March 12, 1999
Volume XXXII No. 10

7th Miles for Smiles set for March 27 at UTSA

Annual Dental School run/walk benefits 11,000 youngsters
participating in preventive dental care programs

mouth guards

The Dental School's seventh annual Miles for Smiles 5K run/2K walk, which benefits dental prevention programs for South Texas schoolchildren, is set for Saturday, March 27, at The University of Texas at San Antonio.

Registration is from 7 to 8 a.m. at the track area near the Convocation Center, and the run and walk start at 8 a.m. An award presentation will follow the events. Entry fee is $12 before race day, and $15 at the event. To register, call ext. 6423 and leave a message to receive more information. All registrants receive a Miles for Smiles T-shirt and packet.

Dental students organize Miles for Smiles, which supports a fluoride mouthrinse program serving thousands of grade-school students in targeted areas of San Antonio and South Texas, as well as free mouthguard clinics for middle, high school and college athletes. This year's Miles for Smiles coordinator is Jon Oefinger, DS-III.

"Proceeds from the run are used to support preventive programs in the community," said Dr. M. Elaine Neenan, associate dean for external affairs in the Dental School. "One is the fluoride mouthrinse program in which 10,312 children from 54 elementary schools are currently enrolled."

This total includes more than 1,200 children in the South Texas towns of Uvalde, Encinal and Cotulla, she said. The program is offered in the San Antonio, Edgewood, Northside and Southwest Independent School Districts as well as the Catholic Archdiocese of San Antonio. Other partners are the Uvalde Consolidated ISD, the Cotulla ISD, the Encinal ISD and Sacred Heart Catholic School in Uvalde, part of the San Antonio Archdiocese.

Beginning in first grade, children receive a weekly rinse at school. "This is a program that has known benefits--we know it works to reduce dental cavities," Dr. Neenan said. She was referring to a study conducted in the late 1980s in two Edgewood elementary schools, Emma Frey and Coronado Escobar, that found lower rates of tooth decay (dental caries) in children receiving fluoride mouthrinses. Dr. John Brown, professor and chairman of the Department of Community Dentistry, was the principal investigator.

Currently, freshmen dental students rotate to Coronado Escobar on Fridays during the spring semester to provide the mouthrinse program there. Junior dental students rotate to the school-based clinic on Fridays in the fall to provide sealants, which are effective in reducing occlusal caries (decay on biting surfaces). "That's one school out of 54," Dr. Neenan said. "The purpose of these preventive dentistry training programs is to teach dental students how to manage school-based prevention programs. Miles for Smiles raises some of the funds to pay for this program."

The dental students train school nurses, teachers, coaches, athletic directors and others to carry out the weekly fluoride rinse program in the 53 other schools.

The race's proceeds also support the mouthguard injury prevention program for middle and high school male and female athletes.

"This involves youngsters playing volleyball, baseball, basketball, soccer or footballbasically, any contact sport in which students are involved and at risk for a dental-facial injury," Dr. Neenan said. "Letters are sent to the schools inviting them to participate in the annual Mouthguard Day, usually held in early August on a Saturday at the Health Science Center. Faculty, staff, residents and students from the Prosthodontics Department take impressions of the teeth and make custom mouthguards, and then deliver them to the waiting students the same day."

The Prosthodontics Department assisted with two Mouthguard Days in 1998: one in Laredo that helped 327 student athletes, and another at the Health Science Center that assisted 238 individuals.

The Laredo Mouthguard Day benefited athletes from Martin, Nixon, Cigarroa, United, United South and Alexander high schools. The program was implemented through the leadership of local community private practitioners via the Laredo District Dental Society in conjunction with the Laredo-Webb County Health Department and the Gateway Community Health Center.

The 238 students fitted at the Health Science Center Mouthguard Day included athletes from Harlandale, Judson, Lee, Edison, Jefferson, Lanier, Southwest, Antonian, Boerne and Poteet high schools. Subsequently, 62 college athletes from St. Mary's University and 79 from UT Austin also received mouthguards.

"The main purpose of Miles for Smiles is prevention," Dr. Neenan said. "The greater the number of participants in the run, the greater the number of children who can be added to the fluoride rinse and mouthguard programs."

Children are enrolled in the rinse program for several years. Some schools offer it from grades K-3 while others go longer. "The best way to prevent dental caries is to provide fluoride until children are at least 14 years of age," Dr. Neenan said.

