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Hleșcu AA, Grigoraș A, Covatariu G, Moscalu M, Amalinei C. The Value of Myocardium and Kidney Histopathological and Immunohistochemical Findings in Accidental Hypothermia-Related Fatalities. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1507. [PMID: 36363464 PMCID: PMC9694447 DOI: 10.3390/medicina58111507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/12/2022] [Accepted: 10/20/2022] [Indexed: 08/30/2023]
Abstract
Background and Objectives: The post-mortem diagnosis of hypothermia is challenging in forensics. The aim of our study was to detect the kidney and heart histopathological changes that occurred in a group of hypothermia-related fatalities. Materials and Methods: The cohort included 107 cases identified in the database of our department between 2007 and 2021, which have been associated with extreme cold stress. Demographic and clinicopathological data were collected from the medico-legal reports. Archived tissue samples were evaluated to identify the histopathological features, in routine haematoxylin-eosin (H&E), Periodic acid-Schiff (PAS), and Masson's trichrome stainings, while cardiac sirtuin1 (SIRT1) and renal ubiquitin (Ub) immunostaining have been performed. Results: The majority of cases exposed to low temperatures were males (76%) from rural regions (68.2%) during the cold season. Paradoxical undressing was documented in 9.3% of cases. The common comorbidities included alcoholism (50.5%), neuropsychiatric diseases (10.3%), diabetes mellitus (3.7%), and lung tuberculosis (4.7%). The microscopic heart exam revealed areas of myocardial degeneration (100%), contraction bands (95.3%), fatty change (13.1%) and focal wavy contractile myocardial cells. Basal vacuolisation of renal tubular epithelial cells (Armanni-Ebstein lesions) (21.5%), focal tubular necrosis (7.5%), tubular renal cysts (7.5%), interstitial haemorrhages (5.6%), diabetic kidney disease (3.7%), background benign nephroangiosclerosis (42.1%), variable thickening of tubules and corpuscles basement membranes, capsular space amorphous material, and intratubular casts were identified in kidney tissue samples. Myocardial cells displayed SIRT1 weak expression, with a loss of immunopositivity correlated with areas with contraction bands, while a variable Ub expression was observed in renal corpuscles capsules, proximal, distal, and collecting renal tubules, Henle's loops, urothelium, and intratubular casts. Conclusions: In the context of the current concept that death associated with hypothermia is still a diagnosis of exclusion, our findings suggest that the microscopic exam provides relevant data that support the diagnosis of hypothermia-related fatalities in appropriate circumstances of death. A deeper insight into the histopathologic findings in hypothermic patients may lead to new therapeutic approaches in these cases.
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Affiliation(s)
- Andreea Alexandra Hleșcu
- Legal Medicine Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adriana Grigoraș
- Department of Morphofunctional Sciences I, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Histopathology, Institute of Legal Medicine, 700455 Iasi, Romania
| | - Gabriela Covatariu
- Faculty of Civil Engineering and Building Services, “Gheorghe Asachi” Technical University, 700050 Iasi, Romania
| | - Mihaela Moscalu
- Department of Preventive Medicine and Interdisciplinarity, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cornelia Amalinei
- Department of Morphofunctional Sciences I, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Histopathology, Institute of Legal Medicine, 700455 Iasi, Romania
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Savioli G, Zanza C, Longhitano Y, Nardone A, Varesi A, Ceresa IF, Manetti AC, Volonnino G, Maiese A, La Russa R. Heat-Related Illness in Emergency and Critical Care: Recommendations for Recognition and Management with Medico-Legal Considerations. Biomedicines 2022; 10:biomedicines10102542. [PMID: 36289804 PMCID: PMC9599879 DOI: 10.3390/biomedicines10102542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/22/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022] Open
Abstract
Hyperthermia is an internal body temperature increase above 40.5 °C; normally internal body temperature is kept constant through natural homeostatic mechanisms. Heat-related illnesses occur due to exposure to high environmental temperatures in conditions in which an organism is unable to maintain adequate homeostasis. This can happen, for example, when the organism is unable to dissipate heat adequately. Heat dissipation occurs through evaporation, conduction, convection, and radiation. Heat disease exhibits a continuum of signs and symptoms ranging from minor to major clinical pictures. Minor clinical pictures include cramps, syncope, edema, tetany, and exhaustion. Major clinical pictures include heatstroke and life-threatening heat stroke and typically are expressed in the presence of an extremely high body temperature. There are also some categories of people at greater risk of developing these diseases, due to exposure in particular geographic areas (e.g., hot humid environments), to unchangeable predisposing conditions (e.g., advanced age, young age (i.e., children), diabetes, skin disease with reduced sweating), to modifiable risk factors (e.g., alcoholism, excessive exercise, infections), to partially modifiable risk factors (obesity), to certain types of professional activity (e.g., athletes, military personnel, and outdoor laborers) or to the effects of drug treatment (e.g., beta-blockers, anticholinergics, diuretics). Heat-related illness is largely preventable.
