R E E D O . D I N G M A N S O C I E T Y2 0 0 5 N E W S L E T T E R

GGrreeggoorryy HH.. BBoorrsscchheell,, MMDD

Dr. Borschel received his B.S. fromEmory University and his medical

training at JohnsHopkinsUniversity prior tocoming toMichigan to jointhe residency.During hisresidency here,

he spent two years in the FunctionalTissue Engineering Laboratoryworking on projects in tissueengineering. His research effortsresulted in the awarding of two grantson which he was the PrincipalInvestigator. He was given awards forthe best paper presentation at sixmeetings. He was honored with the2005 Crudup Award, given by theDepartment of Surgery to the chiefresident with the most distinguished

research achievements. Dr. Borschelhas 10 manuscripts and seven bookchapters in print, and has authored51 presentations. He co-edited withDr. David Brown, The Michigan Manual

of Plastic Surgery, published byLippincott, which serves as thenumber one training resource forresidents, medical students andnurses in many countries around the world. Since leaving Michiganthis summer, Greg went on to theUniversity of Toronto to engage in its Pediatric Plastic Surgeryfellowship. He is currently searchingfor an academic position where hisresearch and clinical niches canflourish. He and his wife Tina have two beautiful young children, Anjali and Nikhil. Greg can bereached at 424 Yonge St, Suite 713, Toronto, ON, Canada M5B 2H3; 416-979-7183; borschel@gmail.com.

hanks for looking at this issue, our second, of the Reed O.Dingman Society News. Despite my best intentions, we

did not publish a spring issue; I offer all the usual excuses.Michigan Plastic Surgery did have aneventful year, with many honors andaccomplishments, some significantchallenges, and some notable changes.In addition to news about ourgraduating residents, a report of ouryearly Dingman VisitingProfessorship, and news of generalgoings-on both here and among ouralumni, I would point your attentionto the item on our many visiting professors this past year. I amparticularly happy that our active effort to bring more visitingprofessors to Michigan throughout the year has beensuccessful. We have enjoyed visits from experts in our fieldwho are diverse in every imaginable way, and who greatlyenhanced our already-rich academic environment.Volunteers to visit are most welcome. I would also point youto this issue’s research update from Paul Cederna. Paul’sgroup has made enormous progress in the cutting-edge fieldof nerve transplantation; I think you will be impressed with thescope and depth of this effort.

We did have challenges this year, the biggest of which wasthe decision by the RRC for Plastic Surgery to place ourresidency program on probation. Although I thought twice(OK, about 20 times) about including this news in a “feelgood” newsletter, I ultimately concluded that it was best thatwe inform our alumni about this decision and about ourresponse. Details are enclosed by Steve Kasten, our AssociateResidency Director. We are all proud of Michigan’s ResidencyProgram; we are working hard, and are confident that we willmaintain the elite status we have enjoyed among Plastic Surgeryresidencies in the country.

Most, most importantly, this issue of the News gives datesand plans for next year’s Dingman Society Meeting, to be heldhere in Ann Arbor. This will be a special meeting because wewill honor Hack Newman, who will be retiring during the2006-2007 academic year. Please put the dates on yourcalendar, and please, please, please plan to attend.

Lastly, I hope to see you all at the Dingman Societydinner in Chicago at the end of this week.

Sincerely.With greatest admiration,

At this year’s Dingman graduation ceremony, held on June 10, 2005 GregoryBorschel, Sameer Jejurikar, and Robert Rodrigues celebrated the completionof their Plastic Surgery Residency. Over 140 attendees, including the residents’families, and the faculty, residents, and staff of the Section of Plastic Surgeryhonored Greg, Sameer, and Robert for their achievements and thanked themfor their contribution to Michigan Plastic Surgery.

TL E T T E R F R O M T H E S E C T I O N H E A D

G R A D U A T I N G R E S I D E N T S :G R A D U A T I O N D A Y 2 0 0 5

–By Dr. Steven Buchman MD

At the graduation dinner on June 10, 2005, Sameer Jejurikar, Gregory Borschel,and Robert Rodrigues celebrated the completion of their Plastic Surgery Residency.The faculty, residents, and staff of the Section of Plastic Surgery as well as theresidents’ families were all in attendance. Each graduating Chief Resident took anopportunity to share their thoughts and reminiscences about the culmination oftheir training; relating anecdotes andheartfelt appreciation for the supportand guidance of those that helped themalong the way. We are all exceptionallyproud of this year’s graduating residentswho are caring and competentphysicians that have achieved at thehighest levels and will be a credit to ourspecialty. We are honored to accept thisyear’s graduating class as our newestmembers of the Dingman Society.

Rodrigues, Borschel & Jejurikar receivingtheir Plastic Surgery Certificates

CChhrriiss PPaannnnuuccccii grew up in the Chicago suburbsand went to undergrad in Bloomington,Indiana (Indiana University). He joins the

University of MichiganSection of PlasticSurgery in this year’sintern class, havingmatched fromWashington Universityin Saint Louis. While

there, he worked toestablish a non-invasive quantificationmethod for axon regrowth after nerve injuryusing transgenic mice whose axonsconstitutively express yellow fluorescentprotein. As he adjusts to life in Ann Arbor,he thanks the 80 hour workweek andrecently closed SICU for allowing him timeto continue his hobbies of rock andmountain climbing and ballroom dancing.He’s been rock climbing all over but

concentrating in the mountains of thePacific Northwest with recent ascents ofMount Baker and Mount Adams inWashington in addition to a thirty daycrossing of British Columbia’s WaddingtonRange.

JJaammeess PP.. PPhhiilllliippss grew up inOklahoma, and did hisundergraduate work atOklahoma StateUniversity, and MedicalDegree at the Universityof Oklahoma.

RRoobbeerrtt BB.. MMaanniikkeerr

grew up in ClevelandOhio, and did hisundergraduate work atUniversity of Michigan,and Medical Degree at theUniversity of Michigan.

2 R E E D O . D I N G M A N S O C I E T Y

SSaammeeeerr SS.. JJeejjuurriikkaarr,, MMDD

Dr. Jejurikar was a Michigan “lifer”. He attended undergraduate and medical

school at the Universityof Michigan, in the 7year combined program.We were lucky to attracthim to stay to do hisresidency training withus, as well. He spent two

years in the MuscleMechanics Laboratory, studying skeletalmuscle denervation injury. He haspublished 11 journal manuscripts, beenawarded two research grants as principalinvestigator, and has given 11 presentationsat national meetings. Dr. Jejurikar wasselected to be the sole resident member ofthe Plastic Surgery Residency ReviewCommittee, selflessly devoting may longhours toward evaluation and betterment ofplastic surgery training programs in theU.S. Sameer was also selected to be theadministrative Chief Resident in theSection, and served as an excellent leaderand mentor to our junior residents. Hewas accepted for fellowship training in thehighly coveted aesthetic program at TheManhattan Eye and Ear Institute. Dr.Jejurikar is currently refining his search fora job to begin next summer.

He and his wife Maria have two wonderfulchildren, Sophie and Kai. Sameer can bereached at 1161York Avenue,Apartment 9-L,New York, NY 10021; 734-223-2594; sjejurikar@gmail.com.

RRoobbeerrtt RR.. RRooddrriigguueess,, MMDD

Dr. Rodrigues grew up in Butte, Montana,and completed his undergraduate degreefrom Carrol College in Helena. He then

moved to Denver, Co,for his medical degreeat the University ofColorado. After 4years in the integratedprogram at CaseWestern Reserve, the

plastic surgery residency program wasclosed by the RRC. UM was fortunate topick-up Dr. Rodrigues who finished hislast two years in our plastic surgery trainingand is now one of 5 Hand Fellows at theprestigious Mayo Clinic. He and wife,Diana, and three children--Tristan (10),Bryson (8), and Eliya (3)--are still unclearas to where they will relocate following thisone year fellowship.Robert can be reached at 4860 Valley Dr.NW, Rochester, MN 55901; 507-292-0314; robert.48176@gmail.com.

