Health & Fitness Experts

Emory University - Spring 1996

May 22, 1996
Media Contact: Sarah Goodwin at 404/727-5686, e-mail: sgoodwi@emory.edu

Sports medicine

Badminton Thomas Moore, M.D., trauma surgeon, is one of the physicians in charge of the badminton venues during The Summer Games. He already has provided medical support at international competitions.

Biomechanics William Hutton, Ph.D., director of research for orthopaedics, runs a biomechanics laboratory at Emory Sports Medicine Center where he applies mechanical engineering principles involving center of gravity, torque and velocity to athletic performance.

Gymnastics Robert Frederick, M.D., orthopaedic surgeon and sports medicine specialist, is the medical director in charge of all gymnastics venues.

Heat-related problems Steven Manoukian, M.D., cardiologist and a team doctor for the Atlanta Knights professional hockey team, can discuss the dangers athletes -- and fans -- face during the height of Atlanta's hot and humid summer, including dehydration and heat stroke.

Injuries Thomas Branch, M.D., orthopaedic surgeon and sports medicine specialist, treats all types of athletic injuries -- from the tennis elbows which plague weekend warriors, to the severe breaks and sprains experienced by Emory varsity athletes, to the amenorrhea (disrupted menstrual cycle) and ensuing bone fractures common to lean, female athletes. Dr. Branch published a study which found a high incidence of broken arms in male pitchers in over-30 baseball leagues, and he is the author of a series of medical papers on shoulder biomechanics. He also was the first surgeon to transplant a damaged knee meniscus via arthroscopy.

Knee cartilage transplants Robert Frederick, M.D., is one of the first surgeons in the South trained in transplanting knee cartilage. The new procedure, which promises to eliminate the need for knee replacement surgery in some patients, begins with the removal of a sampling of cartilage cells from the knee. Once the cells have been nurtured in a laboratory and have multiplied several fold, they are implanted back into the patient's knee, where they take up residence.

Official Olympic hospital John Henry, CEO of Emory Hospitals, can discuss how Crawford Long Hospital of Emory University, the host hospital for The Summer Games, plans to meet the health care needs of athletes, administrators and fans requiring hospitalization. Disaster preparedness training and arranging for middle-of-the-night delivery of hospital supplies (to avoid the traffic gridlock expected downtown) are among the unusual plans hospital administrators are making.

Olympic Village health clinic S. Boyd Eaton, M.D., a radiologist and medical anthropologist, is medical director of the large poly-clinic for the Olympic Village. The clinic will provide health care for all athletes, coaches, trainers, etc., staying at the Olympic Village. Dental services and eye care will be available around-the-clock to accommodate the enormous requests for these services expected from athletes from developing areas. Dr. Eaton, who is an expert in the merits of cavemen's diets to modern human health, will discuss Exercise and Evolution at an international Exercise and Nutrition conference planned for May 24 in Olympia, Greece (near Athens), site of the original Games.

Spine Scott Boden, M.D., orthopaedic surgeon, is known internationally for his expertise in the diagnosis and treatment of spine disorders, particularly back pain. Many athletes, even young children, can develop back pain associated with involvement in sports that require repetitive spine rotation and extension. He provides athletes with tips for avoiding ÜÜ and recovering from ÜÜ back pain. Dr. Boden is also responsible for research with bone growth factors that may help broken bones heal faster and more reliably.

Steroids, blood doping Lamar Fleming, M.D., chairman of orthopaedics, says that since drug testing has become commonplace at international athletic competitions, world-class athletes have become much more aware of the deleterious effects of such compounds as anabolic steroids. But what about high school athletes? In addition to gambling with nature to gain unfair advantage over competitors, sports medicine specialists are seeing more than bulging muscles in young patients who have abused steroids. Joint problems, severe acne scarring, impotence, and excessive anger are only a few of the side effects of abuse.

Sudden death in young athletes David Schroeder, M.D., director of cardiac rehabilitation, says that although rare, even the fittest of athletes may be struck by sudden death. The culprit usually is an undiagnosed cardiac problem, like the atherosclerosis found in Sergei Grinkov, the Olympic ice skater who died suddenly in November 1995 at age 28.

Sunburn, sunstroke Carl Washington, M.D., is a dermatologist who specializes in treating sun damaged skin, from fine wrinkles requiring light acid peels to dangerous melanoma requiring Mohs surgery.

