New scans show key brain interactions
New brain images from the Health Science Center reveal never-before-demonstrated "temporal dynamics" of the interactions of two important brain structures, the
cerebellum and the basal ganglia. The structures imaged are implicated in a wide range of clinical disorders, including Parkinson's disease, autism, and the cognitive and motor effects
of chronic alcoholism.
The findings, from the Research Imaging Center (RIC), are described in the July 22 issue of
"The use of imaging to study the temporal dynamics of regional interactions in the brain is a field in its infancy," said Dr. Peter T. Fox, director of the RIC and
corresponding author on the paper. "The present study is the first to demonstrate changes in regional processing demands and inter-regional interactions in the course of an
ongoing behavior." The term "temporal dynamics" applies to changes over time during performance of a task.
The functional magnetic resonance (fMR) brain images were recorded as subjects held wooden shapes in both hands and distinguished between the two forms.
Participants were asked to compare a series of different objects. The results demonstrated the cerebellum and basal ganglia working together as
the subjects perceived the wooden shapes.
The paper, "Temporal Dissociation of Parallel Processing in the Human Subcortical Outputs," examines the interdependence of the cerebellum and basal ganglia in
cognitive tasks, particularly sensory discrimination, said first author Dr. Yijun Liu of the RIC and the Department of Physiology.
"The new images show that their interaction is involved in both sensory and motor activity," he said, "and at various points in performance of the assigned tasks."
In 1996 RIC scientists showed that the cerebellum, a large portion of the brain near the brain stem, is involved in perceptual, cognitive and motor activity related to
the acquisition of sensory information. The basal ganglia, gray masses deep in the cerebral hemispheres and in the upper brain stem, long have been linked to motor functions.
But the relationship between the two was not strongly known. "The basal ganglia are strongly involved as discrimination of tactile objects begins, and the cerebellum
more strongly as the task continues," Dr. Liu said.
"This is a new way of looking at imaging data which focuses on the time course of functional activations and interactions," Dr. Fox said. "Imaging temporal
dynamics appears to be a promising route to a deeper understanding of clinical disorders of these brain structures."
The Nature article reflects work from Dr. Liu's completed doctoral dissertation. He received his Ph.D. in May. Co-authors from the Research Imaging Center are Drs.
Fox; Jia-Hong Gao, fMR physicist and associate professor; Mario Liotti, assistant professor; and Yonglin Pu, visiting assistant professor. Dr. Fox supervised Dr. Liu's Ph.D.
studies and Dr. Gao was a dissertation committee member.
Any clinical application of the work is years away. "But this gives us future directions for using fMR to study brain function," Dr. Liu said.
The fMR imaging instrument was purchased jointly by the South Texas
Veterans Health Care System and the Health Science Center.
New identity for forensic program
Dental School's forensic efforts acquire new name
The Dental School's forensic education program has a new name to go with its
new facilities in the Bexar County Forensic Science Center. It is now the Center for Education
and Research in Forensics (CERF), and is the only
such post-doctoral training program in the country.
The program offers a master's degree in dental diagnostic science with an
emphasis on forensics and several continuing education courses. The CERF, headed by Dr.
Marden Alder, associate professor of dental diagnostic science and head of the
division of maxillofacial radiology, also sponsors
the world-renowned Southwest Symposium in Forensic Dentistry
every two years.
Dr. Alder and his associate, Dr. David Senn, clinical assistant professor of dental diagnostic science, expect the new
designation to lead to greater national visibility and
increased funding for the center.
Much of the CERF's work involves identifying bodies through dental records at the request of the Bexar County
medical examiner when a visual identification is impossible.
In cases where the body is badly burned or decomposed, the forensic dentists will make an identification to spare the family from having to view the remains.
In one case, Dr. Alder recalls, a young man who was killed while hitchhiking went unidentified for four years. The boy's correct dental records were finally discovered in
California, and Dr. Alder was able to identify him, much to his parents' relief.
"There is a huge psychological burden for the next of kin until they can have some closure," said Dr. Alder. "It's a great feeling to be able to provide that service."
Drs. Alder and Senn also investigate sexual assault and child abuse cases in which the victim is bitten. Using life-size photographs of the bite marks and a transparent
overlay showing the arrangement of a suspect's teeth, Drs. Alder and Senn check for a match. If the case goes to trial, they testify as expert witnesses.
"It is quite often rewarding in that you can help
get someone off the street," said Dr. Alder.
Education also gets high priority at the center. Drs. Alder and Senn recently completed a program to train emergency room nurses how to manage and preserve evidence from
bite marks, including how to differentiate human bites from animal bites. For example, a wound should not be washed until the forensic dentists can get a swab of the area for
possible DNA evidence from the attacker's saliva.
"We've gotten more calls from emergency rooms since the nursing education started than we ever
did before," said Dr. Senn.
