Fluorescence test to identify deep smokers

The lungs of deep smokers contain large numbers of alveolar macrophages with pigment granules in the cytoplasma that are demonstrable by means of fat stains and a distinct green-yellow inherent fluorescence at a wave length range of 350-450 nm. Systematic examinations to test the eluting effect of different solvents on the substances contained in the smoker cells revealed that only extraction in the polar solvent tetrahydrofurane and Folch's solution leads to a reduction of the inherent fluorescence of the pigment granules. Centrifugation of cell or tissue specimens of smoker lungs with Folch's solution results in the fluorescent substances passing into the chloroform phase of the extracting medium, which fluoresces milky-orange-green at a wave length of 366 nm under an ultraviolet lamp. As the fluorescence test is also independent of the degree of freshness of the corpse, extraction of the cell sediments of only a few milliliters of expressed lung tissue fluid or lung tissue mash allows to quickly establish a dead person's smoking habits to help identify the deceased.     

Prevalence of nicotine consumption in drug deaths

One hundred consecutive drug death victims autopsied at the Institute of Forensic Medicine, University of Freiburg, between 1995 and 1997 were studied retrospectively as to whether the drug users had also consumed nicotine. The study included histological examination of the lung tissue for smoker cells and radioimmunological as well as GC-MS assays of the urine for cotinine, the primary metabolite of nicotine. It was found that 98 out of 100 drug victims had consumed nicotine in addition to illicit drugs or replacements. Yellowish-brown discolorations on the middle and index fingers were discernible in 44 drug victims, whereas fresh or scarred burns due to glowing cigarettes were found in six deceased drug consumers. Diseases of the bronchial system typical of heavy smokers were seen in 35 cases. Siderophages could be demonstrated in 17 of the 100 drug deaths.     

Forensic Analysis of Cigarette Ash—Brand Determination Through Trace‐metal Analysis

The information inherent in cigarette ash in the form of trace‐metal concentrations may be of use in a forensic context as it can indicate the brand from which the ash originated. This knowledge might help place suspects at crime scenes or determine how many people may have been present. To develop and test statistical models capable of classifying ash samples according to brand, commercial cigarettes procured in the U.S. and overseas were “smoked” using a peristaltic pump, mimicking the range of human smoking habits. Ash samples were digested in a mixture of nitric and hydrochloric acid applying microwave digestion and analyzed using inductively coupled plasma‐mass spectrometry. Principal component analysis of the elemental data showed intrinsic differences between brands. Partial least squares‐discriminant analysis demonstrated that brand classification yields good sensitivity and specificity for a number of models tested. Varying smoking parameters did not impact the classification of ash samples.     

Smoking trials with mercury contaminated cigarettes. Studies of attempted poisoning]

In the context with an attempted poisoning it was investigated, to which extent an intoxication can be caused by smoking cigarettes, which contain elementary mercury. With a smoking apparatus the effect of the amount (9 mg to 1.4 g) and of the distribution of the Hg within the cigarette on its concentration in the mainstream and sidestream smoke as well as in the ash and the filter was analytically determined. It follows from these experiments, that at a good distribution almost independently of the amount involved only up to 2 mg Hg per cigarette are inhalated with the mainstream smoke, whereas up to 97% are found in the sidestream smoke. In the ash and the filter only small amounts are detected. By comparison with cases described in literature it is shown, that a poisoning by such cigarettes is possible only after frequent smoking or by passive smoking via the sidestream smoke in small and badly aerated rooms.     

Constructive cigarette regulation

Professor W. Kip Viscusi argues for a move away from the adversarial approach to tobacco regulation, an approach that is currently embodied in class action lawsuits and the proposed broadening of FDA regulatory power over cigarettes. In this Article, he suggests that the FDA should take a constructive role in fostering technological innovations to promote cigarette safety, in much the same way that the government currently fosters safety improvements in motor vehicles and jobs. Professor Viscusi claims that the objective of government policy should be to promote informed consumer risk taking--an approach which recognizes that adult consumers have a right to smoke and to incur the associated risks. He provides survey data demonstrating that although consumers know that smoking is a risky decision, they have little exposure to information regarding the comparative riskiness of various cigarette brands. According to Professor Viscusi, the government should assist in compiling and disseminating information regarding the comparative risks of different smoking options and the effects of certain innovative safety features for cigarettes. Making this information available would enable consumers to make more informed smoking decisions and potentially minimize the health hazards that smoking poses.     