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Affiliation(s)
- Gabriele Savioli
- Emergency Department, IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Doctoral Program Experimental Medicine, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Christian Zanza
- Foundation “Ospedale Alba-Bra”, Department of Emergency Medicine, Anesthesia and Critical Care Medicine, Michele and Pietro Ferrero Hospital, 12060 Verduno, Italy
- Correspondence:
| | - Yaroslava Longhitano
- Foundation “Ospedale Alba-Bra”, Department of Emergency Medicine, Anesthesia and Critical Care Medicine, Michele and Pietro Ferrero Hospital, 12060 Verduno, Italy
| | - Alba Nardone
- Department of Internal Medicine, Università degli Studi of Pavia, 27100 Pavia, Italy
| | - Angelica Varesi
- Department of Internal Medicine, Università degli Studi of Pavia, 27100 Pavia, Italy
| | | | - Alice Chiara Manetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Gianpietro Volonnino
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Aniello Maiese
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy
| | - Raffaele La Russa
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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Cheng J, Deng Y, Zhou J. Role of the Ubiquitin System in Chronic Pain. Front Mol Neurosci 2021; 14:674914. [PMID: 34122010 PMCID: PMC8194701 DOI: 10.3389/fnmol.2021.674914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/12/2021] [Indexed: 01/02/2023] Open
Abstract
As a significant public health issue, chronic pain, mainly neuropathic pain (NP) and inflammatory pain, has a severe impact. The underlying mechanisms of chronic pain are enigmatic at present. The roles of ubiquitin have been demonstrated in various physiological and pathological conditions and underscore its potential as therapeutic targets. The dysfunction of the component of the ubiquitin system that occurs during chronic pain is rapidly being discovered. These results provide insight into potential molecular mechanisms of chronic pain. Chronic pain is regulated by ubiquitination, SUMOylation, ubiquitin ligase, and deubiquitinating enzyme (DUB), etc. Insight into the mechanism of the ubiquitin system regulating chronic pain might contribute to relevant therapeutic targets and the development of novel analgesics.
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Affiliation(s)
| | | | - Jun Zhou
- Department of Anesthesiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
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4
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Umehara T, Murase T, Abe Y, Yamashita H, Shibaike Y, Kagawa S, Yamamoto T, Ikematsu K. Identification of potential markers of fatal hypothermia by a body temperature-dependent gene expression assay. Int J Legal Med 2018; 133:335-345. [PMID: 29959558 DOI: 10.1007/s00414-018-1888-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/22/2018] [Indexed: 12/13/2022]
Abstract
Diagnosis of fatal hypothermia is considered to be difficult in forensic practice and even if findings due to cold exposure are evident, cold exposure is not necessarily a direct cause of death. Identification of useful molecular markers for the diagnosis of fatal hypothermia has not been successful. In this study, to identify novel molecular markers that inform the diagnosis of fatal hypothermia, we focused on skeletal muscle, which plays a role in cold-induced thermogenesis in mammals. We made rat models of mild, moderate, and severe hypothermia and performed body temperature-dependent gene expression analysis in the iliopsoas muscle using next-generation sequencing (NGS). NGS showed that after severe hypothermia, the expression levels of 91 mRNAs were more than double those in mild and moderate hypothermia and control animals. Gene ontology (GO) analysis indicated that these mRNAs are involved in a number of biological processes, including response to stress and lipids, and cellular response to hypoxia. The expression of four genes [connective tissue growth factor (Ctgf), JunB proto-oncogene, AP-1 transcription factor subunit (Junb), nuclear receptor subfamily 4, group A, member 1 (Nr4a1), and Syndecan 4 (Sdc4)] and the level of one protein (CTGF) were induced only by severe hypothermia. These genes and protein are involved in muscle regeneration, tissue repair, and lipid metabolism. These results indicate that heat production to maintain body temperature in a process leading to fatal hypothermia might be performed by the iliopsoas muscle, and that Ctgf, Junb, Nr4a1, and Sdc4 genes are potential diagnostic markers for fatal hypothermia.
