Decisionmaking competence and risk

Mark Wicclair criticizes Allen Buchanan's and my claim that determining an appropriate level of competence (Wicclair substitutes "decisional capacity" for "competence", the import of which I note briefly below) for health care treatment decisionmaking involves balancing respecting a patient's self-determination and protecting his or her well-being. The most important implication of this balancing is that a standard of competence should vary in significant part with the effects for the patient's well-being of accepting his or her choice. Wicclair's criticisms take two main forms. First, he considers and rejects four of the positive reasons we offer in support of a risk-related standard. Second, in rejecting our fourth reason he argues that a risk-related standard leads to faulty competence determinations -- too high a standard in some cases and too low a standard in others. If he is correct, there are no positive reasons for adopting a risk-related standard and there are as well specific reasons not to adopt such a standard in order to avoid mistaken competence determinations. My response will address both sorts of criticisms in turn.     

Structural and transcriptional analysis of a human subtelomeric repeat

A human subtelomeric repeat (designated as the HST repeat) has been isolated and characterized from a yeast artificial chromosome containing one human telomere. This repeat is located immediately adjacent to the telomeric T2AG3 repeats at the extreme termini of the human chromosomes. The DNA sequence of 3.6 kb of the HST repeat has been determined. The HST repeat spans over 3.6 kb in length, and contains one evolutionarily conserved CpG-rich region. The copy number of the HST repeat varies among telomeres. Genomic hybridization experiments suggest that the HST repeat consists of two distinct segments, and the distal portions of the HST repeat are also distributed elsewhere in the genome. In HeLa cells, the HST repeat sequence appears to be transcribed into a 6 kb polyadenylated RNA and a variety of non-polyadenylated RNA species.     

心房钠尿肽（ANP）对大鼠卵巢细胞生成雌激...

Isolated ovarian corpus luteal cells and granulosa cells of rat were employed to investigate the effect of alpha-ANP on the secretion of progesterone and estradiol. The contents of the steroid hormones are determined by RIA. The results showed that 0.1-10 ng/ml ANP promoted progesterone production in a dose dependent manner. alpha-ANP also enhanced progesterone production by granulosa cells, but not estradiol. It seems that the effect of alpha-ANP on ovarian steroidogenesis is a direct one.     

Thyroid hormone down-regulates p55, a thyroid hormone-binding protein that is homologous to protein disulfide isomerase and the beta-subunit of prolyl-4-hydroxylase

We have previously characterized a cellular thyroid hormone-binding protein (p55) that is found concentrated on the lumenal face of the endoplasmic reticulum and nuclear envelope (Cheng, S.-y., Hasumura, S., Willingham, M.C., and Pastan, I. (1986) Proc. Natl. Acad. Sci. U.S.A. 83, 947-951). To understand the role p55 plays in thyroid hormone action, we examined the regulation of p55 by 3,3',5-triiodo-L-thyronine (T3). Rat pituitary tumor GH3 cells cultured in regular medium, thyroid hormone-depleted medium (Td medium), or Td medium supplemented with 50 nM T3 (Td + T3 medium) were metabolically labeled with [35S]methionine and immunoprecipitated with antibodies against p55. Treatment with T3 caused a fall in p55 levels. Poly(A+) RNA from cells cultured in regular, Td, or Td + T3 medium was hybridized to a cDNA from p55. T3 withdrawal or addition had no effect on p55 mRNA levels. Furthermore, the initial rates of synthesis of p55 from cells cultured in regular, Td, and Td + T3 were found to be similar. However, analysis of the decay curves from cells in which p55 was pulse-labeled with [35S]methionine indicated that p55 is 2-fold less stable in T3 containing medium. These results indicated that down-regulation of p55 by T3 occurs at the post-translational level. Since DNA sequence analysis indicates that p55 is identical to protein disulfide isomerase and the beta-subunit of prolyl-4-hydroxylase, T3 may mediate its effects on the synthesis, secretion, and/or transport of proteins via p55.     

