PICTURESOF HEALTH

FALL 1999

A pu b l ica t ion fo r f r iends o f t h e U n iver s i ty o f Minnesot a

Molecularmedicine

Page 5

Model senior health clinic

Page 15

Childhood cancer survivors

Page 10

MidwestEastmeets

PLANNERS OF

THE MIND BODY

SPIRIT CLINIC

TOAST ITS

OPENING WITH

CUPS OF

CHAMOMILLE

TEA. FROM LEFT

TO RIGHT ARE

ELAINE

ANDERSON,SHARON

NORLING, PAM

WEISS, AND

MARY JO

KREITZER.

New Mind Body Spirit Clinic integrates conventional medicinewith complementary healing practices such as acupunture,herbal remedies, and spiritual counseling. Page 14

Pictures of Health is published four times a year for friends of the AcademicHealth Center. Suggestions and lettersare welcome. Please send to Pictures ofHealth, Academic Health Center, Box735, A-395 Mayo Building, 420Delaware Street, Minneapolis, MN 55455,or to rinard@mailbox.mail.umn.edu.Tel: 612-624-5100

For more information about theAcademic Health Center and its sevenschools and colleges, refer to the Website at www.ahc.umn.edu.

EditorPeggy Rinard

PhotographerRichard Anderson

Graphic DesignPenfield Hunter

Director of CommunicationsChristine Roberts

Associate Vice President Terry Bock

Senior Vice President forHealth SciencesFrank B. Cerra

School of DentistryMichael Till, Dean

Medical SchoolAlfred Michael, Dean

School of Medicine, Duluth Richard Ziegler, Dean

School of NursingSandra Edwardson, Dean

College of PharmacyMarilyn Speedie, Dean

School of Public HealthEdith Leyasmeyer, Dean

College of VeterinaryMedicine Jeffrey Klausner, Dean

PICTURESOF HEALTH

Millard Hall, built in 1912, was one of three

buildings torn down this summer to make way for

the new Molecular and Cellular Biology Building.

It was named after Perry Millard, the first dean

of the Medical School. See story page 6.

MOLECULES TO MIRACLES 5Construction of the new $70 million Molecular andCellular Biology Building gets under way. Programs willfocus on functional genomics—learning how to repairgenes to prevent and cure disease.

THE DOCTOR IS IN 7New psychiatry department head discovered that teenswith schizophrenia have a structural brain defect.

HOPE HEALS 8Nursing faculty member studies the mind’s influence overthe immune system in cancer patients.

LAB RAT TO REGENTS PROFESSOR 14Ashley Haase, nationally known HIV researcher, is dubbeda Regents Professor, the University’s highest honor.

COMMUNITY PARTNERSHIPS 15The Wilder Senior Health Clinic is a model for traininghealth professionals in the community, which is where 75 percent of care is now delivered.

PICTURESOF HEALTH

INSIDE THIS ISSUE

SKIN DEEP 9A North Woods camp for children with disfiguring skindiseases helps them discover the beauty of their own natures.

LIFE AFTER CANCER 10As the number of children surviving cancer grows, so does theneed to identify and address their special health needs.

DR. LURIE GOES TO WASHINGTON 11Faculty member Nicole Lurie, on leave at the U.S. Departmentof Health and Human Services, returns to speak at the Schoolof Public Health graduation.

JESSIE MIDDENDORF, CHILDHOOD CANCER SURVIVOR, VISITS THE U FOR HER

BIANNUAL CHECK-UP. PAGE 10

ASHLEY HAASE, NATIONAL HIV EXPERT, ENJOYS WORKING WITH STUDENTS

IN HIS LAB. PAGE 14

THE WILDER SENIOR HEALTH CLINIC IS A MODEL FOR COMMUNITY EDUCATION

AND A MAGNET FOR ST. PAUL SENIOR CITIZENS. PAGE 15

3

4A quick look at news from the University ofMinnesota Academic Health Center.

SNAPSHOTS+

REEARCHSEARCH

EDUCATION

OUTREACH

CROSSING DISCIPLINESEAST MEETS MIDWEST 12A joint venture between the Academic Health Center and Fairview Health Services, integrates conventionalmedicine with complementary healing practices.

Back Page:Pet peevesHumans are from Earth, dogs are from Pluto. Behaviortherapist Petra Mertens helps keep these relationships frombreaking up.

4

AIDS research and the School of Public Health got a $43 millionshot in the arm from the National Institutes of Health in September.The grant, the largest in the school’s history, will fund a five-yearresearch project to be conducted at 210 sites in 18 countries. SPHProfessor James Neaton will lead the study, which will seek todetermine whether Interleukin-2, a biological agent used in cancertherapy, can help strengthen immunity in HIV patients. More than30 million people worldwide are infected with HIV.

Minneapolis school children weighed more and had higherblood pressure in 1996 than they did in 1986, according toresearch conducted by Russell Luepker, School of Public Health.Luepker says these increases are because children watch more TV,play more video games, and get less exercise than they did in 1986.

Edwin Haller, School of Medicine-Duluth, led a group of fivemedical students to Petrozavodsk State University in Russia todeliver $27,000 worth of donated medical supplies. The visit,which the students helped pay for with their own money, grew outof a 10-year exchange program between the two schools. Hallerplans to return to Russia soon, he said, because of the desperateneed for even the most basic supplies.

Donna Hecker, School of Dentistry, spent her summer vacationproviding dentures for members of the Blackfeet IndianReservation in Browning, Montana. Hecker is one of a number ofprosthodontists sponsored by the Academy of Prosthodontics todeliver care to reservations in Montana, Oklahoma, and Alaska.

SNAPSHOTS+

SCHOOL CHILDREN ATTENDING KIDS UNIVERSITY MEDICAL SCHOOL

CAMP THIS SUMMER DONNED SURGICAL SCRUBS TO ADMINISTER

HEART RATE AND BLOOD PRESSURE TESTS, AND VIEW DIAGNOSTIC

IMAGES. THEY ALSO LEARNED ABOUT HOW THE BRAIN, HEART, AND

LUNGS WORK FROM MEDICAL PROFESSIONALS. THE PROGRAM, WHICH IS OFFERED ANNUALLY, GIVES CHILDREN AN EXPERIENTIAL

OPPORTUNITY TO LEARN ABOUT THE WORLD OF MEDICINE.

