Towards a Global Human Embryonic Stem Cell Bank

An increasingly unbridgeable gap exists between the supply and demand of transplantable organs. Human embryonic stem cell technology could solve the organ shortage problem by restoring diseased or damaged tissue across a range of common conditions. However, such technology faces several largely ignored immunological challenges in delivering cell lines to large populations. We address some of these challenges and argue in favor of encouraging contribution or intentional creation of embryos from which widely immunocompatible stem cell lines could be derived. Further, we argue that current immunological constraints in tissue transplantation demand the creation of a global stem cell bank, which may hold particular promise for minority populations and other sub-groups currently marginalized from organ procurement and allocation systems. Finally, we conclude by offering a number of practical and ethically oriented recommendations for constructing a human embryonic stem cell bank that we hope will help solve the ongoing organ shortage problem.     

“Show Me” Bioethics and Politics

Missouri, the “Show Me State,” has become the epicenter of several important national public policy debates, including abortion rights, the right to choose and refuse medical treatment, and, most recently, early stem cell research. In this environment, the Center for Practical Bioethics (formerly, Midwest Bioethics Center) emerged and grew. The Center's role in these “cultural wars” is not to advocate for a particular position but to provide well researched and objective information, perspective, and advocacy for the ethical justification of policy positions; and to serve as a neutral convener and provider of a public forum for discussion. In this article, the Center's work on early stem cell research is a case study through which to argue that not only the Center, but also the field of bioethics has a critical role in the politics of public health policy.     

Swedish norms for completion of word stems and unique word fragments

Swedish norms for completion of word stems and single-solution word fragments, with few or many letters specified, were obtained from Swedish students. Comparisons were made for completion rates between stems and fragments that were possible to complete with the same word. As expected, completion rates for fragments were generally superior to those of word stems since the word stems allowed alternative completions. Adding one letter to the word stems and fragments resulted in a significant increase in the probability of completion, for both stems and fragments. A stepwise regression analysis was conducted in order to partial out factors determining the completion probability for fragments. The ratio of specified letters to blank characters, and the familiarity of the solution was found to be the most important factors. Finally, the effect of number of given letters in the word stem on the number of generated words per stem was studied. The mean number of words generated per stem was found to be equal for both two- and three-letter word stems.     

Impact of outpatient non-myeloablative haematopoietic stem cell transplantation in quality of life vs. conventional therapy

The role of outpatient hematopoietic stem cell transplantation (HSCT) as a therapeutic tool has been strengthened significantly because of the increasing number of patients undergoing this treatment. Due the very nature of this procedure, one of the aspects that should not be overlooked is the quality of life (QOL) of patients undergoing HSCT. Thus, one must consider not only health status after treatment, but also, the psychosocial implications for the patient. This is an observational, longitudinal, and prospective study to assess QOL in patients undergoing outpatient HSCT vs. similar patients receiving medical treatment (MxTx). By applying the COOP/WONKA charts on five occasions (pre-HSCT/initial, post-HSCT/first month, and at 3, 6, and 9 months), thirty-eight patients were analysed, 19 with HSCT and 19 with MxTx with no differences in age, gender or diagnosis. The initial survey found significant differences only in pain perception, which was higher in the HSCT group (p = .08); at the first month, there was a greater tendency for feelings of depression or anxiety in the HSCT group (p = .016), with more limitations in social (p = .003) and daily (p = .044) activities. From 3 months post-HSCT, the results were very similar. The differences persisted only in the area of social activities. Four patients developed graft-versus-host disease with no significant difference in the scores obtained compared to other transplant patients at 3, 6, and 9 months (p = .26) of follow-up.     

肿瘤干细胞与肿瘤治疗

肿瘤可看作是由功能异质性的细胞群体所组成的,具有不定增殖能力的异常器官.最近提出的肿瘤干细胞学说认为肿瘤起源于干细胞,肿瘤生长是肿瘤组织中极少量具有特殊细胞表面标志的肿瘤干细胞增殖的结果.因此治疗的关键应是针对肿瘤干细胞,通过靶向肿瘤干细胞及其异常调节的信号转导通路来治疗肿瘤.这对传统的治疗方式提出了巨大挑战,也为有效地根治肿瘤开辟了新的思路.     

干细胞技术应用于口腔医学的希望与困惑

骨髓干细胞、胚胎干细胞已开始应用于口腔医学领域,有关牙髓干细胞、牙周干细胞、牙胚干细胞等研究也取得了一系列重要的进展,为治疗口腔疾病开辟了一个新的途径,但同时也面临着需要进一步探讨的技术和伦理等方面的问题.     

论胰腺癌手术的术式选择

胰腺癌是一种高度恶性的腹部肿瘤.胰腺癌切除手术是一种高风险手术,如果病例选择或处理不当会造成严重后果.从哲学的高度更新指导思想和方法,对胰腺癌术式的合理选择以及提高胰腺癌治疗效果大有裨益.     

联合国教科文组织国际生命伦理学委员会第七届会议报告

在厄瓜多尔政府的盛情邀请下,国际生命伦理学委员会(IBC)第七届会议于2000年11月7～9日在基多举行。来自50个国家的170余名学者到会。IBC讨论了两个工作小组关于胚胎干细胞研究伦理学问题及在人类基因组研究中发达国家与发展中国家之间的团结与合作问题的报告。几位专家召开了一次主题为“生命伦理学教育”的圆桌会议。IBC还就人类基因组研究中经济方面的问题召开了一次工作会议。     

胚胎干细胞在治疗学研究中的应用

目前有许多研究人员希望能够从事胚胎干细胞的研究。这项研究可能对可移植组织用于对目前认为难以治疗或不能治疗的许多疾病的治疗的发展带来极大的帮助。然而,由于干细胞是源自人体胚胎。这就提出了如下问题：为了治疗学研究,在胚胎植入子宫之前从人类胚胎上获取细胞以从事实验室培养和研究在伦理上能够被接受吗?不同国家的伦理委员会或国家立法机构关于胚胎研究的观点及其采取的解决办法可能存在显著差异。这种差异在多元性世界里是不可避免的。     

Making Cells Worthwhile: Calculations of Value in a European Consortium for Induced Pluripotent Stem Cell Banking

The StemBANCC consortium was a large European consortium bringing together scientists from academic institutions and the pharmaceutical industry. The aim of the consortium was to produce 1500 induced pluripotent stem cell (iPSC) lines from participants with a variety of common, complex diseases. These cell lines were intended to help develop iPSC as tools for screening small molecule drug candidates and modelling human diseases in vitro. The scale of investment in this and other biobanks presents iPSC as a valuable commodity. However, StemBANCC was also mandated to make its making cells and data available to European researchers on a not-for-profit basis. To understand how making this quantity of stem cells and data available is configured as a valuable and worthwhile investment for the consortium partners, research materials (project documents, scientific literature and interviews with scientists working on StemBANCC) were analysed using theoretical tools from Valuation Studies. Combining STS and economic sociology, valuation studies analyse how the worth of things, ideas and phenomena result from context-specific practices of assessment and evaluation; worth incorporates moral, financial, scientific, economic. social and cultural registers of value. In this sense, practitioners evaluate the worth of the StemBANCC cells and data at a variety of sites, from participant recruitment to online databases. This provides an alternative to biovalue and similar conceptual models for theorising the generation of value in the Life Sciences.