RESUMEN
Filicide is the killing of a child by his or her parent. Despite the disturbing nature of these crimes, a study of filicide classification can provide insight into their causes. Furthermore, a study of filicide classification provides information essential to accurate death certification. We report a rare case of familial filicide in which twin sisters both attempted to kill their respective children. We then suggest a detailed classification of filicide subtypes that provides a framework of motives and precipitating factors leading to filicide. We identify 16 subtypes of filicide, each of which is sufficiently characteristic to warrant a separate category. We describe in some detail the characteristic features of these subtypes. A knowledge of filicide subtypes contributes to interpretation of difficult cases. Furthermore, to protect potential child homicide victims, it is necessary to know how and why they are killed. Epidemiologic studies using filicide subtypes as their basis could provide information leading to strategies for prevention.
Asunto(s)
Homicidio/psicología , Suicidio/psicología , Gemelos Dicigóticos/psicología , Adulto , Niño , Preescolar , Psiquiatría Forense , Humanos , MasculinoRESUMEN
The turnover of cholesterol in the brain is thought to occur via conversion of excess cholesterol into 24S-hydroxycholesterol, an oxysterol that is readily secreted from the central nervous system into the plasma. To gain molecular insight into this pathway of cholesterol metabolism, we used expression cloning to isolate cDNAs that encode murine and human cholesterol 24-hydroxylases. DNA sequence analysis indicates that both proteins are localized to the endoplasmic reticulum, share 95% identity, and represent a new cytochrome P450 subfamily (CYP46). When transfected into cultured cells, the cDNAs produce an enzymatic activity that converts cholesterol into 24S-hydroxycholesterol, and to a lesser extent, 25-hydroxycholesterol. The cholesterol 24-hydroxylase gene contains 15 exons and is located on human chromosome 14q32.1. Cholesterol 24-hydroxylase is expressed predominantly in the brain as judged by RNA and protein blotting. In situ mRNA hybridization and immunohistochemistry localize the expression of this P450 to neurons in multiple subregions of the brain. The concentrations of 24S-hydroxycholesterol in serum are low in newborn mice, reach a peak between postnatal days 12 and 15, and thereafter decline to baseline levels. In contrast, cholesterol 24-hydroxylase protein is first detected in the brain of mice at birth and continues to accumulate with age. We conclude that the cloned cDNAs encode cholesterol 24-hydroxylases that synthesize oxysterols in neurons of the brain and that secretion of 24S-hydroxycholesterol from this tissue in the mouse is developmentally regulated.
Asunto(s)
Encéfalo/metabolismo , Colesterol/metabolismo , Esteroide Hidroxilasas/genética , Secuencia de Aminoácidos , Animales , Clonación Molecular , Sistema Enzimático del Citocromo P-450/genética , ADN Complementario/genética , ADN Complementario/aislamiento & purificación , Homeostasis , Humanos , Ratones , Datos de Secuencia Molecular , Especificidad de Órganos , Alineación de Secuencia , Esteroide Hidroxilasas/metabolismoRESUMEN
BACKGROUND: Mean blood pressure levels (MBP) appear to rise with age slowly in the population of Mexico City and more swiftly in the U.S. in the black and white population, judging from published survey data. Some evidence suggests that MBP rises at intermediate rates in Hispanics in the U.S. METHOD: This question is explored here in two ways, by review of published survey data and by a novel approach that uses renal tissues obtained from forensic autopsies to estimate MBP. Past studies have revealed good agreement between the two methods of estimating MBP. RESULTS: Good agreement is again observed from the results of this study. Results from both methods agree that MBP is much lower at all ages in Mexican men and women than in blacks and whites in the U.S. Both methods also agree that Hispanics in the U.S. demonstrate an intermediate rise in MBP. A speculative first look at a small sample of U.S. Hispanics suggest that MBP rates of recent immigrants tend to resemble those of Mexico, while MBP levels of migrants of long-term residence resemble the native-born U.S. populations. CONCLUSIONS: The findings underscore the need for definitive testing to confirm if Mexicans who relocate to the U.S. may acquire an acceleration of the renovasculopathies, and of the lifelong progression toward hypertension that this implies.
