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.     

Community midwifery and state measures: the new midwifery in British Columbia

The New Midwifery, a form of community midwifery rooted in home birth and intensive prenatal and postnatal care, has attracted great controversy since its appearance in British Columbia in the early 1970s. On the one hand, this form of community midwifery has endured despite legal prohibition. Midwives derive an income from their practices, obtain necessary supplies and equipment, and are active in lobbying for recognition through the State. On the other hand, community midwifery is marginalized and illegal. Out-of-hospital births comprise less than one percent of births in British Columbia (and nationwide). Community midwives are excluded from the provincal Medical Services Plan and they lack hospital privileges if their clients are transferred to hospital. Community midwives are more likely than medical personnel to be tried for criminal negligence causing death and subject to prosecution under theMedical Practitioners Act of practicing medicine without a license.Community midwifery illustrates the structural limits placed on female birth attendants working outside the norm of professionally accredited, hospital situated childbirth. It is concluded that State measures in Canada structure power relations in a dialectical fashion. This includes measures to consolidate the monopoly status of the medical profession and the nursing profession, while temporizing about demands for independent midwifery practice. State powers are however relatively autonomous of dominant economic groups such as the Medical profession. Not all prosecutions of community midwives are successful, and contradictions in State policies surrounding monopolistic powers and civil liberties, and gender relations are evident.An earlier version of this paper was presented at the Canadian Sociology and Anthropology Association Meetings, University of Manitoba, June 1986. The author is grateful for resources provided through the Social Sciences and Humanities Research Council of Canada, the Department of Anthropology and Sociology (University of British Columbia), and the School of Criminology, Simon Fraser University. Comments from Carol Bullock, Nanette Davis, Bob Ratner, Livy Visano and the Journal referees have been helpful in revising this paper.     

Book reviews

Transborder Data Flows (Proceedings of an OECD Conference) Edited by Hans‐Peter Gassmann North Holland (Elsevier Science Publishers) 1985, US$74.00

Plastic and Electronic Money: New Payment Systems and Their Implications Patrick Frazer Woodhead Faulkner Limited 1985 £35

A User's Guide To Computer Contracting: Forms, Techniques and Strategies Davis, Allen, Bowman and Armstrong Harcourt Brace Jovanovich 1985, $75

Legal Protection of Computer Programs and Data C. Millard Sweet & Maxwell/Stevens 1985, £24

Piracy of Phonograms Gillian Davies ESC Publishing Ltd. 1986. 2nd edition. £17.95.

Biotechnology and Patent Protection—An International Review F. K. Beier, R. S. Crespi and J. Straus O.E.C.D. 1985, £5

Protecting Privacy in Two‐Way Electronic Services David H. Flaherty Mansell Publishing Company 1985, £23.50

High‐Tech Espionage Jay Tuck Sidgwick and Jackson Ltd 1980, £10.95     

Deaths allegedly caused by the use of "choke holds" (shime-waza)

Shime-waza or the "choke hold", when properly applied, should not cause death; therefore, its primary purpose should be to subdue violent suspects. When properly applied, the choke hold causes unconsciousness in 10 to 20 s. No fatalities as a result of shime-waza have been reported in the sport of judo since its inception in 1882. Among the methods of "control holds" taught to law enforcement officers is the choke hold similar or identical to shime-waza used in judo. Using the choke hold, officers may afford themselves maximum safety while subjecting the suspect to a minimum possibility of injury. The author has reviewed 14 fatalities with autopsy findings where death was allegedly caused by the use of choke holds.     

Tumbling abrasions. Injuries from ricocheting bullets

Atypical entrance gunshot wounds may be produced by deflected or ricocheting bullets. One special type of atypical entrance wound involves abrasion of the skin at a site that is remote from the point of dermal penetration. These remote abrasions, termed "tumbling abrasions," are produced by bullets that tumble after impact with an intermediate target. Three cases of tumbling abrasions are presented.     

Reviews

Terry Cox and Gary Littlejohn, eds., Kritsman and the Agrarian Marxists. (Library of Peasant Studies, No. 7), London: Frank Cass & Co. Ltd., 1984, 149 pp., £18.50.

S. G. Wheatcroft and R. W. Davies eds., Materials for a balance of the Soviet national economy 1928–1930 (with foreword by Richard Stone). Cambridge: Cambridge University Press, 1985, xxiv + 467 pp., £35.00, $59.50.

I. Birman, Ekonomika nedostach. New York: Chalidze Publications, 1983, 470 pp.

Richard F. Staar, USSR Foreign Policies After Detente. Stanford, Ca: Hoover Institution Press, 1985, xxvii + 300 pp., h/b $26.95, p/b $10.95.

John J. Maresca, To Helsinki: The Conference on Security and Cooperation in Europe 1973–1975. Durham, North Carolina: Duke University Press, 1985, xiii + 292 pp., £47.50.

Mark V. Kauppi and R. Craig Nation eds., The Soviet Union and the Middle East in the 1980s. Lexington, Mass, and Toronto: Lexington Books, D.C. Heath and Company, 1983, ix + 293 pp., £25.00.

