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PubMed1992

Decisions near the end of life: resource allocation implications for hospitals.

CONCLUSION: At a time when hospitals are having predictable difficulty accommodating infinite expectations with finite resources, there are still some observers who abhor even the possibility that the cost and volume of hospital services to the terminally ill be scrutinized. However, more assertive attention is justified on the basis of qualitative as well as quantitative evidence. Neither unrestricted medical paternalism nor total patient autonomy should be unequivocally endorsed. Both the physician and the patient have a mutual obligation and incentive to achieve a proper balance. This balance is dynamic rather than static because attitudes and values change, and advance directives are not immutable documents. Hospitals have a moral imperative to create an organizational environment in which a genuine collaborative decision-making process will ultimately benefit all participants.

Administrative Personnel↗
PubMed1965

CLINICAL CHEMISTRY.

Explore the source record for details and available documents.

Biochemical Phenomena↗
PubMed2006

In vitro investigation on poly(lactide)-Tween 80 copolymer nanoparticles fabricated by dialysis method for chemotherapy.

Polysorbate 80 (Tween 80) has been widely used as an emulsifier with excellent effects in nanoparticles technology for biomedical applications. This work was thus triggered to synthesize poly(lactide)/Tween 80 copolymers with various copolymer blend ratio, which were synthesized by ring-opening polymerization and characterized by 1H NMR and TGA. Nanoparticles of poly(lactide)/Tween 80 copolymers were prepared by the dialysis method without surfactants/emulsifiers involved. Paclitaxel was chosen as a prototype anticancer drug due to its excellent therapeutic effects against a wide spectrum of cancers. The drug-loaded nanoparticles of poly(lactide)/Tween 80 copolymers were then characterized by various state-of-the-art techniques, including laser light scattering for particles size and size distribution, field emission scanning electron microscopy (FESEM) and atomic force microscopy (AFM) for surface morphology; laser Doppler anemometry for zeta potential; differential scanning calorimetry (DSC) for the physical status of the drug encapsulated in the polymeric matrix; X-ray photoelectron spectrometer (XPS) for surface chemistry; high performance liquid chromatography (HPLC) for drug encapsulation efficiency; and in vitro drug release kinetics. HT-29 cells and Glioma C6 cells were used as an in vitro model of the GI barrier for oral chemotherapy and a brain cancer model to evaluate in vitro cytotoxicity of the paclitaxel-loaded nanoparticles. The viability of C6 cells was decreased from 37.4 +/- 4.0% for poly(D,L-lactide-co-glycolic acid) (PLGA) nanoparticles to 17.8 +/- 4.2% for PLA-Tween 80-10 and 12.0 +/- 5.4% for PLA-Tween 80-20 copolymer nanoparticles, which was comparable with that for Taxol at the same 50 microg/mL drug concentration.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

Applications of the ninhydrin reaction for analysis of amino acids, peptides, and proteins to agricultural and biomedical sciences.

The reaction of ninhydrin with primary amino groups to form the purple dye now called Ruhemann's purple (RP) was discovered by Siegfried Ruhemann in 1910. In addition, imines such as pipecolic acid and proline, the guanidino group of arginine, the amide groups of asparagine, the indole ring of tryptophan, the sulfhydryl group of cysteine, amino groups of cytosine and guanine, and cyanide ions also react with ninhydrin to form various chromophores of analytical interest. Since its discovery, extensive efforts have been made to apply manual and automated ninhydrin reactions as well as ninhydrin spray reagents to the detection, isolation, and analysis of numerous compounds of interest across a broad spectrum of disciplines. These include agricultural, biochemical, clinical, environmental, food, forensic, histochemical, microbiological, medical, nutritional, plant, and protein sciences. This reaction is unique among chromogenic reactions in that at pH 5.5 it results in the formation of the same soluble chromophore by all primary amines which react, be they amines, amino acids, peptides, proteins, and even ammonia. Because the chromophore is not chemically bound to the protein or other insoluble material, it is not lost when the insoluble substrate is removed by centrifugation or filtration after the reaction is completed. The visible color of the chromophore is distinctive and is generally not affected by the yellow colors present in many food, plant, and tissue extracts. Adaptations of the classical ninhydrin reaction to specialized needs in analytical chemistry and biochemistry include the use of acid, alkaline, and fluorogenic ninhydrin reagents. To cross-fertilize information among several disciplines wherein an interest in the ninhydrin reaction has developed, and to enhance its utility, this review attempts to integrate and correlate the widely scattered literature on ninhydrin reactions of a variety of structurally different compounds. Specifically covered are the following aspects: historical perspective, chemistry and mechanisms, applications, and research needs. A better understanding of these multifaceted ninhydrin reactions provide a scientific basis for further improvements of this important analytical technique.

