Search

In this study, we describe two cases with autopsy findings of interstitial myocarditis. They show that supplementing the autopsy with histopathological examination, even when the cause of death is thought to be clear and obvious, is extremely important as it can contribute valuable information to the case, including the circumstances of death. In the first case, we discussed a tram accident in which its driver was killed. The family of the deceased reported that he had been suffering from consciousness disturbances for some time, and additional radiological examinations demonstrated abnormalities in his neck blood vessels. In the second case, a pregnant woman was admitted to hospital after a cardiac and respiratory arrest. A cesarean section was carried out but the fetus was already dead. The woman was declared dead shortly after the operation.

The paper presents selected evident opinionating errors committed by experts in the field of forensic medicine who issued medico-legal opinions in criminal cases, aiming at determining causes of death. The authors analyze the causes of such errors and possibilities of avoiding them, as well as the impact of the said errors on the course of criminal proceedings and the legal position of the suspects or victims. The report emphasizes the potential effect of these opinions on the fate of individuals who have been found suspected or guilty based on such opinions should they be accepted by the court without verification by summoning another expert.

While examining body injuries, a very important issue is to ascertain if they were made ante or postmortem. The majority of authors are of the opinion that the presence of bruises is a proof of an antemortem origin of injuries. Nevertheless, the present authors encountered more than a dozen of cases of postmortem origin of bruises, which had occurred as much as several hours after death. All the observed bruises were inflicted during external examination of bodies at the site where they were found, while examining idiomuscular reactions from biceps brachii and quadriceps femoris muscles. During autopsies carried out in the dissecting room, bruises with central ischaemia and transversal course to the long axis of a limb were noted. Following incision of the integument, we found of shiny ecchymosis (suggilation) in the subcutaneous tissue. Histopathology revealed the presence of blood extravasations in the examined tissues.

The authors present a case of an airgun shot. The airgun Magnum Sport 4.5 mm uses wasp-waist Diabolo style pellets. The initial velocity is 260-290 m/s. This type of guns does not need registration because the energy of the bullet is less than 17 J. In the presented case, the airgun shot could have been an accident occurring while playing with the airgun or else it could have been be feigned. The accused maintained that the victim himself had placed the gun in the subclavicular area and keeping the weapon almost vertically, released the trigger. The victim had not been aware the airgun was loaded (the pellet was left in the gun after the previous play). During autopsy, bluish-red, scanty liver mortis and a rounded wound with a fairly even margin situated in the neck was described. The track of the bullet was traced and found to penetrate the mediastinum. Having dissected the aortic arch and large arteries branching off the aortic arch, the examiner found a full-thickness V-shaped injury involving the left subclavian artery, with each arm of the V-shaped damage approximately 3 mm long. In the tunica adventitia of the vessel, profuse dark cherry-red, shiny sugillation was noted. The length of the pellet track from the skin to the subclavian artery was approximately 5-6 cm.

A robust animal model for "hypothesis-testing/mechanistic" research in human immunology and immuno-pathology should meet the following criteria. First, it has well-studied hemato-lymphoid organs and target cells similar to those of humans. Second, the human pathogens establish infection and lead to relevant diseases. Third, it is genetically inbred and can be manipulated via genetic, immunological and pharmacological means. Many human-tropic pathogens such as HIV-1 fail to infect murine cells due to the blocks at multiple steps of their life cycle. The mouse with a reconstituted human immune system and other human target organs is a good candidate. A number of human-mouse chimeric models with human immune cells have been developed in the past 20 years, but most with only limited success due to the selective engraftment of xeno-reactive human T cells in hu-PBL-SCID mice or the lack of significant human immune responses in the SCID-hu Thy/Liv mouse. This review summarizes the current understanding of HIV-1 immuno-pathogenesis in human patients and in SIV-infected primate models. It also reviews the recent progress in the development of humanized mouse models with a functional human immune system, especially the recent progress in the immunodeficient mice that carry a defective gammaC gene. NOD/SCID/gammaC(-/-) (NOG or NSG) or the Rag2(-/-)gammaC(-/-) double knockout (DKO) mice, which lack NK as well as T and B cells (NTB-null mice), have been used to reconstitute a functional human immune system in central and peripheral lymphoid organs with human CD34(+) HSC. These NTB-hu HSC humanized models have been used to investigate HIV-1 infection, immuno-pathogenesis and therapeutic interventions. Such models, with further improvements, will contribute to study human immunology, human-tropic pathogens as well as human stem cell biology in the tissue development and function in vivo.

