JACOBSON APPOINTEDDEAN OF DIVISIONOn January 1, 1966, Leon o. Jacobson became the seventh Dean of the Divisionof Biological Sciences. He succeeds H. Stanley Bennett, who had asked to be relieved of the administrative responsibilities of the deanship to devote himself toresearch and teaching.Dr. Bennett has been named the Robert H. Bensley Professor of Biologicaland Medical Sciences and will be the Director of the newly established laboratoriesfor Cell Biology in the Division.Dr. Jacobson was born in Sims, North Dakota, in 1911 and before completing hisBachelor of Science degree at North Dakota State University in 1935 taught forthree years in a country school. He recalls this experience as one of the most rewarding periods of his life, and it is clear from his stories about his country schooldays that even at the beginning he communicated those qualities of warmth, humor,and enthusiasm that have distinguished his teaching career.Dr. Jacobson is the first alumnus of the School of Medicine to be appointedDean of the Division. He graduated in 1939 and after internship and residencybecame an instructor in medicine in 1942; assistant professor, 1945; associateprofessor, 1948; and professor of medicine and head of the hematology section in1951. He was Associate Dean of the Division from 1945 to 1951 at which time hebecame Director of the Argonne Cancer Research Hospital. In 1961 he was appointed Chairman of the Department of Medicine and in June, 1965, was namedthe Joseph Regenstein Professor of Biological and Medical Sciences.Dr. Jacobson has made important initial investigations in the field of nuclearmedicine. He was the first to discover that protective shielding of the spleen makesit possible for animals to withstand lethal doses of radiation. In 1939 he began touse radioactive phosphorus in the treatment of some leukemias and in the treatment of polycythemia rubra vera. He was thus the first scientist at the Universityof Chicago to make use of radioactive isotopes in patient therapy. He was alsoone of the first physicians to use nitrogen mustards in the treatment of Hodgkin'sdisease. Dr. Jacobson has made many major contributions to the understanding ofblood formation and disease. He is internationally known for his extensive pioneering studies of the role of the hormone erythropoietin in controlling the formationof red blood corpuscles.He was the U.S. representative to the first and second International Conferenceson Peaceful Uses of Atomic Energy at Geneva in 1955 and 1958. His many appointments to national advisory boards have included the Advisory Committee onIsotope Distribution for the U.S. Atomic Energy Commission from 1952-1956,the Expert Advisory Panel on Radiation for the World Health Organization atGeneva, from 1959 to date, and the National Advisory Committee on Radiationfor the U. S. Public Health Service, from 1961 to date.Dr. Jacobson has received many honors and awards including the Robert Roeslerde Villiers Award of the Leukemia Society in 1956, the Borden Award for researchin the medical sciences in 1962, the Modern Medicine Award for distinguishedachievement in 1963, and election to the N atiorsal Academy of Sciences in 1965.Among the many national and international societies in which he holds membership are the Association of American Physicians, the American Nuclear Society,the American Society of Hematology, the International Society of Hematology,the American Society for Clinical Investigation, the Central Society for ClinicalResearch, and the Chicago Society of Internal Medicine, which he served as President in 1964-65.Our new Dean has an intimate knowledge of the problems and potentialities ofthe school in which he received his medical training and with which he has beenassociated for twenty-seven years. He has been an active participant in the growthand development of the Division, and his appointment has the enthusiastic supportof the faculty, students, and staff.2 MEDICAL ALUMNI BULLETINNOTES AND COMMENTThe three French scientists who sharedthe 1965 Nobel Prize in Medicine andPhysiology have all received honorarydegrees from the University of Chicago.Andre Michel Lwoff was awarded anhonorary D .Sc. degree in March, 1959for his pioneering work in biochemistryand its "profound impact on the studyof virology, biochemistry and genetics."Fransois Jacob and Jacques LucienMonod were presented with honoraryD.Sc. degrees in June, 1965, Dr. Jacobfor his research as a microbial geneticist"whose ingenious experiments and theoretical models have contributed in anoutstanding fashion to the understandingof the molecular basis of heredity," andDr. Monod for his distinction "as aleader in that area of contemporary science in which cytology, genetics andchemistry have come together to forma new biology."Lwoff, Professor of Microbiology atthe Sorbonne, Jacob, Professor of CellGenetics at the College de France, andMonod, Professor of Metabolic Chemistry at the Faculte de Sciences de Paris,are all associates at the Pasteur Institute in Paris.At the Reunion Banquet in June, 1964,Konrad E. Bloch was presented with theDistinguished Service Award of the Medical Alumni Association. Later that yearhe shared the Nobel Prize in Medicineand Physiology for his research oncholesterol biosynthesis which was donewhile he was a member of our faculty,from 1946-1954.The Division is to be congratulatedupon anticipating the recognition ofthese distinguished scientists... MEDICAL ALUMNI BULLETIN MclEANFranklin C. Mclean, Rush '10, aftertwelve active years on emeritus statusin the Department of Physiology, has accepted an appointment at the Universityof Illinois Medical Center in the Collegeof Dentistry as Visiting Professor in theDepartment of Histology. He says thatalthough it was not easy to leave us, hehas been royally received in his new postand is quite happy. Ann Budy, Ph.D.'54, will continue to work with him asResearch Associate.Hilger Perry Jenkins, Rush '27, isarranging an alumni dinner at the Quadrangle Club on Monday evening, June27, during the annual meeting of theA.M.A. Late afternoon tours of theHospitals will be arranged for thosewho are interested. Details will be included in the Reunion mailing. Save thedate.REUNION 1965This year's banquet speaker, RussellH. Morgan, Faculty, 1942-46, Radiologist-in-Chief of Johns Hopkins University talked on "The Changing Patterns in Graduate Medical Education."He pointed out that the tremendous acceleration of scientific knowledge andthe increasing necessity of advance research experience means that the postdoctoral training period for medicalstudents will inevitably become longerbecause it is impractical to transfereven basic medical training to the student's premedical curriculum. Medicaleducators are faced with the dual problem of increasing the number of medicalschool graduates and at the same timeproviding the educational and researchfacilities demanded by the longer postdoctoral training. Dr. Morgan foundthese problems to be interrelated andfelt that one important step in theirsolution would be to remove the economic burden now placed on the graduate medical trainee. Financial assistancein the form of post-graduate fellowshipswould not only provide the young doctor the opportunity of advanced research, but it would also attract prospective students who would no longerbe faced with years of subsistence living. Adequate financial support, he indicated, must also be forthcoming forthe medical institutions in their needto meet the growing demands of postdoctoral training programs. In his conclusion, Dr. Morgan stated his beliefthat the changes taking place in medicaleducation will produce physicians notonly better fitted to meet the expandinghealth needs of the nation but betterfitted to meet their responsibilities ascitizens in the expanding social order.GOLD KEYGeorge W. Bartelmez, ProfessorEmeritus of Anatomy, was chosen thisyear's recipient of the Gold Key. Dr.Bartelmez was unable to attend the Reunion Banquet and in his presentation,Peter P. H. De Bruyn, Professor ofAnatomy, observed that his absence, "regrettable as it is, makes my task a littleeasier, for George Bartelmez is a verymodest man and would not be pleasedat all with me for praising him in public." During the forty years he was on ourfaculty, from the time he received hisPh.D. in 19lO until he became emeritus in 1950, Professor Bartelmez mademost important contributions to hisfield. His outstanding research on thehistological events during the menstrualcycle is characterized by its precisefunctional correlations. In addition hemade noteworthy contributions to ourknowledge of the development of thehuman nervous system and of the morphology of the synapse. His breadth ofinterest and his wide scholarship enabled him to make a beautiful translation from the Latin of Purkinje's monograph on A vian Ovum in which the discovery of the germinal vesicle is described. Dr. Bartelmez received welldeserved recognition for his work whenhe was elected in the forties to the National Academy of Sciences.With the presentation of the GoldKey we also honor Dr. Bartelmez forhis devotion to teaching and to thestudents of this school. Under his sponsorship and guidance, many investigators have emerged from his laboratoryto go on to distinguished careers.After he became emeritus, Dr. Bartelmez did not retire but continued hisproductive work in embryology in thelaboratories of the Carnegie Institutionin Baltimore. He now makes his homein Missoula, Montana, and is guest investigator at the University of Montana.William Hay Taliaferro, EliakimHastings Moore Distinguished ServiceProfessor Emeritus of Microbiology, waspresented by William Bloom, Distinguished Service Professor of Anatomyand Biophysics.Dr. Bloom's presentation of Professor Taliaferro was in the form of asalute:"Biologist of great accomplishmentin diverse, yet overlapping, fields; internationally recognized as a leadinginvestigator in immunology and in parasitology; for many years chairman ofthe department currently called Microbiology; editor of the Journal of Infectious Diseases; dean of the Divisionof the Biological Sciences with itsSchool of Medicine; and, especially, ateacher who has influenced the careersof several thousand medical students:"You have had many honors fromhome and abroad. Tonight you receiveanother from a source close to you.I have the privilege, as a colleague andco-worker, of presenting to you the Gold Key of the Association of Medical Alumni of The University of Chicago intoken of their appreciation of the distinction you have brought to our University and its School of Medicine. Asa friend of long standing I partake ofthe pleasure this a ward will bring toyou and to your wife, Lucy, who hasshared so much of the excitement,beauty, drudgery and rewards of yourlife focused on science."D.S.A.Robert Merritt Chanock, '47, waspresented by Allan L. Lorincz, '47, Associate Professor of Dermatology.In describing their medical school daystogether, Dr. Lorincz recalled Bob Chanock's qualities of intelligence, humor,and enthusiasm that were such a sourceof pleasure and enjoyment to his friendsand was able to trace the beginning ofhis interest in virology back to theirsenior medical school days when he hadworked on encephalitis viruses in HowellWright's laboratory in the basement ofBobs Roberts Hospital.Following his internship and basicpediatric training, Dr. Chanock studiedfor two years under Albert Sabin at theUniversity of Cincinnati and served asassistant professor of research pediatrics at that institution from 1954-1956.For the following year he was an assistant professor of epidemiology at theJohns Hopkins School of Hygiene andPublic Health and in 1957 joined theU.S.P.H.S. Laboratory of Infectious Diseases at the National Institute of Allergy and Infectious Diseases where heis now Medical Director and Chief ofthe Respiratory Virus Unit.Dr. Chanock has published well overa hundred scientific papers, chiefly aboutrespiratory virology. In recent years hislaboratories have made giant contributions to the research in this field. Hisdiscovery of the pathogenetic role inman of respiratory syncytial virus andhis clarification of the roles played bynumerous other myxoviruses in lowerrespiratory tract illnesses are but twoexamples. His demonstration that theEaton agent is really a mycoplasma hassparked enormous interest and activityamong microbiologists studying howthese organisms and their L-form cousins may be involved in human disease.In their explorations of the very complex common cold or rhinovirus group,Dr. Chanock and his associates have recently made phenomenal contributionsMEDICAL ALUMNI BULLETIN 5in the adenovirus field. The' implications of their finding that human adenovirus is able to hybridize wi th a smallcomponent of SV-40 virus so as torender the adenovirus cancerogenic inanimals are indeed far-reaching boththeoretically and practically. Becauseof their discovery, the use of commercial adenovirus vaccine produced inmonkey kidney cell-culture was immediately suspended and Chanock'sgroup developed an adenovirus vaccinegrown on diploid human fibroblast cultures free of this difficulty which provedto be one hundred per cent effective inthe prevention of adenovirus illnesswhen orally administered in entericcoated capsules.In concluding his presentation, Dr.Lorincz regretted that "there is insufficient time to give more detail of BobChanock's numerous other contributionsto the structuring of the respiratoryvirus field which he and his associateshave literally built brick by brick. Inaddition, Dr. Channock has served andcontinues to serve on many national andinternational panels, boards, commissions, and committees dealing with respiratory virus diseases and their controlby vaccines. Among many well-deservedhonors which have already come to himis the much coveted Mead JohnsonAward presented him last year for outstanding pediatric research."As we reflect on the awesome threatwhich viruses transmitted via the respiratory tract potentially hold for humanity as hinted at by past pandemicsof influenza, all of us I'm sure canbreathe more easily knowing that wehave a Bob Chanock in his superb laboratories in Bethesda armed with knowledge and techniques he and his teamhave painstakingly accumulated overmany years, standing ready to conquerany such virologic dragon that mightappear on the horizon."Oliver Howe Lowry, Ph.D. '37, M.D.Rush '37 was presented by Dean H.Stanley Bennett."The choice of Oliver Lowry for anAlumni Distinguished Service Awardbrings special personal gratification tome. He has been Professor and Chairman of the Department of Pharmacology at Washington University, St. Louis,since 1947. During a few years of thisinterval, he served as dean of thatdistinguished medical school, relinquishing this burdensome post to return toscholarship and teaching after makingnotable contributions to the excellence6 MEDICAL ALUMNI BULLETIN LOWRY and BENNETTof his institution. His research, forthirty years, has been characterized bythe development and use of extrememicrochemical methods for the solutionof biochemical problems. This big man,with big hands, a big heart and a bigmind, manipulates his tiny tubes, hishair-like quartz fiber balances, his Cartesian divers and his magnetic flea stirrers with a delicacy, an artistry, a satisfaction, and a craftsman's pride whichyield accurate analyses of minuteamounts of important substance, oftenamounts so small as to characterize thecontents of a single nerve cell, or ofa very few cells. From these studieshave come big ideas and big conceptsrelating to the spacial organization anddistribution of chemical materials in ceilsand tissues."Born here in Chicago, as an alumnusDr. Lowry stands with double credentials, receiving his Rush M.D. and hisPh.D. from The University of Chicagoin 1937. Following this he continuedhis work in Copenhagen, at Harvard,and in New York City before movingto St. Louis. One of his sons receivedhis bachelor's degree from The University of Chicago in 1962."It was at Harvard, in the late 30's,when I first met Ollie and learned tolove and admire him. At that time wewere very junior faculty members andour respective families had young children. We used to visit each other frequently for agreeable converse in ourgenteel academic poverty, fashionableat that time. I remember one evening in late winter, when the deep snowwas melting, my wife, Alice, and I tookour two small daughters to the Lowry'sfor supper, and after the meal, in theearly evening, Ollie and his wife choseto accompany us back to our house,perhaps five blocks away. I had fitteda grocery box to our sled and put ourtwo daughters in it, all bundled up.Ollie and I took the rope, and side byside, like two fire horses, strode alongpulling the sled, with our two youngwives trudging along behind. The husbands, deeply engrossed in conversationabout ion binding to cell componentsand, heeding too little the mounds ofsnow along the sidewalk, dragged thesled with too much velocity over anirregularity so that it upset, casting itstiny occupants, snowsuits and all, intoicy melt water, with ensuing wails fromthe infants and scoldings from the wiveswhich ended the scientific discussionprecipitously. The rest of the returnwas characterized by silence from themen, humbly attentive to eloquent female comments on the incompetence ofscientists to perform ordinary tasks oflife."In spite of this early mishap, Dr.Lowry's tasks in life have been carriedout with extraordinary fruitfulness anddistinction. The University of Chicagois enormously proud of his achievements, which have earned him manyhonors, including election to the National Academy of Sciences. Ollie, withjoy and satisfaction, I convey to youour Distinguished Service Award."Stanton A. Friedberg, Rush, '33, waspresented by John R. Lindsay, JonesProfessor of Otolaryngology.Dr. Friedberg is a native of Chicagoand the son of a graduate of Rush Medical College whose illustrious career hewas destined to follow closely. He tookhis A.B. degree from Dartmouth Collegein 1929 and his M.D. from Rush in 1933.The following three years were spent inpreparatory training at Presbyterian andMunicipal Contagious Disease Hospitals,and at Rush Medical College where heworked under George E. Shambaugh,Sr. His residency training in otolaryngology under Thomas C. Galloway at CookCounty Hospital was begun just thirtythree years after his father had joinedthat staff and where the elder Dr.Friedberg was to become chief of theDepartment of Ear, Nose and Throatin 1913, a