Faculty Bibliography

With the rib cage cut open to expose the chest cavity, Dr. DeBakey gently pulled up the thin tissue surrounding the heart. His partner, Dr. George P. Noon, sliced into the tissue. The diseased coronary artery came clearly into view. The surgeons opened the artery and sewed part of a vein taken from the leg into place as a graft. They did this four times, in one place using an artery as a graft, to create new channels for blood to flow around clogged sections of the diseased coronary arteries. What made it an extraordinary operation is that Dr. DeBakey, the pioneering heart surgeon, turns 90 on Sept. 7. With bushy eyebrows, long dark hair that is combed back on a balding scalp, and a tinge of gray on his sideburns, Dr. DeBakey looks 20 years younger. He is celebrating his 50th year at Baylor College of Medicine, and only a disability will make him retire, he says. It was 88-year-old Dr. DeBakey, not a younger American surgeon, whom President Boris N. Yeltsin's doctors summoned to Moscow for consultation for Mr. Yeltsin's quintuple bypass operation in 1996. In a foreword to the Russian edition of Dr. DeBakey's 1997 book ''The New Living Heart,'' written with Antonio Gotto (Adams), Mr. Yeltsin described Dr. DeBakey as ''a magician of the heart'' and ''a man with a gift for performing miracles.''

OBJECTIVE: To use DNA fingerprinting to characterize nosocomial spread of Mycobacterium tuberculosis following hospitalization of a patient with acquired immunodeficiency syndrome and active pulmonary tuberculosis, for whom respiratory isolation was not initiated promptly. DESIGN: Epidemiological investigation. SETTING: A tertiary-care medical center in Tennessee. PARTICIPANTS: Patients and healthcare workers potentially exposed to the infectious patient in 1992. RESULTS: Of 172 healthcare workers exposed, 35 (20%) were judged to have acquired tuberculous infection. Risk of acquisition was greatest for nurses and medical receptionists. Active tuberculosis later developed in one healthcare worker and one hospitalized patient. Nosocomial transmission was supported by epidemiological evidence and DNA fingerprinting. The outbreak strain of Mycobacterium tuberculosis differed from other isolates at this hospital, but its DNA hybridization pattern was highly similar to that of the multidrug-resistant outbreak strain W that has been prevalent in New York City, suggesting a common strain ancestry. However, the Tennessee isolates were susceptible to all first-line antituberculous agents. CONCLUSIONS: This report suggests the possibility that a molecular characteristic(s) shared by these successful outbreak strains is associated with increased transmissibility or pathogenicity and emphasizes the need for continued vigilance for tuberculosis in the nosocomial setting

An article argues that secret, pro-segregation files assembled by the Mississippi state government from 1956 to 1977 should have been reopened

We studied the effects of LEX032, a novel serine protease inhibitor, on N(G)-nitro-L-arginine methyl ester (L-NAME) induced leukocyte-endothelium interactions in vivo, utilizing intravital microscopy of the rat mesentery. Superfusion of the rat mesentery with 50 microM L-NAME, a nitric oxide (NO) inhibitor, for 90 min resulted in a significant and time-dependent increase in leukocyte rolling, leukocyte adherence, and transmigration of leukocytes, compared to control rats superfused with Krebs-Henseleit (K-H) solution. However, systemic administration of LEX032 (15 mg/kg bolus injection followed by a 15 mg/kg per hour infusion) to L-NAME superfused rats significantly attenuated leukocyte rolling and adherence along the venular endothelium of the rat mesentery, and also inhibited transmigration of leukocytes through the microvascular endothelial wall. Moreover, no significant changes were observed in mean arterial blood pressure or local venular shear rates following systemic administration of LEX032. Our data demonstrate that systemic inhibition of serine proteases by LEX032 reduces enhanced leukocyte-endothelium interactions provoked by inhibition of NO synthesis. These results also explain some of the beneficial effects exerted by serine protease inhibitors in ischemia-reperfusion and other inflammatory states.

