on //. M��i!2ini�jI ..._ � o. _l. Association. f the Medical AlumnlBulletm o. f ChicagoThe University o. 10 leal Sciences.. of the BIO gI• •DiVISIonh I of MedicineThe Pritzker Sc 00.. IGraduation IssueReunionSEP 22 1980President's LetterThe purpose of Medicine on the Midway is to report on your activities andthose of your medical school and to explore the relationship between the two. Itis that relationship with which this column will be most particularly concerned.The class of 1980 has been graduated. 108 students completed an intensivebasic science and clinical program that places them among the best trainedphysicians in this country and therefore the world. Their accomplishments arereflected by internship assignments to all of the best programs in the country.They will, in time, have a collective impact on U.S. and world medicine thatregrettably will never be properly documented; but based on the experience ofyour classes their accomplishments are likely to be awesome. This will be sobecause of the basic character and quality of these students and that of ourmedical school and University. There is now an indissoluble bond between the1980 graduates and this school, forged in the heat of transition from student tophysician. This bond is not unanalogous to that of a farm and its harvest, afamily and its generations. Each must be carefully nurtured and protected fromnature's and man's vicissitudes. So must the future graduates of our school benurtured, and that is our responsibility. Our collective loyalty to this centralshaping force in our lives will determine its continuing strength; it will be areflection of our own character; our fidelity to what has helped make each of uswhat we are. Given the quality of its alumni, our school could not be betterentrusted ��Louis Cohen ('53)BuUetin of the Medical Alumni AssociationThe University of ChicagoDivision of the Biological SciencesThe Pritzker School of MedicineVol 35, No.1, Summer 1980Editor: Scott NewtonContributing Editors: James S. Sweet,John PontarelliPhotographers: Mike Shields, John WellsChairman, Editorial Committee:Robert W. Wissler ('48)Members: Robert Hazelkom,Julian Rimpila (,66), Peter Wolkonsky ('52)Medical Alumni AssociationPresident: Louis Cohen ('53)President-Elect: Sumner C. Kraft ('55)Vice-President: Robert L. Schmitz ('38)Secretary: Randolph W. Seed ('60)Director: Katherine Wolcott WalkerCouncil Members:Fredric Coe (,61)Walter Fried ('58)David G. Ostrow (,75)Robin O. Powell (,57)Jerry G. Seidel ('54)Francis H. Straus (' 57)Copyright 1980 by the Medical AlumniAssociationThe University of Chicago Medicineon the Midway4Misconceptions:A Legal Image of Medical PracticeAnn Dudley Goldblatt9Doctor to the Bedouin:Profile of a Visiting ClinicianScott Newton12Reunion ActivitiesMark Alumni Week15Distinguished Service and Gold KeyA ward Presentations18Graduation Dinner and Reception201980 Residency Assignments 22Medical Alumni Association­A Brief HistoryDr. Frank W. Fitch ('53)26News Briefs30In Memoriam32Alumni News35Departmental News38Abstracts of 1980 SeniorScientific Session3Ann Dudley Goldblatt is a lawyer and Lecturer in the College. Thisarticle is adapted from an ASHUMIAMSA seminar she gave lastfall.I am prepared to argue that the United States Supreme Court hasmisconceived the nature of clinical medical practice and doctor­patient relations. Such a misconception is not unusual.In some instances, this kind of misconception may be uninten­tional. But even in such cases they tend not to be corrected whentheir inaccuracy becomes obvious. Corrections are not made be­cause the distortions are vital parts of arguments supporting a judi­cial court's decisions.My example is abortion, as discussed in several United StatesSupreme Court decisions. These decisions depend on a highlyromantic conception of a doctor-patient relation. It pictures an old­fashioned, friend of the family doc, the Marcus Welby stereotypewho doesn't exist any longer in most of our country. Where thiskind of primary care is still practiced, it most certainly does nottypically include patient-initiated abortion procedures.The second major misconception of the abortion decisions is arefusal to admit or to consider how elective abortion differs fromnormal medical care. I'll return several times to the complexities ofthis argument. The Supreme Court's opinions in the abortion casesare built on a series of interlocking presumptions, all of which de­pend on each other and on distorted images of medical practice.I should note that there are many doctor-patient relationships.Elective abortions can be said to represent one end of the spectrumof these relationships, typically a fleeting and temporary relation, amodem instance of medical procedure.Before I begin to discuss this particular example of a legal mis­conception of medical practice, I want to stop to consider why it isthat lawyers and judges seem particularly prone to misconceive thisand other parts of the science and practice of medicine.In the first place, the professions of law and medicine have muchin common. Both require formal, post-graduate education that lastsseveral years. Much of this education has most of the attributes ofa training program, a trade school, if you will. But we won't. In­deed, the ascendency of scholarship over apprenticeship is main­tained somewhat shrilly at times, as if the phrase trade school is anepithet that hits too close to home.Both professions have also enjoyed a high degree of authorityand prestige in the community, at least traditionally. The membersof these professions have naturally enjoyed and fostered this reputa­tion. Physicians and lawyers cultivate a certain professional mys­tique, as if there were a secret certainty known only to the profes­sional initiate. This too is understandable.What's less understandable is the lawyer's propensity to believethat medicine's secret certainty is really there. There's some evi­dence to suggest that this naivete is bilateral-that doctors aren'taltogether sure lawyers have no real secret. And I admit I'm notalways certain medicine has no secret. Sometimes I wish it did. Iam certain that the law's secret does not exist.Sooner or later every law student realizes he will never receive asudden revelation of the essence of 'the law' or of 'justice.' Oncethe student realizes the law's mystique is only apparent, he is freeto concentrate on mastering the craft of the lawyer. His job is tolearn a special method of analyzing problems and reaching accept­able, helpful and equitable, but not certain or perfect, solutions. Why is it so many lawyers are apparently unwilling to transferthis revelation of non-revelation to the medical profession? Myguess is that lawyers are likely to have only the most superficialtraining in the natural sciences. They may simply assume that theprecision and certainty of basic mathematics apply equally to thephysical and the biological sciences.This may be persuasive in understanding why the judicial deci­sions in the abortion case describe all medical procedures as alikein nature and in the degree of certainty which is available. But itdoesn't explain its distorted images of doctor-patient relationships.I think there's a simple, although also superficial, answer to thisproblem too. The lawyer, or judge, tends to view a patient as if hewere an ideal client: respectful and trusting, obedient and uncom­plaining,-altogether a true believer in the professional mystique.Much of the Court's argument in the abortion cases relies on thepublic's belief, and acquiescence, in this mystique and authority.I must make another detour before I enter the battle over the per­suasiveness of the Supreme Court's abortion decisions. I empha­size, by the way, that I am speaking of the persuasiveness of theCourt's opinions, not the holdings of the abortion decisions. Mydiscussion is of the Court's arguments, not the declaration that theprohibition of abortion is unconstitutional. Abortion is legal; itslegality is based on applicable judicial precedents and tenable con­stitutional interpretation. I am not going to discuss the morality ofabortion either, although the continuing controversy over its moral­ity is important to my argument.My detour is to make it evident that the Court's misconceptionsof clinical practice and the doctor-patient relationship of electiveabortion were mis-conceptions in 1973, when the first abortioncases were decided.In January 1973, just before the first abortion decisions, the De­partment of Health, Education and Welfare, as it was then known,published a report called 'Medical Malpractice.' (Government pub­lications are not known for their inventive titles, still Medical Mal­practice seems unnecessarily dour.)This report documented what it called the malpractice phe­nomenon: the abrupt increase in lawsuits brought by patientsagainst their physicians. It concluded that a major cause of thismalpractice phenomenon was a change in the traditional doctor­patient relationship. Instead of a long-standing acquaintance be­tween doctor and patient, the patient was increasingly likely to betreated by specialists. The physician was becoming a stranger. It ismuch easier to sue a stranger. It is easy to expect more from aspecialist. It is easy to misunderstand the treatment 'promises' of astranger.The report stated that increased patient expectations also contri­buted to the malpractice phenomenon. Professional abuses were athird cause. These abuses included unnecessary elective surgicalprocedures, excessive laboratory tests and excessive charges, andseveral kinds of fraud: imaginary tests, imaginary surgical proce­dures, even imaginary 'patients.' The HEW report on medical mal­practice was an indictment of the medical care system.To go from the 1973 HEW report to the 1973 or even 1976 Sup­reme Court decisions on abortion legislation, which is what I'mgoing to do, is to turn from a somewhat grim realism to a pleasantfantasy. We enter a different world.It's a world where patients have regular, family doctors, and reg­ular, benevolent and understanding gynecologists. It's a worldwhere the doctor is trusted, respected, beneficent and obeyed. It's a5world where the authority of law and of medicine is unquestioned.A world where law and medicine can together, even if not separ­ately, mold public opinion and resolve controversies, even thosecontroversies involving conflicts in basic values. In brief, it's amake believe world where the judiciary, allied with medical scien­ce, can create a consensus that makes abortion legal and at leastmorally neutral, if not morally correct.The United States Supreme Court issued two decisions involvingabortion legislation in January 1973. Roe v. Wade [410 U.S. 113(1973)] declared unconstitutional a 19th century Texas statutewhich made criminal every abortion not performed to save the lifeof the pregnant woman. Doe v. Bolton [410 U.S. 179 (1973)] in­validated several of the limitations of a 1968 Georgia abortionstatute copied largely from the American Law Institute's ModelPenal Code. The invalidated provisions included a residence re­quirement, a requirement that abortions be performed in accreditedhospitals, and the written opinion of a second physician that theproposed abortion was medically indicated.The Court held generally that the 14th amendment to the Con­stitution protects a woman's decision whether or not to terminateher pregnancy.The Court was aware that these would be controversial deci­sions. The cases had been pending in front of the Court for morethan a year. Oral argument had been held first in December 1971.The Court later made an unusual request for a reargument. Thisreargument was held in November 1972. Between these two oralarguments, the Court had issued a decision invalidating a Mas­sachusetts statute which prohibited the distribution or sale of con­traceptive materials to unmarried women.This decision, in Eisenstadt v Baird, had included the statement:"if the right of privacy means anything, it is the right of an indi­vidual ... to be free in matters so fundamentally affecting a per­son as the decision whether to bear or beget a child." [405 U.S438,453 (1972)]The controversy that succeeded the Eisenstadt decision shouldhave warned the Court that it was dealing with issues on whichthere were fundamental conflicts in values. The Court must haveknown that its authority would be attacked even if its abortion deci­sions were as narrow and legalistic as possible.But the Court was apparently determined not only to make abor­tion legal but to make it right, or at least morally neutral. I believethe Court did this because it saw the country divided, thought itcould bring the country together, and believed it appropriate that itdo so. But I am concerned here only with how the Court attemptedto resolve this conflict, and why it failed.The Court's attempt to create a social consensus on abortion ismade up of a series of premises all of which interlock and dependupon each other. It is difficult to separate these premises, and thento show how each relies on each of the others being accepted, andis in return dependent on every other premise. I think I have finallymade it clear in my own mind, and hope I can make it clear - andpersuasive - to you.These are the premises the Court uses.First, that the combined authority of the law and of medicine canmake abortion become perceived first as legal and, immediatelythereafter, as a purely medical decision.Second, that if it is perceived as a purely medical decision, thenabortion can also be perceived as an unexceptional medical treat­ment, a part of normal medical care.6 Third, that if it is perceived as a part of normal medical care,then abortion can be perceived as naturally being performed withinthe Court's description of a traditional, personal doctor-patient rela­tionship.Fourth, and completing the circle, that as soon as abortion islegal, it will indeed be considered a purely medical decision, a nor­mal part of medical care and will be performed within a traditionalconception of the doctor-patient relationship.I begin with the first premise: that the Court intended to makeabortion perceived purely as a medical decision. It would not bepersuasive to argue that once abortion was legal, its legality itselfwould somehow tum it into a purely medical decision; abortion'smoral reputation was too burdensome for such an immediate trans­formation. The Court instead argued that abortion is legal becauseit is and always has been a purely medical decision and 'problem.'It is primarily in the service of this argument that medicine andmedical science pervade the majority opinions in Wade and Bolton.One long section of the Wade decision is devoted to the history ofmedical abortion in America. Changes in its use and socio-medicalacceptability are explained as affected only by the increasing abilityof clinical medicine to protect the health of the pregnant womanand to reduce the mortality of childbirth.Religious beliefs and social conventions and values are treated asimmaterial. Religious beliefs are irrelevant to questions of constitu­tionality. But not to questions of social, or even medical, history.Moreover, the Court did not simply hold religious beliefsirrelevant, both historically and constitutionally. The Court alsoquestioned the persuasiveness of these beliefs on the ground thatthey were inconsistent with the most recent discoveries of biologi­cal science. The following is from the majority opinion in Wade."The existence of life from the moment of conception . . . is aview strongly held by many non-Catholics and by manyphysicians .... Substantial problems for precise definition of thisview are posed, however, by new embryological data that purportto indicate that conception is a 'process' over time, rather than anevent, and by new medical techniques such as ... the 'morning­after' pill, implantation of embryos, (and) artificialinsemination .... "[410 U.S. at 160-1]Now, for one thing it is improper for a Court to pass judgmenton the validity of religious beliefs. And it is doubly improper for aCourt to question the validity of a religious belief on the groundsthat it is inconsistent with the hypotheses of science. Furthermore,the Court's attempted argument is fallacious. An ability to abort orto implant an embryo has nothing whatsoever to do with whetherthe embryo is alive--or ensouled, or a 'person'.I've used this perhaps too provocative part of the Court's deci­sion because it shows how completely the Court accepted, and de­pended on, the authority of medical science.But if the Court were to succeed in making abortion exclusivelya medical decision (the first premise) and therefore an unexception­al part of medical care (the second premise), the Court had to con­clude that the woman's ability to have, rather than just to seek orobtain, an abortion, depended totally on 'her attending physician's'decision that the requested abortion was medically indicated (thethird premise.)Wade and Bolton do not grant a 'right' to have an abortion.They grant the right of the physician to perform abortions that hedetermines, in the exercise of his clinical judgment, are indicated.The closing paragraphs of the majority opinion in Wade state:"The (abortion) decision vindicates the right of the physician toadminister medical treatment according to his professional judgment(the 2nd and 3rd premises) .... The abortion decision in all itsaspects is inherently and primarily a medical decision ... (the firstpremise)." [410 U.S at 165-6]How was this decision perceived by so much of the public as avindication of a woman's 'right to abortion on request. "t Especiallywhen there are express statements in concurring opinions to Wadeand Bolton emphasizing that these decisions did not grant any rightto abortion on demand or to abortions that are not medically indi­cated? [410 U.S. at 208 (concurring opinion, Burger c.j.)]It was perceived as the vindication of a woman's right becausethere is a hidden (and therefore unnumbered) assumption in thesemajority opinions. This is that any woman wanting an abortion willbe able to find a doctor willing to perform it. This assumptioncould not be made explicit. If it had been, it would have describedthe doctor as a fee-for-service tradesman, a plumber of the body.Such an image would have destroyed the scientific neutrality, andprobably also the moral authority, of the medical profession and itspractitioners. But the Court was convinced it needed this scientificand moral authority to make abortion exclusively a medical deci­sion (the first premise.) The expressing of this assumption wouldalso have destroyed the third premise, the premise of the traditionaldoctor-patient relationship, as well as the fourth premise, that ofabortion as a regular part of normal medical care performed withinthat doctor-patient relationship.The majority opinions in Wade and Bolton made several indirectattempts to blunt this conflict between its premise of abortion asregular medical care performed within a traditional doctor-patientrelationship and the reality of abortion on request from the doctorknown in advance to be willing to perform it.First, the Court implied, but did not state (this becomes impor­tant in 1977) that a request for an abortion was itself a sufficientmedical indication. (This can be called premise one prime). Thusall patient-initiated abortions were therapeutic abortions, typicaltreatments within the premise of traditional medical care (thesecond premise.)Finally, all these implied perceptions of what abortions were tobe 'medically indicated' depended on the fourth premise, that oncethe performing of abortions was declared legal, it would be inte­grated into the traditional doctor-patient relationship as an ordinarypart of regular medical care, and would be so perceived by doctors,by patients; and by the community at large.But it was not so perceived by anyone. Abortions were not per­formed as a part of the ordinary doctor-patient medical relationshipin those states where abortion had been legal for a number ofyears. It is not today performed as an ordinary part of normalmedical care.The best that can be said about the Court's description is that itwas, and is, unreasonably naive. I don't want to enter any discus­sion as to whether abortion can, or should, be considered as nomore than one possible treatment for the 'condition' of pregnancy.Regardless of how our society should view abortion, it does view itas an unusual kind of medical treatment.Patient-requested abortion procedures are seen as other than nor­mal because it is a requested treatment, and because the request de­pends on how the patient views this particular pregnancy. We don'ttalk about unplanned tumors or inconvenient gallstones. There areno clinics that perform only tonsillectomies or appendectomies at the patient's request.Most abortions are not performed by the patient's regular physi­cian, assuming she has one. Over 80% of the abortions performedin Illinois have been performed at five free-standing for-profitclinics in Chicago. These clinics offer no medical services otherthan abortion, voluntary sterilizations, and, in some instances,pregnancy tests.I think it's indisputable that the quality of care at these clinics isextremely, and improperly, low. At the same time, there are veryfew available alternatives. Less than 20% of the hospitals and cli­nics in the country permit affiliated physicians to use the surgicalfacilities of these institutions to perform elective abortions.Much of this information was known to the Court in 1973. Allof it was common knowledge in 1976, when the Court issued itsopinions in Planned Parenthood v. Danforth. [428 U.S. 52 (1976)]Yet in Danforth, the Court reaffirmed and strengthened its premisethat abortions were performed within a traditional doctor-patient re­lationship. The opinions in Danforth went even further. Theyasserted that consultation with and the informed clinical judgmentof each patient's 'attending physician' ensured that every abortiondecision was considered, informed, and therefore to be presumed tobe in the patient's best interests.The Court declared this was true even in the commercial abor­tion clinic setting. And for all abortion patients: adults, adoles­cents, and, in the words of the plurality opinion in Danforth, for'the minor mature enough to become pregnant.' I will not acceptthe temptation to discuss the Court's ill-considered choice of theword 'mature'.A concurring opinion in Danforth was infuriated at the plural­ity's refusal to face facts. It described the realities of abortionclinic practices."The physician takes not part in the counselling practice ...The abortion itself takes five to seven minutes .... The physicianhas no prior contact with the patient .... On busy days patientsare scheduled in groups, consisting usually of five patients ....After the abortion the physician spends a brief period with thegroup in the recovery room .... " [428 U.S. at 91-2, n.2 (concur­ring opinion, Stewart, j.)]But even distortions as extreme as those reaffirmed in Danforthhave not succeeded in making abortion a noncontroversial medicaltreatment. The Court's decisions made abortion legal, but exacer­bated and polarized the controversy over its appropriateness andmorality. One consequence is an apparently endless series of law­suits caused by legislative attempts to limit or circumvent the abor­tion decisions.We recently celebrated, although that's a particularly inappropri­ate term, the 25th anniversary of the Court's school desegregationdecision. We have had a quarter of a century of delay, legal presti­digitation and chicanery rather than 'all deliberate speed.' I thinkthe abortion decisions started us down an equally long and shabbyroad. I think we have more than 20 years to go of refining, clar­ifying and amending the abortion decisions before an acceptableconsensus will be achieved, or perhaps discovered would be a moreaccurate word.I've talked at length of the distorted images, particularly the fourunproved and distorted premises of the abortion decisions. I saidearlier that the Supreme Court in Wade implied but did not statethat all requests for abortions were themselves sufficient medicalindication for a therapeutic abortion. This implication was repudi-7ated in the 1977 Supreme Court abortion decisions.The 1977 abortion decisions, there are three of them, are knowncollectively as the Medicaid cases. [Beal v. Doe 432 U.S. 438(1977); Maher v. Roe 432 U.S. 464 (1977); Poelker v. Doe 432U.S. 519 (1977)] The Medicaid cases challenged the constitutional­ity of statutes limiting the disbursement of public funds to payphysicians for abortions performed on 'medically indigent' persons.Reimbursement was limited to those abortions which were medical­ly indicated as defined by the statutes, not just by the clinical judg­ment of the doctor who performed them. The Court found theselimitations valid exercises of legislative discretion.The Medicaid decisions were just as controversial as the earlierabortion decisions, only in 1977 everyone changed sides: the pre­viously outraged were somewhat appeased and the previouslysomewhat pleased were outraged.The Medicaid opinions are in some respects less open to critic­ism as to the arguments presented than the 1973 and 1976 opin­ions. Nonetheless, the majority opinions in the Medicaid cases douse one argument I find un persuasive and even unethical.These decisions assert, using language that had not appearedeven once in previous Supreme Court abortion opinions, that somerequested abortions are therapeutic or medically indicated, andothers are nontherapeutic or elective. State and local statutes maylimit reimbursement from public funds to those abortions that aretherapeutic or medically indicated.If the Court is merely emphasizing that the Constitutional 'right'to obtain an abortion does not include a right to have it paid for, Iagree. I do quarrel, however, with the intimation that the distinc­tion between therapeutic and elective abortions can depend on thepatient's financial status.The Court stated in 1973 that abortion was inherently and pri­marily a medical decision. The Court held in 1977 that the physi­cian's clinical judgment as to the medical indications for abortionisproperly subject to