Morphology of "asphyxia-induced epiglottis form" in newborn infants, infants and young children

A systematic histological study of cross-sections of the larynx from 52 fatalities (neonates, infants and young children) revealed a broad spectrum of anatomical variants in the epiglottis form, which were caused by variations in the epiglottic cartilage. There was no correlation between the epiglottis form and the age of the child. Furthermore, no differences in shape could be established between cases of SIDS and control cases. The term "asphyxial-related epiglottis form" appears to be inappropriate. The commonly found supraglottic laryngitis on the laryngeal aspect of the epiglottis was seen in combination with histologically proven infections in the upper and lower respiratory tract. Histological investigation of the larynx provides valuable information for the morphological diagnosis in fatal cases in early life.     

Sudden death from saccular laryngeal cyst

Laryngeal cysts are benign, uncommon lesions of the larynx that have been reported on rare occasions to cause sudden death in infants and adults by acute airways obstruction. In this report, we document the sudden death of a 36-year-old woman from a previously undiagnosed, asymptomatic laryngeal saccular cyst that presented with acute, and consequent fatal, airway obstruction. Difficulty during intubation, both in theater and in emergency settings, is a frequent presenting problem. This can have significant medicolegal implications in determining possible negligence. The diagnosis, classification, and management of such cysts, and their importance to both the forensic pathologist and clinicians are discussed.     

Regulation Crisis: Evaluating the Potential Legitimizing Effects of "Corporate Manslaughter" Cases

This article identifies a new direction for discussion of the proposed "corporate manslaughter" offense. Considering work-related fatality cases with reference to the concept of legitimacy allows us to obtain a fuller understanding of their importance and the potential benefits associated with reform of the law. Work-related fatality cases have inherent power as "signal offenses." A failure to resolve these cases in a manner that satisfies the interests of the "publics" that the Health and Safety Executive (HSE) faces, may lead to a crisis of legitimacy for the agency. Reforming the law so as to facilitate such a response may offer important legitimatory benefits to regulators.     

Traumatic injuries in pregnant women: a case of motor vehicle accident for "Ground Round" discussion

The main objective for introducing this case study is to create a platform from which the importance of road traffic related injuries and traumas can be emphasized and discussed within and across various fields of investigation. The long term goal is to entice public campaign around unmet needs for higher road safety measures to reduce primary, secondary, and tertiary risks of injuries and traumas. CASE: a 28-year-old pregnant woman with a 16-week gestational age fetus was involved in a road car crash resulting in multiple traumas. Evaluation and treatment was initiated in the local Urgent Care Unit and continued in the emergency department and operation room. Patient underwent the following procedures: laparotomy, diverting colostomy, terminating pregnancy, right calcaneal traction and long leg splint, as well as multiple irrigation-debridements. Finally, the wound was left open and the patient was admitted to Intensive Care Unit. We hope that the introduction of this case for a "Ground Round" discussion will stir up a comprehensive discussion regarding the injury and trauma related preventive measures as well as treatment approaches in cases involving pregnant women in car accidents, and will bring about a holistic overview of this issue by the experts in various fields. ?     

Dependability of ABO findings in stored blood samples

Report on the occurrence of "acquired" A or B in stored blood samples. This bacterial alteration is of importance when an indirect experimental investigation with the absorption-elution technique is needed in advanced cases of hemolysis. One has to consider this disturbing factor in identification tests (alcoholic blood samples). In dried blood stains we did not notice this problem, but it has to be taken into account in genitals stains.     