position which he held untilhis untimely death in 1920.Upon the completion of his residency,Dr. Friedberg joined the otolaryngologystaff at Presbyterian Hospital and became its departmental chairman in 1953.Since the amalgamation of Presbyterianand St. Luke's, he has continued aschairman of the department and has recently been appointed Surgeon-in-Chiefof the joint hospitals.In speaking of Dr. Friedberg's professional achievements, Dr. Lindsay concluded: "His distinction as a scholarwas evident early in his career by election to membership in Phi Beta Kappaand Alpha Omega Alpha. His distinctionas a clinician and investigator is evidenced by some thirty-four contributions to the literature in the field ofotolaryngology and broncho-esophagology. He holds membership and has beenan active participant in the leading local and national scientific societies inhis field and recently completed a termas president of the American BronchoEsophagological Association."His interests have not been limitedto his profession but have includedactive participation in such organizations as the American Physicians ArtAssociation, the Society of Medical History of Chicago and in public serviceto his community."Albert Lester Lehninger, Faculty1945-52, was presented by Earl A.Evans, Jr., Professor and Chairman, Department of Biochemistry."Albert Lehninger was trained atWesleyan University and at the University of Wisconsin. He began his scientificcareer here at The University of Chi- cago in 1945 as assistant professor inthe Department of Biochemistry andwith the group in the Department ofSurgery that was to become the BenMay Laboratory. He left in 1952 asprofessor to become DeLamar Professorand director of the Department of Physiological Chemistry at Johns HopkinsUniversity. However, during this shortperiod he had already established himself as one of the outstanding biochemical investigators of our time."His first experiments involved thesuccessful preparation of an in vitrosystem for the oxidation of lipids. Ican remember Hans Krebs asking tomeet Lehninger, saying that he, Krebs,was always anxious to meet people whohad succeeded where' he had failed. Thelipid work led naturally to an examination of the nature and function ofthe mitochondria. This is a difficult field,filled with talented but difficult and rambunctious scientists-and equallyrambunctious experimental systems. Iam reminded of Mr. Sam Goldwyn'scomment: 'The situation,' Mr. Goldwynsaid, 'can be described in two wordsImpossible.'"Nevertheless, Lehninger has maintained his position as a leader in thisformidable field, although equally activeas an administrator and as a teacherwhose style is characterized by elegance,clarity and precision."He is a member of many learnedsocieties, including the National Academy, and has begun to accumulate honorary degrees at a rapidly increasingrate."His friends in the Department ofBiochemistry and the University are delighted at his recognition and we arehappy in the realization that he hasmany more years to continue his valuable work."HIRSCHOfficers of Medical Alumni1965-66Edwin F. Hirsch, Ph.D., '14 M.D.,Rush, '16, Associate Professor Emeritusof Pathology from Chicago and RushMedical College is President of theAssociation this year. Dr. Hirsch hasbeen an active and loyal member of theAlumni Association for many years andserved on the Council from 1962-65.Until 1959 he was Director of the Department of Pathology of St. Luke'sHospital and although he is now emeritus from Presbyterian-St. Luke's, hisinvolvement in the field of pathologyhas by no means diminished. He is currently the Director of the Clinical Laboratories for Columbus, Cuneo and St.Francis Cabrini Hospitals and has served as an' officer or onthe committees of somany local, state, national and international medical societies that spacedoes not permit us to list them. TheAssociation is pleased to have such avigorous and energetic alumnus in theoffice of President.Sidney Schulman, '44, M.D., '46, thisyear's Vice-President, is Ellen C. Manning Professor of Medicine (Neurology).Robert D. Moore, M.D., '39 (University of Rochester) was renamed Secretary of the Association. He spent ayear's residency here in 1941, joined thefaculty in 1948, and is Professor ofOrthopedic Surgery.Henry L. Wild berger, '51, was reelected Treasurer. He took his internship and residency here and was on thestaff of the Department of Medicineuntil 1962. Dr. Wildberger, now in private practice, is clinical assistant professor at Northwestern University andon the attending staff of Chicago Wesley Memorial Hospital.Elected to three-year terms on theCouncil were:David S. Fox, '44, Chairman of theDepartment of Surgery and Secretary tothe Board of Directors of WoodlawnHospital. Dr. Fox was a research assistant in surgery at the University (1948-49) and is clinical associate professorof surgery at Loyola University.Jean A. Spencer, '50, was on the staffof the Department of Medicine (Gastroenterology) from 1955 to 1963 andhas been since that time an attendingphysician at Woodlawn Hospital.MEDICAL ALUMNI BULLETIN 7BOll BAUGHJACOBSONJONES8 MEDICAL ALUMNI BULLETIN MENNEMURPHYSILER SNORFTHORNTONUNGERNine members of the Class of 1915celebrated their fiftieth anniversary atthe Reunion Banquet. Testimonials commemorating the event were presentedto:Oral B. Bolibaugh, Los Angeles, California, an orthopedic surgeon with thePermanente Medical Group.Edmund Jacobson, Chicago, Illinois,on the staff of the Department of Physiology from 1926-1936, has returned toprivate practice and is Director of theLaboratory of Clinical Physiology.William S. Jones, is practicing ophthalmology in Menominee, Michigan.His son, William, Jr., an otolaryngologist,is in practice with him.Frank R. Menne, Peebles, Wisconsin,emeritus professor of pathology, University of Oregon.Frank G. Murphy, Chicago, Illinois,Two of Dr. Murphy's sons are associatedwith him in the practice of orthopedicsurgery.Marion Pierce Siler, Oak Park, Illinois, still active in general practice.Lowell D. Snorf, Wilmette, Illinois,professor emeritus of medicine, Northwestern University.John W. Thornton, active in generalpractice in Lansing, Iowa.Leon Unger, Chicago, Illinois, in practice of internal medicine and associateprofessor emeritus, Northwestern University.Twenty-seven of the forty-four livingmembers of the class responded to ourrequest for information on their currentactivities. Fifteen are still active in theirmedical careers, and the avocations ofthe group include farming, travel, hunting, golf, photography, writing, and civicservice. Charles E. Thomson, who tooka Master's degree in Greek at Stanford,returned to the study of Greek literatureafter his retirement last year. LudwigA. Emge, representative of the eightwhose work has been primarily in teaching, is now clinical professor emeritus ofobstetrics and gynecology at StanfordUniversity. His long career has includedservice in the Army Medical Corps andthe U.S. Public Health Service, and thepresidencies of a number of obstetricaland gynecological societies. A diplomateof the American Board of Obstetrics andGynecology and a Fellow of the Ameri- THE CLASS OF 1915can College of Surgeons, he is also theauthor of many research articles in hisfield and a contributor to the standardtextbooks on gynecology and obstetrics.Robert Stanley Kneeshaw, who beganpractice in. San Jose, California after hisreturn from overseas Army Service in1920, is one of the sixteen who chose careers in private practice and communityservice. Honored in 1958 as his city'sDistinguished Citizen of the year, he isco-founder of the San Jose Hospital anda past president of its staff and of thestaff of O'Connor Hospital. He has alsobeen president of the County and StateMedical Societies and of other localmedical groups. Dr. Kneeshaw continuesin active practice and exemplifies thespirit of dedication evident in the lives ofall his classmates. His plans to attendthe Reunion Banquet were cancelled because of an emergency operation involving one of his patients. Harry Gauss,whose career included both private practice and teaching appointments, retiredin 1962 and is associate professor emeritus of clinical medicine at the University of Colorado. Dr. Gauss' healthdid not permit him to attend the Banquet, but he wrote what seems to usa fitting testimonial for all his classmembers: "Nothing would please mebetter than to attend this event of myfine class of which I am justly proud.Medicine has been my life's work forfifty years. It has been the means bywhich I have been able to serve humanity. It has given a purpose to my lifeand has made my life worthwhile. Allthis lowe to Rush Medical College andits dedicated faculty which I came toappreciate more as the years accumulated. It has been a rich, rewardingexperience and I would like to do it allover again. . .. "Copies of the biographies we receivedwere given to the class members presentat the banquet and were sent with theirFifty- Year Testimonials to:Lurrine Miles Allen, St. George,Utah.Hillier L. Baker, Chicago, Illinois.Wesley C. Becker, Lincoln, Nebraska.Frederik N. Berken, Aberdeen,Washington.Theodore E. Beyer, La Jolla, California.Paul Black, Lincoln, Nebraska.Homer M. Carter, Madison, Wisconsin. Robert C. Cook, Denver, Colorado.Thomas J. Devereaux, Wayzata,Minnesota.Lawrence G. Dunlap, Anaconda,Montana.Ludwig A. Emge, San Francisco,California.Erse! M. Fessenden, Springfield, Missouri.Harry Gauss, Denver, Colorado.Cyril J. Glaspel, Grafton, NorthDakota.Robert R. Glynn, Springfield, Missouri.Milton P. Graham, Aberdeen, Washington.Faith F. Hardy, Ada, Michigan.Albert I. Haugen, Pasadena, California ..Fred Z. Havens, Rochester, Minnesota.Robert H. Henderson, Medford, Oregon.Lewis A. Hopkins, Santa Barbara,California.James E. Hunter, Seattle, Washington.Robert S. Kneeshaw, San Jose, Cali-fornia.Arthur L. Langhorst, Elgin, Illinois.Karl Lewis, Los Angeles, California.Jay H. McCormack, Seattle, Wash-ington.George McCreight, Carmel Valley,California.James G. Montgomery, Kansas City,Missouri.James S. Orr, Fruita, Colorado.Benjamin Rappaport, Wadsworth,Illinois.Burrell O. Raulston, Los Angeles,California.Francis J. Scully, Hot Springs, Arkansas.William A. Swim, Los Angeles, California.Charles A. Thomson, Bronx, NewYork.Paul F. Thuresson, Riverside, California.Edward W. Westland, DeerfieldBeach, Florida. (since deceased)MEDICAL ALUMNI BULLETIN 9BLOCKMcCLINTOCK AWARDThe class of 1965 chose George E.Block, Associate Professor of Surgery,to be this year's recipient of the fivehundred dollar McClintock Award foroutstanding teaching. Dr. Block held apostdoctoral Fellowship in the Ben MayLabs in 1955-56 and joined the Univer.sity medical faculty in 1960.THE COGGESHALL REPORTLowell T. Coggeshall headed acommittee for the Association of American Medical Colleges to study means toimprove medical education. In their report, the Committee called for teamwork in the health sciences. Since, inthe opinion of the authors, America isnot likely ever to produce enough phy.sicians to satisfy the growing nationalneeds, they conclude that it is essentialthat physician productivity be increasedthrough delegation of specific tasks toothers. There will be an increased needfor persons trained in related healthfields to work as members of the teamunder the leadership and coordination ofthe physician.Dr. Coggeshall, the Frederick H.Rawson Professor in the Departmentof Medicine, was Dean of the Divisionof Biological Sciences from 1948 to 1961and is currently a Vice-President andTrustee of the University.10. ME 0 I CAL A L U M NIB U L LET IN DEDICATION OFPHEMISTER HALLWith the hanging of a temporaryplaque April 28, 1965, the new apartmentbuilding at 5715 Drexel Avenue housinginterns and residents, now bears thename. PHEMISTER HALL. In April, 1963the Board of Trustees of The University of Chicago designated this buildingto be so named in honor of Dallas B.Phemister, Rush '04, the first chairmanof the Department of Surgery.The ceremony was sponsored by TheUniversity of Chicago History of Medicine Society, a student group, and theMedical Alumni Association. Attendingwere Dean Phemister and Mrs. John M.Beal, Jr., a son and daughter of Dr.Phemister, William E. Adams, WrightAdams, Richard K. Blaisdell, '48,M. Edward Davis, '22, Lester R. Dragstedt, '21, Franklin. C. McLean, '10,Peter V. Moulder, '45, R. Wayne Neal,Nels Strandjord, '46, and Misses AnnBudy, Lola Tucker, and Mildred VanSchoick.Afterwards, Dr. Dragstedt spoke at thenoon lecture on "Phemister and Experimental Surgery."A new portrait of Dallas B. Phemisterwas presented to the American Collegeof Surgeons for their gallery in the national headquarters in Chicago, a gift ofhis students and close friends. It portraysDr. Phemister in the presidential robesof the College and was painted by Edmund Giesbert from photographs andsketches that he made for the portraitthat hangs in the lecture room of Billings-P-117. HISTORY OF MEDICINESOCIETYThe History of Medicine Society ofThe University of Chicago had an especially active year in 1964-65. In JuneJohn Maynard Smith spoke on "TheEvolution of Altruism." In October, at ajoint meeting with the Chicago Societyof Medical History, ]. B. de C. M. Saunders presented "Four Hundred Years ofVesalius" and later in the fill Paul Bucy(Fac., '28-'41) spoke on "The Historyof Neurosurgery" and Roy Grinker,Rush '21, gave a personal account of hisexperience with "Freud and Psychoanalysis."There have been monthly meetingssince February 1965. Eugene Gendlindiscussed "Recent Developments in theHistory of Psychiatry" and in MarchLeon o. JacobSon, '39, gave "An Intern's Experience with the Atomic BombProject." William E. Adams was theprincipal discussant at a session devotedto Dallas B. Phemister. A dedicationceremony at Phemister Hall was followedby a lecture by Lester R. Dragstedt,Rush '21, entitled "Dallas Phemister andExperimental Surgery."Recent meetings were on "The Life ofCajal" by Clement A. Fox and "ThreeScottish Doctors" by Douglas N. Buchanan.Officers of the group were EdwardTarlov, '65, president; Patrick Freehill,'65, and Nicholas Vick, '65, secretaries;and Walter Fried, '58, treasurer. Professor Ruth Rhines and Richard K.Blaisdell, '48, provided continual goodcounsel.N. V.M. EDWARD DAVIS, FRANKLIN C. MclEAN, LESTER R. DRAGSTEDT, WILLIAM ADAMS,WRIGHT ADAMS, and DEAN PHEMISTER at the dedication of Phemister Hall.THE SENIOR CLASS OF 1965ACKERMAN, LAURENS VEDDERBorn Jan. 26, 1938; U. of Chicago, BS., 1961;Intern.: Highland-Alameda County H., Oakland,Calif.; Internal Medicine; Unmarried; 645 SheridanRd., Evanston, Ill.AHROON, CARL RICHARDBorn June 25, 1938; Ill. Wesleyan U., B.S., 1961;Intern.: Billings; Internal Medicine; Unmarried;Marquette Lane, Kankakee, Ill.BAllARD, ROBERTA C. ANDERSONBorn Aug. 22, 1940; Earlham College, B.A., 1961;Intern.: Billings; Pediatrics; Married; 6755 Chappel,Chicago; 1505 Alma Drive, Champaign, Ill.BARNES, BARBARA J. DEANBorn Aug. 11, 1940; U. of Chicago, B.S., 1961;Intern.: Billings; Neurology; Married; A.O.A.; 822E. 58th St., Chicago; 135 24th Ave. S.E., St. Petersburg, Fla.BARRICKS, MICHAEL EllBorn Feb. 22, 1940; Harvard, B.A., 1961; Intern.:Palo Alto-Stanford H. Center, Palo Alto, Calif.;Cardiac Surgery; Unmarried; 7829 S. Luella Ave.,Chicago.BEEBE, JOHN ELLIOT, IIIBorn June 24, 1939; Harvard, B.A., 1961; Intern.:U .S.P .H.S. H., San Francisco; Psychiatry; U nmarried; 5 S. 38th St., Philadelphia.BUCHANAN, MONICA ANNBorn Mar. 2, 1939; Marquette U., B.S., 1961;Intern.: Denver Gen. H.; General Practice; Unmarried; R.R. 2, Ellis St., Kewaunee, Wisc.COLLINS, DEIRDRE S.Born Feb. 14, 1937; U. of Chicago, B.S., 1960,M.S., 1963; Married; 10839 S. Hoyne Ave., Chicago.CRAMER, D. BRYANTBorn Apr. 16, 1937; Northwestern U., B.A., 1959;Intern.: U.S. Naval H., Pensacola, Fla.; AerospaceResearch; Married; 2544 S. 7th St., Springfield, Ill.DAHLBERG, ALBERT EDWARDBorn Sept. 19, 1938; Haverford College, B.S.,1960; graduate student in biochemistry; Intern.:1966, Bobs Roberts H. ; Pediatric Hematology ;Married; 5715 S. Drexel Ave., Chicago; 5756 HarperAve., Chicago.DALRYMPLE, DAVID EDWARDBorn Nov. 10, 1936; DePauw U., B.A., 1958;Purdue U., M.S., 1960; Intern.: State U. of Iowa H.,Iowa City; Internal Medicine; Married; 1501 CedarSt., Elkhart, Ind.de la TORRE-UGARTE, FERNANDOBorn July 25, 1942; Intern.: New York U. Upstate Med. Center, Syracuse, N.Y.; Internal Medicine ; Unmarried; Clark Hall Residence, 175 Elizabeth Blackwell St., Syracuse, N.Y.; A vda. Pardo364 Miraflores, Lima, Peru.DWECK, HARRY S.Born Feb. 12, 1940; U. of California, B.A., 1961;Intern.: Strong Memorial H., Rochester, N.Y.; Pediatrics; Unmarried; 79 Durland Rd., E. Rockaway,N.Y.FIREMARK, HUGH MARSHALLBorn July 7, 1938; Columbia U., B.S., 1959; U. ofChicago, Ph.D., 1963; postdoctoral fellow in pharmacology, U. of Oxford, Oxford, England; Neurology; Married; 138-06 226th St., Laurelton 13, N.Y.FREEHlll, PATRICK JOSEPHBorn Apr. 29, 1940; St. Joseph's College, B.A.,1961; Intern.: U.S.P.H.s. H., Seattle, Wash.; Psychiatry; Married; One child; Melvin, Ill.MEDICAL ALUMNI BULLETIN 11THE SENIOR12 ME 0 I CAL A L U M NIB U L LET IN HARRER, DAVID STANLEYBorn Jan. 26, 1939; U. of Florida, B.S., 1961;Intern.: U.S. Naval H., Great Lakes, Ill.; NuclearMedicine; Married; A.O.A. 1964; 1735 N. Chestnut,Waukegan, Ill.; 347 Flagler Blvd., Lake Park, Fla.HILLMAN, ROBERTBorn Oct. 5, 1937; U. of Michigan, B.A., 1959;Intern.: U.S.P.H.S. H., Seattle, Wash.; Psychiatry;Married; 8716 Sand Point Way N.E., Seattle, Wash.;808 Judson Ave., Evanston, Ill.HOFFMAN, GARY FRANKLINBorn Sept. 22, 1942; Intern.: Wilford Hall, U.S.A.F.H., Lackland A.F.B., Texas.; Undecided; Unmarried;Bldg. 4550, Box 1559, Lackland A.F.B., Tex.; 4926 N.Springfield, Chicago.HORNICK, FREDERICK WALTERBorn Apr. 6, 1940; U. of Wisconsin, B.S., 1962;Intern.: Maricopa County Gen. H., Phoenix, Ariz.;Surgery or Obs. & Gyn.; Married; One child; 851. Valley View Dr., Richland Center, Wisc.HUNTER, ROBERT LEEBorn Jan. 27, 1939; Harvard, B.A., 1961; Intern.:Boston City H., Pathology or Internal Medicine;Unmarried; 4837 Kenwood, Chicago.JACOBS, J. WYNNBorn Mar. 20, 1934; Harvard, B.A., 1956; Intern.:U.S.P.H.S. H., Boston; Ophthalmology; Married;1000 Clay St., Montgomery, Ala.JACOBSON, DOUGLAS ROBERTBorn May 30, 1940; Ohio State U., B.S., 1961;Intern.: U. of California H., San Francisco; InternalMedicine; Married; A.O.A.; 6 Locksley, San Francisco.JACOBSON, SALLY J. CASTOBorn July 16, 1940; Ohio State U., B.S., 1961;Intern.: Palo Alto-Stanford H. Center; Internal Medicine; Married; 6 Locksley, San Francisco; 