Cardiac β1-adrenoceptor expression in two stress-induced cardiomyopathy-related deaths.

Stress-induced cardiomyopathy (SICM) is characterized by transient systolic dysfunction of the apical and/or midventricular myocardial segments in the absence of obstructive coronary artery disease and is unique in that it can manifest itself after acute emotional stress. Excessive amounts of catecholamines released from sympathetic nerve endings as well as from the adrenal medulla under stressful conditions are considered to produce intracellular Ca(2+) overload and cardiac dysfunction through the β(1)-adrenoceptor signal transduction pathway. We describe the clinical and pathomorphological findings in two stress-induced cardiomyopathy fatal cases.

Anabolic steroid- and exercise-induced cardio-depressant cytokines and myocardial β1 receptor expression in CD1 mice.

Few animal model studies have been conducted in order to evaluate the impact of androgenic anabolic steroids (AAS) supraphysiological doses on the cardiovascular system and myocardial injury. Twenty-five male CD1 mice (8-10 weeks old; 35g initial body weight) were randomized into three AAS treated groups and two control groups. The AAS mice received intramuscular Nandrolone Decanoate (DECA-DURABOLIN), vehicled in arachidis oil, for 42 days, twice per week, with different dosages, studying plasma lipid analysis, cardiac histopathological features, cardiac β (1) adrenergic receptor expression, and the effects of the myocardial expression of inflammatory mediators (IL-1β, TNF-α) on the induction of cardiomyocytes apoptosis (HSP 70, TUNEL), using proteomic and immunohistochemical analysis.

Cave canem: bite mark analysis in a fatal dog pack attack.

Deaths resulting from animal attacks are rare, and according to The Humane Society of the United States, more than 300 individuals died of dog attacks in the United States from 1979 to 1996. The case of a fatal dog-pack attack on an 83-year-old woman is presented. Wide lacerations of the scalp, several tooth puncture wounds, and bruises reproducing bite marks were recorded on the whole body.

A novel macabre ritual of the Italian Mafia ('Ndrangheta): covering hands with gloves and burying the corpse with burnt lime after execution.

'Ndrangheta is one of the famous "4 Mafias," which typically insists in Southern Italy. A particular case of 'Ndrangheta-related homicide double execution by means of multiple gunshots is presented. To the best of our knowledge, this is the first report of `Ndrangheta's homicidal modality (covering hands with gloves and burying) as a macabre ritual.

The timing of perinatal hypoxia/ischemia events in term neonates: a retrospective autopsy study. HSPs, ORP-150 and COX2 are reliable markers to classify acute, perinatal events.

Background: The understanding of the cellular responses implicated in perinatal brain damages and the characterization of the various mechanisms involved might open new horizons for understanding the time of onset of a brain hypoxic-ischemic lesion and for effective therapeutic strategies.

Methods: We performed an immunohistochemical investigation on brain and brainstem sections of 47 peripartum deaths. The gradation and localization of the expression of antibodies such as TNFalpha, IL-1beta, IL-6, HSPs, beta APP, anti-TrypH, GAP43, GFAP, COX2, ORP-150, could be correlated with an hypoxic-ischemic damage to document a significant correlation between response and the time of onset acute (/=8 hs View Article and Find Full Text PDF

C3a, TNF-alpha and interleukin myocardial expression in a case of fatal sudden cardiac failure during clinic reactivation of systemic lupus erythematosus.

Isolated myocarditis, or dilated cardiomyopathy, is a rare and usually late clinical manifestation of systemic lupus erythematosus (SLE). Increased levels of complement split products are associated with disease activity. Injury of the vascular endothelium due to complement activation and immune complexes may contribute to the vasculopathy in SLE.

A multidisciplinary approach to the investigation of a collapsed building.

Investigating the collapse of a building poses multiple and complex forensic challenges. Large numbers of specialized personnel and equipment are required, as are the combined technical skills of many different kinds of forensic investigators. Forensic pathology teams are integral to these efforts.

CD61 and fibrinogen immunohistochemical study to improve the post-mortem diagnosis in a fat embolism syndrome clinically demonstrated by transesophageal echocardiography.

Fat embolization following major trauma is reported to be a quite common event, while the clinical fat embolism syndrome (FES) seems to be a much rarer event. Fat embolism occurs in 2 up to 23% of patients with isolated femoral shaft fractures. This complication appears to be related not only to the fracture, but also to the timing of stabilization.

MDMA toxicity and pathological consequences: a review about experimental data and autopsy findings.

Studies conducted in humans or in animals explored the presence, nature and potential causes of 3,4-methylenedioxymethamphetamine (MDMA) toxicity. According to literature, there are four principal types of such serious toxicity: hepatic, cardiovascular, cerebral and hyperpyrexic. The molecular mechanisms involved in the genesis of these toxic effects are not yet fully clarified, but the oxidative stress, excitotoxicity, and mitochondrial dysfunction appear to be causal events that converge to mediate MDMA-induced toxicity.

Myocardial expression of TNF-alpha, IL-1beta, IL-6, IL-8, IL-10 and MCP-1 after a single MDMA dose administered in a rat model.

