Attachment 7 April 19, 1956 Franz K. Bauer, M.D. Chief, Radioisotope Service Veterans Administration Center Wilshire and Sawtelle Boulevards Los Angeles 25, California Dear Franz: I have read with great interest your Annual Progress Report of the Veteran Administration's Radioisotope Unit. It is admirably done and reflects the gratifying achievement which the program has made under your direction. My delay in acknowledging receipt of the report resulted from forwarding it to others who are connected with the program, and who were somewhat reluctant to return it. May I take this opportunity to congratulate you on a splendid job. With best wishes, I am Cordially, Stafford L. Warren, M.D. Dean SLW:jl VETERANS ADMINISTRATION CENTER WILSHIRE AND SAWTELLE BOULEVARD LOS ANGELES, 25, CALIFORNIA JANUARY 31, 1956 YOUR FILE REFERENCE: IN REPLY REFER TO: Stafford Warren, M.D. Dean, Medical School University of California Medical Center Los Angeles 24, California Dear Dr. Warren: Enclosed herewith is our Annual Report for 1955. I should like to take this opportunity to thank you again for your help and support in our program. Respectfully yours, Franz K. Bauer, M.D. Chief, Radioisotope Service Enc: (1) ANNUAL PROGRESS REPORT RADIOISOTOPE SERVICE VAC, Los Angeles January 1 thru December 31, 1955 Franz K. Bauer, M.D., Chief 1. PHYSICAL FACILITIES There have been no changes in the physical facilities of the Radioisotope Service during the year. 2. PERSONNEL The following changes in personnel occurred in 1955: Mr. Butler Sanchez resigned to accept a position with Abbott Radiopharmaceutical. Miss Virginia Horkan transferred to Supply and was replaced by Mrs. Elda Tomlinson, who transferred from Sepulveda VAH. Mrs. Geraldine Schick resigned to accept a position with UCLA and was replaced by Mr. Darwin Trotter. A roster is appended. 2.1.1 Deans Committee Stafford L. Warren, M.D., Radiologist, Chairman Dean, UCLA Medical School & Professor of Biophysics John S. Lawrence, M.D., Internist Professor of Medicine, UCLA and Senior Consultant in Medicine, VAH William H. Leaker, M.D., Internist Senior Consultant in Medicine, VAH 2.1.2 Hospital Radioisotope Committee Roger O. Egeberg, M.D., Internist Chief, Professional Services, Chairman Charles F. Bayer, M.D. Internist Center Medical Director John D. Brigs, Surgeon Chief, Surgical Service 1 (Hospital Radioisotope Committee - Contd.) Samuel H. Basset, M.D., Internist Assist Director, Professional Services for Research William A. Gore, M.D., Radiologist Chief, X-Ray Therapy Section Leo Kaolin, M.D., Pathologist Chief, Pathology Service Raymond L. Libby, PhD., Radiobiologist Associate Professor of Radiology, UCLA & Consultant to the Radioisotope Service Franz K. Bauer, M.D., Internist Chief, Radioisotope Service, Secretary 3. CLINICAL ACTIVITIES 3.1 Training 3.1.1. The training program in the clinical uses of radioisotopes is being continued. Two residents on the Medical Service and one resident in Radiology are assigned to the Radioisotope Service on a rotation basis. The medical residents spend 2 months full time on an elective basis and the radiology resident spend 3 months in order to qualify for the American Board of Radiology. 3.2 Diagnosis 3.2.1. Two new procedures have been introduced as routine clinical tests: The radioactive Rose Bengal liver function test as perfected by Taplin et al., and radioactive chromium red cell survival study. 