Funny Rsvps In Spanish

98.-ASTEROID BODIES IN LUNGS FROM DRUG ADDICTS.PROF.GARFIA.A

98.-CUERPOS ASTEROIDS EN DE Pulmon DROGADICTOS VIH +.
PROF.GARFIA.A


98.-ASTEROID BODIES IN LUNGS FROM DRUG ADDICTS VIH +.
PROF.GARFIA.A


98th - Asteroid body in HIV-positive drug addicts .
Prof.Garfia.A








CASE NO 1
Death in custody.
Death in Custody.
Tod in der Haft.


1.-Personal history

man of 37 years, pensioner addicted to drugs and HIV +, treated with antiretrovirals.

Today was also treated with methadone (160 mg), Rohypnol and Trankimazin. At the time of death the subject wore a pillbox with two Trankimazin tablets (2mg), Upjohn Laboratories.
drinker alcohol abuse.


2.-Circumstances of death
was arrested by police the day in question, on the 23 hours in a city in southern Spain. Police said he resisted quietly and that apparently was under the influence of any narcotic substance. He was arrested and locked in a cell receiving a visit from the doctor on duty on 23.30. The police said that the doctor found him asleep, it was not given any assistance. Approximately at 1.30 the next day, went to visit his lawyer that he is kneeling on his bunk and unresponsive to stimuli. Given the situation we apply cardiac massage until the arrival of the doctor on duty, which applies CPR without success.


3.-Medical-Legal Autopsy
was performed legal autopsy, family challenge in order investigate the cause and manner of death.
3.1 Review External
highlighted only, abdominal bruising and abrasions and bruises on both hands. There was a marked facial cyanosis.
3.2 Review Procedure
Brain
congestive and edematous (1250 g). No lesions were detected on the inner surface of the scalp, skull, or brain.
Respiratory
nutritional content on the tracks breathing to tracheal carina.
congestive and edematous lungs (650 g left and right 640 g). Subpleural petechiae.
Heart .-
of 375 g. Gross examination showed patency of the coronary arteries.
rib cage .-
The inside of the ribs were found areas of haemorrhagic infiltration of the intercostal muscles from the 2 nd to 7 th intercostal space on the left side of rib fractures and 4 and 5 right rib, not accompanied by hemorrhage into the area. Rib injuries described do not have projections dermoepidermal or injure internal organs.
Abdomen .-
Liver steatosis, of 2785 g in weight.
Spleen 370 g, congestive cutting.
There were no old or recent injuries in the intestinal loops.
3.3 Analytical postmortem
The alcohol was 2.60g / L. (I ntoxicación acute alcohol, grade: very drunk). The following psychoactive substances were detected in blood samples:
methadone (1.40 mg / L) and its metabolites.
nordiazepam (0.08 mg / L).
in urine was detected traces of Alprazolam, Oxazepam and nordiazepam.
Methadone concentration in blood is within the range of toxic concentrations.


4.-HISTOPATHOLOGY

Brain .-

congestion and brain edema. Discrete perivascular hemorrhage, anoxic white matter of cerebellum.

Heart .-

Of 370 g, post-fixation. Discrete right ventricular hypertrophy and ventricular hypertrophy izuierda hypertensive type. Anterior descending coronary artery and left circumflex had segmental atherosclerotic stenosis, marked or severe degree (75-95% reduction in luminal caliber). Morphological signs compatible with application of a defibrillator in epicardium and endocardium. Numerous expressive red fibers anoxia-ischemia.

Lung .-

massive alveolar edema. Heavy smoker's lung. Pulmonary Granulomatosis addicts.

Liver .-

precirrótica alcoholic liver disease in active phase. Chronic hepatitis type C morphology

Spleen .-

Intense congestion of the pulp roja.Hiperplasia Malpighian corpuscles and the formation of light centers, reagents.

Ribs .-

bleeding of intercostal muscles in the left hemithorax of vital characteristics, attributed to aggressive resuscitation maneuvers cardiopulmonar.Fracturas costal hemithorax rights not characteristics vitality.

Larynx .-

chronic laryngitis. Microinvasive squamous cell carcinoma.

Cause of death .-

Death was attributed to acute alcohol intoxication, and methadone.

Fig.1 .- Lung.

multinucleated giant cells of foreign body type, containing two asteroid bodies.

