFF Research Database (Denmark)

    Jensen, Lisbeth Lund; Banner, Jytte; Byard, Roger W

    2014-01-01

    Archival cerebral tissue from infants whose deaths were attributed to sudden infant death syndrome (SIDS) from South Australia and Western Denmark were stained for β-amyloid precursor protein (β-APP) and graded according to a simple scoring chart. The resulting APP scores were correlated...... with sleeping situation (shared vs. alone) showing a significantly higher amount of β-APP staining in the non-bed-sharing, than in the bed-sharing infants (Mann-Whitney, Australia: p = 0.0128, Denmark: p = 0.0014, Combined: p = 0.0031). There was also a marked but non-significant difference in sex distribution...... between bed-sharers and non-bed-sharers with a male to female ratio of 1:1 in the first group and 2:1 in the latter. Of 48 Australian and 76 Danish SIDS infants, β-APP staining was present in 116 (94%) cases. The eight negative cases were all from the Danish cohort. This study has shown that the amount...

  20. A comparative study between Marshall and Rotterdam CT scores in predicting early deaths in patients with traumatic brain injury in a major tertiary care hospital in Nepal

    Institute of Scientific and Technical Information of China (English)

    Sunil Munakomi

    2016-01-01

    Purpose:CT plays a crucial role in the early assessment of patients with traumatic brain injury (TBI).Marshall and Rotterdam are the mostly used scoring systems,in which CT findings are grouped differently.We sought to determine the values of the scoring system and initial CT findings in predicting the death at hospital discharge (early death) in patients with TBI.Methods:There were consecutive 634 traumatic neurosurgical patients with mild-to-severe TBI admitted to the emergency department of College of Medical Sciences.Their initial CT and status at hospital discharge (dead or alive) were reviewed,and both CT scores were calculated.We examined whether each score is related to early death;compared the two scoring systems' performance in predicting early death,and identified the CT findings that are independent predictors for early death.Results:Both imaging score (Marshall) and clinical score (Rotterdam) can be used to reliably predict mortality in patients with acute traumatic brain injury with high prognostic accuracy.Other specific CT characteristics that can be used to predict early mortality are traumatic subarachnoid hemorrhage,midline shift and status of the peri-mesencephalic cisterns.Conclusions:Marshall CT classification has strong predictive power,but greater discrimination can be obtained if the individual CT parameters underlying the CT classification are included in a prognostic model as in Rotterdam score.Consequently,for prognostic purposes,we recommend the use of individual characteristics rather than the CT classification.Performance of CT models for predicting outcome in TBI can be significantly improved by including more details of variables and by adding other variables to the models.

  1. Clinical Value of Transcranial Doppler in Diagnosis of Brain Death%经颅多普勒在脑死亡诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    姚静远; 李占甫; 张涛

    2015-01-01

    Objective To explore the application value of transcranial Doppler (TCD) in the diagnosis of brain death. Methods 9 patients with brain death in the intensive care unit (ICU) were detected by TCD to detect the changes of blood flow spectrum and dynamic changes in the bilateral cerebral artery. Results Among them, the TCD spectrum showed that there were 6 cases of the shock wave, and 3 cases of the nail. Al patients were performed with breathing machine. Conclusion The diagnostic accuracy of TCD in the diagnosis of brain death was 100%after the change of the frequency of the nail, shock wave and no blood flow signal.%目的:探讨经颅多普勒(TCD)在诊断脑死亡中的应用价值。方法对重症监护室(ICU)的9例临床拟诊为脑死亡的患者,行TCD检测双侧大脑中的动脉,观察血流频谱形态和动力变化。结果其中,TCD频谱呈震荡波有6例患者,3例呈钉子波。以上患者都采用呼吸机进行维持呼吸。结论 TCD在出现钉子波、震荡波、无血流信号频谱改变后,对于脑死亡的诊断准确率达到100%。

  2. Competing Risk Analysis of Neurologic versus Nonneurologic Death in Patients Undergoing Radiosurgical Salvage After Whole-Brain Radiation Therapy Failure: Who Actually Dies of Their Brain Metastases?

    Energy Technology Data Exchange (ETDEWEB)

    Lucas, John T., E-mail: jolucas@wakehealth.edu [Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Colmer, Hentry G.; White, Lance [Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Fitzgerald, Nora; Isom, Scott [Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Bourland, John D. [Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina (United States); Laxton, Adrian W. [Department of Neurosurgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina (United States); Tatter, Stephen B. [Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Chan, Michael D. [Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States)

    2015-08-01

    Purpose: To estimate the hazard for neurologic (central nervous system, CNS) and nonneurologic (non-CNS) death associated with patient, treatment, and systemic disease status in patients receiving stereotactic radiosurgery after whole-brain radiation therapy (WBRT) failure, using a competing risk model. Patients and Methods: Of 757 patients, 293 experienced recurrence or new metastasis following WBRT. Univariate Cox proportional hazards regression identified covariates for consideration in the multivariate model. Competing risks multivariable regression was performed to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for both CNS and non-CNS death after adjusting for patient, disease, and treatment factors. The resultant model was converted into an online calculator for ease of clinical use. Results: The cumulative incidence of CNS and non-CNS death at 6 and 12 months was 20.6% and 21.6%, and 34.4% and 35%, respectively. Patients with melanoma histology (relative to breast) (aHR 2.7, 95% CI 1.5-5.0), brainstem location (aHR 2.1, 95% CI 1.3-3.5), and number of metastases (aHR 1.09, 95% CI 1.04-1.2) had increased aHR for CNS death. Progressive systemic disease (aHR 0.55, 95% CI 0.4-0.8) and increasing lowest margin dose (aHR 0.97, 95% CI 0.9-0.99) were protective against CNS death. Patients with lung histology (aHR 1.3, 95% CI 1.1-1.9) and progressive systemic disease (aHR 2.14, 95% CI 1.5-3.0) had increased aHR for non-CNS death. Conclusion: Our nomogram provides individual estimates of neurologic death after salvage stereotactic radiosurgery for patients who have failed prior WBRT, based on histology, neuroanatomical location, age, lowest margin dose, and number of metastases after adjusting for their competing risk of death from other causes.

  3. Competing Risk Analysis of Neurologic versus Nonneurologic Death in Patients Undergoing Radiosurgical Salvage After Whole-Brain Radiation Therapy Failure: Who Actually Dies of Their Brain Metastases?

    International Nuclear Information System (INIS)

    Purpose: To estimate the hazard for neurologic (central nervous system, CNS) and nonneurologic (non-CNS) death associated with patient, treatment, and systemic disease status in patients receiving stereotactic radiosurgery after whole-brain radiation therapy (WBRT) failure, using a competing risk model. Patients and Methods: Of 757 patients, 293 experienced recurrence or new metastasis following WBRT. Univariate Cox proportional hazards regression identified covariates for consideration in the multivariate model. Competing risks multivariable regression was performed to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for both CNS and non-CNS death after adjusting for patient, disease, and treatment factors. The resultant model was converted into an online calculator for ease of clinical use. Results: The cumulative incidence of CNS and non-CNS death at 6 and 12 months was 20.6% and 21.6%, and 34.4% and 35%, respectively. Patients with melanoma histology (relative to breast) (aHR 2.7, 95% CI 1.5-5.0), brainstem location (aHR 2.1, 95% CI 1.3-3.5), and number of metastases (aHR 1.09, 95% CI 1.04-1.2) had increased aHR for CNS death. Progressive systemic disease (aHR 0.55, 95% CI 0.4-0.8) and increasing lowest margin dose (aHR 0.97, 95% CI 0.9-0.99) were protective against CNS death. Patients with lung histology (aHR 1.3, 95% CI 1.1-1.9) and progressive systemic disease (aHR 2.14, 95% CI 1.5-3.0) had increased aHR for non-CNS death. Conclusion: Our nomogram provides individual estimates of neurologic death after salvage stereotactic radiosurgery for patients who have failed prior WBRT, based on histology, neuroanatomical location, age, lowest margin dose, and number of metastases after adjusting for their competing risk of death from other causes

  4. Ammonium accumulation and cell death in a rat 3D brain cell model of glutaric aciduria type I.

    OpenAIRE

    Paris Jafari; Olivier Braissant; Petra Zavadakova; Hugues Henry; Luisa Bonafé; Diana Ballhausen

    2013-01-01

    Glutaric aciduria type I (glutaryl-CoA dehydrogenase deficiency) is an inborn error of metabolism that usually manifests in infancy by an acute encephalopathic crisis and often results in permanent motor handicap. Biochemical hallmarks of this disease are elevated levels of glutarate and 3-hydroxyglutarate in blood and urine. The neuropathology of this disease is still poorly understood, as low lysine diet and carnitine supplementation do not always prevent brain damage, even in early-treated...

  5. Fibroblast growth factor rescues brain endothelial cells lacking presenilin 1 from apoptotic cell death following serum starvation.

    Science.gov (United States)

    Gama Sosa, Miguel A; De Gasperi, Rita; Hof, Patrick R; Elder, Gregory A

    2016-01-01

    Presenilin 1 (Psen1) is important for vascular brain development and is known to influence cellular stress responses. To understand the role of Psen1 in endothelial stress responses, we investigated the effects of serum withdrawal on wild type (wt) and Psen1-/- embryonic brain endothelial cells. Serum starvation induced apoptosis in Psen1-/- cells but did not affect wt cells. PI3K/AKT signaling was reduced in serum-starved Psen1-/- cells, and this was associated with elevated levels of phospho-p38 consistent with decreased pro-survival AKT signaling in the absence of Psen1. Fibroblast growth factor (FGF1 and FGF2), but not vascular endothelial growth factor (VEGF) rescued Psen1-/- cells from serum starvation induced apoptosis. Inhibition of FGF signaling induced apoptosis in wt cells under serum withdrawal, while blocking γ-secretase activity had no effect. In the absence of serum, FGF2 immunoreactivity was distributed diffusely in cytoplasmic and nuclear vesicles of wt and Psen1-/- cells, as levels of FGF2 in nuclear and cytosolic fractions were not significantly different. Thus, sensitivity of Psen1-/- cells to serum starvation is not due to lack of FGF synthesis but likely to effects of Psen1 on FGF release onto the cell surface and impaired activation of the PI3K/AKT survival pathway. PMID:27443835

  6. Neonatal Death

    Science.gov (United States)

    ... Home > Complications & Loss > Loss & grief > Neonatal death Neonatal death E-mail to a friend Please fill in ... your baby. What are common causes of neonatal death? The most common causes of neonatal death are: ...

  7. Crosstalk between complement and Toll-like receptor activation in relation to donor brain death and renal ischemia-reperfusion injury.

    Science.gov (United States)

    Damman, Jeffrey; Daha, Mohamed R; van Son, Willem J; Leuvenink, Henri G; Ploeg, Rutger J; Seelen, Marc A

    2011-04-01

    Two central pathways of innate immunity, complement and Toll-like receptors (TLRs), play an important role in the pathogenesis of renal injury inherent to kidney transplantation. Recent findings indicate close crosstalk between complement and TLR signaling pathways. It is suggested that mitogen activated protein kinases (MAPKs) might be the key molecules linking both the complement and TLR pathways together. Complement and TLRs are important mediators of renal ischemia-reperfusion injury (IRI). Besides IRI, complement C3 can also be upregulated and activated in the kidney before transplantation as a direct result of brain death (BD) in the donor. This local upregulation and activation of complement in the donor kidney has been proven to be detrimental for renal allograft outcome. Also TLR4 and several of its major ligands are upregulated by donor BD compared to living donors. Important and in line with the observations above, kidney transplant recipients have a benefit when receiving a kidney from a TLR4 Asp299Gly/Thr399Ile genotypic donor. The role of complement and TLRs and crosstalk between these two innate immune systems in relation to renal injury during donor BD and ischemia-reperfusion are focus of this review. Future strategies to target complement and TLR activation in kidney transplantation are considered.

  8. On Death

    Institute of Scientific and Technical Information of China (English)

    Zhangyan

    2016-01-01

    Death is not a terrible word, but a provoking one. Different people have different opinions, but no one can convince others of what death really means. This article made a tentative and superficial analysis on death according to the true feeing and experiences of the author. In her opinion, we needn’t consider more about death; the important for the death is how to live meaningfully.

  9. Autoradiographic studies on the cell kinetics after the whole body X-irradiation. 2. Regularities of the post-irradiation death of differentiating and proliferating cells of the rat brain subependimal zone

    International Nuclear Information System (INIS)

    A wave-like character of death of proliferating and differentiating (D) cells is shown autoradiographically using 3H-thymidine introduced 60-80 min before the whole body X-ray irradiation in doses of 50, 150 or 300 R on subependymal cells of rat brain. Lethally damaged cells irradiated in G2 and S-phases, resulted in 4 peaks of death in mitosis by following the first postradiational mitotic cycle (MC). Lethally damaged cells irradiated in G1-phase lost ability for DNA synthesis as cells irradiated in a dose of 300 R did not include additionally introduced (3 hrs before death) 14C-thymidine from 12 to 17 hrs after 3H-thymidine injection. However, in the first 4 hrs after irradiation there were no cells irradiated in G1-phase among dead ones, as indirec showed the calculations of data obtained tly/ while studying Pliss lymphosarcoma. A supposition is made that the death of cells irradiated in G1-phase is attributed to mitotic phase of the first MC after irradiation. Waves of death of lethally damaged D-cells repeated the peaks of death and corresponded to the mitotic peaks of proliferating cells, which permitted to presuppose the presence of ''short cycle'' (SC) in D-cells, which have the rhythm similar to MC and their death has been attributed to the final SC phase, which corresponds to MC mitotic phase in time. According to the peaks of cell death position of one hour block independent of dose in six MC(SC) points is determined. The cells have experienced the block in the point of MC(SC) in subphase of which they were caught by irradiation. Dose effect is manifested in the number of dead cells

  10. Pro-life role for c-Jun N-terminal kinase and p38 mitogen-activated protein kinase at rostral ventrolateral medulla in experimental brain stem death

    Directory of Open Access Journals (Sweden)

    Chang Alice YW

    2012-11-01

    Full Text Available Abstract Background Based on an experimental brain stem death model, we demonstrated previously that activation of the mitogen-activated protein kinase kinase 1/2 (MEK1/2/extracellular signal-regulated kinase 1/2 (ERK1/2/mitogen-activated protein kinase signal-interacting kinase 1/2 (MNK1/2 cascade plays a pro-life role in the rostral ventrolateral medulla (RVLM, the origin of a life-and-death signal detected from systemic arterial pressure, which sequentially increases (pro-life and decreases (pro-death to reflect progressive dysfunction of central cardiovascular regulation during the advancement towards brain stem death in critically ill patients. The present study assessed the hypothesis that, in addition to ERK1/2, c-Jun NH2-terminal kinase (JNK and p38 mitogen-activated protein kinase (p38MAPK, the other two mammalian members of MAPKs that are originally identified as stress-activated protein kinases, are activated specifically by MAPK kinase 4 (MAP2K4 or MAP2K6 and play a pro-life role in RVLM during experimental brain stem death. We further delineated the participation of phosphorylating activating transcriptional factor-2 (ATF-2 and c-Jun, the classical transcription factor activated by JNK or p38MAPK, in this process. Results An experimental model of brain stem death that employed microinjection of the organophosphate insecticide mevinphos (Mev; 10 nmol bilaterally into RVLM of Sprague–Dawley rats was used, alongside cardiovascular, pharmacological and biochemical evaluations. Results from ELISA showed that whereas the total JNK, p38MAPK, MAP2K4 and MAP2K6 were not affected, augmented phosphorylation of JNK at Thr183 and Tyr185 and p38MAPK at Thr180 and Tyr182, accompanied by phosphorylation of their upstream activators MAP2K4 at Ser257 and Thr261 and MAP2K6 at Ser207 and Thr211 in RVLM occurred preferentially during the pro-life phase of experimental brain stem death. Moreover, the activity of transcription factors ATF-2 at Thr71 and

  11. Understanding Death.

    Science.gov (United States)

    Heath, Charles P.

    1986-01-01

    Bibliotherapy can help children prepare for and understand the death of a loved one. An annotated bibliography lists references with age level information on attitudes toward death and deaths of a father, friend, grandparent, mother, pet, and sibling. (Author/CL)

  12. BAEP、BR及MEP联合检测在脑死亡诊断中的应用%Application of BAEP, BR and MEP combined detection for the diagnosis of brain death

    Institute of Scientific and Technical Information of China (English)

    朴虎男; 朴莲荀; 杜婷婷

    2012-01-01

    目的 探讨神经电生理在脑死亡判定中的应用价值.方法 通过瞬间反射(BR)、脑干听觉诱发电位(BAEP)、运动诱发电位(MEP)三项联合检查对22例脑死亡患者进行评定,并与GCS评分结果进行比较.结果 BAEP、BR和MEP三项联合检查对脑死亡判断准确率为100%,与GCS评分比较差异显著(P<0.05).结论 BAEP、BR和MEP三项联合检测对评价脑死亡患者的脑功能状态、预测预后提供了客观可靠的依据.%Objective To investigate the diagnosis value of neuro-electrophysiology detection for brain death. Methods Combined detection of brainstem auditory evoked potentials ( BAEP) , blink reflex (BR) united motor evoked potentials ( MEP) were used to access 22 brain death patients, and then compared with the Glasgow Coma Scale (GCS) scores. Results The accuracy of BAEP, BR and MEP combined detection was 100% , and which showed significant difference compared with GCS scores. Conclusion BAEP, BR united MEP testing can provide an objective indicator not only for e-valuating brain function of brain death, but also for estimating prognosis.

  13. Selection of reference genes for normalisation of real-time RT-PCR in brain-stem death injury in Ovis aries

    Directory of Open Access Journals (Sweden)

    Fraser John F

    2009-07-01

    Full Text Available Abstract Background Heart and lung transplantation is frequently the only therapeutic option for patients with end stage cardio respiratory disease. Organ donation post brain stem death (BSD is a pre-requisite, yet BSD itself causes such severe damage that many organs offered for donation are unusable, with lung being the organ most affected by BSD. In Australia and New Zealand, less than 50% of lungs offered for donation post BSD are suitable for transplantation, as compared with over 90% of kidneys, resulting in patients dying for lack of suitable lungs. Our group has developed a novel 24 h sheep BSD model to mimic the physiological milieu of the typical human organ donor. Characterisation of the gene expression changes associated with BSD is critical and will assist in determining the aetiology of lung damage post BSD. Real-time PCR is a highly sensitive method involving multiple steps from extraction to processing RNA so the choice of housekeeping genes is important in obtaining reliable results. Little information however, is available on the expression stability of reference genes in the sheep pulmonary artery and lung. We aimed to establish a set of stably expressed reference genes for use as a standard for analysis of gene expression changes in BSD. Results We evaluated the expression stability of 6 candidate normalisation genes (ACTB, GAPDH, HGPRT, PGK1, PPIA and RPLP0 using real time quantitative PCR. There was a wide range of Ct-values within each tissue for pulmonary artery (15–24 and lung (16–25 but the expression pattern for each gene was similar across the two tissues. After geNorm analysis, ACTB and PPIA were shown to be the most stably expressed in the pulmonary artery and ACTB and PGK1 in the lung tissue of BSD sheep. Conclusion Accurate normalisation is critical in obtaining reliable and reproducible results in gene expression studies. This study demonstrates tissue associated variability in the selection of these

  14. Risk factors for liver quality in donation after brain death%脑死亡供体肝脏质量影响因素

    Institute of Scientific and Technical Information of China (English)

    范林; 李弦; 张秋艳; 叶啟发

    2015-01-01

    Liver transplantation,a unique effective treatment for end-stage liver diseases,has already been applied in clinical practice for more than half a century.But the shortage of donor liver source has been the bottleneck limiting its development.How to determine the tiny minority donor liver quality to guarantee the prognosis of transplant patients becomes a hot focus for current research.Brain death causes patho-physiological changes of body organs,including liver.How to carry out related pathological and serologic tests to determine the safety of the donor liver is a very important issue.In this paper,the articles published in recent years were overviewed and analyzed to summarize the evaluation index of donating organ quality.We hope this paper may benefit the treatment through ensuring an effective evaluation on the donor liver in the future.%肝移植作为治疗终末期肝病的唯一有效手段,其临床应用已逾半个世纪,而供肝来源的短缺一直是限制其发展的瓶颈.在为数不多的供肝中,如何确定其质量以保证移植患者的预后为目前研究的主要方向.脑死亡造成的全身脏器病理生理改变亦包括肝脏.为此,如何进行相关病理学及血清学检查以确定肝脏使用的安全性十分重要.本文对近年发表的相关文献进行综合、分析,对供体器官质量评价指标进行综述.以期对捐献供体肝脏进行有效评价以利于临床工作.

  15. Brainstem death: A comprehensive review in Indian perspective.

    Science.gov (United States)

    Dhanwate, Anant Dattatray

    2014-09-01

    With the advent of cardiopulmonary resuscitation techniques, the cardiopulmonary definition of death lost its significance in favor of brain death. Brain death is a permanent cessation of all functions of the brain in which though individual organs may function but lack of integrating function of the brain, lack of respiratory drive, consciousness, and cognition confirms to the definition that death is an irreversible cessation of functioning of the organism as a whole. In spite of medical and legal acceptance globally, the concept of brain death and brain-stem death is still unclear to many. Brain death is not promptly declared due to lack of awareness and doubts about the legal procedure of certification. Many brain dead patients are kept on life supporting systems needlessly. In this comprehensive review, an attempt has been made to highlight the history and concept of brain death and brain-stem death; the anatomical and physiological basis of brain-stem death, and criteria to diagnose brain-stem death in India.

  16. Brainstem death: A comprehensive review in Indian perspective

    Directory of Open Access Journals (Sweden)

    Anant Dattatray Dhanwate

    2014-01-01

    Full Text Available With the advent of cardiopulmonary resuscitation techniques, the cardiopulmonary definition of death lost its significance in favor of brain death. Brain death is a permanent cessation of all functions of the brain in which though individual organs may function but lack of integrating function of the brain, lack of respiratory drive, consciousness, and cognition confirms to the definition that death is an irreversible cessation of functioning of the organism as a whole. In spite of medical and legal acceptance globally, the concept of brain death and brain-stem death is still unclear to many. Brain death is not promptly declared due to lack of awareness and doubts about the legal procedure of certification. Many brain dead patients are kept on life supporting systems needlessly. In this comprehensive review, an attempt has been made to highlight the history and concept of brain death and brain-stem death; the anatomical and physiological basis of brain-stem death, and criteria to diagnose brain-stem death in India.

  17. A novel neuron-enriched protein SDIM1 is down regulated in Alzheimer's brains and attenuates cell death induced by DNAJB4 over-expression in neuro-progenitor cells

    Directory of Open Access Journals (Sweden)

    Lei Joy X

    2011-01-01

    Full Text Available Abstract Background Molecular changes in multiple biological processes contribute to the development of chronic neurodegeneration such as late onset Alzheimer's disease (LOAD. To discover how these changes are reflected at the level of gene expression, we used a subtractive transcription-based amplification of mRNA procedure to identify novel genes that have altered expression levels in the brains of Alzheimer's disease (AD patients. Among the genes altered in expression level in AD brains was a transcript encoding a novel protein, SDIM1, that contains 146 amino acids, including a typical signal peptide and two transmembrane domains. Here we examined its biochemical properties and putative roles in neuroprotection/neurodegeneration. Results QRT-PCR analysis of additional AD and control post-mortem human brains showed that the SDIM1 transcript was indeed significantly down regulated in all AD brains. SDIM1 is more abundant in NT2 neurons than astrocytes and present throughout the cytoplasm and neural processes, but not in the nuclei. In NT2 neurons, it is highly responsive to stress conditions mimicking insults that may cause neurodegeneration in AD brains. For example, SDIM1 was significantly down regulated 2 h after oxygen-glucose deprivation (OGD, though had recovered 16 h later, and also appeared significantly up regulated compared to untreated NT2 neurons. Overexpression of SDIM1 in neuro-progenitor cells improved cells' ability to survive after injurious insults and its downregulation accelerated cell death induced by OGD. Yeast two-hybrid screening and co-immunoprecipitation approaches revealed, both in vitro and in vivo, an interaction between SDIM1 and DNAJB4, a heat shock protein hsp40 homolog, recently known as an enhancer of apoptosis that also interacts with the mu opioid receptor in human brain. Overexpression of DNAJB4 alone significantly reduced cell viability and SDIM1 co-overexpression was capable of attenuating the cell death

  18. Guillain Barre syndrome mimicking cerebral death

    Directory of Open Access Journals (Sweden)

    Rajdev S

    2003-01-01

    Full Text Available Guillain Barre Syndrome, an acute diffuse demyelinating disorder, predominantly present with the motor manifestations with few variants. The present report describes an unusual presentation of GBS, which initially suggested brain death. A 14 years old male presented with sudden onset of rapidly progressive weakness of all four limbs which progressively evolved into clinical condition simulating brain death.

  19. Avaliação do conhecimento de estudantes de medicina sobre morte encefálica Evaluation of medical students knowledge on brain death

    Directory of Open Access Journals (Sweden)

    Almir Galvão Vieira Bitencourt

    2007-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Por ser um conceito relativamente novo e pouco divulgado na sociedade, o diagnóstico de morte encefálica (ME ainda não é bem aceito pela população em geral, inclusive entre médicos e estudantes de Medicina. O objetivo deste estudo foi avaliar o conhecimento de uma amostra de estudantes de Medicina sobre o protocolo diagnóstico de ME. MÉTODO: Estudo descritivo de corte transversal, avaliando acadêmicos de duas faculdades de Medicina de Salvador-BA. Foi distribuído um questionário auto-aplicável composto por questões referentes à conhecimento, técnico e ético, contidos na Resolução nº 1.480/97 do Conselho Federal de Medicina, que dispõe sobre os critérios para caracterização de ME. RESULTADOS: Foram avaliados 115 estudantes. A média de acertos nas 14 questões sobre o conhecimento dos critérios da ME foi de 6,7 ± 1,8; sendo maior entre os estudantes que haviam assistido alguma apresentação sobre ME. A maioria dos estudantes (87,4% soube identificar os pacientes candidatos ao protocolo de ME. No entanto, apenas 5,2% e 16,1% dos estudantes acertaram, respectivamente, os testes clínicos e complementares que devem ser realizados durante o protocolo. Frente a um paciente não-doador com diagnóstico confirmado de ME, 66,4% referiram que o suporte artificial de vida deve ser suspenso. Apenas 15% dos estudantes entrevistados já avaliaram um paciente com ME, sendo este percentual maior entre os que já haviam realizado estágio em UTI (38,2% versus 5,1%; p BACKGROUND AND OBJECTIVES: Because brain death (BD is a new concept and little divulged, it’s not well accepted in general population, including doctors and Medical students. This study aims to evaluate the knowledge of a sample of Medical students on the Brazilian BD diagnosis protocol. METHODS: Descriptive cross-sectional survey that evaluated students from two medical schools in Salvador-BA. We used a questionnaire composed by questions

  20. KIDNEY TRANSPLANTATION FROM DONORS AFTER CARDIAC DEATH

    Directory of Open Access Journals (Sweden)

    R.L. Rozental

    2012-01-01

    Full Text Available From 668 kidney transplantations performed during the period 2000–2005 68 grafts were recovered from donors after cardiac death and 176 from donors with confirmed brain death. Early results (number of primarily non-functioning grafts, rates of delayed graft function and acute rejections were similar in both groups. 5-year patient survival was 85% from donors after cardiac death and 88% from donors with confirmed brain death. 5-year graft survival was 77% and 85%, respectively. Results showed that the use of kidney grafts recovered from donors after cardiac death is valuable additional source of donor organs. 

  1. Brain white matter lesions correlated to newborns death and lethality Fatores correlacionados ao óbito e à letalidade hospitalar em neonatos com lesão da substância branca cerebral

    Directory of Open Access Journals (Sweden)

    Nayara Argollo

    2006-06-01

    Full Text Available OBJECTIVES: to describe hospital lethality rates and factors correlated to death in neonates with brain white matter lesions. METHODS: a retrospective study was performed from January 1994 to December 2001. Neonates with white brain matter lesions were divided into survival and death groups and their medical files reviewed through the single blind method to determine evolution. Death certificates provided the cause of death. The groups were compared through correlation coefficients. Hospital lethality rate was calculated. RESULTS: ninety three cases of white brain matter lesions and seven deaths were determined. Hospital lethality rate was of 8.2.% (95%CI: 2.4-14.0 independently from lesion occurrence time, and of 10.3% (95%CI: 3.3-17.3 for deaths occurred during prenatal and perinatal periods. Death was correlated to: Apgar score, non-cephalic presentation, gestational age, hyperglicemia, hypercalcemia, convulsion, respiratory insufficiency and atelectasy. CONCLUSIONS: hospital lethality was of 10.3% generating the following hypothesis: perinatal asphyxia must be the principal direct and indirect etiologic factor (aggravating the expression of prematurity and infection diseases, of prenatal and perinatal mortality among newborns with white brain matter lesions; and OBJETIVOS: descrever a taxa de letalidade hospitalar e fatores correlacionados com o óbito em crianças com lesão da substância branca cerebral (LSB. MÉTODOS: estudo retrospectivo realizado de janeiro de 1994 a dezembro de 2001. Os neonatos com LSB foram divididos em sobreviventes ou óbito, e seus prontuários revisados de forma cega para a evolução. Dos atestados de óbito, a causa de morte. Os grupos foram comparados por coeficientes de correlação. Calculada a taxa de letalidade hospitalar. RESULTADOS: foram encontrados 93 casos de LSB e sete óbitos. A taxa de letalidade hospitalar foi de 8,2%, (IC95%: 2,4-14,0, independentemente da época de instalação da lesão, e de

  2. Orchestrating an Exceptional Death

    DEFF Research Database (Denmark)

    Jensen, Anja Marie Bornø

    , reinterpret and translate death and organ donation into something culturally acceptable and sense making. With chapters focusing analytically on the performance of trust, the transformative practices of hope, the aesthetization of ambiguous bodies, the sociality of exchangeable organs and the organ donation......This Ph.D. thesis explores the experiences of Danish donor families and the context of organ donation in Denmark. Based on comprehensive ethnographic studies at Danish hospitals and interviews with health care professionals and donor families, readers are invited on a journey into the complex...... processes of facing brain death and deciding about organ donation. This study suggests that organ donation should be understood as a ‘strange figure’ challenging traditions and attitudes regarding the boundaries between life and death and the practices surrounding dead human bodies. Simultaneously, organ...

