Intranuclear ubiquitin immunoreactivity of the pigmented neurons of the substantia nigra in fatal acute mechanical asphyxiation and drowning

Abstract

To evaluate the significance of immunohistochemical staining of ubiquitin (heat shock protein) in the midbrain for the medico-legal diagnosis of fatal asphyxiation and drowning, we investigated forensic autopsy cases of fatal mechanical asphyxia (n = 18), manual/ligature strangulation (n = 9), hanging (n = 4), aspiration/choking (n = 5) and drowning (n = 16). These were compared to control groups (n = 30) consisting of fatalities from brainstem injury (n = 12) and acute myocardial infarction (n = 18). Ubiquitin was clearly demonstrated in the nuclei of pigmented substantia nigra neurons, showing two intranuclear staining patterns: a type of inclusion (possibly Marinesco bodies) and a diffuse staining. The diffuse staining was significantly more frequently observed in cases of drowning. The percentage of total ubiquitin positive neurons was frequently higher in strangulation (5.1-28.4%, mean 17.0%), aspiration/choking (5.3-32.0%, mean 17.6%) and drowning (7.0-34.1%, mean 19.8%), but relatively low in hanging (5.1-12.7%, mean 8.6%), brainstem injury (0-10.4%, mean 5.0%) and acute myocardial infarction (1.5-16.9%, mean 8.3%). These observations suggest that intranuclear ubiquitin immunoreactivity of the pigmented substantia nigra neurons in the midbrain was induced by a fatal severe stress on the central nervous system in asphyxiation and drowning.

Fatal mycotic aneurysm caused by Pseudallescheria boydii after near drowning

“…Near drowning with delayed death after successful treatment of early complications results from prolonged cardiorespiratory failure, hypoxic encephalopathy, or infections [1][2][3][4]. Early and aggressive antibiotic treatment is the therapy of choice after near drowning; mycotic infections after aspiration should be considered as well.…”

Suda Boğulma Tanısında Kullanılan Yöntemlerin İrdelenmesi

“…Sonuç olarak pigmente substantia nigra nöronlar›nda ubiquitin immunoreaktivitesinin, asfiksi ve suda bo¤ulma sonucu SSS üzerinde oluflan fatal fliddetli stresin sonucu oldu¤unu kanaatine var›lm›flt›r (27). Is›-flok Protein 70 ve C-Fos gen antikorlar› ile inferior olivari nukleusta lekelenmenin suda bo¤ulma olgular›nda daha s›k görül-dü¤ü saptanm›flt›r.…”

Enviromental Assessment And Forensic Approach To The Cases Found Death In Water In

“…Son yıllarda suda boğulma tanı-sının konmasında yardımcı olabilecek immunohistokimyasal çalışmalara da (intrapulmoner aquaporin-5 ekspresyonu, medulla oblongatada bulunan inferior olive nukleusta C-fos gen ekspresyonu, substantia nigra nöronlarında ubiquitin immunoreaktivitesi, kapiller endotelinde aquaporin-1 ekspresyonu, kan akımına karışan surfaktan protein-D (SP-D) seviyeleri ve akciğer kompartmanlarındaki myelomonosit alt tipleri varlığı gibi) ağırlık verilmektedir (17)(18)(19)(20)(21)(22). Dünya Sağlık Örgütü'ne göre suda boğulmaya bağlı ölümlerin yıllık insidansı yaklaşık 400.000'dir (23).…”