Effectiveness of saliva and fingerprints as alternative specimens to urine and blood in forensic drug testing

In forensic drug testing, it is important to immediately take biological specimens from suspects and victims to prove their drug intake. We evaluated the effectiveness of saliva and fingerprints as alternative specimens to urine and blood in terms of ease of sampling, drug detection sensitivity, and drug detection periods for each specimen type. After four commercially available pharmaceutical products were administered to healthy subjects, each in a single dose, their urine, blood, saliva, and fingerprints were taken at predetermined sampling times over approximately four weeks. Fourteen analytes (the administered drugs and their main metabolites) were extracted from each specimen using simple pretreatments, such as dilution and deproteinization, and were analyzed using liquid chromatography/mass spectrometry (LC/MS). Most of the analytes were detected in saliva and fingerprints, as well as in urine and blood. The time‐courses of drug concentrations were similar between urine and fingerprints, and between blood and saliva. Compared to the other compounds, the acidic compounds, for example ibuprofen, acetylsalicylic acid, were more difficult to detect in all specimens. Acetaminophen, dihydrocodeine, and methylephedrine were detected in fingerprints at later sampling times than in urine. However, a relationship between the drug structures and their detection periods in each specimen was not found. Saliva and fingerprints could be easily sampled on site without using special techniques or facilities. In addition, fingerprints could be immediately analyzed after simple and rapid treatment. In cases where it would be difficult to immediately obtain urine and blood, saliva and fingerprints could be effective alternative specimens for drug testing. Copyright © 2015 John Wiley & Sons, Ltd.     

Spontaneous internal oblique hematoma successfully treated by transcatheter arterial embolization

Abdominal wall hematoma is an uncommon cause of acute abdominal pain. We report a case of internal oblique hematoma caused by rupture of the subcostal artery in a 57-year-old woman. Ultrasonography (US) showed a hypoechoic mass in the right lateral abdominal wall. Contrast-enhanced computed tomography (CT) showed a large soft tissue mass with extravasation of contrast medium located in the right internal oblique muscle. Angiography showed contrast extravasation from the subcostal artery, and transcatheter arterial embolization was performed successfully.     

Blood Density Monitoring During Dialysis

Abstract Continuous monitoring of blood density (BD) was preformed in 4 stable dialysis patients in 20 sessions using a density meter based on a mechanical oscillator technique. Mean predialysis and postdialysis BDs were 1.0427 ± 0.0031 g/cm³ and 1.0502 ± 0.0055 g/cm respectively. For similar predialysis to postdialysis total body water reduction, significant difference in the mean BD increase was found between hypotensive and nonhy-potensive groups (1.29 ± 0.07%, 0.47 ± 0.12%, respectively; p < 0.001). Eight hypotensive episodes occurred during 6 sessions. The mean value of the blood density changes slope (dBD/dt) during the 5 min preceding a hypotensive episode increased about 2.5 times more than did the mean of the predialysis to postdialysis blood density slope (27.6 ± 2.2 g/cm³ min 10^-5, 10.5 ± 0.4 g/cm³ min 10^-5 respectively; p < 0.001) under the condition of a constant ultrafiltration rate of 18.9 ± 0.6 ml/min. Continuous monitoring of blood density allows abrupt change in plasma volume to be identified and seems to have a potential utility to the prevention of symptomatic hypotension episodes in patients receiving hemodialysis.     

Predictive risk factors for peritoneal recurrence after pancreatic cancer resection and strategies for its prevention

Purpose

To evaluate the risk factors for peritoneal recurrence (PR) of pancreatic adenocarcinoma and to discuss the appropriate management strategies.

Methods

We reviewed the medical records of 236 patients who underwent pancreatectomy for pancreatic adenocarcinoma. We then compared the clinicopathological characteristics of patients with vs. those without PR. The independent risk factors for PR were defined using the Cox proportional hazards regression model.

Results

The median survival of patients with PR was 13.3 months after surgical treatment. The PR group had a significantly higher incidence of portal vein resection, longer operative time (≥648 min), greater blood loss (≥2179 mL), blood transfusion, tumor size, portal vein invasion, artery invasion, pancreatic nerve plexus invasion, and histological grade. Multivariate analysis revealed that excessive blood loss (≥2179 mL; P = 0.010), artery invasion (P = 0.025), pancreatic nerve plexus invasion (P = 0.001), and histological grade 3 (P = 0.011) were independent risk factors for PR. Excessive blood loss was also strongly related to tumor size (P = 0.018).