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Affiliation(s)
- Takahiro Umehara
- Division of Forensic Pathology and Science, Unit of Social Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan.
| | - Takehiko Murase
- Division of Forensic Pathology and Science, Unit of Social Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
| | - Yuki Abe
- Division of Forensic Pathology and Science, Unit of Social Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
| | - Hiromi Yamashita
- Center for Forensic Pathology and Science, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
| | - Yoshinori Shibaike
- Division of Forensic Pathology and Science, Unit of Social Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
| | - Shinichiro Kagawa
- Division of Forensic Pathology and Science, Unit of Social Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
| | - Takuma Yamamoto
- Division of Forensic Pathology and Science, Unit of Social Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
| | - Kazuya Ikematsu
- Division of Forensic Pathology and Science, Unit of Social Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
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Zhang Z, Gong Q, Feng X, Zhang D, Quan L. Astrocytic clasmatodendrosis in the cerebral cortex of methamphetamine abusers. Forensic Sci Res 2017; 2:139-144. [PMID: 30483632 PMCID: PMC6197099 DOI: 10.1080/20961790.2017.1280890] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/09/2017] [Indexed: 11/21/2022] Open
Abstract
Postmortem investigation of methamphetamine (MA) abuse is an important task in forensic pathology. The present study investigated morphological changes in the astrocytes in the parietal cerebral cortex of MA abusers. Glial fibrillary acidic protein immunoreactivity in the cerebral cortex was examined in forensic autopsy cases for MA-detected group and control group. Clasmatodendrotic astrocytes (including those with swollen cell bodies and disintegrating distal processes) were frequently observed in the cerebral cortex of MA abusers. Quantitative analysis using a colour image processor showed a concomitant increase in the astrocyte area and astrocyte-to-vessel area ratio (size and number of astrocytes) in the grey matter in acute MA fatality and other MA-involved cases, although the astrocyte area (size) was also increased in cases of asphyxiation. The total astrocyte area (size) in the white matter was significantly higher in MA fatalities and asphyxia than in the other groups involving MA abusers. Those indices were independent of blood MA level, age, sex, survival or postmortem time. These observations suggest the increasing number and hypertrophic changes of astrocytes in the grey matter in MA abusers can be the outcome of long-term abuse, while disintegrating distal processes may exist only in acute fatal MA intoxication.
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Affiliation(s)
- Zhiyong Zhang
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.,Forensic Science Center, Shunde Branch of Foshan Public Security Bureau, Foshan, China
| | - Qingjin Gong
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Xueying Feng
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Dongchuan Zhang
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Li Quan
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
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Ma S, You S, Hao L, Zhang D, Quan L. Fatal mechanical asphyxia induces changes in energy utilization in the rat brain: An (18)F-FDG-PET study. Leg Med (Tokyo) 2015; 17:239-44. [PMID: 25725531 DOI: 10.1016/j.legalmed.2015.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/16/2015] [Accepted: 02/10/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE This study was designed to evaluate changes in brain glucose metabolism in rats following ligature strangulation. MATERIALS AND METHODS Thirteen male Wistar rats were used in the present study, divided into control (n=7) and asphyxia groups (n=6, ligature strangulation). Positron emission tomography (PET) with 2-deoxy-2-[(18)F]fluoro-D-glucose ((18)F-FDG) was used to evaluate brain glucose metabolism. Rats were scanned for PET-CT, and image data co-registered with a T2WI MRI template using SPM8 software. Image J was employed to draw regions of interest (ROIs) from the MRI template and acquire ROI activity information from the PET images. RESULTS In the asphyxia group vs. controls, (18)F-FDG uptake (FU) was decreased in the substantia nigra (25.26%, p<0.001), rhombencephalon (pons/medulla oblongata, 13.92%, p<0.01), hypothalamus (22.06%, p<0.01), ventral tegmentum (10.12%, p<0.05) and amygdala (12.74%, p<0.05); however, FU was increased in motor (18.21%, p<0.05) and visual cortices (19.2%, p<0.05). CONCLUSIONS The glucose metabolism distribution map in the asphyxiated rat brains were substantially changed versus controls. PET with (18)F-FDG can demonstrate excitement and inhibition of different brain areas even in cases of ligature strangulation.
