University Times

Medical center receives funds for study of TMD

The Pain Evaluation and Treatment Institute of the University of Pittsburgh Medical Center has been awarded nearly $1.5 million by the National Institute of Dental Research to fund five additional years of study and treatment for temporomandibular disorders (TMDs), which affect millions of Americans.

TMDs are characterized by pain in jaw muscles used in chewing, as well as related head and neck muscles, pain in the temporomandibular joint and associated hard and soft tissues, limited mobility of the jaw, and/or jaw joint sounds, particularly a characteristic clicking when the jaw is moved.

Although TMDs have been described since the 1930s and the disorders affect an estimated 12 percent of the U.S. population, diagnosis and treatment can be confusing and costly. The purpose of the new grant is to validate a classification system for TMDs based on physical signs and symptoms, and determine the effectiveness of various conservative treatments. Six hundred patients will be evaluated and treated over the next five years.

Patients will receive a variety of free treatments. To qualify, patients must be between 18 and 60 years of age, have suffered jaw muscle or joint pain for three months and have had no previous TMD surgery.

For more information, call the Pain Evaluation and Treatment Institute at 578-3137.

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Surgery profs win American Heart Association awards

Pitt surgery department faculty members James Gammie and Christopher Deible won the second- and third-place Fellow's Research Day awards, respectively, at the American Heart Association's 1996 Heart Ball this month.

Gammie was honored for his poster presentation on "Mixed Bone Marrow Chimerism Prevents Obstructive Airway Disease in Rats." Deible won for his oral presentation on "Reduced Platelet Deposition onto Intimally Damaged Placental Arteries." The oral and poster presentations were judged by a panel of cardiology and cardiothoracic physicians from local hospitals. The presenters competed for cash awards of $1,000, $750 and $500 for first-, second- and third-place, respectively.

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GSPH researchers present findings at cardiovascular disease conference

Graduate School of Public Health (GSPH) researchers presented the following findings at the American Heart Associa-tion's annual Conference on Cardiovascular Disease Epidemiology and Prevention in San Francisco this month.

High homocysteine levels may contribute to hypertension High levels of homocysteine, a naturally occurring substance in the body that helps to build proteins, may contribute to hypertension and atherosclerosis (the buildup of plaque in the arteries) in some people.

"Our research suggests that individuals with high levels of homocysteine who could lower these levels might be able to reduce their risk of hypertension," said Kim Sutton-Tyrrell, principal investigator for the study and associate professor of epidemiology.

In certain people, homocys-teine may build excessively because the body cannot break it down. In such people, the high levels of homocysteine may damage blood vessels, causing atherosclerosis.

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Menopause alone can cause asymptomatic atherosclerosis

Menopause itself dramatically increases the insidious, but clinically imperceptible, progression of heart disease, according to Holly C. Lassila, study investigator and an epidemiology researcher at GSPH.

Researchers assessed cardiovascular risk and performed ultrasound on the carotid arteries of 208 premenopausal women (average age: 49) and 200 postmenopausal women (average age: 57). The prevalence of plaque, as measured by these techniques, nearly tripled from 18 percent of premenopausal women to 51 percent for postmenopausal women.

The prevalence of subclinical atherosclerosis rises sharply in the years immediately following menopause, independent of age, researchers determined.

"These data, the first of their kind, stress that diagnosis and treatment of plaque in the carotid arteries of premenopausal women may decrease the chance of heart disease in postmenopausal women," Lassila said.

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High estrogen levels may cut cardiovascular disease risk in overweight postmenopausal women

Obesity actually may counter cardiovascular disease in postmenopausal women, according to Elaine Meilahn, an epidemiologist formerly at Pitt, and Lewis Kuller, professor and chairperson of Pitt's epidemiology department.

High body mass index (BMI) is commonly thought to increase the risk of cardiovascular disease in postmenopausal women. However, the researchers found that a high BMI also increased high estrogen levels and determined that high estrogen is related to lower cholesterol. A low cholesterol level is known to reduce the risk of cardiovascular disease.

The findings were derived from a study of 89 women participating in the Health Women Study, which is being conducted at Pitt.

The data on the relationship of obesity and estrogen may help explain conflicting results from studies of cardiovascular heart disease risk and obesity among older women.

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UPMC testing promising hepatitis B drug

Patients with hepatitis B who have not responded to alpha interferon treatments may be eligible to participate in a trial of a new drug at the University of Pittsburgh Medical Center.

The drug, lamivudine, is a promising treatment for hepatitis B patients, according to preliminary study results published recently in the New England Journal of Medicine. Lamivudine also may be effective in treating and preventing recurrence of hepatitis B in liver transplant recipients, UPMC researchers say.

Hepatitis B is the most serious form of viral hepatitis and affects approximately 1 million people in the United States. The drug alpha interferon is the only approved treatment, but it is effective in only 20 percent of patients.

"Treatment options for patients with hepatitis B are extremely limited. Currently, lamivudine is one of the most promising agents under clinical investigation," said Victor R. Araya, assistant professor in the division of transplantation medicine and the division of gastroenterology and hepatology at UPMC.

Araya is principal investigator of the UPMC lamivudine study.

Lamivudine is manufactured by Glaxo Wellcome, Inc., which is funding the trial at UPMC and 55 other centers worldwide.

For more information about the lamivudine trial or other studies conducted at UPMC's Center for Liver Diseases, call 647-2488.

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Vascular surgeons study new method of treating abdominal aortic aneurysms

The medical center's vascular surgery division is participating in a national clinical trial to study a new, sutureless method of treating abdominal aortic aneurysms.

An AAA is the ballooning of the aorta, the main artery in the abdomen. It is the 14th leading cause of death in the United States because the weakened artery may rupture unexpectedly and bleed, killing up to 80 percent of patients. AAAs run in families and cause an estimated 15,000 deaths nationwide each year.

The experimental procedure, called endovascular aneurysm repair, uses a device called the Endovascular Grafting System (EGS) to fix the aneurysm. The FDA has approved clinical trials for the device, which is available at only 20 U.S. medical centers.

The standard procedure to repair an AAA requires a large incision extending over the entire abdomen. The aneurysm is replaced by a Teflon-polyester graft that is sutured into place inside the aneurysm. The EGS is inserted through the femoral artery in the groin and moved to the site of the aneurysm.

The device contains a tubular polyester graft. Once inside the aneurysm, the graft is deployed. A spring-type attachment system hooks the implant to the inside walls of the artery on either end of the aneurysm and anchors it in place. Blood then flows through the implant instead of the aneurysm.

The EGS is made by Endovascular Technologies, Inc., of Menlo Park, Calif.

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LRDC receives $1 million Mellon grant for research on high school literacy and job skills

Pitt's Learning Research and Development Center (LRDC) will receive $1 million over the next three years from the Andrew W. Mellon Foundation to support research on increasing literacy and job skills among high school students.

The research project, "Workplace Simulations in Schools," is led by LRDC's Michelene Chi, Gaea Leinhardt and Kurt VanLehn. It will study simulation-based learning and its pedagogical impact.

Chi said: "By 'simulation,' we mean a classroom experience that gives students the same sorts of information that they would get working in a specific workplace, and that asks them to make the same sorts of decisions that the workplace demands, to take workplace-appropriate action, and to experience the results of those actions." Because the number of school-to-work programs such as youth apprenticeships, technical preparation and cooperative education are limited, many schools are turning to simulation to train students in the skills they will need to compete in the modern workplace, LRDC researchers said.