Simultaneous observation of catecholamine, serotonin and their metabolites in incised skin wounds of guinea pig.

In order to examine the vital reaction in wounds, catecholamines, serotonin (5-HT) and their metabolites in the incised skin wounds of guinea pigs were analyzed simultaneously by high-performance liquid chromatography (HPLC) using electrochemical detection (ECD). The principal changes in the levels of these compounds in vital wounds were as follows: a considerable decrease in norepinephrine (NE) content was observed 12-24 h after injury which persisted to at least 7 days. 3,4-Dihydroxyphenylacetic acid (DOPAC) decreased slightly for up to 30 min and then showed no significant difference compared with postmortem levels. Epinephrine and dopamine were barely detected by the HPLC-ECD method employed. 5-HT concentrations which showed an increase up to 24 h showed maximum levels 800 microns from the wound edge at 10 and 30 min after injury. 5-Hydroxyindoleacetic acid (5-HIAA) was significantly higher than the postmortem level over almost the entire period of these experiments. A 5-HIAA content of at least twice the postmortem level was observed 800 microns from the wound edge of a 10-min-old vital wound. Therefore, 5-HIAA is a likely candidate as a new marker for evaluating the vital reaction in wounds. The vital characteristics of NE, DOPAC, 5-HIAA and 5-HT in 10-min-old wounds persisted for up to 12 h at room temperature after death. These results suggest that the HPLC-ECD method used here is very useful for simultaneous examination of the vital reaction in wounds from the earliest to the later stages of the wound-healing period.     

Localization and quantification of histamine in injured skin as parameters for the timing of wounds.

Localization and estimation of the histamine (HA) content in skin wound edges in 86 Sprague-Dawley rats and three cases of human injuries were carried out by a microfluorimetric method specific for this amine which forms a complex with o-phthalaldehyde (OPT). Distribution and density of the mast cells in the same areas were observed at the same time by toluidine blue stain. In all skin specimens with antemortem wounds, both the epidermis and upper dermis exhibit extracellular yellowish fluorescence of the HA-OPT complex. The fluorescent zone spreads in the wound edges with the lapse of time in vital injuries. The HA content increases gradually up to 30 min and then the yellow histamine fluorescence in areas 0-200 microns from the wound edge decreases. None of these features can be observed in normal skin and postmortem-injured skin. Mast cell degranulation can be demonstrated in all antemortem-injured skin. No statistical relationship exists between the number of mast cells and the HA-OPT fluorescence in either ante- or postmortem-injured groups. This study indicates that skin HA microfluorimetry by the OPT method is of practical value for distinguishing ante- from the postmortem wounds and for timing antemortem wounds.     

Haemostatic plugs as a histological vital reaction in the skin wounds of guinea pigs.

Applying a histological staining method (Carstairs' modification of picro-Mallory staining), haemostatic plugs could be demonstrated at points of vascular lesion in one-minute vital, or older, skin wounds of the guinea-pig on the average in 33% if the specimen was taken immediately after the reaction period, and in about 10% of wounds examined if the specimen was taken five days after death. No haemostatic plugs could be observed in postmortally inflicted skin wounds.     

RT-PCR检测不同时间大鼠皮肤切创TGF-β_1mRNA表达

目的 探讨TGF-β_1mRNA在不同时间的表达变化及其与伤后经过时间的关系。方法 应用逆转录-聚合酶链反应(RT-PCR)分别对大鼠生前0.5h、1h、3h、6h、12h、48h、72h、96h、168h和死后0.5h、1h、3h的皮肤切创组织中的TGF-β_1mRNA表达变化进行检测,采用ID软件对凝胶扫描的数据进行密度分析。结果 TGF-β_1mRNA在生前皮肤切创后0.5h上升,3h开始急剧升高,48h含量达到峰值;死后皮肤切创未见TGF-β_1mRNA的表达。结论 大鼠皮肤切创TGF-β_1mRNA的表达具有时间相关性,RT-PCR是检测细胞因子在基因水平表达的灵敏方法。     

