Amatoxin poisoning from ingestion of Japanese Galerina mushrooms.

BACKGROUND: Although some Japanese Galerina species poisonings manifest as gastrointestinal symptoms followed by late-onset hepatorenal failure (phalloides syndrome), the toxin responsible for this has not been determined. CASE REPORT: We report a 6-year-old boy who developed characteristic cholera-like diarrhea and late-onset severe hepatic deterioration after eating mushrooms, later identified as a Galerina species, most likely Galerina fasciculata. A residual mushroom revealed alpha-amanitin. This account is the first known reported case of poisoning by Japanese Galerina species where an amatoxin was demonstrated to be responsible for the toxicity.

Regional differences in homicide patterns in five areas of Japan.

This article describes regional differences in the homicide patterns which occurred in Sapporo City and the surrounding area, and in Akita, Ibaraki, Chiba and Toyama prefectures in Japan. Information collected from each case of homicide included factors such as age, sex of the victim and assailant, causes of death, disposition of the offender, relationship between assailant and victim, reasons for criminal action, et al. The statistical features of homicidal episodes among the five different regions showed considerable variation, as follows. The mean death rates for homicide (number of victims per 100,000 of population) during the period 1986-1995 were 0.44 (Sapporo), 0.8 (Akita), 0.58 (Toyama), 0.7 (Ibaraki) and 0.75 (Chiba), respectively. Close family relationship between the victim and assailant was observed in the homicidal acts which occurred in Sapporo, Akita and Toyama. Assailant's relationship to victim was commonly extra-familial in Ibaraki and Chiba-neighboring megalopolis Tokyo, where some events of murder by a foreigner occurred. Homicide by female assailant, murder by mentally abnormal killers and homicide-suicide events were closely associated with family members. And these factors contributed to the considerable number of victims in Sapporo, Akita and Toyama. But, this close family relationship of the victim to the assailant did not correspond with the elevation in the number of deaths, and it was rather inversely related to the higher death rates recognized in Ibaraki and Chiba. This comparative study suggested that rapid urbanization considerably affects regional differences in homicide patterns.

A case of fatal intoxication with ammonium sulfate and a toxicological study using rabbits.

Agricultural fertilizers such as ammonium sulfate are widely used in house gardens as well as in agriculture, but few case reports or toxicological studies of ingested fertilizers have been reported. This paper investigates a fatal case of ammonium sulfate poisoning and demonstrates its clinical and biochemical findings in rabbits. An 85-year-old woman was found dead lying on the ground outside her house in the middle of March, but the autopsy could not determine the cause of her death. Examination at the police laboratory of the solution in the beer can found next to her showed that it was very likely ammonium sulfate. Our measurement showed a significant increase of ammonium and sulfate ions in serum and gastric contents. The cause of her death was determined as poisoning by ammonium sulfate. The total dose of 1500 mg/kg of ammonium sulfate was administered to three rabbits, all of which showed similar symptoms such as mydriasis, irregular respiratory rhythms, local and general convulsions, until they fell into respiratory failure with cardiac arrest. EEG showed slow, suppressive waves and high-amplitude slowing wave pattern, which is generally observed clinically in hyperammonemia in man and animal. There was a remarkable increase in the concentration of ammonium ion and inorganic sulfate ion in serum, and blood gas analysis showed severe metabolic acidosis. These results, mainly findings by EEG, have shown that a rapid increase in ammonium ions in blood can cause damaging the central nervous system without microscopic change. When the cause of death can not be determined, measurement of ammonium ion, inorganic ion and electrolytes in blood as well as in stomach contents at forensic autopsy is necessary.

[The cooperation system for drug analysis by computer network].

Generally, the drugs are analyzed by the forensic medicine department in the most of autopsy cases. The forensic medicine department cannot always perform toxicological analysis because a shortage of a verified personnel, appropriate instruments, and financial resources. In order to overcome these difficulties and lack of resources, we developed a computer network called ml-poison. This network consists of the staff of forensic medicine, hospitals, governmental agencies and research facilities of police departments, etc. This network offers immediate and valuable information and expertise to these inexperienced in dealing with cases of poisoning. In cases in which the toxicological analysis cannot be performed in a facility, the network will recommend a facility where the analysis can be performed. Up this point, the network order system has assisted in many cases of poisoning. Although the effectiveness of the network for toxicological analysis has been proven, we still must deal with severed difficult problems: 1. The number of facilities assisting network orders is limited. 2. Who will pay the expenses involved in the analysis. 3. How to maintain security of the system. 4. What agency will assume responsibility for the management of the system.

