Complications following cell therapy

So far, the law in the Federal Republic of Germany still allows the injection of fresh-cell preparations from animals as a roborant to increase the vitality of the organism and to strengthen the body's immune defense system. The use of "sicca-cell" preparations was provisionally forbidden in 1987 by the Federal Health Organization (Bundesgesundheitsamt; BGA). Prohibition of fresh-cell injections would have exceeded the authority of this office, although the same serious reservations also applied in the case of this treatment method. Several publications that have appeared since 1955 have reported serious complications of this therapy, some life-threatening and some even lethal. Two further cases are now added: (1) A woman aged 69 had been receiving treatment with cell injections for 9 years. Immediately after an injection of sicca cells she collapsed and was hospitalized; 7 days thereafter she developed an ascending paralysis with increasing inability to swallow or breathe. She died 25 days after the injection as a consequence of central and peripheral respiratory failure. Autopsy revealed the alterations typical for acute Landry-Guillain-Barré-Strohl syndrome. (2) A 76-year-old healthy woman had been receiving treatment with fresh-cell preparations for several years. After an injection of cell suspensions a painful local swelling was observed. The symptoms were interpreted as the consequence of an iatrogenic local hematoma, and repeated punctures were performed to obtain blood. The patient was transferred to a surgical department for further therapy. Two days after the injection she suddenly died with signs of acute cardiovascular failure. Autopsy revealed the signs of a fulminating clostridial infection and also the characteristic signs of Landry-Guillain-Barré syndrome with involvement of the autonomic nervous system. In both cases the development of an inflammatory process in the peripheral nervous system could be interpreted as an immune-mediated allergic disease, related to the repeated injection of heterologous antigenic material containing nervous tissues. This hypothesis would also explain the two other cases already published and would be consistent with the observed perivenous leukoencephalopathy of the central nervous system. The human disease pictures correspond to the well-established animal models of EAEM (experimental allergic encephalomyelitis) and EAN (experimental allergic neuritis). The pathogenesis is discussed; the major role of the central and peripheral nervous system is stressed, with special reference to the risk of acute autonomic failure. The need for specific autopsy techniques for the investigation of the entire nervous system, including spinal cord, roots, spinal ganglia and peripheral nerves with sympathetic chains, is raised.     

Brief for 885 law professors in support of maintaining adherence to the Roe decision

This brief opposes the overturn of "Roe v. Wade" and resists weakening "Roe's central holding" that would allow states to overturn legal abortion. The brief was written for 885 law professors. "Roe" was not a "constitutional aberration," or "an exercise of raw, judicial power." Some members of the Supreme Court seem to think that the state has "an overriding interest" in protecting fetal life. Some Court members have questioned "Roe's" trimester framework. A person's decision to abort should be done privately. If women are not free to choose abortion, they will not have equality. There is an absence of "express rights of privacy and procreational freedom" in the Constitution. "Roe" was 1 instance of the Court's recognition of constitutional rights that are not named explicitly. Historical materials are drawn on to show the link between trends in society and the "judicial recognition of unenumerated rights." The most serious questions about "Roe" deal with its trimester framework. Justice Blackmun's majority opinion said that the 1st trimester of pregnancy was personal. "Roe" said that abortions created a medical risk at the beginning of the 2nd trimester. Therefore, the government was more interested in the health of the mother at that time. The state could then regulate abortion "in ways that are reasonable related to maternal health." The start of the 3rd trimester was when the fetus was viable. The right of a woman to end her pregnancy "offends powerful moral forces." Some of "Roe's" critics had their scientific facts wrong. Medical authorities think Justice O'Connor is mistaken when she says that "Roe" is "on a collision course with itself." The 23rd to 24th week of pregnancies where the fetal organs can "sustain life outside the womb." This has not changed since "Roe" was decided in 1973, nor is it likely to in the future. Some "amici" believe that the state can never have an interest in the fetus. The state can not have an interest in the fetus distinct from the woman who will give birth to it. During previability, restricting a woman's procreational rights would not be scientifically supportable. The state does have an interest in "upholding the value of human life." "Roe" is "within the mainstream" of constitutional jurisprudence and should be reaffirmed.     