The asteroid bodies are intracellular inclusions, star-shaped, as described in the cytoplasm of multinucleated giant cells in various granulomatous diseases such as sarcoidosis, tuberculosis, leprosy, schistosomiasis and certain infections Fungal (sporotrichosis Lobomycosis). The size of these inclusions ranges from 5 to about 30 microns. The asteroid bodies may have a star (and own up to 30 peaks or arms), or a spider or umbrella. It is noteworthy that the cytoplasm surrounding the vacuolated asteroid bodies is due to the presence of rounded vacuoles, very uniform size, each of which has an inclusion body in the center. It is believed that these vacuoles contain myelin figures, laminated, which appear to be related to the formation of Schaumann bodies.
course, carefully observing the morphology of the asteroid bodies one realizes that look remarkably the mitotic apparatus of cell division. It is possible that the formation of multinucleated giant cells is done through a process of endomitosis and not by the simple fusion of activated macrophages and that the asteroid bodies constitute an anomaly to the mitotic apparatus (mitotic apparatus "abortion?).
With regard to its composition, it is believed that the asteroid bodies are composed of microtubules and / or microfilaments. However, other authors have found that the asteroid bodies can not be considered mere accumulations of filamentous structures but rather complex structures in which cellular cytoskeletal abnormalities related to ubiquitin, at least in the asteroid bodies were observed in granulomas Silicone-induced (Okamoto et al .- International.Vol.42 Pathology, No. 9.pp. 688-689.1992). Prof. Garfia.A

Fig.2 .- Lung.

seen in the image, at least two multinucleated giant cells. One of them, at the top right, contains an asteroid and three major clusters of open chromatin, active. Below, at 6 the clock, there is another cell in which the cytoplasm has a clear zone, consisting of vacuoles containing an inclusion body, similar to those located in the multinucleated cells seen in the photograph No. 1.

Prof. Garfia.A

Fig 3.-Lung.

seen in the picture three? multinucleated giant cells that do not contain asteroid bodies. However, note how the cytoplasm, especially in the upper cell contains numerous rounded vacuoles, together, inclusion bodies containing plants.

Prof. Garfia.A

CASE No. 2
Accident Death traffic.
Death in car accident.
Autounfall bei Tod.

1.-Personal history

is a male, aged 40, HIV +, addicted to intravenous drugs several years ago. He was treated with antiretrovirals.

2.-Circumstances of death

The man died in hospital from a head injury occurred in a traffic accident. It conducted a medicolegal autopsy investigation the cause and manner of death.

3 .- Autopsy Review

The autopsy described the existence of an epidural hematoma, which had been evacuated in the hospital, and a hematoma contusive subdural and numerous foci in the left temporal lobe.

4.-HISTOPATHOLOGY

were issued the following histopathological diagnoses:

Brain .-

epidural and subdural hematoma of several days duration. Multiple foci of perivascular hemorrhage in the white matter of both temporal lobes.

Liver .-

chronic active hepatitis, type C. morphologically Hepatocyte markers of diabetes (glycogenic nuclei).

Kidneys .-

nephroangiosclerosis moderate. Simple cortical cysts.

Lung .-

chronic lung disease drug.

Pancreas .-

intralobulillar.Trombos Fibrosis fibrin inter-and small venules pancreáticas.Hialinización of pancreatic islets.

Heart .-

stenosing chronic arteriolopathy of severe degree, narco-compatible.

epicardial lesions by application of electric defibrillator.

Fig. 4 .- Lung.

Multinucleated giant cells containing asteroid body located in an area rich in cytoplasmic vacuoles containing a central inclusion body. Nuclei, grouped in the upper pole, arranged in a horseshoe-shaped arms to encompass similar vacuolated material surrounding the asteroid body. Prof.Garfia.A

Figure 5.-Lung

Multinucleated giant cells containing asteroid body in the form of an open umbrella and under it, other training that provides the same staining characteristics as the asteroid but in which only become visible remains of the tips of the star and the material body's core. Note that the cytoplasmic matrix in which are embedded structure presents simpre vacuoles with inclusion material within those. Prof. Garfia.A

Fig.6.-Lung.

of this strange form multinucleated giant cells, elongated and large cytoplasm which is open at both ends, in both observed , with some difficulty, phagocytosed material vacuolated structure with a central inclusion, similar to that makes up the matrix in which lie the asteroids. Note the unusual location of the rows, facing each other, of cores. Prof.Garfia.A

Fig 7.-Pancreas.
showing what appear to be two islets of Langerhans, hyalinized. Prof.Garfia.A

Fig. 8 .- Liver.

Presence glucogenic core, hepatic markers of diabetes (see markers in this Blog). Prof.Garfia.A

Fig 9.-Pancreas
- fibrin thrombus in a small venule pancreas. Prof.Garfia.A

Fig.10 .- Heart.

Banda epicardial band necrosis "hypercontraction" caused by the application of an electric defibrillator (the subject died in the Hospital). There is a clear demarcation between the necrotic myocardial area and the rest of the myocardial parenchyma underlying viable. Prof. Garfia.A

Fig 11.-Heart.

Detail at high magnification, the "power brand" heart by applying electrical defibrillator. Hypercontraction bands stained intensely red with fuchsin trichrome staining, making them readily identifiable (see in this Blog, histopathological markers of electrocution). Prof. Garfia.A

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