Medicine on the Midway Vol. 31 No.1Bulletin of the Medical Alumni Association The University of ChicagoDivision of the Biological Sciences and The Pritzker School of Medicine�,I.r,'.,�T hewill of Dr. F. W. Cumming, aScotsman who died in 1725, left 600pounds to the Royal Infirmary inEdi nburgh to provide poor patientswith snuff and tobacco.Your bequest to The University's PritzkerSchool of Medicine may not be used toprovide patients with snuff and tobacco, butit will have an extraordinary impact onresearch, teachi ng, and patient care foryears to come. For more information about wills andtrust plans at The University of Chicago,contact:The Medical AlumniAssociationThe University of Chicago1025 East 57th StreetChicago, Illinois 60637Telephone: (312) 947-5443Cover: Main entrance to The University of Chicago Clinics.Medicine on the MidwayVolume 31, No.1 Summer 1976Bulletin of the Medical Alumni Association of The University of Chicago Division of the Biological Sciences andThe Pritzker School of Medicine.Copyright 1976 by the Medical Alumni AssociationThe University of ChicagoEditor: Jay Flood KistContributing Editor: James S. SweetPhotographer: Mike ShieldsChairman Editorial Committee: Robert W. Wissler (' 48)Medical Alumni AssociationPresident: Asher J. Finkel (' 48)President-Elect: Charles P. McCartney ('43)Vice President: Joseph H. Skom ('52)Secretary: Francis H. Straus II ('57)Director: Katherine Wolcott WalkerCouncil MembersHoward L. Bresler (' 57)Richard H. Evans ('59)Sumner C. Kraft ('55)Donald A. Rowley ('50)Randolph W. Seed ('60)Benjamin H. Spargo ('52)Otto Trippel (' 46) ContentsReport from the DeanDr. Daniel C. Tosteson 4Vice Presidents for Medical Center Appointed 6Pritzker School of Medicine Among Top Ten 8Nursing Grand Rounds 8Zenaida Corpuz, R.N.Psychiatric Research: Ethical and Legal Concerns 10Dr. Burr EichelmanSenior Scientific Session 13Clinical Nutrition in the Highlands of GuatemalaDr. Noel Solomons 24Great Expectations: 1976 Medical Alumni Day 28Profile of the New Alumni President 34Residency Assignments-1976 37News Briefs 38In Memoriam 43Departmental News 45Alumni News 513Report from the DeanDr. Daniel C. TostesonOne year has elapsed since I came to The University ofChicago as Dean of the Division of Biological Sciencesand The Pritzker School of Medicine. During this time Ihave had the opportunity to become familiar with manyof the facets of the institution. In this report, I describesome of my impressions as well as some of the significantdevelopments which have occurred during the past year.Administrative ReorganizationOne of my first tasks was to study the administration ofthe Division and the medical school to determine an effective mode of administration for the next several years.Upon reviewing the diverse but interconnected activitiesof the Division-including research; undergraduate,graduate and continuing education through the College,the Division and The Pritzker School of Medicine; delivery of primary, secondary and tertiary medical carethrough the Hospitals and Clinics; and interactions between the Division and a variety of public and privateagencies involved in health care as a nationalenterprise-it became evident that a different kind of relationship between the Division, the President's office,and the Board of Trustees would be desirable. To thisend, the title and responsibilities of the Dean have beenexpanded to reflect a new role as Vice President of theUniversity for the Medical Center.As Vice President, I report directly to President Wilson on matters relating to the delivery of health care andthe financial and business management of the MedicalCenter, and as an officer of the U ni versity I attend meetings of the Board of Trustees. With regard to academicaffairs, I continue to report to the Provost in the capacityof Dean. This arrangement brings my office into moremeaningful regular contact with the Board and the President, and makes the administration run more smoothly.As part of the reorganization, four Associate Vice President positions were also established within the Office ofthe Dean- Vice President (see page 6 for further details).Obstetrics and GynecologyAnother major development during the year was the appointment of Dr. Arthur Herbst as the Joseph BolivarDeLee Professor and Chairman of the Department ofObstetrics and Gynecology and Chief of Staff of ChicagoLying-in Hospital. Dr. Herbst was formerly an associateprofessor at the Harvard Medical School, and headed the4 research team that in 1971 demonstrated a link betweenvaginal cancer in young women and the use of DES bytheir mothers during pregnancy. He will provide superbleadership for the University's academic programs in reproductive and developmental biology, and thedepartment's subspecialties in gynecologic oncology,endocrinology, and maternal-fetal medicine.The University of Chicago has been designated as aregional Perinatal Center by the state of Illinois. TheCenter has components both at the University hospitalsand at Michael Reese Hospital, and will contribute to thedevelopment of maternal-fetal medicine by providingspecialized medical services for pregnant women inhigh-risk situations and for newborn infants who requirespecial care.Renovation of Chicago Lying-in Hospital for optimalaccommodation of these important programs is a highpriority, with complete modernization of inpatient areas,operative and delivery facilities and laboratories planned.Cancer ResearchA comprehensive program III gynecologic oncology,drawing on the expertise of Dr. Herbst and the existingdepartmental resources in cytology, computer application and cancer prevention, will become an importantpart of the multidisciplinary research efforts of The University of Chicago Cancer Research Center. The Center,under the excellent direction of Dr. John Ultmann, hasjust been notified by the National Cancer Institute thatits virologic, biologic and clinical cancer research programs have been funded for an additional three-yearperiod effective June 30, 1976. For the first full year ofoperation $1.56 million dollars are available for this research work. Another important stride forward for ourcancer program was the ground breaking, last October, ofthe Kovler Viral Oncology Laboratories, a new facilitythat will house research teams investigating the possibleviral etiology of cancer. The facility is scheduled forcompletion in 1977.NeurosciencesThe appointment of Dr. Barry Arnason as Professor andChairman in the Department of Neurology is an important step in the development of the Department and ofacademic programs in the neurosciences. The institutional decision to form a separate Department of N eurol-ogy was taken in Fall of 1974, when Dr. Jacobson appointed a Committee, chaired by Dr. Arthur Rubenstein,to search for a chairman. The neurosciences, the investigation of the structure and function of the nervous system, is one of the most difficult, challenging, exciting andpromising fields in modem biology and medicine. Theaddition of Dr. Amason to our faculty will strengthen thecapacity of The University of Chicago to cultivate thisfield.Dr. Arnason, formerly an associate professor ofneurology at the Harvard Medical School, is an outstanding neuroimmunologist. He is particularly interested in the application of immunological techniquesand concepts to the study of the nervous system and therole of immunological processes in certain chronic diseases of the brain.Research and treatment of neurological disorders willsoon take place in a facility especially designed for closecollaboration between research scientists and practicingclinicians. The new Surgery-Brain Research Institute isscheduled for occupancy in Spring of 1977, and will include patient care areas, operating suites, laboratoriesand administrative offices. This important constructionproject is supported by the Brain Research Foundationand many other contributors.New Educational ProgramAn innovative four-year program of education in the artsand sciences basic to human biology and medicine hasbeen developed to integrate medicine more fully into thelife of the University as a whole. The program will address the changing relation between medicine and science, and between medicine and the health of the peopleand society's attitudes toward health issues. Scheduledto begin in the Fall of 1977, the new program will be opento students who plan careers in medicine as well as tostudents interested in other health-related fields such asbiology, ecology, and the fields of economics, sociology,anthropology, social psychology, and administration asthey relate to health care. Students will begin the program in their junior year of the undergraduate College,and will continue through the first two years of medical orgraduate school.By including persons interested in careers in medicineand persons with other health-related interests, the program expresses the extent to which the physicians of thefuture must work together with other professional colleagues to solve health problems. Robert U retz, DeputyDean for Academic Affairs, has coordinated the planningof the curriculum and Professor Arnold Ravin haschaired the Steering Committee for the venture. TheCommonwealth Fund of New York has made a $2.8 million grant over the next three years to support the program.Michael Reese AffiliationIn 1969 an affiliation agreement was made between the Michael Reese Hospital-Medical Center and The University of Chicago, expressing the hope that cooperativeeducational and research programs and a coordinatedapproach to the problems of health care delivery wouldpermit both institutions to serve society most effectively.Recently, expressions of concern and dissatisfactionabout the implementation of the agreement have come tome from the members of the professional staffs at bothinstitutions. It is clear that the present state of theaffiliation is unsatisfactory and cannot continue.Accordingly, we are in the process of reassessing therelationship in order to produce either a more fruitfulaffiliation or clear disaffiliation. Five task force groupsare presently at work translating guidelines for effectiveaffiliation into recommendations for amending the present agreement. The amendments will be considered bythe two institutions in the Fall.I hope that the challenge of affiliation will be met, forthe effective coordination and integration of the two hospitals would provide the University's Medical Centerand Pritzker School of Medicine with a context for clinical education of a variety and richness that neither institution could achieve alone. Together, we can contribute more creatively to the design and implementation of aplan for delivering tertiary medical care to the people ofthe south side of Chicago. In an era when health planningwill become increasingly important, it behoovesacademic medical centers to use all of their resourceseconomically and effectively.Challenges to Medicine TodayIn my remarks to the Class of 1976 at the time of theirgraduation banquet, I spoke briefly to the challengeswhich medicine faces today and in the foreseeable future.I called to the attention of the graduating physicians thatthis is, in many senses, a time of trouble for medicine-atime when medicine has been much pilloried and derogated in the press, a time of disparity between the desirefor medical services perceived by the public and thequantity of services which the profession provides, atime of increasing costs and decreasing financial resources, both public and private.But it is also a time of great promise. Never before hasmedicine had so much to contribute to the health andwell-being of people. Never before have the prospects ofmedical science for new insights into the nature of diseases such as cancer and heart disease been so favorable.Never before have the potentialities of productive collaboration between medicine and other disciplines suchas economics, sociology and law for the design of aneffective health care system been so great. The University of Chicago has a distinguished tradition of significantcontributions to the science and art of medicine. Withyour continuing support, we intend to build on this tradition to fulfill as best we can these promises of medicinefor the health of human beings.5Vice Presidents for Medical Center AppointedThe designation of four Associate Vice Presidents withinthe office of the Dean-Vice President for the MedicalCenter has been announced by President John T. Wilson. The Associate Vice Presidents report to Dean- VicePresident Dr. Daniel C. Tosteson, and are responsiblefor the day-to-day operations of the Medical Center.Robert B. UretzDeputy Dean for Academic Affairs of the Division and ThePritzker School of Medicine and Associate Vice-Presidentfor the Medical CenterRobert B. Uretz is the Ralph W. Gerard Professor in theDepartment of Biophysics and Theoretical Biology andin the College. A native of Chicago, Uretz served as aU.S. Army Air Corps meteorologist in World War II. Hereceived his B.S. in physics and his Ph.D. in biophysicsfrom the University in 1947 and 1954 respectively. Hewas an Instructor in biophysics from 1954 to 1957, whenhe became Assistant Professor in biophysics. He wasnamed Associate Professor in 1961, Professor in 1964,and Chairman of the Department of Biophysics in 1966.In 1970 he was named Deputy Dean for the Basic Sciences.Uretz was associated with the late William Bloom ofThe University of Chicago in conclusively demonstratingthe localized damaging genetic effect of radiation on living organisms. He is author of some 50 professional publications, and has conducted research on the radiobiology6 and photobiology of viruses, bacteria, and cells in tissueculture. He is interested in the use of refined opticaltechniques in the analysis of chromosome structure.Associate Vice President for the Medical Center (MedicalServices)Dr. Henry P. Russe is Chief of Staff of the University'sHospitals and Clinics and Professor in the Department ofMedicine. A native of Indianapolis, Dr. Russe receivedan A.B. degree in zoology from Indiana University in1953, and a second A.B. in bacteriology in 1954. He received his M.D. degree with honors from The Universityof Chicago School of Medicine, now the Pritzker Schoolof Medicine, in 1957. He served as President of the Medical Alumni Association in 1975-76.Dr. Russe served his internship and residency at theUniversity from 1957 to 1961, and was a U.S. PublicHealth Service trainee in allergy in 1960-61. He was Instructor in the Department of Medicine, 1961-64, Assistant Professor, 1964-68, and Research Associate (Assistant Professor), 1968-70. In 1961-64 he was a SchweppeFellow in Medicine at the University.From 1973 to 1976, Russe was Vice-President, Internal Medicine, at the Columbus-Cuneo-Cabrini MedicalCenter in Chicago, and was Chief of Medicine there in1968-69 and Chairman in the Department of Medicine in1968-73. He was Associate Clinical Professor ofMedicine at Loyola University in 1968-72, and served asHenry P. RusseAssociate Professor of Medicine in the NorthwesternUniversity Medical School in 1972-76.Dr. Russe is the author of research papers on tuberculosis, the effects of radiation and thymectomy on thebody's defenses against disease, bone marrow transplantation, and kidney transplantation.Associate Vice President for the Medical Center (Businessand Finance)David M. Bray was previously Deputy Associate Director for Economics and Government in the office of Management and Budget (OMB) in the Executive Office ofthe President in Washington, D.C.Bray, a native of Texas, is a 1963 graduate of SouthernMethodist University, where he was President of theStudent Government. In 1963--64, he did graduate workin economics at St. Edmund Hall, Oxford University, ona Rotary Foundation Fellowship. He was a doctoralcandidate and teaching assistant at the University ofMaryland, 1964-66, concentrating in internationaleconomics, public finance, and economic development,and completed all his doctoral requirements but the dissertation.He joined the OMB in 1965 as a summer intern ininternational economics in the Office of Statistical Standards. He was appointed a senior budget examiner in theInternational Programs Division in 1966. He became Assistant Chief for Economic Affairs in 1969, supervisinglegislative, economic, management and organizationalanalysis for international economic programs of the U. S.David M. Bray John J, Piva, Jr,government. In 1973 he served briefly as Special Assistant for Economic Affairs to the Director of the CentralIntelligence Agency.From 1973 to 1976 he was Deputy Associate Directorfor Economics and Government in OMB. In this positionhe was responsible for the formulation and administration of the budget and legislation for Federal financial,economic, administrative, regulatory, and judicial programs. These included the budgeted activities of the Departments of Commerce, Treasury, Transportation, andJustice, and of approximately fifty independent agencies,covering over one-third of executive branch employmentand more than $80 billion in annual outlays.Associate Vice President for the Medical Center (Development)John J. Piva, Jr., joined the University in 1972 as Director of Development for the Division and the medicalschool. He also serves as Executive Director of TheUniversity of Chicago Cancer Research Foundation,which raises funds in conjunction with about a dozenaffiliated organizations through a wide variety of activities. He is in charge of raising funds for the MedicalCenter portion of the University's current $280 millionCampaign for Chicago.Piva is Secretary of the Council for the Division of theBiological Sciences and The Pritzker School ofMedicine. The University's Medical Alumni Associationis under his jurisdiction.A native of Jamestown, R.I., Piva attended De LaSalle Academy in Newport, R.I., obtained his B.A. degree in 1965 from Georgetown University, and tookgraduate courses at Johns Hopkins.From 1965 to 1968 he was Assistant Director of Development and Public Relations at Georgetown, and in1968-72 served as Director of Development for JohnsHopkins School of Hygiene and Public Health.7Pritzker School of Medicine Among Top TenThe Pritzker School of Medicine was named one of thetop ten medical schools in the United States by MedicalEconomics, a nonclinical medical journal with a circulation of 176,000.The schools were evaluated and ranked according tofive categories: ability to attract applicants, the numberand percent of graduates who become medical schoolfaculty members, the amount of research grants from theNational Institutes of Health, which schools produce themost medical school deans and the most board-certifiedspecialists, and the percentage of graduates who pass thestate licensing exams.The University of Chicago placed first in producingmedical school faculty and fifth in producing deans, andwas among the top ten in attracting applicants. It thusearned second place in the listing of the composite bestII schools (three schools were tied for ninth place). Thetop schools, in order, are Harvard, The University ofChicago, Columbia, Johns Hopkins, New York University, the University of Pennsylvania, Cornell, Washington University in St. Louis, Albert Einstein in New YorkCity, the University of Michigan, and the State University of New York (Brooklyn).This list was compared with an earlier survey of deansof graduate schools in medicine and other fields, in whichthe Pritzker School was ranked sixth among the top tenmedical schools. It was one of only five medical schoolsto make both the Medical Economics and the deans'"top ten" lists.Nursing Grand RoundsZenaida Corpuz, R.N.Nursing Grand Rounds is a well-known formula withnew participants. Since February, 1975, nurses at theUniversity's Silvain and Arma Wyler Children's Hospital have met monthly to share and learn from each other'spatient care experiences. The two major purposes, aswith all forms of rounds, are to improve the quality ofpatient care and to enhance the education of nurses andother professionals.Rounds may be all too familiar to health professionalsthese days. Anyone connected with a teaching hospitalhas observed this traditional teaching and patient caregroup activity-the attending physician followed by residents, interns, medical students, and sometimes nurses,examine hospitalized patients. They review medicaldata, discuss laboratory results, look at X-rays, and determine a medical regimen for each patient. Hospital corridors are crowded with groups on medical rounds, surgical rounds, and consultative rounds for each subspecialty. Headnurses, supervisors and directors of nursing8 also make rounds for planning and assessment of patientcare and evaluation of staff performance.Then there is the phenomenon called Medical GrandRounds, a larger interdisciplinary group which meetsregularly to discuss selected patients in the interest offurthering and sharing medical knowledge. The locale ofGrand Rounds is changed from the patient's unit to alarger meeting place to avoid discomfort to the patientand prevent the inconvenience of 30 or more peoplecrowding the hallway. Thought-provoking questions andsuggestions invariably lead to improved medical treatment for the patient.Nursing Grand Rounds also utilizes an actual patient'shistory, bringing the teaching-learning field away fromthe bedside and into the classroom. The emphasis, however, is on the problems involved in the nursing management of that particular patient.Here nurses share what they learn in caring for challenging and difficult patients. They have the opportunityNurses discuss care of pediatric patient.to observe peers demonstrating new techniques and sharing expertise in solving patient problems. They may express controversial ideas without fear of ridicule. In addition, they have a unique opportunity to constructivelyevaluate another nurse practicing the profession of nursmg.The Presentation"Jamie M. is a seven-year-old boy who came to theWyler Emergency Room with severe breathingdifficulties. He was admitted immediately and underwenta course of treatment for a serious asthma attack, including a tracheotomy-an emergency procedure to help thepatient breathe."This preliminary case history acquaints the audiencewith the patient's medical problems, course of treatment,and psycho-social background.The nurse presenting Jamie's case cared for him duringhis entire hospitalization, in the role of primary nurse.Following the case presentation, the panel, including theprimary nurse, a social worker, a school teacher, and arecreational therapist, focused the discussion on thispatient's nursing problem-his non-compliance withnursing and medical regimen."Jamie refused his medications and resisted examinations by house staff and attending physicians. He foughtvigorously when the nurses attempted to clear his airways with suctioning. No amount of praise, explanationor scolding seemed to encourage his cooperation," reported the primary nurse.The discussion that followed highlighted the panel'splanning and application of behavior modification theoryto solve this nursing problem. A scoreboard reward system was devised, and for each task Jamie accomplished,he was awarded a predetermined number of points.When he accumulated a certain number of points, hecould trade them for a prize. This approach made iteasier for the nurses to administer the care he badlyneeded. Jamie's case was presented in hopes that othernurses would find the strategy appropriate in similar situations.Each presentation emphasizes the major problem ofthe case from the nurses' point of view. It can deal with apatient's lack of cooperation, his immobility, bedsores, or a multitude of other problems. There is always a livelydiscussion of each situation and how it was handled. Mistakes, accomplishments and changes to make in futuresituations are aptly considered. Anecdotes about the patient, his family, and staff problems make each participant come alive.Latest research findings and trends in medicine andnursing as they relate to specific problems are also considered in the discussion. The January, 1976 presentation, for instance, dealt with the strange reactions of apatient who, when forced to remain very still in a specialbed, insisted that there were bugs in his body cast. Thesereactions were analyzed and interpreted in terms of thepanel's research into the effects of various forms of immobility, as well as in terms of their direct experience.OrganizationThe Nursing Grand Rounds coordinator is responsiblefor the schedule of presentations for the year. Each nursing unit signs up for a certain date, which allows thenurses enough time to choose the patient whose caseoffers the most interesting problems and to assign participants for the presentation.The coordinator oversees the preparation for each presentation, meeting with the participants at least once ortwice to work out details. She also provides help in preparing audio-visual materials. A week before the GrandRounds, notices are circulated throughout Wyler; attendance is encouraged but not mandatory.Serving as moderator in the panel discussion is anotherof the coordinator's responsibilities. Following eachGrand Rounds program, the coordinator, headnursesand supervisors evaluate the presentation, addressingquestions such as, "To what extent did we achieve ourobjectives?" "How could we improve the presentation?" "Can we further increase attendance?" A comprehensive yearly evaluation influences the program's direction for the following year.EvaluationHow is success measured? With few exceptions, theproject has evoked favorable responses from both recentnursing school graduates and longtime Wyler nursingstaff. The teamwork has fostered closer relationships andbetter understanding among the nurses and other members of the health team.Those who probably benefit the most are those whoparticipate in the presentation. They report that the timespent in preparation-reading, analyzing and evaluatingtheir actions-and during the presentation itself promotes personal and professional development."We hope Grand Rounds will encourage nurses tochallenge one another's actions," says Sister AdelineTrautwein, director of Pediatric nursing. "As nurses assume more responsibility and accountability for their decisions, they will expand this opportunity for professional growth and quality patient care."Zenaida Corpuz is Nursing Grand Rounds Coordinator andClinical Nurse Specialist in the University'S Silva in andArma Wyler Children's Hospital.9Psychiatric Research: Ethicaland Legal ConcernsDr. Burr EichelmanI think the necessity of being ready increases.-Look to it.