Detroit Free Press from Detroit, Michigan • Page 16

2C DETROIT FREE PRESSTUESDAY, SEPTEMBER 3, 1991 Hi) I DENTAL HEALTH Computer golf goes way over par Is there some strange, unnatural attraction between golf and computers? Every week, it seems, another computer golf simulation crosses my desk. My office is full of the stuff and it's really getting Q. I'm very concerned with all the news lately about dentists and patients and transmission of the I Jm 4 i Dan GUTMAN Computing I. me you'll excuse the teed off. Accolade, a software publisher in San Jose, js the worst offender.

In 1986 the com CRAIG PORTE RDetrolt Free Press Maude, the purebred beagle who has "broken all the records" for living with an auxiliary heart pump, checks in with Dr. David Anderson, left, and Dr. Larry Stephenson at the Wayne State University School of Medicine. Beagle with heart pump is medical marvel Maude years with artificial pump bodes well for humans with failing hearts not provide an extra pump. Stephenson hopes to get federal approval soon for studies on human beings using cardiomyoplasty.

The technique was developed in 1959 by Dr. Adrian Kantrowitz, a cardio-thoracic surgeon now at Detroit's Sinai Hospital and Wayne State. Quite by accident, a visiting Moscow surgeon who pioneered the technique in humans, Dr. Alexander Kra-kovsky, will join Stephenson in his work. Krakovsky was visiting Detroit last month during the attempted Soviet coup.

He asked to Stephenson if he and his family could stay a few months, until things settle down at home. Stephenson has refined the separate pumping chamber used on Maude so that more of the back muscle is wrapped at the tip of the cone-shaped pouch, eliminating clotting and other complications that developed in some of the 15 dogs on whom his research team has operated. Maude, meantime, is cared for and guarded as if she were a celebrity. She lives in a kennel on the medical school campus, next to other research animals. She looks like any other beagle.

There are no tubes or wires coming out of her. She gets a brief walk a day, is petted occasionally, and eats Purina Dog Chow. As routine as her life is, she does get outstanding medical care. "We can't afford to let anything happen to her," Anderson says. BY PATRICIA ANSTETT Free Press Medical Writer naude paces around the examining table, glancing up yll to see when the doctor will arrive.

II lust 32 vears old. she is too short to reach a treat on the stainless steel counter nearby. So she waits, tail wagging. She seems oblivious to the strangers glancing at this latest medical milestone. Maude, a purebred beagle, has lived 2'2 years with an auxiliary heart pump.

That's longer than any human being or animal with an artificial heart or heart-assist device. "She's broken all the records" for that procedure, says Dr. Larry Stephenson, Maude's unofficial godfather and a pioneering Detroit heart surgeon trying to find ways to help failing hearts. Maude's operation gave her an extra pumping chamber, or ventricle, fashioned from her back muscle. Someday, these auxiliary hearts may provide crucial options to thousands of people who die before donor hearts are located for transplants, says Stephenson, professor and chief of cardio-thoracic surgery at Wayne State University School of Medicine and Detroit's Harper Hospital.

The technique has not been tried in human beings and probably won't be for at least a few more years. But it potentially could help 15,000 people, and as many as 100,000, annually, Stephenson estimates. Most have heart muscles weakened by heart after a mastectomy. Stephenson operated on Maude with a team of other surgeons, including English cardiac surgeon David Anderson, who was in Detroit recently. They explain the procedure this way: The back muscle is taken out, wrapped like a pouch around a Teflon cone, and put back.

At the same time, a special pacemaker is implanted in the abdomen to make the pouch contract and to detect if it is working properly. About four weeks later, when the muscle has healed into a pouch, the cone is removed and the pouch is attached to the chest. The arm retains its normal function. Artificial grafts, or substitute blood vessels, are hooked up, one to the pouch, the other to the aorta, the main artery that supplies blood to the body as it leaves the heart. When completed, blood leaves the aorta, sends it to the pouch, then routes it back to the aorta.

The auxiliary pouch gives the heart an extra kick, says Anderson. The same back muscle has been used in a related procedure called cardiomyoplasty, and people have lived five years or longer. But it only shores up the heart muscle; it does AIDS virus. How much cause for concern is there really? Dentists and their staffs are much more exposed to the possibility of infection than the patient. As long as all the instruments and equipment have been properly sterilized and disinfected, vnur rhanrpa nf Gorski Kaigler infection are negligible.

Barrier techniques such as gloves and masks increase your protection. Even after a patient leaves, the staff still is faced with the possibility of infection during the handling and sterilization of instruments. Although there are occasional deaths from AIDS among health care workers, ser-oprevalence (being a carrier of the HIV virus) rates among dentists are lower than that of the general population. Dr. Robert Gorski practices general dentistry in Harper Woods and is past president of Eastern Dental Society.

