Recent developments in methanol toxicity

Honey as a Cytological Fixative: A Comparative Study With 95% Alcohol

Background

Ninety-five percent (95%) ethyl alcohol (ethanol) has been used as a standard cytological fixative but it is expensive, difficult to procure, and has addictive properties. Alternate substitutes like methanol, which give similar results to ethanol, have toxic potential. Honey, a known preservative, is an eco-friendly fixative and is of great value when ethanol is unavailable and economizing on cost is necessary. The present study was done to assess and compare the fixation property and cytomorphological features of smears fixed in 20% honey in comparison to 95% ethyl alcohol and to determine whether the former can be used as an alternative cytological fixative in routine practice.

Material and methods

The present prospective study was done in the cytology section of the Department of Pathology for one and a half years on 300 cytological samples comprising 100 samples each of various body fluids (peritoneal, pleural, bronchoalveolar lavage, and urine), cervical smears, and fine-needle aspiration samples. The smears from all the 300 cytological samples were fixed separately in 95% ethanol and 20% unprocessed natural honey for a minimum of 15 minutes and were then stained with Papanicolaou (Pap) stain. The cytomorphological parameters of both the smears were compared based on set criteria. Relevant statistical analysis was done using the student t-test, chi-square test, and test of agreement (kappa statistics).

Results

A comparable and good-quality staining pattern, preservation of morphology, and crisp nuclear and cytoplasmic staining were observed between the two fixatives for all three types of samples with a strong agreement between them (kappa value varying between 0.896 and 0.942) and a p-value of <0.05.

Conclusion

Natural honey is a readily available and non-toxic alternative to ethanol as a cytological fixative and can be used in routine practices, especially in resource-constrained settings.

Biochemical mechanism underlying the pathogenesis of diabetic retinopathy and other diabetic complications in humans: the methanol-formaldehyde-formic acid hypothesis

Hyperglycemia in diabetic patients is associated with abnormally-elevated cellular glucose levels. It is hypothesized that increased cellular glucose will lead to increased formation of endogenous methanol and/or formaldehyde, both of which are then metabolically converted to formic acid. These one-carbon metabolites are known to be present naturally in humans, and their levels are increased under diabetic conditions. Mechanistically, while formaldehyde is a cross-linking agent capable of causing extensive cytotoxicity, formic acid is an inhibitor of mitochondrial cytochrome oxidase, capable of inducing histotoxic hypoxia, ATP deficiency and cytotoxicity. Chronic increase in the production and accumulation of these toxic one-carbon metabolites in diabetic patients can drive the pathogenesis of ocular as well as other diabetic complications. This hypothesis is supported by a large body of experimental and clinical observations scattered in the literature. For instance, methanol is known to have organ- and species-selective toxicities, including the characteristic ocular lesions commonly seen in humans and non-human primates, but not in rodents. Similarly, some of the diabetic complications (such as ocular lesions) also have a characteristic species-selective pattern, closely resembling methanol intoxication. Moreover, while alcohol consumption or combined use of folic acid plus vitamin B is beneficial for mitigating acute methanol toxicity in humans, their use also improves the outcomes of diabetic complications. In addition, there is also a large body of evidence from biochemical and cellular studies. Together, there is considerable experimental support for the proposed hypothesis that increased metabolic formation of toxic one-carbon metabolites in diabetic patients contributes importantly to the development of various clinical complications.

Enhanced hydrogen generation efficiency of methanol using dielectric barrier discharge plasma methodology and conducting sea water as an electrode

In this work, methanol decomposition method has been discussed for the production of hydrogen gas with the application of plasma. A simple dielectric barrier discharge (DBD) plasma reactor was designed for this purpose with two types of electrode. The DBD plasma reactor was experimented by substituting one of the metal electrodes with feebly conducting sea water which yielded better efficiency in producing hydrogen gas. Experimental parameters such as; discharge voltage and time were varied by maintaining a discharge gap of 1.5 mm and the plasma discharge characteristics were studied. Filamentary type micro-discharges were found to be formed which was observed as numerous streamer clusters in the current waveform. Gas chromatographic study confirmed the production of hydrogen gas with residence time around 3.6 min. Although, the concentration (%) of H₂ was high (98.1 %) and consistent with copper electrode assembly, the rate of formation and concentration was found to be the highest (98.7 %) for water electrode for specific discharge voltage. The energy efficiency was found to be 0.5 mol H₂/kWh and 1.2 mol H₂/kWh for metal (Cu) and water electrodes respectively. The electrode material significantly affects the plasma condition and hence the rate of hydrogen production. Compositional analysis of the water used as electrode showed a minimal change in the composition even after the completion of the experiment as compared to the untreated water. Methanol degradation study shows the presence of untreated methanol in the residue of the plasma reactor which has been confirmed from the absorption spectra.

