UNASSIGNED: There has been a significant increase in global cardiac-related fatalities, particularly over the last five decades. In India, cardiovascular diseases have emerged as a prevalent condition. Moreover, the incidence of sudden cardiac death has shown a steady rise worldwide.
UNASSIGNED: The aim of this study was to research how frequently cardiac disease was found during postmortem/autopsy cases and how it affects sudden death.
UNASSIGNED: The research was conducted at the Department of Pathology, SRTR, GMC, Ambajogai, India. One hundred and eighty cardiac specimens were examined from October 2019 to October 2021. Formalin-fixed heart specimens had multiple sections cut out of them at 4-5 mm intervals. The tissues underwent preparation, followed by sectioning into 4 μm thickness using paraffin. The standard staining method of hematoxylin and eosin was used to stain the samples. Different cardiac histomorphological alterations were assessed.
UNASSIGNED: The study included 180 autopsy cases. The highest numbers of cases were observed in the age group of 31-40 years (20.2%). Triple-vessel involvement was seen in the majority of 61.5% of cases, out of 180 cases, 52.7% of cases were of hypertrophy.
UNASSIGNED: The research highlights the prevalence of cardiovascular diseases, particularly atherosclerosis and hypertrophy. Notably, sudden death cases showed a distinct distribution across the study years, with males being predominantly affected. This underscores the urgent need for preventive measures and interventions to prevalent cardiovascular conditions effectively.

The incidence of papillary thyroid microcarcinoma （PTMC） increases rapidly. However, epidemiological and autopsy studies show that the prevalence of low-risk papillary thyroid microcarcinoma （LR-PTMC） is very high, but the mortality is very low. There is over-diagnosis and over-treatment for LR-PTMC. Active surveillance （AS） was adopted for LR-PTMCs instead of immediate surgery, and more than 70% of the lesions remained stable or shrank in clinical observation. Therefore, AS is recommended for LR-PTMCs in clinical guidelines of several academic organizations around the world. However, PTMC is not equal to low-risk cancer. The implementation of AS strategy requires a strict grasp of indications and full consideration of population characteristics to ensure the maximum benefit of patients. This paper summarizes the present clinical progress of active surveillance for adult LR-PTMC.
摘要: 甲状腺微小乳头状癌（PTMC）的发病率迅速增长，然而，流行病学和尸检研究结果显示，低危型PTMC（LR-PTMC）的人群患病率很高，但致死率很低，LR-PTMC存在一定程度的过度诊断和过度治疗。对LR-PTMC采取主动监测而非立即手术，70%以上的病灶在临床观察中保持稳定或缩小，于是，世界多个学术团体在临床诊疗指南中，将主动监测作为LR-PTMC的推荐方案之一。然而，甲状腺微小癌并不等于低危癌，主动监测的实施需要严格掌握适应证，并充分考虑人群特征，以保证患者的最大获益。本文就成人LR-PTMC临床主动监测的研究进展作一综述。.

OBJECTIVE: To evaluate autoptic histopathological findings of arrhythmogenic ventricular cardiomyopathy (AVC) as major cause of sudden cardiac death (SCD) in young adults.
BACKGROUND: According to Heart Rhythm Society (HRS)\'s international consensus, histological criteria for AVC diagnosis include a progressive myocardial atrophy of the right ventricle characterized by a transmural fatty or fibrofatty replacement in a segmental or diffuse pattern (residual myocytes <60 % vs 60-75 % by morphometric analysis) explaining the electrical instability with increased risk of SCD. However, there is increasing evidence for atypical patterns of localizations and percentage of fibrofatty replacement suggesting the need to update histopathological features of AVC.
METHODS: Histology examination of ventricles, atria, and septum was performed on 10 autopsy of SCD due to AVC. Staining with hematoxylin-eosin and PicroSirius Red/Fast Green were performed on the heart samples to identify specific fibrofatty patterns.
RESULTS: Our analysis showed that: 1) myocardial replacement by a diffuse segmental fatty or fibro-fatty tissue characterized right and left ventricles as well as atrial walls; 2) the degree of fibrofatty tissue replacement was less than 40 % both in left ventricle (n = 4, 40 %) and biventricular (n = 6, 60 %) localization; 3) perivascular fibrosis, inflammatory infiltrate, areas of hypertrophy and/or areas of coagulative necrosis as signs of hypoxic damage in the first stage.
CONCLUSIONS: We confirmed prior evidence for fibrofatty replacement both in biventricular and septal localizations. Importantly, we observed a less degree (<40 %) of fibrofatty replacement as compared to current guidelines. This supports the need to further explore the histological patterns of fibrofatty infiltration in a larger study population to improve the histological diagnostic criteria of AVC.

