Translating

Research

IntoPractice

1998 Annual Report
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 ..................................................................................................................... 5

Translating Research Into Practice ............................................................................ 7

Science at the Cutting Edge

The Medical Research Service ................................................................................ 10

Applying New Knowledge

The Cooperative Studies Program ........................................................................... 12

Delivering Quality Care

The Health Services Research and Development Service ......................................... 13

Improving Quality of Life

The Rehabilitation Research and Development Service ............................................ 16

Making a Difference

Dissemination ......................................................................................................... 18

Enhancing Research Efforts

Research Collaborations ......................................................................................... 21

Funding for Research .............................................................................................. 22

Opportunities and Challenges

Future Outlook ........................................................................................................ 24

Research and Development Career Development Awardees 1998 .......................... 27

Summary of 1998 Research and Development Projects ........................................... 31
4 Translating Research Into Practice 1998 Annual Report
1998 Annual Report Translating Research Into Practice 5

Preface

Amid sweeping transformation, VA

continues to keep its sights focused

on one constant and overriding

goal: its mission of providing

excellent health care for America’s

veterans. Critically important to

guiding and supporting this mission

is VA’s research program managed

by the Office of Research and

Development.

The Office of Research and

Development focuses on those

health problems that affect veterans

most, its highly successful programs

spanning the entire range of

biomedical, clinical, health services, rehabilitation and epidemiologic research. It also produces

technology assessments on new

medical treatments, devices, and

techniques. VA researchers have

long played key roles in developing important health care innovations, and are dedicated to keeping VA at the cutting edge of

science and medicine.

Under the leadership of Chief

Research and Development Officer

John R. Feussner, M.D., the VA

research enterprise is strengthening

its connection with patient care, so

that lessons gleaned from newly

acquired knowledge are quickly

put into practice where they can

benefit veterans.

This second annual VA research

report provides an overview of the

Office of Research and Development, including details of its evolving structure and highlights of its

recent contributions to improving

veterans’ health care. More than

anything, this report underscores

the commitment of VA research to

helping VA provide the best possible care for our patients. I am

happy to share this document with

you and hope you will find it a

useful resource.

Kenneth W. Kizer, M.D., M.P.H.

Under Secretary for Health
6 Translating Research Into Practice 1998 Annual Report

John R. Feussner, MD

Chief Research and Development Officer

“No other research program

in the United States has

as much opportunity

to directly improve

the lives of patients

as does the VA’s

Office of Research and

Development.”
1998 Annual Report Translating Research Into Practice 7

No other research program in the

United States has as much opportunity to directly improve the lives of

patients as does the VA’s Office of

Research and Development. As

one of the largest integrated health

care systems in the United States,

the VA provides care to nearly 3.5

million veterans. Nested within this

dynamic and evolving health care

system, the Office of Research and

Development is able to put into

practice the findings of its scientific

investigations and trials and observe their effects. Here, the

discovery and the application of

new health care knowledge go

hand in hand.

Shortly after World War II the

modern VA research program

began with a $1 million appropriation to fund prosthetic research,

education, and training to meet the

needs of amputees returning home

from the battlefield. The foundation

of the fledgling program was built

on affiliations between VA medical

centers and schools of medicine

and on models of care used in

academic medicine. In the late

1950s, research became embedded in VA’s authorizing legislation.

As a result, research increasingly

became an integral part of VA

medical center operations. This, in

turn, nurtured the environment for

excellence in patient care for

America’s veterans.

Today, the scope of the VA research

portfolio extends from basic laboratory research on the cause, treatment, and cure for a variety of

diseases, disorders, and disabilities

to research on patient care management. Although the program’s

emphasis is on diseases and disorders that affect veterans, the results of

VA research are applicable to the

health of all Americans.

The mission of the VA research

enterprise is “to discover knowledge

and create innovations that advance

the health and care of veterans and

the nation.” In its strategic plan, the

Office of Research and Development

identified a number of goals, objectives and strategies in support of this

mission. Key among these are goals

to:

• Sustain an environment of

inquiry that is conducive to the

highest quality of research,

education, and patient care.

• Integrate basic, clinical, and

applied research in the best

way to meet the health care

needs of veterans.

• Ensure that new research results

reach clinical care and health

system operations settings,

where they can make a

difference in veterans’ health.

Translating Research Into Practice
8 Translating Research Into Practice 1998 Annual Report

These goals reinforce VA’s commitment to research as it charts a

course through the dramatic

changes that are reshaping health

care delivery not only in VA, but

also throughout the country. As the

focus of VA’s clinical care enterprise shifts from hospital-based

services to patient-centered, ambulatory-based care, VA’s research

activities will play an increasingly

important role in informing and

effecting that transformation.

The Office of Research and

Development at VA National

Headquarters oversees research

within VA through its four service

areas:

The Medical Research Service

provides knowledge of the fundamental biological processes to form an

understanding of disease pathology,

diagnosis, and treatment.

The Cooperative

Studies Program

applies the knowledge gained from

medical research to patients by

determining the effectiveness of novel

or unproved therapies using

multicenter clinical intervention trials.

The Health Services Research

and Development Service

contributes to improving the quality,

effectiveness, efficiency, and accessibility of health care services for

veterans.

Designated Research Areas

Acute and Traumatic Injury

• Amputation (due to injury or disease)

• Bone fractures and joint injuries

(including repair and replacement)

• (Traumatic) brain injury

• Multi-organ failure

• Shock (including sepsis)

Military & Environmental Exposures

• Emerging pathogens

• Post-traumatic stress disorder (PTSD)

• Psychological stress (including violence,

sexual abuse)

• Thermal exposure (burns, hypothermia)

• Toxins and irritants (e.g., dermal, reproductive,

and respiratory)

Chronic Diseases

• Bone and joint disorders

(including chronic low back pain,

osteoarthritis and osteoporosis)

• Cancers (adult leukemia/lymphoma, and

solid tissue tumors; including cancer pain)

• Cardiovascular, cerebrovascular and peripheral

vasculardiseases (including related acute

events such as myocardial infarction, stroke,

and heart failure)

• Chronic infectious diseases (HIV/AIDS,

hepatitis)

• Chronic lung disease

• Chronic renal disease

• Dementia & neuronal dysfunction

(including Alzheimer’s Disease, Parkinson’s)

• Diabetes & major complications

• Gastrointestinal disorders (including bowel

and liver disorders)

• Spinal cord injury & regeneration

Sensory Disorders and Loss

• Hearing disorders

• Vision disorders

• Disorders of taste and smell
1998 Annual Report Translating Research Into Practice 9

The Rehabilitation Research

and Development Service

addresses the minimization of

disability and restoration of function in veterans disabled by trauma

or disease.

While each of these four services

have particular foci and expertise,

the new strategic plan for VA

research streamlines and combines

appropriate goals and objectives

into one integrated effort. Built into

this plan, Designated Research

Areas identify primary research

targets prevalent in the veteran

patient population. (See below for

detailed listing). These Designated

Research Areas cut across the

Mental Illness

• Anxiety disorders

• Behavioral disorders

• Depression and mood disorders

• Schizophrenia

• Specialized VA mental health services

(behavioral and medical interventions)

Substance Abuse

• Alcohol

• Drug

• Tobacco

• Dual diagnosis (e.g., alcohol and drugs)

• Specialized substance abuse services

(behavioral and medical interventions)

Special (Underserved, High Risk) Populations

• Veterans with permanent disabilities

(e.g., blind and paralyzed )

• Veteran cohorts defined by shared

military experience (e.g., prisoners of war,

Persian Gulf veterans)

• Historically underserved veterans

(e.g., women, racial, ethnic and cultural

minorities, rural veterans)

• Veterans whose living arrangements pose

challenges to their health (e.g., homeless or

homebound)

Aging and Age-Related Changes

• Normal age-related changes

• Aging syndromes (e.g., frailty, immobility, falls)

• Compound problems and comorbidities

(e.g., coexisting diabetes and coronary artery

disease, dementia and hip fracture)

• Care of elderly veterans

• End of life issues

traditional boundaries of VA’s four

research services to achieve a new

synergy. Major initiatives in the

coming years will reflect the conviction that solving complex health

problems requires not only specialized expertise but continuing

synthesis, re-examination of important issues, and communication

among disciplines.

Through this dynamic program, VA

conducts an array of research

activities concentrating on some of

the most difficult health care challenges facing society today. Following is a more in-depth description of these activities and recent

VA research achievements.
10 Translating Research Into Practice 1998 Annual Report

The Medical Research Service

Science at the Cutting Edge

VA researchers play key roles in

developing new medical innovations— the cardiac pacemaker, the

CT scan, magnetic resonance

imaging, and modern drug therapy

for mental illness resulted from VA

research. VA surgeons performed

the first kidney transplant in the

United States.

A world leader in the care and

treatment of the elderly, VA is

deeply involved in studies of the

aging process, including

Alzheimer’s disease, prostate

disease, and osteoporosis. VA

cares for approximately 6 percent

of the adult AIDS population in the

United States and has made great

strides in research on drug therapy

and survival rates. Drug addiction,

alcoholism, schizophrenia, spinal

cord injury, post-traumatic stress

disorder, and tissue regeneration

are other areas of VA Medical

Research.

VA Medical Research continues to

make important advances that

benefit not only veterans, but all

Americans. Recently, for example,

VA investigators in Seattle, in

collaboration with an international

team, discovered the first human

gene associated with aging— a

major advance in efforts to determine how the aging process leads

to age-related diseases. The

researchers identified the gene that

causes Werner’s Syndrome, a rare
1998 Annual Report Translating Research Into Practice 11

inherited disorder marked by

premature aging. Additionally, VA

investigators collaborated to

identify a gene that plays a key

role in development of Alzheimer’s

disease— a discovery that may

allow researchers to better understand how the disorder develops in

people who carry the gene. Another major contribution from VA

Medical Research is the recent

discovery of a gene that plays a

major role in schizophrenia, one of

the most common causes of disability among veterans. Although

other schizophrenia genes have

been discovered, this gene is the

first to be found in a majority of

families studied and has been

linked to two different physiological

defects found in schizophrenics

and their families. The gene codes

for a brain receptor activated by

nicotine and helps explain why

schizophrenics as a group tend to

be heavy smokers. Although well

documented, the high incidence of

smoking among schizophrenics

had been overlooked as a possible

link to the root cause of schizophrenia.

Among other recent Medical

Research Service achievements,

investigators in Portland have

paved the way for new treatments

of brain tumors. In protecting brain

tissue, the blood-brain barrier

prevents chemotherapy drugs from

reaching tumors from the bloodstream. The Portland team found

that a sugar solution temporarily

shrinks barrier cells to open spaces

through which drugs can enter.

Meanwhile, researchers in Minneapolis and Nashville found a way to

reduce chronic pain without destroying the normal pain sensations that

help protect against serious injuries.

Their work may play a key role in

the development of new treatments

for chronic pain. Another group of

investigators in San Diego recently

advanced the understanding of how

inflammation causes atherosclerosis— clogging of the arteries. If they

can stop immune system cells from

attacking artery walls in reaction to

inflammation, they may be able to

prevent the condition that is a

leading cause of death in the United

States.

Additionally, the Medical Research

Service has established a new

program that allows VA scientists to

take novel approaches to studying

biomedical problems common

among veterans. The Research

Enhancement Awards Program

(REAP) supports multidisciplinary

research, pilot studies, and research

training for young investigators.

Thus far, 18 proposals have been

approved for funding in research

areas including lung disease, bone

disease, Parkinson’s disease, heart

disease and heart failure, kidney

disease, gastrointestinal disorders,

spinal cord injury, ulcer wound

healing, cancer, multiple sclerosis,

Hepatitis C, Alzheimer’s disease,

and depression.
12 Translating Research Into Practice 1998 Annual Report

The Cooperative Studies Program with a common type of heart attack

(non-Q wave). It found that most of

these patients did not benefit from

routine, early invasive management—

a conclusion counter to conventional

practice. This study will influence

health policy and clinical practice in

the VA and may improve practice

strategies in the private sector as well.

Other Cooperative Studies identified

a better treatment for refractory

schizophrenia with clozapine, established the optimal medical management for benign prostatic enlargement, and affirmed definitively the

effectiveness of urologic surgery for

prostate enlargement.

Three Epidemiology Research and

Information Centers are the newest

addition to the Cooperative Studies

Program. The Centers, located in

Boston, Durham and Seattle, are

studying the incidence, distribution

and control of diseases among

various subgroups of veterans. Many

clinical research questions related to

the cause of disease, application of

health risk assessment, identification

of risk profiles, quantification of

prognostic variables, and disease

surveillance and control techniques

can be informed by this epidemiologic research. These new Centers are

conducting numerous investigatorinitiated epidemiology research

projects on problems such as posttraumatic stress disorder, osteoporosis

in men, prostate and colon cancer,

ischemic heart disease, diabetes, HIV

infection, and spinal cord injury.

Applying New Knowledge

During the past 22 months, the

Cooperative Studies Program has

launched 22 large new multicenter

clinical trials on problems as diverse

as heart disease, atherosclerosis,

cardiac revascularization, heart

failure, arrhythmia, pulmonary

nodules, thromboembolism, hernia

repair, post-traumatic stress disorder,

schizophrenia, alcohol abuse, and

substance abuse. This represents a

major expansion of VA’s clinical

trials program.

VA research clearly improves the

survival and quality of life for veteran patients. Studies compare

surgery or other invasive treatment

with medical treatment, evaluate the

most appropriate use of health care

services, and assess the cost-effectiveness of competing treatment

strategies. For example, a VA study

compared the use of subcutaneous

verses intravenous human recombinant erythropoietin for treating

anemia in patients with end-stage

kidney disease. VA researchers

demonstrated that the subcutaneous

route was much more cost effective

while maintaining equal quality of

care. The study results will influence

policy decisions and prescribing

patterns for end stage renal disease

patients in VA and other federally

supported health care programs.

Another recent VA clinical trial,

VANQWISH, evaluated medical

management strategies for patients
1998 Annual Report Translating Research Into Practice 13

The Health Services Research and

Development Service

Delivering Quality Care

Health Services Research examines

the impact of the organization,

financing, and management of

health care services on the delivery, quality, cost, access to, and

outcomes of those services. The

overarching objectives of the

Health Services Research and

Development Service (HSR&D) are

to improve the quality of patient

care and to increase the efficiency

of health care delivery. Examples

of issues under investigation by

health services researchers include

the shift from inpatient to outpatient

care, use of non-physician professionals, telephone care and

telemedicine, home care strategies,

health care technology assessment

and appropriate techniques for

disseminating research findings.

