A gas chromatographic method for determining acetaldehyde in cadaver blood

Gas-chromatographic method of acetaldehyde detection in blood of subjects who died of alcoholic intoxication is suggested. Method is simple, does not require additional expenses, can be readily used in medicolegal practice and in difficult cases it may help the expert to make an objective conclusion on the cause of death.     

Microbiological investigation of blood, urine, cerebrospinal fluid, and soft tissue material from corpses with purulent and inflammatory foci

A microbiological investigation conducted by the author allowed her to formulate differential-diagnostic signs of the time of death in persons who die of pyoinflammatory complications of polytrauma: up to 24 hours ago or more than 24 hours. Differences in the count of the pathogens depending on the time of death are demonstrated.     

血液、脑脊液中尼可刹米的HPLC法分析

目的建立血液、脑脊液中尼可刹米的HPLC检测方法。方法取空白血液或脑脊液添加不同量的尼可刹米对照液,碱化后用二氯甲烷等有机溶剂提取,用HPLC方法检测。对方法的萃取回收率、线性、精密度等进行考察。结果方法选用二氯甲烷作为萃取溶剂,萃取回收率大于60%。血液中尼可刹米的在0.5~100μg/ml范围内线性良好,R2为0.9993;脑脊液中尼可刹米的线性范围为0.1~100μg/ml,R2为0.9996,最低检出限是5ng(S/N≥3)。检测血液和脑脊液中的尼可刹米方法的精密度均小于6%。结论所建方法准确、简便、灵敏度高,适用于法医毒物分析和临床药物分析。     

Comparative measurement of cocaine and its metabolites in blood, cerebrospinal fluid and the brain

This study investigated the transfer of cocaine and its metabolites from plasma into the cerebrospinal fluid. The concentration of cocaine and its metabolites in plasma and cerebrospinal fluid was determined by radioimmunoassay because this method only, the sum of the drug and metabolites restored. In sheeps a sublethal cocaine hydrochloride dose (2,4 mg/kg b. wt.) was administered intraarterial daily for up to 8 days. In the first hours after administration the concentration of cocaine in cerebrospinal fluid was low. It is supposed that a barrier against the transport of cocaine from blood into cerebrospinal fluid exists. After intrathecal administration a delay of transport could from CSF to blood not be seen.     

Forensic-medical diagnostic implication of morphine levels in the blood and urine

Toxicological characteristics are presented for 198 cases of acute parenteral poisoning with morphine and heroin. The range of their metabolites concentration in the blood and urine encountered in practice are analysed. Principal causes of death due to opiate poisoning in inpatients are shown. Opiates toxicity was assessed by the method of logit-regression and dose-effect curves for analysis of probability of death depending on opiate metabolite concentration in blood and urine. Relations between probability of death and detection of morphine in biological media of the victims are considered. Morphine concentrations in the blood and urine undoubtedly indicating morphine poisoning are determined.     

Forensic significance of postmortem estimation of the blood cerebrospinal fluid barrier permeability

Albumin concentration in cerebrospinal fluid (CSF) and plasma was determined in 44 cadavers divided into three groups on the basis of death agony duration. The same was determined in a control group of 42 patients with no demonstrable neurological disease. Following Schuller's method, the evaluation of the blood CSF barrier permeability was based upon the rate of albumin transfer from plasma to CSF. An average increase of 9% in blood CSF barrier permeability was found in cases of a long-duration death agony but not in cases of short-duration death agony (sudden deaths) or in the control group. We consider these results to be related to the hypoxia and hypercapnia which characterize the agonic suffering period. Therefore, we conclude that the postmortem determination of the rate of albumin transfer from plasma to CSF could be a reliable indicator of the duration of the agonic process.     

The diagnostic value of postmortem blood glucose determinations in cases of diabetes mellitus

In 24 cases of death in diabetic coma the peripheral venous blood showed glucose levels exceeding 3.5 mg/ml (mean value 7.76 mg/ml). In a control material of deaths of other causes the blood glucose was usually low and often zero, and all values were well below the lower limit of the diabetic concentrations. The acetone contents of the diabetic blood varied widely and were of limited diagnostic value. We conclude that glucose concentrations above 3.5 mg/ml in the peripheral blood indicate that death occurred in diabetic coma.     

