Laryngohyoid fractures after agonal falls: not always a certain sign of strangulation

Haemorrhagic fractures of the thyroid cartilage and hyoid bone are frequently observed in cases of strangulation and often regarded as evidence for an assault against the neck. In contrast, two cases of laryngohyoid fractures after agonal falls in prone position are presented to draw attention to alternative causes of these injuries with special regard to practical medicolegal casework. A 45-year-old man collapsed at a fairground and died after unsuccessful resuscitation. He showed excoriations at his elbows and right knee, a crush injury at the mentum and his mandibular front teeth were knocked out. The upper parts of the chest and the head showed blue discolouration as a marked sign of congestion due to heart failure. The right coronary artery (RCA) was completely obturated by a 5 cm long post-stenotic thrombus with subsequent myocardial infarction of the lateral part of the left ventricle. Both superior horns of the thyroid cartilage were fractured with surrounding haemorrhage, the skin and muscles of the neck uninjured. In the second case, a 63-year-old woman with a mobility handicap had fallen from a 2m high lifting platform and was found in prone position with her wheelchair on her. Resuscitation efforts were not successful. Autopsy showed signs of blunt external force against head, neck, chest and limbs. Examination of the neck revealed haemorrhage of the right sternocleidomastoid muscle, both superior horns of the thyroid cartilage were fractured, as well as the hyoid bone, with slight haemorrhage of the surrounding soft tissue and mucosa. On the same level, the fifth intervertebral disk was ruptured, without any injury of the spinal cord. These cases demonstrate that laryngohyoid fractures should not be overestimated as unequivocal indication of neck compression and may well be caused by falls, even at ground level.     

Death due to positional asphyxia under severe alcoholisation: pathophysiologic and forensic considerations

In contrary to "physical restraint", describing a fixed body position due to external devices, "positional restraint" is defined as an abnormal body position, resulting from accidental fixation under unfortunate circumstances. We report on a remarkable case of positional asphyxia of an alcoholised young man after a fall down a staircase. On external examination, the body showed petechiae of the conjunctivae and oral mucosa, abrasions on the left zygomatic region and scratch marks, respectively. Neither broken fingernails, etc. nor signs of external violence against the neck were found. Autopsy revealed haemorrhages in the praevertebral cervical musculature and Simon's sign. Haemorrhagic pulmonary edema and cerebral edema were observed; blood alcohol concentration: 2.60 g/l, urine alcohol concentration: 3.26 g/l. As cause of death, positional asphyxia after blunt head trauma has to be considered as well as lethal ethanol intoxication. To us, alcoholisation attributed to the fall and together with unconsciousness following blunt head trauma circumvented self-rescue efforts, and therefore, aggravated the potentially lethal impact of positional restraint.     

Complex suicide by two gunshots to the chest and consecutive hanging: circumstances and aspects of reconstruction

In cases of suicidal gunshots, the capacity to act may be preserved for a certain period of time, so that the suicide may be completed with another method. In the presented case a 74-year-old man was found hanged on the first floor of his house with two gunshot wounds in the chest. Both on the ground and the upper floor traces of suicidal acts were detected. As shots to the precordial region suggest rapid incapacitation, a suicide extending over two floors seemed almost impossible without knowledge of the cause of death and evaluation of the ability to act. The autopsy findings confirmed vital signs of hanging. Moreover, a through-and-through gunshot wound of the chest and abdomen affecting the spleen and a shot lodged in the body without injuring the lung were found. The injury findings thus sufficiently explained the preserved ability to act. The presented case shows characteristics of a complex suicide not yet described so far, but could be clearly classified as suicide in congruity with the pertinent literature.     

“Staatswirtschaftslehre”—A Component of “Staatswissenschaften” Today and Tomorrow

The paper starts from problems of reorganization of the Welfare State. The second paragraph contains definitions and materials. The third paragraph turns to the development of Staatswissenschaften, especially to cameralistic views, public choice and deregulation. The fourth section deals with present Staatswirtschaftslehre as a component of Staatswissenschaften. The fifth paragraph is focussed on deregulation and reorganization of the state.The paper demonstrates: Staatswissenschaften and Staatswirtschaftslehre will be important academic disciplines also tomorrow, though the State will be reorganized by privatization, non-government-organizations and rearrangements of private and public sector activities under the conditions of new technologies and open markets.     

