Lunetta P, Penttilä A, Hällfors G
Department of Forensic Medicine, University of Helsinki, Finland.
Int J Legal Med. 1998;111(5):229-37. doi: 10.1007/s004140050159.
The diagnostic value of diatom analysis for drowning is considered to be one of the most controversial arguments in forensic medicine. However, the theoretical assumption of the method, i.e. the capacity of diatoms to penetrate the alveolo-capillary barrier during drowning, has never been addressed. Using scanning (SEM) and transmission electron microscopy (TEM), we have investigated the interaction of a natural population of diatoms and an unialgal culture of Phaeodactylum tricornutum (PT) with the alveolo-capillary barrier in an experimental model of drowning. The SEM analysis allowed the identification of several diatom species along the whole airways and their close interaction with the alveolar wall, but was poorly informative about the effective penetration of diatoms into pulmonary vessels. The TEM analysis was more informative and allowed a precise identification of the PT cells in alveolar spaces and to detect their phagocytosis by alveolar macrophages. PT penetrated into the pulmonary vessels through the thinnest portions of the alveolo-capillary barrier and through the interstitial spaces and were identified in pulmonary capillaries and venules. The morphological demonstration of the capacity of diatoms to penetrate the alveolo-capillary barrier is a step forward in assessing the potentiality, reliability and limitations of diatom analysis on a new basis as a tool for the diagnosis of drowning.
硅藻分析对溺水的诊断价值被认为是法医学中最具争议的论点之一。然而,该方法的理论假设,即溺水时硅藻穿透肺泡 - 毛细血管屏障的能力,从未得到探讨。我们使用扫描电子显微镜(SEM)和透射电子显微镜(TEM),在溺水实验模型中研究了自然硅藻种群和三角褐指藻(PT)单种培养物与肺泡 - 毛细血管屏障的相互作用。SEM分析能够识别整个气道中的几种硅藻物种及其与肺泡壁的紧密相互作用,但对于硅藻有效穿透肺血管的信息较少。TEM分析提供了更多信息,能够精确识别肺泡空间中的PT细胞,并检测到它们被肺泡巨噬细胞吞噬。PT通过肺泡 - 毛细血管屏障最薄的部分以及间质空间进入肺血管,并在肺毛细血管和小静脉中被识别。从形态学上证明硅藻能够穿透肺泡 - 毛细血管屏障,是在新的基础上评估硅藻分析作为溺水诊断工具的潜力、可靠性和局限性方面向前迈出的一步。