1
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Wang MF, Ouyang Y, Segura T, Muddiman DC. Optimizing neurotransmitter pathway detection by IR-MALDESI-MSI in mouse brain. Anal Bioanal Chem 2024; 416:4207-4218. [PMID: 38822822 DOI: 10.1007/s00216-024-05354-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024]
Abstract
Mass spectrometry imaging (MSI) platforms such as infrared matrix-assisted laser desorption electrospray ionization (IR-MALDESI) are advantageous for a variety of applications, including elucidating the localization of neurotransmitters (NTs) and related molecules with respect to ion abundance across a sample without the need for derivatization or organic matrix application. While IR-MALDESI-MSI conventionally uses a thin exogenous ice matrix to improve signal abundance, it has been previously determined that sucrose embedding without the ice matrix improves detection of lipid species in striatal, coronal mouse brain sections. This work considers components of this workflow to determine the optimal sample preparation and matrix to enhance the detection of NTs and their related metabolites in coronal sections from the striatal region of the mouse brain. The discoveries herein will enable more comprehensive follow-on studies for the investigation of NTs to enrich biological pathways and interpretation related to neurodegenerative diseases and ischemic stroke.
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Affiliation(s)
- Mary F Wang
- FTMS Laboratory for Human Health Research, Department of Chemistry, North Carolina State University, Raleigh, NC, USA
| | - Yunxin Ouyang
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Tatiana Segura
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - David C Muddiman
- FTMS Laboratory for Human Health Research, Department of Chemistry, North Carolina State University, Raleigh, NC, USA.
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2
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Bailey MJ, de Puit M, Romolo FS. Surface Analysis Techniques in Forensic Science: Successes, Challenges, and Opportunities for Operational Deployment. ANNUAL REVIEW OF ANALYTICAL CHEMISTRY (PALO ALTO, CALIF.) 2022; 15:173-196. [PMID: 35167323 DOI: 10.1146/annurev-anchem-061020-124221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Surface analysis techniques have rapidly evolved in the last decade. Some of these are already routinely used in forensics, such as for the detection of gunshot residue or for glass analysis. Some surface analysis approaches are attractive for their portability to the crime scene. Others can be very helpful in forensic laboratories owing to their high spatial resolution, analyte coverage, speed, and specificity. Despite this, many proposed applications of the techniques have not yet led to operational deployment. Here, we explore the application of these techniques to the most important traces commonly found in forensic casework. We highlight where there is potential to add value and outline the progress that is needed to achieve operational deployment. We consider within the scope of this review surface mass spectrometry, surface spectroscopy, and surface X-ray spectrometry. We show how these tools show great promise for the analysis of fingerprints, hair, drugs, explosives, and microtraces.
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Affiliation(s)
- Melanie J Bailey
- Department of Chemistry, Stag Hill Campus, University of Surrey, Guildford, United Kingdom;
| | - Marcel de Puit
- Netherlands Forensic Institute, The Hague, The Netherlands
- Delft University of Technology, Delft, The Netherlands
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3
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Jin X, Chen D, Li X, Zeng X, Xu L, Hu B, Xu G. Advances in forensic diagnosis of electric shock death in the absence of typical electrical marks. Int J Legal Med 2021; 135:2469-2478. [PMID: 34313847 DOI: 10.1007/s00414-021-02658-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022]
Abstract
Electrical injury is a relatively uncommon but potentially devastating form of multi-system injury with high morbidity and mortality. In common electric injury cases, it is usually difficult to find characteristic changes of electric injury in major organs by using routine histopathological test methods unless there are landmark traces of electric injury, known as electric marks. How to determine electric shock death, especially in the absence of typical electrical marks on the body surface in some cases (which account for about two-thirds of electric injury cases), remains a challenging problem in forensic practice. Our summary shows that many current related studies have focused their efforts to find characteristic histopathological changes in major organs of the body caused by electric injury. Based on the results obtained through comparison of the literature, we find that it may be more urgent and important to find the optimal autopsy or sampling sites in cases with no typical electric marks, knowing that these sites may often reflect the most significant histopathological changes of electric injury, for instance anatomy and sampling of the anterior wrist and the medial malleolus in cases involving the hand-to-foot electric circuit pathway. In this article, we make a summary of advances in identification methods of electric injury, hoping that it could provide some new insights for further research in this field.