At the request of the Bexar County medical
examiner, Drs. Alder and Senn have also trained a 45-member dental forensic victim identification team. Made up of volunteers
from the Dental School and private practice, the dentists on the team will be called in the event of a mass disaster to identify
Thankfully, said Dr. Alder, the team's services haven't been required
STHRC announces small-grants program
The South Texas Health Research Center (STHRC) is launching its
small-grants program for 1999-2001. The center is seeking proposals from faculty researchers whose work has a direct impact on the residents of South Texas. The deadline for submissions is 5 p.m. Aug. 27.
STHRC expects to fund eight to 12 projects with a maximum award of $50,000. Projects of 20 months or shorter duration will be considered, with shorter projects
funded proportionately. Institutional Review Board approval is required.
Proposals considered to be continuations of previous STHRC awards will not be considered.
Funding will be awarded based on scientific value, impact on health care needs of South Texas, collaboration with regional institutions and communities, and the
potential for using STHRC funding as seed money to attract additional funds from other sources.
Past areas of small-grant research include diabetes, infectious diseases, mental disorders, hypertension, nutrition, obesity, cancer, maternal and child health, geriatrics,
disease prevention, health service delivery, health policy, community health education and continuing education.
For information, call Dr. Roberto Villarreal at ext. 7826.
Pioneers in partnering:
HSC, South Texas Veterans Health Care System
Two are better than one, especially in the case of a couple of long-standing partners, the Health Science Center and the South Texas Veterans Health Care
System (STVHCS). The institutions' mutually beneficial relationship serves health care providers who are in training as well as patients and the scientific community, said Dr. John
P. Howe, III, president of the Health Science Center. The result is a body of work that is substantially greater than either the VA or the Health Science Center could
Jose R. Coronado, FACHE, director of the South Texas Veterans Health Care System, made the same points in a recent interview about the partnership between
the STVHCS and the Health Science Center. The institutions' teamwork is a model for VA-health science center collaborations around the country, he said. Excerpts of
the interview follow.
Q. How do you think our San Antonio partnership compares with other
A. If it's not the best partnership outright, then it is a very good
model of one. The basic thing about partnership is trust--accepting the fact that if one side wins, you do
too. I've always felt that we are an integral part of the Health Science Center. We share faculty, we share housestaff, and we share many common concerns. We watch over
each other's welfare.
Years ago, when our institutions were getting established, we said we
would provide the Medical School with a facility that is fully staffed
and equipped, and set up in a
way that enhances the graduate medical education program. In return the
Health Science Center assured us one thing--that a highly qualified physician workforce would
continually provide us with staffing. That is the return package. To get our relationship to work, there are many other things we do, including research, education and patient
care. Both parties are involved, and it is a give-and-take situation.
Q. What is especially noteworthy about the relationship between
the South Texas Veterans Health Care System and the Health Science
A. I think the most valuable aspect is that we have proven that two parties can achieve goals much easier than either one by itself. I'd like to think that the Health
Science Center and the VA were probably the pioneers in partnering in San Antonio, because we had a common mission. The VA is mandated by law to assist in training physicians
for the country, not for the VA alone, but for the country. The Health Science Center is committed to training physicians for the state and the country. When we study our
two missions, we find we have a lot in common, and therefore partnering is a natural.
Q. What are the most current directions of VA/Health Science Center research?
A. Much of our research is centered on medical problems of the region, of the ethnic groups in the area. Diabetes is one that comes to mind. It is a very common problem
here because of the number of Hispanics in the region. Hypertension is also something we are investigating because congestive heart failure is very common among veterans.
We also have an aging veteran population that requires study, and we have a young veteran population that's come back from the Persian Gulf with medical problems that
are unresolved. Then there's the issue of smoking, which creates problems in respiratory systems, and a lot of our research is focused in that direction. The old common goals
that health care has had since the 1950s, of finding cures and treatments for cancer, heart disease and stroke, still are very much alive and we are looking for solutions.
Q. How is clinical care for the veterans enhanced by the university
A. It has always been an accepted fact that when you have a health care program that is tied to an academic medical center, like we have here, you have the latest medical
knowledge available to your patients. You have young physicians who are learning and who are benefiting from having a great deal of technical information on the cutting edge
of health care. We can handle more complex problems because of the broad and continuous coverage provided by housestaff. All of that benefits our veteran patients.
Q. The South Texas Veterans Health Care System is a crucial site for residency rotations, nursing training and other educational activities. What is your perspective on
the teaching contributions of the VA?
A. The VA committed itself to supporting graduate medical education
after the Second World War. At the time medical schools had a larger
number of doctors in training.
The VA, meanwhile, had lost many of its doctors to the war, and now many veterans were home and needing care. It was natural to bring the VA and medical schools together. Even
today, almost every VA medical center has the objective of becoming a teaching hospital, of being affiliated with a medical school. I think the teaching component lends an air of
discovery, of searching for answers and bringing new technologies and new concepts to our patients personally.
