Faculty Bibliography

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

Functioning parathyroid adenomas of the oxyphil cell type are rare, and the clinical characteristics of patients with these tumors have not been well defined. We describe two cases of severe primary hyperparathyroidism (PHPT) caused by benign oxyphil parathyroid adenomas. The patients' clinical presentations mimicked parathyroid carcinoma. Both had very large tumors associated with marked elevations in PTH and serum calcium levels. Skeletal manifestations were also atypical for benign PHPT, with severe osteoporosis in one patient and osteitis fibrosa cystica in the other. These cases also highlight the remarkable capacity of the skeleton to recover after successful parathyroidectomy, previously reported in other forms of severe PHPT. Bone mineral density improved dramatically 1 yr after parathyroidectomy, with increases of 51% at the lumbar spine, 36% at the total hip, and 11% at the distal one third radius. Most of the increases occurred in the first postoperative months. Consistent with this early and accelerated skeletal response, markers of bone turnover were increased 2 months after surgery and normalized by 8 months postoperatively. In patients with PHPT who present with severe or atypical clinical features, oxyphil adenoma should be considered.

According to recent research, interactions between infant health and environment can play crucial roles in clustering health and economic disadvantage among certain families. Researchers have provided a clear example of such intergenerational biosocial cycles when they document that interactions between parental low birth weight status and prenatal environment are associated with the risk of a low birth weight, and that interactions between a child's birth weight status and early childhood environment are associated with adult socioeconomic outcomes. In this article, we consider how existing policies may be revised to more effectively address such interactions between social and biological risk categories. We are particularly concerned in this discussion with revising risk categories so they can encompass biological risk, social risk, and developmental frameworks. A framework of biosocial risk is quite flexible and may be applied to a variety of issues and programs; however, in this article we focus on the single case of low birth weight to illustrate our argument. In considering specific applications, we further explore how attention to biosocial interactions may reshape Medicaid, special education, the Earned Income Tax Credit, and Temporary Assistance for Needy Families

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

Intermittent clamping of the porta hepatis (PHC) is commonly performed during liver surgery to reduce blood loss and has been reported to precondition livers resulting in improved outcome after liver surgery (humans) and transplantation (animals). This study investigated the early expression of cytoprotective stress proteins during ischemia-reperfusion induced by PHC. Liver samples were taken before and after each event in a two-cycle ischemia-reperfusion protocol using 15 minutes of PHC followed by 5 minutes of reperfusion. Liver tissue was analyzed by real-time polymerase chain reaction for heme oxygenase (HO)-1 and heat shock protein (HSP)-70 mRNA expression. Extracted protein was analyzed by Western blot for HO-1, and HSP-70 and nuclear extracts were analyzed by DNA mobility shift assay for hypoxia inducible factor (HIF)-1alpha and heat shock factor (HSF)-1. Within minutes of PHC, significant increases in HO-1 mRNA expression were detected, and these were maintained throughout the protocol (P < 0.01). Protein expression of HO-1 (P < 0.03) and HO-1 activity (P < 0.05) were similarly increased between the start and end of ischemia- reperfusion (40 minutes). Binding of active HIF-1alpha to its consensus sequence was increased within 15 minutes of the start of the ischemia-reperfusion cycle. Although evidence of the transcriptionally active form of HSF-1 was detected at the same time point, this was not reflected in measurable changes in HSP-70 mRNA or protein. In conclusion, expression of the cytoprotective protein HO-1 is significantly up-regulated in the liver within minutes of PHC. It is likely that HO-1 contributes to the early protective effects of ischemic preconditioning.

[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