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PubMed1997

[Forensic autopsies performed because of suspected occupational disease during the period 1987-1991--counties of Funen and Southern Jutland. Guidelines for physicians' notifications and a review of autopsy practice during 5 years].

One hundred and thirty-six forensic autopsies were conducted at the Institute of Forensic Medicine, University of Odense, Denmark (covering the counties of Funen and Southern Jutland) between 1987 and 1991 suspecting occupational disease as the cause of death. The autopsy were requested by the National Board of Industrial Injuries (NBII). The most frequent exposures were asbestos, solvents, sand, dust and welding fumes. Death was caused by lung disease in 92/136 of the cases, of which 48 were lung cancers and ten mesotheliomas. Totally, cancer diseases were found to be the cause of death in 70/136. Comparing data from the official death register and from NBII on mesothelioma it is concluded that only a minor part of the deaths caused by occupational disease are reported. Only a fraction of the diseases listed in the official Danish inventory for occupational diseases were represented among these deaths. To ensure the relatives their rightful compensation and improve the statistical data used for prevention, it is important that doctors report all deaths which may have been caused by occupational diseases.

Adult↗
PubMed1997

Late onset type I familial amyloidotic polyneuropathy: presentation of three autopsy cases in comparison with 19 autopsy cases of the ordinary type.

Clinicopathological features of three autopsy cases of extremely rare late onset type I familial amyloidotic polyneuropathy were presented and compared with 19 autopsy cases of the ordinary type. In the late onset cases, the ages at onset and at death were 27.5 and 24.5 years older, respectively, compared with the ordinary type. Also, duration of the total clinical course from onset to death was 3.7 years less than in the late onset cases. The degree of amyloid deposition was more marked in the heart of the late onset cases, causing prominent cardiac hypertrophy. It was also marked in the kidneys or thyroid of two cases, but slight to moderate in the peripheral or autonomic nervous tissues in all cases. Immunohistochemical investigation demonstrated the presence of transthyretin (TTR) as an amyloid precursor protein and of serum amyloid P-component in amyloid deposits in various organs and tissues of the late onset type. These findings, as well as serum levels of variant TTR, were similar to those of the ordinary type. These results suggest that there are some factors other than the amyloid precursor protein that effect the degree of amyloid deposition.

Adolescent↗
PubMed1984

Incidence and diagnostic significance of minor pathologic changes in the adult pancreas at autopsy: a systematic study of 112 autopsies in patients without known pancreatic disease.

In 112 unselected autopsies of adult patients without known pancreatic disease (except adult-onset diabetes mellitus), the pancreas was examined to establish the incidence and degree of such minor pancreatic lesions as lipomatosis, fibrosis, alterations of ducts and ductal epithelium, inflammatory infiltrates, focal necrosis, acinar dilation, and vascular changes. Each lesion was then tested for statistically significant correlations with the age of the patient and a number of clinical conditions, including cholelithiasis, adult-onset diabetes mellitus, adiposity, generalized severe atherosclerosis, chronic alcoholism, severe bacterial infection prior to death, and generalized malignant tumor. This was done in the hope of finding associated or predisposing factors for the pancreatic lesions. The results show, in addition to the unexpectedly high incidence of the various pancreatic lesions, a clear increase of lipomatosis, fibrosis, and both ductal and ductal epithelial alterations with increasing age; these conditions were accompanied by a steady decrease in the mean weight of the gland, starting at the age of about 40 years, except in cases of advanced lipomatosis. The latter condition was associated with adult-onset diabetes mellitus. Severe generalized atherosclerosis was correlated with lipomatosis and fibrosis, but the two latter conditions were found together only rarely. Acute (terminal) lesions, including focal necrosis and acinar dilation, were associated with severe bacterial disease prior to death. Other statistically significant correlations were rare, indicating the lack of specificity of these minor pancreatic lesions rather than offering a clue as to their pathogenesis. The diagnostic significance and the relations of these lesions to clinically relevant chronic pancreatitis are discussed briefly.

Adolescent↗
PubMed1999

An HIV autopsy--characterization of zidovudine-resistant subtype E HIV-1 from autopsy tissue suggests the route of infection and an alternative protocol of therapy.

This CPC concerns a 47-year-old male patient with acquired immunodeficiency syndrome (AIDS). The patient became symptomatic when he developed Pneumocystis carinii pneumonia, but recovered sufficiently to be treated as an outpatient. Two years after falling ill, he developed septic shock and died within a short time. During this period, he failed to respond to HIV drugs, and there was no improvement in his immunodeficient status. The HIV retrieved from the patient's organs at autopsy was found to be type E and to have acquired resistance to Zidovudine. It was also possible to determine the route of infection. HIV treatment guidelines are continuously being revised on the basis of HIV research and the development of new treatment plans, and at the present time, when no definitive method of treatment has yet been established, it is essential for the clinician to keep abreast of the latest information. Since HIV patients are compromised hosts, it is important to diagnose and treat other infectious complications, not only complications unique to AIDS, and we have briefly described the latest HIV therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Autopsy findings in chronic pyelonephritis patients under dialysis--collected from the Annuals of Pathological Autopsy Cases in Japan.

