Interactions between 3,4-methylenedioxymethamphetamine, methamphetamine, ketamine, and caffeine in human intestinal Caco-2 cells and in oral administration to rats

Amphetamine-type stimulants (ATSs) are often abused orally in the form of tablets for recreational purposes. The ATS tablets contain one or more active ingredients such as 3,4-methylenedioxymethamphetamine (MDMA), methamphetamine (MA), ketamine (KA), and caffeine (CF). The aim of this work is to determine whether such components in tablets interact with each other in intestinal absorption. The interactions between MDMA, MA, KA, and CF in the uptake and permeation by human intestinal epithelial Caco-2 cell line were investigated in monolayer cultures. MDMA, MA, and KA mutually inhibited the uptakes by Caco-2 cells. The inhibition of MA uptake by KA was the greatest of all combinations (72.6% inhibition). Similarly, MDMA, MA, and KA mutually inhibited the permeation from the apical to the basolateral side through Caco-2 cells. Although CF did not affect the uptakes of MDMA, MA, and KA, CF enhanced the permeation of MDMA in comparison to MDMA alone. In addition, the interaction of MA with KA and that of MDMA with CF in intestinal absorption were investigated by oral administration to rats. The area under the plasma concentration–time curve of MA significantly decreased by co-administration with KA in comparison to MA alone, while that of MDMA significantly increased by co-administration with CF in comparison to MDMA alone. The results in rats were similar to those in Caco-2 cells. These findings suggest that the intestinal absorption of similar compounds with amine moieties such as MDMA, MA, and KA are mediated by a common transport system, and that CF affects the absorption of MDMA in a different way from the transport system. In human, intakes of ATS tablets mixed with such components might result in similar interactions in intestinal absorption to those in Caco-2 cells and rats.     

Synthesis and identification of urinary metabolites of 4-iodo-2,5-dimethoxyphenethylamine

This article describes the synthesis and identification of urinary metabolites of 4-iodo-2,5-dimethoxyphenethylamine (2C-I), a new psychoactive drug. 2C-I hydrochloride was administered orally to male Sprague-Dawley rats, and the urinary extracts were analyzed by gas chromatography/mass spectrometry (GC/MS), then five putative 2C-I metabolites were synthesized in our laboratory. In the synthetic process of the 2C-I metabolites, iodination of the aromatic ring was successfully carried out using iodine and orthoperiodic acid as the iodination reagent, and selective debenzylation of aryl benzyl ether was accomplished by the acid hydrolysis method using trifluoroacetic acid and thioanisole. The synthesized metabolites were well separated and detected by GC/MS after valeryl derivatization. The results showed that 2C-I underwent O-demethylation, N-acetylation, and deamination, followed by oxidation to the corresponding carboxylic acid in rats. The data presented in this study will be very useful for the analysis of 2C-I and its metabolites in forensic samples.     

Chelating resin-based extraction of DNA from dental pulp and sex determination from incinerated teeth with Y-chromosomal alphoid repeat and short tandem repeats

A procedure utilizing Chelex 100, chelating resin, was adapted to extract DNA from dental pulp. The procedure was simple and rapid, involved no organic solvents, and did not require multiple tube transfers. The extraction of DNA from dental pulp using this method was as efficient, or more so, than using proteinase K and phenol-chloroform extraction. In this study, the Chelex method was used with amplification and typing at Y-chromosomal loci to determine the effects of temperature on the sex determination of the teeth. The extracted teeth were incinerated in a dental furnace for 2 minutes at 100 degrees C, 200 degrees C, 300 degrees C, 400 degrees C, and 500 degrees C. After the isolation of DNA from the dental pulp by the Chelex method, alphoid repeats, and short tandem repeats, the human Y chromosome (DYZ3), DYS19, SYS389, DYS390, and DYS393 could be amplified and typed in all samples incinerated at up to 300 degrees C for 2 minutes. The DYS389 locus in some samples could not be amplified at 300 degrees C for 2 minutes. An autopsy case is described in which genotypings of DYS19, DYS390, and DYS393 from dental pulp obtained from a burned body were needed. The data presented in this report suggest that Chelex 100-based DNA extraction, amplification, and typing are possible in burned teeth in forensic autopsy cases.     

