Suicide by asphyxiation with a plastic bag placed over the head is a method that has been advocated by right-to-die groups. Recently, such groups have proposed the introduction of helium into the plastic bag as a means of hastening death. Helium is readily available at toy stores, where it is sold in tanks for balloon inflation. It produces asphyxiation by the exclusion of oxygen in enclosed spaces. We report 7 fatalities throughout an 18-month period involving plastic bag suffocation in conjunction with helium use. These fatalities coincide with publication of an update to a popular right-to-die text in which this method is described. Although right-to-die literature was absent from all scenes, this method was not previously observed in our jurisdiction, and the deaths likely reflect exposure to this information. Because of analytical difficulties in testing for helium in biologic specimens, death certification rests on scene investigation.

We describe a novel basic leucine zipper transcription factor, XXBP-1, which interacts with BMP-4 in a positive feedback loop. It is a maternal factor and is zygotically expressed in the dorsal blastopore lip and ventral ectoderm with the exception of the prospective neural plate during gastrulation. Overexpression of XXBP-1 leads to ventralization of early embryos as described for BMP-4, and inhibits neuralization of dissociated ectoderm. Consistent with mediating BMP signaling, we show that the ectopic expression of XXBP-1 recovers the expression of epidermal keratin and reverses the dorsalization imposed by truncated BMP receptor type I, indicating that it may act downstream of the BMP receptor. Its effects can be partially mimicked by a fusion construct containing the VP16 activator domain and the XXBP-1 DNA-binding domain. In contrast, fusing the DNA-binding domain to the even-skipped repressor domain leads to upregulation of the neural markers NCAM and nrp-1 in animal cap assay. Taken together, the results suggest a role for XXBP-1 in the control of neural differentiation, possibly as an activator.

Fetus in fetu is an extremely uncommon cause of abdominal mass in the neonate. A case of retroperitoneal fetus in fetu in a 2 week old boy is reported, the excised mass containing a round mass, covered by hair, containing brain tissue; 2 feet and 2 arms; a cavity containing a loop of intestine of 15 centimeters length, small penis and testis.

The positive effect of bromantan (0.5-50 mg/kg) on the efficiency of physical work of mice and rats (swimming test, running on a treadmill) exceeds that of phenamine administered in optimal doses by 1.3-1.6 times. Such an effect of bromantan lasts no less than 24 h. The drug delays decrease of physical efficiency and restores it sooner in repeated extreme running loads, prevents in rats the corresponding electron-microscopic changes in the cardiomyocyte and myocyte mitochondria of the skeletal muscles. The data obtained suggest that the positive effect of bromantan on the physical efficiency is associated not only with its psychostimulating action but also with the membrane-protecting effect.

The essential oils of aegle, ageratum, citronella, eucalyptus, geranium, lemongrass, orange, palmarosa, patchouli and peppermint, were tested for antibacterial activity against 22 bacteria, including Gram-positive cocci and rods and Gram-negative rods, and twelve fungi (3 yeast-like and 9 filamentous) by the disc diffusion method. Lemongrass, eucalyptus, peppermint and orange oils were effective against all the 22 bacterial strains. Aegle and palmarosa oils inhibited 21 bacteria; patchouli and ageratum oils inhibited 20 bacteria and citronella and geranium oils were inhibitory to 15 and 12 bacterial strains, respectively. All twelve fungi were inhibited by seven oils (aegle, citronella, geranium, lemongrass, orange, palmarosa and patchouli). Eucalyptus and peppermint oils were effective against eleven fungi. Ageratum oil was inhibitory to only four fungi tested. The MIC of eucalyptus, lemongrass, palmarosa and peppermint oils ranged from 0.16 to > 20 microliters ml-1 for eighteen bacteria and from 0.25 to 10 microliters ml-1 for twelve fungi.