The report presents two cases, in which medico-legal assessment of the time of death was supplemented by entomological studies. In Case 1, where the corpse was completely mummified, insects found on the body allowed for determining that death had occurred 1-1.5 years prior to discovery of the victim, thus making it possible to determine the upper limit of the relevant time range, what could not have been accomplished based solely on medico-legal examinations. In Case 2, where highly advanced postmortem changes rendered precise determination of the time of death by medico-legal methods impossible, and the insect species living on the body suggested that death had occurred approximately 3-6 months prior to discovery of the corpse, non-scientific data demonstrated that death might have occurred not earlier than slightly more than two months before the body was found.

The paper presents two cases, in which medico-legal determination of the time of death was supplemented by entomological studies. In Case 1, the possible time of death was determined by a combination of the method based on the sum of effective temperatures with assessment of species composition of insects found on the body. In Case 2, the method based on sum of effective temperatures was combined with an analysis of the isomegalen diagram. The authors demonstrate problems that may be encountered while determining temperature conditions at the site where the corpse stayed prior to its discovery, as well as the effect of local temperature variability on the results of entomological studies.

The applications of fluorinated organic compounds (FOCs) as finishing agent for fabrics, components of extinguishing agents, electroplating bathes, lubricating oils, oxygen carriers in blood substitutes have been discussed. Recent achievements in methods of the fluorination and general principles of the synthesis of useful perfluorinated organic compounds are given as well.

This paper describes a case of ex post opinion in the judgement of work disability for purposes of benefit qualification, in which numerous, frequently contradictory disability certifications by KIZ, WKIZ, ZUS physician-certifiers and court medical opinions were issued. Despite the simplicity of her case, a woman underwent 17 examinations in connection with the opinions and certifications. The court, instead of verifying the opinions and clearing up all doubts through questioning legal experts, submitted subsequent opinions as evidence, and ZUS broke the law by issuing work certification in spite of a legally binding court ruling.

The aim of this research was to define the influence of long-term ethanol intoxication on the changes in end products of lipid peroxidation, reacting with thiobarbituric acid (TBA-reactive products) and free SH-groups concentrations in rat brains. The experiment was conducted on male Lewis rats. The experimental groups received a 1-molar ethanol solution and the control group received tap water. The animals were killed after 4, 8 and 12 weeks of intoxication and their brains were collected for further examination, encompassing measurement of the concentration of TBA-reactive products and free SH-groups. A statistically significant increase in the concentration of TBA-reactive products in 4th week of intoxication and decrease in the concentration of free SH-groups in 8th and 12th week of intoxication--compared to the control group--was noticed.

The aim of this paper was to define the influence of long-term methanol intoxication on the changes of end products of lipid peroxidation, reacting with thiobarbituric acid (TBA-reactive products) and free SH-group concentration in rat brains. The experiment was conducted on male Lewis rats. The experimental groups received a 1-molar methanol solution and the control group received tap water. The animals were killed after 4, 8 and 12 weeks of intoxication and their brains were collected for further examination, which encompassed measurement of the concentration of TBA-reactive products and free SH-groups. The revealed changes of TBA-reactive products and free SH-group concentration were not statistically significant.

In forensic medicine practice poisonings are rather frequent, and among them, those caused by fatal "substitution" of ethyl alcohol. One of the most frequently encountered "substitutes" for ethyl alcohol is methanol. The purpose of our research was to determine the concentration of malonic dialdehyde as the expression of lipid peroxidation and antioxidant enzyme activity after dosed chronic ethyl and methyl alcohol intoxication. The experiment was conducted on approx. 6 month-old male inbred Lewis rats each weighing approx. 250 g. Ethanol and methanol solution was given in the concentration 1.0 M. The control group of rats received water. Each experimental group numbered 30 rats, this number was divided into three sub-groups, which were put-down at 4, 8 and 12 weeks. The activity of superoxide dismutase (CuZu-SOD) was determined by the Misra-Fridovich method, catalase (CAT) by the Beers-Sizer method. The concentration of malonic dialdehyde (MDA) was determined using the method of Placer et al. by assessing the concentration of TBARS compounds. Results are expressed as a mean +/- SD. The paired Student's test for small groups were used. Superoxide dismutase SOD1 activity decreased compared with the control group throughout the duration of the experiment from 2212 U/gHb to 1676 U/gHb for ethanol and from 2212 U/gHb to 945 U/gHb for methanol. Catalase activity for methanol decreased from 9.1 U/gHb to 5.1 U/gHb, for ethanol to 7.4 U/gHb. In the 4th week of the experiment increase of malonyl dialdehyde concentration for methanol group was observed--from 0.14 umol/gHb to 0.34 umol/Hb; after 8th weeks it decreased to 0.2 umol/gHb and in the 12th week increased to 0.23 umol/gHb. For ethanol these changes was less visible and reached the level of 0.24 umol/l. The statistical processing of the results was performed on the basis of parametric tests (the t-Student test for small experiments) and computer software Statistica. The statistical significance was set for p<0.05.

