Microscopic lesions of the myocardium in acute coronary heart disease

A statisticomathematical analysis of microscopic changes in the myocardium has established pathognomonic and differential-diagnostic morphological signs for diagnosis of acute ischemic heart disease--acute coronary failure and acute myocardial infarction at the prenecrotic stage. The results of chromotrop 2B water blue staining of histological preparations and polarization microscopy were compared.     

挤压伤大鼠早期心脏损伤的细胞机制

目的观察挤压伤大鼠血清对培养的新生大鼠心肌细胞的某些作用,拟阐明挤压伤早期心肌细胞损伤的细胞机制。方法培养1～3d龄SD大鼠心肌细胞,观察挤压伤大鼠血清对心肌细胞搏动频率、表面积、蛋白质含量、3H-亮氨酸掺入、胞内钙浓度和Fos蛋白表达的影响。结果与正常大鼠血清组比较,挤压伤大鼠血清培养的心肌细胞搏动频率(次/min)由88.3±20.6降为26.4±16.7,心肌细胞表面积、蛋白质含量、3H-Leu掺入、胞内游离钙浓度(nmol/L)和Fos蛋白表达阳性指数增加。结论挤压伤大鼠血清通过抑制细胞搏动,增加胞内钙浓度诱导Fos蛋白的表达,引起心肌细胞肥大,介导挤压伤早期的心脏损伤。     

Forensic-medical assessment of pathomorphological changes in the myocardium in blunt chest trauma with an isolated heart contusion

A total of 37 autopsy cases were divided into two groups. Group 1 consisted of 17 victims who had died of closed blunt trauma of the chest with isolated heart contusion made by fists, feet in shoes. Group 2 (control) consisted of 20 cases of sudden death of ischemic heart disease because of atherosclerotic cardiosclerosis. Fragments of the heart containing endocardium were studied on the microscope JEIL-SM200 (Japan). Endocardium pathomorphology was represented by relief changes of the endocardium, structural arrangement of separate groups of muscular fibers above the endocardium surface, hemorrhages and blood clots, endotheliocyte desquamation, prelacerations, lacerations and destruction of the endocardium.     

冠心病心肌线粒体DNA5.0kb缺失的检测

目的探讨冠心病心肌线粒体DNA5.0kb缺失的检测。方法120例心脏的左、右心室肌各1份,分为正常对照组、病例相关组和病例组,每组40例80个样本。用断裂点连接PCR分别扩增样本含线粒体DNA5.0kb缺失的片段,巢式PCR检测含5.0kb缺失片段的扩增产物的准确性,半定量PCR对该产物进行定量,聚丙稀酰胺凝胶电泳检测PCR产物。结果在对照片段扩增成功的样本中,正常对照组未检出线粒体DNA5.0kb缺失;病例相关组检出2例,占6.07%(2/33);病例组检出29例,占85.29%(29/34);左、右心室肌线粒体DNA5.0kb缺失量分别为0.0015%~0.7813%和0.0008%~0.3906%。病例组与其他两组缺失率经χ2检验,其差异具有极显著性意义(P<0.001);左、右心室肌的缺失量经t检验,其差异具有极显著性意义(P<0.001)。结论冠心病心肌多有线粒体DNA5.0kb缺失,缺血明显的区域其缺失量也较高。     

Unusual motor ability in gunshot injury of the heart caused by a shotgun

In a case of shotgun-injury of the heart with complete rupture of both ventricles and lesion of the aorta the victim was able to move a few metres in approximately six seconds. Despite other opinions ability to move or act can be maintained in cases of severest injuries of the heart caused by missiles with high energy.     

Detection of apoptosis in ischemic heart. Usefulness in the diagnosis of early myocardial injury

Myocardial samples of hearts with histologic findings of acute myocardial infarction (group A), sudden coronary deaths without histologic changes (group B), and chronic ischemic heart disease (group C) were analyzed to investigate the appearance of apoptosis in acute and chronic ischemic cardiac disorders. This analysis involved the morphologic detection of DNA strand breaks in myocyte nuclei by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay and the biochemical determination of DNA laddering in the myocardium using archival formalin-fixed, paraffin-embedded tissue sections of human myocardium. The authors demonstrated that apoptosis of myocardial cells could occur after ischemic myocardial cell injury. In all documented cases of acute myocardial infarction (group A), the infarcted area included extensive presence of both apoptosis and necrosis. In the tissue bordering on and away from the obviously infarcted areas, positive nuclei were intermingled with nonstained normal myocytes. The number of positive nuclei decreased with the distance from the infarction foci. In group B, myocardial samples showed focal or diffuse nuclear positivity of varying degrees for apoptosis, confirming the presence of myocardial ischemic cell death, whereas the histologic diagnosis remained inconclusive. This finding suggests that apoptosis could be used as a marker for acute ischemic injury. In group C, stained nuclei were dispersed with intermingled normal cardiomyocytes.     

