Thymic function and Sudden Death (Has the term "Status Thymicolymphatics" gone in limbo?)

所有猝死病例都由东京都、大坂和科比的体检医师进行检查。在每1000次调查中，有2-5次是在尸体解剖后突然死亡，死因不明。Srarus thymiclymphatics曾用于此类病例。虽然诊断一直悬而未决，但许多猝死病例表现为胸腺肿大和肾上腺皮质变薄。在本研究中，对法医尸检病例中的胸腺进行了流式细胞术分析。胸腺取自兵库县医疗检查官办公室和三重大学医学部法医科学系的尸检病例。切除后立即获得胸腺细胞并悬浮于磷酸盐缓冲液中。抗CD 3、CD 4、CD 8和bcl-2单克隆抗体作为第一抗体用于免疫组织化学和流式细胞术分析。对照组取自免疫学正常的尸检和心内直视手术患者，儿童和成人猝死患者的CD 4 + CD 8+双阳性胸腺细胞相对数量均增加。bcl-2的表达与对照组不同，bcl-2在CD_3低胸腺细胞中表达上调。总之，不明原因猝死的病例表现出不同的胸腺细胞分化模式。提示胸腺功能可能与猝死机制有关。

All cases of sudden death are examined by medical examiners in Tokyo Metropolitan, Osaka and Kobe. Sudden death of unknown origin even after autopsy accounts for 2-5 per 1000 inquests. Srarus thymicolymphatics had been used in such cases. Though the diagnosis has gone in limbo, many cases of sudden death showed thymic enlargement and thin adrenal cortex. In the present study, flow cytometric analyses of the thymus were done in medicolegal autopsy cases.The thymuses were taken from autopsy cases in the Hyogo Medical Examiner's Office and the Department of Forensic Medicine and Sciences, Mie University School of Medicine. Immediately after the resection, thymocytes were obtained and suspended in phosphate saline buffer. Anti-CD3, CD4, CD8, and bcl-2 monoclonal antibodies were used as the first antibodies for immunohistochemical and flow cytometric analyses. The control thymuses were obtained from immunologically normal autopsy cases and patients from open cardiac surgery.The relative numbers of CD4+CD8+double positive thymocytes were increased in both child and adult sudden death cases. The expression of bcl-2 showed a different pattern of control cases, i.e., bcl-2 up regulation in CD3low thymocytes. It was a reverse pattern of child abuse/neglect.In conclusion, cases of sudden death unknown origin showed a different pattern of thymocytes, differentiation. It is suggested that a thymic function might be related to the mechanism of sudden death.