Objective Diagnosis of Drowning by the "Diatom Test" - A Critical Review.

The identification of diatoms in the body tissues to prove a death by drowning (known as the diatom test) dates back to the end of the 19th century. However, in recent decades the reliability of this method was disproved because of an alleged inaccuracy and high false positive rate; nonetheless, the matter is still highly controversial. The purpose of the present work is to offer a critical review of the subject with a specific emphasis on the technical problems. In particular, contamination of samples during autopsy and of tissue extracts during processing was recognized as the main source of false positive results. However, the possibility of diatom passive penetration into the body (particularly into lungs) during submersion cannot be excluded, especially in highly transformed cadavers. Hence, tissues that are highly secluded from the drowning medium, such as bone marrow, are preferred as samples, according to the most recent literature. Additional information on the drowning site and circumstances can be drawn from the qualitative and quantitative comparison between the diatoms found in the body tissues and those present in the drowning water. From the analytical point of view, the majority of authors digest tissues by treatment with strong acids, often after oxidation; alternatively, proteolytic enzymes are widely used. Detection is generally carried out by light microscopy, but scanning electron microscopy (SEM) shows much better resolution, which is important for the identification of the smallest diatoms or diatom fragments. In the experimental part of the work, a recent evolution of SEM, known as environmental scanning electron microscopy (ESEM) has been tested on drowning victims. The main feature of ESEM is the possibility to work on standard microscopic preparations without the need of sample coating, which allows switching between light and electron microscopy, thus taking advantage of the wide optical field of the former technique and of the high resolution of the latter. On this basis, we propose an integrated approach to the diatom test including a screening with light microscopy (200-400×) and a confirmation with ESEM (5,000-20,000×). The review includes 92 references.

Capillary zone electrophoresis and artificial neural networks for estimation of the post-mortem interval (PMI) using electrolytes measurements in human vitreous humour.

Determination of electrolyte concentrations (mainly potassium) in vitreous humour has long been considered an important tool in human death investigations for the estimation of the post-mortem interval (PMI). On the basis of its well known potential in ion analysis, capillary zone electrophoresis (CZE) has recently been applied to achieve a rapid and simultaneous determination of inorganic ions in this extracellular fluid. In the present work, artificial neural networks (ANN) were applied for modelling of the relationship of multicomponent CZE analysis of K+, NH4+, Na+, and Ba2+ ions in vitreous humour with PMI. In a study based on 61 cases with different causes of death and a known PMI ranging from 3 to 144 h, the use of ANNs considering all inorganic ion data from the human vitreous humour, achieved a substantial improvement of post-mortem interval prediction. Good linear correlation was observed (r2 = 0.98) and in comparison to the traditional linear least squares (LLS) method applied only to K+ levels in the vitreous humour, the prediction of PMI with ANN was improved by a factor of 5 from approximately +/- 15 h to less than 3 h.

Determination of apparent binding constants of drugs by capillary electrophoresis using beta-cyclodextrin as ligand and three different linear plotting methods.

Capillary electrophoretic estimation of apparent binding constants (Kapp) for naproxen, salbutamol, indomethacine and procaine with beta-cyclodextrin is presented. While with naproxen and indomethacine this approach was straightforward and gave well compatible results by three different linearization plots (double reciprocal, x reciprocal and y reciprocal), with salbutamol a higher value than reported for the electromigration estimation of this magnitude was obtained (a fourfold increase). This difference is ascribed to the fact that the measurements were done in the acid region (while the reported values were obtained at higher pH values). As a matter of fact the values of Kapp, reported in this communication for salbutamol comply better with the value of Kapp (69.3) obtained by the solubility method.

Potassium concentration differences in the vitreous humour from the two eyes revisited by microanalysis with capillary electrophoresis.

