The role of trauma in postmortem blood alcohol determination

In postmortem cases, a blood sample is frequently obtained by transthoracic (TT) puncture. The purpose of this study was to determine if, in traumatic death, blood samples collected by TT provided a valid sample for blood alcohol analysis. A retrospective study (1980–1986) was conducted to evaluate possible contamination of blood by GI alcohol in traumatic death cases. Out of 6000 cases reviewed, 19 cses with BACs >500 mg/dl were found and 8 of these cases involved traumatic death with GI laceration and/or transection. The results of this study support the hypothesis that blood samples from the 8 cases had been contaminated, resulting in a falsely elevated BAC. A transthoracic study (1987–1989) was conducted under controlled conditions, where blood alcohol content of TT blood samples was compared with samples collected from the intact heart chamber. Seven out of 28 cases of traumatic injury revealed trauma to the GI tract. The results showed that when GI traumatic injury occurs and unabsorbed ethanol is present in the stomach, contamination of TT blood samples occurs and artificially elevated BACs are obtained. It is recommended that, in cases of traumatic injury, heart blood samples from the intact heart chamber, as well as samples of additional biological fluids, be collected to rule out the possibility of contamination and to ensure that the BAC used for forensic interpretation is accurate.     

Diagnostic role of organ-specific isoforms of lactate dehydrogenase in blood plasma

Changes in plasm isoenzymic spectrum of lactate dehydrogenase (LDG), a glycolytic enzyme, were studied in death of cardiovascular diseases, ethanol poisoning and a mechanical injury. The tests used electrophoresis in 1% solution of agarose. Isoenzymic composition differed between the groups with acute coronary failure, chronic coronary heart disease, alcohol cardiomyopathy and a mechanical injury. Ethanol poisoning caused two types of characteristic shifts in LDG isoenzymic spectrum. Nomograms were designed for practical application in forensic medical expertise of sudden death.     

腐败血液中自生醇现象及法医学应用研究

目的 检测分析腐败血液中乙醇、甲醇等物质的生成过程,为正确判断案发时人血液中醇类物质的实际浓度提供实验依据.方法 以正常健康人血液制作腐败样本,分别模拟人死亡后正常人血液和糖尿病人高糖血液的腐败过程,借助顶空气相色谱仪测定两种血液腐败后醇/醛类物质的生成情况并对比含量差异.结果 相同实验条件下,高糖血液较正常健康血液更...     

人体内血醇浓度变化及其影响因素分析

目的探索饮酒后人体内血醇浓度(BAC)变化及其影响因素,建立BAC代谢的数学模型。方法采用顶空气相色谱氢火焰离子化检测器和内标曲线法测量酒后人体内的BAC,利用SPSS20.0和R软件对数据进行相关性分析并建立数学模型。结果女性的平均BAC消除速率为9.54mg/100m L/h,男性的平均BAC消除速率为12.19mg/100m L/h,女性消除速率小于男性,并且BAC消除速率与性别中等相关,与体重强相关,与年龄无关。通过构建混合效应模型可以准确的预测BAC,该模型的平均绝对误差(MAE)为1.60mg/100m L,其次利用决策树分析数据,其MAE为9.99mg/100m L。结论饮酒后人体内BAC消除速率与性别、体重有关,通过时间、饮酒量、性别、体重建立混合效应模型可以准确推断BAC。     

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.     

气相色谱法测定人血中乙醇的不确定度评估

本文建立了气相色谱法测定人血中乙醇含量的不确定度评定方法,考虑不确定度的来源主要包括仪器的精密度、标准物质标称值的不确定度、样品及标准物质体积的不确定度等。假定传播系数为1,对各分量进行计算与合成。经实验验证,理论推导的结果与实验结果基本吻合。     

The human ear: its role in forensic practice

The human ear has much to offer investigators in relation to many areas of forensic practice including forensic pathology, anthropology, identification and facial reconstruction and yet its full potential is often overlooked. This review paper explores current knowledge related to the human ear drawing attention to those situations where the ear could play a valuable role in a forensic investigation.     

