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College of Osteopathic Medicine and Surgery log book VOLUME 47 * SPRING 1969 · NUMBER 1 the log book
College of Osteopathic Medicine and Surgery VOLUME 47 * SPRING 1969 * NUMBER 1
THE LOG BOOK is published quarterly by the College of Osteo- pathic Medicine and Surgery. Second class postage is paid at Des Moines, Iowa. Address all mail, change of address, or Form 3579 to 722 Sixth Avenue, Des Moines, Iowa 50309.
Editorial Staff
Editor ...... Suzanne Foster Editorial Advisor ...... E. M. Meneough Graphics ...... The Graphic Corporation
NATIONAL ALUMNI OFFICERS President ...... B. B. Baker, D.O. President-Elect ...... William Lavendusky, D.O. Secretary-Treasurer ...... Joseph Baker, D.O. Past-President ...... Stan Sulkowski, D.O. Director ...... Paul T. Rutter, D.O. Director ...... Walter B. Goff, D.O. Director ...... Robert W. Johnson, D.O.
Table of Contents
Finally ...... 3 Senior W eek ...... 10 Featured Speakers ...... 12 On Capitol Hill ...... 13 New Program ...... 14 Students' W ives ...... 15 Com m unication ...... 16 Faculty Facts ...... 19 Alumni ...... 20
ON THE COVER The Honorable Ray Harrison, Judge, Des Moines Municipal Court, delivered the key- note speech during the 1969 Commence- ment exercises. FlAM.NAL When most of us were very little, we learned a nursery rhyme that went ... "London Bridge is falling down, falling down . . ." We generally repeated the words, but thought little of their mean- ing. Today, the buildings that house the complex called College of Osteo- pathic Medicine and Surgery are in a state not unlike the London Bridge. Recognizing this fact isn't difficult; acquiring new facilities is. Some of you may have read about our new idea for an urban medical complex in this publication or heard about it at a state convention. Just as osteopathic medicine is an ever-chang- ing, ever-growing profession, so must our new facilities grow and change with the times. Basically, the building is a three story monolithic structure which con- tains a central interior garden court from which four wings radiate outward. The interior garden court contains a large circular structure half of which is an open auditorium (644 capacity). Three enclosed adjacent lecture rooms (143 capacity each) complete the circle (see figure A). The ceiling of the court stretches to the third floor, thus pro- viding the building with an internal environment. The wings which radiate outward from the court neatly segregate the clinical sciences, the students and related services, the basic sciences, and the administration.
3 OSTEOPJ ANATOMY PHYSICAL M a REHABILI
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NORTH WING and laboratory make up the first floor. The general clinic will be used by all The entire North Wing houses clinical patients for first visits and for follow-up departments and an out-patient diag- treatment by those who will be man- nostic and treatment center. The area aged by the Family Care Clinic. Patients allocated to each clinical department referred to the various specialty areas includes both the departmental space will return to the appropriate specialty and the patient care area appropriate area for future care. to each department. The second floor contains the depart- The basement contains bulk storage ments of Internal Medicine and Osteo- areas, medical records storage, and the pathic Practice and related areas; the Department of Biomedical Communi- third floor, the departments of Psychia- cations. try, Pediatrics, and Obstetrics-Gyneco- The departments of Surgery and logy. Radiology, an emergency room, general clinic and reception area, pharmacy,
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T H I R D ~ ^ ^--^P^I^ ~ ^ ACADEMIC ADMINISTRATION EAST WING stand-up lab for Biochemistry and The East Wing contains student lab- Physiology. Each group of four students oratories and general use facilities. will have one work sink with disposal Central receiving, maintenance, cadaver unit, one closed circuit television moni- storage, and a crematorium are housed tor; one four channel polygraph, and, in the basement. The first floor holds for the first year class, one cadaver in the college library, cafeteria, and a an hermetically sealed stainless steel student supply center all of which are vault. The vault, when closed, also easily accessible from any of the other provides a clean flat surface upon which the group will perform animal wings. The second floor is devoted entirely experiments. The second year class to multi-disciplinary laboratories will have a comparable lab with the (Omni-Labs) for the first year class. exception of a flat work table rather the Within each student laboratory are four than the vault. Omni-Labs for cubicles; each accommodates four second year class will be located on the third floor. students. Within each cubicle, every student has his own desk, microscope locker, bookcase, lab coat locker, and 5 SURGE PATHOLOGY E. M. SUITE RADIOLOt MICROBIOLOGY GENER CLINI SOUTH WING Anatomy