Document 431453

VOL. XXXII, NO. 9
JUNE 1961
IN THIS ISSUE
Airway Resistance
Minnesota Medical Foundation
Index Issue
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M.D.
Edito1'
EIVIND HOFF, JR.
Managing Editor
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Y.
SIEGELMAN
Copy Editor
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E.
B. BROWN, JR.,
Ph.D.
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M.D.
M.D.
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University of Minnesota Hospitals
RAY
M. AMBERG, Director
Minnesota Medical Foundation
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Vice-President
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LAZAROW,
M.D.,
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University of Minnesota Medical School
President
University of Minnesota
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College of Medical Sciences
N. L. GAULT, JR., M.D.
O.
MEREDITH WILSON,
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UNIVERSITY OF MINNESOTA
Medical Bulletin
Official Publication of
UNIVERSITY OF MINNESOTA HOSPITALS
MINNESOTA MEDICAL FOUNDATION
MINNESOTA MEDICAL ALUMNI ASSOCIATION
Circulation this issue 2,600
VOLUME
XXXII
June 1961
NUMBER 9
CONTENTS
STAFF MEETING REPORTS
Changes in Airway Resistance Following
Intravenously Administered D-tubocurarine
HUGH D. WESTGATE, M.D., J. R. GORDON, M.D.,
AND FREDERIf:K H. VAN BERGEN, M.D.
.'378
MINNESOTA MEDICAL FOUNDATION ROSTER
.398
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DR. GEORGE E. FAHR PROJECT
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418
.. 423
Published monthly from October to June at Minneapolis, Minn. Editorial offices:
1342 Mayo Memorial, University of Minnesota, Minneapolis 14, Minnesota.
Spcond Class Postage Paid at Minneanolis, Minnesota.
-1
~
Staff Meeting Report
1..
't
,
1
Changes in Airway Resistance Following
Intravenously Administered D-tubocurarine *
Hugh D. Westgate, M.D., M.S.,t J. R. Gordon, M.D.,t
and Frederick H. Van Bergen, M.D., M.S.§
INTRODUCTION
The use of curare in modern clinical medicine began with
the treatment bv \Vest in 1932 1 and Burman in 1939 2 of the
spasms associated with tetanus and neuromuscular diseases. In
1942 Griffith and Johnson:1 described the use of d-tubocurarine
as an adjuvant to general anesthesia. This report was followed
by others on what now has become curare's primary medicinal
function-muscle relaxation during anesthesia.
West 4 administered curare to patients
with muscular spasticity and described what
today are considered the secondary effects
of curare administration: bright red cutaneous flush, tachycardia, and systolic hypotension. He also described a case of alleged
laryngospasm and stated that "curarine exerts a spasmodic action on bronchial musculature."·-, In 1936 he exposed guinea pig
lungs and noted that curarine caused the
lungs to blanch and lose their elasticity, and
increased the minimum pressure of distention fourfold. n
Hugh D. Westgate
In the same year he described the effects
of curare administration in these words: "Patient takes short
breaths and becomes cyanotic. He is unable to draw air into his
lungs due to inspiratory obstruction which responds to adrenalin. At autopsy one usually sees massive lung collapse."7
Harvey and Masland" observed mild respiratory difficulty,
mainly on inspiration, in patients who had received 4.5 mg. cu°This report was given at the Staff Meeting of the Univ('rsity of Minnf"sota
Hospitals on June 9, 1961.
tMedieal Fellow, Department of Anesthesiology
:f:lnstruetor, Department of Anesthesiology
§Profes."lr and Head, Department of Anesthesiology
378
1
1
1
1
THE MEDICAL BULLETIN
rare intravenously over a three-minute period; this respiratory
distress was brief and responded to treatment with epinephrine.
Cole,H in 1946, stated that laryngospasm did not occur in patients given curare for tracheal intubation, but he added that
pronounced difficulty was encountered in ventilating the lungs of
these patients during the five minutes following intubation.
<:yanosis, unimproved by 100 per cent oxygen, was also present
for this period. In the same year, however, Griffith 1 0 reported
only three cases of bronchospasm in 700 instances of anesthesia
involving d-tubocurarine as the relaxing agent.
In 19.52 Landmesser et a1. 11 measured the expiratory tidal
volume of nine patients who had received rapid intravenous injections of 1.5 to 24 mg. d-tubocurarine. The lungs of each of
these patients were ventilated by a respirator set at a constant
delivery pressure and rate. In one patient a decreased expiratory
tidal volume was noted, the decrease being attributed to a
decrease in bronchial diameter due to d-tubocurarine. Using a
radiographic technique on dogs, Kilburn 12 was not able to demonstrate any change in bronchial diameter following the intravenous administration of d-tubocurarine or succinylcholine.
The purpose of our study was to evaluate the effect on airway resistance of d-tubocurarine administered intravenously to
human subjects as an adjuvant to general anesthesia.
METHODS
Twenty-three patients scheduled for elective surgical operations were studied. Weights of the patients varied between 50.8
and 9004 Kg., and their ages ranged from 21 to 75 years. None
of the patients had any history of allergy, and all were free from
clinical or laboratory evidence of cardiopulmonary disease. Data
from patients who showed increased secretions during the study
period were discarded.
Preoperative medication consisted of pentobarbital, 100 to
200 mg. by mouth the night before surgery and 4 mg/Kg body
weight given intramuscularly 90 minutes prior to the induction
of anesthesia. Fifteen minutes before the induction of anesthesia,
atropine sulfate, .01 mg/Kg body weight, was given jntravenously.
A 2..5 per cent solution of thiopental sodium was administered intravenously in 5 m1. increments to a total dose of 4.4
mg/Kg body weight. To facilitate tracheal intubation, a translaryngeal injection of 1..5 m1. of 5 per cent hexylcaine hydrochloride was given. A second dose of thiopental equal to the first
379
THE MEDICAL BULLETIN
Fig. 1
Representative tmcing showing airway presslll't', intraesophagal
press1II'e, n>spiratoJ'Y How rate. anel J'C'spiratory vlllllllle.
~80
THE MEDICAL BULLETIN
was administered while the patient breathed oxygen via a face
mask. The trachea was intubated, using in all cases the same
No. 8 cuffed portex endotracheal tube. After a closed anesthetic
system was established, the patient's lungs were ventilated with
a Bird Assistor/Controller." The appropriate tidal volume and
respiratory rate were determined from the Radford nomogram,la
and these, along with the peak How rate for each patient, were
kept constant throughout the test period.
Intra-esophageal pressure was measured by means of a catheter and balloon made according to the technique of Mead et
al. 14 The balloon was filled with 1.5 ml. helium, and the open
end of the catheter was attached to a Sanborn differential transducer. t All balloons were individually tested for degree of damping, the maximal response time of the system being 0.02 seconds.
Similarly constructed systems gave a 100 per cent response up to
a frequency of 35 cycles per second when filled with helium.
Airway pressure was measured by the same transducer connected to the oral end of the endotracheal tube by a polyethylene
catheter. A Lilly pneumotachometer, t interposed between the
patient's endotracheal tube and the inspiratory-expiratory valves
of the circle absorption system, measured respiratory How rates.
Respiratory volume was obtained by electrically integrating the
respiratory How rate. Intra-esophageal pressure, airway pressure,
respiratory How rate, and volume were recorded on a four-channel Sanborn polyviso recorder. § Transpulmonary pressure was
detected by a Sanborn differential strain gauge as the difference
between airway pressure and intra-esophageal pressure (Figs.
1 and 2).
These elements were recorded 30 and 3,5 minutes after controlled ventilation had been instituted, when a constant anesthetic state was considered to be in effect. When values for airway
resistance and static lung compliance obtained at the 30 and 35
minute intervals were observed to be statistically similar, d-tubocurarine, 0.44 mg/Kg body weight, was given intravenously in
a Single rapid injection. Recordings then were made every five
minutes for a total of four to six recordings. Thereupon d-tubocurarine, 0.22 mg/Kg was given as before, and two or three
additional recordings were made. All studies were completed
prior to surgical stimulation of the patient.
°Bird (Mark 4) Assistor/Controller. Bird Oxygen Breathing E(luipnwllt. Inc.,
218 Fremont, San Francisco ,5, California
tSanborn Model 268 B, Sanborn Co., Waltham 54, Massachusetts
:j:Technitrol Flometer 115-F-I, Technitrol Engineering Co., Medical Instrument
Division, 2751 North Fourth Street, Philadelphia 33, Pennsylvania
§Sanborn Model 154-IOOB, Sanborn Co., Waltham 54, Massachusetts
381
THE MEDICAL HULLETIN
,
I
I
,._,.
,~
+-H..-+-i
c:,jt~,+-H-++H·-+-l-+-,I...;.......
.I
ii~' -+~Hi+.+!'I1H+-+"1·4'+"hH-d--H-l4+·h."iff!.1-H++ja'·1-++t\;l~;r
• I.
.'
I
Fig. 2
Representative tracing showing transpllimonary pressure, respiratory Row rate, and fCspiratory volume.
Airway resistance, in centimeters of water per liter per second, was calculated by using the standard formula:
R=
A
t:::. P
B
t:::.Q
(Fig. 3),
where t:::.Q is measured at points of elIual expiratory and inspiratory volume and where the point on the inspiratory volume
curve corresponds to the peak inspiratory How rate.
RESULTS
Airway resistance values for the 2.3 patients are shown in
382
TIlE JVIEUICAL BULLETIN
f-
Table 1. Resistance changes of seven patients were subjected
to more detailed analysis and are listed in Table 2.
It was found that the patients could be divided into four
groups on the basis of severity and duration of changes in airway resistance after administration of d-tubocurarine.
=t:::t:=t::=+~-kI'.+H+++-f+-H:-';tK=F1t1'I'r~J:.~!~~-:-I\~t-~
"
,
i
--Ht-+--t--r-TI"'I..
.....
IIII
1.1aii
: .
". ; -I",'
If
1""1..-'
...
,-
--_
;-, ..
.'
;
r-
I
..
Ii·
-
..
'1.0'
..... """
8~.
'/
r-
11_ • 10:
,
:1....
'\.
"
,
II-' l*1I1
•
o•
-
6100114,
Fig. 3
Patiellt tracing showing transpulmonary pressure, respiratory
flow rate, and respiratory volume. Resistance of the lung is
computed as the change in transpulmonic pressure (A) divided
by the flow rate (B).
383
TABLE
(,:J
(Y.J
"""
;
•
1
AIRWAY RESISTANCE CHANGES IN CM. H,O/L/SEC. FOLLOWING INTRAVENOUS D-TUBOCURARINE
No.
Age
(Years)
Weight
(Kilograms)
Amount of
D-Tubo
( Milligrams)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
48
35
37
43
68
73
.50
41
66
.57
69
68
41
68
60.3
59.4
62
67
54
79.4
57
64
68
68
90.4
79.8
66.2
66
30
27
27
33
24
36
24
30
30
30
39
36
30
30
15.
16.
17.
18.
61
21
48
27
71.2
65.3
78.0
81.6
33
30
36
36
19.
20.
21.
75
64
65
57.2
83.9
59.9
22.
23.
52
58
50.8
83.9
, ,
•
•
,
Resistance (ll. P /Q) in em. H,O /L/sec.
I
0
0
.5
10
1.5
20
25
30
7.34
7.31
6.22
6 ..54
10.95
8.71
19.82
7.5,5
10.16
7.35
6.09
8 ..53
.5.98
8.27
8.39
7.1.5
6.34
6.30
11.12
8.86
18.8.3
7.75
10.23
7.14
5.12
8.25
4.78
7.91
8.15
8.08
6.88
6.46
10.32
8.69
19.38
7.10
10.11
7.09
5.38
7.26
4.23
7.34
8.10
8.20
6.90
6..50
10.46
9 ..55
19.37
7.11
10.20
7.00
.5.02
8.64
4.17
7.16
6.91
-
-
9.11
7.35
5.04
6.89
11.44
8.14
19.43
7 ..5,5
10.25
7.84
5.83
9.00
6.15
9.08
8.56
10.32
4.13
10.40
12.65
10.47
3.72
9.57
12.40
11.94
3.67
9.22
11.70
11.8.5
4.8,5
10.79
12.65
10.91
4.88
11.02
12.49
10.61
3.40
9 ..51
11.36
24
36
30
7.93
15.42
8.68
7.79
14.95
8.71
7.59
18.71
20.27
10.98
18.12
23.50
10.49
16.41
23.30
1.5.84
21
36
10.63
10.67
7.04
11.10
5.30
11.02
5.22
8.02
9.53
..
Time in Minutes from
2nd D-Tubo Injection
1.5
5
10
,-Time in Minutes from d-Tubocurarine Injection-..,
6 ..58
8.58
19.28
7.80
7.89
8.70
6.42
gd·
->..
•
10.82
10.50
19.47
7.14
-
4.9.5
7.60
4.23
-
6.88
-
10.91
•
•
8.93
11.07
6.66
11.09
7.56
19.13
4.83
8.93
6.93
.5.04
7.63
6.42
6.67
8.02
12.74
3.37
12..52
.5.20
12..52
11.34
11.21
10.78
15.11
15.51
7.47
1.5.75
11.01
16.10
9.74
-
..,
:I:
~
-
...?
...t:
n
~
;>
t"'
7.80
tl:
q
-
-
t"'
t"'
M
..,
...
Z
9.63
-
-
14.94
9.10
7.08
6.80
10.8.5
7.42
18.53
6.28
10.06
6.97
7.3,5
7.94
3.89
6.84
7.64
-
15.76
•
.~
a-...J-",.
"
,til-
~
,,~
r
m.
Ii
t
Ii
'hi.
I. *
r.,
,fT 1#1'*
t
ttliJPn,
ttl, ......,
..
:S• •
r-- 0 "----,
No.
Mean
Group 1
4.
6.
13.
19.28
Group 11
18.
17.
12.65
10.40
Group 111
19.
21.
7.93
8.68
-
S.D.
Mean
S.D.
,--5"-----.
Mean S.D. S.E.
-
-
11.44
19.43
9.08
.40
.32
.07
10.95
19.82
8.27
.50
.51
.30
.28
.13
12.40
9.57
.42
.25
11.70
9.22
.25
.32
7.79
8.71
.24
.41
.24
f' . . . , .
I
I
2
TABLE
AIRWAY RESISTANCE CHANGES IN CM. H20/L/SEC. OF REPRESENTATIVE CASES FROM GROUPS I TO
,-0"_____
U!
,--lO"~
,--15'f~
III
,--20"~
Mean
S.D.
S.E.
,--25"---.
Mean S.D. S.E.
.27
.34
.13
10.46
19.37
7.10
.21
.13
.33
.23
.17
.19
10.82
19.47
.25
.77
.27
.34
.30
.60
.23
.45
11.36
9.51
.14
.ll
.18
.33
9.63
.09
.13
10.49
.55
23.3 1.31
.31
.79
Mean
S.D.
S.E.
Mean
S.D.
S.E.
.32
.30
.14
11.12
18.93
7.91
.32
.29
.06
.26
.22
.02
10.32
19.38
7.34
.40
.60
.25
.23
.33
.20
.21
12.65
10.79
.12
.52
.18
.41
12.49
11.02
'7.59
.59
20.27 1.58
.37
.89
10.98
23.5
.34
.77
.24
.50
TABLE
3
HISTAMINE BLOOD LEVELS BEFORE AND AFTER INTRAVENOUSLY ADMINISTERED D-TUBOCURARIN3
IN PATIENTS ANESTHETIZED WITH THIOPENTAL SODIUM AND NITROUS OXIDE
Wt.
(Kg.)
Amount of
D-Tubo
(Milligrams)
Blood Sample
Before Curare.
