Collaboration with military
strengthens surgical education
The Medical School's general surgery residency program continues to benefit from a unique blend of civilian and military medical expertise. Surgeons who spend five requisite years in the program receive a much broader educational experience in surgery than is available almost anywhere else, say the program's leaders.
The Medical School offers a general surgery residency to nine doctors a year. It is one of the largest surgical residency programs in the state. In 1998 the Medical School integrated its program with the U.S. Air Force surgical residency program at Wilford Hall Medical Center in San Antonio.
"We looked at the experience of the residents at the Health Science Center, and Wilford Hall did the same with its residents," said Dr. William E. Strodel, professor and chairman of the Health Science Center's Department of Surgery.
"When we looked at the two programs, we saw opportunities for complementary support to improve the education of residents, especially pertaining to the types of diseases they treat and the range of operations they perform."
"Residency" is one of the terms applied to a physician's postgraduate education. Residents have already attained the Doctor of Medicine degree (M.D.) and are in the midst of multiple years of work alongside established peers in surgery or other branches of medicine. Surgical residencies are among the longest such educational experiences.
Residents in the San Antonio program gain proficiency in all areas of surgery, including pediatric surgery, penetrating and blunt trauma surgery, liver and pancreatic cancer surgery, and disaster response. Some of these offerings can be traced to the university-military relationship, Dr. Strodel said.
"Many academic surgical residency programs have tried to integrate with military partners, but few have had as durable or stable a relationship as we do with Wilford Hall."
"The integration makes this a unique setting for physicians interested in trauma surgery," said Dr. Kenneth R. Sirinek, professor of surgery and director of the Health Science Center's general surgery residency program since 1985. "For example, while Wilford Hall records more cases of penetrating trauma, such as stabbing and gunshot wounds, our primary teaching hospital, University Hospital, records more cases of blunt trauma, such as injuries from auto accidents. Young surgeons in training must see both types."
Integration also provides faculty and residents with opportunities to observe and participate in military-related projects abroad. Dr. Ronald Stewart, director of the Department of Surgery's trauma program, recently spent time in Chile working on a project in conjunction with the U.S. Air Force.
"The Air Force surgeons at Wilford Hall participate fully in events around the world, providing triage and other services soon after disasters occur," Dr. Strodel said. "No civilian residency programs offer that aspect of trauma management education."
A general surgeon practicing in a rural community would benefit immensely from such preparation, he said. Were an accident to happen at the local factory, for example, the surgeon would be well prepared to triage patients, determining who could be treated on site and who would need to be airlifted for treatment.
The closure of Kelly Air Force Base and the oft-rumored closure of Brooks Air Force Base served to solidify the historically strong university-military surgical collaboration.
"The base closing issue has brought the university and the military even closer together to preserve medical education, which is one of the strengths of San Antonio," Dr. Sirinek said.
HSC faculty receive promotions, tenure
Annual tenure and promotion actions became effective Sept. 1 and were reported by the Office of the President in the following schools. (T) indicates a faculty member who was previously granted tenure.
School of Allied Health Sciences
Clinical Laboratory Sciences: George Kudolo to associate professor with tenure; Linda Smith to professor (T).
Dental Hygiene: Renee Cornett to associate professor with tenure.
Graduate School of Biomedical Sciences
Biochemistry: Martin Adamo to associate professor with tenure.
Microbiology: Michael Berton to associate professor with tenure.
Molecular Medicine: James Lechleiter to associate professor with tenure.
Pathology: Fiona Craig to associate professor with tenure; Margaret Gulley to associate professor with tenure; Anne Jones to associate professor with tenure; Francis Sharkey to professor (T); Dean Troyer to professor (T); Philip Valente to professor (T).
Pharmacology: Steven Mifflin to professor (T).
Physiology: Patricia Camacho to associate professor with tenure; James Nelson to professor (T).
Dental Diagnostic Science: Peggy Gragg to professor; Olaf Langland to professor emeritus (T).
Oral & Maxillofacial Surgery: Stephen Milam to professor (T); John Schmitz to associate professor.
