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A 24-year-old man presented with dysuria and voiding frequency. Cystoscopy revealed a smooth surfaced nodular mass in the trigonal region. Transurethral insisional biopsy of the mass was done. Histopathological and immunohistochemical examination revealed benign prostatic tissue situated ectopically.

Background: Radiographs are vital diagnostic tools that complement physical examination in trauma patients. A study was undertaken to assess the performance of residents in emergency medicine in the interpretation of trauma radiographs., Methods: 348 radiographs of 100 trauma patients admitted between 1 March and 1 May 2007 were evaluated prospectively. These consisted of 93 cervical spine (C-spine) radiographs, 98 chest radiographs, 94 radiographs of the pelvis and 63 computed tomographic (CT) scans. All radiological material was evaluated separately by five emergency medicine residents and a radiology resident who had completed the first 3 years of training. The same radiographs were then evaluated by a radiologist whose opinion was considered to be the gold standard. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated., Results: The mean (SE) age of the patients was 29 (2) years (range 2-79). There were no statistically significant differences in terms of pathology detection between the emergency medicine residents and the radiologist. The agreement between the emergency medicine residents and the radiology resident was excellent for radiographs of the pelvis and the lung (kappa (kappa) = 0.928 and 0.863, respectively; p<0.001) and good for C-spine radiographs and CT scans (kappa = 0.789 and 0.773, respectively; p<0.001)., Conclusions: Accurate interpretation of radiographs by emergency medicine residents who perform the initial radiological and therapeutic interventions on trauma patients is of vital importance. The performance of our residents was found to be satisfactory in this regard.

A case of sexual asphyxial death by hanging is presented. A 41-year-old man was found dead hanging by a towrope. A mirror was placed in front of a table, reflecting him in full height. A photograph of a celebrity mannequin was found against him. The towrope was arranged for the compression of the neck, and controlled voluntarily by a shower apparatus. Autopsy findings revealed an ascending ligature mark, 2 cm in width on the neck. Although this is a very ancient behaviour, we are presenting a very rare case from Turkey. We aim to discuss sexual asphyxiation phenomenon together with the features of the previous Turkish cases on the aspect of the forensic viewpoint, as well as the similarities and differences between different nations and religious.

A 37-year-old man was admitted with neurological complaints after a traffic accident. Physical examination showed no signs of injury due to the accident. Magnetic resonance imaging of the neck revealed a well-demarcated lesion showing homogeneous contrast enhancement at the level of C(1-2). The patient underwent elective surgery, and histopathological diagnosis of the surgical specimen was made as cervical schwannoma. His neurological complaints disappeared on the second postoperative day. No neurological deficit was observed at six-month follow-up. To our knowledge, there has been no literature report in which the diagnosis of cervical schwannoma was made during investigation of trauma-induced neurological symptoms.

The human brain is uniquely powerful in its cognitive abilities, yet the hippocampal and neocortical circuits that mediate these complex functions are highly vulnerable during aging. In this study, we analyzed age-related changes in the rat hippocampus by studying newborn (1 month), middle-aged (12 months), and older (24 months) male and female Sprague-Dawley rats. We evaluated neuronal dystrophy, neuron scattering, and granulovacuolar degeneration in the hippocampal area using light microscopy, according to age and gender. We detected significant neuronal dystrophy in the CA1, CA2, and CA3 areas in male rats, and in the CA1, CA3, and CA4 areas in female rats. Degenerative changes, indicated by neuron scattering, were observed in the CA1, CA2, and CA3 areas of male and the CA2 and CA4 areas of female rats. Changes in all areas of the hippocampus were observed with increasing age; these changes included neuronal dystrophy and neuron scattering and did not differ significantly between male and female rats.

Small bowel mesenteric volvulus when compared with mesocolonic volvulus, have not high incidence. Two autopsy cases of small bowel mesenteric volvulus in infants, highlighting the importance of a suspicion in early recognition of this rare but potentially fatal intra-abdominal emergency are reported. We also review the literature on possible aetiologies and mechanism of small bowel mesenteric volvulus, as well as its management.