Dr. Darnell Kaigler of Detroit holds a master's degree in prosthodontics and is past president of Wolverine Dental Society. Substance abuse Can you talk about the prob lem of guilt in recovery? Guilt is a serious problem in early recovery. Guilt says, "I'm no good," "I'm a rotten human being," "Nobody loves really another form of self-pity, stops you from taking responsibility for your actions and from honestly apologizing to thf npnnlp vnn Gribbs hurt. Admitting responsibility and making amends helps cancel guilt and restore self-esteem and good mental health.

Katherine Stratis Gribbs is a psychotherapist at the Livonia Counseling Center. the 1980s, Zemel and his colleagues tested black Detroiters on diets with added calcium for as long as a year, reporting significant drops in blood pressure. Black Americans are notorious among dietitians for low calcium intakes, in large part because of lactose intolerance, Zemel says. So, why aren't public health experts calling for blacks and older Americans to drink lactose-free milk? Says Zemel, "They ought to. But there's always a lag time between theory and practice." Home Health Express will bill Medicare andor any private insurance company.

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NJ 07648 -A inwfirimm Hun pany released "Mean 18" (IBM, Mac, Apple II, Amiga), a terrific golf simulation in its day. It really captured golf on a computer screen. You could choose between pro and regulation tee distances and even ask your caddy to suggest the right club. The layouts of Pebble Beach and St. Andrews were on the disk, so you could simulate play at those famous courses.

The game sold more than 200,000 copies, an enormous number for sales of computer software. People liked Mean 18 so much they asked for more. So Accolade released Mean 18 Famous Course Disk, a floppy filled with more famous golf courses around the world. You had to have the original Mean 18 to use the Famous Course Disk. Another success.

Volumes II, III, IV, and VI Mowed. One would think that would be enough golf simulations for one company. But nooooo! Accolade was just getting started. In September 1988 Accolade cut a deal with the most famous golfer in the world and came out with Jack Nicklaus' Greatest 18 Holes of Championship Golf (IBM, Commodore, Amiga, Apple II). It was a big improvement over Mean 18, with fluid animation; aerial closeups; rolling hills; wind; tees for men, ladies and professionals, and stroke or skins format.

Of course, insatiable golfing computerists would demand additional courses to go with the program. So Accolade released Jack Nicklaus Presents the Major Championship Courses of 1989, which added Oak Hill, Royal Troon, Kemper Lakes and others. Next came Jack Nicklaus Presents the International Course Disk, which included St. Creek, St. Mellion and the Australian Golf Club.

They weren't through yet. In June 1990, the company released Jack Nicklaus' Unlimited Golf Course Design (IBM, Amiga) for people who were not satisfied with simulated play on the greatest golf courses in the world and wanted to design their own courses. Things were starting to get ridiculous. Then, last week, I received a copy of Jack Nicklaus' Course Designers Clip Art Volume 1 (IBM, Amiga, $25). With this disk, you can add a seaside vista, lush parkland or a stark desert atmosphere to your personal golf course.

You could place 70 objects trees, cacti, rocks, animals, golf carts, fountains, ball washers anywhere you'd like. Oh, I almost forgot. Accolade also makes Mini-Putt (IBM, Commodore 64128, Apple II), a simulation of miniature golf! All together, Accolade has sold more than a half a million computer golf simulations. And that's just one company. Access Software of Salt Lake City has Links and World Class Leader Board.

Electronic Arts of San Mateo, has PGA Tour Golf. There are others. America is computer golf crazy. "It's the number one sport in America," says Charlotte Taylor of Accolade. "The ratio of people who own computers and play golf is very high." I figure the next release from Accolade is sure to be: Jack Nicklaus Plays Golf on the Moon.

You can blast chip shots out of craters and hit drives 1,000 yards in lunar gravity. This of course, will lead to addon disks that will make it possible to play -on Mars, Venus, Jupiter and other planets. Dan Gutman is a free-lance writer. Milk consumptbn down; calcium's value is up attacks, coronary artery disease, infections or congenital problems. The work has important potential because there is no good way to shore up weakened heart muscles.

Heart attacks destroy part of the muscle which makes the heart pump. Drugs only can help the remaining muscle contract more vigorously. For those with severely failing hearts, mechanical heart-assist devices can be used, but only for short periods because of blood clots and other infections associated with their use. In addition, the devices are cumbersome because tubes and wires to power them go through the skin. The only remaining option is a heart transplant, but donors are scarce because not enough people donate hearts when they die.

Among those lucky enough to get donor hearts, 40 percent face major complications within three to five years because their bodies often reject the donor organs. Strong drugs used to slow the rejection problems may have serious side effects, too. The auxiliary pump is constructed from a fan-shaped back muscle, the latissimus dorsi, that helps raise the arm. Large and powerful, it is used for other types of reconstructive surgery, such as breast reconstruction nutrition consciousness-raising that swept through the American media and many a kitchen in the last decade. Critics charge that 2-percent milk is a misnomer, disguising a white liquid that has 38 percent of its calories in fat.

