Radiographic demonstration of esophageal and tracheal fistulas at autopsy using a contrasting medium that vulcanizes at room temperature

Esophageal and tracheal fistulas, which occur in 0.05% of medicolegal autopsies, were demonstrated in three cases by a postmortem radiographic technique using silicone rubber/lead oxide as a contrasting medium that vulcanizes at room temperature. In one 83-year-old male, a tracheoesophageal fistula was detected, which had developed after surgical repair of an esophageal rupture caused by a flexible fiberoptic endoscope. In a second case, carcinoma of the esophagus in a 78-year-old male had eroded the trachea and arcus of the aorta creating a fatal tracheoesophagoaortic fistula. In a third case, 55-year-old female developed a tracheobrachicephalic artery fistula as a result of an infiltrating cystic adenocarcinoma of the trachea, resulting in a fatal hemorrhage into the trachea. The results of this study indicate that diagnostic radiologic methods using a vulcanized contrasting medium are useful in supplementing normal dissection in autopsy cases with suspected fistulas of the esophagus or trachea.     

The view from below: Local government and Putin's reforms

Local government reforms in contemporary Russia are placed in the broader contexts of political reform under Putin and the historical relationship between local administration and the state. Reforms of local government thus help illuminate the architecture of contemporary state building in Russia and the degree to which contemporary Russia perpetuates political traditions. This study reviews the antecedent action in local government prior to the Putin era. It then examines the Kozak Commission and the new law on local government, assessing the strengths and weaknesses of these reforms. Finally, this study examines the challenges of implementing the reforms and what these challenges tell us about devolution and centralisation under Putin.     

Penal Excess and Surplus Meaning: Public Torture Lynchings in Twentieth-Century America

The most notorious lynchings that occurred in the United States between 1890 and 1940 involved publicity, crowds, ritual, and abnormal cruelty. Several hundred of these "public torture lynchings" took place, most of them in the Deep South. The author develops an interpretation that takes seriously the specific forms and discourses that lynchers and their supporters used to describe and justify these events—characterizing them as criminal punishments, albeit summary, informal ones that were shaped by a white supremacist culture and a politics of racial domination. An interpretation of the penal context and meanings of these public torture lynchings helps us understand their specific forms and their claims to legitimacy. The penal character of these lynchings increased the probability that they would be tolerated by local (and even national) audiences and thus made them a strategic form of violence in struggles to maintain racial supremacy. The author argues that a consideration of these events should lead us to revise our standard narratives about the evolution of modern punishments.     

Christianity and punitive mentalities: A qualitative study

According to David Garland (1990) scholars should be concerned about the cultural foundations of punishment in modern western society, such as religion. To this end, Garland conceptualizes punitive mentalities and sensibilities that provide the cultural support for structural systems ofpunishment. Punitive mentalities are ways of thinking about punishment, whereas punitive sensibilities are ways of feeling about punishment. Garlandsuggests that religious traditions are an important source of punitive mentalities and sensibilities. This research is an empirical analysis ofpunitive mentalities and their cultural roots, using qualitative research.Research questions focus on the following: Are there distinctively punitivementalities? How do punitive mentalities influence the desire for officialpunishment? Data from a previous study (Cook, 1998a) are analyzed here to explore terrains of punitive mentalities within the contexts of Christianity.Findings identify four distinct categories: anti-punitive, non-punitive,retributive and vengeful mentalities where Christian (non)belief systemsare important cornerstones. Respondents in each group have specific desires regarding the state's use of punishments, especially the ``death penalty''.     

Has PPS increased Medicare expenditures on physicians?

We use data from 1983 and 1985 on the volume of Medicare physician services to analyze whether Medicare's Prospective Payment System (PPS), which resulted in a significant decline in hospital spending, led to a partially offsetting increase in real expenditures for physician services. We also analyze the effect of increases in assignment rates, increasing incomes of the elderly, and other factors on real expenditures during this period. Our main conclusion is that PPS has at most a small positive effect on real physician expenditures. Because people spent less time in the hospital, Medicare physician spending declined; but because of incentives to shift radiology and other services out of the hospital, some of this decline was offset. We also conclude that the sharp increase in Medicare assignment rates over this period, along with the rising incomes of the elderly during this period, contributed to the observed growth.     

A modification of the microplate method for reverse ABO typing of bloodstains and additional validation studies

The results of additional validation studies of a sensitive microplate hemagglutination assay for ABO reverse grouping of bloodstains are presented. The results of the validation study demonstrate the reliability of the microplate assay for use in routine serological casework. Based on these studies, the microplate assay has now replaced the Lattes crust test for ABO reverse grouping of bloodstains in the FBI Laboratory.     

Acidic and neutral drugs screen in blood with quantitation using microbore high-performance liquid chromatography–diode array detection and capillary gas chromatography–flame ionization detection

Blood previously acidified with aqueous saturated ammonium chloride solution was extracted with ethyl acetate. The dried extract was subjected to acetonitrile–hexane partition. The acetonitrile portion was analysed for the presence of acidic and neutral drugs by HPLC–DAD (200 mm×2.1 mm I.D. microbore ODS-Hypersil column) and GC–FID (25 m narrow-bore×0.25 mm I.D. HP-5 column with 0.33 μm film thickness). The protocol was found to be suitable for both clinical toxicology (including emergency toxicology) and postmortem toxicology. At least 66 drugs of interest were unequivocally identified by RRTs (HPLC) and UV spectra (DAD) match while another 12 were unequivocally identified by double RRTs match (HPLC and GC). Quantitation was facilitated by incorporating calibration blood standards in each assay batch. The five drugs most commonly encountered in clinical blood specimens (1150 cases) were: paracetamol (47.4% of the cases); chlormezanone (6.6%), theophylline (1.74%), naproxen (1.65%) and mefenamic acid (1.56%). The following drugs were detected in toxicologically significant quantities in postmortem blood specimens (245 cases): phenobarbitone (1.22% of the cases), naproxen (0.82%), chlormezanone (0.82%), theophylline (0.82%), carbamazepine (0.41%) and paracetamol (0.41%).