Acute tubular necrosis after inhalation exposure to methylene chloride. Report of a case.

Nephrotoxic reaction occurred after inhalation exposure to methylene chloride. This exposure is associated with acute renal failure, myoglobinuria, hypocomplementemia, and liver enzyme elevations. Pathologic specimens, both light and electron microscopic, demonstrate renal tubular damage.

An argument for the attendance of clinicians at autopsy.

We recorded the attendance of clinicians at the autopsies they had requested, and following personal notification that the autopsy was in progress. Of 679 residents paged , 37% attended and 63% did not. Of 786 internists paged , 36% attended and 64% did not.

Autopsies in a modern teaching hospital. A review of 2,537 cases.

We reviewed the clinical charts and the postmortem findings of 2,537 autopsies, and correlated them by constructing a "concordance score." In 2,293 cases (90%), the primary disease, as diagnosed at autopsy, had been recognized as such clinically, but in 244 cases (10%) it had not. In 2,300 cases a second disease was present, which had been diagnosed clinically in 1,795 patients.

The concordance score. Correlation of clinical and autopsy findings.

The traditional pathology report does not indicate concordance of the antemortem clinical diagnosis with autopsy findings. While doing a retrospective review of autopsies performed in our facility, we developed an approach that permits the determination of a "concordance score." The concordance score expresses the extent of agreement or disagreement of clinical with autopsy findings in ten predetermined categories.

Arterial thrombosis in scleroderma.

Clinical and pathological observations are presented on five patients with scleroderma who developed thrombosis of a major vessel. Three died following intestinal infarction or limb gangrene and two had digit or extremity amputation. Severe intimal thickening of major arteries with thrombus formation was noted but no significant abnormality was found in the clotting activity of the blood.