Pediatric Dentistry: Jinkun Chen to associate professor with tenure; Jan Ching-Chun Hu to associate professor with tenure; James Simmer to associate professor with tenure.
Prosthodontics: Mickey Calverley to associate professor with tenure; John Jones to professor (T).
Restorative Dentistry: Bernard Boeselt to clinical professor; Joo Leng Ong to associate professor with tenure.
Anesthesiology: Kelly Knape to professor.
Family Practice: Sandra Burge to professor (T); David Espino to professor (T); Ross Lawler to professor (T); Toni Miles to professor with tenure.
Medicine: Sunil Ahuja to associate professor with tenure; Anthony Amato to associate professor; Carmen Cawley to clinical assistant professor; Meghan Gerety to professor (T); Goutam Ghosh-Choudhury to associate professor; Theresa Guise to associate professor with tenure; Helen Hazuda to professor with tenure; Mark Henderson to associate professor; Carlayne Jackson to associate professor; Adrian Lee to assistant professor; Jan Patterson to professor (T); Jacqueline Pugh to professor (T).
Obstetrics & Gynecology: Vincenzo Sabella to associate professor.
Ophthalmology: Charles Garcia to assistant professor; William Sponsel to associate professor.
Pediatrics: Thomas Mayes to professor; Steven Weitman to associate professor with tenure.
Psychiatry: Raymond Faber to professor; John Hatch to professor (T); Martin Javors to professor (T); John Pichot to associate professor; Brenda Talley to clinical associate professor.
Radiology: Carlos Bazan to clinical professor; Kedar Chintapalli to professor; Jia-Hong Gao to associate professor with tenure; Jack Lancaster to professor.
Surgery: Robert Esterl to associate professor; Miguel Fernandez to associate professor; Ronald Stewart to associate professor; Mellick Sykes to professor; Joel Teichman to associate professor with tenure.
School of Nursing
Chronic Nursing Care: Anne Smith to assistant professor.
The Media Report
Aging and cancer research top the news
National & International
Dr. Claudia Miller, family practice, was interviewed by BBC-TV, London, on disabilities related to chemical exposures. Dr. Miller was also quoted in an article, on sensitivity to fragrances, that appeared in the Wall Street Journal.
Hispanic Outlook Magazine listed Dr. Charles Rodriguez, university relations, in its appointments section.
The Texas Mohair Weekly, Rocksprings; the Real American, Leakey; The Big Bend, Marfa; and the Uvalde Leader-News ran stories on the Health Science Center's initiatives in the Winter Garden area.
Dr. Gavin Corcoran, infectious diseases, was quoted in a story in the Austin-American Statesman on the need for physical examinations.
The McAllen Review published a piece on the proposed RAHC research facility in Edinburg. The El Paso Times cited the Health Science Center's success in an article on the establishment of the Border Health Institute in El Paso.
The Hondo Anvil Herald, the Pleasanton Express and The County Wide, Karnes, mentioned the Health Science Center in articles on health-career camps for high school students.
The Alice Echo News and the San Benito News quoted Dr. Jean Smith, medicine, in an article on the Health Science Center's shingles study. Dr. Sylvia Fernandez, special programs, was featured in an Abilene Reporter-News story on the opening of the Women's Center at the Abilene Regional Medical Center.
The Floresville Chronicle Journal printed a story featuring rescue technician Vicky Smith and the Texas Flood Rescue Summit offered by the Depart ment of Emergency Medical Technology.
Dr. Bob Limmer, dermatology, was the subject of an article in the Taylor Daily Press about his presentation at the European Society of Hair Restoration Surgery in Paris.
San Antonio Express-News
Dr. Peter Fox, Research Imaging Center, and his recent study on the workings of the cerebellum and basal ganglia, were the subject of an article, which also appeared on the paper's Web site.
Dr. James Rogers, psychiatry, was quoted in an article following the death of John Kennedy Jr. about coping with grief.
