- 學位論文
小腦中Purkinje cell在不同死因中的變化
The change of Purkinje cell in cerebellum in various death causes
摘要
小腦是人體重要的器官之一，而腦部神經細胞受損時的生物學變化已經有廣泛的研究，但在不同死亡原因下小腦的組織學及生物學表現差異則較少被探討，本研究主要收集彰化及南投地檢署2006年1月至7月，共四十三件經司法相驗的案例，我們依照主要致死的傷害機轉將其分為三大類，分別是：腦性死亡（7例）、心性死亡（22例）及肺性死亡（14例），首先使用蘇木素-伊紅染色（H-E Stain）來觀察小腦中Purkinje cell的細胞型態及數量變化，並利用三種生物指標GFAP、S-100及NSE來評估在不同死因時它們的表現情形；結果發現本研究中腦性死亡者的腦部平均重量為1142.9±123.9公克，明顯較心性死亡的1345.9±146.8公克及肺性死亡的1341.4±254.3公克要來得輕（P＜0.05）；而Purkinje cell的大小、細胞質顏色、及數量的變化等…，在不同死因間並沒有顯著差異；可是免疫組織化學染色（IHC）的觀察卻發現，雖然GFAP在Purkinje cell的反應並不常見，但在肺性死亡中有兩個案例卻可見較多的陽性反應；而NSE方面，在心性死亡的小腦皮質顆粒層及分子層都有較強的免疫染色反應，雖然NSE極不穩定但仍可有如此強的著色，顯示心性死亡對腦部的影響較另外兩類死因要來的小，所以我們可以藉由評估NSE在腦部的表現，來排除心性死亡腦部損傷的可能。
並列摘要
The cerebellum is one of the important organ of human. The biological change in damaged neuron of the brain had been extensively researched, but the examination of histological and biological expression variant of cerebellum in various death cause is lesser. This investigate collection 43 autopsy cases is performed by personnel from judicial units, the prosecutor’s office of Chang-Hua and Nantou district court in Taiwan, between January 2006 to July 2006. According to the lethal mechanism, we divided the causes of death into three kinds: Brain death(7 cases), Heart death(22 cases)and Lung death(14 cases). First we use Hematoxylin - Eosin Staining(H-E stain)to observe the morphology and amount of Purkinje cell, then evaluate the expression of three biomarkers(GFAP, S-100 and NSE)in different death cause. The brain weight of the victims who die in brain death is 1142.9±123.9 g, less heavier than the heart death 1345.9±146.8 g and lung death 1341.4±254.3 g（P＜0.05）. And there is no difference in the change of Purkinje cell size, cytoplasm color and amount in various death cause. In Immunohistochemical Staining(IHC), although GFAP expression is rare in Purkinje cell, 2 cases of lung death victims have more positive expression in Purkinje cell than in the others. In NSE profile, cerebellar cortex granular layer and molecular layer have strong immune reaction in heart death cases, though NSE is unstable, indicating the brain effect in heart death is lesser than the other kinds of death cause. So through the evaluation of NSE expression in brain, to exclude brain damage possibility in heart death victims.