A man is born, he grows, he matures and he dies. In the intervening years between his birth and death, his body carries on several life functions which keep him alive, and in most cases, well. As is true of all living things, he has inherited a certain size range, form, and lifespan from his forebears; but, most important of all, he has acquired in that sperm and egg from his parents the condition called life - a condition that depends for its very existence on the constant release of energy in every tiny cell of his body. Powered by the energy they release from food, his cells are able to carry on the activities that enable them to maintain their own living condition and thus the life of the man of which they are part.

In the simple forms of life, consisting of relatively few numbers of cells, all cells carry on the life functions: respiring, eating, digesting, absorbing and assimilating food; secreting important digestive juices, enzymes and hormones; excreting waste; moving, adapting to environment and reproducing. However in an extremely complex form such as man, consisting of over fifty-thousand billion cells, labor can be divided and early in human development certain group of cells become highly specialized for certain functions such as motion or response. These groups of cells of particular types which do particular jobs are called tissues. They, in turn, are grouped into larger functioning structures known as organs.

The functional activities of cells that result in growth, repair, release of energy, use of food, and secretion are combined under the heading of metabolism. It consist of two opposing parts.The part resulting in building up of rather complex materials from simpler ones, called anabolism. Examples of anabolic processes include the growth and mineralization of boneThe part concerned with tearing down and changing more complex substances into simpler ones with a release of energy, called catabolism. E.g. The change of glycogen into glucose.

The sum of all these chemical reaction within cells is metabolism. Organ systems are composed of several organs concerned with a particular function. The digestive system, for example, is composed of all organs involved in the digestive process and the circulatory system, of all organs contributing to circulation and so on and so on.

The abdominal cavity contains the stomach, liver, gallbladder, pancreas, spleen, small and part of the large intestine. The kidneys are in the back of abdominal cavity. The urinary bladder, the reproductive organs, and the remainder of the large colon are in the pelvic area.

It is this abdominal cavity that will play and important roll if there is a case presented by the prosecution against Dr. Conrad Murray or others as it now looks certain so long as the Michael Jackson story continues to be headline news. There is already conflicting evidence which says that when Prince Michael II or Blanket, Michael Jackson's eldest son walked into his dad's room he says he saw Michael's knees buckled as he fell to the floor. Prince Michael II thought his dad was in one of his jovial moods and made nothing of it. However as can be heard over the 911 call when Dr. Murray was performing CPR, the 911 operator could be heard advising to place Michael on the floor. There is a disconnect here because he was already on the floor.

The liver will play an important roll for the prosecution as core biopsy samples are removed from the cadaver. The liver is the main organ where drugs (compounds) are metabolized. Coincidentally the question of toxic doses of Tylenol (acetaminophen) and death was on the news this week. We also heard that Michael Jackson had in his home, synthetic opioids (Propofol and Fentanyl) which can only be administered via the intravenous route and by an anesthetist. This means that some medical office or hospital's inventory is short of stock since every mm has to be accounted for. Unlike oral tablets, IV injections enter the blood circulation immediately, however certain metabolites may be detected in the liver depending on the sophistication of the laboratory tests.

It is indeed unfortunate, when one considers the tremendous advances in clinical research that pharmaceutical companies which manufacture these safe and powerful drugs when used according to their monograph and where people can have major surgery done without having to suffer through the awakening discomfort of general anesthesia should now be subjected to abuse by the people for whom they were manufactured and which no one predicted that the chief offenders would be the very ones that have access to them.

Snopes dot com says that hair and nails do not continue to grow after death. However we do know that in a cardiac arrest, the heart stops abruptly and no circulation of blood is evident. While the blood will clot due to lack circulation, it is still possible to get an important sample directly from the left ventricle which will determine what synthetic compound last exited during systole. The burden of proof for the prosecution will be to prove who administered it!

Comments to localanesthetics@yahoo.ca M.Sc. PharmD. CCPE Please visit WWW.AnestheticNews.com