3D Rendered Animation of Male Anatomy - Stomach Cancer. Close up rotation. Plain Black Background

MODEL OF HUMAN TORSO OPEN TO EXPOSE LUNGS, STOMACH. HAND MOVING DOWN TORSO DEMONSTRATING HOW THE CAPSULE TRAVELS THROUGH ESOPHAGUS TO STOMACH

Images of an esophagus opening and closing on a computer. A patient reviews the images with his doctor. The medical software shows an image from the film.

Young man sits at dinner table CU plate with steak, plate of potatoes, plate of peas, plate of cabbage (shaking) CU plate with bread and butter CU glass of milk GRAPHIC: Illustration of entire digestive system Man puts forkful of food in mouth CU man chews (front & side view) Nasty cross-section illustration of inside of mouth (supered over live image) Unidentified animal salivary gland (gross) hooked up to tube, stimulated Saliva flows through tube, drips into beaker CU saliva dripping into beaker CU man being given vinegar in eye-dropper CU man's saliva dripping through tube to beaker CU two beakers filled with starch (looks like milk), saliva added (clear liquid) T/L as beaker with saliva becomes clear (molecules of starch broken down) GRAPHIC: Illustration of complex starch molecules (like a net) being broken down Young man chewing thoughtfully, leans forward to spit (not actually shown) ECU wad of chewed food (looks like meatball), forceps pick it apart Two laboratory set-ups labeled 'WATER' and 'SALIVA'; clear liquids poured into each one; water drips through quickly, saliva slowly (more viscous) CU man's chin, throat, and Adam's apple as he chews, swallows GRAPHIC: Illustration of esophagus CU live animal esophagus, chunks of food swallowed, slide down GRAPHIC: animation of food sliding down esophagus GRAPHIC: illustration of the stomach (VERY NICE) GRAPHIC: CU cross-section of stomach lining, gastric juices secreted Old professor-type calmly swallows a tube (!), pumps out some gastric juice Egg cracked into beaker, white separated from yolk Egg white (clear) sucked into glass pipette, cooked (turns white) Section of pipe with egg white placed in dish, gastric juices poured over CU clock reads 7:00 CU petrie dish with tube CU clock reading 9:00 CU petrie dish, egg partly eaten away CU clock reading 11:00 CU egg in dish, more eaten away CU clock reading 1:00 CU egg in dish, almost gone GRAPHIC: Illustration of large protein molecule, breaking down CU live stomach (looks just like illustration), pointer points ECU glistening, vein-covered section of stomach UNDULATING MOISTLY GRAPHIC: Illustration of the duodenum; arrow shows path of food CU live pancreas, secreting pancreatic juice through a tube into a beaker GRAPHIC: cross-section of duodenum, stomach and pancreas, illustrating the flow of juices and food between the three CU live liver and gall bladder, secreting bile ECU bile dripping from tube to the ubiquitous beaker CU two tall beakers full of cream; bile added to both (yum...). Pancreatic juice added to one only. (These could pass for close-ups of milkshakes in some shots). T/L as the one containing pancreatic juice becomes clear. GRAPHIC: Illustration of fat molecules breaking down into glycerin & fatty acid GRAPHIC: Progressive cross-section of the many layers of the small intestine ECU (microscopic) of intestinal villi-- look like white sea anemone waving GRAPHIC: cross section of a single villus, showing flow of nutrition into blood and waste into the lymph system CU live intestine undulating away (weird), moving food through GRAPHIC: Illustration of large and small intestines CU live large intestine contracting as it does when you poop! GRAPHIC: illustration of entire digestive system (recap) GRAPHIC: cross-section of villus (recap) Emaciated boy in diaper-like underpants standing on doctor's scale (pathetic) showing effects of malnutrition. He walks out and is replaced by a healthy specimen of American boyhood in the same weird diapers.

EDIT MASTER FOR A CS ABOUT THE USE OF A STOMACH BALLOON TO TREAT OBESITY. 01:15 vs of an overweight, middle aged woman shopping at a florist. intv/w the woman. tight shot of the balloon. vs of a physician sticking a stomach balloon down a patient's throat. orthoscopic camera ftg of the balloon inflating inside a patient's stomach. orthoscopic ftg of a deflated balloon being dragged through an esophagus. intvs/w physicians in favor of and opposed to the treatment. 03:35 blank. CI: HEALTH: OBESITY, TREATMENT.

