Key imaging substance
The Health Science Center's Research Imaging Center has received state clearance to distribute an imaging agent previously not available to area hospitals and diagnostic clinics.
available to hospitals, clinics
The agent, called 18Fluorodeoxy-glucose or
18FDG, is a "radiotracer" that can be used to demonstrate normal and abnormal function in various organs of the body. Clinical applications include extremely sensitive detection of cancer, heart abnormalities and epilepsy.
The Bureau of Radiation Control in Austin gave final approval to
the Health Science Center's license application in late July, ending a three-year application process that included passage of enabling legislation by the federal government (the FDA Reform Act of 1997) and a subsequent rewrite of state regulations. The Research Imaging Center (RIC) will team with San Antonio-based Syncor to distribute the radiotracer.
18FDG is made with radioactivity in an instrument called a cyclotron. The RIC's cyclotron, purchased in 1991 by the South Texas Veterans Health Care System and the U.S. Department of Defense, is a $3 million particle accelerator.
"A radiotracer enables us to see metabolic processes," said Dr. Peter T. Fox, director of the RIC. "It is given in trace amounts which are barely detectable but enough to do imaging. It is called 'radio' because it gives off x-rays, and 'tracer' because it gives off trace amounts. These amounts are too small to interfere or interact with the physiological processes of the body. We are just getting into the system to measure it."
The RIC is a research facility and the only institution in Texas distributing 18FDG. "Our reason for obtaining this license is to allow other sites to do clinical work with these tracers," Dr. Fox said.
"The chief clinical use of 18FDG is in
determining the stage, or severity, of cancer. 18FDG
measures metabolic rate; tumors have a higher metabolic rate
than surrounding tissue. 18FDG can detect tumors that
are microscopic and can detect those that have metastasized, or
spread. The second most common clinical application is
evaluation of cardiac muscle viability--the strength of the heart wall."
Hospitals and clinics with PET (Positron Emission Tomography) systems or 18FDG-compatible SPECT (Single Photon Emission Computed Tomography) systems will be able to utilize 18FDG in providing billable clinical care. These imaging systems range in cost from $500,000 to $2 million. The South Texas Veterans Health Care System and the U.S. Department of Defense jointly purchased the Research Imaging Center's PET system in 1991.
"Sites will need a scanner compatible with this tracer," Dr. Fox said. "The South Texas Veterans Health Care System, Brooke Army Medical Center and the Baptist Health System are among those that already have 18FDG-compatible SPECT imaging systems."
Congress deregulated use of radio-tracers as part of the FDA (U.S. Food and Drug Administration) Reform Act. "States responded by changing their rules," Dr. Fox said. "The state of Texas did so in 1998. We applied for our license in August 1998 and received final approval this summer. We had been trying to receive authorization to distribute 18FDG for years.
"People at other hospitals had asked us to distribute this radiotracer to them, but we couldn't do it. It literally took an act of Congress to get things moving. We reformatted our license application in January 1999 because the standards were changed after our initial submission."
Acquisition of the tracer represents a new "business opportunity for many medical institutions around this area," he said. "It will require outlay for a PET or 18FDG-compatible SPECT system, but the institutions will be able to offer new imaging procedures and interpret the scans."
The Research Imaging Center utilizes imaging instruments to conduct the latest research studies and to add to scientific literature in a host of areas. These areas include brain mapping, neurological disorders, learning, memory and language. Providing clinical service is not the RIC's focus.
"We're not trying to corner the market on this procedure," Dr. Fox said. "We could do the clinical scanning, but we prefer to give the medical community at large an equal opportunity to provide this service to the patient."
Radiotracer scanning is in high demand wherever it is available, he said. Other institutions that provide clinical PET include Duke University and The University of California at Los Angeles.
The RIC has begun training future providers and has contracts to
distribute 18FDG to the Baptist Health System, the
South Texas Veterans Health Care System and Hill Country
Memorial Hospital in Fredericksburg.
SECC begins with fund-raisers and contests
This week marked the kickoff of the State Employee Charitable Campaign, which runs through Friday, Sept. 17. Employees are encouraged to take advantage of the variety of fund-raising events ranging from bake sales to hilarious contests to a photo opportunity with the San Antonio Spurs Coyote.
The Silliest Hat and Most Outrageous Hawaiian Shirt contests began Sept. 1. Interested participants have the option of advertising their silly hat and shirt in advance and raising funds for the campaign. Participants can contact Al Julian, director of photographic services, ext. 2269, and have a photo taken wearing their entry.
Photographs may be turned into 11-by-17-inch promotional posters for the entrant to impress all of his or her co-workers and solicit donations for the campaign. Judging for the Silliest Hat contest will be held Sept. 10 at 12:30 p.m. in the breezeway near the fountain.
