Maximum intensity projection of cranial computed tomography data for dental identification

Dental radiographs play the major role in the identification of victims in mass casualties besides DNA. Under circumstances such as those caused by the recent tsunami in Asia, it is nearly impossible to document the entire dentition using conventional x-rays as it would be too time consuming. Multislice computed tomography can be used to scan the dentition of a deceased within minutes, and the postprocessing software allows visualization of the data adapted to every possible antemortem x-ray for identification. We introduce the maximum intensity projection of cranial computed tomography data for the purpose of dental identification exemplarily in a case of a burned corpse. As transportable CT scanners already exist, these could be used to support the disaster victim identification teams in the fiel

Fatal scuba diving incident with massive gas embolism in cerebral and spinal arteries

CT and MRI have the potential to become useful adjuncts to forensic autopsy in the near future. The examination of fatal injuries facilitates a profound experience in the clinical-radiological examination of these cases; the more severe findings in corpses with autopsy verification can help one to understand the tiny signs seen in clinical cases of surviving victims. We present the case of a 44-year-old male diver who died from severe decompression sickness after rapid ascent from approximately 120m. Post-mortem CT and MRI studies of the brain and spinal cord revealed extensive gas inclusions in cerebral arteries, spinal arteries and cerebrospinal fluid (CSF) spaces, while the intracranial venous sinuses remained unaffected. These findings were confirmed at autopsy. Appropriate imaging techniques can help forensic pathologists to aim their autopsies at findings that might otherwise remain undetecte

Legionella bozemanii , an Elusive Agent of Fatal Cavitary Pneumonia

Abstract : A 67-year-old patient died of Legionella bozemanii pneumonia with negative urinary antigen and negative serology. Cystic lesions in pneumonia of unknown origin should lead to the differential diagnosis of L. bozemanii infection

Postmortem imaging of blood and its characteristics using MSCT and MRI

The rapid development of computed tomography (CT) and magnetic resonance imaging (MRI) led to the introduction and establishment in postmortem investigations. The objectives of this preliminary study were to describe the imaging appearances of the early postmortem changes of blood after cessation of the circulation, such as sedimentation, postmortem clotting, and internal livores, and to give a few first suggestions on how to differentiate them from other forensic findings. In the Virtopsy project, 95 human corpses underwent postmortem imaging by CT and MRI prior to traditional autopsy and therefore 44 cases have been investigated in this study. Postmortem alterations as well as the forensic relevant findings of the blood, such as internal or subcutaneous bleedings, are presented on the basis of their imaging appearances in multislice CT and MR

Long-term observation reveals high-frequency engraftment of human acute myeloid leukemia in immunodeficient mice

Repopulation of immunodeficient mice remains the primary method for functional assessment of human acute myeloid leukemia. Published data report engraftment in ~40-66% of cases, mostly of intermediate- or poor-risk subtypes. Here we report that extending follow-up beyond the standard analysis endpoints of 10 to 16 weeks after transplantation permitted leukemic engraftment from nearly every case of xenotransplanted acute myeloid leukemia (18/19, ~95%). Xenogeneic leukemic cells showed conserved immune pheno-types and genetic signatures when compared to corresponding pre-transplant cells and, furthermore, were able to induce leukemia in re-transplantation assays. Importantly, bone marrow biopsies taken at standardized time points failed to detect leukemic cells in 11/18 of cases that later showed robust engraftment (61%, termed "long-latency engrafters"), indicating that leukemic cells can persist over months at undetectable levels without losing disease-initiating properties. Cells from favorable-risk leukemia subtypes required longer to become detectable in NOD/SCID/IL2Rγ; null; mice (27.5±9.4 weeks) than did cells from intermediate-risk (21.9±9.4 weeks,; P; <0.01) or adverse-risk (17±7.6 weeks;; P; <0.0001) subtypes, explaining why the engraftment of the first was missed with previous protocols. Mechanistically, leukemic cells engrafting after a prolonged latency showed inferior homing to the bone marrow. Finally, we applied our model to favorable-risk acute myeloid leukemia with inv(16); here, we showed that CD34; +; (but not CD34; -; ) blasts induced robust, long-latency engraftment and expressed enhanced levels of stem cell genes. In conclusion, we provide a model that allows; in vivo; mouse studies with a wide range of molecular subtypes of acute myeloid leukemia subtypes which were previously considered not able to engraft, thus enabling novel insights into leukemogenesis

