Bülent Eren

Occult papillary thyroid carcinoma: prevalence at autopsy in Turkish people.

The epidemiological features of occult papillary thyroid carcinoma (OPTC) at autopsy have not previously been reported in Turkish people. This study provides data on the prevalence of OPTC in people from the Marmara region in Turkey. The study includes thyroid glands from 93 male and 15 female cadavers between 18 and 80 years of age. The thyroid glands were removed, fixed and sectioned at 2-mm intervals. The sections were stained with hematoxylin and eosin, and were examined by a single pathologist. A total of 108 thyroid glands were examined. Macroscopic lesions were found in 36 (33.3%) glands (95% confidence interval=24–42). OPTC was found in four (3.7%) cases (95% confidence interval=1.0–7.5). It was concluded that in the Turkish people from the Marmara region, the prevalence of OPTC found at autopsy was relatively low. No age or sex predilection was detected.

An analysis of carbon monoxide poisoning cases in Bursa, Turkey

Carbon monoxide (CO) poisoning from coal and gas heaters is a public health concern in Turkey. This study estimated the prevalence, mortality rate and clinical predictors of severity of CO poisoning cases treated at the emergency unit of the Uludağ University Medical School, Bursa from 1996 to 2006. Of 305 patients treated over a 10-year period, only 1 case was recorded as suicide. The CO source was a coal heater in 85.9% of cases. Mean Glasgow coma score (GCS) on admission was 12.8 (SD 0.2) and mean carboxyhaemoglobin level was 21.6% (SD 0.92%). There were statistically significant associations between higher GCS score, older age and higher HbCO level. Better education of the public is vital for the prevention of these injuries.

An unusual cause of sudden death : Cardiac myxoma

Primary tumors of the heart are rare; the most common cardiac tumor is atrial myxoma. Sudden death may occur in patients with atrial myxoma, tumor embolization, or obstruction of blood flow at the mitral or tricuspid valve. This report describes an unusual cause of sudden death and the autopsy findings for a 73-year-old man with left atrial myxoma.

Helicobacter pylori infection and skin disorders.

Helicobacter pylori is a Gram-negative bacterium that has been linked to peptic ulcer disease, gastric lymphoma, and gastric carcinoma. Apart from its well-demonstrated role in gastroduodenal diseases, some authors have suggested a potential role of Helicobacter pylori infection in several extra-intestinal pathologies including haematological, cardiovascular, neurological, metabolic, autoimmune, and dermatological diseases. Some studies suggest an association between Helicobacter pylori infection and skin diseases such as chronic idiopathic urticaria and rosacea. There have also been few case reports documenting association between Helicobacter pylori and psoriasis vulgaris, Behçets disease, alopecia areata, Henoch-Schönlein purpura, and Sweets syndrome. However, more systematic studies are required to clarify the proposed association between Helicobacter pylori and skin diseases; most of the studies do not show relevant relationships of these diseases with Helicobacter pylori infections. This review discusses skin diseases that are believed to be associated with Helicobacter pylori.

Age-related changes in the rat hippocampus.

The human brain is uniquely powerful in its cognitive abilities, yet the hippocampal and neocortical circuits that mediate these complex functions are highly vulnerable during aging. In this study, we analyzed age-related changes in the rat hippocampus by studying newborn (1 month), middle-aged (12 months), and older (24 months) male and female Sprague-Dawley rats. We evaluated neuronal dystrophy, neuron scattering, and granulovacuolar degeneration in the hippocampal area using light microscopy, according to age and gender. We detected significant neuronal dystrophy in the CA1, CA2, and CA3 areas in male rats, and in the CA1, CA3, and CA4 areas in female rats. Degenerative changes, indicated by neuron scattering, were observed in the CA1, CA2, and CA3 areas of male and the CA2 and CA4 areas of female rats. Changes in all areas of the hippocampus were observed with increasing age; these changes included neuronal dystrophy and neuron scattering and did not differ significantly between male and female rats.

