[Cardiomyocyte apoptosis in immunohistochemical diagnosis of sudden cardiac death]. / Apoptoza kardiomiocytów w diagnostyce immunohistochemicznej naglych zgonów sercowych.

In a considerable number of cases of sudden death "routine" diagnosis is insufficient to prove myocardial ischaemia especially in early myocardial infarction. One of the additional methods of postmortem diagnosis is detection of cardiomyocyte DNA fragmentation related to apoptosis. The authors presented research on 34 cases. All postmortem examination were conducted in the Chair of Forensic Medicine of the Jagiellonian University in Kraków. The data from history were taken into account as well as the results of gross macroscopic and microscopic examination (hematoxylin et eosin staining). In 19 cases the result of TUNEL assay was positive, in 5 apoptotic cell count was 80-90%. "Positive" cases showed focal or diffuse apoptotic myocytes. In 15 cases apoptotic reaction was negative including 3 cases of fatal ethanol intoxication and 1 aminotryptyline intoxication. In 22 cases the acid fuchsin technique (Nielsen's) was applied. The authors confronted their results with the data from literature and presented principles of qualification and practical interpretation of immunohistochemical apoptosis reaction.