THE SCOPE AND RESPONSIBILITY OF MEDICINE—A Forum with a Purpose

To engender discussion of what the scope and responsibility of medicine ought to be in today''s society, California Medicine printed in its June issue six essays by authors known to have keen if various interest in the subject.In presenting the essays the editors expressed hope that they would be the beginning of a forum from which a definition of our profession''s responsibilities may be distilled. Readers were invited to take part in a continuation of the forum in succeeding issues. Following are three contributions selected from those received to date. Others will be published in the months ahead.If you have thoughts on the subject, just address them to the editors of California Medicine, 693 Sutter Street, San Francisco, California 94102. Keep your essays short, please.     

THE SCOPE AND RESPONSIBILITY OF MEDICINE—A Forum with a Purpose

To engender discussion of what the scope and responsibility of medicine ought to be in today''s society, California Medicine printed in its June issue six essays by authors known to have keen if various interest in the subject.In presenting the essays the editors expressed hope that they would be the beginning of a forum from which a definition of our profession''s responsibilities may be distilled. Readers were invited to take part in a continuation of the forum in succeeding issues. Following are two contributions selected from those received to date. Others will be published in the months ahead.If you have thoughts on the subject, just address them to the editors of California Medicine, 693 Sutter Street, San Francisco, California 94102. Keep your essays short, please.     

THE SCOPE AND RESPONSIBILITY OF MEDICINE—A Forum with a Purpose

To engender discussion of what the scope and responsibility of medicine ought to be in today''s society, California Medicine printed in its June issue six essays by authors known to have keen if various interest in the subject.In presenting the essays the editors expressed hope that they would be the beginning of a forum from which a definition of our profession''s responsibilities may be distilled. Readers were invited to take part in a continuation of the forum in succeeding issues. Following are three contributions selected from those received to date. Others will be published in the months ahead.If you have thoughts on the subject, just address them to the editors of California Medicine, 693 Sutter Street, San Francisco, California 94102. Keep your essays short, please.     

THE SCOPE AND RESPONSIBILITY OF MEDICINE—A Forum with a Purpose

To engender discussion of what the scope and responsibility of medicine ought to be in today''s society, California Medicine printed in its June issue six essays by authors known to have keen if various interest in the subject.In presenting the essays the editors expressed hope that they would be the beginning of a forum from which a definition of our profession''s responsibilities may be distilled. Readers were invited to take part in a continuation of the forum in succeeding issues. Following are three contributions selected from those received to date. Others will be published in the months ahead.If you have thoughts on the subject, just address them to the editors of California Medicine, 693 Sutter Street, San Francisco, California 94102. Keep your essays short, please.     

THE SCOPE AND RESPONSIBILITY OF MEDICINE—A Forum with a Purpose

To engender discussion of what the scope and responsibility of medicine ought to be in today''s society, California Medicine printed in its June issue six essays by authors known to have keen if various interest in the subject.In presenting the essays the editors expressed hope that they would be the beginning of a forum from which a definition of our profession''s responsibilities may be distilled. Readers were invited to take part in a continuation of the forum in succeeding issues. Following are four contributions selected from those received to date. Others will be published in the months ahead.If you have thoughts on the subject, just address them to the editors of California Medicine, 693 Sutter Street, San Francisco, California 94102. Keep your essays short, please.     

RELEVANCE IN MEDICAL EDUCATION—Some Thoughts from a Forum

For the past several months the editors of California Medicine have conducted a forum in this journal on “Relevance for Today and Tomorrow in Medical Education.” The participants were from widely different backgrounds and represented many points of view. This statement is a distillate from published and unpublished material contributed to the forum. If it proves useful to any who may be concerned with new developments in medical education it will have served its purpose.     

RELEVANCE FOR TODAY AND TOMORROW IN MEDICAL EDUCATION—A Forum

Students of today question the relevance of much of their formal education. In medical schools the concern is particularly with the relevance of the educational experience to the professional commitment in modern society. To engender discussion of the subject, California Medicine in its January issue printed eight essays by authors known to have keen interest in the subject.Readers in California and elsewhere are invited to take part in a continuation of the forum in succeeding issues. The following are contributions selected from those received to date. Others will be published in the months ahead. At an appropriate time the material will be collated and, if feasible, the distillate will be prepared in the form of a statement.If you have thoughts on the subject, just address them to the editors of California Medicine, 693 Sutter Street, San Francisco, California, 94102. Keep your essays short, please.     

