Methyl alcohol poisoning in Trabzon (Turkey)

The aim of this retrospective study was to examine methyl alcohol intoxications in Trabzon (Turkey) and to determine any relations between the laboratory results and histopathologic changes. A total of 4492 forensic autopsies were performed from 1998 to 2008. Thirteen of the cases (0.3%) were because of methanol poisoning, and all were men. Their ages ranged from 25 to 62 years. The blood methanol concentrations ranged widely, from 15 to 482 mg/dL. In six cases, poisoning was because of consumption of the alcoholic beverage "Raki," while in five cases, poisoning was because of the ingestion of cologne. The products consumed were unknown in the other two cases because of insufficient history and data records. Mortality because of methanol poisoning may be prevented/decreased with the implementation of some precautions, such as public education regarding the harms of methyl alcohol, routine monitoring of the vendors that sell alcoholic beverages and cologne, and appropriate legal retribution for the illegal production of methanol.     

Liquid chromatography/photodiode array detection for determination of strychnine in blood: a fatal case report

An original liquid chromatography method with photodiode-array detection (DAD) is presented for the determination of strychnine in blood. This sensitive method allows the use of only 0.1 ml of sample. The strychnine was isolated from blood using a liquid-liquid extraction procedure and chloroquine as an internal standard. The limits of detection (LOD) and quantification were 0.06 and 0.5 mg/l, respectively. The recovery was 94% and the coefficients of variation (CV) ranged from 5.9 to 10.8%. A fatal case of strychnine poisoning is presented, with a lethal blood concentration of 25 mg/l.     

内标监控反相高效液相色谱法测定生物材料中的立克命

本文经实验研究,建立了以1,1′-联-(2-萘酚)作为内标监控检测生物材料中立克命的反相HPLC 方法。经实验证明空白兔肝中添加回收率达90%,同一染毒兔肝多次测定结果表明有较满意的重现性。生物材料中的内源性杂质不干扰测定。本法可用于分析毒理学的研究,也可用于立克命中毒案件的检验。     

血中安非拉酮的薄层色谱扫描检测研究

建立血中安非拉酮的快速检测方法。用环已烷或氯仿提取,薄层层析分离,薄层扫描定性和定量检测。结果显示：血清中安非拉酮的线性检测范围为0．2～12μm／ml,最小检出浓度为0．1μg／ml。2例服药过量患者血清中安非拉酮含量为3．2mg／L和4．7mg／L。本法可用于安非拉酮中毒的快速诊断和安非拉酮中毒的法医学鉴定。     

Fatalities due to methyl alcohol intoxication in Turkey: an 8-year study

The aim of this study is to examine methyl alcohol poisoning cases from the medico-legal point of view. The records of the Morgue Department of Council of the Forensic Medicine were reviewed retrospectively for all methyl alcohol poisonings for the period of 27.10.1992 and 30.05.2001. The victim's age, sex, death year, death place, methyl alcohol blood levels, the source of methyl alcohol, accompanying laboratory results and histopathologic tissue changes were recorded. The number of deaths due to the methyl alcohol poisoning was 271 during that period of time. Two hundred and forty-two of the (89.3%) total 271 methyl alcohol fatalities were men and 29 (10.7%) of were women. The largest age group was 36-40 years old, followed by 41-45. The methyl alcohol blood concentrations ranged widely from 50 to 755 mg for per 100 ml. There were 222 cases (81.9%) with the methyl alcohol blood concentrations over 100 mg/dl. Twenty-nine (10.7%) victims were poisoned through the consumption of cologne and three of them with alcoholic beverage named "Raki". Consumed products were not known in all other cases because of insufficient patient history and data. As a conclusion, regarding the distribution according to years, mortality due to methyl alcohol intoxication in our country have been proceeding on a certain level. In order to decrease the mortality due to methyl alcohol intoxication, some precautions should be developed that could prevent the production and consumption of alcoholic beverages illegally produced.     

