Forensic Pathology and Experimental Research on Brain Death

1.本文对近10年来法医学尸检中62例脑死亡和5例植物状态的尸体进行了大体和显微镜检查。在脑死亡持续时间超过5 ~ 6小时的病例中，大脑、小脑和脑干已出现呼吸脑的特征性改变。在延髓和上颈髓，即使在脑死亡持续时间相对较短的病例中，也可见明显的神经细胞皱缩和固缩。延髓作为呼吸中枢，上述发现有助于从形态学上理解脑死亡时自主呼吸消失的原因。本文报道了在日本医学法律学会第71届会议上，日本医学法律学会第11届会议上，对脑死亡病人的心、肝、肾组织学所见的新的有价值的资料，这些资料将成为器官移植的对象。 ...更多信息 e温哥华国际法医学协会、1987年雅加达印度尼西亚病理学家协会第九届全国大会和1988年北京国际法医学大会。用兔子做了脑死亡的动物实验。将动物麻醉、插管并置于呼吸机上。在所有动物中，通过在顶骨或脑干部分的一侧膨胀硬膜外球囊引起脑压迫和水肿。在实验过程中，持续记录脑电图（EEG）和心电图（ECG）。持续停止自主呼吸，使脑电图平坦化，用呼吸机维持脑死亡状态。脑、心脏、肝脏和肾脏的组织学检查结果与脑死亡病例进行了比较。像人类这样持续时间长的脑死亡状态还没有出现过。死后脑组织的变化，自溶，也进行了讨论。少

1. Among the medico-legal autopsies performed in recent 10 years, 62 cases of brain death and 5 cases of vegetative state were evaluated grossly and microscopically. Many important findings were obtained.Characteristic findings of respirator brain could be already recognized in cerebrum, cerebellum and brdin stem in cases with duration of more than five to six hours' brain death. In medulla oblongata and upper cervical cord, marked shrinkage and pyknosis of nerve cells were seen even in cases with comparatively shorter duration of brain death. Such findings in medulla oblongata, as respira tory center, will be of a help to understand morphologically the disappearance of spontaneous respiration in brain death. New valuable informations were obtained on histological findings of heart, liver and kidneys in cases of brain death which will become the objects of organ transplantation.These results were reported on the 71st Congress of the Medico-Legal Society of Japan, the llth Meeting of th … More e International Association of Forensic Sciences in Vancouver, the 9th National Congress of the Indonesian Association of Patholo gists in Jakarta in 1987 and on the International Congress on Forensic Sciences in Beijing in 1988.2. Animal experiments on brain death were done using rabbits. The animals were anesthetized, intubated and placed on a ventilator. In all animals brain compression and edema were caused by inflating an epidural balloon on one side of parietal or brain Stem portion. During the experiments the electroencephalogram (EEG) and electrocardiogram (ECG) were constantly recorded. Continuous stoppage of spontaneous breathing and flattening of EEG were made and the state of brain death were experimentally maintained using ventilator. Histopathological findings of brain, heart, liver and kidneys were compared with those of the human cases of brain death. Such state of brain death with long duration as human cases has not been produced yet. Postmortem changes of brain tissue, autolysis, were also discussed. Less