1981 Spring Faculty Journal

FACULTY JOURNAL UNIVERSITY OF UTAH COLLEGE OF MEDICINE Vol. 4, No. 1 Spring, 1981Unlocking secrets of genetic expression could aid fight against cancer A promising research inquiry into the mechanisms controlling gene ex-pression may ultimately provide a breakthrough in the control of cancer-causing agents. Daniel F. Klessig, Ph. D., assistant professor of cellular, viral and molecu-lar biology, is analyzing the genetic and biochemical interactions between a human virus and monkey cells. With a $ 150,000 grant from the American Cancer Society and $ 440,000 in NIH support, Dr. Klessig is studying how gene expression is controlled in human adenovirus, a widespread virus CVMB researcher Daniel Klessig isolates DNA binding protein thought to be involved in the processing of viral messenger RNA. The understanding of the role this process plays in altering gene expression may provide clues for the control of tumorigenic agents. associated with conjunctivitis and severe respiratory illness. The virus causes tumors in newborn rodents, but it is not thought to be tumorigenic in humans. " An understanding of why certain genes of the virus are allowed to be expressed, while the expression of. others is dramatically inhibited, could lead to a better understanding of how cells control expression of their own genes, as well as those of infecting viruses," explains Dr. Klessig. The research has promising implica-tions in the fight against cancer, since scientists believe that the level of ex-pression - or lack of expression - of certain genes determines whether a cell is normal or cancerous. Recent reports support this hypothesis since oncogenic ( tumor- causing) genes of RNA tumor viruses expressed at high levels in trans-formed cells are very similar, if not identical, to a gene in normal cells ex-pressed at low levels. " Adenovirus is a tool with which I hope to better understand the cell," says Dr. Klessig, a former student of Nobel Laureate James Watson at Har-vard University and Raymond Geste-land, now a Hughes professor of biology at the U. " The virus is a convenient ' packet of genes' which can be intro-duced into the cell and readily studied. Approximately half of the 30 to 60 genes in the virus are expressed at normal levels in the monkey cell, in striking contrast to abnormal expres-sion of other genes in this packet." Dr. Klessig's findings indicate that the block to full expression is due to abnormal synthesis of messenger RNA ( mRNA), particularly the mRNA en-coding the fiber protein. While at Cold Spring Harbor Lab-oratories in 1977, Dr. Klessig and colleagues both there and at M. I. T. found that genes in eucaryotic ( higher) cells, unlike those in bacteria, are often split. The parts of a gene, rather than being contiguous, may be separated by long stretches of DNA which are not essential components of the gene. Since both essential and non- essential com-ponents are transcribed into RNA, further processing of this RNA must occur before it can serve as the message for protein synthesis. " The resulting RNA splicing leading to a mature mRNA with all dispersed parts of the gene copy in proper register has major implications," notes the U virologist. " This phenomenon provides another level at which the control of gene expression can be exercised." Dr. Klessig's research, in fact, provides some of the first evidence that control-may be acting at the level of splicinj In the monkey cell infected with adeno'"^ virus, a large portion of the fiber mRNA appears to be aberrantly spliced. The fiber mRNA is properly processed, however, in monkey cells infected with a mutant of adenovirus which was isolated by Dr. Klessig for its ability to multiply efficiently in these cells. " Another implication of this finding is that a small segment of DNA may encode many mRNA's which differ from each other in their pattern of splicing," says Dr. Klessig. " Thus a small region of DNA can encode many proteins, as appears to be the case for immunoglobulin genes as well as for many viruses. " Like Eli Whitney's interchangeable parts, split genes probably facilitate the rapid reassortment of gene parts to form entirely new genes, in the same fashion that Detroit uses identical com-ponents to make many different auto models," explains Dr. Klessig. " This clearly has major evolutionary implica-tions." Revamped curriculum committee will review four- year offerings A smaller, more workable Curricu-lum Committee which represents the faculty at large rather than the special interests of individual departments is the intent of a recent revision in College of Medicine bylaws. The change, proposed by Dean Lee and overwhelmingly endorsed by the College Council ( 145 for, 36 against), reduced the committee from 28 to 7 members, to include the assistant dean for medical education, two faculty each from the clinical and basic sciences, a fourth- year medical student and the associate dean for academic affairs ( ex officio voting member.) A standing committee of the Col-lege of Medicine, the Curriculum Com-mittee is charged with surveillance and review of the medical curriculum. Its mandate is to " propose and implement such changes as shall be deemed neces-sary to improve the quality of instruc-tion and learning environment..." " Because of its large size, it has been difficult in the past for the Curriculum Committee to take an innovative, active role in curriculum