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Biomedical subjects

G Rutty

Publications and source records attributed to G Rutty.

13 recordsLinked to original sources
PubMed1999

Information before coronial necropsy: how much should be available?

AIM: To assess the amount and quality of information supplied before undertaking a coroner's necropsy, based on the supposition that insufficient information may adversely affect the quality of the necropsy. METHODS: For a one year period (947 cases), sudden death reports from the coronial jurisdiction of South Yorkshire (West) were audited to assess the quality of information supplied. Seven specific items of information were sought: age, sex, occupation, date of death, location of the body, position of the body, date of last seeing a general practitioner, and relevant medical history. The results from necropsy and non-necropsy cases were compared. RESULTS: Only 22.1% of reports contained all seven items of information. There was no difference between the amount of information supplied in necropsy and non-necropsy cases except about when the general practitioner last saw the deceased. An occupational history was not available in 40.4% of all deaths. CONCLUSIONS: The quality of information supplied to the pathologist before necropsy may be suboptimal and could affect the thoroughness of the necropsy itself.

Autopsy↗
PubMed1999

Intra-alveolar haemorrhage in sudden infant death syndrome: a cause for concern?

BACKGROUND: The "Back to Sleep" campaign in 1991 resulted in a dramatic decrease in the incidence of sudden infant death syndrome (SIDS). The proportion of presumed SIDS deaths being actually suspicious deaths from airway obstruction is likely to have become relatively greater. There is usually little pathological evidence to suggest smothering, but intra-alveolar haemorrhage appears to be more prominent in cases where interference with the airway is suspected. AIM: To attempt to quantify intra-alveolar haemorrhage to see whether it could be used as a marker to distinguish between smothering/overlaying and SIDS. METHODS: Intra-alveolar haemorrhage was quantified using digital image analysis on haematoxylin/eosin stained sections taken from the lungs of 62 consecutive infants who had died suddenly and unexpectedly. Cases were initially classified according to the original cause of death. After quantitation, the case histories were critically reviewed. Three pathologists independently made microscopic assessments of the degree of intra-alveolar haemorrhage in the first 24 cases to see whether these accurately reflected the quantitative results. RESULTS: 73% of those infants with a history suggesting possible involuntary overlaying and 45% of those with a history suspicious of smothering had significant intra-alveolar haemorrhage (> 5% of total lung surface area assessed). From the history, the cause of death in 11 cases initially classified as SIDS would better have been given as "Unascertained." Simple microscopic assessments underestimated the true extent of the haemorrhage in 33% (8/24). CONCLUSIONS: If a moderate degree (at least 5%) of pulmonary parenchymal haemorrhage is observed, this may be an indicator of airway obstruction for a significant period, either from overlaying or possibly smothering. The diagnosis of SIDS may be being used inappropriately in such cases.

Asphyxia↗
PubMed1998

Air weapon fatalities.

AIMS: To describe characteristics of a series of people accidentally and deliberately killed by air powered weapons. METHODS: Five cases of fatal airgun injury were identified by forensic pathologists and histopathologists. The circumstances surrounding the case, radiological examination, and pathological findings are described. The weapon characteristics are also reported. RESULTS: Three of the victims were adult men, one was a 16 year old boy, and one an eight year old child. Four of the airguns were .22 air rifles, the other a .177 air rifle. Two committed suicide, one person shooting himself in the head, the other in the chest. In both cases the guns were fired at contact range. Three of the cases were classified as accidents: in two the pellet penetrated into the head and in one the chest. CONCLUSIONS: One person each year dies from an air powered weapon injury in the United Kingdom. In addition there is considerable morbidity from airgun injuries. Fatalities and injuries are most commonly accidents, but deliberately inflicted injuries occur. Airguns are dangerous weapons when inappropriately handled and should not be considered as toys. Children should not play with airguns unsupervised.

Accidents↗
PubMed1997

D-penicillamine reduces renal injury in the remnant model of chronic renal failure in the rat.

