Histopathological and ultrastructural changes in opiate-related deaths

This study was carried out to highlight histopathological and ultrastructuralchanges in livers, kidneys and lungs of 35 opiate related fatalities. Thestudy also included a comparative study of ten accidental fatalities ofhealthy subjects served as controls. The study revealed that causes of deathin the selected series of autopsy were opiate intoxication [57%], violence[suicide, homicide or accidental, 17%] and medical complications [26%] aspneumonia and acute renal failure. The mean concentrations of morphine inblood were 20.5 +or- 3.7, 2.8 +or- 0.94 and 3.36 +or- 1.1 ug/dL in the threegroups, respectively. Light microscopic examination of the liver revealedcentrilobular sinusoidal dilatation with thickening of perisinusoidal wall andvenular wall in all cases of opiate abuse. However, in the lung, evidence ofpulmonary edema was observed in 86% of the cases with intraalveolar red bloodcells and birefringent materials and siderophages were present in 93% of thecases. Examination of renal tissue showed histologic signs of toxic acutetubular necrosis in 20% of the cases, while other cases showed evidences ofmembranoproliferative glomerulonephritis. Electron microscopic examination ofliver sections revealed that ultrastructural changes may occur as a result ofeither sinusoidal dilatation secondary to terminal hepatic vein damage or adirect cellular effect of the drug causing perisinusoidal fibrosis

Evaluation of bladder washing and urine cytology in the diagnosis of bladder cancer

The present work was conducted in order to assess the diagnostic accuracy of bladder washing and voided urine cytology in the diagnosis of bladder cancer and to correlate the resulta with the histopathological features of the biopsy specimens taken from the same patients. This series included 75 patients with positive histopathological and clinical data of bladder cancer. They were subjected to clinical, radiological, endoscopic examination with transuretheral biopsy and voided urine and bladder washing for cytological study. The diagnostic accuracy for voided urine and bladder washing cytology in proven bladder cancer were 76% and 92% respectively. False negative resulta were obtained in 24% for cases of voided urine cytology while it was only 8% for cases of bladder washing cytology. High diagnostic accuracy of urine cytology was detected among cases of transitional cell carcinoma. The results of voided urine and bladder washing cytology were related to the histologic grading of the tumours. Higher diagnostic accuracy of urine cytology were detected in grade III than in grade I and II tumours