For example, researchers studying

a Home Based Primary Care

(HBPC) model found potential for

lowering total health care and

hospital readmission costs among

severely disabled and terminally ill

patients while increasing patient

satisfaction. In an ongoing study

of a telephone-based disease

management program for diabetic

patients, investigators are looking

at the use of an automated voice

messaging system (AVM) with nurse

telephone follow-ups. The AVM

calls patients weekly to monitor

their health status. Nurses use the

patient’s responses to the system to

decide appropriate follow-up. Thus
14 Translating Research Into Practice 1998 Annual Report

far, the system has shown potential

to serve as a “clinician extender”

bringing monitoring, diabetes

education, and behavior support

services into the homes of VA

patients with diabetes.

HSR&D’s technology assessment

efforts inform VA technology-related

policy and decision making. For

example, VA owns 10 positron

emission tomography (PET) imaging facilities that require a commitment of significant resources to

maintain and operate. When the

question of whether VA should

acquire additional PET capacity

arose, HSR&D’s Technology Assessment Program conducted a systematic review of the literature to

evaluate what is known about the

usefulness of PET in diagnosing

diseases important to the veteran

population. The assessment found

that diagnostic applications of PET

were not supported in the literature

and VA decided not to invest in

additional PET centers. In another

technology assessment, the effectiveness and appropriateness of

stereotactic pallidotomy, a surgical

procedure for the treatment of

Parkinson’s disease, was reviewed.

The report concluded that the

quality of existing evidence was

fair to poor with few data on long

term outcomes. Most recently, a

prospective cooperative trial in 15

VA Medical Centers has been

approved for planning to compare

the efficacy, safety, and costs of

pallidotomy for relieving symptoms

of Parkinson’s disease.

A highly productive component of

VA’s Health Services Research and

Development Service is its complement of 11 Centers of Excellence

throughout the United States.

These centers have major program

expertise in areas such as primary

care, care of the elderly, mental

health, quality of care, evidencebased medicine, practice management, provider behavior, management of chronic disease, management systems research, and organizational research. In addition, the

Management Decison and Research Center bridges research

with managers, policy-makers and

clinicians. Our newest center, the

VA Information Resource Center

provides information about reliability and validity of VA data sources.

During the past two years, Health

Services Research has announced

dozens of new research initiatives.

These cover a broad array of

outcomes research priorities,

including access to care, the

impact of managed care practices,

primary care and complementary

roles of generalists and specialists,

implementation of clinical practice

guidelines, ethnic and cultural

variation in the use of health care

services, and a nursing research

initiative. Just this year, VA announced new solicitations in patient

safety and qualitative research

projects in patient-centered care.
1998 Annual Report Translating Research Into Practice 15

VA health services researchers recently published the comprehensive

results of VA’s National Surgical

Quality Improvement Program, a

collaborative effort of VA’s Health

Services Research and the Office of

Quality Management. Through this

initiative, VA has demonstrated its

leadership in capturing information

on the quality of surgical care,

patient-based mortality, morbidity,

and health services use. This project

began in 1992 and showed a

consistent decline in hospital length of

stay accompanied by a significant

decrease in surgical mortality and

morbidity. The program serves as a

tremendous resource for VA managers in enhancing the quality of surgical care, and its many contributions

have been acclaimed by the non-VA

surgical community as well.

In May 1998, VA began extending

its research activities in evidencebased medicine to explore strategies

for translating research results into

clinical practice and health policy.

Initially, this new Quality Enhancement Research Initiative (QUERI) will

target such high-priority issues for

veterans as ischemic heart disease,

congestive heart failure, stroke,

diabetes, spinal cord injury, prostate

disease, prostate and colon cancer,

AIDS, depression, schizophrenia,

and substance abuse. Over the next

several years, QUERI projects will

seek to identify best practices in

additional priority areas for veterans’

health care and facilitate the implementation of those practices.
16 Translating Research Into Practice 1998 Annual Report

The Rehabilitation Research and

Development Service

Improving Quality of Life

Rehabilitation Research is dedicated to promoting the health of

American veterans with disabilities

through a wide spectrum of research activities. Rehabilitation

Research Service portfolio is

designed to elucidate the pathophysiology of, and implement new,

restorative treatments for chronic

impairment including paralysis,

hearing and vision loss, amputation, and cognitive defects. Rehabilitation engineers create accessible environments and apply novel

technologies to the care of veterans

with disabilities. Individual investigators focus on a wide array of

relevant areas ranging from amputation prevention and joint replacement to optimal wheelchair propulsion, orientation techniques for

people who are blind, and early

detection of hearing loss.

Rehabilitation Research funds six

Centers of Excellence nationally in

areas such as aging with a disability, spinal cord injury, functional

electrical stimulation, limitations in

mobility, geriatric rehabilitation,

amputations and prosthetics, and

sensory impairment. Recently, the

Center of Excellence in Cleveland,

which focuses on functional electrical stimulation, was honored for

creating an award-winning innova-
1998 Annual Report Translating Research Into Practice 17

tion, a hand-grasp neuroprosthesis

known as the Freehand System.

This implantable, pacemaker-like

device allows people with spinal

cord injury to grasp, hold, and

release objects of various sizes and

shapes. A solicitation for establishing new Centers was just released

in November and expands

Rehabilitation R&D’s areas of

special interest to include low

vision, upper extremity prostheses,

traumatic and other brain injury,

Parkinson’s Disease (novel rehabilitation interventions), stroke

and neurologic repair, multiple

sclerosis, and spinal cord injury/

disease.

Rehabilitation investigators at the

New York VA Medical Center

Rehabilitation Research Team won

first place in the health care

category at the 1998 Microsoft

Windows World Open with the VA

Pedorthic CAD/CAM System. This

computer-aided design and manufacture method for custom orthopedic footwear benefits the growing

veteran population at risk for

amputation from problems such as

peripheral vascular disease and

diabetes. In 1998, the AdVAntage

Arm became available on the

commercial market, leapfrogging

upper extremity prosthetic technology out of its stagnant state. Developed with Rehabilitation R&D

funding, the veteran population

was the first to benefit from the

lighter weight and increased range

of motion of this prosthesis. More

than 100,000 veterans stand to

benefit from VA developed liquidcrystal, dark-adapting eyeglasses

which improve functional mobility,

contrast sensitivity, and acuity for

people with low vision. Three

companies are pursuing plans to

manufacture and market this

product.

New initiatives planned for Fiscal

Year 1999 include technology

transfer educational workshops,

organizing cooperative trials and

research opportunities to advance

treatment of Multiple Sclerosis.

Rehabilitation R&D and Medical

Research are in the process of

forming a collaborative panel for

evaluating new initiatives in

neurorehabilitation to promote

research efforts which bridge the

gap between the laboratory and

the clinical arena for veterans with

conditions such as stroke,

Parkinson’s Disease, and spinal

cord injury.
18 Translating Research Into Practice 1998 Annual Report

Dissemination

Making a Difference

Dissemination is key to translating

research into practice. The Office

of Research and Development has

a two-pronged commitment to

dissemination:

• Disseminate information from

research as broadly as

possible using a variety of

approaches, and;

• Identify and utilize the most

appropriate evidence based

dissemination methods to

ensure effectiveness and

efficiency.

Our goal is to disseminate information that is timely, audience specific, appropriate and easily

accessible.

Each of the four research services,

Cooperative Studies Program,

Health Services Research, Medical

Research, and Rehabilitation

Research, are encouraged to

develop dissemination plans and

materials for their service. Funded

investigators within each of the

services are also encouraged to

develop dissemination plans for

their research findings. From this

information flow, Research and

Development produces targeted

dissemination pieces such as those

listed below.
1998 Annual Report Translating Research Into Practice 19

Examples of Research and

Development Publications

IMPACTS, a document produced

annually by each of the four Research and Development Services,

provides brief lay language summaries of important current impacts

from research studies.

R&D Catalog, a biannual document, provides an overview and

research focus of all Research and

Development funded centers with

contact information. The catalog

also includes a summary of new

initiatives and funding opportunities.

Priority Research Initiatives, a

biannual document providing an

overview of all Office of Research

and Development research activities to address areas of unique or

special concern to veterans.

VA Research and Development

Annual Report, an annual piece

reporting on the status of Research

and Development funding, emphasis areas and significant accomplishments.

Journal of Rehabilitation Research

and Development, a quarterly

publication providing

multidisciplinary coverage of

rehabilitation research.

Rehabilitation Research and Development Progress Reports, an

annual compendium of all research

being carried out in the area of

disability management.

Reports, such as the Annual Report

of Activities on VA Efforts on Gulf

War Veterans’ Illnesses, are written

to inform particular audiences such

as the Secretary, Under Secretary

for Health, Congress, Special

Committees or constituent groups

about a specific research effort.

VA Practice Matters, a semi-annual

document addressing an important

health care issue in a concise, easy

to read format. The product is

targeted at health care providers

and clinical managers providing

them with the most recent research

evidence, and suggestions for

implementation based on the

evidence. Topics addressed this

year were Acute Stroke Treatment

and Diagnosis and Management of

Benign Prostatic Hyperplasia.

VA Research and Development

Web Page, contains current information about Research and Development, the services, funding

priorities and solicitations as well

as a number of publications and

reports that can be downloaded.

Rehabilitation Research and

Development Clinical Guides have

successfully relayed research results

to veterans and clinicians alike.

Areas such as physical fitness for

persons with disabilities and

practical hearing aid selection

continuously require reprints and

have even entered the university

classroom as teaching tools.

Upcoming guides will include a

focus on gait analysis.
20 Translating Research Into Practice 1998 Annual Report

External Publications

The work of VA Research and

Development-funded investigators is

published in numerous peer-reviewed journals, books, and

monographs, making a major

contribution to the research literature. From October 1997 through

September 1998, VA-funded

researchers published over 4000

articles in over 950 journals. VA

researchers’ work appears in a

broad cross section of the most

highly regarded peer reviewed

journals. Basic medical research

was well represented in the highly

regarded basic sciences journals:

Proceedings of the National Academy of Sciences, Journal of Biological Chemistry, Advances in Experimental Medicine and Biology,

Brain Research, American Journal

of Physiology, Biochimica et

Biophysica Acta, Biochemical &

Biophysical Research Communications, Biochemical Journal, and the

Journal of Immunology. VA clinical

research also appeared in many of

the upper echelon clinical research

journals: JAMA, Journal of Clinical

Investigation, Annals of Internal

Medicine, New England Journal of

Medicine, Journal of the American

College of Cardiology, Journal of

the American Geriatrics Society,

plus AJR-American Journal of

Roentgenology, and Archives of

Internal Medicine. Rehabilitation

research appeared in the Journal of

Applied Physiology, Archives of

Physical Medicine & Rehabilitation,

Journal of Biomedical Materials

Research, Journal of Rehabilitation

Research and Development, and

American Journal of Physical

Medicine and Rehabilitation. VA’s

Health Services Research Development investigators are well represented in the New England Journal

of Medicine, Medical Care, Inquiry

and Health Services Research.

Conferences, Workshops and

Seminars

Many VA Research and Development investigators are leaders in

their fields of study and, as such,

are invited to conduct presentations

at conferences, workshops and

seminars throughout the United

States.
1998 Annual Report Translating Research Into Practice 21

Research Collaborations

The Office of Research and Development enhances its work through

collaborative relationships with other

government, non-government, as well

as private industry organizations. VA

Research works with the Department of

Defense on important areas such as

Mechanisms of Emerging Pathogens;

Combat Casualty and Wound Repair;

Stress Related Chronic Illnesses

(including Post-Traumatic Stress Disorder and Related Gulf War Illnesses)

and Prostate Disease, including

Prostate Cancer. In addition, VA

Research has a number of collaborative activities with the National Institutes

of Health and the Agency for Health

Care Policy and Research.

On the private industry side, VA

Research has collaborations with a

number of leading biotechnology and

pharmaceutical companies including:

Amgen, Astra Merck, Aviron, Bayer

Corporation, Berlex Laboratories,

Boehringer Ingelheim, Bristol Myers

Squibb & Sanofi, DuPont, Eli Lilly,

Fugisawa, Glaxo-Wellcome, Hoescht

Marion Roussel, Hybritech, Intercardia,

Johnson & Johnson (Ortho), KOS,

Marion Merrell Dow, Merck, Pfizer,

Reckitt/Colman, Rhone-Polenc Rorer,

Sandoz, Schein Pharmaceuticals,

Schering Schwartz Pharmaceuticals,

Smith Kline Beecham, Warner Lambert/Parke-Davis, and Wyeth-Ayerst.

In the area of diabetes, VA Research

and Development has funded three

Diabetes Research Centers jointly with

the Juvenile Diabetes Foundation.

Enhancing

Research Efforts
22 Translating Research Into Practice 1998 Annual Report

The number of Research and Development funded research projects is

contingent on the level of appropriated resources, and the average cost

per project. The Office of Research

and Development administers the

research appropriation for Medical

Research, Rehabilitation Research,

Health Services Research, and

Cooperative Studies. During fiscal

year 1998, VA Research funds

supported research projects conducted by over 2000 VA Medical

Center employees in 109 VA facilities. These projects are initiated on

the basis of a VA employee’s own

scientific interest or in response to a

solicitation from the Research and

Development Services in VA Headquarters. Figure 1 shows the recent

growth in the Research and Development budget appropriation to support the direct costs of this work.

VHA allocates Medical Care dollars

to support the research infrastructure

or indirect costs such as laboratory

facilities, ancillary support services,

and physician/clinician salaries.

Given the high quality of VA investigators and the overall quality of the

research program, VA Research and

Development funded investigators

have been successful in augmenting

the research effort through

partnering with other federal agencies, private foundations and industry. Figure 2 provides a summary of

all budgetary resources for the past

three years and a projection for

fiscal year 1999.