A case of aconitine poisoning with analysis of aconitine alkaloids by GC/SIM.

Described here is a fatal case of accidental aconitine poisoning following the ingestion of aconite, Torikabuto, mistaken for an edible grass, Momijigasa. A 61-year-old man developed symptoms of nausea, diarrhea, and discomfort of the body about 2 h after the ingestion and was taken to an emergency room. Resuscitation and antiarrhythmic drugs were ineffective, and ventricular tachycardia and fibrillation developed and lasted for 6 h. He was transferred to a coronary care unit and complete sinus rhythm was obtained on an electrocardiogram 30 h after his admission. The patient fell into a coma and died of brain edema diagnosed by CT on the 6th day. Consent for autopsy was denied by the family but was given for gas chromatography/selected ion monitoring (GC/SIM) to analyze the toxicity of aconitine alkaloids in the blood and the urine. Only a faint amount of jesaconitine was detected, while aconitine, mesaconitine and hypaconitine were not detectable in the blood 24 h after ingestion. On the other hand, aconitine and its related alkaloids such as mesaconitine, jesaconitine, and hypaconitine were clearly detected in the urine.

An infant fatality involving ajmaline.

An infant fatality following accidental ingestion of ajmaline is described. Ajmaline was determined by thin-layer chromatography and infrared spectrophotometry, and quantitated by high performance liquid chromatography. The ajmaline concentration in blood was 5.5 micrograms/mL. The toxicological data relevant to the interpretation of case findings are presented.

A case of homicidal intoxication by chloropicrin.

An 18-year-old girl and her boyfriend were sprayed with toxic chemicals from the left front door of their parked car. The girl died of intoxication about 4 h later. The main findings of postmortem examination were spotty discolorations on her skin and severe pulmonary edema. The unknown chemical was identified as chloropicrin by gas-liquid chromatography and gas chromatography-mass spectrometry of her lung and on samples from the car's console box, cassette tape case, and floor mat, all of which were wet with chemicals. The content of chloropicrin in her lung was calculated at 1.6 ng/g of wet weight.

Effect of chlorphentermine on incorporation of [14C]choline in the rat lung phospholipids.

The effect of chlorphentermine (CP) treatment (50 mg/kg/day, per os [po]) on the incorporation of [14C]choline into rat lung phospholipid was studied. Total phospholipid content was increased 2.0-fold and 1.7-fold after seven and 14 days, respectively, compared with the pair-fed rats. The incorporation of [14C]choline into phosphatidylcholine (PC) was significantly inhibited by either seven or 14 days of CP treatment. Nevertheless, the PC content was significantly increased by day 7 and stayed elevated at day 14 of CP treatment. Choline and phosphorylcholine contents were significantly decreased by the CP treatment. These results suggest that the higher accumulation of PC is due to inhibition of enzymes involved in the hydrolysis of phospholipids rather than to a stimulation of the phospholipid synthesis.

Pulmonary synthesis of 5-hydroxytryptamine in isolated perfused rabbit and rat lung preparations.

The present investigation was designed to determine the pulmonary biosynthesis of 5-hydroxytryptamine (5-HT) from L-tryptophan. Artificially ventilated, isolated rabbit and rat lungs were perfused with a constituted medium. Tryptophan and its metabolites were detected by high pressure liquid chromatography using an electrochemical detector. 14C-tryptophan uptake by the rabbit lung was 5.6% and 3.9% in the rat lung after 1 hr of perfusion. The perfusate (100 ml) concentrations of 5-hydroxytryptophan and 5-hydroxytryptamine increased significantly (1.1 to 1.8 micrograms 5-HT and 4.4 to 6.5 micrograms 5-HTP) during rabbit lung perfusion. However, no metabolites were detected in the perfusate during rat lung perfusion. 5-Hydroxytryptamine and 5-hydroxyindoleacetic acid levels were greater in both rabbit and rat lungs when they were perfused with 0.4 mM tryptophan, compared to their levels in lungs perfused without tryptophan. The increase of 5-HT content in rat lung alone was statistically significant. 5-Hydroxytryptophan was not detected in the rabbit or rat lungs. These results suggest the presence of a mechanism for tryptophan metabolism in lung, similar to that in brain and gastrointestinal tract. However, since the rate of pulmonary metabolism of tryptophan is very low, pulmonary synthesis of 5-HT from tryptophan and its contribution to the circulating 5-HT pool is unlikely to be of significance.