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Meichtry C, Glauser U, Glardon M, Ross SG, Lechner I, Kneubuehl BP, Gascho D, Spadavecchia C, von Rotz A, Stojiljkovic A, Stoffel MH. Assessment of a specifically developed bullet casing gun for the stunning of water buffaloes. Meat Sci 2018; 135:74-78. [DOI: 10.1016/j.meatsci.2017.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/30/2017] [Accepted: 09/13/2017] [Indexed: 10/18/2022]
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Glardon M, Schwenk BK, Riva F, von Holzen A, Ross SG, Kneubuehl BP, Stoffel MH. Energy loss and impact of various stunning devices used for the slaughtering of water buffaloes. Meat Sci 2017; 135:159-165. [PMID: 29035813 DOI: 10.1016/j.meatsci.2017.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 11/28/2022]
Abstract
Stock management of the Swiss water buffalo livestock results in the slaughtering of about 350 animals per year. As the stunning of water buffaloes still is an unresolved issue, we investigated the terminal ballistics of currently used perforating stunning devices. Cartridge fired captive bolt devices, handguns and a bullet casing gun were tested in a shooting steep by firing on bisected heads, forehead plates and soap blocks. Energy loss of captive bolts confirmed their inadequacy when used for heavy water buffaloes, notably adult males. As for the free projectiles, ballistics revealed that beyond the impact energy, bullet deformation has a strong impact on the outcome. Light 9mm Luger or .38 Spl bullets as well as large deformable .44 Rem. Magnum bullets should be avoided in favor of heavier .357 Magnum deformation ammunition. These data have been translated into the development of a new stunning device for water buffaloes meeting both animal welfare and occupational safety requirements.
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Affiliation(s)
- Matthieu Glardon
- Institute of Forensic Medicine, Forensic Physics and Ballistics, University of Berne, Berne, Switzerland.
| | - Barbara K Schwenk
- Division of Veterinary Anatomy, University of Berne, Berne, Switzerland.
| | - Fabiano Riva
- Institute of Forensic Medicine, Forensic Physics and Ballistics, University of Berne, Berne, Switzerland.
| | - Adrian von Holzen
- Institute of Forensic Medicine, Forensic Physics and Ballistics, University of Berne, Berne, Switzerland.
| | - Steffen G Ross
- Institute of Forensic Medicine, Forensic Medicine and Imaging, University of Zurich, Switzerland.
| | - Beat P Kneubuehl
- Institute of Forensic Medicine, Forensic Physics and Ballistics, University of Berne, Berne, Switzerland.
| | - Michael H Stoffel
- Division of Veterinary Anatomy, University of Berne, Berne, Switzerland.
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Schwenk BK, Lechner I, Ross SG, Gascho D, Kneubuehl BP, Glardon M, Stoffel MH. Magnetic resonance imaging and computer tomography of brain lesions in water buffaloes and cattle stunned with handguns or captive bolts. Meat Sci 2015; 113:35-40. [PMID: 26610289 DOI: 10.1016/j.meatsci.2015.11.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 11/03/2015] [Accepted: 11/10/2015] [Indexed: 10/22/2022]
Abstract
Owing to the demand for genuine mozzarella, some 330 water buffaloes are being slaughtered every year in Switzerland albeit a stunning procedure meeting animal welfare and occupational safety requirements remains to be established. To provide a basis for improvements, we sized anatomical specifics in water buffaloes and cattle and we assessed brain lesions after stunning with captive bolts or handguns by diagnostic imaging. In water buffaloes and cattle, the median distance from the frontal skin surface to the inner bone table was 74.0mm (56.0-100.0mm) vs 36.6mm (29.3-44.3mm) and from skin to the thalamus 144.8mm (117.1-172.0mm) vs 102.0 (101.0-121.0mm), respectively. Consequently, customary captive bolt stunners may be inadequate. Free bullets are potentially suitable for stunning buffaloes but involve occupational safety hazards. The results of the present study shall be used to develop a device allowing effective and safe stunning of water buffaloes.
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Affiliation(s)
- Barbara K Schwenk
- Division of Veterinary Anatomy, University of Berne, Berne, Switzerland
| | - Isabel Lechner
- Veterinary Public Health Institute, University of Berne, Berne, Switzerland.
| | - Steffen G Ross
- Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, University of Zurich, Switzerland.
| | - Dominic Gascho
- Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, University of Zurich, Switzerland.
| | - Beat P Kneubuehl
- Institute of Forensic Physics/Ballistics, University of Berne, Berne, Switzerland.
| | - Matthieu Glardon
- Institute of Forensic Physics/Ballistics, University of Berne, Berne, Switzerland.
| | - Michael H Stoffel
- Division of Veterinary Anatomy, University of Berne, Berne, Switzerland.