Clusterin is a circulating multifunctional glycoprotein produced in several kinds of epithelial and neuronal cells. Clusterin is upregulated during different physiological and pathological states, such as senescence, type-2 diabetes mellitus, Alzheimer disease, and in various neoplasms. Herein, we investigated the immunohistochemical expression of clusterin in non-neoplastic adenohypophysis of human autopsy subjects and pituitary adenomas. We also investigated the association of clusterin increase with age in adenohypophysis of autopsy subjects. Immunohistochemically, clusterin was found positive in the cytoplasm of all adenoma cases, and in the cytoplasm of parenchymal cells, stellate cells, mixed cell follicles and in colloidal material inside of the follicles of non-neoplastic adenohypophysis as well. Clusterin expression in pituitary adenomas was found significantly higher than in non-neoplastic adenohypophyses. In addition, in non-neoplastic adenohypophysis, a significant increase in clusterin expression levels between young (or=61 years) subjects (p < 0.00001, analysis of variance [ANOVA]) was found. In addition to clusterin accumulation, presence of calcification (p < 0.045, ANOVA) and presence of large follicles with colloid accumulation (p < 0.004, ANOVA) were also statistically significant factors related to aging in non-neoplastic adenohypophysis. In conclusion, the present study demonstrated that clusterin expression was found in non-neoplastic adenohypophysis and in upregulated amounts in pituitary adenomas. This study also demonstrated that in non-neoplastic adenohypophyses, increase of clusterin positive cells; histopathological findings of calcification or presence colloidal material accumulation in large follicles were associated with age. To our knowledge, immunohistochemical localization of clusterin in pituitary adenomas was not reported previously.

To evaluate the role of adjuvant therapy in survival and to identify important prognostic factors in uterine sarcoma. One hundred five patients with uterine sarcoma have been retrospectively researched to evaluate the results in this tumor group. 43.8% had leiomyosarcoma, 28.6% had endometrial stromal sarcoma and 27.6% had a malign Mullarian mixed tumor while the distribution according to the histological subgroups were found to be 42.6,16.2 and 41.2% in grade I, II and III tumors respectively. 38.1% of the patients had Radiotherapy, 18.1% had chemotherapy and 12.4% had chemoradiotherapy in addition to surgery. The distant metastases rate is 30% and the local recurrence is 16.2%. All the local recurrences and 90% of the distant metastases have occurred within the first two years. The disease free survival and overall survival rates at 3rd and 5th years are 54.46, 49.88, 54.63 and 51.09% all respectively. In our series, univariate analysis for overall survival demonstrated statistical significance for radical surgery, grade, stage, age, menopausal status and presence of RT in treatment modality, but; histology, number of mitosis, tumor size demonstrated no significance. Our data favors treatment for uterine sarcoma with radical surgery plus radiotherapy alone over 54 Gy or with chemotherapy.

Introduction: The toxicity of methanol is as a result of its metabolites, formaldehyde and formic acid. Formic acid induces severe metabolic acidosis causing death, and is the primary agent responsible for ocular toxicity. Glial fibrillary acidic protein (GFAP) immunostaining is the most commonly used method for examining astrocyte proliferation and hypertrophy after various central nervous system injuries. The antigen CD34 is expressed widely on vascular endothelium, including that of the central nervous system and high endothelial venules., Methods: In this study, GFAP and CD34 were immunohistochemically localised in the post-mortem optic nerve head, and brain tissue (basal ganglia putamen) samples were collected from methanol-exposed and non-methanol-exposed (control) subjects., Results: There was a positive correlation between the GFAP and CD34 intensity of staining scores in the methanol-exposed group (P=0.711, P=0.010). Furthermore, there was also a positive correlation between the brain putamen and optic nerve head GFAP extent of staining in the methanol-exposed group (P=0.720, P=0.008). A statistically significant difference was found between the methanol-exposed group and the control group optic nerve CD34 intensity scores (P=0.014), but no significant difference was found between optic nerve CD34 and GFAP extent scores (P=0.05)., Conclusion: The study revealed that methanol affects brain putamen and the optic nerve selectively. We detected a positive significant correlation between brain and optic nerve GFAP expression. CD34 expression was markedly decreased by the toxic effects of methanol.