2. (Diagnosis - con't) Diagnostic procedure during 1955: # Patients # Doses Thyroid uptakes (I131) 615 712 Thyroid scintigrams (I131) 130 137 Brian surveys (RI5A) 132 135 Myeloscintigrams (RI5A) 10 10 Liver surveys (RISA) 15 15 Blood Volumes (RISA) 63 68 Skin tumors (p32) 7 11 Eye tumors (p32) 3 3 Bone (aseptic necrosis)(p32) 4 4 Liver function test (Rose Bengal) 27 27 Red cell survival (Cr51) 51 12 3.3 Therapy 3.3.1 # Patients # Doses Hyperthyroidism (I131) 35 41 Carcinoma of thyroid (I131) 5 8 Carcinoma of prostate 24 24 (chromic phosphate) Polycythemia (p32) 2 9 Intractable angina (I131) 2 3 Chronic leukemia (p32) 2 2 Intracavitary (chromic 4 4 phosphate)(pleural effusion) 3 RESEARCH 4.1.1. Muscular disorders: Under a grant from the Muscular Dystrophy Associations of America, Inc., studies of muscular disorders are being continued. Aminoaciduria has been found in patients with muscular dystrophy and myoedema dystrophic, as well as in healthy female siblings of these patients. The work has been done by technicians on the payroll of UCLA. A paper on the subject is to appear in the Prod. Sec. Exptl. Biol. & Med. (Incomplete) 4.1.2 Rubidium86, potassium42 and sodium22 are being used to determine exchangeable sodium and potassium in electrolyte disorders and muscular disorders. (Incomplete) 4.1.3. Peripheral clearance of radioisotopes in patients with heart disease is being studied by means of the Hypospray. A method of cardiac output determination is being perfected. This method is based on the one described by Huff, employing radioiodinated human serum albumin and direct counting over the heart. This project is supported by a grant from the Los Angeles County Heart Association. (Incomplete) 4.1.4. Localization of antigen, tobacco mosaic virus (TMV) in mouse liver after intravenous injections has been studied both with labeled TMV (p32) and electron microscopy. Uptake by mitochondria has been demonstrated with labeled antigen and confirmed by electron microscopy of isolated fractions. Localization 4 has been demonstrated in thin-sections only in the phagocytic cells of the blood capillaries and sinusoids. Our conclusions from these studies are that both the mitochondria and nuclei of hepatic cells take up either antigen or gradation product thereof after intravenous injection. A paper on this work is nearing completion for submission to the J. Immunology. (Complete) 4.1.5 The morphology of phages for the genes Myocardia have been studied by electron microscopy. All three pages studied (two for host N. globerula and one for N. asteroided are sperm shaped with round heads, and appear to be slightly larger than the largest of the collphages, T5. A paper is being prepared for publication. (Complete) 4.1.6 Electron microscope studies on pathological human skin proceeded at a decelerated pace this year but will be subjected to a greater effort in the coming year. Electron microscopy of human skeletal muscle was initiated with the aim of providing any and we can to the muscular dystrophy program. This study is just beginning with some testing of different fixatives (osmic acid, osmic plus phosphotungstic) and the pH of fixation (5,7, and 9) for optimum conditions. There appears to be little difference in fixation by osmic acid at pH 5,7, or 9. (Incomplete) 5 4.1.7 The distribution of I131 in thyroidectomized animals is being studied since greater concentrates of I131 were found over the spleen in athyrectic humans. (Incomplete) 4.1.8 The absorption and turnover of radioiodine labeled fat and fatty acids is being studies in patients with different types of diabetes mellitus. Oleic acid was labeled in this laboratory and labeled triolein was obtained from Abbott Laboratories. 4.1.9 The following projects are being carried on by research personnel from the University of California with the cooperation of the Radioisotope Service: a. Evaluation of Radioactive Urekon I131 Kidney Uptake Excretion Test in Patients with Urological and Medical Renal Disorders.(George V. Taplin, M.C.) b. Portable Renal X-ray Unit, Using Radioactive Thulium (Tm170). (D.E. Burke, M.D.) c. The Distribution of Fe59 Tagged Erythrocytes in Centrifuged Blood as a Function of Their Age.