This paper presents a study of the variability of potassium concentrations in the vitreous humour of the two eyes of the same body at identical postmortem interval. The study was carried out by collecting microsample amounts (50 microl) of vitreous humour and by using an original method of capillary electrophoresis with indirect detection. The electrophoretic separations were carried out in a pH 4.5 running buffer composed of 5 mmol/l imidazole, 5 mmol/l 18-crown-6 ether and 6 mmol/l alpha-hydroxybutyric acid. Detection was by indirect UVabsorption at 214 nm. Vitreous humour samples were collected from 57 medico-legal autopsies or external examinations of cases of sudden natural or violent deaths. All samples prior to analysis were diluted 1:20 with a 40 microg/ml aqueous solution of barium, the used internal standard, and finally injected by nitrogen pressure. The mean concentrations of potassium measured in the two eyes of all the cases included in the present study ranged from 4.1 to 23.5 mmol/l with the postmortem interval values varying from 7 to 144 h. A highly significant (P<0.0001) linear correlation was found between these two parameters as described by the equation: y=0.1698x+2.3587, r=0.89. The intra-eye variability of potassium concentrations was low with an average RSD of 3.89% (+/- 1.83 SD) (48 eyes, five samples per eye). No statistically significant difference was found between the potassium concentrations in the two eyes of the same subject in a group of 24 cases, excepting a single case.

Use of beta-cyclodextrin in the capillary zone electrophoretic separation of the components of clandestine heroin preparations.

The present paper describes the methodological optimization and validation of a capillary zone electrophoresis method for the rapid determination of heroin, secondary products and additives present in clandestine heroin samples, by using 20 mM beta-cyclodextrins in phosphate buffer, pH 3.23. Applied potential was 15 kV and separation temperature was 24 degrees C; detection was by UV absorption at 200 nm wavelength. Heroin samples were first dissolved in CHCl3-MeOH (96:4, v/v) and injected by pressure (0.5 p.s.i., 3 s; 1 p.s.i.=6894.76 Pa) after evaporation of the organic mixture and reconstitution in aqueous buffer. Under the described conditions, phenylethylamine (internal standard), morphine, monoacetylmorphine, heroin, acetylcodeine, papaverine, codeine and narcotine were baseline resolved in less than 10 min. The limit of detection was better than 1 microg/ml for each analyte. The study of the intra-day and day-to-day precision showed, in terms of migration times, RSDs < or = 0.71% and, in terms of peak areas, RSDs < or = 3.2%. Also, the evaluation of linearity and analytical accuracy of the method provided good results for all the analytes investigated, thus allowing its application to real cases of seized controlled drug preparations.

Field-amplified sample stacking capillary zone electrophoresis applied to the analysis of opiate drugs in hair.

The present paper describes the methodological optimization and validation of capillary zone electrophoresis (CZE) for the determination of major opiates (morphine, codeine, 6-monoacetylmorphine, acetylcodeine, heroin) in hair samples by using a field-amplified sample stacking injection before the separation in a binary running buffer (0.1 M sodium phosphate, pH 2.5, with 40% ethylene glycol). The applied potential was 20 kV, at 25 degrees C. Detection was by UV absorption at the fixed wavelength of 214 nm or by recording the full spectrum between 190-400 nm, thus improving the analytical selectivity and identification power of CZE. Hair samples were liquid/liquid extracted; dried extracts, reconstituted with a low-conductivity solvent (0.1 mM phosphoric acid, with 80% 1-propanol), were injected by electromigration at 10 kV for 99 s, after a 0.5 mm plug of water. Under the described conditions, the limit of detection (with a signal-to-noise ratio of 3) in hair extracts was 100 pg/mL for codeine, 75 pg/mL for morphine and 6-monoacetylmorphine (6-MAM), 150 pg/mL for ethylmorphine, and 0.75 ng/mL for acetylcodeine and heroin. The precision of the method was validated for standards in pure solution by using internal standardization, providing for intraday and day-to-day assays, in terms of migration times, relative standard deviation (RSD) values < or = 0.2%, and in terms of peak areas, RSD values <5.71%.

Capillary electrophoretic separation of vitamins in sodium dodecyl sulfate containing buffers with lower aliphatic alcohols and n-hexane as organic modifiers.

