The NIH Record
U.S. Department
of Healthand
Human Services

August 16
1983
Vol. XXXVof

No. 17

HealthPET Scanning Expands Diagnostic Knowledge
Of Major Diseases of the Human Brain( This is the second of two articles on new
findings about human brain functions
arrived at through the use of positron emission tomography (PET), a new technology
for directly observing the living brain.)Positron em ission tomography (PET), a
new way of observing the living, active
human brain, has disclosed some newunderstanding of Alzheimer's disease as wellas epilepsy, stroke and cerebral tumors.

National
Institutes

infarct dementia.
Since some types of dementia are treatable, Dr. Kuhl emphasized that it is important
to distinguish among them as soon as possible after patients present with symptoms.
Patients with dementia therefore represent
a fourth area of clinical research usefulnessof PET, he said, the other three being focal
epilepsy, stroke, and cerebral tumors.
Further findings in patients with A lzheimer's d isease were presented by Or.

/

NIAID Funds New Center
To Study Sexual Diseases
The National Institute of Allergy and
Infectious Diseases (NIAID) has announced
funding for a new sexually transmitted
diseases research center at Indiana University School of Medicine in Indianapolis.
The 3-year grant, totaling $1 .1 million,
supports studies of three common sexuallyt ransmitted disease agents that cause
gonorrhea, chlamydia! infections and genital warts. These infections affect an estimated 5 million Americans each year.
The center is directed by Dr. Robert B.
Jones, associate professor of medicine,
microbiology and immunology at Indiana
University, and will involve investigatorswith expertise in many d ifferent areas.
A combination of laboratory faci lities anda clinic wil l enable the scientists to study
both the basic biology of t he organisms,
Neisseris gonnorrhoeae, Chlamydia trachomatis and human papilloma viruses, and thesymptoms they prod uce in patients.
Gonorrhea, the most commonly reported
communicable disease in the Un ited States,
is an important cause of pelvic inflammatory
disease in women. Although 1 million casesof gonorrhea are reported each year, physi(See SEX STUDY, Page 5)

Al DS Epidemiology Workshop
Scheduled For Sept. 12-13

Dr. Thomas Chase (c), chief of the NIN CDS Experimental Therapeutics Branch, demonstrates lhe use of
the PET scanner.

Dr. David E. Kuhl of UCLA repo rted someof these findings at the recent international
scientific conference on PET held at NIH
under the sponsorship of the National Institute of Neurological and Communicative
Disorders and Stroke.
New Ideas on Alzheimer's Disease

Dr. Kuhl reported that the rat io of g lucose
metabolism in the cerebral cortex to that in
the caudate-putamen region of the brain differentiates patients with Alzheimer's d isease
from those with other types of dementia,
such as Huntington's disease and multiple

Thomas N. Chase of the NINCDS Experimental Therapeutics Branch. These patientsdisplayed substantial decreases in g lucose
metabolism in both the cerebral cortex andthe basal gang lia. "There was a c lose correlation between the degree of c linical dementia and the decrease in metabolism," Dr.
Chase reported.
When Dr. Chase looked at the pattern ofdecrease in glucose metabolism in the cortex among all patients, he found the greatest
decrease was in an area in the back of thebrain-the parielotemporal region-" which(See SCAN, Page 9)

A Workshop on the Epidemiology of
Acquired Immune Deficiency Syndrome(AIDS), sponsored by the National Institu teof Allergy and Infectious D iseases, theNational Cancer Institute, and the National
Heart, Lung, and Blood Institute, w ill be heldat the Holiday Inn, Crowne Plaza, 1750
Rockville Pike, Rockvi lle, Md. on Sept. 12-13.
The purpose of this workshop is to develop recommendations for research on theepidem iology and natural history of AIDS,
and to exchange information and educate
clinical investigators about epidemio logicalstudy design.
T his 2-day workshop wi ll consist of invited
speakers and panel members and official
partic ipants. Other interested persons whowish to participate in the goals of the workshop are invited to attend.
A program is available from Joni Grigsby
at 496-5717. Because there is limited seating,those wishing to attend this meeting should
confirm by contacting: Mark S. Brown,
Social and Scientific Systems, Inc., 4405
East West Highway, Suite 508, Bethesda,
MD 20814; telephone (301) 656-6346. □The NIH Record
Published biweekly at Betnesda, Md by the Edi tonal Operations
Branch. D1v1s1on of Public lntormahon, tor the mformat1on or
employees Of the Nallonat Institutes of Heal th, Department of
Health and Human Services. and circulated by request 10 wn ters
and lo researchers 1n biomedical and related field The content 1s
reprmtable without permission P1c1ures may be avai lable on..

,equestTne NIH RecortJ reserves the nght to make corrections, changes, ordeletions in su bmitted copy m conformity w ,th the pol1c1es of thepaper and HHS.

-,

Bldg 31, Room2B·03, Pnone496· 2125

Edito rHerschel Cnbb

Stall Wrller1
Joyce F McCa,lhy
Anne BarberJ

NIH Record Office

I

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'I I i' .. ,,. ~ 'J,,...

t-,,,.. 4fl,
Editorial Assistant

Each year outstanding science students from medical schools, colleges, and high schools throughout
the United States are chosen lo spend the summer working on special projects at the Rocky Mountain
Laboratory. The faclllty In Hamilton, Mont., houses 3 of the 13 NIAID Intramural laboratories. This year,

Manlyn Berman

Staff Correspondents

CC, Barba,a Smakula, OCRT, w,11,am Hall, DPM, Judy Fouche,
DAG, Sue Meadows. ORR, Barbara Memck, ORS. Jlm Doherty; FIC,
Susan P Stark. NCI, Patricia A Newman: NEf, Marsha Cofbelt.
NHLBI, 8 111 Sanders. N1A, Clanss.a Wittenberg. NIAIO. Jeanne Win-

14 students were selected to work In such diverse areas as slow virus research and research on Lyme
Disease, whose causative organism was most recently Identified by RML scientists. Students are backrow (I to r): Timothy WIison, Melchlsedek L. Margals, David C. Olson, Joe Lucero, Ronald Smith, Ramona Helland, Dave Waag; front row (I tor): Arthur Rivera, Jon McCarty, Greg Tierney, Albert Olszewski,
Tom Bartkoske, Lori Jansen, Joe Wen Wu.

n,c~: NIADDI<, Barbara Weldon, NICHD, James Hadley. NIDA •• Sally Wllberdlng, N IEHS, Hugh J. Lee; NIGMS. Wanda War<ldell,
NIMH, Harry Bell: NINCDS, o ,ane Stnar; NLM. Aoqer L. Gil kAc;on

Building 1O Parking Areas Will Change August 22

Training Tips
CourseStartsDeadline

On Monday, Aug. 22, parking assignments
in several parking areas near Bldg. 10 will bechanged. This resh uffling of parking
assignments is being done to accommodate
the increasing numbers of outpatients andvisitors who come daily to the ClinicalCenter.

9/26

917

Parking In The ACRF Garage:

10/ 3

9/ 19

11/14

10/26

9/ 13
9/ 19
9/ 13

8/23
8/ 26
8/ 26

9/27
9/ 13

9/ 12
8/ 26

T he 8-3 level of the ACRF garage willremain reserved for outpatients. consultants,
Red Cross volunteers and employees wit hcurrent Patient Care parking permits.
All visitors will be relocated from lot 20-C,
north of Bldg. 10, to the B-3 level. The only
entrance to the B-3 level w ill be from M emorial Dr. at the east end which will continue tobe regu lated from a police booth.
The B-2 level, east portion only, will bereserved for personnel with preferential (red )parking permits and handicapped
employees. The only entrance to the B-2
east portion will be at the east end from
Memorial Dr.
There will be a barricade between the east
and west portions. wit h no access to the B-2
east portion from the other two parking
levels.
The B-2 level, west portion only, and theentire B-1 level (both east and west portions)will be reserved for NIH general employee
and handicap parking. The on ly entrance tothe 8-1 level and the B-2 west portion will be

The fo llowing courses, sponsored by theDivision of Personnel Management, aregiven in Bldg. 31 .
Office Skills

Travel Orders andVouchers
Travel Orders andVouchers
Travel Orders andVouchers
Medical Terminology I
Proofreading
Time and Attendance
Executive, Management
and Supervisory

Effective Communication
Federal Budget

To learn about these and other courses,
contact the Development and Training
Operations Branch, DPM, 496-6371.

R& W Plans Labor Day Weekend Trip
R&W plans to make your Labor Day weekend "special" this year with a whitewater outing on t he Youghiogheny River in southwestern Pennsylvania. Drive up on Sat. Sept.
3, and swim or fish in the river, hike in Ohiopyle State Park, or visit Falling Waters, one
of Frank Lloyd Wright's architectural masterpieces. The one-day canoe trip (a small
amount of whitewater canoeing experienceis necessary) will be on Sun., Sept. 4. The
cost will be $22.30 per person i ncl uding
lunch. M onday, Sept. 5, is for rafting on th eYoughiogheny River. You must be 12 years
or older to participate. Fee for the rafting trip
is $22 which includes lunch. Choose either
trip for day or combine the two at a discountrate of $42.50. Sign up now at the R&W
Activities Center, Bldg. 31. Rm. B 1W30. □Page 2-_/'N◊&• ner•I[,..ployee
Pulil.l• t.