(E. Raymond Borun, M.D.) d. Study of the Incorporation of C14 labeled Glycine into the Precursors of Uric Acid in Patients Who Have Been Treated with Azaserine. (Melvin H. Levin, M.D.) e. Study of the Rate of Maturation, Site of Release and Turnover Rates of White Blood Cells in Human Subjects With Disorders of the Myelopoietic System. (Seymour, M.D.) f. Use of Radioiron Fe59 and Radiochromium Cr51 in Patients with Various Blood Disorders with Particular Emphasis on Hemolytic States. (Irwin M. Weinstein, M.D.) 6 PROFESSIONAL & SCIENTIFIC REPORTS 5.1 Publications (listed chronologically) Electron Microscopic Study of Normal Skin Collagen and Elastic Fiberst I.H.Linden, E. Laden, J.O. Erickson and D. Armen, J. Investigative Derm., 24: 83-88, February 1955 Study of Normal Skin with the Electron Microscope: E.L. Laden, I.H. Linden and J.O. Erickson, AMA Arch. Derm., 71: 219-223, February 1955. Turnover Rate of Serum Albumin in the Nephrotic Syndrome as Determined by I131 Labeled Albumin: W.H. Bland, M. Fields, and R. Goldman, Clin, Research Proc., 3: 64, February, 1955. Radioactive Chromic Phosphate in the Treatment of Urological Tumors: E.V. Moore, R.L. Libby and W.E. Goodwin, J. Urology, 73: 410-416, February, 1955 Radioisotope Studies in Neuromuscular Disease. 2 Studies in Muscular Dystrophy and Myotonia Dystrophic with Sodium22 and Potassium42: W.H. Bland, F.K. Bauer, R.L. Libby and S.D. Rose, Neurology, 5: 201-207, March, 1955 Radioactive Phosphorus in the Diagnosis of Skin Tumors. Differentiation of Nevi, Malignant Melanomas, and other Skin Tumors: F.K. Bauer and C.G. Steffen, J.A.M.A., 158: 563-565, June 18, 1955 Clearance of Radioactive Iodine from the Extremities in Patients with Myocardial Infarctions: F.K. Bauer, F.R. Mugler, V.W. Lieberman and J.P. Westergart, Am. J. Med., 19: 295-296, August, 1955, and Circulation, 12: 677-678, October, 1955. (Abstracts) Possibilities and Limitations of in vivo External Counting Techniques in Biology and Medicine: B. Cassen and F.K. Bauer, International Conference for the Peaceful Uses of Atomic Energy, Geneva, Switzerland, August, 1955. Accumulation of Homologous Radioiodinated Albumin in Experimental Tumors: F.K. Bauer, M. Tubia and H.B. Thomas, Proc. Soc. Exptl. Biol. & Med., 90: 140-142, October, 1955 Turnover Rate of Serum Albumin in the Nephrotic Syndrome as Determined by I131 Labeled Albumin: W.H. Bland, M. Fields, and R. Goldman, J. Lab. & Clin. Med., 46: 747-756, November, 1955 7 (Publications - cont'd) Serum I131 Fractionation In Metastatic Carcinoma of the Thyroid. The fate of endogenous radiothyroxine after I131 therapy: M. Tubis and F.K. Bauer, Cancer, 8: 1113-1121, Nov. - Dec., 1955 Some Observations on the Peripheral Circulation in Patients with Myocardial Infarction: F.K. Bauer, Angiology, 6: 505, December, 1955. (Abstract) 5.2 Papers Accepted or Submitted for Publication A Qualitative Study of Aminoaciduria in Muscular Dystrophy and Myotonia Dystrophic: W.H. Bland, A. Bloom and W. Drell. Proc. Soc. Exptl. Biol. & Med. (In press) Clearance of Radioactive Iodine from the Lower Extremities of Patients with Myocardial Infarction: F.K. Bauer, F.R. Mugler, V.W. Lieberman and J.P. Westergart, Am. J. Med. Sci. (In press) 5.3 Presentations Personnel of the Radioisotope Service have participated in some 20 scientific presentations and talks during the past year. Some of the more important ones, presenting new material are: American Federation for Clinical Research, W.H. Bland: "Turnover Rate of Serum Albumin in the Nephrotic Syndrome as Determined by I131 labeled Albumin."(Carmel, Calif) Western Society for Clinical Research, F.K. Bauer: "Clearance of Radioactive Iodine from the Lower Extremities of Patients with Myocardial Infarction."