  3. Emergindo a complexidade do cuidado de enfermagem ao ser em morte encefálica Complejidad emergente del cuidado de enfermería al paciente con muerte cerebral Emerging the complexity of nursing care facing a brain death

    Directory of Open Access Journals (Sweden)

    Aline Lima Pestana

    2012-12-01

    ambivalentes sentimientos. La complejidad de los cuidados al paciente en muerte cerebral consiste en comprender su singularidad y dialogicidad.This study aimed to unveil the complexity of nursing care to human being in brain death. It was used as a theoretical and methodological reference, complex thinking and Grounded Theory, respectively. Data were collected in a university hospital in northeastern Brazil, from December 2010 to June 2011, through non structured interviews. The theoretical sample consisted of 12 nurses, distributed in three samples groups. The phenomenon of "Unveiling the multiple relationships and interactions to be a nurse in the complexity of care to the brain death" was delimited by five categories. In this article, was discussed the category "Emerging complexity of nursing care to be brain death". The study showed that the care facing a brain death is accompanied by disorder and uncertainties, causing the nurse to experience different feelings and ambivalent. The complexity of care facing a brain death is to understand its uniqueness and dialogical.

  4. Clinical analysis of liver transplant from a child of brain death to an adult%脑死亡儿童供肝成人移植临床分析

    Institute of Scientific and Technical Information of China (English)

    时军; 罗文峰; 丁利民; 徐志丹; 王永刚; 李新长; 罗来邦; 龙成美

    2011-01-01

    目的 探讨脑死亡儿童供肝成人移植的临床可行性,总结1例脑死亡儿童供肝成人移植的临床体会.方法 受者为39岁女性,诊断为原发性肝癌,肝炎后肝硬化(失代偿期).供者为脑肿瘤脑死亡的8岁儿童,供肝采用快速联合脏器切取方法获取.手术方式为经典原位肝移植.术后常规给予免疫抑制、防治感染、护肝、支持等治疗.结果 移植手术历时6 h.术后无严重并发症发生,受者健康存活,门诊随访肝功能正常.结论 儿童供肝成人移植技术是可行的.系统化的供肝评估、良好的手术技巧及完善的术后处理是确保手术成功的关键.%Objective To explore clinical feasibility of liver transplant from child of brain death to adult, to summarize the clinical experiences that a child of brain death transplants liver to an adult. Methods The recipient was a 39-year-old woman patient with primary hepatic carcinoma and posthepatitis cirrhosis (decompensation stage); while the donor was a 8-old-year child of brain death because of brain neoplasms. Donated liver was gained by the method of en bloc multivisceral procurement in a short time; the operative method was classic orthotopic liver transplantation. The postoperative managements included immunosuppression, prevention of infection, hepatic protection, and other relevant supports etc. Results The transplantation operative duration was 6 hours, after which not only did the recipient survive but also her body functioned well including the liver part, with no severe postoperative complications. Conclusions The technology of transplanting livers from children to adults is feasible. The key to ensure the success of transplant operation is systematic preoperative evaluation, excellent operative technique, and perfect postoperative treatment.

  5. Morte encefálica, cuidados ao doador de órgãos e transplante de pulmão Brain death, multiorgan donor and lung transplantation

    Directory of Open Access Journals (Sweden)

    Fernando D'Império

    2007-03-01

    patients. This position is a result of great advances in the field of immunology, critical care medicine and pharmacology. However, organ transplantation is now suffering from its own success as the number of patients in waiting lists is dramatically increasing the same is not happening with organ availability results in increasing number of mortalities while waiting for transplantation. Transplant community responses to this situation consist of reviewing the criteria for organ acceptability and developing new strategies to get organs as the called non-heart beating organ donors. CONTENTS: However the physiopathology of brain death and its consequences are now better understood helping in such patients' management. The purpose of this review is to help to identify the most important clinical and therapeutic aspects related to its physiopathology as depletion of vasoactives substances and its importance in the management of cardio and respiratory systems. We also discuss endocrine and hidroelectrolytes disturbances. Organ specific data are also focused in order to offer a whole view of donor management. CONCLUSIONS: It is important to observe that new technologies will be available in the near future to diminish the low rate between organ availability and organ waiting patients. In conclusion, with the raising numbers in transplant waiting lists and scarce resources of organs make us believe that we have to improve the management of multi organ donors and the preservation technology in order to reduce the mortality in such waiting lists.

  6. Proliferation and cell death in an experimental model of brain tissue heterotopia in the lung Proliferação e morte celular na heterotopia encefálica experimental

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Veiga Quemelo

    2010-08-01

    Full Text Available PURPOSE: To investigate the proliferation and neuronal death in brain tissue heterotopia in the lung in an experimental model during both fetal and neonatal periods. METHODS: Twenty four pregnant female Swiss mice were used to induce brain tissue heterotopia on the 15th gestational day. Briefly, the brain of one fetus of each dam was extracted, disaggregated and injected into the right hemithorax of siblings. Six of these fetuses with pulmonary brain tissue implantation (PBI were collected on the 18th gestational day (group E18 and six other on the 8th postnatal day (group P8. Immunohistochemical staining for PCNA and Bcl2 were used to assess proliferation and cell death. RESULTS: PCNA Labelling Index (LI in heterotopic brain tissue was greater in fetal than postnatal period (E18 > P8 (pOBJETIVO: Investigar a proliferação e morte neuronal na heterotopia encefálica pulmonar em modelo experimental durante o período fetal e neonatal. MÉTODOS: Foram utilizados 24 camundongos Swiss fêmeas prenhes para induzir a heterotopia encefálica no pulmão. O tecido encefálico de um feto de cada fêmea prenha foi removido, picotado e injetado no pulmão dos irmãos. Seis fetos com Implantação Encefálica Pulmonar (IEP foram coletados no 18º dia gestacional (grupo E18 e seis outros fetos no 8º dia pós-natal (grupo P8. Foi realizada a reação Imuno-histoquímica para PCNA e Bcl2 para analisar a proliferação e morte celular. RESULTADOS: O índice de marcação (IM para PCNA era maior no período fetal quando comparado com o período pós-natal (E8 > P18 (p<0,05 e a imunomarcação para o anticorpo Bcl2 não apresentou diferença. CONCLUSÃO: A proliferação celular foi mantida no tecido heterotópico encefálico, embora a apoptose também foi observada.

  7. Disruption of the brain-derived neurotrophic factor (BDNF) immunoreactivity in the human Kölliker-Fuse nucleus in victims of unexplained fetal and infant death

    OpenAIRE

    Anna Maria Lavezzi

    2014-01-01

    Experimental studies have demonstrated that the neurotrophin brain-derived neutrophic factor (BDNF) is required for the appropriate development of the central respiratory network, a neuronal complex in the brainstem of vital importance to sustaining life. The pontine Kölliker-Fuse nucleus (KFN) is a fundamental component of this circuitry with strong implications in the pre- and postnatal breathing control. This study provides detailed account for the cytoarchitecture, the physiology and the ...

  8. Temporal and spatial discordance of programmed cell death-ligand 1 expression and lymphocyte tumor infiltration between paired primary lesions and brain metastases in lung cancer

    Science.gov (United States)

    Mansfield, A. S.; Aubry, M. C.; Moser, J. C.; Harrington, S. M.; Dronca, R. S.; Park, S. S.; Dong, H.

    2016-01-01

    Background The dynamics of PD-L1 expression may limit its use as a tissue-based predictive biomarker. We sought to expand our understanding of the dynamics of PD-L1 expression and tumor-infiltrating lymphocytes (TILs) in patients with lung cancer-related brain metastases. Experimental design Paired primary lung cancers and brain metastases were identified and assessed for PD-L1 and CD3 expression by immunohistochemistry. Lesions with 5% or greater PD-L1 expression were considered positive. Agreement statistics and the χ2 or Fisher's exact test were used for analysis. Results We analyzed 146 paired lesions from 73 cases. There was disagreement of tumor cell PD-L1 expression in 10 cases (14%, κ = 0.71), and disagreement of TIL PD-L1 expression in 19 cases (26%, κ = 0.38). Most paired lesions with discordant tumor cell expression of PD-L1 were obtained 6 or more months apart. When specimens were categorized using a proposed tumor microenvironment categorization scheme based on PD-L1 expression and TILs, there were significant changes in the classifications because many of the brain metastases lacked either PD-L1 expression, tumor lymphocyte infiltration or both even when they were present in the primary lung cancer specimens (P = 0.009). Conclusions We identified that there are significant differences between the tumor microenvironment of paired primary lung cancers and brain metastases. When physicians decide to treat patients with lung cancer with a PD-1 or PD-L1 inhibitor, they must do so in the context of the spatial and temporal heterogeneity of the tumor microenvironment. PMID:27502709

  9. 经颅多普勒超声对脑死亡患者颅内血流动力学的观察%Observation of intracranial hemodynamics in brain death through transcranial doppler ultrasound

    Institute of Scientific and Technical Information of China (English)

    王玉珍; 何奕涛

    2012-01-01

    目的 观察脑死亡患者的脑血流频谱演变过程.方法 采用经颅多普勒超声(TCD)检测脑死亡患者双侧大脑中动脉(MCA)的血流情况.结果 20例临床诊断脑死亡患者的MCA血流速度6~37 cm/s,平均(12.13 ±3.15) cm/s.频谱变化有振荡波(舒张期反向波)、钉子波(收缩期尖小波形)、无血流信号三种TCD特征性频谱,并随病情进展依次出现.20例患者均在出现振荡波频谱后8d内出现心跳不可逆停止,其中有90%(18例)的患者血流频谱出现振荡波-钉子波-无血流信号的演变过程.结论 振荡波、钉子波及血流信号消失这三种规律性演变的特征性TCD血流频谱能辅助脑死亡的诊断.%Objective To observe the evolution process of cerebral blood flow spectrum in brain death by transcranial doppler ultrasound.Methods To detect the blood flow of bilateral middle cerebral artery in brain dead patients by transcranial doppler ultrasound.Results Twenty brain dead patients were collected in the study.The blood flow velocity of middle cerebral artery ranged s from 6 to 37cm/s,and the mean velocity was (12.13 ± 3.15)cm/s.There were three characteristic spectrums which include oscillatory wave (reverse wave in diastolic),nails wave (tip small wave in systolic),no blood flow sign,and they appeared in turn accoerding to worsen of the disease.The heartbeat irreversibly stopped within 8 days after the appearing of oscillatory wave,and ninty percent of the cases had the regular blood flow spectrums of oscillatory wave-nails wave-no blood flow sign.Conclusion The three regularly characteristic transcranial doppler ultrasound blood flow spectrums,which include oscillatory wave,nails wave and no blood flow sign could facilitate the diagnosis of brain death.

  10. Effect of Cocaine on Fas-Associated Protein with Death Domain in the Rat Brain: Individual Differences in a Model of Differential Vulnerability to Drug Abuse

    OpenAIRE

    García-Fuster, María-Julia; Clinton, Sarah M; Watson, Stanley J.; Akil, Huda

    2008-01-01

    This study was designed to (1) assess the effects of cocaine on Fas-associated protein with death domain (FADD) system and its role in the activation of apoptotic vs nonapoptotic events and (2) ascertain whether animals selectively bred for their differential propensity to drug-seeking show differences in FADD levels or response to cocaine. Acute cocaine, through D2 dopamine receptors, induced a dose–response increase in FADD protein in the cortex, with opposite effects over pFADD (Ser191/194...

  11. Brain peroxisomes.

    Science.gov (United States)

    Trompier, D; Vejux, A; Zarrouk, A; Gondcaille, C; Geillon, F; Nury, T; Savary, S; Lizard, G

    2014-03-01

    Peroxisomes are essential organelles in higher eukaryotes as they play a major role in numerous metabolic pathways and redox homeostasis. Some peroxisomal abnormalities, which are often not compatible with life or normal development, were identified in severe demyelinating and neurodegenerative brain diseases. The metabolic roles of peroxisomes, especially in the brain, are described and human brain peroxisomal disorders resulting from a peroxisome biogenesis or a single peroxisomal enzyme defect are listed. The brain abnormalities encountered in these disorders (demyelination, oxidative stress, inflammation, cell death, neuronal migration, differentiation) are described and their pathogenesis are discussed. Finally, the contribution of peroxisomal dysfunctions to the alterations of brain functions during aging and to the development of Alzheimer's disease is considered.

  12. Recomendações técnicas para o registro do eletrencefalograma (EEG na suspeita da morte encefálica Guidelines for electroencephalogram (eeg recording in suspected brain death

    Directory of Open Access Journals (Sweden)

    FRANCISCO JOSÉ C. LUCCAS

    1998-09-01

    Full Text Available Neste trabalho, desenvolvido por uma comissão nomeada pela Sociedade Brasileira de Neurofisiologia Clínica, são apresentadas as recomendações referentes ao registro do eletrencefalograma (EEG nos casos de suspeita de morte encefálica, enfatizando que, apesar do necessário respeito aos parâmetros técnicos, o método não visa substituir o exame neurológico, mas complementá-lo.Brazilian Clinical Neurophysiology Society guidelines and pertaining comments concerning electroencephalogram (EEG recording in suspected brain death are presented. EEG is not intended as a substitute, rather as a complement to neurologic evaluation.

  13. Donor Maintenance of Organ Donation after Brain Death ( Report of 2 Cases )%2例脑死亡无偿器官捐献供体的维护体会

    Institute of Scientific and Technical Information of China (English)

    周志刚; 李超; 李立; 王胤佳; 董权; 郑鹏肖

    2012-01-01

    To explore the donor maintenance points of donor donation after brain death (DBD). Methods From December 2011 to January 2012, two cases of organ DBD in our hospital were performed. After diagnosis of brain death, mechanical ventilation, fluid resuscitation, vasoactive drugs, inotropic drugs, and so on were used, and invasive arterial pressure, central venous pressure, heart rate, blood gas exchange, urine output, electrolyte and acid-base balance, body temperature, hematocrit, albumin level were monitored, the donors vital organ perfusion were successfully kept at acceptable level. Results The vital signs of two cases of DBD donors were stable. The livers, kidneys, and corneas were donated, and the functions were stable and normal. Case one was diagnosed for brain death 6 h after ICU admitted, the period from diagnosis to organ procurement was 33 h. Case two was diagnosed for brain death 8 h after ICU admitted, the period from diagnosis to organ procurement was 31 h. All transplanted organs, livers, kidneys, and corneas, were working well after operation. Conclusions Donor maintenance process of DBD is the cornerstone to ensuring successfully organ donation and transplantation, which is important to improve the utilization rate of donated organs, and release the severely shortage of organ.%目的 探讨脑死亡器官移植供体的维护要点.方法 我院于2011年12月至2012年1月期间共完成2例脑死亡器官捐献(DBD)供体的无偿器官捐献工作.供体确诊为脑死亡,应用机械通气、血管活性药物及其他相关药物维持供体,监测有创动脉压、中心静脉压、心率、血气交换、尿量、电解质酸碱平衡,体温、血细胞比容、白蛋白水平等,维持供体器官灌注.结果 2例DBD供体维持生命体征平稳,捐献的器官功能稳定正常.其中,供体1在人ICU后6h确诊脑死亡,到实施器官捐献共维护33 h;供体2在入ICU后8h确诊脑死亡,到实施器官捐献共维护31 h.捐献的

  14. "Spectacular Death"

    DEFF Research Database (Denmark)

    Jacobsen, Michael Hviid

    2016-01-01

    be labelled ‘spectacular death’ in which death, dying and mourning have increasingly become spectacles. Moreover, the author proposes that what is currently happening in contemporary Western society can be interpreted as an expression of a ‘partial re-reversal’ of ‘forbidden death’ to some...

  15. Maintenance and nursing of 12 brain death organ donation donor in ICU%重症监护病房12例脑死亡器官捐献供体的维护及护理

    Institute of Scientific and Technical Information of China (English)

    赵文静; 朱爽; 马奔; 赵丽萍; 赵文州

    2015-01-01

    Objective To discuss maintenance and nursing of 12 brain death organ dona-tion donor in ICU.Methods The materials of 12 cases with organ donation cardiac death (DCD) in our hospital were summarized,and DCD procedures were developed.And complete maintenance and care for the body according to China Cardiac Death Organ Donation Work Guide.Results There are 35 donor organs from 12 cases,among which there were 23 kidneys,11 livers,one heart and 8 pair of cornea.Conclusion Implementation of organ maintenance and timely care was im-portant work program in DCD,adjusting donor organs function can ensure smoothly organ dona-tion.%目的:探讨重症监护病房脑死亡后器官捐献供体的维护及护理。方法总结性分析12例心脏死亡器官捐献(DCD)工作的临床资料,制定 DCD 工作程序,并依据《中国心脏死亡器官捐献工作指南》完成供体的维护及护理。结果12例供体共产出器官35个,其中肾脏23个、肝脏11个、心脏1个及角膜8对。结论在重症监护病房实施正确及时的器官维护及护理是 DCD 工作的重要程序,在器官切取前将供体器官的功能调o到最佳状态,可确保器官的顺利捐献。

  16. Effect of cocaine on Fas-associated protein with death domain in the rat brain: individual differences in a model of differential vulnerability to drug abuse.

    Science.gov (United States)

    García-Fuster, María-Julia; Clinton, Sarah M; Watson, Stanley J; Akil, Huda

    2009-04-01

    This study was designed to (1) assess the effects of cocaine on Fas-associated protein with death domain (FADD) system and its role in the activation of apoptotic vs nonapoptotic events and (2) ascertain whether animals selectively bred for their differential propensity to drug-seeking show differences in FADD levels or response to cocaine. Acute cocaine, through D(2) dopamine receptors, induced a dose-response increase in FADD protein in the cortex, with opposite effects over pFADD (Ser191/194), and no induction of apoptotic cell death (poly-(ADP-ribose) polymerase cleavage). FADD was increased by cocaine in cytosol (approximately 142%), membranes (approximately 23%) and nucleus (approximately 54%). The modulation of the FADD system showed tolerance of the acute effect over time, as well as a compensatory response on withdrawal that mirrored the acute effect--ie a transient FADD decrease on day 3 of withdrawal, both at mRNA and protein levels. In a second experiment, possible FADD differences were investigated in rats selectively bred for differential responsiveness to novelty, propensity for drug-seeking and cocaine sensitization. High-responders (HR), who were more prone to drug abuse, exhibited higher FADD and lower pFADD levels than low-responder (LR) rats. However, HR and LR rats showed similar rates of cocaine-induced apoptosis, and exhibited a parallel impact of cocaine over FADD within each phenotype. Thus, FADD is a signaling protein modulated by cocaine, regulating apoptosis/proliferative mechanisms in relation to its FADD/pFADD content. Interestingly, animals selectively bred for differential propensity to substance abuse show basal differences in the expression of this protein, suggesting FADD may also be a molecular correlate for the HR/LR phenotype. PMID:18580876

  17. The role of the NADPH oxidase derived brain oxidative stress in the cocaine-related death associated with excited delirium: A literature review.

    Science.gov (United States)

    Schiavone, Stefania; Neri, Margherita; Mhillaj, Emanuela; Pomara, Cristoforo; Trabace, Luigia; Turillazzi, Emanuela

    2016-09-01

    Excited delirium syndrome (ExDS) is a term used to describe a clinical condition characterized by bizarre and aggressive behaviour, commonly associated with the use of psychoactive compounds, especially cocaine. The pathophysiology of ExDS is complex and not yet fully understood. In addition to a central dopamine hypothesis, other mechanisms are thought to be involved in cocaine-related ExDS, such as increased reactive oxygen species production by the family of the NADPH oxidase NOX enzymes. In this review, we will summarize current knowledge on the crucial contribution of brain NADPH oxidase derived oxidative stress in the development of cocaine-induced ExDS. Data from animal models as well as human evidence will be discussed. PMID:27265246

  18. 脑心死亡供体肝移植单中心经验——附33例报告%Liver transplantation with brain and cardiac death donors: a single centre experience with 33 patients

    Institute of Scientific and Technical Information of China (English)

    陈焕伟; 邓斐文; 吴志鹏; 刘洪珍; 欧伟明; 誉铁鸥; 方滨; 李庆生; 梁丽姬

    2015-01-01

    Objective To study the safety and feasibility of liver transplantation using brain and cardiac death donors.Methods The organs from 39 brain and cardiac death donors were harvested at the First People's Hospital of Foshan between September 2011 and April 2014.Five livers were allocated to other liver transplant centers through the China Organ Transplant Response System (COTRS).Two livers were discarded because of major injury and severe hepatic steatosis, respectively.The data of the 39 remaining donors and 33 liver transplant recipients with liver transplantation carried out in our department (including one liver accepted through the COTRS from another transplant center) were retrospectively analyzed.Results Among the 33 donors, 11 were in the China category Ⅰ and 22 category Ⅲ using the classification of China donor after cardiac death.The median age was 38 years.The primary causes of death were brain injury after road accident (n =22), cerebral hemorrhage (n =10), and brain tumor (n =1).The average warm ischemic time of the China category Ⅲ donors was 9.5 min (range 3 ~21 min).The average cold ischemic time of all the donors was 5.2 hours (ranged 3.8 ~ 12.5 h).The median age of the liver transplant recipients was 47.5 years (range 38 to 64 years).The primary disease of the liver transplant recipients was liver cirrhosis due to hepatitis B virus (HBV) infection (n =8), liver failure due to hepatitis C virus (HCV) infection (n =1), liver cirrhosis due to combined HBV and HCV infection (n =1), autoimmune hepatitis (n =1), alcoholic liver cirrhosis (n =1), acute liver function failure due to HBV infection (n =6), acute on chronic liver failure due to HBV infection (n =3), polycystic liver and kidney (n =1), and hepatocellular carcinoma (n =11).The median wait for liver transplantation was 30 days.The median hospitalization after liver transplantation was 28.0 days.At a median follow up of 54 weeks (or 13.5 months), 32 liver recipients were alive and well

  19. Death cap

    DEFF Research Database (Denmark)

    Rudbæk, Torsten R; Kofoed, Pernille Bouteloup; Bove, Jeppe;

    2014-01-01

    Death cap (Amanita phalloides) is commonly found and is one of the five most toxic fungi in Denmark. Toxicity is due to amatoxin, and poisoning is a serious medical condition, causing organ failure with potential fatal outcome. Acknowledgement and clarification of exposure, symptomatic and focused...... treatment is of primary importance. No data from randomised, controlled trials on management exists, and there is not international consensus on treatment regime. We present amatoxin-case contacts to the Danish Poison Centre from 2006-2012 and summarize current knowledge and Danish recommendations...

  20. Nucleolin antagonist triggers autophagic cell death in human glioblastoma primary cells and decreased in vivo tumor growth in orthotopic brain tumor model.

    Science.gov (United States)

    Benedetti, Elisabetta; Antonosante, Andrea; d'Angelo, Michele; Cristiano, Loredana; Galzio, Renato; Destouches, Damien; Florio, Tiziana Marilena; Dhez, Anne Chloé; Astarita, Carlo; Cinque, Benedetta; Fidoamore, Alessia; Rosati, Floriana; Cifone, Maria Grazia; Ippoliti, Rodolfo; Giordano, Antonio; Courty, José; Cimini, Annamaria

    2015-12-01

    Nucleolin (NCL) is highly expressed in several types of cancer and represents an interesting therapeutic target. It is expressed at the plasma membrane of tumor cells, a property which is being used as a marker for several human cancer including glioblastoma. In this study we investigated targeting NCL as a new therapeutic strategy for the treatment of this pathology. To explore this possibility, we studied the effect of an antagonist of NCL, the multivalent pseudopeptide N6L using primary culture of human glioblastoma cells. In this system, N6L inhibits cell growth with different sensitivity depending to NCL localization. Cell cycle analysis indicated that N6L-induced growth reduction was due to a block of the G1/S transition with down-regulation of the expression of cyclin D1 and B2. By monitoring autophagy markers such as p62 and LC3II, we demonstrate that autophagy is enhanced after N6L treatment. In addition, N6L-treatment of mice bearing tumor decreased in vivo tumor growth in orthotopic brain tumor model and increase mice survival. The results obtained indicated an anti-proliferative and pro-autophagic effect of N6L and point towards its possible use as adjuvant agent to the standard therapeutic protocols presently utilized for glioblastoma. PMID:26540346

  1. Nucleolin antagonist triggers autophagic cell death in human glioblastoma primary cells and decreased in vivo tumor growth in orthotopic brain tumor model.

    Science.gov (United States)

    Benedetti, Elisabetta; Antonosante, Andrea; d'Angelo, Michele; Cristiano, Loredana; Galzio, Renato; Destouches, Damien; Florio, Tiziana Marilena; Dhez, Anne Chloé; Astarita, Carlo; Cinque, Benedetta; Fidoamore, Alessia; Rosati, Floriana; Cifone, Maria Grazia; Ippoliti, Rodolfo; Giordano, Antonio; Courty, José; Cimini, Annamaria

    2015-12-01

    Nucleolin (NCL) is highly expressed in several types of cancer and represents an interesting therapeutic target. It is expressed at the plasma membrane of tumor cells, a property which is being used as a marker for several human cancer including glioblastoma. In this study we investigated targeting NCL as a new therapeutic strategy for the treatment of this pathology. To explore this possibility, we studied the effect of an antagonist of NCL, the multivalent pseudopeptide N6L using primary culture of human glioblastoma cells. In this system, N6L inhibits cell growth with different sensitivity depending to NCL localization. Cell cycle analysis indicated that N6L-induced growth reduction was due to a block of the G1/S transition with down-regulation of the expression of cyclin D1 and B2. By monitoring autophagy markers such as p62 and LC3II, we demonstrate that autophagy is enhanced after N6L treatment. In addition, N6L-treatment of mice bearing tumor decreased in vivo tumor growth in orthotopic brain tumor model and increase mice survival. The results obtained indicated an anti-proliferative and pro-autophagic effect of N6L and point towards its possible use as adjuvant agent to the standard therapeutic protocols presently utilized for glioblastoma.

  2. Births and deaths including fetal deaths

    Data.gov (United States)

    U.S. Department of Health & Human Services — Access to a variety of United States birth and death files including fetal deaths: Birth Files, 1968-2009; 1995-2005; Fetal death file, 1982-2005; Mortality files,...

  3. "护理路径"在脑死亡患者捐献器官家属中的实施%Analysis of the Implementation of Organ Donation Families in"Nursing pathway"in Patients with Brain Death

    Institute of Scientific and Technical Information of China (English)

    赵丹丹; 高蕾

    2014-01-01

    目的探讨观察"护理路径"在有器官移植捐献意愿的脑死亡患者中的应用进行综合分析。方法对2012年1月~12月入住的20例脑死亡患者的进行护理,随机分组,观察组(护理路径组)11例和对照组(常规护理路径组)9例,观察两组患者护理后器官保存的完整程度,及患者家属对于护理的满意度等相关资料,进行综合分析。结果观察组,器官完整保存率为院90.9%,护理满意度100%,对照组器官完整保存率为院66.7%,护理满意度55.6%,观察组各项指标均优于对照组,差异有统计学意义(<0.05)。结论"利物浦护理路径"在有器官移植捐献意愿的脑死亡患者中的应用中临床效果好,提高了对临终患者的关怀,加强了患者家属对于护理的满意度,证明其在护理工作流程中占有很重要的地位和优势,是临床上值得推广的、是切实可行的护理方法,使护理质量得到全面的提升。%Objective To explore the observation about a comprehensive analysis that hospitalapply Liverpool nursing path organ in brain death patients with organ donation wil ingness.Mathods To apply this nursing path in twenty brain death patients was in our hospital from January to December 2012.Group randomly two groups. observation group (Liverpool nursing path group)has 11 cases,control group (routine nursing path group)has 9 cases.To observe related data about the complete degree of organ preservation between two groups,and patient'family about nursing satisfacion.Make a comprehensive analysis.Results Organ preserving rate was 90.9%in observation group,nunursing satisfacion was 100%.Organ preserving rate was 66.7%in control group,nunursing satisfacion was 55.6%.Observation group the indicators are the bet er than control group.Differences are statistical y significant ( <0.05).Conclusion Application of Liverpool nursing path in brain death patients with organ donation wil ingness,which has

  4. Analysis of the Implementation of Organ Donation Families in"Nursing pathway"in Patients with Brain Death%"护理路径"在脑死亡患者捐献器官家属中的实施

    Institute of Scientific and Technical Information of China (English)

    赵丹丹; 高蕾

    2014-01-01

    Objective To explore the observation about a comprehensive analysis that hospitalapply Liverpool nursing path organ in brain death patients with organ donation wil ingness.Mathods To apply this nursing path in twenty brain death patients was in our hospital from January to December 2012.Group randomly two groups. observation group (Liverpool nursing path group)has 11 cases,control group (routine nursing path group)has 9 cases.To observe related data about the complete degree of organ preservation between two groups,and patient'family about nursing satisfacion.Make a comprehensive analysis.Results Organ preserving rate was 90.9%in observation group,nunursing satisfacion was 100%.Organ preserving rate was 66.7%in control group,nunursing satisfacion was 55.6%.Observation group the indicators are the bet er than control group.Differences are statistical y significant ( <0.05).Conclusion Application of Liverpool nursing path in brain death patients with organ donation wil ingness,which has achieved good clinical ef ect.Improve the care of dying patients.Strengthen the patient'family for nursing satisfacion.Demonstrate the important position and advantage in nursing work flow.The Liverpool nursing path is worth the clinical promotion,is practical and feasible nursing methods.Improve comprehensive nursing quality.%目的探讨观察"护理路径"在有器官移植捐献意愿的脑死亡患者中的应用进行综合分析。方法对2012年1月~12月入住的20例脑死亡患者的进行护理,随机分组,观察组(护理路径组)11例和对照组(常规护理路径组)9例,观察两组患者护理后器官保存的完整程度,及患者家属对于护理的满意度等相关资料,进行综合分析。结果观察组,器官完整保存率为院90.9%,护理满意度100%,对照组器官完整保存率为院66.7%,护理满意度55.6%,观察组各项指标均优于对照组,差异有统计学意义(<0.05)。结论"利物浦护理路径"在有器官

  5. Invariant death

    Science.gov (United States)

    Frank, Steven A.

    2016-01-01

    In nematodes, environmental or physiological perturbations alter death’s scaling of time. In human cancer, genetic perturbations alter death’s curvature of time. Those changes in scale and curvature follow the constraining contours of death’s invariant geometry. I show that the constraints arise from a fundamental extension to the theories of randomness, invariance and scale. A generalized Gompertz law follows. The constraints imposed by the invariant Gompertz geometry explain the tendency of perturbations to stretch or bend death’s scaling of time. Variability in death rate arises from a combination of constraining universal laws and particular biological processes.

