Enhanced genotoxicity by melphalan and hyperthermia in chronic heroin addicts

Spontaneous melphalan- (MEL-) and MEL-hyperthermia- (MEL-HYP-) induced sister chromatid exchange (SCE) frequencies have been studied in 12 chronic heroin addicts (HER AD) and in 12 age- and sex-matched healthy controls. The incidence of spontaneous SCEs in lymphocytes from the HER AD was significantly greater (P < 0.001) than those from the control subjects. When exposed to MEL in vitro, cells from both groups showed an increase in SCE frequency with yields from HER AD higher than those from controls. When exposed to MEL and hyperthermia (41.5°C for 3 h) in vitro, cells from both groups showed further increases in SCE frequency with yields from HER AD higher than those from controls. We observed that hyperthermia (HYP) in combination with MEL synergistically enhances SCEs and cell division delays in both groups, with the synergistic effects in cells from HER AD higher than those from controls.     

Enhanced genotoxicity by melphalan and hyperthermia in chronic heroin addicts.

Spontaneous melphalan- (MEL-) and MEL-hyperthermia- (MEL-HYP-) induced sister chromatid exchange (SCE) frequencies have been studied in 12 chronic heroin addicts (HER AD) and in 12 age- and sex-matched healthy controls. The incidence of spontaneous SCEs in lymphocytes from the HER AD was significantly greater (P less than 0.001) than those from the control subjects. When exposed to MEL in vitro, cells from both groups showed an increase in SCE frequency with yields from HER AD higher than those from controls. When exposed to MEL and hyperthermia (41.5 degrees C for 3 h) in vitro, cells from both groups showed further increases in SCE frequency with yields from HER AD higher than those from controls. We observed that hyperthermia (HYP) in combination with MEL synergistically enhances SCEs and cell division delays in both groups, with the synergistic effects in cells from HER AD higher than those from controls.     

Medical prescription of heroin--a review

There are many problems associated with injection drug use, problems that affect both the users themselves as well as those close to them and the society in which they live. Whether through complications associated with drug use (multiple infections, mental health problems, etc) or through the consequences on those close to them and on society (family dysfunction, crime, etc), the costs of illegal drug use are considerably greater than the costs of treating drug users.     

GC/MS研究海洛因代谢物在吸毒者体内的分布

应用GC／MS－SIM测定了海洛因代谢物吗啡在两例海洛因延缓死亡者的体内分布,并分析了收集到的7例案子的毛发（头发、腋毛和阴毛）中6-单乙酰吗啡和吗啡含量。生物检材和毛发经酸水解、提取、醋酸酐或双（三甲基硅基）三氟乙酰胺（BSTFA）衍生化,然后进行GC／MS-SIM分析。结果表明尿、胆汁和肝脏是判定死者是否曾使用海洛因的最佳检材;毛发分析与生物检材相比有其独特的优点,可提供数月甚至数年的用药情况。为公安司法机关打击吸毒、惩治犯罪提供更可靠、有效的证据。     

Hypoxic/ischaemic brain damage, especially pallidal lesions, in heroin addicts.

The occurrence of pallidal lesions with or without other hypoxic/ischaemic brain injuries was evaluated in 100 intravenous (i.v.) heroin addicts. The brains were collected consecutively from forensic autopsies during the period from January 1995 to June 1996. The autopsies were required by the police and performed at The Institute of Forensic Medicine, The National Hospital, Oslo. There were 21 women and 79 men, median age 32 (range 21-47) and 34 (19-60) years, respectively. Of 38 brains with abnormalities, twenty-five cases showed isolated or combined lesions of hypoxic/ischaemic origin. Pallidal lesions were found in nine brains; six lesions were old, one was subacute (a couple of weeks), and two were part of recent, generalized hypoxia/ischaemia. Six persons had old infarcts in the hippocampal formation, and one of them in combination with old pallidal infarcts. In seven brains small and old infarcts were found in watershed areas in the cerebellum. Between five and ten percent of i.v. heroin addicts might have pallidal infarcts, either as the sole lesion, or combined with other manifestations of hypoxic/ischaemic brain injury. This might give severe mental disturbances in the affected persons.     

