/Medicine on the Midw . / Vol. 29 �f.:3(/ . . A . .. T u· I nfB) . n n \Bulletin of the Medical lumni sociation he mv S � 9, �;lllC�g9 � .Division of the Biological Sciences and The Pritzker Sc .' tli lI1Jril'dit!in'i O.�.,Ot.trAPR 13 1975 tThe front and back covers capture the mood and make-up of the 1974entering class. Freshmen included are: Patrice Fox-Spitalnik, Walter Stol­ler, Richard Dodd, Harvey Kliman, Linda Go/uch, Cary Keller, KenKampman, Allan Prochazka, Vaughn Wittry, Robert Geist, Ruth Whitham,Harold Yang, Douglass Given, Elio J. Frattaroli, Bruce Fenster, WilliamPhillips, Paul Doroghazi, Deborah Edelman, David Jaffe, Christine White,and Gary Paige.Medicine on the MidwayVolume 29, No.3 Winter 1975Bulletin of the Medical Alumni Association ofTh.e University of Chicago Division of the BiologicalSCIences and The Pritzker School of Medicine.Copyright 1975 by the Medical Alumni AssociationThe University of ChicagoEditor: Nancy SelkContributing Editor: James S. SweetPhotographers: Mike Shields, Bill Rogers, Wayne SorceChairman Editorial Committee: Robert W. Wissler (48)Medical Alumni AssociationPresident: Otto H. Trippel (46)President-Elect: Henry P. Russe (57)Vice-President: Asher J. Finkel (48)Secretary: Francis H. Straus II (57)Director: Katherine T. WolcottCouncil MembersJoseph M. Baron (62)Howard L. Bresler (57)Sumner C. Kraft (55)Richard L. LandauRobert S. Mendelsohn (51)Lauren M. Pachman (61)Edward Paloyan (56)Donald A. Rowley (50)Joseph H. Skom (52) ContentsCampaign for ChicagoDr. Robert Wissler 4Profile-1974 ClassJoseph Ceithaml 7Wine and Cheese Party 10Digestive CancersKathleen Morner 13Medicine Along the AmazonDr. John Rippon 16Medical Records at the Touch of a FingerKathleen Morner 18Training General PractitionersDr. Leon Jacobson 20The Growth of GastroenterologyDr. Joseph Kirsner 22Mural Brightens SceneChristina Madej 27News Briefs 28In Memoriam 36Departmental News 36Alumni News 423It doesn't seem possible that 35 years have passed since Icame to this campus and that I have been on the facultyfor 31 years. But what is more phenomenal and impres­sive to me is the remarkable growth and development ofthis Division of the Biological Sciences and its PritzkerSchool of Medicine during that period-and always withan emphasis on quality! I can't help being proud-and Ithink you too should be-of the way we as an institutionand a faculty have adapted to present day needs. In fact,we have had to adapt continuously for these 35 years tothe ever-changing and almost mind-boggling progress inthe biological sciences and medicine. A transplanted In­diana farm boy like me can only stand in wonder before itall.During this period of fantastic progress and increasingcomplexity, we have managed to remain at the forefrontof American medicine. We have been, as we are today,the leaders in the teaching and training of physicians andphysician-scientists who practice, teach and train addi­tional physicians and physician-scientists all over thiscountry and the world.EndowmentEndowed Professorships12 Distinguished ServiceProfessorships10 University Professorships6 College Professorships6 3 Basic & 3 Clinical $ million(each).75Biological Professorships9 Humanities Professorships .64 Matching Humanities .4Professorships2 Oriental Institute .6Professorships5 Physical Sciences .6Professorships10 Social Sciences .6Professorships6 Matching Social .4Sciences Professorships4 Graduate School of .6Business Professorships3 Divinity School .6ProfessorshipsMatching Divinity School .4ProfessorshipGraduate School of .6Education Professorship5 Law School .6Professorships4 Campaignthe Medical School and theDr. RobertWhat are the critical components of this record ofadaptive growth and development? In' these 35 years, wehave added 1,307,431 square feet of new space-notmerely to increase the number of beds for patient carefrom 325 to over 650, but to accommodate the increase infaculty from 115 to 311, the medical student populationfrom 192 to over 400 and the house staff from 86 to 320.Much of this new space and enlarged faculty are devotedto the specialized facilities that are so necessary for mod­ern medical science. At this University we have the firstand only Atomic Energy Commission hospital in the na­tion, directed by Leon Jacobson (39) and Sam Weiss; themost innovative electron microscope laboratories in theworld-with both transmission and scanning capabilities;one of the nation's strongest groups of immunologicalscientists and laboratories, organized into a degree grant­ing committee by Frank Fitch (53); a superb and highlycoordinated interdisciplinary group of laboratories thatserve cardiologists and basic scientists involved in car­diovascular research which includes a Specialized Centerof Research-SCOR-in Ischemic Heart Disease, led2 Graduate Library School .6Professorships3 School of Social .6Service Admi nistrationProfessorshipsTotal EndowedProfessorships 54.5.75.6.6 Endowed ProgramCollegeEndowment for Harper Library .5Book AcquisitionHumanitiesArt Gallery Endowment 2.Humanities Institute 5.Oriental InstituteCenter for Far Eastern Studies 2.2Social SciencesSocial Sciences Institute 4.Graduate School of BusinessCenter for Mathematical Studies I.in Business and EconomicsResearch Endowment 2.Institute of Professional I.AccountingLaw SchoolCenter for Studies in 1.5Criminal JusticeLaw-Economics Program 1.5Legal History Program I .5Law Research Endowment I.Social Service Administration Center for Research in Social 3.Welfare PolicyExtension Endowment 2.Committe on Public Policies 10.Studies (First Stage)Junior Faculty Opportunity Fund 2.2Total Endowed Programs 40.4Endowment for LibraryEndowment for Maintenance 15.Endowment for Library 10.Operations BudgetSupport of Non-Western and .3International ProgramsTotal Endowment for Library 25.3Endowment for Student AidEndowment of 100 Named 12.5Fellowships at $100.000 each andendowment of 58 Named TuitionScholarships at $60.000 eachPhysical Sciences Research and 4.Fellowship EndowmentSpecial Foreign Student I.FellowshipsTotal Endowment for Student 17.5AidTotal Endowment 137.7 Expendable$ millionOperating Support 3/.5ProgramCollegeBergman Gallery .05Collaborative Teaching .5ProgramFund for Harper Center .1Residence Hall Program .15Special Programs for 2.Instruction and ResearchBiological SciencesBasic Science Program .5Clinic and Hospital Program 1.8Developmental Biology .3ProgramNeurobiology Program .5Structural Biology Program .5AIMS. Support of New .9Programs'Oriental InstituteEpigraphic Survey . IField Work . IMuseum Conservation .1Publication Work .075Physical SciencesJunior Faculty Research .4Program .for Chicago,Division of Biological SciencesW. Wisslerby Leon Resnekov; and a SCOR in Atherosclerosis,which I have the privilege of directing. We also have apioneering Cancer Research Center, established underthe leadership of John Ultmann and built on the firmfoundation of expertise and the record of discovery ofCharles Huggins' Ben May Laboratory, the work in theGoldblatt Hospital's laboratories and the long sustainedAEC (Argonne) research program. These are some ofthe components I know best.The medical school is developing in many other ways,too. It has reached out to join hands with our neighboringmajor medical Center, Michael Reese Hospital, in a spe­cial partnership that should strengthen the contributionto health care and teaching programs of both institutions.We are also developing important ties with several com­munity hospitals. These endeavors enable the UniversityHospitals and Clinics and our neighboring hospitals toprovide improved medical care for many of the com­munities near us.One of the most personally satisfying aspects of myaffiliation with this University has been my association and work with Leon Jacobson, who has, more than anyother man, I think, been responsible for the adaptivegrowth of this institution during this recent period. Hehas provided leadership in many ways. These include hisremarkable discoveries in hematology including pioneer­ing work in developing chemotherapy of lymphomas andHodgkin's disease; discovering that injecting blood­forming tissues into lethally irradiated animals will savetheir lives; and working out the hormonal regulation oferythrocyte production. He has also provided sustainedleadership as a teacher, a skillful bedside physician, thehead of hematology, the developer and director of theAEC Argonne Hospital, the Chairman of the Depart­ment of Medicine and, for the past decade, the Dean ofthe Division and the Medical School. He has personallybeen responsible for the construction of 910,000 squarefeet of new space and for raising millions of dollars fromprivate sources for the Division of the Biological Sci­ences and the University.Enough nostalgia. What now? What needs to be doneduring the next decade? I hope to spend most of it here inObservatories Operations .3 Expendable Student Aid Facilities Graduate School of EducationResearch Facilities .3 50 Fellowships a year at $5,000 2.5 Clinical Research Facility .15Social Sciences each and 80 Scholarships per year $ miUion Judd HaU Renovation .24Center for Far Eastern Studies .3 at $3,250 each for five years University Life Law School Building Addition 3.5Graduate School of Business Revolving Student Loan Fund 2.5 Burton J undson Remodelling .75 Total NOli-Medical Facilities 34.615Application of Management .5 Graduate School of Education .23 Field House 5.Science to Social Problems Early Childhood Training Mandel HaU Renovation 1. AIMS. Advancement in MedicalManagement of Public and .5 Fellowships Stagg Field Improvements .25 Science FacilitiesNon-Profit Organization Research Training Fellowship .18 Theater 4. Ambulatory Care Center 2.4Program Total Expendable Student Aid 5.41 College Basic Science Laboratories 1.4Graduate School of Education Cell Biology Laboratory .05 Billings Hospital 1.1Junior Faculty in Education .535 Development Biology .025 ModernizationProgram Expendable for Library Laboratory Cancer Researcb Center 3.4Law School Fund for Acquisitions 2. Neurobiology Laboratory .05 Cancer Virus Research 4.9Legal Aid Clinic .5 Opportunities Biological Sciences LaboratoryGraduate Library School Fund for Experiments in .125 Basic Sciences Renovation 1.35 Chicago Lying-In Hospital 5.Post-Doctoral Program .75 Information Access Humanities ModernizationSchool of Social Service I ncorporation of Departmental .1 Music Building 2.4 Clinical Pharmacology 1.4Administration Libraries Oriental Institute LaboratoryWordshop for 3 years .06 Support of Non-Western and .5 Museum Extension 2.5 Emergency Care Center .6Extension Division International Programs Physical Sciences RenovationArtist-In-Residence Program .03 Total Expendable for Library 2.725 Institute Building Complex 2.4 Physical Therapy Facility .4Chicago Humanities Project .15 Renovation Radiology- Nuclear MedIcine 2.Chicago Social Sciences .15 Laboratory Instructional 1. LaboratoriesProject Equipment Surgery-Brain Research 21.5Special Lectures and Concerts .03 Development Fund 5. Center for Physics 6.6 PavilionJunior Faculty Opportunity 2.2 Social Sciences Space 2.4 Ultrastructure Research 5.Fund Renovation LaboratoryTotal Program 14.38 Total Expendable Funds 59.015 Graduate School of Business .3 Total AIMS Facilities 49.1ModernizationDivinity School Modernization .65 Total Facilities 83.7155my favorite activities-teaching, research, interactionwith students and house staff in pathology and wrestlingwith the unending stream of diagnostic problems. Whatdo we need to do for the 1980s and the decades ahead?Right now, we face two remarkable challenges. Thefirst is that Jake (Dr. Jacobson) is soon going to stepaside as dean and we are searching for another vigorousleader. The second is that the University is launching a$280 million fund raising drive. A substantial part of thismoney ($58.7 million) has been designated to enable thisDivision of Biological Sciences and its Pritzker School ofMedicine to sustain its position of eminence as theworld's outstanding medical school, devoted to the de­velopment of leaders in biology and medicine for the fu­ture.November 14, 1974, Secretary of State Henry Kis­singer came to the campus to help University PresidentEdward Levi, the Board of Trustees and Dean Jacobsonkick off this Campaign for Chicago.Isn't this a poor time to raise money? you may ask. Wedon't think so-not with your help! There are many un­tapped sources of substantial support from the privatesector which, if gently persuaded by you, can speed us tothe goal. We need your contribution and your help insteering us to potential major donors!What will the Campaign help us do as a Division ofBiological Sciences and a Medical School in the nextdecade and beyond? First of all, it will provide $3.6 mil­lion for six new endowed professorships. Some of thismoney may be used to attract a renowned professor towork with us on atherosclerosis, a subject close to myheart. It will provide endowments that can furnish fundsfor student aid in neurobiology, developmental biology,structural biology and other clinical and basic scienceprograms.Perhaps of greatest significance, the Campaign willprovide funds needed to complete our AIMS program inbiology and medicine. AIMS stands for AdvancementIn Medical Science. These funds, of nearly $50 million,will insure that we can complete the new Surgery-BrainResearch Pavillion ($21.5 million) for which PresidentLevi, Dean Jacobson, David Skinner, John Mullan, andWilliam Fay of the Brain Research Foundation brokeground in May, 1974. Our beloved Lester Dragsted washere for the occasion. There is now a large area of exca­vation and deep-driven piles adjacent to Abbott, Armourand Billings. We need your help to insure completion ofthis much needed building. The six-story structure wiJIprovide space for the University's Brain Research Insti­tute, a 26-bed neurosurgical care unit, 14 operating suitesand their support facilities and offices, as well as researchlaboratories for the neurosurgery section and the surgerydepartment.The money raised by this important fund drive will alsohelp make possible the construction of a Cancer VirusResearch Laboratory at 58th and Drexel, next to theCummings Life Science Center. It will house a virus cul­ture laboratory, a centralized electronmicroscope facil­ity, six virus research laboratories, conference rooms,offices and teaching areas. In addition, the drive will en­able us to expand our radiation therapy center, establish6 a suite of developmental biology laboratories and anumber of other cancer related facilities.The National Cancer Institute has already committednearly $10 million-contingent upon our raising matchingfunds for these programs. Although our scientists lead inthe investigations of the role of viruses in the develop­ment of cancer, they do not have adequate facilities inwhich to work.The additional $25 million of the much-needed moneywiJI help in many important ways to keep us moving for­ward. It will insure the development of our new Am­bulatory Care Center and the Clinical PharmacologyLaboratory for Leon Goldberg, our new leader in thisimportant area. It will also allow us to update ourfacilities for Radiology and Nuclear Medicine; financethe modernization of Chicago Lying-In Hospital; andprovide funds for new laboratories for the Cancer Re­search Center, for the development of our UltrastructureResearch Laboratory, and for improved emergency med­ical care and physical therapy facilities.For those of us who labor at the bench and in thelaboratories in pathology, this campaign will providefunds for modernization of aging basic sciencelaboratories and of Billings Hospital facilities. This willhelp us do our job better as we continue to support andaugment the remarkable cadre of attending staff and themore basic scientists with whom we have the privilege ofworking.Your contribution of time, money and effort will helpinsure that during the next decade and the decades thatfollow, we will sustain our long-established momentumof growth and development to meet the needs of thisremarkable biological and medical education institutionthat forms such an important part of this great Univer­sity. For the campaign to be successful, we must dependon many sources-government, foundations, corpora­tions, and friends, but most important, the alumni-andfor two reasons. First, of course, is the face value of yourgift. Secondly, your contribution provides the model forfoundations and corporations to follow. It is the en­dorsement of people who know our strengths and weak­nesses and are willing to provide their own funds that willhelp convince others to join in the campaign to keep TheUniversity of Chicago and The Pritzker School ofMedicine among the educational leaders of the world.Dr. Robert Wissler (S.M. 43, PhD. 46, M.D. 48) is theDonald N. Pritzker Professor in the Department of Pathol­ogy, the Frankl in Mclean Memorial Research Institute andProfessor in the College. He entered this medical school in1939, interrupting his studies in 1941 to do Army and Navysupported nutritional research in pathology. He continuedhis work here on both his MD. and his PhD. during thenext seven years while also teaching pathology. He wasawarded his M.D. with honors in 1948.For 15 years, he served as Chairman of the Departmentof Pathology. He was president of the Alumni Associationin 1969-1970 and now serves as Chairman of the EditorialCommittee for Medicine on the Midway. He is also amember of the Faculty Committee for the Campaign forChicago.PROFILE-THE 1974ENTERING CLASSJoseph CeithamlThese are days when records were made to be broken.Last year's class was selected from over 4,800 appli­cants, the largest number up to that time ever to apply foran entering medical class at the University of Chicago.However, the applicants who applied for the 1974 classnumbered a record breaking 5,153. The entering class of104 students consists of 22 women (five married) and 82men (nine married). None of the married students hadany .children at the time they began their medical studies,Six of the entering class were selected for the MedicalScientist Training Program (MSTP) which leads to boththe M.D. and Ph.D. degrees in six calendar years. TheMSTP trainees began their studies in the Summer of1974. The other 98 students embarked upon their fouryear program leading to the M.D. degree in the Autumnof 1974.Of the entering students, 102 had at least a bac­calaureate degree. Seven also had achieved Masters de­grees and four had Ph.D. degrees (one each in chemistry,microbiology, molecular biology and psychology). In­cluded in the class are five minority group students (twoblacks, one Puerto Rican and two American Orientals)and four foreign students (two from Hong Kong and oneeach from South Viet Nam and the Philippine Islands).See Table I. Despite the fact that two students entered after butthree years of college preparation, and four students hadPh.D. degrees, the age range in the class is still relativelynarrow. The youngest members of the class are two 19year olds, one from our undergraduate college who hadboth his B.S. and M.S. degrees at the time be began hisMSTP studies. The other is a graduate of Columbia Uni­versity who likewise entered the MSTP. The oldest per­son in the class is a Ph.D. in Psychology who decided toemploy his expertise in Psychology in a medical career.He was 28 years of age when be began his medicalstudies. The average age of the entering class is 22, with88 of the students being 22 years of age or younger whenthey began their medical studies.As seen in Table II, 52 different colleges and univer­sities are represented in this year's entering class. Asexpected, The University of Chicago provides the largestnumber of students-I7. Then followed the Universityof Illinois, Urbana, with eight; University of NotreDame and Johns Hopkins with five each; and sevenschools with three each. The remaining 41 schools hadone or two students each.T able III reveals the geographical distribution of the104 students by their state of residence. As usual, Illinoisclaimed the largest number, 39; New York followed withDean Ceithaml (left) talks with freshmen. Dr. John Madden (right rear) is a student adviser.16; Indiana and Ohio had five each and New Jersey andCalifornia four each. Two states, Maryland and Wiscon­sin, each had three and the remaining 26 students camefrom 18 states and three foreign countries.The entering class possesses the following academiccredentials. The average grade point average (G P A) incollege studies was 3.66 on a scale where 4.0 equals Aand 3.0 equals B, and 90 percent of the class had GPA'shigher than 3.2. On the Medical College Admission Test(MCAT) the entering class, like its predecessors, didvery well. The average total MCAT score exceeded 630,which easily falls within the top quintile of all applicantsto medical schools last year. It is also interesting to ex­amine the academic majors which the entering studentschose to pursue in college. As in past years, most ma­jored in the sciences, particularly in biology (40 percent)and chemistry (17 percent). Nevertheless, slightly over10 percent were non-science majors. As seen in TableIV, 50 percent of the women in the class had biologymajors and almost 25 percent of the women were non­science majors in college.It has been, and remains, the policy of our Committeeon Admissions to evaluate each applicant on his or herown merits. Consequently, it is not at all surprising thatTable I: Entering Medical Class. 1974EnteringClass ApplicantsSingle Men 73Married Men 9Married Men with Children 0Total Men 82 4,157Single Women 17Married Women 5Married Women with Children 0Total Women 22 996Ph.D.'s 4Minority Group Students 5Oriental 2Black 2Puerto Rican 1Foreign Students 4Hong Kong 2South Viet Nam 1Philippine IslandsTotal Students 104 5,1538 Table II: Undergraduate College DistributionBarnard College (1)University of California, Berkeley (2)University of California, Irvine (1)Calvin College, Michigan (1)Carleton College, Minnesota (2)Carroll College, Montana (3)University of Chicago (17)Colorado State Un iversity (1 )Columbia University (2)Cornell University (1)Duke University (1)Fairfield University, Connecticut (1)University of Florida (1)Georgetown University (1)Harvard College (1)Hope College, Michigan (1)Howard University (1)University of Illinois, Urbana (8)Illinois Institute of Technology (1)Johns Hopkins University (5)Loyola University, Chicago (3)Massachusetts Institute of Technology (3)University of Michigan (3)Michigan State University (2)Middlebury College, Connecticut (1)State University of New York, Binghamton (1)State University of New York, Stony Brook (3)Northwestern University (1)Notre Dame University (5)Oberlin College (3)Ohio State University (2)Ohio University (1)University of Oklahoma (1)Princeton University (1)Rice University (1)Rutgers University (1)Skidmore College, N.Y. (1)Smith College, Massachusetts (1)Southern University, Louisiana (1)Southwestern State College, Oklahoma (1)st. Olaf College (2)Stanford University (3)Swarthmore College (1)Syracuse University (1)University of Toledo (1)Trinity College, Connecticut (1)University of Utah (1)Valparaiso University, Indiana (1)University of Washington (1)University of Wisconsin, Madison (2)University of Wisconsin, Milwaukee (1)Yale University (1)Number of Schools: 52Table IV: Academic Major DistributionMajor Men Women TotalTable III: Geographic Distribution Anthropology 0 1 1of Entering Class Biochemistry 7 1 8Biology 30 11 41Biophysics 1 0 1Alabama 1 Missouri 1 Chemistry 15 2 17Alaska 1 Montana 2 Computer Science 1 0 1California 4 New Jersey 4 Engineering 1 1 2Colorado 1 New York 16 English 2 0 2Connecticut 1 Ohio 5 Greek 1 0 1Florida 2 Oklahoma 2 Humanities a 2 2Idaho· 1 Oregon 1 Linguistics 0 1Illinois 39 Rhode Island 2 Mathematics 3 1 4Indiana 5 Texas 1 Natural Sciences 3 a 3Louisiana 1 Utah 1 Physical Sciences 1 1 2Maryland 2 Washington 1 Physics 2 0 2Massachusetts 1 Wisconsin 3 Physiology 1 0 1Michigan 1 Hong Kong 2 PreprofessionalMinnesota 1 South Viet Nam 1 Studies 6 0 6Philippines 1 Psychology 4 1 5Zoology 4 0 4Number of States: 26Number of Foreign Countries: 3 Totals 82 22 1049the family backgrounds of the entering students are quitevaried. Five students come from University of Chicagoalumni families. In each instance, the father is the alum­nus. Three of these are alumni of our medical school (oneof these also received the Ph.D. degree in Pharmacol­ogy), one was a graduate of our College and one of ourGraduate School of Business. Eight members of the en­tering class came from families where one or both parentshad less than a high school education. On the other hand,65 of the students come from families where one or bothparents are college graduates. Reflecting the spread inthe parents' education, the occupations of the parentscover a wide spectrum of the professions, industry andlabor. Included among the fathers are 11 physicians, 11business executives, 10 merchants, eight engineers, fiveaccountants, five college professors, five salesmen, threelawyers, three realtors, three laboratory technicians, twohigh school teachers, two janitors, two pharmacists andtwo stock brokers. Also represented among the fathersare an artist, banker, barber, book seller, chemist, courtreporter, dentist, economist, farmer, laborer, marketingresearcher, mechanic, minister, plumber, publisher,roofer, usher and a waiter. Of the remaining, nine fatherswere retired and five deceased. Of the mothers, approximately one half (5 I) arehomemakers while the remainder had additional careers.In this group are 15 school teachers, eight secretaries,four registered nurses, three office clerks, two adminis­trative assistants, two artists, two design consultants andtwo telephone operators. Also included are an account­ant, bookkeeper, chemist, college professor, librarian,marketing researcher, occupational therapist, pharma­cist, physician, research scientist, sales clerk, socialworker and urban planner. The mothers of two of thestudents were deceased.Year in and year out our medical school has been for­tunate to enroll a bright and talented group of students.Each class, by virtue of its heterogeneity, likewise pos­sesses its own character which makes it different fromany other class. The class entering in 1974 has the poten­tial for achieving excellence in medicine and it will be ourmutual goal to develop that potential during the next fouryears.Joseph Ceithaml is Dean of Students in the Division of theBiological Sciences and The Pritzker School of Medicineand Professor in the Department of Biochemistry.Dr. Trippel sips wine with Gary Bos and Ernie Brahn.The Class of 1978 was welcomed by the Medical AlumniAssociation, November 20, at the Association's annualwine and cheese party, held this year in the Bergman ArtGallery of Cobb Hall. For many of the students, this wasthe first visit to the fourth floor gallery, which also servesas a classroom for College students. Those attendingviewed the photographs of Richard Gordon which wereon display.This is the fifth year the Association has hosted theparty to give freshmen an opportunity to know theirclassmates better and to meet informally with their in­structors, advisors, deans, and alumni. Held in late af-wine.cheesepartIJ10 Dr. Sheppard Kellam (center) talks with Brooke Kountz, Christine Whiteand David Levens.ternoon following anatomy lab, the party provides a re­laxing atmosphere for socializing.Dr. Otto H. Trippel (,46), President of the MedicalAlumni Association, and other members of the MedicalAlumni Council there commented on the students' in­creased social awareness and their professional approachto their studies.The gallery was opened in 1968. It was a gift of Mr.and Mrs. Edwin A. Bergman of Chicago, who aregraduates of The University of Chicago. Mr. Bergman isa member of the Citizens Board and Mrs. Bergman is onthe Women's Board and an officer of Mother's Aid.The times changeAnd we change with them.