Morphometric Studies on Autolysis of the Cerebellar Cortex in Brain Death by Three-dimensional Color Image Analysis System

在日本涉及脑死亡和器官移植的问题中。一个容易引起争议的问题是，是否过早地宣布了脑死亡。我们研究的主题一直是根据小脑中颗粒层自溶(GLA)和逝去时间之间的相关性做出这一判断的指南。为了这项研究。我们使用了奥林普斯生产的彩色图像分析系统。在二维图像分析中，我们观察了正常脑对照标本和脑死亡小脑标本，通过比较两者颗粒层中的颗粒细胞(G)计数。结果，脑死亡样本中的G计数明显下降，与明显脑死亡后经过的时间成比例。这被认为是显示脑死亡状态持续时间的有效指标。对脑死亡病例的小脑内外层进行了三维图像分析，并根据其GLA的特点，将我们的研究分为：(1)红细胞和颗粒细胞自溶完全的类型，(2)-(4)红细胞和颗粒细胞有一定存活的类型。因此，(2)-(4)组被认为是估计外小脑层脑死亡状态持续时间的有效指标。然后，我们尝试对正常和脑死亡病例的所有数据的横截面样本进行三维图像重建。结果。在脑死亡病例中，我们发现GLA被认为是由于存在血栓的小动脉周围血流中断引起的。

Among the issues that concern brain death and organ transplants in Japan. one that is apt to be the subject of controversy is whether or not a brain death pronouncement has been made prematurely. The subject of our study has been the guideline for making this pronouncement based on the correlation between elapsed time and granular layr autolysis (GLA) in the cerebellum. For this research. we employed a color image analysis system manufactured by Olympus.1. On Two-Dimensional Image AnalysisWe investigated normal brain control specimens and brain dead cerebellum samples by comparing the granule cell (G) count in the granular layr of both. As a result, the G count in the case of the brain dead samples declined markedly in proportion to the time elapsed subsequent to pronounced brain death. and this is believed to be an effective indicator that shows the duration of the brain dead state.2. On Three-Dimensional Image AnalysisWe made investigation into the outer and inner strata of the cerebellum of brain dead cases, and, on the basis of their GLA characteristics, we grouped our investigations thus : (1) types where autolysis of erythrocytes and granular cells is complete, (2) - (4) types where erythrocytes and granular cells survive to some degree. As a result, groups (2) - (4) are believed to be effective indicators in the estimation of the duration of brain dead state for the outer cerebellum strata. We then attempted a three dimensional image reconstruction of cross-section specimens of all data for both normal and brain dead cases. As a result.in the brain dead cases.we discovered GLA believed to arise from interruption of blood flow in arteriolar peripheries where thrombi are present.