The Activities of the Administrative Office

Page 1

THE ACTIVITIES OF THE AIXEKCSTRATIVE OFFICE I n the spring of 1955 the Medical Division directed a major effort toward preparations f o r the Geneva Conference on the Peaceful Uses of Atomic for review and possible acceptance for oral presentation atthe conference. Four of the papers were accepted f o r publication and each paper was then retyped for direct reproduction. equipment for exhibits added appreciably t o the ad n in is tr at ive effort. Upon an invitation from the United Nations, eight papers were presented The design, fabrication, and purchase of During the year the Division received a total of 376 visitors. these were a t the hospital for more than one day and the estimated visitor day averaged approximately 2 per work day. were from foreign countries. foreign visitors worked a t the Medical Division facilities for an accumulated total of 225 man weeks. physicians, and the remaining seven obtained t h e i r support from other sources. Approximately 87 of the visitors In addition t o these casual visitors, 11 other Four of t h i s number were employed as resident During June, July, and August ten visiting scientists availed themselves of the Medical Division's research facilities. were' Research Participants assigned to this division by the University Relations Division of the Institute. provide laboratory facilities, equipment, materials, and supplies. The majority of these people The Medical Division paid no salaries but did During this calendar year the Division has been i n a construction facilities, which contain rooms for6 hospital beds, 4 offices, a patient recreation room, a cobalt 60 teletherapy room, and a medical physics room. capital projects budget was so limited that it was necessary t o use operating funds t o complete these facilities. budgetary problems i n FY-55 and FY-56. During the summer and f a l l plaris were developed for a clinical training building of approximately 2,200 square feet. This building will contain special equipment and facilities for the training of visiting medical personnel. construction bids i n late December; every effort will be made t o complete and equip this unit in time for the third week of the advanced medical course. The year saw the completion of the clinical research and out-patient This procedure created a number of The plans and specifications were announced f o r During the year the research program required the use of 25 radioisotopes or a total of 12.2 curies of radioactive materials. required 1.5 curies and the balance of radioisotopes were used i n basic research and inpatient care and treatment programs. The teletherapy program During the year 81 patients were admitted t o the research hospital and 153 former patients were readmitted. 12.5. The first admission patients came from 12 s t a t e s as follows: The average daily patient census was

Page 2

The volume of records on patients has grown t o such an extent that file references and cross-indexing methods had t o be examined and a new system records section during the first p a r t of 1956. This new system will require a major effort of the medical The Medical Division staff remained a t about the same level as for 1954. The total employees averaged 67 for the year and this represented an average of 61 regular employees; 3 residents, and postresidents in radiology; one part-time employee; and ttro temporary employees. year an extensive recruitment program w a s necessary t o replace Dr. Ralph Kniseley, Pathologist, who resigned t o accept another position. effort was made t o employ a clinician to fill the position left vacant when Dr. Malcolm '&or resigned i n June 1954 to enter private practice. I n the fall of this During the year there was an average of 88 purchases per month f o r equipment material and supplies. an average of 79 issues per month from the ORINS warehouse. of 125 shop orders f o r technical services. I n addition t o these purchases there was There was a total During the f i s c a l gear ending June 30 of this year the Division spent more than the authorized budget ceiling. FY-56 has a fixed ceiling. more than the budgeted expenditure f o r the 5 month's FeriOd. The overexpenditure resulted from expenses connected with the Geneva Conference and extraordinary expenses from the Technical Services Department i n completing the clinical research and out-patient facilities. In order t o recover this overexpenditure, it will. be necessary t o maintain a lower than usual average mOnthly cost ceiling for the remaining seven months of this fiscal year. !be authorized operating budget f o r A t the end of November the Mvision had spent And administrative reorganization plan for the Division was presented a t the fall meeting of the Board of Directors. relieve the division chairman of many routine administrative details and t o redefine the areas of responsibilities. Clinical Services; Chief of Iaboratory Research; Chief of Biomedical Research; and Chief of Medical Physics. and the detailed chart i s now i n preparation. This plan was designed t o This plan provides fora Chief of The general organization chart has been completed