-Abraham Lincoln in (I letter to GOI'. Curtinof Pennsylvania, April, 1861Clinical research is being seriously challenged on multiple fronts. The ethics of the protocols, the increasinglitigiousness of our society, the conflict of protocols withhealth policy-all are, at worst, raising total obstacles tocertain categories of clinical research and, at best, forcing a time of introspection and reflection upon clinicalresearchers as a group. This essay is posed as onephysician's reflections generated by several years' involvement with psychiatric research in California. I willfocus on examples in three spheres of influence, examples which highlight problems in ethics, law, and healthpolicy. Solutions to these problems will be difficult incoming. Yet, it seems that in order to cope and obtainmastery, the profession must gain some familiarity withthe terrain and begin to take the initiative in the ethical,legal, and health policy forums where final decisions affecting clinical research will ultimately be made.EthicsDebates over the ethics of protocols, recommendationsof the President's Commission for the Protection ofHuman Subjects, and proposed state laws governing research have often become embittered polemics.Influenced by human qualities such as stubbornness anddeceit, or by the lobbying strength of factions involved,these debates can yet be lifted to a more satisfying anduseful plane by considering how the specific issues incontention relate to overarching ethical principles. Iwould suggest that todays clinical researcher is poorlyequipped to examine and defend his protocol accordingto ethical principles such as respect for persons, justice,and responsibility, which have a long and rich social history. Many of the principles have been honored, andsome abused, in the history of medicine.Little is served in a polemic when two sides argue theirissues on the basis of two differing, overarching principles but both are blind to the principles about which theyare arguing. Clearly, the decision about a protocol will bedifferent for one pursuing truth and claiming that this isthe greatest good, than for one who argues that such apursuit defines the research subject as a mere means toan end, dehumanizes him, and oversteps the primaryethical principle of respect for persons.Clinical researchers are lost in this sea of floating principles unless they have taken time to read the works ofcontemporary authors-such as Paul Ramsey, JohnRawls, and Jay Katz-on the subject. The language ofbioethics is no more foreign than FORTRAN or othercomputer languages which medicine learned easily. Our10 Dr. Burr fiche/manresearch community must incorporate the substance ofbioethics just as swiftly and effectively as the adoption ofcomputer technology was accomplished by medical researchers. We need to encourage some of our medicalstudents, postdoctoral fellows, residents and faculty tobecome skilled in bioethics, for they can initiate an examination of the complex, intertwined ethical issueswithin contemporary clinical research. Through theirspecialized training these colleagues may glimpse withkeener perception the crucial ethical principles involvedand yet maintain the critical rules of action necessary forthe scientific method. An example of this germinal initiative is represented by the work of certain members of theAmerican College of Neuropsychopharmacology whodrafted a statement of principles of ethical conduct inpsychopharmacologic research with human subjects.One example of how a research ethicist might be helpful in solving one current problem facing psychiatric research involves the issue of informed consent. Arguments are being proposed that psychiatric patients needadditional protections regarding consent, more so thanother medical patients. These arguments assert that thementally ill cannot understand what is being asked ofthem, and consequently, research should be banned ormarkedly restricted on such patients.An ethicist from within the medical ranks could offerconsiderable assistance on the question of what defines ajust and respectable informed consent for medical experimentation. Further, the bioethicist might wish toconsider the issue of consent in the context of the princi-pie oi respect for persons. He might note that barring thementally ill from participating in research by questioningtheir ability to give informed consent might well causeloss of respect and contribute to their dehumanization.He might compare this with the relatively wide latitudeand freedom, and considerable "respect," which thecourts recognize in an individual's preparation of a will orcontractual agreements. In order to deny these rights to"first class" citizens, society must first institute legalproceedings which limit or remove these rights. Shouldthe mentally ill become "social exceptions," acquiringwithout due process regulations and procedures beyondthose of other members of society? Or should theybenefit from the same due process as other classes ofindividuals in maintaining their social right to consent?If, by special laws, they are denied the right to contract,do they become even more stigmatized as second-classcitizens?This problem need not be postulated only as anarmchair debate. Behavioral scientists should be able todesign experiments which can record how much an individual understands about his informed consent. Mentallyill patients could easily be contrasted with patients awaiting kidney transplants, or awaiting research protocols forleukemia or hypertension. We need to know, empirically,whether there is a difference between the mentally ill andother research populations in the capacity for informedconsent. Then, if it is demonstrated that a difference exists, the issue might justifiably return to due legal processand a legal prohibition to engage in contracts.If mental health researchers and some of their peerstake up the challenge to master the principles ofbioethics, we may find that the policy decisions they generate will strengthen the ethical grounding of clinical research, to the benefit of both patient and researcher. Theright to consent to the partnership of subject and researcher in the pursuit of knowledge may be a rightwhich, according to the principle of respect for persons,should only be denied through due process of law, notrevocable without that process. We could well "look toit. "LawCalifornia has been the state par excellence to demonstrate the current problems of rising malpractice claimsand rates and the frustrated, uncoordinated attempts ofits. physicians to influence state government in alteringthe situation. If the clinical researcher looks far enoughdown the legal road, he should be able to see that thissame problem is only two or three steps away from hisdoor.Let me cite two cases which illustrate problems involving personal injury in psychiatric research. The first casedescribes the problem of direct damages which might accrue from a research protocol.Case I. Hypothetically, six schizophrenic patients consent totreatment with a new major tranquilizer which has passed allappropriate screening tests. During the clinical trials, all sixsubjects develop tardive dyskinesia, an abnormality characterized by involuntary movements of the lips, mouth, andtongue, and at times by choreic movements of the trunk or extremities. One of the subjects is a receptionist or hostesswho will no longer be able to perform her job due to the newdisability.Conceivably, there could be an argument for disabilitycompensation based upon either negligence or incomplete informed consent.The second case illustrates the problem of indirectdamages which might follow from a research protocol.Case 2. A violent patient is placed on an experimental newbenzodiazepine (Valium-like drug) as part of a protocolstudying the usefulness of this drug in violence-prone individuals. Like a small population of others - who manifestparadoxical effects, this subject becomes more violent whileon the drug and injuries a non-participating third party. Thethird party initiates suit against the researcher-physician.If clinical researchers are going to "look to it" in thelegal arena, they might consider several approaches. Oneis the establishment of a program similar to disabilityinsurance and definition of the limits of liability for such aprogram through test cases. Instituting this approach andothers generally requires a united front, collaborationwith the legal community, and political lobbying.Does, or should, the research community favor theinitiation of remuneration for disability which appears tobe a consequence of research medical treatment? Does itfavor a non-litigious Workman's Compensation model?If not, are the research community and its supportinginstitutions prepared to spend precious hours in thecourtroom, away from the core of medicine and research,to argue whether consent was truly informed or whetherthere was negligence in the execution of a protocol? Ifthe general medical community is moving too slowly,shouldn't the research community take the initiative tolobby for medical disability compensation in general, inclusive of subjects on research protocols? An alternativechoice, perhaps, would be the creation of a disabilitysystem just for research subjects. The University ofWashington has begun such a program which covers itsresearch subjects for disabilities sustained during participation in a research protocol.If the research community develops a remunerationsystem for negative consequences of research participation, where will the limits of liability rest (consider, forexample, Case 2, above)? The results of litigation willeventually define the limits of liability. But legal precedent is malleable and reflects the initiative of the litigants.If the research community wishes the scope of compensation to be either large or small, it should begin to examine potential "test cases" which, if won, would setboundaries for such a program. A lawyer selects as histest case one which has the best chance for interpretingthe law as he believes it should be interpreted. Similarly,test cases for research liabilities should be chosen bymedical researchers and their legal counsel in wayswhich place the researcher's liability where he and hisresearch institution believe the initial limits of liabilityshould be positioned.It is less justified to leave these legal issues to othersbeyond the research community than to allow all research computer programs to be designed by non-11medical, non-research computer specialists who possesslimited experience with the organization of data we attempt to treat statistically. We within the profession musttake responsibility and initiative for these issues.Health PolicyAt times, the best interests of research may run contraryto the interests of established patient care. The Community Mental Health Act has attempted to keep the patientnear his community, and not withdraw or sequester him.This community care philosophy has recently been extended in California to mental patients within the criminal system. Under this legislation, individuals adjudgednot guilty by reason of insanity or incompetent to standtrial will usually remain in their own communities ratherthan be sent to major state treatment facilities. Thesedecisions are probably in the best interest of patient careas we know it now, but they pose significant problems forthe mental health researcher. Such community programsmay dictate to clinical researchers that they must cooperate more fully across university and state lines.In the next decade successful clinical psychiatric research may evolve only from cooperative experiments,such as we have seen in many of the collaborativeleukemia studies, for example. This dispersal of the patient population will also place a premium on referrals forresearch. Once again, if the clinical researcher is going to"look to it," he should be prepared to cooperate withreferring physicians in obtaining patients willing to participate in joint research with an investigator. This wouldmean additional follow-up notes to the referring physician, relinquishing of the primary physician role by theresearcher, and other changes of style. The tendrils of a referral network will need to be protected in other ways. Clinical researchers may need tochange the pattern of leaving for a new department anduniversity every four or five years, and instead remain ata single facility for their research career. This wouldmaintain their local referral sources. Funding agencieswill need to be prepared for long-term support of specificresearch programs, transcending the usual three-yeargrant, to assure the viability of a research network basedon fragile and dispersed referrals.In summary, clinical research in general, and psychiatric research in particular, need to prepare from within toremain viable in the face of challenges in ethics, law, andhealth policy. To maintain viability we need to encourageamong our peers the development of skills in these areas,just as we encouraged the acquisition of skills in computer technology. As consultants within the research community, these peers can help clinical research take theinitiative in formulating solutions to the problems whicharise on the ethical, legal, and health policy frontiers ofscience.Or. Burr Eichelman received his S.B. degree from The University of Chicago in 7964, his MD. degree in 7968, andhis PhD. in Biopsychology in 7970. He was a KennedyFeilow in Medicine, Law and Ethics at Stanford Universityfor one year, until July 7, 7976 when he joined the faculty ofthe University of Wisconsin in Madison as Assistant Professor of Psychiatry, Director of a Laboratory of BehavioralNeurochemistry at the University's Waisman Center, andChief of Psychiatry at the Veterans Administration Hospitalin Madison.SENIOR SCIENTIFIC SESSION WINNERSTwo students were honored for their exceptional presentationsat the Senior Scientific Session. They received their awards atthe Medical Alumni Banquet on June 11. The Medical AlumniPrize for the best oral presentation was awarded to David G.Ostrow, who has begun his residency in psychiatry at MichaelReese Hospital in Chicago. The Catherine L. Dobson Prize forthe best oral presentation by a non-Ph. D. student was awardedto James E. Boggan, who is taking his residency in surgery atThe University of Chicago.12Robert J. DinersteinPaul B. KaplowitzGeorge T. ShybutPatrick Beatty Soloman HolmanIvan V. PacoldDavid G. OstrowWilliam K. P. Li Senior Scientific Session"Thank you for sharing the adventures of your mindswith US," said Dean Daniel C. Tosteson to the twentyfour senior medical students (Class of '76) who participated in the 30th Annual Senior Scientific Session onWednesday, May 19. "This program is a full expressionof what the Division of Biological Sciences and this University are all about." Each student presented a paperbased on hisor her research, followed by further analysisand commentary by a chosen discussant. The studentswere sponsored by faculty members.The all-day program, divided into four parts, waschaired by Dr. Tosteson, Dr. Janet Rowley, Dr. HeinzKohler, and Dr. A. R. Moossa. The ArrangementsCommittee included Dr. John F. Schneider, Ph. D.,chairman; Dr. Constantine Anagnostopoulos, GlynDawson, Ph. D., and Dr. Robert Kirschner. The Medical Alumni Association sponsored the session.Fluorescence Spectroscopy Through the Microscope: Some Novel Techniques and ApplicationsRobert J. DinersteinSponsor: Dr. Lloyd J. RothDiscussant: Philip C. Hoffmann, Ph.D.The measurement of many biological and biologically active trace substances by fluorescence spectrometry hasbecome a powerful tool in examining biological systems.Amounts of substances extracted from tissue have beendetermined quantitatively through the measurement oftheir autofluorescence, by the fluorescence of a chemicalderivative, or through immunofluorescence techniques.Relatively inert fluorescing compounds have been usedas passive probes of such biological phenomena as changing membrane structure and intracellular ion flux.If the components of a fluorescence spectrometer areadded to a microscope, then the capacity to quantitateand identify trace substances in tissue can be coupledwith the ability to observe the distribution of such substances microscopically. It has been the intent of ourresearch project to develop such a microspectrofluorometer of maximum sensitivity and flexibility.In addition, we have developed a tissue preparativetechnique employing freeze-dried frozen sectionsso as to preserve the in vivo localization of fluorescing substances on the microscopic level.Application of these techniques has been made to theidentification of cell types in the myenteric plexus of theguinea pig ileum. Cells containing norepinephrine,serotonin and a nonspecific protein have been identified.13Studies in the mechanism of platelet aggregation havealso been carried out. It has been possible, using thechange in chlorotetracycline fluorescence, to monitor intracellular calcium flux as platelets undergo shapechange.Glutamine Extraction and Ammonia Productionas a Test of Renal ViabilitySoloman HolmanSponsor: Dr. J. Laurence HillDiscussant: Dr. Adrian I. KatzNo reliable and easily performed method exists for predicting the functional viability of an organ before transplantation. Heretofore, imprecise parameters have included the duration of ischemia, the gross appearance oforgans, changes in perfusion flow and pressure, oxygenutilization, glucose consumption, lactate production andvital dye studies. With increasing numbers of patientsreceiving artificial renal support, expected to quintupleby 1980, compounded by the continuing decrease in renaldonors, the need for an effective test has become morecritical. In experimental prolonged organ preservation,elimination of the variables in transplantation operationswould be efficient and economical, and provide more objective data. This is a report of a laboratory effort to finda quick, simple, reliable and specific test of renalmetabolism which would predict satisfactory function.Biochemical assays of glutamine extraction (Ramadanand Greenberg) and ammonia production (Fawaz andvon Dahl) were evaluated and adapted to a porcinemodel. Reproducibility of the assays was found to depend on these technical improvements: 1) incubatingglutamine under strictly controlled conditions in an acidsolution; 2) stabilizing and stimulating glutamic dehydrogenase with ADP; 3) stabilizing NADH in alkalinesolution; 4) eliminating NH3 contamination of samples;and 5) performing the glutamine assays within 24 hours.The test can be completed in two hours and does notrequire biopsy. With standard solutions the assays consistently measured glutamine to levels of 0.007 ±" 0.003J,LM/ml and recovered 97 ± 5% of N H3 and 93 ±" 4% ofglutamine added to porcine plasma. In vivo porcineplasma mean values were determined: glutamine concentration was 0.507 ±" 0.05 J,LM/ml, ammonia concentration 1.004± 0.038 j.LM/ml, glutamine extraction 46.4±"4.8ILM/min, and ammonia production 69.60±"9.28ILM/min.These values were not significantly different fromthose recorded from canine experiments (p > 0.05). Preliminary results from ex vivo renal perfusions indicatethat the extraction of glutamine and production of ammonia approaches zero with greater than six hours ofnormothermic renal perfusion. The efficacy of the testhas been demonstrated; it will be studied further in experimental ischemic models and applied to clinical organpreservation.14 The Effect of Lectins on DNA Synthesis inCultures of Embryonic Neural Retina CellsPaul KaplowitzSponsor: Aron A. Moscona, Ph.D.Discussant: Dr. Stanley YachninConcanavalin A (Con A) and other lectins which bind tospecific carbohydrates on the cell surface stimulate celldivision in resting lymphocytes. I was interested in determining whether other cell types might also be stimulated by lectins. This problem has been explored in cellsfrom the neural retina of the chick embryo. In primarymonolayer cultures of 10-day cells, which normally havea low rate of DNA synthesis, Con A, wheat germ agglutinin, and phytohemagglutinin all elicited an approximately fourfold increase in the rate of 3H-thymidine incorporation after 15 hours. Autoradiographs revealedthat the enhanced isotope incorporation was due to anincrease in the number of DNA-synthesizing cells.The effect of lectins on DNA synthesis was criticallydependent on the embryonic age of the cells: in culturesof 7-day embryo cells which have a high rate of DNAsynthesis, Con A, wheat germ agglutinin andphytohemagglutinin all markedly inhibited ON A synthesis. Another agent which interacts with cell membranes,the Na+-K+ pump inhibitor ouabain, was also found toenhance DNA synthesis, particularly in retina cells fromolder chick embryos. In cultures of 14-day cells, bothouabain and Con A enhance the initially low level ofDNA synthesis, but the combination of both agentselicits an increase which is greater than additive. The factthat agents which react with the cell membrane modifythe rate of DNA synthesis in embryonic retina cells in anage-dependent manner suggests that developmentalchanges in the cell surface play an important role in theregulation of embryonic cell growth.Platelet DOPA Oxidase in Health andDuchenne's Muscular DystrophyI van V. PacoldSponsor: Dr. Louis CohenDiscussant: Dr. Alfred HellerCurrent methods can detect 50 to 70 percent ofheterozygous female carriers of Duchenne' s musculardystrophy (DMD). For better genetic counseling, additional methods to improve the detection rate are desirable. Human platelets contain an enzyme which accelerates the conversion of dihydroxyphenylalanine (DOPA)to melanin. The electrophoretic pattern of this enzyme,DO P A oxidase, has been reported by others to be distinctive in children with DMD and in mothers carryingthe dystrophic gene.Further investigations of this platelet enzyme were undertaken. Red cells and leukocytes were found to containthis enzyme also, necessitating their exclusion with greatcare. Platelets, free of red cell and leukocyte contamination by phase microscopy, were obtained by differentialcentrifugation of citrated blood. The platelets were disrupted by repeated freeze-thawing and the super-natantplatelet extracts electrophoresed for fifteen hours at 130V. The starch gels were then sliced and stained withDOPA at 37°C in the dark. The major differences inthese methods and those previously reported were thedemonstrations that each platelet preparation was virtually free of red and white cells, and that theelectrophoretic components separated as bands with minimal trailing.Thirty-nine control subjects and 29 members of DMDfamilies were studied. In normal men and women,platelet DO P A oxidase was present in one of three electrophoretic patterns: a single rapidly moving band, asingle slowly moving band, and a broad band. Thesethree patterns were also found among boys with DMD,their fathers and mothers. The three patterns were approximately equally distributed in both sexes, and nonewas characteristic for boys with DMD, or their mothers.Thus, DOPA oxidase was found not only in platelets,but also in extracts of red cells and leukocytes. Althoughplatelet DOPA oxidase exists in three forms, electrophoretically, no evidence of a unique polymorphism incarriers and patients with DMD was found.Structure-Activity Relationships of N-AlkylAmphetamines in the Isolated Guinea-PigAtria PreparationGeorge T. Shy butSponsor: Charles R. Schuster, Ph.D.Discussant: Dr. Jai KohliThe effect of N-alkyl substitution on the amphetamine(B-phenylisopropyl-amine) molecule was investigated byexamining the activity of the substituted drugs on the rateof spontaneously contracting, isolated, guinea-pig atria.The compounds studied include: d-amphetamine,I-amphetamine, dl-amphetamine, d, N -methylamphetamine, d,N-ethylamphetamine, and d,N-propylamphetamine. All of these compounds were foundto produce an increase in the atrial contraction rateover the range of cumulative concentrations studied,from 10-8 Molar to 10-4 Molar. The magnitude of thechange was inversely related to the molecular size of thedrug. When atria were pretreated with the monoamineoxidase inhibitor, pargyline (100 mg/kg, in vivo, 4-hourpretreatment), the positive chronotropic effect of eachcompound was potentiated in the same relative order ofactivity as before. Pretreatment with the Beta blockerpropranolol (3 x 10-7 Molar, in vitro, 10-minute pretreatment) blocked all the stimulatory effects of thedrugs.Multiple linear regression analysis according to theHansch procedure was performed and suggested that the respective increases in atrial rate were inversely relatedto steric factors and directly related to lipophilicity factors. However, due to the small number of compoundsinvestigated these results were inconclusive. The interaction of all the compounds with paragyline and propranolol suggests that they act as indirect sympathomimetics and that the intraneuronal release of norepinephrine is probably the major determinant mechanism of theiractivity.Intracellular Compartmentation of PhospholipidBiosynthesis in Baker's YeastDavid G. OstrowSponsor: Dr. Godfrey S. GetzDiscussant: Hewson H. Swift, Ph.D.To discover the origin of lipids of mitochondrial membranes, the intracellular organization of phospholipidbiosynthesis has been investigated. The yeast S. cerevisiae, an organism widely used in studies of membranebiogenesis and assembly, was chosen because of the easewith which its membrane complement can be manipulated nutritionally and genetically.The localization of COP-choline: a,j3-diglyceridephosphorylcholine transferase (PC transferase) was particularly explored. This enzyme catalyzes the terminalstep in the biosynthesis of phosphatidylcholine (PC), themajor neutral phospholipid of eukaryotic cell membranes. Though most of the PC transferase activity appeared in the crude yeast mitochondrial fractions, its distribution upon further separation of crude mitochondriaby density gradient centrifugation did not follow that ofmitochondrial membrane enzyme markers. Rather, itsactivity was similarly distributed to that of the plasmamembrane, which was followed by morphologic examination of membranes prepared from various regions ofthe gradient and by tracing the distribution of radioactivity derived from the radioiodination of intact protoplastswith lactoperoxidase and 131 I, a procedure which labelsthe external membrane.PC transferase activity was also recovered in a lightmembrane fraction almost devoid of mitochondria butcontaining plasma membrane and endoplasmic reticulum. Upon further separation of this fraction the PCtransferase activity tended to be associated with theplasma membrane, which is probably the major site ofthe enzyme. The COP ethanolamine: a,j3-diglyceridephosphorylethanolamine transferase was similarly distributed. In contrast, the enzyme responsible for COPdiglyceride synthesis, a key intermediate in acidic phospholipid biosynthesis, was found largely in associationwith the inner mitochondrial membranes. These resultssuggest that in yeast, as in animal cells, mitochondrialmembranes probably acquire most of theirphosphatidyl-choline and-ethanolamine from other cellular membranes.15Thomas R. GarrickFred HarudaWilliam AbendGlenn T. Meade16 Thomas /. McKearnJohn P. KohlerRaymond J. Monnat, Jr.Stephen F. Kemp Antibody Against the Antigen Receptor of aPlasmacytoma Prolongs Survival of MiceBearing the TumorPatrick G. BeattySponsor: Dr. Donald A. RowleyDiscussant: Dr. Frank W. FitchThe mouse plasmacytoma TEPC15 has on its cell membrane antigen-specific immunoglobulin receptors andproduces a homogeneous, well-characterized myelomaprotein which is IgA of the same antigen specificity as thereceptors.Antibody which combines specifically with anantigen-combining site structure of either the myelomaprotein or the antigen-specific receptor on cells is referred to as anti-receptor antibody. Anti-receptor antibody can be induced in syngeneic host animals by injecting nonviable TEPC15 tumor cells. Mice so immunizedsurvive longer than mice not immunized, when inoculated with viable TEPC15 tumor cells. This protectionafforded by immunization can be transferred to normalmice by serum alone. The protective effect of the passively given serum is eliminated by absorbing antiserumwith the myeloma protein produced by TEPCI5, but notby absorption with other mouse myeloma proteins of different antigen specificity.I f the TEPC 15 tumor is transplanted into a normalhost, a transient (days 7-14) anti-receptor antibody response is detected, with death occurring on about day 25.The disappearance of anti-receptor antibody could bedue to complex formation with the myeloma protein, orperhaps due to active suppression of the anti-receptorantibody response by the TEPCI5 tumor.The mechanism whereby anti-receptor antibody increases survival is not clear. Presumably, antireceptorantibody combines with receptors on tumor cells and iscytotoxic through complement and/or call-dependentpathways. Alternately, anti-receptor antibody, by combining with these receptors, may "regulate" tumor cellsin the same way it regulates the normal immune cells,i.e., the plasmacytoma may still be responsive to normalmechanisms.Maturation of Glioblasts In VitroWilliam K. P. LiSponsor: Dr. Ramon LimDiscussant: Hewson H. Swift, Ph.D.This work deals with the identification of the factors affecting glia cell maturation under tissue culture conditions. Morphologically pure glioblasts were obtained bydissociating embryonic rat brains and culturing the cellsin a monolayer for two passages. Under this conditionthe neuroblasts were eliminated, leaving the glioblasts toform an epithelial cell carpet. Dibutyryl cyclic AMP atI mM transformed the cells into mature astrocytes.In our search for other biological compounds capableof mimicking the effect of dibutyryl cyclic AMP, only aprotein factor found in the adult brain was capable ofpromoting the maturation of the glioblasts. After a latency of about 12 hours, the protein transformed theglioblasts into a cell net of multipolar, mature astrocytes.Other proteins, including those that are known to stimulate cell growth or differentiation-such as ConcanavalinA, phytohemagglutinin, wheat germ agglutinin,pokeweed mitogen, and the Nerve Growth Factor-were without effect on the glioblasts.That the protein factor might have been contaminatedby cyclic AMP was ruled out by preincubating the factorwith cyclic AMP phosphodiesterase. That the factormight have modified the surface of the culture flask wasruled out by the failure of those flasks that were pretreated with the factor to promote glioblast differentiation. The effect of the factor on the cells was blocked byinhibitors of protein synthesis and agents that disruptmicrotubular assemblage. The morphologically differentiated cells also showed an increase in the proteinscharacteristic of mature glial cells.The Role of Passenger Leukocytes in theInitiation of Transplant RejectionThomas GarrickSponsor: Dr. Frank P. StuartDiscussant: Dr. Frank W. FitchThe initiation of the rejection process in kidney transplants has been thought to occur peripherally in the kidney as the recipient's antigen recognition cells passthrough it soon after transplantation. An alternatemechanism was postulated whereby free donor cells,passengers in the donor kidney, sensitize the transplantrecipient centrally as they are flushed into its circulationsoon after transplantation.This alternate mechanism was studied in a rat modelusing kidney transplantation between incompatiblestrains. Various treatments were given the prospectiverecipient to stimulate the early contact between it and thedonor kidney. After a few days, the kidney was transplanted and the recipient bilaterally nephrectomized sothat its blood urea nitrogen (transplant function) could befollowed as a measure of rejection. If, for example, thistransplant is rejected in an accelerated fashion, it impliesthat the pretreatment effectively initiated the rejectionprocess even before the kidney was transplanted.Various forms and quantities of donor antigen werefully capable of initiating the onset of rejection as measured by the accelerated rejection of subsequent kidneytransplants. Moreover, although temporary transplantsleft in recipients for only three hours were capable ofinitiating the rejection response, transplants devoid ofthese free ('passenger') cells were not. It appears thatfree antigen in the form of 'passenger' leukocytes is fullycapable of initiating rejection of rat kidney transplants and seems to be the major mechanism involved in initiating the rejection process.Anti-Idiotypic Antibody in RatTransplantation ImmunityThomas J. McKearnSponsors: Drs. Frank W. Fitch and Frank P. StuartDiscussant: Dr. Donald A. RowleyLewis X Brown-Norway (LBN) kidney allografts are accepted for an indefinite period following injection ofLewis recipients with LBN spleen cells and Lewis antiBN antiserum. This treatment results in production ofantibody reactive with a population of Lewis anti-BNantibodies. This anti-idiotypic antibody (Anti-Id-I) canbe detected using a passive hemagglutination assay.Anti-Id-I achieved maximal levels 10 to 14 days afterinjection of the LBN cells and anti-BN antiserum. NoAnti-Id-l activity was detected following injection ofeither LBN cells alone or anti-BN antiserum alone.When LBN kidney allografts were transplanted ten daysafter injection of LBN cells and anti- BN antiserum (i.e.,at the time of maximal Anti-Id-I response), the Lewisrecipients suffered no azotemic episodes during the first150 days after transplantation. This suppression of allograft rejection was antigen-specific and required injectionof both LBN cells and anti-BN antiserum.Spleen cells taken from these recipients failed to showany significant cytotoxicity in the 51Cr release andHellstrom microcytotoxicity assays. The suppression ofallograft rejection was apparently due to a failure of theserecipients to produce cell-mediated effector cells. I conclude that production of Anti-Id-l is an important earlyevent in the suppression of allograft rejection and suggestthat Anti-Id-I may function