Comparison of blood-ethanol concentration in deaths attributed to acute alcohol poisoning and chronic alcoholism

Ethanol concentrations were measured in femoral venous blood in deaths attributed to acute alcohol poisoning (N = 693) or chronic alcoholism (N = 825), according to the forensic pathology report. Among acute alcohol poisonings were 529 men (76%) with mean age 53 years and 164 women (24%) with mean age 53 years. In the chronic alcoholism deaths were 705 men (85%) with mean age 55 years and 120 women (15%) with mean age 57 years. The blood-ethanol concentrations were not related to the person's age (r = -0.17 in acute poisonings and r = -0.09 in chronic alcoholism). The distribution of blood-ethanol concentrations in acute poisoning cases agreed with a normal or Gaussian curve with mean, median, standard deviation, coefficient of variation, and spread of 0.36 g/100 mL, 0.36 g/100 mL, 0.086 g/100 mL, 24% and 0.074 to 0.68 g/100 mL, respectively. The corresponding concentrations of ethanol in chronic alcoholism deaths were not normally distributed and showed a mode between 0.01 and 0.05 g/100 mL and mean, median, and spread of 0.172 g/100 mL, 0.150 g/100 mL, and 0.01 to 0.56 g/100 mL, respectively. The 5th and 95th percentiles for blood-ethanol concentration in acute poisoning deaths were 0.22 and 0.50 g/100 mL, respectively. However, these values are probably conservative estimates of the highest blood-ethanol concentrations before death owing to metabolism of ethanol until the time of death. In 98 chronic alcoholism deaths (12%) there was an elevated concentration of acetone in the blood (>0.01 g/100 mL), and 50 of these (6%) also had elevated isopropanol (>0.01 g/100 mL). This compares with 28 cases (4%) with elevated blood-acetone in the acute poisoning deaths and 22 (3%) with elevated blood-isopropanol. We offer various explanations for the differences in blood-ethanol and blood-acetone in acute poisoning and alcoholism deaths such as chronic tolerance, alcohol-related organ and tissue damage (cirrhosis, pancreatitis), positional asphyxia or suffocation by inhalation of vomit, exposure to cold coupled with alcohol-induced hypothermia, as well as various metabolic disturbances such as hypoglycemia and ketoacidosis.     

血中乙醇质量浓度与神经行为能力的关系

目的 研究血中乙醇质量浓度与神经行为能力的关系。方法 采用中文第三版计算机化神经行为测试评价系统（NES-C3）,通过自身对照的方式,对233名饮酒者进行神经行为能力的测试。结果 当血中乙醇质量浓度I〉0．157mg／mL时,视简单反应时和数字筛选能力指数有显著性下降;当血中乙醇质量浓度I〉0．204mg／mL时,心算、视觉保留、线条判断能力指数有显著性下降。结论 神经行为能力随着血中乙醇质量浓度的升高而下降,然后随着乙醇的不断代谢,血中乙醇质量浓度的降低,神经行为能力逐渐恢复。     

A controlled study of the time-course of breath alcohol concentration after moderate ingestion of ethanol following a social drinking session

This paper evaluates the breath alcohol concentration (BrAC), nausea (feeling of being slightly intoxicated) and subjective driving performance after ingesting a moderate dose of alcohol in the presence of a light meal, which intends to approach a social drinking setting. 119 healthy individuals (69 males and 50 females, aged 21.7+/-3.0) ingested three glasses of wine (95mL each) and their BrAC was determined by an Alcotest 7410 at 15, 30, 45, 60, 90 and 120min post-drinking. 46% of females and no male subjects exceeded a BrAC of 0.25mg/L, the legal limit for driving fixed by some Western countries. 53% of the study population felt nausea during the experimental session and 20% self-reported impairment of their driving skills. In both cases these subjective effects were more pronounced in females. The major determinants of mean BrAC were time post-drinking, gender (male) and body mass index (BMI), all these variables being inversely associated. Females and individuals with a BMI lower than 22.5kg/m(2) were at an increased risk of exceeding the legal limit of BrAC. The feeling of nausea was significantly associated with gender (females), the ingestion of up to 2 drinks on weekdays, and having exceeded a BrAC of 0.25mg/L during the experimental study. The main predictor of self-perception of impaired driving skills was the feeling of nausea, followed by a BrAC in excess of 0.25mg/L. In conclusion, both females and subjects with lower BMI are at an increased risk of exceeding the legal limit of BrAC after moderate alcohol consumption resembling a social drinking setting.     

