Duke University
Medical Center
Intercom
VOL. 25, NO. 36
SEPT. 8, 1978
DURHAM, N.C.
United Way kicks off
Medical center personnel hear a lot of
talk about the word care.
But the emphasis of the word shifted
from patient care to another type of
caring as speakers addressed pay point
representatives at a United Way kick-off
breakfast in the courtyard cafeteria, Aug.
30.
The kick-off breakfast marked the
beginning of the medical center's 1978
United Way campaign. Representatives
from pay points were urged to show they
care for others in the Durham
community by contributing to the United
Way.
The medical center's goal this year is
$48,000, according to R.C. (Bucky)
Waters, assistant to the vice president for
health affairs. Waters is co-chairing the
drive with John Robinette, assistant
administrative director of patient
services.
Referring to the large and varied
number of local agencies that benefit
from the United Way, Waters said, "If in
1979 someone in your family doesn't use
services supported by the United Way,
you can be sure that one of your relatives
or friends will benefit from the services of
an agency supported by the United Way."
Thirty-one agencies receive support
from the United Way, including the
American Red Cross, the YMCA and
YWCA, Family Counseling Services and
Salvation Army Boys' Club.
Duke receives some of its contributions
back in the form of financial support
given to two foundations and one clinic.
Last year the Community Guidance
Clinic for Children and Youth received
$23,000, the Arthritis Foundation
received $19,000, and the Medical
Research Foundation of North Carolina
fContinued on page 2)
Facial deformities linked
to poor breathing patterns
SETTING SIGHTS ON DUKE NORTH—A surveyor at the Duke Hospital North site is standing
atop what will be the main lobby of the new hospital. The "roof" of the lobby will be in the form of
a giant skylight. For another view, looking down, see photo on page 4. (Photos by Parker Herring)
Dramatic deformities of the face, jaws
and teeth can be caused by the inability to
breathe through the nose properly, two
Duke professors say in the summer-
autumn issue of the North Carolina
Dental journal.
The article, "Deformity of the Face,
Jaws and Dentition: A Preventable
Disease" was written by Dr. Galen W.
Quinn, chief of the division of
orthodontics, and Dr. Kenneth L.
Pickrell, professor of plastic, maxillofacial
and oral surgery.
"In recent years, many heroic,
corrective surgical procedures have been
developed to bring malformed parts into
healthier functioning positions," they
said. "Many machines, devices and
medicines have been manufactured to
treat the results, but little progress has
been made in determining the causes and
how to prevent them.
"There are many individuals with
deformities of this type and the
deformities could be prevented with
(Continued on page 2)
Parents give clues to cancer^s causes
By Wiliiam Erwin
When a child develops cancer, parents
naturally ask "why?" Now the parents of
these young patients have a chance to
help researchers try to learn why cancer
struck their children in a study beginning
this month at the Comprehensive Cancer
Center.
Mothers and fathers can provide clues
that doctors might not think of, according
to Dr. Seymour Grufferman, the
physician who is leading the study.
"Parents who are acquainted with the
day-to-day exposures of their children
may be able to identify factors that a
doctor in his office, away from the child,
might not pick up," he said.
Grufferman is an assistant professor of
pediatrics and director of epidemiology at
the cancer center. Cancer epidemiology is
the study of groups of people who have
cancer.
Questions and hunches
Starting this week in September,
parents of all children with cancer seen at
Duke are being asked to answer 21 pages
of questions on their children's diet,
environment, illnesses and treatments.
The parents also are asked about their
own medical histories and occupations.
Answering the questions takes about an
hour.
At the end of the questionnaire,
parents have a chance to talk about their
own hunches.
The last question reads: "Sometimes
we get our best leads about what causes a
disease from patients or their families. Do
you have any thoughts about what might
have caused your child's illness?"
For each young patient up to age 14, the
researchers will find another child the
same age, sex and race who does not have
cancer. The parents of the cancer-free
children will be asked the same set of
questions.
Then all the answers will be analyzed
by computer to see whether children with
certain types of cancer have anything in
common.
Grufferman said at least one mother
elsewhere in the nation has come up with
the key clue that led researchers to the
cause of her daughter's cancer. He said he
hopes the same sort of breakthrough will
emerge from the Duke study.
"We want to pinpoint causes of
childhood cancer, hopefully," he said.
"Our second aim is to identify a sub-set of
children at high risk for cancer."
Looking 'needle in haystack'
Conducting the study with
Grufferman are Dr. Samuel L, Katz, pro
fessor and chairman of pediatrics; Dr.
John Falletta, associate professor of
pediatrics; Dr. Herman Grossman, pro
fessor of radiology and pediatrics; and Dr.
Sue Y.S. Kimm, assistant professor of
pediatrics.
"We're trying some way out
questions," the scientist said, "but we're
very thorough. We're looking for the
needle in the haystack."
For instance, one question in the
survey asks how often the child has eaten
kidney, liver, tongue or brains.
"We're asking this question because
there's some evidence to support the idea
that people who eat brains have a higher
incidence of a slowly degenerative disease
of the central nervous system called
C r e u t z f e I d t - Ja kobs syndrome,"
Grufferman said.
'It's caused by a so-called 'slow' virus,
one that is dormant in the body for years
before becoming active."
Another question asks whether the
young patient's playmates have had "any
serious illnesses such as mono or cancer,
or any operations."
"We put in this question," Grufferman
said, "because of cancer clusters at
schools and concern about possible
person-to-person transmission of
cancer." He added he doesri’t "quite accept
these clusters as real,"
He said (he question could turn up
shared environmental exposures that
might affect both the patient and his or
her playmates.
The study will continue from now on,
the physician said. He expects that he and
his colleagues will have some conclusions
in about three years.