Autopsy findings in chronic pyelonephritis patients on dialysis were studied in 122 cases. The greatest number of cases was in the 50-59 year-old group among males and in the 60-69 year-old group among females. Infection was the most frequent cause of death (39.3%), followed by bleeding (23.5%). The total number of patients with infections and bleeding was 68 cases (55.7%) and 39 cases (32.0%), respectively. Pneumonia and bronchitis were the most frequent (27.0%) in cases with infections and gastrointestinal bleeding was the most frequent (21.3%) in cases with bleeding. The incidence of tuberculosis (16.4%) as a complication was high.

Adolescent↗
PubMed1983

[Incidence of liver cirrhosis in autopsy cases. A statistical autopsy study].

In this study, data about frequency, age and sex distribution of cirrhosis in 10000 autopsies are summarized. There were 475 (4.75%) cirrhoses, among them 319 complete and 156 incomplete forms. The peak of age distribution was in the 8th decennium. There is a preponderance of males in a proportion of 1.44: 1. Etiological hints were found for hepatitis in 23% and for alcohol in 20% of the cases. Only 159 (33.4%) cases with cirrhosis were known intra vitam. The causes of death were related to the liver disease in 136 cases (28.6%) (bleeding from esophagical varices in 60 cases = 44% of cirrhosis, and coma hepatic in 48 cases = 35% of cirrhoses). Most of the cirrhotics died from cardiovascular and bronchopulmonary diseases. In 33 of 475 cirrhoses (7.2%) a primary liver carcinoma had developed. The results were compared with those obtained previously by other authors.

Adult↗
PubMed1996

[Coexistence of some diseases and analysis of death causes based on autopsy examinations carried out in liver cirrhosis patients based on autopsy observations in 1976-1990].

The 19,094 autopsy examinations carried out between 1976-1990 revealed 698 (3.65%) case of cirrhosis, of which 64.6% were men. During the last 5 years the percentage of coexistance of hepatoma (hepatocellular carcinoma) with cirrhosis was higher 5-year periods (5.8%; 5.4%). Moreover, the same changing interrelation was observed for other malignancies and cirrhosis-higher (15%) in the last period than in the proceeding years (11.1%; 11.3%). The severity of atherosclerotic changes and coexistance of peptic ulcers, gall bladder disease and productive pulmonary tuberculosis in cirrhotic patients were also assessed. Finally the direct causes of these patients' death were discussed.

Adult↗
PubMed1990

[An autopsy case of Alzheimer's disease associated with Parkinson's disease, compared to 2 autopsy cases of diffuse Lewy body disease].

A 68 year old male, diagnosed as Alzheimer's disease clinically, pathologically showed both findings of Alzheimer's disease and Parkinson's disease. The brain weight was 940 g. Macroscopically, severe cortical brain atrophy and depigmentation of the substantia nigra was noted. Microscopic examination showed marked appearance of senile plaque and a large number of neurofibrillary tangle with sever neuronal loss of the cerebral cortex. Additionally, the loss of neuron with many Lewy bodies was found in the substantia nigra. Lewy bodies were also found in the locus ceruleus and the dorsal vagal nucleus, but few in the cerebral cortical neurons. We compared this case neuropathologically with two autopsy cases of diffuse Lewy body disease (DLBD). There was no distinction concerning the lesions of the brain stem between this case and the cases of DLBD. In all three cases, the nucleus of basalis of Meynert showed marked neuronal loss. However, the brain was lighter than those of the cases of DLBD. Senile changes such as senile plaque and neurofibrillary tangles were more marked in this cases than in the cases of DLBD. Furthermore a large number of cortical Lewy bodies were found in the cases of DLBD, but few in this case. The distribution and number of Lewy bodies did not correspond with those of senile changes in the cases of DLBD. Also the cerebral cortical structure was better preserved in the cases of DLBD than in this case. In conclusion, from the clinicopathological findings, we considered that this case is Alzheimer's disease associated with Parkinson's disease. According to Kosaka's study, this case seemed to correspond with a transitional type of the Lewy body disease.

Aged↗
PubMed1992

The clinicopathological implication of myocytes with contraction bands in autopsy hearts. Quantitative analysis of myocytes with contraction bands in autopsy hearts.

To define the normal extent of myocytes with contraction bands, 51 adult autopsied hearts including 30 normal and 21 common hypertrophic hearts were studied. Based on the histologic features, contraction bands were divided into mild and severe types. They were found in 48 and 32 of the total 51 cases, respectively. However, in five hearts, myocytes with contraction bands were more diffused or localized in one part of the ventricular wall. There were no special different treatments before death among the five cases or others. They seemed however to correlate with sudden death or acute cerebral damages. Therefore, reperfusion injury and metabolic cell injuries were considered. If these 5 cases were excluded, the normal extend of myocytes with contraction bands was considered as less than a 1.7% area in the mild type and a 0.5% area in the severe type found in the ventricular wall. These mild and severe contraction bands were considered related to autolysis or events occurring before death.

Adult↗