Histamine in
/Lgm/cc
Blood Sample
After Curare.
Age
(Yrs.)
/Lgm/cc
~b-;a
2
3
4
41
48
72
52
39
72.6
52
97
21
45
30
40
0.042
0.106
0.052
0.093
0.043
0.108
0.049
0.094
-0.001
+0.002
-0.003
+0.001
5
6
7
8
19
49
74
75
53
52
45.4
64.9
30
30
24
30
0.092
0.024
0.045
0.096
0.142
0.061
0.060
0.144
+0.050
+0.037
+0.015
+0.048
11.3
8.4
3.4
10.8
9
57
82.6
40
0.058
0.026
-0.032
7.2
10
52
45.4
21
0.058
0.042
-0.016
3.6
II
48
95.7
45
0.1l8
0.072
-0.046
10.4
No.
I
.u " . , ,.;
L ,
,
"' .
Histamine in
•
•
[T]
Clinical Signs
.23
.45
.68
.23
,.,,,,
None
None
None
None
None
None
None
None
Chest erythema,
BP fal! 160/80-100/70
Questionable erythema,
BP fal! 200/100~160/95
Generalized erythema,
BP fal! 120/75--80/50,
prolonged expiration
•
•
,
''" I
THE MEDICAL BULLETIN
Group I, consisting of 14 patients, showed either a steady
small decrease in pulmonary resistance or a fairly constant resistance value. No statistically significant differences existed among
recordings. Two examples from this group are shown in Figure 4.
12
r
xr
x~/patient 114
x
x
u
CL>
__x
x
10
(f)
"-.J
"-
x_~
o
(\J
I
8
x____
E
u
x-<--
Patient 1113
x_ _ x
c
6
CL>
U
C
C
0+(f)
~
4
0::
GROUP
2
5
10
15
20
25
Time in Minutes
Following Curare Injection
Fig. 4
Group I, patients who showed a steady small decrease in lung
resistance or a fairly constant pulmonary resistance value.
The resistance changes in the four patients in Group II
showed the basic tendencies of Group I superimposed on which
was an increase in resistance, maximal bv 1.5 minutes and
resolved by 20 minutes following the administration of dtubocurarine. (See Figure 5) .
.'386
1,
1
THE MEDICAL BULLETIN
u
(Lj
(f)
'-l
'-
o
N
I
E
u
c
(Lj
u
8
c
o
< f)
(JJ
(Lj
cr:
G
GROUP 2
4 -
5
10
TIme
15
in
20
25
Minutes
Followi ng Curare Injection
Fig. .5
GIOUp II, patients showing the basic tendencies of Group I
with a superimposed increase in resistance, maximal by 1.5
minutes and resolved by 20 minutes, following d-tubocnrarine
admistration.
Group III, consisting of three patients, demonstrated the
most dramatic airway resistance changes (Fig. 6). An increased
resistance was evident at five minutes and maximal at ten minutes. Patient 21, despite therapy, still had clinical signs of bronchial constriction eighteen hours after the study. Patient 19,
some four hours after the study, had subjective difficulty in
inspiring, although no adventitious sounds were present in the
lung fields.
387
THE MEDICAL BULLETIN
,1
24
x---__
-x
u
(l)
(J)
"-.J
1
22
#21
"-
oN
I
x
E 20
u
c:
(l)
u
c:
o
12
+-
x
(J)
(J)
(l)
0:::
X
10
8
~
l---X
GROUP 3
5
10
15
20
Time in Minutes
Following Curare Injection
Fig. 6
Group III, patients who demonstrated a marked change in pulmonary airway resistance followin~ the intravenous administration of d-tubocurarine.
The two patients who make up Group IV are those who do
not fit into any other group. (Figs. 7 and 8).
388
THE MEDICAL BULLETIN
12
x
<..i
OJ
(f)
"-
10
-l
"0
N
I
E
8
x...............
u
x
c
OJ
u
c
-
6
0
( f)
IOmg. Curare
Given
(f)
OJ
a:
4
>,
0
3:
....
«
GROUP 4
PatienP*22
2
O L - - _ - l - _ - - - l_ _--l..-_-----l._ _....l-_---l.-
o
20
15
20
10
Ti me in Minutes
Following Curare Injection
5
Fig. 7
Patient in Group IV requiring a second dose of d-tubocurarine.
The change in resistance was secondary to the onset of spontaneous respirations.
DISCUSSION
Fry,L) Cherniak,16 and Marshall,17 and their respective associates, as well as numerous other workers, have shown that
changes in intrapleural pressure are accurately reflected by
changes in intra-esophageal pressure regardless of patient position. In preliminary work we also demonstrated that the relative
change in esophageal pressure between inspiration and expiration for anyone individual was independent of the patient's
389
THE MEDICAL BULLETIN
position. Because of these findings and because of the greateJ;
ease in handling supine anesthetized patients, all patients were
in the supine position when studied.
16
~x
x
u
C])
,
·1
If)
.......
-.J
14
.......
oN
:r:
E 12
u
c
C])
u
10
c
x
o
+-
If)
If)
C])
0::
GROUP 4
Patient # 23
5
10
Time
Following
15
20
25
in Minutes
Cu rare Injection
Fig. 8
Patient in Group IV displaying a marked rise in resistance probably secondary to an excessive amount of endobronchial mucus.
Airway pressure is the pressure acting on the lung and extrapulmonary elements. The esophageal pressure, since it reflects
intrapleural pressure, is that portion of the airway pressure
transmitted through the lung which acts on the chest wall and
diaphragm. Therefore, the pressure acting on the lung itself is
390
1
1
THE MEDICAL BULLETIN
the airway pressure minus the esophageal pressure, and the resistance to air flow calculated by means of this differential pressure is taken to equal the resistance of the lung.
In speaking of pulmonary resistance we are considering a
number of components as well as the resistance offered by the
elastic qualities of the lung tissue. Resistance offered in overcoming the inertia of the inspired gas and overcoming the airway opening pressure is one. Resistance due to the viscosity of
the lung tissue (that is, the resistance offered as tissue planes
move on one another as the lung expands) is another. The inhaled gas has a certain resistive component dependent upon the
viscosity of the gas and type of flow. As the flow rate increases,
the viscosity of the gas increases, and thus the resistance will
increase. A change from laminar to turbulent flow will also alter
the resistance, since the resistance of a laminar flow is related to
the viscosity of the gas, whereas the resistance of a turbulent
flow is related to the density of the gas. Excessive secretions in
the tracheobronchial tree will increase airway resistance by
changing surface tension and by physically narrowing the tracheobronchial diameter.
It has been shown that 2.5 per cent of the total lung resistance is due to the above factors. The remaining 75 per cent
arises from the resistance to air flow offered by the tracheobronchial tree.l~ This is the segment that can rapidly be changedeither passively, by collapse of the lung due to pneumothorax,
or actively, by chemical substances such as histamine, acetylcholine, or eqinephrin. Small changes in the diameter of the
bronchioles cause marked alterations in resistance, in accordance with Poiseuille's Law, which relates resistance to the reciprocal of the fourth power of the radius.
Neither nitrous oxide, nor 5 per cent carbon dioxide in oxygen, l~ nor 100 per cent oxygen given for periods up to ten minutesl~ has any effect on airway resistance. Atropine has been
observed by Kilburnl~ to constrict and lengthen bronchioles in
dogs.
Since all the factors affecting lung resistance except the bore
of the tracheobronchial airways were kept constant, and since
pulmonary compliance also remained unchanged, we can conclude that any change in pulmonary resistance following the
administration of d-tubocurarine must have been due to a change
in the tracheobronchial diameter.
The values given in Table 1 for pulmonary resistance l l at
zero minutes are considered greater than the commonly given
values of 1.2 to 3.5 em. of water per liter per second for individ-
391
THE MEDICAL BULLETIN
uals respmng spontaneously.!!J In an attempt to explain this
disparity, we measured pulmonary resistance in two patients
before and after they were subjected to endotracheal intubation.
Both patients were breathing spontaneously, and in both cases
the pulmonary resistance was doubled following tracheal intubation. The degree of change in resistance caused by the endotracheal tube depends predominantly upon the difference between the diameter of the endotracheal tube and the diameter of
the portion of the airway which it replaces. Since, in all cases,
the endotracheal tube decreased the lumen of the airway, an
increase in airway resistance was to be expected.
After intubation, respiration became passive on the patient's
part and changed from negative pressure breathing to positive
pressure breathing. Air now entering the tracheobronchial tree
must exert sufficient transmural pressure to overcome the elastic
resistance of the lung tissue which is no longer opposed by the
active outward movemen~ of the chest wall and diaphragm. Also
the diameter of the bronchi are narrowest at the onset of positive
pressure inspiration as the lung is in the resting expiratory position. 1!J,20
Although the flow rate was kept constant during the studies
on anyone patient and an attempt was made to keep the actual
flow rate within a physiological range,20 any increase in flow rate
above the patient's normal flow rate would give a higher resistance value than would be expected in patients breathing spontaneously.
One or any combination of these factors could be responsible
for the initial high resistance values seen in the patients studied.
The greatest number of patients fell into Group I, and these
showed a steady small decrease in lung resistance or else a fairly
constant pulmonary resistance value. In this group the administration of d-tubocurarine did not affect the pulmonary resistance
(Fig. 4).
Following ventilatory control all patients gave relatively high
airway resistance values. In most cases this high airway resistance decreased quickly to a constant value, but in some cases
a period of rapid adaptation to positive pressure ventilation was
followed by a prolonged period of a very small but constant
decrease in the airway resistance. The time referred to as 0
minutes in Tables 1 and 2 (i.e., 30 minutes after ventilatory control had been established) was the time when the two resistance
values were statistically similar. Those patients in Group I who
showed a steady small decrease in lung resistance might have
still been in this adaptive phase.
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D-tubocurarine, through its properties of blocking parasympathetic ganglia, may have blocked the stretch reflex of the vagi,
thereby increasing the diameter of the bronchioles.:n Widdicombe~~·2a showed that these stretch receptors were located in
the bronchioles. Under positive pressure ventilation, intravenous
acetylcholine or histamine caused bronchoconstriction by increasing the frequency of discharge and shortening of the time of onset of discharges from these slowly adapting stretch receptors.~1
The work of Dawes and Comroe~l indicates that the afferent
pathway of this reflex is via the vagus nerves. Guyton~4 has
shown that curare, by blocking impulse transmission over the
vagus nerve through parasympathetic ganglionic blockade, can
obtund this reflex. With the loss of this reflex, passive distention
of the bronchioles would then cause a lowering of resistance by
increasing the total lung volume.~'·
The changes in airway resistance seen in the patients comprising Group II (Fig. .5) can be explained in terms of the three
known actions of curare: neuromuscular blockade, histamine release, and ganglionic blockade. The important observations here
are: first, the sudden rise in rcsistance; second, the small
(though statistically significant) magnitude of the rise; and
third, the rapid return to pre-elevation resistance values.
It is unlikely that ganglionic blockade could be responsible
for a rise in resistance, because such a blockade would have to
involve the sympathetic ganglia, leaving parasympathetic ganglionic transmission intact.~4.~(; No cvidence exists for sympathetic
ganglionic blockade by d-tubocurarine in doses of the magnitude used here. Also parasympathetic ganglia are paralyzed with
much smaller doses, and Guyton has shown that the vagi are
particularly sensitive to this block.~4
This pattern can be attributed to the neuromuscular blocking
effect of curare. The normal peak action of d-tubocurarine occurs
five to ten minutes after administration. Following the injection
of d-tubocurarine the tone of the intercostal muscles and the diaphragm is lost, and the intrapleural pressure (intra-esophageal)
rises from a negative value to very close to zero. The elastic
property of the lung, unopposed by the tone of the diaphragm
and intercostal muscles, tends to collapse it toward the hilum,
narrowing the bronchial tree and perhaps even entirely collapsing scattered terminal segments. This then raises the resistance to airflow until by the adaptive mechanisms already described the previous resistance level is attained.
Because of the prolonged increase in airway resistance and
the magnitude of the reaction of those patients in Group III
393
THE MEDICAL BULLETIN
(Fig. 6), an explanation7 involving the neuromuscular blocking
effect of curare as offered to account for the resistance changes
in group two is not adequate.
No measurement of blood histamine was made on these
patients, but we have shown that d-tubocurarine is capable of
elevating blood histamine under similar test conditions (Table
3). Histamine uptake by end organs related to the tracheobronchial tree is suggested as the cause of this type of reaction.
Bouhays and co-workers 27 have shown that hexamethonium
given to asthmatic patients prior to histamine aerosol inhalation
completely prevents the bronchosconstriction which normally
results. These workers have also shown that epinephrine aerosol
inhalation prior to the histamine aerosol modifies the bronchoconstriction. Atropine has also been reported to diminish the
bronchoconstrictor response. 28 This work adds support to the
proposition that the bronchoconstriction induced by histamine is
mediated through a neurogenic mechanism or reflex. 27 Ganglion
cells are known to exist in the bronchial walls, and like the
stretch receptors, they are approximated to preganglionic vagal
fibres. 2 !l Herxheimer has shown that hexamethonium protected guinea pigs against anaphylactoid- and histamine-induced
shock,30 CurrY:l1 demonstrated the protective effect of hexamethonium on histamine and methacholine action in humans. It
has been suggested that a functional disorder of autonomic
nerve structures in the bronchial walls may be important in the
pathogenesis of bronchial asthma as wel1. 27
We can offer no evidence as to the underlying mechanism of
the reaction. Whether or not any of the previously mentioned
conditions existed in our patients cannot be proved from these
studies. We do know, however, that none of our patients showed
clinical evidence of cardiopulmonary disease and none had any
history of allergy.
Another possible explanation of the reaction is that d-tubocurarine may directly sensitize the end organs in certain individuals. The possibility that the individuals in this group had
latent hypersensitivity to histamine or in effect latent asthma
cannot be excluded. Any degree of bronchial obstruction before
histamine release bv curare-such as edema of the bronchial
endothelium, hypert;ophy of bronchial smooth muscle, and endobronchial mucus-would accentuate the effect of bronchial narrowing by histamine, since resistance is inversely proportional to
the fourth power of the radius.
Patient 22 (Fig. 7) required additional d-tubocurarine at
the fifteen-minute period when she began to inspire spontaneous394
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ly. As controlled positive pressure ventilation was re-established,
the resistance returned to the initial level.
The resistance changes seen in patient 23 (Fig. 8) cannot be
completely explained. The rise occurred too late to be due to
histamine release, and its magnitude was much too great to be
produced by neuromuscular blockade of the chest wall and diaphragmatic muscles. A mucus plug or increasing narrowing of
the bronchioles by retained mucus gives a similar picture.
Twenty patients each received a second dose of d-tubocurarine, and it can be seen from Table 1 that the subsequent airway resistance changes were quite varied. Few conclusions can
be drawn as the study time interval following the second dose
of d-tubocurarine was too short to allow any pattern in resistance
changes to develop. Nevertheless, increases in ahway resistance of a magnitude comparable to those seen in Group III
patients were observed (Patient 2). Secondary airway resistance
changes showed no correlation with the primary changes.
SUMMARY AND CONCLUSIONS
The effect on pulmonary airway resistance of a .44 mg/Kg
body weight dose of d-tubocurarine administered as a single
intravenous injection has been evaluated. Twenty-three patients
free of cardiopulmonary disease and having no history of allergy
comprised the study group.
An elevated airway resistance resulted in seven cases. In
four cases the elevation was minimal and was felt to be due to
the passive collapse of bronchioles resulting from the paralysis
of the intercostal and diaphragmatic muscles.
