Technical Books on Forensic Science and Forensic Medicine: Anil Aggrawal's Internet Journal of Forensic Medicine, Vol.5, No. 1, January - June 2004

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Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology

Volume 5, Number 1, January - June 2004

Book Reviews: Technical Books Section

EXCERPTS

[ Review 1 ] [ Main Page ] [ Review 2 ]

Handbook of Autopsy Practice, 3^rdEdition, Edited by Jurgen Ludwig. Hard Bound, 8.5" x 11".
Humana Press Inc., 999 Riverview Drive, Suite 208, Totowa, New Jersey 07512; Publication Date 10 July, 2002. 592 pages, ISBN 1-58829-169-3 (acid-free Paper). Price $149.50

Official Site:Click here to visit

This is such a revolutionary book, we thought we should give some extracts from it, to enable the reader to gauge a better idea about its excellence. First, the contents in detail:

Part I- Autopsy techniques, laboratory procedures and data processing

Principles of Autopsy Techniques, Immediate and Restricted Autopsies, and Other Special Procedures
by Jurgen Ludwig
Medicolegai Autopsies and Autopsy Toxicology
by Vernard I. Adams
Cardiovascular System
by William D. Edwards
Tracheobronchial Tree and Lungs
by Jurgen Ludwig

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Esophagus and Abdominal Viscera
by Jurgen Ludwig
Nervous System
by Caterina Giannini and Haruo Okazaki
The Eye and Adnexa
by R. Jean Campbell
Skeletal System
by Jurgen Ludwig
Autopsy Microbiology
by Brenda L. Waters
Chromosome Study of Autopsy Tissues
by Gordon W Dewald
Autopsy Chemistry
by Vernard I. Adams
Autopsy Roentgenology and Other Imaging Techniques
by Jurgen Ludwig
Autopsy of Bodies Containing Radioactive Material
by Kelly L. Classic
Fixation, Color Preservation, Gross Staining, and Shipping of Autopsy Material
by Jurgen Ludwig and Brenda L. Waters
Museum Techniques and Autopsy Photography
by Jurgen Ludwig and William D. Edwards
Organization, Maintenance, and Safety Concerns of the Autopsy Service; Tissue Registries; Interviews With the Next of Kin
by Jurgen Ludwig
Autopsy Documents, Data Processing, and Quality Assurance
by Jurgen Ludwig
Autopsy Law
by Vernard I. Adams and Jurgen Ludwig
The State of Autopsy Practice: An Annotated Bibliography
by Jurgen Ludwig

Part II- Alphabetical listing of diseases and conditions

This part has been written by Jurgen Ludwig with Vernard I. Adams (Medicolegal and Toxicologic cases), William D. Edwards (Cardiovascular cases), Caterina Giannini (Neuropathologic cases), and Brenda L. Waters (Pediatric and Infectious Disease cases).

Organization of Part II
Special Histological Stains
Listing

The last part of this section, i.e. "Listing" is the core of this book, and extends from page 175 till 550, covering an astounding 375 pages.

Part III - Normal Weights and Measurements

Weights and Measurements
by Hagen Blaszyk, Jurgen Ludwig, and William D. Edwards
Weights and Measurements in Fetuses, Infants, Children, and Adolescents
Weights and Measurements in Adults

Index

One of the best parts of this book is the A-Z section on diseases and postmortem appearances seen in them. So if one, is dealing with a case of death, say due to suspected Niemann-Pick Disease, all he has to do is open the section at "D"; look for "Disease, Niemann-Pick" and go through the underlying table. These tables specify the various procedures to be undertaken and the possible or expected findings in them. Here is what the writer gives under the entry "Diabetes Mellitus" (pages 251-253):
Diabetes Mellitus