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Affiliation(s)
- Suhua Ma
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2 Road, Guangzhou, Guangdong Province 510080, PR China
| | - Shengzhong You
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2 Road, Guangzhou, Guangdong Province 510080, PR China
| | - Li Hao
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2 Road, Guangzhou, Guangdong Province 510080, PR China
| | - Dongchuan Zhang
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2 Road, Guangzhou, Guangdong Province 510080, PR China
| | - Li Quan
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2 Road, Guangzhou, Guangdong Province 510080, PR China; Department of Legal Medicine, Osaka City University Medical School, Osaka 545-8585, Japan.
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7
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Maeda H, Ishikawa T, Michiue T. Forensic molecular pathology: its impacts on routine work, education and training. Leg Med (Tokyo) 2014; 16:61-9. [PMID: 24480586 DOI: 10.1016/j.legalmed.2014.01.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Accepted: 01/07/2014] [Indexed: 01/14/2023]
Abstract
The major role of forensic pathology is the investigation of human death in relevance to social risk management to determine the cause and process of death, especially in violent and unexpected sudden deaths, which involve social and medicolegal issues of ultimate, personal and public concerns. In addition to the identification of victims and biological materials, forensic molecular pathology contributes to general explanation of the human death process and assessment of individual death on the basis of biological molecular evidence, visualizing dynamic functional changes involved in the dying process that cannot be detected by morphology (pathophysiological or molecular biological vital reactions); the genetic background (genomics), dynamics of gene expression (up-/down-regulation: transcriptomics) and vital phenomena, involving activated biological mediators and degenerative products (proteomics) as well as metabolic deterioration (metabolomics), are detected by DNA analysis, relative quantification of mRNA transcripts using real-time reverse transcription-PCR (RT-PCR), and immunohisto-/immunocytochemistry combined with biochemistry, respectively. Thus, forensic molecular pathology involves the application of omic medical sciences to investigate the genetic basis, and cause and process of death at the biological molecular level in the context of forensic pathology, that is, 'advanced molecular autopsy'. These procedures can be incorporated into routine death investigations as well as guidance, education and training programs in forensic pathology for 'dynamic assessment of the cause and process of death' on the basis of autopsy and laboratory data. Postmortem human data can also contribute to understanding patients' critical conditions in clinical management.
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Affiliation(s)
- Hitoshi Maeda
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan; Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan.
| | - Takaki Ishikawa
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan; Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan; Division of Legal Medicine, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503 Tottori, Japan
| | - Tomomi Michiue
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan; Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan
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8
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Biochemical markers of fatal hypothermia. Forensic Sci Int 2013; 226:54-61. [DOI: 10.1016/j.forsciint.2012.12.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 10/30/2012] [Accepted: 12/02/2012] [Indexed: 11/19/2022]
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Postmortem biochemical investigations in hypothermia fatalities. Int J Legal Med 2012; 127:267-76. [DOI: 10.1007/s00414-012-0738-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 06/26/2012] [Indexed: 10/28/2022]
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10
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Palmiere C, Mangin P. Hyperthermia and postmortem biochemical investigations. Int J Legal Med 2012; 127:93-102. [DOI: 10.1007/s00414-012-0722-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 05/24/2012] [Indexed: 12/22/2022]
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Pathophysiologic changes due to TASER® devices versus excited delirium: Potential relevance to deaths-in-custody? J Forensic Leg Med 2011; 18:145-53. [PMID: 21550562 DOI: 10.1016/j.jflm.2011.01.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 01/13/2011] [Accepted: 01/26/2011] [Indexed: 11/21/2022]
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12
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Maeda H, Ishikawa T, Michiue T. Forensic biochemistry for functional investigation of death: Concept and practical application. Leg Med (Tokyo) 2011; 13:55-67. [DOI: 10.1016/j.legalmed.2010.12.005] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 12/23/2010] [Indexed: 10/18/2022]