In three cases the elevated airway resistance was believed
to be due to histamine uptake by effector end organs located
in bronchial walls; the histamine release was presumably produced by intravenous d-tubocurarine.
Two patients had airway resistance changes which did not
appear to be directly related to d-tubocurarine administration.
No correlation between age, weight, or total d-tubocurarine
and type or degree of airway resistance change was observed.
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39.5
THE MEDICAL BULLETIN
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397
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THE MEDICAL BULLETIN
Contributing Members (continued)
D. R. Hastings·
Earl C. Henrikson·
Fritz D. Hurd
Elizabeth Conforth Jackson
D. W.Feigal
Z. Willard Finherg
C. E. Johnson
Malcolm R. Johnson
Reinald G. Johnson
Rohert R. Kierland
John T. Kometani
Theodore J. Konig
Mrs. M. B. Kuller
Leroy J. Larson
James J. Lawton, Jr.
J. A. Mahnstrom
Satoru Matsuyama
Malcolm B. McDonald
G. W. McGregor
H. H. Minthorn
Fritz H. Moser
Clayton E. J. Nelson·
Leslie F. Nelson
B. L. Neuheiser
E. W. Newmano
Olmsted Medical Group
W. V. Owen
David M. Parker
Elmer C. Paulson
Alonzo P. Peeke"
J. C. Peteler
W. G. Peterson
M. K. Plasha
J. L. Posch
F. W. Quattlehaum
Ray J. Quinlivan"
W. W. Rieke"
Benjamin R. Reiter
Harold G. Seheie"
L. Raymond Scherero
G. T. Schimelpfenig
Hildred Schuell
Alvin L. Schultz
David 1. Seibel
Howard R. Seidenstein
H. J. Setzer·
Howard A. Shaw
J. W. Shubert
John R. Spannuth
Wesley W. Spink·
Mrs. Wesley W. Spink
James W. Stephan
Barhara H. Subak
Leon J. Tiber
G. L. Walker
Harry K. Wolkoff
John J. Yaeger
Toshio Yumihe
Mrs. Harry B. Zimmermanno
• Also Life Member
Annual Members
Arden L. Abraham
Milton Ahramson
Curtis F. Ahrens
Heino Alari
Wm. J. Alcorn
John H. Aides
H. J. Aldrich·
Carl S. Alexander
H. A. Alexander
Donald S. Amatuzio
Frederick K. Amerongen
Kurt Amplatz
Howard A. Andersen
Arnold S. Anderson
Franklin C. Anderson
Gaylord W. Anderson·
Gerald J. Anderson
Gordon A. Anderson
Harold J. Anderson
John A. Anderson
John W. Anderson
Markham J. Anderson
Ray C. Anderson
Richard Anderson
Robert M. Anderson
U. Schuyler Anderson
Wallace R. Anderson
R. L. Andreassen
Richard E. Anonsen
Roger B. Arhelger
Stuart W. Arhelger
Wallace D. Armstrong·
A. I. Arnesono
L. Earl.. Arnow
Frederick P. Amy
" Also Life Member
Joseph J. Asta
J. B. Anst
Austin Clinie
Sol Austrian
William A. Autrey
Reno W. Backus
Osmond J. Baggenstoss
Russell W. Bagley
A. B. Baker·
Edward J. Baldes·
Fred E. Ball·
C. N. Ballentine
Richard E. Barnes
E. G. Barnet
Cyrus P. Barnum, Jr.
James S. Barr
Maxwell M. Barr
E. E. Barrett
Jesse J. Barron
Homer P. Basinger
A. H. Baskin
W. Compere Basom
L. C. Bate
Jacob E. Bearman
Charles J. Beck
Clayton T. Beecham
John J. Beer
Samuel S. Beirstein
R. H. Beiswanger
E. T. Bell"
Richard P. Bendel
Edwin G. Benjamin
Harold G. Benjamin
Frank M. Bennett
Ellis S. Benson
Wilbur M. Benson
Benson Clinic
Deane W. Benton
Heinz Berendes
Kenneth G. Berge
E. H. Bergendahl
George S. Bergh
Solveig M. Bergh
Lavonne B. Bergstrom
Ernest M. Berkas
N. J. Berkwitz
Reuben Bennan 0Theodore M. Berman
Eugene F. Bernstein
Irving C. Bernstein
W. C. Bernstein"
W. E. Bernstein
E. F. Beyer
W. S. Beyer
Joseph F. Bicek
Jerome T. Bieter
John J. Bittner
Orpheus J. Bizzozero
James A. Blake
Samuel Blank
Henry S. Bloch
Robert Blomberg
Norman B. Bloom
Sanford Bloom
John J. Boehrer·
Benjamin Bofenkamp
D. G. Bohn"
Donald A. Bolt
Richard G. Bond
Frank J. Bonello
••Also Patron Member
401
THE MEDICAL BULLETIN
Annual Members (continued)
George Boody, Jr.·
Herbert M. Bosch
H. G. Bosland
D. L. Boucher
M. O. Boudry
B. J. Bouquet
G. E. Bourget
Mrs. Samuel H. Bowman, Jr.
P. D. Boyer
S. H. Boyer, Jr.
Bruce Boynton
Alexander M. Boysen
James F. Boysen
E. L. Brackney
Robert A. Bradley
S. Gaylen Bradley
James Bratholdt
Allyn G. Bridge
Robert B. Breitenbucher
Johu F. Briggs·
Peter F. Briggs
Alice Brill
Roger W. Brockway
Bjorn Bronson
E. B. Brown, Jr.
J. E. Brown
James L. Brown
Paul F. Brown
Harold F. Buchstein·
Joseph J. Buckley
Mary Jane Buckman
William J. Buggy
Mrs. Mary S. Bulkley·
Edward P. Burch
H. B. Burchell
Harry F. Burich
E. C. Burklund
R. O. Burmeister
Robert P. Bush
W. J. Bushard
Morris L. Cable
Clyde M. Cabot
R. J. Cairns
Donald C. Campbell
Orwood J. Campbell·
B. H. Canfield
Thomas P. Cannon
Leslie Caplan
James B. Carey, Jr.
Lester W. Carlander
Curtis H. Carlson
Homer J. Carlson
Norman C. Carlson
Anna-Mary Carpenter
Charles W. Carr
Dick Cason
W. O. Caster
H. Mead Cavert
H. D. Caylor
E. T. Ceder
C. C. Chatterton
• Also Life Member
402
F. G. Chermak
Morris J. Chernaek
Merrill D. Chesler
Tague C. Chisholm
A. Christiansen
Joseph E. Christopherson
Stanley S. Chunn
Earl I. Cilley
Winfred H. Clarke
Daniel P. Clifford
Nora Cline
Byron B. Cochrane
Charles F. Code
John I. Coe
Ephraim B. Coben
Henry W. Cohen
Maynard M. Cohen
Sumner S. Cohen
Sid W. Collier
Dennis J. Collins
C. H. Coombs
C. C. Cooper
:Milton Cooper
Robert R. Cooper
Dale H. Correa
J. A. Cosgriff, Jr.
Everett B. Coulter
K. W. Covey·
George M. Cowan
David M. Craig
Elizabeth M. Cranston
Rohert W. CranstonO
John P. Craven
Stanley Crosbie
Frederick S. Cross
George M. Crow
\Vm. P. Crowley, Jr.
R. C. Cullen
Ormond S. Culp
R. A. Curtis
R. K. Curtiss
Rollin E. CuttsO
L. N. Dale
David V. Damherg
O
Harry A. Daniels
J. W. Dassett
Wm. D. Davidson
Jay Conger Davis
Richard B. Davis
Jerome
J. DeCosse
Donald F. DeMarse
Norman J. Diamond
Antoni M. Diehl
JohnF. Dillon
Robert E. Doan
J. W. Docksey
Richard P. Doe
E. M. Doherty
John Dordal
Donald E. Dougherty
Thomas J. Doyle
L. O. Doyle·
Carl B. Drake
Paul A. Dressel
G. W. Drexler
Herman E. Drill
Della G. Drips·
Rohert C. Dunn
Marbry Duryea
A. F. Dysterheft
Arnold H. Dysterheft
John R. Earl
G. B. Eaves
Raymond L. Eck
Ralph J. Eckman
Charles Edwards
R. G. Edwards
Richard H. Egdahl
Charles T. Eginton
C. J. Ehrenberg
George D. Eitel
Clifford T. Ekeland
Carl N. Ekman, Jr.
L. M. Ekstrand
:Marian L. Eliason
A. J. Ellinger
Joseph A. Elliott Jr.
Karl W. Emanuel
Rndolf Engel
Garth W. Englund
Stephen Epstein
C. O. Erickson
Leif W. Erickson
Raymond L. Erickson
Vernon D. Erickson
Martin G. Ericsson
Murray P. Ersfeld
Dortha Eseh
Robert D. Estrem
M. G. Ettinger
G. B. Eustennan
Gerald T. Evans
E. Frank Everett
O. J. Farness
K. R. Fawcett
John G. Fee
Samuel B. Feinberg
J. Y. Feinstein
Davitt A. Felder
Paul L. Felion
Oscar M. Felland
William F. Feller
M. Fording Fellows
E. Fenger
Donald J. Fergnson
Allan L. Ferrin
Norman E. Fidelman
William R. Fifer
David L. Fingerman
J. S. Finrud
I. Fisher
Harold F. Flanagan·
1
THE MEDICAL BULLETIN
Annual Members (continued)
M. G. Flath"
William Fleeson
Edmund B. Flink"
A. J. Floersch
Duane L. Flogstad
M. C. Florine
J. E. Flynn
W. H. Ford
Q. E. Fortier
Ward S. Fowlcr"
David W. Francis
D. B. Frane
Ivan D. Frantz, Jr.
N. A. Franzen
Harold C. Freedman
Esther F. Freier
Richard J. Frey
Robert E. Fricke
Louis A. Fried
Aaron Friedell
Howard M. Frykman
Alice H. Fnller
Benjamin F. Fuller
Joyce L. Funke
B. J. Gallagher"
Henry F. Gallagher
John J. Galligan
Charles N. Gamhie
E. R. Gamm
Kenneth E. Gamm
Walter P. Gardner
George L. Garske
Russell Gates
N. L. Gault, Jr.
Marvin J. Geih
J. T. Gericke, Jr.
Robert W. Gibbs
Robert Giebink
S. W. Giere"
Conrad Giesen(/.-
H. Z. Giffin
~Iaurice Gilbert
A. Sigrid Gilbertsen
Vietor A. Gilhertsen
D. R. Gillespie
Donald L. Gillespie
Louis Gillman
Gertrude M. Gilman"
Lloyd C. Gilman
Donald A. Gilsdorf
R. A. Glabe"
David Glick
Frederick C. Goetz
Marvin E. Goldberg
Jules S. Golden
Erwin D. Goldenberg
Robert J. Goldish
Theodore 1. Goldman
Meyer Z. Goldner
Robert W. Goltz
Lorraine M. Gonyea
Robert A. Good
Sewell S. Gordon
Stanlcy J. Graiewski
Leslie R. Grams
Suzanne Grant
James H. Graves
Royal C. Gray
Leland J. Green
Robbie Green
A. J. Greenberg
H. Harvey Greene
Richard H. Greenspan
Ian Gregory
Eugene Grim
Claude O. Grizzle
F. N. Grose
John L. Grosh
Jobn K. Grolting
D. E. Guernsey
H. A. Gull
RcubenGull
Glenn Gullickson, Jr.
John M. Gunsolus
PaulO. Gustafson
H. T. Gustnson
Helen Haberer
Charles A. Haberle
:Marvin Hader
John D. Hagen
Paul S. Hagen
Samuel F. Haines
Erick Y. Hakanson
Franz Halberg
Barnard Hall
Harry B. Hall
W.W.Hall
Roger B. Hallgren
R. P. Hallin
Bernard Halper
David J. Halpern
Donald E. Halverson
D. K. Halvorsen
James A. Hamilton
Roland Hammer
Ernest M. Hammes, Jr.
E. M. Hammes, Sr."
Seymour Handler
Borghild Hansen
Curtis M. Hansen
Cyrus O. Hansen
Robert E. Hansen
Eugene W. Hanson
Mark C. L. Hanson
Harold B. Hanson
Harvey P. Harper
B. D. Harrington
John E. Harris
Leon D. Harris
Lewis R. Harris
Wm. F. Hartfiel
J. Francis Hartmann
S. A. Hartman
Grant F. Hartnagel
Donald W. Hastings
S. R. Hathaway
George W. Haugen
John A. Haugen
Louis A. Hauser
Vietor P. Hauser
Lyle J. Hay
Douglas P. Head
Frank G. Hedenstrom
Wm. L. Hedrick
W. G. Heegaard
B. J. Heetderks, Jr.
Carl B. Heggestad
Ben HeUer
E. D. Henderson
Myron J. Hertz
~1aurice Heusinkveld
Anderson C. Hilding"
Wm. R. Hilgedick
Jerome A. Hilger
Earl Hill
Elmer M. Hill
Louis W. & Maud Hill
Foundation
H. P. Hindteraker
Lerner B. Hinshaw
Herbert M. Hirsch
Claude R. Hitchcock
John J. Hochfilzer
R. V. Hodapp
Lucien R. Hodges
H.O.Holf
F. W. Hoffbauer
Lucille Hoilund
Wallace W. Hollcy"
Roy G. Holly
C. H. Holmstrom
John E. Holt
G. Wendell Hopkins
Emerson E. Hoppes
Wayne L. Hoseth
William H. Houlton
Gordon W. Hovde
Ruth F. Hovde
C. E. Howard
Elna M. Howard
Robert B. Howard
S. E. Howard
Carter W. Howell
L. J. Hoyer
William J. Hruza
R. W. Huher
E. G. Huhin
E. R. Hudec"
Arthur B. Hunt
Edward G. Hustad
Charles Hymes
Anthony Iannone
Walter Indeck
" Also Life Member
403
THE MEDICAL BULLETIN
Annual Members (continued)
J. E. Indihar
R. J. Jackman
Charles E. Jacobson, Jr.
Clarence Jacobson·
Wyman E. Jacobson
Jay Jacoby
D. E. Jaeger
Manuel O. Jaffe
Harriet D. James
George W. Janda
Allen G. Janecky
J. R. Jannach
Martin E. Janssen
AlanR. Jay
Herman H. Jensen
Nathan K. Jensen
Reynold A. Jensen·
Richard E. Jensen
J. E. Jenson
Bourne Jerome
H. J. Jeronimus
W. G. Johanson
Henry A. Johnsen, Jr.
C. Laurence Johnson
Douglas L. Johnson
Einer Wesley Johnson, Jr.
Eugene A. Johnson
Frank E. Johnson
John A. Johnson
Ray A. Johnson
Victor Johnson
Luverne W. Johnsrud
Richard H. Jones
Joseph Jorgens
A. N. Joseph
George T. Joyce
Allen S. Judd
E. S. Judd
Leonard L. Kallestad
Dennis J. Kane
Earl R. Kanne
Bernard J. Kaplan
J. Jacob Kaplan
C. I. Karleen
E. M. Kasper
Harold Katkov
Herschel J. Kaufman
Harold W. Keairnes
Donald L. Kegaries
Paul J. Keith
Ted Keller
Roger E. Kelley
Vincent C. Kelley
Edward H. Kelly
John F. Kelly
William D. Kelly
B. J. Kennedy
Ralph Kernkamp
Ancel Keys·
R. R. Kierland
Frank Kiesler
• Also Life Member
404
E. A. Kilbride
Ceorge Kimmel
Archihald D. Kincaid
Lyndon M. King, Jr.
