Preimplantation genetic diagnosis and reproductive autonomy.

This paper examines how reproductive autonomy of women and couples is affected by the availability of preimplantation genetic diagnosis (PGD). Libertarians have argued that PGD enhances reproductive autonomy by increasing options available to prospective parents. We acknowledge that PGD presents prospective parents with more options, but note that the libertarian view of reproductive autonomy overlooks important aspects of the social practice of PGD by focusing too narrowly on the absence of explicit constraints as the main guarantee of reproductive autonomy. We endorse instead a feminist relational account of autonomy in which exercising autonomy involves paying attention to the relevant contextual features that configure and shape prospective parents' choices and understanding of their reproductive options. On this view, PGD has a negative potential to constrain reproductive autonomy. We recommend that this negative potential be addressed by making sure the availability of PGD is accompanied by increased attention to the relevant educational needs of prospective parents and the general public, as well as the availability of adequate social supports for people with disabilities, their care providers and families.

Fine needle aspiration cytology of invasive micropapillary carcinoma of the breast. A case report.

BACKGROUND: Invasive micropapillary carcinoma of the breast is uncommon and was characterized only recently. Awareness of this entity and its cytologic appearance is important to allow early diagnosis by fine needle aspiration cytology (FNAC). To our knowledge, only two cases of FNAC of this lesion have been reported in the English-language literature. CASE: An 80-year-old female presented with a firm, nontender mass in the upper outer quadrant of the left breast. FNAC showed ductal carcinoma, and mastectomy showed invasive micropapillary carcinoma. The patient had axillary metastases and received tamoxifen. CONCLUSION: The cytologic features of invasive micropapillary carcinoma are distinctive, with clusters of cells showing hyperchromatic, irregular and crowded nuclei and peripherally located cytoplasm with a rare central lumen. Fibrovascular cores are absent. Although FNAC experience with this lesion is limited, the characteristic cytologic features, including "inside-out" cell clusters, should raise the suspicion of this variant of ductal carcinoma. Differentiation from other papillary lesions and malignancies may be possible, but more experience is needed as the number of reported cases remains limited.

Recent trends of stroke mortality in Hong Kong: age, period, cohort analyses and the implications.

This study describes the time trend of cerebrovascular disease (CVD) mortality during the period 1976-1995 in Hong Kong and explores the period and birth cohort effects using Poisson regression models with correction for overdispersion of data. A clear downward trend was observed for age-adjusted CVD mortality rate in both sexes. It decreased from 84 per 100,000 to 41 per 100,000 among men (a 51% drop), and from 56 per 100,000 to 35 per 100,000 among women (a 38% drop). The rate of decline was in general greater in the second decade and among males, resulting in a significant downward trend for the male-to-female rate ratio. Both the period of death and the birth cohort showed a significant effect on the reduction in mortality rates, but the latter seemed to have a more substantial influence. However, an increasing trend was observed among younger males in the second decade, and the protective cohort effect seemed to be waning for the more recent cohorts in both sexes. Closer monitoring of the situation in the next years is warranted.

Solubilization of a functionally active platelet-activating factor receptor from rabbit platelets.

Binding of platelet-activating factor (PAF) to a specific high-affinity membrane receptor has been demonstrated in numerous cell types, but very little is known about the molecular nature of this receptor. The receptor from rabbit platelets was solubilized using CHAPS, digitonin, octyl glucoside, Nonidet P-40 or sodium cholate, either with pre-bound [3H]PAF or in the absence of ligand. We have been able to demonstrate for the first time that the receptor solubilized with CHAPS, in the absence of ligand, could retain its binding activity. It migrated as a high molecular mass complex (greater than 350 kDa) on a Bio-Gel A-0.5 m gel filtration column. Binding to solubilized receptor rapidly reached an equilibrium at room temperature, but was much slower at 0 degrees C. Scatchard plots were used to calculate the number (approx. 100 per cell) and the affinity (Kd 2.5 +/- 1.4 nM) of the solubilized receptors. These values were comparable with those obtained from whole-cell binding experiments. Competition by PAF antagonists also verified that the assay was measuring PAF receptor binding activity. The presence of a protein in the receptor complex was demonstrated by heat and trypsin inactivation of binding activity. Trypsin had no effect on binding of PAF to whole cells, but was able to decrease binding activity in solubilized receptor preparations. Attempts to demonstrate the involvement of a glycoprotein by use of various lectin columns proved unsuccessful. The latter results are consistent with findings suggesting that the binding site of the PAF receptor may not be exposed at the cell surface.