Biomedical subjects
Publications and source records attributed to J Fletcher.
The moral and ethical problems resulting from application of pre-natal diagnosis are identified: abortion, questions about euthanasia for defective newborns, and the concept of genetic health. A holistic approach to ethical problems is presented that includes attention to both principles and consequences.
A systematic survey of 1599 male patients attending a subfertility clinic has shown that 2.2% were chromosomally abnormal. This frequency was approximately five times higher than that found among the normal male population. The majority of chromosome abnormalities (at least in chromatin-negative males) appeared to be exerting their effect on male fertility through disturbance of spermatogenesis. The contribution made by chromosome abnormalities causing recurrent abortion in wives was negligible. The possible reasons underlying impairment of spermatogenesis in man are discussed in relation to the findings in other species, and the suggestion that some elimination of chromosomally unbalanced gametes occurs from the human male germ line is proposed.
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Chromosomal abnormalities have been detected in seven mares isolated by their poor reproductive performance. All had small or rudimentary gonads and absent or irregular oestrous cycles. Two mares had an XO genotype, one was a 65,XXX female and another a 64,XY sex-reversed female. Two other mares were sex chromosome mosaics of the 63,X/64,XX type. The seventh mare showed a normal female karyotype but a small extra autosomal fragment was found in a few cells.
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Five cases of coincident salmonellosis and ulcerative colitis are described. In three the diagnostic combination was recognized late. If corticosteroid therapy is given for the colitis once the combination is recognized, then simultaneous systemic antibiotic cover is advisable. One of the five patients died during corticosteroid therapy alone with salmonella septicaemia due to a usually non-invasive organism.
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