Sarcopenia is characterized as aging-related weakness and atrophy, which decreases the diaphragm force generating capacity leading to a decrease of expulsive non-ventilatory motor behaviors, which are critical for airway clearance. Thus, this study aimed to analyze the histopathology of the diaphragm in postmortem samples. Thirty individuals were included. Diaphragm samples were stained with hematoxylin and eosin for histopathological analysis. Picrosirius stain was used to highlight the collagen fibers. We observed a positive association between advancing age and histopathological findings in the diaphragm structure. We suggest that age is a key factor in increasing diaphragm muscle histopathology. However, further clinicopathological studies are needed to confirm our findings.

The HOTAIR gene encodes a long noncoding RNA (lncRNA), which functions in development and tumorigenesis. A single nucleotide polymorphism (SNP) rs920778 in the HOTAIR gene, has been recurrently studied for susceptibility to many cancers including oesophageal cancer, gastric cancer, lung cancer, and hepatocellular carcinoma. Most of these studies were conducted in Chinese populations, and a few in Turkish, Iranian, and Portuguese populations. They mostly give rise to controversial results. It still remains largely unknown whether the cancer risk is conferred in a Japanese population. Here, we established an association study on the representative SNP rs920778, to examine its contribution to the presence of cancer in consecutive autopsy cases in the JG-SNP database. A total of 1373 subjects (mean age 80) including 827 cancer positive and 546 cancer negative subjects were analyzed. As a result, the occurrence of overall cancer was not associated with the rs920778 polymorphism (p > 0.05). For each cancer type, we did not find association except for lung cancer (p = 0.04) which was more likely a by-chance association after multiple testing. Our findings imply that rs920778 polymorphism does not affect total cancer presence and the effect on specific cancer types is also weak in the Japanese population.

This paper presents two cases of human hearts (a 75-year-old woman and an 88-year-old man) with double posterior descending arteries (PDA) of various sizes originating from the right coronary artery, mainly supplying the interventricular septum as well as the posterior walls of both heart ventricles in a different scope. In the analysis of the arterial vasculature, a range of aspects were considered, such as the point of exit of the right coronary artery, the course of the vessel, the range of the blood supply of the interventricular septum and both ventricles, as well as selected morphometric parameters that were simultaneously compared with one another. These atypical changes presented based on the example of the analyzed cases will certainly constitute a valuable source of information for cardiac surgeons and interventional cardiologists in planning operations.

BACKGROUND: Cardiovascular disease is the most common cause of death worldwide which includes coronary heart disease (CHD) as the major contributor. The foremost cause of CHD is atherosclerosis of coronary arteries leading to angina to sudden deaths which is sharply increasing in India; sadly more in the younger people. In this study, results were compared to an autopsy result performed a decade earlier.
OBJECTIVE: Both autopsy studies were conducted to assess the frequency of coronary atherosclerosis, morphological types of lesions and the degree of stenosis in three major coronary arteries. The association of the disease to age, sex, socio-economic status, diet and obesity were studied along with correlating the severity with major risk factors such as hypertension, diabetes mellitus, hyperlipidemia and smoking.
METHODS: 60 hearts in the 1st study and 120 in the 2nd study were studied after collecting from Forensic department with details of the deceased. Hearts were dissected by Virchow\'s method and three major coronary arteries were studied by making serial sectioning. The atherosclerotic lesions were examined histopathologically and typed according to American Heart Association classification along with grading of the luminal stenosis.
RESULTS: The second study showed an alarmingly higher incidence of atherosclerosis (90.83%), especially in younger age. Compared to the older study in which 68.33% had coronary atherosclerosis. In both studies coronary atherosclerosis was more in males, severity increased with age and proximal segment of left anterior descending coronary artery was the most commonly affected part with higher grade lesions.
CONCLUSIONS: The frequency of occurrence of coronary atherosclerosis has definitely increased steeply in the past two decades and alarmingly more in the younger people, with the severity being common in the fourth decade of life itself. There is strong positive correlation with major risk factors reiterating the importance of clinical screening and preventive programs.

