Fulminant liver failure in a young child following repeated acetaminophen overdosing

Acetaminophen (paracetamol), a widely used analgetic drug, is well tolerated at therapeutic doses, but may cause severe hepatotoxicity when ingested in large overdose. Self-poisoning is still very popular in adults and accidental ingestion of one single overdose occurs occasionally in children. In contrast, lethal intoxication in children after repeated administration of therapeutic doses is a very rare event. This case report describes an iatrogenic acetaminophen overdosing in a 5-year-old child receiving 8.5 g acetaminophen in 48 h. Fulminant liver failure developed within 60 h. Autopsy findings included panlobular liver cell necrosis. Acetaminophen serum levels were rather low compared to cases with ingestion of one single overdose. Postmortem diagnosis of chronic acetaminophen intoxication as cause of death should include the clinical history as well as, if available, the calculated drug serum half-life.     

A validation study for the extraction and analysis of DNA from human nail material and its application to forensic casework.

A validation study was conducted to demonstrate that deoxyribonucleic acid (DNA) could be successfully extracted from human nail material and analyzed using short tandem repeat (STR) profiling and/or mitochondrial DNA (mtDNA) sequencing. This study involved the development of a DNA extraction protocol that includes a cleaning procedure designed to remove external contaminants (e.g., biological, chemical). This protocol was used to test human nail material that had been soaked in whole blood from a second donor and coated with gold-palladium to simulate scanning electron microscopic analysis. The results showed no indication of a mixture and were consistent with that of the nail donor. Fresh human nail material usually yielded both STR profiles and mtDNA sequence information; however, aged human nail material (approximately eight years old) yielded only mtDNA sequence information. Upon completion of the validation study, the extraction protocol was used for the analysis of a torn fingernail fragment recovered from the scene of a violent homicide in 1983. A partial STR profile and mtDNA sequence information indicated that the fingernail fragment was excluded as originating from the suspect and was, in fact, consistent with originating from one of the victims.     

Wischnewski ulcers and acute pancreatitis in two hospitalized patients with cirrhosis, portal vein thrombosis, and hypothermia.

Accidental hypothermia has been described in the forensic literature but reports of occurrence in hospitalized patients are rare. Associated anatomic lesions include acute hemorrhagic pancreatitis and characteristic acute gastric ulcers termed Wischnewski ulcers. We report here two patients with cirrhosis and ascites; one also had hepatocellular carcinoma. Portal vein thrombosis, acute hemorrhagic pancreatitis and Wischnewski ulcers were present in both. The clinical records documented hypothermia that progressed over several days. Temperature nadirs of 31.0 degrees C (87.8 degrees F) and 32.2 degrees C (90.0 degrees F) were recorded in each patient, respectively, one day before death, although each transiently reached temperatures that did not register on standard monitoring devices. This is the first report that chronicles antemortem body temperatures in hypothermic patients with Wischnewski ulcers and pancreatitis at autopsy. Also, the association of these findings with portal vein thrombosis and cirrhosis has not been previously described. We discuss this constellation of findings with regard to possible mechanistic interrelations.     

The morphofunctional changes in the internal organs in the modelling of poisonings by psilocybine-containing mushrooms]

Histological analysis of the viscera in experimental poisoning with psilocybin-containing mushrooms showed nonspecific changes in all examined organs, presenting as expressed hemocirculatory disorders and intracellular dystrophy. Quantitative histochemical analysis showed appreciable shifts in the activities of enzymes involved in the cytoplasmic and mitochondrial redox processes and of specific enzymes involved in nerve tissue metabolism. This may reflect some features in the direct effects of narcotic alkaloids contained in psilocybin-producing mushrooms.     

The gas chromatographic detection of acetylene in cadaveric material]

Acetylene traces were detected by gas chromatography in the cadaveric right crural muscle of a 30-year-old man dead from an explosion of an acetylene reservoir at a plant. Acetylene was identified using the absolute calibration method on 3 standard gas chromatographic columns, reaction gas chromatography, and acetylene "deduction" by silver sulfate on silicagel.     

