Drug levels found in cases of fatal self-poisoning

A list of drug levels found in cases of fatal self-poisoning is presented here. These are all cases where only one drug was found and the cause of death in each case was attributed to an overdose of that particular drug. For each case a full drug screen was carried out. In general thin-layer chromatography (TLC) was used as the initial screening technique and any positive findings were then confirmed by gas liquid chromatography (GLC) and high performance liquid chromatography (HPLC). When the drug had been positively identified, the blood level was measured.     

氟乙酸五氟苄基酯的气相色谱分析

目的 对氟乙酸根阴离子的衍生物-氟乙酸五氟苄基酯(PFB-MFA)进行了气相色谱分析，以满足氟乙酰胺类鼠药化验工作的需要。方法 使用GC／ECD、GC／MS Scan、GC／MS SIM对该化合物的标准溶液进行了分析，得到了各种分析方法的校正曲线及检测限。结果 三种方法测定PFB-MFA的线性范围分别为GC／ECD 0.01～0.1ng／μl、GC／MS SCAN 1～100ng／μl、GC／MS SIM 5×10~(-3)～1ng／μl。三种方法对氟乙酸根阴离子的检测限分别为：GC／ECD1.31×10~(-4)ng／μl、GC／MS SCAN 0.13ng／μl、GC／MS SIM 1.76×10~(-4)ng／μl。结论 氟乙酸根阴离子的衍生物氟乙酸五氟苄基酯在GC／ECD及GC／MS上具有一定的线性范围，有非常高的灵敏度，可用于法庭科学的定性定量分析。     

Increased safety and specificity in the thin-layer chromatographic identification of marihuana

We are reporting what we believe to be a safe, rapid TLC system and spray for the identification of marihuana. The use of Fast Blue 2B salt greatly enhances the specificity of the TLC analysis of suspected marihuana samples.     

Gas chromatographic and gas chromatographic-mass spectrometric determination of gasoline in a case of gasoline vapor and alcohol poisoning

A case of fatal poisoning due to the combined effect of alcohol and gasoline following an automobile accident is described. Toxicological analyses by means of gas chromatography and gas chromatography-mass spectrometry permitted the identification and quantitation of alcohol and several hydrocarbons in the heart blood and in the gas in the lung. Great variation was found in the estimates of blood gasoline concentration, depending on which of six constituents of gasoline was chosen for quantitation. The cause of this variation is discussed, together with the possible mechanisms leading to death.     

Gas chromatographic determination of cresols in the biological fluids of a non-fatal case of cresol intoxication

A simple and rapid method for analysis of free and conjugated cresols in biological fluids was developed. Prior to and following freeing of the conjugated cresols by acid hydrolysis in a sealed ampoule, free cresols were extracted by Extrelut column extraction, determined by gas chromatography, and confirmed by gas chromatography-mass spectrometry. In a non-fatal case of cresol intoxication a 46-year-old male had ingested about 100 ml of a saponated cresol soap solution. The concentrations of xylenol (2,4- and/or 2,5-dimethylphenol) and p- and m-cresol in the serum sample collected on admission were 15.8 micrograms/g, 43.3 micrograms/g and 73.8 micrograms/g, respectively. The total cresol concentration of 117 micrograms/g in the serum is within the range of fatal concentrations, and it is suspected therefore that the patient's recovery was due to adequate therapy alone.     

Bullet identification: a case of a fatal hunting accident resolved by comparison of lead shot using instrumental neutron activation analysis.

Bullet identification by chemical analysis often provides a powerful clue in forensic science. A case is reported in which a hunting accident was resolved by using instrumental neutron activation analysis (INAA) for direct comparison of the trace element content in lead shot. Different preparation batches of lead shot appear to have a high within-group composition homogeneity, and good differentiation is achieved between different batches. Determination of the nickel and antimony content on a bush branch demonstrated that the branch had been perforated by one of the shot pellets, and this helped the detectives in reconstruction of the crime scene.     

Penile strangulation: report of a fatal case

Penile strangulation or entrapment is an unusual entity that requires urgent treatment due to its potential complications. Several cases have been reported in the medical literature, some of them describing serious injuries such as necrosis, gangrene, and amputation of the penis. However, as far as we know, no fatal cases have been described before. We present the death of an adult male secondary to the complications due to penile strangulation with a plastic bottle neck. The time of incarceration was unknown, but according to a witness it could be about 10 to 14 days. The findings of autopsy were penile strangulation, necrosis of the penis, acute pyelonephritis, and bronchopneumonia. The subject's refusal to ask for medical help was the cause of this atypical evolution.     

Immunocytochemical identification of AB0 incompatible erythrocytes following fatal transfusion reaction

A patient with blood group O died 8 h after an accidental transfusion of one unit of A1 erythrocytes. The admixture of group A red cells was not detected during postmortem serology. Paraffin-embedded autopsy material was studied by the indirect immunoperoxidase technique using monoclonal antibodies. Group A red cells were easily identified as circulating agglutinates in the larger vessels, in the capillary vessels of all organs examined, and as closely packed cell aggregations in the sinuses of the spleen. However, there was no clear evidence of erythrophagocytosis in the spleen or in liver.     

