Clustering of multiple sclerosis in Galion, Ohio, 1982-1985

Epidemiologic evidence indicates that the outbreak of 30-40 cases of multiple sclerosis and other demyelinating syndromes in Galion, Ohio, USA, during 1982-1985 was related to an excess concentration of heavy-metal wastes, especially of cadmium and chromium in sewage and river water. Both multiple sclerosis and myasthenia gravis were diagnosed by board-certified neurologists.     

Epidemiology, etiology, and prevention of multiple sclerosis. Hypothesis and fact

Slow, retrograde seepage of ionic mercury from root canal or Class V amalgam fillings inserted many years previously, recurrent caries and corrosion around filling edges, and the oxidizing effect of the purulent response may lead to multiple sclerosis in middle age. Epidemiologic studies of MS consistently reveal more neurological disease in the north, inferentially because there may be less caries and therefore fewer fillings done in the south. Clinical and epidemiologic data also suggest that a second heavy metal, lead, may operate almost interchangeably with mercury. Possibly, cases of unilateral MS derive from mercury-amalgam fillings in ipsolateral teeth, whereas the generalized disease may result from ingestion or inhalation of volatile mercury or exhaust fumes of lead additives to gasoline. The forensic and preventive-medical challenge is to identify, monitor, and resolve questions of hidden heavy metal hazards in a high technology society, especially those of lead and mercury. Further clinical-epidemiologic and basic science studies of heavy metal assays in whole blood, CNS tissues, packed cells, and serum are warranted. Prevention awaits further testing of the hypothesis and experience with substitute filling materials.     

New York's Blue Cross and Blue Shield, 1934-1990: the complicated politics of nonprofit regulation.

The story of New York Blue Cross is one of complex interaction with state and federal regulators and also with hospitals, the medical profession, commercial insurers, and the public, who make up the regulatory environment. Negotiation, cooperation, and adaptation among parties whose goals and assumptions were partly parallel characterize the relationships. As we can see from New York Blue Cross's origins and its role in the development and administration of certificate-of-need legislation, Medicare, insurance practice and regulation, and hospital rate setting, this story does not represent the capture of government by a special interest, nor the gradual souring of a public interest organization, nor disinterested and distant government regulation.     

The investigation of alleged insecticide toxicity: a case involving chlordane exposure, multiple sclerosis, and peripheral neuropathy

A man with no previous medical problems had two documented exposures to an insecticide containing the organophosphorous compounds chlordane and heptachlor. Six months to one year later, he began to experience neurological symptoms which progressed until his death. At autopsy, his brain showed classic findings of multiple sclerosis, and he had a severe peripheral neuropathy. Review of the literature indicates that the findings are not compatible with chlordane toxicity. Some of the factors to be used in determining the casual relationship between toxic exposure and disease processes are discussed.     

Paraquat (gramoxone) poisoning in south-west Hungary, 1977-1984. Toxicological and histopathological aspects of group intoxication cases

Fifty-six cases of paraquat poisoning were examined during the 8 years 1977-1984. The ratio of cases of accidental to intentional ingestion of the poison was 1:1; 23.2% of the total (13/56) survived several months or years. In 1983, 11 subjects accidentally drank 10-30 ml of gramoxone; eight of 11 died in 2 weeks. Toxicological investigations demonstrated rapid elimination of poison from the blood, as well as prolonged fixation of paraquat in the lung, kidney, liver, and spleen tissues. Histological examinations showed multiorgan failure from renal tubular necrosis and pulmonary hemorrhage with alveolar epithelial injury. Pulmonary proliferative changes were present in only two cases who survived 7 and 10 days and in which artificial ventilation was utilized.     

