Mountain medical mystery. Unwitnessed death of a healthy young man, caused by lightning.

A healthy 20-year-old man failed to return home after a jog in the Colorado mountains. His lifeless body was found the next day on an exposed mountain slope. The differential diagnosis in such mysterious, unwitnessed mountain deaths includes cardiac arrhythmia, cerebral hemorrhage, pulmonary embolism, seizures, trauma, high-altitude sickness, and hypothermia. The cause of death in this case was established on postmortem examination. The findings of ruptured tympanic membranes and a melted shoe established this as a case of lightning strike fatality. The National Lightning Detection Network can be a valuable resource to investigators by providing information on the location and date of lightning strikes in the vicinity of the victim.

Radiology of blunt abdominal trauma.

Blunt abdominal trauma can produce injury to any of the intra-abdominal organs. While diagnostic studies may be necessary to help determine the most appropriate therapy, all these procedures take time, which in some instances can be better used to treat the patient actively. The condition of the patient and the clinical findings take precedence in the handling of the injured patient. Certain skeletal injuries are often a first clue and can help focus further investigations. Plain films and regular contrast examinations are adequate to evaluate most intra-abdominal injuries. When time is available, a variety of other radiologic techniques are available in most hospitals. Nuclear imaging is of considerable value in studying the liver, spleen, and kidneys. Thus far, ultrasound techniques have left much to be desired although theoretically of considerable potential. Angiography can be of great diagnostic and potentially of some therapeutic value. No diagnostic test beats a good history and careful examination. Radiologic studies, ideally, should be done to confirm a clinical suspicion, not just for the sake of "completeness."

Polysaccharide from dry navy beans, Phaseolus vulgaris: Iits isolation and stimulation of Clostridium perfringens.

A microbiological assay is described for determining gas produced by Clostridium perfringens (Veilon and Zuber) Holland from materials believed to be flatulent. A rationale for its use is given and analyzed. The fractionation and the results of the assay for several components of lima beans, Phaseolus lunatus L., and navy beans, P. vulgaris L., are given. In particular, a polysaccharide was isolated from dried P. vulgaris seeds. Only about one-seventh as much could be isolated from green P. lunatus seeds as from P. vulgaris seeds. The polysaccharide stimulates voluminous gas production by C. perfringens and meets all criteria of the rationale for flatulent sus pects. It has not been tested on humans; however, data from the microbiological assay correlate well with human results for green and dry lima beans and navy beans.