Gas chromatographic method of quantitative determination of carbon monoxide in cadaver blood

A gas chromatographic method has been developed for measurement of carbon monoxide in cadaveric blood on a chromatographer with thermal conductivity detector and air oxygen as the internal standard. The error of the method is no more than 4% with the mean quadratic deviation +/- 0.18-0.33 min. The method was studied on 10 model and 30 expert blood samples. Putrefactive products did not influence the accuracy of analysis.     

个体识别SNPs位点组合筛选与法医学应用价值初探

目的筛选用于包括中国主要民族在内的多个群体个体识别的SNPs位点组合体系。方法以Kidd实验室筛选的86个SNPs位点、欧洲SNPforID组织构建的52-plex SNPs复合检测体系为基础,收集和整理这些位点在HapMap数据库中11个人群的分型数据,计算各位点杂合度和Fst值,筛选杂合度〉0.4,Fst值〈0.06,并在研究人群中处于Hardy-Weinberg和连锁平衡的位点组合。针对这些位点,采用MassARRAY分子阵列技术对自行收集的8个人群（尼日利亚人、坦桑尼亚查加人、印度人、丹麦人、俄罗斯汉特人、中国汉族、藏族、维吾尔族）308份样本进行分型,统计群体遗传学参数。结果按本文标准共筛选出66个SNPs位点,均符合Hardy-Weinberg平衡,之间互不连锁,平均杂合度和Fst值分别为0.475、0.014。在本文收集的8个人群中的随机匹配概率在1.45E-24~4.72E-27之间,累积非父排除率为0.999 995 608~0.999 997 876之间。结论本文筛选的SNPs组合系统具有较强的个体识别能力,可用于本文调查的HapMap数据库中11个人群和本文收集的8个人群的个体识别鉴定。     

Hydrocephalus: a fatal late consequence of mumps encephalitis

Common and usually self-limited diseases may occasionally have fatal consequences. Hydrocephalus is a very rare complication of mumps, with just a few cases reported in the literature. Here we report a fatal case of hydrocephalus presenting 19 years after mumps encephalitis. The long latency period between encephalitis and hydrocephalus-associated symptoms makes this case particularly interesting.     

Cocaine fatality: an unexplained blood concentration in a fatal overdose

A case is presented of a 26-year-old female who died as a result of cocaine intoxication. A blood cocaine concentration of 330 mg/l, about 1.5 times greater than the highest concentration previously reported, was found. Blood benzoylecgonine and ecgonine methyl ester concentrations were 50 and 18 mg/l, respectively. The unusually high blood concentrations of cocaine and the metabolites are suggestive of a massive administration, however, the history suggests a series of recreational uses. The manner of death was undetermined.     

Toxicological findings in a fatal overdose of verapamil

Presented is a case where the death was attributed to the deliberate ingestion of an overdose of verapamil (V). Blood, urine, and gastric concentrations of the drug were determined by gas chromatography with nitrogen phosphorus detection (GC-NPD). Identification of norverapamil (NV) was made. A presumptive identification of o-demethylnorverapamil (DNV) was also made.     

拉曼光谱技术在物证鉴定中的应用

拉曼光谱技术具有不接触样品、不破坏样品、无需样品制备等优点,适用于法庭科学领域不同种类物证的分析.本文综述了拉曼光谱技术在物证鉴定中的应用,并对该技术的发展趋势进行了展望.     

Neonatal death following clozapine self-poisoning in late pregnancy: an unusual case report

The report presents a fatal poisoning of a neonate occurring in the final stage of gestational life and evoked by his mother, who, while 9 months pregnant, took a toxic dose of clozapine aiming at committing suicide. She was also severely poisoned, but ultimately was saved. The woman had been taking the medication due to schizophrenia and depression prior to conception, and the discontinuation of the drug in the course of pregnancy increased the risk of the woman attempting suicide. In the course of comprehensive toxicological analysis based on the developed analytical procedure with the use of LC-APCI-MS, clozapine and its two metabolites, norclozapine and clozapine-N-oxide, were determined in postmortem blood, liver and kidney in concentrations explaining the death of the neonate. The interpretation of the above-described case is complex and--apart from toxicological aspects--also involves issues associated with psychiatry, pharmacotherapy in pregnancy and medicolegal problems.     

A simple gas chromatographic identification and determination of 11 CNS stimulants in biological samples. Application on a fatality involving phendimetrazine

A method is presented for the simultaneous identification and quantification of several CNS stimulants, including amphetamine in plasma and urine by GC/FID using mephentermine as an internal standard. No derivation is necessary and after a single alkaline extraction, GC analysis for the 11 compounds tested is achieved in 23 min. The lower limit of detectability was found to be 4 ng/ml for amphetamine in plasma. This method is sensitive, reproducible, selective and applicable in forensic and clinical toxicological analyses. Toxicological findings, after a fatality involving phendimetrazine are presented as an application of the procedure.     

