PubMed · 8356635
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F Sanfilippo. 1993. Organ allocation: current problems and future issues.. https://pubmed.ncbi.nlm.nih.gov/8356635/
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STUDY DESIGN: A three-dimensional, noninvasive motion analysis method was developed by monitoring the orientation of the principal axes of each vertebra. OBJECTIVES: To develop a method of performing three-dimensional, noninvasive motion analysis of the spine using computed tomography data. SUMMARY OF BACKGROUND DATA: The concept of using principal axes of the moment of inertia tensor to measure the orientation and position of a rigid body has been applied to the wrist and subtalar joints, but has not yet been applied to the spine. METHODS: Scans were taken of two isolated vertebrae in various known positions. Centroids, area, moments, and product of inertia of each scan were determined using a commercial program. Custom software combined data using the parallel axis theorem to give three-dimensional data for each vertebra. Changes in the centroid and principal axes were used to calculate translation and rotation, respectively. RESULTS: The system accuracy was within 1.0 degree in rotation and 1.0 mm in translation. Some errors occurred in minor motions when a smaller number of scans were used. System resolution was 0.43 mm. CONCLUSIONS: A system has been developed capable of calculating three-dimensional spinal motion based on measurements of a series of computed tomography images. The system has an accuracy similar to that of current motion analysis methods, but future studies will be necessary to apply this system in vivo.
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Although the cousience and character of a good doctor are sufficient on their own to allow us to discuss and make decisions regarding very difficult ethical subjects in transplantation, basic ethical principles commonly used in medicine must also be applied to various aspects of organ donation. Some system has to be adopted that assesses the weight that must be given to various possible solutions. For example, would live donor transplantation still be acceptable if there were a surfeit of cadaveric organs? If animal organs can be transplanted successfully, is that more desirable than using human organs: particularly if human donation involves interventional ventilation or non-heart beating donors? Is interventional ventilation more "ethical" than live donor liver or lung transplantation? No doubt future developments in transplantation, opening more opportunities for the successful treatment of more patients, are likely to produce increasingly difficult ethical issues. Discussions of these issues must be firmly based on principles of medical ethics, although accepting that whilst absolute principles may be available, absolute answers are more difficult to come by.