Page 3

I N TIIE USE OF ISOTOPES I N MXDICINE The Proceedings of the second advanced course i n the use of isotopes i n medicine is at the Government Printing Office i n the final stages of publication. The title is "Radioisotopes i n Medicine", and the editors are Gould A. Andrews, Marshall Brucer, and Elizabeth B. Anderson. Forty-two speakers have The other three chapters are the three evening The discussions of the talks have been grouped into 18 discussion The 804 two-column, 8" x 10" pages are illustrated with 569 line drawings I n addition t o the lists of references a$ the ends of chapters,and half tones. a general bibliography arranged in what we believe t o be workable categories has been included. From abcesses t o zinc 65 the book has been indexed i n I n order t o keey the price from being completely beyond the reach,of most isotope users, w e have consented toa paper back. construction, however, and may be bound i n hard covers i f the ownder wishes t o send it t o a bindery. publication i s complete. It will be available from the Superintendent of It i s of sturdy Announcements will be rcade when the price is set and

Page 4

LIST OF PUBKCATIONS OF THE MEDICAL DIVISION Effect of Compounds Related t o 4-(p-Dimethylaminostyryl) quinoline Methiodide on Wphorna 8. Cancer R e s e a - 5 9 2 , October 1955. Brucer, Marshall, Eldridge, James I and Trombka, Jack Thyroid Radioiodine Uptake Calibration. Peaceful Uses of Atomic Energy. International Conference on the Radioisotopes i n Animal Physiology and Nutrition - Mineral Metabolism. International Conference on the Peaceful Uses of Atomic Energy. Therapeutic Usefulness of Radioactive Colloids: Gold 198, Chromic Phos@a$e ( P 32), Yttrium 90, and Lutecium 177. Comparative Value of Harris, Norman 0. and Hayes, R. L. A Tracer Study of the Effect of Acute and Chronic Exposure t o Sodium Fluoride on the Thyroid Iodine Metabolism of Rats. Research 34, 470-477, August 1955. Journal of Dental Some Integral Dose Relationship in Co 60 Teletherapy. Radiation Research 3, October 1955. Abstract 64. Special Report of the Medical Division on Teletherapy Design Problems. Office of Technical Services, Department of Commerce, Washington 25, Brucer, Marshall, Kerman, Herbert D., and Richardson, Jasper E. Teletherapy Design Problems 11. Cobalt 60 Teletherapy Unit. ORO-109. 1953. For sale by the Superintendent of Documents, United States Government Printing Office, Washington 25, D. C. Price: 35 cents.

Page 5

Brucer, Marshall and many others Teletherapy Design Problems 111, with supplement: States Government Printing Office, Washington 25, D. C. Price: 50 cents and 35 cents. Second printing. Proceedings of the ORO-127 and ORO-127---For sale by the Sqerintendent of Documents, United Teletherapy Design Problems IV. curie lleletherapy Machine. ORINS-10, March 15, 1955. Available from t h e Office of Technical Services, Department of Commerce, Washington 25, Isodose Charts f o r the Co 60 Hecto-

Page 6

Previously reported studies on the destruction of the thyroid gland with I 131 are being continued. on patients with multiple myeloma who are given large doses of I 131 and whose thyroid glads showed varying degrees of radiation damage. A series of new histologic specimens is available The long range study of thyroid carcinoma continues, with increased use of the scintiscanner and improved external counting methods i n an effort to understand more clearly the behavior and distribution of radioiodine, specimens and autoradiograms showing the distribution of the isotope in the lesions a r e obtained wherever possible, i n children showing a peculiar clear cell transformation after removal of the norm1 thyroid have been carefully studied and a report on them isin preparation. Two unusual cases of thyroid carcinoma Selected patients with hyperthyroidism and with heart disease are being treated with radioiodine. plasma at daily intervals for periods o f 10 days after each tracer and therapeutherapeutic dose will produce a significant abnormal release of protein-bound iodine material and, if so, whether the quantity of this material released into the blood stream can be used as an index of the effectiveness o f the therapeutic Several types of special studies have been done on One of these is t o follow the protein-bound radioiodine i n the This i s being done i n an effort to determine whether o r not the A series of patients having received radioiodine were studied for the salivary iodine excretion over a period of many days after each dose; this program was chiefly carried by Dr. Zeth Gabrielsen, a visiting resident from Norway. The concentration of the isotope in the saliva was compared with the free and protein-bound isotope i n the plasma. for publication, indicate that the concentration of the isotope inthe saliva derives entirely from the unbound form in the plasm, No evidence has been produced t o support the theory that the saliva ries play an important role in breaki n g down iodine-containing organic compounds. A l l of the data, *ich are being prepared The effort to treat multiple myeloma with large doses of radioiodine has i n general been unsuccessful. been seen but has not been considered t o be of sufficient degree o r duration t o justify recommendation of this form of treatment. several patients with radioassays and autoradiograms has failed to indicate any tendency for the myeloma lesions ta concentrate the radioiodine, that any benefit obtained is a result of the rather generalized radiation produced Slight temporary improvement i n some patients has Detailed autopsy studies on ' Special external counting studies (see section on Medical Physics) on the thyroid with t h e scintiscanner and with various uptake measuring devices have * Present address: Department of Pathology, Eden Hospital, Castro Valley,

