Arterial-esophageal fistulae in patients requiring nasogastric esophageal intubation

A rare and potentially fatal cause of hematemesis is fistula formation between the esophagus and the vascular system. A case report of a 39-year-old woman with congenital aortic arch anomalies hospitalized for treatment of head injuries demonstrates the potential for iatrogenic esophageal trauma to initiate fistula formation between the esophagus and an anomalous arterial system. A literature review revealed 6 other cases of vascular-esophageal fistulae caused by nasogastric esophageal intubation. It is concluded that aortic arch anomalies increase the risk of esophageal injury and subsequent fistula formation from nasogastric esophageal intubation. In addition, the clinical features and pathologic findings of vascular-esophageal fistulae are reviewed.     

Unexpected childhood death due to hemolytic uremic syndrome

Two cases of unexpected childhood death due to hemolytic uremic syndrome are reported. A 21-month-old girl who was discovered dead in bed following a short illness was found at autopsy to have overwhelming sepsis resulting from transmural colitis. Escherichia coli serotype 0157A was isolated from the intestine, and renal changes of hemolytic uremic syndrome were found. A 4-year-old girl died suddenly in hospital from intracranial hemorrhage while being treated for hemolytic uremic syndrome-related renal failure. Culture of urine and feces grew verocytotoxin producing E. coli. These cases demonstrate that hemolytic uremic syndrome may be a rare cause of unexpected childhood death and that the diagnosis may not be established prior to autopsy. Postmortem culture of tissues and fluids in cases of suspected sepsis in children may be essential in establishing this diagnosis, because histologic evaluation may be compromised by profound sepsis and tissue putrefaction. Accuracy in diagnosis may have significant public health and medicolegal consequences.     

Stereolithography: a potential new tool in forensic medicine

Stereolithography is a computer-mediated method that can be used to quickly create anatomically correct three-dimensional epoxy and acrylic resin models from various types of medical data. Multiple imaging modalities can be exploited, including computed tomography and magnetic resonance imaging. The technology was first developed and used in 1986 to overcome limitations in previous computer-aided manufacturing/milling techniques. Stereolithography is presently used to accurately reproduce both the external and internal anatomy of body structures. Current medical uses of stereolithography include preoperative planning of orthopedic and maxillofacial surgeries, the fabrication of custom prosthetic devices; and the assessment of the degree of bony and soft-tissue injury caused by trauma. We propose that there is a useful, as yet untapped, potential for this technology in forensic medicine.     

Genetic enhancement technologies and the new society

So long as procreation continues to remain a central driving force in a marital relationship, and the family the very core of progressive society, efforts will be undertaken to expand the period of fecundity and combat infertility. Genetic planning and eugenic programming are more rational and humane alternatives to population regulation than death by famine and war. Genetic enhancement technologies and the scientific research undertaken to advance them should be viewed as not only aiding (or, sometimes resolving) the tragedy of infertility in family planning, but as a tool for enhancing the health of a Nation's citizens by engineering man's genetic weaknesses out of the line of inheritance. Put simply, healthier and genetically sound individuals have a much better opportunity for pursuing and achieving the "good life" and making a significant contribution to society's greater well being.     

Securitization,insecurity and conflict in contemporary Xinjiang: has PRC counter-terrorism evolved into state terror?

ABSTRACT

In the Introduction to this special issue, I first provide an overview of the programme of 'de-extremification' and mass internment in Xinjiang since early 2017. I then situate this development against the ‘ideological turn’ in Chinese Communist Party policy under President Xi Jinping, highlighting the new emphasis on stability maintenance and ideational governance. Next, I explore experiences of (in)security in Uyghur communities in- and outside of Xinjiang in the era of internment to consider how far PRC counter-terrorism initiatives have now evolved into state terror. In doing so, I apply Ruth Blakeley's (2012) definition of state terror as a deliberate act of violence against civilians, or threat of violence where a climate of fear is already established by earlier acts of violence; as perpetrated by actors on behalf of or in conjunction with the state; as intended to induce extreme fear in target observers who identify with the victim; and as forcing the target audience to consider changing its behaviour. Finally, I discuss the six contributions to the special issue.     

Reconstruction of root morphology in skeletonized remains with postmortem dental loss.

A reversible technique is presented in which the root morphology of missing teeth in skeletonized human remains can be reconstructed for the purpose of radiographic comparison and postmortem identification. In this technique, which is based upon pilot studies with skeletonized mandibles of archival remains, the alveolar socket walls are sealed with a coat of cyanoacrylate cement and injected with a mixture of vinyl polysiloxane and barium sulfate. Radiographs are produced with the radiopaque mixture in place, which highlights the antemortem morphology of the roots. Subsequently, the impression material is removed, resulting in no gross alteration of the evidence. The radiographs made with this technique, as well as the impressions, can be stored for later use at a trial or pending the discovery of antemortem dental evidence.