Biomedical subjects

T S Corey

Publications and source records attributed to T S Corey.

7 recordsLinked to original sources

PubMed1992

Interleukin 2 acutely induces platelet and neutrophil-endothelial adherence and macromolecular leakage.

The acute effects of interleukin 2 (IL-2) were determined in the rat cremaster microcirculation model by intravital, light, and electron microscopy to better understand the pathophysiology of the IL-2-induced vascular leak syndrome. Four groups of rats were studied over a 2-h monitoring period. One group received 1 x 10(6) units of IL-2/kg i.v. (n = 10), while the remaining groups received IL-2 topically applied to the cremaster muscle in dosages of either 1 x 10(5) (n = 9), 1 x 10(6) (n = 5), or 3 x 10(6) (n = 5) units. Each group was compared with controls (n = 9). IL-2 administered i.v. acutely induced platelet and polymorphonuclear leukocyte-endothelial adherence and microvascular macromolecular leakage that occurred synchronous with the development of tachycardia, hypotension, tachypnea, and hypoxemia. Topically applied IL-2 induced similar microvascular alterations but without changes in hemodynamic and respiratory parameters, which suggests that microvascular alterations were not caused by IL-2-induced changes in hemodynamic parameters. Electron microscopy of cremaster muscle sections demonstrated platelet and neutrophil adherence to the endothelium and endothelial injury. We conclude that IL-2 (or a locally generated mediator) acutely induces platelet and neutrophil-endothelial adherence in the rat skeletal muscle microcirculation that is associated with the development of macromolecular leakage from the microcirculation.

Administration, Topical↗

PubMed1992

Infant deaths due to unintentional injury. An 11-year autopsy review.

OBJECTIVE: The number and causes of unintentional infant deaths were determined to identify common, preventable infant deaths. DESIGN: Retrospective autopsy review. SUBJECTS: Infants aged 1 day to 1 year undergoing complete autopsies. SETTING: Autopsies performed by the Louisville Office of the Kentucky Medical Examiner's Program from 1979 through 1989. METHOD: The manner of death was designated as an "accident" based on review of autopsy findings, scene investigation, and investigation by law enforcement officials. The cases were divided into groups based on the nature of the unintentional injury. RESULTS: Causes of death included asphyxia in mechanically unsafe sleeping environments, overlying, drowning, scald burns, plastic bag suffocation, house fires, motor vehicle collisions, aspiration of foreign bodies, hypothermia, blunt head trauma, and alcohol toxicity. The largest group of deaths in this series resulted from mechanically unsafe sleeping environments. CONCLUSIONS: The majority of deaths in this series could have been prevented by minor changes in the household environment. The causes of fatal unintentional injury to infants are different from those in older children. Pediatricians should be aware of hazards unique to this age group.

Autopsy↗

PubMed1992

Unnatural deaths in nursing home patients.

Nursing home residents comprise a large and rapidly growing segment of the national population. Despite this fact, the majority of deaths occurring in nursing homes are not investigated because of the significant medical illnesses suffered by most residents. Herein, we report a series of unnatural deaths in nursing home residents, including two homicides and seven accidental deaths. In four of the deaths, there was an attempted concealment of the cause and manner of death. Fearing criminal or civil proceedings, nursing home personnel may attempt to conceal homicidal or accidental deaths in nursing home residents. Because of the serious, chronic illnesses suffered by these patients, attending physicians are often willing to sign death certificates without personally investigating the circumstances surrounding the patient's demise. The authors contend that unnatural deaths of nursing home patients are significantly underreported. Attending physicians and death investigators should be urged to investigate more fully sudden deaths in nursing home patients.

Accidents↗

PubMed1990

In the shadow of the Baron: sudden death due to Munchausen syndrome.

