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SUBORDINATES WITH MEDICAL PERSONNEL, AS OPERATIONAL CONDITIONS
3. HEADLINES AND GENERAL INTEREST STORIES THIS WEEK:
(930418) -Twenty-six Years Later, Corpsmen Receive Bronze Stars
(930419) -Navy Medical Researcher Crucial in Gene Discovery
(930420) -Immune System Research Opens New Doors
(930421) -Reserve Medical Corps Officer Achieves a First
(930422) -Navy Doctor Praises Military Opportunities
(930423) -Yes You Do Want that American Express Card
(930424) -HEALTHWATCH: Staff Member Shows Healthy Weight Loss
HEADLINE: Twenty-six Years Later, Corpsmen Receive Bronze Stars
THE PENTAGON, Washington (NSMN) — In a ceremony 26 years
after the event, HM3 Barry Ronald Smith and RN Robert R. Wilson
were recognized as heroes by Secretary of the Navy John H.
Dalton, who presented them with Bronze Stars in front of a packed
room of family, friends, dignitaries and media.
"One of the great privileges of this position, " said Dalton,
"is recognizing extraordinary actions on the part of the men and
women in uniform.
"Normally this sort of thing takes place shortly after the
event. In this case, the event was more than a quarter century
Dalton explained the delay, saying, "Their actions were
extraordinary, and so too were the events following their heroic
efforts. Their unit remained under siege, and paperwork,
understandably, took a back seat to survival. Then Ron Smith and
Bob Wilson were transferred, and the paperwork never caught up
with them. " Until now.
On 10 November, the 218th birthday of the U.S. Marine Corps
and the eve of Veterans Day, the Navy recognized the unselfish
actions of veterans Smith and Wilson, who ran into a minefield
not once, but twice, to render aid to two fallen Marines and
remove them from danger.
The award presentation, held in the elegant Pentagon dining
room of the Secretary of the Navy, seemed greatly removed from
the destructive scene recounted in the citation. As the ceremony
progressed, the years and the emotions separating the two scenes
began to fall away.
In accepting the long delayed awards, both men hailed others
as the heroes, not themselves. Wilson took the opportunity of
the Marine Corps birthday to reflect on all Marines who, over the
Corps' 218 years, "paid the price of freedom, for God and
country. . . . They are the heroes, and may they rest in peace. "
Smith talked of the pride he felt when he had returned home
from Vietnam, the joy of greeting his family again, and the
obligation he felt he owed those who'd not returned — to live a
full life. "Two weeks ago at the Wall, my first time there, I
didn't think of sadness, death and dying, " he said. "I thought
of happy faces. The teenage jokes we played on each other. We
were kids; we used Clearasil, not shaving cream. " And in
remembering those friends, those who died and those who returned,
Smith's voice became slightly ragged as he battled his emotions.
"I feel so proud, " he said. "God bless the Marine Corps. God
bless our families . God bless this great nation of ours. "
From among those gathered, a reverent "God bless America"
punctuated Smith's closing remarks. The crowd held many people
who had served in Vietnam, or whose lives had changed because of
the War. Dignitaries included Deputy Surgeon General Richard I.
Ridenour, MC, USN, and Maj. Gen. D.A. Richwine, USMC.
Richwine, who was representing the Commandant of the Marine
Corps, gave the first hint that the ceremony would turn into an
Smith and Wilson received their Bronze Stars for actions
taken on 15 August 1967 while serving as corpsmen with the 3rd
Battalion, 4th Marines, 3rd Marine Division, Kilo Company in the
Republic of Vietnam. As an infantry lieutenant, Richwine had
served in Kilo Company in 1966, and he is now a member of the 3rd
Battalion, 4th Marines Association.
Retired CDR Leo Stanis was also in attendance. He was Kilo
Company's chaplain and had initiated actions to see Smith and
Wilson finally recognized for the heroic actions he had witnessed
in 1967. Stanis thanked Randy Paige for his assistance in
bringing today's ceremony to fruition.
