The application of histochemical methods to the age evaluation of skin wounds: experimental study in rabbits.

Enzyme histochemical methods allow determination of wound age, especially in the range of a few hours, and are used to distinguish between postmortem and antemortem skin wounds. The methods are based on the determination of the presence and changes of the enzyme reaction in the wound area. Increased activity of nonspecific esterases was observed approximately 1 hour after wounding and was followed by an increase in adenosine triphosphatase at approximately 2 hours and alkaline phosphatase at approximately 3.5 hours. Maximum enzyme activity was reached for nonspecific esterases at 24 hours, for adenosine triphosphatase at 20 hours, and for alkaline phosphatase at 32 hours after wounding.

Pesticide deposition in hair: preliminary results of a model study of methomyl incorporation into rabbit hair.

This work studied the incorporation of methomyl, a carbamate insecticide, into the hair of New Zealand white rabbits. A total of 600 mg methomyl was administered by drinking water over 4 mo, and acetylcholinesterase activity in serum was monitored. At the end of the dosing period, hair from the back of the rabbits was cut off, and the methomyl concentration was measured using ELISA and HPLC. A decrease of serum acetylcholinesterase occurred. The top cm of hair contained no methomyl, the second cm contained 0.9 ng/mg and the 3rd cm of hair contained 3 ng methomyl/mg. Methomyl was incorporated into the rabbit hair in a process independent of gender but dependent on the hair growth rate.

Determination of phenytoin in sections of head hair: a preliminary study to evaluate the history of drug use.

Phenytoin (PH) levels were determined in the head hair of twenty five patients (fourteen males and eleven females, aged from five to seventy seven years old) who were receiving this drug chronically. The assay method involved sectional hair analysis by dissolution and liquid phase extraction procedures, using both high pressure liquid chromatography (HPLC) and immunoassay (Abbott TDx) techniques. Five sections were studied, the first being the one closet to the root. The phenytoin levels of the hair sections ranged: a) 1st: 0.68 to 39.56 micrograms/g (mean 16.12 micrograms/g), b) 2nd: 0.85 to 34.15 micrograms/g (mean 9.45 micrograms/g), c) 3rd: 1.33 to 27.90 micrograms/g (mean 3.72 micrograms/g), d) 4th: 1.10 to 10.96 micrograms/g (mean 3.04 micrograms/g) and e) 5th: 1.05 to 7.00 micrograms/g (mean 2.84 micrograms/g) according to the HPLC analysis. The immunoassay technique gave similar results. The mean values of phenytoin in the hair sections according to the immunoassay technique were: 16.28; 9.47; 3.77; 3.22; 2.97 micrograms/g, respectively from the 1st to the 5th section. A reduction of drug concentrations in hair from the first to the consecutive segments was observed. Higher amounts of phenytoin were deposited in black, untreated hair in comparison to blond brown or grey hair. Phenytoin concentrations in hair sections correlated with the oral daily dosage of the drug. Our data indicate to the use of hair testing as a marker of the dosage history and evaluation of the compliance of patients under long treatment with phenytoin.

MDEA related death in Crete: a case report and literature review.

"Designer drugs" are derivatives of approved drugs abused for recreational effect and created by underground laboratories to circumvent legal restriction. By far the most controversial drug has been MDMA (3,4-methylenedioxymethamphetamine) and the newer derivative MDEA (3,4-methylenedioxymethamphetamine) often called "Eve". MDEA-related deaths have not been reported in the US, but there have been a death of MDMA and MDEA severe poisonings. Convulsions, collapse, hyperpyrexia, disseminated intravascular coagulation rhabdomyolysis, and acute liver and renal damage result from the ingestion of the drug. Complications may occur and severity and death possibly result. The case of a 31-y-old male, the first victim of MDEA in Greece, is reported. Blood MDEA was 3.1 micrograms/mL; MDEA concentrations in liver, lung and kidney were 4.8, 5.2, and 4.8 micrograms/g respectively.

Suicide by alcohol overdose.

