MEDICAL NEWS TIPS: SEPTEMBER 1996

September 1996
Media Contact: name, phone number and e-mail address are listed below each story

Listed below are story ideas from The Johns Hopkins Medical Institutions. To pursue any of these stories, call the contact person listed.

EPILEPSY DRUGS CAN LEAD TO UNPLANNED PREGNANCY

A Johns Hopkins study has found that more than 1 in 5 neurologists and obstetricians had patients with epilepsy who developed unwanted pregnancies because their anti-epilepsy drugs interfered with their birth control pills.

Several seizure drugs interfere with contraceptive pills and implants by accelerating the breakdown of an artificial sex hormone used to block conception. The drugs also can increase the risk of birth defects.

"These are known side effects of the seizure medications, but our survey showed they are not appreciated by doctors," says Greg Krauss, M.D., an assistant professor of neurology, who conducted the survey after five epilepsy patients with unplanned pregnancies were referred to him in two years.

Krauss' paper in the June issue of Neurology provided a list of eight steps for doctors treating sexually active female epilepsy patients. Doctors can decrease the risk of unplanned pregnancy by increasing birth control medication levels. Depending upon the type of epilepsy, some patients may be able to switch to drugs that don't interfere with birth control pills. Patients also can use other barrier methods of contraception to further reduce risk.

For media inquiries only, contact Michael Purdy (410) 955-8725 or mpurdy@welchlink.welch.jhu.edu.

WALLACH URGES TIGHTER FERTILITY REGULATIONS

In the wake of numerous controversies, the nation's fertility specialists should seek stricter oversight and develop ethical and scientific guidelines to improve service and patient trust, says a Johns Hopkins gynecologist and assisted reproduction specialist.

"It's obvious that more controls are needed nationwide to put this field in order," says Edward Wallach, M.D., a professor of gynecology and obstetrics and director of the Hopkins In-Vitro Fertilization Program. "These problems must be used for productive purposes."

The most recent controversy involves allegations of stolen eggs and embryos and financial and research misconduct at a California university's fertility clinic. The American Medical Association has issued new guidelines to try to prevent further ethical abuses, and Wallach proposes creating a regulatory agency that licenses fertility specialists and clinics and monitors fertility research.

"This rapidly developing technology is fraught with ethic perils, and it's imperative that we in the field take immediate action to define what is acceptable and unacceptable and hold people accountable to those standards," says Wallach.

For media inquiries only, contact John Cramer at (410) 955-1534 or jcramer@welchlink.welch.jhu.edu.

NEW COMPOUND MAY AID HUNT FOR STROKE DRUGS

Johns Hopkins scientists have discovered a tiny protein that, if used as a prototype, could speed the search for drugs to stop the serious brain damage that often follows a stroke.

The peptide closes a chemical door on the surfaces of certain nerve cells. When open, the door, called an NMDA glutamate receptor, admits calcium and other chemicals that facilitate normal communication between nerve cells. Hyperactivity in this receptor--staying open too wide for too long-- has long been linked to a variety of neuromuscular disorders like Lou Gehrig's disease, Huntington's disease, and Parkinson's disease, and to stroke damage.

Researchers led by Min Li, Ph.D., assistant professor of physiology, found the new peptide by screening billions of peptides for their ability to bind to a target molecule, the NMDA glutamate receptor.

With funding from the Muscular Dystrophy Association, Li began developing this "library" of peptides while at Affymax Research Institute, a private biotechnology company in Palo Alto, Calif.

"Our team found seven peptides that chemically attach to this receptor, and one of them, known as Mag-1.5, shuts it down," he says.

Studying Mag-1.5's characteristics could give researchers traits to look for in potential stroke treatment drugs, Li notes. Watching the peptide bind to the receptor and close it down also could help scientists understand the receptor and how they can shut it.

Li's results appear in the August issue of Nature Biotechnology.

For media inquiries only, contact Michael Purdy at (410) 955-8725 or mpurdy@welchlink.welch.jhu.edu.

GRAFTED MOTER NERVES FOUND EFFECTIVE

A Johns Hopkins animal study suggests that grafted motor nerves may be more effective than sensory nerves for restoring movement. The findings eventually may lead to improved treatment for facial nerve injuries and other nerve peripheral damage in people.

Sensory nerves relay information from the senses to the brain, while motor nerves carry the brain's signals back to the muscles.

Scientists compared the regrowth of bundles of motor nerve fibers in both sensory and motor nerve grafts in rats. They removed sections of both types of nerves from the rats' spines and grafted them into large gaps in a large motor nerve in their legs. Three months later, the results showed that many more of the motor nerve fibers had regenerated.

"Our results suggest that surgeons re-evaluate their traditional use of sensory nerves for grafts in motor, sensory and mixed nerves," says Kyle D. Bickel, M.D., lead author and an assistant professor of plastic surgery and orthopedic surgery.

Grafts using sensory nerves may create numbness in the donor area, while grafts using motor nerves may weaken or paralyze the donor area. Although surgeons usually use sensory nerves because numbness is considered a more acceptable risk, that often means poor function where the graft is placed, says Bickel.

"But if it makes more sense to use motor nerves to restore function, then we may have to reconsider our approach and look for places in the body where a slight loss of muscle movement is acceptable," says Bickel. The study recently was presented at the American Society for Surgery of the Hand's annual meeting. For media inquiries only, contact John Cramer at (410) 955-1534 or jcramer@welchlink.welch.jhu.edu.

NEW TECHNIQUE MEASURES NERVE IMPULSES

A Johns Hopkins researcher has developed a new technique to measure electrical impulses in a cranial nerve, which may lead to improved diagnosis and treatment of some facial nerve disorders.

Researchers stimulated the motor branches of the trigeminal nerve, a major nerve in the jaw, in 42 patients by placing a stimulator in their mouths. They measured the resulting electrical impulses in the muscles with electrodes on the skin. The results show that the technique accurately measured the nerve's electrical impulses and helped researchers to determine the normal level for electrical activity in these nerve branches. Previously, there were no techniques for studying or determining normal electrical impulse activity in the trigeminal nerve motor branches.

"This technique should be useful in diagnosing patients with trigeminal nerve disorders," says Timothy Dillingham, M.D., the study's lead author and director of electrodiagnostic services in physical medicine and rehabilitation at Hopkins.

These disorders may be caused by jaw fractures, spine injuries, dental surgery complications, tumors and blood vessel malformations. The technique also may be useful in patients with swallowing or speaking disorders due to traumatic brain injury. The study, which was supported by the Walter Reed Army Medical Center, was published recently in Muscle and Nerve.

For media inquiries only, contact John Cramer at (410) 955-1534 or jcramer@welchlink.welch.jhu.edu.

CURL NAMED BASKETBALL TEAM DOCTOR

A Johns Hopkins physician has been appointed team doctor for the USA Women's basketball select team.

Leigh Ann Curl, M.D., assistant director of sports medicine at Hopkins, accompanied the team to Taiwan where the United States won the gold medal in the R. William Jones Cup tournament in August.

"I'm thrilled to join these tremendous athletes," says Curl, who was twice chosen as a first-team Academic All-America basketball player at the University of Connecticut. "It was a fantastic trip. It was a great opportunity to represent our country and meet different people from all over the world."

The USA Women's select team consists of former college basketball players, many of whom will compete in the 2000 Olympics and the upcoming professional women's basketball league in the United States.

For media inquiries only, contact John Cramer at (410) 955-1534 or jcramer@welchlink.welch.jhu.edu.


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