Paige is a reporter for "The Crusaders , " a nationally
syndicated television show whose reporters find solutions to
their stories. After the chaplain's remarks, Paige took his
story from solution to reunion, bringing up several special
Platoon leader LT Peter Wymes, USMC, was first up; he had
not seen Smith and Wilson since Vietnam.
The next guests were even more poignant: parents of the two
Marines the corpsmen had risked their lives trying to save. The
mother of one of the Marines struggled to maintain her composure;
she had not realized her son had died surrounded by friends. "He
was in good company, " she said. "If I couldn't be there, " she
started, then dissolved into tears and into Wilson's arms.
"Your son was a hero, " he told her, then repeated what so
many corpsmen have said before, in actions and in words: "We did
our best . "
Story by Liz Lavallee, BUMED Public Affairs
SIDEBAR: Corpsmen Recognized for Service and Sacrifice
BUMED Washington (NSMN) — In Vietnam, Hospital corpsman was
the most decorated enlisted rate. For actions during that war,
corpsmen received three Medals of Honor, 29 Navy Crosses, 121
Silver Stars, two Legions of Merit, 290 Bronze Stars — now 292,
and 4,563 Purple Hearts. Many of these medals were awarded
posthumously; 620 hospital corpsmen were killed in action during
the Vietnam War.
HEADLINE : Navy Medical Researcher Crucial in Gene Discovery
REPLIGEN CORP., Cambridge, MA (NSMN) — Researchers have
discovered a new molecule that may be instrumental in regulating
specific human immune responses, as reported in two papers in the
4 November issue of Science.
Gary Gray, Ph.D., who headed the research team that
identified molecule Bl-2, explained its importance: "This
discovery may lead to the development of therapeutics that can
specifically inhibit an undesirable response without suppressing
the entire immune system. "
The generation of a normal immune response to foreign
invaders such as viruses and microorganisms requires the
interaction of several components of the immune system, including
antigen presenting cells (APC) and T cells. The research team
believes that Bl-2 is the critical co-stimulatory molecule
responsible for initiating an immune response and that blocking
its signal will allow antigen-specific suppression of an immune
Current therapies provide general, non-specific immune
system suppression that leaves patients vulnerable to bacterial
and viral infections. The ability to selectively inhibit immune
system response would be especially useful in organ transplants,
said Gray, which our immune system considers intruders it would
seek to destroy. Gray also said the targeted therapeutics would
have applications "in debilitating autoimmune diseases such as
certain forms of multiple sclerosis, rheumatoid arthritis and
diabetes . "
A crucial step toward discovery of Bl-2 was taken by CDR
Carl H. June, MC, USN, and Craig B. Thompson, who identified Bl-
1, for which the Navy holds the patent. While Bl-1 was known to
interact with CTLA4, a T-cell receptor, it generated only a
partial immune response. The partial response suggested to
researchers that another factor must exist to stimulate an immune
response. This led to the discovery of Bl-2, which also binds to
CTLA4 and has been shown to co-stimulate the immune response.
Bl-2 apparently delivers a second co-stimulatory signal that is
required to generate an immune response.
"Since 1989, we 've known that T cells only become active
when they have been stimulated by both an antigen and a co-
stimulatory factor, initially referred to as B7, " said Lee M.
Nadler, M.D. "The studies in today's Science demonstrate the
existence of a second molecule, B7-2, that may be the immune
system's initial 'decision maker. ' Since B7-2 is continuously
expressed by T cells, it may provide an earlier signal than B7-1,
which is not expressed until some time after an immune response
has been activated. We are conducting additional studies to
confirm our hypothesis that B7-2 provides the initial co-
stimulatory signal necessary to activate an immune response. "
B7-2 was discovered by a collaborative research team of
leading immunologists coordinated by Gray, Repligen Corporation's
director of molecular biology in discovery research, Cambridge,
MA; Nadler, Dana-Farber Cancer Institute, Boston; Jeffrey A.
