Program Review of the Medical Division of Oak Ridge Associated Universities, and Orau Review

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The following consid ez at ions have led to a proposal to change the s tru - cture of the program in the Medical Division of OiUU. 1. Oak Ridge does not have an appropriate demographic base with tert lr ry hoe pital facilities and a range of active programs in clinical invest i - The present c lh ical facilities of the Medical Division do not meet the et and z c ‘ s necessary for accreditation. On the basis of program evaluation and institutional environment,it was re corn ended that clinical investigation should not be continued at Olt w Ned ical Division. 2., The nucl ea rr medicine program and parts of the clinical oncology program could be incorporated into the East Tennessee Cancer Center8 : the University Meso rial Hospital ia Knoxvilie. This could strengthen the develop men c of the Cancer Center 2nd pro * JiCe che necessary environment for He d ical Division programs. at ruc ture. These programs would be nore effective in association with the CXtX

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4 . The Medical DFviSiOn o f ORAU has been effective in conducting educational programs for physicians in management of radiation accidents and in assess rnc nt of radi aci on damage inman. Thcsc programs should be con c in u ed and perhaps as so cfs ced with the capability co dc velo p regional plans for the contingency of industrial exposure and a cci den cal release of r3dioac : ivicy. Exploration of thc feasibility and k np llc a cio o of the sc propositions e hould be started in negotiations with re pre sen cac ives of che concerned 1. The cost of providing adequate space and facilities in the Cancer 2.The attitudes of the staff nt ORAU and Knoxville concern in s the am alga nation. 3.The coat and extent of new facilities in the Oak Ridge Hospital that woul6 sen ? as de non st racion and ln s cr ucc ional areas for 4.The impact of the proposed changes on othct components of the 0lU.U 5.The need to satis factor il ye relocate personnel in the ORAU Medical The ability of ORAU t o mount abroad program in the sociology, epidemiology and contingency planning related to accidental exposure of human populations to radioactivity. Division of Bio medics l and En vfr on nc n cal Research

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ATOMIC ENERGY COMMISSION For several years there ha3 been growing concern over institutional and program a tic problems of the He d ical Division of ORAU. The discussion of these problems which follows is based upon che com n ents of reviewers A . The In sti cut ional S ct tine. licensing and accreditation guidelines 2nd replace nene is ooughc b y 3RUJ through new construction in a wing of the The I led fc al Df vision conducts an invest iga cl ve program in an ure u of rel a civ ely Lou population,in the a bse ncc of a tertiary hospital program adequate for the provision of specialized patient populations and services,and essen cia l Ly i aol a ted from the cri clc al climate of academic cLinical Fn vest iga ci on. The l & oratories in che main building vary from adequate to marginal an date housed in a structure originally designed ' for other purposes and a short lifetime. The marmoset bull ding contains good,per x an enc laboratories and the bio che mfs try building is considered eo be sound and provides good laboratory facilities. Tine separation of these facilities makes effective F nter a cci on of professional personnel and the syne r gf stic development of program v irc u ally impossible. excc ? t for the rnarsosc: building all are considered to he at rik fn gly in a de qua ccw ich respect co construction,pro vrs ion a on it nci on.The animal care prog rms suffer from lack of prof csr fon al supervision.

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me several programs in the Ned ica i Division vary widely in quality. 1. Clinical Il cma colo cv. The reviewers gave this pro gra3anunf3Vor - b. The marrow transplantation program came under severe cr icrc is a. In vieu ot accepted che rape uci c modalities,ethical ques cions were raised with te spec c co che proc oc olsen ploy ed in these studies. The leadership of c his program is ncc defined ; the coordination with i mun ology Is ineffective.Then cn ber oi patients z c ces sib le to the study is snnll and argues astin st n, Bad fo pharmaceutical program. IC was re cog nf zed c hz t Dr. Fitves had de non st rated a high degree of capability and ach : ev caen t. u est ions were raised about the scope and directions of the 91, project,the a bse ncc ‘ of physical ch crni cal data on Call in ccs plex es, and a discernible tendency for che prog rm to dr if c OEUlL is an asset to the proo,r ’ ; ~ p ,b uc in order to be effect r ve, a sign ff i canc nuclear me dlc in e clinical. € aci lit yata Ltr ge Buffers by its present isola ci on. .vith out defined goals. The isotope production facility at b: Clinical program. The number of nuclear medicine procedures cornpctencc and the dcd ica cio nuh ich he hasbro us ht to the program.There ver c questions about the design and ev3Lua cFc n of the GaLlFun cooper at iv c scud y which limr: the value of chc 3.hu no lo q y. The reviewers gave c his pro gra top racing. Dr. Cc ngozi an was re cog niz cd as a product iv c,in nova civ cuor kcr

