Faculty surgeons from the Health Science Center are the first in South Texas to repair an abdominal aortic aneurysm using an experimental stent-graft apparatus.
The surgical team, operating at University Hospital, repaired an aneurysm in the abdominal aorta of a 75-year-old Kerrville woman, Thelma Curlee. The aorta in the abdomen is normally about 1 inch in size, but Curlee's had ballooned to 2 1/2 inches. The Dec. 17 operation was the first with this type of experimental device in South Texas.
Dr. Boulos Toursarkissian, assistant professor of surgery, and Dr. Julio Palmaz, professor of radiology, headed the operating team. A San Antonio vascular surgeon, Dr. Ted Wolf, referred the case to the Health Science Center faculty members. Dr. Wolf is a member of the South Texas Vascular Study Group, a cooperative venture between Health Science Center surgeons and community vascular surgeons for the study of experimental procedures.
Curlee went home five days after the minimally invasive surgery, which involved threading the stent-graft apparatus through arteries via a catheter, starting from an incision in the groin. The usual hospital stay after standard abdominal aneurysm surgery is seven to 10 days.
By using the new device, surgeons avoided putting the patient under general anesthesia and making an incision of 40 to 50 centimeters (15 to 20 inches) through the abdominal area. Pain was minimized and recovery time shortened.
Patients with heart and lung problems, such as Curlee, have a higher risk of suffering complications from general anesthesia. Doctors were able to give her epidural anesthesia and keep her awake during the surgery.
"I've had this aneurysm for several years," Curlee said at a check-up Jan. 28. "It stayed small, then doubled all of a sudden. That's why 'Dr. T' did the surgery. He gave me information on the new device. I read it over and over."
The retired nurse also had a coronary artery angioplasty in May 1998 at Methodist Hospital in San Antonio.
She was at her return appointment with her daughter, Karen Baker. "My mother has had excellent care here, above and beyond our expectations," Baker said. "This is a great group," she added, referring to the Health Science Center/University Hospital team which includes Dr. Mellick Sykes, associate professor of surgery and head of the Vascular Surgery Division, and Joan Godsey, vascular laboratory director.
A homemaker with four children (the others are James Curlee, William Curlee Jr. and LaQueeta Hoffpauir), Thelma Curlee started her nursing career at age 45. She worked at the Kerrville Veterans Hospital and later at Olin Teague Hospital in Temple, and received her Registered Nurse (RN) certification at age 56 from Central Texas College in Killeen. "I was a Licensed Vocational Nurse (LVN) before that, but the VA sent me to school, which was a real honor."
Her first job was as a kitchen assistant at the Kerrville VA. "I went from pots and pans to cardiac intensive care nursing, which is what I worked in for 20 years," she said. Curlee retired in 1987 but still takes continuing nursing education courses to keep her State of Texas nursing license.
Her aneurysm is stable, Dr. Toursarkissian said. The stent-graft apparatus, about two-fifths of an inch in size, was acquired on a "compassionate use" basis for her surgery.
A stent is a wire mesh device that, when released, springs open to anchor in the artery wall. In Curlee's case, the new apparatus combines a stent with a polyester tube to repair the aneurysm. The stent is sewn to the inside of the tube, which prevents blood from leaking through the stent's wire mesh.
The U.S. Food & Drug Administration has not yet released the device, which is used in Australia and Europe. Only a handful are being tested in Phase II clinical trials in the United States. The apparatus, called the "Talent Graft System," is made by World Medical of Sunrise, Fla.
The operation, an "endovascular stented graft," repaired a swollen or ballooned site on Curlee's aorta. Normally, the aorta in the abdominal area is about 1 inch wide; the patient's was more than twice that size and in danger of rupturing, Dr. Toursarkissian said. If an aneurysm this size is left untreated, the chance of it rupturing over the next few years is 40 percent, he said. Death occurs more than 80 percent of the time after a rupture.
A bypass of sorts
The stent-graft apparatus alleviates pressure so the weak vessel wall does not rupture. Instead of blood flowing into the patient's aorta at the weak spot, it now flows through the apparatus positioned at that site.
The aorta begins near the heart and extends through the chest. It splits in the abdomen with one branch extending down each leg.
It's already known that this amazing substance, produced in the brain, regulates the circadian rhythm, an important body "clock." Melatonin level decreases during the day and increases at night.
It also appears that age-related diseases are partly attributable to a decrease in melatonin production, according to research by melatonin authority Dr. Russel Reiter of the Health Science Center.
