2,4-Dinitrophenol: 'diet' drug death following major trauma.

There has been a resurgence in the illicit use of 2,4-dinitrophenol by people wishing to achieve rapid weight loss. Despite its availability, the drug is banned for human consumption as it is toxic and can have fatal consequences. We present the case of a 23-year-old man who regularly consumed 2,4-dinitrophenol to generate fat loss without apparent ill effect. He was involved in a high-speed road traffic collision and sustained limb-threatening injuries. The combination of emergency surgery, trauma and 2,4-dinitrophenol consumption culminated in deterioration under anaesthesia, with subsequent death from multiorgan failure in the intensive care unit 48 h later. Previous cases have reported death from 2,4-dinitrophenol toxicity alone. We believe this is the first reported case of 2,4-dinitrophenol toxicity triggered by the additional physiological stress of polytrauma and emergency surgery.

Death from overwhelming odontogenic sepsis: a case report.

A case of fatal Ludwig's angina from an odontogenic origin complicated by chronic lymphocytic leukaemia is presented. This case highlights that death from odontogenic infection is a reality, particularly in those with systemic disease causing immunocompromise. Early surgical intervention, aggressive intravenous antimicrobial therapy and supportive care is imperative.

Cryopreservation of human skin with propane-1,2-diol.

The tolerance and cryoprotective effect of propane-1,2-diol on human skin was evaluated using tetrazolium reductase enzyme activity to assess tissue viability. The tolerance of human skin was tested by exposing the skin to increasing concentrations of propane-1,2-diol (10, 20, and 40% v/v), at two permeation temperatures (4 degrees C or room temperature), in a stepwise manner, to reduce osmotically induced changes in cell volume. There was no evidence of specific toxicity attributable to the cryoprotectant during the permeation period, even at a concentration of 40%; however a significant decrease in human skin viability was observed after freezing and thawing with high concentrations of cryoprotectant. The only useful protocol was that employing a low cooling rate (-1 degree C min-1) with 10 or 20% (v/v) propane-1,2-diol at a low permeation temperature. The data suggest that propane-1,2-diol does not produced improved results when compared with other cryoprotectants used for skin cryopreservation.

Steroid sulphatase deficiency: identification of heterozygotes using hydrolysis of dehydroepiandrosterone sulphate by peripheral leucocytes.

Diagnosis of X-linked recessive ichthyosis, which is expressed only in males, can readily be made by measurement of leucocyte steroid sulphatase activity. However, because the gene for steroid sulphatase activity partly escapes from the process of X-chromosome inactivation associated with gene dosage compensation, identification of heterozygotes (females) is more difficult. We have measured the steroid sulphatase (by hydrolysis of dehydroepiandrosterone sulphate) and beta-glucuronidase (by hydrolysis of methylumbelliferyl glucuronide) activities in leucocytes from 18 heterozygotes, 100 normal females, 100 normal males and 11 affected subjects. When the ratio of the activities of steroid sulphatase and beta-glucuronidase in mixed leucocytes was plotted as a function of the steroid sulphatase activity, 85% heterozygotes were distinguished from normal females. Measurement of steroid sulphatase activity alone with these cells enabled identification of 78% heterozygotes. Measurements on mononuclear leucocytes were much less effective. Thrombocytes showed 1% of the steroid sulphatase activity of leucocytes. In females, leucocyte steroid sulphatase activity was independent of the stage of the ovarian cycle at which the cells were collected.