BACKGROUND: Glomerulosclerosis and interstitial fibrosis, which are cardinal features of the end-stage kidney, result from accumulation of extracellular matrix proteins, particularly collagen, in the glomerular mesangium and renal interstitium. This study examined the effect of D-penicillamine (DPC), which inhibits collagen deposition, on disease progression in the remnant kidney. METHODS: Two groups of 10 rats underwent two-thirds nephrectomy and were pair-fed 20% casein paste (Gp 1) or the same paste supplemented with 90 mg/kg body wt per day of DPC (Gp 2). Two further groups of five non-nephrectomized animals also received 20% casein paste either alone (Gp 3) or supplemented with DPC (Gp 4). In a further experiment, systolic blood pressure was compared at 1 and 4 weeks after nephrectomy in eight DPC-treated remnants and eight untreated controls. RESULTS: Gp 2 developed significantly less proteinuria than Gp 1 (41 +/- 9 vs 142 +/- 33 mg/24 h at 6 weeks, P < 0.005; 136 +/- 36 vs 282 +/- 59 mg/24 h at 12 weeks, P < 0.05). At sacrifice after 12 weeks, glomerular filtration rates were higher (1.34 +/- 0.08 vs 1.07 +/- 0.1 ml/min, P < 0.05), kidney total collagen content was lower (14.9 +/- 1.5 vs 26.9 +/- 5.4 mg/kidney, P < 0.05) and glomerular abnormalities, interstitial fibrosis and lymphocytic infiltration were less marked in Gp 2 compared with Gp 1. DPC had no effect on protein excretion, total kidney collagen or GFR in non-nephrectomized rats, and did not influence the early rise in blood pressure seen after two-thirds nephrectomy. CONCLUSIONS: These findings demonstrate that DPC reduces renal injury in the remnant kidney, and raise the possibility of a therapeutic role for DPC in the treatment of patients with chronic renal failure.

Animals↗
PubMed1994

A time sequence of vessel wall changes in an experimental model of angioplasty.

A detailed temporal sequence of vessel wall changes in a rabbit model of balloon angioplasty, to the iliac arteries, at 30 min, 2 h, day 1, day 3, day 7, day 14, 1 month, and 3 months was established using light microscopy, immunostaining for proliferating cell nuclear antigen, and electron microscopy. Complete endothelial denudation with extensive platelet and fibrin deposition was evident early. Intimal thickening, characterized by myointimal hyperplasia, was observed at day 7 and reached a maximum at 1 month. Re-endothelization was complete by day 14. Cellular proliferation, seen early at day 1, reached a maximum at day 7 for the media and day 14 for the intima before returning to baseline levels by 1 month. This simple model of angioplasty with its reproducible myointimal hyperplasia should prove useful for assessing any potential agents for inhibiting this process.

Angioplasty, Balloon↗
PubMed1994

Assessment of myointimal cellular kinetics in a model of angioplasty by means of proliferating cell nuclear antigen expression.

A detailed temporal assessment of cellular proliferation was carried out by means of immunostaining for proliferating cell nuclear antigen in a normolipemic rabbit model of balloon angioplasty to the iliac arteries. Assessment was made at 30 minutes, 2 hours, 1 day, 3 days, 7 days, 14 days, 1 month and 3 months after the procedure. Intimal hyperplasia was first noted at day 3; a prominent layer was formed by day 14. Cellular proliferation in the vessel media was observed as early as day 1 (percentage of positive-staining cells 0.5% +/- 0.2%), reaching a maximum by day 7 (16.9% +/- 5.1%) before returning to baseline levels by 1 month (0.2% +/- 0.02%); in the intima, cellular proliferation was first noted at day 7 (0.7% +/- 0.3%) and reached a maximum at day 14 (4.1% +/- 0.4%) before returning to baseline levels at 1 month (0.3% +/- 0.1%). Use of proliferating cell nuclear antigen expression in this model of angioplasty provided a simple and reproducible method of assessing cellular proliferation after vascular injury and may prove useful for monitoring the effects, in experimental models, of agents for reducing myointimal hyperplasia.

Angioplasty, Balloon↗
PubMed1993

Acquired segmental emphysema: the enlarging spectrum of Swyer-James/Macleod's syndrome.

Three cases of Macleod's syndrome are described, all of which required surgical resections for distressing symptoms. This provided a rare opportunity to examine the pathologic features of a condition that is usually diagnosed on its radiologic features, and the etiology of which remains unestablished. Three patients (2 women and 1 man), aged 20, 23, and 24 years, were referred from respiratory physicians because of unilateral hyperlucent lungs and associated symptoms. All 3 patients had unilateral hyperlucent lungs, but only 1 patient had demonstrable mediastinal shift on expiratory and inspiratory chest computed tomographic scan. Segmentectomies were performed (n = 4) in all the patients without perioperative morbidity or mortality. Patients have been followed up between 6 and 18 months, and remain asymptomatic with a return to normal lifestyle. Histologic examination of the specimens found inflammation of the bronchus in all 3 patients, but only two specimens had evidence of bronchiolar inflammation. In only 1 patient was there a reduction in bronchiole number. All 3 patients showed presence of emphysema. These cases are notable for the segmental distribution of the disease. Pathologic examination lends support to the theory that previous respiratory tract infection may play a role in the pathogenesis of this condition.

Adult↗