and Biochemistry; the third floor, the departments of Physiology The entire south wing contains basic and Pharmacology. Each department science departments. contains faculty offices, a conference The College animal facility is located room, secretarial area, and areas for in the basement. use pertinent to each department. The first floor contains the depart- ments of Microbiology and Pathology; the second floor, the departments of 6 ANIMAL FACILITY ADMINISTRATION AREAS WEST WING Utilities are distributed by means of fully accessible, vertical walk-through The administrative offices make up corridors against which laboratory walls the west wing. are juxtaposed. The alumni office, public relations, purchasing and property, and the col- So far, slight variation on the four lege print shop will locate in the base- walls, a roof, and nothing more theme ment. can be noted. The building does not The first floor is an open access to vary until one goes deeper into the central courtyard. structural design. The second floor is devoted to busi- ness administration; the third floor pro- vides for academic administration. 7 OEqiwiVJ-lJ uwnuIJI vrn A ^A r-x x - I -11I -F "W · \ s r KXXXXXXX x 6---& I IA I I I I i I -- -l I ,~e~5·zc~·r"~~c~"-i i I A l On ----L . : !:J I ; cW..IV.9MIIIIIIlAl .:IiiiIiii:,A. !;:, 1611~ FJui PrI;",..i .;. TorPRII., 1,' . FIRM I ':'i' II . I. Ia I B '' '' "'" is ' I 1II. iii I i' ai-- li·:J SECTMON LOIWOU EAST FLEXIBLE DESIGN thus allowing flexibility of curriculum. When the concept was first proposed The main corridors of this wing run chases and all through the planning stages, centrifugally with the utility the idea of flexibility was constantly parallel to the exterior "skin". Future by stressed. Consequently, this building expansion may be accomplished is flexible. removing the "skin", extending the How? floors about 30 feet, thus allowing for All interior walls in the South Wing about 32 more student places per (basic sciences) and the North Wing floor. Utilities would be furnished by (general clinic) will be constructed of the existing most easterly utility chases. movable partitions, using a six-foot Lecture rooms can be enlarged or module. Room-by-room flexibility is additional lecture rooms created by thus provided. The vertical utility chases modification of the relatively modest and main corridors in these wings run auditorium. centrifugally from the courtyard to the Integration of a teaching hospital outer walls. These outer walls are both into this building can be accomplished in the future by removing all partitions non-weight bearing "skins". Expansion in the North Wing (general clinic), of either wing can be accomplished by constructing the appropriate structural removing the "skin", extending the shell as an extension of that wing, and floors and chases, and replacing the redesigning the resulting composite "skins". space as a teaching hospital. The Omni-Labs (East Wing) are de- signed to provide completely integrated student laboratory and study areas, 8 On April 2, 1969, the college was million and a group of alumni have informed by the Bureau of Health Pro- already pledged about $250,000, we fessions Assistance of the Department still have $7,250,000 to go. of Health, Education, and Welfare that We have retained the firm of Ward, the National Advisory Council on Edu- Dreshman and Reinhardt, Inc., to assist cation for Health Professions, had ap- us in conducting an intensive nation- proved our request for Federal con- wide fund raising campaign. struction funds in the amount of ap- Now is the time for alumni and proximately $8.5 million. This Advisory friends of the College to pledge their Council is charged by law with the best efforts and abilities for our devel- evaluation of all applications for Fed- opment program. COMS needs your eral construction funds submitted by emotional, professional and financial schools of the various health profes- support! sions. These Federal funds are Matching Funds and will not be released until C.O.M.S. has raised the rest of the money needed for this project. Since the total cost of the project is $16 9 They began their long and active career with the Renfro Valley Barn Dance in Renfro Valley, Kentucky, SENIOR where they started their present style of parodying currently popular song hits. They stayed on with the Renfro Valley Barn Dance for almost three years. WEEK Both boys served four years in the Army during World War II, Jethro in the Pacific and Homer in the European Henry Doyle Haynes and Kenneth sector. Following their Army experi- Charles Burns are both experts. Experts ence, they became associated with at taking serious, romantic songs and WLW in Cincinnati, where they ap- teasing and twanging them into barely peared with the "Midwestern Hayride". recognizable musical parodies. These While on the staff at WLW, they started two men, better known to a vast and their recording career with the King fast-growing public as Homer and Recording Company and began making Jethro, were the guest stars at