烟草管制与公民权利的包容与界分

毋庸置疑,对已沦为习俗的吸烟行为予以管制,必然会滋生侵犯公民权利方面之不妥,一般而言,其表现为与吸烟者行为自由权、烟商言论自由权、以及吸烟者与企业主财产权三方面存有冲突。我们经由对自由权本质属性的剖析可以明确,有碍他人健康之吸烟行为非属行为自由其类;同时,亦并非所有烟草宣传皆可归属言论自由权范畴,在烟控制度结构中,我们理应对烟草宣传保持"尊重与戒惧"的基本态度。另外,限制购买以及征收烟草税所造成的财产限制,事实上和一般意义上的财产权侵犯亦是有所差别的,购买香烟是一种特殊的财产支配情形,对其予以限制并不违背法经济学上的资源配置法则。最后,对企业主而言,单纯的获利机会、商业利益、赢利预估或期待并非属于财产权的保障范围。     

The relationship between performance on the standardised field sobriety tests, driving performance and the level of Delta9-tetrahydrocannabinol (THC) in blood

The consumption of Delta9-tetrahydrocannabinol (THC) as cannabis has been shown to result in impaired and culpable driving. Testing drivers for the presence of THC in blood is problematic as THC and its metabolites may remain in the blood for several days following its consumption, even though the drug may no longer have an influence on driving performance. In the present study, the aim was to assess whether performance on the standardised field sobriety tests (SFSTs) provides a sensitive measure of impaired driving behaviour following the consumption of THC. In a repeated measures design, 40 participants consumed cigarettes that contained either 0% THC (placebo), 1.74% THC (low dose) or 2.93% THC (high dose). For each condition, after smoking a cigarette, participants performed the SFSTs on three occasions (5, 55 and 105 min after the smoking procedure had been completed) as well as a simulated driving test on two occasions (30 and 80 min after the smoking procedure had been completed). The results revealed that driving performance was not significantly impaired 30 min after the consumption of THC but was significantly impaired 80 min after the consumption of THC in both the low and high dose conditions. The percentage of participants whose driving performance was correctly classified as either impaired or not impaired based on the SFSTs ranged between 65.8 and 76.3%, across the two THC conditions. The results suggest that performance on the SFSTs provides a moderate predictor of driving impairment following the consumption of THC and as such, the SFSTs may provide an appropriate screening tool for authorities that wish to assess the driving capabilities of individuals suspected of being under the influence of a drug other than alcohol.     

Assessment of exposure to opiates and cocaine during pregnancy in a Mediterranean city: preliminary results of the "Meconium Project"

For the first time in Europe, the "Meconium Project" aimed to estimate the prevalence of drug use by pregnant women and the effects of exposure to illicit drugs during pregnancy on the fetus and infant. Between October 2002 and February 2004, 1151 (79%) dyads among the 1439 mother-infant dyads from the Hospital del Mar, Barcelona, Spain, met eligibility criteria and agreed to participate in the study. We present preliminary results on the first 830 meconium samples and 549 mother-infant dyads, for which statistical analysis of socio-economic and demographic characteristics and newborn somatometry was completed. The meconium analysis showed an overall 7.9% positivity for drugs of abuse, with 6-monoacetylmorphine and cocaine being the analytes, most frequently found in samples positive for opiates and cocaine. Structured interview disclosed 1.3, 1.8 and 1.3% of mothers exposed to opiates, cocaine and both drugs, while only one mother declared ecstasy consumption. Meconium analysis showed that prevalence of opiates, cocaine and combined drugs exposure was 8.7, 4.4 and 2.2%, respectively, and confirmed the case of ecstasy use. Arecoline, the main areca nut alkaloid, was found in meconium specimens from four Asiatic newborns, whose mothers declared beetle nut consumption during pregnancy. Parental ethnicity was not associated with drug use, nor was the social class, although a higher tendency toward drug consumption was observed in professional and partly skilled mothers. Drug consuming mothers showed a higher number of previous pregnancies and abortions (p<0.05) when compared to non-consumer mothers (meconium negative test), probably due to a lack of family planning. Consumption of opiates and cocaine during pregnancy was associated with active tobacco smoking, a higher number of smoked cigarettes and cannabis use. Exposure status and smoking behavior correlated with significantly lower birth weight in newborns from mothers exposed only to cocaine and to opiates and cocaine simultaneously. Of the four newborns exposed to arecoline, one showed a low birth weight, low intrauterine growth, hyporeflexia and hypotonia.     

