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Biomedical subjects

S Leadbeatter

Publications and source records attributed to S Leadbeatter.

At least 37 records · Page 2Linked to original sources
PubMed1990

Further evaluation of immunocytochemical staining in the diagnosis of early myocardial ischaemic/hypoxic damage.

The pattern of immunocytochemical staining with antibodies to caeruloplasmin, myosin, myoglobin and C-reactive protein seen in myocardium taken from deaths with macroscopic evidence of myocardial infarction and/or significant coronary artery atherosclerosis and from deaths with neither of these lesions has been correlated with H&E, PTAH and HBFP staining of myocardium and circumstances of each death indicative of antemortem hypoxia and/or ischaemia. Loss of staining with these antibodies correlated well with fuchsinorrhagia and both techniques are more sensitive than H&E and PTAH staining in the detection of early ischaemic/hypoxic damage to myocardium. However, their sensitivity is such that they appear to detect agonal changes and, therefore, cannot be used for specific diagnosis of early myocardial infarction.

Adult↗
PubMed1989

Immunocytochemical diagnosis of early myocardial ischaemic/hypoxic damage.

The sensitive and reliable dinitrophenyl (DNP) hapten sandwich staining (DHSS) procedure (B. Jasani et al., Virchows Arch (Pathol. Anat.), 406 (1985) 441-448) was used to study the distribution of immunoperoxidase staining seen with antibodies to seven protein markers in post-mortem heart tissue. This was obtained from 12 cases with macroscopic myocardial infarction and 17 cases without myocardial infarction (10 with and 7 without significant coronary artery atherosclerosis). The immunostaining patterns were compared with the appearances seen in adjacent sections stained by the routine haematoxylin and eosin (H & E) and phosphotungstic acid haematoxylin (PTAH) methods and a method previously recommended for the detection of early myocardial infarction, the haematoxylin basic fuchsin picric acid (HBFP) stain. Loss of immunostaining with an antibody to myoglobin was found to be a reliable and more objective marker of both early and established myocardial infarction compared with the histological stains. Antibodies to myosin, caeruloplasmin, C-reactive protein and pre-albumin gave similar but less reliable results, whilst those to complement factor C3b and alpha-1 anti-trypsin gave the least reliable results for early myocardial ischaemic/hypoxic damage. The immunocytochemical results are considered sufficiently encouraging to extend the work to a large number of sudden death cases in order to establish a new, more reliable approach to the detection of histologically latent ischaemic/hypoxic damage in the myocardium.

Antigens, Surface↗
PubMed1989

Asphyxiation by glottic impaction of nasal secretions.

An 84-year-old woman died suddenly 20 days after a head injury; a medical witness to the death described laboured breathing consistent with stridor. At postmortem examination, her larynx was found to be occluded by a firm mass of jelly-like material considered initially to be regurgitated food material. The microscopic features of this material were consistent with inspissated mucoid secretions from the nasopharynx. Relationship to cafe coronary and passage of a nasogastric tube are discussed.

Aged↗
PubMed1988

Dental anesthetic death. An unusual autoerotic episode.

The details of an unusual autoerotic death are presented; the postulated method of induction of cerebral hypoxia was inhalation of nitrous oxide from a dental anesthetic machine; the theme of dental anesthesia, presumably an elaborate bondage fetish, recurred in documentary material found at the scene.

Cause of Death↗
PubMed1987

Incidence of familial hypercholesterolaemia in premature deaths due to coronary heart disease.

Cholesterol estimations were performed on blood collected postmortem from a group of subjects coming to autopsy and showing that they had had a high risk for hypercholesterolaemia, and from an unselected group of subjects dying in hospital. Subjects from the first group had apparently been healthy, aged less than 45 years, had had no known risk factors for hyperlipidaemia, and showed extensive coronary artery atheroma (stenosis greater than 50% by diameter). Eleven cases from 485 consecutive autopsies fulfilled these criteria; three showed considerable hypercholesterolaemia (11.2, 11.8, and 21.6 mmol/L). Family studies confirmed the diagnosis of familial hypercholesterolaemia in one case; the other two remain unproven. Cholesterol measurement by cholesterol oxidase and quinoneimine dye production is subject to interference by haemolysis; provided that serum haemoglobin is less than 200 mg/dl, the cholesterol underestimate is less than 5%. The decline in serum cholesterol in the group of unselected subjects was 1.7 (0.3-4.9) mmol/L, 50.4 (28-84) h postmortem. Results are means and ranges for seven subjects. Measurement of cholesterol in serum obtained postmortem (provided that the sample is not grossly haemolysed) is a valid approximation of antemortem levels: this measurement should be made when autopsy reveals evidence of premature coronary heart disease. If hypercholesterolaemia is discovered, the diagnosis of familial hypercholesterolaemia, a common genetic disorder inherited in an autosomal dominant fashion, should be considered and appropriate family studies instituted.

Adult↗
PubMedDate not supplied

Deaths of British nationals abroad--a 10-year survey.

Details are presented of all deaths of British Nationals abroad where a post mortem examination after repatriation was carried out in what is now the Wales Institute of Forensic Medicine. The problems posed by such deaths are discussed and the conclusion is drawn that without international uniformity in technique and documentation of medico-legal post mortem examinations, H.M. Coroner cannot be confident that all pathological evidence has been gathered from such an examination carried out in another country. A plea is made for international uniformity in the criteria for selection of deaths which require post mortem examination.

Adolescent↗
PubMedDate not supplied

Clinical governance and the coroner.

In the face of public expectation of uniformly high standards of medical practice and of open accountability, we suggest that the public interest would be served by a system of transparent, informed and independent scrutiny of those deaths that follow medical treatment, either in hospital or in the community. We do not believe that such a system operates at present in England and Wales or, indeed, that best practice may be achieved within current financial or legislative constraints. However, we suggest that the existing law allows greater involvement of the coroner in the investigation of deaths following medical treatment, should there be the professional desire for self-scrutiny and the political will to release resources to support that desire.

Autopsy↗
PubMedDate not supplied

Detecting homicide in hospital.

The Beverly Allitt case and the subsequent inquiry have focused attention on the detection of covert hospital homicide. Effective investigation can only take place if there is prompt recognition of circumstances that justify suspicion about a death and immediate action is taken to retrieve potentially vital evidence. The hospital itself must take responsibility for the detection of covert homicide. Confidence that such deaths will be uncovered by 'routine' investigation through the existing coroner system, including postmortem examination, is misplaced.

Coroners and Medical Examiners↗