The effect of lower organic alcohols as co-surfactants (methanol, ethanol, n-propanol, isopropanol, propanediol, n-butanol and isoamylalcohol) and n-hexane as an organic modifier in 12.5 mol/l phosphate buffer with varying SDS concentration was investigated using a set of vitamins and p-hydroxybenzoic acid as the test mixture. It was demonstrated that optimum separations can be achieved particularly at high concentrations of the surfactant; the selectivity can be changed by adding a co-surfactant; while propanol and isopropanol show the same properties as co-surfactants, the most efficient alcohols were isoamylalcohol and propanediol. n-Butanol was capable of selective separation of p-hydroxybenzoic acid in the test mixture. Addition of ethanol appears most effective at higher concentrations (while all the other alcohols are effective already at 5% concentration, the best results with ethanol were obtained when it constituted 20% of the background electrolyte). 5% Concentration of methanol resulted in poor separation of the test mixture, however if 300 microl/10 ml of hexane were added to 20 mmol/l SDS containing phosphate buffer, the resulting separation was practically the same as with 50 mmol/l SDS.

Improved method for carbohydrate-deficient transferrin determination in human serum by capillary zone electrophoresis.

Carbohydrate-deficient transferrin (CDT) is a reliable marker of chronic or repeated alcohol abuse. It indicates a group of isoforms of human transferrin (Tf), the main iron transport serum protein, deficient in sialic acid residues (asialo-, monosialo- and disialo-Tf) in comparison to the main isotransferrin which contains four sialic acid groups (tetrasialo-Tf). The aim of the present work was to develop a capillary electrophoretic method suitable for rapid determination of CDT components in serum. Serum samples (0.1 ml) were saturated with iron by incubation with 10 mM FeCl3 (2 microl) and 500 mM NaHCO3 (3 microl) for 30 min, then diluted 1:10 in water and injected by positive pressure (0.5 p.s.i. for 10 s). Separation was performed with a capillary zone electrophoretic method using bare fused-silica capillaries (57 cm x 20 microm I.D.) and a buffer composed of 100 mM sodium tetraborate adjusted with 6 M HCl to pH 8.3 added with 1.5 mM diaminobutane. Applied voltage was 20 kV and temperature 25 degrees C. Detection was by UV absorption at 200 nm wavelength. Under the described conditions, asialo-, monosialo-, disialo-, trisialo- and tetrasialo-transferrin were baseline separated. The limit of detection (signal-to-noise ratio of 2) was about 0.3% for disialo-Tf, and 0.5% of trisialo-Tf, expressed as percentages of the terasialo-Tf peak area. Day-to-day RSDs of relative migration times were < or = 0.2%. Quantitation showed day-to-day RDSs < or = 6.9% and < or = 10.9% for disialo- and trisialo-Tf, respectively. The results from 79 control subjects, including social drinkers, and 23 alcoholics showed disialo- and trisialo-Tf significantly increased in patients (P<0.0001 and <0.01, respectively). A clear interference from trisialo-Tf in an immunoassay for CDT was demonstrated. The present method is suitable for confirmation of CDT immunoassays by independent technique.

Capillary electrophoresis: a new analytical tool for forensic toxicologists.

In capillary electrophoresis, electrophoretic or electrokinetic separations are carried out in tiny capillaries at high voltages (10-30 kV), thus achieving high efficiency (N > 105), resolution power, and mass sensitivity (down to 10(-18)-10(-20) moles). The main characteristics of capillary electrophoresis are versatility of application (from inorganic ions to large DNA fragments), use of different separation modes with different selectivity, low demands on sample volume, negligible running costs, possibility of interfacing with different detection systems including mass spectrometry, and the ruggedness and simplicity of the instrumentation. Capillary electrophoresis applications in the forensic sciences are now rapidly growing, particularly in forensic toxicology. The present paper briefly describes the basic principles of capillary electrophoresis and presents a selected review of its main applications to the analysis of illicit/controlled drugs in biologic samples. An original analytical approach to the determination of carbohydrate deficient transferrin, a new marker of chronic alcohol abuse, based on capillary electrophoresis is also described. It is concluded that the peculiar separation mechanisms and the high complementarity of capillary electrophoresis to chromatography make it a new powerful tool of investigation in the hands of forensic toxicologists.

Hair analysis by using radioimmunoassay, high-performance liquid chromatography and capillary electrophoresis to investigate chronic exposure to heroin, cocaine and/or ecstasy in applicants for driving licences.

