Małgorzata Kłys

A chemical and physicochemical study of an egyptian mummy 'Iset Iri Hetes' from the Ptolemaic period III-I B.C.

Chemical and physicochemical examinations of the fragments of an Egyptian mummy dated between the 3rd and 1st century B.C. were performed. The chemical examinations indicated the presence of resin in the skull and in the fragments of bandages wrapped around the mummy. An analysis of the infrared spectra of the fragments indicated a type of resin originating from the Copal group. Physicochemical investigations showed that main chemical elements such as Ca, Mg, Na, K, P and trace chemical elements such as Fe, Zn, Cu, and Pb occurred in bone fragments in proportions typical for people living today. In tooth fragments, values were similar to normal except for K, P, and Zn, which were lower, and Pb, which was absent. In the fingernails, most elements were found in much higher concentrations except for Cu and Pb, which were lower. The results of the study in terms of their implications on mummification are discussed.

A case of suicide by intravenous injection of pancuronium

This report details a suicide by pancuronium bromide injection by a 31-year old female anesthesiologist. Pancuronium bromide was identified in the blood and brain by means of ion-pair extraction followed by thin-layer chromatography, spectrophotometry and electrospray ionization/tandem mass spectrometry. After this positive identification, the levels of pancuronium were carefully quantified by spectrophotometry: 1.05 mg/ml in the blood and 0.51 mg/g in the brain. The cause of death was judged to be asphyxia due to respiratory muscle paralysis caused by pancuronium.

Ethanol-related death of a child: An unusual case report

The report describes a fatal outcome in a 5-year-old male who died after drinking a fatal dose of ethanol at the party held by his parents. Urine and blood alcohol level of the deceased was 0.4 and 0.5 g/dL, what might explain the sudden death of the child. In addition, the analysis of the boys hair demonstrated the presence of ethyl glucuronide (EtG), a marker of alcohol consumption; hair EtG concentration levels indicated that the boy might have occasionally imbibed alcohol prior to death. Pathological lesions of the liver observed in histopathology did not contradict such a hypothesis.

Usefulness of multiple opiate and amphetamine analysis of hair segments under methadone therapy using LC-APCI-MS-MS

A detailed procedure for simultaneous analysis of morphine, codeine, 6-monoacetylmorphine, amphetamine, methadone, and its metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) in human hair segments by liquid chromatography (LC)-atmospheric pressure chemical ionization (APCI)-tandem mass spectrometry (MS-MS) was established. Hair samples were pulverized and extracted with methanol. The blank hair obtained from healthy subjects showed no interfering impurity peaks. Good linearity was obtained for all compounds in the range of 0.2–20 ng/mg. Accuracy and precision data were also satisfactory. Using the established method, the opiates, amphetamine, methadone, and EDDP in hair segments were measured for 20 patients undergoing methadone therapy. Complete abstinence was achieved by only 6 of the 20 patients. Other patients failed to abstain from opiate(s) and/or amphetamine. Our data show that the present hair analysis of multiple drugs of abuse by LC-APCI-MS-MS is useful for monitoring the success or failure of methadone therapy.

Death of a female cocaine user due to the serotonin syndrome following moclobemide–venlafaxine overdose

To our knowledge, the majority of evidence supporting the relationship between the serotonin syndrome and medications that effect 5HT is based on case reports. The justification for taking up this subject has been a fatal outcome of a 21 year-old female following an administration of toxic doses of moclobemide (MAOI) and venlafaxine (SNRI). As a result of complex toxicological investigations including antemortem and postmortem material, antemortem clinical observations and postmortem examinations, the cause of death was identified as overdose with antidepressants--moclobemide and venlafaxine--in the mechanism of the clinically fully developed severe toxic serotonin syndrome. The analysis of a hair strand collected from the victim documented the use of the above-mentioned drugs simultaneously with cocaine in the period of at least 20 months preceding death. The fact is a matter of considerable interest in view of the employed pharmacotherapy, giving rise to suspicion that the woman had not developed the serotonin syndrome during the almost 2-year antemortem period until she took toxic doses of both medications.

A serological and histological study of the Egyptian mummy 'Iset Iri Hetes' from the Ptolemaic period III-I B.C.

Serological and histological examinations of the muscles of the calf of an Egyptian mummy dated between the third and first centuries B.C. were performed. Human protein was identified, the ABO phenotype was determined as type B, and morphological disruption of the cells was observed.

