Blood carbon monoxide and hydrogen cyanide concentrations in the fatalities of fire and non-fire associated civil aviation accidents, 1991-1998

To evaluate pathophysiological significance of post-mortem urinary myoglobin levels in determining the cause of death, we investigated 210 forensic autopsy cases, partially in comparison with serum levels. Post-mortem serum myoglobin levels were extraordinary high in most cases possibly due to post-mortem change. Urinary myoglobin levels did not correlate with the serum levels, showing possible post-mortem elevation in cases of a prolonged post-mortem period over 48h. A high (>1000 ng/ml), moderate (100-1000 ng/ml), slight (50-100 ng/ml) and not significant (<50 ng/ml) elevation of urinary myoglobin were observed in 26, 43, 31 and 110 cases, respectively. Half the highly elevated cases were those with a survival time over 24h. In cases of minor muscle injury such as head trauma, elevation of urinary myoglobin level was closely related to longer survival. In acute/subacute deaths with a post-mortem interval within 48h, a significant difference was observed in relation to the blood carboxyhemoglobin (COHb) levels of fire victims: myoglobinuria over 100 ng/ml was more frequently and markedly observed in cases with COHb below 60% than over 60%, suggesting muscle damage in fatal burns. Similar elevation was observed in heat stroke victims, and also in some cases of acute and subacute death from polytrauma, asphyxiation, drowning, electricity and spontaneous cerebral bleeding, but not in myocardial infarction. Thus, it was suggested that high post-mortem urinary myoglobin levels in acute and subacute death cases may be a possible indicator of antemortem massive skeletal muscle damage as well as exertional muscle hyperactivity or convulsive disorders associated with hypoxia.     

Susceptibility of PharmChek drugs of abuse patch to environmental contamination

The key component of the PharmChek sweat patch, the membrane, has been tested for the passage of externally applied materials. Drugs in the uncharged state rapidly penetrated the membrane but charged species were greatly slowed. In basic media, detectable concentrations of cocaine, methamphetamine, and heroin were observed at the earliest collection time (ca. 30 s), after drugs were placed on the outside of the membrane. Drug concentrations increased over the 2 h time course, when amounts detected (1710 ng cocaine, 1060 ng methamphetamine, 550 ng heroin per pad at 2 h) represented 5-17% of the drug deposited on the surface of the sweat patch.Drugs externally applied to human skin were shown to bind readily. Drugs deposited on the skin of drug-free volunteers several days prior to application of the sweat patch were not completely removed by normal hygiene or the cleaning procedures recommended before application of the sweat patch. Even 6 days of normal hygiene did not remove all drugs from externally contaminated skin and positive sweat patches resulted. A mechanism for passage of drugs through the sweat patch membrane, a mechanism for retention of drugs on skin, and a redesign of the sweat patch and modification of its use to reduce external contamination are proposed. Appropriate care should be taken in the interpretation of positive results from a sweat patch test until more research is conducted.     

Contracting Out and Public Values: A Symposium

The three papers that constitute this symposium were first commissioned for a workshop entitled Citizenship and Contractualism held in October 2000. The theme of that workshop centred on the contractualisation of the relationship between service deliverers and their clients. 1 They have been published elsewhere in a special issue of Law in Context, March 2001, co‐edited by Terry Carney, Gaby Ramia and Anna Yeatman.
These three papers did not fit that theme. They are concerned more with the general use of contracting out as a tool of contemporary governance. I have used the title contracting out and public values because all three of these papers raise fundamental questions about the implications of contracting out for public values.     

Late-form hemorrhagic disease of the newborn: a fatal case report with illustration of investigations that may assist in avoiding the mistaken diagnosis of child abuse

Hemorrhagic disease of the newborn (HDN) is usually a self-limiting hemorrhagic disorder of childhood that occurs as a result of vitamin K deficiency. It may be defined as early or late form depending on the time of onset related to birth. HDN is recognized as one of several bleeding disorders that can mimic the findings of nonaccidental head injury and may lead to a mistaken diagnosis of child abuse. We present a single fatal case of late-onset HDN with illustration of hematologic assays that can be performed to assist the pathologist in making the correct diagnosis of HDN.     