The present paper describes an integrated diagnostic strategy to check the physical fitness of subjects, formerly users of illicit drugs, to obtain a driving license, after having quit their addiction. According to the Italian law, applicants for a driving license with a history of drug abuse must give evidence to have quit this behaviour and to show no risk of relapse in the future. To prove this, at our institute, they undergo medical examination, hair analysis and a urinalysis program on eight seriate samples, collected over about 40 days. About 700 subjects per year are investigated with this strategy. The hair samples are screened for opiates (morphine), cocaine and ecstasy, the most abused illicit substances in our region, by using commercial radioimmunoassays adopting cut-off levels of 0.1 ng/mg. All positive samples and about 10% of negatives are confirmed by high-performance liquid chromatography. Further confirmation of results can be carried out by capillary electrophoresis (and/or GC/MS or MS/MS). In 1998, the prevalence of positives for morphine, cocaine and ecstasy was 4.8, 11.3 and 2.6%, respectively. In this year, for the first time, the percentage of hair samples positive for cocaine was greater than that for opiates. The results of this integrated diagnostic strategy are presented and discussed, with particular emphasis on the comparison between hair analysis on a single sample and seriate urinalyses (on eight samples).

Capillary zone electrophoresis of potassium in human vitreous humour: validation of a new method.

The analysis of potassium in the vitreous humour has long been regarded as an important tool in medicolegal and forensic toxicological investigation, particularly for the determination of the post-mortem interval. The present work was aimed at the optimisation and validation of a reliable, simple and fast capillary electrophoresis method for potassium analysis in the human vitreous humour with indirect UV detection at a wavelength of 214 nm. Electrophoretic separations were carried out in a running buffer comprising 5 mM imidazole, 5 mM 18-crown-6 ether and 6 mM D,L alpha-hydroxybutyric acid (HIBA), adjusted to pH 4.5. Constant voltage runs were carried out by applying a voltage of 500 V/cm at 25 degrees C. The samples were injected in the hydrodynamic mode at the anodic end of the capillary (0.5 p.s.i. for 10 s; 1 p.s.i. = 6894.76 Pa). The method showed good linearity in the concentration range from 6.5 mM to 16.25 microM, with an r2 value of 0.9994. The limit of detection, based on a signal-to-noise ratio of three, was 9.0 microM. Absolute intra-day RSDs of migration times were <0.40%, while the day-to-day values were < or =1.72%. Absolute peak area reproducibility was always better than 2.50%. A comparison of capillary electrophoresis with flame photometry on twelve real autopsy samples showed an excellent correlation with an r2 value of 0.9333. A preliminary application to real cases (20 subjects) was carried out plotting vitreous humour potassium vs. post-mortem interval with a resulting r2 of 0.904 and a Y-intercept of 4.75 mM, in agreement with the existing literature.

Optimized determination of carbohydrate-deficient transferrin isoforms in serum by capillary zone electrophoresis.

Carbohydrate deficient transferrin (CDT) is one of the most reliable markers of chronic alcohol abuse. It consists of a group of minor isoforms of human transferrin (the main iron transport serum protein) deficient in sialic acid groups (asialo, monosialo and disialo) with a pI > 5.7, while the main isotransferrin (tetrasialo) has a pI of 5.4. The aim of the present work was to develop a capillary electrophoretic method to determine CDT in serum, suitable for routine use as a confirmatory technique of the current screening methods based on immunoassays. Serum samples (0.5 mL) were saturated with iron by incubation with 10 mM FeCl3 (9 microL) and 500 mM NaHCO3 (12 microL) for 30 min, then diluted 1/10 in water and injected by positive pressure (0.5 psi for 10 s). Separation was performed with a capillary zone electrophoretic method using bare fused-silica capillaries (20 microm ID, 37 cm in length) and a buffer composed of 100 mM sodium tetraborate adjusted with boric acid to pH 8.3. Applied voltage was 10 kV and temperature 25 degrees C. Detection was by UV absorption at 200 nm wavelength. Under the described conditions, asialo-, monosialo-, disialo-, trisialo- and tetrasialo-transferrin were separated in human serum. The limit of detection (signal-to-noise ratio of 2) was about 0.3% for disialo-transferrin, and 0.4% of trisialo-transferrin, expressed as percentages of the terasialo-transferrin peak area. Relative standard deviations (RSD) of absolute migration times were < 1%, while RSD of relative migration times (on the basis of tetrasialo-transferrin) were < 0.1%. Intra-day and day-to-day peak quantitation precision studies showed RDS ranging from 4 to 9% and from 13 to 24% for disialo- and trisialo-transferrin, respectively. The results from 30 control subjects, including social drinkers, and 13 alcoholics showed disialo- and trisialo-transferrin significantly increased in patients by a factor of about 4.5 (P < 0.0001).

