Dissecting intramural haematoma of the coronary artery with intimal tears.

A dissecting intramural haematoma of the coronary artery is an infrequent cause of sudden and unexpected death. Most cases are women and in a significant number of these women, the haematoma occurred at term to 80 days postpartum. Because the intimal rupture and communication with the lumen were not found in most of the cases, the site of rupture has been considered to be a vasa vasorum. The authors report on a case of one woman who was at a later postpartum period (106 days). The microscopic finding of the dissected coronary artery revealed two intimal tears in a section. The case showed that the dissecting intramural haematoma of the coronary artery is caused not only by the rupture of the vasa vasorum but also by the rupture of the intima.     

Should Abused Women's Reports of Partner Substance Abuse Be Accepted as Valid?

Current research suggests that a husband's substance abuse is correlated with severity of physical abuse and the woman's decision to leave a violent situation. Often, only the battered woman's report of abuse is available. This study compares women's reports of their partners' substance use/abuse with their partners' report using a brief measure of polydrug and alcohol abuse, the Substance Abuse Subtle Screening Inventory (SASSI) and the Conflict Tactics Scale (CTS). Data were analyzed for 25 recovery couples and 25 nonrecovery couples. The correlations for all 50 couples between the male's reported use and the female's report of her partner's use on the SASSI and the CTS were significant on all but one of the CTS scales. They ranged on SASSI from .73 to .33 and from .31 to .06 on the CTS. This suggests that the SASSI and possibly the CTS could be used as valuable tools for assessing women's reports of their partner's substance use/abuse.     

Highlights from a low-level area: infant mortality and social structure in eight East Frisian parishes, 1740–1839

Considerable variations in infant mortality rates have occurred within the low-lying region of northern Germany's East Frisia. Individual parishes can be assigned to three specific groups by registered mortality levels for the period 1740–1839. Differences also existed between parishes containing Geest (heathland), bogs, and marshland reflecting specific geographical and environment factors, as well as the structure of the local economy. In both Geest and bog parishes, the level of infant mortality and its trend over time were not homogeneous. In the two marshy river parishes, only environmental factors were significant; both registered the lowest rates of infant mortality. They had fertile soil, extensive grazing land, an exceptionally high number of large agricultural holdings, and households that were above average in size. By contrast, the highest rates of infant mortality were found in one bog and two Geest parishes, but these communities remained heterogeneous in terms of geographical size and population growth and density.     

Thyreoglobulin and violent asphyxia

The concentration of thyreoglobulin (tg) was determined for death caused by hanging, strangulation by ligature, and throttling. Cases of sudden death (traumatic aortic rupture, penetrating wounds of the heart) were used for comparison. The mean values in cases of hanging (149.9±202.3 ng/ml), strangulation by ligature (193.1±173.3), manual strangulation (561.6±173.9) are distinguishable from violent acute deaths (23.3±27.6) and living healthy individuals (17.3±16.1). By means of statistical comparisons, significant differences were found between throttling and strangulation by ligature and between throttling and hanging (adjusted P<0.001). In connection with examination of the bodies high tg values can be regarded as a vital reaction in obstructive asphyxia.     

Children in the environment: Forest day-care centers: Modern day care with historical antecedents

Some features of early child care are more prominent in Norway than in other countries, such as emphasis on the outdoor environment. Of general relevance and interest is the form of day care provided by forest day-care centers. Three ideas form the development of these centers placed in wild areas. First, throughout history, Norwegians have had a close attachment to nature and some parents want to provide their children with outdoor experiences at an early age. Second, urging children to play outdoors characterizes the image many parents have of a happy, healthy childhood. Third, provision of day care for children has always been restricted in western countries, forcing parents to invent types of service that can become part of an ecological system that promotes healthy development.The forest day-care centers developed recently represent a supplement to the wide typology of child care in the 21st century. The article outlines the connections between these ideas in general European and western history and Norwegian history and presents debate and decisions about a question dating from the last half of the 1980s. It concludes that the forest day-care centers are perhaps only a modern form of the original kindergarten concept, which started in Europe and America as gardens for children not gardens of children.     

The distribution of ethanol in postmortem blood specimens.

Ethanol was determined by gas chromatography in a variety of tissues and body fluids secured at autopsy in 61 cases. The specimens tested included right and left heart blood, femoral blood, pericardial fluid, cerebrospinal fluid, vitreous humor, urine, stomach contents, and brain. Statistical analysis of the cases revealed no significant differences among the various blood sites tested. However, the variations in blood ethanol concentrations among the various sampling sites within each case were as follows: 40 cases showed differences of less than 25%; 16 cases revealed variability between 25% and 50%, 4 cases had differences exceeding 50%. In one case, satisfactory blood analyses could not be accomplished. The larger variances occurred especially in those instances in which stomach alcohol concentration was 0.50% or greater. In one case, the variability amongst the different blood sites exceeded 400% (femoral blood--0.043%, right atrium--0.070%, root of aorta--0.156%); the brain was 0.050%, and the stomach contents was 1.2%. For all 61 cases, variances in blood alcohol content among the different sampling sites in a single cadaver ranged from 1.8 to 428%.