In the latest laboratory experiments, the wondrous melatonin protected mice against the effects of whole-body gamma radiation, according to findings published by Health Science Center faculty. Dr. Vijayalaxmi (a one-word name), associate professor in the Department of Radiology/Division of Radiation Oncology, is the lead author of the paper, to be printed in Mutation Research.
The researchers exposed three groups of laboratory mice to whole-body gamma radiation. "We used an 'LD50-30' dose. This is a dose strong enough to kill 50 percent of the mice within 30 days," Dr. Vijayalaxmi said.
One hour before radiation exposure, the scientists injected mice with a low (125 mg/kg body weight) or a high (250 mg/kg) dose of melatonin. Control mice were exposed to the same dose of radiation and were not given any melatonin.
"The animals were examined twice daily for 30 days after exposure," Dr. Vijayalaxmi said. "As expected, only 50 percent of the mice in the control group survived. In the low-dose melatonin group, 60 percent of the irradiated mice survived. The significant finding was in the high-dose melatonin group, in which we observed 85 percent survival of irradiated mice."
Co-authors of the paper include Dr. Reiter, professor of cellular & structural biology at the Health Science Center. He is one of the world's foremost experts on melatonin and the pineal gland, and was the lead author of Melatonin, published in 1995 by Bantam Books.
Other co-authors are Dr. Terence Herman, professor of radiology and head of the Division of Radiation Oncology; Dr. Martin Meltz, professor of radiology; and Dr. K. Sree Kumar, a senior scientist at the Armed Forces Radiobiology Research Institute in Bethesda, Md. The Armed Forces Institute funded the study.
"Overall, the finding shows that melatonin protected the mice from whole-body radiation and increased their chances of survival," Dr. Vijayalaxmi said. "The optimum
dose of melatonin for human protection from radiation exposure needs to be determined."
States News Service distributed the story on the STD intervention study to broadcast and online media nationwide.
The Los Angeles Times carried an article on the seven best respiratory therapy degree programs in the country--a list that included the Health Science Center's respiratory therapy degree program.
The Dallas Morning News quoted Dr. Cynthia Mulrow, medicine/general medicine, in a story on saw palmetto, a product found in grocery drug sections.
Health Care Professional Update, a supplement of the Houston Chronicle, carried a photo of U.S. Rep. Henry Bonilla with leaders of health profession organizations donating funds for scholarships in the congressman's name.
The Valley Morning Star ran a story on the draft state budget, mentioning the Regional Academic Health Center (RAHC) and its participants, including the Health Science Center.
The McAllen Monitor also ran a story on RAHC issues.
The daily interviewed Dr. Jonathan Riegler, surgery/organ transplantation programs, for a story on hepatitis C, and Dr. Dean Kellogg, medicine/geriatrics & gerontology, for an article on family fitness.
The Express-News spoke with Dr. Rochelle Shain about a study of behavioral intervention targeted to reduce STDs in Hispanic and African American women.
Dr. Chantal Harrison, pathology, was quoted in a column about the shortage of blood for transfusions during December and January.
The Health Science Center was mentioned as being a recipient of grant funding from the Albert and Bessie Mae Kronkosky Charitable Foundation.
Dr. Glenn Halff, surgery/organ transplantation programs, was quoted in a story about an increase in organ donations and the value of transplants for recipients.
Dr. Ted Kniker, pediatrics, was quoted in an article on the difficulty of distinguishing between the common cold, viral infections and allergy attacks.
Dr. Corbett Holmgreen, anesthesiology, was quoted in a feature story on a historic Castroville cottage he owns.
A story on the start of the 76th legislative session mentioned a proposed children's cancer institute at the Health Science Center and quoted Dr. John P. Howe III, president.
An Express-News article listed winter graduates of the School of Nursing and the School of Allied Health Sciences, and also mentioned Leslie Swift, the graduate who received the 6,000th degree to be awarded by the School of Nursing.
The campus Macintosh User's Group's January meeting was mentioned in a roundup on the local computer scene. A. Jerome York, vice president and chief information officer, was listed as the invited speaker.
Chris Marrou, anchorman for KENS-TV, Channel 5, interviews Drs. James Nelson (left) and Holly VanRemmen, physiology, for a segment on aging, free radicals and vitamins. KENS photographer Cody Marcom captures the footage.
