Faculty Bibliography

Treatment with the somatostatin receptor (sst) subtype 2 predominant analogs octreotide and lanreotide induces clinical and biochemical cure in approximately 65% of acromegalic patients. GH-secreting pituitary adenomas, which are not controlled, also express sst(5). We compared the acute effects of octreotide and SOM230, a new somatostatin analog with high affinity for sst(1,2,3,5) on hormone release in acromegalic patients. In a single-dose, proof-of-concept study, 100 microg octreotide and 100 and 250 microg SOM230 were given s.c. to 12 patients with active acromegaly. Doses of 100 and 250 microg SOM230 dose-dependently suppressed GH levels from 2-8 h after administration (-38 +/- 7.7 vs. -61 +/- 6.7%, respectively; P < 0.01). A comparable suppression of GH levels by octreotide and 250 microg SOM230 was observed in eight patients (-65 +/- 7 vs. -72 +/- 7%, respectively). In three patients, the acute GH-lowering effect of 250 microg SOM230 was significantly superior to that of octreotide (-70 +/- 2 vs. -17 +/- 15%, respectively; P < 0.01). In one patient, the GH-lowering effect of octreotide was better than that of SOM230. Tolerability for SOM230 was good. Glucose levels were initially slightly elevated after octreotide and SOM230, compared with control day, whereas insulin levels were only significantly suppressed by octreotide. We conclude that SOM230 is an effective GH-lowering drug in acromegalic patients with the potential to increase the number of patients controlled during long-term medical treatment.

The official, Dr. Klaus Stohr, said that on Friday his agency learned that initial genetic tests showed that the A(H5N1) strain was resistant to the less expensive class of anti-influenza virals. The class includes amantadine (Symmetrel) and rimantadine (Flumadiine). The number of human cases is small, and the A(H5N1) strain contains only avian genes. But WHO officials said they were concerned that the bird strain might pick up genes from a human virus to create an entirely new virus that could spread easily among people. It would take a combination of events, each of low probability, to produce a large outbreak. But the health agency said the implications for public health were so important that precautionary measures must be taken. Knowing that anti-influenza drugs may be needed in an outbreak of human bird flu and as part of the surveillance process, laboratories in the network have been testing the A(H5N1) strain's susceptibility to the small number of such drugs. The tests are being done at the Centers for Disease Control in Atlanta, and in London and in Hong Kong

The Central African Republic, polio-free since 2000, has confirmed a new case, the World Health Organization said

Developing a vaccine is a complex process. Because the H5N1 strain kills chickens, scientists cannot use chicken eggs to make the vaccine, as they do for human strains of influenza virus. Instead, scientists working with the health agency in London, at the Centers for Disease Control and Prevention in Atlanta, and elsewhere are using a newer laboratory technique known as reverse genetics. The tests clearly indicate that the viruses from Vietnam and South Korea are very closely related, said Dr. Klaus Stohr, a WHO influenza expert. But he said the two viruses were distinct from the strain found in Hong Kong last year. In 1997, that strain infected 18 people in Hong Kong, killing 6; it was found in duck meat in South Korea in 2001

I had ordered a CT scan on 'Mr. Azziz' during a routine physical because he was a smoker. I had always reassured smokers that the test was routine, that a CT scan was more sophisticated than an X- ray in analyzing a smoker's lungs. But knowing that a CT scan or other state-of-the-art test could tell the future made many patients anxious, worrying about the results. I decided to show the CT scan to my office mate, a prominent pulmonologist. He crisply snapped the scan up onto his view box. This type of precision and ease at looking at potential cancers could frighten a patient if he saw it. The report already had the words 'suspicious for a bronchogenic neoplasm' written on it. Like the lung doctor, the radiologist who had interpreted the X-ray was pronouncing sentence on a man he'd never met. The technology told your future and could take away your hopes and plans with a single verdict

New tests have turned up a disturbing problem with the avian influenza virus that is spreading in Asia: The strain appears resistant to one of the two main classes of drugs used to fight influenza viruses, a World Health Organization official said Saturday. The number of human cases is small, and the A(H5N1) strain contains only avian genes. But WHO officials said they were concerned that the bird strain might pick up genes from a human virus to create an entirely new virus that could spread easily among people. It would take a combination of events, each of low probability, to produce a large outbreak. But the health agency said the implications for public health were so important that precautionary measures must be taken. [Klaus Stoehr] said that Friday night, his agency learned that initial genetic tests showed that the A(H5N1) was resistant to the less expensive class of anti-influenza virals. The class includes amantadine (Symmetrel) and rimantadine (Flumadine)

The number of human cases is small, and the A(H5N1) strain contains only avian genes. But W.H.O. officials are concerned that the bird strain might exchange genes with a human virus to create an entirely new virus that could spread easily among people. It would take a combination of events, each of low probability, to produce a large outbreak. But the health agency said the implications for public health were so important that precautionary measures must be taken. Knowing that anti-influenza drugs may be needed in an outbreak of human bird flu, and as part of the surveillance process, laboratories in the network have been testing which of a small number of such drugs may be effective against the A(H5N1) strain. The tests are being done at the C.D.C. in Atlanta, in London and in Hong Kong. Taiwan has reported that a different strain of avian influenza, A(H5N2), is causing mild illness among poultry. Tests show that the strain's genes are closely related to those in a vaccine that is widely used for poultry in Hong Kong and China, Dr. [Klaus Stohr] said. He said that one possibility was that the Taiwan bird cases were from a poor-quality vaccine

P/>New tests have turned up a disturbing problem with the avian influenza virus that is spreading in Asia: The strain appears resistant to one of the two main classes of drugs used to fight influenza viruses, a World Health Organization official said Saturday.<P/>Meanwhile, the strain, A(H5N1), has been detected among birds in a sixth Asian country, Cambodia, and two more human cases have been diagnosed in a new area of Vietnam, said the official, Dr. Klaus Stoehr.<P/>Both Vietnamese cases were in children in Ho Chi Minh City, bringing to seven the total in that country. Six have been fatal. Five earlier Vietnamese cases were in Hanoi.<P/> Thailand has reported two fatal human cases.<P/>All the human cases are believed to be from contact with chickens or their waste, not from eating them or their eggs