Organs and Tissues Procedures Possible or Expected Findings

External Examination and skin Prepare sections of skin lesions, of grossly unaffected skin, and of subcutaneous tissue.
If there is evidence of mastopathy, sample tissue for histologic study.
Prepare sections and smears of intertriginous and other skin infections. Request Gram and Grocott's methenamine silver stains (p. 172).
Prepare whole-body roentgenograms.
Submit samples of skin tissue for electron microscopic study (p. 132). Gangrene of lower extremities and other ischemic changes.
Xanthelasmas of eyelids. Diabetic xanthomas on forearms. Diabetic lipoatrophy.
Subcutaneous atrophy at former sites of insulin injection.
Diabetic mastopathy.
Fungal vulvitis.
Subcutaneous and vascular calcifications. Joint deformities (see below under "Joints"). Diabetic microangiopathy.

Blood Submit sample for bacterial and fungal cultures (p. 102). If diabetic coma must be ruled out or if disease is only suspected, submit samples of blood and vitreous (see below) for biochemical study. For interpretation, see p. 114. Septicemia. Increased concentrations of blood glucose (unreliable for diagnosis) and serum ketones and lipids. Postmortem insulin determination may permit the diagnosis of insulin poisoning.

Heart Record weight and thickness of walls. For coronary arteriography, see p. 118. For histologic sampling, see p. 30. If glycogen content is to be evaluated, place specimens in alcohol (p. 129) or Carnoy's fixative (p. 130) or-preferably-prepare for electron microscopic study (p. 132). Cardiac hypertrophy;* coronary atherosclerosis;* myocardial infarction.

Lungs Submit one lobe for bacterial and fungal cultures (p. 103). Request Gram and Grocott's methenamine silver stain (p. 172). Bacterial or fungal (aspergillosis,* candidiasis,* cryptococcosis*) pneumonia.

Esophagus Sample for histologic study. For special stains, see "Lungs." Intramural pseudodiverticulosis (dilatation of submucosal gland ducts). Fungal esophagitis.

Liver Record weight and sample for histologic study. Hepatomegaly; fatty changes; diabetic steatohepatitis or steatohepatitic cirrhosis. Other types of cirrhosis may be a cause of secondary diabetes (Naunyn's diabetes).

Gall Bladder Record appearance of concrements. Cholelithiasis.*

Spleen Submit sample for histologic study. Lipoid histiocytosis.

Stomach Record size and shape of stomach and appearance of mucosa. Gastric dilatation; mucosal hemorrhages.

Pancreas Prepare soft tissue roentgenogram. Dissect pancreas and record weight. Slice organ in 2-mm sagittal sections. Place one slice in alcohol or Carnoy's fixative (p. 130). Request Best's carmine, Masson's trichrome, Congo red, and Gomori's chromium hematoxylin phloxine stains (p. 172). For the last stain, formalin fixed organs should be refixed for 12-24 h in Bouin's solution (p. 129). Whenever granules are to be demonstrated in beta cells, a slice of fresh tissue should be placed in Bouin's or Helly's fixative (p. 131). Glycogenosis of beta cells in prolonged hyperglycemia (in type II diabetes); degranulation of islets of Langerhans; lymphocytic or eosinophilic infiltration around islets (in type I diabetes); amyloidosis or fibrosis of islets. Lesions that may have caused secondary diabetes include pancreatitis, tumors of the pancreas,* cystic fibrosis,* and hemochromatosis.* Focal or diffuse nesidioblastosis in infants of diabetic mothers (may be a cause of hyperinsulinemic hypoglycemia).

Adrenal glands Record weights. If abnormalities are noted, sample for histologic study. Adrenocortical nodules or tumor or pheochromocytoma (see also under "Syndrome, Cushing's" and "Tumor of the, adrenal glands").

Kidneys Record weights of both organs. For renal arteriography, see p. 59. Submit samples for histologic and electron microscopic study (p. 132). Request PAS-alcian blue and Grocott's methenamine silver stains (p. 172). All sections should include papillae. Submit fresh material for immunofluorescence study. Diabetic nephropathy and microangiopathy. Arteriolonephrosclerosis; diabetic intercapillary glomerulosclerosis; tubular atrophy and interstitial fibrosis; pyelonephritis* and necrotizing papillitis. Glomerular capillary and tubular basement membranes stain for IgG and albumin.