A L U M N I A N D

R E S I D E N T N E W S :Tim Janiga announces the birth of daughter AylaChristine Janiga. His wife Jennifer starteddermatology residency atHenry-Ford.

Keith Wolter and wife Jillannounce their first child,Fiona Skye Wolter, onAugust 25th, 2005. She,and Mom, are doing great!No new pets – the dog isvery jealous, though.

Jafar Hasan announce the birth of his sonAhmed Hasan. He also won MicrinsMicrosurgical Instruments Award forOutstanding Clinical Research (at theDingman talks). The Authors: J. Hasan, K. Chung., A. Storey, M. Bolg, P. Taherititled “Financial Impact of Hand Surgery Programs on

Academic Medical Centers”

(Graduating Residents continued)

N E W R E S I D E N T S W E L C O M E !

RE S I D E N C Y PR O G R A M NE W S

By Steve Kasten, MD

On the residency front, there is mixed news.We had another successful recruiting year,and matched three outstanding students intothe integrated program. This July wewelcomed Chris Pannucci (MD, WashingtonUniversity), Jimmy Phillips (MD, OklahomaUniversity) and Rob Maniker (MD,University of Michigan) as our new interns.Expect great things from them in the future.

Although our training programcontinues to improve in many ways andproduce outstanding residents, we mustinform you that the Plastic SurgeryResidency Review Committee (RRC) hadthree concerns at our site visit in 2004. Wefelt that the concerns were easily addressedand petitioned the RRC with our solution.The RRC agreed; it appeared that the issueshad been resolved, but felt that probationwas warranted until it could be documentedwith a repeat site visit. Confident that wewere in complete compliance with theprogram requirements, we requested anexpedited repeat site visit. We are pleased toinform you that we completed that site visitAugust 29th, and presented thoroughdocumentation that we remain anoutstanding program. We eagerly await aresponse from the RRC and anticipate areturn to full accreditation.

32 0 0 5 N E W S L E T T E R

Dr. Christi Cavaliere was awarded theRobert Wood Johnson Clinical ScholarsProgram and married Todd Bafus inDecember.

Salvatore J. Pacella, M.D. was married on May 28, 2005 to Jennifer Flegier inBuffalo, N.Y. Several of his fellow residentsand attendings attended the ceremony. Dr. Pacella also graduated with an M.B.A.from the Ross School of Business at theUniversity of Michigan in May 2005.

Marlene (Calderon) Welch completed hertraining in June of 2004. Since that time,

she has been an AssistantProfessor of Surgery at theMedical University of Ohioin Toledo. She successfullycompleted her written boardexamination and is preparing

for her oral board examination.Throughout her residency, Dr. Welch wasactively involved in basic science research andearned a PhD in muscle physiology. She iscurrently collaborating with Dr. GeorgeCicila and Dr. David Allison at MUO,preparing to submit a KO8 grant. She isworking on a rat model of obesity to definecandidate genes for polygenic obesity. Dr.

Welch has a busy clinical practice withemphasis on breast surgery. In March,Marlene Calderon married Philip Welch, ofAnn Arbor. They reside in Dundee,Michigan and are looking forward to thebirth of their first child December 31st.

Ramin Behmand, MD (UMPRS ‘01)continues to thrive in private practice in theWalnut Creek suburb of San Francisco, CA.The office and staff of the Behmand Instituteof Plastic Surgery provide an atmosphere forsuperior patient-centered care. Dr.Behmand has now begun to share hisexpertise as an instructor in the Division ofPlastic & Reconstructive Surgery of theUniversity of California at San Francisco.He is highlycommitted to the clinicaladvancementof ourspecialty. He has beentraveling onsurgical missions since residency, mostrecently to the Philippines this year,operating on children with congenital andacquired deformities. He is a true credit toour training program.

A L U M N I A N D R E S I D E N T N E W S : (continued)

Dr. Ian Jackson, Chief of Plastic Surgery and Director ofthe Craniofacial Institute at Providence Hospital, served asour 17th Annual Dingman Visiting Professor June 9-10,2005. Dr. Jackson is an internationally renowned andrespected figure in plastic surgeryand we were honored to have theopportunity to have him visit us inAnn Arbor. Dr. Jackson gave afantastic presentation at theDepartment of Surgery GrandRounds entitled “Management ofSkull Based Tumors”. His talkemphasized to our colleagues inSurgery the multifaceted role thatplastic surgeons play in helping tosolve a wide variety of reconstructiveproblems in a diverse assortment ofpatients. The residents had the opportunity to benefit fromDr. Jackson’s expertise first hand during informal teaching

sessions and through case presentations. He also served asour distinguished judge and guest moderator for our annualresident research competition. The afternoon of researchtalks by our trainees rivaled the program at any of our

national meetings. This years Micrin’sPlastic Surgery Basic Science Awardrecipient was Gregory Borschel. TheClinical Research Award recipient wasJafar Hasan. Dr. Jackson’s DingmanLecture Entitled: “Management ofCraniofacial Vascular Malformations”,was both enlightening and humbling.The breadth of his knowledge,experience and skill in a particularlychallenging aspect of our specialtycaptivated all those present. The faculty

and residents of the Section of PlasticSurgery would like to thank Dr. Jackson for serving as the2005 Dingman Lecturer & Visiting Professor.

1 7 T H D I N G M A N L E C T U R E & V I S I T I N G P R O F E S S O R S H I P

M A R G A L I O T ’ S

D E P A R T U R E :We are sorry to be losing one of ourstaff members this year. Dr. ZviMargaliot, who joined the faculty in thesummer of 2003, has left us to return

to Toronto, Canada.After completing hisplastic surgerytraining at theUniversity ofToronto, Ontario,Canada. Dr.

Margaliot completed a hand andmicrosurgery fellowship at the KleinertInstitute in Louisville, Kentucky. Hewas a valuable addition to our busyfaculty, and he will be missed.

Zvi has taken a position at TrilliumHealth Centre in Mississauga, Ontario,which is in the Greater Toronto Area,working as a hand and wrist surgeon.He will also be covering hand andplastics call at Trillium Health Centre,the Credit Valley Health System, HaltonHealth System, and William OslerHealth Care Centre. This is a non-academic position.

Drs. Behmand & Kasten

Dr. Ian T. Jackson

4

This year is particularly exciting for thehand program because a number of ourresidents have matched into handfellowships and we are hosting severalinternational hand surgery fellows whoare training with us. Robert Rodrigues isdoing his hand fellowship at the MayoClinic, which is one of the premier handsurgery programs in the country.Catherine Curtin, after a successfulRobert Wood Johnson ClinicalScholarship, will do her hand fellowshipat Stanford University, another premierhand surgery program where she canfoster her research and clinical interest inthe upper extremity rehabilitation ofspinal cord injuries. Equally impressive isChristi Cavalier’s selection as the 2006-8Robert Wood Johnson Clinical Scholar atthe University of Michigan. She will learnabout clinical trials and outcomesresearch during her two-year fellowship.

Many international scholars aretraining with us in hand surgery. DrKenji Kawamura, Assistant Professor ofSurgery at Nara University in Japan, isdoing a 6-month hand/researchfellowship with us. He has alreadysubmitted three manuscripts forpublication. Dr S.E. Kim, an attendingplastic surgeon from Pohang, SouthKorea is starting his one yearhand/research fellowship with us.

A couple of foreign fellows sponsoredby major societies in the US will also visitus in the next few months. Dr Ching-Hua Hsieh, attending plastic surgeonfrom Chang Gung Memorial Hospital inTaiwan, is the American College ofSurgeons International Travelling Fellow.He will visit us as part of his fellowship.In 2006, Dr Maria Skvortsova, a handsurgeon from Moscow, Russia will visit usas the American Society for Surgery ofHand International Fellow.