7014Shawnee Run Rd., Cincinnati 43, Ohio.JANDA, WAYNE EDWARDBorn Sept. 17, 1939; U. of Chicago, B.S., 1961;Intern.: Milwaukee County Gen. H.; OrthopedicSurgery; Unmarried; 1643 S. Harvey, Berwyn, Ill.KAHAN, BARRYBorn July 25, 1939; U. of Chicago, B.S., 1960,Ph.D., 1964; Intern.: Mass. Gen. H., Boston; Surgery; Married; 2611 Fenwick Rd., University Heights,Ohio.KALES, ARTHUR NORMANBorn May 23, 1939; U. of Chicago, B.S., 1961;Intern.: Peter Bent Brigham H., Boston; InternalMedicine; Unmarried; A.O.A.; 6408 Marjory Lane,Bethesda 14, Md.KA TI, PAUL LLOYDBorn May 23, 1940; Intern.: U. of Ill. Research &Educational H., Chicago; Surgery; Unmarried; 2345Vardon Lane, Flossmoor, Ill.KAVKA, STEPHEN JUDDBorn June 15, 1941; U. of Chicago, B.S., 1961;Intern.: Passavant Mem. H., Chicago; Neurosurgeryor Internal Medicine; Married; 5455 N. Francisco,Chicago.KOTTRA, JOHN JOSEPHBorn Dec. 9, 1940; Loyola U., B.S., 1962; Intern.:Billings; Medicine; Married; A.O.A.; 2040 E. 68th St.,Chicago; 6324 N. Lenox, Chicago.KOTTRA, LORRAINE D. LANGBorn Sept. 26,1940; Loyola U., B.S., 1962; Intern.:Billings; Internal Medicine; Married; A.O.A.; 2040E. 68th St., Chicago; 6300 N. Glenwood, Chicago.CLASS OF J 965KRANZLER, JEFFERY KENNE.THBorn June 15, 1941; U. of Chicago, B.S., 1961;Intern.: Passavant Mem. H., Chicago; Internal Medicine; Unmarried; 6341 N. Central Park, Chicago.KREIDER, STANLEY J.Born Sept. 18, 1931; Ill. Wesleyan U., B.A., 1961;Intern.: U.S. Naval H., Great Lakes, Ill.; Ophthalmology; Unmarried; 3611 Orchard Rd., Quincy, Ill.KRIEGER, GARY FREDERICBorn Dec. 7, 1940; U. of Southern Calif., B.A.,1961; Intern.: Children's H. of Los Angeles; Pediatrics; Unmarried; 4826 Escalon Ave., Los Angeles.KUHR, MURRAY DAVIDBorn Dec. 19, 1939; U. of Cincinnati, B.S., 1961;Intern.: Johns Hopkins H., Baltimore; Pediatrics;Married; One child; 1814 Burroughs Dr., Dayton,Ohio.LEAVITT, LEWIS A.Born Nov. 7, U. of Chicago, B.S., 1961; Intern.:Bronx Municipal H. Center, N.Y.C.; Undecided; Unmarried; 711 Magenta St., Bronx, N.Y.LINDBERG, PETER JOHNBorn Nov. 26, 1939; Augustana College, B.A.,1961; Intern.: Presbyterian-St. Luke's H., Chicago;Internal Medicine; Married; 1718 W. Flournoy St.,Chicago; 18490 42nd St., Rock Island, Ill.LINDENBAUM, BARRIE LEEBorn Mar. 26, 1938; Lehigh U., B.S., B.A., 1961;Intern.: Bronx Municipal H. Center, N.Y.C.; Surgery;Married; Timber Grove Rd., Owings Mills, Md.LUTTER, LOWELL DEANBorn Sept. 17, 1939; Grinnell, B.A., 1961; Intern.:U. of Minnesota H., Minneapolis; Undecided; Married; 424 Cook, Libertyville, Ill.MAILLlS, MAXWELL SHERWOODBorn Aug. 9, 1939; U. of Chicago, B.S., 1961;Intern.: Royal Victoria H.; Montreal, Quebec, Canada; Neurological Surgery; Unmarried; 7745 Luella,Chicago.MeNIELL, GLENDA FRANCESBorn Apr. 2, 1939; U. of Chicago, B.S., 1961;Intern.: U. of Michigan H., Ann Arbor; Pediatrics;Unmarried; A.O.A.; 2604 Lowell Ave., Memphis,Tenn.MILLER, STANLEYBorn Jan. 17, 1940; C. W. Post College, B.S., 1961;Intern.: Long Island Jewish H., New Hyde Park,N.Y.; General Practice; Married; One child; 16Chance St., Hicksville, N.Y.PILCHARD, WILLIAM ALBERTBorn Oct. 10, 1939; U. of Chicago, B.S., 1961;Intern.: U.S.P.H.S. H., Seattle, Wash.; Ophthalmology; Unmarried; R.F.D. #2, Wellsburg, W. Va.PINNAS, JACOB LOUISBorn Jan. 31, 1940; Rutgers U., B.A., 1961; U. ofChicago, M.S., 1965; Intern.: New York U. UpstateMed. Center, Syracuse, N.Y.; Medicine; Married;Clark Hall Residence, 175 Elizabeth Blackwell St.,Syracuse, N.Y.; 264 Goldsmith Ave., Newark, N.].PREISMAN, RICHARD CHARLESBorn Jan. 14, 1940; Ohio State U., B.S., 1961;Intern.: U. of Pittsburgh H.; Psychiatry; Unmarried;104 Elm Crest Dr., Wheeling, W. Va.RAININ, EDGAR ALANBorn Feb. 23, 1940; Intern.: San Francisco Gen.H.; Ophthalmology; Unmarried; 23575 ShelburneRd., Shaker Hts. 22, Ohio.ME 0 I CAL A L U M N I 8 U L LET I N 13THE SENIOR14 ME 0 I CAL A L U M NIB U L LET IN RHOMBERG, BERNARD BASSLERBorn June 15, 1939; Loras College, B.S., 1961;Intern.: Milwaukee County Gen. H.; General Surgery; Unmarried; 508 W. 7th St., Dubuque, Iowa.RISSER, FRED DEANBorn July 20, 1938; Drake U., B.A., 1960; Intern.:Kaiser Foundation H., San Francisco; Psychiatry;Married; 6530 Elmcrest, Des Moines, Iowa.ROSENBLUM, EDWIN LEONBorn Mar. 20, 1940; New York U., B.A., 1960, U.of Chicago, M.S., 1964; graduate student in biochemistry, LaRabida; Unmarried; 134-54 Maple Ave.,Flushing, N.Y.ROSS, LAWRENCE STEVENBorn May 19, 1941; U. of Chicago, B.S., 1962;Intern.: Michael Reese H., Chicago; Urology; Married; A.O.A.; 2951 S. Parkway; Apt. 1010, Chicago;9130 N. Tripp, Skokie, Ill.ROTH, CHARLES DUANBorn July 29, 1937; Otterbein College, B.S., 1959,U. of Chicago, M.S., 1963; Intern.: Bobs RobertsT.; Neurology; Married; One child; 5527 S. Cornell,Chicago; 311 Seneca St., Defiance, Ohio.SCHONBERG, SAMUEL KENNETHBorn July 30, 1940; Bethany College, B.A., 1961;Intern.: Montefiore, H., Bronx, N.Y.; Pediatrics;Married; 3535 Rochambeau Ave., Bronx; 2320 E. 26thSt., Brooklyn 29, N.Y.SCHWARTZ, MILFORD FRANK, JR.Born Jan. 18, 1940; Washington & Lee U., B.A.,1961; Intern.: Bobs Roberts H.; Pediatrics; Unmarried; A.O.A.; 1400 E. 55th Pl., Chicago; 5701Utah Ave., N.W., Wash. 15, D.C.SPENCE, ALEXANDER MORTONBorn Dec. 22, 1940; Intern.: U. of Oregon Med.Center, Portland; Undecided; Unmarried; A.O.A.;11715 W. 20th Ave., Denver, Colo.STRAUSS, HARVEY STANLEYBorn Jan. 30, 1940; U. of Chicago, M.S., 1964;Intern.: Babies & Children's H.:, Cleveland; ChildPsychiatry; Married; 16000 Terrace Rd., E. Cleveland, Ohio; 1644 S. Taylor Rd., Cleveland Hts., Ohio.TARLOV, EDWARDBorn Nov. 18, 1938; Harvard, B.A., 1960, U. ofChicago, M.S., 1964; Intern.: Johns Hopkins H., Baltimore; Neurosurgery & Neurology; Unmarried; 11505th Ave., N.Y.C.TAYLOR, HARRIS CHAIMBorn Apr. 30, 1940; Queens College of N.Y.C.,B.S., 1961; Intern.: Billings; Medicine or Pediatrics;Married; 1372 E. 57th St., Chicago; 212-09 64th Ave.,Bayside 64, N.Y.TESSLER, HOWARD HARVEYBorn Feb. 3, 1941; U. of Michigan, B.A., 1961;Intern.: Billings; Undecided; Unmarried; 1200 N.Forest Ave., Oak Park, Ill.TITEL, JERRY HARVEYBorn Jan. 21, 1939; Carleton College, B.A., 1961;Intern.: Billings; ENT; Married; One child; 5128S. Cornell, Chicago; Clayton, Wisc.TOMASOVIC, JERRY J.Born Feb. 9, 1940; U. of Chicago, B.S., 1962;Intern.: U.S. Air Force H., Andrews A.F.B., Maryland; Aerospace Medicine; Unmarried; 3818 ManolaAve., St. Louis 21, Mo.TOPOROFF, STUART J.Born Aug. 4,1938; N.Y. City College, B.E.E., 1959,Carnegie Institute of Technology, M.S., 1960; Intern.: Kings County H. Center, Brooklyn, N.Y.:Internal Medicine; Married; 1230 Sheridan Ave.,Bronx 56, N.Y.CLASS OF 1965TURNER, DAVID ARTHURBorn Dec. 30, 1940; U. of Chicago, B.A., 1962;Intern.: Billings; Medicine; Unmarried; 5715 S.Drexel Ave., Chicago; 6639 N. St. Louis, Lincolnwood, Ill.VICK, NICHOLAS A.Born Oct. 3, 1939; U. of Michigan, B.A., 1961;Intern.: BiJlings; Neurology; Married; One child;2851 S. Parkway, Chicago.WEYHRICH, GLENN HOWARDBorn May 30, 1940; Intern.: U. of Oregon Med.Center, Portland; Undecided; Married; A.O.A. 1964;2717 S.W. Corbett Ave., Portland; 335 Prince St.,Pekin, Ill.WINKLER, NORMAN WALTERBorn May 28, 1935; U. of Rochester, B.A., 1957;Intern.: Deferred; Biochemical research at LaRabida;Undecided; Married; One child; 1369 E. Hyde ParkBlvd., Chicago; 867 W. 181st St., N.V.C.WOLF, BETTY IRENEBorn Nov. 3, 1938; U. of Chicago, B.S., 1960;Intern.: Children's Mem. H., Chicago; Pediatrics;Married; 477 Deming Pl., Chicago; 7932 Navajoe,Affton, Mo.WONG, ROLAND JAMESBorn Feb. 26, 1941; Intern.: Highland-AlamedaCounty H., Oakland, Calif.; Urology; Unmarried;618 Sonoma Blvd., Vallejo, Calif.YOUNGER, LEE RICHARDBorn Apr. 14, 1940; Oberlin College, B.A., 1961;Intern.: Beth Israel H., Boston; Internal Medicine;Married; 700 N. Brainard Ave., La Grange Park,Ill.SENIOR SCIENTIFIC SESSIONHuman Heart Rate During24 Hours of Usual ActivityBy D. BRYANT CRAMERPathologyDeterminations of heart rate are usually based on observations of severalminutes or less. However, the heartrate of a normal individual may varyfrom less than 50 to more than 120beats per minute depending on manyfactors. A pulse rate for 24 hours ofusual activity, integrating the amplitude,duration and frequency of variations inrates over a reasonable physiologicalcycle might therefore provide a moreaccurate characterization of the heartrate.Twenty-four heart-rates were determined using a miniature self-containedcounter developed at The University of Chicago. Subjects recorded counter readings and activity at about hourly intervals while awake.A total of 393 twenty-four hour heartrates were obtained in 110 healthymales. Average 24-hour heart-rates inthe group ranged from 59 to 100 beatsper minute, the distribution was normalwith a mean of 78.4 and a standard deviation of 7.6. For indiviudals, averagerates awake and asleep correlated wellwith the average 24-hour rate. Averagerates for 24 hours did not correlate wellwith rates determined by usual clinicalmethods. Computer analysis failed toreveal any statistically significant correlation between age, sleep habits, bodysize or occupation and heart rate. Twogroups of subjects deviated more thantwo standard deviations from the mean;patients with decompensating heart dis- ease had high rates and well trainedathletes had low rates.The results showed that meaningfuldata on 24-hour heart-rates in healthyindividuals could be obtained. It remainsto be determined whether apparentlyhealthy individuals with long term rapidheart-rates have an increased risk ofdeveloping cardiovascular disease.Sympathectomy,Plasma Expansion,and Circulatory DynamicsBy DAVID E. DALRYMPLESurgerySympathetic denervation may produce certain deleterious effects as a result of the disproportionate increase inblood flow to one area of the body. Re-ME D I CAL A L U M NIB U L LET I N 15sultant hemodynamic alterations in certain cases have been implicated in subsequent paradoxical gangrene of the unoperated contralateral extremity, cardiovascular accidents, myocardial infarctions and cardiac arrest. It was thepurpose of this experiment to measurethe effect of unilateral lumbar sympathectomy on cardiac output, blood pressure, and blood flow to the limb. Tenmongrel dogs having an average weightof 20 kilograms were anesthetized withpentobarbitol sodium and underwentsplenectomy. Central venous, peripheralvenous and systemic arterial pressureswere recorded. Cardiac outputs weredetermined by the dye dilution methodand leg blood-flows were represented byexternal iliac artery measurements using an electromagnetic flow probe. Sympathectomy was performed in six of theten animals.Following unilateral lumbar sympathectomy, cardiac output fell 22 percent and systemic blood pressure 16 percent. The administration of 6 per centdextran in normal saline, in additionto correcting the fall in cardiac outputand blood pressure, increased the sympathectomized limb blood-flow nearlythree-fold. This represented an increaseto 900 per cent of the pre-sympathectomy flow value. The percentage of thecardiac output supplying the leg rosefrom approximately one and one-halfto five. In contrast, the percentage supplying the legs of un operated animalsdid not change following dextran infusion.Specific Hormone-InducedChanges in Concentrationof Isocitric Dehydrogenasein Adrenal CortexBy FERNANDO DE LA TORRE-UGARTEBen May LabThe activity of rat adrenal gland isocitric dehydrogenase is related to estrogen levels. Ovariectomy or hypophysectomy induced a rise in adrenal ICD activity from five to fifteen units.Estradiol reversed the ovariectomyinduced enzyme and ACTH reversed thehypophysectomy-induced adrenal ICDbut estradiol had no effect in hypophysectomized animals. Thus it was concluded that the estradiol effect was mediated via the pituitary gland.In ovariectomized animals, estradiol-17B was the only steroid hormone thatinduced the ICD changes. Progesteroneor testosterone were inactive. Proges-16 MEDICAL ALUMNI BULLETIN terone did not block the action of estradiol on adrenal ICD.Long standing hypophysectomy orcortisone injections caused a decline inICD. This was thought to be due to severe atrophy of the adrenal glands asevidenced at autopsy of these animals.It was also learned that thyroidectomy did not have an effect on adrenalICD activity. McKerns, however. produced in vitro inhibition of adrenal leDby thyroid hormone or its analogs.Measurements of ICD in differentzones of the adrenal cortex showed thatthe enzyme is located mainly in thefasciculata and reticularis where steroidbiosynthesis occurs. The glomerulosacontains only small amounts of the enzyme.The present data are not in conflictwith earlier reports that estrogens inhibit the action of TPN-linked dehydrogenases in adrenal glands, but thepossibility of inhibition of synthesis ofadrenal ICD by estrogens cannot bediscarded. The relationship betweenovarian hormones and adrenal hormonesis also shown, which perhaps throwssome light on the etiology of the diseasedescribed in 1934 by 'Cushing.The Mechanism of Action ofCycloserine in MycobacteriumTuberculosisBy PATRICK J. FREEHILLMedicineThe structural similarity of the antibiotic substance cycloserine to d-alaninehas led to the speculation that themechanism of action of the antibioticis by competition with d-alanine in cellwall synthesis. This speculation wassubsequently confirmed by others withStaphylococcus aureus and it has beendemonstrated that cycloserine acts byinhibition of the enzymatic reactionswhich provide d-alanine for cell-wallproduction.Cycloserine has been shown to be active against Mycobacterium tuberculosis in vitro and in vivo. The presentstudy was initiated to ascertain whetherthe mechanism of action of cycloserineagainst mycobacteria was the same inother, non-acid fast, bacteria.The R1Rv strain of Mycobacteriumtuberculosis was grown in liquid Dubosmedia, the growth of the cultures beingfollowed with optical assay. After bacterial growth had reached the logarithmic phase, cycloserine, cycloserine withd- or l-alanine, or cyclorine with alphaamino butyric acid were added to the culture. Controls were provided by adding alanine or alpha-amino butyric acidalone to similar cultures.Results indicated that inhibition ofmycobacterial growth by cycloserinecould be reversed by d-alanine but notI-alanine and that the reversal of inhibition was dependent on the relativeconcentrations of cycloserine and d-alanine. Partial reversal of the inhibition was also obtained by the additionof alpha-amino butyric acid, althoughthis effect was never as great as withd-alanine. The addition of d- or I-alanine or alpha-amino butyric acid to thecultures had no effect on growth.Removal and Dissociationof GastrointestinalEpithelial Cells:A Method and ApplicationsBy DAVID S. HARRERMedicineWith advances in the study of gastrointestinal physiology, knowledge of functions unique to the intact organ has accumulated. To facilitate investigationsat a cellular level, a method has beendeveloped to obtain a pure suspensionof epithelial cells for in vitro studies.Of the several methods available fordissociation of cells, trypsinization asdescribed by Moscona is used. Prior tosacrifice, animals are starved and treatedwith antibiotics. The gut is then removed and lengths of vinyl tubing areinserted intraluminally at distal andproximal ends of the organ and tied into place. This provides an entirelyclosed system in which both wash andenzymatic solutions come in contactonly with the epithelial surface. Thecells are removed by physical and enzymatic disruption of the intercellularbonds using gentle agitation before andafter incubation with trypsin-pancreatinin Tyrode's solution. Sections of gut following trypsinization show a loss ofepithelial cells with an apparently intact basement membrane.This procedure provides a high yieldof viable and isolated homogeneous cellsfor in vitro biochemical, anatomical, andimmunological analysis. Investigationson the respiratory activity of the cellsindicate that they function as intactmetabolic units. The availability ofthese epithelial cells for study introducesa new approach to gastrointestinal research and should lead to further clarification of the many phenomena uniqueto the gastrointestinal tract.Two Patterns ofSplenic PhagocytosisBy ROBERT HUNTERPathologyBy studying the localization and migration within the rat spleen of an immunologically inert material, titaniumdioxide, and a radioactive antigen, J125flagella, it has been demonstrated thatthe phagocytic cells located in thelymphoid follicles of the rat spleen arefunctionally different from those located in the marginal zone and elsewherein the red pulp. The activity of themarginal zone and red-pulp phagocytesis similar to the activity of the hepaticKupffer cells. The follicular phagocytesdiffer from these in several fundamentalrespects. Antigen label is rapidly takenup in both locations, but it disappearsfrom the marginal-zone cells in less thanone day while the label persists for several weeks in the follicular phagocytes.Titanium dioxide, which is not metabolized, persists in both locations. In addtion to location and time of retentionof materials, these two regions also differ in the rate of phagocytosis, in theamount of material handled, in theirsensitivity to destruction by 700 r wholebody x-irradiation, and in the time oftheir development in the young rat. Thenewborn rat has neither functioning follicular nor marginal-zone phagocytesand is unable to produce any antibody.At about one week of age, the marginalzone phagocytes and 19S antibody synthesis develop simultaneously. At abouttwo weeks of age, the follicular phagocytes and 7S antibody synthesis alsodevelop simultaneously. This and other evidence suggests that the marginal zone phagocytes may be involved in19S antibody synthesis and that thefollicular phagocytes are necessary for7S antibody formation.The Biosynthesis of HyaluronicAcid in the Mammalian EyeBy ]. WYNN JACOBSOphthalmologySynthesis of the aqueous humor bythe ciliary body in the. adult eye is wellestablished. In contrast, the vitreousbody in the adult eye has been considered inert and the site of biosynthesisof one of its major constituents, hyaluronic acid (HA), had not been demonstrated. This problem was approachedby incubating diced-tissue .preparationsof ocular structures from adult rabbit eyes with radioactive acetate-H". Acetate is an efficient precursor of the Nacetyl group of N-acetyl glucosamineof HA.Polysaccharide was isolated from theincubation mixture after proteolytic digestion with papain and addition of carrier HA prepared from bovine