  6. Surviving death

    DEFF Research Database (Denmark)

    Gerstroem, Anna

    2013-01-01

    by another bank to which bankers needed to adapt. Even in the acquiring organization, the legacy organizational identity continued to play a significant role. The paper contributes to the important and timely emergence of theory on legacy organizational identity by showing how members of a dead organization......Organizations start, develop, and mature. Much research is done to learn about organizations’ identities during such developments. But organizations also decline and die and less research is conducted to understand these phases and especially how the organization’s identity is formed in and after...... such phases. The aim of this paper is to explore how an organization’s identity is re-constructed after organizational death. Based on interviews with members of a bankrupted bank who narrate their bankruptcy experiences, the paper explores how legacy organizational identity is constructed after...

  7. Role of computed tomography scores and findings to predict early death in patients with traumatic brain injury: A reappraisal in a major tertiary care hospital in Nepal

    Science.gov (United States)

    Munakomi, Sunil; Bhattarai, Binod; Srinivas, Balaji; Cherian, Iype

    2016-01-01

    Background: Glasgow Coma Scale has been a long sought model to classify patients with head injury. However, the major limitation of the score is its assessment in the patients who are either sedated or under the influence of drugs or intubated for airway protection. The rational approach for prognostication of such patients is the utility of scoring system based on the morphological criteria based on radiological imaging. Among the current armamentarium, a scoring system based on computed tomography (CT) imaging holds the greatest promise in conquering our conquest for the same. Methods: We included a total of 634 consecutive neurosurgical trauma patients in this series, who presented with mild-to-severe traumatic brain injury (TBI) from January 2013 to April 2014 at a tertiary care center in rural Nepal. All pertinent medical records (including all available imaging studies) were reviewed by the neurosurgical consultant and the radiologist on call. Patients’ worst CT image scores and their outcome at 30 days were assessed and recorded. We then assessed their independent performance in predicting the mortality and also tried to seek the individual variables that had significant interplay for determining the same. Results: Both imaging score (Marshall) and clinical score (Rotterdam) can be used to reliably predict mortality in patients with acute TBI with high prognostic accuracy. Other specific CT characteristics that can be used to predict early mortality are traumatic subarachnoid hemorrhage, midline shift, and status of the peri-mesencephalic cisterns. Conclusion: We demonstrated in this cohort that though the Marshall score has the high predictive power to determine the mortality, better discrimination could be sought through the application of the Rotterdam score that encompasses various individual CT parameters. We thereby recommend the use of such comprehensive prognostic model so as to augment our predictive power for properly dichotomizing the prognosis

  8. Neuropathophysiology of Brain Injury.

    Science.gov (United States)

    Quillinan, Nidia; Herson, Paco S; Traystman, Richard J

    2016-09-01

    Every year in the United States, millions of individuals incur ischemic brain injury from stroke, cardiac arrest, or traumatic brain injury. These acquired brain injuries can lead to death or long-term neurologic and neuropsychological impairments. The mechanisms of ischemic and traumatic brain injury that lead to these deficiencies result from a complex interplay of interdependent molecular pathways, including excitotoxicity, acidotoxicity, ionic imbalance, oxidative stress, inflammation, and apoptosis. This article reviews several mechanisms of brain injury and discusses recent developments. Although much is known from animal models of injury, it has been difficult to translate these effects to humans. PMID:27521191

  9. Apoyo nutricio en una mujer embarazada y con muerte cerebral: Informe de un caso y revisión de la literatura Nutritional support in a pregnant woman with brain death: Case report and literature review

    Directory of Open Access Journals (Sweden)

    G. F. Hurtado Torres

    2007-08-01

    Full Text Available La presencia de muerte cerebral en pacientes embarazadas representa una entidad catastrófica, aunque poco frecuente. Los objetivos para continuar manejo médico son: preservar la viabilidad y maduración del producto para lograr su vida extrauterina y considerar a la madre como potencial donador de órganos para trasplante; lo anterior basado en consideraciones éticas, deseos de la familia, condición del producto y edad gestacional. Con las estrategias de manejo actual en unidades de terapia intensiva es posible obtener este doble propósito, apoyados en informes de la literatura en los cuales se describe la obtención de resultados favorables. Los aspectos nutricios desempeñan un papel preponderante tanto para preservar la viabilidad y funcionalidad de órganos maternos así como para lograr el crecimiento y desarrollo del producto.The occurence of brain death represents a catastrophic entity althoug infrequent. The aim to continue medical management are focused in a double purpose: to preserve intrauterine product's life and fetal maduration until delivery and to consider the mother as a potential organ donor. Ethical considerations together with gestational age, product well being and relatives' wishes are cardinal for continuing medical support. Modern critical care units allow to obtain favourable results, supported in scientifical reports that describe successful outcomes. Nutritional aspects plays a cardinal role in the medical management, allowing to preserve mother's organs viability and also to preserve product's intrauterine growth and development.

  10. Brain death: from inflammation to metabolic changes

    NARCIS (Netherlands)

    Rebolledo Acevedo, Rolando

    2016-01-01

    Organ transplantation is an excellent opportunity for patients with end-stage organ failure. However, the number of patients that are still on the waiting list indicates the necessity to increase the number of organs suitable for transplantation. Most organs for transplantation are retrieved from br

  11. The definition and criterion of death.

    Science.gov (United States)

    Bernat, James L

    2013-01-01

    The definition and criterion of death have been rendered ambiguous by developments in organ support technology, particularly the positive-pressure ventilator and vasopressor medications, that uncouple the unitary loss of vital functions in death and create cases in which the brain has been destroyed while circulation and ventilation can be supported. Developing a biophilosophic analysis of the meaning of death before physicians can declare it requires four sequential steps: (1) agreement on the paradigm conditions that frame the analysis and clarify the task; (2) identifying the definition of death, which makes explicit the meaning of death that is accepted in our consensual usage of the term but that has become obscured by technology; (3) identifying the criterion of death that shows that the definition has been fulfilled, and that can be incorporated into a death statute; and (4) devising bedside tests of death for physicians to perform to satisfy the criterion. Although there is a strong consensus on death determination medical standards in countries around the world that has been enshrined into laws, and accepted by most societies and religions, there remains an active dispute among scholars on the precise definition and criterion of death. PMID:24182395

  12. Lung transplantation from donor of cardiac death and donation after brain death in one centre Ⅲ: 4 cases report%单中心心脏死亡和脑死亡供肺肺移植临床经验总结

    Institute of Scientific and Technical Information of China (English)

    毛文君; 陈静瑜; 郑明峰; 吴波; 叶书高; 刘峰

    2012-01-01

    Objective To summarize the clinical experience ot harvesting and using the lungs from donation after brain death (DBD) and donation after cardiac death (DCD,Maastricht category Ⅳ) in China.Methods Eleven potential DBDs and DCDs were evaluated by our transplant group preoperatively,including 6 cases of DCDs and 5 cases of DBDs,and all of them received the tests of sputum culture bedside bronchoscopy,chest X rays,and blood gas analysis.After clear evaluation,1 case of DCD and 2 cases of DBD were discharged from the group for bilateral inflammatory infiltration and poor oxygenation index,and one case of DCD was precluded due to long warm ischemic time (>60min).The donor lungs from remaining 7 cases were harvested successfully after the declaration of brain death or cardiac death.The preoperative lymphocytotoxic cross match test was negative,ABO blood types were compatible,and the donors were all suitable for the transplant procedure.Results Seven lung transplants were performed successfully under ECMO support,including 5 cases of bilateral lung transplantation and 2 cases of single lung transplantation.One patient was complicated with severe infection and died of sepsis on postoperative day (POD) 39,and one was succumbed to multiple organ failure.Two patients suffered of acute rejection on POD 30 and POD 19,respectively,and obtained improvements by bolus steroid therapy.The remaining 3 patients all recovered uneventfully.During a follow up period,all the patients lived an active life style with high quality of life.The mean survival time was 23.3 months (3-51 months).Conclusion The DCD and DBD may be one of the available donor resources for lung transplantation after efficient management of the potential donors and detailed preoperative evaluation in China.%目的 总结单中心脑死亡器官捐赠(DBD)和心脏死亡器官捐赠(DCD)的供肺获取以及肺移植的临床经验.方法 11例潜在器官捐献供者进行了术前评估,所有供者均进行痰

  13. Stroke and cardiac cell death: Two peas in a pod.

    Science.gov (United States)

    Gonzales-Portillo, Chiara; Ishikawa, Hiroto; Shinozuka, Kazutaka; Tajiri, Naoki; Kaneko, Yuji; Borlongan, Cesar V

    2016-03-01

    A close pathological link between stroke brain and heart failure may exist. Here, we discuss relevant laboratory and clinical reports demonstrating neural and cardiac myocyte cell death following ischemic stroke. Although various overlapping risk factors exist between cerebrovascular incidents and cardiac incidents, stroke therapy has largely neglected the cardiac pathological consequences. Recent preclinical stroke studies have implicated an indirect cell death pathway, involving toxic molecules, that originates from the stroke brain and produces cardiac cell death. In concert, previous laboratory reports have revealed a reverse cell death cascade, in that cardiac arrest leads to ischemic cell death in the brain. A deeper understanding of the crosstalk of cell death pathways between stroke and cardiac failure will facilitate the development of novel treatments designed to arrest the global pathology of both diseases thereby improving the clinical outcomes of patients diagnosed with stroke and heart failure.

  14. Can we become zombies after death?

    OpenAIRE

    Hili, Alexander; Duca, Edward

    2015-01-01

    Yes, hypothetically we can be transformed into brain loving zombies. A scary answer to a scary question.However, before going out to buy a chainsaw to cut those zombies in half please be aware that a human zombie has never existed. http://www.um.edu.mt/think/can-we-become-zombies-after-death/

  15. Abandoning the dead donor rule? A national survey of public views on death and organ donation

    OpenAIRE

    Nair-Collins, Michael; Green, Sydney R; Sutin, Angelina R.

    2014-01-01

    Brain dead organ donors are the principal source of transplantable organs. However, it is controversial whether brain death is the same as biological death. Therefore, it is unclear whether organ removal in brain death is consistent with the ‘dead donor rule’, which states that organ removal must not cause death. Our aim was to evaluate the public's opinion about organ removal if explicitly described as causing the death of a donor in irreversible apneic coma. We conducted a cross-sectional i...

  16. Cerebrospinal fluid enzymes in acute brain injury

    NARCIS (Netherlands)

    A.I.R. Maas (Andrew)

    1977-01-01

    textabstractSevere brain injury is a major cause of death, especially in young men. In 1972, over 20% of all deaths occurring in England and Wales in men aged 15-25 years were due to head injury (Field, 1976). The mortality rate after severe brain injuries is higb. Jennett et al. (1977) reporting on

  17. Pediatric brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Poussaint, Tina Y. [Department of Radiology, Boston, MA (United States); Panigrahy, Ashok [Children' s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Huisman, Thierry A.G.M. [Charlotte R. Bloomberg Children' s Center, Johns Hopkins Hospital, Division of Pediatric Radiology and Pediatric Neuroradiology, Baltimore, MD (United States)

    2015-09-15

    Among all causes of death in children from solid tumors, pediatric brain tumors are the most common. This article includes an overview of a subset of infratentorial and supratentorial tumors with a focus on tumor imaging features and molecular advances and treatments of these tumors. Key to understanding the imaging features of brain tumors is a firm grasp of other disease processes that can mimic tumor on imaging. We also review imaging features of a common subset of tumor mimics. (orig.)

  18. Sudden Infant Death Syndrome

    Science.gov (United States)

    Sudden infant death syndrome (SIDS) is the sudden, unexplained death of an infant younger than one year old. Some people call ... boys, African Americans, and American Indian/Alaska Native infants have a higher risk of SIDS. Although health ...

  19. National Death Index

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Death Index (NDI) is a centralized database of death record information on file in state vital statistics offices. Working with these state offices,...

  20. Death in CHARGE syndrome after the neonatal period

    NARCIS (Netherlands)

    Bergman, J. E. H.; Blake, K. D.; Bakker, M. K.; Sarvaas, G. J. du Marchie; Free, R. H.; van Ravenswaaij-Arts, C. M. A.

    2010-01-01

    CHARGE syndrome is a multiple congenital anomaly syndrome that can be life-threatening in the neonatal period. Complex heart defects, bilateral choanal atresia, esophageal atresia, severe T-cell deficiency, and brain anomalies can cause neonatal death. As little is known about the causes of death in

  1. Dreams of Death.

    Science.gov (United States)

    Barrett, Deirdre

    1989-01-01

    Examined frequency and characteristics of overt dreams of dying among healthy young adults. Dreams of dying were found to be rare but distinctive content category, representing overwhelmingly pleasant dreams. Over one-half of death dreams involved lengthy afterlife sequence, remainder focused on process of death. Death dreams of these healthy…

  2. Death and Grief

    Science.gov (United States)

    ... How Can I Help a Friend Who Cuts? Death and Grief KidsHealth > For Teens > Death and Grief Print A A A Text Size ... the reaction we have in response to a death or loss. Grief can affect our body, mind, ...

  3. Organ donation after circulatory death: the forgotten donor?

    OpenAIRE

    Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan

    2006-01-01

    Donation after circulatory death (DCD) can be performed on neurologically intact donors who do not fulfill neurologic or brain death criteria before circulatory arrest. This commentary focuses on the most controversial donor-related issues anticipated from mandatory implementation of DCD for imminent or cardiac death in hospitals across the USA. We conducted a nonstructured review of selected publications and websites for data extraction and synthesis. The recommended 5 min of circulatory arr...

  4. Brain Basics

    Medline Plus

    Full Text Available ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  5. Brain Basics

    Science.gov (United States)

    ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  6. Brain Basics

    Medline Plus

    Full Text Available ... Brain Basics provides information on how the brain works, how mental illnesses are disorders of the brain, ... learning more about how the brain grows and works in healthy people, and how normal brain development ...

  7. Eyelid closure at death

    Directory of Open Access Journals (Sweden)

    A D Macleod

    2009-01-01

    Full Text Available Aim: To observe the incidence of full or partial eyelid closure at death. Materials and Methods: The presence of ptosis was recorded in 100 consecutive hospice patient deaths. Results: Majority (63% of the patients died with their eyes fully closed, however, 37% had bilateral ptosis at death, with incomplete eye closure. In this study, central nervous system tumor involvement and/or acute hepatic encephalopathy appeared to be pre-mortem risk factors of bilateral ptosis at death. Conclusion: Organicity and not psychogenicity is, therefore, the likely etiology of failure of full eyelid closure at death.

  8. Severe Traumatic Brain Injury

    Science.gov (United States)

    ... inflicted traumatic brain injury (ITBI), is a leading cause of child maltreatment deaths in the United States. Meeting the ... Awareness Additional Prevention Resources Childhood Injuries Concussion in Children and Teens Injuries from Violence Injuries from Motor Vehicle Crashes Teen Driver Safety ...

  9. Brain herniation

    Science.gov (United States)

    ... herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain ... Brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most ...

  10. Neuro Memento Mori: meditations on death

    OpenAIRE

    Prophet, Jane

    2015-01-01

    In Neuro Memento Mori, digital animations and live action video are projection mapped onto a 3D print of the artist’s head and neck made from data from 3D scans of the head and MRI scans of the brain. The life-sized 3D printed sculptures are dissected to reveal the artist’s brain and ‘make real’ fMRI data gathered as the artist conducted experiments in the MRI scanner including viewing memento mori paintings and meditating on death. Computation is used to produce 3D neuroimages, 3D prints and...

  11. Sugar for the brain: the role of glucose in physiological and pathological brain function

    OpenAIRE

    Mergenthaler, Philipp; Lindauer, Ute; Dienel, Gerald A; Meisel, Andreas

    2013-01-01

    The mammalian brain depends upon glucose as its main source of energy, and tight regulation of glucose metabolism is critical for brain physiology. Consistent with its critical role for physiological brain function, disruption of normal glucose metabolism as well as its interdependence with cell death pathways forms the pathophysiological basis for many brain disorders. Here, we review recent advances in understanding how glucose metabolism sustains basic brain physiology. We aim at synthesiz...

  12. Death proteases come alive

    NARCIS (Netherlands)

    Woltering, E.J.

    2004-01-01

    Cell death in plants exhibits morphological features comparable to caspase-mediated apoptosis in animals, suggesting that plant cell death is executed by (caspase-like) proteases. However, to date, no caspase homologues have been identified in plants and therefore the existence and nature of these p

  13. Physician-Assisted Death

    OpenAIRE

    Senn, John S.

    1994-01-01

    Physician-assisted death includes both euthanasia and assistance in suicide. The CMA urges its members to adhere to the principles of palliative care. It does not support euthanasia and assisted suicide. The following policy summary includes definitions of euthanasia and assisted suicide, background information, basic ethical principles and physician concerns about legalization of physician-assisted death.

  14. Programmed cell death

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    The purpose of this conference to provide a multidisciplinary forum for exchange of state-of-the-art information on the role programmed cell death plays in normal development and homeostasis of many organisms. This volume contains abstracts of papers in the following areas: invertebrate development; immunology/neurology; bcl-2 family; biochemistry; programmed cell death in viruses; oncogenesis; vertebrate development; and diseases.

  15. Death Acceptance through Ritual

    Science.gov (United States)

    Reeves, Nancy C.

    2011-01-01

    This article summarizes the author's original research, which sought to discover the elements necessary for using death-related ritual as a psychotherapeutic technique for grieving people who experience their grief as "stuck," "unending," "maladaptive," and so on. A "death-related ritual" is defined as a ceremony, directly involving at least 1…

  16. Conflicting Thoughts about Death

    Science.gov (United States)

    Harris, Paul L.

    2011-01-01

    Most research on children's conception of death has probed their understanding of its biological aspects: its inevitability, irreversibility and terminal impact. Yet many adults subscribe to a religious conception implying that death marks the beginning of a new life. Two recent empirical studies confirm that in the course of development, children…

  17. Death in media

    Directory of Open Access Journals (Sweden)

    Pavićević Aleksandra

    2010-01-01

    Full Text Available This paper discusses the role of media in a construction of public image speech and presentation of death. The main research questions could be posed as follows: does the media discourse confirm a thesis about modern society as the one which intensely avoids encounter with Death, or does it defy it? Frequent images or hints of death in visual media in films informative and entertainment programs-suggest certain changes related to this issue in the past few decades. This analysis focuses on printed media hence the paper assesses numerous issues of the daily journal Politika from 1963, 1972, 1973, 1979, 1985, 1991, 1995, 1999, 2007 and 2008, as well as some other daily journals after 2000. The analysis confirms a strong connection between the current political systems and ideology and speech about death. In addition, it reveals a political usage of this event but also speaks up about cultural and historical models, underlying all other constructions. During the 1960's and 1970's, the presentations, including the speech about death relied on the traditional understandings about inevitability of death and dying, and alternatively on atheistic beliefs related to the progress and wellbeing of the society. In this particular discourse, death was present to a limited degree, serving primarily to glorify socialist order. The end of the 1970's witnessed an increase in the glorification of the death, correlated with the decrease of the dominant political ideology. On the other hand, the 1990's brought about more presence of the national and religious symbolism and glorification of the dead as heroes. After 2000, mercantilism is evident throughout the media. All of the media broadcast drastic images of death and dead, thus providing an answer to the posed question at the beginning of this paper about the relationship of the modern society towards death but nevertheless, this still leaves out many implicit consequences and possible meanings.

  18. Towards an effective definition of death and disorders of consciousness.

    Science.gov (United States)

    Machado, Calixto; Leisman, Gerry

    2009-01-01

    There exists much controversy in providing an effective definition of human death, largely due to the lack of a rigorous separation and ordered formulation of three distinct elements: a universally accepted definition of death, the medical criterion (anatomical substrata) for determining that death has occurred, and the tests to prove that the criterion has been satisfied. The papers herein review medical standards, philosophical arguments, neurophysiological knowledge, behavioural and cognitive theory and the legal ramifications of the brain-oriented standards of death (whole brain, brainstem and higher brain). The papers examine the notion of connectivities and networks of conscious experience in order to formulate an effective definition of death, based on the basic physiopathological mechanisms of consciousness. We cannot simply differentiate and locate arousal as a function of the ascending reticular activating system, and awareness as a function of the cerebral cortex. Substantial interconnections among the brainstem, subcortical structures, and the neocortex are essential integrating components of human consciousness. This paper attempts to reconcile the brain-oriented standards that are currently inconsistent. The thread of the arguments is the basis for a standard of human death that includes consciousness as the most important function of the body, because it provides the capacity for integrating the functions of the body. The notion of consciousness as the ultimate integrative function is more consistent with the biologically-based systems than the more philosophically-based notions of personhood. Both sides of the argument are presented herein.

  19. [Organ donation after circulatory death].

    Science.gov (United States)

    de Jonge, J; Kalisvaart, M; van der Hoeven, M; Epker, J; de Haan, J; IJzermans, J N M; Grüne, F

    2016-02-01

    Approximately 17 million inhabitants live in the Netherlands. The number of potential organ donors in 1999 was the lowest in Europe with only 10 donors per million inhabitants. Medical associations, public health services, health insurance companies and the government had to find common solutions in order to improve organ allocation, logistics of donations and to increase the number of transplantations. After a prolonged debate on medical ethical issues of organ transplantation, all participants were able to agree on socio-medico-legal regulations for organ donation and transplantation. In addition to improving the procedure for organ donation after brain death (DBD) the most important step was the introduction of organ donation after circulatory death (DCD). Measures such as the introduction of a national organ donor database, improved information to the public, further education on intensive care units (ICU), guidelines for end of life care on the ICU, establishment of transplantation coordinators on site, introduction of autonomous explantation teams and strict procedures on the course of organ donations, answered many practical issues about logistics and responsibilities for DBD and DCD. In 2014 the number of postmortem organ donations rose to 16.4 per million inhabitants. Meanwhile, up to 60 % of organ donations in the Netherlands originate from a DCD procedure compared to approximately 10 % in the USA. This overview article discusses the developments and processes of deceased donation in the Netherlands after 15 years of experience with DCD. PMID:26810404

  20. Acanthamoeba castellanii Induces Host Cell Death via a Phosphatidylinositol 3-Kinase-Dependent Mechanism

    Science.gov (United States)

    Sissons, James; Kim, Kwang Sik; Stins, Monique; Jayasekera, Samantha; Alsam, Selwa; Khan, Naveed Ahmed

    2005-01-01

    Granulomatous amoebic encephalitis due to Acanthamoeba castellanii is a serious human infection with fatal consequences, but it is not clear how the circulating amoebae interact with the blood-brain barrier and transmigrate into the central nervous system. We studied the effects of an Acanthamoeba encephalitis isolate belonging to the T1 genotype on human brain microvascular endothelial cells, which constitute the blood-brain barrier. Using an apoptosis-specific enzyme-linked immunosorbent assay, we showed that Acanthamoeba induces programmed cell death in brain microvascular endothelial cells. Next, we observed that Acanthamoeba specifically activates phosphatidylinositol 3-kinase. Acanthamoeba-mediated brain endothelial cell death was abolished using LY294002, a phosphatidylinositol 3-kinase inhibitor. These results were further confirmed using brain microvascular endothelial cells expressing dominant negative forms of phosphatidylinositol 3-kinase. This is the first demonstration that Acanthamoeba-mediated brain microvascular endothelial cell death is dependent on phosphatidylinositol 3-kinase. PMID:15845472

  1. Children's Death Concepts and Ethnicity.

    Science.gov (United States)

    Wass, Hannelore; Towry, Betty J.

    1980-01-01

    Relationships between death concepts of Black and White children and their racial status were examined. Lower-middle-class elementary children completed a four-item questionnaire on death. Most children defined death as the end of living and listed physical causes as the explanation of death. In general, children's death concepts were similar.…

  2. Sudden infant death syndrome

    Science.gov (United States)

    ... than girls. Most SIDS deaths occur in the winter. The following may increase the risk for SIDS: ... BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; ...

  3. Amending Death Rules

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    China’s Criminal Law is being revised to cut down on death sentences and tighten up punishment for surging crimes The eighth amendment to the Criminal Law, demanding moreprudent use of capital punishment

  4. Hitler's Death Camps.

    Science.gov (United States)

    Wieser, Paul

    1995-01-01

    Presents a high school lesson on Hitler's death camps and the widespread policy of brutality and oppression against European Jews. Includes student objectives, instructional procedures, and a chart listing the value of used clothing taken from the Jews. (CFR)

  5. Eighth Amendment & Death Penalty.

    Science.gov (United States)

    Shortall, Joseph M.; Merrill, Denise W.

    1987-01-01

    Presents a lesson on capital punishment for juveniles based on three hypothetical cases. The goal of the lesson is to have students understand the complexities of decisions regarding the death penalty for juveniles. (JDH)

  6. Epidemiological features of brain tumors

    Directory of Open Access Journals (Sweden)

    Živković Nenad

    2013-01-01

    Full Text Available Brain tumors account for 1.4% of all cancers and 2.4% of all cancer-related deaths. The incidence of brain tumors varies and it is higher in developed countries of Western Europe, North America, Australia and New Zealand. In Serbia, according to data from 2009, malignant brain tumors account for 2. 2 of all tumors, and from all cancer­related deaths, 3.2% is caused by malignant brain tumors. According to recent statistical reports, an overall incidence of brain tumors for benign and malignant tumors combined is 18.71 per 100,000 persons/year. The most common benign brain tumor in adults is meningioma, which is most present in women, and the most common malignant tumor is glioblastoma, which is most present in adult men. Due to high mortality, especially in patients diagnosed with glioblastoma and significant brain tumor morbidity, there is a constant interest in understanding its etiology in order to possibly prevent tumor occurrence in future and enable more efficient treatment strategies for this fatal brain disease. Despite the continuously growing number of epidemiological studies on possible factors of tumor incidence, the etiology remains unclear. The only established environmental risk factor of gliomas is ionizing radiation exposure. Exposure to radiofrequency electromagnetic fields via cell phone use has gained a lot of attention as a potential risk factor of brain tumor development. However, studies have been inconsistent and inconclusive, so more definite results are still expected.

  7. Autoerotic deaths: four cases.

    Science.gov (United States)

    Cooke, C T; Cadden, G A; Margolius, K A

    1994-07-01

    We describe the circumstances and post mortem medical findings of 4 unusual fatalities where death occurred during autoerotic practice. Three cases occurred in young to middle-aged men--hanging, electrocution and inhalation of a zucchini. The manner of death in each was accidental. The fourth case was an elderly man who died of ischemic heart disease, apparently whilst masturbating with a vacuum cleaner and a hair dryer.

  8. Unnatural sudden infant death

    OpenAIRE

    Meadow, R

    1999-01-01

    AIM—To identify features to help paediatricians differentiate between natural and unnatural infant deaths.
METHOD—Clinical features of 81 children judged by criminal and family courts to have been killed by their parents were studied. Health and social service records, court documents, and records from meetings with parents, relatives, and social workers were studied.
RESULTS—Initially, 42 children had been certified as dying from sudden infant death syndrome (SIDS), and 29 wer...

  9. Necrotizing Scleritis, Conjunctivitis, and Other Pathologic Findings in the Left Eye and Brain of an Ebola Virus-Infected Rhesus Macaque (Macaca mulatta) With Apparent Recovery and a Delayed Time of Death.

    Science.gov (United States)

    Alves, Derron A; Honko, Anna N; Kortepeter, Mark G; Sun, Mei; Johnson, Joshua C; Lugo-Roman, Luis A; Hensley, Lisa E

    2016-01-01

    A 3.5-year-old adult female rhesus macaque (Macaca mulatta) manifested swelling of the left upper eyelid and conjunctiva and a decline in clinical condition 18 days following intramuscular challenge with Ebola virus (EBOV; Kikwit-1995), after apparent clinical recovery. Histologic lesions with strong EBOV antigen staining were noted in the left eye (scleritis, conjunctivitis, and peri-optic neuritis), brain (choriomeningoencephalitis), stomach, proximal duodenum, and pancreas. Spleen, liver, and adrenal glands, common targets for acute infection, appeared histologically normal with no evidence of EBOV immunoreactivity. These findings may provide important insight for understanding sequelae seen in West African survivors of Ebola virus disease.

  10. Necrotizing Scleritis, Conjunctivitis, and Other Pathologic Findings in the Left Eye and Brain of an Ebola Virus-Infected Rhesus Macaque (Macaca mulatta) With Apparent Recovery and a Delayed Time of Death.

    Science.gov (United States)

    Alves, Derron A; Honko, Anna N; Kortepeter, Mark G; Sun, Mei; Johnson, Joshua C; Lugo-Roman, Luis A; Hensley, Lisa E

    2016-01-01

    A 3.5-year-old adult female rhesus macaque (Macaca mulatta) manifested swelling of the left upper eyelid and conjunctiva and a decline in clinical condition 18 days following intramuscular challenge with Ebola virus (EBOV; Kikwit-1995), after apparent clinical recovery. Histologic lesions with strong EBOV antigen staining were noted in the left eye (scleritis, conjunctivitis, and peri-optic neuritis), brain (choriomeningoencephalitis), stomach, proximal duodenum, and pancreas. Spleen, liver, and adrenal glands, common targets for acute infection, appeared histologically normal with no evidence of EBOV immunoreactivity. These findings may provide important insight for understanding sequelae seen in West African survivors of Ebola virus disease. PMID:26153408

  11. CDC WONDER: Mortality - Infant Deaths

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Mortality - Infant Deaths (from Linked Birth / Infant Death Records) online databases on CDC WONDER provide counts and rates for deaths of children under 1 year...

  12. Death among children and adolescents

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001915.htm Death among children and adolescents To use the sharing features on ... injuries) are, by far, the leading cause of death among children and teens. THE TOP THREE CAUSES OF DEATH ...

  13. Brain Fingerprinting

    Directory of Open Access Journals (Sweden)

    Ravi Kumar

    2012-12-01

    Full Text Available Brain Fingerprinting is a scientific technique to determine whether or not specific information is stored in an individual's brain by measuring a electrical brain wave response to Word, phrases, or picture that are presented on computer screen. Brain Fingerprinting is a controversial forensic science technique that uses electroencephalography (EEG to determine whether specific information is stored in a subject's brain.