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Affiliation(s)
- Xin Jin
- Forensic and Pathology Laboratory, Judicial Expertise Center, Jiaxing University Medical College, Jiaxing, 314001, ZJ, China
| | - Deqing Chen
- Forensic and Pathology Laboratory, Judicial Expertise Center, Jiaxing University Medical College, Jiaxing, 314001, ZJ, China
| | - Xuebo Li
- Key Laboratory of Evidence Identification in Universities of Shandong Province, Shandong University of Political Science and Law, Jinan, 250014, SD, China
| | - Xiansi Zeng
- Forensic and Pathology Laboratory, Judicial Expertise Center, Jiaxing University Medical College, Jiaxing, 314001, ZJ, China
| | - Long Xu
- Forensic and Pathology Laboratory, Judicial Expertise Center, Jiaxing University Medical College, Jiaxing, 314001, ZJ, China
| | - Bo Hu
- Department of Pathology and Key-Innovative Discipline Molecular Diagnostics, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing University, Jiaxing, 314001, ZJ, China
| | - Guangtao Xu
- Forensic and Pathology Laboratory, Judicial Expertise Center, Jiaxing University Medical College, Jiaxing, 314001, ZJ, China.
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4
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Legaz I, Barrera-Pérez E, Prieto-Bonete G, Pérez-Martínez C, Sibón A, Maurandi-López A, Pérez-Cárceles MD. Trace elements in forensic human lung: A new approach to the diagnosis of seawater drowning. A preliminary study. Forensic Sci Int 2021; 323:110815. [PMID: 33990017 DOI: 10.1016/j.forsciint.2021.110815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 03/01/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
The diagnosing of drowning remains one of the most challenging activities for the forensic pathologist. There is little information on the impact on the lung as a target organ in death by drowning. We aimed to investigate the concentration of trace elements in the lungs of people who had suffered different types of death to evaluate the discriminating ability of trace elements to identify seawater drowning (SWD). A total of 11 trace elements were analyzed by Inductively Coupled Plasma-Mass Spectrometry in 74 forensic cases. Sampler scanning electron microscopy and Energy Dispersive X-ray spectroscopy (EDX) were used to identify ultrastructural lung alterations. A Principal Component Analysis (PCA) of trace elements was carried out. The trace elements in SWD lungs were detected in the following order of concentration: Br˃Zn˃Sr˃Cr˃Cu˃As˃Pb˃Se˃Mn˃Ni˃Cd. Our results showed significantly higher concentrations of Br and Sr (P = 0.010 and P = 0.000) and significantly lower concentrations of Zn, Pb, Cu, Cd, and Se in SWD compared with other causes of death. After adjusting by confounder factors, Sr and Br remained as predictive independent factors for diagnosis of drowning (p = 0.042, in both cases). These results were confirmed by PCA, which revealed a wide separation between SWD and the rest of the causes of death. Our SWD cohort was characterized by high concentrations of the trace elements Br and Sr and low concentrations of Zn, Pb, Cu, Cd, and Se in lung tissue, while PCA showed its discriminatory capacity to identify death by seawater drowning. These findings, together with those obtained using other techniques, can be of great importance in the diagnosis of SWD.
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Affiliation(s)
- Isabel Legaz
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, Murcia, Spain.
| | | | - Gemma Prieto-Bonete
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Cristina Pérez-Martínez
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Agustín Sibón
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, Murcia, Spain; Institute of Legal Medicine and Forensic Science, Cádiz, Spain; Department of Didactics of Mathematical and Social Sciences, University of Murcia, Spain
| | - Antonio Maurandi-López
- Department of Didactics of Mathematical and Social Sciences, University of Murcia, Spain
| | - María D Pérez-Cárceles
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, Murcia, Spain
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5
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Brown HM, McDaniel TJ, Fedick PW, Mulligan CC. The current role of mass spectrometry in forensics and future prospects. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2020; 12:3974-3997. [PMID: 32720670 DOI: 10.1039/d0ay01113d] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Mass spectrometry (MS) techniques are highly prevalent in crime laboratories, particularly those coupled to chromatographic separations like gas chromatography (GC) and liquid chromatography (LC). These methods are considered "gold standard" analytical techniques for forensic analysis and have been extensively validated for producing prosecutorial evidentiary data. However, factors such as growing evidence backlogs and problematic evidence types (e.g., novel psychoactive substance (NPS) classes) have exposed limitations of these stalwart techniques. This critical review serves to delineate the current role of MS methods across the broad sub-disciplines of forensic science, providing insight on how governmental steering committees guide their implementation. Novel, developing techniques that seek to broaden applicability and enhance performance will also be highlighted, from unique modifications to traditional hyphenated MS methods to the newer "ambient" MS techniques that show promise for forensic analysis, but need further validation before incorporation into routine forensic workflows. This review also expounds on how recent improvements to MS instrumental design, scan modes, and data processing could cause a paradigm shift in how the future forensic practitioner collects and processes target evidence.