Only skim and Vi-percent milk truly qualify as health foods, purists insist. Health food evangelists question milk safety, citing outbreaks of salmonella and Listeria bacteria in the mid-1980s and the PBB contamination a decade before in Michigan. The best-selling diet title of the last decade used an entire chapter to blast milk. In more than two million copies, the discredited but hugely successful pop-nutrition book "Fit for Life" written by a couple whose nutrition credentials are from an unaccredited correspondence school indicted the unnaturalness of drinking another animal's milk. Anti-establishment thinking has further dried milk enthusiasm.

Baby boomers reared on milk spurned a product intimately tied to agribusiness. Result? One of out every five dairy farms likely will go out of business in the next few years, many in Michigan, as ever-larger dairy farms consolidate in the Southwest and California, Here arp some tips Lactaid drops is a drugstore product that removes even more lactose from Lactaid, as much as 99 percent. For questions on either Lactaid product, or for free samples, call 800-522-8243, weekdays 9-4. Dairy Ease is a chewable pill sold in drugstores that provides lactase. For a free brochure called "Getting Along with Milk: For People with Lactose Intolerance," call 800-548-8097.

weekdays Source Michigan Dairy Council awareness of according to a 1985 Cornell study. Could a wake-up call on calcium reverse the trend? Although the full story isn't in, calcium has been shown by research to help defeat osteoporosis, or brittle bone disease, which looms ever larger in U.S. health costs as we live longer. Doctors already see plenty of aging Americans who fall and suffer crippling fractures, and population experts warn of a flood of such cases in coming decades. Milk, while no panacea, helps head off osteoporosis early in life by providing calcium along with the Vitamin essential to assimilating it and the magnesium that also plays a role in bone health.

Calcium intake builds bones from childhood through our 20s, right through the years when teenagers and young women begin trading milk for diet pop. After that, calcium fights a waiting game, slowing a steady, inevitable loss of bone mass as we age. "With the increasing life expectancies we're seeing, men and women both are going to live to fall and break a hip. So milk is very important," says Dr. Carl Karoub, a preventive health expert in Royal Oak.

"I tell my patients to drink four 8-ounce glasses of skim milk a day. That's 1,200 milligrams of calcium" -more than the Recommended Dietary Allowance, or RDA but Karoub is taking no chances. An 8-ounce glass of milk any kind contains about 300 milligrams of calcium. Adult Americans should get about 800 milligrams daily, according to the RDAs. Many scientists are pushing for a higher calcium RDA.

For ages 11-24, the RDA is 1,200 milligrams daily. That's a change made in 1989 based on new concerns about building enough bone mass early on to forestall osteoporosis later iilife. Most Americans, particularly those at lower income and education levels, get only 300 to 500 milligrams daily. The calcium link to high blood pressure also is not universally accepted. But even early data is riveting to many researchers, who see high blood pressure as a major public health problem.

While alcoholism, obesity, smoking and family traits are well-known risk factors for high blood pressure, research now points to a widespread inherited sensitivity to salt, one that calcium often can blunt. Milk could make a difference, yet those who need it most may be stopped by bodies that reject dairy products. Lactose intolerance the inability to digest milk sugar is found in about 21 percent of American whites, more than half of Hispanics and 75 percent of black Americans as well as many Asians and older Americans of all races. Estimates range as high as 50 million for the number of Americans who react to dairy products, in varying degrees, with gas, diarrhea and other digestive discomfort. Immigrants from Hispanic or Asian countries are sure candidates for high blood pressure as they begin gulping the high-fat American diet, and enjoying our abundant booze and cigarettes, while avoiding dairy products.

Those close to major studies are convinced that many Americans, particularly blacks and many elderly whites, would see their blood pressures drop if they began drinking milk. "It would appear that most in the scientific community would accept that calcium exerts an antihypertensive effect in blacks," says Michael Zemel, chairman of nutrition at the University of Tennessee. At Wayne State University during MILK, from Page 1C incomplete, points to a link between higher calcium intake and lower blood pressure, especially among black Americans and older whites. Drinking milk could help, especially in forms that are easier to digest, such as low-lactose milk, powdered milk, even chocolate milk. There are other reasons to quaff moo juice, of course.

For example, calcium is associated with a resistance to polyps, tiny precancerous growths in the colon, and resistance to colon cancer itself. A study announced in the spring by U.S. Department of Agriculture scientists suggests that symptoms of premenstrual syndrome from depression to backache can ease when women double their calcium intake. Milk isn't the only way to obtain calcium. It's just the cheapest and most convenient, says Judith Anderson, a nutrition consultant with the Michigan Department of Public Health.

"Fluid skim milk is the second cheapest source of calcium, right after powdered milk," says Anderson. Yet milk did not ride the tide of Can't handle milk? See DIGEST, Page 1C emptying, decreasing the load of lactose on the small intestine at any one time. Adults can try nonfat powdered milk; after mixing with water, it has less than one-third of the lactose of an equivalent serving of fluid milk. Lactaid is a brand of low-fat milk that contains 70 percent less lactose than regular milk. It is available in many supermarkets.

Cost is about $1.50 a quart. iJ.