Pathological myophosphorylase reaction in malignant hyperthermia

In malignant hyperthermia, myophosphorylase reaction shows characteristic changes that take place within minutes: (1) a generally strongly weakened reaction; (2) numerous negatively reacting fibres; (3) frequently, fibre sections that show spotty and/or striatal weak or negative reactions and fibre sections with strong striatal reactions with relatively narrow sarcomere spacings (a "sign of hypercontraction"). Obviously, the morphological findings that show characteristic "striated fibres" are typical of the malignant hyperthermia syndrome! It is important to note that the muscular fibres showing such changes are, as a rule, inconspicuous when using other stains and reactions. These pathological myophosphorylase reactions were observed in five deceased patients (one independently of anaesthesia after an extended walk) and in 19 pigs (18 times after halothane testing and once in an experimental animal with clinical evidence of the presence of malignant hyperthermia). These reactions were not noted in pigs with negative halothane reactivity or prior to halothane testing. They were also not seen in a large number of very different healthy and diseased control and reference cases from our biopsy and autopsy material. Myophosphorylase reaction enables convincing demonstration of malignant hyperthermia, past or present. Hence, it is possible to elucidate puzzling deaths or verify apparently clear death occurring during or subsequent to anaesthesia or simply following stress ("human stress syndrome"). Many of these deaths doubtlessly escape the attention of clinicians using the usual morphological examination methods. However, the reaction cannot be used to identify potential victims.     

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     

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.     

Local Governments' Fiscal Responses to Welfare Reform

The devolution of the social safety net means that local governments must increasingly respond to the needs of their citizens, particularly those who are coming off the welfare rolls and making the transition to work. Based on our findings from a statewide, randomized experiment, this article describes how welfare reforms have affected the well-being of current and former welfare recipients. We look specifically at how those leaving welfare in Indiana are using the township trustee system, the state's general assistance program providing poor relief, to meet basic needs, as well as how the trustees have responded to welfare reform.