as an anti-receptor antibodyin blocking the membrane-bound receptors of those lymphocytes which are specifically reactive with BN antigen.The Fetal Inflammatory ResponseFred HarudaSponsor: John R. Esterly, Ph.D.Discussant: Dr. Robert L. HunterHistologic characteristics of fetal inflammatory responses were studied in experimental bowel perforationsand kidney bums in fetal, newborn and adult rabbits, andthrough turpentine-induced peritonitis in fetal, newbornand adult rats. Histologic material from fetal, newbornand adult specimens were compared. Peritoneal exudatesmears from turpentine peritonitis were differentiallycounted. Cell populations in fetal, newborn and adultexudates were compared. To explore possiblehematogenous origin of fetal inflammatory cells, circulating leukocytes were labeled with intravenous India ink17injection followed by intraperitoneal turpentine injectionin fetal, newborn and adult rats. Labeled cell proportionsin blood and exudate were compared.Adult and newborn animals exhibited typical acuteinflammatory response. Fetal lesions exhibited variablereactions consisting uniformly of mononuclear cell aggregations and exudates. Differences between cell populations in adult and newborn exudates and fetal exudateswere statistically significant. White blood counts and differentials from turpentine peritonitis specimens revealedno statistical difference between newborn and fetal absolute myeloid counts. The labeling study demonstratedphagocytosis of carbon particles by circulating leukocytes in all groups. Large numbers of labeled cells werepresent in adult and newborn exudates and sections, butwere absent except for minute numbers in fetuses nearfull term. Absence of polymorphonuclear leukocytes andlabeled leukocytes suggests absence of cell migration infetal wound healing. Previous investigations are reviewed. Inflammatory chemical mediation in adult andfetal animals is compared. Fetal immunology, endocrinology, cell dedifferentiation and congenital intestinalanomaly literatures are reviewed. Relevance of fetalinflammation to pathogenesis of congenital anomalies isdiscussed.Immunoglobulin and lactoferrin in Pleural FluidJohn P. KohlerSponsor: Dr. Nicholas J. GrossDiscussant: Dr. John E. HopperThe presence of immunoglobulins in various secretionsincluding pleural fluid has been demonstrated. Onecharacteristic feature of immunoglobulin secretion ofmucosal surfaces is a relative increase of IgA over IgG.Lactoferrin is an iron-binding protein with bacteriostatic properties. It is found in breast milk, tears, bile,synovial fluid, bronchial mucus, saliva and the secretorygranules of neutrophil leukocytes. The concentration oflactoferrin has previously been used to differentiateinflammatory from non-inflammatory synovial effusions.The immunoglobulin and lactoferrin concentrations ofhuman pleural fluid were measured to determine whetherdefense mechanisms present in mucosal surfaces andjoint spaces are applicable to the pleural space, and todetermine their origin, if possible.The circulatory origin of immunoglobulins in thepleural space was supported by: 1) the relative predominance of IgG over IgA; 2) the lack of evidence for localproduction; 3) the significant correlation of the concentrations of the lower molecular weight immunoglobulinsIgG and IgA in pleural fluid with their concentration inserum; and 4) the significantly higher level of these lowermolecular weight immunoglobulins in exudates, a situation associated with increased capillary permeability.The concentration of lactoferrin in exudates wassignificantly higher than that of transudates in pleural effusions. This is presumed to be due to the higher con-18 centration of neutrophils in exudates at some point in thepathogenesis of a pleural effusion.Organization of the Superior Vestibular Nucleusof the Squirrel MonkeyWilliam AbendSponsor: Jay M. Goldberg, Ph.D.Discussant: Dr. Henry B. PerlmanThe response to angular acceleration of neurons in thesuperior vestibular nucleus of anesthetized squirrel monkeys was used to study the distribution of semicircularcanal inputs to the nucleus. One group of so-called intactanimals had six active semicircular canals. In anothergroup of animals, the three canals on one side were rendered nonresponsive by plugging them with bone dust:the nucleus on the unplugged and plugged sides was explored. Convergence of canal inputs into single neuronswas studied by successive stimulation in the plane ofeach pair of canals.In both plugged and unplugged animals, convergenceof influences arising in two orthogonally-related canalswas rarely detected. In plugged animals, superior, posterior, and horizontal canal neurons were encountered onboth the plugged and unplugged sides, showing that allsix canals influence the nucleus.Two observations suggest that most of the neurons inthe nucleus receive bilateral canal influences. First, fewneurons in intact animals did not respond to angular acceleration, and unilateral canal plugging did not increasethe incidence of such neurons on either the plugged orunplugged sides. Second, most canal neurons were bilaterally activated by d.c. labyrinthine polarization; sincemost neurons did not respond to position, the polarization responses are likely due to stimulation of canals.Few neurons appeared to receive influences fromorthogonally-related canals, so the bilateral canalinfluences must arise in parallel canals. An observationwhich appears to reflect a synergic effect of influencesfrom parallel canals is that the mean sensitivity to angularacceleration of neurons on the plugged and unpluggedsides is significantly smaller than that of neurons in intactanimals. Finally, most superior-canal neurons were located in the lateral half of the nucleus; posterior-canalneurons in the medial half. Relatively few horizontalcanal neurons were encountered.Fitness of a Mutant Human Genotype:Huntington's Disease in a Scottish PopulationRaymond J. Monnat, Jr.Sponsors: Drs. Alan E. H. Emery and James E. BowmanDiscussant: Dr. Harold KlawansHuntington's disease (HD) is a hereditary disorder, apparently limited in its expression to the central nervoussystem, which is characterized by the onset, usually inadult life, of progressive dementia and chorea. The genetics of HD are relatively well understood, and the disease has long served as the classical example of autosomal dominant inheritance with virtually completepenetrance. The biochemicallesion(s) responsible for theHD phenotype is unknown, and therapy remains largelyineffectual.In studying 25 HD kindreds followed by the University of Edinburgh Department of Human Genetics, I wasinterested in answering two questions: 1) is there goodevidence for increased reproductive fitness in individualscarrying the HD gene? (this observation has been madeby a number of workers, with varying degrees ofdocumentation); and 2) how could we explain a net reproductive advantage in HD gene carriers?To answer the first of these questions, I used two different methods to estimate fitness. Both show an increased reproductive fitness in HD gene carriers whencompared with unaffected sibs and with controls. Thesecond of the above questions is more problematic. Atpresent, no good explanation exists for this dramatic effect of a single gene mutation on human reproduction.Though often suggested as causes, the progressive dementia and chorea of HD often appear years after reproduction is completed, and thus do not appear to playcausal roles. Also unexplained is the curious finding of anet reproductive deficit in unaffected sibs of HD patients.Two important goals for HD research today are: 1)identification of the biochemicallesion(s) associated withthe HD phenotype, preferably in cells outside the centralnervous system; and 2) perfection of a good technique foridentification of asymptomatic carriers of the HD gene.When these goals have been met, the second of our questions will most likely be answerable, and the control orcure of HD will be within our grasp.Non-Invasive Studies of the Cardiopathyin Duchenne's Muscular Dystrophy (DMD)Glenn T. MeadeSponsor: Dr. Louis CohenDiscussant: Dr. Rene ArcillaAlthough the cardiopathy associated with DMD hasbeen extensively studied, there is no accepted explanation for the electrocardiographic abnormalities which arecharacteristic of this disease. These abnormalities are:increased R wave and RJS ratio in VI, and deep Q wavesin I, aVL, and V5-6. Previous vectorcardiographicfindings have shown increased early vectors with anteriordisplacement. Echocardiographic studies in three patients suggested impaired posterior wall relaxation. Autopsies have shown focal, fibrotic replacement ofmyocardium, especially in the left ventricular posteriorwall and septum. From these various studies, the characteristic electrocardiographic features have been attrib- uted to right ventricular or septal hypertrophy, loss ofposterobasal myocardium, conduction defect, or persistence of an infantile pattern.In the study to be presented, serial electrocardiograms, vectorcardiograms, echocardiograrns, and oneautopsy case in ten DMD patients ages 4-13 years, wereexamined. Electrocardiograms revealed abnormally increased R in VI (30 percent) and V2 (70 percent), anddeep Q's in V6 (40 percent). Vectorcardiograms showedincreased early anterior forces (70 percent), but also increased late posterior forces (60 percent). Echocardiograms showed both increased septal and left ventricularposterior thicknesses, and normal systolic movement.One autopsy case showed that the heart weight was inthe upper limits of normal. Nevertheless, the septum andleft ventricular wall were abnormally thickened, but notthe right ventricular wall. Although there was ageneralized microscopic focal fibrosis and other degenerative changes, most marked in the left posterobasilar wall, scarring probably represented less than five percent of the myocardium, and the major cause of thethickening appeared to be the result of hypertrophy ofmuscle.Thus, the characteristic increased anterior and posterior electrical forces in DMD, seen with the electrocardiograph and vectorcardiograph, are associatedwith and seem best explained not by previously suggested causes, but by myocardial hypertrophy of the septum and posterior wall of the left ventricle, which wererevealed echocardiographically and confirmed at autopsy.Metabolism of Glycosphingolipids in CulturedCells of Neural OriginStephen F. KempSponsor: AIlen C. Stoolmiller, Ph.D.Discussant: Nancy B. Schwartz, Ph.D.Cultured NB4IA cells derived from C1300 mouseneuroblastoma synthesize neutral glycosphingolipids,hematoside (GM3), and N -acetylgalactosaminecontaining gangliosides (GM2, GMl and GDl) which arecharacteristic of nervous tissue. Although the acceptedpathway for ganglioside synthesis involves GM3 as an obligate intermediate, the observation that these cells contained asialo-Gv; suggested that ganglioside formation inNB4IA cells might proceed by an alternate pathway involving asialo-Gv.. This has been investigated by studying the pattern of incorporation of labeled precursors intosialoglycosphingolipids.Cultured NB4IA cells incorporated radioactivity derived from N-(3H)acetylmannosamine into the sialic acidmoiety of GM3 in less than ten minutes. Labeled GM2 wasnot detected in cells incubated for less than 30 minutes,while measurable radioactivity did not appear in GM1until after 60 to 90 minutes. These results were corrobo-19James H. BeesonRichard M. BergenstalRobert A. LipsonJohn M. Clark20 James E. BogganPatrick J. CahillAlan D. WoolfStephen 5. Mariani rated by a similar experiment using (l4C)galactose. Nosignificant amount of labeled hexose was incorporatedinto asialo-Gv; during 60 minutes of culture, suggestingthat it was not a biosynthetic intermediate. Additionally,cell-free preparations catalyzed the transfer of sialic acidfrom its CM P-derivative to G L-2a to form GM3.Asialo-Gj., was not an acceptor of the sialyltransferaseunder a variety of conditions. Enzyme preparations alsocontained an N-acetylgalactosaminyltransferase whichcatalyzed the conversion of GM3 to GM2. No significanttransfer of N-acetylgalactosamine to GL-2a could bedemonstrated. These data are most consistent with thefollowing pathway for synthesis of gangliosides:G L-2a�GM3�GM2�GMl.The Synthesis of an Immobilized Pepsin and ItsApplication to the Routine Production ofF(ab'h Fragments of IgCJames H. BeesonSponsor: Dr. Robert W. WisslerDiscussant: Dr. Robert L. HunterTraditional methods for demonstrating cell-specific antigens at the ultrastructural level require the fixation of alabel to an antibody using a non-specific coupling reagentand the separation of excess reactants and oligomericproducts. Yields are poor and conjugation reduces antibody activity. Hybrid antibody labeling avoids theseproblems.Hybridization of two divalent antibodies produces adivalent, bispecific molecule. The hybrid is useful as aspecific link between cellular antigen and label or as anon-precipitating antibody to produce solublelabel/antibody complexes.F(ab')2 fragments are preferable to native IgG for hybridization. They are obtained by pepsin digestion of IgGat pH 4.5, alkaline denaturization of the enzyme and separation by gel filtration.An indirect synthesis was employed. Cyanogenbromide-activated Sepharose was allowed to react with analiphatic diamine. Addition of succinic anhydride produced a terminal carboxyl group which was anhydrouslyesterified with N-hydroxysuccinimide. This ester couples spontaneously with pepsin at pH 6.5.Since the stability of pepsin at the coupling pH wasuncertain, pepsinogen was immobilized by the samemethod and later activated. The activities of the twopreparations were compared in hydrolysis of denaturedhemoglobin at pH 1.8 and IgG at pH 4.5. The two wereequivalent.The digestion of IgG proceeds cleanly at pH 4.5, yielding F(ab')2 and Fe' fragments with no loss of antibodyactivity. After simple filtration, the product is ready forhybridization.The immobilized enzyme has been stable for over oneyear. It may be reused indefinitely.A Rat Model for Investigating Spinal Cord InjuryJames E. BogganSponsor: Dr. Jack de la TorreDiscussant: Dr. Edward GanzA rat model for investigating spinal cord injury, using thesomatosensory evoked response (SER) and measurements of local spinal cord blood flow (SCBF) by hydrogen clearance technique, is described. Rats are anesthetized with sodium pentobarbital I P and ketamine hydrochloride 1M. Following tracheostomy and curarization, the animals are maintained on a respirator. Rats areplaced in a stereotactic apparatus and the vertebral column immobilized. Bipolar recording electrodes arescrewed into burr holes placed in the skull overlying thesensory cortex, and computer-averaged SERs to electrical stimulation of an isolated peripheral nerve recorded.After TIO-TI2 laminectomy, a blood flow microelectrode is inserted into the spinal gray matter, and measurements taken. Systolic blood pressure, pulse rate,body temperature and EEG are monitored periodically.Variable gram-centimeter force impact injury is appliedto the spinal cord segment in which blood flow is measured. SER wave component latencies are seen to increase, while the SCBF decreases, both temporarily, inresponse to reversible impact injury.Experiments are continuing to further establish the relationship of the changes observed in the SER and SCBFto the pathologic changes resulting from trauma. To thebest of our knowledge this is the first description of a ratspinal injury model monitoring the above physiologicparameters. Our results are consistent with changes inSCBF following trauma observed in other animal models, and support the recent clinical use of the SER as aprognostic tool in the evaluation of spinal cord injury. Wefeel that this is an economical and reliable model forstudying the pathophysiology and potential therapies ofspinal cord injury.Familial Hyperproinsulinemia: PartialCharacterization of the Defect inCirculating ProinsulinRichard M. BergenstalSponsor: Dr. Arthur H. RubensteinDiscussant: Dr. Donald F. SteinerFamilial hyperproinsulinemia is a genetic defect presenting with strikingly elevated levels of serum proinsulinlike material (PLM). The defect affects progeny in fourgenerations and is inherited as an autosomal dominanttrait. The PLM ranges from 74 to 91 percent of totalserum insulin immunoreactivity (controls = 3 to 22 percent).To determine whether an abnormal proinsulin (PI)may underlie this defect, trypsin (T) was incubated withserum, PLM purified from plasma, and porcine proinsu- lin. A tracer of 131 l-porcine-Pl was added to each material being converted with trypsin. The conversion ofPLM to insulin was monitored by gel filtration, the fractions being counted for 131 I and measured in the insulinassay using an IZ5I-lnsulin tracer.Porcine PI conversion was nearly identical to 131 I-PI;for example, 62 versus 61 percent, 93 versus 90 percent at0.5 J.Lglml T for 4 and 15 minutes respectively. The conversion of PLM, however, was markedly slower than131 I-PI in serum (0 versus 76 percent, 10 versus 80 percent at 50 J.Lglml T for 30 and 60 minutes respectively),and in purified PLM (23 versus 88 percent, 42 versus 92percent at 5.0 J.Lglml T for 2 and 5 minutes respectively).Studies with two human C-peptide antisera which differin their relative PI immunoreactivity show equal reactivity with serum PLM, suggesting that PLM may be atwo-chain PI intermediate.These data indicate that circulating PI in familialhyperproinsulinemia may have a structural abnormalitywhich impairs its conversion to insulin within the betacells.The Use of Pulmonary Capillary Wedge PressureWave Form in Determining the Severityof Mitral RegurgitationPatrick J. CahillSponsor: Dr. Jafar AI-SadirDiscussant: Dr. Raul E. FalicovBedside hemodynamic measurements including pulmonary capillary wedge (PCW) pressure in acutely ill patients are widely used. Assessment of the severity ofmitral regurgitation (MR) in such patients, utilizing onlythe mean PCW pressure and height of the 'V' wave, ismany times inaccurate. We attempted, therefore, furtheranalysis of PCW pressure wave form in 30 patients withmild, moderate or severe MR proven by left ventriculography. The ratio (R):0.10 secmean PCWwas calculated, where PI equals the pressure at the peakof the 'V' wave and Ps equals the pressure 0.10 secondsafter Pl. Mean R was significantly lower in the mildgroup (3.03) than in the moderate (4.68) and severe (5.88)groups (p < .005 and < .001 respectively).Furthermore, the height of the 'V' wave was analyzedduring sinus beats, premature ventricular beats (PVC),and in the first beat following a PVC (PPVC). The 'V'wave increased unpredictably in all these groups during aPVC and therefore did not discriminate among them.When the PPVC beat was analyzed, however, 6 of 11patients with moderate or severe MR had an increase inthe'V' wave of more than 5 mm Hg over the control' V'wave, while no patient with mild MR showed such anincrease.It is concluded that analysis of the rate of descent of21the 'V' wave during sinus beats, and of the magnitude ofthe 'V' wave increase during ppve beats, may improvethe diagnostic usefulness of the pew pressure waveform in assessing the severity of MR.A Study of Pyloric Function in the PrimateRobert A. LipsonSponsor: Dr. David B. SkinnerDiscussant: Dr. Charles S. WinansIt has often been proposed that due to increasedduodenal-gastric reflux, duodenal contents, including bilesalts, may help break the gastric mucosal barrier, permitting back diffusion of acid with subsequent mucosal celldamage leading to gastritis and the eventual developmentof gastric ulceration. This pathogenetic mechanismplaces the pylorus in a key position. Most surgical procedures offered for the management of peptic ulcer diseaseeither denervate, resect, bypass or modify the anatomyof the pylorus. Some complications associated with theseprocedures are attributed to the absence of a physiologicpylorus.There is some uncertainty that the pylorus is aphysiologic sphincter. One recent study revealed that thepylorus in man is a sphincter with an elevated basal pressure, capable of responding to G I hormones, and thatthere is some sphincter dysfunction permitting increasedduodenal-gastric reflux in patients with gastric ulcer disease. Other past and more recent studies have failed todemonstrate the pylorus in man, monkey or dog as a highpressure zone with sphincter properties. Much of the debate over the pylorus is a result of technical difficultiesassociated with manometry.Studies of baboons and Rhesus monkeys have beenperformed in an attempt to delineate the manometricproperties of the pylorus. Studies have been started todetermine the effects of truncal vagotomy on the pylorus.With our techniques it has been observed with someconsistency that the pylorus has a modestly elevated,non-rhythmic, basal pressure in the fasted primate. In thefed monkey, the distal portion of the gastro-duodenaljunction reveals a much higher basal pressure with spikesof great pressure occurring in a rhythmic fashion. In theproximal portion of the gastro-duodenal junction it isoften seen that there is not as high a basal pressure, butthe rhythmic spikes equal or exceed those seen distally.In the distal antrum the basal pressure is much lowerthan the gastro-duodenal junction, and yet the terminalantral contractions are often as high as the spikes seendistally. This defines the pylorus as a 'pyloro-antralsphincter-pump' .Acid infusion to the duodenum in a fasting monkeygreatly increases the basal pyloric pressure without anyrhythmic activity. In a fed monkey, acid infusion to theduodenum abolishes the rhythmic spikes in the pyloroantrum and greatly increases the basal pyloric pressure.Alkalization of an acidic, food-containing stomach diminishes the basal pressure in the pylorus. Bile infusion22 into the antrum has also been seen to do this. Preliminarystudies with intravenous cholecystokinin appear to showan increase in the basal pyloric pressure with muchrhythmic activity in the antrum, pylorus and duodenum.Secretin appears to only raise the basal pressure. In thefasting monkey infusion of a hypertonic fluid into theduodenum appears to cause a non-rhythmic increase inthe basal pyloric pressure.Injuries Sustained by Children in Free Falls:Analysis of 66 CasesAlan D. WoolfSponsors: Drs. John D. Burrington and Melvin D. SmithDiscussant: Dr. Jay E. BerkelhamerFrequency and patterns of injury were studied in 66 children seen after free falls of up to 96 feet. Soft tissuebruises, minor lacerations and mild drowsiness wereconsidered insignificant injuries (11 cases).Of the 48 fractures sustained, 27 percent involved theradius, 21 percent the skull and 19 percent the femur.Seven of the 10 skull fractures resulted from falls of threestories or more.Eighteen children without skull fractures had signs ofconcussion such as headache, lethargy, vomiting, loss ofconsciousness, convulsions or ataxia. Most of these children fell two stories or less.Eleven intra-abdominal injuries included three each tothe kidney, spleen and liver. Two children ruptured theirjejunum. Sixteen children sustained multiple injuries, butthere were none to the cardiopulmonary system. Ten ofthese children fell three stories or more and the twodeaths were in the group with multiple injuries.Medial Architecture of the AortaJohn M. ClarkSponsors: Drs. Seymour Glagov and Charles E. OxnardDiscussant: Dr. Charles E. OxnardAortas of rabbits, pigs and rats were studied by scanning,transmission and light microscopy in an effort to determine the relative mechanical interactions of medial cells,collagen, elastin and proteoglycan. Vessels were subjected to mechanical and pharmacological manipulationand fixed by means of a, controlled-pressure perfusionsystem, permitting observation of structural changes associated with a variety of conditions.The functional and morphogenetic units of aortic structure were found to be clearly delineated cell groups sharing common patterns of orientation and development.Each "cell fascicle" was formed by a distinct populationof parallel, interdigitating smooth muscle cells investedby and firmly attached to a common framework of elastinfibers, collagen fibrils and basal lamina. Elastin "Iamel-Susan Terrislae" were formed by the juxtaposition of long elastin barssurrounding and parallel to adjacent cell fascicles. Large,wavy collagen fibers ran among the components of theelastin lamellae; these were distinct from collagen fibrilswithin cell fascicles.Medial tension was transmitted to and from the smoothmuscle units through the compliant protein matrix of afascicle, which apparently absorbed enough of the increasing stress to maintain the cell groups as mechanicaland biosynthetic units during vessel growth. The smoothmuscle myofilaments were coupled to the elastin bars bya specialized dense body-cell membrane-basal laminacollagen fibril complex. The findings establish amechanism for the regulation of aortic medial growth,and help to explain the dynamic mechanical properties oflarge vessels by defining the role of the medial smoothmuscle group as a parallel contractile element.Fifty Non-Functioning Chromophobe Adenomasof the Pituitary: Therapy and ResultsStephen S. MarianiSponsor: Dr. Melvin L. GriemDiscussant: Dr. Jeannie KinzieFifty patients with non-functioning chromophobeadenomas were treated with megavoltage radiationtherapy at The University of Chicago between 1954 andmid-1974. Visual field defects were found in 78 percentwhile endocrine problems were seen in 66 percent of patients. X-ray studies and/or surgery showed suprasellarextension in 72 percent of the cases. Fifty-four percent ofthe patients were treated with surgery followed by radiation therapy, while 46 percent received radiation therapyas the initial treatment.Failure, defined as rapid (less than one year) progression of visual field defect or enlargement of sella aftertherapy, occurred in six of 23 patients treated with radiation therapy alone, and in one of the 27 patients treatedwith surgery followed by radiation therapy. All failures occurred within the first year of treatment. Our studyshows that better control rates were achieved withsurgery and radiation therapy than with radiation therapyalone. Inadequate treatment ports resulting from underestimation of tumor size may have contributed to treatment failure. In all of the radiation therapy failures, subsequent surgery demonstrated that the tumors were cystic and/or the port sizes were smaller than tumor sizes.We thus recommend that all patients receiving treatmentfor chromophobe adenomas have studies to delineatesuprasellar extension and possibly identify cystic lesions.Binding and Metabolism of Insulin by Rat LiverSusan TerrisSponsor: Dr. Donald F. SteinerDiscussant: Dr. Arthur RubensteinThe binding and degradation of insulin by rat liver wasstudied using isolated rat hepatocytes and perfused ratliver. At total insulin concentrations of 5 x 10-11 toI O-(;M, the velocity of insulin degradation showed a firstorder dependence on the total amount of insulin bound toisolated rat hepatocytes at steady state. The overall reaction had an apparent rate constant ofO.030± 0.011 min-I.The degradation of a given amount of 12"I-insulin boundto cells was more rapid and extensive than the degradation of the same amount of insulin which had been newlyexposed to fresh cells. Mild pretreatment of isolatedhepatocytes with trypsin and chymotrypsin depressed tothe same degree the amount of 125 I -insulin bound atsteady state and the velocity of 1251-insulindegradation. Peptide hormones unrelated to insulin, aswell as the oxidized A and B chains of insulin, failed todepress the amount of 1251-insulin bound or the velocityof 1251-insulin degradation when present at high concentrations. Over a wide range of concentrations, varioussynthetic insulin analogues and naturally-occurring insulins depressed to the same degree the amount of125 I -insulin bound at steady state and the 125 I -insulin degradation velocity.Other studies revealed that non-cyclically perfused ratliver retained 25 percent and degraded 10 percent of1251-insulin administered as a one-minute pulse. Additionof native insulin, but not native glucagon, to the1251-insulin pulse depressed both the retention and thedegradation of the iodinated material. In contrast, theretention and degradation of two iodinated insulinanalogues of low biological potency, proinsulin anddesaparaginyl-desalanyl insulin, was small although theirdegradation products were qualitatively similar to thoseof 1251-insulin.These observations suggest that for insulin to be degraded by the liver it must be bound to sites on thehepatocyte plasma membrane which are believed tomediate its biological action.23Clinical Nutrition In the Highlands of GuatemalaDr. Noel SolomonsThe Pan Am 707 crossed the Yucatan peninsula of Mexico and began its descent over the purple-blackCuchumatan mountains of northern Guatemala. To theright, we could see the triangular silhouette of Agua, thevolcano of water; to the left, a lazy column of blacksmoke rising from the active crater of the Pacaya volcano. We banked and circled, and soon the jet wasfloating across the deep ravines or barrancos which surround the city. I had come to Guatemala to study theproblems of malnutrition and would spend the next several years working at the Institute of Nutrition of CentralAmerica and Panama (lNCAP) in Guatemala City.As I travel through the country, I am constantly struckby its incredible scenic beauty, abundant archeologicalruins and fascinating contemporary culture. Beyond theSpanish ruins of the colonial capital Antigua lies LakeAtitlan, - considered by some geographers to be the mostbeautiful lake in the world. Surrounded by three majorvolcanos, Atitlan reaches a depth of over 1500 feet insome areas. The shoreline is dotted by remote villages,many of which are named for the apostles. Across thehighway is the city of Santo Tomas Chichicastenangowith its huge Indian market. Each village in Guatemalahas a distinct traditional blouse called huipil. The colorful, richly embroidered huipils of "Chichi" are amongthe most beautiful. In the heart of the Peten province arethe ruins ofTikal, a religious and ceremonial capital builtby the Mayas during the classical period before theirmysterious migration to the deserts of the Yucatan. Rising out of the