Use of Autopsy to Determine Live or Stillbirth: New Approaches in Decision-support Systems.

Fetal deaths are important cases for forensic medicine, as well as for criminal and civil law. From a legal perspective, the determination of whether a deceased infant was stillborn is a difficult process. Such a determination is generally made during autopsy; however, no standardized procedures for this determination exist. Therefore, new facilitative approaches are needed. In this study, three new support systems based on 10 autopsy parameters were tested for their ability to correctly determine whether deceased infants were alive or stillborn. Performances were analyzed and compared with one another. The artificial neural networks and radial basis function network models had 90% accuracy (the highest among the models tested), 100% sensitivity, and 83.3% specificity. Thus, the models presented here provide additional insights for future studies concerning infant autopsies.

Autopsy evaluation of coal mining deaths in the city of Zonguldak, Turkey.

BACKGROUND: In this study, our aim was to evaluate the fatal occupational accidents that occurred in Zonguldak coal mines between the years 2005-2008. MATERIAL AND METHODS: We retrospectively evaluated 42 fatal coal mine occupational accidents in Zonguldak (Turkey) between the years 2005-2008. The forensic records of autopsies referred to the chief prosecutors' office during 2005-2008 were reviewed retrospectively. There were 42 cases. The cases were evaluated with respect to age, mechanism of injury, body region of wound, cause of death, and legality of the mine. RESULTS: Ages of the deceased ranged between 17 and 52 (median: 32.9 yrs). Deaths were mostly in the 21-30 (35.8%), and 31-40 (30.9%) age groups. Only 1 case was younger than 18 years of age. Review of occupational fatalities has revealed that fatal accidents occurred mostly (76.2%) in the private, and fewer (23.8%) in the public mining enterprises. Crime scene investigation findings have demonstrated that of all occupational deaths (total n=42), 27 (64.3%) were due to subsidence, followed by methane gas poisoning (n=6, 14.2%), tram crash (n=3, 7.1%), log falls (n=2, 4.8%), electrocution (n=2, 4.8%), and methane explosion (n=2, 4.8%). CONCLUSIONS: Despite laws and regulations concerning mining and because of problems in their implementation, Turkey leads the world in work-related accidents, occupational injuries, and deaths. Evaluation of autopsy findings of deaths in fatal occupational accidents occurring in coal mines is quite important in planning to decrease rates of occupational fatalities.

Acute effects of moderate and strenuous running on trace element distribution in the brain, liver, and spleen of trained rats.

OBJECTIVE: Trace elements such as manganese (Mn), cobalt (Co) and chromium (Cr) play key roles in metabolic reactions and are important in many physiological enzymatic processes. In this study, we aimed to investigate the acute effects of moderate and strenuous running (treadmill) exercise on the levels of Mn, Co and Cr in the brain, liver, and spleen of trained rats. STUDY DESIGN: Animal experiment. MATERIAL AND METHODS: Twenty-one Wistar-Albino adult male rats were used in the study. Rats were grouped as control group (no mandated exercise; n=8), moderate exercise group (30 min exercise duration; n=7), and strenuous exercise group (60 min exercise duration; n=6). The levels of Mn, Co, and Cr in the frontal lobe, temporal lobe, brain stem, liver, and spleen were determined by atomic absorption spectrophotometer. RESULTS: Cr levels in liver of rats increased in parallel to the time course of running supporting the exercise training effect on the action of insulin. Compared to the control group, the level of Co significantly decreased in the brain stem of rats in the moderate exercise group (p=0.009) and in the frontal lobe of rats in the strenuous exercise group (p=0.004). In the strenuous exercise group, an examination of the brain stem revealed that the level of Mn significantly decreased (p=0.001), and levels of Co and Cr were apparently depleted to the extent that these elements were no longer detectable. CONCLUSION: A notable finding is that during or after single bout strenuous exercise, levels of Co decreased in the spleen and particularly decreased in the brain stem of regularly trained rats. From this study, it can be inferred that sportsmen should aware trace element disturbances among the body parts or depletion of some trace elements after single bout of chronic strenuous running exercise.

Endogenous ADP-ribosylation of eukaryotic elongation factor 2 and its 32 kDa tryptic fragment.