RELEVANCE FOR TODAY AND TOMORROW IN MEDICAL EDUCATION—A Forum

Students of today question the relevance of much of their formal education. In medical schools the concern is particularly with the relevance of the educational experience to the professional commitment in modern society. To engender discussion of the subject, California Medicine in its January issue printed eight essays by authors known to have keen interest in the subject.Readers in California and elsewhere are invited to take part in a continuation of the forum in succeeding issues. The following are contributions selected from those received to date. Others will be published in the months ahead. At an appropriate time the material will be collated and, if feasible, the distillate will be prepared in the form of a statement.If you have thoughts on the subject, just address them to the editors of California Medicine, 693 Sutter Street, San Francisco, California, 94102. Keep your essays short, please.     

RELEVANCE FOR TODAY AND TOMORROW IN MEDICAL EDUCATION—A Forum

Students of today question the relevance of much of their formal education. In medical schools the concern is particularly with the relevance of the educational experience to the professional commitment in modern society. To engender discussion of the subject, California Medicine in its January issue printed eight essays by authors known to have keen interest in the subject.Readers in California and elsewhere are invited to take part in a continuation of the forum in succeeding issues. The following are contributions selected from those received to date. Others will be published in the months ahead. At an appropriate time the material will be collated and, if feasible, the distillate will be prepared in the form of a statement.If you have thoughts on the subject, just address them to the editors of California Medicine, 693 Sutter Street, San Francisco, California, 94102. Keep your essays short, please.     

The Concept of Mainstream Medicine for All Californians—Part I Fifth Progress Report of the Committee on Role of Medicine in Society

This Fifth Progress Report is to be printed in three parts in California Medicine. Following the appearance of Part III the report will be bound in a pamphlet which may be ordered at $1 a copy from 693 Sutter Publications, Inc., 693 Sutter Street, San Francisco, California 94102.     

The Concept of Mainstream Medicine for All Californians—Part III (Conclusion) Fifth Progress Report of the Committee on Role of Medicine in Society

This Fifth Progress Report is being printed in three parts in California Medicine. Following the appearance of Part III the report will be bound in a pamphlet which may be ordered at $1 a copy from 693 Sutter Publications, Inc., 693 Sutter Street, San Francisco, California 94102.     

The Concept of Mainstream Medicine for All Californians—Part II Fifth Progress Report of the Committee on Role of Medicine in Society

This Fifth Progress Report is being printed in three parts in California Medicine. Following the appearance of Part III the report will be bound in a pamphlet which may be ordered at $1 a copy from 693 Sutter Publications, Inc., 693 Sutter Street, San Francisco, California 94102.     

The Role of Pediatric Nurse Practitioners as Viewed by California Pediatricians

A single-mailing questionnaire surveyed attitudes of members of District IX, American Academy of Pediatrics (California) toward the role of the pediatric nurse practitioner (pnp). Responses from 568 members (53%) represented a broad range of age, practice type (58% group, 25% solo, 17% “other”), geographic location, and opinion. The most favorable attitudes toward pnp use were expressed by young pediatricians in large-group and “other” categories; least favorable were solo practitioners older than 60 years. Practice type was more important than age. Most respondents expressed the opinion that a pediatrician-pnp team approach would enrich both professions, and that parental acceptance of the pnp was likely; but that pnp use would not reduce costs. Majorities favored the concept of the pnp as part of the practice team but under constant pediatrician surveillance: seeing the patient for part of the visit and participating under supervision in care for minor illness, but not replacing the pediatrician even in well-child care. Some pnps hope for a more independent role on the pediatrician-pnp team. Modification of both pediatrician and pnp ideas appears requisite to a team approach that will satisfy both professional groups and the public.     

Professional Corporations—Recent Developments

A lengthy, detailed article reviewing legal and tax problems of professional corporations has been withdrawn from this issue of California Medicine. Instead, we are presenting a status report which is simply another chapter in a continuing saga.     