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Ampanozi G, Flach PM, Fornaro J, Ross SG, Schweitzer W, Thali MJ, Ruder TD. Systematic analysis of the radiologic findings of aortic dissections on unenhanced postmortem computed tomography. Forensic Sci Med Pathol 2015; 11:162-7. [DOI: 10.1007/s12024-015-9654-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2015] [Indexed: 11/24/2022]
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Ross SG, Bolliger SA, Ampanozi G, Oesterhelweg L, Thali MJ, Flach PM. Postmortem CT angiography: capabilities and limitations in traumatic and natural causes of death. Radiographics 2015; 34:830-46. [PMID: 24819799 DOI: 10.1148/rg.343115169] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Whole-body postmortem computed tomographic (CT) angiography is a promising new development in forensic radiology that has the potential to improve vascular and soft-tissue imaging beyond levels currently achievable with unenhanced postmortem CT. Postmortem access to the vascular system and injection of contrast medium are different from those steps in clinical (antemortem) radiology. Because there is no circulation in a corpse that could transport or dilute a contrast medium, the injection must be performed by using a roller pump to fill the vasculature (arterial and venous) with a mixture of a water-soluble iodized contrast medium and polyethylene glycol. In contrast to a classic autopsy, postmortem CT angiography is a minimally invasive procedure. It allows the diagnosis of vascular lesions without the disruption or destruction of anatomic structures, which could result in a loss of evidence in a criminal investigation. Furthermore, postmortem CT angiography facilitates the display of vascular pathologic conditions in areas that are not typically covered with autopsy alone, such as the craniocervical junction and the small pelvis. Therefore, postmortem CT angiography adds substantial value to the classic forensic autopsy; cross-sectional data can be reevaluated objectively at any time and are fully reproducible as counterexpertise, which is as useful in the fields of forensic medicine and pathology as in clinical research. Familiarity with the capabilities of postmortem CT angiography may help radiologists working with forensic cases improve their diagnostic performance.
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Affiliation(s)
- Steffen G Ross
- From the Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich, Switzerland (S.G.R., S.A.B., G.A., M.J.T., P.M.F.); the Institute of Forensic Medicine, University of Berne, Berne, Switzerland (S.G.R.); the Institute of Forensic Medicine, University of Berlin, Berlin, Germany (L.O.); and the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland (P.M.F.)
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Teistler M, Brunberg JA, Bott OJ, Breiman RS, Ebert LC, Ross SG, Dresing K. Understanding spatial relationships in US: a computer-based training tool that utilizes inexpensive off-the-shelf game controllers. Radiographics 2014; 34:1334-43. [PMID: 25110963 DOI: 10.1148/rg.345130039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The authors present a simulation-based ultrasonographic (US) training tool that can help improve the understanding of spatial relationships in US. Use of a game controller to simulate a US probe allows examination of different virtual three-dimensional (3D) objects. These 3D objects are either completely artificial simple geometric objects (eg, spheres, tubes, and ellipsoids, or more complex combinations thereof) or derived from photographed gross anatomic data (eg, the Visible Human dataset [U.S. National Library of Medicine]) or clinical computed tomographic (CT) data. The virtual US probe allows infinitely variable real-time positioning of a "slice" that is displayed as a two-dimensional (2D) cross-sectional image and as part of a 3D view. Combining the 2D and 3D views helps elucidate the spatial relationships between a 3D object and derived 2D images. This training tool provides reliable real-time interactivity and is widely available and easily affordable, since it utilizes standard personal computer technology and off-the-shelf gaming hardware. For instance, it can be used at home by medical students or residents as a complement to conventional US training. In the future, this system could be adapted to support training for US-guided needle biopsy, with use of a second game controller to control the biopsy needle. Furthermore, it could be used as a more general interactive visualization tool for the evaluation of clinical 3D CT and magnetic resonance imaging data, allowing efficient and intuitive real-time creation of oblique multiplanar reformatted images.
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Affiliation(s)
- Michael Teistler
- From the Faculty of Information and Communication, Flensburg University of Applied Sciences, Kanzleistrasse 91-93, 24943 Flensburg, Germany (M.T.); Department of Radiology, UC Davis, Sacramento, Calif (J.A.B.); Department of Information and Communication, Faculty III, Hannover University of Applied Sciences and Arts, Hannover, Germany (O.J.B.); Department of Radiology and Biomedical Imaging, UCSF School of Medicine, San Francisco, Calif (R.S.B.); Institute of Forensic Medicine, University of Zürich, Zürich, Switzerland (L.C.E., S.G.R.); and Department of Trauma Surgery, Plastic and Reconstructive Surgery, Georg August University Medical Center, Göttingen, Germany (K.D.)
