Urinary hypoxanthine and pseudouridine as indicators of tumor development in mesothelioma-transplanted nude mice.

A human mesothelioma was heterotransplanted to nude mice, and the urinary excretions of hypoxanthine, xanthine, pseudouridine, orotic acid, 7-methylguanine, and 1-methylhypoxanthine have been followed before and after the tumor transplantation. The compounds were measured by means of isotachophoresis, which has been found a rapid and precise method. The tumor reached maximum size within 30 days, and at this time a significantly increased excretion of pseudouridine and hypoxanthine was observed. Tumor growth was stopped by chemotherapy (vincristine, cyclophosphamide, prednisolone, and Adriamycin), and corresponding to this, a decrease occurred in both pseudouridine and hypoxanthine excretion to normal values.

Alcohol and drugs (medical and illicit) in fatal road accidents in a city of 300,000 inhabitants.

During a 1-year period all fatal road accidents in the police district of Aarhus, Denmark, were investigated regarding the presence of alcohol, medical drugs or narcotic substances, and the nature of the accident. Out of a total of 30 accidents 24 were investigated. Two thirds had been caused by the victim him- or herself. In one third of the accidents alcohol was present and considered an important contributory factor. Medical drugs and narcotic substances played a lesser role.

Prevalence of cannabinoids in urine samples from forensic autopsies.

Urine samples from 393 forensic autopsies were tested for the presence of cannabinoids by means of the radio-immunoassay test kit from DPC, Los Angeles. Fifteen per cent were found positive, mainly men and young adults. Use of cannabis was found to be closely related to drug addiction, and thus in cannabis-positive drug addicts, non-natural manners and causes of death dominate. In non-addicts the prevalence of cannabis use was 7.5%, and in non-addicted cannabis users, manners and causes of death were not very different from those found in cannabis-negatives.

[Fatal ecstasy intoxication]. / Letalt forløbende ecstasyforgiftning.

A case of full-blown, lethal MDMA intoxication, owing to abuse of ecstasy is described. The increasing popularity of ecstasy among young, otherwise healthy, people prompts health care providers to recognise better the symptoms of systemic intoxication in order to initiate early treatment, such as rehydration, cooling in cases of hyperthermia, seizure treatment, correction of cardiac arrhythmia, and metabolic and electrolyte abnormalities.

[Alcohol, drugs and narcotics in suicides in the Aarhus police district]. / Alkohol, medicin og narkotika ved suicidier i Aarhus Politikreds.

For a period of one year all suicides in Aarhus police district were investigated with a view to identifying the presence of alcohol or drugs in the body of the deceased. Fifty-one suicides occurred, 46 of which were examined. One third of the suicides were due to poisoning and one fourth to hanging. Alcohol was detected in 20% and drugs or narcotics were found in approximately 60%. The most frequent findings were benzodiazepines, analgetics, antidepressants and carbon monoxide. Approximately 40% of the deceased had received psychiatric treatment.

[Citalopram in forensic samples. Citalopram concentrations in samples from legal autopsies and from living persons in connection with traffic accidents or cases of violence in Denmark 1989-1996]. / Citalopram i retskemiske sager. Citalopramkoncentrationer i prøver fra retslige obduktioner og fra levende personer i forbindelse med trafik- eller voldssager i Danmark fra 1989 til 1996.

Citalopram was found in 92 autopsy cases and 27 cases from living persons and the concentrations are described. A range of 6.2-19 mumol/kg whole blood was found in cases where citalopram alone was the cause of death and a range of 1.9-16 mumol/kg whole blood in cases, where citalopram together with other compounds were considered to be the cause of death. In autopsy cases toxic concentrations were in the range 1.2-2.8 mumol/kg whole blood and concentrations between 0:09 and 1.9 mumol/kg were considered therapeutic. In cases from living persons the citalopram concentrations in whole blood were 0.06-0.9 mumol/kg.

[Deaths among drug addicts in Denmark. A forensic medical study of deaths among drug addicts during the period 1991-1992 related to the period 1984-1985]. / Narkomandødsfald i Danmark. En retsmedicinsk undersøgelse af narkomandødsfald 1991-1992 relateret til 1984-1985.