The determination of pyrazidol in blood and urine

Methods of pyrazidole isolation from blood and urine as well as of its identification and quantification are developed. These methods allow one to isolate 53-55% of pyrazidole from blood and 90-95%, from urine.     

Detection of drugs of abuse in simultaneously collected oral fluid, urine and blood from Norwegian drug drivers

Blood and urine samples are collected when the Norwegian police apprehend a person suspected of driving under the influence of drugs other than alcohol. Impairment is judged from the findings in blood. In our routine samples, urine is analysed if morphine is detected in blood to differentiate between ingestion of heroin, morphine or codeine and also in cases where the amount of blood is too low to perform both screening and quantification analysis. In several cases, the collection of urine might be time consuming and challenging. The aim of this study was to investigate if drugs detected in blood were found in oral fluid and if interpretation of opiate findings in oral fluid is as conclusive as in urine. Blood, urine and oral fluid samples were collected from 100 drivers suspected of drugged driving. Oral fluid and blood were screened using LC-MS/MS methods and urine by immunological methods. Positive findings in blood and urine were confirmed with chromatographic methods. The analytical method for oral fluid included 25 of the most commonly abused drugs in Norway and some metabolites. The analysis showed a good correlation between the findings in urine and oral fluid for amphetamines, cocaine/benzoylecgonine, methadone, opiates, zopiclone and benzodiazepines including the 7-amino-benzodiazepines. Cocaine and the heroin marker 6-monoacetylmorphine (6-MAM) were more frequently detected in oral fluid than in urine. Drug concentrations above the cut-off values were found in both samples of oral fluid and urine in 15 of 22 cases positive for morphine, in 18 of 20 cases positive for codeine and in 19 of 26 cases positive for 6-MAM. The use of cannabis was confirmed by detecting THC in oral fluid and THC-COOH in urine. In 34 of 46 cases the use of cannabis was confirmed both in oral fluid and urine. The use of cannabis was confirmed by a positive finding in only urine in 11 cases and in only oral fluid in one case. All the drug groups detected in blood were also found in oral fluid. Since all relevant drugs detected in blood were possible to find in oral fluid and the interpretation of the opiate findings in oral fluid was more conclusive than in urine, oral fluid might replace urine in driving under the influence cases. The fast and easy sampling is time saving and less intrusive for the drivers.     

The determination of ethylene glycol in blood and urine

Method of ethylene glycol isolation from blood and urine with subsequent gas-chromatographic determination was developed. The method makes it possible to extract 60-80% of ethylene glycol and to detect its toxic concentration in the cadaveric blood and urine.     

The presence of trace amines in postmortem cerebrospinal fluid in humans

The postmortem levels of biogenic amines in cerebrospinal fluid may represent a useful tool in defining some pathological conditions; no information is available concerning the occurrence of trace amines in postmortem cerebrospinal fluid. Thus, the occurrence of octopamine, synephrine and tyramine were evaluated by using a HPLC system in 20 postmortem samples of cerebrospinal fluid (obtained from 11 males and 9 females) and their levels were compared with those of 20 living subjects (obtained from 11 males and 9 females). The results show that trace amines dramatically increase in the postmortem cerebrospinal fluid (100, 20, and 4 fold increase for tyramine, octopamine, and synephrine respectively). To our knowledge, our data represent the first time trace amines have been identified in postmortem cerebrospinal fluid and the dramatic increase observed for tyramine has the potential of becoming a new tool in forensic science for better defining the time of death.     

The value of the Emit-dau system in the examination of cadaveric urine

Randomly taken postmortem urine samples (170) were analyzed by the Emit-dau system for their barbiturate and benzodiazepine content. Of the samples, 23% and 25% were found positive for barbiturate and benzodiazepine, respectively. The percentages of the positive samples were reduced by a heating process to 9% and 11%, respectively. TLC and Emit-st were used for reference procedures. The relative high percentage (above 30%) of the urine samples analyzed exhibited elevated lysozyme activity and protein value. It was found that the disturbing proteins in the Emit-dau system contained not only endogene lysozyme but other thermolabile fractions with higher molecular weight.     