Jonathan Haslam, The Soviet Union and the Struggle for Collective Security in Europe, 1933–1939. New York: St. Martin's, 1984, xii + 310 pp., $29.95.

Alfred L. Monks, Soviet Military Doctrine: 1960 to the Present. New York: Irvington Publishers, 1985, xii + 351 pp., $34.50.

Jeffrey D. Boutwell, Paul Doty, and Gregory F. Treverton eds., The Nuclear Confrontation in Europe. London: Croom Helm, 1985, 247 pp., £22.50.

Condoleezza Rice, The Soviet Union and the Czechoslovak Army, 1948–1983: Uncertain Allegiance. Princeton, N.J.: Princeton University Press, 1984, xiv + 303 pp. Tables. £40.40.

Vitaly Rapoport and Yuri Alexeev, High Treason: Essays on the History of the Red Army, 1918–1938. Translated by Bruce Adams. Durham: Duke University Press, 1985, xvii + 436 pp., £35.00.

Robert Conquest, Inside Stalin's Secret Police. NKVD Politics 1936–1939. Stanford, California: Hoover Institution Press, 1985, ix + 222 pp., $22.95.

Jeffrey T. Richelson, Sword and Shield. The Soviet Intelligence and Security Apparatus. Cambridge, Massachusetts: Ballinger Publishing Company, 1986, xix + 279 pp., $39.95 h/b, $16.95 p/b.

P. Marer, Dollar GNPs of the USSR and Eastern Europe. The Johns Hopkins University Press, Baltimore and London: For the World Bank. 1985, xiii + 241 pp., £20.00.

Moshe Lewin, The Making of the Soviet System: Essays in the Social History of Interwar Russia. London: Methuen, 1985, viii + 354 pp., £19.00 h/b, £8.95 p/b.

Eric P. Hoffmann and Robbin F. Laird, Technocratic Socialism: the Soviet Union in the Advanced Industrial Era. Durham: Duke University Press, 1985, viii + 228 pp. h/b £37.50, p/b £12.50.

Robert Cassen ed., Soviet Interests in the Third World. London: Sage Publications, 1985, xi + 329 pp., h/b £27.50, p/b £10.50.

Václav Havel et al., The Power of the Powerless: Citizens Against the State in Central‐Eastern Europe, Ed. John Keane, Introduction by Steven Lukes. London, Melbourne, Sydney, Auckland, Johannesburg: Hutchinson, 1985, 228 pp., £16.95.

Michael M. Boll, Cold War in the Balkans: American Foreign Policy and the Emergence of Communist Bulgaria, 1943–1947. Lexington, Ky.: The University Press of Kentucky, 1984, ix + 250 pp., £27.50.

Edward R. Girardet, Afghanistan: The Soviet War. London: Croom Helm, 1985, 259 pp., £17.95.

Henry S. Bradsher, Afghanistan and the Soviet Union. Durham: Duke University Press, 1985, viii + 384 pp., £12.95.

David W. Lovell, Trotsky's Analysis of Soviet Bureaucratization. London: Croom Helm, 1985, ix + 82 pp., £7.95.

Katerina Clark and Michael Holquist, Mikhail Bakhtin. Cambridge, Mass, and London: Harvard University Press, 1984, xi + 398 pp., £19.95.

Hans‐Georg Heinrich, Hungary. Politics, Economics and Society. London: Frances Pinter, 1986, xviii + 198 pp., £17.50.

Henry Rollet, La Pologne au XX^e Siècle. Paris: éditions A. Pedone, 1985, 603 pp., 240F.

Mieczyslaw F. Rakowski, Ein schwieriger Dialog. Aufzeichnungen zu Ereignissen in Polen 1981–1984. Mit einem Vorwort von Peter Bender. Econ Verlag. Düsseldorf‐Wien 1985. 269 pp. Index. DM. 38,00.

John Ambler, Denis J. B. Shaw and Leslie Symons eds., Soviet and East European Transport Problems. London and Sydney: Croom Helm, 1985, xix + 260 pp., £19.95.

Joan de Bardeleben, The Environment and Marxism‐Leninism: The Soviet and East German Experience. Boulder and London: Westview Press, 1985, xi + 338 pp., no price quoted.

John R. Lampe, The Bulgarian Economy in the Twentieth Century. London: Croom Helm, 1986 x + 245 pp., £25.00.

Pedro Ramet, Nationalism and Federalism in Yugoslavia, 1963–1983. Bloomington: Indiana University Press, 1984, xviii + 299 pp., $27.50.

Boris Meissner, Partei, Staat und Nation in der Sowjetunion. Ausgewdhlte Beitrage. Berlin: Duncker & Humblot, 1985, 544 pp., DM148.00.

Jiri Hochman, The Soviet Union and the Failure of Collective Security, 1934–1938. Cornell Studies in Security Affairs. Ithaca and London: Cornell University Press, 1984. 253 pp. $32.95.