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Bird flu is highly lethal, having killed 32 of the 44 people previously confirmed to have caught it this year, all in Thailand and Vietnam. But the tests from Japan confirm reports that the virus can also cause infection that produces mild symptoms or none. Such findings have come from tests of farmers and health workers exposed to the A(H5N1) virus in an outbreak in Hong Kong in 1997, and a different type of avian influenza in the Netherlands in 2003. Scientists at the National Institute of Infectious Diseases in Tokyo had to adapt laboratory tests developed elsewhere to detect antibodies to A(H5N1) virus in humans. The more sophisticated tests were needed because the level of antibodies of the virus that humans form is much lower than the level formed in response to the regular human influenza, [Klaus Stohr] said. Because the tests involve live viruses, they must be conducted in a laboratory with tight biological security, he said. Scientists also must confirm the findings by using tests validated by other laboratories

The first successful organ transplant recipient was a 23-year- old man from Northboro, Massachusetts named Richard Herrick, who had just been discharged from the Coast Guard. On Dec. 23, 1954, he received a kidney from his healthy identical twin brother, Ronald, in an operation performed at what is now Brigham and Women's Hospital in Boston. Richard survived for eight years until the original kidney disease destroyed his new organ. Over the years, the biggest obstacle facing patients and surgeons has been the rejection of transplanted organs. Several years after Herrick's surgery, doctors began using anti-rejection drugs like azathioprine and, later, cyclosporine. In the early 1990s, [Thomas Starzl] and other transplant surgeons noticed that some patients who did not take their drugs regularly or at all were able to keep their donated organs. Perhaps the most disputed frontier in transplantation science is the face transplant, a procedure that surgeons say is now within their capabilities and that raises complex ethical questions extending even beyond identity and appearance. Ethics committees in England and France have rejected proposals to perform face transplants because of the unknown risks of long-term use of large doses of immunosuppressive drugs for a procedure that does not save lives. But in October, an institutional review board that oversees the safety of human experiments at the Cleveland Clinic became the first such group to approve a face transplant

The tests from Japan confirm reports that the virus can also cause infection that produces mild symptoms or none. Such findings have come from tests of farmers and health workers exposed to the A(H5N1) virus in an outbreak in Hong Kong in 1997, and a different type of avian influenza in the Netherlands in 2003. Scientists at the National Institute of Infectious Diseases in Tokyo had to adapt laboratory tests developed elsewhere to detect antibodies to A(H5N1) virus in humans. The more sophisticated tests are needed because the level of antibodies of the virus that humans form is much lower than the level formed in response to the regular human influenza, Dr. [Klaus Stohr] said. because the 58 people whose blood was tested were a tiny fraction of workers exposed to the A(H5N1) virus, they did not represent a scientifically valid random sample, Dr. Stohr said, and firm conclusions about the frequency of symptomless infections cannot be drawn. More information may come from tests to be done on 1,200 blood samples obtained in Korea and hundreds more in China, Thailand and Vietnam

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Thursday, Dec. 23, will be the 50th anniversary of the first successful organ transplant, a kidney transplant from a living donor performed in Boston in 1954. Mr. [Robert Phillips] and a small number of other long-term survivors attest to how well organ transplants can work in the best cases. A face transplant could also raise unrealistic hopes, experts say. No guarantee exists that the transplant recipient will look normal. The new face could worsen the appearance and reduce facial expression. A face transplant could be technically successful but leave the recipient and the family dissatisfied. At the same time, a successful transplant may send a message that disfigured people who do not choose to have transplants cannot have a high quality of life. Robert Phillips has lived almost 42 years since a kidney transplant. (Photo by Steve Ruark for The New York Times); [Richard Herrick], front left, recipient, and Ronald Herrick, donor, with the surgical team after the 1954 kidney transplant. (Photo by Courtesy of Brigham and Women's Hospital); The first successful organ transplant took place on Dec. 23, 1954, when Richard Herrick received a kidney from his healthy identical twin brother, Ronald. Richard survived for eight years until the original kidney disease struck again. (Photo by Courtesy of Brigham and Women's Hospital)(pg. F7); (Illustrations by Al Granberg, Alain Delaqueriere/The New York Times)(pg. F1)