Analysis of 4‐Bromo‐2,5‐DimethoxyphenethylamineAbuser's Urine: Identification and Quantitation of Urinary Metabolites

The metabolites of 4‐bromo‐2,5‐dimethoxyphenethylamine (2C‐B), a psychoactive drug with hallucinogenic activity, were investigated in a urine sample from a user of 2C‐B. The urine sample was deconjugated enzymatically and the metabolites were recovered by liquid–liquid extraction. The extract was analyzed by gas chromatography/mass spectrometry after derivatization, and the results were used to identify and quantitate the metabolites. 4‐Bromo‐2,5‐dimethoxyphenylacetic acid was the most abundant metabolite of 2C‐B in human urine and accounted for 73% of the total amount of detected metabolites, followed by 4‐bromo‐2‐hydroxy‐5‐methoxyphenylacetic acid (13%) and 4‐bromo‐2,5‐dimethoxyphenylethyl alcohol (4.5%). According to the literature, the main metabolites of 2C‐B in rat urine are N‐(4‐bromo‐2‐methoxy‐5‐hydroxyphenylethyl)acetamide and N‐(4‐bromo‐2‐hydroxy‐5‐methoxyphenylethyl)acetamide. However, these metabolites accounted for only a small proportion of the total amount of detected metabolites in human urine, which indicates that there are significant species‐specific differences in the metabolism of 2C‐B. 4‐Bromo‐2,5‐dimethoxyphenylacetic acid, which was the most abundant metabolite in human urine, is thought to be generated by deamination of 2C‐B by monoamine oxidase (MAO) followed by oxidation by aldehyde dehydrogenase. Our results suggest that MAO plays a crucial role in the metabolism of 2C‐B in humans.     

A delayed drowning death with histological findings of shock

A delayed drowning death case with histological findings of shock was described. The person was sustained by continuous positive-pressure respiration and died 2 days after resuscitation from drowning. The histological findings were intravascular microthrombi, hyaline bodies and fibrin thrombi in the brain, multiple megakaryocytes in the pulmonary capillaries, hyaline membranes of the lung, multiple small hyaline bodies in the liver sinusoids, and erosion of the mucous membrane of the stomach as well as histological findings of shock kidney. Drowning and systemic hypotension during resuscitation seemed to cause irreversible oxygen debt of the organs and the tissues to lead to shock.     

Forensic usefulness of the silicone rubber cast of the cardiac vessels

Adequate examination of the coronary arteries at forensic autopsy is often difficult. No matter whether the arteries are opened longitudinally or transversely, each method has its disadvantages. A technique making silicone rubber casts of the cardiac vessels providing simultaneous angiography is described. The method allows the three-dimensional precise assessment of stenotic lesions of the coronary arteries. It is concluded that the method examined could be useful for the forensic problems.     

A method for screening for various sedative-hypnotics in serum by liquid chromatography/single quadrupole mass spectrometry

A screening method for the detection of sedative-hypnotics in serum is described. The target drugs, which include practically all the sedative-hypnotics distributed in Japan, consisted of 5 barbiturates, 30 benzodiazepine-related drugs and 11 other sedative-hypnotics (i.e., apronalide, bromisovalum, chloral hydrate, triclofos, chlorpromazine, promethazine, diphenhydramine, hydroxyzine, zopiclone, zolpidem and tandospirone). Thirty-nine analytes, selected in terms of the pharmacokinetics of the target drugs, in human serum were screened using a combination of mixed-mode solid-phase extraction and liquid chromatography/electrospray-ionization single-quadrupole mass spectrometry. The detection limits (non-basic analytes, 1-50 ng/ml; basic analytes, 0.1-5 ng/ml) were sufficient to permit the screening of a single therapeutic administration of a target drug.     

A fatal case of sulindac-induced Lyell syndrome (toxic epidermal necrolysis)

A 37-year-old woman died after 18 days from her starting to take sulindac for low back pain. Based on her clinical course and the autopsy findings, the cause of her death was Lyell syndrome (toxic epidermal necrolysis) induced by sulindac. This case is described together with the legal aspects of medical malpractice to which it gave rise.     

The course of respiration and circulation in death by carbon dioxide poisoning

To investigate the effects of very high concentrations of carbon dioxide (CO2) upon the course of respiration and circulation, dogs were allowed to breathe high concentrations of CO2 while intrathoracic pressure, blood pressure (BP) in the femoral artery, electrocardiogram and electroencephalogram readings were registered. The respiratory movements either increased just after inhalation of high concentrations of CO2 and then ceased in 1 min, or decreased and continued for a while according to the concentrations of CO2. The BP showed an initial depression, then returned to the original level, then fell again rapidly or maintained an appreciable level for a while until circulatory breakdown. In the dogs allowed to breathe the gas mixture of 80% CO2 with 20% O2, the respiratory movement ceased in 1 min, and the terminal respirations were seen with the circulatory breakdown after apnoea of several minutes. These findings showed that the cause of death in breathing high concentrations of CO2 is not hypoxia, but the CO2 poisoning.