Faculty Bibliography

A congressional hearing was told on Jun 15, 1994 that the University of Pittsburgh's own auditors found serious problems at 10% of the hospitals it checked that carried out federally financed breast cancer studies, but the university professors conducting the studies failed to correct them in a timely and constructive manner

A dispute between the Journal of the American Medical Association and the journal Science, published by the American Association for the Advancement of Science, over the validity of findings in a published report about Kaposi's sarcoma is examined. Kaposi's sarcoma is a skin cancer that affects many AIDS patients. The dispute involves an experimental compound, sulfated polysaccharide-peptoglycan, that is believed by some to hold promise for treating the cancer

Two months after suspending entry of new patients into the University of Pittsburgh's flawed breast and rectal cancer studies, federal health officials on Jun 8, 1994 approved resumption of the trials on a limited basis. The breast cancer studies are intended to evaluate the effectiveness of tamoxifen and other chemotherapy for certain groups of patients who have developed breast cancer

The smallpox virus, which was targeted for destruction by Dec 31, 1993, will survive in freezers in Moscow and Atlanta for at least another year. Some scientists oppose the destruction of smallpox because they say study of the virus could yield useful medical knowledge about other diseases

Doctors have long arbitrarily divided lymphomas into two types: Hodgkin's disease and a dozen other forms grouped as non-Hodgkin's lymphomas. Hodgkin's disease is named for Thomas Hodgkin, a 19th century physician in London who distinguished the cancer from tuberculosis. The possibly infectious nature of lymphomas is reflected in their symptoms, including fever, fatigue and weight loss, which can mimic those produced by many infections. But most lymphomas are symptomless in their early stages. Usually, it is a painless swollen lymph node that leads a person to seek medical attention for a lymphoma, which is what happened with [Jacqueline Kennedy Onassis]. This year, 52,900 lymphoma cases (7,900 Hodgkin's and 45,000 non-Hodgkin's lymphoma) will be diagnosed in the United States. Nearly 23,000 of these patients are expected to die from the disease

In contrast to the earlier findings of the FDA, a report from an advisory committee to the NIH said on Jun 2, 1994 that it had found no evidence of wrongdoing in studies of fialuridine, or FIAU, an experimental drug for hepatitis B that led to the deaths of 5 participants. The NIH conducted the experiments, but canceled them in Jun 1993

Internists advanced toward a patient care model based on critical, qualitative, and quantitative assessment of clinical care processes and outcomes. The complete internist must consider social context as well as traditional risk factors in promoting the health of patients

The host response to Mycobacterium tuberculosis is characterized by interactions between mononuclear cells, with recruitment and fusion of these cells culminating in granuloma formation. In addition, the host response to M. tuberculosis requires CD4+ T-cell reactivity, mediated by antigen-independent as well as antigen-dependent mechanisms. Thus, we hypothesized that cell adhesion molecules such as intercellular adhesion molecule 1 (ICAM-1; CD54) would participate in the response to infection with M. tuberculosis. Exposure of THP-1 cells derived from a monocyte/macrophage cell line to M. tuberculosis (1:1 bacterium/cell ratio) elicited a sustained increase (660% +/- 49% above resting level) in the expression of ICAM-1 that continued for at least 72 h. Neither the expression of vascular cell adhesion molecule 1 (VCAM-1; CD106) nor that of the integrins lymphocyte function-associated antigen 1 (LFA-1; CD11a/CD18) or CR3 (CD11b/CD18) was increased to a similar extent at corresponding time points. The increase in ICAM-1 protein expression was accompanied by an increase in steady-state mRNA (Northern [RNA] analysis). Neutralizing monoclonal antibodies directed against tumor necrosis factor alpha but not interleukin 1 alpha or interleukin 1 beta substantially abrogated the response to M. tuberculosis consistent with a paracrine or autocrine response. Continuous upregulation of the expression of ICAM-1 on mononuclear phagocytes induced by M. tuberculosis may mediate the recruitment of monocytes and enhance the antigen presentation of M. tuberculosis, thus permitting the generation and maintenance of the host response

The researchers said they had expected to learn that the most severe damage was in the cortex of Quinlan's brain, the gray outer layer where many higher brainfunctions take place, because autopsies on others in this condition had shown extensive damage in that area. Wide publicity about Quinlan's case in New Jersey prompted a national debate about life support for individuals in the persistent vegetative state. Her landmark case also spurred the development of living wills and similar medical-legal guidelines that allow proxy decisions to be made for people who develop a severe neurological or other illness

The researchers said they had expected to learn that the most severe damage was in the cortex of Quinlan's brain, the gray outer layer where many higher brain functions take place, because autopsies on others in this state had shown extensive damage in that area. Wide publicity about Quinlan's case in New Jersey prompted a national debate about life support for individuals in the persistent vegetative state. Her landmark case also spurred the development of living wills and similar medical-legal guidelines that allow proxy decisions to be made for people who develop a severe neurological or other illness