Fatal poisoning in childhood, England & Wales 1968-2000

We analysed deaths certified as due to poisoning in England & Wales, 1968-2000, in children aged <10 years by age, sex, circumstances of death, intent, and agents involved. The number of deaths fell from 165 (20.6 per million children) in 1968 to 30 (4.6 per million) in 2000, a decrease of approximately 80%. The age-specific death rates were similar in boys and girls. The rate was initially much higher, and fell more, in those aged <5 years. Most deaths (n=1923) occurred in fires, and had been attributed to inhaling combustion products. A small number (n=104) occurred in fires resulting from motor vehicle and other transport accidents. From 1979 (use of ICD-9) the coding of some of these deaths changed from poisoning with carbon monoxide to poisoning with 'other gases, fumes or vapours'. These 'fire deaths' do not appear as poisonings in mortality statistics based on a single underlying cause of death, and cannot be tabulated as poisoning in many countries. Fire deaths and deaths coded to accidental, deliberate, or undetermined poisoning (n=702) decreased substantially with time, and by 2000 numbered 14 and 10, respectively. Accidental deaths declined from 151 in 1968 to 23 in 2000, but homicides and open verdicts varied from 5 to 20 per year, with no clear trend. Deaths attributed to carbon monoxide and to 'other gases, fumes or vapours' (mostly fire-related) totalled 2431 (84% of all poisoning deaths). Overall, 10% of these deaths were either certified as homicides or open verdicts. However, homicide or open verdict was recorded in half of the 47 fatal opiate poisonings. Opioids have now superseded antidepressants as the commonest agents encountered in fatal poisoning with drugs in children.     

Fatal and nonfatal poisoning by hydrogen sulfide at an industrial waste site

An adult man (A) entered a pit to collect seepage at an industrial waste site in Japan. As he suddenly lost consciousness, three colleagues (B, C, D) entered the pit to rescue him. All of these men lost consciousness in the pit. Two workers (A and B) died soon after the accident, one worker (C) died 22 days after the accident, and one worker (D) survived. Since hydrogen sulfide gas was detected in the atmosphere of the pit, gas poisoning was suspected. Toxicological analyses of sulfide and thiosulfate, a metabolite of sulfide, in blood and urine of the victims were made using the extractive alkylation technique combined with gas chromatography/mass spectrometry (GC/MS). Sulfide was detected in the blood of A and B at levels of 0.13 and 0.11 mg/L, respectively, somewhat higher than in healthy persons. Thiosulfate was detected in whole blood of deceased victims A and B, in the plasma of deceased victim C, at concentrations of 10.53, 4.59, and 4.14 mg/L, respectively. These values were similar to those found in fatal cases of hydrogen sulfide poisoning. Thiosulfate was not detected in the plasma of survivor D. With respect to urine samples, thiosulfate was the highest in the non-acute death victim C (137.20 mg/L), followed by that in the survivor D (29.34 mg/L), and low (0.90 mg/L) and not detected in the acute death victims, A and B, respectively. Based on these results, all four patients were victims of hydrogen sulfide poisoning. The concentrations of thiosulfate in blood and urine were more useful than that for sulfide for determining hydrogen sulfide poisoning. Thiosulfate in urine was the only indicator of hydrogen sulfide poisoning in the non-fatal victim.     

毒鼠强中毒的凋亡细胞研究

目的通过动物实验,研究观察在不同剂量下毒鼠强中毒后不同时间各器官的病理学变化,以期为法医学鉴定提供指标。方法建立小鼠毒鼠强中毒的实验模型,通过常规H.E染色及凋亡细胞检测技术对小鼠毒鼠强急、慢性中毒后脑、心、肝、肾等器官的病理学改变进行系统研究,并对研究结果进行计算机病理学图像分析;对中毒实验组的小鼠上述器官检材进行毒物分析。结果慢性中毒组小鼠在中毒后的不同时间段内,脑、心、肝、肾等器官凋亡细胞数均高于正常对照组及急性中毒致死组,且同一器官的凋亡细胞数在不同中毒时间段内有所差异,差别均有显著性;不同器官的凋亡细胞数的峰值在不同中毒时间段内亦有所不同。急性中毒组小鼠各器官的毒物分析结果为阳性,慢性中毒组均为阴性。结论慢性毒鼠强中毒,在临床症状不明显及法医毒物分析难以检测的情况下,应用凋亡细胞检测技术可成功检测出机体的主要器官的病理学改变,表明小剂量、慢性中毒对机体仍有一定的影响。     

Identification and quantitation of xenobiotics by 1H NMR spectroscopy in poisoning cases

