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Results for “The Right to Reproduce”
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Human cloning and the right to reproduce.
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Reproducibility of right and left ventricular volume measurements by electron-beam CT in patients with congestive heart failure.
UNLABELLED: The applicability and reproducibility of electron-beam computed tomography (EBCT) was tested to define left and right ventricular volumes in patients with congestive heart failure in a clinical setting. METHODS: Ten patients (mean age 64 +/- 11 years) with dilated hearts and stable congestive heart failure (functional class III-IV) were studied. After determination of the individual circulation time, two serial short axis polytomographic EBCT studies were performed within a mean interval of 14.8 +/- 10 days. Following intravenous contrast administration, biventricular end-diastolic volumes (LVEDV, RVEDV), end-systolic volumes (LVESV, RVESV), and left ventricular muscle mass (LVMM) were determined using previously developed techniques. RESULTS: Adequate contrast opacification in both ventricular cavities was obtained in all patients at baseline and at follow-up. Values were 323.4 +/- 99.3 (mean +/- SD) and 332.6 +/- 105.4 ml for LVEDV, 249.3 +/- 75.6 and 250.5 +/- 79.3 ml for LVESV, 236.8 +/- 56.2 and 251.2 +/- 72.7 ml for RVEDV, 179.8 +/- 76.4 and 188.3 +/- 64.0 ml for RVESV, and 207.7 +/- 70.6 and 204.9 +/- 81.9 g for LVMM (p = NS, respectively, paired t-test). Linear regression analysis correlating biventricular volumes and left ventricular muscle mass measurements in the serial scans yielded r-values in the range of 0.89 to 0.95 and a small SEE. The SE of the mean differences between left and right ventricular ejection fraction measurements was 1 point, respectively. CONCLUSION: EBCT studies of ventricular volumes in patients with dilated hearts and congestive heart failure are highly reproducible and offer the potential for serial assessment of these patients in whom quantitation of ventricular volumes has been shown to be of prognostic value.
Letter: A woman's right to reproduce.
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Redefining the right to reproduce: asserting infertility as a disability under the Americans with Disabilities Act.
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In vitro fertilization and the right to reproduce.
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Laboratory and hospital testing of new infrared tympanic thermometers.
A patented approach to infrared thermometry based on the use of a standard pyrosensor has resulted in the development of two new infrared tympanic thermometers, one for professional use, the other for home use. Both were tested to evaluate accuracy in the laboratory and to evaluate equivalence to standards, correlation to standards, and precision in human subjects. Accuracy was found to be well within ASTM standards on both models. Mean ear temperatures were 0.2 degrees C below oral and 0.7 degrees C below bladder temperature. Correlations between ear and oral and ear and bladder temperatures were r = .77 to .84. Repeatability in the same ear was very high at r = .95 (left) and .97 (right). Reproducibility between left and right ear ranged from r = .89 to .92.
Should we have an unrestricted right to reproduce?
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Visual field plasticity in a female with right occipital cortical dysplasia.
Brain plasticity refers to its ability to recover after damage. Visual field plasticity is not well recognized. We report a 12-year-old female who first presented with recurrent seizures and was subsequently found to have a large, right occipital cortical dysplasia on magnetic resonance imaging. Her visual field by Goldmann perimetry was totally normal. Visual-evoked potential studies revealed the left hemifield P100 response was detected maximally at the right temporal and parietal regions. A weak but reproducible right hemifield P100 response was located at the right medial skull base. Functional magnetic resonance imaging with flashlight stimulation revealed cerebral activity mainly at the right posterior temporal and parietal lobes and left occipital lobe. These studies suggested that the left hemifield function was located at the right posterior temporal and parietal lobes. The left occipital lobe may also have been reorganized, with a P100 vector pointing out from its inferiomedial base. We reviewed other related reported cases. We believe that visual-evoked potential studies and visual functional magnetic resonance imaging should be performed more liberally for recognition of visual field plasticity.
[Polymer microparticles for right and left heart echocardiography and imaging myocardial perfusion after peripheral vein injection].