(Carmel, Calif) American College of Angiology, Atlantic City, F.K. Bauer: "Some Observations on the Peripheral Circulation in Patients with Myocardial Infarction." Society for Experimental Biology and Medicine and America Association for the Advancement of Science, Pasadena, Calif., m.Tubis: "Accumulation of Homologous Radioiodinated Albumin in Experimental Tumors." International Conference for the Peaceful Uses of Atomic Energy, Geneva, Switzerland, B. Cassen and F.K. Bauer: Possibilities and Limitations of in vivo External Counting Techniques in Biology and Medicine. 8. (5.3 Presentations - cont'd) American College of Physicians, Coronado, Calif., W.H. Bland: "Radioisotope Studies in Neuromuscular Disease." 6. SPECIAL ITEMS Drs. Bauer, Cassen and Libby became consultants to the Oak Ridge Institute of Nuclear Medicine. ILLEGIBLE become necessary to have AEC Forms 313 for each investigator from UCLA who carries on research within the confines of the Veterans Administration Center. In the past, One authorization either with UCLA or with the VA, was sufficient but now UCLA investigators must have separate authorization for UCLA and VA. This has created a great deal of additional clerical work which will have to be remedied, probably by the University making available clerical help for their personnel carrying on research within the VA. 7. BUDGET 7.1 Grants $17,694.72 Muscular Dystrophy Associations of America, Inc. $ 2,000.00 Los Angeles County Heart Association 7.2 Funds expended under Program 8210 for Radioisotope Unit Jan 1 - Jun 30, 1955 Jul 1 - Dec 31, 1955 (a) Personnel Services $22,110 $23,520 (Civil Service Personnel (b) Consultants 6,845 5,720 (c) Supplies 2,714 3,366 (d) Equipment 0 800 (e) All other 544 947 $32,213 $34,353 9 1-1-56 CIVIL SERVICE PERSONNEL Erickson, John O. GS-1310-13 Physicist (Gen) RATE OF PAY: $9,205 EFF DATE OF EMPL.: 7-1-49 Flaskerod, Esther A. GS-318-4 Secretary-Steno RATE OF PAY: $3,925 EFF DATE OF EMPL: 2-4-51 Hensley, Thomas J. GS-1311-6 Phys. Sci. Aid (Gen) RATE OF PAY: $4,755 EFF DATE OF EMPL: 6-21-53 Horkan, Virginia GS-312-4 Clark-Steno RATE OF PAY: $3,925 EFF DATE OF EMPL: 5-15-49 (transferred to Supply 10-23-55) Johnson, Laurence V. WA-7706-7/1 Lab. Animal Caretaker RATE OF PAY: $1.67p/hr EFF DATE OF EMPL: 12-11-49 Kinney, Billie J. GS-1311-5 Phys. Sci. Aid RATE OF PAY: $3.940 EFF DATE OF EMPL: 3-30-53 Sanchez, Butler H GS-1310-11 Physicist (General) RATE OF PAY: $5,940 EFF DATE OF EMPL: 2-14-52 Stiglic, Victor WA-3502-10(in lieu of) Machine Shop) RATE OF PAY: $657 EFF DATE OF EMPL: 8-12-54 (reassigned 4- 1-55, reassigned 11-21-55) Thomas, Howard B. GS-1311-5 Phys. Sci. Aid RATE OF PAY: $3,805 EFF DATE OF EMPL: 4-20-54 Thomas, Panchita B. GS-1311-7 Supervisory Phys. Sci. Aid RATE OF PAY: $4660 EFF DATE OF EMPL: 10-30-49 Tomlinson, Elda D. GS-312-4 Clark Steno RATE OF PAY: $3,840 EFF DATE OF EMPL: 10-30-55 Trotter, Darwin C. GS-404-6 Med. Biol. Tech. (Gen.) RATE OF PAY: $4,075 EFF DATE OF EMPL: 3-3-55 Tubis, Samuel GS-1320-13 Biochemist RATE OF PAY: $9,205 EFF DATE OF EMPL: 12-6-48 * On General Medical Research ceiling and funds On Housekeeping Division, ILLEGIBLE, ceiling and funds 1-1-56 PERSONNEL Radioisotope Unit Los Angeles, California DEPARTMENT OF MEDICINE & SURGERY Name Position Rate of Eff Date of Grade, No., Pay Employment Title & Specialty BAUER, Franz K. MS-1507 Physician (Senior) $10,965 6-18-51 Internal Medicine *25% BLAND, Wm. H. MS-1129 Physician (Senior) 10,320 8-15-52 Internal Medicine *25% SHOOP, Lucille MS-1531 Nurse (Junior) 4,560 4-1-51 CONSULTANTS LIBBY, Raymond L. Fee basis, Pub. Law. 346, $50 8-2-48 Sec. 1500 Consultant p/visit NTE $2,400 p/a ILLEGIBLE, Benedict Fee basis, Pub. Law. 346, $50 11-21-49 Sec. 1500 Consultant p/visit NTE $2400 p/a DRESSER, ILLEGIBLE Fee basis, Pub. Law 346, $18.91 p/day 7-1-55 Sec. 1500 Consultant NTE $4708.59 p/a