VOLUME, NO.

1, FEBRUARY 1981
THE AMERICAN TINNITUS ASSOCIATION
TINNITUS SYMPOSIUM
Ciba Foundation, London, England, January, 1981
Front r ~ , Left to right, seated: Ellis Douek, Patricia House, Mary Meikle, Joan Box
Front r ~ , standing: Abe Shulman, David Kemp, Harold Feldmann, Jonathan Hazell, Ron Goodey, Richard Tyler
Charles Berlin, Gloria Reich
Back Row, standing: William Burns, Don Brown, Jurgen Tonndorf, Ross Coles, John House, John Emmett, Jack
Vernon, Pat ~ J i l son, Jean-Marie A ran, Ted Evans
At the Ciba Foundation tinnitus symposium, chaired by Professor E. F. Evans (University of Keele), 21
participants from three continents shared their knowledge of the classification , assessment and epidemiology
of tinnitus and discussed preventative measures and new methods of treatment. Continued on page 2.
Tinnitus Symposium continued from page 1
The Ciba Foundation sponsors about eight
scientific seminars each year. A distinguishing
feature of these symposia is that, to allow
plenty of time for informal discussion, member-
ship is restricted to about 25 people, all leaders
in their particular branches of science or
medicine. The proceedings of these meetings are
published in book form. Proceedings of the
tinnitus meeting will be published in Autumn 1981
by Pitman Medical, London, under the title
Tinnitus Ciba Foundation S m osium 85 .
Here 1s a 1st1ng o t e papers presented at
the tinnitus symposium.
1. Classification of Tinnitus, Ellis Douek,
Hearing Research Group, Guy's Hospital, London,UK
2. Epidemiology of Tinnitus, Ross Coles, MRC
Institute of Hearing Research, The Medical School,
University of Nottingham, Nottingham, UK
3. The Measurement of Tinnitus in Humans, Jonathan
W. P. Hazell, The Royal National Institute for the
Deaf, London, UK
4. Physiologically Active Cochlear Micromechanics-
One Source of Tinnitus, David T. Kemp, Institute
of Laryngology and Otology, London, UK
5. Objective Recordings of Tonal Ti nnitus, J. P.
Wilson and G. J. Sutton, Department of Communi-
cation and Neuroscience, University of Keele, UK
6. Animal Models of Tinnitus, E. F. Evans, Dept.
of Communication and Neuroscience, University of
Keele, Keele, UK
7. Electrophysiological Simulation of Tinnitus,
Charles I. Berlin and Patricia Shearer, Kresge
Hearing Research Laboratory of the South,
Louisiana State University Medical Center, New
Orleans, Louisiana, USA
8. Ototoxic Drugs and Noise, R. Don Brown*, Joe E.
Penny+, Charles M. Henley*, Keri Hodges+, Suzjo
Kupetz*, David W. Glenn*, and Phillip C. Jobe@.
* Department of Pharmacology and Therapeutics and
+ Department of Anatomy, LSU Medical Center; and
@ Department of Psychiatry, Veterans Administration
Medical Center; Shreveport, Lou i siana, USA
9. Tinnitus in Children with Hearing Loss, John M.
Graham, Royal Ear Hospital, London, UK
10.Personality of the Tinnitus Patient, Patricia R.
House, Counseling & Psychotherapy Associates, San
Gabriel Valley, California, USA
11. Ttnnitus: Surgical Management, John W. House
and Derald E. Brackmann, Otologic Medical Group,
Inc., los Angeles, California, USA
12. Electrical Suppression of Tinnitus, Jean-Marie
Aran, Michel Negrevergne, Yves Cazals, Jean-Pau l
Erre and Renaud Charlet de Sauvage, Laboratorie
d'Audiologie Experimentale, Hopital Pellegrin,
Bordeaux, France
13. Clinical and Theoretical Implications of
Tinnitus Jack Vernon and Mary Meikle,
Department of Otolaryngology, Kresge Hearing
Research laboratory, Universit.v of Oregon Health
Sciences Center, Portland, Oregon, USA
14. Drug Treatment of Tinnitus, Ronald J . Goodey,
Dilworth Avenue Clinic, Auckland, New Zealand
Tribute Fund continued
In Honor of
Pulaski Award to
Max M. Novich, M.D. J. Alam & T. Drucker
Special Donations for ATA Research from:
chae 1 Cure i , Jewe 11 N. Jackson and Ga ius L itt 1 e.