legislative limitation, at least when public fundswill be used.Both implications-the importance of financial status and theneed to review clinical decisions-project an unflattering image ofthe physician. Both imply the physician is a tradesman-a scalpelfor hire. Both question whether the physician does--or should-actalways in the best interests of the patient.The Court attempted in 1973 and again in 1976 to create a pub­lic consensus based on the perceived moral neutrality-if not cor­rectness--of elected abortion. These decisions relied heavily on thescientific authority and ethical prestige of the medical profession.The Court seemed to have given up this attempt in 1977. Indoing so, the Court was careless of medicine's reputation, as wellas its own. The abortion decisions, studied together, make the lawseem an ass and the doctor a profiteer.This wasn't necessary. Judicial precedents and constitutional his­tory support sufficiently an argument that unborn fetuses are notconstitutionally protected persons. Recent Court opinions h�d de­clared that a constitutionally protected right to personal privacy in­cluded contraceptive freedom, a liberty to decide whether 'to bearor beget.' These precedents were sufficient to invalidate state leg­islation that prohibited or substantially interfered with the ability toseek and obtain an abortion prior to the fetus's medically supportedcapacity to survive ex utero.I think the original abortion decisions could have and shouldhave stopped at this point. When they continued, they did so in anattempt to mold public opinion. The attempt was clumsy and in­effective, and has brought disrepute on the Court, the judiciary, the8 profession of law and the profession of medicine.A Court can't make decisions based on a fiction rather thanavailable and commonly known facts without losing the respect ofits constituency and clouding the reputation of all who profess thelaw. The judiciary can't contradict its own depiction of a medicalpractice and the perogatives of clinical judgment without making it­self, and the clinicians it described, appear untrustworthy.The Court built its own house of cards in the abortion decisions,shored it up for four years, and then off-handedly pushed it down.I have discussed a legal image of one medical practice. In theabortion cases the United States Supreme Court tried to make asocially and morally complex decision, and, at the least, a highlyindividual decision, into an exclusively medical decision and anordinary part of regular medical care.The Court tried to fit a medically mediated procedure that is formany reasons removed from normal medical practice, (thesereasons are financial and logistical as well as conventional), into aromanticized, traditional doctor-patient relation that is for most ofus a memory.I have mentioned only in passing why I believe these and similarmisconceptions and distortions have damaged the professions oflaw and medicine. To be again brief, and speaking generally, thesemisconceptions cause decreased trust and an increased suspicion ofthese professions and of professional expertise in general.We live in a self-concerned, legally pugnacious society. It is alsoa society with massive amounts of legal regulation, particularly ofwhat is called by the regulators (and even the phrase ought to makeus mistrustful) the delivery of health care systems management.Every new hospital bed or medical machine, every medical proce­dure, it almost seems that every disease, must demonstrate its com­pliance with applicable rules, laws, regulations, orders and guide­lines.One recent study, contracted and paid for by the federal govern­ment, concluded that impatient care can be 'inputted' into one of380 'diagnosis related groups', each with a nonnegotiable price forreimbursement (and therefore, under current regulation, for manycost and expense determinations). There is talk of using thistriumph of computerized financial planning in New Jersey, a prop­osal that may not please those of us who are or will become pa­tients.But such proposals, added to the rules and regulations already ineffect, are creating a medical-legal establishment. I think thismedical-legal establishment is already becoming to the dissatisfiedof today what the industrial-military complex was to the outragedof the sixties. Lawyers and doctors who misconceive each other'sprofessions help shape the distrust we have for such a medical-legalcomplex.The psalmist said that the beginning of wisdom is the fear of theLord. I do not pretend to offer wisdom, but only what I believe isgood opinion. So my aphorism is appropriately scaled down: thebeginning of good opinion is a clear vision of ourselves and ofothers.That's also good common sense.Doctor to the Bedouin:Profile of a Visiting ClinicianScott NewtonDr. Wesley Ulrich ('66) works in a small hospital for chest dis­eases in rural Jordan. He came back to the University of Chicagorecently for two weeks of intensive training in the Visiting ClinicianProgram. While here he was interviewed by Medicine on the Mid­way.Outside the town of Mafrak, Jordan, close to the Syrian border andsome 45 miles east of the Jordan valley, Dr. Wesley Ulrich ('66)practices a singular variety of medicine. The diagnostic techniqueshe employs and the therapy he prescribes are quite conventionalbut little else about his situation is.Dr. Ulrich treats chest diseases in a population in which they arerife: the desert bedouin of Jordan, Iraq, Syria and Saudi Arabia. Hemust make do with resources which though adequate, are woefullylimited in comparison with those available even to the rural physi­cian in this country. He is constantly thrown back on his own ing­enuity-which, happily, is formidable-in devising ways to over­come the ever-frustrating limitations. In an age when specializationreigns supreme, he is a most valuable example of a generalist. Hisduties are rather extraordinarily diverse, encompassing a range ofclinical and laboratory work, equipment maintenance and adapta­tion, chemical preparation, administration including financial man­agement, and even farming. And his reasons for finding himself insuch a situation at all are special, for they are primarily spiritual.Dr. Ulrich is a missionary doctor with World Presbyterian Missions. Dr. Ulrich came to rrussionary work only after his career hadchanged directions several times. Almost every aspect of the di­verse background he acquired in this way, however, has proved in­dispensable to his chosen vocation. Dr. Ulrich received his B.A.from Houghton College in Chemistry, then came to the PritzkerSchool of Medicine, from which he received his M.D. in 1966.After his internship, Dr. Ulrich entered the Navy under the BerryPlan and, distressed at the frustrations of a conventional medicalcareer, pursued a degree in electrical engineering. He had alwaysbeen technically adept, so this was a natural move. As a result ofhis training he gained expertise in the field of medical technology.At about this time Dr. Ulrich had become interested in medicalmissionary work in which he saw a means of putting his diversetalents to use and of finding the personal and spiritual fulfillment hehad long sought. His resolve was confirmed after a meeting in1971 with T. Stanley Soltau, a well-known missionary statesmanwho had worked for many years in Korea, and whose daughter,Dr. Eleanor Soltau, a physician, had been working among bedouinin Jordan for several years. Dr. Ulrich agreed to come to Jordan toassist her as a short-term missionary but ultimately remained.At 31 he faced the task of acquiring his first foreign language, achallenge he successfully met. After completion of his Arabic stu­dies, he assumed his responsibilites at the newly-opened AnoorHospital for Chest Diseases in Mafrak. He took charge of the tech­nical facilities under Dr. Soltau, the medical director.9The Anoor Hospital represented the culmination of years of tire­less efforts by Dr. Soltau and her assistant Aileen Coleman, R.N.,on behalf of ailing bedouin. After practicing for some years on theWest Bank and among nomadic tribes, Dr. Soltau and Aileen Cole­man had chosen to locate in the Northeastern part of the country inorder to be nearer the crossroads of bedouin migration routes andthe heaviest concentration of their chosen patient population. TheJordanian government granted them permission to open a hospitalin Mafrak. They rented a two-storey stone building in which theyinstalled a 16-bed TB facility, the only one in the areaAs the Israeli occupation of the West Bank shunted large bedou­in populations eastward, Dr. Soltau and Nurse Coleman foundthemselves forced to cope with a considerable influx of patients,which put a severe strain on their limited resources. A volunteerworker from Ohio, Lester Gates, came over initially to improveand maintain the rented quarters, but he and Dr. Soltau togetherdetermined that a new hospital was what was really necessary. Heundertook to serve as chief contractor for the construction. Twenty­five acres of land were acquired outside Mafrak, and the new hos­pital was erected.The completed Anoor Hospital is a 60-bed facility of a sprawlingdesign, attractively landscaped. The adjoining land is planted withsome 8,000 trees some for windbreak, but the majority fruit andolive, for cultivation. Mr. Gates, a farmer, conceived the idea ofcultivating the land as a means of helping to subsidize the hospital.The fruit and olives are harvested and sold. The hospital also main­tains livestock pens for goats and sheep, and a recently-built chick­en coop.The hospital treats chest diseases alone. The targeting of a spe­cific set of diseases in a particular population, which may seemarbitrary at first, is grounded on sound epidemiologic considerationshaving to do with the distinctive circumstances of the bedouin wayof life.Although there has long been a tendency for bedouin tribes tobecome sedentarized, many are still nomadic, constantly on themove with their herds in the search for pasturage. The incidence oftuberculosis among them is high, on the order of I %. The TBproblem is particularly intractable in the nomadic bedouin.Although required to identify themselves as Jordanians, Syrians,Iraqis, or Saudis, bedouin are by nature notoriously unconcernedwith national borders. Authority for treatment of TB-sufferersamong them is indeterminate at best. Their nomadic ways makeany type of extended therapeutic regime exceedingly difficult to im­pose. The partially cured have a tendency to relapse and infectothers. The Jordanian government is happy to have an independentmissionary health service to complement its own programs in com­bating the problem of TB among bedouin.10 In addition to Drs. Soltau and Ulrich and Aileen Coleman, thereare several practical nurses whom they have trained, and a support­ing non-medical staff. The small scale of the operation forbids anyextensive division of labor; the staff is necessarily resourceful.Though the Anoor Hospital is now a well-equipped modern di­agnostic and therapeutic facility for chest diseases, thanks largelyto Dr. Ulrich's perseverance in procuring the necessary technicalresources over the years, because of its isolation from major medic­al centers it suffers from a chronic shortage of 'nuts and bolts'technical supplies and adjunct services which the physician in awestern environment simply takes for granted. Dr. Ulrich's compe­tence in medical technology permits him to remedy these lacunaeto a significant extent.Dr. Ulrich spends hundreds of hours in improvising solutions tothe ever-recurring problems. His engineering skills allow him tomaintain the various apparatus, such as the electrocardiograph. andpulmonary function unit, in working condition. When from time totime faced with a shortage of x-ray film because of perturbations inthe silver market, Dr. Ulrich relies on an alternative system of hisown devising, consisting of a conventional camera and a fluorosco­pic screen. He recently adapted a computer to the pulmonary func­tion unit. When he could not obtain cyanide solutions for hemoglo­bin determination commercially, Dr. Ulrich prepared his own re­agents from scratch. Quality control studies revealed them to be su­perior to the commercial variety. He has even had to fashion hisown petri dishes for bacteriological culture out of oven-roastingfilm when he could not obtain standard ones.The hospital's work is financed chiefly by donations from charit­able individuals and institutions in the States, but these must besupplemented wherever possible. The fees charged patients helpsomewhat, but they account for less than ten percent of total costof care. The agriculture and animal husbandry also help to defrayoperating costs. What is most important is that costs themselves bekept to a minimum in the first place. In addressing himself to thelogistic exigencies of the situation, Dr. Ulrich is always looking toaccomplish just this. He indeed makes a virtue of necessity; a fortun­ate concomitant of his inventiveness is thrift. In an age when thecost of health care is prodigal, Dr. Ulrich's economy is cause foradmiration.The staff sees some 5-6,000 outpatients annually; of these ap­proximately 110 are hospitalized for an average stay of between 2and 4 months. Drs. Soltau and Ulrich like to hospitalize patientsfor as long as practicable. Since compliance is such a problem it isnecessary that they provide as much drug therapy as possible inorder to reduce the likelihood of relapse.Only about one-third of the disease diagnosed is new. Most of itis either old disease that has proved resistant or disease of morerecent origin for which the patient has been referred from else­where. Frequently patients have been treated for a number of yearspreviously, but have been non-compliant, and present with ad­vanced disease.In order to treat bedouin successfully, the physician must havesomething of a sociological perspective. Many bedouin have con­siderable wealth (in livestock) but do not choose to spend it onfamily health; the notion is culturally alien. Dr. Ulrich's ultimatetask is as much to inculcate a regard for the sanctity of health as toheal. Patients pay a nominal fee ($15/month for inpatient care) onlyso that they appreciate the value of what they receive.Dr. Ulrich's sense of religious devotion is much the most impor­tant aspect of his work as he sees it. Indeed, in the social contextin which he practices medicine, it is quite as much a practical ne­cessity as his technical and clinical skill-something that may bedifficult for some physicians to grasp. His patients are well awarethat the institution is a religious one and Dr. Ulrich makes no se­cret of his convictions. Both doctor and patient appeal to divineassistance in the course of treatment. Neither perceives any incon­gruity in the recourse to both sophisticated medical procedure andprayer. Though the majority of the patients are Muslim, the bondof a shared religious (in the wide sense) approach to life counts formore than sectarian differences. A secular physician would havemuch more difficulty in relating to such patients than Dr. Ulrichhas.Bedouin with model tents which they build as a pastime.The integration of his professional knowledge and his religiousconvictions which operates at all levels of his relationship with hispatients, represents a remarkable personal achievement. The attain­ment of such unity of vision in a profession the sheer technicalcomplexity of which would seem to obligate fragmentation and dis­junction in one's world view should give one pause. It is a chal­lenge to rethink the received notions of the relation (or supposedlack of it) between empirical knowledge and human values.Dr. Ulrich balances a profound respect for the enormous powerand success of modern medicine against an equally profoundawareness of its limitations in the face of existential verities. Thisadmirable' balance is mirrored by cultural disposition in his pa­tients, who in their attitude toward medicine display a sanity andsimple humanity which is rare indeed in a Western setting.Cure is the rule but given the circumstances of the bedouin de­scribed above, the occasional death of a patient is unavoidable. There is much sorrow on the part of the survivors, but the frustra­tion, incomprehension, and bitterness which too often characterizethe family's reactions in an American context are wholly absent.Dr. Ulrich describes the dominant emotion of most relatives asgratitude. The doctor is naturally expected to have done everythingpossible and the mortal outcome is attributed to the will of Allah,not the failure of medical technology or the incompetence of thephysician. This reaction is so marked under what seem to onebrought up in this society unlikely circumstances that Dr. Ulrichconfesses to an abiding astonishment. It is hard to conceive a moreradical contrast to the litigiousness which is unfortunately such acharacteristic feature of the contemporary American response to'medical failures.'Dr. Soltau explaining X-rays to a young patient.If the patients at Anoor repose in their physicians a sober trustand confidence, the respect is mutual. Dr. Ulrich makes everyeffort to give his patients a thorough understanding of their condi­tion. They are shown all their laboratory data and x-rays and theircases are carefully explained. Says Dr. Ulrich "I think it's onearea where the patient does a lot better when he is told as much aspossible about himself. They're perfectly familiar with lungs andheart from butchering sheep, and have no trouble understandingthat an amoebic absess in the liver has burst upward to hit the lungand filled it with pus. They can see on their own x-rays how thesethings improve with time-this breeds a great deal of confidence inwhat we are doing."Dr. Ulrich returned to the University for two weeks in June toparticipate in the Visiting Clinician Program. Although he alwaystakes CME courses when he visits the States (as required by hisMinnesota license), he found himself faced with the need of acquir­ing facility in certain necessary diagnostic techniques and clinicalprocedures which only intensive study on a one-to-one basis couldprovide. The Visiting Clinician Program proved ideal and whilehere he earned 80 credits. Of the program he says, "I have greatlyappreciated the golden opportunity to return to the University ofChicago as a Visiting Clinician. As far as I know there is no otherprogram that can at once meet the very particular needs of the mostskilled specialists and at the same time meet the very broad de­mands that are made upon a physician in rural mission work in theMiddle East. For those hundreds of men, women, and childrenwho will benefit from my stay here, I can only pass on theirwords, "Shukran juzilan wa-Allah yubarakikum" (Thank you verymuch and God bless you ali).IIREUNION ACTIVITIES MARK ALUMNI WEEKThis year the Medical Alumni Reunion events were timed" to coin­cide with those of the general University Alumni Reunion in mid­May. The Graduation dinner was held separately in JuneMedical Alumni Reunion activities began May 14 with a day­long Frontiers of Medicine program on Controversies in CoronaryHeart Disease held in conjunction with the Reunion. Experts whoparticipated in the program included Dr. Denton Cooley. MedicalAlumni Day proper, May 15, was ushered in with a Dean's Break­fast honoring Century Club Members. In the morning, the reci­pients of the Distinguished Service A wards presented a scientificprogram. This was followed by the Awards Luncheon and Recep­tion at the University's Center for Continuing Education.Dean Uretz opened the luncheon by welcoming the gatheredfaculty, alumni, and guests. Outgoing President of the AssociationFrank W. Fitch ('53) then introduced Hanna H. Gray, the Presidentof the University. Dr. Fitch initiated Mrs. Gray as an honorarymember of the Alumni Association and presented her with anAssociation T-Shirt to mark the auspicious occasion. In her'acceptance speech', Mrs. Gray said that she was duly grateful andcould conceive no higher honor. In a more serious vein, she re­minded the assembled of the role of the Medical Center in the Uni­versity as a whole. On this the fiftieth anniversary of the graduationof its first class from the Medical Center, Mrs. Gray took note ofthe inestimable contributions the Medical School has made to theintellectual standing of the University. The University's tradition ofacademic excellence is reflected, she observed, in the faculty offirst-rank physician-scientists and the generations of outstandingstudents they have trained.Or. and Mrs. Filos-Diez ('50) who journeyed from Panama to attend theReunion.12 Mrs. Gray's remarks were followed by presentation of the Dis­tinguished Service Awards and of the Association's Gold KeyAwards. Fifty-year citations were presented to the class of 1930.Ceremonies closed with the approval of the new slate of Associa­tion Officers for 1980-81.In the afternoon the Class of '55 presented a scientific program,Dr. Herbert Greenlee presiding. The program proved a resoundingsuccess. There could have been no finer testimony to the enduringacademic excellence of the graduates of the School of Medicine.A reception at the David and Alfred Smart Gallery rounded offthe day's events. Alumni, faculty, and guests were given a privateshowing of the new Joan Mira exhibition.Those alumni who stayed through the week had a chance to par­ticipate in Hospital Rounds on Friday morning. A special classchairmen's luncheon was held Friday afternoon. Dean of the Pritz­ker School of Medicine and the Division of the Biological SciencesRobert B. Uretz reviewed the plans for the new hospital andannounced the launching of a campaign in October to help financethe project. Dean of Students Joseph Ceithaml discussed the spiral­ling costs of medical education and the correspondingly increasingneed for assistance to students. Two class chairmen receivedawards: Henry De Leeuw ('47) for the highest participation of anyclass (68%), and Arnold Tanis (,51) for the greatest improvementin class participation (41% to 64%). Dr. De Leeuw received abound copy of Dr. Vermeulen's 50-year history of the medical cen­ter and Dr. Tanis received Dreams in Stone, the photographic re­cord of University architecture.The Class of '60 at the Chicago Yacht Club celebrating their 20th re­union.President Hanna Gray proudly displays the symbol of the high honorjust conferred upon her. The Class of '45 at the Hyde Park Hilton celebrating their 35th reunion.Guest of honor is Dr. Charles B. Huggins.Distinguished Service and Gold Key AwardsFive Distinguished Service Award recipients were presented withtheir awards at the luncheon ceremony at the Center for ContinuingEducation. Recipients and the topics of the talks they delivered atthe morning scientific session were:Robert M. Dowben(,49), The Organization of Contractile Pro­teins in Muscle. Dr. Dowben is Professor of Physiology andNeurology and Director of the Biophysics Graduate Program at TheUniversity of Texas Health Science Center, Dallas, Texas.Lawrence M. Lichtenstein (,60), Studies of IgE-mediated Phe­nomena. Dr. Lichtenstein is Professor of Medicine at The JohnsHopkins University School of Medicine, Baltimore, Maryland.Henry J. Mankin, Allograft Transplantation and the Treatmentof Malignant Bone Tumors. Dr. Mankin is the Edith M. AshleyProfessor of Orthopaedic Surgery at the Harvard Medical School,and Chief of the Orthopaedic Service at Massachusetts GeneralHospital, Boston, Massachusetts.Robert Y. Moore (,57, Ph.D. '62), Biological Rhythms and theDr. and Mrs. Ryan (,40), who travelled from their home in England toattend the Reunion, talk with Dr. Frank Fitch ('53), President of theMedical Alumni Association. Brain. Dr. Moore is Professor and Chairman of the Department ofNeurology at the School of Medicine, Health Sciences Center,State University of New York at Stony Brook, Long Island, NewYork.J. Edwin Seegmiller (,48), Genetic Defects in Purine Metabo­lism in Human Immunodeficiency Disease. Dr. Seegmiller is Pro­fessor of Medicine at the University of California, San Diego,School of Medicine.The two Gold Key Award recipients were also presented with theirawards at the luncheon ceremony. They were:Catherine L. Dobson ('30 Rush). Dr. Dobson is a gynecologistin private practice and is a member of the Clinical Associate Staffof Chicago Lying-in Hospital.Lloyd J. Roth ('52). Dr. Roth is Professor Emeritus, Depart­ment of Pharmacological and Physiological Sciences at the Uni­versity of Chicago.Dr. Alfred Heller ('60) presents the Gold Key Award to Dr. Lloyd Roth('52). Dr. Catherine Dobson ('30), the other recipient of the award, isseated next to him. 13The 50-year Class of '30 at the Awards Luncheon.Fifty- Year CitationsThirteen members of the Class of 1930 received fifty-year citationsat the Awards luncheon. They were:Marcus BlockCatherine L. DobsonR. Kennedy GilchristJohn G. HandPaul HarmonLlewelyn HowellGene Kistler Frederick KnierimArthur RappeportJack SloanEdward SteichenW. Mary StephensHoward B. Weaver1980-81 Alumni Association OfficersThe slate of officers submitted by the Nominating Committee wasapproved at the A wards Luncheon. The new officers for 1980-81are:President-Louis Cohen ('53), Professor, Department of Medi­cine, the University of Chicago.President Elect-Sumner C. Kraft ('55), Professor, Departmentof Medicine, the University of Chicago.Vice President-Robert L. Schmitz ('38), Chairman of Surgery,Mercy Hospital and Professor, Department of Surgery, AbrahamLincoln School of Medicine.Secretary-Randolph W. Seed ('60), Surgeon, Private Practice,staff member of Grant Hospital and Assistant Professor, Depart­ment of Surgery, Northwestern University Medical Center.Council Members 1980-83-Walter Fried ('58), Professor, De­partment of Medicine and Director, Division of Hematology/Oncol­ogy, Michael Reese Hospital; David G. Ostrow ('75), Coordina­tor, Biological Psychiatry Programs, Northwestern UniversityMedical Center and Research Associate, V.A. Lakeside MedicalCenter; Jerry G. Seidel ('54), Ophthalmologist, Private Practice,Staff Member, Lutheran General Hospital and ResurrectionHospital.14 Dean Robert 8. Uretz catches a few quiet moments at the Mifo exhibi­tion.Class ReunionsIn addition to the Fifty-Year Class