Investigations were aimed at demonstrating changes in the activity of enzymes forming an antioxidative barrier and oxidative stress parameters in erythrocytes of rats which were administrated ethylene glycol during 4 weeks. Superoxide dismutase activity (CuZn-SOD) was evaluated by the Misra and Fridovich method, catalase (EC1.11.1.6.) by the Beers and Sizer method and malonyl dialdehyde concentration (MDA) with Placer et all were assessed in the obtained material through the evaluation of TBARS compounds concentration. In the 4th week of the experiment a decrease in catalase (9.3 U/gHb to 5.7 U/gHb) and superoxide dismutase (2378 U/gHb to 1759 U/gHb) activity was observed. Malonyl dialdehyde concentration increased from the initial 0.14 mumol/gHb to 0.24 mumol/gHb. The investigations carried out have demonstrated that long-term intoxication with ethylene glycol leads to a constant generation of free radicals (increase of MDA concentration) and gradual exhaustion of the antioxidative system.

The case of iatrogenic trachea injury during endotracheal intubation is reported in this article. The case concerns a 36 years old woman, with diagnosed DIC resulting from postpartum complications. Injury of the brachiocephalic trunk and the tracheoarterial fistula were found during autopsy. The authors considered the time and the mechanism of both injuries.

The carbon source-responsive element (CSRE) functions as an activating promoter motif of gluconeogenic genes in Saccharomyces cerevisiae. The positively acting regulatory genes CAT8 and SIP4 encode CSRE-binding proteins which contribute unequally to the regulated expression of a CSRE-dependent reporter gene (85% and 15%, respectively, under conditions of glucose derepression). Deregulated variants of Cat8 and Sip4 are able to bind to the CSRE and allow glucose-insensitive gene activation, even in the absence of the other protein, arguing against the physiological significance of heterodimer formation. Gel retardation assays provide evidence for a different binding affinity of Cat8 and Sip4 to at least some CSRE sequence variants. Both efficient biosynthesis of and transcriptional activation by Sip4 require a functional CAT8 gene, while Cat8 was not dependent on SIP4. Thus, our data suggest that the apparent minor importance of Sip4 may be the result of autoregulatory cross-talk among the isofunctional activators Cat8 and Sip4. The derepression deficiency of a CSRE-dependent reporter gene in a strain lacking the Cat1 (Snf1) protein kinase can be suppressed by Sip4 fused to a strong heterologous activation domain. This finding agrees with the idea that phosphorylation by Cat1 may convert Sip4 into a functional activator.

BRCA1 is a susceptibility gene for breast and ovarian cancer with growth-inhibitory activity for which the mechanism of action remains unclear. When introduced into cells, BRCA1 inhibits growth of some but not all cell lines. In an attempt to uncover the mechanism of growth suppression by BRCA1, we examined a panel of cell lines for their ability to reduce colony outgrowth in response to BRCA1 overexpression. Of all variables tested, only those cells with wild-type pRb were sensitive to BRCA1-induced growth suppression. In cells with an intact rb gene, inactivation of pRb by HPV E7 abrogates the growth arrest imposed by BRCA1. In accordance with these observations, we found that BRCA1 could not suppress BrdUrd uptake in primary fibroblasts from rb-/- mice and exhibited an intermediate ability to inhibit DNA synthesis in rb+/- as compared with rb+/+ cells. We further found that the BRCA1 protein complexes with the hypophosphorylated form of pRb. This binding is localized to amino acids 304-394 of BRCA1 protein and requires the ABC domain of pRb. In-frame deletion of BRCA1 fragment involved in interaction with pRb completely abolished the growth-suppressive property of BRCA1. Although it has been reported that BRCA1 interacts with p53, we find the p53 status did not affect the ability of BRCA1 to suppress colony formation. Our data suggest that the growth suppressor function of BRCA1 depends, at least in part, on Rb.