Julia Garcia, head nurse for the Edgewood ISD, said the school district conducted dental screenings during February, which was Dental Health Month. The purpose was assessment of dental problems. Results were to be ready in mid-March. Fluoride mouth-rinses are offered at all Edgewood elementary campuses, while the sealants are offered only at Coronado Escobar, she said.

The need for screening programs is great.

Martha Baez, assistant professor in the Department of Community Dentistry, coordinates the program at Coronado Escobar. A review of her 1997-98 records showed that 96 children gave consent to participate in the sealant program that year. "We examined these children and found that 60 needed urgent referral for dental treatment ranging from minor to urgent," she said. "This rate among new, entering children does not change much from year to year, demonstrating the need for prevention."

Baez also said that she received a call recently from a nurse, talking about the alarming rate of tooth decay in students.

Miles for Smiles typically receives financial support from local merchants and some dental companies. Every year Roger Soler Sports, for example, allows the students to place registration forms in that establishment.

Miles for Smiles proceeds also have helped finance PSAs (public service announcements) in Spanish and English on a host of prevention topics, including baby bottle tooth decay, oral cancer prevention, importance of sealants, dental visits, gum disease and tooth care such as flossing.

Surfactant clinical trials coordinator continues research at HSC

Drs. Gunkel and Escobedo

A Medical School alumnus, who helped make surfactant therapy a commonplace treatment for premature newborns, continues that work today at the Health Science Center.

Dr. John Harry Gunkel, 1974 graduate who completed a neonatology fellowship at the Health Science Center in the late '70s, is a clinical associate professor in the Department of Pediatrics' Neonatology Division. He still studies surfactant, a substance often missing from the lungs of premature, extremely low birth weight infants.

Tiny lungs collapse without surfactant. Before the 1980s, thousands of premature babies died each year in the United States because of lack of surfactant in their lungs. This is characteristic of a condition called respiratory distress syndrome (RDS).

Dr. Gunkel was one of the key developers of a pulmonary surfactant drug, Survanta®, at Abbott Laboratories' Ross Products Division in Columbus, Ohio. Derived from cow lungs, the drug is administered through the trachea, or windpipe. More than 350,000 premature babies with RDS have received Survanta® since 1991, the year it was approved by the U.S. Food & Drug Administration.

Dr. Gunkel was a practicing neonatologist after his pediatrics residency at Children's Hospital in Columbus and his fellowship at the Health Science Center. In 1985 he accepted an offer from Ross to help develop Survanta®. "I worked on all aspects of the drug's development, but clinical trials were my main responsibility," he said.

"The surfactant story has many authors, and no one including Harry would claim to be the sole contributor," said Dr. Marilyn Escobedo, professor of pediatrics and chief of the Division of Neonatology, who supervised Dr. Gunkel during his fellowship. "Like all great scientific innovations, everyone's contributions are important or the whole does not exist. However, Harry did lead the largest worldwide clinical trial. The next year, the national neonatal mortality statistics showed a drop in deaths.

"I am very proud that we were able to recruit someone like Harry, who is well known nationally in leading the surfactant effort, to come back to San Antonio and the Health Science Center."


The drug has saved the lives of many babies, including 15 pictured in a calendar distributed recently by Ross. One of the babies, Eriq Cisneros, was treated in the Neonatal Intensive Care Unit at University Hospital, where Health Science Center neonatologists and pediatric nurses practice. "The drug has in fact changed people's lives," Dr. Gunkel said. "Its use affects not only premature newborns but also their families. To be part of it is a great honor, and fun and overwhelming. Those of us on the development team used to talk about how we would never work on anything this important again."

Dr. Gunkel worked in Columbus until 1995, when he returned to the Health Science Center. "Shortly after I came here, I went to a clinical care conference where the discussion centered on a patient who had been treated with Survanta®. I think it was the first time it really hit me what an important thing we had accomplished."

"Surfactant has changed the face of neonatology," Dr. Escobedo said. "The whole emphasis of neonatology used to be saving babies from dying of pulmonary disease and limiting its damage. Now the damage is so ameliorated by surfactant that we can go beyond the pulmonary crises to more subtle issues such as nutrition, growth and development, and immunity. I don't know if there will ever be as big a leap in neonatology as surfactant has provided. Preventing prematurity would be the next one."