of 1930, the Classes of 1935,1940, 1945, 1950, 1955, and 1960 celebrated reunions. Alumniattending the reunion dinners were:1935George V. LeRoy Vida WentaArthur Rosenblum George WilcoxonDavid Tschetter1940Harriet Gilette Albert RyanGerald Macarthy Frank Ziobrowski1945Ralph Carlson Eugene MindellEdwin Eby Raymond E. RobertsonHarry W. Fischer John RussellFrank W. Hesse Stewart TaylorCharles M. Johnson, Jr. Louis ThomasChauncey Maher Everett Van Reken1950Donald Benson Harry KrollJose Filos-Diaz Abbie LukensPaul Frederickson Donald A. RowleyFrances O. Kelsey Jay P. RuzikAttallah Kappas1955John Benfield Sharon MeadArnold Brenman William McCollFaylon M. Brunemeier Jack RobertsonClarence Cawvey Leonard SaganHerbert M. Greenlee Howard ShapiroDale S. Grimes Saul SiegelE. Jack Harris Betty lo T ricouLawrence Kartun Elliot WeitzmanRichard Katzman Kenneth WilcoxSumner C. Kraft F. Thomas WilsonWerner Kunz Richard Woellner1960Donald Comiter Donald MillerAlfred Heller Robert MoodyKenneth Hendricks Randolph SeedLawrence Lichtenstein John ZwaanstraDistinguished Service and Gold KeyAward PresentationsDistinguished Service Awards(Note: The presentation speech for Dr. Robert M. Dowben by Rad­van Zak was not available as we went to press)Dr. lawrence M. Lichtenstein ('60)Lawrence Mark Lichtenstein's professional career has been spent attwo institutions: the University of Chicago, 1951 to 1960, and JohnsHopkins from 1960 to the present. Here he received his B. S. withhonors, and M.D. with the Roch Award and AOA. He interned atHopkins; obtained his Ph.D. in immunology there; and he has pro­ceeded up the Hopkin's ladder to professor.Lawrence is one of less than a handful of immunologists whohave brought credibility to the modem study of clinical allergythrough fundamental research, in Lawrence's case primarilythrough a study of the mechanisms of mediation of inflammationtriggered by the IgE-antigen interaction.Several years ago while on study section, Lawrence was the onemember capable of critical criticism of grant applications for workin clinical allergy. In the course of his criticism it was frequentlynecessary to stop proceedings so that Lawrence could give us amini-lecture on the subject. As those of you who heard Lawrencetalk this morning know, his talks to us were clear and crisp, andbrought intelligence to this immensely important but much-neg­lected area of immunology.The study section lost Lawrence because a new section wasformed and NIH needed at least one immunologist of Larry's quali­ty and qualifications in the new section. I tell you this to confirmmy contention that there is only one Larry Lichtenstein in the coun­try.Lawrence, you bring great credit to the University. It gives memuch personal pleasure to be asked to give this presentation.Dr. Donald A. Rowley ('50) Dr. Jarvis E. Seegmiller ('48)It is my privilege to introduce you to Dr. Jarvis Edwin Seeg­miller-and, Jay, for me a distinct pleasure to welcome you backto your alma mater. Dr. Seegmiller is an honors graduate from theclass of '48.So great was his zest for biochemistry that he had time for onlyone year of housestaff training at Johns Hopkins before engaging inadvance training in enzymology in some of the best biochemicallaboratories in the country. From 1954 to 1969 we find him in va­rious capacities at the National Institute of Arthritis and MetabolicDiseases, from 1966 to 1969 as Chief of the Section of HumanBiochemical Genetics. In 1969 he became one of the foundationpillars of the new Department of Medicine at the University ofCalifornia at San Diego, where Jay continues to function as Profes­sor of Medicine, Director of the Division of Rheumatology andDirector of the Human Biochemical Genetics Program.Dr. Seegmiller's research contributions have focused on elucida­tion of genetic and biochemical abnormalities of hereditary dis­eases, in particular gout, studies which culminated in 1967 with thediscovery of the first known enzyme deficiency in primary gout.Currently he is pursuing basic studies linking immunodeficiencystates to certain enzyme deficiencies in purine metabolism, a sub­ject he addressed this morning. He was some 275 publications tohis credit. Jay has had important impact upon American medicine.Many of the leaders of the younger generation received their earlycareer development in Jay's laboratory; names like Goldfinger,Grayzel, Rodney Howell, Bill Kelley, Klinenberg, and Malawistacome to mind. Many honors have been bestowed on Dr. Seeg­miller; he is a member of the National Academy of Science and ofthe Institute of Medicine.Those of us who haven't accomplished as much as Jay may finda little consolation in knowing that Jay still needs two more yearsof housestaff training before he becomes eligible to take the boardsin Internal Medicine.Jay, in recognition of your great and innovative contributions inthe field of human genetic diseases, I present to you the Dis­tinguished Service A ward on behalf of the U of C Medical AlumniAssociation.Dr. Leif B. SorensenLeft to right, Dowben, Lichtenstein, Mankin, Moore, Seegmiller.15Dr. Henry J. MankinNo contemporary orthopedic surgeon has had a greater cumulativeimpact upon American orthopedics than Henry Mankin.He is a leader and a prime example of the shift from technical,empirical, muscular orthopedics to cerebral orthopedics. His con­tributions are significant in basic research, in clinical innovationand in education and evaluation.Dr. Mankin's extensive work in the physiology and biochemistryof cartilage place him among the world authorities on this subject.He has been a careful and thoughtful pioneer in developing limb­saving procedures using allograft transplantation for skeletaltumors. His work in developing, studying and refining theorthopedic resident in-training examination led to its being iden­tified as (or, occasionally cursed as) "Henry Mankin's Exam". Heheads one of the best graduate orthopedic training programs in theworld. He has served important leadership roles in many organiza­tions because he is recognized by his peers as someone who notonly gets things done, but makes things better.His habit for success could be seen early in his career as a navalofficer during the Korean conflict. There was not a single Chineseor North Korean ship or sailor which was allowed to threatenAmerican security in proximity to his duty station in the Nevadadesert.It is a pleasure to count Henry Mankin among those who haveexperienced the University of Chicago and to present him with thisDistinguished Service Award.Dr. Gerald S. LarosGold Key AwardsDr. Catherine l. Dobson ('32)Catherine Lindsay Dobson, M.D. was born in Chicago. She initial­ly thought of a career as a ballet dancer but eventually decided onmedicine. At the early age of 13 years she also developed a life­long affiliation with the violin.In 1926 she was a member of the first class to admit women atNorthwestern University Medical School. Finding the atmospherethere somewhat inhospitable to members of the fair sex, she trans­ferred to the then Rush Medical College-University of Chicago andgraduated in 1930.After completing her residency training at Cook County Hospitalshe entered the practice of Obstetrics and Gynecology. In 1944 shewas certified by the American Board of Obstetrics and Gynecologyand 34 years later in 1978 she successfully passed their re­certification examination. She has been an active contributor toAlumni affairs and served as President of the Alumni Associationin 1973.She joined the staff of Chicago Lying-In Hospital almost 40years ago and has been a continuously active member during all ofthat time. She has perpetuated her great interest in the ChicagoLying-in Hospital and in Obstetrics and Gynecology by setting up atrust with the University that will establish support for additionalyoung faculty interested in pursuing studies in infertility at our De­partment. A portion of this fund has been created by the sale of herfamous and valued Stradivarius violin. She is an energetic, multi­talented and charming woman who certainly is "The Lady ofLying-In" .Dr. Arthur L. Herbst16 Dr. Robert Y. MooreIt is my pleasure to present the Distinguished Service Award of theMedical Alumni Association to Dr. Robert Y. Moore, Professorand Chairman of the Department of Neurology at the State Uni­versity of New York at Stonybrook.Bob Moore was a pioneer in being among the first to recognizethe necessity for defining the anatomic basis for brain transmitterneurochemistry. His initial work in this field became the model fora vast array of studies which have now made it possible to specifythe neurochemical characteristics of many functional systems ofbrain. His research accomplishments on the neuroanatomy, de­velopment and plasticity of specific central transmitter pathwaysand their relation to neuroendocrine function have added immeasur­ably to our understanding of the central nervous system.I had the pleasure of working with Bob for more than a fewyears. It was an extremely important part of my own and I believeof Bob's research career. Since then I have followed his move­ments as well as his research with great interest. He has beenbounding from coast to coast, first to a professorship at the Uni­versity of California in San Diego, and then to Stonybrook in NewYork. He can wander all he wants, but his intellectual home willalways be in Chicago. It is a great personal pleasure for me to havehim visiting again and to present him with this DistinguishedService Award.Dr. Alfred Heller ('60)Dr. Lloyd J. Roth (,52)Lloyd Roth joined the University of Chicago faculty in 1952 afteralready having established an enviable research record in chemistry.He served here as Chairman of the Department of Pharmacologyfrom 1957 to 1972.His impact on this University has been long and enduring. Hisresearch on the use of isotopes in drug localization and the de­velopment of autoradiographic techniques for water-soluble sub­stances remain a model of the application of chemical techniques tomajor biological problems.In addition he championed a series of intellectual endeavors infields which have become well established and important aspects ofthe life of this University. These include Clinical Pharmacology forwhich he argued and worked for some 20 years, as well as the useof stable isotopes for which a laboratory was dedicated in his hon­or. It was Lloyd Roth who really began the first serious efforts inbiological sciences at this University to develop a major program inneurobiology.I did my Doctoral research under Lloyd Roth and spent the ma­jor parts of my early career here working with him. I don't reallythink of Lloyd as having retired, but as being on a short holiday inDenver. I expect every morning to walk in and see him again atwork at a new refinement in autoradiographic technique. It is a ple­asure to have him back and to award him the Gold Key of theMedical Alumni Association for his long and dedicated service tothe Division and the University.Dr. Alfred Heller ('60)The Medical AlumniAssociation isn't asking you togive us the shirt off your back ...MEDICAL ALUMNI ASSOC.We're asking you to put our shirt on your back!Medical Alumni Association T-Shirts are available at $5.00 each, plus $1.00 postage andhandling. Sizes are Small, Medium, Large and Extra-Large. Children's shirts are availablealso in Small (6-8) and Large (10-12). Shirts are maroon with white lettering, of cotton­polyester blend.SizeSmallMed.LargeExtra-LChild (S)Child (L)Amt. Enc. Quantity Ship to:Name: _Address: _$,----Make check payable to The University of ChicagoSend form to:T-ShirtMedical Alumni AssociationCulver Hall Room 4001025 E. 57th St.Chicago, IL 6063717GRADUATIONDINNERAND RECEPTIONGraduating seniors, families, guests, and faculty attended the recep­tion and dinner honoring the Class of 1980 at the Drake Hotel June 12.Students, housestaff, and faculty were presented with awards atthe evening ceremony. Dr. Douglas N. Buchanan, Professor Emer­itus in the Departments of Pediatrics and Neurology, administeredthe Hippocratic Oath to the graduating class in the most solemnmoment of the evening. The festivities closed with musical selec­tions from the Senior Skit.Awards to StudentsSeniors in the Pritzker School of Medicine elected to beta of Illi­nois Chapter of Alpha Omega Alpha for excellence in the work ofthe School:Kathleen Blakejames Link Breeling, IIITimothy George Buchmanjohn Chris Dion Cheronisjeffrey Alan Cohenjames Peoples DrennanEdward john DropchoLowell GarnerBruce Daggett GivenEddie Hong-Lung HuSeniors in the Pritzker School of Medicine graduating "WithCarolyn jean KellyPatrick Michael KochanekThomas j. Leipzigjames C. MillerFrances Clifford MunkenbeckNathan Edward Nachlas, Jr.Richard john NovakCraig Michael Schrammjohn YanosHonors":Shelly C. BernsteinTimothy George Buchmanjohn Chris Dion CheronisEdward John DropchoBruce Daggett GivenDouglass Bruce GivenMichael james KarbowskiNathan Edward Nachlas, jr.Thomas QuertermousCarl joseph VybornyThe Joseph A. Capps Award, to a Senior Medical student for pro­ficiency in clinical medicine, is made toCarolyn Jean KellyThe Franklin McLean Medical Student Research Award, to a Sen­ior who has performed the most meritorious research is awarded toBruce Daggett GivenThe Medical Alumni Prize, to a Senior for the best oral presenta­tion of research done during medical school, is awarded toShelly C. BernsteinThe Catherine Dobson Prize, to a Senior for the best oral presenta­tion of research done by a non-Ph.D. student, is awarded toLorraine Anne FitzpatrickThe John Van Prohaska Award, for outstanding potential inteaching, research and clinical medicine, is made toTimothy George Buchman18 The Mary Roberts Scott Memorial Prize, to a woman medical stu­dent for academic excellence, is awarded toKathleen BlakeThe Nels M. Strandjord Memorial Award, to a Senior Medical stu­dent for outstanding performance in the general field of Radiology,is awarded toCarl joseph VybornyThe Upjohn Award in Medicine, to a Senior for outstandingachievement during four years in medical school, is made toDorothy joan BalcombeThe Dr. Harold Lamport Biomedical Research Award, for the bestThesis in Biomedical Research, is awarded toTimothy George BuchmanThe Richard W. Reilly Award, to a Senior medical student for out­standing aptitude in the field of Gastroenterology, is awarded toTimothy Richard KochThe Sandoz Pharmaceutical Award, in recognition of outstandingperformance in the field of Psychiatry, is awarded toRichard Bruce LiptonThe American Medical Women's Association Awards, to womenmedical srudents for scholastic achievement, are awarded toDorothy joan BalcombeKathleen BlakeCynthia Lorraine Boddie-WillisCarolyn jean KellyFrances Clifford MunkenbeckMadonna Lynn Rybolt TalbertThe Henry J. Kaiser/NMF Merit Graduation Award, to a graduat­ing minority medical student who has demonstrated academicexcellence, integrity, leadership involvement and potential forcontributions to the field of medicine and the community, isawarded toCynthia Lorraine Boddie-WillisAwards to FacultyThe McClintock Award, for outstanding teaching voted by thesenior class, was given for the second time in three years to Dr.Margaret C. Telfer, Assistant Professor, Department of Medicineat Michael Reese Hospital. Dr. Telfer, a hematologist, teaches thejunior c1erkships in medicine for University of Chicago students.She is a graduate of Washington University in St. Louis and coI1l­pleted her residency at Michael Reese.The Hilger Perry Jenkins Award, for excellence in the performanceof academic and patient-oriented service by a member of the house­staff, voted by the senior class, was given to Dr. Theresa Sha­piro, a second year Resident in the Department of Medicine. Dr.Shapiro is a graduate of Johns Hopkins University School ofMedicine.Or. Catherine Dobson and Lorraine Ann Fitzpatrick, recipient of Recipients of named prizes.the Catherine Dobson Prize.Musical number from the 1980 Senior Skit, performed at the close ofthe Graduation Dinner.Dean joseph Ceithaml presents the Medical Alumni Prize to Shelly C.Bernstein. Mrs. Harold Lamport and Timothy C. Buchman, recipient of the Or.Harold Lamport Biomedical Research Award.191980 Residency AssignmentsOf the 109 students in the senior medical class, 108 participated inthe 1980 National Residency Matching Program (NMRP). The oneexception participated in a separate Ophthalmology Matching Pro­gram which occured in the fall of 1979 and he was selected for theOphthalmology Program at the University of Chicago. Of the 108students who did participate in the NRMP, one secured hisresidency appointment prior to the actual matching procedure underspecial arrangements for married couples.49 of our students will be entering post graduate year I (PGY -I)positions in Internal Medicine and 20 more in Surgery (includingOrthopedic Surgery). Often 5 and sometimes as many as 10 ormore of our students applied for the same residency at the samehospital in these disciplines. Since the Directors of Residency Pro­grams are understandably inclined to take only I or 2 students fromanyone medical school other than the one affiliated with that par­ticular hospital, it might be expected that relatively few of our stu­dents would receive their first or second choices under those cir­cumstances. Nevertheless of our 108 students in the NRMP, 50(46%) received their first choice and an additional 21 (19%) re­ceived their second choice. These figures are even more impressivewhen one recognizes that 99 of our students (92%) secured PGY-Ipositions in residency programs which fill their quotas in theNRMP. Similarly, of the 79 different hospital units where our stu­dents will begin their residency programs this coming July, 70 ofthese residency programs (89%) filled all of their allocated posi­tions in the NRMP.U. of Chicago Hosp. (21)U. of Arkansas Hosp.Barnes Hosp. Group (2)Baylor Col. Affil.P.B. Brigham Hosp. (2)Bronx. Mun. Hosp. CenterButterworth Hosp.Univ. of Cal. Hosp., L.A.Univ. of Cal. Affil., San Diego (3)Univ. of Cal. Hosp., San FranciscoChildren's Center - BostonUniv. of Colorado Affil. Hosp. (3)Duke Univ. Medical CenterGrady Mem. Hosp. - Emory Univ.Univ. of Illinois Hosp. (4)Univ. of Iowa Hosp. (5)Jewish Hosp. - Mo.Johns Hopkins Univ. Hosp.L.A. County - USC Center (2)Loyola Univ, Affil. - ChicagoMaine Medical CenterMass. General Hosp.Mayo Grad. School Med. Center (3)McGaw Med. Center - N.U. (4)Univ. of Michigan Affil. Hosp. (4)Montefiore Hosp. - N.Y.20 HospitalsMt. Sinai Hosp. - N.Y.Univ. of New Mexico Affil. Hosp.The New York Hosp.N.Y.U. Medical Center (3)Ohio State Univ. Hosp.Hosp. of Univ. of Penn. (2)Univ. of Pittsburgh Health Center (3)Presbyterian Hosp. - N.Y.Presbyterian-St. Lukes Hosp. (2)Michael Reese Hosp. (6)Univ. of Rochester Assoc. Hosp.St. Louis Childrens Hosp.Wm. Shands Hosp. - Fla.Univ. of South Carolina Med. CenterS.W. Michigan Area Health Ed.Stanford Univ. Hosp. (2)Strong Mem. Hosp.Temple Univ. Hosp.Univ. of Texas Affil. Hosp. - HoustonUniv. of Texas S.W. Affil. Hosp. - DallasUniv. of Utah Affil. Hosp. (2)Univ. of Virginia Med. CenterWadsworth V.A. Hospital, L.A.Univ. of Washington Affil. Hosp.Univ. of Wisconsin Hosp. MadisonYale New Haven Med. Center (2) The 109 students who will begin their residencies in 1980-81 aredistributed among the various disciplines as indicated in the table.The largest number, 49, will be in Internal Medicine. Another 17will be in Surgery; in addition 3 more will be in OrthopedicSurgery. Nine will be in Obstetrics and Gynecology; 8 in Pediatricsand 6 in Psychiatry.It is evident that members of the senior medical class will beserving at excellent teaching hospitals throughout the country. It isnoteworthy that the 3 students who participated in the NRMP andwere unmatched were quickly placed into very good teaching hos­pitals.In my opinion the 1980 graduating class did extremely well inthe residency match and certainly as well as any graduating class inthe last 10 years. This success, I believe, is directly related to theexcellent cooperative efforts of our students and faculty members.The members of the Committee on Residency Placement of SeniorMedical Students and its chairman, Dr. Alfred Baker, deserve ourgratitude and commendation for the time and effort which they ex­pended. In addition, the various departmental sub-committees, andparticularly the one in Medicine, since 49 students sought residen­cies in Internal Medicine, likewise should be cited for their parts incounselling students on their choice of hospitals. The results of the1980 residency appointments secured by our students reflect theefforts of all those involved.Joseph CeithamlTABLEDistribution of Residency Assignmentsby Clinical DisciplineAnesthesiologyFamily PracticeFlexibleInternal MedicineNeurologyObstetrics & GynecologyOphthalmologyPathologyPediatricsPsychiatryRadiology - DiagnosticSurgeryOrthopedic Surgery 4I349195862173109TotalStudentJon Steven ArnoldMark R. AschlimanJeffrey M. BaermanJoan D. BalcombeGene J. BartucciJames L. BenthuysenShelly Bernstei nKathleen BlakeCynthia L. Boddie - WillisBreck G. BorcherdingJames L. BreelingJerry H. BromanTimothy G. BuchmanCandida J. BushShih-Wen ChangJohn D. CheronisRosa ChoyJeffrey A. CohenRand T. CollinsAntonio J. ConvitDennis H. CotcampRichard J. CoteLawrence E. CutlerWilliam C. DannenmaierRobert S. DanzigerAndrew M. DavisRamon A. DiazJames DrennanDavid J. DriesEdward J. DropchoWilliam A. EbingerBrad L. EpsteinLorraine A. FitzpatrickJames J. FoodyPaul A. FreierMitchell E. GallagherLowell GarnerBruce D. GivenDouglass B. GivenMark H. GonzalezJames B. GrotbergLee W. HammerlingRichard C. HendersonDon M. HenryStephanie C. HoltEddie H. HuMartin L. JacobRenee H. JacobsDavid KaplanMichael J. KarbowskiCarolyn J. KellyGary W. KerberLawrence L. KernsTodd S. KirkTimothy R. Koch HospitalJewish Hosp. - Mo.Strong Memorial Hosp. - N.Y.Barnes Hospital GroupUniv. of Utah Affil. Hosps.U. of Chicago Hosp.McGaw Med. Center - N.W. Univ.Childrens Ctr., BostonStanford University Hosps.Presbyterian - 51. LukesU. Rochester Assoc. Hosp. Progs.Peter Bent Brigham Hosp.University Hosps., MadisonJohns Hopkins HospitalU. New Mexico Allil. Hosps.U. of Chicago Hosps.Univ. Colorado Allil. Hosp.L.A. County, USC Med. Or.Hosp. of Univ. of Penn.Loyola Univ. Allil. - III.NYU - University Med. Or.S.W. Mich. Area Health Ed.Univ. Michigan Affil. Hosps.The New York HospitalUniversity Hosp. - Ark.Mayo Grad. School Med.U. of Iowa Hosps. - Iowa CityUniv. of Cal. Hosp., L.A.U. of Iowa Hosps. - Iowa CityDuke Univ. Med. Or.U. of Chicago Hosps.Univ. of Mich. Allil.Presbyterian-51. LukesPresbyterian Hosp. - N.Y.U. of Chicago Hosps.Grady Memorial - GeorgiaU. of Iowa Hosps. - Iowa CityUniv. Virginia Med. Or.Peter Bent Brigham Hosp.Massachusetts Gen. Hosp.U. of Illinois Allil.McGaw Med. Or. - N.W. Univ.Wm. Shands Hosp. - Fla.U. of Iowa Hosps. - Iowa CityU. Texas Allil. Hosps.U. of Chicago Hosps.U. Calif., San Diego Affil.Micael Reese Hosp. - III.U. of Chicago Hosps.Barnes Hospital GroupUniv. Washington Affil.Hosp. of U. of Penn.U. of Chicago Hosps.U. of Chicago Hosps.Michael Reese Hosp. - III.Mayo Grad. School Med. StudentPatrick M. KochanekJoseph LadowskiSi-Hoi LamMichael LaucellaStephen E. LeeThomas J. LeipzigRichard B. LiptonMark R. LitzowJames B. LohrThomas W. LukensMitchell S. MarionJames C. MillerFrances C. MunkenbeckNathan E. NachlasRichard J. NovakDavid J. PalmerJay M. PenslerJoseph A. PiszczorEric K. PoonHarry P. PoulosWilliam C. PughThomas QuertermousWilliam F. ReusGreg H. RibakoveRicardo J. RomanJames D. RossenRandall R. RowlettJack D. RushMark L. SanzMark H. SawyerDavid J. SchifelingRobert K. SchmidtCraig M. SchrammThomas W. SeidelNeil R. SelingerJames B. SparingLarry S. StoneRobert J. StrattaMichael J. SueJames E. SvensonMadonna TalbertSeth R. TanenbaumClaire V. ThomasKenneth J. TumanLawrence C. UhtegElizabeth A. UngerCarl J. VybornyArthur WeissJohn B. WhitakerDavid H. WhitneyHarold C. YangJohn YanosGail S. YanowitchJerrold R. Zeitels HospitalU. Calif., San Diego Allil.Hosps. Univ. Health Or. - PittsburghMontefiore Hosp. Or. - N.Y.Michael Reese Hosp. - III.Hosps. Univ. Health Or. - PittsburghU. of Chicago Hosps.McGaw Med. Or. - N.W. Univ.Mayo Grad. School Med.Hosps. Univ. Health Or. - PittsburghTemple University Hosps.Butterworth Hosp. - Mich.U. of Chicago Hosps.U. of Chicago Hosps.Yale - New Haven Med. Or.Stanford Univ. Hosps.Michael Reese Hosp. - III.NYU - University Med. Or.McGaw Med. Or. - N.W. Univ.U. of Chicago Hosps.Univ. of III. Allil. Hosps.U. of Chicago Hosps.U. of Chicago Hosps.U. of Chicago Hosps.NYU - University Med. Or.U. Texas SW Allil. DallasU. of Chicago Hosps.U. of Chicago Hosps.U. of Iowa Hosps. - Iowa CityUniv. Colorado Allil. Hosp.U. Calif., San Diego Allil.Med. Or. Hosps., S. CarolinaL.A. County - USC Or.Univ. Colorado Allil. Hosp.Univ. Michigan Allil.Michael Reese Hosp. - III.Yale - New Haven Med. Or.U. of Chicago Hosps.Univ. Utah Affil. Hosps.Vet Admin - Wadsworth - L.A.Maine Medical Or.Ohio State Univ. Hosps.Baylor Col. Affil. Med. Or.Univ. of III. Affil. Hosps.Univ. of III. Affil. Hosps.Bronx Municipal Hosp. Or.U. of Chicago Hosps.U. of Chicago Hosps.Univ. California Hosps., S.F.SI. Louis Childrens Hosp.Michael Reese Hosp. - III.U. of Chicago Hosps.U. of Chicago Hosps.Mount Sinai Hosp. - NYUniv. Michigan Affil.21Medical Alumni Association-A Brief HistoryAlthough early records are meagre, available information indi­cates that the Medical Alumni Association came into existence in1934 as the result of efforts of the "Class of 1934". The history ofthe University of Chicago School of Medicine has been reviewed insome detail elsewhere. However, a bit of background informationmay help explain the basis for some of the traditions of the AlumniAssociation.Biological Sciences have been represented on the campus sincethe founding of the University. Initially, the science departments ofthe University were organized as the Ogden Graduate School ofScience. (This administrative arrangement continued until 1930when the Division of Biological Sciences came into existencethrough the general reorganization of the University). A medicalpresence at the University began when an affiliation was effected in1898 between the prestigious Rush Medical College' and the Uni­versity after several years of negotiation. Beginning in 1900, Rushstudents