Fatal outcome of poisoning with the benzodiazepines flunitrazepam and diazepam

On a wintry day a 29-year-old woman was found dead beside her car showing head injuries and signs of hypothermia. Several empty packets of sedative and hypnotic drugs were lying inside the car. Toxicological analysis revealed the presence of flunitrazepam (heart blood of the left and right chamber 0.033 mg/L each), norflunitrazepam (left heart blood 0.029 mg/L, right heart blood 0.027 mg/L), 7-amino-flunitrazepam (left heart blood 0.090 mg/L, right heart blood 0.104 mg/L), diazepam (left heart blood 0.395 mg/L, right heart blood 0.386 mg/L), nordazepam (left heart blood 0.112 mg/L, right heart blood 0.115 mg/L) and temazepam (left heart blood 0.034 mg/L, right heart blood 0.033 mg/L). Neither alcohol nor other drugs were found. It was concluded that benzodiazepine intake led to a disturbance of consciousness. Whether the woman died in this situation due to the icy temperature as a result of hypothermia or whether she died or would have died solely due to benzodiazepine overdosage could not be clarified.     

P物质在过敏性休克家兔胃肠道内的表达

目的观察P物质在过敏性休克家兔胃肠道组织中随时间变化的规律,探讨其在过敏性休克中的作用。方法 30只家兔随机分为实验组(24只)和对照组(6只)。实验组采用多人混合血清致敏家兔,建立过敏性休克模型。休克不同时间段(猝死即刻、休克0.5h、休克1h、休克2h)提取家兔胃、小肠、圆小囊。冰冻切片,应用免疫组化(IHC)SP法和原位杂交(ISH)方法进行P物质染色,BI-2000计算机图像分析系统进行图像分析,计算阳性积分光密度值(IOD),用SPSS11.5统计软件进行方差分析,SNK检验。结果与对照组相比,实验组各小组胃、肠、圆小囊P物质蛋白和mRNA表达明显增加,且随着休克时间的变化逐渐减弱(P0.001)。IHC方差分析结果为:胃组织F=198.008,肠组织F=56.796,圆小囊组织F=67.231;ISH统计学分析方差分析结果为:胃组织F=67.506,肠组织F=72.117,圆小囊组织F=216.798。结论家兔胃肠道P物质在过敏性休克后一段时间内(2h)均表达增高,随休克时间的延长逐渐下降。     

Suicidal contact gunshot wounds to the head with .38 Special Glaser Safety Slug ammunition

Glaser Safety Slug TM ammunition is a uniquely designed, essentially prefragmented ammunition. Tests performed by the U.S. Justice Department demonstrated that the ammunition possesses high kinetic energy, high relative incapacitation index (RII) and poses a very low risk to bystanders because of its total loss of kinetic energy in the target. Despite having been manufactured since 1974, no deaths from this ammunition have been previously reported. The authors herein describe the first three reported human deaths.     

Control of communicable diseases. Interim final rule with comment period

The Public Health Service Act authorizes the Secretary, in consultation with the Surgeon General, to make and enforce regulations as are necessary to prevent the introduction, transmission or spread of communicable diseases from foreign countries into the States or possessions, or from one State or possession into any other State or possession. The existing regulations are outdated and do not address communicable diseases that currently pose a substantial public health threat. As of April 2, 2003, the World Health Organization (WHO) has reported 2236 cases and 78 deaths related to outbreaks of a severe form of pneumonia of unknown origin in Hong Kong SAR, Vietnam, Guangdong province in southern China, Canada, Singapore, and Thailand, which appears to have spread rapidly. For this reason, the Director General of the World Health Organization (WHO) issued a global alert about cases of atypical pneumonia and recommended that travelers with atypical pneumonia who may be related to these outbreaks be placed into isolation and assessed by quarantine officials. The Centers for Disease Control and Prevention (CDC) is currently investigating 85 suspected cases of the disease in the United States. This is being issued as an interim final rule because this newly-detected disease is likely spread in person-to-person fashion and may have an adverse public health impact if further introduced into the United States.     

Dieulafoy lesion of the esophagus causing massive upper gastrointestinal bleeding and death: a case report

Dieulafoy lesion is a rare cause of upper gastrointestinal bleeding. We present a case report of sudden and unexpected death in a previously healthy male where autopsy revealed a classic Dieulafoy lesion with a submucosal artery protruding through a small mucosal defect in the esophagus, thereby exposing it to stress and consequent rupture. Advances in endoscopic techniques have drastically reduced mortality from Dieulafoy lesion. Nevertheless, it is an important diagnosis to be kept in mind when autopsy reveals an upper gastrointestinal bleeding.     

浅谈高空轻生事故的处置

近年来,社会上出现高空轻生的事故越来越多.处置高空轻生事件成为消防部队社会救助行动中一个新的课题.对高空轻生者实施救援难度大,如何顺利救出轻生者成为消防部门救援的一个难点.本文结合福州市公安消防支队近年来的案例及当前救援实际情况,对高空轻生事故的原因、特点、救援措施进行研究和探讨.     

Suicidal electrocution using timers. Case reports and review of the literature]

Suicidal electrocution using a time switch is relatively rare. Based on two cases from the authors' own forensic material and seven cases from literature peculiarities regarding the concomitant intake of medicines (benzodiazepines) and alcohol are discussed and comments are made how to proceed in the criminal and forensic investigation of such cases.     

Homicidal traumatic asphyxia associated with pebble impaction of the upper airway.

