Osler-Weber-Rendu syndrome--pathological manifestations and autopsy considerations

An 18-year-old university student with Osler-Weber-Rendu disease collapsed in the bathroom. Attempted resuscitation was unsuccessful. Her past history included recurrent epistaxes, mucosal telangiectasias, intracranial arteriovenous malformations with previous hemorrhage, a single pulmonary arteriovenous malformation, recent onset of grand mal seizures, and depression. There was a positive paternal family history. At autopsy the pulmonary arteriovenous malformation was confirmed. In addition, within the brain there were widespread areas of gliosis with hemosiderin deposition and small vascular malformations. No other significant abnormalities were detected and toxicological screening revealed only moderately elevated levels of carbemazepine. Death was attributed to epilepsy associated with glial scarring from previous microhemorrhages. The detection of vascular malformations in the lung or brain at autopsy should prompt careful examination of all tissues for similar lesions. Given the possibility of Osler-Weber-Rendu disease in such cases, fibroblast cultures should be undertaken to enable molecular studies to proceed. The heritable nature of this disorder necessitates accuracy of diagnosis at autopsy; once the diagnosis is confirmed family screening should be recommended.     

Potentially lethal complications of tracheostomy: autopsy considerations

Tracheostomy is widely used to facilitate respiration by protecting the airways. It may be performed to relieve upper airway obstruction from congenital stenoses or from acquired conditions such as foreign body impaction, swelling from neck trauma or anaphylaxis, benign or malignant tumors, and infection. Tracheostomy may also be performed in individuals with respiratory impairment who require suctioning for accumulated mucoid secretions and in those with obstructive sleep apnea. Review of autopsy files and the literature was undertaken to demonstrate the range of lethal circumstances that may involve tracheostomy. Unexpected death may result from incorrect positioning of an endotracheal tube with failure of oxygenation, tracheal perforation with pneumothorax, mucus plugging, accidental extubation, and hemorrhage from tracheovascular fistulas. Lethal tracheovascular fistulas usually involve the innominate artery and result from mural perforation by the tip of a tracheostomy tube, mural necrosis from a high-pressure cuff, prolonged intubation, radiotherapy, and low tracheal incisions. Increased movement of tubes in patients with impaired consciousness and excessive head movements may also increase the chances of hemorrhage, as may infiltrating tumors. Given the wide range of potential fatal mechanisms that may be found in such cases, careful autopsy evaluation and dissection will be required to demonstrate the exact nature and site of the lethal lesion in individuals who underwent tracheostomy and die unexpectedly.     

心理验尸

心理验尸是一种重建死亡方式 ,特别是研究自杀死亡的科学方法。它是通过回溯性收集、研究有关资料来认定死亡方式 ;适用于死亡方式不清楚的案件。心理验尸需要法律精神医学知识和有关自杀的信息     

心理验尸

心理验尸是一种重建死亡方式，特别是研究自杀死亡的科学方法。它是通过回溯性收集、研究有关资料来认定死亡方式；适用于死亡方式不清楚的案件。心理验尸需要法律精神医学知识和有关自杀的信息。     

国外生物安全立法及对中国立法的思考

随着现代生物技术的迅速发展,生物安全立法越来越引起国际社会的重视。中国作为《卡塔赫纳生物安全议定书》的缔约国,不仅负有保护生物安全的国际义务,而且也有为本国生物安全利益而进行生物安全管理的现实必要性。中国目前虽然制定了一些生物安全立法,但就整体而言,这些立法无法适应生物安全管理的需要。参考和借鉴国际和国外生物安全立法,建立与国际接轨而又适合中国国情的生物安全立法体系,对于保护中国的生物安全,维护国家和全人类的利益,具有十分重要的意义。一、生物安全国际法的沿革和主要渊源(一)生物安全国际法的沿革国际生物安全…     

尸检中危险因子防护的研究进展

近来的SARS防治工作中,因该病毒的特殊生物性及疾病特性,因而使人们在仪器设备、防治策略、其生物实验的操作上都采取了各种防护措施。尸体检验可使操作者及其他人遭受到多种危险因子的侵害,包括血源性、气溶胶性和其它的致病原(例如SARS病毒)。法医病理人员和其它尸检参与者需要加强个人防护措施,同时实验室操作程序和有关设备安装设计也都要以保护所有人员的安全为其根本原则。     

A device which allows dictation of the autopsy report during the autopsy

We describe a device for the simultaneous recording of the autopsy findings during the autopsy, thereby offering a convenient way of obtaining correct and timely autopsy reports.     

Legionnaires' disease at autopsy

Sporadic deaths from Legionnaires' disease may escape detection at autopsy. Known epidemiological and clinical features of the disease should arouse suspicion and prompt appropriate bacteriological studies. The pathological findings in Legionnaires' disease are almost entirely confined to the lungs and are not distinct from any other severe bacterial bronchopneumonia. The causative organism, Legionella pneumophila, is difficult to identify on a Gram stain but will stain nonspecifically with the Giemsa, Warthin-Starry, and Dieterle techniques. The direct fluorescent antibody method allows specific identification of Legionella in paraffin-embedded tissue sections.     

Doctrinal considerations for fast-food obesity suits

Lawsuits brought by obese plaintiffs against fast-food chains have been the subject of some derision in the late-night talk shows and popular press, and have not succeeded so far. But the common law tort theories on which such lawsuits should be grounded are straightforward, unremarkable, and mainstream. This article first offers an overview of obesity-related health problems that can arise from fast-food diets. It then critiques the seminal Pelman v. McDonald's--how it was pleaded and how it should have been pleaded--and offers alternative legal theories under which such lawsuits can be brought in the future.     

Biotechnology and relevant aspects of the New Biosafety law]

On 24 March 2005, the President of the Federative Republic of Brazil approved the New Law on Biosecurity. This law has very diverse aspects, ranging from the genetically modified organisms to the genetic manipulation of human embryos or the liberalisation of the transgenic soy crops during 2004-2005. This article tries to analyse and criticise the content of the law, highlighting the genetic research and experimentation, the GMOs and their effect in the environment and the criminal responsibility derived from such actions. Likewise, it leaves rooms for the reader to reach his/her own conclusions. The author poses the moral dilemma on whether it is legitimate to make governmental decisions solely taking into account the economic and political interests, leaving aside the opinion of society.     

意外死亡尸检率下降原因分析

本文调查分析了公众对意外死亡是否同意进行尸检态度的影响因素。利用设计的“公众对意外死亡进行尸检认知情况调查问卷”对386名社会随机个体进行问卷调查。运用Logistic回归分析、最优尺度回归分析的统计学方法对回收的问卷进行分析。通过调查分析，发现公众对尸检相关知识了解程度的因素、对尸检结果的认可程度因素、文化程度因素、家庭经济状况因素，影响着公众对意外死亡后尸体解剖检验的态度。