dense rain forests are the white rostra of themajestic temple pyramids of the ancient Mayas.Despite its diversity, Guatemala is a surprisingly compact country. It takes only eight hours to traverse thePan-American Highway from the Mexican border to thefrontier of EI Salvador. In the same time, one can spanthe Interoceanic Highway from the black sands of thePacific beaches of San Jose to the crystal clear Caribbeanwaters off Puerto Barrios.Two outstanding features of the Guatemalan lifestyleseem to contribute to the subclinical forms of malnutrition which affect the inhabitants of rural areas here. Thefirst is diet, which is largely a monotonous regimen ofcorn, in the form of tortillas, and mashed black beans.The proteins in this diet are of low biological quality dueto specific amino acid deficiencies, and the overall energycontent is poor. Sufficient amounts of vitamin A and ironare difficult to obtain. Thus, the background of nutritional deficiency is set. The second feature is the endemicnature of infectious diarrhea in Guatemala. In 1964, themortality rate from diarrheal disease was 115 times thatof the United States. It has been well established that themetabolic costs of such infections contribute to nutritional depletion; it has also been suggested that abnormal24 bacterial overgrowth in the intestine and recurrent enteritis contribute to the chronic malabsorption seen inrural populations.The seeds of my work in Guatelmala were plantedmore than seven years ago, when Dr. Irwin Rosenbergand I would get together after meetings of the MedicalCommunity for Human Rights to exchange experiencesin foreign nutrition work. He had recently returned toBoston from the Cholera Laboratories in Dacca, EastPakistan (now Bangladesh), and I had spent the -sumrnerresearch elective after my first year at Harvard MedicalSchool with a nutrition center in Lima, Peru. We did notlose touch when I left Boston for an internship and residency at the University of Pennsylvania and he departedfrom Boston City Hospital to join the GastroenterologySection at The University of Chicago, and when it wastime for me to formulate a definite plan for postdoctoraltraining in international clinical nutrition, it was Dr.Rosenberg's counsel I sought first. He suggested that,given my internal medicine training, gastroenterologywould be an appropriate focus for training. I would cometo The University of Chicago for a year of clinical training in gastroenterology, and then complete my fellowshipoverseas under the auspices of the University.The next step was to choose a country in which to dothe later years of training. Dr. Rosenberg referred me toDr. Leonardo Mata, chief of one of the scientific divisions at INCAP. He suggested that since my primaryinterest and training were in clinical areas, I should basemyself in the Biomedical Division, which is headed byDr. Fernando Viteri, a Guatemalan physician who hashad postdoctoral training in pathology, internal medicineand physiology in the United States. For years Dr. Viterihas been working to unravel the physiologic andmetabolic problems associated with severe proteincalorie malnutrition syndromes in children, which weknow by the exotic names of kwashiorkor and infantilemarasmus.Dr. Rosenberg and I arranged a meeting with Dr. Viteri at his hotel in Mexico City, where he launched into adiscussion of the directions which research at Biomedicawas taking. The more he spoke, the more common wefound our interests to be. When Dr. Rosenberg outlinedthe technological innovations in folate technology andstable isotope absorption tests which were being developed at The University of Chicago in collaborationwith the Argonne National Laboratories, I could see theinitial reserve and restraint on Dr. Viteri's face tum todelight and excitement. Clearly, we had struck a responsive chord.Central America in no way lacks the brain power orsophistication to carry out high quality research. What itoften does lack is the financial and technological infra-A woman from Santa Catarina sells textiles on the shore of Lake Atitlan.structure needed to apply emerging research techniquesto basic health problems. Guatemalan research has suffered at times from a misguided arrogance on the part ofNorth American granting institutions, which hold that"third-world" countries should maintain a "third-world"research capacity. Moreover, it has suffered from a styleof scientific colonialism or imperialism on the part ofsome North American investigators who, based on workperformed by Guatemalans in Guatemala, enhance theirown scientific status and reputation in "international nutrition." Dr. Rosenberg and I tried to demonstrate thatour commitment would be in Guatemala, and that ourresponses would be to the needs and directions ofINCAP. Our resources and talents would be shared, anda clearly two-way arrangement was our goal.There followed a series of multilateral correspondences and personal visits to Guatemala, to refine thescientific and administrative details. In july of 1973 Ijoined the Department of Medicine at The University ofChicago as a Fellow in Gastroenterology and ClinicalNutrition. Immediate attention was given to the development of new techniques which could be applied tothe problems of absorption in malnourished and diarrhealstates. Folic acid, for example, is an important vitaminnutrient, but its full role in intestinal function is incompletely understood, especially in groups such as youngchildren and pregnant women, in whom folic acid nutrition is most important.Some limitation in the study of folic acid absorptionand metabolism in these vulnerable populations was dueto the availability of only a folic acid tracer labeled withtritium, a radioactive isotope of hydrogen. The use ofradioisotopes for investigational purposes in thesegroups seemed inappropriate. However, work in theGastroenterology Section in conjunction with Argonnehad been directed at synthesizing tracer compounds offolic acid which contain deuterium, a non-radioactiveheavy isotope of hydrogen. An ideal research applicationwould be to use this substance in the aforementioned groups to avoid the hazard of radiation. Similar techniques for studying nutrient absorption using nonradioactive and non-invasive procedures were also on thedrawing boards as I arrived on the Midway.In addition to research, there was clinical work at theUniversity. With five other first-year fellows I shared theresponsibilities of G I consultations, proctoscopy clinic,gastroscopy, and Dr. Joseph Kirsner's busy and instructive Saturday morning outpatient clinic. In addition, Iwas trying to learn as much as I could about pediatricgastroenterology. Dr. Viteri visited the University inJanuary of 1975 to see our operation and put some finaltouches on research designs and protocols, and later thatmonth I was on my way to Guatemala City.INCAP is a subsidiary of the Pan American HealthOrganization and the United Nations. It includes anumber of divisions-such as Applied Nutrition, Agricultural Chemistry, Physiological Chemistry, HumanDevelopment, Environmental Biology, and Biomedical-which approach the problems of malnutritionfrom diverse but complementary scientific disciplines.Research projects and programs do not follow strictlydivisional lines but most often combine the resources andexpertise of several divisions. There is also a Division ofEducation which runs a college-level school for trainingnutritionists, and includes four Master of Science programs and postdoctoral tutorials. (NCAP's full-time professional staff and non-professional staff are drawn predominantly from Central American countries andPanama, but a number of Europeans, North and SouthAmericans and Asians are also employed. The professional staff meets weekly with Dr. Carlos Tejada, thedirector of INCAP, and attends research sessions presented by various investigators.The Biomedical Division, conditioned by years of diverse investigations, is a flexible, ever-changing andpresently expanding institution. Its operations are basedin the one-story Centro Clinico situated in the center ofthe INCAP campus. Inpatient facilities are currentlyA child in the metabolic bed in the Clinical Center during a nitrogenbalance collection.25Dr. Soiomcn» with a recovered child in the Center's metabolic ward.being used for toddlers between 18 and 36 months of agefor studies on amino acid requirements of pre-schoolers.These children. with their parents' consent. are admittedfrom the outpatient clinics of nearby Roosevelt Hospitalwith moderate. edematous protein-calorie malnutrition(PCM), and usually a host of accompanying infectionsranging from tuberculosis and hepatitis to viral encephalitis and whipworm infestation.Early INCAP investigations first brought world attention to the synergistic association between malnutritionand infection in the evolution of severe PCM. Today,this dictum still proves itself with every new admission.With nutritional rehabilitation and specific treatment ofinfections, the children leave the isolation unit for themetabolic wards. A nutritionist and a metabolic kitchenstaff prepare meals and record dietary intake. At regularintervals the children are placed in metabolic beds, andtheir urine and feces are collected for measurement ofnitrogen balance. Day-to-day patient care is the responsibility of a pediatric resident who serves in the CentroC linico for at least a six-month rotation, and a full-timecomplement of nursing auxiliaries (niiierias) who staffthree 8-hour shifts.Biochemical determinations are performed by theDivision's laboratory staff, headed by Fabio Saldana.Mrs. Velia de Tuna, an expert in clinical folic acid determinations, conducts hematological analyses. The relationship of nutritional status to growth and endocrinechanges is the specific interest of Dr. Benjamin Torun,the associate chief of the Division. One divisional subsection concentrates on a field study of the nature ofintestinal malabsorption in rural Guatemalans. And aDutch-born graduate student in economics at the U niversity of Hawaii, Maarten Immink, has been gatheringdata for his thesis on the microeconomics of caloric sup-26 pie mentation in a field study on calorie intake and workcapacity on a coastal plain sugar cane plantation.Somewhere within this sea of research activity 1 amperforming my own investigations. The day-to-daycourse of events may find me beginning a bile salt breathtest on one of the children at 5:30 in the morning ordistributing isotopic doses of cobalt to a group of adultvolunteers; sitting at the bedside of a patient in thediarrheal unit of Roosevelt Hospital or incubating bacterial homogenates in some in vitro laboratory experiment.Soon we will apply our newly developed techniques tothe same rural populations in our quest to find ways tointervene in the downward spiral of infection, malabsorption and malnutrition.I have also become involved in ongoing studies of ironabsorption. This area was not in the original plans, but inkeeping with the spirit at INCAP of solving problemswhich are relevant to people as well as to investigators, aproject to develop an iron supplement for the CentralAmerican diet had been initiated; consequently, therewas a need to develop and apply a new absorptive test.And there I was!What of my personal responses to life and work inGuatemala? There is a refreshing perspective to begained from living outside of the United States during itsthroes of internal social and economic upheaval, and it iscomforting to be among people for whom racial prejudice is essentially non-existent. It is frustrating but, atthe same time, enormously satisfying to grapple withscientific questions even though we have far fewersophisticated scientific instruments than exist in Chicagoand, yet, to see valid answers emerge. The issues hereare the problems of promoting and improving generalhealth more often than of treating the individual's disease, and it is satisfying to solve problems the solution ofwhich have the potential to help multitudes of people leadmore productive, healthier lives. Moreover, there is astimulating challenge in gaining a proficiency in a foreignWard rounds including the dietician, resident, nursing supervisors, and thedirector and associate director of the Biomedical Division.language, and in understanding the sensibilities of a complex culture.Of course, there are features in Guatemalan life whichdetract from a utopian view. The repressive attitude toward women, shared even among the upper middle class,is painful and destructive. The gulfs between middle andlower classes, Latino and Indian, are too obvious anddisturbing to allow social complacency.Equally apparent are potentials for creative socialchange here, potentials which are shared by most thirdworld countries but which may not be so possible fortheir more developed counterparts. A drive along thePan American Highway reveals views of incrediblebeauty and remnants of a remarkable culture. Perhaps inthe emerging change Guatemala can find the strengths inits Mayan heritage to put it in closer touch with itsnatural bounty, and in the process both may be preserved.Or. Noel Solomons is Research Associate in the Departmentof Medicine (Gastroenterology) at The University ofChicago, and Research Associate at INCAP in Guatemala.Or. Solomons is located in a section of Guatemala heavilydamaged by the severe February 4 earthquake. He described the aftermath in letters to members of the Gastroenterology Section, excerpts of which are printed here.February 5, 7:00 a.m. I am like an emergency wardresident again, but with more responsibility. We haveconverted the [NCAP clinical center into a make-shifthospital. The Social Security hospital and the two general hospitals are full, with patients in the corridors.Roosevelt General Hospital is without water and without electricity except for the operating room. Conditionsare very septic. Water is from public faucets. WithGuatemala's reputation for diarrheal disease, shigellosisand salmonellosis even of the typhoid variety can be expected. Let me recount the first minutes and hours of theearthquake. I awoke to a loud rumble as the shock wavereached a crescendo. I jumped out of bed-the motionwas enough to throw me to the floor, where I couldn'trise for the uneven motion. I finally crawled to the door,raised myself on the doorknob and got out of the housejust as the shock wave passed.The next morning we went to INCAP. The laboratorybuilding had suffered a chemical explosion which hadcaused a fire that had burned in the library. In the mainlaboratory of the Biomedical Division, the fumes of sulfuric, perchloric and acetic acid made entrance almostimpossible. But we had to rescue the distilled water jugsfor use by the children in the clinical center.The Following Week. Our principal location is the fieldhospital set up by the Honduran Red Cross. The conditions of the field hospital were incredible. Infected cottonand gauze were strewn on the ground. Patient after injured patient were placed on the same three filthy mattresses. Analgesics, gauze, plaster, valium and soap werefortunately available. A gasoline generator provided lightat night. We had limited IV solutions which were administered via hypodermic needles taped carefully inplace. The number of cases of fractured pelvises, fractured clavicles and dislocated femurs was largest.With the Honduran Red Cross I made a food drop atthe Lion's Club Recuperation Center for malnourishedchildren in San Juan. The director had been killed in hersleep by the earthquake. Miraculously, the 76 children intheir cribs were all unscathed as the concrete roof cavedin on the nursery.The problems are not over. Landslides continue to interrupt traffic on the major highways. Some towns mustbe burned to the ground, for the cadavers which remainentombed in the houses represent a sanitation hazard.Aid has come from all sides. The courage and stoicismof the Guatemalan people have been inspiring. Already,the process of cleaning and rebuilding is under way. Theradio messages say, "Guatemala esta enpie" -Guatemala is on her feet again. "ReconstruirernosGuatemala"-We shall rebuild Guatemala.27Great Expectations1976 Medical Alumni Day"Y ou are the lifeblood of the future of medicine in thiscountry," Dr. Daniel C. Tosteson told the graduatingmedical students at the Medical Alumni Association'sReunion Banquet on June 10. "We expect much of you,we have confidence in your capabilities to meet theseexpectations, and we wish you well in your future lives."The fourth annual Medical Alumni Day was a dayfilled with expectation and honor for all involved. Theactivities of the day attested to the excellence andachievements of the graduates, alumni and faculty of TheUniversity of Chicago Division of Biological Sciencesand Pritzker School of Medicine.It started with a special hour-and an early one, atthat-for the Century Club members who were guests ofhonor at an 8:00 a.m. breakfast at the Quadrangle Club.These "special friends" of the Division and the medicalschool, who have contributed $100 or more in support oftheir alma mater, received a warm welcome from DeanTosteson, who also reported at some length on the activities and goals of the Division.Scientific SessionA scientific program by the reciprents of the distinguished service award followed the breakfast. Thosehonored, and their topics, are:George J. Brewer (,56), Professor of Human Genetics andInternal Medicine, University of Michigan Medical School;The Treatment of Sickle Cell Anemia with Zinc. Dr.Brewer's investigations in medical genetics and molecularbiology continue to lead to significant advances in the understanding and treatment of the genetic aberration in the redcell of sickle cell anemia and other related disorders. Hereceived his distinguished service award from his formerteacher and research sponsor, Dr. Leon O. Jacobson (,39), ata luncheon following the scientific program.Donald D. Brown (,56), Staff Member, Department of Embryology, Carnegie Institute of Washington; The New Genetics. Dr. Brown's studies have pioneered the molecularbiological approach to problems of cogenesis and early embryonic development, and his observations of ribosomal geneamplification, a remarkable process that occurs duringcogenesis, have provided the basis for the first isolation in pureform of genes from eukaryotic organisms. He received hisaward from his good friend and former classmate inBiochemistry, Dr. Donald F. Steiner ('56). Dr. Brown alsoreceived an honorary degree of Doctor of Science at theUniversity's Convocation in Rockefeller Chapel.Walter Lawrence, Jr. (,48), American Cancer Society Professor of Clinical Oncology; Chairman, Division of SurgicalOncology; and Director, Cancer Center, Medical College ofVirginia; Oncology-A New Specialty? Dr. Lawrence hasmade major contributions to the knowledge of operativetreatment of gastric cancer, the effect of surgery on nutrition,the biochemistry of ammonia in the body, the development ofregional chemotherapy perfusions, and the field of bone marrow transplantation. His award was presented by Dr. DavidB. Skinner, Chairman of the Department of Surgery.28 Lt. Gen. Richard R. Taylor (,46), The Surgeon General,Department of the Army, Washington, D.C.; BicentennialRef/ections on Contributions of the Army Medical Department to Medicine. Lt. Gen. Taylor has had a long and distinguished career in military medicine. He received his awardfrom Dr. Otto H. Trippel (,46), Vascular Surgeon and Associate Professor at Northwestern University MedicalSchool.John S. Thompson (,53), Vice Chairman and Professor, Department of Internal Medicine, the University of Iowa;Human Histocompatibility Antigens and Their ClinicalSignificance. Dr. Thompson has been recognized as. an innovative scientist, a clinician of exceptional skill and wisdom, and an outstanding academic leader. Dr. Clifford W.Gurney (,51), Deputy Dean of the Division, the medicalschool, and for the Clinical Sciences, presented Dr.Thompson's award.Fifty Year ReunionFifty-year citations were presented to members of theClass of 1926 at the 50th Reunion Luncheon. Nine members of the class were on hand to receive their citations:Stuart Bergsma, Michigan; Dale E. Beverly, New Jersey; Clarissa E. Devney-Rainey, Florida; James C.Ellis, Illinois; Helen C. Hayden, Illinois; Harold H.Lampman, Michigan; George F. O'Brien, Illinois;Theodore J. Smith, Florida; and Van W. Taylor, Missouri.Following the luncheon, alumni had an opportunity tobecome reacquainted with the University by joining anafternoon campus or hospital tour. Those opting for thehospital tour visited the Wyler Intensive Care Unit andwere apprised of recent advances in the treatment ofReye 's Syndrome; viewed the first filming of the atom, arecent University of Chicago breakthrough, and discussed its implications for medical research; learnedabout the University's excellent perinatal program; andreceived a mini-course in heavy ion radiography, a newand promising development in the field of radiology.Graduates and Faculty HonoredThe culminating event of the day was the evening reception and banquet at Jacques East, where specialawards and honors were presented to graduating seniorsand faculty members. Four alumni and faculty memberswere there to see relatives receive the Oath of Hippocrates: Richard D. Simon (,44), a pediatrician in WallaWalla, Washington, whose son, Richard, Jr., is amember of the Class of 1976; Paul L. Katz (,65), an orthopedic surgeon in Northfield, Illinois, who attendedthe Alumni Day activities in honor of his brother, Lee D.Katz; and Georgine and Jerome Kavka, both lecturers inPsychiatry at the University'S medical school, who havea daughter, Audrey Beth, among the graduating class.Awards to GraduatesGraduation with Honors:Mary Judith Kemeny AlpernRobert Jay AlpernPatrick John CahillRonelle Ann DuBrowDavid Eugene HallPaul B. Kaplowitz Jeffrey Conrad LaurenceThomas J. McKearnDavid G. OstrowJohn Walter SmithDavid Sheldon StrayerAlpha Omega Alpha:Mary Judith Kemeny AlpernRobert Jay AlpernPatrick John CahillJohn Dougher CarrollSusan ClasterRonelle Ann DuBrowKathleen Dunne EggliStewart Charles GarneauDavid Eugene Hall Walter Michael JakubasPaul B. KaplowitzMerlin KelsickThomas J. McKearnPhillip Thiele NorthDavid G. OstrowRobert Jay RothbaumMarcis T. SodumsRonald Jay SokolThe American Medical Women's Association AnnualAwards, to outstanding women graduates for scholasticachievement: Mary Judith Kemeny Alpern, Ronelle AnnDuBrow, Kathleen Dunne Eggli, and Susan Terris.The Joseph A. Capps Award, to a senior medical studentfor proficiency in clinical medicine: John Walter Smith.The Catherine L. Dobson Prize for the best oral presentation of research done by a non-Ph.D. student duringmedical school: James E. Boggan.The Mark Perry Galler Prize, to an individual who hassubmitted the best Ph.D. thesis in the Division of Biological Sciences during the previous academic year: SusanTerris.The Franklin McLean Medical Student ResearchAward, to a senior who has performed the most meritorious research: Richard Mauritz Bergenstal.The Medical Alumni Prize for the best oral presentationof research done during medical school: David G. Ostrow.The John Van Prohaska Award for outstanding potentialin teaching, research, and clinical medicine: David Sheldon Strayer.The Mary Roberts Scott Memorial Prize, to a womanmedical student for academic excellence: KathleenDunne Eggli.The Nels M. Strandjord Memorial Award, to a seniormedical student for outstanding performance in the general field of Radiology: Jack Michael Protosevich.The Upjohn Award in Medicine, to a senior for outstanding achievement during four years in medical school:David Eugene Hall.And, in recognition of extraordinary contributions tomusical theatre at the University, a special award toStephen F. Kemp.Award to FacultyOutstanding faculty, past and present, were next to belauded. Dr. Edward Ganz was presented with theM cC lintock A ward for outstanding teaching, an honor accorded to him by the graduating class. Dr. Ganz, Assistant Professor in the Neurosurgery Section of the Department of Surgery, received his M.D. degree from theUniversity in 1967. He also completed his internship insurgery and residency in neurosurgery here. In additionto his academic activities, Dr. Ganz is involved in research on stimulation techniques for the treatment ofpain.The Hilger Perry Jenkins Award, given by the graduating seniors for excellence in performance of academicand patient-oriented service, was presented to Dr.Richard Gaeke, who has just completed his second yearof residency in the Department of Medicine. Dr. Gaekereceived his M.D. degree from the University in 1973,and took his internship here.The Gold Key of the Medical A lumni A ssociation waspresented to Dr. Peter P. H. De Bruyn, ProfessorEmeritus in the Department of Anatomy, 1941-76, andChairman, 1946-61; and to Dr. Henry B. Perlman (,25),Professor Emeritus in the Otolaryngology Section of theDepartment of Surgery, 1931-68. University professorsDr. Ronald Singer and Dr. John R. Lindsay presentedthe keys. Their tributes to the recipients are excerptedhere:Armed with an M.D., received in 1938 from the University ofAmsterdam, and a number of publications on granulation ofleukocytes, Peter De Bruyn brought his young family from wartorn Europe to the U.S.A. in 1941, at the behest of WilliamBloom and R. R. Bensley and as a consequence of the behindthe-scenes maneuvering of the President of the University, M r.Robert Hutchins. He was hoping to sit in on the lectures of thegreat men of Anatomy so as to improve his English. Instead,upon arrival, he was told to give a course in neuroanatomyduring the summer while the rest of the Department were awaydoing research. Peter often reminisces how his poor pronunciation and lack of experience in neuroanatomy must have confused these students. However, 35 years later we can point tothe tremendous enthusiasm with which dozens of freshmanmedical classes have received his histology lectures.Students have been impressed not only by the clarity of histeaching but by the vitality with which his lectures have beencharged. This inspiration has been transmitted not only to themedical students but also to the graduate students and his colleagues.During his academic career as a tissue and cell biologist, Dr.De Bruyn became an established authority on blood and connective tissue, and in recent years has concentrated on celllocomotion through the sinusoidal walls of liver, bone marrowand spleen, and the phagocytic capability of their vessels. Nowretired, he still has a very active group working in his laboratory. They have demonstrated that the Shay transplantableleukemia is an excellent model for studying the transmural passage of malignant blood cells in myeloid leukemia. Their transmission and scanning electron microscope studies indicate thatthe mode of migration of malignant cells in the bone marrow isdistinctly different from that of normal blood cells. They arealso working on the possible effects of endotoxins on the abilityof the Shay leukemia cells to produce a successful subcutaneous transplant and, after intravenous administration, an acutemyeloid leukemia. Their results indicate that endotoxins mayinhibit both events.Dr. De Bruyn has trained a number of excellent graduatestudents. Last year his first graduate student, Dr. Richard S.Farr (,46), now chairman of the department of medicine at Na-29130 234. Dean Ceithaml congratulates James E. Boggan (76), who received the Catherine L. Dobson Prize.1. Dr. Peter P. H. De Bruyn is handed the Medical AlumniAssociation's Gold Key by Dr. Ronald Singer.2. Dr. Henry B. Perlman, Gold Key recipient, enjoys the eveningreception with his sons, Dr. Robert Perlman (M.D. '61) and DanielPerlman (Ph.D. '71), and Mrs. Perlman.3. Dr. John s. Thompson ('53) received a distinguished serviceaward.455. Or. Edward Ganz ('67) receives the McClintock Award fromDavid E. Hall ('76).6. Senior medical students spoof their medical school years in theannual Senior Skit.7. Or. Walter Lawrence, Jr. (,48) delivers one of the scientific session presentations.8. Or. Sherwyn Warren (surgery resident and instructor, '61-'66),Dean Daniel Tostesoti, and Gaylord oonnelley, member andformer chairman of the University's Board of Trustees, enjoy apre-breakfast chat.7 6831tional Jewish Hospital and Research Center and professor atthe University of Colorado Medical Center, was honored bythe alumni with a Distinguished Service Award, and last yearalso, Dr. De Bruyn graduated his last graduate student, Andrew Farr. I think it quite remarkable that his last graduatestudent was the son of his first.Dr. De Bruyn began his career here as an I nstructor in 1941,and in 1952 became Chairman of the Department of Anatomy, apost he held until 1961. I n addition to his academic accomplishments and teaching distinctions, he has served as editor ofthe Scientist's Library series of the University of Chicago Presssince 1952, as a departmental editor and advisor of the Encyclopaedia Britannica, and as a member of the editorial board ofthe American Journal of Anatomy. This distinguishedanatomist also hides distinctive cultural attributes under hisbushel: Peter De Bruyn not only plays the classical guitar but isa fine sculptor and an expert on antique furniture.I am delighted that this Gold Key is being awarded to someone who so closely meets the distinction required of an awardeeand who so closely matches the attributes in teaching andscholarship of last year's recipient of the Gold Key, WilliamDoyle, with whom Dr. De Bruyn has been closely associated inthe Department of Anatomy for 30 years. For his outstandingand meritorious service to our Division and for his excellentcontributions to our knowledge of the blood and connectivetissues, I am honored to present this Gold Key on behalf of theMedical Alumni.