Virtopsy: Zukunftsträchtige Forschung in der Rechtsmedizin

Computed tomography techniques have been developed over the last 10 years and have found various applications in the forensic field. The most recent development is multislice computed tomography combined with photogrammetry-based surface optical scanning and image rendering techniques. This combination of techniques can be used to produce 3-dimensional images of injury patterns for comparison with suspect weapons and also to screen for pathological conditions in the living or deceased. This technology provides a minimally invasive procedure for capturing forensically relevant images which can be produced in the courtroom. The rapid developments in imaging techniques could provide an alternative to conventional autopsy procedures in the futur

T-bet negatively regulates autoimmune myocarditis by suppressing local production of interleukin 17

Experimental autoimmune myocarditis (EAM) appears after infectious heart disease, the most common cause of dilated cardiomyopathy in humans. Here we report that mice lacking T-bet, a T-box transcription factor required for T helper (Th)1 cell differentiation and interferon (IFN)-γ production, develop severe autoimmune heart disease compared to T-bet−/− control mice. Experiments in T-bet−/− IL-4−/− and T-bet−/− IL-4Rα−/− mice, as well as transfer of heart-specific Th1 and Th2 cell lines, showed that autoimmune heart disease develops independently of Th1 or Th2 polarization. Analysis of T-bet−/− IL-12Rβ1−/− and T-bet−/− IL-12p35−/− mice then identified interleukin (IL)-23 as critical for EAM pathogenesis. In addition, T-bet−/− mice showed a marked increase in production of the IL-23–dependent cytokine IL-17 by heart-infiltrating lymphocytes, and in vivo IL-17 depletion markedly reduced EAM severity in T-bet−/− mice. Heart-infiltrating T-bet−/− CD8+ but not CD8− T cells secrete IFN-γ, which inhibits IL-17 production and protects against severe EAM. In contrast, T-bet−/− CD8+ lymphocytes completely lost their capacity to release IFN-γ within the heart. Collectively, these data show that severe IL-17–mediated EAM can develop in the absence of T-bet, and that T-bet can regulate autoimmunity via the control of nonspecific CD8+ T cell bystander functions in the inflamed target organ

Burkitt lymphoma with a granulomatous reaction: an M1/Th1-polarised microenvironment is associated with controlled growth and spontaneous regression

Aims: Burkitt lymphoma (BL) is an aggressive B-cell lymphoma that, in some instances, may show a granulomatous reaction associated with a favourable prognosis and occasional spontaneous regression. In the present study, we aimed to define the tumour microenvironment (TME) in four such cases, two of which regressed spontaneously. Methods and results: All cases showed aggregates of tumour cells with the typical morphology, molecular cytogenetics and immunophenotype of BL surrounded by a florid epithelioid granulomatous reaction. All four cases were Epstein–Barr virus (EBV)-positive with type I latency. Investigation of the TME showed similar features in all four cases. The analysis revealed a proinflammatory response triggered by Th1 lymphocytes and M1 polarised macrophages encircling the neoplastic cells with a peculiar topographic distribution. Conclusions: Our data provide an in-vivo picture of the role that specific immune cell subsets might play during the early phase of BL, which may be capable of maintaining the tumour in a self-limited state or inducing its regression. These novel results may provide insights into new potential therapeutic avenues in EBV-positive BL patients in the era of cellular immunotherapy