We are privileged to have aninternational interest to learn from us.Our international trainees and visitorshave enriched our residency program. Ithas also provided invaluable experiencesfor our faculty and residents to new ideasand cultures from abroad.

––KKeevviinn CChhuunngg

R E E D O . D I N G M A N S O C I E T Y

Gulden Avci, MD Ministry of Health, Dr. LutfiKirdar Kartal Education &Research Hospital, Instanbul, Turkey

William Kuzon, MD, PhD 12/2004 – 3/2004

C L I N I C A L F E L L O W S , 2 0 0 4 - 2 0 0 5

Ayman Ahmed Elmeligy, MD Ain Shams UniversityCairo, Egypt

Steven Buchman, MD 9/2004 – 9/2006

Mazen Silman Al-Janabi, MD Shaikh Khalifi Medical CenterAbu Dhabi, UAE

Edwin Wilkins, MD 6/2005 – 8/2005

Kenji Kawamura, MD Nara Medical University,Nara, Japan

Kevin Chung, MD 6/2005 – 12/2005

Seong Eon Kim, MD Pohan SM Christianity Hospital,Pohang, Korea

Kevin Chung, MD 9/2005 – 8/2006

NAME HOME INSTITUTION UM HOST FACULTY TENURE

Dr. Shohei Omokawa, Chief ofOrthopedic Surgery at Ishinkai-YaoGeneral Hospital in Osaka, Japan visitedthe Section of Plastic Surgery in September2004. Dr. Omokawa’s visit was part of hisitinerary as the Traveling Fellow of theJapanese Society for Surgery of the Hand.Dr. Omokawa observed our clinics andoperating rooms, and gave didactic sessionsfor our faculty and residents, including asession on his innovative approach todifficult phalangeal fractures.

Drs. Sherick, Peled & Buchman

F O R S A L E :

Dr. Gary Nobel who will be coming toAnn Arbor for his Medical SchoolAlumni Reunion, October 7-8 is alsowinding down his practice in SanDiego, California in the next year.

Of course, he hopes a U-MGraduate will assume his practice. Ifinterested, please contact Dr. Nobel atglnob@aol.com.

Dr. Issac Peled, Professor and Chief of theDepartment of Plastic Surgery at RambamMedical Center in Haifa, Israel, visited theSection of Plastic Surgery in August, 2004.Dr. Peled spent time in the clinic and theOR, and gave two teaching sessions oninnovative approaches to clinical problems,including wound closure, lipreconstruction, and the cleft lip nasaldeformity. Dr. Peled is a Dingman Societymember, having completed a fellowshipwith Dr. Dingman.

I N T E R N A T I O N A L F E L L O W S

52 0 0 5 N E W S L E T T E R

This past academic year, the faculty andresidents at Michigan continued to excelat both the national and internationallevel, receiving honors, awards, andspecial recognitions that are far toonumerous to cite individually. Thefollowing are some of the highlights,offering a glimpse of our proudaccomplishments.

Our faculty has traveled all over theworld giving invited lectures and visitingprofessorships this year. Dr. Kuzon wasinvited to speak on neurovascular muscletransfers at “Advances in Plastic Surgery,” aninternational symposium held inHannover, Germany. Dr. Rees traveledto Paris, France, to present at the WorldUnion of Wound Healing Society.

Finally, Dr. Chung presented his workon distal radius fracture fixation as aninvited speaker both in Japan and inAustralia, adding 2 additional continentsto the list.

Closer to home, Dr. Buchman gaveseveral invited lectures, on topics rangingfrom facial fractures to stem cells, at theFlorida Cleft Palate meeting in DaytonaBeach. In New York City–on September11, 2004, in fact–Dr. Chung reportedon his Sterling Bunnell travelingfellowship to the members of theAmerican Society for Surgery of theHand. On the heels of completing thisvery prestigious fellowship, Dr. Chunghas been awarded an additional honor:as the American College of Surgeons’

2004-2005 Australia/New ZealandTraveling Fellow, he will continue torepresent Michigan Plastic Surgery on theinternational stage.

Our residents continue to make usvery proud as well. For his work in tissueengineering, Dr. Borschel took homethe Best Research Paper Award at the2005 Plastic Surgery Senior ResidentsConference, the Outstanding BasicScience Paper Award at the MichiganAcademy of Plastic Surgeons, and theFirst Prize for PSEF Basic Research GrantAward at the 2004 ASPS meeting inPhiladelphia. To recognize his overallaccomplishments in research, Dr.Borschel also received the CrudupAward, given annually to the residentwith the most outstanding researchrecord in the Department of Surgery.

There are far too many additionalhonors to list in this brief column, manyof which are equally impressive. Pleasejoin us in congratulating all of our facultyand residents on another outstandingyear.

F A C U L T Y / R E S I D E N T A C C O M P L I S H M E N T S :

1st row - Gregory Borchel, Robert Rodrigues, William Kuzon Jr, Sameer Jejurikar

2nd row - Cynthia Marcelo, De-Hong Tang, Edwin Wilkins, Salvatore Pacella, PaulCederna, Steven Haase, Nicholas Watson, Jafar Hasan, Christi Cavaliere, CatherineCurtin, Daniel Sherick, Emily Hu

3rd row - teven Kasten, Laura Monson, Amy Holland, Keith Wolter, Brent Egeland, Joon Choi, Jeffrey Kozlow, Timothy Janiga, Andrew Zwyghuizen, Douglas Sammer, Amy Alderman, David Brown

Not pictured - Steven Buchman, Kevin Chung, Zvi Margaliot, M. Haskell Newman, RileyRees, Richard Beil, David Hing, Paul Izenberg, John Markley, Robert Oneal, MichaelBernstein, Edwin Chang, Jonathan Wilensky, Tonyia Seeland, Melanie Urbanchek

U N I V E R S I T Y O F M I C H I G A N

S E C T I O N O F P L A S T I C S U R G E R Y 2 0 0 5

J O Y G . L O V E ’ S

MM YY LL II FF EE WW II TT HH OO UU TT

PP EE RR FF EE CC TT II OO NN

B A S E D O N A T R U E S T O R Y

Joy Love was a patient of Dr. Dingman’sand dedicated the book to him.

Available at www.publishamerica.com oramazon.com or your local book store.

On November 16, 2002 in NorthVietnam, an enduring friendship came toan abrupt and mournful end. The placewas Hoa Binh –“Peace” inEnglish – astruggling,dusty little city located 43 miles westof Hanoi. The mainthoroughfarebisecting thebustling, but poor metropolis is dailyfilled with the cacophony of the blaringtrumpets of lorries, incessant beeps ofmopeds and honking of automobilehorns. Just off this street, at the bottomof a slight incline is a squat, sprawlinghospital complex of vintage Frencharchitecture. Peeling beige paint and airybuildings speak of another, and perhaps,better time. The Vietnamese had longrepaired the craters and the hole blownthrough the roof of the main building byUS Air Force bombing during theVietnamese-American war. JohnO’Connor and I had come to this City ofPeace on a medical mission, and it washere in this spare, old hospital – the sameroom where we had operated on palatesjust 12 hours earlier – he lay dying.

