1999

Office of Research & Development

Veterans Health Administration

Department of Veterans Affairs

Annual Report

New Knowledge Advancing 

Health Care for Veterans

1999

Office of Research & Development

Veterans Health Administration

Department of Veterans Affairs

Annual Report

New Knowledge Advancing 

Health Care for Veterans
Office of Research and Development

John R. Feussner, M.D.

Chief Research and Development Officer

Cooperative Studies Program

John R. Feussner, M.D.

Director

Health Services Research and Development Service

John G. Demakis, M.D.

Director

Medical Research Service

Paul M. Hoffman, M.D.

Director

Rehabilitation Research and Development Service

Mindy Aisen, M.D.

Director
Table of Contents

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Overview: 

New Knowledge Advancing Health Care for Veterans . . . . . . . . . 3

Research Across the Nation and Around the World: 

The Cooperative Studies Program . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Improving the Quality and Efficiency of Health Care: 

The Health Services Research and Development Service . . . . . . . . 9

Expanding Knowledge of Disease Processes: 

Medical Research Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Removing the Barriers to Independence: 

Rehabilitation Research and Development Service . . . . . . . . . . . . 13

Preparing Research Leaders of Tomorrow: 

Career Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Expanding Knowledge through Collaboration . . . . . . . . . . . . . . . . 16

Supporting Discovery: Research Funding . . . . . . . . . . . . . . . . . . . . 18

Building for the Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Career Development Awardees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Summary of 1999 R&D Projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
The Veterans Health

Administration provides the

nation with an extraordinarily

diverse and dynamic environment

for health care research.
1

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

As the largest integrated health care system in the

United States, the Veterans Health Administration

provides the nation with an extraordinarily diverse

and dynamic environment for health care research.

VA’s medical centers and clinics form a network of

clinicians, researchers, administrators and managers,

who are dedicated to finding and implementing the

most effective and efficient ways to deliver the best

quality of care to our veterans and the nation.

A central element of this endeavor is the Office of

Research and Development, which administers a

program covering the spectrum of research from

discovery to application. Led by John R. Feussner,

M.D., Chief Research and Development Officer, this

research enterprise includes basic biomedicine, clinical trials, rehabilitation, and health services

research. All aspects of the program focus on health

care issues that are prevalent among veterans and

also produce groundbreaking research results that

benefit the entire country.

In the last year, the Office of Research and Development intensified its determination to rapidly translate research results into practice. More than ever, its

priority is the connection between research and

patient outcomes. Our research achieves its maximum value when we share our findings with those

who can apply them in the daily care of patients.

VA is proud of its position as one of the world’s

premier academic health systems. We take great

pride in the research that helps keep VA at the forefront of modern medicine and health care. This

annual report serves, perhaps most importantly, as

a mark of progress. While it highlights some of the

research achievements and enhancements in our

programs, it also represents our pledge to diligently

sustain our search for new knowledge that promotes

the health of veterans and the nation.

Preface

Thomas L. Garthwaite, M.D.

Acting Under Secretary for Health

3

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Research findings create new knowledge. Without

research, there can be no new cures, no new medications that relieve the symptoms of chronic illnesses, and no innovative new technologies that

improve the daily living of those with disabilities.

The Veterans Health Administration’s Office of

Research and Development (R&D) conducts research

that brings hope to millions and real progress in the

fight against an array of diseases and conditions,

affecting veterans and non-veterans alike. 

Through its scope and diversity, the Veterans

Health Administration (VHA) offers clinicians and

researchers an educational and research environment that is unmatched. Serving nearly 3.5 million

veterans each year – at more than 1,100 care delivery sites across 50 states, the District of Columbia,

Puerto Rico, U.S. Virgin Islands, Guam, and the

Philippines – VA provides unique research opportunities that directly benefit patients. VA R&D’s

research portfolio includes basic laboratory research

that identifies the causes, treatments and cures for

diseases, disorders and disabilities, as well as clinical research on patient care management. The four

research services that make up VA’s Office of

Research and Development, the Cooperative Studies

Program, Health Services Research and Development Service, Medical Research Service, and Rehabilitation Research and Development Service,

complement each other ensuring comprehensive

study of today's complex health care issues. 

The Cooperative Studies Program (CSP) conducts

multicenter clinical trials to determine the effectiveness of promising new therapies. As one of the most

important large-scale clinical trial programs in the

world, the CSP has achieved international recognition for its accomplishments in many areas –

including ischemic heart disease, chronic lung disease, benign prostate disease, chronic renal failure,

and schizophrenia — that are prevalent among our

veterans as well as the general population. In addition, CSP investigators conduct population-based

research focusing on critical health care issues, such

as the epidemiology of hepatitis C, the occurrence

of amyotrophic lateral sclerosis (Lou Gehrig's disease) in Gulf War veterans, and the progression 

of prostate cancer and rates of illness among

deployed veterans.

The Cooperative Studies Program has four Coordinating Centers, a Clinical Research Pharmacy, and

three Epidemiological Research and Information

Centers. Clinical trial results obtained through the

CSP inform VA's health care policy makers so that

they can make the appropriate changes in clinical

practice that result in improved patient care for veterans and the nation. 

New Knowledge Advancing

Health Care for Veterans

John R. Feussner, M.D.

Chief Research and Development Officer
4

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

The Health Services Research and Development

Service (HSR&D) strives to improve the quality and

accessibility of health care services for veterans

while evaluating the cost effectiveness of services

and therapies. The work of HSR&D reaches across

the continuum of health care research and focuses

on identifying effective, efficient strategies for the

organization and delivery of health care to improve

patient and system-level outcomes. Chronic diseases, mental illness (such as post-traumatic stress

disorder, substance abuse and addictive disorders),

and health issues related to aging are among the

topics being investigated from an HSR&D point of

view. HSR&D conducts this ambitious research program through an extensive portfolio of peer

reviewed research and its key centers which include

eleven Centers of Excellence, the Management

Decision and Research Center, the VA Information

Resource Center, and the Health Economics

Resource Center.

Since translating research results into changes in

policy and practice that improve patient care has

always been a priority for HSR&D, it is natural for

HSR&D to be leading the Quality Enhancement

Research Initiative (QUERI) which addresses this

challenge. In its second year, QUERI targets eight

conditions that are highly prevalent among veterans – chronic heart failure, diabetes, HIV/AIDS,

ischemic heart disease, mental health, spinal cord

injury, stroke, and substance abuse – and is already

producing valuable results. 

The Medical Research Service (MRS) studies the

basic biological processes of disease and expands

our understanding of its origin, pathology, diagnosis and treatment. The biomedical arm of VA

Research & Development, MRS clinicians and nonclinician scientists target a wide variety of diseases

and disorders affecting veterans, such as cardiovasThe Veterans Health

Administration’s Office of

Research and Development (R&D)

conducts research that brings hope

to millions and real progress in

the fight against an array of

diseases and conditions, affecting

veterans and non-veterans alike.
5

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

cular disease, cancer, diabetes, AIDS, neurological

disorders, mental illness, and spinal cord injury,

among others. A few of the recent MRS advances

include the identification of genes linked to

Alzheimer's disease and schizophrenia, and potential genetic therapy for heart disease. 

MRS accomplishes this important research

through numerous programs and initiatives, most

notably through its Merit Review Program, which

comprises the majority of research funded by MRS.

Its new Research Enhancement Award Program

(REAP) supports multidisciplinary research, pilot

studies, and research training for young investigators. MRS also has numerous designated research

centers for basic science and clinical studies,

including four AIDS Centers, three Research Centers

for Schizophrenia, two Research Centers for Basic

Science and Clinical Studies on Alcoholism, four

centers that focus on environmental hazards, and

three Diabetes Research Centers – a collaboration

with the Juvenile Diabetes Foundation. MRS continues working to train the best investigators and to

provide them with optimal research environments. 

The Rehabilitation Research and Development

Service (RR&D) encourages innovative research

designed to restore lost function or minimize the

impact of disability. Progress made by clinician

researchers makes it possible to realize great strides

in functional recovery thus optimizing independence for patients. For example, RR&D investigators

are studying the use of pharmacologic agents in

ameliorating fatigue as a consequence of multiple

sclerosis. Through the dedication and hard work of

RR&D clinician researchers, exciting rehabilitation

possibilities are becoming realities. An increasing

arsenal of rehabilitative therapies that focus not

only on adaptation but restoration is now a reasonable expectation. 

At nine Centers of Excellence, investigators concentrate on areas such as amputation prevention

and joint replacement, optimal wheelchair propulsion, orientation techniques for people who are

blind, and early detection of hearing loss. In addition, three new centers established in 1999 concentrate specifically on wheelchair and related

technology, brain rehabilitation, and the restoration

of function for those with spinal cord injury or multiple sclerosis. VA researchers at these Centers are

breaking research boundaries every day to improve

the quality of life for disabled veterans. 

VA R&D’s research portfolio includes 

basic laboratory research that identifies the

causes, treatments and cures for diseases,

disorders and disabilities, as well as clinical

research on patient care management.

7

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

The Cooperative Studies Program (CSP) utilizes 

rigorous scientific clinical trial methodology to conduct research that will have a direct impact on 

veterans' clinical care. Sixteen new projects are currently underway, four large study initiatives have

been launched, and nine major projects have been

completed.

CSP studies focus on major health concerns of

veterans, and several important findings from recent

studies are in areas such as diabetes, heart disease,

kidney disease, lung disease, prostate disease, infectious disease, and substance abuse. For example,

groundbreaking VA research demonstrated the effectiveness of the drug gemfibrozil in reducing coronary heart disease (CHD) among certain patients that

have low HDL-cholesterol in the absence of highrisk LDL-cholesterol. This seven-year study showed

that daily use of gemfibrozil reduced CHD risk by

22% in this patient group by raising HDL, lowering

triglycerides, and maintaining LDL cholesterol levels. This can result in significant reductions in CHD

deaths, heart attacks, strokes, and transient ischemic

attacks. Another landmark CSP study compared

medications for benign prostate disease. Results

showed that the drug terazosin effectively relieved

symptoms, while the drug finasteride did not.

Enlarged prostate is a common problem in older

men, and findings from this study provide an effective alternative to surgery. 

A recent CSP study linked smoking to abdominal

aortic aneurysms, which cause 150,000 deaths

every year. This study, conducted at 15 VA medical

centers, showed that smokers are more than five

times as likely as non-smokers to develop abdominal aortic aneurysms. Because many people with

aneurysms have no symptoms, it is critical to identify risk factors for developing this extremely dangerous condition. Another CSP study helped determine treatment changes for patients with HIV. VA

researchers analyzed a method for measuring viral

load in relation to changes in HIV development and

found that changes in patients’ blood values can

predict illness. With this new knowledge, physicians

can determine an appropriate treatment course

more efficiently and effectively.

Exciting CSP research continues and is being

enhanced by some remarkable collaborations. Internationally, CSP has joined with the national Medical Research Councils of Canada and the United

Kingdom as part of an effort to establish a formal

tri-national clinical trials collaboration that will

target clinical trials important to the health care

concerns of all three countries. Clinical trials conducted as part of this international collaboration

will define optimal treatments and inform clinical

care policy in VHA and health care systems

throughout the world. In addition, VA and the

Canadian government's Medical Research Council

Research Across the Nation 

and Around the World:

The Cooperative Studies Program
8

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

VA investigators will soon be able to take advantage of exciting advances in human genetics

through the DNA Bank Demonstration Project. This

“DNA bank” is a program-wide genetic tissue databank that will ensure protection of individual

patient rights, while providing VA investigators

with the opportunity to study human genetics. This

is an area that promises dramatic progress in medical research and will serve a wide range of studies

in several disease areas. Another new CSP programwide project – Enhancing the Quality of Informed

Consent (EQUIC) – will systematically improve the

standards of informed consent by testing and measuring the results of innovative approaches to providing informed consent to research patients. In

taking steps to systematize high standards in regard

to informed consent, VA will make certain that

patients are fully aware of what their participation

in research entails and that their participation 

is voluntary. 

CSP continues to seek answers for Gulf War veterans who returned from the conflict with unexplained symptoms and illnesses. Three new studies

explore symptoms and illnesses such as chronic

fatigue syndrome, neurological abnormalities, and

generalized body pain of unknown origin. One trial

will determine if antibiotic treatment directed

against Mycoplasma bacteria will improve function

and relieve symptoms, such as fatigue, muscle and

joint pain, or memory and thinking problems.

Another trial focuses on whether aerobic exercise

and cognitive behavioral therapy can significantly

improve physical function, and whether the combination of both will be more beneficial than either

therapy alone. In a third study, a random sample of

1,000 Gulf War veterans, their spouses, and their

children will undergo clinical examinations. Findings from this study will help determine if health

problems are more prevalent among Gulf War 

veterans and their families compared to nondeployed veterans.

will jointly fund a major new clinical research initiative to compare the effectiveness of angioplasty

with drug therapy for patients with coronary heart

disease. This study may pave the way for a new paradigm to manage heart disease for the millions of

patients who are afflicted with myocardial ischemia

in the U.S. and Canada.

CSP is working with a number of other organizations on the national level. CSP has joined forces

with the National Parkinson Foundation, Inc. to

improve treatments and seek a cure for Parkinson's

disease. CSP researchers have also formed a

research alliance with the National Cancer Institute

and the Southwest Oncology Group to study the

effects of vitamin E and selenium on the prevention

of prostate cancer. In addition, CSP is working with

the National Institute on Allergy and Infectious Diseases to assess a possible vaccination for shingles,

and with the Juvenile Diabetes Foundation to identify primary research areas for Phase III clinical trials on macrovascular complications of adult-onset

diabetes. Other CSP efforts include alliances with

the National Institute on Aging (NIA) to address

clinical questions important to VA and non-VA

aging populations. CSP is currently collaborating

with NIA to develop a study to evaluate the effectiveness of testosterone in reducing the occurrence

of bone fractures among the elderly. In addition,

CSP is working with the National Institute on Drug

Abuse to support the development and approval of

new drug treatments for addictive and certain psychiatric disorders.

In regard to informed consent, VA will make

certain that patients are fully aware of what their

participation in research entails and that their

participation is voluntary.
9

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

The Health Services Research and Development Service (HSR&D) works to identify, advance and promote effective, efficient strategies and methods that

improve the organization and delivery of health

care, while optimizing patient and system-level

outcomes. HSR&D programs and initiatives include

research on a range of health care issues, in addition to the examination of the effects of organization, cost and management on the outcomes of

health care. HSR&D also focuses on the dissemination of research results and the application of

research findings to clinical, managerial and policy

decisions that affect change in clinical practice,

research and, ultimately, improve patient care.

Examples of current issues under investigation by

HSR&D researchers include telemedicine, pain management, quality improvements in ambulatory care

and surgical care, outcomes measurement in mental

health, cost-effective treatment for patients with

substance abuse disorders, and the design and

implementation of clinical service lines. For example, in one recent HSR&D study, researchers compared dermatologists’ diagnoses and treatment

recommendations for traditional clinic-based consultations with those performed via remote consultation using digital imaging technology. The

researchers found that teledermatology consultations using digital imaging technology result in

reliable and accurate diagnostic outcomes. While

telemedicine has great potential to improve both

access to care and quality of care, many questions

remain about the effectiveness of telemedicine

applications. VA is expanding efforts to determine

what works and why, and how VA can best 

use telemedicine to improve the quality of care for

veterans.

Recent findings from HSR&D research also

include information that will help patients with

type II diabetes (non-insulin dependent) achieve the

appropriate level of glycemic control and determine

whether or not to begin insulin therapy. This is particularly important to VA and the nation because

diabetes affects 10-16 million people in the United

States and is one of the leading causes of morbidity, mortality and health care costs in VA. Another

focus for research is HSR&D’s Service Line Evaluation Project. Thus far, this project has clarified the

various purposes and organizational designs of

service lines, and has produced a detailed analysis

that compares service line development in VA with

that in the private sector. Another project product is

the development of VA’s national service line guideImproving the Quality and

Efficiency of Health Care: 

The Health Services Research 

and Development Service
10

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

lines. HSR&D researchers also had a regional and

national impact on how disorder-specific performance is measured in VA in regard to the care of

patients with schizophrenia. These researchers are

collaborating with VHA’s Mental Health Strategic

Health Care Group and the Office of the Chief

Information Officer to develop national indicators

for the quality of medication management for

schizophrenia.

Essential to HSR&D’s success are its 11 Centers of

Excellence that are located throughout the United

States and are linked to VA medical centers. Each

Center of Excellence has a particular focus and

research agenda that addresses important health

care issues such as chronic disease, mental health,

substance abuse, geriatrics, evidence-based medicine, rehabilitation, practice management, primary

care, provider behavior, management systems, and

organizational research. 

In addition, HSR&D has three specialized resource

centers. The Management Decision and Research

Center conducts, coordinates and disseminates

research that informs policy makers and managers

about organizational and managerial practices

affecting the quality, cost, and accessibility of patient

care. The VA Information Resource Center provides

information about the content, availability, reliability and accessibility of VA’s extensive databases. And

the newest addition – the Health Economics Resource

Center – is a national center dedicated to improving

VA’s capacity to conduct high-quality health economics research and cost-effectiveness studies.

