Rapid death from thrombotic thrombocytopaenic purpura following caesarean section.

We report a case of rapid death from thrombotic thrombocytopaenic purpura (TTP) in a young pregnant lady who developed full blown symptoms soon after caesarean section. Extensive intramyocardial confluent haemorrhages and widespread microthrombi in heart, brain, adrenals and kidney were found at autopsy. Thrombotic thrombocytopaenic purpura is an uncommon condition, which carries a high fatality rate if untreated. Awareness of this syndrome together with its high risk of sudden death underlines the importance of rapid diagnosis and treatment.     

Determination of cocaine and benzoylecgonine in human amniotic fluid using high flow solid-phase extraction columns and HPLC.

A new solid-phase extraction procedure for the determination of cocaine and benzoylecgonine in amniotic fluid, using high flow co-polymeric sorbents is reported. The recoveries of cocaine and benzoylecgonine within the range 0.1-1 mg/l were 95.7% and 50.3%, respectively. The use of high-flow sorbents allowed the easy extraction of amniotic fluid regardless of sample viscosity or physical nature. The use of these solid-phase columns provided many advantages over the more commonly used solvent extraction, including an increase in extraction speed and efficiency, reduced operator time, reduced solvent use and disposal volumes and exceptional extract quality. Further, the determination of amniotic fluid obtained from pregnant cocaine users may provide important information about handling of cocaine by the fetus at various gestational ages. The procedure was successfully applied to amniotic fluid from suspected cocaine abusers.     

Polymerase chain reaction (PCR) amplification and human leukocyte antigen (HLA)-DQ alpha oligonucleotide typing on biological evidence samples: casework experience.

The polymerase chain reaction (PCR) method of specific gene amplification was used in casework to synthesize millions of copies of the polymorphic second exon of the human leukocyte antigen (HLA)-DQ alpha (or DQA1) locus from a variety of evidence samples. The HLA-DQ alpha allelic variants in the amplified deoxyribonucleic acid (DNA) were determined in a rapid non-radioactive test by hybridization to sequence-specific oligonucleotide probes in both the dot-blot and reverse dot-blot formats. This genetic typing system has been subjected to blind proficiency testing; the performance of this test in the analysis of experimentally mixed samples was also evaluated. As of August 1990, over 250 cases have been tested and more than 2000 individual evidence (bloodstains, semen stains, individual hairs, bone fragments, and tissue sections) and reference samples have been analyzed. The first 198 of these cases are summarized in this paper; in 65% of the cases with conclusive results a suspect was included, and in 35%, all suspects were excluded. Individual cases as well as some of the general issues relating to forensic science analysis and this genetic typing system are discussed. The high rate of exclusion reported here combined with the ability of PCR to type old evidence samples suggests the relevance of this genetic test for postconviction review; two cases in which the convicted suspect was excluded are discussed.     

Civil procedure: Can the Scots learn from Woolf?

Conclusion So can the Scots learn from Woolf? The answer must be in the affirmative, for his review points up similar problems to those we encounter here. There is no room for complacency in the civil justice system in Scotland, particularly in the field of Information Technology, where court systems and expertise are sadly lacking. It is clear that there is a need for a system of case management in all civil courts, targeted in particular areas or on particular cases, but only after a rigorous reappraisal of court timetabling; and that the public will lose confidence in a civil justice system which does not meet their needs for speedy and affordable decisions, perhaps by turning their backs on it and seeking means of Alternative Dispute Resolution. As for written pleadings, perhaps the most that can be said is that the case for their complete abolition is “not proven”, but that thestatus quo should not be maintained is beyond reasonable doubt. Sheriff of Lothian and Borders at Edinburgh; Member, Sheriff Court Rules Council.     

Preadolescent peer friendships: A critical contribution to adult social relatedness?

The primary aim of this paper is to review the literature on preadolescent friendships in order to examine the relationship between preadolescent friendships and social support in adulthood. Social supports are important to health, both directly and as a stress buffer. Few studies, however, have specifically examined adult social supports from the perspective of their developmental precursors and critical developmental periods. Some data indicate that the preadolescent period may be of particular importance to the development of adult social skills and ties. Observational and empirical studies of preadolescent peer relationships, and in particular best friendships, suggest unique and critical contributions to adult social relatedness. Present research is suggestive but is insufficient to validate preadolescence as a critical period in adult social relatedness. Our review has implications for better understanding the mechanisms by which preadolescent friendships effect adult social support—an important mediator of the effects of stress on health. Further longitudinal study is needed.Received Ph.D. from University of Maryland. Research interests are social supports and psychological responses to trauma and disaster.Received M.D. from Yale University. Research interests are social supports and traumatic stress.     

The use of either the nose or outer ear as a means of determining the postmortem period of a human corpse.

Presented in this paper are the initial results involving the use of the nose or outer ear as temperature measurement sites to determine the postmortem period of the human corpse. Simple mathematical models for both sites are developed based on cooling curves of five corpses. Analysis of errors between actual and calculated postmortem intervals suggest that in its present form, the described methods would not be suitable for use in accurately determining the time since death of human corpses.     

Learning from the Danish case: A comment on Palle Svensson's critique of the Franklin thesis

Abstract. Palle Svensson in this issue of EJPR has objected to the characterisation of Danish voters made by Franklin and others who, in various publications, expounded the thesis that on issues of low salience, referendum votes tend to follow party lines. Svensson finds evidence that the Maastricht Treaty was not an issue of low salience to Danish voters in the ratification referendums conducted there, and gives other details of the evolution of public opinion regarding Europe that clarify the circumstances in which our thesis should apply. In the light of his arguments, this Comment presents a more nuanced version of the thesis that learns from the Danish case, and should be of greater utility than our earlier version in helping to interpret the role of government standing in referendum outcomes.     

Dissecting intramural haematoma of the coronary artery with intimal tears.

A dissecting intramural haematoma of the coronary artery is an infrequent cause of sudden and unexpected death. Most cases are women and in a significant number of these women, the haematoma occurred at term to 80 days postpartum. Because the intimal rupture and communication with the lumen were not found in most of the cases, the site of rupture has been considered to be a vasa vasorum. The authors report on a case of one woman who was at a later postpartum period (106 days). The microscopic finding of the dissected coronary artery revealed two intimal tears in a section. The case showed that the dissecting intramural haematoma of the coronary artery is caused not only by the rupture of the vasa vasorum but also by the rupture of the intima.