...

V

'i\
II

\,,
from Convent Dr.
Parking Lot Changes:

Parking lot 20-C north of Bldg. 10-now
used by visitors-will be reserved for NIH
general employee parki ng. The 18 carpool
spaces and 7 CC vehicle spaces now locatedin lot 20-C will stay where they are. □R&W Sponsoring Horseback Riding Weekend and Orioles Bus Trips
The R&W will sponsor a horseback riding
weekend in the mountains of Western Maryland, near Deep Creek Lake. The trip isscheduled for Sept. 9-11, and the cost will be$85 per person. Beginners as well as experienced riders can share in t he fun. Nonriders are welcome to come along at a
reduced rate. Sign up now at the R&W Activities Desk, Bldg. 31.

R&W will provide t ickets and bus t ransportation to Memorial Stadium for t he games
Wednesday, Sept. 7, with the Boston Red
Sox; bus leaves at 5:30 p.m., and Sunday,
Oct. 2, against t he New York Yankees: bus
leaves at 12:30 p.m. Upper box seats and bus
costs is $12.50. Buses will depart from Bldg.
31C. Order your tickets now at the R&W
Activities Center, Bldg. 31, Rm. B1W30. □The NIH Record

August 16, 1983

NIH "Gashouse Gang" Zaps TV-9 Again
The NIH "Gashouse Gang" again conquered "The One & Only TV-9" team with a" come-from-behind" victory of 10-9 in the
8th Annual Patient Emergency Fund (PEF)
Softball Game on Sunday, July 17.
T he "Gashouse Gang," which has become
known for its power and fi nesse, began thegame with a flourish. Debbie Rorabaugh,playing right f ield, scored the first run after a
triple. The "Gashouse Gang" then continued
on to what appeared to be an easy victory.
At the beginning of the 7th inning, the score
was 8-2. the NIH team lead ing by a 6-run
margin.
The " One & Onlys," however, tied thescore and then went on to a 9-8 lead, led byJerry Grossman w ith a 3-run homer, M ike
Buchanan, Ron Sarro and Lee Zeidman.
NIH's John Garrison came home on a triple
and tied t he game again. At t he bottom of
the 8t h inning, Freddie Harris hit a home run ,breaking the t ie and winning the game for
the NIH " Gashouse Gang."

The " Gashouse Gang's" Jim Alexander (1), Maurice Mil,es (r) and "The One & Only TV-9's" Mike
Buchanan (c) take a break between innings.

...

~

The " One & Only's" Mike Buchanan showing his

Linda Grossman, a "Gasho use Gang" pitcher andalso a member of NIH's championship Women's
League, continues to demoralize the Channel 9
team.

catching form.

" The agony of defeat" and 99 degree temperatures
were just too much for Mike Buchanan.

Putting on the PEF game involves many
people: the chefs and staff of the Nutrition
Depart ment cooked the hot dogs, the Occupational Medical Service provided the firstaid kit, R&W donated door prizes, A l Laoang
of t he medical arts section contributed theposter design, John Slovikosky volunteered
his services as umpire for the 3rd consecutive year, Amy Coombs, R.N .. volunteered as"game nurse" and the normal volunteers
without whose help there would not h ave
been a game.
The " Gashouse Gang,'' managed by Doren

Vest, and the "One & O nly TV-9" deserve a
thank you from all their fans and co-workers
fo r outstanding performances.
In answer to the many questions asked
about where the name "Gashouse Gang"orig inated-"The Gas House Gang," a fighting St. Louis Cardinals team won the
N ational Leag ue title in 1934. D izzy Dean,
Pepper Martin and others on the team weren oted for their reckless style of play.
The proceeds from don ations for door
prizes and food concessions were donatedto the Patient Emergency Fund. □Physical Fitness Presentation Being Offered in September
In September, the Occupational Medical
Service and the NIH Fitness Center will present a 26-minute f il m, To Your Heart's Content. which emphasizes the importance ofincreasing our level of activity.
Appraise Fitness

In addition, staff at the Fitness Center will
provide information on how to appraise yourlevel of physical fit ness. The Occupational
Medical Service staff will offer t he Healt h
Risk Appraisal questionnaire on how toevaluate the effect of your lifestyle (forexample, diet, smoking) on the most common causes of death for your age and sex.
The program will be offered at the following dates and locations:Wed., Sept. 14, ACRF Amphitheater, 11 :30

August 16, 1983

a.m. & 12:15 p.m.;
Thurs .. Sept. 15, B lair Bldg., Rm. 10, 11:30
a.m.;Fri., Sept. 16, Shannon Bldg., Wilson Hall,
11:30 a.m. & 12:15 p.m.;Mon., Sept. 19, Federal Bldg., Rm. B119,
11:30a.m.:
Tues., Sept. 20, Westwood Bldg., Cont. Rm.
D. 11 :30 a.m.:
Tues., Sept. 20, Poolesville Animal Center,
2:30 p.m.;Wed., Sept. 21, Bldg. 13, Rm. G313, 2:30
p.m.;
T hurs .. Sept. 22, Bldg. 38A, Rm. B1 N308,
1 1 :30a . m. □Experience is not what happens to a man.
It is what a man does with what happens to
hi m- Aldous Hu xley □The NIH Record

Theater Group To Hold Auditions
For 1920s-Style Variety Show
Auditions for the NIH/ R&W TheaterGroup's fall variety program w ill be held
Aug. 23, 25, and 29, f rom 7:30 to 10:30 p.m.
in the Masur A ud itorium, B ldg. 10.
The program is entitled "Remembering the20s," so those wishing to audition should
bring material re lating to the 1920s. The
p roduct ion is scheduled for m id-November.
Performers needed include actors, singers,
m usicians and dancers. A lso needed are ac horeographer, makeup helpers, technicalstaff and seamstresses. Anyone interest ed inhelping w ith the production is welcome at
the auditions.
For more information call Alice Smyth at
496-347 1, or Adele Weeks at 496- 1924, or
942-7117. □Page 3

Married Men Usually Live Longer Than Single Males;
But Do Some Wives Contribute to Husbands' Heart Disease?
Married men as a group live longer thansingle, widowed or divorced men. That fact
has been documented t ime and again.
Married men also have lower rates ofcoronary heart disease (CHO), which may
help to explain why husbands have a lower
death rate.
However, the latest findings f rom t he
Framingham Heart Study, reported in t heJuly issue of the American Journal of
Epidemiology, ind icate that some marriedmen may be at higher risk of developing
heart d isease if they are married to womenwith some education beyond high school
who work outside the home most of theiradult life.
The stu dy was conducted by D r. Suzanne
Haynes of t he University of N orth Carolina,
Chapel Hill; Dr. Elaine Eaker of the National
Heart, Lung, and Blood Inst itute, and Dr.
Manning Feinleib, formerly w ith NHLBI.
The Framingham H eart Study subgroupof marri ed couples represented a fairlysmal I (269 spouse pairs) and specificpopulation.
T he mean age for men was 54 years: t hemajority were blue-collar workers, had ahigh school education or less, and the vast
maj ority reported being married only oncefor over 25 years. Since this data wascollected in the mid-1960s and may have
limited application today- given changing
life styles and wider acceptance of newro les for women- generalizations to o thergroups must be made with caution.

1950s, and is funded by the National Heart,
Lung, and B lood Institute.
Psychological and Social Variables

Between 1965 and 1967, an extensive
questionnaire measuring psychological andsocial variables was given to 269 spousepairs. At th at time. the husbands ranged
from 45- to 64-years-old. The researchers
followed the couples for 10 years andrecorded the development of heart disease
among the husbands.
When the men enrolled in the study, theirstandard risk factors were also assessed.
These included age, cholesterol levels,
blood pressure, and number of cigarettes
smoked per day. The findings reported here
are independent of these factors, however.
Educational levels, employment status
and occupation of both sp ouses wererecorded, as was the occupation of each
person's father.
Employment and Education