-From Owen's EpigrammataName Graduation YearHome Address TelephoneCity, State, ZipBusiness Address TelephoneCity, State, ZipTitleNew address?New position?New medical practice?military assignment?civic or professional honor?book?Please tear out, fold, staple, or tape, and drop in the mail box. Thanksl------- - -------- -- - --------_._-- - - -- - -_._------_._---_._. _. - -- - - __ .-Medical Alumni Association1025 East 57th StreetChicago, Illinois 60637Fold this flap in first PlaceStampHereI.1.. _Digestive Cancers:A Comprehensive ApproachKathleen MornerFor over a year, Medicine 6 has been the site of a com­prehensive approach to cancers of the digestive tract.Two projects, both under the direction of Dr. BernardLevin, Assistant Professor of Medicine, Section of Gas­troenterology, are going on simultaneously. One, whichinvolves patients with chronic ulcerative colitis, is astudy aimed at the early detection of colon cancer. Theother, a gastrointestinal oncology clinic, is a team ap­proach to the care of patients with advanced gastrointes­tinal cancer. It also serves as an interdisciplinary educa­tional and house staff training unit.Although the University has long been a leader instudies of gastrointestinal disease, the new comprehen­sive approach has been instituted as a way of formulizingclinical activities related to cancer of the colon and rec­tum and other gastrointestinal cancers. It is also seen as ameans of reorganizing and intensifying research in thisfield at the University.The early detection project involves ulcerative colitispatients who are predisposed to carcinoma of the colon.This would include patients whose colitis involves theentire colon, and who have had the disease for more thanseven years, dating from their teens. For purposes oftesting, the colitis must also be inactive.They come as outpatients and then for two or threedays they are hospitalized in the clinical research centerwhere they undergo a variety of tests. These are adminis­tered free of charge. Early detection of malignancy in­creases the probability of complete cure, but, says Dr.Levin, arriving at a reliable means of detection is a com­plex task. It involves a wide range of medical andscientific disciplines and techniques, including endos­copy, cytology, pathology, immunology, scanning andtransmission electron microscopy, and chromosomalanalysis. One problem, Dr. Levin points out, is thatchronic ulcerative colitis is itself as difficult to define as itis to detect."This disease should really be termed 'chronic, nonspecific, ulcerative colitis,' " he says. "This dis­tinguishes it from colitis with known causes, such as ba­cillary dysentery and other infectious diseases. Somephysicians have suggested that it might be caused by dis­orders of the immune response of the body. Others haveattributed it to infectious causes. Neither of thesetheories has been proven. Gradually it has become ap­parent that the disease can be identified only through theprocess of exclusion. There is, for example, no connec­tion between it and 'spastic colitis' (a misnomer for whatshould be called irritable bowel or irritable colon syn­drome). Irritable colon syndrome is a stress-related dis­ease which usually can be managed quite effectively byunderstanding, diet manipulation, and simple medica­tion. Chronic, non-specific, ulcerative colitis is muchmore serious. It requires long standing medical manage­ment and sometimes surgical intervention. It is a sys­temic disease which can have many peripheral manifesta­tions involving the eyes, liver, kidney, joints or skin."In order to diagnose it, the physician must take a care­ful history and perform a general physical examination.A proctoscopic (rectal) examination allows the physicianto determine whether the rectum is inflamed. Rectalbiopsies can also be obtained. If a patient has ulcerativecolitis, the tissue will show characteristic traits. Chroniculcerative colitis and carcinoma of the colon often goundetected because patients resist the proctoscopic ex­amination and physicians do not always insist upon ad­ministering it. " Unfortunately," Dr. Levin says, "weoften see patients whose rectal bleeding has been as­cribed by themselves, their family, or their physician tohemorrhoids. These people may subsequently presentcancer of the colon or rectum which was obviously mis­diagnosed.' ,Dr. Levin stresses that anyone who has rectal bleedingnot caused by hemorrhoids should have a thorough proc­toscopic examination and a barium enema. This warningalso applies to patients whose colitis has been inactive for13Staff of the C. I. Oncology Clinic from left: Maura Todt, R.N.; Dr. Warren Enker, consulting surgeon;Phillis Cullen; Dr. Karlin and Dr. Levin.some years who suddenly experience rectal bleeding. Ifthe colitis is not very active, the color X-ray will still giveinformation about the type of colitis, its extent, and itsseverity. If bleeding persists, the individual should alsohave a colonoscopic examination."The fiberoptic flexible colonoscope has rev­olutionized the field of colonic disease," Dr. Levin says."One can now look inside the entire length and breadthof the colon, including the cecum-the first part of thecolon-and even the last part of the small bowel where itjoins the colon, which is the terminal ileum. It is possibleto obtain tissue for microscopic analysis and brushings ofthe inside of the colon. These can be stained as with a'Pap' smear and examined for evidence of malignancyand other abnormalities. Carcinoma of the colon can de­velop during quiescent as well as active states of ulcera­tive colitis. In many cases, it does not produce symptomssufficiently early for curative treatment. Even whensymptoms begin to show-rectal bleeding, cramping-they are not easily distinguishable from symptoms of arecurring colitis. We have seen some patients whoseproctoscopic and barium X-ray studies were normal, butin whom a lesion was discovered at the time of colonos­copy. This could theh be removed and the patient cured.The proctoscopic examination, barium X-ray, and thecolonoscopic examination are complementary ratherthan exclusive investigative procedures. They should beused in conjunction with each other."Because of the increased risk of carcinoma of the colonin patients with chronic ulcerative colitis, some physi­cians have suggested that those with long-standing colitishave their colons removed prophylactically. Dr. Levinhopes that by studying high-risk patients, researchers canlearn more about the way the colon behaves and developmore revealing diagnostic approaches which would makethe proctocolectomy a less routine procedure than it cur-14 Dr. Harvey Colomb and Susan Schulman.rently is. At present, colonoscopy is the most effectivediagnostic tool, but unfortunately, it is not yet widelyavailable outside of large medical centers.At the University, a number of diagnostic studies areunderway. One project involves the comparison of colonlining cells in patients with ulcerative colitis or otherinflammatory bowel disease and those with cancer. Col­laborators in this work are: Dr. Charles Platz (63), As­sociate Professor in the Department of Pathology andAssociate Director of the Surgical Pathology Labora­tory; Dr. Harvey Golomb, Fellow in Hematology­Oncology; Dr. Russell Brynes, Fellow in Pathology; Dr.Robert Ridell, Visiting Assistant Professor of Pathologyfrom St. Mark's Hospital in London; and Dr. Levin.They look at surface cells through a scanning electronmicroscope and cut the cells with a diamond knife tostudy their structure."We're particularly interested in the way the normaland the malignant cells interact," Dr. Levin says. "Wewant to see what constitutes the junction. We also hopeto do chromosomal analysis. New work in banding ofchromosomes-such as that being done by Dr. JanetRowley (48), Associate Professor in the Department ofMedicine and in the Franklin McLean Institute-has notyet been widely applied to gastrointestinal cancer."In another project, Dr. Sumner Kraft (55), Professor inthe Department of Medicine, Section of Gastroenterol­ogy, is working on tests for measuring immunologicalresponses of people with this disease.Dr. Hyman Rochman, Associate Professor of Pathol­ogy, is studying CEA (carcinoembryonic antigen), a sub­stance which has been found in the blood of people withvarious kinds of cancer. Blood CEA levels are also ele­vated in benign conditions, such as alcoholic disease, andin the blood of individuals who smoke cigarettes."If a kind of CEA can be identified, which isspecifically related to carcinoma of the colon, or to car- .cinoma of the pancreas, it would be possible to developmuch better methods of detection," Dr. Levin says.Of special importance for these early detection studiesis the fact that the University's Section of Gastroen­terology has long had a prominent position in the careand study of patients with inflammatory bowel disease-including ulcerative colitis. Largely as a result of thedistinguished work in this area by Dr. Joseph B. Kirsner,former director of the Section of Gastroenterology andnow the Louis Block Distinguished Service Professor inthe Department of Medicine, Deputy Dean for MedicalAffairs and Chief of Staff, 100 to ISO new patients withthese diseases are seen each year. A computer file, whichis ten years old, has information which provides detailedfollow-up of nearly 2,000 patients. In addition to screen­ing new patients for the early detection project, coor­dinator Gloria Thorp is engaged in a continuing searchfor previous patients, who are encouraged to return tothe clinic for six-month or annual visits.More than ISO new patients with advanced digestivecancers have been seen in the gastrointestinal oncologyclinic since the clinic was established in July, 1973. Mostof them have had carcinoma of the colon. In recentweeks, however, many of the patients entering the clinichave had cancer of the pancreas, according to the clinic'sresearch coordinator, Susan Schulman.The principal research effort of the clinic is inchemotherapy. Dr. Levin and his colleagues-Dr. DavidKarlin (70) and Dr. Robert Kippen, Fellows in Gastroen­terology, Ms. Schulman, and Phillis Cullen, R.N.-areconducting two investigations."We are studying three drugs in combination," Dr.Levin says, "to see how the patients tolerate the drugsand whether there is any effectiveness in this particularcombination. The combination was originally used atM.D. Anderson Hospital, but we are using a slightlydifferent sequence. The drugs are cyclophosphamide anda nitrosourea compound (CCNU), plus another drug,S-fluorouracil, which has long been used as therapy forcarcinoma of the gastrointestinal tract without particu­larly good results. We are hoping that by combining itwith other agents, we might gain a greater response rate."We are also conducting a test of a drug from theU.S.S.R. which is new to the United States. The drug,called ftorafur, appears not to be highly toxic and canthus be combined with other more toxic drugs."These patients who come to us for chemotherapyhave usually had surgery or radiotherapy or both, andhave been told that there is no more hope. In a sense,they come asking if there is anything else to do. We saywe are willing to try. They are very grateful for this lastchance."We try to provide psycho-social support as well asmedical treatment for the advanced cancer patient," saysMs. Cullen, who specializes in the new field of oncologynursing. "We are working for patient rehabilitation withemphasis on the quality of the patient's life. We try toredefine the word 'hope' so that it doesn't only meanhope for survival but other kinds of hope as well-forcomfort, for the support of loved ones, for the right to continue to make decisions. Our social worker, Mrs.Willa Murdock, keeps in touch with patients and withtheir families to help them understand what the patientneeds from them."Frequently, we send a visiting nurse to aid them. Ifpatients can be made comfortable at home, we encouragethem to remain with their families. Hospital beds andwheel chairs and other equipment are available on loan,free of charge, from the American Cancer Society."When patients do need to be hospitalized, we try toprovide continuity from our clinic to the hospital. Forsuch patients, there is often no further need to inserttubes and take blood, procedures which can no longerhelp them but which cause them pain. Instead, we en­courage the hospital staff to offer the patient all availablemeans of comfort."Carcinoma of the colon is rapidly increasing in bothincidence and fatality while other cancers are decreas­ing. According to American Cancer Society statistics for1974, colon cancer is the second leading form of fatalmalignancy of both men and women."I think this is probably because the results of therapyhave not changed very much over the last 20 years," saysDr. Levin. "One still gets approximately the samefive-year survival rate. There has been no dramaticbreakthrough. But we are hoping that with improved un­derstanding of cell biology and the kinetics of the colonlining, we will be able to approach the therapy of patientswith drugs more rationally. And if we improve diagnosticprocedures and make them generally available, manycases of colon and pancreatic cancer could be arrestedbefore they become fatal."Medicine Along the AmazonDr. John W. RipponThe scene is Iquitos in the Amazonas section of Peru. Itis hot and humid, and one counts species, not individu­als, of the biting insects on one's arms. We are about toboard a boat euphemistically called the" AmazonQueen" to travel through some tributaries of the Ama­zon, eventually landing some 380 miles downstream atTabatinga (Brazil) and on to Manaus. The scene con­trasts sharply with the pleasant evening we experiencedthe night before, reveling in good wine and food at arestaurant in the cosmopolitan capital of Peru, Lima. It isonly two hours by air from Lima to Iquitos, on the edgeof that massive, dark-green sea called the Amazon rainforest. This trip is being made in the interest of observingthe types of diseases (particularly those caused by fungi)of the inhabitants along the river and to note the type andadequacy of medical facilities available to the indigenouspopulation. It is one of numerous trips I have made toSouth and Central America and expeditions down suchrivers as the Orinoco, Magdalena and Paragua.People living in the interior of the Amazon basin fallroughly into three categories. The wandering tribes or"unreconciled (uncivilized) natives" are Indians, usuallyin groups of thirty, who wander along the river and aresti II "hunter-gatherers" having no permanent settle­ments. Though they are considered the "lowestclass" in the caste system, they seem to me here, as theyhad in other river expeditions, to be healthier in generalthan some of their social "superiors." Perhaps the sicklyand sick are simply left behind. There are conflicting re­ports. Malnutrition also was not apparent among theseIndians, who appear to have limited their children tonumbers commensurate with the available food supply.The second group, the river people, are those whohave a permanent dwelling place along the river and are16 usually mesclados (mixed Indian and European). Theyraise com, squash, beans, and sometimes a little live­stock. Here children appear not to be limited and exceedwhat is supportable by the productivity of the land.Therefore malnutrition (marasmus and kwashiorkor) ispresent along with the debilitating diarrhea and ancylo­stomiasis. Sometimes these people come together insmall farm-oriented villages and thereby seem to exagger­ate their medical problems. Socially, however, they aresuperior to the wandering Indians, or so the missionariestell them.At the top of the caste system are the town people.These are also mesclados or Europeans of various stockwho live in settlements large enough to have a name on amap. They may be involved in manual labor such as log­ging or boat building. In the towns, the quality of life nowdepends on economic factors. Even in settlements of afew hundred the "workers" enjoy fair health and nutri­tion, but the larger proportion of the population is com­posed of shanty dwellers who work erratically and are nohealthier (and perhaps worse) than the farm villagers.There appears to be a transient quality to their lives.They work and live in one "town" for a while (months,years) then move somewhere else for no apparentreason. They do not appear to have a rooted communityfeeling, strong family ties, or a sense of past or future.They exist.The health facilities available to these three groups canbe summarized as erratic. The government has a"medico" who visits one of the settlements along theriver about once a month. This frequently would be whatwe call a nurse-practitioner or sometimes someone hav­ing no more than two weeks of training. The medicine, ofcourse, is primary level. If there is diarrhea, some pillsDr. Ripponare dispensed; if it's an infected wound, it is lanced andsome antibiotics are given. The choice of drug is notbased on the sensitivity of the offending microorganism,but on what is available in the box of free drugs (some­times outdated). Then there are always parasites; de­worming drugs are given that can at least somewhat clearthe patient of parasite load until the next batch of wormsis acquired. Occasionally some blood pressure pills aredispensed but in general "medicine" in these areasmeans something that will oppose an infectious agent. Itis only peoples in "developed" nations that live longenough to develop other diseases.As stated before, the so-called wandering hunter­gatherers (in the present case Yaraguas and H uitoto) ap­pear to be in fair health. Their children do not show thetelltale signs of marasmus, kwashiorkor, or hookworm.Very seldom are open sores observed and, if present, areusually treated by an herbalist. These wanderers seemquite able to survive life in the jungle but of course theyhave been there for thousands of years, the river peopleonly a hundred or so. Occasionally the natives visit avillage when the "medico" is present and obtain treat­ment for some major problem of one of their clan. Thisdoes not occur on a regular basis.The river people and farm villagers are an interestingcase study. They are subject to almost every tropicaldisease known. One can see not only cases of almost alldiseases listed in Hunter and Frye's Manual of TropicalMedicine but most of the clinical variants as well. Aboutten years ago travelling "medicos", physicians, or medi­cal missionaries began to bring the skills and facilities ofmodern medicine to bear on these endemic diseases, andthe morbidity and mortality among the population les­sened. One consequence of this is that instead of one outof six children living to puberty, now perhaps five out ofsix will. (Few families are limited to six births.) How­ever, the productivity of the land has not increased withthe increasing population, and physically and mentallyretarded children reach puberty, have "families" and re- peat the cycle. Family planning (practiced by the "un­civilized" Indians) would help greatly, but this is againstthe prevailing religious doctrine of the area.People living in towns, especially the larger towns,have more access to medical facilities than the river peo­ple. A "medico" visits regularly or in some places aclinic is available most of the tiine. Medicine still consistsgenerally of preparations against infectious agents. In thetowns, however, the clinics may charge a small fee forservice and drugs. This means the workers generally canafford the luxury of fair health, but the shanty-town in­habitants are as bad off as or worse than the river peoplebecause they cannot afford the medicine.The Peruvian government supplies the "medicos" butthe numbers can hardly begin to combat the problem. Afew "socially aware" medical students and recentgraduates volunteer to work in these areas. In one or twoareas a practicing physician has set up shop and donevery well financially. The clinics, such as the leper col­ony at San Pablo, are usually financed by outside con­tributions. The San Pablo clinic provides a place for lep­ers and their families to live, some small industry, and apsychologically healthy environment. Other clinics areless successful. This whole picture may change soon, asoil has been discovered in the area.Brazil, with greater resources, is involved in develop­ing the Amazon. A highway that more or less parallelsthe river is being cut through, and a vast program (INPA)of biological, agricultural and medical research is in pro­gress.On reflecting during the long tropic night (the evening'sentertainment is picking off the day's crop of leeches)one concludes that the jungle is a fascinating place to visitand study, but I wouldn't want to live there.Dr. John Rippon is Associate Professor in the Departmentof Medicine (Dermatology), Research Associate (AssociateProfessor) in the Departments of Microbiology and Biologyat The University of Chicago Pritzker School of Medicineand the Division of Biological Science and Director of theMycology Service Laboratory at The University of ChicagoHospitals and Clinics.17Medical Records at the Touch of a FingerKathleen MornerDr. Melvin Griem, Professor of Radiology and Directorof the Section of Radiation Therapy, was recording asample physical examination of a patient with Hodgkin'sdisease. The screen on the computer terminal in front ofhim flashed a question with multiple answers. He chosethe positive right neck node response, pressing his fingeragainst the screen at the point where that response ap­peared. The question and the responses vanished fromthe screen, giving way to a question which listed thenodes located on the right side of the neck. Dr. Griemindicated the appropriate node. As he touched the screenagain and again, a series of questions about the charac­teristics of the node appeared in logical succession. Eachselected answer determined the next question. At onepoint, Dr. Griem deliberately chose an answer that wasmedically inconsistent. Within ten seconds a reprimandappeared on the screen.Dr. Griem was displaying CORADS (ComputerizedOncology Radiation and Data System), an innovation inmedical record-keeping in therapeutic radiology whichwill result in improved patient care in the immediate fu­ture. In the long run it will greatly facilitate the kind ofcomprehensive research that, with previous methods, isan almost impossible labor.A number of other computer systems organize and pre­sent a wide variety of medical data. But, frequently, inorder to use these data, it is necessary to collect themmanually and then transcribe them into computerlanguage-a procedure which can cause clerical errorsand delay. CORADS eliminates that step by allowing the18 physician or technician to record his information merelyby touching a screen in response to English languagemultiple-choice questions, as Dr. Griem did in the dem­onstration. A cathode-ray tube carries his responses tothe computer. The choices presented to him are struc­tured according to a hierarchical tree format in which thequestion-and-answer sequence is, like the patient him­self, unique for each case.Because this technique is new to therapeutic radiology,Dr. Griem and his associates must create the question­and-answer tree structure. They have already developedmore than 1500 question frames. When they are finished,they expect to have nearly 30,000.Devising the questions is a laborious process. Thequeries must cover all possibilities and accurately reflectthe approach used in the clinical examination of oncologypatients. Care must be taken that the questions do notstimulate forced answers. At the same time, patient re­cords must contain answers to specific questions if theyare to be of any value for later study. Until now, clinicalradiation therapy information has been entered on apatient's record largely in narrative form, organizedunder the headings of "history," "examination," and"diagnosis." Dr. Griem points out that although his de­partment has approximately 25 years of radiation therapyrecords which contain treatment information which couldbe used for research, each research project that has beenundertaken has resulted in one to one-and-a-half years ofmanually collecting and coding information forkeypunching and analysis on a computer.During patient treatment, CORADS will function inseveral important ways that will concomitantly aid re­searchers:1. All dose calculation information for eachpatient will be stored, and routine field calcula­tions will be done automatically as the physicianenters his prescription. This will simplify thetechnician's job since the daily dose calcula­tions will be done by the computer. Changes inprescriptions can be handled easily.2. If elaborate calculations are required (asfor moving or multiple fields, irregular shapessuch as extended mantle fields, orbrachytherapy radiation fields), the medicalphysicist can extract needed data from thestored, active patient record. These data willthen be used together with the appropriate pro­gram for the calculation of dose distributions.Following approval of the treatment plan, es­sential data from the plan will be added to thepatient record. Since the computationcapabilities of the system are sufficiently large,most, if not all, dose calculations can be per­formed by CORADS.3. A third function is the use of the computerfor checking the machine setup: it will verify aswell as monitor the setting of the treatmentmachine against the stored field descriptionparameters. This will provide a safety featureduring actual treatment as well as field descrip­tion information for future use. An obvious ad­vantage is the elimination of routine arithmeticerrors in the daily treatment record.4. It will relieve the personnel of paperwork.Scheduling, billing, recording blood values,preparing standard reports and letters, record­ing follow-up information, and compiling de­partment