Sudden cardiac death(SCD)is the leading cause of death worldwide.Myocardial ischemia(MI)is the most common underlying causal disorder for SCD.Metabolic risks leading to SCD during acute MI are still not fully understo...Sudden cardiac death(SCD)is the leading cause of death worldwide.Myocardial ischemia(MI)is the most common underlying causal disorder for SCD.Metabolic risks leading to SCD during acute MI are still not fully understood.Here,using tissue metabolomics,we aimed to investigate myocardial metabolic alterations relevant to SCD events in an acute MI rat model induced by coronary artery ligation(CAL).Thirty-four rats were successfully performed CAL,of which 13 developed lethal ventricular tachyarrhythmia(LVTA)-SCD and 7 developed severe atrioventricular block(AB)-SCD.Fourteen rats that survived within 70 min after the ligation were served as peer controls.The partial least squares-discriminant analysis plots demonstrated clear separations between the SCD rats and controls,indicating obvious differences in myocardial metabolome between these rats.The levels of isoleucine,lactate,glutamate choline,phosphorylcholine,taurine and asparagine in ischemic myocardia were positively associated with LVTA-SCD events;in contrast,the levels of alanine,urea,phenylalanine,linoleic acid,elaidic acid and stearic acid were inversely correlated with LVTA-SCD events.The levels of glutamate and urea were positively and negatively relevant to AB-SCD events,respectively.The dangerous metabolites indicated that lower levels of energy substrates,severe hypoxia,the inhibition of transamination and hyper sympathetic excitement and reactive oxygen species in myocardia were vulnerable to SCD during acute MI.The results suggest fatal metabolic alterations correlated with SCD events during acute MI,which could offer novel clues for the prevention or treatment of acute MI-related SCD.展开更多
Intramedullary schwannoma of the upper cervical spinal cord is rarely reported in forensic medicine.We herein report a case involving a patient who died of compression from an intramedullary schwannoma in the upper ce...Intramedullary schwannoma of the upper cervical spinal cord is rarely reported in forensic medicine.We herein report a case involving a patient who died of compression from an intramedullary schwannoma in the upper cervical spinal cord.A 30-year-old man initially presented with a five-day history of pain in the left chest that progressed to weakening in the left arm.Although the patient was treated with analgesic poultices,he developed inspiratory dyspnoea and died while working the next day without having undergone any medical imaging examination or surgical treatment.Anatomical and histopathological examinations revealed an intramedullary schwannoma in the left cervical spinal cord(C_(3)-C_(5))underneath the spinal nerve root.The cause of death might have been asphyxia secondary to the tumour,which interfered with the nerve function in the respiratory muscles.This finding suggests that an autopsy is essential for pathologists and medicolegists to comprehensively undertake their due obligation to obtain“the first evidence”,especially when there is a lack of directly related evidence.As part of the central nervous system,the spinal cord could be systematically included in a routine pathological autopsy in some cases.展开更多
基金supported by the Natural Science Foundation[grant number 2015A408119346049]Science and Tech-nology Innovation project of Guangdong Province[grant number 2013KJCX0076].
文摘Sudden cardiac death(SCD)is the leading cause of death worldwide.Myocardial ischemia(MI)is the most common underlying causal disorder for SCD.Metabolic risks leading to SCD during acute MI are still not fully understood.Here,using tissue metabolomics,we aimed to investigate myocardial metabolic alterations relevant to SCD events in an acute MI rat model induced by coronary artery ligation(CAL).Thirty-four rats were successfully performed CAL,of which 13 developed lethal ventricular tachyarrhythmia(LVTA)-SCD and 7 developed severe atrioventricular block(AB)-SCD.Fourteen rats that survived within 70 min after the ligation were served as peer controls.The partial least squares-discriminant analysis plots demonstrated clear separations between the SCD rats and controls,indicating obvious differences in myocardial metabolome between these rats.The levels of isoleucine,lactate,glutamate choline,phosphorylcholine,taurine and asparagine in ischemic myocardia were positively associated with LVTA-SCD events;in contrast,the levels of alanine,urea,phenylalanine,linoleic acid,elaidic acid and stearic acid were inversely correlated with LVTA-SCD events.The levels of glutamate and urea were positively and negatively relevant to AB-SCD events,respectively.The dangerous metabolites indicated that lower levels of energy substrates,severe hypoxia,the inhibition of transamination and hyper sympathetic excitement and reactive oxygen species in myocardia were vulnerable to SCD during acute MI.The results suggest fatal metabolic alterations correlated with SCD events during acute MI,which could offer novel clues for the prevention or treatment of acute MI-related SCD.
文摘Intramedullary schwannoma of the upper cervical spinal cord is rarely reported in forensic medicine.We herein report a case involving a patient who died of compression from an intramedullary schwannoma in the upper cervical spinal cord.A 30-year-old man initially presented with a five-day history of pain in the left chest that progressed to weakening in the left arm.Although the patient was treated with analgesic poultices,he developed inspiratory dyspnoea and died while working the next day without having undergone any medical imaging examination or surgical treatment.Anatomical and histopathological examinations revealed an intramedullary schwannoma in the left cervical spinal cord(C_(3)-C_(5))underneath the spinal nerve root.The cause of death might have been asphyxia secondary to the tumour,which interfered with the nerve function in the respiratory muscles.This finding suggests that an autopsy is essential for pathologists and medicolegists to comprehensively undertake their due obligation to obtain“the first evidence”,especially when there is a lack of directly related evidence.As part of the central nervous system,the spinal cord could be systematically included in a routine pathological autopsy in some cases.