It is conceivable that a stable ultrasound contrast agent could be used for reproducible right and left heart echocardiography and myocardial visualization after intravenous injection. Microparticles from different polymers and preparation procedures were screened in six dogs leading to one superior agent with reproducible high quality echo contrast in doses of 1 mg/kg. This special agent is based on condensates of aspartic acid, ethanolamine and decanoic acid. Out of this material particles were formed with an average diameter of 2 micrometers. The easily suspendable particles were used for the following studies in a dose of 1 mg/kg intravenously in eight pigs. Maximal video intensity averaged 116 +/- 42 relative intensity units (IU) in the right, 137 +/- 42 IU in the left ventricle, 42 +/- 7 in the normally perfused and 11 +/- 2 in the hypoperfused myocardium after circumflex ligature. The area under the intensity curve was 1942 +/- 100 IUxs in the right, 2452 +/- 1291 IUxs in the left ventricle, 518 +/- 124 in the normally perfused and 202 +/- 94 in the hypoperfused myocardium after circumflex ligature. There was no change of heart rate, central arterial or pulmonary artery pressure during and after the injections. There was also no loss of echo intensity during the passage of contrast material through the heart due to systolic pressure. The described agent can be used for the opacification and ultrasonic visualization of the right and left heart as well as normally and hypoperfused myocardium without visible side-effects in animal studies.
Back school programs. The young patient.
CC's treatment goals were all met with the exception of eliminating the AMNT sign. Slump-sit right knee extension (-15 degrees), right SLR (80 degrees coupled with dorsiflexion), and lumbar flexion (85% coupled with neck flexion) all continued to reproduce right buttock cramping and pain. Currently he is playing basketball without restriction, performing an individualized exercise program that emphasizes lower extremity muscle stretching, AMNT stretching, and advanced truncal stabilization exercises. He has a very good understanding of body mechanics and an awareness of safe SFP during activities of daily living and on the basketball court. His motivation, along with the motivation of parents, coaches, athletic trainer, and physical therapist, greatly assisted CC in returning to competitive basketball. CC is intermittently evaluated to monitor the AMNT sign and the effectiveness of the home exercise program. Currently CC's AMNT appears to regress if he is not monitored on a monthly basis; thus he warrants intermittent treatment. Monitoring of the patient is an integral aspect of long-term management of chronic discogenic disease that is often neglected. It can be hypothesized that monitoring may prevent serious complications in the future for many patients. CC is a patient who needed specific therapeutic intervention beyond rest, general instructions about body mechanics and exercise, modalities, and traditional back school. The history of this patient's problem revealed that rest and general exercises had failed, thus necessitating specific therapeutic treatment. This patient is an excellent example of how physical therapy in the form of manual therapy, specific therapeutic exercise, education through repetition of functional tasks, and the team approach to patient care can lead to a successful treatment outcome.
Three-dimensional echocardiography. In vivo validation for right ventricular volume and function.
BACKGROUND: Current two-dimensional echocardiographic measures of right ventricular volume are limited by the asymmetrical and crescentic shape of the ventricle and by difficulty in obtaining standardized views. Three-dimensional echocardiographic reconstruction, which does not require geometric assumptions or standardized views, may therefore have potential advantages for determining right ventricular volume. Three-dimensional techniques, however, have not been applied to the right ventricle in vivo, where cardiac motion and contraction could affect accuracy. The purpose of this study was to determine the feasibility and accuracy of three-dimensional echocardiographic reconstruction for quantifying right ventricular volume and function in vivo. In particular, it was designed to test the accuracy of a newly developed system that provides rapid, efficient, and automated three-dimensional data collection (minimizing motion effects) and takes advantage of the full three-dimensional data set to obtain volume. METHODS AND RESULTS: The three-dimensional system was applied to reconstruct the right ventricle and measure its volume and function during 20 hemodynamic stages created in five dogs. Actual instantaneous volumes were measured continuously by an intracavitary balloon connected to an external column. Hemodynamics were varied by volume loading and induction of ischemia. Three-dimensional reconstruction successfully reproduced right ventricular volume compared with actual values at end diastole (y = 1.0 chi-3.4, r = .99, SEE = 1.8 mL) and end systole (y = 1.0 chi+ 2.0, 4 = .98, SEE = 2.5 mL). The mean difference between calculated and actual volumes throughout the cycle was 2.1 mL, or 4.9% of the mean. Ejection fraction also correlated well with actual values (y = 0.96 chi-0.3, r = .98, SEE = 3.3%). CONCLUSIONS: Despite the irregular crescentic shape of the right ventricle, this newly developed three-dimensional system and surfacing algorithm can accurately reconstruct its shape and quantitate its volume and function in vivo without geometric assumptions. The increased efficiency of the system should increase applicability to issues of clinical and research interest.