TRIBUTE FUND
Many people find that the most fitting
to honor or commemorate a
speciaZ event is a gift to provide funds
for research. to the
fund are all directed to research
about tinnitus . All gifts are promptly
acknowledged both to the person honored
or the family of a person commemorated
and to the giver. Contributions are
Tax Deductible. ATA thanks the people
listed below for their help in the fight
to conquer tinnitus .
In Memory Of
Hyman Schiffer
Shirley Goft
Marguerite Riggan
Nathan Rubin
Myron L. Werner
Edmund Louis Mohr
Arthur Burnett, DCD
Emi 1 Gas pari
Mrs . Martin Fischer
Ruby Boolootian
Ruby Keeler
Joe Crone
Leslie Pendergraph
Alice Spinney
B i 11 i e Ke 11 ey
Gerard Ho 11 and
11rs. Cecil Steckel
Dale Brackett
Mrs. Jane Barnwell
Birthday
Helen E. Bowman
George Winchester Stone
Max M. Novich, M.D.
Jacqueline Doyle
Nina Novich
Mrs. Strei b's Mother
Or. Philip Silverstein
Trudy Drucker
Trudy Drucker
Eve U. Shaw
Harry Diener, M.D.
I lya Spagno 1 i
Anniversary
Mary & Gil Cassel
Bill & Andrea Hart
In Honor Of
Andrew Ambrosia
Andrew Ambrosia
Andrew Ambrosia
Ambrosia
Andrew Ambrosia
Andrew Ambrosia
Roy & Ronnie Grossman
Scott Grossman &
Lee Evan Grossman
Marjorie Vernon
Joseph E. Fischer Family
Ret irement
Jules Drucker
Donation From
Dora Smith
& Mrs. B. Leon
Bill & Mary Davis
Ida Rubin
Helen 11. Werner
Barbara Mohr
Barbara Burnett
Rose Vogelfanger
Timothy L. Fischer
11r. & Mrs. Henry Adams
& Mrs.Mac lamb &
& Mrs. Joe Dedic
Bill & Anne Story &
Veronica Perusina
Bill & Anne Story
Henry Quinn
Joy & Laura Mitchell
Mrs. Gerard Holland
Roger & Mary Parian
Robert Brickhouse
Dr & Mrs P. Silverstein
Don Bowman
J. Alam & T. Drucker
J . Alam & T. Drucker
J . Alam & T. Drucker
J. Alam & T. Drucker
Mrs. Martha Streib
Mrs. Pearl Silverstein
Joe Al am
Jules Drucker
Trudy Drucker
Trudy Drucker
Nancy Spagnoli
J. Alam & T. Drucker
J. Alam & T. Drucker
Sen.John H.Chafee
Christine Karras
Doreen Karras
Hazel Cherry
Carole Starkey
Anthony Vendresa
Ronnie Grossman
Shirley Schoedes
Mary Ann Herold
Timothy L. Fischer
J. Alam & T. Drucker
TI NNITUS MASKING PROGRAM
SURVEY RESULTS
Approximately two year s ago, (January, 1979),
the American Tinnitus Association conducted its
first tinnitus workshop in Portland, Oregon. In
the intervening two years, 20 tinnitus workshops
have been conducted throughout the United States
and approximately 1,200 physicians, audiol ogists
and hear ing aid dispensers have participated in
this program. After having attended a works hop,
many clinicians made a positive decision to ini-
tiate a masking program in their local area while
others did not . In an effort to determine how
many professionals were actively involved in
tinnitus programs and to assess the efficacy of
the individual programs, a questionnaire was
mailed to 1,150 individual s. Of this number, 292
or 25% returned the initial survey. A follow-up
letter was sent to 798 of those people who had not
responded. 408 responses were received, thus
increasing the total reply rate to 61%. Of this
group, 306 wished to remain i n the tinnitus
referral program and 40 did not. 62 letters were
undelivered . These later responses to the
follow-up letter are not included in the sample
being reported on the followi ng questions. The
survey included nine questions, six of which
requested specific information while the other
three were essay type questions pertaining to
future programming. It seems reasonable that
both clinicians and tinnitus sufferers would be
interested in the results of the survey and
therefore it is being publ ished in the Newsletter.
The results are reported and discussed relative
to the six questions .
1. Have you chosen to initiate a tinnitus
program?