Agriculture↗
PubMed1998

Interpreting the notion that technology is value-neutral.

Value-freedom or value-neutrality is a well-known topic in the philosophy of science. But what about the value-neutrality of technology, medical or other? Is it too far-fetched to imagine technology as in some sense value-neutral--in view of its intimate connection with purposeful human action? No; unexpected perhaps, but less far-fetched than expected. If we try to conceive of technology as a cognitive possibility abstracted from each and every specific social context, we shall find (at least) three senses in which it may be regarded as value-neutral: (1) neutral vis-à-vis different possible uses and ends; (2) neutral before action; (3) neutral qua cognitive object, analogous to the cognitive core of science. The further meanings and implications of these three senses of value-neutrality are discussed. What is this exercise good for? The nature of technology is indeed worth pondering in its own right, not least from this rather unusual angle. But beyond that: as the possible meanings of value-neutrality are tried out, the radical nature of human responsibility for the social implementation of technology will be highlighted.

Diffusion of Innovation↗
PubMed2003

Ivan Illich and the Nemesis of Medicine. The man and his message in memoriam.

Ivan Illich, philosopher, historian, priest and social commentator died in Bremen, Germany on December 2, 2002. Illich was noted for his critique of the Church, education and medicine but his concepts dealt with more fundamental issues. This article reveals aspects of Illich, the man, and explores his ideas as they apply to the meaning of medicine and, in particular, the role of health care in contemporary society.

Attitude to Death↗
PubMed2004

Optical coherence tomography: feasibility for basic research and image-guided surgery of breast cancer.

Diagnostic trends in medicine are being directed toward cellular and molecular processes, where treatment regimens are more amenable for cure. Optical imaging is capable of performing cellular and molecular imaging using the short wavelengths and spectroscopic properties of light. Diffuse optical tomography is an optical imaging technique that has been pursued as an alternative to X-ray mammography. While this technique permits non-invasive optical imaging of the whole breast, to date it is incapable of resolving features at the cellular level. Optical coherence tomography (OCT) is an emerging high-resolution biomedical imaging technology that for larger and undifferentiated cells can perform cellular-level imaging at the expense of imaging depth. OCT performs optical ranging in tissue and is analogous to ultrasound except reflections of near-infrared light are detected rather than sound. In this paper, an overview of the OCT technology is provided, followed by images demonstrating the feasibility of using OCT to image cellular features indicative of breast cancer. OCT images of a well-established carcinogen-induced rat mammary tumor model were acquired. Images from this common experimental model show strong correlation with corresponding histopathology. These results illustrate the potential of OCT for a wide range of basic research studies and for intra-operative image-guidance to identify foci of tumor cells within surgical margins during the surgical treatment of breast cancer.

Animals↗
PubMed1995

Stochastic resonance and the benefits of noise: from ice ages to crayfish and SQUIDs.

Noise in dynamical systems is usually considered a nuisance. But in certain nonlinear systems, including electronic circuits and biological sensory apparatus, the presence of noise can in fact enhance the detection of weak signals. This phenomenon, called stochastic resonance, may find useful application in physical, technological and biomedical contexts.

Animals↗
PubMed2006

Boundary lubrication under water.

Boundary lubrication, in which the rubbing surfaces are coated with molecular monolayers, has been studied extensively for over half a century. Such monolayers generally consist of amphiphilic surfactants anchored by their polar headgroups; sliding occurs at the interface between the layers, greatly reducing friction and especially wear of the underlying substrates. This process, widespread in engineering applications, is also predicted to occur in biological lubrication via phospholipid films, though few systematic studies on friction between surfactant layers in aqueous environments have been carried out. Here we show that the frictional stress between two sliding surfaces bearing surfactant monolayers may decrease, when immersed in water, to as little as one per cent or less of its value in air (or oil). We attribute this to the shift of the slip plane from between the surfactant layers, to the surfactant/substrate interface. The low friction would then be due to the fluid hydration layers surrounding the polar head groups attached to the substrate. These results may have implications for future technological and biomedical applications.

Adhesiveness↗