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ASA NEWSLETTER
 
 
January 2003
Volume 67
Number 1


Granting Researchers a Chance to Shine

The Foundation for Anesthesia Education and Research (FAER) Board of Directors is pleased to announce the award recipients from the August 2002 submissions. FAER is grateful to ASA, its individual members, component societies, subspecialty societies and corporations for the generous contributions that allow funding of these awards. The descriptions of the projects were provided by the investigators.


Research Training Grant

Yungping Li, M.D.,

Yungping Li, M.D., Beth Israel Deaconess Medical Center, Boston, Massachusetts: “Myometrial Quiescence and Preterm Labor — Toward a Molecular Understanding.” Mentor: Kathleen G. Morgan, Ph.D. Co-Sponsor: Society for Obstetric Anesthesia and Perinatology-Obstetric Anesthesia and Perinatology Endowment Fund.

Many pregnancy-related diseases originate from dysfunctional uterine contractions. Understanding the factors that regulate uterine contractility during labor is key to prevention of premature births and more rational approaches to labor management.

Uterine smooth muscle contraction and relaxation are regulated through extrinsic modulators such as hormones, neuronal factors and anatomical changes and intrinsic subcellular regulatory mechanisms. This proposal will focus on the little-studied gestation-dependent changes in basal contractility intrinsic to myometrium. The general aim of this proposal is to test the hypothesis that intracellular regulatory mechanisms are adaptively and dynamically changed during pregnancy and labor. The specific aims are to investigate roles of ERK/Caldesmon pathway in the regulation of uterine contractility.

It is hoped that insights into the mechanisms of regulation of uterine contractility may potentially lead to the development of new strategies of therapeutic intervention in cases of preterm labor and dysfunctional labor.



Research Fellowship Grant


Larry Chu, M.D., M.S.
Larry Chu, M.D., M.S., Stanford University, Stanford, California: “Measurement of Tolerance and Hyperalgesia in Pain Patients on Chronic Opioid Therapy.” Mentor: David Clark, M.D., Ph.D. Co-Sponsor: GlaxoSmithKline.

The fundamental goal of this proposal is to develop a sensitive method to measure opioid-induced tolerance and hyperalgesia in patients receiving opioids for the treatment of chronic pain. Considerable controversy exists concerning whether or not tolerance and hyperalgesia exist in patients receiving opioids for chronic pain and, if it does exist, the clinical relevance of these effects. This study will examine a method of measuring opioid-induced tolerance and hyperalgesia in chronic pain patients by directly measuring the opioid concentration versus response relationship and will document the changes in this relationship over time. Additionally, we will follow pain thresholds and tolerances to heat and cold stimuli. Our hypotheses are: 1) Chronic opioid therapy changes the opioid concentration versus effect curve; 2) Two distinct changes exists, a) a change in drug potency (tolerance) and b) a change in pain perception (hyperalgesia); 3) These changes can be detected in an acute experiment in which the curve is experimentally measured during the course of opioid therapy and compared with baseline assessment. If this study demonstrates tolerance and hyperalgesia in chronic pain patients, it will suggest that these are causally related to the opioid administration. However, a causal relationship cannot be established without a properly randomized and controlled trial. Once we have demonstrated that this methodology is sufficiently sensitive to measure tolerance and hyperalgesia with chronic opioid administration, it is our intent to determine the causal relationship with opioid therapy in a properly randomized and controlled trial.



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