Characterization and chemical properties of phosphoribosylamine, an unstable intermediate in the de novo purine biosynthetic pathway

Incubation of [1-13C]-5-phosphoribosyl pyrophosphate ([1-13C]PRPP) and glutamine with PRPP amidotransferase results in rapid production and disappearance of two new resonances at 89.3 and 85.9 ppm. These resonances coincide with two of the products produced upon incubation of [1-13C]ribose 5-phosphate with NH3. Extensive NMR studies (15N and 1H-13C chemical shift correlation spectra) have allowed assignment of these resonances to beta- and alpha-phosphoribosylamine. These studies represent the first spectral observations of this chemically reactive intermediate. The rate of interconversion of alpha- to beta-phosphoribosylamine as a function of pH has been determined by saturation and inversion-transfer NMR methods. The rate of formation of 5-phosphoribosylamine (PRA) from ribose 5-phosphate and NH3 and its rate of decomposition as a function of pH have been determined with a glycinamide ribonucleotide synthetase trapping system fashioned after earlier studies of Nierlich and Magasanik [Nierlich, D. P., & Magasanik, B. (1965) J. Biol. Chem. 240, 366]. Phosphoribosylamine has a t1/2 = 38 s at 37 degrees C and pH 7.5. The pH-independent equilibrium constant for ribose 5-phosphate and NH3 with phosphoribosylamine has been established, 2.5 M-1, by use of these rate constants as well as by NMR methods. This equilibrium constant and the rates of nonenzymatic interconversion of alpha- and beta-PRA provide essential background for studying the mechanism of glycinamide ribonucleotide synthetase and investigating the possibility of channeling phosphoribosylamine between this enzyme and the first enzyme in the purine pathway.     

Variation in crypt size and its influence on the analysis of epithelial cell proliferation in the intestinal crypt.

The standard model of epithelial cell renewal in the intestine proposes a gradual transition between the region of the crypt containing actively proliferating cells and that containing solely terminally differentiating cells (Cairnie, Lamerton and Steel, 1965 a, b). The experimental justification for this conclusion was the gradual decrease towards the crypt top of the measured labeling and mitotic indices. Recently, however, we have proposed that intestinal crypts normally undergo a replicative cycle so that at any time in any region of the intestine, crypts will be found to have a wide range of sizes. We show here that if this intrinsic size variation is taken into account, then a sharp transition between the proliferative and nonproliferative compartments of individual intestinal crypts is consistent with the labeling and mitotic index distributions of mouse and rat jejunal crypts. Thus there is no need to invoke the region of gradual transition from proliferating to nonproliferating cells as is done in the standard model. The position of this sharp transition is estimated for both the mouse and rat. Experiments to further test our model are suggested and the significance of the results discussed.     

The stereochemical course of phosphoryl transfer catalyzed by herpes simplex virus type I-induced thymidine kinase

Herpes simplex virus type I (HSV-I)-induced thymidine kinase has been shown to catalyze phosphoryl transfer from adenosine 5'-[gamma-(S)-16O,17O,18O]triphosphate to thymidine with inversion of configuration at phosphorus. The simplest interpretation of this result is that phosphoryl transfer occurs by a single in-line group transfer between ATP and thymidine within the ternary enzyme complex.     

普通烟草和黄花烟草及体细胞杂种过氧化物酶同工酶等电聚焦电泳

日本学者长尾照义(1978)用原生质体融合获得普通烟草与黄花烟草的体细胞杂种植株。1980年陈家玉等在国内首先获得普通烟草(Copus Yeusuku No.4)和黄花烟草(Yellow Flower)的体细胞杂种植株。之后,中国农科院烟草所(1981)也得到相同的结果。陈家玉等(1983)对上述杂种进行了形态学、细胞学和同工酶的分析并取得一定的结果。Dlineee等(1975)分析比较了用等电聚焦技术分离的过氧     

用三维图象量测卵裂前蛙卵膜分子的三维运动

两栖类卵第一次卵裂前,缩时电影显示出卵表面有收缩波。由于卵的体积未变,在收缩时卵的高度必然增加。Sawai(1978)利用棱镜侧面摄取了蝾螈卵轮廓的高度变化,证实了卵裂前卵最高处的高度确有增加。但这一方法不能测知整个卵表面各处的高度变化,而且仅是二维的。在林蛙卵上,我们用荧光漂白恢复技术发现第一次卵裂前卵表面分子有规律性的流动,推测这是卵球的张弛。为了进一步