KENS, Channel 5, interviewed Dr. Martha Hanes, laboratory animal resources, for a story on use of anti-depressants to treat separation anxiety in dogs. The station also spoke with Drs. Laura Collins, medicine/cardiology, and Connie Mobley, dental diagnostic science, about caffeine's effect on the heart. Nutrition is one of Dr. Mobley's areas of interest.
KENS also interviewed Dr. Deborah Conway, ob-gyn, on the prevalence of Cesarean sections; Dr. Corbett Holmgreen, anesthesiology, on anesthesia and children; Dr. Linda Rhodes, psychiatry, on the trauma of a child ending a parent's life; and Dr. Lawrence Parsons, Research Imaging Center, on PET scans of the effect of music on the brain.
KABB, Channel 29, spoke with Dr. Parsons about the same subject; Dr. Tim Jones, medicine, about asbestos exposure; and Dr. John Calhoon, surgery/thoracic surgery, about the visit of 50 thoracic surgeons to the Health Science Center and the unveiling of a new device for open-heart surgery.
KSAT, Channel 12, also interviewed Dr. Calhoon about the surgeons' visit and the new heart device.
WOAI-AM, 1200, interviewed Dr. Connie Mobley about caffeine and the heart, and Dr. Rochelle Shain about a Health Science Center study of behavioral intervention to prevent STDs in minority women.
WOAI also reported on thoracic surgeons' visit to the Health Science Center, quoting Dr. Calhoon, and mentioned the new heart surgery instrument. WOAI spoke with Dr. Robert Brzyski, ob-gyn, about trimegestone, a promising new hormone-replacement therapy.
KTSA-AM, 550, spoke with Dr. Pamela Wood, pediatrics, about how the flu bug affects children.
The Health Science Center's quarter-century anniversary was recognized in the official newsletter distributed by the office of Leticia Van de Putte, state representative from Bexar County's District 115.
La Prensa carried a front-page story quoting Dr. Rochelle Shain about the study of behavioral intervention to reduce incidence of STDs in at-risk minority women.
The San Antonio Business Journal ran a story about the Medical School's sweeping changes in its curriculum, quoting Dr. Nan Clare, medical dean's office.
Dr. Maurice Albin, anesthesiology, (left) receives a medal from the University of Carabobo during the 15th Venezuelan Congress of Anesthesiology in Valencia, Venezuela. The medal, presented by the rector of the University of Carabobo, Dr. Asdrubal Romero, (right) cited Dr. Albin's "accomplishments in the academic, scientific, intellectual and cultural fields, and his presence in our country to share his experiences with Venezuelan scientists-anesthesiologists." Dr. Albin has trained more than 30 anesthesiologists from Latin America in the specialty of neuro-anesthesia. His protégés practice in Spain and throughout Latin America. Drs. Albin, Somayaji Ramamurthy, Joseph Naples and Ralph Erian presented papers at the Venezuelan Congress.
The National Cancer Institute (NCI) in January announced formal renewal of the San Antonio Cancer Institute's designation. The SACI is a research collaboration of the Health Science Center and the Cancer Therapy & Research Center.
The cooperative center oversees basic and clinical research programs, including projects in the areas of cancer prevention, control and population-based research.
To re-obtain Comprehensive Cancer Center status, the SACI had to exhibit a strong body of interactive research bridging the three key areas, and ongoing outreach and educational activities, including making information available to health care professionals and members of the lay community.
The NCI first awarded a peer-reviewed grant for SACI center status in 1991. Five years later, the center received the prestigious comprehensive designation. The designation will be reviewed when the next SACI core grant is renewed in four years.
Dr. Vijayalaxmi (a one-word name) (left), associate professor, and Belinda Leal, senior research associate, both from the Division of Radiation Oncology, work on a computer-based "Comet" image analysis system that provides measurements of primary DNA damage (single- and double-strand breaks). In this technique, cells embedded in agarase gel are processed on a microscope slide and focused under the microscope. An undamaged cell is observed to have a round nucleus, while a cell with damage appears as a comet with a tail. A camera captures the image and transmits it to the computer, where the software interprets the data, provides several "comet" measurements and stores the data for final analysis. Dr. Vijayalaxmi is testing whether or not cells exposed to non-ionizing radiation (such as electromagnetic fields) will exhibit primary DNA damage. This work is part of a project supported by the U.S. Air Force Office for Scientific Research. Dr. Martin Meltz, professor of radiology, is the principal investigator.
