Faculty Bibliography

NEW YORK - A new study has found surprisingly sharp increases over 15 years in two uncommon types of cancer in elderly white Americans. They are brain cancer and multiple myeloma, a marrow cancer that can painfully destroy bone. The authors are Devra Lee Davis, an expert at the National Research Council in Washington, an arm of the National Academy of Sciences, and Joel Schwartz, a biostatistician with the federal Environmental Protection Agency. The authors said the study was their own and not an official report of their agencies. The researchers, who analyzed federal mortality data, found that deaths from brain cancer rose by an average 8 percent each year in white men and women 75 to 84 years old, nearly tripling from 1968 to 1983 to reach annual rates of 30 deaths per 100,000 in men and 24 deaths per 100,000 women

The heart is a pump that is almost purely muscle. [Leslie A. Leinwand]'s interest in the disorders that damage it stems from her research on muscle cells that began in 1981, when she moved to Einstein from Rockefeller University. Leinwand said scientists also have observed that exercise or disorders such as diabetes and high blood pressure can alter myosin in the hearts of animals. Leinwand's research focuses on genes that control production of proteins that cause muscle cells to contract in rhythmic heartbeats. But other key substances involved in her research are destroyed by enzymes within 30 minutes of death, so Leinwand must rely on the samples taken immediately after the heart is removed from the body and frozen in the operating room

The avenue Dr. [Leslie A. Leinwand] and a few other scientists are taking is ''important and terribly exciting'' in exploring new ways to understand the basic defects that can trigger heart disease, said Dr. Claude Lenfant, who heads the National Heart Lung and Blood Institute in Bethesda, Md. ''The value of pinpointing the starting point is that when you want to treat the condition, you can take a rifle approach, instead of a shotgun approach,'' Dr. Lenfant said. ''You might develop a guided missile that could go right to that molecule, right to that gene, or to the protein that is responsible for the damage, and then you might find ways'' to stop its progression. The heart is a pump that is almost purely muscle. Dr. Leinwand's interest in the disorders that damage it stems from her research on muscle cells that began in 1981, when she moved to Einstein from Rockefeller University. Much of her research involves the genes that control a key component of muscle called myosin, the chief protein involved in making muscle cells contract. There are roughly a dozen genes that control myosin in humans; those that specifically control myosin in the muscles attached to the skeleton are on chromosome 17, and those affecting the heart are on chromosome 14

Mr. [Joseph Biden Jr.] had what doctors call a berry aneurysm, because it resembles a berry. Such aneurysms appear on the arteries that nourish the brain. Doctors at Walter Reed have not said exactly where Mr. Biden's aneurysm occurred, but they often appear where the arteries branch, abetted by normal thinning of artery walls, added turbulence in the bloodstream and other factors. About a third of patients experience an unusual, intense headache a few days or weeks before the aneurysm breaks. Patients have described such headaches as ''the worst headache of my life,'' and ''a hammer hitting my head.'' ''We're still in diapers on this technique,'' Dr. [Alejandro Berenstein] said, but he expressed optimism that it would be used on more patients with berry aneurysms and lead to other new therapies for difficult-to-treat problems in blood vessels in the body.

Nevertheless, critics have said [John J. Cannell] was playing God, making pariahs of smokers, persecuting a segment of the population and encouraging doctors to use personal habits as criteria for selecting patients. Some foresaw thorny practical and ethical problems if many doctors adopted Cannell's policy or extended it to alcoholics and the obese. Who would treat the rejected? Cannell, in turn, defends his unusual stance by citing the tradition of allowing doctors and patients to choose each other. Putting a novel twist on the ethical obligations of physicians to treat patients, he also cites Hippocrates, who warned physicians that their primary duty was to do no harm. Cannell argues that by treating smokers for tobacco-related problems he is, in effect, encouraging them in their deadly habit. Cannell 'is not going against any kind of ethical practice I know of,' said Dr. John Burkhart, head of the American Medical Association's ethics and judicial affairs council. Burkhart said he admired Cannell for 'not wanting to be a co-conspirator' with smoking patients