In general, men married to women withsome education beyond high school are
more than twice as li kely to develop CHO(coronary heart disease) than men married
to women with grammar school educations.
T he increased ris k of CHO among these
men was noted only among husbands ofwomen employed outside the home.
For men of type A personality-the harddriving, time-pressured, ambitious type- therisk of developing CHO is 3.5 t imes that of
the more sedate type B men when both aremarried to women working out side thehome. There is no difference i n the rates ofheart disease between type A and type B
husbands if married to non-working
housewives.
When t he behavior types of both spouses
were considered, the highest rates of CHO
were found among type A men married totype B wives, among whom 25 percent
developed CHD over the 10-year fol lo wup
period compared with type B men with typeB wives, whose rate o f CHO was only 7.8
percent.
These effects were seen regardless of thehusband's occupational status or his otherrisk factors such as high blood pressure orcigarette smoking.
These conclusions were part ol the lindi ngs of a 10-year study of spouse pairs,
correlating social status, behavior types,
educat ional levels and personality characteristics to the rate of coronary heartdisease among husbands. The Framingham
Heart Study has been in progress since theOverall , the resu lts of the study show thatmen married to women with some education beyond high school were 2.6 times
more likely to develop heart d isease thanmen married to women with a grammar
school educat ion.
The man is at high risk if married to a
women of high educatio n, regardless of his
own educational level.
The study showed that men married to
women in white-collar jobs were 3 to 5
times more likely to develop heart diseaset han men married to women in the bluecollar or c lerical categories or to housewives. This was true whatever t he men'soccupations. Of the 15 men in the study
who were married to white collar women, 7(46. 7 percent) developed heart disease during the 10-year study.
When the combined effect of the w ives'
education and employment status wascorrelated with their husbands' rate of heartdisease, i ncreased risk among men married
to women with some education beyond highschool was limited to those whose wives
worked outside the home.
These men were 7.6 times more likely todevelop heart disease than were men married to women with grammar school
educations.
In the Framingham spouse subgroup,
there was no association between thehusband's own educational level and his
rate of heart disease. The rate of disease
was slightly higher among blue-collar compared to white-collar workers.
The apparent effect of wives' educational
level to d isease rates among husbands is
independent of the husband's educational
level, except for blue-collar men married to
women work ing outside the home. T his
suggests that the heart disease associationreflects more than social status as such,perhaps, a more complex interaction
between spouses.
Several hypotheses were put forth by the
researchers to explain their findings withthe suggestion that each be explored infuture studies.

Page 4The NIH Record

General Findings

Among these: the possibility of role
conflicts for the women; that is, the dual
responsibility of holding a wh ite-collar j ob
and raising children. Or. perhaps wo men
wh o worked in high-st atus jobs outside thehome may have threatened their husbands'
self-esteem, creating stress in t he re lationship. Although these explanations seemlogical and appealing, they were not supported in the Framingham analysis.
Self selection of high-risk men to marrywomen of high social status also was ru led
out as an explanation. However, these
possibilities should be examined in larger
and more contemporary populations, theresearchers indicated .
The Real Reason

Further analysis revealed that highly educated working wives whose husband developed heart d isease were significantly more
likely to have had a nonsupportive boss andfewer job promotions than wives of men
who rema ined healthy.
This indicates that it may not be thewoman's status as such t hat is associatedwith her husband's risk of h eart disease, but
the stressf ul environment in which she
works.
Th e husband may fee l sympathy for his
wife's stressful job situation, but be helplessto ease her situation.
These men who developed heart disease
did not report more marital d issatis faction
or marital disagreements than noncases. D

Women 'Pill' Users Who Exercise
Sought For Blood Clotting Test
The Exercise Laboratory, Departments ofPhysiology and Medicine, at the Uniformed
Services University of the Health Sciences in
Bet hesda needs volunteers to take part in astudy on how exercise and use of birth control pills affect blood clotting and clot
dissolving.
Three groups of pill users are needed:
women who do no regular en durance exercise such as runn ing, swimming, or biking;
women who run between 5 and 15 miles per
week; and women who run more than 50
miles per week.
All volunteers must be non-smokers
between the ages of 18 and 45.
Also needed are women p ill users andnon-pill-users who run over 50 miles a week
and are experiencing menstrual irregularities
connected with their running.
Volunteers will run on a treadmill while
oxygen consumption and temperature aremonitored. Testing will be supervised by aphysician. Benefits include an extensive
physical fitness evaluation and screening foratherosclerotic heart disease and risk
factors.
For further information, contact Sue
Wigutoff or Janet Yu-Y ahiro, Department of
Physiology, Un iform ed Services Universityof the Health Sciences, 4301 Jones Bridge
Rd., Bethesda, MD 20814, or call (301)295-3623 D
August 16, 1983

NIH Symposium on Eye Epidemiology Published
Eye epidemiology, a field in its infancy
only 10 years ago, drew 130 epidemiologists, ophthal mologists, statisticians, andother vision researchers to the National
Institutes o f Health last year for the fi rst
symposium of its kind in t he United States.
Selected presentations from this meeting
will be published in the August issue of theAmerican Journal of Epidemiology.
In his opening address at the symposium,
Fred Ederer, chief of NEl's Office of B iometry and Epidem io logy (OBE). remarked on
the growing interest in eye epidem iology
and traced factors contributing to theincrease in the number of scientists working
in this specialty.
N EI support of randomized clinical trials
and other epidemiologic studies has provided on-the- job training in epidemiologic
principles and methods.
It has also spurred departments of ophthalmology to add biostatisticians andepidemiologists to their staffs, and epidemiology departm ents to include staff memberswith a major interest in eye disease, he said.
In addition, educational activities of the
OBE have stimulated interest in eye epidemiology and encouraged researchers todevelop the skills needed for such work.
OBE educational projects other than theepidemiology symposium have included
workshops, publications, annual courses forclinical vision researchers, and an epidemiology fellowship program for
ophthalmologists .
The focus of the symposium was on
chronic eye diseases and vision disorders
occurring in the United States. Criticalreviews of the literature on the epidemiology of cataract, senile macular degeneration, diabetic retinopathy, amblyopia, andglaucoma were presented as well as 28
reports on individual research projects. Fourof the l iterature reviews and n ine of thereports are presented in this special issue ofthe American Journal of Epidemiology.

SEX STUDY( Continued from Page 1)

Eye diseases aflectlng older Americans are of particular Interest to eye epidemiologists. A poten•
tially blinding form of senile macular degeneration($MD) is associated with inc reased age as well as
certain risk factors.

were weakly linked to development of thedisease.
Dr. Hyman and her colleagues, Ors. Frede.-ick Ferris, Stuart Fine, and Abraham
Lilienfield, also looked into ris k factors forthe neovascular form of SMD, a pot entiallyblinding disease which is characterized by
the growth of abnormal new b lood vessels
in the eye.
They found associations between thismore critical form of the disease andincreased age and card iovascular d isease.
Decreased hand grip strength (an indicationof physiological aging) was a significant
factor only when cardiovascular disease
was p resent.

c ians estimate the t ru e incidence is c loser
to 2 million cases.
Another 3 million Americans suffer fromchlamydia! infections. C hlamydiae are themajor cause of nongonoccoccal uret hritis inmen . They also cause 20 percent of diagnosed cases of pelvic inflammatory disease
in women, and thousands of cases o f eye
infections and pneumon ia in infants born tochlamyd ia-infected women.
The 1980 Status Report on Sexually
Transmitted Diseases by an N IAi D study
group estimated that, in this country, genital
warts caused by human papilloma viruses
are the fourth most common sexually t ransmitte d disease in men and the third mostcommon in women: the total incidence is atleast one- half million cases a year. Treatment is difficult and recurrences are common . Some evidence has also linked humanpapilloma viruses to cervical cancer.
Four specific research projects have been
approved for the new center. One study
fo cuses on the cel l wall stru c ture of N.
gonnorrhoeae, or gonoccoccus, to learn
more about how the immune system
responds to particular components of theorganism. This inf ormation is important for
better treatment of patien ts with gonorrhea
as well as for vaccine development.
One study on chlamydia will provide
basic information on the development of theo rganism. Another will search for immunologic methods to study the epidem iology o fgenital chlamydia! infections and also todefine the ro le o f immun ity in protection
against relapse and reinfection.
Th e goal of the f ourth project is to devise
immunologic tests that can be used for
epidemiologic and other studies of humanpapilloma virus infections. □Visual Acuity Impairment Survey

In one report, Dr. Lawrence I. Rand at the
Joslin Diabetes Center, Boston, discussed
his case-control study o f insulin-dependent
diabetics and presented preliminary resul ts.
The objective of his study is to identify
personal, biological, familial, or environmental factors that could explain why somediabetics develop diabe tic retinopathy andlose vision while others do not. He isinvestigating such risk factors for diabetic
retino pathy as control of diabetes, bloodpressure, smoking, growth hormone levels,and HLA antigen types.

Also discussed at the symposium was the
Visual Acuity Impairment Survey (VAIS).
This study was designed to provide prevalence data on i mpairment of distance visualacuity and on the diseases which cause it,and study cases of impairment from the
major eye diseases: cataract, senile maculardegeneration, glaucoma, diabetic ret ino pathy and amblyopia.
A pilot study was undertaken first to
determ ine the feasibility of conducting the
VAi S in 15 to 20 metropolitan areas. In thepilot study, the NE I, in collaboration with
the National Center for Health Statistics andthe Bureaus of the Census, gathered dataon visual impairment and its causes.