  14. Brain Fingerprinting

    Directory of Open Access Journals (Sweden)

    ravi kumar

    2012-12-01

    Full Text Available Brain Fingerprinting is a scientific technique to determine whether or not specific information is stored in an individual's brain by measuring a electrical brain wave response to Word, phrases, or picture that are presented on computer screen. Brain Fingerprinting is a controversial forensic science technique that uses electroencephalograph y (EEG to determine whether specific information is stored in a subject's brain

  15. Brain Tumors

    Science.gov (United States)

    A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, ... cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are ...

  16. The mechanism of oligodendrocyte precursor cell death passway in hypoxic - ischemic brain damage.%缺氧缺血性脑损伤中的少突胶质前体细胞死亡通路机制

    Institute of Scientific and Technical Information of China (English)

    杨雪; 郝艳秋

    2011-01-01

    缺氧缺血性脑损伤( hypoxic - ischemic brain damage,HIBD)是围产期常见疾病,致病机制尚未完全明确,治疗困难,预后差.少突胶质前体细胞( Oligodendrocyte precursor cell,OPC)是HIBD的主要靶细胞之一.缺氧缺血可以通过凋亡、氧自由基、兴奋毒性损伤等途径引发OPC死亡.亚低温、神经营养因子、OPC移植等方法可以通过抑制凋亡、抗氧化应激、拮抗兴奋毒性损伤等机制用于临床治疗HIBD.%Hypoxic - ischemic brain damage is a common disease in perinatal period, and it's pathogenic mechanism is not defi-nite completly. It is difficult to treat HIBD and the prognosis is not ideal. Oligodendrocyte precursor cell is the main target of HIBD. Hypoxic - ischemia can induce OPC to die through apoptosis, oxygen radicals and exitotoxicity. Mild hypothermia, neurotrophic factors and OPC transplantation can be applied to treat HIBD through depressing apoptosis, confronting oxygen radicals and inhibitting exito-toxicity.

  17. Donation after cardiac death and the emergency department: ethical issues.

    Science.gov (United States)

    Simon, Jeremy R; Schears, Raquel M; Padela, Aasim I

    2014-01-01

    Organ donation after cardiac death (DCD) is increasingly considered as an option to address the shortage of organs available for transplantation, both in the United States and worldwide. The procedures for DCD differ from procedures for donation after brain death and are likely less familiar to emergency physicians (EPs), even as this process is increasingly involving emergency departments (EDs). This article explores the ED operational and ethical issues surrounding this procedure. PMID:24552527

  18. [Deaths in hotels].

    Science.gov (United States)

    Risse, Manfred; Weilbächer, Nadine; Birngruber, Christoph; Verhoff, Marcel A

    2010-01-01

    There are no verified statistics about deaths occurring in hotels, and only a few cases have been described in the literature. A recent case induced us to conduct a systematic search for deaths in hotels in the autopsy reports of the Institute of Legal Medicine in Giessen for the period from 1968 to 2009. This search yielded 22 evaluable cases in which persons had been found dead or had died in hotels. Data evaluated in the study were sex and age of the deceased, reason for the stay in the hotel and cause of death. Among the deaths, 18 were males and 4 females and the average age was 41 and 40 years respectively. 6 of the male guests had died from a natural and 10 from a non-natural cause. In the remaining two cases, the cause of death could not be determined, but as there was no evidence that another party had been involved, the cases were not further investigated. Of the 4 female guests, 3 had died of a natural cause; in one case, the cause of death remained unclear even after morphological and toxicological investigations. Surprisingly, a third of the men were found to be temporarily living in hotels due to social circumstances. This was not true for any of the women. Our retrospective analysis is based on a comparatively small number of deaths in what were mostly hotels in small to medium-sized towns. Interestingly, the gender ratio of 18:4 for deceased men and women was significantly higher than the usual gender ratio of 2:1 found for forensic autopsies. To be able to draw further conclusions, a greater number of cases would have to be analysed, for example by recruiting additional case files from other institutes of legal medicine. This would also open up the option of investigating possible regional variations.

  19. Early Brain Vulnerability in Wolfram Syndrome

    OpenAIRE

    Hershey, Tamara; Lugar, Heather M.; Shimony, Joshua S.; Rutlin, Jerrel; Koller, Jonathan M.; Perantie, Dana C.; Paciorkowski, Alex R.; Eisenstein, Sarah A.; Permutt, M. Alan; ,

    2012-01-01

    Wolfram Syndrome (WFS) is a rare autosomal recessive disease characterized by insulin-dependent diabetes mellitus, optic nerve atrophy, diabetes insipidus, deafness, and neurological dysfunction leading to death in mid-adulthood. WFS is caused by mutations in the WFS1 gene, which lead to endoplasmic reticulum (ER) stress-mediated cell death. Case studies have found widespread brain atrophy in late stage WFS. However, it is not known when in the disease course these brain abnormalities arise, ...

  20. Brain Basics

    Medline Plus

    Full Text Available ... as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are the basic working unit of the brain ... specialized for the function of conducting messages. A neuron has three basic parts: Cell body which includes ...

  1. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  2. Brain Malformations

    Science.gov (United States)

    Most brain malformations begin long before a baby is born. Something damages the developing nervous system or causes it ... medicines, infections, or radiation during pregnancy interferes with brain development. Parts of the brain may be missing, ...

  3. Brain Basics

    Medline Plus

    Full Text Available ... Brain Basics provides information on how the brain works, how mental illnesses are disorders of the brain, ... others live with symptoms of mental illness every day. They can be moderate, or serious and cause ...

  4. Brain Basics

    Medline Plus

    Full Text Available ... The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are the basic working unit of the ... distant nerve cells (via axons) to form brain circuits. These circuits control specific body functions such as ...

  5. Brain Basics

    Medline Plus

    Full Text Available ... Basics will introduce you to some of this science, such as: How the brain develops How genes and the environment affect the brain The basic structure of the brain How different parts of ...

  6. Brain Basics

    Medline Plus

    Full Text Available ... science, such as: How the brain develops How genes and the environment affect the brain The basic ... that with brain development in people mental disorders. Genes and environmental cues both help to direct this ...

  7. Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Yipsy María Gutiérrez Báez

    2015-09-01

    Full Text Available Since the second half of the twentieth century, dying suddenly due to heart-related problems has become the main health issue in all countries where infectious diseases are not prevalent. Sudden death from cardiac causes is an important global health problem. Major databases were searched for the leading causes of sudden cardiac death. It has been demonstrated that there is a group of hereditary diseases with structural alterations or without apparent organic cause that explains many cases of sudden death in young people, whether related or not to physical exertion. Certain population groups are at higher risk for this disease. They are relatively easy to identify and can be the target of primary prevention measures.

  8. The "moment of death".

    Science.gov (United States)

    Valentine, Christine

    2007-01-01

    The "moment of death," once a dominant concept in preparing for a "good death", has been eclipsed by a focus on the wider concept of the "dying trajectory". However, findings from interviews with 25 bereaved individuals suggest that dying loved ones' final moments may still be experienced as highly significant in their own right. In some accounts the dying individual's final moments did not feature or made little impression, either because the survivor was not present, or there was no obviously definable moment, or because other, usually medical factors, such as whether to resuscitate the person, took precedence. However, in six cases such moments were constructed as profound, special, and memorable occasions. These constructions are explored in relation to achieving a good death, the dying trajectory as a whole, and making sense of the bereavement experience. Their implications for sociological theories of identity and embodiment are also considered. PMID:18214069

  9. Sudden infant death syndrome, childhood thrombosis, and presence of genetic risk factors for thrombosis

    DEFF Research Database (Denmark)

    Larsen, T B; Nørgaard-Pedersen, B; Banner, Jytte;

    2000-01-01

    in the child. This prompted us to investigate these genetic markers of thromboembolic disease in 121 cases of sudden infant death syndrome and in relevant controls, in the expectation of a more frequent occurrence of these markers if thrombosis is an etiological factor in sudden infant death syndrome......Sudden infant death syndrome or "cot death" has until the late eighties been a significant cause of death in children between the ages of 1 month and 1 year. Approximately two per 1000 children born alive dies of sudden infant death syndrome each year in Western Europe, North America, and Australia....... The vulnerability of the infant brain stem to ischemia has been suggested to be a conceivable cause of sudden infant death syndrome. This is compatible with a hypothesis that genetic risk factors for cerebral thrombosis could cause microinfarction in the brain stem during the first month of life, affecting vital...

  10. Is there science behind the near-death experience: Does human consciousness survives after death?

    Directory of Open Access Journals (Sweden)

    Pranab Kumar Bhattacharya

    2013-01-01

    Full Text Available Near death experiences (NDEs have been reported throughout world in essentially all cultures, including amongst the believers of the Hindu religion The contents of NDEs are independent of the gender, age, profession, religion, belief of soul, belief in angels of death or ghosts and belief in death kingdom and heaven, of people who experienced it. The frequency of occurrence is estimated to be between 5% to 48% in adults, and around 85% in children who experienced near-death situations. This frequency may be higher still, perhaps even 100 percent, were it not for the dreamlike and dissociative character of these experiences, and the amnesia-prone participation of the temporal lobe cortex of brain, causing a clear tendency to forget the NDE. A number of experiences can be very similar to NDEs, such as review of one′s life in this planet, or an out-of-body experience (OBE, in which the physical body and its surroundings are observed from various external vantage points, often from above, such that the body is passing through a deep dark tunnel, or seeing flash of light equal to thousands of sun for pure souls. The experience of seeing God and conversing with him, seeing alien lands, seeing dead relatives or someone′s future, can all be regarded as similar in nature. Many individuals have reported horror experiences as well. Numerous cases-are existing in which the reality of the the OBE-observation can be independently ′verified, by external conditions, situations, people, objects, etc. Even people who are non-religious, subsequent to NDE experiences have displayed a markedly decreased fear of death, and a corresponding increase in the belief in "life after death" and re-incarnation. Certain elements of NDE- experiences can be induced by drugs, such as hallucinogenic substances and anesthetic drugs like ketamine, and electrical stimulation of the right temporal lobe or the limbic system has also produced such effects. The possibility that the

  11. Digital language death.

    Directory of Open Access Journals (Sweden)

    András Kornai

    Full Text Available Of the approximately 7,000 languages spoken today, some 2,500 are generally considered endangered. Here we argue that this consensus figure vastly underestimates the danger of digital language death, in that less than 5% of all languages can still ascend to the digital realm. We present evidence of a massive die-off caused by the digital divide.

  12. Death of a child.

    OpenAIRE

    Goertzen, J

    1993-01-01

    The death of a small child from a terminal illness is an uncommon but influential event in a family physician's career. Through dialogue with colleagues and friends, self-reflection, and acknowledgment of some of the difficulties, this experience can stimulate personal growth.

  13. Bee deaths need analysing

    NARCIS (Netherlands)

    Boonekamp, P.M.

    2011-01-01

    Alarm bells are ringing all over the world about the death of bee populations. Although it is not known exactly how severe the decline is, it is important to take the problem seriously. The signals are alarming and the bee is important, not just for natural ecosystems but also for the pollination of

  14. Sudden cardiac death

    DEFF Research Database (Denmark)

    Hougen, H P; Valenzuela, Antonio Jesus Sanchez; Lachica, E;

    1992-01-01

    53 and one case was inconclusive. After studying the circumstances of death, the number of discrepancies were reduced to 20, so that concordance was reached in 86% of all the cases. The results show that the combination of different methods leads to a diagnosis of myocardial infarction in far more...

  15. Death in Flames

    DEFF Research Database (Denmark)

    Harvig, Lise; Kveiborg, Jacob; Lynnerup, Niels

    2015-01-01

    This paper presents osteoarchaeological analyses of the human skeletal material from a burnt down house in Jutland, Denmark, dated to the first century bc. We describe how the osteological analyses of this complex site were approached and illustrate how we reconstructed the death of the human...

  16. Optimal Aging and Death

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan; Strulik, Holger

    the representative consumer is subject to physiological aging. In modeling aging we draw on recent research in the fields of biology and medicine. The speed of the aging process, and thus the time of death, are endogenously determined by optimal health investments. We calibrate the model to US data and proceed...

  17. Digital language death.

    Science.gov (United States)

    Kornai, András

    2013-01-01

    Of the approximately 7,000 languages spoken today, some 2,500 are generally considered endangered. Here we argue that this consensus figure vastly underestimates the danger of digital language death, in that less than 5% of all languages can still ascend to the digital realm. We present evidence of a massive die-off caused by the digital divide. PMID:24167559

  18. Digital Language Death

    OpenAIRE

    András Kornai

    2013-01-01

    Of the approximately 7,000 languages spoken today, some 2,500 are generally considered endangered. Here we argue that this consensus figure vastly underestimates the danger of digital language death, in that less than 5% of all languages can still ascend to the digital realm. We present evidence of a massive die-off caused by the digital divide.

  19. The Death Penalty.

    Science.gov (United States)

    Crockett, Mark

    1990-01-01

    Provides a lesson plan on the Eighth Amendment to the U.S. Constitution and the imposition of the death penalty. Focuses on the controversy concerning capital punishment and stimulates critical thinking in an analysis and discussion of eight hypothetical situations. Includes suggestions for readings, videotapes, and writing assignments. (NL)

  20. Radiosensitized treatment of malignant brain tumors

    Science.gov (United States)

    Bloznelyte-Plesniene, Laima

    2003-12-01

    Around 12,000 deaths from glioblastoma occurs within the European Community annually. At present, the best available treatment for malignant brain tumors results in a median survival of patients of 15 months despite surgery, radiotherapy, and chemotherapy. The purpose of this paper is to review our results of radiosensitized treatment of malignant brain tumors.

  1. Brain Basics

    Medline Plus

    Full Text Available ... Welcome. Brain Basics provides information on how the brain works, how mental illnesses are disorders of the brain, ... highly developed area at the front of the brain that, in humans, plays a role in executive functions such as ...

  2. Brain Basics

    Medline Plus

    Full Text Available ... Research Modern research tools and techniques are giving scientists a more detailed understanding of the brain than ever before. Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses magnetic fields to take pictures of the brain's structure, studies ...

  3. Early maternal death due to acute encephalitis

    Directory of Open Access Journals (Sweden)

    M Vidanapathirana

    2014-03-01

    Full Text Available Maternal death in an unmarried woman poses a medico-legal challenge. A 24-year-old unmarried schoolteacher, residing at a boarding place, had been admitted to hospital in a state of cardiac arrest. At the autopsy, mild to moderate congestion of subarachnoid vessels and oedema of the brain was noted. An un-interfered foetus of 15 weeks with an intact sac and placental tissues were seen. Genital tract injuries were not present. Histopathological examination showed diffuse perivascular cuffing by mononuclear cells suggestive of viral encephalitis, considering the circumstances of death and the social stigma of pregnancy in this unmarried teacher, the possibility of attempted suicide by ingestion of a poison was considered. Abrus precatorius (olinda seeds commonly found in the area is known to produce acute encephalitis as well as haemorrhagic gastroenteritis and pulmonary congestion was also considered as a possible cause for this unusual presentation

  4. Receptores de trasplante renal de donantes en asistolia y muerte cerebral: diferencias en los cuidados enfermeros Recipients of kidney transplants from donors in asystole and brain death: differences in nursing care

    Directory of Open Access Journals (Sweden)

    Mª Concepción García Viana

    2012-03-01

    Full Text Available Hoy en día es indiscutible que el trasplante renal es el tratamiento sustitutivo de elección para pacientes con enfermedad renal crónica. En nuestro hospital realizamos fundamentalmente dos tipos de trasplante renal, el clásico donante en muerte cerebral y el donante en asistolia. El objetivo de nuestro estudio fue evaluar si existían diferencias en las cargas de trabajo del personal de enfermería dependiendo de un tipo de trasplante u otro. Se trata de un estudio transversal con 73 pacientes que recibieron un trasplante renal durante el año 2010, 18 procedentes de donante en muerte cerebral y 55 en asistolia. Los trasplante renales de donante en asistolia presentaron mayor incidencia de fallo primario del injerto (15% vs 1,4% así como mayor retraso de la función renal (18 días vs 0 días. Debido a esto, nuestra labor asistencial se vio incrementada en este tipo de trasplante por precisar un mayor número de biopsias renales que implican unos cuidados de preparación y de vigilancia de sus complicaciones, la necesidad de más sesiones de hemodiálisis y la administración de un mayor número de dosis de timoglobulina. No se objetivaron diferencias significativas en la incidencia de infecciones entre ambos tipo de trasplante, así como en la estancia media hospitalaria, aunque esto último podría estar influido por el tamaño de la muestra. A pesar de las complicaciones mencionadas, la función renal a medio plazo de ambos tipos de trasplante fue similar, lo que alienta la utilización de los donantes en asistolia.Nowadays it is indisputable that kidney transplant is the preferred replacement therapy for patients with chronic kidney disease. In our hospital we carry out basically two types of kidney transplants, the classic brain dead donor and the asystolic donor. The aim of our study was to evaluate whether there were differences in the workload of nursing staff depending on the type of transplant. This is a transversal study of 73

  5. AN AUDIT OF MATERNAL DEATHS

    Directory of Open Access Journals (Sweden)

    Basavana Gowda

    2015-03-01

    Full Text Available OBJECTIVES: A study of maternal death conducted to evaluate various factors responsible for maternal deaths. To identify complications in pregnancy, a childbirth which result in maternal death, and to identify opportunities for preventive intervention and understand the events leading to death; so that improving maternal health and reducing maternal mortality rate significantly. To analyze the causes and epidemiological amounts maternal mortality e.g. age parity, socioeconomic status and literacy. In order to reduce maternal mortality and to implement safe motherhood program and complications of pregnancy and to find out safe motherhood program. METHODS: The data collected was a retrograde by a proforma containing particulars of the diseased, detailed history and relatives were interviewed for additional information. The data collected was analysed. RESULTS: Maternal mortality rate in our own institution is 200/ 100,000 live births. Among 30 maternal deaths, 56% deaths (17 were among low socio - economic status, groups 60% deaths among unbooked 53.5% deaths more along illiterates evidenced by direct and indirect deaths about 25% of deaths were preventable. CONCLUSION: Maternal death is a great tragedy in the family life. It is crusade to know not just the medical cause of the death but the circumstances what makes these continued tragic death even more unacceptable is that deaths are largely preventable

  6. Certification of deaths attributable to epilepsy

    OpenAIRE

    Langan, Y.; Nashef, L; Sander, J

    2002-01-01

    Methods: All 1997 death entries mentioning epilepsy as a cause of death in those 16–50 years were examined and classified as sudden unexpected death in epilepsy (SUDEP), other epilepsy related deaths, or non-epilepsy deaths.

  7. [Karoshi, death by overwork].

    Science.gov (United States)

    Uehata, Tetsunojo

    2005-07-01

    Karoshi (death by overwork) is one of social medical terms, which used by survivors of victims who attacked with cardiovascular diseases such as stroke, myocardial infarction and sudden cardiac death. In Dec. 2000, Compensation Standard of cardiovascular diseases in Workers' Insurance was changed and admitted the relationship between chronic fatigue and cardiovascular attacks. As a result, compensation numbers of Karoshi attributed to three hundred and more from about 80 cases. The Ministry of Health, Labour and Welfare thinks that most of Karoshi caused by long working hours continuing for several months, especially without payment, so that the Labour Standard Inspector Office requests to decrease overtime work more than 45 hours per month to firm administrators. PMID:16001791

  8. Identity after Death

    DEFF Research Database (Denmark)

    Gerstrøm, Anna

    2015-01-01

    Purpose: The purpose of this paper is to explore how legacy organizational identity and death relate to each other and, thereby, contribute to closing the gap in knowledge on organizational identity constructions in times of death. Design/methodology/approach: The paper opted for an exploratory...... of the financial industry. Findings: The paper finds that members of a dead organization construct a bankruptcy narrative that is also a legacy organizational identity narrative including a legacy organizational identity transformation and several identities that have positive and negative aspects...... and are conflicting but integrated into a coherent narrative. Furthermore, the paper provides empirical insights on how members of a dead organization draw upon their legacy organizational identity to justify their (lack of) past interpretations and responses to an unfolding bankruptcy. Finally, it provides empirical...

  9. Preventing child deaths

    OpenAIRE

    Gallagher, Bernard

    2008-01-01

    In the week I began to write this editorial, City and Hackney Local Safeguarding Children Board (LSCB) published an executive summary of the serious case review (SCR) into the deaths of ten year old Antoine Gamor-Ogunkoya and his three year old sister Kenniece in London (City and Hackney Local Safeguarding Children Board, 2008). Both had been killed by their mother, Vivian Gamor. Antoine had been beaten with a hammer and Kenniece had been suffocated with clingfilm. Their mother was convicted ...

  10. Gaddafi's Death Poses Challenges

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The death of Muammar Gaddafi marks a new era for Libya.It also poses a huge challenge for Libyan authorities dealing with tribal conflicts.He Wenping,a researcher with the Institute of West-Asian and African Studies at the Chinese Academy of Social Sciences,believes that Libya is in danger of falling into a period of internal strife and tribal conflict.

  11. Death and Digital Photography

    Directory of Open Access Journals (Sweden)

    Helen Ennis

    2011-03-01

    Full Text Available This essay considers new possibilities for photographing the dying and dead in Australia that have been enabled by digital technologies. It argues that vernacular digital photographs demonstrate unprecedented degrees of control and privacy and further that they are purposefully withheld from public view, thus raising issues about visibility and secrecy. Some historical context is provided. Post mortem photographs were not uncommon in the nineteenth century but were in the domain of professional studio photographers. Commissioning post mortem portraits was rare for most of the twentieth century, due to changing attitudes to death and the transformation of the photographic industry. Photographing the deceased re-emerged in the 1980s, notably in the area of neonatal death. In the last five years death-related vernacular photographs have begun to proliferate. Unlike analogue processes, digital photography bypasses the involvement of others in processing and printing private images. Distribution to intimates can be achieved instantaneously via the internet, reinforcing social and familial connections. Vernacular digital photographs of the deceased do not address historical tradition but share their domestic and intimate contexts. Nor do they belong to a unified group, yet they have a common vocabulary which emphasises specificity and detail.

  12. Death and digital photography

    Directory of Open Access Journals (Sweden)

    Ennis, Helen

    2011-01-01

    Full Text Available This essay considers new possibilities for photographing the dying and dead in Australia that have been enabled by digital technologies. It argues that vernacular digital photographs demonstrate unprecedented degrees of control and privacy and further that they are purposefully withheld from public view, thus raising issues about visibility and secrecy.Some historical context is provided. Post mortem photographs were not uncommon in the nineteenth century but were in the domain of professional studio photographers. Commissioning post mortem portraits was rare for most of the twentieth century, due to changing attitudes to death and the transformation of the photographic industry. Photographing the deceased re-emerged in the 1980s, notably in the area of neonatal death.In the last five years death-related vernacular photographs have begun to proliferate. Unlike analogue processes, digital photography bypasses the involvement of others in processing and printing private images. Distribution to intimates can be achieved instantaneously via the internet, reinforcing social and familial connections.Vernacular digital photographs of the deceased do not address historical tradition but share their domestic and intimate contexts. Nor do they belong to a unified group, yet they have a common vocabulary which emphasises specificity and detail.

  13. A need for definition: a matter of life and death for human embryos

    OpenAIRE

    Shurpyak, Serhiy A; Walsh, Anthony PH; Walsh, David J.; Sills, E Scott

    2009-01-01

    A recent IMJ commentaryon brain stem death criteria summarised ethical and technical issues concerning “end of life decisions”, and we concur that physicians should have competence in eliciting the proper sequence of brain stem signs in clinical practice. However, a truly comprehensive dialogue on the definition of death should address another question that confronts IVF clinics in Ireland each day—when does a human embryo die? Despite the enormous social and political energy focused on “righ...

  14. Death Sentences: A Content Analysis of Children's Death Literature

    Science.gov (United States)

    Poling, Devereaux A.; Hupp, Julie M.

    2008-01-01

    A multidimensional concept of death must include biological, sociocultural, and emotional components. Children glean information about death in many ways, one of which is through books. In this study, the authors compared the 3 dimensions of death-related information (irreversibility, inevitability, nonfunctionality) in 24 young children's picture…

  15. A Death in the Family: Death as a Zen Concept

    Science.gov (United States)

    Black, Helen K.; Rubinstein, Robert L.

    2013-01-01

    This study is based on original research that explored family reaction to the death of an elderly husband and father. We interviewed 34 families (a family included a widow and two adult biological children) approximately 6 to 10 months after the death. In one-on-one interviews, we discussed family members' initial reaction to the death, how the…

  16. Legal and Medical Relevance of Establishing the Moment of Death

    Directory of Open Access Journals (Sweden)

    Irina STREBA

    2012-12-01

    Full Text Available For centuries, death has been defined, from a medical point of view, as the irreversible cessation of breathing, circulation and activity of nervous system.The actual techniques of reanimation, by giving the possibility of artificial surviving (the so called living dead and by blurring the barrier between life and death, have brought into question the problem of establishing the moment of death. If in the traditional definition of death, the criteria for establishing death which are cessation of any vital functions, indicated by cessation of heartbeat and no breathing, are clear and the determination of timing of death doesn’t raise any medical, ethical or legal problems, controversy arises when referring to brain death.From a medical point of view, the biologic organism is still alive as long as the heart continues to beat although conditioned by artificial breathing. But, in conformity with the definition of the status of a human being, in terms of legal and ethical criteria, a person may be considered deceased independent of the status of the biological body.Issues raised by the timing of death, in particular cases as that of brain death, are reflected not only in medical field but also in civil and penal law. Consequences of the death of a person are legally passed on all aspects of ending of his civil capacity: the opening sequence, ending of civil rights and obligations of individuals, etc.The fact that Law 95/2006 clearly states that organs can be harvested both from those who are brain dead and from those with irreversible cardio-respiratory cessation, they being declared dead without doubt, clears up, in terms of legal considerations, the status of persons in this situation.Another problem of keeping alive the body in order to take over organs for transplantation is the preservation of human dignity. When a brain dead person (in all senses that are involved in the definition is declared dead we deal with a body, kept alive but which

  17. Readmissions Complications and Deaths - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Readmissions Complications and Deaths measures - state data. This data set includes state-level data for 30-day death and readmission measures, the hip/knee...

  18. Readmissions Complications and Deaths - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Readmissions Complications and Deaths measures - national data. This data set includes national-level data for 30-day death and readmission measures, the hip/knee...

  19. Life, Death, and Second Chances

    Science.gov (United States)

    ... Home Current Issue Past Issues Special Section Life, Death, and Second Chances Past Issues / Fall 2007 Table ... New Asthma Guidelines: What You Should Know / Life, Death, and Second Chances / Asthma Research: The NIH-NJRC ...

  20. Causes of Death in Athletes

    Directory of Open Access Journals (Sweden)

    A.L. Khodasevich

    2012-06-01

    Full Text Available The literature survey, concerning the causes of death in athletes, contains traumas, doping and cardiac pathology. The article presents clinicopathologic characteristics of different forms of cardiac pathologies, causing sudden death in athletes.

  1. Readmissions Complications and Deaths - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Readmissions, Complications and Deaths - provider data. This data set includes provider data for 30-day death and readmission measures, the hip/knee complication...

  2. Childhood Deaths from Physical Abuse.

    Science.gov (United States)

    Kasim, Mohd. Sham; and Others

    1995-01-01

    This paper describes 30 cases of childhood deaths caused by physical abuse in Kuala Lumpur, Malaysia. Data presented include ethnic origins, age, causes of death, identity of perpetrators, and marital situation of parents. (DB)

  3. The price of donation after cardiac death in liver transplantation : a prospective cost-effectiveness study

    NARCIS (Netherlands)

    van der Hilst, Christian S.; IJtsma, Alexander J. C.; Bottema, Jan T.; van Hoek, Bart; Dubbeld, Jeroen; Metselaar, Herold J.; Kazemier, Geert; van den Berg, Aad P.; Porte, Robert J.; Slooff, Maarten J. H.

    2013-01-01

    This study aims to perform a detailed prospective observational multicenter cost-effectiveness study by comparing liver transplantations with Donation after Brain Death (DBD) and Donation after Cardiac Death (DCD) grafts. All liver transplantations in the three Dutch liver transplant centers between

  4. On social death: ostracism and the accessibility of death thoughts.

    Science.gov (United States)

    Steele, Caroline; Kidd, David C; Castano, Emanuele

    2015-01-01

    Being rejected, excluded, or simply ignored is a painful experience. Ostracism researchers have shown its powerful negative consequences (Williams, 2007), and sociologists have referred to such experiences as social death (Bauman, 1992). Is this is just a metaphor or does being ostracized make death more salient in people's minds? An experiment was conducted in which participants experienced ostracism or inclusion using the Cyberball manipulation, and the accessibility of death-related thoughts was measured via a word-stem completion puzzle. Results showed enhanced death-thought accessibility in the ostracism condition, as well as a negative effect of dispositional self-esteem on the accessibility of death-related thoughts. PMID:24592875

  5. Brain Basics

    Medline Plus

    Full Text Available ... all. She was happily married and successful in business. Then, after a serious setback at work, she ... than ever before. Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses ...

  6. Brain Basics

    Medline Plus

    Full Text Available ... the anatomy, physiology, and chemistry of the nervous system. When the brain cannot effectively coordinate the billions ... basic working unit of the brain and nervous system. These cells are highly specialized for the function ...

  7. Brain Basics

    Medline Plus

    Full Text Available ... the brain cannot effectively coordinate the billions of cells in the body, the results can affect many ... unit of the brain and nervous system. These cells are highly specialized for the function of conducting ...

  8. Brain Basics

    Medline Plus

    Full Text Available ... Trials — Participants Statistics Help for Mental Illnesses Outreach Research Priorities Funding Labs at NIMH News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The ...

  9. Brain Basics

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    Full Text Available ... brain may play a role in disorders like schizophrenia or attention deficit hyperactivity disorder (ADHD) . Glutamate —the ... mental disorders, including autism , obsessive compulsive disorder (OCD) , schizophrenia , and depression . Brain Regions Just as many neurons ...

  10. Brain Basics

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    Full Text Available ... body, the results can affect many aspects of life. Scientists are continually learning more about how the brain grows and works in healthy people, and how normal brain development and function ...

  11. Brain Basics

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    Full Text Available ... Brain Basics will introduce you to some of this science, such as: How the brain develops How ... cell, and responds to signals from the environment; this all helps the cell maintain its balance with ...

  12. Brain Basics

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    Full Text Available ... How the brain develops How genes and the environment affect the brain The basic structure of the ... inside contents of the cell from its surrounding environment and controls what enters and leaves the cell, ...