Bluestone, Ph.D., and Thompson, University of Chicago; and June,
Naval Medical Research Institute, Bethesda, MD. The Navy has a
Cooperative Research and Development Agreement with Repligen
Story based on release from Clare Clifford, director, Corporate
Communications , Repligen
HEADLINE : Immune System Research Cpens New Doors
NMRI Bethesda, MD (NSMN) — Researchers at the Naval Medical
Research Institute 's Immune Cell Biology Program are working on
the development of a therapy that will allow them to better
understand T cells, which are central players in developing both
good and bad immune responses.
According to NRMI endocrinologist CDR David M. Harlan, MC, T
cells hold the key that may open the door to new life-saving
techniques. If researchers can understand what activates those
cells, they will be able to understand what activates the immune
Harlan explained: "The T cells act as sentries, and their
job is to circulate through the body looking for something that
is foreign and kill it. They also act as the quarterback of the
immune system, directing responses . We need T cells. A classic
example of disease where you don't have T cells is AIDS. HIV,
the AIDS virus, destroys the T cells of the immune system, and
without those T cells there to direct things, one may succumb to
virtually any infection. "
He said that the main goal of researchers is to learn how to
control the T cell — how to make it accept cells and tissues
they want it to accept, like a transplanted organ, and how to
make it reject things they want it to reject, like cancer cells.
"We want to know how to make it become activated when it needs to
be and how to prevent it from becoming activated when we don't
want it to be, " said Harlan.
Researchers know that T cells generate an antigen-specific
T-cell receptor. A receptor is a protein on the surface of cells
with the function of binding to specific hormones, growth factors
"We all have millions of different receptors on our T
cells, " said Harlan, "but each individual T cell has only one
specific antigen it ' s always 'looking for; ' its own very specific
area of expertise. "
Harlan said that in order for a T-Lymphocyte to become
activated, it has to see the antigen it is designed to recognize
through its receptor. It also has to receive a second, or co-
stimulatory signal (see previous article on the B7-2 molecule) .
"If the T cell sees its antigen and gets that co-stimulatory
signal, it knows to destroy that target, " he said.
"For example, during a viral infection, the T-Lymphocyte
'sees' cells infected with a virus and also gets a co-stimulatory
signal. The T-Lymphocyte is thus activated, and it kills the
infected cell, limiting the infection . A similar process happens
when we are given organ transplants . Our T cells become
activated and reject the graft.
"We want to know how T cells can differentiate between
invading antigens and you. "
Harlan referred to the research efforts at the University of
Chicago, saying that researchers there gave mice a drug that
kills the portion of the pancreas that makes insulin, the beta
cells, in the Islets of Langerhans. This made the mice diabetic.
They then took human Islets of Langerhans and transplanted them
into those mice that were now diabetic. That cured the diabetes
for two or three days, but then the mice rejected the human
islets, became diabetic again, and died.
These researchers then transplanted human islets into
another group of diabetic mice, but this time also administered a
reagent that prevented T-Lymphocyte co-stimulation. The drug,
given for two weeks only, prevented the rejection process. The
mice were watched for six months and they never became diabetic,
never rejected the human islets. As far as those mice were
concerned, the human Islets of Langerhans were mouse tissues.
The immune system of those mice was otherwise normal.
Subsequent tests backed up these findings, that a very
specific state of immune tolerance had been created, that the
mouse immune system had recognized the islets from the original
donor to which it had been tolerized. Those results support the
contention that it should be possible to transplant tissue from
an animal into a human with a reagent similar to the one they
gave the mice.
Harlan is very enthusiastic about the possibilities this
offers. "We're talking about developing a therapy that will
allow us to transplant an organ from an animal to a human
suffering from disease due to defective organ function. A drug
would then be given for a short time to prevent lymphocyte co-
stimulation, prevent rejection, and cure the disease. The organ
could be a heart, a kidney, a liver or Islets of Langerhans to
cure heart failure, kidney failure, liver failure or diabetes,
"So far, this has been done only from human to mouse.