Research from this Center will help VA make betterinformed decisions about whether new health care

interventions are sufficiently cost-effective for use

throughout the VA system.

During the past few years, VA has launched

numerous initiatives, perhaps none as ambitious as

the Quality Enhancement Research Initiative

(QUERI). Designed to translate research discoveries

and innovations into better patient care and systems improvements, QUERI has made significant

progress since its inception in 1998. Targeting 

diseases and conditions that are highly prevalent and

difficult for veterans – chronic heart failure, diabetes,

HIV/AIDS, ischemic heart disease, mental health,

spinal cord injury, stroke, and substance abuse –

QUERI is quickly becoming a national model for

translating evidence-based research into practice. 

For example, Stroke-QUERI has produced an

Acute Stroke Toolbox to assist facilities in developing local strategies to promote best practices in caring for veterans with stroke. QUERI IHD, which

focuses on the care of veterans with ischemic heart

disease, recently completed a report that, in part,

highlights processes and outcomes of care for veterans with acute myocardial infarction (AMI). This

report showed that veterans with AMI receive comparable or superior quality of care in VA facilities

compared to the private sector. 

QUERI is also establishing a dissemination network dedicated to communicating the results of the

initiative to VA clinicians, researchers, policy makers, and managers system-wide to improve healthcare practice and patient outcomes.

Other HSR&D research initiatives target priority

areas such as: access to care, managed care, implementation of clinical practice guidelines, women

veterans’ health care, and the role of ethnicity and

culture in VA health care. Additional solicitations

address key issues for the veteran population and

the nation as a whole, including patient safety and

the prevention of adverse outcomes. Through the

VISN (Veterans Integrated Service Network) Collaborative Research Initiative, HSR&D works to

enhance capacity and expertise for addressing

important health services research issues of broad

interest to the VA and to the networks.

Through its dedicated researchers, clinicians,

managers and administrators, HSR&D will continue

to make valuable contributions to VA's comprehensive health care system.
11

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

VA’s Medical Research Service (MRS) contributes to

improved health care for veterans and the nation

through the study of the cause, development, diagnosis and treatment of a wide variety of diseases

and disorders. In conducting vital biomedical

research, MRS investigators have contributed to

such landmark medical advances as the first successful treatment for tuberculosis, the first successful liver and kidney transplants, and the

development of the cardiac pacemaker.

Exciting health care advances that lay the

groundwork for improved patient care continue.

Studies by Ferid Murad, M.D., Ph.D., proved instrumental in illuminating the role of nitric oxide in

body functions, including the relaxing of blood vessels and regulation of blood pressure. For this work,

conducted in part while at the Palo Alto VA Medical

Center, Dr. Murad shared the 1998 Nobel Prize in

Medicine. (Dr. Murad is now at the University of

Texas Medical School in Houston.) The 1998

William S. Middleton Award, one of VA’s highest

scientific honors, went to Robert McCarley, M.D.,

Deputy Chief of Staff for Mental Health Services at

the Brockton/West Roxbury VA Medical Center.

Recognized as an authority on REM (rapid eye

movement) sleep, Dr. McCarley has made enormous

contributions to our understanding of sleep and

dreaming. His work has helped set the stage for new

approaches to treating sleep abnormalities. He also

directs one of three MRS designated centers for

schizophrenia research. 

During the past year, MRS researchers reported

advances against many health problems affecting

veterans. For example, an MRS team studied gene

therapy that may offer new hope to millions of diabetics who need daily insulin injections. When

inserted into rat liver cells, a gene developed by

these researchers prompted the cells to produce

insulin, the hormone needed to use the simple sugar

that serves as the body’s fuel. Just as important, the

gene turned off insulin production before blood

sugar fell too low.

Another MRS team identified a part of the brain

that is involved in the thinking process—the motor

cortex, an area scientists previously believed was

limited to controlling voluntary movements. This

work is an important step in the quest to understand

the brain’s higher functions and perhaps ultimately

identify new approaches to brain disorders.

MRS investigators and their colleagues also

developed a laboratory technique to grow mouse

stem cells, the bone marrow “mother” cells that

evolve into all the different types of mouse blood

cells. If human stem cells can be similarly grown,

this VA finding could have a major impact on gene

Expanding Knowledge 

of Disease Processes: 

Medical Research Service
12

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

therapy for blood cell disorders and bone marrow

transplantation for cancer and other diseases.

Investigators supported by the Medical Research

Service accomplish this vital research through a

number of initiatives, most notably through the

Merit Review Program. Funded at over $100 million

annually, the Merit Review Program is the mainstay

of MRS programs, supporting approximately 75

percent of all MRS-funded research.

In 1998 the Medical Research Service created the

Research Enhancement Award Program (REAP) to

promote and support groups of VA investigators.

REAP funds programs of exceptional quality that

address specific medical problems of the veteran

population. The program also provides training for

junior level investigators and enhances ongoing

research efforts of independent investigators. REAP

awards support research in gene therapy and disease areas such as Alzheimer’s disease, heart failure,

spinal cord injury, kidney disease, multiple sclerosis,

cancer, lung disease, hepatitis C, and Parkinson’s

disease. MRS recently expanded the REAP,

announcing five new awards in addition to the 20

already funded under the program. Beginning in

fiscal 2000, new REAP awards will provide up to

$1.35 million each, over five years, to VA medical

centers in several locations: Seattle for studies on

Alzheimer’s disease; Brooklyn for heart attack

research; Palo Alto for studies on hepatitis; Iowa

City for prostate cancer research; and Detroit for the

study of the genetics of diabetes.

In addition to the REAP, the Medical Research

Service continues initiatives in a number of

research arenas, such as prostate disease (in collaboration with the Department of Defense), Parkinson’s disease, and the epidemiology of chronic

diseases and other disorders of particular importance to veterans. In 1999, MRS announced two

Centers for basic science and clinical studies in the

battle against one of the leading health problems

for veterans and the nation – alcoholism. The West

Haven and Omaha VA Medical Centers will each

receive a $1.6 million award over five years for

research to advance the understanding and treatment of alcoholism. Furthermore, proposals are

being considered for new or renewed VA centers

that would focus their research on environmental

hazards and schizophrenia. 

Underscoring VA’s commitment to training new

clinician and non-clinician investigators, the

recently established Merit Review Entry Program

increases opportunities for beginning researchers to

obtain funding. As part of VA’s continuing efforts to

recruit new investigators, especially from historically underrepresented minority groups, MRS is

expanding the Research Training Initiative for Historically Black Colleges and Universities (HBCU)

and Hispanic Serving Institutions (HSI) to include

the Research Experience Program. The purpose of

this program is to encourage students and scientists

from minority academic institutions to participate

in the research enterprises of VA, acquainting them

with future employment possibilities and advancing

the research efforts of the participating programs.

These achievements and initiatives lay the groundwork for ongoing studies that advance the frontiers

of knowledge in medical science. As VA enters the

new millennium, these and other VA Medical

Research Service programs will continue devoting

their efforts to health problems facing our nation.

These achievements and initiatives 

lay the groundwork for ongoing studies 

that advance the frontiers of knowledge 

in medical science.
13

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

The Rehabilitation Research and Development 

Service (RR&D) strives to advance the state-of-theart in rehabilitative health care for veterans. More

than 200 investigators work to develop compensatory therapies, help veterans both restore function

and maximize remaining function, mitigate secondary conditions, employ cutting-edge technologies,

and cultivate better ways to live with disability. 

Nine Rehabilitation R&D Centers located at VA

facilities across the nation attract the best and

brightest minds from clinical practice and foster

productive relationships with academia and industry. These Centers target particular areas of rehabilitation, such as functional loss and restoration

associated with aging, healthy aging with a disability, improvement of mobility in persons with neurologic or orthopedic impairments, electrical

stimulation to aid those with spinal cord injury or

paralysis, early detection of hearing loss, amputation

prevention, and lower-limb prosthetic improvement.

Building on its commitment to addressing rehabilitation issues of concern to veterans, RR&D

established three new special centers in 1999.

Researchers at the Center for Wheelchair and Related Technology in Pittsburgh focus on developments

that improve the design, selection, prescription and

configuration of wheelchairs and related technology. At the Brain Rehabilitation Center in

Gainesville, FL, investigators work on functional

rehabilitation for veterans with mental and motor

impairments due to traumatic brain injury, cerebral

vascular diseases, and degenerative diseases. In

addition, researchers at the Center for Restoration of

Function in Spinal Cord Injury and Multiple Sclerosis in West Haven, CT work toward translating

research at the molecular and cellular levels into

restorative therapies that can be used to help

patients in the clinical domain.

Approximately 70% of all RR&D funding supports investigator initiated studies developed in

clinical settings and for many aspects of disability.

For instance, through innovative transplantation

techniques, coupled with pharmacological interventions and a strategy known as constraint-induced

therapy, RR&D researchers can be optimistic about

the possibility of genuine functional recovery for

those patients affected by spinal injury and stroke.

The use of robotics to supplement clinical therapies

also has promised successful preliminary findings in

VA facilities across the country. In Atlanta,

researchers have found that cognitive interventions

Removing the Barriers 

to Independence: 

Rehabilitation Research 

and Development Service
14

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

are as critical to reducing fall risk in elderly patients

as traditional methods. Also in Atlanta, researchers

are working with VA Blind Rehabilitation Services

throughout the country to develop new functional

assessment and training tools for patients with low

vision. In San Diego, researchers are studying the

anatomical basis for direct skeletal anchoring of

prostheses in order to facilitate improved feedback

control and, therefore, function. RR&D investigators also work to improve mobility aids that will

allow people access to places that have been inaccessible. For example, investigators at the Pittsburgh VA are coupling wheelchair mobility with

virtual reality to help people learn how to navigate

their wheelchairs more safely. Training in such cutting edge technology will be especially helpful for

people who also have visual impairments. 

In 1999, Rehabilitation Research and Development awarded Career Enhancement Awards to two

established investigators, one working in the area of

aphasia and the other working in cortical reorganization. Dr. Patrick Doyle is working with researchers

at the World Health Organization to develop outcome measures in keeping with international classification systems for disability. Dr. Peter Gorman is

working with investigators at the National Institute

for Neurological Disorders (NINDS) to use functional brain imaging techniques to better understand

how the nervous system reorganizes after stroke.

RR&D also made significant strides with several

groundbreaking initiatives in 1999. Building upon

an initiative begun in 1997, the Service continued

to translate rehabilitation research findings from

anecdotal reports to well-documented and quantified outcomes. This new approach will make

research findings more universally applicable and

will help ensure that veterans receive optimal therapies for their conditions. 

Significant progress in this area occurred in

RR&D’s Technology Transfer Program. In 1999,

RR&D focused on finding new opportunities for

transferring research findings into immediate practice. Clinicians have concentrated on moving

beyond creating prototypes of rehabilitation aids,

such as wheelchairs and prosthetics, to putting them

into practical use. Expanded efforts enhance these

activities, truly bringing new discoveries into clinical practice. Investigators are assisted with patenting and necessary partnering with industry. 

The goal of this effort is commercial production of

such devices so they may benefit the greatest number of people. Researchers are also enhancing the

capacity for conducting clinical trials with newly

devised technologies.

In keeping with VA’s efforts to disseminate

research findings, RR&D emphasizes publication of

its findings. The Service publishes its own peerreviewed scientific periodical, the Journal of Rehabilitation Research and Development, and this year

will expand its scope, increase the frequency of

publication, and provide clinical commentary on

scientific abstracts. 

Specific research goals for 2000 include increasing research in upper extremity prosthetics, developing priority areas for research in neurorehabilitation, and launching an initiative addressing

necessary follow-up care, vocational rehabilitation,

and long-term outcomes. As in the past, RR&D will

remain committed to improving the quality of life

for veterans and will lead rehabilitation research

into the future.

Clinicians have concentrated on moving 

beyond creating prototypes of rehabilitation 

aids, such as wheelchairs and prosthetics, 

to putting them into practical use.
15

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

The future quality of R&D’s research depends on its

success in recruiting, educating and training some

of this country’s most talented young investigators.

This demands a substantial investment in the

careers of the next generation of VA scientists. The

Career Development Program was established by

R&D to nurture and retain talented investigators

committed to the health care of veterans.

R&D now devotes nearly 10 percent of its appropriation to Career Development. Each of the four

research services offer various levels of research

career development awards. These awards provide

salary support to clinician investigators, allowing

them to devote 75% of their time to pursuing

research and education under the guidance of experienced mentors. The Cooperative Studies Program

recently established a sabbatical clinical research

program for senior clinical investigators, and soon

will offer a Clinical Research Career Development

program for junior researchers and non-clinical

researchers. HSR&D’s career development efforts

financially and intellectually support highlyqualified clinician and non-clinician doctoral

trained investigators. Rehabilitation Research and

Development’s Research Career Development Program provides mentoring to doctoral-level rehabilitation clinical professionals. Mentoring and other

resources for young investigators are provided

through Centers of Excellence in both RR&D and in

HSR&D. The Medical Research Service offers a

Research Enhancement Award Program (REAP),

which supports collaborations by groups of investigators through special funding, including a training

element and the Merit Review Entry Program that

increases opportunities for beginning investigators

to enter the VA Medical Research Program. All of

these R&D efforts are focused on building future

research capacity. 

R&D’s dedication to education and training is

underscored by the collaboration between the VA

health care system and leading medical schools

throughout the country. Nearly all VA investigators

hold faculty positions at affiliated medical schools

that include many of the nation’s most prestigious

institutions. 

Graduates of VA’s career development and training programs have become nationally and internationally recognized leaders in their chosen areas of

interest. Most of these Career Development graduates contribute further to VA by mentoring junior

VA investigators.

Preparing Research 

Leaders of Tomorrow: 

Career Development
16

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Stimulating creativity through collaboration, the

Office of Research and Development enhances its

mission by forging alliances with other government

and non-government organizations, as well as private industry. By combining the experience and

expertise of researchers, clinicians, managers and

administrators from various organizations, both the

science and the patients benefit. Here are some

examples of these valuable collaborations.

VA and the Department of Defense (DoD) work

together in research areas important to veterans,

such as traumatic brain injury, prostate diseases

including cancer, stress-related illnesses (e.g.,

PTSD), and Gulf War veterans’ illnesses. Two major

nationwide efforts recently began to study possible

treatments for symptoms of undiagnosed illnesses

in Gulf War veterans. In addition, VA will lead a

study of the occurrence of amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, among

Gulf War veterans. This study is a collaboration

with the DoD, Department of Health and Human

Services, and the Centers for Disease Control.

In collaboration with the National Institutes of

Health, National Institute of Allergy and Infectious

Disease, VA is conducting a large nationwide study

to determine whether an experimental vaccine can

prevent shingles, a painful skin and nerve infection

that is most common in the elderly.

VA recently dedicated the new Northwest Veterans

Affairs Cancer Research Center in Portland, Oregon.

With 66 labs focusing on the genetic basis and biological pathways of cancer, the Center will house

joint research projects of the Portland VA Medical

Center and the Oregon Health Sciences University. 

The Juvenile Diabetes Foundation (JDF) and VA’s

Medical Research Service have formed a partnership

in the battle against diabetes through the establishment of centers devoted to diabetes research. 

Diabetes is one of the leading causes of morbidity

and mortality among veterans. The Cooperative

Studies Program is also collaborating with JDF to

identify primary research areas for clinical trials on

macrovascular complications of type II diabetes

mellitus.

VA and the National Parkinson’s Foundation, Inc.

have joined forces to strengthen both organizations’

efforts to improve treatment and find a cure for

Parkinson’s disease, a progressive degenerative neurological disease that is a major health problem in

veterans and the general population.

Expanding Knowledge 

Through Collaboration

By combining the experience and expertise 

of researchers, clinicians, managers and

administrators from various organizations, 

both the science and the patients benefit.
The American College of Cardiology, the Robert

Wood Johnson Foundation, the American Heart

Association, and VA’s Health Services Research and

Development Service are working together to improve

the quality of care for heart disease and stroke.

VA has collaborated or formed partnerships with

approximately fifty pharmaceutical companies that

provide study medications, devices or other support

for numerous clinical trials (see box below). 

As part of an effort to expand international collaborative research, VA joined with the national research establishments of Canada and the United

Kingdom to issue the first tri-national clinical trials

research solicitation. Research topics are being considered in areas that are particularly appropriate for

large, multi-center clinical trials that will determine

the effectiveness of promising new therapies. These

possible research topics include chronic disease,

brain disorders, and emerging surgical procedures.

17

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Astra Merck

AstraZeneca

Aviron

Berlex Laboratories

Bristol-Myers-Squibb

Chiron

Core-Vent

Datascope

Du Pont Pharmaceuticals

Eli Lilly and Company

Evans

Fujisawa Healthcare

Glaxo Wellcome

Hoechst-Marion-Roussell

Hybritech, Inc.

