October 1, 1998

Stroke risk related to oxygen use in the brain

Finding revives interest in surgical option for some patients

By Jim Dryden

By measuring oxygen use in the brain, researchers at the School of Medicine can determine which patients with blocked carotid arteries are at high risk for a stroke.

The findings, reported in the Sept. 23-30 issue of the Journal of the American Medical Association, could have implications for reviving a discarded surgical procedure that increases blood flow to the brain.

Robert L. Grubb Jr., M.D., the Herbert Lourie Professor of Neurological Surgery and professor of radiology; William J. Powers, M.D., professor of neurology and associate professor of radiology; and colleagues report that patients with complete blockage of the carotid artery and a condition called hemodynamic failure face a stroke risk six to seven times greater than those with just a blocked carotid artery. Hemodynamic failure occurs when the brain is not receiving the normal amount of oxygenated blood.

Using positron emission tomography (PET) images, the investigators measured blood flow and oxygen metabolism in the brains of 81 study subjects. All had complete blockage of one of their carotid arteries and had suffered either a stroke or a transient ischemic attack, which resembles a stroke but resolves itself in a few hours. The PET scans suggested which patients were in hemodynamic failure by revealing the amount of blood reaching their brains and the percentage of oxygen that the brain used.

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Fourth-year medical
student Amanda
Heidemann talks to
Derrek Deida and other
students at Francis
Howell High School in
St. Charles, Mo., about
becoming a physician.
Heidemann, a graduate
of Francis Howell,
speaks occasionally at
area high schools to
advise students how to
prepare for careers in medicine.

Physical therapist Sahrmann receives APTA lecture award

Honor recongizes lifetime achievement

Sahrmann: Renowned therapist

Shirley A. Sahrmann, Ph.D., professor of physical therapy at the School of Medicine, has received the Mary McMillan Lecture Award from the American Physical Therapy Association (APTA). The award, the highest given by the APTA, recognizes lifetime achievements of an individual whose work will have a lasting effect on the profession of physical therapy.

In accepting the award, Sahrmann, also professor of cell biology and physiology and associate professor of neurology, addressed the association's membership at its 1998 Annual Conference in Orlando, Fla., where she shared professional perspectives and projections for the future of physical therapy.

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Combat has little influence on health problems in Vietnam vets

Investigators at the Veterans' Affairs Medical Center and the School of Medicine have found that the psychological trauma of combat had little effect on the physical health of Vietnam veterans 20 years after their experience in Southeast Asia.

Studying more than 4,700 pairs of identical and fraternal twin brothers who served during the Vietnam War, the researchers found that combat played only a minor role in health problems such as hypertension, respiratory difficulty and gastrointestinal disorders. The findings, reported in the Sept. 23 issue of Psychosomatic Medicine, show that inherited factors and environmental experiences not related to combat explain more than 90 percent of reported health problems.

Past studies that have suggested an association between combat and physical health lacked adequate control groups, according to principal investigator Seth A. Eisen, M.D., associate professor of medicine and staff physician for the Department of Veterans' Affairs.

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Eisen: Veterans researcher

Mueller named assistant vice chancellor for international affairs

Daniel K. Mueller, Ph.D., has been appointed assistant vice chancellor for international affairs at the School of Medicine.

In addition to his appointment at the medical school, Mueller will remain director of International Healthcare Services for BJC Health System. In his new combined position, Mueller will work to increase global awareness of the reputations and available services of BJC hospitals and of School of Medicine physicians.

The appointment was announced by William A. Peck, M.D., executive vice chancellor for medical affairs and dean of the medical school.

"Dan Mueller will help us enhance the visibility of the School of Medicine in important international settings and further cement the relationship between the school and BJC," Peck said. "We look forward to working with Dan and our faculty physicians to provide the world's citizens with cutting-edge health care services."

Mueller hopes to attract more international patients to the Washington University Medical Center and to gain contracts managing health care facilities in other countries, especially in Latin America and Pacific Rim nations.

"Our current volume of international patients is not up to the level of expertise that resides at the BJC hospitals at Washington University Medical Center," Mueller said. "We would like to greatly increase the number of international patients who come to us for treatment, and we hope to share our expertise and deliver care on a local basis whenever possible."

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