Battered wives,lawyers, and district attorneys: An examination of law in action

The legal services received by 146 Milwaukee women who had been beaten by their husbands, but had been free of the violence for at least a year, are described and evaluated. Of these women 106 recieved legal help in connection with at least one battering incident. Some women saw more than one member of the legal profession, so the total number of legal contacts among the 106 women was 255. There is evidence that lawyers and district attorneys were most likely to be used by those battered women for whom the use of personal strategies and informal help sources (such as family and friends) were ineffective in combatting the violence. Contrary to the negative image of lawyers and district attorneys found in the literature on wife beating, most legal service contracts were rated as very or fairly successful by the battered women. The more difficult and severe the situation, the higher the success ratings given to lawyers and district attorneys by their clients. Despite the generally positive reactions that most beaten women had to lawyers and district attorneys, there were many negative incidents reported, including district attorneys who refused service or discouraged battered women from filing charges, and lawyers who sided with the aggressors or attempted to meet their personal and professional needs at the expense of their clients. These incidents remind us that it would be useful to educate legal professionals about the nature of family violence, the situation and needs of battered women, and the legal and ethical responsibilities that lawyers and district attorneys have when they are contacted by battered women.     

Hypernatremia due to amniotic fluid embolism during a saline-induced abortion

A case of fatal amniotic fluid embolism leading to hypernatremia during a hypertonic saline-induced abortion is reported. This sequence of events has not, to our knowledge, been previously reported. Hypernatremia as a diagnostic aid for amniotic fluid embolism is discussed.     

Detection of drugs using XAD-2 resin. II:Analysis of liver in medical examiner's cases

Liver tends to concentrate drugs in quantities generally higher than those found in blood or other body compartments. This fact as well as the general availability of liver in postmortem cases makes it an important specimen for comprehensive toxicologic investigation. A scheme for the analysis of liver for drugs with tissue hydrolysis, XAD-2 resin extraction, and TLC has been developed and the parameters affecting recovery have been studied. The hydrolysis of liver specimens at various pH conditions resulted in an improved recovery for morphine by using pH 2 (2N hydrochloric acid). Recoveries of barbiturates, codeine, and meperidine were essentially the same at pH 2 and pH 3. A considerable loss (22 to 55%) was observed for four drugs (pentobarbital, morphine, codeine, and meperidine) as a result of drug binding to the tissue pellets during the process of centrifuging the liver homogenates. This method is recommended as a comprehensive screening procedure for drugs in liver tissue. For quantitative purposes, however, it is necessary to determine a correction factor for all the losses occurring at the various steps of the procedure. This procedure compared favorably with other procedures for liver analysis reported in literature.     

Extravasation of plasma proteins in brain trauma

The cellular distribution of extravasated plasma proteins in cortical contusions was studied with an immunoperoxidase method using polyclonal antibodies against human plasma albumin, alpha 1-acid glycoprotein, alpha 2-macroglobulin, alpha 1-antitrypsin, transferrin, hemopexin, haptoglobin, fibrinogen, fibronectin and immunoglobulin G. The material consisted of 24 human autopsy brains with a primary diagnosis of cerebral contusion due to blunt trauma. The time interval between injury and death ranged between minutes and 7 years. Immediately after the trauma, a complete breakdown of the blood-brain barrier (BBB) occurred with hemorrhage and extravasation of all types of plasma proteins. This was followed by spreading of edema fluid within the extracellular space in and around the wound. Uptake of extravasated protein by glial cells began on the 3rd day followed by proliferation of reactive astrocytes whose ample cytoplasm appeared to serve as a reservior for the extravasated plasma proteins. Within the reactive astrocytes, plasma proteins and S-100 protein had a similar and diffuse distribution in the immunostained sections. The plasma proteins once incorporated into the glial cells remained unchanged for several years with little sign of degradation. It is suggested that the extravasated plasma proteins subsequent to uptake and processing by the glial cells, may serve some important physiological function in wound healing.