It had all started, 30 years before and8,000 miles away in the quintessentialuniversity town of Ann Arbor. We werefellow residents in plastic surgery at theUniversity of Michigan. It was a uniqueclass–Bruce Novark, an oral surgeon,John, a dentist and otolaryngologist, andmyself, a general surgeon – all boardcertified. We would be guided, for twoyears, by a notable troika of teachers –each a perfect compliment to the othertwo: the cerebral and perfectionist BobOneal; the meticulous and methodicalBill Grabb whose encyclopedic knowledge

of plastic surgery was downrightintimidating; and the chief – aninnovator, pragmatist and super-surgeon,the imperturbable Reed O. Dingman. Tohold together that disparate sextet ofpersonalities was the supremely efficientand erudite Lauralee Lutz, a.k.a. L-3,who carried the rather insufficient title of“Secretary”, but whom we residents knewwas the “de facto Chief”. Those wereheady times, and more than anyone, wecould attribute our fine spirit ofcamaraderie and cooperativeness to thattall, effervescent Nebraskan, JohnO’Connor. I can say, without fear ofcontradiction, that we had the finestplastic surgery group anywhere. John and I bonded despite ourconsiderable differences. How manyresidents with a family, at the end of along day, would come by the operatingroom to find out how things were goingand give a hand in an in-continuity resection of aleft forehead melanoma,parotidectomy andradical neck dissection –or drop by at the end ofthe day and help finish ahip disarticulation andthigh flap? JohnO’Connor would. Wecovered each other’s casesand freely shared ourexpertise. Politics neverintruded on ourconversations, but weknew and respected eachother’s sentiments. Johnhovered to the right of the center, I wasfirmly implanted to the left, but over thatchasm we found a bridge of commoninterests and mutual affection. I hadprofound respect for his breadth ofknowledge, his intellectual curiosity, andhis intellectual honesty.

John was one of those rare individuals

a person meets, maybe, once or twice in alifetime – a sui generis. Where do you finda guy whom you have to fight to pay thebill every time you go to a restaurant? Wewere in Williamsburg, Virginia, in 1985and John told me about this excitingrestaurant located on an old plantation.By that time, I had up given up squabblingwith him over who would pay and statedflatly: “ John, it is my turn to pay and Iam not going unless we have that clear!”Thinking he had conceded, we went to therestaurant that evening. Never sure thathe hadn’t again outwitted me, Isurreptitiously handed the maitre d’ mycredit card and told him: “That big fellowthere with the toothpick stuck between histeeth is going to try to pay the bill, butjust tell him it’s been taken care of.” Themaitre d’ sympathetically responded: “ Iam sorry, sir, but that big fellow came inthis afternoon and paid.”

John could be devastatinglyoutspoken. His frankness was nevermotivated by viciousness – just honesty.Once he walked in the operating roomwhile I was in the middle of a procedure,looked over my shoulder and asked: “ Jim,what are you doing?” and as I proceededto show him – he proclaimed, with the

6 R E E D O . D I N G M A N S O C I E T Y

A N H O M A G E T O M Y F R I E N D — J O H N E D W A R D O ’ C O N N O R

Left to right, Bottom row: Reed Dingman & Bill GrabbTop Row: Jim Norris, Bruce Novark & John O’Connor

92 0 0 5 N E W S L E T T E R

least finesse in his booming, baritonevoice: “Why Jim, that is just wrong!” Not offended, I simply replied: “John,you may be right, but this is the way I amdoing it.”

His folksy homilies and signature

toothpick disappearing between his lipswere as much a part of his persona as hisdistinctive laugh and gentle manner. Johnhad a bank of aphorisms that he woulddraw on whenever the situationdemanded. Once I got in an argumentwith him; the more I said, the worse Isounded; he finally and curtly cut off thediscussion: “Jim, when you’re in a hole,quit digging.”

I had hoped that John would havestayed at the U of M for I felt he belongedthere, but at the end of the residency, hetook off for the hills of Montana.Although I had numerous invitations tovisit him, my great regret is that I neverdid. Nevertheless, we made just aboutevery society meeting, and our familiesalways had the ritual dinner. Only in thethree years before he passed did I take himup on his offer to travel together onmedical missions. Our first trip was toBrazil in 1999. In 2002, we were off toHonduras. While on the trip toHonduras, he asked about my trips toVietnam. He said: “You know, I alwayswanted to go there.”

On John’s first mission to Vietnamand his last anywhere, he operated everyday for four days. On Thursday,November 15th he repaired threepalates, teaching the staff on each one.I marveled at his patience and

consideration for theresidents. That eveningwe were invited to agoat’s meat dinner, buthe declined theinvitation because of anearlier commitment. I returned aboutmidnight to the ThapVang Hotel in Hoa Binhand he was having severepain. I was relieved Ihadn’t twisted his armabout joining us for I

would have surely felt that the meal hadcontributed to his illness. I insisted thatwe go over to the hospital and have himchecked, but he steadfastly refused. Hecouldn’t sleep for discomfort; I couldn’tsleep because I knew he was havingdiscomfort, so we talked. We regaledeach other withstories aboutourselves and ourwives – Bunny of 46years and Motoko of35 years, and oursons, his three –Dan, Sven, and Billand my son, Takashi,of whom we wereintensely proud. Webrought up again thevisit he and Bunnyhad taken to Tokyoto visit Bill about1995. Takashi was living there and heand Bill had connected. They all agreedto go out for dinner. To this day, it isnot clear which son selected therestaurant. What is not in dispute is the

bill – $800.00 for the four. I asked:“John, how in the hell could those guysselect a restaurant where the cost was$200.00 a person?” He shot back inhis inimitable style: “Oh Jim, that’s easy– they weren’t paying for it.” Johnwould be dead six hours later.

John had been in Vietnam with ourgroup only five days, but in that briefperiod he had captured the hearts ofeveryone. The outpouring of grief overhis death came from the Vietnamese andthe Americans – doctors, nurses,volunteers, hotel staff, but mostpoignantly, the parents of the childrenhe had helped. Did John have apremonition of his impending death?We don’t know. We all are puzzled as towhy he would bring some 160 oddsurgical instruments to the mission.The family donated them to ProjectVietnam. A memorial service was heldand it was fitting that Project Vietnamnamed the mission, The John O’Connor

Medical Mission.

Barry Behrstock, a physicianvolunteer with Project Vietnam, could

not have written amore appropriateepitaph than thesewords in the 2002Newsletter: “He had a

great life, a great last day

filled with everything he

valued most. He was

loving, caring, gregarious,

skillfully applying his well

honed surgical talents and

nurturing. He loved his life

and up until the last

moment, he generously

shared his mind, life,

spirit and talent with everyone. This is and was a

great man.”

I might add: “and a great friend.”

- James E. C. Norris, M.D.

J O H N E D W A R D O ’ C O N N O R ( C O N T . )

10 R E E D O . D I N G M A N S O C I E T Y

In 1980, the US Congress passed the Bayh-Dole technology-transfer law whichallowed universities and researchersownership ofresearchbreakthroughsthat weredeveloped oncampuses withthe backing offederalfunding. Thistransfer oftechnologyfrom thecampus to themarketplacehas been afinancialwindfall forboth theuniversity andtheresearcher. Inthis article wefocus ourattention ontwo DingmanSocietymembers whohave made this transfer: Ernie Manders(Promethean LifeSciences) and Riley Rees(KeraCure).

It is not surprising that the DingmanSociety should promote such entrepreneurialspirits; founder, Reed O. Dingman designedthe Dingman Mouth Gag which wasmanufactured by Dick Sarns, founder ofSarns-3M (now Terumo). The DingmanMouth Gag is still used today for cleft palatesurgery.

Ernie Manders, MD, wife, Sandra andthird son, Christian work in PrometheanLifeSciences. They produce a wounddressing. The dressing is prepared fromhuman allograft skin harvested from multipleorgan donors. They process it in such a waythat it can be stored for two years at room

temperature and it is used straight out of thebag with no preparation. It sticks to thewound and in two hours you need no over

dressing.The patientmay bathe in itand wearclothes over it.It lasts typicallyfrom 4 to 8weeksdepending onthe nature ofthe wound.It has been alifesaver inAfghanistanand Iraqwhere ittraveled withour SpecialForces and wasused intreating Iraqiburn victims.It is now soldall over the USandPrometheanhas a Japanese

partner who will be their Far Easterndistributor.

