Rapid Screening for drugs and poisons in emergency medical care and clinical forensic toxicology.

本研究分为基础研究和实践研究两部分。此外，基础研究分为以下三个主题：1。2.药代动力学研究；3.质量控制研究；药物和毒物分析新方法的发展。通过生理药代动力学分析，探讨了个体间药物作用和毒性差异的机制。建立了个体化剂量的系统方法。为了预测肝损伤再生和恢复过程中的变化，发现AST改变是一个很好的代谢功能指标。酸性药物的结构与腹膜转运之间也建立了定量关系。发现了化学药物对生物技术药物作用的潜在影响。研究了IRMA、EIA和CLEIA法对LH、FSH等的测定。在医院实验室的血浆里在此基础上，具体论证了质量控制的重要性。(1)建立了超临界流体萃取和超临界流体色谱法分析苯二氮卓类药物的新方法。(2)初步考察了快速定量分析系统（remed - hs）的可用性。在实际应用中，将remed - hs系统应用于急诊医疗和法医尸检案件的样本中，并对该系统的优缺点进行了讨论。(3)采用脉冲加热法分析挥发性物质，包括广泛使用的麻醉药。(4)即使在福尔马林固定组织中，也可以通过GC-MS检测甲基苯丙胺、挥发性物质、地西泮和氯丙嗪。在紧急医疗和法医尸检病例中，采用上述筛查系统对血液和尿液进行分析。在急诊病例中，有1例被系统成功诊断为急性溴缬素中毒，该信息对患者的特异性治疗有很大帮助。在尸检病例中，有甲基苯丙胺和巴比妥分别被确定为致死水平和治疗水平的病例。在这种情况下，药物分析为评估尸体上的客观证据提供了有用的信息。少

The present research is composed of basic and practical studies. Furthermore, the basic study is divided into the following three subjects : 1. pharmacokinetic study, 2. study on quality control and 3. development of new analytical methods for drugs and poisons.1. The mechanism of interindividual differences on drug action and toxicity was investigated by using physiological pharmacokinetic analyzes. Systematic approach to individualizing the dose was established. In order to predict the change during regeneration and recovery from hepatic damage, an altered AST was found to be a good index of metabolic function. Quantitative relationship between structure and peritoneal membrane transport for acidic drugs were also established. The potential effects of chemical drugs on the effects of biotechnological drugs were discovered.2. IRMA,EIA and CLEIA methods were studied for LH,FSH,etc. in the plasma in a hospital laboratory. Based on the results obtained, the importance of quality control … More was concretely demonstrated.3. (1) An analytical method for benzodiazepines was newly developed using supercritical fluid extraction and supercritical fluid chromatography. (2) The availability of rapid quantitative analytical system (REMEDi-HS) was basically examined. Practically, REMEDi-HS system was applied to the samples in emergency medical care and medico-legal autopsy cases, and the advantages and disadvantages of the system were discussed. (3) Pulse heating method was applied to the analysis of volatile substances including widely used anesthetics. (4) Even in the formalin-fixed tissues, methamphetamine, volatile substances, diazepam and chlorpromazine were determined by GC-MS.In emergency medical care and medico-legal autopsy cases, blood and urine were analyzed by the screening system above. Among the emergency care cases, there was a case with successful diagnosis as an acute bromisovalum intoxication by the system, and the information much contributed to the specific therapy of the patient. In the autopsy cases, there were cases in which methamphetamine and barbital were determined in the lethal and therapeutic level, respectively. In such cases, drug analysis gives useful information to assess objective evidence on dead bodies. Less