Complications following cell therapy

So far, the law in the Federal Republic of Germany still allows the injection of fresh-cell preparations from animals as a roborant to increase the vitality of the organism and to strengthen the body's immune defense system. The use of "sicca-cell" preparations was provisionally forbidden in 1987 by the Federal Health Organization (Bundesgesundheitsamt; BGA). Prohibition of fresh-cell injections would have exceeded the authority of this office, although the same serious reservations also applied in the case of this treatment method. Several publications that have appeared since 1955 have reported serious complications of this therapy, some life-threatening and some even lethal. Two further cases are now added: (1) A woman aged 69 had been receiving treatment with cell injections for 9 years. Immediately after an injection of sicca cells she collapsed and was hospitalized; 7 days thereafter she developed an ascending paralysis with increasing inability to swallow or breathe. She died 25 days after the injection as a consequence of central and peripheral respiratory failure. Autopsy revealed the alterations typical for acute Landry-Guillain-Barré-Strohl syndrome. (2) A 76-year-old healthy woman had been receiving treatment with fresh-cell preparations for several years. After an injection of cell suspensions a painful local swelling was observed. The symptoms were interpreted as the consequence of an iatrogenic local hematoma, and repeated punctures were performed to obtain blood. The patient was transferred to a surgical department for further therapy. Two days after the injection she suddenly died with signs of acute cardiovascular failure. Autopsy revealed the signs of a fulminating clostridial infection and also the characteristic signs of Landry-Guillain-Barré syndrome with involvement of the autonomic nervous system. In both cases the development of an inflammatory process in the peripheral nervous system could be interpreted as an immune-mediated allergic disease, related to the repeated injection of heterologous antigenic material containing nervous tissues. This hypothesis would also explain the two other cases already published and would be consistent with the observed perivenous leukoencephalopathy of the central nervous system. The human disease pictures correspond to the well-established animal models of EAEM (experimental allergic encephalomyelitis) and EAN (experimental allergic neuritis). The pathogenesis is discussed; the major role of the central and peripheral nervous system is stressed, with special reference to the risk of acute autonomic failure. The need for specific autopsy techniques for the investigation of the entire nervous system, including spinal cord, roots, spinal ganglia and peripheral nerves with sympathetic chains, is raised.     

Brief for 885 law professors in support of maintaining adherence to the Roe decision

This brief opposes the overturn of "Roe v. Wade" and resists weakening "Roe's central holding" that would allow states to overturn legal abortion. The brief was written for 885 law professors. "Roe" was not a "constitutional aberration," or "an exercise of raw, judicial power." Some members of the Supreme Court seem to think that the state has "an overriding interest" in protecting fetal life. Some Court members have questioned "Roe's" trimester framework. A person's decision to abort should be done privately. If women are not free to choose abortion, they will not have equality. There is an absence of "express rights of privacy and procreational freedom" in the Constitution. "Roe" was 1 instance of the Court's recognition of constitutional rights that are not named explicitly. Historical materials are drawn on to show the link between trends in society and the "judicial recognition of unenumerated rights." The most serious questions about "Roe" deal with its trimester framework. Justice Blackmun's majority opinion said that the 1st trimester of pregnancy was personal. "Roe" said that abortions created a medical risk at the beginning of the 2nd trimester. Therefore, the government was more interested in the health of the mother at that time. The state could then regulate abortion "in ways that are reasonable related to maternal health." The start of the 3rd trimester was when the fetus was viable. The right of a woman to end her pregnancy "offends powerful moral forces." Some of "Roe's" critics had their scientific facts wrong. Medical authorities think Justice O'Connor is mistaken when she says that "Roe" is "on a collision course with itself." The 23rd to 24th week of pregnancies where the fetal organs can "sustain life outside the womb." This has not changed since "Roe" was decided in 1973, nor is it likely to in the future. Some "amici" believe that the state can never have an interest in the fetus. The state can not have an interest in the fetus distinct from the woman who will give birth to it. During previability, restricting a woman's procreational rights would not be scientifically supportable. The state does have an interest in "upholding the value of human life." "Roe" is "within the mainstream" of constitutional jurisprudence and should be reaffirmed.     

