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Biomedical subjects

J Lynn

Publications and source records attributed to J Lynn.

At least 199 records · Page 11Linked to original sources
PubMed1987

Brain death.

To establish the diagnosis of brain death, the physician must document the irreversible loss of all brain function while excluding conditions that can mimic brain death. Confirmation of irreversibility requires continued observation for variable periods, depending on individual circumstances and the use of confirmatory tests. In some cases, consultation with an expert who is experienced in the diagnosis of brain death may be necessary. Several scientific and social issues relating to brain death remain unresolved.

Apnea↗
PubMed1986

Brain death.

Brain death is a condition widely recognized by philosophers, theologians, the public, and the law. Criteria for the determination of brain death have been progressively refined for almost 30 years. They involve clinical evidence of the loss of brain function and various periods of observation, which can often be shortened by confirmatory tests, particularly cerebral blood flow studies or electroencephalography. Prompt declaration of brain death is therefore possible. In addition, it is important for physicians to offer the possibility of organ donation to the patient's family both because organs are desperately needed and because many families desire this. A model algorithm for the determination of brain death, explanatory text, and appropriate references are presented to aid the development of protocols for individual and hospital use.

Algorithms↗
PubMed1986

Ethical issues in caring for elderly residents of nursing homes.

Good decision making is important, especially with patients who are disadvantaged in the ways common to long-term care institutions. Few decisions are as important as where to live and where to receive medical care for chronic illnesses, and these decisions deserve careful consideration by providers. Dying is common in long-term care facilities but is commonly managed poorly. Physicians could help this situation by encouraging advance directives, better educating patients, knowing more adequate symptom control measures, and understanding moral and legal considerations better. Pressures for cost containment are forcing physicians to re-examine and defend their role as patient advocate and to defend reasonable expenditures even on patients who are close to death.

Aged↗
PubMed1985

Hard choices: who lives, how, and who decides? The physician's dilemma.

America's health care dilemma is the result of increasing medical capabilities in the face of necessarily limited health care expenditures. The question thus arises, who should receive the benefits and who should be denied? If we wish to create an even distribution of health care we can not allow people as broad a change of choices as they have enjoyed in the past. We may not be able to allow people to buy all of the health care they could afford if allowing such a market would reduce the chances of the poor to obtain urgently needed medical care. Any equitable allocation scheme will require persons to make distributions and access decisions about individual ill people. This is a social role to which no group is presently well suited.

Ethics, Medical↗
PubMed1984

Specific binding of 1,25 dihydroxyvitamin D3 in lymphocytes.

We examined ten cellular or tissue sources of lymphocytes for specific binding of 1,25(OH)2D3, the hormonally active form of vitamin D3. A specific-binding protein was found in three of these sources. Scatchard analysis of cytosol from a follicular lymphoma cell line revealed binding sites with a Kd of 7.0 X 10(-11) and a receptor concentration of 6.6 fmol/mg protein. Sucrose density centrifugation of 3H-1,25(OH)2D3 labeled cytosol showed a 3.75 peak which was absent in cytosols incubated with excess nonradioactive 1,25(OH)2D3. The relative amounts of vitamin D3 metabolites required to displace 50% of the specifically bound 3H-1,25(OH)2D3 were 1,25(OH)2D3: 1,24,25(OH)3D3: 25(OH)D3: 24,25(OH)2D3 = 1: 180: 1000: 2700. Excess vitamin D3, cortisol, and estradiol failed to displace 3H-1,25(OH)2D3. Scatchard analysis of spleen cytosol from a patient with prolymphocytic transformation of chronic lymphocytic leukemia demonstrated a binding protein with a Kd of 1.2 X 10(-10) and a receptor concentration of 0.2 fmol/mg protein. DNA cellulose binding confirmed the presence of the specific-binding protein in this cytosol. Specific binding of 3H-1,25(OH)2D3 was also quantitated in a cell line from a patient with Burkitt's lymphoma with a Kd of 0.3 X 10(-10) and a receptor concentration of 29.6 fmol/mg protein. No specific binding of 3H-1,25(OH)2D3 was observed in lymphocytes from seven other malignant and nonmalignant sources. These results are the first to demonstrate a specific-binding protein for 1,25(OH)2D3 in lymphocytes from tissue and from these specific cell lines. The presence of this protein in some lymphocytes but not others may reflect the state of activation of the lymphocytes.

Binding, Competitive↗
PubMed1984

Brief and appendix for amicus curiae: the American Geriatrics Society.

In February 1984, the following "friend of the court" (amicus curiae) brief was submitted to the New Jersey Supreme Court by the American Geriatrics Society to assist in the Court's deliberation in the case known as In re Claire C. Conroy. The Board of Directors of the AGS had decided to undertake this endeaver because the reasoning adopted by the Appellate Division in this case would, if affirmed by the Supreme Court, greatly diminish the capacity of physicians to serve their patients, especially their older patients. The brief was prepared by AGS member Joanne Lynn, MD, and was critiqued, revised, and finally approved by all of the members of the Executive Committee of the Board of Directors. A New Jersey attorney, Mr. Charles Deubel, III, filed the brief and the necessary associated papers on behalf of the AGS and without charge. Expenditures by the AGS in this endeavor totalled less than $300. The Editors of the Journal and the Board of Directors of the AGS would welcome comments from the membership and other concerned persons concerning the content of the brief and the process of developing and submitting it.

Aged↗
PubMed1984

Post-parathyroidectomy restoration of normal calcium homeostasis in neonatal primary hyperparathyroidism.

Total parathyroidectomy is required to cure neonatal primary hyperparathyroidism (NPH) as any parathyroid remnant quickly becomes hyperplastic, causing recurrent hypercalcaemia. We present a patient with NPH who had total removal of his eutopic parathyroid glands but continued to have parathyroid hormone secretion from presumed ectopic parathyroid tissue. Hypercalcaemia initially recurred but normal calcium homeostasis was established as the child grew older. We postulate that the underlying defect in NPH is decreased sensitivity to the serum ionic calcium feedback inhibition at the parathyroid receptor level and that this sensitivity can improve with age.

Age Factors↗