大鼠皮肤切创愈合过程中ICAM-1及P选择素的表达

目的　探讨细胞间粘附分子 1(ICAM 1)及P选择素的表达变化与损伤时间的关系。方法　应用免疫组织化学技术 ,对实验大鼠不同损伤时间的生前伤 ( 5min～ 7d)及死后伤 ( 5～ 3 0min)皮肤组织中ICAM 1及P选择素的表达变化进行观察。结果　在生前损伤组中 ,ICAM 1最早在伤后 1h ,最迟至伤后 3d在表皮层中呈阳性表达 ;P选择素最早在伤后 10min ,最迟至伤后 5h即在血管内皮细胞中呈阳性表达。此外 ,ICAM 1还在炎症细胞及纤维母细胞中表达 ,且随损伤时间变化而呈规律性变化。在时间段分组 ,ICAM 1在第Ⅰ组 ( 5min～ 1h)中阳性细胞率极低( 0 41± 0 73 % ) ,第Ⅱ组 ( 3h～ 7h)及第Ⅲ组 ( 9h～ 12h)均呈显著性增高 ( 9 79± 3 74% ,2 3 3 3± 1 10 % ) ,至第Ⅳ组 ( 1d)达高峰 ( 3 0 5 8± 2 65 % ) ,其后逐渐减少。ICAM 1及P选择素在死后伤中均呈阴性表达。结论　ICAM 1及P选择素可作为法医学损伤时间判定的有效指标。     

Immunohistochemical detection of fibronectin and tenascin in incised human skin injuries

Immunohistochemical detection of molecules involved in inflammatory reaction can be useful for the diagnosis of vitality in skin wounds. We studied the expression of fibronectin (FN) and tenascin (TN) in 58 human skin wounds (48 vital and 10 postmortem). The age of vital injuries ranged from 3 min to 8 h and postmortem specimens were collected after a postinfliction interval of 15-180 min. One hundred thirty-seven formalin-fixed paraffin-embedded sections (mean: 2.3 sections per case) were stained with each of two monoclonal antibodies against FN and TN using the streptABC technique. A reticular staining for FN in wound edge and dermis was observed in 50% of vital specimens versus 0% in postmortem cases. Immunoreactivity was reduced in 10 autolysed cases. FN positivity exclusively at the injury margin was observed in 39.4% of vital wounds and 10% of postmortem cases. TN was negative in all specimens. Vital and postmortem hemorrhage areas showed positivity for FN and TN. Due to its low sensitivity, immunohistochemical analysis of FN is useful for determining vitality only in a minority of cases. Different factors in everyday practice, including autolysis and technical problems often produce false negative reactions with the result that FN cannot be regarded as a reliable parameter of vitality. Positive reactions (network staining) are more valuable than negativity but are not pathognomonic. Both vital and postmortem hemorrhages show an enhanced positivity for FN and TN, thus impeding the diagnosis.     

Changes in the amount of prostaglandin F2 alpha in incision wounds of the skin with different time intervals after injury

A radioimmunological method is presented for the determination of the quantity of prostaglandin F2 alpha in cut wounds on the skin of guinea pigs. Rapidly increasing quantities of prostaglandin F2 alpha can be found in skin cuts, and the level reaches 71 ng/g within the 1st hour after the injury. In the postmortem period, the quantities calculated in the cuts while the animals were still alive gradually decreased and reached a value of 17 ng/g in the 6th h after death. In postmortem cuts, inflicted in the 8th h after death, the prostaglandin was 14-18 ng/g. In later postmortem cuts the quantity was about 9-10 ng/g. Establishing the dynamics of the quantitative changes permits investigation of the prostaglandin to be used to certify whether the victim was alive or not, as well as when the skin damage was inflicted.     

