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  1. Article ; Online: The Promise of Molecular Autopsy in Forensic Pathology Practice.

    Cunningham, Kristopher S

    Academic forensic pathology

    2017  Volume 7, Issue 4, Page(s) 551–566

    Abstract: Molecular autopsy is changing the practice of forensic pathology. Under some circumstances, one must contemplate the involvement of genetic factors to help explain why someone has died unexpectedly. Such considerations most commonly occur when a young ... ...

    Abstract Molecular autopsy is changing the practice of forensic pathology. Under some circumstances, one must contemplate the involvement of genetic factors to help explain why someone has died unexpectedly. Such considerations most commonly occur when a young person dies by natural means. However, there are deaths that occur by nonnatural means that the forensic pathologist will be asked to investigate, which could involve natural disease that has a significant genetic underpinning. Elucidation of genetic mutations may not only further an understanding of the pathophysiology at hand, but also speak to underlying susceptibilities in an individual who dies that may not have been recognized. In addition, one may occasionally identify pathological findings that are confused for trauma that may actually be better explained by an underlying disease process. Using molecular medicine as a tool to explore such possibilities can improve the quality of death investigations and provide a new lens to probe challenging and contentious forensic cases that have proved resistant to traditional methods.
    Language English
    Publishing date 2017-12-01
    Publishing country United States
    Document type Journal Article
    ISSN 1925-3621
    ISSN (online) 1925-3621
    DOI 10.23907/2017.047
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Mesenchymal stem cell-secretome laden photopolymerizable hydrogels for wound healing.

    Doshi, Riddhesh B / Vakil, Devashree / Molley, Thomas G / Islam, Md Shariful / Kilian, Kristopher A / Cunningham, Corey / Sidhu, Kuldip S

    Journal of biomedical materials research. Part A

    2024  

    Abstract: Mesenchymal stem cell-derived secretome represents an emerging acellular therapeutic which possess significant opportunity for clinical applications due to its anti-inflammatory, immunomodulatory, and wound healing properties. However, maintaining ... ...

    Abstract Mesenchymal stem cell-derived secretome represents an emerging acellular therapeutic which possess significant opportunity for clinical applications due to its anti-inflammatory, immunomodulatory, and wound healing properties. However, maintaining therapeutic efficacy and ensuring stability of cell-based products is challenging, requiring a robust delivery method. Therefore, we designed a hydrogel-based scaffold loaded with CK Cell Technologies' proprietary Mesenchymal stem cell-secretome for controlled release treatment of acute and chronic wounds. We incorporated both conditioned media (CM) and extracellular vesicles (EVs) into gelatin methacryloyl (GelMA) hydrogels and demonstrated how we can tune the diffusive release of the EVs from them. To demonstrate viability of the approach, we developed a wound healing scratch assay where we see in situ release of CM and EVs promote enhanced migration of human dermal fibroblasts (hDFs). We see the colocalization of these EVs in the fibroblasts using fluorescent microscopy. Finally, as a surrogate for in vivo neovascularization, we conducted an in vitro tube formation assay for the MSC-secretome using matrigel-embedded human microvascular endothelial cells. By adding CM and EVs, we observe an increase in tubulogenesis. Collectively, our data demonstrates by tuning the GelMA properties, we can influence the controlled release of the MSC-secretome for a wound dressing and bandage application for chronic and acute wounds.
    Language English
    Publishing date 2024-03-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2099989-6
    ISSN 1552-4965 ; 1549-3296 ; 0021-9304
    ISSN (online) 1552-4965
    ISSN 1549-3296 ; 0021-9304
    DOI 10.1002/jbm.a.37697
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Heart of glass: fatal hematemesis caused by bronchiole-cardiac fistula.

    Bellis, Maggie / Cunningham, Kristopher S / Pickup, Michael J

    Forensic science, medicine, and pathology

    2020  Volume 17, Issue 2, Page(s) 334–337

    Abstract: A 58-year old woman presented for autopsy after having been found unresponsive in a public bathroom surrounded by a pool of blood. During attempts at resuscitation, blood was noted in her airway. She had a past medical history that included surgical ... ...

