Faculty Bibliography

Three American pharmacologists were awarded the Nobel Prize yesterday for their surprising discoveries of how natural production of a gas, nitric oxide, can mediate a wide variety of bodily actions. Those include widening blood vessels, helping to regulate blood pressure, initiating erections, battling infections, preventing formation of blood clots and acting as a signal molecule in the nervous system. The prize, for physiology or medicine, went to Dr. Robert Furchgott, 82, of the State University of New York in Brooklyn; Dr. Louis J. Ignarro, 57, of the University of California at Los Angeles, and Dr. Ferid Murad, 62, of the University of Texas Medical School in Houston. Dr. Ignarro ''discovered the principle that led to the use of Viagra as an anti-impotency drug,'' said Dr. Sten Orrenius, a professor of toxicology at the Karolinska Institute. Nitric oxide starts the process by which blood vessels in the penis widen to produce an erection

The researchers made surprising discoveries of how natural production of a gas, nitric oxide, can affect a variety of bodily actions, including widening blood vessels, helping to regulate blood pressure, initiating erections, battling infections, preventing formation of blood clots and acting as a signal molecule in the nervous system. The prize, for physiology or medicine, went to Dr. Robert Furchgott, 82, of the State University of New York in Brooklyn; Dr. Louis Ignarro, 57, of the University of California, Los Angeles; and Dr. Ferid Murad, 62, of the University of Texas Medical School in Houston. Nitric oxide, a chemical relative of the anesthetic gas nitrous oxide, is better known as a common air pollutant formed when nitrogen burns, such as in automobile exhaust fumes. But scientists now know it is distributed widely in the body. The discoveries honored on Monday were made largely during the 1980s at a time when scientists knew that bacteria produced nitric oxide but did not think it was important in animals and humans

Three American pharmacologists were awarded the Nobel Prize yesterday for their discoveries of how natural production of nitric oxide can mediate a wide variety of bodily actions. The prize, for physiology or medicine, went to Dr. Robert Furchgott, 82, of the State University of New York in Brooklyn; Dr. Louis Ignarro, 57, of the University of California at Los Angeles; and Dr. Ferid Murad, 62, of the University of Texas Medical School in Houston. Nitric oxide, a chemical relative of the anesthetic gas nitrous oxide, is better known as a common air pollutant formed when nitrogen burns, such as in automobile exhaust fumes. But scientists now know it is distributed widely in the body. The discoveries honored were made during the 1980s, at a time when scientists knew that bacteria produced nitric oxide but did not think it was important in animals and humans

Three American pharmacologists were awarded the Nobel Prize on Monday for their surprising discoveries of how natural production of a gas, nitric oxide, can mediate a wide variety of bodily actions. The prize, for physiology or medicine, went to Dr. Robert Furchgott, 82, of the State University of New York in Brooklyn; Dr. Louis Ignarro, 57, of the University of California at Los Angeles; and Dr. Ferid Murad, 62, of the University of Texas Medical School in Houston. Nitric oxide, a chemical relative of the anesthetic gas nitrous oxide, is better known as a common air pollutant formed when nitrogen burns, such as in automobile exhaust fumes. But scientists now know it is distributed widely in the body. The discoveries honored on Monday were made largely during the 1980s, when scientists knew that bacteria produced nitric oxide but did not think it was important in animals and humans

However, several cancer experts not connected with Strawberry's case were more cautious in their optimism about his future, because the detection of cancerous cells in even 1 of the 36 lymph nodes removed from his abdomen during the operation meant the cancer had spread. The finding meant Strawberry's post-operative course would include chemotherapy; if none of the lymph nodes had shown evidence of cancerous cells, presumably Strawberry would not have needed chemotherapy. The finding also substantially reduced the odds of a five-year cure, from the approximately 90 percent that could have been expected if the cancer had not spread. Strawberry, described as ''still weak'' yesterday by Dr. Stuart Hershon, the Yankees' team physician, remains at Columbia-Presbyterian Medical Center in Manhattan. Hershon, a specialist in bone and joint surgery, said Strawberry ''needs to get his strength. He'll go home when he's ready.'' Hershon said that an earlier news release from Columbia-Presbyterian should not have stated that Strawberry would leave the hospital yesterday. Dr. Stanley R. Hamilton, the head of pathology at the University of Texas M. D. Anderson Cancer Center in Houston, and Dr. Alfred Cohen, a colon cancer surgeon at Memorial Sloan-Kettering Cancer Center in Manhattan, said Strawberry had a 70 percent to 75 percent five-year survival rate with adjuvant chemotherapy and about a 60 percent rate without such therapy

