Subvalvular aortic stenosis as a cause of sudden death: two case reports

Sudden death is defined as a death that occurs suddenly, develops during an unpredictable course, and is due to natural or unnatural causes. Although there is no universally standardized definition on how "sudden" a sudden death is, WHO defines sudden death as a death that occurs within 24 hours after the onset of symptoms. The aim of this study is to present 2 rarely reported autopsy cases and to emphasize the importance of systemic autopsy at sudden death. On macroscopic examination, crescent-shaped, thick, fibrous membranes, located 5 mm and 3 mm away from the aortic valves, were detected. Fibrous membranes extended from the ventricular septum to the left ventricular outflow tract, thus apparently narrowing this region. Left ventricular wall and septum were slightly thickened, and there were scattered grayish-white areas of a small diameter. These became more intense in the septum and myocardium of the left ventricle on the anterior plane of the myocardial sections. In both cases, the aortic valves of were thickened and also markedly narrowed on one of them. In this case, the fibrous membrane adhered to the aortic valve and extended to the anterior leaflet of the mitral valve at one side. Both aortic valves comprised 3 leaflets. Other valves and coronary arteries showed no macroscopic pathologic findings. Microscopic examination of both cases demonstrated that the fibrous membrane comprising abundant collagen fibers was situated on the ventricular septum. Hypertrophy, moderate to severe interstitial fibrosis, and focal areas of scarring were observed in the specimens taken from the septal and ventricular myocardium. No abnormality was found on the conduction system examinations. Toxicologic analysis results in blood were negative. Based on the findings, membranous-type (discrete type) subvalvular aortic stenosis, diagnosed during the autopsy, was considered as the cause of sudden death in both cases.     

Estimation of stature from body parts

Anthropometric technique commonly used by anthropologists and adopted by medical scientists has been employed to estimate body size for over a hundred years. With the increasing frequency of mass disasters, the identification of an isolated lower extremity and the stature of the person it belonged to has created problems for the investigation of the identity of some of the victims. In spite of a need for such a study, there is a lack of systematic studies to identify fragmented and dismembered human remains. The purpose of the paper is to analyze anthropometric relationships between dimensions of the lower extremity and body height. Analysis is based on a sample of middle class male (N=203) and female (N=108) adult Turks residing in Istanbul. The participants are mostly students and staff members of a medical school, and military personnel. Measurements taken are stature, trochanteric height, thigh length, lower leg length, leg length, and foot height, breadth, and length. Of the five variables entered into the regression analysis, all but foot breadth participate in the analysis with leg length as the first and followed by thigh and foot lengths, and finally foot height in males (R(2)). There were also individually calculated formulae for some of these measurements which provided smaller R(2)-values. Student's t-test to assess if there was any intraobserver error in measurements take by individual anthropometrist did not show such any statistically significant difference. In conclusion, the study suggested that estimation of a living height can be made possible using various dimensions of the lower extremity. One must consider differences between populations in order to apply functions as such to others.     

Alpha-1-antitrypsin (PiM) subtypes in Japanese

Using isoelectric focusing (IEF) in thin-layer polyacrylamide gel, the polymorphism of the serum alpha-1-antitrypsin (Pi system) was investigated in 335 healthy unrelated Japanese individuals living in Miyagi prefecture, the northern part of Japan. Six common and five rare variant phenotypes were identified in our population samples, and the estimated allele frequencies for the genes Pi^M1, Pi^M2 and Pi^M3 were 0.718, 0.238 and 0.044, respectively. Family studies (n = 46) showed an autosomal codominant inheritance, and no exclusion was found in 23 mother-child pairs.     

C. Reviews: general

Lucette Valensi (ed.) ‘Recherches sur l'Islam, histoire et anthropologie’, Annales. Economie, Sociétés, Civilisations, 36 (3–4 May‐August 1980). [Special number.]     

