Complete Cardiac Rupture Associated with Closed Chest Cardiac Massage: Case Report and Review of the Literature

Chest skeletal injuries are the most frequent complications of external chest massage (ECM) during cardiopulmonary resuscitation, but heart and great vessels lacerations that are indeed very rare. We report the case of a 35‐year‐old workman who collapsed and underwent ECM by his co‐workers for almost 30 min. At autopsy, no external injuries, fractures or bruises of the ribs or sternum, were observed. A hemopericardium with a rupture of the heart was found, with no signs of pre‐existent cardiac disease. Bruises of thoracic aortic wall, lung petechiae, a contusion of the liver, and bruises of lumbar muscles were found. The cause of death was due to sudden cardiac death with an extensive cardiac rupture. This is an unusual report of massive heart damage without any skeletal or muscle chest injuries, secondary to cardiopulmonary resuscitation. This kind of cardiac lesions may be considered when thoracic–abdominal trauma, or medical history, is unclear.     

An Autopsy Case of Acute Massive Hematochezia Caused by Superior Mesenteric Vein Thrombosis: A First Report in Forensic Medicine

Superior mesenteric vein thrombosis (SMVT) is an uncommon cause of intestinal ischemia and massive gastrointestinal bleeding. This report describes a man with alcoholic liver cirrhosis, who died of massive hematochezia due to SMVT. A medicolegal autopsy disclosed a thrombus at the superior mesenteric vein and hemorrhagic infarction of the bowel wall, an area also within the territory of the superior mesenteric vein. Liver cirrhosis, an enlarged spleen, and esophageal varices without rupture were also observed, but ulcers and variceal bleeding were not. Other organs showed no significant findings. His blood alcohol level was 0.14% w/v. Thus, this man died from severe hematochezia associated with SMVT due to liver cirrhosis and alcohol dehydration, which can lead to coagulopathy and rapid progress of thrombus formation. This is the first report on an alternate cause for massive gastrointestinal hemorrhage with a cirrhotic patient in a forensic autopsy.     

Fatal rupture of hepatic adenomatosis: Autopsy case and review of the literature

Hepatic adenomatosis is a rare disease consisting of multiple adenomas in otherwise-normal liver parenchyma. Though the discovery of this entity goes back several years, its diagnosis is still challenging in terms of its definition and pathophysiology. Clinically, patients may be completely asymptomatic and the diagnosis is only made incidentally through imaging tests. The discovery could be made when complications occur such as intraperitoneal hemorrhage with hypovolemic shock due to the rupture of an adenoma. We report a fatal case of a ruptured adenoma in a case of hepatic adenomatosis discovered at autopsy. In order to achieve a better view of this disease, we conducted a literature review on this subject describing the pathogenesis, manifestations, and autopsy contribution to addressing this entity.     

新藤黄酸通过PTEN-PI3K/AKT/VEGF/eNOS信号通路干预人脐静脉内皮细胞血管生成的研究

目的 探究PTEN-PI3K/Akt/VEGF/eNOS信号通路在新藤黄酸(gambogenic acid,GNA)抑制人脐静脉内皮细胞(human umbilical vein endothelial,HUVECs)迁移中的作用.方法 倒置显微镜下观察HUVECs形态变化;Boyden chamber实验以及细胞划痕...     

A Bridge Too Far? Examining Bridging Assumptions in Common-Space Estimations

While most common-space estimations rely upon members who served in both the House and Senate as “bridges” to scale the remaining members, this assumes that these “bridge members” do not change their preferences when they change chambers. Such an assumption conflicts with standard notions of representation, that is, that legislators’ votes reflect (at least to some degree) the wishes of their constituents. We examine the constancy of this common-space voting assumption by focusing on a subset of House members who move to the Senate: those who come from statewide House districts. Using these members as the bridge actors—and thus bridging by constituency explicitly—in a one-dimensional item response theory model, we find that the standard assumption of chamber switchers in common-space estimations is technically, but immaterially, false. While there are statistically distinguishable differences in House and Senate voting records for chamber switchers, they are not sufficiently large to meaningfully undermine bridging.     

Rapid knowledge: ‘Bridging research and policy’ at the Overseas Development Institute

Numerous organizations advocate the need to ‘bridge research and policy’. Philanthropic foundations, national social science funding regimes and international organizations have sought to improve knowledge utilization. Similarly, research consumers such as NGOs and government departments complain of research irrelevance for policy purposes. The concern of this article is with ‘evidence informed policy’ within the field of international development in which the Overseas Development Institute (ODI), a London‐based think tank, forms the case study. Most think tanks are driven by the need to influence immediate political agendas but ODI has also developed organizational strategies of policy entrepreneurship that extend to longer term influence through creating human capital, building networks and engaging policy communities. Copyright © 2009 John Wiley & Sons, Ltd.     

Descending thoracic aortic aneurysm rupture during postpartum period

Aortic aneurysm refers to the pathological dilatation of the normal aortic lumen involving one or several segments. Thoracic aortic aneurysms are much less common than aneurysms of the abdominal aorta. Descending thoracic aortic aneurysm leading to dissection and spontaneous rupture is a potentially catastrophic illness. Although rare, dissection and rupture of a preexisting aortic aneurysm have been reported during pregnancy and early puerperium. To the best of our knowledge, such cases among young pregnant women are rarely reported in literature. Herein, an autopsy case of spontaneous rupture of a clinically undiagnosed descending thoracic aortic aneurysm during early puerperium in a young woman is presented along with the review of relevant literature. The victim was found dead on her hospital bed on the seventh day of puerperium. Autopsy with ancillary investigations revealed that the young woman died because of hemothorax from a ruptured dissecting descending thoracic aortic aneurysm secondary to chronic aortitis.     

行政权力的历史维度

从人类建立了自足与互助的组织之后,行政权就开始萌生了.作为现代国家中的一种重要权力,从其诞生开始人们就在探索一条如何规范其运行的路径,其差异主要体现于规范权力的目的不同而已.近现代宪法与行政法也将落脚在如何控制权力的滥用,使行政权定位在有限与有为之上.     

冠状动脉肌桥与心源性猝死

冠状动脉肌桥也称冠脉肌桥或心肌桥,是一种先天性冠状动脉分布走行的发育畸形,为冠状动脉某一段或其分支的某一段走行于心外膜下的心肌层内。这种先天性冠状动脉分布走行的发育畸形可以引起猝死,在尸体解剖中也较为常见。本文对冠脉肌桥的形态学特点、临床影像学与心电图改变、猝死机制以及法医学鉴定中需要注意的问题等方面进行了阐述。     

Severe Cardiac Rupture by Only One Blow to the Chest in a Young Boy: An Autopsy Case

Cardiac rupture by blunt chest trauma is commonly seen after motor vehicle accidents and falls; however, it is rarely caused by a blow to the chest. We herein report an autopsy case of a high school boy who sustained severe right ventricular rupture by only one knee kick to the chest during a quarrel. He was hospitalized and developed cardiopulmonary arrest. Emergency surgery was performed, but the patient died. The autopsy revealed no external severe trauma or deformation, but the side wall of the right ventricle contained a large V‐shaped laceration. The other thoracic organs had no injuries. This case illustrates that severe cardiac rupture can occur by only one blow to the chest. Blunt cardiac injuries can occur even if no severe injuries are present on the body surface. We should consider the possibility of severe cardiac injuries regardless of the presence of external injuries.