■ ■ ■ ■ ■ ■ ■ ■ ■

■ ■ ■ ■ ■ ■ ■ ■ ■

■ ■ ■ ■ ■ ■ ■ ■ ■

■ ■ ■ ■ ■ ■ ■ ■ ■

■ ■ ■ ■ ■ ■ ■ ■ ■

LIGHT OF THE YELLOW STAR--A LESSON OF LOVE FROM THE

HOLOCAUST, AN EXHIBIT BY PEDIATRICS PROFESSOR ROBERT FISCH,WAS FEATURED AT THE MINNEAPOLIS INSTITUTE OF THE ARTS THIS

FALL. THE EXHIBIT INCLUDED 17 PAINTINGS AND PROSE BY FISCH,WHO WAS IMPRISONED IN A NAZI CONCENTRATION CAMP DURING

WORLD WAR II. FISCH HAS ALSO DISPLAYED HIS WORK AT THE

WEISMAN ART MUSEUM. THE THEME OF THE EXHIBIT IS THE

TRIUMPH OF THE HUMAN SPIRIT OVER TRAGEDY.

THE MINNESOTA RURAL HEALTH SCHOOL RECEIVED A THREE-YEAR,$500,000 GRANT FROM THE DEPARTMENT OF HEALTH AND HUMAN

SERVICES. HEADQUARTERED AT THE SCHOOL OF MEDICINE-DULUTH,THE RURAL HEALTH SCHOOL TRAINS AND RECRUITS HEALTH

PROFESSIONAL STUDENTS TO PRACTICE IN MINNESOTA’S SMALL TOWNS

AND RURAL

COMMUNITIES.BYRON CROUSE,ASSOCIATE

PROFESSOR AND

HEAD OF THE

DEPARTMENT OF

FAMILY MEDICINE,IS DIRECTOR.

■ ■ ■ ■ ■ ■ ■ ■ ■

IT’S OFFICIAL. WHOLE GRAIN CONSUMPTION, AS PART OF

A LOW-FAT DIET, REDUCES CANCER AND HEART DISEASE

RISK. LABELS ON WHOLE-GRAIN BREAD AND CEREALS MAY

NOW CARRY THAT CLAIM THANKS TO RESEARCH BY SCHOOL

OF PUBLIC HEALTH PROFESSOR DAVID JACOBS. THE STUDY

WAS RECENTLY PUBLISHED IN THE AMERICAN JOURNAL OF

PUBLIC HEALTH.

5

CONTINUED PAGE 6

When sequencing of the human genome iscompleted in three years, it will fill the equiv-alent of thousands of Minneapolis phonedirectories. And scientists in the University’snew Molecular and Cellular BiologyBuilding will be poised to begin making callson its 100,000 genes.

Research focus will switch from struc-ture to function—learning how genes work,what happens when they don’t, and how tofix them to prevent or cure serious diseases.Functional genomics is expected to revolu-tionize medicine.

“The health and economic benefits will be tremendous,” says Charles Moldow,senior associate dean for research in theMedical School. “That’s why it’s so importantto invest human and financial resources infunctional genomics now.”

The 1999 Minnesota Legislature providedthe University with $35 million for constructionof the $70 million Molecular and CellularBiology Building, which will be the center offunctional genomics research. Next year theUniversity will go back to the Legislature to ask for the remaining $35 million needed tocomplete construction.

“Thirty-five million for a new buildingis a very good and generous start,” Moldowsays. “But we need to be aware that allaround the country, universities are makinghuge investments in molecular and cellularbiology. Not just the Harvards and Stanfords,but large public universities such asMichigan, Wisconsin, and Iowa.”

For example, last May, the University of Michigan’s Board of Regents committed$200 million to a new genomics institute.The Michigan Legislature followed that witha $50 million allocation.

In a Chronicle of Higher Educationarticle, Michigan President Lee Bolingercommented that the biological revolutiontriggered by the completion of the humangenome project will equal the revolution in physics during the first half of the 20thcentury, when Einstein formulated the theoryof relativity, and quantum and particlephysics were explored.

The University of Minnesota’s newbuilding is the centerpiece of President Mark Yudof’s molecular and cellular biologyinitiative, which involves scientists on theMinneapolis, St. Paul,and Duluth campuses.The 230,000-square-foot, eight-level building

Now that

mapping of

the human

genome is nearly

complete, the huge

task of using this

information to

prevent and cure

diseases begins.

Scientists in the U’s

new Molecular and

Cellular Biology

Building will help

carry that work out.

CONSTRUCTION IS BEGINNING ON THE NEW MOLECULAR AND CELLULAR BIOLOGY BUILDING,WHICH WILL PROVIDE AN ENTRYWAY TO THE ACADEMIC HEALTH CENTER.

RE SEARCHSEARCH

Moleculesto miracles

CONTINUED FROM PAGE 5

6

will be located in the Academic HealthCenter. Situated on Washington Avenuebetween Church and Harvard streets, it willprovide a literal and figurative entryway tothe University’s health sciences schools andprograms. Ground was broken this fall, andconstruction is scheduled to be completed byDec. 31, 2001.

Planning for the building has beenaccompanied by a U-wide reorganization ofbasic sciences departments to support molecularand cellular biology and make more effectiveuse of human and physical resources. Scientists

who will occupy the building will come fromthree new departments that grew out of thereorganization: Biochemistry, MolecularBiology, and Biophysics; Genetics, Cell Biology,and Development; and Neuroscience.Additionally, new faculty with expertise infunctional genomics will be recruited.

Research programs will likely focus onexisting strengths, such as neuroscience andneurodegenerative diseases, immunology,cancer, and diabetes, Moldow says. Scientistsalso will be linked by interests in developingand using common bio-techniques to probe

and manipulate genetic information.

“Biomedical scientists today are work-ing with about 1 percent of the informationthey will have have after the function ofhuman genes is fully understood,” Moldowsays. “It’s really a miracle that we can treatillness as well as we can, given how little weknow about the underlying molecular basisof diseases.”