the personal appearances. The boys formed C.O.M.S. Pacemaker Ball. The Ball, their own act and went on tour with held June 3rd from 9:00 p.m. to 1:00 a tent show. a.m. in the Val Air Ballroom, West Des Under the management of Spike Moines, also featured the Don Hoy Jones, they again toured the country, Orchestra. playing such spots as the Roosevelt Homer and Jethro were born, reared, Hotel, New Orleans; the Forrest Park and educated in and around Knoxville, Hotel, St. Louis; Olympia Theatre, Tennessee. They teamed up as a hill- Miami; and the Chicago Theatre. While billy singing team while in school, play- in Chicago, the boys were invited to and ing school audtoriums, churches, become regular members of the WLS benefit shows. National Barn Dance, where they re- mained for eight years. In those years, they were regular guests on Don McNeil's Breakfast Club, made TV guest spots on various national and local Chicago TV shows and had a multitude of appearances before con- ventions, state and county fairs, the 10 Thunderbird and Show Boat in Las Vegas, and other top clubs in the United States. Homer and Jethro have been rated in trade papers as the top country and western comedy singing team for the past six years. Stories on their career have appeared in TIME and PAGEANT magazines, as well as the leading coun- try and western magazines in the country. Neither of them has had any formal musical training, but Homer is con- sidered one of the finest guitarists in the business, and Jethro rates high as a mandolin player. The boys live music, often sitting in on jam sessions. Homer and Jethro have been with RCA Victor for a number of years. They admit that in the past, RCA has been unaccountably worried about their sales. But the boy's Tennessee-style logic is too much for RCA's citified executives, "Like when we were in New York last for a recordin' session," says Jethro, "One of the execs came down to ask if we had any ideas that would help the sales of our records. I told him sure thing. Put Perry Como's name on the label." Homer and Jethro Alumni and friends and families of graduates were invited to attend the Pacemaker Ball. During the festivities, the Pacemaker Queen was selected from candidates and crowned. 11 FEATURED SPEAKER FEATURED SPEAKER FOR SENIOR BANQUET FOR COMMENCEMENT J. Scott Heatherington, D.O., President- The keynote speaker for the seventieth elect of the A.O.A., was the featured annual C.O.M.S. commencement exer- speaker at the annual Senior Farewell cises was the Honorable Ray Harri- Banquet during Senior Week activities son, Judge of the Municipal Court, at the College. Des Moines. Dr. Heatherington, a general prac- Judge Harrison earned his doctor of tioner from Gladstone, Oregon, is a jurisprudence in 1925 from Drake Uni- 1944 graduate of C.O.M.S. and a mem- versity. That same year, he was the ber of its Board of Trustees. He has recipient of the David I. McCahill served as a member of the Board of scholarship which enabled him to take Trustees of the A.O.A. since 1959. He a year of post graduate work at Yale. is a former chairman of the AOA con- In 1949, Judge Harrison won the stitution and by-laws committee, dis- Community Award; in 1956, he was tinguished service awards committee, appointed to the bench. Four years council on development, department later, in 1960, he was named the Inter- of public affairs, department of busi- national Man of the Year by the Sera- ness affairs and department of pro- toma Club. fessional affairs. He was twice president Judge Harrison has long been known of the Oregon Osteopathic Association for his work with individuals suffering and served for 12 years as a trustee of from alcoholism. The officials of the the O.O.A. He is a former chief of detoxification center noted this fact in staff of the Portland Osteopathic Hos- renaming the center in his honor. "We pital. feel this is the least we can do for a man who has knocked himself out to help alcoholics and to assist others in becoming familiar with the dangers of the disease" 12 The gold-leafed dome of the Iowa State Capitol building dominates the Eastern skyline of Des Moines. Beneath the H dome, pertinent, and sometimes not E T -VAz so pertinent, legislation is debated and passed into law. To C.O.M.S., some of the legislation passed by the 63rd General Assembly was particularly important. Two years ago, at the last General Assembly, a law was passed in a precedent-breaking action which pro- vided $200,000 for medical tuition loans. Last year, sixty-one of our stu- dents were recipients of these loans. This year, there was a suggestion to revise the loan qualifications and pro- vide a flat rate, rather than base the loan on tuition. This suggestion was defeated. Instead, additional monies were allocated, bringing the amount available for loans to $300,000. Other legislation directly affecting programs of concern to the College ON were two bills dealing with alcoholism. Our Harrison Treatment and Rehabili- tation Center, an alcoholism detoxifica- tion center, has been plagued by an CAPITOL HILL extremely rocky financial road. Two bills that were passed this year should Like the Grand Canyon, legislation alleviate this difficulty. such as this doesn't just "happen"; it One of the bills redefines the duties is the result of long hours and hard of the state Commission on Alcoholism work. We need your support. and establishes a method for securing Next year, another election will be larger, firmer fiscal support for such held in June to elect legislators for the local operations as our Center. 