Funding for Research
1998 Annual Report Translating Research Into Practice 23

Figure 2

Budget Appropriation and Summary of Budget Resources

SUMMARY OF BUDGETARY RESOURSE S

(dollars in thousands) 1996 1997 1998 1999

Actual Actual Actual Estimate

Medical and prosthetic research appropriation $256,678 $262,000 $272,000 $316,000

Medical Care Support $334,700 $319,793 $310,665 $353,910

Other* $331,615 $402,767 $430,073 $474,648

Total budgetary resources. $922,993 $984,560 $1,012,738 $1,144,558

*Includes federal grants, NIH, DOD, private foundations and industry

Figure 1
24 Translating Research Into Practice 1998 Annual Report

Future Outlook Additionally, VA continues to

redouble its support for the training

of future investigators, especially

clinician investigators. During FY

1999, VA’s investment in research

career development will approach

10% of its entire research appropriation. This is a level of investment not matched in this decade.

VA research has observed a

gratifying increase in applicants for

its career development awards

including new awardees in surgical

specialties as well as physician

investigators in medicine and

psychiatry.

Our Programs

In the coming years, VA will focus

on many new initiatives critical to

improving the health of our veteran

patients.

Medical Research will experience

continued growth of the new

program in epidemiology research.

Basic research focusing on the

biology of Hepatitis C infection will

be an increasing priority as this

pathogen threatens to emerge in

epidemic dimensions. New initiatives focus on fundamental research

on neuro-degenerative diseases,

especially Parkinson’s disease, with

possible new collaboration with the

National Parkinson Foundation.

Opportunities and Challenges

The outlook for health related

research is quite promising in the

near term. Support for enhanced

federal investment in health related

research is strong at both executive

and legislative levels. Recognition

of the value provided by health

related research to the country’s

global competitiveness seems to be

at a new high.

Our Opportunities

Within VA, research and scientific

opportunities are outstanding. The

VA research program couples

scientific opportunities with clear

prioritization of research activities

to reflect the burden of disease

characterizing the veteran population we serve. Currently, more

than 99% of the VA research

portfolio is devoted to health

problems facing veterans

Our People

The greatest resource within the

Office of Research and Development is our people. We strive to

attract and retain the best and the

brightest investigators to conduct

research that will improve the

health and quality of life of our

veterans. We will continue working to assure that competitive

investigators receive the time

obligated in their grants to do their

research work.
1998 Annual Report Translating Research Into Practice 25

New collaborations between

medical and rehabilitation research

on neural regeneration and basic

research initiatives concerning

spinal cord injury will receive

additional funding. Rehabilitation

research recently released a call

for applications for additional

Centers of Excellence, focusing on

such high priority areas as upper

extremity prostheses, low vision,

traumatic brain injury, spinal cord

injury, and rehabilitation for patients with stroke and multiple

sclerosis.

Health Services Research continues

to focus on implementation of

research results that demonstrate

improvements in patient outcomes

and systems efficiencies. The goal

of the Quality Enhancement Research Initiative (QUERI) is to

create new synergy among innovators such as researchers, clinicians,

experts in informatics, managers,

and policy-makers. QUERI will

become fully operational in FY

1999 and will produce near-term

quality improvements while planning new research projects to

facilitate future improvements in

health care. Heart disease, stroke,

cancer, diabetes, AIDS/HIV,

schizophrenia, depression, substance abuse, and spinal cord

injury are initial focus areas.

The Cooperative Studies Program

has released program announcements in several areas resulting in

exciting new projects in 1999.

Notable among them are three

new projects investigating Gulf

War illnesses. These include

completion of the congressionally

mandated survey of Persian Gulf

veterans, Phase III; and two treatment trials focusing on antibiotic

treatment and non-pharmacological

treatments. New and ambitious

treatment trials for Parkinson’s

disease are in the planning stages.

Prostate cancer remains a high

priority for VA research. Efforts to

prevent this cancer may lead to

new collaborations with the National Cancer Institute. VA’s minority patients, especially Hispanic

and African American men, add a

new dimension to the NCI research

effort. Other anticipated collaborations with the National Institutes of

Aging include treatments of problems especially prevalent among

aging Americans. This research

effort is building on the strengths of

both institutions to conduct research

that neither could accomplish

efficiently alone.
26 Translating Research Into Practice 1998 Annual Report

Our Challenge

VA shares many challenges in

common with our academic

affiliates. For the immediate future,

these concerns include sustaining

executive and legislative support

for health related research. We will

work to secure support for research

infrastructure, especially the

research equipment and wetlaboratory space needed for VA

research to remain world class.

Hopefully, the outlook for health

related research will remain bright.

Research will continue to add value

to the quantity and quality of life

for veterans, and all Americans, if

we focus on illnesses prevalent in

the population we serve, and work

purposefully to translate the research discoveries to enhance

patient outcomes and health

systems efficiencies.

We remain optimistic and enthusiastic about our future.
1998 Annual Report Translating Research Into Practice 27

Research and Development

Career Development Awardees 1998

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. This salary

support frees up time for the investigators

to conduct their research or obtain specific

training to enhance their research skills.

Following is a list of investigators who

received Career Development Awards

during the 1998 Fiscal Year.

Health Services Research and

Development Service

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

Philadelphia, PA

Steven Asch, M.D.,

Los Angeles, CA

Brenda Booth, Ph.D.,

Little Rock, AR*

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

San Diego, CA

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

West Haven, CT

Kendon Conrad, Ph.D.,

Hines, IL*

David Edelman, M.D.,

Durham, NC

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

Seattle, WA

Vincent Freeman, M.D.,

Hines, IL

Terri Fried, M.D.,

West Haven, CT

Alan Garber, M.D., Ph.D.,

Palo Alto, CA

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

Boston, MA

Megan Gerety, M.D.,

San Antonio, TX

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

Palo Alto, CA

Howard Gordon, M.D.,

Houston, TX

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

Palo Alto, CA

Timothy Hofer, M.D., M.Sc.,

Ann Arbor, MI

Susan Hughes, D.S.W.,

Hines, IL*

T. Michael Kashner, Ph.D., J.D.,

M.P.H.,

Dallas, TX*

Lewis E. Kazis, Sc.D.,

Bedford, MA*

Eve Kerr, M.D.,

Ann Arbor, MI

JoAnn Kirchner, M.D.,

Little Rock, AR

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

West Haven, CT
28 Translating Research Into Practice 1998 Annual Report

Rudolph Moos, Ph.D.,

Palo Alto, CA*

Richard Owen, M.D.,

Little Rock, AR

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

Palo Alto, CA

John Peabody, M.D.,

West Los Angeles, CA

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

Houston, TX*

Dawn Provenzale, M.D.,

Durham, NC

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

Houston, TX

Jaya Rao, M.D.,

Indianapolis, IN

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

West Haven, CT

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

West Los Angeles, CA

Gary Rosenthal, M.D.,

Cleveland, OH

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

White River Junction, VT

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

Boston, MA

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

Los Angeles, CA

James Tulsky, M.D.,

Durham, NC

Peter A. Ubel, Ph.D., M.D.

Philadelphia, PA

Morris Weinberger, Ph.D.,

Indianapolis, IN*

John Whited, M.D.,

Durham, NC

Mary Whooley, M.D.,

San Francisco, CA

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

San Antonio, TX

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

White River Junction, VT

*HSR&D Research Career Scientist

Medical Research Service

Sherry L. Abboud, M.D.,

San Antonio, TX

Carlos L. Arteaga, M.D.,

Nashville, TN

Raj Batra, M.D.,

West Los Angeles, CA

Peter Bloom, M.D.,

Baltimore, MD

Douglas Bremner, M.D.,

West Haven, CT

Matthew D. Breyer, M.D.,

Nashville, TN

Blase A. Carabello, M.D.,

Charleston, SC

Paul J. Christensen, M.D.,

Ann Arbor, MI
1998 Annual Report Translating Research Into Practice 29

Melissa P. Clark, M.D.,

Nashville, TN

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

Nashville, TN

Mark E. Dibner-Dunlap, M.D.,

Cleveland, OH

Lois J. Geist, M.D.,

Iowa City, IA

Scott D. Gitlin, M.D.,

Ann Arbor, MI

Martin Gluck, M.D.,

Bronx, NY

Carla Greenbaum, M.D.,

Seattle, WA

Michael C. Heinrich, M.D.,

Portland, OR

Karl P. Houglum, M.D.,

San Diego, CA

Arif Hussain, M.D.,

Baltimore, MD

F. Frank Isik, M.D.,

Seattle, WA

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

Iowa City, IA

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

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

Iowa City, IA

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

Rama K. Mallampalli, M.D.,

Iowa City, IA

Peter J. Mannon, M.D.,

Durham, NC

Stephen E. McGowan, M.D.,

Iowa City, IA

Barbara E. Menzies, M.D.,

Nashville, TN

Joseph M. Moates, M.D.,

Nashville, TN

James C. Oates, M.D.,

Charleston, SC

Terrence X. O’Brien, M.D.,

Charleston, SC

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 Pisegna, M.D.,

West Los Angeles, CA
30 Translating Research Into Practice 1998 Annual Report

Barbara A. Ramlo-Halsted, M.D.,

San Diego, CA

Michael Reale, M.D.,

West Haven, CT

Robert F. Reilly, M.D.,

West Haven, CT

Jane E. B. Reusch, M.D.,

Denver, CO

George Sachs, M.D.,

West Los Angeles, CA

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

West Haven, CT

Andrew V. Schally, Ph.D.,

New Orleans, LA

Jeremiah E. Silbert, M.D.,

Bedford, MA

Catherine Stehman-Breen, M.D., M.S.,

Seattle, WA

Richard T. Stravitz, M.D.,

Richmond, VA

Roger H. Unger, M.D.,

Dallas, TX

Douglas E. Vaughan, M.D.,

Nashville, TN

Margaret E. Wierman, M.D.,

Denver, CO

Rehabilitation Research and

Development Service

Linda Auther, Ph.D.,

Nashville, TN

Anne S. Carter, Ph.D.,

Mountain Home, TN

Graham Creasy, M.D.,

Cleveland, OH

Margot S. Damaser, Ph.D.,

Hines, IL

Steven A. Gard, Ph.D.,

Chicago, IL

Carolynn Patten, M.S., Ph.D.,

Palo Alto, CA

Karen L. Perell, Ph.D.,

West Los Angeles, CA

Lisa Riolo, Ph.D.,

Atlanta, GA
1998 Annual Report Translating Research Into Practice 31

Summary of 1998

Research and Development Projects

Following is a summary of all VA Research

and Development funded studies during

Fiscal Year 1998. 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.

Cooperative Studies

Vitamin E Treatment of Tardive Dyskinesia

Adler, Lenard, M.D.

$4,086

Reducing the Efficacy-Effectiveness Gap in

Bipolar Disorder

Bauer, Mark S., M.D.

$1,084,377

VA Non-Q-Wave Infarction Strategies InHospital (VANQWISH)

Boden, William E., M.D.

$52,166

The Clinical and Economic Impact of

Olanzapine Treatment on Refractory

Schizophrenia

Charney, Dennis S., M.D.

Rosenheck, Robert, M.D.

$454,138

Evaluation of GEM Units and Geriatric

Follow-Up

Cohen, Harvey J., M.D.

Feussner, John, M.D.

$692,855

Beta-Blocker Evaluation of Survival Trial

(BEST)

Eichhorn, Eric J., M.D.

Domanski, Michael, M.D.

$872,865

National Health Survey of Persian Gulf

Veterans and their Families

Eisen, Seth, M.D.

Kang, Han

Murphy, Frances

$1,601,280

Warfarin and Aspirin in Secondary

Prevention

Fiore, Louis, M.D.

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

$1,896,905

F-Flurodeoxyglucose (FTP) Positron Emission

Tomography (PET) Imaging in the Management of Patients with Solitary Pulmonary

Nodules

Fletcher, James W., M.D.

$499,158

Group Treatment of PTSD for Vietnam

Theater Veterans (TOP)

Friedman, Matthew J., M.D., Ph.D.

Schnurr, Paula, Ph.D.

$1,216,341

Registry to Obtain Long Term Patency Data

on Saphenous Vein and Internal Mammary

Artery Grafts

Goldman, Steven, M.D.

$181,931
32 Translating Research Into Practice 1998 Annual Report

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, M.D.

$728,385

Processes, Structures, and Outcomes of

Care in Cardiac Surgery

Hammermeister, K. E., M.D.

Glover, Frederick

$166,279

Oral Anticoagulant Therapy to Improve

Patency of Small Caliber Prosthetic Bypass

Grafts

Johnson, Willard , M.D.

$131,489

Naltrexone in the Treatment of Alcoholism

Krystal, John, M.D.

Rosenheck, Robert, M.D.

$1,027,693

NIDCD/VA Hearing Aid Trial

Larson, Vernon D., Ph.D.

$541,165

Natural History of Large Abdominal Aortic

Aneurysms

Lederle, Frank A., M.D.

$30,922

Aneurysm Detection and Management

(ADAM)

Lederle, Frank E., M.D.

Wilson, Samuel A., M.D.

$672,939

Effect of Polyunsaturated Lecithin on Liver

Fibrosis

Lieber, Charles W., M.D.

$1,498,372

Prospective Evaluation of Risk Factors for

Large (>1 cm) Colonic Adenomas in

Asymptomatic Subjects

Lieberman, David , M.D.

$373,344

The Coronary Artery Revascularization

Prophylaxis Trial (CARP Trial)

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

$297,669

Colchicine in the Treatment of Alcoholic

Cirrhosis of the Liver

Morgan, Timothy R., M.D.

$1,189,700

Urgent Revascularization in Unstable

Angina (AWESOME)

Morrison, Douglass, M.D.

Gulshan, Sethi, M.D.

$891,963

Trial of Varicella Vaccine for the Prevention

of Herpes Zoster and its Complications

Oxman, Michael N., M.D.

$312,937

Treatment of Seizures in the Elderly

Population

Rowan, A. James, M.D.

Ramsay, R. Eugene, M.D.

$1,228,933
1998 Annual Report Translating Research Into Practice 33

The VA HDL Intervention Trial (HIT):

Secondary Prevention of Coronary Heart

Disease in Men with Low HDL-Cholesterol

and Desirable LDL-Cholesterol

Rubins, Hanna, M.D., M.P.H.

Robins, Sander, M.D.

$1,174,093

The Effects of Antiarhythmic Therapy in

Maintaining Stability of Sinus Rhythm in

Atrial Fibrillation

Singh, Steven N., M.D.

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

$1,002,809

Comparison of Anterior and Posterior

Chamber Lens Implants After Vitreous Loss

in Attempted Extracapsular Cataract

Extraction

Smith, Thomas, M.D.

