External quality assessment schemes for toxicology

A variety of external quality assurance (EQA) schemes monitor quantitative performance for routine biochemical analysis of agents such as paracetamol, salicylate, ethanol and carboxyhaemoglobin. Their usefulness for toxicologists can be lessened where the concentrations monitored do not extend fully into the toxic range or where the matrix is synthetic, of animal origin or serum as opposed to whole human blood. A scheme for quantitative determinations of a wider range of toxicological analytes such as opioids, benzodiazepines and tricyclics in human blood has been piloted by the United Kingdom National External Quality Assessment Scheme (UKNEQAS). Specialist schemes are available for drugs of abuse testing in urine and for hair analysis. Whilst these programmes provide much useful information on the performance of analytical techniques, they fail to monitor the integrated processes that are needed in investigation of toxicological cases. In practice, both qualitative and quantitative tests are used in combination with case information to guide the evaluation of the samples and to develop an interpretation of the analytical findings that is used to provide clinical or forensic advice. EQA programs that combine the analytical and interpretative aspects of case studies are available from EQA providers such as UKNEQAS and the Dutch KKGT program (Stichting Kwaliteitsbewaking Klinische Geneesmiddelanalyse en Toxicologie).     

法医毒物检验技术方法的质量要求

本文通过对73个法医毒物检验方法进行综合分析,从技术方法的质量特性上对方法的建立与确认提出质量要求.即从内部质量和外部质量的角度,针对法庭科学领域毒物检验技术方法,阐述其功能性、可靠性、易用性和有效性四个维度要求.     

Forensic toxicological analysis of tetrahydrofuran in body materials

Routine analysis of tetrahydrofuran (THF) in biologic materials has become feasible using GC and GC/MS and the headspace method. Problems of the headspace method and this substance which has a high water- and lipid-solubility were overcome by using the salting-out technique. Identification was made by mass spectral examination, in case of concentrations over 5 micrograms per sample. For quantitative determinations, tetrahydropyran (pentamethylene oxide) was used as an internal standard in GC, and a stable isotopic substance, octadeuterated THF (TDF) in GC/SIM. THF was detected in 1 microgram per sample by GC, and 0.1 microgram per sample by GC/SIM. THF blood levels in laboratory animals reached their highest values about 1 h after the oral administration, and the half-life was about 5 h. Ratios of tissue levels to blood were ca. 1.5-2 in the adipose tissue and kidney, and fairly equal in the brain, liver, spleen, and muscle.     

Complex chemical and toxicological analysis of prosidol

Methods for measuring a Russian narcotic analgesic prosidol are suggested: thin-layer chromatography, microcrystalloscopy, gaseous chromatography with ionization flame detector, gas chromatography with mass selective detector, ultraviolet spectroscopy, high-performance liquid chromatography with ultraviolet detector, proton nuclear magnetic resonance used in chemical toxicological analysis, pharmacological analysis, and investigation of material evidence pieces.     

Greek appeals courts’ quality analysis and performance

Our effort in this paper is to focus on Greek Appeals Courts’ Quality Analysis and Performance examining sample real cases to document the long delays of the Greek judiciary. We also examine evidence to support the suggestion that the main problem of the Greek judicial system is not only of insufficient staffing, but also a problem of insufficient organization, excessively burdensome procedures and severe restrictions in the way legal services are supplied in Greece. In particular, we present evidence of poor justice quality that can be also used to interpret the Greek case focusing on the quality of the judiciary and on inefficiencies in legal service markets. We also present a number of case-files that demonstrate the large delays in the Greek judiciary. We finally summarise policy proposals from the existing literature and use them to suggest appropriate judicial reforms for Greece.     

Development of a computerized sexual assessment laboratory

Computer-assisted psychological assessment has been operational for 25 years. It has been well received by patients and shows a degree of reliability that is comparable to that of conventional testing. The authors report on the development of a computerized psychosexual assessment laboratory in a forensic facility housing convicted sex offenders who volunteered for treatment. The development of the laboratory was in response to the need for uniform psychosocial data on each resident that can be used for making better diagnoses, developing personalized treatment programs, and assessing treatment outcome. The process of selecting the psychological tests and programming them for interactive administration is described, as are the testing procedures using the penile plethysmograph with stimuli based on the Tanner developmental stages. A computer-assisted psychosocial assessment that produces a psychosocial history was developed. The laboratory's overall value in the treatment program is assessed.     

