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。     

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.     

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.     

Immunocytochemical diagnosis of early myocardial ischaemic/hypoxic damage

The sensitive and reliable dinitrophenyl (DNP) hapten sandwich staining (DHSS) procedure (B. Jasani et al., Virchows Arch (Pathol. Anat.), 406 (1985) 441-448) was used to study the distribution of immunoperoxidase staining seen with antibodies to seven protein markers in post-mortem heart tissue. This was obtained from 12 cases with macroscopic myocardial infarction and 17 cases without myocardial infarction (10 with and 7 without significant coronary artery atherosclerosis). The immunostaining patterns were compared with the appearances seen in adjacent sections stained by the routine haematoxylin and eosin (H & E) and phosphotungstic acid haematoxylin (PTAH) methods and a method previously recommended for the detection of early myocardial infarction, the haematoxylin basic fuchsin picric acid (HBFP) stain. Loss of immunostaining with an antibody to myoglobin was found to be a reliable and more objective marker of both early and established myocardial infarction compared with the histological stains. Antibodies to myosin, caeruloplasmin, C-reactive protein and pre-albumin gave similar but less reliable results, whilst those to complement factor C3b and alpha-1 anti-trypsin gave the least reliable results for early myocardial ischaemic/hypoxic damage. The immunocytochemical results are considered sufficiently encouraging to extend the work to a large number of sudden death cases in order to establish a new, more reliable approach to the detection of histologically latent ischaemic/hypoxic damage in the myocardium.     

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。     

滥用海洛因对心血管系统的损害

海洛因滥用对人体各个系统产生严重的损害,其中对心血管系统的损害作用是多方面的。本文就滥用海洛因对心率、血压、心电图、心功能、血液循环、心血管内一些物质的变化、心血管并发症等进行综述,为相关的研究提供参考。     

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.     

Further evaluation of immunocytochemical staining in the diagnosis of early myocardial ischaemic/hypoxic damage

The pattern of immunocytochemical staining with antibodies to caeruloplasmin, myosin, myoglobin and C-reactive protein seen in myocardium taken from deaths with macroscopic evidence of myocardial infarction and/or significant coronary artery atherosclerosis and from deaths with neither of these lesions has been correlated with H&E, PTAH and HBFP staining of myocardium and circumstances of each death indicative of antemortem hypoxia and/or ischaemia. Loss of staining with these antibodies correlated well with fuchsinorrhagia and both techniques are more sensitive than H&E and PTAH staining in the detection of early ischaemic/hypoxic damage to myocardium. However, their sensitivity is such that they appear to detect agonal changes and, therefore, cannot be used for specific diagnosis of early myocardial infarction.     

Alleged brain damage, diminished capacity, mens rea, and misuse of medical concepts.

As focus on the insanity defense diminishes, defendants may place emphasis on a lack of knowing or purposeful behavior in order to negate a criminal charge. This use of a mens rea defense in accord with Model Penal Code principles is exemplified by the current New Jersey statute. Such a defense may result in a lesser charge or a finding of not guilty. In addition to reviewing applicable law, this report presents a sex offense case in which remote brain damage was invoked as a purported basis for incapacity to formulate the required intent; the study also raises the issue of the inappropriate or questionable use of medical principles, a practice that diminishes professional credibility in the courts and in the community.     

Determination of potassium/sodium ratio in heart tissue. Evaluation of its use as an index of myocardial ischaemic damage. Comparison with the nitro-BT test

The succinate dehydrogenase method of staining and the determination of the K⁺/Na⁺ ratio of heart tissue have been applied to forensic material as a tool for demonstrating early signs of myocardial infarctions. Both methods are controlled by a series of forensic cases dying from causes other than arteriosclerosis of the coronary arteries. Based on an analysis of normal material some factors influencing the K⁺/Na⁺ ratio are defined. It is concluded that the determination of the K⁺/Na⁺ ratio shows more infarcts than the formazan method; however, the evaluation of the K⁺/Na⁺ ratio is difficult. The K⁺/Na⁺ determination is not recommended for routine use. A possible indication for the use of the K⁺/Na⁺ determination together with the formazan test could be cases of instantaneous death by accidents suspected to have been provoked by a fatal heart attack.     

FTIR法检验海洛因中的淀粉、葡萄糖、蔗糖

目的建立检验掺有淀粉、葡萄糖、蔗糖的海洛因的新方法。方法红外光谱。结果给出了用FTIR检验掺有淀粉、葡萄糖、蔗糖的海洛因的判据。结论用红外光谱法可以准确、无损鉴定掺杂淀粉、葡萄糖、蔗糖的海洛因。     

Fatal poisoning in drug addicts in the Nordic countries.

