1/18. tissue distribution of olanzapine in a postmortem case.Olanzapine is a relatively new antipsychotic drug used in the united states for the treatment of schizophrenia. Since its release in the united states market in 1996, few cases of fatal acute intoxication have been reported in the literature. This article describes the case of a 25-year-old man found dead at home who had been prescribed olanzapine for schizophrenia. This case is unique because of the measurement of olanzapine in brain tissue obtained from seven regions in addition to the commonly collected biologic matrices. Olanzapine was detected and quantitated by basic liquid-liquid extraction followed by dual-column gas chromatographic analysis with nitrogen phosphorus detection. The assay had a limit of detection of 0.05 mg/L and an upper limit of linearity of 2 mg/L. The presence of olanzapine was confirmed by gas chromatography-mass spectrometry by use of electron impact ionization. The concentrations of olanzapine measured in this case were as follows (mg/L or mg/kg): 0.40 (heart blood), 0.27 (carotid blood), 0.35 (urine), 0.61 (liver), negative (cerebrospinal fluid), 0.33 mg in 50 ml (gastric contents). In the brain, the following distribution of olanzapine was determined (mg/kg): negative (cerebellum), 0.22 (hippocampus), 0.86 (midbrain), 0.16 (amygdala), 0.39 (caudate/putamen), 0.17 (left frontal cortex), and 0.37 (right frontal cortex). The cause of death was determined to be acute intoxication by olanzapine, and the manner of death was accidental.- - - - - - - - - - ranking = 1keywords = gastric content, content (Clic here for more details about this article) |
2/18. Postmortem blood and vitreous humor ethanol concentrations in a victim of a fatal motor vehicle crash.A 20-year-old male was found on the passenger side of a small car after a collision with a semi-trailer truck. Postmortem blood, collected from the chest cavity, and vitreous humor samples were collected following harvesting of the heart and bones. Gas chromatographic analysis revealed a blood ethanol concentration of 0.32 g/dL and a vitreous humor ethanol concentration of 0.09 g/dL. The stomach was intact and full of fluid and food, but its contents were not collected. Possible explanations for the large difference between the two results include diffusion of ethanol from the stomach into the chest cavity, contamination of the blood sample prior to collection, and ingestion of a large quantity of ethanol shortly before death. This case demonstrates the importance of proper quality assurance procedures in collecting postmortem specimens and of collecting a vitreous humor sample for ethanol analysis in postmortem toxicology cases.- - - - - - - - - - ranking = 0.00053188450454679keywords = content (Clic here for more details about this article) |
3/18. Post-mortem castration by a dog: a case report.A man was found dead in a room where two dogs and a cat were wandering freely. His legs were bare and his underpants presented a few small tears. The deceased exhibited a partial emasculation but with only a small amount of bleeding. No other significant injuries were found, particularly no defence lesions. Death was natural, caused by the rupture of a myocardial infarct. A small piece of connective tissue was found in the gastric contents of one of the dogs. This fragment, as well as bloodstained hairs from its jaws, were analysed for dna.- - - - - - - - - - ranking = 1keywords = gastric content, content (Clic here for more details about this article) |
4/18. Lethal cyanide inhalation with post-mortem trans-cutaneous cyanide diffusion.A 27-year-old worker in a metal processing factory was found dead in a basin, sitting in a solution containing potassium dicyano argentate, potassium cyanide, master batch and brightener 'Elfit 73'. The worker was wearing an acid-resisting overall, rubber boots and a simple dust respirator. While the cyanide concentration in the stomach contents was only 0.05 microg/ml, it was 7.7 microg/g in the lung tissue, 6.3 microg/ml in the heart blood and 31 microg/ml in the femoral vein blood. The different concentrations suggest an initial lethal inhalation of cyanide and an extensive post-mortem diffusion of cyanide through primarily non-injured skin of buttocks and legs. The possibility of a post-mortem cyanide diffusion bars from concluding a vital sign from a high cyanide concentration in a blood sample of one single body site.- - - - - - - - - - ranking = 0.00053188450454679keywords = content (Clic here for more details about this article) |
5/18. frontotemporal dementia with ubiquitinated neuronal inclusions presenting with primary lateral sclerosis and parkinsonism: clinicopathological report of an autopsy case.We report a case displaying upper motor sign, parkinsonism, and behavioral abnormality, with marked degeneration of the precentral cortex, neostriatum and frontotemporal lobes, as well as ubiquitinated neuronal inclusions. The patient was a 66-year-old male at the time of death. At age 57, he noticed progressive difficulties in speaking and swallowing. At age 60, he was severely anarthric and displayed emotional lability and incontinence. Neurologically, very poor movement of tongue was observed, but without atrophy or fasciculation. Deep tendon reflexes were hyperactive. Grasp reflex and snout reflex were also positive. Needle electromyography revealed no abnormalities. A diagnosis of primary lateral sclerosis and character change was made. At age 62, he developed bradykinesia and rigidity of the neck and all extremities. Treatment with carbidopa-levodopa was initiated, but resulted in minimal improvement. At age 65, he was bed-ridden, and had repeated occurrences of aspiration pneumonia; he died of pneumonia. Neuropathological examination revealed marked atrophy of the frontal and temporal lobes with Betz cells completely absent and moderate atrophy of the neostriatum. The spinal cord and nerve roots appeared normal. Immunohistochemically, ubiquitin-positive but tau-negative intraneuronal inclusions were found in the frontal and temporal cortices, including the precentral cortex and the hippocampal dentate gyrus, and the neostriatum. This case could be included with inclusion-associated disorders such as frontotemporal dementia or amyotrophic lateral sclerosis with dementia, and furthermore, predominant upper motor sign and parkinsonism could represent phenotypes of clinical manifestations with such inclusions.- - - - - - - - - - ranking = 1.2361265991041E-5keywords = aspiration (Clic here for more details about this article) |