After training under Dr. Escobedo 20 years ago, Dr. Gunkel is back in the division conducting research of new therapies for newborn patients. "We work with other medical centers around the country," he said. "One study partners us with five other neonatal ICUs around Texas in looking at a new use for Survanta®."

The surfactant drug usually is given to premature babies with RDS who need a ventilator. The six Texas centers are studying its use in babies with milder RDS who are not on ventilators and who are not as small or premature. "We are asking, if we administer even one dose of surfactant, can we shorten this group of babies' hospital stays and the length of their exposures to the potentially damaging therapies of oxygen and mechanical ventilation," Dr. Gunkel said.

The surfactant improvement process is ongoing. "Since Texas has nearly 10 percent of the births in the United States, we are poised to be able to contribute to this process," Dr. Escobedo said. "The problems are too complex for any one center to have enough patients, but putting together Texas' six centers gives us sizable numbers."

The new partnership, called CliNeTex, was founded by Dr. Escobedo and includes centers in San Antonio, Houston and Dallas. The Health Science Center is providing leadership for collaborative trials among this group.

Dr. Gunkel was in charge of Ross' clinical trials and published multiple scientific papers on surfactant therapy. But he is quick to say the effort was collaborative, involving thousands of scientists and clinicians at multiple centers and in the company itself. He modestly notes that Dr. Richard J. King, professor in the Health Science Center's Department of Physiology, and Dr. Steven Seidner, associate professor and a colleague of Dr. Gunkel in the Division of Neonatology, are "much more prominent and well-known surfactant experts than I am."

Wizards of Wood

Physical plant's skilled craftsmen
apply more than a century of cabinet-making
experience to the campus' most
challenging custom projects.

wizards of wood

Joe Veillon, or "Joe V." as he is called, heads a Physical Plant Department cabinetmaking team that works wonders with wood. Their work is in use throughout the Health Science Center campus: cabinets, doors, workstations, shelves, podiums and more.

The offices of the Department of Cellular & Structural Biology were recently outfitted with complete, attractive workstations made by the "Wizards of Wood."

Joe V. has put in 24 years at the physical plant cabinet shop. His colleagues are Joe Alegria, 23 years; Manuel Villarreal, 18; Richard Carter, 14; and Mark Ledford, eight. "That's just the time we've worked here," Carter says. "We all spent years in outside cabinet shops."


"We all do the same quality and type of work," Alegria chimes in. "We measure the rooms after receiving drawings from the draftsmen, then go to work." "Everyone enjoys working together," Veillon says. "We know our stuff. All you have to do is point us in the right direction and we will take care of your project."

The Department of Prosthodontics is a satisfied customer. The department unveiled a new state-of-the-art conference room that includes a wooden podium with a built-in motor for up and down adjustment.

The cabinet shop can make anything to custom size. Its work is not an assembly line process. "I like the specialty projects," Ledford says. "The more complicated or creative the job is, the more I enjoy it."

One of those specialty projects involved making knives to match molding bought for tables in the medical dean's office suite and the Parman House Conference Center.


For the conference center, the Wizards of Wood built three 6-by-12-inch pine trusses out of rough-hewn lumber for the ceiling span of 28 feet. David Rech, carpenter leader at the time and now assistant superintendent of construction and maintenance, directed the physical plant team working on the conference center renovation.

"Our primary mission is to provide maintenance and renovations, but we really are a small construction firm over here," Veillon says.

After plans are received from the draftsmen and visits are made to the renovation site to take measurements, team members begin cutting the pieces. Measurements must be precise and everything must be level. "We assemble the pieces in our shop to ensure specifications have been met," Alegria says. "We disassemble them and send them to our paint shop for finishing. Then we take everything to the site for final assembly and installation."

The craftsmen remember a couple of projects that were too large to be assembled in their shop, as amazing as that sounds.

No matter the size of the job, the Wizards of Wood find it satisfying to admire the handiwork when it is completed and in use. "When a job is done, you look at it and feel good about yourself," Carter says.

"I always had a knack for woodworking," says Veillon, the chief Wizard. "As a child I was always hammering away at something."

"Yeah, didn't you help build the Mayflower?" Carter jokes.

The cabinet shop craftsmen, those Wizards of Wood, are a fun-loving and superbly skilled group who build to specification at the Health Science Center.

