Biomedical subjects
Publications and source records attributed to D F Smyth.
A case is reported where phenol, a disinfectant, was ingested and resulted in the death of a 40-year-old white female. Concentrations of phenol were determined in blood (130 mg/L), urine (47 mg/L), bile (187 mg/L), brain (486 mg/kg), kidney (331 mg/kg), muscle (204 mg/kg), liver (228 mg/kg), and stomach content (668 mg) and compared to other cases reported in the literature.
From September 1983 through November 1986, autopsies were performed on 6810 patients at the Office of the Maryland Medical Examiners; of these 40 had detectable cocaine, its metabolites, or both in body fluids. These patients were divided into two groups: natural cocaine-associated deaths (31 patients, mean age 28 +/- 5 years, blood level of cocaine 5.3 +/- 8.1 mg/L) and homicide deaths with detectable cocaine (nine patients, mean age 33 +/- 8 years, blood level of cocaine 0.3 +/- 0.3 mg/L). Cocaine-associated deaths were compared to a control group of 27 victims of sudden traumatic death (mean age 34 +/- 5 years). Total thrombotic occlusion of the left anterior descending coronary artery overlying mild coronary atherosclerosis occurred in one patient with cocaine-associated death. Results of histologic examination showed myocarditis (mononuclear infiltrate) in 8 of 40 (20%) patients dying with detectable cocaine in body fluids compared to 1 of 27 victims of sudden traumatic death (3.7%, p less than or equal to 0.05). Contraction band necrosis occurred in 25% of cocaine-associated deaths compared to a 41% incidence among victims of sudden traumatic death. We conclude that myocarditis occurs frequently in patients dying of cocaine abuse and may represent microvascular injury.
A case is reported where the death of an individual resulted from the ingestion of diflunisal. Diflunisal was identified by a combination of liquid chromatography, UV spectrophotometry and colorimetry. Diflunisal was quantified in blood (260 mg/l), bile (71 mg/l), kidney (350 mg/kg), liver (400 mg/kg), stomach contents (34 mg) and urine (78 mg/l). No previous literature references discussing diflunisal related fatalities were available.
A fatal intoxication involving multiple substances including carbamazepine (CBZ), desipramine (DI), and ethylene glycol (EG), in which the blood CBZ concentration was higher than any previously reported in the literature is presented. Each compound, as well as the 10,11-epoxide metabolite of carbamazepine (CBZ-EP), was quantified in blood (CBZ, 79 mg/L; CBZ-EP, 11 mg/L; DI, 4.2 mg/L; EG, 3.6 g/L), bile (CBZ, 69 mg/L; CBZ-EP, 13 mg/L; DI, 23 mg/L; EG, 4.8 g/L), urine (CBZ, 6.5 mg/L; CBZ-EP, 5.7 mg/L; DI, 30 mg/L; EG, 3.3 g/L), stomach contents (CBZ, 280 mg; DI, 49 mg; EG, 2.8 g), liver (CBZ, 75 mg/kg; CBZ-EP, 11 mg/kg; DI, 49 mg/kg; EG, 2.0 g/kg), and kidney (CBZ, 41 mg/kg; CBZ-EP, 11 mg/kg; DI, 23 mg/kg; EG, 1.9 g/kg) using the following analytical techniques: high performance liquid chromatography with ultraviolet detection for CBZ and CBZ-EP, gas-liquid chromatography with mass selective detection for DI and gas-liquid chromatography with flame ionization detection for EG.