Swimming Patricia ñSkippyî Mattson, P.T., A.T., is director of physical therapy at the Emory Sports Medicine Center, holds world records in two master's level swimming events, is a sanctioned U.S. Olympic Committee trainer and helps elite swimmers like Olympic swim team members Carlton Bruener and Eric Winderlich improve their strokes at Emory Sports Medicine Center's swim flumes, the first in the state. She teaches swimmers techniques for preventing the shoulder overuse injuries to which they are prone and helps injured swimmers and divers get back in top shape as quickly as possible.

T'ai chi for balance Steven L. Wolf, Ph.D., professor of rehabilitation medicine, heads the Atlanta component of the national Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) trial. The Emory researchers have investigated the use of t'ai chi classes for improving balance and reducing frailty in older adults. Emory visiting professor of biochemistry Tingsen Xu, a t'ai chi grand master, leads the exercise classes.

Tennis Lamar Fleming, M.D., chairman of orthopaedics, will provide medical support during the Games for athletes at the tennis venue.

U.S. Olympic Committee trainer Patricia ñSkippyî Mattson, P.T., A.T., is one of the few U.S. Olympic Committee athletic trainers in the South. In addition to serving as a trainer at amateur sporting events around the world and at the U.S. Olympic Training Center in Colorado Springs, CO, Ms. Mattson worked with local elite athletes including runners, Tae Kwon Do players, and swimmers. She is a double world record holder in master's level swimming.

Volleyball Hal Silcox, M.D., orthopaedic surgeon, is providing medical support during the beach volleyball competition of The Summer Games. He can discuss common traumatic and overuse injuries experienced by volleyball players, including jumper's knee.

Eye Care

Glaucoma advances Mary Lynch, M.D., eye surgeon, has developed a new surgical approach to primary congenital glaucoma which requires only one operation instead of three, significantly reduces scarring and eliminates the nearsightedness present in many children after they undergo traditional treatment. She also has invented an ocular probe that allows surgeons to achieve more successful outcomes in glaucoma surgery for children.

Laser refractive surgery George O. Waring III M.D., and his Emory colleagues, are among the first in the country testing a new laser refractive surgery technique to treat mild to severe nearsightedness. Called LASIK, for excimer laser in situ keratomileusis, eye surgeons slice a flap of corneal tissue, use a laser to sculpt the middle layer of cornea, then reposition the protective flap. The beauty of LASIK, says Dr. Waring, is much less pain, faster recovery of vision and less long-term wound healing.î

Precious poison Ted Wojno, M.D., uses a minute form of the deadly poison known as Botulinum toxin to quell the eye twitching that troubles some patients. Emory neurologists use "Botox" to reduce the muscle spasms of dystonia and otolaryngologists (ear, nose and throat doctors) open closed vocal cords and free patients to speak.

Preventing blindness in preemies Antonio Capone, M.D., and other Emory eye surgeons tote a diode laser to neonatal units all over town to deliver to premature infants sight-saving eye care. The very oxygen which keeps preemies alive in incubators also puts them at risk for a blinding disease called retinopathy of prematurity.

Prosthetic corneas David Palay, M.D., corneal transplant surgeon, allowed two completely blind men to see after he fitted them with prosthetic corneas in a procedure called keratoprosthesis. It is more of an implantation than transplantation, since human tissue is not involved. Dr. Palay also is one of a few eye surgeons in the state performing corneal transplantation on infants and children.

Virtual reality for poor vision Ned S. Witkin, O.D., is helping apply virtual reality technology to the visually impaired. He is letting qualified patients know about the first vision-enhancing device of its kind in Georgia and one of the first in the South. The low vision enhancement system is designed for patients with vision as poor as 20/800 (after correction with eyeglasses or contact lenses), many of whom are legally blind.

Heart

Angioplasty vs. bypass surgery Spencer King III, M.D., directs the Andreas Gruentzig Cardiovascular Center, named for the late Emory physician-researcher who developed balloon angioplasty to clear blocked coronary arteries. Doctors at the Center have performed more than 10,000 angioplasties -- more than any other group in the world. Their research focuses on restenosis as well as new plaque-reducing techniques involving advanced balloons, drills and lasers. Dr. King led the first study that showed angioplasty was as safe as coronary bypass surgery. He now is principal investigator of one of the first human studies to determine if radiation applied to arteries after angioplasty will keep them from reclogging.

Antioxidants Sampath Parthasarathy, Ph.D., one of the leading proponents of the antioxidant theory of atherosclerosis, clarifies in his book Modified Lipoproteins in the Pathogenesis of Atherosclerosis (R.G. Landes Company, Austin, TX, 1994) some of the facts and fiction surrounding the theory. He was the first scientist to identify the cholesterol-lowering drug probucol as an antioxidant. He also reports that the postcoital pill RU-486 is a potent antioxidant.

