ABSTRACT
Procalcitonin is regarded as a valuable marker for sepsis in living persons and even in post-mortem investigations. At the Institute of Legal Medicine, 25 autopsy cases with suspected bacterial infectious diseases or sepsis were examined using the semi-quantitative PCT-Q(®)-test (B.R.A.H.M.S., Germany) in 2010 and 2011. As controls, 75 cadavers were used for which there was no suspicion of a bacterial infectious disease or sepsis. Femoral blood was cultured from the cases and from controls, and samples from the brain, heart, lungs, liver, spleen and kidneys were examined histologically for findings seen in sepsis. Twelve cases in the sepsis/infectious disease group (48%) were classifiable as sepsis following synopsis of PCT levels, autopsy results, and histopathological and microbiological findings. This study shows that the semi-quantitative PCT-Q(®)-test is a useful supplementary marker in routine autopsy investigations, capable of classifying death as due to sepsis.
Subject(s)
Calcitonin/blood , Protein Precursors/blood , Sepsis/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers/blood , Brain/pathology , Calcitonin Gene-Related Peptide , Case-Control Studies , Female , Forensic Pathology , Granulocytes/pathology , Humans , Kidney/pathology , Leukocytes/pathology , Liver/pathology , Lung/pathology , Male , Middle Aged , Myocardium/pathology , Prospective Studies , Spleen/pathology , Young AdultABSTRACT
Acute aortic dissection is a life-threatening disease with a high rate of mortality. At the Institute of Legal Medicine of the Hanover Medical School, 30 cases with aortic dissections were found during autopsy and examined histologically between 2006 and 2009. The grade of medial alterations in the form of cystic medial necrosis, elastin fragmentation, fibrosis and medionecrosis were estimated semi-quantitatively. In order to assess the normal aging process, samples of the aortic wall of 25 decedents without dissecting aneurysms were analyzed histologically. This study demonstrates that there are partly quantitative differences, particularly with a statistically significant increase in cystic medial necrosis (p<0.001) and elastin fragmentation (p<0.001), between aortas from dissecting aneurysms and the normal aging aorta, which may help to identify genetically predisposed relatives of patients with a dissection of the aorta.
Subject(s)
Aorta/pathology , Aortic Aneurysm/pathology , Aortic Dissection/pathology , Adult , Aged , Aged, 80 and over , Aging/pathology , Aorta/metabolism , Arteriosclerosis/pathology , Case-Control Studies , Elastin/metabolism , Female , Fibrosis , Forensic Pathology , Humans , Male , Middle Aged , Necrosis , Tunica Media/pathologyABSTRACT
Birth injury of the skull and central nervous system can be a complication of a difficult delivery, especially following forceps or vacuum-assisted delivery. Birth trauma of the head can also mimic the appearance of a non-accidental head injury and is therefore an important differential diagnosis. We report on two young infants with serious head injuries. The difficult differential diagnosis birth trauma versus non-accidental head injury is discussed and the necessity for cooperation between clinicians, forensic doctors and specialized neuroradiologists is emphasized.