Urine Prepare sediment and submit sample for protein, glucose, and acetone determination. Abnormal sediment. Proteinuria, glycosuria, and acetonuria.

Urinary Bladder Urocystitis

Seminal Vesicles, Spermatic cords, and testes Submit samples for histologic study. Submucosal granular deposits in seminal vesicles; calcification of vas deferens; tubular atrophy of testes.

Ovaries Submit samples for histologic study. Stromal hyperthecosis.

Lower extremities For arteriography, see p. 120. Submit samples from smaller arteries for histologic study. For decalcification procedures, see p. 97. Request von Kossa's and Verhoeff-van Gieson stains (p. 172). Gangrene. Obliterating arteriosclerosis of anterior and posterior tibial arteries, peroneal arteries, and dorsal artery of the foot. Mönckeberg's sclerosis* of muscular arteries.

Calvarium Record color of bone. Calvarium often strikingly yellow (carotene deposition).

Brain and Spinal cord For removal and specimen preparation, see pp. 65 and 67, respectively. If cerebral infection is suspected, submit sample for bacterial and fungal cultures (p. 102). For cerebral arteriography, see p. 80. Degeneration of spinal tracts and microinfarctions. Cerebral mucormycosis.* Cerebral infarctions.

Pituitary Gland For removal and specimen preparation, see p. 71. Infarctions.

Eyes For removal and specimen preparation, see p. 85. Diabetic retinopathy with capillary microaneurysms; cataracts; microaneurysms of conjunctival vessels. Nutritional amblyopia.*

Vitreous If diabetic coma or ketoacidosis must be ruled out, submit sample of vitreous (p. 85) from one eye for determination of glucose and ketone concentrations (see p. 115). Glucose values less than 2 h after death or combined glucose and lactate values several days after death can be used for the diagnosis of hyperglycemia (1).

Peripheral nerves For sampling and specimen preparation, see p. 79. Include anterior tibial and sciatic nerves. Request Luxol fast blue stain for myelin (p. 172). Diabetic neuropathy. Patchy demyelinization.

Skeletal muscles For sampling and specimen preparation, see p. 80. Diabetic myopathy.

Breast tissue Submit sample for histologic study. Hyalinization around mammary ducts.

Joints For removal, prosthetic repair, and specimen preparation, see p. 96. Deformation (Charcot joints) of tarsal and metatarsal joints or - less commonly - of ankle and knee joints. Such deformations occur after diabetic neuropathy.

