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Duke University Medical Center
VOLUME 24, NUMBER 16
APRIL 22,1977
DURHAM, NORTH CAROLINA
Eye Cancer Cures Bring
Need of Genetic Counseling
DELICATE WO/?/C—Craftsman James Blackwood alters a nozzle to handle larger
surgical suction tubes than those furnished by the manufacturer. The Surgical
Instruments Shop can modify commercially available equipment or build new items
to meet physicians' specifications. (Photo by Jim Wallace)
By William Erwin
Cancer specialists can now cure
almost nine out of every 10 children
with retinoblastoma, the most
common eye cancer of childhood.
But that success has brought a new
challenge.
Survivors of the disease can pass it
on to their children. As more young
patients grow up and have kids of
their own, more and more cases are
appearing. Stepped-up genetic
counseling may be the only answer.
One peisoh concerned about the
disease and its legacy is IDr. Joseph
A.C. Wadsworth, professor of
ophthalmology and head of the Eye
Center.
"In 1930, about half of all children
with retinoblastoma died,”
Wadsworth said. "Now, with
pediatricians watching for the
disease and with better methods of
treatment, we can save about 85 per
cent of them."
Workshop on Eye Cancer
The professor, also chairman of the
medical centei-'s Ophthalmology
Department and a member of the
Comprehensive Cancer Center, will
lead a workshop on cancer of the eye
and surrounding tissues Saturday
morning (April 23) at the Eye Center.
Eight other Ouke eye specialists will
make presentations.
As parents leam at the center,
retinoblastoma (ret-i-no-blas-
TO-ma) starts growing in the back of
the eye. It looks like a flesh-colored
cauliflower to a physician peering
through the eye's black pupil;
sometimes flecks of calcium can be
seen on the tumor.
From Sharpening Scissors to Building Stretchers
Surgical Instruments Shop Fills Requests
By Ina Fried
"Sometimes we get sketches but
most of the time we get
handwaving," Billy R. Barber said
about the instructions for work in
the Surgical Instruments Shop. For
30 years and several patents he has
been manager of the shop in the
basement of the Bell Building.
Established in 1947 by Dr. J. Deryl
Hart, first chairman of the
Department of Surgery and
president emeritus of the university,
the shop employs skilled craftsmen
to produce instruments or
equipment to meet physicians'
specifications.
"We had a lot of research going
and we frequently needed
complicated things in a hurry so we
set up a way to get them," Hart
recalls.
"We first tried to get surplus
equipment from the government,"
he said, "but they were pretty well
taken up." Instead, he sent the
shop's first manager to New York
with $15,000 to buy as much
second-hand equipment as he could.
Getting Started
One of the first jobs in the shop
was building equipment for Dr.
Joseph W. Beard, first head of the
Division of Experimental Surgery,
for his studies of leukemia in
chickens.
'The shop built a rotating table
around which several people could
work," Hart said. "One could catch
the chicken, the next one could draw
blood and do a smear, and the next
person could check the slide under
the microscope."
An anesthesia ii\haler designed in
the shop was patented and sold,
bringing enough profits to pay for
two large pieces of equipment to cut
and bend % inch (1.91 centimeters)
steel plates. Weighing 75,000 pounds
(24,020 kilograms) each, these pieces
of equipment were brought down
from Washington, D.C., with the
cooperation of the Virginia and
North Carolina highway
depsutments. Hart said. Once they
were in position, an addition to the
Bell Building was built around them.
Only One in Captivity
The steel-bender, which exerts 400
tons (364 metric tons) of pressure, is
"the only one in captivitj^' in this
part of the country. Barber said. The
shop also has the only machine on
campus that can cut thick plastic
smoothly enough to be used without
(Continued on page 3)
The disease is found most often in
children between one and two years
old and almost never occurs after age
seven.
Cat's Eye
In about half of all cases, the child
will have a whitish pupil, caused by
light reflecting off the tumor.
Physicians call this a "cat's eye"
appearance.
Another symptom can be crossed
eyes, resulting when the cancer
destroys central vision in an eye.
That eye, no longer focusing,
wanders out of line.
"We try our best to get
pediatricians to be suspicious"
about crossed eyes, Wadsworth said.
Any child with this problem should
be checked for retinoblastoma as a
first step, he pointed out.
Pediatric Referrals
"Pediatricians aware of changes in
the eye and referring these children
for further study are saving a lot of
lives," the professor said.
Specialists usually treat the disease
by removing the affected eye. This
must be done without delay,
Wadsworth said, because the tumor
(Continued on page 4)
Turn Clocks Ahead
Before Going to Bed
When your alarm clock rings
Monday morning, you may wonder
why it's so dark outside. At least,
you may if you remember to set your
clock ahead one hour.
Daylight Saving Time begins at 2
a.m. Sunday, April 24. University
clocks will be turned to 3 a.m. at that
time.
The change in time may result in
an hour reduction in work schedules
for some employees. Any employee
whose regularly scheduled work falls
within the affected shift will have the
opportunity to work a full shift,
according to Richard L. Jackson,
assistant vice president and director
of personnel. Employees will be paid
only for the hours actually worked.