Aortic aneurysm repair Elliot L. Chaikof, M.D., Ph.D., vascular surgeon, delivers grafts to the site of an aortic aneurysm (dilation of a major artery at risk for rupture) via catheter rather than by opening the abdomen.

Blood pressure gene R. Wayne Alexander, M.D., Ph.D., chief of cardiology, was a leader of the team that isolated the gene for the major hormone receptor controlling blood pressure.

Chaos control Jonathan J. Langberg, M.D., cardiologist, has developed a chaos control technique that may help control irregular cardiac rhythms by altering chaotic patterns in the electrical signals controlling the heart. If successful, the technique could lead to development of a new type of implantable device that would be smaller and apply less electrical energy than the defibrillators now used to correct the erratic heartbeat of atrial fibrillation. He is working in conjunction with Georgia Tech physicist William L. Ditto, Ph.D., and Dr. Mark L. Spano of the Naval Surface Warfare Center.

Cardiac imaging Roderic Pettigrew, M.D., Ph.D., a radiologist, employs the extraordinary computer graphics techniques developed by George Lucas in Star Wars, to give pediatric heart surgeons the ability to do something impossible in the operating room: pick up a child's heart and turn it upside down and all around while it is pumping. Dr. Pettigrew, who also is a physicist, is using magnetic resonance imaging (MRI) to create some of the world's first three- dimensional images of the heart in motion.

Ernest V. Garcia, Ph.D., director of the Center for Positron Emission Tomography (PET), is determined to improve imaging technology so that physicians may evaluate the heart muscle more precisely. Dr. Garcia has collaborated with Cedars-Sinai Medical Center in Los Angeles to develop, refine and market advanced two-dimensional heart imaging technology. The advantage of the new computer software is that it provides valuable quantitative information to enhance the visual, qualitative, information provided by conventional cardiac scans.

Echo Randolph P. Martin, M.D., cardiologist and director of the Noninvasive Cardiology Program, uses cardiovascular ultrasound to obtain valuable information about the structure and function of the heart, great vessels and carotid arteries in the neck. This technique uses both two-dimensional echocardiography and Doppler echocardiography, and has been important in telling status and function of native and artificial heart valves, as well as the function of the pumping chambers of the heart. A specialized form, called transesophageal echo, is extremely useful in patients who have life- threatening situations, such as infection of the heart valves, a tear in the inner lining of the great blood vessel of the body, the aorta, and is of great use in patients who have recently undergone surgery or patients who have had strokes.

Endothelial cells S. Wright Caughman, M.D., director of the Emory Skin Disease Research Core Center, is interested in the single layer of endothelial cells (dubbed "the cell of the decade") that lines blood vessels, particularly human microvascular endothelial cells of the skin and other organs which are involved in inflammatory and immunologic processes, thrombosis (clot formation) and atherosclerosis, leukocyte trafficking, and support of tissue nutrition.

Elliot L. Chaikof, M.D., Ph.D., is studying whether the tissue that lines blood vessel walls along curves is under greater stress than tissues that line the straight-aways? Are the endothelial cells lining the inside of branching arteries at higher risk for developing atherosclerosis? Emory heart researchers are collaborating with engineers from the Georgia Institute of Technology to apply fluid flow mechanics to these questions.

Thomas J. Lawley, M.D., chairman of dermatology, developed the world's only immortalized human microvascular endothelial cell line in conjunction with the U.S. Centers for Disease Control and Prevention. The availability of such lines is significant, he says, since the majority of disease events associated with endothelial cells occur at the microvascular level.

Russell Medford, M.D., Ph.D., is both a cardiologist and a basic scientist interested in how oxidation damages endothelial cells that line arteries and triggers atherosclerosis. He has identified a regulatory protein that tells damaged endothelial cells to express vascular cell adhesion molecules (VCAMs). VCAMs are (sticky) adhesion molecules that are supposed to attract circulating white blood cells to help heal the site of the blood vessel's injured lining. Unfortunately, the glut of cells attracted is actually the precursor to plaque formation „ and lethal atherosclerosis. Most significantly, Dr. Medford has learned that one can quiet the expression of this regulatory protein with certain antioxidants, preventing it from urging white blood cells to attach to endothelial cells „ and initiate the events which ultimately result in atherosclerotic plaque formation.