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13
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Maeda H, Zhu BL, Ishikawa T, Michiue T. Forensic molecular pathology of violent deaths. Forensic Sci Int 2010; 203:83-92. [DOI: 10.1016/j.forsciint.2010.07.024] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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14
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Piette MHA, Pieters SEP, De Letter EA. Evaluation of the agonal stress: can immunohistochemical detection of ubiquitin in the locus coeruleus be useful? Int J Legal Med 2010; 125:333-40. [PMID: 20396898 DOI: 10.1007/s00414-010-0434-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 02/19/2010] [Indexed: 11/25/2022]
Abstract
The determination of the survival time after a crime as well as the concomitant physical and mental load of the victim is an important task for the forensic pathologist. The heat shock protein, ubiquitin, exerts an essential role in the cellular response to stress. We aimed to investigate the usefulness of the ubiquitin expression in the locus coeruleus as a marker for the evaluation of agonal stress. Is the amount of ubiquitin in this brain locus an indication of the length and/or intensity of the agonal period following various causes of death? The immunohistochemical (IHC) expression of ubiquitin is examined in formalin-fixed, paraffin-embedded slides of the human locus coeruleus (n = 48). The evaluation of the IHC staining is blindly performed, prior to the study of the medico-legal files. According to the length of agony, a division into subgroups is made. Three possible IHC staining patterns are observed: a staining of the neuronal nucleus or the cytoplasm or both. In addition, the number of neurons with ubiquitin expression per μm(2) is calculated in each locus coeruleus. Significant differences in the number of ubiquitin-immunoreactive neurons are noticed with respect to the length of the agony: A higher density of positive neurons is seen in case of a pronounced and extended death struggle.
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Affiliation(s)
- Michel H A Piette
- Department of Forensic Medicine, Forensic Institute Ghent University, J. Kluyskensstraat 29, 9000, Ghent, Belgium.
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15
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Yoshida C, Ishikawa T, Michiue T, Quan L, Maeda H. Postmortem biochemistry and immunohistochemistry of chromogranin A as a stress marker with special regard to fatal hypothermia and hyperthermia. Int J Legal Med 2009; 125:11-20. [DOI: 10.1007/s00414-009-0374-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 08/31/2009] [Indexed: 10/20/2022]
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16
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Zhu BL, Ishikawa T, Michiue T, Li DR, Zhao D, Quan L, Oritani S, Bessho Y, Maeda H. Postmortem serum catecholamine levels in relation to the cause of death. Forensic Sci Int 2007; 173:122-9. [PMID: 17395415 DOI: 10.1016/j.forsciint.2007.02.013] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Revised: 02/08/2007] [Accepted: 02/12/2007] [Indexed: 11/17/2022]
Abstract
Catecholamines are major humoral factors and neurotransmitters that contribute to various stress responses. However, they have been considered unstable due to agony, terminal medical care and postmortem interference. The present study was a comprehensive investigation of postmortem serum levels of adrenaline (Adr), noradrenaline (Nad) and dopamine (DA) with regard to the cause of death in serial medicolegal autopsy cases (n=542) including fatalities from various traumas and diseases. There was a slight tendency toward postmortem increases of Nad and DA in cardiac blood as well as Adr and Nad in peripheral blood, a slight age-dependent decrease in Adr and DA in right heart blood, and a marked increase in serum DA due to administration during critical medical care. When these factors were taken into consideration, significantly higher cardiac blood levels were observed for Adr and Nad in injury and asphyxiation cases and for Adr in fatal methamphetamine (MA) abuse and other poisoning cases, whereas those levels were lower in fatal hypothermia. Drowning, fire fatality, acute cardiac death and cerebrovascular disease showed intermediate Adr and Nad levels. The DA level was elevated in cases of injury, hyperthermia, MA fatality and other poisoning. Topographical analyses suggested that the major sources of increased serum catecholamines in cases of injury was abdominal viscera including adrenal glands, and that in cases of asphyxiation, drowning, fire fatality, hyperthermia, MA fatality, other poisoning, acute cardiac death and cerebrovascular disease was the extremities in addition to abdominal viscera. However, there was in part a large case-to-case difference in each marker related to individual causes of death. These findings differed markedly from clinical observations and suggest that the postmortem serum catecholamine levels may reflect the magnitude of physical stress responses during the process of death in individual cases.
