Faculty Bibliography

Furthermore, another treatment for a common Marfan's symptom can cause problems of its own. In either eye of people with Marfan's, the lens is often off-centre, causing blurred and distorted vision. Although the turkeys did not have Marfan's, researchers quickly reasoned that such a drug might also protect Marfan's victims. The area of the artery most vulnerable to development of aneurysms in Marfan's is the root of the aorta as it emerges from the heart. Until a few years ago, surgery to repair aneurysms in Marfan's killed as many patients from severe bleeding and other complications as it helped

Dr. [Robert Dugal] said tests of the urine sample taken immediately after [Ben Johnson] set a world record in the Olympic 100-meter race last weekend ''showed an entirely different'' pattern than those performed in Canada. The tests in Seoul detected evidence of the anabolic steroid stanozolol. Hopes of Escaping Detection ''What I cannot understand is an athlete of the stature of Ben Johnson being caught so stupidly; it is really unexplainable,'' Dr. Dugal said. ''But obviously he took a chance.'' ''It is nonsense,'' Dr. Dugal said. ''The scientific data goes against that possibility.''

Prince Alexandre de Merode, the chief of the International Olympic Committee's medical commission, said that the test results of [Ben Johnson]'s urine ''excluded all possibility'' that stanozolol could have been administered after the competition and before the test. Another official, Richard Pound, an I.O.C. vice president and a Canadian, said that tests of Johnson's urine had indicated a ''chronic suppression of his adrenal functions.'' The body has two adrenal glands, which are attached to the kidneys, that produce vital hormones. Dr. Richard H. Strauss, an associate professor of medicine at Ohio State University in Columbus, who has done research on anabolic steroids, said he ''was not aware that taking anabolic steroids leads to adrenal suppression.''

In a novel approach to teaching the intricate details of human anatomy, some medical schools are experimenting with advanced computer-imaging techniques to create electronic 'cadavers.' 'By no means will electronic cadavers entirely replace the dissection of a cadaver,' said Dr. Robert A. Chase, whose team at Stanford University has developed a pioneering electronic cadaver. ILLUSTRATION; Computer-generated `cadavers' will allow anatomy students to study a full skull, top left, or to zoom in on a particular area, top right.; Computer-animated drawings will show how finger muscles work, bottom left, and how the various bones in the finger rotate at the joints, bottom right.; Credit: The New York Times

One problem in Marfan's concerns the dura, or the tissue that surrounds and protects the spinal cord. In people with the syndrome, the dura loosens and can form a sac. The sac itself may not be particularly dangerous, but some patients have been put at risk because doctors have mistaken the sac for a tumor and operated on it, said Dr. Reed E. Pyeritz, a Marfan's expert at Johns Hopkins Hospital in Baltimore, Md. Furthermore, doctors are realizing that another treatment for a common Marfan's symptom can cause problems of its own. It has long been known that in either eye of people with Marfan's, the lens is often off-center, causing blurred and distorted vision. Even when Marfan's is diagnosed, specialists in one field often fail to refer a patient to a cardiologist to monitor changes in the aorta, or to geneticists to examine other family members. Each child born to an affected parent has an even chance of developing Marfan's

Second, as more people with a disorder live longer, doctors often learn that it can cause previously unrecognized and distinctive problems. One in [Antoine Marfan]'s concerns the dura, or the tissue that surrounds and protects the spinal cord. In people with the syndrome, the dura loosens and can form a sac. The sac itself may not be particularly dangerous, but some patients have been put at risk because doctors have mistaken the sac for a tumor and operated on it, said Dr. Reed E. Pyeritz, a Marfan's expert at Johns Hopkins Hospital. The area of the artery most vulnerable to development of aneurysms in Marfan's is the root of the aorta as it emerges from the heart. Until a few years ago, surgery to repair aneurysms in Marfan's killed as many patients from severe bleeding and other complications as it helped. Also, additional aneurysms developed near the operative site in the aorta. If further study determines that fibrillin or a similar compound is the key abnormality, researchers then could develop a reliable diagnostic test for Marfan's, possibly detecting it even before birth. Repairing a Flaw Before it Kills In Marfan's syndrome, an aneurysm or ballooning of root of the aorta, the body's main artery, can rupture, causing sudden death. In an increasingly common operation, the bulge is repaired before it bursts. First the valve between the aorta and the left ventricle is removed and replaced with an artificial valve attached to a long dacron tube. The coronary arteries that feed the heart muscle are reattached to the tube. The walls of the aorta where the ballooning occurred are trimmed, and the new tube and valve are wrapped inside the original aorta.

It is difficult to know whether Washington or Baghdad is right, experts say. One, Dr. Jan L. Willems, a Belgian Army medical officer who also teaches toxicology at the University of Ghent Medical School, speaking of the general problem of accusing a government of using chemical warfare poisons, said ''the final conclusion is always a political one'' because it relies in part on nonmedical sources such as intelligence information. Mustard gas reacts very quickly in the body and ''does not stay around as such for more than a very short time'' before it is converted into other substances, said Dr. John Ambre, a physician and toxicologist at Northwestern University Medical School in Chicago. In humans, the chemical traces of mustard gas disappear faster than the wounds heal. ''It is a tricky business,'' said Dr. Willems, who visited the European medical centers to which about 175 Iranian victims of mustard gas attacks were evacuated from 1984 to 1986

The reluctance of doctors to diagnose chemical-warfare poisoning among Kurds who have fled Iraq underscores the difficulties a physician has in documenting such poisonings when he is able to examine supposed victims only after they have left the scene of the alleged attacks. The classic symptoms of the most severe mustard-gas poisonings are scarred flesh, clouded eyes and seared lungs, experts say. In less severe cases, the victims may suffer minor skin burns without lung damage. Some Kurds who fled to Turkey suffered such symptoms. One difficulty in diagnosing chemical-warfare poisoning is that those who flee a gassed area are likely to be among the less-severely injured. The distinctive features might be less apparent in milder cases, particularly to doctors who are not experienced with mustard gas, which was first used in warfare in 1917

The new study was undertaken in part to address the questions of timing and duration of the use of a specific combination of drugs. It involved 1,229 women in Italy, Spain, Sweden, Switzerland, West Germany, Yugoslavia, South Africa, Australia and New Zealand. The Ludwig Institute for Cancer Research in Berne, Switzerland, reported on the study in today's issue of The New England Journal of Medicine. Toxic Effects Countered Two patients died from the drug therapy during the first year after the surgery. Other reported toxic effects included systemic infections, tearing of the surgical scar, painful inflammation of the mouth, an abnormally low white cell count that could lead to infections and a low platelet count that could lead to bleeding

The researchers said this and other data in the study suggested that the herpes and syphilis infections predated infection with the AIDS virus. Further comparisons among the men indicated that, depending on which prior ulcerative disease they had and whether it was currently active, the chance of AIDS virus infection ranged from threefold to eightfold higher than among men with no ulcerative disease. The study took into account differences in rates of sexual intercourse that might have exposed the men to the AIDS virus. The study lends new weight to the growing belief among experts, based on theory and observations of various groups at risk of AIDS, that sexually transmitted diseases involving open sores enhance the chances that the AIDS virus will spread from person to person through sexual intercourse. Similar links between genital ulcer diseases and susceptibility to infection with the AIDS virus have been found in studies of heterosexuals in Africa. Scientists theorize that the open sores provide a ready pathway for the virus to the bloodstream