PubMed · 15239573
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Margaret Brazier. 2004. Human tissue retention.. https://doi.org/10.1258/rsmmlj.72.2.39
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BACKGROUND: South Africa has one of the largest miner autopsy databases, PATHAUT, dating back to 1925. The diagnoses recorded on this database have never been evaluated for coal miners. The objective was to determine the validity of the autopsy diagnoses for coal workers, specifically bronchitis, silicosis, tuberculosis, coal workers' pneumoconiosis and emphysema, from 1975 to 1997. METHODS: Three pathologists experienced in miner respiratory pathology conducted the review. They were blinded to employment and medical histories as well as to previous pathological diagnoses on PATHAUT and reviewed 28 coal miners with mixed mining exposures, and 31 cases with exclusive coal mine exposure--all selected randomly. The reviewers' independent and consensus diagnoses were compared to PATHAUT. An additional 31 cases with available whole mount sections were reviewed for the diagnosis of emphysema. Kappa statistics were used to determine degrees of agreement among reviewers and between reviewers and PATHAUT. RESULTS: There was good to excellent agreement between the reviewers and PATHAUT for silicosis, tuberculosis, and pneumoconiosis that had progressed beyond the stage of macules, among the mixed and exclusive coal exposure cases. There was good to excellent inter-reviewer agreement for all diseases except bronchitis (agreement=fair to very good). For emphysema, there was good to very good inter-reviewer agreement but fair agreement with PATHAUT. CONCLUSIONS: This, the first systematic review of PATHAUT autopsy diagnoses made on coal workers, showed that PATHAUT can be used with confidence to establish a diagnosis of moderate to severe grades of coal workers' pneumoconiosis. The grade of emphysema recorded on PATHAUT could be used for epidemiological purposes, when whole mount sections have been prepared.
Parkinson's disease is a continuously progressive degenerative disorder of the central, peripheral and enteric human nervous systems. Not only the substantia nigra, but also a number of other components of the motor and limbic systems, as well as the autonomic regulation, suffer heavy damages. Only a few of the many types of nerve cells in the human central nervous system develop the characteristic Lewy bodies and Lewy neurites. They are composed primarily of aggregated alpha-synuclein and lead to the premature destruction of the affected neurons. Due to the selective neuronal vulnerability, a distinctive distribution of changes occurs within the central nervous system, leading to a corresponding loss of functionality in many systems. The changes occur in an ordered timely fashion. The ascending pathological process begins within the brain at the glossopharyngeal and vagal areas, nearly destroys the substantia nigra, and reaches the mesocortex of the gray matter. From here it expands to further areas of the neocortex, thereby marking the end phase of the disease.
Intracranial invasion by a basal cell carcinoma on the scalp is extremely rare. We present an autopsy case of a 57-year-old woman who developed a large destructive basal cell carcinoma with extension through the calvarium and compression of the dura. We compare 7 similar cases reported in the literature and review the risks for development of these aggressive fatal basal cell carcinomas on the scalp.