Integrated Therapeutics

Intercardia

Interpore Corporation 

Key Pharmaceuticals

KOS Pharmaceuticals

Merck

Noblepharm

Novartis

Nycomed Amersham

Ortho Dermatologies

Parke-Davis

Pfizer

Reckitt & Colman

Rhone-Pôulenc Rorer

Sanofi Pharmaceuticals

Schein Pharmaceuticals

SmithKline Beecham 

Pharmaceuticals

Solvay Pharmaceuticals

Somerset Pharmaceuticals, Inc.

Wyeth-Ayerst

Pharmaceutical Companies

VA’s Cooperative Studies Program has collaborated or formed partnerships with the following

pharmaceutical companies, that provide study medications, devices or other support for some 

of the ongoing cooperative studies:

The Cochrane Collaboration is an international

effort by health care professionals to collect and disseminate high quality research evidence about the

effects of health care practices. VA supports a

Cochrane Center within VA’s Veterans Evidencebased Implementation and Dissemination Center in

San Antonio, TX, an HSR&D Center of Excellence.

VA also supports a Cochrane Review Group on Urologic Diseases through the HSR&D Center for

Chronic Disease Outcomes Research in Minneapolis,

MN. This scientific alliance promotes evidencebased medicine.

With support from VA’s Office of Policy and 

Planning, HSR&D is developing a framework for the

merger of VA and Health Care Financing Administration data that will allow both organizations to

examine issues surrounding health care utilization.
18

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

The success of VA’s research program depends to a

large extent on the financial support that makes

research possible. The Office of Research and Development administers VA appropriations for research,

with the total number of funded projects contingent

upon the level of appropriated resources and the

average cost per project. During fiscal year 1999,

VA Research funds supported studies conducted by

more than 3800 VA researchers in 110 VA facilities.

These projects were initiated by investigators in

their areas of interest or in response to solicitations

from the Office of Research and Development. 

Figure 1 shows recent growth in the Research and

Development budget appropriation to support costs

of this work. VHA also allocates Medical Care 

dollars to support the research infrastructure or

indirect costs such as laboratory facilities and

physician salaries.

The outstanding quality of the research program

has helped VA investigators augment their efforts

through partnering with other federal agencies, private foundations and industry. Figure 2 summarizes

all budgetary resources for the past three years and

gives a projection for fiscal 2000.

Figure 3 shows how Research and Development

funds are distributed across service directed

research, investigator-initiated research, Centers of

Excellence, career development, and clinical trials.

Supporting Discovery:

Research Funding

Figure 1. VA Research Funding History (millions)

Figure 2. Budget Appropriation (millions)

Figure 3. Functional Research Portfolio
19

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

As we enter the new millennium, we will need to

solve the complex medical mysteries that no doubt

await us, as well as deal with those that already

affect our veterans. How health care is provided will

undergo even more changes as we continue to

adapt to economic challenges while trying to maintain the highest standards of health care. Fortunately, VA has always had a cadre of dedicated, talented

and committed clinicians and researchers who see

change as an opportunity for innovation, and who

welcome challenge as an opportunity for discovery. 

The future of VA research depends on its clinicians and scientists conducting health care research

to advance health care technology, providing innovations in rehabilitation, and discoveries leading to

cures, or a better quality of life for those affected by

disease. As you have read throughout this publication, many of these advances are well underway,

while several areas of exciting research are just

beginning to show their potential. Over the next

few decades we expect important advancements:

genetic mapping and the identification of genes

that cause disease may lead to treatments for a host

of inherited or acquired conditions; the evolving

use of vaccines to target tumors, in addition to

combating viruses; and new and improved medical

technologies. VA’s Office of Research and Development joins the broader health care community of

this nation and others in embracing all the opportunities of the 21st century so that we can continue

to provide the best possible health care for veterans

and the nation as a whole. 

Building for the Future

The future of VA research depends 

on its clinicians and scientists

conducting health care research to

advance health care technology...
20

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Research and Development 

Career Development Awardees 1999

David A. Asch, M.D., M.B.A.

Philadelphia, PA

Steven M. Asch, M.D., M.P.H.

West Los Angeles, CA

John D. Birkmeyer, M.D.

White River Junction, VT

Steven J. Borowsky, M.D., M.P.H.

Minneapolis, MN

Samuel A. Bozzette, M.D., Ph.D.

San Diego, CA

John P. Concato, M.D., M.S., M.P.H.

West Haven, CT

Joseph Conigliaro, M.D., M.P.H.

Pittsburgh, PA

Kendon J. Conrad, Ph.D.

Hines, IL

David Edelman, M.D.

Durham, NC

Nathan R. Every, M.D., M.P.H.

Seattle, WA

Liana Fraenkel, M.D., M.P.H., FRCPC

West Haven, CT

Susan Frayne, M.D., M.P.H. 

Boston, MA

Vincent Freeman, M.D., M.P.H.

Hines, IL

Terri R. Fried, M.D.

West Haven, CT

Raul I. Garcia, D.M.D, M.Med.Sc.

Boston, MA

Mary K. Goldstein, M.D., M.S.

Palo Alto, CA

Howard S. Gordon, M.D.

Houston, TX

Michael K. Gould, M.D., M.Sc.

Palo Alto, CA

Ian M. Gralnek, M.D., M.S.H.S.

West Los Angeles, CA

Susan C. Hedrick, Ph.D.

Seattle, WA

Paul A. Heidenreich, M.D., M.P.H., M.S.

Palo Alto, CA

Timothy P. Hofer, M.D., M.S.C.

Ann Arbor, MI

Susan L. Hughes, D.S.W.

Hines, IL

Judith Jones, D.D.S., M.P.H.

Bedford, MA

T. Michael Kashner, Ph.D., 

J.D., M.P.H.

Dallas, TX

Lewis E. Kazis, Sc.D.

Bedford, MA

Eve A. Kerr, M.D., M.P.H.

Ann Arbor, MI

JoAnn Kirchner, M.D. 

Little Rock, AK

Sara J. Knight, Ph.D. 

Chicago, IL

Mark E. Kunik, M.D.

Houston, TX

Richard A. Marottoli, M.D., M.P.H.

West Haven, CT

Joshua Metlay, M.D., Ph.D.

Philadelphia, PA

Rudolf H. Moos, Ph.D.

Palo Alto, CA

Richard R. Owen, M.D.

Little Rock, AK

Douglas K. Owens, M.D., M.Sc.

Palo Alto, CA

John W. Peabody, M.D., Ph.D.

West Los Angeles, CA

Laura A. Petersen, M.D., M.P.H.

Houston, TX

Dawn Provenzale, M.D., M.S.

Durham, NC

Jeffrey M. Pyne, M.D.

Little Rock, AK

Linda Rabeneck, M.D., M.P.H.

Houston, TX

Jaya K. Rao, M.D., M.H.S.

Durham, NC

Gayle E. Reiber, M.P.H., Ph.D.

Seattle, WA

M. Carrington Reid, M.D., Ph.D.

West Haven, CT

Kenneth E. Rosenfeld, M.D., M.P.H.

West Los Angeles, CA

John S. Rumsfeld, M.D.

Denver, CO

Lisa M. Schwartz, M.D., M.S.

White River Junction, VT

Alfredo J. Selim, M.D., M.P.H.

Boston, MA

Paul G. Shekelle, M.D., Ph.D.

West Los Angeles, CA

Health Services

Research &

Development

(HSR&D) 

Career Awardees

The VA Office of Research and Development is

committed to supporting and strengthening the

development of its investigators in the early, mid

and advanced stages of their careers in order to

attract and retain the best and the brightest.

Career development awards within the Health 

Services, Medical and Rehabilitation Research 

Services provide salary support for investigators.

Qualified Career Development candidates may

receive salary support through the Career Development Program, so that they can devote their

full time and attention to developing careers as

independent investigators specializing in medical

research, rehabilitation research, and health services research. In addition to salary support and

protected research time, Career Development

awardees receive the guidance of experienced 

VA investigators who serve as their mentors. 

Following is a list of investigators who received

Career Development Awards during the 1999 

Fiscal Year.
21

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Research and Development 

Career Development Awardees 1999

James A. Tulsky, M.D.

Durham, NC

Peter A. Ubel, M.D.

Philadelphia, PA

Marcia A. Valenstein, M.D.

Ann Arbor, MI

Morris Weinberger, Ph.D.

Indianapolis, IN

John D. Whited, M.D., M.H.S.

Durham, NC

Mary A. Whooley, M.D.

San Francisco, CA

John W. Williams, Jr., M.D., M.H.S.

San Antonio, TX

Linda S. Williams, M.D.

Indianapolis, IN

Steven Woloshin, M.D., M.S.

White River Junction, VT

Bevan Yueh, M.D.

Seattle, WA

HSR&D 

Career Awardees

(continued)

Medical Research

Service Career

Development 

Awardees

Sherry L. Abboud, M.D.

San Antonio, TX

Bradley L. Allen, M.D., Ph.D.

Iowa City, IA

Richard Aranda, M.D.

West Los Angeles, CA

David B. Arciniegas, M.D.

Denver, CO

Carlos L. Arteaga, M.D.

Nashville, TN

Daniel F. Balkovetz, M.D.

Birmingham, AL

Juan C. Bandres, M.D.

New York, NY

Raj Batra, M.D.

West Los Angeles, CA

Peter Bloom, M.D.

Decatur, GA

Carol A. Bogdan, M.D.

New York, NY

James D. Bremner, M.D.

West Haven, CT

Matthew D. Breyer, M.D.

Nashville, TN

Michael R. Bubb, M.D.

Gainesville, FL

Blase A. Carabello, M.D.

Charleston, SC

Helen K. Chew, M.D.

San Antonio, TX

Mary E. Choi, M.D.

West Haven, CT

Paul J. Christensen, M.D.

Ann Arbor, MI

Melissa P. Clark, M.D.

Nashville, TN

Robert J. Coffey, Jr., M.D.

Nashville, TN

Andrea J. Cohen, M.D.

Denver, CO

Errol D. Crook, M.D.

Jackson, MS

David I. Daikh, M.D., Ph.D.

San Francisco, CA

Mark E. Dibner-Dunlap, M.D.

Cleveland, OH

Ngozi E. Erondu, MBBS, Ph.D.

Iowa City, IA

Bahaa M. Fadel, M.D.

Palo Alto, CA

Sidney M. Finegold, M.D.

West Los Angeles, CA

Robert Frederich, M.D., Ph.D.

Lexington, KY

Juan P. Frias, M.D.

San Diego, CA

Lois J. Geist, M.D.

Iowa City, IA

Sarah L. George, M.D.

Iowa City, IA

J. Christian Gillin, M.D.

San Diego, CA

Scott D. Gitlin, M.D.

Ann Arbor, MI

Martin Gluck, M.D.

Bronx, NY

Francisco J. Gomez, M.D.

Cincinnati, OH

Daniel J. Gottlieb, M.D.

Boston, MA

Mary O. Gray, M.D.

San Francisco, CA

Carla Greenbaum, M.D.

Seattle, WA

John B. Harley, M.D., Ph.D.

Oklahoma City, OK

Edward A. Hirschowitz, M.D.

Lexington, KY

Jeffrey W. Hott, M.D.

Indianapolis, IN

Arif Hussain, M.D.

Baltimore, MD

Frank Isik, M.D.

Seattle, WA

Randy H. Kardon, M.D., Ph.D.

Iowa City, IA

Gwendolyn Kartje, M.D., Ph.D.

Hines, IL

Carolyn J. Kelly, M.D.

San Diego, CA

William J. Kovacs, M.D.

Nashville, TN

Michael Kozal, M.D.

Iowa City, IA

Arthur M. Krieg, M.D.

Iowa City, IA

Dennis F. Kucik, M.D.

Birmingham, AL

David J. Kusner, M.D., Ph.D.

Iowa City, IA

Christopher C. La Ganke, M.D.

Birmingham, AL
22

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Research and Development 

Career Development Awardees 1999

Medical Research

Service Career

Development 

Awardees

(continued)

Rehabilitation

Research and

Development

Service Career

Awardees

H. Jeffrey Lawrence, M.D.

San Francisco, CA

Steven R. Lentz, M.D., Ph.D.

Iowa City, IA

Daniel E. MacDonald, D.M.D., Sc.D.

Bronx, NY

Richard Macko, M.D.

Baltimore, MD

Joseph F. Maher, M.D.

Jackson, MS

Mark G. Mainwaring, M.D., Ph.D.

Gainesville, FL

Rama K. Mallampalli, M.D.

Iowa City, IA

Peter J. Mannon, M.D.

Durham, NC

Alan E. Mast, M.D., Ph.D.

Memphis, TN

Stephen E. McGowan, M.D.

Iowa City, IA

Barbara E. Menzies, M.D.

Nashville, TN

Patrice W. Miller, M.D.

West Los Angeles, CA

Joseph M. Moates, M.D.

Nashville, TN

Bruce A. Molitoris, M.D.

Indianapolis, IN

Wendy C. Moore, M.D.

Baltimore, MD

John P. Mulhall, M.D. 

Hines, IL

Mary C. Nakamura, M.D.

San Francisco, CA

David Naylor, M.D., Ph.D.

Sepulveda, CA

James C. Oates, M.D.

Charleston, SC

Terrence X. O'Brien, M.D.

Charleston, SC

Anna Olincy, M.D., Ph.D.

Denver, CO

Mohammed B. Omary, M.D., Ph.D.

Palo Alto, CA

Dan Oren, M.D.

West Haven, CT

John H. Peters, M.D.

West Los Angeles, CA

Joseph R. Pisegna, M.D.

West Los Angeles, CA

Joseph F. Quinn, M.D.

Portland, OR

Javier Quintana, M.D., Ph.D.

West Los Angeles, CA

Barbara A. Ramlo-Halstead, M.D.

San Diego, CA

Robert F. Reilly, M.D.

West Haven, CT

Matthew B. Rettig, M.D.

West Los Angeles, CA

Jane E. B. Reusch, M.D.

Denver, CO

Mary-Claire Roghmann, M.D.

Baltimore, MD

Randal G. Ross, M.D.

Denver, CO

David M. Roth, M.D., Ph.D.

San Diego, CA

George H. Rudkin, M.D.

West Los Angeles, CA

Karl A. Sanders, M.D.

Salt Lake City, UT

Barbara E. Scanley, M.D., Ph.D.

West Haven, CT

Jay W. Schneider, M.D., Ph.D.

Brockton, MA

Richard V. Sims, M.D.

Birmingham, AL

Catherine Stehman-Breen, 

M.D., M.S.

Seattle, WA

Martin J. Stevens, M.D.

Ann Arbor, MI

Richard T. Stravitz, M.D.

Richmond, VA

Chris C. Streeter, M.D.

Boston, MA

John R. Teerlink M.D.

San Francisco, CA

Hoang M. Thai, M.D.

Tucson, AZ

Douglas E. Vaughan, M.D.

Nashville, TN

Anna K. Vinnikova, M.D.

Richmond, VA

Jeffrey A. Wesson, M.D., Ph.D.

Milwaukee, WI

Margaret E. Wierman, M.D.

Denver, CO

Joseph K Wong, M.D.

San Diego, CA

Linda L. Auther, Ph.D.

Nashville, TN

Anne Strouse Carter, Ph.D.

Mountain Home, TN

Eileen G. Collins, Ph.D., RN

Hines, IL

Graham H. Creasey, M.D.

Cleveland, OH

Patrick J. Doyle, Ph.D.

Pittsburgh, PA (HD)

Steven A. Gard, Ph.D.

Chicago, IL (Lakeside)

Peter H. Gorman, M.D.

Baltimore, MD

Margot S. Damaser, Ph.D.

Hines, IL

Margaret A. Nield, Ph.D., RN

West Los Angeles, CA

Carolyn Patten, Ph.D.

Palo Alto, CA

Karen L. Perell, Ph.D.

West Los Angeles, CA

Lisa Riolo, Ph.D.

Decatur, GA

Richard F. Weir, Ph.D.

Chicago, IL (Lakeside)
23

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Following is a summary of all VA Research and

Development funded studies during Fiscal Year

1999. Studies are organized by research service

(Cooperative Studies Program, Health Services

Research and Development Service, Medical

Research Service, and Rehabilitation Research and

Development Service), and then alphabetically 

by investigator.

Reducing the Efficacy-Effectiveness

Gap in Bipolar Disorder

Bauer, Mark S., M.D.

$1,017,744

VA Non-Q-Wave Infarction

Strategies In-Hospital (VANQWISH)

Boden, William E., M.D.

$66,000

Clinical Outcomes Utilizing

Revascularization and Aggressive

Drug Evaluation (COURAGE) Trial

Boden, William E., M.D.

O’Rourke, Robert, M.D.

$895,751

Evaluation of GEM Units and

Geriatric Follow-up

Cohen, Harvey J., M.D.

Feussner, John R., M.D.

$942,052

Persian Gulf – 

Antibiotic Treatment Trial

Donta, Samuel, M.D.

$947,742

Persian Gulf CFS/Fibromyalgia

Treatment Trial

Donta, Samuel, M.D.

Clauw, Daniel, M.D.

Engle, Charles, M.D.,M.P.H.

$1,787,658

Beta-Blocker Evaluation of 

Survival Trial (BEST)

Eichorn, Eric J., M.D.