Mechanical airway obstruction caused by accidental aspiration of part of a ballpoint pen

The authors present three cases of death in children aged 4, 9, and 10 years, respectively, that were first thought to be caused by herbal or other poisonings but at autopsy were found to be caused by airway obstruction from aspiration of ballpoint pen parts. Aspiration of a foreign body is a leading cause of accidental death in children, but the circumstances in these cases were unique. In the first case, a 4-year-old child died shortly after a visit to a traditional healer. The child's mother blamed him for the death and fatally assaulted him. The second case was a 9-year-old who died at school. Case 3 was a 10-year-old who collapsed while playing with a ballpoint pen in her mouth. In the latter two cases, the relatives alleged poisoning. At autopsy, there was no evidence of trauma, disease, or poisoning in all three cases. Ballpoint pen parts were present in the larynx, carina, and left main bronchus, respectively. Features of "asphyxial" death were present, and included subconjunctival hemorrhages, subendocardial hemorrhages, and congestion of the face and internal organs. These deaths are preventable by education of children, parents, and teachers. Ballpoint pen manufacturers should also modify the design of these pens to improve their safety.     

Prior problem behavior accounts for the racial gap in school suspensions

Purpose

A large body of empirical research finds a significant racial gap in the use of exclusionary school discipline with black students punished at rates disproportionate to whites. Furthermore, no variable or set of variables have yet to account for this discrepancy, inviting speculation that this association is caused by racial bias or racial antipathy. We investigate this link and the possibility that differential behavior may play a role.

Methods

Using data from the Early Childhood Longitudinal Study, Kindergarten Class (ECLS-K), the largest sample of school-aged children in the United States, we first replicate the results of prior studies. We then estimate a second model controlling for prior problem behavior.

Results

Replicating prior studies, we first show a clear racial gap between black and white students in suspensions. However, in subsequent analyses the racial gap in suspensions was completely accounted for by a measure of the prior problem behavior of the student – a finding never before reported in the literature.

Conclusions

These findings highlight the importance of early problem behaviors and suggest that the use of suspensions by teachers and administrators may not have been as racially biased as some scholars have argued.     

Soft tissue hemorrhage within the larynx following strangulation

The inner soft tissues of the larynx (i.e., true vocal cord, false vocal cord, paralaryngeal space) were examined by special preparation of the larynx: thyroid cartilage was detached from the cricoid and the laryngeal cords, which could then be examined. Bleeding (not visible before) was found in 18 of 40 cases of persons killed by throttling or choking; bleeding occurred whenever blunt trauma of the throat had taken place (n = 8). Hemorrhage develops even in cases without damage to the laryngeal skeleton; this bleeding can result from direct compression of the larynx (large and not well defined bleeding) and can originate indirectly (small hemorrhages mostly in the vocal muscles). The finding of hemorrhages like this can help to demonstrate that the victim has undergone a violent attack on the throat.     

Instructions for the complete preparation of the larynx

A method of preparing the larynx in forensic cases is described especially when death occurs by strangulation (manually or using some form of ligature). After the usual dissection of the hyoid bone and the upper horns of the thyroid cartilage, the complete larynx is clipped and fixed in formaldehyde overnight. The first part of dissection after that is to cut away the thyroid gland and the remaining muscles in front of the larynx, except for the cricothyroid muscle and the esophagus and hypopharynx from the back of the larynx. The complete thyroid cartilage is dissected out, and then a horizontal cut is made through the cricoid cartilage. Median-sagittal halving of the remaining larynx completes the gross dissection. Arytenoid cartilages are exposed by dissection of the arytenoid muscles and opening the cricoarytenoid joints. Now all parts of the laryngeal skeleton and all articulations are examined, and all muscles and soft tissues are visible and can be clipped for histological examination.     

Aspiration of gastric contents in hanging with typical position of the strangulation cord and free suspension]

Among 193 cases of hanging from the years 1978 to 1991 examined in the institute of Forensic Medicine of the Freie Universit?t Berlin 8 cases with an aspiration of stomach contents had been reported. Herefrom 3 cases were hanging in a "typical" position (suspension point at the back of the head, free suspension of the hanging body) and did not undergo resuscitation. By free suspension of the hanging body the observed massive aspiration of gastric contents only can be explained by an at least partly open connecting passage between the laryngeal entry and the entrance of the oesophagus. The post mortem flowing in of stomach contents as well as a post mortem gastro-oesophageal peristalsis seem not to be able for explicating the findings. Differences in important parameters (e.g. gastric contents, alcoholization) to the cases of hanging without aspiration were not found. Even by free suspension of the body, running noose and point of suspension in the back of the neck sometimes the connection between larynx and oesophagus may stay open, especially when by emesis a high pressure is produced by the stomach.     

