Forensic Neuropathological Studies on Presenile and Senile Dementias

对阿尔茨海默型痴呆(ATD)的研究，不仅从法医神经病理学的角度，采用各种常规染色和银染技术，而且用星形细胞的特异性标志物--胶质纤维酸性蛋白抗血清进行免疫组织化学染色，发现ATD组与智力正常的对照组在显微镜下的表现有显著差异。ATD的主要组织学特征是存在大量的老年斑和神经原纤维改变，两者都被认为是有帮助的诊断标志。前者染色可见典型的老年斑，被反应性星形胶质细胞包围，突起向内穿透。后一种染色可很好地显示淀粉样核。另一种方法是Partic…对淀粉样蛋白较为敏感，如淀粉样核或淀粉样血管病变，硫代黄素S染色。胶质纤维酸性蛋白的免疫组织化学染色显示，反应性星形细胞过程强烈参与斑块内的活动。根据Khachurian报告的阿尔茨海默病尸检标准，老年斑在显微镜放大x200视野下计数。检测到大量完全符合标准的斑块。这份报告由Bless等人撰写。老年受试者大脑皮层的平均斑块计数与痴呆程度之间存在高度显著的相关性，这对法医病理学家非常有帮助，并得到了高度评价。有报道称阿尔茨海默病患者大脑中的阿蒙角铝含量增加(CRapper et al，1973)。在本研究中，将磷酸铝注入17只兔的小脑延髓池、硬膜下间隙和脑实质。在总共16只兔子中，除了一只在注射半天后死亡外，发现了非常类似于阿尔茨海默氏症神经纤维变化的发现，特别是在海马区。较少

Alzheimer-type dementia (ATD) was discussed not only from the aspects of forensic neuropathology by using various techniques for general stains and silver-impregnation, but also immunohistochemically by using antiserum against glial fibrillary acidic protein which is a specific marker for astrocytes.There were marked differences in microscopic findings between the ATD group and control groups of elderly subjects whose intellectures have been maintained. The main histlogical features of ATD were presence of numerous senile plaques and neurofibrillary changes, both of which were thought to be helpful diagnosis markers.Double stains by glial fibrillary acidic protein (GFAP) stain using avidin-biotin peroxidase complex (ABC) method and Congo red stain were performed. By the former stain, typical senile plaques, encircled by reactive astrocytes and penetrated interiorly by their processes, were demonstrated. By the latter stain, amyloid core was well detected. Another method which is partic … More ularly sensitive to amyloid, such as amyloid core or amyloid angiopathy, thioflavin S stain. Immunohistochemical stains for glial fibrillary acidic protein demonstrated an intense participation within the plaques by processes of reactive astrocytes.Using the autopsy criteria for the diagnosis of Alzheimer's disease reported by Khachturian, senile plaques were counted on microscopic magnification x200 field. Numerous plaques satisfying thoroughly the criteria were detected. The report by Blessed et al. that there is a highly significant correlation between mean plaque counts in sections of cerebral cortex of elderly subjects and degrees of dementia is very helpful for forensic pathologists and is highly evaluated.There has been a report on the increase of aluminium in Ammon's horns in brains of Alzheimer's disease (Crapper et al, 1973).In the present study, aluminum phosphate was injected in the cerebellomedullar cistern, subdural space and brain substance of 17 rabbits. In 16 out of total rabbits, except one that died one-half day after injection, findings very similar to Alzheimer neurofibrillary changes were recognized, especially in hippocampus. Less