Fatal birth trauma due to an undiagnosed abdominal teratoma: case report and review of the literature

The fetus is subjected to mechanical forces during labor and delivery, which may result in traumatic injuries. Such injuries include intracranial hemorrhage, spinal cord lesions, cephalhematoma, cranial or peripheral nerve palsies, intraabdominal organ rupture, or bony fractures. Risk for perinatal trauma and mortality is increased in primigravidas, multiple gestations, abnormal presentations, maternal-fetal disproportion, oligohydramnios, forceps or vacuum extractions, and internal version maneuvers. Very-low-birth-weight neonates (<1500 g) are at high risk due to ease of deformity of the cranium. Infants with certain congenital anomalies or pathologic processes that distort normal anatomy are also at increased risk, especially when a prenatal diagnosis is lacking. The authors present a case of a term gestation neonate who sustained a cervical spine dislocation fracture of C5-7, with subtotal transection of the spinal cord and resultant paralysis. The fetus was in vertex presentation, and a manual vaginal delivery was attempted. When the infant lodged in the birth canal following a difficult delivery of the head and arms, its enlarged abdomen was palpated, and the delivery was converted to an emergent cesarean section. The infant lived for 3 days and then expired due to neurologic complications of trauma sustained during the attempted vaginal delivery. Autopsy revealed a previously undiagnosed intraabdominal immature teratoma. The pathology of teratomas, the most common neonatal tumor and occasionally implicated in cases of birth trauma, will be addressed, followed by a review of the literature concerning birth trauma.     

Natural death in the forensic setting: a study and approach to the autopsy

Although unexpected natural deaths comprise a large proportion of the cases seen in the forensic setting, the investigation of these cases remains a unique challenge. Some cases are straightforward; however, others require special examination and dissections, as well as the use of special dissections and ancillary studies. For the forensic investigator to accurately assign a cause and manner of death, one must be aware of the differential diagnoses, common scenarios, and typical victim. The authors reviewed all forensic cases referred to the Forensic Section of the Medical University of South Carolina over a 15-year period from January 1989-December 2003. The number of natural deaths occurring in adults (age 18 years and older) was 6932, compared with the overall number of 13,227 cases. The natural deaths were then analyzed as to autopsy findings, cause of death, cardiac versus noncardiac, age, race, and gender. Current techniques, special dissections, and ancillary studies that can assist in the classification of these deaths in the forensic setting are reviewed.     

An Assessment of the Utility of Universal and Specific Genetic Markers for Opium Poppy Identification

Abstract: The proper identification of illicit plants such as Papaver somniferum L (opium poppy) is important for law enforcement agencies. The identification of opium poppy was presently tested using 10 genetic markers that are universal for all plants or specific to a few poppy plants. The genetic distances of universal markers such as nuclear internal transcribed spacer (ITS), 18S rRNA, plastid rbcL, and trnL‐trnF intergenic spacer (IGS) of 14 species included in the Papaveraceae and Fumariaceae family were acquired by sequence comparisons. Both the ITS region and trnL‐trnF IGS showed high levels of interspecific divergence. Six Papaver genera‐specific markers were developed from coding regions involved in morphine biosynthesis. Three markers (TYDC, NCS, and BBE) produced amplicons only in opium poppy, providing a presence/absence test for opium poppy, while three additional markers (CYP80B1, SAT, and COR) were genus specific. These 10 markers might be useful for the forensic DNA analysis of opium poppy.     

Criminal victimization in South Korea: A multilevel approach

A growing number of studies in criminal victimization had integrated the individual model and the context model to examine the dynamics of influences from the predictors at different levels. Only a few studies, however, had explored the impact of multilevel factors upon criminal victimization outside the U.S. context. Using the survey data gathered in Seoul, South Korea, the current study tested the applicability of the multilevel approach in criminal victimization to the Korean context. The results were mixed. At the macro level, poverty and community cohesion were positively associated with victimization by street crime and residential crime, respectively. Inconsistent with the findings in the U.S. studies, however, community cohesion increased the chance of residential crime victimization, and residential mobility was not significantly associated with criminal victimization. At the micro level, avoidance behaviors and target hardening efforts were associated with more criminal victimization, contrary to the proposition by opportunity theory. These unexpected findings could be explained by the unique social and cultural characteristics of Korean society. The unique contexts of modern Korean society as well as the limitation of the current study are discussed.     