Asunto(s)
Arteriosclerosis/epidemiología , Hispánicos o Latinos , Hipertensión/etiología , Corteza Renal/irrigación sanguínea , Arteria Renal/patología , Adolescente , Adulto , Negro o Afroamericano , Factores de Edad , Anciano , Arteriosclerosis/complicaciones , Arteriosclerosis/patología , Autopsia , Causas de Muerte , Diabetes Mellitus/epidemiología , Progresión de la Enfermedad , Emigración e Inmigración , Femenino , Fibrosis , Humanos , Hiperplasia , Estilo de Vida , Louisiana/epidemiología , Masculino , México/epidemiología , México/etnología , Persona de Mediana Edad , Factores de Riesgo , Texas/epidemiología , Túnica Íntima/patología , Población BlancaRESUMEN
Perinatal autopsies present forensic patholgists with a variety of challenges, not the least of which involves the removal and examination of very small and sometimes fragile organs. Removal of the immature brain can be particularly troublesome. Even if great care is taken during brain removal, one is often left with no more than a semifluid amorphous mass of softened tissue by the time the brain is ready to be fixed in formalin. We describe a method of perinatal brain removal which helps to preserve brain shape and integrity. By removing the brain while the head (and body) is totally immersed in water, we find that the brain is easier to remove and less apt to destruction. Subsequent fixation in formalin results in well-preserved, intact specimens, allowing for optimal examination and sectioning.
Asunto(s)
Autopsia/métodos , Encéfalo/patología , Inmersión , Manejo de Especímenes/métodos , Humanos , Recién NacidoRESUMEN
The implantable cardioverter-defibrillator (ICD) is an implantable electronic device that has been proven to be safe and effective in treating various malignant tachyarrhythmias in susceptible individuals. As the use of ICDs becomes more widespread, more individuals with the implanted devices will be encountered at autopsy. Manipulation of an activated ICD can result in electrical shock. To avoid injury, pathologists must be properly prepared to deal with bodies containing activated ICDs. These devices can also provide valuable information that may be helpful in determining the cause and mechanism of death. Herein, we present information regarding the appropriate guidelines and safeguards for pathologists confronted with an activated ICD.
Asunto(s)
Desfibriladores Implantables , Traumatismos por Electricidad/prevención & control , Seguridad de Equipos , Patología Clínica/métodos , Accidentes de Trabajo/prevención & control , Autopsia , Desfibriladores Implantables/efectos adversos , Traumatismos por Electricidad/etiología , Humanos , SeguridadRESUMEN
Lipomatous hypertrophy of the interatrial septum ("massive fatty deposits in the atrial septum") may represent an incidental autopsy finding or may be associated with atrial arrhythmias, obstructive symptoms, or sudden death. Antemortem diagnosis is becoming much more common. In a literature review and in a review of our 12 cases, this condition was found to occur more frequently in obese middle-aged or elderly subjects, who frequently demonstrated atherosclerotic coronary artery disease. The unencapsulated mass generally occurred anterior or superior to the fossa ovalis, and histologically was characterized by mature fat with varying quantities of fetal fat, inflammation and fibrosis, and entrapment of myocardial fibers with cytologic atypia. Cases were included that had a minimum atrial septal thickness of 1.0 cm. The septum ranged up to 7.0 cm in maximum thickness (2.6 cm average). In our cases, no deaths were directly attributed to this disorder. It is important that forensic pathologists become more generally aware of this condition. To further delineate the true pathological significance, the atrial septum should be routinely examined by palpation and sectioning to determine its thickness and fat content.
Asunto(s)
Tejido Adiposo/patología , Cardiomegalia/patología , Tabiques Cardíacos/patología , Anciano , Cardiomegalia/mortalidad , Cardiomiopatías/patología , Femenino , Atrios Cardíacos/patología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
PURPOSE: We isolated genes whose expression differs between normal and malignant prostate. MATERIALS AND METHODS: Differential display polymerase chain reactions revealed a messenger ribonucleic acid (mRNA) with higher expression in prostatic adenocarcinoma versus age matched normal tissue. Deoxyribonucleic acid sequencing identified this mRNA as the product of the early growth response-1 gene. RESULTS: Early growth response-1 mRNA levels were elevated in 12 of 12 intraprostatic adenocarcinomas but not in breast or ovarian cancers, or in rapidly dividing rat ventral prostate cells. Early growth response-1 mRNA was detected in epithelial and stromal cells at tumor margins but not in lymph node metastases. CONCLUSIONS: Early growth response-1, a nuclear transcription factor, is implicated in the growth and invasion of intraprostatic cancers.
Asunto(s)
Adenocarcinoma/genética , Proteínas de Unión al ADN/genética , Regulación Neoplásica de la Expresión Génica , Proteínas Inmediatas-Precoces , Neoplasias de la Próstata/genética , ARN Mensajero/biosíntesis , Factores de Transcripción/genética , Dedos de Zinc/genética , Adenocarcinoma/química , Animales , Secuencia de Bases , Proteína 1 de la Respuesta de Crecimiento Precoz , Masculino , Datos de Secuencia Molecular , Neoplasias de la Próstata/química , ARN Mensajero/análisis , Ratas , Ratas Sprague-DawleyRESUMEN
There is much anecdotal information being disseminated, even offered in expert witness testimony, concerning the deposit of primer residues on the hands of persons in front of the muzzle of handguns. We present data for 9 mm and 380 Auto pistols and for a 38 caliber revolver depicting the procedure for obtaining wipings taken from targets representing the hands of a gunshot victim. These wipings from pork tissue were then analyzed for the primer residue metals antimony, barium, and lead. The data show that the two primary metals, antimony and barium, are deposited on the targets out to 4 feet for the pistols and out to three feet for the 38-caliber revolver. Testing will continue in actual cases with the gun and ammunition involved in the shooting.
