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工作场所木屑粉尘吸入导致的死后内源性乙醇产生及从肺部的扩散。

Postmortem endogenous ethanol production and diffusion from the lung due to aspiration of wood chip dust in the work place.

作者信息

Furumiya Junichi, Nishimura Hiroyuki, Nakanishi Akinori, Hashimoto Yoshiaki

机构信息

Department of Legal Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan.

出版信息

Leg Med (Tokyo). 2011 Jul;13(4):210-2. doi: 10.1016/j.legalmed.2011.04.004. Epub 2011 May 17.

Abstract

We report an autopsy case of postmortem ethanol diffusion into the cardiac blood after aspiration of wood chips, although antemortem ethanol consumption was not evident. A man in his twenties, who was loading a truck with small wood chips in a hot, humid storehouse, was accidentally buried in a heap of chips. At the time the body was discovered, 20 h after the accident, rectal temperature was 36°C. Autopsy showed the cause of death to be asphyxia due to obstruction of the airway by aspiration of wood chips. The ethanol and n-propanol levels were significantly higher in the lungs (left, 0.603 and 0.009 mg/g; right, 0.571 and 0.006 mg/g) than in other tissues. A significant difference in ethanol concentration was observed between the left cardiac blood (0.243 mg/g) and the right femoral blood (0.042 mg/g). Low levels of ethanol and n-propanol were detected in the stomach contents (0.105 and 0.001 mg/g, respectively). In order to determine whether aspiration of wood chips affects postmortem ethanol production in the lung, we measured the ethanol and n-propanol levels of homogenized rabbit lung tissue incubated with autoclaved or non-autoclaved wood chips. Levels of ethanol and n-propanol were significantly higher in the homogenates incubated with non-autoclaved chips for 24h. The results of this animal experiment suggested that the ethanol detected in the lung was produced by putrefactive bacteria within the wood chips. After death, the ethanol produced endogenously in the lung appears to have diffused and affected the ethanol concentration of the left cardiac blood.

摘要

我们报告一例木屑吸入后死后乙醇扩散至心脏血液的尸检病例,尽管生前乙醇摄入并不明显。一名二十多岁的男子在炎热潮湿的仓库里往卡车上装载小木屑时,不慎被一堆木屑掩埋。在事故发生20小时后尸体被发现时,直肠温度为36°C。尸检显示死亡原因是木屑吸入导致气道阻塞引起的窒息。肺组织中的乙醇和正丙醇水平(左肺,0.603和0.009mg/g;右肺,0.571和0.006mg/g)显著高于其他组织。左心血液(0.243mg/g)和右股静脉血(0.042mg/g)中的乙醇浓度存在显著差异。胃内容物中检测到低水平的乙醇和正丙醇(分别为0.105和0.001mg/g)。为了确定木屑吸入是否会影响死后肺内乙醇的产生,我们测量了用高压灭菌或未高压灭菌的木屑孵育的兔肺组织匀浆中的乙醇和正丙醇水平。用未高压灭菌的木屑孵育24小时的匀浆中乙醇和正丙醇水平显著更高。该动物实验结果表明,肺中检测到的乙醇是由木屑中的腐败细菌产生的。死后,肺内内源性产生的乙醇似乎已经扩散并影响了左心血液中的乙醇浓度。

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