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 Nature.

"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 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 victims.

Thankfully, said Dr. Alder, the team's services haven't been required yet.

Etched in stone

Three researchers win CREF awards

The fund supports new faculty members at the levels of assistant professor or instructor who have a high potential for obtaining federal, private or industrial research grants within three years of receiving CREF support.

Dr. Hart, who received $40,000 in grant money, is working on a project titled "Structure/Function of CuZnSOD and its Copper Chaperone in Familial ALS."

Dr. Kelly, who was awarded $35,000, is studying "Social Influences on Adolescent Girls' Sexual Behavior," and Dr. Clever, who received $26,028 in funding, is working on a project titled "Critical Sequences for HIV-1 First Strand Transfer."

Office of Human Resources opens
a Benefits Enrollment Resource Center

The center will be located in room 112 of the Administration Building, and will be open July 26, July 28 and July 30 from 8:30 a.m. to 4:30 p.m. On July 27 and July 29 it will be open from 8:30 to 11 a.m.

Employees using the resource center must bring their Personal Identification Numbers (PINs) with them and know what benefit changes they wish to make. HR staff members will be in the center to help employees and retirees access the Internet or answer general questions only. Specific questions regarding benefits or enrollment should be addressed to the HR benefits section at ext. 2610.

If you have questions regarding the use of the resource center, call the Employee Development and Training Office at ext. 2323.

Lawrence addresses school violence
prevention panel

Dr. Leonard E. Lawrence, a child psychiatrist and associate dean for student affairs in the Medical School, provided expert testimony July 15 at the San Antonio meeting of the Attorney General's School Violence Prevention Task Force.

Dr. Lawrence, chairman of the Texas Youth Commission, discussed "Working with Troubled Youth" during the meeting at The University of Texas at San Antonio's Downtown Campus.

"The Task Force heard testimony about issues of juvenile violence and is looking at ways to reduce these outbursts that result in death and injury to children," Dr. Lawrence said. "My talk addressed spur-of-the-moment, impulsive violence, but also the planned activity that generally follows a great deal of internal obsessing and that reflects inability on the part of the perpetrator to think analytically about satisfactory behaviors."

Dr. Lawrence is completing his eighth year on the Youth Commission and his fourth year as chairman of the panel. Initially appointed by Gov. Ann Richards, he was reappointed to a six-year term by Gov. George W. Bush.

STHRC announces small-grants program

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.

Internet service provider rates change;
more hours added

As of July 1, clients are eligible to upgrade advanced account services to a new 100-hour-a-month plan for $17.95, with overtime hours priced at 10 cents an hour. The hours for the standard $13.95 account have increased from 30 to 40 hours per month, with an overtime charge of 25 cents an hour. The basic account remains the same at $6.95 per month for 20 hours. Advanced and standard accounts may be paid by the Health Science Center, subject to departmental approval.

For more information, contact the triage help desk in the Department of Computing Resources at ext. 2069 or DCCI Internet Services at 731-6611.

Pioneers in partnering:

HSC, South Texas Veterans Health Care System
reap benefits of sharing

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 partnerships elsewhere?

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 Center?

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 faculty?

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 our consolidation 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 less care.

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.

Stern joins Health Science Center

Before coming to San Antonio, Dr. Stern was associate professor of psychiatry at the Ohio State University College of Medicine in Columbus. He earned his bachelor's degree at Columbia University and attended medical school at New York University, followed by a residency at the Hospital of the University of Pennsylvania.

During his tenure with Ohio State, Dr. Stern founded the Mood Disorders Clinic at the Ohio State University Hospitals and the Lithium Clinic at the VA Outpatient Clinic in Columbus.

Dr. Stern's research focuses on mood disorders and their relationship to physical illness. He is conducting a study of physiologic mechanisms by which depression and ischemic heart disease might be linked. His most recent article is titled "Do Health Professionals' Attitudes Interfere with the Treatment of Depression?"

Dr. Stern has made numerous presentations, most recently "Hopeless Feelings and All-Cause Mortality in Older Mexican- and European-American Community Residents" at the 152nd annual meeting of the American Psychiatric Association, and "Psychiatric and Psychotherapeutic Issues in AIDS Patients" in the South Texas AIDS Training for Mental Health Providers publication.