received two years of pre-clinical instruction in basic sci­ences on the University campus and two years of clinical trainingat the facilities of Rush Medical College. A certificate was issuedafter the completion of this four year program, but the degree ofDoctor of Medicine was not conferred by Rush Medical Collegeuntil after completion of one year of internship. Discussion regard­ing optimal organization of medical education continued over theyears, and in 1916 the Board of Trustees approved a plan thatwould establish two medical schools: one, on campus and theother, a post-graduate school at Rush. However, World War I andescalating costs of the post-war period delayed final acceptance ofthe plan until 1924. The affiliation with Rush Medical College wasre-negotiated at this time, and the University took over the work ofRush as the Graduate School of Medicine of the Ogden GraduateSchool of Science. With the opening of the clinical facilities on theUniversity campus in 1927, students could choose to undertaketheir clinical study either on the Quadrangles or at Rush MedicalCollege.Apparently, flexibility has been a characteristic of medicaleducation on the University campus from the beginning. For stu­dents graduating from the University, the policy of awarding acertificate after completion of four years of medical school wascontinued. However, the M.D. degree was awarded only after ayear of internship or at least three quarters of advanced study insome of the departments associated in medical work. The first22 Dr. Frank W. Fitch ('53)(Although I have been a member of the Association for more thanhalf of its existence, when I assumed the office of President lastJune. I was a bit uncertain about the objectives of the Associationand my role in it. I realized that I did not know the background formany of its "traditions". I decided to review the history of theAssociation in order to understand how the Association hadevolved. Some of the things I uncovered in this search seemed tome to be of general interest, so I am sharing them with you in thisarticle.)M.D. degree awarded by the University of Chicago was earned byWilliam Westbrook Redfern in the summer quarter of 1930. Stu­dents made use of various options and some undertook an extendedperiod of study before receiving the medical degree. Almost equalnumbers of students graduated at each of the quarterly convocationsduring these early years. The varying period of training betweencompletion of the four years of medical school and the awarding ofthe M.D. degree led to considerable confusion regarding theassignment of a "class year" for any given student. Not until1937, when the requirement for a "5th year" was dropped, didmedical school classes become reasonably cohesive and a majorityof students graduate during a single quarter. The question of classyear for early gradutes was resolved (although not necessarily toeveryone's satisfaction) in 1960 when the Alumni Association pre­pared class lists and made them available to alumni. A decisionwas made rather arbitrarily to identify graduates from 1918 to 1936by the year in which they were awarded the four-year certificatesince sometimes up to five years elapsed before the internship wascompleted and the M.D. degree was awarded.The graduating class of 1933-34 was the fifth to receive themedical degree from the University and the first sizeable class.This vigorous group of students developed plans for the MedicalAlumni Association, and the first meeting was held in 1 une, 1934.The aims of the Association were to advance scientific and culturalrelations among its members, to provide a forum for scientific dis­cussion, and to promote advancement of medical education. Dr.Normand Hoerr ('31) was selected to be the first president of theAlumni Association. The key, originally designed by the father ofDr. Hilger Perry lenkins for presentation to members of the resi­dent staff, was altered somewhat and adopted as the Official Keyof the Association. The tradition of awarding the Gold Key to out­standing faculty members began at the first meeting of the Associa­tion with the presentation of one to Dr. Dallas B. Phemister.Although this tradition has been modified somewhat in later years,the Gold Key is still awarded to an outstanding faculty memberwho has recently retired. At the early Annual reunions, a full daywas devoted to a scientific session at which papers were presentedby alumni and members of the faculty. The day was culminated bythe annual banquet bringing together alumni, faculty, and the grad­uating class. Most of the activities of the Alumni Association weresuspended during the years of World War II.The Alumni Association was reactivated and reorganized in1944. Dr. Hilger Perry Jenkins (R'26), Associate' Professor ofSurgery, and Dr. Huberta Livingstone, Assistant Professor in Anes­thesia, played important roles in developing interest among thegraduating class, the alumni, and the faculty. That year, the grad­uating class decided to publish a Year Book financed by individualcontributions and by advertizing. The student editors, Andrew Can­zonetti and J. Alfred Rider, set out to make the book as representa­tive as possible of the University of Chicago Medical School. Adirectory of alumni was included in addition to information aboutstudents and student activities. The only Alumni Directory pub­lished was in 1957.Several other traditions were resumed in 1944. The annualAlumni Gathering was held again and consisted of an evening sci­entific program followed by a reception. In addition to the annualreunion, reunions were held in conjunction with annual AMA con­ventions; 219 alumni and guests attended such a banquet in 1948 inChicago. Receptions are still held in conjunction with meetings ofseveral medical organizations throughout the country each year.The banquet for graduating seniors became at this time a joint re­sponsibility of the Medical School and the Alumni Association. Dr.John van Prohaska ('34), who had served as president of the Asso­ciation during the war years of 1941-44, supervised the develop­ment of a new constitution and by-laws and was instrumental inbringing about the reorganization of the Association. Active mem­bership was made available not only to graduates of the school ofmedicine but also to the faculty and resident staff members. Annualdues of $1.00 were charged, but life memberships were availablefor $20.00. The Bulletin was developed by the Association to fur­nish a channel of communication between the University and itsmedical alumni. The first issue of the Bulletin was published inDecember, 1944; 1,900 copies were distributed at a total cost of$278. By September, 1945, there were 616 living graduates of theMedical School. In 1968 the Bulletin was renamed Medicine on theMidway, and today 12,000 copies are distributed to alumni, housestaff, students, parents, faculty and friends of the Medical Center.Most of the affairs of the Association were entrusted to the Ex­ecutive Committee of the Council. This group usually met threetimes a year and consisted of elected officers, appointed members,editor of the Bulletin, and chairmen of the membership, internship,and program committees. The Senate consisting of delegates fromthe graduating classes, the resident staff, the faculty, and the stu­dent body in addition to the Executive Committee, met about twicea year. Membership in the Association grew over the next severalyears to reach 700 dues paying members by 1947. The studentYear Book was published annually through 1948, but rising costsled to its demise. The tradition of including pictures of the graduat­ing class in the Bulletin along with a list of their residencies beganin 1948. This tradition ended in 1968. The graduates' pictures arenow included in the program book distributed at the dinner givenby the Medical Alumni Association.The first Senior Scientific Session was organized by Dr. LeonJacobson and held on March 20, 1947 under the sponsorship of theAlumni Association. Enthusiastic response to the twelve papers ledto the decision to sponsor this program annually, if possible at thetime of the annual meeting and reunion of the Association. TheMedical Alumni Prize, given for the best oral presentation of a stu­dent's research at the Senior Scientific Session, was first awardedin 1960. In 1974 an additional prize was established by Dr. Cather­ine L. Dobson (R' 30) to recognize the best presentation by a non­Ph.D. graduate. The Distinguished Service Awards of the Medical Alumni Asso­ciation were awarded first on October 3, 1952 at the banquet on theoccasion of the 25th anniversary of the University of ChicagoClinics. Twenty-eight awards were presented at that time. Duringthe next two decades, Distinquished Service Awards and the GoldKey of the Alumni Association were presented at the annual ban­quet for graduating senior students.The Rush Medical College also had an alumni association forgraduates who received their medical degree from that institution.News of the activities of the Rush Medical College Alumni Asso­ciation began to appear in the Bulletin in 1952, and news itemsabout individual alumni were added in 1953. The tradition of invit­ing the 50th Anniversary Class of Rush Medical College to theannual meeting began in 1953 when the class of 1903 attended thereunion banquet held for the graduating seniors. Rush Alumni alsobegan to receive the bulletin of the Alumni Association at this timeand the constitution and by-laws of the Association were revised toinclude graduation from Rush Medical College as a qualificationfor membership in the Association.A significant change in the structure of the Association wasmade in 1954 when the Association gave up its independent status.This change was made for several reasons including changes in theinternal revenue code. A tax exempt status for contributions wasbeing assured by having the accounts of the Association adminis­tered by the University as the Medical Alumni Education Fund andthe Medical Alumni Loan Fund. The Alumni Loan Fund was estab­lished when the Association turned over half of the accumulatedlife membership fund to the .Dean of Students to be used for stu­dent support at his discretion. More than half of the $40,000 avail­able at that time in student loan funds could be attributed directlyto efforts of members of the Medical Alumni Association. The re­quirement for annual dues was abolished in 1959. A decision wasmade at that time to appeal to alumni for contributions to the Universityin a single appeal from both the medical and university associations.The wine and cheese party has been sponsored for the first yearclass by the Alumni Association since 1970, This event, tradi­tionally held after the mid-term examination in Gross Anatomy,provides an opportunity for first year medical students to meet in­formally with faculty responsible for courses of the' first two yearsof medical school and with members of the Council of the MedicalAlumni Association, Mr. A, N. Pritzker usually has attended theseenjoyable receptions, and students have taken great pleasure inmeeting and chatting with this remarkable gentleman.The idea of an Annual Alumni Day was revived in 1973. A sci­entific program was presented in the morning by the recipients ofthe Distinguished Service Awards. The actual Awards were pre­sented at a luncheon at which certificates were also given to themembers of the 50th year reunion class. Departmental open housesand tours of campus were arranged in the afternoon, and the annualdinner for graduating students was held in the evening. This yearmarks the return of Alumni Reunion activities to a time not associ­ated with medical school graduation. This seems appropriate sincethe interests of the past and present graduates are not always thesame. The number of alumni now is sufficient to sustain a programdirectly related to their needs and interests.Over the years, the Medical Alumni Association has fared some­times well and sometimes not so well. One thing has remainedconstant, however. From the beginning, the Medical School hasbeen blessed with an outstanding group of students who have be­come outstanding alumni. It is our graduates who give us honor.The Medical Alumni Association really exists to recognize that fact.23University Alumni AwardsFour medical alumni received awards fromthe University Alumni Association at theReunion Luncheon and Awards AssemblyMay 17.The Public ServiceCitationsThe Alumni Citations for Public Servicehonor those who have fulfilled the obliga­tions of their education through creativecitizenship and exemplary leadership involuntary service which has benefited soci­ety and reflected credit upon the Universi­ty.Kate Hirschberg Kohn, M.D.'35, formore than 40 years has dedicated herself tomedical care of the disabled, both profes­sionally as a physician and voluntarily as acivic leader. For many years a member ofthe medical staff at Michael Reese Hospit­ai, and now Chairman of the Departmentof Rehabilitation Medicine and the firstwoman chairman of a clinical departmentof its Medical Center, she has collaboratedthroughout her career with the ChicagoHeart Association, working with childrendisabled by heart disease as a volunteercardiologist for the Spaulding and Christ­opher Schools. Her work in cardiovascularmedicine led to her involvement in rehabil­itation medicine. Funded by a grant fromthe Chicago Heart Association, she con­ducted a study of the hearts of patientswho had lost limbs due to vascular diseaseand were receiving training with articiallimbs-this study was one of the first prog­rams to use portable chest electrocardio­graphs for amputee victims. Continuing herrehabilitation efforts at institutions for theaged, Dr. Kohn has been consultant inphysical medicine and rehabilitation at theDrexel Home since 1966. Although herwork in recent years has centered on re­habilitation medicine techniques, her in­terest in other help for victims of cardiacdisease has never flagged. In 1979 the Chi­cago Heart Association awarded her theHeart of the Year Award for her incrediblededication and her pioneering efforts tobring under control rheumatic fever and togive stroke patients comprehensive rehabi­litation treatment. She was instrumental inthe development of a therapeutic recreationprogram offered by the Multiple SclerosisSociety of Chicago. In 1977, the YMCA24 acknowledged the city's debt to her withan Achievement Award, which commendedher inspiration to others physically able tohelp those ravaged by disease. Now Clinic­al Professor at the University of Illinois,Dr. Kohn has provided exemplary lead­ership and humanitarian service in themedical field of rehabilitation of the dis­abled.Arnold L. Tanis, Ph.B. '47, S.B. '48,M. D. ' 51, combines professional excellenceas a pediatrician with a highly compassion­ate attitude toward people-qualities thathave resulted in twenty-three years of ser­vice to his fellow citizens of Hollywood,Florida. As a staff member of MemorialHospital and a founder of a private medicalgroup, he has consistently put the interestsof children first. His vision, initiative, andconcern for the well-being of infants led tothe opening in 1979 of a neonatal unit forhigh-risk babies at Memorial Hospital. Theunit utilizes sophisticated techniques andequipment usually available only in majorcities and medical centers, and has savedthe lives of infants born prematurely orwith surgical and functional anomalies. Dr.Tanis is a vocal and effective proponent ofbreastfeeding and has been strongly sup­portive of the local chapters of the LaLeche League International, which provideinformation and support to prospective andnursing mothers. He has given additionaltime to the organization as a keynotespeaker at its international conventions. Anactive member and officer of the FloridaPediatric Society, the Broward CountyPediatric Society, and the AmericanAcademy of Pediatrics, he was volunteerstate chairman last year of the Academy's"Speak Up for Children" campaign duringthe International Year of the Child. Hisefforts in organizing public forums, schoolposter contests, and television, radio, andnewspaper exposure for the campaigncaused an awareness in Florida of the needto guard the state's children from harmthrough accident prevention, includingsafety belt laws, health education, im­munization and nutrition education. For hiscommunity, and in fact, the entire state,Arnold L. Tanis has been a valuablemedical resource and a model of the physi­cian as humanist, and has served as an ex­ample to the young physicians in the com­munity. The ProfessionalAchievementAwardsThe Professional Achievement Awards rec­ognize those alumni whose attainments intheir vocational fields have brought distinc­tion to themselves. credit to the University.and real benefit to their fellow citizens.Henry S. Kaplan, B.S. '38, M.D. '40,D.Sc. (Hon.)'69, is one of the world'sleading radiotherapists. The Committee onHonorary Degrees of the University of Chi­cago recognized the extraordinary qualityof his contributions in the realm of purescience in 1969. His work has continued tohave a profound influence on conqueringdisease. The first small linear acceleratorthat provided a break-through for megavol­tage therapy for cancer patients was de­veloped by Dr. Kaplan. Until the accelera­tor was in operation, most cancerradiotherapy used low-energy X-raymachines (which were effective for super­ficial tumors, but could not deliver ade­quate doses to deep-seated cancers). Withthe continuing growth of skilled treatmentusing the techniques developed by Dr.Kaplan, cure rates for many types of can­cer have increased significantly. Hodgkin'sdisease, a cancer of the lymph glands, isnow one of the most curable of all cancers.Although no one person can ever be whol­ly responsible for such a prognosis, Dr.Kaplan is the dominant figure in makingthat fact possible. He received the Atomsfor Peace Award in 1969, the only physi­cian to be so honored. He was one of thefirst three researchers to receive the Gener­al Motors Cancer Research Prizes in 1979.In 1978, the first Medal of Honor of theDanish Cancer Society was awarded tohim. The honors he has accrued in recogni­tion of his work number in the dozens.Among his research findings of great im­portance to medicine was his isolation of avirus that caused leukemia in mice, a land­mark step in working toward a betterunderstanding of the disease. Dr. Kaplanserved from 1948 to 1972 as Professor andChairman of the Department of Radiology,and is currently Maureen Lyles d' Ambro­gio Professor of Radiology and Director ofthe Cancer Biology Laboratory at the Stan­ford University School of Medicine. Hecontinues to train other radiotherapists tocarry out clinical and laboratory programsaround the world.Paul Roberts Cannon, Ph,D,'21,M.D. '25, retired in 1957 as Professor andChairman of the Department of Pathologyof the University of Chicago MedicalSchool, after 17 years in that office. In1954, he was appointed Editor of the Ar­chives of Pathology of the American Medic­al Association, As a medical researcher, heis best known for his distinguished studieson the relationship of nutrition to immunol­ogy and pathology. He gave his countrythe benefit of his skills during wartime as amember of the Committee on Pathology ofthe Division of Medical Sciences of theNational Research Council. After the war,he continued to benefit his country through active participation on other Federal agen­cies-particularly for the Public HealthService, the National Academy of Scien­ces, the National Institutes of Health, theOffice of Naval Research, the ArmedForces Institute of Pathology, and theQuartermaster of the U, S. Army. Dr. Can­non's many contributions to the field ofpathology, as consultant and problem­solver and as research scientist and teacher,have been acknowledged by the GerhardMedal of the Philadelphia PathologicalSociety, the Burdick Gold Medal of theSociety of Clinical Pathologists, theGroedel Medal of the American College ofCardiology, and the prestigious Gold Headed Cane of the American Associationof Pathologists and Bacteriologists, His re­search and collaborative and consultativework engendered a large product of tangi­ble results from his Chicago education-hisbibliography of published research runs tosome 13 pages of reports. But teaching andhelping launch young investigators wereparamount to him, Many of his disting­uished students were first infused with acommitment to research in the electivecourse on immunology offered by Dr. Can­non. He has given a lifetime of service anda legacy of hundreds of trained clinical In­vestigators to the field of medicine.University of Chicago Medical Alumni AssociationDistinguished Alumnus/na NominationThe Executive Committee of the Medical Alumni Associationapproved the following recommendation for alumni awards at itsApril 7, 1980 Council Meeting: "There shall be up to five Disting­uished Scientific Service Awards and up to two DistinguishedHumanitarian and/or Civic Service Awards presented to alumniannually. The total number of awards shall not exceed six with aminimum of four scientific awards. The alumnus is expected toattend an A wards Program and present a 20 minute oral presenta­tion of his or her work." The Gold Key award is a separate awardgiven to senior physicians, usually faculty, for outstanding con­tributions to the Medical School and to the University.Purpose: To recognize outstanding contributions by alumni tothe health field through basic research, clinical research, health ser- vices administration and health care as well as other outstandingcontributions of a humanitarian and/or civic nature.Eligibility: Graduates of the University of Chicago MedicalSchool, Rush Medical College up to and including 1942 and for­mer housestaff and faculty are eligible for the Distinguished Scien­tific and Humanitarian/Civic Award. The Gold Key award is usual­ly presented to a faculty member at retirement.Nominations: Nominations may be made by a graduate of theUniversity of Chicago Medical School, Rush Medical College. andcurrent and former housestaff and faculty, The nomination must in­clude meaningful statements and a curriculum vitae, Nominationsshould be sent to the Chairman, Awards Committee. MedicalAlumni Association, 1025 East 57th Street, Chicago, Illinois 60637no later than October J.Distinguished Alumnus/na Nomination FormI submit the name of Class of _for nomination for a (Distinguished Scientific/Humanitarian and/or Civic Award or theGold Key) _Candidate's office address _Homeaddress _Office telephone Home telephone _Nominated by Class of _Address _Please attach supportive statements and a curriculum vitae.25News BriefsLawrence Gartner toChair PediatricsDr. Lawrence M. Gartner has been namedChairman of the Department of Pediatrics,effective July I, 1980.The announcement was made by RobertB. Uretz, Vice President for the MedicalCenter and Dean of the Division of theBiological Sciences and the Pritzker Schoolof Medicine."Dr. Gartner brings with him demon­strated leadership abilities and experiencethat prepare him well for the administrativeresponsibility he will assume for the De­partment of Pediatrics and Wyler Chil­dren's Hospital. In addition, he is a dis­tinguished neonatologist whose research in­terest and special expertise in the care ofnewborn infants will contribute to the pro­grams of our regional Perinatal Center,"said Dr. Uretz.Dr. Gartner comes to the University af­ter 21 years of service at the Albert Ein­stein College of Medicine in New Yorkwhere he is currently Director of the Divi­sion of Neonatology and Professor ofPediatrics.. His clinical and research specialty areasinclude neonatology and liver disease inchildren. For the past seven years Dr.Gartner has been involved in a studyfunded by the National Institute of Health,focusing on the safety and effectiveness ofphototherapy, a type of treatment to pre­vent kernicterus, the brain damage that canoccur from excessive jaundice in newborninfants.He succeeds Dr. Marc O. Beem whocurrently serves as Acting Chairman of thedepartment. Dr. Beem is Professor ofPediatrics, specializing in infectious dis­eases. He will resume his clinical and re­search work on a full-time basis when Dr.Gartner begins his chairmanship.Dr. Gartner received his B.S. degree in1954 from Columbia College in New Yorkand his medical degree in 1958 from JohnsHopkins University School of Medicine inBaltimore, Maryland.From 1967 through 1975, Dr. Gartnerwas a Career Development Awardee of theNational Institute for Child Health and Hu­man Development and is the recipient ofseveral grants from this Institute.He has published 52 articles in scientificand medical professional journals and has26 co-authored chapters on the subject of liverdisease and perinatology for several books.Dr. Gartner's wife Carol is a Professorof English at Pace University and Chair­man of the Division of Arts and Letters atthe College of White Plains of Pace Uni­versity in New York.They have two children, Alex andMadeline.Freedman Elected to APAPresidencyDr. Daniel X. Freedman, Louis Block Pro­fessor and Chairman, Department ofPsychiatry, was elected president of theprestigious American Psychiatric Associa­tion (APA) for 1981-1982, by a wide mar­gin of 70.2%.The election was held by mail ballot lastmonth, in advance of the APA conventionin San Francisco. Over 10,000 members ofthe association, or 46% of its membership,participated in the election.Dr. Freedman was recently awarded the8th annual McAlpin Research AchievementA ward of the National Mental HealthAssociation.Leroy Hood ReceivesRicketts AwardDr. Leroy E. Hood, the Bowles Professorof Chemical Biology at the California Insti­tute of Technology, received the HowardTaylor Ricketts Award of the University ofChicago on May 19.The award recognizes "outstandingaccomplishment in the field of the medicalsciences. "Dr. Hood delivered the Ricketts Lecture,entitled "Antibodies: Split Genes andJumping Genes," in the Billings Auditor­IUm.Dr. Hood's research has focused on anti­body genes and molecules. Antibody mole­cules are key elements in the immune sys­tem, the body's major line of defenseagainst invading disease organisms andcancer. Each antibody molecule recognizesa specific foreign substance such as a