In order to analyse a wide range of xenobiotics and their metabolites present in biological fluids, NMR spectroscopy can be used. A large variety of xenobiotics (therapeutic agents, pesticides, solvents, alcohols) can be characterized and quantitated directly, without sample preparation. NMR investigations were applied to acute poisoning cases, involving drugs such as salicylates and valproic acid (VPA). In a salicylate poisoning case, the three major metabolites of acetylsalicylic acid have been detected in crude urine, and rapid identification of lysine revealed the origin of the intoxication, namely lysine acetylsalicylate (Aspegic). Valproic acid as its glucuronide was identified in urine samples from two poisoned patients. 1H NMR was also used to identify and quantitate paraquat (Gramoxone) in urine owing to its two aromatic signals at 8.49 and 9.02 ppm, in two acutely poisoned patients (183 and 93 mg/l). An intentional poisoning case with tetrahydrofuran (THF) was also investigated. Serum and urine samples were collected. THF was characterized by its resonances at 1.90 and 3.76 ppm, and quantified at 813 and 850 mg/l in the two biological fluids, respectively. Moreover, two other compounds were detected: lactate and gamma-hydroxybutyric acid (GHB). 1H NMR spectroscopic analysis of serum samples from three poisoned patients revealed methanol in one case and ethylene glycol in the two others. Moreover, in the same spectrum, the corresponding metabolites formate and glycolate were found. Compared with the reference chromatographic or spectrophotometric methods, requiring time-consuming extraction and/or derivatization steps, NMR spectroscopy allows the determination of many exogenous and endogenous compounds, without any pre-selection of the analytes.     

一起毒鼠强食物中毒的调查分析及其实验室筛查探索

目的　探讨原因不明性食物中毒的检查策略。　方法　结合一起发生的原因不明性食物中毒案例 ,应用流行病学和简易急性动物试验等方法 ,对导致中毒的致病因素进行分析与判定。　结果　中毒案例的暴露时间为早餐时 ,平均潜伏期为 4 7.84分。中毒反应以神经症状和消化道症状为主。依病例的客观特征分层对其食谱分析 ,筛选出水煮豆腐是本次中毒的可疑食物。 7种剩余食物进行的急性动物试验中发现 ,水煮豆腐的小白鼠灌注量与中毒反应呈剂量反应关系 ,半数致死剂量为LD5 0 =1.68mg/ g。气相色谱 - -质谱仪分析确定水煮豆腐中的毒性性质为四次甲基二砜四胺。　结论　本案通过采用症状分析、急性动物实验和毒物分析测定方法确定了一起原因不明性食物中毒的中毒原因。这种检查策略有助于原因不明性食物中毒及其它突发中毒事件的性质判定。     

A case of suicide by ingestion of sodium nitroprusside.

The study reports a case of suicide by ingestion of sodium nitroprusside which resulted in acute cyanide poisoning. Analyses carried out on body fluid yielded the quantitation of total (5.00 mg/L) and free (3.30 mg/L) cyanide in blood and of methemoglobin (blood = 10.5%). At the scene, some solid reddish-brown material was found in a glass, which on toxicological analysis was found to contain sodium nitroprusside; about 9 g of the same substance was identified in stomach contents. The detection and quantification of cyanide and methemoglobin in biological samples from the case indicated that the lethal effect was due to both metabolic products (cyanide and methemoglobin).     

Pesticide poisoning initially suspected as a natural death

A pesticide poisoning victim suspected initially as having died a natural death was autopsied. The victim was a 47-year-old male. Macroscopically, signs of acute death and, in particular, general erosion in the mucosa of the airways and esophagus were observed. In the gastric contents, which had a pungent smell and a greenish-brown color, 5.00 g/L of propanil, 1.27 g/L of carbaryl, 0.38 g/L of ethylbenzene, and 0.32 g/L of xylene were detected. In the blood (serum), 21.6 mg/L of propanil, 8.1 mg/L of carbaryl, 1.7 mg/L of ethylbenzene, and 4.0 mg/L of xylene were identified. Postmortem methemoglobinemia (45%) was recognized. The cause of death was considered to have been pesticide poisoning; propanil was probably most responsible for his death. The police considered the case to be "death with illness as the suspected cause." By performing an autopsy, however, we were able to clarify that the cause of death was pesticide poisoning.     

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。     

Fatal tolperisone poisoning: autopsy and toxicology findings in three suicide cases

Tolperisone (Mydocalm) is a centrally acting muscle relaxant with few sedative side effects that is used for the treatment of chronic pain conditions. We describe three cases of suicidal tolperisone poisoning in three healthy young subjects in the years 2006, 2008 and 2009. In all cases, macroscopic and microscopic autopsy findings did not reveal the cause of death. Systematic toxicological analysis (STA) including immunological tests, screening for volatile substances and blood, urine and gastric content screening by GC-MS and HPLC-DAD demonstrated the presence of tolperisone in all cases. In addition to tolperisone, only the analgesics paracetamol (acetaminophen), ibuprofen and naproxen could be detected. The blood ethanol concentrations were all lower than 0.10 g/kg. Tolperisone was extracted by liquid-liquid extraction using n-chlorobutane as the extraction solvent. The quantification was performed by GC-NPD analysis of blood, urine and gastric content. Tolperisone concentrations of 7.0 mg/l, 14 mg/l and 19 mg/l were found in the blood of the deceased. In the absence of other autopsy findings, the deaths in these three cases were finally explained as a result of lethal tolperisone ingestion. To the best of our knowledge, these three cases are the first reported cases of suicidal tolperisone poisonings.     