The study includes medicolegally examined fatal poisonings among drug addicts in 1997 in the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden, and the results are compared to a similar investigation from 1991. A common definition of "drug addict" was applied by the participating countries.The highest death rate by poisoning in drug addicts was observed in Denmark, where it was 6.54 per 10(5)inhabitants, followed by Norway with 6.35, Sweden with 2.21, Finland with 1.63 and Iceland with 1.20 per 10(5)inhabitants. All countries showed a higher death rate in 1997 than in 1991. For all countries the distribution of deaths according to geographical regions showed a decreasing number of drug deaths in the metropolitan area and an increasing number in other cities. Heroin/morphine dominated as the cause of death and was responsible for about 90% of the cases in Norway. In Sweden and Denmark, however, heroin/morphine caused only about 70% of the fatal poisonings. About 30% of the fatal poisonings in Denmark and Sweden were caused by other group I drugs, in Denmark mainly methadone and in Sweden mainly propoxyphene. Apart from two cases in Sweden methadone deaths were not seen in the other Nordic countries. In Finland heroin/morphine deaths have increased from about 10% in 1991 to about 40% in 1997. Forty-four percent of the fatal poisonings in Finland were caused by other group I drugs, mainly codeine and propoxyphene. The two fatal poisonings in Iceland were caused by carbon monoxide. Only few deaths in this investigation were caused by amphetamine and cocaine. A widespread use of alcohol, cannabis and benzodiazepines, especially diazepam, was seen in all the countries.     

Temporal clustering of heroin overdoses in Washington, DC

During the 5-day period from 28 Feb. 1985 through 4 March 1985, 24 heroin overdoses occurred in the District of Columbia. Statistical tests for clustering of fatal and nonfatal overdoses during this interval identified 7 heroin-related deaths that occurred on March 1 to 2 as a statistically significant cluster (p = 0.007). An extension of the analysis for clustering to a 15-month period identified 2 additional clusters, 1 of fatal overdoses and 1 of nonfatal ones. When all victims of fatal overdose in cluster intervals were combined and compared with all other heroin-related deaths, no significant differences were noted for levels of morphine or ethanol in blood. However, bile morphine concentrations of cluster decedents were significantly lower than those of noncluster decedents (p = 0.033), suggesting that these decedents were less tolerant to the effects of narcotics than the comparison group. Heroin concentrations in street-level heroin samples collected during clusters did not differ from those collected during comparison intervals. These data conflict with the traditional explanation of overdose clusters, which attributes these events to unusually potent street-level heroin.     

用GC／ECD方法分析海洛因中毒尿液吗啡代谢物

目的　考查尿检材中海洛因的代谢物吗啡和单乙酰吗啡的液液萃取条件、三氟乙酰化和气相色谱电子捕获检测 (GC/ECD)条件。方法　以烯丙吗啡为内标 ,氯仿∶异丙醇 (9∶1)为液相萃取剂萃取尿中的吗啡和单乙酰吗啡 ,采用MBTFA衍生化 (三氟乙酰化 ) ,GC/ECD检测。结果　尿中加样相对回收率吗啡 89% ,单乙酰吗啡 75 % ,最小检测量吗啡 5 0ng ,单乙酰吗啡 10 0ng。通过实验兔的中毒实验 ,对尿检材进行了分析。 结论　所建立的萃取与检测方法分析海洛因中毒尿检材中的吗啡准确、灵敏 ,可用于海洛因的吸毒检验     

A 'cold synthesis' of heroin and implications in heroin signature analysis utility of trifluoroacetic/acetic anhydride in the acetylation of morphine

Treatment of morphine, at room temperature, with a mixture of trifluoroacetic anhydride (TFAA) and acetic acid (20-30min) affords good yields of heroin. GC-MS and HPLC examination shows that heroin produced by this route to be extremely clean, but the product contains slightly less heroin than observed via the more traditional acetic anhydride (AA) route (76.1% versus 83.55%); and greater quantities of 3-MAM and 6-MAM (6.9% versus 0.75% and 7.13% versus 0.63%). The concentration ratios of the major alkaloid impurities were found to be both production method (TFAA and AA) as well as morphine extraction methodology dependant. Data contained herein describe the impact of this new production method on current intelligence efforts, largely by-passing existing heroin signature programs and the UNDCP's efforts to restrict access to key synthetic precursors. Given the methodology dependency we find that examination of the major alkaloid ratios is unsuitable for the development of a new heroin signature program. Further examination of the TFAA methodology allowed the identification of TFAA specific marker compounds, namely bis-trifluoroacetylmorphine (30), 3-trifluoroacetyl-6-acetylmorphine (31), 3-acetyl-6-trifluoroacetylmorphine (32) and trifluoroacetylcodeine (33). However, the hydrolytic lability of trifluroacetyl esters requires careful treatment of suspect samples, thus we propose a modification to existing HSP's in instances were the 6-MAM/WM ratio falls within the average minimum and maximum values of 6.17 and 17.32.