Sudden cardiac death due to giant cell inflammatory processes

Granulomatous inflammation of the myocardium may occur in a number of systemic disease processes including those with infectious etiologies such as fungal, mycobacterial and parasitic infections, as well as hypersensitivity reactions, and rarely autoimmune disorders. In many of these disorders, giant cells are components of the inflammatory infiltrate. Systemic granulomatous processes of unknown pathogenesis, most notably sarcoidosis, may also be associated with involvement of the myocardium. Occasionally, these disorders are associated with sudden death due to pathologic involvement of the heart. In contrast, giant cell myocarditis, also known as idiopathic myocarditis, a rare, frequently fulminant and fatal disorder of unknown etiology, is isolated to the heart and lacks systemic involvement. This disorder is most commonly diagnosed at autopsy. We present two cases in which sudden death resulted from a giant cell inflammatory process affecting the myocardium. Both individuals lacked antemortem diagnoses and collapsed at their respective places of employment. These cases compare and contrast the clinical and pathologic issues involved in the differential diagnoses of the subgroup of sudden cardiac deaths resulting from giant cell inflammatory processes that affect the myocardium, as well as the value of histologic examination and immunohistochemical studies.     

An Incidental Diffuse Midline Glioma Found at Autopsy

This case shows an unexpected midline glioma found at autopsy. Two siblings were riding on a single bicycle on the side of a road. The 13‐year‐old brother was seated and steering the bicycle, while the 14‐year‐old sister held onto the back. The bicycle veered left into traffic and was struck by a vehicle. The siblings were admitted to the local Level 1 trauma center, but both later succumbed to injuries. Autopsies were performed on the children, including brains for neuropathologic evaluation. The brother was found to have an infiltrating astrocytoma located in the left middle cerebellar peduncle, with extension to the pons and medulla. His hospital course included several imaging studies using CT and MRI modalities. However, this lesion was not identified until the postmortem neuropathologic examination. This rare case shows the continued need for postmortem autopsy and the current limitations of medical imaging.     

Incidence of cocaine metabolites in urine specimens from medical examiners' cases

Isobutane CIMS is useful for determining the molecular weight of morphine and its derivatives, as well as for identifying labile acyl substituents on morphine's O-6 position. Furthermore, this technique will provide information relating to the presence or absence of pi-bonding on the C-7 carbon. The spectra of morphine derivatives can be further simplified by employing ethylenediamine as a reagent gas. This approach proves useful for eliciting or confirming molecular weight information from the CI spectrum. In our laboratory extended use of ethylenediamine has been accomplished without any deleterious effect on the mass spectrometer's source or its vacuum system. The utility of isobutane and ethylenediamine CI rests with its ability to supply the analyst with structure elucidation data that may be used to complement more detailed information extractable from either EI or CE spectra. This aspect of mass spectrometry is especially useful when one is dealing with an unknown member of a particular class of organic compounds.     

Distributing Responsibility for Wrongdoing Inside Corporate Hierarchies: Public Judgments in Three Societies

The decision rules individuals use to judge wrongdoing committed inside corporations and other hierarchical organizations are not well understood. We explore this issue by asking random samples of individuals in Moscow, Tokyo, and Washington, D. C., to respond to four short vignettes describing acts of wrongdoing by people in corporations. The vignettes are experiments that manipulate the actor's mental state, the actor's position in the organization, and whether the actor's decision was influenced by others in the organization. We examine (1) the distribution of responsibility among people in the organization, (2) how individual responsibility affects the attribution of responsibility to the organization itself, and (3) cross-national differences in attributions. We find that both what the actors did (their deeds) and the position they occupied (their roles) significantly influence the responsibility attributed to them. The responsibility attributed to the organizations themselves is a function of the responsibility attributed to the actors inside the organization, but not a function of the independent variables in the experiments. Cross-national differences emerge with respect to the responsibility assigned both to individuals and to the organizations themselves. We discuss implications of these results for past and future work.     

Cocaine and benzoylecgonine excretion in humans.

Maximal urinary excretion of unchanged cocaine occurred within 2 h of the intranasal absorption of 1.5 mg/kg body weight of cocaine hydrochloride, and diminished rapidly thereafter. Excretion of benzoylecgonine was maximal 4 to 8 h following administration of the drug and diminished slowly over an interval of several days. Peak cocaine and benzoylecgonine concentrations observed were 24 and 75 microgram/ml, respectively. Benzoylecgonine/cocaine ratios were too varied to allow estimation of cocaine concentrations from benzoylecgonine concentration data or vice versa. Benzoylecgonine concentrations generally exceeded the corresponding cocaine values by a wide margin, but excretion of free cocaine in the absence of benzoylecgonine was observed in one subject. Cocaine was generally detected for only approximately 8 h, and for a maximum of 12 h, whereas benzoylecgonine was generally detected by chromatographic or enzyme immunologic assays for 48 to 72 h. Benzoylecgonine was positively identified in urine by raidoimmunoassay for 96 to 144 h after dosing.     

Unpacking the Diaspora Channel in New Democracies: When Do Migrants Act Politically Back Home?

Migrant influence on politics back home has arguably become broader and deeper in the wake of a widespread convergence between out-migration and democratization. This article seeks to identify the structural conditions under which migrants from post-1980 democracies are likely to activate the “diaspora channel” of political influence back home. Specifically, I identify, explain, and code two sets of incentives likely to induce migrants to engage in home-country politics from abroad: (1) socioeconomic incentives generated by cross-border linkages and migrant characteristics likely to predispose them toward broader forms of transnational engagement and (2) political incentives generated by diaspora politicization and formal access to the political process in the home country. I score these incentives in 40 developing countries and then generate hypotheses about the degree to which migrants from these countries are likely to activate the diaspora channel through participation in home-country elections, lobbying for policy changes by the home-country government, or transnational coproduction.