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An autopsy report on multiple system atrophy diagnosed immunohistochemically despite severe ischaemic damage: a new approach for investigation of medical practice associated deaths in Japan

A 60-year old man with a 10-year history of multiple system atrophy (MSA) was found in respiratory arrest. After 4 months of respiratory support with two episodes of septic shock, he died. Autopsy disclosed severe atrophy of the mesencephalon, brainstem, medulla oblongata and cerebellum. Gallyas–Bra...

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Autores principales: Nakajima, M, Kojima, H, Takazawa, Y, Yahagi, N, Harada, K, Takahashi, K, Unuma, K, Yoshida, K
Formato: Texto
Lenguaje:English
Publicado: BMJ Group 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771852/
https://www.ncbi.nlm.nih.gov/pubmed/19861562
http://dx.doi.org/10.1136/jcp.2009.065060
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author Nakajima, M
Kojima, H
Takazawa, Y
Yahagi, N
Harada, K
Takahashi, K
Unuma, K
Yoshida, K
author_facet Nakajima, M
Kojima, H
Takazawa, Y
Yahagi, N
Harada, K
Takahashi, K
Unuma, K
Yoshida, K
author_sort Nakajima, M
collection PubMed
description A 60-year old man with a 10-year history of multiple system atrophy (MSA) was found in respiratory arrest. After 4 months of respiratory support with two episodes of septic shock, he died. Autopsy disclosed severe atrophy of the mesencephalon, brainstem, medulla oblongata and cerebellum. Gallyas–Braak, α-synuclein and ubiquitin-positive inclusions in the cytoplasm of glial cells were evident, despite the severe ischaemic damage due to respiratory arrest and subsequent respiratory support for 4 months. The cause of respiratory arrest was not identified, but could be explained by the natural history of MSA. The bereaved family, who had suspected malpractice, was satisfied with the explanation based on the investigation performed by eight expert doctors, one expert nurse, two coordinator nurses and two lawyers in the model project promoted by the Japanese government.
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spelling pubmed-27718522009-11-16 An autopsy report on multiple system atrophy diagnosed immunohistochemically despite severe ischaemic damage: a new approach for investigation of medical practice associated deaths in Japan Nakajima, M Kojima, H Takazawa, Y Yahagi, N Harada, K Takahashi, K Unuma, K Yoshida, K J Clin Pathol Case Reports A 60-year old man with a 10-year history of multiple system atrophy (MSA) was found in respiratory arrest. After 4 months of respiratory support with two episodes of septic shock, he died. Autopsy disclosed severe atrophy of the mesencephalon, brainstem, medulla oblongata and cerebellum. Gallyas–Braak, α-synuclein and ubiquitin-positive inclusions in the cytoplasm of glial cells were evident, despite the severe ischaemic damage due to respiratory arrest and subsequent respiratory support for 4 months. The cause of respiratory arrest was not identified, but could be explained by the natural history of MSA. The bereaved family, who had suspected malpractice, was satisfied with the explanation based on the investigation performed by eight expert doctors, one expert nurse, two coordinator nurses and two lawyers in the model project promoted by the Japanese government. BMJ Group 2009-11 2009-10-20 /pmc/articles/PMC2771852/ /pubmed/19861562 http://dx.doi.org/10.1136/jcp.2009.065060 Text en © Nakajima et al 2009 http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Nakajima, M
Kojima, H
Takazawa, Y
Yahagi, N
Harada, K
Takahashi, K
Unuma, K
Yoshida, K
An autopsy report on multiple system atrophy diagnosed immunohistochemically despite severe ischaemic damage: a new approach for investigation of medical practice associated deaths in Japan
title An autopsy report on multiple system atrophy diagnosed immunohistochemically despite severe ischaemic damage: a new approach for investigation of medical practice associated deaths in Japan
title_full An autopsy report on multiple system atrophy diagnosed immunohistochemically despite severe ischaemic damage: a new approach for investigation of medical practice associated deaths in Japan
title_fullStr An autopsy report on multiple system atrophy diagnosed immunohistochemically despite severe ischaemic damage: a new approach for investigation of medical practice associated deaths in Japan
title_full_unstemmed An autopsy report on multiple system atrophy diagnosed immunohistochemically despite severe ischaemic damage: a new approach for investigation of medical practice associated deaths in Japan
title_short An autopsy report on multiple system atrophy diagnosed immunohistochemically despite severe ischaemic damage: a new approach for investigation of medical practice associated deaths in Japan
title_sort autopsy report on multiple system atrophy diagnosed immunohistochemically despite severe ischaemic damage: a new approach for investigation of medical practice associated deaths in japan
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771852/
https://www.ncbi.nlm.nih.gov/pubmed/19861562
http://dx.doi.org/10.1136/jcp.2009.065060
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