bac­teria or virus and attaches chemically ontoit. This attachment leads to the destructionor elimination of the foreign virus orbacteria. Dr. Hood and his colleagues as well asothers have demonstrated the antibodymolecule is composed of two distinct func­tional parts. The recognition functions ofthe antibody molecule are carried out byhighly diverse variable domains, whereasthe destruction or elimination functions arehandled by the constant domains.Dr. Hood has used recombinant DNAtechniques to demonstrate that multiplegenetic elements code for both the constantand variable domains. In addition, he hasshown that these genetic elements are re­combined in many different ways with oneanother as the body manufactures the cellsthat make antibody molecules. These re­arranged or jumping-gene elements producethe enormous diversity of antibody mole­cules.The award memorializes Howard TaylorRicketts, a University of Chicago patho­logist who demonstrated that Rocky Moun­tain spotted fever is caused by an organ­ism, Rickettsia, that is transferred to manby ticks. Later he found-at the cost of hislife-the related organism that causedtyphus.Jensen Receives KetteringPrizeElwood V. Jensen, Director of the BenMay Laboratory for Cancer Research, wasrecently named a recipient of the CharlesF. Kettering Prize, one of three prizesawarded annually by the General MotorsCancer Research Foundation for cancer re­search achievements. The Kettering medalis awarded for the most outstanding con­tribution to the diagnosis or treatment ofcancer.The award, which consists of a goldmedal and $100,000, will be presented atceremonies in Washington on June 18. Jen­sen was honored for his research into thenature of human breast cancer.Prize winners were selected by anawards assembly composed of 28 interna­tionally prominent basic and clinical scien­tists.In his basic studies of the biochemicalmechanism of steriod sex hormone action,Jensen discovered that estrogenic hormonescombine with specific receptor proteins inreproductive tissues to exert their hormonaleffect. Applying this knowledge to humanbreast cancers, he showed that only thosecancers that contain the estrogen receptorare hormonally sensitive. This knowledgeis used today throughout the world to de­termine hormonal dependency in breastcancer and to apply appropriate treatment.The understanding of the role ofestrogen receptors provided by Jensen hasled to the clinical use of anti-estrogen com­pounds in the treatment of primary and re­current breast cancer.Jensen received his doctorate from theUniversity in 1944, and had taught heresince 1947. In 1969 he was named Direc­tor of the Ben May Laboratory.In 1977, Jensen was appointed the firstCharles B. Huggins Professor of BiologicalSciences. He is also Professor in the De­partments of Biochemistry, Biophysics andTheoretical Biology, and Pharmacologicaland Physiological Sciences.Jensen has received numerous honors forhis work, including; honorary D.Sc. fromWittenberg University (1963) and AcadiaUniversity (1976); the D. R. EdwardsMedal from the Welsh National School ofMedicine, Cardiff (1970); the G.H.A.Clowes Award from the American Associa­tion for Cancer Research (1975); the PapAward for 1975 from the Papanicolaou Re­search Institute, Miami; the Prix Roussel,Paris (1976); the American Cancer Socie­ty's Annual National Award (1976); theAmory Prize in Reproductive Biology,American Academy of Arts and Sciences(1977); the Gairdner Foundation Award(1979); and the Lucy Worthem JamesLaboratory Research A ward from the Soci­ety of Surgical Oncologists (1980).Jensen has published 160 scientific arti­cles and reviews.Foundation ToIncreased AlumniKaiserMatchGivingThe Henry J. Kaiser Family Foundationhas established a $100,000 scholarship andloan fund at the University's MedicalSchool to assist deserving and qualifiedmedical students. The announcement wasmade by Joseph J. Ceithaml, Dean of Stu­dents in the Medical School, at the ClassChairmen's meeting on May 16th duringreunion week. In addition, the Foundationhas offered to assist the Medical School inraising an additional $50,000 in matchingfunds. The Foundation will match new giftsover and above the average amount theMedical School has raised in loan andscholarship funds in the last two fiscalyears. The program works in the followingway. The Foundation will contribute $1 forevery $2 given for scholarships over $600;$1 for every $3 given for loan funds over$46,550, and $1 for every $4 given for en­dowed scholarship funds over $25, 100.Kaiser Matching Funds may be applied tonamed funds without restriction.Dean Ceithaml emphasized that alumnigifts and pledges designated for the KaiserChallenge Fund count towards the AnnualFund. Alumni giving will be very impor­tant to us during the next two years tomeet the increased needs of our students.Federal funding is steadily being cut off tothe school, and we must look to the alumnifor increased support, Dean Ceithaml said.Randolph Seed ('60) Chairman of theAnnual Fund, announced the gift categoriesfor the 1980 Annual Fund include the Cen­tury Club for $100 donors, the Dean'sAssociates for $1,000 donors and two newclubs: The Midway Club recognizingdonors of $500 and The Phoenix Societyhonoring donors of $2,500.Medical Alumni Honoredby City of ChicagoFive Medical Alumni were honored byChicago's Mayor Jane M. Byrne as out­standing Chicagoans and inducted into theCity's Senior Citizens Hall of Fame onMay 27. The Hall of Fame is in its 19thyear and is Chicago's way of honoringmen and women past age 62 who havecontributed to the social, cultural, reli­gious, economic, scientific, and technolog­ical life of the City.Of the six physicians honored, five weregraduates or affiliated with the Universityof Chicago. They are:John I. Brewer, (S.B.'25, Rush '29, Ph.D.'36) age 73, was named chairman of thedepartment of obstetrics and gynecology atNorthwestern University Medical School in1972; his greatest achievement was the de­velopment of an 80% effective drug ther­apy cure for women with choriocarcinoma,cancer of the placenta. He helped launchthe Illinois Cancer Council. Roy R. Grinker, Sr., (S.B. '21, Rush'21) age 79, has fully or partially trainedtwo-thirds of all the psychiatrists in Chi­cago; is currently the director of theSchizophrenia Research Project at MichaelReese Hospital, clinical director at BarclayHospital and chairman emeritus of the de­partment of psychiatry at Michael ReeseHospital; one of the two last survivors ofthe group of Freud's ex-patients, he wasrecently chosen in a world wide survey ofpsychiatrists as one of the top ten names inWorld Psychiatry.Abraham F. Lash (S.B. '19, Rush '21)age 81, has had a 57 year career as ateacher, clinician, scholar and innovator inobstetrics and gynecology; became profes­sor of obstetrics and gynecology at North­western University in 1965 where he taughtuntil 1974; served as chairman of the de­partment of gynecology at Cook CountyHospital from 1959 to 1961; currentlyserves as examining gynecologist at theGeorge and Anna Portes Cancer PreventionCenter.Maurice Lev (Professional Lecturer since1961 in the Department of Pathology), age71, director of congenital heart disease re­search and training center for Hektoen In­stitute for Medical Research, has donepioneer research in the areas of the con­genitally malformed heart and the conduc­tion system; has faculty appointments insix medical schools in the Chicago area,was presented the gifted teacher award bythe American College of Cardiology in1973.Walter L. Palmer, (S.B. '18, M.S. '19,Rush '21, Ph. D. '26) age 83, noted scien­tist since the 1920's contributing to thefield of gastroenterology; is the Richard T.Crane Professor Emeritus of Medicine atthe University of Chicago; has held topoffices in five major professional associa­tions including the presidency of the Amer­ican College of Physicians and of theAmerican Gastroenterological Association;has served in important policy-makingpositions in scores of other national andlocal professional organizations includingthe presidency of the American CancerSociety in 1967-68; has served on itsBoard of Directors since 1958.27PCP Found to EnhanceBrain Dopamine Activity"Angel dust" (PCP) can increase theactivity of brain dopamine, a substancewhich may play a role in the cause ofsome forms of schizophrenia."It's generally agreed that PCP-inducedpsychoses in man have more similarities toschizophrenic states than any other drug­induced psychosis, such as those of amphe­tamine of LSD," says Dr. Herbert Y.Meltzer, Professor in the Department ofPsychiatry .Meltzer and his associates, R. DavidSturgeon, Miljana Simonovic, and RichardFessler, gave PCP to rats and found byfour separate methods that it increasedbrain dopamine activity. The findings areconsistent with the hypothesis that exces­sive dopamine may cause acute psychoticsymptoms found in schizophrenia, saysMeltzer.One of the methods involved behavioralstudies. "Rats given PCP began movingtheir limbs and heads in a repetitive man­ner, a behavior which has been found to berelevant to human schizophrenia in termsof drug action," says Meltzer.Symptoms similar to those found inschizophrenia are consequent upon angeldust abuse. "These include auditory hallu­cinations, paranoid delusions, distortions ofbody image, and depersonalization, thefeeling that you exist separately from yourbody."Since about 1970, PCP has become oneof the major street drugs in America.Known as angel dust or hog, it is veryeasily synthesized. It used to be used ex­tensively by veterinarians at high doses asan animal tranquilizer. At low doses, it is astimulant and "psychotomimetic."The University of Chicago studies ofPCP revealed that it has a unique profile ofeffects which markedly enhance dopamineactivity. It enhances dopamine release, bya mechanism closer to that of methylpheni­date (Ritalin) than to amphetamine, but ithas other unique features as well, such asstrong anticholinergic effects. (Ritalin isused to calm down hyperactive children.)PCP, amphetamine, and Ritalin allmarkedly increase psychotic symptomswhen given to most schizophrenics who areexperiencing an exacerbation of theirpsychosis, says Meltzer.The effects of PCP in rats can be block­ed by certain antipsychotic drugs, particu­larly haloperidol (Haldol) and reserpine.28 Frequently, these drugs will be helpful intreating PCP-induced psychoses.Meltzer's group was the first to suggestthat PCP would increase dopamine activity."There are many other actions of the drug,however. Like most drugs, there are multi­ple types of action," Meltzer comments.Meltzer is also studying the ability ofPCP to interact with endorphins, thebody's own brain-made opiates, and withacetylcholine. "In the same way PCPpromotes dopamine activity, it inhibits cho­linergic activity. That may be why it's sopotent, because we believe that there is abalance between dopamine and acetyl­choline in the brain. Normally, if you haveincreased dopamine it could be offset byincreased acetylcholine. But PCP not onlyincreases dopamine, it also decreasesacetylcholine. So it dramatically upsets thebalance. "IntercellularCommunication in NeuralDevelopmentHow the brain develops in the embryo isone of the most challenging problems inmodern science and medicine. A team ofscientists working with Aron A. Moscona,Louis Block Professor in the Departmentsof Biology and Pathology, the College, andthe Committees on Developmental Biolo­gy, Genetics, Neurology and Immunology,discovered sometime ago that cell-to-cellcommunications play a crucial role in set­ting up the nervous system from its build­ing blocks-the cells-and that "faulty"cell communication may result in brainabnormalities.Glia cells in the brain and nervous sys­tem were once thought to serve merely as aphysical support framework for nerve cells.Now, says Moscona, "We know that theyalso function as 'biochemical factories' formaking molecules that are needed by nervecells. "Drs. Moscona and associate Paul Linserare now exploring a new aspect of cell-to­cell communication in neural development:contacts between embryonic cells areneeded not only for tissue formation, butthey also provide signals for the biochem­ical differentiation and specialization ofcells. If specific cell-to-cell contacts areperturbed or disrupted, the cells fail to de­velop normally. The work was recentlypublished in the Proceedings of the Nation- al Academy of Sciences. Moscona com­ments, "We have been investigating thedevelopment of the neural retina inembryos. Nerve cells need glutamine; thisamino acid is normally supplied to themlargely by glia cells which make it with thehelp of a specific enzyme, glutamine synth­etase. In the embryo, glia cells are stimu­lated to make this enzyme by cortisol, ahormone secreted by the adrenal glands.The hormone turns on in glia cells thegenes which control the formation of thisenzyme."However, this hormonal stimulus doesnot work unless glia cells are in close con­tact with neurons," say Moscona and Lin­ser. "Apparently, a signal from theneurons is required to make glia cells re­sponsive to this hormone. We found thatdisconnected and separated glia cells can­not make the enzyme if treated with corti­sol. However, when such glia cells areagain combined with neurons so that theyreestablish normal glia-neuron contacts,they regain responsiveness to cortisol andcan now make the enzyme. If one con­cludes in such combinations still otherkinds of cells, which normally do not be­long there, the resulting 'noise' perturbsthe glia-neuron interaction system and pre­vents it from functioning normally."These results, say Moscona and Linser,raise various important and far-reachingimplications. They suggest that, in theembryo, even a transient faculty com­munication between glia and neurons, dueto genetic or environmental factors, mayprevent the normal biochemical develop­ment of nerve tissue, and make it eventu­ally function sub-optimally, or abnormally.Moscona concludes:.. At a more basic level, our findingsstress the significance of informational­collaborative circuits among cells duringembryonic development of the nervous sys­tem. Here we have a situation, in which ahormone sent out by cells in the adrenalgland triggers in glia cells of the retina theformation of an enzyme that makes a pro­duct for export to nerve cells; in turn,nerve cells communicate to glia cells a sig­nal that renders them responsive to the hor­mone. Undoubtedly, other cases of suchmultilevel celluar interactions will be dis­covered. It is our future task to identifytheir nature, to find out how they work andunder what conditions they can malfunc­tion. It is not going to be an easy task;having come so far, we are encouragedthat the next steps are within reach."Surgical Induction ofClots in Treatment ofAneurysmsDr. John Mullan, John Harper Seeley Pro­fessor and Head of the Section of Neuro­surgery in the Department of Surgery andDirector of the Margaret Hoover andWilliam E. Fay Brain Research Institute,has developed new ways to induce bloodclots to seal off brain arteries that threatento burst.Mullan induces clots in aneurysms, caro­tid-cavernous fistulae, and arteriovenousmalformations by packing them with avariety of materials, including superfinewire and silastic pellets. Alternatively,where appropriate, he closes off one end ofthem with a tiny balloon or tiny clamp.Sometimes he surgically removes thebulging vessels.A patient had gone blind in one eyefrom a carotid aneurysm. Her other eyewas failing. A carotid branch had bulgedout into a hollow area in the skull behindthe eyes and was pressing on the opticnerve.Mullan inserted a hollow needle into theaneurysm. Through the needle he pushedten feet of curling, extra-fine-phosphor­bronze wire. The wire filled up theaneurysm, inducing a clot in the aneurysm,saving the patient's second eye and prob­ably her life.The alternative is to cut down on thepressure in the artery with a tiny mechanic­al device. The device, placed on one offour arteries going to the brain, will alsoinduce a clot in the artery-but now thereare only three main arteries supplying thebrain. "So we developed this other methodof going directly to the aneurysm."Another patient was dying of heart fail­ure because of a fistula in the head. Com­ments Mullan, "The blood was doingnothing but coming back down to theheart. The heart was pumping so hard thatit was going into failure." Mullan induceda clot in the fistula, using his fine-wiretechnique, closing it off.In the case of a third patient with anarteriovenous malformation, Mullan em­ployed another new procedure that he hasmodified. He put a catheter in an artery inthe patient's groin and ran it up throughthe aorta into his neck and the affectedarea of his brain.One by one, he injected tiny silastic pel­lelts into the blood stream in his brain. Since most of the blood was flowingthrough the malformation, the blood flowcarried the pellets there, where they formedemboli."You notice after putting in about 50 orso of these little tiny plugs that a lot of theblood supply to this area has been cutoff," remarks Mullan. "We cut it off, bitby bit, in four or five sessions, under localanesthesia. An X-ray-opaque dye is in­jected along with the pellets to observewhat is occurring."Mullan and his colleagues have spent thepast 20 years developing the wire andpellet blood-clotting procedures. Beforeattempting them with humans, it was firstnecessary to spend years trying them onexperimental animals, says Mullan. The re­search was supported by the MargaretHoover and William E. Fay ResearchInstitute.Male Infertility HighThe idea that women account for most ofthe problems of infertility is quickly fad­ing, according to a specialist at the Uni­versity of Chicago Medical Center whosays that as many as half of the problemspreventing couples from having childrencan be attributed to male infertility.Dr. Thomas M. Jones, an endocrinolo­gist in the University's Department ofMedicine, is one of the few doctors in theChicago area who deals primarily with pa­tients suffering from male infertility."Even though we're finding that moreand more men are the source of infertility,research on the subject has been limited.Male infertility is a new area of medicineand is still a socially sensitive issue. I'mvery gratified that in recent years, bothpartners come to see the physician whenthey encounter problems having children,"he said.Physicians from a four-state area refer150 to 200 new patients a year to special­ists at the University's Billings Hospital fortreatment of male infertility. Most are re­ferred directly to Dr. Jones in the Depart­ment of Medicine's Adult EndocrinologyClinic. In addition, a substantial number ofmen are referred from the Chicago Lying­in Hospital Infertility Clinic headed by Dr.George Maroulis. Dr. Maroulis is Asso­ciate Professor in the Department of Ob­stetrics and Gynecology."My patients are, for the most part,very healthy men, aside from the fact that they have not conceived a child. Patienceand a willingness to work with us as longas it takes to reverse the problem are es­sential," Dr. Jones said.He explained that the largest category ofreversible male infertility cases is the vari­cocele, a varicose vein in the left scrotalcompartment that is associated with de­creased production of sperm. Because ofcareful screening, Dr. Jones said that hissuccess at treating varicocele is better thanthe national average which is 25 to 30 percent. Varicocele surgery is done by doctorsin the Department of Surgery's UrologySection.In rare cases, infertility in the male iscaused by pituitary or hypothalamic dis­orders, according to Dr. Jones. For thesepatients, combined Gonadotropin Therapyis prescribed. Gonadotropins are drugs thatimitate the functions of pituitary hormoneswhich stimulate the testes in order to in­duce sperm production."Usually, treatment of the primary dis­order results in a reversal of infertility,"Dr. Jones explained.The idea that male infertility may bepsychological is refuted by Dr. Jones. Apsychological disruption of spermatogene­sis has never been documented. This is inmarked contrast to females, in whompsychological causes can block ovulationand interrupt the menstrual cycle. In males,psychology can cause impotence, but notinfertility," he concluded.29In MemoriamBeatrice B. Garber,1926-1980The death, due to cancer, on 26 April 1980of Beatrice B. Garber marks the loss toThe University of Chicago of an incom­parable colleague, teacher and friend. Herfriends and associates knew her as Bea andI will continue that practice here.Bea was born in St. Louis (18 March1926), the daughter of Dr. and Mrs.Nathan Bilsky. She did her undergraduatework at Vassar College, receiving an A.B.in Chemistry in 1946. Bea then became thefirst woman to be admitted to the School ofMedicine at Washington University, buteventually decided against going there andchose a career in basic biological scienceinstead. This decision was, in part, a resultof her devotion to her future husband, andto the violin. It was through their mutuallove of playing music that Bea met AlanGarber, a native of Chicago, and they weremarried in 1946.Bea then came to the University ofChicago as a graduate student in Zoologyworking with Prof. Paul Weiss in ex­perimental embryology; getting an M.S. in1948 and a Ph.D. in 1951. Her thesis,"Quantitative Studies on the Dependenceof Cell Morphology and Motility upon theFine Structure of the Medium in TissueCultures", was the first of her many stu­dies devoted to increasing our understand­ing of how the intricate spatial and tempor­al organization of complex organisms isderived from the interactions of cells witheach other and with their environment.30 Since she was close to delivery of herfirst son, Dale, at the time of her Ph.D.final orals she did not immediately con­tinue her work in Developmental Biology;instead she was occupied with the develop­ment and growth of a family; a secondson, Bruce, was born in 1953. In 1960 shetaught for a year as a member of the Facul­ty of Science of the National College ofEducation in Evanston, Illinois and in 1961returned to this University as a ResearchAssociate with Prof. A.A. Moscona in theDepartment of Zoology.It was not easy to re-enter the field aftera 10 year hiatus, but Bea was persistentand with Alan's support made the success­ful transition. In 1968 Bea took the respon­sibility for several undergraduate biologycourses and was appointed Assistant Pro­fessor in the College. In 1971 her appoint­ment was changed to Assistant Professor inBiology and Anatomy and in 1974 she wasmade Associate Professor in both depart­ments, and in the College and in the Com­mittee on Developmental Biology.Throughout her career she maintained anintense interest in undergraduate teachingboth in the lecture room and in her ownlaboratory; this dedication was recognizedwhen she was given the Quantrell Awardfor Excellence in Undergraduate Teachingin 1975.Bea's research was concerned with thestudy of nerve cell recognition factors thatmay operate in the formation of tissuescharacteristic of differentiated brain. Touse her own words, "Since functionalneuronal circuitry is based on finely spe­cified synaptic connections and projectionswithin the central nervous system, thesebasic studies are designed to exploremechanisms of specificity regulating selec­tive associations between cells during brainhistogenesis." The work in Bea's lab hadseveral dimensions but was all centered onthis fundemental problem.Her interest and enthusiasm extended toseveral other systems in which tissue de­velopment could be studied in vitro but herfinal illness did not permit her to devotethe time and energy she considered neces­sary for these problems. In addition to herresearch and teaching Bea gave generouslyof her time and effort to local and nationalorganizations in her field, and to NIHstudy sections, while still maintaining anactive role as a violinist with the Evanston Symphony Orchestra.It is impossible to capture, in wntmg,the qualities of Bea that endeared her toher associates. She was completely de­pendable; everyone, from beginning under­graduates to U ni versity administratorsknew that she would do what needed to bedone; that she would do it to the best ofher ability, with grace, and without res­ervation. Bea could also be outspoken andpersistent in her pursuit of what shethought was the correct course to take, butwithout the self-serving attitude that so fre­quently mars academic life.Dependability was only one aspect ofher collegiality. To an extent rarely foundamong her peers, Bea was a true col­league, her generosity with respect to time,effort and spirit was well known to her stu­dents and collaborators. She believed in theidea of the University as a community andin collegiality as more than a word: it wasa daily practice. Her collaborations in re­search with faculty colleagues in severaldepartments were all intensive; she givingof her good-humored best and expectingthe same of her collaborators.One quality, perhaps, stood out beyondthe others; she was an enthusiast. Eachpersonal interaction and each problem wasapproached with good-natured, ebullient,high spirits that communicated her excit­ment and eagerness to get on with thesearch. In the classroom as in conversa­tions her optimism and enthusiasm were in­fectious, convincing us all to go aheadwith trying to solve problems. We willmiss her, but we should consider ourselvesfortunate in having had the opportunity tobe her colleagues and friends.