皮肤切创组织IL—2、TNF—α时间相关性表达的ELISA分析

目的了解细胞因子在创伤及修复过程中的表达的含量变化与损伤时间的关系。方法用免疫酶联吸附方法(ELISA)检测不同损伤时间(生前伤0.5～168h)实验动物皮肤切创组织中IL-2和TNF-a的表达水平。结果IL-2、TNF-a在造创后0.5h即升高,并分别在造创后3h和1h到达峰值,在造创后48h均有反弹,在72h和168h持续升高。结论上述细胞因子在创口修复中的蛋白表达水平呈时间相关性特点。     

Expression of adhesion molecules in skin wounds: diagnostic value in legal medicine

The adhesion molecules identified in recent years can help improve the diagnosis of the wound age, especially of injuries with a short survival time. This is also indicative of the vitality of the wounds. The material investigated in the study originated from 465 skin wounds. The samples were taken from human autopsy material, during the surgical treatment of wounds (excision) of patients and from experimental incised wounds of mice. To judge the age of skin wounds the endothelial adhesion molecules were detected in paraffin sections after autoclaving and using the ABC technique. Human skin wounds: strong positive staining was observed of ICAM-1 1.5 h at the earliest and 3.5 days at the latest, for the P-selectin 3 min at the earliest and 7 h at the latest, for the E-selectin 1 h at the earliest and 17 days at the latest and for VCAM-1 3 h at the earliest and 3.5 days at the latest after the time of injury. The L-selectin was expressed constitutively. Mice skin wounds: strong positive immunohistochemical reactions were found as a rule earlier than in human skin wounds. The detection of an increased expression of ICAM-1, VCAM-1 and P- and E-selectins can improve the wound age assessment in injuries with short survival times.     

Peroxidase activity in traumatic skin lesions

Peroxidase activity was determined in experimental compression-excoriation lesions and incision wounds of rat skin after different periods of vital time. The peroxidase enzyme was extracted from the tissues by homogenization in 0.5% cetyltrimethylammoniumbromide, and the enzyme activity was measured from the supernatant by o-dianisidine-H2O2 assay. In the blood of the rats a mean activity of approx. 5.26 +/- 1.11 U/g dry weight was observed. In the control specimens of the skin the activity was very low and generally below the detection limit of the methods used. In 30-min-old compression-excoriation lesions the mean peroxidase activity was 0.38 +/- 0.21 U/g dry weight. In lesions older than 30 min the activity started to increase rapidly. In 4-h-old compression-excoriation lesions it was 10 times higher than the 30-min level and was 40 times higher in 12-h-old lesions and 70-100 times higher in 1-3-day-old compression-excoriation lesions, respectively. In 30-min-old incision wounds the mean peroxidase activity was 0.65 +/- 0.37 U/g dry weight. The increase of the activity compared with the 30-min level was even faster in the incision wounds: in 4-h-old wounds the mean activity was 50 times higher, in 12-h-old wounds 200 times higher and in those of 1-5 days it was several hundreds of times higher. Compression-excoriation lesions made after death showed activity similar to the control specimens. Postmortem autolysis at +22 degrees C resulted in a loss of the enzyme activity in 1-day-old compression-excoriation lesions so that after 3 days approx. 80% remained, and after 5 and 7 days approx. 40% was present. After 3 days of autolysis at +4 degrees C, nearly 100% of the activity remained and approx. 90% was present after 5 and 7 days of autolysis. Increased peroxidase activity was also detectable in human vital excoriations in the specimens which were taken in autopsies several days postmortem.     

人体皮肤创伤组织细胞因子表达的时间相关性

目的探讨TGF-β1、b—FGF和VEGF在人体皮肤创伤组织中的表达变化及其与损伤时间的关系。方法收集15例机械性致伤的人体皮肤组织(受伤5—120min内死亡),常规制作组织切片后进行免疫组化染色,并统计分析TGF-β1、b—FGF和VEGF因子的表达情况。结果 TGF-β1在16—50min组表达升高,60～120min组呈阳性至强阳性表达;b—FGF在16—50min组表达升高明显,强阳性表达亦出现在60～120min组;VEGF仅在60—120min组出现阳性表达。统计学分析表明,TGF—β1和b—FGF的表达升高分别在受伤60~120min(P<0.01)和在16—50min(P<0.01)有显著性意义,VEGF表达升高只在60~120min(P<0.05)有显著性意义。结论 TGF-β1、b—FGF和VEGF的表达时间和表达强度与损伤时间有关;TGF-β1、b—FGF和VEGF的表达可为人体短存活期损伤时间的推断提供参考。     