Senile Macular Degeneration Study

Summary Statement

A case-control study of risk factors forsenile macular degeneration (SM D) waspresented by Dr. Leslie Hyman , a
researcher at the State University of New
York at Stony Brook. Statisticially sign ificant associations were found between SMD
and a maternal and sibling history of thedisease and between SMD and light iris
color.
The study suggested that genetic factors
were strong ly associated with SMD in both
men and women , and that exposure to
ind ust rial chemicals and cigarette smoking

In a summary statement at the end of themeeting, Mr. Ederer said the conference
re vealed needs for the fo llowing:Standardized definitions of eye diseases;
more studies analyzing differences in theprevalence and incidence of eye diseases indifferent populations.
Also well-designed case-control andcohort studies of eye disease in clearly
defined populations; studies to evaluteobserver error: and technological advances
to simplify and increase the re liability ofobservations by ophthal mologists. □Diana S. Parker of the Laboratory of Chemistry,
NHLBI, played a pivotal role in the recent victoryof her team, the Mclean Redshins, in the U.S.
Soccer Federation-Budweiser National Challenge
Cups held in Houston, July 2-3. During the semifinal game against the Region II team from Missouri, Diana allowed only one goal to be scored by
the opposition, for a 3-1 Redshins victory. In the
finals agai nst the Region IV team from Oregon,
Diana led the Redshlns to a 2-0 shutout, making
them the Women's Over 30 National Champions.

August 16, 1983

Th e NIH Record

Page 5Insulin-Dependent Diabetics Study

Cancer Communications Interns Functioned Like Staff;
Planned Projects, Wrote Reports, Answered Public Queries
Susan Oehme and Dave Moore answered
thousands of phone calls from cancer
patients, their fam ilies, and other membersof the public. Ina Silverman helped write thet hird edition of Cancer Rates and Risks, abook in progress for laymen. Ruth Mattingly
helped coordinate and publicize a new
toll-free phone number for the 23 Cancer
Information Service Centers in the UnitedStates.
All four were part of a grou p of 10
graduate students who recently completed a
6-month communications internship with
the National Cancer Institute.
Created in 1975 by the Office of Cancer
Communications (OCC). the internship program now has 89 alumni. Each intern gains
professional experience in one of several
areas: science writing, health education,
public inquiries, information science, andhealth planning. Intern groups begin each
January and July .
Interns in OCC's Information Projects
Branch receive intensive experience inmounting health education programs ofnational scope. They have contributed toprograms in antismokin g, breast cancer andpatient education, and to special efforts toreach minority audiences.
O ften, in terns take on a specific aspect ofeach education program. Some help pretest
educational materials with re presentativesof t he intended audience, gaining feedback
that improves communication .
For example, Paul Kerns, a graduate
student from the University of Southern
Califo rn ia, revised a patient education booklet, "Chemotherapy and You," after th emanuscript was pretested with cancer
patients. Kerns also continued a project
begun by one of his predecessors, Donna
Maxwell of the University of Missouri, to
produce a videotape for orientation of new
NC I employees.
Television and radio announcements andcancer education materials are often written
by interns. " We treat the interns just likestaff, wi th the same responsibilities," said
Barbara Blumberg. a p ub lic health educatorin OCC.
"The great thing about the program isthat interns aren't observers, but active
participants," said Nancy McCormickPickett, director of the internship program.
" They' re immersed in the work
immediately."
After 2 weeks o f intensive training in
OCC's Public Inquiries Section, Susan
Oehme and Dave Moore (Marquette Un iversity) began responding each week to an
average of 250 callers who were seeking
information about cancer.
" Public Inquiries was my f irst choice for
an internship experience," said Oehme, a
graduate student in journalism at Kansas
State University. "I wanted the contact withpeople."Penny Passikoff interned in OCC's Document Reference Section, w here over 300
data bases can be searched by medical
librarians experienced in retrieving bothtechnical and lay-oriented information on
cancer. A candidate for a master's degree inlibrary science from Syracuse University,
Page 6

Passikoff already holds an M.A. inpsychology.
"Because of my interest in library
research and in science, the internshipseemed perfect for me," she noted . The
computer link to the nearby National
Library of Medicine, other data bases andour own computerized fi les are used togather information the OCC staff needs toanswer a question for a cancer patient or areporter on deadline."
J. Paul Van Nevel, NCl's associate director for cancer communications and founderof the internship program, commented:" Aside from the immediate benefits wegain from work the interns do while they're
here- work that often would not get doneo therwise-the program develops a cadre ofpeople who go out to other institutions or
become science writers. who have knowledge about cancer and the National Cancer
Institute, and who improve the communication of cancer information."
Former intern Steve Findlay (University of
Maryland) writes about science for USA
Today, Janet Raloff (Northwestern University) is at Science News, and Sana Siwolop(Massachusetts Institute of Technology) is ascience reporter for o;scover magazine.
"Cancer is a hard topic to write about ."Siwolop said. "Before my internship at NCI,
I was always on the receiving end for press
releases about science research , rather thanwriting them. At NCI I learned to appreciate
the special kind of decision-making process
involved in writing background material forthe press.
" It may not be clear if a cancer drug isgood or not, or how effective a medical
treatment is. It's important to get enoughinformation and as balanced a perspective
as possible when you' re dealing with peop les' lives," she said.

Rose Mary Romano joined the permanent
staff of OCC after her internship ended in
1978. She is now in charge of developing anawareness program about cancer prevention
for the public.
During her internship, she conducted astudy of public service announcements andother health messages to see which wereeffective in reach ing their aud iences. Later.
she helped OCC pioneer in developing
pretesting and evaluation techniques forhealth education programs.
Now Romano has interns of her own:
Kathy Fitzpatrick, a journalism graduate
student from West Virginia University,
recently helped Romano in p lanning thecancer prevention campaign.
Science writing interns are assigned to
OCC's Reports Section where their work
may include reporting Congressional hearings on health issues, writing press backgrounders on cancer research andtreatment , and reporting some of the weekly
NIH science lectu res.
" It was great interviewing scient ists whose
j ou rnal articles I had read in school," said
Ina Silverman, a science-writing intern from
Yale's School of Public Health. Silverman
met with the scientists as part of her workin writing an NCI book on cancer rates andrisks.
The interns visited the Washington Post,
the Voice of America, attending a taping ofNBC's " Meet the Press," and took a daylong trip to the Frederick Cancer Research
Facility. McCormick-Pickett, who organized
the trips, repeats them for each group ofinterns.
Ot hers who completed their internship in
July were Ron Cowen (University of Maryland) in the Reports Section, Gladys Borges(University of M iami) in the NCI Systems
Planning Branch, and Marylou Warwick(University of Denver) in the International
Cancer Research Data Bank office. Information about the internship program is available from McCormick-Pickett at 496-6792. □NCI OCC Interns- Back row, I to r: Ina Silverman, Dave Moore, Marylou Warwick, Ron Cowen, Paul
Kerns. Fron t row, I to r: Gl adys Borges, Ruth Mattingly, Kathy Fitzpatrick, Susan Oehme, Penny
Passikoff.

The NIH Record

August 16, 1983

Growth Factor, Simian Virus:
Common Clues to Cancer
Protein produced by a gene responsible
for the cancer-causing activity of a monkey
virus has been found to be strikingly similar
to a wound-heali ng protei n found in humanblood cells known as platelets, a team ofscientis ts has reported.
Called platelet-derived growth factor(PDGF) , the blood protein triggers theprocess of healing after injury by stimulati ng cells around the wound site to begi nmultiplying.
Authors o f the July 15 Science report
entitled, "A simian sarcoma virus oncgene ,v-sis is derive d from the gene(s) encoding
human platelet-derived growt h factor," are:Ors. Russell R. Doolittle, University ofCalifornia, San Diego; M ichael W. Hunkapiller and Leroy E. Hood, California Instit ute
of Technology, Pasadena; Sushilkumar G.
DeVare, Keith C . Robbins and Stua rt A.
Aaronson, National Cancer Institute; andHarry N . Antoniades, Center for B lood
Research and t he Harvard University Schoolof Public Health, Boston.
"The finding may help us understand how
cancer genes transform normal cells into
rapidly dividi ng cancer cel ls with uncontrolled growth," said NC l's Dr. Aaro nson.
The research team suggests that th iscancer gene, v-sis, may either produce analtered protei n product after damage to its
DNA, or "turn on" production of this protein
in a cell where it is not normally made.
In either case, the cel l somehow responds
inappropriately by continuing to grow i n theuncontrolled fashion typical of cancer.
The partial amino acid sequence of PDGF
was described in an article by Ors. Hunkapiller and An toniades in the May 27 issue ofNine NI Hers Graduate From Apprenticeship Class at MC

NIH Apprentices, front row {I to r): Caldwell, Jones, Biser, Reggia, and Badua. Back row (I tor): Orrison,
Oliver, Craig, and Welborn.

Nine members of the 1983 NIH apprenticeship class received certificates for having
completed the related tech nical inst ruction
portion of the program.
T hey are:Daniel Reggia, Air Conditioning/Refrigeration; Thomas Caldwell, boiler operator; Rodney Jones, boiler operat or; Gerald Oliver,boiler operator.
•
Ildefonso Q. Badua, e lectric ian; Robert C .
Welborn, electrician; Anita L. Biser, carpenter; Herman M. Orrison , carpen ter; Robert B.
Craig, plumber.
The ceremony was held June 25, 1983 at
Montgomery College's Rockville Campus.