1971 General Assembly. Your legislator The other bill provides for the appro- will be asking for your support in June; priation of $500,000 for the next bien- ask for his next January. nium to the Commission on Alcoholism for the support of local alcoholism centers to be matched by county funds. 13 jails are still prone to human frailties, the ride out to the county hospital for medical attention was more of a treat ANEW than a threat. Then, too, the escape from tedium was, in one or two in- stances, also an escape from detention. In addition, the cost to the county for PROGRAM medical attention was steadily rising. Jail is no longer a place to incarcerate Secondly, as Dr. Connair reported, hardened criminals until the necktie "Our senior students can see more party begins. By the same token, med- patients and they are challenged by the ical school is no longer a place where need for accurate diagnosis without the students are "jailed" until they are use of sophisticated medical equipment studied into practicing physicians. More and elaborate clinical tests. The cases and more, community service is de- run the gamut of cardiac problems, veloped as an active part of the COMS epilepsy and so forth, through minor curriculum. Programs have been de- surgery." They have also done some veloped to provide health care for psychiatric counseling. poverty areas; to find ways to treat and, The program has been operating on ultimately, to rehabilitate patients suf- a five-day-a-week basis; however, there fering from alcoholism; and to re- is a physician on call twenty-four-hours establish valid communication between a day, seven days a week. A total of individuals. Now, a new program is 866 patients were seen during the under development to extend commun- five month operation at a modest cost ity service into providing medical care to the county. for county jail inmates. Sheriff Hildreth, in commenting on Since December, fourth year students the viewpoint of the county, reported, serving their clinic service quarter in "The need for a service of this type has the downtown College Clinic have been apparent for some time. The been accompanying an osteopathic benefits to the inmates and the eco- physician to the jail for morning sick nomic benefits to the county make call. The D.O., Robert J. Connair, was this a very impressive program". one of the originators of the program Dr. Connair, Assistant Professor of which was designed to replace prison- Osteopathic Principles & Practice and ers' almost daily trips to the county Director of the Division of Physical hospital for medical care. He and Polk Medicine and Rehabilitation, recently County Sheriff Wilbur Hildreth worked completed a fellowship in Physical out the details of the program, then Medicine and Rehabilitation at the presented it to the Board of Super- College and is now eligible for certifi- visors for approval. cation. The new program serves a two-fold purpose. First, since even prisoners in county 14 from left, Mrs. Irwin Groff, counselor for the wives' club, Mrs. Tedd McKinney, president, Mrs. Nigh, and Dr. Vigorito. Clyde had his Bonnie, Romeo had his Juliet, and most student doctors have STUDENTS WIVES CLUB their wives. Students' Wives Club at each school. Wives traditionally keep the lid on This year, Mrs. Ruth Harms Nigh, wife catastrophes while their husbands labor of Dr. E. G. Nigh, of McPherson, Kan- toward the sometimes elusive goal of sas, serves in this capacity. D.O. However, most wives are not Mrs. Nigh is a charter member of the content to merely keep the home fires Auxiliary to the Kansas State Osteo- burning, they get involved. Wives of pathic Association and has held every students at COMS get involved with Auxiliary office at the state and district Students' Wives Club. level. Before becoming AAOA Presi- Annually, the members of Wives dent, she served as first and second Club carry through with a variety of vice- president, recording secretary, service projects aimed at earning both scholarship program, and public rela- money and a bit of community respect. tions chairman. The Wives' projects range from a During Mrs. Nigh's recent visit, she bake sale, rummage sale, annual formal was given a tour of the present College dance, through such services as a bas- facilities. Thomas Vigorito, D.O., Presi- ket of food at Thanksgiving for a family dent, discussed COMS plans for an from one of the clinics and a big urban medical complex, detailing his Christmas party for children of clinic conversation with