The authors describe a woman who died suddenly in an emergency department restroom after self-injection of corn starch in an attempt to gain admission to the hospital. At autopsy, multiple pulmonary vascular corn starch granulomata were identified, as well as pulmonary arteries filled with brewer's yeast. Retrospective evaluation of the patient's medical history showed multiple signs of Munchausen Syndrome. The authors suggest that the case illustrates the importance of scene investigation and review of the medical history by emergency department personnel and the forensic pathologist.

Adult↗

PubMed1990

Nonfracture-associated fatal fat embolism in a case of child abuse.

Fatal fat embolism is usually thought of as a sequel to long-bone fracture, although cases secondary to soft tissue injury and atraumatic conditions have been infrequently reported. In this case of a two-year-old child-abuse victim who sustained multiple blunt traumatic injuries without skeletal fractures, pulmonary and systemic (brain and kidney) fat emboli were identified. At autopsy, all thoracic and abdominal viscera were intact; cranial contents exhibited only diffuse symmetrical petechial hemorrhages of the white matter. Because of the severe and widespread nature of soft tissue hemorrhage, and the absence of a grossly discernible cause of death, fat embolism was suspected. Using a combination of frozen section with oil red O staining and formalin-fixed osmium stained tissues, the immediate cause of death was determined to be diffuse fat embolism. Review of the literature reveals a pathophysiologic basis for fat embolism in the absence of fracture, both as a consequence of an acute increase in local pressure at the site of trauma and an alteration of the emulsification of blood lipids during shock. In light of these findings, we present this case to remind the forensic science community to consider fat embolism as the cause of death in cases of blunt-force injury without fracture.

Cause of Death↗

PubMed1989

Postoperative percutaneous choledochoscopy.

Postoperative percutaneous choledochoscopy (PC) is becoming an important aid to surgeons in the diagnosis and treatment of complex biliary tract disease. The authors retrospectively examined the results of 27 PCs performed on 22 patients at the University of Louisville Affiliated Hospitals from 1980 to 1987. Indications for PC included: suspected choledocholithiasis stricture, sclerosing cholangitis, and cholangiocarcinoma. The biliary tree was accessed through a T-tube tract in 18 patients, and through a biliary-enterocutaneous fistula in four patients. The patient population included 11 men and 11 women with a mean age of 62 years. T-tubes varied in size from #16F to #24F. The time allowed for T-tube tract maturation ranged from four weeks to five months. Percutaneous choledochoscopy was performed 16 times in 13 patients for possible choledocholithiasis. Stones were present in 13, and 11 of 13 attempted extractions were successful. Two patients underwent PC for stent placement. Nine procedures were performed on eight patients to obtain biopsies or to evaluate possible strictures. Four studies were normal, two patients had sclerosing cholangitis, one had a stricture of the Sphincter of Oddi, and one patient had benign ductal tissue on biopsy after an iridium implantation for cholangiocarcinoma. Two minor complications occurred in this series. The authors conclude that by using PC the surgeon may safely manage complicated biliary problems and avoid re-operation in selected cases.

Adult↗

PubMed1988

Effect of photodynamic therapy on blood flow in normal and tumor vessels.

The aim of this series of experiments was to determine the dynamic blood flow changes that occur in normal and neoplastic tissues during photodynamic therapy. Mice bearing SMT-F tumors and rats with transplanted chondrosarcomas were injected with graded doses of dihematoporphyrin ether. Studies of changes in single-vessel and whole-tumor blood flow were carried out with 630 nm light activation. A helium neon laser Doppler velocimeter was used to stimulate dihematoporphyrin ether, as well as to measure changes in flow velocity in both single-vessel and whole-tumor models. There was a reduction of flow velocity in all vessels and tumors in animals injected with 1 to 40 mg/kg dihematoporphyrin ether intraperitoneally. The extent of flow reduction was related to drug dose administered. Decreases in blood flow began within 10 seconds of light stimulation and were maximal within 5 minutes. Both normal and tumor vessels responded similarly. We conclude that photodynamic therapy leads to significant microcirculatory changes that may be pertinent to the mechanism of tumor necrosis.

Animals↗