Included w ith the N IH graduates were 23
other apprentices from eight o ther businesses o r agencies in the area.
These apprentices are completing a 4-year
structured program combin ing on- the-job
training with re lated technical inst ruction,
leading to the developmen t of skills at the
fu ll mechanic level.
Speakers at the college's ceremony
included Dr. Robert E. Parilla, president ofMontgomery College and D r. Theodore F.
Rybka, Maryland State Dept. o f Education .
Stan ley Allen, chairm an , NIH Apprenticesh ip
Committee, represen ted the N IH on the
program. D

Gerontology Research Center Celebrates Native Americans Week
Peace pipes, war clubs, medicine ratt les,and memory sticks used by Indians of theNortheast United States were plentiful
recent ly when the N IA Gerontology
Research Center (GRC) held Nat ive Americans Week. The event was organized andsponsored by the GRC' s Cu ltural Committee
in cooperat ion with the N IH Di vision o f
Equal Opportunity.
John Moore and Sandra Clark- Linkins of
Baltimore's Indian Education Project fasc inated GRC staff with legends, crafts, andhistorical data on Baltimore's Lumbee Indian
population, numbering some 4,000. The
Lumbees are believed to be descendants of
Sir Walter Raleigh's " Lost T ribe of Roanoke."The 3-day event also featured Dr. Larry
Brant, GRC/ NIA who described the customs
and living conditions of Alaska's Indian andEskimo populations.
Native dancers in feathers. beads, andbuckskins were joined by enthusiastic GRC
employees to close the celebration. D

Science.
Dr. Doolittle had been storing the aminoacid sequences of proteins in a computerbank for his studies of protein evolution.
When he entered the amino acid sequenceof PDGF into this data ban k, he discoveredthat 87 percent of the 70 amino acids in the
known segments of PDG F matched those in
the sequence of amino acids of the v-sis
protein.
The v-sis gene and its p rotein p roductwere discovered, sequenced, and studied indetail by Ors. DeVare. Robbins, Aaronson
and colleagues in t he NCI Laboratory of
Cellular and Molecular Biology.
"Considering the species differences,"
said Dr. Aaronson, "we would expect a 13
percent mismatch between human andmonkey proteins with the same functions .
" It is too early to assess the clinicalimportance of these findings," he said. "I t ispossible, however, that once the protein
products of cancer genes are identified andscientists determine how they function ,steps can be taken to alter cancer progression by interfering with or i nhibiting thebiologic activi ty of those proteins," Dr.
Aaronson added.
The scientists are planning fut u re collaborative research to determine whether thefunct ion of the monkey protein made by thev-sis cancer gene is identical to the human
PDG F, and whether other cancer geneproteins may be matched with other normal
g rowth proteins. □Tony Kaminski, GRC Personnel, and Elizabeth
Locklear perform an Indian "jig" at GRC's Native
American Powwow.

The Clinical Pharmacology Branch of NCI
is seeking normal volunteers w illing to
donate single bone marrow aspirates for use
in drug metabolism studies. Volunteers will
be paid $75. For details contact Dr. Gregory
Curt, 496-4522. □August 16, 1983

The NIH Record

Page 7

Bone Marrow Donators Needed
For Drug Metabolism Studies

NHLBI Sets Workshop
On Heart Arrhythmias

Two International Authorities
Discuss Alzheimer's Disease

A scientific workshop on electrical controlof tachyarrhythmias by implantable devices
will be held at the NIH Lister Hill National
Center for Biomedical Communications,Sept. 1-2. It is being sponsored by the Devices and Technology Branch of the NHLBI.
Battery-powered devices can be used inhumans to correct overly fast heartbeats byadministering a mild electric shock. These
devices can be implanted without major
surgery. T hey can save lives of patients witha high likelihood of sudden arrhythmic
death, a disorder of 300,000 persons in theU.S.
The workshop will explore the current
state of the art, identify gap areas inresearch and provide direction to th e commercial companies developing and marketing these devices.
.
.
.
Sessions will focus on five maior topics:
Pathophysiology of cardiac arrhythmia; current c linical management techniques; current status of electrical control of tachyarrhythmia; safety of clin ical procedures anddevices, and clinical needs and resea rch
opportunities.
Chairing the five conference sessions are
Drs. Arthur Moss. University of Rochester
Medical Center; Michael Bilitch, Universityof Southern California School of Medicine;
Nanette Wenger, Emory University School of
Medicine: Robert Myerberg. University ofMiami and Stanley Biller, University of Pittsburgh. The overall chairman of the workshop
are Dr. William Hood, University of Rochester and Dr. Briller.
Advance registration is required. Further
information is available from Dr. Watson:(301) 496-1586, NHLBI, Federal Bldg., Rm.
312, Bethesda, MD 20205. D

The causes of death of Alzheimer's disease
patients was one of several major unanswered questions about the disease discussed by two international authorities on
the ailment at a recent informal seminar
hosted by the National Institute on Aging.
Drs. Klaus Bergmann of the Institute of
Psychiatry at Maudsley Hospital in London
and Franz Baro of the University PsychiatricCenter at St. Kamil lus in Bierback, Belgium
joined about 20 NIA researchers and staff to
discuss clin ical and epidemio logical aspectsof Alzheimer's disease.
According to Dr. Bergmann, a decrease in
the efficiency of the patient's immune
system may lead to death.
But both Drs. Bergmann and Baro agreed
that damage to subcortical neurons (forexample, in the hypothalamus) may play animportan t role in the u ltimate fai l ure of thecentral nervous system.
Dr. Stanley Rapoport, chief of NIA Laboratory of N eurosciences, led the discussion.
Drs. Bergmann and Baro were in
Washington to conclude a series of public
lectures on tne current state of knowledge
and public policy on Alzheimer's disease.
Th e discussants also exam ined the role ofdiagnostic imaging techniques in evaluating
Alzheimer's d isease. NIA is one o f several
institutions currently studying the utility ofCT (computed tomograhy) and PET (positron emission tomography) scans forscreening and diagnosing dementias. At thepresent t ime, however, CT cannot identify
Alzheimer's or other dementias in individual
patients.
Dr. James Haxby of NIA's Laboratory of
Neurosciences, suggested that clinicallysignificant deficits in memory or othercognitive functions may precede thechanges observed on PET scans.
All the participants agreed that autopsy is
the only way to confirm the diagnosis of
Alzheimer's disease and to fu lly understandthe findings of clin ical studies.
Both Ors. Bergmann and Baro stressedthat the disability of Alzheimer's disease
results from a combination of medical,
familia l, social and economic factors. They
went on to say that research should pay
greater attention to such things as family
and social supports which may affect thepatient's prognosis and survival.
Drs. Bergmann and Baro's lecture tour isthe first of three to be sponsored in part by
the University of Michigan's Institute on
Gerontology and the Veterans' Administ ration's Office of Geriatrics and Extended
Care. DNIH Daycare Center
Receives $750 Donation
The Parents of Preschoolers, Inc., daycare
center for children of NIH employees, hasreceived a S750 check to help the center'sscholarship fund.
T he check was a gift from T ime-Life
Books, Inc. in appreciation of the research
assistance by the NIH information community over the past years for Time-Life's medical publications. D

The National Institute on Aging held its second
annual awards ceremony June 28 In Wilson Hall. A
number of Institute staff received awards for theiroutstanding contributions to the Institute during
the previous year. During the ceremony, Dr.
James B. Wyngaarden, NIH Director, presented a
special award to Dr. Robert L. Ringler, Acting
Direc tor, NIA, (r) in recognition of his many
achievements at NIA and NIH. Other awardees not
pictured: NIH Merit Awards- Pamela W. Jones,
Dr. Richard L. Sprott, and Mary J. Wendehack.
Group Awards- Biomedical Research and Clinical
Medicine, and Grants Management Office.

New Brochure on NIA Available
National Institute on Aging, a newly
revised brochure describing the Institute andits functions, is now avai lable.
The brochure outlines N I A's extensive
resea rch activities on t he biomedical, behavioral and social aspects of the aging process,the diseases of aging and other concerns of
the elderly.
It also highlights the various N IA intramural and extramural programs, and summarizes findings reported by Institute scientists
and researchers receiving grant support.
The brochure also focuses on the I nstitute's efforts to stimulate specialized training
in geriatric medicine through the development of medical school curricu la. Other sections review the significant events in thelnstitute's history and provide information on
the Federal advisory groups involved withaging.
Copies of National Institute on Aging areavailable free from Expand Associates/NB,
8630 Fenton St., Suite 508, Silver Spring, MD

20910. D

Visiting Scientists Program Participants
6/13 Dr. Andres Negro-Vilar, Argentina. Sponsor:
Dr. Robert L. Di xzon, Lab. of Reproductive andDevelopmental Toxicology, NIEHS, Research Triangle Park, N.C.
6/1 3 Dr. Eduardo J. Splnedl, Argentina. Sponsor:
Or. Andres Nigro-Vilar, Lab. of Reproductive andDevelopmental Toxicology, NIEHS, Research Triangle Park, N.C.
6/20 Dr. Aklhlro Yachle, Japan. Sponsor: Dr. R.
Michael Blaese, Metabolism Branch, NCI, Bg. 10,
Rm. 4N108.
6/22 Dr. Yoh-ichlroh Ohno, Japan. Sponsor: Dr.
John I. Gallin, Laboratory of Clinical Investigation, NIAID, Bg. 10, Rm. 11N114.
6/26 Dr. Tommaso Costa. Italy. Sponsor: Dr. David
Rodbard, Endocrinology and Reproduction
Research Branch, NICHD, Bg. 10, Rm. 8C312.
6/26 Dr. Takeshl Sakiyama, Japan. Sponsor: Or.