Four nonfatal and six fatal cases of opiate use: utility of morphine, its metabolites, and their ratios in blood specimens

Four nonfatal and six fatal cases of opiate use are presented with careful toxicological analysis. Levels of morphine (M), 6-monoacetylmorphine (6-MAM), morphine-6-glucuronide (M6G), and morphine-3-glucuronide (M3G) in blood specimens were measured by the sophisticated method of liquid chromatography (LC)-electrospray ionization (ESI)-tandem mass spectrometry (MS-MS). Fatal cases were characterized by much higher levels of free M than the nonfatal cases; this caused lower ratios of M6G/M and M3G/M in the fatal cases when compared with the nonfatal cases. Among the six fatal cases, the M6G/M ratios were especially low in four cases, in which rapid deaths were estimated. The present data are compared with data previously reported by other groups, and we discuss the utility of the levels of M, M6G, and M3G in blood and their ratios for estimating the antemortem status of each individual.

Population pharmacokinetic modelling of valproic acid and its selected metabolites in acute VPA poisoning

BACKGROUND Valproic acid (VPA) is a first-line antiepileptic drug. It is used in the treatment of many different types of partial and generalized epileptic seizures. Though the clinical pharmacokinetics of VPA has been well defined, information about pharmacokinetics after overdoses is rare. The aim of this study was to try to build a population pharmacokinetic model that would describe the time course of VPA and its selected metabolites when the drug is ingested in an overdose situation. METHODS Blood samples were collected during admission to the hospital and several times during treatment for poisoning (10 men and 10 women). The concentration of VPA and its metabolites were determined by liquid chromatography coupled with mass spectrometry. For population pharmacokinetic evaluation of VPA and its metabolites, the two-compartment-model was applied. RESULTS The estimated doses of VPA taken ranged from 6 to 65g, while the time after ingestion ranged from 1 to 30h. Results showed that the β-oxidation process exhibited Michaelis-Menten kinetics becoming saturated during acute intoxication. The same could not be said for the desaturation route. VPA therapy increased the Vmax for β-oxidation by 59% while decontamination appeared to be of moderate efficacy lowering the F value by 34% on the average. CONCLUSIONS None of the models perfectly described the experimental data. Important factors like the variable degree of protein binding by VPA could not be included in the models. The small number of subjects used in the study made the analysis of more covariates impossible.

Death of a female addict due to heroin and cocaine overdoses: a case report with multiparameter evaluation

This study undertook a multiparameter evaluation of the death of a 21-year-old woman known to be an abuser of heroin and cocaine. The toxicological analysis of multiple postmortem specimens such as blood and hair was carried out using liquid chromatography atmospheric pressure chemical ionization tandem mass spectrometry (LC-APCI-MS-MS). The blood specimens of the deceased showed the presence of opium components such as morphine and its glucuronides together with cocaine and benzoylecgonine. The detected xenobiotic levels probably explained the cause of her death resulting from combined action of unintentional illicit drug overdose. By analysis of four 2-cm long hair segments, a heroin-cocaine addiction for at least 8 months antemortem was able to be documented; the presence of 6-monoacetylmorphine (6-MAM), cocaine, and benzoylecgonine was demonstrated. The histopathological findings of lesions of the internal organs of the deceased were consistent with long heroin and cocaine abuse. The use of multiple parameters, such as blood and hair segments as matrices and drug metabolites such as 6-MAM, morphine, glucuronides, and benzoylecgonine as target compounds, gave a well-defined outline of her death.

Forensic medical examination of the corpse of General Władysław Sikorski, a putative victim of assassination in 1943

The Krakow Department of Forensic Medicine was granted a unique opportunity to examine the body of a historical figure, i.e. General Władysław Sikorski, the Prime Minister of the Polish government in exile, deceased in 1943. General Sikorski died in the crash of a Liberator aircraft at Gibraltar, and the British commission investigating the crash decided it had been an accident. In the past several decades, doubts have been repeatedly expressed as to the circumstances of the Generals death and the theory of assassination has become very popular. On November 25, 2008, the Generals corpse buried in the cathedral of the Royal Castle on Wawel Hill in Krakow was exhumed and the body was thoroughly examined. The examinations demonstrated numerous fractures of the cranium, spine and extremities, the character of which corresponded to effects of an air crash. Based on corpse examination alone it was impossible to establish whether the air crash had been an effect of sabotage or an ill-fated accident. Although no typical evidence of intravitality was found, such as bruises or fat embolisms, yet the character of some fractures suggested that they had been incurred intravitally. These were represented by a spiral fracture of the femoral bone shaft, a fracture of the sustentaculum tali of the calcaneal bone and fractures of the transverse processes of the lumbar vertebrae.