Forensic Neuropathological Studies on Alzheimer - Type Dementia

对全联合皮层的脑组织进行了化学染色。在科比大学医学院法律的医学系和兵库县医学检查官办公室进行的尸检中，包括10例急性死亡病例，其中5例为非痴呆症，3例为阿尔茨海默型痴呆症（ATD），2例为痴呆症或非痴呆症不明。至于ATD患者，他们一生中在一些医疗机构接受过临床诊断。在每次尸检时，称量全脑重量，右侧大脑半球立即固定在4%甲醛溶液中，左侧大脑半球冠状切片5 - 10 mm厚，并在4%多聚甲醛0.01 M缓冲液（pH7.4）中固定数天后，用15%蔗糖0.01 M缓冲液（pH7.4）固定。从大脑半球的每一侧，海马、杏仁核、额联合皮质（上级额回）、颞联合皮质（颞叶）、杏仁核 ...更多信息 取颞上回（上级）、视联合皮层和颞顶联合皮层（角回）作为组织块和标本。右侧标本行经典染色和淀粉样蛋白染色，左侧标本行GFAP、乳转铁蛋白（LF）和HLA-DR免疫组化染色。在SP和NFT的好发区方面，两组的得分也存在差异。此外，在某些地区，SP多，而在另一些战神，NFT在一个病例中占主导地位。因此，SP或NFT的出现在病例和地区中的分布差异很大。在ATD病例和对照组中检测到反应性星形胶质细胞和反应性小胶质细胞。但总体上，ATD患者的SP、NFT、反应性星形胶质细胞和反应性小胶质细胞的阳性率均高于对照组，尤其是在SP和NFT阳性的区域，两例未确诊ATD患者的SP、NFT、反应性星形胶质细胞和反应性小胶质细胞在各区域的阳性率均不同。这些病例综合起来可诊断为ATD，但仍有部分区域无明显改变，提示法医学尸检中要诊断为ATD，需对整个联合皮质进行检查。少

Autopsied human brain tissues of whole association cortex were examined immunohistochemically. The brains, autopsied at the Department of Legal Medicine, Kobe University School of Medicine and the Medical Examiners Office of Hyogo Prefecture, included 10 cases of acute death consisting of 5 cases of non-demented, 3 cases of Alzheimer-type dementia (ATD) and 2 cases of demented or non-demented unknown. As for patients of ATD,they were clinically diagnosed at some medical facilities in their life time. At the time of each autopsy, whole brain was weighed and right side hemisphere was fixed in 4% formaldehyde solution instantly, and left side hemisphere was sliced with 5 to 10 mm thickness in coronal sections and after fixation for several days in 4% paraformaldehyde 0.01M buffer solution (pH7.4) , fixed by 15% sucrose 0.01M buffer solution (pH7.4). From each side of hemisphere, hippocampus, amygdaloid nucleus, frontal association cortex (superior frontal gyrus) , temporal association cor … More tex (superior temporal gyrus) , visual association cortex and parietotemporal association cortex (angular gyrus) were obtained as tissue blocks and specimens. Each specimen from right side was stained by classical methods and amyloid staining methods, and specimens from left side were stained immunohistochemically with GFAP,lactotransferrin (LF) and HLA-DR.In some ATD cases, senile plaques (SP) were significantly numerous, and in others, neurofibrillary tangles (NFT) were marked strongly. Concerning with predilectional areas of SP and NFT,their scores were also variable. Furthermore, in some areas, SP were numerous and in other ares, NFT were marked dominantly in a case. So, distributions of appearance of SP or NFT were awfully variable in cases and also in areas. Reactive astrocytes and reactive microglias were detected in ATD cases as well as in controls. However, on the whole, they were more detected in ATD cases than in controls and particularly they were detected numerously in areas with marked SP or NFT.Two cases undiagnosed as ATD marked variable scores of SP,NFT,reactive astrocytes and reactive microglias in each area. These cases were synthetically able to be diagnosed as ATD.However, they had some areas without remarkable changes, it was suggested that for the purpose of diagnosing as ATD in the medicolegal autopsy cases, examinations in whole association cortex were needed. Less