Janice Chou, Neonatal and Pediatric Medicine
Branch, NICHD, Bg. 6, Rm. 128.
6/26 Or.Marina BoJanovskl, Fed. Rep. of Germany. Sponsor: Dr. H. Bryan Brewer, Molecular
Disease Branch. NHLBI, Bg. 10, Rm. 7N117.
6/26 Dr. Juan C . Monge, Costa Rica. Sponsor: Dr.
Harry Heiser, Office of the Director, NHLBI Bg.
10, Rm. 8C103.
6/27 Dr. Janendr~ Batra, India. Sponsor: Dr.
Ernest Hamil, Laboratory of Medicinal Chemistry& Biology. NCI, Bg. 37, Rm. 5C02.
6/27 Dr. Yogendra Singh, India. Sponsor: Dr.
Gopal Krishna, Laboratory of Chemical Pharmacology, NHLBI, Bg. 10, Rm. 8N107.
6/28 Dr. Michael Thaler, Israel. Sponsor: Dr. PhilipPizzo, Infectio us Disease Program, NCI, Bg. 10,
Rm. 13C101.

To be good is noble; but to show others
how to be good is nobler-and notrouble.-Mark Twain □Page 8The NIH Record

August 16, 1983

Judo Demonstration Set for August 17
A free Judo Demonstration by the N IH
Judo Club will be held from noon until 1
p.m., Wednesday, Aug. 17, in the ClinicalCenter's Masur Auditorium. Dr. Thomas E.
Malone, NIH Deputy Director, will head thedemonstration team. D

SCAN(Continued from Page 1)

has been relatively overlooked" in earlier
studies of this disorder.
" It is reasonable to say that many of the
major symptoms of Alzheimer's refl_ect .~ysfunction in the parietotemporal region, Dr.
Chase stated.
Stroke is being understood in new ways
because of information gathered throughPET scanning. Speaking for the PET
research team at Massachusetts General
Hospital in Boston, Dr. Robert Ackerman
described an important pattern seen in somestroke patients whose CT scan was normal
and whose blood flow to the brain area
affected by the stroke was also relatively
normal on t he second or th ird post-strokeday.
The amount of oxygen being utilized,
however, was very low. A CT scan taken a
few months later showed that the tissue inthe affected part of the brain had died, Dr.
Ackerman reported.
This observation contradicts previous
dogma that blood flow primarily dictates theoutcome in stroke. The new theory suggeststhat t issue metabolism is more important
than blood f low to the prognosis of stroke
patients.
Or. Ackerman noted that this new insightwould only have come from PET studies:"No previous technique has been able toshow us this, since blood flow is not always
the important information," and only PET
can show both blood flow and metabolism.
Dr. Marcus E. Raichle of Washington University School of Medicine described how
PET's ability to measure both blood flow andtissue metabolism is helping physiciansevaluate cerebral bypass surgery.
This surgery is designed to increase bloodflow to the affected area of the brain, on theassumption that neurological problems instroke victims simply result from inadequate
blood supply.
But, Dr. Raichle and his colleagues found,among 17 patients studied both before andafter reconstructive vascular surgery, " only
six patients showed the expected anddesired changes in blood flow and metabolism."
These six patients had an increase inblood flow and a decrease in a measurement
called the oxygen extraction rat io, which isthe fraction of the total oxygen in the bloodthat is taken out by the brain tissue.
When the oxygen extraction ratio is very
high, as it often is after a stroke, the brain
has less leeway to increase its oxygen
metabolism in response to a stimulus suchas the need for intense thought or heightened activity.
In the six patients where surgery reduced
the oxygen extraction ratio, there is presumably a decreased chance of brain damage
leading to loss of speech or muscle functions. But in the other 11, it is possible thatthe bypass operation didn't help.
All patients who benefited from bypass
surgery had had small strokes but no residual neurological symptoms. Dr. Raichle andhis colleagues are following these six
patients with PET scans and studying other
patients to see if they can predict who will
benefit from the bypass.
August 16, 1983

Given such ability, physicians could apply
the surgical procedure more efficiently, andinvestigators could focus their efforts ondeveloping new treatments for patients
unlikely to benefit from bypass.
Tumor Malignancy and Glucose UseDr. Giovanni Di Chiro of the NINCDSNeuroradiology and Computer Tomography
Section presented the results of his team's 3year experience with tumors of the central
nervous system.
Confirming for the first time in the living
human being, the theory advanced by Warburg more than 50 years ago, the NIN CDS
workers have shown a strong correlation
between the malignancy of tumors and theirrate of glucose utilization.
.
A practical application of this ob~ervat1on,
Dr. Di Chiro suggested, is that a scIentIst
can accurately establish how malignant abrain tumor is with this method.
The NINCDS investigators have also beenable to recognize very early t he transformation of a benign tumor into a malignant one.
The implications of this method for theproper therapeutic management of brain
tumors are far-reaching, Dr. Di Chiro said.
What Happens During a Seizure?

PET scanning is also shedding light onchanges in the brains of persons with epileptic seizures.
Dr. Jerome Engel reported the UCLA
research team's observations on metabolism
in patients with focal seizures. In such cases,
the cause of the epilepsy is localized to a
specific part of the brain, and surgical removal often controls the seizures.
Among more than 100 such patients studied with PET so far at UCLA. more than 70
percent have shown a region of decreased
metabolism on PET. The area of abnormal
metabolism revealed by PET agreed in mostcases with the area of abnormal electricalactivity defined by EEG (electroencephalogram).
These findings have been reproduced by
NINCDS scientists, reported Dr. William H.
Theodore of the NIN CDS Clinical Epilepsy
Section. He raised the possibility that "PET
may obviate the need for invasive EEG studies in some patients."
The UCLA group has also found intriguing
information about the brain during seizures:in patients studied with PET during a seiz~ure, the epileptic focus increased its actIvIty.
Drugs that were effective in controlling
seizures returned this hypermetabolism tonormal. Further research along these lines
may help guide therapy or even illuminate
the cause of the altered brain metabolism inepilepsy patients.
The proceedings of the PET conference
will be published as a supplement to Annalsof Neurology. □Stop Smoking Program Offered
The Employee Assistance Program of the
Occupational Medical Service will p_res~nt a6-week Stop Smoking Program beginning
Sept. 7.
The program, to be held on Wednesdays
from noon to 1 p.m., in Bldg. 31, Rm. 83857,
is designed to help the smoker cut down_
gradually. To register, call Moms Schapiro,
496-3164. □The NIH Record

Dr. Gerald M. Shean Dies;
Active in NIH and Community
Dr. Gerald M. Shean, Jr., executive secretary in the Review Branch, Division ofExtramural Activities, NIADDK, died July 5of cardiac arrest. He had spent the last 25
years of his career working for the Institute.
Prior to his
career at NIH, Dr.
Shean served with
the U.S. Navy. He
also held positionsof high school
teacher, superintendent of schools'/J in Shaumut, Mont.,
and petroleum
geologist on wildcat oil wells with- Core Laboratories,
Inc.
From 1958 to 1980, Dr. Shean worked as a
research chemist in the molecular biophysics section, Laboratory of Chemical Physics.
There he collaborated with Dr. Karl
Sollner, scientist emeritus, on artificial porous and liquid membranes and their use incomplex membrane systems and models.
In 1980 he transferred to extramural programs as a health scientist administ~a_tor,
where he was responsible for organizing andconducting initial scientific merit reviews of
research training and project grant
proposals.
.
Or. Shean received a B.A. degree inbotany from Carleton College, Northfield,
Minn. and a Ph.D. in plant physiology from
Missouri University, Columbia, Mo.
In addition to his scientific endeavors, Dr.
Shean took an active part in other facets of
NIH life. He served 2-year terms each as an
EEO counselor on the NIH EEO Advisory
Council, and as NIH R&W vice-president. He
participated in several athletic activities, andwas in the NIH Well Health Program.
A man of many talents and interests, Dr.
Shean took an active role in community
affairs. His diverse activities included beekeeping (he maintained seven hives in his
backyard). As a member of the Maryland
Beekeepers Association he was called on
several times to collect swarming bees fromthe yards of Montgomery County resident_s.
Active in politics, Dr. Shean helped organize
and establish Nonpartisans for a Better
Montgomery County. He was a Boy Scoutleader, and active in homeowner issues in
his commuity.
An accomplished actor and singer, Dr.
Shean was a member of the original NIH
Hamsters, and participated in Rockville Little
Theater and the Montgomery and Glenmont
Players.
Dr. Shean was a warm individual with aready smile and easy conversat ion. His longtime friend Dr. Harry Saroff characterized
him as a "pleasant person, full of vitality andhumor, whose company was always
enjoyable."
Dr. Shean is survived by his children,
Michelle, Holly Akenson, Bonnie, Valery,
Deirdre, and Gerald M. Shean Ill.