  13. Brain Basics

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    Full Text Available ... affect many aspects of life. Scientists are continually learning more about how the brain grows and works ... early brain development. It may also assist in learning and memory. Problems in making or using glutamate ...

  14. Brain Basics

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    Full Text Available ... have been linked to many mental disorders, including autism , obsessive compulsive disorder (OCD) , schizophrenia , and depression . Brain ... studies show that brain growth in children with autism appears to peak early. And as they grow ...

  15. Brain Basics

    Medline Plus

    Full Text Available ... may help improve treatments for anxiety disorders like phobias or post-traumatic stress disorder (PTSD) . Prefrontal cortex ( ... brain's structure, studies show that brain growth in children with autism appears to peak early. And as ...

  16. Brain Basics

    Medline Plus

    Full Text Available ... body, the results can affect many aspects of life. Scientists are continually learning more about how the brain grows and works in healthy people, and how normal brain development ...

  17. Brain Basics

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    Full Text Available ... medications could reduce the amount of trial and error and frustration that many people with depression experience ... early brain development, and may also assist in learning and memory. hippocampus —A portion of the brain ...

  18. Brain Diseases

    Science.gov (United States)

    The brain is the control center of the body. It controls thoughts, memory, speech, and movement. It regulates the function of many organs. When the brain is healthy, it works quickly and automatically. However, ...

  19. Brain Basics

    Medline Plus

    Full Text Available ... than ever before. Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses ... depression experience when starting treatment. Gene Studies Advanced technologies are also making it faster, easier, and more ...

  20. Brain Basics

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    Full Text Available ... mainly involved in controlling movement and aiding the flow of information to the front of the brain, ... the neuron will fire. This enhances the electrical flow among brain cells required for normal function and ...

  1. Brain Basics

    Medline Plus

    Full Text Available ... works in healthy people, and how normal brain development and function can go awry, leading to mental ... and are working to compare that with brain development in people mental disorders. Genes and environmental cues ...

  2. Brain Basics

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    Full Text Available ... and epigenetic changes can be passed on to future generations. Further understanding of genes and epigenetics may ... than ever before. Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses ...

  3. Brain Basics

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    Full Text Available ... neurons, the most highly specialized cells of all, conduct messages. Every cell in our bodies contains a ... brain's structure, studies show that brain growth in children with autism appears to peak early. And as ...

  4. Brain Basics

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    Full Text Available ... can be related to changes in the anatomy, physiology, and chemistry of the nervous system. When the ... healthy people, and how normal brain development and function can go awry, leading to mental illnesses. Brain ...

  5. Brain Basics

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    Full Text Available ... Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah is a ... blues" from time to time. In contrast, major depression is a serious disorder that lasts for weeks. ...

  6. Stillbirth, Miscarriage, and Infant Death

    Science.gov (United States)

    ... AmazonSmile Contact Us Donate Stillbirth, Miscarriage, and Infant Death A baby’s death, whenever or however it occurs, is a profound ... of isolation –A need to talk about the death and the details of what happened –Feelings of ...

  7. Death of an Adult Child

    Science.gov (United States)

    ... iGive.com Purchase Through AmazonSmile Contact Us Donate Death of an Adult Child The death of any child, regardless of cause or age, ... the situations that may have caused their child’s death. Judgmental statements from others indicating that the child ...

  8. Brain Cancer in Workers Employed at a Laboratory Research Facility.

    Directory of Open Access Journals (Sweden)

    James J Collins

    Full Text Available An earlier study of research facility workers found more brain cancer deaths than expected, but no workplace exposures were implicated.Adding four additional years of vital-status follow-up, we reassessed the risk of death from brain cancer in the same workforce, including 5,284 workers employed between 1963, when the facility opened, and 2007. We compared the work histories of the brain cancer decedents in relationship to when they died and their ages at death.As in most other studies of laboratory and research workers, we found low rates of total mortality, total cancers, accidents, suicides, and chronic conditions such as heart disease and diabetes. We found no new brain cancer deaths in the four years of additional follow-up. Our best estimate of the brain cancer standardized mortality ratio (SMR was 1.32 (95% confidence interval [95% CI] 0.66-2.37, but the SMR might have been as high as 1.69. Deaths from benign brain tumors and other non-malignant diseases of the nervous system were at or below expected levels.With the addition of four more years of follow-up and in the absence of any new brain cancers, the updated estimate of the risk of brain cancer death is smaller than in the original study. There was no consistent pattern among the work histories of decedents that indicated a common causative exposure.

  9. Sudden Death of Entanglement

    CERN Document Server

    Yu, Ting

    2009-01-01

    A new development in the dynamical behavior of elementary quantum systems is the surprising discovery that correlation between two quantum units of information called qubits can be degraded by environmental noise in a way not seen previously in studies of dissipation. This new route for dissipation attacks quantum entanglement, the essential resource for quantum information as well as the central feature in the Einstein-Podolsky-Rosen so-called paradox and in discussions of the fate of Schr\\"{o}inger's cat. The effect has been labeled ESD, which stands for early-stage disentanglement or, more frequently, entanglement sudden death. We review recent progress in studies focused on this phenomenon.

  10. The Merchant of Death

    OpenAIRE

    Farias, Antonio

    2014-01-01

    Benjamin Cieza is a death merchant, having spent the last thirty years globetrotting from one global hot spot to another, working for a shadow company of expats who cross borders and the law with impunity. With his mother's suicide shortly after his brothers, he now finds himself obligated to fulfill his father's wish to be buried in the ancestral lands along the coast of latitude zero, where the roads end and the jungle devours both men and time. Finding his father's diary, a tale of two liv...

  11. Brain Basics

    Medline Plus

    Full Text Available ... pituitary-adrenal (HPA) axis. Brain Basics in Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah ... having trouble coping with the stresses in her life. She began to think of suicide because she ...

  12. Brain Basics

    Medline Plus

    Full Text Available ... Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah is a middle-aged woman ... new memories. hypothalmic-pituitary-adrenal (HPA) axis —A brain-body ... stress. impulse —An electrical communication signal sent between neurons ...

  13. Brain Aneurysm

    Science.gov (United States)

    A brain aneurysm is an abnormal bulge or "ballooning" in the wall of an artery in the brain. They are sometimes called berry aneurysms because they ... often the size of a small berry. Most brain aneurysms produce no symptoms until they become large, ...

  14. Happiness and Death Distress: Two Separate Factors

    Science.gov (United States)

    Abdel-Khalek, Ahmed M.

    2005-01-01

    The aim of the present study was to explore the relationship between happiness and death distress (death anxiety, death depression, and death obsession) in 275 volunteer Kuwaiti undergraduates. They responded to the Oxford Happiness Inventory, the Death Anxiety Scale, the Arabic Scale of Death Anxiety, the Death Depression Scale-Revised, and the…

  15. The impact of repeat stereotactic radiosurgery on the management of brain metastasis with maintaining brain function

    International Nuclear Information System (INIS)

    We investigated the utility of repeat stereotactic radiosurgery (RSRS), assisted with a careful monitoring by MRI, in the management of brain metastases. Thirty-seven patients harboring brain metastasis received RSRS. RSRS at the same site was performed in 14. The cumulative 5-year survival rate was 29% and the median survival time was 32 months. Cause of death was as follows: 14 uncontrolled extracranial disease and 2 progressed brain metastases. There were no severe adverse events. For 16 patients, neurocognitive function was examined and the most recent results revealed that 88% was not associated with impaired neurocognition. RSRS appears a preferred option to manage brain metastases with maintaining brain function. (author)

  16. Stressing Mitosis to Death

    Directory of Open Access Journals (Sweden)

    Andrew eBurgess

    2014-06-01

    Full Text Available The final stage of cell division (mitosis, involves the compaction of the duplicated genome into chromatid pairs. Each pair is captured by microtubules emanating from opposite spindle poles, aligned at the metaphase plate, and then faithfully segregated to form two identical daughter cells. Chromatids that are not correctly attached to the spindle are detected by the constitutively active spindle assembly checkpoint (SAC. Any stress that prevents correct bipolar spindle attachment, blocks the satisfaction of the SAC, and induces a prolonged mitotic arrest, providing the cell time to obtain attachment and complete segregation correctly. Unfortunately, during mitosis repairing damage is not generally possible due to the compaction of DNA into chromosomes, and subsequent suppression of gene transcription and translation. Therefore, in the presence of significant damage cell death is instigated to ensure that genomic stability is maintained. While most stresses lead to an arrest in mitosis, some promote premature mitotic exit, allowing cells to by-pass mitotic cell death. This mini-review will focus on the effects and outcomes that common stresses have on mitosis, and how this impacts on the efficacy of mitotic chemotherapies.

  17. Stressing mitosis to death.

    Science.gov (United States)

    Burgess, Andrew; Rasouli, Mina; Rogers, Samuel

    2014-01-01

    The final stage of cell division (mitosis), involves the compaction of the duplicated genome into chromatid pairs. Each pair is captured by microtubules emanating from opposite spindle poles, aligned at the metaphase plate, and then faithfully segregated to form two identical daughter cells. Chromatids that are not correctly attached to the spindle are detected by the constitutively active spindle assembly checkpoint (SAC). Any stress that prevents correct bipolar spindle attachment, blocks the satisfaction of the SAC, and induces a prolonged mitotic arrest, providing the cell time to obtain attachment and complete segregation correctly. Unfortunately, during mitosis repairing damage is not generally possible due to the compaction of DNA into chromosomes, and subsequent suppression of gene transcription and translation. Therefore, in the presence of significant damage cell death is instigated to ensure that genomic stability is maintained. While most stresses lead to an arrest in mitosis, some promote premature mitotic exit, allowing cells to bypass mitotic cell death. This mini-review will focus on the effects and outcomes that common stresses have on mitosis, and how this impacts on the efficacy of mitotic chemotherapies. PMID:24926440

  18. [The definition of death and organ retrieval: a persisting philosophical controversy].

    Science.gov (United States)

    Kinnaert, P

    2014-01-01

    Since the publication of the recommendations of the ad hoc committee of the Harvard Medical School to examine the definition of brain death in 1968, philosophical discussions concerning the licit character of organ retrieval in brain dead patients never ceased. The present paper summarizes the main arguments of supporters and opponents of this procedure. PMID:24908950

  19. Does Inflammation after Stroke Affect the Developing Brain Differently than Adult Brain?

    OpenAIRE

    Vexler, Zinaida S.; Yenari, Midori A.

    2009-01-01

    The immature brain is prone to hypoxic-ischemic encephalopathy and stroke. The incidence of arterial stroke in newborns is similar to that in the elderly. However, the pathogenesis of ischemic brain injury is profoundly affected by age at the time of the insult. Necrosis is a dominant type of neuronal cell death in adult brain, whereas widespread neuronal apoptosis is unique for the early postnatal synaptogenesis period. The inflammatory response, in conjunction with excitotoxic and oxidative...

  20. Brain endothelial TAK1 and NEMO safeguard the neurovascular unit

    OpenAIRE

    Ridder, Dirk A.; Wenzel, Jan; Müller, Kristin; Töllner, Kathrin; Tong, Xin-Kang; Assmann, Julian C; Stroobants, Stijn; Weber, Tobias; Niturad, Cristina; Fischer, Lisanne; Lembrich, Beate; Wolburg, Hartwig; Grand'Maison, Marilyn; Papadopoulos, Panayiota; Korpos, Eva

    2015-01-01

    Inactivating mutations of the NF-κB essential modulator (NEMO), a key component of NF-κB signaling, cause the genetic disease incontinentia pigmenti (IP). This leads to severe neurological symptoms, but the mechanisms underlying brain involvement were unclear. Here, we show that selectively deleting Nemo or the upstream kinase Tak1 in brain endothelial cells resulted in death of endothelial cells, a rarefaction of brain microvessels, cerebral hypoperfusion, a disrupted blood–brain barrier (BB...

  1. Cause of Death Affects Racial Classification on Death Certificates

    OpenAIRE

    Andrew Noymer; Penner, Andrew M.; Aliya Saperstein

    2011-01-01

    Recent research suggests racial classification is responsive to social stereotypes, but how this affects racial classification in national vital statistics is unknown. This study examines whether cause of death influences racial classification on death certificates. We analyze the racial classifications from a nationally representative sample of death certificates and subsequent interviews with the decedents' next of kin and find notable discrepancies between the two racial classifications by...

  2. Organ donations after death

    Directory of Open Access Journals (Sweden)

    Bernarda Logar

    2003-09-01

    Full Text Available The paper discusses public opinion on post-mortem organ donation, especially the difference between high support of public opinion to transplant activity, its general readiness to donate organs and the low number of signed organ donor cards. Through different approaches the article tries to point out possible factors relevant to the decision to donate organs. Early studies showed demographic variables and information as significant factors when deciding to donate organs after death. As there was not enough evidence that long-term effect through these factors is significant, the need for new investigation has grown. Social cognition theories helped understanding the difference mentioned above. It seems that the use of this approach might contribute to the understanding the problem and to delimit most useful factors when working with public.

  3. Optimal Aging and Death

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars; Strulik, Holger

    2010-01-01

    expectancy in the same year ("the Preston curve"); cross-country income differences can explain differences in life expectancy at age 20 of up to a decade. Moreover, technological change in health care of about 1.1% per year can account for the observed shift in the Preston curve between 1980 and 2000.......This study introduces physiological aging into a simple model of optimal intertemporal consumption. In this endeavor we draw on the natural science literature on aging. According to the purposed theory, the speed of the aging process and the time of death are endogenously determined by optimal...... health investments. At the same time, physiological aspects of the aging process inuence optimal savings and health investment. We calibrate the model for the average US male in 2000 and proceed to show that the calibrated model accounts well for the cross-country link between labor productivity and life...

  4. Optimal Aging and Death

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars; Strulik, Holger

    2010-01-01

    and life expectancy in the same year ("the Preston curve"); cross-country income differences can explain differences in life expectancy at age 20 of up to a decade. Moreover, technological change in health care of about 1.1% per year can account for the observed shift in the Preston curve between 1980......This study introduces physiological aging into a simple model of optimal intertemporal consumption. In this endeavor we draw on the natural science literature on aging. According to the purposed theory, the speed of the aging process and the time of death are endogenously determined by optimal...... health investments. At the same time, physiological aspects of the aging process influence optimal savings and health investment. We calibrate the model for the average US male in 2000 and proceed to show that the calibrated model accounts well for the cross-country link between labor productivity...

  5. Near-death experience: arising from the borderlands of consciousness in crisis.

    Science.gov (United States)

    Nelson, Kevin R

    2014-11-01

    Brain activity explains the essential features of near-death experience, including the perceptions of envelopment by light, out-of-body, and meeting deceased loved ones or spiritual beings. To achieve their fullest expression, such near-death experiences require a confluence of events and draw upon more than a single physiological or biochemical system, or one anatomical structure. During impaired cerebral blood flow from syncope or cardiac arrest that commonly precedes near-death, the boundary between consciousness and unconsciousness is often indistinct and a person may enter a borderland and be far more aware than is appreciated by others. Consciousness can also come and go if blood flow rises and falls across a crucial threshold. During crisis the brain's prime biologic purpose to keep itself alive lies at the heart of many spiritual experiences and inextricably binds them to the primal brain. Brain ischemia can disrupt the physiological balance between conscious states by leading the brainstem to blend rapid eye movement (REM) and waking into another borderland of consciousness during near-death. Evidence converges from many points to support this notion, including the observation that the majority of people with a near-death experience possess brains predisposed to fusing REM and waking consciousness into an unfamiliar reality, and are as likely to have out-of-body experience while blending REM and waking consciousness as they are to have out-of-body experience during near-death.

  6. Cell Death Atlas of the Postnatal Mouse Ventral Forebrain and Hypothalamus: Effects of Age and Sex

    Science.gov (United States)

    Ahern, Todd H.; Krug, Stefanie; Carr, Audrey V.; Murray, Elaine K.; Fitzpatrick, Emmett; Bengston, Lynn; McCutcheon, Jill; De Vries, Geert J.; Forger, Nancy G.

    2016-01-01

    Naturally occurring cell death is essential to the development of the mammalian nervous system. Although the importance of developmental cell death has been appreciated for decades, there is no comprehensive account of cell death across brain areas in the mouse. Moreover, several regional sex differences in cell death have been described for the ventral forebrain and hypothalamus, but it is not known how widespread the phenomenon is. We used immunohistochemical detection of activated caspase-3 to identify dying cells in the brains of male and female mice from postnatal day (P) 1 to P11. Cell death density, total number of dying cells, and regional volume were determined in 16 regions of the hypothalamus and ventral forebrain (the anterior hypothalamus, arcuate nucleus, anteroventral periventricular nucleus, medial preoptic nucleus, paraventricular nucleus, suprachiasmatic nucleus, and ventromedial nucleus of the hypothalamus; the basolateral, central, and medial amygdala; the lateral and principal nuclei of the bed nuclei of the stria terminalis; the caudate-putamen; the globus pallidus; the lateral septum; and the islands of Calleja). All regions showed a significant effect of age on cell death. The timing of peak cell death varied between P1 to P7, and the average rate of cell death varied tenfold among regions. Several significant sex differences in cell death and/or regional volume were detected. These data address large gaps in the developmental literature and suggest interesting region-specific differences in the prevalence and timing of cell death in the hypothalamus and ventral forebrain. PMID:23296992

  7. Brain glycogen

    DEFF Research Database (Denmark)

    Obel, Linea Lykke Frimodt; Müller, Margit S; Walls, Anne B;

    2012-01-01

    Glycogen is a complex glucose polymer found in a variety of tissues, including brain, where it is localized primarily in astrocytes. The small quantity found in brain compared to e.g., liver has led to the understanding that brain glycogen is merely used during hypoglycemia or ischemia....... In this review evidence is brought forward highlighting what has been an emerging understanding in brain energy metabolism: that glycogen is more than just a convenient way to store energy for use in emergencies-it is a highly dynamic molecule with versatile implications in brain function, i.e., synaptic...... activity and memory formation. In line with the great spatiotemporal complexity of the brain and thereof derived focus on the basis for ensuring the availability of the right amount of energy at the right time and place, we here encourage a closer look into the molecular and subcellular mechanisms...

  8. Children and unintentional firearm death

    OpenAIRE

    Hemenway, David; Solnick, Sara J.

    2015-01-01

    Background Children in the United States are at far greater risk of unintentional gun death than children in other developed countries. The relative figures may even be worse since the estimates for US child unintentional gun deaths are derived from the Vital Statistics which have been shown to be underestimates. No study has used a national data system to investigate the circumstances of fatal child gun accidents. Methods We use data from the National Violent Death Reporting System for 16 st...

  9. Children and unintentional firearm death

    OpenAIRE

    Hemenway, David; Solnick, Sara J.

    2015-01-01

    Background: Children in the United States are at far greater risk of unintentional gun death than children in other developed countries. The relative figures may even be worse since the estimates for US child unintentional gun deaths are derived from the Vital Statistics which have been shown to be underestimates. No study has used a national data system to investigate the circumstances of fatal child gun accidents. Methods: We use data from the National Violent Death Reporting System for 16 ...

  10. Effects of brain death on donor organ viability in transplantation

    OpenAIRE

    Hoeven, Joost Alexander Boreas van der

    2005-01-01

    Organ transplantation has evolved from an experimental procedure in the 1950's and 60's to the therapy of choice for end-stage organ failure. The first solid organ to outgrow the experimental transplantation setting was the kidney. At that time the succesful transplant programs were those in which donor organs form living family members were used for transplantation in their ill relatives (living-related transplant combination). ... Zie: Summary

  11. Brain death induces apoptosis in donor liver of the rat

    NARCIS (Netherlands)

    van der Hoeven, JAB; Moshage, H; Schuurs, T; Nijboer, M; van Schilfgaarde, R; Ploeg, RJ

    2003-01-01

    Background. A difference in short- and long-term function between living-related and cadaveric donor organs is consistently shown in kidney- and liver-transplant studies. We hypothesize that this is caused by induction of apoptosis and inflammation of the potential graft because of the phase of brai

  12. The Fated Death of Tess

    Institute of Scientific and Technical Information of China (English)

    李莉

    2012-01-01

      The theme of this essay is about the fated deaths of Tess.The emphasis is‘inevitability’. Tess’s Death is mainly due to the social influence and man-made factors. Because of the low social status and moral conceptions, there is no living room left for Tess. Her parents push her get closer to her tragedy as well. Alec and Angel are the two persons who directly and indirectly cause Tess’s death. In addition, there are also some subjective causes for her doom. The symbolic red in the novel intentionally indicates the’inevitability’of her death.

  13. Deaths from Cysticercosis, United States

    OpenAIRE

    Sorvillo, Frank J.; DeGiorgio, Christopher; Waterman, Stephen H.

    2007-01-01

    Cysticercosis has emerged as a cause of severe neurologic disease in the United States. We evaluated cysticercosis-related deaths in the United States for 1990–2002 by race, sex, age, state of residence, country of birth, and year of death. A total of 221 cysticercosis deaths were identified. Mortality rates were highest for Latinos (adjusted rate ratio [ARR] 94.5, relative to whites) and men (ARR = 1.8). The mean age at death was 40.5 years (range 2–88). Most patients (187 [84.6%]) were fore...

  14. The pathobiography and death of Wolfgang Amadeus Mozart: from legend to reality.

    Science.gov (United States)

    Baroni, C D

    1997-05-01

    Mozart, perhaps one of the greatest geniuses of modern age, died mysteriously at the age of 35 in Vienna in 1791. The causes of his death are still somewhat obscure and debated since we do not have any documentation acceptable by current scientific standards. Inevitably, the conclusions reached are highly debatable. In the present article the various interpretations of Mozart's death are taken into consideration-from his possible poisoning to causes of death more acceptable by the present diagnostic criteria. We suggest that the terminal cause of death was brain hemorrhaging or stroke, complicated by broncopneumonia and associated with renal failure induced by proliferative glomerulonephritis and glomerulosclerosis.

  15. Brain endothelial TAK1 and NEMO safeguard the neurovascular unit

    Science.gov (United States)

    Ridder, Dirk A.; Wenzel, Jan; Müller, Kristin; Töllner, Kathrin; Tong, Xin-Kang; Assmann, Julian C.; Stroobants, Stijn; Weber, Tobias; Niturad, Cristina; Fischer, Lisanne; Lembrich, Beate; Wolburg, Hartwig; Grand’Maison, Marilyn; Papadopoulos, Panayiota; Korpos, Eva; Truchetet, Francois; Rades, Dirk; Sorokin, Lydia M.; Schmidt-Supprian, Marc; Bedell, Barry J.; Pasparakis, Manolis; Balschun, Detlef; D’Hooge, Rudi; Löscher, Wolfgang; Hamel, Edith

    2015-01-01

    Inactivating mutations of the NF-κB essential modulator (NEMO), a key component of NF-κB signaling, cause the genetic disease incontinentia pigmenti (IP). This leads to severe neurological symptoms, but the mechanisms underlying brain involvement were unclear. Here, we show that selectively deleting Nemo or the upstream kinase Tak1 in brain endothelial cells resulted in death of endothelial cells, a rarefaction of brain microvessels, cerebral hypoperfusion, a disrupted blood–brain barrier (BBB), and epileptic seizures. TAK1 and NEMO protected the BBB by activating the transcription factor NF-κB and stabilizing the tight junction protein occludin. They also prevented brain endothelial cell death in a NF-κB–independent manner by reducing oxidative damage. Our data identify crucial functions of inflammatory TAK1–NEMO signaling in protecting the brain endothelium and maintaining normal brain function, thus explaining the neurological symptoms associated with IP. PMID:26347470

  16. Staging Death, Translating Death, Rehearsing Death: A Photographer’s Apprenticeship in Dying

    Directory of Open Access Journals (Sweden)

    Daniela Fargione

    2010-11-01

    Full Text Available The preponderance of death imagery in the mass media and a recent interest of photography in the practice of death suggest the need to reevaluate our approach to death and dying, especially when violence is involved. This essay is a case study of History of Violence, Claudio Cravero's last photographic project. His collection of "portraits" reproduce apparent dead bodies, mostly attacked in their own domestic spheres, but neither the perpetrator of death (a mysterious murderer?, nor the weapon used (an omnipresent knife, should be considered as main focal points of the artist's inquiry. The undoubtful protagonist of these photographs, instead, is the light, that illuminates fear: not of death itself, rather of the obnoxious indifference to it, as the result of generalized death imagery saturation.     The staged apparent death displayed in Cravero's photographs serve both as a memento mori and as a strategy to come to terms with the idea of death. In short, it is an apprentship in dying through a domesticating translation practice. Eventually, Cravero's History of Violence offers a complex reflection on the interplay between each individual story and macrolevel social History, thus providing some hypotheses of where violence and death fit in that odd geometry of time and space that we call life.

  17. Brain Basics

    Medline Plus

    Full Text Available ... as they grow there are differences in brain development in children who develop bipolar disorder than children who do not. Studies comparing such children to those with normal brain development may help scientists to pinpoint when and where ...

  18. Brain Basics

    Medline Plus

    Full Text Available ... PTSD) . Prefrontal cortex (PFC) —Seat of the brain's executive functions, such as judgment, decision making, and problem solving. ... brain that, in humans, plays a role in executive functions such as judgment, decision making and problem solving, ...

  19. Brain Basics

    Medline Plus

    Full Text Available ... Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses magnetic fields to take pictures of ... to slow or stop them from progressing. Functional magnetic resonance imaging (fMRI) is another important research tool in understanding ...

  20. Brain Basics

    Medline Plus

    Full Text Available ... little dopamine or problems using dopamine in the thinking and feeling regions of the brain may play ... axis —A brain-body circuit which plays a critical role in the body's response to stress. impulse — ...

  1. Brain Basics

    Medline Plus

    Full Text Available ... Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses magnetic fields to take ... to slow or stop them from progressing. Functional magnetic resonance imaging (fMRI) is another important research tool in ...

  2. Brain Basics

    Medline Plus

    Full Text Available ... Basics in Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah is a middle-aged woman who seemed to have it all. She was happily married and successful in business. Then, after a serious setback at work, she lost interest ...

  3. Parthanatos, a messenger of death.

    Science.gov (United States)

    David, Karen Kate; Andrabi, Shaida Ahmad; Dawson, Ted Murray; Dawson, Valina Lynn

    2009-01-01

    Poly-ADP-ribose polymerase-1 (PARP-1)'s roles in the cell span from maintaining life to inducing death. The processes PARP-1 is involved in include DNA repair, DNA transcription, mitosis, and cell death. Of PARP-1's different cellular functions, its role in cell death is of particular interest to designing therapies for diseases. Genetic deletion of PARP-1 revealed that PARP-1 overactivation underlies cell death in models of stroke, diabetes, inflammation and neurodegeneration. Since interfering with PARP-1 mediated cell death will be clinically beneficial, great effort has been invested into understanding mechanisms downstream of PARP-1 overactivation. Recent evidence shows that poly-ADP ribose (PAR) polymer itself can act as a cell death effector downstream of PARP-1. We coined the term parthanatos after Thanatos, the personification of death in Greek mythology, to refer to PAR-mediated cell death. In this review, we will present evidence and questions raised by these recent findings, and summarize the proposed mechanisms by which PARP-1 overactivation kills. It is evident that further understanding of parthanatos opens up new avenues for therapy in ameliorating diseases related to PARP-1 overactivation. PMID:19273119

  4. Death: A Part of Life.

    Science.gov (United States)

    Otero, George G.; Harris, Zoanne

    This two-part curriculum unit includes 20 slides depicting Days of the Dead in Mexico and the United States. The unit is designed to help middle school students compare customs and practices associated with death throughout the world in a way that promotes understanding of the values and needs that produce and are reinforced by death rituals and…

  5. Death Drive in Tourism Studies

    NARCIS (Netherlands)

    Buda, Dorina

    2014-01-01

    The psychoanalytical concept of the death drive refers to a constant metapsychological force at the junction between life and death: it is not understood in a biological sense of physical demise of the body, nor in opposition to life. Geographies of tourist performances in places in the proximity of

  6. Death Competence: An Ethical Imperative

    Science.gov (United States)

    Gamino, Louis A.; Ritter, R. Hal, Jr.

    2012-01-01

    The authors argued that death competence, defined as specialized skill in tolerating and managing clients' problems related to dying, death, and bereavement, is a necessary prerequisite for ethical practice in grief counseling. A selected review of the literature tracing the underpinnings of this concept reveals how a robust construct of death…

  7. Cardiovascular deaths related to Carbon monoxide Exposure in Ahvaz, Iran

    OpenAIRE

    Gholamreza Goudarzi; Sahar Geravandi; Mehdi Vosoughi; Mohammad javad Mohammadi; Abdolkazem neisi; Sepideh sadat Taghavirad

    2014-01-01

    Carbon monoxide is an odorless, colorless and toxic gas that emitted from combustion. Carbon monoxide can cause harmful health effects by reducing oxygen delivery to the body's organs (like the heart and brain), tissues, fibrinolysis effects, abortion and death at extremely high levels. The aim of this study was to assess health- effects of carbon monoxide exposure in Ahvaz city. Data were collected through Ahvaz Meteorological Organization and Department of Environment. Raw data processing b...

  8. Prevention of hypoglycemia-induced neuronal death by minocycline

    OpenAIRE

    Won Seok; Kim Jin; Yoo Byung; Sohn Min; Kauppinen Tiina M; Park Man-Seong; Kwon Hyung-Joo; Liu Jialing; Suh Sang

    2012-01-01

    Abstract Diabetic patients who attempt strict management of blood glucose levels frequently experience hypoglycemia. Severe and prolonged hypoglycemia causes neuronal death and cognitive impairment. There is no effective tool for prevention of these unwanted clinical sequelae. Minocycline, a second-generation tetracycline derivative, has been recognized as an anti-inflammatory and neuroprotective agent in several animal models such as stroke and traumatic brain injury. In the present study, w...

  9. Out-of-body and near-death experiences

    OpenAIRE

    Marsh, Michael N; Professor John Hedley Brooke

    2006-01-01

    What certainty is there for personal survival after death? Five key authors, critically analysed in this thesis, think that OB/ND experiences offer such assurances. Most OB/ND events follow severe clinical crises profoundly embarrassing cerebral function. At the nadir of brain function, invariably resulting in unconsciousness, authors aver that the escape of soul (Sabom), mind, or free consciousness (Moody, Ring, Grey, Fenwick), in providing glimpses of heaven, offers proof of...