    Abstract A 58-year old woman presented for autopsy after having been found unresponsive in a public bathroom surrounded by a pool of blood. During attempts at resuscitation, blood was noted in her airway. She had a past medical history that included surgical repair of Tetralogy of Fallot as a child. At autopsy, a shard of glass was identified projecting from the surface of the left lung, having formed densely fibrotic adhesions at the pleural surface. The glass also penetrated through a bronchiole lumen and into a previously surgically repaired bulging right ventricular outflow tract, forming a bronchiole-cardiac fistula, allowing for the massive hemoptysis that led to her death. After further inquiry, it was discovered that the decedent also had a history of seizure disorder and had fallen through a glass door during a seizure many years ago, requiring several shards of glass to be removed from her chest wall.
    MeSH term(s) Bronchioles ; Fatal Outcome ; Female ; Fistula ; Heart Ventricles ; Hematemesis/etiology ; Humans ; Middle Aged
    Language English
    Publishing date 2020-11-27
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2195904-3
    ISSN 1556-2891 ; 1547-769X
    ISSN (online) 1556-2891
    ISSN 1547-769X
    DOI 10.1007/s12024-020-00320-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Evaluation of cardiac hypertrophy in the setting of sudden cardiac death.

    Cunningham, Kristopher S / Spears, Danna A / Care, Melanie

    Forensic sciences research

    2019  Volume 4, Issue 3, Page(s) 223–240

    Abstract: Ventricular hypertrophy is a common pathological finding at autopsy that can act as a substrate for arrhythmogenesis. Pathologists grapple with the significance of ventricular hypertrophy when assessing the sudden and unexpected deaths of young people ... ...

    Abstract Ventricular hypertrophy is a common pathological finding at autopsy that can act as a substrate for arrhythmogenesis. Pathologists grapple with the significance of ventricular hypertrophy when assessing the sudden and unexpected deaths of young people and what it could mean for surviving family members. The pathological spectrum of left ventricular hypertrophy (LVH) is reviewed herein. This article is oriented to the practicing autopsy pathologist to help make sense of various patterns of increased heart muscle, particularly those that are not clearly cardiomyopathic, yet present in the setting of sudden cardiac death. The article also reviews factors influencing arrhythmogenesis as well as genetic mutations most commonly associated with ventricular hypertrophy, especially those associated with hypertrophic cardiomyopathy (HCM).
    Language English
    Publishing date 2019-08-19
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2885963-7
    ISSN 2471-1411 ; 2096-1790
    ISSN (online) 2471-1411
    ISSN 2096-1790
    DOI 10.1080/20961790.2019.1633761
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Bilateral adrenal histoplasmosis in a man with chronic alcoholism.

    Turashvili, Gulisa / Cunningham, Kristopher S

    Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi

    2016  Volume 49, Issue 5, Page(s) 797–798

    MeSH term(s) Adrenal Glands/microbiology ; Adrenal Glands/pathology ; Alcoholism/complications ; Granuloma/pathology ; Histoplasma/isolation & purification ; Histoplasmosis/complications ; Histoplasmosis/diagnosis ; Histoplasmosis/microbiology ; Histoplasmosis/mortality ; Humans ; Male ; Middle Aged
    Language English
    Publishing date 2016-10
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1497590-7
    ISSN 1995-9133 ; 1684-1182 ; 0253-2662
    ISSN (online) 1995-9133
    ISSN 1684-1182 ; 0253-2662
    DOI 10.1016/j.jmii.2015.02.660
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Surviving Sudden Death: Where Does Next-Generation Sequencing Fit in the Assessment of Sudden Death Victims and Their Families.