Quantitative Analysis of the DNA Distribution on Cigarette Butt Filter Paper*

The distribution of DNA on the filter paper of smoked cigarette butts was quantitatively mapped using real‐time quantitative polymerase chain reaction. The filter papers from smoked cigarette butts collected from indoor and outdoor sources were sliced into equal pieces and the amount of DNA on each slice was determined. This study found that the cigarette butt filter papers sliced parallel to the seam of the cigarette had more uniformly distributed DNA on the slices and in most cases, there was enough DNA on each slice to obtain a complete DNA profile. The perpendicular slices had a less uniform pattern of distribution and some slices did not have enough DNA to obtain an interpretable DNA profile. Cigarette butts found indoors also had more DNA per cigarette on average than cigarette butts found outdoors.     

Morphometric investigation of emphysema aquosum in the elderly

We compared the lungs of six drowned and six non-drowned persons over 70 to determine whether there is evidence of acute overinflation in drowning that can be distinguished from senile lung emphysema. All left lungs underwent intrathoracic formalin fixation to preserve their state of insufflation. To assess the effects of lung collapse, all right lungs were sectioned as usual and then immersed in formalin. After histological processing, microphotography and image processing of 12 specimens per corpse, 50 binary images of each specimen were measured by computerized morphometry. Intrathoracic fixation resulted in significantly less tissue area (and more airspace) in the left than in the right lungs of both groups. Comparing both groups' left lungs revealed that the interalveolar septa were thinner and the area occupied by connecting nodes smaller in drowning; these single nodes also tended to be smaller. There was a tendency for less alveolar tissue area per image in drowning than in control lungs and for narrow tissue structures to comprise a higher percentage of both the total tissue area and total tissue perimeter per image. We conclude that there is morphological evidence of acute overinflation even in senile lungs, but this is masked by postmortem lung collapse as suggested by the overlapping values of the right lungs. Support to the diagnosis of drowning among drowned elderly patients can only be available in lungs subjected to intrathoracic postmortem fixation.     

Extraction of high quality DNA from biological materials and calcified tissues

Calcified tissues, such as bone and tooth, and some other sample types, such as those containing adhesive, present a challenge to standard extraction protocols. We have developed a lysis reagent, BTA™ lysis buffer, which is designed for use with PrepFiler™ Kit reagents. The BTA™ lysis buffer disrupts calcified tissue matrices and achieves effective extraction of DNA from pulverized bone and tooth samples. In addition, the BTA™ lysis buffer mildly but efficiently extracts DNA from challenging substrates like tape, chewing gum, and cigarette butts and, as with bone and tooth, DNA from these lysates is purified using established PrepFiler™ reagent extraction protocols.We successfully extracted DNA from powdered human bone samples, chewed gum and smoked cigarettes using BTA™ lysis buffer. Extraction yields for bone, gum and cigarette samples tested were consistent and reproducible. This extraction method efficiently removed potential PCR inhibitors from all samples tested, and C_T values for the internal PCR control of Quantifiler^® Human DNA Quantification Kit were consistent and within the normal range. The DNA extracted from these samples also provided conclusive profiles that were free of PCR artifacts when amplified using the AmpF?STR^® Identifiler^® PCR Amplification Kit. The protocol is easily adapted for automation.     

人体颅脑贯通枪创后心肌和肺的超微结构观察

本文报告6例人体颅脑贯通枪创后2小时所取心肌和肺的超微结构变化。6例心肌及肺的超微结构基本相似。心肌最明显的变化是:Z 带排列不规则,灶性肌原迁维溶解,线粒体肿胀、基质电子密度降低和嵴消失,间质水肿。肺组织的明显变化是肺泡隔和肺间质增宽伴电子密度降低,肺泡隔毛细血管内中性粒细胞聚集,肺间质或肺泡腔内中性粒细胞浸润。本文对主要病理变化的意义和发生原理进行了讨论,认为肺间质水肿与神经源性肺水肿有关,由于伤后经过时间长短不同或有无颅内高压形成,而出现间质性水肿或肺泡内水肿。心肌的变化与缺氧有关。     

Immunohistochemical study of blood group activities in severely burned human tissue

