Ancillary studies in amniotic fluid embolism: a case report and review of the literature

The incidence of amniotic fluid embolism during pregnancy is approximately 1/50,000 and has a mortality rate in excess of 80%. The postmortem diagnosis of amniotic fluid embolism can be challenging for forensic investigators and pathologists. At autopsy, usually signs of disseminated intravascular coagulation suggest an amniotic fluid embolism. A definitive diagnosis of amniotic fluid embolism cannot be made until ancillary studies are performed on the decedent's tissues. We report a case of a 37-year-old G3P2 white female who was 36 weeks gestation when her membranes spontaneously ruptured. She suddenly became breathless, went into cardiogenic shock, and died. The autopsy revealed gross and microscopic findings of amniotic fluid embolism, which was confirmed with ancillary studies consisting of special stains, immunohistochemistry, and a serum tryptase level. The authors hope this case report, including gross and microscopic autopsy findings with procedural and ancillary studies, and review of the literature will help investigators and pathologists in the diagnosis of amniotic fluid embolism.     

Youth violence in everyday life

What we now know about violence in the United States is that it is a common occurrence and recurrence for youth. Self-report methods have greatly enhanced our understanding of interpersonal violence. Specifically, from the 1980s to the present the age group most vulnerable to violence is youth. In addition, and in any given year, one third will physically fight with peers, more than one third physically fight with dating partners, and a majority of those who fight with either peers or partners will repeat this at least one more time.     

Compensating victims for harms caused by pollution and other hazardous substances: a comparison of American and Japanese policies

This paper reviews recent American proposals to reform the system for compensating victims of pollution and compares them with the Japanese approach. American proposals fall into three categories: balanced approaches that combine administrative relief with tort reform; proposals that would provide administrative relief but eliminate tort remedies; and proposals to reform tort law which have nothing to say about administrative relief. While American policy-makers are still groping for a solution, in Japan tort law changes provided the rationale for a system of administrative relief that preserves the victims' right to sue. While the Japanese approach is not perfect, the early development of a policy reduced legal and political uncertainties and provided a stable environment for economic growth.