C Margairaz | PubMed Health

PubMedDate not supplied

[Forensic medicine aspects of sudden death in sports].

Our study which deals with cases examined by the Institute of Forensic Medicine at the University of Geneva, of sudden nontraumatic death while engaged in sporting activities, covers the last fifteen years from 1980 to 1994. We discovered 31 cases, all males, aged between 17 and 68 years. There were 15 cases of young sportsmen (under the age of 45-50) where the cause of death was unclear, and where an autopsy was requested by the police and 16 cases, where we were asked to make an external examination of the bodies, in order to exclude any signs of violence. Of the 15 autopsies, 10 sportsmen presented signs of myocardial infarction and 2 showed evidence of hemorrhage in an atheromatous plaque. Five cases showed evidence of previous myocardial infarctions. The youngest victim was a 17-year-old boy with previously diagnosed obstructive cardiomyopathy.

Adolescent↗

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Immunopathological changes in human cerebral malaria.

Pathogenic mechanisms in human cerebral malaria remain unclear. We reevaluate the role of cell-mediated immune mechanisms in the pathogenesis of this disease based on autopsy findings in a 34-year-old Caucasian male. Histologic examination of brain tissue showed typical features of severe malaria infection (sequestration of Plasmodium falciparum-infected erythrocytes in vessels, cerebral oedema, petechial lesions and Dürck granulomas). In addition to these classical changes, we found that leukocytes that stained positively in immunohistochemistry for CD68 and tumor necrosis factor-alpha (TNF) coexisted with infected erythrocytes in capillaries, whereas in venules the monocyte population outnumbered the erythrocytes. Notable expression of ICAM-1 on endothelial cell surface was detected by immunohistochemistry in vessels with sequestered cells but not in unaffected vessels. These changes are identical to those of the murine model of the disease, in which cell-mediated immune mechanisms and TNF have been implicated. In vitro, ICAM-1 has been shown to be a potential ligand for P. falciparum-infected erythrocytes. In malaria patients, high serum TNF levels, which have been detected in close correlation with disease severity, may thus favor adhesion to endothelial cells of either red or white blood cells via enhanced ICAM-1 expression. The present observations are further evidence for a role of cell-mediated immunity in the pathogenesis of human cerebral malaria.

AIDS-Related Opportunistic Infections↗