The shielding capacity of the standard military flak jacket against ballistic injury to the kidney

An animal model was designed to evaluate the ability of the standard military flak jacket to protect the kidneys from direct ballistic trauma. Yorkshire swine were anesthetized and their flanks were protected by flak jackets. Ballistic insults ranging from a low-velocity handgun to a high-velocity rifle were evaluated. The results demonstrate that a flak jacket provides adequate protection against low- and mid-velocity projectiles since none of the animals from this group had evidence of internal trauma and because only minor superficial surgical attention would have been required. Survivability in each case was considered to be excellent. The flak jacket failed to provide any protection against several types of high-velocity bullets. These weapons caused severe internal injury to the genitourinary system as well as to other major organ systems. Survival would have been unlikely.     

Destruction of intracerebrally applied red blood cells in cervical lymph nodes. Experimental investigations

In rabbits, intracerebrally applied erythrocytes can move with the cerebrospinal fluid along connecting pathways between the subarachnoid space and the cervical lymph nodes. This study compares the time dependency for the degradation of intracerebrally injected erythrocytes in the brain as well as in the cervical lymph nodes. Rabbits were killed at various predetermined intervals after the intracerebral erythrocyte injection. Microscopic and histologic examination of the brain and the cervical lymph nodes revealed the following findings: (1) Erythrophages first appeared in the brain 24 h after the injection; siderophages, 4 days after the injection. Siderophages were still demonstrable at the conclusion of the study, i.e. 240 days after the injection. (2) In the cervical lymph nodes erythrophages were first observed 1 h after the injection; siderophages, 9 h after the injection. Only isolated erythrophages and siderophages were found in the lymph nodes 12 days after intracerebral injection of red blood cells. Later on no erythrocytes or siderophages were observed in the lymph nodes. The findings indicate that non-phagocytized red blood cells arriving at the lymph nodes were ingested by local macrophages. The extremely rapid ingestion and digestion of the red blood cells by lymph node macrophages as well as the possible reasons were discussed.     

An infant fatality involving ajmaline

An infant fatality following accidental ingestion of ajmaline is described. Ajmaline was determined by thin-layer chromatography and infrared spectrophotometry, and quantitated by high performance liquid chromatography. The ajmaline concentration in blood was 5.5 micrograms/mL. The toxicological data relevant to the interpretation of case findings are presented.     

Foregoing life-sustaining treatment for adult, developmentally disabled, public wards: a proposed statute.

This Article proposes a procedure for making decisions to forego life-sustaining treatment for adult, developmentally disabled, public wards who are not competent to make health care decisions. Few commentators or cases address the special considerations involved in making life-sustaining treatment decisions for this patient population. The proposal attempts to fill this gap with a patient-centered process that allows decisionmakers, without prior judicial approval, to forego life-sustaining treatment for adult, developmentally disabled, public wards who have been reliably diagnosed with specific medical conditions.