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Biomedical subjects

S D Cohle

Publications and source records attributed to S D Cohle.

50 records · Page 3Linked to original sources
PubMed1985

Natural history of pulmonary scar cancers. Clinical and pathologic implications.

Twenty-two cases of resected pulmonary scar cancers in which 10 year or greater follow-up could be obtained were evaluated to determine morphologic and clinical criteria which would predict long-term survival and elucidate the cause and effect relationship of the scar to the cancer. Maturity of the scar was found to be an important criterion in predicting long-term survival. Of patients with tumors less than or equal to 3 cm, only one of six with an early scar died with cancer, whereas four of eight patients with advanced scars died with cancer. All tumors greater than 3 cm had advanced scars and five of eight patients in this category died with cancer. These findings support the concept that the scar develops secondary to the cancer and that the maturity of the scar can be used as a prognostic criterion in resected tumors.

Aged↗
PubMed1985

Sudden unexpected death due to atherosclerotic coronary artery aneurysm.

The case of a 34-year-old white male who died suddenly and unexpectedly of a thrombosed coronary artery aneurysm is presented. Coronary artery aneurysms have a prevalence of approximately 2%; over half of these are caused by atherosclerosis with the remainder due to syphilis, infections, trauma, congenital malformations, vasculitis, neoplasms, and connective tissue disorders (Ehlers-Danlos and Marfan's syndromes). Replacement of the media by atherosclerotic debris is the cause of atherosclerotic aneurysms. Complications include rupture and thrombosis. Sudden death has been reported in eight other cases of atherosclerotic aneurysms; sudden unexpected death as the presenting symptom of atherosclerotic coronary artery aneurysm, as in our case, is rare.

Adult↗
PubMed1985

Sudden death caused by embolization of trophoblast from hydatidiform mole.

A 16-year-old pregnant female presented to a hospital emergency room with vaginal bleeding and uterine cramping. She underwent a hysterotomy and curettage and, during the procedure, her pulse dropped from 130 to 30 beats/minute, her pO2 fell to 10 mm of mercury, and she could not be resuscitated. At autopsy, she was found to have massive pulmonary embolization of syncytiotrophoblast from a hydatidiform mole of the uterus. This is the sixth reported case of trophoblastic embolization from a hydatidiform mole ending in death. This fatal termination may occur after a period of respiratory symptoms and may occur regardless of the mode of treatment.

Adolescent↗
PubMed1985

Sudden death in hemodialysis patients.

Hemodialysis patients may die suddenly and unexpectedly from a number of causes. These may be divided into those deaths due directly to and occurring during hemodialysis, those deaths occurring while the patient is not undergoing dialysis, and those deaths that may occur at any time. The first group includes brain herniation, air embolism, acute hemorrhage as a result of machine malfunction or fistula rupture, electrocution, cardiac arrhythmia caused by hypokalemia, complications of subclavian intravenous catheter insertion, third-degree heart block as a result of triglyceride emulsion, and disseminated intravascular coagulation (DIC) or hyperkalemia caused by overheated dialysate. The second group includes deaths due to pericardial tamponade because of effusion and suicidal causes of death (exsanguination, electrolyte imbalance as a result of excessive intake of salt, fluid, or potassium) as well as more conventional methods of suicide. The last category includes people dying of arteriosclerotic cardiovascular disease, hypertensive cardiovascular disease, and internal hemorrhage. Investigation of these deaths, including pertinent historical, laboratory, and autopsy data and investigation of dialysis equipment, is discussed.

Aged↗
PubMed1982

Sudden unexpected death due to coronary giant cell arteritis.

A previously healthy 19-year-old woman died two hours after the sudden onset of severe chest pain. The only gross abnormality seen at the time of autopsy was thrombosis of the left main coronary artery. Microscopic examination of the artery showed eccentric necrotizing arteritis with giant cells, associated with the thrombus. The aorta was infiltrated with lymphocytes, histiocytes, and an occasional giant cell. Sudden cardiac death as the initial manifestation of a giant cell arteritis that involves only the coronary artery and aorta is rare.

Adult↗
PubMed1981

Effects of storage of blood on stability of hematologic parameters.

The hematologic parameters of blood stored at 4 degrees C and at room temperature were studied. In blood stored at 4 degrees C with intermittent mixing, leukocyte count, hemoglobin, erythrocyte count, mean corpuscular volume (MCV), hematocrit, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration (MCHC), and platelet count showed no statistically significant change for three days. Blood stored at room temperature showed a significant increase in MCV in 24 hours, and corresponding changes occurred in hematocrit and MCHC. It is concluded from these observations that blood from normal healthy donors can serve as an adequate control for the Coulter Counter for three days if kept at 4 degrees C and mixed intermittently.

Blood Preservation↗
PubMed1981

Granular cell tumor of the esophagus. Report of three cases.

Granular cell tumors, (formerly called myoblastomas) involving the esophagus were encountered in three patients. In all three the tumors were asymptomatic and in two they were multiple. The first published endoscopic photographs of such a tumor are presented. The successful total removal of this neoplasm using the endoscope is described. The pathologic, radiologic and therapeutic aspects of previously reported cases of granular cell tumor of the esophagus are reviewed and compared with the three reported herein.