Indirect effects of 3,4-methylenedioxy-N-methylamphetamine (MDMA) and metabolites on the cardiac cells are well-known, the mechanism(s) underlying direct MDMA-induced cardiotoxicity remaining to be clarified. To better understand the immuno-inflammatory phenomena accompanying the cardiac alterations during MDMA administration, we conducted a study in an in vivo animal model to evaluate the cellular morphological alterations related to the biological response between MDMA administration and inflammatory cytokines (tumor necrosis factor-alpha, IL-1beta, IL-6, 8, 10, and monocyte chemotactic protein-1). A total of 25 male rats were used.

Collection of trace evidence of explosive residues from the skin in a death due to a disguised letter bomb. The synergy between confocal laser scanning microscope and inductively coupled plasma atomic emission spectrometer analyses.

In most deaths caused by explosive, the victim's body becomes a depot for fragments of explosive materials, so contributing to the collection of trace evidence which may provide clues about the specific type of device used with explosion. Improvised explosive devices are used which contain "homemade" explosives rather than high explosives because of the relative ease with which such components can be procured. Many methods such as chromatography-mass spectrometry, scanning electron microscopy, stereomicroscopy, capillary electrophoresis are available for use in the identification of explosive residues on objects and bomb fragments.

Insight into stress-induced cardiomyopathy and sudden cardiac death due to stress. A forensic cardio-pathologist point of view.

Emotional, physiological and physical stress is associated with increased rates of cerebrovascular events and sudden deaths. The pathophysiology of stress-induced cardiomyopathy is not well understood. Proposed mechanisms for catecholamine-mediated stunning in stress cardiomyopathy include epicardial vasospasm, microvascular dysfunction, hyperdynamic contractility with midventricular or outflow tract obstruction, and direct effects of catecholamines on cardiomyocytes.

How old are you? Newborn gestational age discriminates neonatal resuscitation practices in the Italian debate.

Background: Multidisciplinary study groups have produced documents in an attempt to support decisions regarding whether to resuscitate "at risk" newborns or not. Moreover, there has been an increasingly insistent request for juridical regulation of neonatal resuscitation practices as well as for clarification of the role of parents in decisions regarding this kind of assistance. The crux of the matter is whether strict guidelines, reference standards based on the parameter of gestational age and authority rules are necessary.

Reconstruction of the weapon in a case of homicidal decapitation.

Decapitation as homicidal mode of death is relatively rare. In most cases of decapitation, the differentiation between the modes of death might be difficult to some extent, particularly in cases where essential investigative elements, like the decedent's head and the weapon, are unavailable. Our report concerns a case of homicide by decapitation without any further mutilation of the victim, where only the combination of autopsy results, histologic findings, and engineering technical reconstruction allowed us to identify with certainty the mode of death as vital decapitation.

Enzymatic-nonenzymatic cellular antioxidant defense systems response and immunohistochemical detection of MDMA, VMAT2, HSP70, and apoptosis as biomarkers for MDMA (Ecstasy) neurotoxicity.

3,4-Methylenedioxymethamphetamine (MDMA)-induced neurotoxicity leads to the formation of quinone metabolities and hydroxyl radicals and then to the production of reactive oxygen species (ROS). We evaluated the effect of a single dose of MDMA (20 mg/kg, i.p.

Virtopsy versus digital autopsy: virtual autopsy.

Multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) are being increasingly implemented in forensic pathology. These methods may serve as an adjuvant to classic forensic autopsies. Imaging of the interior of corpses is performed using MSCT and/or MRI.

Brugada-like EKG pattern and myocardial effects in a chronic propofol abuser.

Introduction: Cases of death are reported due to medical use of propofol, whereas deaths due to recreational purpose are unusual.

Case Report: A 26-year-old Caucasian man, physician trainee in anesthesiology, was referred to an intensive care unit. The man was found unconscious in his bed with a butterfly-needle canalized into the vein of the left forearm and connected to an empty syringe.

Amniotic fluid embolism: still a diagnostic enigma for obstetrician and pathologist?

Eight fatal cases of amniotic fluid embolism (AFE) are described to identify definable and preventable risk factors increasing the incidence of AFE. Maternal age, past medical history, previous pregnancies and outcome, prenatal care, gestational age, neonatal outcome, mode of delivery, time of the onset of clinical symptoms, and maternal autopsy findings were retrospectively analyzed. Risk factors and clinical manifestations present in the patients were investigated.

Pushing a catheter remnant into the coronary tree: complication of the procedure? Maybe, but sometimes the fragment needs to be removed.

Patients with catheter fragments that were entrapped during percutaneous transluminal coronary angioplasty remain a particular challenge because little is known about the clinical outcome. Absolutely unique is the partially cutting of the dilator and the pushing of the fragment by the guidewire advancing into the femoral artery to the coronary tree. We describe this exceptionally complication with a complete coronary obstruction and an anterior myocardial infarction sustained by the retained fragment into the left main branch.

Immunohistochemical marker for Na+ CP type Valpha (C-20) and heterozygous nonsense SCN5A mutation W822X in a sudden cardiac death induced by mild anaphylactic reaction.

A sudden death likely due to mild anaphylactic reaction in a young man is described. Autoptic, histologic, immunohistochemical, and laboratory findings were strongly consistent with the diagnosis of a mild anaphylactic reaction. Genetic molecular analysis, performed on formalin-fixed, paraffin-embedded tissues, showed a mutation described as W822X in a family with electrocardiographic pattern typical of Brugada Syndrome.