What you see may not be what you get: beware of patients bearing gifts

The professional boundaries of practice for nurses and midwives are specifically addressed in professional codes of ethics and conduct, employer policies and guidelines and more frequently in the professional literature. There are many forms in which boundary violations and boundary crossings may present or circumstances in which they may occur. This column considers a recent case (involving a bequest to a registered nurse under a will) which came before the Queensland Nursing Tribunal. The decisions of the tribunal, the District Court and the Court of Appeal provide practical guidance to nurses and midwives on the importance of establishing and maintaining the professional boundaries essential to the therapeutic relationship with their patients and clients.     

Gender in the Context of Same‐Sex Divorce and Relationship Dissolution

This article identifies ways that judges, lawyers, researchers, and policy makers may attend to the role of gender and gender dynamics facing same‐sex couples upon divorce or other relationship dissolution. When same‐sex couples marry, the legal system and society at large may project conceptions of gender onto same‐sex couples, often in a manner that conflicts with couples' intentions and practices. Gender and gender dynamics may affect the bases for dissolution, the financial aspects of dissolution, and the determination of child custody. The article also suggests directions for future research on the impact of gender on the dissolution of same‐sex relationships.     

LIMITED WAR,UNLIMITED TARGETS

In the early days of the Korean War, the U.S. Air Force (USAF) had a policy of precision bombing military targets only. Policy-makers in Washington, D.C., formulated this policy to ensure the protection of Korean civilians and to increase the effectiveness of their air operations. Senior USAF officers in Korea, however, were unhappy about the limitations placed on them by Washington. In their strategic air operations against targets in North Korea USAF officers followed Washington's precision bombing policy, but they insisted that USAF bombers be permitted to use incendiary bombs against population centers in North Korea. China's entry into the war in November 1950 led to a drastic change in the precision bombing policy. On 5 November 1950, when the UN forces began suffering defeat after defeat in battles with the new enemy, General Douglas MacArthur designated cities and villages in North Korea as “main bombing targets” and permitted the use of incendiary bombs, which had been used in attacks against Japanese cities during World War II. From that point until the end of the war, the USAF regarded North Korean cities and villages as their crucial targets as political and military occasion demanded.     

An investigation of the relationship between anger and offence-related shame and guilt

Abstract

A number of accounts of shame and guilt emphasise an association between shame and anger difficulties, and it has been suggested that shame and rage may promote one another. The shame–anger relationship may be particularly relevant to the study of forensic populations, as the fact of having committed a criminal offence has the potential to be a highly shame-provoking experience. The current study investigates the prediction that shame and guilt reactions to an offence are differentially related to the propensity to experience and ability to control anger. A measure of offence-related shame and guilt and a measure of anger experience and control was completed by 60 men detained in forensic psychiatric units. The results supported the prediction that offence-related shame is associated with elevated levels of anger difficulties, whilst offence-related guilt is associated with ability to control anger. The findings of the current study are consistent with those of previous investigations of shame, guilt and anger. Specific implications for the understanding and prevention of violent offending are discussed.     

Family succession through adoption in the Chosun Dynasty

Using a unique data source of genealogies of upper-status families, called Bulcheonwye families, we assess how the extent of family succession through adoption changed over five centuries from 1450 to 1949 in Korea. Our analysis shows the continued increase in the share of adopted sons among total family successors up to the end of the 19th century when three out of ten family successors were adopted. The trend of the increasing role of adoption is closely related to the declining number of sons per family, suggesting that not only the rising influence of Confucian culture but also demographic changes increased the demand for adoption. Finally, our comparison provides evidence that the likelihood of achieving high social status was significantly higher among adopted sons than biological ones, suggesting that the socioeconomic potential of adopted sons could be an important factor for adoption decision.     

Differing patterns of marriage between a city and villages in 18th century Korea: The case of Taegu Area

While the urban area was increasingly filled with middle- and low-status residents, the rural area was dominated by high-status settlers whose number increased because of migration from the city and natural growth. Remarkable differences existed between urban and rural marriage features such as marriage age and rate of remarriage. The more sincere adoption of the high-status marriage culture in the rural area may be attributed to its occupational homogeneity. In the rural agrarian settings, landlords, self-cultivators and tenants shared a similar living pattern and value system based on the agricultural cycle. The urban area, however, exhibited a variety of work patterns of local functionaries, artisans and merchants. Many middle- and low-status people might well have found the high-status culture of the rural area incompatible with their own.