Dr. Leroy E. Burney, who as Surgeon General of the United States Public Health Service in the Eisenhower Administration was the first Federal official publicly to identify smoking as a cause of lung cancer, died on Friday at a hospital in Park Ridge, Ill. He was 91. On July 12, 1957, after organizing a group of scientists to appraise 18 studies on smoking and health, Dr. Burney, himself a smoker, issued a report saying, ''It is clear that there is an increasing and consistent body of evidence that excessive cigarette smoking is one of the causative factors in lung cancer.'' Dr. Burney was not the first Surgeon General to discuss the hazards of smoking. Last year, in the journal Public Health Reports, Dr. John Parasandola, the Public Health Service's historian, wrote that in 1929, Surgeon General Hugh Cumming ''warned that smoking could lower the 'physical tone' of the nation.''

Few periods in American history have been as thoroughly mined by scholars and journalists as the Cold War years of the late 1940s and 1950s, known to millions as the McCarthy era. Named after the Red-hunting Republican Sen. Joseph Raymond McCarthy of Wisconsin, it is vividly recalled as a time of great anxiety over communist expansion, when civil liberties were trampled in the relentless search for spies and subversives. Recently, however, the release of classified documents from U.S. and Russian archives has led researchers in a different direction. While the historical portrait of McCarthyism as a dangerous assault on American values remains solidly intact, the evidence accumulated about Soviet spying in the United States has reinforced the critical role played by America's Communist Party. As a result, defending the party, a labor of love for certain scholars, has become a much tougher job. In "Many Are the Crimes," author Ellen Schrecker, a history professor at Yeshiva University in New York, is candid about her beliefs: "I do not think that I conceal my sympathy for many of the men and women who suffered during the McCarthy era," she writes, "nor my agreement with much (though not all) of their political agenda." And Schrecker, to her credit, is careful to note that the main targets of McCarthyism were not "political innocents" who attended the wrong meeting, but rather people who joined the Communist Party or were close to its cultural orbit

Adrenocorticotrophic hormone (ACTH) and corticosteroids have no maintenance values for inflammatory bowel disease but serve to reduce the severity of disease. The effectiveness of intravenous corticotrophin versus hydrocortisone in ulcerative colitis has been determined including whether previous steroid therapy influenced the better response to one rather than the other, but no such studies have ever been done in Crohn's disease. Eighty-eight patients hospitalized with moderate-to-severe Crohn's disease (Present-Korelitz [P-K] Index -3 to -2 and the International Organisation for the Study of Inflammatory Bowel Disease-Crohn's & Colitis Foundation of America [IOIBD-CCFA] Index, mean 14, range 5-23) were treated in a prospective, randomized, double-blind clinical trial to receive either continuous intravenous infusion of 120 U/day of ACTH (44 patients) or hydrocortisone 300 mg/day (44 patients). Patients were also subdivided into those who received oral steroids during the 30 days prior to intravenous therapy and those who had not. Response was followed on a daily basis and tabulated at 3, 5, and 10 days. Patients were followed from 1-3 years to determine the later status. After 10 days of intravenous therapy 36 of 44 patients (82%) who received ACTH and 41 of 44 patients (93%) who received hydrocortisone fully responded (P-K index +3 and IOIBD-CCFA Index mean of 3). At the end of the study, response to intravenous ACTH and hydrocortisone was not statistically different whether or not patients received oral steroids during the 30 days prior to admission, although the response to IV ACTH tended to be faster at 3 days in those who had received previous steroid therapy. Intravenous ACTH and hydrocortisone are equally effective in achieving therapeutic goals in patients with Crohn's disease who have not achieved results with oral medications. Moreover the response rate was high (mean 88%), serving to buy time for establishment of successful maintenance programs of treatment with oral 5-ASA and immunosuppressive drugs for 69% of patients at 1-3 years