Of the 292 respondents, 270 chose to i nitiate
a program. Programs have been established in al l
50 states, the District of Columbia, all six
Provinces in Canada and in six foreign countries.
Several of the 22 who did not elect to initiate
a program indicated that they preferred to refer
patients to other facilities in their geographi -
cal location. Although we have no evidence that
such is the case, we assume that those clinicians
who did not respond to the questionnaire have also
chosen not to become involved in the program.
2. Approximatel y how many patients have you
seen since this program was initiated whose
chief complaint was tinnitus and who would
seemingly benefit from treatment?
Responses to this question varied from 0 to
400 pati ents with a mean of 38 patients per
fac il ity. A majority of the clinicians reported
that they have seen only a sma l l number of
patients, but 23 facilities have evaluated over
100 patients. Much of this difference i s due to
the length of time the program has been in exist-
ence but some clinicians report that they are not
receiving referrals from the medical profession.
More and more, it is becoming apparent, especially
in large urban areas, that clini ci ans are
referring tinnitus patients to selected facilities
that have become actively involved and interested
in working with these patients.
3. Were these patients given a tinni t us
evaluation in your facility?
Two hundred forty clinicians responded
affirmatively to this question and only 14
indicated t hat they do not perform evaluations.
A small number of clinicians did not respond to
thi s question .
4. What kind of equipment is available at
your facili t y to evaluate and treat
tinnitus patients?
This question was asked in an open-ended
manner in an attempt to obtain information regard-
ing both evaluation equipment and masking instru-
ments. Responses fell into four different cate-
gories: Synthesizers, audiometric equipment,
mas king devices and other equipment. Of the
251 clinicians who indicated that they were
eval uating pati ents in their facilities, 95 had
purchased tinnitus synthesizers whereas the others
utilized either audiometers or special types of
modi f i ed equipment to make their measurements.
Many clinicians indicate that they could not
justify t he expense of the synthesizer because
of the limited number of tinnitus patients.
Surprisingly, only 73 clinics indicated
that they had tinnitus maskers or tinnitus
instruments available for testing purposes. This
has seemingly been one of the major problems
i nvolved in the fitting of masking devices . The
manufacturers are not providing masking devices
on a consignment basis and many clinics are
attempting to provide a tinnitus service without
having t hese instruments available. This
procedure has been found to seriously affect the
success of the program in that some patients who
can be masked effectively under earphones, cannot
benefit from masking devices. Likewise, some
patients who are difficult to mask under earphones
can be masked quite eas i ly with tinnitus maskers
or tinnitus instruments. Again, the limiting
factor denying clinicians from stocking tinnitus
maskers and instruments is economics. They state
they simply cannot afford the cost of a large
inventory of instruments with the limited popula-
tion of tinnitus patients.
5. Have the majority of your patients
followed your recommendation and put into
effect the treatment prescribed by you?
Approximately 80% of the responders answered
this question with a simple "yes". Others report-
ed a percentage figure and in most cases this
figure was quite high, (75%-90%). This is
consistent with previous find i ngs in that most
tinnitus patients who experience considerable
distress are wi l ling to follow through on any form
of treatment which might offer them relief .
6. How successful would you judge your
program to be in offering relief to
t i nnitus patients?
Several different answers were provided with
regard to this question. Many clinicians indicated
the success of their program in terms of a per-
centage figure while others made judgements
relative to ratings of excellent, good, fair or
poor . Still others rated their programs as highly
effective, not too effective, etc. In an effort
to record the various responses, the answers were
judged in terms of either percentages or catagories
of excel lent,good, fair,or poor. The numerous other
responses were translated into the latter four
catagories.
Tinnitus Survey continued from page 3
Of the 270 persons who have initiated tinnitus programs, 130 reported their success ratios in percentages,
115 rated them categorically and 25 indicated that they could not make a judgement at this time.
The results are shown in Tables 1 and 2.
Table 1. Reported success ratios (in percent) for 130 clinics involved in a tinnitus masking program.
20-29%
10
30-39%
12
40-49%
7
50-59%
33
60-69%
22
70-79%
26
80-89%
13
90-100%
4
These percentages are both interesting and informative. Pervious reports regarding the efficacy of mask-
ing as a treatment procedure for tinnitus have varied considerably from clinic to clinic. Preliminary data
suggested very high ratios of success but more recent surveys report success ratios ranging from 30% to 70%
depending upon the type of instrument used and the size of the population.