Causes of unexpected death in patients with multiple sclerosis: a forensic study of 50 cases

To determine the cause of death (as a result of neurologic or nonneurologic complications or accidents) in patients with multiple sclerosis (MS), we reviewed the autopsies of 50 subjects with MS from the Office of the Chief Medical Examiner of Maryland (OCME) between 1982 and 2004. The series included 32 females and 18 males (mean age, 45.8 years; range, 25-69 years) and the causes of death were classified into 3 categories: (A) neurologic complication directly related to MS; (B) nonneurologic complications or other medical causes; and (C) accidents, etc. Of the 50 cases, in 43 there was a history of MS, but in 7 subjects there was not, and the diagnosis was established by neuropathologic examination. In Group A, 21 (42%) cases, deaths were directly related to a neurologic complication; in Group B, 14 (28%) cases were related to the following nonneurologic and medical causes: ASCVD 9 (18%), metabolic disorder 1 (2%), pulmonary embolism 3 (6%), and bronchopneumonia 1 (2%); and in Group C, 15 (30%) cases, deaths were due to trauma, 9 (18%); intoxication, 5 (10%); and thermal injury, 1 (2%). Thus, among the 50 subjects, in 26, deaths occurred naturally; and in 24, from accidents, homicides, suicides, or undetermined causes. Pathologically, the majority of cases showed either chronic inactive (66.7%) or chronic active (15.6%) demyelinating lesions, mainly in the cerebral hemispheres. In some cases, it appears that demyelinating lesions, involving brain regions that regulate cardiorespiratory activity, could be considered as the immediate cause of death, but a large proportion appears to be due to other causes such as accidents and trauma. Thus, it seems likely that taking specific precautions could prevent some deaths in MS.     

Legal Mobilization and the Politics of Reform: Lessons From School Finance Litigation in Kentucky, 1984-1995

This article is about legal mobilization by claimant groups seeking left-liberal reform in the United States. Drawing on a growing body of work in political science and legal studies, it takes an interpretive, legal-mobilization approach to one litigation-based reform effort: school finance litigation and education reform in Kentucky. In turn, this case study provides leverage for theorizing about legal mobilization and the role of law and courts in social reform. The article argues that current theoretical approaches either overlook or neglect the implications of important dimensions of legal mobilization by would-be reformers. Specifically, it highlights and explicates the meaning of two related themes: (1) legal translation, taken up here as legal framing and legal construction, and (2) the degree of coherence or fit between the legal and political components of reform projects that include both legal mobilization and extrajudicial strategies and tactics. This article suggests that the "degree of coherence" may have an important but underappreciated relationship to the overall success or failure of such reform projects.     

Registration and reregistration application fees. Confirmation of final rule,remanded for further notice and comment,and response to comments

DEA is publishing a final rule regarding the registration and reregistration fees charged to controlled substances registrants. DEA is required to charge reasonable fees relating to the registration and control of the manufacture, distribution, and dispensing of controlled substances. To address this mandate, on March 22, 1993 DEA published a final rule in the Federal Register, establishing registration fees for controlled substances registrants (58 FR 15272). Following publication of the final rule, the American Medical Association (AMA) and others filed a complaint in the United States District Court for the District of Columbia objecting to the new fees. The district court issued its final order granting the government's motion for summary judgment and disposing of all claims. The AMA appealed. The United States Court of Appeals for the District of Columbia Circuit found DEA's rulemaking to be inadequate. The appeals court remanded, without vacating, the rule to DEA, requiring the agency to provide an opportunity for meaningful notice and comment on the fee-funded components of the Diversion Control Program. DEA responded to the remand requirement through a document published in the Federal Register on December 30, 1996 (61 FR 68624). This Final Rule supplements the December 30, 1996 Federal Register document and with that document, constitutes the final rule on the Drug Diversion Control Fee Account.     

Geographical patterns of incendiary and accidental fires in Springfield,Massachusetts, 1980–1984

Arson is a serious crime occurring with increasing frequency in urban America today. To date, this crime remains poorly documented and seldom discussed in the literature, particularly from a geographical viewpoint. This study examined the spatial distribution and underlying factors associated with 440 arson and 732 accidental fires recorded in Springfield, Massachusetts, between 1980 and 1984. Based upon a series of dot and choropleth maps, there was evidence that both incendiary and accidental fires were clustered not only in specific Springfield neighborhoods but also along individual city streets. In an attempt to understand better the varying frequency of arson fires among the 36 census tracts in the Springfield study area, a multiple regression analysis was performed using census data reflecting a variety of social, economic, and housing characteristics. Two variables, representing housing vacancy and tenement-type housing, entered into the final regression equation. Together, these two variables accounted for 70.4% of the reported arson cases. A subsequent inspection of the regression residuals revealed a random geographical pattern, thereby precluding any simple explanation for the remaining unexplained arson. Other factors such as insurance, building ownership, and length of occupancy were thought to warrant examination in future research.     