$116,356

Follow-Up Study of the Medical and

Surgical Therapies for Gastroesophageal

Reflux Disease

Spechler, Stuart, M.D.

$172,485

A Genetic Linkage Study of Schizophrenia

Tsuang, Ming, M.D., Ph.D.

$264,826

A Multi-Site Randomized Trial of Team

Managed Hospital Based Home Care

Weaver, Frances, Ph.D.

Cummings, Joan, M.D.

Hughes, Susan, D.S.W.

$692,855

VA Topical Tretinoin Chemoprevention

Trial

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

$228,014

Costs and Outcomes of

Telephone Care Pilot

Welch, H. Gilbert, M.D., M.P.H.

$332,679

Normative Evaluation of a ComputerAssisted Neuropsychological Screening

Battery Pilot

White, Roberta, Ph.D.

$499,149

Prostate Cancer Intervention Versus Observation Trial (PIVOT): A Randomized Trial

Comparing Radical Prostatectomy versus

Pattiative Expectant Management for the

Treatment of Clinically Localized Prostate

Cancer

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

Brawer, Michael, M.D.

$1,252,693

The Iron (Fe) and Atherosclerosis Study

(FeAST) - Pilot

Zacharski, Leo R., M.D.

$23,400
34 Translating Research Into Practice 1998 Annual Report

Health Services Research And

Development Service

Preventing Progression to

Chronic Back Pain

Atkinson, Joseph, M.D.

$157,300

Rehabilitation Issues of Concern for

Women with Spinal Cord Injuries

Bach, Carol Ann, Ph.D.

$43,164

Developmental Projects Program at Providence, RI: Ambulatory Care, Mental

Health

Bauer, Mark, M.D.

$100,000

Quality of Life and Patient Utility for Veterans with Prostate Cancer

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

$190,752

Pressure Ulcer Care in Nursing Homes:

Effect of Clinical Guidelines

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

$282,200

Enhancing Access to Primary Care for

Veterans with Psychiatric Illness

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

$122,700

Developmental Projects Program at Baltimore, MD: Outcomes, Geriatrics

Bradham, Douglas, M.D., Ph.D.

$97,128

Veteran Women’s Alcohol Problems:

Prevalence, Screening and Self Help

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

$131,096

Pain Management and Behavioral Outcomes in Patients with Dementia

Buffum, Martha, D.N.Sc.

$68,939

Psychophysiology of PTSD in Female Nurse

Vietnam Veterans

Carson, Margaret, R.N., Ph.D.

$200,000

The Effect of Managed Care on VA Hospital Costs

Cary, Kathleen, Ph.D.

$135,200

Reducing Lower Back Injuries in VAMC

Nursing Personnel

Caska, Barbara, Ph.D.

$95,385

Comprehensive Outcomes of

Nonmelanoma Skin Cancer

Chren, Mary-Margaret, M.D.

$40,666

Prostate Cancer Outcome Measures: Age

and Race Effects

Clark, Jack, Ph.D.

$149,454

Informal Caregivers of Veterans with

Dementia: Cost, QOL and Service Use

Clipp, Elizabeth, Ph.D.

$168,656

Outcomes Assessment for Dementia Care:

Development of a Module

Cody, Marisue, Ph.D., R.N.

$11,709
1998 Annual Report Translating Research Into Practice 35

Exercises Effect on Aerobic Capacity and

QOL in Heart Failure

Collins, Eileen, Ph.D., R.N.

$120,900

Effectiveness of Screening for Prostatic

Cancer: A Cohort Study

Concato, John, M.D.

$121,025

Risk Mortality in Prostate Cancer

Concato, John, M.D.

$148,470

Educational Efforts to Reduce the

Cultural and Ethnic Variation in

Cardiac Procedure Use

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

$153,446

Home Walking Exercise Training in

Advanced Heart Failure

Corvera, Teresita, R.N., M.N.

$124,250

Ethnic/Cultural Variations in the Care of

Veterans with Osteoarthritis

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

$109,800

Migration Patterns of U.S. Veterans

Cowper, Diane, M.A.

$49,000

Familial Patterns in Prostate Cancer

Cunningham, Glenn, M.D.

$101,537

SAFE-GRIP Fall/Injuries Interventions:

A Randomized Trial

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

$186,700

Nurse Counseling for Physical Activity

in Primary Care Patients

Dubbert, Patricia, Ph.D.

$122,675

Processes, Structure, and Outcomes

of Post-Stroke Rehabilitation Care

Duncan, Pamela W., Ph.D.

$436,124

Treatment of Depression in Patients

with PTSD

Dunn, Nancy Jo, Ph.D.

$189,803

A Follow-up Investigation of the

Effectiveness and Efficiency of GEM Care

Engelhardt, Joseph, Ph.D.

$21,800

Developmental Projects Program at

Decatur, GA: Quality, Cost, Performance

Measures

Etchason, Jeff, M.D.

$108,300

Evaluation of Subacute Rehabilitation Care

Evans, Ron, M.S.W.

$90,050

An Evaluation of the Organization of

Subspecialty Cardiac Care within VA

Every, Nathan, M.D.

$236,360

Ambulatory Care Quality

Improvement Project: (ACQUIP)

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

$780,365

Cost-Effectiveness of Lung Volume

Reduction Surgery

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

$23,500
36 Translating Research Into Practice 1998 Annual Report

Schizophrenia Outcomes Module:

Enhancement and Field Testing

Fischer, Ellen, Ph.D.

$269,451

Decision Making for Depression in Women

Veterans: Patient and Physician Factors

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

$28,300

A Pilot Study: Effectiveness of Telecare in

the Management of Diabetes

Gaehde, Steven, M.D.

$34,762

Gait and Balance Training in Reducing

Occurrence and Fear of Falls in the Elderly

Galindo-Ciocon, Daisy, Ph.D.

$93,350

Assessment of Respiratory Function in

Chronic Spinal Cord Injury

Garshick, Eric, M.D., M.O.H.

$62,212

Practice Patterns and Variations in

Care of VA Patients with Acute MI

Gaziano, Michael J., M.D., M.P.H.

$238,100

Utility of PTF Data in Monitoring

Outcomes of Surgical Care

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

$82,451

Improved Management of Patients

with Chronic Airflow Obstruction

Goldman, Michael, M.D.

$37,900

Costs, Quality of Life and Functional

Outcomes in Veterans Treated for MS

with Beta-Interferon 1-B (Beta seron)

Guarnaccia, Joseph, M.D.

$178,051

Using Pain Resource Nurses to Improve

Cancer Patient Pain Outcomes

Hagan, Susan, M.S.

$65,850

Ethnicity and Veteran Identity as

Determinants of VA Ambulatory Care Use

Harada, Nancy, Ph.D.

$200,700

Effectiveness of Team Treatment of

Depression in Primary Care

Hedrick, Susan, Ph.D.

$168,529

Evaluating HEDIS 3.0 for VHA

Hendricks, Ann, Ph.D.

$209,200

Evaluating Quality of Care Screens from

Laboratory Databases

Hofer, Timothy, M.D.

$244,047

Guidelines for Drug Therapy of

Hypertension: Closing the Loop

Hoffman, Brian, M.D.

$53,175

Developmental Projects Program at

Lexington, KY: Pulmonary

Rehabilitation Treatments, Cost

and Physician-Patient Preferences

Holleman, Donald, M.D.

$25,000
1998 Annual Report Translating Research Into Practice 37

Clinical Management and Outcomes of

Veterans with Strokes at VAMC

Horner, Ronnie, Ph.D.

$54,780

Protocols to Manage Resistance to Care in

Veterans with Alzheimer’s Disease

Hurley, Ann, R.N., D.N.Sc.

$95,382

Database Resource Center

Hynes, Denise, Ph.D.

$68,861

Oral Health and Quality of Life in Older

Veterans

Jones, Judith, D.D.S.

$122,400

A Randomized Trial to Implement the

AHCPR Smoking Cessation Guideline

Joseph, Ann, M.D., M.P.H.

$6,842

Cultural Factors in Adaptation to Chronic

Illness

Katz, Murray, M.D.

$137,800

Developmental Projects Program at Tucson,

AZ: Special Populations

Katz, Murray, M.D.

$18,750

Health Related Quality of Life in Veterans:

A Pilot Study

Kazis, Lewis, Sc.D.

$310,963

Toward Gender-Aware VA Health Care:

Staff Ideology, Sensitivity, & Knowledge

King, Lynda, Ph.D.

$79,900

Proactive Diabetes Case Management

Krein, Sarah, Ph.D., R.N.

$600

Mental Health Outcomes Associated

with Bosnia Peacekeeping Mission

Litz, Brett, Ph.D.

$94,482

Nurse Managed Clinic for Dementia

Patients and Family Caregivers

Maddox, Melitta, M.S.N., R.N.C.S.

$24,550

Impact of Provider Substance Abuse

Education on Guideline Implementation

McCormick, Richard, Ph.D.

$221,700

Development of Individual-Patient

Physical Health Profiles with IRT

McHorney, Colleen, Ph.D.

$71,887

Area Variation in Length of Stay, Pre

and Post-hospital Care and Survival

Menke, Terri, Ph.D.

$114,602

Developmental Projects Program at Augusta, GA: Tech Assessment (Telemedicine)

Middleton, III, Henry, M.D.

$64,040

Determinants of VA and Non-VA Health

Care Use Among Elderly Veterans

Morgan, Robert, Ph.D.

$71,200

Gender Differences in Compensation

and Pension Claims Approval for PTSD

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

$109,160
38 Translating Research Into Practice 1998 Annual Report

Developmental Projects Program at Tampa,

FL: Labor Management Issues, Outcomes,

Rehabilitation

Nelson, Audrey, R.N., Ph.D.

$99,996

Redesigning Patient Handling Tasks to

Prevent Nursing Back Injuries

Nelson, Audrey, R.N., Ph.D.

$132,800

Evaluating Society’s Costs for Veterans’

Healthcare Through VHA

Nugent, Gary, M.H.A.

$818,662

Race, Patient Preference and Stroke

Risk Reduction

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

$339,867

A Multi-site Study of Strategies for

Implementing Schizophrenia Guidelines

Owen, Richard, M.D.

$211,982

The Quality of Medication Management

for Schizophrenia

Owen, Richard, M.D.

$202,648

Are Clinical Vignettes Better than Chart

Abstraction to Measure Quality?

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

$93,174

Evaluation of a Comprehensive Advance

Care Planning Intervention

Pearlman, Robert, M.D.

$164,414

Appropriateness and Necessity of Cardiac

Procedure Use After AMI in VHA

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

$78,964

Factors that Influence the Demand for

Outpatient VA Services

Phibbs, Ciaran S., Ph.D.

$103,200

Automated Calls with Nurse Follow-up

to Improve Diabetes Ambulatory Care

Piette, John, Ph.D.

$197,600

Predicting Inpatient Service Use Among

VA Substance Abuse Patients

Piette, John, Ph.D.

$29,700

Developmental Projects Program at Columbia, MD: Labor Management Issues,

Managed care

Pillinger, Carole, M.D.

$122,170

VA and Non-VA Resource Use and

Outcomes in HIV Infected Men

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

$24,162

Developmental Projects Program at Cincinnati, OH: Outcome Measurement, Cost,

Quality, Access, Satisfaction

Render, Marta, M.D.

$107,064

Effect of Activity on Sleep of

Cognitively-Impaired Veterans

Richards, Kathleen, Ph.D., R.N.

$165,542
1998 Annual Report Translating Research Into Practice 39

Coronary Angioplasty OutcomesVeterans and the Private Sector

Ritchie, James L., M.D.

$92,231

Ambulatory Case Mix Measures:

Implications for VA Managed Care

Rosen, Amy, Ph.D.

$196,100

Decline in Functional Status as a Quality

Indicator for Long-Term Care

Rosen, Amy, Ph.D.

$167,025

Practice Patterns in Care of Chronically

Mentally Ill and Homeless Veterans

Rosenheck, Robert, M.D.

$233,458

Impact of Outsourcing VA Cardiac Surgery

on the Cost and Quality of Care

Rosenthal, Gary E., M.D.

$29,700

A Regional Market-Based Analysis of

Patient Outcomes in a VA Hospital

Rosenthal, Gary, M.D.

$100,700

A Casefinding and Referral System for

Older Veterans Within Primary Care

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

$188,680

Efficacy of Telepsychiatry in the Treatment

of Depression

Ruskin, Paul E., M.D.

$108,705

A Prospective Study of Patient Preferences

for Prostatic Cancer Treatment

Schapira, Marilyn, M.D.

$25,169

The Impact of a Specific Drug

Program on Alcoholics

Schuckit, Marc, M.D.

$78,776

Implementing Smoking Cessation

Guidelines: Randomized Trial of

Evidence Based Quality Improvement

Sherman, Scott, M.D.

$40,198

Effect of Behavioral Management on

Quality of Life in Heart Failure

Shively, Martha, Ph.D.

$52,150

Quality of Life in Women Veterans

Using VA Ambulatory Health Care

Skinner, Catherine, Ph.D.

$51,137

Effectiveness and Cost Impact of

Telecommunications System in COPD

Sparrow, David, D.Sc.

$62,664

Randomized Control Trial of Exercise

Training in Patients with COPD

Sparrow, David, D.Sc.

$93,785

Developmental Projects Program at Buffalo,

NY: Outcomes, Chronic Diseases

Spaulding, Steven, M.D.

$102,159
40 Translating Research Into Practice 1998 Annual Report

PTSD Among VA Ambulatory Care Patients

Spiro, Arron, III, Ph.D.

$165,000

Developmental Projects Program at

Omaha, NE: Customer Satisfaction, Cost,

Chronic Diseases, Special Populations

Spurzem, John R., M.D.

$99,684

Objective Measurement of Daily

Activity in COPD

Steele, Bonnie, Ph.D.

$79,012

Causes of Protein-Energy Undernutrition

Among Elderly Patients

Sullivan, Dennis M.D.

$23,170

An Integrated Model of Primary Care in

Mental Health

Swindle, Ralph, Ph.D.

$214,044

Health Services Databases and Data

Quality Information

Swindle, Ralph, Ph.D.

$99,700

Computerized Guidelines Enhanced by

Symptoms & History: Clinical Effects

Tierney, William, M.D.

