曲马多在急性中毒大鼠体内的分布

目的建立一种快速、准确的气相色谱分析方法,研究曲马多在急性中毒大鼠体内的分布,为曲马多中毒案的法医学鉴定取材和结果评价提供参考。方法以1140mg/kg(5×LD50)剂量曲马多对大鼠灌胃染毒,运用气相色谱法检测其体液和组织中曲马多的浓度。结果血液、尿液中曲马多的检出限为0.1μg/mL,肝中的检出限为0.1μg/g。方法的日内及日间精密度分别在3.1%和5.5%以内,血液中曲马多的回收率在98%以上。曲马多在急性中毒大鼠体液和组织中的含量从高到低依此为心血、肝、外周血、尿液、玻璃体液、肾、肺、脾、心、大脑。结论所建方法能够满足体内毒物分析的要求,血液、尿液、肝、肺和肾均可作为体内曲马多分析的良好检材。     

Arsenic Poisoning Caused by Intentional Contamination of Coffee at a Church Gathering—An Epidemiological Approach to a Forensic Investigation

Abstract: An outbreak of apparent food‐borne illness following a church gathering was promptly reported to the Maine Bureau of Health. Gastrointestinal symptoms among church attendees were initially attributed to consumption of leftover sandwiches that had been served the previous day. However, a rapid epidemiological and laboratory assessment revealed the etiology of illness, including the death of an elderly gentleman, was not food‐borne in origin. A criminal investigation determined that deliberate arsenic contamination of the brewed coffee by one of the church members was the source of the outbreak. Public health officials and criminal investigators must be aware that intentional biologic aggression can initially present as typical unintentional disease outbreaks. Practitioners must also consider the need to properly maintain and preserve potential forensic evidence. This case demonstrates the key role public health practitioners may play in criminal investigations.     

Rare Death Via Histamine Poisoning Following Crab Consumption: A Case Report

Histamine poisoning (scombroid food poisoning) is a toxicity syndrome that results from eating spoiled fish. To date, however, few poisoning (or mortality) cases have been reported in relation to crab consumption. Here, we describe a very uncommon case in which a 37‐year‐old woman and her 14‐year‐old son ate cooked crabs (Scylla serrata), resulting in the death of the female. Samples of vomitus, food residue, liver tissue, gastric content, intestinal content, and cardiac blood were analyzed by high‐performance liquid chromatography. Toxicological analysis revealed that histamine concentrations were very high in the cooked crab (47.08 mg/100 g) and intestinal content (22.54 mg/100 g). Comparing our toxicological results, police investigations, and family member statements, it can be assumed that the decedent ingested spoiled crabs, and by excluding other causes of death, lethal intoxication with histamine poisoning was confirmed.     

三种安定类药物在中毒家兔体内的分布研究

为探求安定类药物在急性中毒家兔体内的代谢分布，采用固相萃取法和HPLC同时测定氯硝安定、佳静安定和安定。家兔按一定剂量将三种药物同时灌胃造成急性中毒2小时，处死后测定血、胆汁、尿液及其它脏器的三种药物浓度。结果表明，氯硝安定在胆汁和尿中含量较高，为0．82μg／ml和0．68μg／ml，而佳静安定及安定在胆汁和肝中浓度高，分别为9．32μg／ml和13．81μg／g。提示三种药物在家兔体内分布既有相同点也有显著差别。因此，利用本方法既可同时测定三种不同药物，也可为法医检案中毒案例的最佳检材采取和毒物分析结果评价提供了科学依据。     

毒鼠强中毒现状及研究进展

毒鼠强是急性中枢神经兴奋性杀鼠剂,具有中毒量小、毒作用快、后果严重的特点。由于毒鼠强属违禁药品,对毒鼠强的研究目前多局限于毒鼠强中毒的临床救治,而缺乏对毒鼠强中毒的系统基础研究。笔者结合国内外有关文献,将毒鼠强的中毒机制、病理变化及有关研究前景综述。     