Dr. Jay Bishoff, surgery, was featured in an article about the first laparoscopic removal of a donor kidney to be performed in San Antonio. The daily featured Drs. Richard Lin, pharmacology, and Jeanne Anderson, medicine, in an article about their grants from the American Federation for Aging Research.
Dr. Steven Weitman, pediatrics, was interviewed for a story on children's cancer treatments.
Susan Yerkes mentioned Drs. Michael Stern and Steven Haffner, medicine,in a column on diabetes research and prevention.
Dr. Michael Lichtenstein, medicine, was quoted in an article on the benefits of animal interactions with the elderly.
An article on osteoporosis quoted Dr. Jan Bruder, medicine. The paper ran a story on a study of a new ALS drug delivery system headed by Dr. Carlayne Jackson, medicine.
A front-page article discussed Institute of Biotechnology Director Dr. Wen-Hwa Lee's study on the BRCA1 tumor suppressor gene.
KENS, Channel 5, interviewed Dr. Jaime Garza, surgery, on traumatic cleft ear lobe; Dr. Kyriacos Athanasiou, orthopaedics, on musculoskeletal banks; and Dr. Craig Witz, ob-gyn, on the pros and cons of Depo-Provera.
Also appearing on KENS were Drs. Chantal Harrison,
pathology, and Yair Gazitt, medicine, who discussed a new
bone marrow transplant procedure. Dr. Robin Brey,
medicine, described new treatments for migraine. Dr. Stephen
Brannon, psychiatry, spoke about the death of JFK Jr. and
the sense of personal loss. Dr. Kenneth Washburn,
surgery, touched on Spur Sean
Elliott's recent kidney transplant.
The station also
interviewed Dr. John Gunn, microbiology, about
chlorine in swimming pools; Tom Turturro, physical therapy, about lower back pain; and Dr. Ivy Schwartz, general dentistry, about the special dental care needs of women.
KSAT, Channel 12, spoke with Jim Barrett, computing resources, about the Y2K computer bug. The station also interviewed Dr. Sandra Ehlers, pediatrics, about the live virus vs. dead virus polio vaccines.
KMOL, Channel 4, interviewed Tony Ferrara, vice president for administration and business affairs, about the parking situation at the Health Science Center.
KTSA-AM, 550, interviewed Dr. Steven Shanfield, psychiatry, about road rage and Dr. Gustavo Roman, medicine, about sleep paralysis. The station also spoke with Drs. Thomas Ball and Kenneth Washburn, surgery, about Sean Elliott's kidney transplant surgery.
Dr. Peter Fox, Research Imaging Center, discussed brain activity on KTSA and on WOAI-AM, 1200. WOAI also interviewed Dr. Ivy Schwartz about women's dental care needs and Dr. John Gunn about chlorine in swimming pools.
KWED-AM in Seguin interviewed Dr. Bill Watson of the Poison Control Center. KURV-AM spoke with Denise Hicks, medicine, about shingles.
Dr. Gerald Dodd, radiology, was featured in a San Antonio Business Journal article about thermal ablation of liver tumors. The weekly also ran a story on Dr. Jan Vijg, physiology, on the relationship between cancer and aging, and quoted Dr. Ian Thompson, urology, on prostate cancer research.
The Business Journal also interviewed Dr. Helen Cronenberger, distance learning and telehealth, for an article about the future of telemedicine and a story on the expansion of a technology firm into San Antonio.
Wendy Rigby, left, medical reporter for KENS-TV, Channel 5, interviews Dr. Robert Nolan, pediatrics, about ear thermometers.
Annual Hollers Lecture set for Oct. 29
Dentists and their office teams are invited to the James P. Hollers Memorial Lectureship sponsored by the Health Science Center's Dental School. This year's course, "Great Communication Equals Great Production," will be offered Friday, Oct. 29, at the Omni San Antonio Hotel, 9821 Colonnade Blvd. Reservation cutoff date for the block of rooms at the Omni is Thursday, Oct. 14. For more information or to register, call the Office of Continuing Dental Education (CDE) at ext. 3177.
