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      Microscopic examination of pituitary glands in cases of fatal accidental hypothermia

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          ABSTRACT

          In cases of death caused by hypothermia, histological analysis can be used to determine the cause of death. Certain histological alterations of the pituitary glands in hypothermia have been reported in the literature, including haemorrhage, hyperaemia and cellular vacuolization of cells in the anterior lobe. In the present study, the validity of these morphological alterations as markers for fatal accidental hypothermia was investigated in autopsy material. A total of 34 pituitary glands in cases of verified fatal accidental hypothermia were examined histologically (haematoxylin and eosin, ferric, azan) and immunohistochemically (LCA, ACTH, C5b-9). The findings were compared with 61 cases in a control group. Hyperaemia was found in 50.0% of the study group cases and 59.0% of the control group cases. Cellular vacuolization was observed in one case (2.9%) in the study group and one case (1.6%) in the control group. Acute or recent haemorrhage in the glandular tissue was never detected. In our study, the histopathological characteristics described in the literature as pathognomonic for hypothermia could not be confirmed. Furthermore, histological differences in the pituitary glands between fatal hypothermia cases and control group cases were not observed.

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          Most cited references28

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          Thermoregulation: some concepts have changed. Functional architecture of the thermoregulatory system.

          While summarizing the current understanding of how body temperature (T(b)) is regulated, this review discusses the recent progress in the following areas: central and peripheral thermosensitivity and temperature-activated transient receptor potential (TRP) channels; afferent neuronal pathways from peripheral thermosensors; and efferent thermoeffector pathways. It is proposed that activation of temperature-sensitive TRP channels is a mechanism of peripheral thermosensitivity. Special attention is paid to the functional architecture of the thermoregulatory system. The notion that deep T(b) is regulated by a unified system with a single controller is rejected. It is proposed that T(b) is regulated by independent thermoeffector loops, each having its own afferent and efferent branches. The activity of each thermoeffector is triggered by a unique combination of shell and core T(b)s. Temperature-dependent phase transitions in thermosensory neurons cause sequential activation of all neurons of the corresponding thermoeffector loop and eventually a thermoeffector response. No computation of an integrated T(b) or its comparison with an obvious or hidden set point of a unified system is necessary. Coordination between thermoeffectors is achieved through their common controlled variable, T(b). The described model incorporates Kobayashi's views, but Kobayashi's proposal to eliminate the term sensor is rejected. A case against the term set point is also made. Because this term is historically associated with a unified control system, it is more misleading than informative. The term balance point is proposed to designate the regulated level of T(b) and to attract attention to the multiple feedback, feedforward, and open-loop components that contribute to thermal balance.
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            Accidental hypothermia.

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              Hypothermia: evaluation, electrocardiographic manifestations, and management.

              Hypothermia-related cases typically occur after exposure to low ambient temperatures; however, numerous cases occur in individuals with no history of exposure to cold environment. Hypothermia is associated with such complications as acidosis, impaired myocardial function, bleeding diathesis, and decreased kidney and liver function. The well-known electrocardiographic manifestations of hypothermia are the presence of J (Osborn) waves, prolonged PR, QRS, and QT intervals, and atrial arrhythmias. The choice of rewarming therapy is based on the degree of hypothermia. The evaluation, electrocardiographic manifestations, and management of hypothermia are reviewed.
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                Author and article information

                Journal
                Forensic Sci Res
                Forensic Sci Res
                TFSR
                tfsr20
                Forensic sciences research
                Taylor & Francis
                2096-1790
                2471-1411
                2017
                07 June 2017
                : 2
                : 3
                : 132-138
                Affiliations
                Institute of Forensic Medicine, University of Bonn , Bonn, Germany
                Author notes
                Article
                1330804
                10.1080/20961790.2017.1330804
                6197093
                30483631
                c4b0a077-ef65-4202-800a-06503a3a01f0
                © 2017 The Author(s). Published by Taylor & Francis Group on behalf of the Institute of Forensic Science, Ministry of Justice, People's Republic of China.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 March 2017
                : 05 May 2017
                Page count
                Figures: 7, Tables: 4, References: 31, Pages: 7
                Categories
                Original Article

                forensic pathology,adenohypophysis,haemorrhage,hypothermia,hyperaemia,pituitary gland,vacuolization,post-mortem examination

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