Because it works in that mammalian system, it should be possible
to develop a similar strategy for transplanting animal organs
"A pig's heart is very similar to a human's. We want to be
able to use this technology to save human lives. Pigs are used
for meat and shoes, but all those hearts get thrown away. We
want to give a new heart, followed by two weeks of therapy,
giving the patient 's T cells those two weeks to learn to
recognize the new heart, then leave it alone. This would not be
painful. Nobody's hair would fall out."
In addition to transplant rejection, diabetes is a special
interest of Harlan's. He feels deeply about the suffering this
illness causes, especially in cases involving children. "The
diabetes that kids get, called type 1 diabetes, is a horrible
illness. Affected individuals suffer with more heart disease,
kidney failure, blindness, limb loss and premature death.
"As it stands now, we can give insulin, but that ' s only a
treatment, not a cure. I am dedicated to this research because
all of our therapies to date have been directed toward doing our
best to manage a bad situation. We need to learn how to prevent
the disease or cure it instead of merely controlling it.
"We now have an extensive body of evidence that diabetes is
a T-cell autoimmune disease. T cells go in and direct the
killing of the cells in the pancreas that make insulin. Other
autoimmune illnesses, like thyroid disease, are also mediated by
inappropriately activated T-Lymphocytes .
"Autoimmune illness is an illness caused by your immune
system attacking something that it shouldn't. It is attacking
you. It is recognizing a certain tissue of your body as abnormal
and getting rid of it, even though it is not abnormal. "
Harlan's idol is Dr. Frederick Banting, who won the Nobel
prize for discovering insulin.
"He was a GP (general practitioner) who went to a lab in
Toronto and asked to use it for experiments. He was given a lab
for the summer, received no money and lived in a one-room place.
He got a medical student, and the two of them worked all summer
looking for the protein that would cure diabetes. Over the next
couple of years, he was able to purify and crystallize insulin.
It was a miracle, an inspirational story.
"When it became obvious that insulin was going to be a
miracle drug, Banting was offered millions of dollars for rights
to it. He sold the patent rights to Lilly for one dollar. His
answer to that was, 'I didn't do it for the money. I did it to
cure diabetes . ' "
Story by Teal Ferguson, Journal staff writer
Reprinted from The Journal, 4 November 1993
HEADLINE: Reserve Medical Corps Officer Achieves a First
MSU East Lansing, MI (NSMN) — Doctor of Osteopathy Barbara
Ross-Lee, associate dean for health policy at Michigan State
University's College of Osteopathic Medicine, has been named dean
of the Ohio University College of Osteopathic Medicine, Athens,
OH. She becomes the first black woman to lead a medical school
in the United States.
Ross-Lee, who received her doctorate from MSU in 1973, is a
county medical examiner and a captain in the U.S. Naval Reserves'
medical corps. From 1983-1991, she was chair of the Department
of Family Medicine in MSU's College of Osteopathic Medicine.
Reprinted from MSU's Alumni Magazine, Fall 1993
HEADLINE: Navy Doctor Praises Military Opportunities
OHIO STATE Columbus, OH (NSMN) — LT Leon McDougle, MC, has
wanted to be involved in health care for as long as he can
remember . In addition to his interest in science and his desire
to improve the quality of people's lives, McDougle credits the
influence of a man he never met in helping make his career in
medicine a reality.
