Retrospective Analysis of Sudden Cardiac Deaths in a 10-Year Autopsy Series in the City of Isparta in Turkey.

Sudden cardiac death (SCD) is an important public health problem that accounts for approximately 15% to 20% of global deaths. Our retrospective study aimed to analyze etiological distribution and epidemiological data of 128 cases with SCD as death cause based on autopsies between 2010 and 2019. The mean age of SCD cases was 57.09, with the highest incidence in older than 60 years (43.8%). Male/female ratio was 4.5:1, peaking with 9.2:1 in the 41- to 60-year age group. Deaths occurred mostly at home (41.4%). Coronary atherosclerotic heart disease (CAD) was main SCD cause (65.6%) with cardiac tamponade (10.9%), unexplained SCD (8.6%), and hypertrophic cardiomyopathy (7.8%) after it. A total of 71.2% of CAD cases had coronary artery stenosis of greater than 75% and 92.9% had atherosclerotic degeneration in the left anterior descending artery. Based on the body mass index-based normal heart weights table, 91.7% of CAD cases had cardiomegaly. This study showed CAD, cardiomegaly, and high body mass index concurrence as a very important SCD risk. Because SCD incidence increases in older than 40 years, determining risk groups through regular medical examinations and inspections, older than 30 years would provide implementation of preventive measures. Some cardiac diseases causing sudden death are undetectable despite detailed autopsy and histopathological examinations. Including postmortem cardiogenetic analysis among routine techniques in sudden deaths would lower sudden unexplained death diagnosis rates.

Does scapular elevation occur with glenohumeral flexion and abduction? A study through open magnetic resonance imaging and autopsy.

OBJECTIVES: This study aims to reveal whether there is an elevation in scapula during flexion and abduction of the glenohumeral joint. PATIENTS AND METHODS: In the first stage of our study 32 subjects were randomly divided into two groups. The mobility of the scapular notch was examined using open magnetic resonance imaging (MRI) assay when the glenohumeral joint was in flexion in the first group (5 males, 10 females; mean age 21.1 years; range 18 to 24 years) and in abduction in the second group (8 males, 9 females; mean age 22.1 years; range 18 to 27 years) and the motion range was found to be between 0 and 150 degrees. In the second stage of our study, the mobilities of the scapular notch was examined on autopsy during passive humeral mobility. RESULTS: According to the open MRI results, there was no elevation or depression during the passive flexion and abduction of the glenohumeral joint. While the scapular notch migrated slightly to the medial side during abduction of the glenohumeral joint, it did not move during flexion. Also in an autopsy study, we observed that scapula did not move in vertical direction during the glenohumeral abduction and flexion mobilities. CONCLUSION: There is no vertical mobility in the scapula during glenohumeral flexion and abduction. Also, there is no medial mobility during flexion except during abduction.

Foreigners dying in Istanbul.

The study included 411 deaths selected from 14,647 medicolegal deaths autopsied in the Morgue Department of Forensic Medicine Institute Directorate, affiliated with the Ministry of Justice, between 1998 and 2002. Data were collected from court documents, coroner's investigation reports, and autopsy reports. The parameters of age, gender, nationality and origin, cause and place of death in foreigners dying in Istanbul were evaluated in the study. Out of 14,647 medicolegal deaths, 3.5% were foreigners from 34 different nationalities. The nationality with the highest rate of foreigner deaths (34%) was Romanian. Out of 411 deaths, 74.3% were male and 25.7% were female. Of all cases, 64.4% were tourists visiting Istanbul and 35.6% had a job in Istanbul. Of 146 foreigners employed in Istanbul, 94.5% did not have a work permit, while only 5.5% had a work permit.

Lemierre syndrome: a case of a rarely isolated microorganism, Staphylococcus auerus.

BACKGROUND: Lemierre syndrome is an extremely rare complication of mild-to-moderate pharyngeal infections that causes septic embolization to the lungs and other distant sites. One-third of cases present a polymicrobial bacteremia, although the most isolated microorganism is Fusobacterium necrophorum. A case of postanginal sepsis caused by a rarely isolated microorganism, Staphylococcus auerus, in a geriatric patient is reported. CASE REPORT: An 80-year-old man was admitted to hospital with fever and sore throat. Doppler ultrasonography imaging of the neck veins demonstrated an occlusive thrombus in the right internal jugular vein. Clinical deterioration occurred in spite of all ICU therapy. The revealed right internal jugular vein filled with thrombus. Staphylococcus aureus was cultivated on blood and urine samples. CONCLUSIONS: The responsible microorganism and the advanced age of the patient may make clinicians aware of the variants of this syndrome.

