PMID- 15885067
OWN - NLM
STAT- MEDLINE
DCOM- 20050726
LR  - 20061115
IS  - 0305-1846 (Print)
IS  - 0305-1846 (Linking)
VI  - 31
IP  - 3
DP  - 2005 Jun
TI  - The significance of beta-APP immunoreactivity in forensic practice.
PG  - 304-13
AB  - The neuropathologist involved in forensic work is not uncommonly confronted with 
      a case in which there is no or only a limited history or, if available, the 
      information is uncertain or is often conflicting. In recent years the 
      immunohistochemical stain beta-amyloid precursor protein (beta-APP) has been used 
      to assess the extent of axonal injury in a variety of pathological processes but 
      in forensic practice is of greatest utility in the assessment of traumatic brain 
      injury. Diffuse traumatic axonal injury (TAI) in humans has been demonstrated by 
      beta-APP immunoreactivity in patients surviving at least 2 h after head injury. 
      However, many of these patients also have an associated ischaemic injury, either 
      focal or diffuse, which may make the interpretation of beta-APP immunoreactivity 
      difficult. The present study was designed to evaluate if the published 
      descriptions of the different morphological patterns and distributions of 
      beta-APP immunoreactive axons could be used to microscopically distinguish axonal 
      injury attributed to trauma from other causes. To test this hypothesis a total of 
      73 cases were reviewed. The cases were selected from six different groups based 
      on clinical information. Immunostained sections from each case were assessed 
      'blind' to the clinical history, and the microscopic pattern and distribution of 
      beta-APP positive axons were recorded. Haematoxylin and eosin (H+E) stained 
      sections were then reviewed for each case and a final pathological diagnosis was 
      recorded and compared to the clinical history. 62/73 (85%) cases were correctly 
      correlated with the clinical history and in particular 14/17 (82%) cases of TAI 
      were correctly identified. These findings indicate that the published microscopic 
      patterns of the distribution of beta-APP positive axons in TAI and in diffuse 
      ischaemic injury can be used, in conjunction with microscopy of H+E stained 
      sections to determine the cause of axonal pathology in most cases.
FAU - Reichard, R R
AU  - Reichard RR
AD  - Academic Unit of Neuropathology, University of Glasgow, Institute of Neurological 
      Sciences, Southern General Hospital, Glasgow G51 4TF, UK.
FAU - Smith, C
AU  - Smith C
FAU - Graham, D I
AU  - Graham DI
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Neuropathol Appl Neurobiol
JT  - Neuropathology and applied neurobiology
JID - 7609829
RN  - 0 (Amyloid beta-Protein Precursor)
SB  - IM
MH  - Adult
MH  - Amyloid beta-Protein Precursor/*metabolism
MH  - Brain Injuries/*diagnosis/etiology/metabolism
MH  - Brain Ischemia/diagnosis/etiology/pathology
MH  - Carbon Monoxide Poisoning/complications
MH  - Child
MH  - Diagnosis, Differential
MH  - Female
MH  - *Forensic Pathology
MH  - Heart Arrest/complications
MH  - Humans
MH  - Hypoglycemia/complications
MH  - Immunohistochemistry
MH  - Male
MH  - Middle Aged
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Status Epilepticus/complications
EDAT- 2005/05/12 09:00
MHDA- 2005/07/27 09:00
CRDT- 2005/05/12 09:00
PHST- 2005/05/12 09:00 [pubmed]
PHST- 2005/07/27 09:00 [medline]
PHST- 2005/05/12 09:00 [entrez]
AID - NAN645 [pii]
AID - 10.1111/j.1365-2990.2005.00645.x [doi]
PST - ppublish
SO  - Neuropathol Appl Neurobiol. 2005 Jun;31(3):304-13. doi: 
      10.1111/j.1365-2990.2005.00645.x.