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Affiliation(s)
- Hilary M Brown
- Chemistry Division, Research Department, Naval Air Warfare Center, Weapons Division (NAWCWD), United States Navy Naval Air Systems Command (NAVAIR), China Lake, California 93555, USA.
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6
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Laser Ablation Inductively Coupled Plasma Spectrometry: Metal Imaging in Experimental and Clinical Wilson Disease. INORGANICS 2019. [DOI: 10.3390/inorganics7040054] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Wilson disease is an inherited disorder caused by mutations in the ATP7B gene resulting in copper metabolism disturbances. As a consequence, copper accumulates in different organs with most common presentation in liver and brain. Chelating agents that nonspecifically chelate copper, and promote its urinary excretion, or zinc salts interfering with the absorption of copper from the gastrointestinal tract, are current medications. Also gene therapy, restoring ATP7B gene function or trials with bis-choline tetrathiomolybdate (WTX101) removing excess copper from intracellular hepatic copper stores and increasing biliary copper excretion, is promising in reducing body’s copper content. Therapy efficacy is mostly evaluated by testing for evidence of liver disease and neurological symptoms, hepatic synthetic functions, indices of copper metabolisms, urinary copper excretions, or direct copper measurements. However, several studies conducted in patients or Wilson disease models have shown that not only the absolute concentration of copper, but also its spatial distribution within the diseased tissue is relevant for disease severity and outcome. Here we discuss laser ablation inductively coupled plasma spectrometry imaging as a novel method for accurate determination of trace element concentrations with high diagnostic sensitivity, spatial resolution, specificity, and quantification ability in experimental and clinical Wilson disease specimens.
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7
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Daruich A, Le Rouzic Q, Jonet L, Naud MC, Kowalczuk L, Pournaras JA, Boatright JH, Thomas A, Turck N, Moulin A, Behar-Cohen F, Picard E. Iron is neurotoxic in retinal detachment and transferrin confers neuroprotection. SCIENCE ADVANCES 2019; 5:eaau9940. [PMID: 30662950 PMCID: PMC6326753 DOI: 10.1126/sciadv.aau9940] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/28/2018] [Indexed: 05/12/2023]
Abstract
In retinal detachment (RD), photoreceptor death and permanent vision loss are caused by neurosensory retina separating from the retinal pigment epithelium because of subretinal fluid (SRF), and successful surgical reattachment is not predictive of total visual recovery. As retinal iron overload exacerbates cell death in retinal diseases, we assessed iron as a predictive marker and therapeutic target for RD. In the vitreous and SRF from patients with RD, we measured increased iron and transferrin (TF) saturation that is correlated with poor visual recovery. In ex vivo and in vivo RD models, iron induces immediate necrosis and delayed apoptosis. We demonstrate that TF decreases both apoptosis and necroptosis induced by RD, and using RNA sequencing, pathways mediating the neuroprotective effects of TF are identified. Since toxic iron accumulates in RD, we propose TF supplementation as an adjunctive therapy to surgery for improving the visual outcomes of patients with RD.
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Affiliation(s)
- Alejandra Daruich
- INSERM, UMRS1138, Team 17, From physiopathology of ocular diseases to clinical development, Université Sorbonne Paris Cité, Centre de Recherche des Cordeliers, 15 rue de l’Ecole de Médecine, 75006 Paris, France
- Department of ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
- Ophthalmology Department, Necker-Enfants Malades University Hospital, AP-HP, Paris, France
| | - Quentin Le Rouzic
- INSERM, UMRS1138, Team 17, From physiopathology of ocular diseases to clinical development, Université Sorbonne Paris Cité, Centre de Recherche des Cordeliers, 15 rue de l’Ecole de Médecine, 75006 Paris, France
| | - Laurent Jonet
- INSERM, UMRS1138, Team 17, From physiopathology of ocular diseases to clinical development, Université Sorbonne Paris Cité, Centre de Recherche des Cordeliers, 15 rue de l’Ecole de Médecine, 75006 Paris, France
| | - Marie-Christine Naud
- INSERM, UMRS1138, Team 17, From physiopathology of ocular diseases to clinical development, Université Sorbonne Paris Cité, Centre de Recherche des Cordeliers, 15 rue de l’Ecole de Médecine, 75006 Paris, France
| | - Laura Kowalczuk
- Department of ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - Jean-Antoine Pournaras
- Department of ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - Jeffrey H. Boatright
- Department of Ophthalmology, School of Medicine, Emory University, Atlanta, GA, USA
- Center of Excellence, Atlanta Veterans Administration Medical Center, Decatur, GA, USA
| | - Aurélien Thomas
- Geneva University Hospitals, Unit of Toxicology, CURML, Geneva, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland
| | - Natacha Turck
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland
- Geneva University, Department of Human Protein Science, Geneva, Switzerland
| | - Alexandre Moulin
- Department of ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - Francine Behar-Cohen
- INSERM, UMRS1138, Team 17, From physiopathology of ocular diseases to clinical development, Université Sorbonne Paris Cité, Centre de Recherche des Cordeliers, 15 rue de l’Ecole de Médecine, 75006 Paris, France
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland
- Ophtalmopole, Cochin Hospital, AP-HP, Assistance Publique Hôpitaux de Paris, 24 rue du Faubourg Saint-Jacques, 75014 Paris, France
- Corresponding author.