Prizes will be awarded for both contests, including prizes for participants who raised the most funds. Employees not interested in participating in the "advertising campaign" prior to the two contests may still take part in the hat/shirt hijinks by donating $1 before the judging begins.
A basketball competition will be held in the courtyard in conjunction with the Silly Hat festivities. Come by to cheer for your favorite two Health Science Center teams, which will be coached by Jerry York, vice president and chief information officer, and Tony Ferrara, vice president for administration and business affairs. Plenty of food will be on hand for spectators as department volunteers sell baked goods and other treats during the events to raise money for the campaign.
The Spurs Coyote will visit the Health Science Center on Thursday, Sept. 16, bringing along the 1999 NBA Championship Trophy. The energetic mascot will appear at 11:30 a.m. in the auditorium foyer. For a $5 donation, employees may be photographed with the Coyote and the trophy. Donors will be allowed to keep the negatives from the photos. Proceeds will go to the United Way of San Antonio and Bexar County.
To reserve a table for a food sale during the Sept. 10
event (Basketball Day), contact Rudy Gomez at
<firstname.lastname@example.org>, and for Sept. 16 (Spurs Event),
contact La Shawn Payton at <email@example.com>.
The Most Outrageous Hawaiian Shirt contest will culminate Friday, Sept. 17, with judging beginning at 12:30 p.m. in the third-floor Medical School snack bar area. The 2 1/2-week charitable campaign also will include activities such as bake sales and breakfast taco sales to raise funds for local, non-profit organizations. Below is a schedule of events, to date, for the week of Sept. 6 through Sept. 10.
A listing of additional events throughout the campaign will be
printed in upcoming editions of The News.
Dental students committed to volunteerism
Some 200 dental students and residents from the Dental School participated in 21 extramural and in-house programs this summer. The participants provided services to indigent populations in Mexico and along the Texas border, migrant workers in Colorado, federal prisoners throughout the country and clinic patients in San Antonio as part of their training.
Sponsored by various organizations, the outreach programs provide opportunities for students to get hands-on experience in general dentistry and various specialties while helping the community.
In South Texas, summer externship programs sponsored by the Alamo Area Health Education Center and the state-supported South Texas/Border Initiative focused on health promotion/disease prevention and clinical training. For six to 10 weeks, 59 dental students worked with dental directors and community educators at federally funded community clinics and local health departments along the U.S.-Mexico border and in San Antonio.
An additional 30 dental students spent one week at University Hospital to experience hospital dentistry, including assisting dental residents on call to the Emergency Center.
The Oral and Maxillofacial Surgery Externship Program, conducted
by Dr. Mike Startzell, gave five senior dental students
the chance to spend a month receiving intensive exposure to
oral surgery techniques.
Managing chronic pain
Pump gives sufferers lease on life
A fall changed John Thompson's life 13 years ago. It broke his back, crippling him with excruciating pain and transforming the once vibrant life he enjoyed to an existence in which persistent discomfort and limited movement are his constant companions.
Chronic pain syndrome is pain that persists beyond the normal healing time and lasts longer than three months, said Dr. James Rogers, associate professor of anesthesiology at the Health Science Center.
For 13 years Thompson tried every known therapy for chronic pain. "I lost my life after the fall. The pain was so unbearable, I couldn't do anything," he said. "I couldn't stand for more than a few moments, I couldn't sit and I couldn't go anywhere. I was a prisoner of this unrelenting pain."
Today Thompson has a new lease on life. A few months ago, he decided to have a pump surgically placed inside his abdomen to deliver pain medication throughout the day.
"It's called an Arrow 3000 Implantable Pump," said Dr. Rogers. "The pump looks like a silver hockey puck and the inside is filled with pain medication, which is released continually and directly to the lower spinal cord. Pumps have given Mr. Thompson and other chronic pain sufferers an effective way to manage the pain without injections or taking pills, and with fewer side effects."
The pumps have been around for about 20 years. Newer models are much more durable, and once implanted can last throughout the patient's life.
Patients make monthly visits to have the pump reloaded with pain medication. It's a quick, painless procedure.