Excretion of alcohol in urine and diuresis in healthy men in relation to their age, the dose administered and the time after drinking

Healthy male volunteers drank neat whisky in amounts corresponding to 0.51, 0.68, or 0.85 g ethanol/kg body weight in 15-25 min after an overnight (10 h) fast. Urine was collected immediately before drinking and then at 60 min intervals for 7-8 h after intake. The volumes of urine voided were measured and the concentrations of alcohol (UAC) were determined by an enzymatic method. Ethanol-induced diuresis showed large inter-subject variations. The flow of urine was maximum between 60 and 120 min post-drinking when the median rates of production were 117 ml/h (range 55-335), 113 ml/h (range 41-453) and 373 ml/h (range 215-485) for 0.51, 0.68, and 0.85 g ethanol/kg respectively. The output of urine returned to normal (30-60 ml/h) after the peak UAC had passed despite an elevated blood alcohol concentration (BAC). The average amount of alcohol excreted in urine was 0.29 g (S.D. 0.119), 0.44 g (S.D. 0.246), and 1.00 g (S.D. 0.427) after the consumption of 0.51, 0.68 and 0.85 g ethanol/kg respectively. Neither peak diuresis nor the amount of alcohol excreted depended on a subject's age between 20 and 60 years. This work shows that after drinking a moderate dose of alcohol, only 0.7-1.5% of the amount consumed is excreted unchanged in urine. Ethanol-induced diuresis is most pronounced for the first 1-2 h after drinking (rising BAC). The production of urine returns to normal during the post-absorptive state.     

Relationship between the concentration of ethanol and methanol in blood samples from Swedish drinking drivers

Headspace gas chromatography was used to determine the concentration of ethanol and methanol in blood samples from 519 individuals suspected of drinking and driving in Sweden where the legal alcohol limit is 0.50 mg/g in whole blood (11 mmol/l). The concentration of ethanol in blood ranged from 0.01 to 3.52 mg/g with a mean of 1.83 +/- 0.82 mg/g (+/- S.D.). The frequency distribution was symmetrical about the mean but deviated from normality. A plot of the same data on normal probability paper indicated that it might be composed of two subpopulations (bimodal). The concentration of methanol in the same blood specimens ranged from 1 to 23 mg/l with a mean of 7.3 +/- 3.6 mg/l (+/- S.D.) and this distribution was markedly skew (+). The concentration of ethanol (x) and methanol (y) were positively correlated (r = 0.47, P less than 0.001) and implies that 22% (r2) of the variance in blood-methanol can be attributed to its linear regression on blood-ethanol. The regression equation was y = 3.6 + 2.1 x and the standard error estimate was 0.32 mg/l. This large scatter precludes making reliable estimates of blood-methanol concentration from measurements of blood-ethanol concentration and the regression equation. But higher blood-methanol concentrations are definitely associated with higher blood-ethanol in this sample of Swedish drinking drivers. Frequent exposure to methanol and its toxic products of metabolism, formaldehyde and formic acid, might constitute an additional health risk associated with heavy drinking in predisposed individuals. The determination of methanol in blood of drinking drivers in addition to ethanol could indicate long-standing ethanol intoxication and therefore potential problem drinkers or alcoholics.     

Doing time after time: an Interpretative Phenomenological Analysis of reformed ex-prisoners' experiences of self-change,identity and career opportunities

Abstract

The study of desistance from crime has generated a wealth of research in the last few decades. Despite the many barriers ex-prisoners face when attempting to ‘go straight’ many successfully lead law-abiding lives. Two key features identified in criminal desistance are a shift to a pro-social identity and worthwhile employment or the development of a new career path. There is, however, little psychological knowledge available on reformed offenders' experiences of self-change. This study focuses on ex-prisoners' experiences of employment and career opportunities. Five male reformed offenders took part in semi-structured interviews. Data collected was subjected to an Interpretative Phenomenological Analysis. Participants demonstrated that desistance involves a shift to a pro-social identity and that self-change was a positive experience. An important aspect to emerge was the conflict experienced by the label ‘ex-offender’, which had a contradictory influence on the men's sense of self.     