Growing up in Sandusky, OH, McDougle for years heard stories
about Dr. Waudell William Hunter, an African-American family
practitioner in Sandusky who saw a wide variety of patients . "I
never met Dr. Hunter, " says McDougle, "but I grew up hearing
stories about how he would accept chickens and farm produce from
patients who were unable to pay him. He became a real
inspiration to me. "
Years later, while reviewing a listing of African-American
alumni of The Ohio State University College of Medicine, McDougle
was delighted to discover that his mentor was an alumnus of Ohio
State's medical school, graduating in 1934. "I can't describe
what I felt when I saw his name listed in the program, " says
McDougle. "Dr. Hunter helped pave the way for me and other
African-Americans to get our medical degrees. "
The oldest of five children, McDougle graduated in 1985 from
the University of Toledo with a BA in biology. He entered the
College of Medicine on a naval scholarship and graduated in 1989.
Upon graduating from Ohio State, McDougle entered a family
practice residency at Naval Hospital Camp Pendleton, CA. "I
enjoy the whole concept of family practice, " he says. "The name
says it all. There's a wide variety of medicine involved in
treating the total family. I enjoy children and elderly people;
I also enjoy delivering babies. In family practice, I'm not
limited in what I can do. "
The Navy has allowed McDougle to expand his professional
horizons . In April, he returned from a six-month Western Pacific
tour of duty to Singapore, Thailand, the United Arab Emirates,
the Persian Gulf and Africa. During the deployment, he served
aboard USS Tripoli (LPH 10) as a member of fleet surgical team
five. Tripoli was the major surgical platform for the initial
six weeks of Operation Restore Hope in Somalia.
"In the Navy, I have seen cases that I probably wouldn't see
in a civilian practice, " says McDougle . "For example, in Somalia
I had the opportunity to take care of patients suffering from
malaria and illnesses caused by various other parasites . I also
have applied to take a tropical medicine course held in Puerto
Rico and the Dominican Republic to increase my proficiency in
treating such diseases. "
Of all McDougle ' s experiences in the Navy, his trip to
Africa had the most profound effect on him. "This has been my
first trip to Africa, but definitely not my last, " he says.
"There is a large public health problem in Africa. The continent
has a population of 600 million and a $290 billion debt. In a
continent where the number of HIV cases is skyrocketing, the
total budget for health care amounts to about $10 per person per
In his free time, McDougle and his wife, Natasha, an English
professor at El Dorado Community College, enjoy going to concerts
and traveling through California. His future career goals
include teaching in a family practice residency program,
returning to school for a master's degree in public health, and
continuing to talk to youth of all ages about how to better
prepare themselves for college and the various issues they will
face in today's society.
McDougle is the secretary and treasurer for the aerospace,
military and occupational medicine section of the National
Medical Association. He is also a diplomate of the Board of the
American Academy of Family Physicians and a member of the
Uniformed Services Academy of Family Physicians.
Reprinted from The Ohio State University College of Medicine
Journal, Summer 1993
HEADLINE: Yes, You Do Want that American Express Card
BUMED Washington (NSMN) — Frequent government travelers
have been using a government -is sued Diners Club credit card for
several years now. That ' s soon to end. The government ' s new
contract, which begins 30 November 1993, is with American
Express. So, don't cut up your card from American Express when
it comes "unsolicited" in the mail. And don't be too hasty in
cutting up your Diners Club card — you '11 need it for any travel
you take before 30 November.
HEADLINE: HEALTHWATCH: Staff Member Shows Healthy Weight Loss
NAVHOSP Camp Pendleton, CA (NSMN) — The Navy Physical
Readiness Test a recurring requirement that includes Navy
personnel being measured for their fat percentage.
Passing "the test of the tape" has become increasingly
difficult, especially with the termination of the overfat
This is the problem HM3 Amy Culver wished to address in the
hospital 's recent Wellness Fair. She did so by sharing her
personal struggle on how she finally was able to control her
"The Command Wellness Program works, " said Culver. "There
are a lot of people out there who are angry and probably scared,
but if they lose the weight, those negative feelings would be
replaced by a sense of accomplishment . "
Culver said that first you have to admit you have a weight
problem and be motivated to correct it . When she reported to the
command in February 1992, she weighed 195 pounds. She had been
at a previous high of 210 pounds after the birth of her second
child but had lost some 15 pounds while with the Marines (she's
an 8404 — a medical field service technician) .