Three-dimensional echocardiography: in vivo validation for right ventricular free wall mass as an index of hypertrophy.
OBJECTIVES: This study tested the ability of three-dimensional echocardiography to reconstruct the right ventricular free wall and determine its mass in vivo using a system that automatically combines two-dimensional images with their spatial locations. BACKGROUND: Right ventricular free wall thickness is limited as an index of right ventricular hypertrophy because right ventricular mass may increase by dilation without increased thickness and because trabeculations and oblique views can exaggerate thickness in individual M-mode and two-dimensional scans. Three-dimensional echocardiography may have potential advantages because it can integrate the entire free wall mass, uninfluenced by oblique views or geometric assumptions. METHODS: The three-dimensional system was applied to 12 beating canine hearts to reconstruct the right ventricular free wall in intersecting views. The corresponding mass was compared with actual weights of the excised right ventricular free wall (15.5 to 78 g). For comparison, right ventricular sinus and outflow tract thickness were also measured by two-dimensional echocardiography, and the ability to predict mass from these values was determined. RESULTS: The three-dimensional algorithm successfully reproduced right ventricular free wall mass, which agreed well with actual values: y = 1.04x + 0.02, r = 0.985, SEE = 2.7 g (5.7% of the mean value). The two-dimensional predictions showed increased scatter: The variance of mass estimation, based on thickness, was 9.5 to 12.5 (average 11) times higher than the three-dimensional method (p < 0.02). CONCLUSIONS: Despite the irregular crescentic shape of the right ventricle, its free wall mass can be accurately measured by three-dimensional echocardiography in vivo, providing closer agreement with actual mass than predictions based on wall thickness. This method, with the increased efficiency of the three-dimensional system, can potentially improve our ability to evaluate the presence and progression of right ventricular hypertrophy.
Volumetric MRI measurements of the tree shrew hippocampus.
Protocols suitable for repeated magnetic resonance imaging (MRI) studies of the tree shrew's brain were established. This included the development of (i) a technique for prolonged inhalation anesthesia by endotracheal intubation; (ii) a reproducible fixation of the animal's head in a stereotaxic frame and finally (iii) the set-up of the hardware (rf coil) and software (MRI sequences) of the MRI system. The endotracheal intubation as well as the repeated and prolonged anesthesia showed no complications. The in vivo measurements of the tree shrew's hippocampal formation revealed a high reproducibility. Right and left hippocampal volume was determined as 85.2 mm3 +/- 8% and 87.4 mm3 +/- 10%, respectively. The utility of MRI in delineating alterations in brain anatomy was demonstrated in three animals receiving cortisol via the drinking water (5 mg/animal/day). After a 4-week treatment, in two of the three tree shrews a reduction in hippocampal volume was observed. Thus, the MRI protocols used here allow for repeated and non-invasive measurements of changes in hippocampal anatomy within the same animal and to monitor the temporal dynamics of structural alterations within this brain structure.
A philosopher looks at assisted reproduction.
The article first examines the various objections to IVF: religious, health and safety and feminist. It is argued that none of these objections provides good reasons for banning IVF, though certain controls and procedures to protect individuals from harm and exploitation may be appropriate. Next, the article critiques John Robertson's strong conception of procreative liberty, which entails a right to be a surrogate mother or serve as a sperm donor. Roberton's interpretation misconceives the nature and value of the right to reproduce. The righ to reproduce is best interpreted as a right to have one's own children to rear. Where there is no intent or ability to rear, there is no fundamental moral right to reproduce. However, since assisted reproduction is used to enable individuals to have their own children to rear, it should be available to infertile individuals who cannot otherwise reproduce.