-Dr. Ronald Singer 910Dr. Henry B. Perlman, Professor Emeritus at The Universityof Chicago, The Pritzker School of Medicine, began his medical school training at the University of Wisconsin and transferred to Rush Medical School for the clinical years, graduatingin 1925. Following one year of internship at Los AngelesCounty Hospital, he began general practice in Wisconsin.After four years' experience with the many complex problems faced in general practice, he sought further training, joining the E.N.T. service at Billings Hospital in July, 1930 asAssistant Resident. Early in his residency Dr. Perlman's special interest in the fundamentals of otology became evident. Hemastered the complicated anatomy of the temporal bone bymaking Wood's metal casts of the labyrinthine spaces, injections of the vascular system and the study of serial sectionunder the microscope.Utilizing cinematography, he made a contribution to the understanding of Eustachian tube function in the human and itseffect on middle air pressure and threshold hearing.Dr. Perlman's studies with Dr. Heinrich Kobrak in the earlythirties included analyses of the movements of the ossicular 11chain in response to sound in animals, and of the movements ofthe eardrum in the human by cinematography. He also studiedthe contractions of the middle muscles and their effect on soundtransmission studied and recorded in suitable cases in thehuman. These early observations formed the basis for later development of clinical tests now popular in the audiological field.In 1939 Dr. Perlman, with the assistance of a colleague in theEncephalography Laboratory, developed a method for recording the electrical corneo-retinal potentials during eye movements. About fifteen years later this method ofnystagmographycame into general use in clinical diagnosis.At the beginning of World War II the question of deafnessdue to explosions and gun fire was of major interest to thearmed forces and to industry. Dr. Perlman was engaged inanalysing the effect of the shock pulse from a gun fired close toan animal's ear. His sense of the dramatic emerged one eveningduring a presentation of his work to a somewhat satiated audience of his colleagues. He startled his audience into abrupt32attention by pulling a gun from his pocket and firing a shot intothe air.After World War I I, Dr. Perlman devised a method for studyof microcirculation in an animal's ear. The rate of movement ofblood cells through the vessels and changes in the lumen ofvessels under varying conditions was recorded by motion picture camera, for detailed analysis later. The project continuedfor more than a dozen years under support by NIH.Perhaps Dr. Perlman's greatest contribution to the training ofthe younger men on the staff was his good judgement. conservatism and responsiveness to requests for guidance or advice.H is contributions to otology have earned him the highest respect by his colleagues both in the U. S. A. and in internationalcircles.-Dr. Jolin R. Lindsay12 139. Class of 7946: (left), Dr. and Mrs. john W. Green, Ll. Gen.Richard R. Taylor and Mrs. Taylor, Dr. and Mrs. Edward Munnell,and Dr. and Mrs. john Donnelly.10. Dr. Leon jacobson ('39) with former student and distinguishedservice award recipient Dr. George l. Brewer ('56).11. Class of 7956: (left), Dr. Donald Steiner, Dr. and Mrs. WalterEdibo, Dr. and Mrs. Edward Kolner, Dr. and Mrs. Donald Brown,and Dr. Eugene Balter.12. Class of 7957: (left), Dr. Robert Wirtshafter, Dr. CarolynPalmgren, Dr. Harold Malkin, Dr. William Sippel, Dr. ArnoldTanis, Dr. Harold Marcus, Dr. Duane Hyde, Dr. Clifford Gurney,Dr. Ralph Stephan, and Dr. Robert Bloom.13. Class of 7926: (left), Dr. Stuart Bergsma, Dr. Dale E. Beverly,Dr. Clarissa Devney-Rainey, Dr. Helen C. Hayden, Dr. Harold H.Lampman, Dr. George F. O'Brien, Dr. Theodore l. Smith, Dr. jamesC. Ellis, and Dr. Van W. Taylor. ReunionsIn addition to the 50-year reunion of the Class of 1926,members of the classes of 1946, 1951, and 1956 held special celebrations to commemorate their anniversaries.Pervading these festive events was a spirit of pride in theUniversity and happiness at being reunited with formerclassmates.The Class of 1946 celebrated its 30th anniversary atJovari's Restaurant. Dr. Earl Hathaway and Dr. Otto H.Trippel were co-chairmen of the event, which was attended by 32 alumni and spouses. Alumni attending included:Meyer Barrash. IllinoisMark Beaubien. Washington.D.C.Jack Berger, IllinoisJohn Donnelly, ColoradoDaniel Enerson,PennsylvaniaPaul Francke, Jr., West VirginiaPhilip Graff, IllinoisJohn W. Green, IowaJohn Hanni, Illinois Earl Hathaway, IllinoisRobert Mac Duffee. FloridaBuel Morley. IllinoisEdward Munnell. OklahomaJohn Schaeffer. MontanaLt. Gen. Richard R. Taylor.Washington, D.C.Otto Trippel. IllinoisHerbert Warden. WestVirginiaPaul Zuelke, OregonFifty percent of the Class of 1951 attended reunionevents, a record percentage for alumni participation.Thirty-four alumni and spouses met for cocktails anddinner at the Metropolitan Club on the 66th floor of theSears Tower, where Dr. Clifford Gurney gave a briefretrospective of the events of the last 25 years at themedical school. Dr. Arnold (Bud) Tanis and his wifeplan fled the reunion, and prepared a newsletter for thosewho did not attend. Alumni attending reunion eventswere:Donald Anderson, IllinoisFranz Berlacher, OhioRobert Bloom, MichiganC. Larkin Flanagan, IllinoisNaomi Ragins Goldsmith,PennsylvaniaMortimer Gross, IllinoisClifford W. Gurney, IllinoisMarcia Hughes, IllinoisDuane Hyde, CaliforniaHenry Inouye, IllinoisJay Jensen, UtahEric Lauter, MichiganHarold Malkin, CaliforniaHarold Marcus, New YorkJack McCarthy, New Mexico Robert S. Mendelsohn,IllinoisRichard Neudorfer, NewYorkJoseph Ousley, WisconsinCarolyn Palmgren, IllinoisRobert Raiman, MichiganLeo Sadow, IllinoisWilliam Sippel, ArizonaGeorge Spikes, ArizonaRalph Stephan, FloridaArnold Tanis, FloridaJohn Westergart, CaliforniaHenry Wildberger, IllinoisRobert Wirtshafter, IllinoisThe Class of 1956 held their reunion dinner at theNinety-Fifth Restaurant in the John Hancock Building.Co-chairmen Dr. Donald Steiner and Dr. Alvin Tarlovwelcomed a group of 26 alumni and spouses, includingthe following class members:Eugene Anderson, IllinoisEugene Balter, IllinoisGeorge Brewer, MichiganDonald Brown, MarylandErl Dordal, IllinoisWalter Edibo, IowaArnold Gombiner, IllinoisLawrence Gottlieb, Wisconsin Zdenek H ruban, IllinoisEdward Kolner, WisconsinConstantine Panos, IndianaMorton Pastor, CaliforniaSheldon Schiff, IllinoisDonald Steiner, IllinoisAlvin Tarlov, Illinois33Profile of the New Alumni PresidentOfficers of the Medical Alumni Association for 1976-77 are: loseph H.Skora, vice president; Benjamin H. Spargo, councilor; Francis H. Straus II,secretary; and Asher I. Finkel, president. Not pictured: Charles P. McCartnev , president-elect; and Richard H. Evans, councilor.Dr. Asher J. Finkel, the new president of the MedicalAlumni Association, had a rather unusual entry into themedical profession. He recounts the circumstances behind his decision to enter medical school: "I had passedthe preliminary exams for my Ph.D. examination in TheUniversity of Chicago Department of Zoology. One day,while I was in the army as an enlisted man, the firstsergeant asked if I was interested in going to medicalschool. I responded that even going to medical schoolwas better than doing k.p. once a week. One thing led toanother, I returned to the University as a medical student, and I was able to complete my Ph. D. in Zoology atthe same time."That was a serendipitous happening, indeed, for Dr.Finkel has had a long career in medicine and science. Following his internship at the University Clinics, he spentthe next 20 years at Argonne National Laboratory,where for more than 15 years he was Director of theHealth Division. During this time he was engaged in investigative work in two areas: a study of the metabolismof radium in animals and the long-term effects of radiumdeposition in man, and physiological studies of deuteriumoxide.In 1970 Dr. Finkeljoined the American Medical Asso- cation, where he presently serves as Group VicePresident for Scientific Affairs and Continuing MedicalStudies.Dr. Finkel's affiliation with the University spanned theyears from 1932 to 1949, during which he earned his S.B.and Ph.D. in Zoology, and his M.D. degree. "I startedat the University as a freshman in the College in 1932,"he says. "It was a very exciting time, because this was inthe second year of President Hutchins' New Plan. It isvery difficult to highlight anyone experience from thevast array of experiences I had at the University-myundergraduate years in the medical school, my graduatework in the Department of Zoology, and my internship inthe University Clinics all rank very high as pleasurablememories. "The University and the medical school are more thanjust a memory for Dr. Finkel, however. He has beenactive in the Medical Alumni Association for severalyears, serving as Vice- President, President-Elect,member of the Council, and now as President. He looksforward to an active year on his part, and on the part ofthe council members. "The activities of the MedicalAlumni Association do not depend on the goals andprojects of the president, but are in a sense the collectiveactivities of the Alumni Council. While it is appropriatefor the administration of the medical school to have someinput from the Medical Alumni Association, the 'oldgrads' should not presume on the responsibilities of theDean, and should not offer unsolicited advice."Dr. Finkel is a member of several professional associations related to occupational medicine, nuclear medicine,medical research, zoology, ecology, and archaeology.He has served as President and Secretary-Treasurer ofthe Central Chapter and member of the Board of Trustees of the Society of Nuclear Medicine.In 1943 Dr. Finkel married the former Miriam D.Posner, who also has a Ph.D. in Zoology from the University. She has been involved in scientific investigationat Argonne National Laboratory for more than 30 years,and Dr. Finkel is proud of her achievements. "I considerher to be a far more distinguished scientist than I am. Themost recent aspect of her work, and probably the mostexciting, is her studies on the viral etiology of osteosarcomas in mice, and perhaps in humans."The Finkels have lived in the Beverly Hills area ofChicago for the last 25 years, and have four sons.34Let the great world spin forever downthe ringing grooves of change.-TennysonName 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 mailbox. Thanks!Medical Alumni Association1025 East 57th StreetChicago, Illinois 60637Fold this flap in first ,-------lI II II Place II II Stamp II II Here II I� JResidency Assignments-1976Ninety-seven percent of the 105 senior medical studentswho participated in this year's National Internship andResidency Matching Program (N I RM P) were acceptedby hospitals of their choices. Sixty-one seniors werematched to the hospital of their first choice, 18 to thehospital of their second choice, and six to the hospital oftheir third choice. The remaining 17 were accepted byhospitals of their fourth choice or higher. Their assignments began on July 1.The class of 1976 includes 110 graduates, three morethan last year's class, until then the largest in the historyof the medical school. The five students who did notparticipate in the matching program include a marriedcouple who will enter residencies at the Army's WalterReed Hospital; a student who will enter a residency insurgery under the auspices of the United States AirForce; one who participated in the Canadian MatchingProgram and will be a resident in surgery at TorontoGeneral Hospital; and a Ph.D.lM.D. graduate who willdo postdoctoral research in pharmacology here before hebegins his residency.This is the second year that all first-year post-graduateclinical appointments are designated as residencies, ofwhich there are three possible types. Categorical residencies are comparable to straight internships in thepast; diversified residencies are analogous to mixed internships in the past, with emphasis on one specific clinical discipline; and flexible residencies are similar to therotating internships of the past.Of the 105 students who received their residency appointments through the matching program, 88 percent(92) were placed in residency programs which filled alltheir positions in the N I RM P. Similarly, of the 82 hospital units where our students began their residencies last month, 84 percent (69) filled all of their positions in theNIRMP.The 109 students now beginning their residencies aredistributed among the various clinical disciplines as follows: More than a third (41) will be in internal medicine;22 will be in surgery, including two in orthopedic surgery;and 21 will be in pediatrics. Here is the distribution byclinical disciplines:AnesthesiologyFamily PracticeFlexibleInternal MedicineObstetrics-GynecologyOphthalmologyOrthopedic SurgeryPathologyPediatricsPsychiatryRadiologySurgery 22416225215220Total 109"Members of the senior medical class will be servingat excellent teaching hospitals located throughout thecountry," says Joseph Ceithaml, Dean of Students. "Itis noteworthy that only three of our students who participated in the N I RM P were unmatched, and all three weresubsequently placed in excellent hospitals. This lownumber of unmatched students is especially remarkablein view of the fact that seven percent (952) of all studentsfrom U.S. medical schools in the national matching program did not match, and a large number (41) of our students sought residencies in internal medicine, a disciplinein which 91 percent of all available residencies in theU.S. were filled in the N I RM P this year. The success ofour students in the matching program can be attributed tothe concerted and cooperative efforts of both our students and faculty members."2 Barnes H. Group I Mt. Auburn H., Mass. I Toronto General H.I Beth Israel H., Boston 3 Mt. Zion H., S.F. I U. of Calif. Affil. H., DavisI Boston Univ. Affil. H. I New England Med. Ctr. I U. of Calif. H., L.A.I Case Western Reserve Affil. H. I N. Y. Med. Colt-Metro H. I U. of Calif. H., S.F.I Childrens H., N. Calif. 3 North Carolina Memorial H. 23 U. of Chicago H.I Childrens H., Philadelphia 2 Northwestern Univ. Med. Ctr. 2 U. of Colorado Affil. H.I Childrens H., S.F. I Ohio State Univ. H. I U. of Indiana Med. Ctr.I Cook County H. I Pennsylvania H., Philadelphia I U. of Kentucky Med. Ctr.I Duke Univ. Med. Ctr. 2 Presbyterian H., N.Y.C. I U. of Missouri Med. Ctr.I Henry Ford H., Detroit 2 Presbyterian-St. Lukes H. I U. of Oregon Med. Ctr.I Indiana Univ. Med. Ctr. I St. Francis H., Peoria I U. of Rochester Assoc. H.I Jewish H., St. Louis I St. Josephs H., Phoenix I U. of Tennessee Memorial H.4 Johns Hopkins H. I St. Josephs Mercy H. M I. I U. of Utah Affil. H.3 L.A. County H.-USC Ctr. I St. Louis Childrens H. 3 U. of Washington Affil. H.I Long Beach VA. H.-Irvine I St. Paul-Ramsey H. I U. of Wisconsin H., Madison3 Massachusetts General H. 3 San Diego County Univ. H. I Vanderbilt Univ. Affil. H.I Medical Ctr. of W. Mass. I Stanford Univ. H. 2 Walter Reed H.I Medical College of VA. H. 3 Syracuse Univ. Med. Ctr. I Willford Hall Med. Ctr., TX.6 Michael Reese H. 3 The New York H., N.Y.C. I Yale-New Haven Med. Ctr.37News BriefsArnason Appointed Chairman of NeurologyDr. Barry G. W. Amason was appointedProfessor and Chairman in the Department of Neurology, effective July I. Dr.Amason was formerly associate professor of neurology in the Harvard MedicalSchool.The Department of Neurology was established as a separate department in1975. Its Acting Chairman has been Dr.Douglas N. Buchanan, ProfessorEmeritus in the Departments of Pediatrics and Neurology. Dr. Buchanan hadreturned from his retirement in Englandto help organize the new department,which was formerly a section in the Department of Medicine.Amason is a specialist in multiplesclerosis, allergic neuritis, amyotrophiclateral sclerosis, myasthenia gravis, encephalomyelitis, and tumors of the nervous system. He is also an expert in immunology and the immunological aspects of diseases of the nervous system.A native of Winnipeg, he received hisM.D. degree with honors in 1957 fromthe University of Manitoba, where hewas an undergraduate also. He held internships and residencies at WinnipegGeneral Hospital and MassachusettsGeneral Hospital and was subsequentlya teaching fellow and clinical and research fellow in neurology at HarvardMedical School and assistant in neurology at Massachusetts General Hospital.In 1962-64, Dr. Amason was principalinvestigator in research sponsored by theNational Multiple Sclerosis Society inthe laboratory of Dr. Pierre Grabar. inthe Institut de Recherches Scientifiquessur Ie Cancer, Villejuif, France.He subsequently served as instructorassociate in Neurology and assistantprofessor in Neurology at Harvard,being appointed associate professor in1971. He was also assistant and associate neurologist at MassachusettsGeneral Hospital. He was certified bythe American Board of Psychiatry andNeurology in 1971.He is the author and co-author ofnumerous published research studies onthe role of the thymus and the spleen inimmunology, immunoglobulins and antibodies, immunity to tumors, demyelination (multiple sclerosis), and nervegrowth factor.Chief of Urology AppointedDr. Harry W. Schoenberg has been appointed Professor and Chief of the Sec-38 t\\I�,J \�-WOr. Michael Newton, Or. Raoul Palmer and Or.Luis A. Cibils engage in conversation at the dedication of the J. P. Greenhill Library of the Department of Obstetrics and Gynecology.tion of Urology in the Department ofSurgery. His appointment became effective July I. Schoenberg was Professorand Chairman of the Department ofUrology in the St. Louis UniversitySchool of Medicine from 1972 to 1976.He is the author of more than 1 ()() research publications on kidney, urinary,and prostate problems, and is a specialistin urological cancers and in problems ofthe neurogenic bladder.A native of New York City, Schoenberg received his B.S. degree from YaleUniversity and his M.D. degree in 1952from the University of Pennsylvania,where he also served his internship andresidencies in both surgery and urology.He was a Fellow of the Harrison Department of Surgical Research and Assistant and Senior Resident in Urologybetween 1952 and 1960. In 1954-56 hewas commanding Officer of the 271 stMedical Detachment and 187th GeneralDispensary, U.S. Army, Worms, Germany.He held faculty appointments at Pennsylvania in the Department of Surgeryfrom 1953 to 1972, becoming Professorin 1969, and was on the attending staffsof the Hospital of the University ofPennsylvania and the Children's Hospital of Philadelphia.Palmer Second Greenhill Visiting ProfessorDr. Raoul Palmer of the Faculty ofMedicine, Paris, France, was the secondJ. P. Greenhill Visiting Professor of Obstetrics and Gynecology. Dr. Palmer,formerly Chef des Travaux de la Chairede Gynecologie, Hopital Broca, Paris,delivered lectures on "Corpus LuteumInsufficiency" and "Tubal Surgery inInfertility" while here in March. Following the latter lecture. Dr. Palmer participated in the dedication of the J. P.Greenhill Library, the newly-renamed library of the Department of Obstetricsand Gynecology on the second floor ofthe University's Chicago Lying-in Hospital.Dr. Greenhill, who died in 1975, madea gift of $84,037 to the Universitythrough the J. P. Greenhill Fund in Obstetrics and Gynecology. The fund established a traveling fellowship and a lectureship and lends support to the departmental library.Dr. Palmer, who was a close friend ofDr. Greenhill, was on the staff of theHopital Broca, Paris, from 1934 to 1972.Among his accomplishments:In 1939, he first described the effect ofprogesterone, a sex hormone, on bodytemperature. This established the valueof basal body temperature in evaluatingovarian function. It is currently a routinetest in evaluation of infertility.He started the use of laparoscopy ingynecology in 1943.In the 1940s and 1950s he developedhysterosplingography (a technique forradiographic examination of the uterusand Fallopian tubes with radio-opaquedyes) and utero-tubal insufflation (pumping of gas into the uterus and tubes) tostudy the physiology of the uterine andtubal muscles. Both are also routine testsnow in the evaluation of infertility.In 1962 he published the first report ontubal sterilization by laparoscopy.As Director of Research of thegynecologic chair of Paris, he supervisedand guided more than 100 doctoral candidates.Through the influence of his teachingand research, French gynecology became a specialty oriented to physiologyand function and was no longer purelysurgical.Ricketts AwardMaurice Green, Professor in the Institute for Molecular Virology, St. LouisUniversity, delivered the 1976 HowardTaylor Ricketts Award Lecture on May24. His topic was .. Adenoviruses-Model Systems of Virus Replication,Human Cell Molecular Biology, andNeoplastic Transformation."Green's research in the early 1960slaid the basis for all current studies of themolecular biology of adenoviruses,which are commonly found in the humanrespiratory tract. He has also made important contributions to the study ofRN A tumor viruses (oncogenic RN Aviruses, or oncornaviruses), which causecancer in experimental animals andperhaps in man.The Ricketts Award and Lecture honors the memory of Howard Taylor Ricketts (1871-1910), a University of Chicagopathologist who in 1906 discovered thatRocky Mountain spotted fever is causedby a bacterium, Rickettsia rickett sii, thatis transmitted to man by ticks.Stein Gift for Eye ResearchDr. and Mrs. Jules Stein of BeverlyHills, California, have given the University over $1 million in support of a VisionResearch Building. Dr. Stein, an alumnus of the University, is the founder ofMCA, Inc. (Music Corporation ofAmerica). The gift has been designatedby Dr. and Mrs. Stein as "seed money"and will be used by the Department ofOphthalmology solely for the eye research building.The new eye center will eventuallyoccupy all four floors of the Experimental Biology Building, 939 East 57thStreet. The department of Ophthalmology plans to expand its eye cancer diagnosis and treatment laboratories as wellas its research and treatment in the fieldof hemorrhagic and diabetic eye diseases, said Dr. Frank W. Newell, theJames N. and Anna Raymond Professorand Chairman of Ophthalmology at theUniversity.The most advanced equipment andfacilities will be incorporated in thebuilding to enable the ophthalmologistsnot only to make the most up-to-date useof diagnosis but also to advance and develop further equipment and techniques.This will be in combination with a mostrefined electrophysiology laboratory andfacilities for electron microscopy. Particular emphasis will be placed on thecongenital eye disorders of children andhereditary diseases such as retinitis pigmentosa.According to Dr. Newell, the buildingwill triple the department's researchspace and permit expansion of its workin preventing eye disease. Thedepartment's facilities for clinical care ofpatients will remain in the University'sMedical Center.Commenting on the gift, Dr. Stein expressed confidence that a large numberof the eye disorders which blind almost50,000 Americans each year will eventually be wiped out through research."Eye research is in its infancy," he said,"yet it has brought enormous advancesin the management of cataracts,glaucoma, diabetic retinopathy, andother diseases which damage and destroy sight. We have the scientific competence to reduce drastically the terribletoll of blindness. The answer lies in continued acceleration of research effort."Dr. Stein received his Ph. B. degree atThe University of Chicago in 1915 andhis M.D. degree at The University of Chicago Rush Medical School in 1921.He was a resident in ophthalmology atCook County Hospital and practicedophthalmology in Chicago with Dr.Harry S. Gradle before establishingMCA, Inc. in 1924.In 1960, he joined forces with RobertE. McCormick, the corporate vice president of Olin Matthieson, Mary Lasker,and others to found Research to PreventBlindness Inc. (RPB). RPB has sincethen made annual unrestricted gifts, nowtotaling $3 million, to some 50 U.S. medical institutions for eye research. TheUniversity's Department of Ophthalmology has received a total of $80,000since 1960 in such gifts.To meet the need for modern facilities,RPB sponsors construction campaignsfor which it underwrites the campaigncosts, provides the services of professional development personnel, and actsto crystalize institutional focus on eyeresearch. RPB has been instrumental inchanneling more than $26 million intoconstruction of six modern eye centersacross the country. Among these is theJules Stein Eye I nstitute at the U niversity of California, Los Angeles, namedin his honor. Dr. Stein and his organization were the moving force in the establishment by the federal government ofthe National Eye Institute in the National I nstitutes of Health in 1968.In 1975, Dr. Stein received the AlbertLasker Public Service Award and in1976, he received the Jean HersholtHumanitarian Award of the Motion Picture Academy of Arts and Sciences, twoof many honors given him. On June 26,he received the Lions InternationalHumanitarian Award, during the serviceclub organization's international convention in Hawaii.Award-Winning Pediatric AmbulatoryCare ProgramThe Silvain and Arma Wyler Children'sHospital- University of Chicago Department of Pediatrics Ambulatory CareProgram was nationally recognized inApril as the recipient of the AmbulatoryPediatric Association's 1976 Outstanding Teaching Award. Dr. Jay E. Berkelharner, Wyler director of AmbulatoryServices and Assistant Professor ofPediatrics, accepted the honoraryplaque, the second such award in theAssociation's 20-year history.Dr. Berkelhamer described the threefold ambulatory program: "Our primarygoal is excellence in the delivery ofpediatric health care. Outpatient services are provided in a General PediatricClinic, a Pediatric Subspecialty Clinic,and an Emergency U nit, with approxi- Or. lay E. Berkelhamer, on behalf of the Department of Pediatrics Ambulatory Care Program, accepts the 7976 Outstanding TeachingAward of the Ambulatory Pediatric Association.mately 75,000 patient visits yearly.Two-thirds of our patients live in the surrounding community; the remainder arereferred by practicing physicians fromNortheast Illinois and throughout theMidwest. ..Comprehensive care is delivered on acontinuous basis in the General Clinic.Services are provided by Health careteams consisting of attending physicians,residents, pediatric nurse associates, social workers, and consulting psychiatrists. Each patient has a primary relationship with one member of the team.When that particular professional is unavailable, other team members providebackup coverage. Patients are seenprimarily on an appointment basis.Specialty Clinics offer consultationand subspecialty care in allergy and immunology, cardiology, cystic fibrosis,endocrinology, gastroenterology, genetic counseling, hematology and oncology,mental development, metabolism,neurology, nutrition, orthopedics, renaldisease, surgery and urology. Childrenwith craniofacial anomalies and otherswith multiple handicaps are seen in special multidisciplinary clinics. Highlyspecialized care is fostered by roundtable discussions following clinic sessions where a program of care is developed and discussed with the child andhis parents.The Emergency Room, under the direction of Dr. Janis Mendelsohn, Assistant Professor of Pediatrics, uses a triagesystem that insures that all children areevaluated upon arrival and cared for according to the immediacy and type ofhealth problem. Health professionals in39the Emergency Room include pediatricnurse associates; resident physicians inpediatrics, pediatric surgery, andemergency medicine; and full-time faculty physicians.Outstanding Teacher of Basic SciencesDr. Martha L. Warnock, Associate Professor of Pathology, was chosen by theUniversity's freshman and sophomoremedical students to receive the secondannual award for Outstanding Teacherof the Basic Sciences. Dr. Warnock isalso Director of the University's Schoolof H istotechnology and the PathologyDepartment's Autopsy Service.Dr. Warnock received her M. D. degree in 1960 from Harvard MedicalSchool, and took her internship inpathology at St. Francis Cabrini Hospital in Seattle. She came to The University of Chicago for her residency, and in1965 joined the faculty as an Instructorin the Department of Pathology.Author of many scientific publications. Dr. Warnock is involved in research on the association between lungcancer and exposure to asbestos fibers.and on other diseases of the lungs.Heart Attack PreventionHeart surgeons may some day kill part ofthe heart to protect the rest of the heart.This may become one strategy to outwit"sudden death" from heart attacks, saysUniversity cardiologist Dr. Harry A.Fozzard. Others are twenty-four hourelectrocardiograms. and a better understanding of heart electrophysiology, particularly the role of calcium ion flow inarrhythmias (irregular heart spasms).leading to the possible development ofnew heart drugs.According to Fozzard, certain heartareas can originate faulty electrical signals that can suddenly throw the heartinto irregular spasms. Most heart deathsare caused by such spasms. "Perhaps inthe future we can map the heart to showwhich part of the muscle is producing thearrhythmia." he says. "Then we couldkill that part under direct vision and controlled conditions and remove the propensity to irregular heart rhythms."Computer reading of ECG data is becoming a diagnostic help in detecting patients at risk for "sudden death." Readings are from 24-hour tapes. not from theusual short-form ECG. The Universityof Chicago is one of several U.S. medical centers now operating such a system,which can analyze a 24-hour tape in 48minutes. The system picks out suchproblems as the occurrence of prematureventricular contractions. On standard40 Dr. Arthur L. Herbst (right) was guest of honor ata dinner given by the Chicago Lying-in HospitalBoard of Directors to welcome him as Chairman of the Department of Obstetrics andCynecology. Also present at the May 26 Directors' Dinner were (left): Dr. Daniel C Tosteson;Dr. Beatrice Tucker, first recipient of the JosephBolivar DeLee Humanitarian Award; Robert C.Cunness, University Trustee and Chairman ofthe Committee on Hospitals and Clinics; andJohn T. Wilson, President of the University.ECG graph paper, a 24-hour ECGwould be 8700 feet long, or one and a halfmiles.A disturbance in heart membranefunction is the probable cause of suddendeaths from arrhythmias, says Fozzard.Heart contractions are triggered bychanges in sodium and potassium ionflows into and out of heart muscle cells.However. calcium ion flow also affectsthe heart. it has been learned. In damaged (ischemic) heart muscle, calciumion action may replace sodium ion