Pointers from the pros

  • Always wear safety goggles when cutting wood

  • Measure twice, cut once (which holds true for everyone, from the professionals to the amateurs)

  • Cut paneling with the face down, to prevent splintering of the finished veneer

  • Know what is inside a wall before cutting a hole for a door, window or other opening

  • When building a wood deck, always put the "crown" of the grain facing upward; the crown can be seen by looking at the edge of the board

  • For campus jobs, call ext. 2885 (the physical plant office) and let professionals do the work, says Joe Veillon, cabinetmaking team leader.

Keep poisons out of sight, out of reach

March 21-27 is National Poison Prevention Week. The Health Science Center's South Texas Poison Center reminds everyone that it can take only seconds for a child to reach poisonous cleaners, cosmetics or medications, possibly resulting in a lifetime of injury.

The home can be made safer through poison proofing. As a public service, the poison center provides these tips:

Remember to keep the poison center's phone number posted next to the phone. For phone stickers or more information on poison proofing the home, call the poison center at 1-800-764-7661 (1-800-POISON-1).

1999 teaching award nominations due on or before March 31

Wanted: nominations recognizing the Health Science Center's best teachers.

Each year the university awards up to six Presidential Awards for Teaching Excellence to faculty members who have demonstrated outstanding accomplishments in teaching. Last year's winners were Drs. D. Michael Foulds, pediatrics; Lawrence Harkless, orthopaedics/podiatry; Robin Leach, cellular & structural biology; Stephen Mattingly, microbiology; Peter Melby, medicine; and Stanley Nelson, restorative dentistry.

To be eligible, a nominee must have taught as a full-time faculty member at the Health Science Center for a minimum of three consecutive years as of Sept. 1, 1998, and must not have received the award in the past eight years.

Faculty members may be nominated by any of the following individuals: three students or house officers, two faculty members, or a department chair. Nomination forms may be obtained from class presidents, department chairs or the President's Office.

Completed nomination forms must be returned to Dr. Deborah Greene, vice president for institutional effectiveness and planning, in the President's Office by Wednesday, March 31.

Of Note

Alzheimer's explored
Dr. Mary Ann Matteson, professor and interim chair of the Department of Family Nursing Care, will speak on new discoveries in the care of patients with Alzheimer's disease at 7:45 a.m. Wednesday, March 24, at the San Antonio Country Club.

Dr. Matteson's recent publications include abstracts and papers reporting on issues in Alzheimer's disease, gerontological nursing, dementia, and behavioral characteristics of the elderly with Alzheimer's and related diseases.

The event is the second in a series of health care seminars sponsored by the Nursing Advisory Council of the School of Nursing. To RSVP, call ext. 5800. Cost is $20 per person including breakfast and valet parking.

Materials in database
Material Safety Data Sheets are now available online to faculty, staff and students, the Institutional Safety Office announced.

The MSDS database provides users a list of safety sheets on substances and mixtures of substances. This user-friendly program can be an excellent safety tool on the job, said Virginia Fulkerson, manager of safety training. For more information about the database, call her at ext. 2987.

Pet Clinic closed
Laboratory Animal Resources' Private Pet Clinic will be closed March 15-19. Pet supplies will be sold. Questions may be directed to Patty Spencer, ext. 6161.

Japan featured
Dr. Toshiyuki Kuwa and his wife, Yuka Kuwa, from Fort Sam Houston and Osaka, Japan, will be the presenters for an upcoming International Evening Program, set for 7 p.m. Friday, March 19, in the Dental School Cafeteria.

Light refreshments will be provided at 7:30 p.m., but attendees are asked to bring a plate of food to share, representative of their respective native countries.

The Kuwas' cultural exchange program on Japan will begin at 8 p.m. The event sponsor is the International Alliance.

HHMI proposals due
Grant proposals for the Howard Hughes Medical Institute (HHMI) Research Resources Program are due by April 1. For more information, call Rosie Marti, medicine, ext. 4978.

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
Director of Public Affairs.....Dr. Charles Rodriguez
Editor.....Will Sansom
Writers.....Myong Covert, Catherine Duncan, Joanne Shaw
Photographers.....Lee Bennack, Lester Rosebrock
Designer.....Kris Doyle
Production.....Printing Services

Office of Public Affairs, 7703 Floyd Curl Drive, San Antonio, Texas 78284-7768
(210) 567-2570