importance of sampling sites for postmortem evaluation of ethyl alcohol

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Can et al., J Forensic Res 2012, 3:7

Forensic http://dx.doi.org/10.4172/2157-7145.1000156Research

Importance of Sampling Sites for Postmortem Evaluation of Ethyl Alcoholsmail zgr Can1*, Erdem zkara1, Serpil Salain1 and Mukaddes Gmtekin21Dokuz Eyll University, Faculty of Medicine, Department of Forensic Medicine, 35340 Izmir- Turkey2Dokuz Eyll University, Faculty of Medicine, Department of Pharmacology, 35340 Izmir- Turkey

Abstract

Detection of ethyl alcohol and its origin in postmortem specimens is essential in terms of medico-legal aspects.It is a complicated process to determine whether alcohol has been taken in the ante-mortem period and/or originatesfrom postmortem endogenous production.

In this study, considering sampling sites and storage conditions, we aimed to develop an approach for postmortemethyl alcohol investigations. Samples were collected from 32 cases. Blood specimens drained from the femoral veinand the vena cava inferior were put into well covered PET tubes with anti-coagulants and urine samples were putinto well covered PET tubes without anti-coagulants and preserved at + 4C, analyzed with enzymatic immunoassaywithin ve days of specimen collection.

Scene investigations, sampling and sampling sites, specimen handling, preserving specimens and preparationsbefore analyses are highly important for an accurate and scientic evaluation of postmortem ethyl alcohol. Therewere signicant differences in ethyl alcohol concentrations between blood from the femoral vein and vena cavainferior and urine. Femoral vein and urine specimens seemed to be more reliable than vena cava inferior specimens.

Keywords: Postmortem ethyl alcohol; Forensic toxicology; Samplingsites

Introduction

Te determination o ethyl alcohol and its origin in postmortemspecimens are essential or medicolegal purposes [1-4]. It is well knownthat researching whether the determined alcohol origin belongs to theantemortem period or not is dicult due to the many kinds o both

endogenous and exogenous actors in the postmortem period [58]. Blood ethanol concentrations in decomposed bodies may showdrinking during lie and/or endogenous production aer death [8-12].

In this study, we aimed to develop an approach or the evaluation opostmortem ethanol based on the data about sampling sites and storageconditions.

Material and Methods

We investigated the eects o dierent causes o death, handlingmedical history, postmortem interval, gastric contents, trauma to theabdominal cavity and thoracic organs and decomposition stages onpostmortem ethanol concentrations in dierent sampling sites. We alsocompared ethanol concentrations in the vena cava inerior closer to

the heart, the emoral vein and urine and determined whether urineand central and peripheral blood alcohol concentrations collected romdierent sites were correlated.

Blood specimens rom the emoral vein and vena cava inerior andurine specimens were collected rom a series o 32 medicolegal autopsiesperormed in Morgue Department o Council o Forensic Medicine,zmir, in urkey. All cases were examined; scene investigations,histopathological studies and toxicological analyses were perormedand medical records, external and internal ndings, and history oevents were reviewed. Blood and urine samples were aspirated bydisposable sterile syringes as in the ollowing: rst, emoral venousblood was aspirated under direct visualization. Second, the vena cavainerior closer to the heart was punctured and a sample o blood was

aspirated. Tird, the bladder was punctured under direct visualizationand urine was aspirated. Blood samples were put into well covered(purple lid) 9 mL Polyethylene erephthalate (PE) tubes which

containing EDA. Urine samples were put into well covered (red lid) 9mL PE tubes. Sodium Fluoride (NAF) or any other preservative wasnot used or preventing bias on immunoassay method and also sampleswere analyzed immediately at +4C. richloroacetic acid (6% solution)was used or preanalytic process. Ethanol was measured with enzymaticimmunoassay (912 Hitachi auto-analyzer) by using DRI ethyl alcoholassay, calibrators and controls. Sensitivity o the method was high orethanol levels ranging between 10 mg/dL and 600 mg/dL.

Data were analyzed with SPSS or Windows 11.0. Non parametrictest (Friedman Variance Analyze) was used to test the dierencebetween the specimens and t test (Wilcoxon test and BonerroniCorrection) was used to determine which specimen was dierent. Testudy was approved by Ethics Committee o Dokuz Eyll Universityand Council o Forensic Medicine.