Benefits enrollment period extended

Last date to file insurance changes is August 6

The deadline was extended to allow employees and retirees sufficient time to review their enrollment packets and decide on benefit plan selections for the 1999-2000 fiscal year.

A special parking edition of The News

2000--Make it compute

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

7:00 a.m.
Orthopaedic Teaching Conf. "Hand Fellows' Research Papers," Drs. Neil Callister, Peter Chan, Robert Rhoad & John Sanders ( MED: 309L call ext. 5125 for more information)

8:00 a.m.
Medical Housestaff Specialty Conf. "Emergency Series: Tachyarrythmias," Dr. David Murray (MED: 409L)

8:00 a.m.
Rehab Medicine PM&R Conf. "Prosthetic Knee Units," Drs. Eugenio Monasterio & Norman Gall (UH: Reeves Rehab Center 3rd-floor classroom)

3:00 p.m.
Biochemistry Seminar "Turning 7TM Receptors On & Off With Metal Ions & ChelatorsFrom Basic Structure to Possible Control of Transgenes," Dr. Thue Schwartz (MED: 409L)

TUESDAY, JULY 27

8:00 a.m.
Rehab Medicine Lecture Series "Myoelectrics & Electrically Switched Prostheses," Vincent Gassaway (UH: Reeves Rehab Center 3rd-floor classroom)

8:00 a.m.
Medical Housestaff Specialty Conf. "Emergency Series: Oncologic Emergencies," Dr. Helen Chew (MED: 409L)

Noon
Cellular & Structural Biology Seminar "The Role of IGF-I in CNS Development: Studies of Transgenic Mice," Dr. A. Joseph D'Ercole (MED: 409L)

Noon
TNT "Cytology: FNA of Soft Tissue," Dr. Fadi Adul-Karim, University Hospitals of Cleveland, Ohio (call ext. 2700 for information)

1:30 p.m.

WEDNESDAY, JULY 28

7:00 a.m.
Vascular Surgery Grand Rounds, Dr. Mellick Sykes (LEC: 2.042)

8:00 a.m.
Medical Grand Rounds "Skin Cancer: Recognition & Treatment," Dr. Ronald Grimwood (MED: 409L)

9:00 a.m.
Surgery Trauma M&M Conf., Dr. Ronald Stewart (MED: 309L)

Noon
TNT "Women's Health Issues & Trends: Osteoporosis: Screening & Treatment Issues," Dr. Roberto Civitelli, Washington University, St. Louis, Mo. (call ext. 2700 for information)

1:00 p.m.
Continuing Education Teleconf. System "Medicare Fraud & Abuse" (call ext. 7810 for information)

1:30 p.m.
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

7:30 a.m.
Thoracic Surgery Resident Teaching Conf. (UH: 5th-floor neonatal ICU classroom)

8:00 a.m.
Neurology Grand Rounds "Dissections of Cervical & Cerebral Arteries," Dr. Robert Hart (MED: 444B)

Noon
Pulmonary, Thoracic & Oncology Conf. (MED: 209L)

4:00 p.m.
Surgery Tumor Conference, Dr. Anatolio Cruz (MED: 209L)

4:30 p.m.
Citywide Thoracic Grand Rounds Conf. "Case Presentation," Dr. Allan Brants (MED: 309L)

FRIDAY, JULY 30

7:30 a.m.
Pediatric Grand Rounds "In Search of Novel Therapies for Pediatric Sepsis," Dr. Brett Giroir,
The University of Texas Southwestern Medical Center (MED: 409L)

8:00 a.m.
Rehab Medicine PM&R Conf. "Principles of Hip Disarticulation Prostheses," Drs. James Williams & Norman Gall (UH: Reeves Rehab Center 3rd-floor classroom)

8:00 a.m.
Medical Housestaff Specialty Conf. "Emergency Series: Bradyarrythmias," Dr. Laura Collins (MED: 309L)

SATURDAY, JULY 31

9:00 a.m.
General Surgery Grand Rounds, Dr. Wayne Schwesinger (MED: 409L)