Domanski, Michael J., M.D.

$536,913

National Health Survey of Persian

Gulf Veterans and Their Families

Eisen, Seth, M.D.

Kang, Han, Sc.D.

Murphy, Frances, M.D., M.P.H.

$3,571,932

F-Flurodeoxyglucose (FTP) 

Positron Emission Tomography

(PET) Imaging in the Management

of Patients with Solitary 

Pulmonary Nodules

Fletcher, James W., M.D.

$501,814

Group Treatment of PTSD for

Vietnam Theater Veterans (TOP)

Friedman, Matthew J., M.D.

Schnurr, Paula P., Ph.D.

$1,318,255

Registry to Obtain Long Term

Patency Data on Saphenous 

Vein and Internal Mammary 

Artery Grafts

Goldman, Steve, M.D.

Copeland, Jack, M.D.

$70,893

RCT to Assess the Efficiency of

Prevention from Natural Influenza

Virus of Live Attenuated and

Inactivated Influenza Virus Vaccines

in Patients with Chronic Obstructive

Pulmonary Disease

Gorse, Geoffrey J., M.D.

$2,709,712

A Multi-Site Randomized Trial of

Team Managed Hospital Based

Home Care

Hughes, Susan, D.S.W.

Weaver, Fran, Ph.D.

Cummings, Joan, M.D.

$123,771

Anti-Thrombotic Agents 

in the Prevention of Hemodialysis

Access Thrombosis

Kaufman, James S., M.D.

$1,086,293

Naltrexone in the Treatment of

Alcoholism

Krystal, John, M.D.

Rosenheck, Robert, M.D.

$972,595

Natural History of Large 

Abdominal Aortic Aneurysms

Lederle, Frank A., M.D.

$44,773

Prophylaxis of Medical Patients for

Thromboembolism Study

Lederle, Frank A., M.D.

$333,914

Aneurysm Detection and

Management (ADAM)

Lederle, Frank A., M.D.

Wilson, Samuel E., M.D.

$700,487

Effect of Polyunsaturated Lecithin

on Liver Fibrosis

Lieber, Charles S., M.D.

$1,455,993

Prospective Evaluation of 

Risk Factors for Large (>1 cm)

Colonic Adenomas in 

Asymptomatic Subjects

Lieberman, David, M.D.

$358,913

Warfarin and Antiplatelet Therapy

Study in Heart Failure

Massie, Barry, M.D.

$454,695

The Coronary Artery

Revascularization Prophylaxis Trial

McFalls, Edward O., M.D., Ph.D.

Ward, Herbert B., M.D.

$835,155

Colchicine in the Treatment of

Alcoholic Cirrhosis of the Liver

Morgan, Timothy R., M.D.

$1,098,513

Urgent Revascularization in

Unstable Angina (AWESOME)

Morrison, Douglass A., M.D.

Scott, Stewart M., M.D.

Sethi, Gulshan, M.D.

$865,039

Randomized Clinical Trial of

Surgical Hernia Repair

Neumayer, Leigh A., M.D., F.A.C.S.

$840,631

Trial of Vancella Vaccine for 

the Prevention of Herpes Zoster

and its Complications

Oxman, Michael N., M.D.

$1,789,231

Vitamin E Treatment 

of Tardive Dyskinesia

Retrosen, John, M.D.

Adler Lenard, M.D.

$44,773

The Clinical and Economic Impact

of Clozapine Treatment on

Refractory Schizophrenia

Rosenheck, Robert, M.D.

$948,911

Cooperative

Studies Program

Project List
24

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Cooperative

Studies Program

Project List

(continued)

Health Services

Research &

Development

(HSR&D) Projects

Treatment of Seizures in the 

Elderly Population

Rowan, James, M.D.

Ramsay, Eugene, M.D.

$1,270,125

The Effects of Antiarryhthmic

Therapy in Maintaining Stability of

Sinus Rhythm in Atrial Fibrillation

Singh, Bramah N., M.D., Ph.D.

Singh, Steven N., M.D.

$1,078,794

Follow-up Study of the 

Medical and Surgical Therapies for

Gastroesophageal Reflux Disease

Spechler, Stuart, M.D.

$165,707

VA Topical Tretinoin

Chemoprevention Trial

Weinstock, Martin A., M.D., Ph.D.

$360,535

Normative Evaluation of a

Computer-Assisted

Neuropsychological Battery Pilot

White, Roberta F., Ph.D., A.B.P.P.

$486,204

Prostate Cancer Intervention 

Versus Observation Trial (PIVOT)

Wilt, Timothy J., M.D., M.P.H.

Brawer, Michael, M.D.

$1,108,009

The Iron (Fe) and 

Atherosclerosis Study (FeAST)

Zacharski, Leo R., M.D.

$261,400

Developmental Projects Program at

Decatur, GA: Quality, Cost,

Performance Measures

Aguayo, Samuel, M.D.

$159,904

Adherence of HIV+ 

Patients to Highly Active

Antiretroviral Treatment

Ampel, Neil M., M.D.

$102,000

An Illustrative Patient 

Satisfaction Evaluation Tool for

Ambulatory Populations

Asch, David, M.D., M.B.A.

$100,800

Changes in Mortality, Utilization,

and Quality of Care FY95-FY99

Ashton, Carol, M.D.

$218,558

Preventing Progression to 

Chronic Back Pain

Atkinson, Joseph, M.D.

$52,433

Rehabilitation Issues of Concern for

Women with Spinal Cord Injuries

Bach, Carol Ann, Ph.D.

$19,539

Health Economics Resource Center

Barnett, Paul, Ph.D.

$28,468

Developmental Projects Program at

Providence, RI: Ambulatory Care,

Mental Health

Bauer, Mark S., M.D.

$100,000

Complimentary Medical Treatment

Among Veterans Receiving VA

Primary Care

Bell, Iris, M.D., Ph.D.

$168,500

Quality of Life and Patient Utility

for Veterans with Prostate Cancer

Bennett, Charles, M.D., Ph.D.

$64,452

Treatment Decision Intervention for

Veterans with Prostate Cancer

Bennett, Charles, M.D., Ph.D.

$57,597

Developing and Implementing a

Quality Measure for 

Glycemic Control

Berlowitz, Dan R., M.D., M.P.H.

$46,459

Pressure Ulcer Care in Nursing

Homes: Effect of Clinical Guidelines

Berlowitz, Dan R., M.D., M.P.H.

$265,700

Developmental Projects Program at

Baltimore, MD: Outcomes,

Geriatrics

Bradham, Douglas D., Dr.PH.

$140,922

Veteran Women's Alcohol

Problems: Prevalence, Screening

and Self Help

Bradley, Katherine, M.D., M.P.H.

$122,616

Pain Management and 

Behavioral Outcomes in 

Patients with Dementia

Buffum, Martha, D.NSc.

$70,600

Validity of New and Original 

ASI Summary Indices

Cacciola, John, Ph.D.

$52,790

Psychophysiology of PTSD in 

Female Nurse Vietnam Veterans

Carson, Margaret, RN, Ph.D.

$150,000

The Effect of Managed Care on 

VA Hospital Costs

Cary, Kathleen, Ph.D.

$124,300

Reducing Lower Back Injuries in

VAMC Nursing Personnel

Caska, Barbara, Ph.D.

$83,155

Comprehensive Outcomes of

Nonmelanoma Skin Cancer

Chren, Mary-Margaret, M.D.

$147,100

Prostate Cancer Outcome Measures:

Age and Race Effects

Clark, Jack, Ph.D.

$280,680

Informal Caregivers of 

Veterans with Dementia: 

Cost, QOL, Service Use

Clipp, Elizabeth, Ph.D.

$141,702

Outcomes Assessment for Dementia

Care: Development of a Module

Cody, Marisue, Ph.D., RN

$190,893

Exercise Effect on Aerobic Capacity

and QOL in Heart Failure

Collins, Eileen, Ph.D., RN

$120,200
25

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Effectiveness of Screening for

Prostatic Cancer: A Cohort Study

Concato, John, M.D.

$121,075

Risk Mortality in Prostate Cancer

Concato, John, M.D.

$133,670

Educational Efforts to Reduce

Cultural & Ethnic Variation in

Cardiac Procedure Use

Conigliero, Joseph, M.D., M.P.H.

$128,849

Development of a Flexilevel Scale

of Shoulder Functioning

Cook, Karon, Ph.D.

$54,100

Home Walking Exercise Training in

Advanced Heart Failure

Corvera, Teresita, RN, M.N.

$190,600

Ethnic/Cultural Variations in the

Care of Veterans with

Osteoarthritis

Covinsky, Kenneth, M.D., M.P.H.

$302,200

Familial Patterns in Prostate Cancer

Cunningham, Glen, M.D.

$0 (no cost extension)

SAFE-GRIP Fall/Injuries

Interventions: A Randomized Trial

Devito, Carolee, Ph.D., M.P.H.

$229,766

Validation of Spanish Translation of

Folstein Mini Mental Exam

Devito, Carolee, Ph.D., M.P.H.

$53,250

Determining of Clinical

Implementation Effectiveness

Doebbeling, Bradley, M.D., M.S.

$64,925

Nurse Counseling for Physical

Activity in Primary Care Patients

Dubbert, Patricia, Ph.D.

$106,300

Processes, Structure, and Outcomes

of Post-Stroke Rehabilitation Care

Duncan, Pamela, Ph.D.

$402,900

Treatment of Depression in 

Patients with PTSD

Dunn, Nancy Jo, Ph.D.

$186,249

Effectiveness of a Health Education

Program in a Primary Care Setting

Engelhardt, Joseph, Ph.D.

$208,000

Evaluation of Subacute

Rehabilitation Care

Evans, Ron, M.S.W.

$89,300

An Evaluation of the 

Organization of Subspecialty

Cardiac Care within VA

Every, Nathan, M.D.

$267,757

Determination of Utilization 

Rates of Cardio Procedures and

“Standards of Care Pharmacological

Therapy” in Patients Admitted 

to VA Hospital 92-98

Ezekowitz, Michael, M.D., Ph.D.

$34,050

Ambulatory Care Quality

Improvement Project: ACQUIP

Fihn, Stephan D., M.D., M.P.H.

$676,026

Schizophrenia Outcomes Module:

Enhancement and Field Testing

Fischer, Ellen, Ph.D.

$14,710

Shared Goals and 

the Process of Care in

Schizophrenia – A Pilot Study

Fischer, Ellen, Ph.D.

$109,308

Improving Service Delivery Through

Access Points

Fortney, John, Ph.D.

$75,758

Decision Making for Depression in

Women Vets: Patient & Physician

Factors

Frayne, Susan, M.D., M.P.H.

$113,500

Communication Alternatives and

Preferences in End of Life Care

Fried, Terri, M.D.

$121,425

Gait & Balance Training in Reducing

Occurrence & Fear of Falls in Elderly

Galindo-Ciocon, Daisy, Ph.D.

$70,050

Practice Patterns and Variations in

Care of VA Patients with Acute MI

Gaziano, Michael, M.D.

$263,500

Utility of PTF Data in Monitoring

Outcomes of Surgical Care

Geraci, Jane, M.D., M.P.H.

$42,504

Health Seeking and Treatment

Selection in Patients with Coronary

Disease

Gordon, Howard, M.D.

$37,800

Costs, Quality of Life & Functional

Outcomes in Veterans Treated for

MS with Beta-Interferon 1-B

Guarnaccia, Joseph, M.D.

$102,260

Using Pain Resource Nurses to

Improve Cancer Patient Pain

Outcomes

Hagan, Susan, M.S.

$67,800

Ethnicity & Veteran Identity 

as Determinants of 

VA Ambulatory Care Use

Harada, Nancy, Ph.D.

$322,200

Effectiveness of Team Treatment of

Depression in Primary Care

Hedrick, Susan, Ph.D.

$144,983

Evaluating HEDIS 3.0 for VHA

Hendricks, Ann, Ph.D.

$98,700

Evaluating Quality of Care Screens

from Laboratory Databases

Hofer, Timothy, M.D.

$53,300

Guidelines for Drug Therapy of

Hypertension: Closing the Loop

Hoffman, Brian, M.D.

$166,725

Cost-Effectiveness of Lung Volume

Reduction Surgery

Huizenga, Hugh, M.D., M.P.H.

$51,850

Protocols to Manage Resistance 

to Care in Veterans with

Alzheimer's Disease

Hurley, Ann, RN, D.N.Sc.

$31,793

Development of a Cancer Pain

Prognostic Scale

Hwang, Shirley, RN, M.S.

$23,575

Database Resource Center

Hynes, Denise, Ph.D.

$349,680

HSR&D Projects

(continued)
26

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

HSR&D Projects

(continued)

A Randomized Trial to 

Implement the AHCPR 

Smoking Cessation Guideline

Joseph, Anne, M.D., M.P.H.

$266,710

Developing Risk Adjustment

Models in Veterans Health Status

Kazis, Lewis W., Sc.D.

$89,150

Health Related Quality of Life in

Veterans: A Pilot Study

Kazis, Lewis W., Sc.D.

$122,454

Toward Gender-Aware VA Health

Care: Staff Ideology, Sensitivity, 

& Knowledge

King, Lynda, Ph.D.

$80,900

Proactive Diabetes Case

Management

Krein, Sarah, Ph.D., RN

$191,720

Racial Variations in 

Cardiac Procedures: 

Do Health Beliefs Matter?

Kressin, Nancy, Ph.D.

$420,032

Mental Health Outcomes

Associated with Bosnia

Peacekeeping Mission

Litz, Brett, Ph.D.

$35,643

Pressure Ulcer Assessment 

Via Telemedicine

Lowery, Julie, Ph.D.

$148,153

Nurse Managed Clinic for Dementia

Patients and Family Caregivers

Maddox, Melitta, M.S.N., RNCS

$96,775

Impact of Provider Substance Abuse

Education on Guideline

Implementation

McCormick, Richard, Ph.D.

$220,100

Development of Individual-Patient

Physical Health Profiles with IRT

McHorney, Colleen, Ph.D.

$47,489

Area Variation in Length of 

Stay, Pre and Post-hospital 

Care and Survival

Menke, Terri, Ph.D.

$114,182

Developmental Projects Program 

at Augusta, GA: Technical

Assessment (Telemedicine)

Middleton, III, Henry M., M.D.

$122,590

Determinants of VA and 

Non-VA Health Care Use 

Among Elderly Veterans

Morgan, Robert, Ph.D.

$48,525

Antecedents and Consequences of

Sexual Harassment in the Military

Murdoch, Maureen, M.D., M.P.H.

$151,950

Gender Differences in

Compensation and Pension 

Claims Approval for PTSD

Murdoch, Maureen, M.D., M.P.H.

$79,400

Developmental Projects Program at

Tampa, FL: Labor Management

Issues, Outcomes, Rehabilitation

Nelson, Audrey, RN, Ph.D.

$74,198

Redesigning Patient Handling Tasks

to Prevent Nursing Back Injuries

Nelson, Audrey, RN, Ph.D.

$143,900

Evaluating Cost for Veteran’s

Health Care (Medicare Cost)

Nugent, Gary, M.H.A.

$1,274,714

Race, Patient Preference and 

Stroke Risk Reduction

Oddone, Eugene, M.D., M.H.Sc.

$351,356

Cost-Effectiveness of GuidelineConcordant Care for Schizophrenia

Owen, Richard R., M.D.

$16,883

Documentation of Major

Depressive Disorder and

Schizophrenia Related Performance

Owen, Richard R., M.D.

$68,598

A Multi-site Study of Strategies for

Implementing Schizophrenia

Guidelines

Owen, Richard R., M.D.

$449,612

The Quality of Medication

Management for Schizophrenia

Owen, Richard R., M.D.

$118,161

Are Clinical Vignettes Better 

than Chart Abstraction to 

Measure Quality?

Peabody, John, M.D., Ph.D.

$62,359

Risk Factors for Femorodistal 

Bypass Surgery and Amputation

Pearce, William, M.D.

$63,500

Evaluation of a Comprehensive

Advance Care Planning

Intervention

Pearlman, Robert, M.D.

$63,689

A Novel Clinical Anatomic Staging

System for Prostate Cancer

Penson, David, M.D.

$7,000

Proposal to Present Data on

Variation in Care for Acute

Myocardial Infarction to Practicing

Cardiologists

Petersen, Laura A., M.D., M.P.H.

$53,400

Automated Calls with Nurse 

Follow-up to Improve Diabetes

Ambulatory Care

Piette, John, Ph.D.

$97,075

Improving Diabetes Care 

Via Telephone Assessment and

Patient Education

Piette, John, Ph.D.

$87,789

Developmental Projects Program at

Columbia, SC: Labor Management

Issues, Managed Care

Pillinger, Carol L., M.D.

$54,938

Adherence to Antiviral Therapy in

HIV Infected Adults

Powell-Cope, Gail, Ph.D.

$45,700

Developmental Projects Program 

at Cincinnati, OH: Outcome

Measurement, Cost, Quality, 

Access, Satisfaction

Render, Marta L., M.D.

$48,282

Effect of Activity on Sleep of

Cognitively-Impaired Veterans

Richards, Kathleen, RN, Ph.D.

