Direct Abortion or Legitimate Medical Procedure Double Effect?

The distinction between direct abortion and legitimate medical procedures deemed necessary to save the life of the mother but resulting in the death of the unborn child challenge all clinicians and persons of faith. A careful analysis of the principle of double effect and a recent statement by the Committee on Doctrine of the United States Conference of Catholic Bishops offer some clarity to this difficult conflict. Two case examples offer illustration for the analysis.

Pathophysiologically relevant levels of hydrogen peroxide induce glutamate-independent neurodegeneration that involves activation of transient receptor potential melastatin 7 channels.

Stroke/brain ischemia is a leading cause of death and long-term disabilities. Increased oxidative stress plays an important role in the pathology of brain ischemia. Hydrogen peroxide (H(2)O(2)) is a major oxidant known to cause neuronal injury; however, the detailed mechanism remains unclear.

Transient receptor potential melastatin 7-like current in human head and neck carcinoma cells: role in cell proliferation.

Ion channels are involved in normal physiologic processes and in the pathology of various diseases. In this study, we investigated the presence and potential function of transient receptor potential melastatin 7 (TRPM7) channels in the growth and proliferation of FaDu and SCC25 cells, two common human head and neck squamous carcinoma cell lines, using a combination of patch-clamp recording, Western blotting, immunocytochemistry, small interfering RNA (siRNA), fluorescent Ca(2+) imaging, and cell counting techniques. Although voltage-gated K(+) currents were recorded in all cells, none of FaDu cells express voltage-gated Na(+) or Ca(2+) currents.

Extracellular zinc protects against acidosis-induced injury of cells expressing Ca2+-permeable acid-sensing ion channels.

Acidosis is a common feature of neurological conditions including brain ischemia, epileptic seizures, and neurotrauma. Activation of Ca(2+)-permeable acid-sensing ion channels (ASIC1a) is involved in acidosis-mediated ischemic brain injury. Zn(2+) is a divalent cation concentrated in nerve terminals in various brain regions, and is released into the extracellular space during excitatory stimulation.

Modulation of acid-sensing ion channel currents, acid-induced increase of intracellular Ca2+, and acidosis-mediated neuronal injury by intracellular pH.

Acid-sensing ion channels (ASICs), activated by lowering extracellular pH (pH(o)), play an important role in normal synaptic transmission in brain and in the pathology of brain ischemia. Like pH(o), intracellular pH (pH(i)) changes dramatically in both physiological and pathological conditions. Although it is known that a drop in pH(o) activates the ASICs, it is not clear whether alterations of pH(i) have an effect on these channels.

Selection on Glycine beta-1,3-endoglucanase genes differentially inhibited by a Phytophthora glucanase inhibitor protein.

Plant endo-beta-1,3-glucanases (EGases) degrade the cell wall polysaccharides of attacking pathogens and release elicitors of additional plant defenses. Isozymes EGaseA and EGaseB of soybean differ in susceptibility to a glucanase inhibitor protein (GIP1) produced by Phytophthora sojae, a major soybean pathogen. EGaseA, the major elicitor-releasing isozyme, is a high-affinity ligand for GIP1, which completely inhibits it, whereas EGaseB is unaffected by GIP1.

Diagnostic mid trimester amniocentesis: how safe?

Objective: Genetic mid-trimester amniocentesis is a common invasive procedure. The origin of the commonly quoted 0.5% rate of procedure-related pregnancy loss after amniocentesis is obscure and is in conflict with the only randomized prospective study that reported a procedure-related rate of loss of 1.

ACOG technology assessment in obstetrics and gynecology. Number 3, September 2003. Saline infusion sonohysterography.

Saline infusion sonohysterography consists of ultrasonographic imaging of the uterus and uterocervical cavity, using real-time ultrasonography during injection of sterile saline into the uterus. When properly performed, saline infusion sonohysterography can provide information about the uterus and endometrium. The most common indication for sonohysterography is abnormal uterine bleeding.

Analysis of the retrovirus capsid interdomain linker region.

In structural studies, the retrovirus capsid interdomain linker region has been shown as a flexible connector between the CA N-terminal domain and its C-terminal domain. To analyze the function of the linker region, we have examined the effects of three Moloney murine leukemia virus (M-MuLV) capsid linker mutations/variations in vivo, in the context of the full-length M-MuLV structural precursor protein (PrGag). Two mutations, A1SP and A5SP, respectively, inserted three and seven additional codons within the linker region to test the effects of increased linker lengths.

Sonographic evaluation of a uterine angiolipoleiomyoma.