Q. What changes have taken place since the Audie L. Murphy Memorial Veterans Hospital was enlarged into a regional health care system?
A. We have taken this whole system that was hospital-based and made it a health care
system that provides care to the patients close to their homes. During
of facilities, we started with one aim--to convert some of our tertiary care to primary care. Many surgeries that required extended hospital stays now are done as same-day surgery.
Other procedures such as cardiac catheterizations now are done same day.
We had always required the patient to be in the
hospital for several days before we would do a procedure. Now
many procedures are done on an outpatient basis.
Q. Wasn't the South Texas Veterans Health Care System honored recently for being in the highest echelon of VA centers?
A. We have been recognized by VA headquarters with two Centers of Excellence citations. The South Texas system has always been recognized as being progressive. We are
moving ahead in developing an electronic medical record. That was something we always wanted and decided to move ahead on our own. We are two-thirds of the way there. Once we do
that, the moving of patient medical information between San Antonio, McAllen, Laredo and Corpus Christi will be computerized. We also want to have our X-rays digitized, along
with MRIs and CT scans, so that they can become part of the medical record and transmitted by computer. All this can be retrieved anywhere within the organization without having
to wait. We are in the midst of this right now; it is not science fiction.
Q. So a veteran who lives anywhere in the system can have confidence he is getting the up-to-the-minute, best care right now?
A. We are guaranteeing that. We want to be the provider of choice for veterans. Veterans have choices, and we know that. With Medicare and Medicaid, they could go
anywhere. Probably up until three years ago, we were losing a lot of veterans because of restrictive liability criteria. We would only take veterans who were service-connected to bring into
the hospitals. Now the old eligibility has changed and we are accepting all veterans. We are increasing our capabilities and making sure the standard of care is uniform throughout
the system. No one will have to feel that because he is coming to a small VA facility that he is going to get
We are involved in a project with the Health Science Center's School of Allied Health Sciences in which we are providing cardiac monitors for use in the homes of patients. We
have equipment in the homes and telephones to transmit information back to us. Our objective is to give people as high a quality of life as possible.
Q. The VA has contributed to many key projects, including the acquisition of a $5.3 million PET scanner at the Research Imaging Center. Please comment on the vital sharing
of resources and the inherent benefits.
A. One project involved the joint purchase of an MRI at University Hospital. Neither institution could afford to buy its own several years ago, so we came together and utilized a
VA special purchase program that provides funding if we can find a partner. More recently, the Cancer Therapy & Research Center needed new linear accelerators, which are very
expensive. The VA matching program was able to help again.
Our biggest partner is the Health Science Center. The reason the VA has flourished here is that the community has been very supportive. In many cities the VA is considered a
poor cousin. Here we are really part of the main center, primarily because of our relationship with the Health Science Center.
Q. Like the Health Science Center, the VA recently celebrated its 25th anniversary. What are some goals for the next 25 years?
A. Our goals for the next several years will be to stabilize our
organization and to strike a balance between three levels of care--primary care, secondary care at our satellite clinics
and tertiary care, which is hospital-based.
We need to strike a balance and make sure we continue with our ability to provide services to our veterans close to their homes. They should not have to drive more than 30
miles or 30 minutes to get health care. And we need to continue our
research efforts to enrich the delivery of health care by always
pushing and supporting biomedical research. We continue to look for new
ways to take care of old problems, such as cancer.
One of the things that is embarrassing to the country, and to us, is
that we have not reached everyone--not everybody has access to health
care. Improving access needs to be a
goal for the next 25 years.
The supplemental section includes the new parking rates,
a map of the various parking areas and payroll deduction options.
A calendar of parking registration locations, dates and times also is available.
2000--Make it compute
Q. Will all Y2K fixes be done on time?
A. We are confident they will. One major project, however, will go right down to the wire. The building automation system is being replaced because it is not Year
2000 compliant. This system controls heating, cooling, ventilation and alarm monitoring on the Health Science Center's campus. The project is scheduled for completion
in December at a cost of $1.7 million.
Q. What about the payroll system?
A. The Health Science Center's payroll system has been converted, and is in the final stage of testing for Year 2000 compliance.
Q. Will my electronic deposit be OK?
A. The Health Science Center contracts with Frost Bank to electronically transfer your payroll deposit information to your financial institution. Frost Bank has informed
us that its system for transmitting the funds from the Health Science Center's bank account has been fixed and tested to work properly in the Year 2000. If your financial
institution has not informed you of its Year 2000 efforts, you should consider asking if it is Year 2000 compliant with regard to electronic deposit.