$280,196

Matching Outcomes and Costs in Substance Abuse/Psychiatric Treatment

Timko, Christine, Ph.D.

$82,775

Defining the Attributes of the Quality

of Dying

Tulsky, James A., M.D.

$87,070

Negotiating Patient Expectations and

Requests in A Managed Care Environment

Tulsky, James A., M.D.

$158,140

Patient Preferences and the Care of

Diabetes

Vijan, Sandeep, M.D.

$400

Developmental Projects Program at Iowa

City, IA: Tech Assessment (Telemedicine)

Wakefield, Bonnie, Ph.D., R.N.

$72,190

Development of a VA Long-Term Care

Database

Weaver, Frances, Ph.D.

$14,785

Surgical Risks and Outcomes of Women

Treated in VA Hospitals

Weaver, Frances, Ph.D.

$123,650

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.

$205,190

Teledermatology: Diagnosing

Dermatologic Lesions by Digital Imaging

Whited, John, M.D.

$65,050
1998 Annual Report Translating Research Into Practice 41

Cultural Barriers to Access to VA Blind

Rehabilitation Services

Williams, Marjory, R.N.

$55,650

An Objective Indicator of Risk of Developing a Pressure Ulcer

Wilson, Paulette Russell, Ph.D.

$64,051

Patient Preferences in End Stage Prostate

Cancer

Wray, Nelda, M.D., M.P.H.

$100,525

Managed Care Performance of VHA

Primary Care Delivery Systems

Yano, Elizabeth, Ph.D.

$186,937

Medical Research Service

CSF-1 Gene Expression in

Osteoclast Biology

Abboud, Sherry L., M.D.

$50,800

Growth Factors and Mesangial Cell

Function

Abrass, Christine K., M.D.

$109,010

Radiation, Cell Cycle and Protein Kinase C

Acevedo-Duncan, Mildred E., Ph.D.

$72,630

Role of Bombesin-Like Peptides in Chronic

Airflow Obstruction

Aguayo, Samuel M., M.D.

$110,000

Studies of Protein Kinase CK2 Regulation

in Cell Growth

Ahmed, Khalil, Ph.D.

$56,640

Mechanism of Colon Cancer Prevention

by NSAIDs

Ahnen, Dennis J., M.D.

$110,000

Molecular Analysis of Eosinophil

Activation by Chemokines

Ahuja, Sunil, M.D.

$157,940

Radioiodine Uptake Restoration in

Dedifferentiated Human Thyroid Cancer

Ain, Kenneth B., M.D.

$59,940

Striatal and Subthalamic mGluRs

Albin, Roger L., M.D.

$77,550

Heterogeneity of the Interhepatic Biliary

Tree

Alpini, Gianfranco D., Ph.D.

$103,230

Thyroid Hormone Metabolism by Sulfate

Conjugation

Anderson, Robert J., M.D.

$50,160

Mechanisms of Cutaneous

Neuroinflammation

Ansel, John C., M.D.

$72,710

Mechanisms of Development of

Parapneumonic Effusions

Antony, Veena B., M.D.

$94,490
42 Translating Research Into Practice 1998 Annual Report

Alzheimer’s Disease and Aging:

Therapeutic Potential of Estrogen

Asthana, Sanjay, M.D.

$57,480

Aging and Lymphocyte Luteinizing

Hormone-Releasing Hormone

Azad, Nasrin, M.D.

$73,700

Oligodeoxynucleotides as Cancer

Immunotherapeutic Agents

Ballas, Zuhair, M.D.

$108,900

Role of Adaptive Processes in Mediating

the Effects of Drugs on Mood

Barrett, Robert J., Ph.D.

$65,670

Genetic Determinants of Plasma

Factor VII Levels

Bauer, Kenneth A., M.D.

$110,000

Cross-Sensitization as a CNS Model for

Gulf War Chemical Intolerance

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

$48,000

GRP Receptor Expression and

Functional Regulation in Cancers of the

Stomach and Colon

Benya, Richard, M.D.

$104,500

PLA2 Mechanisms in an Animal Model

Relevant to Schizophrenia

Berger, S. Paul, M.D.

$109,890

Sarcolemmal Ion Transport in

Ischemic Myocardium

Bersohn, Malcolm M., M.D., Ph.D.

$43,920

The Effect of Microtubules on B-Adrenergic

Responsiveness in the Heart

Bies, Roger D., M.D.

$14,214

Molecular Mechanisms of Function of

the B Cell Transforming Protein LMP1

Bishop, Gail A., Ph.D.

$128,133

Hyperoxia and the L-Arginine: NO

Pathway in Human Lung Endothelium

Block, Edward R., M.D.

$59,640

Cell-Assisted Tendon Repair with Aging

Boivin, Gregory P., M.S., D.V.M.

$55,560

Chronic Inflammation and

Gastrointestinal Cancer

Boland, C. Richard, M.D.

$110,000

Physiological Arousal and the

Measurement of Sleepiness

Bonnet, Michael H., Ph.D.

$62,500

Structure-Function Studies of the

SHV-1 B-lactamase

Bonomo, Robert A., M.D.

$43,020

Oncogene Intervention into

Hematopoietic Signaling

Boswell, Scott, M.D.

$60,000
1998 Annual Report Translating Research Into Practice 43

Genetic Analysis of T-Cell Leukemogenesis

Brandt, Stephen J., M.D.

$42,900

Androgen Effects in Men

Bremner, William J., M.D., Ph.D.

$110,000

Postmenopausal Hormone Therapy

and HDL Metabolism

Brinton, Eliot A., M.D.

$60,000

Cellular and Molecular Mechanisms

of Enhanced Wound Healing

Browder, I. William, M.D.

$78,100

3882 Psychological, CNS & Myocardial

Mechanisms in Mental Stress Ischemia

Burg, Matthew M., Ph.D.

$30,000

Soufer, Robert, M.D.

$30,000

Regulation of Bone-Forming Cells by

Calcitonin Gene-Related Peptide

Burns, Douglas M., Ph.D.

$136,850

The Cellular Immune Response to

Myelin Antigens in Multiple Sclerosis

Burns, James B., M.D.

$67,100

Molecular Genetics of Acquired and

Hereditary Human Disease

Buxbaum, Joel, M.D.

$60,000

The Behavioral Pharmacology of

Conditioned Responses Induced

by Drugs of Abuse

Carey, Robert J., Ph.D.

$53,240

Molecular Regulation of B Lymphocyte

Activation by CD19

Carter, Robert H., M.D.

$87,450

Parenteral Nutrition, Gut Hypoplasia,

and Cancer Cachexia

Chance, William T., Ph.D.

$109,259

Cytokine Cascades in Granuloma

Formation

Chensue, Stephen W., Ph.D., M.D.

$103,108

Molecular Interaction Between

Phosphocitrate and Calcium Crystals

Cheung, Herman S., Ph.D.

$105,820

Influence of Platelet Protein

Phosphorylation on Platelet Function

Chiang, Tom M., Ph.D.

$123,227

Surfactants for the Disinfection of

Complex Wounds

Christensen, Gordon D., M.D.

$52,800

Translational Regulation of Gene

Expression

Chu, Edward, M.D.

$110,000

Structural Analysis of the Interleukin-2

Receptor Complex

Ciardelli, Thomas L., Ph.D.

$137,410

Safety and Efficacy of Aortomyoplasty

for Long-term Counterpulsation

Cmolik, Brian L., M.D.

$42,720
44 Translating Research Into Practice 1998 Annual Report

Mechanisms of UV Radiation Therapy in

Psoriasis

Cooper, Kevin D., M.D.

$110,000

Bacterial DNA Induction of Macrophage/

Dendritic Cell IL-12 Production

Cowdery, John S., M.D.

$54,480

Recruitment and Activation of Pulmonary

Lymphocyte Subsets

Curtis, Jeffrey L., M.D.

$87,230

A New Protective Antigen of

Group A Streptococci

Dale, James B., M.D.

$59,820

T Cell Receptor - MHC - Peptide

Interactions in Rheumatoid Arthritis

Davey, Michael P., M.D., Ph.D.

$40,740

Mechanisms of Gonadotropin Action

Davis, John S., Ph.D.

$106,700

A Program in Biological Psychiatry

Davis, Kenneth L., M.D.

$57,480

Pulmonary Circulation: Hemodynamics

and Nonrespiratory Function

Dawson, Christopher A., M.D.

$110,000

5434 Antioxidant Supplementation in

Diabetic Nephropathy

De Rubertis, Frederick R., M.D.

$50,215

Neuroendocrine Prostate Cancer

Deftos, Leonard J., M.D.

$109,670

Asymmetrical Cognitive Profiles in

Individuals with ApoE-E4 Genotype

Delis, Dean C., Ph.D.

$78,820

Inositol Phosphate and Ca2+

Signaling in Xenopus Oocytes

Delisle, Sylvain, M.D.

$54,480

Parallel Processing of Information

in the Human Visual System

DeMarco, Paul J., Ph.D.

$39,870

Pulmonary Artery Smooth Muscle Cell

Proliferative Response to Hypoxia

Dempsey, Edward C., M.D.

$55,200

Schwann Cell Response to

Myelin-Derived Peptides

Devries, George H., Ph.D.

$177,900

Growth Factor Regulation of the

Bradykinin Receptor in Vascular Injury

Dixon, Bradley S., M.D.

$86,240

Lipoprotein Metabolism: Lipase Processing

and Regulation

Doolittle, Mark H., Ph.D.

$137,590

The Effects of C-Reactive Protein on

Autoimmunity

Du Clos, Terry W., M.D., Ph.D.

$60,000
1998 Annual Report Translating Research Into Practice 45

Use of Stable Isotopes to Examine In Vivo

Levodopa Pharmacokinetics in Parkinson

Disease

Durso, Raymon, M.D.

$104,500

Human Vascular Responses to Anesthesia

Ebert, Thomas J., M.D., Ph.D.

$57,180

Intracellular Angiotensin II and Nuclear

Receptors of Vascular Tissue

Eggena, Peter, Ph.D.

$54,360

CaN19 Function in Regenerative Epidermal Differentiation

Elder, James T., M.D., Ph.D.

$59,040

Mechanisms of Myocyte Apotosis

Engler, Robert L., M.D.

$110,000

Structure & Function of Na+-pump: SiteDirected Mutagenesis/180 Exchange

Faller, Larry D., Ph.D.

$155,554

Molecular Pathogenesis of

Hepatopulmonary Syndrome

Fallon, Michael B., M.D.

$42,360

3625 The Role of Phospholipids in the

Mechanism of Action of Insulin

Farese, Robert V., M.D.

$90,900

Standaert, Mary L., Ph.D.

$57,750

Oxidative Damage in Parkinson’s Disease

Ferrante, Robert J., Ph.D.

$57,120

Strategies to Reverse Neuronal Death,

in Aging, Disease and Trauma

Festoff, Barry W., M.D.

$109,890

CD4 Regulatory Cells in Immune Tolerance

Field, Elizabeth H., M.D.

$97,300

Normal Aging and Alzheimer’s

Disease:Blood-Brain Barrier Dynamics

Fine, Richard E., Ph.D.

$100,450

Neurotrophin Gene Transfer

Fink, David J., M.D.

$57,480

Paroxysmal Dystonia-Choreoathetosis

Fink, John K., M.D.

$24,975

Structure-function Relationships in

Glutamate Dehydrogenases

Fisher, Harvey F., Ph.D.

$126,550

Episodic Hypoxia as a Cause of Chronic

Blood Pressure Elevation

Fletcher, Eugene C., M.D.

$42,061

Mechanisms of Protein Accumulation in

Renal Hypertrophy

Franch, Harold A., M.D.

$39,660

Quantitative Imaging of Articular Cartilage

with Magnetic Resonance

Frank, Lawrence R., Ph.D.

$36,600
46 Translating Research Into Practice 1998 Annual Report

Markers for Alzheimer’s Disease in

Cerebrospinal Fluid

Galasko, Douglas R., M.D.

$90,200

Benzodiazepines: Behavior and

Functional Neuroanatomy

Gallaher, Edward J., Ph.D.

$101,120

Mediators of Hepatic Pathophysiology

Gandhi, Chandrashekhar R., Ph.D.

$45,520

The Role of Protein Kinase C in

Glomerular Disease

Ganz, Michael B., M.D.

$86,520

Desire for Assisted Suicide in

Terminally-Ill Patients

Ganzini, Linda K., M.D.

$81,400

TIPS vs Large Volume Paracentesis

for Refractory Ascites

Garcia-Tsao, Guadalupe, M.D.

$46,260

Familial Non-Affective Psychosis:

Nosology and Pathology II

Garver, David L., M.D.

$59,400

Adenoviral Vector Replication in

Non-Small Cell Lung Cancer

Garver, Jr., Robert I., M.D.

$109,890

Regulation of HIV-1 Replication

Gaynor, Richard B., M.D.

$106,090

Myocardial Protection During

Cardiac Arrest

Gazmuri, Raul J., M.D., Ph.D.

$54,060

Preclinical and Clinical Genetic

Studies of Anxiety Disorders

Gelernter, Joel, M.D.

$127,540

Colonization for the Prevention of

Clostridium difficile Disease

Gerding, Dale N., M.D.

$90,810

Islet Gene Expression in Diabetes Mellitus

Giddings, Stephen J., Ph.D., M.D.

$76,560

MRI Hippocampal Volume in Twins

Discordant for Combat Exposure and PTSD

Gilbertson, Mark W., Ph.D.

$60,000

Control of Cellular Function in

Heart Failure

Goldman, Steven, M.D.

$58,200

Clinical Correlation of Automated

Neuropsychological Test Systems

Goldstein, Gerald, Ph.D.

$98,230

Rotavirus: Studies of Viral Entry, Protection

and Lymphocyte Homing

Greenberg, Harry B., M.D.

$110,000

Metabolic and Genetic Basis of

Atherogenic Dyslipidemia

Grundy, Scott M., M.D., Ph.D.

$110,000
1998 Annual Report Translating Research Into Practice 47

Mechanistic Approaches to RadiationImmunotherapy of Murine Renal Cancer

Haas, Gabriel P., M.D.

$59,880

Anesthetics and GABA Receptors on

Human Dorsal Root Ganglion Cells

Hackman, John C., Ph.D.

$84,240

Synthesis and Control of Endogenous

Ouabain, a Digitalis-like Factor

Hamilton, Bruce P., M.D.