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Affiliation(s)
- Bao-Li Zhu
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan.
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Ishikawa T, Zhu BL, Li DR, Zhao D, Michiue T, Maeda H. Immunohistochemical investigation of ubiquitin and myoglobin in the kidney in medicolegal autopsy cases. Forensic Sci Int 2007; 171:136-41. [PMID: 17166680 DOI: 10.1016/j.forsciint.2006.10.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2006] [Revised: 08/28/2006] [Accepted: 10/30/2006] [Indexed: 10/23/2022]
Abstract
We examined the immunohistochemical distributions of ubiquitin (Ub) and myoglobin (Mb) in human kidney tissues to assist the pathological assessment of death due to trauma. Medicolegal autopsy cases at our institute (n=138: 0-96 years of age, 105 males and 33 females) were examined. Causes of death were blunt injury (n=31), sharp injury (n=15), poisoning (n=11), drowning (n=10), fire fatalities (n=25), hypothermia (n=7), asphyxiation (n=14), hyperthermia (n=3), and natural diseases (n=22) for controls. Immunostaining of Ub and Mb was performed on the formalin-fixed paraffin-embedded kidney tissue sections. Quantitative analyses by estimating the proportion of Ub- and Mb-positive cells (%positivity) of renal tubule epithelial cells showed that the positivities for Ub and Mb were higher in subjects who died due to fire, blunt injury, sharp injury and fatal hypothermia than in other groups. The Ub-positivity correlated with the severity of airway thermal injury in fire deaths, survival time in blunt injury, and serum markers for renal failure in deaths due to sharp injury. Concomitant increases in the tubular Mb- and Ub-positivities were characteristic to deaths from injury and hypothermia. These findings suggest that Ub may serve as a sensitive indicator of the fatal influence of traumas.
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Affiliation(s)
- Takaki Ishikawa
- Department of Legal Medicine, Osaka City University Medical School, Asahi-Machi 1-4-3, Abeno, Osaka 545-8558, Japan.
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Li DR, Zhu BL, Ishikawa T, Zhao D, Michiue T, Maeda H. Immunohistochemical distribution of S-100 protein in the cerebral cortex with regard to the cause of death in forensic autopsy. Leg Med (Tokyo) 2006; 8:78-85. [PMID: 16338157 DOI: 10.1016/j.legalmed.2005.09.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2005] [Revised: 08/18/2005] [Accepted: 09/04/2005] [Indexed: 12/17/2022]
Abstract
S-100 protein (S100) is an acidic calcium-binding protein, which is abundantly found in the brain. The aim of the present study was to investigate the immunohistochemical distribution of S100 in the cerebral cortex in forensic autopsy cases with regard to the cause of death and relationship to its serum levels. The cases (n = 286, 3-48 h postmortem) included fatal head injuries (n = 89), acute death from other blunt injuries (n = 29), sharp instrument injuries (n = 20), asphyxiation (n = 29: strangulation/hanging, n = 22; aspiration, n = 7), drownings (n = 22), fire fatalities (n = 68), cerebrovascular diseases (n = 9) and acute myocardial infarction/ischemia (AMI, n = 20). S100-immunopositivity was mainly observed in the gliacytes, in part, in the neurons and myelins. For S100B-immunostaining, the gliacytes and myelins were positive, whereas the neurons were negative. Positivity in astrocytes was dependent on the cause of death, and was significantly lower in acute deaths due to strangulation/hanging and drowning, and mildly low in those due to injuries. Positivity in neurons and myelins was frequently observed in delayed head injury deaths and fire fatalities, showing an inverse relationship with the positivity in astrocytes in head injury cases. For cases of acute death, there was an inverse relationship between S100-positivity in the astrocytes and the serum S100B level. These observations suggest that astrocytes are more rapidly and severely injured than neurons during fatal brain damage, thereby causing an elevation in the serum S100B level.
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Affiliation(s)
- Dong-Ri Li
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan.
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