Grape brandy production, composition and sensory evaluation

Grape brandy is a spirit drink produced by wine distillation and is matured in wooden casks. According to legislation, it can be characterised by the geographical area where the grapes were produced, the grape variety used and the selected distillation and ageing techniques. Distillation increases ethanol concentration and aromatic constituents which are already present in grapes or are developed during fermentation and distillation. During maturation in wooden casks, compounds that contribute to the aroma and taste are extracted from the wood. Hence the spirit acquires the desired softer mouth feel, aromatic complexity and overall quality. Different methods of analysis are used in order to pursuit this process by analysing volatile and non-volatile substances and correlate composition with quality. Analysis can also be useful in identification of brandy safety, potential adulterations, provenance and differentiation from other spirits drinks.

Apparent metabolizable energy of crude glycerin originating from different sources in broiler chickens

An energy balance experiment was conducted to determine the AME(n) of various crude glycerin samples, and to generate an equation to predict AME(n) of crude glycerin based on its chemical composition. Dietary treatments consisted of a corn-soybean meal basal diet with no added glycerin and a basal diet supplemented with 6% glycerin. Crude glycerin samples were obtained from biodiesel production facilities throughout the United States, which use a variety of lipid products as their initial feedstock. Two identical energy balance trials were conducted. In each trial, 864 male broilers (Ross × Ross 708) were fed a common starter diet until 17 d of age when they were switched to 1 of 12 experimental diets (6 replicates per treatment) from 17 to 22 d of age, with a 48-h collection period on d 21 and 22. Nitrogen-corrected apparent metabolizable energy values of crude glycerin samples were estimated by difference, whereby AME(n) of the basal diet was subtracted from the complete diet containing the test ingredient. The AME(n) of the basal diet and US Pharmacopeia-grade glycerin were determined to be 3,085 and 3,662 kcal/kg, respectively, whereas the AME(n) of the 10 crude glycerin samples ranged from 3,254 to 4,134 kcal/kg. Two crude glycerin samples had high levels of fatty acids compared with the other samples (24 and 35% vs. <0.30%), and even though their AME(n) was higher than that of the other glycerin samples (3,806 vs. 3,611 kcal/kg, P < 0.01, respectively), their AME(n) as a percentage of gross energy (GE) was lower than that of the other samples (65.5% vs. 97.4%, respectively; P < 0.01). Including all of the glycerin samples, the stepwise regression equation to predict AME(n) was determined to be: [AME(n) (kcal/kg) = 1,605 - (19.13 × % methanol) + (39.06 × % fatty acid) + (23.47 × % glycerin)]; (R(2) = 0.25; SE = 379; P ≤ 0.01). These data indicate that glycerin is a good source of energy for broilers, and the AME(n) of glycerin is dependent on fatty acid, methanol, and water contents.