"Chronic pain can be managed," said Dr. Rogers. "The
patient, however, has to be proactive and not give up when physicians
say there isn't anything that can be done. There are
Calendar for Sept. 6 - 12
Monday, September 6
LABOR DAY HOLIDAY
Tuesday, September 7
Podiatry Case Conf. (LEC: 2.010)
Medical Housestaff Specialty Conf. "Managed Care & Economics," Dr. Charles Duncan (MED: 409L)
Otorhinolaryngology Head & Neck Surgery Grand Rounds Teleconf. "Neck Mass," Dr. Anna Lee (MED: 444B)
TNT "Blood Banking: Cord Blood Banking for Transplantation," Dr. David Harris, University of Arizona, Tucson (call ext. 2700 for information)
Dept. of Medicine Research Conf. "Chronic Beta-Blockade in Experimental Heart Failure: Effects on LV Remodeling & Function, NO & Pro-inflammatory Cytokine Expression," Dr. Sumanth Prabhu, & "Free Radicals & Myocardial Reperfusion Injury," Dr. Bysani Chandrasekar (MED: 209L)
TNT "Clinical Chemistry & Toxicology: Fetal Hemolytic Disease Testing," Dr. Kristen Skogerboe, Seattle University (call ext. 2700 for information)
Psychiatry Grand Rounds "New Developments in the Neurobiology & Treatment of ADHD," Dr. Steven Pliszka (MED: 409L)
Molecular Medicine Seminar Series "Cell Cycle Regulation in Normal & Tumorigenic Cells," Dr. James Roberts, Fred Hutchinson Cancer Research Center, Seattle (LEC: 3.002)
Cardiovascular Pathobiology Research Conf. "Apoptotic & Non- Apoptotic Mechanisms of Hypoxic Cell Injury," Dr. Manjeri Venkatachalam (LEC: 331.5B)
Wednesday, September 8
Vascular Surgery Grand Rounds, Dr. Mellick Sykes (MED: 209L)
Medical Grand Rounds "Vancomycin-Resistant Enterococci:
Where Do We Go From Here?" Dr. Jan Patterson (MED: 409L)
Surgery Trauma M&M Conf., Dr. Ronald Stewart (MED: 309L)
TNT "Environmental Sciences: Y2K--Time is Running Out--Are
You Ready?" Cynthia Leeman, Executive Housekeeping Today,
Westerville, Ohio (call ext. 2700 for information)
TNT "Laboratory Management: So You Want New
Equipment--Negotiating Techniques Part II," Edward
Peterson, Shore Memorial Hospital, Somers Point, N.J. (call
ext. 2700 for information)
Cellular & Structural Biology Seminar "Molecular
Regulation of T Cell Apoptosis in the Healthy & Diseased
Immune System," Dr. Michael Lenardo, National Institutes
of Health (MED: 209L)
Thursday, September 9
Thoracic Surgery Resident Teaching Conf. (VA: 4th-floor CT
Neurology Grand Rounds Clinicopathological Conf., Dr. Chris
Williams, Wilford Hall Medical Center (MED: 444B)
Pain Management Grand Rounds, "Opioids for Non-Cancer
Pain," Dr. Stuart Hough, Brooke Army Medical Center (UH:
Reeves Rehab Center 3rd-floor classroom)
TNT "Radiology: The Networked Enterprise in
Radiology," Col. Anna Chacko, M.D., Brooke Army
Medical Center (call ext. 2700 for information)
Continuing Dental Education "Luncheons for Learning:
Dental Considerations in Joint Replacement," Dr.
Catherine Riley (call ext. 3177 for information)
Pulmonary, Thoracic & Oncology Conf. (MED: 309L)
TNT "Pain Management: Acute Pain Case Study," Dr.
Mary Heye (call ext. 2700 for information)
Surgery Tumor Conference, Dr. Anatolio Cruz (MED: 209L)
Citywide Thoracic Grand Rounds Conf. "Case
Presentation," Dr. A. Joseph Atiya (MED: 309L)
Friday, September 10
Pediatric Grand Rounds "Lower Respiratory Tract
Infections," Dr. Donna Beth Willey-Courand (MED: 409L)
Medical Housestaff Specialty Conf. "Hyperbaric
Medicine," Dr. Charles Davis (LEC: 3.102B)
Cardiovascular Research Conf. "Xenical &
Cardiovascular Specialist," Chip Putnam, Roche
Pharmaceuticals (LEC: 3.078V)
Continuing Dental Education "Practice Transitions &
Practice Monitors," Dr. John Wagner (call ext. 3177)
Continuing Dental Education "A Continuum in
Prosthodontic Procedures--Session I: Fixed Prosthodontics"
(first of two-day session) (call ext. 3177 for information)
General Surgery Grand Rounds, Dr. Wayne Schwesinger
TNT "Health Care Chaplains: Three Models for Spiritual
Abuse--O'Neill, Pruyser, Booth," Rev. Richard Gilbert,
The World Pastoral Care Center, Valparaiso, Ind. (call ext.
2700 for information)
Saturday, September 11
Surgical Physiology Conf., Dr. Kenneth Sirinek (MED: 209L)
Continuing Dental Education "A Continuum in Prosthodontic
Procedures--Session I: Fixed Prosthodontics" (second day
of two-day session) (call ext. 3177 for information)
Continuing Dental Education " Advanced
Cleaning & Shaping in Root Canal Therapy: Using
TaperedNickel-Titanium Files & Thermoplastic
Gutta-Percha," Dr. Kenneth Koch (call ext. 3177 for
General Surgery Grand Rounds, Dr. Wayne Schwesinger (MED: