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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chairman of the Subcommittee on Aging of the US Congressional Committee on Labor and Human Relations supports the Research Freedom Act designed to lift the ban on fetal tissue transplantation research. Transplanting fetal tissue into patients may treat Parkinson's disease and perhaps even diabetes, genetic disorders, and spinal cord injuries. In 1988, the National Institutes of Health (NIH) proposed to perform the 1st neural transplant on a patient with Parkinson's disease and underwent the required scientific and ethical reviews, but the Reagan administration forbade this procedure. It called for an independent evaluation of the moral and ethical issues of this research. The hand-picked panelists, most of whom opposed abortion, even determined that its funding was appropriate and it would not encourage women to seek abortion. Yet the Reagan administration continued the ban and the Bush administration followed suit despite the panel's results and many requests from people with progressive debilitating diseases. The Research Freedom Act heeds the recommendations of the NIH panel. Legislators include safeguards to place a firm barricade between abortion and research in the act. For example, the physician must substantiate in writing that the woman agreed to donate the fetal tissue after she decided to pursue an abortion. The Act forbids the sale of fetal tissue and assesses criminal penalties on any such exchanges. We allow transplantation of organs from murder victims even though we do not support murder. So we can condone the use of fetal tissue for life-saving research without endorsing abortions. The Act also renews the integrity of NIH's scientific review process. It can renew hope for people with diseases that fetal tissue transplantation may be able to treat. The US can either use the lifeless tissue for transplants or for other research or it can throw it away.
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PMID:Restoring hope: lifting the ban on fetal tissue transplantation research. 131 78

Researchers believe fetal tissue can be easily transplanted into and cure people with incurable debilitating diseases such as Parkinson's disease. In 1988, the Reagan Administration stopped funding transplantation research of fetal tissue from induced abortions. An advisory panel later decided that it is an acceptable public policy as long as certain conditions a re met. Yet the Bush Administration continued the ban. In 1992, it erroneously claimed that transplantation research could use alternative sources of fetal tissue. 1 alternative is fetal tissue obtained from ectopic pregnancies. Yet spontaneously aborted ectopic pregnancies tend not to produce recognizable or viable in culture fetal tissue and if they do the tissue has been ischemic for days. Ectopic pregnancies requiring surgical sterilization tend to be morphologically abnormal. The only likelihood of viable fetal tissue form ectopic pregnancies is a fetus with myocardial contractility before surgery. The administration also recommended use of fetal tissue from spontaneous abortions but these fetuses often have a major chromosomal or other fatal defect. Researchers cannot use chromosomally abnormal fetal tissue since it growth, development, and function are unreliable. Expulsion of the necrotic fetus tends to occur a couple of weeks after death. The Bush Administration also proposed use of tissue from stillbirths but their tissue tends to be nonviable and the tissue, even if it were viable, is generally not at the developmental stage needed for transplantation. The placenta and yolk sac were other suggested alternatives, but the placenta is likely to be less immunogenic than embryonic tissue. It can help develop certain cell lines which produce insulin or neurotransmitters like dopamine, however. The yolk sac could replace fetal liver cells in transplantation. Nevertheless the only advantage of using the suggested alternatives is the perception of them raising less ethical concern than fetal tissue from an induced abortion.
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PMID:Are there really alternatives to the use of fetal tissue from elective abortions in transplantation research? 143 88

Ventral mesencephalic tissue from aborted human fetuses (age, 6-7 weeks' postconception) was implanted unilaterally into the putamen using stereotaxic surgery in 2 immunosuppressed patients (Patients 3 and 4 in our series) with advanced idiopathic Parkinson's disease. Tissue from 4 fetuses was grafted to each patient. Compared with our previous 2 patients, the following changes in the grafting procedure were introduced: the implantation instrument was thinner, more tissue was placed in the operated structure, and the time between abortion and grafting was shorter. There were no postoperative complications. Both patients showed a gradual and significant amelioration of parkinsonian symptoms (most marked in Patient 3) starting at 6 and 12 weeks after grafting, respectively, reaching maximum stability at approximately 4 to 5 months; patients remained relatively stable thereafter during the 1-year follow-up period. Clinical improvement was observed as a reduction of the time spent in the "off" phase and the number of daily "off" periods; a lessening of bradykinesia and rigidity during the "off" phase, mainly but not solely on the side contralateral to the graft; and a prolongation and change in the pattern of the effect of a single dose of L-dopa. Neurophysiological measurements revealed a more rapid performance of simple and complex arm and hand movements bilaterally, but primarily contralateral to the graft. The results indicate that patients with Parkinson's disease can show significant and sustained improvement of motor function after intrastriatal implantation of fetal dopamine-rich mesencephalic tissue. The accompanying paper by Sawle and colleagues describes the results of repeated positron emission tomography scans in these patients.
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PMID:Transplantation of fetal dopamine neurons in Parkinson's disease: one-year clinical and neurophysiological observations in two patients with putaminal implants. 157 54

