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Biomedical subjects

R H Kirschner

Publications and source records attributed to R H Kirschner.

At least 19 recordsLinked to original sources
PubMed1996

Physician complicity in misrepresentation and omission of evidence of torture in postdetention medical examinations in Turkey.

Between June 1994 and October 1995, representatives of Physicians for Human Rights studied the problem of physician complicity in torture (ie, misrepresentation and omission of medical evidence in postdetention examinations of detainees) in Turkey. The research consisted of a survey of forensic documentation of torture, interviews with individual physicians who examine detainees, analyses of official medical reports of detainees, and interviews with survivors of torture. Results from the survey, interviews, and medical report analyses provide evidence that torture of political and criminal detainees continues to occur in Turkey and that Turkish physicians are coerced to ignore, misrepresent, and omit evidence of torture in their examinations of detainees to certify that there are no physical signs of torture.

Attitude↗
PubMed1994

The application of the forensic sciences to human rights investigations.

Prior to the mid-1980's, human rights abuses were documented almost entirely through witness and victim testimony. In 1984-85, forensic scientists from the United States, working under the auspices of the American Association for the Advancement of Science, exhumed skeletal remains of disappeared persons in Argentina. They provided physical evidence for the trial of members of the deposed military junta and trained an Argentine forensic anthropology team. It became apparent that medical and forensic verification of torture and extrajudicial executions could provide irrefutable evidence that such activities had, in fact, taken place. Requests for assistance came from human rights groups throughout the world, and led to the development of an international protocol for the investigation of government sponsored murders. The United States based Physicians for Human Rights has now conducted missions to nearly 30 countries. The recent documentation of mass graves in El Salvador, Guatemala, Iraqi Kurdistan and the former Yugoslavia demonstrates how forensic scientists expose such crimes to international scrutiny, and the necessity of scientific evidence when confronting human rights violations.

Adult↗
PubMed1989

[Pathologic-anatomic findings in sudden heart death].

Sudden cardiac death can be caused by a large variety of pathological conditions detected morphologically. In most cases it is the result of coronary sclerosis. A coronary thrombus is not only found in myocardial infarction, but also frequently occurs in unstable angina without infarction. In most instances these thrombi develop following rupture of an atheromatous plaque. A higher risk of sudden cardiac death is associated with abnormalities of the coronary ostia, most commonly an anomalous origin of the left coronary artery from the right sinus. HOCM is the most important cardiomyopathy causing sudden cardiac death in young athletes. Furthermore, myocarditis, pathological changes of the conduction system, and other rare conditions can lead to sudden cardiac death. A particular set of diseases contributes to sudden cardiac death in the young. Occasionally, disturbances in the texture of the ventricular septum can be found that have so far not been described in the literature. Acute arrhythmias hold a key position among the pathophysiological mechanisms leading to sudden cardiac death.

Cause of Death↗
PubMed1986

The cardiac pathology of sudden, unexplained nocturnal death in Southeast Asian refugees.

Sudden death during sleep has occurred among previously healthy Southeast Asian male refugees, but routine autopsies have not determined the cause of death in any of these cases. We report the first systematic attempt to define the cardiac abnormalities associated with this syndrome. Among 18 hearts examined, 14 showed slight to significant cardiomegaly, characteristic of increased cardiac work load. The reasons for the cardiomegaly remain unexplained. Conduction system anomalies were present in all but one heart. These included persistent fetal dispersion of the atrioventricular node and/or bundle of His, present in 14 hearts; accessory conduction fiber connections, found in 13 cases; and congenital heart block, observed in one case. These abnormalities were associated with variations in the structure of the cardiac base, suggesting a common aberrant developmental process. Although the functional significance of these findings has not been established, the conduction system anomalies may be the substrate for sleep-related cardiac arrhythmias and sudden death.

Adult↗
PubMed1985

The mistaken diagnosis of child abuse. A form of medical abuse?

The suspected diagnosis of child abuse may prove to be unfounded. Reports in the literature have focused on unusual diseases and folk medicine practices that may mimic abuse. We report ten cases where allegations of abuse were lodged against parents because the treating physicians in the emergency room mistook life-threatening illness or postmortem artifacts for inflicted injury. In all cases the families were from the inner city, and with two exceptions the involved institutions were small hospitals without pediatric personnel present in the emergency department. Although the histories related by the parents were in all cases truthful and consistent with the results of physical examinations of the child, the involved physicians failed to make a correct diagnosis. Not only a lack of experience with severe childhood illness and death but also an attitude of suspicion and/or hostility probably contributed to these misdiagnoses.

Child↗
PubMed1984

The use of drugs in torture and human rights abuses.

The forced administration of drugs, usually by injection, may accompany physical torture. In the extrajudicial environment in which torture occurs, documentation of the types of drugs used is difficult. In violation of all codes of professional ethics, physician participation appears to be ubiquitous. In the Soviet Union, human rights abuses have become institutionalized within the mental health care system. Therapeutic drugs are used, often at toxic levels, to punish political and/or religious dissidents.