action. and may act as a reservemec han ism . A lso , the primarypacemaker cells. the sinoat rial (SA)node and the atrioventricular (A V) node,depend on calcium ion current to stimulate the heart electrically.Understanding the basic biophysics ofheart cell membrane processes is the"new frontier" in heart research, saysFozzard. Heart drugs designed to control arrhythmias by blocking the entry ofsodium ions into the cell cannot succeedif calcium ions are in fact responsible forirregularities instead of sodium. It'sknown that calcium ion current is greatlyenhanced by catecholamines-such asepinephrine and norepinephrine-released from the sympathetic nervoussystem. Other drugs are known to interfere with calcium ion current. Thesearch for drugs that affect the calcium iswide open. says Fozzard, but harmfulside-effects of such drugs must be carefully studied because the calcium currentis also important for heart contraction.Most sudden heart attack deaths aredue to arrhythmias, including deaths ofvictims who do not know they have heartdisease. In myocardial infarction a por- tion of the heart muscle dies because thearteries supplying it are plugged up withfatty, or atherosclerotic, plaques. Arteriosclerosis of the arteries in the heartmay give some advance warning, such asangina. But some arrhythmias occurwithout the development of myocardialinfarction, and the victim may drop deadwith little warning.Even if a person survives the first attack, because of prompt treatment bycommunity rescue squads, says Fozzard, "he is at risk for a second catastrophic event. As many as 30 percentdie suddenly within a year of the firstepisode. Serious effort must be made todetermine how we can identify the individuals at risk and institute preventivetreatment. "Fozzard, the Otho S. A. Sprague Professor of Medical Science in Medicineand Pharmacological and PhysiologicalSciences, co-Director of the Section ofCardiology, and Director of the Biomedical Computation Facility, has a grantfrom the National Heart and Lung Institute to study the mechanism of the heartbeat. His comments on arrhythmias appeared in a recent issue of lAMA."Marketing" Good Health HabitsThe medical profession should learnfrom Madison Avenue how to marketgood health, says Dr. Alvin R. Tarlov,Professor and Chairman of the Department of Medicine. He favors a programof "social marketing" to change selfdestructive behavior which leads to illhealth and death. Among the causes ofself-inflicted illness he includes carelessdriving, alcohol and drug abuse,cigarette smoking, overeating, poor nutrition, avoidable stress and lack of exercise."One must recall the enormous effectiveness of our advertising industry,"Tarlov told the nnd Annual Congress ofMedical Education in Chicago. "Thebillions of dollars poured into advertisingannually by the industrial establishmenthave effectively sold ideas and goodswhich the people previously were unaware they wanted." After a period of"learning how," the medical professionshould put a major effort into popularizing good health habits.It is still not proved that the SurgeonGeneral's report linking cigarette smoking and cancer has failed to halt growingcigarette sales, says Tarlov. The largestimpact of the Surgeon General's reportwill be "on that generation which fromits beginning received indoctrination relative to the harmful effects of smoking. "To recent public awareness of environmental health hazards must beadded a growing awareness of theself-inflicted hazards, said Dr. Tarlov."The morbidity and mortality from thesecauses, listed on death certificates assuicide, drug toxicity, ischemic heartdisease, cancer, bronchitis, emphysema,asthma, cirrhosis of the liver, and accidental death, are enormous. They aremajor potential payoff areas for thehealth care dollar."Radioisotope Therapy PossibleDr. Simon J. Simonian reports that itmight be possible to target the shortlived radioactive element astatine selectively to kill cancer cells and to killselected white blood cells (lymphocytes)responsible for rejection of donated kidney and other organ transplants.Research performed by an interdisciplinary team at the University and theArgonne National Laboratory provesthat astatine can be firmly bound chemically to another substance, such as a protein that will selectively seek out a predetermined target tissue to be destroyedby the astatine. Simonian, a kidneytransplant surgeon and immunologist,and Assistant Professor of Surgery, iscoordinator of the research project.It should theoretically be possible,says Simonian, to link astatine (211 At-) toantibodies that will seek out humancancer cells and be relatively indifferentto normal cells. South African scientistshave already shown that astatine can killselected cells in test-tube conditions.Free astatine normally concentratesmost heavily in the stomach and will diffuse out to all tissues of the body, saysSimonian. To target it to tissues selectedfor destruction it must be chemicallylinked to a substance such as an antibodyprotein or an antigen protein that willseek out the desired tissue. He describedexperiments at the University and Argonne Laboratory in which astatine waschemically bound (conjugated) with aprotein, albumin from the blood of cows(bovine serum albumin-BSA). The conjugated astatine-BSA compoundtraveled in increased amounts to theliver in experimental mice, implying thatthe conjugate remained stable in theanimal. Three experiments showed thatthe BSA protein was not denatured ordamaged during the chemistry of joiningastatine and protein.A possible future step, says Simonian,is to try to link astatine to cancer antibodies or to "foreign" kidney transplant tissues and try the method out asan anticancer compound or antirejection agent in experimental animals.Previously, it had been difficult to pro- duce a stable combination of astatine andtissue-seeking protein for use in livingorganisms, he says. The isotope ofastatine used in the experiment has a halflife of about seven hours. It also has ashort path length of 60 microns. aboutthe distance across six human cells. andshould do little damage, if it can be correctly targeted, to normal, non-targetedcells. Astatine (atomic number 85) usedin the experiment was synthesized atArgonne National Laboratory by bombarding bismuth (atomic number 83) withalpha particles for two or three hours.Here is how astatine would kill cancercells without harming normal cells andprotect against the rejection of kidneyand other transplanted organs withoutdamaging the general immune defenseresponse of the recipient:Lethal alpha particles emitted by theastatine would quickly kill the targetedcancer cells and would not travel muchbeyond them.In kidney transplants, the astatinewould first be chemically linked to smallamounts of tissue taken from the kidneydonor. This "foreign" tissue would beattacked by a family of lymphocytes inthe body of the kidney's intended recipient.The astatine, chemically linked to the"foreign" tissue, would kill the attackingfamily of lymphocytes, thus therecipient's "immune rejection responses" against that particular transplant would be knocked out. The recipient would retain all his other lymphocytes unharmed, for body defenses.The "foreign" kidney could now betransplanted without danger of immediate lymphocyte attack.Radioactive isotopes have been usedin medicine since the 1940s, but mostlyfor diagnosis, says Simonian. Except forradioactive iodine, which is naturallyselected by the thyroid gland, it has notbeen possible to use radioisotopes fortherapy in an immunologically specificand selective manner. The reason is thatthey eventually disperse throughout thebody and deliver damaging radiation tonormal cells.Simonian warns that much remains tobe done before astatine can be used onhumans ... A way must be found to loadthe target-seeking protein with as muchradioisotope as possible," he says. "Weneed very thorough safety tests forhazards and their control. Ways to targetastatine to specific tissues with differentproteins must be developed."He says that the cost could be competitive with other types of cancer andantirejection treatment. However, astatine can only be produced in a fewhigher-energy cyclotrons. Joseph Ceithaml was honored by students andfaculty March 11 at a surprise celebration of his25th anniversary as Dean of Stuclems in the Division of Biological Sciences and PritzkerSchool of Medicine.New lactose Intolerance TestScientists at The University of Chicagoand the I nstitute of Nutrition of CentralAmerica and Panama (INCAP) havedeveloped a new breath test to detectimpaired ability to digest sugar. The testmeasures respiratory hydrogen produced from undigested milk sugar (lactose) and is non-invasive, unlike the current blood test for lactose intolerance. Itdoes not expose the patient to radioactivity, unlike another such test now in use.It is relatively inexpensive and has thepotential to become a standard medicaltest for carbohydrate malabsorption. Anestimated 70 to 80 percent of non-whiteadults and 20 to 30 percent of whiteadults have some degree of lactose (milk)intolerance.The test was described by Dr. NoelSolomons at a meeting of the AmericanGastroenterological Association. Solomons is Research Associate in the Department of Medicine (Gastroenterology) at the University and Research Associate at INCAP, Guatemala City. Hedescribed results from use of the test onchildren at INCAP. Co-authors of thepaper were Dr. Fernando Viteri, director of the Biomedical Division ofINCAP, and Dr. Irwin Rosenberg, Professor and Chief of Gastroenterology inthe University's Department ofMedicine.The test measures exhaled hydrogenfrom undigested lactose. Air samples aretaker. from the breath of patients andanalyzed through gas chromatography,which separates exhaled air into its con-41stituent gases and measures the concentration of each gas.The test is based on the fact that bacterial exposure to unabsorbed sugars inthe digestive tract results in hydrogenproduction which is carried to the lungsby the blood and exhaled.Solomons reported that at some timeduring sleep hydrogen concentrationrose from 2.5 to 4 times the hydrogenlevels seen during hours the subjectswere awake, indicating a so-called circadian rhythm in hydrogen production inthe gastrointestinal system of small children.Symptoms of malabsorption arediarrhea, abdominal distention, pain,and excessive gas. Malabsorption can bea serious problem in cases of malnutrition, says Solomons. A particular issuein the study of lactose tolerance inGuatemala is the ability of Guatemalansto digest lactose and other sugars, andcomplex carbohydrates in the local diet.Bacteria in the colon and intestineutilize some of the carbohydrates in thediet, and the long-range purpose of thetest is to determine the bacterial contribution to loss of energy from carbohydrate sources in the diet. Hydrogenis produced by the bacteria in the intestines when they ferment undigestedsugars and carbohydrates. This can bedetected in exhaled air. I n cases of malnutrition, such tests are useful in determining how much milk can be includedin a corrective diet. Children on thewhole tend to have less lactose intolerance than adults, says Solomons. because infants normally utilize milk as afood.The breath test is being used at theUniversity's Medical Center as well asat INCAP.Children's FallsIt happens every spring. When warmweather arrives, children start fallingfrom multi-story buildings. The epidemiccontinues through the summer and autumn, until it's too cold to leave the windows open and for children to play onbalconies or roofs. Many of the victimsare children two to five years of age, saysDr. John D. Burrington, Professor ofSurgery and Chief of Pediatric Surgery.Last year the falls started in April,says Dr. Melvin D. Smith, Visiting Assistant Professor of Pediatrics in the Department of Surgery. From Aprilthrough October, 1975.25 children whohad fallen one to four stories were seenat the University's Wyler Children'sHospital. Three died. The number ofsuch patients seen last year "decidedlyincreased" over previous years, says42 Smith. It's common in some areas to"hang out of windows to see what'sgoing on," he says.Up to 20 percent of accidental deathsof children in big cities result from vertical falls from heights, reports Smith. Accidents of all types, including falls, arethe chief cause of death in children under15. Smith was principal author of a University of Chicago study, "Injuries inChildren Sustained in Free Falls," in theJournal of Trauma. Co-authors of thereport were Dr. Burrington and Dr.Alan D. Woolf, a 1976 graduate of ThePritzker School of Medicine."Such accidents (falls) differ fromburns, cuts, poisonings, and foreignbody accidents," says Smith, "in thatthey occur in significant numbers only indense, urban populations where multistory structures are common. Factors relating to free falls in children includepoor supervision and residence in slumdwellings where windows, screens, andrailings are missing or defective."The article reports on 66 cases of victims of vertical falls under age 15 whowere evaluated at Wyler Children'sHospital during the years 1966 to 1974.Only cases in which the distance of thefall was known were included. Fiftythree patients (80 percent) were male,and 13 were female. Fifty percent of the66 cases involved children under 5 yearsof age, with a peak incidence near 2years. Two of the victims died. Half thefalls were from a distance of 12 feet(equal to one story) or less. Only fiveinvolved falls from 48 feet (four stories)or higher.Children who fall from heights aremuch less likely than adults to fracturetheir legs and feet, report Smith and hisassociates. "Reasons for this might include the relatively large head in children, which tends to make the center ofgravity higher than in adults, so that theypitch forward in a fall. The greater frequency of fractures of the skull andupper extremity indicate that childrentend to land on their heads and try tobreak the fall by extending their arms. "There were nine fractured thigh bones."Surprisingly, there were no cervicalspine injuries encountered in these 66children although there were ten childrenwith skull fractures and 18 children withconcussion or other evidence of cranialinjury," said Smith. "Also, no spinalcord injuries were noted in spite of 18patients who fell 30 feet or more." Sevenof the ten skull fractures were sufferedby children who fell 36 feet (threestories) or more."No lung contusions or rib fractureswere noted in this series even thoughthey occur frequently in adults falling significant distances," say Smith and hisassociates. "The flexibility of the child'sribs probably protects him from rib fractures and lung punctures resulting fromsharp rib ends lacerating the lung."Eleven patients had only minorbruises. The remaining 55 suffered atotal of 82 injuries requiring medical orsurgical attention. Thirty-nine of thechildren required hospitalization of fromthree days to over a month. Twenty-fourof the patients were in the hospital lessthan ten days. Fractures accounted for48 of the injuries, which were sustainedby 36 patients. There were eleven internal injuries, distributed evenly amongthe kidneys, spleen, liver, and bowel.The most severe internal injuries resulted from falls of 36 feet or more.Dangers of Mislabeling in learning DisabilitiesDelinquent, retarded, hyperactive, mentally ill, emotionally disturbed. Theseare "loaded" words. When attached aslabels, they can follow a child throughout life-whether the labels are accurately applied or not. "Children inaccurately identified are stigmatized, coloredwith the same brush as their peers whoare correctly identified," says Joseph M.Wepman, University of Chicagospecialist in learning problems and disabilities.One distinction not always made, saysWepman, is between children who havesome perceptual or emotional problemthat impedes learning and those whohave a mental disability that prevents it inpart or entirely.Most children learn to read by associating letters with sounds, saysWepman, but 25 percent of children donot have this auditory learning ability byage 6, and fall behind. "Everyone at onepoint must learn phonics," says Wepman, "but it should be introduced whenthe child is ready." The 25 percent wholag can often be taught at first by visualmethods, but this does not fit in withmass methods of teaching reading.A child late to speak, slow to learn hisfirst words and then longer expressions,says Wepman, "likely is following thenatural bent of a poor auditorizor. If visual skills develop adequately despitethe poor auditory ability, learning canand should follow the child's predilection."Wepman has developed a series oftests over the past eighteen years thatdistinguish between predominatelyaural and visual learners. Associatedwith him in recent years has been AnneMorency, Research Associate in Behavioral Sciences and Associate Direc-tor of the Speech and Language Research Laboratory. She wrote her doctoral disseration on Wepmans testingmethods, which are used all over theEnglish-speaking world. Published bythe Language Research Associates,Chicago, the examination kits consist ofa series of six individual tests, three ofauditory and three of visual abilities:Auditory-individual tests for discrimination of key sounds, memory of words,and sequential order of numbers; andvisual-tests of discrimination of freeforms, visual memory of forms, and spatial orientation memory.The tests employ the language commonly used by the child's community.They have been used in Louisiana, forinstance, with children who speak socalled Cajun English, a combination ofEnglish and Louisiana French. Wepmanhas received a request for special testsfor children in Kenya. Ten thousandchildren in Australia were tested lastyear.Diagnostic Advances for RadiologyThe Department of Radiology has installed two devices that will greatly extend its diagnostic capabilities: a G.E.Spectrotherm 2000 thermographic unitand a Xerox 125 xeroradiography system. Both are under the direction of Dr.Joel R. Bernstein, Instructor in Radiology.Thermography offers an immediatepictorial display, via a Polaroid print, ofthe infrared radiation given off by thepatient's body surfaces. Processes causing subtle changes in the local surfacetemperature of the body are discovered.An abnormally bright area indicates abnormal warmth, a dark spot abnormallylow temperature. These changes intemperature cannot ordinarily be measured otherwise. There is no applicationof external radiation to the patient andno danger associated with the procedure,which is non-invasive.Xeroradiography applies to X-ray imaging the principles of xerography,which is a system to reproduce an imagewithout the use of liquid chemicals. Therecording system is a specially preparedselenium-coated paper plate rather thanfilm. The Xerox 125 system contains twounits, a conditioner to put an electriccharge on the plate, and a processor,which produces a blue-tinted image afternormal X-ray exposure of the sheet.Xeroradiography enhances visualization of sharp edges in foreign bodies inskin or muscle, such as glass or plastic,and enhances contrast in visualizing softtissues of differing density. Joint Perinatal CenterEstablishment of The University ofChicago Perinatal Center, to be jointlyoperated by the University's MedicalCenter and Michael Reese Hospital andMedical Center, was announced byDean Daniel C. Tosteson."Infant mortality is the nation's fifthgreatest killer," says Dr. John D. Madden, Professor of Pediatrics, Director ofClinical Services, and AdministrativeDirector of the UC Center. "Our objectives as a center are to offer health professionals in local communities innovative educational programs to upgradeperinatal care and to help lower the veryhigh rate of infant mortality and birth defects by caring for high risk cases referred to us by area physicians."The Center, which will utilize clinicalstaff and facilities of both the Universityand Michael Reese, has been designatedan Illinois regional perinatal center bythe state's Department of Public Healthand will serve 12 community hospitals.The value of specialized perinatalunits is reflected in studies which showthat among those babies treated in highrisk nurseries, the infant mortalityattributed to respiratory distress has decreased from 40 percent to 20 percent,while the survival rate and improvedquality of life for very small babies hasincreased significantly.The perinatal teams at each medicalcenter will include obstetricians, pediatricians, anesthesiologists, pathologists,and specially trained nurses. Patientswill be provided transportation from referring hospitals, accompanied bytrained personnel. Specialists in otherfields are available for consultation inboth medical centers.The risk of neonatal problems is considerably greater for babies born to highrisk mothers than for other newborns.Infant mortality and damage to newborns can be reduced by a strict regimenof prenatal care for the mother and immediate diagnosis and treatment for anewborn with a serious medical problem.Perinatal teams at both medical centers will employ advanced prenatalmonitoring techniques such as amniocentesis, ultrasound measurements ofthe unborn fetus, and electronic fetalmonitoring during labor.Physicians in communities served bythe Perinatal Center may refer patientsto either the University or MichaelReese for consultation or continuingcare. As a regional resource, the Centeris developing perinatal educational programs for physicians and nurses practicing in the communities it serves. Or. Gail M. oackIn MemoriamGail M. Dack, 1901-1976Dr. Gail M. Dack, Professor Emeritusof Microbiology, faculty member from1925 to 1966, and for many years thenation's leading expert on food poisoning, died June 21 in Elgin, Illinois. Amemorial service was held at the FirstUnited Methodist Church in Elgin onJune 23.Dr. Dack and several University ofChicago associates demonstrated andelaborated the toxin responsible forstaphylococcal food poisoning. He wasthe author of Food Poisoning, the leading book on the subject, and many published research reports on intestinal bacteriology, ulcerative colitis, botulism,and salmonella and staphylococcus infections.During World War I I, Dr. Dack was aconsultant to the U.S. Army on foodhandling, receiving a special governmental citation in 1946 for his wartime work.Following the war, he organized TheUniversity of Chicago Food ResearchInstitute and served as its only Directorfrom 1946 to 1966. After his retirement in1966 he joined the Food Research I nstitute of the University of Wisconsin,where he served as Professor until 1971.Dr. Dack worked for several decadeswith governmental, international, andscientific agencies and the food industryin setting standards for the safe handlingof food. He served as a consultant to theFood and Drug Administration, U.S.Public Health Service, and to the Chief43of the U. S. Army Chemical Corps. Hewas Chairman of the Committee on Microbiology of the National Academy ofSciences-National Research Counciland a consultant to the Robert A. TaftSanitary Engineering Center in Cincinnati. From 1951 to 1954 he was Chairman of the National Research CouncilCommittee on Foods. He was an advisorto the Lobund I nstitute at the Universityof Notre Dame, 1956-64.A native of Belvidere, Illinois, Dr.Dack received the B.S. degree from theUniversity of Illinois in 1922, and thePh.D. and M.D. degrees at The University of Chicago in 1927 and 1933. He became I nstructor in Hygiene and Bacteriology at the University in 1925, andwas appointed Assistant Professor in1929, Associate Professor in 1937, andProfessor in 1946.He was President in 1953 of the Society of American Microbiologists, nowthe Society for Microbiology, and wasactive in numerous other medical andscientific organizations. In 1925 he received the University's Ricketts Awardfor outstanding student research. He received the Babcock-Hart Award of theI nstitute of Food Technologists, and thePasteur Award of the Society of IllinoisBacteriologists, in 1956.Dr. Dack is survived by his wife,Martha; a son, John, of Wyckoff, NewJersey; a daughter, Carol (Mrs. WendellJordan) of Indianapolis: and four grandsons.Klaus Ranniger, 1927-1976Dr. Klaus Ranniger , former Professor inthe Departments of Radiology andMedicine at The University of Chicago,died in Denver on March 30 while visiting Colorado with his family. He wasChairman and Professor of Radiology atthe Medical College of Virginia in Richmond. Dr. Ranniger was an authority onthe use of X-ray and related proceduresto diagnose heart disease and bonetumors.A memorial service for Dr. Rannigerwas held on April 23 at the Bond Chapelon campus. The Reverend Joseph Sittler, Professor Emeritus in theUniversity's Divinity School, conductedthe service, and Dr. Robert Moseley,former Professor and Chairman ofRadiology at the University, was thespeaker. Dr. Moseley is now on theradiology faculty of the University ofNew Mexico School of Medicine.Dr. Ranniger came to the Universityin 1955 as a Resident in Radiology, andserved as Chief Resident, Instructor,Assistant Professor, Associate Professor, and Professor of Radiology, and44 Dr. Klaus RannigerProfessor of Medicine, before joining theMedical College of Virginia in 1972.A native of Germany, Dr. Rannigerreceived his M.D. degree at the University of Kiel in 1951 and was an intern andresident in medicine at Kiel and a fellowin pathology at the University of Cologne before coming to the UnitedStates. He became a United States citizen in 1964. Dr. Ranniger is survived byhis wife, Renata, and two daughters,Monica, 12, and Claudia, 9.A visiting lectureship fund is being established at the University in Dr.Ranniger's memory. Donations shouldbe addressed to the Medical Alumni Association, 400 Culver Hall, The University of Chicago, Chicago, Illinois, 60637.Clayton C. Loosli, 1907-1976Dr. Clayton G. Loosli, former Professorof Medicine and Chief of the Section ofPreventive Medicine at The Universityof Chicago, died June 27 in Pasadena,California. He was Dean of the University of Southern California School ofMedicine from 1958 to 1964, a time ofgreat physical expansion of the USCMedical Center. At the time of his deathhe was Director of the school's HastingsFoundation for Research.Dr. Loosli received his Ph. D. degreefrom The University of Chicago in 1934,and his M.D. degree in 1937. He joinedthe faculty of the University's Department of Medicine in 1940 as an Instructor, became Assistant Professor in 1942,Associate Professor in 1946, and Professor in 1949. From 1946 to 1949 he servedas Director of the Student Health Service. A specialist in respiratory medicine,Dr. Loosli was a member of severalmedical associations, served as president of the Central Society of ClinicalResearch in 1955, and was editor of theJournal of Laboratory and ClinicalMedicine from 1949-54.Dr. Loosli is survived by his wife,Jean, and two sons, Alvin and Edward.Memorial contributions may be made toThe University of Chicago MedicalAlumni Fund.Herbert S. Anker, 1913-1976Dr. Herbert S. Anker, Professor in theUniversity'S Department of Biochemistry, died at his home on May 18. Amemorial service was held Tuesday,June 15 in Bond Chapel on campus.Dr. Anker joined the University in1945 as a Research Associate inBiochemistry and became AssociateProfessor in 1954 and Professor in 1959.He was known for his work in lipidmetabolism, antibiotics, antibody production, and protein synthesis, and heparticipated in the introduction of research methods involving stable andradioactive isotopes in biochemical research.He is survived by his widow Dorothyand three children, Martin, of Washington, D.C.: Wendy, a graduate student atthe University of Michigan; and Anthony, a student at The University ofChicago Laboratory School.The family has requested that memorial gifts be made to The University ofChicago Cancer Research Foundationor other charitable organizations.ALUMNI DEATHS'15. Theodore E. Beyer, Denver, Colorado, June 28, 1975, age 91.'17. Arthur M. Washburn, LittleRock, Arkansas, August 3, 1975, age 85.'18. George M. Fister, Ogden, Utah,May II, 1976, age 83.'18. John R. Merriman, Evanston, Illinois, February II, 1976, age 82.'18. Henry C. Sauer, Fairbury, Illinois, December 4, 1974, age 89.'19. Alice M. Hunter, Grand Forks,North Dakota, December 7, 1975, age84.'20. Elbert S. Parmenter, Dixon, Illinois, October 5, 1975, age 81.'21. Clarence H. Schaller, Phoenix,Arizona, June 19, 1975, age 80.'22. Raul de la Garza, Laredo, Texas,August 28, 1975, age 88.'22. Dorothy Grey, Evanston, Illinois,June 5, 1976, age 85.'22. A mold G. Isaac. Newton, Kansas, April 9, 1976, age 83.'24. William M. Moffat, Santa Barbara, California, January 10, 1976, age83.'27. Thorsten E. Blomberg, Rockford,lIIinois, September 16, 1975, age 75.'27. R. J. Schacht, Racine, Wisconsin, February 13, 1976, age 80.'30. Herbert A. Sheen, Los Angeles,California, April 28, 1976, age 79.'32. John W. Davis, Burley, Idaho,August, 1975, age 69.'32. Arthur R. Young, Pontiac,Michigan, March 1, 1975, age 79., 33. George C. Allen, Lumberton,North Carolina, January 20, 1976, age 70., 33. Robert A. Behrendt, NewportBeach, California, March 19, 1975,age71.'33. Gail M. Dock, Elgin, Illinois,June 21,1976, age 75.'33. James M. DePue, Spencer, WestVirginia, November 16, 1974, age 76., 35. Robert R. Crawford, Mansfield,Ohio, March 14, 1976, age 71.'35. Albert G. Martin, Seabrook,Texas, February 1, 1976, age 67.'35. Alfred D. Miessner, Port Clinton,Ohio, December 19, 1975, age 69.'36. Abraham I. Doktorsky, Chicago,Illinois, April 10, 1976, age 64.'36. Dan Glassman, Point Pleasant,West Virginia, February 20, 1976, age66.'37. Glenn Ashworth, Columbus,Ohio, March, 1974, age 63.'37. Clayton G. Loosli, Los Angeles,California, June 27, 1976, age 69.'37. Robert H. Parker, Kansas City,Missouri, April 13, 1975, age 64.'38. Manford B. Dahle, Kerrville,Texas, February 18, 1976, age 63.'40. Robert E. Zellner, Orlando,Florida, February 23, 1975, age 60.'42. Louis C. Allard, Billings, Montana, January 8, 1975, age 59.'52. John F. Ziegler, Lowell, Indiana,September 5, 1975, age 51.FORMER STAFF AND FACULTYJames S. Clarke (Surgery, InternResident, 1944-1950; I n struct orAssistant Professor, 1951-1956), PacificPalisades, California, May 19, 1976, age58.May E. Davies (Anesthesiology, Resident, '34-'35), Madison, Wisconsin,JUly, 1974, age 80.Arthur R. Turner (Pediatrics, Instructor, '31-'35; Assistant Professor,'35-'46), Washington, D.C., March I,1976, age 81. Departmental NewsAnatomyRobert P. Becker, Ph.D., Research Associate in the Department of Anatomy,was named co-editor of Scanning Electron Microscopy.Dr. Peter P. H. De Bruyn, Professor,Department of Anatomy, was appointedto the Editorial Board of the A mericanJournal of Anatomy.Dr. Charles E. Oxnard, Professor inthe Departments of Anatomy and Anthropology, presented two papers at theUniversity of Hong Kong in March:"An Occult Lesion in Captive Primates:Vitamin BI2 Deficiency" and" Structureand Stress Bearing in Cancellous Bone."Dr. Oxnard also gave a lecture on:"Australopithecines and Human Evolution: the Other Halfofthe Evidence," atthe Archaeological Society of HongKong.Dr. Oxnard spoke at the Symposiumheld April 13 at Northern Illinois U niversity in De Kalb on "Australopithecines and Their Relation toHominid Evolution" and "The Structure of Bony Fragments and Their Combination: A Problem Underlying the Assessment of the Australopithecinae."Richard Wassersug, Assistant Professor in the Department of Anatomy andthe College, was elected to the Board ofGovernors of the American Society ofIchthyologists and Herpetologists.The following faculty and students ofthe Department of Anatomy presentedpapers at the annual meeting of theAmerican Association of Physical Anthropologists in St. Louis, April 14-17:G. H. Albrecht, J. McArdle, and Dr.Charles E. Oxnard.The following faculty and students ofthe Department of Anatomy presentedpapers at the annual meeting of theAmerican Association of Anatomists inLouisville, April 19-23: D. A. Baron, R.P. Becker, Yongock Cho, Peter P. H.De Bruyn, J. R. Esterly, M. Felong, S.Fichera, E. S. Kane, L. F. Kromer, E.Palacios, M. F. Press, W. Todd Rainey,A. M. Schwartz, H. M. Tsai, and PhilipS. Ulinski.AnesthesiologyAppointments:Dr. Lolita Velasquez Cruz-I nstructor/Trainee.Dr. Gerry F. Emmanuel-I nstructor. Ben May laboratoryElwood V. jensen ("44, Ph. D.), Professorand Director in the Ben May Laboratoryfor Cancer Research and the BiomedicalCenter for Population Research and Professor in the Departments of Biophysicsand Theoretical Biology, delivered thefirst Adolf Butenandt lecture of theGesellschaft fur Biologische Chemie atthe University of Munich, March 9.Adolph Butenandt, who won the NobelPrize for Physiology and Medicine in1939 for estrogen research, was present.He discussed "Estrogen Research fromA to Z."Professor jensen has been named cowinner of the French Prix Roussel for1976. The Roussel Prize, which is givenevery two years for original research inthe fields of steroids, was awarded tohim for the discovery of sex hormone receptors and elucidation of their role inthe biochemical mechanisms of estrogenic hormone action. The $10,000prize was shared with Professor EtienneBaulieu of the University of Paris andpresented at a ceremony in Paris on June10.Elmar Zeitler, Ph. D., Professor inBiophysics and Theoretical Biology,Physics, the Enrico Fermi Institute andthe College, has been elected a directorof the Electron Microscopy Society ofAmerica.BiochemistryDr. Donald F. Steiner (,56), the A. N.Pritzker Professor and Chairman in theDepartment of Biochemistry, Professorin Medicine and the College, and Director of the Diabetes-Endocrinology Research Center, was awarded the 1976Banting Medal of the American Diabetes Association at the Annual Meetingin San Francisco in June. This is thehighest scientific award of the Association.BiologyGeorge W. Beadle, President Emeritusand Honorary Trustee of the Universityand Nobel prize-winning biologist, received an honorary degree from IndianaState University during the 105th annualcommencement in May.james A. Teeri, Ph. D., Assistant Professor in the Department of Biology andthe Committee on Evolutionary Biology,discussed "The Interaction of HighFrequency Temperature Fluctuationswith Plant Growth" at the South-easternPlant Environment Laboratories(Phytotron) conference at NorthCarolina State University, Raleigh,March 10.45Mr. Teeri discussed" I ntra- PopulationVariability for Climatic Modification ofPlant Phenotypes" at the annual meetingof the Ecological Society of America atTulane University, New Orleans, inJune.Emergency MedicineThe Division of Emergency Medicinesponsored a three-day postgraduate medical program at The Center for Continuing Education from July 13-15. Theprogram consisted of seminars on thebasics of emergency medicine and several elective courses which offered experience in the performance of certainimportant emergency skills and procedures. The following faculty participated: Dr. Peter Rosen, Professor,Emergency Medicine and Director ofthe Emergency Medical Services; Dr.Frank J. Baker II, Assistant Professorand Associate Director, EmergencyMedicine; Dr. Frederick A. Mausolf,Assistant Professor in the Departmentof Ophthalmology; and Drs. G. ThomasEvans, Beverly J. Fauman, Harvey W.Meislin, and George Sternbach, all Assistant Professors In EmergencyMedicine.MedicineAppointment:Dr. Henry P. Russe-Professor.Dr. James L. Boyer, Associate Professorin Medicine and Director of the LiverStudy Unit, received a Josiah Macy, Jr.Foundation Faculty Scholarship Awardfor 1976-77.Dr. Nicholas J. Gross, Assistant Professor in Medicine, discussed bronchialasthma at a recent interdisc iplinarystudy conference on immunology andthe respiratory system held at GrantHospital in Chicago.Dr. Joseph B. Kirsner (Ph. D., '42),Louis Block Distinguished Service Professor in Medicine, was asked by theU.S. State Department to visit KingHassan II, King of Morocco, regardingthe k ings G.l. disorder. In FebruaryDr. Kirsner flew to the palace at Fez. Hereturned to Morocco again in Marchwith Dr. John Fennessy, Chairman of theDepartment of Radiology. Dr. Kirsnermade a third visit in April to the palace atRabat, and the King is reported doingmuch better. In July Mrs. Kirsner accompanied her husband to Morocco fora visit which coincided with the King'sbirthday.Dr. Kirsner was the key speaker at abanquet held May 26 in Miami, Florida,to mark the 35th anniversary of the46 American Society for GastrointestinalEndoscopy. Dr. Kirsner was one of thefounding members of this society. Hewas also co-director of a post-graduatecourse in endoscopy held in Miami, May27-28, and took part in a "Meet the Professor" series on gastroenterology, givenunder the auspices of the American Gastroenterological Association. On June 8he lectured at Wayne State UniversityMedical School in Detroit, where he alsoappeared on radio station WJR and addressed the Detroit chapter of the N ational Foundation for Ileitis and Colitis,Inc.Dr. Sumner C. Kraft (,55), Professorin Medicine, served as a Visiting Professor at the University of Wisconsin Medical School on March 11-12. He lecturedon "The Immunology of InflammatoryBowel Disease," "Clinical Aspects ofInflammatory Bowel Disease," and"Gut Immunology: Basic and ClinicalConsiderations. "Dr. Kraft on April 8-10 served asguest faculty member for a postgraduatecourse entitled "Three Days of Gastroenterology." The course was sponsored by Emory University School ofMedicine and the Medical College ofGeorgia, Atlanta.Dr. Julian J. Rimpila (,66), Senior Fellow in Gastroenterology, and Dr. Kraftwere awarded a grant for immunochernical studies of inflammatory bowel disease by the National Foundation forIleitis and Colitis, Inc.Dr. Bernard Levin, Assistant Professor in Medicine, presented a lecture atNorthwestern University as part of aseries entitled "Current Nutrition Topics." He spoke on "Fiber in the Diet."Dr. Samuel RefetotT, Associate Professor in Medicine, presented a paperentitled "Importance of the Intracellularly Formed Triiodothyronine (T3) inthe Regulation of Cell Metabolism" atthe National Meeting of the AmericanFederation for Clinical Research in Atlantic City, New Jersey, on May 1-2.Dr. Arthur Rubenstein, Professor andAssociate Chairman in the Departmentof Medicine, gave the annual guest lecture of the American Diabetes Association, Wisconsin Affiliate, in Milwaukee,April 7. He discussed research on theinsulin-producing cells of the pancreas.Dr. Rubenstein was invited to attend aWhite House meeting on the problem ofjuvenile diabetes on May 24, sponsoredby the White House Office of PublicLiaison in cooperation with the JuvenileDiabetes Foundation. The meeting included lectures, panel comments anddiscussions.Dr. Alvin R. Tarlov (,56), Professorand Chairman in the Department of Medicine, was a speaker at the nnd annual Congress on Medical Education inChicago in March. His speech wassummarized in the March 15 issue ofU.S. Medicine. He proposes that medical schools and teaching hospitals embrace continuing medical education forpracticing physicians as a responsibilityequal to that already assumed for medical students and housestaff. This newapproach will require the establishmentof a new division within medical schools.Dr. John E. Ultmann, Director of theCancer Research Center and Professorin the Department of Medicine and theFranklin McLean Memorial ResearchInstitute, was Visiting Professor at theCollege of Physicians and Surgeons,Columbia University, and at Yale University School of Medicine, where hespoke on "N on-Hodgkin's Lymphoma-Current Clinical and Laboratory Research."Dr. Ultmann, Dr. A. R. Moossa,Associate Professor in the Departmentof Surgery (General), and Dr. Jeannie J.Kinzie, Assistant Professor in the Department of Radiology, participated in aprogram on "Current Concepts inCancer Nursing," held April 28-30 atthe Center for Continuing Education.The program was sponsored by theAmerican Cancer Society, Illinois Division, and The University of ChicagoCancer Control Center.NeurologyAppointments:Dr. Jack P. Antel-Assistant Professor.Dr. Ewa E. Chelmicka-Schorr-Assistant Professor.Dr. David P. Richman-AssistantProfessor.Dr. Raymond P. Roos-AssistantProfessor.Obstetrics and GynecologyDr. Arthur L. Herbst, the Joseph BolivarDe Lee Professor and Chairman in theDepartment of Obstetrics and Gynecology, received on May 5 a final portion ofthe $750,000 raised by Mothers' Aid, thevolunteer auxiliary of Chicago Lying-inHospital, at a luncheon and fashionshow aptly titled "Celebration."Dr. Marshall D. Lindheimer, Professorin Obstetrics and Gynecology and inMedicine, received a Senior International Fellowship from the Fogarty International Center.Dr. Gebhard F. B. Schumacher,Professor in the Department of Obstetrics and Gynecology and the Committeeon Immunology, and Chief of the Sec-tion of Reproductive Biology, participated in a meeting of the World HealthOrganization's Expanded Program inResearch Development and ResearchTraining in Human Reproduction, heldApril 14-15 in Munich, Germany.Dr. Joseph R. Swartwout, AssociateProfessor of Obstetrics and Gynecology, was a speaker in April at a programon "Oral Contraceptives in Perspective" at the University of Illinois Medical Center, co-sponsored by the Schoolof Public Health and the Training andResearch Center of Planned Parenthood, Chicago. His topic was "Contraceptive Research and Future Implications. "Dr. George L. Wied, the Blum-RieseProfessor in the Department of Obstetrics and Gynecology, participated in theFourth Annual Cancer Symposium atMercy Hospital and Medical Center onApril 14.OphthalmologyAppointment:Dr. Frederick A. Mausolf-AssistantProfessor.Some 125 Chicago-area ophthalmologists returned for the Department'sNinth Annual Alumni Day on March 3.Dr. Peter Morse (,63), Associate Professor, chaired the program.At the meeting it was announced thatplans are proceeding on the Eye Institutebuilding. As described in more detailelsewhere in this issue, Dr. Jules Stein(,21) donated a million dollars toward theI nstitute, and the department has combined this with a meaningful clinicaleconomic plan. The department shouldbe able to move fairly soon, and planscall for the relocation of electroretinography and retinal function testing, someperimetry and tonography, orthoptics,B-scan ultrasonography, and photocoagulation to this building. Clinicalspace on the second floor of BillingsHospital will be retained.Dr. Frank W. Newell, the James andAnna Louis Raymond Professor andChairman of the Department ofOphthalmology, delivered the SeventhAnnual Jules Stein Lecture and Postgraduate Seminar of the Jules Stein Institute of Ophthalmology at the Universityof California in Los Angeles, on April23. He spoke on "The Lysomal StorageDiseases, the Eye, and the Contributionof the Ophthalmologist."The Institute also gave tribute to Dr.and Mrs. Frank Newell and Dr. andMrs. Jules Stein at a party in celebrationof Dr. Stein's 80th birthday.Dr. Newell received the John HughesDunnington Award on April 29, at a meeting of the Association for Researchin Vision and Ophthalmology inSarasota, Florida. The award was established in 1969 by the National Society forthe Prevention of Blindness, and honorsa physician who has made a unique contribution to clinical practice, professional education or research, which improves or increases opportunities forpreventing blindness.PathologyAppointment:Dr. Sandra Panem-Assistant Professor.Dr. James E. Bowman, Jr., Professorin the Departments of Pathology andMedicine and the Committee on Genetics, and Medical Director of the BloodBank, the Laboratories, and the Comprehensive Sickle Cell Center, was appointed by the Government of Nigeria'sMinistry of Health as a consultant in establishing a nationwide blood transfusionservice. Dr. Bowman served as VisitingProfessor of Pathology at the Universityof Lagos Medical School, November19-December 15. While in Nigeria, healso presented a paper on "The Population Genetics of Abnormal Hemoglobinsin the United States" at the Universityof Ibadan.Dr. Bowman delivered a lecture at theCenter for Disease Control Workshop,the Departme-nt of Health, Educationand Welfare, in Phoenix, Arizona,March 31. His lecture was on"Thalassemia-Clinical Aspects andTherapy" and" Legal and Ethical Problems of the Hemoglobinopathies."Dr. Bowman participated in The University of Chicago, Fullbright-HaysConference, sponsored by the LawSchool, on May 6. His topic was on" Educational Exchange-Yesterdayand Tomorrow."Dr. Andrew Churg (,73), Instructor inPathology and Director of the SurgicalPathology Electron MicroscopyLaboratory, presented a paper entitled"So-called Minute PulmonaryChemodectoma" at the InternationalAcademy of Pathology Conference inBoston, March 23-26.Dr. Seymour Glagov, Professor in theDepartment of Pathology and in the College, has been named a member of theBasic Sciences in Cardiology Committeeof the Chicago Heart Association.Dr. Glagov was appointed to serve as amember of the Illinois State MedicalSociety's newly-created Task Force onMedical Examiner Bill. This Task Forcewas created to co-ordinate efforts to passa law regarding a statewide medical examiner system for Illinois. Dr. Heinz Kohler, Associate Professorin the Departments of Pathology andBiochemistry and in the College, delivered a paper entitled "ComplementaryIdiotype in the Regulation of the Immune Response" as a Symposiumspeaker for the 60th Annual Meeting ofthe Federation of American Societies forExperimental Biology, April 11-16, inAnaheim, California.Dr. Kohler is the principal investigatorfor the following grants: a five-year NIHgrant to study" Antigen and Antibody inthe Immune Response" (co-investigatoris Dr. Donald Rowley (,50), Professor ofPathology and Pediatrics and ResearchDirector of La Rabida-University ofChicago Institute) and a three-year NIHgrant to study "Structure of the MajorRed Cell Membrane Polypeptide" (coinvestigator is Dr. Theodore L. Steck,Associate Professor in the Departmentsof Biochemistry and Medicine, also aco-investigator for a one-year grant tostudy "Multiple Myeloma: Regulationby Anti-receptor Antibody," awarded toDr. Hans Schreiber, Research Associate at La Rabida-University ofChicago Institute, by the AmericanCancer Society, lIIinois Division).Dr. Robert Kirschner, Assistant Professor in the Department of Pathology,presented a review paper, "I dentification and Characterization ofIsolated Cell Organelles by High Resolution Scanning Electron Microscopy,"at the IITRI/SEM meeting in Toronto,Canada on April 5-9. Coauthor wasMichael Rusli, a first-year medical student at The University of Chicago.Dr. Francis Straus II (,57), AssociateProfessor in Pathology and Director ofthe Surgical Pathological Laboratory,spoke on "Grading and Staging ofMalignant Turnors " at a meeting of theChicago Area Tumor Registrars Association on April 28.Dr. Robert W. Wissler (,48), theDonald N. Pritzker Professor in the Department of Pathology and in the College, was invited to participate in aworkshop conference on Cell Proliferation and Atherosclerosis, March 15-17,at the University of Washington in Seattle.Dr. Wissler co-chaired with Dr. EarlP. Benditt an overview session onatherosclerosis, and presented a talk entitled" Atherosclerosis '76," at the annual meeting of the American Association of Pathologists and Bacteriologistsin Boston, March 20-23. Dr. Bendittwas a member of the Department ofPathology here from 1943 to 1957. Henow serves as professor and chairman ofpathology at the University of Washington in Seattle.47Dr. Wissler spoke on "Reversibilityof the Atherosclerotic Lesion" in a postgraduate course on March 25 atWashington University in S1. Louis, andpresented a paper entitled "Effect ofVarious Dietary Responses on Progression of Atherosclerosis in Rhesus Monkeys" at the annual meeting of the Federation of American Societies for Experimental Biology, April 11-16, inAnaheim, California. Dr. Wissler alsoparticipated in a Conference on Lipidsand Atherosclerosis at the University ofWest Virginia in Morgantown, April23-24. His topic was" Arterial Lipidsduring Evolution and Regression ofAtherosclerosis in Nonhuman Primates. "PediatricsThe Home for Destitute Crippled Children, which operates Silvain and ArmaWyler Children's Hospital in affiliationwith The University of Chicago,contributed approximately $180,000 forconstruction and equipment in expanding Wylers intensive care facilities froma 4-bed to a 7-bed unit. An informalopening celebration on May 18 includeda tour of the new unit and talks by thefaculty. Dr. Daniel C. Tosteson welcomed the guests to the medical program.In April two distinguished pediatricsurgeons visited The University ofChicago as guests of Dr. John D. Burrington, Professor and Head of PediatricSurgery. They were: Dr. Boix-Ochoa,Professor in the Clinica Infantil "Francisco Franco," Departmento CirurgiaPediatrica, Barcelona, Spain and President of the International Pediatric Surgical Association, who will organize the1977 World Symposium of PediatricSurgery in Barcelona; and Dr. James Lister, Professor in the Department ofPediatric Surgery at the University ofLiverpool. He is a staff member of theAdler Hey Children's Hospital in Liverpool, one of the world's most prestigious children's hospitals.Dr. Burrington was elected Presidentof the Illinois Pediatric Surgical Association, and Dr. Hernan M. Reyes,Associate Professor in the Departmentof Surgery, was elected theAssociation' s Secretary-Treasurer.Glyn Dawson, Ph. D., Associate Professor in Pediatrics and Research Associate (Associate Professor) in the Department of Biochemistry, attended theMarch 16 meeting of the American Society of Neurochemistry meeting in Vancouver, British Columbia, along withGrace Chen Tsay, Ph.D., Research Associate in Pediatrics. They presented a48 paper entitled "Fucosidase anda-Fucosidosis. "Dr. Barbara S. Kirschner, Fellow inPediatrics, was elected to membership inthe North American Society for Pediatric Gastroenterology.Dr. Robert Rosenfield, Associate Professor in Pediatrics, participated in theDepartment of Obstetrics andGynecology's postgraduate course on"Gynecologic Endocrinology" at theUniversity of Tennessee College ofMedicine, March 10. He spoke on"Hormonal Events and Disorders ofPuberty. "Dr. Rosenfield was appointed to theeditorial board of the Journal of ClinicalEndocrinology and Metabolism,Dr. Samuel Spector, Professor andChairman of Pediatrics and Director ofthe La Rabida Children's Hospital andResearch Center. discussed "FactorsInfluencing Growth" at St. John's Hospital, Southern Illinois UniversitySchool of Medicine, Springfield, April I.Pharmacological and Physiological SciencesPaul Grobstein, Ph. D .. Assistant Professor in the Department of Pharmacological and Physiological Sciencesand the Committee on DevelopmentalBiology, has been awarded an Alfred P.Sloan Foundation Fellowship for 1976 inBasic Research. Dr. G robstein has alsoreceived notification of approval andfunding for a grant from the NationalEye Institute for a three-year study ofthe" Development of Connectivity inAnuran Visual Systems."Dr. Daniel C. Tosteson, Dean of theDivision of the Biological Sciences andThe Pritzker School of Medicine and theLowell T. Coggeshall Professor of Medical Sciences in the Department ofPharmacological and Physiological Sciences, was named Chairman of theStanding Committee on Governance andStructure of the Association of American Medical Colleges. He served asChairman in 1973-74.Dr. Tosteson served as Co-Chairmanof the Symposium Organizing Committee for an international program entitled"Transport of Ions Across Membranes," sponsored jointly by theAcademy of Sciences of the USSR andthe National Academy of Sciences of theUnited States. The symposium, heldJune 21-25 at the University's Center forContinuing Education, was organizedunder the auspices of the Department ofPharmacological and Physiological Sciences. University participants includedDr. Tosteson; Dr. Robert B. Gunn, Associate Professor; and Dr. Ramon R. Latorre, Research Associate (AssistantProfessor); of the Department of Pharmacological and Physiological Sciences.Other participants were Dr. WolfgangEpstein, Associate Professor inBiochemistry, Biophysics and Theoretical Biology, and the College, and Dr.Theodore L. Steck, Associate Professorin Biochemistry and Medicine.PsychiatryDr. Lawrence Z. Freedman, Professor inPsychiatry, spoke on "Alcoholism andTreatment of Clients" at the NationalDrug Abuse Conference held in NewYork City, March 25-28.Dr. Freedman commented thatmethadone has not proved to be a meansof getting abusers off addicting drugs. Itseems not unlikely, he said, thatmethadone-substitution and other recentdrug abuse programs may prove to befailures.Dr. Chase Kimball, Associate Professor in Psychiatry, participated in the annual meeting of the AmericanPsychosomatic Society in Pittsburgh,March 26-28, in a discussion of the"Teaching of Liaison Medicine andPsychiatry. "Dr. Joseph Swartwout, Associate Professor in Obstetrics and Gynecology,participated in a program on "Treatmentof Sexual Dysfunction." The seminar,sponsored by the Sex and MaritalTherapy Clinic of the University's Department of Psychiatry, was held at theCenter for Continuing Education, June4-5. Dr. Swartwout's topic was "Review of Physical Factors AffectingHuman Sexual Functions."Dr. R. Taylor Segraves, Assistant Professor in Psychiatry, and Mr. ArthurSchwartz, Associate Professor inPsychiatry and in the School of SocialServices, were program directors.RadiologyAppointments:Dr. Malcolm D. Cooper-AssociateProfessor.Dr. James L. Lehr-Associate Professor.Franca T. Kuchnir, Ph.D., AssociateProfessor in the Department of Radiology and the Franklin McLean MemorialResearch I nstitute, is principal investigator for the Frederick E. Hummel andIda H. Hummel Foundation's award forthe study of "Development of an Improved Target for Fast Neutron Radiation Therapy."Dr. Dieudonne J. Mewissen, Professorin Radiology, was elected GeneralChairman of the International Syrn-posium on Cf-252 Utilization, which washeld on April 22-24 in Brussels and April26-28 in Paris. The meeting was sponsored by the U.S. Environmental Research and Development Administration, the European Communities and theAmerican Nuclear Society.Dr. Jonathan M. Rubin (,74), a resident in Radiology, was the recipient ofthe 1975 Joseph A. Capps Prize awardedby the Institute of Medicine of Chicagoin recognition of outstanding research.Dr. Rubin's paper is entitled" A Developmental Organizer: The Tip fromthe Pseudoplasmodium of the CellularSlime Mold Dictyostelium Discoideum. "SurgeryThe Dallas B. Phemister Lecture, whichhonors the memory of Dr. Dallas B.Phernister , first Chairman of the Department of Surgery at The University ofChicago, was delivered by Dr. Owen H.Wagensteen, Regent's Professor at theUniversity of Minnesota, on March 23.H is topic was "Durable Contributionsto American Surgery, 1776-1976."Dr. George E. Block, Professor inSurgery, participated in a panel on "TheManagement of Disseminated BreastCancer" at the American College ofSurgeons Fourth Annual Spring meetingin Boston, April 27. He discussed "Endocrine Ablation: The Role of HormoneReceptors. "Dr. Andrew Hall, Research Associate(I nstructor) in Surgery (General), wonthe Annual Resident/Fellow ResearchPrize, sponsored by the Chicago Societyof Gastroenterology, for his abstract onthe "Effect of 50 percent Distal SmallBowel Resection on Gastric SecretoryFunction in Rhesus Monkeys." He presented the abstract to the Society andreceived the award on June 23.Dr. J. J. Lamberti, Assistant Professor in Surgery (Cardiovascular andThoracic), presented a paper entitled"An Examination of the Use of Membrane Oxygenators for Routine OpenHeart Surgery" at the Eleventh Congress of the European Society forSurgery Research in Dublin, Ireland,April 30. Co-authors were Dr. RobertReplogle, Professor in Pediatric Surgery(Cardiac), Dr. Constantine Anagnostopoulos, Professor in Surgery, and Dr.C. Y. Lin, Associate Professor in Anesthesiology.Dr. A. R. Moossa, Associate Professorin Surgery, presented an instructionalcourse to the Chicago Medical Societyentitled "Surgical Aspects of BiliaryTract Disease" on March 29.Dr. Ralph Naunton, Professor in the Department of Surgery and Chairman ofthe Otolaryngology Section, is editor ofThe Ve stibular System. recently published by Academic Press.Dr. Martin C. Robson, Associate Professor in the Department of Surgery andChief of the Section of Plastic and Reconstructive Surgery, spoke on cleft lipand palate at the Sixth Annual MedicalAssistants Seminar March 28 in Chicago.Dr. Robson was appointed to the Specialty Consultants Board of ChicagoMedicine. published monthly by theChicago Medical Society.Dr. David B. Skinner, the Dallas B.Phemister Professor of Surgery, delivered the Presidential Address. entitled.. Federal Biomedical ResearchPolicies," at the annual meeting of theAmerican Society for Artificial InternalOrgans in San Francisco on March31-April 3.Dr. Phillip G. Spiegel, Assistant Professor in Surgery (Orthopedic), spoke on"Factors of the Humeral Shaft" and"How NOT to Do the AO Technique"at a meeting of the Chicago Committeeon Trauma of the American College ofSurgeons, held in Chicago on May13-15.Dr. Spiegel spoke on "The Adolescentwith Scoliosis" at the Pediatric NursingGrand Rounds, held May II at the University of Chicago's Center for Continuing Education.Dr. Frank P. Stuart, Professor inSurgery, has received a five-year grantfrom the National Cancer Institute for astudy entitled" I mmunological Enhancement of Renal Allografts." Dr.Stuart will study how to prevent rejection of cadaver kidney transplants fromnon-related individuals.Dr. Jack de la Torre, Assistant Professor in the Departments of Surgery(N eurosurgery) and Psychiatry, was aninvited participant in the InternationalWorkshop on Dynamic Aspects ofCerebral Edema held at the MontrealNeurological Institute of McGill University (Canada), May 26-29. He presented a paper entitled "UltrastructuralFormation of Edema and Its TreatmentFollowing Experimental Brain Infarction in Monkeys." The paper will appearin book form late in 1976 as DynamicAspects of Cerebral Edema, publishedby Springer- Verlag, Berlin.Dr. David E. TurnifT, Research Associate (Assistant Professor) in Surgery(Neurosurgery), was awarded a twoyear U.S. Public Health. PostdoctoralFellowship to study the purification andcharacterization of brain proteins.Dr. TurnifT presented a paper entitled"Sequential Changes in MorphologicalTransforming Fetal Brain Cells" at the annual meeting of the American Societyfor Neurochemistry, held in Vancouver,Canada on March 14-19. Coauthors ofthe paper are Dr. Shuang Troy, ResearchAssociate (Instructor) in Surgery(Neurosurgery), and Dr. Ramon Lim,Assistant Professor in Surgery(Neurosurgery).ZollerDr. Thomas M. Graber, Professor in theZoller Dental Clinic and the Departmentof Pediatrics and Research Associate inAnthropology, and Kaija M. Virolainen,Associate Professor and Fellow in Orthodontics and Associate Professor inPediatrics, presented courses on "Current Orthodontic Concepts and Techniques" at Tokyo Medical and DentalUniversity and at Osaka University,March 30-April II.Dr. Graber and Robert Cederquist,Fellow in the Wyler Children's HospitalDental Clinic, directed a program entitled "Training for the OrthodonticNurse" on April 22-23 at theUniversity's Center for ContinuingEducation. The sessions were open todental hygienists.