Comprehensive analysis and investigation of accident/occupational disease responsibility rates: A case study for accidental CO poisoning

One of the major problems of courts and insurance companies is the lack of a proper technique to determine the rate of responsibility of the parties involved in the accident. The aim of this study was to determine the Accident/Occupational Diseases Responsibility Rates (AOD RR) for complex events. Accordingly, a case study of a complex accident of carbon monoxide (CO) poisoning was selected and Occupational Accident Tree Analysis (OATA) and Occupational Accident Component Analysis (OACA) techniques, which were solely used to investigate occupational accidents, were used with the new names Accident/Occupational Disease Tree Analysis (AOD TA) and Accident/Occupational Disease Component Analysis (AOD CA) to evaluate their applicability to investigate non-occupational accidents and occupational diseases. For this purpose, causes of CO penetration to victims’ room was assessed using gas tracking methods. Finally, Fuzzy Accident/Occupational Disease Tree/Component Analysis (FAOD TA and FAOD CA) techniques were developed and used for determining AOD RR in fuzzy environment. The results showed that the AOD RR obtained by AOD TA and AOD CA based on the average of experts’ personal opinions and consensus between experts, and AOD TA and AOD CA in a fuzzy environment were close to each other, with the power terminal and the power cable crossing route being the main routes of transmission and penetration of CO to the victims’ room. Also, the owner, contractor, tenant, and serviceman were responsible for the CO poisoning of victims. It can be concluded that any hole, crack, or fission in the building can result in CO penetration to the individuals’ living rooms, and gas tracking in early winter, especially in older buildings, plays a very significant role in preventing residents’ poisoning. Further, due to the uncertainty of AOD TA and AOD CA techniques, it is recommended to use FAOD TA and FAOD CA techniques for increasing the accuracy of the results. This will enhance the court and insurance companies’ trust in the opinions of accident investigation experts, decrease delays in the proceedings, and prevent any violation of the individual rights.     

乙醇与乌头碱联合染毒对大鼠心肌细胞RYR2的影响

目的研究不同浓度乙醇与乌头碱联合染毒对大鼠心室肌细胞RYR~2蛋白表达的影响。方法用优化的方法进行新生大鼠心室肌细胞原代培养,设置4组实验组,分别为A、B、C、D组,即分别用1μmol/L乌头碱、5mmol/L乙醇+1μmol/L乌头碱、50mmol/L乙醇+1μmol/L乌头碱以及100mmol/L乙醇+1μmol/L乌头碱进行染毒,同时设立对照组(E组)。染毒1h后,用Western blot技术检测RYR~2蛋白含量,重复实验,将对所得数据进行统计分析。结果 1μmol/L乌头碱作用1h,使培养的大鼠心肌细胞RYR~2蛋白量增加;5mmol/L乙醇、50mmol/L乙醇分别与乌头碱联合染毒组中RYR~2蛋白表达量均较单独乌头碱染毒组低;100mmol/L乙醇-乌头碱联合染毒组RYR~2蛋白量与单独乌头碱染毒组相较未见明显差异。结论乙醇-乌头碱联合染毒对RYR~2的蛋白量有明显影响,不同浓度乙醇与乌头碱联合染毒对RYR~2的影响效果不一致,低浓度乙醇能拮抗乌头碱引起的RYR~2含量增加,随着乙醇浓度逐渐升高,拮抗作用逐渐减弱,且有向协同作用转化的趋势。     

Thiodicarb and methomyl tissue distribution in a fatal multiple compounds poisoning