Alcohol is the most often detected substance in the body of a person who has committed suicide. It may be used to reduce the last instinctive hestitations to taking one's own life. Suicide is common in cancer patients. People with cancer-related depression often use alcohol as a means of coping but they very rarely use it in order to kill themselves through acute intoxication. However, a case of a cancer patient who committed suicide consuming two bottles of spirit was recently investigated and the conclusions are presented. The post-mortem cardiac blood and vitreous humor alcohol level was found to be 9.0 and 6.2 mg/ml respectively.

Death following intentional methyl bromide poisoning: toxicological data and literature review.

A case of fatal poisoning due to ingestion-inhalation of methyl bromide (MeBr) is presented. In previously reported fatalities due to MeBr inhalation, only inorganic bromide levels in biological specimens were reported. Intact MeBr has not been isolated from human tissues following exposure. In the present case, MeBr was detected, confirmed and quantitated in various biological samples by headspace gas chromatography, and the clinical manifestations and autopsy findings are described. Postmortem MeBr peripheral blood concentration was 3.3 micrograms/mL and in subclavian blood was 3.8 micrograms/mL. Lung, brain, adrenal gland, kidney, liver and testis MeBr was 2.9, 3.5, 3.4, 2.6, 1.9 and 2.8 micrograms/g respectively; MeBr in bile was 1.2 micrograms/mL. Inorganic bromide concentrations were 530, 30, 310 and 130 micrograms/g in blood, brain, kidney and adrenal gland respectively.

Fatal and non-fatal outcome by accidental intoxication with paint thinner.

Although poisonings (fatal and non-fatal) due to intentional or accidental acute exposure to toluene or toluene mixture fumes have been previously reported in the literature, several issues concerning lethal doses or lasting post-exposure neuropathological impairments still remain unclear. Two male painters (18 and 30 years old) were accidentally exposed to toxic concentrations of paint diluent fumes containing toluene (TL), acetone (ACT) and methyl ethyl ketone (MEK) (60:15:15 w/w/w respectively) during their work in an underground reservoir. Both workers were found unresponsive by colleagues and were immediately transferred to the regional hospital. On admission, the younger man was pronounced dead, while the other remained in the intensive care unit for 3 days and then 4 days in the internal medicine ward. TL, ACT and MEK concentrations in blood samples taken from the survivor on admission were 6.3, 30.6 and 40.5 microg/mL. Postmortem toxicology of the dead worker revealed TL, ACT and MEK blood levels of 12.4, 90.8 and 80.4 microg/mL respectively. The solvent levels in the liver, kidney, lung, brain, testis and gland were also quantified and showed a somewhat similar distribution of the chemicals among these tissues with the highest levels found in the brain and the liver. The fatal and the non-fatal outcome that resulted despite similar intoxication conditions, most probably demonstrates the interindividual tolerance among the painters who also had similar body weights. The surviving painter did not develop any neuropsychological impairment in post-exposure time. The reported case strongly emphasizes the necessity to take precautions when using paint diluents in enclosed spaces.

Experiences with acute organophosphate poisonings in Crete.

Nine human acute poisonings due to intentional ingestion of organophosphorous pesticides are presented. Six of the victims died. Six patients were treated in the Intensive Care Unit (ICU) from 34 h to 45 d, while 3 were found dead by relatives. Two of the patients treated in the ICU fully recovered after 15 and 24 d while the third survivor developed delayed neuropathy. Organophosphate blood levels were determined on admission and during therapy, and in 1 case atropine and pralidoxime levels were also detected. Significant fluctuations of the plasma cholinesterase activity were observed during therapy. Postmortem analysis revealed higher levels of pesticides in organs (eg 23.1 micrograms fenthion/g kidney) and in fat (135.2 micrograms fenthion/g) than in blood (eg 4.8 micrograms fenthion/ml) and vitreous humor. Considerable pesticide was measured in testis (eg 5.8 micrograms fenthion/g, 0.8 micrograms methidathion/g) and uterus (170.5 micrograms malathion/g). Extracorporeal decontamination to enhance pesticide elimination is a therapeutic challenge.