Faculty Bibliography

Some scientists and organizations of office workers have speculated about VDT use and miscarriages or birth defects. But these findings are the first epidemiological evidence based on substantial numbers of pregnant VDT operators to show a statistically significant increase of miscarriages among those who use the terminals more than 20 hours a week. The Kaiser findings grew out of a study that originally was intended to determine the effects on pregnant women of pesticides used to combat Mediterranean fruit flies in California in 1981 and 1982. The researchers, Marilyn K. Goldhaber, Michael R. Polen and Dr. Robert A. Hiatt, surveyed 1,583 pregnant women who attended three Kaiser-Permanente obstetrics and gynecology clinics in northern California

NEW YORK - Women who used video display terminals for more than 20 hours each week in the first three months of pregnancy suffered almost twice as many miscarriages as women doing other types of office work, according to a new study. The authors of the study, researchers at the Kaiser-Permanente Medical Care Program in Oakland, Calif., said the findings did not necessarily mean that the terminals themselves had caused the miscarriages and that such unmeasured factors as job-related stress and poor working conditions could have been responsible. Some scientists and organizations of office workers have speculated about links of VDT use to miscarriages or birth defects. But these findings are the first epidemiological evidence based on substantial numbers of pregnant VDT operators to show a statistically significant increase of miscarriages among those who use the terminals more than 20 hours a week

The study involved almost 1,600 pregnant women. The researchers also found that heavy users of VDTs were more likely to have children with birth defects, but that increase was not statistically significant, the researchers said. Some scientists and organizations of office workers have speculated about links of VDT use to miscarriages or birth defects. But these findings are the first evidence based on substantial numbers of pregnant VDT operators to show a significant increase in miscarriages

LEAD: In an unusual warning, doctors have reported the case of a man who injected cocaine into his urethra to heighten sexual pleasure and then, through ''extravagant complications,'' suffered gangrene that led to the loss of both legs, nine fingers and his penis. In an unusual warning, doctors have reported the case of a man who injected cocaine into his urethra to heighten sexual pleasure and then, through ''extravagant complications,'' suffered gangrene that led to the loss of both legs, nine fingers and his penis

Researchers from the Memorial Sloan-Kettering Cancer Center in New York found cancerous cells in the bone marrow of 18 of 51 women with breast cancer, or 35 percent, in a group in whom no cancerous cells could be detected in the marrow by conventional tests, according to a report in the May issue of The American Journal of Surgical Pathology. Using the new test, these researchers also found cancerous cells in the marrow of six of 22, or 27 percent, of women with no evidence that cancer had spread to the lymph nodes, and cancerous cells were found in the marrow of 12 of 29, or 41 percent, of those in whom cancer had spread to the lymph nodes

The article, noting that recovery of the AIDS virus from saliva is much rarer than recovery from blood, reported in passing that blood tests from the woman in the 1984 article still showed no evidence of infection and that ''repeated efforts to culture virus from her have been unsuccessful.'' The woman remains healthy, and scientists now believe she was never infected. It is not clear how the original error occurred. Dr. [Jerome E. Groopman] said he had not previously considered writing a letter to the Lancet to provide the new information. But on reflection, Dr. Groopman said he would write to The Lancet stating that failure to isolate the virus from the woman in seven follow-up tries led his team to conclude that she was never infected. The letter is intended ''to emphasize the lack of evidence'' for transmission of AIDS by saliva, he said. ''It should not be any harder to find out that something wasn't right than it was to read about it the first time,'' he said. ''Readers should not have to ferret that out.''

The new tests rely on immunologic and chemical reactions to detect cancer cells that originate in the breast and travel to the bone marrow. The bone marrow procedure is used because it is easily done and because bone is where breast cancer most often spreads. How Tests Differ The highly refined tests use monoclonal antibodies, proteins that the body forms in response to particular antigens, to detect antigens that prior research has shown exist only in epithelial cells. Monoclonal antibody tests are highly specific; a monoclonal antibody binds to only a single antigen. But detection of spreading cancer cells with the new tests is indirect, because the antigens are present in all epithelial cells, whether cancerous or not. Ordinarily, no epithelial cells are present in the bone marrow, so detection of any is considered abnormal and an indication that the cells are cancerous. (Although the test would detect any epithelial cells from the skin that were introduced into the bone marrow during the tests to obtain such samples, this has not happened so far, the researchers said.) The test cannot distinguish a cancer cell that originated in the breast from one that came from the lung, for example. The test's ability to detect any epithelial cell opens it up to further possible applications, and the New York team hopes to develop studies for three other types of cancer, lung, prostate and colon, Dr. [Michael P. Osborne] said.

One reason the agency is studying the prescriptions for Accutane is to determine whether there is a pattern among certain specialists. ''What if pediatricians and other specialists prescribed it correctly and the problems were in dermatological practice?'' Dr. [Frank E. Young] said. ''Then we would not want to restrict it by specialty.'' ''If we can see which physicians are prescribing Accutane and under what circumstances,'' he said, ''we may be able to help design a strategy to help avoid this situation in the future.'' Dr. Young said he hoped the educational campaign would correct the abuses of drug prescribing. Doctors and the general public have not viewed the problem ''as seriously as they should have,'' he said, but now ''it is not business as usual.''

Noting the poor experience with artificial hearts so far, Dr. Claude Lenfant, director of the National Heart, Lung and Blood Institute, said federal efforts will focus instead on developing a partial artificial heart, known as a left-ventricular assist device. One device made by Novacor, of Oakland, Calif., worked continuously in a laboratory for a year without major problems under simulated circulatory conditions. It also met other rigorous tests of reliability, Lenfant said. The device for permanent use is nearing the stage where it will be tested in humans, subject to approval from the Food and Drug Administration, Lenfant said. Lenfant views the research on an improved ventricular-assist device as a possibly speedier route to an artificial heart because it can more quickly resolve some medical problems potentially associated with all these devices. By testing permanent ventricular-assist devices, he said, 'we will know in three to four years whether we have with that simple device the same problems that exist with the Jarvik heart.'