Hypertension in blacks Josiah H. Wilcox, Ph.D., associate professor of hematology/oncology, is studying heart disease in blacks at the basic science level. W. Dallas Hall, director of the division of hypertension, Department of Medicine, is a co- founder of The International Society for Hypertension in Blacks, which provides forums for the discussion of ethnicity and disease research. The group is committed to determining why blacks have much higher rates of high blood pressure and kidney failure than whites.

Modified heart valve John Gott, M.D., cardiothoracic surgeon, helped develop a covering for porcine replacement heart valves made of anticalcification compound that improves the long-term acceptance of the valve.

Women and heart disease Nanette Wenger, M.D., cardiologist, was named by Ladies' Home Journal as one of the 10 most important women in medicine in 1995. Among many other accomplishments, she published in a July 1993 edition of the New England Journal of Medicine a comprehensive list of reasons why women with heart disease often fare worse than men. Dr. Wenger currently is the principal investigator of the Emory component of the 15-center Heart and Estrogen-Progestin Replacement Study (HERS), the purpose of which is to determine just how important hormone replacement therapy may be in reducing a woman's risk for recurrence of coronary heart disease after menopause.

Women's Health Initiative Ora Strickland, Ph.D., professor of nursing, is one of the principal investigators of the Emory component of the largest women's health study ever: the $625 million Women's Health Initiative funded by the National Institutes of Health. The researchers will study 3,490 eligible postmenopausal women age 50-79 over the next decade to evaluate low-fat diets and women's health, hormone replacement therapy, and the use of calcium and vitamin D supplementation to prevent osteoporosis.

Infectious Diseases

AIDS drugs Raymond Schinazi, Ph.D., internationally prominent antiviral drug researcher, holds 11 patents on drugs designed to inhibit HIV viral activity, three of which are currently in clinical trials. His work is based on lulling the virus into a constant state of latency.

AIDS vaccine Richard Compans, Ph.D., one of the world's pre-eminent research virologists, was recruited to Emory in 1992 to chair Emory's Department of Microbiology and Immunology. He is leading a National Cooperative Vaccine Development Group, funded by the National Institutes of Health, that is working on a vaccine to protect against sexual transmission of HIV.

Condom pros: legal prostitutes Robert Hatcher, M.D., director of the Emory/Grady Family Planning Clinic and a leader inthe field of birth control, studies condom usage among sex workers in Nevada's legal brothels. He and Alexa Albert believe the research may be of use to other condom users and to public and private health professionals who counsel persons about condom-preventable diseases.

Eye implant for AIDS Daniel F. Martin, M.D., reports that an experimental eye implant delays the progression of cytomegalovirus (CMV) retinitis, a potentially blinding disease that strikes one in four persons with AIDS. HIs device may be used for other types of drug delivery in the eye.

Georgia's largest AIDS clinic Stephen Nesheim, M.D., directs the pediatric portion of the infectious disease clinic (IDC) -- the single largest source of care for HIV-positive Georgians. Run by Emory doctors and Grady Memorial Hospital nurses and physician assistants the IDC ministers to roughly 4,500 people, including 60 percent of the state's children with AIDS. Dr. Nesheim directs several National Institutes of Health pediatric AIDS clinical trials at the center.

Mother Teresa's AIDS Hospice Sharne Sheehey, M.D., infectious diseases specialist who practices at the Emory/Grady women's AIDS clinic, wrote a letter to Mother Teresa about the plight of Atlanta's homeless AIDS population that led to the opening of a hospice in Midtown for HIV-infected mothers and their children. Nuns from Mother Teresa's order provide food and shelter for the residents. Staff at the AIDS clinic provide health care.

Tuberculosis Henry Blumberg, M.D., has been working to clear Atlanta's name as the city with the highest rate of tuberculosis (TB) in America. Among many other activities, he works closely with local and state government representatives, and national experts at the nearby U.S. Centers for Disease Control and Prevention, to increase the availability of directly observed therapy for high- risk persons in homeless shelters, the prison system, and in public hospitals and clinics.

Vaccine Center Rafi Ahmed, Ph.D., a world leader in vaccine research, recently was recruited to Emory to head the Georgia Vaccine Development Center based at Emory University. He is particularly interested in immune memory -- the ability of immune cells to launch attacks against bodily invaders they were barely introduced to through illness or vaccination 60, 70 or even 100 years prior. The Emory-based team already is collaborating with the Special Pathogens Branch of the U.S. Centers for Disease Control and Prevention on ways to develop protective immunity against Ebola virus and hantavirus. The group plans to begin research on vaccines for HIV, rotovirus and measles.

Misc.

