Faculty Bibliography

In February, the Massachusetts General Hospital in Boston said scientists there and at Harvard Medical School had found what ''may be the Achilles heel of HIV,'' the virus that causes AIDS. The findings were made by a Harvard medical student, Yung-Kang Chow, working in the laboratory of Dr. Martin S. Hirsch, principal study investigator. In an interview Wednesday, Hirsch said that the new reports had prompted his team to repeat its original studies, which led to the finding of an error in one part of the paper. The error was a misidentification of a part of a mutant form of HIV used in the experiments, Hirsch said. Hirsch said his Harvard team planned to send a letter Thursday to Nature reporting its error

New findings cast serious doubt on the premise of a national trial of a combination of three drugs that experts have called the best hope for treating AIDS

In February, Massachusetts General Hospital in Boston said scientists there and at Harvard Medical School had found what 'may be the Achilles heel of HIV,' the virus that causes AIDS. The findings were made by a Harvard medical student, Yung-Kang Chow, working in the laboratory of Dr. Martin S. Hirsch, the principal investigator for the study. The Harvard team had reported using a combination of two marketed drugs, AZT and ddI, and either of two experimental ones, pyridinone and nevirapine, to attack a single component of HIV, an enzyme that makes copies of the virus' genetic material. In test tubes, the combination of drugs blocked the virus from growing and spreading to other cells, the Harvard team reported

In this case, the patient benefited from a combination of unusually fortunate circumstances. His surgeons inserted a tube through the skin above the pubic bone to drain urine from the bladder until the penis heals. Because nerves were cut, Bobbitt at present has no sensation in the reattached portion of the penis. But his doctors said prospects for the return of sensation are good. In about a month, they will do a series of neurological tests to measure how rapidly the sutured nerves are regenerating. As the nerves in the severed part die, they leave a sheath or skeleton behind and the nerves from the base of the penis grow along the same path, [David E. Berman] said. He expects that it will probably take a year or two before the man's nerves regain significant sensation. Graphic, Diagram; Dr. [James T. Sehn], Prince William Hospital, Manassas, Va., New York Times News Service; Complex Procedure Under a Microscope. Surgical reattachment of the penis began with the identification and tagging of severed structures. First the urethra was rejoined over a catheter used as a splint. Then the soft tissue around the urethra, the lower third of the corpora cavernosa and a deep artery were rejoined. The next step rejoined the dorsal arteries, the deep dorsal vein and dorsal nerves. Finally, a superficial vein, soft tissues and skin were sewn . . . illustrating diagram showing cross section of a penis and surgical reattachment procedures

A study of the experimental drug vesnarinone, released on Jul 15, 1993, raised hopes of a possible method of treating congestive heart failure. The study indicated that the drug was associated with a reduction of 62% in the death rate of test subjects; other drugs have reduced the rate by from 15% to 25%

MANASSAS, Va. - Sixteen days after surgeons reattached his severed penis, a man left the hospital last weekend to convalesce from a rarely performed operation. In it, surgeons peered through microscopes as they worked nine and a half hours reattaching blood vessels less than a millimeter in diameter and sewing other tissues. The need for this operation resulted from a highly publicized incident in which a man's wife - who told the police that her husband raped her June 23 - cut off his penis with a 12-inch filleting knife while he was asleep. Minutes later, while driving to a friend's home, she hurled the detached organ into a field. Police have not released the couple's names

'It was a horrific sight,' said Dr. [James T. Sehn]. 'He was on his back and there was just a clot left for where there should have been a penis.' 'Once I looked at him, it was pretty clear what I needed to do,' Dr. Sehn said. He put a tourniquet on the stump to prevent further bleeding. 'I carefully explained to him what I could do and could not do,' Dr. Sehn said. 'You know, once you are doing things under a microscope it doesn't really matter where the artery goes to or what it belongs to,' said Dr. [David E. Berman]. 'What is most important is the size and condition of the vessels you are trying to attach and how accessible the tissues are.'

The World Bank on Jul 6, 1993 reported startling health gains for poor people in LDCs. Since 1960, life expectancy at birth has soared to 63 years from 46, and the number of children who die before age five has dropped by two-thirds. The gains are attributed to the wider availability of public health measures

A Cuban government health official said the week of Jun 27, 1993 that the mysterious epidemic that has afflicted more than 46,000 people has apparently peaked. However, the cause of the disease, which impairs vision and damages nerves, continues to baffle international scientists

Researchers throughout the world now recognize the desperate need for new drugs and they are pursuing a number of leads. But until such drugs are found, health officials are left with prevention as the best line of defense against HIV. The two most effective barriers are preventing other sexually transmitted diseases, like gonorrhea, syphilis and chancroid, which promote acquiring HIV, and impeding the spread of HIV among drug abusers. Making headway on these measures, both of which are politically fraught, is among the many challenges that Kristine Gebbie faces in becoming Washington's long-awaited AIDS czar. Elsewhere in the world AIDS is hitting hardest in Africa and Asia, where the overwhelming majority of HIV infections are spread through heterosexual sex. Yet throughout the world political leaders have largely ignored pleas from medical leaders to increase financing for treating and preventing sexually transmitted diseases. Swedish health officials have reduced the incidence of sexually transmitted diseases to among the lowest in the world, and a dividend has been a very low incidence of HIV infection. Experts say that among the reasons AIDS therapy is bleaker than predicted is that they have been hampered by too many variables in evaluating studies of AZT and its pharmacological cousins, ddI and ddC. The studies often have different criteria for entry, test different amounts of drug for people at different stages of HIV infection and AIDS, vary in the length of followup of volunteers, and set different criteria for stopping the trials. 'All the studies are right, and the problem is how to put all the pieces together into a clear picture,' which is impossible 'because all the pieces do not exist,' said Dr. Douglas Richman, an infectious disease expert at the University of California at San Diego