Evaluation of the nutritional value of glycerol for nursery pigs

In Exp. 1, a total of 144 pigs (BW, 6.68 ± 0.17 kg) were weaned at 21 d, blocked by BW, and allocated to 48 pens with 3 pigs per pen. Pens were randomly assigned to 1 of 6 dietary treatments (0, 2.5, 5, 7.5, and 10% glycerol supplemented to replace up to 10% lactose in a basal starter 1 diet containing 20% total lactose, which was fed for 2 wk), and a negative control diet with 10% lactose and 0% glycerol. A common starter diet was fed for the next 2 wk. In Exp. 2, a total of 126 pigs (BW, 6.91 ± 0.18 kg) were weaned at 21 d of age, blocked by BW, and allocated to 42 pens with 3 pigs per pen. Pigs were assigned to 1 of 6 treatments in a 2 × 3 factorial arrangement in a randomized complete block design with factors being 1) glycerol inclusion in replacement of lactose in starter 1 diets (0 or 5%) fed for 2 wk, and 2) glycerol inclusion in starter 2 diets (0, 5, or 10%) fed for 3 wk. In Exp. 1, glycerol supplementation at 10% improved (P=0.01) ADG (266 vs. 191 g/d) and G:F (871 vs. 679 g/kg) during the starter 1 period when compared with the negative control. Incremental amounts of glycerol linearly (P<0.05) increased ADG and ADFI, but did not affect G:F during starter 1. There was no effect of feeding glycerol during the starter 1 phase on subsequent performance during the starter 2 phase or overall. Serum glycerol concentrations increased linearly (P=0.003) with increasing dietary glycerol, and serum creatinine (P=0.004) and bilirubin (P=0.03) concentrations decreased with increasing glycerol. In Exp. 2, glycerol did not affect performance during starter 1, but it linearly increased (P≤0.01) ADG and ADFI during starter 2 (464, 509, and 542 and 726, 822, and 832 g/d, respectively) and overall (368, 396, and 411 and 546, 601, and 609 g/d, respectively). At the end of the study, pigs were 1.0 and 1.5 kg heavier when fed 5 and 10% glycerol, respectively (linear, P<0.01). Serum glycerol concentrations increased linearly during starter 2 (P<0.001), but were not affected during starter 1. Glycerol supplementation increased serum urea N quadratically (P<0.001) and decreased creatinine linearly (P<0.05) in the starter 2 phase. Overall, data indicate that glycerol can be added to nursery pig diets at 10%, while improving growth performance.

Outcomes of Severe Methanol Intoxication Treated with Hemodialysis: Report of Seven Cases and Review of Literature

To identify factors associated with the outcome of severe methanol intoxication treated with hemodialysis, we analyzed the clinical course of 7 patients admitted with serum methanol level higher than 50 mg/dL, and therefore requiring hemodialysis. Four patients (group A) had adverse outcomes (1 death, 3 severe neurological deficits and/or blindness) and 3 patients (group B) had no adverse outcomes. Compared to group B, group A appeared to have a longer delay between ingestion of methanol and arrival at the emergency department (ED), a longer wait in the ED until ethanol infusion was started (3.6 ± 2.7 vs 1.3 ± 0.9 hr, p < 0.05), and, on admission, higher serum methanol (504 ± 219 vs 321 ± 228 mg/dL, p < 0.05), higher serum osmolality (460.5 ± 98.2 vs 397.6 ± 52.3 mOsm/kg, p < 0.05), higher serum osmolal gap (162.6 ± 76.7 vs 105.6 ± 52.9 mOsm/kg, p < 0.05), lower arterial pH (6.86 ± 0.08 vs 7.38 ± 0.16, p < 0.01), lower serum bicarbonate (4.6 ± 1.6 vs 19.9 ± 5.7 mmol/L, p < 0.01), and higher serum anion gap (36.5 ± 1.3 vs 14.3 ± 6.7 mEq/L, p < 0.01). Delay in the ED until hemodialysis was started did not differ (group A 6.4 ± 2.6 hr, group B 5.3 ± 3.5 hr), while duration of hemodialysis until serum methanol levels became permanently undetectable was longer in group A (15.0 ± 0.5 vs 8.4 ± 4.4 hr, p < 0.01). The ingested dose of methanol and the delay between ingestion and initiation of therapy to block methanol metabolism (ethanol infusion) and remove methanol from the body (hemodialysis) appear to be the critical factors influencing the outcome of methanol intoxication. Early diagnosis and initiation of treatment before substantial parts of the ingested methanol have been metabolized are of paramount importance in ensuring a favorable outcome.

