False positives and false negatives with a cocaine-specific field test and modification of test protocol to reduce false decision

The specificity of the Scott test, which is widely used in the field to detect cocaine, was investigated. Several drugs and medicines were applied to the test, and the conditions leading to false positives or false negatives were defined. The Scott test consists of three steps, each involving the addition of a certain reagent and observation of the color that consequently develops. In the first step, blue precipitates appear. In the second, these precipitates completely disappear. In the third step, blue appears again, but in the lower layer. It became clear that proper sample size is critical for correct decision, since too much heroin or dibucaine showed exactly the same color sequence as cocaine HCl and thus gave false positives, and too much cocaine HCl showed persisting precipitates in the second step, yielding a false negative. The appropriate sample size was 1mg or smaller. Freebase (crack) cocaine gave false negatives even when the sample size was appropriate, and it could not be distinguished from a newer substance of abuse, 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DIPT, foxy). The authors developed a new protocol to distinguish crack from 5-MeO-DIPT.     

Fluidity of cadaveric blood after sudden death: Part III. Acid-base balance and fibrinolysis

In rats, fibrinolytic activity and acidosis increased rapidly after death. Postmortem fibrinolysis and the pH, base excess (BE), and [HCO3-] levels were affected by the method of sacrifice: the lower the pH, BE, and [HCO3-] levels, the higher the fibrinolytic activity. Conversely, in experiments using the vascular perfusion technique, low pH, BE, and [HCO3-] levels of the perfusate induced abundant release of plasminogen activator from the vascular wall.     

The Baltic as a shipping and information area: the role of Amsterdam in Baltic integration in early modern Europe

In early modern times, the Netherlands imported grain from the Baltic, especially Poland, and re-exported it elsewhere in Europe. The Dutch shipping industry was extremely profitable, for transport costs were very high, and the number of Dutch ships was by far the largest among the European countries. Dutch prosperity was based on shipping of grain from the Baltic. Amsterdam was also a center of information because it was a port at which many ships stayed, and which attracted various merchants owing to its policy of religious tolerance. Much commercial information and know-how were accumulated in and spread from Amsterdam which contributed to the growth of the regional European economy from the Baltic because many merchants migrated to Northern Europe via the city, bringing with them the latest commercial techniques. Amsterdam therefore served as a core of Baltic integration in the early modern period, for it was a center of shipping and information.     

The generic drug market in Japan: will it finally take off?

Historically, brand-name pharmaceuticals have enjoyed long periods of market exclusivity in Japan, given the limited use of generics after patent expiration. To improve the efficiency of the health-care system, however, the government has recently implemented various policies aimed at increasing generic substitution. Although this has created expectations that the Japanese generic drug market may finally take off, to date, generic usage has increased only modestly. After reviewing the incentives of key market participants to choose generics, we argue that previous government policies did not provide proper incentives for pharmacies to boost generic substitution. We offer some recommendations that may help to increase generic usage.     

Fluidity of cadaveric blood after sudden death: Part II. Mechanism of release of plasminogen activator from blood vessels

Experiments by the vascular perfusion technique in isolated hind leg of the dog showed that after addition of various vasoactive drugs to the perfusate, fibrinolytic activity (plasminogen activator level) of the effluent was elevated. The effects of the drugs were completely inhibited only by the specific blocker of their receptor on the vascular wall. High K+ level of the perfusate also induced abundant release of plasminogen activator from the vascular wall.     

Fatal subarachnoid hemorrhage complicating actinomycotic meningitis

Actinomycosis is caused by Gram-positive Actinomyces species that are part of the normal oral flora with low virulence. We describe a rare case of sudden death of a 48-year-old man with actinomycotic basilar meningitis that was complicated by fatal subarachnoid hemorrhage. Autopsy revealed meningitis at the basilar region of the brain, and histological examination revealed characteristic bacterial aggregates with extensive leukocyte infiltration and severe vasculitis of arteries of this region. Rupture of an artery by severe arteritis was thought to be the cause of the subarachnoid hemorrhage. The probable primary source of infection was found in the left lung. To the best of our knowledge, the complication of subarachnoid hemorrhage has not been reported previously in actinomycotic meningitis.     

Fluidity of cadaveric blood after sudden death: Part I. Postmortem fibrinolysis and plasma catecholamine level

In rats, fibrinolytic activity and plasma catecholamine levels increased rapidly after death. Postmortem fibrinolysis was affected by the method of sacrifice, but catecholamine level was not always affected. Immediately after death, the plasma adrenalin level was higher than the noradrenalin level, but then adrenalin remained unchanged or tended to decrease while noradrenalin tended to increase gradually with time. In human subjects after rapid death, the plasma catecholamine and fibrinolytic activity levels were high. However, in cases after slow death they were low.