The news media tend to sensationalize murders involving multiple methods because of their inherent brutality. Similarly, when addressing a jury, prosecutors often emphasize the most grisly part of a murder to ensure a speedy conviction. This paper reports a case of a teenage boy who was murdered by the use of multiple methods of asphyxia. The methods of asphyxial death and the reconstruction of the sequence of events by the medical experts during the murder trial played an important role in the conviction and ultimate sentencing of the perpetrators.     

Case comment: Moore v. Regents of the University of California.

The increasing use of human tissues in medical research has spawned a host of ethical and legal debates. Legal analysis in this area has almost exclusively focused on the question of property rights in both the tissues used in research and in the resulting products. One illustrative case is Moore v. Regents of the University of California, in which a patient sued his doctor for conversion of his spleen which had been removed for therapeutic purposes. The doctor later used the spleen to develop a patented and profitable cell-line. This Comment examines and rejects the property law approach to this issue. Instead, this Comment proposes two legislative changes which would 1) eliminate any trade in human tissues and 2) require doctors to inform their patients of any research interest in proposed medical procedures. These proposals resolve the problem presented in Moore, and avoid the misleading, and inevitably unanswerable, question of property rights.     

Further insights into the persistence of transferred fibres on outdoor clothes.

This study was conducted to assess persistence of fibres on items of outdoor clothes in normal wear situations. The persistence of acrylic and wool fibres transferred on 23 recipient garments was examined in relation to: time of wear; features of the recipient garment (fibre composition, surface structure and texture); conditions of wear (public transport used or not), and; their location on the recipient. After 8 hours of wear more than 75% of transferred fibres were lost during 8-10 hours of wear. After 16 hours of wear no more than 10%, most often up to 5%, of fibres remained. Fibres were lost at higher rate when public transport was used. The persistence of fibres depended more on the surface structure and texture of the recipient garment and the location of donor fibres rather than on the type of fibre.     

从警察执法权威缺失透析暴力袭警问题

近年来,公安民警在执法过程中遭遇暴力袭击的事件频发,不仅严重阻碍了正当执法工作的进行,而且对人民警察的人身安全构成了极大威胁,本文试从当前警察执法权威缺失的角度对暴力袭警的问题进行探讨.     

Medicare program; Medicare coverage of screening mammography--HCFA. Interim final rule with comment

This interim final rule implements section 4163 of the Omnibus Budget Reconciliation Act of 1990 (Pub. L. 101-508), which provides limited coverage for screening mammography services. It amends current Medicare regulations to set forth payment limitations and conditions for coverage of screening mammography. The conditions consist of quality standards to assure the safety and accuracy of screening mammography services performed by qualified physicians and other suppliers of these services.     

Medicaid program; State share of financial participation--HCFA. Interim final rule with comment

Under certain circumstances, States are currently permitted to use voluntary contributions (donated funds) from providers and all revenues from State-imposed taxes, as the State share of the costs of the Medicaid program. There is now widespread use of State donations or other voluntary provider payment programs that unfairly affect the Federal share of Federal Financial Participation (FFP). This practice circumvents the States' statutory obligation to expend funds for medical assistance. Therefore, effective January 1, 1992, this interim final rule requires that the amount of funds donated from Medicaid providers be offset from Medicaid expenditures incurred on or after this date before calculating the amount of FFP in Medicaid expenditures. It also interprets section 4701(b)(2) of the Omnibus Budget Reconciliation Act of 1990, which added section 1903(i)(10) to the Social Security Act. Section 1903(i)(10), precludes Federal Financial Participation (FFP) in State payments to hospitals, nursing facilities, and intermediate care facilities for the mentally retarded for facility expenditures that are attributable to provider-specific State taxes.     

Medicaid program; Medicaid managed care. Withdrawal of final rule with comment period

This document withdraws all provisions of the final rule with comment period on Medicaid managed care that we published in the Federal Register on January 19, 2001 (66 FR 6228) with an initial effective date of April 19, 2001. This January 19, 2001 final rule, which has never taken effect, would have combined Medicaid managed care regulations in a new part 438, implemented Medicaid managed care requirements of the Balanced Budget Act of 1997 (Pub. L. 105-33), and imposed new requirements on entities currently regulated as "prepaid health plans' (PHPs). The regulations set forth in the final rule being withdrawn have been superseded by regulations promulgated in a subsequent rulemaking initiated on August 20, 2001 (66 FR 43613). In addition, this document addresses comments received in response to an interim final rule with comment period that we published on August 17, 2001 in the Federal Register (66 FR 43090) that further delayed, until August 16, 2002, the effective date of the January 19, 2001 final rule with comment period.     

Graduate and professional study fellowships--Department of Education. Final regulations with invitation to comment

The Secretary issues final regulations for the Graduate and Professional Study Fellowships Program. The regulations, which implement Title IX, Part B of the Higher Education Act of 1965, have been amended to reflect the statutory changes in the Education Amendments of 1980 and to reflect changes required by the Education Department General Administrative Regulations (EDGAR). These regulations specify the selection criteria the Secretary uses in evaluating applications for fellowships for graduate and professional study, public service education, and studies in domestic mining and mineral and mineral fuel conservation. These regulations also describe application procedures, eligibility requirements, and the terms and conditions of an award.     

再论计算机犯罪概念

犯罪学与刑法学都以犯罪作为主要的研究对象,但是由于两种学科的任务和目的不同,导致犯罪学与刑法学是两种不同的语言环境。计算机犯罪概念在犯罪学和刑法学的定义中也会存在较大的差异,此差异是目前计算机犯罪概念难以形成统一认识的最重要的原因。如果在犯罪学语境中定义计算机犯罪,那么计算机犯罪的外延包括以计算机作为犯罪对象的计算机犯罪和以计算机作为犯罪工具的计算机犯罪。