Abstract:  Thiodicarb is a nonsystemic carbamate insecticide whose acetylcholinesterase activity is related to its main methomyl degradation product. A 40-year-old woman was found dead in her car. Empty packages of medicines and an open bottle of Larvin^® containing thiodicarb were found near her body. No signs of violence nor traumatic injuries were noticed upon autopsy, and police investigations strongly suggested a suicide. Systematic toxicological analysis performed on postmortem specimens revealed the presence of various sedatives, hypnotics, and antipsychotic drugs in blood, urine, and gastric content. Some of the compounds identified were determined at blood concentrations well above the known therapeutic concentrations: zolpidem (2.87 mg/L), bromazepam (2.39 mg/L), nordazepam (4.21 mg/L), and levopremazine (0.64 mg/L). Specific analysis of thiodicarb and of its methomyl metabolite was then performed on all fluids and tissues collected during autopsy by liquid chromatography ion trap tandem mass spectrometry (LC-MS-MS). The anticholinesterase capacity of blood, urine, and gastric content collected at autopsy was 83%, 82%, and 32%, respectively (normal value: 0%). The presence of thiodicarb in the bottle found near the body corroborates the hypothesis of an intake of that compound. Although thiodicarb was only detected in gastric content (24.3 mg/L), its methomyl metabolite was quantified in most postmortem tissues and fluids: gastric content (19.9 mg/L), peripheral blood (0.7 mg/L), urine (8.5 mg/L), bile (2.7 mg/L), liver (0.7 mg/kg), kidney (1.7 mg/kg), lung (1.5 mg/kg), brain (9.3 mg/kg), and heart (3.6 mg/kg).     

Can computed tomography replace or supplement autopsy?

Postmortem computed tomography (PMCT) has been integrated into the practice of many forensic pathologists. To evaluate the utility of PMCT in supplementing and/or supplanting medicolegal autopsy, we conducted a prospective double-blind comparison of abnormal findings reported by the autopsy pathologist with those reported by a radiologist reviewing the PMCT. We reviewed 890 cases: 167 with blunt force injury (BFI), 63 with pediatric trauma (under 5 years), 203 firearm injuries, and 457 drug poisoning deaths. Autopsy and radiology reports were coded using the Abbreviated Injury Scale and abnormal findings and cause of death (COD) were compared for congruence in consensus conferences with novel pathologists and radiologists. Overall sensitivity for recognizing abnormal findings was 71% for PMCT and 74.6% for autopsy. Sensitivities for PMCT/autopsy were 74%/73.1% for BFI, 61.5%/71.4% for pediatric trauma, 84.9%/83.7% for firearm injuries, and 56.5%/66.4% for drug poisoning deaths. COD assigned by reviewing PMCT/autopsy was correct in 88%/95.8% of BFI cases, 99%/99.5% of firearm fatalities, 82.5%/98.5% of pediatric trauma deaths, and 84%/100% of drug poisoning deaths of individuals younger than 50. Both autopsy and PMCT were imperfect in recognizing injuries. However, both methods identified the most important findings and are sufficient to establish COD in cases of BFI, pediatric trauma, firearm injuries and drug poisoning in individuals younger than 50. Ideally, all forensic pathologists would have access to a CT scanner and a consulting radiologist. This would allow a flexible approach that meets the diagnostic needs of each case and best serves decedents' families and other stakeholders.     

A Case of Accidental Fatal Aluminum Phosphide Poisoning Involving Humans and Dogs

Aluminum phosphide is one of the commonest poisons encountered in agricultural areas, and manner of death in the victims is often suicidal and rarely homicidal or accidental. This paper presents an unusual case, where two humans (owner and housemaid) and eight dogs were found dead in the morning hours inside a room of a house, used as shelter for stray dogs. There was allegation by the son of the owner that his father had been killed. Crime scene visit by forensic pathologists helped to collect vital evidence. Autopsies of both the human victims and the dogs were conducted. Toxicological analysis of viscera, vomitus, leftover food, and chemical container at the crime scene tested positive for aluminum phosphide. The cause of death in both humans and dogs was aluminum phosphide poisoning. Investigation by police and the forensic approach to the case helped in ascertaining the manner of death, which was accidental.