Consumption of a large dose of alcohol in a short time span.

Blood alcohol concentrations (BAC) and time to peak BAC were determined in 16 subjects after ingestion of a large quantity of alcoholic beverages within a short drinking time span not exceeding 30 min. The first group (7 subjects) consumed alcohol after a 3- to 4-h fast. In the second group (9 subjects) the consumption of alcohol took place after eating a large meal. Venous blood samples taken 30 min after drinking finished were compared to the near-simultaneous Breathalyzer results. In addition, the minimum duration of a BAC plateau for these drinking circumstances was assessed.     

The relationships between time in jail,time on electronic monitoring,and recidivism: An event history analysis of a jail-based program

Considerable theoretical and empirical attention has been given to the relationship between time incarcerated and recidivism. Much less attention has been devoted to alternative sanctions such as house arrest with electronic monitoring and recidivism following participation in such programs. In this paper we use event history techniques to assess the relationships between time spent in jail, time spent on electronic monitoring, and recidivism in a sample of offenders who spent at least some time on electronic monitoring. The results suggest that the longer the time on electronic monitoring, the lower the likelihood of recidivism. This effect, however, varies by type of offender. Despite some evidence of a curvilinear relationship between time in jail and recidivism, the relationship is not robust to the inclusion of other control variables. Theoretical and practical implications of these findings are discussed.     

Fatal intoxications in the age group 15-34 years in Denmark in 1984 and 1985. A forensic study with special reference to drug addicts

This survey deals with the Danish part of a study on fatal intoxications conducted in the Nordic countries in 1984 and 1985 with special reference to drug addicts. There were 315 cases of fatal intoxications in people 15-34 years of age. These were examined at the Forensic Institutes in Denmark and described with reference to cause of death, sex, age and drug addiction. Of the deceased, 194 were drug addicts according to a specific definition of this term. Women accounted for 28% of all the fatalities investigated in the study and 24% of those in addicts. More than 90% of the deaths were caused by drugs, with ethanol as a contributory factor in approximately 40% of cases. Deaths caused by heroin/morphine predominated, causing 50% of the deaths among drug addicts, but legal drugs, such as dextropropoxyphene, methadone and ketobemidone were also frequent causes of death in this group. In half the cases the concentration of morphine in blood following injection of heroin/morphine was found to be equal to or less than 0.5 mumol/kg, and in only about one-tenth of cases was the blood concentration above 2.0 mumol/kg.     

F. Maupain,The Future of the International Labour Organisation in the Global Economy,Hart Publishers,Oxford 2013, xix + 300 pp. ISBN 978-1-84946-502-1.

Netherlands International Law Review -     

“三权分置”的中国民法典确认与表达

三权分置改革是继家庭联产承包责任制后深化我国农村土地制度改革的又一重大政策制度创新。中国民法典物权编编纂应当与《农村土地承包法》修改联动进行,积极回应三权分置改革。落实集体所有权并不要求创设农村集体经济组织法人土地所有权,应当继续坚持《物权法》的立法设计,农民集体为农村集体土地所有权主体,农村集体经济组织法人为行使主体。土地承包权与土地承包经营权具有同质关系,应当增加规定国家保护农村土地承包关系稳定并长久不变的宣示性规范,强化土地承包经营权的期限以及承包期内发包方不得随意调整或者收回承包地的义务,并充实土地承包经营权的抵押权能。土地经营权应为中国民法典物权编新增用益物权类型,应增加一章专门规定土地经营权的基本内容,并明确土地经营权的物权变动模式为登记生效主义。     

Stomach contents and the time of death. Reexamination of a persistent question

The inspection of the contents of the stomach must be part of every postmortem examination because it may provide qualitative information concerning the nature of the last meal and the presence of abnormal constituents. Using it as a guide to the time of death, however, is theoretically unsound and presents many practical difficulties, although it may have limited applicability in some exceptional instances. Generally, using stomach contents as a guide to time of death involves an unacceptable degree of imprecision and is thus liable to mislead the investigator and the court.