vitreousbodies. The polysaccharide was precipitated with cetyl pyridinium chloride(CPC), and was purified to constantspecific activity by repeated precipitation with CPC. The radioactive productobtained was characterized by ion exchange chromatography on Dowex 1(C 1), cellulose acetate electrophoresisand gel filtration on Sephadex G-7 5.These procedures indicated that the radioactive product had the characteristicsof HA. Isolation of acetate from an acidhydrolysate of the polysaccharide demonstrated that the radioactivity of thepolysaccharide was in the N-acetyl groupof the N-acetyl glucosamine moiety.The ciliary body, the retina and thechoroid consistently incorporated themost radioactivity, while the lens, scleraand cornea were least active. All characterization was done on polysaccharideisolated from the structures showing thehighest activity. These studies demonstrate an unexpected biosynthetic ability of the retina and choroid, indicatepossible intraocular sources of HA andsuggest turnover of HA in the vitreousbody of the adult eye.Combined Effect of Cobalt andTestosterone on ErythropoiesisBy WAYNE E. JANDAMedicineCobalt is known to exert an erythropoietic effect by initiating erythropoietin formation, and evidence suggeststhat testosterone may effect erythropoiesis in a similar manner. One canmeasure the erythropoietic effect ofcobalt and testosterone either by determining the magni tude of the erythropoietic response in the polycythemicmouse following administration of theseagents, or by assaying in the polycythemic mouse the erythropoietin titerof plasma obtained from normal testosterone-and-cobalt treated animals.Transfusion-induced polycythemicmice receiving testosterone two or threedays prior to cobalt administration, demonstrate an approximately seven-foldgreater increase in erythropoiesis thanthe sum of the erythropoietic responsesof polycythemic mice receiving onlytestosterone or cobalt. Plasma from normal mice given testosterone two daysprior to cobalt administration, had approximately nine times the erythropoieticactivity as the sum of the activities ofplasma from normal mice receiving onlytestosterone or cobalt. Thus, a combination of cobalt and testosterone served topotentiate erythropoiesis in the polycythemic mouse, and acted synergistically to increase erythropoietin titers inthe plasma of the normal mouse. Thesynergistic interaction demonstrated inthese exepriments suggests that the fundamental mechanisms by which cobaltand testosterone stimulate elaborationof erythropoietin are different. Theseexperiments also suggest that greaterclinical effectiveness in cases of refractory anemias might be attained by combining lower doses of both agents, thancan be obtained with either medicationalone, and with fewer side effects.Isolation of a SolubleTransplantation AntigenBy BARRY D. KAHANSurgery & PhysiologyThe fate of tissue transplants dependsupon the genetic relation of the donorto the host: Histocompatibility allelesdetermine the production of antigenswhich elicit an immunological response-the homograft reaction. Operationally,these "transplantations antigens" maybe defined as substances which, whenparenterally administered, induce amore or less donor-specific sensitization.Several investigators have recentlyisolated water-insoluble, presumablymembrane-bound lipoprotein substanceswhich appear to be transplantation antigens. These materials have resistedsolubilization and purification, and thenature of their antigenic determinantis unkown.A water-soluble transplantation antigen was isolated from dissociated spleniccells which were disrupted in a physiological medium by exposure to 9 kc persecond magnetostrictive oscillation. Although the majority of the antigenicactivity of the oscillated suspensionwas sedimented at 20,000 g, appreciableactivity remained in the 105,000 g cellsap supernate. This fraction possessedboth histocompatibility-2 (H-2) andnon-H-2 antigenic specificities. The purified active principle of the supernatea) comprised 0.004 per cent of the wetweight of the starting material, b) wassoluble in deionized water and in 78 percent ammonium sulfate solutions, had aME Die A L A L U M NIB U LL E TIN 17density greater than 1.238 and an absorption maximum at 280 millimicronsand was homogeneous in sucrose gradients, on Sephadex G-200, and on electrophoresis at pH 7.9. Its approximatemolecular weight was 200,000.The bulk properties of this materialwere not those of a lipoprotein, and itseemed probable that the transplantationantigenic determinant had been isolatedin a different form. The water solubilityand relative purity of the presentpreparation may facilitate the dissectionof the histocompatibility determinants.The Anemia ofS/m-Mutant MiceBy ARTHUR KALESMedicineSlm is a mutation occurring inC57B 1/6 mice which produces, in thehomozygous condition, a macrocyticanemia associated with coat-color changeand sterility. The anemia of the mutanthomozygote is due to a gastrointestinalbleeding defect and to an erythropoieticdefect. The anemic animals lose approximately 3.5 per cent of their bloodvolume into the gastrointestinal tractdaily, as demonstrated by studies usingradioiron-labelled red cells. The causeof this blood loss has not been established. The anemic animals also havean erythropoietic defect which rendersthem unable to respond normally toerythropoietin or to hypoxia. Althoughthe homozygotes appear refractory toerythropoietin in moderately large single doses, they do respond if sufficientlylarge doses are given repeatedly. Theerythropoietic defect detected in thehomozygote is also evident in the hetorozygote. However, the defect remainslatent in the heterozygote, for althoughthis animal is subnormally responsiveto erythropoietin and to hypoxia, it isnot anemic.The Relation of GlutathioneStability to G6PD DeficiencyBy MURRAY KUHRMedicineAn inherited deficiency of erythrocyticG6PD is associated with drug-inducedhemolytic anemia that is due to aninability of the affected erythrocytes tocope with oxidative stress. The latter isdemonstrated by the glutathione stability test in which affected cells losereduced glutathione in the presence of18 MEDICAL ALUMNI BULLETIN an oxidant drug acetylphenylhydrazine.The mechanism of GSH instability wasinvestigated in stroma-free hemolysatesto which the effect of various treatmentsand additives could be explored.In preliminary experiments the distinction between normal and G6PDdeficient blood was found to be abolished in hemolysates. Thus the additionof glucose failed to result in GSH stability in normal or deficient hemolysatewhereas the addition of G6P resulted inGSH stability even in G6PD deficients.Subsequent experiments showed thatthe critical concentration of G6P necessary to result in GSH stability did notvary from normal to deficient hernolysate. The addition of reduced enzymeNADPH by-passes the substrate requirement, consistent with the dependency of GSH stability on the pentosephosphate pathway. When the NADPis removed by dialysis and norit treatment GSH instabiilty occurs despiteG6P addition. The latter is reversibleby the addition of NADP.In view of the GSH instability ofG6PD-deficient cells as compared tonormal cells and hemolysates fromeither normal or deficient when G6P isadded, the possibility of hexokinase inhibition operating in G6PD-deficienthemolysates was investigated. Hexokinaseactivity of normal and deficient hemolysate before and after incubation withacetylphenylhydrazine were found tobe equal. Addition of ATP and glucoseresulted in GSH stability in normal anddeficient hemolysates.These experiments show that although"pentose-phosphate shunt activity is required for GSH stability the degree towhich that activity is impaired in G6PDdeficiency does not account for GSHinstability. There would seem to besome other mechanism operative in theintact cells, perhaps stroma, which results in GSH instability of G6PDdeficient cells.Stress-Relaxation: A VitalVariable in ArterialViscoelastic StudiesBy BARRIE LINDENBAUMMedicineStress-relaxation (SR) was studiedin the thoracic aorta (TA), pulmonaryartery (PA), and umbilical artery (VA),these vessels being selected as prototypes whose predominant histologicalcomponents were elastin, collagen, and smooth muscle respectively. These arterial segments were reconstituted to theirin vivo lengths and diameters, and investigated at 38°C and 20°C by establishing graded radial pressures by stepwise micrometer injections of a balancedsalt solution. At all pressures and temperatures, SR, as measured by the pressure decay from an established initialpressure (Pi), continued for at least20 minutes, with the pressure decay.vA> >PA> TA. At mean physiologicalpressures, the VA, PA, and '_fA stressrelaxed to 70 per cent of Pi in 45 seconds, 20 minutes, and 30 minutes respectively. Temperature alterations hadlittle influence on stress-relaxation forthe TA and VA, but the pressure in thePA decayed to 50 per cent of its Pi in14 minutes at 20°C as compared tofive minutes at 38°C. This suggests analteration in internal viscosity whichprobably is related to the collagen system. The influence of SR upon pressure-volume (PV) plots as related tothe SR time (t�r) and histological composition was carefully investigated byvarying the methods of vessel distention. Linear PV diagrams with decreasing slopes were obtained as t"r and Piincreased (Pi always established fromequilibrium conditions). Classical sigmoid curves could be demonstrated onlywhere vessel distention continually increased as graded pressure levels weregenerated and tKr<30 seconds; in allother circumstances, the PV plots werelinear. These studies indicated that SRis a complex function of initial pressure,time, histology, and temperature. and isa critical parameter in any attempt tocharacterize the viscoelastic propertiesof arteries.Immunologic Studieson Thymectomized RatsBy JACOB PINNASPathologyCFN rats were thymectomized in thefirst day of life; litter-mates were shamoperated or left intact. The animals wereimmunized with sheep erythrocytes,flagella, or flagellin intravenously, orbovine serum albumin (BSA) in adjuvant in the foot pad at one to fourmonths of age. The amount and typeof the antibodies were determined. Completeness of thymectomy was confirmedat autopsy by gross and histologic evidence.Thymectomized animals had impairedresponse to BSA as measured by passivehemagglutination and immunodiffusionwhich was most marked in animals injected at one month of age. At thisage the antibody response of nonthymectomized animals was incompletely developed to BSA, but completely developed to sheep erythrocytes.Thymectomized rats given sheep erythrocytes had an equal response asmeasured by the formation of hernagglutinins as well as in the number ofhemolysin-forming cells of spleen andlymph nodes.To determine whether the differencein reactivity of thymectomized animalsto BSA and sheep erythrocytes might bea result of the soluble or particulatenature of the antigen, purified flagellarantigen of Salmonella typhosa was administered in a particulate, or in asoluble form. Thymectomized rats hadno impairment of antibody responsesto either of these antigens indicatingthat the physical form of the antigendoes not appear to be responsible forthe difference in reactivity betweenantigens.These data suggest that immunologicmaturity does not develop simultaneoously for all antigen-antibody systemsand that neonatal thymectomy impairsantibody production in those systemswhich reach immunologic maturity ata later time.Ventricu la r Hypertrophy:A Functional StudyBy LAWRENCE S. RossSurgeryVentricular hypertrophy is a frequently encountered cardiac abnormality. Itsanatomy, histology and histochemistryas well as its relationships to diseasestates, congenital and acquired, havebeen well described. No references havebeen found to studies in experimentalanimals comparing the functional response of chronically hypertrophiedand normal hearts to acute circulatorystress.Biventricular hypertrophy was produced in mongrel dogs by placing partially constricting bands of Teflon clotharound the descending thoracic aortaand main pulmonary artery. Cardiacfunction was assessed in these animalsand in a similar group of normal animals by giving acute circulatory volumeloads of plasma expander (Dextran 6per cent in normal saline) sufficient toincrease basal circulating volume to ap- proximately twice the basal volume.Cardiac output and arterial, centralvenous, and left intraventricular pressures were measured, the latter by apercutaneous, transmediastinal, ventricular puncture technique developed forthis experimental study.Comparison of cardiac output (ascardiac index) to central venous pressure, to the load, and to left ventricularend diastolic pressure for each group;and comparison of stroke volume atvarious loading doses for each groupshowed no significant difference betweenthe normal and the banded dogs withmyocardial hypertrophy. Inherent in thisfinding is evidence of the great degreeof functional reserve in the heart. Thus,hearts chronically stressed by ventricularoutflow resistances respond to acute circulatory stress in a manner indistinguishable from normal hearts. With lowto moderate loading doses (10 per centto 50 per cent increase in circulatingvolume) comparison of central venousto left ventricular end diastolic pressureresponse in both groups indicated thatthe left ventricle functioned more efficiently than the right ventricle in thebanded dogs, whereas the reverse wastrue in the normal animals.A Study of Axon Varicosities inPeriphera I Nerve DevelopmentBy CHARLES DUAN ROTHAnatomySince 1833 fusiform dilatations of central and peripheral nerve axons havebeen observed, but no agreement hasevolved regarding their significance. Although these focal swellings have beennoted in fresh and fixed preparationsby a variety of techniques, the possibility remained that they were artifactual. Similar aneurysm-like enlargements have been described movingproximally and distally along neuronsin tissue cultures.In this study fresh sciatic nervesfrom embryonic and adult chickens wereisolated by teasing in saline and observed with phase microscopy, or werefixed in situ with buffered osmiumtetroxide for light and electron microscopy. Varicosities characterized manyfresh and fixed nerve fibers at allstages of myelination. The finest unmyelinated moniliform axons varied between 0.1 and 1.0 micron in diameter.Although well-myelinated axons up toten microns diameter were usually cy- lindrical, the light microscope demonstrated axon constrictions persistingwith myelin clefts of Schmidt-Lanterman.Serial observations of myelin-sheathdevelopment reveal that layers ofSchwann-cell cytoplasm encircle theaxon many times, then become compressed focally and asymmetricallyalong the axon. At maturation Schwanncell cytoplasm persists between compact myelin membranes at nodes ofRanvier and within clefts of SchmidtLanterman.No consistent aggregation of axonorganelles were found which might havesuggested an obvious cause for thevaricosities. Since fusiform axon dilatations were present in fresh teased andfixed embedded material, it was concluded that this morphology is probably not a fixation artifact. The Schwarmcell or myelin sheath are not responsible, since the varicose contour is mostobvious in unmyelinated neurons. Theobservation' of varicosities with electron microscopy during early myelinogenesis suggests that this axon activitymay be of importance in the maturationof the myelin sheath, although the underlying cause of the varicose phenomenon still remains unknown.The Tecto-Thalamic Nerve FiberConnections in the Rabbit BrainBy EDWARD T ARLOVAnatomyDirect surgical lesions were made inthe inferior and superior colliculi, andthe resulting degenerated axons werestained by Nauta's silver method. Thecellular architecture of nuclei in themidbrain and caudal thalamus was correlated with the connections to theseregions from the tectum.The inferior colliculus projects ipsilaterally to the central gray, the superior colliculus and via the brachiumof the inferior colliculus to its interstitial nucleus and the parabrachial region of the midbrain tegmentum. Fromthe brachium, fibers fan out to theprincipal and internal divisions of themedial geniculate. A smaller contralateral pathway crosses in the commissure of the inferior colliculus to sweepinto the contralateral inferior colliculusand in its brachium to the interstitialnucleus, the parabrachial region, and theinternal and principal divisions of themedial geniculate.MEDICAL ALUMNI BULLETIN 19The superior collicular projection ismainly ipsilateral. Medially, fibersterminate in the central gray and thepretectal area. Laterally, fibers ascendin the superior brachium to the parabrachial region, the suprageniculatepretectal nucleus, the posterior complex, the caudodorsal internal divisionof the medial geniculate, and a discretepart of the ventral nucleus of the lateralgeniculate. A component of the commissure of Gudden originates in the rostral superior colliculus and terminatesin the contralateral ventral lateral geniculate, posterior complex, pretectal areaand midbrain tegmentum.Overlap between projections of theinferior and superior colliculi is presentin the midbrain reticular formation and. internal division of the medial geniculatebut not in the posterior thalamus.The Preservation ofMammalian Germ CellsBy JERRY J. TOMASOVICObstetrics & GynecologyLow-temperature preservation of germcells provides a valuable tool for thestudy of germ-cell maturation, fertilization, and division as this applies toinfertility problems and developmentalchromosomal aberrations. Storage ofmammalian ova has only recently beenaccomplished with the demonstrationthat morphological changes incurred inthe freezing of mouse ova could be prevented with extracellular glycerol (Sherman, 1963). Our initial attempts topreserve the morphological integrity ofsperm and follicular ova from bothrabbit and human were highly successful.It remained, however, to determine thefertilizability of thawed ova previouslyfrozen in liquid nitrogen with 35 percent glycerol.In a typical experiment seventy-eightfollicular rabbit ova were collected,frozen, and stored at -196°C. for 36hours. Seventy intact, thawed ova wereincubated with fresh rabbit sperm forfour hours and followed individuallythereafter. Cleavage occurred in over15 per cent of the ova with microscopic observation of cleavage up tosixteen cells. Although parthenogeneticdevelopment cannot be excluded, thefrequency of in vivo parthenogenesis inrabbits has been estimated at only 2per cent. These preliminary experimentssuggest that rabbit ova thus preservedmay retain their capacity to becomefertilized and divide.20 M E 0 I CAL A L U M NIB U L LET I N The Effect of Quinidine on theAction of Muscle RelaxantsBy NICHOLAS A. VICKPharmacologyA case of apparent post-operative"recurarization" after administration ofquinidine suggested the possibility ofsynergism between this drug and themuscle relaxants. Using the head-droptechnique, once used as a sensitivebioassay for curare, the clinically observed phenomenon was reproduced inrabbits.It was found that 5 mg/kg of quinidinegiven after recovery from head-dropinduced by d-tubocurarine, decamethonium or succinylcholine resulted in repeat head-drop and often generalizedmuscle paralysis. The same dose ofquinidine given prior to titration withthese muscle relaxants had no effect onhead-drop; if, however, a dose of20mg/kg was given, head-drop dosageof the muscle relaxant was reduced by30 per cent. Quinidine alone had noobservable effect on skeletal muscle tone,even in near-toxic doses of 30mg/kg.It is not clear why quinidine is moreeffective when given after rather thanbefore the muscle relaxant. The mechanism of action of quinidine at the myoneural junction is itself obscure, butstudies with nerve-muscle preparationsindicate that it slows conduction andwill further depress a partially curarized muscle. The efficacy of the chinchona alkaloids in myotonia and theiroccasional deleterious effects in myasthenia gravis are well known.This study demonstrates that qUInIdine is another of the drugs synergisticwith the muscle relaxants and indicatesthat its use after surgical neuromuscularblockade must be cautioned. SENIOR HONORS ANDAWARDSFive members of the Class of 1965were graduated with honors. They were:David Harrer, Barry Kahan, GlendaFrances McNiell, lawrence Ross, andlee Younger.Arthur Kales won the Borden Awardfor his paper on "The Anemia of SlmMutant Mice." His research , was donein the Department of Medicine.The Medical Alumni Prize for excellence in the presentation of a paper atthe Senior Scientific Session was awardedto J. Wynn Jacobs for his paper: "Studies on the Biosynthesis of HyaluronicAcid in the Mammalian Eye."For his paper: "The Tecto-ThalamicNerve Fiber Connections," Edward Tarlov won an American Academy of N eurology award for the best student neurological research work in the country.He was also the recipient of this year'sGellhorn Prize in Neurophysiology,awarded annually by the Department ofPhysiology.Robert 1. Hunter, Jr., received aSheard-Sanford Award for his paper:"Two Patterns of Splenic Phagocytosis." His research, in the Department ofPathology, also won for him third placein the S.A.M.A.