How Useful is Basal Renal Tubular Epithelial Cell Vacuolization as a Marker for Significant Hyperglycemia at Autopsy?

Basal vacuolization of renal tubular epithelial cells (so-called Armanni-Ebstein phenomenon) has been attributed to hyperglycemia causing accumulation of cytoplasmic glycogen. Review of 34 autopsy cases with significant hyperglycemia (vitreous glucose ≥ 15 mmol/L/270 mg/dL) was undertaken to determine whether there was any significant association between the degree of hyperglycemia and the severity of this morphological change (graded as 0, 1+, 2+, and 3+). No association was demonstrated. Review of the subgroup of 14 cases with terminal hyperglycemia without ketoacidosis was then undertaken to assess the effect of hyperglycemia in isolation on renal tubular epithelial cells. Vitreous glucose levels in these 14 cases ranged from 17 to 49.7 mmol/L (306-894.6 mg/dL) with a mean of 26.25 mmol/L (472.5 mg/dL) and β-hydroxybutyrate levels ranged from 0.02 to 2.55 mmol/L (0.36-45.9 mg/dL) with a mean 0.79 mmol/L (14.22 mg/dL). Not one of the latter cases displayed basal vacuolization. No relationship between basal vacuolization of renal tubular epithelial cells at autopsy and terminal hyperglycemia could, therefore, be demonstrated.     

The constitutional political economy of Gordon Tullock

This paper surveys Gordon Tullock’s contributions to constitutional political economy. His first major contribution was his joint project with James Buchanan on liberal constitutional design. The explicitly constitutional analysis of The Calculus was followed by a series of papers and books that focused on the use of resources in conflict, including Tullock’s contributions to the anarchy and rent-seeking literatures. Tullock also pioneered the rational choice-based analysis of dictatorships and the relative merits of alternative legal systems, topics that has been neglected until fairly recently by most scholars working in the CPE tradition.     

On the political economy and limits of crisis insurance: the case of the 2008–11 bailouts

The bailouts of 2008–10 are the most recent in a long series of insurance-like policies designed to limit the losses of those harmed by a crisis of some kind—but enacted after a crisis is under way. This paper analyzes the economics and politics of “crisis insurance” programs. The analysis helps explain why ex-post insurance is popular, why it tends to be undersupplied by private markets, and why governments may be better able to provide it. The analysis also points out that there are limits to what losses can be covered. The routine adoption of new programs to limit losses from crises tends to require greater expenditures through time because of moral hazard problems and the nature of crises. Eventually, this trend may produce “uninsurable” crises. The analysis of this paper suggests that such problems can be moderated, although not eliminated, through appropriate standing polices for ex-post funding of crisis insurance.     

Still three Wales? Social location and electoral behaviour in contemporary Wales

Wales provides a notable exception to the contemporary academic consensus that electoral behaviour is best studied via choice-based approaches. In Wales, the orthodoxy remains that of the Three-Wales Model, an approach formulated in the 1980s which saw voting behaviour as defined by class, language and national identity. This article submits the Three-Wales Model to detailed scrutiny for the first time. The model is argued to have been constructed on a very narrow theoretical basis, and on flawed measurements. Most importantly, however, the Three-Wales Model is shown to have little empirical leverage on voting behaviour in Wales – either for the period when it was formulated or for more recent elections. Factors associated with ‘valence politics’ theories are shown to provide far greater insight into voting behaviour in contemporary Wales.     

Fracture patterns on the infant porcine skull following severe blunt impact

The objective of this study was to document patterns of fracture on infant porcine skulls aged 2-28 days (n = 57) because of a single, high energy blunt impact to the parietal bone with rigid (nondeformable) and compliant (deformable) interfaces. Fracture patterns were mapped using Geographic Information System software. For the same generated impact force, the rigid interface produced more fractures than the compliant interface for all ages. This study also showed that this increased level of impact energy versus an earlier study using a lower energy resulted in new sites of fracture initiation and also caused previously defined fractures that propagate into an adjacent bone. Several unique characteristics of bone and diastatic fracture were documented as a function of specimen age, impact energy, and interface. These data describe some baseline characteristics of skull fracture using an animal model that may help guide future studies from forensic case files.     

Is There a Relationship Between Bladder Outlet Obstruction due to Benign Prostatic Hyperplasia and Pulmonary Thromboembolism?

Benign prostatic hyperplasia with chronic bladder outlet obstruction has been associated with deep venous thrombosis (DVT) and fatal pulmonary thromboembolism (PTE). To evaluate this further, 60 autopsy cases of men with PTE were compared with 60 age-matched controls. The criteria for outlet obstruction were macroscopic prostatic enlargement with bladder trabeculation and benign prostatic hyperplasia on microscopy. Ten of the 60 men (16.7%) with fatal PTE had evidence of bladder outlet obstruction (age 57-78 years; mean 71.4 years). Of the 60 controls, 12 had evidence of bladder outlet obstruction (20%) (age 67-86 years; mean 75.5 years). No significant relationship could be demonstrated between bladder outlet obstruction and fatal PTE cases (p = 0.8). Given reports of this association, however, it is possible that bladder distension with venous compression may act as a risk modifier in certain individuals in association with other significant comorbidities, but this risk appears low.     

Autoerotic death: incidence and age of victims--a population-based study

Review of the Australian National Coronial Information System and the Swedish National Forensic Database was undertaken over a 7-year period from 2001 to 2007 for all cases where death had been attributed to autoerotic death or sexual asphyxia. In Australia, there were 44 cases (M:F = 42:2) with the majority of victims aged >30 years (77%)-a yearly national rate of approximately 0.3/million. In Sweden, there were nine cases (M:F = 9:0) with the majority of cases aged <30 years (55%)-a yearly national rate of approximately 0.14/million. The usual male predominance was present in both populations, although the Australian victims were older than is usually reported. Lethal sexual asphyxia is uncommon in both the Australian and Swedish populations, with a lower rate than has been cited for North America. Whether this is because of different kinds of paraphilic activities in different populations or of differences in methods of central data collection is uncertain.