Kasai Kentaro, Tanaka Toshiko, Satou Hiroaki
Department of Forensic Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
J UOEH. 2019;41(2):231-237. doi: 10.7888/juoeh.41.231.
We had a forensic autopsy case in which drugs were detected in a cadaver that had been stored in a cold and wet condition for 5 years. The skin of the cadaver was hard, and the color was partly whitish or dark brown. Though the cadaver had transformed into adipocere in the wet and cold condition, QuEChERS extraction and LC-MS/MS revealed the presence of sulpiride and estazolam in the femoral muscle and bone marrow. The concentrations of sulpiride and estazolam in the femoral muscle were 10.6 ng/g and 39.9 ng/g, respectively. The result of a drug screening test led not only to the cause of death but also to the personal identification of the cadaver. The individual had a history of drug taking, which had been stored in his medical records at the hospital for a long time. The fact of taking sulpiride and estazolam at the same time was characteristic, and it was useful in identifying the cadaver in this case. The progress in analytical technology has made possible the detection of particle drugs from old or adipoceratous cadavers, but there have been no reports of particle drugs being detected in a cadaver that had been dead for 5 years and had transformed to adipocere, as in our present case. The analytical results by LC-MS/MS were certainly important for the diagnosis of the cause of death, and, moreover, they were useful for the purpose of personal identification.
我们有一个法医解剖案例,在一具在寒冷潮湿环境中存放了5年的尸体中检测到了药物。尸体的皮肤坚硬,颜色部分呈白色或深褐色。尽管尸体在潮湿寒冷的环境中已变成尸蜡,但采用QuEChERS萃取法和液相色谱-串联质谱法(LC-MS/MS)检测发现股肌和骨髓中存在舒必利和艾司唑仑。股肌中舒必利和艾司唑仑的浓度分别为10.6纳克/克和39.9纳克/克。药物筛查测试的结果不仅揭示了死因,还实现了对该尸体的个人身份识别。此人有吸毒史,医院的病历中对此有长期记录。同时服用舒必利和艾司唑仑这一情况很有特点,对本案尸体的身份识别很有帮助。分析技术的进步使得从陈旧或呈尸蜡化的尸体中检测出微量药物成为可能,但此前尚无像我们当前案例这样在一具已死亡5年且已变成尸蜡的尸体中检测出微量药物的报道。LC-MS/MS的分析结果对死因诊断无疑很重要,而且对个人身份识别也很有用。