Aednet: A single-discipline network in a multi-national setting

The computer-mediated network is a moderately expanding phenomenon. A major reason for this growth is the need for transferring technology to developing nations. But because many of these nations are not traditional users of advanced technology and because even the purveyors are not yet fully comfortable with the networks, the medium is not being used as much as perhaps it ought to be. In establishing a multinational network, one should be careful to treat all potential users with equity and not create an informational elite. Part of the challenge of such a system is making it accessible to operatives in the field. An effective way of introducing a network is to blend it with existing technologies, keep the costs down and the quality of information up, provide a usable information-retrieval system, and pay attention to microand macro-ergonomics. The Adult Education Network (AEDNET) of the Kellogg Project at Syracuse University has started working on a next-generation computer-mediated network system. It is proposed that AEDNET involve three action groups in the project: researchers, those interested in social implications, and users.     

Fertility,development, and family planning, 1970–1980: An analysis of cases weighted by population

A series of related studies (Freedman and Berelson, 1976; Mauldin and Berelson, 1978; and Tsui and Bogue, 1978) have presented empirical findings based on multiple regression analysis which indicated that family planning program effort (FP), as measured by an index developed by Lapham and Mauldin (1972), was the single most important predictor of (or influence on) fertility reduction in less-developed countries (LDCs). The basic results have been confirmed repeatedly. A more extensive data set was used to extend the analysis to a comparison of results of corss-sectional models circa 1970 and 1980. The study builds upon the results of past studies yet differs from them in several ways. All the variables in the present study were measured at 2 points in time: circa 1970 and circa 1980, allowing a comparison between cross-sectional models for 1970 and 1980. Among the cases included in this multivariate analysis was China, a country usually excluded for lack of data. The analysis was extend to 85 countries. Cases were weighted by population, having the effect of increasing the impact of larger countries such as India and China on the outcome of the analysis. Total fertility rate (TFR) was used as an indicator of fertility. For 1970, family planning program effort had the strongest direct influence on fertility (a result consistent with previous studies). Life expectancy at birth was the other direct influence. The direct influence of life expectancy at birth was less than that of family planning, but the total influence was greater. After life expectancy and family planning, school enrollment and relative educational status of women had the strongest indirect and total influences. The other variables all had a positive influence on fertility. When the total variance attributable was considered, directly and indirectly to each of the independent variables, urbanization, carlorie supply, and per capita gross national product all accounted for less than 5% of the variance in fertility, all of it indirect. Life expectancy, family planning, and school enrollment each explained (directly plus indirectly) more than 10% of the variance in fertility. The pattern differed somewhat for 1980. Calorie supply, per capita gross national product, and relative educational status of women had no influence, direct or indirect on fertility. Also for 1980, life expectancy had a stronger direct influence on fertility than family planning. Overall, life expectancy at birth, family planning program effort, and total school enrollment emerged as the principal influences on fertility.     

The cutaneous ink sign: a tipoff to suicide or suicide notes

The presence of smeared or unsmeared ink on the skin resulting from the writing process has been observed in a number of suicide victims who have left suicide notes. The authors report a case of a palmar "cutaneous ink sign" and discuss its forensic science import.     

System of cities dynamics in newly industrializing nations

Rapid industrialization in such countries as Korea, Malaysia, and Taiwan suggests that the complex functional structures of cities in the periphery may appear early in development. This paper proposes a 4-stage framework for the dynamics of a system of cities in a developing country undergoing industrialization and encompassing both nonindustrial and industrial development. The synthesis is assessed with evidence from the newly industrializing Asian nations of Korea, Malaysia, and Taiwan. The 4 stages of cities' industrial change include 1) increasing primacy with industrial satellites, 2) increasing primacy with industrial satellites and nodal towns on a transport network, 3) rapidly increasing primacy with rapidly growing industrial satellites and nodal towns on the transport network, and 4) decreasing primacy with slowly growing industrial satellites and rapidly growing peripheral industrial towns. The 4-stage synthesis suggests that economic development in the periphery may occur even while the primate city maintains its hegemony over control and coordination functions. Peripheral industrial growth does not challenge this hegemony. The growth of industrial cities is, instead, part of a process of regional specialization in which the low cost labor in the periphery becomes an attraction for industry. These stages are not inevitable. Government efforts are necessary to develop rural areas in terms of social improvements (education and health), capital infrastructure (transportation and utilities), and fair payments to farmers for their outputs. These seem to be the lessons learned from the industrialization process in Korea, Malaysia, and Taiwan.     

Ethical concerns expressed by forensic psychiatrists

A survey was made of American Academy of Forensic Sciences (AAFS) forensic psychiatrists to evaluate whether there is concern among them about potential ethical problems in criminal justice work. Of the respondents, 93.8% had encountered such problems. The main concerns indicated were about those psychiatrists who become a "hired gun," become an advocate, do not give an honest opinion, or have problems with confidentiality. The need for ethical guidelines and further debate about ethical issues is presented.