Faculty Bibliography

The baby in the Dallas case was Jeanella Aranda, who had surgery on July 16 for a noncancerous liver tumor called a hamartoma. According to legal documents filed by the family's malpractice lawyer, Steven Laird of Fort Worth, damage to blood vessels during the surgery cut off the blood supply to the liver, and doctors, unable to repair the damage, had to remove Jeanella's liver. Without a transplant, she would die within 24 to 48 hours. Her parents, Cesar and Alicia Aranda, were told that one of them might be able to donate a partial liver to save their daughter. Their blood was drawn to see which parent matched Jeanella's Type O. The laboratory initially reported that Mrs. Aranda matched, but then called back to say it had made a mistake and Mr. Aranda matched. In fact, the first result was correct -- Mrs. Aranda matched -- but doctors accepted the second, incorrect report. In the days and weeks after the transplant, Jeanella deteriorated, developing a blood disorder, fever, kidney problems, lung hemorrhages and severe jaundice. The blood type mismatch was not detected until Aug. 5, 19 days after the surgery, when Mrs. Aranda, aware that her husband had Type A blood, noticed that Jeanelle's transfusions were Type O, and asked whether the transplant had been a mismatch. Doctors determined that she was correct. The baby died the next day

The baby in the Dallas case was Jeanella Aranda, who had surgery on July 16 for a noncancerous liver tumor called a hamartoma. According to legal documents filed by the family's malpractice lawyer, Steven Laird of Fort Worth, damage to blood vessels during the surgery cut off the blood supply to the liver, and doctors, unable to repair the damage, had to remove Jeanella's liver. Without a transplant, she would die in 24 to 48 hours. Her parents, [Cesar Aranda] and Alicia Aranda, were told that one of them might be able to donate a partial liver to save their daughter. Their blood was drawn to see which parent matched Jeanella's Type O. The laboratory initially reported that Mrs. Aranda matched, but then called back to say it had made a mistake and Mr. Aranda matched. In fact, the first result was correct -- Mrs. Aranda matched -- but doctors accepted the second, incorrect report. In the days and weeks after the transplant, Jeanella deteriorated, developing a blood disorder, fever, kidney problems, lung hemorrhages and severe jaundice. The blood type mismatch was not detected until Aug. 5, 19 days after the surgery, when Mrs. Aranda, aware that her husband had Type A blood, noticed that Jeanelle's transfusions were Type O, and asked whether the transplant had been a mismatch. Doctors determined that she was correct. The baby died the next day

Until a revision on Nov. 25, the cancer institute's fact sheet said studies showed ''no association between abortion and breast cancer.'' At that point, the sixth and current fact sheet appeared on the agency's Web site and said the evidence for a link between induced abortions and breast cancer was inconclusive. At the workshop the institute held last month, Dr. Leslie Bernstein, a leading cancer epidemiologist at the University of Southern California, reported findings from the four studies showing no link between induced abortions and breast cancer. Dr. Bernstein said she reported findings from a study of teachers in California and another study involving women at five medical centers that also showed no link. Dr. Bernstein, who is senior associate dean for faculty affairs at the University of Souther California, said she was a researcher in these two unpublished studies

Until a revision on Nov. 25, the cancer institute's fact sheet said studies showed 'no association between abortion and breast cancer.' At that point, the sixth and current fact sheet appeared on the agency's Web site and said the evidence for a link between induced abortions and breast cancer was inconclusive. The new report on the Web site says that neither induced abortion nor spontaneous abortion is 'associated with an increase in breast cancer risk.' Still, the official fact sheet has not been changed. At the workshop the institute held last month, Dr. Leslie Bernstein, a leading cancer epidemiologist at the University of Southern California, reported findings from the four studies showing no link between induced abortions and breast cancer

David M. Oshinsky reviews the book "A Consumers' Republic: The Politics of Mass Consumption in Postwar America" by Lizabeth Cohen