statistics will be logical uses of'the as­sembled data. These functions can free thetreatment personnel for other tasks.Dr. Griem believes that one of the most importantconsiderations in planning for a computerized medicalrecord system is the psychological interaction of thephysician with the system. A busy physician concernedwith the immediate care of his patients will probably re­sist any extra work which does not aid him in a direct,visible fashion. Dr. Griem says, "We've found that thereare several things a physician cannot do-I) he cannottype; 2) he doesn't like forms; 3) his interest span is haifasecond; and 4) he would like some immediate pay-off. Ifyou can build a system that takes all of these things intoaccount, you'll get your data."Dr. Griem's insight into physician-computer psychol­ogy grows out of a series of visits he and his associatesmade to other medical centers to survey the state ofcomputerized medical record-keeping. They reportedconsiderable fear and diffidence on the part of computerprogram initiators and not always unwarranted hostilityin the ranks of the medical staff. The data systems toofrequently created new problems while they were solving the old ones. One system, which is in use at the Univer­sity of Vermont, and from which CORADS is beingadapted, seemed to the University doctors to bephysician-proof: with it there would be no forms to fillout, no need to use the computer keyboard (Dr. Griemwould like to keep the keyboard covered); the physiciancould record an answer to a question in less than half asecond; and he would get his pay-off-i.e., immediate,visible aid from the computer-in addition to long-termgains for research.If, for example, the telephone rings while the physicianis recording his data, and he answers a question illogi­cally or incompletely, the computer will object. It servesas a kind of intellectual conscience, requiring its user toorganize his thoughts. If the physician wishes to verify orchange any of his responses or to see how his currentresponses are integrated into the patient's general status,he can request a summary screen. Should he want theinformation in written form, he can request a print-out.If he has just seen a new patient with a diagnosis ofrhabdomyosarcoma of the head and neck, and would liketo see histories of previous diagnoses, treatments, com­plications, and survival of all patients with this diseasetreated in the past, he will be able to request all relevantrecords on each patient, presented one at a time. He canalso request screens of data showing simultaneous figureson prescriptions, complications, and survival rate of allpatients with a specified tumor and time period.When enough cases to provide statistically significantcomparisons have been entered, the data may be used tocalculate survival and recurrence rates. To be effectivefor any significant length of time, CORADS must be agrowing system, Dr. Griem says. As medical knowledgeadvances or the physician's interests change, new ques­tions will be added and others deleted. The coding usedfor earlier cases will be retained so that previous data willstill be available for statistical analysis. Ultimate dataretrieval will be done on the big computer in theUniversity's Institute for Computer Research. Datahandling concepts are being developed by Dr. Griem andhis associates in consultation with the Institute.Dr. Griem stresses the need to keep medical recordsconfidential, a problem in any system. He says a methodinvolving an elaborate series of passwords, developed inSweden, would be used as a model.He also hopes that cooperative arrangements can bemade with radiology departments in other institutions inthe Chicago area. A first step in that direction has beentaken in conjunction with Michael Reese Hospital. Acomputer identical to the one used in the CORADS sys­tem is being used there for a more theoretical researchproject in radiology. By means of a telephone hook-up,the University and Michael Reese will be able to sharethe benefits of both projects.If several institutions cooperate in this venture. andthe historical file contains data from patient treatmentsfrom each institution, it will be easy to compare cure andmorbidity rates and, they hope, to determine the cause ofany differences. Dr. Griem says uncovering these causescould be a vital step in advancing the overall cure rate.19Training General PractitionersDr. leon JacobsonTo paraphrase the Old Testament, "In the beginning,there were only general surgeons."In antiquity, some so-called physicians werephilosophers; some, barbers; some, faith healers; andsome knew the value of a few palliative drugs. In morerecent centuries, surgeons with technical skill were su­preme; but beyond this skill and a very limited number ofpalliative and/or curative drugs, symptomatic care re­mained the essence of the art. Even more recently, whenthe slow but inexorable revolution in the life sciencesbegan, 'the practice of medicine was made up of generalpractitioners who did minor surgery, set fractures, deliv­ered babies, and cared for all the other medical problemsin children and adults with skills slowly acquired on anapprenticeship basis and with the few drugs that wereavailable. They also counseled, using "horse sense"psychiatry. Some of these general practitioners had smallten-bed hospitals or medical centers whose facilities wereas modern as the times and whose staffs generally con­sisted of specialists in surgery, internal medicine, pediat­rics, radiology, and obstetrics and gynecology.With the revolution in the basic biological sciences andin technology during the past four or five decades, it be­came evident that the knowledge base was growing solarge and so furiously that some degree of specializationwas essential. Many medical educators would agree,however, that in our enthusiasm the great teaching medi­cal centers, the medical schools and their teaching hospi­tals, went too far. In varying degrees, super­specialization was glorified. Often our academic facultiesbelittled our colleagues in general practice in small ruralcommunities or within the urban setting; similarly, theytended to look askance at general training programs.The term" general practice" is used by the lay publicmore or less synonymously with "primary care" and,more recently, with what has been adopted by a segmentof the profession as "family practice." The social andpolitical demand for "general practitioners" the countryover does not necessarily relate to the current high cost20 of health care but rather to the uneven distribution andthus, the lack or unavailability of health care to segmentsof our population. To the more affluent, it means it isdifficult, or impossible, to get a physician to make ahouse call. In my home state of North Dakota, a sparselysettled rural area, most small towns of 300 to 1,000 nolonger have a physician. Three decades ago, they eachhad one or two general practitioners. They made housecalls by day or night to treat pneumonia, or heart failureor to deliver babies. But with mechanization on the farmsand the enormous industrial development in the bigcities, the migration from the rural to the urban settingaccelerated rapidly and transportation became morereadily available; those living on farms and ranches andin small villages could now get into cars and go to thenearest medical center, where excellent care was avail­able. The absence of physicians in the small rural townsis not alone the result of a lack of local business for thephysician. Many-or perhaps most-doctors prefer to bewhere modern facilities are available; where there arelibraries and educational, cultural, and social activities.Recently I visited the small town of Carson, NorthDakota, which has a population of 70. Several thousandfarmers and ranchers live in the surrounding territory.Carson is served by two physicians. Each makes a goodliving but both are overworked and do not have adequatevacations. They also have a very limited opportunity forcontinuing education. These two physicians are beggingfor one or more physicians to join them.The problems of the large industrial cities have pro­duced a much more serious dilemma. Large sections ofour cities have practically no medical manpower wherevirtually hundreds of physicians formerly practiced.Crime, the economic status of the depressed areas of ourcities, the lack of superior primary and secondary educa­tional facilities in the inner city, and "undesirable livingconditions" have fostered a migration of hospitals, aswell as professionals, to the suburbs. Urban areas havebeen left with a few large medical and teaching centersthat attempt to fill the gap. The emergency rooms ofthese facilities are therefore inundated with patients whohave no local general practitioner to turn to.These dilemmas of rural and urban health care deliverylargely result from social and economic forces. Develop­ing a national policy that will reverse these trends andestablish a system of health care commensurate with na­tional needs is beyond the medical schools' capabilities.There is no doubt, however, that medical schools anduniversities can help in the solution-they have some ofthe expertise if not the material resources.The problem of providing adequate health care to thepublic is not a simple one that can be reversed by traininghealth care professionals in medical schools and centers;nor is the dilemma one of providing continuing educationfor the health care professionals outside the medicalcenter walls.The solution to our health care dilemma obviously in­cludes a workable geographical distribution of facilitiesand personnel, with a proper balance between primarycare physicians, physician helpers, health team provid­ers, and the medical centers whose specialists would fur-nish largely tertiary care. No changes in medical schoolcurriculum or programs and no post-graduate trainingprogram, no matter how creative, will solve theseenormously difficult problems. Solutions require the es­tablishment of a national policy. Once a policy is estab­lished, we as educators can and will meet the challenge ofeducating the kinds of medical personnel necessary toprovide the medical care essential to society. On theother hand, none of us wish to participate in the degener­ation of current training for health personnel. Health careeducators must not contribute to the development ofsecond-rate medical education and second-rate health de­livery systems.In the absence of a national health policy in the UnitedStates, we must strive to develop educational processesthat will foster the development of primary health careprofessionals and up-grade the continuing education ofthe physicians already in practice.Most medical schools in the United States fortunatelyare different from one another. Each has its separate ob­jectives and mandates. This diversity is laudable and onehopes it will remain so.There are those in "academic medicine" who feel thatall medical schools should immediately begin to convertto largely "general practice" training programs. Othermedical schools, whose records of producing physician­scientists and teachers are well established, vigorouslydefend their belief that a diversity of medical school goalsand programs is essential to the progress of medicine as awhole. They stress basic science teaching and research.These scientists feel that while training of ultra­specialists must continue, some attempt to prepare pri­mary care professionals, without reducing quality of ser­vice, is a worthwhile priority. The questions are, ofcourse: how many physician-scientists, how many ultra­specialists, and how many primary care types are or willbe required? What should the mix be today and tomor­row? What should be acceptable in the preparation ofprimary care health personnel?Some educators, business leaders, and politicians saythe primary care physician should be trained in medicalschool and during the immediate post-M.D. period toassume responsibility for the ills of the entire family-minor surgery, obstetrics, well-baby surveillance, andthe general run of medical problems.Others strongly feel that this physician may be an in­ternist and/or pediatrician, with a modest training in ob­stetrics and a more strenuous experience in emergencymedicine.The eventual pattern will emerge, I am confident, asnational policy develops and as it becomes more evidentwhat the public will demand and support.Continuing education is vital for the practicing physi­cian, no matter what his or her role is in the presentnon-system. The personnel in teaching hospitals as­sociated with medical schools are not without need ofcontinuing education. But these staffs are in the businessof service and education. The teaching process involveseager students, house staff, and young faculty who makeit difficult to avoid piercing inquiry into fact. It is nolonger possible to hide behind anecdotal statements. On the other hand, the practicing physician who serveshis in-patients in a community hospital not affiliated witha university or medical center, is quite another problem.Now, as in the past, most of us who originate in a univer­sity setting are called upon to provide the continuingeducation. We have failed miserably because we havegenerally chosen to give lectures far too esoteric to at­tract the attention of the general practitioner. We spokeof those subjects-often our own research-that hadrather little relevance to the listening physician. Lectureseries on campus and courses given by the medical spe­cialty groups were by no means universally successful.A new trend in continuing education for the practicingphysician outside the medical school-medical centercomplex is now emerging. It is expensive in terms ofmedical faculty time but worthwhile. Stanford and TheUniversity of Chicago, among others, go to the homebase of the practitioner. We send medical school facultyto lecture, to conduct teaching rounds on in-patients, andto conduct clinics on ambulatory patients in certainspecialties on the home ground of the private prac­titioner. This is a reversal from the old approach in whichthe academician lectured on his own often too narrowsubject with little interest in the relevancy or appeal tothe practicing physicians. Today, dealing with the prac­titioners' problems on their home base has created awhole new approach. It challenges the academician andexcites the practitioner to study his own patients' prob­lems in greater depth. This, or some related or modifiedapproach, will without doubt up-grade medical care as itprovides the practitioner with an "on the job" educationprocess. It will also help to bridge the artificial gap thatexists between "town" and "gown." It tends to fosterthe referral of difficult and rare medical problems to thelocal large medical centers and the university hospitalswhere specialization and expensive facilities andequipment are deliberately available for just such tertiarycare. At the same time, it will tend to keep the less com­plicated problems such as appendectomies in the localcommunity hospitals where these problems are wellcared for at a lesser cost.This approach should not be considered the only wayto provide continuing education for the practicing physi­cian. Regular lecture series; once-a-month half-day con­centrations in specific areas of medicine; and week-longcourses on selected topics such as are conducted underthe auspices of many of the specialty societies, shouldcontinue. Attempts should also be made to find amechanism to bring the practitioner back to the medicalcenter or university hospital for periods of a week to amonth, during which a structured, intense exposure toteaching rounds, seminars, and selected technical ad­vances could be made available.Dr. Jacobson presented these remarks at the Josiah Macy,Jr. Foundation Symposium on Medical Education in Siena,Italy, in September, 1974. He is Dean of the Division of theBiological Sciences and the Pritzker School of Medicine,and the Joseph Regenstein Professor of Biological and Med­ical Sciences and the College.21The Growth of Gastroenterology Education In the United States"Medicine is not a trade to be learned," wrote FrancisPeabody in 1927, "but a profession to be entered. It is aneverwidening field that requires continued study and pro­longed experience in close contact with the sick .... Thepractice of medicine in its broadest sense includes thewhole relationship of the physician with his patient."This characterization of medicine applies especially togastroenterology. Understanding of digestive disordersrequires knowledge of the broad field of internalmedicine. Rapidly accumulating information on a widevariety of gastrointestinal problems is opening newscientific vistas. The digestive illnesses caused, precipi­tated or aggravated by emotional stress compel attentionto the patient as a total human being and to thepsychogenic concomitants of gastrointestinal disorders.In the BeginningAlthough gastroenterology in its elemental aspectsdates to antiquity, important advances appeared duringthe latter part of the 19th century, and then increasedduring the early years of the 20th century. The teachingof gastroenterology originated with investigators such asIvan Pavlov, William Cannon and A. J. Carlson. As inmedicine generally, instruction progressed from the ap­prentice system, to unstructured and later structuredcourses; from ritualism and empiricism to qualitative andthen quantitative measurements; from individuals tohospitals, hospital schools and then to universities. Gas­troenterology achieved status as a medical specialty inthe United States in 1897, with the establishment of theAmerican Gastroenterological Association. The Ab­raham Flexner report of 1910, emphasizing bothscientific and clinical instruction, dramatically advancedmedical education in this country. Introduction of thebasic sciences into medical education and the closer as­sociation of medical schools with universities during thefirst half of the 20th century sharpened the focus of medi­cal teaching. It also created a gastroenterologist trainedin science, yet involved in the care of patients in teachingand in clinical research. Gastroenterologic teaching em­phasized the acquisition of clinical skills, includingroentgen examination of the digestive tract, gastric andduodenal intubation, proctosigmoidoscopy and otherdiagnostic procedures. In a few centers, such as at TheUniversity of Chicago, and at the Mayo Clinic, com-22 Dr. Joseph B. Kirsnerprehensive medical and surgical programs were sup­plemented by clinical and laboratory research. Trainingin gastroenterology thus evolved into more formalizedacademic programs. Since financial support for facultyand for research was limited to University budgets, onlyoccasionally supplemented modestly from other sources,the number of teachers, the laboratory facilities and di­rect support for the gastroenterology trainee were lim­ited. Nevertheless, the broad orientation of gastroen­terologic training remained a prime consideration. Frank­lin White, past president of the American Gastroen­terological Association, on its 30th Anniversary wrote:"Our work can never be a narrow specialty; it is tooclosely related to many important fields of medicine. Thebest, broadest and safest man is one who himself is agood internist and also to some degree a physiologist,chemist, a pathologist and a radiologist." Today, onemight add, a surgeon, hepatologist, psychiatrist,biophysicist, enzymologist, electron microscopist,geneticist, nutritionist and pharmacologist!The progress of gastroenterology during the 1950' s wasrelated in part to the advance of general scientific know­ledge and to the increasing availability of governmentalfunds for the support of medical research and training.The National Institutes of Health, a component of theDepartment of Health, Education and Welfare, was or­ganized in 1930. It first provided support for medical re­search in 1937 through the National Cancer Institute.Public Law 692, the Omnibus Act of 1950, establishedseveral additional institutes. These included the NationalInstitute of Arthritis and Metabolic Diseases, which laterbecame the instrument for evaluating and funding re­search grants, fellowships and training applications ingastroenterology, among other disciplines. In 1972, itwas redesignated the National Institute for Arthritis,Metabolic and Digestive Diseases. The organization ofthe General Medicine study section within the NIAMDin 1956 provided, for the first time in the NIH system,consultants with recognized clinical and research exper­tise in gastroenterology.The Gastroenterology Training Committee, also estab­lished in 1956, encouraged the development of educa­tional programs "to meet the need for competent inves­tigators and teachers in gastroenterology." This objec­tive was soon modified to the preparation of physiciansfor fulltime academic careers. Thus began a steady in­crease in NIH financial support for research and trainingin gastroenterology in the United States, utilizing a sys­tem of double peer-review that ensured objective reviewof each application. The numbers of faculty, the labora­tory facilities and the educational opportunities in­creased. Gastroenterology gradually became recognizedas worthy of faculty staffing and other support. TheNIH-supported programs varied in content and in dura­tion. Clinical activities, however, were dominated byresearch-oriented programs, and direct support for train­ing in clinical gastroenterology lagged. Nevertheless, in1969 more than two million dollars were expended for thesupport of 44 NIH-funded training programs in theUnited States. The 1973 August issue of Gastroenterol­ogy included more than 200 training programs within theUnited States, Canada and Puerto Rico. Among thesewere 18 Veterans Administration-oriented programs. In1973, 32 NIH-supported programs were listed, asignificant decline from the 45 programs recorded in1970.The success of this training effort is reflected in a re­cent analysis of more than 650 gastroenterology trainees.More than 75 percent indicated a part- or full-timeacademic affiliation, as clinical teachers with or withoutresearch interests, or as investigators with clinical andteaching interests. Nevertheless, from the standpoint ofdeveloping productive investigators, the scope of the re­search training in these programs has remained a concernperhaps expressed best in the statement: "Basic researchhas become a specialty in itself, requiring long and ex­pensive training. The development of gastroenterologistsskilled in clinical medicine, teaching, and also in basicresearch now is increasingly difficult, if not impossible."The status of clinical training in gastroenterology, alwaysa concern, grew more uncertain. In part this happenedbecause of the governmental (NIH) emphasis upon re­search support. Though NIH recognized th� importanceof informed clinicians in patient care and in teaching,unfortunately, no practical mechanism was developedthen, or indeed exists today, for the organized support ofclinical training in gastroenterology in the United Statesby Governmental agencies. Repeated discussions of gas­troenterologic training objectives and content have em­phasized the need for a spectrum of professional talentsincluding: the basic scientists, the clinical scientist, theclinical scholar, and the practicing gastroenterologist.These idealistic objectives reaffirm the traditional com­prehensiveness of gastroenterology and the usefulness ofvaried gastroenterologic educational experiences.Despite the significant role of the NIH in gastroen­terologic training, governmental control of research andeducation, directly or indirectly, did not materialize dur­ing the 1950s and 1960s. The independence of medicalschools and the freedom of investigators were not re­stricted, although it might be argued that the limited sup­port of clinical programs represented a de facto influenceupon the direction of gastroenterologic education. Thegeneral atmosphere, however, was one of mutual under­standing and cooperation in assisting medical schools tostrengthen poorly supported or insufficiently recognized medical areas such as that of gastroenterology.Emerging in the 1940s and 1950s at a time of greatneed, the NIH was indispensable to the growth of gas­troenterology in the United States. However, as thenumber of faculty and the scope of research increased inall areas of the health sciences, medical school budgetscould absorb only a portion of the costs. The "soft"federal monies of the 1940s and 1950s became the" hard"monies of the 1960s and 1970s. Another developmentwas the dominance of medical school policies which re­lated faculty appointments and promotions to major, ifnot exclusive, emphasis upon research productivity. Theacademic status of the clinician and the teacher, at leastin some schools, declined. As a direct consequence, in­terest in patient care diminished among faculty, house­staff and medical students. Today, the importance of ex­cellence in patient care and in clinical teaching once moreis being recognized. But the current financial difficultiesof universities and medical schools limit the implementa­tion of programs seeking to meet these needs.Thus, in the mid-twentieth century, gastroenterologyhad achieved recognition as an important medical disci­pline, worthy of full-time faculty and of more adequatelaboratory and clinical facilities. However, in relation toits actual and growing needs, gastroenterology in theUnited States remains a relatively "deprived" specialty.Digestive disorders, at one time or another, affect morethan one-half of the country's population and account forone-sixth of all illnesses, one-third of all operations, one­third of all cancer deaths, and eight percent of all deaths.Digestive illness is the leading single cause for hospitali­zation and for sickness-related inability to work. Theeconomic loss from digestive illness now is estimated inexcess of $8 billion annually . Yet, gastroenterology is theprimary interest of only approximately 2,500 physiciansand a much smaller number of investigators. Govern­mental support of gastroenterologic research and educa­tion is but a tiny fraction of the nation's total health ex­penditure.Problems Influence TrainingThe serious problems confronting American medicineinfluence directly and indirectly the content and the qual­ity of all training programs, including those in gastroen­terology. Briefly listed, these problems include:a) The enormously increased burden upon an alreadyinadequate health delivery system, intensified by the in­creased health care expectations of the American people.b) The demands upon our health services in relation tothe care of the poor, the aged and the mentally ill.c) The problems in health care caused by the use andthe abuse of tobacco, alcohol, and drugs, by poor eatinghabits, by a surprising degree of malnutrition and by thepollution of our environment.d) The need for "better" distribution, if not largernumbers, of physicians to deal with the problem ofdifficult access to health care.e) The increasing complexity of to day's diagnostic andtherapeutic procedures, which accelerates the costs ofmedical care to levels beyond individual resources.f) The mounting financial plight of American medical23schools, with no solution in view at the present time.g) And the decline in service and motivation amonghospital personnel, the blunting of humanitarian attitudesin the care of the sick, and the inefficiency of some hospi­tals and medical centers which reflects similar problemsin American society generally.Medicine, in fact, is being modified by the significantsocial upheavals taking place globally, by the ever ac­celerating rate of change in human affairs, and by theprofound alterations in our patterns of living. Today'scounterparts of the Flexner report of 1910 are the Car­negie Foundation report of 1970 and the two John Millisreports. Their influence upon medical education andtraining in the United States cannot be fully assessed atpresent, but their impact already is being experienced bymedical schools and by hospitals throughout the country.The entire system of medical care has come under publicand governmental scrutiny. This inquiry is directed alsoat the "worthiness" of biomedical research, the supplyof health manpower, and the quality, organization, deliv­ery and financing of health services. Significantinfluences in this governmental involvement include theunfavorable comparison of morbidity and mortalitystatistics in the United States with those of other coun­tries; identification of the poor, the black and the aged asspecial groups receiving inadequate medical care; and therapidly increasing costs of medical care. These activitiesin turn have generated "peer review" procedures, pro­fessional standard review organizations, justification ofthe indications for hospitalization of patients, evaluationof outcomes of care for defined disorders, the problem­oriented medical record, and computer-based evaluationprograms. The implications of these approaches for clini­cal practices and for medical education are yet to berealized fully but they promise to change dramatically thepattern of health care in this country.The tendency today to utilize medical institutions as aninstrument for the correction of long-standing social andeconomic problems in the United States is disturbing andyet understandable. This effort probably will provemore destructive than constructive, unless the Americanpublic develops a realistic awareness of the magnitude ofits health problems and of the supporting fiscal needs; thegovernment recognizes the necessity for more substantialfinancial support of medical schools; health agencies de­velop the resources of manpower, facilities and healthprograms; and sufficient administrative expertise is madeavailable. The public should be aware that the completediversion of academically-based physicians and scientistsfrom their primary responsibilities for the. education ofphysicians and the development of new knowledge, mayprove self-defeating by depriving the country of medicaladvances.Medical EducationIn an effort to accelerate the production of physicians,suggestions have been made to shorten the medical cur­riculum by elimination of the fourth year of medicalschool; abolition of the year of internship; early ("prema­ture' ') sequestration of medical students into discretecareer-development categories; and earlier subspeciali-24 zation, perhaps after one year of residency training. Suchefforts to meet the need for more doctors are not new.Nor, in fact, do they guarantee quality medicine andquality medical care. "Cafeteria curricula" and frag­mented specialty education may, indeed, produce tech­nologically skilled "super-specialists," but such physi­cians probably will not be qualified for other than verynarrow segments of medicine or surgery. Such educa­tional trends could have serious consequences for thegastroenterologist who requires a broad knowledge baseand comprehensive clinical exposure. The curtailed clin­ical experience also will accentuate the current trend to­ward de-personalization of health services, a problem al­ready of considerable importance. The ultimate conse­quences of accelerated medical educational programsDr. Kirsner has trained many Fellows, as one of whom is shown here:Odile Voinchetupon the patterns and scope of continuing medical educa­tional programs and the issues of re-licensure andre-certification are too complex for consideration here.There already is some indication of a more "conserva­tive" attitude toward extensive curricular revision.Modifications of the medical curriculum are necessary todiscard obsolescent information and to update the qualityof the educational process. However, the ultimate valueof repetitive modifications in curricular content aloneseems doubtful. Medical education is a demanding,time-related process.· It cannot be abbreviated; it must belife-long in duration. The educational environment;humanistically-oriented teachers; and motivatedpeople-oriented students with the capacity for accurateobservation, orderly thinking and responsible action, aremore important determinants of what is learned and laterapplied than are extensive revisions of curriculum.At CrossroadsThus training and education in gastroenterology in theUnited States is at a crossroad in its history. To developits potential, and to meet present and future require­ments, gastroenterology needs more clinicians, more in­vestigators, more laboratories, and more educational op­portunities. Too many training programs in the past havenot provided opportunity for adequate attention to thepatient. Too many medical centers continue to em­phasize fragmented, episodic, occasionally dramatic buttransitory exposure to clinical problems. Too many med­ical schools continue to ignore ambulatory medical care.There is need, therefore, not only in gastroenterology butalso in medicine generally, for increased attention to thepatient as a human being. We should endeavor to achievean appropriate balance between the sciences and the artof medicine, utilizing not only the laboratory but also thepatient, not only biochemical techniques but also clinicalobservations. Skilled compassionate care of the sick isnot incompatible with scientific medicine. It dependsupon it, and scientific medicine derives its justificationfrom the needs of the patient. The potential contributionsof the critical clinician to gastroenterologic knowledgehardly have been exploited. More information is neededon the course of digestive diseases, the efficacy of vari­ous therapeutic regimens and the role of environmental,sociocultural and psychogenic influences upon digestiveillness, to mention a few areas.Clinical training is an essential component in the de­velopment of all types of gastroenterologists. For theclinician, training in internal medicine and gastroenterol­ogy is indispensable in the management of patients withdigestive disorders. For the investigator, a significantclinical experience helps identify important researchproblems and often provides clues to their solution. Clin­ical training in gastroenterology probably is best obtainedat a university medical center or a closely affiliated hospi­tal. The advantages theoretically include: a sufficientlylarge full-time faculty with varied research interests andwith specialized knowledge (such as intestinal absorp­tion, liver disease, inflammatory bowel disease); an intel­lectual environment of constant inquiry; constant scrutiny of established procedures; opportunity for theexchange of ideas with other trainees, housestaff andstudents in teaching rounds, clinical research and litera­ture review conferences; interaction with departments ofinternal medicine, surgery, pediatrics, pathology, radiol­ogy, psychiatry and the basic sciences; a varied clinicalmaterial through referrals; and comprehensive diagnosticfacilities for in-depth evaluation of clinical problems.Scholarly clinical activity and active participation in re­search contribute to the intellectual development of thetrainee and promote life-long habits of study and a criticalattitude towards gastroenterologic information in the lit­erature.The disadvantages of a university-based clinical pro­gram allegedly include: conflict between the researchmission of the university and comprehensive patientcare; faculty involvement in research and administration,limiting clinical participation; imbalance in the clinicalmaterial favoring "unusual cases" and exclusion ofcommon digestive disorders; the absence of a formal gas­troenterology hospital service, necessitating uncertaindependence upon consultations and consequent lack ofresponsibility in the decisions governing patient care; thetendency to crisis medicine rather than the continuouspatient care necessary in gastroenterology; an absent orinadequate outpatient follow-up program; and the deper­sonalized medical care often ascribed to university cen­ters, a serious handicap in the management of digestiveillness, including the common and poorly approachedphysiologic ("functional") disorders. In actual fact,however, university centers are not uniformly so disad­vantaged. These debits are more likely to be present ifthe university service lacks an adequate number of com­mitted clinicians, and only if the research interests aredivorced from commitments to patient care and there isno academic recognition of clinical excellence.The disadvantages of the university center theoreti­cally are assumed to be the advantages of "communityhospitals" and other institutions completely committedto patient care. This assumption, too, should not betaken as fact. Patient care in hospitals presumably de­voted to clinical medicine is not always informed or con­sistently dedicated. These hospitals lack the research andthe educational advantages of the university center, andthe personnel and the technological resources requiredfor scholarly clinical activity.Since, with few exceptions, the comprehensive re­quirements of the "idea}" training program are not metexclusively in one institution, clinical training can besupplemented through organized programs at selected,well-staffed "community" and VA hospitals, providedhigh standards are maintained through responsiblesupervision and the clinical material is ample and varied.The flavor of individual clinical training programs de­pends upon the individual medical center and upon theinterests of the faculty. Liver disease may predominate inone hospital, inflammatory bowel disease in another andsmall bowel disorders in a third. Flexibility and balanceare desirable in all training experiences. Programs shouldbe at least two years in duration. Third and fourth yearsare advantageous in the development of clinical leaders.25At the University ...The University of Chicago training program illustratesone approach at a university center. The Gastroenterol­ogy Section is a definitive unit within the Department ofMedicine, with total responsibility for two hospital ser­vices which have approximately 32 beds. Active gas­troenterology consultation services in liver disease andgeneral gastroenterology provide additional clinical ma­terial. The gastroenterology outpatient facility is de­signed for many diagnostic procedures, includingesophagoscopy, esophageal manometries and bougien­age, gastroscopy (and duodenoscopy), proctosigmoidos­copy and fiberoptic colonoscopy, gastric secretoryanalysis, duodenal drainage, exfoliative cytology, intes­tinal and rectal biopsies and gastrointestinal fluoroscopy.Trainees rotate through many of these procedures, par­ticipating actively, initially under the guidance of an ex­perienced faculty member and later independently. Theoutpatient clinic functions six days each week, attractingsubstantial numbers of referred patients from Midwestand nationwide areas, as well as from the clinical de­partments of the medical school and includes sessionsdirected to liver disorders and inflammatory bowel dis­ease. An expanding gastrointestinal oncology clinic dealswith the problems involving gastrointestinal cancer. Theemphasis is upon the resolution of clinical problemsthrough long-term observation and care. Trainees as­sume increasing and then independent responsibility.The Gastroenterology Section participates actively in allof the teaching programs of the medical school. The clin­ical, research, radiology and hepatology conferencesregularly involve faculty from the Departments ofMedicine, Pathology, Surgery, Radiology, Pediatricsand Psychiatry, among others. These are supplementedby the many conferences, which involve local and visit­ing professional talent.The Role of Research HereAll training programs in gastroenterology benefit fromthe inclusion of research experience. Research developsa critical attitude toward new information and helps es­tablish life-Long habits from study and inquiry. The scopeand depth of the research will vary with the individualprogram and, to a significant degree, will depend uponthe commitment of the program director to investigation.Interest may be in a "basic" problem or in a clinicalsubject. Current research activities at the University in­clude: the biochemical and metabolic properties of intes­tinal and colonic epithelial cells, esophageal motor activ­ity, genetic and immunologic aspects of inflammatorybowel disease, host immunologic defenses, intestinal ab­sorption, folic acid metabolism, the process of oral im­munization via the digestive tract, the secretory IgA sys­tem, bile salt metabolism, the effects of alcohol upon theliver, the toxic effects of vitamin A upon the liver, andporphyrin and protein synthesis. Clinical research proj­ects include various aspects of inflammatory bowel dis­ease, hyperalimentation, controlled studies of im­munosuppressive medication, hepatic disease and ex­foliative cytology. There is sufficient variety in gastroen­terology for the interests of virtually all trainees. Re-26 search experience begins with the initiation of the train­ing period, under the direct supervision of a member ofthe Gastroenterology faculty. During the first year, it isconcurrent with the clinical program; it occupies 50 to 75percent of the time during the second year and up to 90percent during the third year of training, depending uponthe individual trainee's capacities and objectives. Fortrainees interested in research careers, more intensiveresearch-training programs are available in cooperationwith basic science departments in the Division of Biolog­ical Sciences. Similarly, for trainees interested inclinically-oriented careers, more intensive clinical train­ing can be arranged. Trainees also participate in the man­agement of one of the two gastroenterology hospital ser­vices for periods of two to four months as they gain ex­perience in the care of challenging clinical problems andsupervision of housestaff and medical students.The logistics of training in gastroenterology today ex­ceed the resources of even the most comprehensive pro­gram. Possibly lacking in the Chicago program are for­malized teaching programs in gastrointestinalpathophysiology and histopathology, and in diagnosticareas such as peritoneoscopy and radiology. But noteverything can be taught to all trainees within a reasona­ble time period. Even if such an exhaustive trainingsomehow were feasible, it would be impossible physi­cally and intellectually for anyone physician to maintainskills in each diagnostic procedure. Delegation of diag­nostic responsibility, as in radiology and pathology, is theonly practical approach to the impressive array of diag­nostic (and therapeutic) procedures now available.The "ideal" training program in gastroenterology thusincludes an able and dedicated faculty with varied clinicaland research interests, strong administrative support,ample clinical material, direct responsibility for the con­tinuing care of patients, comprehensive diagnosticfacilities, motivated trainees, enough time, and completecommitment to first-class patient care. Training involvesall three components: patient care, teaching and re­search. Medical research is stultified without clinicalorientation; clinical care is incomplete in an environmentlacking the spirit of inquiry; and stimulating teaching isimpossible in the absence of either. Multiple training ap­proaches are available, as illustrated by the YaleStatewide Gastroenterology program. Whatever the de­sign, the ultimate objective must remain the advance­ment of scientific knowledge and of clinical skills towardsexcellence in the care of the sick. For the essence ofgastroenterology is service to sick people-a functiondependent upon the continuing flow of new information,continuing medical education and continuing attention tothe human needs of the patient.Dr. Joseph B. Kirsner is the Louis Block Distinguished Ser­vice Professor of Medicine, Chief of Staff-and Deputy Deanfor Medical Affairs, the University of Chicago. Dr. Kirsneroriginally presented this paper in Scandinavian Journal ofGastroenterology in 1971. It was brought up to date for thispublication.MuralBrightensSceneChristina MadejcThe long Chicago winter has been brightened a bit by sixUniversity students enrolled in Fine Arts 201, "BasicDesign and Composition." This group, with the help offriends, professors, and interested passersby, is respon­sible for the mural painted on the fence bordering theSurgery-Brain Research Pavilion construction site at58th and Ellis.. In October, the class, under the direction of HaroldHaydon, Professor in the Department of Art and Direc­tor of Midway Studios, was commissioned by the Uni­versity to create the mural. After receiving Universityapproval for their design, the students raced inclementweather to prime the wall with paint and sketch in theirpreliminary figures.The brain is largely in control of the senses, and, ap­propriately enough, the mural begins with a representa­tion of one of life's more sensual experiences-music.This section, designed by Michael Moore, depicts color­ful, attenuated figures of jazz musicians in the midst of aperformance (A). From this group flows a progression ofmusical notes, seemingly absorbed by a bright greencaterpillar "bus" (B). In this vehicle, Robert New­combe, another contributor to the painting, has utilized ahumorous variation on the "Streetcar Named Desire"theme.From this point, the mural unfolds into a series of bril­liantly colored symbols of biological phenomena, de­signed by Karen Moline and Lori Siegal. Inspired by acourse they had taken on the physiological basis of pe r­ception, the artists include simplified representations ofbrain cells, neuron networks, and the lens of the eye intheir repertoire of imagery (C). The musical note motifwhich occurs early in the work is reechoed in Ms. Siegal's illustration of brain wave formations-unifyingthe otherwise disparate sections of the painting (D).The biological theme is carried over to the 58th Streetwall, where large symbols of the brain flank the truckentrance at the southwest comer of 58th and Ellis. Forthis portion of the mural, Ms. Moline depicts a series ofimages which begins with various cells, evolves into redtree-like forms, and concludes with an abstract pattern oflarge leaves. Perhaps one of the most original features ofthe work is the group of chromatids created by BarbaraHarms near the western end of the 58th Street wall.These genetic elements, painted in blue and green, arecaught in a lively "dance of life" reminiscent of the danc­ing figures of Matisse (E). Also for the western end of thewall, Larry Siegal designed a large red tree with poly­chrome foliage and an abstract root system.Although it is not yet completed, the University'sentry into the Chicago mural movement has elicited quitea viewer reaction. Students and faculty in the biologicalsciences and medical school have been receptive to themural because of its dominant subject matter.Working on the mural has been a great learning experi­ence for the students involved. "We must now wait tosee if it is 'graffiti-proof ," comments Haydon. Whetheror not this ephemeral painting is a major artisticachievement remains to be seen. What is undeniable,however, is that the Surgery-Brain Research mural ac­complishes one of its original purposes-that is, it bright­ens the surroundings. Perhaps this fact is best illustratedby Cosmo Campoli, prominent Chicago Artist. "I likeit," he says, "because it makes me happy. Now, at least,we have something fun to look at."27News BriefsThe "Wild Bunch" won the All University Football Championship for the second consecutive year.Tony Meyer (5th year M.D./Ph.D.) was coach and captain. Team members pictured before theirDecember victory (from left): Dave Kapelanski (2nd yr.). Matt Malerich (orthopedics resident), DanCooperman (74lsurgery resident), Dave Murray, Mark Wheeler (75), John Car/son (75), Tony Meyer,and Harold Lloyd. Not pictured: Jim Stankiewicz (74lsurgery resident), Earl Henry (74lmedicineresident), Jeff Hill (3rd year MSTP), and Bob Hunter (65, Ph.D. 691Assistant Professor of Pathology).The team's statistics: average height: 6 '2 W'; average weight: 210. Excuses for missing games in­cluded "in surgery, seeing patients, taking internship interviews."Michael Reese-PritzkerThe following full-time members ofMichael Reese Hospital and MedicalCenter have been named to the staff ofThe Pritzker School of Medicine:Department of MedicineAppointments:Dr. Alberto Goldbarg to AssociateProfessor for two years, effectiveNovember 1, 1974. Dr. Goldbarg servedas Instructor and Trainee, 67-68, andAssistant Professor, 69-73, in theUniversity's Department of Medicine(Cardiology).Promotions:Dr. Emanuel Arbel to Assistant Pro­fessor from Instructor, for two years,effective December 1, 1974.Dr. Imitiaz Hamid to Clinical Instruc­tor, for two years, effective November1, 1974.Dr. Charles Shapiro (54) to ClinicalProfessor from Clinical Associate Pr0-fessor, for two years, effective De­cember 1, 1974.Dr. Julian Zinder to Clinical AssistantProfessor from Clinical Instructor, fortwo years, effective December 1, 1974.Reappointments:Dr. Arthur Billings, Clinical As­sociate Professor, for two years, effec­tive December 1, 1974.Dr. Sheldon Cogan, Clinical As­sociate Professor, for two years, effec­tive, December 1, 1974.Dr. Samuel DeNosaquo, ,Clinical In-28 structor, for two years, effective De­cember 1,1974.Dr. Richard Langendorf, Clinical Pro­fessor, for two years, effective De­cember I, 1974.Dr. Noah Levin (37), Clinical As­sociate Professor, for two years, effec­tive December 1, 1974.Dr. Irving Mack (42), Clinical Profes­sor, for two years, effective December1, 1974.Dr. Jerome Mehlman, Clinical Pro­fessor, for two years, effective De­cember I, 1974.Dr. Oscar Moore, Clinical Instructor,for two years, effective December I,1974.Dr. Edward Newman, Clinical As­sociate Professor, for two years, effec­tive December 1, 1974.Dr. August Paredes, Clinical Instruc­tor, for two years, effective December 1,1974.Dr. LeRoy Pesch, Professor, for twoyears, effective December 1, 1974.Dr. Stewart Rosenfeld, Clinical Assis­tant Professor, for two years, effectiveDecember 1, 1974.Dr. James Sheinin (62), Clinical Assis­tant Professor, for two years, effectiveDecember 1, 1974.Dr. Irving Sherman, Clinical Profes­sor, for two years, effective DecemberI, 1974.Dr. Earl Silber, Clinical Professor, fortwo years, effective December 1, 1974.Dr. Gerald Sobel, Clinical Assistant Professor, for two years, effective De­cember 1, 1974.Dr. Mitchell Spellberg, Clinical Pro­fessor, for two years, effective De­cember 1, 1974.Dr. Arnold Tatar, Clinical AssociateProfessor, for two years, effective De­cember 1, 1974.Dr. Irving Zitman, Clinical Professor,for two years, effective December 1,1974.Department of Obstetrics and Gynecol­ogyAppointments:Dr. Nader Bozorgi to Clinical Assis­tant Professor for two years, effectiveSeptember 1, 1974.Dr. Norman R. Cooperman (38) toClinical Professor for two years, effec­tive September 1, 1974.Dr. Sidney Lash (39) to Clinical As­sociate Professor for two years, effectiveSeptember 1, 1974.Dr. Alex Tulsky to Clinical AssociateProfessor for two years, effective Sep­tember 1, 1974.Department of PathologyAppointments:Dr. Kenneth C. Robbins to Professorfor two years, effective January 1, 1975.Dr. Robbins also holds the rank of Pro­fessor in the Department of Medicine.Department of PediatricsAppointments:Dr. Robert R. Chilcote to AssistantProfessor for two years, effectiveJanuary 1, 1975.Department of PsychiatryAppointments:Dr. Alice Davison to Clinical Assis­tant Professor for two years, effectiveJuly 1, 1974.Department of RadiologyAppointments:Dr. John E. Arnold to Assistant Pro­fessor for two years, effective Sep­tember 1, 1974.Record Year for Alumni FundThe 1974 Medical Alumni Fund hadanother record year. New highs were re­ported in unrestricted gifts and studentaid contributions. Alumni also re­sponded to the request to raise the levelof their gifts and we can report moreDean's Fund members, Sponsors, andCentury Club members than in any pre­vious year. These donors have receivedthe University's 1975 pocket calendarand will be the Dean's guests at the June12 Alumni Day Breakfast.A total of $200,736 was contributed tothe 1974 Fund. Of this, $87,991 went togeneral support of the medical school,$69,594 went to student aid, and $43,151went for purposes designated by thedonors. December gifts through theAmerican Medical Association­Education and Research Fund were notreceived in time to include in this pre­liminary report for Medicine on theMidway.Gifts were received from 1,074alumni, 63 non-alumni faculty, and 259former staff and friends, compared to1973 which reported gifts from 1,251alumni, 62 non-alumni faculty, and 172former staff and friends and totaled$236,308, including a special gift of$84,037 from Dr. J. P. Greenhill.We thank all our donors and especiallyour volunteers who helped atphonathons across the country andwrote personal letters to achieve the1974 total. A detailed report will bemailed to each alumnus in the spring.Dr. Best (leit), Dr. Joseph SkomDiabetes-Endocrinology CenterDr. Charles H. Best, who with SirFrederick G. Banting in 1921 discoveredinsulin, was the principal speaker at theNovember 16 dedication of theUniversity'S Diabetes-EndocrinologyCenter.The University received a first-yeargrant of $266,819 for the Center from theU.S. National Institute of Arthritis,Metabolism, and Digestive Diseases. Afive-year total of $1.3 million is foreseen.Michael Reese Hospital and MedicalCenter will also participate in theCenter's program.Speakers at the dedication includedDr. Donald F. Steiner (56), Director ofthe Center and the A. N. Pritzker Pro­fessor and Chairman of the Departmentof Biochemistry, and Professor inMedicine and in the College; Dr. ArthurH. Rubenstein, Program Coordinator for the Center and Professor InMedicine; and Edward H. Levi.Additional remarks were made byKaetha K. Krueger, National Instituteof Arthritis, Metabolism, and DigestiveDiseases; Dr. Louis M. Sherwood, Pro­fessor and Chairman of the Departmentof Medicine, Michael Reese Hospital;Dr. Joseph H. Skom (52), Chicagoaffiliate of American Diabetes Associa­tion; and Marilyn Furer, Juvenile Dia­betes Foundation.Hans Hecht laboratoriesThe latest radiographic, hemodynamicand radioisotope imaging equipment isemployed in the diagnosis of heart dis­ease in a new $1 million facility at theUniversity of Chicago. The Hans HechtHemodynamics Laboratories, dedicatedNovember 13, have been designed tobring together several highly sophisti­cated and locally unique techniques in anintegrative approach to hemodynamicassessment of cardiac disease in theadult. The first patient was examined inthe Hecht Laboratory January 23.Facilities include:-An adult cardiac catheterizationlaboratory, to be used primarily for thestudy of all types of adult heart disease,including valvular, congenital and coro­nary disease. In addition to the latestcoronary arteriographic techniques forvisualizing blockage in the coronary ar­teries, it will employ a newly-developedprocedure-the injection of a radio­isotopic Xenon 133 directly into thecoronary arteries, via the femoral arteryin the groin. The patient's heart will beelectronically stressed, as in an anginaattack, via a pacing catheter inserted inthe right atrium area of the heart.Localized effects of the stress on theblood supply to the entire heart musclewill be recorded by a radioisotope scan­ning technique. Simultaneous cinean­giograms in more than one view will beavailable. The motion picture imagingwill be preserved on videotape to pro­vide a permanent record of the action ofthe heart, and the accompanying datawill be analyzed by a computer. Otherestablished techniques of measuringblood pressure and flow in the heart willalso be used. The laboratory will alsoevaluate certain cardiac arrhythmias byhigh-speed electrocardiograms recordedfrom intracardiac electrodes during elec­tronic stimulation of the heart.