Identification of the driver in two-rider motorcycle accidents. Inguinal contusion-laceration as an indication of the driver

In motorcycle accidents involving two riders, medicolegal identification of the driver is necessary when one or both riders die. It is particularly important in the latter case, because the survivor almost always insists that he or she was not driving. One characteristic injury that distinguishes the driver from the passenger is inguinal contusion-laceration (accompanied internally by pelvic fracture). This injury, caused by collision of the pelvis with the fuel tank, identifies the driver.     

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.     

Histochemical demonstration of phenobarbital by immunocytochemistry

A method for the demonstration of the topographical distribution of phenobarbital at the cellular level in various tissues was established. Mice that had been exposed to various doses of phenobarbital by intraperitoneal injection were killed, and their tissues were fixed with 0.1 M phosphate buffer solution (pH 7.4) containing paraformaldehyde and glutaraldehyde. Thereafter, paraffin and frozen sections were made and stained by the indirect immunoperoxidase method using antisera obtained from commercial sources and used for the immunochemical assay of the blood level of phenobarbital in clinical medicine. A specific positive reaction was observed solely in testing the intoxicated tissues, and this reaction was inhibited when phenobarbital was added to the antisera. The minimal sensitivity of the positive reaction, which can be discerned by observing the stained slides macroscopically, was in the range of 10 mg/kg. Thus, the diagnosis of phenobarbital intoxication in the forensic autopsy can be made by immunohistochemistry. A positive reaction was found in various tissue cells, including nerve cells, myelin sheaths, glia cells, hepatocytes, cells of the alveolar and bronchial wall, epithelial cells of the distal part of the renal tubules, and so forth. Endothelial cells of the capillaries in all tissues gave a strong positive reaction. The immunocytochemical electron microscopy of the hepatocytes revealed that the positive reaction in the cytoplasm was located solely in the intraluminal space of the smooth endoplasmic reticulum. These results indicate some interesting aspects of the pharmacokinetics of phenobarbital in vivo. It is expected that the antisera, which are used widely for the assay of the blood concentration of various drugs (phenobarbital, amphetamines, morphine, and so forth), may be regarded as excellent reagents for immunocytochemistry. This clearly indicates that morphological evidence in toxicology, which had so far remained obscure, can be easily obtained by applying these antisera against various drugs.     

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.     

Posttraumatic acute cholecystitis. Relationship to the initial trauma

Posttraumatic acute cholecystitis is an often unrecognized and potentially fatal complication seen among patients hospitalized for trauma, and differs in etiology from cholecystitis which develops de novo. The cause, although not yet clearly defined, is believed to be related to bile stasis, ischemia, bacterial infection, sepsis, the activation of factor XII, and the Shwarzman reaction. A case is described in which a 53-year-old man with pelvic fractures developed acute acalculous cholecystitis and died of multiple organ failure 3 weeks following cholecystectomy. The histopathological findings are also reported; these are most likely attributed to the Shwarzman reaction or the activation of the factor XII pathways. There has been a tendency to regard posttraumatic acute acalculous cholecystitis as induced by trauma, and calculous as mere coincidence. We believe, however, that it is not calculous but histopathological findings that determine whether acute cholecystitis following trauma was more than coincidence or just mere coincidence. Although progress in clinical care has improved the chances of survival of severely traumatized patients, posttraumatic acute cholecystitis has been increasing in frequency. We cannot be careful enough in judging the relationship of this fatal complication to the initial trauma.     

An improved method for the histological preparation of single hairs and dust samples--morphological and immunological examination

An improved method of the serological and morphological investigation of human hair is reported. The hair was firmly fixed onto a microscopic slide with cellophane tape and observed microscopically to confirm the cuticula images and the presence of the medulla. A piece of the hair containing the medulla was dissected, embedded in paraffin, and a cross section of this hair was prepared. By treating the sample with immunohistochemistry (biotin-antibiotin ABC technique), the blood type of the hair was confirmed definitively. Dust containing shaved beard can be examined in the same way.     

Visualization of latent fingerprints using fluorescence lifetime imaging on paper emitting strong fluorescence

Latent fingerprints were successfully visualized using fluorescence lifetime imaging (FLIM) on paper which emits strong fluorescence with a lifetime close to that of fingerprints and thus from which it is difficult for time-resolved spectroscopy to visualize fingerprints. Latent fingerprint samples on paper were excited using a 450 nm or 532 nm nanosecond pulsed-laser, and time-resolved fluorescence images were obtained at a delay time of 6–16 ns in intervals of 1 ns, to the excitation pulse. The excitation beam was expanded using a lens, and the fluorescence from the fingerprints was captured using an intensified CCD camera. Because of the large fluorescence intensity of the background paper of approximately two to four orders of magnitude larger than that of the fingerprint, the fingerprint was not visualized on each fluorescence image by time-resolved spectroscopy. However, the fingerprint was visualized in a FLIM image constructed using a series of the fluorescence images for the case with the fluorescence intensity of the background paper being four orders of magnitude larger than that of the fingerprint. The difference in fluorescence lifetime in the FLIM image of the visualized fingerprint and background paper was in the order of 0.1 ns, which was an order of magnitude smaller than the inherent fluorescence lifetime of a few nanoseconds for the fingerprints and paper. It was demonstrated that, at a background fluorescence intensity with a certain order of magnitude larger than that of fingerprints, FLIM has the potential to visualize latent fingerprints which cannot be visualized by time-resolved spectroscopy.