It is conceivable to me even that this would be done outside of NIH. But if it is done within NIH, it should be clearly separated from the extramural and intramural research programs at NIH. That doesn't mean people shouldn't talk to each other and exchange information but that the responsibility shouldn't follow along the same lines in both programs.

Senator HARRIS. What about the suggestion Dr. Starr made, which was commented on by Dr. Walker, of the possibility of creating a National Institute of Bioengineering or the National Institute of Engineering and Medicine, within the NIH framework?

Dr. RUINA. I don't think you are going to solve any problems by creating institutes. I think there has got to be a national decision that we do want to go ahead very seriously along certain directions, and that it is wise to. I am not suggesting that it is wise to. But when you are ready, you know, you have got to decide to go ahead to do this. Obviously it can go organized in many different ways, and it's not clear which type of organization is best.

But I think if there is an interest and resources are allocated, and if the scientific and technical leaders in the field feel that it is not a blind alley, and that it is an important thing to go ahead with, you can then mobilize the groups-small groups, large groups—to go ahead with the problem.

I think the creation of an institute by itself, or as I mentioned before, the creation of bioengineering departments at universities would not be very significant. There has got to be a real customer for the service.

In the Department of Defense, when the Department says "We want a new airplane" and airplane designers know they can build one, a customer is there waiting and wanting it. The creation of a new aircraft division in the Air Force alone with no resources and no mission, would get us nowhere by itself.

Senator HARRIS. I understand that, but supposing the mission and

resources

Dr. RUINA. Those are the decisions that must be made first. Then how you organize it, whether it becomes a special institute or an institute within the NIH, those are secondary factors. My own feeling is that if a bioengineering activity is started it should be separated from the basic research activity, if for no other reason than NIH is doing very well now in basic research and I would hate to see that jeopardized.

Senator HARRIS. Very good suggestions. Thank you very much, Dr. Ruina. We appreciate your testimony, your response to questions and your presence here.

Dr. RUINA. Thank you.

Senator HARRIS. Excuse me, Senator Hansen, do you have any questions?

Senator HANSEN. I don't have any questions. I just want to compliment you, Doctor, on a very excellent presentation, and for the incisiveness with which you have presented your statement here this morning. I think you have made a very fine contribution. I have been most impressed.

Dr. RUINA. Thank you very much.

Senator HARRIS. Thank you, Dr. Ruina.

Dr. Samuel M. Nabrit is our next witness. Dr. Nabrit is Commissioner of the U.S. Atomic Energy Commission here in Washington, D.C. He holds a Ph. D. degree which he received in 1932. Without objection, we will insert in the record at this point certain additional biographical data.

Biographical Sketch: Dr. Samuel M. Nabrit

Executive Director, The Southern Fellowship Fund, Atlanta, Ga., Ph. D., 1932. Background Data: Commissioner, U.S. Atomic Energy Commission; President, Texas Southern; Dean, Graduate School, Atlanta University; General Education Board Fellow, Columbia University; Research Fellow, Brussels; Coordinator, Carnegie Experimental Grant-in-Aid Research Program. Member of many boards, foundations, etc.

Senator HARRIS. Dr. Nabrit, would you introduce your associates? Dr. NABRIT. I have with me two of our senior staff people, Dr. English, who is assistant general manager and Dr. Dunham, who is the head of biology and medicine.

Senator HARRIS. Fine. We are very pleased to have all of you here. I believe, Dr. Nabrit, that you have a prepared statement, and you may proceed with that, or however you desire.