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Flach PM, Gascho D, Schweitzer W, Ruder TD, Berger N, Ross SG, Thali MJ, Ampanozi G. Imaging in forensic radiology: an illustrated guide for postmortem computed tomography technique and protocols. Forensic Sci Med Pathol 2014; 10:583-606. [DOI: 10.1007/s12024-014-9555-6] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2014] [Indexed: 11/30/2022]
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Berger N, Paula P, Gascho D, Flach PM, Thali MJ, Ross SG, Ampanozi G. Bone marrow edema induced by a bullet after a self-inflicted accidental firing. Leg Med (Tokyo) 2013; 15:329-31. [DOI: 10.1016/j.legalmed.2013.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 09/09/2013] [Accepted: 09/10/2013] [Indexed: 11/26/2022]
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Germerott T, Preiss US, Ross SG, Thali MJ, Flach PM. Postmortem ventilation in cases of penetrating gunshot and stab wounds to the chest. Leg Med (Tokyo) 2013; 15:298-302. [PMID: 24060461 DOI: 10.1016/j.legalmed.2013.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 07/30/2013] [Accepted: 08/15/2013] [Indexed: 11/29/2022]
Abstract
We sought to determine the effect of postmortem ventilation in combination with a suction pump in cases showing penetrating trauma to the chest with haemo- and/or pneumothorax, for better evaluation of the lungs in postmortem computed tomography (PMCT). The study included 6 subjects (1 female, 5 male; age 32-67years) with a penetrating gunshot or stab wound to the chest and consecutive pneumo- and/or haemothorax. The pneumo- and haemothorax were evacuated by a suction pump, and postmortem ventilation was applied using a home care ventilator. PMCT images with and without postmortem ventilation were compared, as well as the autopsy results. In three cases haemo- and pneumothorax was clearly reduced. Postmortem ventilation led to distinct re-expansion of the lungs in two cases, and to re-expansion of single lung lobes in two cases with shotgun injuries. No visible effect was seen in the remaining two cases, because of extensive destruction of lung tissue and blood aspiration. In two cases the injuries sustained in the individual lung lobes were successfully located during postmortem ventilation. The bullet channel was apparent in one case; in another case, injury of the pericardium became visible by generating pneumopericardium. The present method is capable of improving evaluation of the postmortem lung in the presence of single stab or gunshot wounds and if there is no severe destruction of the respiratory system and aspiration. Forensic autopsy should still be considered as the gold standard, although in some cases the present method might be helpful, especially where no autopsy is required.
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Affiliation(s)
- Tanja Germerott
- Institute of Forensic Medicine, Center of Forensic Imaging and Virtopsy, University of Bern, Buehlstrasse 20, 3012 Bern, Switzerland; Institute of Forensic Medicine, Medical School Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
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Ruder TD, Ross SG, Hatch GM. Second congress of the International Society of Forensic Radiology and Imaging (ISFRI)—Towards a joint future in forensic imaging. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jofri.2013.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Berger N, Ross SG, Ampanozi G, Majcen R, Schweitzer W, Gascho D, Thali MJ, Flach PM. Puzzling over intracranial gas: Disclosing a pitfall on postmortem computed tomography in a case of fatal blunt trauma. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jofri.2013.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Schweitzer W, Spycher I, Winklhofer S, Thali MJ, Ruder TD, Ampanozi G, Flach PM, Ross SG. Assessment of laryngeal tube placement on post mortem computed tomography scans. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jofri.2013.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Flach PM, Ross SG, Ebert LC, Thali MJ, Ampanozi G. Response to "the detection of internal cocaine drug packs: a radiological challenge in the future?". Eur J Radiol 2013; 82:1588-90. [PMID: 23726125 DOI: 10.1016/j.ejrad.2013.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Filograna L, Hatch G, Ruder T, Ross SG, Bolliger SA, Thali MJ. The role of post-mortem imaging in a case of sudden death due to ascending aorta aneurysm rupture. Forensic Sci Int 2013; 228:e76-80. [PMID: 23485035 DOI: 10.1016/j.forsciint.2013.01.039] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2011] [Revised: 06/13/2012] [Accepted: 01/27/2013] [Indexed: 11/28/2022]
Abstract
A 65-year-old man collapsed suddenly, while on an escalator. Despite intensive cardio-pulmonary resuscitation, the subject died 1h later. Post-mortem magnetic resonance imaging and post-mortem computed tomography angiography demonstrated rupture of an ascending aortic aneurysm, with haemorrhage into the pericardial cavity and the uncommon associated finding of haemorrhage into the left hemi-thorax through a small left-sided pericardial defect. The cause of death was thus attributed to the rupture of thoracic aortic aneurysm, and traditional autopsy was not performed. The circumstances of the case will be discussed, followed by a discussion of the imaging findings, mechanism of death, and explanation of the findings in this case. Finally, on the basis of this case report, we suggest that in selected cases, post-mortem imaging can be used as a screening tool for conducting hypotheses on the cause and mechanism of death before autopsy.