Eukaryotic elongation factor 2 (eEF-2) can undergo ADP-ribosylation in the absence of diphtheria toxin. The binding of free ADP-ribose and endogenous transferase-dependent ADP-ribosylation were distinct reactions for eEF-2, as indicated by different findings. Incubation of eEF-2 tryptic fragment 32/33 kDa (32F) with NAD was ADP-ribosylated and gave rise to the covalent binding of ADP-ribose to eEF-2. 32F was revealed to be at the C-terminal by Edman degradation sequence analysis. In our study, the elution of 32F from SDS-PAGE was ADP-ribosylated both in the presence and absence of diphtheria toxin. These results suggest that endogenous ADP-ribosylation of 32F might be related to protein synthesis. This modification appears to be important for the cell function.

A novel application of Fourier-transformed infrared spectroscopy: classification of slime from staphylococci.

It has been proposed that the virulence of nosocomial Staphylococcus infections associated with indwelling medical devices is related to the ability of the bacterium to colonise these materials by forming a biofilm composed of multilayered cell clusters embedded in a slime matrix. However, the pathogenic role of exopolysaccharide biofilms is not fully understood. A new method was sought for differentiating the structure of slime from two closely related bacterial strains, Staphylococcus aureus and Staphylococcus epidermidis. Using PCR it was confirmed that these strains were positive for the icaA and icaD genes and the complete ica operon (2.7 kb). Monosaccharide analysis by thin-layer chromatography revealed an identical profile for both strains, with xylose and glucose present among the four visible bands. Using Fourier-transformed infrared spectroscopy and hierarchical cluster analysis, three of four S. aureus samples (75%), and four of five S. epidermidis samples were grouped according to species. A novel FTIR approach in classifying slime produced by S. aureus and S. epidermidis is reported.

Evaluation of disseminated candidiasis on an experimental animal model: a fourier transform infrared study.

Invasive candidiasis, defined as candidemia and disseminated candidiasis, is the most common fungal infection in hospitalized patients. In the current study, we used Fourier transform infrared (FT-IR) spectroscopy as a rapid, non-perturbing technique to investigate the effects of disseminated candidiasis on mouse liver tissues at the molecular level. The results revealed that the infection caused compositional changes in the tissues by decreasing the lipid content and the ratio of the saturated lipids to unsaturated lipids. An increase in the lipid/protein ratio was also observed. In addition, investigation of the olefinic band at 3014 cm(-1) showed that lipid peroxidation took place in the infected samples. These results indicate that FT-IR spectroscopy is a promising technique for the evaluation and diagnosis of disseminated candidiasis.

Concentrations of toxic metals and trace elements in the meconium of newborns from an industrial city.

OBJECTIVE: To investigate fetal exposure to toxic metals [lead (Pb), cadmium (Cd)] and fetal levels of trace elements [zinc (Zn), copper (Cu), and iron (Fe)] in newborns from an industrial city. Relationships between meconium mineral contents and parental occupation and location of residence were also tested. METHOD: The meconium mineral contents of 117 healthy newborn infants were measured by flame atomic absorption spectrophotometer. RESULTS: The median concentrations (interquartile range) of toxic metals and trace elements in the meconium were as follows: Pb: 46.5 (1,399) microg/g dry weight (wt), Cd: 2.3 (55.6) microg/g dry wt; Zn: 234 (3,049) microg/g dry wt; Cu: 11.8 (818.7) microg/g dry wt, and Fe 105 (2,980) microg/g dry wt. All the meconium samples contained both toxic metals and trace elements. The proportions of trace elements in the meconium samples with concentration higher than 100 microg/g dry wt of the substances tested were Zn 90%, Cu 64%, and Fe 53%. There were significantly positive correlations between the concentrations of toxic metals and trace elements. Also there were positive correlations between the levels of Zn, Fe, and parental occupations, and between the level of Fe and location of residence of the parents (proximity to the petroleum refinery or the dye industries). CONCLUSION: All the meconium samples were positive for toxic metals, and thus may reflect environmental pollution in the city. The occupation environments and the location of the family residence are linked with levels of trace elements in meconium.

Endogenous ADP-ribosylation for eukaryotic elongation factor 2: evidence of two different sites and reactions.

