Biomedical subjects

Regula Wick

Publications and source records attributed to Regula Wick.

7 recordsLinked to original sources

PubMed2006

Mechanisms of unexpected death and autopsy findings in Leigh syndrome (subacute necrotising encephalomyelopathy).

A 21-year-old previously-well woman who was undergoing medical investigations for problems with balance and suspected multiple sclerosis, developed a headache and breathing difficulties, and died suddenly and unexpected at home. The autopsy was unremarkable except for pulmonary and cerebral oedema. However, subsequent microscopy of the brain revealed characteristic features of Leigh syndrome with multifocal areas of astrogliosis, capillary proliferation, and parenchymal vacuolation. While Leigh syndrome is more commonly diagnosed in infancy, manifestations may occur throughout early life into adulthood. Sudden and unexpected death is a rare presentation that may be associated with cerebral necrosis and oedema. An awareness of the variable manifestations of Leigh syndrome is necessary in forensic practice as not all cases will present in a typical manner and sudden death may occur before a diagnosis has been established. The heritable nature of this condition makes accuracy of diagnosis essential.

Adult↗

PubMed2006

Fatal electrocution in adults--a 30-year study.

A retrospective study was undertaken of all cases of death in adults (>16 years) due to electrocution which were autopsied at Forensic Science SA, Adelaide, Australia, over a 30-year period from 1973 to 2002. A total of 96 cases were identified with 87 males (91%) (mean age=41.6 years; range 17 to 86 years) and nine females (9%) (mean age=49.2 years; range 20 to 76 years). Deaths were due to accidents in 66 cases (69%; M:F = 63:3), suicides in 28 cases (29%; M:F=24:4) and homicides in two cases (2%). Both homicide victims were females, with females accounting for only 5% of the accidents and 14% of suicides. The number of accidental deaths increased until the early 1990s and then declined, whereas suicidal electrocutions were only found in the last 20 years of the study. Most deaths (N = 80; 83%) were due to low voltage circuits (<1000 volts), with deaths due to high voltages occurring in 15 cases (16%). One death was due to lightning (1%). While suicides were evenly distributed throughout the year, most accidental deaths occurred in late spring and summer (N = 42; 64%) with the lowest number of accidental deaths occurring in winter and early spring. This report demonstrates a significantly higher rate of electrocution deaths among males, with a summer predominance of accidental deaths, most likely due to increased outdoor activities in better weather. The reduction in cases over the last decade of the study may be a reflection of the success of workplace and domestic safety campaigns. Female electrocution suicides and electrocution homicides were rare events.

Accidents↗

PubMed2005

Café coronary syndrome-fatal choking on food: an autopsy approach.

To examine the characteristic features of fatal food asphyxia and to develop an autopsy approach to such cases a retrospective study of autopsy files was undertaken at Forensic Science SA (Adelaide, Australia) over a 10 year period from 1993 to 2002 for all cases of food asphyxia/café coronary syndrome. Forty-four cases were identified (M;F=21:23), with one infant (11 mths) and 43 adults (30-96 yrs; mean 68.9 yrs), with a preponderance of victims (57%) aged between 71 and 90 yrs. Deaths occurred in nursing homes (N=22) cases, at home (N=11) and in restaurants (N=4). Twenty-seven of the victims (61%) had histories of neurological or psychiatric disorders such as dementia (N=8), schizophrenia (N=6), Alzheimer disease (N=4), atherosclerotic cerebrovascular disease (N=4), mental impairment (N=2), multiple sclerosis (N=1), Parkinson disease (N=1) and obsessive-compulsive disorder (N=1). Twenty-seven cases (61%) were described as either edentulous or having significant numbers of teeth missing. Toxicological evaluation of blood revealed alcohol and a variety of psychotropic prescription medications in 19 cases. Sudden collapse during or shortly after a meal should always raise the possibility of café coronary and the autopsy examination should not only attempt to demonstrate airway occlusion by a bolus of food, but also to identify or exclude underlying neurological disease. Such cases may raise issues concerning adequacy of care and appropriateness of medication. The diagnosis of café coronary syndrome can only be made with confidence after the clinical history and circumstances of death have been clearly established, impacted material has been demonstrated in the airway at autopsy (or recorded by those attempting resuscitation), risk factors have been identified and other possible causes of death have been excluded.

Adult↗

PubMed2005

Mechanisms of unexpected and/or sudden death in Lafora disease.

A 23-year-old male was found dead wedged between two chairs at his home address. His past history included a diagnosis of Lafora disease (a type of heritable progressive myoclonic epilepsy) at the age of 16 years. This had been characterised by the development of epilepsy and progressive motor impairment and mental deterioration. Diagnosis had been confirmed by demonstration of mutation in the EPM2A gene on chromosome 6q24. At autopsy, petechial haemorrhages were noted of the face and conjunctivae bilaterally. There were no other significant findings apart from gastric contents within the airways. Death was attributed to positional asphyxia complicated by aspiration of gastric contents. Although death in Lafora disease is usually predictable and often protracted, sudden and/or unexpected death may occur and involve status epilepticus, sudden unexpected epileptic death, choking, aspiration of gastric contents, and cardiac arrhythmias. In addition, the possibility exists of unnatural causes of death, such as accidents, provoked by epilepsy or physical inability of the victims to extricate themselves from dangerous situations, or homicides, provoked by difficulties in caring for individuals with significant and progressive disabilities.

