Solid-phase extraction and analysis of 20 antidepressant drugs in human plasma by LC/MS with SSI method

A simultaneous determination of 20 antidepressant drugs (imipramine, amitriptyline, desipramine, trimipramine, nortriptyline, clomipramine, amoxapine, lofepramine, dosulepin, maprotiline, mianserin, setiptiline, trazodone, fluvoxamine, paroxetine, milnacipran, sulpiride, tandspirone, methylphenidate and melitracen) in human plasma was developed using LC/MS with sonic spray ionization (SSI) method. These drugs showed good separation and sensitivity by LC-MS using an Inertsil C-8 column with methanol:10mM ammonium acetate (pH 5.0):acetonitrile (70:20:10) as mobile phase at 0.10 mL/min at 35 degrees C. Solid-phase extraction of these drugs added to the human plasma was performed with an Oasis HLB cartridge column. Recovery and limit of detection of these drugs were between 69 and 102% and between 0.03 and 0.63 microg/mL, respectively. The present procedure offers an easier and more convenient screening method for antidepressants, and will be useful for forensic toxicology investigations.     

Postmortem determination of the biological distribution of formic acid in methanol intoxication.

Two 25-year-old men were fatally intoxicated with methanol. The formic acid levels in their blood, urine, and organs were determined postmortem by headspace gas chromatography. The postmortem concentrations of formic acid in the two patients were the following: 0.32 and 0.23 mg/mL in blood, 2.27 and 0.47 mg/mL in urine, 0.11 and 1.17 mg/g in the brain, 0.54 and 0.51 mg/g in the liver, and 0.13 and 1.19 mg/g in the kidneys. The total amounts of formic acid in the gastric contents were 108 and 23.2 mg.     

Estimation of postmortem interval from hypoxic inducible levels of vascular endothelial growth factor

Estimation of the postmortem interval (PMI) is one of the most important tasks in forensic medicine. Five autopsy organ tissues such as brain, lungs, heart, liver, and kidneys were taken at the time of forensic autopsy from 19 known PMI cases with a range of postmortem intervals ranging from 1 to 120 h (the mean was 25.81 h), and the time-course of vascular endothelial growth factor (VEGF) expression was measured. The human hepatoma-derived Hep 3B cell line was used as a control. The levels of VEGF increased linearly with the PMI up to 20 h in lung (r = 0.95 and in kidney (r = 0.89), and up to 15 h PMI in liver (r = 0.88). The VEGF levels fell after 24 h PMI, and then remained stable. In brain, the levels of VEGF started to increase after 24 h PMI and increased linearly with PMI up to 40 h in brain (r = 0.94) and then begin to fall. In heart, there was no clear correlation between the PMI and VEGF level. Some variations occurred in selected cases, such as the infant and asphyxial deaths. In conclusion, measurement of hypoxia-inducible levels of VEGF in various body organs appears to be a useful method of estimating the PMI up to 24 h in forensic medicine and pathophysiology. This method is also probably applicable in ischaemia in clinical and basic medicine.     

Severe Cardiac Rupture by Only One Blow to the Chest in a Young Boy: An Autopsy Case

Cardiac rupture by blunt chest trauma is commonly seen after motor vehicle accidents and falls; however, it is rarely caused by a blow to the chest. We herein report an autopsy case of a high school boy who sustained severe right ventricular rupture by only one knee kick to the chest during a quarrel. He was hospitalized and developed cardiopulmonary arrest. Emergency surgery was performed, but the patient died. The autopsy revealed no external severe trauma or deformation, but the side wall of the right ventricle contained a large V‐shaped laceration. The other thoracic organs had no injuries. This case illustrates that severe cardiac rupture can occur by only one blow to the chest. Blunt cardiac injuries can occur even if no severe injuries are present on the body surface. We should consider the possibility of severe cardiac injuries regardless of the presence of external injuries.