Pages 251-253

Diabetes Mellitus
Organs and Tissues	Procedures	Possible or Expected Findings
External Examination and skin	Prepare sections of skin lesions, of grossly unaffected skin, and of subcutaneous tissue. If there is evidence of mastopathy, sample tissue for histologic study. Prepare sections and smears of intertriginous and other skin infections. Request Gram and Grocott's methenamine silver stains (p. 172). Prepare whole-body roentgenograms. Submit samples of skin tissue for electron microscopic study (p. 132).	Gangrene of lower extremities and other ischemic changes. Xanthelasmas of eyelids. Diabetic xanthomas on forearms. Diabetic lipoatrophy. Subcutaneous atrophy at former sites of insulin injection. Diabetic mastopathy. Fungal vulvitis. Subcutaneous and vascular calcifications. Joint deformities (see below under "Joints"). Diabetic microangiopathy.
Blood	Submit sample for bacterial and fungal cultures (p. 102). If diabetic coma must be ruled out or if disease is only suspected, submit samples of blood and vitreous (see below) for biochemical study. For interpretation, see p. 114.	Septicemia. Increased concentrations of blood glucose (unreliable for diagnosis) and serum ketones and lipids. Postmortem insulin determination may permit the diagnosis of insulin poisoning.
Heart	Record weight and thickness of walls. For coronary arteriography, see p. 118. For histologic sampling, see p. 30. If glycogen content is to be evaluated, place specimens in alcohol (p. 129) or Carnoy's fixative (p. 130) or-preferably-prepare for electron microscopic study (p. 132).	Cardiac hypertrophy;* coronary atherosclerosis;* myocardial infarction.
Lungs	Submit one lobe for bacterial and fungal cultures (p. 103). Request Gram and Grocott's methenamine silver stain (p. 172).	Bacterial or fungal (aspergillosis,* candidiasis,* cryptococcosis*) pneumonia.
Esophagus	Sample for histologic study. For special stains, see "Lungs."	Intramural pseudodiverticulosis (dilatation of submucosal gland ducts). Fungal esophagitis.
Liver	Record weight and sample for histologic study.	Hepatomegaly; fatty changes; diabetic steatohepatitis or steatohepatitic cirrhosis. Other types of cirrhosis may be a cause of secondary diabetes (Naunyn's diabetes).
Gall Bladder	Record appearance of concrements.	Cholelithiasis.*
Spleen	Submit sample for histologic study.	Lipoid histiocytosis.
Stomach	Record size and shape of stomach and appearance of mucosa.	Gastric dilatation; mucosal hemorrhages.
Pancreas	Prepare soft tissue roentgenogram. Dissect pancreas and record weight. Slice organ in 2-mm sagittal sections. Place one slice in alcohol or Carnoy's fixative (p. 130). Request Best's carmine, Masson's trichrome, Congo red, and Gomori's chromium hematoxylin phloxine stains (p. 172). For the last stain, formalin fixed organs should be refixed for 12-24 h in Bouin's solution (p. 129). Whenever granules are to be demonstrated in beta cells, a slice of fresh tissue should be placed in Bouin's or Helly's fixative (p. 131).	Glycogenosis of beta cells in prolonged hyperglycemia (in type II diabetes); degranulation of islets of Langerhans; lymphocytic or eosinophilic infiltration around islets (in type I diabetes); amyloidosis or fibrosis of islets. Lesions that may have caused secondary diabetes include pancreatitis, tumors of the pancreas,* cystic fibrosis,* and hemochromatosis.* Focal or diffuse nesidioblastosis in infants of diabetic mothers (may be a cause of hyperinsulinemic hypoglycemia).
Adrenal glands	Record weights. If abnormalities are noted, sample for histologic study.	Adrenocortical nodules or tumor or pheochromocytoma (see also under "Syndrome, Cushing's" and "Tumor of the, adrenal glands").
Kidneys	Record weights of both organs. For renal arteriography, see p. 59. Submit samples for histologic and electron microscopic study (p. 132). Request PAS-alcian blue and Grocott's methenamine silver stains (p. 172). All sections should include papillae. Submit fresh material for immunofluorescence study.	Diabetic nephropathy and microangiopathy. Arteriolonephrosclerosis; diabetic intercapillary glomerulosclerosis; tubular atrophy and interstitial fibrosis; pyelonephritis* and necrotizing papillitis. Glomerular capillary and tubular basement membranes stain for IgG and albumin.
Urine	Prepare sediment and submit sample for protein, glucose, and acetone determination.	Abnormal sediment. Proteinuria, glycosuria, and acetonuria.
Urinary Bladder		Urocystitis
Seminal Vesicles, Spermatic cords, and testes	Submit samples for histologic study.	Submucosal granular deposits in seminal vesicles; calcification of vas deferens; tubular atrophy of testes.
Ovaries	Submit samples for histologic study.	Stromal hyperthecosis.
Lower extremities	For arteriography, see p. 120. Submit samples from smaller arteries for histologic study. For decalcification procedures, see p. 97. Request von Kossa's and Verhoeff-van Gieson stains (p. 172).	Gangrene. Obliterating arteriosclerosis of anterior and posterior tibial arteries, peroneal arteries, and dorsal artery of the foot. Mönckeberg's sclerosis* of muscular arteries.
Calvarium	Record color of bone.	Calvarium often strikingly yellow (carotene deposition).
Brain and Spinal cord	For removal and specimen preparation, see pp. 65 and 67, respectively. If cerebral infection is suspected, submit sample for bacterial and fungal cultures (p. 102). For cerebral arteriography, see p. 80.	Degeneration of spinal tracts and microinfarctions. Cerebral mucormycosis.* Cerebral infarctions.
Pituitary Gland	For removal and specimen preparation, see p. 71.	Infarctions.
Eyes	For removal and specimen preparation, see p. 85.	Diabetic retinopathy with capillary microaneurysms; cataracts; microaneurysms of conjunctival vessels. Nutritional amblyopia.*
Vitreous	If diabetic coma or ketoacidosis must be ruled out, submit sample of vitreous (p. 85) from one eye for determination of glucose and ketone concentrations (see p. 115).	Glucose values less than 2 h after death or combined glucose and lactate values several days after death can be used for the diagnosis of hyperglycemia (1).
Peripheral nerves	For sampling and specimen preparation, see p. 79. Include anterior tibial and sciatic nerves. Request Luxol fast blue stain for myelin (p. 172).	Diabetic neuropathy. Patchy demyelinization.
Skeletal muscles	For sampling and specimen preparation, see p. 80.	Diabetic myopathy.
Breast tissue	Submit sample for histologic study.	Hyalinization around mammary ducts.
Joints	For removal, prosthetic repair, and specimen preparation, see p. 96.	Deformation (Charcot joints) of tarsal and metatarsal joints or - less commonly - of ankle and knee joints. Such deformations occur after diabetic neuropathy.
Pages 251-253