Adult↗
PubMed1981

Communication of the coronary sinus with both atria.

The coronary sinus of a healthy 18-year-old man who died of a skull fracture was found to communicate with both the right and left atria. The anomaly can function as an atrial septal defect; thus, it needs recognition in the treatment of a patient with an interatrial shunt with an apparently normal right atrium.

Adolescent↗
PubMed1979

ACTH-secreting carcinoma of the breast.

We report a case of ACTH-secreting carcinoma of the breast. Membrane-bound secretory granules were seen within the cancer cells electron microscopically. Cytoplasmic granules reacting immunochemically to anti-ACTH antisera were seen on light microscopy. Breast cancers have been shown to secrete calcitonin, parathyroid hormone, human chorionic gonadotropin, and norepinephrine in addition to ACTH. This suggests either the presence of neuroendocrine cells in the breast as a source of such neoplasms, as in the lung, or genomic derepression during neoplastic transformation.

Adrenocortical Hyperfunction↗
PubMedDate not supplied

Sudden death due to ventricular septal defect.

Ventricular septal defects (VSD) are usually considered non-life-threatening, usually closing spontaneously or causing symptoms of congestive heart failure, which can be surgically treated in time to save the patient's life. Despite the usually benign clinical course of VSD, serious arrhythmias occur in 16-31% of patients. Sudden death accounted for one-third of all deaths in a series of medically managed patients and occurred in 4.2% of patients in a study of VSD and arrhythmias. Cardiac hypertrophy is the common denominator in all cases reported in detail of VSD-associated sudden death. We have encountered four cases of sudden unexpected death from VSD in infants ranging in age from 1 week to 3 and (1/2) months. In each case there was cardiomegaly and in one case there was pulmonary arteriolar medial thickening, with extension of smooth muscle into small intralobular vessels. In half of our cases the attending physician was sued for malpractice. We believe that VSD in infants and young children are potentially life-threatening malformations which warrant careful clinical follow-up.

Cardiomegaly↗
PubMedDate not supplied

The negative autopsy: sudden cardiac death or other?

One of the most frustrating challenges faced by the forensic pathologist is the inability to determine the cause of death in a young person previously thought healthy. The four steps in the investigation of a sudden death include obtaining the history and scene information, performing a gross and microscopic autopsy, performing appropriate laboratory tests, and making the diagnosis. When examining the heart grossly it is important to preserve the anatomic landmarks, section the coronary arteries closely, and recognize lethal abnormalities such as anomalous origin of the coronary arteries. Specimens useful for toxicologic analysis include whole blood, serum, vitreous humor, gastric contents, bile, urine a purple top tube of blood, and frozen myocardium and spleen. Lethal cardiac diseases with minimal or no anatomic findings include Brugada and Garg's syndromes, the long QT syndrome, and Wolff-Parkinson-White (WPW) syndrome. Consultation with other experts, including cardiac pathologists, cardiologists, electrophysiologists, and molecular biologists, may be helpful in determining a cause of death.

Autopsy↗
PubMedDate not supplied

An unusual site for the AV node tumor: report of two cases.

Atrioventricular (AV) node tumors are very uncommon primary cardiac tumors located exclusively in the AV nodal region. The nomenclature has been diverse according to different histogenetic theories proposed since the first description in 1911. Histochemical, ultrastructural, and immunohistochemical studies have demonstrated its endodermal origin. Patients with these tumors can develop complete heart block or sudden death, but the tumor can also be an incidental finding at autopsy. We present two accidental deaths cases in which multiple foci of atrioventricular node tumor (Case 1) and an isolated cyst (Case 2) were observed in the atrial septum, sparing the conduction system.

Adolescent↗
PubMedDate not supplied

Anomalous coronary arteries: a multicenter pediatric autopsy study.

Anomalous coronary arteries (ACAs) are a potential cause of myocardial ischemia resulting in arrhythmias, angina, infarction, and sudden death. We analyzed 7857 pediatric autopsy cases from four tertiary centers to gain an overall picture of the range and significance of ACAs within this pediatric autopsy population. The incidence of ACAs was 0.5%, with ectopic origin from the aorta (43%) being most frequent, followed by ACA arising from the pulmonary trunk (40%). The mean age at death was 2.2 years (4 h-14 years). ACAs were associated with other anomalies in 57% of cases, 43% of these being cardiac defects. Growth retardation was noted in 50% of the cases. Examination of the heart showed cardiomegaly in 92% of cases, which was marked (> 95 percentile) in 63%, but histologically apparent ischemic damage was seen in only 50% of cases. ACAs arising from the pulmonary trunk were associated with earlier death (1.4 years), more frequent cardiomegaly (100%), and more frequent myocardial scarring (92%) than other types of anomalies. Although the terminal presentation was sudden death in 45% of cases, ACAs associated with other cardiac defects presented mainly with problems related to the latter anomalies. The results highlight the need to examine coronary arteries carefully during the pediatric autopsy. Not only are the positions of the coronary artery ostia important, but also the variations in the angles of arterial take-off, initial courses through the aortic adventitia, subsequent courses, and presence of ostial ridges or membranes that may result in significant compromise of blood flow.

Cardiomegaly↗