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 AnesthesiologyAppointment:Dr. Daniel S. Crowley to AssistantProfessor. for two years, effective MayI, 1976.Department of MedicineAppointments:Dr. Bruce Benin to Clinical I nstructor, for one year, effective July I, 1976.Dr. Clarence Gantt to Associate Professor, for one year, effective July I,1976.Dr. Javier Garau to Instructor, forone year, effective July I, 1976.Dr. Robert Holstein to Clinical I nstructor, for one year, effective July I,1976.Dr. Richard A. Levinsky to AssistantProfessor, for one year, effective July I,1976.Dr. Patricia M. Lindsay to ClinicalInstructor, for one year, effective July I,1976.49Dr. Robert Mutterperl to Clinical Instructor, for one year, effective July I,1976.Dr. Ravindra Prabhu to Instructor,for one year, effective July I, 1976.Promotion:Dr. Leslie J. Sandlow to AssociateProfessor from Assistant Professor, forone year, effective July I, 1976.Reappointments:The following reappointments havebeen made, effective for one yearthrough June 30, 1977:Dr. R. Arbel, Assistant ProfessorDr. A. Billings, Clinical AssociateProfessorDr. A. Chan, Clinical InstructorDr. A. Chediak, InstructorDr. F. Coe , Associate ProfessorDr. S. Cogan, Clinical Associate Pro-fessorDr. H. Cohen, Associate ProfessorDr. I. D'Cruz, Assistant ProfessorDr. S. DeNoszquo, Clinical Instruc-torDr. R. Desser, Clinical Assistant Pro-fessorDr. J. Engel, Assistant ProfessorDr. F. Fishman, Clinical InstructorDr. A. Goldbarg, Associate ProfessorDr. J. Goldman, Assistant ProfessorDr. I. Hamid, Clinical InstructorDr. L. Hirsch, Assistant ProfessorDr. A. Kanter, Clinical AssociateProfessorDr. T. Langendorf, Clinical ProfessorDr. N. Levin, Clinical Associate Pro-fessorDr. I. Mack, Clinical ProfessorDr. J. Mehlman, Clinical ProfessorDr. C. Mendelsohn, Clinical Assis-tant ProfessorDr. E. Mond , Clinical Associate ProfessorDr. O. Moore, Clinical InstructorDr. E. Newman, Clinical AssociateProfessorDr. A. Paredes, Clinical InstructorDr. A. Pick, ProfessorDr. R. Pick, ProfessorDr. S. Rosenfeld. Clinical AssistantProfessorDr. C. Shapiro, Clinical ProfessorDr. J. Sheinin, Clinical Assistant Pro-fessorDr. E. Silber, Clinical ProfessorDr. A. Sloan, Clinical InstructorDr. G. Sobel, Clinical Assistant Pro-fessorDr. M. Spellberg, Clinical ProfessorDr. M. Stachura, Assistant ProfessorDr. A. Tatar, Clinical Associate Pro-fessorDr. E. Walton, Clinical InstructorDr. J. Zinder, Clinical Assistant Pro··fessor50 Department of PathologyReappointments:Dr. Ruth Pick, Professor, effective forone year, through June 30,1977.Dr. Martin Swerdlow, Professor, effective for one year, through June 30,1977.Department of PediatricsReappointments:The following reappointments havebeen made, effective through June 30,1977:Dr. Robert R. Chilcote, AssistantProfessorDr. P. Chiemmongkoltip, AssistantProfessorDr. Nancy B. Esterly, Associate ProfessorDr. David E. Fisher, Assistant Pro-fessorDr. Samuel P. Gotoff, ProfessorDr. B. Jayalakshamma, InstructorDr. Roberto Kretschmer, AssistantProfessorDr. Lynne L. Levitsky, AssistantProfessorDr. Sharon Libit, Assistant ProfessorDr. Sherwood Libit, Assistant ProfessorDr. Eddie S. Moore, Associate ProfessorDr. John B. Paton, Assistant ProfessorDr. Eugene N. Pergament (,70), Associate ProfessorDr. Arthur H. Rosenblum ('35), Clinical ProfessorDr. Irving Rozenfeld (,47), ClinicalProfessorDr. Milfrod Schwartz (,65), AssistantProfessorDr. Andree Walczak, Clinical Assistant ProfessorDepartment of PsychiatryAppointments:Dr. Petronilo Costa to Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Sanford I. Finkel to Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Doris Gruenwald to Clinical Associate Professor, for one year, effectiveJuly I, 1976.Dr. Daniel Shapiro to Clinical Associate Professor, for one year, effectiveJuly I, 1976.Dr. Sidney Weissman to Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Reappointments:Dr. Michael Basch, Clinical Associate Professor, for one year, effecti ve July I,1976.Dr. Helmut Baum, Clinical AssociateProfessor, for one year, effective July I,1976.Dr. Robert H. Beebe, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Bernard Block, Clinical AssociateProfessor, for one year, effective July I,1976.Dr. Stuart S. Burstein, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Alicia G. Davison, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Robert A. Fajardo, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. James M. Fisch, Clinical Assistant Professor, for one year, eff�ctiveJuly I, 1976.Dr. Burton M. Franklin, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Benjamin Garber, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Arnold Goldberg, Clinical Associate Professor, for one year, effectiveJuly I, 1976.Dr. Edward Goldfarb, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Martin Harrow, Associate Professor, for eight months, effectiveNovember I, 1976.Dr. Richard Herron, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Gerson H. Kaplan, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. David A. Marcus, Clinical Associate Professor, for one year, effectiveJuly I, 1976.Dr. Richard S. Meyer, Clinical Instructor, for one year, effective July I,1976.Dr. Sheldon J. Meyers, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Eugene D. Mindel, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Kenneth M. Newman, ClinicalAssistant Professor, for one year, effectiveJuly 1,1976.Dr. Thomas J. Pappadis, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Stephen L. Patt, Clinical Assistant Professor, for one year, effectiveJuly I, 1976.Dr. Esther Pizer, Clinical AssistantProfessor, for one year, effective July 1,1976.Dr. Robert N. Polsky, Clinical Assistant Professor, for one year, effectiveJuly 1. 1976.Dr. F. Theodore Reid, Clinical Associate Professor, for one year, effectiveJuly I, 1976.Dr. David Rothstein, Clinical Assistant Professor, for one year, effectiveJuly 1, 1976.Dr. James H. Saft, Clinical AssociateProfessor, for one year, effective July 1,1976.Dr. Henry Seidenberg, Clinical Associate Professor, for one year, effectiveJuly I, 1976.Dr. Saul M. Siegel, Clinical AssociateProfessor, for one year, effective July 1,1976.Dr. Seymour B. Siegel, Clinical Associate Professor, for one year, effectiveJuly 1, 1976.Dr. Morris A. Sklansky, Clinical Professor, for one year, effective July I,1976.Dr. Richard H. Telingator, ClinicalAssociate Professor, for one year, effective July I, 1976.Dr. Irving Tracer, Clinical AssistantProfessor, for one year, effective July I,1976.Dr. James E. Wilson, Clinical Assistant Professor, for one year, effectiveJuly 1, 1976.Promotions:Dr. Jerome Beigler to Clinical Professor, for one year, effective July 1, 1976.Dr. Sherman Feinstein to ClinicalProfessor, for one year, effective July I,1976.Dr. Edward Wolpert to Clinical Professor, for one year, effective July I,1976.Department of RadiologyPromotion:Dr. Steven M. Pinsky to AssociateProfessor from Assistant Professor, forone year, effective July I, 1976.Reappointments:Dr. Bertram Levin, Professor, effective for one year, through June 30, 1977.Dr. Jacques Ovadia, Professor, effective for one year, through June 30, 1977.Dr. William L. Schey, Associate Professor, effective for one year, throughJune 30, 1977.ZollerReappointments:Dr. Benjamin J. Gans, Clinical Professor of Oral Surgery, effective for oneyear, through June 30, 1977. Dr. Charles S. Greene, Clinical Associate Professor of Dental Surgery, effective for one year, through June 30,1977.Alumni News1920Joseph Brennan of Pendleton, Oregon,age 86, appeared on a Portland televisionshow featuring three octogenarians involved in diverse careers. Dr. Brennanhas practiced medicine for 54 years, andhas been active in community affairs. In1961 he was named Pendleton's first citizen, and Oregon doctor of the year in1968. Last year he was honored as founder of the Oregon Heart Association.1921Dr. and Mrs. Walter L. Palmer ofChicago celebrated their 50th weddinganniversary on May 15 at a party for 500guests at the Quadrangle Club. Theirthree sons, Drs. Robert, Donald, andHenry, and daughter Beth returned tothe city for the party.1924Eugene Ziskind of Los Angeles wasmade an honorary Fellow of the RoyalSociety of Psychiatry, London.1930James F. DePree, a prominent Seattle,Washington surgeon, was presented the1976 Award of Merit of the InternationalLutheran Laymen's League for outstanding Christian service to the Leagueand the church. The presentation wasmade at the 1976 convention held July25-28 in St. Paul, Minnesota. Dr. DePree has been on the University ofWashington Medical School facultysince 1946. He served the League as amember of its Board of Governors from1959-63 and has held many other officeson the state, district and local levels.1935Robert Lewy is acting Chairman of theDepartment of Otolaryngology atMichael Reese Hospital, Chicago.1940Henry S. Kaplan is directing a new program in cancer research in the new $1.2million Louis B. Mayer Cancer BiologyLaboratory dedicated last fall at Stanford University School of Medicine. Dr. Kaplan, the Maureen Lyles0' Ambrogio Professor of radiology atStanford, has spent the past 20 yearsworking to improve the prognosis forHodgkin's disease and other malignantlymphomas. His new program is a parallel research effort on what he terms "thebiology of human lymphomas."1944Jacob J. Zuidema has retired from hispractice in otolaryngology at GreeleyClinic, Colorado and has moved toLoveland, Colorado.1946Dr. and Mrs. Paul E. Zuelke of Portland,Oregon expressed appreciation for theirreunion on behalf of the Class of 1946 ina charming handlettered plaque whichread: "To the Alumni Office-The Classof 1946 is grateful ! You made our 'looking back' a truly great experience!"Thank you, Dr. and Mrs. Zuelke.1947Robert M. Chanock has received ModernMedicine's 1976 Award for Distinguished Achievement. Dr. Chanock ischief of the Infectious DiseasesLaboratory of the National Institute ofAllergy and Infectious Diseases, the National Institutes of Health. He is aspecialist in viral diseases, in which hebecame interested while a resident inpediatrics at The University of Chicago,according to Modern Medicine. In 1973he was elected a member of the NationalAcademy of Sciences.1948Clement E. Brooke and Mrs. Brookewere honored by his many friends andcollegues on the faculty of the U niversity of Missouri-Columbia School ofMedicine on March 17 following his retirement last June. Dr. Brooke joined thefaculty in 1955. The following year hewas a Markle Scholar, and in 1964 hewas named director of the MedicalCenter's newly established multiplehandicap clinic, where he was instrumental in developing comprehensivetreatment programs for Missouri's handicapped children.Walter N. Francke of Billings, Montana has been cited for distinguishedachievement by being named a Fellow ofthe American College of Radiology atthe College's annual meeting, held inMarch in Washington, D.C. Dr.Francke is affiliated with St. VincentHospital.1949Nancy E. Warner, professor and chairman of the Department of Pathology at57the University of Southern CaliforniaSchool of Medicine, was presented the"First Annual Woman in Medicine"Award of Cares (Center Auxiliary forRecruitment, Education and Service) atCounty-USC Medical Center on May25. The award was presented followingher moderation of a panel on "You'veCome a Long Way, Doctor," which featured four other prominent women doctors.1950Frances Oldham Kelsey recei ved TheUniversity of Chicago Washington,D.C. Alumni Club's distinguishedalumna award. Dr. Kelsey is director ofscientific investigation at the Food andDrug Administration's Bureau of Drugs.She achieved international recognition in1962 for her refusal to approve the marketing of the drug thalidomide in theUnited States.1951Robert Mendelsohn has been writmg acolumn in The C hieago Daily Neil'ssince March, answering questions fromreaders on medical matters. He alsomaintains a private pediatric consultingservice, and is associate professor in thedepartment of preventive medicine andcommunity health at Abraham LincolnSchool of Medicine at the University ofIllinois, Chicago Circle.1952Alvan R. Feinstein presented the annualRobert A. Cooke Memorial Lectureshipduring the Postgraduate Course at the32nd Annual Meeting of the AmericanAcademy of Allergy, held last March inSan Juan, Puerto Rico. Dr. Feinstein isprofessor of medicine and epidemiologyat the Yale University School ofMedicine. His lecture was entitled:"Compassion, Computers and ClinicalScience." He also serves as director ofthe Robert Wood Johnson ClinicalScholar Program at Yale. The Feinsteinsrecently became the parents of a secondchild, Daniel.Joseph H. Skom, associate professor ofclinical medicine at Northwestern University Medical School, is the new president of the Illinois State Medical Society.1953James I. Gabby was elected president for1976 of the California PsychologicalHealth Plan, a prepaid mental health insurance plan. Dr. Gabby lives in Hillsborough.Morris J. Seide is president of theHartford (Connecticut) Medical Society.52 Antigoni Lefteris (A.B. '65), president of theWashington, O.c. alumni club, congratulatesOr. Frances Oldham Kelsey (PhD. '38, MD.'50), who received the club's distinguishedalumna award.Dr. and Mrs. Seide were among theguests at the alumni cocktail party heldin Philadelphia during the American College of Physicians meeting.1954Henry C. Maguire, Jr. returned toHahnenann Medical College inPhiladelphia where he is professor ofmedicine (dermatology) and associateprofessor of microbiology. His researcharea continues to be delayed-type hypersensitivity, with particular reference toallergic contact dermatitis and hypersensitivity to tumor-specific surface antigens. Dr. Maguire writes that two ofhis children are attending Stanford andPrinceton, and the third is a junior inhigh school.Jerry G. Seidel has been honored bythe Park Ridge (Illinois) Jaycees with theDistinguished Service Award forhumanitarianism and service to peopleboth within his profession and in thecommunity. Dr. Seidel has been in private practice in Park Ridge since 1962Dr. Alvan R. Feinstein and has been active in community affairs. He served as Rotary Club president and as a member and president ofthe Board of Education of District 64.Edwin L. Stickney, in family practicein Miles City, Montana, writes that hehas a new interest in hypnosis and is amember of the I ntroductory MedicalWorkshop of the Society for Clinical &Experimental Hypnosis. He was on thefaculty of the Society's annual meetinglast year at The University of ChicagoCenter for Continuing Education andwill again be teaching at the summermeeting in Philadelphia. His Paper on"Hypnotic Regression Therapy" waspublished in the Rockv Mountain Medical Journal. His wife jessica is chairmanof the local zoning commission, on thelocal government study commission, andis trustee of the local community college.Their daughter Claudia just graduatedcum laude from Rocky Mountain College in Billings; their son Jeffrey playswith the Jazz Workshop at the University of Montana and recently played"back-up" for Peter Nero and RobertShaw performances; another daughterLaura is in college.Shu- Yung Wang is clinical associateprofessor of oral pathology at the U niversity of Illinois, and clinical assistantprofessor, division of plastic surgery, atRush Medical School.1955Edward Jim was recently appointed associate professor of surgery (head andneck surgery) at the newly-created University of Hawaii School of Medicine.Dr. Jim holds memberships in the Society of Head and Neck Surgeons and theAmerican Society for Head and NeckSurgery.1956Eugene Halpert of Great Neck, NewYork completed one year as president ofthe Long Island Psychoanalytic Societyand continues on the editorial board ofthe International Journal ofPsychoanalytically-Oriented Psychotherapy. Dr. Halpert is a training andsupervising analyst in the Division ofPsychoanalytic Education, Departmentof Psychiatry, Downstate MedicalCenter, State University of New York.1958Henry Rothschild is professor ofmedicine and anatomy at LouisianaState Medical Center in New Orleans.1962Edward B. Crowell, Jr. and Mrs.Crowell left the University of Wisconsinand have recently arrived in India towork with the Christian Medical Collegein Ludhiana, Punjab for the next threeyears and nine months. Dr. Crowell willbe teaching in the department ofmedicine while Mrs. Crowell teaches inthe section of biochemistry in the department of pathology. He will work as aclinical hematologist, and take a specialinterest in the laboratory aspects ofbleeding disorders. Both hope to get involved in the Community MedicineProgram. He also hopes to provide someresearch backup for the community medical outreach, particularly with regardsto the epidemiology of anemia and otherblood problems.Stephen L. Michel, part-time assistantto the director of surgery at the CedarsSinai Medical Center, Los Angeles, hasbeen appointed a county commissionerto serve on the County of Los AngelesCommission for Emergency MedicalCare. Nominated by the Los AngelesSurgical Society, Dr. Michel reviews therecommendations of the Department ofHealth Services, Emergency MedicalServices Division and monitors ongoingevaluation of county-wide emergencycare facilities.1963Harvey Wolinsky reported at a seminaron atherogenesis sponsored by the NewYork Heart Association and the NewYork Diabetes Association that ametabolic defect which enhances accumulation of lipoproteins in vessel wallcells may be a key factor in the development of coronary artery disease. Dr.Wolinsky is associate professor ofmedicine and pathology at Albert Einstein College of Medicine, and visitingprofessor in biochemical cytology atRockefeller University.19�4Dominic A. Antico is associate professorand director of the Diagnostic Radiology Division at West Virginia University Medical Center in Morgantown.Alan P. Braun is involved in civic andprofessional organizations. He is president of the Plainfield (New Jersey) Medical Association, president-elect of theAmerican Diabetes Association-N.J.affiliate, and secretary-treasurer of theWarren Township Board of Health. Dr.Braun is associate attending physician atMuhlenberg Hospital and assistant clinical professor of medicine at the Collegeof Medicine and Dentistry of New Jersey.Abdollah Sadeghi-Nejad is associateprofessor of pediatrics at Tufts University School of Medicine, and pediatric endocrinologist at the New EnglandMedical Center in Boston.1967David Horwitz, assistant professor ofmedicine at The University of Chicago,was honored as one of the "TenOutstanding Young Citizens ofChicago for 1976" for his work in diabetes and pancreatic cancer.1968Burr S. Eichelman, Jr.,joined the facultyof the University of Wisconsin as an assistant professor of psychiatry on July I.He will be chief of psychiatry at the Veterans Administration Hospital in Madison and director of the Laboratory ofBehavioral Neurochemistry-WaismanCenter at the University.Thomas R. Gadacz is assistant professor of surgery at Johns Hopkins University, with duties at Loch Raven V.A.Hospital.Hugh N. Hazenfield completed his residency in otolaryngology and maxillofacial surgery at Northwestern Universitylast year and on January I was appointedchairman of the division of otolaryngology at Cook County Hospital.David Kindig is the new director ofMontefiore Hospital, Bronx, New York,effective June I. Dr. Kindig is responsible for administration and operation ofthe Medical Center under broadguidelines established by the president ofthe institution. Dr. Kindig served his internship and residency at Montefiore in1968 and 1969 and was Chief Resident inthe departments of pediatrics and socialmedicine for the year 1970-71.Marshall Morgan has been assistantprofessor of medicine (cardiology) andacting co-director of the EmergencyMedicine Center at UCLA since 1974.He recently left the full-time faculty tobecome associate director of theEmergency Department at SantaMonica Hospital.1969Bernard G. Fish on July I became adjunct attending physician in pediatricsand assistant professor at Albert Einstein Medical School, in the Bronx. InJune he was certified by the sub-board ofPediatric Cardiology.Nathan Goldstein III is assistant professor of pediatrics at Kansas UniversityMedical Center. He also is serving aspediatric section chief for the Childrenand Youth Neighborhood Health Clinic,as a member of the ambulatory section ofthe department of pediatrics.Harris L. Greenwald recently opened aconsultation practice in developmentalpediatrics in Santa Monica. He also is a consultant for Crippled Childrens Services, Regional Center for the Developmental Disabled, and the LosAngeles County School System. He wascertified by the American Board ofPediatrics in February and recently married Dr. Audrey Konow, who began herresidency in internal medicine at UCLA.Robert Rubenzik moved from SanAntonio, Texas to Phoenix, Arizona,and began a practice in ophthalmic plastic surgery on August I.Michael Sherlock is chief resident inchild psychiatry at Johns Hopkins Medical School.1971LCDR Vincent P. Gurucharr finished hisresidency in general surgery at the U niversity of Missouri in Columbia and, effective July I, is stationed at the U.S.Naval Regional Medical Center's department of surgery at Great Lakes, Illinois.LCDR John A. McDonald has beenassigned as director of emergency services at the Pearl Harbor Regional Medical Clinic.1972James W. Bateman is a captain in theU.S. Army at Reynolds Army Hospital,Ft. Sill, Oklahoma.Louis Constan was certified as a diplomate of the American Board of FamilyPractice and is in practice in Saginaw,Michigan.Carl Englebardt is a surgical residentat the Cleveland Clinic in Ohio.Allen L. Horwitz is assistant professorin the department of pediatrics at TheUniversity of Chicago.Robert P. Lorenz is a resident in obstetrics and gynecology at the Universityof Michigan.Paul A. Nausieda joined the staff ofMichael Reese Medical Center, divisionof neurology, in July as a clinical instructor with a joint appointment at The University of Chicago, where he will continue his research in neuropharmacology. He represented Michael Reese atthe International Symposium ofPsychosomatic Medicine in Rome, andpresented a paper on "The Effects ofChronic Dopamine Agonism."Stephen Schabel is assistant professorin the department of radiology at theMedical University of South Carolina, inCharleston.Louis Smolensky is chief resident in thedepartment of pediatrics at Los AngelesCounty University of Southern California Medical Center.Scott Lawrence Spear is in the department of surgery at Guy's Hospital inLondon, England.53Golder Wilson is a Fellow in pediatricgenetics at the University of Michigan inAnn Arbor.1974Howard R. Schwartz is taking a residency in rheumatology at the MayoGraduate School of Medicine in Rochester, Minnesota.David J. Smith is in a second year residency in orthopedics at Loyola University Medical Center, Maywood, Illinois.Former StaffWilliam R. Barclay (Medicine, faculty,'48-'56; '64-'70) was named editor of theJournal of the A merican Medical A ssociation. Dr. Barclay also serves theAM A as group vice president forscientific publications.William G. Birch (Obstetrics, internresident, '33-'37) received an honoraryLL.D. degree in May from WesternMichigan University for his pioneerwork in the development of the first baccalaureate Physician Assistant Program.Maximo Cuesta (Obstetrics, resident,'61-'62) was elected president of themedical staff of Burrell Memorial Hospital in Roanoke, Virginia.Philip J. Feitelson (Medicine, resident,fellow, '64-'71) is in the solo practice ofinternal medicine and nephrology inLouisville, Kentucky.Nathan B. Friedman (Pathology, resident, '38-'39) was named honoraryalumnus of the year of the Cedars-SinaiMedical Center, Los Angeles, for hisoutstanding contributions to medicaleducation at the Center. Dr. Friedman isnow senior consultant, division oflaboratories, at the Center and clinicalprofessor of pathology at the Universityof Southern California.Gary G. Ghahremani (Radiology,resident-faculty, '68-'72) is professorand chairman of the department of diagnostic radiology at Evanston Hospital,Northwestern University.Dwight J. Ingle (Pharmacological andPhysiological Sciences faculty, '53-'74)served as visiting professor at the University of Idaho, teaching a course entitied" Science, Fantasy, and the Unexplained." The course was based on hislatest book, Is It Really So?, A guide toclear thinking, a guide on how to reasonaccurately and think for oneself.Richard J. Jones (Medicine, internresident, '44-'49; faculty, '64-'76) wasappointed director of the division ofscientific activities of the AmericanMedical Association on July I. Dr.Jones had been associate professor in theUniversity's department of medicine, director of the faculty and administration54 care service and director of theUniversity's Coronary Drug Project.Fred H. Katz (Medicine, faculty,'63-'66) will enter a full-time privatepractice of internal medicine and endocrinology in Denver, Colorado on September I. He was professor of medicineand head of the division of endocrinology at the University of ColoradoSchool of Medicine.Ronald L. Kirschner (EmergencyMedicine, resident, '73-'75) is assistantprofessor in the division of emergencymedicine at Southern Illinois UniversitySchool of Medicine in Springfield. Hepreviously was at West Virginia University Medical Center.Ardis R. Lavender (Medicine, internresident-faculty, '53-'68) has joined thestaff of the Moses Taylor Kidney andHypertension Institute in Scranton,Pennsylvania.Huberta M. Livingstone (SurgeryAnesthesiology, faculty, '28-'52) is afounding director of the American Retired Physicians Association, designedto serve retired and semi-retired physicians and their spouses and widows,aged 55 and over.William H. McCartney (Radiology,resident-faculty, '70-'74) completed hismilitary service July I, having served fortwo years as chief of the nuclearmedicine clinic at William BeaumontArmy Medical Center, EI Paso, Texas.He was recently appointed associateprofessor of radiology at the Universityof North Carolina Hospitals in ChapelHill.Roscoe E. Miller (Radiology, internresident-instructor, '51-'56) has beennamed Distinguished Professor ofRadiology by the board of trustees at Indiana University School of Medicine, inrecognition of his ability, leadership, andoutstanding achievement.Robert D. Moseley, Jr. (Radiology,resident-faculty, '50-'71) has been appointed as United States representativeto the United Nations Scientific Committee on the Effects of Atomic Radiation. Dr. Moseley is assistant chairmanin the University of New Mexico Schoolof Medicine's department of radiologyand chief of diagnostic radiology at Bernalillo County Medical Center.Fredric Pashkow (Medicine, internresident, '71-'74) has completed twoyears of service at Ft. Campbell, Kentucky and is practicing medicine andcardiology in Loveland, Colorado.Peter I. Reed (Medicine-Gastroenterology, trainee and instructor, '60-'63)writes that he enjoys keeping in touchwith his old friends through Medicine onthe Midway. Dr. Reed is now senior lecturer in medicine at the Royal Post- graduate Medical School, HammersmithHospital, London, as well as senior attending physician and head of the sectionof gastroenterology in the department ofmedicine of the East Berkshire Group ofHospitals, England. In 1972 he waselected a Fellow of the Royal College ofPhysicians of Canada and last April waselected a Fellow of the Royal College ofPhysicians, London.Frank J. Schue (Zoller, intern, '65-'66)is a dentist, in Phoenix, Arizona.Jerome I. Starr (Medicine, Endocrinology, fellow, '71-'73) was elected aFellow of the American College ofPhysicians. Dr. Starr is an endocrinologist with the Worcester DiabetesMetabolic Associates and is an associatein medicine at the University of Massachusetts Medical School. He serveson the board of directors of the American Diabetes Association, New EnglandAffiliate.Hiroshi Tsuji (N eurosurgery,resident-faculty, '65-'67) has been appointed to the division of neurosurgeryat National Kyoto Hospital. Since 1968he has been assistant neurosurgeon inthe divison of neurological surgery at theKyoto University Medical School.Harwell Wilson (Surgery, internresident-instructor, '32-'39) of Memphis, Tennessee, has been elected firstvice president of the American SurgicalAssociation.CalendarWednesday, October 13Reception for alumni and spousesduring American College ofSurgeons Meeting in Chicago,Blackstone Hotel, French Room,5:30-7:00.Friday-Sunday, November 5-7Fall Weekend Seminar (see insideback cover).Reminder to alumni of 1961, 1966and 1971: Reunions are plannedfor November 6. Write to yourclass chairman or the MedicalAlumni Office for information.Class chairmen are:1961: Roger W. Becklund1966: Julian J. RimpilaCHALLENGES TO MEDICINE: CRITICAL ISSUESFirst Fall Weekend Seminar for Medical AlumniNovember 5-7, 1976EXTRA! REUNION FOR CLASSES OF 1961,1966 and 1971In response to the changing interests and needs of our Alumni, The University of ChicagoMedical Alumni Association announces a new and exciting Fall Weekend Seminar on campus.Centered on the theme "Challenges to Medicine: Critical Issues," the seminar program willfeature stimulating and challenging colloquium sessions with members of the University's faculty.All alumni, spouses and friends are cordially invited to attend. Program sessions and accommodations will be arranged at the Center for Continuing Education on the campus.Reunion events for the classes of 1961, 1966 and 1971 will be scheduled for Saturday evening,November 6th.PROGRAMFriday, November 5th, EveningHuman Values and Medical Technology-James M.Gustafson, Professor, Divinity SchoolWine and CheeseSaturday, November 6thMedical Malpractice and Contract Law-Richard A.Epstein, Professor, Law SchoolLicensure and Competence in Medicine Today-MiltonE. Friedman, Paul Snowden Russell DistinguishedService Professor, Department of EconomicsIs Continuing Education Relevant?-Leonard D. Fenninger, M.D., Group Vice President for MedicalEducation, the American Medical AssociationLuncheon Speaker: "What's New at the U"-Henry P.Russe, M.D. (,57), Associate Vice Presidentofthe University for the Medical Center (Medical Services);Chief of Staff of the University's Hospitals and Clinics;and Professor in the Department of Medicine. Reception and DinnerReunion Classes Special EventsSunday, November 7thRx for the Runaway-Margaret K. Rosenheim, HelenRoss Professor, School of Social Service AdministrationThe Politics of Health: Planning and Regulation-J. JoelMay, Director, Graduate Program in Hospital AdministrationThe Politics of Health: National Health Insurance as a'Critical Issue' -Theodore R. Marmor, Associate Professor, School of Social Service Administration; andResearch Associate, Center for Health AdministrationStudiesProgram Monitor: Asher J. Finkel, M. D. (,48), GroupVice President for Scientific Affairs and ContinuingMedical Studies, the American Medical Association;and President, University of Chicago Medical AlumniAssociation, 1976-77.* * * * *This continuing Medical Education offering meetsthe criteria for 6 hours of credit in Category I for thePhysician's Recognition Award of the AmericanMedical Association and 6 hours from the American Academy of Family Physicians. For information, fees and registration forms contact:Medical Alumni OfficeUniversity of Chicago1025 East 57th StreetChicago, Illinois 60637(312) 947-5443Medicine on the MidwayThe University of ChicagoThe Medical Alumni AssociationThe Pritzker School of Medicine1025 East 57th StreetChicago, Illinois 60637 NON·PROFIT ORG.U.s. POST AGEPAIDPERMIT NO. 9666CHICAGO. ILL.•Address corrections requestedreturned postage guaranteed