Page 9

Biofeedback, Relaxation Can Help Control High Blood Pressure
By Esther Solomon

H igh blood pressure or hypertension, issometimes called the " silent killer" because
it often produces no symptoms. When bloodpressure stays high, it can create a strain on
the heart and blood vessels, and can lead tostroke, heart disease and kidney failure.
Hypertension affects about 60 million
people in t he United States. In many cases,
hypertersion is controlled with drugs, usually con tinued for life to keep blood pressure at safe levels. These medicines canalso cause unwanted side effects.

Patients who measured their own blood pressuresdaily achieved reductions in blood pressures.
Relaxation training and biofeedback lowered
blood pressures further.

Scientists at the Gerontology ResearchCenter in Baltimore, part of the National
Institute on A ging, are showing that behavioral trai n ing can be one alternative to druguse for some patients with borderline
hypertension.
Ors. Bernard Engel, Michael Glasgow,
and Kenneth Gaarder tested three behavioral techniques: daily self-monitoring ofblood pressure, biofeedback (a process inwhich patients use monitoring devices toget signals or feedbac k on speci fi c bodyfunctions -in th is case, b lood pressure
sounds in the arteries) and relaxation
trai ning.
In this study, patients who measured theirown blood pressures daily and reviewed theresults once a month with a health professional, achieved reductions in blood pressures. Relaxation train ing and biofeedback
lowered blood pressures further.
B lood pressure readings for adu lts
depend on many factors, incl uding age, sex,
race, whether the patient is standing or
recl ining during testing and the level ofactivity before measurement.
A typical normal reading in an average
healthy adult as recorded in a doctor's
office is about 120 millimeters of mercury
of systolic pressure (the force of the heartbeat pushing b lood into t he vessels) and 80
millimeters of mercury of diastolic pressure (when the heart is at rest between
beats).
The N IA study began with 127 volunteers
whose average diastolic b lood pressures inthe doc tors' offices were at least 90 mm Hg.
Page 10Investigators first tested the feasibility of
having these people monitor their own
blood pressures.
The volunteers learned to use sphygmomanometers and monitored their own bloodpressures 3 times a day for 1 month. Once aweek, their blood pressures were measu red
by a health professional. At the end of themonth, each patient rev iewed the measurements with one of the investigators.
About half of the patients were receiving
no antihypertensive drugs and half weretaking di uretics (medications that remove
salt from the body and help reduce bloodpressure).
This stage of the study showed thatpatients could successfully monitor thei r
own blood pressures and report the results.
In addition, these patients achieved significant reductions in blood pressures.
Patients who completed the initial study
were assigned to groups for biofeedback orrelaxation t ra ining or to a control groupwhich continued self-monitoring.
Those using biofeedback and relaxat ion
took their pressures before and after practi ci ng the techniques. After 3 months, halfof the patients in each training grouplearned to use the other technique. Patientspracticing biofeedback learned to initiate
and keep the cuff of the sphygmomanometer at about systolic pressure while listening
to and trying to inhibit artery sounds.
When they succeeded in reducing systolicpressure, the sounds disappeared. They
practiced this technique several times daily,
especially at the times of day when previous
measurements had shown their pressures tobe highest, which was generally in theafternoons.
Later they learned to recognize bodysensations that resu lted in lower systolicblood pressure. Eventually they practiced
biofeedback without th e sphygmomanometer to lower their blood pressures at convenient times, such as du ring work breaks,
while waiting at traffic signals, or standi ng
in line at a store.
Patients using relaxation techniqueslearned to identify and re lax specific muscle
groups especially tense. This al lows blood
to flow more freely through the tissues.
They also used these techniques when theirpressures were likely to be h ighest.
Eventually they learned to recog n ize feelings of relaxation which successfully
lowered blood pressure and to practicethese techniques at convenient times.
Both the biofeedback and relaxation techniques lowered blood pressures significantly as the pat ients developed their skills.
A combination of biofeedback and thenrelaxation was better than either method
used alone.
Improvements were noted in patientsusing diuretics as well as those taking no
medications: however, the techniques weremost effective for those not on ant ihypertensive medication.
Followup studies showed that these
reductions in blood pressure could bemaintained for at least 18 months. About
one-third of the patients receiving diruetic
therapy were asked by physicians to discontinue the medication. They were able to
The NIH Record

keep their b lood pressures down to safe
levels throug hout a 9-month followup
period with no medications.
Having shown behavioral methods to be
successful with borderline hypertension, thescientists are testing the effectiveness o fthese techniques on persons who havemore severe high b lood pressure.
Dr. Engel advises people who might beinterested in trying these methods to consult a doctor. " Although these are selladministered techniques, th ey must be
learned from properly t rained professionals
and the patients should be under professional supervision," Dr. Engel said. " No one
should discontinue medication without consu lting his or her doctor."
The Biofeedback Society o f America
keeps a list of clinicians who use behavioral
techniques to control hypertension andother conditions in their patients. To obtainthe names of clinicians in specific areas of
the country or for further information about
biofeedback, contact the Biofeedback
Society of America, 4301 Owens St., Wheat
Ridge, CO 80033. D

Koch Institute Seeks Director;
Americans May Be Eligible
The famed Koch Institute in West Berlin islooking for a new director and says that
Americans with sufficient command of German may apply.
The Institute, which operates under theFederal Republic's Health Office, is concerned with the diagnosis, prevention andcontrol of communicable diseases in man.
An applicant for the director's post must
be a physician (male or female) with above
average scientific qualifications in bacterio logy, virology or immunology as attested byscientific publications.
And h e or she should have held a key medical administrative post in the past and haveshown skill in negotiation and administrat ion. D

Dr. Murray Goldstein, NINCOS Director (second
from r), and Dr. Chang Hsiang Tung, Director of
Shanghai Brain Research Institute (second fromI), recently signed an agreement for researchcooperation at Stone House during a ceremonyarranged by 1he Fogarty International Center. Dr.
Chang Is currently a Fogarty Scholar. T his agreement comes under the NIH-Chinese Academy of
Sciences Agreement signed in Beijing in May by
NIH Director James B. Wyngaarden. Also attending the signing were Dr. Phyllis Eveleth, FIC (I),and Dr. Philip Schambra, FIC (r).

August 16, 1983

Tardive Dyskinesia (Involuntary Twitchings):
Definition, Cause and Cure Unsettled
Tardive dyskinesia is a condition manifested by involuntary, repetitive
movements- most often of the tongue,
mouth, and face, occasionally of other bodyparts.
It occurs in some ind ividuals (estimates
range from 5 to over 50 percent) who havebeen treated with neuroleptic drugs, agroup of psychoactive medicines used totreat psychiatric and neurological disorders
such as schizophrenia, mental retardation,
autism, Tourette's syndrome, and Huntington's disease.
Dyskinesias can also be caused by illness,brain damage, and other neurologicalconditions.
Videotapes of developmentally disabled
youngsters were shown recent ly to National
Institute of Mental Health scientists by Dr.
Thomas Gualtieri, University of North Carolina School of M&dicine, who asked themeeting participants t o diagnose theyoungsters' conditions without knowledgeof their h istories.
Dr. Gaultieri conceded the cases wereparticularly difficult in terms of differentiating movements caused by tardive dyskinesia from movements associated with otherdisorders.
D iscussion following the tape's showing
centered on problems that c linicians face intreating psychiatric and developmentallydisabled patients.
One such problem is the double-edged
action of the drugs themselves. Whileneuroleptic drugs can cause dyskinesia,
they can also ameliorate both drug andnondrug-related dyskinesias in many
patients, which can lead to a vicious cycle.
Dyskinesia is treated with a neuroleptic,
which suppresses it for a time. but w ith
continued dosage causes the reappearanceof dyski nesia.
The patient is then treated with increased
doses of another neuroleptic, which resu lts
in a replay of the suppression and ultimate
reappearance pattern.
N evertheless, neuroleptics remain thetreatment o f choice for schizophrenia. They
diminish hallucinations, delusions, andbizarre behaviors, freeing many patientsfrom institutions. For the developmentallydisabled, neuroleptics may control selfdestructive and aggressive behaviors as well
as stereotypies (repetitive, compulsive
movements).
Many techniques are available to help
trained observers monitor movements associated with tardive dyskinesia. One developed by NIMH scientists called theAbnormal Involuntary Movements Scale(AIMS) was discussed by Dr N ina Schoolerof NIMH' s Pharmacologic and Somatic
Treatments Research Branch.
She noted that systematic examination
procedures and standardized rating scales
are prerequisites to diagnosing tardive dyskinesia. A onetime observation can, at best,
identify a "presumable" dyskinesia.
According to th e Research Diagnoses for
Tardive Dyskinesia (RD-TD ) developed byOrs. Schooler and John Kane, Long Island
Jewish Hillside Hospital, an AIMS rating of

