Faculty Bibliography

On Nov. 14 in Houston, Dr. Michael J. Reardon removed Mrs. [Joanne Minnich]'s heart from her chest, put it in ice in a metal bowl, and cut out three large cancerous tumors and one small one. With the heart still in the bowl, Dr. Reardon rebuilt it using parts of a cow's heart. Mr. Minnich said, ''Joanne did what she wanted to do, and that was trying to help others.''

The patient, whose name has not been made public, developed a respiratory infection and has continued to experience bouts of intestinal bleeding, said the doctor, Dr. Laman A. Gray Jr., who implanted the device with Dr. Robert D. Dowling on July 2 at Jewish Hospital in Louisville, Ky. Dr. Gray said the patient's appearance was encouraging. ''He looks very good, is up in a chair, exercising lightly with hand weights, and has shown remarkable progress,'' Dr. Gray said. Dr. Gray attributed the setback to the man's chronic debilitated condition before the implant, not to the AbioCor artificial heart. The device has continued to work flawlessly, he said. It pumps about seven liters of blood a minute (within the normal range), compared with the two liters the patient's diseased heart had been able to deliver

The patient, whose name has not been made public, developed a respiratory infection and has continued to experience bouts of intestinal bleeding, said Dr. Laman Gray Jr., who implanted the device with Dr. Robert Dowling on July 2 at Jewish Hospital in Louisville, Ky. The respiratory infection, which is either severe bronchitis or early pneumonia, is responding to antibiotics and other therapy, Gray said

[Joanne Minnich] went to Houston, where surgeons had reported success with what is known as bench surgery for cancerous heart tumors. On Nov. 14 in Houston, Dr. Michael J. Reardon removed Minnich's heart from her chest, put it in ice in a metal bowl and meticulously cut out three large cancerous tumorsand one small one. With the heart still in the bowl, Reardon rebuilt it, using parts of a cow's heart

The RuvB hexamer is the chemomechanical motor of the RuvAB complex that migrates Holliday junction branch-points in DNA recombination and the rescue of stalled DNA replication forks. The 1.6 A crystal structure of Thermotoga maritima RuvB together with five mutant structures reveal that RuvB is an ATPase-associated with diverse cellular activities (AAA+-class ATPase) with a winged-helix DNA-binding domain. The RuvB-ADP complex structure and mutagenesis suggest how AAA+-class ATPases couple nucleotide binding and hydrolysis to interdomain conformational changes and asymmetry within the RuvB hexamer implied by the crystallographic packing and small-angle X-ray scattering in solution. ATP-driven domain motion is positioned to move double-stranded DNA through the hexamer and drive conformational changes between subunits by altering the complementary hydrophilic protein- protein interfaces. Structural and biochemical analysis of five motifs in the protein suggest that ATP binding is a strained conformation recognized both by sensors and the Walker motifs and that intersubunit activation occurs by an arginine finger motif reminiscent of the GTPase-activating proteins. Taken together, these results provide insights into how RuvB functions as a motor for branch migration of Holliday junctions.

Previous studies have suggested that the terminal complex of complement may contribute to the pathogenesis of atherosclerosis. C5b-9 complexes colocalize with the extracellular lipid in the aortic intima of hypercholesterolemic rabbits, and C6-deficient rabbits develop less atherosclerosis than controls. To test the role of complement in atherosclerosis in a different animal model, C5 deficient (C5def) mice were cross-bred with atherosclerosis susceptible apoE(-/-) mice, generating mice deficient in both apoE and C5 and control apoE(-/-) mice. Progeny were typed for C5 titer and serum cholesterol levels. Both male and female mice were fed a high fat diet from weaning until 22 weeks of age. At that time there were no significant differences in plasma cholesterol or triglycerides between apoE(-/-) control and apoE(-/-)/C5def groups. Morphometric analysis of the aortic root lesions gave mean (+/-SEM) lesion areas for male apoE(-/-) and apoE(-/-)/C5def mice of 468,176 +/- 21,982 and 375,182 +/- 53,089 microm(2), respectively (n = 10 each, P value = 0.123). In female apoE(-/-) mice (n = 5), the mean lesion area was 591,981 +/- 53,242 microm(2), compared to 618,578 +/- 83,457 microm(2) for female apoE(-/-)/C5def mice (n = 10) (P value = 0.835). Thus neither male nor female mice showed a significant change in lesion area when C5 was not present. In contrast to the case in the hypercholesterolemic rabbit, activation of the terminal complex of complement does not play a major role in the development of atherosclerosis in apoE(-/-) mice.

President [Bush] is in ''outstanding health'' and at very low risk for a heart attack, his doctors said today after performing Mr. Bush's first medical checkup since he took office. The only new abnormality reported was the removal of three potentially cancerous lesions from Mr. Bush's face. Dr. Richard A. Keller, the chief dermatologist at Walter Reed Army Medical Center, used liquid nitrogen to remove the lesions, which are known as actinic keratoses. They are common and result from chronic sun exposure; if untreated, a small percentage of them can become skin cancers. A White House spokesman described them as ''small, dry patches'' that had a red tint and felt ''like sandpaper.'' He takes vitamins but does not routinely use prescription medications and has not missed a day of work since his last checkup. The examination was performed by Dr. Kenneth H. Cooper of Dallas, who has given Mr. Bush annual checkups since 1989

Dr. [Robert D. Dowling] said his team would face many unknowns. One is the possible formation of blood clots in the device, which can lead to a stroke. The doctors have prescribed anti-coagulants to prevent such clots. But they have had to stop the drugs or keep the doses small because the man has had bleeding from inflammation of his stomach. The man needs to regain 30 pounds of muscle that wasted when he was suffering from end-stage heart failure. He is receiving 2,900 calories a day through a feeding tube and additional calories in his diet that is gradually including solid foods, Dr. Dowling said, and ''has regained a small amount of muscle mass.'' The AbioCor has worked flawlessly as it has beat more than 5 million times in the man, pumping about 7 liters of blood a minute compared with the 2 liters his diseased heart could deliver, Dr. Dowling said. Earlier, the doctors and technicians manually set the number of heart beats, but now the device regulates itself automatically as it adjusts to the man's activity