European Corporate Laws, Regulatory Competition and Path Dependence

Beyond the well-known discussion in regard to the Cassis de Dijon of the European Court of Justice, implying the mutual recognition of national product regulations, the topic of mutual recognition and regulatory competition has emerged again in the realm of European corporate laws (“Centros” of the ECJ in 1999). Can effective competition among European corporate laws be expected? In the US a broad discussion has developed whether the existing competition process among US corporate laws leads to permanent legal improvements by legal innovations or to a race to the bottom. Beyond this discussion a new point has been raised recently: the possibility and importance of path dependence as a potential problem for the efficacy of competition among corporate laws (lock-ins). For the analysis of this problem we apply the concept of technological paradigms and trajectories to legal rules in corporate law and introduce “legal paradigms,” which direct the search for better legal solutions in certain directions and might be stabilized by certain factors (esp. complementarities to other legal rules) leading to considerable path dependence effects. Our results show that path dependence might play a crucial role for competition among European corporate laws, even if the principle of mutual recognition would be introduced to corporate laws in the EU, implying that competition among European corporate laws might be difficult and sluggish. Consequently the question arises whether additional meta-rules should be established that might mitigate the problem of path dependence and lock-ins in regulatory competition in corporate law.     

定性变量指数的编制及其监狱安全事故评估研究

在讨论单一现象动态总指数与多现象静态总指数分类的基础上,介绍了针对伴随安全事故发生的变量多为定性的非数值型变量的特点,怎样运用静态总指数方法编制监狱安全事故指数,并通过案例实证了运用指数评估监狱安全的实际意义,最后对研究成果的理论意义作出了客观评价。     

实质刑法解释合理实现的程序性论证规则

刑法解释是研究中国刑事法治形成的重要题域。以程序与议论为双轨的实质刑法解释论是超越主观主义解释论与客观主义解释论之争的第三条道路,它通过程序与议论、对话与论证在交谈意义的合理性上来实现刑法价值判断的客观性。取消最高人民检察院有权刑法解释主体的地位,废除《刑法》第306条规定的辩护人、诉讼代理人毁灭证据、伪造证据、妨害作证罪,取消法官错案追究制,建立判决书说理制度,都是围绕如何构造一个平等、自由、不受强制的议论场域而设计的程序规则,以保障实质刑法解释的合理实现。     

How extensive can injury of the larynx in self-choking be?]

Is it possible to distinguish between suicidal and homicidal strangulation by the extent of the injuries of the larynx if the results of the police investigations are uncertain? Therefore evaluation of the German publications (115 reported cases of suicidal strangulation) and our own cases (17 cases). Hereafter more intensive injuries of the neck are extremely rare in cases of self-strangulation. Casuistic: Body of a 40 years old woman with signs of strangulation. The husband declared his wife strangulated herself in the bathtub with the belt of a bathrobe. Autopsy: Typical findings of drowning, intensive injuries of the neck tissues and the larynx. Kind and extent of the findings are speaking well for an assault mainly by manual strangulation. Undepending of the medical findings the police investigations are almost excluding a suicide. Condemnation of the husband.     