-Eugene GoldwasserThe Beatrice B. Garber Summer ScholarFund has been established to encouragepromising undergraduate students by offer­ing summer research opportunities in theUniversity's laboratories. The University ofChicago Cancer Research Foundation willadminister this fund and contributions canbe sent to UCCRF at 1025 E. 57th. Street,Chicago, fl. 60637.A memorial' service for Dr. Garber willbe held in Bond Chapel on the Universitycampus in Autumn Quarter.Esmond R. Long,1890-1980Esmond R. Long was born in Chicago in1890. He attended the Morgan ParkAcademy, a secondary school of the Uni­versity of Chicago, and went on to earn hisA.B., Ph.D. (Pathol.), and M.D. degreesfrom this university and its then consti­tuent, Rush Medical College in 1911,1919, and 1926, respectively. The relative­ly long educational span was in consider­able measure due to a long bout withtuberculosis, first recognized when, as asecond year medical student, he notedhemoptysis, stained his sputum, and foundit full of tubercle bacilli. For six years heexperienced all the then-current therapeuticregimes for tuberculosis including exposureto the dry desert air of Arizona, continuousbed rest for a year in Seattle concomitantwith superalimentation and time spent atSaranac Lake and the Trudeau SanitariumWhile recuperating from these therapeu­tic experiences, Dr. Long completed histhesis for the Ph.D. on purine metabolism,this work being done with Dr. H. GideonWells and the degree completed under Dr.Ludwig Hektoen. He completed work forhis medical degree in the midst of busyresearch activities, and in 1928 wasappointed Professor of Pathology at theUniversity of Chicago. During these yearsof teaching and research he was acquaintedwith a broad range of pathologists and re­search scientists among whom his percep­tive intelligence and qualities as a gentle­man in the best sense of the word werewidely appreciated. Dr. Long's earlier work on the mannerin which the tubercle bacillus convertscomplex proteins into simple substances forits own use opened a new field of studies.A logical sequence was his work with Flor­ence Seibert in developing and standardiz­ing purified protein derivative (PPD). Thisbecame the tuberculin standard for theU.S. Public Health Service, and in 1952became the international standard of theWorld Health Organization.In 1932, Dr. Long accepted a profes­sorship at the University of Pennsylvaniawhere he became director of the HenryPhipps Institute for the Study, Treatmentand Prevention of Tuberculosis. He re­mained there until his "academic retire­ment," as he termed it, in 1955. The in­stitution was famed for studies of environ­mental factors and racial differences intuberculosis, for studies in the experimentalpathology of this disease, and for work onits prevention, detection and control. Thismilieu served Dr. Long well since he wasachieving in his own mind a synthesis ofthe pathology of the active disease with itsepidemiology and he noted that his back­ground of understanding of the metabolicand anatomic changes tuberculosis wroughtseemed to give him a better basis for itsdemographic study.During World War II Dr. Long servedas consultant on tuberculosis to the U.S.Army Medical Corps, and was laterappointed deputy chief of the ProfessionalService Division of the Office of the Sur­geon General with multiple duties relatedto hospital development and other activi­ties. In the months following the war hisresponsibilities included care and preven­tion of tuberculosis in the population ofdisrupted Germany.Esmond Long's experience with tubercu­losis as a patient and as a prime mover inits investigation and conquest spanned fivedecades of important changes in its treat­ment, prevention and gravity as a worldhealth problem. He surveyed thesechanges, took pride in the accomplish­ments, and was pleased to have played asignificant role in the conquest of this dis­ease. Nevertheless, his sense of history andperspective in pathology led him to scien­tific modesty and objectivity in noting thatthe changes were also influenced by manysocial factors in addition to the advances inmedical science. This sense of history was initiated by hismother's deep interest in cultural resourcesjust as his interest in science had been fos­tered by his father who was professor ofphysiologic chemistry at Northwestern Uni­versity Medical School. Dr. Wells furtherencouraged this interest and in 1928 hepublished History of Pathology, followedby Selected Readings in Pathology fromHippocrates to Virchow in 1929, and AHistory of American Pathology in 1962.His work as a medical scientist calledforth over 270 articles and editorials, thepresentation of 20 special named lectures,and nine books in addition to those men­tioned above. Prominent among the latterwere the three editions of The Chemistry ofTuberculosis in the first edition of whichhe collaborated with H. G. Wells andLydia M. Dewitt (1922); the third editionbeing titled The Chemistry and Chemother­apy of Tuberculosis with Dr. Long as thesole surviving author (1958). He served aseditor of three different journals, The Jour­nal of Outdoor Life, the American Reviewof Tuberculosis, and for five years duringhis retirement, The International Journal ofLeprosy. For years he served as medicaleditor for Webster's International Diction­ary, defining or approving definitions ofabout 15,000 words.His awards of recognition were many,prominent among them the Trudeau Medalof the National Tuberculosis Associationand the prestigious Gold-Headed Cane ofthe American Association of Pathologists.However, judging from correspondenceand visits with the Longs, this writer isinclined to believe that for Dr. Long hisgreatest reward was his marriage in 1922to Marian Soak, a distant relative withwhom he shared great, great grandparentsand a long companionship.His period of retirement from academictenure was long and productive. Retirementmade little difference in his way of thoughtand, as he said, "brought no envy or dis­satisfaction," but presented time for reflec­tion, study, writing and maintaining profes­sional associations. Despite his wryly notedearly experience with excessively highcholesterol hyperalimentation, he remainedalert in mind and memory.During the latter portion of this periodMrs. Long fell victim to leukemia and fortwo and a half years her husband nursedher skillfully, devotedly shielding her from31excessive reference to the. progress of herdisease. Thus she was able to be at homein their Philadelphia flat for most of her ill­ness. After her passing, Dr. Long finishedhis last work, a history of the departmentof pathology at the University of Pennsyl­vania. He followed his Marian on Novem­ber 11, 1979 at the age of 89. They aresurvived by a daughter, Judith L. NealAlumni Deaths'13. Louise W. Sauer, Coral Gables,Florida, February 10, 1980, age 94.'16. Ralph O. Porter, Logan, Utah,April 9, 1980, age 93.'17. John H. Nichols, Oberlin, Ohio,deceased date unknown.'18. Robert L. Kerrigan, Michigan City,Indiana, deceased date unknown.'22. Vernon J. Hittner, Seymour, Wis­consin, deceased date unknown.'24. Joanna Lyons, Rawalpindi, Pakis­tan, deceased date unknown.'24. Charles F. Rennick, EI Paso,Texas, November, 1979, age 79.'25. Mary L. Gilliland, Van Nuys, Cali­fornia, July 4, 1979, age 87.'30. Harold C. Voris, Chicago, Illinois,March 13, 1980, age 77.'31. Richard K. Schmitt, Columbus, In­diana, February 7, 1980, age 80.'31. Robert F. Sharer, Miami Shores,Florida, February 1, 1980, age 86.Alumni News (Mrs. Robert W.) of Arlington, Massachu­setts, a son Esmond Ray Long, Jr. ofWayne Pennsylvania, and five grand­children.The undersigned has in the past quotedin appreciation of two men an old Chinesesaying, "He who is for one day myteacher, is my father for life." One ofthem was "Es" Long.'31. Eugene R. Walkowiak, Chicago,Illinois, deceased date unknown.'32. Alfred J. Platt, Chicago, Illinois,June 4, 1980, age 72.'33. Arnold Wilson, Pasadena, Texas,November 14, 1972, age unknown.'34. G. R. Hamilton, San Antonio,Texas, March 21,1980, age 71.'35. Nathaniel Safran, Lakeview, NewYork, December 25, 1979, age 69.'36. Willard G. De Young, Chicago,Illinois, March 21, 1980, age 71.'37. Weir C. Stevens, Kearny, Arizona,December 25, 1979, age unknown.'39. Martin E. Janssen, St. Paul, Min­nesota, deceased date unknown.'41. Paul P. Pickering, San Diego,California, December 27, 1979, age 67.'42. Thomas F. Dwyer, Newton, Mas­sachusetts, November, 1979, age 65.'50. John H. Hummel, Joliet, Illinois,January 27, 1980, age 58. The uniqueness and greatness of theUniversity of Chicago rests on the livesand accomplishments of alumni and staffmembers such as Dr. Long who set thestyle. As long as this pattern of integrity,dedicated productivity and open-minded in­quisitiveness remain, the university will re­tain its uniqueness and greatness.-Dr. Olaf K. Skinsnes ('47)Division Alumni Deaths'51. Ph.D. Beatrice B. Garber, Chica­go, Illinois, April 26, 1980, age 54.Former Staff DeathsOlev R. Aavik (Medicine, Resident, '51-'53; Student Health, '54), Bloomington,Illinois, June 2, 1980, age 60.Hugh Carmichael (Psychiatry, Faculty,'35-'43; '60-'61), Stevensville, Michigan,February 19, 1980, age 82.Orion D. Coppock (Obstetrics and Gyne­cology, Resident, '25), Oak Lawn,_ Illinois,May 6, 1980, age 85.Kirkland John Fritz (Psychiatry, Resi­dent, '64-'67; Faculty, '71-72), January10, 1980, age 71.Bernard I. Saliterman (Obstetrics andGynecology, Resident, '32), Minneapolis,Minnesota, May 29, 1980, age 77.1935Arthur H. Rosenblum is clinical professoremeritus in the department of pediatrics,University of Chicago-Michael Reese, butcontinues as co-director of pediatric allergyand immunology at Michael Reese MedicalCenter.32 1939Abraham Kauvar, manager and chief ex­ecutive officer of Health and HospitalsAgency of the City and County of Denver,Colorado, was appointed a member of thePanel of Specialists to the Joint Distribu­tion Committee Health and Welfare Profes­sional Advisory Committee. As one of athree-member Task Force from America he will visit Israel to help them set up anambulatory health care system similar toone in Denver. Dr. Kauvar has beenelected to serve as a member of the UnitedStates Conference of City Health Officers.In 1976 he received an OutstandingAmbulatory Care A ward from HEW and in1977 he received an award for OutstandingHealth Delivery System from the RobertWood Johnson Foundation.Abraham Kauvar '391943Jonas E. Schreider retired from privatepractice of dermatology in Walnut Creek,California and moved to "Leisure World"in Laguana Hills. He joined the part-timevoluntary staff of the department of der­matology at the School of Medicine of theUniversity of California, Irvine. Dr.Schreider reports that he has met twomedical school alumni in Leisure World­so far.1944Charles G. Gabelman brough us up-to­date on his activities. "I completed myresidency in internal medicine at theUSV AH, Hines, Illinois in December,1950 and entered private practice in Den­ver. I served two years in the army (1954-55) and then resumed internal medicine. Iadded allergy to my practice and have con­fined to allergy since 1962. In 1973 I relo­cated to southern California (Laguna Hills).I became a diplomate of the AmericanBoard of Allergy and Immunology inMarch, 1974. My oldest son, Charles, is agraduate of Pritzker and is serving hissecond year residency in surgery at the cli­nics. "Raymond D. Goodman writes, "I haveretired from private practice to become themedical director of U.S. Administrators,Inc., a Los Angeles based private healthcare company that evaluates and processeshealth claims for more than one millionsubscribers. I am an emeritus attendingphysician in the department of medicine atthe Cedars-Sinai Medical Center and anadjunct associate professor at the UCLASchool of Public Health." Dr. Goodmanlives in Beverly Hills, California. 1953E. Russell Alexander reported the follow­ing: "After 19 years at the University ofWashington in the department of pediatricsin the School of Medicine and the depart­ment of epidemiology in the School ofPublic Health (which I chaired for sixyears), I have moved to the University ofArizona where I am professor and head,section of pediatric infectious diseases. Iam very lucky to have C. George Ray('60) as a contributor to our section. He isa professor in the department of pathologyand is director of the clinical virologylaboratory. ' ,1953Fred Matthies is chairman of the depart­ment of family medicine at Harbor-UCLAMedical Center.1955Jesse Tapp has been appointed actingdirector of the Health Department of theSeattle-King County Department of PublicHealth (Washington). Dr. Tapp comes tothe office of the director after serving aschief of physician services in Seattle,where he considered the search for ways tomake better use of the available physicianwork force a stimulating challenge. Dr.Tapp worked in a rural clinic in PuertoRico for five years and has taught at theUniversity of Kentucky and at the Uni­versity of Arizona, where he helped to cre­ate a neighborhood health center. In 1968Dr. Tapp took a sabbatical and worked inthe British National Health Service for oneyear.1957Harry A. Oberhelman, Jr. was elected tomembership on the board of directors ofthe Federation of State Medical Boards.Dr. Oberhelman's three-year term extendsthrough the 1982 annual business meeting.Dr. Oberhelman was a faculty member atthe University of Chicago until 1960 whenhe moved to Stanford. Since 1964 he hasbeen professor and chief of general surgeryat Stanford. Quoting from the FederationBulletin, "Harry Oberhelman's credentialsas a scientist, surgeon and medical educa­tor are impeccable. He has had extensiveexperience in leadership roles in medical licensing as a member of the CaliforniaBoard. A member of the former 'FLEX 1-FLEX II Committee,' his ongoing parti­cipation in the activities of the merged'uniform licensure and competence for re­licensure committee.' is groundwork thatwill be of increasing importance in the fu­ture of the Federation. "1959Richard L. DeGowin, professor of inter­nal medicine and radiology at the Universi­ty of Iowa College of Medicine, has beenappointed director of the University's newCancer Center. One hundred faculty mem­bers have committed their efforts to the in­terdisciplinary aims of the new Center. Dr.DeGowin joined the faculty in 1968.1961J. Terry Ernest has been appointed chair­man of the department of ophthalmology atthe Indiana University School of Medicine.1965Fernando de la Torre-Ugarte writes fromLima, Peru where he has been appointedassistant surgeon, General Surgery ServiceNo.3, Hospital Central No. 1 del S.S.P.in Lima. He is a member of many Peru­vian medical societies and a fellow of theInternational College of Surgeons, and haswritten 46 general surgery articles.1968William A. Ehlers is living in Portland,Oregon where he has a practice in child,adolescent and adult psychiatry.David Kindig has been named vicechancellor for health sciences at the Uni­versity of Wisconsin-Madison. Dr. Kindighad been director and chief operatingofficer of the 1200 bed Montefiore Hospitaland Medical Center in the Bronx. His newpost is the top administrative one in theUniversity's Center for Health Sciences,which includes the university hospital andclinics, the schools of medicine, nursing,pharmacy and allied health professions,and the State Laboratory of Hygiene, Wis­consin Psychiatric Research Institute andUniversity Health Service.33Walter L. Palmer (S.B. '78, M.S. '79, M.D.Rush '27, Ph. D. '26), Richard T. Crane Pro­fessor Emeritus, received the DistinguishedAlumnus Award from Rush Medical Collegeon June 6th and delivered the commencementbanquet speech on the history of Rush Medi­cal College. Dr. Palmer was also recentlyhonored by the City of Chicago (see NewsBriefs).1971 emergency medicine at Bowman GraySchool of Medicine. He has beenappointed director of the emergency depart­ment at St. Mary's Hospital in Saginaw,Michigan and director of advanced lifesupport for Saginaw County. The Holler­mans have a new son Daniel Philip, bornFebruary 13.Margaret Mary Barron and JurriannStrobos are in Morgantown, West Virginia.They write: "Jurri will do two years of re­search in the department of surgery beforefinishing a general surgery residency. Peg­gy has finished a pediatrics residency andwill begin an internal medicine residency."Divisional Alumni NewsVincent P. Gurucharri finished a car- 1915diothoracic residency at the University ofMissouri and has joined a Columbia (Mo.)surgical group in private practice. In 1976-78 he served a two year hitch with theNavy.Gordon Telford completed a surgicalresidency at the University of Marylandand is a senior research fellow in the de­partment of surgery and gastroenterologyunit of the Mayo Clinic. His work there issupported by a three-year clinical investiga­tor award from the National Institute ofArthritis, Metabolism, and Digestive Dis­eases of the National Institutes of Health.1973Edward J. Prendergast is an assistantprofessor of medicine in the hematologysection at the University of WisconsinMedical School, Madison.1975Edward Hutt opened a private practicewith two other physicians in Compton,California. Edward and wife Diana havetwo sons, David, age 3 and Michael, age 3months (in February).1977Jeremy J. Hellerman finished his year aschief resident in the department of34 Elizabeth C. Crosby (M.S. ' 12, Ph.D., 15, Anatomy) was awarded the NationalMedal of Science by the President of theUnited States on January 14 "for outstand­ing contributions to comparative and hu­man neural anatomy and for the synthesisand transmission of knowledge of the en­tire nervous system of the vertebrate phy­lum." Dr. Crosby was the first woman tobe named a full professor at the Universityof Michigan Medical School in 1936. Afterforty years of service she became emeritusin 1960, but continues as a consultant inneurosurgery. She also is an emeritus pro­fessor of anatomy at the University of Ala­bama Medical Center. The author of morethan 100 papers and 4 books, at 91 yearsof age she continues to work as a produc­tive scientist.1947Elsie Taber (Ph.D. '47, Zoology) washonored at a luncheon at the Medical Uni­versity of South Carolina where it wasannounced the alumni had established alectureship in her name and made her anhonorary alumna. Professor of anatomyand faculty member for 32 years, Dr. Ta­ber is well known to the MUSC graduatesin medicine and the biological sciences.Earlier in the year she was recognized forher teaching ability. Dr. Taber has pub­lished 48 scientific papers since joining theMUSC faculty and served as interim chair- man of the department of anatomy for twoyears.1953Ira Singer (S.M. '49, Ph.D. '53, Micro­biology) was appointed director of theOffice of the Section on Medical Schoolsof the American Medical Association.1963Dorothy Kupelian (M.S. '63, Biology)has a new position as science teacher atArcadia High School in Oak Hall, Vir­ginia.1977Roger A. Powell (M.S. '77, Biology) isassistant professor of zoology and forestryat North Carolina State University.Former StaffGeorge J. Andros (Obstetrics and Gyne­cology, faculty, '46-'53) is professor andassociate chairman of obstetrics and gyne­cology at Jefferson Medical College anddirector of the division of maternal-fetalmedicine at Thomas Jefferson UniversityHospital in Philadelphia.Ronald N. Gaster (Ophthalmology, res­ident, '75-'78) has two new appointments.He is chief of ophthalmology at the LongBeach V. A. Medical Center and assistantprofessor in the department of ophthalmol­ogy at the University of California, Irvine.Noel S. Howard (Pathology, resident,'66- '70) is director of psychiatric educationat the National Naval Medical Center,Bethesda, Maryland.Louis M. Sherwood (Chairman, Medi­cine, Michael Reese Hospital, '74-'80) asof July 1 is professor and chairman of thedepartment of medicine at Albert EinsteinCollege of Medicine in Bronx, New York.John W. Weiss (Dermatology, resident,'60-'63) delivered a lecture on "Dermatol­ogy Program without a Residency Prog­ram" at the Association of Professors ofDermatology meeting in Washington, D.C.last fall. At the American Academy ofDermatology meeting he was chairman andmoderator of Dermavision 1979, a four­hour program on closed circuit televisionattended by 1,600 dermatologists. He is amember of the Audiovisual Committee ofthe American Academy of Dermatologyand of the Manpower Committee of theAssociation of Professors of Dermatology.Dr. Weiss is chairman of the section ofdermatology and clinical professor of medi­cine at Loyola University Medical Center,Departmental News Maywood, Illinois.Paul A. Weiss (Zoology, assistant pro­fessor, '33-professor, '42-'54) wasawarded the National Medal of Science bythe President of the United States on Janu­ary 14 "for outstanding contributions tocell biology and understanding of the de- velopment of the nervous system includingthe basis for surgical repair of injury toperipheral nerves". Dr. Weiss is a memberand officer of numerous societies includingthe National Academy of Science. He isthe author of more than 300 scientific pa­pers and six books.AnatomyAppointment:Armand de Ricqles-Visiting ProfessorDr. Francis J. Manasek, AssociateProfessor in the Departments of Anatomyand Pediatrics and the Committee on De­velopmental Biology, gave an invitedaddress "The Tubular Heart: Developmentand Fate" at the symposium "CardiacShape and Structure" sponsored by theCardiac Mechanics Section of the Amer­ican Physiological Society in Anaheim,California. Dr. Manasek was also an in­vited participant in the Workshop onMechanisms of Cardiac Morphogenesis andTeratogenesis in Lausanne, Switzerland.He was chairman of the session on Ex­tracellular Matrix and also presented a pap­er "Synthesis and Distribution of Gly­copeptides and Glycosaminoglycans in Cul­tures of Embryonic Heart Cells."AnesthesiologyAppointment:Dr. Setlur Ranaraj-InstructorBiochemistryAppointment:Dr. Takaji Miyake-Visiting AssociateProfessorBiologyDr. A. A. Moscona, Louis Block Pro- fessor of Biological Sciences was an in­vited speaker at a symposium on "Gluta­mine: Metabolism, Enzymology and Reg­ulation," held in Mexico. This symposiumcommemorated the fiftieth anniversary ofthe National University of Mexico. He wasa participant and speaker at a meeting on"Cell Interactions and Development," heldat the University of Puerto Rico, MedicalScience Campus.Emergency MedicineAppointment:Dr. Ann L. Harwood-Assistant Profes­sorMedicineAppointment:Dr. Rodwin Jackson-Visiting AssociateProfessorDr. Leslie J. DeGroot, Professor in theDepartments of Medicine and Radiologyand Head of the Endocrine Section, partici­pated in a speaking tour that includedseveral major cities in Asian countries. Hespoke on the general subject of "ThyroidNodules and Cancer" in cities such asBangkok, Hong Kong, Taipei, Osaka, andTokyo, and also in Honolulu, Hawaii. Justbefore this tour began, Dr. DeGroot pre­sented two papers at two separate interna­tional meetings held in Australia, as fol­lows: "Mechanism of Triiodothyronine Sti­mulation of RNA Polymerase in Rat LiverNuclei" was presented at the Eighth Inter- national Thyroid Congress in Sydney;"Mechanism of Thyroid Hormone Actionon the Cell Nucleus" was presented at theSixth International Congress of Endocrinol­ogy in Melbourne.Dr. Michael O. Blackstone, AssistantProfessor in the Department of Medicine(Gastroenterology), presented a lecture atthe Gottlieb Memorial Hospital in MelrosePark, Illinois, The title of his lecture was"Cancer of the Pancreas."Dr. Michael Field, Professor in the De­partments of Medicine (Gastroenterology)and the Pharmacological and PhysiologicalSciences, was presented with the fourthannual Hoffman-LaRoche Award in Gas­trointestinal Physiology by the Gastro­Intestinal Section of the American Phy­siological Society at its thirtieth annualmeeting in Anaheim, California. He wascited for his "several outstanding contribu­tions to the understanding of active electro­lyte secretion of the intestine." He deli­vered a lecture: "Intestinal Anion Trans­port: Separate Mechanisms of Mucosal andSerosal Borders."Obstetrics andGynecologyDr. Marshall D. Lindheimer, Professorin the Departments of Medicine and Ob­stetrics and Gynecology, lectured at AinShams University, Cairo, Egypt, where hewas an invited consultant of the local com­mittee planning a Congress for the Interna-35tional Society for the Study of Hyperten­sion. He also was an invited speaker at anInternational Symposium on HypertensiveDisorders in Pregnancy, honoring the re­tirement of Leon Chesley, held at Down­state Medical Center, State University ofNew York.Dr. Atef Moawad, Professor in the De­partment of Obstetrics and Gynecology,Chief of Obstetrics and Co-director, Peri­natal Center, and co-chairman of an Inter­national Symposium on Uterine andPlacental Blood Flow which was held atthe Center for Continuing Education, re­ceived a grant of $16,320 from the Nation­al Heart Lung and Blood Institute towardthe support of this meeting.Dr. Gebhard F. B. Schumacher, Pro­fessor and Chief of the Reproductive Biol­ogy Section in the Department of Obstet­rics and Gynecology and in the Committee onImmunology, was an invited speaker at theplenary session of the 169th annual meet­ing of the Society of Gynecology andObstetrics of Rheinland/Westphalia inCologne, West Germany. The topic of histalk was "Immunological Fertility Disturb­ances. " He also was guest professor at theDepartment of Obstetrics and Gynecology,University of Essen, where he deliveredlectures on "Immunology of Reproductionand Fertility-Experimental and ClinicalAspects. "OphthalmologyDr. Frank W. Newell, Raymond Pro­fessor and Chairman, Department of Oph­thalmology, was elected president of theAcademia Ophthalmologica Internationalisfor 1980-1984 at its recent meeting in Lon­don. The group is limited to 50 memberswho must have published at least I bookand 100 scientific papers. Dr. Newell alsogave the 8th F. Bruce Fralick Lecture atthe annual seminar of the Department ofOphthalmology at the University of Michi­gan. Dr. Fralick was an Instructor inOphthalmology at the University of Chica­go from 1931 to 1932. He was Professorand Chairman of the Department ofOphthalmology at the University of Michi­gan from 1937 until his retirement in 1972.Dr. Ramesh C. Tripathi, Professor,and Dr. Brenda J. Tripathi, ResearchAssociate (Assistant Professor), in the De­partment of Ophthalmology, jointly pre­sented "Lowe's Syndrome-Ocular Pathol­ogy" at the centenary meeting of theOphthalmological Society of the United36 Kingdom recently held in London, and"Clinicopathologic Study of Peters'Anomaly" at the fourth meeting of theEuropean Congress of Ophthalmology heldin Brighton, England.PathologyAppointment:Dr. David M. Scollard-Visiting Assis­tant ProfessorDr. Robert W. Wissler, Donald N.Pritzker Distinguished Service Professor inthe Department of Pathology and Professorin the College, was chairman of the work­shop entitled "Laboratory-ExperimentalSection" of the Conference on the HealthEffects of Blood Lipids: Optimal Distribu­tions for Populations," sponsored by theAmerican