Book reviews

Turkey in the Middle East By Philip Robins. Pinter for the Royal Institute of international Affairs. 1991.130 pp. £22.50. ISBNO 86187 198 7. PBk £8.95. ISBN 0 86187 1995.

Hitler Slept Late and other blunders that cost him the war By James P. Duffy. London: Praeger. 1991.176pp. £17.50.

Alliance within the alliance: Franco‐German Military Cooperation and the European Pillar of Defense By David G. Haglund. Boulder: Westview Press, 1991. 213 pp.

Homeward Bound? Allied Forces in the New Germany Edited by David G. Haglund and Olaf Mager. Boulder: Westview Press, 1992. 299 pp. £24.95

Avoiding War: Problems of crisis management By Alexander L. George (ed.), Westview Press, 1991. 590 pp. £16.95.

The Future of NATO: Facing an Unreliable Enemy in an Uncertain Environment By S.N. Drew et al. Praeger Publishers, New York, 1991. pp. 206.

Parliament and international relations Edited by Charles Carstairs and Richard Ware. Milton Keynes: Open University Press, 1991. 195 pp. £12.99 (paperback)     

Separation of stomach contents using the sieve-tower technique]

The authors present a method to separate and preserve stomach contents for forensic purpose. Analysis by "sieve tower" technique is simple and quickly done during autopsy. Solid phases of stomach content are arranged size up and can be stored for subsequent examinations. With the fluid phase drug analysis or microscopic analysis to confirm identy of the foodstuffs may be done. By adding alcohol (70%) enzymatic digestion and bacterial degradation of the stomach content are stopped.     

The structure of the conclusions in the forensic medical expertise of material evidence]

A new structure of conclusions including special chapter "Conclusion validity", which ensures their high availability for officials of legal investigation agencies is suggested. The examples of conclusion making on the basis of new form in case of blood, secretion and hair tests performed in two variants (known and unknown criminal) are presented.     

Medicaid and access to child health care in Chicago.

In this article we examine how increasing the reimbursement of physicians and expanding Medicaid eligibility affect access to care for children in Cook County, Illinois, which overlies Chicago. Using Medicaid claims and other data at the zip-code level, we compare the places where Medicaid children live with the places where all the physicians who treat children and those who accept Medicaid patients have their practices. Our findings suggest that the recent changes in legislation are unlikely to benefit extremely poor children, who are more likely to live in depressed inner-city areas, where there are few physicians. "Near-poor" children whose homes are dispersed throughout the county, who are now eligible for Medicaid as a result of the recent changes, are likely to see improvements in their access to care. Further changes in policy, aimed at enhancing the capacity of institutions providing care, could improve access for the children of the inner city.     

Complications following cell therapy

So far, the law in the Federal Republic of Germany still allows the injection of fresh-cell preparations from animals as a roborant to increase the vitality of the organism and to strengthen the body's immune defense system. The use of "sicca-cell" preparations was provisionally forbidden in 1987 by the Federal Health Organization (Bundesgesundheitsamt; BGA). Prohibition of fresh-cell injections would have exceeded the authority of this office, although the same serious reservations also applied in the case of this treatment method. Several publications that have appeared since 1955 have reported serious complications of this therapy, some life-threatening and some even lethal. Two further cases are now added: (1) A woman aged 69 had been receiving treatment with cell injections for 9 years. Immediately after an injection of sicca cells she collapsed and was hospitalized; 7 days thereafter she developed an ascending paralysis with increasing inability to swallow or breathe. She died 25 days after the injection as a consequence of central and peripheral respiratory failure. Autopsy revealed the alterations typical for acute Landry-Guillain-Barré-Strohl syndrome. (2) A 76-year-old healthy woman had been receiving treatment with fresh-cell preparations for several years. After an injection of cell suspensions a painful local swelling was observed. The symptoms were interpreted as the consequence of an iatrogenic local hematoma, and repeated punctures were performed to obtain blood. The patient was transferred to a surgical department for further therapy. Two days after the injection she suddenly died with signs of acute cardiovascular failure. Autopsy revealed the signs of a fulminating clostridial infection and also the characteristic signs of Landry-Guillain-Barré syndrome with involvement of the autonomic nervous system. In both cases the development of an inflammatory process in the peripheral nervous system could be interpreted as an immune-mediated allergic disease, related to the repeated injection of heterologous antigenic material containing nervous tissues. This hypothesis would also explain the two other cases already published and would be consistent with the observed perivenous leukoencephalopathy of the central nervous system. The human disease pictures correspond to the well-established animal models of EAEM (experimental allergic encephalomyelitis) and EAN (experimental allergic neuritis). The pathogenesis is discussed; the major role of the central and peripheral nervous system is stressed, with special reference to the risk of acute autonomic failure. The need for specific autopsy techniques for the investigation of the entire nervous system, including spinal cord, roots, spinal ganglia and peripheral nerves with sympathetic chains, is raised.     

Introduction

The Federal Republic of Germany celebrated its fortieth anniversaryin May 1989. In spite of the devastation brought by World WarII, the division of the country between East and West, and theloss of one-fourth of its territory, the Bonn Republic was foundedunder more propitious circumstances than was its democraticpredecessa after World War I, the Weimar Republic. Togetherwith an "economic miracle" that brought about economic growthand a high standard of living. West Germany experienced a "politicalmirracle" that led to governmental stability and a system asdemocratic as any other in Europe. Federalism has contributedto this miracle, and, in contrast to the nineteenth century,is now identified closely with democracy in Germany. The articlescontained in this volume provide a broad overview of postwarfederalism in Germany, from its origins, organization, strengths,and weaknesses, to interpretations and assessments of currenttrends and developments.