The blood, livers and lungs obtained from donors or cadavers of known blood groups were experimentally burned, while the temperatures inside the tissue specimens were automatically measured. All the distinguishable portions with various thermo-changes in each burned tissue specimen were examined for their blood-group activities A, B, Lea, Leb and P1 by means of the immunofluorescence and immunoperoxidase techniques. In the layer immediately before charring of the blood masses (tissue temperature: ca. 200-250 degrees C), the activities A, B, Lea, Leb and P1 could be specifically demonstrated on the erythrocyte membranes. In case of the burned livers and lungs, the A- and B-activities could be detected in the small blood vessels in the layer immediately before charring (ca. 200-250 degrees C), though the layer was so severely thermo-changed, that their original tissue structures could be no more observed. In the severely thermo-coagulated, porous and hardened layer of both organ tissues, the A- and B-activities could be demonstrated on the endothelial cells of the hepatic sinus and small blood vessels (especially in the alveolar walls). The simply thermo-coagulated inner portions well retained their original tissue structures and the A- and B-activities remained on the epithelial cells of the alveoli and bronchioles of the lung as well as the cells described above. The Lewis blood-group activities could be demonstrated on the epithelial cells of the bronchioles in the simply thermo-coagulated inner portion of the lung. The P1-activity could not be demonstrated in the burned tissues of the livers and lungs.     

Determination of fetal age by immunohistochemical estimation of surfactant-producing alveolar type II cells.

We monitored the immunohistochemically determined amount of surfactant-producing alveolar type II cells in human fetal lung using polyclonal antibodies against apoprotein B and C of human pulmonary surfactant. Lungs of 30 dead-born fetuses without lung affection aged between 15 and 38 weeks of gestation were evaluated and the surface density of surfactant-producing alveolar type II cells was determined by morphometry. In lungs of fetuses with a gestational age less than 22 weeks no relevant number of positively reacting cells could be found. Between the 22nd and 29th week a progressive increase with considerable inter-individual variability was observed. From the 30th week on the number of the type II pneumocytes appeared rather constant without further significant increase. We provide evidence that the immunohistochemical detection of surfactant-producing alveolar type II cells is useful for the determination of the age of unknown and especially fragmented fetuses: The lack of surfactant-producing alveolar type II cells in fetal lungs before the 22nd week allows a rather safe distinction between fetal lungs of higher age from those of lesser age. Between the 22nd and 29th week an age-dependent increase in the number of these cells occurs with wide inter-individual variability allowing only an approximate age determination. In particular, this may be an important piece of information in fragmented fetal corpses. Furthermore, the number of surfactant-producing alveolar type II cells provides additional information on pulmonary maturation and may thus be helpful in the estimation of a theoretical survival chance.     

Ultrastructure of acute ammonia toxicity in the human lung

A tanker truck carrying anhydrous ammonia (NH3) fell off a freeway, releasing a dense cloud of NH3 gas, killing several people. The driver was dead upon impact. To our knowledge, pulmonary NH3 toxicity in humans has not been studied previously by electron microscopy (EM). Therefore, in two cases, the paraffin-embedded tissue blocks of lung were deparaffinized and reembedded in plastic for 1-mu sections and EM examination. The lung tissue of a third case, the truck driver, was similarly processed as a control. Light-microscopic pulmonary findings in the acute NH3 deaths included denudation of the tracheobronchial epithelium, edema of the lamina propria, and marked alveolar edema, congestion, and hemorrhage. In contrast, in the truck driver's lungs, the bronchial epithelium was intact, and there was no gross odor of NH3. Massive pulmonary hemorrhages in his lungs were attributed to trauma rather than NH3 inhalation. EM examination of the lungs of the truck driver showed no discernible toxic alterations in either the capillary endothelial cells or the Type I or II alveolar epithelial cells, and alveolar and capillary basement membranes were intact. In contrast, EM study of the lungs from two individuals dying acutely of NH3 inhalation showed marked swelling and imbitional edema of Type I alveolar epithelial cells; however, alveolar basement membranes and capillary endothelial cells appeared as usual. These electron-microscopic findings demonstrate the Type I epithelial cell to be the target cell of acute alveolar wall injury in NH3 inhalation.     

The reaction of lung mast cells to acute barbiturate and bromureide poisoning (author's transl)]

Guinea pigs were poisoned by large oral doses of hypnotics in order to study the effect of bromureides on the mast cell contents of the lungs in comparison to the influence of barbiturate intoxication. The dose of the hypnotics chosen was thus, that all animals died within the first three hours after the beginning of feeding. Then the degranulation of mast cells with decrease of the mast cell number in the lung tissue was merely small in the barbiturate poisoned animals, but very extensive in the animals intoxicated by bromureides. The difference is highly significant. The possible influence of this effect upon the different clinical course of both kinds of intoxication is discussed.     