architect's schematics. families. Later that day, Mrs. Nigh was the Each year, the Past-President of the featured speaker at the monthly meet- Auxiliary to the American Osteopathic ing of the wives club. Association tours the five osteopathic colleges serving as Counselor to the 15 COMMU N ICATION. A RETURN TO THE BEGINNING When man first learned to communi- climate were reached between two cate, he probably used grunts and people, it would then be possible to monosyllables to convey his thoughts. establish real communication through How strange to have evolved, through the true understanding of oneself and the mechanization of our society, to his impact on the other. a stage where again grunts and mono- Thus, it is Dr. Wieman's approach to syllables are used for communication. communication that makes the Des An awareness of this problem is slowly Moines Center for Creative Interchange taking form. as individual as fingerprints. The trend toward improving com- The Center is located in a renovated munication began in the late 1940's section of the College, which is also when a psychologist named Kurt Lewin lending administrative support to its conducted an indepth study of pre- formation. To understand the real judice among social groups at the significance behind the Center, one University of Michigan. Lewin made must look first to the man who form- the discovery that "feedback", a term ulated the concepts of Creative Inter- denoting the regenerating response to change, Henry Nelson Wieman, Ph.D. an initial reaction, could also apply to In the first edition of "Interchange", people. Using "feedback" as a learning the monthly newsletter published by tool, Lewin found that he could study the Center, Dr. Wieman discusses con- individual and group behavior as well flict and creativity and in doing so, he as the effects of that behavior on others. states his philosophy on the subject: While Lewin went on to bring his "Perhaps the most serious problem of ideas to the National Training Labora- our time is how to deal with conflict, tory Institute of Applied Behavioral to make it creative and not destructive. Sciences in Washington, D. C., others We live in the age of conflict due to who were working independently of rapid social change, breaking down the each other on very similar concepts regulative control of tradition; due to were arriving at very similar conclusions. ever closer interdependence of people One such man was Dr. Henry Nelson with conflicting interests; due to a Wieman. Taking "feedback" one step technology making conflict more de- further to the concept of "creative structive than ever before; due to interchange", Wieman brought still a television awakening people to possi- new dimension to this movement. Wie- bilities of improvement by conflict. man maintained that if the proper "Throughout history conflict has been the chief way to improvement, politically, economically, educationally, 16 artistically, widening the consciousness Board of Advisors to the Center and of values for the individual and giving Chairman of the Department of Psychi- fuller content of value to the prevailing atry. culture. Also, conflict has been the Professor Palmgren is aided in the chief destroyer of value, reducing the administration of the Center by Assis- range of consciousness of value for the tant Directors, Margaret Voorhees and individual and impoverishing the con- Mary Lou Cook. Mary Lou edits the tent of value for the prevailing culture. monthly publication, "Interchange". "Conflict brings parties together with Through "Interchange", members of very diverse values. This makes it possi- the Center are kept informed of ideas ble for each to undergo a change and activities that are both current and whereby each acquires from the other forth-coming. Its premier edition was new values not otherwise possible. This published in February. The style and occurs by a kind of interchange be- content of the newsletter reflect the tween the conflicting parties. When the creative and artistic potential found ruling commitment of life is given to in the Center. Each month's issue fea- this kind of interchange conflict can be tures comments by Dr. Wieman. made creative and not destructive. Since the Center's inception, Pro- "Our age will bring forth a culture fessor Palmgren and his associates have with fuller content of value than ever been using the techniques of lecture before or else drive to destruction more classes, sensitivity training, psycho- devastating than ever before. This is so drama, body dynamics, dance, graphics, because of the magnitude of conflict in non-verbal communication as well as our time. The Center for Creative that exercises known as "T-groups". Interchange seeks to lead our society Standing for "training" and not to concentrate resources on the kind "therapy", the T-group is usually of interchange leading from disaster to thought of as a form of sensitivity that fuller content of value made pos- training. At the Center, the Wieman sible by this age of conflict." concept