Alimentary Tract, The

HAND RUNNING THE WAND (PROBE) UP AND DOWN THE MAN'S ESOPHAGUS AND STOMACH. WAND MAKES STATIC SOUND AS IT REACHES NEAR THE PATH OF THE RADIOACTIVE CAPSULE.

THE DIGESTIVE SYSTEM

FTG FOR TIMOTHY JOHNSON CS VO ON HEARTBURN, WHICH IS LINKED TO THE FASTEST-GROWING CANCER IN AMERICA, ESOPHAGEAL CANCER HEARTBURN LOGS TAPE 6 PILL CAM 1:00:47 "we're going to place a couple of leads onto your chest" 1:01:05 cu of lead 1:01:13 puts on second lead wider shot 1:01:29 cu of second lead 1:02:13 puts belt on her 1:02:28 cu of belt 1:02:48 data recorder is put into pocket and attaches lead to recorder 1:04:08 Sharon drinks some water to clear esophagus 1:04:33 "we're going to have you lie down onto your left side" 1:05:27 opens pill cam ( w/o gloves) cu 1:05:45 takes out pill cam it's flashing 1:06:47 takes it out with gloves 1:06:58 cu of it blinking 1:07:51 holds up pill with both sides flashing 1:08:18 puts pill cam by electrodes to set it 1:08:40 recorder is blinking too 1:09:42 cu of Sharon's face 1:10:40 put the capsule in your hand: 1:10:48 puts capsule in her mouth see it flashing in her outh 1:11:00 she takes a sip of water. 1:11:49 cu Sharon's face 1:12:15 lower shot of Sharon' 1:12:27 cu data recorder Sharon Benzeno Had reflux 7 to 8 years 1:13:03 sharp rising burning pain sensation , Is on a PPI right now 1:13:40 had endoscopy 5 years ago another two years ago found esophagitis 1:14:08 a the Pill cam appeals to me be causes um,,um 1:14:13 It's a shorter procedure , there's no anesthesia and you don't need to have someone pick you up afterwards. (8) 1:14:27 with busy schedules it's much more convenient 1:15:24 the pill cam is great, I think it's a great technology and an in and out type of thing. (6) Dr. Felice Schnoll - Sussman Gastroenterologist 1:16:40 this can be use for initial examination, this can be used as a follow up examination any patient with esophageal symptom otology. (9) 1:16:48 The only patient you wouldn't do it in is someone we already know has lets say a pre malign at condition 1:17:25 Most of the exams that are done in patients with heartburn don't necessarily require biopsy being done. (7) because you're able to get visual imaging that give you the diagnosis. 1:18:35 the majority of patients can be done and the interpretation of the imaging is enough to make the diagnosis. (8) 1:18:59 The images are comparable to doing an upper endosceopy and the majority of patient would actually just require that alone. (7) 1:19:26 the convenience factor and that probably is one of the most important things for us in terms of patients, we want to motivate them to actually go through with this type of exam. (9) 1:19:38 It takes little time, the preparation is much smaller for them than traditional endoscopy, they don't get sedation as a consequence they don't have the side effect potential of the anesthesia. They can go about their business right after the exam. 1:20:03 The main drawback is if you need to take a biopsy you can't do that. 1:21:01 the exam is very simple, essentially the patient comes in , the pill is the size of a large vitamin, it's very easy to swallow, they only need not to eat or drink two hours before the examination, the exam is done 1:21:18 usually take about 20 minutes of time. Get results within a half hour. 1:21:29 they can basically swallow the pill and get the results within a half an hour. (5)***** 1:22:23 the most important thing I could say to a patient is not to ignore their symptoms, 1:22:30 If you've had chronic heartburn for several years, especially if you've had it several times a week, and you've not been seen by a physician, you should. (8) You may be at risk for changes in the esophagus whether it be just inflammation or something worse thant that. 1:22:46 There are changes that can happen in the esophagus related to just heartburn itself that potentially can lead to cancer. (7) *** 1:26:20 Dr. Sussman goes over results with Sharon 1:27:30 "we're getting the sense of a small erosion." 1:29:09 cu of screen moving thorugh photos** 1:29:35 uses curser to point to erosion 1:30:06 point to to erosion with finger**** 1:30:43 front shot of the two of them again