Course participants will hone a number of communication and management skills, including establishing trusting relationships with patients, determining patients' wants and needs, and setting achievable objectives. Presenter Cathy Jameson is founder and president of Jameson Management Inc., a dental practice management company, and serves as an adjunct faculty member at the University of Oklahoma School of Dentistry.
Representatives from national dental supply companies and equipment manufacturers will exhibit their products as part of the Hollers Lectureship. "The Dental School appreciates the participation of these commercial exhibitors in meeting the educational and product needs of the professional dental community as well as their educational grant in support of this continuing dental education program," said William Butler, director of CDE in the Dental School.
Sponsors funding the grant include Beutlich, LP; Brasseler, USA; Colin Medical Instruments; Dentsply-Caulk; Designs for Vision; HPSC Inc.; Lightspeed Technology; Med-National; Oral Designs; Patterson Dental Supply; Procter & Gamble; Vivadent; and Warner Lambert.
The Hollers Memorial Lectureship pays tribute to the leadership and achievements of James P. Hollers, D.D.S. (1899-1976). He was one of San Antonio's leading citizens, played an active role in the development of the Dental School, and served as president of the American Dental Association and other organizations.
Dentists who attended at least 100 hours of CDE courses at the Health Science Center between Sept. 1, 1998, and Aug. 31, 1999, will be honored at the Hollers Lectureship with the Kenneth D. Rudd Continuing Dental Education Participant Award.
The Health Science Center has established a process to determine if its current administrative computer systems are sufficient or if they need to be replaced. Included in this assessment are the human resources system; payroll system; financial system, including budget and general ledger; purchasing system; and student and student financial aid systems.
Dr. John P. Howe, III, president, has appointed an institution-wide committee chaired by Anthony Ferrara, vice president for administration and business affairs, and Jerry York, vice president and chief information officer.
Based on initial meetings, two vendors have been invited to demonstrate their systems to the Health Science Center community. Systems and Computer Technology (SCT) and PeopleSoft will demonstrate their systems for two days during September. The first day of each session will be reserved for committee members and the second day will be open to all faculty and staff.
SCT is scheduled to present Sept. 21-22 and PeopleSoft on
Sept. 27-28. For information on demonstration times, see the
Attendees will have an opportunity to submit evaluations and further questions to the committee at the end of each session. Questions may be directed to Ferrara at ext. 7020 or York at ext. 7050.
Microbiologist searching to understand and treat little-known parasitic brain disease
An intestinal parasite that has long existed in areas of Mexico and nations to the south is now making its way across the border with more frequency.
With an infection cycle that includes infiltration of the brain and nervous system, the resulting disease, neurocysticercosis, has caught the attention of researcher Judy Teale, Ph.D., a professor in the Department of Microbiology at the Health Science Center.
Dr. Teale is working to determine the effects of current treatments for the disease and the role of certain cells in immune response, in the hopes of developing better medicines.
Neurocysticercosis begins with the ingestion of parasitic eggs that eventually result in the infection of the brain and central nervous system by larvae. Patients suffering from neurocysticercosis vary in terms of symptoms. Some are asymptomatic and the disease is not even found until the patient has died from the affliction. Others exhibit a variety of maladies, including headaches, nausea and seizures.
Depending upon the length of infection and the location of the parasitic larvae, patients also may suffer more life-threatening conditions, including increased pressure on the brain.
The initial parasitic infection is largely the result of poor hygiene when preparing foods and inadequate sanitary conditions. The disease is normally seen in Third World countries where standards in food preparation and sanitation are lower. But as people migrate from Mexico into the United States, local hospitals are seeing more and more cases of neurocysticercosis, including University Hospital, which now treats several cases a month.
"It is the most common parasitic disease of the central nervous system worldwide," Dr. Teale said. "It is a really serious problem."
The life-threatening disease has seen little in the way of research until now. Current treatments, which include anti-helminthic drugs, have been known to cause adverse side effects and additional problems for patients instead of alleviating the illness altogether.