of creativity is injected into The Center's Director, Charles Palm- gren, Associate Professor of Psychology and Special Assistant to the President, affirms Dr. Wieman's concepts and potentiates his ideas together with his own. Demonstrating how closely allied these men are in their commitment to the concept of Creative Interchange, they are currently compiling material for a book which should be ready for publication later this year. Working on this project with Dr. Wieman and Pro- fessor Palmgren is Erie Fitz, D. O. Dr. Fitz is a member of the National 17 the T-group, thus transforming it into consultant, and trainer. Like Dr. Wie- Creative Interchange. man and Professor Palmgren, Miss Trying to tell it like it is, members Tarry's academic background is in of these Creative Interchanges attempt religion. Her work will involve class to break down the subtle barriers and private counseling in addition to which have been preventing people working with sensitivity labs. She and from having meaningful exchanges of Professor Palmgren will develop sen- communication for too long. In doing sitivity training programs for churches, so, participants hope to peel away the business, and industrial groups. veneers they have formed as a result Del R. Poling, who is Assistant Direc- of years of coping with the intense tor at the Pastoral Counseling Institute, strains society has placed upon us. Inc., has also been invited to serve as Also working and teaching with trainer. Charles Palmgren at the Center for Since its inception, considerable Creative Interchange are Bob Scott, interest has been shown in the Center Sherry Levine and Dr. Fitz. and its Director. Professor Palmgren Mr. Scott is the Director of the has been interviewed frequently on Harrison Treatment and Rehabilitation local television shows and is often Center and teaches classes in Psycho- asked to speak at public functions. cybernetics at the Center. Professor Palmgren, rather than view- Classes on self-awareness through ing the role of Director as strictly creative dance, body exercise and crea- leadership, sees his obligations as tive expression are offered by Sherry "more a process of creating an innova- Levine. Here, again, is still another tive environment in which our mem- avenue of communication. bers, staff, Assistant Directors, local Dr. Fitz contributes in yet another and national boards engage in Creative way by offering classes which delve Interchange". more deeply into the philosophies of In experiencing life with its endless Henry Nelson Wieman. ramifications, if the individual chooses Hoping to improve interpersonal to profit and learn from his conflicts relations in management and to increase as well as from his conquests, he is productivity in their own organization, employing Dr. Wieman's concepts. a Des Moines architectural firm has Rather than allowing alienation and awarded the Center its first industrial retaliation to result from everyday con- contract. It seems inevitable that other frontations, Creative Interchange means fields will soon be discovering what recognition and utilization of these positive changes Creative Interchange same conditions. Further, it means can bring about. knowing, understanding and accepting. During the past year, the Center In a day when so many people are acquired the part-time services of asking "What can I do to make the Willene Tarry as staff member, special world a better place?", Creative Inter- change and its Center in Des Moines can hold the answer for many. 18 FACULTY FACTS Teresamma Pinakatt, Ph.D., Associate Professor of On April 24th, Erle W. Fitz, D.O., Professor of Physiology, was the featured speaker at the monthly Psychiatry and Chairman of the department, spoke meeting of the Fourth District of the Iowa Society to the Department of Philosophy at the University of Osteopathic Physicians and Surgeons held in of Southern Illinois concerning "Philosophy as Tripoli, May 4th. Ground for Psychotherapy". Dr. Fitz was also the sole psychiatrist to attend the annual meeting of the Western Division of the American Philosophical Two members of the faculty were notified of grant Association held in Cleveland, Ohio, early this awards from the College's General Research Support month. Program. Duncan Thomson, Ph.D., Assistant Professor of Physiology, received almost $2000 to L·BM5iI e ir* ·i e 9 , 9 R study the "Bone Up-Take Rate of Radioactive Calcium in Rats". Byron E. Laycock, D.O., Professor of Osteopathic Principles and Practice and Chairman Mohinder S. Jarial, Ph.D., Assistant Professor of of the department, Anatomy, received over $5000 to finance research was a featured speaker at the 70th annual convention for "Utilization of the Electron Microscope to of the Michigan Association of Osteopathic Determine How Cerebral Spinal Fluid is Physicians and Surgeons held May Manufactured". 5-7th. Dr. Laycock discussed the "Manipulative Aspects The General Research Support Program is of Pediatrics". funded by the National Institutes of Health. P1BJBBC Be 4f b hSaB b P i