Importance of electromyography and the electrophysiological severity scale in forensic reports

Forensic reports on traumatic peripheral nerve injuries include dysfunction degrees of extremities, which are arranged according to the Turkish Penalty Code. The aim of this study is to discuss the role and importance of electromyography while preparing forensic reports in the cases of traumatic peripheral nerve injuries and the usefulness of scoring systems. A modified global scale, recommended by Mondelli et al., was used to assess the electrophysiological impairment of each peripheral nerve. Forensic reports of 106 patients, reported between 2002 and 2004, were evaluated. Thirty-four percent of the cases were reported as "total loss of function," 41.5% were reported as "functional disability," and there were no dysfunctions in the other cases in forensic reports that were prepared based on Council of Social Insurance Regulations of Health Processes and Guide prepared by the Council of Forensic Medicine and profession associations of forensic medicine. When we rearranged these forensic reports based on the electrophysiological severity scale (ESS), it was clearly found that all of the score 2 cases and 86.7% of the score 3 cases corresponded to "functional disability" and 91.4% of the score 4 cases correspond to "total loss of function." We found a significant correlation between the ESS and functional evaluation in peripheral nerve injury cases. Evaluation of functional disabilities in peripheral nerve injuries with the ESS represents a standardized and objective method used for forensic reports.     

WHY A LAWYER?—THE IMPORTANCE OF CLIENT‐DIRECTED LEGAL REPRESENTATION FOR YOUTH

This article begins with a discussion about the importance of ensuring that all children have lawyers in abuse and neglect cases. Lawyers provide a vital role in giving youth a voice in proceedings that sound profoundly affect their lives. The article then discusses why the client‐directed lawyer's role is consistent with federal law and legal ethics. Finally, the article discusses the growing support for client‐directed representation and what the American Bar Association has done to support this type of child representation.     

Young Lawyers and Work in the Public Interest

Much of the discussion of the bar's "public interest" effort has centered on the apparent unwillingness of lawyers, including young lawyers, to pursue public interest rather than traditional careers. To the extent that it is agreed that public interest work should be increased, the problem has been viewed as one of supply of lawyers rather than one of demand for their services. In this paper, just the opposite is argued; a variety of evidence is brought forth to suggest that the current public interest effort is limited mainly by the number of jobs available in that sector. In this light, various methods of increasing the funding of the public interest sector, and hence the number of jobs, are reviewed.     

Virtopsy hemorrhage of the posterior cricoarytenoid muscle by blunt force to the neck in postmortem multislice computed tomography and magnetic resonance imaging

In forensic autopsies, one of the most important and common signs of violence to the neck is hemorrhages of the soft tissues. The Institute of Forensic Medicine in Bern evaluates the usefulness of postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) of forensic cases prior to autopsy. The aim of this study was to prove the sensitivity of postmortem MSCT and MRI in the detection of hemorrhages of the neck muscles. A full body scan prior to and a detailed scan of the explanted larynx after autopsy were performed. MSCT detected multiple fractures of the larynx. Detailed MRI was able to demonstrate the hemorrhage of the left posterior cricoarytenoid muscle. The minor hemorrhage of the right posterior cricoarytenoid muscle could not be detected with certainty. Although more experience is required, we conclude that combined MRI and MSCT examination is a useful tool for documentation and examination of neck muscle hemorrhages in forensic cases.     

肥羊之争:产权界定的法学和经济学思考——兼论《商标法》第9、11、31条

通过对"小肥羊"商标案判决理由的批评性讨论,从法律解释和经济分析两个层面表明,单一适用《商标法》第11条第二款及其隐含的强者通吃的产权进化理论,不仅会与该法第31条包含的在先权利保护规则相冲突,而且可能导致严重的社会福利损失。主张通过法律解释结合《商标法》第9、11、31条的有关规定,依据责任规则处理权利冲突情况下的产权界定问题,可能获得更为公平也更有效率的司法和社会结果。     

Public corruption and fraud in the Netherlands: Research and results

Empirical research by social scientists on public corruption and fraud in the Netherlands has been scarce. Exceptions are research on criminal cases of corruption and, recently, a survey among local government functionaries to establish the extent of public corruption and fraud in the country. The article presents the conceptual framework and the results of this survey research on local corruption and fraud. A discussion of the findings concludes the article: How serious is the problem of Dutch public corruption and fraud? To stimulate comparative research, the questionnaire is added in an Appendix.