Background: The concentration of Des-gamma-carboxy-prothrombin (DCP) or PIVKA-II has been described to be increased in patients with hepatocellular cancer, along with its elevation in vitamin K deficient states by warfarin or dicoumarol treatment. The aim of the study was to investigate its clinical value in HCC in comparison with alpha-fetoprotein., Patients and Methods: Measurements were performed in duplicate in serum of 87 patients with benign (acute/chronic hepatitis B/C/autoimmune, liver cirrhosis B/C/alcoholic) and 154 patients with highly probable (CT, MRT imaging) or histologically proven HCC. Two commercial or research ELISA tests (1: Eitest MonoP-II, Eisai, Tokyo, Japan; 2: Asserachrom PIVKA-II, Stago, France) using murine monoclonal anti-PIVKA-II antibodies were used comparatively and compared with a laboratory-developed conventional AFP-RIA., Results: By ROC analysis, a highly significant discrimination (p < 0.0001) was found at cutoffs of 0.09 AU/ml (Eisai) or 0.8 ng/ml (Stago) at a specificity of about 90% (Eisai: s = 78.6%, ppv = 0.92, npv = 0.70; Stago: s = 77.9%, ppv = 0.93, npv = 0.70) compared with the AFP-test at a cutoff of 45 ng/ml (sp = 91%, s = 58.4%, ppv = 0.92, npv = 0.55). A higher significant correlation was seen between both DCP tests in malignant (rS = 0.89, p < 0.0001) than benign groups (rS = 0.41, p < 0.001) and a lower correlation between the AFP and Eisai (rS = 0.27/0.36, p < 0.01) and Stago test for the malignant group (0.16; p < 0.05)., Conclusion: DCP determination in serum/plasma adds significantly in the discrimination between benign and malignant liver diseases.

The absence of significant symptoms and signs makes the diagnosis of pulmonary embolism difficult. Sensitivity and specificity of laboratory tests, chest X-ray, ECG, echocardiography and venous studies is low. Ventilation-perfusion scanning is also often not diagnostic. The combination of several diagnostic techniques, however, and pulmonary angiography confirm the diagnosis. Heparin remains the standard therapy for patients with stable haemodynamics. Thrombolytic therapy is recommended in haemodynamically compromised patients, since it yields accelerated clot lysis and pulmonary reperfusion. In standard dose regimes streptokinase, urokinase and t-PA are equally efficient. t-PA, however, acts more rapidly than the other agents. So far there is no study to prove that thrombolytic therapy significantly reduces mortality in pulmonary embolism.

In the absence of significant symptoms and signs the diagnosis of pulmonary embolism remains difficult. Sensitivity and specificity of laboratory tests, chest x-ray, ECG, echocardiography and venous studies on their own is low. Ventilation-perfusion scanning establishes or excludes the diagnosis only in those patients with "high-probability" or "normal" scanning results. The diagnosis of pulmonary embolism should be made by combining clinical assessment, several diagnostic techniques, and, finally, pulmonary angiography in doubtful cases. Heparin remains the standard therapy for patients with stable hemodynamics. Thrombolytic therapy is recommended in hemodynamically compromised patients. In short-term dose regimens the thrombolytic agents urokinase and rt-PA seem to be equally effective. So far, however, no study has proven that thrombolytic therapy significantly reduces mortality in pulmonary embolism.

Very recently, the concept of artificial intracorporeal oxygenation of blood for patients suffering from respiratory failure has been introduced into clinical practice through development of a totally implantable intravascular oxygenator (IVOX). We report on the use of such a device in a patient who developed severe respiratory insufficiency secondary to prolonged hypovolaemic shock and pneumonia following successful repair of a ruptured abdominal aortic aneurysm in September, 1990. Postoperatively, severe hypoxaemia occurred (AaDO2 548-602 torr) despite extensive mechanical ventilatory support. There was no obvious chance to overcome this situation by conventional therapeutic measures and the decision was made to institute IVOX therapy. Hypoxaemia was resolved immediately and both FiO2 and tidal volume could be reduced within hours. The patient's respiratory condition continued to improve over the next days leading to termination of IVOX therapy after 71 hours. However, the necessity of long-term ventilatory support secondary to recurrent pneumonia and sepsis, multiple abdominal reoperations for ischemic colitis and retroperitoneal abscess prolonged his recovery. He was discharged from the hospital after four months and is alive and well now 14 months after his operation. He is the first long-term survivor after IVOX therapy in Europe. IVOX may be successfully used in selected patients while the indications and it's potential role in the therapy of severe respiratory failure still need to be defined.

Presented are the results of experimental investigations evaluating the influence of perfluoroalcane on the ocular tissue in rabbits. The examined animals were divided into 2 groups. The rabbits from the first one received the compound into the anterior chamber of the right eye, the rabbits from the 2-nd group to the vitreous of the right eye. The left eye was the control one. Evaluated was the degree of absorption of the compound from the anterior chamber and vitreous, its influence on the anterior segment, transparency of the lens and intraocular pressure. An ERG was performed before the application of the compound and after 7, 14 and 49 days; subsequently the eyes were excised and a histopathological examination was performed in a light microscope.