It is possible to generate useful predictive models of organ confined disease using logistic regression or neural networks with high indexes of clinical and statistical validity. However, using these variables neural networks did not prove to be better than logistic regression analysis. Therefore, better predictive variables must be identified, preferably nonlinear characteristics with respect to the probability of organ confined tumor, to generate better predictive models using neural networks.
The levels of Cr (2.49±0.89 ppm), Mn (5.08 ± 1.60 ppm), Ni (1.81±0.95 ppm) and Pb (4.43 ± 3.12 ppm) were measured in dessicated liver from 44 cases of sudden traumatic death considered as representative of the general population in our area, after ruling out the presence of any underlying disease. Atomic absorption spectrophotometry and electrothermal atomitazion was carried out after hot, acid digestion, of the dessicated samples. After cancelling the influence of age and cause of death, a significant, positive correlation between Cr/Mn (P = 0.0009; R = 0.493) and Cr/Ni ( P = 0.0245; R = 0.347) levels was found.
The correlation between the type of pathological lesion of the lung and the circumstances which encompass their evolution in 66 cases of violent death have been examined.
Pulmonary lesions have been classified into four groups.
1. Inflammatory alveolar lesions without a diffuse interstitial involvement (IAL) which result from direct aggressions in subjects of advanced age.
2. Inflammatory alveolar lesions with a diffuse interstitial affection (IALW) which are more frequent in younger subjects having a higher defense capacity and with severe lesions requiring admission to an intensive care unit.
3. Edemohemorrhagic lesions (EHL) appearing as a precocious lesion at any age.
4. Unspecific chronic lesions (UCL) previous to the aggression and without any relationship to death.
The most obvious feature noted was the frequent occurrence of certain types of acute pulmonary lesions indicative of the rapid and extensive capacity of the lung to react to a lesion agent even when death follows rapidly after the aggression. The scarcity of acute interstitial lesions among the older group can be related to a diminution of biological defense activity leading to a less vigorous response; on the contrary, diffuse lesions of the wall seem to be related to an excess of defense mechanisms, determined more by age, severity of lesion, and type of medical assistance received than by a specific type of aggression.
The results are presented of the pathological study of the lungs in 66 cases of violent death observing the more frequent types of lesion and establishing 4 different groups of postlesioned pulmonary condition.
1. Inflammatory alveolar lesions without a diffused interstitial involvement (IAL) including contusions or direct aggressions, lobular pneumonias, or bronchopneumonias with a predominance of intra-alveolar inflammatory exudation.
2. Inflammatory alveolar lesions with a diffuse interstitial involvement (IALW) including generalized affectation of the parenchyma with lesions in the capillary structure of the wall.
3. Edemohemorrhagic lesions (EHL) presenting phenomena of capillary congestion with hematic extravasation and interstitial and intra-alveolar edema, without inflammatory involvement. This is the most numerous group and it can constitute the preliminary stage of any other.
4. Unspecific chronic lesions (UCL) not related to the cause of death, being chronically inflammatory and fibrotic alterations of limited interest in our study.
We emphasize the importance of the inflammatory involvement of the alveolar wall in the pathogenia of diffuse alveolar damage (DAD) and the aggravation of pulmonary lesions by capillary structure alteration, direct lesions of alveolar epithelium, presence of macrophages, and liberation of certain intracellular enzymes.
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