-An adjoining non-invasive labor­atory will employ phonocardiography, orelectronic recording, and analysis ofheart sounds, and a new technique,echocardiography, which is the analysisof ultrasound echo patterns set up by the heart. The recently developed echocar­diography technique enables car­diologists to diagnose certain heart prob­lems non-invasively that would ordinar­ily require cardiac catheterization. It canbe used to help diagnose not only thepresence of heart disease but also tomeasure the effects the disease has hadon the various chambers of the heart.Studies can be made of mitral stenosis, anarrowing of the mitral valve of theheart; congenital defects in the atrial andventricular septa, the walls separatingthe atrial and ventricular chambers of theheart; abnormal thickening of the ven­tricular septum; diffusion into thepericardial space surrounding the heart;and failure and abnormal enlargement ofthe left ventricular chambers.-An experimental animal laboratoryfunded by grants from the NationalHeart and Lung Institute, Sinton Chari­table Associates and The Louis BlockFoundation will be incorporated into theHans Hecht Hemodynamic Laborato­ries. The surgical HemodynamicLaboratory has been in operation for twoand a half years, studying responses ofthe heart to experimentally inducedcoronary thrombosis under varioustypes of induced stress. An effort is alsobeing made to find species of animalswith coronary and cardiac anatomy simi­lar to the human and to generate ad­vanced coronary atherosclerosis in theexperimental animal. Active collabora­tion is being undertaken in this projectwith Dr. Robert W. Wissler.-A computer laboratory for develop­ing automation of analysis of theanalogue signals from all the cardiachemodynamic procedures and develop­ing a useful data base. The laboratory isan integrated minicomputer facility foranalysis of both clinical and researchtypes of cardiac hemodynamic, radio­graphic, and isotope data.The new laboratories were dedicatedby Mrs. Hans Hecht, who unveiled aplaque commemorating her late hus­band, who was Head of the CardiologySection and Chairman of the Depart­ment of Medicine in the University'sDivision of the Biological Sciences andThe Pritzker School of Medicine. Dr.Rory Childers, Associate Professor,Medicine (Cardiology) introduced Mrs.Hecht. Before the dedication, Dr. How­ard E. Morgan, the Evan Pugh Professorand Chairman of Physiology at Pennsyl­vania State University, gave the secondHans Hecht memorial lecture. His topicwas "Control of Protein Turnover inNormal and Ischemic Hearts." The lec­ture was sponsored by the Section ofCardiology, Department of Medicine,Hans Hecht Memorial Fund.29Dr. Harold L. Brooks, Assistant Pro­fessor in the Department of Medicine(Cardiology), is Director of theHemodynamic Laboratories. He de­signed the new facilities after visitingleading cardiac catheterization and otherheart research laboratories throughoutthe United States. Dr. Raul Falicov,Associate Professor in the Departmentof Medicine (Cardiology), is Director ofClinical Hemodynamics, and will directclinical studies in the new cardiaccatheterization laboratory.Funds to build the laboratories weresupplied by the University as part of itsprogram to maintain University leader­ship as one of the nation's top referralcenters for heart disease research, diag­nosis, medical treatment, and surgery.Ischemic Heart Disease SCORThe University of Chicago has re­ceived a five-year grant from the Na­tional Heart and Lung Institute of theU. S. Public Health Service to establish aSpecialized Center of Research (SCOR)in Ischemic Heart Disease. Initial fund­ing is $1,169,193 for the first year of op­eration, effective January I; the totalsupport for the five-year period exceeds$5 million.Ischemic disease is local deprivationof blood, such as to the heart muscle,due to obstruction of the blood flow. Dr.Leon Resnekov is Principal Investigatorand Director. The grant will supportclinical and basic studies in myocardialinfarction (heart attack), angina pectoris,and sudden cardiac death. Dr. Resnekovis Professor in the Department ofMedicine and Joint Head of the Cardiol­ogy Section of the Department ofMedicine in the University's Division ofthe Biological Sciences and The PritzkerSchool of Medicine.The new Center will continue and ex­pand the work of the University'sMyocardial Infarction Research Unit(MI RU). "It will allow important newinformation to be gathered safely, duringboth the acute and chronic stages of thedisease process. It will provide the pa­tient with the benefits of the best in med­ical and surgical therapy, as determinedby the results of studies undertaken inthe Center," said Dr. Resnekov, who isalso Director and Principal Investigatorof MIRU.The University's MIRU grant termi­nates June 30, as do the grants to eightother MIRUs in the United States. TheUniversity of Chicago Myocardial In­farction Research Unit was establishedunder an NHLI grant in 1971. TotalMIRU funding since 1971 to the Univer­sity has been $3.9 million. Seven of the30 nine original MIRUs at leading UnitedStates medical centers have been namednew Ischemic Heart Centers. Two otherresearch centers that did not haveMyocardial Infarction Research Unitshave also been designated SCORs in Is­chemic Heart Disease.Other SCORs in Ischemic Heart Dis­ease, effective January 1, are at Mas­sachusetts General Hospital, Boston;the University of Alabama; the Univer­sity of California, San Diego; DukeUniversity; Johns Hopkins University;Washington University, St. Louis; andthe University of Texas SouthwesternMedical Center, Dallas.SCOR activities are coordinated byN H L I, which encourages cooperationamong the centers to facilitate rapid dis­semination of new knowledge, develop­ment of standardized methods of datacollection, and prompt eval�ation ofpromising new approaches to preventionand therapy.Projects authorized and funded underthe grant are:I. Clinical Studies Section, Dr. Res­nekov, Section Leader.-Radionuclide imaging studies, Dr.Paul V. Harper. Dr. Harper is Pro­fessor in the Departments of Surgery(General) and Radiology and theFranklin McLean Memorial Re­search Institute.-Adaptation of ventricular perfor­mance and myocardial perfusion toobstructive coronary disease, Dr.Harold L. Brooks. Dr. Brooks is As­sistant Professor in the Departmentof Medicine, and Director of theHans Hecht Hemodynamic Labs andof the Experimental AnimalHemodynamics Lab.2. Surgical Studies, Dr. Robert Re­plogle, Section Leader. Dr. Replogleis Professor in the Department ofSurgery and Head of CardiacSurgery.-Clinical and experimental studiesof surgical treatment for acutemyocardial infarction, Dr. David B.Skinner. Dr. Skinner is the Dallas B.Phemister Professor and Chairman inthe Department of Surgery.-Prevention and reversal of acutemyocardial ischemia from coronaryartery disease: retrograde coronaryvenous perfusion in comparison toother methods, Dr. Constantine E.Anagnostopoulos. Dr. Anagnos­topoulos is Associate Professor in theDepartment of Surgery (Cardiac).-Fate of bypassed and bypassingvessels, Dr. Seymour Glagov. Dr.Glagov is Professor in the Depart­ment of Pathology and the College.3. Electrophysiology, Dr. Harry Foz- zard, Section Leader. Dr. Fozzard isProfessor in the Departments ofMedicine and Pharmacological andPhysiological Sciences, Joint Head ofthe Cardiology Section of the De­partment of Medicine, and Directorof the Biomedical Computation Facil­ity.-Effect of antidysrhythmic drugs onthe membrane properties, cablecharacteristics and excitability ofmammalian cardiac Purkinje fibers,Dr. Morton F. Arnsdorf. Dr.Arnsdorf is Assistant Professor in theCardiology Section of the Depart­ment of Medicine.-Intraventricular conduction and au­tomaticity in ischemic heart disease;effects of exercise, drugs and pacing;long term observation, Dr. HowardCohen. This research will be done byDr. Cohen at Michael Reese Hospi­tal, Chicago.-Exposure of myocardial damage:infarction vectors recalled by prema­ture atrial stimulation, Dr. Rory W.Childers. Dr. Childers is AssociateProfessor in the Cardiology Sectionof the Department of Medicine andDirector of the ElectrocardiographicServices Lab.4. Core Pathology Laboratory for theStudy of Ischemic Human Hearts andIschemic Damage to ExperimentalAnimal Hearts, Dr. Robert W. Wis­sler.5. Animal Hemodynamics, Dr. HaroldBrooks, Section Leader.-Biventricular contractile responsesto acute myocardial infarction in thenormal and atherosclerotic animal,Drs. Harold Brooks and Robert Wis­sler.-Chemical mediators ofinflammation in acute myocardial is­chemia, Dr. Louis Cohen. Dr. Cohenis Associate Professor in the De­partment of Medicine.6. Biochemical Studies, Dr. MurrayRabinowitz, Section Leader. Dr.Rabinowitz is the Louis Block Pro­fessor in the Departments ofMedicine and Biochemistry.-Mechanism of destruction and re­pair of cardiac muscle cell con­stituents, Dr. Radovan Zak. Dr. Zakis Associate Professor in the De­partment of Medicine and ResearchAssociate in the Department ofBiochemistry and the FranklinMcLean Memorial Research Insti­tute.-Con trol of muscle cell prolifera­tion, Dr. Donald Fischman. DrFischman is Associate Professor inthe Departments of Biology andAnatomy, the Committee on De-velopmental Biology, and the Col­lege.-Phospholipid metabolism followingcardiac injury and repair, Dr. God­frey S. Getz. Dr. Getz is Master inthe Division of the Biological Sci­ences and The Pritzker School ofMedicine, Professor in the Depart­ments of Pathology, Biochemistry,and the College, and Director of theResearch Chemistry Laboratory inPathology.-Electrophysiological studies ofsympathetic innervation in tissue cul­ture, Dr. Harry A. Fozzard.7. Ultrastructure-Effects of ischemia and anoxia oncardiac ion trans port, Dr. ErnestPage. Dr. Page is Professor in theDepartments of Medicine and Phar­macological and Physiological Sci­ences.-Ultrastructural consequences ofmyocardial ischemia: morphometricand microchemical studies, Dr. Er­nest Page.8. Data Management, Dr. Harry Foz­zard, Section Leader.-Statistics and data files, PaulMeier. Mr. Meier is Professor in theDepartments of Statistics, Phar­macological and Physiological Sci­ences, and the College.-Electrocardiographic analysis sys­tem, Plato Kinias. Mr. Kinias is Re­search Associate in the Departmentof Medicine and Programmer in theBiomedical Computation Facilities.-Computer analysis of myocardialperfusion, ventricular wall dynamicsand on-line hemodynamic data, A. L.Pai, Mr. Pai is Research Associate inthe Cardiology Section of the De­partment of Medicine.9. Organization and Administration,Dr. Leon Resnekov, Section Leader.Health Delivery GrantA grant of $282,796 by the W. K. Kel­logg Foundation of Battle Creek,Michigan, to the University of Chicagowas announced by Richard N. Rosett,Dean of the University's GraduateSchool of Business. The five-year grantwill be used to initiate and provide sup­port for a program designed to help im­prove the management of health deliveryorganizations. Under the plan, ten ex­perienced persons involved in the man­agement of health care delivery organi­zations will be admitted each year to aspecially-designed curriculum of ad­vanced studies at the master's level.They will be enrolled in the Health Ex­ecutive Program. While retaining theirfull-time jobs, they will undertake a two-year course of studies involving onefull day a week in classes.Walter D. Fackler, Professor of Busi­ness Economics and Director of Man­agement Programs at the School, is Di­rector of the Executive Program. J. JoelMay is Director of the Graduate Pro­gram in Hospital Administration. Fack­ler says, "In recent years a growingnumber of applicants for admission tothe Executive Program have been fromthe health field, including physicians.There seems to be a very substantialneed for improved management skills inthis area. As the costs of health care de­livery rise, administrators clearly need toknow more about efficient managementand effective use of resources, and theExecutive Program offers them an op­portunity to acquire such knowledge.""We expect to draw students for theHealth Executive Program from amongpromising administrators now function­ing at various levels in hospitals andother health care organizations," saysMay. "We also expect to provide alearning experience for selected chiefexecutive officers of such organizationsand their senior staff members, by pro­viding exposure to new knowledge andnew techniques in their field."Students in the Health ExecutiveProgram will become members of theregular Executive Program groups. Theywill take a core of general managementsubjects alongside executives from otherfields, and will also receive separate in­struction in a series of courses dealingspecifically with problems of managinghealth care delivery organizations.Louros is Greenhill Visiting ProfessorDr. N. C. Louros, professor emeritusof obstetrics and gynecology at the U ni­versity of Athens, Greece, was the J. P.Greenhill Visiting Professor in the De­partment of Obstetrics and Gynecologyfor 1975. January 16, he participated in adiscussion of "Motility of the UterineMuscle" and in a seminar of" ArtificialVagina" and "Radical Hysterectomy".The Greenhill visiting professorshipswere established in 1973 by Dr. J. P.Greenhill of Chicago, first resident atChicago Lying-in Hospital. Dr.Greenhill is on the emeritus attendingstaff at C. L.1. and holds attending andteaching posts at Michael Reese Hospi­tal and at Cook County Hospital.Dr. Louros is president of the Interna­tional College of Surgeons and served onthe faculty of the University of Athensuntil his retirement in 1968.President's PanelThe American Medical Association has submitted nine nominees for thePresident's Biomedical Research Panelto be established under the NationalCancer Act extension (PL 73-352). Thepanel, which will serve in an advisorycapacity to the National Institutes ofHealth, willreview projects and grants.University of Chicago alumni recom­mended for the panel are: William R.Barclay, AMA deputy executive vicepresident, whose affiliation with theUniversity began in 1948; Robert W.Wissler (48), the University'S Donald N.Pritzker Professor in the Department ofPathology; and Miriam P. Finkel (Ph.D.44) Argonne National Laboratory (andwife of Asher J. Finkel (48), vice presi­dent of the Medical Alumni Associa­tion.)Buchanan HonoredThe first John B. Hower Award of theChild Neurology Society has been pre­sented to Douglas N. Buchanan (Profes­sor Emeritus, Medicine-Pediatrics31-73). The award consists of a $'1,500honorarium and is given for the" pediat­ric neurologist who has made the mostoutstanding contribution to pediatricneurology." It honors John B. Hower, amember of the board of Children's Hos­pital of Akron, which established theaward. The recipient is chosen by theChild Neurology Society. Dr. Buchan­an, who now lives in London, England,returned to accept the award and to lec­ture at the Society'S third annual meet­ing, at the University of Wisconsin, Oc­tober 10 through 12. He also spoke at theChildren's Hospital of Akron.Arcilla HonoredDr. Rene Arcilla, Professor in theDepartment of Pediatrics and Directorof Pediatric Cardiology at The Univer­sity of Chicago Pritzker School ofMedicine, was honored as an "outstand­ing man in the field of medical practice"by the Philippine government in a cere­mony in Manila, January 17. He was oneof 13 Filipinos living abroad to be citedfor his contributions to society. Dr. Ar­cilia was honored for his clinical and re­search efforts in pediatric cardiology.Dr. Arcilla, 49, was born on the islandof Catanduanes, in the Philippines. Hecame to the United States in 1954 andbecame assistant director of pediatriccardiology at Cook County Children'sHospital in 1960. He joined the faculty ofthe University of Chicago in 1963.Lederer Fellowship to KaplanDavid R. Kaplan, a first year student31Dr. Lederer (top), Daniel Kaplan (bottom)in the six-year combined M.D./Ph.D.medical scientist program at The Uni­versity of Chicago, has received the Dr.Francis L. Lederer Fellowship. The Fel­lowship, consisting of tuition and astipend, was established this year by theFrancis L. Lederer Foundation, Chi­cago. It honors Dr. Francis L. Lederer,(B.S. 19. M.D. 21) former Professor andChairman of Otolaryngology at the Uni­versity of Illinois College of Medicine,Chicago, who died in Chicago, April 3,1973. Dr. Lederer's wife, the formerAnne Pollock, was a member of the classof 1924 at the University, and their sonFrancis L. Lederer II received the A.M.degree from the University in 1967.David, the son of Mr. and Mrs.Robert Kaplan, 3530 Meda Pass, FortWayne, Indiana, is a 1974 University ofChicago biology honors graduate. As anundergraduate he participated in re­search on organ transplantation and im­munology and was co-author of ascientific report on "Clonal Depletion inNeonatal Tolerance" in Sciencemagazine November 15, 1974. As an32 M.D.lPh.D. student, he will continuehis research in the laboratory of Dr.Heinz Kohler in LaRabida Institute-TheUniversity of Chicago. Dr. Kohler isAssociate Professor in the Departmentsof Pathology, Biochemistry, the Com­mittee on Immunology, and the College.David worked summers as a lifeguardwhile an undergraduate at The Univer­sity of Chicago. He plays the violin inthe University orchestra and in stringquartets and participates in intramuralsports. He is a member of Sigma Xi, anhonorary scientific research association.He is a graduate of South Side HighSchool, Fort Wayne.The University of Chicago combinedM.O.lPh.D. program trains medical sci­entists seeking faculty positions in medi­cal colleges. The University ofChicago's Pritzker School of Medicineleads all U.S. medical schools in theproportion of its graduates (15 percent,according to a recent U.S. governmentsurvey) who enter academic medicine.Merwald Receives FellowshipA fellowship in honor of the late Rev­erend Carl A. Nighswonger has been es­tablished in the Department of Chap­laincy Services of the University ofChicago Hospitals and Clinics (UCHC).The first recipient of the $6,000 Carl A.Nighswonger Fellowship in PastoralStudies is Reverend Alfred A. Merwald,a chaplain-intern in UHCH clinical pas­toral education. He is also a graduatestudent at Chicago Theological Semi­nary, and consultant minister at Inde­pendence Hill Presbyterian Church inMerrillville, Indiana.Reverend James Gibbons, Director ofUCHC Chaplaincy Services, says"This fellowship will continue the tradi­tion of training and professional de­velopment in clinical pastoral servicethat Carl Nighswonger started. Theaward honors his contributions as aminister, chaplain, teacher, scholar, andauthor. "Dr. Zuspan The Rev. Mr. Merwald is a native ofGary, Indiana and has earned a master'sdegree with honors from MemphisTheological Seminary. His currentstudies include Stress Levels in PatientCare Personnel and Value Shifts in theFatally Ill.The renewable fellowship will beawarded annually. It is supported by theUniversity of Chicago Hospitals andClinics and the Carl A. NighswongerMemorial Fund. Donations should bemade out to the University of Chicagoand designated for the Carl A.Nighswonger Memorial Fund.American College of Surgeons FellowsThe following alumni were inducted asFellows of the American College ofSurgeons at the 1974 American Collegeof Surgeons meeting held in MiamiBeach, October 24:Thomas A. Borden (63), Albuquer­que, New Mexico; Paul A. Hinenburg(59), Hollywood, Florida; James D. HullIII (64), Morehead, Kentucky; Barry D.Kahan (65), Chicago, Illinois; Horst R.Konrad (63), Los Angeles, California;Daniel Paloyan (64), Chicago, Illinois;and Joan Zajtchuk (66), Denver, Col­orado. Former interns, residents andpresent faculty also inducted were: Lt.Col. Arthur Mason Ahearn, MC USA,Fort Gordon, Georgia; Thomas R. DeMeester, Chicago, Illinois; Warren E.Enker, Chicago, Illinois; J. LauranceHill, Chicago, Illinois; AbdolhamidHosseinian, Chicago, Illinois; FrancisD. Keenan, J r., Leesburg, Florida;Gregory J. Matz, Chicago, Illinois;Robert J. McCardle, Columbia, SouthCarolina; Robert H. Oswald, Jr.,Evansville, Indiana; George J. Reul-Jr.,Houston, Texas; Karl H. Siedentop, Ar­lington Heights, Illinois; and Phillip G.Spiegel, Chicago, Illinois.Zuspan Tribute by DepartmentDecember 31, after nine years of ser­vice Dr. Frederick P. Zuspan, theJoseph Bolivar DeLee Professor andChairman of the Department of Obstet­rics and Gynecology at Chicago Lying­in Hospital, left The University ofChicago to assume a new position aschairman of the Department of Obstet­rics and Gynecology at The Ohio StateUniversity, his alma mater. A few weeksearlier, the faculty had honored him at afarewell dinner, presented him with aplaque signed by members of his staffand gave him a gold, pocket alarmwatch. We would like to share with youthe tribute given him by his faculty andstaff and recently published in the1973-74 Annual Report of The ChicagoLying-in Hospital."Dr. Zuspan possesses a unique com­bination of talents and skills. As a physi­cian, he combines clinical expertise witha deep concern for his patients. As ateacher, he is dedicated and highly effec­tive. With his example and support, theDepartment has attained a new level ofcommitment to the education of housestaff and students. As a researcher in thearea of amine mechanisms in reproduc­tion, Dr. Zuspan enjoys an internationalreputation. As chief of staff, he posses­ses sincerity, warmth, and an ability torelate to all members of the hospitalstaff. As a speaker, he has a specialcharm and charisma. As Chairman, Dr.Zuspan has set a standard of excellencefor the Department."The Medical Alumni Associationjoinsin wishing Dr. Zuspan well in his newposition.You Can Go Home AgainDr. Leon O. Jacobson, Dean of theDivision of the Biological Sciences andThe Pritzker School of Medicine, wasthe honored guest at a 90th anniversarycountry church celebration and LaborDay program in North Dakota August31 through September 2.August 31, he was the subject of a"This is Your Life" slide show in theNorwegian Lutheran Church at theformer site of Sims, N.D., where he wasborn. The town is no longer on the map.Slides depicted the former two-roomschool house in which Dr. Jacobsontaught all eight grades between 1930 and1933, his students, the big potbellied fur­nace that kept teacher and students fromfreezing when the weather feli to minus20°F., and the school's former carriagebarn in which Dr. Jacobson unsuccess­fully tried to raise chickens.At the church anniversary programthe following day, Dr. Jacobson recalledthat when he worked as health officerwith Enrico Fermi in the plutonium pro­ject at The University of Chicago duringWorld War II, it was necessary to get abaptismal record from the NorwegianLutheran Church at Sims to prove thathe had been born at all. The doctor whodelivered him had kept no record andcouldn't in good conscience say he re­membered bringing Leon into the world.Dr. Jacobson also spoke of the en­couragement he received from histeachers in the Sims grade school and atnear-by Almont High School. The com­munity valued "not education as a goalin itself," he said, .. but education forservice ... We have been taught to facethe future confidently with the idea that we can be of some good use."Labor Day, Dr. Jacobson was invitedto speak once more to the Almont,N. D. Chamber of Commerce. He rem­inisced and told a joke in Norwegian.Other events of the day in Almont in­cluded a parade, a school program, bar­becue, 4-H exhibits, demonstrations ofold-time steam threshing and harvesting,a horse show, pony rides, and a dance.Dr. Jacobson's parents owned a ranchin Sims. He graduated from AlmontHigh School at the age of 16. He at­tended North Dakota State College from1928 to 30 and 1933 to 35, before andafter his stint as a school teacher. In 1939he received his M.D. degree from TheUniversity of Chicago.The town of Sims disappeared whenthe Northern Pacific Railroad moved itstracks. Dr. Jacobson's brother addedmost of the former town to his ranch,which he later sold to one of Dr.Jacobson's high school classmates. Allthat is left of the town today is thechurch. Also, Dr. Jacobson's brother­in-law once owned the Maltese Cross,President Theodore Roosevelt's formerranch at Medora, N. D.Dr. Jacobson praised his "verysuperior" teachers at Sims and Almontfor helping him to develop an interest inmathematics and science. He went on toreceive his degree in agricultural sci­ence.How does an "unsuccessful NorthDakota chicken farmer" get to become aphysician, professor of medicine, and amedical dean when he was born in a statethat did not then have a medical school?He was able to pursue his interest inscience in the state agricultural school,said Dr. Jacobson, where scientificstudies were a tradition. He didn't wantto become a county agent, so the nextlogical step was to apply for graduatestudies in science or medicineelsewhere-and The University ofChicago Medical School admitted him.As