Lewis typing of human saliva stains by enzyme-linked immunosorbent assay (ELISA) using monoclonal anti-Le(a) and anti-Le(b) antibodies

The Lewis blood grouping of human saliva stains could be detected by an enzyme-linked immunosorbent assay (ELISA) using anti-Le(a) and anti-Le(b) monoclonal antibodies with an avidin-biotin complex (ABC). The saliva stains (1.0 by 1.0 cm in size) were used as samples and not only could the Lewis substances of 57 individual stains be correctly typed by this method, but also it was clarified that there are several different secretion patterns of amounts of Le(a) and Le(b) substances in 3 individual Lewis types.     

The course of respiration in death caused by obstructive asphyxia

Experiments were carried out on 30 dogs to investigate the course of respiration during obstructive asphyxia. They were asphyxiated by occlusion of the exposed trachea. Intrathoracic pressure, blood pressure in the femoral artery, electrocardiogram and electroencephalogram readings were registered. In most cases, the respiration course during the dyspnea stage by occlusion of the trachea generally had an inspiratory character. In a few animals, when the trachea was occluded in the expiratory phase, there were a few positive expiratory respirations with moderate inspiratory movement and thereafter the respirations were inspiratory during the dyspnea stage. The terminal respirations, which occurred 1-2 min before the circulatory breakdown, were generally inspiratory, but in a few dogs they were expiratory.     

Urinary catecholamines in hyperthermia-related deaths

A group of five hyperthermia-related deaths is presented in which urinary noradrenaline (NA) concentrations were elevated (172.1 +/- 119.4 ng/ml) compared with a control group of rapid violent deaths (43.7 +/- 26.1 ng/ml). Urinary adrenaline (A) concentrations were not elevated in the hyperthermia cases, nor were there any significant differences in urinary dopamine (DA) concentrations between the two groups. All except one of the hyperthermia victims were under the influence of ethanol. It is suggested that a combination of heat stress and ethanol consumption was responsible for the elevated urinary NA in the hyperthermia cases, reflecting increased sympathetic nervous system activity. A combination of high urinary NA with low A seems to be characteristic of hyperthermia fatalities, in contrast to hypothermia deaths, where both NA and A are usually elevated.     

An autopsy case of malignant hyperthermia

A report is made of a 44-year-old female who died of malignant hyperthermia during general anesthesia for an operation of left subtrochanteric femoral fracture. Symptoms began with increases in heart rate and blood pressure after the introduction of anesthesia with halothane and were accelerated by the administration of succinylcholine, followed by muscle rigidity and high temperature. The typical wine red urine was observed. The oral temperature of 42 degrees C was recorded within 1 h after succinylcholine. The rectal temperature was 30 degrees C 22 h after death. Severe pulmonary edema and tubular necrosis of the kidney were found by postmortem examination. No latent myopathy was observed. The creatine phosphokinase levels in plasma obtained after the onset of malignant hyperthermia and at the time of autopsy were abnormally high and were 5632 and 34,854 mU/ml, respectively. Plasma myoglobin levels were 130,000 and 2.8 X 10(6) ng/ml, respectively.     

Nonprofit and for-profit medical care: shifting roles and implications for health policy

The contemporary expansion of investor-owned health care facilities has stimulated much controversy but little response from policymakers. We believe this results from the apparently ambiguous relationship between ownership and socially valued outcomes. In our assessment, this ambiguity occurs largely because the effects of ownership are mediated in complex ways by characteristics of the services being delivered and the training of health care providers. Reviewing both the history and current performance of nonprofit and for-profit health care facilities, we identify some of the more important of these mediating factors. Taking these into account, there is a consistent influence of ownership on the delivery of health services. On the basis of this analysis, we discuss appropriate policy responses to the future growth of investor-owned health care organizations.     

An analysis of a prehistoric homicide from northern California

An analysis was performed on a prehistoric human vertebral column recovered during an archaeological excavation in the Sierra of northern California. Fifteen burials believed to represent the Maidu culture of 400 to 700 years ago were recovered. The vertebral column from one of the individuals is particularly significant because of three embedded projectile points. The analysis attempts to recreate the trajectory of each point; to determine the possible extent of damage done by each with emphasis upon which could have been fatal; and by employing available ethnographic and archaeological data, to suggest the possible circumstances surrounding the violent event. The conclusion suggests that death may have resulted from any of the three wounds and was probably the result of an intratribal dispute.     

Gas chromatographic determination of cresols in the biological fluids of a non-fatal case of cresol intoxication

A simple and rapid method for analysis of free and conjugated cresols in biological fluids was developed. Prior to and following freeing of the conjugated cresols by acid hydrolysis in a sealed ampoule, free cresols were extracted by Extrelut column extraction, determined by gas chromatography, and confirmed by gas chromatography-mass spectrometry. In a non-fatal case of cresol intoxication a 46-year-old male had ingested about 100 ml of a saponated cresol soap solution. The concentrations of xylenol (2,4- and/or 2,5-dimethylphenol) and p- and m-cresol in the serum sample collected on admission were 15.8 micrograms/g, 43.3 micrograms/g and 73.8 micrograms/g, respectively. The total cresol concentration of 117 micrograms/g in the serum is within the range of fatal concentrations, and it is suspected therefore that the patient's recovery was due to adequate therapy alone.     

Lifting the 'No Haste,Be Patient' Policy: Implications for Cross-Strait Relations

Cross-Strait relations remain deadlocked following Chen Shui-bian's inauguration as Taiwan's president. Amid this political stalemate, Chen's administration decided to change the 'no haste, be patient' ( jie-ji yueng-ren ) policy while refusing to endorse the 'one China' principle. While this policy change is in response to domestic demands, Chen and his ruling Democratic Progressive Party (DPP) are unlikely to reap any benefit from these actions without active cooperation from China's leaders. Beijing will continue to use its economic clout in an attempt to pull Taiwan into political union, as Taipei needs to nurture an environment favourable for domestic and foreign investment in Taiwan in order to maintain its competitive edge over China and thus preserve its de facto independence. Beijing's leaders will need to rethink their rigid stand on the 'one China' principle, since increased cross-Strait economic integration may not lead to the expected political union they desire.