■ Peggy Rinard

Founding fathers

Perry Millard (1848-1897)moved to Stillwater,Minnesota in 1872 after los-ing everything he owned inthe great Chicago fire.Often summoned to loggingcamps to treat injuries, hesoon established a thrivingpractice. When he becamepresident of the MinnesotaMedical Association in 1882,he lobbied to create a med-ical school in the state. In1887 the regents named himdean, and in only threemonths he had appointed afaculty, established a three-year curriculum, and setadmissions and graduationrequirements and fees.

Medical School and School of Dentistryleaders who ushered in the last century will be memorialized in a history corridorplanned for the new Molecular and CellularBiology Building.

The buildings named in their honorhave housed generations of scientists, includ-ing two Nobel-prize winners, and witnessednearly a century of advances in biomedicalresearch. But memories of Perry Millard,

Elias Lyon, Alfred Owre, and ClarenceJackson—early leaders of the MedicalSchool and School of Dentistry—have faded with time.

This summer, Millard Hall, Owre Hall,and Lyon Laboratories were torn down tomake room for the new Molecular andCellular Biology Building. Jackson Hall wascompletely renovated. The demolition andreconstruction created a revival of interest in

the buildings and their namesakes, who willbe honored in a history corridor in the newbuilding. Fixtures and design motifs fromthe old complex will be incorporated intothe new building as another means of recog-nizing their heritage.

Here’s a glimpse of who these men wereand what they accomplished.

Elias Lyon (1867-1937),dean of the Medical Schoolfrom 1913 until his retire-ment in 1936, was consid-ered one of the chiefengineers of the school and“a sincere, modest intellec-tual with a humorousexpression and a kindlyglance.” He was devotedto medical students, andadvocated applying researchto clinical problems. Healso helped advance educa-tion for nurses. Early in his career, Lyon was aninstructor at Woods HoleMarine Biology Instituteand served as biologist ona scientific expedition toGreenland.

Alfred Owre (1870-1935),School of Dentistry deanfrom 1905 to 1927, haddegrees in both medicineand dentistry. His missionwas to unify the two fields,believing that physical anddental health were insepa-rable. Owre was noted forhis research on tooth decay,and he was president ofthe Minnesota DentalAssociation. A man ofeclectic interests, heauthored a book on dietcalled “Prunes andPancakes,” collected cloi-sonne artifacts, and was atireless hiker. His obituaryin the New York Timessays that he had hiked theU.S. from coast to coast.

Born in What Cheer, Iowa,Clarence Jackson (1875-1947) became dean of theUniversity of MissouriMedical School at the ageof 34. In 1913 he gave upthe job and took a pay cutto head anatomy at theUniversity of Minnesota,where he became one ofthe school’s most popularteachers and administra-tors. A colleague wrotethat he was “tall andhandsome with a splendidphysique,” and that “hisvoice inspired confidence.”He won many professionalhonors, and served as act-ing dean of the GraduateSchool twice before retir-ing in 1941.

RE SEARCHSEARCH

7

Charles Schulz often citesCharlie Brown, Snoopy, Linus,and Lucy during his lectures.Duh, you say? After all, Schulz,the St. Paul native, created thepopular “Peanuts” comic strip.True enough, but we refer toanother Charles Schulz—not the cartoonist, the psychiatrist.

“Yes, I use copies of his cartoons to pep up my lectures—it’s a lot of fun,” says S. CharlesSchulz, an Illinois native, who onJuly 15 became the head of theMedical School’s Department of Psychiatry.

Along with his appreciationfor the Peanuts creator, Schulzcomes to Minnesota with anadmiration for the University.And the U of M is delighted tohave him.

“Dr. Schulz is an interna-tionally recognized psychiatristwho has madeimportant con-tributions tomental healthin general andschizophreniain particular,”says AlfredMichael,MedicalSchool dean.

Before coming toMinnesota, Schulz served 10years as chair of Case WesternReserve University’s psychiatrydepartment and director ofUniversity Hospitals psychiatrydepartment in Cleveland. Priorto that, he conducted schizo-phrenia research at the NationalInstitute of Mental Health in

Maryland and started the schizophrenia program at theMedical College of Virginia inthe early 1980s. He holds a B.A.in history from the University ofSouthern California and an M.D.from the UCLA Medical School.

His most significant workhas been research on schizo-phrenia, which is characterizedby hallucinations, delusions,disorganized thinking, and/orapathy. About 2.5 million—orone in 100—Americans sufferfrom schizophrenia, whichstrikes males and femalesequally. Typically, it first isnoticeable by the age of 19 or20. There’s no known cause orcure, although it is treatablewith medication and counseling.

Through his research,Schulz discovered that youthwho suffer from schizophrenia

have a struc-tural braindefect. Previousstudies by otherscientists usingCT scannersindicated thatadult schizo-phrenics hadenlarged ventri-cles in the

brain, providing the first evi-dence that schizophrenia wasnot merely a psychologicalresponse to stress.

“At the start of my career,the question that remained was‘were enlarged ventricles a char-acteristic of the illness and didthey become enlarged frombeing treated with medications,

or was it a degenerative illness,’”Schulz explains. In 1980, he andhis colleagues at the MedicalCollege of Virginia set out tofind out. They performed CTscans on teen-agers, at about theonset of the illness, and foundthat those suffering from schizo-phrenia already had enlargedventricles. They also found thatas the size of the ventriclesincreased, the effectiveness ofmedication decreased.

A follow-up study by Schulzat Case Western using MRIscanners showed that teenagerswith schizophrenia and thosesuffering from bi-polar psychosisnot only had enlarged ventricles,but that spaces on the brain’scortex were also wider than onbrains of teens without the illness.A separate study by the NationalInstitute of Mental Health (NIMH)came to similar conclusions.

“I think our group and theNIMH group demonstrated thatteen-age schizophrenia and teen-age psychosis are really veryserious business,” Schulz said.

At the University ofMinnesota, Schulz will continuehis research using the University’sworld-class MRI facilities, buthe has broader goals for thedepartment. These includeestablishing a formal clinical trials division; coordinating theresearch and education effortsof the Twin Cities campus withthe Veterans AdministrationHospital; and working moreclosely with the state hospitalsystem to help treat the state’smost seriously ill patients.

■ Mark Engebretson

Thedoctoris in

Schulz discoveredthat youth who suffer

from schizophreniahave a structural

brain defect.

New Psychiatry

Department Head Charles Schulz

is widely known for his research

on schizophrenia in teenagers.