Homicide by burning

Compared to the total number of deaths by heat (burning, scalding), homicides by the direct effect of thermal energy (setting the victim on fire, pouring hot liquids over them) are rare; accordingly this subject is seldom dealt with in forensic and criminological literature. From our own autopsy material three cases are presented describing some peculiarities of homicide by heat. Sometimes additional findings (e.g., residual traces of gagging or tying) primarily point in the direction of homicide.     

Simulation of homicide to hide child's suicide

A case of pretending a homicide to conceal a child suicide is reported in which characteristic findings of the postmortem examination and conclusions from the analysis of forensic autopsy series provided substantial support for the police investigation. In the late night hours of a spring day the police authorities were informed that a 10-year-old girl had been found dead on a playground near its parents' house. As injuries of the neck were recognized by the police officers a homicide investigation was initiated. The post mortem examination showed a furrow symmetrically slanting from the front to the nape of the neck, discrete punctate haemorrhages of the skin of the face and numerous 'tram-line' bruises of the back, buttocks and extremities. These findings indicated as cause and manner of death suicidal hanging following corporal punishment. Confronted with these conclusions the mother immediately made a corresponding confession.     

Secondary combined suicide viewed by the wife]

A 47-year-old man was found dead at the bottom of a wall outward the door of the cellar of his house. Preliminary physical examination at the scene of the death revealed a laceration of the scalp, an incised wound in front of the neck and several stab wounds in the left chest penetrating through the clothing. Questioned by the police his wife told that her husband who suffered from severe depression had inflicted the incised and the stab wounds himself, had made an unsuccessful attempt at self-strangulation and had finally jumped down from the wall beside the stairs declining to the cellar of their house. As the circumstances of the scenario were suspicious and as the pattern of injuries arose doubts concerning self-infliction homicide was taken into consideration as well. Autopsy showed additional hesitation marks adjacent to the left end of the incised wound in front of the neck. The stab wounds of the chest were restricted to the region of the heart and displayed only minimal penetration of the chest-wall, findings characteristic of self-infliction. As a consequence the manner of death could be determined as prolonged suicide, and exact reconstruction was possible with the help of the wife's testimony.     

Acheiving Full Employment: Four Perspectives

Books reviewed in this article.
Samuel Bowles, David M. Cordon, and Thomas E. Weisskopf, Beyond the Wasteland: A Democratic Alternative to Economic Decline
Economic Report of the President 1981
Helen Cinsburg, Full Employment and Public Policy: The United States and Sweden
Elliot Jaques, Free Enterprise, Fair Employment     

Bridging the donor-decentralization gap: Rethinking incentives and institutional impacts in control-oriented bureaucracies

Some important studies suggest that the organizational imperatives of donor agencies explain the tendency of foreign aid to reinforce institutional centralization rather than to support the development of decentralized institutions in recipient countries. This article shows that certain design features of two decentralized USAID projects completed in Peru during the 1980s facilitated achieving donor objectives, decentralized institutional development, and national-level reforms favoring decentralization. Analysis of this experience reveals that these design features reduced the costs and increased the benefits of decentralized implementation for the donor, while allowing synergies between implementation and institution building to be exploited. Indeed, in the context of Peru’s highly centralized, control-oriented public sector, bypass mechanisms traditionally used by donors to expedite implementation and insulate projects from uncertainty also generally enhanced the development of decentralized institutions. The lessons distilled in this case study have broad relevance since the sorts of administrative obstacles encountered by USAID in Peru—excessive centralization, disbursement bottlenecks, and onerous bureaucratic controls—are all too frequently found in other developing countries. Gregory D. Schmidt is an associate professor of political science at Northern Illinois University and an associate ofSeguimiento, Análisis y Evaluación Para el Desarrollo (SASE), a Peruvian nongovernmental organization specializing in grassroots development. He is the author of a book and various journal articles on development issues, and of a forthcoming book on the 1990 Peruvian presidential election.     

Technology transfer in snow control engineering

The design and construction of a complex snow fence system, the development and implementation of a visual range monitoring system, and the development and use of a snow profile prediction model for highway design, are used as examples of successful technology transfer. Contributing factors include a strong imperative and commitment to solving an urgent problem; the availability of knowledge, the direct involvement of scientists and engineers working together throughout the planning, implementation, and evaluation stages; and a synergetic relationship between research and application.