The relationship between alcohol elimination rate and increasing blood alcohol concentration--calculated from two consecutive blood specimens

In the period 1991-2005, a blood-alcohol concentration (BAC) analysis was carried out at the Institute of forensic medicine in Novi Sad including 2023 two consecutive blood specimens using the Headspace Gas Chromatography method. Cases with no alcohol concentration values, as well as cases where blood samples were taken within 1 h after the criminal act, were not taken into consideration. Following this rule, 1198 cases were considered in this study and all samples were grouped in 29 ranges of BAC1 of delta(BAC) = 0.1 g/kg, starting from 0.1-0.19 g/kg to 2.9-2.99 g/kg of absolute alcohol. Gathered results and elimination curve differ from the zero-order model of elimination proposed by Widmark and point to an elimination process similar to a well-known Michaelis-Menten elimination kinetics model and its variants. Results reported in this study show dependence of alcohol elimination rate (beta-slope) and BAC value. The analysis of beta60-slope versus BAC shows that a correlation between beta60 (y) and BAC (x) has a logarithmic trend line. The value of alcohol elimination rate shows a slight increment with increase of BAC alcohol, with the mean value of beta60 = 0.221 +/- 0.075 g/kg. Differences in values of beta60 among consecutive intervals of delta(BAC) = 0.1 g/kg are not significant (p>0.05). When obtained samples were grouped into ranges of 0.5 g/kg each in these intervals beta60 had the following values by range: 0.1-0.49 g/kg = 0.139 g/kg +/- 0.035; 0.5-0.99 g/kg = 0.184 g/kg +/- 0.043; 1-1.49 g/kg = 0.213 g/kg +/- 0.052; 1.5-1.99 g/kg = 0.239 g/kg +/- 0.058; 2-2.49 g/kg = 0.265 g/kg +/- 0.073; 2.5-2.99 g/kg = 0.306 g/kg +/- 0.096. Differences in values of beta slope among consecutive intervals of delta(BAC) = 0.5 g/kg are significant (p<0.01). The elimination curve in the BAC interval 0.5-2.5 g/kg has a linear trend, while beta-slope (y)/BAC (x) correlation is given as beta60 = 0.15 g/kg + (0.05 g/kg x BAC). Retrograde calculation of the blood alcohol concentration in tempore criminis (BAC(tc)) based on the determined alcohol concentration in the blood specimen (BAC(t)) shows a statistically significant difference between BAC(tc) calculated using a standard zero-order model versus corrected methodology. The higher the BAC(t) and the longer the calculation time, the greater and statistically more significant (p<0.01) is the difference between the calculated values of BAC(tc).     

人类CCK-45C/T遗传多态性及与抑郁症的相关性

目的 调查胆囊收缩素-45C/T(CCK-45C/T)的遗传多态性,探讨其与抑郁症的遗传相关性.方法 采集111例中国健康汉族人和130例抑郁症患者全血样本,利用TaqMan荧光标记探针杂交技术,使用Prism@7900HT型荧光定量PCR仪,对CCK-45 C/T进行基因频率调查,并比较分析健康人群和抑郁症患病人群CCK-45C/T等位基因的分布差异.结果 CCK-45C/T等位基因T的频率在健康群体中为0.369 4,在抑郁症患者群体中为0.496 2,组间比较存在显著性差异(P＜0.05).结论 CCK-45C/T等位基因T的分布在健康和抑郁症患者中差异显著,该基因可能与抑郁症易感相关.     

氯氮平及其代谢物在人血液中的药代动力学研究

目的研究氯氮平及其代谢物在人血液中的药代动力学和检出时限,为氯氮平中毒的法医学鉴定提供实验依据。方法 29名太原汉族人口服12.5mg氯氮平后不同时间采集肘静脉血,固相萃取法提取,超高效液相色谱-串联质谱仪分析,MRM(多反应离子检测)记录方式,保留时间和定性离子对定性,内标法和标准曲线法定量检测其中氯氮平、去甲氯氮平、氮氧氯氮平含量,3p97药代动力学软件拟合C-T数据,计算药代动力学参数。结果口服12.5mg氯氮平后,氯氮平、去甲氯氮平、氮氧氯氮平在血中动力学过程均符合一级吸收二室开放模型,达峰时间分别为2.96±1.32h、8.65±3.00h、9.31±26.38h,达峰浓度分别为34.68±9.32ng/mL、11.16±4.15ng/mL、9.62±13.88ng/mL,半衰期分别为17.02±23.63h、27.06±12.58h、41.27±29.75h,血中检出时限分别为81.72±26.19h、93.21±29.40、19.93±14.62h。结论口服氯氮平后氯氮平及其代谢物去甲氯氮平、氮氧氯氮平的药物动力学符合一级吸收二室开放模型,模型和参数可以为氯氮平的法医学鉴定提供实验依据。     