On this logic, Dr. [JOHN J. Cannell] has received support from an expert in ethics. Dr. Cannell ''is not going against any kind of ethical practice I know of,'' said Dr. John H. Burkhart, who heads the American Medical Association's council on ethics and judicial affairs. In an interview, Dr. Burkhart said he admired Dr. Cannell for ''not wanting to be a co-conspirator'' with smoking patients. Dr. Cannell smoked briefly at age 17 but stopped because inhaling made him sick. He attended medical school in the early 1970's at the University of North Carolina in Chapel Hill, in the heart of tobacco country, and recalls being appalled at one lecture on tobacco-related diseases. A spokesman for the tobacco companies ''was given equal time and told us none of the dangers were proven and tobacco is a great thing,'' Dr. Cannell said. ''It was incredible.'' ''Diehard smokers just don't call me anymore,'' he said. ''And I am amazed by how many people say, 'I finally kicked the habit, doctor, and I wanted to thank you because I never thought about it like I was a drug addict before, and I am.' That makes me feel good.''

[Claude Lenfant] said in an interview that the choice of this journal was made by the principal investigator, Dr. Charles H. Hennekens of Harvard, and not the government. Lenfant said the government had reached an agreement with the journal under which it sped up the timing of scientific review and publication in return for the government's cooperation in not publicly releasing the data until it held a news conference on the day of publication. In a rare instance, the research was reported one day early this time when the Reuter news agency moved the story on its wire. Reuters said it had learned about the findings from industry sources who declined to be identified. Wednesday, the medical grapevine was full of rumors on who those sources were. One principal, who asked not to be identified, said that Dr. Arnold S. Relman, the editor of the New England Journal, had made inquiries trying to pinpoint the source of the leak of information that was already widely known. Relman said he opposed scientists at meetings 'holding news conferences because they are not an appropriate scientific channel' if they do not present all the data that have been scrutinized by other experts. Most scientists agree with him, Relman contended

''You call a friend who has a study that he has submitted there,'' he said, ''and you say, as a friend, off the record, and I promise I will not talk to anyone about it, could you tell me what you found. And the friend will not. That is a threat, suppression of evidence of a major sort.'' Dr. [Arnold S. Relman] described as ''a misperception'' those who believe the journal's policy inhibits dissemination of information. ''We support communications among physicians at scientific meetings and we have no desire to interfere with that and I do not believe we do,'' he said. ''We have never turned down a paper because it was presented at a meeting,'' he said. ''What we do tell prospective authors is that they are free to discuss with reporters what they have said, but we caution them against giving the manuscript away because occasionally a detailed version finds its way'' into medical newspapers and magazines that function without any special reviewing process, much the way other newspapers do

Cocaine's dangers have not always been recognized. The drug was used for centuries by South American Indians and since 1884 in medicine as a local anesthetic. Sigmund Freud even used it in the belief that it would be a ''cure-all'' before he recognized the threat of addiction. Since Freud, doctors have learned of more dangers, such as seizures, delirium, fever, loss of the sense of smell, and death of cells in the lining of the nose, leading to holes between the nostrils. Some of the most drastic examples of the dangers of cocaine have involved so-called mules or body packers. ''Mule'' is the name given to those who transport cocaine from one country to another. ''Body packers'' stuff cocaine into condoms, balloons or plastic bags and, when trying to elude authorities, swallow them or conceal them in the rectum or vagina. Packets have broken open, overwhelming the body with massive amounts of cocaine. In other instances, holes in the condoms or bags have allowed cocaine to leak or fluid to be drawn in, causing the bags to burst. In such cases, the victims have suffered seizures and died. As a result, when doctors detect bags of cocaine in X-rays of these people, they consider emergency surgery to remove the bags before they rupture. How Cocaine Assaults the Body Cocaine's chief effects are on the nervous system and blood vessels. Researchers have found these direct and indirect actions from ingesting cocaine either in its powder form or in crack pellets:

Andy Warhol's death last year and a controversy over the 1984 death of Libby Zion, a college freshman, have plunged New York Hospital into a series of government inquiries, bad publicity and internal dissension