Mary Jumbelic

Evaluation of prostatitis in autopsied prostates--is chronic inflammation more associated with benign prostatic hyperplasia or cancer?

PURPOSE Chronic inflammation is associated with prostate cancer and benign prostatic hyperplasia. However, the prevalence of chronic inflammation in malignant and benign glands has not been compared. We evaluated the association of inflammation, benign prostatic hyperplasia and cancer in autopsied prostates. MATERIALS AND METHODS We prospectively analyzed 167 autopsied prostates. Pathological analysis identified each focus of cancer, benign prostatic hyperplasia nodules and areas of acute or chronic inflammation. Any cancer focus or benign prostatic hyperplasia nodule involved directly with inflammation was recorded. The association of the prevalence of prostate cancer, benign prostatic hyperplasia and inflammation was statistically assessed. RESULTS Inflammation was present in 113 (67.6%) of 167 cases. Chronic inflammation was identified in 88 (53%), acute inflammation in 6 (4%), and chronic inflammation and acute inflammation in 19 (11%) glands. In the majority of cases inflammation was present in the transitional zone. A total of 93 glands (56%) were involved with benign prostatic hyperplasia and 49 (29%) with cancer. Of the glands harboring benign prostatic hyperplasia 75% were also involved with chronic inflammation compared to only 50% of those without benign prostatic hyperplasia (p <0.01). Comparatively the glands with or without any evidence of cancer were similarly involved with chronic inflammation (55% vs 58%, p >0.1). Of the 27 glands involved with cancer and benign prostatic hyperplasia, chronic inflammation was more associated with benign prostatic hyperplasia than cancer (p = 0.006). Acute inflammation was not significantly associated with either benign prostatic hyperplasia or cancer. CONCLUSIONS Chronic inflammation was a common finding in autopsied prostates. It appeared to be directly associated with the presence of benign prostatic hyperplasia but not with cancer.

Stun Gun Injuries in the Abuse and Death of a Seven-Month-Old Infant

The author autopsied a seven-month-old infant who was shocked repeatedly with a stun gun by his foster mother, in an attempt by the foster mother to get the infant to stop crying. The stun gun injuries were round, well-circumscribed, erythematous macular lesions, which were found in pairs. The lesions were 2 in. apart, and were found to match the distance between the electrodes of the stun gun found in the foster mothers purse. Based on the electrical output of the stun gun, the small size of the infant, location of stun gun discharge, and the decreased resistance of the infants skin, it can be concluded that the stun gun injury is responsible for the infants death.

Open air carbon monoxide poisoning.

An unusual manner of carbon monoxide poisoning claimed the lives of two adults in two separate incidents. In the first case, a young man was four wheeling in a swampy area when his jeep became stuck in the mud as he continued to floor the accelerator. Carbon monoxide fumes entered the vehicle through the rusted floorboards, killing the driver. In the second case, two teens were skinny dipping behind a motor boat when they became affected by the boat exhaust. One of the youths was overcome and submerged into the lake. Both incidents were initially attributed to incorrect causes--a car accident and a drowning--because of the false notion that carbon monoxide is not a hazard in a ventilated area. The carboxyhemoglobin levels in these victims were 78 and 62% respectively. It was only through laboratory testing that carbon monoxide poisoning was identified as the cause of their demise. Physicians as well as the public need to be aware of the potential for this life threatening hazard to occur so that there can be proper emergency treatment and the prevention of fatalities.

Death by compaction in a garbage truck.

We report on two deaths by compaction in a garbage truck that recently occurred in this county. In both cases, the victim apparently climbed into a recycling dumpster to sleep, and was emptied with the contents of the receptacle into a garbage truck. Subsequent compaction of the victim with the load led to death. We also discuss several similar fatalities that have been reported to the U.S. Consumer Product Safety Commission.