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Abstract. TRH immunoreactivity levels were measured in human blood, urine, saliva, spinal fluid, amniotic fluid and gastric juice. Urinary TRH excretion during a 48-h period was measured in 11 healthy persons. Blood and urinary TRH immunoreactivity were measured at 2 and 5 h, respectively, after administration of 40 mg of TRH. All the samples were prepurified by SP-Sephadex-C-25 cation-exchange chromatography and subjected to reverse-phase high-pressure liquid chromatography (HPLC). TRH immunoreactivity levels were then measured by our TRH radio-immunoassay. The TRH immunoreactivity (TRH-ir) levels found in urine were 14.6 ± 2.5 pmol/l; in blood 7.5 ± 2.0 pmol/l; in spinal fluid 2.8 ± 1.4 pmol/l, and in gastric juice 23.2 ± 7.1 pmol/l. In all of the amniotic fluid and saliva samples, in almost one half of the blood and spinal fluid samples, and in almost one third of the gastric juice samples, TRH-ir was below the detectable limit. In blood and urine samples taken after oral administration of TRH, TRH-ir was eluted at the same time as synthetic TRH. The recovery of synthetic TRH added to the samples ranged from 36 to 99%. In all of the biological fluid samples, endogenous TRH-ir was eluted at the same time in HPLC, at 15–18 min, as was synthetic TRH which had been added to the samples. Urine was found to contain two TRH immunoreactive peaks, the second of which was eluted at the same time as synthetic TRH. No diurnal variation in urinary TRH excretion or TRH-ir levels was found. The levels of TRH-ir measured in blood, urine, spinal fluid and amniotic fluid are lower than most of those reported earlier. This study suggests that our method can be used to measure TRH immunoreactivity more accurately in a variety of biological fluids.

Background: The number of aircraft-assisted suicides can only be considered a rough estimate because it is difficult and, at times, impossible to identify all cases of suicide. Methods: Four recent reports of accidents occurring in 1997 in Indonesia, 1999 in Massachusetts in the United States, 2013 in Namibia, and 2015 in France related to commercial aircraft-assisted suicides were analyzed. This analysis relied on data extracted from the accident reports that supported aircraft-assisted suicide from the: (a) cockpit voice recorder (CVR) and flight data recorder (FDR), (b) medical history, (c) psychosocial history, (d) toxicology, (e) autopsy, and (f) any methodology that utilized aviation medicine. There are some limitations in this study. Although all analyzed accident investigations followed ICAO Annex 13 guidelines, there is variability in their accident investigations and reporting. In addition, accident investigation reports represent accidents from 1997 to 2015, and during this time, there has been a change in the way accidents are reported. The nature of this analysis is explorative. The aim was to identify how the various aircraft accident investigators concluded that the accidents were due to suicidal acts. Results: In all four accident reports, FDR data were available. CVR data were also available, except for one accident where CVR data were only partially available. Comprehensive medical and psychosocial histories were available in only one of four of the accident reports. Conclusion: To prevent accidents involving commercial aircraft, it is necessary to identify the causes of these accidents to be able to provide meaningful safety recommendations. A detailed psychological autopsy of pilots can and likely will assist in investigations, as well as generate recommendations that will substantially contribute to mitigating accidents due to pilot suicide. Airborne image recording may be a useful tool to provide additional information about events leading up to a crash and thus assist in accident investigations.

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