an example of agricultural researchthat became medically important, hecited studies by one of his North Dakotamentors who discovered sweet cloverdisease. Cattle that eat the diseasedclover bleed to death. Later, Karl Linkof the University of Wisconsin isolatedthe substance, warfarin, which is nowused as an anticoagulant. It is also usedto kill rats.Like many others in the 1930s, Dr.Jacobson lost his savings when the localbank closed and had to borrow to go tomedical school. One of his college pro­fessors suggested he write ShreveArcher, a Minneapolis businessman.Archer loaned Dr. Jacobson $600 a yearand cancelled the debt when Dr. Jacob- son graduated. After Archer died, Dr.Jacobson established the Shreve Archerstudent loan fund at the University, andmore than repaid the loan in contribu­tions to the Archer Fund.Community celebrations are a tradi­tion at Sims. Dr. Jacobson helped startthe tradition when he organized com­munity affairs as a prairie schoolteacher. The State of North Dakotaliked the way he ran the school and usedit as a demonstration center for ruraleducation.Life as a school teacher was rugged,says Dr. Jacobson. In the winter he hadto fire two furnaces. He tried to raisesome chickens on the premises, butskunks got them. He taught everything,including manual training and agricul­tural subjects.While at the University of ChicagoMedical School in the 1930s, Dr. Jacob­son served as ajudge at the InternationalLivestock Shows and helped chaperoneyoung people who came from all over theUnited States and Canada to compete inthe shows.Salute to KirsnerA 65th birthday program in honor ofDr. Joseph B. Kirsner (Ph.D. 42), theLouis Block Distinguished Service Pro­fessor of Medicine, Chief of the ClinicalStaff, and Deputy Dean for Medical Af­fairs, was held October 27 and 28 at theCenter for Continuing Education. Theprogram featured a banquet, scientifictalks and reminiscences. Participants in­cluded Dr. Charles B. Huggins, the Wil­liam B. Ogden Distinguished ServiceProfessor in the Ben May Laboratory forCancer Research and in the Departmentof Surgery (Urology); Dr. Clifford W.Gurney (51), Deputy Dean of the Divi­sion of The Biological Sciences, ThePritzker School of Medicine and theClinical Sciences; and Dr. Walter L.Palmer (21), the Richard T. Crane Pro­fessor Emeritus in the Department ofMedicine.Dr. Kirsners recent honors includethe 1974 Award of Distinction of the Na­tional Foundation for Ileitis and Colitis,presented in December; and theFriedenwald Medal to be presented atthe American Gastroenterological As­sociation Convention in San Antonio.Texas next May, in recognition of hisvaried contributions to gastroenterologyin the United States. Dr. Kirsner wasalso elected chairman of the NationalScientific Board of the National Founda­tion for Ileitis and Colitis. With Dr. RoyShorter of the Mayo Clinic. he has writ­ten Inflammatory Bowel Disease,recently published by Lee and Feriger,Philadelphia.33National Study Needs VolunteersThe University of Chicago Hospitalsand Clinics has passed the half-waymark in recruiting 300 volunteers for theMultiple Risk Factor Intervention Trial.Its goal is to demonstrate whether thisdisease may be prevented by recognizingand controlling three high risk factors:smoking, high blood cholesterol and highblood pressure, says Dr. Richard Jones,Associate Professor of Medicine at theUniversity of Chicago Pritzker School ofMedicine. "Only half of those with highblood cholesterol or blood pressure areaware of it. These are usually detectedby medical tests."Those found in the initial screenings tobe in the nation's top 10 percent of risk(but below the top I percent) will beeligible to participate in a six-year re­search program designed to thwart thenumber one killer. Those in the top Ipercent of risk will not be accepted butwill be referred to their family physiciansfor immediate medical attention."Several studies have shown strongindications that physicians can interveneto improve risk factors. We are now test­ing this on a larger scale with the hope ofreducing the number of heart attacks.Nationally, an estimated 12,000 men willtake part in the study."Volunteers will be randomized intotwo groups. The first will receive inten­sive care by the staff of the Multiple RiskFactor Intervention Trial. The controlgroup will continue to receive usual carefrom family physicians. "Both groupswill probably include some men who willsuffer an attack during the course of thestudy. It is our aim, however, to estab­lish whether the number will be smalleramong those in the 'intensive' treatmentsection..Subjects must go through three screen­ings before they are accepted for theprogram; all are now offered at The Uni­versity of Chicago Hospitals andClinics. Saturday appointments areavailable. Volunteers are urged to call947-5508.Infant Development ProgramAn Infant Development Program de­signed to prevent or limit the extent ofdevelopmental disabilities in high-risk in­fants is underway in the Neonatal Inten­sive Care Unit of Chicago Lying-inHospital. Funded by the Department ofMental Health of the State of Illinois,the program will aid approximately 85newborn infants admitted yearly to theUnit with perinatal problems that mayaffect their development. This group in-34 eludes: Premature infants; infants ofdiabetic mothers; infants with a historyof shared maternal-fetal infection; in­fants showing fetal monitoring evidenceof distress; infants who are small for dateand infants who have had seizures in theneonatal period. An appreciable numberof these infants sustain permanent de­velopmental disability such as mental re­tardation, cerebral palsy, neuro-sensoryimpairment such as hearing loss, andperceptual handicaps.The program provides follow-up in­vestigation for infants who leave theNeonatal Intensive Care Unit, to deter­mine which will need immediate continu­ing care. Program staff are aided by in­formation provided by the Nursing andSocial Service staff in the Unit and byresults of the infan ts' medical examina­tions. Working with the family, a pro­gram is formulated to meet the needs ofthe child in the areas of physical health,intellectual and emotional development.Director of the program is Dr. Paul S.Weiner, Associate Professor in the De­partments of Pediatrics and Psychiatry.Other staff members include Ms. CherylSchwartz, Nurse; and Ms. Joyce Davis,Pre-School Educator.Symposium for NursesThe University of Chicago CancerControl Center and the University ofChicago Hospitals and Clinics Depart­ment of Nursing Services is sponsoring asymposium series to up-date skills and tore-orient nurses philosophically in work­ing with cancer patients and theirfamilies.Thirty-seven UCHC nurses partici­pated in the first comprehensive two-dayseminar, December 3 and 4,. This wasthe first program in a continuing effort totest cancer control curriculum in on­cologic nursing to be offered to nursingstaffs throughout the University'sCancer Control Center service area. Thesecond program, for pediatric nurses,was held February 4. A weekly series insurgical oncology will begin in March.Organizer of the program was LisaMarino, R.N., UCHC Oncology NurseCoordinator and Clinical Specialist inOncology Nursing."Nurses and others ministeringtherapy for cancer victims are some­times guilty of a fatalistic attitude towardthose with cancer. With better methodsof treatment, as knowledge increasesabout the causes and control of the dis­ease, the percentages are more oftenfavoring the patient. This trend must betranslated into positive feelings amongthose rendering daily care for patients,"Marino said. "We face special problems in deliver­ing care to cancer patients here, becauseas a major cancer treatment center, wesee the most difficult, sometimes mostadvanced cases. The fear cancer gener­ates often isolates the patient from fam­ily and friends, especially in long-term oradvanced cases. Unfortunately, manytimes we see that patients have begun tosuccumb to their hopelessness by thetime they are admitted to our medicalcenter," she continued."Our intent here is to help the patientbegin anew to fight to adapt to the cir­cumstances of his illness," Marino said.UCHC nurse participants, who willreceive continuing education creditsfrom the Illinois Nurses Association,will also tour UCHC cancer treatmentfacilities, review community resourcesavailable to patients and families, andlearn more about diagnostic proceduresand the preventive aspects of care.University of Chicago nurses servingas faculty during the December 3 and 4symposium were: Phyllis A. Cullen,Medical Nurse Associate; Carolyn El­liot, Radiation Oncology Nurse; Mar­garet Kelly, Nurse Coordinator, BreastStudy Program; Judith Kooser, ClinicalSpecialist in Psychiatric Nursing; LisaMarino, Clinical Specialist in Oncology;Nina Oetzel, Nurse Coordinator, Lym­phoma Program; and Margaret Sherrell,Community Liaison Nurse.Medical faculty included Dr. BernardLevin, Assistant Professor of Medicine;Dr. Abdool R. Moosa, Assistant Pro­fessor of Surgery; Dr. Paul Schwab, As­sociate Professor of Psychiatry; and Dr.Donald Sweet, Fellow in the Section ofHematology-Oncology; all of theUniversity's Division of the BiologicalSciences and The Pritzker School ofMedicine.Experts Discuss Latest Developments inTreatmentThe University of Chicago MedicalReviews, six cassette tape discussionsby University of Chicago Hospitals andClinics experts, has been issued by TheUniversity of Chicago Press. The tapessummarize latest developments in thediagnosis and treatment of common dis­eases.Dr. Richard L. Landau, Professor inthe Department of Medicine and Direc­tor of the University's General ClinicalResearch Center, is editor and mod­erator of the series.Topics and specialists included are:-Diabetes Mellitus, Dr. Arthur H.Rubenstein, Professor in the Depart­ment of Medicine and Program Coor-dinator, The University of ChicagoDiabetes-Endocrinology Center.-Essential Hypertension, Dr.Suzanne Oparil, Assistant Professor,Medicine and Director of the Hyperten­sion Clinic at the University's Divisionof the Biological Sciences and ThePritzker School of Medicine.-Treatment of Bronchial Asthma,Dr. Nicholas J. Gross, Assistant Pro­fessor and Chief of the Respiratory Dis­eases Section, Department of Medicine.-Management of Lymphomas, Dr.John E. Ultmann, Professor, Medicine,and Director, The University of ChicagoCancer Research Center.-Treatment of Rheumatoid Arthritis,Dr. Daniel J. Mc Carty , MilwaukeeCounty Hospital, formerly Professorand Chief of the Section of Arthritis andMetabolism, Department of Medicine.-Evaluation and Management of Pa­tients with Chronic Active Hepatitis,Dr- James L. Boyer, Associate Profes­sor, Medicine, and head of theUniversity's Liver Study Unit.The tapes cost $45 for the complete setof six with a binder, postpaid anywherein the world. Individual tapes cost $8.50.Orders should be set to The Universityof Chicago Press, Order Department,11030 S. Langley Avenue, Chicago, Il­linois 60628.Famed Surgeons HereFamed heart transplant surgeonsDavid Sabiston, Denton Cooley andNorman E. Shumway participated in aUniversity of Chicago program in De­cember. "Lethal Diseases of the As­cending Aorta and Branches" was thetopic of this session of The Frontiersof Medicine 1974-75 lecture series. Theprogram was arranged by Dr. Constan­tine E. Anagnostopoulos.University faculty members were: Dr.David B. Skinner, the Dallas B. Phemis­ter Professor and Chairman of Surgery;Dr. Anagnostopoulos, Associate Pro­fessor of Surgery and Senior CardiacSurgeon; Dr. Rene Arcilla, Professor ofPediatrics, Chief of Pediatric Cardiol­ogy; Dr. Robert Replogle, Professor ofSurgery, Chief of Cardiac Surgery; Dr.John J. Lamberti, Assistant Professor,Surgery; Dr. Leon Resnekov, Professorof Medicine and Co-Director of Car­diology; and Dr. Raul E. Falicov, As­sociate Professor of Medicine and Co­Director, Cardiac Catheterization Facil­ity.Visiting specialists included: Dr.Cooley, Surgeon-in-Chief, Texas HeartInstitute, Houston, Texas; Dr. Shum­way, Chairman, Department of CardiacSurgery, Stanford University; Dr. David C. Sabiston, Jr., Professor andChairman, Department of Surgery,Duke University Medical Center; Dr.Victor A. McCusick, Chairman andPhysician-in-Chief, Department ofMedicine, the Johns Hopkins UniversitySchool of Medicine; and Dr. Rolf Gun­nar, Professor of Medicine and Chief ofCardiology, Loyola University,Maywood, III.Fulfills Life DreamAt the age of 29, Dr. Carrie Lou Wal­ters is doing what she first wanted to doat age 8-brain surgery. Dr. Walters is aSenior Resident in Neurosurgery at TheUniversity of Chicago Hospitals andClinics. In July, 1977, she will completeher fifth year of residency training, andin 1979 she can seek final "board"certification as a neurosurgeon.Surgery is the "last frontier" forwomen in medicine. It is not so rare anymore for a woman to become a physi­cian, but it is still relatively unusual for awoman to become a surgeon. Typicalspecialties for U.S. women physiciansare pediatrics or obstetrics-gynecology.When Dr. Walters was eight, shewatched a teacher dissect a worm. Shesaw a little ganglion chain in the wormthat fascinated her. Right then, she says,she decided to spend her life studying thenervous system.At The University of Chicago, she is amember of a team of four attendingneurosurgeons, four basic scientists, fiveresidents, and a surgical intern, plusphysician's assistants, technicians, andspecially trained neurosurgery nurses.Neurosurgery is the University's busiestsurgical specialty, with about 40 adultbeds, plus from two to ten beds in theUniversity's Wyler Children's Hospital.As Senior Resident, Dr. Walters partici­pates in operations on the brain andnervous system. The operating team inneurosurgery consists of the attendingsurgeon, chief resident, and senior resi­dent. "It's a tight operation," says Dr.Walters. "You can't get more than threearound the operating area. "The residents participate in patientDr. Walters care under the direction of staff physi­cians. The Chief Resident, Dr. HenryM. Kawanaga, is less intimately in­volved with the floor patients. He han­dles the most critical cases and consultson patients' neurosurgical problems withthe physician's in other medical servicesat the University.Surgery is one of the most physicallydemanding of medical specialties. "Alight day is a 12-hour day," says Dr.Walters. "I seldom leave before 7 p.m."Quite frequently, she puts in 36 hours ofcontinuous duty. That happens when itis her tum to go "on call." It also hap­pens because there are frequentemergency cases requiring neuro­surgery-gun shot wounds to the head,children who fall from second or third­story windows, head accidents to bicy­clists who are hit by automobiles, andhigh speed accidents to motorcyclists, inwhich she has to deal with spinal in­juries, broken necks, and life-threateningsubarachnoid bleeding. There are alsobrain and spinal cord tumors and prob­lems of the blood supply of the brain in­volving hardening of the arteries andaneurysms (abnormally bulging arteries).She likes "being a lady in medicine. Idon't like to think I am 'one of theboys.' " She "never looked for any dis­crimination and never found it."There are no doctors in the Waltersfamily. Her father is a clerk in a grocerystore and her mother a department storeclerk. "I believe my family thinks I am alittle crazy."She received her bachelor's degree inchemistry from Willamett University inSalem, earning money for medicalschool by working as a laboratory tech­nician in Salem General and SalemMemorial Hospitals. During the sum­mers she had research jobs at The Uni­versity of Oregon and Peter BentBrigham Hospital, Boston. She receivedher M.D. from Northwestern in 1971.She obtained an internship at TheUniversity of Chicago right away, fillingin for another woman intern who was ill."I was on the neu rosurgery service threemonths before I officially began my gen­eral surgery internship." After that cameher first-year residency in 1972. She per­formed angiography, in which a radio­opaque substance is fed via an arteryinto the brain for X-ray studies. Shespent a year in the NeurosurgeryLaboratory and has developed an in­terest in animal research on subarach­noid bleeding, which she hopes to pursuein the future.Book of HealthThe following faculty members have35contributed sections to The Trans/visionBook of Health, Encyclopaedia Brit­tanica, Inc., Helen Hemingway Benton,Publisher, (Chicago, London, Toronto,Geneva, Sydney, Tokyo, Manila) 1974:Sumner C. Kraft (55) Professor ofMedicine, Chapter 6-Indigestion;Michael Newton, Professor of Obstet­rics and Gynecology, Chapter iO-Sexand Pregnancy; Nicholas A. Vick (65),Assistant Professor of Medicine(Neurology), Chapter 12-The NervousSystem; and Roy R. Grinker, Sr. (21),Professor, Michael Reese Hospital andThe University of Chicago, Chapter13- The Integrative System: ThePsyche.A Tale of Three FamiliesThe University of Chicago PritzkerSchool of Medicine intertwines the livesof many people. This is a story about theGordon family.Martin E. Gordon (Intern 1946) com­pleted his training with support from hiswife, Evelyn, who worked in thelaboratories of Drs. Phemister and Wil­liam Fishman. Some years later, theirson, Jeffrey Ivan, (M.D. 1973) com­pleted his training with the help of hiswife, Deborah, a clinical coordinator forDr. Kirsner. Jeffrey received the Up­john Award for outstanding achievementduring his four years in medical school.Subsequently, daughter Judy Iris ob­tained a Masters Degree in Russian His­tory from the University and became aclinical coordinator for Dr. Kirsner andmet her husband, Jules L. Dienstag(Intern- Resident 1972-74).To bring the story up-to-date, JeffreyGordon is now a resident in medicine atBarnes Hospital, St. Louis, and will domolecular biology research at N.1. H.next year.' Jules Dienstag is at N. I. H.now. Martin Gordon is associate clinicalprofessor at Yale School of Medicineand a practicing gastroenterologist inNew Haven. He produces medical filmsof which the recent series on "ClinicalAspects of Parasitology" has receivedmany national and international filmawards.In MemoriamLeonidas D. Marinelli1906-1974Dr. Leonidas D. Marinelli, ArgonneNational Laboratory, Department of Ra­diology, Research Associate (Assistantand Associate Professor, 48-71) died Sep-36 tember 13, 1974 at age 67. He joined Ar­gonne National Laboratory in 1948 as aSenior Biophysicist and Associate Di­rector of the Radiological Physics Divi­sion. He became its Director in 1963,serving until 1967 , after which he workedfull time in research until retirement.The Medical Alumni Association ex­tends its sympathy to his family.Dr. MarinelliALUMNI DEATHS'11. Rex R. Frizzell, San Marino,California, May 17, 1974, age 89.'11. Walter H. Theobald, Chicago, Il­linois, December 15, 1974, age 87.'15. James E. Hunter, Seattle,Washington, August 18, 1974, age 83.'15. William Allan Swim, LosAngeles, California, June 9, 1974, age88.'17. Marie Ortmayer, Carmel,California, July 24, 1974, age 80.'17. Frederick W. Siobe, Largo,Florida, July 19, 1974, age 80.'18. Earl C. Kading, Saratoga,California, September 16, 1974, age 82.'20. Nicholas L. Tartar, Corvallis,Oregon, September 29, 1974, age 80.'21. Henry A. Callis, Washington,D.C., November 12, 1974, age 87.'21. T. F. Krauss, Rockford, Illinois,June 20, 1974, age 72.'22. Abraham C. Eitzen, Hillsboro,Kansas, July 4, 1974, age 83.'22. Oliver M. Moore, San Marino,California, May 7, 1974, age 75.'23. Henry Harold Conley, ParkRidge, Illinois, August 15, 1974, age 81.'23. Robert F. Schoenbeck,Stoughton, Wisconsin, September 5,1974, age 77.'24. Robert A. Coombs, Chicago, Il­linois, May 29, 1974, age 73.'24. Howard E. Crawford, Hilo,Hawaii, August 10, 1974, age 74.'24. Fred O. E. Eggert, Chicago, Il­linois, September 3, 1974, age 75.'25. Ernest H. Clay, Montebello,California, October 4, 1974, age 80.'28. Samuel L. Goldberg, Chicago, Il­linois, October 9, 1974, age 69.'28. Frank Pearcy, Dallas, Texas,July 22, 1974, age 78. '28. Reuben Ratner, Beverly Hills,California, July 4, 1974, age 76.'29. Leonard Cardon, Chicago, Il­linois, December 31, 1974, age 69.'29. S. Lewis Stern, Hammond, In­diana, May 26, 1974, age 72.'29. Elizabeth K, Straus, Chicago, Il­linois, October 18, 1974, age 74.'30. Edward N. Anderson, Mansfield,Connecticut, April 26, 1974, age 73.'30. John P. Medelman, St. Paul,Minnesota, July 6, 1974, age 69.'30. Milton Wolpert, East Liverpool,Ohio, June 12, 1974, age 71.'31. John S. Moffatt, Rockford, Il­linois, August 10, 1974, age 72.'32. Arthur J. Vorwald, Green Bay,Wisconsin, November 29, 1974, age 70.'32. Mark F. Williams, Edina, Min­nesota, August 22, 1974, age 71.'33. Boris B. Rubenstein, Chicago, Il­linois, December 31, 1974, age 67.'36. Lawrence G. Slapion, Bronx,New York, December 13, 1974, age 63.'37. Edmond Uhry, Jr., New York,New York, October 24, 1974, age 61.'39. Stephen Kaimmer, Olympia,Washington, July 5, 1974, age 60.'40. Jesse W. Bowen, Jr., Tacoma,Washington, April 2, 1974, age 58.'41. William C. Lewis, Madison, Wis­consin, November 11, 1974, age 57.'42. Anthony J. Brunse, Los Angeles,California, August 9, 1974, age 57.'42. Frederic B. Emery, Concordia,Kansas, June 28, 1974, age 57.'48. Edward S. Ellis, Cleveland, Ohio,May 1, 1974, age 59.'49. Charles L. McKeen,Bloomington, Indiana, October 6, 1974,age 53.'57. Myron R. Karon, Los Angeles,California, November 16, 1974, age 42.Departmental NewsAnatomyAppointments:Philip S. Ulinski, Ph.D.-AssistantProfessorGrants:Dr. Eileen S. Kane, Assistant Profes­sor, received a $10,000 grant for otolog­ical research, "Connections in LowerAuditory System in Cats", from TheDeafness Research Foundation.Dr. Charles Oxnard, Dean of the Col­lege and Professor of Anatomy, An­thropology, and on the Committee onEvolutionary Biology, has been ap­pointed External Examiner to the Uni­versity of Hong Kong.Dr. Ronald Singer, Chairman, De­partment of Anatomy, Robert R. Bens-ley Professor in Biology and MedicalSciences, Departments of Anatomy andAnthropology, presented a paper, "Car­pal Growth Changes in Hottentot Chil­dren" at the Midwest Anatomists meet­ing, Chicago, October 11-13. He servedas chairman of the first session of theGeneral Scientific Program.Dr. Beatrice Garber, Associate Pro­fessor, was a keynote speaker at thebanquet. Her subject was "Cell Recog­nition in Brain Tissue Assembly."Dr. Singer is co-author of "Excava­tion of the Clactonian Industry at theGolf Course, Clacton-on-Sea, Sussex"in the 1973 Proceedings of the Prehistor­ical Society. University associated co­authors are John Wymer, Research As­sociate, and Ronald G. Wolff, formerpost-doctoral Fellow. Further report onthe excavation will appear in the Bulletinof the Royal Society of New Zealand.AnesthesiologyPromotions:Dr. Julia L. Dos Santos-to AssistantProfessor.Dr. Jacobus W. Mostert, Professor, ina letter to lAMA, December 2 issue,commented on the superiority of pen­tazocine as an analgesic in myocardialinfarction. His letter opposes an earlierlAMA article which recommended mor­phine for this purpose.Approximately 150 friends and col­leagues attended a cocktail party anddinner at the Blackstone Hotel, January16, to honor Dr. Donald W. Benson, re­cently appointed Professor and Chair­man of the Department.Ben May LaboratoryGrants:Dr. Charles B. Huggins, William B.Ogden Distinguished Service Professorin the Ben May Laboratory and the De­partment of Surgery, has been awarded aone year research grant from the Ameri­can Cancer Society in the amount of$66,000, effective January I, 1975, tosupport "Cell Transformation andCancer."Elwood V. Jensen, Professor and Di­rector of the Ben May Laboratory, Di­rector of the Biomedical Center forPopulation Research, and Professor inthe Department of Biophysics andTheoretical Biology, received a one-yearresearch grant in the amount of $73,250,effective December I, 1974, to supportthe "Role of Estrogen Receptors inHormonal Control of Growth."The Ben May Laboratory for CancerResearch, the Department of Bio­chemistry, and the Franklin McLeanMemorial Research Institute sponsored a lecture November 26 by Dr. ChristianDe Duve, Professor at Rockefeller Uni­versity and 1974 Noble Laureate inMedicine-Physiology. The topic was:"Chemotherapy by Way of Ly so­somes". Dr. De Duve described an ex­perimental technique by which anti­leukemia drugs are chemically bound toDNA from calf thymus.Eugene R. De Sombre (Ph.D. 63),Associate Professor in the Ben MayLaboratory and Research Associate,Biomedical Computation Facilities, pre­sented a paper, "Steroid Receptor Pro­teins and Regulation of Growth inMammary Tissues," at the NationalCancer Institute, September 30, inBethesda. His report was part of theprogram entitled, "A Report to the Pro­fession from the Breast Cancer TaskForce of National Cancer Institute."BiochemistryAppointments:Kan L. Agarwal-Assistant Profes­sor.BiologyStuart A. Altmann, Professor, De­partments of Biology and Anatomy,Committee on Evolutionary Biology andthe College, spoke in December on"Malnutrition and Infant Survival in theBaboon" to Des Moines Alumni of TheUniversity of Chicago.Aaron A. Moscona, Ph.D., the LouisBlock Professor, Departments of Biologyand Pathology and on the Committee onGenetics and the College, and Chairmanof the Committee on DevelopmentalBiology, is editor of "The Cell Surfacein Development," published by JohnWiley and Sons, New York. He is alsoco-editor of Current Topics in Develop­ment, which is issued annually.Arnold Ravin, Professor in the De­partments of Biology and Microbiologyand member of the Committee on Genet­ics, has been awarded a National Sci­ence Foundation Faculty Fellowship fornine months, January 1 to September1975.He is one of 91 recipients of the fel­lowships, established by the NationalScience Foundation in 1974. The pur­pose of the fellowships is to help facultymembers at universities and colleges inthe United States broaden their perspec­tives in science as applied to societalproblems.Biophysics and Theoretical BiologyGrants:The University has received a $13,900grant from the Damon Runyon-Walter Winchell Cancer Fund for Fellowshipsupport for Richard Sheivitz, ResearchAssociate, to investigate the" MolecularBasis of Protein. Nucleic Acid Recogni­tion. "Emergency MedicineDr. Lionel W. Coppleson, AssistantProfessor, Emergency Medicine andPathology and Institute for ComputerResearch, gave papers on the preventionof carcinoma of the cervix in Sydney,Australia and in Florence, Italy at theXI International Cancer Congress.Dr. G. Thomas Evans, Jr., AssistantProfessor, Emergency Medicine, spokeon the "Contract between the Public andthe Health Professional" at the Associa­tion for Hospital Medical Education,Association of American Medical Col­leges, in Chicago, November 15.Dr. Peter Rosen, Director,Emergency Medicine Residency Prog­ram and Professor Emergency Medicinewas appointed to the Scientific Commit­tee for the next national American Col­lege of Physicians conference. He alsomoderated a session at the 1974 Work­shop of the