Assisted death--a compassionate response to a medical failure.
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Biomedical subjects
Publications and source records attributed to H Brody.
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Froom and Froom call attention to referral bias as a frequent cause for misinterpreting the medical literature. This is particularly a source of false certainty, and therefore false science, in U.S. practice, where referral centers are often seen as the only legitimate source of medical knowledge and where primary care is discounted as a source of scientific observations. Appreciation of the primary care setting is therefore a critical element in theoretical understanding of medical epistemology.
In the contig mapping and analysis package, CMAP, we provide a foundation for reverse genetics by organizing information about DNA fragments obtained from an organism's genome into a physical map. The user can store information about a particular segment of DNA. This information can be both descriptive, such as any genes contained in a particular DNA fragment, or experimental, such as hybridization profiles or restriction digest patterns for comparison with other fragments. The package can then be instructed to update the physical map or provide information on a DNA fragment within the map, such as its location. The user interface is designed to minimize the learning curve associated with database usage, while eliminating the possibility of entering data outside the ranges of fields through error-checking protocols. Queries are currently accomplished by the use of dynamic SQL (structured query language), which gives the user the ability to build queries based on any combination of the attributes contained within the database without requiring that all possible queries be permanently programmed within the query software. In order to eliminate the need for knowledge of SQL, an interface was designed to allow users to build queries by menu choices. Thus, CMAP is a software package supporting a database for both the production and storage of a physical map as well as being the first step toward the production of a physical mapping workstation.
A recent interest in aging of the nervous system is related to the remarkable increase in the numbers of elderly persons throughout the world. As a reflection of the added years, pathologies in the older person have also increased. Primary among those which affect the activities and behavior of these people are the dementias, especially Alzheimer's Disease. To focus on such problems, however, requires an understanding of the changes which take place in the normal aging nervous system. This paper reviews some of the accepted criteria for these changes as well as the possible attempts by the nervous system to alter its structure in response to these changes.
Development of physical genomic maps is facilitated by identification of overlapping recombinant DNA clones containing long chromosomal DNA inserts. To simplify the analysis required to determine which clones in a genomic library overlap one another, we partitioned Aspergillus nidulans cosmid libraries into chromosome-specific subcollections. The eight A. nidulans chromosomes were resolved by pulsed field gel electrophoresis and hybridized to filter replicas of cosmid libraries. The subcollections obtained appeared to be representative of the chromosomes based on the correspondence between subcollection size and chromosome length. A sufficient number of clones was obtained in each chromosome-specific subcollection to predict the overlap and assembly of individual clones into a limited number of contiguous regions. This approach should be applicable to many organisms whose genomes can be resolved by pulsed field gel electrophoresis.
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Decisions to limit nutrition and hydration in irreversibly or terminally ill patients are becoming more frequent in both hospitals and home-care settings. Although clear-cut principles or rules are not always possible, appropriate decisions about any form of life-sustaining treatment, nutrition and hydration included, require conducting a productive moral conversation within the medical management team and/or the institutional ethics committee. In this article, we discuss how dietitians can participate in these medical decisions.
Recent recommendations that physicians be allowed to withhold cardiopulmonary resuscitation, without patient consent, from patients for whom it would be futile have drawn objections that such unilateral judgments would undermine respect for patient autonomy. These objections assume that since futility determinations involve value judgments, patient input is always required. However, certain sorts of value judgments must be made unilaterally by physicians as part of reasonable medical practice. Moreover, the mixed messages inherent in requesting patient consent to withhold futile therapy serve to undermine rather than to enhance autonomous choice. Real patient interests can better be saved by a broad public dialogue around judgments of medical reasonableness and medical futility, rather than concern for the form but not the substance of patient autonomy.
This issue of Michigan Medicine marks a turning point in MSMS posture regarding advance directives ("living wills"). For many years, MSMS has discussed the issue and has supported legislation, more or less behind the scenes. We are now involved in a more proactive stance, trying to encourage more discussion and wider use of these devices, whether or not legislation is enacted. In this article I will: 1) review some basic terms and ethical principles; 2) recount the deliberations of the MSMS Committee on Bioethics on this topic; and 3) indicate why the time is now ripe for more action by Michigan physicians.
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An electrophoretic karyotype of Aspergillus nidulans has been obtained using contour-clamped homogeneous electric field gel electrophoresis. Six chromosomal bands were separated, with two of the bands migrating as doublets. Using the Schizosaccharomyces pombe and Saccharomyces cerevisiae chromosomes as size standards, we estimate the sizes of the chromosomes to be between 2.9 and 5.0 megabase pairs (mb) with a total genome size of approximately 31 mb. Four of the eight genetic linkage groups were assigned to chromosomal bands by hybridization of contour-clamped homogeneous electric field gel blots with various radiolabeled probes each specific to a particular linkage group. Contour-clamped homogeneous electric field gel analysis of reciprocal translocation strains gave chromosomal assignments for the four remaining linkage groups. In order of decreasing size, the A. nidulans chromosomes are: VIII (5.0 mb), VII (4.5 mb), II (4.2 mb), I and V (3.8 mb), III and VI (3.5 mb), and IV (2.9 mb).
The e14 element appears to be integrated into the Escherichia coli K-12 isocitrate dehydrogenase structural gene (icd). In being integrated, it replaced the last 52 codons of the gene with a closely related sequence. The two versions of the icd gene produce proteins of the same length but differ by 12 base substitutions that would cause two conservative amino acid replacements.
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