Results

Te mean postmortem vena cava inerior ethanol concentration[VCEC] was 51.1 66.7 mg/dL, ranging rom 0 to 253 mg/dL, themean emoral blood ethanol concentration [FBEC] was 39.8 50.4mg/dL, ranging between 0 and 195 mg/dL and the mean urine ethanolconcentration was 21.1 28.1 mg/dL, ranging between 0 and 131 mg/

dL.Tere was a marked increase in ethanol concentration in vena cava

inerior blood samples compared with emoral vein blood samplesin all cases (antemortem alcohol ingestion history prior to death or

*Corresponding author: smail zgr Can, Dokuz Eyll University, Facultyof Medicine, Department of Forensic Medicine, 35340 Izmir- Turkey, E-mail:[email protected]

Received February 21, 2012; Accepted June 21, 2012; Published June 23, 2012

Citation: Can , zkara E, Salain S, Gmtekin M (2012) Importance ofSampling Sites for Postmortem Evaluation of Ethyl Alcohol. J Forensic Res 3:156.doi:10.4172/2157-7145.1000156

Copyright: 2012 Can , et al. This is an open-access article distributed underthe terms of the Creative Commons Attribution License, which permits unrestricteduse, distribution, and reproduction in any medium, provided the original author andsource are credited.

J Forensic ResVolume 3 Issue 7 1000156

ISSN: 2157-7145 JFR, an open access journal
http://dx.doi.org/10.4172/2157-7145.1000156http://dx.doi.org/10.4172/2157-7145.1000156http://dx.doi.org/10.4172/2157-7145.1000156http://dx.doi.org/10.4172/2157-7145.1000156


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Citation: Can , zkara E, Salain S, Gmtekin M (2012) Importance of Sampling Sites for Postmortem Evaluation of Ethyl Alcohol. J ForensicRes 3:156. doi:10.4172/2157-7145.1000156

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decomposition) (t test, p=0.001). [VCEC] and [FVEC] were oundsignicantly and strongly correlated (r=0.88, p


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Volume 3 Issue 7 1000156J Forensic Res

ISSN: 2157-7145 JFR, an open access journal

Citation: Can , zkara E, Salain S, Gmtekin M (2012) Importance of Sampling Sites for Postmortem Evaluation of Ethyl Alcohol. J ForensicRes 3:156. doi:10.4172/2157-7145.1000156

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11. Briglia EJ, Bidanset JH, Dal Cortivo LA (1993) The distribution of ethanol in postmortem blood specimens. J Forensic Sci 37: 991-998.

12. Cox DE, Sadler DW, Pounder DJ (1997) Alcohol estimation at necropsy:

epidemiology, economics, and the elderly. J Clin Pathol 50: 197-201.13. Chikasue F, Yashiki M, Miyazaki T, Okamoto I, Kojima T (1988) Abnormality

high alcohol concentration in the heart blood. Forensic Sci nt 39:189-195.

14. Pelissier-Alicot AL, Coste N, Bartoli C, Piercecchi-Marti MD, Sanvoisin A, et al.(2006) Comparison of ethanol concentrations in right cardiac blood, left cardiacblood and peripheral blood in a series of 30 cases. Forensic Sci Int 156:35-39.

15. ONeal CL, Poklis A (1996) Postmortem production of ethanol end factors thatinuence interpretation; a critical review.Am J Forensic Med Pathol 17:8-20.

16. Alexander W (1998) Postmortem urinary alcohol is unreliable in diabetes. BMJ317:206.

17. Lough PS, Fehn R (1993) Efcacy of 1% sodium uoride as a preservative inurine samples containing glucose and Candide albicans. J Forens Sci 38:266-271.

18. Gudrun H, L Kristoffersen, Bente L, Marianne A, Nils OH, Jrg M. In vitroformation of ethanol in autopsy samples containing uoride ions. Int J LegalMed online.

19. Keim ME, Keim M, Barteld JM, Raccio-Robak N, Abhyanker VV, et al. (1999) Accuracy of an enzymatic assay device for serum ethanol measurement. ClinToxicol 37: 75-81.

20. Gjerde H, Christophersen AS, Skuterud B, Klemetsen K, Mrland J (1990)Screening for drugs in forensic blood scmples using EMIT urine assays.Forensic Sci nt 44: 179-185.

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importance of sampling sites for postmortem evaluation of ethyl alcohol

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