CHARLES SCHULZ IS THE NEW HEAD OF THE MEDICAL SCHOOL’SDEPARTMENT OF PSYCHIATRY.

8

Can your mind make you feel better? And if it can, how can people who are seriouslyill tap that capability to improve their qualityof life and perhaps even their chances of survival? Janice Post-White hopes to find the answers to those questions.

“There is a great deal of anecdotal evi-dence that techniques such as imagery helppeople survive cancer longer,” says Post-White, American Cancer Society Professor ofOncology in the School of Nursing. “As ascientist, I want to know how it works. Howdo these activities affect the immune system?”

Post-White has been studying this linksince 1981, while working on her master’sdegree. “I didn’t know anything about thisfield,” she says. “In fact, it didn’t even havea name yet. Today we call it psychoneuroim-munology, but at the time I was just inter-ested in why cancer patients on high doses of steroids got depressed when they stoppedtaking the medication.”

Since then, she has done several studies,mostly with cancer patients, to determinewhat happens to their bodies when they

imagine being in a place that brings comfortand peace, when they are treated with heal-ing touch or massage therapy, or when theysimply have hope.

In one clinical study she compared theeffects of imagery and support on coping,attitude, immune function, quality of life,and emotionalwell-being afterbreast cancer.Comparedwith patientson standardcare, patientsusing bothimagery andattending sup-port groupsimproved theircoping skills.Imagery participants, however, tended tohave less stress, increased vigor, and improvedfunctional and social quality of life.

The study also examined biologicalmarkers for immune function. Interestingly,there was very little difference between thethree groups’ physical immune responses.“It would have been wonderful to find aclear-cut answer,” Post-White says. “We doknow that stress reduces immune function,so perhaps these methods work by increasingrelaxation or because people are moreinvolved in caring for themselves, whichreduces stress.”

In another study, Post-White exploredhow different patients define and sustainhope. She also looked at the relationshipbetween hope, spiritual beliefs, and qualityof life.

Patients’ responses to the question“What gives you hope?” generally fell into

five categories: findingmeaning, relying on innerresources, having affirm-ing relationships, living inthe present, and anticipat-ing survival. Her next stepwill be to learn what makespeople with different per-sonality types—such asextroverts and introverts—feel hopeful. Ultimately, shewants to learn how nursesand families can reduce

stress and increase hope for cancer patients.

“Perhaps there really is a way to buildimmune response through imagery or otheractivities and we’ll find it with more sensitivetests,” says Post-White. “Until then, how-ever, I know how important hope is and Iwant to find out what I can do, as a scientist,that will help people lead more fulfilling livesduring these difficult times.”

■ Margaret Kaeter

“What gives you hope?” Cancerpatients’ responses to thatquestion generally fell into fivecategories: finding meaning,relying on inner resources,having affirming relationships,living in the present, andanticipating survival.

Hope healsSchool of

Nursing faculty

member Janice Post-White

studies the mind’s influence

over the immune system

JANICE

POST-WHITE

EXPERIENCED THE

TOLL CANCER CAN

TAKE ON A FAMILY

WHEN HER SON

BRENNAN WAS

DIAGNOSED WITH

LEUKEMIA TWO

YEARS AGO.

BRENNAN, WHO IS BEING

TREATED WITH

CHEMOTHERAPY, HAS

AN EXCELLENT

CHANCE OF A FULL

RECOVERY.

RE SEARCHSEARCH

PHOTO COURTESY

PIONEER PRESS

9

Sitting across the lake fromMark Dahl’s summer cottage 30miles north of Brainerd sitsCamp Knutson, a camp foryouth with special needs. In1992, Dahl discovered that sev-eral weeks on the camp schedulewere open. A light bulb cameon. Camp Discovery was born.

Beginning in 1993, for one week in July each yearCamp Knutson becomes CampDiscovery, a summer camp forchildren ages 10 to 13 with severeskin diseases. Dahl, head of theMedical School’s dermatologydepartment, was president of the American Academy ofDermatology (AAD) when hedeveloped the idea.

The goals of the camp,Dahl says, are to help the childrenhave fun, build their self-esteem, and show them that they’re not the only peoplewith skin disorders.

“It’s really an awakening for the chil-dren,” Dahl says. “They go back home withmore confidence.”

“Nobody is excluded at the camp,” saysJulie Winfield, a pediatric dermatologist at theUniversity of Minnesota and chair of AAD’sCamp Discovery committee. “The kids feelaccepted. They feel that people are not goingto judge them based on how they look. Peopleare going to allow them to just be kids.”

The AAD was instrumental in providingstart-up funds, which were repaid throughdonations from AAD members, dermatolog-ical societies, allied health groups, industrygroups, corporations, and individuals.

About 50 youth from 27 states attendedthe first Camp Discovery. All expenses for the youth—including airfare—are paid fromcontributions. For many of the campers,it marks the first time they’ve ventured from home.

The experience creates both opportuni-ties and challenges.

Each camper has the opportunity toshed inhibitions, meet others with similarskin disorders—campers and counselors—and experience camaraderie while roastingmarshmallows arounda campfire. Activitiesinclude horseback rid-ing, swimming,boating, arts andcrafts, archery, anddancing.

Meanwhile,the staff—counselors, nurses, and dermatol-ogists—has the challenge of making surethat each camper’s special needs are met.For example, the children with epidermolysisbullosa, one of the most severe skin diseases,require daily dressing changes. Epidermolysisbullosa, which ranges in severity, causespainful blisters that leave large raw patcheson the skin. Some other campers requirespecial diets or extensive medical care

regimens, while others needto avoid the sun or heat.

By the end of the firstCamp Discovery, it wasclear that the opportunitieswere realized and the chal-lenges met.

“It’s absolutely empow-ering for the kids,” Dahlsays. “And it’s empoweringfor the parents, too. Theysee that their children aregoing to be able to grow upand cope.”

Although at week’send, the campers return totheir harsher world—one of teasing and exclusion—Winfield notes that theCamp Discovery experiencebuilds within them a lastingself-confidence.

“It gives them innerstrength,” she says. “Partlybecause they meet counselorswho have some of the samechallenges and skin diseasesthat they have.”

The success of the first Camp Discovery, heldthe second week of July,prompted the creation of asecond camp in Pennsylvania,Camp Horizon, which runs

the second week of August each year.