Q. Will my TRS check be affected?
A. The Teacher Retirement System of Texas reports that its benefit processing and other systems are Year 2000 compliant, and it anticipates no problem issuing checks in
the new year.
Q. What about my student financial aid?
A. The computer systems for student records and financial aid have been remediated and are up, running and ready for the Year 2000.
Q. Who makes sure the Health Science Center is doing its job on Y2K?
A. The project is under the supervision of the President's Year 2000
Task Force, whose members were appointed in August 1997 by Dr. John P.
Howe, III, president. Progress
is monitored by the U. T. System administration and the Texas
Department of Information Resources. The Health Science Center's
Year 2000 program has been cited by
U. T. System auditors as outstanding.
Calendar for July 26 - Aug. 1
MONDAY, JULY 26
Orthopaedic Teaching Conf. "Hand Fellows' Research Papers,"
Drs. Neil Callister, Peter Chan, Robert Rhoad & John Sanders (
MED: 309L call ext. 5125 for more
Medical Housestaff Specialty Conf. "Emergency Series: Tachyarrythmias," Dr. David Murray (MED: 409L)
Rehab Medicine PM&R Conf. "Prosthetic Knee Units," Drs. Eugenio Monasterio & Norman Gall (UH: Reeves Rehab Center 3rd-floor classroom)
Biochemistry Seminar "Turning 7TM Receptors On &
Off With Metal Ions & ChelatorsFrom Basic Structure to Possible Control of Transgenes," Dr. Thue Schwartz
TUESDAY, JULY 27
Rehab Medicine Lecture Series "Myoelectrics & Electrically Switched Prostheses," Vincent Gassaway (UH: Reeves Rehab Center 3rd-floor classroom)
Medical Housestaff Specialty Conf. "Emergency Series: Oncologic Emergencies," Dr. Helen Chew (MED: 409L)
Cellular & Structural Biology Seminar "The Role of IGF-I in CNS Development: Studies of Transgenic
Mice," Dr. A. Joseph D'Ercole (MED: 409L)
TNT "Cytology: FNA of Soft Tissue," Dr. Fadi Adul-Karim, University Hospitals of Cleveland, Ohio (call ext. 2700 for information)
TNT "Laboratory Technology Issues: Update on LeukemiasPart I," Tim Randolph, St. Louis University, St. Louis, Mo. (call ext. 2700 for information)
WEDNESDAY, JULY 28
Vascular Surgery Grand Rounds, Dr. Mellick Sykes (LEC: 2.042)
Medical Grand Rounds "Skin Cancer: Recognition & Treatment," Dr. Ronald Grimwood (MED: 409L)
Surgery Trauma M&M Conf., Dr. Ronald Stewart (MED: 309L)
TNT "Women's Health Issues & Trends: Osteoporosis: Screening & Treatment Issues," Dr. Roberto Civitelli, Washington University, St. Louis, Mo. (call ext. 2700 for
Continuing Education Teleconf. System "Medicare Fraud & Abuse" (call ext. 7810 for information)
TNT "Health Care Commentaries: Distance Learning in Health Care Continuing Education,"
Dr. Barbara Covington, Webster University, Crocker, Mo. (call ext. 2700 for information)
THURSDAY, JULY 29
Thoracic Surgery Resident Teaching Conf. (UH: 5th-floor neonatal ICU classroom)
Neurology Grand Rounds "Dissections of Cervical & Cerebral Arteries," Dr. Robert Hart (MED: 444B)
Pulmonary, Thoracic & Oncology Conf. (MED: 209L)
Surgery Tumor Conference, Dr. Anatolio Cruz (MED: 209L)
Citywide Thoracic Grand Rounds Conf. "Case Presentation," Dr. Allan Brants (MED: 309L)
FRIDAY, JULY 30
Pediatric Grand Rounds "In Search of Novel Therapies for Pediatric Sepsis," Dr. Brett Giroir,
The University of Texas Southwestern Medical Center (MED: 409L)
Rehab Medicine PM&R Conf. "Principles of Hip Disarticulation Prostheses," Drs. James Williams & Norman Gall (UH: Reeves Rehab Center 3rd-floor classroom)
Medical Housestaff Specialty Conf. "Emergency Series:
Bradyarrythmias," Dr. Laura Collins (MED: 309L)
SATURDAY, JULY 31
General Surgery Grand Rounds, Dr. Wayne Schwesinger (MED: 409L)
Index of issues
THE NEWS is published Fridays by the Office of Public Affairs for faculty and staff of The University of Texas Health Science Center at San Antonio.
Vice President for University Relations.....Judy Petty Wolf
Executive Director of Development & Public Affairs.....Dr. Charles Rodriguez
Writers.....Myong Covert, Catherine Duncan, Heather Feldman, Jennifer Lorenzo
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Web Editor.....Joanne Shaw
Office of Public Affairs, 7703 Floyd Curl Drive,
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