08:10:55:00,Young man sits at dinner table, CU plate with steak, plate of potatos, plate of peas, plate of cabbage (shaking), CU plate with bread and butter, CU glass of milk, GRAPHIC: Illustration of entire digestive system, Man puts forkful of food in mouth, CU man chews (front & side view), Nasty cross-section illustration of inside of mouth (supered over live image), Unidentified animal salivary gland (gross) hooked up to tube, stimulated, Saliva flows through tube, drips into beaker, CU saliva dripping into beaker, CU man being given vinegar in eye-dropper, CU man's saliva dripping through tube to beaker, CU two beakers filled with starch (looks like milk), saliva added (clear liquid), Timelapse as beaker with saliva becomes clear (molecules of starch broken down), GRAPHIC: Illustration of complex starch molecules (like a net) being broken down, Young man chewing thoughtfully, leans forward to spit (not actually shown), ECU wad of chewed food (looks like meatball), forceps pick it apart, Two laboratory set-ups labelled "WATER" and "SALIVA", clear liquids poured into each one, water drips through quickly, saliva slowly (more viscous), CU man's chin, throat, and Adam's apple as he chews, swallows, GRAPHIC: Illustration of esophagus, CU live animal esophagus, chunks of food swallowed, slide down, GRAPHIC: animation of food sliding down esophagus, GRAPHIC: illustration of the stomach (VERY NICE), GRAPHIC: CU cross-section of stomach lining, gastric juices secreted, Old professor-type calmly swallows a tube (!), pumps out some gastric juice, Egg cracked into beaker, white separated from yolk, Egg white (clear) sucked into glass pipette, cooked (turns white), Section of pipe with egg white placed in dish, gastric juices poured over, CU clock reads 7:00, CU petri dish with tube, CU clock reading 9:00, CU petri dish, egg partly eaten away, CU clock reading 11:00, CU egg in dish, more eaten away, CU clock reading 1:00, CU egg in dish, almost gone, GRAPHIC: Illustration of large protein molecule, breaking down, CU live stomach (looks just like illustration), pointer points, ECU glistening, vein-covered section of stomach UNDULATING MOISTLY, GRAPHIC: Illustration of the duodenum, arrow shows path of food, CU live pancreas, secreting pancreatic juice through a tube into a beaker, GRAPHIC: cross-section of duodenum, stomach and pancreas, illustrating the flow of juices and food between the three, CU live liver and gall bladder, secreting bile, ECU bile dripping from tube to the ubiquitous beaker, CU two tall beakers full of cream, bile added to both (yum...). Pancreatic juice added to one only. (These could pass for close-ups of milkshakes in some shots). Timelapse as the one containing pancreatic juice becomes clear, GRAPHIC: Illustration of fat molecules breaking down into glycerine & fatty acid, GRAPHIC: Progressive cross-section of the many layers of the small intestine, ECU (microscopic) of intestinal villi-- look like white sea anemone waving, GRAPHIC: cross section of a single villus, showing flow of nutrition into blood and waste into the lymph system, CU live intestine undulating away (weird), moving food through, GRAPHIC: Illustration of large and small intestines, CU live large intestine contracting as it does when you poop !, GRAPHIC: illustration of entire digestive system (recap), GRAPHIC: cross-section of villus (recap), Emaciated boy in diaper-like underpants standing on doctor's scale (pathetic) showing effects of malnutrition. He walks out and is replaced by a healthy specimen of American boyhood in the same weird diapers

Surgeons perform a new technique, transhiatal esophagectomy, to repair the patient's esophagus. PLEASE NOTE - news reporter audio is for reference only and is not available for licensing purposes. Mastered in Apple Pro Res 422 HQ, available in all forms of HD and SD.

Male abdominal and pelvic organs, animation.