W. 'l. Kinney
Thomas J. Kinsella·
L. B. Kiriluk
Llovd H. Klefstad
Ilo;acc D. Kleino
Lowell H. Kleven
Christian R. Klimt
)';dward K. Kloos
Frank R. Klune
Halph T. Knight·
W. A. Knight, Jr.
Hobert R. Koefoot
Fred H. Koenecke
Arthur A. H. Koepsell
lIl'nnan J. Kooiker
I h-'llrV A. Korda
Michael Kosiak
Frederic J. Kottke·
H. J. Kotval
Carl D. Koutsky
George F. Kowallis
hhu D. Krafchllk
Walter E. Krafft
Arnold J. Kremen
ThOlTlas K. Krczowski
William Krivit
l.arry Kruger
Frank H. Krusen
\V. G. Kubicek
Anne C. Kuhn
Warren L. Knmp
David B. Kuris
Bradley W. Kusske
Hoswith I. Lade
John S. Ladue
Sheldon M. Lagaard
Mrs. Alhina Phillips Lambert
Leonard A. Lang·
William A. Lange
n. G. Lannin
L. N. Lano
Frank W. Larst'll
Eva Jane Larsono
Leonard W. Larsono
Leighton W. Larson
Lester E. Larson 0
Oliver E. H. Larson
Paul N. Larson 0
K. E. Latterell
Donald J. Lawler
Arnold Lazarow
G. E. Ledfors
J. S. Lee
Hubert W. Lee
Thomas J. Lehar
Harold R. Leland·
M. E. Lenander
Edith M. Lentz
Gilbert Gordon Lenz
J. Paul Leonard
Richard G. Lester
Robert D. Letsou
J. H. Leversee
Alfred G. Levin
Jules D. Levin
N. M. Levine·
George X. Levitt·
Barton L. Lewis
Herman C. Lichstein
Dagfinn Lie
A. G. Liedloff
Nathan Lifson
W. B. Light
C. Walton Lillehei
James P. Lillehei
Richard C. Lillehei
Ludvig Lima, Jr.
Carl John Lind, Jr.
Maurice L. Lindhlom
Robert Lindell
Charles E. Lindemann
Russell C. Lindgren·
Douglas T. Lindsay
E. H. Lindstrom
Gardner Lindzey
John H. Linner
Paul W. Linner
H. P. Lippman·
Mark B. Listerud
Robert B. Litin
Arthur G. Litman
Neil N. Litman
Robert E. Litman
M. B. Llewellyn
Paul H. Lober
Karl A. Lofgren
S. V. Lofsness
Dennis E. Lofstrom
James E. Lofstrom
John Logothetis
Merle Loken
George L. Loomis
Frederick H. Loll
James M. Louisell
E.R.Lowe
Elizabeth C. Lowry
Jeanette K. Lowry
Thomas Lowry
Stanley Lundblad
Karl R. Lundeberg
C. W. Lundquist
Virgil J. P. Lundquist
Warren L. Macaulay
D. C. MacKinnon
Lloyd D. MacLean
Gordon C. MacRae
A. E. Magnuson·
J
THE MEDICAL BULLETIN
Annual Members (continued)
f
Richard Magraw
D. G.Mahle
Edgar L. Makowski
E. T. Maitland
Sheldon C. Mandel
James C. Mankey
Frank D. Manno
David M. Marcley
George H. Marking
Donald C. Martin
D. L. Martin
G. M. Martin
George R. Martin
Carlos Martinez
C. L. Martinson
Elmer J. Martinson
Joseph S. Massee
James C. Masson O
James K. Matayoshi
Roland W. Matson
Hamlin Mattson
William P. Maverlis
Donald M. Mayberg
Charles W. Mayo
William F. Mazzitello
Donovan L. McCain
Malcolm A. McCannei 0
Francis M. McCarten
A. M. McCarthy
Donald McCarthyO
R. James McCellan
C. N. McCloud
D. P. McCormick
M. Donald McGeary
Elizabeth A. McGrew
Brian J. McGroarty
Richard B. McHugh
Frank F. McKean
John M. McKelvey
C. A. McKinlayo
F. S. McKinney
Leroy C. McLaren
Charles E. McLennan
John M. McLinden
B. J. Mears
Fredrick B. Mears
Sidney H. Medof
Paul E. Meehl
Rohert L. Meller
George T. Mellinger
J. Mendez
T. B. Merner
Robert L. Merrick
R. W. Merrill
W. A. Merritt
P. F. Meyer
Henry H. Michel o
R. P. Michels
Henry E. Michelson o
James L. Michie
A. S. Midthune
V. E. Mikkelson
Fletcher A. Miller
H. A. Miller, Jr.
Harold D. Miller
Harold E. Miller
Harry Arthur Miller
J. C. Miller
R. Drew Miller
Z. R. Miller
D. Keith Millett
J. L. Mills o
John E. Minckler
Rabbi & Mrs. Albert G. Minda O
Raymond K. Minge
Minneapolis N europsychiatric Clinic
B. D. Mitchell
Russell H. Mitchell
A. S. Moe
Gordon K. Moe
John H. Moe·
Thomas Moe
Johannes K. Moen
Herman
J. Moerscho
Robert Hugh Monahan
George E. Moore
Walter H. Moran
M. E. Mosby
Andrew M. Movius
John B. Moyer
Donald R. Mueller
Mark A. Muesing
J. R. Mulder
A. Eugene Muller
John J. Muller
John E. Mulvahill
Edward S. Murphy
Marion 1. Murphy
Thomas O. Murphy
M. J. Murray
Rohert A. Murray
Robert J. Murtaugh
Elizaheth Mussey
J. A. Myers·
James Myhre
H. B. Nachtigall
Arnold E. Naegeli
Frank D. Naegeli
Ilgvars S. Nagobads
V. George Nagobads
Leo A. Nash
Donald E. Nealy
W. S. Neff
D. R. Nelimark
Carl Gilbert Nelson
Douglas A. Nelson
E. N. Nelson
Kenneth L. Nelson
Kenneth R. Nelson
Lloyd S. Nelson
Maxine O. Nelson
Maynard C. Nelson
Nonnan A. Nelson
Wallace I. Nelson·
Samnel Nesbitt·
Roland F. Neumann, Jr.
Charles Neumeister
Cecil E. Newell
David J. Nielsen
John F. Noble·
Donald J. Nollet
Robert E. Nord
M. A. Nordland, Jr.
Martin Nordland·
W. F. Nordman
Stanley R. Norqnist
N. T. Norris
W. F. Nnessle
A. W. Nuetzman
Holand E. Nutting·
Malvin J. Nydahl·
Katherine A. Nye
C. G. Ochsner
Orville E. Ockuly
John W. O'Donnell
M.Ogurak
J.Ohage
J. H. O'Leary
John B. O'Leary
Vern C. Olmanson
Jack G. Olsen
Ralph L. Olsen
C. A. Olson
C. Kent Olson
D. M.Olson
Eldon C. Olson
R. A. Olson
Rohert W. Olson
Ruth E. Olson
Valentine O'Malley
Rnth O'Neal
C. P.O'Neill
H. P. O'Neill
C. L. Oppegaard·
E. G. Oppen
Earl T. Opstad
Harry W. Orme
Edward W. Ostergren
Carlton L. Onld·
C. A. Owen, Jr.
Ben Owens
Vincent J. Paciotti
R. L. Page
B. J. Palen
Neil Palm
Enrique Sanchez PalomeTa
Peter J. Pankratz
A. A. Papermaster
Charles W. Parker
Robert L. Parker
A. W. Pasek
Eric R. Paulson
o Also Life Memher
40.5
THE MEDICAL BULLETIN
Annual Members (continued)
B. F. Pearson
R. C. Pedersen
Louis Pelner
Charles R. Pelzl
Thomas A. Peppard'
John R. Perkins
Harold O. Perry
John F. Perry, Jr.
John Wm. Perry
J. C. Peteler
Glenn L. Petersen
Rohert T. Petersen
Carl A. Peterson
Harold O. Peterson °
Helen Peterson
Joel L. E. Peterson'
John H. Peterson
}"farvin G. Peterson
Rohert T. Peterson
W. E. Peterson
Julian V. Petit
Thomas G. Petrick
W. L. Pew
John T. Pewters
Walter S. Phares
Kenneth A. Phelps'
R. H. Picha
R. F. Pierson o
N. C. Plimpton
Harry L. Plotke
Kurt Pollak
David B. Post
Konald A. Prem
Robert F. Premer
Robert E. Priest
James T. Priestley
R. K. Proesehel
William E. Proffitt
Raymond D. Pruitt
E. E. Pumala
Quain & Ramstad Clinic
Wentworth Quast
Robert O. B. Quello
PaulG. Quie
Harley J. Racer
Richard B. Raile
D. E. Ralston
R. M. Ramlow
Theodore Rasmussen
Otto Raths, Jr.
Vcrna Rausch
Everett C. Ravits
Harold G. Ravits
Willis A. Redding
John F. Regan
E. A. Regnier'
Henry J. Reif
Richard E. Reiley
Milton P. Reiser
Elise L. Renning
Carl O. Rice
° Also
406
Life Memher
Roberta G. Rice
L. F. Richdor!
Samuel Richman
Robert W. Rieman
R. E. Risch
A. F. Risst'r
Wallace P. Ritchie'
A. E. Ritt
Norton D. Ritz
Dean K. Rizer
Donald E. Roach
Francis Roach
Edward W. Roberts
O. W. Roherts
Rohert E. Roekney
C. L. Roholt·
Lucy Balian Rorke
Mitchell J. Rosenholtz
Rohert G. Rossing
Robert J. Rotenherg
Clarence J. Rowe
Phil C. Roy
Anthony T. Rozycki
Vendela Olson Rucker
John G. Rukavina
J. G. Rushton
A. N. Russeth
Elmer M. Rusten
Wayne C. Rydhurg
Robert E. Rydell
Yoshio Sako
Samuel T. Sandell
Bernard Sandler
Karl E. Sandt
John B. Sanford
M. M. Sarnecki
E. R. Sather
James G. Sawyer
A. M. Shorov
Victor Shorov
Frederick H. K. Schaafo
Raymond W. Scallen
Joseph A. Schaefer
William F. Scherer
Burtrum C. Schiele
Fredrick W. Sehilla
James R. Schlichting
Leonard D. Schloff
W. R. Schmidt
H. Laurence Schochct
\Villiam Schofield
Edward Schons
D. V. Schoon
Hugo F. Schroeckel1stein
Alhert J. Schroeder
Irwin Schulz
\\'iIIiam M. Schulze
Leonard M. Schuman
Elmer S. Schutz
E. Rohert Schwartz
Samuel Schwartz
Arnold G. Schwyzer
Hanns C. Schwyzer
Horace G. Scott
Rosel T. Seashore
Martin A. Segal
Milton H. Seifert
Thomas Scmba
Donald B. Shahon
S. J. Shanoski
~Iorse J. Shapiro
Robert Shapiro'
Sidney K. Shapiro
Clark A. Shattuck
Andrew Shea
Abraham Shedlov
J. A. Sheinkopf
C. G. Sheppard
Lloyd F. Sherman'
II arry Shragg
John S. Siegel
~1(·lIa H. Sikkema
L. O. Simenstad
Daniel Simon
Werner Simon
John B. Simons
Ernst Simonson
Melvin B. Sinykin
David Siperstein
G. Skaff
Ahhott Skinner
Rudolph B. Skogerboe
John E. Skogland
I van W. Sletten
Arthur C. Smid
E. A. Smisek
Adam M. Smith
Archie M. Smith
Arthur F. Smith'
Baxter A. Smith
Duane S. Smith
Graham G. Smith
Howard R. Snider
Suzanne A. Snively
R. T. Soderlind
Juan Solari
Ben Sommerso
Nels N. Sonnesyn
D. W. Sontag
L. W. Sontag
J. P. Spano
Mitchell W. Spellman
Bernard J. Spencer
Michael P. Sperl. Jr.
Kenath H. Sponsel
Joseph L. Sprafka
R. G. Sprague
Clifford J. Stadem
William A. Stafne
A. C. Stahr
Lorel A. Stapley
David State
THE MEDICAL BULLETIN
Annual Members (continued)
Burton H. Stein
Sam 1. Stein
Sherman T. Stenbcrg
H. M. Sterling
Donald C. Sterner
J. M. Stickney
G. Keith Stillwell
Robert Stoltz
Norman F. Stonc
Albert V. Stosser
Everett L. Strandell
John J. Stransky
Gordon E. Strate O
Maurice L. Straus
Bernard L. Street
Edward L. Strem
J. H. Strickler
J. M. Stickney
Harold W. StOllC!,)
H. Jerome Stulberg
Rodney F. Sturley
WalterSubby
W. Albert Sullivan
R. Dorothy Sundberg
N. J. Sundet
Janet B. Sutton
Harry A. Swedlund
H. B. Sweetser, Jr.
Orvie J. Swenson
J. T. Syverton
A. George Tanbara
George M. Tangen
George T. Tani
E. J. Tan'luist, Jr.
Leslie W. Tasche"
Gerald J. Taylor
Henry L. Taylor
Kenneth W. Teich
William S. Terry
Carlo A. Terzuolo
Gordon H. Tesch
J. P. Tellie
Jerome O. Textor
Joseph W. Teynor
R. D. Thielen
John V. Thomas
Arthur Thompson
F. A. Thompson
Stewart C. Thomson
Cyril R. Tifft
Jan H. Tillisch"
R. G. Tinkham
Leonard A. Titrud"
Louis Tobian, JT.
John D. Tobin
Lyle Tangen
Fernando Torres
Benedict B. Trach
Bertram L. Trelstad
Bror S. Troedsson
Richard C. Tucker
Richard B. Tudor
Robert B. Tudor
Nail' Tuna
John A. Tweedy
Roland L. Udaseo
Alfred Uihlein
U. R. Ulferts
Robert A. Ulstrom
Lawrence E. Ulvestad
Frank Ungar
B. Ure
A. L. Vadheim"
F. H. Van Bergen
H. Van Meier
Donald J. Van Ryzin
Richard L. Varco oo
Jack A. Vennes
John E. Verby, Jr.