Ego identity status,ego development,and locus of control in college women

This study examined the relationship of identity status to ego development and locus of control in 75 college women. The identity statuses did not differ significantly in self-reported locus of control, but did differ on the depth measure of ego development. Consistent with identity theory and with previous research with males, identity achievers and moratorium (incrisis) women were more advanced in their ego development than fore-closure and diffusion women.This article is based in part on the doctoral dissertation of Sheila D. Ginsburg, Submitted in partial fulfillment of the Doctor of Philosophy degree, University of Missouri—St. Louis.Received her Ph.D. in clinical psychology from the University of Missouri—St. Louis. Current research interests include normative and dysfunctional development in children and adolescents.Received his Ph.D. in clinical psychology at State University of New York at Buffalo. Research interests include personality and social development of adolescents and young adults.     

Adolescents view their mental health

A new 40-item behavioral checklist, the Adolescent Life Assessment Checklist (ALAC), was devised to be used with patient and nonpatient samples. A comparable form obtains information from a parent or guardian. Responses of 356 adolescents from three sources were analyzed for differences attributable to race, sex, age, sample source, and their interactions. A factor analysis was carried out on the average within-race-sex-source subgroup correlation matrix, resulting in seven meaningful and six usable oblique factors. Subscales were developed and corrections were computed to remove estimated differences due to race, sex, and age. Corrected scales significantly differentiate the three samples.This study was supported in part by MCHS Grant No. MC-R-390201, the Adolescent Clinic Foundation, and USPHSMH Fellowship Grant No. 0597921.Received her Ph.D. in psychology from Washington University, St. Louis; received a Foundations Fund for Research in Psychiatry interdisciplinary research-teaching grant, 1959–1965. Current research interests include test development, evaluation, and personality research.Received her M.D. from Medical College of Georgia at Augusta; her medical internship was at Michael Reese Hospital, Chicago, Illinois. Current research interests include stress, coping, and adaptation in children and adolescents.She is a licensed psychologist with the State of Ohio, with an M.A. from the University of Cincinnati. Current research interests include verbal behavior, psychotherapeutic efficacy, and dream research.Received his M.D. from College of Medicine, University of Cincinnati; his medical internship was with Boston City Hospital, and he is the founder of the Adolescent Clinic, Cincinnati General Hospital. Current research interests include growth and development and medical/social problems at adolescence.     

B. Reviews and notes of recent bibliographies

i. Le Moyen‐Orient contemporain. By Guy Feuer, with the collaboration of S. Chauvin and F. Pourcelet. (Guides de Recherches, No. 6) Paris, Fondation Nationale des Sciences Politiques, 1975. pp. 245. 48 fr.

ii. Eléments de bibliographie des études arabes. By Aubert Martin. Paris, Publications Orientalistes de France, 1975. pp. iii, 235. 35 fr.

iii. The Emergence of Arab Nationalism from the 19th century to 1921: A Bibliography. Compiled and annotated by Frank Clements, London, Diploma Press, 1976. pp. x, 290. £10.00

iv. Union catalogue of Arabia Serials and Newspapers in British Libraries. By the Middle East Libraries Committee, edited by Paul Auchterlonie and Yasin H. Safadi. London, Mansell, 1977. pp. xvi, 146. £12.50.

v. Arabia Historical Writing, 1973 & 1974. By Fawzi Abdulrazak. Cambridge, Mass., Harvard University Library, 1974 & 1976. 2v. $ 8.65 (for both vols).

vi. Modern Arabic Literature: A Bibliography of Articles, Books, Dissertations and Translations in English. By Salih J. Altoma. Bloomington, Indiana University, Asian Studies Research Institute, 1975. pp. 73. $ 4.00

vii. The Kurds in Iran, a Selected and Annotated Bibliography. By Wolfgang Behn. London, Mansell, and Munich, Verlag Dokumentation, Publishers, 1977. pp. 76. £6.00

ix. American Doctoral Dissertations on the Arab World 1883–1974. Second edition. By George Dimitri Selim. Washington D.C., Library of Congress, 1976. pp. xviii, 173. Obtainable from: Superintendent of Documents, Government Publications Office, Washington D.C. 20402. Price: outside USA $5.75 plus $1.44 for overseas postage.

x. International and regional politics in the Middle East and North Africa: a guide to information sources. (International Relations Information Guide Series, 6). By Ann Schulz. Detroit, Gale, 1977. pp. xii, 244. $18.00

xi. The politics of African and Middle Eastern states: an annotated bibliography. By Anne Gordon Drabek & Wilfrid Knapp. Oxford, Pergamon, 1976. pp. x, 192. £6.75