Cases reported "Autolysis"

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1/5. Posttraumatic diaphragmatic hernia and death--etiologic factor or putrefactive artifact?

    Late-presenting diaphragmatic hernias, whether congenital or acquired, may remain clinically undetected until mediastinal shift with cardiorespiratory compromise or intestinal or gastric infarction with perforation occur. A right-sided diaphragmatic hernia with herniation of small intestine into the adjacent pleural cavity is described in a 72-year-old man who was found dead at home in a putrefactive state. Subsequently, a history of a motor vehicle accident 8 years previously was obtained. Although postmortem herniation due to extensive putrefactive change may have occurred, producing gaseous distention and migration of the intestine, tight twisting of the herniated intestine several times around a pleural fibrous adhesion suggested that the herniation could have been an antemortem event. Unfortunately, marked tissue autolysis prevented assessment of possible ischemic changes in the herniated intestine. Although diaphragmatic hernia may be a contributing factor to death at all ages, it may not be possible to exclude it as an artifact of putrefaction in a predisposed individual.
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keywords = death
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2/5. diagnosis of Alzheimer's disease in an exhumed decomposed brain after twenty months of burial in a deep grave.

    After 20 months of interment in a deep grave, the decomposed body of the 81-year old testator of a will was exhumed to sustain the burden of proof that he lacked testamentary capacity when the will was rewritten two days prior to his death. The brain was mushy and pulverized with complete disappearance of the brainstem, cerebellum and subcortical ganglia. Small foci of relatively intact dorsal frontal neocortex were identified. Sections from these foci were stained with hematoxylin and eosin, bielchowsky silver stain and immunostains for beta amyloid peptide (betaA4), tau and alpha-synuclein. Despite severe autolysis and decomposition, the bielchowsky stain and the betaA4 immunostains showed preserved frequent neuritic amyloid plaques with very few residual neurofibrillary tangles. cerebral amyloid angiopathy was present. At the present time this case represents the first documented and reported case of direct tissue diagnosis of Alzheimer's disease pathology in a decomposed brain following long term burial in a deep grave.
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ranking = 0.2
keywords = death
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3/5. Intravascular "mulberry-like" bodies: morphological, immunohistochemical, and ultrastructural observations of an incidental finding caused by autolysis?

    Intravascular "mulberry-like" bodies in a stillborn female infant with moderate maceration are reported. The histogenesis of these structures is discussed based on light-microscopic, immunohistochemical and ultrastructural findings. No demonstrable causal relation between the intravascular lesions and fetal death was found, the cause of death being attributed to intrauterine asphyxia. It is concluded, that intravascular "mulberry-bodies" most likely represent artifacts due to red blood cell autolysis.
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ranking = 0.4
keywords = death
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4/5. Diagnostic significance of nerve cells in human CSF with particular reference to CSF cytology in the brain death syndrome.

    Cytological examination of the cerebrospinal fluid (CSF) in 5 cases of the brain death syndrome treated on a respirator revealed the presence of nerve cells (mostly purkinje cells), massive pleocytosis with many polymorphonuclear leukocytes, and numerous macrophages containing erythrocytes, leukocytes, lipid droplets, and hemosiderin. Portions of connective tissue with well preserved capillaries, and debris which could not be more closely identified, were also found. Neuropathological examination in 4 cases revealed progressive autolysis of brain tissue and displacement of the autolyzed tissue into the subarachnoid space of the spinal canal, partly due to tonsillar herniation. All five patients exhibited clinical signs of brain death and had been placed on respirators for various periods of time. The cytological findings in the CSF, together with the clinical signs of brain death, constitute an intravital morphological indication of brain tissue autolysis.
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ranking = 1.4
keywords = death
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5/5. Auditory brainstem response and temporal bone and brainstem pathology in brainstem death, with special reference to autolysis of red blood cells.

    We studied the pathological changes in the temporal bone and brainstem, with particular attention to the autolysis of red blood cells in and around the blood vessels, in six cases of brainstem death determined by auditory brainstem responses (ABRs). Our findings showed that the cochlea, the visceral organs and the spinal cord below a certain level of the cervical segments continued to live after brainstem death. Red blood cells in the vessels of the brainstem and cerebellum exhibited severe autolysis, whereas most red blood cells in the cochlea were preserved. Our findings of autolytic changes in red blood cells in the brainstem, and the preservation of red blood cells in the cochlea, imply initial loss of brainstem function and delayed loss of cochlear function after prolonged absence of ABRs.
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ranking = 1.2
keywords = death
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