Eukaryotic elongation factor 2 can undergo ADP-ribosylation in the absence of diphtheria toxin under the action of an endogenous transferase. The investigation which aimed to gain insight into the nature of endogenous ADP-ribosylation revealed that this reaction may be, in some cases, due to covalent binding of free ADP-ribose to elongation factor 2. Binding of free ADP-ribose, and NAD- and endogenous transferase-dependent ADP-ribosylation were suggested to be distinct reactions by different findings. Free ADP-ribose could bind to elongation factor 2 previously subjected to ADP-ribosylation by diphtheria toxin or endogenous transferase. The binding of free ADP-ribose was inhibited by neutral NH2OH, L-lysine and picrylsulfonate, whereas endogenous ADP-ribosyltransferase was inhibited by NAD glycohydrolase inhibitors and L-arginine. The ADP-ribosyl-elongation factor 2 adduct which formed upon binding of free ADP-ribose was resistant to neutral NH2OH, but decomposed almost completely upon treatment with NaOH. The product of endogenous transferase-dependent ADP- ribosylation was partially resistant to NH2OH and NaOH treatment. Moreover, this reaction was reversed in the presence of diphtheria toxin and nicotinamide. Both types of endogenous ADP-ribosylation gave rise to inhibition of polyphenylalanine synthesis. This study thus provides evidence for the presence of two different types of endogenous ADP-ribosylation of eukaryotic elongation factor 2. The respective sites involved in these reactions are distinct from one another as well as from diphthamide, the site of attack by diphtheria toxin.

Genetic and enzymatic properties of metallo-beta-lactamase VIM-5 from a clinical isolate of Enterobacter cloacae.

A VIM-5-producing Enterobacter cloacae isolate (EDV/1) was identified in a collection of clinical strains stored before 2002. The gene, bla(VIM-5), was located on a 2,712-bp BamHI-HindIII fragment of a 23-kbp (approximately) nonconjugative plasmid (pEDV5) in a class 1 integron as a single gene cassette.

Effect of carbapenems on the transcriptional expression of the oprD, oprM and oprN genes in Pseudomonas aeruginosa.

The effects of imipenem and meropenem on the transcriptional expression of resistance-related genes oprD, oprM and oprN in Pseudomonas aeruginosa were studied by quantitative real-time PCR. Four strains were examined: the type strain PT5 (PAO1), its derivatives M7 and PT149, and a clinical isolate, PaKT3. The derivative M7 is a nalB mutant, overexpressing the MexAB-OprM pump, and the derivative PT149 is a nfxC-type mutant, overexpressing the MexEF-OprN pump while it is down-regulated for the OprD protein. After 18 h incubation in broth, the cultures were divided into three portions. Two were supplemented with antibiotics and the other was left antibiotic-free as the control. After a further 45 min incubation, total RNA was isolated from the strains by guanidine denaturation and acid-phenol/chloroform extraction. DNA-free total RNAs were immediately reverse-transcribed by MMuLV reverse transcriptase. Concentrations of mRNAs obtained by quantitative PCR were expressed relative to uninduced portions of the strains. The results showed that oprD was relatively stable against carbapenem antibiotics. oprM was induced significantly by imipenem in only one strain and oprN was induced by imipenem in most of the strains. The responses at the mRNA level found here were unexpected and suggested a chaotic, unpredictable regulatory mechanism.

Plasma lipid and lipoprotein concentrations in pregnancy induced hypertension.

OBJECTIVES: Aim of this study was to evaluate implication of pregnancy induced hypertension on maternal plasma lipid, lipoprotein, apolipoprotein concentrations and lipid peroxidation products by a comparison of normal pregnancy vs. preeclampsia. DESIGN AND METHODS: Thirty-four women with preeclampsia and 32 healthy pregnant women (controls) in the third trimester were recruited for this study. RESULTS: In the preeclamptic group plasma total triglyceride, low density lipoprotein cholesterol (LDL-C), malondialdehyde (MDA) and apolipoprotein B (apo-B) were significantly increased, while plasma high density lipoprotein cholesterol (HDL-C) was significantly decreased compared to that of control group. There was no significant difference in total cholesterol and apolipoprotein A1 (apo-A1) concentrations. CONCLUSION: Our findings suggest that preeclampsia share some metabolic characteristics with coronary artery disease such as dislipidemia and increased lipid peroxidation. However lipoprotein concentrations may be better biochemical markers of dislipidemia in the preeclamptic state than the corresponding apolipoproteins.