Page 7

mation and a small crystal has proved t o be of distinct value i n studying certain types of isotope distribution pattern. has been i n evaluating the location of areas o f functioning tissue in the neck of patients with thyroid carcinoma. to differentiate between residual normal and areas o f carcinoma. We have been unable t o confirm, however, the reports of success i n delineating small hyper- and hypofunctioning lesions inthe thyroid gland. It appears t o us that the old type of scintiscanner is considerably less discriminating than it has been reported t o from normal tissue but not detected by the scintiscanner. success i n delineating the criteria for evaluation of scintiscan records, and des crib ix the cause of artifacts. isotopes other than radioiodine The old type of scintiscanner with a simple cylindrical colli - I’erhaos its greatest single usefulness The scintiscanner has freauently made it possible We have seen examples of adenomas showing distinct differences in function There has been some The instrument kis been found useful in many C. C. Harris has been given limited trial and shows great promise, tues area high degree of sensitivity,relative freedom from inverse square law effect, and fine discrimination, Another instrument developed largely by P. R. Eell and the group working This has been found t o bewith him isa probe counter for surgical procedures. of distinct value chiefly with radioiodine. ROSE EDJGAL TAGGED ~ I T HI 131 Work has begun, and is continuing, on the evaluation of Rose Bengal tagged with I 131 as a liver function test. Warren mser and other members of the staff. into two parallel an5 simultaneous determinations. This program i s being carried out by Dr. The experiment has been divided 1. The first part of t h e work has involved ( a ) injecting Rose Bengal I 131 intravenously into selected patients admitted t o the clinical service. The surface of the l i v e r has then been surveyed with the medical spectrometer and a permanent record has been obtained on a Brown o r Esterline-Angus recorder, (b) The data obtained are correlated with the liver chemistries and the clinical cond it ion of the patient a t the time of testing. The second part of the work involved injecting Rose Bengal I 131 i n t o adult rats and sacrificing them a t appropriate intervals. assayed forI 131 activity and gross and microscopic autoradiograms are made. Other tissues such as the gastrointestinal tract and spleen are also assayed. The livers are then At this time it i s too early t o attempt tom kea direct correlation between the curves obtained on liver survey and the various diseases of the liver. There are, however, definite indications that the shape of the curve (time necessary t o reach maximum activity, the absolxte height of the curve, the plateau and slope of the excretion portion) is altered by both intrinsic and extrinsic hepatic . The technique for microscopic autoradiography of the liver is still to be locate inthe hepatic cells and is not corcentrated i n the Kupfer cells. careful resolution is necessary before a final evaluation can be made. However, preliminary data suggest t h a t the radioactivity does diffusely

Page 8

BONE-SEEhTIIJG ISOTOPES AND OSTEOGENIC SARCOMA A study of osteogenic sarcoma has been continued and a considerable number of patients have been followed throughout the course of the disease. gallium has not been continued during the last six months butP 32 and other isotopes have been given for the purpose of the study of their distribution i n D r , George Minor of the University of Virginia f o r removal of pulmonary metastases although this appears t o be a rather discouraging therapeutic approach. of the multiplicity of metastases i n most cases, several patients have shown evidence of significant palliation and further study of the operation appears worth while. One of t h e unusual findings in t h i …