| | - Emilie Picard
- INSERM, UMRS1138, Team 17, From physiopathology of ocular diseases to clinical development, Université Sorbonne Paris Cité, Centre de Recherche des Cordeliers, 15 rue de l’Ecole de Médecine, 75006 Paris, France
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8
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Aljakna A, Lauer E, Lenglet S, Grabherr S, Fracasso T, Augsburger M, Sabatasso S, Thomas A. Multiplex quantitative imaging of human myocardial infarction by mass spectrometry-immunohistochemistry. Int J Legal Med 2018; 132:1675-1684. [PMID: 29556718 DOI: 10.1007/s00414-018-1813-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 02/22/2018] [Indexed: 02/01/2023]
Abstract
Simultaneous assessment of a panel of protein markers is becoming essential in order to enhance biomarker research and improve diagnostics. Specifically, postmortem diagnostics of early myocardial ischemia in sudden cardiac death cases could benefit from a multiplex marker assessment in the same tissue section. Current analytical antibody-based techniques (immunohistochemistry and immunofluorescence) limit multiplex analysis usually to not more than three antibodies. In this study, mass spectrometry-immunohistochemistry (MS-IHC) was performed by combining laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) with rare-metal-isotope-tagged antibodies as a technique for multiplex analysis of human postmortem myocardial tissue samples. Tissue sections with myocardial infarction were simultaneously analyzed for seven primary, rare-metal-isotope-tagged antibodies (troponin T, myoglobin, fibronectin, C5b-9, unphosphorylated connexin 43, VEGF-B, and JunB). Comparison between the MS-IHC approach and chromogenic IHC showed similar patterns in ionic and optical images. In addition, absolute quantification was performed by MS-IHC, providing a proportional relationship between the signal intensity and the local marker concentration in tissue sections. These data demonstrated that LA-ICP-MS combined with rare-metal-isotope-tagged antibodies is an efficient strategy for simultaneous testing of multiple markers and allows not only visualization of molecules within the tissue but also quantification of the signal. Such imaging approach has a great potential in both diagnostics and pathology-related research.
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Affiliation(s)
- Aleksandra Aljakna
- University Center of Legal Medicine, Lausanne-Geneva, Rue Michel-Servet, 11211, Geneva, Switzerland
| | - Estelle Lauer
- University Center of Legal Medicine, Lausanne-Geneva, Rue Michel-Servet, 11211, Geneva, Switzerland
| | - Sébastien Lenglet
- University Center of Legal Medicine, Lausanne-Geneva, Rue Michel-Servet, 11211, Geneva, Switzerland
| | - Silke Grabherr
- University Center of Legal Medicine, Lausanne-Geneva, Rue Michel-Servet, 11211, Geneva, Switzerland
| | - Tony Fracasso
- University Center of Legal Medicine, Lausanne-Geneva, Rue Michel-Servet, 11211, Geneva, Switzerland
| | - Marc Augsburger
- University Center of Legal Medicine, Lausanne-Geneva, Rue Michel-Servet, 11211, Geneva, Switzerland
| | - Sara Sabatasso
- University Center of Legal Medicine, Lausanne-Geneva, Rue Michel-Servet, 11211, Geneva, Switzerland
| | - Aurélien Thomas
- University Center of Legal Medicine, Lausanne-Geneva, Rue Michel-Servet, 11211, Geneva, Switzerland.