Institute of Medicine ofChicago, November 15 on "The Lawand the New Health Practitioners."The Emergency Medicine Divisionwas notified that its Residency Programhas been approved by the American Col­lege of Emergency Physicians.Seventeen members of the EmergencyMedicine staff attended the annualscientific session of the American Col­lege of Emergency Physicians. The fol­lowing presented papers: Dr. Frank J.Baker II, Assistant Professor: "Diabet­ic Emergencies;" Dr. Lionel Coppleson:"Cardiopulmonary Resuscitation Pro­tocol;" Dr. Beverly Fauman, AssistantProfessor and Director, PsychiatricEmergencies: "Psychosis Induced byPhencyclidine;" and Dr. Peter Rosen,"Drug Overdoses."La RabidaDr. Eugene N. Fox, Associate Pro­fessor, La Rabida Children's Hospitaland Research Center and the Collegeand Research Associate (Associate Pro­fessor), Department of Microbiology, atLa Rabida, has been appointed to athree-year term on the editorial board ofInfection and Immunity. He lectured atthe Fifth Pan-American Conference onthe Study and Prevention of RheumaticFever, Buenos Aires, Argentina. August29-31. On November 13-15 he gave twolectures, "Status Streptococcal Im­munization" and "Streptococcal I n­fection-I mrnunity and Postin fectiou sSequelae", at the symposium on .. Ad­vances in Clinical Pediatrics" at the37Children's Mercy Hospital, KansasCity, Missouri.Dr. Burton J. Grossman (49), Profes­sor at LRUCI and in the Department ofPediatrics, was appointed Senior Medi­cal Consultant at La Rabida. He hadserved the institution for 12 years as itsMedical Director.MedicinePromotions:Dr. Dipankar Sri Das Gupta­Assistant Professor.Dr. Richard Reilly (53)-Professor,Gastroenterology.Dr. Nicholas Vick (65)-AssociateProfessor.Dr. Robert M. Bennett, AssistantProfessor of Medicine and Director ofthe Rheumatology Service Laboratory,initiated a new Rheumatology Clinic atSouth Suburban Hospital, East HazelCrest, in co-operation with thedepartment's rheumatoid disease unit.Aiding Dr. Bennett in providing theonce-a-month consultation service at thenew clinic are Dr. John Skosey (61), As­sistant Professor; Dr. Leif Sorenson,Professor; and Dr. Dennis J. Levinson,Instructor, (Neurology).Drs. Bennett and Levinson presenteda videotape and discussion on "CurrentConcepts in Diagnosis and Management'of Rheumatoid Disease" at the Ameri­can Medical Association's 28th ClinicalConvention in Portland, Oregon, De­cember 2.Dr. Leslie De Groot, Professor in theDepartments of Medicine (Endocrinol­ogy) and Radiology, is featured in theFilm, "Thyroid Today: An EndocrineUpdate," shown at the DecemberAmerican Medical Association meeting.Dr. Rose Engel is a general physicianin the University Health Services on apart-time basis. She was formerly in theDepartment of Anesthesiology.Hiroshi Fukura, a leading world ex­pert on mitochondrial nucleic acids inmutants of yeast, is a visiting Professorfrom the Laboratore de GenetiqueMoleculaire, Gif-Sur- Yvette, France.He is working with Dr. MurrayRabinowitz, the Louis Block Professorin the Departments of Medicine andBiochemistry, and Hewson H. Swift,Distinguished Service Professor in theCollege and the Committee on Genetics,and Chairman of the Department ofBiology.Dr. Nicholas J. Gross (Ph.D. 70), As­sistant Professor, was a contributing au­thor to the article, "Bronchial BrushBiopsy in Hodgkin's Disease," whichappeared in a winter issue of Chest.Dr. Sumner C. Kraft (55), Professor,spoke on "Gut Immunology: Basic and38 Clinical Aspects," at Washington Uni­versity School of Medicine, October 24.Dr. Richard Landau, Director of theClinical Research Center and Chief ofthe Endocrinology Section, commentedon testosterone therapy for impotence in"Questions and Answers," lAMA, Sep­tember 2 issue.Drs. Thomas J. Layden, Instruc­tor (Gastroenterology); and JosephSchwarz, Senior Research Technician;and J. L. Boyer, Associate Professor;presented a paper at the American As­sociation for the Study of Liver Dis­eases, Chicago, October 29, entitled"Scanning Electron Microscopic (SEM)Evaluation of Models of Cholestasis­Lithocholate Produces a Distinct Injuryto Bile Camalicular Membranes."Dr. Allan L. Lorincz (47), Professorand Chief of the Section of Dermatol­ogy, led a discussion on "Atopic andSeborrheic Eczema" at the meeting ofthe American Academy of Dermatologyin Chicago, December 7 through 12.Colin Morley, Research Associate(Assistant Professor), participated in aSymposium on Clinical Pathology at the26th Congress of Physiological Sciencein Madras, India, November 6 through9. He spoke on "Humoral Regulation ofMammalian Tissue Growth and Re­placement. " Dr. Morley also delivered alecture to the faculty of the Institute ofPhysiology and Experimental Medicinein Madras on "Fetal Calf Serum FactorStimulating Ornithine Decarboxylase inMouse Liver."Dr. Ruth Pick, Professor in the De­partments of Medicine and Pathology,and Dr. Gerald Glick, at Michael ReeseHospital and The University of Chicago,reported in Circulation Research,September issue, that high blood pres­sure and a diet rich in fat and cholesterolare dangers to the heart.Dr. John W. Rippon, Associate Pro­fessor (Dermatology) and Research As­sociate in the Department of Microbiol­ogy, has been appointed Editor-in-Chiefof Mycopathologia, a journal devoted toadvances in medical mycology.Dr. Irwin Rosenberg, Associate Pro­fessor (Gastroenterology), is Chairmanof a Food and Drug Administration ad­visory committee on over-the-countersales of vitamins, minerals, andhematicum products.Dr. Charles M. Shapiro (54), ClinicalProfessor, Michael Reese Hospital andThe University of Chicago, and his col­leagues reported in the lAMA, Octoberissue, a discovery whereby a blood testcould determine if a person has been ex­posed to marijuana.Dr. Alvin R. Tarlov (56), Professorand Department Chairman, spoke at the University of Illinois Medical Center,Chicago, October 24, on "Mandates forChange in the Academic MedicalCenter," and at the Association ofAmerican Medical Colleges meeting on"Primary Care by Internists," Chicago,November 11 through 15.Dr. John E. Ultmann, Professor in theDepartment of Medicine and the Frank­lin McLean Memorial Research Insti­tute, and Director of the Cancer Re­search Center, was chairman of a ses­sion on Hodgkin's disease and presenteda paper on "Pathophysiology and Com­plications" at the International Societyof Hematology in Jerusalem last Sep­tember. He also visited the WeizmannInstitute of Science and Ben-GurionUniversity in Israel, and the Universityof Freiburg, and the German CancerResearch Center in Heidelberg.Dr. Ultmann and Dr. Richard K.Desser, Assistant Professor, MichaelReese Hospital and The University ofChicago, were participants in the teach­ing sessions on malignant lymphomas atthe American Society of Hematologymeeting in Atlanta, December 7 through10. Dr. Thomas Deuel, Assistant Pro­fessor, was chairman of a 'session on"Cell Metabolism" at the same meeting.At the 47th Scientific Session of theAmerican Heart Association Meeting inDallas, November 18 through 21, paperswere presented by Dr. Howard Cohen,Assistant Professor; Dr. RichardLangendorf, Clinical Professor; and Dr.Alfred Pick, Professor; all holdingMichael Reese-University of Chicagoappointments. Dr. Harry A. Fozzard,Professor, Departments of Medicine andPhysiology and Co-Chief of the Cardiol­ogy Section, served on the planningcommittee and co-authored a paper on"Effect of Lidocaine on Excitability inShort Segments of Cardiac PurkinjeFibers." Dr. Suzanne Oparil, AssistantProfessor (Cardiology), spoke on "Ef­fects of Ph and Enzyme Inhibitors onApparent Generation of Angiotensin I inHuman Plasma." Dr. Morton F.Arnsdorf, Assistant Professor (Cardiol­ogy), spoke on "Hypertension: Humoraland Chemical Factors."Members of the Liver Study Unit in­cluding Drs. Zdenek Hruban, Professor,Department of Pathology and College;Robert M. Russell, former resident;James L. Boyer, Associate Professor;Seymour Glagov, Professor of Pathol­ogy and the College; and Saeed A.Bagheri, Resident; are, the authors of"Ultrastructural Changes in Livers ofTwo Patients with Hypervitaminosis A"in the American lournal of Pathology,September 1974, and "Hepatic Injuryfrom Chronic Hypervitaminosis A Re-suiting in Portal Hypertension and As­cites" in the New England Journal ofMedicine, August 1974.MicrobiologyThe following doctors were partici­pants in the Second International Sym­posium on Herpesvirus Oncogenesis,sponsored by the International Agencyfor Cancer Research, Nuremberg, Ger­many, October 14 through 16:Bernard Roizman, Professor, De­partments of Microbiology and Bio­physics and Theoretical Biology; theCommittee on Genetics and Chairmanof the Committee on Virology, pre­sented a paper on herpesvirus structureand replication.Bernard Jacquemont, Research As­sociate, presented a paper, "RNASynthesis in Cells Infected with HerpesSimplex Virus; Analysis of HighMolecular Weight and Symetric ViralTranscripts in Herpesvirus InfectedCells." Dr. Roizman was a co-author.Patricia G . Spear, Assistant Profes­sor, gave a paper on "GlycoproteinsSpecified by Herpes Simplex Virus Type1: Their Synthesis, Processing and An­tigenic Relatedness to HSV-2 Glycopro­teins. "Obstetrics and GynecologyGrants:Dr. Marluce Bibbo, Associate Profes­sor, Departments of Obstetrics andGynecology and of Pathology, is thePrincipal Investigator on a contract theUniversity has received from the Na­tional Cancer Institute (NCI) to evaluatethe Pap (Papanicolaou) test for cancer ofthe cervix. The contract is for $77,030for one year.The program is part of the effort ofThe University of Chicago Cancer Re­search Center in the diagnosis andtreatment of cancer. Under the NCIcontract, the Pap test will be studied andmodified for rapid analysis by automatedinstruments. The automated system willinclude a computer system developed byDr. George L. Wied, Blum-Riese Pro­fessor and Acting Chairman in Obstet­rics and Gynecology and Professor inthe Department of Pathology. Dr. Wiedhas developed a method for image proc­essing for the features of cervical smearcells fixed on slides. A microscope scan­ner gives high-resolution multicolor im­ages of cell details, for computer digitalstorage and processing. This scanner hasbeen develped under the contract withNCI. The current level of NCI supportis $120,405 for Dr. Wied's contract.Dr. Bibbo and the other investigatorswill study aspects of the preparation ofspecimens more suited to instrumentanalysis than are present Pap smears. Dr. Uwe E. Freese, Professor, wasmoderator of an annual program spon­sored by the Chicago Lying-in Board ofDirectors, "Sexuality and the MatureWoman" in Chicago, January 21. Otherparticipants on the symposium panelwere Dr. Robert T. Segraves, AssistantProfessor, Department of Psychiatryand Director of the Sexual and MaritalTherapy Clinic, and Dr. Michael New­ton, Professor and Chief of the Oncol­ogy Section.Dr. Newton also was a guest speakerat the following meetings: Third AnnualNorth Central Wisconsin ClinicalCancer Conference, September 21:"Overview of Endometrial Cancer;"Third Annual Regional PostgraduateMeeting in Obstetrics and Gynecology,October 9: "I nfectious, Antibiotics andCancer;" and Second WisconsinMaternal-Infant Conference, October18: "Problems Concerned with theOnset of Labor."Dr. Gebhard F. B. Schumacher, Pro­fessor of Obstetrics and Gynecology,participated in a special meeting on"Local Immunity in the Female GenitalTract" sponsored by the Human Repro­duction Unit of the World Health Or­ganization, Geneva, Switzerland, heldJanuary 6-8. Thirty experts in the field ofimmunology and reproductive biologyfrom 12 nations participated. The pur­pose of the meeting was 1) to review crit­ically the available information on theimmune response in the female genitaltract with emphasis on that of thehuman; 2) to decide what further infor­mation is required for reliably achievinglocal immunity with antigens relative toreproduction; and 3) to make specific rec­ommendations for research in this areato fill the existing information gap.OphthalmologyDr. Frank W. Newell, the James andAnna Louise Raymond Professor andDepartment Chairman, was named pres­ident of the American Academy ofOphthalmology and Otolaryngology atits annual meeting in Dallas, October 6.Dr. Albert M. Potts (Ph.D. 38), Pro­fessor and Director of Research, pre­sented a paper at the Annual Conferenceon the Biochemistry of the Eye held atOakland University, Rochester, Michi­gan, October 10 through 13.The Department of Ophthalmologyheld a series of retina and eye researchconferences in January which were opento all physicians.PathologyDr. James E. Bowman, Professor ofPathology, and Director of the Com­prehensive Sickle Cell Center, presented the following papers on genetics andsickle cell anemia: "Genetics and Race:The Sickle Cell Model," November 26,at the Columbia University Seminar onAfrican Americans; "Diagnostic Chal­lenges of Sickle Cell Screening," De­cember 7, at the Intrascience ResearchFoundation Conference on Sickle CellDisease and Related Hemoglobin Ab­normalities in Santa Monica, California;and" Sickle Cell Trait: Problems in In­terpretations" at the International Sym­posium at Abidjan, Ivory Coast, January26 through 31.Dr. Franka E. Kocka, Assistant Pro­fessor, is the principal author of" PyocinTyping: a Method of CategorizingPseudomonas aeruginosa Cultures" and"The Irisdescent Material andPyocyanin of Pseudomonasaeruginosa," in the annual Transactionsof the Illinois State Academy of Science.Dr. Josephine Morello, Director ofClin­ical Microbiology and Associate Profes­sor, Departments of Pathology andMedicine, is a co-author of "SodiumPolyanethol Sulfonate Sensitivity ofAnaerobic Cocci" in Applied Microbiol­ogy, June 1974.Dr. Ward Richter, Professor, De­partment of Pathology, and Director, A.J. Carlson Animal Research Facility,has been appointed to the Food andDrug Administration's Science Advi­sory Board to the National Center ofToxicological Research.Dr. Donald A. Rowley (50), Profes­sor, Department of Pathology, LaRabida, Department of Pediatrics andDirector of Research at La Rabida, pre­sented a paper on" Feedback Regulationby Antibody," at the joint session of theCentral Society for Clinical Researchand the Central Rheumatism Associa­tion of the Arthritis Foundation inNovember.Dr. Robert Wissler (48), DonaldPritzker Professor in the Department ofPathology and Director of theSpecialized Center of Research inAtherosclerosis, was the William D.Studenbord Visiting Professor at CornellMedical College, October 28 through 31.He presented the annual Studenbord lec­ture on "Progress and Problems inAtherosclerosis Research" and partici­pated in a seminar on "Studies of theI nteraction between Lipoproteins andArterial Cells in vitro" at the PathologyStaff Conference, and in student facultyconferences.Dr. Wissler was a co-author with Dr.Godfrey Getz, Professor, Departmentsof Pathology, Biochemistry and the Col­lege; Dr. Katti Fisher-Dzoga, ResearchAssociate (Assistant Professor); and Dr.Robert Mao-Yuan Chen, Resident; of39"Comparison of the Effects of H yper­lipemic Serum on the Lipid Metabolismof Rabbit Aortic Medial Cells, RabbitSkin Fibroblasts and Mouse L-cell Fi­broblasts" presented at the AmericanHeart Association meetings in Dallas,November 19. At the plenary session ofthe National Conference on Thrombosisand Hemostasis in Dallas, November2 I, Dr. Wissler spoke on "Athero­sclerosis and Lipoproteins."The Pathology Panel of the MycosisFungoides Cooperative Study Groupmet at the Center for Continuing Educa­tion, December 12 and 13. The StudyG roup is an inter-institutional coopera­tive project supported by a NationalCancer Institute grant on mycosis fun­goides. The Pathology Panel was one ofa number of panels set up under thestudy. University participants included:Dr. Henry Rappaport, Professor ofPathology; Dr. Diana Variakojis, Assis­tant Professor of Pathology; Dr. AllanL. Lorincz, (47), Professor and Chief ofthe Dermatology Section in the Depart­ment of Medicine; Dr. Maria Nedenica,Associate Professor, Medicine (Der­matology); Dr. Keyournars Soltani, As­sistant Professor, Medicine (Dermatol­ogy); Dr. Sylvia F. Griem, AssistantProfessor, Medicine (Dermatology); Dr.Edgar M. Moran, Assistant Professor,Medicine (Hematology); Dr. NicholasGross, Assistant Professor, Medicine;and Dr. Melvin L. Griem, Professor,Radiology and McLean Institute. Dr.Stanford Lanberg, Formerly AssistantProfessor in Medicine and now As­sociate Professor of Dermatology atJohns Hopkins, is principal investigatorof the national group. Dr. Lorincz ishead of the Study Group's ClinicalEvaluation Office, and Dr. Moran isprincipal in vestigator of the Un iversity' sportion of the project. It is hoped 35 in­stitutions will eventually participate.PediatricsAppointments:Dr. Yves W. Brans-Assistant Pro­fessor.Dr. Andrew J. Aronson (69), Re­search Fellow in Pediatrics Nephrologyat La Rabida Children's Hospital and inthe Department of Pediatrics, delivereda paper entitled "The Clinical Course ofFocal Segmental Glomerular Sclerosisin Children" at the Third InternationalSymposium of Pediatric Nephrology inWashington, D.C., September 30. Co­authors were Dr. Ronald Kallen, Assis­tant Professor of La Rabida and the De­partment of Pediatrics, and Drs. ChaimLichtig, Assistant Professor, and Ben­jamin Spargo (52), Professor, Pathology.Dr. John D. Burrington, Professor40 and Head of the Pediatric Surgery Sec­tion, presented a paper, "Profile of a Pa­tient at Risk to Develop Neonatal Nec­rotizing Enterocolitis" at the Ross Sym­posium on pediatric research in Phoenix,Arizona, November 10 through 13.Dr. Richard M. Rothberg (58), Pro­fessor of Pediatrics and Pathology (Im­munology Section), is a co-author of"The Lack of Effect to Transfer Factorin Thymic Dysplasia with Immuno­globulin Synthesis" published in Pediat­rics, May 1974.Dr. Samuel Spector, Professor andChairman of the Department of Pediat­rics and Director of the La RabidaChildren's Hospital and ResearchCenter, was Visiting Professor ofPediatrics at the University of Mary­land, Baltimore, November 19 through22. He gave a Grand Rounds discussionon "Failure to Thrive" and a lecture on"Control of Growth". December 5, hegave a Grand Rounds discussion on"Growth Problems" at the Universityof Illinois School of Medicine, Depart­ment of Pediatrics, Peoria.Dr. Frank K. Thorp (60), AssociateProfessor, the Joseph P. Kennedy, J r.,Scholar, and Director of the Mental De­velopment Clinic in the Department ofPediatrics, discussed the "Integration ofNutrition Training for Medical Studentsand Allied Health Personnel" at theAmerican College of Nutrition FirstAnnual Interim Meeting in Chicago,November 16.Dr. Paul S. Weiner, Associate Profes­sor, De partme nts Ped iatric sandPsychiatry, talked on "The Problems ofthe Pre-School Child with LanguageDisorders" at a conference on childrenwith lanauage disorders held atChildren's Hospital of Los Angeles,November I.Pharmacological and Physiological Sci­encesDr. Leon I. Goldberg, Professor, De­partment of Pharmacological andPhysiological Sciences and Medicine,and Chairman, Committee on ClinicalPharmacology, was named a Sesquicen­tennial Distinguished Alumnus of theMedical University of South Carolina,where he received his Ph. D. in 1952.PsychiatryPromotions:Dr. John M. Davis-Professor.Dr. Herbert Y. Meltzer-Professor.Dr. Harry Trosman-Professor.Dr. Daniel X. Freedman, Chairmanand Louis Block Professor, organizedthe program of the Association for Re­search in Nervous and Mental Diseasesin New York, December 6 through 7. He is president of the association. Thetheme of the meeting was "The Biologyof the Major Psychoses: a ComparativeAnalysis." Dr. Freedman led a discus­sion on "Biological Measurements andClinical Events." Dr. Herbert Y. Melt­zer, Professor, and Dr. John M. Davis,Professor, and Vice President of the As­sociation, aided in organizing the pro­gram. Dr. Meltzer discussed"Neuromuscular Abnormalities in Pa­tients with the Major Mental Illnesses"and Dr. Davis discussed "Critique ofSingle Amine Theories: Evidence of aCholinergic Influence in the Major Men­tal Illnesses." Other participants werePhilip Holzman, Professor, Depart­ments of Psychiatry and the BehavioralSciences: "Eye Tracking Abnormalitiesin Patients with the Major Mental Illnes­ses;" and Dr. Harold Klawans, As­sociate Professor, Medicine (Neurology)at Michael Reese Hospital-The Uni­versity of Chicago: "Amine Precursorsin Neurological Diseases and the Psycho­ses. "Dr. Lawrence Zelic Freedman,Foundation's Fund Research Professor,participated in the World Man Work­shop entitled "Focus on Man" in Como,Italy, September 10 through 15. Hespoke on "The Inner City and WorldMan. "Dr. Freedman was made a Fellow inthe Royal Anthropological Institute ofGreat Britain and Ireland and in theWorld Academy of Arts and Sciences.Dr. Charles R. Schuster, Professor inPsychiatry, Pharmacological andPhysiological Sciences, and in the Col­lege, chaired a meeting on "Progress inMethodology of Evaluation of Depen­dence Liability of Drugs" at the WorldHealth Organization, Geneva, Switzer­land, November 4 through 10. He alsodelivered a paper on "The Use of Ani­mal Models in the Study of Drug De­pendence". Co-author is Christ EllynJohanson, Research Associate.Dr. Eberhard H. Uhlenhuth, Profes­sor, is the author of" Symptom Intensityand Life Stress in the City" in the Ar­chives of General Psychiatry,December, 1974. He was quoted in theNovember 26 and 27 Chicago Sun­Times on this subject. Changes infinancial status (and therefore in life­style) cause psychological stress,whether the individual's income in­creases or decreases, he says.RadiologyPromotions:Dr. Jerome J. Brosnan-AssociateProfessor.A scientific exhibit from the Depart­ment, entitled "Detection and Evalua-tion of Localization Error using TherapyVerification Film Technique," receivedan Honoralbe Mention Award at the60th Assembly and Annual Meeting ofThe Radiological Society of NorthAmerica, December 4, in Chicago. Itwas prepared by Arthur G. Haus, Re­search Associate; Drs. James E. Marks,former Assistant Professor now atWashington University, St. Louis; Mel­vin L. Griem, Professor; and KurtRossmann, Professor.The following presented papers at thismeeting: Kunio Doi, Associate Profes­sor; Dr. Harry K. Genant, formerly As­sistant Professor and now at Universityof California at San Francisco; and KurtRossmann; presented "Comparison ofImage Quality in Optical and Radio­graphic Magnification Techniques forFine-Detail Skeletal Radiography;" Ar­thur G. Haus; Dr. John T. Chiles (69),former Assistant Professor now at theOhio State University Columbus, Ohio;Kunio Doi; Kurt Rossmann; andCharles E. Metz, Assistant Professor,presented "The Effects of GeometricU nsharpness, Recording System U n­sharpness and the X-Ray Spectrum onImage Quality in Mammography."Dr. Melvin L. Griem's clinical ex­perience with radiation treatment ofmycosis fungo ides was reported in theSeptember 23, issue of fA MA. The arti­cle entitled, "Cell Kinetics and CancerTherapy," stated that when patientswith advanced mycosis fungoides wereinjected with colchicine, optimal effectsfrom therapeutic radiation were obtained16 hours after injection.SurgeryGrants:Two grants have been awarded to Dr.Warren E. Enker, Assistant Professor:$109,625 from the National Cancer Insti­tute for active-specific immunotherapyof experimental colon cancer, and$13,500 from the American Cancer Soci­ety for the development of an in vitroassay of cellular immunity for the MorrisHepatoma system.Dr. C. E. Anagnostopoulos, As­sociate Professor in Surgery (Cardiol­ogy), at the World Congress of Cardiol­ogy in Buenos Aires, September, 1through 7, presented two motion pic­tures, participated in two panel discus­sions and presented a paper on a newexperimental technique of transpositionof the great vessels. He also lectured atthe University of Athens. As a result ofthese trips he has been invited to lectureat the Universities of Bombay, BuenosAires, Paris, and Athens.Dr. George E. Block, Professor, pre­sented two films as part of the Cine Clinic Program, entitled "One StageTotal Proctocolectomy for UlcerativeColitis," and "Emergency Colectomyfor Toxic Megacolon" at the AmericanCollege of Surgeons Sixtieth AnnualClinical Congress, Miami Beach, in Oc­tober.Dr. John D. Burrington, Professor ofSurgery and Chief of Pediatric Surgery,Wyler Children's Hospital, was chair­man of the Ross Symposium on Pediat­ric Research, Phoenix, November 10through 13. He gave a paper on "Profileof Patient at Risk to Develop NeonatalNecrotizing Enterocolitis." He alsospoke at the meeting of the Western Sur­gical Society in San Francisco,November 20 through 24, on "Recto­Vaginal Separation Procedure for Girlsafter a Cut-Back Procedure for Anorec­tal Anomalies."Dr. Warren E. Enker has beenawarded a Junior Faculty Clinical Fel­lowship of the American Cancer Societyand has been elected to membership inthe Frederick A. Coller Surgical Societyof Sigma Xi. He is also an initiate of theAmerican College of Surgeons.Dr. Javad Hekmatpanah, AssociateProfessor, Surgery (Neurosurgery), pub­lished "Management of Head Trauma"in Surgical Clinics of North America, anannual publication.Dr. Edwin L. Kaplan, Associate Pro­fessor, and Dr. James A. Schulak (74),Resident, published a paper on"Gastrin-induced Hypocalcemia inThryoparathyroidectomized Rats,"Metabolism, Vol. 23, No. 12, 1974. Dr.Kaplan et al. also published a paper on"Ulcer Disease, Metabolic Alkalosisand Hyperparathyroidism" in Annals ofSurgery, Vol. 180, No.4, October 1974.They gave a paper on "The Stomach: ARegulator of Calcium Homeostasis" atthe Association for Academic Surgerymeeting in Los Angeles, November, 6through 8.Dr. Kaplan presented a paper on"Experimental Acute Pancreatitis: Ef­fects of Thyroidectomy on CalciumMetabolism," at the Society of Univer­sity Surgeons, Tucson, Arizona, Feb­ruary 12 through 17. Co-author is Dr.Hans Norberg, Resident.Dr. Kaplan was recently elected to theCentral Society of Clinical Investigation(Illinois).Dr. John J. Lamberti, Assistant Pro­fessor of Surgery (Cardiology), pre­sented a paper entitled "Reduction ofAcute Myocardial Ischemia byHemodilution with Clinical Dextran" atthe meeting of the Association forAcademic Surgery in Los Angeles,November 6 through 8.Dr. Gerald S. Laros, Professor and Chief of the Section of Orthopedics, wasthe President's Guest Speaker at the an­nual meeting in Honolulu, October 8, ofthe Western Orthopedic Association.His topic was "Fixation in Intertrochan­teric Fractures."Dr. Laros, r». Phillip G. Spiegel, andDr. Louis W. Kolb (62), Associate Pro­fessors in the Section of OrthopedicSurgery, presented a series of lectureson orthopedic problems in Rock Island,Melrose Park, and Harvey, Illinois,sponsored by the Illinois Academy ofFamily Practice. Similar programs areplanned during the year at four other lo­cations in Illinois.November 26 Dr. Laros moderated aprogram on "Musculoskeletal Trauma"at Evanston Hospital, sponsored by theAmerican College of Surgeons, ChicagoTrauma