-Mead Johnson competition.Alexander Spence was chosen to bethe first recipient of the newly established Joseph A. Capps student award.The award, set up by friends of Dr.Capps, will be given annually to a seniorwho has shown outstanding proficiencyin clinical work.ALPHA OMEGA ALPHA ELE'TIONSNine members of the senior class wereelected to membership at the March 17,1965 meeting of the Alpha Omega Alpha.They were.:Barbara BarnesDouglas JacobsonArthur KalesJohn Kottralorraine KottraFrances Glenda McNeillLawrence RossMilford SchwartzAlexander Spence Two other members of the class, David Harrer and Glenn Weyrich, wereelected to membership during their junior year. Students elected from the current junior class were Robert Barton,Eugene Blackstone, and Joel ElizabethMurray.The A.o.A. lecture was given by Albert Sjoerdsma, Jr., Ph.D. '48, M.D.'49, Chief of the Experimental Therapeutics Branch of the National Institutesof Health. The title of his talk was"Amines I Have Known."ESTROGENS AND THE AGING PROCESSThe transition from youth to middleage is imperceptible. As Rainer MariaRilke wrote, "The future enters into us,in order to transform itself in us, longbefore it happens." So gradual andsubtle is the aging process that fewindividuals are aware of it. Yet the cessation of the menstrual cycle in womenis a logical sign of a very importantchange. It marks the start of the menopause and often jolts the composure ofbusy mothers or successful careeristswho may be psychologically unready orunwilling to acknowledge that the reproductive years have ended and thata new period has begun.Whereas the testes of the male produce sperm cells and sex hormonesthroughout his life, in the female acomplete stock of cells, called oocytes,is formed during intrauterine life. Atbirth a girl has some 400,000 of theseoocytes in her ovaries and no additionaloocytes are produced. After the girl'sreproductive organs have become mature, the oocytes are disposed of in thefollowing manner. Approximately onceeach month, a number of oocytes begin to grow. One of these oocytes matures into an ovum and is ovulated,ready for fertilization. The other growing oocytes secrete the hormone estrogen for several days, then shrink andwaste away.This process is repeated some 400times during a woman's childbearingyears. When all oocytes have been exhausted, the woman can no longer bearchildren. And, since the oocytes thatgrow during each monthly cycle arethe principal source of estrogen, whenthe supply of oocytes is exhausted, thewoman's ability to secrete estrogen declines greatly. The changes of the menopause then follow.We have indicated that estrogen isin some manner concerned in the causation of menopausal changes. What areits functions in earlier years?Most succinctly, estrogen is whatmakes a girl a girl. Several years beforethe onset of puberty the ovaries produce increasing amounts of estrogen asa result of a sudden spurt in growth ofprimary oocytes. Estrogen stimulates thedevelopment of femininity through itsaction on the body contours and breasts; By M. EDWARD DAVIS, RUSH '22Joseph Bolivar De Lee Professor and Chairman,Department 0/ Obstetrics and GynecologyDAVISit also prompts the reproductive organsto mature. When ovulation begins andmature ova are formed, the girl reachesfull maturity. The outward manifestation of this attainment is the establishment of regular menstrual periods.Menstrual periods usually stop between the ages of 35 and 50 years inabout 50 per cent of women. There appears to be little relation between thetime of onset of the menses and the ageat which the menopause begins, nor doeschildbearing seem to influence the duration of menstrual function. The functional life of the ovaries is probablygenetically determined and gonadalfunction may be under the same control,for there is a tendency of daughters tofollow the menstrual patterns of theirmothers. However, physical, racial, constitutional and social factors also affect the functional lifespan of theovaries.A progressive decline in ovarian function brings on the menopause. This period of waning ovarian function is calledthe climacteric. It results from aging ofthe ovaries, which accelerates as exhaustion of the supply of oocytes approaches.In an occasional cycle a follicle fails toreach maturity, and no ovulation takesplace. In the absence of ovulation, progesterone, the other female sex hormone,is not secreted. Menstrual bleeding stilloccurs but its regularity may be dis- turbed when progesterone is not secreted. The continued decline of ovarianactivity may prolong the intervals between periods or provoke grossly irregular bleeding episodes. Finally, as production of estrogen reaches a low ebb,bleeding periods stop altogether, although some follicle activity may stillbe apparent. The menopause has arrived.Complete ovarian failure may be aslow process extending throughout theclimacteric, or it may occur more rapidly. The significant change during thisentire transitional phase is the progressive drop in the supply of estrogens.Estrogens may be available in smallamounts for several years or longer following complete cessation of menstruation.The decline and ultimate extinctionof ovarian function initiates subtle rearrangements in the hormonal activityof the other glands that control the reproductive process. The withdrawal ofestrogen inhibition of the hypothalamicpituitary unit affects the productionof adrenocorticotropic, thyrotropic andgrowth hormones, all of which contribute to the health and well-being of thewoman. Thus, the climactenc brings withit changes in the functioning of otherendocrine glands and it is difficult orimpossible to identify cause and effectof the bizarre manifestations of theclimacteric and its sequelae. Studentsof the menopause have studied the various symptoms and changes associatedwith it and have concluded that onlythe vasomotor phenomena, the hotflushes, can be positively characterizedas menopausal.Although there is still no accurateknowledge of what. triggers the onset ofthe climacteric, estrogen deprivation isthe most acceptable explanation forseveral reasons. The prompt abatementof the menopausal woman's vasomotorinstability and characteristic hot flushesafter medication with estrogen supportsthis view. Furthermore, the administration of estrogen immediately followingthe surgical removal of the ovaries suppresses the onset of menopausal symptoms indefinitely. However, the neurovascular manifestations characteristic ofthe menopause are not observed inME Die A L A L U M NIB U L LET I N 21women castrated at an early age nor inthose in whom the ovaries are congenitally absent.Failing ovarian function releases thehypothalamic-pituitary system and thereis a rapid increase in the serum pituitary gonadotrophins to a level more thantwenty times the normal amount in theurine. It is unlikely that this overproduction of FSH by the pituitary is responsible for the menopausal symptoms.There is little correlation between thegonadotrophic titer and the severity ofsymptoms, and the high levels in youngwomen with primary ovarian deficiencydo not induce menopausal changes.The menopause initiates widespreadatrophic changes that vary in degree indifferent women depending on gonadalfunction and estrogen supply. The reproductive organs are the primary sitesof these atrophic changes. They are visible in the external genitalia. the vulva.and the vagina. The subcutaneous fatvanishes and the labia shrink. The clitoris and its folds decrease in size, andthe mucous membrane becomes thinand parchment-like. The vaginal mucosa gradually loses its cornified epithelium. This epithelium is the mostsensitive index of the degree of postmenopausal atrophy. The walls of thevagina lose their muscular tone, theirfascial strength and their normal elasticity. The uterus decreases in size, becoming progressively smaller. The endometrium may show varying patterns.but its cyclical activity disappears. Itmay even exhibit progressive atrophicchanges.Atrophy is not limited to the reproductive structures. It includes the entire body. Breast tissues atrophy andare replaced by areolar tissue, and thebreasts lose their elasticity and droop.The skin and hair age. Not only doesthe bony skeleton begin to show osteoporotic changes at an earlier age thanin the male, but osteoporosis itself progresses more rapidly.Estrogens and AtherosclerosisThere has been increasing evidence inrecent years of a direct relationshipbetween decreased endogenous estrogenproduction and the pathogenesis ofatherosclerosis in menopausal and postmenopausal women. Coronary arterydisease in premenopausal women is ararity. The onset of the climacteric andthe diminution of estrogen supply coincide with a rapid and progressive increase in the incidence of atherosclerosis and its sequelae.22 M E 0 I CAL A L U M NIB U L LET I N The most provocative report in support of the role of estrogens in atherosclerosis published recently is an eightyear follow-up of "The FraminghamStudy: A Prospective Study of CoronaryHeart Disease" under the auspices ofthe Heart Disease Epidemiology StudySection of the National Heart Institute(National Institutes of Health). Thisbeautifully designed long-term clinicalstudy of a sampling of normal men andwomen is intended to assess the manyfactors that may contribute to atherosclerosis and coronary disease. This initial report emphasizes what we haveknown for a long time. that coronarydisease is twenty times more commonamong males than among females duringthe years thirty to thirty-nine but increases in frequency in females as theend of the reproductive period approaches.Ever since the discovery that theatherosclerotic plaque contains lipid material, interest in lipid metabolism andits relation to atherosclerosis and heartdisease has been mounting steadily. Animal experiments have indicated thatexcess dietary and serum cholesterolpromotes the development of atherosclerosis. The classic experiments byPick, Stamler, Rodbard and Katz provide some basic information concerning the role of estrogens in the prevention of atherosclerosis and in its regression. When estrogens were administeredto chickens fed an atherogenic diet consisting of foods high in cholesterol andfat content, coronary atherosclerosisdid not develop. If estrogens were administered after the development ofcoronary lesions, the atherogenic plaquesregressed and the lesions healed. Anyestrogen, natural or synthetic, was effective. These findings sparked increasedinterest in the role that estrogens playin the retardation of atherosclerosis inpostmenopausal women.Age is not an important factor in thedevelopment of atherosclerosis in women. When the menopause occurs prematurely, the incidence of ischemicheart disease increases. Sznajdermanand Oliver recently reported a ten-yearfollow-up of 35 women who stoppedmenstruating spontaneously before theage of 35. Cardiac ischemia developedin 4 women, 7 women had significantcardiovascular complications and 1 diedof myocardial infarction. This incidenceof serious sequelae of atherosclerosis isapproximately seven times that found ina healthy population of similar age.Stander recently reported the results of a prospective study undertaken atIndiana University on a limited number of premenopausal patients undergoing surgical removal of the ovaries ortheir destruction by radiation. They received no exogenous estrogen replacement. Significant changes in the ratio ofcholesterol to phospholipids were foundwithin a year of castration. This studysuggests that significant changes in lipidmetabolism occur soon after completecessation of ovarian function.Although the manner in which estrogen helps to prevent atherosclerosis isunknown, a recent paper throws somelight on this important problem. Usinga new chromatographic method for thequantitation of Il-desoxy-17-ketosteroids, Dingman and Lim presented datawhich showed that hypercholesterolemicsubjects had a significant increase inepiandrosterone excretion and loweredcholesterol levels to normal. These findings suggest that estrogens may affectthe relative activity of steroid hydroxylating enzymes which may regulate thesynthesis or degradation of cholesterol.Our Experience with Long-TermEstrogen SubstitutionOur interest in the long-term substitution of estrogens in postmenopausalwomen began over 25 years ago. Theintroduction of diethylstilbestrol, a synthetic estrogen effective on oral administration, provided the incentive tostudy how estrogens suppress the menopause with its unwelcome sequelae aswell as retard the aging process.Our early patients were women whoseovaries had been removed at the time ofhysterectomy. A few days after surgerythey were placed on substitution therapyto suppress the onset of the climacteric.The fact that the dreaded menopausalsymptoms did not appear and the continuance of their feeling of well-beingprovided the incentive for these womento return for periodic examinations sothat we could keep them under observation.As our interest in estrogen medicationcontinued, we added three other groupsof patients to our studies: (1) premenopausal women to serve as controls;(2) women who had had bilateral oophorectomy with hysterectomy and hadreceived no hormonal therapy; and (3)women who had had a natural menopause and no hormonal medication.The increasing interest in atherosclerosis and its sequelae and the possiblerole of the steroid hormones in its prevention prompted us to initiate a pro-gram of intensive periodic examinationof these patients. During the last tenyears we have been studying an increasing number of women in order to evaluate the character of so-called "physiologic" postmenopausal atrophic changes,atherosclerosis and its sequelae.Patients returned at least once a yearfor complete physical examinations whichincluded electrocardiograms. Womenwith abnormal findings were examined byour cardiologists. Laboratory proceduresincluded quantitative blood sugar determinations, serum cholesterol. esters, lipids, phospholipids and triglycerides.To date more than 400 women haveparticipated in the study. The followingconclusions appear warranted. Womenof reproductive years studied as controlshave lower serum-cholesterol levels thanmen. Estrogens reduce the serum-cholesterol levels. There is an associated fallin serum triglycerides, but there is noconcomitant reduction in serum lipids.Women who have had continuous estrogen replacement following gonadal removal or a spontaneous menopause donot exhibit unusual changes in serumcholesterol levels with advancing years.Recent studies by Feldman and AIbrink on patients with coronary diseaseindicate that triglycerides are more frequently elevated and to a higher degreethan serum cholesterol. They suggestthat serum cholesterol and serum triglycerides operate together to acceleratethe atherosclerotic process. There isample evidence that postmenopausalchanges speed up aging and atherosclerosis. The loss of estrogens may bethe inciting factor in initiating the altered lipid metabolism which stimulatesthe onset of atherosclerosis.The evidence linking serum cholesterol levels and coronary artery diseaseappears incontrovertible. And in womenthe value of estrogens as long-term replacement therapy after the menopauseis beyond question. It is therefore onlyreasonable to inquire what part estrogentherapy may play in preventive medicine.Postmenopausal OsteoporosisOsteoporosis is a major orthopedicdisorder in about 25 per cent of postmenopausal women. Lutwak and Whedonhave estimated that at least 4 millionpersons in the United States have asignificant degree of osteoporosis andthat four-fifths of these patients arepostmenopausal women.To understand the pathogenesis ofosteoporosis requires an understanding of bone as a tissue. Bone is a calcifiedcollagenous matrix laid down