Sudden natural death at the wheel--a particular problem of the elderly?

Thirty-nine autopsy cases of sudden natural death at the wheel were analysed with special respect to the questions if this is a peculiar problem of the elderly and if there are particular pathological features in the elderly. The ages ranged from 33 through 83 years and the median age was 56.4 years. 97% of the deaths were attributable to cardiovascular diseases, about 90% to coronary heart disease. People older than 60 years of age tended to exhibit severe chronical arterio-sclerotic changes of the coronary arteries, especially multiple calcified stenoses and myocardial scars, but there was a low percentage of recent thrombotic occlusion of a coronary artery.     

Aberrant MN bloodgroup inheritance in a German family: a 'silent' allele?

By means of extensive serogenetic testing of a family, RFLP analysis and biostatistic evaluation we present evidence for the rare transmittance of a 'silent' information at the MN blood group locus in a Caucasian family.     

Implementing regulatory reform: the saga of Michigan's debedding experiment

This paper traces the implementation of Michigan's program for hospital bed reduction through four phases in the critical first 30 months following enactment: standard-setting, plan development, plan approval, and legislative oversight. Procedural complexity and goal conflict complicated implementation from the start: what began as a simple proposal to close unneeded beds soon became enmeshed in efforts to address long-standing issues of equity in access to care. A combination of administrative, political, and economic factors peculiar to Michigan, as well as the more generic problems incurred in applying a regulatory approach to containing medical care costs, contributed to the difficulties encountered in implementing bed reduction. Long-range prospects for the program depend upon whether the modest results it is likely to achieve are deemed to be worth the costs incurred in administering it.