海洛因成瘾者神经、内分泌及免疫系统超微病理变化研究

目的 研究海洛因成瘾者中枢神经、内分泌、免疫及生殖系统的超微结构变化。方法 应用透射电镜技术对 4例海洛因成瘾者中枢神经系统、内分泌系统、免疫系统以及生殖系统进行了观察。结果 神经系统表现为线粒体肿胀、嵴断裂、空泡变、内质网扩张、神经纤维数量减少、细胞器减少;免疫系统表现为淋巴细胞数量减少,胞浆成分减少,死亡细胞增多;内分泌系统表现为线粒体扩张,局部嵴断裂,内质网扩张;生殖系统表现为男性生精细胞减少,细胞器减少。女性未见卵泡结构。结论 海洛因滥用者的亚细胞超微结构呈急、慢性缺氧性变性、坏死改变。     

Vascular changes in the nasal submucosa of chronic cocaine addicts

A detailed, correlative, histologic evaluation of postmortem changes in the nasal mucosa of chronic cocaine users has shown characteristic mucosal and arteriolar changes as well as typical perivascular and subepithelial alterations compatible with chronic inflammation. These findings confirm and extend recent reports on the effects of cocaine in the coronary circulation and heart muscle as well as provide a new diagnostic tool to the forensic pathologist who suspects that a decedent has been a long-term cocaine abuser.     

Deaths among drug addicts in Denmark in 1968-1986

In the period 1968-1986 a total of 1618 fatalities among drug addicts were investigated at the three University Institutes of Forensic Medicine in Denmark. The annual number rose from 5 in 1968 to 163 in 1980, thereafter there has been a gradual fall to 121 in 1986. About 80% were males. The average age has risen from 22/23 years in the early 1970s to 31 years in 1986, and the percentage of addicts with a duration of abuse more than 10 years has increased gradually; both facts indicate a decrease in the recruitment among the quite young. In the whole period morphine was abused, supplemented by various medicines. Amphetamine was abused in the first years and again in 1986. The percentages of addicts with an abuse of alcohol and of addicts dying after a period of abstinence lasting more than 1 year, respectively, have increased. No essential changes were observed regarding distribution of residence or of the cause and manner of death. In the poisoning cases the predominant drug of poisoning was morphine/heroin, in all the years constituting approx. 30-50%. The second most frequent drugs of poisoning in the first half of the period was barbiturate, in the last half dextropropoxyphene and methadone. Only very few cases dying of cocaine poisoning were present and deaths due to so-called designer drugs have not been observed.     

Histologic findings of the sinus node and the perinodal area in street heroin addicts, victims of sudden unexpected death

Sudden unexpected death is frequent in street heroin addicts. We conducted a histologic study of the sinus node (SN) to offer some evidence about the possible arrhythmogenic cause of death. Postmortem coronary angiography and microscopic examination of the SN and the perinodal area were performed in 50 heroin addicts (group 1) and in 50 nonaddicts (group 2), all men (16-40 years old). In heroin addicts, fatty and/or fibrous tissue replaced SN tissue in 21 cases (42%). Perinodal infiltration was found in 15 cases (30%). Fibromuscular dysplasia in branches of the sinus node artery (SNA) was found in eight cases (16%). Inflammation with focal and/or diffuse concentration of round cells was detected in the SN in 22 cases (44%). Old mural thrombi were also found in 13 cases (26%). The histologic changes in the SN and perinodal area offer an explanation about the possible mechanism of arrhythmia and sudden death in this population.     

Family role in the reintegration process of recovering drug addicts: a qualitative review of Israeli offenders

In an outcome evaluation of recovering addicts who participated in a prison-based therapeutic community, 39 clients, a nonrandomized subsample, are interviewed about their rehabilitation and reintegration experience. This study focuses on the family as the main source of support and as an agent of change for the recovering drug addict. Although many studies show marriage and family to be positively related to successful reintegration and rehabilitation, clients in this study report families as having a negative effect on the rehabilitation and reintegration process. This is especially true among those who reunite with their spouse. The findings are discussed in regard to role expectations and support mechanisms, and suggestions are made for further research.     