The results shown in Table 2 are consistant with the earlier surveys. Some clinics report very good suc-
cess while others appear to be experiencing difficulty with the program. By and large, however, the majority
of clinicians are having better than average success treating tinnitus patients. Eighty-one of the 130 clinics
report success ratios between 50% and 79%. However, some of these clinics have been seeing tinnitus patients
for only a short period of time and the long term success of the program will need to be evaluated at a later
date.
Table 2. Reported success ratios (in catagorical
in a tinnitus masking program.
Excellent Good
19 50
terms) for 115 tinnitus clinics involved
Poor
36 10
Although these results are not as definitive as percentage figures, the trend is very similar. Eighty-
six of the 115 clinics rated their success as either good or fair. Again, we see only a few clinicians
achieving outstanding results or failing entirely. These results would seem to indicate that about one-half
of the population who suffer from this symptom can achieve some relief from the masking technique. Fortunately,
some of the patients for whom masking is inappropriate respond well to other forms of treatment such as
biofeedback or drug therapy. Most importantly, this survey reveals that many tinnitus patients throughout the
United States and Canada are obtaining relief from this distressing symptom.
Two tinnitus workshops will be offered in
1981. The format of the workshops will be ex-
panded to include instruction about biofeedback
as well as masking. Each workshop will be two
full ~ a y s and will carry 15 hours of continuing
education credit. As in the past, enrollment
will be limited and registrations will be
assigned in the order of pre-paid receipt.
The first of these workshops will be held
at the Granada Royale Hometel, 2333 East Thomas
Road, Phoenix, AZ, 85016, on April 3 and 4, 1981.
Faculty for this workshop will be John W.
House, M.D., Patricia R. House, Ph.D., Robert M.
Johnson, Ph.D., and Jack A. Vernon, Ph.D.
Tuition is $250 for both days or $150 to
attend either day. This fee includes lunches,
refreshment and workshop materials. Hotel res-
ervations must be made on your own. The Granada
Royale Hometel is holding a block of rooms for
ATA and if you wish to stay there you may call
800-528-1445.
The second workshop in 1981 is tentatively
scheduled for October and will be at an East
Coast location. Details will be in the next
Newsletter.
These workshops are appropriate for atten-
dance by otolaryngologists, audiologists and
hearing aid dispensers as well as other health
professionals who might have contact with the
tinnitus patient. Theoretical and practical infor-
mation about the evaluation and management of
tinnitus is provided.
You may register for the workshop by sending
your check along with your full name, address and
profession to ATA, P. 0. Box 5, Portland, OR 97207.
MOVING?
Please Zet us avoid missing you
by supplying us with your new
address .
zip ____ _
ATA Statement for the fiscal year ending 10-31-80
Beginning Fund balance (11-1-79)
Revenue:
Contributions
Workshops
Other
Expenses:
Fund raising
Program services
Grants
Management & General
$55,422.
32,938.
11,404.
12,345.
62,927.
7,200.
11,908.
Ending Fund Balance (10-31-80)
$ 49,969.
99,764.
( 94 ,380.)
$ 55,353.
TELL ME, DOCTOR .. .
Jack Vernun, Ph. D., gives answers to some of the
most frequently asked questions about tinnitus.
you have a tinnitus question that you would
to see answered in this column please
address your letter to "Newsletter - Mailbag
Qr..estions".
Q. My noises, which are very loud, start only
I l i e down and shut my eyes. Once started
1t 2 hours of activi ty, physical and mental,
to d1ss1pate them. Then if I keep active all is
well. Is this a typical form of tinnitus?
A. Many tinnitus patients note an increase in the
level of tinnitus when they lie down. For such
it is usually the case that when they
l1e down they are also in a more quiet environ-
ment. That is to say, there is a reduction of
ambient environmental noise which has been
effecting some masking. In addition there is
usually a reduction of distractions. For these
patients properly arranged masking usually works
well. There are some few patients for whom a
prone position does indeed increase the level of
tinnitus regardless of the ambient conditions.
These cases most likely need medical attention
and should be seen by an otologist as well as
possibly a cardiologi st.
Q. Is flying by a major airline bad for those
who suffer from tinnitus?