Have you wanted to mentor a youngster, but haven't had an evening free or the time at lunch to drive off campus? Perhaps it's time to mentor online.
The Health Education Training Centers Alliance of Texas (HETCAT), South Central Region, in cooperation with Southwest Texas Junior College in Uvalde and high schools in the region, will start an electronic mentoring program this spring. "It's called 'telementoring,'" said Dr. Sergio Rivas, coordinator of the South Central Region HETCAT. "Our immediate goal is to encourage faculty, staff and students from the Health Science Center to join the effort."
Averaging two to three e-mail exchanges weekly, mentors will help students appreciate the benefits of an education by showing them how various subjects--particularly English, math and science--can be applied to life situations. Students will be encouraged to excel in these subjects, while improving their communication and problem-solving skills.
The program will serve the "Winter Garden Region," which includes Del Rio and Val Verde County, and counties to the south and east. To date, the Eagle Pass ISD, Uvalde ISD and Del Rio Consolidated ISD have expressed interest, but mentors are scarce and commitments are still tentative.
"We are seeking responses from high schools in other communities, such as Carrizo Springs, Crystal City, Pearsall and Leakey, at the present time," Dr. Rivas said. "We need volunteers to become mentors."
Once the program begins in March, most students will go to their high schools' computer labs to access the mentors' messages.
HETCAT, established in 1990, is a federally funded alliance of centers charged with improving access to health care education and training in historically underserved regions. The telementoring program is another example of Health Science Center efforts to include South Texas students in the "informational pipeline" that exposes them to the potential of biomedical careers.
Want to improve the life of a South Texas teenager? Tell the youngster about careers in the biomedical sciences, and about your work or studies at the Health Science Center.
To volunteer or for more information, call Dr. Sergio Rivas or Paula Melendez at ext. 7810, send e-mail to <firstname.lastname@example.org>, or visit the HETCAT Web site.
The selection was announced in a letter from Dr. Enoch Gordis, NIAAA director. Dr. Johnson's term extends through June 2002. Review committees study grant applications submitted to the National Institutes of Health, make recommendations on these applications to the National Advisory Council on Alcohol Abuse and Alcoholism, and survey the status of research in their fields of science.
Dr. Johnson joined the psychiatry faculty on July 1, 1998. He is head of psychiatry's Alcohol and Drug Addiction Division.
Apple QuickTime specialist Steve Chazin (left) and Dr. Bill Winborn, professor of cellular and structural biology (in lab coat), check out software during "Producing and Publishing Your Ideas with QuickTime Technologies," a free workshop offered Jan. 29 at the Health Science Center. QuickTime can be used for digital media capture, creation, editing and publishing on the Web and CD-ROM.
Dr. Nicolas Walsh, professor and chair of the Department of Rehabilitation Medicine, has been named executive associate dean of the Medical School. He will continue to serve concurrently as rehabilitation medicine chair.
The executive associate dean is the chief operating officer of the Medical School and is responsible to the dean for providing day-to-day oversight of and operational direction to all activities. This is to further the Medical School's educational, research, patient care and community service missions.
In his new role, Dr. Walsh works with associate and assistant deans in the Medical School, department chairs and center directors. He also coordinates routine Medical School activities with other UT System components and affiliated institutions.
"Dr. Walsh is eminently qualified to serve the Medical School in this new role," said Dr. James Young, dean of the Medical School. "He not only leads an exceptional educational and clinical department, but he has served with distinction as chief of staff at University Hospital. I am most pleased with his acceptance of this challenge. His presence will enable me to direct more of my attention to policy matters and other new opportunities for the Medical School, such as the initiation of the Reg-ional Academic Health Center (RAHC) in the Lower Rio Grande Valley."
Dr. Walsh received his medical degree from the University of Colorado School of Medicine in 1979, and selected the Health Science Center's rehabilitation medicine residency program for his specialty training.
He joined the UTHSCSA faculty in 1982, and in 1990 he was promoted to professor and chair of the Department of Rehabilitation Medicine.
The fair is a resource for faculty, staff and students interested in:
Representatives from the Health Science Center's Travel Services Office and from the university's designated travel agencies, Rennert World Travel and Corporate Travel Planners Inc., will answer attendees' questions.
Door prizes will include airline tickets, car rentals and hotel stays.
Displays will be provided by the Bookstore, the Office of Accounting and
the Office of Computing Resources, among others. The Bookstore will
display travel maps and software, and offer T-shirts, software and other giveaway items.
Index of issues