In addition, Winfield was instrumentalin organizing a third camp for teens ages 14 to 16 with skin diseases. That camp isheld in June each year at Camp Knutson in

Minnesota. All told, thethree camps host a totalof about 165 youth eachyear. A fourth camp may open next year in California.

All in all, the camp-ing experience helps kids

realize that they can develop friendships,belong to a group, and grow up to have afulfilling life.

For more information about CampDiscovery, contact Debbie Kroncke or JulieWinfield at the American Academy ofDermatology at 847-330-0230.

■ Mark Engebretson

“It’s really an awakeningfor the children,” Dahl

says. “They go back homewith more confidence.”

A North

Woods camp

for children with

disfiguring skin

diseases helps them

discover the beauty

of their own natures.

OUTREACH

MORGAN TAPP, 13, HAD NEVER TOUCHED LAKE WATER BEFORE VISITING

CAMP DISCOVERY THIS SUMMER. TAPP, ABOVE WITH THE UNIVERSITY’SJULIE WINFIELD, HAS JUNCTIONAL EPIDERMOLYSIS BULLOSA, A PAINFUL

SKIN DISEASE THAT REQUIRES LENGTHY DAILY DRESSING CHANGES.

Skin deep

10

About all Jessie Middendorf remembersabout being five years old is feeling, in herwords, “like a garbage can.”

Middendorf, of rural Browerville,Minn.,was just days away from startingkindergarten in 1988 when she was diag-nosed with non-Hodgkin’s lymphoma.Weeks of radiation and chemotherapy at theUniversity of Minnesota left her bald, sore,and sicker than any little kid ever ought tobe. But it also did the job: Today the busy16-year-old cheerleader is a member of thegrowing group of individuals who have con-quered childhood cancer.

Making it possible for kids like JessieMiddendorf to beat cancer is one of modernmedicine’s brightest success stories. Thanks toresearch, the long-term survival rate for chil-dren with cancer has risen from one out ofthree in the 1960s to three out of four today.

Heartwarming as this success story is,it has a sobering sequel. As the number ofsurvivors has grown, it’s become clear thatmany have increased risk of other healthproblems, according to Les Robison, profes-sor of pediatrics and associate director forprevention and etiology with the Universityof Minnesota Cancer Center.

Robison is working to minimize sucheffects by learning more about them. He andcolleagues at the U and around the U.S. aregathering data from some 20,000 childhoodcancer survivors on deaths, second cancers,heart and lung complications, reproductiveproblems, genetics, and behavioral issues.

Though the decade-long study is onlyabout half complete, information gathered todate confirms the suspicions that promptedRobison to undertake it.

“We’re finding, as we expected, thatthere is mortality associated with the long-term complications of treatment patientsreceived as well as the cancer.”

The researchers hope the study willallow them to make specific connectionsamong cancer type, treatment type, andhealth effects. For example, they have foundan elevated risk for second cancers amongsurvivors of Hodgkin’s disease. While it isclear that radiation treatment contributessubstantially, other factors, such as genetics,may also determine risk.

“It’s a very complex picture,” Robisonsays. “It takes a large and varied populationof patients” to be able to draw specific con-clusions about cause and effect.

How will the information Robison andcolleagues are gathering help childhood can-cer survivors?

For those who have already undergonecancer treatment, “it tells us who’s at greaterrisk so we can recommend follow-up screeningand so forth,” Robison says. Middendorf,for example, returns to the University everyother year for a checkup. Results from thisstudy can give her doctors a better idea ofspecific late effects associated with her can-cer and the treatments she received, so theycan more quickly recognize and resolveproblems when and if they do occur.

In addition to providing a “heads up”on potential health repercussions, the studyalso will help strike the optimum balance

between effectiveness and negative effects oftreatment.

“For a newly diagnosed patient, it willhelp researchers fine-tune treatment to mini-mize long-term complications while still providing a cure,” Robison says.

A second phase of the study is lookingat the relationship between specific informa-tion—for example, radiation dose—andhealth risks. Researchers are also collectingcells from the inside of the mouths of sur-vivors as a source of genetic information.This information, Robison says, could helpguide development of cancer treatments customized to individual needs.

■ Mary K. Hoff

Life after cancerAs the number of

children surviving cancer

grows, so does the need

to identify and address

their special health needs

16-YEAR-OLD JESSIE MIDDENDORF, WHO WAS SUCCESSFULLY TREATED FOR LYMPHOMA

AT THE U WHEN SHE WAS FIVE YEARS OLD, RETURNS EVERY TWO YEARS FOR CHECK-UPS.

OUTREACH

11

Nicole Lurie has always consid-ered herself a community doctor.In September of last year hercommunity grew—by about 200 million people.

Currently on a leave ofabsence from the University asprofessor of medicine and publichealth, Lurie is the principaldeputy assistant secretary forhealth in the Office of PublicHealth and Science in the U.S.Department of Health andHuman Services.

There, Lurie works directlywith Surgeon General DavidSatcher, who “out of the blue”recruited her for the position lastyear. Together, they oversee thefollowing divisions under theOffice of Public Health andSciences: Disease Prevention andHealth Promotion, EmergencyPreparedness, HIV/AIDS policy,International and Refugee Health,Minority Health, Women’sHealth, Population Affairs,Research Integrity, the President’sCouncil on Physical Fitness andSports, and Veterans Affairs.

Last spring, Lurie returnedto the U to deliver the com-mencement address for theSchool of Public Health.Speaking to about 75 graduates,she urged them to learn bydoing and to keep learning. Shealso spoke about the goals ofher office, which are, “to movetoward a balanced communityhealth system, to eliminate

ethnic and racial disparities inhealth, and as we live increas-ingly in a global community, toimprove global health.”

To that end, Lurie is work-ing with Satcher and others to“remove racial and ethnic dis-parities while continuing theprogress we have made inimproving the overall health ofthe American people” by 2010.Areas of emphasis include infantmortality, cancer screening andmanagement, cardiovascular disease, diabetes, HIV/AIDS,and immunizations.

In an interview, Lurie saidthe biggest difference between hernew position and her position atthe U “is clearly both the rangeof issues that I’m dealing withand the difference of opportu-nity. I can have an impact on alarge population—the health ofa country.”