Adult↗

PubMed2005

The pathological features and circumstances of death of lethal crush/traumatic asphyxia in adults--a 25-year study.

A 25-year retrospective study of cases of crush/traumatic asphyxia autopsied at Forensic Science SA, Adelaide, Australia from 1980 to 2004 was undertaken. A total of 79 cases of crush asphyxia was found consisting of 63 males (80%) and 16 females (20%). The age range of the males was 19-86 years (mean=41.8 years) and of the females was 19-75 years (mean=38.6 years). In 18 cases the exact circumstances of death were unclear, leaving 61 cases in which details of the fatal episode were available. Major categories included vehicle crashes (N=37), industrial accidents (N=9), farm accidents (N=6) and entrapment beneath vehicles (N=5). Forty of the 79 victims (51%) had only very minor bruises and abrasions; 28 (35%) had evidence of chest compression with rib and sternal fractures and large areas of soft tissue bruising of the chest; 7 cases (9%) had other significant injuries or findings that had contributed to death. All of these victims had signs of crush asphyxia in the form of intense purple congestion and swelling of the face and neck, and/or petechial hemorrhages of the skin of the face and/or conjunctivae. The pattern of pathological findings of crush asphyxia was not influenced by the presence or absence of concomitant serious or lethal injuries. In 4 cases (5%) where the circumstances of the lethal episode were those of crush asphyxia there were no characteristic pathological findings. This study has shown that a high percentage of crush asphyxias may be caused by vehicle accidents. It has also demonstrated that on occasion fatal crush asphyxia may have to be a diagnosis of exclusion, made only when there are characteristic death scene findings, and no evidence of lethal natural diseases or injuries at autopsy, with negative toxicological screening.

Adult↗

PubMed2002

Ultrastructural changes in the uterine luminal and glandular epithelium during the oestrous cycle of the marsupial Monodelphis domestica (grey short-tailed opossum).

Ultrastructural changes in the endometrium associated with the oestrous cycle were studied in the South American marsupial Monodelphis domestica. The most conspicuous changes include the height and the differentiation of the uterine luminal and glandular epithelium, which consists of ciliated and non-ciliated cells. The glandular epithelium attains its maximum development during oestrus, the luminal epithelium at postoestrus. A distinct increase in the number of ciliated cells can be observed during pro-oestrus, reaching a maximum number at oestrus; this is followed by a process of deciliation. The presence of solitary cilia on the apices of non-ciliated cells is very conspicuous during all oestrous stages and can best be seen on the luminal epithelium. These findings differ from the observations in eutherian mammals, where solitary cilia are only found in the immature uterus or after ovariectomy. The secretory activity of non-ciliated cells of the luminal epithelium is hardly noticeable along the apical membrane and stains only very faintly with Alcian blue. The glandular epithelium cells are filled apically with exocytotic vesicles at oestrus and early postoestrus. However, in contrast to the cervical gland cells, they hardly stain with Alcian blue, indicating that mucins of a different type must be present. Mechanisms for the remodelling of the luminal and glandular epithelium are especially conspicuous at metoestrus and early pro-oestrus and include the presence of autolysosomes, residual bodies and apoptotic bodies. In the endometrial stroma, around the uterine glands, macrophages accumulate and attain a typical oestrous stage-dependent appearance during their phagocytotic activities.

Animals↗

PubMed2002

Ultrastructural changes in the cervical epithelium during the estrous cycle of the marsupial Monodelphis domestica (grey short-tailed opossum).

Ultrastructural changes in the cervical epithelium related to the estrous cycle have been studied in the South American marsupial Monodelphis domestica. The two cervices protrude with prominent papillae into the sinus vaginalis. At times of simple columnar at others of more pseudostratified character consists of two types of cells, ciliated and secretory cells. The mucosal epithelium is uniform in its entire length and shows no division into an endo- and ectocervix. The mucosa of the cervix differs from the uterine endometrium. There are no glandular structures, but the luminal epithelium shows deep invaginations underlined by dense connective tissue. The most conspicuous changes include the height and the differentiation of the cervical epithelium which attains its maximum development during estrus, where secretory cells are fully packed with large secretory granules and ciliated cells are well developed. After extruding their granules, secretory cells may transform into ciliated cells, while ciliated cells show the phenomenon of deciliation in which cilia packets are shed into the cervical lumen. This transformation process takes place mainly during post- and metestrus. The presence of solitary cilia is only noticeable during pro-estrus, being in contrast to the uterine epithelium where they appear during the whole estrous cycle.

Animals↗