- Faculty of Biology and Medicine, University of Lausanne, Vulliette 04, 1000, Lausanne 25, Switzerland.
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Luo R, Su X, Xu W, Zhang S, Zhuo X, Ma D. Determination of arsenic and lead in single hair strands by laser ablation inductively coupled plasma mass spectrometry. Sci Rep 2017; 7:3426. [PMID: 28611353 PMCID: PMC5469827 DOI: 10.1038/s41598-017-03660-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 05/03/2017] [Indexed: 01/29/2023] Open
Abstract
The purpose of this study was to develop matrix-matched hair standards and a LA-ICP-MS technique for determination of the As and Pb in a single human hair using single spot scan mode. These results could subsequently be used to infer when the element entered the body. This study was conducted in two parts. First, a method was developed and validated for the elemental analysis of hair by LA-ICP-MS. A calibration strategy in LA-ICP-MS was developed using prepared matrix-matched laboratory hair standards doped with analytes of interest at a defined concentration. The use of hair strand standards enables calibration curves to be obtained by plotting the analyte ion (M+) intensity normalized to34S+(the ratio M+/34S+) as a function of the concentration determined by ICP-MS of the acidic digests. The linear correlation coefficients (R2) of the calibration curves for the analytes As and Pb were typically between 0.9970 and 0.9998, respectively. Second, an actual hair was measured using the developed method. The spatial distribution of As along the hair was observed in a hair sample from a leukaemia patient treated with arsenic trioxide (As2O3). The actual and estimated times over which the drug entered the body were compared and discussed.
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Affiliation(s)
- Ruxin Luo
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R.China, Shanghai, 200063, Shanghai, China
| | - Xiaohong Su
- Lanzhou Industry Research Institude, Lanzhou, 730000, China
| | - Weicong Xu
- Department of Health Inspection and Quarantine, School of Public Health, Southern Medical University, Key Laboratory of Military Preventive Medicine of Guangdong Province, Guangzhou, 510515, China
| | - Sujing Zhang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R.China, Shanghai, 200063, Shanghai, China
| | - Xianyi Zhuo
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R.China, Shanghai, 200063, Shanghai, China
| | - Dong Ma
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R.China, Shanghai, 200063, Shanghai, China.
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Comment L, Varlet V, Ducrot K, Grabherr S. A fatal case of oxygen embolism in a hospital. Forensic Sci Res 2017; 2:100-106. [PMID: 30483626 PMCID: PMC6197113 DOI: 10.1080/20961790.2017.1329695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/05/2017] [Indexed: 01/26/2023] Open
Abstract
This case reports on a 68-year-old man who was found dead in hospital next to his bed. Before this, he had been treated with intravenous antibiotics for pneumonia. The body was found with a peripheral venous catheter connected to a nasal cannula delivering oxygen (O2) from the wall. Extensive medico–legal examinations were performed, including post-mortem computed tomography (CT), complete conventional autopsy, histological and immunohistochemistry analysis, toxicological analysis and post-mortem chemistry. Additionally, CT-guided gas sampling was performed at multiple sites to collect samples for gas analysis. During the external examination, massive subcutaneous emphysema was visible over the entire surface of the body. The CT scan revealed the presence of gas throughout the vascular system, and in the subcutaneous and muscular tissues. The autopsy confirmed the presence of lobar pneumonia and multiple gas bubbles in the vascular system. The gas analysis results showed a subnormal concentration of oxygen, confirming the suspected pure O2 embolism. Moreover, the carbon dioxide (CO2) concentration in the gas sample from the heart was elevated to a level similar to those found in scuba diving fatalities. This could come from degassing of dissolved CO2 that accumulated and was trapped in the cardiac cavity. Based on the results of the different exams performed, and especially the gas analysis results, it was concluded that the cause of death was O2 embolism.
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Affiliation(s)
- Lionel Comment
- Forensic Medicine Unit, University Center of Legal Medicine, CHUV Hospital, Lausanne-Geneva, Switzerland
| | - Vincent Varlet
- Forensic Toxicology and Chemistry Unit, University Center of Legal Medicine, CHUV Hospital, Lausanne-Geneva, Switzerland
| | - Kewin Ducrot
- Unit of Forensic Imaging and Anthropology, University Center of Legal Medicine, CHUV Hospital, Lausanne-Geneva, Switzerland
| | - Silke Grabherr
- Unit of Forensic Imaging and Anthropology, University Center of Legal Medicine, CHUV Hospital, Lausanne-Geneva, Switzerland
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