by osteoblasts. It is constantly undergoing resorptive remodelling. When this processis rapid, multinucleated osteoclasts maybe seen. In the normal adult skeletonthe rate of bone formation is matchedby the rate of bone resorption. The factors which control the rate of boneformation include the stimulation ofosteoblasts by stresses and strains, thethyroid and estrogens and androgens.An osteoporotic bone has less absolute volume than similar normal bone.Morphologically an osteoporotic boneexhibits thinner cortices and thinner andsparser trabeculae than normal bone.Postmenopausal osteoporosis is a physical change, an aging phenomenon. Itis not a disease. It is the most commonmetabolic disorder of bone. It represents a decrease in total bone mass withno change in its chemical composition.Postmenopausal osteoporosis is an inevitable sequel of the failure of gonadalfunction with its decline and disappearance of estrogen production. As farback as 1941 Albright suggested thatosteoporosis is a bone disease producedby too little bone matrix formation. Itwas his impression that this was broughtabout by inadequacy of the supply ofestrogens.Decreased activity of the aging female reduces the stress-and-strain stimulus to bone formation. The result is adisproportion between the rate of boneformation, which is decreased, and therate of absorption, which remains normal. As a result, bone mass graduallydecreases. Males are spared this process,for their gonads continue to produceandrogens and estrogens for most oftheir lives. However, decreased physicalactivity as senility approaches brings onsenile osteoporosis in both sexes.There have been no accurate methodsfor the diagnosis of early osteoporoticchanges in the bony skeleton. Wallachand Henneman, surveying their 25 yearsof experience with 242 postmenopausalwomen prior to and following the administration of estrogens, concluded thatthe continuing loss of height of thesepatients was a sensitive index of osteoporotic progress. Following the administration of estrogens further heightloss ceased.Our interest in postmenopausal osteoporosis dates back many years and waskindled by the observation that few ofour patients on estrogen replacementtherapy complained of low back pain,discomfort or crippling. Cooperative studies with Franklin C. McLean andPaul C. Hodges with the use of serialradiographs failed to demonstrate obvious bone changes in patients on exogenous estrogen replacement.It is difficult, if not impossible, tomeasure small degrees of change inbone density in the lumbar spine. Densitometric studies on films, even byphotoelectric instrumentation, have somany variables of exposure and developing that they, too, are not accurateenough for the measurement of changesof minor degree.For a long time, our studies werehandicapped by this technical inadequacy. Then, about 18 months ago, NelsM. Strandjord and Lawrence H. LanzIof our Radiology Department developedan ingenious machine for the accuratedetermination of bone density. Thismethod is based on the fact that whilethe small bones of the hands do nothave as severe changes in osteoporosisas does the spine, it has been well demonstrated that there is a direct ratio ofthe mineral content of the phalangesto that of the spine and to that of thepelvis (Fig. 1).Fig. J. Subject with finger immobilized between plastic plates for counting. Data recordappears on paper tape at lower right.The instrument devised by Strandjord and Lanzl permits nondestructivetesting to determine the condition ofthe bone mineral in the skeleton. This isaccomplished by studying the transmission through a single finger bone ofthe radiation emanating from iodine-125. The smaller the bone mineral content, the higher the transmission of theradiation through the bone. A lowervalue of bone mineral content may bedue to a thinner bone, a bone of lowerdensity, or a combination of both. Achange in the effective atomic numberM E 0 I CAL A L U M NIB U L LET I N 23TO DISCRIMINATORAND SCALER "PHOTOMULTIPLIERHOUSINGCOLLIMATOR( 3 "'111.010. HOLE 1 FINGERLOCATORSOURCE SHIELDFig. 2. Diagram illustrating the position of-finger locator, radiation source, collimator andphotomultiplier.of the bone will also result in a change inthe radiation transmitted through it.In the machine illustrated, a sourceof 1-12 5 is placed below the digit andthe transmission of the 28 kV gammaradiation is counted by a crystal photomultiplier system. The machine sectorsacross the digit and, with a print-outdevice, a record of the absorption isobtained. The bones of the hand can beaccurately measured as to size (Fig. 2).We have determined the bone densityof three groups of patients during thepast two years. They comprise the threecategories listed in Table 1. The datapresented demonstrate that the bonedensity of women with surgically inducedor natural menopause, who have beenon exogenous estrogen substitution ismuch greater than that in the controlgroup of postmenopausal women givenno estrogen medication. We have nowfollowed a sufficiently large number ofpatients to demonstrate that estrogenreplacement for gonadal failure definitely retards or prevents postmenopausal osteoporosis. This is the firstpositive evidence that normal bone metabolism can be maintained or re-established in postmenopausal women by theadministration of estrogens.Current PracticeCurrent practice in the medical management of the menopause has not provided the maximum benefits to patients.The basic philosophy has been the following: (1) to supplement the woman's24 M E Die A L A L U M NIB U L LET I N failing endogenous estrogen supply during the period of gonadal failure to relieve her menopausal symptoms; (2) toreduce the exogenous supply as rapidlyas possible; and (3) to stop medicationas soon as this can be conveniently accomplished.This symptomatic treatment has beenmoderately successful, for it bridges thegap betwen youth and middle age. Itassumes that the initiation of the agingprocess with the decline and the eventual extinction of ovarian function isphysiologic and inevitable. Even thoughthere has been increasing evidence thatcontinued estrogen medication may bedesirable to retard the inevitable postmenopausal changes, its long-term administration has been questioned.Historically, estrogens have been credited with malignant potentialities as aresult of very early experiments in mice.However, there is no evidence that estrogens can induce cancer in man. Yearsago Emge, a pioneer student of estrogens, made the statement that estrogens are not carcinogenic in man; andthe most to be said is that they mayimprove the soil in which cancer maybe present. Many recent studies support this view. In a recent symposiumon "Atherosclerosis and the Role ofEstrogens" the chairman, Louis N. Katz,noted that "even with large doses overa long period of time, no evidence ofcancer of the breast in man or womanor of the pelvic organs in women, hasbeen noted." Modern ManagementThe enlightened management of themenopause and the postmenopausal period of life has a fourfold objective:(1) to suppress menopausal symptoms;(2) to retard the physical atrophicchanges; (3) to retard the developmentof atherosclerosis and its dire sequelae;and (4) to prevent or retard osteoporosis and other skeletal changes.There is little doubt that estrogensubstitution compensates for natural inadequacy of the female gonads. Thisprogress in the medical management ofwomen in their postmenopausal yearswill inevitably create problems whichtime and experience will solve. However, there are basic safeguards whichcan be exercised to prevent unnecessary complications.Women who are placed on estrogentherapy should remain under the careof a physician and' return for periodicexaminations. Cancer screening shouldcontinue throughout the life of the individual. Vaginal cytology is an excellentindicator of estrogen sufficiency and canbe used as a guide in dosage, eventhough it is not of use in the quantitative analysis of sex steroids.The function of estrogens in the medical management of the premenopausaland postmenopausal periods of womendiffers somewhat. During the premenopausal period the supply of endogenousestrogens varies greatly depending largelyon the degree of ovarian atrophy.During the menopausal period smallBONE-DENSITY EVALtj\TIONS FRCXt1 JANtj\RY, 1954 TI-ROLGH MAY, 1965-IA II � and a in emGROUPPremenopausal Normal Females(27 patients) � = 2.23 :.21 em-Io 2 Postmenopausal FemalesWithout Hormones(78 patients) 1.78 :.31 em-Io 3 Postmenopausal FemalesWith Hormones(89 patients) . + -I�B = 1.98 -.28 emTable 1. Over-all bone density coefficients of pre- and postmenopausal patients. January, 1964to May, 1965.quantities of estrogen may be secretedfor several years by the ovaries and theadrenal gland, even after the menseshave vanished. The classic menopausalsymptom, hot flushes, as well as a variety of other related or unrelated complaints such as nervousness, headachesor dizziness usually becomes apparentwhen the endogenous supply of estrogen decreases to a critical level. Duringthis period estrogen supplementationmay be desirable generally to attainsymptomatic relief. It has been ourpractice to begin with a small amountof this steroid and to increase the doseas complete ovarian failure progresses.The Surgical Induction01 the MenopauseThe surgical removal of the ovariesfor gynecologic complications in premenopausal women usually brings onsymptoms within a few days. It hasbeen our practice to begin estrogen replacement about the third or fourthpostoperative day, following the patient's recovery from the immediateeffects of the operation. We prescribea 0.5 mg tablet of diethylstilbestroldaily at bedtime.The continued administration of estrogens will suppress the onset of menopausal symptoms indefinitely. The individual is not aware of the removal ofher endogenous hormonal supply. Theusual endocrinal and physical changesdo not place. However, sudden cessation of therapy does induce "hot flushes"promptly regardless of the interval oftime that has elapsed following gonadalremoval.Estrogens are likewise administeredin the immediate postoperative periodin postmenopausal women who have hadtheir pelvic organs removed for benigndisease. In addition to its usual role atthis time of life this hormone promotesrapid healing of pelvic tissues. It isgratifying at the postoperative examination to note the healthy external genitalia, the youthful vaginal mucosa, andthe suppleness of the vaginal walls.These healthy remaining pelvic structures probably reflect a decreased hazardof infection that is usually invited bytraumatized atrophic tissues. Estrogensassist in the re-establishment of normalfunction following the patient's recovery.The Selection of an Estrogenand Its AdministrationThe choice of an estrogen dependson individual experience and preference.Our use of diethylstilbestrol results from our long familiarity with this syntheticpreparation. The natural estrogens, estradiol, estriol, estrone, and a host ofmetabolites are available in a varietyof commercial preparations. In the selection of an estrogen it is important toconsider the estrogenic potency ratherthan the source. There is no evidencethat the action of natural estrogens differs from that of synthetic preparations.Estrogens should be administeredorally, not parenterally. Oral medication is desirable in the long-term administration of any drug or hormone.Cyclic administration of estrogens inthe postmenopausal period is not indicated. It is unnecessary and unphysiological to re-establish cyclical changesin the reproductive organs of the postmenopausal individual that simulate thereproductive pattern. In the normalcycle estrogens are responsible for thenormal growth and development of theendometrium. Progesterone converts thatendometrium into a progestational phasesuitable for the implantation of a fertilized ovum. Alas, there are no ova atthis time of life. It has been demonstrated that small amounts of estrogenswill stimulate the growth of the endometrium for a short time, after whichit regresses and remains inactive inspite of continued therapy.Cyclic therapy provokes uterine bleeding in the woman who has her uterus.Uterine bleeding in the menopausal andpostmenopausal periods must alwaysbe regarded with a high degree of suspicion. It may be induced by the cessation of estrogen therapy for a shortperiod or occasionally it may occur inpatients who do not stop taking thehormone. Although estrogens may beresponsible for the bleeding, the possibility of early endometrial carcinomacan be ruled out only by curettage.There is no need for the administration of other steroids in the treatmentof the postmenopausal woman. Althoughandrogen is commonly added, there islittle evidence that it will decrease thefrequency of uterine bleeding, nor hasit been demonstrated that its supplementation has any desirable effect onthe retardation of osteoporosis. Furthermore, minimum amounts of androgenicmetabolites continue to be available asa result of adrenal steroid metabolism.The criteria for the optimal dosageof estrogens for long-term substitutionin the human female are not clearly established. In spite of the vast accumulation of knowledge concerning theirchemistry, their mechanism of action on mammalian tissues remains obscure.Estrogenic steroids undergo a varietyof metabolic transformations and giverise to a large number of urinary metabolites, many of which possess varying degrees of "estrogenic potency".Investigations on the metabolism ofestrogens have been difficult becauseminute amounts elicit biological responses. It has been reported by Beerand Gallagher that the excretion pattern resulting from large doses of estrogen differs from that resulting fromtracer amounts. In a recent study byDavis, Wiener, Jacobson and Jensen, anattempt was made to determine thetissue distribution and metabolic fateof estradiol in pregnant and nonpregnant women by using tritiated hormoneof high specific activity in minuteamounts, an approach developed by Jensen and Jacobson. Some fundamentalinformation concerning the metabolismof estradiol-d-Zrl" was obtained.Only small amounts of estrogens areproduced during the menstrual cycle.They vary from 0.08 to 0.34 mg. in24 hours. The total amount does notexceed 4.8 mg. during a thirty-day cycle. Inasmuch as the gonads are theprimary source of these steroids it isapparent that in the human only smallamounts of estrogens are necessary topromote growth and development ofthe adolescent and to maintain thehealth and vigor of the woman duringher active reproductive years.SummaryThe current practice in medical management of the menopause of prescribing supplementary estrogens only to relieve the symptoms is archaic. Recentstudies have demonstrated that ovarianfailure and the drop in the supply ofestrogens initiate widespread atrophicchanges which begin in the reproductiveorgans and rapidly extend to the bodytissues and the bony skeleton. Furthermore, this general aging is associatedwith the progressive development ofatherosclerosis and its dire sequelae.Our present philosophy is to relievethe woman's symptoms by providingestrogens to supplement her failingovarian supply during the establishmentof her climacteric. However, long-termexogenous estrogen substitution for complete gonadal failure is far more rewarding and should be continued indefinitely to prevent or delay the physical atrophic changes, the developmentof atherosclerosis and osteoporosis. Thisis an exciting area of preventive medi-MEDICAL ALUMNI BULLETIN 25cine which will help our women to retain good health in their advancingyears.REFERENCESAtherosclerosis and the role of estrogens.Transcript of a round table conference onatherosclerosis, reviewing pertinent datathat have led to the therapeutic use ofestrogens in atherosclerosis, with particular emphasis on the ability of estrogensto increase the survival rate in patientswith myocardial infarction. Katz, L. N.(moderator), Excerpta M ed. Found.,June, 1963.ALBRIGHT, F., SMITH, P. H., and RICHARDSON, A.M. Postmenopausal osteoporosis,its clinical features, l.A.M.A., 116:2465,1941.BEER, C. T., and GALLAGHER, T. F. Excretion of estrogen metabolites by humans,r. Bioi. Chem., 214:335, 1955.BEHRMAN, S. J. Secondary amenorrhea(Searle Symposium), 1963 (in press).DAVIS, M. EDWARD. Estrogen and the agingprocess. Year Book oj Obstetrics andGynecology, 1964-1965. Edited by J. P.GREENHILL. Year Book Medical Publishers.DAVIS, M. EDWARD. Long-term estrogensubstitution after the menopause, Clin.Obst. & Gynec., 7:558, 1964.DAVIS, M. EDWARD. The therapeutic role ofthe estrogens, S. Clin. North America,43:114, 1943.DAVIS, M. EDWARD. The treatment of senilevaginitis with ovarian follicular hormone,Surg., Gynec. & Obst., 61:680, 1935.DAVIS, M. EDWARD, and BOYNTON, M. W.Stilbestrol-indications, clinical use andtoxicity of 4, 4-dihydroxydiethyl stilbene,r. Clin. Endocrinol., 1:4, 1941.DAVIS, M. EDWARD, JONES, R. J., and JAROLIM, C. Long-term estrogen substitutionand atherosclerosis, Am. J, Obst. &Gynec., 82:1003, 1961.DAVIS, M. EDWARD, WIENER, M., JACOBSON,H. E., and JENSEN, E. V. Estradiol metabolism in pregnant and nonpregnantwomen, Am. l. Obst. & Gynec., 87:979,1963.DINGMAN, J. F., and LIM, N. Y. Androgenmetabolism in patients with hypercholesteremia and coronary artery disease,l.A.M.A., 186:4, 1963.EMGE, L. A. Geriatric aspects of primaryendometrial cancer, J, Am. Geriatrics Soc.,2:552,1954.FELDMAN, R. G., and ALBRINK, M. J. Serumlipids in cerebrovascular disease, Arch.Neurol., 10:91, 1964.FROST, H. M. Bone Remodelling Dynamics.