$159,925
27

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

HSR&D Projects

(continued)

Ambulatory Case Mix Measures:

Implications for VA Managed Care

Rosen, Amy, Ph.D.

$186,800

Decline in Functional 

Status as a Quality Indicator 

for Long-Term Care

Rosen, Amy, Ph.D.

$161,725

Practice Patterns in Care of

Chronically Mentally Ill and

Homeless Veterans

Rosenheck, Robert, M.D.

$119,394

Impact of Outsourcing VA 

Cardiac Surgery on the Cost and

Quality of Care

Rosenthal, Gary, M.D.

$201,000

The Use of Computer Telephony 

for the Administration of 

SF-36V – SF-12V

Rothendler, James, M.D.

$166,500

A Casefinding and Referral 

System for Older Veterans 

Within Primary Care

Rubenstein, Laurence, M.D., M.P.H.

$194,000

Efficacy of Telepsychiatry in the

Treatment of Depression

Ruskin, Paul, M.D.

$111,870

Lipid Measurement and

Management System

Sales, Anne E., RN, Ph.D.

$37,519

Implementing Smoking Cessation

Guidelines: ...Evidence Based

Quality Improvement

Sherman, Scott, M.D.

$201,277

Effect of Behavioral Management

on Quality of Life in Heart Failure

Shively, Martha, Ph.D.

$111,592

QUERI Proposal to Expand 

Data Collection and Reports to

Evaluate VA Cardiac Surgery

Program Performance

Shroyer, Anne, Ph.D.

$94,650

Documenting Barriers to 

Patient Centered Care in an

Academic Clinic

Smith, Curtis S., M.D.

$36,900

Effectiveness and Cost 

Impact of Telecommunications

System in COPD

Sparrow, David, D.Sc.

$185,766

Randomized Control Trial 

of Exercise Training in 

Patients with COPD

Sparrow, David, D.Sc.

$119,184

Developmental Projects 

Program at Buffalo, NY: 

Outcomes, Chronic Diseases

Spaulding, Steven, M.D.

$79,178

PTSD Among VA Ambulatory 

Care Patients

Spiro, III, Avron, Ph.D.

$127,900

Developmental Projects Program 

at Omaha, NE: Customer

Satisfaction, Cost, Chronic 

Diseases, Special Populations

Spurzem, John, M.D.

$99,842

Objective Measurement of Daily

Activity in COPD

Steele, Bonnie, Ph.D.

$31,476

Computerized Guidelines 

Enhanced by Symptoms & History:

Clinical Effects

Tierney, William, M.D.

$318,550

Matching Outcomes and 

Costs in Substance Abuse/

Psychiatric Treatment

Timko, Christine, Ph.D.

$146,900

Defining the Attributes of the

Quality of Dying

Tulsky, James A., M.D.

$102,412

Negotiating Patient Expectations

and Requests in a Managed 

Care Environment

Tulsky, James A., M.D.

$234,607

Mental Health Providers

Perceptions of Quality Indicators

Valenstein, Marcia, M.D.

$56,612

Patient Preferences and the 

Care of Diabetes

Vijan, Sandeep, M.D.

$116,929

Developmental Projects Program 

at Iowa City, IA: Technical

Assessment (Telemedicine)

Wakefield, Bonnie J., RN, Ph.D.

$96,750

Surgical Risks and Outcomes of

Women Treated in VA Hospitals

Weaver, Frances, Ph.D.

$120,500

An Integrated Model of Primary

Care in Mental Health

Weinberger, Morris, Ph.D.

$193,885

Delivery of Mental Health 

Services to American Indians and

Hispanic Americans in New Mexico

and Minnesota

Westermeyer, Joseph, M.D., M.P.H.,

Ph.D.

$408,310

Teledermatology: 

Diagnosing Dermatologic 

Lesions by Digital Imaging

Whited, John, M.D.

$29,250

Cultural Barriers to Access to VA

Blind Rehabilitation Services

Williams, Marjory, RN

$3,925

An Objective Indicator of Risk of

Developing a Pressure Ulcer

Wilson, Paulette, Ph.D.

$38,439

Patient Preferences in End Stage

Prostate Cancer

Wray, Nelda, M.D.

$111,768

Managed Care Performance of VHA

Primary Care Delivery Systems

Yano, Elizabeth, Ph.D.

$157,660
28

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Medical Research

Service Projects

Immunopathology of Hepatitis C

Virus Infection

Agnello, Vincent, M.D.

$91,550

Interaction of Helicobacter pylori

with Neutrophils

Allen, Lee-Ann H., Ph.D.

$64,950

Locomotor Training and Motor

Function after Spinal Cord Injury

Anderson, Douglas K., Ph.D.

$108,600

Induction of Macrophage Apoptosis

by Myobacterium Avium

Arbeit, Robert D., M.D.

$69,200

Vitamin D Metabolism – 

Effect of Age and Longevity

Armbrecht, Harvey J., Ph.D.

$62,100

Use of GM-CSF in the Treatment of

Ocular Malignant Melanoma

Armstrong, Cheryl, M.D.

$81,100

Urinary Acidification

Arruda, Jose A.L., M.D.

$93,000

Mechanisms of ErbB-2-targeted

Antitumor Interventions in 

Human Breast Carcinoma

Arteaga, Carlos L., M.D.

$27,375

Efficacy of Antidepressants in

Chronic Back Pain

Atkinson, Joseph H., M.D.

$73,350

Studies of Myeloperoxidase 

Gene Expression in Normal and

Leukemic Cells

Austin, Garth E., M.D., Ph.D.

$128,000

Post-Receptor Cytokine 

Signal Transduction

Ballou, Leslie R., Ph.D.

$215,000

Blood-Brain Barrier Transport of

Met-Enk in Alcoholism

Banks, William A., M.D.

$61,650

Mechanisms of the

Anticarcinogenic Actions of 

Ellagic Acid

Barch, David H, M.D.

$40,950

Quantitating Immunosuppression

by Cyclosporine and FK-506 in

Patients

Batiuk, Thomas D., M.D., Ph.D.

$55,000

Combination Osteogenic Therapy in

Established Osteoporosis

Baylink, David J., M.D.

$165,700

The Renal Na+/HCO3-Cotransporter:

Regulation by NHE-RF

Bernardo, Angelito A., M.D.

$39,100

Serotonin and the Upper Airway in

Obstructive Sleep Apnea

Berry, Richard B., M.D.

$41,900

The Cellular and Biochemical Basis

of MBP Degradation

Bever, Christopher T., M.D.

$98,500

Role of Neurotrophins and

Oxidative Stress in Parkinson’s

Disease

Bickford, Paula C., Ph.D.

$194,580

The Calcium Sensing Mechanisms 

of Keratinocytes

Bikle, Daniel D., M.D., Ph.D.

$122,200

Genetic Studies of Neurologic and

Dementing Disorders

Bird, Thomas, M.D.

$131,700

Pathogenesis of Streptococcal 

Skin and Soft Tissue Infections

Bisno, Alan L., M.D.

$137,300

Retrieval and Analysis of

Orthopedic Implants

Bloebaum, Roy D., Ph.D.

$108,100

Regulation of the cAMP-specific

Phosphodiesterases

Bolger, Graeme B., M.D.

$38,350

Erythropoietin Action on

Homogeneous Erythroid

Progenitors

Bondurant, Maurice C., Ph.D.

$96,000

Efficacy of Threshold vs.

Subthreshold TMS in the 

Treatment of Depression

Boutros, Nashaat, M.D.

$113,800

Evaluation of a Novel

Lipopolysaccharide Binding

Intervention for Sepsis

Brackett, Daniel J., A.S.

$64,800

Memory and the Hippocampus in

Vietnamese Twins with PTSD

Bremner, James D., M.D.

$29,000

Cyclic Nucleotide-Dependent

Vasorelaxation

Brophy, Colleen M., M.D.

$102,300

Mechanisms of the HPV 11 E1–E4

Protein in the Virus Life Cycle

Brown, Darron R., M.D.

$62,200

Phenotypic Characterization and

Genetic Analysis of an Attenuated

Mycobacterium Abscessus Mutant

Byrd, Thomas F., M.D.

$55,000

Biomechanics of Total 

Hip Dislocation

Callaghan, John J., M.D.

$57,700

The Role of MARCKS and 

StAR Protein in Priming of

Aldosterone Secretion

Calle, Roberto A., M.D.

$31,550

Altered Receptor-Mediated

Endocytosis: Its Role in 

Alcoholic Apoptosis

Casey, Carol A., Ph.D.

$152,900

Forebrain Mechanisms of Chronic

Neuropathic Pain

Casey, Kenneth L., M.D.

$85,800

Medical Research Service funded approximately

1100 projects in FY99. The following listing represents only those projects approved for funding 

in the spring 1998 and fall 1998 merit review

cycles and began in fiscal year 1999.
29

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Neuropsychology of Information

Processing and Memory

Cermak, Laird S., Ph.D.

$92,000

Androgen Action and 

Receptor Inactivation

Chatterjee, Bandana, Ph.D.

$100,500

Surgical Peritonitis: Local Peritoneal

and Remote Organ Responses

Cheadle, William G., M.D.

$132,800

Regions of the Cardiac Sodium

Channel Involved in Permeation

and Gating

Chiamvimonvat, Nipavan, M.D.

$125,000

Regulation of Neutrophilic 

Lung Inflammation

Christman, John W., M.D.

$131,050

Melatonin and Myocardial

Protection

Chua, Balvin H. L., Ph.D.

$98,800

Biology of IGF-1 in Bone

Clemens, Thomas L., Ph.D.

$158,100

Diverse Effects of Thromboxane A2

in Kidney Transplantation

Coffman, Thomas M., M.D.

$58,750

Genetic Factors Causing Pancreatitis

Cohn, Jonathan A., M.D.

$115,800

Mechanisms of Plaque Pathogenesis

in Alzheimer’s Disease

Cole, Gregory M., Ph.D.

$106,150

Regulaton of 15-Lipoxygenase by

its 3'-Flanking Sequence

Conrad, Douglas J., M.D.

$68,700

Role of APP and 

Presenilins in Neuronal 

Intracellular A-beta Metabolism

Cook, David G., Ph.D.

$88,700

Genetic Analysis of Hereditary

Prostate Cancer Families

Cooney, Kathleen, M.D.

$34,350

Alternative Pre-mRNA Splicing in

Diabetes and Insulin Resistance

Cooper, Denise R., Ph.D.

$197,900

Insulin, Neurogenetics and 

Memory in AD: A Novel

Therapeutic Approach

Craft, Suzanne, Ph.D.

$121,900

Ultraviolet Radiation and HIV

Infection

Cruz, Ponciano D., M.D.

$68,900

Mechanisms and Prevention of

Anthracycline Cardiotoxicity 

and Aging

Cusack, Barry J., M.D.

$59,750

Evaluation of Regimens for

Treatment of MDRTB

Cynamon, Michael H., M.D.

$41,200

Benzodiazepine Regulation of

Human GABA Receptors

Davidoff, Robert A., M.D.

$105,900

Growth Factors and Gene Therapy

in Diabetic Wounds

Davidson, Jeffrey M., Ph.D.

$102,000

Structural Prerequisites for 

Amyloid Fibrillogenesis

de Beer, Frederick C., M.D.

$88,800

Receptor Mediated DNA Uptake

and Inflammation in the Lung

Deffebach, Mark E., M.D.

$74,200

Neurophysiology and

Pathophysiology of Eye Movements

Dell’osso, Louis F., Ph.D.

$242,800

Insulin Action: Role of Skeletal

Muscle and Insulin-Mediated 

Blood Flow

Dengel, Donald R., Ph.D.

$103,800

Cytokine-Dependent Regulation of

the Polymeric Ig Receptor in

Intestinal Epithelial Cells

Denning, Gerene M., Ph.D.

$98,582

T and PSMA: Targets for 

Novel Prostate Cancer Therapies

Deutscher, Susan L., Ph.D.

$121,900

Differentiated Sympathetic 

Neural Control of the Kidney

Di Bona, Gerald F., M.D.

$91,700

Characterization of 

Pemphigus Antibodies

Diaz, Luis A., M.D.

$75,100

A Simple Test to Identify Clinically

Relevant Central Auditory

Asymmetry

Divenyi, Pierre L., Ph.D.

$151,779

Proteolysis and Ethanol-Induced

Oxidative Stress in Cultured

Hepatoma Cells

Donohue, Terrence M., Ph.D.

$52,400

Regulation of Corticotropin

Releasing Hormone Gene

Expression

Dorin, Richard I., M.D.

$119,000

Ethambutol Mediated Visual 

Loss is Due to Excitotoxic 

Neuronal Damage

Dreyer, Evan B., M.D., Ph.D.

$89,500

Regulatory Activity of Vitamin D

and IGF-Binding Proteins in

Prostate Tumor Cells

Drivdahl, Rolf H., Ph.D.

$150,300

Mechanisms of NaCl Absorption in

the Human Colon

Dudeja, Pradeep K., Ph.D.

$122,300

Cholinergic Mechanisms in 

Heart Failure: Role of 

Ganglionic Transmission

Dunlap, Mark E., M.D.

$113,350

Epileptogenic Focus Localization 

by EEG Source Modeling

Ebersole, John S., M.D.

$80,100

Home Studies of Insomnia and

Normal Sleep in Three Age Groups

Edinger, Jack D., Ph.D.

$54,150

Medical Research

Service Projects

(continued)
30

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Medical Research

Service Projects

(continued)

Common Factors Regulate 

CYBB and NCF2 Transcription 

in Myeloid Cells

Eklund, Elizabeth, M.D.

$108,650

Cellular and Molecular Mechanisms

by Which Insulin Regulates

Apolipoprotein B

Elam, Marshall B., M.D., Ph.D.

$56,950

Regulation of Insulin-like Growth

Factor Binding Protein-3 (IGFBP-3)

Erondu, Ngozi E., M.B.B.S., Ph.D

$59,700

Actin Filament Dynamics: 

Role of Actin Binding Proteins

Estes, James E., Ph.D.

$98,900

Mechanisms of Pathogenesis of

Helicobacter pylori

Evans, Doyle J., Ph.D.

$53,900

Skeletal Alkaline Phosphatase:

Function, Degradation, and 

Release to Circulation

Farley, John R., Ph.D.

$110,888

Sleep Enhancing Properties of

Glutamate Antagonists

Feinberg, Irwin, M.D.

$117,500

Role of Oxysterols and LXR in

Epidermal Differentiation

Feingold, Kenneth R., M.D.

$78,250

Cellular Basis of Osmotically

Induced Changes in Taste

Feldman, George M., M.D.

$160,500

Low Dose Intermittent Oral Aspirin:

Effects on Platelets and the 

Upper GI Tract

Feldman, Mark, M.D.

$67,300

Neural Control of

Acetylcholinesterase Molecular

Forms in Adult Muscles

Fernandez, Hugo L., Ph.D.

$167,200

Hereditary Spastic Paraplegia

Fink, John K., M.D.

$146,400

Nervous System Delivery Vectors

from Clostridial Neurotoxins

Fishman, Paul S., M.D., Ph.D.

$138,700

Structural Changes in Idiopathic

and Experimental Parkinsonism

Forno, Lysia K. S., M.D.

$77,200

Growth Hormone Receptor

Proteolysis and Shedding

Frank, Stuart J., M.D.

$153,000

Models of Beta-Amyloid

Deposition, Neurotoxicity and

Neuroprotection in Aging Rodents

Frautschy, Sally A., Ph.D., M.S.

$59,650

Role of Cytokines in 

Postischemic Myocardium

Freedman, Gregory L., M.D.

$85,200

Neurophysiological Deficits in

Schizophrenia

Freedman, Robert, M.D.

$140,800

In Vivo Mechanisms of StatusEpilepticus-Induced Neuronal Death

Fujikawa, Denson G., M.D.

$159,300

Control of Arterial Remodeling

Gaballa, Mohamed, Ph.D.

$127,200

Macrophage Function in the

Pathogenesis of CMV Infection

Geist, Lois J., M.D.

$28,000

Axonal Injury Response and

Calcium Homeostasis

George, Edwin B., M.D., Ph.D.

$55,050

Gastrointestinal Pathophysiology 

of Diarrheal Disorders

Giannella, Ralph A., M.D.

$205,400

Genetics, Metabolism and Weight

Loss in Older, Obese Veterans

Goldberg, Andrew P., M.D.

Niklas, Barbara J., Ph.D.

$89,500

Cocaine-Induced Seizures: 

A Quantitative Trait Loci 

Genetic Study

Golden, Gregory, T., Ph.D.

$97,500

Adrenal Corticosteroids 

and Hypertension

Gomez-Sanchez, Celso E., M.D.

$149,300

Gonococcal Opas: 

Role in Invasion of Human

Fallopian Tube Epithelium

Gorby, Gary L., M.D.

$105,200

Experimental Studies of 

Dyesthetic Central Pain 

Following Spinal Cord Injury

Gorecki, John P., M.D.

$59,000

The Role of Inducible

Cyclooxygenase in Delayed

Neuronal Death

Graham, Steven H., M.D., Ph.D.

