Faculty Bibliography

According to an autopsy performed on the brain of Karen Ann Quinlan, who died in a coma in 1985, 10 years after her family won a landmark court battle to remove her from a respirator, the major damage to her brain that caused her to fall into a persistent vegetative state was to the thalamus, not the cortex

The researchers said they had expected to learn that the most severe damage was in the cortex of [Julia Quinlan]'s brain, the gray outer layer where many higher brain functions 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. Quinlan, who was put on life support after an accident that left her in a persistent vegetative state, survived in a coma for 10 years after her family won a court battle to have the respirator removed. Wide publicity about Quinlan's case in New Jersey prompted a 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 [Karen Ann Quinlan]'s brain, the grey outer layer where many higher brain functions take place, because autopsies on others in this state had shown extensive damage in that area

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. Through such tests, lymphomas are often divided into T-cell and B-cell types. Tests showed that Mrs. [Jacqueline Kennedy Onassis]' lymphoma was of neither type and that it was Ki-1, which is named for Kiel, Germany, where the test was developed. Attempts to correlate such markers with specific therapies for lymphomas is a promising area of research. But Mrs. Onassis' rapid demise clearly shows that there is a long way to go in cancer research. 'A Cancer's Rise' shows incidence and mortality rate of cases of non-hodgkin's lymphoma andHodgkin's disease from '73-'90. (Source: American Cancer Society, 'The Human Body,' Arch Cape Press) (pg. C3)

Experts are stymied about why this should be. But three factors can explain part of the overall rise. One is HIV, the virus that causes AIDS, which somehow increases the risk of lymphoma. A second is the growing number of people with transplanted organs, who are at increased risk for developing lymphoma because of the immunosuppressant drugs used to prevent rejection of donated organs. A third is improved diagnostic techniques

These diseases join a list that includes, among others, AIDS, legionnaire's disease, Lyme disease, Lassa fever and bleeding and fever from the Ebola and Marburg viruses. Some were unknown or minor hazards only a decade or two ago. Others increased significantly in incidence over the last 20 years. Still others threaten to become bigger hazards in the near future. Successful surveillance hinges on the accuracy of statistical analyses, and they hinge on the accuracy of reports that doctors and hospitals are supposed to mail to local health departments about specified infections. But many diseases are notoriously underreported in the United States.One of the most astonishing discoveries in recent years is that a bacterium, Helicobacter pylori, can cause ulcers and other stomach ailments including possibly some forms of stomach cancer. Last February, the bacterium's causative role for ulcers was given widespread acceptance by a government-appointed panel of experts that made antibiotics a required component of ulcer treatment. Scientists in the United States and South Africa have reported evidence linking a microbe, Chlamydia pneumoniae, to coronary artery disease. C. pneumoniae, which is also known as TAWR, is a common cause of pneumonia, bronchitis and sinusitis. The findings suggest but do not prove a link between C. pneumoniae infections and atherosclerosis, the underlying cause of heart attacks

Jacqueline Kennedy Onassis returned to her apartment on Fifth Avenue last Wednesday, after doctors at New York Hospital-Cornell Medical Center had found that cancer had spread to her liver and had told her there was nothing more they could do for her. Aggressive therapy, including antibiotic treatment of pneumonia that she developed early that week, was halted in keeping with the wishes she had expressed in a living will, a health worker familiar with her care said. Non-Hodgkin's lymphoma is a painless enlargement of lymph tissue that can damage the immune system and be fatal if unchecked. Non-Hodgkin's lymphoma is more common than Hodgkin's disease, another disease involving the lymph nodes, and it can be more difficult to treat. About 45,000 people in the United States will be diagnosed as having non-Hodgkin's lymphoma this year, and about 21,200 will die, according to the American Cancer Society. Fifty-two percent of those diagnosed will live at least five years, the society said. The lymphoma may be treated with chemotherapy, radiation or both

The type of cancer of the lymph system that [Jacqueline Kennedy Onassis] had, non-Hodgkins lymphoma, is often treatable for years, and she had been reported to be responding well to treatment. As recently as Sunday, Onassis was seen walking in Central Park. But the health worker said she had been unable to walk very far and had needed to be supported by her companion, Maurice Tempelsman. Onassis' condition was diagnosed in the winter. And in recent weeks, the health care worker said, she had been receiving radiation therapy to her brain, after the cancer was found to have spread there. She had also received chemotherapy directly into the brain. The cancer elsewhere in her body had initially responded to standard chemotherapy, including steroids, the health care worker said, but more recently had spread through her body. The health worker spoke out of concern that a mistaken impression of the care Onassis had received at New York Hospital-Cornell Medical Center might have resulted from statements made earlier this week by Nancy Tuckerman, a spokeswoman for Onassis. Tuckerman had been quoted as saying: 'She's fine. She goes in for routine visits, routine treatment. That's what this is.'

The type of cancer of the lymph system that Mrs. [Jacqueline Kennedy Onassis] had, non-Hodgkins lymphoma, is often treatable for years, and she had been reported to be responding well to treatment. As recently as Sunday, Mrs. Onassis was seen walking in Central Park. But the health worker familiar with her her care said she was unable to walk very far and needed to be supported by her companion, Maurice Tempelsman. Her condition was diagnosed in the winter, and in recent weeks, the health care worker said, she had been receiving radiation therapy to her brain, after the cancer was found to have spread there. She was also receiving chemotherapy directly into the brain. The cancer elsewhere in the body had initially responded to standard chemotherapy, including steroids, the health care worker said, but more recently had been found to have spread through her body. The health worker spoke out of concern that a mistaken impression of the care Mrs. Onassis had received at New York Hospital-Cornell Medical Center might have resulted from statements made earlier this week by Nancy Tuckerman, a spokeswoman for Mrs. Onassis. Tuckerman was quoted as saying: 'She's fine. She goes in for routine visits, routine treatment. That's what this is.'