In an effort to improve the clinical signs of Parkinson's disease, we have implanted mesencephalic dopamine cells from a 7-week human embryo into the caudate and putamen of a 52-year-old man with Parkinson's disease. Fetal tissue was obtained from elective abortion. The woman and the patient with Parkinson's disease were unknown to each other. The woman gave specific consent and was not paid. The patient had a 20-year history of parkinsonism treated with multiple drug therapies including levodopa/carbidopa (Sinemet) every 2 1/2 hours. His symptoms were worse on the left side. For 5 months prior to transplantation, the patient underwent clinical evaluations by both a neurologist and a computer system installed in his home for daily measurement of walking and hand movements. Preoperative positron emission tomographic scanning with 6-L[18F]fluorodopa (fluorodopa) demonstrated severe dopamine depletion bilaterally. Fetal tissue was matched to the patient for ABO blood antigens, and maternal serum was screened for hepatitis B and human immunodeficiency virus type 1 prior to surgery. Fetal tissue was implanted stereotactically throughout the caudate and putamen on the right side of the brain via 10 needle tracks. The patient was not immunosuppressed. Results 12 months after surgery showed 42% improvement in left-hand speed before the first morning dose of drug and 40% greater response to drug therapy. Right-hand speed increased 15% before drug therapy and 23% after drug therapy. Reaction time was unaffected. Walking speed increased 33% after drug administration, although walking speed before the first morning dose of drugs declined 40%. Walking speed on an all-day basis improved 17%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Transplantation of human fetal dopamine cells for Parkinson's disease. Results at 1 year. 233 98

W. Kostowski's The Pathomechanism and Pharmacotherapy of Parkinson's Disease was published in 1987. M. Weissel's Thyroid Gland Hormones Can Affect the Plasma Level of Atrial Urinary Sodium Peptide in Man was issued in Die Schilddruse in 1987. The following articles were published in the New England Journal of Medicine: 1. Madrazo's Microsurgical Graft of Adrenal Medulla to the Right Caudate Nucleus in Two Patients with Intractable Parkinson's Disease in 1987. R. Noore's Parkinson's Disease--A New Therapy? in 1987. F. Needelman's A Cardiac Hormone Intimately Involved in Fluid, Electrolyte, and Blood Pressure Homeostasis in 1986. G. Dersy's Arterial Endocrine Function in Humans with Artificial Hearts in 1987. W. Crowley's Progesterone Antagonism in 1986. B. Couzinet's Termination of Early Pregnancy by the Progesterone Antagonist RU-486 (Mifepristone) in 1986. Progesterone is indispensable for the maintenance of pregnancy; its elimination results in abortion. The progesterone antagonist RU-486, or mifepristone, which is a 19-nonsteroid, has been used lately for early pregnancy termination. A group of French and American authors conducted a study of 100 women with early unwanted pregnancy during 10 days following the end of expected menstruation. 34 women received 400 mg of RU-486 in the course of 4 days, 26 got 600 mg also in the course 4 days, and 40 women received 800 mg within 2 days. Uterine bleeding appeared in all women in the course of 4 days from the moment of giving the drug, and it lasted 5-17 days. A clear reduction of gonadotropin concentration was observed after 6 days. Ultrasound showed empty uterus within 13 days from the use of the drug. In 15 women after receiving RU-486, the increased level of gonadotropin lasted beyond 6 days, which was indicative of the lack of action of RU-486. In this group of women the uterine cavity was evacuated by nonpharmacological methods. The drug was safe and effective, although 15% of women did not react to it and significant prolonged bleeding occurred in 18% of them.
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PMID:[Progress in endocrinology]. 298 Sep 95

Fetal tissue transplants have now been successful in primates, raising the possibility of treatment for Parkinson's disease and other chronic illnesses. Whether or not abortion is morally justified, use of human fetal tissue for research or therapy is justified in certain circumstances. The rationale, both for permitting transplantation of fetal tissue and for limitations in exercising the technology, is based on the same set of ethical principles that supported restrictive legislation in the past: respect for autonomy and a balancing of harms and benefits that gives priority to those most affected.
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PMID:The ethical options in transplanting fetal tissue. 355 44