慢性阿片依赖者外周血单个核细胞白介素-2的免疫组织化学研究

探讨长期使用阿片类毒品对人体外周血单个核细胞IL 2蛋白表达的影响。以 2 1例阿片依赖者及 16例正常健康人为研究对象 ,用免疫组化SABC法、DAB染色 ,检测IL 2蛋白表达。 2 1例慢性阿片依赖者PBMCDAB染色细胞阳性率明显低于 16例正常健康人 ,二者具有显著差异 (P <0 0 1)。慢性阿片依赖者PBMCIL 2蛋白合成减少 ,由此使IL 2产生减少 ,这对吸毒者的免疫功能改变有重要作用。     

海洛因慢性依赖大鼠神经元一氧化氮合成酶变化

目的 研究海洛因药物滥用致脑神经细胞一氧化氮合成酶(ncNOS)表达的变化及法医学鉴定意义。方法 采用ncNOS免疫组织化学SP法、ncNOS mRNA原位分子杂交及图像分析技术,观察大鼠海洛因慢性依赖和自然戒断大脑皮质、中脑导水管周围灰质和中脑腹侧被盖区神经细胞ncNOS的变化和ncNOSmRNA的表达。结果 实验组神经细胞ncNOS含量和ncNOS mRNA表达比对照组明显增加,阳性细胞数明显增多;自然戒断组较慢性依赖组改变更加明显(P<0.05)。结论 ncNOS在海洛因慢性依赖和戒断中起重要作用,脑神经细胞ncNOS免疫组织化学变化可作为海洛因药物滥用法医学鉴定的形态学依据。     

4-Dimethylaminopyridine as a catalyst in heroin synthesis

In this paper, we describe an acetylating method for fast synthesis of heroin from morphine in the presence of 4-dimethylaminopyridine (4-DMAP) as a catalyst. In the reaction which led to heroin formation, the morphine base was subjected to a solution made up of 4-DMAP (catalyst), methylene chloride (solvent) and acetic anhydride (acetylating agent). We showed that in comparison with classic acetylating procedures, reaction time can be reduced from at least several hours at elevated temperatures to <10 min at room temperature. In general, reaction time is dependent on the molar concentration ratio between morphine and 4-DMAP.     

尿样中海洛因代谢物的测定及海洛因滥用的确认

用ＳＰＥ－ＧＣ－ＮＰＤ法建立了尿样中吗啡、６－单乙酰吗啡及可待因的定性分析方法,适用于海洛因滥用者的尿样分析。尿样中吗啡及可待因的最小检测限均为５０ｎｇ／ｍｌ。方法的相对标准偏差分别为：吗啡１１．３％（ｎ＝５）,可待因１４．２％（ｎ＝５）。方法简便、灵敏、快速,１５ｍｉｎ可完成一例尿样的分析。研究了服用含可待因成分的复方甘草合剂后,尿样中的吗啡及可待因的峰面积比为０．４５７±０．１９７（Ｐ＝９９％）;统计了４０例明确滥用海洛因尿液的分析结果,吗啡与可待因的峰面积比为３．４６±０．８９４,Ｐ＝９９％。可作为判断海洛因滥用的依据。同时与免疫板法比较,附５５例免疫板法阳性尿样的分析结果     

Iliac cancellous bone in drug addicts: a histomorphometric study

Histomorphometry was used to determine structural bone changes in drug addicts. Iliac crest bone biopsies were obtained at autopsy from 28 subjects (21 male, 7 female, aged 18 to 45 years) who had a history of drug abuse and had died due to overdose of illicit drugs. For histomorphometry, undecalcified sections were investigated using the Merz grid. The following histomorphometric indices were measured and calculated: BV/TV, BS/BV, Tb.Th, Tb.N, Tb.Sp, OV/TV, OS/BS, Ob.S/BS, O.Th, ES/BS, Oc.S/BS, and N.Oc/T.A. In 28 controls (24 male, 4 female, aged 17 to 47 years) trabecular bone specimens were investigated in the same way. The parameters in drug addicts did not show any correlation to age, body weight, height or sex differences. Trabecular bone volume and trabecular thickness were slightly but not significantly increased (BV/TV: 23.37 +/- 5.77% (mean, SD), controls 22.23 +/- 5.08%, p = 0.434; Tb.Th: 172.67 +/- 36.83 mcm, controls 169.73 +/- 36.13 mcm, p = 0.764). Only the eroded surface was significantly different to the controls (ES/BS: 8.16 +/- 2.04%, controls 6.96 +/- 2.17%, p = 0.038). We conclude that the incidence of metabolic bone disease in drug addicts is low.