FETAL PIG ANATOMY

Young man sits at dinner table CU plate with steak, plate of potatoes, plate of peas, plate of cabbage (shaking) CU plate with bread and butter CU glass of milk GRAPHIC: Illustration of entire digestive system Man puts forkful of food in mouth CU man chews (front & side view) Nasty cross-section illustration of inside of mouth (supered over live image) Unidentified animal salivary gland (gross) hooked up to tube, stimulated Saliva flows through tube, drips into beaker CU saliva dripping into beaker CU man being given vinegar in eye-dropper CU man's saliva dripping through tube to beaker CU two beakers filled with starch (looks like milk), saliva added (clear liquid) T/L as beaker with saliva becomes clear (molecules of starch broken down) GRAPHIC: Illustration of complex starch molecules (like a net) being broken down Young man chewing thoughtfully, leans forward to spit (not actually shown) ECU wad of chewed food (looks like meatball), forceps pick it apart Two laboratory set-ups labeled 'WATER' and 'SALIVA'; clear liquids poured into each one; water drips through quickly, saliva slowly (more viscous) CU man's chin, throat, and Adam's apple as he chews, swallows GRAPHIC: Illustration of esophagus CU live animal esophagus, chunks of food swallowed, slide down GRAPHIC: animation of food sliding down esophagus GRAPHIC: illustration of the stomach (VERY NICE) GRAPHIC: CU cross-section of stomach lining, gastric juices secreted Old professor-type calmly swallows a tube (!), pumps out some gastric juice Egg cracked into beaker, white separated from yolk Egg white (clear) sucked into glass pipette, cooked (turns white) Section of pipe with egg white placed in dish, gastric juices poured over CU clock reads 7:00 CU petrie dish with tube CU clock reading 9:00 CU petrie dish, egg partly eaten away CU clock reading 11:00 CU egg in dish, more eaten away CU clock reading 1:00 CU egg in dish, almost gone GRAPHIC: Illustration of large protein molecule, breaking down CU live stomach (looks just like illustration), pointer points ECU glistening, vein-covered section of stomach UNDULATING MOISTLY GRAPHIC: Illustration of the duodenum; arrow shows path of food CU live pancreas, secreting pancreatic juice through a tube into a beaker GRAPHIC: cross-section of duodenum, stomach and pancreas, illustrating the flow of juices and food between the three CU live liver and gall bladder, secreting bile ECU bile dripping from tube to the ubiquitous beaker CU two tall beakers full of cream; bile added to both (yum...). Pancreatic juice added to one only. (These could pass for close-ups of milkshakes in some shots). T/L as the one containing pancreatic juice becomes clear. GRAPHIC: Illustration of fat molecules breaking down into glycerin & fatty acid GRAPHIC: Progressive cross-section of the many layers of the small intestine ECU (microscopic) of intestinal villi-- look like white sea anemone waving GRAPHIC: cross section of a single villus, showing flow of nutrition into blood and waste into the lymph system CU live intestine undulating away (weird), moving food through GRAPHIC: Illustration of large and small intestines CU live large intestine contracting as it does when you poop ! GRAPHIC: illustration of entire digestive system (recap) GRAPHIC: cross-section of villus (recap) Emaciated boy in diaper-like underpants standing on doctor's scale (pathetic) showing effects of malnutrition. He walks out and is replaced by a healthy specimen of American boyhood in the same weird diapers. EDUCATIONAL/1954/BW DINGD 25 MIN Two small pine cones on an open hand Hand replaces cones on table, hand picks up stuffed bear, turns it for the camera, hand strokes bear, Mrs. Frances Horwick puts bear down CU tiny moccasins, she touches them and squeezes them, she returns them to the table She shows tiny clay head, returns it to table She shows small painted stone head, returns it to the table She shows head made from a thread spool, returns it to the table She reaches for bunch of grapes on table, picks them up, returns to table She shows clothespin doll, fingers doll's paper skirt She shows unidentifiable paper animal and strokes it She shows chicken featliers (small feather duster) She shows paper dinosaur with clothespin legs She shows papier-mGchT clown with one arm She shows rag doll CU teacher's face as she talks to camera like it was a child Teacher points to row of bell pictures on the wall, she touches each one and describes it Full view of teacher as she talks about pictures CU aquarium with goldfish CU mailbox CU teacher points to avocado tree, she points to small avocado tree, camera pans up both plants Teacher points to acorn seedling in clay pot Camera pans to middle shelf, sandbox, teacher points to box and shells, she scoops up sand with shells and talks to camera Teacher stacks toy barrels Teacher rubs shell necklace on her throat Teacher lays large sheet of paper on desk, she begins to paint, she paints a mountain, tree, sun and house Teacher introduces Miss Frances, who plays harpsichord and smiles Teacher asks to speak to children's caretakers, she tells them to let babies play with gloves on long trips, she asks for people to send in sunflowers

Abdominal and pelvic organs of a male golfer, animation.