$110,000

Control of Cerebral Blood

Flow During Hypoxia

Harder, David R., Ph.D.

$99,110

Extracellular SOD in Atherosclerosis

Harrison, David G., M.D.

$110,000

Homocysteine Decreases Endothelial

Cell Glutathione, Increasing the

Sensitivity to Oxidants

Hempel, Stephen L., M.D.

$44,280

Neuropeptide Modulation of

Pavlovian Learning

Hernandez, Linda L., Ph.D.

$101,090

Cerebral Endothelial Cell Activation

in Stroke: Role of NFkB

Hess, David C., M.D.

$97,790

Strategies to Inhibit Effector Function of

Activated T Cells

Hinrichs, David, Ph.D.

$123,450

TGF-Beta1 in Vein Graft Intimal

Hyperplasia

Hoch, John R., M.D.

$108,680

Hypercholesterolemia Perturbation

of Vascular Permeability

Holland, James A., M.D.

$46,380

Novel SAPK Activating Kinase in

Renal Epithelial Stress

Holzman, Lawrence B., M.D.

$110,000

Organization of Mitochondrial

Fatty Acid Oxidation

Hoppel, Charles L., M.D.

$110,000

The Role of GABAa Receptors in

Absence Seizures

Hosford, David A., M.D., Ph.D.

$107,360

Targeting HIV to Myeloid Cells: A Novel

Approach to Vaccine Development

Howell, Alexandra L., Ph.D.

$174,400

Mechanisms by Which the Estrous

Cycle Modulates Cancer Spread

Hrushesky, William J. M., M.D.

$105,160

Role of Angiotensin in Progression of

Renal Disease

Hutchison, Florence N., M.D.

$58,200
48 Translating Research Into Practice 1998 Annual Report

Molecular Staging of Colon Cancer

Jacobson, Daniel R., M.D.

$84,810

Neuroendocrine and Metabolic Regulation

of Growth Hormone Secretion

Jaffe, Craig A., M.D.

$56,640

Impact of HIV on Mucosal and Serum

Responses to Cholera Vaccines

Janoff, Edward N., M.D.

$108,790

Molecular Analysis of Virulent

Escherichia coli Clones

Johnson, James R., M.D.

$71,190

Cloning and Characterization of

Proteins that Interact with GLUT4

Jung, Chan Y., M.D., Ph.D.

$60,000

Efflux-related Multidrug Resistance

in Staphylococcus Aureus

Kaatz, Glenn W., M.D.

$81,290

Characterization of a Cellular Protein

that Interacts with HIV-1 Tat

Kamine, James R., Ph.D.

$133,920

Mechanisms of Asbestos-Induced

Alveolar Epithelial Cell Injury

Kamp, David W., M.D.

$88,490

Cell Signaling in Cardiac Fibroblasts

Karliner, Joel S., M.D.

$58,020

Identification and Characterization

of a Human Renal Sulfate Transporter

Karniski, Lawrence P., M.D.

$84,150

Optimizing Insulin Therapy for the

Prevention of Type I Diabetes

Karounos, Dennis G., M.D.

$51,120

Glomerular Basement Membrane

Proteoglycan in Diabetes Mellitus

Kasinath, Balakuntalam S., M.D.

$99,220

Cellular and Matrix Glomerular Barrier

Function in Early Diabetic Nephropathy

Katz, Murray A., M.D.

$30,200

Duodenal Mucosal Defense Mechanisms

Kaunitz, Jonathan D., M.D.

$90,375

Mapping Genes for Information Procesing

Deficits in Schizophrenia

Kelsoe, Jr., John R., M.D.

$110,000

Mechanisms of Altered Opioid Disposition

Kharasch, Evan D., M.D., Ph.D.

$111,550

Prolonged ex vivo Preservation of the

Donor Porcine Heart

Khuri, Shukri, M.D.

$109,670

Interactions of Lipoproteins and Cells

in Diabetes Mellitus

Klein, Richard L., M.D.

$141,060
1998 Annual Report Translating Research Into Practice 49

Renal Stone Crystal Attachment Factors

Kleinman, Jack G., M.D.

$48,420

Prevention of Breast Cancer: Role of

Dietary Glutamine

Klimberg, V. Suzanne, M.D.

$101,640

Pathophysiology of Nerve Injury and

Neuroma

Kocsis, Jeffery D., Ph.D.

$97,320

Cerebral Morphology, Cognitive Functions

and Symptoms of Schizophrenia

Kuldau, John M., M.D.

$59,280

Standardized Relevant Antigens of Allergic

Aspergillosis

Kurup, Viswanath P., Ph.D.

$30,060

Characteristics and Mechanisms of Respiratory Muscle Fatigue

Laghi, Franco, M.D.

$28,800

Phosphoprotein/G-protein Interactions in

Vision and Blindness

Lee, Rehwa H., Ph.D.

$60,000

Investigation and Treatment of VestibuloVisual Disorders

Leigh, R. John, M.D.

$80,080

Mechanisms of Ischemic Damage to

Cytochrome Oxidase

Lesnefsky, Edward J., M.D.

$106,590

Opioids, Feeding and Reward

Levine, Allen S., Ph.D.

$109,890

Lipopolysaccharide Depression in

Cardiac Myocytes

Lew, Wilbur Y. W., M.D.

$104,000

Determinants of Transport in

Dialysis-Associated Peritonitis

Leypoldt, John K., Ph.D.

$150,160

Regional Gene Therapy to Heal Segmental

Bone Defects: Genetic Modification of

Cells Via Retroviral and Adenoviral Gene

Transfer

Lieberman, Jay R., M.D.

$106,810

Lipoprotein Metabolism and

Cell Lipoprotein Interactions in

Diabetes Mellitus

Lopes-Virella, Maria F., M.D., Ph.D.

$114,750

PFC 5-HT and Limbic D3 Receptors:

Relevance for Chronic Schizophrenia?

Lynch, Minda R., Ph.D.

$4,900

ZO-1 Protein Regulation of Intestinal

Epithelial Paracellular Barrier

Ma, Thomas Y., M.D., Ph.D.

$118,890

Neurohumoral-Immunologic Activation

Following Myocardial Infarction

Maisel, Alan S., M.D.

$110,000
50 Translating Research Into Practice 1998 Annual Report

The Metastatic Phenotype of Transitional

Cell Carcinoma

Malkowicz, Stanley B., M.D.

$60,000

Lipid Regulation of Cytidylyltransferase

in Adult Lung

Mallampalli, Rama K., M.D.

$25,000

Cause and Consequence of TNF

Overexpression in the Heart

Mann, Douglas L., M.D.

$93,690

Characterization of Peptide YY as a

Growth Factor in Intestinal Epithelium

Mannon, Peter J., M.D.

$24,000

Induction of Apoptosis in Prostate Cancer

Cell Lines

Marcelli, Marco, M.D.

$93,430

Thromboregulation by Endothelial Cells:

Role of CD39

Marcus, Aaron J., M.D.

$110,000

Characterization of Two Novel Endothelial

Basement Membrane Components

Marinkovich, M. Peter, M.D.

$71,610

Regulation of Calcium Channel Expression

Marsh, James D., M.D.

$110,000

Purkinje Origin of Ischemic Ventricular

Tachycardia

Martins, James B., M.D.

$57,540

Virulence Related to the Mycobacterium

Avium Hemolysin

Maslow, Joel N., M.D., Ph.D.

$60,000

Calcium/Calmodulin-Dependent Protein

Kinase II Regulation of PTH Secretion

Matovcik, Lisa M., Ph.D.

$131,170

Control of Graft vs Host Disease in

Bone Marrow Transplantation

Maziarz, Richard T., M.D.

$108,020

Gene Regulation of Thrombopoietin

Expression

McCarty, John M., M.D.

$78,650

Calmodulin Signaling in the

Pathogenesis of HIV-1 Infection

McDonald, Jay M., M.D.

$95,260

Linkage and Association Studies in

Juvenile Myoclonic Epilepsy

McNamara, James O., M.D.

$110,000

Regulation of Myocardial Protein

and Glucose Metabolism

McNulty, Patrick H., M.D.

$54,560

Mechanisms of Diabetic Impotence

McVary, Kevin T., M.D.

$68,090

DNA Immunization against

Leishmania donovani

Melby, Peter C., M.D.

$105,865
1998 Annual Report Translating Research Into Practice 51

HIV-1 Resistance to RT and Protease

Inhibitors

Mellors, John W., M.D.

$110,000

Interactions Between Food and the Gut

in Health and Disease

Meyer, James H., M.D.

$58,190

Cognitive Deficit Identification in Dementia

Milberg, William P., Ph.D.

$93,500

Pharmacodynamics in Patients with

Small Cell Lung Cancer

Miller, Antonius A., M.D.

$35,750

Gene Expression During Adipocyte

Differentiation

Miller, Richard E., M.D.

$59,820

Biological Function of Liv 88 a Novel

Gene Encoding a RING-H2 Motif, in Liver

Development

Mishra, Lopa, M.D.

$94,490

Synovial Fibroblasts and Adhesion

Molecules in Dialysis Amyloidosis

Moe, Sharon M., M.D.

$38,100

Encapsulation and Virulence of Vibrio

Vulnificus

Morris, Jr., J. Glenn, M.D.

$110,000

Higher Order Processes in Vision

Motter, Brad C., Ph.D.

$123,055

Cardiovascular Isoforms of PDE3 Cyclic

Nucleotide Phosphodiesterase

Movsesian, Matthew A., M.D.

$105,710

Mechanisms of Beta-Amyloid Vasoactivity

& Relevance to Alzheimer’s Disease

Mullan, Michael, M.D., Ph.D.

$104,390

Mechanisms of the Relative

Hypogonadism of Aging

Mulligan, Thomas M., M.D.

$96,910

Osteoblast Differentiation, BMP, and

the Calpain System

Murray, Samuel S., M.D.

$73,370

Clearance of Cartilage Markers in

Osteoarthritis

Myers, Stephen L., M.D.

$91,685

Ammonia Production and Transport

by the Proximal Tubule

Nagami, Glenn T., M.D.

$94,600

Coulomb Controlled Iontophoresis

for Treatment of CMV Retinitis

O’Grady, Guy E., M.D.

$39,600

Regulation of Sucrase-Isomaltase

by TRANS-acting Proteins

Olsen, Ward A., M.D.

$110,000

Role of the Cdk-Inhibitors p21 and

p27 in Melanoma Invasion

Orengo, Ida, M.D.

$109,780
52 Translating Research Into Practice 1998 Annual Report

Smoke-Induced Inhibition of Active

Sodium Transport in Stratified Squamous

Epithelium: Mechanisms and Effects on

Cell pH, Volume, and Sur

Orlando, Roy C., M.D.

$59,340

Pathobiology of p185neu/EGF

Receptor Interactions

O’Rourke, Donald M., M.D.

$49,740

Effects of Nitric Oxide on

Metalloproteinase Activity

Owens, Michael W., M.D.

$41,100

Alveolar Epithelial Cell-Macrophage

Interations in Host Defense

Paine, III, Robert, M.D.

$88,220

Pathogenesis of Human Insulin Dependent

Diabetes

Palmer, Jerry P., M.D.

$60,000

Chromogranin A and the Plasminogen/tPA System: Regulatory Interactions

Parmer, Robert J., M.D.

$105,950

Angiotensin IV Receptor Regulation of Lung

Endothelium NO Synthase

Patel, Jawaharlal M., Ph.D.

$96,022

Endothelial Cell Barrier Regulation by

Adhesive Processes

Patterson, Carolyn E., Ph.D.

$52,230

Serotonin-2 Receptors and

Corticotegmental Excitatory

Amino Acid Release

Pehek, Elizabeth A., Ph.D.

$48,240

Neural Mechanisms of

Cognitivo-Motor Processes

Pellizzer, Giuseppe, Ph.D.

$85,250

Learned Helplessness Model of Stress

Petty, Frederick C., M.D., Ph.D.

$169,600

Mechanism of ras-Oncogene-Induced

Cell Transformation

Pincus, Matthew R., M.D.

$29,760

Molecular Biology of Primary

Polycythemias

Prchal, Josef T., M.D.

$60,000

3033 Effects of Cirrhosis on the

Pathogenesis of Pneumococcal Infection

Preheim, Laurel C., M.D.

$27,300

Gentry, Martha J., Ph.D.

$67,850

Combined Nortriptyline and Transdermal

Nicotine for Smoking Cessation

Prochazka, Allan, M.D., M.Sc.

$60,000

A Novel Signaling Pathway Activating

Multiple Antibiotic Resistance

Rather, Phillip N., Ph.D.

$112,640
1998 Annual Report Translating Research Into Practice 53

The 5-HT Transporter: Function and

Expression in Antidepressant Therapy

Rausch, Jeffrey L., M.D.

$110,000

Novel Serotonergic Pathways

Activate Fibroblast MAP Kinase

Raymond, John R., M.D.

$96,300

The Role of Glutathione in

Delay Wound Healing

Rees, Riley S., M.D.

$108,570

Pharmacologic Manipulation of

Aortic Aneurysms

Reilly, Jeffrey M., M.D.

$29,820

The Neuropharmacology of Impulsivity

in American Veterans

Reist, Christopher, M.D.

$70,840

Melanoma Growth Stimulatory Activity

Richmond, Ann, Ph.D.

$169,450

A Radical Approach to Delivery of

Chemotherapeutic Agents

Riscoe, Michael K., Ph.D.

$186,300

In vivo Analyses of Hypertrophy

Mediated Gene Activation

Ritchie, Michael E., M.D.

$88,000

Naltrexone and Nicotine Replacement

Effects on Cue Reactivity of Smokers

Rohsenow, Damaris, Ph.D.

$87,595

Monti, Peter M., Ph.D.

$30,410

Combined Pharmacologic/Behavioral

Treatment for Smoking Cessation

Rose, Jed E., Ph.D.

$170,697

Immunotherapy in Animal Models of

Neuroimmunologic Disease

Rose, John W., M.D.

$55,200

Effects of Stress on REM Sleep:

Limbic Mechanisms

Ross, Richard J., M.D., Ph.D.

$104,500

Central ET & Control of AVP and Arterial

Pressure: Baroreflex Integration

Rossi, Noreen F., M.D.

$109,670

Sodium Channel Function in Myotonia

and Myasthenia Gravis

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

$61,490

Mechanisms and Modulation of

Lung Excitotoxicity

Said, Sami I., M.D.

