Suchergebnisse

Abstract

Aim
To study types and incidence of histological changes in liver of people deceased due to harmful use of alcohol.


Methods
A retrospective review of medico-legal autopsy of 236 adults who died in the years 2015–2016 due to harmful use of alcohol was done. Histopathological liver samples taken during autopsies were evaluated. Blood alcohol content was analyzed. Serological tests for hepatitis B surface antigen and anti-hepatitis C virus (HCV) were performed.


Results
The most common liver pathology (83.1%) was steatosis, mainly mixed type (50%); 66.9% had high-grade steatosis. Liver fibrosis was detected in 39.4% of cases, with fibrosis of higher than or equal to third grade in 14%, hepatitis in 44.5% and steatohepatitis in 19.1%. Toxic hepatocyte injury features (ballooning degeneration, Mallory–Denk bodies) were found in 20.8% cases and degenerative-damage changes in 41.1%. The correlation between the grade of steatosis and fibrosis (P = 0.0005), toxic injury (0.00000101) and degenerative–traumatic changes (P = 0.00000741) was found. The correlation was found between hepatitis and higher than or equal to third grade steatosis (P = 0.037), cholestasis (P = 0.0139), toxic injury features (P = 2.58 × 10−13), degenerative–damage changes (P = 7.9 × 10−12) and presence of anti-HCV (P = 0.00723) and between progression of fibrosis and presence of toxic injury features (2.28 × 10−19), degenerative–damage changes (P = 4.25 × 10−11) and anti-HCV (P = 0.0263).


Conclusions
Spectrum of histopathological liver changes is broad regardless of sex, and various traits are present in various patterns. Comorbidities have strong influence on the picture of changes in the liver. Exact evaluation how often and what histopathological changes will develop in alcohol liver disease is not possible by reason of variability of external factors.

Cover -- Contents -- Preface -- Sport in Czechoslovakia 1945-1989 -- The Czechoslovak Olympic Movement in 1945-1989 -- Sport and the Olympic Movement in Poland (1944-1989) -- Sport and the Olympic Movement in Hungary (1945-1989) -- Summary -- Bibliography -- Appendix: Important Persons Mentioned in the Text.

This study presents the results of the analysis of forensic examinations of the remains of 194 prisoners exhumed at Powązki Military Cemetery in Warsaw. In all probability, most of those buried there were judicially sentenced to death by firing squad or hanging in connection with activities of the Polish independence underground in its struggles with the postwar communist regime. Forensic medical research focussed on determining causes of death and reconstructing the mechanisms of injury leading to death. Most probable causes of death were found in 108 of 194 cases; of these, 76 were isolated gunshot wounds to the head, mostly directed to the occipital region. In 29 of 194 cases, only extensive skull fractures were observed, making it impossible to determine the mechanism of injury. The condition of these skulls do not permit the exclusion of injuries due to gunshots, which were very likely given the historical context of the studied location. In one case, it is assumed that the cause of death could be blunt force trauma to the head. In 86 of 194 cases, it was not possible to determine the cause of death. Of these cases, 20 skeletons were in such poor condition that erosive changes could have completely obliterated even very extensive head injuries leading to death. No injuries were observed that could be associated with execution by hanging.