Hair analysis for abused drugs by capillary zone electrophoresis with field-amplified sample stacking.

The present paper describes the methodological optimisation and validation of a capillary zone electrophoresis method for the determination of morphine, cocaine and 3,4-methylenedioxymethamphetamine (MDMA) in hair, with injection based on field-amplified sample stacking. Diode array UV absorption detection was used to improve analytical selectivity and identification power. Analytical conditions: running buffer 100 mM potassium phosphate adjusted to pH 2.5 with phosphoric acid, applied potential 10 kV, temperature 20 degrees C, injection by electromigration at 10 kV for 10 s, detection by UV absorption at the fixed wavelength of 200 nm or by recording the full spectrum between 190 and 400 nm. Injection conditions: the dried hair extracts were reconstituted with a low-conductivity solvent (0.1 mM formic acid), the injection end of the capillary was dipped in water for 5 s without applying pressure (external rinse step), then a plug of 0.1 mM phosphoric acid was loaded by applying 0.5 psi for 10 s and, finally, the sample was injected electrokinetically at 10 kV for 10 s. Under the described conditions, the limit of detection was 2 ng/ml for MDMA, 8 ng/ml for cocaine and 6 ng/ml for morphine (with a signal-to-noise ratio of 5). The lowest concentration suitable for recording interpretable spectra was about 10-20-times the limit of detection of each analyte. The intraday and day-to-day reproducibility of migration times (n = 6), with internal standardisation, was characterised by R.S.D. values < or = 0.6%; peak area R.S.D.s were better than 10% in intraday and than 15% in day-to-day experiments. Analytical linearity was good with R2 better than 0.9990 for all the analytes.

Simultaneous chiral separation of 3,4-methylenedioxymethamphet- amine, 3-4-methylenedioxyamphetamine, 3,4-methylenedioxyethylam- phetamine, ephedrine, amphetamine and methamphetamine by capillary electrophoresis in uncoated and coated capillaries with native beta-cyclodextrin as the chiral selector: preliminary application to the analysis of urine and hair.

The importance of the chiral analysis of amphetamine-related substances in both clandestine preparations and biological samples is widely recognized. For this purpose, capillary electrophoresis was successfully applied by several authors, but only few reports concerned ring-substituted amphetamines, which represent the main components of "ecstasy", a widely abused "recreational" substance. In the present work, the simultaneous chiral analysis of ephedrine, amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), 3-4-methylenedioxyamphetamine (MDA) and 3,4-methalenedioxyethylamphetamine (MDE) is reported, by using capillary electrophoresis with native beta-cyclodextrin (15 mM) as the chiral selector. After preliminary tests at different pH values (phosphate buffer 100 mM, pH 2.5-9.0) and with bare or coated fused-silica capillaries, the optimized conditions were: pH 2.5 phosphate, uncoated capillary (45 cm x 50 microm inner diameter), potential 10 kV. Detection was either by fixed wavelength (200 nm) or multiwavelength (190-400 nm) UV absorbance. Under these conditions, good resolution was obtained for all the analytes, with excellent chiral selectivity and efficiency. The sensitivity for the individual enantiomers was better than 0.2 microg/mL, analytical precision was characterized by relative standard deviation values < 0.8% (< or = 0.15% with internal standardization) for migration times intra-day and < 2.0% (< or = 0.54% with internal standardization) day-to-day; linearity, in the range 0.156-40 microg/mL, and accuracy were also satisfactory. After a simple liquid-liquid extraction, urine samples could be analyzed with a sensitivity well below the recommended NIDA cut-off of 500 ng/mL. For hair samples, it was necessary to increase the sensitivity by applying a field-amplified sample stacking procedure, which allowed the chiral determination of MDA, MDMA and MDE at concentrations occurring in real samples from ecstasy users, with the possibility of recording UV spectra of the peaks.

Optimization of a simple method for the chiral separation of phenethylamines of forensic interest based on cyclodextrin complexation capillary electrophoresis and its preliminary application to the analysis of human urine and hair.