planning," says Anne G. Osborn, M. D., associate professor of radiology and assistant dean for medical education. " Its major function had been to review and ap-prove requests for courses referred to it by various departments through the subcommittee structure." Dr. Osborn says a review of the entire four- year curriculum is necessary. " To do this and at the same time insti-tute innovative changes would have been very difficult for a body of that size, which met once a month for 45 minutes." After soliciting applications from all interested faculty members and nomi-nations from individual departments, the Dean has appointed these committee members to terms of unspecified length: Peter Lawrence, M. D., surgery; Louis Borgenicht, M. D., family and com-munity medicine; Elvera E. Ehrenfeld, biochemistry and cellular, viral and molecular biology; and Richard J. Mullen, Ph. D., anatomy. The Execu-tive Committee has approved these ap-pointments and has endorsed the ap-pointment of Dr. Osborn as chair-person of the committee. The student member will be selected and approved by early June. " Appointment, rather than election, of members will help guarantee interest and commitment," Dr. Osborn believes. " All members should expect to devote approximately one- half day a week to committee business." Previously, there was no mechanism by which decisions of the committee could be appealed. Now departmental concerns can be arbitrated by the Executive Committee, which can over-ride a curriculum committee decision by a three- quarters vote. Dr. Osborn says the new commit-tee, which should be functioning by late spring, will evaluate the curriculum as a whole, rather than examining it piecemeal. " We expect some major changes in the curriculum structure," says Dr. Osborn. " Although some of these changes may be implemented during 1981- 82, major changes are unlikely before the following academi year." ^ ' lancial Planner James Wheeler Doctors, do you know where your money is? " We spend millions of dollars teach-ing physicians how to make money and virtually nothing on telling them how to manage it once they earn it," says James C. Wheeler, a certified financial planner. " Physicians usually fall into two extreme camps when it comes to finan-cial planning," according to Mr. Wheel-er. " They're total procrastinators in doing anything to make their money work more effectively for them, or they invest impulsively in anything that strikes their fancy, with no game plan." Mr. Wheeler has a prescription for this financial irresponsibility. He teaches " Financial Planning for Doctors in an Inflationary Economy," an invest-ment planning workshop sponsored by the University of Utah's Division of Continuing Education, in cooperation with the Department of Finance. " Physicians make two frequent mis- ^^ kes in financial planning," says T< Vheeler. " They give up the earning power of their money to a savings insti-tution or an insurance company, or they speculate. " Doctors don't need to speculate," he emphasizes. " They'll make all the money they ever need to make with a 15- 20 percent return on their invest-ment." By the end of the four- part course, each doctor will have developed his or her personal financial plan. " I encourage everyone to use a money market fund as the base of his plan," explains Mr. Wheeler. " And I suggest that an emergency reserve be built into it. This reserve varies widely depending on the physician's circum-stances. It can range from $ 1,000 to $ 20,000." Wheeler says all financial plans should be divided into two basic areas: Working dollars and loan dollars. In the latter category are such items as corporate and municipal bonds, annui-ties and short- term mortgages. " Most people have too much money in this area - all their money is in savings accounts, life insurance, etc.," com-ments Wheeler. Working dollar areas, which should be equal in size, include equities, energy- related investments such as oil income programs ( low- risk) or oil drilling, real estate and other business interests such as gold. " Many people have all their money in real estate - which has a potential liquidity problem," Mr. Wheeler cautions. " Also, physicians should put only one- third of their money in stocks, and these stocks should be good value stocks that should be kept two or three years and then sold. " The whole key to financial plan-ning is diversification - both among different areas and within each area," he stresses. Spouses are invited to attend the workshop as part of the $ 98 registra-tion fee. " Many people don't under-stand how to take full advantage of our tax laws," says Mr. Wheeler. " Owner-ship of property is very important. I encourage the spouse to own the house. I also advise that one investment should be made in the spouse's name each year. If the spouse is working, an even larger investment should be made." The financial consultant says that by the time physicians have finished the course, they know what they should be doing. " They also learn a lot about themselves and their own tem-perament." One house staff officer who took the course a year ago says he's " certainly doing things now that I didn't do before the course." He says the workshop gave him a good overview of invest-ment fundamentals and increased his " basic fund of knowledge - which was zero. It's given me the tools to ask more intelligent questions and assess the skills of any financial counselor I might