    Hamilton, Robert M / Cunningham, Kristopher S / Behr, Elijah R

    Circulation. Cardiovascular genetics

    2018  Volume 10, Issue 6

    MeSH term(s) Arrhythmias, Cardiac/genetics ; Cardiac Conduction System Disease ; Death, Sudden ; Genetic Testing ; High-Throughput Nucleotide Sequencing ; Humans
    Language English
    Publishing date 2018-08-16
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2477394-3
    ISSN 1942-3268 ; 1942-325X
    ISSN (online) 1942-3268
    ISSN 1942-325X
    DOI 10.1161/CIRCGENETICS.117.002015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Evaluation of cardiac hypertrophy in the setting of sudden cardiac death

    Kristopher S. Cunningham / Danna A. Spears / Melanie Care

    Forensic Sciences Research, Vol 4, Iss 3, Pp 223-

    2019  Volume 240

    Abstract: Ventricular hypertrophy is a common pathological finding at autopsy that can act as a substrate for arrhythmogenesis. Pathologists grapple with the significance of ventricular hypertrophy when assessing the sudden and unexpected deaths of young people ... ...

    Abstract Ventricular hypertrophy is a common pathological finding at autopsy that can act as a substrate for arrhythmogenesis. Pathologists grapple with the significance of ventricular hypertrophy when assessing the sudden and unexpected deaths of young people and what it could mean for surviving family members. The pathological spectrum of left ventricular hypertrophy (LVH) is reviewed herein. This article is oriented to the practicing autopsy pathologist to help make sense of various patterns of increased heart muscle, particularly those that are not clearly cardiomyopathic, yet present in the setting of sudden cardiac death. The article also reviews factors influencing arrhythmogenesis as well as genetic mutations most commonly associated with ventricular hypertrophy, especially those associated with hypertrophic cardiomyopathy (HCM).
    Keywords forensic sciences ; forensic pathology ; ventricular hypertrophy ; arrhythmia ; sudden cardiac death ; genetics ; Criminal law and procedure ; K5000-5582 ; Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2019-07-01T00:00:00Z
    Publisher Taylor & Francis Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article: A large familial pathogenic Plakophilin-2 gene (

    Alhassani, Saad / Deif, Bishoy / Conacher, Susan / Cunningham, Kristopher S / Roberts, Jason D

    HeartRhythm case reports

    2018  Volume 4, Issue 10, Page(s) 486–489

    Language English
    Publishing date 2018-07-25
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2834871-0
    ISSN 2214-0271
    ISSN 2214-0271
    DOI 10.1016/j.hrcr.2018.07.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Hypertrophic Cardiomyopathy-Related Sudden Cardiac Death in Young People in Ontario.

    Weissler-Snir, Adaya / Allan, Katherine / Cunningham, Kristopher / Connelly, Kim A / Lee, Douglas S / Spears, Danna A / Rakowski, Harry / Dorian, Paul

    Circulation

    2019  Volume 140, Issue 21, Page(s) 1706–1716

    Abstract: Background: Hypertrophic cardiomyopathy (HCM) is considered a leading cause of sudden cardiac death (SCD) in younger people. The incidence of HCM-related SCD and its relationship to exercise have not been well studied in large comprehensive studies ... ...