Acupuncture Yung Fong Sung, M.D., associate professor of anesthesiology, is not only chief of anesthesiology for The Emory Clinic's Ambulatory Surgery Center -- she has for many years headed the Center's acupuncture clinic.

Cancer pain Deborah McGuire, Ph.D., professor of oncology nursing, believes much can be done to reduce the acute and especially chronic pain that may be associated with cancer. Interventions such as working with patients' -- and practitioners' -- fears of addiction and other misconceptions about pain medicine can improve compliance on the part of patients, reduce pain and improve quality of life. She says that minority and low-income patients are at high risk for poor pain management.

Chinese herbs for warts Linda Gooding, Ph.D., professor of microbiology and immunology, was awarded one of the first three grants for the newly established Office of Alternative Medicine at the National Institutes of Health. The study is looking at the use of Chinese herbs to augment cryosurgery in the treatment of recalcitrant warts on the hands and feet. ñWe're the first in the United States to test something like this on humans, and the first ever to receive Food and Drug Administration approval to test herbals,î she says.

Endoscopic plastic surgery John Bostwick, M.D., chairman of plastic and reconstructive surgery, and his Emory colleagues were among the first to perform endoscopic plastic surgery worldwide. They have worked with manufacturers to custom design many of the surgical tools used today for the procedure. Emory's reputation as one of the world's premier training sites for this technique has drawn hundreds of surgeons from the United States and abroad to Atlanta to learn this less- invasive, less-expensive form of cosmetic surgery.

Faith and health Fran Wenger, Ph.D., professor of nursing and director of the Transcultural and International Nursing Center at Emory's Nell Hodgson Woodruff School of Nursing, conducts training for congregational health promoters within the certain clusters of The Atlanta Project. Once trained, the health promoters go back to their congregations to organize health development and health awareness activities. The program is part of the Atlanta Interfaith Health project, sponsored by The Carter Center.

Fragile X syndrome gene Stephen Warren, Ph.D., Howard Hughes Medical Institute Investigator and W.P. Timmie Professor of Human Genetics, discovered in 1991 the gene (FMR1) responsible for fragile X syndrome, the most common form of inherited mental retardation, and in 1993 discovered FMRP, the protein expressed by the normal gene. They learned that fragile X syndrome occurs when the FMR1 gene does not produce the FMRP protein. That protein suppression is responsible for the symptoms of the disease, namely mental retardation, attention deficit disorder and connective tissue disorders. The scientists also learned that most affected patients share a common genetic mutation: the unstable expansion of a triplet of CGG nitrogenous base pairs within the FMR1 gene. The CGG, CGG, etc., triplet is usually repeated between 230 to 1,000 times in those affected by fragile X syndrome but only 30 times in unaffected persons.

Hawaiian maternal health Dyanne Affonso, Ph.D., dean of Emory's Nell Hodgson Woodruff School of Nursing, is applying to inner city teens in Atlanta, principles from maternal- child health projects she developed in her native Hawaii. The programs are based on providing culturally sensitive interventions to pregnant women and new mothers -- and enlisting key community support. In Hawaii, local ethnic healers were an integral part of the program.

Health literacy Mark Williams, M.D., family and preventive medicine, reported in 1995 that the quality of health care provided many Americans is diminished by the inability to read. Prescriptions, discharge orders and instructions on pill bottles represent information inaccessible to millions Americans who are illiterate.

International nursing Helen O'Shea, Ph.D., nursing professor, coordinates the Nursing Education Partnership Program, which allows undergraduate nursing students from Taiwan to work on their bachelors' of nursing and allows future nursing professors in Ethiopia to take graduate level courses at Emory.

Mitochondrial DNA Douglas C. Wallace, Ph.D., caught the attention of other geneticists when he began investigating the tiny pieces of DNA found outside the cell's nucleus, in the energy-producing mitochondria (mtDNA). This DNA is distinct from nuclear DNA in that its genes are passed on only through the mother. Anthropologists are still reeling from Dr. Wallace's deductions that Homo sapiens is a young species, arising in Africa about 100,000-200,000 years ago. Theologians have called it the Eve hypothesis; journalists have dubbed that early Homo sapien ñour mitochondrial mom.î Linguists are validating some of his other theories of human migration around the world, such as mtDNA evidence for several waves of migration from Siberia and coastal Asia, giving rise to the various Native American linguistic groups. Physicians were thrilled with Dr. Wallace's confirmation in 1988 that an insidious form of blindness is caused by mitochondrial gene mutations; he has since linked such mutations to Parkinson's, Alzheimer's, muscular dystrophy, some forms of epilepsy, heart disease and adult-onset diabetes. Geriatric specialists are fascinated by the clues Dr. Wallace uncovered in 1992 in heart and brain tissue mtDNA that promise much information about the aging process itself.