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Affiliation(s)
- Laura Filograna
- Institute of Forensic Medicine, Center of Forensic imaging and Virtopsy, University of Bern, Bühlstrasse 20, 3012 Bern, Switzerland.
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Ross SG, Thali MJ, Bolliger S, Germerott T, Ruder TD, Flach PM. Sudden death after chest pain: feasibility of virtual autopsy with postmortem CT angiography and biopsy. Radiology 2012; 264:250-9. [PMID: 22570504 DOI: 10.1148/radiol.12092415] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine the potential of minimally invasive postmortem computed tomographic (CT) angiography combined with image-guided tissue biopsy of the myocardium and lungs in decedents who were thought to have died of acute chest disease and to compare this method with conventional autopsy as the reference standard. MATERIALS AND METHODS The responsible justice department and ethics committee approved this study. Twenty corpses (four female corpses and 16 male corpses; age range, 15-80 years), all of whom were reported to have had antemortem acute chest pain, were imaged with postmortem whole-body CT angiography and underwent standardized image-guided biopsy. The standard included three biopsies of the myocardium and a single biopsy of bilateral central lung tissue. Additional biopsies of pulmonary clots for differentiation of pulmonary embolism and postmortem organized thrombus were performed after initial analysis of the cross-sectional images. Subsequent traditional autopsy with sampling of histologic specimens was performed in all cases. Thereafter, conventional histologic and autopsy reports were compared with postmortem CT angiography and CT-guided biopsy findings. A Cohen κ coefficient analysis was performed to explore the effect of the clustered nature of the data. RESULTS In 19 of the 20 cadavers, findings at postmortem CT angiography in combination with CT-guided biopsy validated the cause of death found at traditional autopsy. In one cadaver, early myocardial infarction of the papillary muscles had been missed. The Cohen κ coefficient was 0.94. There were four instances of pulmonary embolism, three aortic dissections (Stanford type A), three myocardial infarctions, three instances of fresh coronary thrombosis, three cases of obstructive coronary artery disease, one ruptured ulcer of the ascending aorta, one ruptured aneurysm of the right subclavian artery, one case of myocarditis, and one pulmonary malignancy with pulmonary artery erosion. In seven of 20 cadavers, CT-guided biopsy provided additional histopathologic information that substantiated the final diagnosis of the cause of death. CONCLUSION Postmortem CT angiography combined with image-guided biopsy, because of their minimally invasive nature, have a potential role in the detection of the cause of death after acute chest pain.
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Affiliation(s)
- Steffen G Ross
- Centre for Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Berne, Bern, Switzerland
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Germerott T, Flach PM, Preiss US, Ross SG, Thali MJ. Postmortem ventilation: a new method for improved detection of pulmonary pathologies in forensic imaging. Leg Med (Tokyo) 2012; 14:223-8. [PMID: 22546246 DOI: 10.1016/j.legalmed.2012.03.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 03/06/2012] [Accepted: 03/06/2012] [Indexed: 11/17/2022]
Abstract
Postmortem imaging has gained prominence in the field of forensic pathology. Even with experience in this procedure, difficulties arise in evaluating pathologies of the postmortem lung. The effect of postmortem ventilation with applied pressures of 10, 20, 30 and 40 mbar was evaluated in 10 corpses using simultaneous postmortem computed tomography (pmCT) scans. Ventilation was performed via a continuous positive airway pressure mask (n=5), an endotracheal tube (n=4) and a laryngeal mask (n=1) using a portable home care ventilator. The lung volumes were measured and evaluated by a segmentation technique based on reconstructed CT data. The resulting changes to the lungs were analyzed. Postmortem ventilation at 40 mbar induced a significant (p<0.05) unfolding of the lungs, with a mean volume increase of 1.32 l. Small pathologies of the lung such as scarring and pulmonary nodules as well as emphysema were revealed, while inner livores were reduced. Even though lower ventilation pressures resulted in a significant (p<0.05) volume increase, pathologies were best evaluated when a pressure of 40 mbar was applied, due to the greater reduction of the inner livores. With the ventilation-induced expansion of the lungs, a decrease in the heart diameter and gaseous distension of the stomach was recognized. In conclusion, postmortem ventilation is a feasible method for improving evaluation of the lungs and detection of small lung pathologies. This is because of the volume increase in the air-filled portions of the lung and reduced appearance of inner livores.