We report the case of a 51-year-old postmenopausal woman with an angiolipoleiomyoma, a rare mesenchymal uterine tumor, and describe its sonographic appearance. The clinical presentation of these invariably benign tumors often mimics that of uterine leiomyomas, making angiolipoleiomyomas difficult to diagnose correctly before histopathologic evaluation. In this case, sonography performed to determine the cause of the patient's vaginal bleeding showed a sharply marginated, brightly echogenic solid mass adjacent to the echogenic endometrium, without associated shadowing.

Hantavirus nucleocapsid protein oligomerization.

Hantaviruses are enveloped, negative-strand RNA viruses which can be lethal to humans, causing either a hemorrhagic fever with renal syndrome or a hantaviral pulmonary syndrome. The viral genomes consist of three RNA segments: the L segment encodes the viral polymerase, the M segment encodes the viral surface glycoproteins G1 and G2, and the S segment encodes the nucleocapsid (N) protein. The N protein is a 420- to 430-residue, 50-kDa protein which appears to direct hantavirus assembly, although mechanisms of N protein oligomerization, RNA encapsidation, budding, and release are poorly understood.

Does augmented growth impose an increased risk of fetal death?

Objective: Our purpose was to examine the risk of fetal death associated with augmented fetal growth.

Study Design: All live births recorded in Virginia between January 1, 1991, and December 31, 1993, were examined. Mortality rates were examined for infants born at or beyond 24 weeks' gestational age with weights between the 75th and 90th percentiles, from the 90th to the 95th percentile, and >95th percentile.

Borderline genitourinary tract abnormalities.

The ability to detect major malformations of the fetal urinary tract using diagnostic antenatal ultrasound is well-known. Serious obstructive or dysgenetic abnormalities are often clearly seen and their implications well-known. Less clear is the meaning of mild or minimal pyelectasis, unilateral renal agenesis, nonvisualization of the fetal bladder, and pelvic kidneys.

Impaired growth and risk of fetal death: is the tenth percentile the appropriate standard?

Objective: Our purpose was to determine whether the 10th percentile of birth weight for gestational age is appropriate to identify fetuses at risk of death associated with impaired growth.

Study Design: All live births recorded in Virginia from Jan. 1, 1991, through Dec.

The routine or screening obstetrical ultrasound examination.

The debate concerning the value of routine screening ultrasound in the low-risk patient continues. The most likely benefits are obstetrical, with confirmation of dates, detection of multiple gestation, baseline growth data, and location of the placenta being primary advantages gained from such an examination. The detection of the unexpected major fetal malformation has always been the least likely benefit of routine ultrasound.

Hyperreactio luteinalis associated with pregnancy: a case report and review of the literature.

Hyperreactio luteinalis is a condition associated with bilateral and, in rare cases, unilateral ovarian enlargement due to theca lutein cysts. Hyperreactio luteinalis is a benign condition, usually found incidentally at cesarean section, which can appear anaplastic and lead to unnecessary ovarian resection. A 21-year-old Hispanic woman, G2P1, presented at 19 weeks with a singleton pregnancy, bilaterally enlarged ovaries, and a normal beta hCG.

The relation between pulmonary hypoplasia and amniotic fluid volume: lessons learned from discordant urinary tract anomalies in monoamniotic twins.

Background: Adequate amniotic fluid (AF) volume is one of several factors felt to be essential for normal lung development. Renal agenesis and urinary tract obstruction usually result in oligohydramnios and pulmonary hypoplasia.

Case: Two sets of monoamiotic twins with discordant urinary tract anomalies were seen.

Acute maternal and fetal cardiovascular effects of caffeine ingestion.

Little data exist regarding the acute maternal and fetal cardiovascular effects of caffeine ingestion. The purpose of this study is assess the cardiovascular effects of caffeine ingestion in pregnant subjects and their fetuses. We examined seven caffeine-naive gravidas longitudinally at 25.

Ligation of the umbilical cord of an acardiac-acephalus twin with an endoscopic intrauterine technique.

Background: Fetal acardia is a rare entity that complicates twin gestation. Reported survival of the normal or "pump" twin is below 50%. Perinatal mortality and morbidity typically result from heart failure in the pump twin caused by the circulatory demands of perfusion of the abnormal twin.

Oligohydramnios: problems and treatment.

Oligohydramnios is a severe and common complication of pregnancy. The finding of oligohydramnios can be associated with fetal anomalies, PROM, uteroplacental insufficiency (eg, growth retardation, postdatism, abruptio placenta, significant maternal illness), abnormalities of twinning, and idiopathic oligohydramnios. Ultrasound detection of this complication should prompt the clinician to thoroughly evaluate the gravida for hypertension, diabetes, or other significant illness.