Injuries of the large arteries of the brain and vital reactions. An electron microscopy study

In 90 forensic autopsies (Craniocerebral injury, gunshot, stabbing, blow, strangulation, etc.), semithin sections of great arteries were prepared from around 770 Epon blocks and checked for vital reactions at the mural and intimal ruptures. In 21 cases in which death had occurred immediately or soon after the trauma, with three exceptions, there was a subsequent electron microscopic investigation. In all six mural ruptures and in five of ten intimal ruptures, thrombocyte aggregates were found at the rupture margins. In five intimal ruptures, the possibility of the occurrence of preparations injuries had to be considered. In five cases, the results of the histological study were negative. The success rate is limited in principle in such a screening test since there are technical difficulties in preparing serial sections on long vessels. Death was rapid and the thrombocytes were observed to adhere to the injured wall sites immediately after the trauma. The "thrombocyte sign" is thus of substantial importance as the earliest local vital reaction. In two control cases (strangulation), thrombocyte aggregates were found at intimal ruptures of the basilar artery, which were regarded as the results of stretching via the vertebral arteries during attacks to the neck. The healing processes of intimal ruptures and traumatic medial necrosis in incomplete ruptures occurring later in life are discussed. Even if a cadaver is a few days old, the histological findings at the level of the thrombocytes can be evaluated.     

Book reviews

Transborder Data Flows (Proceedings of an OECD Conference) Edited by Hans‐Peter Gassmann North Holland (Elsevier Science Publishers) 1985, US$74.00

Plastic and Electronic Money: New Payment Systems and Their Implications Patrick Frazer Woodhead Faulkner Limited 1985 £35

A User's Guide To Computer Contracting: Forms, Techniques and Strategies Davis, Allen, Bowman and Armstrong Harcourt Brace Jovanovich 1985, $75

Legal Protection of Computer Programs and Data C. Millard Sweet & Maxwell/Stevens 1985, £24

Piracy of Phonograms Gillian Davies ESC Publishing Ltd. 1986. 2nd edition. £17.95.

Biotechnology and Patent Protection—An International Review F. K. Beier, R. S. Crespi and J. Straus O.E.C.D. 1985, £5

Protecting Privacy in Two‐Way Electronic Services David H. Flaherty Mansell Publishing Company 1985, £23.50

High‐Tech Espionage Jay Tuck Sidgwick and Jackson Ltd 1980, £10.95     

Reviews

Rajan Menon, Soviet Power and the Third World. New Haven and London: Yale University Press, 1986, ix + 261 pp. £18.50.

Georgi Arbatov, Cold War or Detente? The Soviet Viewpoint. London: Zed Books, 1983. xviii + 219 pp. £16.95, $30.00 h/b; £4.95, $8.95 p/b.

Jonathan Steele, World Power: Soviet Foreign Policy under Brezhnev and Andropov. London: Michael Joseph, 1983, xii + 287 pp. £14.95.

Imre Vincze, The International Payments and Monetary System in the Integration of the Socialist Countries, The Hague: Martinus Nijhoff, 1984, ix + 185 pp. £20.50, $32.00.

M. M. Kostecki ed. The Soviet Impact on Commodity Markets, London: Macmillan, 1984, xl + 271 pp. £25.00.

Gerhard Fink ed. East‐West Economic Relations Now and in the Future: Die Ost‐West‐Wirtschaftsbeziehungen heute und morgen, Vienna: Springer‐Verlag, 1985, 100 pp. DM 34,00.

András Köves, The CMEA Countries in the World Economy: Turning Inwards or Turning Outwards, Budapest, Akadémiai Kiadó, 1985, 248 pp. £18.25.

Ger P. van den Berg, The Soviet System of Justice: Figures and Policy, Martinus Nijhoff, Dordrecht, Boston, Lancaster (series Law in Eastern Europe No. 29) 1985, xiii + 374 pp incl appendices, indices and references, £56.95, $71.50.

Eugene Huskey, Russian Lawyers and the Soviet State. The Origins and Development of the Soviet Bar, 1917–1939. Princeton: Princeton University Press, 1986, xii + 247 pp. £19.00.

David Lane, Labour and Employment in the USSR. Brighton: Wheatsheaf Books (distributed by Harvester Press), 1986, 280 pp. £28.50.