Defining a tolerable concentration of methanol in alcoholic drinks

Methanol, a potent toxicant in humans, occurs naturally at a low level in most alcoholic beverages without causing harm. However, illicit drinks made from "industrial methylated spirits" [5% (v/v) methanol:95% (v/v) ethanol] can cause severe and even fatal illness. Since documentation of a no-adverse-effect level for methanol is nonexistent in the literature a key question, from the public health perspective, is what is the maximum concentration of methanol in an alcoholic drink that an adult human could consume without risking toxicity due to its methanol content? Published information about methanol-intoxicated patients is reviewed and combined with findings in studies in volunteers given small doses of methanol, as well as occupational exposure limits (OELs), to indicate a tolerable ("safe") daily dose of methanol in an adult as 2 g and a toxic dose as 8 g. The simultaneous ingestion of ethanol has no appreciable effect on the proposed "safe" and "toxic" doses when considering exposure over several hours. Thus, assuming that an adult consumes 4 x 25-ml standard measures of a drink containing 40% alcohol by volume over a period of 2 h, the maximum tolerable concentration (MTC) of methanol in such a drink would be 2% (v/v) by volume. However, this value only allows a safety factor of 4 to cover variation in the volume consumed and for the effects of malnutrition (i.e., folate deficiency), ill health and other personal factors (i.e., ethnicity). In contrast, the current EU general limit for naturally occurring methanol of 10 g methanol/l ethanol [which equates to 0.4% (v/v) methanol at 40% alcohol] provides a greater margin of safety.

Chemical Hazards and Poison Control for the Health Professional—Review of Select Principles and Exposures

Exposure to a wide variety of chemicals can pose significant hazards to patients, and present health care professionals with scenarios that require proper assessment and treatment. Knowing when a chemical exposure requires emergency medical attention is equally as important as knowing when such assistance is not necessary and that simple treatment measures performed at home will suffice. This current discussion is intended to highlight selected principles and clinical information pertaining to common chemical exposures, but not to replace the full spectrum of information that would be available to health care professionals (and the lay public) by contacting their nearest poison control center. There are several factors that should be considered when assessing the nature of and possible clinical outcomes (and medical needs) from patient exposure to chemicals. Identification of the chemical(s) involved, events leading up to the exposure, route of exposure (e.g., ingestion, dermal, inhalation, ocular), patient medical history and current symptoms, are just a few of the variables that must be ascertained before various treatment approaches can be undertaken.

Inhalation toxicity of methanol/gasoline in rats: effects of 13-week exposure

The subchronic inhalation toxicity of a methanol/gasoline blend (85% methanol, 15% gasoline, v/v) was studied in rats. Sprague Dawley rats (10 animals per group) of both sexes were exposed to vapours of methanol/gasoline at 50/3, 500/30 and 5000/300ppm for 6 hours per day, 5 days per week, for 13 weeks. Control animals inhaled filtered room air only. Control recovery and high dose recovery groups were also included which inhaled room air for an extra 4 weeks following the treatment period. No clinical signs of toxicity were observed in the treatment group and their growth curves were not significantly different from the control. Except for decreased forelimb grip strength in high dose females, no treatment-related neurobehavioural effects (4-6 hours post inhalation) were observed using screening tests which included cage-side observations, righting reflex, open field activities, and forelimb and hindlimb grip strength. At necropsy, the organ to body weight ratios for the liver, spleen, testes, thymus and lungs were not significantly different from the control group. There were no treatment-related effects in the hematological endpoints and no elevation in serum formate levels. Minimal serum biochemical changes were observed with the only treatment-related change being the decreased creatinine in the females. A dose-related increase in urinary ascorbic acid was detected in males after 2, 4 and 8 weeks of exposure, but not after the 12th week, and in females only at week-2. Increased urinary albumin was observed in treated males starting at the lowest dose and at all exposure periods, but not in females. A treatment-related increase in urinary beta 2-microglobulin was detected in males at week-2 only. Except for mild to moderate mucous cell metaplasia in nasal septum B, which occurred more often and with a slightly higher degree of severity in the low dose groups of both sexes, and presence of a minimal degree of interstitial lymphocyte infiltration in the prostate glands in the high dose males. No other significant microscopic changes were observed in the tissues of treated animals. Based on the marked increase in urinary ascorbic acid and albumin in the high dose males and the decreased forelimb grip strength in the high dose females, we concluded that the no-observed adverse effect level (NOAEL) of methanol/gasoline vapour is 500/30 ppm.