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DoD Funds Brain Research Institute, Provides Grants

By Douglas J. Gillert
American Forces Press Service

GAINESVILLE, Fla., May 6, 1999 – When service members suffer battlefield injuries, their survival may depend on receiving the right treatment as quickly as possible.

Although the military services train and equip their medics to handle any emergency, DoD continues seeking better treatment methods. Medical research is key to improving health care and behind a DoD decision to contribute $18 million toward the University of Florida's state-of-the-art Brain Institute.

Opened in October 1998, the institute provides laboratories and facilities for physicians and scientists to research new ways of treating brain trauma and spinal cord injuries. The institute's goal, according to Director William Luttge, is to help DoD, the Department of Veterans Affairs and medicine in general by transferring research findings to clinical practice as quickly as possible.

Besides co-funding the building with VA and the university, DoD has awarded large grants for research at the Brain Institute. Luttge said DoD is primarily interested in the long-term effects of brain trauma as well as of Parkinson's Disease.

For example, DoD awarded $291,580 to Dr. Camilynn Brannan for her research in juvenile leukemia; Dr. Kenneth Heilman received $538,812 to study cognitive changes in presymptomatic Parkinson's disease; and James Simpkins, a pharmacist, received $335,367 to research the effects of estrogen treatment on brain injuries.

Each of the new people Luttge has hired to staff the facility came with DoD research grants, he said. "We've gone out, we've got DoD money, and we're doing things that are relevant to DoD," he said. What the institute provides them is laboratories equipped as well or better than any other lab in the world, he said.

In the surgical research and teaching laboratory, Dr. Richard Fessler manages 16 individual stations, each comprising a full surgical operating room setup. A part-time instructor at the Uniformed Services University of the Health Sciences, Bethesda, Md., Fessler said the laboratory is ideal for teaching new surgical techniques to physicians who have been in the field and want to update their skills. Closed-circuit TV monitors at each station allow them to observe an actual operation and practice the procedure on research cadavers. Each session is videotaped, so they have a permanent record, he said.

One objective is to shorten surgical procedures and get people out of the hospital and back on their feet sooner, he said. "For example, the way I do lumbar discs now is an out-patient procedure where the patient goes home in four hours and can resume unrestricted activities in one to two weeks, as opposed to six weeks in the past. There's cost cutting for hospitalization, and the patient requires one-tenth as much pain medicine.

"The difference is, we no longer have to dissect any muscle," Fessler said. "That's what hurts, it turns out."

Luttge said available courses will be announced at national medical meetings and on the institute's Web site at http://www.ufbi.ufl.edu/.

Luttge also touted the institute's advanced magnetic resonance imaging facility. Containing the largest magnets in the world, the facility is staffed to help researchers invent better ways of using clinical scale magnets and to show them what they can expect in the future. "This is the future," he said, pointing to the world's first wide-bore 12 and 17.6 Tesla magnetic resonance imaging spectroscopy systems.

A Tesla is the international unit for measuring magnetic field strength, Luttge explained. One Tesla is 20,000 times stronger than Earth's magnetic field, "so you can get an idea how strong these magnets are," he said. The instruments will enable researchers to examine the functional processes within living animals at a resolution far greater than they could with other MRI systems.

In an adjacent laboratory, Dr. Sanford Meeks manages a linear accelerator capable of producing high-energy X-rays that home in on damaged tissues while not affecting healthy tissues. Called radio surgery, the technique is used for cancerous diseases and benign lesions in the brain. "We can get the accuracy down to about two-tenths of a millimeter," Meeks said.

Not everything at the institute, however, is geared to high- level research. Samsun Lampotang, a mechanical engineer, helped develop a medical manikin that simulates a human patient. Currently, Gainesville-area paramedics train on the simulator at the institute every Friday, Lampotang said. They practice the same emergency medical procedures combat medics at far-forward locations need to know to save wounded combatants' lives. In fact, he said, the Army has begun purchasing the $200,000 simulators from the Sarasota, Fla., manufacturer for medical training at several locations, including Fort Detrick, Md., and Fort Sam Houston, Texas.

Without the manikins for training and exercises, military medics have to rely on volunteers, whom they "moulage," or apply with makeup that resembles various wounds.

"Trouble is, you can't make their blood pressure drop or their oxygen saturation drop, and you can't administer morphine and other drugs to volunteers, because they're healthy people," Lampotang said. "You can do all these things with the human patient simulator, which breathes, takes in drugs, simulates paralysis and can even be given tracheotomies."

Under development is a complex structural model of the human neck. Equipped with sensors, it will help medics learn to handle compacted spinal injuries such as occur during diving accidents.

"In 25 percent of neck injuries, the trauma is aggravated by the health care providers who worsen the patient by moving him," Lampotang said.

In the confusion and noise of battle or aboard a loud, vibrating evacuation helicopter, medics may also mistakenly insert breathing tubes, which can prove fatal. Better to "kill" the simulator a few times than make mistakes on a live human, he said. The simulator allows medics to understand the implications of erring and motivates them to perfect their skills, he said.

Luttge foresees the institute becoming a resident and Internet- based school of continuing education for military physicians and others. "Like everyone in medicine, DoD needs improved technologies," he said. "This place is capable of providing that."

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Click photo for screen-resolution imageWilliam Luttge, right, director of the University of Florida Brain Institute in Gainesville, and Dr. Richard Fessler, director of clinical service and education at the institute, view microscopic brain tissues at one of 16 teaching stations that will be used to teach new surgical techniques to military and civilian physicians worldwide. DoD and the Department of Veterans Affairs each contributed $18 million to building of the institute, which opened in October 1998. DoD also has provided large grants for specific research projects at the institute that will benefit military medicine. Douglas J. Gillert  
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Click photo for screen-resolution imageSamsun Lampotang adjusts computer-connected sensors to a human patient simulator at the University of Florida Brain Institute in Gainesville. The institute developed the medical manikin for use in training paramedics and others in the proper handling of patients with brain and spinal cord injuries. Lampotang is an assistant professor of anesthesiology and associate assistant professor of mechanical, electrical and computer engineering at the university. Douglas J. Gillert  
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