Background: Electrical energy has gained wide acceptance since the middle of 20th century. Rapid progress of industrialization and widespread utilization of electrical appliances lead to many electrical accidents and deaths. Aim of our study was to analyze such injuries with a forensic perspective and to draw conclusions., Methods: Sixty-three death cases (59 males, 4 females; mean age 32.5+/-12.7; range 5 to 62 years) due to electrical current injury that underwent forensic autopsy between the years of 1996-2003 in Bursa city of Turkey were included into the study. Demographic features, origin of death, scene of the injury, localization of entry and exit lesions were examined., Results: The cases were most common in between 30-39 years of age and 93.7% were male. Sixty-three point five percent of the deaths were occupational accidents. Deaths occurred usually in summer. Although homicidal and suicidal cases were rare in the literature, all of our cases were accidental in origin., Conclusion: The physician who performs autopsy should be thoroughly informed about the place of death due to electrocution. It is necessary to solve infra-structural problems, increase security measures and provide training about prevention of electrical injuries.

Pulmonary artery dissection and aneurysms ruptures are rare events, occasionally reported as a cause of sudden death. We report a 27-year-old man who was admitted to the hospital with history of a loss of consciousness and died soon after resuscitation was performed. On autopsy macroscopic examination, 2500 ml partially coagulated blood was found upon opening the right part of chest, also aneurysmal dilatation and intimal rupture of pulmonary artery distal branch were observed. The aim of this case report is to contribute to a better understanding of the pulmonary artery aneurysm rupture as a cause of sudden death and to emphasise its medical and legal importance (Fig. 1, Ref. 11). Full Text (Free, PDF) www.bmj.sk.

Massive ovarian oedema is a rare entity described as accumulation of oedema fluid within the ovarian stroma, separating normal follicular structures. Our case was a 27-year-old woman who presented with a large solid pelvic mass after recurrent episodes of self-limited abdominal pain. On physical examination, she had left abdominal tenderness with minimal rebound and guarding. With a diagnosis of malignant ovarian tumor, an exploratory laparotomy was done and a twisted ovarian mass was found which was excised completely. Histopathological evaluation of the mass revealed massive oedema of the ovary. Massive ovarian oedema should be suspected in women at the fertile age range with solid enlargement of the ovary.

A 33-year-old man was found 20 Cm upper of the floor, compressed by rubbish container in the elevator in an unusually awkward position. The scene investigation corresponded exactly with the localization of the injuries found in the victim. This is a case of death by thorax compression without other fatal factors in which the force causing the chest compression was distinctly determined by the autopsy and scene investigation as accidental traumatic asphyxia.

Introduction: Factors that emerge as crucial participants in tumour invasion and metastases are matrix metalloproteinases (MMPs), tissue inhibitor of metalloproteinase (TIMP) inhibitors and cellular adhesion molecules (CD44 and similar molecules). They play important roles in tumour invasion and metastasis in non-small-cell lung carcinomas (NSCLCs)., Materials and Methods: The study was performed using the data of 33 patients. MMP-2 from the metalloproteinase family, TIMP-2 from the metalloproteinase inhibitor family and the adhesion molecule CD44v6 expression were investigated immunohistochemically to search their role in the metastasis and the clinical outcome of the patients with NSCLCs., Results: Twenty-three tumours (70%) were squamous cell carcinoma (SCC), 9 (27%) were adenocarcinoma (AC), and 1 (3%) was large cell carcinoma (LCC). MMP-2 and TIMP-2 were expressed in high rates in NSCLC but CD44v6 expression was about 50%. Lymphatic invasion was less frequent in TIMP-2- positive patients and this difference was statistically significant (P = 0.005). There was a statistically significant difference between SCCs and ACs with respect to CD44v6 tumoral expression (P = 0.004). Also, there was a negative correlation between lymphatic invasion and the extent of CD44v6; lymphatic invasion was significantly less in CD44v6-positive cases (P = 0.013)., Conclusion: We found that TIMP-2 and CD44v6 can decrease the lymphatic invasion in NSCLCs. Also there was observed histiotype-related pattern of CD44v6 variant expression in SCCs.