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Affiliation(s)
- Tanja Germerott
- Institute of Forensic Medicine, Center of Forensic Imaging and Virtopsy, University of Bern, Buehlstrasse 20, 3012 Bern, Switzerland.
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Flach PM, Ross SG, Bolliger SA, Ampanozi G, Hatch GM, Schön C, Thali MJ, Germerott T. Massive systemic fat embolism detected by postmortem imaging and biopsy. J Forensic Sci 2012; 57:1376-80. [PMID: 22537470 DOI: 10.1111/j.1556-4029.2012.02144.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Postmortem computed tomography (pmCT) and pmCT angiography (pmCTA) provide a minimally invasive method to determine the cause of death. Postmortem image-guided biopsy allows for precise sampling of histological specimens. This case study describes the findings of lethal systemic fat embolism (FE) on whole-body unenhanced pmCT, pmCTA, and image-guided biopsy, with autopsy and histopathologic correlation. Unenhanced pmCT revealed a distinct fat level on top of sedimented layers of corpuscular blood particles and serum in the arterial system and pulmonary trunk. Subsequent pmCTA showed reproducible results, and image-guided biopsy confirmed fatal FE. pm CT/pmCTA combined with image-guided biopsy established the cause of death as right heart failure as a result of systemic fatal FE prior to autopsy. All imaging findings were consistent with traditional autopsy and histological specimens. This unique case demonstrates new imaging findings in massive, fatal FE and highlights that postmortem imaging, supplemented by image-guided biopsy, may detect the cause of death prior to traditional autopsy.
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Affiliation(s)
- Patricia M Flach
- Centre for Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, Bern, Switzerland.
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Flach PM, Ross SG, Bolliger SA, Preiss US, Thali MJ, Spendlove D. Postmortem whole-body computed tomography angiography visualizing vascular rupture in a case of fatal car crash. Arch Pathol Lab Med 2010; 134:115-9. [PMID: 20073614 DOI: 10.5858/2008-0503-crr3.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In addition to the increasingly significant role of multislice computed tomography in forensic pathology, the performance of whole-body computed tomography angiography provides outstanding results. In this case, we were able to detect multiple injuries of the parenchymal organs in the upper abdomen as well as lesions of the brain parenchyma and vasculature of the neck. The radiologic findings showed complete concordance with the autopsy and even supplemented the autopsy findings in areas that are difficult to access via a manual dissection (such as the vasculature of the neck). This case shows how minimally invasive computed tomography angiography can serve as an invaluable adjunct to the classic autopsy procedure.
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Affiliation(s)
- Patricia M Flach
- Centre for Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, Bern, Switzerland.
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Abstract
The aim of the VIRTOPSY project () is utilizing radiological scanning to push low-tech documentation and autopsy procedures in a world of high-tech medicine in order to improve scientific value, to increase significance and quality in the forensic field. The term VIRTOPSY was created from the terms virtual and autopsy: Virtual is derived from the Latin word 'virtus', which means 'useful, efficient and good'. Autopsy is a combination of the old Greek terms 'autos' (=self) and 'opsomei' (=I will see). Thus autopsy means 'to see with ones own eyes'. Because our goal was to eliminate the subjectivity of "autos", we merged the two terms virtual and autopsy - deleting "autos" - to create VIRTOPSY. Today the project VIRTOPSY combining the research topics under one scientific umbrella, is characterized by a trans-disciplinary research approach that combines Forensic Medicine, Pathology, Radiology, Image Processing, Physics, and Biomechanics to an international scientific network. The paper will give an overview of the Virtopsy change process in forensic medicine.
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Affiliation(s)
- Michael J Thali
- Institute of Forensic Medicine, Center of Forensic Imaging/Virtopsy, University of Berne, Switzerland.