Committee.Dr. Daniel Paloyan (64), AssistantProfessor, presented a paper on "AcutePancreatic Ascites" at the 15th An­niversary Meeting of the Halstead Soci­ety at the Johns Hopkins University,School of Medicine, September 21. Co­author of the paper is Dr. David B.Skinner.Dr. Robert Replogle, Professor(Pediatric Surgery), participated in theAmerican Academy of Pediatrics annualmeeting, San Francisco, October 19through 23. He spoke on "Surgical Con­siderations and Techniques."Dr. David B. Skinner, Chairman andDallas B. Phemister Professor, Depart­ment of Surgery, delivered the annualGeorge A. Stewart Memorial Lecture atSt. Agnes Hospital, Baltimore, Mary­land, December 6, on "Management ofBenign and Malignant Esophageal Stric­tures." Recently he was elected a direc­tor of the American Board of Surgery,and the representative on the Board ofthe Society of University Surgeons. Healso became a member of the AmericanSurgical Association.Dr. Skinner was named by theChicago Sun-Times among leaders 10America under the age of 45.Section of OtolaryngologyGrants:Dr. Raul Hinojosa, Research As­sociate (Associate Professor), wasawarded a $57,774 grant from the Na­tional Institute of Health to support"Electron Microscope Studies of theVestibular System."Dr. Ralph F. Naunton, Professor andHead, Section of Otolaryngology, wasawarded $229,798 from the National In­stitute of Health to support a "SensoryDisease Clinical Research Center."Dr. Naunton presented a paper andfilm, "Electrocochleography," and41chaired a panel on "Longitudinal StudyPrograms" at the International Confer­ence on Infant Hearing Testing, Halifax,Nova Scotia, September 8 and 9.Robert Butler, Professor of Surgery(Otolaryngology), was named Presi­dent-Elect of the Association for Re­search in Otolaryngology at its October4 through 10 meeting in Dallas.The following members of the Sectionpresented papers at the meeting: Dr.Robert Butler; Dr. Anthony Geroulis,Resident; Dr. Paul Fleming, Resident;Dr. John Lindsay, Professor; Dr. Gre­gory Matz, Associate Professor; Dr.Ralph Naunton; and Dr. Stanley Zerlin,Research Associate.The following members of the Sectionpresented papers at the Chicago Laryn­gological and Otological Society meet­ing, November 4: Dr. Paul M. Fleming:"Surgical Treatment of Benign SinusDisease;" Dr. Russell J. Ord, Resident:"Experience with carcinoma of theParanasal Sinuses at The University ofChicago Hospitals;" and Dr. William J.Powell, Assistant Professor: "The Sur­gical Treatment of Extensive Mucocelesof the Frontal Ethmoid Sinuses."Dr. Fumino Suga, Research As­sociate (Associate Professor), presenteda paper on "Histopathological Observa­tions of Labyrinthitis Ossificans" at theForum Session of the October ClinicalCongress of the American College ofSurgeons meeting in Miami.Stanley Zerlin presented a paper co­authored by Dr. Ralph Naunton on"Threshold Determination by Elec­trocochleography," at the annual meet­ing of the American Speech and HearingAssociation, Las Vegas, November 5.Alumni' News1917William F. Moncreiff retired last Au­gust. He is emeritus clinical professor ofophthalmology at the University of Il­linois and consulting ophthalmologist atPresbyterian-St. Luke's Hospital. Heand Mrs. Moncreiff (Dr. BerthaA. Klein, Ophthalmology faculty1955-1966) moved to 6162 Rafter Circle,Tucson Estates, Tucson, Arizona 85713.A man of many talents, Dr. Moncreiffplays the clarinet and the accordion. Heand his wife swim nearly every day andhe hopes to find time to improve hischess game. Dr. Moncreiff was chair­man of ophthalmology at Rush MedicalCollege and Presbyterian Hospital1930-1942 and chairman of the depart-42 ment of ophthalmology at Cook CountyGraduate School of Medicine1932-1946. Dr. Klien was on the facultyof Rush Medical School and the staff ofPresbyterian-St. Luke's in the 1930's.1929Noel G. Shaw, pediatrician in Evan­ston, Illinois, received the first annualFounder's Award given by St. FrancisHospital, Evanston, on October 4.1931Marcus T. Block at 71 is still in prac­tice as a dermatologist and assistant pro­fessor at New Jersey College ofMedicine and Dentistry.1932Julius E. Ginsberg, in June becameprofessor emeritus of NorthwesternUniversity Medical School. He receivedspecial commendation and a plaque pre­sented by Dr. S. M. Bluefarb, chairmanof the Department of Dermatology. Dr.Ginsberg now lives at 5369 Algarrobo,Apt. 3d, Laguna Hills, California, 92653.Nathaniel E. Reich was promoted toclinical professor of medicine at StateUniversity of New York, DownstateMedical Center. Last year he served asvisiting professor at the University ofAfghanistan, University of Indonesia,and the University of San Marcos inLima, Peru.1933Clarence W. Monroe retired last Sep­tember as a plastic surgeon in Oak Park,Illinois and is now living at 400 RobinRoad, Waverly, Ohio 45690.1936Elizabeth F. Gentry of Austin, Texas,retired October 1 as Deputy Director ofthe Austin-Travis County Health De­partment after 30 years of public healthservice. Five of those years were spentwith the State and 25 with the localhealth department. Prior to this she wasin private practice for five years. Herhusband is Dr. George Gentry, (Ph.D.31.)1937Jacob S. Aronoff writes he is stillspending about seven to eight monthseach year in practice and teaching at Mt.Sinai and Montefiore Hospitals. The restof the year is spent in travel throughoutthe world and work with his colleaguesin facial esthetic surgery.Eli L. Borkon, professor of medicineand assistant dean at Southern IllinoisUniversity School of Medicine, saysUniversity of Chicago alumni wereamong the founding faculty of the school. They include Richard H. Moy(57), dean and provost; William Kabisch(Ph.D. 54; Anatomy Faculty 49-62), ex­ecutive associate dean; Terence An­thony (68), assistant professor, and DonBrowning (Ph.D. 64), assistant profes­sor.Charles H. Rammelkamp, professorof medicine at Case Western ReserveUniversity, Cleveland, was elected amember of the National Academy ofScience.1938Herman Serota has moved to La Jolla,California where he is a training andsupervising analyst with the new SanDiego Psychoanalytic Institute. He isalso in private practice. He is acouncillor-at-Iarge of the AmericanPsychoanalytic Association and chair­man of its Committee on Liaison withthe American Association for the Ad­vancement of Science.1939Robert Warner, medical director ofthe Children's Rehabilitation Center ofBuffalo for 19 years, received the Man ofthe Year Award from the Greater Buf­falo Advertising Club for building theCenter into one of the Country's out­standing facilities and for his "unselfishand untiring leadership".1940Roland C. Olsson, semi-retired, isworking part-time as a physician in in­dustrial medicine at the constructionequipment plant of International Har­vester in Melrose Park. He is enjoyinghis place in the country (Spring Grove,Illinois) where he is learning vegetablefarming and horticulture.1941Owen C. Berg after twenty-five yearsas a urologist in Wichita Falls, Texas,has moved to 125 Pennsylvania Drive,Denton, Texas 76201. He will continuehis practice there.1942Richard B. Berlin of Teaneck, NewJersey, says that Richard, Jr. is servingas an intern in the Central Hospital ofthe Negev, Israel.Harvey Blank, professor and chair­man of dermatology at the University ofMiami School of Medicine, was honoredby his University recently. The HarveyBlank Study Room, the first of severalstudy chambers in the Louis CalderMemorial Library, was named after him.At the ribbon-cutting ceremony, a bustof Dr. Blank was unveiled. In an earlierceremony, Dr. Blank was awarded theArmy's Surgeon General's "Outstand­ing Civilian Service Medal" in recogni­tion of his 15 years of service as an Armyconsultant on skin disease.1943David Minard retired August, 1973.He is professor emeritus of occupationalhealth, Graduate School of PublicHealth, University of Pittsburgh. Hecontinues to live in Pittsburgh at 7 Al­legheny Center, (Zip Code 15212).1944Hugh A. Frank in July was appointedassociate clinical professor, departmentof surgery, at the University of Califor­nia at San Diego School of Medicine,and director of the Regional BurnTreatment Center at University Hospi­tal at San Diego.Robert Jamplis, of Palo Alto, Califor­n!a was presented the prestigious SilverAnniversary award by Sports Illus­trated. Dr. Jamplis serves as teamphysician for the Stanford football teamin addition to being executive director ofthe Palo Alto Clinic where he is athoracic surgeon. In September, he be­came the 25th president of the AmericanGroup Practice Association. He partici­pated in an HEW "mini-summit" con­ference on health care inflation, aforerunner to the White House meetingon inflation September 27 and 28.1947Irving Rozenfeld (Pediatrics 1 ntern­Resident 48-51) is Chief of the Section ofNeurology in the Department of Pediat­rics of Michael Reese-University ofChicago Pritzker School of Medicine.His son David is a senior in the PritzkerSchool of Medicine.Edyth Schoenrich joined the faculty ofthe Johns Hopkins University School ofHygiene and Public Health in Decemberas a professor in the department of pub­lic health administration.1948Winslow G. Fox and Mrs. Fox (PhB48) spent two weeks in Honduras withthe Christian Medical Society lastMarch. In September, some of the vil­lages where Dr. Fox had served as amedical missionary were wiped out bythe devastating hurricaine. Dr. Fox is afamily physician in Ann Arbor.Ernst R. Jaffee "retired" to his formerpost as head of the division of hematol­ogy in the department of medicine at Al­bert Einstein College of Medicine afterserving two and a half years as actingdean. He continues to play an adminis­trative role as senior associate dean. 1950Attallah Kappas, professor and seniorphysician at The Rockefeller University,New York, was named physician-in­chief of The Rockefeller UniversityHospital, effective last October. Dr.Kappas is the fifth in this post in theUniversity's 73-year history. Dr. Kap­pas also holds joint appointments as pro­fessor of medicine and pharmacology atthe Cornell University Medical Collegeand has headed the Division of Clinicalpharmacology in the department ofmedicine at Cornell since 1972. Dr.Kappas has been on the Rockefeller fa­culty since 1967. Before that, he was onthe faculty of the Department ofMedicine at the University of Chicagofrom 56 to 66.1951Harold M. Malkin of Palo AltoCalifornia is the president and medica'idirector of MMLISoiano Laboratories,the largest medical laboratory in North­ern California. In his spare time he iswriting a book on the history of clinicalpathology and says, "it will take the restof my life, since the field moves morerapidly than I write." He has remarriedand his new wife is Sonja Sandeman, aSan Francisco criminal attorney. Theyare parents of a new daughter, Dinah,who was four months old in December.Clyde G. Miller of Tucson, Arizona,has been deputy director of the SouthernArizona Mental Health Center and Di­rector of its walk-in clinic since June,1972.1952Donald F. Tapley, professor ofmedicine, was named dean of the Co­lumbia University Faculty of Medicinein September. He is the 18th head ofColumbia's 207 year old College ofPhysicians and Surgeons. He becameacting dean of the Faculty of Medicine ayear ago. He has been associated withColumbia since 1956. A pioneer inthyroid hormone research he was thefirst to observe that the hormone thyrox­ine has a direct effect on mitochondria.Dr. Tapley Dr. Kappas1953Robert M. Edwalds, of the LaCrosse,Wisconsin County Comprehensive Dis­ability Services, has assumed the posi­tion of medical director.1955John R. Benfield was a guest of theJapanese Association for ThoracicSurgery last November. He deliveredthe special lecture at the Association'sannual meeting on the subject of "LungTransplantation-Past, Present and Fu­ture." Following this, he was visitingprofessor at the Chiba University Schoolof Medicine and at Osaka University.Before returning home to the Universityof California at Los Angeles, he partici­pated in the XI International CancerCongress in Florence, Italy, and servedas visiting professor at the University ofGroningen in The Netherlands.Richard A. Katzman is in full timeprivate practice of internal medicine inCleveland, Ohio. He teaches part time atCase Western Reserve Medical Schoolwhere he is assistant clinical professor ofmedicine. He and his wife (the formerRoberta Brown) have four children.1956Selwyn J. Pereira has been appointedassistant professor of clinical psychiatryat the Medical School of the State Uni­versity of New York at Stony Brook.1957Robert E. May has recently becomedirector of the department of urology atGermantown Hospital, Philadelphia.1958James M. Huffer has a new surgicalpractice in Madison, Wisconsin at 2704Marshall Court, Madison 53705.John T. McEnery is serving as vice43president of the Chicago Pediatric Soci­ety.Zane D. Parzen is president elect ofthe San Diego Psychoanalytic Societyand is on the faculty of the San DiegoPsychoanalytic Institute.A. Yvonne Russell is director of theDepartment of Medical Institutions ofSanta Clara Valley Medical Center, SanJose, California. She formerly was as­sociated with the Division of PublicHealth in Dover, Delaware.1959Berle Barth, medical neurologist, wasselected for "Who's Who in the West",14th and 15th editions, and "Who's Whoin America", 38th edition.William B. Lloyd is medical directorof Martin Luther King Hospital in theBronx, New York.Wu Tsuan Wong was elected chief ofthe department of pediatrics at Los Ro­bles Hospital in Thousand Oaks,California.1960Donald Cannon has moved from VanNuys, California to Houston, Texas tobe chief of pathology at the University ofTexas Medical School in Houston.Norman Rozansky is an ophthal­mologist in private practice in SanDiego. He is also assistant clinical pro­fessor in the department of surgery at theUniversity of California at San Diego.1961Milan John Packovich is in privatepractice of internal medicine andtherapeutic nutrition at 3032 WestStreet, Weirton, West Virginia 26062.1963Harold N. Bass, pediatrician atKaiser-Perrnanente Medical Center inPanorama City and at U.C.L.A. Medi­cal Center, has been appointed byMayor Thomas Bradley of Los Angelesto the Mayor's San Fernando ValleyAdvisory Committee.1966Gary Goldstein has been an assistantprofessor of neurology and pediatrics atthe University of California at San Fran­cisco since July, 1973.R. Wes Keller has been appointed as­sistant professor at the University ofUtah. He also is co-director of the G- ITraining Program at the V.A. Hospitalin Salt Lake City.Ronald J. Krone is assistant professorof medicine at Washington University inSt. Louis and director of the cardiaccatheterization laboratory at JewishHospital. He recently was made a Fel-44 low of the American College of Cardiol­ogy.Norman Leaf has opened an office inBeverly Hills, California at 436 NorthRoxbury Drive, 90210, in plastic and re­constructive surgery. He also joined theU .C. L. A. faculty as a clinical instructorin plastic surgery.1968William A. Ehlers is a child psychiatryfellow in his final year of residency at theUniversity of Oregon Medical School inPortland.1970Joseph S. Dickstein was chief residentin obstetrics-gynecology at H uey P.Long Memorial Hospital and TulaneUniversity. January 1, he entered pri­vate practice with the Group HealthCooperative of Puget Sound, Seattle,Washington.Joseph Gatewood completed twoyears with the U.S. Air Force in Col­orado Springs as a general medicalofficer. In July, he began a residency ininternal medicine at McGill University,Royal Victoria Hospital, Montreal,Canada. His son, Medley O'Keefe, wasborn with dual citizenship in July.As of December 1, Roxane McKay isstudying at The Hammersmith Hospital,Du Cane Road, London W12 England.Reed C. Rasmussen is stationed atScott Air Force Base, Illinois 62225. Hebegan a family practice residency inJuly.1971Ronald M. Klar received a special ci­tation and $1,000 award from the De­partment of Health, Education and Wel­fare in July for "outstanding contribu­tions to the formation of the President'sproposal for a comprehensive health in­surance plan and the development of de­partmental policy for the end-stage renaldiseases program of medicare.David B. Martin, after serving as a Lt.Commander in the U .S.P.H.S. for theCoast Guard in Traverse City,Michigan, became a first year fellow inthe department of medicine at the Cleve­land Clinic. He and his wife, Cathie, anddaughter Kate, are living at 3701 Men­low Road, Shaker Heights, Ohio 44120.Gordon Telford is stationed in theSurgeons Office of the Recruiting Com­mand of the U.S. Army at Ft. Sheridan,Illinois 60037. At the annual meeting ofthe Midwest Surgical Association he re­ceived the award for the best resident'spaper. His subject was "Enhancementof Small Bowel Transplants in Rats." 1972Robert L. Chevalier was awarded theLouis Welt Fellowship for post-doctoralresearch in renal physiology in the de­partment of medicine, at the Universityof North Carolina School of Medicine,Chapel Hill, to begin August, 1975. Hewill be studying acute renal failure usingmicropuncture methodology in thelaboratory of Dr. Carl W. Gottschalk.Louis Constan is chief resident in afamily practice residency at the Saginaw(Michigan) Cooperative Hospitals. Hewill begin a practice in family medicinein July.William A. Lamb is a fellow in pediat­ric pathology at St. Christopher's Hospi­tal for Children in Philadelphia.1973Congratulations to Elizabeth Reid andArlen Holter who were married in Bos­ton on November 9. They are continuingin their residencies at MassachusettsGeneral Hospital.Jeffrey David Semel was awarded the"Dr. Will F. Lyon Award" as one of theoutstanding interns at Rush-Pres­byterian-St. Luke's Hospital, 1973-74.Former StaffRichard Albin (Ph.D. 71; Intern 67;Surgery Resident 70) completed a gen­eral surgery residency at Beth IsraelHospital, Boston, and is now chief, sur­gical services, at Loring Air Force Base,Maine. When he leaves the military in1976, he plans to do a plastic surgery re­sidency at the University of Virginia atCharlottesville.Michael Bihari (Pediatrics Intern­Resident 66--69), a pediatrician in Yon­kers, New York, is a member of a newinnovative family oriented health teamset up in Yonkers. It was establishedunder the auspices of Montefiore Hospi­tal Medical Center and the Institute forHealth Team Development to demon­strate the viability of a team orientedmedical practice.Gail B. Broberg (Anesthesiology Re­sident 46-48) is in general practice withthe North Eastern Medical Group, Inc.,Los Angeles.Paul C. Bucy (Neurosurgery Residentand Faculty 28-41) delivered the firstSnodgrass Lecture at the University ofTexas, Galveston. The lectureship inneurosurgery was established by formerresidents of Dr. Samuel Snodgrass, theAshbel Smith Professor Emeritus ofSurgery at the University of Texas.November 21 and 22. Dr. Bucy was avisiting professor at The University ofMississippi Medical Center and guestspeaker at the Mississippi NeurosurgicalSociety. Dr. Bucy is editor of SurgicalNeurology.James L. Burks (Obstetrics andGynecology Resident-Faculty 59-74)became associate professor in the de­partment of obstetrics and gynecology atRush-Presbyterian-St. Luke's MedicalCenter, Chicago, January 1.Hugh Carmichael (Psychiatry Faculty35-43) of Washington, D.C., retired lastJune after seven years as director of theOffice of Continuing Education forPsychiatrists, American Psychiatric As­sociation. He has been selected to re­ceive the Vestermark Prize for his con­tributions to psychiatry in the area ofcontinuing education. He will present apaper at the annual American Psychiat­ric Association meeting next May andreceive a plaque and $500 honorarium.Arnold Case (Obstetrics and Gy­necology Assistant Professor 66-69) re­cently joined the medical staff of Hamp­den County Gynecologists and Obstetri­cians, Inc., Springfield, Massachusetts.He formerly was assistant director of thedepartment of obstetrics and gynceologyat Hartford Hospital, Connecticut.John N. Chappel (Psychiatry Resident65-67; Assistant Professor 68-74) is pro­fessor of psychiatry at the University ofNevada School of Medical Sciences.William G. Couser (Medicine Assis­tant Professor 72) has been awarded a$155,500 research grant from the U.S.Public Health Service for work at Bos­ton University Medical Center where heis assistant professor of medicine. Histhree-year study, entitled" ImmunologicMechanism of Glomerular Injury", willexamine antibodies to find out how theyinduce glomerulonephritis.Paul S. Fox (Surgery Intern 68) isstationed at Andrews Air Force Base,Washington, D.C.Mildred L. Geiger (Intern 49) hasbeen elected chief-of-staff of CommunityMemorial General Hospital, La Grange,Illinois. She also is assistant professor atRush Medical College.Alexander Gottschalk (RadiologyResident-Faculty 59-74; Chairman; andDirector of the Franklin McLeanMemorial Research Institute) left TheUniversity of Chicago September I tobecome chief of the section of nuclearmedicine at the Yale University Schoolof Medicine.Joel R. Husted (Medicine Intern­Research Associate 45-47) has discon­tinued practice after 24 years at theBoulder Medical Center as aninternist-endocrinologist. He hasformed his own company and is editor­publisher of M.D. (Medical Discus­sions), 3870 Spring Valley Road, Boul­der. The company provides detailed medical information in nontechnical lan­guage for lay audiences.Victor V. Kitt (Otolaryngology Res­ident 70--73) has entered private practicein Elgin, Illinois. Following his resi­dency and a fellowship in ear surgery atthe Eye and Ear Hospital in New York,Dr. Kitt worked with the U. S. PublicHealth-Alaska Native Medical Center inAnchorage.Harry J. Lowe (Anesthesiology Pro­fessor 66-74; Chairman 71-74) hasmoved to Downey, California and ispracticing at Rancho Los Amigos Hospi­tal.Richard Mark (Psychiatry Resident68) is assistant director of NuclearMedicine-Health Science Center atWinnepeg, Manitoba, Canada.Daniel J. Pachman (Pediatrics In­structor 34-40) was re-elected chairmanof the Illinois Pediatric CoordinatingCouncil for 75-76. Dr. Pachman is pro­fessor of pediatrics at the University ofIllinois and at Rush Medical College.Jack R. Pickle man (Surgery Resident67-73), assistant professor of surgery atLoyola University Stritch School ofMedicine, was voted outstanding clinicalprofessor for 73-74.Manuel Porth (Surgery Intern­Resident 68-72) is completing an or­thopaedic residency at Walter ReedArmy Hospital. He recently presented apaper on the "Use of Methyl Methacry­late in Fixation of Pathologic Fracturesof Long Bone" at the annual meeting ofMilitary Orthopaedic Surgeons. He andhis wife Diane have two children, Arland Jason.David L. Rabin (Medicine Intern­Resident 58-60) is professor and actingchairman of the department of commu­nity medicine and international health atGeorgetown University School ofMedicine.Henry Rappaport (Pathology Profes­sor 65-74) has been appointed director ofthe department of anatomic pathology atthe City of Hope National MedicalCenter, Los Angeles.Bernard Raxlen (Psychiatry Resident69-71) has been appointed to the Staff ofthe Child Guidance Clinic of GreaterBridgeport, Connecticut, where he willconduct clinical seminars in familytherapy. He is also director of consulta­tion and training at the GreaterBridgeport Mental Health Center, con­sultant and trainer to Fairfield Hills ado­lescent and drug unit, and monthly lec­turer at the Clifford Beers Child Guid­ance Clinic in New Haven. He recentlyhas been appointed assistant clinical pro­fessor at the Yale University School ofMedicine.Richard S. Stein (Medicine Intern- Resident-Fellow 70-74) is assistantprofessor of medicine at the MedicalCollege of Wisconsin.Ramon Sy (OtolaryngologyResident-Instructor 62-65) is presidentof the medical staff of Kaiser FoundationHospital, Honolulu, Hawaii.Graham A. Vance (Pathology Resi­dent 47) of Skokie, Illinois has been re­elected president of the medical-dentalstaff of Holy Family Hospital in DesPlaines. He formerly served as chairmanof the hospital's department of medicineand as chairman of the medical staff cre­dentials committee.Robert M. Walter, Jr. (MedicineIntern-Resident 65-68) is assistant pro­fessor of medicine and endocrinology atthe University of California School ofMedicine at Davis.Association ActivitiesThe Medical Alumni AssociationContinuing Education Cruise to theBlack Sea and Russian Riviera has beencancelled on the advise of the travelagent and the Viking Steamship Line.This decision was based on the uncertaineconomy and the political unrest in thatpart of the world. The Association mayconsider the trip next year if there issufficient interest.Another alumni activity has beenplanned closer to home over the Sep­tember 19-21 weekend to enjoy theMidwest's fall colors. Alumni are invitedto join their friends at Pheasant RunLodge in the beautiful Fox River valley,three miles east of St. Charles, Illinois.The lodge is 45 minutes from Chicago'sloop. Limousine service is available toand from 0' Hare Field and privateplanes may land at adjoining Du PageAirport.Steering committee members, OttoTrippel (46), Henry Russe (57) andHoward Bresler (57), promise somethingfor everyone-bridge and poker games,indoor and outdoor swimming and ten­nis, an 18-hole regulation golf course,horseback riding, skeet shooting, starentertainment in the Pheasant RunDinner-Theater, Dixieland music on theNew Orleans' Bourbon Street, as well asour own entertainment. Details will bemailed later but mark your calendarnow.4546 CALENDARMonday, April 7Reception for alumni and spouses during American College of Physi­cians Meeting, San Francisco, The Stanford Court, Nob Hill, 5:30 to7:30 p.m.Sunday, May 4Chicago Lying-in Hospital Annual Alumni Dinner during AmericanCollege of Obstetricians and Gynecologists Meeting, Boston, SheratonHotel; cocktails at 7 p.m.; dinner at 8 p.m. Spouses invited. Reserva­tions through the Medical Alumni Association office.Friday, May 16Senior Scientific Session, Billings Hospital, P-117, 9:30 to 5:00 p.m.Thursday, June 12Medical Alumni Day: breakfast honoring Century Club members,scientific program, luncheon honoring Distinguished ServiceAward recipients and Class of 1925, evening banquet honoringthe graduates, reunion classes, Gold Key recipients, McClintockaward winner.Reminder to alumni in classes 1940, 45, 60, and 65: If you are in­terested in holding a reunion, write to the Medical Alumni Office,1025 E. 57th Street. The classes of 1950 and 1955 are makingplans for reunions.Friday-Sunday, September 19-21Fall weekend at Pheasant Run Lodge, St. Charles, Illinois (see Associa­tion Activities).Medicine on the MidwayThe University of ChicagoThe Medical Alumni AssociationThe Pritzker School of Medicine1025 East 57th StreetChicago, Illinois 60637•Address corrections requestedreturned postage guaranteed The Jose negenstein LibrarySerial R ords Department, Room-2221100 Ea 57th streetChicago, Illinois 60637 NON-PROFIT ORG.u.s. POSTAGEPAIDPERMIT NO. 9666CHICAGO, ILL..,