FTG FOR COVERAGE ON MICHAEL JACKSON / MICHAEL JACKSON DEATH INVESTIGATION / DOCTOR CONRAD MURRAY TRIAL DAY 14 CONRAD MURRAY TRIAL 10/20 DAY 14 WITNESSES: STEVEN SHAFER 8:51:55-- COURT RESUMES-- 8:52:33-- DIRECT RESUMES ON SHAFER-- WALGREN-- 8:53:52-- Yes you did-- (answering that he received a report by Dr. White) 8:54:07-- did dr. white suggests that Michael Jackson might have orally consumed Propofol ***8:54:19-- I was disappointed, bc it is not possible. 8:54:33-- because just on first principle alone- oral propfol has no biological activity. 8:54:47-- Propofol is so rapidly metabolized by the liver that very little prop gets past the liver everything that enters the stomach or the intestine goes first to the liver..so when a drug is put into The stomach it first goes tot he liver. The liver has such powerful mechanisms for metabolizing prop that only a very small amount can get past the liver. This is a principal that is taught o first year medical students....it first passes the liver in the first pass effect is what the liver does on the that effect. with propfol we expect all of the drug to be removed by this first pass effect. 8:58:280-- WALGREN INTRODUCES PEOPLE'S 216-- 11 PAGE POWERPOINT SLIDES--P 8:59:17-Bioavailibility refers to whether or not the drug is available to the body after it is given in this case orally. if you inject it, by definition it is in the blood stream. if you eat something it may or may not get into the blood stream and the amount hat does get into the blood stream is called bio-available. 9:00:47-- So- quite obviously this is the digestive track and this shows the mouth the esophagus, the esophagus is the tube that connects the mouth to the stomach. the stomach is this piece here. This si wehre the drug is first processesed of course then it goes to the small intestine and then to the large intestine and then out...all of the blood and all of these organs first flow through to the liver. 9:01:50-- The prop would go down the esophagus to the stomach and absorption would start almost immediately bc it can pass quite quickly....so it would start passing through biological membranes...it passes into the blood stream, all of this blood will take it to the liver....it will turn to the vena cava which is the large blood vessel that takes the blood back to the heart. 9:03:51-- next page of people's 216 9:04:51-- The point of this slide is just to show that the veins that come from the digestive track all go to the liver...so the esophagus here it goes into the stomach, if you take a look at this blue piece here- it goes tot he portal vein and that takes the blood to the liver. Here the intestines, again, that goes into this vein here which comes up and joins this vein here. Those viens all come back into this vein and go to the liver. this is the stomach...the spleen isnt involved in this....this is the small intestine, this large coil is the large intestine. when we talk about Lorazepam we will spent time talking about the Gall Bladder. They wll come together at the portal vein and they go first to the liver where it is subjected to metabolism. 9:07:01-- Functionally it is about 99 percent....99 percent of the drug is removed before it enters the body.. 9:07:30-- so there is no reason to expect oral propofol would have any 9:07:45-- We have learned recently that in fact a propofol is metabolized in two different places. and that is the lining of the gut itself is very active against propfol that is recent information. bc if you look at the liver alone maybe 5-10 percent would get past it. but the gut itself (me . 99 percent is correct, from recent information it is a bit more complex. ***9:08:52--- Absolutely. (NO CHANCE MICHAEL JACKSON DIED OF ORAL PROPOFOL) 9:10:07-- Who is J.B Glen?.....Dr Glen is a scientist at the company which developed propfol as a drug at the time it was called ICI....ICI started making propofiol in about 1973 and Glen was responsible for the development and changes that had to be made for 15 years and JB Glen deserves the title for the father of Propfol. He saw the possibilities of the drug...ups and downs for 15 years. 9:11:31-- Yes, he did the research (for propofol) 9:11:46-- This study looked at prop in various and it was given to mice....And what they found was that intravenous doses of 5-15 mg/kilograms were effective. but even a dosage of 300 mg/kg did not cause the animals to go into general anesthesia. a 20 fold overdose given orally to the mouse was not able to produce general anesthesia. 9:14:22-- well, first what it shows, is that the bioavailability is less than one percent. so less than one percent of the drug is available. it is important to remember in teh diagram where the colon also drains to the liver like the stomach so the fact that it was rectal administration- bc both doses drain to the liver. 9:15:33--Correct. (99 percent is processed through the liver and basically cleaned out of the system) 9:15:55-- shows another publication 9:16:17-- They actually found 10 percent in circulation. so they found a higher percentage, it is a different species- but still a dose was found after oral administration. 