Is the appearance of macrophages in pulmonary tissue related to time of asphyxia?

In order to connect the appearance of macrophages and giant cells in pulmonary tissue with the time of asphyxia the authors analyzed 50 asphyxiated human lungs paying their attention on the number of alveolar and interstitial macrophages and giant cells. They compared histological specimens of 25 asphixiated humans lungs following a slow asphyxia (30 min or more) with 25 histological specimens of asphyxiated human lungs following a rapid asphyxia (10-15 min). Alveolar and interstitial macrophages and giant cells per section, were considered and numbered. Controls were done on histological examination of traumatized lungs. In the pulmonary alveoli following on acute asphyxia there were 27.7+/-4.4 macrophages per section. Subjects dead after a slow asphyxiation showed 68.2+/-7.1 alveolar macrophages per section (p<0.001). Interstitial macrophages were also frequently present. No differences are detectable in the number of polynuclear giant cells between rapidly and slowly asphyxiated human lungs. The number of alveolar and interstitial macrophages per section can be considered as a further histological evidence of a slow asphyxia and can differentiate a slow asphyxia from an acute one.     

Nicotine and cotinine levels in body fluids of smokers who committed suicide

Cigarette smoking is associated with a higher risk for suicide. The present study was conducted on the hypothesis that suicide smokers show higher nicotine and cotinine levels in blood and urine than non-suicide smokers. We determined nicotine and cotinine levels in blood and urine of 87 deceased individuals (18 suicides and 69 non-suicides) by gas chromatography. The smoking rate was 77.8% for individuals who committed suicide and 42.0% for those who did not commit suicide. Average nicotine and cotinine levels in blood were significantly higher in the suicide smokers than in the non-suicide smokers (nicotine: 93.2+/-46.6 ng/ml versus 25.8+/-14.4 ng/ml, p<0.0001 and cotinine: 378+/-235 ng/ml versus 201+/-137 ng/ml, p<0.005). Average levels of urinary nicotine and cotinine were also significantly higher in the suicide smokers than in the non-suicide smokers (nicotine: 1980+/-2210 ng/ml versus 394+/-376 ng/ml, p<0.005 and cotinine: 1170+/-1330 ng/ml versus 414+/-290 ng/ml, p<0.05). Twenty-six decedents were intoxicated with alcohol, and they included 7 suicides (7 smokers) and 19 non-suicides (15 smokers). Our data suggest that cigarette smokers who commit suicide smoke more heavily than other cigarette smokers.     

Human pulmonary histopathological changes from marijuana smoking

Thirteen individuals ranging in age from fifteen to forty years, who were known smokers of marijuana, all of whom died suddenly, were autopsied as coroner's cases. The pulmonary histopathologic changes revealed light to heavy infiltrations of pigmented monocytes within alveoli as well as varying degrees of monocytic and lymphocytic infiltration into the interstitium of the lungs. The intensity of the pulmonary infiltrate appears to be dose related. This report calls attention to the accelerated pathological changes in the lungs from marijuana smoking as compared to tobacco smoking leading to pulmonary scarring, emphysema, and eventual chronic obstructive pulmonary disease.     

The effect of sodium hydroxide and hydrochloric acid on pig dermis. A light microscopic study

In order to compare the dermal changes after exposure to direct current (d.c.) with changes after influence of acid and base influence, the skin of fully anaesthetized Danish Landrace pigs were exposed to acid and basic solutions. Biopsies were obtained immediately after and up to day 7 after the injury. Collagen fibres with increased affinity for eosin and irregular cross-striation in polarized light together with shrunken cells with dark stained nuclei were found just beneath the epidermis immediately after application of 1 N HCl. Immediately after exposure to 1 N NaOH dispersed collagen fibres showed increased eosinophilia and a fine densely spaced cross-striation in polarized light and vesicular nuclei were present within dermal cells. During the following days a narrow demarcation zone of neutrophilic granulocytes separated the zone containing abnormal collagen fibres from normal tissue below. Calcified collagen fibres were not observed and no other abnormal histochemical reactions were present. It is concluded that the morphology of acid induced lesions and base induced lesions shows resemblance to the morphology of anode and cathode lesions, respectively, but not to heat lesions. The reason for not finding depositions of calcium salts on collagen fibres in skin exposed to basic solutions could be a non-optimal pH in the tissue or that other electrochemical processes than shift in pH are necessary for the calcification process.