And after a year on the job,Lurie has become keenly awareof how political Washington can be.

“You have to deal with it,”she said. “If everybody agreedon what to do and how to do it,it would be done. The differencesof opinion stand in your way.”

Despite all of the timedevoted to her administrativeresponsibilities, Lurie still spendsevery Thursday morning practic-ing medicine in a clinic for peoplewithout health insurance.

“Never again will I take for granted the safety net inMinnesota,” she said of herD.C. experience. “I very muchappreciate what a leaderMinnesota has been in takingcare of its underprivileged. I alsoappreciate the creativity andwillingness to do things differ-ently to solve social problems.”

And Lurie always keepsspace open in her date book forher husband, Jesse Goodman, aprofessor of medicine at the U,and their three children. “In thefinal analysis, my family comesfirst,” Lurie said. “I try to struc-ture my day so that I can havequality time with them. Whenother things come up and theyneed me I have to make time tobe with them. Fortunately that’sbeen totally possible.”

Goodman currently is asenior advisor to the commis-sioner at the U.S. Food andDrug Administration. He is alsocontinuing to run his research labat the University of Minnesota.

Washington D.C. has atleast one drawback from the Ufor the doctors. “This is the firsttime in our professional livesthat we have not worked in thesame building,” she said. “I miss that.”

■ Bethany Johnston

Public

health advocate

Nicole Lurie, on leave

from the University

to work in the U.S.

Department of Health

and Human Services,

returned briefly to

speak at the School of

Public Health

graduation.

goes to Washington

NICOLE LURIE,PROFESSOR OF

MEDICINE AND

PUBLIC HEALTH, IS SERVING AN

APPOINTMENT

IN THE U.S.DEPARTMENT OF

HEALTH AND

HUMAN SERVICES.

OUTREACH

CROSSING

The Mind BodySpirit Clinic,

a joint venture between

the Academic Health

Center and Fairview

Health Services,

integrates conventional

medicine with

complementary healing

practices.

MidwestEastmeets

In most of the United States, physicians andpractitioners of alternative medicine essen-tially work in parallel universes. Though bothpursue the same goal—to heal patients—theyrarely communicate, let alone cooperate.

In the Mind Body Spirit Clinic, whichopened Sept. 27 at Fairview-RiversideMedical Center in Minneapolis, they notonly work under the same roof, they actuallywork together, practicing what has becomeknown as “integrative” medicine. Even theappearance of the 12th-floor clinic reflectsthis unusual marriage: Though located in ahospital, the rooms, which were designedwith the aid of a Feng-shui consultant (Feng-shui is the Taoist discipline of living in har-mony with the environment), have carpetedfloors, gurgling fountains, and art intendedto help patients relax.

The clinic, a partnership between theUniversity Academic Health Center and

Fairview Health Services, provides a widearray of alternative health care services,including meditation, support groups, clinicalhypnosis, acupuncture, massage, nutritioncounseling, herbal remedies, dietary supple-ments, and nondirective spiritual counseling.Faculty from the School of Nursing andMedical School serve on the clinic staff,assuring that patients receive conventionaltreatment when necessary.

“I firmly believe in all the benefits ofconventional medicine, especially in the areaof acute care,” says clinic medical directorSharon Norling, M.D., an assistant professorin the department of obstetrics and gynecol-ogy. “We have the best medicine in theworld, in many ways. This isn’t about a negative. It’s about taking that medicine and expanding healing options for patients.A principle of the clinic is that patients arepartners in their care and they have choices.”

HYPNOTISM

IS ONE OF THE

COMPLEMENTARY

CARE PRACTICES

OFFERED AT THE

NEW MIND BODY

SPIRIT CLINIC. HERE, DONALD

HOUGE HYPNOTIZES

SUE TOWEY.

12

13

The Mind Body SpiritClinic operates as the clini-cal arm of the Center forSpirituality and Healing,providing medical students,residents, and students in the University’s new interdisciplinary minor,Complementary Therapiesand Healing Practices, aplace to gain hands-onexperience and do research.“We want to have a placewhere we can provide care,but also where students canintegrate these complemen-tary therapies along withmore conventional prac-tices. It’s also important tohave a site for research,”says Mary Jo Kreitzer, RN,Ph.D., the Director of theCenter for Spirituality andHealing.

Another of the clinic’skey roles is to provide thepublic with reliable information about alter-native treatments. “There is a lot of informa-tion out there that isn’t accurate,” Kreitzersays. “If peopleare going to makethe choice to seekout complemen-tary therapies,they need accu-rate, reliable infor-mation. We willbe offering a classeach week calledExploring Choicesin Healing at theMind Body SpiritClinic. In thisclass, we will talk about becom-ing informed con-sumers and active participants in our own care,” Kreitzer says.

Clinic practitioners and physicians willcontinue to take a scholarly, evidence-basedapproach to treatment, Norling and Kreitzersay. Thus the initial comple-mentary services were cho-sen because there isevidence of their safety andeffectiveness. New serviceswill be added as demandand evidence grows.

To some extent,Fairview and the Universityare simply responding toconsumer demand.According to recentresearch, nearly half of allAmericans have tried com-plementary medicine. Butthe research also raises animportant concern, sinceherbs and other alternativeremedies may conflict withconventional medicines:

70 percent of Americans did not tell theirdoctors about the complementary treatment.

With physicians and alternative practi-tioners cooperating, clinicadministrators believe theycan provide better care. “Ithink every physician canidentify a dozen patientsfor whom conventionalmedical care has not ade-quately addressed theirneeds,” says GregoryPlotnikoff, M.D., the med-ical director of the Centerfor Spirituality and Healingand an assistant professorof clinical medicine andpediatrics who serves as astaff physician in the newclinic. “It’s those types ofpatients for whom the

clinic will be an important resource.”

The Mind Body Spirit Clinic does notprovide primary care. While individuals cancontact the clinic on their own, many willlikely be referred by primary care providers.

The clinic staff communicates andworks with thepatient’s primaryphysician.

“We think it’simportant that peo-ple be tied into aprimary careprovider and have avery thorough eval-uation to rule outany disease thatwould be moreeffectively treatedwith conventionalmedicine,” Kreitzersays. “We don’twant people todelay seeking con-ventional treatmentwhen that may bemost appropriate.”

