ABSTRACT
Recently, it has been reported that a diagnosis of diffuse axonal injury in cases with a short survival period can be made with the use of immunolabelling for beta-amyloid precursor protein (APP). We examined whether immunostaining for neuron-specific enolase (NSE) can also be a useful marker for the detection of axonal injury in its early stages. Sections of the corpus callosum from 19 cases of head injury and from 9 cases of no head injury were immunostained for NSE and stained by the standard Holmes' silver method. For comparison, serial sections from several cases were immunostained for APP. Immunostaining for NSE as well as for APP, labelled injured axons in head injury cases with as early as 1.5 h survival where Holmes' staining failed to detect any changes of axons. Since NSE and APP labelled only injured axons but not normal axons, the results were readily interpretable. These findings indicate that NSE should be an effective marker for the detection of axonal injury in its early stages.
Subject(s)
Biomarkers/analysis , Brain Injuries/enzymology , Brain Injuries/pathology , Corpus Callosum/enzymology , Corpus Callosum/pathology , Immunohistochemistry/methods , Phosphopyruvate Hydratase/analysis , Adolescent , Adult , Aged , Aged, 80 and over , Amyloid beta-Protein Precursor/analysis , Autopsy , Brain Injuries/mortality , Case-Control Studies , Cause of Death , Female , Humans , Male , Middle Aged , Postmortem Changes , Reproducibility of Results , Time FactorsABSTRACT
Presented is the case of a 10-month-old boy who died of general peritonitis due to an isolated perforation of the proximal jejunum. The autopsy findings included multiple bruises and abrasions inflicted at different times, probable bite marks, an old cerebral contusion tear, malnutrition, and an involution of the thymus, this evidence cumulatively suggesting that the decedent was a battered child. The abdomen showed a general peritonitis, and the wall of the jejunum was ruptured on the antimesenteric surface, 2 cm from the duodenojejunal junction (the ligament of Treitz). Microscopically, the ruptured area showed a linear rent in the mucosa and muscularis, and the narrow necrotic lesion was surrounded by normal-appearing bowel tissue. Therefore, it appeared that an external force had compressed the jejunum against the spine, thus rupturing the jejunum near the duodenojejunal junction, a point of fixation.
Subject(s)
Child Abuse/diagnosis , Intestinal Perforation/etiology , Jejunum/injuries , Humans , Infant , MaleABSTRACT
An autopsy case of death due probably to neurogenic shock (primary shock) is reported. A 14-year-old boy got into a fight with his elder brother and received blows against the chest and abdomen. The young boy fell down senseless on the floor and had a spasm. An ambulance was called, but he was dead on arrival at a hospital. An autopsy revealed no external injuries on the chest and abdomen. There was no evidence of preexisting disease. On histological examination, there were signs of acute cardiac failure; edema of the lungs, liver and gall bladder, partial myofibrillar degeneration and cytoplasmic vacuoles in the media of a small coronary artery. Thus, the autopsy did not give any explanation of the fatality. It seems probable, however, that the blow(s) against the abdomen (the solar plexus) caused a fatal shock (vagal inhibition). In addition, the adrenal cortices (especially the zona fasciculata) were narrowed and the aorta was slightly narrow in caliber. It is likely that these hypoplasia might affect the fatal shock consequent to very slight injuries.
