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Biomedical subjects

C M Coyne

Publications and source records attributed to C M Coyne.

11 recordsLinked to original sources

Recommended technique for brain removal to retain anatomic integrity of the pineal gland in order to determine its size in sudden infant death syndrome.

A standardized removal and dissection procedure is presented for human infant brain. A previously unreported cistern of the pineal gland must be severed at autopsy in order to preserve the gland's anatomic integrity during brain removal. Utilization of these methods to investigate Sudden Infant Death Syndrome brain tissue should facilitate interdisciplinary studies and comparisons of inter agency findings. We use these dissection procedures to extend our findings on reduced pineal gland size as an anatomic marker assisting the forensic pathologist in making the diagnosis of Sudden Infant Death Syndrome.

Brain↗

Increased density of senile plaques (SP), but not neurofibrillary tangles (NFT), in non-demented individuals with the apolipoprotein E4 allele: comparison to confirmed Alzheimer's disease patients.

The apolipoprotein E genotype and cortical senile plaque (SP) and cortical and hippocampal neurofibrillary tangle (NFT) densities were determined in non-demented individuals and neuropathologically confirmed AD patients. The non-demented population was further subdivided according to presence or absence of pathologically established critical coronary artery disease (cCAD), hypertension (HyperT), or neither (non-heart disease; non-HD). The apolipoprotein E4 (APOE4) allele incidence and dose frequencies were increased in the AD, cCAD and HyperT groups compared to the non-HD controls. The mean number of SP and NFT was significantly increased with the presence of the APOE4 allele within the entire population. After grouping the non-demented subjects according to cardiac status, SP but not NFT density was increased among those individuals with the APOE4 genotype. In HyperT, the increased density of SP also correlated to the APOE4 allele dose frequency. The density of SP and NFT was increased in all regions of AD brain compared to all other non-demented groups, but no significant difference was found between AD patients with or without an APOE4 allele. These two AD groups were age-matched, but could not be matched for disease duration. The data suggest a relationship between heart disease, APOE4 genotype and the presence of SP regardless of cognitive status.

Aged↗

Increased ALZ-50 immunoreactivity in sudden infant death syndrome.

Neuronal expression of the ALZ-50 epitope was investigated in hippocampus and medulla from infants dying of sudden infant death syndrome or known causes (controls). Hippocampal studies include data from 31 infants dying of known causes between 32 weeks' gestation and 16 months postpartum and 46 infants who died of sudden infant death syndrome. The medulla at the level of the mid olivary protuberance was investigated in 22 infants with sudden infant death syndrome and 11 controls matched for age and postmortem interval. Medullary sections were also examined using immunohistochemical methods to demonstrate reactivity to glial fibrillary acidic protein antibody. The density of ALZ-50-immunodecorated neurons in control hippocampus rises from the level observable in utero to a maximum between 1 and 4 months of age and declines thereafter. The density of ALZ-50-immunoreactive neurons in hippocampus is significantly increased in infants with sudden infant death syndrome at all ages. Significant regionally specific increases in the number of ALZ-50-immunoreactive neurons, and glial fibrillary acidic protein-reactive cells were found in sudden infant death syndrome medulla; coincidental increases were observed in only the solitary nucleus. Neurons exhibiting the ALZ-50 epitope may reflect apoptotic neuron death of normal development, and increased numbers of immunoreactive neurons may suggest enhanced neurodegeneration in sudden infant death syndrome.

Antibodies↗

Oxidative stress in sudden infant death syndrome.

We investigated the hippocampus and parahippocampal cortex of victims of sudden infant death syndrome and of age-matched infants dying acutely of known causes (non-sudden infant death syndrome controls). Tissue sections were investigated for the presence of neurons expressing signs of elevated levels of free radical using immunohistochemical markers for superoxide dismutase and glutathione peroxidase. Brain tissues displayed immunopositive neurons in every infant. In control infants, an age-related decline in the number of superoxide dismutase- and glutathione peroxidase-immunoreactive neurons was apparent in the hippocampus and parahippocampal cortex. Significantly increased numbers of immunoreactive neurons were found in victims of sudden infant death syndrome under 6 months of age compared to age-matched controls. This suggests that infants who later become victims of sudden infant death syndrome may experience antemortem periods of oxidative stress, elevated levels of free radicals, and compensatory up-regulation of the free radical scavenger enzymes superoxide dismutase and glutathione peroxidase.

Cerebral Cortex↗

Chasing the casing: a 38 Special suicide.

Multiple self-inflicted gunshot wounds of the head are uncommon. Detailed history, scene investigation, autopsy findings, consideration of ballistics, and evidentiary proceedings are necessary to determine the manner of death in these cases. This report involves a pattern of atypical, self-inflicted bullet wounds of the head of a 26-year-old male. Investigation confirmed that a single eyewitness and several earwitnesses reported a single discharge of a firearm. The eyewitness testified that the decedent singly discharged a Smith & Wesson revolver, caliber .38 Special, to the right side of his head after interposing several objects between the muzzle and his skin immediately prior to discharge. He was declared brain dead two days later. At necropsy two contiguous atypical entry wounds were present in the right preauricular temple. The inferior wound was interpreted to be a near contact wound. The gray metal slug fragmented, creating separate tracks to the right maxillary sinus and the mid left posterior cerebrum, respectively. The larger, atypical wound of entry was associated with passage of the projectile through the right temporalis muscle and squamous temporal bone. The projectile, consisting of a slightly distorted empty metallic cartridge case containing a "live" primer, was recovered from its point of final lodgment in the right temporal lobe. The literature addressing paired entry wounds following single discharge of the firearm with interposed targets is relatively sparse. Cases reporting multiple bullet wounds involving suicide are only sporadically reported. This report summarizes the investigative findings supporting the determination of the manner of death and revealing the interesting origin of the "misplaced" casing.