$129,200

Alcohol Abuse and

Neuropsychological Impairment

Grant, Igor, M.D.

$125,000

Prognostic Factors in Patients with

Non-Small Cell Lung Cancer

Graziano, Stephen, M.D.

$37,300

Heptocellular Transport in 

Health and Disease

Green, Richard M., M.D.

$133,800

The Uroguanylin Peptide Family:

Cellular Mechanisms and

Regulation

Greenberg, Richard N., M.D.

$66,400

Adenosine’s Role in 

Sleep and Arousal

Greene, Robert W., M.D., Ph.D.

$133,850

Effects of Ethanol on 

Lung Glutathione and 

Susceptibility to Injury

Guidot, David M., M.D.

$92,400

Flow Mediated Vasodilation in the

Human Coronary Microcirculation

Gutterman, David D., M.D.

$69,580

Parathyroid Gland Function 

and Aging

Halloran, Bernard P., Ph.D.

$79,900
31

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Medical Research

Service Projects

(continued)

Insulin-Sensitive Peroxisomal

Enzyme Function in NIDDM

Hamel, Frederick G., Ph.D.

$71,000

Sodium Transport in the 

Collecting Duct

Hamm, L. Lee, M.D.

$125,000

Neuroimaging in PTSD: Functional

Imaging of the Anterior Cingulate

Cortex During Procaine Challenge

Hamner, Mark B., M.D.

$112,700

Glutamatergic Dysfunction 

and Dementia in Elderly

Schizophrenic Patients

Haroutunian, Vahram, Ph.D.

$65,950

Serum Markers in Non-Small 

Cell Lung Cancer

Harpole, David H., M.D.

$53,500

Neural Correlates of 

Action Representations

Harrington, Deborah L., Ph.D.

Haaland, Kathleen Y., Ph.D.

$183,754

Signal Transduction in 

Myeloid Differentiation

Harris, Kevin W., M.D., Ph.D.

$94,500

Nitric Oxide Regulates Pulmonary

Endothelial Barrier Dysfunction

Hart, C. Michael, M.D.

$126,300

Viral Gene Expression and

Replication in PapillomavirusAssociated Neoplasia

Haugen, Thomas H., M.D., Ph.D.

$155,500

Depression and Stress Models: GRK

Underexpression and CRF Receptors

Hauger, Richard L., M.D.

$114,200

Mechanisms of Antibiotic

Resistance Transfer in 

Bacteroides fragilis

Hecht, David W., M.D.

$61,650

Mechanisms of Graft Rejection

after Indirect Recognition

Heeger, Peter S., M.D.

$102,750

Regulation of mRNA Stability 

during Erythroleukemic

Differentiation

Hensold, Jack O., M.D.

$88,150

Human Immune Response to 

U1-70kD snRNP Autoantigen

Hoffman, Robert W., D.O.

$117,300

Studies on the Transport of Folates

and Antifolates in Prostate

Horne, Donald W., Ph.D.

$127,145

Neuronal Loss and 

Plasticity in Epilepsy (V)

Houser, Carolyn R., Ph.D.

$132,350

A cAMP-Dependent 

Trans-Activator that Governs

Mitochondrial Gene Expression

Hudson, Alan P., Ph.D.

$124,900

Fibroblast Growth Factors 

(FGFs) and FGF Receptors in

Prostate Cancer

Ittman, Michael M., M.D., Ph.D.

$57,950

Hypoxic Regulation of Superoxide

Dismutases in Acute Lung Injuries

Jackson, Robert M., M.D.

$105,600

Fungal Ferric Reductants and

Leukocytic Oxidants

Jacobson, Eric S., M.D., Ph.D.

$127,300

Colon Cancer Susceptibility Genes

Jacoby, Russell F., M.D.

$130,300

Developing a Malignant Glioma

Vaccination Strategy Using

Membrane M-CSF

Jadus, Martin R., Ph.D.

$188,750

Tyrosine Augmentation of

Clozapine-Induced Dopamine

Release in the Prefrontal Cortex

Jaskiw, George E., M.D.

$127,000

Platelet Stimulus 

Response Coupling

Johnson, Gerhard J., M.D.

$147,100

Aging and Immunologic 

Defenses Regulated by Signal

Transducing Lipids

Jurivich, Donald A., D.O.

$165,100

Neuronal Transplants in Repair 

of Stroke Lesions in the Aged

Kartje, Gwendolyn L., M.D., Ph.D.

$38,500

Cellular and Matrix Glomerular

Barrier Function in Early 

Diabetic Nephropathy

Katz, Murray A., M.D.

$152,000

Regulation of Plasma Protein

Composition in Nephrosis

Kaysen, George, M.D., Ph.D.

$134,200

M. tuberculosis Survival 

Within Macrophages

Kernodle, Douglas S., M.D.

$92,700

Promoting Self-Management of

Chronic Pain in Primary Care

Kerns, Robert D., Ph.D.

$60,500

Impact of Defective Prohormone

Trafficking in Thyroidal ER 

Storage Disease

Kim, Paul S., M.D.

$80,000

Strain-specific Immunity to

Plasmodium vivax in Humans

King, Christopher L., M.D., Ph.D.

$73,250

Alcohol Liver Disease: 

Immune Responses to Aldehyde

Modified Proteins

Klassen, Lynell W., M.D.

Thiele, Geoffrey M., Ph.D.

$51,200

Cytokine Control of Neutrophils:

Role of Apoptosis Rescue Proteins

Klein, Jon B., M.D., Ph.D.

$143,500

Interaction of Candida 

albicans Adhesin Protein, 

ALA1 with Fibronectin

Klotz, Stephen A., M.D.

$98,550

HSP60, Apoptosis, and 

Myocardial Injury

Knowlton, Anne A., M.D.

$54,150
32

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Soluble Adhesion Molecules 

as Inflammatory Angiogenic

Mediators

Koch, Alisa E., M.D.

$134,500

The Role of CpG DNA in Breaking

Tolerance to DNA in Lupus

Krieg, Arthur M., M.D.

$97,800

Role of Transforming Growth

Factor beta in Progressive Ankylosis

Krug, Hollis E., M.D.

$48,350

Neurotoxic Amphetamines,

Protooncogenes, and Apoptosis

Kuhn, Donald M., Ph.D.

$147,700

A Neuronal Degeneration

Mechanism Associated with

Cognitive Decline

Kuljis, Rodrigo O., M.D.

$132,600

Regulation of Phagocytosis 

by Phospholipase D

Kusner, David J., M.D., Ph.D.

$105,500

Remote Masking in Human Vision

Kuyk, Thomas K., Ph.D.

$54,000

MR - Regulation of

Glomerulonephritis by 

T-Cell Cytokines

Lakkis, Fadi G., M.D.

$154,000

Component Mechanisms of 

Visual Perception and Attention

Lamb, Marvin R., Ph.D.

$69,161

Neural and Cognitive Bases of

Diencephalic Amnesia

Langlais, Philip J., Ph.D.

$148,300

Molecular Genetics of 

Male Hypertension

Lau, Yun-Fai Chris, Ph.D.

$125,000

Gallbladder Mucosal Function

Lee, Sum P., M.D., Ph.D.

$116,000

Role of Angiotensin II in Mesangial

Matrix Degradation in Diabetes

Leehey, David J., M.D.

$72,500

The Effect of Obesity on the

Regulation of Leptin Secretion

Levy, James R., M.D.

$102,450

IL-6, Apoptosis and 

Multiple Myeloma (V)

Lichtenstein, Alan K., M.D.

$112,450

Regulation of 

Cholecystokinin Secretion

Liddle, Rodger A., M.D.

$105,250

Novel Activation Mechanism of 

LDL Receptor Transcription

Liu, Jingwen, M.D., Ph.D.

$148,800

Alzheimer’s Therapy: 

Modulation of Neurotrophin

Actions by LAR Receptors

Longo, Frank M., M.D., Ph.D.

$106,500

Intracellular Mediators of 

HPS Hantavirus Pathogenesis

Mackow, Erich R., Ph.D.

$208,800

Mechanisms of Age-Impaired

Vasorelaxation

Mader, Scott L., M.D.

$55,400

Colorectal Adenoma:

Chemoprevention with Folic Acid

Majumdar, Adhip N., Ph.D., D.Sc.

Jaszewski, Richard, M.D.

$121,100

Crystal Retention in Kidney 

Stone Disease

Mandel, Neil S., Ph.D.

$57,650

Immunoisolation and

Characterization of 

CFTR-Expressing Vesicles

Marino, Christopher R., M.D.

$77,400

Epidemiology of Genetic and

Acquired Risk Factors for 

Venous Thrombosis

Marlar, Richard A., Ph.D.

Welsh, Carolyn Helen, M.D.

$66,500

Regulation of Chemokine 

Function in the Lungs

Martin, Thomas R., M.D.

$138,650

Aging and 

Neuroendocrine Regulation

Matsumoto, Alvin M., M.D.

$95,850

Kallikrein-Kinin System in 

Renal Function and Disease

Mayfield, Ronald K., M.D.

$121,900

Mechanism and Use of 

Alpha 2 Adrenergic Agonists for

Anesthetic Action

Maze, Mervyn, M.B., Ch.B.

$153,500

MRI Anatomy of Schizophrenia

McCarley, Robert W., M.D.

$151,500

Proximal Mechanisms of Neuronal

Injury in HIV-1 Infection

McCarthy, Micheline B., M.D., Ph.D.

$100,650

Dysregulated TNF/FAS Signaling 

in Alcoholic Liver Disease

McClain, Craig J., M.D.

$122,500

Eosinophil-mediated Formation of

Reactive Tyrosine Species

McCormick, Michael L., Ph.D.

$92,750

Role of Mitochondrial 

Metabolism in Histoplasma

Capsulatum Virulence

McEwen, Joan E., Ph.D.

$71,100

Automatic Decomposition of 

the Electromyogram

McGill, Kevin C., Ph.D.

$62,100

The Role of Proteases in 

Parasite Invasion

McKerrow, James H., M.D., Ph.D.

$70,900

Axonal Protein Interactions 

during Axonal Regeneration

McQuarrie, Irvine G., M.D., Ph.D.

$62,950

Synapse Changes in an Animal

Model of Parkinson’s Disease

Meshul, Charles K., Ph.D.

$236,516

Role of Novel Gene Expression in

Metastatic Prostate Cancer

Meyer-Siegler, Katherine, M.S., Ph.D

$157,500

Medical Research

Service Projects

(continued)
33

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Lymphocyte/Endothelial 

Adhesion Cascades in Inflamed

Extranodal Sites

Michie, Sara A., M.D.

$50,000

Living-Related Donor Bone 

Marrow Immunoregulation in

Kidney Transplants

Miller, Joshua, M.D.

$234,250

Alcohol and Growth Factors in 

the Adult Brain

Miller, Michael W., Ph.D.

$49,150

Biology of Membranous Bone

Regeneration: Effects of Age

Miller, Timothy A., M.D.

$118,500

Function of Alveolar Epithelial TIA

Miller, York E., M.D.

$103,800

Inhibition of NF-kB Enhances

Apoptosis in Lung Cancer Cells

Milligan, Shawn A., M.D.

$96,400

Mechanisms of Altered Autonomic

Reflexes after Myocardial Infarction

Minisi, Anthony J., M.D.

$115,700

Dopamine and Renal NaCl Balance

Moe, Orson W., M.D.

$47,350

Complement Regulation in

Fetomaternal Tolerance

Molina-Vicenty, Hector D., M.D.

$94,100

Suicide Genes for Controlled 

T Cell Ablation in Leukemia

Moolten, Frederick L., M.D.

$121,100

Enhancement of Tumor Uptake of

Ga-67 by Photodegraded

Nifedipine

Morton, Kathryn A., M.D.

$50,500

Hepatic Membrane Transport in

Health and Disease

Moseley, Richard H., M.D.

$51,350

Cyclin-A Mediated 

Transcriptional Regulation

Mudryj, Maria, Ph.D.

$104,452

Molecular Manipulation to 

Enhance Anti-Myeloma Response

Munshi, Nikhil C., M.D.

$136,100

Neural Control of 

Mammalian Visceral Function

Nadelhaft, Irving, Ph.D.

$167,300

Application of Medicinal Chemistry

to Alcoholic Liver Disease

Nagasawa, Herbert T., Ph.D.

$72,900

Molecular Mechanisms 

of Purinergic and FGF Signaling 

in Astrocytes

Neary, Joseph T., Ph.D.

$179,645

Glutamate Transport in 

MPTP Neurotoxicity, Role in

Parkinson’s Disease

Norenberg, Michael D., M.D.

$232,300

The Role of Apoptosis During 

Acute Pancreatitis

Norman, James G., M.D.

$140,900

Mechanism and Potentiation 

of a Th1 Cell-Directed 

Antitumor Response

Norton, Jeffrey A., M.D.

$152,000

Acquisition of a Peptide Phenotype

by Neuroendocrine Cells In Vivo

O’Connor, Daniel T., Jr., M.D.

$169,600

Beta-Adrenergic Blockade of

Increased Conditionability in PTSD

Orr, Scott P., Ph.D.

$136,838

Regulation of Cholic Acid

Formation: Its Role in 

Cholesterol Homeostasis

Pandak, William M., M.D.

$136,700

Molecular Mechanisms of

Experimental Pancreatitis

Pandol, Stephen J., M.D.

$128,500

The Effect of Alcohol Intake on

Mineral Metabolism

Perry, Horace M., III, M.D.

$91,000

Fibronectin Alternate Splice

Isoforms in Osteoarthritis

Peters, John H., M.D.

$58,700

Signaling Pathways Involved in

Activation and Adhesion of the

Leukocyte Integrin LFA-1

Petruzzelli, Lilli M., M.D., Ph.D.

$50,800

Genetic Determinants of 

Drug Effects

Phillips, Tamara J., Ph.D.

$88,834

Respiration in Sepsis

Piantadosi, Claude A., M.D.

$69,600

Clinical Biomechanics of Cervical

Spondylotic Degeneration

Pintar, Frank A., Ph.D.

$88,600

Mechanisms of Anti-DNA

Production in Autoimmune Mice

Pisetsky, David S., M.D., Ph.D.

$62,550

Role of PPAR-alpha on Proximal

Tubule Ischemic Cell Injury

Portilla, Didier, M.D.

$126,600

ACE Inhibition, Calcium Handling,

and Remodeling in Heart Failure

Prabhu, Sumanth D., M.D.

$87,800

Sodium Resorptive Mechanisms 

and Blood Pressure Regulation

Pratt, John H., M.D.

$90,600

Prognostic Factors in 

Renal Cell Carcinoma

Presti, Joseph C., M.D.

$108,550

Membrane Transport Mechanisms

in the Human Small Intestine

Ramaswamy, Krishnamurthy, Ph.D.

$113,350

Molecular and Cellular 

Mechanisms of Muscle Atrophy

Rando, Thomas A., M.D., Ph.D.

$86,300

Interaction of Bile Acids 

with Gastrointestinal 

Cholinergic Receptors

Raufman, Jean-Pierre, M.D.

$68,300

Medical Research

Service Projects

(continued)
34

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Role of Chloride Channels in

Oxidant-Induced Renal Cell Injury

Reeves, W. Brian, M.D.

$130,800

Optical Mapping of Repolarization

Patterns in the Long QT Syndrome

Restivo, Mark, Ph.D.

$133,469

Chromosomal Gene Exchange and

Resistance Transfer in Enterococci

Rice, Louis B., M.D.

$107,200

Biomagnetic Activity of Ischemic

Alimentary Tract Smooth Muscle

Richards, William O., M.D.

$166,388

Modulation of VEGF mRNA

Turnover and Translation

Rigby, William F. C., M.D.

$105,200

Nitric Oxide in Airway Disease

Robbins, Richard A., M.D.

$66,400

Autocrin Regulation of Mesangial

Cell Hexokinase Activity

Robey, Robert B., M.D.

$100,000

Fibronectins Modulate Epithelial

and Inflammatory Cell Interactions

Romberger, Debra J., M.D.

$29,150

Hepatocyte Growth Factor &

Vitamin D Therapy in Advanced

Prostate Cancer

Roos, Bernard A., M.D.

$136,600

Improving Compliance 

with Metformin

Rosen, Marc I., M.D.

$33,650

Cellular Heterogeneity, 

Alternans, and Structure Form

Arrhythmia Substrate

Rosenbaum, David S., M.D.

$98,600

Age-Related Changes in Cartilage

Matrix Promote CPPD Arthritis

Rosenthal, Ann K., M.D.

$51,200

T-Cell Regulation in 

Autoimmune Arthritis

Rosloniec, Edward F., Ph.D.

$170,700

Organization and Lateralization of

Affective Prosody in Brain

Ross, Elliott D., M.D.

$105,700

RNA Editing of the T-cell Receptor

in Peripheral Lymphocytes

Rubin, Donald H., M.D.

$114,100

Role of MCSF in GlucocorticoidInduced Osteoporosis

Rubin, Janet E., M.D.

$111,300

IGF-I Induced Myelination of

Sensory Axons

Russell, James W., M.D.

