Suspected MPTP-induced parkinsonism.

The case of an intravenous heroin user who developed parkinsonian symptoms from the age of 28 years is presented. Neuropathologic examination revealed a marked loss of neurons and gliosis with the presence of Lewy bodies in the substantia nigra and locus ceruleus; they stained variably with antibody to ubiquitin and negatively with antibodies to tau and neurofibrillary tangles. Pseudo-Lewy bodies were also seen.

Cerebral amyloid angiopathy. A review.

Cerebral amyloid angiopathy (CAA) is a condition characterized by amyloid deposition in cerebral blood vessels. It occurs most frequently in association with clinical Alzheimer's disease but also occurs in some nondemented elderly people. CAA is a cause of spontaneous cerebral hemorrhage and may therefore present as a sudden unexpected death in an elderly person.

Solid phase extraction of morphine and its metabolites from postmortem blood.

A simple and rapid high-performance liquid chromatographic method is described for the determination of morphine-3-glucuronide, morphine-6-glucuronide, normorphine and morphine in postmortem blood. A solid phase extraction technique employing C18 Sep-Pak cartridges was used to recover morphine and its metabolites from 0.5 ml of blood.

Sudden death due to undiagnosed medullary-pontine astrocytoma.

A 20-year-old woman died suddenly and unexpectedly from low-grade medullary pontine fibrillary astrocytoma. She had experienced neurological symptoms including coughing and choking thought to be asthma, poor motor coordination, nasopharyngeal incompetence, and arm pain since the age of 11 months. Despite the long history of symptoms, the tumor remained clinically undiagnosed.

High-performance liquid chromatographic procedure for the measurement of nitrobenzodiazepines and their 7-amino metabolites in blood.

A simple and sensitive HPLC method is described for the determination of the nitrobenzodiazepines, nitrazepam, flunitrazepam and clonazepam and their respective 7-amino metabolites in post-mortem blood. Using a single-step extraction the nitrobenzodiazepines were recovered from 0.5 ml of blood using butyl chloride.

Postmortem drug metabolism by bacteria.

Studies were undertaken to determine the possible role of enteric bacteria in the postmortem bioconversion of the nitrobenzodiazepines flunitrazepam, clonazepam, and nitrazepam. Flunitrazepam, clonazepam, and nitrazepam were completely metabolized in blood in the presence of eight species of enteric bacteria to their respective 7-amino-metabolites. The rates of metabolism, at 37 degrees C, ranged from 0.

Early onset of multiple sclerosis with autopsy confirmation.

A female had her first generalized epileptic seizure at age 11 yrs. Apart from intermittent seizures she remained well until 15 yrs of age when she developed double vision, unsteadiness and bilateral plantar responses which resolved spontaneously. Brain MRI scan at this stage revealed changes typical of multiple sclerosis.

Traumatic pericallosal artery aneurysm.

We present the case of a 33-year-old man who sustained head trauma in a motor vehicle accident. He remained unconscious from the time of the accident until his death 10 days later. He was shown to have severe hemorrhage that destroyed the corpus callosum from genu to splenium in association with a pericallosal artery aneurysm (distal anterior cerebral artery aneurysm).

Death due to benzhexol toxicity.

A rare case of death due to benzhexol toxicity is reported in a 48-year-old schizophrenic male with a resolving empyema and underlying patchy, mild bronchopneumonia. Toxicological analysis revealed the benzhexol blood and liver concentrations to be 0.12 mg/l and 0.

Detection of antidepressant and antipsychotic drugs in postmortem human scalp hair.

The presence of therapeutic drugs in postmortem human scalp hair was investigated. Hair samples from 21 cadavers known to have taken antidepressant and antipsychotic drugs were solubilized in 1 M sodium hydroxide. Drugs were extracted using solvent extraction procedures and analyzed by gas chromatography-mass spectrometry (GC-MS) and high performance liquid chromatography (HPLC).

Extraction of psychotropic drugs from human scalp hair.

A comparison of techniques for the extraction of antidepressant and antipsychotic drugs in human scalp hair is described. Human scalp hair was obtained from cadavers known to be taking psychotropic drugs prior to their death. Following a washing step, hair was either solubilized in sodium hydroxide, or treated with dilute hydrochloric acid, methanol or subtilisin.

Homicidal strangulation by victim's own hair presenting as natural death.

We report an unusual case of homicidal strangulation of a healthy woman using her own head hair as the ligature. An attempt was made by the accused murderer to mask the homicide. Autopsy findings are presented that emphasize the lack of injuries to the deep neck structures when a soft, broad ligature is used.

A device for cutting brain slices.

A device for cutting brain slices is described as an alternative to cutting angle guides and the "brain macrotome." With this new device, slices of uniform thickness optimal for assessing morphological detail and photography can be produced. A similar but smaller device for cutting pieces of tissue for paraffin embedding is also presented.

A study of deaths involving oxycodone.

Nine deaths involving oxycodone were investigated to assess the contribution of this opiate to these fatalities. All except one of the bodies were subjected to a full autopsy by specialist pathologists with a subsequent thorough toxicological examination. No significant anatomical pathology was found at autopsy.

Simultaneous determination of morphine and codeine in blood and bile using dual ultraviolet and fluorescence high-performance liquid chromatography.

The separation and identification of morphine and codeine from postmortem blood and bile was accomplished using a liquid-phase extraction method followed by reversed-phase high-performance liquid chromatography with combined UV and fluorescence detection. Identification of morphine and codeine was based on relative retention time matching with calibration standards, together with their fluorescence-to-UV response ratios. Linear calibration curves for morphine and codeine ranged from 0.

Capillary gas chromatographic drug screen for use in forensic toxicology.

A screening method is presented involving the use of capillary gas chromatography using a BP-5 column and nitrogen-phosphorous detection. This method is a quick yet reliable procedure for a large range of neutral and basic drugs and uses 1 mL or less of blood. Running standards that contain a number of commonly observed drugs with each batch of cases allows for more accurate tentative identifications of likely drugs in unknown cases and also provides a measure of quality assurance.

Responsibility analysis: a methodology to study the effects of drugs in driving.

In order to study the role of drugs in driving, a responsibility analysis was developed to allow an assessment to be made of the driver's culpability or responsibility in an accident. Factors possibly mitigating drivers' responsibility in each accident were identified and scored. Factors considered were: condition of road, condition of vehicle, driving conditions, accident type, witness observations, road law obedience, difficulty of task, and level of fatigue.

Postmortem clomipramine: therapeutic or toxic concentrations?

Postmortem blood and liver concentrations of clomipramine were determined in ten cases by high performance liquid chromatography (HPLC). Blood concentrations ranged from 0.21 to 4.

Incidental embryonal rhabdomyosarcoma of the prostate gland in sudden infant death syndrome.

An incidental rhabdomyosarcoma of the prostate gland in a sudden infant death syndrome (SIDS) case, which highlights the value of histological examination of all organs in autopsy cases, is reported. The possible significance of coexistent malignant tumors in death attributable to SIDS is discussed.