9:17:06-- In this study yes, (they found 90 percent is cleaned out through the liver) 9:17:28-- shows US patent 9:17:57-- How did you become aware of this patent?.......Google. ***9:18:13-- What did this patent reveal to you?............this patent described a study also in rats, in this study here, the bio-availability is less than one percent .23 which is a quarter of one percent. it is interesting that one study is 10 percent of bioavailability so there is a study-study difference in rates. it is clear there is an overall pattern that there is not proprofol oral availability in rats. 9:19:29-- shows another patent ***9:19:35-- the possibility that propofol was consumes and affected mj is ruled out by this study.. they give it to dogs and monkeys and less than on percent appeared in the blood in dogs and monkeys after given oral propofol. 9:20:43-- describes White's report suggested that MJ drank propofol and that is what lead to his death. 9:21:40-- All of these studies confirm there was zero possibility this was the cause of MJ's death?.....Correct. 9:22:23-- Yes. (conducted a study with humans regarding the human 9:22:35-- Not that...it is an interesting questions. a company was engaged in looking at this study, at this question, they may have conducted a study but there was nothign published. 9:23:12---Do you know why that was?............I think the answer was considered obvious so it wasnt an interseting question. 9:23:38-- who is Dr. Sepulvida? ....He is a professor of anesthesiology in Chile and a personal friend and he is one of the leaders in contemporary studies of bio-co-kinetics and is the past president and was the host of the conference i attended in May. 9:24:56-- Can you describe the basis parameters of the study?..........There were 6 subjects. the First 3 drank 20 ml of Prop... 9:25:30-- 20 ml bottle is what is represented here in People's 122? 9:26:27-- sidebar ***9:28:28-- 3 volunteers drank 200 mg.... the next 3 drank twice that dose, 400 mg of Propofol. 9:29:02-- Was data collected?............Yes first pulse oximetry was measured, blood pressure was measured and ...additionally blood was taken through the arm and was measured fro propofol. 9:29:38-- The level of sedation was measured?........repeatedly. 9:29:52-- That is the name fo the scale that we use...it is a common validated scale in anesthesia studies. ***9:30:19-- were any of them sedated at any time?.......No, there was no sedation at any time following oral consumption of Propofol. 9:30:39-- Did the level of oxygen every drop?.........No. 9:30:53-- Did the blood pressure ever drop?......No. 9:31:16-- it was presented at the international society of anesthetic pharmacology in Chicago. 9:31:40-- Goes back 25 years and it is the primarily society that brings together scientists and doctors interested in the pharmacology of anesthesiologist drugs. It is once a year, it is a place where all the breaking science in the field of anesthesia is introduced. 9:32:38-- This was presented Victor Contreras was the primary doctor 9:33:19-- Yes I was. It is a lifetime achievement award for my work in anesthetics. 9:34:00-- Why did you do the study?......There is an effort by the DEA to make propofol a restricted drug in the sense that it has to be handled like morphine and it was my view that the publicity about that possibility of MJ drinking propofol was one of the reasons tis was being pursued and my personal belief is that Patients will be hurt. This is a drunk used to maintain anesthesia...have to be able to have ready access bc if you run out....you have to be able to have access quickly. anything that blocks that access, i believe patients are at an increased risk. this study by showing the drug cannot be used orally, meaning that if the drug is abused it will only be through the intravenous route, which limits....i think it addresses an important question about propofol..or places paperwork and hurdles to have access to it. 9:36:14-- I rejected that theory in our initial phone call. 9:36:50-- There was zero possibility that Michael's oral ingestion whether it occurred or not caused his death?.....correct. 9:37:31--- WALGREN INTRODUCES PEOPLE'S 217--- 22 PAGE DOCUMENT LORAZEPAM 9:49:49-- Principal investigator on a randomized comparison of IV lorazepam versus Midazolam 9:50:34-- can you describe what this study was and what is represents?.........This study looked at Lorazepam and Midazolem they were given in the ICU by a computer. We used a computer so we could target exactly the right amount in the blood. also in the ICU they are on the drug for a long period of time....so we can records for a period of days.... 9:51:28-- All controlled by a computer. it simply means that we didnt know what drug the computer givnig. The computer knew if it was Lorazepam or Midozelam but the person operating the computer didnt know. 9:51:56-- We gathered blood levels from the artery to get a very precise model to get the dose of Lorazepam or Midazolem in the blood. 