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ASA NEWSLETTER
 
 
May 1999
Volume 63
Number 5
 
FAER REPORT

FAER Announces 1999 Award and Fellowship Recipients

The Board of Directors of FAER is pleased to announce the recipients of the 1999 Research Fellowships and New Investigator Awards. The descriptions of the projects have been provided by the investigators. We thank Abbott Laboratories, Organon, Inc., Smiths Industries Medical Systems, the Society for Obstetric Anesthesia and Perinatology and the Society for Pediatric Anesthesia for co-sponsoring these awards. Without support from corporations and societies, we would not be able to fund these talented, promising young anesthesiologists.

New Investigator Award Recipients

Ellen M. Lockhart, M.D., Duke University Medical Center, Durham, North Carolina, Society for Obstetric Anesthesia and Perinatology: "Progesterone as an Endogenous Neuroprotectant"

The fetus is exposed to very high concentrations of progesterone in utero. We hypothesize that these high concentrations confer to the fetal brain enhanced resistance to hypoxia. Exposing cultured neurons to various neurologic insults such as hypoxia, hypoglycemia and ischemia, both with and without exposure to progesterone will test this hypothesis. The degree of cellular injury will then be assessed. The long-term goal of the study is to understand the role of naturally occurring hormones such as allopregnanolone in protecting developing neurons against such neurologic insults as hypoxia and ischemia. Completion of this study will yield important new information about how naturally occurring hormones may act to protect the fetal brain from injury. These results will be useful in assessing if pharmacologic manipulation of serum hormone levels has potential as a prenatal or postnatal intervention during neurologic insults.

Wanda Miller-Hance, M.D., University of California, San Francisco, California, Society for Pediatric Anesthesia: "Impact of Intraoperative Transesophageal Echocardiography on Anesthetic and Surgical Management of Pediatric Patients with Congenital and Acquired Heart Disease"

Remarkable advances in anesthetic, perfusion and surgical techniques now allow for correction of major cardiac defects in children, even in early infancy. Refinements in echocardiography and the miniaturization of probes that provide for real time acquisition of information on cardiac structure and hemodynamics via the transesophageal approach have resulted in increasing applications of this technology to pediatric patients undergoing cardiothoracic surgical procedures. The proposed investigation will prospectively assess the anesthetic and surgical impact of intraoperative transesophageal echocardiography (TEE) in neonates, infants and children undergoing surgery for congenital or acquired heart disease. Potential influences of this technology on clinical outcomes will be addressed. The study will definitely establish the incidence of vital new information provided by intraoperative TEE, identify the cardiac pathology where TEE is more likely to reveal important residual defects and determine the true incidence of immediate reoperation for unacceptable results in pediatric cardiac surgery.

Slobodan M. Todorovic, M.D., Ph.D., Washington University, St. Louis, Missouri, Abbott Laboratories: "Voltage-gated Ca2+ Channels in Sensory Neurons as Targets for Anesthetic and Analgesic Agents"

The extent to which voltage-gated Ca2+ channels may be targets for some anesthetics and analgesics remains incompletely understood. Recently, the applicant has demonstrated that in rat sensory neurons N20 blocks selectively T-type Ca2+ currents in subanesthetic concentrations (IC50 45 percent or 0.3 MAC) while cholinergic agonist carbachol blocks HVA Ca2+ currents presumably acting at muscarinic receptors. He proposes to follow up these findings with additional studies aimed at further clarifying the cellular targets in sensory neurons for these agents. Specifically: the mechanisms and functional significance of T-type Ca2+ current blockade by N20 will be examined and then, pharmacological characterization and second messengers involved in muscarinic receptor mediated-modulation of HVA currents will be studied. Thus, the proposed research will help define the cellular mechanisms of N20 anesthesia and analgesia and will help the applicant to develop a new avenue in his research pertaining to neurotransmitter modulation of voltage-gated Ca2+ channels.

Research Fellowship Recipients:

Paul M. Wischmeyer, M.D., University of Chicago, Chicago, Illinois, Smiths Industries Medical Systems: "The Effects of Glutamine on Induction of the Stress Response to Improve Outcome from Sepsis"

My research focuses on the use of nutritional pharmacology, specifically glutamine, to manipulate the body's response to stress, injury and illness. I have found that glutamine is a potent inducer of heat shock protein 72 and that this induction confers direct cellular protection in vitro. I plan to utilize my FAER funding to determine if glutamine induces heat shock protein at the tissue level in a rat model. Using this model, I hope to determine the ideal dose and route of administration of glutamine. If these preliminary studies prove successful, I plan to examine the effects of glutamine on a rat model of sepsis. If glutamine is effective in enhancing survival against sepsis, I will examine several other models of in vivo tissue injury (i.e. hyperoxic lung injury). I hope to use these findings to enhance the care of the perioperative and critically ill patient.

Raymond A. Zollo, M.D., University of Rochester Medical Center, Rochester, New York, Organon Inc.: "The Effect of Antisense PKG-* Knockdown on Neuropathic Pain"

It is estimated that chronic pain affects more than 50 million people in the United States, causing partial or total disability and costing 90 billion dollars annually. A significant proportion of chronic pain is neuropathic in origin, resulting from nerve injury. Further, neuropathic pain is notoriously difficult to treat because its symptoms are remarkably resistant to conventional analgesics. Recent evidence suggests that the development of neuropathic pain depends on a plastic reorganization of the nervous system called central hypersensitization. The involvement of protein kinase C-gamma (PKC-*) prevent the development of and/or reverse the neuropathic state. The ultimate goal of this line of investigation is to demonstrate the feasibility of antisense oligonucleotide knockdown of PKC-* as a treatment for neuropathic pain.

 


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