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[From medicolegal toxicology to forensic toxicology].

The importance of forensic toxicology has been increasing until now, because of the increasing numbers of toxic substances and poisoning incidents. In Japan, a special translational word "houi-chudoku-gaku" has been used for the forensic toxicology especially in the field of legal medicine. The Japanese word, however, does not seem appropriate for translation of forensic toxicology, because it covers medicine, pharmacy and police sciences interdisciplinary. In 1980, Emeritus Prof. Hidetoshi Yoshimura created an appropriate word "hochudoku-gaku" for translation of forensic toxicology. In 1982, Prof. Yoshimura and his friends established the Japanese Association of Forensic Toxicology, consisting of people from legal medicine, pharmacy and police institutes. This Association enabled lively discussions among different fields and greatly contributed to advances of forensic toxicology in Japan. We started studies of forensic toxicology using gas chromatography (GC)/mass spectrometry (MS) in 1979. Until now, we delt with solid-phase extraction (1987-1994), surface ionization GC (1989-1997), negative ion chemical ionization MS (1981-now), solid-phase microextraction (1994-now), cryogenic oven trapping GC (1997-now), surface ionization organic MS (1998-now) and high-performance liquid chromatography/tandem MS (1998-now). In this review, the author presents some details of solid-phase microextraction, negative ion chemical ionization MS, cryogenic oven trapping GC and surface ionization organic MS. Unprecedented poisoning terrorism by use of sarin took place in Matsumoto and Tokyo in 1994 and 1995, respectively. On July 25, 1998, a curry poisoning incident using arsenious acid occurred in Wakayama, resulting in the death of 4 people and injury of 63 people. Since then, more than 30 imitative poisoning cases have been reported by mass communication within 1 year. In spite of the above continuing poisoning cases, almost no effective measures have been taken by the administration of our country and local governments. Many serious problems concerning poisoning and drug abuse are accumulating in Japan. In this review, the problems are also made manifest, and some proposals are presented to solve the problems.

Forensic Medicine↗

Recent trends in analytical procedures in forensic toxicology.

Forensic toxicology is a very demanding discipline,heavily dependent on good analytical techniques. That is why new trends appear continuously. In the past years. LC-MS has revolutionized target compound analysis and has become the trend, also in toxicology. In LC-MS screening analysis, things are less straightforward and several approaches exist. One promising approach based on accurate LC-MSTOF mass measurements and elemental formula based library searches is discussed. This way of screening has already proven its applicability but at the same time it became obvious that a single accurate mass measurement lacks some specificity when using large compound libraries. CE too is a reemerging approach. The increasingly polar and ionic molecules encountered make it a worthwhile addition to e.g. LC, as illustrated for the analysis of GHB. A third recent trend is the use of MALDI mass spectrometry for small molecules. It is promising for its ease-of-use and high throughput. Unfortunately, re-ports of disappointment but also accomplishment, e.g. the quantitative analysis of LSD as discussed here, alternate, and it remains to be seen whether MALDI really will establish itself. Indeed, not all new trends will prove themselves but the mere fact that many appear in the world of analytical toxicology nowadays is, in itself, encouraging for the future of (forensic) toxicology.

Chemistry Techniques, Analytical↗

Forensic toxicology: web resources.

Forensic toxicology is the study and practice of the application of toxicology to the purposes of the law. The internet provides abundant web-sites and resources for the practicing forensic toxicologist and those interested in the field of forensic toxicology. This review includes a description of web-sites, databases of toxicological and analytical data, and web-based journals, forums and mailing lists.

Databases as Topic↗

Importance of information in forensic toxicology.

Information in forensic toxicology plays a very important role. The forensic pathologist usually seeks toxicologic analyses on basis of the information available at the time of the medicolegal autopsy. Such information may be obtained from different sources: hospitals, authorities, relatives, friends, or neighbors of the deceased and, obviously, macroscopic findings at the time of the autopsy. In order to evaluate the relative importance of these different sources of information, the authors have studied, retrospectively, results of 580 postmortem examinations performed at the Institute of Legal Medicine of Lisbon, wherein toxicologic analyses had been requested. These cases pertain to the years 1987 and 1988, but do not include alcohol determination in the blood in cases of traffic accidents. In 274 (47.4%) of the 580 cases, there were positive findings while in the remaining 306 (52.6%) findings were negative. In cases with positive findings, circumstances and factors, which may have influenced the pathologist's decision to request toxicologic analysis, are discussed. In more than half the cases, hospital information was the decisive factor, while in approximately 25% of the cases, autopsy findings were the justification. In contrast, it is worth mentioning that in approximately 45% of the cases with analytical negative results, requests were made, in cases of blank autopsies, for toxicologic analyses in order to exclude the possibility of poisoning. It is interesting to note that in the same proportion requests were justified on grounds of hospital information. Some of the factors that may explain this apparent discrepancy are discussed. Finally, the relevance of background information is emphasized at the level of the interpretation of analytical results, whether positive or negative.(ABSTRACT TRUNCATED AT 250 WORDS)

Carbon Monoxide Poisoning↗

[Continuous challenges in Japanese forensic toxicology practice: strategy to address specific goals].