Dissent and Disputes↗
PubMed1979

Scanning electron microscopy of infective endocarditis.

As part of a study of the development of infective endocarditis in ncarcotic addicts, we sought to establish the feasibility of using scanning electron microscopy (SEM) to view the surface characteristics of human heart valves obtained at autopsy. Normal and infected heart valves from humans and animals were obtained at autopsy, fixed in formalin, and processed for SEM. Parallel samples from immediately adjacent regions were processed for light microscopy. Active and healed endocarditis were readily recognizable by SEM, and the observations correlated well with those made by light microscopy. The advantage of SEM in the study of endocarditis is that it provides significant information about damage to the endocardial surface across the entire valve. The relative proportions of fibrin, platelets, leukocytes, exposed stromal connective tissue and bacteria on the surface of a lesion can easily be analysed. SEM may prove particularly useful in the study of the pathogenesis of the early lesions of infective endocarditis on previously "undamaged" valves.

Animals↗
PubMed1977

Characterization of the nuclear envelope, pore complexes, and dense lamina of mouse liver nuclei by high resolution scanning electron microscopy.

We have used high resolution scanning electron microscopy (SEM) to study the nuclear envelope components of isolated mouse liver nuclei. The surfaces of intact nuclei are covered by closely packed ribosomes which are distinguishable by SEM from nuclear pore complexes. After removal of nuclear membranes with the nonionic detergent Triton X-100, the pore complexes remain attached to an underlying, peripheral nuclear lamina, as described by others. The surface of this dense lamina is composed of particulate granules, 75-150 A in diameter, which are contiguous over the entire periphery. We did not observe the pore-to-pore fibril network suggested by other investigators, but such a structure might be the framework upon which the dense lamina is formed. Morphometric analysis of pores and pore complexes shows their size, structure, and density to be similar to that of other mammalian cells. In addition, several types of pore complex-associated structures, not previously reported by other electron microscope (EM) techniques, are observed by SEM. Our studies suggest that the major role of the dense lamina is associated with the distribution, stability, and perhaps, biogenesis of nuclear pore complexes. Treatment of isolated nuclei with a combination of Triton X-100 and sodium deoxycholate removes membranes, dense lamina, and nuclear pore complexes. The resulting "chromatin nuclei" retain their integrity despite the absence of any limiting peripheral structures.

Animals↗
PubMed1977

Cell and organelle shrinkage during preparation for scanning electron microscopy: effects of fixation, dehydration and critical point drying.

The critical point drying method of preparing samples for scanning electron microscopy is associated with a variable amount of specimen shrinkage. We studied the causes of this phenomenon is isolated mouse hepatocyte nuclei and in human erythrocytes and found that the critical point drying process itself caused most of the shrinkage that we observed (a 25-30% reduction in diameter in both specimens). Glutaraldehyde fixation and ethanol dehydration caused only minimal size reduction, prior to critical point drying. Substitution of an inert (ethylene glycol-ethylene glycol monethyl ether) dehydration technique did not alter the final result. Previous studies in our laboratory using high resolution SEM and correlative transmission microscopy of isolated nuclei have demonstrated that the shrinkage represents a miniaturization of the organelles in which all structural components retain their usual relationships.

Cell Nucleus↗
PubMed1976

Familial Sjögren's syndrome with associated primary salivary gland lymphoma.

Primary salivary gland lymphoma has been rarely documented in patients with or without Sjögren's syndrome. The association of disseminated lymphoreticular neoplasms with Sjögren's syndrome has been recognized, and the malignancy is usually widespread at the time of diagnosis. Familial occurrence of Sjögren's syndrome is likewise infrequently observed. In the present report we describe a patient with Sjögren's syndrome in whom a primary parotid gland lymphoma subsequently developed. In addition to the propositus, two of four siblings had definite evidence of Sjögren's syndrome and a third had several abnormal studies commonly associated with the disease. This observation suggests that genetic influence alone or in conjunction with other factors may facilitate the development of Sjögren's syndrome.

Female↗
PubMed1975

Epithelioid granulomas in Hodgkin disease. A favorable prognostic sign?

Histologic sections of spleen and liver prepared from tissue obtained during exploratory laparotomy and splenectomy in 91 untreated patients with Hodgkin disease were reviewed to assess the incidence and possible implications of noncaseating, epitheliod, sarcoid-like granulomas. The 17 patients with granulomas and the 74 patients without granulomas did not differ appreciably with respect to pretreatment indexes. All patients were observed for at least 15 months following laparotomy or until the time of death (range, 15 to 67 months; median, 25 months). The 17 patients with granulomas tended to have fewer relapses, longer survival, and lower incidence of subsequent herpes zoster infection compared to the 74 without granulomas. The presence of epithelioid granulomas in association with Hodgkin disease may reflect a host response to the tumor with favorable prognostic implications.

Adult↗