Dr. Teale has been working to define what the immune response is in the brain following treatment with the anti-helminthic drugs, including what cells are involved and what those cells secrete. She has determined that one particular type of cell, the gamma delta T-cell, is involved in controlling the infection in animal models, but research will continue to determine exactly what those cells do.
"It is the kind of cell that infiltrates--a massive
infiltration--and seems to be involved in controlling the
infection in animals," Dr. Teale said. "So we are now
doing studies to figure out the exact role of these gamma
delta T-cells. Even in all of immunology this is the type of
cell--it is not clear what it is doing--exactly what its role
is in the immune response."
Dr. Teale said prevention also is key in stopping the spread of neurocysticercosis. The old adage warning tourists to steer clear of the drinking water in many foreign countries may not be the only caution to remember when traveling. Fruits and vegetables, which become contaminated with parasite eggs during the fertilization process, also should be under scrutiny and should be washed thoroughly. Preferably, salads should be avoided and fruits should be peeled prior to eating. Strawberries are a particular risk.
"It is becoming more and more of a problem here in the U.S.," Dr. Teale said. " In some areas of the U.S., they are not used to seeing it and it will take a lot longer to diagnose and treat."
Scholarship grows at School of Nursing
The School of Nursing made extraordinary gains in scholarship during the last fiscal year (ending Aug. 31, 1999). Compared with fiscal year 1998, faculty members published twice as many peer-reviewed articles, wrote three times the book chapters, tripled research grant submissions and received funding for several major educational projects.
More than 40 faculty members in the departments of chronic care, acute care, and family nursing care were recognized by Dr. Janet Allan, dean of the nursing school, at a ceremony last month with candy "kisses and kudos."
"The nursing faculty decided that scholarship would have
priority in every mission of the nursing school--education, practice and research," Dr. Allan said. "Everyone agreed to focus on this."
That focus took form in a number of new programs implemented over the last year. Among them are a mentorship program for new or non-tenured faculty to help them develop their own research; a consultation program through which faculty researchers could use discretionary funds to consult with experts elsewhere in the country; ongoing brown-bag sessions on writing and submitting articles for publication; and a series on winning grants.
"We initiated a summer salary support program in which faculty can apply for 1 to 3 months of summer salary to support their scholarship activities. It's a way for us to support selected faculty so they can focus on their scholarship," Dr. Allan added. This program also has supported the research of two new doctoral graduates just hired by the School of Nursing. "It's a jump start for new faculty with the expectation that they will eventually get grant funding," she said.
Dr. Allan said funding for nursing research lags far behind that for other health research. "We are still neophytes in federal funding," she added. The National Institute of Nursing Research (NINR) was one of the last components of the National Institutes of Health to be established and in 1999 had $67 million in funding for research. The next-largest institute has more than $200 million, Dr. Allan explained.
Dr. Barbara Holtzclaw, associate dean for nursing research, pointed out two faculty members who have NINR funded grants: Dr. Donna Taliaferro, for a study on the effects of illness on a person's circadian rhythms, and Dr. Elizabeth Reifsnider, for a five-year study on growth patterns and nutrition in Mexican-American children.
Some highlights among recent publications are "Teaching Pain Management: How to Make it Work," by Drs. Mary L. Heye and Leslie Goddard, in the Journal of Nursing and Staff Development; the textbook chapter "Loss, Death, and Dying," by Cheryl L. Staats, in Introductory Nursing Care of Adults (2d ed.); the article "Predictive Ability of Social Cognitive Theory in Exercise Research: An Integrated Literature Review," by Dr. Collen Keller, et al., in The Online Journal of Knowledge Synthesis for Nursing; and "Clinical Interventions with Battered Migrant Farmworker Women," by Dr. Rachel Rodriguez, in Empowering Survivors of Abuse.
The Office of Public Affairs is looking for story leads on clinical breakthroughs, research discoveries, human-interest items, community service, innovative teaching stories and other topics of interest for the Health Science Center's publications and for outside media coverage. Story ideas and leads can be sent to public affairs electronically through a new Web site.