$59,160

Oxyradicals and Macromolecular Damage

in Aging Dopaminergic Neurons

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

$87,690
54 Translating Research Into Practice 1998 Annual Report

Supplemental Oxygen and Anastomotic

Intimal Hyperplasia

Santilli, Steven M., M.D., Ph.D.

$70,180

Molecular Mechanisms of Drug

Resistance in Small Cell Lung Cancer

Savaraj, Niramol, M.D.

$72,650

Structure-Function Analyses of

Macromolecules Relevant to the

VA Mission

Sax, Martin, Ph.D.

$55,000

Alterations in Ion Transport During

Preconditioning

Schaefer, Saul, M.D.

$94,490

Visuospatial Information Processing

as a Risk Factor for Alcoholism

Schandler, Steven L., M.D.

$123,330

Identification of the Frontotemporal

Lobe Dementia Gene

Schellenberg, Gerard, Ph.D.

$110,000

Regulators of Ventricular Hypertrophy

Schiebinger, Rick J., M.D.

$52,140

Tuberculosis and Macrophage Lectin

Biology

Schlesinger, Larry S., M.D.

$60,000

Nicotine Delivery Systems: Research

and Treatment

Schneider, Nina G., Ph.D.

$110,302

Regulation of Gastric Endocrine and

Exocrine Secretion

Schubert, Mitchell L., M.D.

$100,800

Mechanics of Stomach and Small Intestine

Schulze, Konrad S., M.D.

$58,410

Neurophysiologic Mechanisms of

Attention in Schizophrenia

Schwartz, Barry D., Ph.D.

$111,918

Positional Cloning of the LPS Gene

Schwartz, David A., M.D.

$110,000

Requirements for Recognition of Class I

MHC Antigens by Ly-49 Receptors

Seaman, William E., M.D.

$102,630

Penile Advanced Glycation End Products

Produce Impotence in Aging Men

Seftel, Allen D., M.D.

$53,880

Sensitivity to Pyridostigmine Bromide:

Persistent Neural Dysfunction

Servatius, Richard J., Ph.D.

$90,590

Heme Oxygenase and Subarachnoid

Hemorrhage

Sharp, Frank R., M.D.

$118,480

Lectin-Mediated Phagocytosis of

Mycobacterium

Shepherd, Virginia L., Ph.D.

$102,190
1998 Annual Report Translating Research Into Practice 55

Mechanisms for the Induction of

Homology-Dependent Genomic

Rearrangement

Shmookler Reis, Robert J., Ph.D.

$102,250

Effects of Trophic Factors in Models

of Parkinson’s Diesease

Shults, Clifford W., M.D.

$109,730

Neuronal Activity Responsible for

Cataplexy

Siegel, Jerome M., M.D.

$150,000

Ion Channel Function/Regulation in

Astrocytes Activated by CNS Injury

Simard, J. Marc, M.D., Ph.D.

$57,780

Integrin Signaling in Renal Tubule

Cells After Oxidant Stress

Simon, Eric E., M.D.

$36,600

Mechanisms of Implanted Enteric Neurons

Using an Opossum Achalasia Model

Singaram, Chandar, M.D.

$37,000

Adhesive Interaction Between

Lymphocytes and Fibroblasts

Smith, Theresa H., Ph.D.

$70,800

Alveolar Wall Remodeling in the

Pathogenesis of Emphysema

Snider, Gordon L., M.D.

$108,570

Androgenic Regulation of EGF

Expression and EGF mRNA Metabolism

Spaulding, Stephen W., M.D.

$110,000

Influence of T Cell Activation on the

Regulation of HIV Replication

Spina, Celsa A., Ph.D.

$130,569

Fluoxetine as a Quit Smoking Aid for

Depression-Prone Smokers

Spring, Bonnie J., Ph.D.

$158,290

Effects of Neovascularization Upon

Transplanted Islet Function

Stagner, John I., Ph.D.

$109,120

Atherogenicity of Oxidized Lipids

in the Diet

Staprans, Ilona, Ph.D.

$88,200

Neurobiology of Severe Psychological

Trauma in Women

Stein, Murray B., M.D.

$105,710

Respiratory Control and Obesity

Strohl, Kingman P., M.D.

$110,000

Molecular Biology Studies of the IGF II

System in Bone Cells

Strong, Donna D., M.D.

$126,740

Immunopathogenesis of

Collagen-Induced Arthritis

Stuart, John M., M.D.

$60,000
56 Translating Research Into Practice 1998 Annual Report

V-erbA: DNA Binding Specificity and

Function

Subauste, Jose S., M.D.

$40,260

Topoisomerase II in Prostate Cancer

Drug Resistance and Apoptosis

Suttle, D. Parker, Ph.D.

$106,283

The Role of Basic Fibroblast Growth

Factor (bFGF) in Ulcer Pathogenesis

Szabo, Sandor, M.D., Ph.D.

$49,920

Dendritic Mechanisms Underlying

Neuronal Hyperexcitability

Tang, Cha-Min, M.D., Ph.D.

$30,000

IL-8 and Inflammation in Chondrocalcinosis

Terkeltaub, Robert A., M.D.

$98,920

Sprouting by Substance P. Axons

in the Spinal Cord

Tessler, Alan, M.D.

$82,940

Growth Hormone Regulation of

IGF-1 Gene Expression

Thomas, Michael J., M.D., Ph.D.

$3,873

Central Nervous System Glial Ion

Channels and Potassium Homeostasis

Timpe, Leslie C., Ph.D.

$155,640

Tissue Function and Late-Stage

Inhibition of Cholesterol

Tint, G. S., Ph.D.

$172,910

Leukemic Fusion Proteins as Nucleosome

Associated Phosphatases

Tkachuk, Douglas, M.D.

$55,320

Bartonella: Characterization and Isolation

of Angiogenic Factors

Tompkins, David C., M.D.

$73,040

Mycobacterium marinum, A Surrogate

Model for the Study of M. tuberculosis

Trucksis, Michele, M.D., Ph.D.

$63,580

Insulin and Hypertension: Modulation

of Vascular Cell Signaling Pathways

Tuck, Michael L., M.D.

$99,000

Viral and Cellular Gene Regulation in

Papillomavirus-Associated Neoplasia

Turek, Lubomir P., M.D.

$103,700

Surgical Studies on Injury-Induced

Pulmonary Edema

Turnage, Richard H., M.D.

$59,620

Regulation of Insulin-like Growth Factor

Binding Protein-1

Unterman, Terry G., M.D.

$109,670

Liver and Proton Transport and Endocytosis

Van Dyke, Rebecca W., M.D.

$59,400

A Transgenic Model to Test the

Mitochondrial Theory of Aging

Van Remmen, Holly, Ph.D.

$42,600
1998 Annual Report Translating Research Into Practice 57

Opioid Mediated Myocardial Protection

Van Winkle, Donna M., Ph.D.

$101,961

Role of Plasminogen Activator

Inhibitor-1 in Diabetic Vasculopathy

Vaughan, Douglas E., M.D.

$101,310

Markers for Differential Diagnosis

and Virulence of Prostate Cancer

Vessella, Robert L., Ph.D.

$150,179

Immunopathogenesis of Murine

Graft-vs-Host Disease

Via, Charles S., M.D.

$101,310

Cardiac Peptide Fragments in the

Regulation of Body Fluid Balance

Villarreal, Daniel, M.D.

$75,350

Function of Midbrain Structures in

Oculomotor Control

Waitzman, David M., M.D., Ph.D.

$58,140

Motion Perimetry: A New Method

for Early Detection of Visual Loss

Wall, Michael, M.D.

$78,540

Cytoskeleton in Polyamine-Dependent

GI Mucosal Restitution

Wang, Jian-Ying, M.D., Ph.D.

$88,000

Taxonomy, Physiology and Antigenic

Composition of Mycobacteria

Wayne, Lawrence G., Ph.D.

$60,000

6961 MRI and 1H MRSI of

Post Traumatic Stress Disorder

Weiner, Michael W., M.D.

$30,000

Marmar, Charles R., M.D.

$30,000

Regulation of Prostate Cancer

Progression by EGF Receptor Signaling

Wells, Alan, M.D.

$87,890

Molecular Genetics of H. pylori assoc.

Gastric MALT and MALT Lymphoma

Weston, Allan P., M.D.

$52,920

The Role of Citrullinated Myelin Basic

Protein in Multiple Sclerosis

Whitaker, John N., M.D.

$108,990

Cellular Defense Against Complement

Whitlow, Michael B., M.D.

$75,130

Regulation of Gonadotropin Releasing

Hormone (GnRH) Gene Expression

Wierman, Margaret E., M.D.

$58,620

Substance P-saporin: A Selective Toxin for

NK1-R Expressing Neurons

Wiley, Ronald G., M.D., Ph.D.

$89,760

Effect of Substitutions at Position 443 on

the Function of C1 Inhibitor

Wisnieski, Jeffrey J., M.D.

$110,000
58 Translating Research Into Practice 1998 Annual Report

Antipsychotics Alter Serotonin Signal

Transduction in the Basal Ganglia

Wolf, William A., Ph.D.

$85,500

Pathophysiology of Negative Syndromes in

Schizophrenia

Wolkin, Adam, M.D.

$60,000

Cutaneous Oncology-Genotypic/

Phenotypic Analysis of Lymphomas

Wood, Gary S., M.D.

$107,800

Psychobiologic Alterations in Aging

Combat Veterans with PTSD

Yehuda, Rachel, Ph.D.

$109,890

Control of Gene Expression by

Hepatitis B Virus

Yen, Tien-Sze B., M.D., Ph.D.

$59,940

Rehabilitation Research And

Development Service

Factors Contributing to Older Adult

Disability in Rising from a Bed and

from the Floor

Alexander, Neil, M.D.

$124,046

Factors Affecting Time Between

CVA Onset and Rehabilitation in the VA

Bates, Barbara, M.D.

$15,000

Effects of Work Activity and Cognitive

Rehabilitation on Schizophrenia:

A Matching Study

Bell, Morris D., Ph.D.

$212,600

Rehabilitation Effects of Pay, Activity

and Support on Schizophrenia

Bell, Morris D., Ph.D.

$47,525

Feasibility of a Cross Trained

Rehabilitation Therapy Assistant on

an Inpatient Rehabilitation Team:

Blake, Donna Jo, M.D.

$37,500

Development of a Data Base of

Cane Techniques

Blasch, Bruce, Ph.D.

$22,896
1998 Annual Report Translating Research Into Practice 59

The Effect of Hydrostatic Pressure on

Intervertebral Disc Metabolism

Boden, Scott, M.D.

$109,886

Synergy of Osteoinductive Protein and

Electric Stimuli for Spinal Fusion

Boden, Scott, M.D.

$140,000

Electrical Control of Bowel and Bladder

in Spinal Cord Injury Patients

Bodner, Donald, M.D.

$196,500

Quantification of Prosthetic Treatment

Outcomes

Boone, David, C.P.

$114,352

Investigation of Dynamic Prosthetic

Function: Flexibility

Boone, David, C.P.

$173,004

Development and Pilot Testing of Plantar

Ulcer Healing Boot

Boone, David, C.P.

$24,913

Exercise Program Designs for Older Adults

Boyette, Lisa W., M.Ed.

$62,810

A Prospective Study of Plantar Foot

Pressure and Diabetic Foot Ulcer Risk

Boyko, Edward, M.D.

$175,131

Long-Term Strength Training and

Functional Status in Older Adults

Brandon, L. Jerome, Ph.D.

$106,400

Improving Stepping-Over Responses

in the Elderly Using Simulated Objects

Brown, David, Ph.D.

$89,150

Differential Pressure Walking Assistance

Burgar, Charles G., M.D.

$95,800

Graded Weight-Bearing Exercise for

Improving Ambulation After Stroke

Burgar, Charles G., M.D.

$93,800

Mechanically Assisted Upper Limb

Movement for Assessment and Therapy

Burgar, Charles G., M.D.

$95,000

Mechanical Regulation of

Peri-Prosthetic Tissue Differentiation

Carter, Dennis, Ph.D.

$107,300

Stimulation of Bone Healing Using

Bone-Matrix-Related Biomaterials

Chakkalakal, Dennis, Ph.D.

$119,000

Finite Element and Gait Analysis:

Tools for Prosthesis Design

Childress, Dudley, Ph.D.

$195,700

Technology Transfer of a Computer

Aided Socket Fabrication Technique

Childress, Dudley, Ph.D.

$106,858

Generalized EPP Position Controller for

Electric-Powered Upper-Limb Prostheses

Childress, Dudley, Ph.D.

$158,600
60 Translating Research Into Practice 1998 Annual Report

Out of Laboratory Feedback-Controlled

FNS for Locomotion

Chizeck, Howard J., Sc.D.

$184,400

Validation and Field Testing of a National

Pain Treatment Outcome System

Clark, Michael E., Ph.D.

$9,860

Continuation of the Center for

the Examination of Retrieved,

Orthopaedic Prostheses

Collier, John, D.E.

$142,483

Characterizing Postural Stability in

Relation to Age and Susceptibility

to Falling

Collins, James, Ph.D.

$168,150

Behavioral and Functional Problems in

Dementia Patients with Sensory Loss

Connell, Bettye Rose, Ph.D.

$129,442

Effects of Cushion and Back Support

on Wheelchair Ride Comfort

Cooper, Rory A., Ph.D.

$109,800

Manual Wheelchair User Upper

Exremity Pain

Cooper, Rory A., Ph.D.

$138,313

Restoration of Forearm and Elbow

Functions by FNS

Crago, Patrick E., Ph.D.

$60,961

The Neural Basis of Stress Urinary

Incontinence

Damaser, Margot, Ph.D.

$25,000

UTI Prophylaxis Using Bacterial

Interference Following SCI

Darouiche, Rabih O., M.D.

$116,709

Outcome Assessment of the

Rehabilitation of the Visually Impaired

Del’Aune, William, Ph.D.

$151,750

Effects of Stimulus Variability on

Speech Recognition

Dirks, Donald, Ph.D.

$56,853

Gait Mechanics of the Partial

Foot Amputee

Dorostkar, Mohammad G., M.D.

$146,315

Quantifying Spoken Language

Handicap in Aphasia

Doyle, Patrick, Ph.D.