Enzyme activities of leukocytes in skin cut wounds with various wound ages

A study was carried out on leukocyte enzyme activity from prints of skin cut wounds of guinea pigs at various time intervals after the injury. The following enzymes were examined: alkaline and acid phosphatase, succinate, lactate, and glucose-6-phosphate dehydrogenases. Cytochemical analysis revealed a rapid increase in enzyme activity in the 4th h after the wound occurred, which can be explained by the alteration in leukocyte metabolism induced by the damaging agent, i.e., the skin trauma inflicted. The rise in lactate dehydrogenase and glucose-6-phosphate dehydrogenase activity is the most characteristic feature. In accordance with these changes in enzyme activity, some conclusions can be made about certain intracellular alterations. There is a close relationship between the course and the degree of these cellular changes and the time interval between the injury and examination of the enzyme activity. These changes make it possible to draw conclusions concerning the vital character and the interval after inflicting as well.     

应用ELISA测定成人皮肤切创纤维连接蛋白

应用双抗体夹心酶联免疫吸附剂测定法（ELISA），定量研究了12例成人腹部2小时以内手术切创皮肤可检测的Fn。实验批内变异系数＜5％，批间变异系数＜10％，检测Fn浓度范围3．91～1000ng／ml。结果：成人腹部每克皮肤可检测Fn含量为7．5920±1．7364μg（M±SD）；随着损伤时间延长，不同时间段创伤局部皮肤Fn的含量逐渐升高；各不同时间段与损伤即刻皮肤Fn含量的差值和损伤时间之间存在直线相关（r=0．9843）。经方差分析处理，发现创伤局部皮肤Fn含量在损伤经历30分钟后，有显著增加。本此结果可为推断切创形成的时间提供参考数据。     

Quantitative analysis of proinflammatory cytokines (IL-1beta, IL-6, TNF-alpha) in human skin wounds

Proinflammatory cytokines play an important role in the mediation of inflammation and trauma. They could be useful for the determination of vitality and wound age. In the present study, 144 human skin wounds due to sharp force were investigated. The material was collected during operations (N=96) and postmortem examinations (N=48). The wound age varied from several seconds or minutes to 9 days. Control skin was available in each individual. The tissue specimens were homogenized and extracted in a solution of PBS and protease inhibitors. Interleukin-1beta (IL-1beta), interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-alpha) were measured by quantitative ELISA analysis. Statistical evaluation was performed by the t-test using the quotients of levels (wound sample/control skin). In surgical specimens the cytokine levels revealed a clear tendency to increase with wound age. IL-1beta in early skin wounds (24 h, P<0.05). The quantitative analysis of proinflammatory cytokines in wound extracts can contribute to the determination of vitality and wound age, in particular in the very early post-traumatic interval (classic stab wounds).     

小鼠皮肤切创IL-10和IL-4的表达及其与损伤时间关系

目的　探讨IL 10、IL 4在小鼠皮肤切创愈合过程中的表达变化规律及其与损伤时间的关系。方法　应用免疫组织化学及图像分析技术 ,观察实验小鼠不同时程的生前伤 ( 0 5～ 168h)及死后伤 ( 1～ 6h)皮肤创伤局部IL 10、IL 4的表达情况。结果　生前伤 ,IL 10在伤后 1～ 3h阳性反应逐渐增强 ,3h达峰值 ,2 4h降至较低水平 ,伤后 48h再次升高 ,72h又达新峰值 ,其阳性表达部位主要在表皮细胞及单核 /巨噬细胞 ;IL 4于伤后 2 4h出现明显阳性反应 ,96h表达水平达峰值 ,168h仍维持在较高水平 ,其阳性细胞主要为创伤局部的成纤维细胞。死后伤 ,IL 10仅于死后 1～ 3h呈阳性染色 ,IL 4未见阳性染色。结论　IL 10、IL 4在小鼠皮肤切创愈合过程中的表达呈现一定的时序性变化。     