From here the company is branching outto launch a new tissue expander with anadjustable base. It makes each expander acustom model because you can make it longeror shorter and change the angle between thearms so that it fits the defect of each patient.This will greatly simplify the challenge ofmaintaining an inventory of tissue expandersbecause only four sizes will be needed to treatsmall to extremely large defects.

Beyond this Promethean has newtechnology in the patent offices in the USand abroad that will be of major importancefor world medicine. They are also filing apreliminary patent application for a newmeans of cancer radiation therapy. In short,

Promethean is booming and the Manders areenjoying it more every year. The business isone of the few biotech startups that is sellingproduct and is actually profitable!

But that is not to say that the road waseasy. Dr. Manders admits; “We have learned alot in the process. We could give a heck of atalk to a business or medical audience. Wehave dealt with the FDA, the Federal Courts(over naked patent infringement), andforeign businesses and regulatory agencies.We have been deeply involved in developingnew intellectual property and then protectingit. We have learned that with a good ideayou can start a business without VC moneyand make it a success. We have learned tobudget and sweat, from anxiety and effort,also! Sometime I hope we get to tell thisstory.”

KeraCure, a University of Michiganstart-up, has submitted an investigationaladvice exemption to the FDA for approval.The company, which just completed a pilottrial with 11 patients, demonstrated successfulhealing of diabetic foot ulcers. The companyis prepared to start a multi-center clinicaltrial and has applied for approval to treatapproximately 300 patients in 15 centers.The product, which is a keratinocytebandage, will be used to treat diabetic foot ulcers.

KeraCure, was started five years ago atthe University of Michigan, was founded by

Riley Rees, M.D., aplastic surgeon who isthe Director of theUniversity ofMichigan WoundCare Center. Thecompany has beencapitalized with $7.6

million and has businessoffices in Chicago and a manufacturing sitein Boston. The KeraCure patents are ownedby the University of Michigan will provideroyalties to the Section of Plastic Surgery ifsuccessful.

– Riley S. Rees, M.D.

T E C H N O L O G Y T R A N S F E R I N T H E D I N G M A N S O C I E T Y

112 0 0 5 N E W S L E T T E R

I have had an enjoyable association with Luke Air Force Base

here in Phoenix since my first few years of practice in the early

1990s. I have cared for many military and dependants over

that time. The military insurance carrier, Tricare, is both

difficult to deal with and a poor payer. Most of my colleagues

do not participate. Consequently, we see many of its patients.

I was introduced to the base commander, General Phillip

“Bwana” Breedlove in late 2003 at a function at the Luke AFB

officers club. Bwana knew of my commitment to, and support

of, the local military community. He also knew of my

fascination with Jet fighters and their exploits. He kindly

offered to nominate me to join the Honorary Commanders

ranks. I accepted and was inducted as Honorary commander

of the 56th Aerospace Medical Squadron in 10/2004.

My family and I

have enjoyed our

wonderful

interactions with

the base community

and we have tried to

“give back”

generously to those

who defend our freedom. One of the ‘perks’ of being an

honorary commander is the privilege of the “incentive flight”.

Mine was set for 8-19-2005 at 1440 hours. My pilot, Major

Rod “Kid” Gard was the reigning

“Top-Gun” at Luke. He spent the entire

day with me including egress training

(how to get into and out of the jet and

emergency conditions including

ejection), medical clearance, G-Suit and

harness fitting, and pre-flight briefing.

We took off of runway 3 northward over

Northern Avenue at precisely 1440

hours. The F-16 is also known as the

“Viper”. Kid had my wife and good

friend, Lt. Colonel Ty “Split” Witt (his

name is from his OB-Gyn training) park

my Viper on Northern Avenue at the end of the runway. We

took off on full afterburners and flew to the road at 50 feet.

We reached 400+

MPH and headed

up into a 60 degree

climb over the

other Viper. Stacey

and Split were

super heated by Jet

wash. We flew north

to the Grand

Canyon and Lake

Powell. We then

headed south and

west. I flew the jet most of the way. Before heading back to

Luke, we did some barrel rolls, loops, and high speed

maneuvers. We topped out at 8.4Gs. No, I did not get sick as

most civilians do. We did 3 touch and go landings before

circling back and landing.

The whole crew of the “Top Dogs” 61st fighter squadron

was there for our arrival with my family and I got a fire hose

shower in celebration. That night I was included in the sacred

student pilot naming ceremony (Luke is a training base and

the largest fighter wing in the world). My fighter pilot name is

“Jugs”. No one at Luke calls me Steve or Dr. Gitt anymore. I

am known to all as Jugs.

The flight and related experiences

were, of course, awesome and

outstanding. More importantly, however,

I have been blessed by the opportunities

for me and my family to get to know the

men and women of Luke air force base.

These experiences have added greatly to

all of our lives and we now have

incredible respect and admiration for

our persons in uniform. Best regards

to all.

A M O M E N T W I T H S T E V E N “ J U G S ” G I T T , M D , F A C S

Options for reconstruction of peripheral nervegaps are currently limited. In clinical practice,long nerve gaps following injury or tumorresection that cannot be repaired primarily arerepaired with autologous nerve grafts. Thisprocedure requires sacrifice of healthy nerveswith permanent functional impairments. Insome clinical situations, there may not besufficient autologous nerve available forreconstruction of larger, more complex nervedefects. As a result, some investigators andclinicians have turned to peripheral nerveallografting as an alternative (MacKinnon1992). The main obstacle to widespread clinicaluse of peripheral nerve allografts however hasbeen T cell mediated immune rejection(Ansselin 1990). Although potentimmunosuppressive drugs are currentlyavailable to prevent graft rejection, they areassociated with many toxicities. In addition,chronic global suppression of the immunesystem with these medications may result inopportunistic infections or secondarymalignancies and their routine use in nerveallografting is not justified (Elster 2000).Therefore more selective immunomodulatorystrategies to prevent graft rejection of peripheralnerve allografts such as induction of specificimmune tolerance will need to be developedbefore this technique can be routinely usedclinically.

The CD40-CD40L co-stimulatorypathway has been shown to play a crucial role inallograft rejection. CD40 is a 50-kDamembrane glycoprotein found on a variety ofantigen-presenting cells (APCs) of graftedtissue. The ligand for this membrane receptoris CD40L, a 39-kDa glycoprotein that ispreferentially expressed on activated CD4+ Thelper cells of the recipient. The CD40-CD40L interaction mediates T cell immuneresponses by enhancing the co-stimulatorypathway which leads to rejection (Steurer2001). Manipulation of the CD40-CD40Lco-stimulatory pathway may be beneficial inpreventing allograft rejection. Indeed,

consistent with its central role in cell mediatedimmunity, blockade of CD40-CD40L by anti-CD40L monoclonal antibody (mAb) has beenshown to prevent rejection of solid organtransplants such as cardiac and renal allografts(Kirk 1997, 1999,Larsen 1996,Kenyon 1999,Pierson 1999).

Current thinking about the mechanismsleading to tissue rejection followingtransplantation revolve around T cell receptor(TCR) binding to genetically disparate majorhistocompatibility class II antigens (MHC II Ag)on APCs. The binding of the TCR to theMHC II antigen leads to release of cytokinesfrom the T cell that lead to rejection of thegrafted tissue. The most important cytokinesreleased in this process are interferon gamma(INF- g) and interleukins (IL) 2, 4, and 5.INF- g and IL-2 are designated as TH1responses and mediate cellular rejection byactivating macrophages as well as helper T andcytotoxic T cells. IL-4 and IL-5 are designatedas TH2 responses and mediate humoralrejection by transforming B lymphocytes intoplasma cells with subsequent antibodyproduction.

