Faculty Bibliography

'It was like ignoring half of it on purpose,' Dr. [Catherine Wilfert] said. Because her name was on the masthead, 'it implied that I agreed with it, when I didn't

The Nobel Prize in Physiology or Medicine was awarded yesterday to Dr. Stanley B. Prusiner, a 55-year-old maverick scientist in San Francisco whose discoveries about infectious particles called prions have been criticized by other researchers as unproved. The Nobel committee compounded its departure from the tradition of rubber stamping well-accepted scientific work by awarding the prize to only one researcher, emphasizing its confidence in Dr. Prusiner's discovery of a ''new genre of disease-causing agents.'' These agents, neither bacteria nor fungi nor viruses, are proteins and have been linked to mad cow disease and other lethal brain-wasting conditions. The committee cited Dr. Prusiner for discovering the rogue prion proteins as ''a new biological principle of infection'' and adding them ''to the list of well-known infectious agents.'' But some scientists doubt that they can cause disease because unlike other infectious agents, they contain no genetic material

At the same time, they cast new light on persistent questions about Mr. Reagan's mental state as President, questions rekindled by the disclosure, in November 1994, that he had Alzheimer's. Nearly 70 when he took office in 1981, Mr. Reagan became the oldest President, and throughout his two terms, a series of well-publicized memory lapses and a casual executive style had provoked uncertainty -- even ridicule -- about his mental competence. Mr. Reagan ''absolutely'' did not ''show any signs of dementia or Alzheimer's,'' said Dr. John E. Hutton Jr., who cared for him from 1984 until the end of his Presidency and remains a close family friend. Extensive mental-status tests did not indicate evidence of Alzheimer's until 1993, more than four years after Mr. Reagan left office, Dr. Hutton said. Dr. Lawrence C. Mohr, one of the White House doctors in Mr. Reagan's second term, was seeing him for the first time in six months, and afterward, the doctor and the former President talked. As usual, Mr. Reagan asked about Dr. Mohr's family. But Mr. Reagan ''was distant,'' he said, and seemed ''preoccupied, which was unusual, because Ronald Reagan is a person who was engaged when he would talk to you.''

IN FEBRUARY 1996, George Shultz went to visit his old boss, Ronald Reagan, at the former president's home in the Bel Air neighborhood of Los Angeles. That night Shultz, the former secretary of state, received a call from Mrs. Reagan, who told him that 'something poignant happened today that you would like to know about.' At one point in the visit, Reagan had left the room briefly with a nurse. When they came back, Mrs. Reagan went on, 'he said to the nurse: `Who is that man sitting with Nancy on the couch? I know him. He is a very famous man.' '

Dr. Alfred D. Hershey, who used a household blender to do experiments that made him a Nobel laureate by proving that DNA is the molecule that carries genetic information, died on Thursday at his home in Syosset, N.Y. He was 88. Dr. Hershey, who did much of his work at the Cold Spring Harbor Laboratory on Long Island, shared a Nobel Prize in 1969 with Dr. Salvador E. Luria and Dr. Max Delbruck for their work in discoveries concerning the genetic structure of viruses and how they replicate, which provided new insights into viral diseases and inheritance. By the time he was honored by the Swedish Nobel Committee, Dr. Hershey had been engaged in his field of research for decades. Indeed, when he won his prize, other scientific leaders said that without his work, Dr. James D. Watson and Dr. Francis H. C. Crick would not have been able to accomplish their own work for which they had been awarded a Nobel seven years earlier: development of their helix model of DNA, which determined its molecular structure

Large-cell change of hepatocytes (LCC), also called liver cell dysplasia of large-cell type, is a set of cytologic changes comprising nuclear and cytoplasmic enlargement, nuclear pleomorphism, and multinucleation. This entity is encountered frequently on histologic or cytologic examination of specimens obtained from livers with a variety of chronic diseases and originally was thought to have a premalignant nature. Accumulating evidence, however, now suggests that LCC is merely a reactive change. Having often observed LCC in liver specimens with chronic biliary tract disease, that is, in livers where cholestasis preceded hepatocyte injury, we surmised that LCC may be a result of prolonged cholestasis. To determine whether there was any association between LCC and cholestasis, we examined microscopically a series of 400 nodules from 40 consecutive adult cirrhotic livers, resected on transplantation, and graded LCC and cholestasis semiquantitatively. LCC was present diffusely in cirrhotic nodules of 25 specimens (62.5%). Nine additional specimens (22.5%) had focal mild LCC. Usually, LCC and cholestasis occurred together, in the same cirrhotic nodules and in the same areas of nodules. There was a statistically significant association between the presence and grade of LCC and those of cholestasis (p < 0.0001; chi-square test). Within etiological categories of cirrhosis (chronic hepatitis; n = 28; alcoholic liver disease; n = 6; biliary disease: n = 6), the significance was maintained. We conclude that, in cirrhosis of different etiologies, LCC may represent a reactive change that results from prolonged cytoplasmic cholestasis

Twenty-six patients with Grade III acromioclavicular joint separations were evaluated to determine the outcomes of nonoperative and operative management. Evaluation consisted of a detailed functional questionnaire, physical examination, and comprehensive isokinetic strength assessment. The patients were divided into two groups: operative (n = 16) and nonoperative (n = 10). Operative management consisted of coracoclavicular stabilization with heavy suture material and with nine of the sixteen patients treatment also consisted of coracoacromial ligament transfer and lateral clavicle resection. Nonoperative management consisted of short-term immobilization with early range of motion and rehabilitation. The two groups were similar in all characteristics except mean age: 30.7 years for the operative group and 49.6 years for the nonoperative group. Follow-up evaluation was performed an average of 32.9 months after either injury (nonoperative group) or surgery. Our results indicated that nonoperative management was superior to operative management with respect to time to return to work (0.8 months vs. 2.6 months), time to return to athletics (3.5 months vs. 6.4 months) and time of immobilization (2.7 weeks vs. 6.2 weeks). However, operative management was superior to nonoperative management in the following parameters: time to attain completely pain-free status, the patient's subjective impression of pain, range of motion, functional limitations, cosmesis, and long-term satisfaction. There were no significant differences between the two groups with respect to shoulder range of motion, manual muscle testing, or neurovascular findings. Isokinetic strength testing of the involved shoulder, expressed as a percentage of the uninvolved shoulder, showed no significant differences in peak torque, total work, or total power between the operative and nonoperative groups. However, comparison of the involved to the uninvolved extremity within each group did reveal a trend toward decreased peak torque, work, and power for abduction in the involved extremity regardless of the treatment used. These findings reached statistical significance only for power at the slower testing speed (60 degrees/sec). There was also a significant decrease in power in the involved extremity for external rotation at the faster speed (120 degrees/sec) in the nonoperative group. Finally, the absolute values for peak torque, work, and power were significantly greater for all motions tested in the operative group as compared to the nonoperative group. This may reflect the difference in age between the two groups. Based upon the patients studied, there are benefits to both nonoperative and operative methods of treatment of Grade III acromioclavicular separations. Recovery of strength did not differ between the two groups and therefore should be viewed as a less important factor in patient selection for operative versus nonoperative management. Careful patient selection should remain an important aspect of treatment for this controversial injury