Punched with a fist: the etiology of a fatal depressed cranial fracture

We report a case in which a 33-year-old man was discovered unconscious following a fistfight with another man. Emergency neurosurgical efforts to repair a depressed temporoparietal skull fracture and associated brain injuries were unsuccessful. The forensic anthropologist and pathologist worked in tandem to sort out a complex combination of cranial evidence, including healed antemortem trauma, perimortem blunt force trauma, remote and recent neurosurgical intervention, and the craniotomy cut performed at autopsy. The victim had suffered head injuries and a right temporoparietal craniotomy ten years prior to death. The perimortem cranial fractures were centrally located within a surgically repaired roundel of bone involving portions of the right temporal and parietal bones. Reportedly, the victim was punched on the right side of his head as he was lying on the ground with the left side of his head against an asphalt surface. A primary question in the case was whether a blow with a fist could have produced the observed cranial injuries. To adequately answer that question, known data on the minimum amount of force required to fracture the temporoparietal region were compared to data on the amount of force generated by a blow with a fist. A biomechanics expert demonstrated that a single blow with a fist to the rigidly supported head of the victim could generate the required force to produce the observed fractures. The previous medical condition possibly predisposed the victim to the cranial fractures and contributed to the depressed nature of the fractures. Although depressed cranial fractures do not typically result from a blow with a fist, it was determined in this case that the fracture pattern was consistent with a punch to the head.     

Gas chromatographic/mass spectrometric analysis of morphine and codeine in human urine of poppy seed eaters

In this study, poppy seeds were examined for a natural constituent that might serve as a maker for the seeds' ingestion as opposed to opiate abuse. Thebaine was selected as possible marker, since it was found to be a component of all poppy seeds examined and was not a natural component of different heroin samples. During the course of this investigation, a new extraction and cleanup procedure was developed for the gas chromatographic/nitrogen phosphorus detection (GC/NPD) and gas chromatographic/mass spectrometric (GC/MS) analysis of morphine and codeine in urine. A linear response, over a concentration range of 25 to 600 ng/mL, was obtained for codeine and morphine (r = 0.9982 and 0.9947, respectively). The minimum detectable level (LOD) and limit of quantitation (LOQ) for morphine were 10 and 30 ng/mL, respectively; whereas LOD and LOQ for codeine were 2 and 8 ng/mL, respectively. The coefficients of variance (CV, n = 6) for morphine and codeine analyses at the 100-ng/mL level were 13.3 and 4.6%, respectively. This procedure was used for the analysis of urine samples from five poppy seed eaters who each ingested 200 g of poppy seed cake. Results indicated that significant amounts of morphine and codeine are excreted in urine and that in all subjects, at least at one point in time, the apparent morphine concentration as determined by radioimmunoassay (RIA) analysis exceeded the cutoff value (300 ng/mL) established for screening. Thebaine was not detected in urine specimens collected following poppy seeds ingestion and thus could not be used as a marker.     

Tissue-specific differences in mRNA quantification of glucose transporter 1 and vascular endothelial growth factor with special regard to death investigations of fatal injuries

Glucose transporter 1 (GLUT1) and vascular endothelial growth factor (VEGF) have been established as being responsible for cellular adaptation to oxygen deficiency in tissue ischemia and hypoxia mediated by hypoxia-inducible factor 1. We hypothesized that mRNA quantification of these factors in autopsy tissue specimens could have diagnostic significance for investigating the pathology of death, especially after injury. Various cases (total, n=119; less than 48h postmortem) were examined, including fatal blunt injury (n=71) and sharp instrument injury (n=18), as well as asphyxia (strangulation/hanging, n=12) and acute myocardial infarction/ischemia (n=18) as controls. Quantification of mRNA by TaqMan real-time RT-PCR and immunostaining were performed for GLUT1 and VEGF in lung, kidney, and skeletal muscle specimens. The postmortem interval showed no significant influence on the relative quantification of mRNA during the early postmortem period. Characteristic results were found in blunt injury cases: both GLUT1 and VEGF mRNAs decreased in the lung but increased in the skeletal muscle depending on survival time. In the kidney, subacute deaths showed higher GLUT1 mRNA levels compared with acute deaths from blunt injury, but no significant change was found for VEGF mRNA. Immunohistochemistry showed visually predominant GLUT1 immunoreactivity in the renal cortex for cases with a longer survival time, coincident with the results at the mRNA level. Tissue-specific differences in mRNA quantification of GLUT1 and VEGF shed light on tissue ischemia/hypoxia and subsequent tissue-dependent pathophysiological changes leading to death after injury.