Intermedin在大鼠急性心肌缺血再灌注损伤中的作用

目的探讨Intermedin（IMD）对大鼠急性心肌缺血再灌注损伤的作用。方法72只健康雄性sD大鼠随机分为3组：对照组;缺血再灌注组（缺血1h再灌30min）;IMD预处理组（缺血再灌注前30min静脉注射10^-7mol／LIMD）。检测血清中LDH、心肌中MDA和SOD活性;半定量实时荧光PCR法检测心肌降钙素受体样受体（ealcitonin receptor like receptor,CRLR）、受体活性修饰蛋白（receptor activity modiying protein,RAMP）1／2／3的mRNA表达水平;酶联免疫吸附法（ELISA）测定心肌cAMP含量,SABC法检测Bcl-2／Bax蛋白表达及比值。结果与对照组比较,缺血再灌注组大鼠LDH、MDA分别升高87％和189％,SOD活性下降84％,IMD预处理组LDH、MDA均降低41％,SOD活性升高38％（均P〈0．01）;实验组心肌CRLR、RAMPl／2／3的mRNA水平均明显上调（P〈0．05或P〈0．01）,与对照组心肌cAMP相比,缺血再灌注组和IMD预处理组分别升高1．36、2．90倍（P〈0．05）。Bcl-2／Bax表达比值,缺血再灌注组较对照组降低,IMD预处理组亦低于对照组但高于缺血再灌注组2．225倍。结论IMD对大鼠急性缺血再灌注损伤的心肌有一定保护作用,减少缺血再灌所致的氧化应激,抑制心肌细胞凋亡可能是其作用机制之一。     

The myocardium in epileptics

The main purpose of this investigation was to examine by quantitative methods if pathological fibrosis could be found in the myocardium of epileptics. The investigation was retrospective and included 23 epileptics and 30 controls who were age- and sex-matched with the epileptics. No difference was found between epileptics and the control group as far as cellular infiltration, single myocyte necrosis, basophilic cell degeneration, and fresh bleeding were concerned. Fibrosis of the myocardium was measured quantitatively by point counting. The fibrosis was approximately 6% of the muscle mass in both groups. In conclusion, no structural difference in the myocardial composition was found between epileptics and the control group.     

Morphological signs of impaired excitation conduction in the myocardium

The article describes morphological changes in cardiac muscular fibers and cardiomyocytes secondary to disorders in conduction of excitation in the myocardium. These changes may indicate cardiac arrest as a result of reflex impacts including cases of damage which is not lethal.     

跌倒致心脏破裂2例报告

心脏破裂在法医检案中经常出现,可以由钝器打撞击或锐器刺伤所形成,但因跌倒所致心脏破裂较为少见,现将作者遇到的两例报道如下:     

跌倒致心脏破裂2例报告

心脏破裂在法医检案中经常出现 ,可以由钝器打撞击或锐器刺伤所形成 ,但因跌倒所致心脏破裂较为少见 ,现将作者遇到的两例报道如下 :案　例【案例 1】　 1998年 9月 ,在一布满鹅卵石的河道内发现一具男尸 ,群众疑为他杀报案。经检验 :尸长 16 3cm ,发育正常 ,营养中等 ,尸体呈仰卧状态 ,衣着完整 ,胸部心前区有一 4cm (3cm皮下出血区 ,其下方有一突出之鹅卵石 ,大小为 6 .5cm (4.5cm ,外表其余未见损伤。解剖见心包膜完整 ,内有血液约定 2 0 0ml,左心壁有一 2cm (0 .5cm裂口。纵隔、双肺未见损伤 ,颅腔、腹腔、盆腔经检验未见异常。现场勘查…     

Cardic death and apoptosis of myocardium

TdT-mediated Dutp nick end labeling (TUNEL) method was applied to detect apoptosis of myocardium of corpses dying from cardiac death. For arteriosclerotic coronary heart death, diffused apoptosis was observed around the border zones of histologically infarcted myocardium, and in the epithelial and smooth muscle of arteries. Few apoptosis cells were present for hypertensive heart death, and none for corpses dying from falling and hanging. Myocardium apoptosis may provide a new target for heart failure.     

Phase-contrast and polarization microscopic studies of the myocardium in forensic medical practice]

Describes the major acute pathologic changes in the myocardiocytes detectable by phase-contrast and polarization microscopy. Demonstrates the significance of these changes for a correct diagnosis of sudden coronary death, death from ethanol poisoning or closed injuries of the heart after blunt trauma of the chest.