Faculty Bibliography

On Dec. 6, 1967, three days after Dr. [Christiaan N. Barnard] gave Louis Washkansky a new heart, Dr. Adrian Kantrowitz, who had relied on Dr. Shumway's technique while experimenting on dogs, performed a heart transplant on an infant at Maimonides Medical Center in Brooklyn. The infant died six and a half hours later, and Dr. Kantrowitz declared the operation a failure. On Jan. 2, 1968, Dr. Barnard carried out his second heart transplant on Dr. Philip Blaiberg, who lived 19 months. Mr. Washkansky survived 18 days. In the late 1960's, Dr. John Hauser, the coroner of Santa Clara County, Calif., which included Stanford, sought criminal charges against Dr. Shumway for transplanting organs without an autopsy on the donor, an act that would have made transplantation impossible. The two men shouted at each other over the issue in Dr. Shumway's office, recalled Dr. Eugene Dong, then a transplant surgeon at Stanford and now a lawyer. Dr. Shumway's group began to test the drug independently after a member of the Cambridge team gave a lecture about its findings at Stanford and achieved good long-term results in dogs. ''The animal experiments kept us going while everyone else, who did not have that experimental background, dropped out,'' Dr. Shumway said

The turnaround owes largely to what Shumway called his 'radical perseverance.' He rescued heart transplants with a new immunosuppressant drug, cyclosporin, that helped keep the body from rejecting its new organ, and with a heart biopsy technique to detect and treat rejection before it became lethal. Shumway reshaped the way chest surgeons learn their craft, and he trained many who now perform heart transplants. The transplant revolution he helped set in motion extended far beyond medicine, upsetting the traditional definition of death as the moment the heart stops beating. Instead, an organ donor can now be considered dead as soon as electrical activity of the brain has ceased, allowing transplantation of a living heart or other organ. For a decade starting in 1958, and supported by federal grants from the National Institutes of Health, Shumway experimented on dogs to create what is now the standard technique to remove a patient's heart and replace it with a stranger's. By the time Shumway performed his first human heart transplant on Jan. 6, 1968, it was the world's fourth. But those early transplants seldom achieved long-term success. It was easy enough to transplant a heart, as Shumway once said, 'but it's what happens later with regard to the containment of rejection that makes the real difference.'

The World Health Organization declared two more nations free of indigenous polio, leaving only four -- an all-time low -- where a reservoir of the paralytic disease remains

After three years, 93 percent of the older kidneys that scored favorably functioned well, a rate comparable to kidneys from younger donors. Among older transplanted kidneys that were not biopsied, the rate was 72 percent. In the United States, of the estimated 60,000 patients who await kidney transplants each year, 16,000 receive a kidney. In 2003, 12 percent of kidneys from donor bodies were discarded, chiefly because of the donor's age and the quality and size of the kidneys. Dr. [Edward Cole], who has been a research partner with Dr. [Giuseppe Remuzzi] of Italy, said that one possible problem is that while the lists for older kidneys have been short, ''the more we publicize their potential benefits, the more people will sign up for them, the longer the lists will be'' and ''if you do more double kidneys,'' there will be fewer recipients

One goal is to help her anticipate and react to what friends and other people might say about her new appearance and to adjust to eventual exposure to hordes of photographers and journalists, said Bernard Devauchelle, the surgeon who performed the transplant operation in Amiens with Jean-Michel Dubernard, also a leader of the transplant team, assisting. Two days after the operation, the woman was transferred to the Edouard Herriot Hospital in Lyon where Dubernard and a team of immunologists could monitor her course. Dubernard led the team that performed the first hand-arm transplant in Lyon. The woman's recovery has gone so well that on Wednesday she will be transferred to Amiens, closer to her home, for continuing care with psychiatrists and social workers, Dubernard and Devauchelle said. Medical teams from the two cities will confer daily on her progress, and she is expected to return periodically to Lyon for further immunologic tests

The French team, headed by Dr. Jean-Michel Dubernard of Lyon and Dr. Bernard Devauchelle of Amiens, was loudly applauded after members showed detailed pictures of the procedure and answered technical questions about the experiment that was performed in Amiens in November. The patient, identified as Isabelle Dinoire, 38, was transferred Wednesday to Amiens, near her home, from Lyon. In Lyon, experts at Dr. Dubernard's hospital, which is a leader in immunology, monitored her immuno-suppressive drugs and treated her for one rejection reaction. Some critics also charged that the French doctors were breaching ethics by simultaneously conducting two experiments in the same patient. One experiment was the face transplant. The other was injecting Ms. [Dinoire] with bone marrow that the doctors had taken from the donor in hopes of reducing the amount of antirejection drugs she will need

One goal is to help Ms. Dinoire anticipate and react to what friends and other people might say about her new appearance and to adjust to eventual exposure to hordes of photographers and journalists, said Dr. Bernard Devauchelle, the surgeon who performed the transplant operation in Amiens with Dr. Jean-Michel Dubernard, also a leader of the transplant team, assisting. Before Sunday's visit, Ms. Dinoire had walked around the hospital, often wearing a mask until she took it off two weeks ago. On a brief visit to Amiens last week, Ms. Dinoire stopped to shop, and she was very pleased no one recognized her or saw anything unusual, Dr. [Devauchelle] said. To monitor Ms. Dinoire's progress in gaining new sensation in the transplanted face, the doctors said they were obtaining M.R.I. scans to pick up subtle changes in brain activity as they prick her skin with a pin or touch it with a wad of cotton. An M.R.I. test on Sunday showed that Ms. Dinoire was beginning to gain some sensitivity in her new upper lip. The doctors also plan to use M.R.I. to monitor if and when she will begin to contract muscles to smile, open and close her mouth and make other facial expressions

Two days after the operation Ms. [Dinoire] was transferred to the Edouard Herriot Hospital in Lyon where Dr. [Jean-Michel Dubernard] and a team of immunologists could monitor her course. Dr. Dubernard led the team that performed the first hand-arm transplant in Lyon

Heparin, a short-acting anticoagulant, is given to prevent a recurrent stroke, not to dissolve the offending clot. But giving it can be dicey in the early stages of a stroke because it can help turn a mild ischemic stroke into a devastating bleeding one. Ischemic strokes account for a vast majority of strokes. They occur because the brain is starved of oxygen and other vital nutrients from a clot that forms in a brain artery or that breaks off from a larger artery elsewhere in the body and travels to lodge in a brain artery. Also, a long-term buildup of fats in the walls of brain arteries can narrow the vessels and reduce flow to critically low levels, causing an ischemic stroke. The two categories make it imperative to use CT and M.R.I. imaging scans in the initial care. The distinction between ischemic and hemorrhagic strokes is critical because drugs like T.P.A. and urokinase can rapidly reverse the damage from an ischemic stroke, but giving them for a hemorrhagic stroke is like pouring gas on a fire

The new findings concern only the strain of influenza causing regular seasonal influenza, and not avian influenza or pandemic influenza, said the centers' director, Dr. Julie L. Gerberding. She said 91 percent of the human influenza A (H3N2) virus samples isolated in her agency's laboratories this flu season were resistant to both amantadine and rimantadine. A (H3N2) is this season's dominant strain. The agency's influenza surveillance program studies samples from state health departments. Influenza viruses constantly mutate. One theory is that the A (H3N2) influenza strain suddenly developed a mutation against amantadine and rimantadine. Another theory is that the resistance developed from inappropriate use of the two drugs, which are widely available over the counter in many countries. In the United States, all marketed antiviral drugs effective against influenza require a prescription