    Abstract Background: Hypertrophic cardiomyopathy (HCM) is considered a leading cause of sudden cardiac death (SCD) in younger people. The incidence of HCM-related SCD and its relationship to exercise have not been well studied in large comprehensive studies outside of tertiary care settings. This study sought to estimate the incidence of HCM-related SCD and its association with exercise in a large unselected population.
    Methods: Using the Office of the Chief Coroner of Ontario database encompassing all deaths attended by the coroner, we identified all HCM-related SCDs in individuals 10 to 45 years of age between 2005 and 2016 (70 million person-years). Confirmation of HCM was based on typical macroscopic and microscopic features (definite HCM-related SCD). Sudden deaths with a prior clinical diagnosis of HCM but no autopsy were considered probable HCM-related SCDs. Cases with typical features but no myofiber disarray were considered possible HCM. The completeness of data was verified in a subset of patients in the Toronto area with the use of a registry of all emergency medical services-attended cardiac arrests, with an autopsy rate of 94%. To estimate the number of HCM-related aborted cardiac arrests and lives potentially saved by implantable cardioverter-defibrillators, all de novo implantations for secondary prevention and all implantations and appropriate shocks for primary prevention in patients with HCM 10 to 45 years of age, respectively, were identified with the use of a registry containing data on implantable cardioverter-defibrillator implantations from all implanting sites throughout Ontario.
    Results: Forty-four, 3, and 6 cases of definite, probable, and possible HCM-related SCDs, respectively, were identified, corresponding to estimated annual incidence rates of 0.31 per 1000 HCM person-years (95% CI, 0.24-0.44) for definite HCM-related SCD, 0.33 per 1000 HCM person-years (95% CI, 0.34-0.62) for definite or probable HCM-related SCD, and 0.39 per 1000 HCM person-years (95% CI, 0.28-0.49) for definite, probable, or possible HCM-related SCD (estimated 140 740 HCM person-years of observation). The estimated annual incidence rate for HCM-related SCD plus aborted cardiac arrest and HCM-related life-threatening arrhythmia (SCD, aborted cardiac arrest, and appropriate implantable cardioverter-defibrillator shocks) was 0.84 per 1000 HCM person-years (95% CI, 0.70-1.0). The majority (70%) of SCDs occurred in previously undiagnosed individuals. Most SCDs occurred during rest (64.8%) or light activity (18.5%).
    Conclusions: The incidence of HCM-related SCD in the general population 10 to 45 years of age is substantially lower than previously reported, with most cases occurring in previously undiagnosed individuals. SCDs are infrequently related to exercise.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Cardiomyopathy, Hypertrophic/diagnosis ; Cardiomyopathy, Hypertrophic/mortality ; Cardiomyopathy, Hypertrophic/therapy ; Cause of Death ; Child ; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/prevention & control ; Defibrillators, Implantable ; Electric Countershock/instrumentation ; Exercise ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Ontario/epidemiology ; Primary Prevention/instrumentation ; Registries ; Risk Assessment ; Risk Factors ; Secondary Prevention/instrumentation ; Sex Factors ; Time Factors ; Young Adult
    Language English
    Publishing date 2019-10-21
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/CIRCULATIONAHA.119.040271
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: A fatal case of atrioesophageal fistula following radiofrequency ablation of left atrium and pulmonary veins for atrial fibrillation.

    Rajapaksha, W R A S / Cunningham, Kristopher S / Rose, Toby H

    Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology

    2014  Volume 23, Issue 4, Page(s) 238–240

    Abstract: Atrial fibrillation (AF) is associated with significant morbidity and mortality. Hemodynamic compromise and formation of thrombi within the fibrillating atrium or atrial appendage can occur. Surgical treatment aims to eliminate dysrhythmia-triggering ... ...

    Abstract Atrial fibrillation (AF) is associated with significant morbidity and mortality. Hemodynamic compromise and formation of thrombi within the fibrillating atrium or atrial appendage can occur. Surgical treatment aims to eliminate dysrhythmia-triggering foci in the pulmonary veins and posterior left atrium by radiofrequency ablation techniques using ohmic heat. As medical treatment may be ineffective, radiofrequency catheter ablation is increasingly being used by interventional cardiac electrophysiologists for AF. Serious complications have been observed among patients who have undergone radiofrequency ablation, atrioesophageal fistula being a very rare example. This case describes a 43-year-old man who died after the development of an atrioesophageal fistula following radiofrequency ablation of the left atrium and pulmonary veins for treatment of AF.
    MeSH term(s) Adult ; Atrial Fibrillation/surgery ; Catheter Ablation/adverse effects ; Esophageal Fistula/etiology ; Esophageal Fistula/pathology ; Fatal Outcome ; Heart Atria/pathology ; Heart Atria/surgery ; Heart Diseases/etiology ; Heart Diseases/pathology ; Humans ; Male ; Pulmonary Veins/surgery
    Language English
    Publishing date 2014-07
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1134600-0
    ISSN 1879-1336 ; 1054-8807
    ISSN (online) 1879-1336
    ISSN 1054-8807
    DOI 10.1016/j.carpath.2014.02.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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