ISSN: 2573-1734
Authors: Morozov YE* and Ng MJ
Relevance: In order to figure out the cause of death and present the evidences to the court, law enforcement authorities instructed forensic medicine experts to carried out differential diagnosis, by using the posthumous exogenous alcoholemia to differentiated between the severity of acute ethanol intoxication, and death caused by alcohol poisoning. However, the experts are difficult to carried out the assessment to determine the severity of alcohol intoxication, even using the following criteria: exogenous alcoholemia level, signs of conditionally fatal ethanol poisoning with trauma. There are differences in the ethanoloxidizing dehydrogenase enzymatic activity, make it easier to determine individual ethanol tolerance, which can be used for forensic medical substantiation to determine severity of acute alcohol intoxication and fatal ethanol poisoning. Purpose of the Study: We carried out the research by evaluating the severity of the acute alcohol intoxication, by taking into account the blood ethanol concentration level and the death caused by the fatal ethanol poisoning; we use the 2 indicators of the ethanol- oxidizing enzymatic activity, which are the alcohol dehydrogenase in liver, and acetaldehyde dehydrogenase in the brain. Material and Methods: Forensic medical experts using 72 corpses to carried out the research, we had identified ethanoloxidizing enzymatic activities in the brain stem and liver and divided into 3 observation groups : Group I – death from fatal ethanol poisoning (FEP) with blood ethanol concentration between the range from 3.0 to 5.3 g/L (22 cases); Group II – death caused by car accidents as the drivers who are having severe ethanol intoxication with vehicle’s mechanical damage, the blood ethanol concentration between the range from 3.0 to 4.8 g/L (25 cases); Group III (controlled group) – death caused by car accidents with vehicle’s mechanical damage without exogenous alcoholemia (25 cases). Results: In the fatal ethanol poisoning group, we compared with the controlled group, there are decrease in enzymatic activities, and there were significant statistically decreases (P<0.05). When comparing these enzymatic activities between IInd and IIIrd group , there were no significant statistically differences (P>0.05). Conclusion: We used the following criteria and indicators to determine the fatal ethanol poisoning: alcohol dehydrogenase (ADH) enzymatic activity is between the range 2.60 - 3.44 c.u.; aldehyde dehydrogenase (ALDH) enzymatic activity is between the range 1.47 - 1.98 c.u.; blood ethanol concentration is between the range from 3.0 to 5.3 g/L. In group I , due to the excessive ethanol amount and the newly formed acetaldehyde, so there are inhibition of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) enzymatic activities. When group II comparing with controlled group, the ethanol-oxidizing enzymatic activities are approximately at the same level. This phenomena can be explained that the individuals have high ethanol tolerance. To determine the individual high ethanol tolerance, using the following criteria: the alcohol dehydrogenase (ADH) enzymatic activity in the liver between the range 3.97 - 4.79 c.u.; aldehyde dehydrogenase (ALDH) enzymatic activity in the brain between the range from 2.29 to 2.89 c.u.; the blood ethanol concentration of the corpse is between the range from 3.0 to 4.8 g/L.
Keywords: Ethanol metabolites; Severe ethanol intoxication; Fatal ethanol poisoning; Individual exogenous ethanol tolerance