mild abnormal involuntary movements in
two body parts or moderate movements in
one body part is a criterion for diagnosing
dyskinesia.
Ors. Jonathan Cole, Mclean Hospital,
Boston, and James Smith, Hudson River
Psychiatric Cen ter, Poughkeepsie, N .Y.,
both used Al MS to study psychiatric populations. They found no clear pattern for
either onset of tardive dyskinesia or remission following drug withdrawal.
Dr. Smith found females had more severe
forms of the disorder, and that age affects
its persistence. Older, chronic schizophrenics show no improvement even after 3 years
off medications, he said.
In contrast, Dr. Stephen Bruening, Western Psychiatric Institute and Clinic, reported
t hat among the developmentally disabled,
many individuals withdrawn from drugs
show major improvements after 4 months.
Initially following drug wit hdrawal, abnormal movements and behavioral problems
occu rred in 34 percent of t he study populat ion. The prevalence of moderate to severe
symptoms i ncreased during the first 4
weeks, then diminished, dropping dramatically by 15 or 16 weeks.
Dr. Kane, who conducted the first ,prospective study of tardive dyskinesia in 800
patients with all types o f psychiatric diagnoses, said he d id not see the same
dramatic increase in symptoms following
drug withdrawal in the mentally ill population that Dr. Bruening reported in thedevelopmentally disabled.
Dr. Cole pointed out that biolog ical
variabil ity in patients appears to play animportant ro le in vul nerability to tardive
dyskinesia. Some patients get tardive dyskinesia atter very short exposure to drugs,
he noted.
In summarizing the 2-day meeting, Dr.
Arnold Friedhoff, M illhouser Laboratories,
NYU School of Medicine, pointed out thatthe definition of tardive dyskinesia mayneed revision because drugs other thanneuroleptics have been found to cause
similar movements. Also, the variety ofdyski nes ias-with drawal, ii I ness-relatedmake it a confusing term.
When discussing future research needs,
Dr. Friedhoff suggested more studies on
specific factors p lacing individuals at risk
for tardive dyskinesia.
Women and older people appear to beparticularly vulnerable and there is evidence
associating duration and dosage of medication with severity, but there are enoughdifferences in outcome to warrant morestudies, he said.
A major concern of the scientists was theneed to educate clinicians and superintendents of institutions-particularly for thedevelopmentally disabled- about appropriate use of medication and behavioral
procedures to cut back both the number of
those treated with drugs and dosages used
to treat them.
For further information, contact Dr.
Schooler or Natalie Reatig, PSTRB, 5600
Fishers Lane, Rm. 10C06, Rockville, MD

August 16, 1983

The NIH Record

John Campbell recently joined NCI as the chief ofthe Research Contracts Branc h, Office of Administrative Management. He comes to the Institutefrom the National Institute of Drug Abuse (NIDA),
where he was chief of the Contracts Management
Branch. Mr. Campbell graduated from the University of Tennessee i n 1965 with a B.S. in businessadministration and joined NCI In 1973 as a contracts specialist in the newly established Cancer
Control Program. He later joined NIDA in 1978.

Two R&W Golf Groups
Plan 'Shotgun Start' Outing
Members and invited guests of the NIH
Golf Association (NIHGA) and the NIH Golf
League (NIHGL) are planning a joint "Shotgun Start" golf outing at the Montgomery
Country Club in Laytonsville, Md. on Monday, Aug. 29, 1983.
The start is set for 1 p.m. In a shotgun
start, a golf foursome tees off on each of
the 18 holes of the golf course at the sametime. As a result. at least 72 golfers
commence play almost simultaneously.
Additional foursomes are set to tee off
immediately after the starting foursomes
until all participants are off on their 18 holeround of golf.
NIH employees who are not members ofeither league but wish to play should makearrangements through a League member orcontact Ben Fulton (N IHGA) or Lynn
Mueller (NIHGL) . The only requirement isthat a player have an established golfhandicap which can be verified by a League
member.
Costs for the outing will be $15 perperson including greens fee and cart. D

Interested in Volunteering?
The Volunteer Clearinghouses of the Metropolitan Area help individuals or groupsinterested in volunteer work find the bestplace in the community to share their time
and talents.
Volunteers are needed in health, research,
computer science, medical, education, arts/ culture, counseling/ guidance, recreation,
public relations, environmental, and administrative/ clerical programs.
The Volunteer Program is being coordinated by the NIH Recruitment and Employee
Benefits Branch, Division of Personnel Management, Bldg. 31, Rm. B3C03, 496-5979. D

20857. -Marllyn Sargent □Page 11

Dr. Metzger Named
NIADDK Branch Chief
Dr. Henry Metzger was recently appointed
chief o f the Arthritis and Rh eumatism
Branch, N IADDK. He succeeds Dr. John
Decker who, after 18 years as ch ief of thatbranch, res igned to assume new duties as
D irector of the Warren Grant Magnuson
C linical Center.
Prior to his appointment, Dr. Metzger
served as chief, section on chemical immunology in the b ranch, a position he has held
since 1973. His research interests have

NIH Employee Named Winner
Of Shriner Scholarship PageantPaula C. Chandler, 21, an employee at theNIH Division of Research Services, B ldg. 13,
was selected as first place winner of the
Beauty/ Talent Scholarship Pageant held by
the Mecca Temple No. 10, Ancient Egyptian
Order of the Mystic Shrine in Washington,
D .C., recent ly .
Paula will rep resent the local Temple atthe N ati onal S hrine Convention in St. Louis,
Mo. the week of Aug. 15.
James W. Garrison, the Illustrious Potentate of Mecca Temple No. 10, an employee of
N IH LBV in B ldg. 5, presented th e award.
Should Paula win at the National Convention, she will receive an additional scholarship and represent Shri ners worldwide for
1983/ 84. D

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God made the country, man the town. William Cowper □Fitness and Sports Medicine
To Be Discussed at Symposium

Dr. Metzger

focused on the nature and effect of antibodies. Related to inflammation, the work of
Dr. Metzger and his colleagues has broad
applicability in biology, specifically inunderstanding the immune system.
His recent studies have focused o n how
antibody activates the re lease of inflammatory substances from cells. In reactions
mediated by antigen-antibody complexes, itis necessary for antibodies to agg regate orc lump together for biological act ion. Usually
the antibodies that c lump together are attached to the cell surface by receptors.
When an antigen attaches to the antibody
on the cell surface, a chemical change
occurs. This change is a message to the cellthat an antigen is present.
D r. Metzger is attempting to describe one
such receptor- the receptor for the lgE (onetype of immunoglobulin) antibody-by b iochemical means. Once the structure andfunction of the receptor is known, it may
give a clue to how the subsequent b io logicalevents can be identified.
Dr. Metzger was born in Mainz, Germany,
emigrated to the United States in 1938, andbecame a citizen in 1945. He earned an A .B .
degree from the University of Rochester in
1953. and an M.D. degree from Columbia
University in 1957.
His internsh ip and res idency were served
at Columbia-Presbyterian Medical Center in
New York. He came to the NIH and the
N IADDK in 1959, and with t he exception of a2-year fellowsh ip at the University of Californ ia, San D iego, has remained with theInstitute. D
Page 12The 1983 White House Symposium on
Physical Fitness and Sports Medic ine will beheld Nov. 16-17 at the Mayflower Hotel inWashington, D.C. More than 600 health andfitness professionals are expected to attend
this symposium on muscle strength, endurance development and maintenance.
Medical, research and program specialists
will present current research and participate
in panel discussions and demonstrations on
muscle physiology and1 anatomy, theresearch basis for muscular strength andendu rance in physical fitness , sports performa nce, work, health, and rehabil itation;and program applications of scientificprinciples.
Sponsors of the symposium are the President's Council on Physical Fitness andSports, Department of Health and Human
Services, American College of Sports Medicine, American Medical Association.
Also American Orthopedic Society forSports Medicine, National At hletic Trainers
Association, National Fit ness Foundation,
Natio nal Strength and Conditioning Association, and the U.S. Olympic Committee'sSports Medicine Council.
The Campbell Soup Company wi ll be theprimary corporate sponsor, and more than
20 additional medical and sports organizations will support the symposium as cooperating agencies.
Registration fees are: physicians. $175;
other professionals, $90; fu ll-time college oruniversity students, $35. For additional
information and registration forms , contact
the Office of Sports Medicine, President's
Council on Physical Fitness and Sports, 450
Fift h St., N.W.. Washington, D. C . 20001, or
call (202) 272-3424. o

NOTE
The telephone number for the Division o f
Safety is 496-1985 for copies of the Air Quality Index Article. D
U.S. GOVERNMENT PRINTING OFFICE 1983-34 1-134/ 24

The NIH Record

August 16, 1983