$56,550

Disturbance of Motoneuron

Regulation in Spinal Injury

Rymer, William Z., M.D., Ph.D.

$110,763

Morphologic and Compositional

Characterization of Carotid 

Artery Plaque

Saloner, David, Ph.D.

$124,800

Induction and Effect of

Intraprostatic Immunity to

HER2/NEU and HER3

Salup, Raoul R., M.D.

$48,950

Stem Cells as a Source of

Dopaminergic Neurons for Brain

Repair (Parkinson’s Disease)

Sanchez-Ramos, Juan R., M.D.,

Ph.D.

$170,400

Effects of Mechanical 

Ventilation on Diaphragm

Contractile Properties

Sassoon, Catherine S. H., M.D.

$115,850

The Role of Thyrotropin-Releasing

Hormone (TRH) in Antidepressant

Treatment

Sattin, Albert, M.D.

Pekary, Albert Eugene, Ph.D.

$125,000

Vascular Cell Metabolism 

in Hemostasis

Schafer, Andrew I., M.D.

$48,600

The Role of Gap Junctions in the

Anabolic Skeletal Actions of PTH

Schiller, Paul C., Ph.D.

$145,100

Mechanism of Action of 

Antiviral Drugs

Schinazi, Raymond F., Ph.D.

$125,000

Basis for the Age-Related Decline in

the Gut Mucosal Immune Response

Schmucker, Douglas L., Ph.D.

$89,900

Mitotic Proteins in Myocardial Cells

Schneider, Jay W., M.D., Ph.D.

$90,600

Importance of Hormone Sensitive

Lipase in Foam Cells in

Atherosclerosis

Schotz, Michael C., Ph.D.

$129,700

Thyroid Hormone: 

A Potential Modulator of 

Aqueous Outflow in the Eye

Schwartz, Daniel M., M.D.

$124,500

The Biology of BCG Tumor Cell

Interaction: Role of Interleukin-6

See, William A., M.D.

$120,650

Neural Development, Plasticity 

and Regeneration

Seil, Fredrick J., M.D.

$62,500

Allosteric Regulation of 

Intrinsic Tenase: 

A Novel Antithrombotic Target

Sheehan, John P., M.D.

$27,600

Sodium-calcium Exchange 

and Transverse Tubules in 

Cardiac Hypertrophy

Shepherd, R. Neal, Ph.D.

$143,272

Regeneration and Neural

Transplant Integration in Lesioned

Hippocampus During Aging

Shetty, Ashok K., Ph.D.

$125,150

Structural Neuroimaging 

in Kraepelinian and 

Non-Kraepelinian Schizophrenia

Shihabuddin, Lina, M.D.

$98,900

Gender Dependent Regulation of

Hepatic Alcohol Dehydrogenase

Simon, Francis R., M.D.

$144,200

Medical Research

Service Projects

(continued)
35

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Medical Research

Service Projects

(continued)

Mechanism of Porphyria Caused by

TCDD and Other Compounds

Sinclair, Peter, Ph.D.

$131,000

Osteopontin Expression in 

Heart and its Role in 

Myocardial Remodeling

Singh, Krishna, Ph.D.

$142,200

Muscle Metaboreceptor

Desensitization in Heart Failure

Sinoway, Lawrence, M.D.

$114,500

Mechanisms of 

Ischemia-Induced Corporal 

Veno-Occlusive Dysfunction

Siroky, Mike B., M.D.

$124,500

Sleep-disordered Breathing: Causes

and Cardiovascular Consequences

Skatrud, James B., M.D.

$143,500

Is the Human Fibroblast a

Significant Mediator of 

Thyroid Disease?

Smith, Terry J., M.D.

$70,500

Signal Transduction in 

Pneumocystis carinii

Smulian, A. George, M.B., B.Ch.

$130,200

Dysregulated Apoptosis and

Resistance of Prostate Cancer 

to Chemotherapy

Smyth, Miriam J., Ph.D.

$3,600

Antimicrobial Activity 

of Calprotectin

Sohnle, Peter G., M.D.

$35,200

Pathogenesis of Diabetes 

Mellitus: Studies of Insulin 

Action and Calmodulin

Solomon, Solomon S., M.D.

$61,100

Alcohol and HepatocyteExtracellular Matrix Interactions

Sorrell, Michael F., M.D.

Tuma, Dean J., Ph.D.

$125,000

Intestinal Microvascular 

Control During the Trauma of

Hemorrhagic Shock

Spain, David A., M.D.

$84,800

Mechanisms of Synaptic Integration

in Central Neurons

Spain, William J., M.D.

$131,600

Isolation of Cervical Cancer 

Tumor Suppressor Gene

Srivatsan, Eri S, M.S., Ph.D

$84,300

Focal Sources of Atrial Fibrillation

in Experimental Heart Failure

Stambler, Bruce S., M.D.

$112,600

Evaluation of the 

Mechanism of Antibody 

Negative Hepatitis C Infection

Stapleton, Jack T., M.D.

$140,900

Preclinical Trials of Gene 

Transfer in the Treatment of

Endstage Limb Ischemia

Stedman, Hansell H., M.D.

$135,700

Streptococcal Toxic Shock

Syndrome: Mechanisms of 

Vascular Dysfunction

Stevens, Dennis L., M.D., Ph.D.

$119,300

Aging and Cardiac Sympathetic

Nervous System Function

Stratton, John R., M.D.

$21,431

Adenosine and the Basal Forebrain

in the Control of Behavioral State

Strecker, Robert E., Ph.D.

$118,150

Connective Tissue Degradation in

Skin Cancers

Stricklin, George P., M.D., Ph.D.

$58,100

Neurotoxic Metabolite of

Dopamine in Neuropathology of

Parkinson’s Disease

Strong, Randy, Ph.D.

$175,000

Reactivated Neurologic 

Herpetic Disease

Stroop, William G., Ph.D.

$142,600

Physiologic Effects of 

PRMST & Testosterone in the

Debilitated Elderly

Sullivan, Dennis H., M.D.

$133,100

Mechanical Stretch of Vascular Cells

Sumpio, Bauer E., M.D., Ph.D.

$123,700

Hypothalamic and Basal Forebrain

Regulation of Sleep and Arousal

Szymusiak, Ronald S., Ph.D.

$136,200

The Cytokine Environment

Determines Immune Proliferation

and Apoptosis

Thompson, John S., M.D.

$75,100

Homeostatic Efficiency of

Tubuloglomerular Feedback

Thomson, Scott C., M.D.

$61,300

Pulmonary Defenses to

Opportunistic Infections in the

Compromised Host

Toews, Galen B., M.D.

$148,600

Gene Therapy in Spinal Cord Injury

Tuszynski, Mark H, M.D., Ph.D.

$137,000

Control of CNS Progenitor 

Cell Development for 

Functional Restoration

U, Hoi Sang, M.D.

$113,600

Molecular Mechanisms of

Anesthesia: Antagonists of 

Volatile Anesthetics

Ueda, Issaku, M.D., Ph.D.

Kamaya, Hiroshi, M.D., Ph.D.

$45,800

Regulation of 

Carbohydrate Metabolism

Uyeda, Kosaku, Ph.D.

$136,800

Senescent Fibroblasts: 

A Missing Link to 

Understanding Wound Chronicity

Vande Berg, Jerry S., Ph.D.

$86,662

Immunoregulation of 

Myelin-Specific T Lymphocytes

Vandenbark, Arthur A., Ph.D.

$175,000

Follow-up of Psychological and

Neurocognitive Gulf War Outcome:

Relation to Stress

Vasterling, Jennifer J., Ph.D.

$81,750
36

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Neurochemical Interactions

Between Vitamin E and

Apolipoprotein E

Vatassery, Govind T., Ph.D.

$149,900

Regulation of Renal Distal Tubule

Salt Transport Mechanisms

Velazquez, Heino, Ph.D.

$201,700

Biochemical Pharmacology 

and Toxicology of Carboxylic 

Acid Conjugation

Vessey, Donald A., Ph.D.

$124,900

Pharmacology and Molecular

Modeling of Cytochrome P450 

1A1 Inhibition

Vestal, Robert E., M.D.

$37,400

Co-Distribution of Risk Factors in

Families of Schizophrenics

Waldo, Merilyne C., Ph.D.

$102,564

Regulation of Vascular

Diacylglycerol Kinase

Walsh, James, M.D., Ph.D.

$96,200

Inhibitory Mediators of 

Gastric Acid Secretion

Walsh, John H., M.D.

$123,500

Neurochemistry of 

Post-Traumatic Epilepsy

Wasterlain, Claude, M.D.

$153,500

Alternative Splicing of the IR Gene

Webster, Nicholas J. G., Ph.D.

$165,100

Effects of Glucocorticoids on Bone

Cell Development and Remodeling

Weinstein, Robert S., M.D.

$78,250

Mechanisms of Drug Induced

Pulmonary Hypertension

Weir, Edward K., M.D.

$127,300

Non-B Lactamase Mediated

Antimicrobial Resistance in

Bacteroides fragilis Group

Organisms (V)

Wexler, Hannah M., Ph.D.

$74,950

Immunopathogenesis of

Histoplasmosis

Wheat, L. Joseph, M.D.

$120,100

Recombinant Commensals for the

Study of Mucosal Immunity and

Immunologic Tolerance

Wilson, Kenneth H, M.D.

$102,600

Matrix Metalloproteases in 

Prostate Cancer Progression

Wilson, Michael J., Ph.D.

$156,407

Seizures and Neuroplasticity:

Physiology and Biochemistry

Wilson, Wilkie A., Ph.D.

$106,450

Ion Transport in the Collecting Duct

Wingo, Charles, M.D.

$133,500

Molecular Mechanisms of

Androgen Regulation of 

Osteoblast Function

Wiren, Kristine M., Ph.D.

$175,400

Murine Models of

Immunodeficiency-Related 

CMV Auditory System Infections

Woolf, Nigel K., Sc.D.

$141,400

Molecular and Genetic Studies of

Bladder Tumorigenesis

Wu, Xue-Ru, M.D.

$124,300

Glycolipid Function in Normal and

Defective Macrophages

Yohe, Herbert C., Ph.D.

$135,278

The Role of 5-HT2 Receptors in

Atypical Antipsychotic Action

Young, Keith A., Ph.D.

$69,250

Pigment Epithelium 

Removal and Transplantation

Zarbin, Marco A., M.D., Ph.D.

$122,200

Protective Aspects of 

Antibodies Against HIV

Zolla-Pazner, Susan, Ph.D.

$67,650

Role of Endothelin-1 in HypocapnicInduced Cerebral Vasoconstriction

Zuccarello, Mario, M.D.

Rapaport, Robert M., Ph.D.

$73,600

Medical Research

Service Projects

(continued)

Rehabilitation

Research and

Development

Projects

A Measurement of the 

Efficacy of an Adult Aural

Rehabilitation Program

Abrams, Harvey, Ph.D.

$70,220

Factors Contributing to Older Adult

Disability in Rising from a Bed and

from the Floor

Alexander, Neil, M.D.

$124,046

Career Development Project

Auther, Linda, Ph.D.

$92,528

Prevention of Bone Loss in Acute

and Chronic Spinal Cord Injury

Bauman, William, M.D.

$57,170

Effects of Work Activity and

Cognitive Rehabilitation on

Schizophrenia: A Matching Study

Bell, Morris, Ph.D.

$190,800

Evaluation of Robotic Upper

Extremity Neuro-Rehabilitation

Bever, Jr., Christopher, M.D.

$100,000

Feasibility of a Cross Trained

Rehabilitation Therapy Assistant on

an Inpatient Rehabilitation Team:

Blake, Donna Jo, M.D.

$12,500

The Effect of Hydrostatic Pressure

on Intervertebral Disc Metabolism

Boden, Scott, M.D.

$54,443

Synergy of Osteoinductive 

Protein and Electric Stimuli for

Spinal Fusion

Boden, Scott, M.D.

$140,000
37

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Electrical Control of 

Bowel and Bladder in Spinal 

Cord Injury Patients

Bodner, Donald, M.D.

$267,000

Investigation of Dynamic 

Prosthetic Function: Flexibility

Boone, David, CP.

$86,502

A Prospective Study of 

Plantar Foot Pressure and 

Diabetic Foot Ulcer Risk

Boyko, Edward, M.D., M.P.H.

$189,431

Long-Term Strength Training and

Functional Status in Older Adults

Brandon, L. Jerome, Ph.D.

$105,800

Graded Weight-Bearing 

Exercise for Improving Leg

Movement After Stroke

Brown, David A., Ph.D.

$127,407

Improving Stepping-Over 

Responses in the Elderly Using

Simulated Objects

Brown, David, Ph.D.

$93,700

Differential Pressure 

Walking Assistance

Burgar, Charles G., M.D.

$91,700

Mechanically Assisted Upper 

Limb Movement for Assessment

and Therapy

Burgar, Charles G., M.D.

$108,671

Dichotic Listening and Audiologic

Rehabilitation in Elderly Patients

Carter, Anne, Ph.D.

$88,933

Prediction and Early 

Detection of Damage 

Accumulation in Human Tendons

Carter, Dennis, Ph.D.

$118,200

Mechanical Regulation of PeriProsthetic Tissue Differentiation

Carter, Dennis, Ph.D.

$139,685

Stimulation of Bone Healing Using

Bone-Matrix Related Biomaterials

Chakkalakal, Dennis, Ph.D.

$120,000

Finite Element and Gait Analysis:

Tools for Prosthesis Design

Childress, Dudley, Ph.D.

$198,400

Generalized EPP Position 

Controller for Electric-Powered

Upper-Limb Prostheses

Childress, Dudley, Ph.D.

$158,400

Technology Transfer of a Computer

Aided Socket Fabrication Technique

Childress, Dudley, Ph.D.

$110,979

Validation and Field Testing 

of a National Pain Treatment

Outcome System

Clark, Michael, Ph.D.

$63,050

Assessing Outcomes of 

Pulmonary Rehabilitation

Collins, Eileen, Ph.D.,

$43,421

Characterizing Postural 

Stability in Relation to Age and

Susceptibility to Falling

Collins, James, Ph.D.

$169,038

Behavioral and Functional 

Problems in Dementia Patients 

with Sensory Loss

Connell, Bettye Rose, Ph.D.

$76,182

Center of Excellence for Wheelchair

and Related Technology-WART

Cooper, Rory A., Ph.D.

$263,500

Effects of Cushion and 

Back Support on Wheelchair 

Ride Comfort

Cooper, Rory A., Ph.D.

$157,300

Improvement of Control for Electric

Powered Wheelchair

Cooper, Rory A., Ph.D.

$6,250

Manual Wheelchair User Upper

Extremity Pain

Cooper, Rory A., Ph.D.

$66,767

Restoration of Proximal Arm

Function by FES

Crago, Patrick, Ph.D.

$256,400

Electrical Control of 

Bowel and Bladder in Spinal 

Cord Injury Patients

Creasey, Graham, M.D.

$73,767

Home Bladder Monitoring:

Biomechanics and 

Clinical Applications

Damaser, Margot, Ph.D.

$134,912

The Neural Basis of Stress 

Urinary Incontinence

Damaser, Margot, Ph.D.

$18,750

UTI Prophylaxis Using Bacterial

Interference Following SCI

Darouiche, Rabih O., M.D.

$116,709

Outcome Assessment of 

the Rehabilitation of the 

Visually Impaired

De l'Aune, William R., Ph.D.

$151,750

Outcomes of the 

Outpatient Rehabilitation of 

the Visually Impaired

De l'Aune, William R., Ph.D.

$81,750

Effects of Stimulus Variability on

Speech Recognition

Dirks, Donald, Ph.D.

$99,016

Gait Mechanics of the 

Partial Foot Amputee

Dorostkar, Mohammad G., M.D.

$74,483

Quantifying Spoken Language

Handicap in Aphasia

Doyle, Patrick, Ph.D.

$64,600

Characterizing Measures of Stroke

Rehabilitation Outcomes

Duncan, Pamela W., Ph.D.

$63,500

Effects of Aging Motor Unit Firing

Behavior-Continuation

Erim, Zeynep, Ph.D.

$161,317

Biochemical Analysis of Synovial

Activation in Joint Dysfunction

Evans, Christopher, Ph.D.

$149,752

Rehabilitation

Research and

Development

Projects 

(continued)
38

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Development of an Automated

Technique for the Clinical

Evaluation of Tinnitus

Fausti, Stephen A., Ph.D.

$68,000

Investigation of Individualized

High-Frequency Regions for Early

Detection of Ototoxicity

Fausti, Stephen A., Ph.D.

$253,600 

Veterans Affairs Center for 

Rehab Auditory Research

Fausti, Stephen A., Ph.D.

$688,000

Improved Bone-Formation 

Through VEGF

Fava, Roy, Ph.D.

$25,000

A Computer-Controlled Power

Wheelchair Navigation System

Fehr, Linda, M.S.

$30,250

A Computerized Device for

Fabricating Sockets with 

Variable Stiffness

Gard, Steven, Ph.D.

$103,760

Investigation of the Functional

Biomechanics of Normal and

Lower-Limb Amputee Gait

Gard, Steven, Ph.D.

