Faculty Bibliography

Superman Returns [Motion Picture] -- AFTER returning to Earth from an extended sojourn, Superman (Brandon Routh) saves a space shuttle and its carrier jumbo jet from disaster, is assaulted by and prevails over criminals (in an incredibly vivid scene, his invulnerability to bullets is depicted as one is actually flattened by his eyeball), and is attacked by the evil Lex Luthor (Kevin Spacey). Luthor has discovered tiny remnants of Superman's home planet of Krypton that glow an unearthly green and make Superman ultra-vulnerable, and uses them with crystals from Krypton to build an expanding island that threatens to supplant North America. In trying to rid Earth of this island, Superman comes close to death and is brought to Metropolis General Hospital for treatment

For the ideal combination, mix an informed patient with an inquiring physician. Arthur Caplan, chairman of the medical ethics department at the University of Pennsylvania, likes to cite a quote attributed to the ancient Greek physician Galen: 'The best physician is something of a philosopher.' Such a physician does more than 'pose questions,' says Caplan. He 'isn't afraid to have them asked. The process of questioning can lead to understanding and patient satisfaction.' I treated [Brian Morton] for high blood pressure with a diuretic and a pill, Diovan, that dilates arteries. But when I began raising his Diovan dose in response to high readings -- ranging from 160 to 180 systolic pressure over 100 to 110 diastolic pressure (normal is generally considered less than 130 over 85) -- he was uneasy. Concerned about the potential side effects of higher doses, including fatigue and dizziness, he began to measure the pressure himself and record the values at home. The readings he got were consistently lower, 120 to 140 over 80 to 90. In the meantime, my patient's cholesterol readings remain high. After reading a news report about two patients suing Pfizer over pain, weakness and memory loss they claim was caused by Lipitor, she shot me an e-mail, saying such complaints are 'exactly what concerns me about the drug du jour.' Still, she is also more concerned about her cholesterol than before. On my end, there is a growing appreciation of her right to choose as well as her intuitive wisdom regarding her health

David Oshinsky reviews the books "The Great Deluge: Hurricane Katrina, New Orleans, and the Mississippi Gulf Coast" by Douglas Brinkley and "Breach of Faith: Hurricane Katrina and the Near Death of a Great American City" by Jed Horne

THIS made-for-TV movie stars Scott Bairstow as Jute, one of the few humans left in a world run by androids. After killing an android in a bar fight, Jute is sentenced to a prison deep in the wasteland. Another android, DeeCee (played by Joseph Lawrence), is responsible for bringing him to the prison camp, but instead helps him escape. As they spend time together, DeeCee becomes more and more human- like, which is ultimately explained by the fact that android brains are made using human brain fluid. In his growing empathy, DeeCee even goes so far as to allow his hand to be amputated to free Jute from the shackle that binds them together

Tests at George Washington University Hospital found that Mr. Cheney's cardiac pacemaker was working properly and had not been activated due to arrhythmia, or irregular heartbeat, said Mr. Cheney's spokeswoman, Lea Anne McBride. Mr. Cheney, 65, has had four heart attacks, the first when he was 37 and the fourth on Nov. 22, 2000, in the thick of the dispute between former Vice President Al Gore and President Bush over the outcome of the 2000 presidential election. Mr. Cheney has also had quadruple heart bypass surgery and two angioplasties, procedures to clear blockages in the arteries

Factors influencing tuberculosis cluster growth are poorly understood. The authors examined clusters of two or more culture-confirmed Mycobacterium tuberculosis cases between January 1, 2001, and December 31, 2003, that had insertion sequence 6110 (IS6110) restriction fragment length polymorphism and spoligotype patterns identical to those of another study case. Genotypes first seen in New York, New York, before or during 1993 were considered historical; recent strains were those first seen after 1993. The authors examined the effect of the combined characteristics of infectiousness of the first two cases in a cluster on the rate of cluster growth. Genotyping was performed for 2,408 (91.8%) of the 2,623 tuberculosis cases diagnosed; 873 cases were in 212 clusters. Thirty-one clusters had historical strains, 153 were recent, and 28 were of unknown period. Patients' infectiousness was not associated with the rate of cluster growth among historical strain clusters. Among recent strain clusters, infectiousness of both of the initial cases was associated with a higher rate of cluster growth compared with clusters in which neither initial case was infectious, upon adjustment for male sex (rate ratio = 2.62, 95% confidence interval: 1.19, 5.78). The rate of genotype cluster growth should be monitored regardless of how long the strain has been present in the community. However, infectiousness in the first two cases may be useful to prioritize genotype cluster investigations

Many lines of evidence implicate mitochondria in phenotypic variation: (a) rare mutations in mitochondrial proteins cause metabolic, neurological, and muscular disorders; (b) alterations in oxidative phosphorylation are characteristic of type 2 diabetes, Parkinson disease, Huntington disease, and other diseases; and (c) common missense variants in the mitochondrial genome (mtDNA) have been implicated as having been subject to natural selection for adaptation to cold climates and contributing to "energy deficiency" diseases today. To test the hypothesis that common mtDNA variation influences human physiology and disease, we identified all 144 variants with frequency >1% in Europeans from >900 publicly available European mtDNA sequences and selected 64 tagging single-nucleotide polymorphisms that efficiently capture all common variation (except the hypervariable D-loop). Next, we evaluated the complete set of common mtDNA variants for association with type 2 diabetes in a sample of 3,304 diabetics and 3,304 matched nondiabetic individuals. Association of mtDNA variants with other metabolic traits (body mass index, measures of insulin secretion and action, blood pressure, and cholesterol) was also tested in subsets of this sample. We did not find a significant association of common mtDNA variants with these metabolic phenotypes. Moreover, we failed to identify any physiological effect of alleles that were previously proposed to have been adaptive for energy metabolism in human evolution. More generally, this comprehensive association-testing framework can readily be applied to other diseases for which mitochondrial dysfunction has been implicated.

The radio frequency ablation segmentation tool (RFAST) is a software application developed using the National Institutes of Health's medical image processing analysis and visualization (MIPAV) API for the specific purpose of assisting physicians in the planning of radio frequency ablation (RFA) procedures. The RFAST application sequentially leads the physician through the steps necessary to register, fuse, segment, visualize, and plan the RFA treatment. Three-dimensional volume visualization of the CT dataset with segmented three dimensional (3-D) surface models enables the physician to interactively position the ablation probe to simulate burns and to semimanually simulate sphere packing in an attempt to optimize probe placement. This paper describes software systems contained in RFAST to address the needs of clinicians in planning, evaluating, and simulating RFA treatments of malignant hepatic tissue.

Prostatitis is a common urologic diagnosis. Although treatment algorithms are available for this poorly understood entity, several adaptations must be made in order to accommodate the therapeutic needs of HIV-positive patients. The most important consideration when treating HIV-infected patients for prostatitis is their current immune status, whether they are immunocompromised or not (non-progressive disease or reconstituted with highly active antiretroviral therapy). A treatment algorithm for those with chronic bacterial prostatitis (Category II), chronic nonbacterial prostatitis (Category IIIA), and prostatodynia (Category IIIB) is presented in this article. In the HIV-positive patient population, there is a greater likelihood for atypical pathogens including fungi, tuberculosis, anaerobes, and viruses. Because the HIV-infected patient is at increased risk for the development of prostatic abscess and urosepsis than the general population, increased monitoring and evaluation and longer-term appropriately directed antimicrobial therapy are required.