QuEChERS方法在法医毒物分析领域的研究进展

在中毒或疑似中毒案件中,毒物鉴定对于提供侦查线索与犯罪证据、澄清案件性质、还原犯罪过程具有重要意义。基于液液萃取和分散固相萃取原理而建立起来的QuEChERS方法,由于其快速、简单、廉价、高效、可靠、安全等优势,正逐渐应用于法医毒物分析的样品前处理过程中。本文综述了QuEChERS方法的基本原理及其在提取和净化等过程中的优化改进,重点详述近年来QuEChERS方法在法医毒物分析领域的应用现状,并对未来发展方向进行展望。     

Detection of "uncommon" tranquillizers-sedatives during screening toxicological analysis

A 56-year-old man is discovered unconscious in a pool of blood in the kitchen of his house. According to findings, the man used a 22 long Rifle to fire 14 shots at his thorax with trajectories going from front to back, from right to left and on a nearly horizontal level. All the projectiles got into the left front side of his thorax and came out just under the back of his left armpit. One of them then got through his left arm and fractured his left humerus. According to the findings made on the premises and the position of the bloodstains, we think that man put his rifle against the wall, resting on a pipe. He fired, unloading two clips into his thorax. He had to handle the bolt of the rifle before each shot. To reload, he took the bullets which were on the nearby table on which blood marks can be seen. When reloading at a certain moment, he sat down in his armchair and when he wanted to stand up, he leaned on the armrests, on which blood marks can be seen. The last bullet was probably the one which went through his left arm, preventing him from keeping on shooting. His death, caused by a hypovolemical shock, was obviously very slow.     

Chemical toxicological analysis of urinary cannabinoids by chromatography mass spectrometry

A chromato-mass-spectrometric method for identification of cannabinoids and 9-carboxy-11-nor-delta 9-tetrahydrocannabinol by their methyl derivatives is proposed. Use of alkaline hydrolysis in pretreatment of samples ensures the optimal conditions for complete isolation of 9-carboxy-11-nor-delta 9-tetrahydrocannabinol. Derivation with methyl iodide in absolute acetone in the presence of potassium carbonate was used. Preliminary conclusion on the presence of cannabinoids in the urine can be made from the results of enzyme immunoassay.     

凶杀案件主体责任能力评定影响因素分析

目的探讨20年来凶杀案件主体(被鉴定人)责任能力评定中的影响因素。方法将1985~2004年288例凶杀案件资料分成A期(1985~1989年)、B期(1990~1997年)和C期(1998~2004年),用SPSS 11.0统计软件进行相关分析和逐步判别分析,筛选出对责任能力评定有重要影响的判别因子。结果A、B、C期责任能力的相关因素稍有差异,但均与作案动机、自我保护能力、医学诊断、情感障碍、行为障碍、自知力障碍、辨认能力和控制能力呈显著相关(P<0.01)或相关(P<0.05)。A、B、C期责任能力的判别因子也不尽相同,环境辨认、危害行为的突然性、自我保护能力和自知力障碍为A期责任能力评定的判别因子;案前先兆、作案动机、环境辨认、自我保护能力、情感障碍、自知力障碍、医学诊断、感知障碍和思维障碍为B期的责任能力评定的判别因子;作案动机、自我保护能力、情感障碍和自知力障碍为C期责任能力评定的判别因子。结论影响A、B、C期凶杀案件主体责任能力评定的因素有所差异,“动机论”对责任能力评定的影响较大。     

Studies on fluorescamine: Part I--Applications of fluorescamine in forensic toxicological analysis.

This paper describes some applications of the fluorescamine spot test to forensic toxicological analysis. The fluorescamine test only reacts with primary amines; thus, this test makes a clear-cut distinction between amphetamine and methamphetamine. Previous common spot tests used reacted the same with these two amines. Fluorescamine is 100 times more sensitive in detecting amphetamine extracted from urine on thin-layer chromatograms than ninhydrin. Thus, it is a more sensitive method of detecting amphetamine abuse in urinalysis screening programs.     