(Springfield, Ill.: Charles C Thomas,1963) .HIGANO, N., ROBINSON, R. W., and COHEN,W. D.: Atherosclerosis in castrate women,New England r. M ed., 268:1123, 1963.JENSEN, E. F., and JACOBSON, H. I. Basicguides to the mechanism of estrogen action: Recent progress in hormone research, 18:387, 1962.KAGAN, A., DAWBER, T. R., KANNEL, W. B.,and REVOTSKIE, N. The Framinghamstudy: A prospective study of coronaryheart disease, Fed. Proc. 21 (part II,supp.) :4, '1962.KEETTEL, W. C., and BRADBURY, J. T. Premature ovarian failure, permanent andtemporary, Am. l. Obst. & Gynec., 89-95, 1964.26 M E 0 I CAL A L U M N ,. B U L LET I N DEATHS'98. Frank E. Pierce, Pasadena, Calif.,December 10, 1964, age 91.'00. Ralph Graham, Monmouth, Ill.,June 21, 1962, age 87.'01. Wilbur M. Avery, Mendota, Ill.,January 20, 1965, age 89.Frank W. VanKirk, San Francisco, May24, 1964, age 89.'02. John W. Young, Hutchinson, Kans.,December 15, 1964, age 85.'03. Claude F. Fleming, Elkhart, Ind.,February 20, 1964, age 83.Loran M. Martin, Fort Dodge, Iowa,March 26, 1965, age 87.Ernest H. Ruediger, Long Beach, Calif.,January 22, 1965, age 90.'05. Homer D. Ludden, Mineral Point,Wis., March 19, 1965, age 86.'08. Hugh A. McGuigan, Winnetka, IlL,March 1, 1964, age 89.William G. Sachse, Morris, IlL, December 10, 1964, age 82.'09. Dosu Doseff, Chicago, January 28,1965, age 82.Thomas E. Flinn, Redwood Falls, Minn.,April 8, 1965, age 81.'10. Benoni A. Place, Berkeley, Calif.,November 8, 1964, age 86.Eugene S. Talbot, Jr., Chicago, April 2,1965, age 91.'11. Charles F. Nelson, Beverly Hills,Calif., June 15, 1965, age 81.LANZL, L. H., and STRANDJORD, N. M. Radioisotopic Device for Measuring BoneMineral. Argonne Cancer Research Hospital. Semiannual Report to the AtomicEnergy Commission, March, 1965.LERNER, M., and ANDERSON, O. W. HealthProgress in the United States, 1900-1960,Chapter 10, "Health and The Sexes" (Chicago: University of Chicago Press, 196.3).LUTWAK, L., and WHEDON, G. D. Osteoporosis in Disease-a-M onth (Chicago:Year Book Medical Publishers, Inc., April,1963) .PICK, R., STAMLER, J., RODBARD, S., andKATZ, L. N. The inhibition of coronaryatherosclerosis in cholesterol-fed chicks,Circulation, 6:276, 1952.RANDALL, C. L., et al. Causes of death incases of preclimacteric menorrhagia, Am.J. Obst. & Gynec., 88:880, 1964 (RichardW. Stander-Discussant).ROBINSON, R. W., HIGANO, N., and COHEN,W. D. Effects of long-term administrationof estrogens on serum lipids of postmenopausal women, New England J, M ed.,263:17,1960.SZNA]DERMAN, M., and OLIVER, M. F.Ischemic heart disease in early menopause,Lancet, 1:962, 1963.WALLACH, S., and HENNEMAN, P. H. Prolonged estrogen therapy in postmenopausal women, l.A.M.A., 171:1637, 1959.WILSON, R. A. The roles of estrogen andprogesterone in breast and genital cancer,l.A.M.A., 182:327, 1962.WILSON, R. A., and WILSON, T. A. The fateof non treated postmenopausal woman: Aplea for the maintenance of adequateestrogen from puberty to the grave, l.Am. Geriatrics Soc., 11:347, 1963. Henry O. Wernicke, Chicago, July 3,1965, age 78.'12. Arthur H. Fisher, McAllen, Tex.,April 13, 1965, age 79.Nephi J. Rees, Salt Lake City, Utah, December 17, 1963, age 85.'13. Marcia A. Patrick, Los Angeles, November 24, 1964, age 89.'17. Elmer R. Hancock, Chicago, January18, 1961, age 69.'18. Frederick W. Burcky, San Marino,Calif., March 19, 1965, age 75.Jacob F. Henken, Racine, Wis., December 7, 1964, age 71.George J. Mohr, Skokie, Ill., March 6,1965, age 70. -'19. Maxwell P. Borovsky, Chicago, November 29, 1964, age 68.Frank Kostal, Lombard, 111., November3, 1964, age 78.Ralph H. Warden, Scottsdale, Ariz.,June 8, 1965, age 77.'20. Jay M. Garner, Winnetka, III., April18, 1965, age 72.Robert E. Grogan, San Clemente, Calif.,March 27, 1965, age 70.'21. Harold O. Ellis, Fair Oaks, Calif.,February 16, 1965; age 69.Alice McNeal, Birmingham, Ala., December 29, 1964, age 67.Ezra H. Rogers, Milwaukee, June 30,1965, age 69.'22. Lucille M. McConnell Gustafson,Long Beach, Calif., February 28, 1964, age64.'23. Leo W. Peterson, Sun Prairie, Wis.,February 9, 1965, age 70.'24. Benjamin Goldberg, Corvallis, Ore.,March 1, 1965, age 68.Philip H. Henderson, Longview, Wash.,January 15, 1965, age 65.'25. James L. Hall, Chicago, June 10,1965, age 73.'26. John P. Davis, Santa Ana, Calif.,December 20, 1964, age 64.John M. Forney, New York City, December 22, 1964, age 63.'27. Martha B. F. Minor, Tucson, Ariz.,April 30, 1965, age 71.'28. Kenneth G. Cook, Fairfield, Iowa,April 24, 1965, age 64.'30. Albert J. Entringer, Dubuque, Iowa,February 8, 1965, age 61.'32. Arthur Liveson, Brooklyn, N.Y.,August 29, 1964, age 62.'33. William L. Cole, Evansville, Ind.,April 15, 1962, age 54.Percy D. Peabody, Jr., Sisseton, S.D.,October 13, 1964, age 59.'34. George B. Isenhart, Portland, Ore.,January 22, 1965, age 58.'37. Masashi Otsuka, Wailuku, Maui,Hawaii, January 4, 1965, age 55.'38. Howard B. Emerson, Tarentum, Pa.,April 6, 1965, age 52.Carl N. Fischer, La Porte, Ind., June 2,1965, age 51.'41. James G. Phillips, Oklahoma City,Okla., December 3, 1964, age 58.'43. Joseph L. Fleming, Orchard Lake,Mich., April 27, 1965, age 46.Robert H. Snapp, Phoenix, Ariz., January 3, 1965, age 49.FACULTYAlf S. Alving, professor of medicine,Chicago, May 18, 1965, age 63.FACULTY NEWSWilliam E. Adams was elected first vicepresident and chairman of the Council onPostgraduate Medical Education of theAmerican College of Chest Physicians andchairman of the section on Diseases of theChest of the American Medical Association.Wright Adams, Associate Dean andChief of Staff, has been named vice-president of the American Heart Association.President George W. Beadle was thechairman, appointed by President Johnson,of the White House Conference on Healthheld in Washington in early November.Among the participants were L. T. Coggeshall, vice-president and Trustee of theUniversity, Robert H. Ebert, '42, Dean ofHarvard Medical School, and Ray E.Brown, former Superintendent of the Hospitals and Clinics and now at Duke University.Richard K. Blaisdell, '48, has receiveda Lederle Medical Faculty Award in recognition of his superior talents as a teacher.The award will be used to support his salaryand professional expenses over the next threeyears.James Roy Blayney, Professor Emeritusof Dental Surgery, received the H. TrendleyDean Fluoridation Award from the International Association for Dental Research.M. Edward Davis, '22, is president of theAmerican Association of Planned Parenthood Physicians for the coming year.Albert Dorfman, '44, has been namedthe Richard T. Crane Professor of Pediatrics. The professorship was first held byFrederick W. Schlutz, former chairman ofthe Department of Pediatrics, and in 1954Walter L. Palmer, Rush '21, was namedthe second holder. He is currently the Richard T. Crane Professor Emeritus in Medicine.Frank W. Fitch, '53, pathology, is spending a year in Switzerland studying developments in protein chemistry through a Commonwealth Fund Fellowship.Robert Haselkorn was named one of theten Outstanding Young Men of 1965 by theChicago Junior Association of Commerceand Industry.Charles B. Huggins received the 1965Passano Award for his contributions to theknowledge of the role of hormones in theinduction and control of cancer. On October 30 he was awarded an honorary degreeof Doctor of Science from Trinity College,Hartford, Connecticut.Dwight J. Ingle, chairman of the Department of Physiology, has been electedpresident of the Society for ExperimentalBiology and Medicine for a two-year term.Joseph B. Kirsner has been elected president of the American GastroenterologicalAssociation for 1965-66. He has also beenappointed to the National Advisory Councilon Arthritis and Metabolic Diseases of thePublic Health Service.Bertha A. Klien, Professor Emeritus ofOphthalmology, is president of the ChicagoOphthalmological Society.Heinrich Kluver, Sewell L. A very Distinguished Service Professor Emeritus in theDivision, received the 1965 Gold MedalAward of the American Psychological Foundation. The award was given for his long record of distinguished contributions in thefields of psychology, neurophysiology, neurohistology, and psychochemistry.In the spring, Dr. Kluver was elected tomembership in the American PhilosophicalSociety. The society was founded by Benjamin Franklin in 1743 "for the promotionof useful knowledge among the British plantations in America" and for the companionship of "sensible, virtuous, and elegantminds."In December Dr. Kluver was awarded anhonorary M.D. degree from the Universityof Basel, Switzerland.Ray Koppelman, biochemistry, has beennamed Master of the Biology CollegiateDivision and Associate Dean of the College.Ann Miller Lawrence has been appointeda Teaching and Research Scholar by theAmerican College of Physicians. The appointment is for three years and may be renewed for two additional years. Dr. Lawrence also won the 1965 Merit Award of theWoman's Medical College of Pennsylvania.Robert Y. Moore, '57, has received aJohn and Mary Markle Foundation grantwhich will enable him to study trainingmethods in pediatric neurology. The MarkleScholarship will support his work for a fiveyear period.Peter V. Moulder, '45, Professor of Surgery, received from the University of NotreDame one of its coveted Centennial Awardsgiven for "distinction in research, technology, or scientific attainment."Frank W. Newell will serve on a newadvisory subcommittee on vision and itsdisorders of the National Institute of Neurological Diseases and Blindness.Malcolm I. Page, '56, has left our medical faculty to accept the appointment asphysician-in-chief of the Mary ImogeneBassett Hospital, Cooperstown, New York.Dr. Page served as epidemiologist and resident in medicine at that hospital in 1959through 1962. He has recently been certifiedby the American Board of Internal Medicine.Robert G. Page received a Commonwealth Fund Fellowship to study medicaland premedical education. He visited medical schools in Norway, Sweden, Denmark,Germany, France, England and Scotland aswell as various research laboratories of cardiology in the early autumn.Henry T. Ricketts is president of the Institute of Medicine of Chicago.The Saymans (Wynn, '53, and ElizabethFord, '61) have left Billings and are nowliving in Richmond, Massachusetts. Wynnhas opened an office for the practice ofgeneral surgery in Pittsfield, and is on thestaff of the Pittsfield General and St. Luke'sHospitals in that city.Wynn was in charge of the very successful1964 Biomedical Career Conference.Ronald Singer was named Chairman ofthe Department of Anatomy on July 1,1965. He joined the faculty in 1962 as Professor of Anatomy and Anthropology andhas served as Acting Chairman since 1963.Nels M. Strandjord, '46, became Professor and Chairman of the Department ofRadiology at the University of Kansas Medical Center in Kansas City on July 1.Nels holds the first McClintock Awardfor excellence in teaching as the choice ofthe Class of 1960.Richard E. Tracy, '61, won the 1964Joseph A. Capps Prize conferred by the Institute of Medicine for his paper on "Hyper- lipemia and Tubular Cell Transport of Protein in the Nephrotic Rat." Dr. Tracy is aninstructor in pathology.Nancy E. Warner, '49, left the Universitylast spring after six years as Director of theLaboratory of Surgical Pathology and Associate Professor of Pathology to return toLos Angeles. She is now associate directorof the division of laboratories, Cedars division of the Cedars-Sinai Medical Center,Associate Clinical Professor of Pathologyat the University of Southern California.and attending physician at Los AngelesCounty General Hospital.Samuel B. Weiss won the AmericanChemical Society Award in Enzyme Chemistry for his work on the enzyme called RNApolymerase.RUSH NEWS'12. Morris Fishbein is president of theChicago Heart Association.'14. Mary M. Gage wrote to us recentlyrecalling her 1960 visit to the campus whenshe saw again the dissecting room in Anatomy where she had worked as a studentand the room in Green Hall where she hadlived. She said it was not until she lookedout from the fourth floor of Green that sherealized she had been away for forty-fiveyears-the trees and the President's Househad cut off the view she remembered of theMidway.She said she planned to move this winterto the United Presbyterian Home in Glendale, California which is near the homes ofher two sons.'17. Samuel J. Pearlman of Beverly Hills,California, received an Alumni Citation forPublic Service in June. Until his retirementin 1960. Dr. Pearlman was on the staffs ofMichael Reese and Cook County Hospitalsand taught at Northwestern University. Heorganized and planned the out-patient facility for ear, nose, and throat diseases atCook County Hospital. He is now lecturerin the Department of Head and Neck Surgery at the University of California in LosAngeles.'23. The Women's Council of the ChicagoHeart Association has established the Willis J. Potts Foundation for Pediatric Cardiology, Pathology and Surgery. Also the Congenital Heart Disease Research and Training Center of the Hektoen Institute has beenrenamed for Dr. Potts.'34. Col. John L. Anderson and Lt. Col.Joseph B. Davis, '41, participated in the36th annual International Aerospace Medical Association meetings in New York Cityin a series of programs that revealed thelatest advancements in the medical aspectsof aviation and space travel. Dr. Andersonis a surgeon at Hamilton A.F.B., California, and Dr. Davis is a flight surgeon atAndrews A.F.B., Maryland. They are bothwith the reserve program.'35. Hyman Heller of Webster, Massachusetts is president of the Worcester District Medical Society for the year 1965-66.'38. John D. Porterfield III, coordinatorof medical and health sciences at the University of California, Berkeley, has beennamed director of the Joint Commission onthe Accreditation of Hospitals.M E 0 I CAL A L U M NIB U L LET I N 27HECHTHans H. Hecht became Professor ofMedicine and Physiology and head ofthe cardiology service in July, 1964. OnJanuary 21, 1966 he was named the seventh Chairman of the Department ofMedicine.Dr. Hecht was born in Basel, Switzerland, in 1913. He received the M.D.degree from the University of Berlinin 1936. A year later he came to theUnited States and in 1946 was grantedan M.D�rom the University of Utah.Wpile still a student, Dr. Hecht became interested in the electrical activity of the heart and its possible relation to heart disease. He was instrumental in introducing special techniquesof electrocardiography (precordial andesophageal leads) and worked for manyyears (with Frank N. Wilson at theUniversity of Michigan) in an effort toprovide basic physiologic understandingof the mechanism of the heart actionand heart function. He joined the faculty of the newly formed medical schoolat the University of Utah in 1944 andserved on that staff for twenty years.In 1957 he was named the L. E. VikoProfessor of Cardiology. He was thefirst to set up a cardiac catheterizationlaboratory for clinical and researchstudies west of the Mississippi, and thefirst to record the electrical effects of theheart beat from within the cardiacchambers, thereby elucidating some ofthe mechanisms of irregular heart action. He was the first in this country touse the glass microelectrode to record electrical potentials from the inside of isolated cardiac muscle cells28 M E Die A L A L U M NIB U L LET I N MENGUYRene Menguy was appointed Chairman of the Department of Surgery onJuly 1. He succeeds William E. Adamswho asked to be relieved of his administrative responsibilities after six years aschairman.Dr. Menguy came from the University of Kentucky Medical Center wherehe was professor of surgery and associate professor of physiology. His mainresearch interests are the biochemistryof glucoprotein secretion by the stom- ach and the effects of steroids andsalicylates on such secretion.He was born in Prague, Czechoslovokia in 1926 and grew up in Indochina. In 1944 he earned a B.S. degreefrom the University of Hanoi and in1951 he received his M.D. degree fromthe University of Paris where he becameinterested in gastric and pancreatic physiology. After interning at the AmericanHospital of Chicago under a Fulbrightgrant, he continued his studies at theUniversity of Minnesota and was granteda Ph.D. in 1957 for his work on the"Physiology of Pancreatic and BiliaryDucts in Dogs." At the same time hecompleted his surgical residency at theMayo Clinic and was then appointedassistant professor of surgery at theUniversity of Oklahoma School of Medicine. In 1958 he was awarded a Marklescholarship and in 1961 he joined thefaculty of the newly established Collegeof Medicine at the University of Kentucky.Dr. Menguy met his future wife, anAmerican, in Paris while she was studying dress design and he was studyingmedicine. They have a son, Jean, 14,and a daughter, Ghislaine, 13.Dr. Menguy's principal goals as chairman of the Department of Surgery willbe to expand and diversify its teachingand research activities with increasedbenefits to patient care.and has carried on this work overthe years. In addition, he is much concerned with the basic aspects of mechanical heart function and its disturbance in health and disease, and has madesignificant contributions to the problemof adaptation of the vascular system toaltitudes and other environmental factors. In the course of this study he discovered a peculiar form of heart failurein cattle grazing at high altitudes whichhas since been used as a model of heartfailure in a variety of experiments. Dr.Hecht has a wide interest in all aspectsof the functioning of the circulatorysystem and his research publicationsrange extensively in this field. He hopesto be able, in Chicago, to attract avariety of scientists working in different areas of medicine and to provideat the University a unique center forresearch and teaching. Dr. Hecht is a member of the editorial boards of Circulation, Diseases ofthe Chest, Excerpttu Medica: Cardiovascular Diseases, and M alattie Cardiouascolari.He was president of the Utah HeartAssociation in 1957 and of the WesternSociety of Clinical Research in 1949. Heis a member of the training grant committee of the National Heart Instituteand of the publications committee of" theAmerican Heart Association, and is vicechairman of the cardiovascular subspecialty board of the American Boardof Internal Medicine.He is a member of the Association ofAmerican Physicians, the American Society for Clinical Investigation, the Royal Society of Medicine and others.Dr. Hecht is a naturalized Americancitizen; he is married to the formerlIse Wagner and has three children.LEWONTINRichard Charles Lewontin joinedour faculty as Professor of Zoology inthe autumn of 1964 and he has recentlybeen appointed Associate Dean of theDivision of Biological Sciences.Dr. Lewontin is widely known for hisuse of computers in the highly complexmathematical analysis of biologicalpopulations and in the building oftheoretical concepts of evolution. He isco-author of the revised edition ofQuantitative Zoology and associate editor of Evolution and The AmericanNaturalist.He was born in New York City in1929. He earned the B.A. degree fromHarvard in 1951 and the M.S. (1952)and Ph.D. (1954) from Columbia. Before coming to Chicago he taught atNorth Carolina State College and atthe University of Rochester and hespent a year at the University of Sydney, Australia, as a Fulbright and National Science Foundation fellow.Dr. Lewontin is a member of theBiometric Society, the Genetics Society,is vice-president of the Society for theStudy of Evolution