Militancy and violence in West Africa: reflecting on radicalisation,comparing contexts and evaluating effectiveness of preventive policies

By 2000, ‘radicalisation’ had become a major global issue. Although ‘9/11’ was still a year away, the American Embassies in East Africa had been bombed in 1998 and violent conflicts simmered in many parts of the world. At just about the same time, bitter civil wars, resource-centred conflicts and intra-ethnic strife raged in West Africa. Against the background of research being undertaken at King's College London,1 1. For example, Dr Olonisakin was researching into the civil wars in the region and was completing her book on the politics of United Nations involvement in the Sierra Leone war, while Dr Alao Alao, Abiodun. 2007. Natural Resources and Conflict in Africa: The Tragedy of Endowment, Rochester: University of Rochester Press.  [Google Scholar] was looking at the politics of natural resource conflicts in the region and was also completing a book on the subject. The Conflict Security and Development Group (CSDG), King's College London, was awarded a grant from the UK Department for International Development (DfID) to undertake a research project on youth vulnerability and exclusion in West Africa, with Dr Olonisakin Olonisakin, 'Funmi. 2008. Peacekeeping in Sierra Leone: The Story of UNAMSIL, Boulder: Lynne Reinner.  [Google Scholar] as principal investigator. the mutually reinforcing links between ‘radicalisation’ and ‘violence’ (potentially sensitive terms, discussed below) in West Africa became clearly obvious and a successful application to investigate this was submitted to the UK Economic and Social Research Council (ESRC).2 2. ‘Militancy and Violence in West Africa: Reflecting on Radicalisation, Comparing Contexts, and Evaluating Effectiveness of Preventive Policies’. Dr F. Olonisakin and Prof A.J.W. Gow. ESRC Award No. RES-181-25-0024. This Special Issue contains articles emerging from that work, with a set of country studies complemented by overarching synthetic analysis.     

The heritage of war and state collapse in Somalia and Somaliland: Local-level effects,external interventions and reconstruction

Somalia and Somaliland are both inhabited basically by Somaliswith small Oromo minorities in both, and a large Swahili minority in the latter. Both have multiple clans, sub-clans, lineage and blood groups and in both Islam is central to social values. Somalia had no history of a stable state before Italian rule but Somaliland did (Haud-Hargeisa-Berbera-Arabia trade axis centred). The United Republic of Somalia (rejected in the referendum by Somaliland) passed from political instability to two decades of Said Barre's increasingly centralised and repressive dictatorship which waged war against the North-west (Somaliland) and North-east (Bosaso) as well as against Ethiopia. The dictatorship collapsed in 1991 basically because of the 1987-91 Somaliland Liberation war. The economies of Somalia/Somaliland turn on pastoral production, commerce and remittances. These have recovered in part in Somalia and fully in Somaliland. However, only a fraction of the Barre regimes dissolution of service delivery and user friendly law and order capicity has been made good in Somaliland and virtually more in Somalia. USA/UN intervention did limit starvation and-for a time-open violence. That was at a high cost in finances, in the reputation of peacekeeping and to Somalis. UNOSOM answered political and civil questions before having any real grasp of civil, political and economic realities. The price was to entrench warlords and militias and to marginalise 'peacelords' (elders and merchants). Somaliland, never occupied by UNOSOM, has engaged in a series of large, long peace conferences of elders from all parts of its territory leading to a real if fragile national/territorial identity with personal security in most areas, an elected president and two house parliament, a user friendly police force and court system and the beginnings of a restored professional civil service.     

Criminal epidemiology and the immigrant paradox: Intergenerational discontinuity in violence and antisocial behavior among immigrants

Purpose

A growing number of studies have examined the immigrant paradox with respect to antisocial behavior and crime in the United States. However, there remains a need for a comprehensive examination of the intergenerational nature of violence and antisocial behavior among immigrants using population-based samples.

Methods

The present study, employing data from Wave I and II data of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), sought to address these gaps by examining the prevalence of nonviolent criminal and violent antisocial behavior among first, second, and third-generation immigrants and compare these to the prevalence found among non-immigrants and each other in the United States.

Results

There is clear evidence of an intergenerational severity-based gradient in the relationship between immigrant status and antisocial behavior and crime. The protective effect of nativity is far-and-away strongest among first-generation immigrants, attenuates substantially among second-generation immigrants, and essentially disappears among third-generation immigrants. These patterns were also stable across gender.

Conclusion

The present study is among the first to examine the intergenerational nature of antisocial behavior and crime among immigrants using population-based samples. Results provide robust evidence that nativity as a protective factor for immigrants wanes with each successive generation.