9:52:23-- The amount of data was huge. Each subject was studied very intensely over a number of days. This study provides the best pharma-co-kinetics data. 9:53:22-- Dr. Gellar was responsible for conducting the study, he was the ehad of the ICU. I was responsible for the data analysis. 9:54:40- Are you aware .169 in Femoral blood. 9:54:51-- Are you aware the defendant in his statement, He stated he gave just 4 mg throughout the night in two seperate dosages?...I am ***9:55:42-- There will be a lot of pictures like this....Down here is time. and pharmacokinetic model talk about drugs over time. Allows us to see over time whats happening to the concentration with drug. The model predicts the concentration of Lorazepam in the plasma. It starts at zero....and then conrad murray in his interview stated that at 2 pm he gave approximately 2 mg. this shows teh 2 MG dose- after he pushes that into the vein in the blood concentration goes to .05. Of course the body starts trying to metabolize it immediately. After the a few minutes it goes into other tissues. Both because of the metabolize and bc it is moving in other tissues...bc of that the concentrations fall quite quickly, after the dose it goes up to .05 but just an hour alter it drops. Some of the that is the liver, but most is the drug moving into other tissue. Then coming up here at 5 (5 am) there is another 2 mg dose. there we get to a higher level bc there is already the drug in the body.....And at this point here you see it is a little bit higher, but again there is a very rapid washout of drug. so at 6 am in the morning it is about .6-.4 but we are down to about a third. then at noon at the time of Michael Jackson's death- we are looking at a projected concentration at only 10 percent of what was measured. The red line shows the blood concentration...this green line (femoral blood concentration) is what was measured at autopsy.... this is the number we need to account for. this dose of 2 MG doesn't get you there. 10:00:12-- So, the blood levels prove to you that there is more than 4 MG of Lorazepam administered to Michael Jackson?.....That is correct. 10:01:00-- MID MORNING BREAK--- 10:26:18-- If this had been a total that Michael Jackson received, the femoral vein concentration should have been here, .03...... IF this accurately describes the dosage of what Michael Jackson received, the coroner should find this level....im pointing to this point right here, .025 thats what the coroner would have seen in the autopsy...at 12 o clock circulation stops so the clock stops. 10:27:50-- assuming only 2 doses of 2 mg each...the level is below by about 3 fold. 10:28:24-- shows next slide 10:28:36-- in the case right here, what i have modeled is the administration of a 4 mg dose....basically with continued dosing until given 40 ml you would be able to stack these doses up, so that when the levels start to drop- you see this number that was observed on autopsy. 10:29:45-- No. In this simulation the only number i have to work with is the .169. most simulation you know the dose it is on the medical record. there is no medical record so i cant simulate what was done bc there is no medical record. Is there a sequence of regular doses consistent with this time period where Dr. Murray was trying to get Michael Jckson off to sleep? 10:31:16-- Walgren approaches witness with empty lorazepam bottle 10:31:30-- 10 ML of drug and each ML of drug has 4 mg in it. So 4 MG/ ML times ton is 40 MG of drug inside this empty vial. ***10:32:17-- Does reach the .169 at about the noon hour?.... it reaches the correct level we have from autopsy and it is consistent with the quantity of drug in one vial of Lorazepam. 10:33:05-- There is Lorazepam which is the drug and there is a metabolite that is produces by the liver when Lorazepam goes through the liver. that is called Lorazepam Glucuronide bc the liver attaches a littel sugar molecule to it and that creates Lorazepam Glucuronide 10:34:02-- explains the diagram of Lorazepam Glucuronide molecule. 10:35:00-- this drug cannot pass out through the urine......so the liver and the kidney's go together 10:35:32-- shows slide of lorazepam molecule and the vial 10:35:45-- thats the molecule that makes you sleepy. 10:36:01-- This is what the coroner measured and in our own research at Standford this is what we measure. 10:36:32-- The drug it goes through the liver and the liver attaches this glucose moelcule to it. It first makes it is inactive, it doesnt make you sleepy. but additionally this molecule can go out in the urine. so the liver converts lorazepam to Lorazepam Glucuronide. 10:37:41-- Walgren shows Defense exhibit GG or People's 218 (which has additional hand-writing on it)

THE HEIMLICH MANEUVER. DR. HENRY HEIMLICH, A LEADING SPECIALIST IN ESOPHAGUS SURGERY, TEACHES A SIMPLE FIRST AID PROCEDURE THAT HE HAS DEVISED AND WHICH HAS PROVEN SUCCESSFUL IN SAVING THE LIVES OF CHOKING VICTIMS