皮肤切创愈合中caspase-3表达的免疫组化研究

目的探讨皮肤切创损伤愈合过程中,caspase-3在损伤区内的表达以及不同损伤时间caspase-3的变化规律。方法应用免疫组织化学技术对33例不同损伤时间小鼠皮肤切创组织中caspase-3的表达进行研究。同时以3例非切创小鼠皮肤组织做对照。结果伤后6h的损伤皮肤组织中可见少量中性粒细胞表达caspase-3,伤后12～24h,大部分浸润的中性粒细胞及部分单核细胞为caspase-3阳性。随伤后时间延长,caspase-3阳性细胞以单核细胞及成纤维细胞为主。伤后0～3h,caspase-3阳性细胞比率较低,为(4.53±6.53)%,12h后逐渐增加,伤后3d达高峰,为(62.66±4.84)%,其后逐渐下降。结论小鼠皮肤损伤愈合过程中,caspase-3可能在诱导损伤区内中性粒细胞、单核巨噬细胞及成纤维细胞发生凋亡过程中发挥重要作用,同时,caspase-3的规律性表达可用于损伤时间的推断。     

大鼠皮肤切创愈合过程中泛素的表达及其法医学意义

目的观察大鼠皮肤切创后泛素(ubiquitin)表达的变化规律。方法应用免疫组化方法,观察大鼠皮肤切创后1、3、6、12h和1、3、6、10、14d ubiquitin的表达情况,并用图像分析系统进行图像分析。结果正常对照组大鼠皮肤有低水平ubiquitin表达,切创后ubiquitin表达增加,伤后6d达峰值,伤后10d开始下降,伤后14d恢复到正常水平。结论ubiquitin可作为法医学损伤时间推断的有效指标。     

人皮肤组织刺、切创后IL-8表达的免疫组织化学研究

为探讨人皮肤刺、切创后白细胞介素 8(interleukin 8,IL 8)在推断皮肤损伤时间中的应用价值 ,本研究应用免疫组化技术对 5 2例不同损伤时间人体皮肤刺、切创组织中IL 8的表达进行了研究。伤后 4h的损伤皮肤组织中可见部分的多核粒细胞表达IL 8。伤后 12～ 2 4h ,大部分浸润的多核粒细胞及部分单核细胞为IL 8阳性。随伤后时间延长 ,IL 8阳性细胞以单核及成纤维细胞为主。伤后 4～ 6h的皮肤中 ,IL 8阳性细胞比率较低 ,为 16 0±10 1%。伤后 1～ 4d达高峰 ,为 5 9 6± 8 7%。其后逐渐减少。本研究结果表明 ,IL 8的表达可用于皮肤刺、切创后损伤时间的推断。     

The time-dependent expressions of IL-1beta, COX-2, MCP-1 mRNA in skin wounds of rabbits

In this study, we investigated the time-dependent expression of IL-1beta, COX-2, MCP-1 mRNA after incised wounds in rabbit skin using real-time fluorescent quantitative PCR. The tested wound ages were distributed as following: <0.5h, 0.5h, 1h, 2h, 3h, 4h, 5h, 6h, 8h, 12h, 24h, 2d, 3d, and 7d. The expressions of three markers in postmortem wounds were determined. Comparison of each wound age with control group, expression of IL-1beta mRNA showed that the significant increase occurred at <0.5h (p<0.01), and the peak level at 2h. The expression was almost normalized at 2d. But for COX-2 and MCP-1 mRNA, the significant increase occurred at 1h for COX-2 mRNA, and 3h for MCP-1 mRNA. The expression peak levels were at 3h and 5h, and were almost normalized at 3d and 7d, respectively. There was no significant increase in all postmortem samples for IL-1beta, COX-2, MCP-1 mRNA compared with control group. Thus, the results of these cytokines and enzyme significant increase at different early wound ages implied that the combined investigation could make wound age determination more objective and accurate. Moreover, the three markers could also be used to distinguish the supravital injuries.     

Cathepsin D: a new marker of the vitality of the wound. Comparative study with histamine and serotonin

We have studied the variation of specific activity of the most important lysosomal enzyme: Cathepsin D. This study has been developed in pig skin incision wounds for its application to the differential diagnosis between vital and postmortem wounds. At the same time, we have determined histamine and serotonine levels to make a comparative study with Cathepsin results. Our results show the utility of this new marker to determine the vitality of wounds, even when the time elapsed until death has been very short. Nevertheless, there is no correlation between Cathepsin D results and those of histamine or serotonin, a fact that induces us to think that this new marker is not useful to determine wound age.