Asunto(s)
Antimonio/análisis , Bario/análisis , Armas de Fuego , Medicina Legal/métodos , Piel/química , Heridas por Arma de Fuego/patología , Animales , Técnicas In Vitro , Plomo/análisis , Espectrofotometría Atómica , PorcinosRESUMEN
In the United States, there is currently an epidemic of firearms violence. Among victims of this violence, there are striking racial and ethnic patterns in the manners and circumstances of death. This study was conducted to explore and quantitate some of these differences. Autopsy and investigation reports of 554 consecutive firearms deaths in Dallas County, Texas, from March 1992 to February 1993 were reviewed. Overall suicide rates by race for 1970 and 1990 were calculated. Suicide rates for blacks have increased while overall rates (all races) have decreased slightly. Large racial and ethnic differences in the homicide-suicide ratio (H:S) were found (0.42 in non-Hispanic whites; 7.44 in others) (p < 0.001). Non-Hispanic whites who committed suicide with a firearm were less likely than other groups to do so with another person present (12% non-Hispanic whites; 49% others) (p < 0.001). Blacks and Asians who committed suicide with a firearm killed another person in 67% of witnessed cases (those with another person present during the incident). Whites (Hispanics and non-Hispanics) killed another person in only 12% of witnessed firearm suicides. The data suggest that the subtypes, psychodynamics, and causes of suicide may currently differ among racial and ethnic groups. These differences should be considered in order to formulate adequate prevention strategies and to assess the suicide and homicide risk in depressed individuals. The difficulty of accurate death certification in some cases is also discussed.
Asunto(s)
Homicidio/estadística & datos numéricos , Suicidio/estadística & datos numéricos , Heridas por Arma de Fuego/etnología , Heridas por Arma de Fuego/mortalidad , Negro o Afroamericano/estadística & datos numéricos , Asiático/estadística & datos numéricos , Femenino , Armas de Fuego/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Masculino , Grupos Raciales , Texas/epidemiología , Población Blanca/estadística & datos numéricosRESUMEN
Isozymes of steroid 5 alpha-reductase (5 alpha-reductase) have crucial roles in androgen physiology by synthesizing the potent hormone dihydrotestosterone. The expression pattern of the 5 alpha-reductase type 2 isozyme was determined in genital and extragenital tissues by developing an immunohistochemical assay using formalin-fixed tissue and affinity purified polyclonal antibodies that specifically recognize this isozyme. Expression was detected in basal epithelial and stromal cells of the normal prostate but not in luminal epithelial cells. Stromal cells of the seminal vesicle also expressed the type 2 isozyme. In contrast, staining was detected in epithelial cells of the epididymis but not in the surrounding stroma. Myofibroblasts in foreskin samples of normal and hypospadiac individuals expressed antigen and were distributed in bands throughout the prepuce, suggesting a clonal origin. In most cells the type 2 isozyme exhibited a perinuclear subcellular distribution. However, in liver hepatocytes the protein was distributed throughout the intracellular membrane compartment.
Asunto(s)
3-Oxo-5-alfa-Esteroide 4-Deshidrogenasa/biosíntesis , Isoenzimas/biosíntesis , 3-Oxo-5-alfa-Esteroide 4-Deshidrogenasa/análisis , 3-Oxo-5-alfa-Esteroide 4-Deshidrogenasa/clasificación , Adulto , Anciano , Células Cultivadas , Epidídimo/química , Epidídimo/citología , Epidídimo/metabolismo , Humanos , Inmunohistoquímica , Lactante , Isoenzimas/clasificación , Hígado/química , Hígado/citología , Hígado/metabolismo , Masculino , Persona de Mediana Edad , Pene/química , Pene/citología , Pene/metabolismo , Próstata/química , Próstata/citología , Próstata/metabolismoRESUMEN
The synthesis of dihydrotestosterone is catalyzed by steroid 5 alpha-reductase isozymes, designated types 1 and 2. Mutation of type 2 results in male pseudohermaphroditism, in which the external genitalia are phenotypically female at birth. Two striking and unexplained features of this disorder are that external genitalia of affected males undergo virilization during puberty and that these individuals have less temporal hair regression. The tissue-specific and developmental expression patterns of the 5 alpha-reductase isozymes were investigated by immunoblotting. The type 1 isozyme is not detectable in the fetus, is transiently expressed in newborn skin and scalp, and permanently expressed in skin from the time of puberty. There was no qualitative difference in 5 alpha-reductase type 1 expression between adult balding vs. nonbalding scalp. The type 2 isozyme is transiently expressed in skin and scalp of newborns. Type 2 is the predominant isozyme detectable in fetal genital skin, male accessory sex glands, and in the prostate, including benign prostatic hyperplasia and prostate adenocarcinoma tissues. Both isozymes are expressed in the liver, but only after birth. These results are consistent with 5 alpha-reductase type 1 being responsible for virilization in type 2-deficient subjects during puberty, and suggest that the type 2 isozyme may be an initiating factor in development of male pattern baldness.