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Affiliation(s)
- J L Gamble
- Department of Pediatrics, The Johns Hopkins Medical School
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Di Bella EV, Ross SG, Kadrmas DJ, Khare HS, Christian PE, McJames S, Gullberg AG. Compartmental modeling of technetium-99m-labeled teboroxime with dynamic single-photon emission computed tomography: comparison with static thallium-201 in a canine model. Invest Radiol 2001; 36:178-85. [PMID: 11228582 PMCID: PMC2818759 DOI: 10.1097/00004424-200103000-00007] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
UNLABELLED Di Bella EVR, Ross SG, Kadrmas DJ, et al. Compartmental modeling of technetium-99m-labeled teboroxime with dynamic single-photon emission computed tomography: Comparison with static thallium-201 in a canine model. Invest Radiol 2001;36:178-185. RATIONALE AND OBJECTIVES A compartmental modeling approach to deriving kinetic parameters from a time series of single-photon emission computed tomography (SPECT) images of technetium-99m-labeled (99mTc-) teboroxime may have value for semiquantitative assessment of myocardial perfusion. This study investigated the value of the kinetic parameters derived from a two-compartment model of 99mTc-teboroxime for measuring myocardial perfusion and compared it with static thallium-201 (201Tl) uptake and microsphere-measured blood flow in dogs. METHODS Experiments were successfully conducted in 9 of 11 open-chest dogs. During adenosine stress, a single complete set of projections of 201Tl uptake was acquired. 99mTc-teboroxime was then injected during adenosine stress, and a complete set of projections was acquired every 5.7 seconds for 17 minutes. Resting studies were performed on 4 of the animals. All of the projection sets were reconstructed with an iterative algorithm and incorporated corrections for attenuation and the geometric response of the collimators. Regional kinetic parameters (washin and washout) were determined semiautomatically from the time series of reconstructed 99mTc-teboroxime images and registered with microsphere data. Regional washin estimates were compared with 201Tl intensities and myocardial blood flows determined from microspheres. RESULTS Optimally scaled 99mTc-teboroxime washin parameters and 201Tl uptakes were correlated with microsphere-determined blood flows (r = 0.91, y = 0. 99x + 0.01, and r = 0.92, y = 0.88x + 0.28, respectively). In six of the studies, the left anterior descending coronary artery was occluded, and stress occluded-to-normal (O/N) ratios were calculated. The O/N ratios were 0.32 +/- 0.17 as determined from microspheres injected with 201Tl and 0.38 +/- 0.29 from microspheres injected with 99mTc-teboroxime (P = NS). The O/N ratios were 0.48 +/- 0.16 for static 201Tl uptake and 0.27 +/- 0.21 for 99mTc-teboroxime washin (P < 0.05). CONCLUSIONS Both 201Tl uptake and 99mTc-teboroxime kinetic parameters were well correlated with flow. The 99mTc-teboroxime washin parameters offer semiquantitative flow values and provide greater defect contrast than can be obtained with 201Tl uptake values.
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Affiliation(s)
- E V Di Bella
- Medical Imaging Research Laboratory, Department of Radiology, University of Utah, 729 Arapeen Dr., Salt Lake City, UT 84108-1218, USA.
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Ross SG, Welch A, Gullberg GT, Huesman RH. An investigation into the effect of input function shape and image acquisition interval on estimates of washin for dynamic cardiac SPECT. Phys Med Biol 1997; 42:2193-213. [PMID: 9394407 DOI: 10.1088/0031-9155/42/11/014] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Dynamic cardiac SPECT and PET can be used to measure myocardial perfusion by estimating the kinetic rate constant describing the washing of radioactive-labelled tracers from the blood to the extravascular myocardial tissue. Because of differences in photon statistics and data acquisition techniques, protocols which produce optimal estimates of the washin for dynamic cardiac PET may give suboptimal estimates if applied in dynamic cardiac SPECT. Two important factors in the estimation of washin are the shape of the tracer input function and the image acquisition interval. This study uses computer simulations to investigate the effect of varying the tracer infusion length and image acquisition interval on the bias and variance of estimates of washin obtained with dynamic cardiac SPECT and 99mTc-labelled teboroxime. Bias in parameter estimates can be introduced by aliasing, integration of the time-varying radioactivity by the detector, and detector motion. This bias can be reduced by decreasing the acquisition interval and using a longer-duration input function. However, this results in poor photon statistics, which generate large variance, and can also introduce bias in the estimates of the washin. Our studies indicate that better estimates of the washin are obtained by using an acquisition interval that is of sufficient duration to obtain adequate photon statistics even if this is at the expense of temporal resolution. The increase in bias caused by using a 10 or 20 s acquisition interval instead of a 5 s acquisition interval is minimal when compared with the reduction in variance. Variance in estimates is also reduced by using a sharp input function, resulting in higher peak counts during washin. It is also shown that the variance of estimates of the washin increases generally when faster kinetics are observed. This variance can, however, be reduced by using longer acquisition intervals.