Rohert L. Vernier
P. M. Vickers
Hildegard .I. Virnig
Richard P. Virnig
Maurice B. Visscher o
Howard A. Vogel
Ruth Von Bergen
Stanley C. Von Drashek
Richard W. Von Korff
George W. Waldron
R. H. Waldschmidt"
S. A. Walker
Walter W. Walker"
M. O. Wallace
Ira O. Wallin
Francis M. Walsh
Frederick H. Walter
Jnn-Chinan Wang
Charles T. Wangenstel'J1"
Lewis W. Wannamaker
Percy A. Ward
Herbert E. Warden
LorenF. Wasson
Alex M. Watson
C. J. Watson"
Dennis W. Watson
S. W. Watson
John M. Waugh
Edgar A. Webb
Lowell W. Weber
David Webster
Mark .I. Wegleitner
Harry Weiner
B. A. Weis
J. H. Weisberg
S. J. Weisman"
Lewis J. Weller
Herbert S. Wells
W. B. Wells
John P. Wendland
W. T. Wenner"
H. A. Wente
Gilbert P. Wenzel
Stanley P. Wesolowski
Catherine C. West
James R. West
Robert K. West
D. E. Westover
M. L. Whalen
Joseph L. Whelan
Walter M. Whitaker
Asher A. White
Francis M. Whittaker
Dexter D. Whittmore
W. F. Widen"
Rudolph J. Wilkowske
George E. Williams
J. A. Williams
John 1. Williams
M. R. Williams
W. Lane Williams
H. A. Williamson
C. A. Wilmot
H. E. Wilmot"
.I. Allen Wilson
Robert K. Wilson
Paul Winchell
Louis Winer
Winona Clinic
F. F. Wippermann
A. Cabot Wohlrabe
Donald E. Wohlrabe
Earl H. Wood
Robert Woodruff
Kenneth R. Woods
Thomas D. Wright
Merrill B. Yeomans
Lanritz S. Ylvisaker
H. S. Ylvisaker"
Earl G. Yonehiro
N. A. Young
Thomas O. YoungO
Leslie Zieve
Bernard Zimmermann
Charles W. Zinn
Horace H. Zinneman
Thomas Ziskin
E. Zupanc
"Also Life Member
407
INDEX FOR VOLUME 31 and VOLUME 32,
1959-60 and 1960-61
UNIVEHSlTY OF MINNNESOTA MEDiCAL BULLETIN
Abdominoperineal Resection, see
Long and Bernstein, 31 :384
Ackerman, Norman B., McFee,
Arthur S., Wangensteen, Owen H.,
Diagnosis of Gastric Malignancy by
Vivo Balloon Radioautography, 32:
:3:34
Action Potential of Spinal Motoneurons, Terzuolo, Carlo A., 32:180
Airway Resistance, see Westgate,
Gordon, and Van Bergen, 32:378
Alexander, Carl S., see Hunt, Vincent
R; 31:526
Amberg, Ray, Annual Report,
University of Minnesota, Hospitals,
1958-1959, 31:2
Amberg, Ray, Biennial Report; Univ.
of Minn. Hospitals, 1958-59, 195960, 32:2
Aminopeptidase, see Rosenholtz and
Wattenberg, 31:62
Amplatz, Kurt, Percutaneous Arterial
Catheterization and its Applieatiems, 31: 339
Anemia, see Yonehiro, Perry, Shahon,
Marvin, and Wangensteen, 31:250
Anesthesia, see Tanasichuk, Schultz,
Matthews, and Van Bergen, 31 :596
Antibodies, see DeSanto, 31 :494
Antihemophiliac Globulin, see Bentley
and Krivit, 31: 166
Annual Report, University of Minnesota Hospitals, 1958-19,59, Ray
Amberg, 31:2
Arnesen, Paul M., see Richard D.
Grancluist; et aI., 31 :504
Arterial Catheterization, see Amplatz,
31:339
Assay of Antihemophiliac Globulin
Activity in the Carrier Female,
Herschel P. Bentley, Jr., and William Krivit, 31:166
408
Bacon, Gilbert A. and I\loe, John H.,
Primary Bone Tumor Study, 194019,56, 32:312
Baker, A. B., Etiologic Factors in
Cerebrovascular Disease, 32:212
Baker, Annie Laurie, University Hospitals in the State Welfare Structure, 31 :446
Barr, Robert N., see Kleinman,
Herman; et al. 31:263
Bauer, Henry; see Kleinman,
Herman; et al 31 :263
Beck, Robert H., Some Issues Facing
the American High School, 31: 113
Benson, Ellis S.; see Nelson, Douglas
A., 32:260
Bentley, Herschel P., Jr. and Krivit,
vVilliam; An Assay of Antihemophiliac Globulin Activity in the
Carrier Female, 31: 166
Bernstein, William C.; see Long,
David M., 31 :384
Biennial Report; University of Minnesota Hospitals, 1958-59, 1959-60,
Ray M. Amberg, 32:2
Binder, G. H., Jr., Evaluation of the
Reiter Protein Complement Fixation
Test, A New "Treponemal" Test
for Syphilis, 31: 106
Blegen, Theodore C., Some Thoughts
on the Nature and Meaning of
Scholarship, 31 :89
Boies, L. R., Hohmann, Albert, and
Sigel, Melvin, Research Studies
Related to the Surgical Treatment
of Clinical Otosclerosis, 32: 348
Bone Tumor, see Bacon and Moe,
32:312
Bowers, John Z., Observations on
Medical Education and Medicine,
Here and Abroad 31:413
Breast Cancer Morphology and
~1,
1
i,,
•
THE MEDICAL BULLETIN
Adrenal Corticosterone Elevation in
C and D s Mice with Heterotopic
Pituitary Isografts, by Erhard Haus,
Franz Halberg, Darline D. Smith,
and Kathleen Shane Michels,
.'32:1.'34
Bridges, Robert A.; Good, Robert A.;
Esther F. Freier, Immunoelectrophoretic Characterization of Diseases Associated with Defects in
the Immune Response, .'31:.'374
Brown, E. B., Jf. see MacArthur,
J. D., .'31:462
Cancer, see Haus, Halberg, Smith and
Michels, .'32:1.'34
Cancer, see Kennedy, Theologidcs,
Foley, and Fortuny, .'32:294
Cancer of the Pharynx, Jerome A.
Hilger, Bradley W. Kusskc, Richard
R. Lund, and Frank Van De
Water, .'31 :402
Carbon Dioxide Tension, sec MacArthur and Brown, .'31 :462
Carcinoid Syndrome: A Clinical and
Biochemical Study, Richard B.
Davis, .'32:198
Carotid Endarterectomy, Erich S.
Wisiol, Lyle A. French, and Shelley
N. Chou, .'32:24.'3
Central Nervous System in Congenital
Heart Disease, Maynard M. Cohen,
Fernando Torres, Gilbert Frank,
and J. T. Jabbour, .'31:.'302
Cerebral Cortex, see Chou, .'31 :.'3.'30
Cerebrovascular Disease, see Baker,
.'32:212
Changes in Airway Resistance Following Intravenously Administered DTubocurarine by Hugh D. Westgate, J. R. Gordon, and Frederick
H. Van Bergen, .'32:.'378
Chemotherapy, see Kennedy,
Theologides, Foley and Fortuny,
.'32:294
Child Psychiatry-Retrospect and
Prospect, by Leo Kanner, .'31 :290
Chlorothiazide, see Tobian, .'32:82
Chou, Shelley N., Some Aspects of
Microelectrode Investigation of the
Cerebral Cortex of Cats, 31 :330
Chou, Shelley N., see Erich S. Wisiol,
et. aI., 32:243
Chromosomes, see Goodlin, 32: 170
Chronic Osteomyelitis of the Extremities; a Review of Treatment, Richard D. Granquist, Paul M. Arnesen,
and John H. Moe, 31 :504
Clinical Studies of Circulating Insulin
Binding Antibodies, Lawrence W.
DeSanto, 31 :494
Cohen, Maynard M.; Torres, Fernando; Frank, Gilbert; Jabbour, J. T.,
The Central Nervous System in
Congenital Heart Disease, 31 :302
Congential Heart Disease, see Cohen,
Torres, Frank and Jabbour, 31 :302
Cooney, Marion K.; see Kleinman,
Herman; et. a1. 31:263
Corticosterone, see Haus; Halberg;
Smith and Michels, .'32: 134
Creevy, C. D.; see A. Hakim; et. a1.
31:4.'34
Current Aspects of Cancer Chemotherapy, B. J. Kennedy; Athanasios
Theologides; John Foley; and Ignacio Fortuny, 32:294
DaSilva, Mauricio Martins; see Kleinman, Herman; et. a1. .'31:263
Davis, Richard B., The Carcinoid
Syndrome: A Clinical and BioChemical Study, 32:198
Dehydrogenase, see Ungar, .'31 :226
DeSanto, Lawrence W., Clinical
Studies of Circulating Insulin Binding Antibodies .'31 :494
Diabetes, see Wells, .'31: 186
Dillon, John F., Interstitial Radium
Therapy, .'32:2.'34
Doubly Labeled Water as a Possible
Tool for Measurement of Energy
and Material Balance, Nathan Lifson, .'31 :218
Effect of Hydrogen Ion Concentration
and Carbon Dioxide Tension on
Oxyhemoglobin Dissociation, John
D. MacArthur and E. B. Brown,
Jr., .'31 :462
Effects of Irradiation on the Phospha409
THE MEDICAL BULLETIN
tides from Normal and TumorBearing Mice, Theresa C. Lee;
Robert J. Salmon; Donn G. Mosser;
and Merle K. Loken, 31 :54.5
Egdahl, Richard; see Goetz, Frederick C. et. aI. 31:79
Electron Microscopy of Human Skin,
Alvin S. Zelickson, .32:74
Endarterectomy, see Wisiol, French,
and Chou, .32:24.3
Endocarditis, see Pankey, 31 :557
Endocrinology, see Wells, .31: 186
Etiologic Factors in Cerebrovascular
Disease, A. B. Baker, 32:212
Evaluation of the Reiter Protein
Complement Fixation Test, a New
"Treponemal" Test for Syphilis, by
G. H. Binder, Jr., 31: 106
Fatty Acids, see Tuna, Louden, and
Sundeen, 31: 1.34
Fetal Endocrinology, with a Consideration of Diabetes and Pregnancy,
Lemen J. Wells, 31: 186
Field Trials with the Lederle-Cox
Strains of Live Poliovirus Vaccines:
A Short Review, Herman Kleinman,
Robert N. Barr, Henry Bauer,
Eugene A. Johnson, Mauricio Martins DaSilva, Anne C. Kimball, and
Marion K. Cooney, 31 :263
Foley, John; see B. J. Kennedy, et. aI.
32:294
Fortuny, Ignacio; see B. J. Kenn('dy,
ct. aI. 32:294
Frank, Gilbert; see Cohen, Maynard
M., et. aI. 31 ::302
Freier, Esther F.; sec Robert A.
Bridges, et. aI. 31:374
French, Lyle A.; sec M. J. Meier, .31:
611
French, Lyle A.; see Erich S. Wisiol,
et. aI. 32: 243
Fritz, Edna L., Nursing Education to
Meet Today's Needs, 31:586
Gastric Malignancy; see Ackerman,
McFee and Wangensteen: .32:.3.34
Geniculocalcarine Pathways in the
Temporal Lobe, John P. \Vendland
and Sidney Nerenberg, 31 :482
410
Goetz, Frederick c., Eugene A. Johnson, and Richard Egdahl, Insulin
Secretion and the Problem of Insulin Assay, 31:79
Good, Robert A.; see Robert A.
Bridges, et. aI. 31 :374
Goodlin, Robert C., Study of Human
Chromosomes, 32: 170
Gordon, J. R.; see Hugh D. vVestgate,
et. aI. 32:378
Granquist, Richard D., Paul M. Arnesen, and John H. Moe, Chronic
Osteomyelitis of the Extremities; A
Review of Treatment, .31:504
Hakim, Ali, M. P. Reiser, and C. D.
Creevy, Transplantation of Vesical
Mucosa to the Intestine: An Experimental Study, 31 :434
Halberg, Franz; see Erhard Haus, et
aI. 32: 134
Handwriting; see Meier and French,
31 :611
Hastings, Ruth; see Frederic J.
Kottke, et. aI. .32: 114
Haus, Erhard, Franz Halberg, Darline
D. Smith and Kathleen Shane
Michels, Breast Cancer Morphology
and Adrenal Corticosterone Elevation in C and Dk t\lice with Herterotopic Pituitary Isografts, 32: 134
Hcmispinal Anesthesia: Its Applicability and Its Relation to Hypotension in Geriatric Patients, Murray
A. Tanasichuk, Earl A. Schultz,
James H. Matthews, Frederick H.
Van Bergen, 31:.596
High School; see Beck, .31:U3
Hilger, Jerome A., Bradley VV.
Kusske, Richard R. Lund and
Frank \"1. Van De Water, Cancer
of the Pharynx, 31 :402
Histochemical; see Rosenholtz and
Wattenberg, 31:62
Hohmann, Albert; see L. R. Boies,
et. aI. 32:348
Holland, John J.; sec McLaren, Leroy
c., 31:143
Hunt, Vincent R., and Carl S. Alexander, Immunologic and Metabolic
,
1
,,
'"
THE MEDICAL BULLETIN
Aspects of Aminonucleoside Nephrosis, 31 :.526
Hydrogen Ion Concentration, see
MacArthur and Brown, .'31 :462
Hypotension; see Schultz, Matthews,
Van Bergen, and Tanasichuk, ,'31:
.596
Immune Response; see Bridges, Good,
and Freier, 31:374
Immunoelectrophoretic Characterization of Diseases Associated with
Defects in the Immune Response,
by Robert A. Bridges, Robert A.
Good, and Esther F. Freier, 31 :374
Immunologic and Metabolic Aspects
of Aminonucleoside Nephrosis,
Vincent R. Hunt, and Carl S.
Alexander, .'31:.526
Insulin; see DeSanto, 31 :494
Insulin Assay, see Goetz, Johnson and
Egdahl, .'31 :79
Insulin Secretion and the Problem of
Insulin Assay, Frederick C. Goetz,
Eugene A. Johnson and Richard
Egdahl, 31:79
Interstitial Radium Therapy, John F.
Dillon, 32: 234
Irradiation; see Lee, Salmon, Mossl'r,
Loken, .'31:.54.5
Jabbour, J. T.; see Maynard l\f.
Cohen, et. a!. 31 :,'302
Johnson, Eugene A.; see Frederick C.
Goetz, et. aI. 31:79
Johnson, Eugene A.; see Kleinman,
Herman, et. a!. 31 :263
Kanner, Leo, Child Psychiatry-Rl'trospect and Prospect, ,'31 :290
Kennedy, B. J., Anthanasios
Theologides, John Foley and Ignacio Fortuny, Current Aspects of
Cancer Chemotherapy, .'32:294
Kimball, Anne c.; see Herman
Kleinman, et. a!. 31:263
Kleinman, Herman, Robert N. Barr,
Henry Bauer, Eugene A. Johnson,
Mauricio Martins da Silva, Anne
C. Kimball and Marion K. Cooney,
Field Trials with the Lederle-Cox
Strains of Live Poliovirus Vaccines:
A Short Review, 31 :263
Kottke, Frederic J., William G. Kubicek, Mildren E. Olson and Ruth H.
Hastings, Studies on the Work of
the Heart in a Hospital Environment, 32:114
Krivit, William; see Herschel P. Bentley, ,'31:166
Kubicek, vVilliam c.; see Frederic J.
Kottke, et. aI. :32: 114
.
Kusske, Bradley W.; see Jerome A.
Hilger, et. aI. 31 :402
Lee, Theresa C., Robert J. Salmon,
Donn G. Mosser and Merle K.
Loken, Effects of Irradiation on the
Phosphatides from Normal and
Tumor-Bearing Mice, 31 :.54.5
Lifson, Nathan, Doubly Labeled
Water as a Possible Tool for
Measurement of Energy and Material Balance, 31:218
Live Poliovirus Vaccines; see Kleinman, et. aI. 31 :26:3
Loken, Merle K.; see Theresa C. Lec,
et. aI. 31:.54.5
Long, David M., Jr., and William C.
Bernstein, Sexual Dysfunction Following Abdominoperineal Resection of the Rectum for Cancer: An
Anatomic and Physiologic Study,
31 :384
Louden, Mary L.; see Naip Tuna, et.
aI. 31: 1,'34
Lumbar Lordosis, sec Schoening, 31:
1.58
Lund, Richard R.; see Jerome A. Hilger, et. aI. 31 :402 .
MacArthur, John D., and Brown, E.
B. Effects of Hydrogen Ion Concentration and Carbon Dioxide
Tension on Oxyhemoglobin Dissociation, ,'31 :462
Marvin, James F.; see Earl G. Yonehio, et. aI. ,'31 :2.50
Maternal Mortality Study; see McKelvey,31:197
Matthews, James H.; see Murray A.
Tanasichuk, et. aI. ,'31 :.596
McFee, Arthur S.; see Norman B.
411
THE MEDICAL BULLETIN
Ackennan, et. aI. 31 :334
McKelvey, J. L., The Minnesota
Maternal Mortality Study, 31: 197
McLaren, LeRoy C., and John J.