hire." Another faculty member, a profes-sor of internal medicine, says she made some changes in her financial planning after the course - " mostly things I knew but had just put aside. The class was a spur to make me take stock and re-organize again." Mr. Wheeler warns physicians not to put their newly made financial plan in mothballs, to be unwrapped in a time of need. " An annual financial check- up is absolutely essential," he stresses. " It's a dynamic situation that you just can't walk away from." Remembering George Cartwright The First Annual George E. Cart-wright Lecture was delivered April 22 at University Medical Center by Alvin M. Mauer, M. D., director of St. Jude's Children's Research Hospital and pro-fessor of pediatrics at the University of Tennessee Center for the Health Sci-ences in Memphis. Dr. Mauer discussed " Acute Lymphoblastic Leukemia: Ex-pectations for Prognosis in the 1980s." Another Cartwright memorial lectureship was established this year - this one at the Albany Medical College of Union University in New York. " We share with you the good fortune to have had him as a force in our lives, and as a friend whose importance can-not be diminished by time," says an Albany biochemist of Dr. Cartwright. " This lecture is our modest way of re-membering him and sharing a hint of his enthusiasm with our colleagues." Dr. Cartwright was a founding father of the College of Medicine who helped create the Division of Hemato-logy in the 1950s and served as chair-man of the Department of Internal Medicine for 13 years prior to suffering a fatal heart attack on April 6, 1980. The U of U Cartwright memorial brings a distinguished hematologist to the campus for two or three days each year. Contributions to the memorial fund can be sent to Development and Community Relations, University of Utah Medical Center, 50 North Medi-cal Drive, Salt Lake City, Utah 84132. Alumnus dies in Spain An educational trust fund for the son of Lt. Douglas Edward Jacobsen, M. D. ( Class of ' 79) has been established. Dr. Jacobsen, a physician in the United States Navy, was killed in a helicopter accident Feb. 23, 1981 while on duty in Almeria, Spain. Dr. Jacobsen's widow, Peggy, has requested that in lieu of any other type of memorial tribute, contributions be made to a trust fund for 19- month- old Douglas Michael Jacobsen. Contributions should be sent to Lt. Col. A. C. Zinni, MOQ 2705, Camp Lejeune, N. C. 28542 or to Maj. Ray L. Smith, 512 University, Jacksonville, N. C. 28540. ACADEMIC HONORS Russell A. Brown, M. D. (' 79); Theodore S. Roberts, M. D., professor of surgery and chief of the Division of Neurosurgery; and Anne G. Osborn, M. D., associate professor of radiology, have received the first annual Stouffer Award for the Best Clinical Article in Radiology, presented at the annual meeting of the Association of Univer-sity Radiologists April 22 in New Orleans. The award, which is accom-panied by a $ 1,000 prize, was presented for " Stereotaxic Frame and Computer Software for CT- directed Neurosur-gical Localization," which appeared in Investigative Radiology, July- August, 1980. Lyle A. Dethlefsen, D. V. M., pro-fessor of radiology, has been named the specialist subject editor for the section on " Cell Cycle Effects of Drugs" for the International Encyclopedia of Pharmacology and Therapeutics. Edwin Englert, Jr., M. D., professor of internal medicine, has received a cer-tificate of commendation from the Vet-erans Administration Medical Center for his 22 years of dedicated service. Dr. Englert established the G. I. Divi-sion and implemented the first research and education training program in gas-troenterology in the VA system. Clark H. Millikan, M. D., professor of neurology, has received the Scien-tific Councils Distinguished Achieve-ment Award of the American Heart Association - an award presented for the first time this year. The AHA said " Dr. Millikan's commitment to the pre-vention of stroke has unquestionably been a major force in the now well-documented reduction in stroke mor-tality and morbidity in the United States." Michael W. Piepkorn, M. D., Ph. D., assistant professor of internal medicine, has received a $ 5,000 research grant from the Dermatology Foundation. Cecil O. Samuelson, Jr., M. D., associate professor of internal medicine, has been elected to fellowship in the American College of Physicians, in re-cognition of his medical scholarship and achievements in internal medicine. J. Robert Stewart, M. D., professor of radiology, has been appointed asso-ciate director for medicine of the jour-nal Radiation Research. Dixon M. Woodbury, Ph. D., pro-fessor of pharmacology and head of the Division of Neuropharmacology and Epileptology, has received, for the 20th consecutive year, a renewal of his Re-search Career Award from the NINCDS of the National Institutes of Health, for continued research en-titled " Pharmacology and Cellular Bio-chemistry of the CNS." FACULTY JOURNAL ( ISSN- 0199- 3879) UNIVERSITY OF UTAH COLLEGE OF MEDICINE Vol. 4, No. 1 Spring, 1981 Second- class postage paid at Salt Lake City, Utah. Published quarterly by Univer-sity of Utah Medical Center, Office of Devel-opment and Community Relations, 50 North Medical Drive, Salt Lake City, UT 84132, under the auspices of G. Richard Lee, M. D., Dean, College of Medicine. POSTMASTER: Send address changes to University of Utah Mailing Bureau, Bldg. 50, Room 113, Salt Lake City, UT 84112. Faculty Journal