Conclusions

Local invasion and tumor size-related factors suggested the possibility of intraoperative dissemination at the time of tumor resection. Preoperative treatment and an operative procedure to prevent tumor exposure may help prevent PR.

     

Estimation of day of death using micro-segmental hair analysis based on drug use history: a case of lidocaine use as a marker

International Journal of Legal Medicine - During investigations of unnatural death, the time of death is generally estimated using anatomical examinations. However, it can be difficult to...     

Clinical evaluation of the cause of left ventricular dysfunction in type 2 diabetes without significant cardiac disease

OBJECTIVES: The relationship between left ventricular dysfunction and hypertension or proteinuria was evaluated in type 2 diabetic patients without significant cardiac disease to investigate the cause of diabetic cardiac dysfunction. METHODS: Twenty-one patients with type 2 diabetes mellitus (mean age 63.8 +/- 7.4 years) underwent left ventriculography and Doppler echocardiography to calculate the ejection fraction and E/A ratio (E/A). RESULTS: Thirteen patients had hypertension (61.9%) and six patients had proteinuria (28.6%). The E/A was 0.82 +/- 0.21 in all patients. The E/A in patients with hypertension or proteinuria was significantly less than in those without these diseases (0.74 +/- 0.18 vs 0.97 +/- 0.18, p = 0.011; 0.65 +/- 0.10 vs 0.89 +/- 0.20, p = 0.010, respectively). The ejection fraction was 73.3 +/- 7.2% in all patients. The ejection fraction in patients with proteinuria was significantly less than in those without proteinuria (67.6 +/- 10.0% vs 75.5 +/- 4.4%, p = 0.019), but there was no significant difference in ejection fraction between patients with and without hypertension. The duration of diabetes was significantly related to the ejection fraction (r = -0.436, p = 0.048) but not to the E/A. CONCLUSIONS: In patients with type 2 diabetes without significant cardiac disease, left ventricular diastolic function may be related to both hypertension and proteinuria and left ventricular systolic function may be related to proteinuria and duration of diabetes. Therefore, in addition to hypertension, complications of nephropathy or long duration of diabetes may be related to the cause of the diabetic cardiac dysfunction.     

Signet-ring cell carcinoma of the colon 7mm in size with peritonitis carcinomatosa

Received: November 24, 2000 / Accepted: April 27, 2001     

A case of metastatic chondrosarcoma of the stomach

A case of metastatic chondrosarcoma of the stomach in a 34-year-old female is reported. This patient had been diagnosed as having chondrosarcoma of the right knee and was operated on in 1984. There-after, there was repeated local recurrence and operations were performed on multiple metastases, including those of the lung, brain, ovary and spleen. In September, 1990, the patient was readmitted because of advanced anemia. Gastroendoscopy disclosed a firm elevated lesion with central irregular erosion. Histologically, there was cellular atypical cartilage with pleomorphic chondrocytes, which showed the same staining reactions as those in the primary lesion. Therefore this case was diagnosed as metastatic chondrosarcoma. This may be the first documentation of a case of gastric metastasis of chondrosarcoma.     

Molecular mass screening to incriminate sand fly vectors of Andean-type cutaneous leishmaniasis in Ecuador and Peru

Sand flies from the Andean areas of Ecuador and Peru were examined for Leishmania infections by using our recently established molecular mass screening method. Leishmanial minicircle DNA-positive sand flies were detected in 3 of 192 and 1 of 462 samples from Ecuador and Peru, respectively. Sand fly species were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) of the 18S ribosomal RNA (rRNA) gene, and the positive flies were Lutzomyia (Lu.) ayacuchensis and Lu. peruensis, respectively. Furthermore, cytochrome b and mannose-phosphate isomerase gene sequence analyses identified the parasites from Ecuador and Peru as Leishmania (Leishmania) mexicana and L. (Viannia) peruviana, respectively. Thus, the mass screening method was confirmed to be a powerful tool for sand fly research.