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R 120500Z NOV 93 ZYB 




653-1315/TEL-.DSN 294-1315/-// 



(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 
ago. " 

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 
emotional reunion. 

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 
guests . 

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 
response . 

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 
or targets. 

"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, 
respectively . 

"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 
into man. 

"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 
year. " 

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 
category . 

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 
weight problem. 

"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 
regimen . 

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) . 
Scheduled Meetings: 

— 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 
Antonio . 

— 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 
article. ) 

— 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 


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