Chlorobutanol poisoning. Report of a fatal case.

A fatal chlorobutanol intoxication is reported and a gas chromatographic method for the determination of this drug in human fluids and tissues is described. Analytical findings for blood, urine, stomach contents, bile, liver, kidney, spleen, and brain are reported.     

中毒死亡案件的法医学分析

目的分析中毒性死亡案件和与中毒死亡有关的医疗纠纷案件的法医学特点,探讨此类案件的防护重点和鉴定要点。方法对四川大学法医学院1985～2004年106例中毒死亡尸体剖验病理材料进行回顾性统计分析。结果性别:男性61例,女性45例,男女比例1.36:1;年龄:以21～40岁年龄组(60.38%)为主;死亡方式:意外死亡最多见(52.83%),其次为自杀(33.02%)和他杀(14.15%);死亡原因:CO中毒、有机磷类中毒、毒鼠强及药物中毒多见(72.64%);医疗纠纷:发生医疗不当12例(11.32%),7例为医源性中毒性医疗纠纷,5例为中毒后在医院抢救中发生的医疗纠纷,主要发生于乡镇医院和县级医院(83.33%)。结论加强毒物的管理、提高安全意识、加强法制教育、增加生产安全等是减少中毒性死亡的重要手段。提高城乡医疗水平,加强中毒急诊抢救临床技能是防止中毒性医疗纠纷的关键。     

Fatal tolperisone poisoning: autopsy and toxicology findings in three suicide cases

Tolperisone (Mydocalm) is a centrally acting muscle relaxant with few sedative side effects that is used for the treatment of chronic pain conditions. We describe three cases of suicidal tolperisone poisoning in three healthy young subjects in the years 2006, 2008 and 2009. In all cases, macroscopic and microscopic autopsy findings did not reveal the cause of death. Systematic toxicological analysis (STA) including immunological tests, screening for volatile substances and blood, urine and gastric content screening by GC-MS and HPLC-DAD demonstrated the presence of tolperisone in all cases. In addition to tolperisone, only the analgesics paracetamol (acetaminophen), ibuprofen and naproxen could be detected. The blood ethanol concentrations were all lower than 0.10 g/kg. Tolperisone was extracted by liquid-liquid extraction using n-chlorobutane as the extraction solvent. The quantification was performed by GC-NPD analysis of blood, urine and gastric content. Tolperisone concentrations of 7.0 mg/l, 14 mg/l and 19 mg/l were found in the blood of the deceased. In the absence of other autopsy findings, the deaths in these three cases were finally explained as a result of lethal tolperisone ingestion. To the best of our knowledge, these three cases are the first reported cases of suicidal tolperisone poisonings.     

Intravenous amphetamine abuse, primary cerebral mucormycosis, and acquired immunodeficiency

Two intravenous amphetamine abusers had fatal, rapidly progressive cerebral mucormycosis with abscess formation in the presence of absolute lymphopenia. Postmortem examination confirmed the primary nature of the fungal cerebritis, documented by postmortem culture and histology. The clinical and pathologic features of these cases are compared to previously reported occurrences of primary fungal cerebritis (and abscess) among intravenous drug abusers, including cocaine users. Primary fungal cerebritis associated with intravenous abuse of stimulant drugs is discussed as a possible variant of the acquired immunodeficiency syndrome.     

Chemical poisoning in three Telengana districts of Andhra Pradesh.

Medical records of (i) toxico-medico-legal death cases from three districts of Telengana region in the state of Andhra Pradesh, viz. Hyderabad, Ranga Reddy and Medak, and (ii) clinical toxicology cases in suspected poisoning from hospitals in and around Hyderabad city were examined for a period of 5 calendar years. The age group at risk in both the types of cases is 15-24. The cause of suicides includes physical illness, family/spouse problems and financial problems. Labourers form a dominant risk group in rural and semi-urban industrial area, whereas in urban area the employees were the dominant risk group. The agricultural pesticides and household insecticides were the predominant poisons used for suicide purposes.     