Many of theclinic’s practitioners

have training in both conventional and andcomplementary medicine. Lead acupunctur-ist Pamela Weiss, for example, has an R.N.degree and a Ph.D. in nursing as well as anacupuncture license.

Norling says the Mind Body SpiritClinic should be operating at full capacity bythe end of the year. She expects it to expandby the year 2001—even though most patientspay for alternative treatments out of theirown pockets.

The long-term goal, Kreitzer says, is forthe University to weave the principles of theCenter for Spirituality and Healing and theMind Body Spirit Clinic into the education,research, and clinical care programs of theAcademic Health Center. “It’s a bold initia-tive for the University of Minnesota, for theAcademic Health Center, to say we are committed to being a national leader in this field,” she says.

For more information about the MindBody Spirit Clinic, call 612-672-5595.

■ Frank Clancy

DISCIPLINES

“I think every physician canidentify a dozen patients forwhom conventional medicalcare has not adequatelyaddressed their needs,” says clinic staff memberGreg Plotnikoff, M.D. “It’sthose types of patients forwhom this clinic will be animportant resource.”

TOASTING THE CLINIC’S OPENING WITH CHAMOMILLE TEA ARE ELAINE ANDERSON, BSN,PROGRAM MANAGER; SHARON NORLING, M.D., MEDICAL DIRECTOR; PAM WEISS, R.N.,PH.D., ACUPUNCTURIST; AND MARY JO KREITZER, DIRECTOR OF THE UNIVERSITY’S CENTER

FOR SPIRITUALITY AND HEALING.

CHRIS HAFNER, ASTAFF MEMBER OF

THE MIND BODY

SPIRIT CLINIC

DEMONSTRATES

HIS ACUPUNCTURE

SKILLS ON PAM

WEISS, ALSO AN

ACUPUNCTURIST.HAFNER IS

AN EXPERT

ON CHINESE

MEDICINAL HERBS.

One of the University’s newestRegents’ Professors is by his owndescription a “lab rat” with anearly life-long affinity for chem-istry. Yet, his introduction to thework that brought him this, thehighest recognition the Universitybestows on its faculty members,was entirely serendipitous.

Ashley Haase,professor and headof the MedicalSchool’s Departmentof Microbiology,first stumbled upona passion for virusesmore than 30 yearsago, when as amedical resident at Johns HopkinsHospital inBaltimore, heattended a lectureabout the work ofCarlton Gajdusekon so-called “slow”viruses. It was,Haase remembers,“the most interesting thing I’dever heard about.” (Slow virusesinfect human beings or animalsbut appear to lie dormant foryears before producing often-devastating symptoms. Gajduseklater won a Nobel Prize for this work.)

Haase began his ownresearch on slow viruses in theearly 1970s, after he became anassistant professor of medicineat the University of California,San Francisco and chief of theInfectious Disease Section in SanFrancisco’s VA hospital. Muchof his early research focused onthe visna virus, which infectssheep and causes symptoms similar to multiple sclerosis inhuman beings.

A decade later, AIDS beganto ravage San Francisco. “It wastruly appalling and frightening,because nobody knew what wasgoing on,” Haase recalls.“Increasing numbers of patientswere appearing in hospitals,dying of infections and rare dis-eases. All we knew was that itwas related to the immune systemand infectious in nature. Peoplewere extremely afraid. No oneknew how it was transmitted.”

Haase quickly saw parallelsbetween the visna virus andHIV, the human immunodefi-ciency virus. As it turned out,his early research was like basictraining for work on one of themost devastating epidemics ofthe 20th Century.

Haase, a native of theChicago area, came to Minnesotain 1984 to head the Departmentof Microbiology. Since then, hisresearch has focused mainly onunderstanding the dynamics ofthe AIDS virus. In the early 1990s,he and his colleagues developed atechnique, known as polymerase

chainreactionin situ,thatallowedthem topeer intocells andsee theviruslurking inlymphoidtissueslongbefore thesymptomsof AIDSappeared.This work

provided insight to how HIV isstored, how it reproduces in thebody, and how it begins to wreckhavoc on the immune systemsoon after infection occurs.Using the same methods, Haaseand his colleagues showed lastspring that the immune system ofa person with AIDS can actuallyrejuvenate itself if the underlyinginfection is controlled.

Haase was named Regents’Professor in June along with twoothers—Thomas Clayton, a pro-fessor of English and near Easternstudies, and John Sullivan, aprofessor of political science.There are just 20 Regents’Professors, who retain the titlefor as long as they remain at the University.

Colleague Patrick Cleary, aprofessor of microbiology, wasthe one who nominated Haase.“I thought he was doing fantas-tic work,” Cleary explains. “Ithought the University shouldrecognize what a star we have.”

“He’s certainly one of theoutstanding investigators in thefield of AIDS research,” saysAnthony Fauci, the director ofthe National Institute of Allergyand Infectious Diseases. “Hiswork has had a profound impacton AIDS treatment.” Haase’sdiscovery that HIV replicates inlymphoid tissue, Fauci explains,set the stage for the currentpractice of treating personsinfected with HIV very early,even if there are no symptoms.

“He’s one of theoutstanding

investigators in the field of AIDSresearch,” says

Anthony Fauci, theDirector of the

National Institute ofAllergy and Infectious

Diseases. “His workhas had a profound

impact on treatment.”

14

From‘lab rat’ to

RegentsProfessorAshley Haase, nationally

known HIV researcher, is dubbed a

Regents Professor—the University’s

equivalent of knighthood.

ASHLEY HAASE, NEW REGENTS PROFESSOR, IN HIS

LAB WITH POST-DOCTORAL FELLOW ZHI-QIANG ZHANG.

EDUCATION

Community partnerships

In 1985, Gordon Diedrich had extensive dentalwork at the University of Minnesota Schoolof Dentistry. Diedrich was pleased with thework, which took more time but cost muchless than if he’d gone to a private practice.But when it came time for his next check-up,he went elsewhere.

“Down at the University, I had to parktwo or three blocks away from the buildingwhere I go for treatment. It was inconvenient,”said the 87-year-old.

So, instead, Diedrich took his dentist’sadvice and visited the Wilder Senior DentalClinic near his home in West St. Paul. Theclinic is staffed by University faculty and residents under a contract with Wilder thatdates to 1981.