During Culver's first few months at the naval hospital, she
gained back 5 pounds. "I was put on the remedial program, " she
said, "which made me mad because I was passing the requirements
of the PRT anyway. "
After her initial resentment, however, she put her heart and
mind into the task at hand and undertook a vigorous exercise
In addition to the scheduled exercises of the remedial
program, she took it one step further and started exercising
three times a week for two hours a day — sit-ups, push-ups, a
two-and-a-half -mile run and 45 minutes of aerobics.
Today, after a year of hard work, Culver is no longer 200
pounds. She has dropped 50 pounds and is a fit and trim 150, the
recommended weight for her height of 5 feet 9 inches.
"If your peers are trying to lose weight, " said Culver, "it
would help to give them encouragement and support . People would
come out and give me compliments , and it made me happy and
increased my resolve to exercise harder. "
She also credits the Wellness aerobics instructors, whom she
said volunteer their time and abilities to help fellow shipmates
get ready for the Physical Readiness Test .
She also outlined some of the things that helped her with
her program, like watching her diet by staying away from red
meats, using no extra salt, and sticking to diet sodas and black
or unsweetened coffee or tea.
Culver said she drank more water, ate more fruits and
vegetables and controlled the habit of binging. She said she has
learned to use exercise to release stress and that gives her a
chance to meditate spiritually.
Story by HM2 Edgar Nem Singh
4. Professional Notes: Information on upcoming symposiums or
conferences of interest to Navy Medical Department personnel and
wrap-ups on ones attended. Anyone with information to share in
this section should contact the editor (see the last paragraph of
this message on ways to do so) .
— 13-17 November 1993, Association of Military Surgeons of
the United States, 100th Annual Meeting, San Antonio.
— 18-20 November 1993, American Academy of Medical
Administrators , 36th Annual Conference and Convocation, San
— 19-21 November 1993, AMA regional meeting, "The AMA
Brings Washington to You, " Philadelphia. For information call 1-
— 20 November 1993, AMA regional meeting, "Physicians
Forum: Agenda for Action, " Philadelphia. For information call 1-
— 7-10 December 1993, Navy Aeromedical Problems Course and
Aerospace Medicine Technician Problems Course. For information,
call (904) 452-2457/2458, DSN 922-2457/2458. (Also see following
— 25 February - 4 March 1994, 35th Navy Occupational Health
and Preventive Medicine Workshop. For information, contact CAPT
Richard L. Buck, (804) 444-7575, ext. 451.
— 29-31 March 1994, Sea-Air-Space Exposition, Sheraton
Washington Hotel, Washington, DC. For information, contact
Pamela Broberg, Navy League of the United States, (703) 528-1775.
5. November observances and events occurring 14-21 November:
American Heart Disease Prevention Month
Child Safety and Protection Month
National Diabetes Month
National Epilepsy Awareness Month
American Indian Heritage Month
14 November: American Education Week begins
14 November: National Geography Awareness Week begins
14 November: Snore Day
15 November: National Children's Book Week begins
17 November: National Young Reader's Day
18 November: Great American Smokeout/Navy Smokeout Day
21 November: National Adoption Week begins
6. ADDRESSEES ARE ENCOURAGED TO SUBMIT INFORMATION AND NEWS
ITEMS OF MEDICAL DEPARTMENT OR BENEFICIARY INTEREST (IN STORY
FORMAT) BY TELEPHONE, FAX OR E-MAIL TO BUMED, ATTN: EDITOR,
NAVAL SERVICE MEDICAL NEWS (MED 00P2) . TELEPHONE (202) 653-1315;
DSN 294-1315. FAX (202) 653-0086; DSN 294-0086. E-MAIL
NMCOENLQBUMEDl . MED . NAVY . MIL .