Health Foundation in New York.The proceedings were published in Preven­tive Medicine (November 1979).PediatricsDr. Mila Pierce, Professor Emeritus inthe Department of Pediatrics, was pre­sented with a special plaque commemorat­ing her 50 years of service in the field ofPediatric Hematology/Oncology. Duringthe recent award dinner, sponsored by theHematology/Oncology Section of the De­partment of Pediatrics, physicians from theChicagoland area and Michigan along withrepresentatives from the Children's Re­search Foundation, celebrated the outstand­ing achievements made by this dedicatedphysician. Dr. Pierce is the Pediatric Con­sultant in the section of Clinical Hematolo­gy at Rush-Presbyterian-St. Luke's MedicalCenter.Dr. F. Howell Wright, Professor Emer­itus in the Department of Pediatrics, re­ceived the Abraham Jacoby Award of theAmerican Academy of Pediatrics at itsSpring meeting in Las Vegas. Pharmacological andPhysiological SciencesDr. Leon I. Goldberg, Professor in theDepartments of Pharmacological and Phy­siological Sciences and Medicine, andChairman, Committee on Clinical Pharma­cology, was an invited speaker at a sympo­sium entitled, "Origins of TherapeuticAdvance" celebrating the 1 OOthanniversary of the Burroughs WellcomeFoundation and the 50th anniversary ofDuke University School of Medicine heldat Duke. The title of his lecture was "CanPublic and Private Research Meet theObjectives Set by Consumers-Can theUnited States Stay at the Forefront of NewDrug Development?"Dr. Goldberg also was the Morris HenryNathanson Memorial Visiting Professor atthe University of Southern California. Hegave formal lectures, participated in semi­nars with students, and presented the AlphaOmega Alpha honorary medical societylecture "Creativity and Ethics in ClinicalResearch. "PsychiatryAppointment:Dr. Robert L. Sprague-Visiting Profes­sorMembers of the Parent-Infant Develop­ment Service of the Department ofPsychiatry Child Psychiatry Clinic pre­sented three papers at the InternationalConference on Infant Studies in NewHaven, Connecticut. These papers were:"The Development of Maternal FeelingsDuring Pregnancy" by Myra Leifer; "AnInvestigation of Mother-Infant Interactionin a Methadone-Addicted Population" byJoanne Householder; "An InterventionModel for Mothers and Infants" by ChayaRoth. All three are Research Associates(Assistant Professors) in the Department ofPsychiatry.Dr. Lawrence Z. Freedman, Founda­tions Fund Research Professor in the De­partment of Psychiatry, participated in twoworkshops at the International Society ofPolitical Science in Boston. He discussedthe "Duty to Inform" intended victims ofthreats of violence against them by releasedmental patients. This topic concerns lawcases and decisions affecting psychiatrists'duties to their patients and the public. Dr.Freedman also took part in a session onterrorism, presenting a paper on "Personal­ity Factors in Terror Games." The lattertopic concerns a United States governmentterrorist simulation game in which Dr.Freedman took part in Washington in1979. He also discussed "Why Does Ter­rorism Terrorize?" at the meeting of theAmerican Academy of Psychoanalysts inSan Francisco.Dr. Chase P. Kimball, Professor in theDepartments of Psychiatry and Medicine,and the College, presented the annual lec­ture in psychosomatic medicine at the YaleUniversity School of Medicine. His topicwas: "Non-compliance: A Study of PatientBehavior in a Hypertensive Clinic." Healso participated in an on-going study ofmedical student education, the developmentof courses in medical ethics, and a discus­sion of what constitutes a behavioral scien­ce course for psychiatry.He also presented the annual academiclecture of the Ontario Psychiatric Societyin Toronto. His topic was "Reactions toIllness: The Psychosocial Stresses of theIntensive Care Unit."Dr. Kimball participated in a symposiumon "Stress, Anxiety, and Illness" at theProvidence Hospital, University ofWashington.RadiologyThe Department of Radiology honoredthe memory of the late Marc Tetalman('68) on June 23 at a dinner at the Quad­rangle Club when Mrs. Marc Tetalmanpresented the Marc Tetalman Award to Dr.Paul Frank, Associate Professor in Radiol­ogy and Director of the Section of Di­agnostic Radiology, in recognition of "out­standing contributions to the residencytraining program." The recipient waschosen by the current residents. This willbecome an annual award and a plaque withthe recipient's name will be hung in theDepartment of Radiology.Dr. Eugene Duda, Associate Professorand Director of Neuroradiology, Depart­ment of Radiology, presented three lecturesat the International Special ProceduresConference held May 19-22, 1980 in Hill­side, Illinois, as follows: "MagnificationStereoscopic Cerebral Angiography: ANew Technique," "Interventional Neuro­radiology," and "Computer-Aided Tech­nique for Combining Cerebral Angiographyand Computed Tomography." SurgeryMembers of the Department of Surgerypresented papers before the Society of Uni­versity Surgeons meeting at Houston asfollows: "Etiology and Pathogenesis ofAcute Biliary Pancreatitis;" "Pathogenesisof Esophagitis in Patients with Gastro­esophageal Reflux;" "Artery Stenosis In­hibits Regression of Diet-Induced Ather­osclerosis. "Dr. Edwin L. Kaplan, Professor andGeneral Surgeon in the Department ofSurgery, recently became President-elect ofthe American Association of EndocrineSurgeons.Dr. Gerald Chodak, resident in Urolo­gy, received first prize in the Walter S.Kerr, Jr. Resident Prize Essay Contestsponsored by the American UrologicalAssociation Inc. His essay was entitled"The Economic Ramification of UsingProphylactic Antibiotics in UrologicSurgery. "Dr. A. R. Moossa, Professor in the De­partment of Surgery (General), acted asvisiting professor at the Cedars-SinaiMedical Center in Los Angeles. He wasalso guest speaker at the PostgraduateCourse in General Surgery organized bythe Department of Surgery of the Universi­ty of California at San Francisco and theHoward C. Naffziger Surgical Society. Dr.Moossa lectured on pancreatic cancer di­agnosis and treatment, operative injury ofthe bile duct and management of the pa­tient with an obstructed colon. Dr. Moossawas recently elected to the American Sur­gical Association.Dr. Lawrence A. Pottenger, AssistantProfessor in the Department of Surgery(Orthopedics), presented a paper at theOrthopaedic Research Society entitled"Formation of Intracartilaginous Prote­oglycans Aggregates in Vitro."Zoller Dental ClinicAppointment:Dr. Reza S. Mostofi-Assistant ProfessorDr. Louis Fine, Associate Professor inthe Zoller Dental Clinic, presented an all­day Continuing Education Program to theScott County Dental Society in Davenport,Iowa. The title of the program was "AConservative Approach for Immediate andOverdentures. " Continuing MedicalEducationAugust 9The Film Badge - Why, How, Where,What5 creditsAugust 16-23Tutorial on Clinical Cytology76 creditsSeptember 27-29Problem Solving in Lung Disease: A Prac­tical ApproachSeptember 28-30 and December 4-6Psychiatry Board Preparation: Part II20 creditsSeptember 29 - October 3Tutorial on Neoplastic Hematopathology40 creditsOctober 15-18Postgraduate Course in Obstetrics andGynecology26 creditsOctober 25 - November 1 in Vienna,AustriaNinth International Tutorial on ClinicalCytology, in Vienna76 creditsDecember 1-4International Society for the Study ofHypertension in Pregnancy16 credits37Abstracts of the 1980Senior Scientific SessionNineteen senior medical students from theClass of' 80 presented reports on theirresearch projects at the 34th SeniorScientific Session held May 13.The all-day program was chaired by Dr.Wolfgang Epstein, Professor in theDepartments of Biochemistry andBiophysics and Theoretical Biology, theCollege, and Chairman of the Committeeon Genetics.Chairman of the four sections of theScientific program were: Dr. LawrenceDevoe, (,70) Assistant Professor in theDepartment of Obstetrics and Gynecology;Dr. Fredric Coe, ('61) Professor in theDepartment of Medicine, Michael ReeseHospital; Dr. Javad Hekmatpanah,Professor in the Department of Surgery;and Dr. Elliott Kieff, Professor in theDepartments of Medicine andMicrobiology, the Committees on Virologyand Immunology, and Chief of the Sectionof Infectious Disease.Histochemical and ImmunologicalStudies of Atheroma-Derived Fat-Filled("Foam") CellsEugene J. BartucciSponsor: Dr. Robert W. WisslerDiscussant: Dr. Robert L. HunterThe origin of a variable population of fat­filled cells (so called "foam" cells) in bothhuman and experimental animal diet­induced atherosclerotic lesions has longbeen in doubt. It has been suspected thatsome of these cells are derived fromsmooth muscle cells in the arterial wallwhich have imbibed excessive amounts ofLDL which they cannot metabolizeadequately while others are derived frommonocytes that infiltrate the arterial intimafrom the blood stream. In this study cellsof this sort isolated from diet-induced ex­perimental arterial intimal plaques ofNZW-rabbits and M. fascicularies (cyno­molgus) monkeys and from human surgicalamputation material were analyzed forseveral features characteristic of mac­rophages. These included I) surface bind­ing and phagocytosis of IgG-coated ery­throcytes to detect specific surface recep­tors, 2) cytochemical tests for cell func­tion, 3) ultrastructural study to evaluatemorphology, and 4) rapid adherence toglass, a feature of macrophage activity.38 Both the easily dislodged cells fromatheromatous lesions and cells migratingout of explanted lesions were studied. 80-90% of the easily dislodged glass adherentcells from lesions had surface receptors forthe Fe-portion of IgG. Coated red bloodcells were phagocytized, but non-coatedcells were not. Acid lipase activity wasdemonstrated in the Fe-receptor positivecells and these cells were devoid ofultrastructural features of smooth musclecells. Similar results were found for apopulation of large round foam cells mig­rating from explants; while another popula­tion of largely fusiform lipid vacuolatedcells that grew out of ex plants had none ofthese characteristics and were believed tobe smooth muscle cells. These data indi­cate that an important part of the popula­tion of "foam" cells in atheromatous le­sions are probably derived from mono­cytes.Genetic Variation and Evolution inCameroon: Thermostability Variantsof Hemoglobin and ofGlucose-6-Phosphate DehydrogenaseShelly C. BernsteinSponsor: Dr. James E. BowmanDiscussant: John L. Hubby, Ph.D.The amount of genetic variability and themechanism of the maintenance of thisvariability have been objects of consider­able research in population genetics. Avariety of techniques have been used todemonstrate variability in populations, themost important of which, recently, hasbeen the electrophoresis of proteins. Theo­retically, however, the majority of aminoacid substitutions will be missed by stan­dard electrophoresis. In order to detectsome of the variability that is not revealedby electrophoresis alone, heat denaturationfollowed by the electrophoresis of hemo­globin and of red cell glucose-6-phosphatedehydrogenase was performed on samplesfrom subjects in Cameroon, EquatorialAfrica.The number of thermostability variantsper electrophoretic allele was estimated forhemoglobin and G6PD. A minimum of 3to a maximum of 13 thermostabilityvariants were estimated for Hb A and HbSand a minimum of 2 to a maximum of10 thermostability variants were estimatedfor Gd A, Gd B, and Gd A. Heat de­naturation determinations were reproduciblein samples from the same individual andpost-translational modifications were ex­cluded as a source of increased variability.Pedigree analysis and analysis of varianceindicated that hemoglobin and G6PD thermostability variants are genetically de­termined, and are probably structural inorigin.Hemoglobin and G6PD appear to be pro­teins that tolerate a variety of amino acidsubstitutions, the effects of which run thegamut from apparently neutral to severelypathological. It is not difficult to envisagea role for both natural selection and ran­dom genetic drift in determining the manypolymorphisms that occur in populations.The extraordinary incidence of allelicvariation, as demonstrated by thermostabil­ity, ultimately provides abundant substratefor the process of molecular evolution.The Molecular Epidemiology of HerpesSimplex VirusesTimothy G. BuchmanSponsor: Bernard Roizman, Sc.D.Discussant: Dr. Elliott KieffIn herpes simplex virus (HSV) DNA, thepresence and location of restriction en­donuclease cleavage sites are stable geneticproperties subject to drift. Because thevirus is maintained in the host, sometimesfor the lifetime of the individual and istransmitted by personal contact, non-lethalmutations affecting the presence and loca­tion of cleavage sites are perpetuated in thepopulation. This is reflected in the observa­tion that no two epidemiologically unre­lated isolates have so far been identical,whereas virus maintained in tissue cultureor in the human host or transmitted fromone individual to another retains its uniquecleavage patterns, exemplified in our handsby agarose gel electrophoresis of DNAcleaved with EcoRl, Bgl II, Hsu I, Hpa I,Kp n 1 and Bam HI restriction endonu­cleases. We have applied this analyticaltechnique to five clinical situations to dem­onstrate the following:First, in a temporal cluster of cases ofHSV-l encephalitis, none of the isolateswere related. In the second and third situa­tions, sets of isolates were obtained frominfants whose hospitalization in pediatricintensive care units was spatially (byisolation bassinets) and temporally sepa­rated: one set proved to be unrelated HSV-2 isolates, thus documenting coincidentalinfection, while the other set contained twoHSV -1 isolates that gave identical cleavagepatterns. Either two independent strainswere fortuituously indistinguishable or thevirus was transmitted in some fashion fromone infant to the second. Fourth, in anotherpediatric intensive care unit, we demon­strated two independent introductions ofvirus. One virus was apparently introducedby a patient and transmitted to and throughthe nursing personnel. The second viruswas initially isolated from a symptomaticnurse and subsequently recovered fromsymptomatic and asymptomatic nurses, aswell as a patient. Fifth, we studied sequen­tial isolates from each of eight patientswho had recrudescent genital lesions anddemonstrated that infection with HSY -2 inthe same or nearby site can occur in theface of prior infection with a geneticallydifferent strain of the same serotype.We concluded that restriction endonu­clease analysis of groups of isolates is anovel and useful tool in epidemiologicstudies of HS Y, providing rapid, accurateestimates of viral relatedness.Pharmacologically Induced Alterationsin Striatal Tyrosine Hydroxylase ActivityJohn D. CheronisSponsor: Dr. Alfred HellerDiscussant: Richard J. Miller, Ph.D.One method of measuring the turnoverrate of neurotransmitters (an estimate ofneuronal activity) is the assessment of thedecline in tissue levels of the transmitter inquestion after the inhibition of its biosyn­thesis. In this way the decline in the levelsof dopamine in the striata of rats after theinhibition of tyrosine hydroxylase (TH) byalpha-methyl tyrosine (AMT) has beenused to investigate the "activity" of thenigrostriatal dopamine neurons undervarious experimental conditions. Implicit inthis estimate of transmitter turnover is theassumption that the blockade of biosyn­thesis in no way alters the activity of theneurons under investigation.Increases in the activity of nigrostriataldopamine neurons caused by either directelectrical stimulation or by treatment withneuroleptics such as haloperidol has beenclosely correlated with an increased affinityof TH for the cofactor 6-methyl, 2, 3, 4,5-tetrahydropterine (6MPH4) when mea­sured in vitro. We have shown that AMT(400 rug/kg, methyl ester, S.c.) is associ­ated with a decrease in the K.m of striatalTH for 6MPH4 similar to that caused byhaloperidol (2 mg/kg , S. C.). This resultsuggests that a hitherto unrecognized con­sequence of inhibition of dopamine biosyn­thesis may be an increase in neuronalactivity.The Prediction of Unusual PostoperativeResults by Urodynamic Testing inBenign Prostatic HyperplasiaRichard J. CoteSponsor: Dr. Harry W. SchoenbergDiscussant: Dr. Edward S. Lyon A survey of pre- and postoperative urineflow rates, urodynamic data and symptomsin patients undergoing transurethral pros­tatectomy (TURP) for benign prostatichyperplasia (BPH) indicates that there arecertain urodynamic findings which can helppredict early and late postoperative symp­toms. It is generally accepted that long­term obstruction of the bladder can lead toloss of normal neurologic control of detru­sor function, resulting, in some cases, inlow volume, high pressure detrusor con­tractions that cannot be inhibited by the pa­tient. This phenomenon is known as detru­sor hyperreflexia. In our series, althoughall patients demonstrated relief of their ob­struction when postoperative urine flowrates were measured (P < .005),28% of thepatients who had a hyperreflexic detrusor re­sponse had an exacerbation of the symp­toms of obstruction (frequency, nocturiaand urgency) at 4 weeks following surgery,while none of the patients with a normaldetrusor response noted any increase intheir symptoms. At 3 months postoper­atively, all of the patients complaining ofobstructive symptoms demonstrated detru­sor hyperreflexia. Patients with detrusorhyperreflexia preoperatively tended to re­vert to a normal detrusor response follow­ing the relief of bladder obstruction, withonly 41 % of patients remaining hyperre­flexic at 3 months postoperatively. It isconcluded that the preoperative finding ofdetrusor hyperreflexia should alert thesurgeon to the possibility of untoward re­sults following surgery. Although the de­trusor response will eventually become nor­mal in most of these patients postoperative­Iy, thus relieving the exacerbation of theirsymptoms, pharmacologic managementbased on well-established principles maybe used to alleviate the acute problem.The Conformation of the CarbonMonoxide Bound Heme Group inMyoglobinRobert S. DanzigerSponsor: Marvin W. Makinen, Ph.D.Discussant: John Westley, Ph.D.Kinetic studies have demonstrated that inthe binding of molecular oxygen (02) andcarbon monoxide (CO) by myoglobin(Mb), there are two protein related struc­tural barriers to the binding of carbon mon­oxide while there is only one in the bind­ing of oxygen. Since the structure ofmyoglobin does not change greatly withligand binding, the origin of the addedsteric barrier to CO binding is notassigned. My studies were carried out toinvestigate possible conformational differ­ences in the binding of carbon monoxide and molecular oxygen to the heme iron inmyoglobin.The conformation of the carbon monox­ide bound heme was characterized on thebasis of polarized single crystal absorptionspectra. Metmyoglobin crystals (spacegroup P212121) were converted to the CObound form by chemical reduction withadded sodium dithionite under approx­imately 2 atm. of carbon monoxide in areaction bomb.The polarized absorption spectrum ofMbCO in single crystals shows an increasein the intensity of the Qo band and addedz-polarized intensity near 21 OOOcm-l.These features are not characteristic of theMbCO molecule in solution or in crystalswhich contain small (20-30%) fractions ofmetmyoglobin. The increase in the intensi­ty of the Qo band can be ascribed to a lift­ing of the degeneracy of the excited statesof porphyrin electron system by structuralperturbation of the axial ligand. The addedintensity near 21000cm-' is ascribed to apromotion into the iron dz2 orbital, whichis decreased in energy, as expected for abent heme-CO conformer. These results in­dicate that there are at least two conforma­tional states of herne-CO groups in myog­lobin. Only one conformer of the oxyhemegroup has been demonstrated in crystal andsolution states. The extra structural barrierto CO binding is probably related to themultiple conformations available to theheme-bound CO ligand.Contrasting Defects of T-lymphocyteMitogenic Response in MultipleSclerosis and Myasthenia GravisEdward J. DropchoSponsor: Dr. David P. RichmanDiscussant: Dr. Jack P. AntelAbnormalities of immune function appearto operate in the pathogenesis of multiplesclerosis (MS) and myasthenia gravis(MG). Diminished avid E-rosette formationand reduced suppressor T lymphocyteactivity occur in MS and there is evidencefor defective immune regulation in MG. Tofurther investigate T cell function in thesediseases, we studied the dose response pro­file of peripheral blood lymphocytes to thephytomitogen concanavalin A (Con A) in10 patients with MS, in 6 patients withMG, and in 12 healthy controls by measur­ing uptake of tritiated thymidine after 72 hrin culture. For normals, the unfractionatedblood mononuclear cells (MNCs) preparedby Ficoll-Hypaque centrifugation respondedto a wide range of Con A concentrations(0.3 to 150 ugrnlml) with a broad peak andmaximum response of 74.9 ± 3.8 x 103cpm (mean ± SEM) at 15 ugrnlml Con A.Purified T cells obtained by E rosetting re-39sponded to a much narrower range of Con Aconcentrations (6 to 60 ugm/ml) with asharp peak of 38.1 ± 4.4 x 103 cpm at30 ugmlml Con A. Addition of purifiedmonocytes restored the T cell response to 3ugmlml Con A to that of the MNCs. Thesedata suggest two distinct mechanisms for Tcell stimulation by Con A: one system thatresponds to low concentrations of Con Abut requires the mediation of monocytes,and another system that is relatively inde­pendent of the presence of monocytes butresponds mainly to higher concentrations ofCon A. Neither the background counts forMNCs and T cells nor the shapes of thedose response curves in MS and MG pa­tients differed from controls. However, inMS the MNC response was diminished atall Con A concentrations (peak response56.3 ± 2.8 x 103 cpm, p < 0.05), whilethe response of purified T cells did not dif­fer from normals. In contrast, the MNC re­sponse in MG patients was normal, whilethe T cell response was markedly reduced(peak response 22.6 ± 9.6 x 103 cpm, p< 0.01). These results reveal an abnormal­ity in MS of monocytes and/or of a mono­cyte-dependent T cell subset, while in MGthere is a decreased responsiveness of themonocyte-independent T cell subset.Experimentally Induced Abnormalitiesof Heart RotationLorraine A. FitzpatrickSponsor: Dr. Francis ManasekDiscussant: Dr. Wade HamiltonIn all vertebrates including man the earlyembryonic heart rudiment undergoes rapidbulging and rotation to form a so-called"loop", normally to the right (d-Ioop).Previous experiments on isolated chickembryo hearts demonstrated that bending isintrinsic to the heart. However, the regula­tion of the direction of the loop in un­known. For example, a strain of micehomozygous for gene iv exhibits random­ness with respect to the direction of loop­ing. It is not know if this defect is cardiacor extracardiac in origin. Some investiga­tors have demonstrated that physical forcesmay alter cardiac morphogenesis. Theplacement of glass rods on the splanchno­pleure or surgical cuts through this regionresults in variations in cardiac looping.In the present experiment intact chickembryos were cultured in vitro. Cuts weremade in the pericardial splanchnopleure oneither side of the embryo. Embryos wereincubated and observed for direction ofcardiac looping. Embryos with left-sidedless ions developed largely d-loops (94%)similar to control hearts. Embryos that re­ceived right sided lesions, however, were40 53% d-looped and 47% either midlinelooped or left-looped (I-loop). Bilateralcuts or complete removal of splanchno­pleure resulted in normal d-looping.This experimental model demonstratesthat an extracardiac event can alter the nor­mal asymmetry of the developing heart.Cutting the right splanchnopleure apparent­ly introduces a new signal since bilateralcuts or total removal of splanchnopleure re­sult in normal situs. Thus, the heart canloop normally in the absence of splanchno­pleure but the presence of abnormal splan­chnopleure can alter development.These experiments implicate the splanch­nopleure as a possible origin of the phe­notypic defect in homozygous iv mice. Ex­amination of this hypothesis may offer anexplanation for abnormal cardiac loopingand insight into normal cardiac mor­phogenesis.Characterization of an Abnormal Insulinin a Patient with Diabetes MellitusBruce D. GivenSponsor: Dr. Arthur H. RubensteinDiscussant: Howard S. Tager, Ph.D.We evaluated a 51 year old man diagnosedas being diabetic in 1970, who had beencontrolled with diet and oral hypoglycemicagents. In 1977, he was mildly hyperg­lycemic and markedly hyperinsulinemic.Circulating serum insulin antagonists in­cluding glucagon, growth hormone, andcortisol were not evaluated; insulin anti­bodies and receptor antibodies were absent.Proinsulin levels were normal. In vivo testsof sensitivity to exogenous insulin ruledout true insulin resistance. Insulin receptorson the patient's circulating monocytes werepresent in normal numbers. These resultssuggested an abnormality in the patient'scirculating insulin.The patient's serum insulin was isolatedvia affinity chromatography. The purifiedinsulin bound to IM-9 lymphocytes and ratadipocytes 40-43% as well as insulin fromhuman controls. Its biological activity, de­termined via radiolabeled glucose uptakeand oxidation in rat adipocytes, was furtherreduced to 14-16% of that seen in controls.Following laparotomy for an abdominalmass involving the pancreas, 3.1 grams ofnormal pancreas was made available to us.Insulin was extracted from this tissue with95% purity. The above binding and biolog­ical activity results were confirmed. Aminoacid analysis revealed a lower than ex­pected value for phenylalanie (2.4 v 3) andhigher than expected for leucine (6.6 v 6).The phenylalanie residue normally presentat the NHz terminus of the B-chain wasconfirmed. Two phenylalanine residues normally occur in the terminal octapeptideof the B-chain (positions 23 and 24).Analysis of this fragment revealed 1.4phenylalanine residues (nl 2.0) and 0.6leucine residues (nl 0).We conclude of this patient producesboth normal and abnormal insulin with aresulting reduction in biological activityleading to clinical diabetes.The Organization of the DNA of theEpstein-Barr VirusDouglas B. GivenSponsor: Dr. Elliott KieffDiscussant: Dr. Werner KirstenThe Epstein-Barr Virus (EBV) is a herpes­type virus endemic in all human popula­tions. EBV is the causative agent of infec­tious mononucleosis and is associated withBurkitt Lymphoma. The virus infectsIymphoctyes and remains latent indefinite­Iy. Following infection in vitro, lympho­cytes are transformed in growth potentialinto a continuous lymphoblastoid cell line.Because of the unique biological prop­erties of the virus including difficultygrowing and characterizing the virus byclassical virologic procedure, detailedknowledge of the viral DNA was essentialto understanding the mechanisms by whichthe virus transforms cells. Previous studiesof the DNA of purified virus indicated theDNA is a linear, nicked double-strandedmolecule of I. I x 108 daltons with a basecomposition of 58 mol% guanine pluscytosine. Furthermore, the size of DNAfragments generated by several restrictionendonucleases was known.In this study the arrangement of restric­tion enzyme sites in the DNA of severalisolates was determined from the size ofthe single-enzyme-cleaved fragments andfrom blot hybridizations that identify whichfragments cut from the DNA with one en­zyme contain nucleotide sequences in com­mon with fragments cut from the DNAwith a second enzyme. The data indicatethe common skeletal anatomy of the DNAconsists of four elements: a short segmentof 10 x 106 daltons, a segment consistingof between two and ten copies of a reiter­ated 1.9 x 106 dalton sequence, a longsegment of 80-87 x 106 daltons and ter­mini which consist of between one and tencopies of a 3 x 105 dalton sequence.In order to determine if the terminalDNA is a direct or inverted repeat, thestructures formed following denaturationand reannealing of the DNA from one ter­minus and after annealing of lambda­exonuclease-treated DNA were examinedin the electron microscope. The data indi­cate that there exist direct repeats at theends of the DNA. Hybridization betweenthe ends is likely to be the mechanism bywhich EBV DNA circularizes in infectedcells.Comparison of the DNAs of other iso­lates of EB V with the prototype isolatewhose DNA was originally characterizedhas led to the following findings: 1) Twoother isolates are missing a 7 x 106 daltonsequence in the long segment. The pro­totype isolate was derived from a patientwith infectious mononucleosis in contrastto the other isolates which were obtainedfrom Burkitt tumor tissue. The significanceof the difference in DNA in the long seg­ment with respect to the origin of the iso­lates is not clear. 