Forensic Neuropathological Studies on Presenile and Senile Dementias

本文应用各种普通染色和银染技术，从法医神经病理学和免疫化学两个方面对阿尔茨海默型痴呆（Alzheimer type dementia，ATD）进行了探讨。ATD的主要组织学特征是存在大量老年斑和神经原纤维改变，这两种变化都被认为是有用的诊断标志物，采用抗生物素蛋白-生物素过氧化物酶复合物（ABC）法进行胶质纤维酸性蛋白（GFAP）染色和刚果红染色进行双重染色。前一种染色显示典型的老年斑，被反应性星形胶质细胞包围，并被其突起穿透。通过后一种染色，淀粉样蛋白核心被很好地检测到。另一种方法是partic ...更多信息 对淀粉样蛋白特别敏感，如淀粉样核心或淀粉样血管病，硫磺素S染色。胶质细胞酸性蛋白的免疫组化染色显示，反应性星形胶质细胞的过程中的斑块内的强烈参与。使用Khachturian报告的阿尔茨海默病的诊断尸检标准，老年斑在显微镜下放大x200场计数。检测到大量完全符合标准的噬菌斑。Blessed等人关于老年人大脑皮层切片中的平均斑块计数与痴呆程度之间存在高度显著相关性的报告对法医病理学家非常有帮助，并受到高度评价。有关于阿尔茨海默病患者脑中阿蒙角中铝增加的报告（Crapper等，1973）.本研究将磷酸铝注射于17只家兔的小脑延髓池、硬膜下腔和脑实质内。在16只家兔中，除1只在注射后半天死亡外，发现了非常类似于阿尔茨海默氏症的神经系统变化，特别是在海马。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