Faculty Bibliography

The FDA is probing at least 243 possible cases of a strange flu-like illness that appears to be linked to the non-prescription drug L-tryptophan, which is used as a dietary supplement

''That is one of the greatest canards'' inflicted on premedical students, Dr. [Myron S. Magen] said in an interview. ''They know we are lying and consequently they load up on the sciences, and that is what we look at.'' Dr. [Lewis Thomas] placed the blame squarely on the admission policies of the nation's 127 medical schools. These institutions, he said, ''used to say they wanted applicants as broadly educated as possible, and they used to mean it.'' Dr. [David W. Fraser] said that as an undergraduate majoring in biology at Haverford, his goal was to become a college teacher. His experience, he said, ''told me I didn't want to be a lab scientist doing what my mentors were doing.''' Now, Dr. Fraser said, he wishes he had majored in philosophy.

The score is one of the simplest, least costly, most widely used tests in medicine. Many pediatricians consider it one of the most useful, but other doctors argue that the test is outmoded and abused, renewing a debate that has simmered almost since Dr. Virginia Apgar announced the test in 1953. Lancet said that many Apgar scores were erroneous because of variability among those who perform the test and because hospital staff members are sloppy in the way they perform the test and record the results. For example, in a separate reply to Lancet, a team of doctors in Birmingham, England, reported on a study of 100 babies with a low Apgar score that determined 61 of them had received care that was possibly less than optimal

When cyclosporine was stopped, the woman's dying liver was saved by FK-506. Since then FK-506 alone has had stunning results in experimental use in more than 100 transplant patients, and other scientists familiar with the work credit Dr. [Thomas E. Starzl] with saving FK-506 from being discarded. Dr. [Richard D. Leavitt], the Fujisawa official, said the company's researchers tested scores of samples before they came across FK-506 and could not have discovered the drug without the new screening tests. ''The chance of getting a strike is remote,'' said Dr. Varro E. Tyler, the executive vice president of Purdue University and a former dean of its school of pharmacy. But, he added, ''one of the sad things about the drug discovery process is that it has been too narrowly focused'' in recent decades. Tens of thousands of isolates from the soil were screened only for a specific activity such as for use against bacteria and fungi and not for broader purposes, Dr. Tyler said. He added that with broader screening ''we probably would have picked up several useful drugs.'' ''It is all right to pick out a new soil sample, a new microorganism or new chemical entity because you can patent that,'' Dr. Tyler said. ''But there are a lot of natural substances known for centuries that no one will do the necessary work on because they could not get exclusive patent protection and wouldn't recoup their research costs.''

Doctors of 57-year-old Buck Helm, the man who survived the Interstate 880 collapse during the Oct 17, 1989 earthquake in Northern California, say the man was on the verge of a cardiac arrest when rescuers found him. Doctors say he probably would not have survived another day trapped in the wreckage

[Buck Helm]'s condition was upgraded from critical to very serious and may improve again to serious, [Floyd Huen] said. He said Helm was likely to spend two or three more days on a respirator

They receive little about their obligation as future physicians to treat people. It would be the rare medical school, for instance, that sent applicants or entrants a suggested reading list about the traditions of the medical profession and the ethical obligations of physicians

Lancet, the respected medical journal published in London, said recently, 'The [Virginia Apgar] score has served its purpose, and should now be pensioned off.' Lancet's reasoning reflected the many laboratory tests, such as one for the amount of oxygen in the blood, introduced in the last 36 years to provide more precise measures of a newborn's physiological status. The editorial also reflected improved techniques to resuscitate and care for sick infants. Lancet's attack brought sharp rebuttals from 19 members of the editorial board of the Journal of Perinatology and from pediatricians in other scientific publications. They defended the Apgar test for its simplicity in alerting staff members to the need for special care when it might not otherwise be considered. The defenders also said Apgar scores provide standardized observations in the care given to maintain a newborn's vitality. The Apgar score is the sum of points assigned to the five factors, which a doctor, nurse or midwife can quickly judge at intervals of 1 minute, 5 minutes and often 10 minutes after birth. Depending on the score and the circumstances, the Apgar test is repeated every 5 or 10 minutes as long as it is needed

He expressed confidence that with more research FK-506 will eventually replace cyclosporine as the standard drug for most transplant surgery. But he cautioned that there is no reason for a transplant recipient now taking cyclosporine to switch to FK-506 unless that individual develops serious problems. [Thomas Starzl] has repeatedly called FK-506 'a miraculous drug, a wonder drug, one of those drugs that comes along once in a lifetime.'