Now, can anyone get more detailed than this!

And here is the publisher's blurb. Readers can make their own decision. I, for one, would agree with every word of it.

Publisher's Blurb

There is an acute need for a complete and readily accessible resource for autopsy work because few pathologists still specialize in autopsy practice and, as a consequence, expertise in autopsy technology and autopsy pathology has declined. In Handbook of Autopsy Practice, Third Edition, Jurgen Ludwig, MD, has updated and expanded his recognized "masterpiece" to create an indispensable source of both classic and innovative procedures for successful autopsy diagnosis and documentation. The section on autopsy methods and all their corollary activities has been completely modernized with current laboratory methods, quality assurance procedures, methods for processing autopsy data, and increased safety precautions for dealing with potentially fatal infectious diseases. The heart of the book - a thoroughly revised alphabetical listing of diseases and conditions - tabulates all the recommended technical procedures and their expected findings for instant reference during work in the autopsy room. This gold mine of diverse facts and information provides the prosector with critical guidance on what to look for in each case and how to dissect and preserve it. Numerous updated appendices detail organ and body weights and sizes, conversion factors, fetal development tables, and all manner of esoteric and useful information. This new, richly enhanced Third Edition has been written by highly experienced academic autopsy pathologists, as well as the medical examiner of a major city, and technical experts in related fields.

Comprehensive, authoritative, and indispensable, the Handbook of Autopsy Practice, Third Edition illuminates the practical pathology of disease and readily provides to anatomic and forensic pathologists all the critical information and procedures needed for thorough, accurate autopsy diagnosis and documentation today.

KEY POINTS

Recommended procedures and their expected findings tabulated by disease
Expert guidance on what to look for in each case and how to dissect and preserve it
Classic and innovative procedures for successful autopsy diagnosis and documentation
Many current autopsy-specific laboratory methods and methods for processing autopsy data
Techniques for dealing with potentially fatal infectious diseases
The only publication to provide recommendations for case-specific autopsy procedures
Hundreds of references to classic and recently published works
Procedure for the dissection of hearts for comparison with clinical images
Methods for postmortem angiography or gross staining of tissues for amyloid or iron

READERSHIP

Anatomic, clinical, and forensic pathologists

SUBJECT CATEGORIES

Anatomic Pathology, Forensic Pathology, and Clinical Pathology

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