TESTIMONY OF DR. SAMUEL M. NABRIT, COMMISSIONER, U.S. ATOMIC ENERGY COMMISSION, ACCOMPANIED BY DR. SPOFFORD G. ENGLISH, ASSISTANT GENERAL MANAGER FOR RESEARCH AND DEVELOPMENT; AND DR. CHARLES L. DUNHAM, DIRECTOR, DIVISION OF BIOLOGY AND MEDICINE; ATOMIC ENERGY COMMISSION

Dr. NABRIT. Mr. Chairman and members of the subcommittee, I am pleased to appear before you to present testimony on the Atomic Energy Commission's role in the Nation's biomedical research and development programs. We will be pleased to respond to any questions or to discuss any of these matters in further detail as you may wish. The Atomic Energy Commission was formed in 1946 to carry on the work of the wartime Manhattan Engineer District. Later the objectives of the program shifted to the introduction and development of nuclear energy in our peacetime national economy. With the passage of years, the activities of the Commission have enlarged until the responsibilities of the Commission now extend into nearly every critical facet of our national life. But in the matter of health and safety, the Commission has a responsibility to assure that daily association with nuclear energy shall be carried out in a safe, responsible manner. In order to do this the Commission must be as fully informed as is possible about the dose-effect relationships between radiation and living things. This in turn implies an ever-growing body of information on the mechanisms of interactions of radiations with tissues, cells, and molecules.

Within the Commission, the Division of Biology and Medicine has been assigned the responsibility of developing this information through its basic research program as well as for exploiting nuclear energy and its by-products in medicine and biological research.

As it happens, medicine was the first of the sciences to put artificial radioactivity directly to work for the benefit of mankind. Studies

on radiation and the use of radioisotopes have been responsible for many major advances in the biomedical sciences in recent years. By reason of long acquaintance with X-rays and radium for diagnosis and therapy, it was natural that physicians were eager to investigate the clinical and research uses to which these new particles and radioisotopes might be put. The 20 years since the war have seen "nuclear medicine" become a recognized part of the practice of medicine and in the process a great deal has been learned about the effects of radiation on man and, through the use of radiation, we have also learned a great deal about body processes. In large part, this has been due to Atomic Energy Commission support of medical research as well as that of other Federal agencies.

The mission of the Division of Biology and Medicine of the AEC, briefly is threefold: (1) To learn what are the effects of radiations on living structures and on their ecological relationships. Always in the background if not specifically in the foreground, is concern for man and his reactions to irradiation. (2) To learn what can be done to counteract or modify these effects of radiations. (3) To find what biological and medical use radiations and radioisotopes can be put for the benefit of mankind.

The Division's research programs fall into 14 areas of interest. The first six includes the following and I am presenting these on a percentage basis of the dollar support of the total program:

These account for about two-thirds of the research effort. In these six categories are the researches which are intended to identify and analyze the effects of radiations on a wide range of biomedical systems. In character they range from the very fundamental to the pragmatic; there is need for both kinds of study and the range in between.

The broad nature of biomedical studies in nuclear energy generally requires a team effort: such a team is likely to have both fundamental and pragmatic interests, a combination which works out to everyone's advantage.

The next six areas are investigations of the practical health and safety problems encountered in the development of nuclear energy.

Health physics

Radiation instruments__.

Combating detrimental effects of radiation_
Chemical toxicity

Nuclear energy civil effect_.

Atmospheric radioactivity and fallout_.

Percent

2421

1

10

Twenty-two percent of the program is devoted to these areas of research.

The remaining two areas, cancer research and selected beneficial applications, account for 7 percent and 4 percent, respectively, of the total effort. Here the main interests lie in the application of theoretical

and practical knowledge about radiations and isotopes for the solution of medical problems. In the beginning, there were numerous medical situations to which nuclear techniques could be directly applied.

Medical research involving patients is supported through contracts at a number of medical schools and hospitals, and at four major projects the AEC maintains hospital beds to facilitate its research efforts. These are: The Oak Ridge Institute of Nuclear Studies, the Brookhaven National Laboratory Medical Department, the Argonne Cancer Research Hosptial at the University of Chicago School of Medicine and the Donner Laboratory at the University of California, Berkeley. These are our principal points of direct contact between the scientists and the medical practitioners.

Also, at the Washington level there is close liaison with the National Institutes of Health, National Aeronautics and Space Administration and other Federal agencies which have biomedical programs. In some instances the AEC participates in joint programs such as the cocarcinogenesis project at Oak Ridge National Laboratory supported in conjunction with the National Cancer Institute and several of these directly involve bioengineering.