Holland, Some Aspects of VirusCell Relationship, 31: 143
Measurement of Energy; see Lifson,
31 :218
Medical Citizen, Leo G. Rigler, 32:36
Medical Education; see Bowers,
31:413
Meier, Manfred J., and L. A. French,
Quantitative Assessment of Handwriting and Gait in Parkinson's
Disease, .'31:611
Michels, Kathleen Shane; see Erhard
Haus, et. al. 32: 134
Microelectrode Investigation; see
Chou, 31:330
Minnesota Maternal Mortality Study,
J. L. McKelvey, .'31: 197
Moe, John H.; see Richard D. Granquist, et. al. 31 :504
Moe, John H.; see Gilbert A. Bacon,
32:312
Morphologic Histochemical Studies of
Aminopeptidase in Surgical and
Autopsy Specimens, Mitchell
Rosenholtz and Lee \V. \Vattenberg, 31:62
Mosser, Donn G.; see Theresa C. Lee,
ct. al. 31 :545
Myocardial Ultrastructure; see Nelson, Benson, 32:260
Nelson, Douglas A., and Ellis S. Benson, Observations on Myocardial
Ultrastructure, 32: 260
Nerenberg, Sidney; see John P.
Wendland, 31 :482
Nephrosis; see Hunt and Alexander,
31:526
Nervous System; see Cohen, Torres,
Frank and Jabbour, 31:302
Nursing Education to Meet Today's
Needs, Edna L. Fritz, 31:586
Observations on Medical Education,
Here and Abroad, John Z. Bowers,
31:413
Observations on Myocardial Ultra412
structure, Douglas A. Nelson, and
Ellis S. Benson, 32:260
Observations of Radioactive Iron
Uptake by Malignant Tissue and its
Possible Relationship to Anemia,
Earl G. Yonehiro, John F. Perry,
Jr., Donald Shahon, James F. Marvin and Owen H. \Vangensteen,
31:2.50
Olson, Mildred K; see Frederic J.
Kottke, et. al. 32: 114
.
Osteomyelitis; see Gnm(luist, Arnesen,
and Moe, 31:504
Ostosclerosis; see Boies, Hohmann,
and Sigel, 32:348
Oxyhemoglobin Dissociation; see
MacArthur and Brown, 31:462
Pankey, George A., A Review of
Cases Seen at the University of
. Minnesota Hospitals, 1939-19.59,
31:557
Parkinson's Disease, see Meier and
French, 31 :611
Pelvic Tilt; see Schoening, 31: 158
Percutaneous Arterial Catheterization
and its Applications, Kurt Amplatz,
31:339
Perry, John F., Jr.; see Earl G. Yonehiro, et. al. 31 :2.50
Pharynx; see Hilger, Kusske, Lund
and Van De Water, 31 :402
Phosphatides; see Lee, Salmon, Mosser, Loken, 31:545
Pituitary Isografts; see Haus, Halberg, Smith and Michels, 32: 134
Pregnancy; see Wells, 31:186
Primary Bone Tumor Study, 19401956, Gilbert A. Bacon and John H.
Moe, .'32:.'312
Psychiatry; see Kanner, 31 :290
Quantitative Assessment of Handwriting and Gait in Parkinson's Disease,
Manfred J. Meier, and Lyle A.
French, 31 :611
Quie, Paul G., and Lewis W. Wannamaker, An Unusual Staphylococcal
Product and its Host Interactions,
32:125
Radioactive Iron; see Yonehiro, Perry,
,
1
,
I
~
THE J\fEDICAL BULLETIN
Shahon, Marvin and vVangensteen,
31:250
Radioautography; see Ackerman, McFee, and Wangensteen, 32:3.'34
Radium Therapy; see Dillon, 32:234
Rationale and Teclmirlue for Diagnosis of Gastric Malignancy by In
Vivo Balloon Radioautography,
Norman B. Ackerman, Arthur S.
McFee, and Owen H. Wangensteen, 32 :250
Rectum; see Long amI Bernstein,
31:,'384
Reiser, Milton P.; see A. Hakim, et.
aI. .'31:4.'34
Reiter Protein Complement Fixation
Test; see Binder, 31 :106
Relationship betwcen Pelvic Tilt and
Lumbar Lordosis, Herbert A.
Schoening, 31: 158
Research Studies Related to the Surgical Treatment of Clinical Otosclerosis, L. R. Boies, Albert Hohmann,
and Melvin Sigel, 32:348
Retrospect and Prospect, Owen H.
Wangensteen, 31 :351
Rigler, Leo G., The Medical Citizen,
32:36
RosenhoItz, Mitchell and Wattenberg,
Lee W., Morphologic Histochemical Studies of Aminopeptidase in
Surgical and Autopsy Specimens,
31:62
Salmon, Robert T.; see Theresa C.
Lee, et. aI. 3i :545
Schoening, Herbert A., The Relationship Between Pelvic Tilt and Lumbar Lordosis, 31: 158
Scholarship; see Blegen, 31 :89
Schultz, Earl A.; sec Murray A. Tanasichuk, et. aI. 31 :596
Sexual Dysfunction Following Abdominoperineal Resection of the
Rectum for Canccr: An Anatomic
and Physiological Study, David M.
Long, Jr. and William C. Bernstein, 31 :384
Shahon, Donald; see Earl G. Yonehira, et. aI. 31:250
Sigel, Melvin; see L. R. Boies, ct. aI.
32:348
Skin; see ZeIickson, 32:74
Smith, Darlene D.; sce Erhard Haus,
ct. aI. 32: 134
Some Aspects of Microelectrode Investigation of the Cerebral Cortcx
of Cats, Shelley N. Chou, 31 :330
Some Aspects of Virus-Ccll Relationships, LeRoy C. McLaren and John
J. Holland, 31: 143
Some Issues Facing thc Amcrican
High School, Robert H. Bcck, 31:
u.'3
Somc thoughts on thc Nature and
Meaning of Scholarship, Thcodorc
C. Blegcn, ,'31:89
Spinal Motoneurons; see Terzuolo,
32:180
Staphylococcal Products; sce Quie and
Wannamaker, 32: 12.5
State Welfare; see Baker, 31 :446
Stokes-Adams Attacks; see Tobian,
32:82
St::dies on "Serum .Fatty Acid~ of
Normal AmerIcans and Normal" Japanese, Naip Tuna, Mary
L. Louden, and Mary J. Sundeen,
31: 134
Studies on the vVork of the Heart in
a Hospital Environment, Frederic
T. Kottke, William G. Kubicek,
'Mildred E. Olson, and Ruth
Hastings, 32: 114
Study of Human Chromosomes,
Robert C. Goodlin, 32:170
Subacute Bacterial Endocarditis: A
Review of Cases Seen at the University of Minnesota Hospitals,
] 939-1959, George A. Pankey,
31:5.57
Sundeen, Mary S.; see Naip Tuna, et.
aI. 31:134
Surgical Treatment; see Boies, Hohmann and Sigel, 32:348
Syphilis; see Binder, .'31: 106
Tanasichuk, Murray A., Earl A.
Schultz, James H. Matthews and
Frederick H. Van Bergen, Hemi413
THE MEDICAL BULLETIN
spinal Anesthesia: Its Applicability
and its Relation to Hypotension in
Geriatric Patients, 31:596
Temporal Lobe; see Wendland and
Nerenberg, 31 :482
Terzuolo, Carlo A., The Action Potential of Spinal Motoneurons, 32:
180
Theologides, Athanasios; see B. J.
Kennedy, et. a1. 32:294
Three-Hydroxysteroid Dehydrogenase
Activity in Mammalian Liver,
Frank Ungar 31 :226
Tobian, Louis, Treatment of StokesAdams Attacks by Lowering Plasma
Potassium with Chlorothiazide, 32:
82
Torres, Fernando; see Maynard M.
Cohen, et. a1. 31 :302
Transplantation of Vesical Mucosa to
the Intenstine: An Experimental
Study, Ali Hakim, Milton P. Reiser,
and C. D. Creevy, 31 :434
Treatment of Stokes-Adams Attacks
by Lowering Plasma Potassium
with Chlorothiazide, Louis Tobian,
32:82
Tubocurarine; see Westgate, Gordon
and Van Bergen, 32:378
Tuna, Naip, Mary L. Louden and
Mary J. Sundeen, Studies on Serum
Fatty Acids of "Normal" Americans
and "Normal" Japanese, 31: 134
Ungar, Frank, 3-Hydroxysteroid Dehydrogenase Activity in Mammalian
Liver, 31 :226
University Hospitals in the State
Welfare Structure, Annie Laurie
Baker, 31:446
Unusual Staphylococcal Product and
Its Host Interactions, Paul G. Quie
and Lewis W. Wannamaker, 32:
125
414
Van Bergen, Frederick H.; see Murray A. Tanasichuk, et. a1. 31 :596
Van Bergen, Frederick H.; see Hugh
D. Westgate, et. a1. 32:378
Van De Water, Frank; see Jerome A.
Hilger, et. a1. 31:402
Vesical Mucosa; see Hakim, Reiser,
and Creevy, 31:434
Virus-Cell Relationships; see McLaren and Holland, ·31: 143
\Vangensteen, Owen H.; see Earl G.
Yonehiro, et. aI., 31:250
Wangensteen, Owen H., Restrospect
and Prospect, 31 :351
Wangensteen, Owen H.; sce Norman
B. Ackerman, et. aI., 32:334
\Vannamker, Lewis W.; see Paul G.
Quie, 32: 125
Wattenberg, Lee W.; see Mitchell
Rosenholtz, 31 :62
Wells, Lemen J., Fetal Endocrinology
with a Consideration of Diabetes
and Pregnancy, 31: 186
Wendland, John P. and Sidney Nerenberg, The Geniculocalearine
~~~lway in the Temporal Lobe, 31:
Westgate, Hugh D., J. R. Gordon,
and Frederick H. Van Bergen,
Changes in Airway Resistance
Following Intravenously Administered D-Tubocurarine, 32: 378
Wisiol, Erich S., Lyle A. French
and Shelley N. Chou, Carotid Endarterectomy, 32: 243
Yonehiro, Earl G., John F. Perry, Jr.,
Donald Shahon, James F. Marvin
and Owen H. Wangensteen, Observations of Radioactive Iron Uptake by Malignant Tissue and Its
Possible Relationship to Anemia,
31:250
Zelickson, Alvin S., Electron Microscopy of Human Skin, 32:74
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Medical School News
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CLASS OF 1961 HONORED
ON RECOGNITION DAY
Traditional Recognition Day Exercises were observed June
9 at the Medical School for 114 members of the Class of 1961.
The graduating seniors and faculty of the medical school
marched in academic procession to Mayo Auditorium were
Dr. Chester Scott Keefer, Professor of Medicine at Boston
University Medical School, delivered the Recognition Day address. His topic was "The University and Medicine."
Dr. Robert B. Howard, Dean of the Medical School, presided at the exercises, and Dr. Wallace H. Cole, (Med. '10),
professor emeritus of orthopedic surgery, administered the Declaration of Geneva to the graduates.
Dr. Martin G. Bruhl (Med. '61) received the Southern Minnesota Medical Association Award given to the member of the
Senior Class who has demonstrated ontstanding proficiency in
medicine and surgery.
Dr. Fred L. Shapiro (Med. '61) received the Borden Award
for significant contributions to research during student years,
and G. Nicholas Rogentine, a medical school junior, received
the Mediclinics Award for exemplary scholastic and professional
achievement.
Dr. Edward S. Peterka (Med. '61) was named winner of the
Minnesota Dermatological Society Award for writing a meritorious essay on a dermatological topic, and Dr. Ronald D.
Guttman (Med. '61) received the Rollin E. Cntts Memorial
Award for having demonstrated ontstanding proficiency in
surgery.
Graduates, parents and guests gathered in the evening for a
Senior Class banquet at Coffman Memorial Union. Dr. Donn
G. Mosser, Professor of Radiation Therapy, was Master of
Ceremonies, and the main address was given by Dr. M. John
Murray, Assistant Professor of Medicine. Dr. Evan L. Nelson,
Jr., (Meet '61) gave the Class Response.
415
DR. GEORGE E. FAHR TO BE
HONORED ON 80th BIRTHDAY
Friends and former students of Dr. George E. Fahr are
planning a testimonial celebration honoring him at the Universitv of Minnesota Medical School on January 2.5, 1962, the
occasion of his 80th birthdav.
.
Dr. Fahr, emeritus professor of medicine, is widely known
as the American disciple of Willem Einthoven, father of electrocardiography. Dr. Fahr's teaching and scientific achievements during 40 years on the faculty at the
Medical School are legendary. He retired in
1950, but remains active in Minneapolis
medical circles.
A committee of physicians whose medical careers he influenced have announced
plans to present the Medical School with a
portrait of Dr. Fahr, especially painted for
the occasion, which will be hung alongside those of other distinguished medical
teachers at the Universitv.
Papers written by his former students
will be presented during a day-long scienGt'orge E. Fahr
tific session at the Medical Center. There
will be an honorary luncheon and formal dinner in the evening.
Dr. Arthur C. Kerkhof, Minneapolis cardiologist, announced
the committee has asked for gifts from several hundred former
students of Dr. Fahr. Contributions will be used to finance
the event, and to endow a George E. Fahr Medical Scholarship,
which would be given each year to an outstanding medical
student at the University. A festschrift containing all papers
on the scientific program, Dr. Fahr's biography, his memoirs
of Einthoven, and the evening's main address will be bound
and copies given to all who contribute .$30.00 or more.
Contributions are welcome and may be sent in care of the
Minnesota Medical Foundation, 1342' Mayo Memorial Bldg.,
University of Minnesota, Minneapolis 14. Make checks payahle
to: "Minnesota Medical Foundation, George Fahr Fund."
Scientific papers IJy former students of Dr. Fahr
are invited. They are limited to 12 minutes' presentation time, and must he douMe spaced on not more
than six typewritten pages. Manuscripts must he
suhmitted by Octoher 1, 1961 to Dr. A. C. KerkllOf,
601 Medical Arts Bldg., Minneapolis 2, Minn.
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Faculty News
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PHYSIOLOGY
Dr. Maurice B. Visscher, professor and head of the department, was elected to the executive board of the National Society
for Medical Research at the group's 1961 annual meeting. The
Society, established in 1945, is concerned chiefly with promoting public understanding of the methods, needs and accomplishments of medical research.
Dr. Robert E. Swanson, assistant professor, was appointed
an associate professor of physiology at the University of Oregon
Medical School. His appointment was effective June 1, 1961.
DERMATOLOGY
Dr. Francis W. Lvnch, director of the division, has been
elected a correspondiri. g member of the Danish Dermatological
Society.
MEDICINE
Dr. Wesley W. Spink has been certified by the American
Board of Microbiology as one nine eminent scientists qualified
in public health and medical laboratory microbiology. The
American Academy of Microbiology, which announced the
certification, recognized Dr. Spink for his discovery of an
effective treatment of brucellosis in man.
The late Dr. Jerome T. Syverton, former head of the
Medical School's department of bacteriology and immunology,
who died January 28, 1961, was certified posthumously.
ANATOMY
At the Annual Meeting of the American College of Chest
Physicians in New York on June 25, 1961, Dr. E. A. Boyden,
former Head of the Department of Anatomy at Minnesota was
awarded an honorary fellowship in the American College of
Chest Physicians. Others receiving this honor at the same meeting were Dr. Luther L. Terry, Surgeon General of the United
States Public Health Service and Rear Admiral Edward C.
Kenney, Surgeon General of the United States Navy.