and a Fellow of theAmerican Association for the Advancement of Science. This year he waselected to membership in the AmericanAcademy of Arts and Sciences.Bernard Roizman was appointed Associate Professor of Microbiology onAugust 1.Professor Roizman received his B.A.in 1952 and his M.S. in 1954 from Temple University. He continued his studies RAPPAPORT Henry Rappaport joined the facultyas Professor of Pathology and Directorof Surgical Pathology on April 1, 1965.He was Professor of Oncology at Chicago Medical School.Dr. Rappaport is a native of Lemberg,Austria, and earned his M.D. degreefrom the University of Vienna in 1937.Soon afterward he came to the UnitedStates and served with the MedicalCorps of the Army from 1943 to 1946.Subsequently, he was a member of thefaculty of George Washington University and on the staff of the Armed ForcesInstitute of Pathology in Washington,D.C. From 1954 to 1958 he was directorof the pathological laboratories at Mt.Sinai Hospital in Chicago and in 1958joined the faculty of Chicago MedicalSchool.Dr. Rappaport is one of the world'sexperts in hematopathology and is interested in the classification of malignant lymphomas.ROIZMANin microbiology at The Johns HopkinsUniversity where he earned the Sc.D.degree in 1956. From 1956 until comingto Chicago, he was a member of thefaculty at Johns Hopkins. In 1960 hereceived the Lederle Faculty Award and1961-62 was an American Cancer Society Scholar at the Institut Pasteur inParis.Dr. Roizman is a virologist withspecial interest in virus multiplication.He is a native of Rumania and becamea United States citizen in 1954. LUBRANMyer Lubran joined the faculty lastautumn as Professor of Clinical Pathology and Director of the ClinicalChemistry Laboratory. He had beendirector of clinical pathology at WestMiddlesex Hospital, London, where heestablished one of the first radioactiveisotope laboratories in England, in 1951,and developed the hospital's clinical andchemistry unit.Dr. Lubran was born in England in1915. He received his M.D. degree in1938 and his Ph.D. in chemistry in 1955,M E 0 I CAL A L U M NIB U L LET I N 29·both from the University of London.From 1938 to 1944 he taught physiology at Guy's Hospital and from 1944 to1948 he was in military service. In 1948he joined the staff of West MiddlesexHospital and was made consultant clinical pathologist for the National HealthService.Here Dr. Lubran supervises the service laboratory for the clinical chemistrylaboratories which were combined threeyears ago under Martin E. Hanke.He is also planning an undergraduateseminar and a new post-graduate training program for interns, residents. graduate students and practicing physicians.He finds the atmosphere of the cityand the University stimulating and says,"There is an open-mindedness here thatis unusual. Many people are ready tohelp on projects that are only tangentially related to their own."STINNETTECharles R. Stinnette, Jr., Professorof Pastoral Theology in the DivinitySchool, has been named to a joint appointment in the Department of Psychiatry.Professor Stinnette joined the University faculty in 1962 after havingtaught at Union Theological Seminaryand the University of Rochester. Heholds a B.S. degree from North Carolina State College, 1937, B.D. fromUnion Theological Seminary, 1940,S.T.M. from Hartford Theological Seminary, 1943, and a Ph.D. from Columbia University in 1950. He is an ordained minister of the Episcopal Churchand he was granted the first certificatein applied psychiatry for the ministry30 M E 0 I CAL A L U M NIB U L LET I N PROMOTIONS1965-66To Professor:William R. Barclay-Medicine (7-1-64)Clifford W. Gurney, '51-Medicine(ACRH) and PhysiologyTheodore Pullman-Medicine (7-1-64)Schulman, Sidney '46-Manning Profes-sor, NeurologyWarren K. Sinclair-Radiology (7-1-64)Bernard Strauss-MicrobiologyGeorge L. Wied-Obstetrics and GynecologyIra G. Wool, '53-PhysiologyTo Associate Professor:Robert A. Butler-Otolaryngology andPsychologyRobert Haselkorn-Biophysics andChemistry and Research Associate, Biochemistry (10-1-64)Alfred Heller, '60-PharmacologyAlex E. Krill--OphthalmologyEdward S. Lyon, '53-UrologyAlvin Markovitz-La Rabida and Microbiology (7-1-64)Christen G. Rattenborg-AnesthesiologyLennart Roden-La Rabida and Bio-chemistryJohn L. Sommer, '53-UrologyEdwin W. Taylor-Biophysics (10-1-64)Stanley Yachnin-Medicine and ACRHTo Assistant Professor:Richard L. De Gowin, '59-MedicineTibor G. Farkas-OphthalmologyJohn J. Fennessy-RadiologyHenri Frischer-MedicinePeter Jungblut-Ben May Lab (7-1-64)Sanford Krantz, '59-MedicineAnn M. Lawrence-Medicine and AGPScholar)Natividad Ozoa-Pediatrics and LaRabidaEdward Paloyan '56-SurgeryJames J. Rams-SurgeryBabette K. Stern-Medicine and Research Associate in BiochemistryFrancis H. Straus II, '57-PathologyTo Instructor:David Beal, '61-OtolaryngologyRichard I. Breuer-MedicineIvan F. Diamond, '61-NeurologyRobert C. Eberle-OtolaryngologyJ. Terry Ernest, '61-0phthalmologyRichard H. Evans, '59-Surgery andChief ResidentRobert A. Fink-Neurosurgery andChief ResidentFloyd A. Fried, '61-UrologyAllan Goodman-SurgeryJohn R. Hotchkiss, '61-MedicineErik Houttuin-SurgeryMarjorie J. Jacobson-PsychiatryMyron Jacobson, '58-Surgeryby the William Alanson White Institute of Psychiatry.He will collaborate in teaching andresearch with other members of thepsychiatric faculty. TOBIAS MEMORIAL LECTUREJulian M. Tobias, Professor of Physiology, died April 12, 1964 at the age of53. He had been a member of the University faculty since 1941. He held an M.D.from The Johns Hopkins University andthe Ph.D. from The University of Chicago.During World War II he served aschief of the physiology section of theMedical Research Laboratory, EdgewoodArsenal in Maryland where he did research on gas casualties. In 1955 he received a Guggenheim Fellowship forneurophysiological research at the University of Berne, and in 1962 he becamethe first professor at the University toreceive the Research Career Award madeby the United States Public Health Service to outstanding scientists.After Dr. Tobias' death, a number ofhis friends started a memorial fund forhim. Mrs. Tobias suggested that the fundbe used to serve the current needs ofgraduate students in physiology as determined by the staff of the department.Earnings from the invested capital havebeen used to purchase books and journalson neurophysiology for the departmentallibrary, and in December, the first JulianM. Tobias Memorial Lecture was given.Ralph W. Gerard, Rush '25, spoke on"Computers and the Future Universities."Contributions may be made to theTobias Memorial Fund of The University of Chicago and sent to Dwight J.Ingle, Chairman, Department of Physiology.Lawrence Jurkowitz-Medicine (7-1-64)Chien-Tai Lu-RadiologyReuben Matalon-Pediatrics and LaRabidaClifford S. Melnyk-Medicine (7-1-64)Zelma Molnar-PathologyMilton Moss-OrthopedicsAngelo K. Ozoa-PathologyRalph W. Riley-Pathology (7-1-64)Jafar Shah-Mirany-SurgeryIrving Shapiro-Otolaryngology(7-1-64)George W. Sleight, III-PediatricsThomas A. Stockert, '62-Medicine andChief ResidentRamon Ko Sy-OtolaryngologyFrank K. Thorp, '60-Pediatrics and LaRabida and Chief ResidentRobert J. Walsh-OrthopedicsMartha L. Warnock-Pathology andChief ResidentDouglas C. Wilkerson, Jr.-Clinical Instructor in PsychiatryStuart O. Zimmerman-Zoller and Research Associate (Instructor) Mathematical BiologyTo Research Associate (Instructor)Julia T. Apter-Mathematical BiologyGRADUATE NEWS'31. James O'Leary has been elected anhonorary foreign member of the Associationof British Neurologists. Dr. O'Leary is professor and head of the Department of Neurology at Washington University School ofMedicine, St. Louis.'37. Clinton Compere is vice-president incharge of medical affairs of the Rehabilitation Institute of Chicago.Richard V. Ebert of the University ofArkansas Medical Center, has been appointed to the National Advisory HeartCouncil of the U.S. Department of Health,Education, and Welfare.James D. Wharton has been appointedchief of the Division of Community HealthServices of the U.S. Public Health Service.'48. Doris C. Gilpin has completed herresidency in psychiatry at Cochran V.A.Hospital and for the next two years willhold a fellowship grant in child psychiatryat Washington University, St. Louis. Thegrant is made by the St. Louis Section ofthe National Council of Jewish Women.'58. Joseph R. Lancaster has become assistant professor of surgery at West VirginiaSchool of Medicine after completing his surgical residency. Last year he was chief resident in surgery at Billings.Franklin J. Star has entered private practice of general surgery in Columbus, Georgia.'59. James R. Dahl is in the private practice of internal medicine with two otherphysicians in San Rafael, California.'60. William Riley completed his Ph.D.at the University of Minnesota last summerand has joined their faculty as assistant professor of neurology. He is also attendingneurologist at the Hennepin County GeneralHospital and at the Minneapolis VeteransAdministration Hospital.'61. Charles A. Tietz is in the practiceof obstetrics and gynecology at the LenontPeterson Clinic in Virginia, Minnesota.'62. Lt. Robert Sonnenburg, U.S.N.,doubled as an aquanaut in a IS-day stay inthe Navy's Sealab 2 on the ocean bottom offLa Jolla, California. He treated nine of theten-man team for ear infections and one ofthem, astronaut-aquanaut M. Scott Carpenter, for a sting from a scorpion fish. TheNavy reported that the team had provedthat man can live and work efficiently inthe ocean depths.'63. Rostik Zajtchuk and Barry Kahan,'65, were awarded the Chicago Surgical Society's 1965 Research Prize for their workon "Soluble Transplantation Antigen."'64. Capt. Dominic Antico and Capt.David Hill have been graduated from theU.S. Air Force School of Aerospace Medicine at Brooks A.F.B., Texas. Antico is assigned to the Tactical Air Command atDyess A.F.B., Texas and Hill is a memberof the Military Air Transport Service atMcGuire A.F.B., New Jersey.Capt. George J. Plzak as completed theorientation course for officers of the U.S.Air Force Medical Service at Gunter A.F.B.,Alabama. He is assigned to Albrook A.F.B.,Canal Zone to practice as a physician withthe U.S. Air Forces Southern Command. EBERT BECOMES DEANAT HARVARDRobert H. Ebert, '42, became Dean ofthe Faculty of Medicine of Harvard University on July 1, 1965. He joined theHarvard faculty a year ago as JacksonProfessor of clinical medicine and chiefof medical services at MassachusettsGeneral Hospital.Dr. Ebert earned his B.A., '36, andM.D.,'42, from Chicago and the D. Phil.,'39, from Oxford where, as a RhodesScholar, he studied with Lord Florey.After internship and a year of residencyat Harvard he served for over two yearswith the Navy and then returned to Chicago in 1946 to complete his residencyand join the medical faculty. He was aMarkle Scholar in 1948-53. When he leftin 1956 he was professor of medicine andchief of the chest service. For the nexteight years he was Hord Professor anddirector of the Department of Medicineat Western Reserve University, Cleveland.RESIDENT NEWSOtto Gaga-Bousquet, '62-'65, has leftThe Clinics to return to the Department ofSurgery of the University of Michigan.James A. Esterly, '63, pathology, won thefirst-place Grand Award in the annual competition sponsored jointly by S.A.M.A. andthe Mead Johnson Scientific Forum for hisresearch paper entitled: "Observation on thePossible Relationship of Hypertension, Increased Arterial Permeability to Blood Cells,and Atherogenesis: An Electron Microscopic HALL OF FAMEFrances Oldham Kelsey, Ph.D.'38, M.D. '50, was named toWomen's Hall of Fame in ceremonies at the New York World'sFair. Portraits of the ten livingand ten deceased women so honored were hung in the HospitalityCorridor of the Better Living Center.Dr. Kelsey is Chief of the Investigational Drug Branch of theFood and Drug Administration.In 1962 her caution and persistence in demanding proof of thesafety of thalidomide preventedthe drug's introduction into medical usage in this country.The Gold Key of the MedicalAlumni was presented to her atthe Reunion in 1963.Daniel J. Fortmann '40, wasnamed to the professional footballHall of Fame last spring. As anundergraduate he played guardfor Colgate University and in1936 he was picked for the Chicago Bears in the first NationalFootball League draft ever held.He was an all-pro guard on threeworld championship Bears' teamsduring his medical school years.With the cooperation of DeanHarvey and Coach Halas he wasable to substitute the summerquarter for the autumn quarterin school and he continued to playthrough his internship year inDetroit.Dr. Fortmann practices generalsurgery and is chief of staff of St.Joseph's Hospital in Burbank,California.Study." His work was conducted under thesponsorship of Seymour Glagov.Zelma Molnar, resident-fellow in pathology, won the 1965 Hektoen Award given bythe Chicago Pathological Society.Francis Murphey, '33-'34, professor ofneurological surgery at the University ofTennessee, Memphis, is President of theHarvey Cushing Society and Chairman ofthe American Board of Neurological Surgery.Norman Siderius, '57-'63, after twoyears with the Air Force, has entered privatepractice of thoracic and vascular surgery inWaterloo, Iowa.MEDICAL ALUMNI BULLETIN 31PROFILE OF THE MEDICAL CLASS OF 1968On Wednesday, September 30, 1964,the seventy-three members of the entering freshman medical class arrivedon campus from their homes in eighteen states, Washington, D.C. and Nigeria. Nineteen of the students camefrom Illinois and twenty-three morecame from other Midwestern states.The following table gives general information regarding the selection of theclass of 1968:Total number of applicantsTotal number in entering class ..Number of foreign .Total number of men .Single .Married .Married wi th children .Total number of women .Single .Married " .Married with children . 12157316558708530All seventy-three students in the entering medical class, including the oneforeign student, received their undergraduate education in the followingforty-four American colleges and universities.Barnard C.Boston U.Brandeis U., Mass.Brooklyn C.Brown U. (2)U. California, Berkeley (3)Carleton C., Minn. (2)Catholic U., Washington, D.C.U. Chicago (16)Columbia U. (2)Cornell U. (2)Denison U., OhioDePaul U'J ChicagoDrake U., IowaEastern Illinois U.Harvard U. (2)Holy Cross C., Mass.U. KentuckyLebanon Valley C., Penna.Loyola U., ChicagoLuther C., IowaU. MichiganMichigan State U.U. of MissouriNorthwestern U.Oberlin C., Ohio (2)U. of PennsylvaniaPrinceton U.Rice U., TexasU. of Rochester (3)Rutgers U., New JerseySt. Olaf C., Minn. (2)San Diego State C.Stanford U. (3)Swarthmore C., Penna. (2)32 M E Die A L A L U M NIB U L L ET I N U. of ToledoUnion C., New YorkWabash C., IndianaWashburn U., KansasWashington U., Mo.Washington State U.Western Reserve U., OhioWittenberg U., OhioU. of WyomingThe average age of the entering classwas between twenty-one and twentytwo years and fifty-six members of theclass were twenty-two years old oryounger. The age range for the classwas a rather narrow one this year. Theyoungest student, a coed from BarnardCollege, was nineteen years of agewhen she began her medical studies.The oldest entering student, a Navyveteran, who had previously earned adegree in electrical engineering, wastwenty-six years.As in previous years the Committeeon Admission considered seriously eachapplicant's non-scholastic attributes inaddition to his scholastic achievementsand aptitudes. Nevertheless, of theseventy-three entering students, nonehad a college grade average below Band fifty-seven possessed grade averagesof B+ or better. The composite collegegrade average of the class was B+ andthirty-two of the class members weregraduated from college with honorswhile nine were elected to Phi BetaKappa. Sixty-six members of the classhad earned a bachelor's degree in somecollege, one of these having also earnedan M.A. and a Ph.D. degree in anthropology. The other seven class membershad fulfilled their premedical requirements in three years' time without receiving a bachelor's degree. On theMedical College Admission Test, whichis required of all medical applicants,the entering freshman medical class asa group scored high above the nationala verage, and indeed, slightly higherthan any previous entering class at theUniversity of Chicago School of Medicine since the inception of the examination over fifteen years ago. On the basisof their performance on the MCAT, theentering freshmen were easily in the topten percent of all medical applicants inthe United States last year.Since each applicant is considered onhis own merits by the Committee onAdmissions, it is not surprising to learnthat the family backgrounds of the en- .tering medical students are most variedand interesting. Five come from alumnifamilies. In two of these instances, bothparents are University of Chicago alumni, although only one of the sevenalumni parents is a medical schoolalumnus. The other six are graduatesfrom our college and graduate schools.Seven members of the class of 1968come from homes where one or bothparents have had less than a high schooleducation. At the other end of the educational spectrum, more than one-half(38) of these students come fromfamilies where one or both parentsare college graduates. As might also beexpected, the occupations of the fathersof the entering freshmen represent across-section of 'the professions, industry, and labor. Included in the group areeleven doctors, five school teachers,four university professors, three ministers, two engineers and a lawyer, inaddition to a wide variety of businessmen, merchants, office workers, andskilled and semi-skilled laborers. Similarly, twenty-five of the mothers havecareers in addition to that of housewife.Nine are school teachers, six are secretaries, and two are bookkeepers. Theremainder include a translator, a physician, a nurse, a librarian, a lawyer,a dressmaker, a cook, and a clerk. Theclass of 1968 has now completed itsfirst year of medical studies. By itsperformance it has already fully justified its selection by the AdmissionsCommittee.JOSEPH CEITHAMLDean of StudentsBULLETIN •of the Alumni AssociationThe University of ChicagoSCHOOL OF MEDICINEDIVISION OF BIOLOGICAL SCIENCES950 East 59th Street Chicago, Illinois 60637VOL. 21 SPRING-AUTUMN 1965 No.1EDITORIAL BOARDJESSIE BURNS MACLEAN, SecretaryARCHIE LIEBERMAN, Art EditorWUGHT ADAMS ROBERT J. HASTEllLIXRICHAllD K. BLAISDELL ELEANOR M. HUMPHREYSL. T. COGGESHALL HUBERTA LIVINGSTONERICHARD EVANS PETER V. MOULDERWALTER L. PALMER