In an effort to study the interaction of pregnancy and Parkinson's disease (PD), I interviewed 18 women who had had a total of 24 pregnancies after onset of PD symptoms. Conception occurred at mean age 34.7 (SD 6.1) years. There were 3 miscarriages, 4 elective abortions, and 17 term pregnancies. Use of amantadine during the first trimester was associated with a heterogeneous group of obstetric complications including miscarriage. Ten of the 17 completed pregnancies were associated with permanent worsening of PD symptoms, which did not affect overall disability. Among the series as a whole there was no excess incidence of obstetric complications or fetal defects.
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PMID:Parkinson's disease and pregnancy. 360 Oct 93

Tissue from human fetal cadavers has long been used for medical research, experimental therapies, and various other purposes. Research within the last two decades has led to substantial progress in many of these areas, particularly in the application of fetal tissue transplantation to the treatment of human disease. As a result, clinical trials have now been initiated at centers around the world to evaluate the use of human fetal tissue transplantation for the therapy of Parkinson's disease, insulin-dependent diabetes mellitus, and a number of blood, immunological and, metabolic disorders. Laboratory studies suggest a much wider range of disorders may in the future be treatable by transplantation of various types of human fetal tissue. A combination of characteristics renders fetal tissue uniquely valuable for such transplantation, as well as for basic research, the development of vaccines, and a range of other applications. Although substitutes for human fetal tissue are being actively sought, for many of these applications there are at present no satisfactory alternatives. Important issues remain unresolved concerning the procurement, distribution, and use of human fetal cadaver tissue as well as the effects of such use on abortion procedures and incidence. These issues can be addressed by the introduction of appropriate guidelines or legislation, and need not be an impediment to legitimate research and therapeutic use of fetal tissue.
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PMID:Human fetal tissue research: practice, prospects, and policy. 801 29

Research using human fetal tissue is well established in biomedical science and indicates promising results in clinical transplantation for some diseases. Because the most optimal tissue for use in transplantation is obtained from fetuses resulting from elective abortions, this technology provokes ethical controversy. Societal concern about the ethical feasibility of human fetal tissue transplantation research (HFTTR) culminates with its investigative use in the treatment of Parkinson's disease. Reflective of such concern in the United States was the 1988 ban on federal funding for HFTTR using tissue obtained from electively terminated abortuses and the establishment of the HFTTR Panel. Considerations generating ethical debate about HFTTR include the moral status of the fetus, who should consent to use of fetal tissue in transplantation research, and issues related to complicity in, and legitimization of, abortion. The moratorium on federal funding for HFTTR has been lifted, but ethical issues and societal concerns remain unresolved.
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PMID:Human fetal tissue: ethical implications for use in research and treatment. 822 Mar 72

In 1990, 390 professionals involved or interested in reproductive health issues from 20 European countries were randomly selected to participate in this study in collaboration with the Institute for Bioethics at Maastricht, the Netherlands. The group of scientists, physicians, public health officials, lawyers, philosophers, theologians, and ethicists were mailed an English-language, self-administered questionnaire. Surveys were completed by 198 professionals (51% response rate) from 20 European countries. 66% (n = 118) of the professionals believed that the therapeutic use of human fetal tissue from elective abortion was ethically acceptable, whereas 34% (n = 60) did not. Bivariate analysis showed that 87% (n = 47) of those who believed that life begins at or after viability and 90% (n = 60) of those who believed elective abortion was morally acceptable found the use of fetal tissue for research and therapy ethically acceptable. 137 did not believe that the potential medical benefits arising from fetal tissue therapy outweighed any moral problem associated with the abortion. Even so, 61% (n = 82) holding that position believed that the therapeutic use of fetal tissue from selective abortion was ethically acceptable. However, about half the sample stated that they were not knowledgeable about animal studies research on fetal tissue therapy in the treatment of Parkinson disease. Of the 68% (n = 113) who supported fetal tissue therapy generally, only 80 (70%) of these would continue to do so if research showed that fetal tissue therapy offered only temporary relief rather than actual cure. Consequently, 48% would support fetal tissue therapy in humans under these conditions. None of the multiple regression analysis variables measuring demographics or the concepts of beneficence, justice, abortion morality generally, or the use of scientific evidence remained significant. The only significant variables associated with an increased likelihood of approving the use of fetal tissues were ones representing the value and belief concepts of fetal rights, concerns over second-trimester abortion, respect for autonomy of the mother, and nonmaleficence.
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PMID:The bioethics of human fetal tissue research and therapy: moral decision making of professionals. 829 13


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