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coos ld t ted to be of high prior ft y and product iv c of sign if ic3nc achieve nen t. IC was felt that he was intellectually,as .-le11 rev1rJ ers raised the question of uh c the t Dr. Snyder mr ghc not have Co reproductive interactions in another laboratory sec z r ng. an nr rang c ment vh ich re vieu ers consid crc d to be Fn3p prop rr2te vas brought in,and since then there have been eff orcs co interface the computers. This system is not good computer ecf cn ce. An effort to use v irc u al memory concepts with the d ioc through che IEM-1800 and the change of the s ys cem from the sharing to mult f - programming 3re laudable eff orcs,but not essential to any s cf ent iii c pros rama c ORXU. Interface at tm pcs to the Ohio Nuclear Scanner and che ganma c mer aue re questioned because the investigators lack sound notions as to vhat is CJ be done with che cn coded dac a.Ideas of image enhancement and quan c lt ation were nor: well thought through. O th cr critical comments of there vie cer s re laced to the in - ap prop rfa cc ness of a patient in for nation dac a system fort mall clf nfc al service of eight patients per day, and tothe rand- and un pro duc rive interaction of the s caff of the computer c cnt cr uic hoc her in ve sci gac or s.ICua5observed that the use .of coa puce r service for che biostatistics associa ced with the Call iu a scud y and Gcher data analysis programs is appr opr iz cc, but coy ld be Frnplencntcd with or uic nc ucc he present co c puce,r dc ros copts tW L th cons r der able experience and achi ev c ment, rc cef ve dsc rong supp or ciro nrc vieu ers for his u or kon the biophysics and ultra structural aspects of Gallium localization opec cro s copy and ttan sais si one lec cr on microscopy in any th lng Dr. Nelson,a path o logi ! ~ tu ho docs chc routine u or k of the vcr e cnut io us in vic = if ngS is cn try in ta a de landing 3nd com?cc::Lve

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prop a concerning the distribution and kinetics of U ol n lng, and scientific achieve7c nc might advise a coll abc rac r ve effort or scn e opportunity for s upc rvis lon. Although an enthusiastic and c ~ rcful 7. Rod lac ion Accidents : Human Radiation Exo o sure. The brozd c xp erie ncc of Dr. Lushbaugh and his achieve nen c in published c38essrnent o f human radi aci on expos urc ue-e considered by rev feu cz s co have gre ac value.Although a large part oi his research effort is funded by NASA,itv as considered to be effectively supportive of AEC missions and vel1 done. It was report cd by reviewers th ac the computer services have noc provided adequate consultative treatment on statistical problems. Dt. Lush bau sh ' s new findings on coloni c cancer in ones c rain of chc nat nose tue reconsidered by reviewers to be a significant dia cove ty worthy of subs canci al support. he.Andrews and Lushbaugh have been an eff ecr iv c tern in dealing with problems of radi acf on accidents. Micro b fol oz v. vF th respect co this prog rm.The rou cine micro bio lc gy of the clinical services is handled by con pec enc technicians and appeared to be of high quality. a resulc, some of the crucial studies of patient suit ht at21 body irradiation have neither been followed up nor initiated. a de qu awl y planned,iso lot zd from consultation u ich L-TunoLogists and molecular biologists,and not coord in aced with che principal responsibilities of the microbiology pro z rm. The corn ents of re vie vets were generally unE cv or abLe Cyto cene tics. Dr. Littlefield u as appointed to work with Dr. Coh on a project Supported by NE.I dc j ling with cyto genetic effects of oral cont race pc ives in women. When Dr. Goh lef cOU U, Dr. Li c tle ii el d bec me principal investigator and succeeded to rcs pons rbi l icy Lna sid c red by the rc v Leu ez s to be ace ch nic ally con pec cnt cy c - ~u 3enct ~ c1 s c who had pcr for ncd creditably, but u ho had noc yet natured scienc iL : - that much o f Dr. Li c tle li cl d ' s effort was spc nc in unplanned and