Faculty Bibliography

OBJECTIVE: To assess genetic diversity and drug resistance of Mycobacterium tuberculosis isolates collected at Christian Medical College Hospital (CMCH), Vellore, India, between July 1995 and May 1996. MATERIALS AND METHODS: Isolates were subjected to IS6110-based restriction fragment length polymorphism (RFLP) analysis and tested for resistance to isoniazid, rifampin, ethambutol, streptomycin, and pyrazinamide, and DNA from selected strains was sequenced in regions associated with drug resistance. RESULTS: One hundred and one M. tuberculosis isolates were collected from 87 patients with pulmonary tuberculosis. Charts of 69 patients were reviewed for history of tuberculosis illness and treatment. DNA from 29 strains was sequenced in katG, rpoB, and gyrA, and sometimes pncA regions. Analysis by RFLP revealed a high degree of genetic diversity, with no identifiable clusters of infection. Of the strains tested, 51% were resistant to at least one antibiotic, and 43% were resistant to more than one drug. There was a high rate of resistance observed in patients whose charts indicated a history of improperly administered tuberculosis treatment, whereas little drug resistance was observed in patients never previously treated for tuberculosis. Sequencing of genes associated with drug resistance revealed several previously unreported mutations in resistant strains. CONCLUSIONS: This analysis suggests that the cases of tuberculosis in the sample are largely reactivation of long-standing infections and that the drug resistance among patients in CMCH is largely acquired or secondary rather than attributable to the spread of drug-resistant strains

How does one maneuver through this information logjam? A new book, "The Civil War on the Web" (Scholarly Resources, $18.95 paperback), offers much needed help. After exhaustive investigation, the authors - William Thomas, director of the Virginia Center for Digital History at the University of Virginia, and Alice Carter, project manager for education at New York Times Digital - recommend 95 sites based on the richness of sources, ease of navigation and visual appeal. These criteria are flexible, they say, because most sites were not made by professional Web designers but by "librarians and archivists, reenactors and preservationists, students and educators - people more interested in the Civil War than in slick appearances or sophisticated menus." Put simply, most sites are stronger on content than on aesthetics.

The Web site examines two Shenandoah Valley counties -- Franklin in Pennsylvania and Augusta in Virginia -- in the late 1850s and 1860s. The CD contains wonderful photographs, a foot-tapping music score and a helpful time line linking Augusta and Franklin counties to important national events, like the Dred Scott decision and John Brown's raid on the federal arsenal in nearby Harper's Ferry, W.Va. Both were prosperous farming communities, known for their grain and livestock; both were settled by people from Germany and the British Isles; both were deeply racist places, with whites viewing blacks as inferior. The defining difference, quite simply, was that Augusta County had slavery, and Franklin County did not.

Visitors flock to its battlefields, where re-enactments are the rage. Truckers and accountants boldly storm Gettysburg's Little Round Top or Chickamauga's Horseshoe Ridge in the tailored uniforms of "Billy Yank" and "Johnny Reb." More than 40 million people watched Ken Burns's 1990 documentary, The Civil War. Even the chapters on Web sites concerned with military matters go beyond battles and armaments to the experiences of common soldiers. Want to learn about the treatment of wounded troops? The University of Toledo has a good site (http://www.cl.utoledo.edu/ canaday/quackery/quack8.html). Need some material about Jews in the Civil War? Click on (http://www.jewishhistory.com/civilwar.htm). Curious about the layout of the Civil War prison at Andersonville, Ga.? A National Park Service Web site, (http://www.nps.gov/ande), provides the details, including evidence of an uncompleted escape tunnel. Or the searcher can explore the mixed emotions of Franklin County's whites concerning the evils of slavery and its further expansion. Some viewed slavery as the proper station for those with dark skin, while others accepted its presence in the South but opposed its spread into new territory. A few demanded its abolition on moral grounds.

For the immigrants who came through New York harbor in the late 19th and early 20th centuries, the Statue of Liberty no doubt dazzled their senses, but Ellis Island determined their fate. A new CD-ROM gives you a feeling for what they saw and felt as they arrived. The key sections of this CD-ROM - The Journey and The Golden Door - are well done. Combining videos, photographs, primary documents and crisp commentary, they follow the immigrant path from the tiny villages of Europe to the controlled chaos of Ellis Island. Viewers should have no trouble navigating along. There is an adequate search function, a zoom lens to enlarge images and simple commands to store and print documents. One disappointment is the failure of "The Ellis Island Experience" to emphasize the changing dynamic of immigration. In the 1890s, some Americans grew uneasy about the enormous flow of immigrants from places such as Greece, Italy, Russia, Poland and Hungary. Without new safeguards, some believed, these immigrants would pollute the nation with a stream of alien blood. Ellis Island was a logical response.

MOST Americans view the immigrant experience through the bold strokes of struggle and assimilation. They barely notice the underside of immigration--the rules for inspecting, admitting and excluding newcomers to American shores.