In addition to the MHC II Ag, APCs ofthe transplanted tissue also express a moleculereferred to as CD40 on their cell surface.When T cells encounter the foreign MHC II Agof grafted tissue they become activated andproduce the ligand for the CD40 molecule,referred to as CD40L on their cell surface.Interaction of CD40 with CD40L is essentialfor the TCR binding to the transplanted MHCII antigen. Without this CD40-CD40L co-stimulatory pathway, the T cell receptor cannotbind to the MHC II antigen of the graftedtissue, and cytokine production is inhibited,averting the cellular and humoral responsecascades. This data has led many investigators toblock this pathway using a monoclonal antibodydirected against the CD40L molecule ofactivated T cells in an attempt to inducetolerance to transplanted tissue. This approachhas been shown to be highly effective in

preventing rejection in cardiac and renaltransplantation models (Kirk 1997, Pierson1999). However, induction of tolerance tonerve allografts using this method has yet to bedetermined.

In previous work from our laboratory, wehave used sciatic nerve grafting betweengenetically disparate strains of mice such asBALB/c and C57BL/6 as a model of peripheralnerve allografting. Sciatic nerves from BALB/cdonor mice are placed into a subcutaneouspocket in the back of recipient C57BL/6 mice.Following nerve grafting and post-op recovery,we harvest splenocytes and brachial lymph nodecells and expose these cells to the alloantigensfrom the peripheral nerve graft donor.Cytokine production (INF- g, ILs-2, 4, and5)by these cells is then measured by the ELISPOTtechnique as a measure of cellular rejection.Humoral rejection is evaluated by measuringserum IgM and IgG levels by mean channelfluorescence. In this model, we have found thattreatment of mice with a 3 day course of anti-CD40L mAb at the time of nerve allograftingsignificantly reduces both T cell mediated TH1and TH2 responses as well as alloantibodyproduction. The reduction in cytokineproduction is demonstrated in T cells isolatedfrom the spleen as well as the draining lymphnode basin. In addition, this hypo-responsiveness may be tissue specific asrechallenge with nerve allograft maintains anattenuated response while rechallenge withcardiac allografts results in a more dramaticresponse.

In cardiac and renal allograft models, thereported timing and duration of the anti-CD40L mAb is quite variable. Whentreatment is delayed until 5 days after surgeryin the mouse model of cardiactransplantation, no prolongation of graftsurvival has been observed (Larsen 1996).Because sensitization to nerve allografts occurswithin the first several weeks followingtransplantation, coverage of the host withanti-CD40L mAb at least during this period

12 R E E D O . D I N G M A N S O C I E T Y

T H E C D 4 0 - C D 4 0 L C O - S T I M U L A T O R Y P A T H W A YI N P E R I P H E R A L N E R V E A L L O G R A F T R E J E C T I O N

-Paul S Cederna, M.D., Anil K Mungara, M.D., Sherri Y Wood, Keith D Bishop, PhD.

132 0 0 5 N E W S L E T T E R

appears to be critical in promoting graftsuccess.

The exact mechanism of CD40L blockadein inhibiting graft rejection has beeninvestigated by several groups. CD40L is foundon activated CD4+ cells. At least in some animalmodels, CD40L blockade induces a state ofreversible T cell anergy (Yamada 2002). In theinduction phase of anti-CD40L mAb therapy,apoptosis of antigen reactive T cells is known tobe enhanced (Graca 2000,Li 1999,Wells1999). However, this may not be the onlymechanism of tolerance. Graca has shown thattolerance, once it has been induced by anti-CD40L mAb, cannot be broken by theadoptive transfer of large numbers of naïvenontolerant T cells. In addition, when thesenaïve cells are allowed to coexist with theregulatory population for 6 weeks, they becometolerant themselves, exhibiting infectioustolerance(Yamada 2002).

Although it is now clear that CD40Lblockade is effective in inhibiting CD4+ T cellresponses, it is not as effective in blockingCD8+ T cell activation (Iwakoshi 2000, Jones2000). It has been suggested that this may bewhy anti-CD40L monotherapy is ineffective inpreventing chronic graft rejection (Ensminger2000, Guillot 2002). While this may be truefor solid organ transplants such as cardiac orrenal grafts, chronic rejection is not as much ofa concern in nerve allografts. Nerve allograftsmainly function as a scaffold to allow host axonsand schwann cells to grow into the graft.Blockade of the host rejection process is onlyrequired until this ingrowth has occurred andthe grafted nerve is completely replaced by hostnerve. Once this has occurred, nerve allograftswill no longer elicit an immunologic response.

Peripheral nerve allografting holdspromise as a possible alternative toautografting. However, for this to become areality, rejection is the main obstacle that needsto be overcome. At present, the risks ofimmusuppressive drugs do not justify theirroutine use in clinical nerve allografting.Therapies aimed at co-stimulatory pathwayblockade may allow nerve allografting tobecome clinically useful in the future.

MacKinnon SE, Hudson AR. Clinical application ofperipheral nerve transplantation. Plast. Reconstr. Surg.90:695-699,1992

Ansselin AD, Pollard JD. Immunopathological factors inperipheral nerve allograft rejection: Quantification oflymphocyte invasion and major histocompatibilitycomplex expression. J. Neurol. Sci. 96:75-78, 1990

Elster AE, Blair PJ, Kirk AD. Potential of co-stimulationbased therapies for composite tissue allotransplantation.Microsurgery 20:430-434, 2000

Steurer W, Oellinger R, Perwanger F, Brandacher G, etal. Prolonged allograft survival following ex vivo blockadeof costimulatory signals B7-1/2 and CD40.Transplantation proceedings. 33:274-275, 2001

Kirk AD, Burkly LC, Batty DS et al. Treatment withhumanized monoclonal antibody against CD154 preventsacute renal allograft rejection in nonhuman primates.Nat Med 5:686-693, 1999

Larsen CP, Elwood ET, Alexander DZ, et al. Long-termacceptance of skin and cardiac allografts after blockingCD40 and CD28 pathways. Nature 381:434-438, 1996

Kenyon NS, Chatzipetrou M, Masetti, M et al. Longterm survival and fuction of intrahepatic islet allografts inrhesus monkeys treated with humanized anti-CD154Proc Natl Acad SCi USA 96:8132-8137, 1999

Lederman S. The role of CD154 (CD40-Ligand) incostimulation. Transplantation Proceedings 33;202-206, 2001

Yamada A, Sayegh M.The CD154-CD40 costimulatorypathway in transplantation. Transplantation 73:s36-39,2002

Graca L, Honey K, Adams E, Cobbold S, Waldmann H.Cutting Edge: Anti-CD154 therapeutic antibodiesinduce infectious tolerance. Journal of Immunology .165:4783-4786, 2000

Li Y, Li XC, Zheng A et al.Blocking both signal 1 andsignal 2 of T cell activation prevents apoptosis ofalloreactive T cells and induction of peripheral allografttolerance. Nat. Med. 5:1298, 1999

Wells AD, Li XC, Li, Y, et al. Requirement for T cellapoptosis in the induction of peripheral transplantationtolerance.Nat. Med. 5:1303, 1999

Iwakoshi NN, Mordes JP, Markees TG, Phillips NE,Rossini AA, Greiner DL. Treatment of allograftrecipients with donor-specific transfusion and anti-CD154 antibody leads to deletion of alloreactive CD8+ Tcells and prolonged graft survival in a CTA4-dependentmanner. J Immunol 164:512, 2000

Jones ND, Van Maurik A, Hara M, et al.CD40-CD40ligand independent activation of CD8+ T cells cantrigger allograft rejection. J Immunol 165:1111 , 2000

Ensminger SM, Witzke O, Spriewald BM, et al.CD8+ Tcells contribute to the development of transplantarteriosclerosis despite CD154 blockade. Transplantation69;2609, 2000