$85,515

A Study to Determine the

Biomechanical Effects of 

Shock-Absorbing Pylons

Gard, Steven, Ph.D.

$103,998

FDG-PET Imaging in the

Management of the Painful 

Total Hip Prosthesis

Garino, Jonathan, M.D.

$88,025

In Vivo Tissue Response to In 

Vitro Synthesized Bone

Garino, Jonathan, M.D.

$108,500

New Strategy for Improved

Outcome in Occult Periprosthetic

Musculoskeletal Infections

Garvin, Kevin, M.D.

$88,900

Effects of Common Drugs on

Recovery After Stroke

Goldstein, Larry, M.D.

$54,800

VA RR&D Brain 

Rehabilitation Center

Gonzalez-Rothi, Leslie J., Ph.D.

$261,212

Development of Improved 

Middle Ear Prostheses

Goode, Richard, M.D.

$59,300

Cortical Sensorimotor

Reorganization in Spinal 

Cord Injury

Green, Joseph, M.D.

$104,000

Functional Restoration of 

Grasp in Quadriplegia

Hentz, Vincent R., M.D.

$214,194

Effects of Chronic Pain and

Dynamic Exercise on Pain Patients

Hoffman, Martin, M.D.

$28,650

Impact of Occupational 

Therapy on the Health Status of

Elderly Veterans

Holleman, Jr., Donald, M.D.

$128,000

Prevention of Recurrent Pressure

Ulcers After Myocutaneous Flap

Holmes, Sally, M.D.

$99,300

Changes in Auditory Abilities 

with Hearing Aid Use

Holte, Lenore, Ph.D.

$49,450

Clinical Testing of the Enhanced

VA-Cyberware BK Prosthetics

Optical Digitizer

Houston, Vern, Ph.D.

$95,179

Evaluation of Prosthetics 

Hand Held Digitization &

Virtual Casting Systems

Houston, Vern, Ph.D.

$47,800

Orthopedic Footwear 

CAD/CAM and Diabetic Risk of

Pedal Ulceration

Houston, Vern, Ph.D.

$263,254

Disuse Induced Articular Cartilage

Atrophy, Over-Exercise and Arthritis

Howell, David, M.D.

$44,750

Cause of Male Infertility 

After Spinal Cord Injury 

and its Prevention

Huang, Hosea, Ph.D.

$192,671

The Effect of Compressive Force 

on the Disc In Vivo

Hutton, William, D.Sc.

$79,150

Gonadal Steroids as 

Rehabilitative Agents After 

Partial Spinal Cord Injury

Jones, Kathryn, Ph.D.

$116,200

Promotion of Functional Recovery

Following Spinal Cord Injury

Jones, Kathryn, Ph.D.

$250,150

Frequency Selectivity 

Assessment: Implications for

Auditory Rehabilitation

Kane, James, Ph.D.

$24,650

Electric Field Effects on 

Slow Axonal Transport 

Components in SCI

Khan, Talat, Ph.D.

$141,942

Fracture Occurrence and Healing in

Spinal Cord Injured Patients

Kiratli, Beatrice Jenny, Ph.D.

$64,425

Static Versus Dynamic FES 

Exercise and Heart Disease Risk

Factors in SCI

Kiratli, Beatrice Jenny, Ph.D.

$112,700

The Effects of Spinal

Instrumentation

Kirkpatrick, John, M.D.

$55,225

The Impact of Blind Rehabilitation

on Quality of Life in Visually

Impaired Veterans

Kuyk, Thomas, Ph.D.

$49,950

Polestriding Exercise and 

Vitamin E for Management of

Claudication Pain

Langbein, W. Edwin, Ph.D.

$78,810

Quantitative Study and

Augmentation of Cough in Persons

with Spinal Cord Injury

Langbein, W. Edwin, Ph.D.

$72,100

Rehabilitation

Research and

Development

Projects 

(continued)
39

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Comparing Off-Loading Modalities

to Heal Diabetic Foot Wounds

Lavery, Lawrence, DPM

$92,000

The Effect of Exercise 

Training on Hemoglobin A1c's of

Type II Diabetics in a Controlled

Randomized

Leach, Carol, MHA

$48,600

Physical Exercise Strength 

Training to Improve the Health of

Dialysis Patients

Leaf, David, M.D.

$75,250

Biomechanics of the Glenohumeral

Joint in Spinal Cord Injury Patients

Lee, Thay, M.S.

$120,300

Biomechanics of the 

Patellofemoral Joint

Lee, Thay, M.S.

$54,900

Mechanical Basis for Surgical

Transfer of Forearm Muscles

Lieber, Richard, Ph.D.

$256,600

Functional Magnetic Cough in

Patients with Spinal Cord Injury

Lin, Vernon, M.D.

$115,600

Functional Magnetic Micturition in

Patients with Spinal Cord Injury

Lin, Vernon, M.D.

$55,900

Prevention of Bladder Stones

Following Spinal Cord Injury

Linsenmeyer, Todd, M.D.

$100,900

Eustachian Tube and 

Middle-ear Prosthesis Implants:

Chronic Ear Disease

Linstrom, Christopher, M.D.

$69,057

A Biodegradable Device for

Peripheral Nerve Repair

Madison, Roger, Ph.D.

$109,451

Development of the Scanning Laser

Ophthalmoscope for Low Vision

Rehabilitation - Phase 2

Maino, Joseph, O.D.

$207,900

Design of New Toilet Inserts for

Disabled and Elderly Veterans

Malassigne, Pascal, M.D.

$76,800

Design of a New Collapsible Bowel

Care-Shower Chair for SCI Veterans

Malassigne, Pascal, M.D.

$100,207

Redesign & Evaluation of a Device

for Rehabilitation of People with

Visual Field Loss

Mancil, Rickilyn, M.A.

$49,900

Use of Tretinoin to Prevent Pressure

Ulcers in Spinal Cord Injury Patients

Markowski, Janusz, M.D.

$12,175

Problem Solving Strategies of 

Brain Injured and Normal Subjects

Marshall, Robert C., Ph.D.

$62,000

Clinical Evaluation of a

Dermofluorometer in 

Diabetic Patients

Marshall, William, M.D.

$11,575

Long-Term Evaluation of 

Maxillary Sinus Bone Grafts with

Dental Implants

McAnear, Jon Tom, D.D.S.

$24,120

An In-Vivo Model for 

Cartilage Regeneration

McGuire, Jr., Hunter, M.D.

$218,900

Development of Quality of Life

Measures for Use in Dysphagia

McHorney, Colleen, Ph.D.

$83,300

Electrophysiology Indices: 

Auditory Discrimination and

Cognitive Processes

Moenter, Darlene, Ph.D.

$72,000

Electrical Activation of the

Diaphragm for Ventilatory Assist

Mortimer, J. Thomas, Ph.D.

$234,000

Physical Activity in Persons with

Multiple Sclerosis

Mulcare, Janet, Ph.D.

$170,700

Sweat Response in MS Patients

During Exercise - A Pilot Study

Mulcare, Janet, Ph.D.

$21,300

Anatomical Basis of

Osseoperception

Myers, Robert, Ph.D.

$105,000

Quantifying Auditory 

Perceptual Learning Following

Hearing Aid Fitting

Nelson, Charles, M.S.

$99,300

A Minimal Test Effort for 

Patients in Pain Using the Back

Analysis System

Oddsson, Lars

$185,420

Preventing Slips & Falls in the

Elderly – Effects of Simple

Biomechanical Interventions

Oddsson, Lars

$190,250

Fracture Prediction for Femurs with

Wear Particle-Induced Osteolytic

Lesions Associated with Joint

Replacement Prostheses

Orr, Tracy, Ph.D.

$100,233

Effects of Functional Incidental

Training (FIT) in VA NHCU Residents

Ouslander, Joseph, M.D.

$159,384

Prorgam Analysis and Review

Section Administration

Ouslander, Joseph, M.D.

$164,127

Physical Conditioning in

Management of Chronic 

Venous Insufficiency

Padberg, Jr., Frank, M.D.

$70,500

Motor-Unit Firing 

Patterns in Hemiplegia

Patten, Carolyn, Ph.D.

$95,712

Effect of Spinal Implants on the

Response of the Lumbar Spine

Under In Vivo Compressive Loads

Patwardhan, Avinash, Ph.D.

$101,100

Rehabilitation

Research and

Development 

Projects 

(continued)
40

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Effect of the Type of 

Annular Incision on the

Postoperative Stability of a

Herniated Lumbar Disc

Patwardhan, Avinash, Ph.D.

$40,432

Microphotodiode Tiles as 

Prostheses for the Restoration of

Visual Function

Peachey, Neal, Ph.D.

$127,645

FES Control of the Upper 

Extremity in SCI

Peckham, P. Hunter, Ph.D.

$411,750

Functional Electrical Stimulation

Center of Excellence

Peckham, P. Hunter, Ph.D.

$878,400

Bicycle Exercise Feedback 

as an Intervention for those 

with Gait Deficits

Perell, Karen, Ph.D.

$85,101

Prostate Compliance of Patients

with Spinal Cord Injuries

Perkash, Inder, M.D.

$72,600

Improvements in a New 

Technique for Increasing 

Movement after Stroke

Pidikiti, Rama D., M.D.

$93,075

Outcome of Lower Extremity

Constraint-Induced Therapy 

After Stroke

Pidikiti, Rama D., M.D.

$195,800

Effects of Medications on 

Spasticity in Spinal Cord Injury: 

A Quantitative Study

Priebe, Michael, M.D.

$123,200

Clinical Trial of Footwear in

Patients with Diabetes

Reiber, Gayle, Ph.D.

$147,399

Colonic Rehabilitation with

Microstimulators After Spinal 

Cord Injury

Riedy, Lisa, Ph.D.

$89,300

Effects of Acute Spinal Cord Injury

on Colonic Motility and Tone

Riedy, Lisa, Ph.D.

$49,200

Effects of VA BRC Mobility Training

on Gait, Posture and Balance

Riolo, Lisa, PhD

$49,975

Restricted Useful Field of View as a

Risk Factor for Falls in Older Adults

Riolo, Lisa, Ph.D.

$79,950

Role of Attention Status in Fall 

Risk in Older Adults

Riolo, Lisa, Ph.D.

$70,352

Motion and Velocity Encoder 

for Monitoring Essential or

Neurological Tremor (Movement)

Robinson, Charles, D.Sc.

$61,275

Physical Performance Measures 

for Young, Middle-Aged and

Elderly Manual Wheelchair Users

Rodgers, Mary, Ph.D.

$124,500

Employment of Infra-Red 

Beacons as Guides for People 

with Visual Disability

Ross, David, M.S.E.E

$37,485

Back Exercise Prescription and

Implementation by Surface

Electromyographic Procedures

Roy, Serge H., Sc.D.

$50,167

Functional Neuromuscular

Stimulation (FNS) for Chronic

Stroke Patients

Ruff, Robert, M.D., Ph.D.

$12,500

Restoration of Gait for Acute

Stroke Patients Using FES

Ruff, Robert, M.D., Ph.D.

$169,200

Advanced Accelerometric 

Motion Analysis System

(Design/Development)

Sabelman, Eric, Ph.D.

$97,600

Clinical Trial of Artificial 

Peripheral Nerve Graft

Sabelman, Eric, Ph.D.

$211,652

Reliability and Validity of

Accelerometric Gait and 

Balance Diagnosis

Sabelman, Eric, Ph.D.

$193,107

Biomechanics of Foot 

Deformities and Alternatives for

Surgical Correction

Sangeorzan, Bruce, M.D.

$100,075

RR&D Center for Amputation,

Prosthetics, Limb Loss Prevention

Sangeorzan, Bruce, M.D.

$740,642

Neurotrophin Secreting 

Schwann Cells for Treatment of

Spinal Cord Injury

Sayers, Scott, Ph.D.

$37,500

Fatigue Strength of 

Composite Femoral Components

for Hip Arthroplasty

Schutte, Jr., H. Del., M.D.

$48,740

FES on Spinal Cord Injured 

Patients: Effects on Muscle Blood

Flow and Metabolism

Scremin, A.M. Erika, M.D.

$60,500

Evaluation of Limb Blood Flow

Measurements with H2150 PET to

Determine Level of Amputation

Scremin, Oscar, M.D., Ph.D.

$37,500

Acclimitization in 

Monaurally Fitted Adults

Silman, Shlomo, Ph.D.

$87,977

Effects of Aerobic Exercise on 

Gait and Functional Performance 

in Hemiparetic Stroke

Silver, Kenneth, M.D.

$110,200

Mechanical Loading Effects on

Cartilage Repair and Regeneration

Smith, Robert Lane, Ph.D.

$53,800

Mechanical Loading Effects on

Cartilage Repair and Regeneration

Smith, Robert Lane, Ph.D.

$65,884

Home-Based Pulmonary

Rehabilitation via a

Telecommunications System

Sparrow, David, D.Sc.

$98,161

Rehabilitation

Research and

Development

Projects 

(continued)
41

New Knowledge Advancing Health Care for Veterans • 1999 Annual Report

Summary of 1999 Research and Development Projects

Randomized Controlled Trial of

Upper-Extremity Exercise Training

in Patients with COPD

Sparrow, David, D.Sc.

$62,500

Effectiveness of a Home-Based

Pulmonary Rehabilitation Program

Spurzem, John, M.D.

$73,562

Team Characteristics and Patient

Outcomes on VA Rehab Services

Strasser, Dale, M.D.

$137,600

Cortical Contributions to the

Recovery of Motor Function

Strick, Peter, Ph.D.

$194,425

Visual Rehabilitation with 

Retinal Prosthetic Microtiles

Stubbs, Jr., Evan, Ph.D.

$36,375

Orthostatic Manipulation of 

Blood Flow and Cognitive 

Functions in the Elderly

Swamy, Lalitha, M.D.

$26,750

Assessment of Reading Capabilities

of the Parafoveal Retina and

Evaluation of Techniques to

Szlyk, Janet P., Ph.D.

$337,175

Evaluation of Central and

Peripheral Vision Enhancement

Devices for Driving

Szlyk, Janet P., Ph.D.

$86,400

Predictors of Driving 

Performance& Successful Mobility

Rehab in Patients with Medical 

Eye Conditions

Szlyk, Janet P., Ph.D.

$119,600

Exercise, Standing and Ambulation

with Implanted FES Systems

Triolo, Ronald, Ph.D.

$290,925

Development of an Assistive Robot

for Effective Health Care Delivery

Van Der Loos, Hendrik, Ph.D.

$162,279

Driver's Simulation Environment for

Arm Therapy: A Pilot Study

Van Der Loos, Hendrik, Ph.D.

$37,275

Noninvasive Recording of 

Bladder Pressure in Elderly Males

Walter, James, Ph.D.

$15,150

Treatment of Urinary 

Incontinence in Women: 

Use of an Information System

Walter, James, Ph.D.

$12,250

Evaluation of Deficit-Oriented

Treatments for Aphasic 

Naming Disorders

Wambaugh, Julie, Ph.D.

$167,600

Impact of Low Vision and

Rehabilitation on Elder Literacy

Watson, Gale, M.A., Ed.D.

$119,040

Rehab R&D Center for 

Restoration of Function in SCI &

Multiple Sclerosis

Waxman, Stephen, M.D., Ph.D.

$239,179

Fading-in of Right Hemispatial

Information in the Treatment of

Unilateral Neglect

Webster, Jeffrey, Ph.D.

$95,800

Development of an Externally

Powered Prosthetic Hand for

Persons with Partial Hand

Amputations

Weir, Richard, Ph.D.

$106,659

Cultural Influence on Aphasia in

African Americans

Wertz, Robert, Ph.D.

$83,335

Sensitivity and Specificity of a

Clinical Examination of Swallowing

Wertz, Robert, Ph.D.

$112,556

Predicting Real-World Visual

Problems in the Elderly from 

Vision Tests

White, Janis, Ph.D.

$85,000

Evaluation of Word-Recognition

Performance with Sentence

Materials

Wilson, Richard, Ph.D.

$119,000

Biological Responses in the

Pathogenesis of Aseptic Loosening

Wooley, Paul, Ph.D.

$174,900

Rehabilitation

Research and

Development

Projects 

(continued)
Note of Appreciation

We are deeply grateful to all veterans who have participated in VA 

research studies. Without the cooperation of thousands of veteran 

patients, high quality health care research would not be possible.

Veterans’ partnership with VA investigators allows us to conduct 

research that contributes to the health of veterans and all Americans.
Copies of this annual report and other VA Research and Development 

information are available on the World Wide Web at: 

http://www.va.gov/resdev or on the intranet at http://vaww.va.gov/resdev

Look under “What’s New?” to see recent additions to the R&D web page.

For additional information on VA Research and Development activities, contact:

Office of Research and Development (12)

Veterans Health Administration

Department of Veterans Affairs

810 Vermont Avenue, NW

Washington, DC 20420

(202) 273-8284
Office of Research and Development (12)

Veterans Health Administration

Department of Veterans Affairs

810 Vermont Avenue, NW

Washington, DC 20420

(202) 273-8284