Poppy seed consumption and toxicological analysis of blood and urine samples

Poppy seeds contain morphine in different amounts. Reported concentrations are up to 294 mg morphine/kg poppy seeds. Since penalties based on Street Traffic Law (parapgraph 24a StVG) in Germany (administrative offence) require definitive proof of morphine in blood samples, and the "Grenzwertkommission" in consultation with the Ministry of Transportation recommended a threshold of free morphine of 10 ng/mL, the question arose whether the consumption of poppy seeds can lead to a blood concentrations equal or higher than 10 ng/mL of free morphine. Therefore, five volunteers ate poppy seed products (50 mg morphine/kg poppy seeds). In urine, all on-site tests were enzyme immunologically positive for opiates and were positive to morphine by GC/MS. All the blood samples were negative to morphine by EIA and to free morphine by GC/MS. However, after hydrolysis, morphine was detected by GC/MS in all cases. Accordingly, in Germany, penalties based on parapgraph 24a StVG are not likely to cause road users any concerns should they have consumed poppy seeds. Driver Licensing Authorities, however, should be advised of this problem to avoid unjustified legal measures.     

An assessment of human performance in stabbing.

Stab-resistant body armour is now becoming a standard item of equipment for police officers in the United Kingdom. In the UK these are usually required to have a stab resistance as specified by the Police Scientific Development Branch KR42 standard [G. Parker, PSDB Stab Resistant Body Armour Test Procedure, Police Scientific Development Branch, Publication No 10/93, 1993]. There are several other test standards, all of which specify that body armour must resist penetration by a specific blade type delivered at a specific energy level or range of levels. However, the actual range of energy levels specified varies over almost an order of magnitude and the basis for these levels is not clearly defined. This paper describes tests to determine the energy range and characteristics of stabbing actions that might be directed against stab resistant body armour by an assailant. The energy and velocity that can be achieved in stabbing actions has been determined for a number of sample populations. Volunteers were asked to stab a target using an instrumented knife that measured the axial force and acceleration during the stabbing. The maximum energy obtained in underarm stabbing actions was 64 J whilst overarm stabbing actions could produce 115 J. The loads produced on contact with the target often approached 1000 N.     

Medicare and Medicaid programs; hospital conditions of participation: quality assessment and performance improvement. Final rule

This final rule requires hospitals to develop and maintain a quality assessment and performance improvement (QAPI) program. In the December 19, 1997 Federal Register, we published a proposed rule to revise the hospitals conditions of participation (CoPs). The QAPI CoP was one of the conditions included in the proposed rule. We separated the QAPI CoP from the larger set of hospital CoPs so that it could be published in advance of the remaining CoPs to implement the Administration's initiatives regarding medical errors. QAPI focuses provider efforts on the actual care delivered to patients, the performance of the hospital as an organization, and the impact of treatment furnished by the hospital on the health status of its patients. Specifically, it is important to note that a QAPI is not designed to measure a hospital's quality, but rather a minimum requirement that the hospital systematically examine its quality and implement specific improvement projects on an ongoing basis. State agencies (SAs) during their surveys, review all aspects of a hospital's operations and this review provides a framework in which the SA can assess a hospital's QAPI program. In addition, the QAPI entails all activities required for measuring quality of care and maintaining it at acceptable levels. This typically includes; 1) Identifying and verifying quality-related problems and their underlying cause; 2) Designing and implementing corrective action activities to address deficiencies; 3) Following up to determine the degree of success of an intervention and to detect new problems and opportunities for improvement. Performance improvement activities aim to improve overall performance assuming that there is no permanent threshold for good performance. Under performance improvement framework, hospitals will continuously study and improve the processes of healthcare and delivery of service.     

浅论对刑事案件中的司法精神病鉴定的审查

我国刑诉法第120条规定:精神疾病的医学鉴定由省级人民政府指定的医院进行.因此,公、检、法机关的专职法医不再直接参与司法精神病鉴定,而只对其进行审查.具体而言:一是对提出进行司法精神病鉴定委托或要求的案件进行审查,决定是否进行司法精神病鉴定;二是对已经作出的司法精神病鉴定进行审查,确定其证据效力.     

浅论对刑事案件中的司法精神病鉴定的审查

我国刑诉法第120条规定:精神疾病的医学鉴定由省级人民政府指定的医院进行。因此,公、检、法机关的专职法医不再直接参与司法精神病鉴定,而只对其进行审查。具体而言:一是对提出进行司法精神病鉴定委托或要求的案件进行审查,决定是否进行司法精神病鉴定;二是对已经作出的司法精神病鉴定进行审查,确定其证据效力。一、对刑事案件提出的司法精神病鉴定委托或要求的审查。笔者在实践中体会到:对提出的司法精神病鉴定委托或要求进行审查,决定是否进行司法精神病鉴定时需切实把握住精神病人实施危害行为的下述一般特征:1目的和动机不明显。精神病…