417
Medical Foundation News
MEDICAL FOUNDAnON
RECEIVES LARGE BEQUEST
The Minnesota Medical Foundation has announced receipt
of a be(luest of $215,000 from the estate of the late Arvid
Olson, a North Dakota farmer and merchant who died in 1958.
It was the largest single gift in the 22-year history of the Foundation, an organization of alumni, physicians, corporations, and
citizens providing private support for the University of Minnesota Medical School.
Under the terms of the bequest, the Foundation will use
the funds to finance medical research in heart disease and cancer. Dr. Arnold Lazarow, Foundation president, said a new program is being formulated which
would make the research funds
available primarily to meritorious projects and younger scientists at the Medical School.
"We will attempt to provide assistance for projects and men
who are not vet well known,
and therefore ~nable to readilv
attract research grants from th~
customary sources," he said. The
Foundation's Research Grants
Committee, headed by Dr. John
A. Anderson, is formulating a
new medical research program
to be financed bv annual inARNOLD LAZAROW
come from the be(luest.
Dr. Lazarow called Mr. Olson's bequest "one of the most
significant gifts ever received by the Foundation," enabling
the organization to launch an entirely new support program for
the Medical School. He praised the donor for providing a
"local source" of research funds, and said the Foundation hoped
to interest other donors in investing gifts for medical research
purposes through the Foundation.
Mr. Olson's bequest more than tripled the existing assets
of the Foundation, which was organized in 1939 to attract and
disburse funds for private support of the Medical School.
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DR. N. L. GAULT TO SPEAK ON
MEDICAL FOUNDATION DAY
Dr. N. L. Gault, Assistant Dean of the Medical School, will
give the annual Minnesota Medical Foundation Day address
on September 25, 1961, as the 1961-62 academic year commences.
For the past two years, Dr. Gault has
been an advisor in medicine to the Seoul
National University School of Medicine,
Korea, under the' medical teaching exchange program. His wife and family have
been with him in Korea during the past two
years, and Dr. Gault has been eyewitness
to some of the most turbulent ~vents in
Korean historv. He will also evaluate the
results of the Korean teaching exchange
program, which was established in 1954,
and which will be concluded in 1961.
N. L. GAULT
Invitations to Foundation Day events,
including ceremonies awarding medical scholarships and the
Foundation's 1961 annual luncheon meeting, will be sent to all
members in August.
FRESHMAN SCHOLARSHIP WINNERS
NAMED BY MEDICAL FOUNDATION
Minnesota Medical Foundation scholarships of $500 each
for work in the University of Minnesota medical school next
fall have been won by 14 incoming freshman medical students.
The recipients, chosen on the basis of scholastic achievement and financial need, according to Dr. Arnold Lazarow,
foundation president, were: Marian R. Karlstrom, David M.
Thompson, Yossef Aelony, David Collin, and Guy E. O'Grady,
all of Minneapolis, and Dale Von Ruden, St. Paul.
Out-state winners of the Minnesota Medical Foundation
awards were: Paul Vander Kooi, Herman; Darla Ann Bjork,
Austin; James S. Good, Faribault; Darrel L. Lary, Northfield;
James J. Nordlund, White Bear Lake; David Raetz, Maple
Lake; Elton G. Wing, Trimont, and Daniel J. Murphy, Dallas,
Texas.
The Minnesota Medical Foundation is a non-profit private
organization of alumni, physicians, faculty and friends of the
University of Minnesota medical school established in 1939 to
assist the school. The foundation awards to students now total
$117,000 in scholarship funds to 229 medical students. Awards
to sophomore, junior and senior students will be announced later
in the year.
4H.l
Alumni Notes
• 1920
Lillian M. Fink was honored with the University of Minnesota Alumni Service Award. She received the' award on
Charter Day, 1961, from Stanley J. Wenberg, Vice President
of the University of Minnesota, in recognition of her "intense
concern with promoting the interest of the students at the
University, particularly women in medicine." She is a past
president of the Minnesota Alumnae Association, and has served
the parent Minnesota Alumni Association as
a member of the Board of Directors for
twelve years.
• 1922
Leonard W. Larson, Bismarck, N.D.,
pathologist, was installed as President of
the American Medical Association on June
27, 1961, in New York City. He recently received an honorary doctor of science degree
from Jamestown College, Jamestown, N.D.
LEONARD
W.
LARSON
• 1924
Harvey Nelson, Minneapolis physician, received a University
of Minnesota Alumni Service Award on February 23, 1961, the
HOth birthday of the University of Minnesota. A past president
of Minnesota Alumni Association. Dr. Nelson was cited for
furthering closer relations between the association and the
University's Board of Regents, and for strengthening the freshman scholarship program.
•
1935
Laurentius O. Underdahl, consulting physician at the Mayo
Clinic, was elected secretary of the American Diabetes Association at its 21st annual mee"ting recently in New York.
• 1937
T. J. Bloedel, Osseo, Minn., is president of Psi chapter, Alpha
Kappa Kappa medical fraternity, which held its 63rd annual
meeting recently in St. Paul. Secretary-treasurer is Dr. K. O.
Nimlos (Med. '46), St. Paul.
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•
1937
Jerome Hilger, St. Paul, was elected
president of the Minnesota Academy of
Ophthalmology and Otolaryngology for
1961-62. Dr. Harold Ulvestad (Med. '44)
of Minneapolis and Dr. Robert Hugh Monahan (Med. '42) of St. Paul were named vice
presidents. Dr. Richard O. Leavenworth
(Med. '50) of St. Louis Park was reelected
secretary-treasurer.
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1939
Jane E. Hodgson, St. Paul obstetrician
and gynecologist, spent the month of May
teaching and working in a mission hospital operated by the
Augustana Lutheran church in Tanganyika, East Africa. She
was accompanied by her husband, Dr. Frank W. Quattlebaum,
a surgeon.
JEROME HILGER
•
1942
Virgil J. P. Lundquist, Minneapolis surgeon, has been installed as President of the Minnesota Alumni Association, parent
alumni body with 17,000 members representing all colleges
within the University of Minnesota. He is also serving as general
chairman of the medical alumni campaign to build a medical
student center at the Medical School, and recently received a
certificate of merit for distinguished service as 19,59-60 president
of the Minnesota Medical Alumni Association.
•
1944
David D. Daly a consultant in neurology, will leave the Mayo
Clinic, Rochester, on August 15, 1961, to join the staff of the
new Barrow Neurological Institute, Phoenix, Ariz. He was
named chairman of the division of neurology. Dr. Daly joined
the staff of the Mavo Clinic in 1951 and had served continuouslv
there since.
.
.
•
1953
James R. Jude, resident in surgery at the Johns Hopkins
Medical Institutions, Baltimore, Md., was chosen 1961 recipient
of the Francis F. Schwentker Award for a research paper entitled "A New Approach to Cardiac Resuscitation." The prize
consists of $100 and an inscribed medal, presented annually
in recognition of outstanding research work. Dr. Jude has been
John Hopkins since 1953, except for two years when he was in
active militarv service.
421
THE MEDICAL BULLETIN
• 1955
Charles Zinn, a native of \Vavzata, Minn., recentlv returned
to his home town to become a;sociated in practice'with Drs.
W. W. Rieke (Med. '32) and D. W. Feigal (Med. '42). Dr. Zinn
interned at Ancker hospital, St. Paul, and has practiced since
then at Elk River, Minn.
• 1956
M. Donald Olmanson, St. Peter, Minn. physician, accepted
a two year appointment as a medical practitioner with the
American Medical Center for Burma. There he will be associated with Dr. Gordon Seagrave, the famed "Burma Surgeon," in
the Namkham hospital. Mrs. Olmanson and his family will
accompany Dr. Olmanson. They were scheduled to leave July 1,
• 1957
Joseph H. Eusterman has entered the U.S. Navy and been
assigned as a medical officer at the Naval Hospital, Bethesda,
Md.
• 1959
Ronald J. Nelson was married June 10, 1961 in Los Angeles,
Calif. to Miss Ruth Needles of Santa Barbara, Claif. Dr. Nelson
is preparing for a career as a medical missionary and is presentlv
a surgical resident at the University of Washington. He was
president of the 19,59 Class of the Universit~, of Minnesota
Medical School.
• 1959
Homer H. Russ, who practices in LeCenter, Minn., was appointed LeSueur Countv health officer for 1961 by the board of
countv commissioners.
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CLASS OF 1960 FACING
NEW MEDICAL CHALLENGES
Members of the Class of 1960, University of Minnesota
Medical School, are scattering far and wide to new assignments
and challenges following completion of their internship training.
A survey conducted by the MEDICAL BULLETIN, in cooperation with class president Dr. Ken Manick, indicates nearly
half of the 122 new doctors (,')3) have elected to enter advanced medical training as residents and fellows. Another large
group (3,,)) have launched into general practice of medicine,
some on their own, but most in association with established
physicians and medical clinics. Twenty are in military service,
and the remainder who answered the survev are busv with a
".
variety of medical endeavors.
Most exciting prospect belongs to Dr. Jim Man!twrdt, who
is spending the summer in Alaska, serving as physician accompanying a team of climbers attempting to scale Mt. McKinley, the highest peak in North America.
Results of the survey:
Eugene L. Acuff received an appointment as a resident in internal medicine at the Mavo Clinic, Rochester, Minn.
Paul Albrecht has become ass"ociated with the medical staff at
the Sparta Clinic, Sparta, Wisconsin.
John G. Albright has begun the general practice of medicine at
220 Iroquois Street, Laurium, Michigan.
James R. Allen's plans were uncertain.
Loren Anderson is doing research in physiology at Northwestern
University. His address is Abbott Hall, 710 N. Lake Shore
Drive, Chicago 11, lllinois.
Richard O. Anderson will take a residencv in medicinc at the
Strong Memorial Hospital, Rochester, New York.
Costas Assimacopoulos has begun a residency in surgery at the
University of Minnesota Hospitals.
Gary H. Babb is now with the U. S. Public Health Service,
Indian Division, and is practicing at the U.S.P.H.S. Health
Center, White Earth Indian Reservation, White Earth,
Minn. He plans a residency in internal medicine following
two years of duty with U.S.P.H.S.
C. Robert Baker has gone into general practice at 170,'3 Selby
Avenue, St. Paul, Minn.
David W. Bean is a medical officer in the U. S. Air Force,
stationed at Minot Air Force Base, Minot, North Dakota.
Donovan L. Beckman has entered the U. S. Navv. His home
address is 2216 Elliot Ave. S., Minneapolis 4, "Minn,
423
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THE MEDICAL BULLETIN
Roger J. Benjamin has begun a residency in surgery at Ancker
Hospital, St. Paul.
Julian L. Berman is taking a genetics-pediatrics residency at
Children's Hospital, Northwestern University, Chicago, Ill.
Ernest T. Bohland has become associated with the Palen Clinic,
a group practice in Minneapolis, Minn. His home address is
2021 26th Ave. S., Minneapolis 6, Minn.
Jon E. Boline is a Captain in the U. S. Army Medical Corps,
stationed at Schofield Barracks, Oahu, Hawaii.
Ray I. Brace is joining Dr. Carl Christenson (Med. '59) in private practice at Clinton, Minn.
Harold R. Broman, Jr., will practice general medicine in North
St. Paul, Minn., in association with Dr. A. E. Muller and
Dr. Charles J. Beck (Med. '40). His home address is 2540
E. 19th Ave., North St. Paul, Minn.
Robert Dean Bugby has begun a radiology residency at the
Minneapolis Veterans Administration Hospital. His home
address is 5308 Bloomington Ave., Minneapolis.
Tom Casey will take a general practice residency at Contra
Costa County Hospital, 2500 Alhambra Ave., Martinez,
California.
William L. Christian has joined two generalists in a group practice in Austin, Minn. His address is c/o the Medical Building, Austin.
C. Carlyle Clawson is taking a residency in pediatrics at the
University of Minnesota Hospitals.
Sheldon W. Damberg has been appointed a resident in radiology at Minneapolis Veterans Administration Hospital.
Joseph Davidson (no response).
Lawrence W. DeSanto is taking a residency in internal medicine
at the Mayo Clinic, Rochester, Minn.
Daniel L. de Ward is taking a residency in ear, nose, and throat
at the Mayo Clinic, Rochester, but may be entering military
service soon.
Robert A. Diamond has entered the U. S. Army as a medical
officer. His home address is 3949 Zenith Ave. S., Minneapolis.
Owen P. Doyle is taking a surgical residency at the Southern
Pacific General Hospital, San Francisco, Calif.
Joe Eckert is in the U. S. Air Force and is taking a residency in
radiology at Brooke General Hospital, San Antonio, Texas.
His address is 322 Artemis Ave., San Antonio.
Dale L. Eichelberger is now in the U. S. Navy, as a medical
officer with the 3rd Marine Division. His home address is
Route I, Box 208, Alexandria, Minn.
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William B. Eilers has gone into general practice in Minot, North
Dakota. His address is 1309 Fourth St. N.E., Minot.
Orland D. Eliason has begun a residency in urology at Minneapolis Veterans Administration Hospital. He expected a
draft call during the summer.
James L. Erickson has gone into private practice at 5643 Pia
Street, Honolulu 16, Hawaii.
James D. Fett (no response).
Harold Gambill is taking a residency in internal medicine at
Highland Hospital, Oakland, Calif. His address is 2701
14th Ave., Oakland 6, Calif.
James G. Garber (no response).
Wendell Geary received a staff appointment for general practice at the Berrien County Hospital, Berrien Center, Mich.,
effective September 1, 1961.
Alvan R. Gendein is a resident in psychiatry at Presbyterian
St. Luke's Hospital, Chicago, 111.
Mace G. Goldfarb will take a pediatrics residency at University
of Minnesota Hospitals. His address will be 2246 W. Seventh
St., St. Paul 16.
Gordon O. Greene has joined two other physicians in a group
practice at Arlington, Minn.
John A. Grover has begun a two-year assignment with the U. S.
Public Health Service. He is stationed at the U.S.P.H.S.
Outpatient Clinic, Cleveland, Ohio.
Elizabeth M. Haaland is married to Dr. Robert Lee Johnson,
Minneapolis, of the class of 1960.
Hovald K. Helseth, Jr. has become associated in practice with
the Adams Clinic, Chisholm, Minn.
John C. Henry (no response).
Richard T. Henry is practicing general medicine at Foley,
Minn., in association with Dr. Clifford Stiles.
Norman P. Herman (no response).
Clement N. Herred (no response).
Bruce H. Hiller has begun a residency ill psychiatry at University of Minnesota Hospitals.
C. John Hodgson accepted an appointment as a resident ill
neurology at the Mayo Foundation, Mayo Clinic, Rochester,
Minn. His home address is 1517 Durand Court, Rochester.
David Hopkins is practicing in partnership with another physician in Tacoma, Washington. His address is c/o MedicalDental Bldg., Brown's Point, Tacoma.
Vincent R. Hunt has begun the general practice of medicine at
Red Lake Falls, Minn.
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THE lIIEDICAL BULLETIN
Phil Iversiie is piacticing in association with a group of physicians in North Minneapolis. His address is 7301 Riverdale
Road, Minneapolis 12.
Clarence A. Jenike is a resident in radiology at St. Joseph's
Hospital in Denver, Colo.
Alan R. Johnson is in the U. S. Navy and in training at the
Naval School of Aviation Medicine, Pensacola, Fla. His
home address is 880 20th Ave. S.E., Minneapolis 14, Minn.
Arthur G. Johnson is in general practice with the medical staff
at Park Region Medical Center, Fergus Falls, Minn.
Robert Lee Johnson is taking a residency in internal medicine at
the Veterans Administration Hospital, Minneapolis. His address is 2609 9th St. S., Minneapolis. His wife is Dr. Elizabeth M. Haaland.
