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Updated 12:00 PM February 2, 2004
 

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Research notes


Robot-assisted surgery for young heart patients reduces hospital stay, pain

In the first-ever direct comparison of robot-assisted and traditional surgery for children's heart defects, U-M surgeons report that the robot's help reduces patients' recuperation time and surgery-related trauma and scarring, while extending the length of the operation by just over half an hour.

A patient undergoes robot-assisted surgery. (Photo courtesy Dr. Richard Ohye)

Their finding suggests that the minimally invasive surgical techniques made possible by the surgeon-controlled, camera-guided robot system can give the same surgical result as open-chest techniques, with less impact on the young patient's body.

And although the study group was small, the finding demonstrates that robot-assisted surgery may be a good option for certain defects.

U-M Congenital Heart Center pediatric heart surgeons presented their results in San Antonio last week at the annual meeting of the Society of Thoracic Surgeons.

Surgeon Dr. Richard Ohye says, "Robot-assisted surgery has already shown quite a bit of promise in the adult population, including adults who have congenital heart anomalies. But we feel from our experience that it can be used on many pediatric patients weighing more than 10 kilograms, and can reduce hospital stays, operative trauma, cosmetic impact and overall recovery time. And we found it does so with an acceptable impact on a patient's time in the OR."

Ohye and U-M pediatric cardiac surgery colleagues Dr. Edward Bove and Dr. Eric Devaney performed the robot-assisted and open surgeries compared in the report. Ohye and Devaney began using the robot at the C.S. Mott Children's Hospital in November 2002, one year after the U-M Health System acquired the $1 million da Vinci robot system.

Burning fossil fuels has cooling effect on climate

Atmospheric researchers have provided observational evidence that burning fossil fuels has a direct impact on the solar radiation reflectivity of clouds, thereby contributing to global climate change.

Joyce Penner, professor in the Department of Atmospheric, Oceanic and Space Sciences; Yang Chen, a U-M graduate student; and Xiquan Dong, assistant professor from the University of North Dakota, reported their findings in the Jan. 15 issue of the journal Nature.

Most evidence that increased levels of fossil fuel particles (aerosols) affects the reflectivity of clouds, thereby producing a cooling effect on the climate, has been indirect. "This made it difficult to determine the impact this phenomena, known as the indirect aerosol effect, has on the global climate," Penner says. "Our data makes the direct connection and opens new areas of study."

Solar radiation, which adds to global warming, is reflected back into space by clouds. Cloud droplets are increased with higher levels of aerosols, allowing for less radiation, or heat, to reach the lower atmosphere. The end result is a measurable, though short-term, cooling effect on the climate.

Researchers discover new fossils in Ethiopia

Newly discovered fossils from northwest Ethiopia are providing scientists with information about elephant evolution and the ancestors of other mammals.

Artist's reconstruction of what ancient palaeomastodonts might have looked like. These proboscideans are archaic forerunners of today's elephants. Their last occurrence, at 27 million years, was documented by work in Chilga, Ethiopia. (Drawing by H.F. Osborn (1936))

Team members were surprised to find several species of primitive proboscideans—distant cousins of today's elephants. They were found to be living side by side with more advanced species that are the ancestors of today's elephants.

"The story of early elephant evolution is one that we have long suspected to have occurred entirely in Africa," says William Sanders, assistant research scientist and supervising preparatory of the Vertebrate Fossil Preparation Laboratory at the Museum of Paleontology. "These new fossils provide the evidence that we needed to lock down this story. These ancestral elephants were much smaller than today's African elephants, but at nearly 1,000 kg—about that of a medium-sized Texan longhorn—they were still a bit too big to keep in your backyard."

The results of the research were reported in the journal Nature. The project is supported by the National Science Foundation, the National Geographic Society, the Leakey Foundation and the Ethiopian Ministry of Culture. The team intends to continue its fieldwork in winter 2004. In addition to Sanders, the team includes scientists from the University of Texas at Austin, Washington University, Ethiopia's Addis Ababa University and National Museum, and more.

Heavy drinkers use narcotics to relieve back pain, despite possible interactions

Despite warnings about interactions between alcohol and narcotic pain relievers, a study suggests many people taking these drugs continue to drink, in some cases heavily.

In a study examining how alcohol use affects back pain, researchers at the U-M Health System (UMHS) also found people with chronic back pain who reported heavy drinking showed less physical disability on a series of functional tests than light drinkers. Further, women seldom reported heavy alcohol use, suggesting doctors need to be more careful about prescribing narcotic pain relievers.

"Be careful if you're a heavy drinker with pain, because doctors don't seem to pay attention to the interaction between alcohol and drugs," says study co-author Dr. Andrew Haig, associate professor of Physical Medicine and Rehabilitation at the Medical School and director of the Spine Program at UMHS.

The study, published in the December issue of Disability and Rehabilitation, is the first to look at the relationship between alcohol and chronic back pain. The study found no difference in the use of narcotic pain relievers by people who claimed heavy alcohol use and people who reported light drinking. This suggests patients or their doctors are not heeding drug manufacturers' warnings against mixing alcohol and narcotics.

