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Duke University Medical Center
VOLUME 24, NUMBER 4
JANUARY 28,1977
DURHAM, NORTH CAROLINA
May Help Heart Attack, Stroke Victims
Chemicals Halt Blood Clots
IT’S PRETTY BUT—Co\d weather here not only brought the snow that decorates the
Davison Building in this picture but also has caused serious energy problems. The
university currently is burning coal faster than it can be unloaded from the railroad
cars, said Ronald L. Wilson, associate director of the physical plant. The unusually
cold temperatures also are causing a greater demand for electricity than was
expected. Wilson urged cooperation in conserving steam heat and electricity by
lowering thermostats and turning off unused lights and other electric appliances.
By David Williamson
Scientists here have developed a
series of chemical compounds that
interfere with blood clotting under
laboratory conditions.
If the chemicals, which are called
monocyclic peroxides, can be made
to work the same way in the human
body, they may have far-reaching
effects in the prevention and
treatment of strokes and certain heart
attacks, according to Dr. DanigI B.
Menzel, associate professor of
pharmacology.
Menzel said the compounds
mimic the action of a recently
discovered natural hormone known
as prostacyclin or PGX.
Protects Arteries
Prostacyclin, described only last
month by Dr, John Vane of Wellcome
Laboratories, serves to protect
arteries against the build-up of
platelets along their inner walls, a
process long associated by medical
researchers with stroke and
cardiovascular disease.
Prostacyclin decomposes rapidly,
however, limiting its potential
'Playing Doctor' Eases Anxiety
By John Becton
If the pupils in Cynthia Thomas'
second grade class at Little River
Elementary School are representative
of the norm — and there's no reason
to assume otherwise — going to the
doctor would not be on any
youngster's list of "my favorite
things."
But for this particular group of
kids, going to the doctor in the future
may not be so bad, thanks to Dr.
Corry Sibrack, pediatric resident.
A five-week block of the first year
pediatrics residency is devoted to
"Behavior Development." For Dr.
Sibrack, this includes spending
about one half of each week at Little
River School visiting classes and
working with the school's counselor,
Steve Harris.
Seeking to Reduce the Threat
One thing she is trying to
accomplish is to make trips to the
doctor less threatening.
The visit to Ms. Thomas' class
illustrates how.
First of all. Dr. Sibrack herself was
not threatening to the class. She was
dressed casually and without white
jacket.
She was introduced as "Corry
Sibrack, a doctor," rather than as
"Dr. Sibrack."
And she engaged the pupils in a
thorough discussion about visits
mth the doctor.
"How do you feel about going to
the doctor?" she began.
None of the answers was
especicdly positive: "Bad;" "I don't
like it because they stick tubes in my
ears." "I feel sick;" and, the least
negative, "I don't have to go to the
doctor, because my mother is one."
Discussing "What" and "Why"
Others related experiences —
blood tests, shots, stitches, etc. —
and Dr. Sibrack agreed they were
less than pleasant, though important
and necessary.
Then, one by one, she pulled from
her "little black bag" a stethoscope,
opthalmoscope, otoscope and reflex
hammer.
Most of the class had seen most of
these before and had some idea what
they were for.
Dr. Sibrack discussed more fully
how doctors use each, and why.
Then she let the class spend some
time listerung to each other's hearts,
looking in each other's ears and
hammering on each other's knees.
Not So Bad After All
After a while of lub-dubs and knee
jerks. Dr. Sibrack listened to a few
more questions and comments about
various pupils' own experiences and
encouraged them to ask questions of
their own doctors as well.
She then asked if the next trip to
the doctor would seem as bad as
before. The ovendiefaning vote was
a resounding "No."
When she is not at the school. Dr.
Sibrack works with a psychiatric
advisor and observes children at
Presbyterian Day Care Center,
Wright School, and the Child
Guidance Clinic.
This part of the residency,
according to Dr. Sibrack, "gives us a
(Continued on page 4)
usefulness in preventing clots.
"Our compounds, these
monocyclic peroxides, are the first
chemically synthesized drugs which
have prostacyclin properties,"
Menzel said. "TTiat makes them an
entirely new route of attack to
prevent blood coagulation.
Exciting Possibilities
"We are very excited about the
possibilities, and the research was
very well received at the yearly
symposium of the Intra-Science
Research Foundation held in Santa
Monica, Calif., in December," he
said.
Collaborating with Menzel in the
discovery were Dr. Ned A. Porter,
associate professor of chemistry; J. R.
Nixon, a chemistry graduate student;
and Drs. Joseph H. Roycroft and
Ramadas Isaac, research associates in
pharmacology and surgery,
respectively.
The five published a report of their
findings in the January issue of
Research Communications in Chemical
Pathology and Pharmacology, a
professioiud journal.
Like a Clogged Pipe
Menzel said the coagulation or
clotting of blood is an essential
mechanism by which the body uses
platelets to close off wounds and
preyent death by loss of blood. But
when clotting occurs along the walls
of arteries that are not otherwise
damaged, the vessels begin to shrink
in size internally, much like a pipe in
a kitchen sink that is becoming
clogged.
If a mass of platelets called a
thrombus then breaks away from an
artery wall, it may stop blood flow
(Continued on page 2)
SO THAT’S WHAT THE DOCTOR SEES—Dr. Corry Sibrack, pediatric resident,
demonstrates the otoscope to secorul graders at Little River Elementary School, as
part of a discussion about visits to the doctor. (Photo by John Becton)