Continuity and Change in the Constitutional Experience of the German Jews

Despite the progress of Emancipation in the nineteenth century,German Jews were required to to legally recognized Jewish communities.Even after this requirement was lifted, Jewish communal liferemained strong. The community structure that the Prussian stateexpected the Jews to implement was modeled after German civiladministration. This framework, however, resembled both medievalGerman and medieval Jewish models. Thus, German Jews, whilemodernizing their own communal institutions, continued to maintainboth their own and their German neighbors' political traditions.The German Jewish communal constitutions attest to a Jewishpolitical tradition of adaptation to prevailing gentile norms,as well as retention of ancient Jewish elements.     

Cocaine and sudden "natural" death

The cardiovascular effects of cocaine may culminate in clinical episodes of angina pectoris, myocardial infarction, arrhythmias, and intracranial hemorrhage. To clarify whether or not cocaine causes fatalities by these mechanisms, we studied 24 cases of sudden, apparently natural deaths as a result of coronary arteriosclerosis (15 cases), hypertensive cardiovascular disease (4 cases), and intracranial hemorrhage (5 cases) associated with cocaine use. In 11 cases, cocaine was found in the blood (average concentration: 0.57 mg/L, range: 0.05 to 1.45 mg/L), whereas in the remainder, cocaine or its major metabolite was found in the urine or other tissues. In the majority of decedents, autopsy disclosed the existence of severe natural disease which could have been exacerbated by the administration of stimulant drugs, including cocaine. These data, and a review of the current medical literature, indicate that cocaine may precipitate the sudden death of an individual with undiagnosed cardiovascular disease. A contributory role of cocaine should be considered in any apparently natural death occurring in a population where cocaine abuse is prevalent.     

Hypopharyngeal lipoma as a cause for sudden asphyxial death

Lipomas of the hypopharynx are uncommon tumors that are rarely life threatening. When positioned in the hypopharynx, asphyxia may be the result of the tumor size or sudden displacement into the oropharynx. We present a case of a large hypopharyngeal lipoma, review the literature, and discuss mechanisms by which these lesions may cause sudden asphyxial death.     

Stud guns revisited: report of a suicide and literature review

Stud guns (powder-actuated fastening tools) are a commonly used construction tool. Accidental injuries and fatalities are no longer frequent, presumably because of current safety features and practices. A case of an intentional fatal wound (suicide) is described. A literature review of stud gun injuries is also presented.     

Endotracheal tube ignition by electrocautery during tracheostomy: case report with autopsy findings

This case of upper airway tract fire resulting from the use of electrocautery during elective tracheostomy has significance for surgeons, anesthetists, and forensic pathologists alike. The major autopsy findings are described and illustrated. Suggestions that may help to prevent or minimize the risk of fire in this context are reviewed.     

Practical approach to investigative ethics and religious objections to the autopsy.

The application of investigative ethics to religious objections to the autopsy is essential for harmony in achieving the mission of medical legal death investigations. In Florida, an ethical advisory committee composed of religious, ethics, legal, and medical leaders established a unified statement for the practice of discretionary judgment and liaison with clergy. Our approach to religious objections to the autopsy as well as illustrative cases will be discussed.     

Aortoesophageal fistula and sudden death. A report of two cases and review of the literature

Two cases of aortoesophageal fistula are presented. The etiology, symptoms, and diagnosis of aortoesophageal fistula are reviewed. Signs and symptoms of gastrointestinal hemorrhage followed by sudden collapse hours to days later should prompt consideration of an aortoesophageal fistula. Accidental ingestion of foreign bodies, particularly by children, is a frequent etiology.