Leukocyte adhesion deficiency type 2 (LADII) is characterized by defective selectin ligand formation, recurrent infection, and mental retardation. This rare syndrome has only been described in 2 kindreds of Middle Eastern descent who have differentially responded to exogenous fucose treatment. The molecular defect was recently ascribed to single and distinct missense mutations in a putative Golgi guanosine diphosphate (GDP)-fucose transporter. Here, we describe a patient of Brazilian origin with features of LADII. Sequencing of the GDP-fucose transporter revealed a novel single nucleotide deletion producing a shift in the open-reading frame and severe truncation of the polypeptide. Overexpression of the mutant protein in the patient's fibroblasts did not rescue fucosylation, suggesting that the deletion ablated the activity of the transporter. Administration of oral L-fucose to the patient produced molecular and clinical responses, as measured by the appearance of selectin ligands, normalization of neutrophil counts, and prevention of infectious recurrence. The lower neutrophil counts paralleled improved neutrophil interactions with activated endothelium in cremasteric venules of nonobese diabetic/severe combined immunodeficiency (NOD/SCID) mice. However, fucose supplementation induced autoimmune neutropenia and the appearance of H antigen on erythrocytes, albeit without evidence of intravascular hemolysis. The robust response to fucose despite a severely truncated transporter suggests alternative means to transport GDP-fucose into the Golgi complex.

PURPOSE: We examined the relationships among urethral hypermobility, intrinsic sphincter deficiency and incontinence in women. MATERIALS AND METHODS: A total of 65 consecutive women with stress urinary incontinence and 28 with lower urinary tract symptoms not associated with stress urinary incontinence were evaluated with videourodynamics, 24-hour voiding diaries and pad tests, vesical leak point pressure measurement and the cotton swab test. RESULTS: A total of 93 patients with a mean age +/- SD of 63 +/- 13 years were studied, including 65 who presented with stress urinary incontinence and 28 who presented with lower urinary tract symptoms without stress urinary incontinence. The incidence of urethral hypermobility was 32% in the stress urinary incontinence group and 36% in the lower urinary tract symptoms group (p = 0.46). When stress urinary incontinence cases were stratified according to a vesical leak point pressure of 0 to 60, 60 to 90 and greater than 90 cm. H2O, urethral hypermobility was noted in 25%, 31% and 41%, respectively, a difference that was not statistically significant (p = 0.6). Overall incontinent patients with and without urethral hypermobility had the same median number of incontinence episodes (5, range 1 to 13 versus 7, range 1 to 15, p = 0.39) and median pad weight (39.5 range 1 to 693 gm. versus 33.5, range 1 to 751, p = 0.19). When patients with intrinsic sphincter deficiency, defined as vesical leak point pressure less than 60 cm. H2O, were divided into those with and without urethral hypermobility, there were no differences in the mean number of incontinence episodes (9.4 +/- 3 versus 6 +/- 3.6, p = 0.17) or median pad weight (90 gm., range 10 to 348 versus 86, range 30 to 81, p = 0.76). The degree of change in the urethral angle did not correlate with vesical leak point pressure (r = 0.16, p = 0.24) or with pad weight (r = -0.23, p = 0.1). CONCLUSIONS: Urethral hypermobility was equally common in this group of women with lower urinary tract symptoms and stress urinary incontinence. Intrinsic sphincteric deficiency and urethral hypermobility may coexist and they do not define discrete classes of patients with stress urinary incontinence. Urethral hypermobility did not appear to have an independent effect on the frequency or severity of incontinence. Patients with stress urinary incontinence can still be characterized by vesical leak point pressure and change in the urethral angle, although these variables do not always define discrete classes.

The new quinolone garenoxacin (BMS-284756), which lacks a C-6 fluorine, was examined for its ability to block the growth of Staphylococcus aureus. Measurement of the MIC and the mutant prevention concentration (MPC) revealed that garenoxacin was 20-fold more potent than ciprofloxacin for a variety of ciprofloxacin-susceptible isolates, some of which were resistant to methicillin. The MPC for 90% of the isolates (MPC(90)) was below published serum drug concentrations achieved with recommended doses of garenoxacin. These in vitro observations suggest that garenoxacin has a low propensity for selective enrichment of fluoroquinolone-resistant mutants among ciprofloxacin-susceptible isolates of S. aureus. For ciprofloxacin-resistant isolates, the MIC at which 90% of the isolates tested were inhibited was below serum drug concentrations while the MPC(90) was not. Thus, for these strains, garenoxacin concentrations are expected to fall inside the mutant selection window (between the MIC and the MPC) for much of the treatment time. As a result, garenoxacin is expected to selectively enrich mutants with even lower susceptibility