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Affiliation(s)
- S G Ross
- University of Utah, Salt Lake City 84132, USA
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Verbeeck RK, Corman CL, Wallace SM, Herman RJ, Ross SG, Le Morvan P. Single and multiple dose pharmacokinetics of enteric coated ketoprofen: effect of cimetidine. Eur J Clin Pharmacol 1988; 35:521-7. [PMID: 3234462 DOI: 10.1007/bf00558248] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The effect of cimetidine on the single and multiple dose pharmacokinetics of enteric coated ketoprofen was studied in 12 healthy volunteers. Each subject completed two 8-day study treatment periods: either ketoprofen alone (100 mg p.o. twice daily), or co-administered with cimetidine (600 mg twice daily). tlag, Cmax, tmax, t1/2, and k for ketoprofen were not significantly different between single and multiple dose administration. AUC of ketoprofen was slightly but significantly larger following multiple (21.2 micrograms.h.ml-1) as compared to single dose administration (19.0 micrograms.h.ml-1). As a result, plasma clearance of ketoprofen was slightly but significantly reduced following multiple dose administration (80.6 ml/min vs 89.3 ml/min). Cimetidine had no effect on the single or multiple dose pharmacokinetics of enteric coated ketoprofen. Total 12-h urinary recovery of ketoprofen (mostly in the form of ketoprofen glucuronide) was 83.5% of the dose following single dose administration and was significantly greater following multiple dose administration (93.1%). Again cimetidine co-administration had no effect on the single and multiple dose urinary recovery. The results of this study show that cimetidine is not affecting the oral pharmacokinetics of enteric coated ketoprofen.
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Affiliation(s)
- R K Verbeeck
- College of Pharmacy, University of Saskatchewan, Saskatoon, Canada
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Abstract
1. The effect of dose (100 mg, 250 mg, 500 mg, 750 mg and 1000 mg) on the glucuronidation and sulphation of diflunisal was studied in six healthy volunteers. 2. Total urinary recovery ranged from 78.9 +/- 11.9% to 91.5 +/- 18.7% of the administered dose. Urinary recovery (normalized for total urinary recovery) of diflunisal sulphate (DS) significantly increased with dose from 9.3 +/- 3.7% to 18.1 +/- 4.8%. 3. Normalized urinary recovery for diflunisal phenolic glucuronide (DPG) was unaffected by dose (range: 30.6 +/- 3.8% to 40.6 +/- 6.6%). Normalized urinary recovery for the acyl glucuronide (DAG) significantly decreased from 52.3 +/- 4.6% to 40.2 +/- 3.4% as the dose increased. 4. Total plasma clearance of diflunisal significantly decreased from 14.4 +/- 1.4 ml min-1 to 8.7 +/- 1.4 ml min-1 as the dose increased from 100 mg to 750 mg. A further increase in dose to 1000 mg resulted in an unexplained increase in total plasma clearance to 10.3 +/- 1.8 ml min-1. 5. Dose-dependent plasma clearance of diflunisal was caused mainly by saturation of the formation of DAG, whereas the formation of DS and DPG were relatively unaffected by dose.
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Affiliation(s)
- G R Loewen
- College of Pharmacy, University of Saskatchewan, Saskatoon, Canada
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Richardson CJ, Blocka KL, Ross SG, Verbeeck RK. Piroxicam and 5'-hydroxypiroxicam kinetics following multiple dose administration of piroxicam. Eur J Clin Pharmacol 1987; 32:89-91. [PMID: 3582473 DOI: 10.1007/bf00609964] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Piroxicam (20 mg once daily) was administered orally to six healthy young volunteers for 15 days. Trough steady-state levels of piroxicam and 5'-hydroxypiroxicam were 5.5 and 1.2 micrograms/ml, respectively. Piroxicam's plasma half-life (54.9 h) was significantly shorter than that of 5'-hydroxypiroxicam (70.5 h). Percent unbound piroxicam and 5'-hydroxypiroxicam in plasma at steady-state averaged 1.10 and 8.07 respectively. An average of 25.2% of the dose was recovered in urine as 5'-hydroxypiroxicam; approximately two-thirds (17.2%) in the form of the glucuronide conjugate. Average steady-state plasma levels (Css) of piroxicam (7.0 micrograms/ml) were significantly higher than predicted from a previously reported single dose study (5.3 micrograms/ml).