Before I turn to specific questions asked by your committee about the role of Government institutions in the area of biomedical development, I should like to express a concern I have. I am concerned with a trend that seems to be growing-that much greater emphasis may be given to the application of developments at the expense of basic research. I would urge the utmost caution to not cut back on basic research in order to speed up application of information from basic research. We must continue basic research without diminishing it in any way.

Now I shall turn to specific questions asked by your committee about the role of Government institutions in the area of biomedical development. My remarks will be limited primarily to the role that the Atomic Energy Commission plays in developing the biomedical sciences. In addition to my comments, we will provide written answers to each of the six questions raised by Senator Harris.

The Atomic Energy Commission has been conscious of the need for additional attention by Federal agencies in the field of biomedical development and application. In the nuclear energy family, a vast array of special purpose sources of radiation has been developed for research in physics and some have been used in biomedical applications. But the costliness of these devices puts them beyond the reach of many medical institutions. It would be beneficial if a way could be found to support the purchase of a carefully considered number of these special purpose biomedical devices such as small accelerators and computers designed for diagnostic applications.

Another problem area, if you wish, is the need for more concerted effort in translating the results of basic research into day-to-day applications. There are probably numbers of more or less basic items of information already discovered or in the process of being identified which might be put to work. But to do so requires more effort to be put into bridging the gaps between the findings or results of research and the immediate and most obvious applications. In our National Laboratories, and to a lesser extent on university campuses, there are many interdisciplinary groups interacting and working closely with one another on a daily basis. The results of such close relationships,

and one of our scientists has called it a "wedding," have already been manifested in several outstanding accomplishments. I would mention in particular such notable development applications as the zonal ultracentrifuge, teletherapy units, blood cell separators, laminar airflow clean rooms, analysis of structure of human chromosomes through computer technology, an scintillation cameras and other clinical radioisotope scanning techniques.

The Laboratories must be allowed to continue and, indeed, expand this relationship if further accomplishments are to come about. I believe that greater effort can be made through increased funding that would permit more rapid evaluation of the possibilities that exist for changing results from basic research projects into research-development projects and thence on to the culmination of ideas that take the form of a device, method, or technique having broad applications. I also believe that we shall find partners in increasing numbers in this enterprise; partners who will come forward from private industry. This group is showing more and more interest in participating in these developments on a commercial scale.

Another specific area that suffers today is radiopharmaceutical development. Only a handful of chemists are now working on improving labeling techniques or exploring the potential usefulness of radioisotopes for diagnostic purposes. We need new and untried labeled molecules, such as are found in hormones and enzymes, which may have usefulness in diagnosing diseases of the human body. Much theoretical work needs to be done before actual application to patient care. The theoretical part suffers from the lack of interest or competently trained people to carry out such studies. We need, somehow, to strengthen our resources in this and other areas of high potential.

I believe that the Atomic Energy Commission has an outstanding record of technical information activities through which communication is maintained with scientists and engineers. In the field of biomedical development these take the form of articles published and widely disseminated in technical periodicals, journals and AEC report series. We are proud of our support of and participation in international scientific meetings both in this country and abroad. Senior staff members of the AEC present the latest topical information at meetings of societies and agencies supporting biomedical research; they also reach audiences that often include medical practitioners and hospital staffs.

In these ways, progress has been made in the development of improved instrumentation for radiation detection, methods for radiation dosimetry, and discovery of ways to achieve improved protection prophylactically against the effects of radiation. The knowledge gained of the effects of radiation on microorganisms, plants and animal tissues has allowed the progress we can point to today that places the food irradiation program on a solid scientific footing. Modifications of cyclotrons, accelerators and reactors have provided sources of radiations which are being actively investigated at clinical centers for their beneficial uses in the treatment of cancer. Today, radioisotopes are recognized as a standard tool for treatment and diagnosis in medicine and a strong impetus continues within the medical field to find new and improved uses.