Toxoplasma is an obligate intracellular parasite that remains asymptomatic in humans but, at times, can cause devastating disease. Here, we describe an autopsy study of a young immunocompetent gentleman with no comorbidities whose presentation was acute transverse myelitis. Magnetic resonance imaging spine showed longitudinally extensive spinal cord lesion (LESCL) that mimicked neuromyelitis optica with normal brain imaging at presentation. Investigations showed albuminocytological dissociation which prompted a course of parenteral steroid. However, the lesion relentlessly progressed to involve the brain stem and cerebrum leading to toxoplasmic encephalitis that terminated fatally. This report highlights that toxoplasma can present as LESCL and needs to be considered in the differential diagnosis of atypical myelitis.

BACKGROUND: Previous evidence linking diabetes to Alzheimer\'s disease (AD) neuropathology is mixed and scant data are available from low- and middle-income countries.
OBJECTIVE: To investigate the association between diabetes and AD neuropathology in a large autopsy study of older Brazilian adults.
METHODS: In this cross-sectional study, diabetes was defined by diagnosis during life or use of antidiabetic medication. A standardized neuropathological examination was performed using immunohistochemistry. The associations of diabetes with Consortium to Establish and Registry for Alzheimer Disease (CERAD) scores for neuritic plaques and Braak-Braak (BB) scores for neurofibrillary tangles were investigated using multivariable ordinal logistic regression. We investigated effect modification of education, race, and APOE on these associations.
RESULTS: Among 1,037 subjects (mean age = 74.4±11.5 y; mean education = 4.0±3.7 y; 48% male, 61% White), diabetes was present in 279 subjects. Diabetes was not associated with BB (OR = 1.12, 95% CI = 0.81-1.54, p = 0.48) or with CERAD (OR = 0.97, 95% CI = 0.68-1.38, p = 0.86) scores on analyses adjusted for sociodemographic and clinical variables. We observed effect modification by the APOE allele ɛ4 on the association between diabetes mellitus and BB scores.
CONCLUSIONS: No evidence of an association between diabetes and AD neuropathology was found in a large sample of Brazilians; however, certain subgroups, such as APOE allele ɛ4 carriers, had higher odds of accumulation of neurofibrillary tangles.

BACKGROUND: Historical data has shown that cancer in general has been associated with less atherosclerosis while recently several studies have demonstrated more heterogeneous relations. However, most investigations were carried out clinically or radiographically and updated exhaustive, comprehensive autopsy studies are lacking. In our study, we aimed to assess the relationship between malignancy and grade of atherosclerosis in different locations (general, coronary) in a large study population over the course of 14 years.
METHODS: 2370 patients (autopsy reports) were analyzed retrospectively in regard to various parameters including demographics, organ weights, distribution and severity of atherosclerosis and presence or absence of malignancy.
RESULTS: Our study shows that malignant disease is usually associated with less general and coronary atherosclerosis (p=0.002 and p<0.001). Especially breast, colorectal and pancreatic cancer as well as lymphomas/lymphoid leukaemia and sarcomas were associated with significantly less general and coronary AS (p-values<0.001-0.031). In addition, a positive correlation between coronary atherosclerosis and heart weight could be detected (ρ=0.302, p<0.001). As a common observation, male sex was associated with increased severity of general and coronary atherosclerosis in both cancer and non-cancer groups (p<0.001).
CONCLUSIONS: We demonstrated that an inverse correlation between atherosclerosis and cancer in general is still sound today despite tremendous changes and advances in therapy strategies and diagnostics. Additionally, we could highlight that the effect was most pronounced in breast, colorectal and pancreatic cancer, sarcomas and lymphomas/lymphoid leukaemia.