is published exclusively for College of Medicine faculty and alumni. Article suggestions, guest commentaries and correspondence are welcomed. Articles may be reprinted with permis-sion. Copyright 1981 by the University of Utah College of Medicine. Photographs by Medical Illustration Service, University of Utah College of Medicine. Editor: Anne Brillinger Contributing Editors: Erin Basta, Robert Glass, Shery Harris Michael Stevens heads CME effort; Matsen resigns associate deanship Dr. Stevens Michael H. Stevens, M. D., associ- ^• ate professor of surgery, has been named assistant dean for continuing medical education. In his new position, Dr. Stevens will administer an outreach program in continuing medical education, coordi-nate a hospital referral office, plan on-site educational efforts, and serve as a liaison for other hospitals in University Medical Center's six- state referral area. A 1966 graduate of the U of U Col-lege of Medicine, Dr. Stevens joined the Medical Center staff in 1974. He is chief At noon on March 9, 1981, seven • md a half hours following the first combined heart and lung transplant in a human in almost 10 years and the fourth one ever done, Stanford Univer-sity Medical Center held a news con-ference with the two surgeons involved, Bruce A. Reitz and Norman E. Shum-way. The next day, media across the country and the world carried the story that the 45- year- old recipient was alive and well. Neat. Clean. No reporters sneaking around in hospital laundry baskets. No TV crews camped on the doorstep of the patient's home. The complete absence of advance publicity made it possible to perform the surgery quietly, out of the spotlight, and gave the patient a chance to brace herself for the media onslaught ahead. Responsibility to Inform So why hasn't University of Utah Medical Center taken the easy route? Why has the Development and Com-munity Relations Office allowed every step in the process of preparing for im-lantation of an artificial heart to be Covered in minute detail by local, national and international media? The of the Ear, Nose and Throat Division of the Veterans Administration Medical Center. John M. Matsen, M. D., who has served as associate dean for academic affairs of the College of Medicine since March, 1979 will relinquish the admin-istrative post to resume direction of the University Hospital and Veterans Administration Hospital clinical micro-biology laboratories. He also will assume additional teaching responsibil-ities in the field of microbiology and infectious diseases. answer is simple. We've had no choice, and one of our responsibilities is to inform the public concerning such projects. On June 11, William C. DeVries, M. D., chief of the Division of Car-diothoracic Surgery, submitted to the University's Review Committee for Re-search with Human Subjects a proposal to implant a total artificial heart in a human. Cat Out of Bag The submission was routine. There was no fanfare, no publicity. It was business- as- usual for the 13- member review committee until several weeks later, when Donald B. Olsen, D. V. M., the veterinarian who has earned inter-national recognition for his animal work on the heart, inadvertently told a local UPI reporter about the proposal. Dr. Olsen described the procedure as a temporary life- saving measure until a permanent transplant donor could be found. When that story hit the newspapers on July 23 the phones in the Medical Center's Development and Community Relations Office started ringing off the Development and Community hooks. And they haven't stopped in nine months! PR Turf Divided Ours wasn't the only office under siege. The Park Building Public Rela-tions Office was overwhelmed with calls, too. In an unusual division of the public relations turf, the Medical Cen-ter's community relations group ( CR) is responsible for telling the story of the heart's clinical application while the Park Building office ( PR) takes charge of publicizing the research on the heart and other artificial organs. As media pressure to hear more about implant plans mounted, Univer-sity PR, with the concurrence of Medi-cal Center CR, scheduled a press con-ference at the heart lab at old St. Mark's Hospital to give lab director Olsen; Robert K. Jarvik, M. D., the heart's designer; and Willem J. Kolff, M. D., Ph. D., head of the Division of Artificial Organs; a chance to handle the flood of inquiries all at once. To protect Dr. De- Vries, he was not in attendance, nor was he identified to the media. Dr. DeVries remained unidentified as the implant surgeon through autumn and much of the winter while interest LETTER FROM THE EDITOR Faculty Journal editor Anne Brillinger is associate director of the Medical Center's Relations Office. in the human application of the heart continued to be keen. " What's new with the review committee?" became the media question of the day. DeVries' profile was so low, in fact, that cardiothoracic referrals to Univer-sity Hospital seemed to be going that-away. On December 10, our office issued a feature story on DeVries and his division. The release focused on heart disease generally and the state- of-science in valve replacements and coro-nary bypass surgeries. It also disclosed what several local reporters knew but had kept quiet at our request - that Dr. DeVries would be the implant sur-geon. This release to Wasatch Front media ( local newspapers, radio and TV stations, wire services and pape