In vitro fertilization Ana Murphy, M.D., is an unusual matchmaker; her top priority is encouraging the courtship between egg and sperm in infertile couples . Fertility treatment may be as simple as advising couples to have intercourse more often, or as high-tech as manually inserting a single sperm inside a single egg with an extremely fine glass needle guided by a specially equipped microscope (micromanipulation).

Organoids Elliot L. Chaikof, M.D., Ph.D., is conducting research in tissue engineering which allows him to combine his skills as a vascular surgeon and as a Ph.D.- trained chemical engineer. He is designing a hybrid arterial prosthesis, or organoid, which combines both artificial and natural biological elements.

Sickle cell anemia James R. Eckman, M.D., director of the Georgia Sickle Cell Center, led the Emory component of work reported in the May, 1995, New England Journal of Medicine, which described the usefulness of hydroxyurea for reducing the excruciatingly painful episodes which disable children with sickle cell anemia. Center research also involves transfusion therapy for neurologic and surgical complications. Now under way are investigations of factors that impede blood flow such as the tendency for sickle cells to adhere to blood vessel walls, the tendency for sickle cells to aggravate the lining of the lungs which may lead to inflammation and lung damage, the use of fish oil to inhibit the tendency of sickle cells to initiate blood clots, and further research into ways to prevent the chronic organ damage associated with sickle cell anemia, particularly kidney failure. Much of the research on cell adhesion is done in collaboration with the Georgia Institute of Technology, where engineers use an in vitro flow model of the blood vessel to study how sickle cells interact with endothelial cells lining the vessel wall. One of the newest alternatives at Emory for treating selective cases of sickle cell anemia -- those at high risk for stroke -- is bone marrow transplantation.

Neurosciences and Psychiatry and Behavioral Sciences

Aneurysm coils Robert Dawson, M.D., interventional neuroradiologist, is the first physician in the region using platinum microcoils to greatly reduce the risk of certain kinds of stroke in patients with brain aneurysms deemed inoperable or at high risk for surgery. The microcoils are delivered via microcatheter to the weak, balloon-like defects in the walls of brain arteries known as aneurysms. Once in place, the coils fills the aneurysm, isolating it from the circulation and thereby reducing the likelihood of rupture and stroke.

Attention deficit and PET imaging Julie Schweitzer, Ph.D., leads one of the first research groups applying positron emission tomography (PET) to attention deficit hyperactivity disorder (ADHD). In a recent study she describes for the first time how cerebral blood flow patterns differ between adults with and without ADHD when performing difficult attentional tasks.

Autism Gail McGee, Ph.D., associate professor of psychiatry and behavioral sciences, is just as excited as the parents of her patients on the first day of school each fall. She and her staff have been so successful in getting preschoolers with autism to talk, that many are able to go to regular public school in first grade. Just a decade ago those children would probably have been institutionalized. The Emory researchers enlist the aid of normal preschoolers to help apply the technique of incidental teaching to youngsters, even toddlers, with autism.

Epilepsy and PET imaging Thomas R. Henry, M.D., epileptologist, has known for some time that the ability of persons with the most common type of epilepsy (left temporal lobe epilepsy) to name people and objects may be impaired. He conducted pioneering brain mapping work in 1995 that showed how images of brain regions responsible for naming "light up" on positron emission tomography (PET) scans -- information valuable for planning epilepsy surgery. He and his colleagues at the Emory Epilepsy Center also are carrying out clinical trials of promising, new antiepileptic drugs.

Epilepsy surgery Roy A.E. Bakay, a neurosurgeon, performs temporal lobectomy on qualified epilepsy patients diagnosed with partial seizures. The theory behind the surgery is to simply remove small portions of the brain in which seizure discharges begin.

Pallidotomy Mahlon DeLong, M.D., chairman of neurology, pioneered the brain mapping technique used in the pallidotomy surgery used to relieve the tremors and other movement disorders associated with Parkinson's disease.

Rape victims Barbara Rothbaum, Ph.D., assistant professor of psychiatry and behavioral sciences, is using two innovative techniques to help victims of rape who are plagued by post-traumatic stress disorder. During eye movement desensitization and reprocessing (EMDR), the patient simultaneously re-tells the story of her experience while following the therapist's finger moving. Many patients report immediate relief from anxiety they have felt for years. Although the precise mechanism for EMDR's success is unclear, many believe it is related to rapid eye movement (REM) sleep. Dr. Rothbaum also reports promising results using zoloft to treat post-traumatic stress in rape victims.