Weight-losing diets have appealed to people who want to lose weight in the short-term. They usually apply high-protein (HP) diets (like Atkin's, Stillman's, Scarsdale) which they practice for 2 weeks or so. Unfortunately, these people who have rapid weight loss return to their old habits and quickly regain the weight lost. We have shown in previous work that actually these weight losses have been associated with body fluids, protein and glycogen storage. In our study, we examined the effect of unbalanced diet-related to an HP diet- on liver glycogen storage.For this study 40 Swiss albino mice consisting of two groups were used. The first group (HPSD) was fed with 25% HP for fifteen days and then were fed standard meals for the remaining 15 days; the other group was fed with standard meals throughout. The two groups were fed their respective diets for 30 days. At the end of 15th, 20th, 25th and 30th days 5 from each group were killed with cervical dislocation. The livers were removed perfused and then fixated.There were major differences in weight between the first and the fifteenth days. We detected remarkable increase in the weight gain of mice in the remaining 15 days. Glycogen storage was significantly reduced in HPSD (15) stained with PAS. In the others 20th, 25th and 30th days abnormally dense glycogen deposits were observed. Vacuoles in the hepatocyte cytoplasm, brownish deposits within hepatocytes, wide sinusoids, macrovesiculler steatosis structures and hydropic degeneration were observed in PAS and H&E stained HPSD group.As a result for the HPSD group a significant decrement in glycogen storage at the 15th day and also an accumulation of excessive amounts of glycogen deposits in mice liver was observed in the normal feeding phase.

Postmortem examination performed on a 70-year-old man revealed a thinly encapsulated, ovoid, large mass in the right hemithorax. The tumor was attached with its pedicle to the atrioventral pericardium and adjoined the diaphragm with compression of the right lower lobe of the lung. There was no adhesion between the tumor and the surrounding organs. Light microscopy showed a lipoma consisting of mature adipose tissue, and no malignancy was found.

Coronary artery anomalies that entail a risk of sudden death are frequently associated with complex cardiac malformations but may occasionally be solitary. A 31-year-old man became ill in the night and lost consciousness. He was taken to a hospital where he was treated. However, he died on the same day. The death was considered to be suspicious and an autopsy was mandated. On macroscopic examination, the heart weighed 410 g. A single coronary artery that originated from the right aortic sinus was found. The coronary artery ostium was 0.8 cm in diameter and had a hole-like shape. Demonstration of coronary artery pathologies in autopsies is vital for the elucidation of sudden death cases related to these lesions and for the development of new treatment approaches. The aims of this case report are to contribute to a better understanding of the coronary artery anomalies and emphasise their medicolegal importance.

Coronary artery anomalies that may be an isolated defect or part of complex congenital malformations of the heart are also often associated with a high risk of sudden death. A 19-year-old woman lost consciousness in the night. She was taken to hospital where she was treated. However, she died on the same day. The prosecutor considered the death suspicious, and the victim was taken to the morgue department for further examination and autopsy. On macroscopical examination, both coronary arteries originated from the left aortic sinus with the left one being dominant. The orifice of the sinus coronarius in the right atria was covered with a fenestrated membrane. Demonstration of coronary artery pathologies and associated anomalies in autopsies is vital for the elucidation of sudden death cases related to these lesions and for the development of new treatment approaches. The purposes of this case report are to characterise and identify markers of the coronary artery anomalies and to highlight their medicolegal importance in sudden death cases.