“We know that despite efforts toimprove access to our clinics, some peoplewant and need the kind of care we provide in

their own communities,” says Steve Shuman,associate professor in the University’s Schoolof Dentistry and director of the Wilder SeniorDental Program.

Like Diedrich, many other older peopleare taking advantage of the opportunity to seefaculty physicians and other health care pro-fessionals at the Wilder Senior Health Clinic.The Wilder Foundation leases space to theMedical School’s Department of FamilyPractice and Community Health, and con-tracts for services with the School ofDentistry, College of Pharmacy, and School of Nursing. In addition, HealthEast funds theUniversity’s fellowship program and ownsthree on-site nursing homes that are managedby University faculty physicians.

“The Wilder Senior Health Clinic is one of our models for community training,”says Frank Cerra, senior vice president forhealth sciences at the University ofMinnesota Academic Health Center.“Right now we train 75 percent ofthe students in hospitals when 75percent of the care is being deliveredin the community. What we’re tryingto do is reconnect education withthe care delivery system.”

William Jacott, chair of theMedical School’s Department ofFamily Practice and CommunityHealth, credits the clinic withstrengthening the University’s

geriatric programswhile providingquality care to St. Paul’s elderlypopulation. “We’revery pleased withthe partnership,” he says. “And weanticipate that someof our geriatric fellows will chooseto practice in the St.Paul area.”

Ken Hepburn, director of geriatrics pro-grams in the Department of Family Practiceand Community Health, points out that the site also offers interdisciplinary trainingopportunities. “It’s not just a partnershipbetween the University, Wilder, andHealthEast,” he says. “It’s a partnershipwithin the University—it’s really an AHC-wide clinic.” He adds that it also providesresearch opportunities.

“The University affiliation stands forquality,” Cerra adds. “As we expand ourcommunity-based education program, moreand more Minnesotans—both in the TwinCities and greater Minnesota—will havegreater access to health care provided byUniversity physicians, dentists, nurses, andpharmacists.”

■ Mark Engebretson

When he’s not traveling,Haase, who turns 60 inDecember, can often be found inhis lab on the 14th floor of theMayo Building, working along-side students and assistants. Inrecent years, he’s devoted muchof his time to developing and

refining a technique known asquantitative image analysis,which allows researchers tomeasure the amount of HIVthat is present in tissue samples.

In an age when many scien-tists function as lab managers

and administrators, it’s rare forsomeone of his stature to spendso much time in the lab, butHaase says it’s crucial to theway he works. “It’s probablynot the most efficient way towork,” he concedes, “but itenables me to see things and

interact with students and col-leagues much more . . . You par-tially think through your fingersand hands and eyes. At least inmy case, it’s essential.”

■ Frank Clancy

The Wilder

Senior Health

Clinic in St. Paul is a

model for training students

in the community, which is

where 75 percent of patient

care is now delivered.

GORDON DIEDRICH NOW SEES UNIVERSITY DENTISTS AT THE

WILDER SENIOR HEALTH CLINIC, WHICH IS CLOSER TO HIS HOME.

WHEN JAMES PACALA, FAMILY PRACTICE AND COMMUNITY HEALTH,MOVED HIS PRACTICE TO THE WILDER SENIOR CENTER, PATIENTS

CORNELIUS AND EDITH BOTHOF MOVED WITH HIM. CORNELIUS

HAS PARKINSON’S DISEASE AND EDITH HAS DIABETES.

EDUCATION

PICTURESOF HEALTH

FALL 1999

Nonprofit Org.U.S. POSTAGE

PAIDPermit No. 155

Minneapolis, MNOffice of Communications420 Delaware Street SE, Box 735Minneapolis, MN 55455

change service requested

The bond thatforms between person and pet can be a wonderful thing. Buteven the closest of these relationships can be threatened by mysteri-ous, frustrating behaviors. What can a pet owner do when Fido iswracked by fear, when Polly pulls her feathers out, or when littleLulu seems to have forgotten the meaning “litterbox?”

A lot more than most think they can, says Petra Mertens, thenew animal behavior expert at the Veterinary Teaching Hospitals.

“Whatever the animal, whatever the behavior problem, we try to help people understand the behavior and hopefully modify it,”Mertens says. Far too often, people don’t realize there is somethingthey can do. Consequently, undesirable behavior is a top reason pets are put to sleep.

When a pet owner approaches her for assistance, Mertens’ firststep is to give the animal a checkup to eliminate physical causes.Then she puts on her detective hat.

Take the Newfoundland a frustrated client brought to her a cou-ple of years ago because he refused to go outdoors. After making surethere was no physical problem, Mertens started asking questions.Eventually she discovered that the dog was terrified of flying insectsbecause it had been bitten by bees as a pup.

The solution? Patience, loads of attention—and a jar of flies.Mertens had the owner place a couple of insects in a jar, then keep itnearby when she was playing with or feeding her dog. Gradually, shewas to move the jar closer to her pet. It took close to a year, but “shegot to the point where he was walkable outside, and that’s all shewanted,” Mertens relates.

In addition to her work at the University, Mertens spends twodays each week at the Animal Humane Society in Golden Valley,one of the handful of animal shelters in the nation that offer formalbehavioral advising and rehabilitation services.

As intent as she is on solving pet behavior problems, Mertens iseven more intent on preventing them. She advises people to evaluatepet traits carefully and choose a species and breed that fits theirlifestyle. She also urges learning about the animal’s health and nutri-tion needs, beginning training on day one, and exposing the pet to a variety of people and places early on.

Finally, if a person does find themself with a pet with problems,Merten recommends getting help as soon as possible.

“It’s not wise to wait,” she says. “It’s not going to go away. Andthe longer it goes on, the harder it is to treat.”

■ Mary Hoff

Humans are from Earth, dogs arefrom Pluto... Sometimes that’s the way it seemswhen pets and people get on each others’ nerves.Behavior therapist Petra Mertens has some answers that can keep theserelationshipsfrombreakingup.

Petpeeves

PET ‘PSYCHOTHERAPIST’ PETRA MERTENS (LEFT) WORKS

WITH OWNERS TO UNDERSTAND CAUSES OF PET BEHAVIOR

PROBLEMS, WHICH IS THE KEY TO RESOLVING THEM.