Schizophrenia Richard Lewine, Ph.D., professor of psychiatry and behavioral sciences, is studying one of the world's largest cohorts of schizophrenia patients and has one of the most diverse collections of data available on this mental illness. Researchers have looked at home movies to identify childhood behavioral markers and they have detected on magnetic resonance images actual gender differences in the shape of the brain in male and female patients.

Sleep Donald Bliwise, Ph.D., and David Rye, M.D., Ph.D., lead the Emory Sleep Disorders Program, which has garnered a reputation for being one of the major sites for sleep research in the country. In addition, the following conditions are treated at the program: insomnia, snoring, sleep apnea (diminished breathing in sleep), narcolepsy (falling asleep uncontrollably during the day), restless leg syndrome, and parasomnias such as sleepwalking, sleeptalking, sleep terrors, toothgrinding, sleep paralysis and nocturnal seizures.

t-PA for stroke Michael Frankel, M.D., neurologist, reports that stroke patients given the clot- busting agent tissue plasminogen activator (t-PA) within the first three hours of stroke symptoms are 30 to 50 percent more likely to have little or no disability after three months when compared to a control group. He led the Emory component of the national study published in the New England Journal of Medicine.

Virtual reality for fear of heights Barbara Rothbaum, Ph.D., assistant professor of psychiatry and behavioral sciences, published with colleagues from the Georgia Institute of Technology, the first controlled application of virtual reality to behavioral therapy. They found that persons with acrophobia (fear of heights) are helped by exposure therapy using virtual reality technology. One of the three virtual environments students were exposed to gave them the sensation they were riding in an open elevator in the atrium of a large hotel. In actuality, they stood on a small platform with railings at Georgia Tech's College of Computing. Nutrition

Antioxidants Sampath Parthasarathy, Ph.D., was recruited to Emory from the team at the University of California, San Diego, that conducted the landmark research involving low-density lipoproteins (LDLs), antioxidants and atherosclerosis. The group hypothesized that oxidation of LDL results in its atherogenic characteristics. Dr. Parthasarathy's more recent work demonstrates that antioxidant HDL (high-density lipoprotein, the good cholesterol) and monounsaturated fatty acids may prevent the oxidative modification of lipoproteins. This work has resulted in the identification of antioxidants such as probucol and vitamin E as important and potential therapeutic means of retarding atherogenesis. His research interests include fatty acids, lipid metabolism, lipid peroxidation, phospholipases, lipoprotein metabolism, monocytes/macrophages and lymphocytes, chemotaxis, antioxidants, cytokines and adhesion molecules.

Apple/pear body shapes Henry Kahn, M.D., preventive medicine, conducts research on the relation between fat distribution and risk for cardiac events. Persons with the so- called "apple" body shape appear to be at somewhat higher risk for heart disease than "pears".

Breast cancer and food Ralph J. Coates, Ph.D., adjunct associate professor of epidemiology, Public Health, is trying to answer questions such as "Does a teenage girl's diet affect her risk of developing breast cancer later in life? What about a young woman's use of oral contraceptives?" Dr. Coates also is investigating the use of biologic markers and other means to assess dietary intakes in culturally diverse populations, the role of diet in the development of lung and colon cancer among non-smoking women, and how dietary habits and weight may influence the prognosis of breast, colon, uterine and bladder cancer. He is one of the principal investigators for the Emory component of the Women's Health Initiative, the largest study of women's health ever undertaken.

Cholesterol W. Virgil Brown, M.D., is past national president of the American Heart Association (1992); director of the division of arteriosclerosis and lipid metabolism; and co-author, Fischer/Brown Low Cholesterol Gourmet Cookbook (Acropolis Books, 1981). He is internationally known for his blood cholesterol research, particularly the tendency for high blood cholesterol to run in some families. He is often called upon to discuss topics such as the following: butter vs. margarine vs. oil; the structure and metabolism of lipoproteins (fat molecule carriers); the new food labels and nutrition; and the human lipoprotein lipase gene.

Corn toxins and cancer Alfred H. Merrill Jr., Ph.D., believes that researchers at the Emory Center and Graduate Program for Nutrition and Health Sciences conduct basic science and clinical research one bite at a time. The series of corn toxin discoveries made by Dr. Merrill, who directs the Center, illustrate just how the process works. In 1994 he described for the first time the means by which a fungus that is frequently found on corn can cause cancer. Consumption of the toxins, called fumonisins, has been correlated with human esophageal cancer in various parts of the world. Until Dr. Merrill's study, however, there had been no molecular explanation for the association of fumonisins and cancer. One of the potential benefits of this knowledge is that we can now begin to look for other types of cancer that may be caused by these food contaminants, he says. Dr. Merrill's group has also reported that sphingolipids may be important in preventing colon cancer.