Primary tumors of the heart are rare; the most common cardiac tumor is atrial myxoma. Sudden death may occur in patients with atrial myxoma, tumor embolization, or obstruction of blood flow at the mitral or tricuspid valve. This report describes an unusual cause of sudden death and the autopsy findings for a 73-year-old man with left atrial myxoma.

Electrocutions deaths are mostly accidental, suicidal electrocutions are rarely reported. The records of Forensic Medicine Council of Turkey Bursa Morgue Department reveal second case of suicidal electrocution during the past 20 years. The presented case was a 61 year old man, found by his wife at his home bedroom, using a homemade suicidal electrocution device with bare copper wires. The mechanism of death and autopsy findings in suicidal electrocution is discussed.

High Protein diets (HP) have been popular for people who want to lose weight since the 1960s. Even though these diets do not harm healthy people in the short term, there is insufficient data to support their safe use and efficiency over a long period. Because of the fact that the proteins in these diets are mainly from animal sources, it induces a higher intake of total fat, saturated fat and cholesterol. It is proven that high protein diets cause both physical and pathological abnormalities in the body. However, there exist very few studies about the effects of high protein nutrition on liver glycogen storage. For this study 40 Swiss albino mice consisting of two groups were used. The first group was fed with 25% High Protein; the other was fed with standard meal. The two groups were fed with respect to their diets for 30 days. At the end of 15th, 20th, 25th and 30th days 5 from each group were killed with cervical dislocation. The livers were removed after perfusion then fixated. The routine paraffin pursuit was applied before cutting into 5 micrometer sections and staining with H-E, PAS and silver. There were major differences in weight loss between the first and the fifteenth days. Glycogen storage was significantly reduced in HP (15) stained with PAS. Hydropic degeneration and regenerative activity was observed in H-E and silver stained HP group. As a result for the high protein diet group, weight loss at the 15th day and a significant decrement in glycogen storage at the 30th day was observed.

Objectives: Our objective was to compare data on contraceptive use in relation to reported sexual activity in women from different minority ethnic groups., Design: We analyzed the National Survey of Sexual Attitudes and Lifestyles 2000., Subjects: Women aged 16-44 years, numbering 6932 and residing in Britain, participated in this study., Main Outcome Measures: Our main outcome measures are as follows: percentage of women reporting sexual activity, use of contraception and type of contraception (hormonal, barrier or permanent methods)., Results: Overall, fewer women from the UK's four main ethnic minority groups reported recent sexual activity, compared with white women. Among sexually active women, contraceptive use was significantly lower in all ethnic minority groups than in white women, but this pattern differed according to marital status. In ever-married or cohabiting women, lower contraceptive use was reported by Indian (78%) and Pakistani women (74%) than by other groups. Among single women, black Caribbean (88%) and black African (82%) women reported using less contraception compared with white (95%) and Indian (100%) women. Women from all ethnic minority groups were less likely than white women to report using hormonal contraception and permanent methods and were more likely to use barrier methods. The differences between ethnic groups remained significant after adjusting for educational achievement and parity. Deprivation and acculturation did not account for the use of contraception or the type of contraceptive method used., Conclusion: Sexually active married Pakistani and Indian women reported the lowest overall use of contraception. Among sexually active single women, black African and black Caribbean women reported levels of contraceptive use that were lower than those reported by white women. Sexually active women from all four minority ethnic groups were less likely than white women to use reliable methods of contraception.

We report an autopsy case of an 11-year-old girl who suffered mechanical asphyxia from falling off the metal bars in the playground. This autopsy case is interesting because of the atypical trauma and lesions. To our knowledge there has been no similiar published case reports in the forensic literature. The young age of the victim, the setting and the pattern of the injuries are rare in a fall at playground by a child.