Quantitative analysis of tropane alkaloids in biological materials by gas chromatography-mass spectrometry

A simple and rapid method for quantitation of tropane alkaloids in biological materials has been developed using an Extrelut column with gas chromatography-mass spectrometry (GC-MS). Biological materials (serum and urine) were mixed with a borate buffer and then applied to an Extrelut column. The adsorbed tropane alkaloids were eluted with dichloromethane before a GC-MS analysis. Atropine-d(3) was used as an internal standard. The extracted tropane alkaloids were converted to trimethylsilyl derivatives prior to GC analysis, to improve the instability of tropane alkaloids from heating and the property of them for a GC column. The recoveries of the compounds, which had been spiked to biological materials, were more than 80%. The GC separation of the derivatives from endogenous impurities was generally satisfactory with the use of a semi-polar capillary column. Tropane alkaloids showed excellent linearity in the range of 10-5000 ng/ml and the limit of detection was 5.0 ng/ml for biological materials. The present method is simple and more rapid than those previously reported, and was applied to a poisoning case. It is useful for the routine analysis of tropane alkaloids in cases of suspected tropane alkaloids poisoning.     

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.     

大鼠博落回总碱中毒心肌细胞凋亡的研究

目的观察博落回总碱中毒后大鼠不同时间内心肌细胞凋亡情况,为博落回总碱中毒提供毒理学指标。方法以SD大鼠博落回总碱中毒为实验模型,通过HE染色及凋亡细胞检测技术对大鼠博落回总碱中毒后心肌病理变化进行研究,并对研究结果进行计算机病理学图像分析。结果大鼠在中毒后的不同时间段内,心肌细胞凋亡数高于正常对照组(P<0.01),且凋亡数在不同时间段差异有显著性。结论博落回总碱中毒在临床症状不明显及毒物分析难以检测的情况下,应用凋亡细胞检测技术可成功检测出心肌的病理学变化。     

Toxicological findings in a multi-drug death involving propoxyphene, caffeine, phenacetin, acetaminophen and salicylate

The toxicological findings of a multi-drug related fatal poisoning are described here. A 35-year-old Caucasian male found dead on the kitchen floor was a known user of abused drugs and had been taking aspirin alone or in combination with phenacetin and caffeine for the relief of joint pains. The gross examination of the organs at autopsy revealed slight grooving of the uncus and various stages of necrosis in the renal papillae. Histological examination confirmed the gross appearance of pulmonary congestion and edema, cerebral edema and interstitial nephritis of the tubules. Toxicological evaluation of the blood and urine samples disclosed the presence of propoxyphene (51 and 250 mg/l), salicylate (185 and 2750 mg/l), caffeine (16 and 37 mg/l), and phenacetin (9.6 and 20 mg/l). Furthermore, acetaminophen also was present in the plasma (54 mg/l) and urine. A gas liquid chromatographic method for simultaneous analysis of phenacetin and caffeine utilizing a nitrogen phosphorus detector was proposed.     

染毒兔体内各脏器中立克命的含量及分布

本文用家兔作为实验动物,以25mg/kg 和100mg/kg 两个剂量给药,建立立克命中毒模型,观察染毒兔的中毒表现和解剖所见。兔内脏中的立克命含量用高效液相色谱法进行了测定。本文报导了观察所见和内脏中立克命的分布,并对所得结果进行了讨论。     

The determination of toxic metals in simulated stomach contents by energy dispersive X-ray fluorescence analysis and a fatal case of mercury poisoning

Soup is used as a simulated stomach contents matrix to determine the lower level of detection for 16 metals. All of the metals can be detected at the levels which might be expected for acute fatal doses even if the stomach contents are considerably diluted. However where small doses are administered over a prolonged period this method may not be sufficiently sensitive. A case of fatal poisoning by the ingestion of mercuric chloride is described to illustrate the effectiveness of the method. In this case mercury was also detected and determined at highly significant levels in blood and liver by the same technique. This energy dispersive X-ray fluorescence (EDXRF) method is easy to use, rapid and non-destructive.