Adult↗

Increased incidence of neurofibrillary tangles (NFT) in non-demented individuals with hypertension.

The incidence rates and numerical densities of argryophilic neurofibrillary tangles (NFT) and senile plaques (SP) were determined in non-demented individuals and subjects with Alzheimer's disease (AD). The non-AD subjects were grouped according to cardiac status; those individuals with critical coronary artery disease (cCAD), those hypertensive individuals without cCAD (HyperT), and those without heart disease (non-HD). The incidence and densities of SP and NFT were significantly greater in AD than any of the non-demented groups. The prevalence of SP was increased in both HyperT and cCAD compared to non-HD controls, while NFT occurrence was accentuated in non-demented HyperT subjects only. The densities of SP and NFT in HyperT were elevated compared to cCAD or both cCAD and non-HD controls; NFT densities were similar in cCAD and non-HD. NFT density increased with increasing age in only the non-HD and cCAD groups, suggesting a possible relationship between disease process and NFT formation in the AD and HyperT populations.

Age Factors↗

Neurochemical and histopathologic alterations characteristic of Pick's disease in a non-demented individual.

In the course of investigating a large number of non-demented subjects, a 68 year old female dying of coronary artery disease was found to have Pick bodies in her grossly normal brain. Although only mild subcortical gliosis and no neuron loss were observed. Pick bodies were found throughout the brain and occasional balloon cells were noted. Pick bodies and numerous neurons were also ALZ-50 and Tau-1 immunoreactive. Retrospective studies indicated a lack of overt intellectual decline or depression in this individual. Frontal, temporal and occipital poles, amygdala, hypothalamus and nucleus basalis of Meynert (nbM) were analyzed for ChAT, AChE and MAO-A and -B enzymatic activities and for the binding of 5HT and imipramine. Cholinergic decreases were found only in subcortical structures. Serotonin binding decreases were widespread, excluding the nbM. Altered MAO-B activity was regionally variable, and no differences in MAO-A activity or imipramine binding were observed. Few differences in neurochemical alterations were observed in the current non-demented subject with abundant Pick bodies compared to previous studies of demented Pick's patients. This case strongly suggests that chemical dysfunction and neuropathological features of Pick's disease occur in advance of overt clinical manifestations of the disorder.

Acetylcholinesterase↗

Temporal sequence of plaque formation in the cerebral cortex of non-demented individuals.

One of the hallmarks of Alzheimer's disease is the presence of argyrophilic plaques (arg-P) accompanying dementia and other forms of cognitive alterations. In the present investigation 195 non-demented, cognitively normal patients were grouped according to the presence or absence of critical coronary artery disease (cCAD), defined as a 75% or greater stenosis of one of the epicardial arteries. None of the subjects had significant cerebral vascular disease. The parahippocampal gyrus (PHG) and frontal pole were analyzed for the presence of arg-P, A4 deposition, ALZ-50 immunoreactive (IR) neurons and neuropil threads (NT). Individuals with cCAD have a significantly greater incidence of plaques than non-heart disease (non-HD) subjects. Every cCAD subject had ALZ-50 IR neurons in the PHG and a greater incidence of NT as compared to the non-HD subjects. Every subject with plaques also had IR neurons and NT in the PHG. Based on the presumption that early neurodegeneration labeled by ALZ-50 antibody and amyloid deposition are in some way linked, then the sequence of plaque formation is initiated by the presence of ALZ-50 IR neurons followed in order by NT, A4 deposition and diffuse form arg-P.

Adult↗

Double valve replacement for lupus valvulitis: report of a case and review of the literature.

Hemodynamically significant lupus valvulitis, requiring valve replacement, is rare: 21 cases have been reported so far in the literature, and only 2 of these have involved double valve replacement. We describe an additional case of double valve replacement in a patient with systemic lupus erythematosus. The histopathologic and clinical features of this case suggest that valvular involvement resulted from both acute and chronic disease processes. Medical success in the treatment of systemic lupus erythematosus, especially that achieved through prolonged or high-dose steroid therapy, may cause chronic valvular disease to become a more common surgical problem. A review of the literature supports this contention.

Journal Article↗

Premenstrual tension syndrome.

The premenstrual syndrome is discussed in relation to prevalence, symptomatology, severity, and time course. Methodologic problems common to the study of the menstrual cycle are presented. The research on psychologic and physiologic etiologies is reviewed, and results of studies on various treatment modes are discussed. Newer theories suggesting a combined psychophysiologic etiology and concomitant nonpharmaceutical treatment modes encompassing self-care and stress management skills are included.

Anxiety↗