Fatal Methanol Ingestion in a Child: Case Report

The records of Forensic Medicine Council of Turkey Bursa Morgue Department reveal the first case of fatal methanol ingestion in a child. Household methanol exposures are mostly due to accidental ingestion of washing fluids. A 4 year-old girl was admitted to the emergency department with her parents with gastrointestinal symptoms; nausea, vomiting and abdominal pain. Toxicological studies revealed 79 mg/dl blood level of methanol. We presented infant autopsy case of methanol toxicity and discussed the case from medicolegal aspect.

The Significance of Hemosiderin Deposition in the Lungs and Organs of the Mononucleated Macrophage Resorption System in Infants and Children

Hemosiderin deposition is not often recognized on routine examination with hematoxylin and eosin staining; however, iron stains may be helpful in the evaluation of hemosiderin deposition in infant autopsies. This report describes the data obtained from autopsy of 86 infants and children whose deaths were investigated at the Forensic Medicine Council Bursa Morgue Department from January 2000 to January 2003. A histochemical technique was used to identify hemosiderin in lung, liver and spleen specimens, which was correlated with other descriptive variables such as the reported cause of death, postmortem interval, trauma history, gender, and age. There was a weakly positive but significant correlation between lung and liver hemosiderin scores (Spearmans rank correlation coefficient, rho=0.348, p=0.001); i.e., given an increase in lung hemosiderin scores, an increase in liver hemosiderin scores was also observed. Similarly, a marked positive correlation between spleen and liver hemosiderin scores (Spearmans rank correlation coefficient, rho=0.335, p=0.002) was observed. The probability of spleen hemosiderin-positive cases belonging to the age group under 6 months was found to be 4.3 times greater than those who were hemosiderin-negative (95% confidence interval, 1.6-11.8). After the major differential diagnoses were ruled out, this study demonstrated, that depending on the statistically assessed morphometric grounds, the presence of hemosiderin deposits in the liver and spleen were significantly higher in the age group under 6 months.

Myocardial bridging as a possible cause of unexplained sudden death: A case report

A 35-year-old man was found dead on the road by the police patrol. As the cause of his death was unknown, a forensic autopsy was performed in the morgue department. No traumatic change was detected on external or internal examination. Macroscopic investigation of the heart revealed a 2.2 cm extension of the left anterior descending coronary artery embedded in the myocardium 1 cm from its origin; a 1–1.2 cm superficial myocardial bridge overlying the left anterior descending coronary artery was detected. Histological examination of the heart revealed no evidence of acute or chronic ischemia, only mild hypertrophy was detected. We reported that myocardial bridging could be a cause of unexplained sudden death in the presented case.

Fatal Blunt Trauma of the Larynx in a Child

We report an autopsy case of an 11-year-old girl who suffered mechanical asphyxia from falling off the metal bars in the playground. This autopsy case is interesting because of the atypical trauma and lesions. To our knowledge there has been no similiar published case reports in the forensic literature. The young age of the victim, the setting and the pattern of the injuries are rare in a fall at playground by a child.

The Role of ADAMTS1 and Versican in Human Myocardial Infarction: A Postmortem Study

OBJECTIVE To determine the role of a disintegrin and metalloproteinase with thrombospondin type 1 motif (ADAMTS1) and fragmented versican in the myocardial infarction (MI) process in humans and to evaluate the diagnostic efficacy of ADAMTS1 for postmortem diagnosis of MI. METHODS Thirty autopsied individuals were allocated into 2 groups, namely, a study group of individuals who died of myocardial infarction (n = 20), and a control group who died of trauma (n = 10). We performed standard immunohistochemical staining on myocardial tissue specimens, studying anti-ADAMTS1, anti-versican, and anti-versican C terminal peptide sequence (DPEAAE) fragments. RESULTS Strong, diffuse staining was observed throughout myocardial tissue for ADAMTS1 in the 2 groups. However, in the study group, we observed no expression for ADAMTS1 around fibrotic areas but detected slight staining in coagulative and necrotic zones. CONCLUSION Similar localizations of ADAMTS and fragmented versican in human heart tissue indicate that versican presumably is cleaved by ADAMTS1. Hence, ADAMTS1 can be regarded as a new marker for postmortem differential diagnosis of MI.