B. reviews and notes of recent bibliographies

i. Oman and Southeastern Arabia: A Bibliographic Survey. By Michael Owen Shannon. Boston, Mass., G.K.Hall & Co., 1978. pp.xvi, 165. $18.00.

ii. Türk Dili ve Edebiyati Ansiklopedisi: Devirler/Isimler/ Eserler/Terimler. Istanbul, Dergah Yayinlari, 1977. TL600 (for 2 vols.).

iii. Arab‐Israeli conflict: a historical, political, social and military bibliography. By Ronald M.De Vore. Oxford, Clio Press, 1976, pp.273. £10.45.

Conflict in the Middle East from October 1973 to July 1976: a selected bibliography. By Michael Rubner. Los Angeles, Center for the Study of Armament and Disarmament, California State University, 1977. pp.83. $3.00.

The Palestine Question: a select bibliography. Compiled from the holdings of the Dag Hammarskj?ld Library, United Nations. New York, United Nations, 1976. pp.63. £3.25 (Distributed in the U.K. by H.M.S.O.).

iv. Middle East Contemporary Survey: Volume I 1976–77.

Edited by Colin Legum. Tel Aviv, Shiloah Center for Middle Eastern and African Studies, University of Tel Aviv, and New York and London, Holmes and Meier, 1978. pp.xxiv, 684. £32.50.

v. The Modern Middle East: A Guide to Research Tools in the Social Sciences. By Reeva S.Simon. Boulder, Colorado, Westview Press, 1978. pp.xv, 283. £6.10.

vi. Gustav Meisels, Reference Literature to Arabic Studies, a bibliographical guide. Tel Aviv, University Publishing Projects Ltd., 1978. pp.xiv + 251.

vii. Saudi Arabia (World Bibliographical Series Vol.5).

Compiled by Frank A.Clements. Oxford and Santa Barbara, Clio Press, 1979. pp.xiv, 195. £16.75.

viii. The Records of the British Residency and Agencies in the Persian Gulf. IOR R/15. (India Office Records: Guides to Archive Groups). By Penelope Tuson. London, India Office Library and Records, 1979. pp.xix, 188. Pl.6. Index. £21.95.

ix. Modern Syria: An Introduction to the Literature. Compiled by C.H.Bleaney. Durham University, Centre for Middle Eastern and Islamic Studies (Occasional Papers Series, no.6). 1979. £4.00.

x. The Encyclopaedia of Islam. New Edition: Encyclopédie de 1'Islam. Nouvelle édition. Index to Volumes/aux [sic: read ‘des‘] Tomes I‐III. Compiled by/Établi par H.& J.D. Pearson. Edited by/Publié par E.van Donzel. Leiden, Brill/Paris, G.P.Maisonneuve & Larose S.A., 1979. pp.viii, 195. 60 guilders.     

A review of major factors contributing to errors in human hair association by microscopy.

Forensic hair examiners using traditional microscopic comparison techniques cannot state with certainty, except in extremely rare cases, that a found hair originated from a particular individual. They also cannot provide a statistical likelihood that a hair came from a certain individual and not another. There is no data available regarding the frequency of a specific microscopic hair characteristic (i.e., microtype) or trait in a particular population. Microtype is a term we use to describe certain internal characteristics and features expressed when observing hairs with unpolarized transmitted light. Courts seem to be sympathetic to lawyer's concerns that there are no accepted probability standards for human hair identification. Under Daubert, microscopic hair analysis testimony (or other scientific testimony) is allowed if the technique can be shown to have testability, peer review, general acceptance, and a known error rate. As with other forensic disciplines, laboratory error rate determination for a specific hair comparison case is not possible. Polymerase chain reaction (PCR)-based typing of hair roots offer hair examiners an opportunity to begin cataloging data with regard to microscopic hair association error rates. This is certainly a realistic manner in which to ascertain which hair microtypes and case circumstances repeatedly cause difficulty in association. Two cases are presented in which PCR typing revealed an incorrect inclusion in one and an incorrect exclusion in another. This paper does not suggest that such limited observations define a rate of occurrence. These cases illustrate evidentiary conditions or case circumstances which may potentially contribute to microscopic hair association errors. Issues discussed in this review paper address the potential questions an expert witness may expect in a Daubert hair analysis admissibility hearing.