Mr. (Clint) Hallam had been a patient of a major member of the team, Dr. Earl Owen, a microsurgeon in Sydney, Australia, for more than two years and had undergone extensive psychological evaluation in Australia and in France. But the hospital did not say that two days before the operation, the head of the surgical team, Dr. Jean-Michel Dubernard, learned from the patient that he had a criminal record. The West Australian, a newspaper in Perth, later reported that Mr. Hallam was due in court there in January to face seven fraud charges. But the operation proceeded because ''this man desperately wanted the graft,'' Dr. Dubernard said. ''As a doctor, I take care of everybody and did not change anything'' in his treatment, said Dr. Dubernard, who is not only a transplant surgeon but also a member of the French parliament and a deputy mayor of Lyons. ''It is a pity that the Australian newspapers revealed that he had been to jail.''

The surgical team at Columbia-Presbyterian Medical Center in Manhattan, headed by Dr. George J. Todd, said it removed a cancerous tumor that measured 2.4 inches in length and that nearly blocked Strawberry's intestine. There was no visible evidence during the operation that the cancer had spread beyond that area of the bowel, the doctors said in a statement issued last night. But it will be about a week before the results of the key pathology tests are available. The findings will determine what anti-cancer therapy, such as drugs and radiation, the doctors will recommend for Strawberry after he recuperates from surgery. He was expected to stay in the hospital for one week. The pathology findings will provide the doctors with information they need to stage, or classify, the severity of Strawberry's cancer and provide a statistical base for a long-term prognosis. Although Strawberry's wife, Charisse, had said the cancer was a favorable stage A or B, cancer experts said in interviews that there was no way to stage the cancer until the final pathology tests were available

Strawberry is one of an estimated 800 American men in the 35-39 age group who will be found to have colon and rectal cancer this year, according to figures from the American Cancer Society. The figure represents 1.2 percent of the estimated 64,000 American men who will develop colon cancer in 1998. About 77,000 American women of all ages will develop colon and rectal cancer. Doctors and Yankee officials have provided few specific details about Strawberry's case, but the Yankees' team physician, Stuart Hershon, said yesterday that Strawberry's cancer was in a favorable location for removal from his colon. Crucial information will come during the operation when Dr. [George] Todd is expected to remove the cancer and the segment of normal colon to either side of it. As is usual in such operations, Dr. Todd will also feel Strawberry's entire intestines, liver and other tissues for evidence of spread of the cancer. Also, pathologists will look through a microscope at the tissues removed in the operation. They include the cancer, adjacent segment of colon, and lymph nodes

[Darryl] Strawberry is one of an estimated 800 American men in the 35-39 age group who will be diagnosed with colon and rectal cancer this year, according to the American Cancer Society. The figure represents 1.2 percent of the estimated 64,000 American men who will develop colon cancer in 1998. About 77,000 American women of all ages also will develop colon and rectal cancer

The advent of triple-drug therapy for HIV disease has raised the concern that disadvantaged patients with multiple social problems may be nonadherent to treatment. Fearing that partial adherence will lead to drug resistance, some clinicians are withholding these powerful new drugs from such patients. The historical record demonstrates that labeling patients as nonadherent may be both stigmatizing and inaccurate. Since 1900, such adjectives as ignorant, vicious, and recalcitrant have been used to describe patients who do not follow medical advice. Less judgmental terms, such as nonadherent and noncompliant, are now used, but these terms still imply that patients should obey physician-imposed regimens. Studies of nonadherence have consistently shown that the problem is widespread among all persons and cannot reliably be predicted on the basis of patient characteristics. This paper argues that physicians should deemphasize the standard approach of predicting and correcting nonadherent behavior in certain patients. Rather, clinicians should encourage all HIV-positive patients to devise individualized treatment plans that can facilitate reliable ingestion of medication. Although the potential development of resistance to triple-drug therapy remains an important public health issue, concern about this possibility must be balanced with respect for patients' rights. Encouraging the active participation of HIV-positive persons in their own treatment will help avoid judgmental and inaccurate assessments of patient behavior and may help patients take medications more successfully.