Guillot C, Guillonneau C, Mathieu P, Gerdes C, et al.Prolonged blockade of CD40-CD40 ligand interactionsby gene transfer of CD40Ig results in long term heartallograft survival and donor specific hyporesponsiveness,but does not prevent chronic rejection. Journal ofImmunology 168:1600-1609, 2002

Sayegh MH, Turka LA. The role of T-cell costimulatoryactivation pathways in transplant rejection. NEJM338:1813-1821, 1998

Bishop DK, Wood S, Eichwald E, Orosz C.Immunobiology of allograft rejection in the absence ofINF-g: CD8+ effector cells develop independently ofCD4+ cells and CD40-CD40 ligand interactions.Journal of Immunology. 166:3248-3255, 2001

Matesic D, Lehmann PV, Heeger PS. High resolutioncharacterization of cytokine producing alloreactivity innaïve and allograft primed mice. Transplantation.65:906, 1998

Durham MM, Bingaman AW, Adams AB, et al. Cuttingedge: administration of anti-CD40 ligand and donorbone marrow leads to hemopoietic chimerism anddonor-specific tolerance without cytoreductiveconditioning. Journal of Immunology. 165:1-4, 2000

Pierson RN, Chang AC, Blum MG, et al. Prolongationof primate cardiac allograft survival by treatment withANTI-CD40 ligand (CD154) antibody.Transplantation. 68 (11): 1800-5, 1999.

Gordon EJ, Woda BA, Shultz LD, et al. Rat xenograftsurvival in mice treated with donor-specific transfusionand anti-CD154 antibody is enhanced by elimination ofhost CD4+ cells. Transplantation. 71:319-27, 2001

Kirk AD, Harlan DM, Armstrong NN, et al. CTLA4-Igand anti-CD40 ligand prevent renal allograft rejectionin primates. Proceedings of the National Academy ofSciences of the United States of America. 94: 8789-94,1997

Gordon EJ, Markees TG, Phillips NE, et al. prolongedsurvival of rat islet and skin xenografts in mice treatedwith donor splenocytes and anti-CD154 monoclonalantibody. Diabetes. 47:1199-206, 1998

Sun H, Subbotin V, Chen C, et al. Prevention ofchronic rejection in mouse aortic allografts by combinedtreatment with CTLA4-Ig and anti-CD40 ligandmonoclonal antibody. Transplantation. 64:1838-43,1997

J M Rovak, D K Bishop, L K Boxer, S C Wood, A KMungara, P S Cederna.

Peripheral Nerve Transplantation: The Role of ChemicalAcellularization in Eliminating Allograft Antigenicity.Journal of Reconstructive Microsurgery (In Press).

27. D L Brown, D K Bishop, S Y Wood, P S Cederna.Short-Term Anti-CD40L Co-stimulatory BlockadeInduces Tolerance to Peripheral Nerve Allografts,Resulting in Improved Skeletal Muscle Function. Plasticand Reconstructive Surgery (In Press).

P S Cederna. Anti CD40 Ligand Antibody PermitsRegeneration Through Peripheral Nerve Allografts in aNon-Human Primate Model. By M J Brenner, J NJensen, J B Lowe, T M Myckatyn, I K Fox, D A Hunter,T Mohanakumar, S E Mackinnon. Plastic andReconstructive Surgery 114:7, 1815-1818, 2004.

A K Mungara, P S Cederna. The CD40/CD40L Co-Stimulatory Pathway in Nerve Allograft Rejection.Journal of the American College of Surgeons 197:3,S60, 2003.

References:

14 R E E D O . D I N G M A N S O C I E T Y

The Plastic Surgery Section with support

from colleagues from across the University

of Michigan has been awarded a second 5-

year funding period.

The NIH Training grant in Burn,

Trauma and Wound Healing Research has

as PI and Program Director Cynthia L.Marcelo, PhD and William M.Kuzon, Jr,

MD, Ph.D. as co-PI and co-Director.

This grant supports the training of

potential academic medical

surgeon/scientist in basic research related

to trauma in muscle and bone, burn

injuries, and wound healing and tissue

engineering. Residents can train in health

related areas of investigation and can chose

more fundamental research fields

(biophysics, tissue engineering, lipid

biochemistry and molecular and cell

biology).

The Grant supports two postdoctoral

fellows per year, plus supplies, course work

and travel allowances. The current

trainees are Deborah Yu, MD and Ian

Lytle, MD. Deborah Yu, MD, from

Bethesda, MD (Georgetown University

School of Medicine) is studying the muscle

differences between cleft palate and

normal palate muscle in a goat model.

She is also studying the origin of Schwann

cells in a peripheral nerve allograft. Dr Yu

is mentored by Paul Cederna, MD. IanLytle, MD has just arrived from the

University of Cincinnati, and is beginning

his studies with Dr. David Brown in the

area of muscle regeneration. Applications

for the July 1, 2006 positions are being

accepted.

The Plastic Surgery Research

laboratories’ research faculty, composed of

Cynthia Marcelo, PhD, MelanieUrbanchek, PhD, and Dennis Claflin,PhD, continue their studies in the areas of

keratinocyte biology, facial muscle

reinnervation, muscle pathology

accompanying ventral hernia, contractile

properties of human single muscle fibers,

and effects of the absence of the protein

dystrophin on skeletal muscle contractile

properties.

Several fellows made significant

contributions to the Plastic Surgery field

through their research efforts. They

include: Yasushi Fujimori, MD is an

instructor of Plastic and Reconstructive

Surgery of Osaka Medical College and he

is currently a visiting fellow in the

laboratory of Dr. Marcelo. He is

investigating the role of fatty acids in

epidermal stem cell culture development as

part of an ongoing project in the

keratinocyte biology laboratories. VikasDhawan, MD, PhD from Chandigarh,

India (Moscow State University of Medical

and Stomatological Sciences, Moscow,

Russian Federation) is studying skeletal,

cardiac, renal and tendon tissue

engineering. Dr Dhawan is mentored by

David Brown, MD. Erika Henkelman,MD, is from Toronto (University of

Toronto). She is studying the

biomechanical pathogenesis of chronic

incisional hernia with special focus on

single muscle fiber function in the

presence of surgically induced ventral

hernia; and the role of mechanical strain

during laparotomy wound healing and

incisional hernia repair with focus on

fibroblast culture response to mechanical

stretch. Dr. Henkelman is mentored by

Drs Kuzon, Urbanchek, Franz and

Marcelo. Daniel Schwarz, MD(University of Illinois in Chicago) is

studying metrics of bone healing in

Mandibular distraction ostegenesis

undergoing irradiation with the help of

Ayman Elmeligy, MD (University of

Cairo). They are mentored by Steven RBuchman, MD.

Three current U of M medical

students have found time to complete

research investigations in the laboratories.

Winston Choi from Denver, CO.

(Stanford University, Biomechanical

Engineering) completed a project studying

the abdominal oblique muscular atrophy,

fibrosis and decreased compliance

associated with ventral incisional

herniation. Daniel Krochmal who is

from Farmington Hills, Michigan

(Washington University in St. Louis,

Biology, PNP (Philosophy, Neuroscience,

Psychology) is beginning an outcomes

study of recurrent ventral hernia repair

techniques after completing a study on

muscle force and power output following

tendon repair with altered tension.

Daemeon Nicolaou, from Los Angeles,

CA (UCLA Neuroscience Major) is

continuing a study on immunomodulation

with Anti-CD40L monoclonal Antibody

(MR1) and neuroregeneration in the nerve

allografts.