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Richardson CJ, Ross SG, Blocka KL, Verbeeck RK. High-performance liquid chromatographic analysis of piroxicam and its major metabolite 5'-hydroxypiroxicam in human plasma and urine. J Chromatogr 1986; 382:382-8. [PMID: 3782409 DOI: 10.1016/s0378-4347(00)83548-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
The excretion of breast milk was studied in six lactating women following the oral administration of a single trazodone tablet (50 mg). The milk/plasma ratio of trazodone based on area under the plasma and milk curves was small: 0.142 +/- 0.045 (mean +/- s.d.). Assuming that the babies would drink 500 ml 12 h-1, they would be exposed to less than 0.005 mg kg-1 as compared to 0.77 mg kg-1 for the mothers. It is concluded that exposure of babies to trazodone via breast milk is very small.
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Abstract
Piroxicam kinetics were studied after a single, oral, 20-mg capsule was taken by 12 young (six women, six men) and 13 elderly (seven women, six men) healthy subjects. Plasma samples were drawn for 216 hr after dosing. Plasma protein binding was studied in vitro by equilibrium dialysis and piroxicam concentrations were measured by HPLC with ultraviolet detection. The apparent volume of distribution was smaller in elderly women (7.8 +/- 0.4 l) than in young men (11.3 +/- 0.3 l) and elderly men (10.8 +/- 0.8 l). There were no such differences when the apparent volume of distribution was normalized for total body weight. There was a strong correlation between total body weight and apparent volume of distribution in all subjects (r = 0.83). Plasma protein binding of piroxicam ranged from 98.90% to 99.54% bound and was not affected by age or sex. Piroxicam body clearance in elderly women (0.026 +/- 0.002 ml/min/kg) was approximately 33% lower than in young women (0.039 +/- 0.003 ml/min/kg). This difference was reflected in different t1/2s of 61.7 and 44.9 hr. Predicted steady-state plasma piroxicam concentrations were 5.7 micrograms/ml in young women, 5.4 micrograms/ml in young men, 5.7 micrograms/ml in elderly men, and 9.3 micrograms/ml in elderly women. The high value in elderly women results from the lower piroxicam body clearance and total body weight. Our data suggest that healthy elderly women eliminate piroxicam at a slower rate than healthy young women. The clinical significance of these data needs to be assessed in patients.
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Ross SG. Social security: a worldwide issue. Soc Secur Bull 1979; 42:3-10. [PMID: 505236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Ross SG. A portrait of Osler by his contemporaries. JAMA 1969; 210:2261-4. [PMID: 4902646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Lloyd-Davies RW, Ross SG. Dialysis. 1. Peritoneal dialysis. Nurs Times 1968; 64:587-91. [PMID: 5647137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Ross SG. Some Problems of Neo-Natal Life. Can Med Assoc J 1945; 52:491-494. [PMID: 20323436 PMCID: PMC1581967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ross SG, Malloy HT. Blood Prothrombin in the New-born: the Effect of Vitamin K Upon the Blood Prothrombin and Upon Haemorrhagic Disease of the New-Born. Can Med Assoc J 1941; 45:417-421. [PMID: 20322262 PMCID: PMC1826992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ross SG. The Acute Gastro-Intestinal Disorders of Infancy. Can Med Assoc J 1929; 21:176-180. [PMID: 20317449 PMCID: PMC1710981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Scriver JB, Ross SG. The Use of Banana as a Food for Healthy Infants and Young Children. Can Med Assoc J 1929; 20:162-165. [PMID: 20317202 PMCID: PMC1710246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ross SG. A Case of Haemothorax in a New-Born Infant. Can Med Assoc J 1926; 16:1108-1110. [PMID: 20315949 PMCID: PMC1709226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ross SG. Hydrocephalus Complicating Intracranial Haemorrhage in a New-Born Infant. Can Med Assoc J 1924; 14:519-520. [PMID: 20315009 PMCID: PMC1707834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ross SG. Gonococcal Arthritis in a New born Male Infant. Can Med Assoc J 1923; 13:437-439. [PMID: 20314717 PMCID: PMC1707215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ross SG. Observations on Tetany. Can Med Assoc J 1923; 13:97-103. [PMID: 20314633 PMCID: PMC1706918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ross SG. The AEtiology and Prophylaxis of Simple Goitre. Can Med Assoc J 1921; 11:144-146. [PMID: 20313087 PMCID: PMC1524631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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