WORKMEN'S COMPENSATION ACT—Some Aspects of Interest to California Physicians

This article was prepared by Mr. William M. Whelan, Director of Special Services, California Medical Association, under the supervision of Dr. Francis J. Cox, Chairman of the Medical Services Commission of the Association, and Mr. Howard Hassard, the Association''s Legal Counsel. It is intended as a brief synopsis of the California Workmen''s Compensation Law as it applies to the physician in private practice. It is not an exhaustive treatment of the subject. A physician who desires to acquaint himself in detail with California industrial practice should consult the article entitled “The Physician''s Role in Workmen''s Compensation,” California Medicine, 82:352-362, April, 1955. Inquiries regarding industrial medicine should be addressed to Mr. William M. Whelan, California Medical Association, 450 Sutter St., San Francisco 8.     

C.P.S.—Its Strengths and Weaknesses

The following, a supplement to the annual report of the Board of Trustees of California Physicians'' Service that was published in the March 1961 issue of California Medicine, was delivered at the 1961 Annual Session of the House of Delegates by Dr. John G. Morrison, chairman of the board.     

Medicine in Society—Part I: Change and Challenge

The Committee to Study the Role of Medicine of the California Medical Education and Research Foundation (CMERF) is grateful to Dr. Watts for the following paper which served as the philosophical basis for the Committee''s study and discussions. The Committee is also grateful to CMERF and to its president, James C. Doyle, for the encouragement and cooperation it has received in the course of its intensive study of a problem which is of great interest and concern to the medical profession of California.Dr. Watts'' background paper has served as a potent stimulus in directing the Committee''s attention to the continuing dialogue between medicine and society, and in focussing on problems and issues which will be the subject of the Committee''s Second Progress Report, excerpts from which are scheduled for publication in the next issue of California Medicine.     

Amino Acid Isomerization in the Production of l-Phenylalanine from d-Phenylalanine by Bacteria

To establish an advantageous method for the production of l-amino acids, microbial isomerization of d- and dl-amino acids to l-amino acids was studied. Screening experiments on a number of microorganisms showed that cell suspensions of Pseudomonas fluorescens and P. miyamizu were capable of isomerizing d- and dl-phenylalanines to l-phenylalanine. Various conditions suitable for isomerization by these organisms were investigated. Cells grown in a medium containing d-phenylalanine showed highest isomerization activity, and almost completely converted d- or dl-phenylalanine into l-phenylalanine within 24 to 48 hr of incubation. Enzymatic studies on this isomerizing system suggested that the isomerization of d- or dl-phenylalanine is not catalyzed by a single enzyme, “amino acid isomerase,” but the conversion proceeds by a two step system as follows: d-pheylalanine is oxidized to phenylpyruvic acid by d-amino acid oxidase, and the acid is converted to l-phenylalanine by transamination or reductive amination.     

A Nonproteolytic "Trypsin-like" Enzyme: Purification and Properties of Arachain

By the use of the proteolytic substrates benzoyl-dl-arginine-p-nitroanilide and benzoyl-l-arginine ethyl ester the enzyme arachain has been purified 325-fold from acetone powders of ungerminated peanuts. The pH optimum for the hydrolysis of benzoyl-dl-arginine-p-nitroanilide was 8.1 in tris buffer, and for benzoyl-l-arginine ethyl ester was 7.5 using N - 2 - hydroxyethylpiperazine - N′ - 2 - ethanesulfonic acid buffer. The purest fraction showed one main band with one to three minor bands on disc gel electrophoresis. The major protein component had an S_20,w of 6.20. The energy of activation for the hydrolysis of benzoyl-dl-arginine-p-nitroanilide was calculated to be 16 kilocalories. The Michaelis constant for benzoyl-dl-arginine-p-nitroanilide was 10 micromolar and for benzoyl-l-arginine ethyl ester was 110 micromolar. The enzyme showed essentially no activity with casein, dimethyl casein, or bovine serum albumin as substrates. A large number of peptides were hydrolyzed by the enzyme, only l-leucyl-l-tyrosine being resistant of the peptides tested. The results suggest that arachain is not a “trypsin-like” protease but is a peptide hydrolase.