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

在日本，有关脑死亡和器官移植的问题。一个容易引起争议的问题是，是否过早地宣布了脑死亡。我们研究的主题是根据小脑颗粒层自溶（GLA）与时间流逝之间的相关性来判断这一结论的指南。为了这项研究。我们采用了奥林巴斯公司生产的彩色图像分析系统。二维图像分析通过比较正常脑对照标本和脑死亡小脑标本颗粒层中颗粒细胞(G)的计数。结果，在脑死亡样本的情况下，G计数与宣布脑死亡后的时间成比例地显著下降。这被认为是显示脑死亡状态持续时间的有效指标。三维图像分析我们对脑死亡病例的小脑内外层进行了调查，并根据其GLA特征将调查分为：(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程度的存活类型。因此，(2)-(4)组被认为是估算小脑外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标本进行三维图像重建。因此。在脑死亡病例中。我们发现GLA被认为是由血栓存在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.