A. Usually the noise inside commercial aircraft
is not suffi cient to increase tinnitus, however
people vary and if one notices any temporary
increase in tinnitus due to flying ear plugs
should be used. The change in pressure often
causes discomfort for those who do not clear
their middle ears resulting in a stuffy pressure
sensation which is uncomfortable. For such
people the use of custom fitted ear plugs is
recommended. These plugs are to be inserted
just prior to descending for a landing and then
removed after being on the ground for about 15
to 20 minutes.
Q. Would masking or any other treatment for
tinnitus be effective in a typical case of
Meniere's disease?
A. Usually the tinnitus accompanying 'burnt-out'
Meniere's disease is easily masked, sometimes
the use of a hearing aid alone even though the
a1d may not help the hearing. A trial with
masking is recommended for relief of the tinnitus.
Q. Why do people with my kind of tinnitus hear an
increase in loudness after a few drinks, when they
clench their teeth, when they drive in a noisy
auto? And how about the others, does their
tinnitus fluctuate in response to any stimulus?
A. It is a great mistake to assume that any one
statement about tinnitus applies to all cases of
tinnitus. Remember, tinnitus is a symptom not a
disease. It is a symptom associated with every
known pathological condition of the ear.
Alcohol can increase tinnitus just as certain
allergic reactions can also increase tinnitus but
neither case do we that happens. It
1s to learn about the many whys' of tinnitus that
research and support of it is needed. When we
learn the whys of tinnitus we will be able to
understand what i s needed for relief and hope-
fully for cures.
Noise, such as automobile/traffic sounds, is
well known to increase tinnitus for many patients.
Like alcohol and other items, if exposure to these
things causes an increase in tinnitus then clearly
these are things to be avoided and one is fortunate
to have such information.
LETTERS
TO THE
EDITOR
ATA l'eceivcs about a letters each
month. i-!ost of these are new inquiries about
tinnitus and a.;k us uhere to obtain help.
Some letters are full of information or make
a point; that LJc uoutd like to share you.
For th1.s l'eason we are inaugurating this
colwrm and hope t;zat yo:.. wiU write to us
with whatever you wouid like to share with
other l'eaders . We reselve the right to select
and edit Lcttel'D used in this colwnn.
Gentlemen:
I believe it would be useful to bring to the
attention of your readers two important facts
about tinnitus:
. 1. It is common for physicians to prescribe
ant1depressant medications for tinnitus sufferers.
It is not generally well known that the most
commonly used anti-depressants can, on occasion,
produce tinnitus. The Physicians' Desk Reference
mentions tinnitus as an adverse reaction to
imipramine (Tofranil), desipramine (Norpramin),
and amitriptyline (Elavil ). Recently, the July,
1980 issue of the American Journal of Psychiatry
(pp. 854-855) contained an article describing
the tinnitus side effects in four patients on
imipramine therapy. These patients did not
previously suffer with tinnitus, experienced
tinnitus when placed on imipramine, and enjoyed
an alleviation of the tinnitus when the dose of
anti-depressant was reduced.
. .There no question that there are many
pat1ents who are receiving increasingly
h1gher doses of anti-depressant medication. For
many, they are being made worse, not better, by
the anti-convulsant.
2. l>lany tinnitus patients, such as myself,
have been advised by well-meaning physicians
(even neurologists and otolaryngologists), that
they should have no concern about scuba-diving
because only the middle ear is affected by the
pressure changes involved in such diving. This
is well meaning, but misguided, advice. There
are a number of cases reported in the 1 iterature
of sensorineural hearing loss and tinnitus,
which had their onset when the patient was diving
with an artificial pressure system. A well
documented description of this phenonenon is
described in the June, 1972, issue of the
Archives of Otolaryngology, (pp. 556-563). The
mechanism of such hearing loss in tinnitus can
?nly be speculated upon. The patients described
1n the aforementioned article all had difficulty
performing the Valsalva maneuver, that is, they
had experienced difficulty equalizing pressure
in their middle ears and suffered pain as a
result of the pressure inequality. The authors
postulate that the cochlea can be traumatized by
the violent movement of the stapes that occurs
with middle ear clearing problems and Valsalva
maneuvers. I believe that this may have been
a factor in the etiology of my own tinnitus.
Again, I hope you will bring these points
to the attention of your readers.
signed: Richard A. Gardner, M.D.
Associate Clinical Professor
of Child Psychiatry
Columbia University, College
of Physicians and Surgeons
THIS MIGHT BE YOUR LAST
NEWSLETTER or, How can we convince
you that ~ e need your heZp?
