Ethanol exerts its behavioural effects largely by interacting with receptors for brain neurotransmitters. However, the molecular mechanisms involving these interactions and the pathogenesis of alcohol-withdrawal symptomatology are still not well understood. Until recently, no data were available about homocysteine (Hcy) levels in acute alcohol intoxication of chronic alcoholics and in patients undergoing withdrawal from alcohol. Hcy, blood-alcohol concentrations, vitamins B6, B12, and folate concentrations were assessed in 29 chronic alcoholics, who underwent withdrawal from alcohol. We observed increased Hcy levels in most patients. Hcy levels steadily decreased during the observation period. We postulate that hyperhomocysteinaemia and excitatory amino acid neurotransmitters, by their agonism at the N-methyl-D-aspartate receptor, may partly mediate alcohol-associated withdrawal symptomatology. The importance of assessing serum Hcy levels in order to detect methylation deficiency in patients with chronic alcoholism and for possible therapeutic strategies is discussed.

A 24-year-old student died while filling flasks with liquid nitrogen. The arms, legs and back were frozen and the face, ears and neck showed a dark red and livid colour with horizontal lines of demarcation. In the electrocardiogram, the heart showed asystolia followed by wide ventricular complexes. The patient was intubated orally as the situs of the larynx and pharynx showed no pathology findings. Cardiopulmonary resuscitation was carried out and terminated after 90 min. Unfortunately, the body temperature was not measured. The gas analysis of venous blood showed metabolic acidosis and oxygen deficiency. The student had worked alone with nitrogen, without opening the windows and without a working ventilation system. While filling the third flask he lost consciousness. As nitrogen does not cause characteristic prodromal signs he laid on the floor and was unable to help himself. The liquid nitrogen which was still escaping spread over the floor and vaporized. The student died from asphyxia due to oxygen deficiency in an atmosphere of nitrogen.

No abstract

Forty-eight cases of electrocution in the bathtub are reported which were recorded in Düsseldorf and Göttingen from 1972 to 1986; 19 cases were established to be suicides, with a sex ratio of 1:3 in favor of females. Marks of electricity were found in 8 cases. Five other cases were distinguished by linear marks indicating the water level, and in 10 cases a peculiar restriction of the postmortem hypostasis on the submersed areas could be seen. We presume from our own material that the latter findings can be easily ignored. As linear, circumscribed lividity could not be detected in bath deaths without electricity, it may be a specific finding. We recommend that more attention be paid to this phenomen. In all of our cases, 220 V current was involved, i.e., the usual household supply. The calculated amperage was about 100 to 250 mA, which means that ventricular fibrillation occurred within a few seconds. In 14 cases foam was established at the mouth and the nostrils, or in the air passages. We presume that, in these cases, death by electrocution was finally superimposed by drowning without developing the typical emphysema aquosum.