The objectives of this study were to (1) develop a behavioral assessment tool for the measurement of pain in the preterm and full-term neonate; (2) establish the construct and concurrent validity, interrater reliability, and internal consistency of the tool; and (3) examine the relationship between the pain scores and infant characteristics. Thirty-eight infants contributed to the 90 procedures videotaped for the study. The Neonatal Infant Pain Scale (NIPS) was used to score behavioral responses before, during, and after each intrusive procedure. The significant difference in NIPS scores over time indicates that the scale provides a measurement of intensity of infant responses to intrusive procedures. Concurrent validity was established by correlations, ranging from .53 to .84, between NIPS scores at each minute of observation and scores on the Visual Analogue Scale. Interrater reliability was high: Pearson correlations ranged from .92 to .97 across successive minutes of observation. The six component scores of the NIPS had high internal consistency: Cronbach's alphas were .95, .87, and .88 for before, during, and after the procedures, respectively. Although gestational age and five-minute Apgars were positively associated with NIPS scores over time, there was no association between these factors and responsiveness to pain, as measured by change in NIPS scores from before to during the procedure. Results are discussed in terms of the use of the NIPS in clinical trials and its clinical application in a neonatal intensive care unit.

Experimental observation was made on the effect of GFDH pills and their oral liquid preparation on thymus and spleen weight, formation of the antibody haemolysis plaque and phagocytic function of the macrophages of peritoneal cavity. The result revealed that both GFDH pills and their oral liquid preparation were found helpful to the enhancement of immunological function. The oral liquid preparation also increased markedly the plasma level of testosterone in immature rats.

Hoodoo is a folk belief system common among black Americans. Conjuration and rootwork are other terms used to describe this system which includes the casting of spells and witchcraft. This paper describes the black folk concept of 'white liver', an aspect of hoodoo which bears striking resemblance to AIDS. White liver refers to a condition characterized by sexual excess and a wasting to death of sexual partners. Although clearly antedating by many years the current AIDS epidemic, white liver is important as a contemporary black cultural entity that may be used to describe AIDS or to articulate a fear of AIDS.

Using the grounded theory method, a substantive theory of postpartum depression was developed. Data were obtained through participant observation in a postpartum depression support group over an 18-month period. In addition, 12 in-depth taped interviews were conducted with mothers who had attended the support group. Analysis of the data by the constant comparative method revealed loss of control as the basic social psychological problem. Women suffering from postpartum depression attempted to cope with the problem of loss of control through the four-stage process of teetering on the edge. The stages that emerged from the data included (a) encountering terror, (b) dying of self, (c) struggling to survive, and (d) regaining control.

The short-term therapy of streptococcal pharyngotonsillitis and scarlet fever with ceftriaxone (Rocephin) is reported. Sixty children, in whom the clinical diagnosis was confirmed by rapid enzyme immunoassay and smear test, were divided into two randomized groups and treated with a single dose of 50 mg/kg ceftriaxone or 50 mg/kg ceftriaxone on 3 consecutive days. Clinical cure was obtained in 100% of the patients and pharyngeal sterilization in 95%, with no significant differences between the two groups.

A 2-year-old boy was found to have a 47,XXX karyotype. Restriction-fragment-length-polymorphism analysis showed that, of his three X chromosomes, one is of paternal and two are of maternal origin. The results of Y-DNA hybridization were reminiscent of those in XX males in two respects. First, hybridization to Southern transfers revealed the presence in this XXX male of sequences derived from the Y-chromosomal short arm. Second, in situ hybridization showed that this Y DNA was located on the tip of the X-chromosomal short arm. We conclude that this XXX male resulted from the coincidence of X-X nondisjunction during maternal meiosis and aberrant X-Y interchange either during or prior to paternal meiosis.

Suicide attempts made by cutting the wrist artery (A. radialis et ulnaris) are usually unsuccessful if the vessel wall or blood clotting has not changed pathologically. Fatal exsanguination, however, can also result even if the arteries are not completely severed crosswise--which is usually not the case--but are instead slit open lengthwise or partially severed crosswise. For this reason, the invagination processes of the artery stumps controlled by the elastic structure of the vessel walls and consequently the spontaneous arterial hemostasis are obstructed. The importance in establishing the type and position of the cut artery is demonstrated by means of an exactly dissected model limb.

A case of two nontwin brothers, 19 and 17 years old, who had both Klinefelter's syndrome with a chromosomal mosaicism 46 XY/47 XXY, is reported here. The analysis of their mother's karyotype revealed a 46 XX/47 XXX mosaicism. It is hypothesized that the presence of an extra X chromosome in all three subjects could depend on the transmission of two X chromosomes from the mother to the sons or, less likely, on an increased liability to nondisjunction of the X chromosomes during one of the early mitotic divisions in the zygotes.

Clinical signs of developmental anomalies found in the 49, XXXXY patients have been reported based on the author's case.