19例毒鼠强中毒报告

毒鼠强(tetramine)又名"四二四"、"没鼠命"、"鼠没命"、"王中王"等,化学名"四次甲基二砜四胺"(C2H4O2-N2S)2.1949年由原西德拜耳公司首先合成,是一种粉末状结晶体,无味,剧毒,不或微溶于水,对酸、碱和乙醇稳定,对鼠类的接受性好,常用作杀鼠剂,由于管理上的混乱,常被不法分子利用来投毒,往往产生严重的后果.1997年6月以来,我局受理数起投毒案例,每次1～3人中毒,共计19例.     

Acute fatal poisoning cases due to furathiocarb ingestion.

Seven cases involving acute fatalities due to ingestion of furathiocarb, a carbamate insecticide, are presented. Furathiocarb was detected in the gastric contents using thin layer chromatography (TLC) and gas chromatography/mass spectrophotometry (GC/MS), and quantified in the blood using a gas chromatograph equipped with a nitrogen-phosphorus detector (NPD). The fatal levels of furathiocarb in the blood ranged from 0.1 to 21.6 micrograms/ml.     

Postmortem tissue embolisms. Report of 3 cases

In three cases of autopsy (cause of death - intoxication and drowning) we found in the lung intraalveolar und intravasal lymphatic tissue and bone-marrow. The results cannot be explained with violence during lifetime, but in tow cases as an effect of fracture of rips caused by external cardiacmassage, in one case by embalming with injection of conservation fluids.     

Ultralight aircraft fatalities. Report of five cases

A study of ultralight aircraft fatalities was performed based on the cases files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida. A total of five cases were collected during the years 1981-1985. These are presented in some detail. A discussion ensues concerning the safety of ultralight aircraft and whether people should be allowed to fly them.     

中毒死亡案件的法医学分析

目的 分析中毒性死亡案件和与中毒死亡有关的医疗纠纷案件的法医学特点，探讨此类案件的防护重点和鉴定要点。方法 对四川大学法医学院1985～2004年106例中毒死亡尸体剖验病理材料进行回顾性统计分析。结果 性别：男性61例，女性45例。男女比例1．36：1；年龄：以21—40岁年龄组（60．38％）为主；死亡方式：意外死亡最多见（52．83％），其次为自杀（33．02％）和他杀（14．15％）；死亡原因：CO中毒、有机磷类中毒、毒鼠强及药物中毒多见（72．64％）；医疗纠纷：发生医疗不当12例（11．32％），7例为医源性中毒性医疗纠纷。5例为中毒后在医院抢救中发生的医疗纠纷，主要发生于乡镇医院和县级医院（83．33％）。结论 加强毒物的管理、提高安全意识、加强法制教育、增加生产安全等是减少中毒性死亡的重要手段。提高城乡医疗水平．加强中毒急诊抢救临床技能是防止中毒性医疗纠纷的关键。     

First practical applications of eye temperature measurements for estimation of the time of death in casework. Report of three cases

This paper presents first three successive cases of death where at scene measurements of the internal eyeball temperature soon after death allowed to precisely estimate the times of deaths based on this data (33.1°C, 32.2°C and 29.5°C, respectively), which were later confirmed during the police investigation. Simultaneously the rectal temperatures in all three cases were measured and appeared to be between 36.3 and 36.8°C-reflecting a living individual's body temperature. Thanks to a significantly faster postmortem decrease of the eye temperature and a residual or nonexistent plateau effect affecting the eye, using the formula developed in previous comprehensive studies in pigs, the time of death in real cases could be estimated with good precision: 1 h 33 min, 2 h 24 min and 3 h 17 min since death respectively. The actual TOD established during investigation appeared to be: between 1 h 30 min and 1 h 50 min in case 1; 1 h 55 min in case 2 and between 2 h 55 min and 3 h 05 min in case 3. Such precise estimation, mainly due to the plateau effect lasting up to a few hours, could not have been done based only on rectal temperature, commonly measured in forensic practice.     

