The application of selected histochemical and immunohistochemical markers and procedures to the diagnosis of early myocardial damage.
Histochemical (= HIS) methods (haematoxylin-eosin, luxol fast blue, chromotrope aniline blue) and various immunohistochemical (= IH) markers (myoglobin, desmin, fibrinogen, complement C5b-9) were applied in parallel to test the efficiency, specificity and sensitivity for the recognition of early ischemic myocardial damage. The whole series was subgrouped into cardiac deaths (N = 35) and controls (N = 13). Cardiac deaths were sub-divided into 3 groups: 1. infarction visible in gross examination (N = 15), 2. coronary thrombosis without infarction (N = 11), 3. stenosing coronary atherosclerosis without infarction (N = 9). The control group (group 4) consisted of unnatural deaths with presumed short agonal periods (N = 13). Group 1 cases usually exhibited extended coagulation necrosis of the diffuse type and the contraction type in combination (1 exception). Group 2 showed mainly a patchy type of coagulation necrosis and contained 1 cases where all methods failed to react and 3 more cases where only the HIS methods failed to react. Group 3 and 4 were associated with a disseminated type of single and/or grouped fibre necrosis. In addition, the average reaction strengths showed a decrease from group 1 to group 4 which was more pronounced in the HIS reactions compared with the IH reactions. One case in group 1 showing negative IH reactions cannot be explained. Positive IH reactions observed in a few cases in group 2 contrasting with negative HIS reactions would indicate a greater sensitivity of this methodology and this interpretation also applies to groups 3 and 4. From pathophysiological considerations, the positive cases in groups 3 and 4 can be well explained.(ABSTRACT TRUNCATED AT 250 WORDS)
Brinkmann
B
B
Institut für Rechtsmedizin, Westfälische Wilhelms-Universität Münster, Germany.
Sepulchre
M A
MA
Fechner
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001329:Autolysis; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000378:metabolism; D003328:Coronary Thrombosis / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D005554:Forensic Medicine / Q000379:methods*; D006651:Histocytochemistry / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000378:metabolism; D009336:Necrosis; D009929:Organ Size; D012680:Sensitivity and Specificity; D013997:Time Factors