Genetically-induced variability of alcohol metabolism and its effect on drinking behavior and predisposition to alcoholism

Alcoholism is one of the most challenging current health problems in the Western countries with far-reaching medical, social, and economic consequences. There are a series of factors that interact in predisposing or protecting an individual against alcoholism and alcohol-related disorders. This article surveys the state of our knowledge concerning the biochemical and genetic variations in alcohol metabolism and their implications in alcohol sensitivity, alcohol drinking habits, and alcoholism in different racial/ethnic groups. The major pathway for the degradation of ethanol is its oxidation to hydrogen and acetaldehyde--to which many of the toxic effects of ethanol can be attributed. Variations in alcohol and acetaldehyde metabolism via genetically determined polymorphisms in alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) seem to play an important role in individual and racial differences in acute and chronic reactions to alcohol, alcohol drinking habits, as well as vulnerability to organ damage after chronic alcohol abuse. Alcohol sensitivity and associated discomfort symptoms accompanying alcohol ingestion may be determinental for the significantly low incidence of alcoholism among the Japanese, Chinese and other Orientals of Mongoloid origin. An abnormal ALDH isozyme has been found to be widely prevalent among individuals of the Mongoloid race and is mainly responsible for the acute sensitivity to alcohol commonly observed in this race. Persons sensitive to alcohol by virtue of their genetically controlled ALDH isozyme deficiency may be discouraged from drinking large amounts of alcohol in their daily life due to the initial adverse reaction experienced after drinking alcohol. Indeed, a significantly low incidence of the mitochondrial ALDH isozyme deficiency has been observed in alcoholics as compared to psychiatric patients, drug dependents and healthy controls in Japan. How far any variation in ADH and/or ALDH activity among individuals of Caucasian origin will have similar effects has yet to be studied.     

The histoenzymological diagnosis of the time of occurrence of a closed spinal cord trauma]

Time course of the activities of transport enzymes in capillary walls of human spinal cord was studied in various periods after closed injury to the cord, inflicted by hard blunt objects, with the use of histochemical methods for the detection of alkaline phosphatase and Mg-dependent ATPase. Wave-like fluctuations in the activities of the examined enzymes were revealed. The findings may be used to assess the period elapsed since the cord injury.     

Presentation of fingerprints of cadavers after an extended period of time, and also immersed cadavers

Dactyloscopic fingerprints of longer time in water laying corpses can be taken from the surface and rear face of the epidermis and from the corium with a simple method. Used are in household occurring or easily available substances. For best results in identification it is important to get all fingerprints without exchanging them.     

The morphological characteristics of the brain injuries in acceleration trauma depending on the conditions of its occurrence

The series of 175 cases of cranio-cerebral trauma (acceleration trauma by mechanism of its formation) was studied. Morphology of percussion and anti-percussion cerebral lesions was shown to depend on conditions of trauma formation and other factors including presence or lack of cranial bone fractures, cerebral vascular pathology, nature of trauma (isolated or combined) etc.     

The effect of time of death on extravascular tissue/blood secobarbital concentration ratios in the rat

Extravascular liver/blood and brain/blood ratios were found to be an average of 6% and 1% higher, respectively, in all experiments than total liver/blood and brain/blood ratios. This difference may be informative in establishing true tissue levels. There was a significant time effect (P less than 0.05) with the extravascular liver/blood ratios but not with the extravscular brain/blood ratios. Extravascular liver/blood ratios were slightly higher in phenobarbital-pretreated animals than in non-pretreated animals. Tissue secobarbital levels in pretreated and non-pretreated animals are not different at 1/4 or 1 h, even though pretreated animals received higher doses than non-pretreated animals. Tissue levels are significantly higher (P less than 0.01) in pretreated animals than in non-pretreated animals at 4 h. It is possible that, at this time period, the barbiturate-metabolizing enzymes have become saturated or exhausted.