Dieting Mary Ellen Sweeney, M.D., compared the effect of moderate versus severe caloric restrictions for weight loss in obese subjects. It appeared that, even though more severe caloric restriction initially promoted faster body weight loss, after six months the weight loss was similar in the two groups. The more severe food restriction may have activated energy conservation measures sooner, thus limiting the beneficial effects of caloric deficit. A more modest caloric restriction (about 500 kcal/day) is recommended.

Malnutrition Glen F. Maberly, M.D., chairman of International Health, Rollins School of Public Health, leads worldwide efforts toward ending "the hidden hunger" known as micronutrient malnutrition. That solutions to ending this form of malnutrition are cheap and simple makes the toll taken by micronutrient malnutrition that much more a travesty, he says. Diets deficient in iodine, vitamin A and iron can lead to a 15 percent reduction in intellectual functioning of whole populations, 30 percent reduction in childhood mortality and 30 percent reduction in adult work productivity. The Program Against Micronutrient Malnutrition (PAMM), based at Emory, brings together heads of state, public health officials and food manufacturers (especially salt manufacturers who can easily add iodine to the salt supply) from developing countries to find local solutions to this global yet preventable problem.

Reynaldo Martorell, Ph.D., Robert W. Woodruff Professor of International Nutrition, Rollins School of Public Health, believes that investing in childhood nutrition is investing in economic development. As one of the researchers involved in the landmark human nutrition studies begun a quarter century ago in rural Guatemala, Dr. Martorell has witnessed first hand the physical, mental, emotional and community-wide benefits of improved nutrition. The latest findings from the Guatemalan cohort suggest that improving girlhood nutrition increases the chances of delivering healthier babies in adulthood.

Maternal diet and fetal health Carolyn D. Drews-Botsch, Ph.D., epidemiologist, is interested in the relation of zinc, folic and maternal weight gain on fetal growth retardation, and on the relation of maternal magnesium and antioxidant intake on neonatal respiratory complications and blindness.

Metabolic disorders Rani H. Singh, Ph.D., genetic research nutritionist, has developed a "Metabolic Summer Camp" where children with metabolic disorders learn nutrition education, have fun and meet other children who can relate to their challenges.

Newborn screenings Louis J. Elsas II, M.D., medical geneticist, is probably the individual most responsible for Georgia's comprehensive newborn screening program. He has lobbied before the state legislature for the addition of tests to screen for a total of seven metabolic abnormalities such as maple syrup urine disease and galactosemia, which are preventable causes of death and disability in early childhood. Some of these children, for instance, are at risk for clogged arteries before age 30.

Obesity Peter J. Brown, Ph.D., medical anthropologist, emphasizes in his research the cultural dimensions of eating behavior, cultural ideals of the body, and social stresses that predispose people to obesity or eating disorders. His paper on the history of obesity is frequently cited.

Schoolchildren Marsha D. Hearn, Ph.D., health educator and behavioral scientist, is putting behavior change theory into practice through Gimme 5, a nutrition education program geared toward fourth and fifth graders, and TeachWell, a health promotion program designed for their teachers. Gimme 5 incorporated games, easy in-class and make-at-home recipes, a parent newsletter, rap songs, and incentives and educational means to encourage children to eat five total servings of fruits and vegetables daily. TeachWell included daily in-house exercise classes for teachers and weekly seminars on topics such as nutrition, quitting smoking and losing weight.

Underserved Claudia Fishman, Ph.D., assistant professor of international health, has looked at infant and child nutrition in Africa, promoting breast-feeding in French- speaking countries in Africa, improved communication of nutrition information, and food stamp clients in Los Angeles.

Vegetarianism Erica Frank, M.D., internist and preventive medicine faculty member, has learned from her research that vegetarians are thinner, have lower cholesterol, blood pressure and death rates than the population at large. According to Dr. Frank, vegetarians comprise about two percent of the U.S. population.

Vitamins Donald B. McCormick, Ph.D., biochemist, is recognized worldwide as an authority on coenzymes and vitamins, particularly vitamins B2 (riboflavin), B6 (pyridoxine) and biotin.

For more general information on The Robert W. Woodruff Health Sciences Center, call Health Sciences News and Information at 404-727-5686, or send e-mail to hsnews@emory.edu.

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