血液样品中乙醇稳定性的实验研究

目的考察在不同存放条件下含乙醇的血液样品中乙醇浓度的变化情况。方法采用顶空-气相色谱法,以异丙醇为内标,对存放条件不同的血液样品中乙醇进行检测。结果冷冻(-10℃)条件存放1至30天,血液样品中乙醇含量无显著变化;冷藏(4℃)条件存放1至30天,血液样品中乙醇含量变化不显著;室温(28℃~33℃)条件存放1至30天,血液样品中乙醇含量显著改变。结论含有乙醇的血液样品,在冷冻、冷藏条件下可较稳定的存放30天;在室温条件下存放30天血液样品中乙醇浓度发生显著变化,不可在此条件下存放。     

Abnormally high alcohol concentration in the heart blood

A 46-year-old male alcoholic whose whereabouts had been unknown for about a month was found dead at the foot of a cliff 31 m deep. Fractures of the mandible, thorax and left patella were found at autopsy, but fatal injury to the brain or other organs was not observed. The alcohol distribution was 7.44 mg/g in the heart blood, 13.91 mg/g in the left thoracic cavity fluid and 1.88 mg/g in the urine. The high ethanol concentration in the heart blood was assumed to be mainly due to the diffusion of ethanol from the contents of the stomach and postmortem production of ethanol. It was decided that the cause of death was not acute alcohol intoxication but respiratory failure caused by fractures of the thorax.     

Diagnostic implication of blood and urine morphine content in alcohol intoxication

A total of 198 cases of acute parenteral poisoning with opiates are characterized. The range of concentrations of opiates metabolites in the blood and urine, main causes of death due to opiate poisoning in alcohol intoxication are analysed. Opiates toxicity was assessed with the logit-regression method and dose-effect curves valid for analysis of relationships between probability of death and opiate metabolites concentration in blood and urine. Correlation between probability of death and detection of morphine and ethanol in biological media of the victims is considered. Concentrations of morphine in blood and urine definitely indicating opiates poisoning in alcohol intoxication as a cause of death are determined.     

Determination of the effects of alcohol dehydrogenase (ADH) 1B and ADH1C polymorphisms on alcohol dependence in Turkey

Alcoholism is a complex genetically influenced disorder which refers to alcohol abuse and alcohol dependence. There are controversial results on the role of gene polymorphisms in alcohol dependence in the literature. Differences in population groups and selective inclusion criteria for alcohol dependence may affect results. In this study, we investigated the role of ADH1B Arg48His (rs1229984) and, ADH1C Ile350Val (rs698) gene polymorphisms in Turkish population. 100 healthy volunteers and 75 patients who were admitted to Ege University Alcohol Dependence Unit enrolled in the study. We found significant increase both in ADH1B (Arg48His) polymorphism Arg allele and Arg/Arg genotype frequency in patients. No profound connection between alcohol dependence and ADH1C Ile350Val gene polymorphism was detected. Alcohol dependence is an important health problem that depends on many genetic and environmental factors but we think that it is possible to interpret genetic risk for developing early diagnostic methods and treatment strategies by comprehensive linkage and association studies.     

A study concerning the blood/breath alcohol conversion factor Q: concentration dependency and its applicability in daily routine

The conversion factor Q, obtained by division of blood alcohol concentration (BAC) by breath alcohol concentration (BrAC) is a widely discussed topic due to its great variance. By Austrian law, regulations frequently require an estimation of a corresponding BAC by a measured BrAC. It is known that Q depends among other things, on the alcohol kinetic state of the person being tested, which mathematically can be transformed to a dependency on the BrAC. Theoretically calculated Q values per BrAC level form a hyperbola shaped curve, thus decreasing with increasing BrAC values. Applying Austrian forensic standards for BAC and BrAC measurements, these calculations were verified in a study under practical conditions with BAC and BrAC data of 390 individuals. Q decreases from 2629 (+/- 455) for BrAC levels < 0.1 mg/l to 2229 (+/- 160) for a BrAC range of 0.4-0.5 mg/l and increases again to 2428 (+/- 124) for BrAC levels > 0.6 mg/l. Since these results were obtained under realistic practical conditions they can be directly applied in routine forensic expert opinion and can eliminate avoidable variances in the calculation of Q.