Controversies in the determination of death: perspectives from Switzerland.

In 1968, an Ad Hoc committee at the Harvard Medical School advanced new criteria for determining death. It proposed that patients in irreversible coma with no discernible central nervous system activity were actually dead. The committee paved the way for the "whole brain" definition of death, which has reached broad public acceptance and legal enactment in many countries. Despite this, the philosophical and ethical debate about the "whole brain" definition of death is far from being closed. This paper analyses the ongoing controversy and evaluates the recent revision of the Swiss Academy of Medical Sciences guidelines for determining death.

The homeobox gene Arx is a novel positive regulator of embryonic myogenesis.

Skeletal muscle fibers form in overlapping, but distinct phases that depend on the generation of temporally different lineages of myogenic cells. During primary myogenesis (E10.5-E12.5 in the mouse), embryonic myoblasts fuse homotypically to generate primary fibers, whereas during later development (E14.5-E17.5), fetal myoblasts differentiate into secondary fibers. How these myogenic waves are regulated remains largely unknown. Studies have been hampered by the lack of markers which would distinguish embryonic from fetal myoblast populations. We show here that the homeobox gene Arx is strongly expressed in differentiating embryonic muscle, downstream of myogenic basic helix-loop-helix (bHLH) genes. Its expression progressively decreases during development. When overexpressed in the C2C12 myogenic cell line, Arx enhances differentiation. Accordingly, it stimulates the transcriptional activity from the Myogenin promoter and from multimerized E-boxes when co-expressed with MyoD and Mef2C in CH310T1/2. Furthermore, Arx co-immunoprecipitates with Mef2C, suggesting that it participates in the transcriptional regulatory network acting in embryonic muscle. Finally, embryonic myoblasts isolated from Arx-deficient embryos show a delayed differentiation in vivo together with an enhanced clonogenic capacity in vitro. We propose here that Arx acts as a novel positive regulator of embryonic myogenesis by synergizing with Mef2C and MyoD and by establishing an activating loop with Myogenin.