  10. Encephalic death. ¿life or death? Ethic aspects.

    Directory of Open Access Journals (Sweden)

    Ariel Uriarte Méndez

    2006-12-01

    Full Text Available In this work a historical approach is made about the determination of death. Here is exposed how man has looked for objective criteria that allow him to state when a person has definitely died. A revision is made about the evolution of these criteria until reaching encephalic death, clinical situation that comes to light as a consequence of the intensive care development and that asks for a safe and opportune recognition due to its importance for organs donation. The encephalic death is considered by the scientific community as the subject’s death, which is supported by legislation of most countries including Cuba. This work offers data demonstrating that the criteria to define the irreversibility of encephalic functions, are safe. It is analyzed how the lack of unanimity of doctors to withdraw the assistance to a patient with encephalic death and declare him dead, shows the complexity of the theme in the sense that it implies an ethic problem. This is linked to the incomprehensible it may result to the family that a relative be dead having cardiac function. It is concluded that the concept of death is also sociocultural and that it has to be considered at the time of debating about the intensive care assistance withdrawal to a patient with encephalic death.

  11. Rates of TBI-related Emergency Department Visits, Hospitalizations, and Deaths — United States, 2001–2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — In general, total combined rates for traumatic brain injury (TBI)-related emergency department (ED) visits, hospitalizations and deaths have increased over the past...

  12. Addressing Consent Issues in Donation After Circulatory Determination of Death.

    Science.gov (United States)

    Overby, Kim J; Weinstein, Michael S; Fiester, Autumn

    2015-01-01

    Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria (i.e., brain death), there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients. PMID:26225503

  13. Audit of practice in sudden unexpected death in epilepsy (SUDEP) post mortems and neuropathological findings

    Science.gov (United States)

    Michalak, Zuzanna; Wright, Gabriella; Dawson, Timothy; Hilton, David; Joshi, Abhijit; Diehl, Beate; Koepp, Matthias; Lhatoo, Samden; Sander, Josemir W.; Sisodiya, Sanjay M.

    2015-01-01

    Aims Sudden unexpected death in epilepsy (SUDEP) is one of the leading causes of death in people with epilepsy. For classification of definite SUDEP, a post mortem (PM), including anatomical and toxicological examination, is mandatory to exclude other causes of death. We audited PM practice as well as the value of brain examination in SUDEP. Methods We reviewed 145 PM reports in SUDEP cases from four UK neuropathology centres. Data were extracted for clinical epilepsy details, circumstances of death and neuropathological findings. Results Macroscopic brain abnormalities were identified in 52% of cases. Mild brain swelling was present in 28%, and microscopic pathologies relevant to cause or effect of seizures were seen in 89%. Examination based on whole fixed brains (76.6% of all PMs), and systematic regional sampling was associated with higher detection rates of underlying pathology (P < 0.01). Information was more frequently recorded regarding circumstances of death and body position/location than clinical epilepsy history and investigations. Conclusion Our findings support the contribution of examination of the whole fixed brain in SUDEP, with high rates of detection of relevant pathology. Availability of full clinical epilepsy‐related information at the time of PM could potentially further improve detection through targeted tissue sampling. Apart from confirmation of SUDEP, complete neuropathological examination contributes to evaluation of risk factors as well as helping to direct future research into underlying causes. PMID:26300477

  14. [Death investigation system in the United States].

    Science.gov (United States)

    Kurosu, M; Nihira, M; Watanabe, T; Noguchi, T T

    1991-08-01

    In light of recent developments and public interest on the issue of organ transplant and the definition of death by neurological function ("brain death"). A more expansive role of medicolegal investigation of deaths may be needed. This article was presented for the purpose of understanding the medicolegal investigative system in the United States. The traditional coroner system in the United States was taken from the English system and was established as an elected coroner system during a colonial period. The coroner system became more politically involved and the coroner was elected by popular votes. The political aspect was the main driving force and the medicolegal aspect was ignored, thus, the Commonwealth of Massachusetts was the first state to adopt the medical examiner system. In 1991, 41 out of 50 states have adopted the medical examiner system, either state-wide or on a local option. One of the principal differences between coroner and medical examiner systems is the qualification of the head of the agency. The coroner is an elected individual who acts as an administrator and conducts quasi-judicial function of the department. The medical function is delegated to a physician who performs his duty often on a part-time basis. The medical examiner's office is headed by a Board certified Forensic Pathologist who acts as an administrator and directs all functions including medical and scientific investigation. He is a public employee and is protected under the civil service rules, thus, his decision would be less likely influenced by political pressure. The jurisdiction of the coroner and medical examiner is generally the same by law, however a medical examiner's approach and decision-making is more medically oriented and tends to be more expansive and ready to adopt to the needs in medicolegal issues arising from scientific progress.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Psychosocial Aspects of the Sudden Infant Death Syndrome ("Cot Death").

    Science.gov (United States)

    Bluglass, Kerry

    1981-01-01

    Reviews literature on reactions of parents and siblings to Sudden Infant Death Syndrome (SIDS). The prospects for prolonged, adverse reactions are considered, and professional concerns regarding abnormal adaptation are noted. (Author/DB)

  16. Near death experiences: a multidisciplinary hypothesis.

    Science.gov (United States)

    Bókkon, István; Mallick, Birendra N; Tuszynski, Jack A

    2013-01-01

    Recently, we proposed a novel biophysical concept regarding on the appearance of brilliant lights during near death experiences (NDEs) (Bókkon and Salari, 2012). Specifically, perceiving brilliant light in NDEs has been proposed to arise due to the reperfusion that produces unregulated overproduction of free radicals and energetically excited molecules that can generate a transient enhancement of bioluminescent biophotons in different areas of the brain, including retinotopic visual areas. If this excess of bioluminescent photon emission exceeds a threshold in retinotopic visual areas, this can appear as (phosphene) lights because the brain interprets these intrinsic retinotopic bioluminescent photons as if they originated from the external physical world. Here, we review relevant literature that reported experimental studies (Imaizumi et al., 1984; Suzuki et al., 1985) that essentially support our previously published conception, i.e., that seeing lights in NDEs may be due to the transient enhancement of bioluminescent biophotons. Next, we briefly describe our biophysical visual representation model that may explain brilliant lights experienced during NDEs (by phosphenes as biophotons) and REM sleep associated dream-like intrinsic visual imageries through biophotons in NDEs. Finally, we link our biophysical visual representation notion to self-consciousness that may involve extremely low-energy quantum entanglements. This article is intended to introduce novel concepts for discussion and does not pretend to give the ultimate explanation for the currently unanswerable questions about matter, life and soul; their creation and their interrelationship.

  17. Common Patterns of Bcl-2 Family Gene Expression in Two Traumatic Brain Injury Models

    OpenAIRE

    Strauss, Kenneth I.; NARAYAN, RAJ K.; Raghupathi, Ramesh

    2004-01-01

    Cell death/survival following traumatic brain injury (TBI) may be a result of alterations in the intracellular ratio of death and survival factors. Bcl-2 family genes mediate both cell survival and the initiation of cell death. Using lysate RNase protections assays, mRNA expression of the anti-cell death genes Bcl-2 and Bcl-xL, and the pro-cell death gene Bax, was evaluated following experimental brain injuries in adult male Sprague-Dawley rats. Both the lateral fluid-percussion (LFP) and the...

  18. 38 CFR 3.211 - Death.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Death. 3.211 Section 3..., Compensation, and Dependency and Indemnity Compensation Evidence Requirements § 3.211 Death. Death should be... community where death occurred. (2) A copy of a coroner's report of death or a verdict of a coroner's...

  19. Brain tumor - primary - adults

    Science.gov (United States)

    ... Vestibular schwannoma (acoustic neuroma) - adults; Meningioma - adults; Cancer - brain tumor (adults) ... Primary brain tumors include any tumor that starts in the brain. Primary brain tumors can start from brain cells, ...

  20. Brain radiation - discharge

    Science.gov (United States)

    Radiation - brain - discharge; Cancer-brain radiation; Lymphoma - brain radiation; Leukemia - brain radiation ... Decadron) while you are getting radiation to the brain. It may make you hungrier, cause leg swelling ...

  1. Brain and Addiction

    Science.gov (United States)

    ... Teens / Drug Facts / Brain and Addiction Brain and Addiction Print Your Brain Your brain is who you ... is taken over and over. What Is Drug Addiction? Addiction is a chronic brain disease that causes ...

  2. Brain Basics

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    Full Text Available ... related to changes in the anatomy, physiology, and chemistry of the nervous system. When the brain cannot ... who can diagnose mental disorders are psychologists or clinical social workers. The psychiatrist asked Sarah and her ...

  3. Brain Basics

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    Full Text Available ... begun to chart how the brain develops over time in healthy people and are working to compare ... listless, and had no appetite most of the time. Weeks later, Sarah realized she was having trouble ...

  4. Brain Basics

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    Full Text Available ... as in areas of the brain that control movement. When electrical signals are abnormal, they can cause ... normal mood functioning. Dopamine —mainly involved in controlling movement and aiding the flow of information to the ...

  5. Brain Basics

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    Full Text Available ... Statistics Help for Mental Illnesses Outreach Outreach Home Public Involvement Outreach Partners Alliance for Research Progress Coalition ... also linked to reward systems in the brain. Problems in producing dopamine can result in Parkinson's disease, ...

  6. Brain Basics

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    Full Text Available ... related to changes in the anatomy, physiology, and chemistry of the nervous system. When the brain cannot ... husband questions about Sarah's symptoms and family medical history. Epigenetic changes from stress or early-life experiences ...

  7. Brain Basics

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    Full Text Available ... at the front of the brain that, in humans, plays a role in executive functions such as ... to another. Share Science News Connectome Re-Maps Human Cortex ECT Lifts Depression, Sustains Remission in Older ...

  8. Brain Basics

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    Full Text Available ... treatments, and possibly prevention of such illnesses. The Working Brain Neurotransmitters Everything we do relies on neurons ... depression, can occur when this process does not work correctly. Communication between neurons can also be electrical, ...

  9. Brain Basics

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    Full Text Available ... in controlling movement, managing the release of various hormones, and aiding the flow of information to the ... at the front of the brain that, in humans, plays a role in executive functions such as ...

  10. Brain Basics

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    Full Text Available ... the understanding of how the brain grows and works and the effects of genes and environment on mental health. This knowledge is allowing scientists to make important discoveries that ...

  11. Brain Basics

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    Full Text Available ... may help improve treatments for anxiety disorders like phobias or post-traumatic stress disorder (PTSD) . Prefrontal cortex ( ... doctor, who ran some tests. After deciding her symptoms were not caused by a stroke, brain tumor, ...

  12. Brain Basics

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    Full Text Available ... related to changes in the anatomy, physiology, and chemistry of the nervous system. When the brain cannot ... NIMH Strategic Plan in 2016 August 31, 2016, 2:00-3:00 PM ET General Health Information ...

  13. Brain Basics

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    Full Text Available ... sends impulses and extends from cell bodies to meet and deliver impulses to another nerve cell. Axons ... in Real Life—How Depression affects the Brain Meet Sarah Sarah is a middle-aged woman who ...

  14. Brain Basics

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    Full Text Available ... Director’s Blog Budget Strategic Plan Offices and Divisions Careers@NIMH Advisory Boards and Groups Staff Directories Getting ... works in healthy people, and how normal brain development and function can go awry, leading to mental ...

  15. Brain Basics

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    Full Text Available ... little dopamine or problems using dopamine in the thinking and feeling regions of the brain may play ... but can still remember past events and learned skills, and carry on a conversation, all which rely ...

  16. Brain Basics

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    Full Text Available ... and plays an important role during early brain development. It may also assist in learning and memory. ... but can still remember past events and learned skills, and carry on a conversation, all which rely ...

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    Full Text Available ... These factors may act alone or together in complex ways, to change the way a gene is ... little dopamine or problems using dopamine in the thinking and feeling regions of the brain may play ...

  18. Brain Basics

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    Full Text Available ... the brain, which is linked to thought and emotion. It is also linked to reward systems in ... or-flight response and is also involved in emotions and memory. anterior cingulate cortex —Is involved in ...

  19. Brain Basics

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    Full Text Available ... or serious and cause severe disability. Through research, we know that mental disorders are brain disorders. Evidence ... many different types of cells in the body. We say that cells differentiate as the embryo develops, ...

  20. Brain Basics

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    Full Text Available ... These circuits control specific body functions such as sleep and speech. The brain continues maturing well into ... factors that can affect our bodies, such as sleep, diet, or stress. These factors may act alone ...

  1. Brain Health

    Science.gov (United States)

    ... Love Your Brain Stay Physically Active Adopt a Healthy Diet Stay Mentally and Socially Active We Can Help ... of any wellness plan. Learn More Adopt a Healthy Diet > Eat a heart-healthy diet that benefits both ...

  2. Brain Basics

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    Full Text Available ... for the function of conducting messages. A neuron has three basic parts: Cell body which includes the ... disorder (ADHD) . Glutamate —the most common neurotransmitter, glutamate has many roles throughout the brain and nervous system. ...

  3. Brain Basics

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    Full Text Available ... the brain, which is linked to thought and emotion. It is also linked to reward systems in ... stay focused on a task, and managing proper emotional reactions. Reduced ACC activity or damage to this ...

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    Full Text Available ... they can cause tremors or symptoms found in Parkinson's disease. Serotonin —helps control many functions, such as ... brain. Problems in producing dopamine can result in Parkinson's disease, a disorder that affects a person's ability ...

  7. Brain Basics

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    Full Text Available ... as sleep and speech. The brain continues maturing well into a person's early 20s. Knowing how the ... as judgment, decision making and problem solving, as well as emotional control and memory. serotonin —A neurotransmitter ...

  8. Brain Basics

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    Full Text Available ... mental disorder, or perhaps you have experienced one yourself at some point. Such disorders include depression , anxiety ... control specific body functions such as sleep and speech. The brain continues maturing well into a person's ...

  9. Brain Basics

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    Full Text Available ... some point. Such disorders include depression , anxiety disorders , bipolar disorder , attention deficit hyperactivity disorder (ADHD) , and many others. ... differences in brain development in children who develop bipolar disorder than children who do not. Studies comparing such ...

  10. Brain Basics

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    Full Text Available ... can diagnose mental disorders are psychologists or clinical social workers. The psychiatrist asked Sarah and her husband ... the understanding of how the brain grows and works and the effects of genes and environment on ...

  11. Preliminary observation on 32 cases of brain injury-induced acute pancreatitis in donors from donation after citizen death%公民逝世后器官捐献供者脑源性胰腺炎32例的诊治观察

    Institute of Scientific and Technical Information of China (English)

    王小平; 韩明; 袁小鹏; 陈传宝; 周健; 林建伟; 焦兴元; 何晓顺

    2016-01-01

    Objective To observe the diagnosis and treatment of acute pancreatitis (AP) induced by the brain trauma and cerebral stroke in donors from donation after citizen death (DCD),and maintenance of organ functions.Method The clinical data of 32 patients with different degrees of AP after brain trauma and cerebral stroke admitted by organ donation program between July 2011 and June 2015 were retrospectively analyzed.The donors with abdominal trauma and trauma after drinking were recruited.The serum amylase and lipase levels were increased in the first time,will be diagnosed as acute pancreatitis;Based on the original treatment,immediately given Ulinastatin,somatostatin and strengthen anti infection treatment;monitoring of serum amylase and lipase levels;color Doppler ultrasound examination of the pancreas;Identification of pancreatitis grading by careful investigation of the pancreatic appearances in organ procurement operation.Result 24 males and 8 females,aged from 16 to 57 years,Median-age 36 years.Cerebral stroke 13 cases,brain trauma 19 cases;Initial examination of serum amylase 440.06 ± 144.93 U/L (normal reference value ranges from 30 to 110 U/L),serum lipase 1045.22 ± 103.20 U/L (normal reference value 20-300 U/L);Treatment after 72h,serum amylase 120.78 ± 40.34 U/L,serum lipase 279.63 ± 103.20 U/L;Diagnostic accuracy of color Doppler ultrasound in acute pancreatitis was about 56%.Results from organ procurement operation:31 cases of acute pancreatitis,1 cases of normal appearance.Conclusion After potential donor into the donation program,routinely monitoring of pancreatitis related blood index including serum amylase and serum lipase,early diagnosis and early treatment,continuous monitoring of Results of the index to observe the effect of treatment,The condition of acute pancreatitis-induced by the brain trauma and cerebral stroke donors is not serious,they will be reversible after treatment and reduce the damage for other organs to be donated.%目的 观

  12. Birth and death of stars

    International Nuclear Information System (INIS)

    The evolution of stars is summarized, giving emphasis to the phenomena related with their formation (birth) and their late stages (death). We also remark the basic physical concepts that regulate stellar evolution

  13. Another Facet of Ubiquitylation: Death

    Institute of Scientific and Technical Information of China (English)

    W. Wei-Lynn Wong; John Silke

    2009-01-01

    Ubiquitylation of caspase-8 by the Cullin3 E3 ligase allows its translocation to cytosolic aggregates in the cell by p62/sequestosome-1, increasing caspase-8 activation and thus leading to TRAIL-induced cell death.

  14. Autoerotic death due to electrocution

    Directory of Open Access Journals (Sweden)

    Piotr Arkuszewski

    2014-08-01

    Full Text Available Autoerotic death is a very rare case in forensic medicine. It is usually caused by asphyxia, but other reasons are also possible. Herein we present a case of autoerotic death due to electrocution caused by a self-made electrical device. The device was constructed to increase sexual feelings through stimulation of the scrotal area.

  15. Suicidal Erythrocyte Death in Malaria

    OpenAIRE

    Koka, Sai Sudha

    2008-01-01

    Malaria is one of the most devastating diseases with lethal outcome in more than 1 million humans per year. The course of the disease is not only a function of the pathogen but is heavily influenced by properties of the host. Mechanisms possibly conferring protection against a severe course of malaria include suicidal death of the infected cell. A particular form of suicidal erythrocyte death is eryptosis, which is characterized by Ca2+-entry with subsequent activation of Ca2+-sensitive K+ ch...

  16. Sudden death in eating disorders

    Directory of Open Access Journals (Sweden)

    Jáuregui-Garrido B

    2012-02-01

    Full Text Available Beatriz Jáuregui-Garrido1, Ignacio Jáuregui-Lobera2,31Department of Cardiology, University Hospital Virgen del Rocío, 2Behavioral Sciences Institute, 3Pablo de Olavide University, Seville, SpainAbstract: Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfactory explanation of the cause can be ascertained. In many cases of sudden death, autopsies do not clarify the main cause. Cardiovascular complications are usually involved in these deaths. The purpose of this review was to report an update of the existing literature data on the main findings with respect to sudden death in eating disorders by means of a search conducted in PubMed. The most relevant conclusion of this review seems to be that the main causes of sudden death in eating disorders are those related to cardiovascular complications. The predictive value of the increased QT interval dispersion as a marker of sudden acute ventricular arrhythmia and death has been demonstrated. Eating disorder patients with severe cardiovascular symptoms should be hospitalized. In general, with respect to sudden death in eating disorders, some findings (eg, long-term eating disorders, chronic hypokalemia, chronically low plasma albumin, and QT intervals >600 milliseconds must be taken into account, and it must be highlighted that during refeeding, the adverse effects of hypophosphatemia include cardiac failure. Monitoring vital signs and performing electrocardiograms and serial measurements of plasma potassium are relevant during the treatment of eating disorder patients.Keywords: sudden death, cardiovascular complications, refeeding syndrome, QT interval, hypokalemia

  17. Brain resuscitation in the drowning victim

    NARCIS (Netherlands)

    Topjian, A.A.; Berg, R.A.; Bierens, J.J.; Branche, C.M.; Clark, R.S.; Friberg, H.; Hoedemaekers, C.W.E.; Holzer, M.; Katz, L.M.; Knape, J.T.A.; Kochanek, P.M.; Nadkarni, V.; Hoeven, J.G. van der; Warner, D.S.

    2012-01-01

    Drowning is a leading cause of accidental death. Survivors may sustain severe neurologic morbidity. There is negligible research specific to brain injury in drowning making current clinical management non-specific to this disorder. This review represents an evidence-based consensus effort to provide

  18. Deadly Pluralism? Why Death-Concept, Death-Definition, Death-Criterion and Death-Test Pluralism Should Be Allowed, Even Though It Creates Some Problems

    OpenAIRE

    Zeiler, Kristin

    2009-01-01

    Death concept, death definition, death criterion and death test pluralism has been described by some as a problematic approach. Others have claimed it to be a promising way forward within modern pluralistic societies. This article describes the New Jersey Death Definition Law and the Japanese Transplantation Law. Both of these laws allow for more than one death concept within a single legal system. The article discusses a philosophical basis for these laws starting from John Rawls understandi...

  19. Sudden death due to a glial cyst of the pineal gland.

    OpenAIRE

    Milroy, C M; Smith, C.L.

    1996-01-01

    Asymptomatic cysts of the pineal gland are found frequently by radiological examination of the brain or at postmortem examination. Symptomatic cysts are rare, and may require surgical intervention. Sudden death due to a cystic lesion of the pineal gland is very rare. A case of a 22 year old man who collapsed and died unexpectedly is reported. Postmortem examination revealed a glial cyst of the pineal gland and evidence of chronic obstructive hydrocephalus. Deaths from colloid cysts and pineal...

  20. Successful Lung Transplant From Donor After Cardiac Death: A Potential Solution to Shortage of Thoracic Organs

    OpenAIRE

    McKellar, Stephen H.; Durham, Lucian A.; Scott, John P.; Cassivi, Stephen D.

    2010-01-01

    Lung transplant is an effective treatment for patients with end-stage lung disease but is limited because of the shortage of acceptable donor organs. Organ donation after cardiac death is one possible solution to the organ shortage because it could expand the pool of potential donors beyond brain-dead and living donors. We report the preliminary experience of Mayo Clinic with donation after cardiac death, lung procurement, and transplant.

  1. Inflammation Enhances the Risks of Stroke and Death in Chronic Chagas Disease Patients

    OpenAIRE

    Guedes, Paulo Marcos Matta; de Andrade, Cléber Mesquita; Nunes, Daniela Ferreira; de Sena Pereira, Nathalie; Queiroga, Tamyres Bernadete Dantas; Machado-Coelho, George Luiz Lins; Nascimento, Manuela Sales Lima; Do-Valle-Matta, Maria Adelaide; da Câmara, Antônia Cláudia Jácome; Chiari, Egler; Galvão, Lúcia Maria da Cunha

    2016-01-01

    Ischemic strokes have been implicated as a cause of death in Chagas disease patients. Inflammation has been recognized as a key component in all ischemic processes, including the intravascular events triggered by vessel interruption, brain damage and repair. In this study, we evaluated the association between inflammatory markers and the death risk (DR) and stroke risk (SR) of patients with different clinical forms of chronic Chagas disease. The mRNA expression levels of cytokines, transcript...

  2. Gingerol sensitizes TRAIL-induced apoptotic cell death of glioblastoma cells

    OpenAIRE

    Lee, Dae-Hee; Kim, Dong-Wook; Jung, Chang-Hwa; Lee, Yong J.; Park, Daeho

    2014-01-01

    Glioblastoma multiforme (GBM) is the most lethal and aggressive astrocytoma of primary brain tumors in adults. Although there are many clinical trials to induce the cell death of glioblastoma cells, most glioblastoma cells have been reported to be resistant to TRAIL-induced apoptosis. Here, we showed that gingerol as a major component of ginger can induce TRAIL-mediated apoptosis of glioblastoma. Gingerol increased death receptor (DR) 5 levels in a p53-dependent manner. Furthermore, gingerol ...

  3. The ambiguity about death in Japan: an ethical implication for organ procurement.

    OpenAIRE

    McConnell, J. R.

    1999-01-01

    In the latter half of the twentieth century, developed countries of the world have made tremendous strides in organ donation and transplantation. However, in this area of medicine, Japan has been slow to follow. Japanese ethics, deeply rooted in religion and tradition, have affected their outlook on life and death. Because the Japanese have only recently started to acknowledge the concept of brain death, transplantation of major organs has been hindered in that country. Currently, there is a ...

  4. Exploring Children's Understanding of Death: Through Drawings and the Death Concept Questionnaire

    Science.gov (United States)

    Bonoti, Fotini; Leondari, Angeliki; Mastora, Adelais

    2013-01-01

    To investigate whether children's understanding of the concept of death varies as a function of death experience and age, 52 children aged 7, 9, and 11 years (26 had a personal death experience), drew a picture reflecting the meaning of the word death and completed the Death Concept Questionnaire for examination of Human and Animal Death. The…

  5. Glutathione in Cancer Cell Death

    Directory of Open Access Journals (Sweden)

    Jose M. Estrela

    2011-03-01

    Full Text Available Glutathione (L-γ-glutamyl-L-cysteinyl-glycine; GSH in cancer cells is particularly relevant in the regulation of carcinogenic mechanisms; sensitivity against cytotoxic drugs, ionizing radiations, and some cytokines; DNA synthesis; and cell proliferation and death. The intracellular thiol redox state (controlled by GSH is one of the endogenous effectors involved in regulating the mitochondrial permeability transition pore complex and, in consequence, thiol oxidation can be a causal factor in the mitochondrion-based mechanism that leads to cell death. Nevertheless GSH depletion is a common feature not only of apoptosis but also of other types of cell death. Indeed rates of GSH synthesis and fluxes regulate its levels in cellular compartments, and potentially influence switches among different mechanisms of death. How changes in gene expression, post-translational modifications of proteins, and signaling cascades are implicated will be discussed. Furthermore, this review will finally analyze whether GSH depletion may facilitate cancer cell death under in vivo conditions, and how this can be applied to cancer therapy.

  6. Glutathione in Cancer Cell Death

    Energy Technology Data Exchange (ETDEWEB)

    Ortega, Angel L. [Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 17 Av. Blasco Ibanez, 46010 Valencia (Spain); Mena, Salvador [Green Molecular SL, Pol. Ind. La Coma-Parc Cientific, 46190 Paterna, Valencia (Spain); Estrela, Jose M., E-mail: jose.m.estrela@uv.es [Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 17 Av. Blasco Ibanez, 46010 Valencia (Spain)

    2011-03-11

    Glutathione (L-γ-glutamyl-L-cysteinyl-glycine; GSH) in cancer cells is particularly relevant in the regulation of carcinogenic mechanisms; sensitivity against cytotoxic drugs, ionizing radiations, and some cytokines; DNA synthesis; and cell proliferation and death. The intracellular thiol redox state (controlled by GSH) is one of the endogenous effectors involved in regulating the mitochondrial permeability transition pore complex and, in consequence, thiol oxidation can be a causal factor in the mitochondrion-based mechanism that leads to cell death. Nevertheless GSH depletion is a common feature not only of apoptosis but also of other types of cell death. Indeed rates of GSH synthesis and fluxes regulate its levels in cellular compartments, and potentially influence switches among different mechanisms of death. How changes in gene expression, post-translational modifications of proteins, and signaling cascades are implicated will be discussed. Furthermore, this review will finally analyze whether GSH depletion may facilitate cancer cell death under in vivo conditions, and how this can be applied to cancer therapy.

  7. Sudden Infant Death Syndrome (SIDS)

    Science.gov (United States)

    ... the brain that may help control breathing and awakening during sleep. If a baby is breathing stale ... grief counseling, support, and referrals. And growing public awareness of SIDS and precautions to prevent it should ...

  8. Life Experience with Death: Relation to Death Attitudes and to the Use of Death-Related Memories

    Science.gov (United States)

    Bluck, Susan; Dirk, Judith; Mackay, Michael M.; Hux, Ashley

    2008-01-01

    The study examines the relation of death experience to death attitudes and to autobiographical memory use. Participants (N = 52) completed standard death attitude measures and wrote narratives about a death-related autobiographical memory and (for comparison) a memory of a low point. Self-ratings of the memory narratives were used to assess their…

  9. Oscillation death in coupled oscillators

    Institute of Scientific and Technical Information of China (English)

    Wei ZOU; Xin-gang WANG; Qi ZHAO; Meng ZHAN

    2009-01-01

    We study dynamical behaviors in coupled nonlinear oscillators and find that under certain condi- tions, a whole coupled oscillator system can cease oscil- lation and transfer to a globally nonuniform stationary state [I.e., the so-called oscillation death (OD) state], and this phenomenon can be generally observed. This OD state depends on coupling strengths and is clearly differ- ent from previously studied amplitude death (AD) state, which refers to the phenomenon where the whole system is trapped into homogeneously steady state of a fixed point, which already exists but is unstable in the ab- sence of coupling. For larger systems, very rich pattern structures of global death states are observed. These Turing-like patterns may share some essential features with the classical Turing pattern.

  10. [What is death?--Definitions and diagnoses from 2500 years of natural philosophy and medicine].

    Science.gov (United States)

    Schäfer, D

    2013-12-01

    For very long medicine has been dealing with the question what death means and when it has occurred. The promotion of this debate is mainly owed to the new medical findings and the concrete requirements of the clinical practice; but other factors like social-historical influences (in particular the dispute over the secure determination of death) as well as the (de-)medicalization of the concept of death have also to be taken into account. In a concise historical overlook this study aims to demonstrate the development of the definition of death: In ancient Greece Aristotle, disregarding the transcendent teleology, describes the natural or non-natural death that occurs when the production of the vegetative warmth in the central organ - the heart - has ceased. In the Enlightenment Johann August Unzer (emulated later by Bichat and Hufeland) worked out the concept of the step-by-step process of death: In the attempt to explain sudden death, apparent death and reanimation the enlightened physiologist differentiated between the cessation of the senses (caused by heart death and brain death) and the vegetative functions. In the second half of the 20th century progress made in transplanting and intensive care generated a broadened medical definition of death that met strong opposition in the discussions on the autonomy of the patient and the worth of human life. Generally considered, the increasing differences in interpreting death between physicians and medical laymen, but also in medical practice and basic research are mainly due to the divergent demands regarding the definition and diagnosis of death. PMID:24343185

  11. Sudden death during sports activities

    OpenAIRE

    STERGIOULAS APOSTOLOS; PRIFTAKIS ANASTASIOS G; VASILAKIS NIKOLAOS

    2016-01-01

    Sudden death during sports activities is a relatively rare, yet tragic event, with significant economic and social consequences. According to the existing studies, the annual incidence ranges from 3/100,000 to 1/250,000. The victims are mainly males with ratios varying from 18/1 to 9/1. The colored athletes are proportionally more susceptible and have a particular sensitivity to hypertrophic cardiomyopathy. Athletes have a 2.8/1 higher risk to have sudden death than non-athletes. But this is...