In this paper, the status quo of forensic toxicology in Japan and the West is surveyed and a strategy to address future goals of Japanese forensic toxicology is proposed. Forensic toxicology in the West consists of three main areas--post-mortem forensic toxicology, human-performance forensic toxicology and forensic urine drug testing. In Japan, post-mortem forensic toxicology is practiced in university forensic medicine departments while most of the human-performance forensic toxicology is carried out in police laboratories. However, at least at present, strictly controlled workplace urine drug testing is not being performed, despite the abuse of drugs even by uniformed members of the National Defence Forces and police. For several years, the author has been introducing Western forensic toxicology guidelines and recommendations, translated into Japanese with the help of Western forensic toxicologists, to Japanese forensic toxicologists. Western forensic toxicology practice is at an advanced stage, whereas Japanese practice is in a critical condition and holds many problems awaiting solution, as exemplified by the urine drug testing in police laboratories. There is never any sample left for re-examination by the defence in all cases, though the initial volume of the urine sample available for examination is 30-50 ml. Only one organisation carries out everything from sampling to reporting and, in addition, the parent drug and its metabolites are not quantified. It is clear that the police laboratories do not work within good laboratory practice guidelines, nor do they have quality manuals or standard operating procedures manuals. A basic change in Japanese forensic toxicology practice is now essential. The author strongly recommends that, first of all, Japanese toxicologists should prepare forensic toxicology guidelines based on the Western models. The guidelines would progress the following objectives for forensic toxicology laboratories: 1) to have documented good laboratory practice standards; 2) to have a quality control system including a quality manual and standard operating procedures manual; 3) to have some degree of compulsion to implement quality assurance both through their own internal efforts and by appropriate remedial actions based on the results of an external proficiency testing scheme. For forensic toxicologists, the implications are that they should be: 1) responsible for ensuring that laboratory practices are performed under satisfactory conditions and 2) required to be certified as a forensic toxicology specialist in order to prove their forensic toxicology ability. For their part, governments should: 1) carry out administrative reforms related to forensic toxicology; 2) simplify the procedure for obtaining certified reference materials; 3) introduce a strict workplace urine drug testing programme for government employees, at least for those related to law enforcement. When all of these objectives have been realised, the specific goal will be achieved through which Japanese forensic toxicology is able, in practice, to fulfill its responsibility to society.

Forensic Medicine↗

Computer-assisted systems for forensic pathology and forensic toxicology.

A computer software, RättsBASE (RB), was developed for all forensic pathology units in Sweden and introduced in 1992. Simultaneously, a corresponding software, ToxBASE (TB), was developed for the Department of Forensic Toxicology, where all forensic toxicology in Sweden is managed. Both of the databases were created using dBASE IV, and the programming was carried out according to specifications from the staff at the forensic toxicology and forensic pathology units. since the development or RB and TB was coordinated, the systems can run together smoothly. The purpose of both systems was to automate the offices and to enable compilation of detailed statistics. Installation of Novell Netware and ISDN-connections (Integrated Service Digital Network) has enabled rapid communication between the units and easy compilation of nationwide statistics of forensic pathology and forensic toxicology. the systems offer a wide spectrum of reports and include a simple module for evaluation of the importance of the forensic efforts for th whole death investigation. The configuration of the softwares has also enabled processing of a large amount of related toxicological and autopsy data that in turn has yielded a base for compilation of toxicology interpretation lists. This article includes a summary of the features of the software and a discussion of its benefits and limitations.

Autopsy↗

Historic development of forensic toxicology in America up to 1978.

The development of forensic toxicology in the United States is reviewed from colonial times. Medical education started expanding after Independence, but no program in medical jurisprudence existed until 1804, when Dr. James S. Stringham initiated such a teaching program at Columbia University in New York City. Since then, instruction in medical jurisprudence has become more or less a part of the medical school's curriculum. Little has been written in the field of toxicology in contrast to overall European development. With the availability of contributions from European and British authors, the development of chemical toxicology in this country started to take shape, with significant progress occurring after the Civil War. The original contributions in toxicology were done by Drs. Wormley, Reese, and Witthaus. The faults of the coroner system led its replacement in Massachusetts with the office of medical examiner in 1877. The Chief Medical Examiner's Office of New York started functioning in 1918 and a toxicology laboratory was founded under the direction of Dr. Alexander Gettler, whose students spread the ideas of toxicology throughout the country. This institution is regarded as the birthplace of American forensic toxicology. Other significant events include the formation of the American Academy of Forensic Sciences after World War II and the establishment of the American Board of Forensic Toxicology in 1975; both have contributed greatly to the development of forensic toxicology in the United States.

Adult↗

[The role of laboratory methods in clinical and forensic toxicology].

In the present work problems of differences between laboratory methods used in contemporary toxicological clinical and forensic analysis. The significance of instrumental methods as a factor quarantined proper level of scientific investigation has been underlined. A role of an analyst in clinical laboratory and an expert in toxicological forensic areas has been discussed.

Chemistry Techniques, Analytical↗

Forensic toxicology. An overview and an algorithmic approach.

Forensic toxicology has benefited from advances in immunoassay and thin layer chromatography (Toxi-Lab) chemistry and widespread availability of sophisticated instrumentation, such as gas chromatography with mass spectroscopy. Coupled with the increasingly widespread proliferation of illicit drugs of abuse, these have added new challenges to old adversaries in the medicolegal investigation of death. This article presents a comprehensive approach to forensic toxicology from a metropolitan medical examiner's office with emphasis on common questions and problems encountered in this discipline.

Algorithms↗