Martin McCauley and Stephen Carter, eds. Leadership and Succession in the Soviet Union, Eastern Europe and China. London: Macmillan, 1986, xiii + 256 pp. £27.50 h/b, £8.95 p/b.

Leslie Holmes, Politics in the Communist World. Oxford: Oxford University Press, 1986, xi + 457 pp. £25–00 h/b, £9.95 p/b.

Peter Kenez, The Birth of the Propaganda State: Soviet Methods of Mass Mobilization, 1917–1929. Cambridge: Cambridge University Press, 1985. xi + 308 pp. £27.50, $39.50 h/b, £9.95, $12.95 p/b.

Joseph J. Collins, The Soviet Invasion of Afghanistan: a Study in the Use of Force in Soviet Foreign Policy. Lexington, Mass.: Lexington Books, 1986, xv + 197 pp. £22.50, $31.25.

Leszek Buszynski, Soviet Foreign Policy and Southeast Asia. London: Croom Helm, 1986, 303 pp. £25.00.

William J. Kelly, Hugh L. Shaffer and I. Kenneth Thompson, Energy Research and Development in the USSR: Preparations for the Twenty‐First Century. Durham, North Carolina: Duke University Press, 1986, xvi + 417 pp. £62.50.

Gregory D. Andrusz, Housing and Urban Development in the USSR, London: Macmillan in association with CREES, University of Birmingham, 1985, xix + 354 pp. £30.00.

Jane Ellis, The Russian Orthodox Church: a Contemporary History, London & Sydney: Croom Helm, 1986. 531 pp. £27.50.

Edward Acton, Russia: The Present and the Past, London and New York: Longman, 1986, xiii + 342 pp. £17.50 h/b, £8.95 p/b.

Robert Service, Lenin: A Political Life. Vol. 1. The Strengths of Contradiction. London: Macmillan, 1985, x + 246 pp. £25.00.

Abbott Gleason, Peter Kenez and Richard Stites, eds., Bolshevik Culture. Experiment and Order in the Russian Revolution. Bloomington: Indiana University Press, 1985, xii + 304 pp., $27.50.

Josef Garlinski, Poland in the Second World War, London: Macmillan, 1985, xxi + 387 pp., £25.00

Andreas Dorpalen, German History in Marxist Perspective. The East German Approach. London: I. B. Tauris & Co., 1985, 542 pp., £24.50.

Walter Parchomenko, Soviet Images of Dissidents and Nonconformists. New York: Praeger, 1986, xv + 251 pp., $33.95.

Soviet Armed Forces Review Annual. Vol. 9 (1984–1985). Edited by David R. Jones. Gulf Breeze, Florida: Academic International Press, 1986. x + 313 pp., $69–50.     

Tumbling abrasions. Injuries from ricocheting bullets

Atypical entrance gunshot wounds may be produced by deflected or ricocheting bullets. One special type of atypical entrance wound involves abrasion of the skin at a site that is remote from the point of dermal penetration. These remote abrasions, termed "tumbling abrasions," are produced by bullets that tumble after impact with an intermediate target. Three cases of tumbling abrasions are presented.     

Wrongful termination lawsuits: the employers finally win a few

Much attention has been given of late to the erosion of the "employment-at-will" doctrine. Exceptions to this doctrine began to emerge when courts held that at-will employees could sue if their termination violated public policy. The at-will doctrine was further eroded by court rulings that a contract requiring good cause in order to terminate could be inferred from employee handbooks, company personnel policies, and circumstances of employment. As the initial flood of wrongful termination lawsuits now reaches the appellate level, some guidance on the standards employers must observe can be drawn from court decisions. The authors examine these decisions as well as the legislative reform being proposed in response to them.     

Practitioner fraud and abuse in medical benefit programs: government regulation and professional white-collar crime

Physicians who defraud and abuse medical benefit programs provide a unique group of lawbreakers for scientific study. They could be considered to epitomize white collar criminals given their exceedingly high socioeconomic status and power as a professional group. Using official reports and documents, as well as interviews with enforcement and program personnel at both state and federal levels, this study examines the problem of physician fraud and abuse in Medicare and Medicaid. Major areas relevant to understanding this phenomenon and its control are presented and policy implications of present knowledge in the area are discussed.