6/18. Postmortem toxico-kinetics of co-proxamol.Postmortem drug redistribution in suicidal poisonings by co-proxamol (dextropropoxyphene and paracetamol) has been studied. Analytical data for 8 tissue samples, including muscle and fat, up to 8 blood samples, and gastric and small bowel contents were obtained in 4 cases. blood samples were taken from multiple sites at the start of autopsy and after 24 or 48 h. Concentrations of both drugs were site dependent with the lowest concentrations in peripheral blood. Paracetamol concentrations varied two to threefold and propoxyphene concentrations varied seven to tenfold. pulmonary artery concentrations of paracetamol did not change significantly with time; propoxyphene concentrations typically increased twofold over 24 h and threefold over 48 h. Propoxyphene concentrations in the inferior vena cava increased unpredictably but occasionally significantly (up to sevenfold). For both drugs the most dramatic elevations of blood concentrations were seen in the aorta; in one case paracetamol rose to 1.9 g/l, 8 times the peripheral blood concentration and 4 times the liver level (454 mg/kg); propoxyphene rose to 191.5 mg/l, 55 times the peripheral blood concentration. This appears to reflect postmortem diffusion of unabsorbed drug from the gastric lumen. It is likely that markedly higher concentrations in the putrefactive fluid from the left pleural cavity as compared with the right also reflect diffusion from the stomach.- - - - - - - - - - ranking = 0.00053188450454679keywords = content (Clic here for more details about this article) |
7/18. An unusual case of post-mortem redistribution of ethanol.We report an unusual case of post-mortem redistribution of ethanol in a woman diver who died by drowning in seawater. The ethanol concentrations were right heart blood 0.60 g/l, left heart blood 2.08 g/l, femoral venous blood 0.63 g/l, gastric contents 5.87 g/l, bile 0.83 g/l. The mechanisms of post-mortem redistribution of ethanol described in the literature, that is, early redistribution from the stomach or the lung parenchyma in the case of inhalation of gastric contents, are inadequate to account for the degree of variation observed between the measurements. We believe that this difference in concentration is explained by the presence of seawater in the pulmonary alveoli at the time of death.- - - - - - - - - - ranking = 2keywords = gastric content, content (Clic here for more details about this article) |
8/18. Postmortem tissue distribution of atomoxetine following fatal and nonfatal doses--three case reports.Atomoxetine (Strattera, Lilly) is a selective norepinephrine reuptake inhibitor (SNRI) prescribed for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children, adolescents, and adults. It is the first nonstimulant drug-therapy option for ADHD. Three case reports are presented in which atomoxetine was detected in two individuals who died from causes unrelated to the drug and a third from the intentional ingestion of atomoxetine and other drugs. In addition, a brief description of the pharmacokinetics and side effects of atomoxetine are given. Postmortem fluid and tissue concentrations of atomoxetine were as follows: aortic blood, <0.1-8.3 mg/L; femoral blood, 0.33-5.4 mg/L; vitreous humor, 0.1-0.96 mg/L; bile, 1.0-33 g/L; urine, <0.1 mg/L; liver, <0.44-29 mg/kg; and gastric contents, 0.0097-16.8 mg total. autopsy findings in the two cases in which death was not attributed to drug toxicity included arrhythmogenic right ventricular dysplasia and hypertrophic cardiomyopathy. The analytical method utilized was a modified basic drug, liquid-liquid procedure followed by gas chromatography/mass spectrometry and nitrogen phosphorous detection. Atomoxetine can be considered nontoxic at whole blood and liver concentrations below 1.3 mg/L and 5 mg/kg, respectively.- - - - - - - - - - ranking = 1keywords = gastric content, content (Clic here for more details about this article) |
9/18. The case of the empty body.autopsy on an externally intact decomposed body showed empty thoracic and abdominal cavities with no trace of normal organ content. The process producing this previously unencountered situation is discussed.- - - - - - - - - - ranking = 0.00053188450454679keywords = content (Clic here for more details about this article) |
10/18. Differences between multisite postmortem ethanol concentrations as related to agonal events.In a study of postmortem ethanol concentrations, blood was withdrawn from the right atrium, ascending aorta, and inferior vena cava. These samples, vitreous humor, and gastric fluid were analyzed in 307 autopsies, where a minimum blood ethanol concentration of 0.05% weight/volume (w/v) was present. Premortem, agonal, and postmortem events were reviewed in an attempt to account for differences in blood ethanol concentrations between sites. The agonal aspiration of vomitus having at least 0.80% w/v ethanol appears to be associated with an increase in aortic ethanol concentrations. We conclude that valid interpretation of postmortem ethanol concentrations must take into consideration the possible entry of ethanol into the pulmonary venous circulation via the respiratory system.- - - - - - - - - - ranking = 1.2361265991041E-5keywords = aspiration (Clic here for more details about this article) |
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