2) One isolate which haslost a region of the DNA during passage inculture has lost the ability to transformlymphocytes. In contrast, the virus fromthe parent cell line transforms lympho­cytes. 3) The structure of a nonhuman pri­mate EBV isolate is similar to that of hu­man EBV DNA and discrete segments ofnucleotide homology are conserved.Tricyclic Antidepressants ReduceAcetylcholine Turnover and HighAffinity Choline UptakeMichael KarbowskiSponsor: Dr. Angelos HalarisDiscussant: Dr. Thomas G. AignerCentral cholinergic imbalances appear toplaya role in the pathogenesis of affectivedisorders. We therefore determined theeffect of tricyclic antidepressants (TAOs)on acetylcholine (ACh) turnover. Groupsof six mice were administered 2S or SOmg/kg, i.p., of amitriptyline (AMI), dox­epine (DOX), iprindole (IPR), chlorimipra­mine (CMI), imipramine (IMI) or desipra­mine (DMI). Thirty min. later, the micewere given 3H-Choline (Ch) (lSuCi/2Sg;Sp.act. 10 Ci/rnrnole), i.v., one min. priorto sacrifice. Labeled metabolites were sepa­rated and ACh turnover was determined bya previously reported method (Pharmacol­ogist 17: 182, 1975). All drugs tested pro­duced a significant decrease (p. < .OS) inArch turnover. Since the high affinity (HA)uptake of Ch may be the rate-limiting stepin the synthesis of ACh, we investigatedthe effect of the above drugs on HA uptakeof Ch. Whole brain synaptosomal suspen­sions were incubated with Krebs-Ringerbuffer, drug, and 3H-Ch (0.4uCi/ml;Sp.act. 10 Ci/rnmole) for 4 min. at 370 C.All drugs decreased the HA uptake of Ch(1.c.50 range: .9 to 8.S X 1O-5M). The de­crease in ACh turnover and Ch uptake wasnot related to the atropinic action of thesedrugs; the rank order of potency for in vi­tro uptake blockade was similar to the rank order for in vivo Ach turnover inhibition.The data suggest that the clinical effect ofT ADs may, in part, be related to a de­creased turnover rate and synthesis ofACh, which, in tum, may be secondary toa decreased uptake of Ch. Furthermore,these actions on the cholinergic systemmay predict which of the T ADs will bemore effective in agitated vs. retardive de­pression.Distribution of Neurotransmitters andPossible Neurotransmitters in theHuman Gastrointestinal Tract inInflammatory Bowel DiseaseTimothy R. KochSponsors: Dr. David R. Cave and Dr.Joseph B. KirsnerDiscussant: Dr. Richard J. MillerThere is little published data on the dis­tribution and quantitation of neurotransmit­ters of the human intestinal tract. In thisstudy we utilized ileal and colonic tissuesremoved at surgery for a variety of dis­eases including carcinoma, diverticulosis,polyposis coli, ulcerative colitis (U'.C.'),and Crohn's disease (C.D.).Glyoxalic acid condensation staining ofhistological sections allowed semi-quan­tation of catecholamines on a scale of 0-4 +, while quantitation of norepinephrine(NE) and dopamine (DA) utilized aradioenzymatic (RE) assay of tissue sam­ples. Results are summarized in the table.Morphologically the catecholaminergicnerves of the colon were increased in U. C.but there was no significant increase in NEor DA.The 5-amino acid polypeptides met- andleu-enkephalin (ENK) appear to aid inmodulation of motility and secretory func­tions of the gut. Using antibody specificfor these "endogenous opiates", indirectimmunoperoxidase staining has revealedthe presence of ENK in human colon with­in the myenteric plexus only in 6 coloncarcinomas and 3 U .C. colons, but ab­scence of staining in 7 and only traces in 2C.D. colons. ENK deficiency in C.D. col­itis may provide a new mechanism for thediarrhea which may occur with minimal Horizontal and Vertical Pursuit EyeMovements, the Oculocephalic Reflexand the Functional PsychosesRichard B. LiptonSponsor: Dr. Patti TigheDiscussant: Dr. Jarl E. DyrudSixteen schizophrenic patients and 16 man­ic depressive patients, diagnosed by Feigh­ner criteria, and 14 non patient control sub­jects, were tested for horizontal and verti­cal smooth pursuit eye movements and theoculocephalic reflex. Eye movements wererecorded on F.M. tape using electronystag­mography and scored qualitatively using afive point rating scheme and quantitativelyusing frequency analysis. All patients withimpaired horizontal pursuit also displayeddisrupted vertical pursuit suggesting that acommon mechanism underlies these abnor­malities. The oculocephalic reflex was in­tact in all subjects whether or not pursuitwas disrupted, suggesting that the locus ofthe eye movement disorder in psychosismay be cortical. For horizontal pursuitthere were significant differences betweenschizophrenics and nonpatient controls(t = 2.43S, P = .02), between manic de­pressives and nonpatient controls (t =3.096, P = .02), but not between schizo­phrenics and manic depressives (t = .456,NS) suggesting that the smooth pursuit eyemovement disruption occurs with signi­ficant prevalence in the major functionalpsychoses and not only in schizophrenia.Regulation of Chylomicron MetabolismThomas W. LukensSponsor: Dr. Jayme BorensztajnDiscussant: Dr. Godfrey S. GetzThe initial step in the metabolism ofchylomicrons is the hydrolysis of theirtriacylglycerols (TG) by lipoprotein lipase(LPL). Using in vitro assay techniques andartificial TG emulsions as substrates, manystudies have shown that apoprotein C-II(apo C-II) stimulates LPL activity whileapo C-I and apo C-III inhibit it. Sincedisease.No. NE No. DA No. Mean NETissue Samples nglmg (SE) Samples ngtmg (SE) Samples StainingOther DiseasesIleum 8 3.4 (0.3) 8 0.49 (0 12)Asc. Colon 8 3.0 (0.2) 5 0.48 (0.28) 7 1.6+Trans. Colon 7 3.6 (0.5) 6 0.85 (0.17) 5 1.4+Desc. Colon 10 3.5 (0.5) 9 0.65 (0.14)Sigmoid 9 5.3 (0.5) 9 0.89 (0.17) 8 1.6+Crohn's Ileum 10 3.2 (05) 9 0.72 (014)Ulcerative ColitisAsc. Colon 10 4.3 (06) 8 0.97 (0.20) 8 1.5+Trans. Colon II 3.2 (0.2) 7 0.42 (0.09)Desc. Colon 10 3.2 (0.5) 4 1.17 (0.22) 8 1.9+Sigmoid 6 3.5 (0.7) 3 0.42 (0.10) 9 2.2+41these apoproteins are normally present onthe surface of chylomicrons, it had beenassumed that they play a major role in thein vivo regulation of LPL action, andtherefore the metabolism of chylomicrons.In order to study the physiological interac­tion of LPL with chylomicrons in the pre­sence of C apoproteins, chylomicrons werefirst depleted of their apoproteins by tryp­sin digestion. This treatment did not alterthe shape or lipid composition of thechylomicrons but effectively digested theirsurface apoproteins.Direct evidence that apo C-II activatesLPL in vivo was obtained using the iso­lated perfused rat hearts, a model system inwhich LPL is bound to the capillary en­dothelium, its physiological site of action.The rate of hydrolysis of TG in apoprotein­depleted chylomicrons perfused through thehearts was markedly reduced (> 80%) butcould be restored to normal levels by bind­ing small amounts of apo C-II to the sub­strate. When apo C-I or apo C-III wereadded to the trypsinized chylomicrons noeffect on enzyme activity was noted. Furth­ermore, apo C-I or apo C-III did not alterthe rate at which apo C-II reactivated chy­lomicrons were metabolised, suggestingthat they, unlike apo C-II, do not have arole in the regulation of LPL activity invivo.Chronic Daily Narcotic Use in Patientswith Crohn's DiseaseRichard J. NovakSponsor: Dr. Richard F. GaekeDiscussant: Dr. Joseph B. KirsnerAn important consideration in the prescrip­tion of daily narcotic medication for chron­ic illness is the potential for narcotic de­pendence and addiction. One hundred con­secutive admissions to our gastroenterologyin-patient services were studied for theprevalence of chronic daily prescriptionnarcotic use and compared to 50 randomadmissions to the general medicine ser­vices.Results show 22% (5 of 22) of patientswith Crohns disease used narcotics dailyfor periods of I year or longer, comparedwith 3.8% (3 of 78) of the remainder ofthe gastroenterology patients (p < .03),and 2% (I of 50) of the general medicinepatients (p < .02). The 5 patients withCrohns disease who used narcotics dailyfor longer than one year had the followingcharacteristics: (I) Crohn ' s disease for atleast 5 years prior to onset of narcotic us­age; (2) narcotics prescribed for abdominalpain in 4 patients, and for diarrhea in onepatient; (3) length of daily use ranging42 from 18 months to 14 years; (4) multiplehospitalizations (mean = 16 per patient);(5) narcotics initially prescribed by referingphysician, prior to arrival at University ofChicago Medical Center. Drugs most fre­quently used were meperidine, codeine,and pentazocine.Others in the gastroenterology groupused narcotics for greater than one year forpain of peptic ulcer disease (1), chronicpancreatitis (1), and low back pain (1).Ulcerative colitis did not predispose tochronic narcotic use.Overall, 8% (8 of 100) of gastroenterol­ogy patients were taking daily narcoticmedication for 1 year or longer, comparedwith 2% (1 of 50) of the general medicinepatients (p = .27).These data demonstrate a higher preva­lence of chronic daily narcotic use in gas­troenterology patients, and establish thesignificant prevalence of chronic narcoticuse in patients with Crohn's disease. In ourexperience, patients with Crohri's diseaserepresent a high risk group for narcotic de­pendence and addiction.Continence After lIeo-Anal Anastomosiswith Ileal ReservoirGreg H. RibakoveSponsor: Dr. Wolfgang H. SchrautDiscussant: Dr. George E. BlockIleo-anal anastomosis has been investigatedas an alternative to ileostomy after totalproctocolectomy. However, such approachhas been complicated by incontinence andprolonged diarrhea. We have evaluated theeffectiveness of an ideal reservoir proximalto the ileo-anal anastomosis (6 dogs) atcontrolling these complications. The reser­voir was constructed by placing a reversed12 cm. segment of terminal ileum in aside-to-side fashion onto tile nco-terminalileum which was then anastomosed to theanus. The anal sphincter mechanism waspreserved. Four dogs with standard ileo­anal anastomosis served as controls. Allanimals survived 3-6 months.Normal sphincter control and reflexcould be ascertained in all dogs by man­ometric studies. Control animals exhibiteda constant fecal discharge whereas dogswith reservoir defecated 6-8 times in 24hours. Sequential compliance studies of thereservoir revealed a 200-300% increase incapacity within 6 weeks. Average intestinaltransit time (2-6 months post-operatively)was 110 minutes for control dogs and 200minutes for dogs with reservoir.Motility patterns were investigated by in­fusion and balloon manometry at monthlyintervals. Type I intestinal pressure waves (frequency: 10/minute;amplitude: 10-20cmH20) with intermittent superimposedtype III waves (elevation of baseline pres­sure by 15-40 ern H20; frequency: 2-41hour) were detected in control animalswhereas within the empty reservoir, onlyrespiratory variations were transmitted.Distention of the reservoir with 300-500cc's elicited type I waves but only occa­sional type III waves « lIhr).We conclude that continence after thedescribed operation is physiologic andoccurs because the reservoir is able tomaintain baseline pressures despite largedistending volumes.The Use of Histoacryl in TemporaryTarsorraphyLarry S. StoneSponsor: Dr. Ramesh TripathiDiscussant: Dr. Robert W. ParsonsA tarsorrhaphy is the temporary or perma­nent surgical union of the upper and lowerlid margins, customarily carried out bydenuding the lid margin epithelium andopposing the two surfaces with mattress su­tures. Within three weeks, fibrous adhe­sions between the lid margins form, andthe sutures are removed. Indications for theprocedure include exposure keratitis secon­dary to facial nerve paralysis or exophthal­mus, and keratitis metaherpetica.The interest of my investigation was theuse of Histoacryl (butylcyanoacrylate), atissue adhesive, for temporary lateral tar­sorrhaphy. Successful utilization of His­toacryl in lateral tarsorrhaphy would besignificant in that its usage would be lesscostly and less time consuming thanconventional techniques. Additionally, itwould be more suitable for the treatment ofdiseases requiring shorter periods of eyelidmargin union.Five rabbits (ten eyes) underwent gluetarsorrhaphy. I carried out the procedure byrubbing the epithelial surfaces with acetonein two eyes, and by denuding the lateral lidmargin epithelium by shaving or cauteriza­tion techniques in the remaining eyes. Inall eyes, I next applied Histoacryl and Iheld the eyelid surfaces together for thirtyseconds. In some of the eyes, I glued theupper eyelashes to the cheek to reinforcethe adherence. The mean duration ofadherence was 4.7::+::: 2.9 days for all groupscombined; the maximal length of adherencewas IO days.The feasibility of glue tarsorrhaphy wasdemonstrated, and the low incidence ofmorbidity and texicity found in rabbits jus­tifies its use in limited clinical trials. Pre­liminary results of suture less tarsorrhaphyhave been encouraging.Influence of Fatty Acyl ChainStereoisomerism on the RespiratoryActivity of an Unsaturated Fatty AcidAuxotroph of Saccharomyces cerevisiseElizabeth R. UngerSponsor: Dr. Godfrey GetzDiscussant: John H. Law, Ph.D.The effect on respiration of altering thefluidity of the hydrophobic environment ofmitochondrial membranes was studied. Theavailability of the unsaturated fatty acidauxotroph KDI15 of yeast allowed man­ipulation of the hydrophobic environmentby cis or trans C16: I supplementation tothe semi-synthetic growth medium. Theprototrophic parent strain S288C wasgrown as a control. Each isomer was asatisfactory supplement for growth and re­sulted in specific enrichment of C 16: I to70-80% of the total fatty acid compositionof the yeast. However, trans supplementedKDI15 had only 1110 the whole cell ox­ygen consumption of cis supplementedKD liS which in turn was comparable tothat of S288C grown with a cis or transsupplement. Further analysis of severalmitochondiral enzymes demonstrated aselective defect in the activity ofcytochrome c oxidase and in the content ofhemes aa , and b in trans C 16: I sup­plemented KD 115. Semiquantitative im­munoprecipitation of cytochrome c oxidasein cholate extracts of mitochondria fromtrans C16:1 supplemented KDI15demonstrated only half the cytochrome ox­idase precipitable from similarly preparedextracts of cis C 16: I KD 115. Electro­phoresis of the trans cytochrome c oxidaseimmunoprecipitates demonstrates a slowingor cessation in the processing of the pre­cursor of the cytoplasmic subunits in thatthere is an almost total absence of subunitsIV - VI and the appearance of high molecu­lar weight peaks at 52,000; 38,000 andSeniorScientificSessionWinners 21,000 daltons. The relationship of thesenew elements to the cytoplasmic subunitsof cytochrome c oxidase is the subject ofcontinuing investigation. It is speculatedthat the decreased fluidity of themitochondrial hydrophobic domain intro­duced by trans supplementation is responsi­ble for the observed changes in the quan­titative and qualitative content ofcytochrome oxidase, and the assembly ofthe holoenzyme.Iodine Absorption Following TopicalUse of a Povidone-Iodine SolutionJerrold ZeitelsSponsor: Dr. Edwin L. KaplanDiscussant: Dr. Samuel RefetoffIt is well known that iodine is absorbedorally and through mucous membranes ordenuded skin. It is less clear whetheriodine is absorbed through intact skin. Inorder to clarify this problem we studiedseveral human and experimental models.Urinary iodine excretion was measured inoperative patients and in volunteers whoreceived either an organic iodine solution(Betadine) or an acetone and alcohol opera­tive skin prep.In addition, these solutions were appliedto the backs of 250-270gm rats in such away that oral ingestion of the iodine wasnot possible. Twenty-four hours later, 13115fl-C, was given to each rat and a thyroiduptake of iodine was determined.Betadine preparation of the skin of ninesurgical patients resulted in a 24 hour urin­ary iodine excretion of 4,836 ± 2,002fl-giodine/gram creatinine (mean±S.E.). Insix other patients scrubbed with acetoneand alcohol, the mean 24 hour urinaryiodine excretion was 331.3 ± 162. 2fl-gllgcreat (p < 0.05). Pre-operative and post­operative urinary iodine values were deter­mined in four patients in each group. ATwo awards were presented to students fortheir exceptional presentations at the SeniorScientific Session. They received theirawards at the Graduation Dinner June 12.The Medical Alumni Prize for the bestoral presentation was awarded to Shelly C.Bernstein, who is taking his residency inpediatrics at Children's Hospital MedicalCenter in Boston. The Catherine DobsonPrize for the best oral presentation by anon-Ph.D. student was awarded to Lor­raine Ann Fitzpatrick, who is taking herresidency in internal medicine at ColumbiaUniversity-Presbyterian Hospital, NewYork. considerable increase in iodine excretionwas noted following operation in theBetadine group while no rise occurred inthe acetone and alcohol treated subjects.In eight normal volunteers, the 24 hoururinary iodine excretion was 138.3 ± 23.5fl-gllg creat. After undergoing a standardBetadine surgical hand scrub for ten mi­nutes, the 24 hour urinary iodine was250.1 ± 70.5fl-gUg creat. and after applyingBetadine solution to a 3x5 inch area of themedial side of their forearms, the 24 hoururine output was 190.1 ±35.8fl-glig creat.(N.S). However, in four volunteers whoscrubbed and painted their abdomen tosimulate the area prepped for a typicallaparotomy, there was a statistically signi­ficant rise in urinary iodine excretion. Pre­prep values of 144.8 ± I 6. 2 u.gl/g creat in­creased to 267.9 ± 15. I fl-glig creat at oneday post-prep. By one week after the skinprep, however, the increase was no longerdetectable.In the animal model, Group I rats,which were prepped with acetone and alco­hol had a mean thyroid uptake of 1311 of8.23 ± 0.34% of the administered dose.Group II rats, which had Betadine solutionapplied for two hours and then removed,had a 1311 uptake of 1.83±0.19 percentwhile Group III rats, which had Betadineapplied for a full 24 hours, had thyroiduptake values of 0.64±0.07 percent (p <0.01).Iodine solutions commonly used astopical antiseptic agents are absorbed dur­ing operation and can reduce the thyroiduptake of 13110dine. This could be particu­larly deleterious in patients with cancer ofthe thyroid who require radioactive iodinetherapy postoperatively, since misleadingnegative scans might be obtained if thesewere done soon after operation. We sug­gest that a non-iodine containing solutionbe used as a "skin prep" in patients under­going thyroidectomy for a nodule.43Additions To Medical Center Honor RollAlumni Patrons andDean's AssociatesGifts of $1 000 or more Dr. Richard J. Jones, '76Dr. Attallah Kappas '50Dr. Ernest S. Roberts, R'28Dr. & Mrs. Clarence Young , 53Century Club Dr. Faylon M. Brunemeier '55Dr. Asher J. Finkel '48Dr. Harold W. Fuller, R'39Dr. William R. Gronewald '64Dr. Michael Hoffman '69Dr. Gerald S. KaneDr. & Mrs. Robert Karp '70Dr. & Mrs. Charles E. Koch '55Dr. James R. McGrath '45Dr. & Mrs. Authur Rappeport, R'30Dr. K. K. ShinDr. Robert L. Smith '43Dr. Verner S. Waite '54Dr. Kenneth Yamashiro '66We would like to introduce our newclass chairmen: 1953Dr. Marvin Weinreb2457 Grove Way, Suite 106Hayward, CA 945441954Dr. Jerry Seidel104 Main StreetPark Ridge, IL 600681962Dr. B. H. Gerald Rogers505 N. Lake Shore Drive, Suite 5511Chicago, IL 606111980Dr. David Dries31-1 Chapel Tower1315 Morreene RoadDurham, North Carolina 277051937Dr. Joseph Teegarden5830 Stoney Island A venue, Apt. 40AChicago, IL 606371943 (March)Dr. Campbell Cutler420 South BallengerFlint, Michigan 485041950Dr. Attallah Kappas3 Sherman A venueBronxville, NY 1070844The times changeAnd we change with them.-From Owen's EpigrammataName Graduation YearHome Address TelephoneCity, State, ZipBusiness Address TelephoneCity, State, ZipTitleN ew address?N ew position?New medical practice?military assignment?civic or professional honor?book?Please tear out; fold, staple, or tape; and drop in the mail box.Thanks!45---------------------------------------------------Medical Alumni Association1025 East 57th StreetChicago, Illinois 60637 1------11 I1 Place 11 11 Stamp 11 Here 1I 11 11 --1--------------------------------------------------Fold this flap in firstThe Executive Committee of the Medical Alumni Council met fordinner at the Quadrangle Club on Monday, April 7, 1980. The fol­lowing officers and councillors were present: President, FrankFitch; President-elect Louis Cohen; Councillors: Herbert Greenlee,Robin Powell, Julian Rimpila, Francis Straus; Robert Wissler,Chairman, Editorial Board, Medicine on the Midway, and KathyWalker, Executive Director. Absent: Drs. Fredric Coe, RandolphSeed and Peter Wolkonsky.The following by-law revision was presented to the Councilfor approval. Addition to Chapter VIII Elections, Section I Nomi­nating Committee: The Nominating Committee shall prepare a slateof which at least half of the nominees for the elected officers ofpresident-elect, vice president, secretary and councilors shall bealumni not currently on the University faculty. The position ofpresident-elect shall not be held two years in succession by alumniwho are University faculty members. The motion was unanimouslyendorsed by the members present. Those absent will be sent themotion for approval, and if approved the motion will be presentedto the Senate at the annual meeting on May 15. (The motion wasapproved and the revision was in fact ratified at the annual meet­ing.) Alumni MinutesApril 7 Executive Committee MeetingDr. Louis Cohen, Chairman of the Awards Committee, movedthat in the future there should be up to five Distinguished Ser­vice A wards presented to alumni and up to two distinguishedhumanitarian and or civic awards. The total number of awardsshould not exceed six with a minimum of four academic or scien­tific service awards. Motion seconded and carried.To encourage university alumni activities it was suggested thatregional dinners be held and awards might be considered as partof the program. Dr. Cohen spoke favorably to this matter and willbring it up for later discussion. It was felt that Ph.D. holders alsoshould be included.It was recommended that the editorial board of Medicine onthe Midway be expanded. Dr. Fitch reported that Drs. FrancisStraus, ('57) Robert Haselkorn, Julian Rimpila ('66) and PeterWolkonsky ('52) had agreed to serve as a local editorial boardunder Dr. Robert Wissler (,48), chairman of the editorial board. Itwas suggested that there be some members of the board who donot live in Chicago. The board should meet once a quarter to planthe issues.47Medicine on the MidwayThe University of ChicagoThe Medical Alumni AssociationThe Pritzker School of Medicine1025 East 57th StreetChicago, IL 60637•Address correction requestedReturned postage guaranteedInside this issue:Misconceptions:A Legal Image ofMedical Practice 4Doctor to the Bedouin:Profile of aVisiting Clinician 9Reunion ActivitiesMark Alumni Week 12Abstracts of 1980 SeniorScientific Session 38 NON-PROFIT ORG.U.S. POSTAGEPAIDPERMIT NO. 9666CHICAGO, ILL.The Joseph Regenstein LibrarySerial Records Department, Roo:n-2221100 East 57th StreetChicago. Illinois 60637CalendarTuesday, September 16Alumni Reception-American College ofEmergency Physicians, Las Vegas Hilton6:00 p.m. - 7:30 p.m.Thursday, October 16Frontiers of MedicineCurable Cancers-All-day session.Wednesday, October 22Alumni Reception-American College ofSurgeons, Hyatt Regency, AtlantaMay 12-15, 1981Medical Alumni Reunion ActivitiesJune 18, 1981Graduation BanquetFor additional information contact theMedical Alumni Office (312) 947-5443,Continuing Medical Education Office (312)947-5646, or Frontiers of Medicine (312)947-5777.