Cyclooxygenase-2 expression in primary and recurrent pterygium.

BACKGROUND: Pterygia are common, benign, fibrovascular, and infiltrative processes of the corneo-conjunctival junction of unknown pathogenesis. Cyclooxygenase-2 (COX-2) mediates the rate-limiting step in arachidonic acid metabolism. Extensive evidence indicates that the COX-2 prostanoid pathway is involved in inflammation. The aim of the study was to document the immunohistochemical expression of COX-2 in primary and recurrent pterygia. MATERIALS AND METHODS: In this study, 21 primary pterygia and 12 recurrent pterygia from subjects undergoing pterygium surgery and six normal corneal-scleral tissue specimens were studied immunohistochemically for COX-2 expression. RESULTS: COX-2 was expressed in primary pterygia and recurrent pterygia specimens. There was a statistically significant difference in COX-2 expressions in fibroblasts between primary and recurrent pterygium cases ( P = 0.001). There were statistically significant differences in COX-2 expressions in surface epithelium ( P = 0.028) and stromal inflammatory cells ( P =0.000) between control tissues and primary pterygia tissues. We also detected statistically significant differences in COX-2 expressions in surface epithelium ( P =0.000), stromal fibroblasts P =0.000 (stromal fibroblasts and inflammatory cells), vessels ( P = 0.027) and inflammatory cells ( P =0.001) between control tissues and recurrent pterygia tissues. CONCLUSIONS: This is the first study to document the expression of COX-2 in primary and recurrent pterygia. In our opinion after excision of pterygia, fibroblastic proliferation continues and this contributes to recurrence.

Evaluation of the effects of toluene inhalation on alveolar epithelial permeability by 99mTc-DTPA inhalation scintigraphy in automobile painters.

BACKGROUND: The main component of paint thinner used in industry is toluene diisocyanate (TDI) which can cause occupational asthma in 5-10% of exposed workers. AIM: To investigate the effect of TDI on 99mTc clearance rate of alveolar epithelium and on pulmonary function tests (PFT) in automobile painters, and to determine the relationship between 99mTc-DTPA radioaerosol lung scintigraphy and serum levels of antioxidant enzymes and metalloproteinases (MMPs) of automobile painters. METHODS: Twenty-eight automobile painters and 13 control subjects were included in the study. 99mTc-DTPA aerosol inhalation scintigraphy and PFT were administered to all subjects. Clearance half-time (T1/2) and penetration index (PI) on the first-minute image after 99mTc-DTPA scintigraphy were calculated. Blood levels of MDA, antioxidant enzymes and metalloproteinases were measured. RESULTS: The mean T1/2 values of automobile painters were longer in both smoker and non-smoker subjects, but the difference was not significant (P>0.05). Although the PFT values decreased in automobile painters, there was no significant difference between each group. Any correlation between spirometric measurements and T1/2 or PI values in non-smoking automobile painters was not detected. Negative correlation among mean T1/2 value and FVC% and FEV1% in smoking automobile painters, and positive correlation between mean T1/2 value and MMP-9, GSH-Px levels in non-smoking automobile painters were detected. CONCLUSION: Our results suggested that the clearance of 99mTc-DTPA from the lungs of automobile painters was slower than in the control group, but the difference is not statistically significant. This data also supports the observation that TDI occasionally stimulates bronchial changes rather than alveolar changes in automobile painters.

The mechanism of injury of the abducens nerve in severe head trauma: a postmortem study.

The aim of this study is to investigate the mechanism of injury of abducens nerve at petroclival region in severe head trauma. Twenty specimens provided from 10 autopsied cases due to severe head trauma were investigated macroscopically and histopathogically. The slices of the abducens nerve taken consecutively along its course at petroclival region were stained with Hematoxylline-Eosin and evaluated under light microscope. In addition, coexisting cervical injuries in these cases were assessed macroscopically. Edema and perineural hemorrhagia of abducens nerve were identified in all cases. Nerve injury was found more exaggerated at the sites of dural entry point and petrous apex than any other parts of the abducens nerve. Furthermore, microscopically, also remarkable perineural hemorrhage of the abducens nerve was observed at the site of its anastomoses with the sympathetic plexus on the lateral wall of the internal carotid artery (ICA). Abducens nerve is injured at the sites of dural entry point, petrous apex and lateral wall of the ICA, directly proportional with the severity of the trauma. This finding is also significant in verification of the severe head trauma.