Postmortem wound dehiscence. A report of three cases

Three cases of healing incised wounds that dehisced following death are reported. All three deaths were apparent drownings during summer months. The incised wounds had occurred from 1 week to 6 months prior to death. The length of post-mortem immersion ranged from 2 days to 3 weeks, and all three decedents exhibited significant decompositional changes. Proper recognition of this postmortem artifact eliminates undue suspicions and contributes to proper identification.     

CI-mass fragmentographic analysis of methamphetamine and amphetamine in human autopsy tissues after acute methamphetamine poisoning

A 22-year-old male methamphetamine abuser was put under police protection owing to his abnormal state of excitation, but died 1 h later. Distribution of methamphetamine and amphetamine in the body was analyzed by the chemical ionization mass fragmentographic method. Amphetamine/methamphetamine concentrations (μmol/100 g) were $\text{0.24}\text{5.59}$ in blood, $\text{0.41}\text{9.43}$ in liver, $\text{0.41}\text{10.02}$ in brain, $\text{0.37}\text{9.80}$ in kidney, $\text{0.18}\text{4.57}$ in muscle, $\text{0.02}\text{0.63}$ in subcutaneous fat and $\text{1.87}\text{1464}$ in gastric contents. Total amount of methamphetamine hydrochloride in stomach contents was about 54 mg. Amphetamine concentrations in tissues ranged from 3.2% to 4.3% of methamphetamine, and was 0.1% in stomach contents. Amphetamine in tissues seems to be a metabolite of methamphetamine, and amphetamine in gastric contents is presumed to result from gastric mucous excretion. The blood concentration of methamphetamine was at a fatal level, and the total amount of the drug in gastric contents indicates that fatal poisoning occurred by ingestion.     

36例一氧化碳中毒分析

本文对36例59人因管道煤气引起一氧化碳中毒案例进行了分析. 资料分析 资料来源:本文收集1993年10月至1997年12月经东风汽车公司公安处检验鉴定的东风汽车公司范围内管道煤气用户中毒案共36例59人,其中死亡58人,仅1人经抢救存活.     

36例一氧化碳中毒分析

本文对36例59人因管道煤气引起一氧化碳中毒案例进行了分析。资料分析资料来源:本文收集1993年10月至1997年12月经东风汽车公司公安处检验鉴定的东风汽车公司范围内管道煤气用户中毒案共36例59人,其中死亡58人,仅1人经抢救存活。资料统计:季节分布:春季12例26人;夏季8例12人;秋季6例7人;冬季10例14人。一次中毒涉及人数:1人:19例;2人:11例;3人:3例;4人:1例;5人:1例。其中有3例中毒中有2人有逃生行为,1人经抢救存活。发现情况:36例均由邻居、家人、同事嗅到煤气味或尸臭味或因没去上班而发现。死后24ｈ内发现27例40人,24～48ｈ6例11人,48ｈ以…     

毒鼠强中毒法医临床学检案16例分析

本文通过对16例TETS中毒者1周内，半年、1年的临床表现和有关酶学检查结果进行分析，探讨TETS中毒的对人体的中远期影响及其损伤程度和伤残等级评定。     

毒鼠强中毒法医临床学检案16例分析

本文通过对16例TETS中毒者1周内,半年、1年的临床表现和有关酶学检查结果进行分析,探讨TETS中毒的对人体的中远期影响及其损伤程度和伤残等级评定。     

Is sternal bone marrow needle biopsy still a hazardous technique? Report of three further fatal cases

Three fatal cases of death following sternal bone marrow needle biopsy have come to the authors' attention in the past 10 years. The hazards of the technique may be related to the incongruous stylet guard-adjustment for the thickness and hardness of the sternal wall. All three cases involved suits for professional malpractice. Controversial aspects of these cases involving physician liability are discussed.     

Alpha-phenylethylamine in illegally produced amphetamine.

The possibility of simultaneous synthesis of alpha-phenylethylamine and amphetamine from mixture of acetophenone and benzylmethylketone was studied. The structures of specific impurities were predicted and these compounds were synthesized and finally found in reaction mixtures, as well as in the final product. The data collected by gas chromatography, proton and carbon magnetic resonance, Fourier transform infrared spectrometry and mass spectrometry are presented.