Leslie Lukash

Comparative study of postmortem barbiturates, methadone, and morphine in vitreous humor, blood, and tissue.

With the introduction of radioimmunoassay (RIA) techniques, it has become toxicologically possible to determine drug concentrations in postmortem vitreous humor. This study demonstrates and confirms this toxicological feasibility. In 49 medical examiners drug related cases, postmortem tissue levels of morphine, barbiturates, and methadone were compared to the vitreous humor.

Evaluation of the Abuscreen for methadone.

The increased use and abuse of methadone in recent years has posed a problem of both its identification and quantitation in body tissues. Recent development of a radioimmunoassay for methadone appears to have solved the problem. In our hands the assay was extremely sensitive and specific. It also appears to be an excellent tool when quantitative estimates are to be obtained. Although it initially appears to be relatively expensive, the time saved in doing a complete tissue distribution equalizes the cost. It is hoped that other radioimmunoassays currently under development will prove as satisfactory.

Alcohol levels in intracranial blood clots

In 1967 a routine alcohol determination was performed on the brain and blood of a 43-year-old male (HVB) who had been found unconscious, lying at the foot of a stairway in his home. He had sustained a fracture of the skull and survived nine hours in the hospital.

Separation of barbiturates using reverse-phase thin-layer chromatography.

A procedure for separating barbiturates by reverse-phase TLC is described. A spotted TLC plate is dipped in mineral oil/petroleum ether (1:10) and run 15 cm in a solvent of water/methanol/ammonium hydroxide, (80:20:2). After visualization, the drugs tested showed distinct separation.

A bizarre case of vehicular suicide

The upper torso of a man was discovered under a highway sign next to tire tread marks leading from the highway and continuing beyond the sign. The victims lower torso and automobile were also found along the same path 31 m (101 ft) and 41 m (133 ft) beyond the sign, respectively. The decedent was initially thought to be a disposed, homicide victim who had been dismembered by his assailant(s). Accident reconstruction revealed that the victim was the driver of the automobile and was transected by the highway sign stanchion as he protruded through the passenger side window of his moving vehicle. Based on the scene findings, autopsy, and psychological autopsy, the manner of death was classified as suicidal. The criteria used by medical examiners for vehicular suicide are also discussed.

Reconstruction of Mutilated Victims for Identification

Death by violent means, rendering a victim mutilated beyond recognition, presents the medical examiner and the police department with a problem of legal identification. This paper outlines the reconstruction of victims mutilated beyond recognition, by intent or accident, when the remains are not skeletal. This type of reconstruction and restoration requires an excellent knowledge of skull anatomy and some of the talent of a sculptor.

Harness racing injuries and deaths. report of a fatal accident and review of 178 cases

&NA; A case of a harness racing accident in which the driver died of head injuries is presented. To evaluate the victims head injury and corresponding helmet damage, a videotape of the race was reviewed and analyzed. Based on calculations of a simplified trajectory analysis and testing of the helmet, it was determined that the helmet design did not provide adequate protection for the victim. The standards for harness helmet design are being re‐eval‐uated by the harness racing industry to ensure the safety of the drivers. A review of 178 harness racing injuries and deaths, current harness helmet research, and recommendations for safer helmets are discussed. A protocol for the forensic investigation of sports‐related injuries and/or deaths is also presented to assist medical examiners in fulfilling their roles as practitioners of preventive medicine.

Separation of organophosphate, chlorinated, and carbamate insecticides using conventional and reverse-phase thin-layer chromatography.

This paper demonstrates that the RPTLC system can be used as a confirmation tool for regular adsorption TLC because it separates the pesticides of interest and also reverses their positions on the plate due to their partitioning with water solubility. A clinical procedure was devised for screening samples of gastric and urine for chlorinated, organophosphate, and carbamate insecticides via the use of conventional TLC. The presence of these insecticides was then confirmed by reverse-phase TLC via spotted TLC plates. In view of the plethora of insecticides currently found in the home, and in view of the numerous incidents of adults and children accidentally or purposely ingesting them. This confirming procedure should prove to be a clinically valuable tool in crucial emergency situations.

Herniation of the Heart: A Death Following Intrapericardial Pneumonectomy

A case is presented involving a patient who underwent an intrapericardial pneumonectomy for lung cancer and died of cerebral hypoxia due to herniation of the heart. The etiology and pathophysiology of cardiac herniation are reviewed.

A study of the myocardial depressant factor and its relative influence in drug/alcohol mortality.

A shock factor, a low molecular weight peptide, has been isolated from postmortem blood. High levels of this peptide, which depresses the myocardium, were seen in cases where drug overdose or alcoholism, or both, were the cause of death. An elevated myocardial depressant factor (MDF) level also demonstrated in a fire victim and a patient in cardiogenic shock. The peptide analysis was accomplished by using an isolated cat papillary muscle followed by paper chromatographic confirmation. Postmortem electrolytes, alcohol, and various toxic agents were eliminated as causes of myocardial depression in the isolated cat papillary muscle assay. The presence of elevated MDF levels may be significant in the overall death process.