血液和尿液样品中海洛因代谢物稳定性研究

目的对尿液和血液中海洛因代谢物3-β-D-葡萄糖醛酸吗啡（M3G）,吗啡,O6-单乙酰吗啡（O6）在180d内的稳定性进行研究。方法准备空白添加血液、尿液、染毒动物（大白兔）血液、尿液和吸食海洛因者血液、尿液样本,分别置于20℃、4℃、-20℃下,分别于0、1、2、4、7、14、28、56、112、156、180d时间点测定样品中M3G、吗啡,O6相对含量。结果在3种不同温度下,随保存时间的延长,血液、尿液中的O6含量均逐渐下降至零;血液中吗啡含量升高（空白血液添加组）或下降（染毒动物组）,在尿液则均升高;血液样中M3G含量均升高,尿样中则略有下降。下降和升高的幅度均随保存温度的下降而缩小。结论海洛因代谢物在-20℃时保存稳定性最佳。     

Brain acetaldehyde and ethanol: method of determination and diagnostic significance in ethanol poisoning

The content of ethanol and acetaldehyde in the limbic cortex and reticular formation of the brain was measured by gas-liquid chromatography in lethal ethanol poisoning. The content of acetaldehyde was significantly increased in the gyrus cinguli of the brain. Lethal poisonings occurred during any stage of ethanol intoxication. The data characterizing individual ethanol tolerance were obtained, which can be used for differential diagnosis of ethanol poisoning in practical forensic medicine.     

Serotonin, 5-hydroxyindolylacetic acid and cholesterol content in blood, cerebrospinal fluid and brain areas for differentiation of suicidal from non-suicidal cause of death

In the present study serotonin and its metabolite 5-hydroxyindoleacetic acid was investigated in the cerebrospinal fluid and in discrete brain areas of the left and right hemisphere collected from 34 bodies. Sixteen subjects were suicide victims, and 18 were matched as controls. Matching was done for gender, age, sex and cause of death. In suicide victims the concentration of 5-hydroxyindoleacetic acid in cerebrospinal fluid (occipital) was significantly decreased whereas there was no difference comparing the particular results established from the various brain areas. Nevertheless, there was a non-significant trend towards a higher concentration of serotonin in the thalamic area and towards a lower level in samples collected from the mesencephalon in suicide brains. In suicide subjects, the level of 5-hydroxyindoleacetic acid was often found to be increased in the hippocampus and to be decreased in the thalamus. A differentiation between suicide and homicide seems promising only on condition that the distribution of serotonin and metabolite concentrations in various brain areas is considered. The amount of total cholesterol in blood is suggested to be of limited value.     

腰椎间盘突出症体感诱发电位诊断及法医学意义

目的探讨体感诱发电位(SEP)对腰椎间盘突出症(LDH)的诊断价值。方法对60例LDH患者和30例正常人行皮节体感诱发电位(DSEP)和胫后神经体感诱发电位(PTNSEP)检查。结果DSEP的异常率为93.3%,显著高于PTNSEP检测的异常率(43.3%)(P<0.001)。L3-4椎间盘以L4DSEP异常为主,L4-5椎间盘突出以L5DSEP异常为主,L5S1椎间盘突出以S1DSEP异常为主。结论DSEP与腰骶神经根损伤有良好的相关性,弥补了影像学检查的不足,既可判定单根神经根的功能状态,又可辅助定位诊断,是一种敏感的辅助诊断LDH的电生理方法。     

Study of the diagnostic value of strontium,chloride, haemoglobin and diatoms in immersion cases

Tests of haemoglobin (Hb), strontium (Sr) and chloride(Cl), as well as diatoms, toxicological and pathological studies were performed in biological samples from 133 immersion fatalities occurred since 1991 to 1996 in central and northern Spain. Hb, Sr, and Cl where analyzed in blood samples where increasing decomposition could be demonstrated in most of the cases. The samples were frequently accompanied with well documented forensic reports, including autopsies findings and other circumstances of the death. The goal of our study is to evaluate the difference of blood Sr concentration between the left and right side of the heart (LVSr–RVSr) as a marker of drowning. For this purpose, the cases investigated were classified in `typical drowning' (TD) cases and `atypical drowning' (AD) cases. This last group was used as a control. The comparison of the LVSr–RVSr between TD and AD cases was highly significant (P=0.0002) in blood specimens extracted from cases occurred in putative drowning media where Sr concentration was higher than 800 μg/l. No significant differences were found comparing neither Cl nor Hb biventricular concentrations between TD and AD cases in blood samples extracted from bodies found in both fresh and seawater.