Fatal decompression sickness following therapeutic hyperbaric environment (author's transl)

In Hannover/Germany in 1976 a so called "Society for Regenerative Hyperbaric Therapy" (Gesellschaft für Regenerative Uberdruck-Therapie) subjected 20 patients within two coupled multi-place chambers to a simulated hyperbaric environment, equivalent to a maximum of 4 ata, followed usually by gradual reductions of the pressure. The patients were of an average age of 67.2 years and were afflicted by various disorders. During one of the "dives" a patient developed air embolism of the central nervous system. During ensuing confusion of the chamber was opened suddenly, with resultant explosive reduction of the high pressure. This resulted in five letal accidents of decompression sickness. Post mortem examination revealed diffuse distribution of gas bubbles throughout the entire body. By elecronmicroscopy each bubble was covered by an osmiophilic coat. Post mortem findings are discussed and correlated with well-known and new clinical symptomes. These observations present for the first time fatal accidents of decompression sickness in humans, associated with hyperbaric air-therapy.     

Reviews

Vojtech Mastny, Russia's Road to the Cold War: Diplomacy, Warfare, and the Politics of Communism, 1941–1945. New York: Columbia University Press, 1979. xix + 409 pp. $16.95.

Hugh Seton‐Watson, The Imperialist Revolutionaries: Trends in World Communism in the 1960s and 1970s. Stanford, California: Hoover Institution Press, 1979. x + 157 pp. $6.95.

Egbert Jahn (ed.), Soviet Foreign Policy: Its Social and Economic Conditions. London: Allison and Busby, 1978. 160 pp. £6.50.

Stephen White, Political Culture and Soviet Politics, London: Macmillan, 1979. xi + 234 pp. £10.00 and £4.95.

Donald R. Kelley (ed.) Soviet Politics in the Brezhnev Era, New York: Praeger Publishers, 1980, vii + 269 pp. £14.25.

Morton Kaplan (ed.), The Many Faces of Communism, New York: The Free Press, 1978. x + 366 pp. $14.95.

David H. Howard, The Disequilibrium Model in a Controlled Economy, Farnborough: Lexington Books, 1980. x + 112 pp. £9.50/$20.50.

Felicity Ann O'Dell, Socialisation through children's literature: The Soviet example, Cambridge: Cambride University Press, 1978, x + 277 pp. £14.00.

Martin McCauley, Marxism‐Leninism in the German Democratic Republic. The Socialist Unity Party (SED), London: Macmillan, 1979. xix + 267 pp. £12.00.

R. W. Makepeace, Marxist Ideology and Soviet Criminal Law, Croom Helm, Barnes & Noble, 1980. 319 pp. £13.95.

Jan Tomasz Gross, Polish Society under German Occupation: The General‐gouvernement, 1939–1944, New Jersey: Princeton University Press, 1979. xviii + 343 pp. £11.00     

Pitfalls in the diagnosis of drug smuggler's abdomen

Narcotics "body packing" can be detected in abdominal X-rays by the ring shadow caused by air trapped in the packs. In a series of 82 cases admitted for abdominal X-ray in Helsinki, Finland, in 1982 through 1988, we encountered 9 (11.0%) true positives, 3 (3.6%) false positives, and 1 (1.2%) false negative. The false positives were due to the constipation often associated with the narcotics abuse. The false negative X-ray diagnosis was attributable to an inexperienced radiologist. False negatives may also be associated with packets containing marijuana, packs with few wrappings, aluminum-foil coated packs, and machine-packed narcotics. Searching for trapped air in radiographs, repeated X-raying by an experienced radiologist, use of computed tomography, or combined urinary drug screening may be applied to diminish false findings and to avoid unnecessary arrest for the purpose of fecal screening over several days.     

Selective pregnancy reduction: medical attitudes, legal implications, and a viable alternative

"Selective pregnancy reduction" is a medical procedure used to reduce a multiple pregnancy, often a multiple pregnancy induced by in vitro fertilization or drug therapy. In such instances, healthy embryos are sacrificed in order to maximize the chances of survival of the remaining embryos or to allow the mother to choose the number of babies she wishes to deliver. Physicians appear to rely on Roe v. Wade in assuming the legality of the procedure, although such an assumption may be erroneous. Rather than continue to implant an excessive number of pre-embryos, the American Medical Association and the Association of Obstetrics and Gynecology should adopt guidelines similar to those established by the Voluntary Licensing Authority in London, which limit the number to be inserted to a maximum of three. Careful ultrasound monitoring could ensure that no more than three embryos implant when fertility drugs are used. Such practices would help physicians avoid the many moral, ethical, legal, and philosophical problems caused by selective pregnancy reduction.     

Book reviews

David Granick, Enterprise Guidance in Eastern Europe. A Comparison of Four Socialist Economies. Princeton, N.J.: Princeton UP, 1976. xvi+505 pp. £17.20 or £6.10 (paperback).

A. Zauberman, Mathematical Theory in Soviet Planning (Concepts, Methods, Techniques). London: OUP for the Royal Institute of International Affairs, 1976. xiv+464 pp. £17.00.

H. Gordon Skilling, Czechoslovakia's Interrupted Revolution. Princeton, N.J.: Princeton UP, 1976. 924 pp. £31.30 or £10.50 (paperback).

Alex Pravda, Reform and Change in the Czechoslovak Political System: January‐August 1968. Sage Research Papers in the Social Sciences, vol. 3, series No. 90–020 (Contemporary European Studies Series). Beverly Hills and London: Sage Publications, 1976. 96 pp. £1.30.

R. G. Gidadhubli (ed.), Fifty Years of Soviet Power—a Study of Social, Economic and Political Developments. Centre of Soviet Studies, University of Bombay, 1976. 295 pp. 29 rupees.

Occasional Papers, Centre for Soviet and East European Studies, Jawalharlal Nehru University, New Delhi, Nos. 2 and 3, 1976 (mimeographed).

Adam B. Ulam, A History of Soviet Russia. London: Martin Robertson, 1976. viii+312 pp. £5.00.

Olga A. Narkiewicz, The Green Flag: Polish Populist Politics 1867–1970. London: Croom Helm, 1976. 314 pp. £7.95.

Jacques Levesque, L'URSS et la révolution cubaine. Montreal: Presses de 1'Université de Montréal, 1976. 221 pp.

John B. Dunlop, The New Russian Revolutionaries. Belmont, Mass.: Nordland, 1976. 344 pp. $18.50.

Brian Hunter, Soviet‐ Yugoslav relations 1948–1972: a bibliography of Soviet, Western and Yugoslav comment and analysis. New York and London: Garland, 1976. 223 pp. $20.00.