Thomas P. Johnson is taking a residency in psychiatry at the
Menninger Clinic, Topeka, Kansas. His address is c/o 1821
Independence Ave. S., Minneapolis 26, Minn.
Eugene R. Jonas has begun the general practice of medicine at
Ellsworth, Wis. As an intern at Minneapolis General Hospital, he received a citation from the City of Minneapolis
for outstanding service rendered the department of police
while on emergency ambulance runs.
Robert E. Kalina is taking a residency in ophthalmology at the
University of Oregon Medical School Hospital, Portland,
Oregon. The address is 3181 S.W. Sam Jackson Park Board,
Portland 1.
Arnold P. Kaplan has begun a residency in medicine at Mt.
Sinai Hospital, Minneapolis, Minn.
Charles E. Keenan, Jr. (no response).
John Clark Kelly is living at 783 Armstrong Ave., St. Paul 2,
Minn., while taking a radiology residency at University of
Minnesota Hospitals.
Tom Kenefick has begun a residency in neurologic surgery at
the Mavo Clinic, Rochester, Minn. His address is 1704
Second ·St. S.W., Rochester.
William N. Kinney has joined the medical staff of the Little
Falls Medical Center, Little Falls, Minn., in the general
practice of medicine.
James F. Knapp's plans were uncertain. His present address is
118 S. Van Buren Ave., Hopkins, Minn.
Robert J. Knip has begun general practice in association with
the Hedemark Clinic, Ortonville, Minn. He is the third
physician on the staff.
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Michael F. Koch is entering military service. His home address
is 611 First Street S.W., Wadena, Minnesota.
John B. LaLonde (No response)
Shirley Lansky was undecided about her next medical assignment.
John E. Larkin is taking a residency in surgery at Harvard
Medical School, Boston, Mass. His address is c/o Harvard
Surgery Service, Boston City Hospital, Boston 18, Mass.
Thaddeus J. Lelwica is in the U.S. Air Force. His home address
is 1634 Gilmore Avenue, Winona, Minn.
Michael D. Levitt is taking a residency in medicine at the
Massachusetts Memorial Hospital, Boston, Mass.
Morris L. Lommen is practicing general medicine in a threeman medical clinic in Austin, Minn. His address is 309
Fifth Ave. S.W., Austin.
Murray W. Lufkin is in the U.S. Navy and under training at the
Naval School of Aviation Medicine, Pensacola, Fla. His
home address is 330 E. Diamond Lake Road, Minneapolis,
Minn.
John D. MacArthur has begun a residency in surgery at Peter
Bent Brigham Hospital, Boston, Mass.
James Duncan MacGibbon has begun practice in Minneapolis
in association with Dr. Dean K. Rizer at the Medical Arts
Building.
Kenneth P. Manick has begun a residency in dermatologv at
University of Minnesota Hospitals. His address is 727 E.
14th Street, Minneapolis, Minn.
James E. Marquardt is spending the summer as a doctor accompanying a mountaineering expedition on Mt. McKinley,
Alaska. He has also received a fellowship in research with
the department of surgery, Los Angeles County General
Hospital. His address is 1200 N. State Street, Los Angeles
33, Calif.
John M. McKelvey has begun a residency in neurology at the
University of Minnesota Hospitals, Minneapolis, Minn.
John A. McLeod is engaged in general practice in association
with the Mesaba Clinic, Chisholm, Minnesota.
Fred E. Mecklenburg is taking a residency in obstetrics and
gynecology at University of Minnesota Hospitals.
Charles B. MerciI is practicing general medicine alone at
Mahnomen, Minn.
Robert M. Morse has entered the U.S. Air Force, and was to
receive his duty assignment on September I, 1961.
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Roger D. Morse began the general practice of medicine at LeRoy, Minn., although he anticipated being drafted soon.
Ronald A. Moss accepted a residency in pathology at Louisiana
State University Medical School, New Orleans, La.
Ronald John Nels~n is in the U.S. Air Force. His home adress
is 3508 40th Ave. S., Minneapolis 6, Minn.
Bruce C. Nydahl is taking a residency in internal medicine at
Highland-Alameda County Hospital, and his address is 1340
E. 28th Street, Oakland 6, Calif.
John A. Ochsner is taking a residency in urology at Milwaukee
County Hospital, Milwaukee, Wis. His address is 3338 W.
Highland Blvd., Milwaukee 8, Wis.
Barbara Ford Olson is taking a residency in anesthesiology at
University Hospitals, Cleveland, Ohio.
Richard E. Olson has begun a residency in internal medicine at
San Diego County Hospital, San Diego 3, Calif.
Betty J. Oseid is taking a pediatric residency at University of
Minnesota Hospitals.
Henry J. Osekowsky is in general practice at 1074 S. Robert
St., St. Paul, Minn.
Charles R. Peterson (no response).
Willard C. Peterson has begun a residency in dermatology at
University of Minnesota Hospitals.
Bernard Pollara received a postdoctoral research fellowship
from the Arthritis & Rheumatism Foundation, and is conducting research at the University of Minnesota Hospitals
while attached to the department of pediatrics.
Roger H. Princell is in the U.S. Navy. His home address is 4018
Lyndale Ave. S., Minneapolis 9, Minn.
George E. Reisdorf planned to begin general practice somewhere in rural Minnesota.
Dennis M. Robertson is in the U.S. Public Health Service,
Indian Division, and is practicing at an Indian reservation
at Winnebago, Nebraska.
Richard G. Rowe is in private practice in Littlefork, Minn., and
is doing medical missionary work among Indians in Canada.
Elliott L. Rustad has begun a residency in dermatology at
University of Minnesota Hospitals.
Jerry L. Schottler is taking a residency in surgery at Minneapolis Veterans Hospital. His address is 4916 First Ave. S.,
Minneapolis, Minn.
Peter A. Schunk (no response).
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THE MEDICAL BULLETIN
Sheldon J. Segal is a resident in surgery at Minneapolis Veterans
Administration Hospital.
Odean M. Severseike has begun general practice in association
with the Belzer Clinic, 3809 42nd Ave. S., Minneapolis,
Minnesota.
David E. Siewert is a resident in medicine at Minneapolis Veterans Administration Hospital. His home address is 313 "c"
Street N.E., Brainerd, Minn.
Paul M. Silverstein lives at 2246 W. Seventh Street, St. Paul
16, Minn., and is taking a residency in neurology at University of Minnesota Hospitals.
Warren F. Sims, Jr., is a resident in obstetrics & gynecology at
Mary Fletcher Hospital, Burlington, Vt., where he took
his internship.
Olof S. Sohlberg has joined his father, Dr. O. I. Sohlberg (Med.
'14) in general practice at .56.5 Lowry Medical Arts Bldg.,
St. Paul, Minn.
Richard E. Streu is engaged in general practice in association
with Drs. D. B. Frane (Med. '37) and E. Robert Schwartz
(Med. 36) at 1206 42nd Ave. N., Minneapolis 12, Minn.
James D. Swenson is associated with a group practice in Osage,
Iowa.
Gerald T. Telander is taking a residency in radiology at the
University of California. His address is 67.5 4,5th Ave., San
Francisco 21, Calif.
Gershom J. Thompson, Jr., is taking a residency in psychiatry
at Mayo Clinic, and his address is 1704 Second Street S.W.,
Rochester, Minn.
Ronald L. Villella is in the U.S. Army, and is a resident in
pathology at TripIer Army Hospital, Honolulu, Hawaii. His
home address is 3932 Cedar Ave., Minneapolis, Minn.
Louis A. Vontver is in the U.S. Air Force, stationed at the
Tachikawa Air Force Base, Japan. His address is c/o A.P.O.
323, San Francisco, Calif.
Darrell T. Weinman received an appointment as a resident in
orthopedics at the Mayo Clinic, Rochester, Minn.
Martin G. Weisberg (no response).
Jon D. Wempner is a U.S. Public Health Service physician at
the Indian Hospital, Gallup, New Mexico.
L. Ashley Whitesell, Jr. is in general practice in Pineville,
Louisiana, attached to the Huey P. Long Charity Hospital
in that community.
429
THE MEDICAL BULLETIN
Norman P. Wigg is in general practice as an associate of Dr.
Walter Krafft (Med. '51) at the SOllthdale Medical Building, Minneapolis, Minn. His home address is 6034 Wentworth Ave. S., Minneapolis 19.
Conrad J. Wilkowske is in the U.S. Air Force. His home address
is 1803 S. Grove Street, Owatonna, Minn.
Edward T. Wong is a resident in internal medicine at the Minneapolis Veterans Administration Hospital. His home address is 4141 Dupont Ave. S., Minneapolis 9, Minn.
Philip J. Worrell is in general practice at 3819 W. Broadway,
Robbinsdale, Minn., in association with Drs. Roger Lienke
(Med. '46), Frank B. Rice (Med. '48), and Donald D. Metz.
Thomas Jerry Wright is taking a residency in obstetrics and
gynecology at Santa Clara County Hospital, San Jose, Calif.
His address is 929 Princess Anne Drive, San Jose 2.5, Calif,
MEDICAL FOUNDAnON GIVES
CANCER RESEARCH GRANT
The Minnesota Medical Foundation has granted $.'500.00 in
cancer research funds to Dr. B. J. Kennedy, associate professor
of medicine at the University of Minnesota
Medical School.
The grant is the third made for medical
research since the Foundation was reOl'ganized in 1959, and is provided from gifts
made in memorv of the late Mrs. Leona
Mutch, Minneap·olis. Dr. Kennedy will use
the grant to help finance cancer chemotherapy and metabolic studies in ambulatory
patients in the V.F.W. Cancer Research
Center at the University Hospitals. He said
the Foundation grant will provide vital inB. J. KENNEDY
terim support for his project until U.S.
Public Health Service research funds become available.
The Foundation generally grants funds for medical research
at times and in situations where primary sources of funds are
unavailable.
Previous medical research grants made by the Foundation
went to Dr. F. C. Goetz and Dr. Donald Duncan for studies
related to developing substitutes for insulin in the treatment of
diabetes.
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THE MEDICAL BULLETIN
ALUMNI DEATHS
•
1905
Dr. John F. Hendrickson of Minneapolis died May 7, 1961.
He was 89 vears old and a member of the American Medical
Association fwd a life member of the Hennepin County Medical
Societv.
• 1913
Dr. Charles Clifford Hawke of Winfield, Kans., died January 13, 1961 of coronary thrombosis. He was a fellow of the
American College of Surgeons, a veteran of World War I, and
former city commissioner and mayor of Winfield. Dr. Hawke
was 75 years old, and was on the staffs of St. Mary's and
William Newton Memorial hospitals.
1926
Dr. Mark H. Wall, Mesa, Arizona, died in Januarv 1961 at
the age of 62 years. He was a native of Eau Claire, ·Wis., and
practiced many years in the Superior area before moving to
Arizona. Dr. Wall was organizer and first president of the
Arizona Amateur Athletic association, and was a member of the
Maricopa (Arizona) County Medical Society.
•
•
1931
Dr. Max E. Pickworth, San Jose, Calif., died Februarv 14,
1961 of acute coronary thrombosis at the age of 54. He was
born in Saskatoon, Canada. He was a specialist certified by the
American Board of Surgery and a fellow of the American College of Surgeons. Dr. Pickworth served during World War II,
and was a member of the staff of the San Jose Hospital and the
O'Connor Hospital.
•
1938
Dr. Robert A. Maves died Januarv 31, 1961, in Seattle,
Washington, where he was in general practice. He was 46 years
old. Dr. Maves was a veteran of World War II, and member of
the American Academv of General Practice and American Medical Association. He spent his internship at Minneapolis General
Hospital.
•
1951
Dr. John Rosiak, Jr., of Minneapolis, died January 12, 1961
at the age of 40 years. Death was caused by a myocardial infarction. Dr. Kosiak interned at the Charles S. Silson Memorial Hospital in Johnson City, N.Y., and was practicing in Minneapolis.
He was on the medical staff of St. Mary's Hospital.
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• 1954
Dr. Kathleen H. Decker died in Los Angeles, Calif. January
9, 1961, of injuries received in an automobile accident. She was
32 years old and a member of the American Medical Association. Dr. Decker had interned at Los Angeles County Hospital,
and was later a resident physician and medical staff member
there. She was recently associated with the Long Beach Memorial Hospital.
Memorial Gifts
Memorial gifts to the Minnesota Medical Foundation
have been received recently in memory of:
Mr. James Gardner Rainey
Milwaukee, Wis.
Baby Marion Lee
Minneapolis, Minn.
Mr. Cedric Adams
Hopkins, Minnesota
Mr. Frederick M. Atkinson
Deephaven, Minnesota
Mr. Ward Lucas
Winona, Minnesota
Mr. James Ford Bell
Minneapolis, Minnesota
Mrs. Louise Heffelfinger Bell
Minneapolis, Minnesota
Memorial contributions are a practical means of honoring the memory of a friend or loved one, while helping the
Minnesota Medical Foundation in the advancement of
medical education and research. Appropriate acknowledgements are promptly sent to both donor and family of the
deceased.
This is the concluding issue of Volume 32 of the Universitv of Minnesota MEDICAL BULLETIN, which
has l;een published monthly in nine issues during the
1960-61 academic year. Publication of Volume 33 will
begin in Octoher, 1961.
432
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COIning Events
University of Minnesota Medical School
Continuation Medical Education Courses for Physicians
University of Minnesota
Center for Continuation Study
September 18-21
October 2-4 .
October 19-21
November 6-10
November 15-17 .
r
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November 16-18 .
January 2-6
January 25-27
Februarv 12-17
March 5-7
March 16-17
April 12-14
April 16-18
April 3D-May 2
Mav 7-9
Mav 10-12
Mav 14-18
May 31-June 2
1961
Pediatrics for Pediatricians
Obstetrics for Specialists
Dermatology for General Physicians
Radiology for Radiologists
(U rologic Radiology)
Ophthalmology (Refraction) for General
Physicians
Orthopedics for Orthopedic Surgeons
and General Physicians (Hand Surgery)
1962
Intermediate Electrocardiography for
General Physicians and Specialists
Otolaryngology for Specialists
Pediatric Neurology
Anesthesia for General Physicians
Treatment of Traumatic Injuries
Otolaryngology for General Physicians
Internal Medicine for Internists
Gynecology for General Physicians
Ophthalmology for Specialists
Surgery for Surgeons
Proctology for General Physicians
Psychiatry for General Physicians
The University of Minnesota reserves the right to change this schedule
without notification.
Courses are held at the Center for Continuation Study or the Mayo
Memorial Auditorium on the campus of the University of Minnesota.
Usual tuition fees are $30 for a two-day course, $50 for a three-day
course, and $75 for a one-week course. These are subject to change
under certain circumstances.
Specific announcements are sent out for each course to all members
of the Minnesota State Medical Association and to any physicians
who request information for a specific course, about six weeks to two
months before the date of the course. For further information write to:
DIRECTOR
DEPT. OF CONTINUATION MEDICAL EDUCATION
1342
MAYO MEMORIAL
UNIVERSITY OF MINNESOTA
MINNEAPOLIS
14,
MINNESOTA
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A Word About
Memorial Gifts
The Minnesota Medical Foundation welcomes
your memorial contributions when an appropriate
occasion arises. Memorial gifts serve the living
and pay thoughtful tribute to the memory of a
friend or relative.
The Foundation will promptly acknowledge
your gifts to both the donor and the family of
the deceased. The gift will help finance the
Foundation's program for the advancement of
medical education and research. The Medical
School at the University of Minnesota will be
the direct beneficiary. .
Gifts should be sent to the Minnesota Medical
Foundation, 1342 Mayo Memorial, University of
Minnesota, Minneapolis 14, Minn.
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