  12. Alterações fisiológicas da morte encefálica em potenciais doadores de órgãos e tecidos para transplantes Los cambios fisiológicos de la muerte cerebral en potenciales donadores de órganos y tejidos para trasplante Physiological changes of brain death in potential donors of organs and tissues for transplantation

    Directory of Open Access Journals (Sweden)

    Sarah Gabriel Freire

    2012-12-01

    órnea (3,1%. Se cree que el conocimiento de estos cambios permite al equipo de atención de la salud dirigir sus acciones al potencial donador de acuerdo a sus necesidades y así mantener los órganos/tejidos viables para el trasplante.The objective was to describe the physiologic changes of brain death in potential donors of organs and tissues for transplantation. Exploratory descriptive study with prospective data and quantitative approach carried out in emergency and intensive care units hospital adult, in the period from April to October 2011. The population consisted of 32 potential donors of organs and tissues for transplantation. After approval of Ethics Committee, data were collected, tabulated and analyzed by descriptive statistics by SPSS 15.0 software and presented in tables. Physiological changes were: hypotension (100%, hypothermia (75%, hypernatremia (62,5%, diabetes insipidus (37,5%, hyperglycemia (32,3%, infection (25,0%, hypertension (9,4% and corneal ulcer (3,1%. It was found that knowledge of these changes allows the team of health care to direct the potential donors according to their needs and thus keep the organ/tissue viable for transplant.

  13. 体重指数预测脑-心双死亡器官捐献供肝脂肪肝的价值%Value of body mass index on predicting fatty liver in donor with donation after brain plus cardiac death

    Institute of Scientific and Technical Information of China (English)

    甄作均; 陈焕伟; 吴志鹏; 计勇; 李梅生; 陈应军; 李杰原; 邓斐文; 王峰杰

    2013-01-01

    目的 评价体重指数(BMI)预测脑-心双死亡器官捐献(donation after brain plus cardiac death,DBCD)供肝脂肪肝的价值.方法 回顾性分析2011年7月至2013年3月在广东省佛山市第一人民医院移植中心实施的22例DBCD供体的临床资料.根据供体BMI将22例供体和17例受体分为体重正常组(18.0~22.9 kg/m2)和体重过重组(≥23.0 kg/m2).比较两组供体的术前临床指标及供肝脂肪肝程度,比较两组受体术后7d肝酶学指标、凝血功能及并发症发生情况.采用Pearson法分析供体BMI和供肝脂肪肝程度的相关性,采用受试者工作特征(ROC)曲线分析BMI预测供肝脂肪肝的灵敏度和特异度,并计算最佳截点值及相应的灵敏度和特异度.结果 DBCD供体BMI为(22.5 ±1.3) kg/m2,其中体重正常组13例,体重过重组9例,所有捐献者BMI均未超过28.0 kg/m2.体重过重组的平均年龄及供肝脂肪肝程度高于体重正常组,两组比较差异有统计学意义(均为P<O.05).两组受体术后7d的临床指标比较,体重过重组的丙氨酸转氨酶峰值高于体重正常组(P<0.05).两组受体术后未发生移植物失功或功能不全和急性排斥反应.供体BMI与供肝脂肪肝呈中等程度相关(r =0.572,P=0.005).ROC曲线分析显示BMI预测肝细胞脂肪变性率≥30%的曲线下面积为0.87(95%可信区问为0.68 ~1.00,P=0.005),最佳截点值为BMI≥23.0 kg/m2,此时的灵敏度为0.875,特异度为0.643,具有中等程度的预测价值.结论 DBCD供体BMI可以较好地预测供肝脂肪肝,但特异度有待进一步提高.

  14. 婴幼儿脑死亡后供者器官捐献供肾成人双肾移植23例%Reports of 23 cases of dual kidney transplantation from donation after brain death pediatric donors to adult recipients

    Institute of Scientific and Technical Information of China (English)

    刘凌霄; 余少杰; 彭龙开; 彭风华; 郭勇; 蓝恭斌; 谢续标; 方春华; 唐笑天

    2015-01-01

    Objective To investigate the clinical effect of dual kidney transplantation from donation after brain death (DBD) pediatric donors to adult recipients.Method Twenty-three cases of dual kidney transplantation from DBD pediatric donors to adult recipients were analyzed.Donors" age ranged from 50 days to 37 months,and body weight ranged from 2.8 to 11.5 kg.The age of recipients ranged from 15 years to 44 years and weighted from 42.8 to 66.0 kg.Dual en bloc kidney transplantations were performed on 8 cases,and dual separating kidney transplantations on 15 cases.Result One patient was diagnosed as delayed graft function,and graft function recovered after 20 days of hemodialysis.Nineteen cases who met the three "5" principle didn't receive prophylactic anticoagulation,and no thrombotic complication occurred.In 4 cases who didn't meet the three "5" principle,bilateral renal embolism occurred in 1 case and unilateral renal embolism occurred in 2 cases,and middle to large amount of proteinuria was found during the follow-up period.Conclusion The clinical effect of dual kidney transplantation from DBD pediatric donors to adult recipients is satisfactory.Making full use of these organs was an efficient way to expand the donor pool.%目的 探讨婴幼儿脑死亡器官捐献供肾成人双肾移植的临床疗效.方法 23例婴幼儿脑死亡供肾成人双肾移植.23例供者的年龄为50 d至37个月,体质量为2.8~11.5 kg;23例受者的年龄为15~63岁,体质量为42.8~66.0 kg.32例中,整块移植8例,分离式双肾移植15例.结果 23例双肾移植受者中,1例发生移植肾功能恢复延迟,予规律血液透析治疗20 d后恢复.供者年龄大于5个月的19例受者未常规抗凝血,无一例血栓形成;供者年龄小于3个月的有4例,其中1例发生双肾栓塞,2例发生单肾栓塞,术后出现中到大量蛋白尿.结论 婴幼儿脑死亡供肾成人双肾移植临床效果良好,可作为扩大供者来源的途径之一.

  15. Robot brains

    NARCIS (Netherlands)

    Babuska, R.

    2011-01-01

    The brain hosts complex networks of neurons that are responsible for behavior in humans and animals that we generally call intelligent. I is not easy to give an exact definition of intelligence – for the purpose of this talk it will suffice to say that we refer to intelligence as a collection of cap

  16. Brain Basics

    Medline Plus

    Full Text Available ... early brain development. It may also assist in learning and memory. Problems in making or using glutamate have been linked ... we see, and help us to solve a problem. Some of the regions most commonly ... also appears to be involved in learning to fear an event, such as touching a ...

  17. Brain Basics

    Medline Plus

    Full Text Available ... or post-traumatic stress disorder (PTSD) . Prefrontal cortex (PFC) —Seat of the brain's executive functions, such as ... making, and problem solving. Different parts of the PFC are involved in using short-term or "working" ...

  18. Brain Basics

    Medline Plus

    Full Text Available ... at the front of the brain that, in humans, plays a role in executive functions such as ... ClinicalTrials.gov : Federally and privately supported research using human volunteers PubMed Central: An archive of life sciences ...

  19. Brain Basics

    Medline Plus

    Full Text Available ... ADHD , schizophrenia , and depression . Hippocampus —Helps create and file new memories. When the hippocampus is damaged, a ... portion of the brain involved in creating and filing new memories. hypothalmic-pituitary-adrenal (HPA) axis —A ...

  20. Can Suicide Be a Good Death?

    Science.gov (United States)

    Lester, David

    2006-01-01

    The issue of whether suicide can be a good death was separated into two different questions: (1) can suicide be an appropriate death, and (2) can suicide be a rational death? Several definitions of an "appropriate" death were proposed, and suicide was seen as potentially appropriate. Similarly, several criteria for rationality were proposed and…

  1. Metaphysical Beliefs as Predictors of Death Anxiety.

    Science.gov (United States)

    Naidu, R. K.; Sinha, Ambalika

    1992-01-01

    Investigated impact of four metaphysical beliefs (existence of God, attributes of God, afterlife, consequences of suffering) on death anxiety. Householders (n=120), one-half of whom lived in high exposure to death sight areas, responded to pictures depicting death and nondeath scenes to measure death anxiety. Subjects from low exposure areas…

  2. Subsequent pregnancy outcome after previous foetal death

    NARCIS (Netherlands)

    Nijkamp, J. W.; Korteweg, F. J.; Holm, J. P.; Timmer, A.; Erwich, J. J. H. M.; van Pampus, M. G.

    2013-01-01

    Objective: A history of foetal death is a risk factor for complications and foetal death in subsequent pregnancies as most previous risk factors remain present and an underlying cause of death may recur. The purpose of this study was to evaluate subsequent pregnancy outcome after foetal death and to

  3. Brain Tumors (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Brain Tumors KidsHealth > For Parents > Brain Tumors Print A ... radiation therapy or chemotherapy, or both. Types of Brain Tumors There are many different types of brain ...

  4. Brain tumor - children

    Science.gov (United States)

    ... children; Neuroglioma - children; Oligodendroglioma - children; Meningioma - children; Cancer - brain tumor (children) ... The cause of primary brain tumors is unknown. Primary brain tumors may ... (spread to nearby areas) Cancerous (malignant) Brain tumors ...

  5. Multiple Analysis on the Death of Socrates

    Institute of Scientific and Technical Information of China (English)

    任丽丽

    2015-01-01

    The death of Socrates is often associated with the death of Jesus, in order to highlight the important role of the death in the whole human civilization. people's thinking about the causes and meaning of the death has never stopped since Socrates was sentenced to death by the public trial court of Athens, with the majority of 361 to 140 in 399 BC. Many of the ancient and modern, Chinese and foreign philosophers, statesmen, ethicists, legistes have expressed their views on this affair.

  6. Sudden Infant Death Syndrome (SIDS)

    Science.gov (United States)

    ... that stays unexplained after a complete investigation. This investigation can include an autopsy, a review of the death scene, and complete family and medical histories. 1 A diagnosis of SIDS is made by collecting information, conducting scientific or forensic tests, and talking with parents, other ...

  7. Ordinal Position and Death Concerns.

    Science.gov (United States)

    Eckstein, Daniel; Tobacyk, Jerome

    The relationship between birth order and how a person deals with death is investigated. Both theoretical and empirical evidence indicates that birth order influences how a person deals with life tasks. First-borns appear more achievement-oriented than their younger siblings, as exemplified by the fact that disproportionately greater numbers of…

  8. Overdose Deaths Among Homeless Persons

    Science.gov (United States)

    ... causes of mortality for those over 45.) The new findings are in stark contrast to those from an earlier study examining mortality among Boston’s homeless between 1989 and 1993, when relative rates for HIV and overdose death were almost exactly the opposite— ...

  9. Death in a catheterization laboratory.

    OpenAIRE

    Morton, B C; Higginson, L A; Beanlands, D. S.

    1993-01-01

    OBJECTIVE: To assess current rates of death from diagnostic and therapeutic cardiac catheterization as well as changes in the rates, if any, from 1977 to 1991. DESIGN: A prospective descriptive study. SETTING: Catheterization laboratory, University of Ottawa Heart Institute. PATIENTS: Consecutive patients undergoing diagnostic and therapeutic procedures from 1977 to 1991. Those undergoing endomyocardial biopsy or electrophysiologic study were excluded. INTERVENTIONS: Cardiac catheterization w...

  10. Psychology and death. Meaningful rediscovery.

    Science.gov (United States)

    Feifel, H

    1990-04-01

    The place of death in psychology is reviewed historically. Leading causes for its being slighted as an area of investigation during psychology's early years are presented. Reasons for its rediscovery in the mid-1950s as a legitimate sector for scientific inquiry are then discussed, along with some vicissitudes encountered in carrying out research in the field. This is followed by a description of principal empirical findings, clinical perceptions, and perspectives emerging from work in the thanatological realm. The probability that such urgent social issues as abortion, acquired immunodeficiency syndrome (AIDS), and euthanasia, and such destructive behaviors as drug abuse, alcoholism, and certain acts of violence are associated with attitudes toward death offers a challenge to psychology to enhance the vitality of human response to maladaptive conduct and loss. Recognition of personal mortality is a major entryway to self-knowledge. Although death is manifestly too complex to be the special sphere of any one discipline, psychology's position as an arena in which humanist and physicist-engineer cultures intersect provides us with a meaningful opportunity to advance our comprehension of how death can serve life. PMID:2186680

  11. The Experience of Near Death

    Science.gov (United States)

    Sabom, M. B.; Kreutziger, S.

    1977-01-01

    Reported phenomena occurring in people encountering near-death situations have recently stimulated considerable public interest. In an informal survey, few professionals who care for critically ill patients were aware of these occurrences. Approximately 50 patients with documented near-fatal encounters were interviewed to confirm the existence and…

  12. Introduction: Mediating and Remediating Death

    DEFF Research Database (Denmark)

    Christensen, Dorthe Refslund; Sandvik, Kjetil

    2014-01-01

    of a social or cultural activity assume media form, see below). The volume presents a wide variety of ethnographies of death from Norway, Finland, Sweden, the US, Papua New Guinea, Bosnia and Hercegovina, Libya, Tibet, Uganda and Denmark as well as a number of online sites and social media material...

  13. Organ donation after circulatory death: the forgotten donor?

    Science.gov (United States)

    Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan

    2006-01-01

    Donation after circulatory death (DCD) can be performed on neurologically intact donors who do not fulfill neurologic or brain death criteria before circulatory arrest. This commentary focuses on the most controversial donor-related issues anticipated from mandatory implementation of DCD for imminent or cardiac death in hospitals across the USA. We conducted a nonstructured review of selected publications and websites for data extraction and synthesis. The recommended 5 min of circulatory arrest does not universally fulfill the dead donor rule when applied to otherwise neurologically intact donors. Scientific evidence from extracorporeal perfusion in circulatory arrest suggests that the procurement process itself can be the event causing irreversibility in DCD. Legislative abandonment of the dead donor rule to permit the recovery of transplantable organs is necessary in the absence of an adequate scientific foundation for DCD practice. The designation of organ procurement organizations or affiliates to obtain organ donation consent introduces self-serving bias and conflicts of interest that interfere with true informed consent. It is important that donors and their families are not denied a 'good death', and the impact of DCD on quality of end-of-life care has not been satisfactorily addressed to achieve this. PMID:17020597

  14. Fatal cerebral malaria diagnosed after death in a French patient.

    Science.gov (United States)

    Alunni-Perret, Veronique; Vandenbos, Fanny; Kechkekian, Aurore; Marty, Pierre; Legros, Fabrice; Michiels, Jean François; Cardot-Leccia, Nathalie; Fortineau, Nicolas; Durant, Jacques; Quatrehomme, Gérald

    2010-09-01

    We report on the case of a French citizen who was found dead in his home, 4 days after returning from Cameroon. The patient died of imported malaria, as revealed by the postmortem investigations. Few such cases have been reported throughout the world. This article reviews deaths due to malaria diagnosed at the time of autopsy in France between 1995 and 2005. We conclude that the nonspecific symptoms of malaria can lead to a misdiagnosis and the need for a forensic expert to intervene at the scene of death, which usually occurs in the home. We will remind forensic pathologists of the clinical, biologic, and forensic aspects of this infectious disease. In particular, the uses of microbiologic analyses, the QBC malaria test and the Core malaria Pan/Pv/pf test as well as brain tissue histology will be reviewed. PMID:20508488

  15. Religiosity and the Construction of Death in Turkish Death Announcements, 1970-2009

    Science.gov (United States)

    Ergin, Murat

    2012-01-01

    Death and rituals performed after death reflect and reproduce social distinctions despite death's popular reputation as a great leveler. This study examines expressions of religiosity and constructions of death in Turkish death announcements, paying particular attention to gendered, ethnic, and temporal variations as well as markers of status and…

  16. Quantum Brain?

    CERN Document Server

    Mershin, A; Skoulakis, E M C

    2000-01-01

    In order to create a novel model of memory and brain function, we focus our approach on the sub-molecular (electron), molecular (tubulin) and macromolecular (microtubule) components of the neural cytoskeleton. Due to their size and geometry, these systems may be approached using the principles of quantum physics. We identify quantum-physics derived mechanisms conceivably underlying the integrated yet differentiated aspects of memory encoding/recall as well as the molecular basis of the engram. We treat the tubulin molecule as the fundamental computation unit (qubit) in a quantum-computational network that consists of microtubules (MTs), networks of MTs and ultimately entire neurons and neural networks. We derive experimentally testable predictions of our quantum brain hypothesis and perform experiments on these.

  17. Predicting the risk of sudden cardiac death.

    Science.gov (United States)

    Lerma, Claudia; Glass, Leon

    2016-05-01

    Sudden cardiac death (SCD) is the result of a change of cardiac activity from normal (typically sinus) rhythm to a rhythm that does not pump adequate blood to the brain. The most common rhythms leading to SCD are ventricular tachycardia (VT) or ventricular fibrillation (VF). These result from an accelerated ventricular pacemaker or ventricular reentrant waves. Despite significant efforts to develop accurate predictors for the risk of SCD, current methods for risk stratification still need to be improved. In this article we briefly review current approaches to risk stratification. Then we discuss the mathematical basis for dynamical transitions (called bifurcations) that may lead to VT and VF. One mechanism for transition to VT or VF involves a perturbation by a premature ventricular complex (PVC) during sinus rhythm. We describe the main mechanisms of PVCs (reentry, independent pacemakers and abnormal depolarizations). An emerging approach to risk stratification for SCD involves the development of individualized dynamical models of a patient based on measured anatomy and physiology. Careful analysis and modelling of dynamics of ventricular arrhythmia on an individual basis will be essential in order to improve risk stratification for SCD and to lay a foundation for personalized (precision) medicine in cardiology. PMID:26660287

  18. Towards elimination of maternal deaths: maternal deaths surveillance and response

    Directory of Open Access Journals (Sweden)

    Hounton Sennen

    2013-01-01

    Full Text Available Abstract Current methods for estimating maternal mortality lack precision, and are not suitable for monitoring progress in the short run. In addition, national maternal mortality ratios (MMRs alone do not provide useful information on where the greatest burden of mortality is located, who is concerned, what are the causes, and more importantly what sub-national variations occur. This paper discusses a maternal death surveillance and response (MDSR system. MDSR systems are not yet established in most countries and have potential added value for policy making and accountability and can build on existing efforts to conduct maternal death reviews, verbal autopsies and confidential enquiries. Accountability at national and sub-national levels cannot rely on global, regional and national retrospective estimates periodically generated from academia or United Nations organizations but on routine counting, investigation, sub national data analysis, long term investments in vital registration and national health information systems. Establishing effective maternal death surveillance and response will help achieve MDG 5, improve quality of maternity care and eliminate maternal mortality (MMR ≤ 30 per 100,000 by 2030.

  19. Animating Brains

    Science.gov (United States)

    Borck, Cornelius

    2016-01-01

    A recent paper famously accused the rising field of social neuroscience of using faulty statistics under the catchy title ‘Voodoo Correlations in Social Neuroscience’. This Special Issue invites us to take this claim as the starting point for a cross-cultural analysis: in which meaningful ways can recent research in the burgeoning field of functional imaging be described as, contrasted with, or simply compared to animistic practices? And what light does such a reading shed on the dynamics and effectiveness of a century of brain research into higher mental functions? Reviewing the heated debate from 2009 around recent trends in neuroimaging as a possible candidate for current instances of ‘soul catching’, the paper will then compare these forms of primarily image-based brain research with older regimes, revolving around the deciphering of the brain’s electrical activity. How has the move from a decoding paradigm to a representational regime affected the conceptualisation of self, psyche, mind and soul (if there still is such an entity)? And in what ways does modern technoscience provide new tools for animating brains? PMID:27292322

  20. Violent death in Connecticut, 2001 to 2004.

    Science.gov (United States)

    Borrup, Kevin; Gelven, Erica S; Carver, H Wayne; Banco, Leonard; Lapidus, Garry

    2008-04-01

    We reviewed medical examiner, law enforcement, crime laboratory data, and death certificates on all 1,530 violent deaths (homicide, suicide, undetermined firearm) in Connecticut occurring from 2001-2004. There was an average of 383 deaths (rate = 11.2 deaths per 100,000 persons annually). Overall, males aged 20 to 29 were at the greatest risk of violent death (rate = 30.5/100,000). Of all violent deaths 72% were suicides and 28% were homicides. Firearms were used in 33% of suicides and 58% of homicides. The rate of violent death is lower than most other states in the country. In Connecticut suicide is the leading cause of violent death overall; however, in areas characterized by the highest levels of poverty and lowest levels of education, homicide is the leading cause of violent death. PMID:18478984

  1. Altered calcium signaling following traumatic brain injury

    Directory of Open Access Journals (Sweden)

    John Thomas Weber

    2012-04-01

    Full Text Available Cell death and dysfunction after traumatic brain injury (TBI is caused by a primary phase, related to direct mechanical disruption of the brain, and a secondary phase which consists of delayed events initiated at the time of the physical insult. Arguably, the calcium ion contributes greatly to the delayed cell damage and death after TBI. A large, sustained influx of calcium into cells can initiate cell death signaling cascades, through activation of several degradative enzymes, such as proteases and endonucleases. However, a sustained level of intracellular free calcium is not necessarily lethal, but the specific route of calcium entry may couple calcium directly to cell death pathways. Other sources of calcium, such as intracellular calcium stores, can also contribute to cell damage. In addition, calcium-mediated signal transduction pathways in neurons may be perturbed following injury. These latter types of alterations may contribute to abnormal physiology in neurons that do not necessarily die after a traumatic episode. This review provides an overview of experimental evidence that has led to our current understanding of the role of calcium signaling in death and dysfunction following TBI.

  2. Death patterns among Nigerian leaders

    Directory of Open Access Journals (Sweden)

    Martin A.‎ Nzegwu ‎

    2010-07-01

    Full Text Available BACKGROUND:The aim of this study is to establish the patterns of death amongst Nigerian leaders since independence, thus providing a feasible avenue to avoid their recurrence if possible especially amongst the political elite who currently hold power. METHODS: Using available unclassified authentic public information, all leaders who had ruled Nigeria since her independence on 1 October, 1960 until her 45th birthday on 1 October 2005, irrespective of whether they are dead or alive were included. Data was extracted and analyzed. RESULTS: On 1 October 2005, Nigeria celebrated 45 years as a sovereign nation. Within this period, the country has had eleven leaders, all of whom were men. Only three (27.3% were civilians, while eight (72.7% were army generals. Of the eleven leaders, four (36.4% had died before Nigeria reached its 45th birthday and all of these four (100% died while still in office. Three of the dead leaders (75% were assassinated, while one (25% died suddenly in mysterious circumstances, believed to be the result of poisoning by unknown external powerful interest groups. Three of the deaths (75% occurred during violent periods of Nigeria’s checkered history (1966-1970 and 1993-1999, showing that periods of national and international strife appeared to be the weakest link in chains of events that led to their death while in office. Autopsies were neither requested nor performed on any of the dead leaders, signifying an entrenched culture of nonchalance, a lack of a coordinated national coroner’s law and contempt for accurate and detailed death records. Worse still, no valid tenable death certificate has ever been issued. In other words, no attempt has been made to determine the cause of death of four of the nation’s former leaders. Only hurried national burials were accorded two (50% of them while the other two (50%, who died in the coup and revenge coup of 1966, were completely neglected, and not even given a decent national

  3. Short- and Long-Term Cause of Death in Patients Treated With Primary PCI for STEMI

    DEFF Research Database (Denmark)

    Pedersen, Frants; Butrymovich, Vitalij; Kelbæk, Henning;

    2014-01-01

    ,804 consecutive patients with STEMI (age 63 ± 13 years, 72% males) treated with primary PCI. RESULTS: Patients were followed up for a median of 4.7 years. During a total of 13,447 patient-years, 717 patients died. Main causes of death within the first 30 days were cardiogenic shock and anoxic brain injury after...

  4. Prehospital Care of Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    TVSP Murthy

    2008-01-01

    Full Text Available Traumatic brain injury (TBI occurs when a sudden trauma causes brain damage. Depending on the severity, outcome can be anything from complete recovery to permanent disability or death. Emergency medical services play a dominant role in provision of primary care at the site of injury. Since little can be done to reverse the initial brain damage due to trauma, attempts to prevent further brain damage and stabilize the patient before he can be brought to a specialized trauma care centre play a pivotal role in the final outcome. Recognition and early treatment of hypoten-sion, hypoxemia, and hypoglycemia, objective neurological assessment based on GCS and pupils, and safe transport to an optimal care centre are the key elements of prehospital care of a TBI patient.

  5. Parents bereaved by infant death

    DEFF Research Database (Denmark)

    Christiansen, Dorte M.; Elklit, Ask; Olff, Miranda

    2013-01-01

    Losing an infant or fetus late in pregnancy, during birth or in the first year of life is a potentially traumatic event for parents. However, little is known about the factors contributing to chronic posttraumatic stress reactions in this population. The present study examined chronic posttraumatic...... stress disorder (PTSD) symptoms and potential correlates in 634 mothers and fathers up to 18 years (M=3.4 years) after the death of their infant. Members of a private national support organization for parents bereaved by infant death were contacted and asked to participate in the study. Participants...... avoidance, attachment anxiety, emotion-focused coping, avoidant coping, feeling let down and social support satisfaction accounted for 44% of the variance in PTSD severity. The study highlights the long-term impact of infant loss and points to attachment, coping and social support as important contributors...

  6. Parents Bereaved by Infant Death

    DEFF Research Database (Denmark)

    Christiansen, Dorte Mølgaard; Elklit, Ask; Olff, Miranda

    2013-01-01

    Objective: Losing an infant or fetus late in pregnancy, during birth or in the first year of life is a potentiallytraumatic event for parents. However, little is known about the factors contributing to chronic posttraumatic stress reactions in this population. The present study examined chronic...... posttraumatic stress disorder (PTSD)´symptoms and potential correlates in 634 mothers and fathers up to 18 years (M=3.4 years) after the death of their infant. Methods: Members of a private national support organization for parents bereaved by infant death were contacted and asked to participate in the study......, female sex, attachment avoidance, attachment anxiety, emotion-focused coping, rational coping, feeling let down and social support satisfaction accounted for 42% of the variance in PTSD severity. Conclusions: The study highlights the long-term impact of infant loss and points to attachment, coping...

  7. Hypokalemia and sudden cardiac death

    DEFF Research Database (Denmark)

    Kjeldsen, Keld

    2010-01-01

    Worldwide, approximately three million people suffer sudden cardiac death annually. These deaths often emerge from a complex interplay of substrates and triggers. Disturbed potassium homeostasis among heart cells is an example of such a trigger. Thus, hypokalemia and, also, more transient...... was found in 24% of hospitalized patients. Hypokalemia is associated with increased risk of arrhythmia in patients with cardiovascular disease, as well as increased all-cause mortality, cardiovascular mortality and heart failure mortality by up to 10-fold. Long-term potassium homeostasis depends on renal...... capacity for potassium exchange. In cardiovascular patients, hypokalemia is often caused by nonpotassium-sparing diuretics, insufficient potassium intake and a shift of potassium into stores by increased potassium uptake stimulated by catecholamines, beta-adrenoceptor agonists and insulin. Interestingly...

  8. Sudden infant death syndrome, childhood thrombosis, and presence of genetic risk factors for thrombosis

    DEFF Research Database (Denmark)

    Larsen, TB; Nørgaard-Pedersen, B; Lundemose, JB;

    2000-01-01

    . The vulnerability of the infant brain stem to ischemia has been suggested to be a conceivable cause of sudden infant death syndrome. This is compatible with a hypothesis that genetic risk factors for cerebral thrombosis could cause microinfarction in the brain stem during the first month of life, affecting vital...... centers or their blood supply. The presence of three common point mutations seen in families with thrombophilia (1691G-->A in the coagulation factor V gene, 677C-->T in the methylenetetrahydrofolate reductase gene, and the 20210G-->A mutation in the prothrombin gene) could increase the risk for thrombosis...... in the child. This prompted us to investigate these genetic markers of thromboembolic disease in 121 cases of sudden infant death syndrome and in relevant controls, in the expectation of a more frequent occurrence of these markers if thrombosis is an etiological factor in sudden infant death syndrome...

  9. Sudden death in eating disorders

    OpenAIRE

    Jáuregui-Garrido B; Jáuregui-Lobera I

    2012-01-01

    Beatriz Jáuregui-Garrido1, Ignacio Jáuregui-Lobera2,31Department of Cardiology, University Hospital Virgen del Rocío, 2Behavioral Sciences Institute, 3Pablo de Olavide University, Seville, SpainAbstract: Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfact...

  10. Euphemism on Death in English

    Institute of Scientific and Technical Information of China (English)

    胡丽

    2012-01-01

      In western countries, people could trace back the history of English euphemism to the period of An-glo-Saxon. People can find euphemism in the text of its national epic, Beowulf, for instance, the literal meaning of“ellorsi”is“journey elsewhere”, however, it is used as euphemism to avoid saying death directly in fact. After Norman Conquest in 1066, euphemism started to flourish.

  11. Hepatitis E and Maternal Deaths

    Centers for Disease Control (CDC) Podcasts

    2012-11-06

    Dr. Alain Labrique, assistant professor in the Department of International Health and Department of Epidemiology at the Bloomberg School of Public Health, gives us his perspective on hepatitis E and maternal deaths.  Created: 11/6/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID); National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 11/7/2012.