Four undergraduates are contributing

to our research goals through coursework,

independent studies, and summer

fellowships. Daniel Calderon, from Ann

Arbor, MI, Shaun Patel, from

Woodhaven, MI, and Thane Wolcott from

Dexter MI are LSA students majoring in

Biology at the U of M. Daniel studies

Collagen types I and III concentrations in

rectus abdominus and external oblique

muscles of a hernia model. Shaun studies

the effects of hernias upon abdominal

muscle properties, while Thane studies.

abdominal muscle contractile and material

properties following prostheses onlay.

Richard Cheng, another Ann Arbor

native who attends Northwestern

University studied the nerve morphology

related to an improved muscle recovery

using FK506 in a nerve repair model.

-Drs. Urbanchek and Marcelo

N E W S F R O M T H E L A B O R A T O R I E S :

Modest about his own accomplishments,Harvey Lemmen (BBA ‘44, MBA ‘49) ofGrand Rapids grows positively effusivewhen he speaks of Dr. Reed O. Dingman(AB ‘28, DDS ‘32, MS ‘32, MD ‘36,MDRES ‘45).

“He was a dynamic personality,”recalls Lemmen. “He was very impressive,very down-to-earth. I had a lot of respect for him.”

Dingman was apioneer in oral andmaxillofacial surgery, aplastic surgeon when thespecialty was in itsinfancy and thefounder, in 1964, of theplastic surgery section inU-M’s Department ofSurgery. A role model forthree generations of plastic surgeons untilhis death in 1985, Dingman was equallywell known for his gentleness andcompassion for patients.

Lemmen can attest to thatextraordinary bedside manner. Born and raised in Ionia, Mich., Lemmenbecame Dingman’s patient in his freshmanyear at Michigan. As an undergraduate, he underwent more than a dozenreconstructive operations for a cleftpalate—”some of them minor, some ofthem not so minor,” Lemmen says wryly—all with Dingman as chief surgeon.

He also recalls Dingman’s larger-than-life confidence. “I remember oneextensive operation, when the head of thedental school asked Dr. Dingman if hehad ever done it before, and Dr. Dingmansaid, ‘No, but I know I can’,” Lemmensays.

When Lemmen learned of theMedical School’s initiative to establish aprofessorship in Dingman’s name, heleaped at the chance to give to the cause.

The reason was simple: “Heaccomplished miracles,” says Lemmen.“He ought to be recognized for what he was.”

Lemmen’s generosity to the Reed O.Dingman Professorship in Plastic Surgeryincludes a cash gift of $30,000, a bequestin his will and the establishment of a$150,000 charitable gift annuity (CGA).

He chose to give through the CGAbecause, he says, “I might as well give itnow, and I thought they’d probably

welcome that. A bird in thehand is worth two in thebush. And on top of that,I get a return.”

It’s a sound answerfrom a man who knowssomething about managingmoney. After receiving hisMBA from the U-M in1949, Lemmen went towork for Meijer Inc. as anoffice manager when the

company had but fourstores, all small supermarkets. He rosewithin the Meijer organization to becomepresident in 1975 and retired in 1986 ascompany deputy chairman.In appreciation of Lemmen’s service andthat of his colleague, Earl D. Holton, FredMeijer, chairman of the executivecommittee of Meijer, Inc. and his wife,Lena, named the Lemmen-HoltonCancer Pavilion, part of the SpectrumHealth System, in Grand Rapids.

Immediately upon retirementLemmen became an American Red Crossvolunteer, driving disabled and seniorpatients to hospitals within Kent County,where he lives. Since the programexpanded its boundaries in 1992,Lemmen has driven hundreds of patientsto hospitals throughout Michigan, oftenvolunteering seven days a week, andoccasionally making twice-daily roundtrips from Grand Rapids to Ann Arbor.He also schedules other volunteer drivers.

“This is something I can do thatseems worthwhile,” says Lemmen. “It’sbeneficial to me. I see people who are awhole lot worse off than I am.”

Spoken in the generous spirit of Dr.Dingman himself.

7 R E E D O . D I N G M A N S O C I E T Y

G R A T E F U L PA T I E N T, P I O N E E R I N G D O C T O R : H A R V E Y L E M M E N A N D R E E D D I N G M A N

Harvey Lemmen

WWW.UMSURGERY.ORG

Reed Dingman led Plastic Surgery at Michigan asan extraordinary surgeon and a teacher withoutpeer. His contributions to maxillofacial surgery,facial trauma, and pediatric cleft lip and palaterepair are important to the present day. He traineda generation of leaders for Plastic Surgery. For hispatients, he performed miracles by forming smiles.His legacy is the excellence in clinical care, thededication to teaching, and the world classresearch that defines Plastic Surgery at theUniversity of Michigan.

Please join the effort to immortalize this great manwith the Reed O. Dingman Professorship.

H O W ’ S Y O U R H I S T O R Y O F U M P L A S T I C S U R G E R Y ?

Seated (L-R): Lois Stilwell, Sophia

Hernandez, Reed O Dingman,

Thelma Dingman, Clyde Litton,

Dolly Mauzy

Standing: Leon Hernandez,

Jim Stilwell, Jack Alger, Ann

Natvig, Paul Natvig, Gordon Bell,

Cozy Grabb, Jane Lucid,

Marilyn Bell, Morgan Lucid,

Bill Grabb, Merit Mauzy

TThhaannkkss ttoo CCoozzyy GGrraabbbb ffoorr pprroovviiddiinngg tthhee aannsswweerrss ttoo oouurr ffiirrsstt DDiinnggmmaann MMeeeettiinngg GGuueesstt LLiisstt aabboovvee..

Dr. Homer Stryker, was a UMOrthopaedic Alumnus who startedStryker Instruments, a multi-billiondollar surgical instrument company,name which Dingman Society memberamputated Homer Stryker’s finger?Answer: James Stillwell (‘62) who lives in Rome, AL,

but practiced in Kalamazoo, MI.

Dr. Grant Fairbanks’ father was a worldrenown sculptor at the University ofMichigan, what Dingman member was an art student in his father’s class?Answer: Avard Fairbanks taught Reed Dingman at UM.

Aside from Drs. Reed and DavidDingman, what other Dingman Societymembers have spawned plastic surgeons?Answer: Otto Au (‘63) and Victor Au, North Carolina

Can you list the 5 surgical societies at the University of Michigan?Answer: Carl Badgley Society (Orthopaedics),

Reed Dingman Society (Plastics), John Alexander Society

(Thoracic), Reed Nesbit Society (Urology),

Fred Coller Society (General Surgery)

Harvey Lemmen was a patient of Dr.Reed Dingman’s back in the 1940s, whatplastic surgeon is Mr. Lemmen’s cousinand who trained with Reed Dingman andFerris Smith in Grand Rapids?Answer: Howard Lawrence, MD, who lives and

practiced in Scottsdale, AZ.

Two grandchildren of UM SurgicalSocieties ran cross-country and track at Dartmouth. Who are these twograndchildren?Answer: Dagny Dingman (grand daughter of Reed

Dingman and daughter of David Dingman) and Jessie

Coller Allen Young (great granddaughter of Fred Coller)

and now and Architecture Student at UM.

N E W Q U E S T I O N : Who cycles Route 66

and is related to Reed Dingman and also a plastic surgeon?

Photo below

82 0 0 5 N E W S L E T T E R

SAVE THE DATE & PLEASE JOIN US FOR:18TH DINGMAN SOCIETY SCIENTIFIC MEETING AND GRABB LECTURE

HONORING DR. HACK \NEWMAN

June 9 and 10th, 2006

Dr. Jack Gunter (res 1980)

C A L E N D A R O F E V E N T S

ASPS UM DINGMAN

SOCIETY DINNER

Sunday, September 25th, 7:00 pmGibson’s Steakhouse

& Hugo’s Frog and Fish House 1028 North Rush Street, Chicago, IL.

2ND STRYKER LECTURE

IN HAND SURGERY

December 9th-10thJames Lee, MD, West Virginia

University School of Med.