In October, the nation's expected supply of influenza vaccine was suddenly cut in half when the British government suspended the manufacturing license of the Chiron Corporation, an American biotechnology company, because of contamination at its factory in Liverpool, England. Chiron, one of two major manufacturers of the vaccine for Americans, had been expected to supply nearly 50 million doses. The C.D.C. responded by limiting use of the vaccine to the vulnerable groups. Health officials still consider those groups a priority for influenza vaccine. But midseason estimates of vaccination rates are below those of last season for adults in the priority groups, said Dr. Julie L. Gerberding, the director of the centers

Not at all, each said, though their relationship was unusual in two ways. First, they were friends before Mr. [John Edwards] became Dr. Edmundson's patient. Second, because of Mr. Edwards's good health, Dr. Edmundson had not yet needed to treat Mr. Edwards since 1998, when he had an attack of vertigo. Dr. Edmundson met Mr. Edwards when their daughters were on a soccer team in Raleigh that Mr. Edwards coached. In the mid-1990's, one of Dr. Edmundson's partners, who was retiring, asked him to take on one of his patients. Mr. Edwards may have been among those who got extra tests. Dr. Edmundson said that when Mr. Edwards once fainted in 1996, two years before he was Dr. Edmundson's patient, a neurologist found no serious medical reason for the episode and Mr. Edwards was then referred to a cardiologist. It was a more extensive work-up than ''most people would have because he was a famous trial lawyer,'' Dr. Edmundson said

The W.H.O., a United Nations agency based in Geneva, has been warning about the potential for the A(H5N1) strain of avian influenza virus (known popularly as bird flu) to mutate and cause the next pandemic. The virus has spread widely among bird populations in Southeast Asia. Dr. Malik Peiris, a top influenza researcher at Hong Kong University, said Dr. [Shigeru Omi]'s range of possible death tolls was realistic and consistent with research into the A(H5N1) avian influenza virus. ''H5N1 in its present form has a pretty lethal effect on humans,'' he said. No significant quantities of vaccine are likely to be available until five or six months after the virus becomes a pandemic, Dr. Omi said. The virus is constantly evolving, and manufacturers will not want to commit themselves to large-scale production of a vaccine that may prove worthless if the virus evolves further before starting a pandemic, he said

Dr. [John R. Vane], a British pharmacologist who shared a Nobel Prize for clarifying how Aspirin works and helping to expand its use, died last Friday in Farnborough, England, the University of London reported. He was 77 and had been in failing health since he underwent heart surgery two years ago. Vane shared the Nobel Prize in physiology or medicine in 1982 with Sune K. Bergstrom and Bengt I. Samuelsson, both of the Karolinska Institute in Stockholm, Sweden. Vane worked at the Wellcome Research Foundation in England. The Nobel committee cited Vane for identifying the secret of Aspirin's ability to reduce fever, pain and inflammation and said he made 'the fundamental discovery' that Aspirin almost completely blocks the formation of prostaglandins and a related substance, thromboxane

[John R. Vane]'s research with Aspirin, already the most widely used drug in the world, also helped advance new therapies for heart and blood vessel disease and contributed to the development of two classes of widely prescribed drugs, the cox-2 inhibitors for pain and inflammation and the ACE inhibitors in blood pressure. Vane shared the Nobel Prize in physiology or medicine in 1982 with Sune K. Bergstrom and Bengt I. Samuelsson, both of the Karolinska Institute in Stockholm. Vane worked at the Wellcome Research Foundation in England. The Nobel committee cited Vane for identifying the secret of Aspirin's ability to reduce fever, pain and inflammation and said he made 'the fundamental discovery' that Aspirin almost completely blocks the formation of prostaglandins and a related substance, thromboxane