Asunto(s)
3-Oxo-5-alfa-Esteroide 4-Deshidrogenasa/biosíntesis , Regulación Enzimológica de la Expresión Génica , Genitales Masculinos/enzimología , Isoenzimas/biosíntesis , ARN Mensajero/metabolismo , 3-Oxo-5-alfa-Esteroide 4-Deshidrogenasa/análisis , 3-Oxo-5-alfa-Esteroide 4-Deshidrogenasa/metabolismo , Adenocarcinoma/enzimología , Envejecimiento/metabolismo , Alopecia/enzimología , Animales , Encéfalo/enzimología , Células CHO , Cricetinae , Feto , Humanos , Immunoblotting , Recién Nacido , Isoenzimas/análisis , Isoenzimas/metabolismo , Cinética , Hígado/enzimología , Masculino , Especificidad de Órganos , Hiperplasia Prostática/enzimología , Neoplasias de la Próstata/enzimología , Pubertad , ARN Mensajero/análisis , Cuero Cabelludo/enzimologíaRESUMEN
We reviewed the Dallas County Medical Examiner's Office records of all individuals who had died in a local Christian Science Sanatorium during a 5 1/2-year period. Of 116 such patients, only 13 (11%) had pressure sores (decubitus ulcers). In 10 of these patients, the sores were described as small, superficial, and/or healing, while the other three patients had more serious ulcers. In contrast, for patients dying in nursing homes or hospitals, the incidence of pressure sores may be as high as 54-57%. It is our opinion that the difference in incidence is due to the personal and conscientious nursing care provided by Christian Science institutions.
Asunto(s)
Ciencia Cristiana , Hogares para Ancianos/normas , Úlcera por Presión/epidemiología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Tiempo de Internación , Masculino , Casas de Salud/normas , Úlcera por Presión/prevención & control , Prevalencia , Texas/epidemiologíaRESUMEN
Bullet embolism is a well-recognized phenomenon. While bullet embolism is not common, renal artery bullet embolism appears to be very rare. We report three cases of bullet embolism to a renal artery. Autopsy findings and bullet types are presented. Such cases are of particular interest to both the medical examiner and the clinician. Failure to consider this phenomenon clinically could lead to infarction of a kidney. A consideration of this phenomenon at autopsy could shorten the dissection time required to retrieve the bullet.
Asunto(s)
Obstrucción de la Arteria Renal/etiología , Traumatismos Torácicos/complicaciones , Trombosis/etiología , Heridas por Arma de Fuego/complicaciones , Adulto , Humanos , MasculinoRESUMEN
A 70-year-old black man was found to have primary hyperparathyroidism due to an oxyphil cell adenoma. Ultrastructural studies were essential in elucidating the cell type of the tumor. The morphologic findings in relation to the clinical findings and a brief review of the literature are discussed.
Asunto(s)
Adenoma/complicaciones , Hiperparatiroidismo/etiología , Neoplasias de las Paratiroides/complicaciones , Adenoma/ultraestructura , Anciano , Humanos , Masculino , Neoplasias de las Paratiroides/ultraestructuraRESUMEN
One hundred forty-three incidental carcinomas from 500 step-sectioned prostates were classified independently by two pathologists according to the Gleason system. The area involved by each tumor was measured by photographic techniques. Observer agreement was 94 per cent when tumors were divided into groups with "pattern scores" 4 or less (less than or equal to 4) and greater than 4 (greater than 4). About 25 per cent of tumors in both races had pattern scores 4 or less (less than or equal to 4). Tumors with pattern scores greater than 4 (greater than 4) were, on the average, significantly larger than those with pattern scores 4 or less (less than or equal to 4) (p less than 0.001). We therefore believe that the Gleason histologic classification system is reproducible and that it discriminates tumors with different biological behavior.