Because of the forensic importance of the chiral analysis of amphetamine and other phenethylamines for investigating their synthetic pathways and the metabolic patterns of these compounds, a capillary electrophoresis method has been developed based on the chiral selectivity of beta-cyclodextrin. The influence of different experimental conditions, such as cyclodextrin nature and concentration, voltage, temperature and buffer concentration and pH, on analytical performance has been studied. The optimized analytical conditions are: capillary: bare fused silica, 50 microns I.D., 40 cm effective length; buffer: 150 mM phosphate pH = 2.5, 15 mM beta-cyclodextrin; voltage: 10 kV; temperature: 17.5 degrees C; detection: UV absorption at 200 nm wavelength. Under these conditions, amphetamine, methamphetamine and ephedrine have been easily separated, with baseline resolution of the respective enantiomers. Sensitivity was better than 300 ng per ml. The average precision of migration times of the three analytes was good with RSD = 0.45% and 0.58% in intra-day and day-to-day tests, respectively. Reproducibility of peak heights was also good, with RSD = 2.51% and 3.14% in intra-day and day-to-day tests, respectively. The preliminary analysis of amphetamine in human urine and hair samples, subjected to a simple work-up procedure based on liquid-liquid extraction, showed clean blank electropherograms, excellent chiral resolution and sensitivity, suitable for the analysis of real samples from amphetamine users.

Hair analysis, a novel tool in forensic and biomedical sciences: new chromatographic and electrophoretic/electrokinetic analytical strategies.

Hair analysis for abused drugs is recognized as a powerful tool to investigate exposure of subjects to these substances. In fact, drugs permeate the hair matrix at the root level and above. Evidence of their presence remains incorporated into the hair stalk for the entire life of this structure. Most abusive drugs (e.g. opiates, cocaine, amphetamines, cannabinoids etc.) and several therapeutic drugs (e.g. antibiotics, theophylline, beta 2-agonists, etc.) have been demonstrated to be detectable in the hair of chronic users. Hence, hair analysis has been proposed to investigate drug abuses for epidemiological, clinical, administrative and forensic purposes, such as in questions of drug-related fatalities and revocation of driving licences, alleged drug addiction or drug abstinence in criminal or civil cases and for the follow-up of detoxication treatments. However, analytical and interpretative problems still remain and these limit the acceptance of this methodology, especially when the results from hair analysis represent a single piece of evidence and can not be supported by concurrent data. The present paper presents an updated review (with 102 references) of the modern techniques for hair analysis, including screening methods (e.g. immunoassays) and more sophisticated methodologies adopted for results confirmation and/or for research purposes, with special emphasis on gas chromatography-mass spectrometry, liquid chromatography and capillary electrophoresis.

Integrated use of hair analysis to investigate the physical fitness to obtain the driving licence: a casework study.

According to the laws presently in force in Italy and the guidelines of the Driving Licence Enforcement Commission of Verona, applicants for the driving licence with a history of drug abuse undergo a medical examination, during which complete anamnestic and clinical data are recorded. On this occasion, a hair sample (50-200 mg) is collected and a urinalysis program is started consisting of EMIT controls for opiates, methadone, cocaine, barbiturates, amphetamines, cannabinoids, benzodiazepines and alcohol carried out on eight seriate samples, collected at random over about 40 days under direct supervision. The positive results from urine immunoassays are confirmed by standardized GC/MS methods. The hair samples are screened for morphine and cocaine, the most abused illicit substances in our region, using commercial RIAs adopting cut-off levels of 0.1 ng/mg. All positive samples and about 10% of negative are confirmed by HPLC. In case of confirmed positive results, the applicant is informed: if the subject denies use of opiates or cocaine in the recent months, he or she has the chance of submitting for analysis a new hair sample, which is analyzed in parallel with the hair remaining from the previous assay. In case of persisting denial, claiming analytical interferences by other drugs or endogenous substances, further confirmation of results can be carried out by CE and/or by qualitative MS/MS. In addition, hair sampling from multiple sites (scalp, axillary, pubic hair) with different susceptibility to contamination from the external sources can be carried out to rule out the possibility of passive contamination. At present, we investigate more than 700 subjects per year. The results of this integrated diagnostic strategy are presented and discussed.