  12. Sudden Cardiac Death in Athletes.

    Science.gov (United States)

    Wasfy, Meagan M; Hutter, Adolph M; Weiner, Rory B

    2016-01-01

    There are clear health benefits to exercise; even so, patients with cardiac conditions who engage in exercise and athletic competition may on rare occasion experience sudden cardiac death (SCD). This article reviews the epidemiology and common causes of SCD in specific athlete populations. There is ongoing debate about the optimal mechanism for SCD prevention, specifically regarding the inclusion of the ECG and/or cardiac imaging in routine preparticipation sports evaluation. This controversy and contemporary screening recommendations are also reviewed. PMID:27486488

  13. The Near-Death Experience: A Reality Check?

    Directory of Open Access Journals (Sweden)

    Michael N. Marsh

    2016-03-01

    Full Text Available This paper critically reviews assertions that near-death and out-of-body experiences (ND/OBE offer proof of extra-corporeal existence when the brain is supposedly “dead”. While this field has almost moved away from mere anecdotal recording, the current trend is focussed on demonstrating existence without functional brains. These endeavours have fallen far short of anticipated results—that cardiac patients would report on strategically-placed markers around acute resuscitation units. Two problems arise: a failure to produce corroborative empirical evidence for extra-corporeal cognition (a when the brain is “dead”, (or “clinically dead”, so-called and (b how the memory required for recall could paradoxically be set down at that critical time-point. The view advanced here is that ND/OBE occur as subjects’ states are returning to complete resumption of conscious-awareness and which, from several published accounts, is particularly abrupt but which nevertheless accounts perfectly for memory—and recall. Similar transcendental adventures accompanying returns to conscious-awareness occur with other preceding states of reduced consciousness. Most recollections are intensely geo-physical, anthropomorphic, banal and illogical: their dream-like fantasy provides nothing revelatory about life without a brain, or importantly, about other supposed cosmic contexts. Additionally, it is proposed that since prevalence rates are so extremely low (<1% globally, the few subjects undergoing ND/OBE may have predisposed brains, genetically, structurally or resulting from previous psychological stress. In a somewhat similar vein to post-traumatic stress disorder, subjects with predisposed brains exhibit markedly changed post-experiential phenotypes, so that the ND/OBE itself could be viewed as a transient, accompanying epiphenomenon.

  14. An analysis of nuclear industry workers' death risk and related occupational harms

    International Nuclear Information System (INIS)

    Objective: The causes of death and related occupational harms in nuclear industry worker were investigated and analyzed emphatically to determine the relationship between occupations and health. Methods: Workers of 11 units from the time of their foundation to the end of 1990 were observed by groups. The number of workers and death data in every year were investigated. The causes of death were classified according to ICD-9. Results: The crude mortality was 193.66 x 10-5, standard mortality 237.65 x 10-5, those for exposed group and control group were 346.11 x 10-5 and 202.03 x 10-5, respectively (P<0.01), which were lower than those for whole China. When the exposed group was compared with the control, RR was 1.70 (P<0.01), but when silicosis and accidental deaths were excluded, the RR was 1.30 (P<0.05). tumor was first cause of death and injury and poisoning came next. SMR of total death cause was 0.46, that of tumor 0.76, injury and poisoning 1.20 (P<0.01), lung cancer 1.40 (P<0.01), and brain tumor 1.51 (P<0.05). In uranium mines, lung cancer, brain tumor, stomach cancer, liver cancer and leukemia increased obviously. Conclusion: The occupational harms related to death were dust, industrial injury and radon daughters. Because of them the death risk in the exposed group was increased, but conditions were changing constantly. Males had more death risk than females and the increase of uranium miner's lung cancer was considered to be associated with exposure to radon daughters

  15. Deaths from heart failure: using coarsened exact matching to correct cause-of-death statistics

    OpenAIRE

    Shibuya Kenji; King Gary; Stevens Gretchen A

    2010-01-01

    Abstract Background Incomplete information on death certificates makes recorded cause-of-death data less useful for public health monitoring and planning. Certifying physicians sometimes list only the mode of death without indicating the underlying disease or diseases that led to the death. Inconsistent cause-of-death assignment among cardiovascular causes of death is of particular concern. This can prevent valid epidemiologic comparisons across countries and over time. Methods We propose tha...

  16. Cocaine Causes Apoptotic Death in Rat Mesencephalon and Striatum Primary Cultures

    Directory of Open Access Journals (Sweden)

    Lucilia B. Lepsch

    2015-01-01

    Full Text Available To study cocaine’s toxic effects in vitro, we have used primary mesencephalic and striatal cultures from rat embryonic brain. Treatment with cocaine causes a dramatic increase in DNA fragmentation in both primary cultures. The toxicity induced by cocaine was paralleled with a concomitant decrease in the microtubule associated protein 2 (MAP2 and/or neuronal nucleus protein (NeuN staining. We also observed in both cultures that the cell death caused by cocaine was induced by an apoptotic mechanism, confirmed by TUNEL assay. Therefore, the present paper shows that cocaine causes apoptotic cell death and inhibition of the neurite prolongation in striatal and mesencephalic cell culture. These data suggest that if similar neuronal damage could be produced in the developing human brain, it could account for the qualitative or quantitative defects in neuronal pathways that cause a major handicap in brain function following prenatal exposure to cocaine.

  17. Apelin-13 as a novel target for intervention in secondary injury after traumatic brain injury.

    Science.gov (United States)

    Bao, Hai-Jun; Qiu, Hai-Yang; Kuai, Jin-Xia; Song, Cheng-Jie; Wang, Shao-Xian; Wang, Chao-Qun; Peng, Hua-Bin; Han, Wen-Can; Wu, Yong-Ping

    2016-07-01

    The adipocytokine, apelin-13, is an abundantly expressed peptide in the nervous system. Apelin-13 protects the brain against ischemia/reperfusion injury and attenuates traumatic brain injury by suppressing autophagy. However, secondary apelin-13 effects on traumatic brain injury-induced neural cell death and blood-brain barrier integrity are still not clear. Here, we found that apelin-13 significantly decreases cerebral water content, mitigates blood-brain barrier destruction, reduces aquaporin-4 expression, diminishes caspase-3 and Bax expression in the cerebral cortex and hippocampus, and reduces apoptosis. These results show that apelin-13 attenuates secondary injury after traumatic brain injury and exerts a neuroprotective effect. PMID:27630697

  18. Parodies in Death and the Compass

    Institute of Scientific and Technical Information of China (English)

    雒娜娜

    2016-01-01

    "Death and the Compass" parodies the traditional detective story by subverting that the detective would solve the mysteries and good would triumph over evil. It announces the death of the detective and limitation of knowledge.

  19. Death of a Special Needs Child

    Science.gov (United States)

    ... iGive.com Purchase Through AmazonSmile Contact Us Donate Death of a Special Needs Child When a child ... Needs Child Dies The grief that follows the death of a special-needs child comes not only ...

  20. Death in the United States, 2011

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Death in the United States, 2011 Recommend on Facebook ... 2011 SOURCE: National Vital Statistics System, Mortality. Do death rates vary by state? States experience different mortality ...

  1. Fast Action Can Prevent Sepsis Death: CDC

    Science.gov (United States)

    ... fullstory_160574.html Fast Action Can Prevent Sepsis Death: CDC Know the signs of extreme response to ... treated long before it causes severe illness or death, U.S. health officials report. Sepsis, or septicemia, occurs ...

  2. Diabetes Ups Risk of Heart Attack Death

    Science.gov (United States)

    ... 159557.html Diabetes Ups Risk of Heart Attack Death Study points to need for better coordinated care, ... people with diabetes have a higher risk of death after a heart attack. "We knew that following ...

  3. Helping Your Child Deal with Death

    Science.gov (United States)

    ... About Zika & Pregnancy Helping Your Child Deal With Death KidsHealth > For Parents > Helping Your Child Deal With ... important points to remember in all cases. Explaining Death in a Child's Terms Be honest with kids ...

  4. National Violent Death Reporting System (NVDRS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Violent Death Reporting System (NVDRS) provides states and communities with a clearer understanding of violent deaths to guide local decisions about...

  5. Use of death certificates for mesothelioma surveillance.

    OpenAIRE

    L K Davis; Martin, T R; Kligler, B

    1992-01-01

    Data from the Massachusetts Cancer Registry and death certificates were linked for mesothelioma cases reported to the registry from 1982 through 1987 to determine the extent to which the cause of death information that is given on the death certificate is useful in identifying mesothelioma cases for disease surveillance. Only 12 percent of all persons reported with mesothelioma who had died were detected using underlying cause of death codes for cancers of the peritoneum and pleura, which are...

  6. Death in the Modern Greek Culture

    OpenAIRE

    Pentaris, Panagiotis

    2012-01-01

    Each culture recognizes and identifies death, dying and bereavement in unique ways. Commonly, aculture may be seen through the lens of death rituals; how those are shaped, interpreted and used by the society. This paper aims to look at the Modern Greek culture and depict its ‘visualization’ of death, as well as capture the rituals that mostly identify this specific culture. The Greek culture in overall is strongly influenced by the Greek Orthodox Church. Hence, the experiences of death, dyi...

  7. Cell death in the cardiovascular system

    OpenAIRE

    Clarke, Murray; Bennett, Martin; Littlewood, Trevor

    2006-01-01

    Cell death is important for both development and tissue homeostasis in the adult. As such, it is tightly controlled and deregulation is associated with diverse pathologies; for example, regulated cell death is involved in vessel remodelling during development or following injury, but deregulated death is implicated in pathologies such as atherosclerosis, aneurysm formation, ischaemic and dilated cardiomyopathies and infarction. We describe the mechanisms of cell death and its role in the norm...

  8. Sudden unexpected death in infancy in Denmark

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Holst, Anders Gaarsdal; Theilade, Juliane;

    2011-01-01

    Abstract Background. Incidence of sudden unexpected death in infancy (SUDI) and sudden infant death syndrome (SIDS) differs among studies and non-autopsied cases are difficult to assess. Objectives. To investigate causes of sudden death in infancy in a nationwide setting. Validate the use of the ...... are SUDI, and the majority of these are caused by cardiac disease or SIDS. Autopsy is not always performed and valuable information is subsequently lost. Cause of Death registry data is not accurate in describing SIDS....

  9. Polycation-mediated integrated cell death processes

    DEFF Research Database (Denmark)

    Parhamifar, Ladan; Andersen, Helene; Wu, Linping;

    2014-01-01

    standard. PEIs are highly efficient transfectants, but depending on their architecture and size they induce cytotoxicity through different modes of cell death pathways. Here, we briefly review dynamic and integrated cell death processes and pathways, and discuss considerations in cell death assay design...

  10. Physician's Death Anxiety and Patient Outcomes.

    Science.gov (United States)

    Schulz, Richard; Aderman, David

    1978-01-01

    It was shown that terminal patients of physicians with high death anxiety survive longer during their final hospital stay than terminal patients of physicians with low death anxiety. Physicians high in death anxiety seem to be less willing to accept patients' terminality and use heroic measures to keep them alive. (Author)

  11. The Danish registers of causes of death

    DEFF Research Database (Denmark)

    Juel, K; Helweg-Larsen, K

    1999-01-01

    In 1875 registration of causes of death in Denmark was established by the National Board of Health, and annual statistics of death have since been published. Until 1970 the national statistics were based upon punched cards with data collected from the death certificates. Since then the register has...

  12. Mitochondria: pharmacological manipulation of cell death

    OpenAIRE

    Bouchier-Hayes, Lisa; Lartigue, Lydia; Newmeyer, Donald D.

    2005-01-01

    Cell death by apoptosis or necrosis is often important in the etiology and treatment of disease. Since mitochondria play important roles in cell death pathways, these organelles are potentially prime targets for therapeutic intervention. Here we discuss the mechanisms through which mitochondria participate in the cell death process and also survey some of the pharmacological approaches that target mitochondria in various ways.

  13. Exploring Children's Understanding of Death Concepts

    Science.gov (United States)

    Lee, Joo Ok; Lee, Joohi; Moon, Sung Seek

    2009-01-01

    This study is an investigation of the effects of death education on children and their understanding of death. The participants of this study were eighty 5- and 6-year-olds who were enrolled in a suburban kindergarten in Korea. To examine the level of children's understanding of death, researchers interviewed each child in both the control and…

  14. Helping Children Understand and Cope with Death

    OpenAIRE

    Young, Margaret

    1989-01-01

    To mention the words, children and death, in the same breath is almost inconceivable. The one is life, sunshine, and laughter. The other is closure, and darkness, and tears. Yet death touches each one of us, including children. To understand life is to understand that there is also death, and as children grow and develop, they observe that what lives must also die.

  15. 20 CFR 638.513 - Death.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Death. 638.513 Section 638.513 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR JOB CORPS PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.513 Death. In each case of student death,...

  16. 5 CFR 1651.11 - Simultaneous death.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Simultaneous death. 1651.11 Section 1651.11 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD DEATH BENEFITS § 1651.11 Simultaneous death. If a beneficiary dies at the same time as the participant, the beneficiary will be...

  17. The Destined Death of the Travelling Salesman

    Institute of Scientific and Technical Information of China (English)

    何苗

    2015-01-01

    Death of a Travelling Salesman is a short story with heated discussion and dispute. Death, as the title of the story presents, has always been the center of criticism. This paper aims to dissect this short story, and to discuss the destined death of the travelling salesman.

  18. 38 CFR 3.459 - Death compensation.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Death compensation. 3.459..., Compensation, and Dependency and Indemnity Compensation Apportionments § 3.459 Death compensation. (a) Death compensation will be apportioned if the child or children of the deceased veteran are not in the custody of...

  19. 38 CFR 3.460 - Death pension.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Death pension. 3.460 Section 3.460 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Apportionments § 3.460 Death pension. Death...

  20. Birth-death processes and associated polynomials

    NARCIS (Netherlands)

    Doorn, van Erik A.

    2003-01-01

    We consider birth-death processes on the nonnegative integers and the corresponding sequences of orthogonal polynomials called birth-death polynomials. The sequence of associated polynomials linked with a sequence of birth-death polynomials and its orthogonalizing measure can be used in the analysis

  1. Developmental Apoptosis Mediates Entry and Positioning of Microglia in the Zebrafish Brain.

    Science.gov (United States)

    Casano, Alessandra Maria; Albert, Marvin; Peri, Francesca

    2016-07-26

    In the brain, neurons that fail to assemble into functional circuits are eliminated. Their clearance depends on microglia, immune cells that colonize the CNS during embryogenesis. Despite the importance of these cells in development and disease, the mechanisms that target and position microglia within the brain are unclear. Here we show that, in zebrafish, attraction of microglia into the brain exploits differences in developmental neuronal apoptosis and that these provide a mechanism for microglial distribution. Reducing neuronal cell death results in fewer microglia, whereas increased apoptosis enhances brain colonization, resulting in more microglia at later stages. Interestingly, attraction into the brain depends on nucleotide signaling, the same signaling system used to guide microglia toward brain injuries. Finally, this work uncovers a cell-non-autonomous role for developmental apoptosis. Classically considered a wasteful process, programmed cell death is exploited here to configure the immune-neuronal interface of the brain. PMID:27425604

  2. Finitude and Death - certainties denied

    Directory of Open Access Journals (Sweden)

    Maria Helena Villas Bôas Concone

    2014-11-01

    Full Text Available The themes of this issue of the Journal Kairós Gerontology seemed determined to submit the publication to opposing pressures: on one side there were the several articles and article propositions sent by many authors and distinct approaches, demanding more than ever the effort of our collaborators in the evaluation process; on the other side there were our own difficulties (technical and personnel to take forward and quickly the task and the inevitable delays. If the influx of articles clearly showed the interest and the opportunity of the journal’s proposal, the unwillingly delays seemed to confirm the denial/avoidance face of the themes of finitude and death. Indeed, it seemed to us necessary the election of these themes for reflection for obvious reasons, especially when involved in a Masters in Gerontology: the more avoided the more the reflection is needed; in case of working or having a relationship (professional or personal with many elderly, people close to death, or people facing definitive diagnosis, the avoidance perhaps brings more suffering than benefit to the parts involved. The old saying “In home of hanged don’t talk about ropes” might have its justification, but common sense and touch is needed; it is not a “folk remedy”. It always seemed to me (I do not place myself out of it that most humans think they are immortal or at least non-mortal (an indeterminate human deviation, to the extent that death and dying are pushed deep to the unconsciousness only surfacing back to consciousness in extreme situations. Death can be thought intellectually, turned into subject of literary, religious or philosophical speculation; it also can be turned into subject of anthropological, sociological or other types of investigation; it can be thought in numbers supporting epidemiological questions and population analysis; focused in cuts of gender, class, age, ethnicity; specified in causes and causes connected to each of the cuts above

  3. Near-death experiences in cardiac arrest survivors.

    Science.gov (United States)

    French, Christopher C

    2005-01-01

    Near-death experiences (NDEs) have become the focus of much interest in the last 30 years or so. Such experiences can occur both when individuals are objectively near to death and also when they simply believe themselves to be. The experience typically involves a number of different components including a feeling of peace and well-being, out-of-body experiences (OBEs), entering a region of darkness, seeing a brilliant light, and entering another realm. NDEs are known to have long-lasting transformational effects upon those who experience them. An overview is presented of the various theoretical approaches that have been adopted in attempts to account for the NDE. Spiritual theories assume that consciousness can become detached from the neural substrate of the brain and that the NDE may provide a glimpse of an afterlife. Psychological theories include the proposal that the NDE is a dissociative defense mechanism that occurs in times of extreme danger or, less plausibly, that the NDE reflects memories of being born. Finally, a wide range of organic theories of the NDE has been put forward including those based upon cerebral hypoxia, anoxia, and hypercarbia; endorphins and other neurotransmitters; and abnormal activity in the temporal lobes. Finally, the results of studies of NDEs in cardiac arrest survivors are reviewed and the implications of these results for our understanding of mind-brain relationships are discussed.

  4. Cryoethics: seeking life after death

    OpenAIRE

    Shaw, D.M.

    2009-01-01

    Cryonic suspension is a relatively new technology that offers those who can afford it the chance to be ‘frozen’ for future revival when they reach the ends of their lives. This paper will examine the ethical status of this technology and whether its use can be justified. Among the arguments against using this technology are: it is ‘against nature’, and would change the very concept of death; no friends or family of the ‘freezee’ will be left alive when he is revived; the considerable expe...

  5. Paths to iDeath

    Directory of Open Access Journals (Sweden)

    Vincent DUSSOL

    2007-06-01

    Full Text Available I am grateful to Ray DiPalma for his generously giving me access to copies of An August Daybook (2005, Mules at the Wake (2006 and Ascoso (2006. All other quotes from DiPalma are from a private correspondence.There is a delicate balance in iDEATH. It suits us.(Richard Brautigan In Watermelon SugarAn autobiography is about an “I” and it traces a path. But the “I” and teleology have long been called into question by poets. This interrogation continues: wanderers blaze new trails. We propose...

  6. [Death in a relaxation tank].

    Science.gov (United States)

    Rupp, Wolf; Simon, Karl-Heinz; Bohnert, Michael

    2009-01-01

    Complete relaxation can be achieved by floating in a darkened, sound-proof relaxation tank filled with salinated water kept at body temperature. Under these conditions, meditation exercises up to self-hypnosis may lead to deep relaxation with physical and mental revitalization. A user manipulated his tank, presumably to completely cut off all optical and acoustic stimuli and accidentally also covered the ventilation hole. The man was found dead in his relaxation tank. The findings suggested lack of oxygen as the cause of death.

  7. The Experience of Death and Dying: Psychological, Philosophical and Spiritual Aspects

    Directory of Open Access Journals (Sweden)

    Stanislav Grof

    2015-12-01

    Full Text Available The article discusses some psychological, philosophical, and spiritual aspects of the research on death and dying. The author challenges materialistic understanding of death, based on metaphysical assumption inherited from the Cartesian-Newtonian paradigm that had became one of the leading myths of the Western science, according to which consciousness is an epiphenomenon of matter, a product of the physiological processes in the brain, and thus critically dependent on the body. By reviewing the existing data and observations from various fields of research he points out to the fact that there is no proof for such a reductive claim. The research of the psychological, philosophical, and spiritual aspects of death and dying discussed in this paper offers considerable theoretical and practical implications, enabling the refusal of materialistic interpretation of death as the final end of human existence and conscious activity of any kind.

  8. Key Proteins of Activating Cell Death Can Be Predicted through a Kainic Acid-Induced Excitotoxic Stress

    Directory of Open Access Journals (Sweden)

    Hsiu-Ling Tsai

    2015-01-01

    Full Text Available Epilepsy is a major neurological disorder characterized by spontaneous seizures accompanied by neurophysiological changes. Repeated seizures can damage the brain as neuronal death occurs. A better understanding of the mechanisms of brain cell death could facilitate the discovery of novel treatments for neurological disorders such as epilepsy. In this study, a model of kainic acid- (KA- induced neuronal death was established to investigate the early protein markers associated with apoptotic cell death due to excitotoxic damage in the rat cortex. The results indicated that KA induces both apoptotic and necrotic cell death in the cortex. Incubation with high concentrations (5 and 500 μM, >75% and low concentrations (0.5 pM: 95% and 50 nM: 8% of KA for 180 min led to necrotic and apoptotic cell death, respectively. Moreover, proteomic analysis using two-dimensional gel electrophoresis and mass spectrometry demonstrated that antiapoptotic proteins, including heat shock protein 70, 3-mercaptopyruvate sulfurtransferase, tubulin-B-5, and pyruvate dehydrogenase E1 component subunit beta, were significantly higher in apoptosis than in necrosis induced by KA. Our findings provide direct evidence that several proteins are associated with apoptotic and necrotic cell death in excitotoxicity model. The results indicate that these proteins can be apoptotic biomarkers from the early stages of cell death.

  9. Recombinant DNA studies on stored necropsy brain samples from patients with Huntington's chorea.

    OpenAIRE

    Upadhyaya, M; G. P. Reynolds; P.S. Harper

    1985-01-01

    An analysis of deoxyribonucleic acid (DNA) in deep frozen brain samples taken from 100 patients with Huntington's chorea after death showed undegraded DNA in 44 cases. Of these, 16 were analysed with G8, a recombinant DNA probe, linked to the Huntington's chorea locus. In all cases unambiguous Southern blots were obtainable. No correlation between the yield of DNA and the principal storage factors was observed. The use of stored brain tissue obtained after death from patients with Huntington'...

  10. Novel Humanized Recombinant T Cell Receptor Ligands Protect the Female Brain After Experimental Stroke

    OpenAIRE

    Pan, Jie; Palmateer, Julie; Schallert, Timothy; Hart, Madison; Pandya, Arushi; Vandenbark, Arthur A.; Offner, Halina; Hurn, Patricia D.

    2014-01-01

    Transmigration of peripheral leukocytes to the brain is a major contributor to cerebral ischemic cell death mechanisms. Humanized partial major histocompatibility complex class II constructs (pMHC), covalently linked to myelin peptides, are effective for treating experimental stroke in males, but new evidence suggests that some inflammatory cell death mechanisms after brain injury are sex-specific. We here demonstrate that treatment with pMHC constructs also improves outcomes in female mice w...

  11. Involvement of neuroleptic drugs in selenium deficiency and sudden death of cardiac origin: study and human post-mortem examination.

    Science.gov (United States)

    Hamdan, Lamia; Bost, Muriel; Chazot, Guy; Bui-Xuan, Bernard; Vaillant, Fanny; Dehina, Leila; Descotes, Jacques; Tabib, Alain; Mamou, Zahida; Timour, Quadiri

    2012-06-01

    The involvement of psychotropic drugs in sudden deaths has been highlighted. The objective of this work was to establish a link between selenium levels in heart tissue, psychotropic treatment and sudden death. Selenium levels were measured by electrothermal atomic absorption spectroscopy post-mortem in heart, brain and liver. Histological examination evidenced dilated cardiomyopathy in 45% of cases, left ventricular hypertrophy in 36%, and ischemic coronaropathy in 18%. A significant reduction of myocardial selenium levels compared to controls was seen in patients treated with neuroleptic drugs or meprobamate. No changes in brain or liver selenium levels were seen. These results suggest that selenium deficiency can facilitate sudden death in patients on psychotropic drugs. The reduced activity of glutathione peroxidase due to selenium deficiency can result in augmented oxidative stress in myocardial cells and myocardiopathy leading to sudden death. PMID:22664334

  12. Two philosophical deaths: Hume and Hitchens.

    Science.gov (United States)

    Miller, Franklin G

    2013-01-01

    This essay describes the deaths of David Hume (1711-1776) and Christopher Hitchens (1949-2012). Both distinguished thinkers and writers, who shared much in their world views, died around the same age after a similarly prolonged course of terminal illness. However, the great difference in the power of medicine to intervene with the goal of cure or preserving life made their lives while facing death dramatically different. The narratives of these two deaths help shed light on some of the key features that make particular deaths and the processes of dying good or bad, as well as highlight the difficulty in achieving a good death in the world of contemporary medicine.

  13. Brain and Nervous System

    Science.gov (United States)

    ... to Know About Zika & Pregnancy Brain and Nervous System KidsHealth > For Parents > Brain and Nervous System Print ... is quite the juggler. Anatomy of the Nervous System If you think of the brain as a ...

  14. Traumatic Brain Injury

    Science.gov (United States)

    Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that ...

  15. The Additional Detrimental Effects of Cold Preservation on Transplantation-Associated Injury in Kidneys from Living and Brain-Dead Donor Rats

    NARCIS (Netherlands)

    Hoeger, Simone; Petrov, Kiril; Reisenbuechler, Anke; Fontana, Johann; Selhorst, Jochen; Hanusch, Christine; Beck, Grietje; Seelen, Marc A.; van Son, Willem J.; Waldherr, Ruediger; Schnuelle, Peter; Yard, Benito A.

    2009-01-01

    Background. Brain death and cold preservation are major alloantigen-independent risk factors for transplantation Outcome. The present study was conducted to assess the influence of these factors on transplantation-associated injury independently or in combination. Methods. Brain death was induced in

  16. Cardiovascular deaths related to Carbon monoxide Exposure in Ahvaz, Iran

    Directory of Open Access Journals (Sweden)

    Gholamreza Goudarzi

    2014-08-01

    Full Text Available Carbon monoxide is an odorless, colorless and toxic gas that emitted from combustion. Carbon monoxide can cause harmful health effects by reducing oxygen delivery to the body's organs (like the heart and brain, tissues, fibrinolysis effects, abortion and death at extremely high levels. The aim of this study was to assess health- effects of carbon monoxide exposure in Ahvaz city. Data were collected through Ahvaz Meteorological Organization and Department of Environment. Raw data processing by Excel software includes (instruction set correction of averaging, coding and filtering and after the impact of meteorological parameters was converted as input file to the Air Q model. Finally, health-effects of carbon monoxide exposure were calculated. The results showed that the concentration of carbon monoxide was 7.41 mg/m3 in Ahvaz as annual average. Sum of total numbers of deaths attributed to carbon monoxide was 16 cases within a year. Approximately 4.3% of total Cardiovascular deaths happened when the carbon monoxide concentrations was more than 20 mg/m3. This could be due to higher fuel consumption gasoline in vehicles, Oil industry, steel and Heavy industries in Ahwaz. Mortality and Morbidity risks were detected at current ambient concentrations of air pollutants.

  17. Cryoethics: seeking life after death.

    Science.gov (United States)

    Shaw, David

    2009-11-01

    Cryonic suspension is a relatively new technology that offers those who can afford it the chance to be 'frozen' for future revival when they reach the ends of their lives. This paper will examine the ethical status of this technology and whether its use can be justified. Among the arguments against using this technology are: it is 'against nature', and would change the very concept of death; no friends or family of the 'freezee' will be left alive when he is revived; the considerable expense involved for the freezee and the future society that will revive him; the environmental cost of maintaining suspension; those who wish to use cryonics might not live life to the full because they would economize in order to afford suspension; and cryonics could lead to premature euthanasia in order to maximize chances of success. Furthermore, science might not advance enough to ever permit revival, and reanimation might not take place due to socio-political or catastrophic reasons. Arguments advanced by proponents of cryonics include: the potential benefit to society; the ability to cheat death for at least a few more years; the prospect of immortality if revival is successful; and all the associated benefits that delaying or avoiding dying would bring. It emerges that it might be imprudent not to use the technology, given the relatively minor expense involved and the potential payoff. An adapted and more persuasive version of Pascal's Wager is presented and offered as a conclusive argument in favour of utilizing cryonic suspension.

  18. Genetics of sudden cardiac death.

    Science.gov (United States)

    Refaat, Marwan M; Hotait, Mostafa; London, Barry

    2015-07-01

    Sudden cardiac death (SCD) is defined by the World Health Organization (WHO) as death within 1 h of symptom onset (witnessed) or within 24 h of being observed alive and symptom free (unwitnessed). It affects more than 3 million people annually worldwide and affects approximately 1/1000 people each year in the USA. Familial studies of syndromes with Mendelian inheritance, candidate genes analyses, and genome-wide association studies (GWAS) have helped our understanding of the genetics of SCD. We will review the genetics of arrhythmogenic hereditary syndromes with Mendelian inheritance from familial studies with structural heart disease (hypertrophic cardiomyopathy, dilated cardiomyopathy, and arrhythmogenic cardiomyopathy) as well as primary electrical causes (long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, and short QT syndrome). In addition, we will review the genetics of intermediate phenotypes for SCD such as coronary artery disease and electrocardiographic variables (QT interval, QRS duration, and RR interval). Finally, we will review rare and common variants that are associated with SCD in the general population and were identified from candidate gene analyses and GWAS. Our understanding of the genetics of SCD will improve by the use of next-generation sequencing/whole-exome sequencing as well as whole-genome sequencing which have the potential to discover unsuspected common and rare genetic variants that might be associated with SCD. PMID:26026997

  19. Programmed Cell Death in Neurospora crassa

    Directory of Open Access Journals (Sweden)

    A. Pedro Gonçalves

    2014-01-01

    Full Text Available Programmed cell death has been studied for decades in mammalian cells, but simpler organisms, including prokaryotes, plants, and fungi, also undergo regulated forms of cell death. We highlight the usefulness of the filamentous fungus Neurospora crassa as a model organism for the study of programmed cell death. In N. crassa, cell death can be triggered genetically due to hyphal fusion between individuals with different allelic specificities at het loci, in a process called “heterokaryon incompatibility.” Chemical induction of cell death can also be achieved upon exposure to death-inducing agents like staurosporine, phytosphingosine, or hydrogen peroxide. A summary of the recent advances made by our and other groups on the discovery of the mechanisms and mediators underlying the process of cell death in N. crassa is presented.

  20. Classification of sudden and arrhythmic death

    DEFF Research Database (Denmark)

    Torp-Pedersen, C; Køber, L; Elming, H;

    1997-01-01

    as being arrhythmic or sudden are all biased by the difficulty of having to decide on the degree of unexpectedness or the likelihood that life could continue without the arrhythmia. The uncertainties are enlarged by the fact that critical data (such as knowledge of arrhythmias at the time of death......Since all death is (eventually) sudden and associated with cardiac arrhythmias, the concept of sudden death is only meaningful if it is unexpected, while arrhythmic death is only meaningful if life could have continued had the arrhythmia been prevented or treated. Current classifications of death...... or autopsy) are available in only a few percent of cases. A main problem in using classifications is the lack of validation data. This situation has, with the MADIT trial, changed in the case of the Thaler and Hinkle classification of arrhythmic death. The MADIT trial demonstrated that arrhythmic death...