This study includes all deaths among drug addicts in the years 1991 (n = 219) and 1992 (n = 214) investigated at the three institutes of forensic medicine in Denmark. The results are compared with deaths among drug addicts in 1984-1985. The number of deaths among drug addicts increased by approximately 50% in 1991-1992 compared with 1984-1985. The increase was most significant among drug addicts over 35 years of age. The cause of death was intoxication in three-quarters of the cases in 1991-1992. In half of these cases heroin/morphine had caused death, while intoxications caused by methadone accounted for approximately 30% of the cases. In the metropolitan area the frequency of methadone intoxications increased significantly compared with 1984-1985, whereas the number of heroin/morphine intoxications did not change. Outside the metropolitan area, however, a significant increase in heroin/morphine intoxications was noticed. In all parts of the country the number of propoxyphene intoxications decreased to a few annual cases. The most commonly used drugs of abuse were heroin/morphine, diazepam and methadone, often in combination with alcohol.

[Fatal intoxications among drug addicts in Denmark in 1997]. / Forgiftningsdødsfald blandt narkomaner i Danmark i 1997.

INTRODUCTION: The purpose of this study was to investigate fatal poisonings among drug addicts in 1997 and to compare the results to similar investigations from 1985 and 1991. MATERIAL AND METHODS: All fatal intoxications among drug addicts in Denmark in 1997, investigated at the three Institutes of Forensic Medicine in Denmark. RESULTS: The number of fatal intoxications increased by 32% from 1991 to 1997, mainly outside the metropolitan area, The average age increased from 32 to 36 years. The proportion of heroin/morphine intoxications increased from 57% to 71%. The most commonly used drugs were as in 1991 heroin/morphine, diazepam and methadone. The frequency of cocaine increased from one positive case in 1991 to 14% positive cases in 1997. DISCUSSION: This study showed an increasing number of fatal intoxications and changes in drug abuse pattern and place of death since 1991.

Citalopram concentrations in samples from autopsies and living persons.

Concentrations of citalopram in medicolegal samples from 92 autopsies and 27 living persons are described. In autopsy cases in which citalopram alone was the cause of death, concentrations ranged from 2.0 to 6.2 mg/kg whole blood. In autopsy cases in which citalopram together with other substances was considered to be the cause of death, the concentrations of citalopram ranged from 0.6 to 5.2 mg/kg whole blood. In autopsy cases toxic concentrations ranged from 0.4 to 0.9 mg/kg whole blood and therapeutic concentrations from 0.03 to 0.6 mg/kg whole blood. In samples from living persons the concentrations of citalopram in whole blood were 0.02 to 0.3 mg/kg.

Acetate versus lactate in peritoneal dialysis solutions.

The acid-base characteristics of two peritoneal dialysis solutions containing either lactate or acetate are compared and the time course of changes in intraperitoneal pH following instillation into the abdominal cavity is measured. The concentration of titratable acid (cTA) is 5.58 mmol/l or 7 times as high in solutions containing acetate as in those containing lactate (0.79 mmol/l). The buffer capacity, -dcTA/dpH, is 11.43 and 1.82 mmol/l, respectively. Following intraperitoneal instillation of 1.5 liter of the solutions, the time course is 2-3 times as long before intraperitoneal pH reaches 7 using acetate (18 min) as when using lactate (7 min). The above mentioned difference in acid-base characteristics as well as an individual acetate intolerance is supposed to be the cause for the development of abdominal pains and peritoneal irritation observed in some patients using acetate-containing solutions. 123 mmol/l of sodium bicarbonate is to be added to the acetate solution to raise the pH value from 5.6 to 7.4. Neutralization using sodium bicarbonate will thus result in sodium intoxication of the patient. The use of lactate instead of acetate for peritoneal solutions is advocated.

The effect of L-carnitine on lipid metabolism in patients on chronic haemodialysis.

Twenty-one patients (median 49 years; range 20-72 years) on chronic haemodialysis (median: 54 months; range 16-154 months) were examined in a clinical controlled trial for the effect of carnitine on hyperlipoproteinaemia. Initial values of serum carnitine were within the normal range. Carnitine was added to the dialysis fluid to a final concentration of 100 mumol/l. The trial was carried out for 6 months, and the serum of fasting patients was analysed at monthly intervals for carnitine, triglycerides, HDL-cholesterol, LDL-cholesterol and apolipoprotein A and B. The loss of carnitine to the dialysis fluid also was examined, as was the retained amount in those receiving carnitine. We could not confirm the findings of others that carnitine produces lowering of serum triglycerides and increases of serum HDL-cholesterol. The study was extended for another year with ten patients; however, no change was observed in the lipid pattern.