Study of early ischemic myocardial damage in forensic pathology

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The postmortem diagnosis of early ischemic myocardial damage has lain as intricate problem on forensic practice.We examined the histopathological findings of heart of a total of sixty-three cases obtained in the autopsies at the Department of Legal Medicine in Nagasaki University School of Medicine. Their causes of death were natural death, asphyxia, traumatic shock and head injury. We used the immunohistochemical staining by the antibodies to Fibronectin, i.e. the intercellular adhesion molecule, component of complement C9 and Troponin I, i.e. the specific protein of myocardium, in addition to conventional histological staining with hematoxylin and eosin (H&E) and Mallory's phosphotungstic acid hematoxylin (PTAH) method. Fibronectin and component of complement C9 are considered that they may be expressed in cardiomyocytes at myocardial damage and Troponin I is regarded as it may loss from cardiomyocytes at myocardial damage conversely. The immunohistochemical staining pattern of these markers were varied from case to case. These results suggested that these findings reflected the sensitive transitions of these three markers during myocardial damage.Furthermore, we used each single block of left ventricle from 74 forensic autopsy hearts to detect the early ischemic myocardial damage with immunohistochemical technique for complement component C9. The results lead the conclusion that C9 staining on cardiomyocytes is a reliable marker for early ischemic myocardial damage since it was sensitive enough to detect from just one block of each patient. Moreover, although in eleven cases the samples were fixed in formalin over one year, the immunostaining of C9 was not affected. This immunostaining for C9 is simple and valuable to detect early ischemic myocardial damage in retrospective forensic specimens. This immunostaining for C9 is simple and valuable to detect early ischemic myocardial damage in retrospective forensic specimens.