Funding for the study came from the Michigan Rehabilitation Engineering Research Center and the National Institute for Disability and Rehabilitation Research. Other study authors from U-M were Dr. Michael Geisser, associate professor in the Department of Physical Medicine at Rehabilitation at UMHS, and Karen Yamakawa, Spine Program research associate.

Genital pain more common than believed

The character Charlotte York on HBO's "Sex and the City" is far from being the only woman with a "depressed vagina"—a term used on the show when the character had chronic vaginal pain and was prescribed antidepressants.

While the term isn't entirely accurate, the problem is very real—and more widespread than previously believed, according to research from the U-M Health System. The little known condition, called vulvodynia, involves chronic and potentially severe pain at the outer genital region, or vulva.' "We used to think this was rare," says study author Dr. Barbara Reed, professor of family medicine at the Medical School. "It turns out it's much more prevalent than we thought: 3 percent of women report chronic pain and 1.7 percent currently have pain. That's millions of women across the United States."

In a Web-based survey of 994 women, researchers found 27.9 percent of women had experienced pain at the vulvar vestibule, the opening to the vulva, and 3 percent reported chronic pain. Previously, researchers estimated as few as 150,000 women were affected by vulvodynia. The paper was published in the January issue of the Journal of Lower Genital Tract Disease.

The study was funded in part by a grant from the Department of Family Medicine. In addition to Reed, study authors from U-M include Mick Couper of the Institute for Social Research; Christin Cave of the Undergraduate Research Program; and Dr. Hope Haefner of the Department of Obstetrics and Gynecology.

More information about vulvar diseases can be found at http://www.med.umich.edu/obgyn/vulva. Patients may call (734) 763-6295 or (734) 475-1321 for appointments.

Children's doctors say parents' vaccine concerns on the rise

The doctors who treat America's children are hearing more and more concerns from their patients' parents about vaccines, and occasionally encountering parents who refuse some or all recommended vaccines for their children, according to study by U-M researchers.

Many of the concerns heard by the nearly 750 pediatricians and family practice physicians surveyed for the study were about known, short-term effects from vaccines, such as pain and fever.

But many others were about unproven or disproved allegations that vaccines can cause everything from autism to diabetes, according to results published in the January issue of the American Journal of Preventive Medicine.

And that, says lead researcher Dr. Gary Freed, means that children's doctors need to be understanding of parents' concerns, equipped with the latest information on vaccine safety, and ready to react to vaccination concerns or refusals. Freed is director of the Division of General Pediatrics at the U-M Health 'System and the Percy and Mary Murphy Professor of Pediatrics and Child Health Delivery at the Medical School.

Freed's co-authors were Sarah Clark, associate director for research in the Division of General Pediatrics and research investigator at the Medical School; registered nurse Beth Hibbs; and Dr. Jeanne Santoli.

The survey was performed in the year 2000, and funded by the Association of Teachers of Preventive Medicine and the Centers for Disease Control and Prevention.

Crim races lift Flint economy

The Crim Festival of Races, Flint's annual tourist tradition, delivered an $8.5 million boost to the Genesee County economy in 2003, according to a study by the U-M-Flint School of Management.

Runners race through the streets of Flint during the Crim Festival, an event that brings big benefits to the Flint-area economy, research shows. (Photo by brightroom.com)

More than 13,000 participants are attracted to the event each August, and runners in recent years represented 42 states, 20 countries and five continents. Including spectators, crowds in downtown Flint for the 2003 Crim were estimated at almost 50,000 people for the three-day event.

The study was conducted by Mark Perry, associate professor of finance at U-M-Flint, in conjunction with Darryl Barber, an economics undergraduate student.

"The Crim Festival of Races is a first-class athletic event for the city of Flint, and we now know that the Crim is also a first-class economic event for the Flint community," Perry says. "There is no other single, annual tourist event that comes anywhere close to generating that level of economic impact for the city of Flint."



For leg-bypass patients, heart drugs save lives and limbs

The same drugs that help millions of heart patients also can aid people who have painful blockages in the blood vessels of their legs, new research from the Cardiovascular Center shows.

Drugs called statins and ACE inhibitors can save those patients' lives or their limbs, if the patients take the medications before having a leg bypass operation, the study finds. But the researchers found that only about half of patients whose leg vessel disease has progressed far enough to require a bypass operation are actually taking the potentially beneficial drugs.

The results, published in the February issue of the Journal of Vascular Surgery, suggest that vascular surgeons should make sure their patients are receiving appropriate drugs before performing leg bypass surgery to re-route blood flow around a severely clogged leg artery.

"What we found surprised us," says lead author and U-M vascular surgeon Dr. Peter Henke. "Patients who were taking statins before their leg bypass operation had better patency, or openness, of their bypass graft, and a lower risk of leg amputation after surgery. Those taking ACE inhibitors had a lower risk of dying after the operation. And the effect of the medications far outweighed the effects of the patients' PAD [peripheral arterial disease] severity, other medical problems, or the type of graft used."

In addition to Henke, the study's authors are Susan Blackburn, Mary Proctor, Jeri Stevens, Dr. Debabrata Mukherjee, Dr. Sanjay Rajagopalan, Dr. Gilbert Upchurch, Dr. James Stanley and Dr. Kim Eagle, all of the Cardiovascular Center.

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