We've been talking at ATA about how best to pry
some money out of you. We've talked about Test
Mailings, this approach, that approach, this
gimmick, and that gimmick. We can't afford
advertising agencies; we can't afford fund raising
counsel; we can barely afford our mailings.
Inflation is crushing us just the way it is you.
We don't know whether our appeals for money fall
on deaf ears, you'll pardon the pun, or not. We
can't experiment to find out, and we don't think
you'd want us to anyway. The point is we can't
continue our work without money. Your money.
Since the inception of ATA in 1972, we've
been able to maintain our services through private
donations and, for a time, from fees for masking
devices and workshop fees . This income has
allowed us to maintain an office, provide infor-
mation to thousands of tinnitus patients, conduct
tinnitus workshops in twenty cities throughout
the United States and exhibit at various profes-
sional meetings. During the initial years of
organization, the membership was relatively small
and dissemination of information was not too
costly. However with the recent interest in
tinnitus the mailing list has expanded to about
40,000 names during the past two years. The
result of this increase in membership coupled with
a reduction in fees from workshops and maskers
has seriously affected our economic position.
The cost of mailing the Newsletter has become
prohibitive and unless additional funding can be
generated it will be necessary to reduce the
number of Newsletters in order to maintain our
other services. During the past month we rec-
eived over 1000 letters requesting information
and we feel that our first priority must be to
offer referrals to tinnitus sufferers and answer
any concerns from clinicians involved in a
tinnitus program.
PubUshed by the
Membership in ATA is a recognition of your
donation. You are encouraged to contribute on a
regular basis to help carry on the work needed
to promote research about tinnitus and to provide
information about tinnitus both to sufferers and
to those working in the field. In 1980 ATA was
able, even with our limited funds, to make our
first grants for tinnitus research totalling
$14,400. This is a fantastic accomplishment and
the credit goes to you.
Your annual contribution to ATA in any
amount that you can afford will help bring the
solution to the problem of tinnitus. In addition
to regular contributions a special fund, just for
research, the tribute fund, exists and through
it you can make donations in memory of or in
honor of some special person or occasion.
You wouldn't be reading this if you didn't
have tinnitus or an interest in tinnitus so
please give us your continued support . With the
renewed interest in tinnitus research we can be
hopeful for major breakthroughs in the near
future, but only if this research can be under-
taken.
Thank you for your contributions.
ANNUAL CONTRIBUTION AMERICAN TINNITUS ASSOCIATION
Regular Member $ 15 or more 0
Sustaining Member $ 25 or more 0
Professional Member $100 or more 0
Benefactor $500 or more 0
YOUR GIFT IS TAX DEDUCTIBLE
Do you know someone who has t innitus and would like to receive our newsletter?
Name __________________________________________ __
Address -------------------------------
State, Zip
AMERICAN TINNITUS ASSOCIATION
A pl"ivo:te non-profit CO'f'l'OMtion
undel" the ~ s of Ol"egon
The American Tinnitus Association
Post Office Box 5
Non-Profit Organ.
U.S. Postage
PAID
Permit No. 1792
Portland, Oregon
Medical Advisory Board
Roger Boles, H. D.
San Francisco, California
David D. DeWeese, M. D.
Portland, Oregon
Howard P. House, M. D.
Los Angeles, California
Robert M. Johnson, Ph.D.
Portland, Oregon
Merle Lawrence, Ph. D.
Ann Arbor, Michigan
Jerry Northern, Ph.D.
Denver, Colorado
Gunnar 0. Proud, M. D.
Kansas City, Kansas
George f. Reed, M. D.
Syracuse, New York
Robert Sandlin, Ph. D.
San Diego, California
Abraham Shulman, M. D.
New York, New York
Harold G. Tabb, M. D.
New Orleans, Louisiana
Board of Directors
Robert Hocks, Chairman
Portland, Oregon
Gloria Reich,
Portland, Oregon
Charles Unice, M. D.
Downey, Califo!nia
Jack Vernon, Ph.D.
Port land. Oregon
Thomas Wissbaum, C.P.A.
Portland, Oregon
Honorary Directors
Del Clawson,
Downey, California
Honorable Mark Hatfield
United States Senate
Portland. Oregon 97207
(503) 248-9985
ADDRESS CORRECTION REQUESTED