CORE--NEUROPATHOLOGY

神经病理学(NP)核心为匹兹堡ADRC提供完整的脑库和神经病理学诊断服务。为了确保在短时间内收获高质量的组织，身体解剖每24小时进行一次，过去四年的平均尸检时间约为4小时。尸检时，大脑呈矢状等分。右半脑被解剖并广泛取样(冰冻样本储存，左半脑固定在10%缓冲的福尔马林中。固定后，取左侧大脑进行NP诊断试验，包括H&E、刚果红免疫细胞化学(β-A4淀粉样蛋白、tau、α-突触核蛋白和泛素)和银染(Bielschowsky)。根据最新的NIA建议对左侧大脑进行显微分析，包括神经原纤维缠结密度分期(Braak分期)，并遵循CERAD方案进行采样和半定量。路易小体病理按McKeith et的共识标准描述。艾尔NP Core最近开始使用α-突触核蛋白染色来评估路易小体的存在。脑库被编目并与NP诊断相关联，以向ADRC和其他研究人员提供具有良好特征的组织。每季度向调查人员发出通知，提醒他们银行案件的可用性和诊断。储存的组织样本使用唯一的NP Core银行识别符进行编码，该识别符不允许调查人员识别患者，但提供了一个链接(通过RAIN银行，该银行在一个安全的通行证-工作链接文件上维护密钥，只有NP Core人员才能访问)。调查人员还被提供了额外的非识别信息(年龄、性别、死后时间竞赛等)。组织和数据只有在经过ADRC执行委员会和Wiley博士的审查和批准后才能提供给研究人员，并需要IRB批准研究方案。NP诊断和2-3页的叙述性报告在死亡后一个月内提供给ADRC数据库和家属。截至1998年，国家警察的核心银行每年约有50例ADRC尸检。此外，对照大脑已经被储存，并以包括显微神经病理评估在内的相同方案为特征。核心包括用于开发滞留和定量分析的参考实验室(包括Ar/Kr激光共聚焦显微镜和Image 1工作站)。

The Neuropathology (NP) Core provides complete brain banking and neuropathology diagnostic services for the Pittsburgh ADRC. To assure harvesting of excellent quality tissues with short post-mortem times, autopsies are performed are performed on a 24 hour basis and the average post-mortem time over the past four years is approximately 4 hours. The brain is bisected sagittally at the time of autopsy. The right half is dissected and extensively sampled (frozen samples banking, the left half of the brain is fixed in 10% buffered formalin. After fixation the left hemi-brain is intensely sampled for NP diagnostic tests including H&E, Congo Red immunocytochemical (beta-A4 amyloid, tau, alpha-synuclein, and ubiquitin) and silver stains (Bielschowsky). Microscopic analysis of the left hemi-brain is performed according to current NIA- recommendations which includes staging of neurofibrillary tangle density (Braak staging) and follows CERAD protocols for sampling and semi- quantitation. Lewy Body pathology is described per the consensus criteria of McKeith et. al. The NP Core has recently initiated use of alpha- synuclein staining to assess for the presence of Lewy bodies. The brain bank is catalogued and correlated with NP diagnoses to make available well characterized tissues to ADRC and other investigators. Quarterly are issued to investigators to alert them to the availability and diagnoses of banked cases. Banked tissue samples are coded with a unique NP Core banking identifier which does not allow investigators to identify the patient, however, provides a link (through the rain bank which maintains the key on a secure pass-work linked file, with access only by NP Core personnel). Investigators are also provided with additional non- identifying information (age, sex, post-mortem time race, etc.) Tissues and data are made available to investigators only after review and approval by the ADRC Executive Committee and Dr. Wiley and requires IRB approval of the research protocol. NP diagnoses and a 2-3 page narrative report are supplied to the ADRC database and families within one month of death. As of 1998 the NP core banks approximately 50 ADRC autopsies per year. Additionally, control brains have been banked and characterized by identical protocols including microscopic neuropathologic evaluation. The core contains reference laboratory (including a Ar/Kr laser confocal microscope and Image 1 workstation) for development of detained and quantitative analyses.