$120,100

Characterizing Measures of

Stroke Rehabilitation Outcomes

Duncan, Pamela W., Ph.D.

$252,400

Effects of Aging on Motor Unit

Firing Behavior

Erim, Zeynep, Ph.D.

$50,025
1998 Annual Report Translating Research Into Practice 61

Biochemical Analysis of Synovial

Activation in Joint Dysfunction

Evans, Christopher, Ph.D.

$149,752

Investigation of Individualized

High-Frequency Regions for Early

Detection of Ototoxicity

Fausti, Stephen A., Ph.D.

$249,600

Development of an Automated Technique

for the Clinical Evaluation of Tinnitus

Fausti, Stephen A., Ph.D.

$75,500

Improved Bone-Formation Through VEGF

Fava, Roy, Ph.D.

$37,500

A Study to Determine the Biomechanical

Effects of Shock-Absorbing Pylons

Gard, Steven, Ph.D.

$41,200

In Vivo Tissue Response to In Vitro

Synthesized Bone

Garino, Jonathan, M.D.

$79,400

New Strategy for Improved Outcome in

Occult Periprosthetic Musculoskeletal

Infections

Garvin, Kevin, M.D.

$108,000

Effects of Common Drugs on Recovery

After Stroke

Goldstein, Larry, M.D.

$33,750

Development of Improved Middle

Ear Prostheses

Goode, Richard, M.D.

$59,300

Soft Tissue Attachment to Proximal

Femoral Allografts for Hip Revision

Heiner, John P., M.D.

$162,000

Functional Restoration of Grasp in

Quadriplegia

Hentz, Vincent R., M.D.

$104,600

A Study of VA Stroke Rehabilitation

Services and Patient Outcomes

Hoenig, Helen M., M.D.

$36,500

Impact of Occupational Therapy on

the Health Status of Elderly Veterans

Holleman, Donald R., M.D.

$185,200

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.

$76,500

Orthopedic Footwear CAD/CAM and

Diabetic Risk of Pedal Ulceration

Houston, Vern, Ph.D.

$263,254

Clinical Testing of the Enhanced VACyberware BK Prosthetics Optical Digitizer

Houston, Vern, Ph.D.

$143,034
62 Translating Research Into Practice 1998 Annual Report

Disuse Induced Articular Cartilage

Atrophy, Over-Exercise and Arthritis

Howell, David, M.D.

$87,500

Cause of Male Infertility After Spinal

Cord Injury and Its Prevention

Huang, Hosea F.S., Ph.D.

$178,060

Quantitative Study and Augmentation of

Cough in Persons with Spinal Cord Injury

Jaeger, Robert, Ph.D.

$72,100

Gonadal Steroids as Rehabilitative

Agents After Partial Spinal Cord Injury

Jones, Kathryn J., Ph.D.

$116,200

Treatment of Sciatic Nerve Injury with

Gonadal Steroids

Jones, Kathryn J., Ph.D.

$86,700

Frequency Selectivity Assessment:

Implications for Auditory Rehabilitation

Kane, James, Ph.D.

$60,000

Transport of NGFs + MIF-1 into

Spinal Cord

Kastin, Abba J., M.D.

$135,760

Electric Field Effects on Slow Axonal

Transport Components in SCI

Khan, Talat, Ph.D.

$135,000

Electric Fields and Carbon Fibers in the

Treatment of Spinal Cord Injury

Khan, Talat, Ph.D.

$165,100

Fracture Occurrence and Healing in Spinal

Cord Injured Patients

Kiratli, Beatrice J., Ph.D.

$85,200

Static Versus Dynamic FES Exercise

and Heart Disease Risk Factors in SCI

Kiratli, Beatrice J., Ph.D.

$111,100

The Effects of Spinal Instrumentation

Kirkpatrick, John, M.D.

$55,225

Polestriding Exercise and Vitamin E

for Management of Claudication Pain

Langbein, W. Edwin, Ph.D.

$104,400

Comparing Off-Loading Modalities

to Heal Diabetic Foot Wounds

Lavery, Lawrence, D.P.M.

$108,300

The Effect of Exercise Training on

Hemoglobin A1c’s of Type II Diabetics

in a Controlled Randomized

Leach, Carol, M.H.A.

$59,200

Physical Exercise Strength Training to

Improve the Health of Dialysis Patients

Leaf, David, M.D.

$60,250

Biomechanics of the Patellofemoral Joint

Lee, Thay Q., M.S.

$27,475
1998 Annual Report Translating Research Into Practice 63

Biomechanics of Patellofemoral Joint

and Peripatellar Retinaculum

Lee, Thay Q., M.S.

$22,500

Effect of the Bankart Lesion on

AnteriorJoint Stability with Simulated

Glenohumeral Muscle Forces

Lee, Thay Q., M.S.

$29,750

Physiological Basis of Strength

Following Surgical Tendon Transfer

Lieber, Richard L., Ph.D.

$165,000

Functional Magnetic Cough in Patients

with Spinal Cord Injury

Lin, Vernon W., M.D.

$186,700

Functional Magnetic Micturition in

Patients with Spinal Cord Injury

Lin, Vernon W., M.D.

$48,325

High-Frequency Magnetic Stimulation

of the Bladder and Bowel

Lin, Vernon W., M.D.

$19,325

Acute Effects of Spinal Cord Injury on

Sperm Function

Linsenmeyer, Todd, M.D.

$99,100

Eustachian Tube and Middle-ear

Prosthesis Implants: Chronic Ear Disease

Linstrom, Christopher, M.D.

$135,543

Quantitative Measurement of

Upper Limb Spasticity

Little, James, M.D., Ph.D.

$14,300

A Biodegradable Device for

Peripheral Nerve Repair

Madison, Roger, Ph.D.

$86,000

Clinical Evaluation of a

Dermofluorometer in Diabetic Patients

Magin, Richard, Ph.D.

$38,525

Development of the Scanning Laser

Ophthalmoscope for Low Vision

Rehabilitation - Phase 2

Maino, Joseph, O.D.

$211,170

Design of a Motorized Prone Cart

Malassigne, Pascal, M.I.D.

$113,330

Factors Leading to Disuse of Low Vision

Devices by Visually Impaired Elderly

Mancil, Gary L., O.D.

$29,975

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.

$48,700
64 Translating Research Into Practice 1998 Annual Report

Problem Solving Strategies of Brain

Injured and Normal Subjects

Marshall, Robert C., Ph.D.

$60,500

FES Mobility in Paraplegia:

RF-Controlled Implanted System

Marsolais, E. Byron, M.D.

$272,650

Vision Evaluation and Training

System (VETS)

Massof, Robert, Ph.D.

$111,100

Long-Term Evaluation of Maxillary Sinus

Bone Grafts with Dental Implants

McAnear, Jon Tom, D.D.S.

$7,520

An In-Vivo Model for Cartilage

Regeneration

McGuire, Jr., Hunter H., M.D.

$167,932

Development of Quality of Life Measures

for Use in Dysphagia

McHorney, Colleen, Ph.D.

$118,000

Performance-Based Prevention/Rehabilitation of Falls in Elderly Veterans

Means, Kevin M., M.D.

$157,312

Electrophysiology Indices: Auditory

Discrimination and Cognitive Processes

Moenter, Darlene, Ph.D.

$44,000

Establishing Standard of Care:

Upper Limb Prosthetic services

Monga, Trilok N., M.D.

$66,166

Electrical Activation of the Diaphragm

for Ventilatory Assist

Mortimer, J. Thomas, Ph.D.

$275,290

Sweat Response in MS Patients During

Exercise - A Pilot Study

Mulcare, Janet, Ph.D.

$34,450

Effect of Wrist Exposures on Median

Nerve Conduction: A Pilot Study

Nelson, Audrey, Ph.D.

$50,000

Quantifying Auditory Perceptual Learning

Following Hearing Aid Fitting

Nelson, Charles, M.S.

$67,450

A Minimal Test Effort for Patients in

Pain using the Back Analysis System

Oddsson, Lars

$178,976

Preventing Slips & Falls in the

Elderly - Effects of Simple

Biomechanical Interventions

Oddsson, Lars

$210,950

Optimized Surface Bonding and Stiffness of

Femoral Endoprostheses

Orr, Tracy, Ph.D.

$99,994

Fracture Prediction for Femurs with

Wear Particle-Induced Osteolytic

Lesions Associated with

Orr, Tracy, Ph.D.

$122,827
1998 Annual Report Translating Research Into Practice 65

Compliance Monitor to Measure Patient

Wearing-Time for Spinal Orthoses

Patwardhan, Avinash G., Ph.D.

$63,800

Microphotodiode Tiles as Prostheses

for the Restoration of Visual Function

Peachey, Neal, Ph.D.

$127,900

FES Control of the Upper

Extremity in SCI

Peckham, P. Hunter, Ph.D.

$240,550

Improvements in a New Technique

for Increasing Movement after Stroke

Pidikiti, Rama, M.D.

$124,850

Outcome of Lower Extremity ConstraintInduced Therapy after Stroke

Pidikiti, Rama, M.D.

$195,800

Cognitive Rehabilitation of Dementia

by Stimulation-Induced Normalization

of the EEG Power Spectrum:

Politoff, Alberto, M.D.

$22,179

Exercise Testing and Training of

Multiple Sclerosis Patients

Ponichtera-Mulcare, Janet A., Ph.D.

$26,083

Effects of Medications on Spasticity in

Spinal Cord Injury: A Quantitative Study

Priebe, Michael, M.D.

$123,300

Evaluation of Non-Auditory Factors Which

Affect Hearing Aid Use in Elderly Veterans

Rappaport, Bruce Z., Ph.D.

$24,475

Clinical Trial of Footwear in Patients

with Diabetes

Reiber, Gayle, Ph.D.

$166,998

Colonic Rehabilitation with

Microstimulators After Spinal Cord Injury

Riedy, Lisa, Ph.D.

$89,300

Restricted Useful Field of View as a Risk

Factor for Falls in Older Adults

Riolo, Lisa, Ph.D.

$55,600

Physical Performance Measures for

Young, Middle-Aged and Elderly

Manual Wheelchair Users

Rodgers, Mary, Ph.D.

$102,645

Employment of Infra-Red Beacons as

Guides for People with Visual Disability

Ross, David, M.S.E.E

$49,980

Back Exercise Prescription and

Implementation by Surface

Electromyographic Procedures

Roy, Serge H., Sc.D.

$222,000

Effect of Component Placement on the

Patellofemoral Joint in TKA

Rubash, Harry E., M.D.

$56,800

Restoration of Gait for Acute Stroke

Patients Using FES

Ruff, Robert, M.D.

$169,200
66 Translating Research Into Practice 1998 Annual Report

Clinical Trial of Artificial

Peripheral Nerve Graft

Sabelman, Eric, Ph.D.

$180,800

Advanced Accelerometric Motion

Analysis System (Design/Development)

Sabelman, Eric, Ph.D.

$119,900

Reliability and Validity of Accelerometric

Gait and Balance Diagnosis

Sabelman, Eric, Ph.D.

$162,600

Is There an “Acclimitization Effect”

with Hearing Aids?

Sammeth, Carol A., Ph.D.

$10,800

Biomechanics of Foot Deformities and

Alternatives for Surgical Correction

Sangeorzan, Bruce, M.D.

$95,715

Neurotrophin Secreting Schwann Cells

for Treatment of Spinal Cord Injury

Sayers, Scott, Ph.D.

$12,500

Fatigue Strength of Composite Femoral

Components for Hip Arthroplasty

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

$97,980

FES on Spinal Cord Injured

Patients: Effects on Muscle Blood

Flow and Metabolism

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

$122,000

Evaluation of Limb Blood Flow

Measurements with H2150 PET to

Determine Level of Amputation

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

$12,500

Evaluation of Word-Recognition

Performance with Sentence

Materials

Shanks, Janet E., Ph.D.

$68,900

Acclimitization in Monaurally

Fitted Adults

Silman, Shlomo, Ph.D.

$175,954

Effects of Aerobic Exercise on Gait

and Functional Performance in

Hemiparetic Stroke

Silver, Kenneth, M.D.

$72,050

Mechanical Loading Effects on

Cartilage Repair and Regeneration

Smith, Robert Lane, Ph.D.

$98,818

Randomized Controlled Trial of

Upper- Extremity Exercise Training

in Patients with COPD

Sparrow, David, D.Sc.

$113,500

Modification of Polyethylene to

Improve the Wear Performance of

Joint Replacement Prostheses

Spector, Myron, Ph.D.

$45,396

Team Characteristics and Patient

Outcomes on VA Rehab Services

Strasser, Dale, M.D.

$150,420
1998 Annual Report Translating Research Into Practice 67

Cortical Contributions to the

Recovery of Motor Function

Strick, Peter, Ph.D.

$215,900

Visual Rehabilitation with Retinal

Prosthetic Microtiles

Stubbs, Jr., Evan, Ph.D.

$13,625

Assessment of Reading Capabilities

of the Parafoveal Retina and

Evaluation of Techniques to Enhance

Reading in Patients with Age-Related

Macular Degeneration

Szlyk, Janet P., Ph.D.

$45,300

Evaluation of Central and Peripheral

Vision Enhancement Devices

for Driving

Szlyk, Janet P., Ph.D.

$215,000

Video-Based Functional Performance

Assessment and Training Tool

Van Der Loos, H. F. Machiel, Ph.D.

$17,100

Development of an Assistive Robot

for Effective Health Care Delivery

Van Der Loos, H.F., Ph.D.

$129,500

Noninvasive Recording of Bladder

Pressure in Elderly Males

Walter, James, Ph.D.

$60,600

Analysis and Treatment of Apraxic

Sound Errors

Wambaugh, Julie L., Ph.D.

$122,800

Impact of Low Vision and

Rehabilitation on Elder Literacy

Watson, Gale R., M.A.Ed.

$30,073

Measuring Low Vision Reading

Assessments Using a Scanning

Laser Ophthalmoscope

Watson, Gale R., M.A.Ed.

$62,850

Fading-in of Right Hemispatial Information

in the Treatment of Unilateral Neglect

Webster, Jeffrey, Ph.D.

$96,630

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

Personal Relevance and Ethnicity in

Stoke Patients as a Health Care

Delivery Issue

Wolfe, Gary

$21,370

Biological Responses in the

Pathogenesis of Aseptic Loosening

Wooley, Paul, Ph.D.

$174,900
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.

Note of Appreciation