The Wayne State University School of Medicine Department of Immunology and Microbiology has announced two seminars for the month of January.

Nicholas G. Davis, Ph.D., associate professor of the Department of Pharmacology, will present “Protein palmitoylation in yeast and at the synapse” Jan. 6.

On Jan. 27, Fei Song, M.D., Ph.D., assistant professor of the Department of Neurology and the Center for Molecular Medicine and Genetics, will speak on “Immunomodulation and immunotherapy in CNS inflammatory autoimmune diseases.”

Both seminars will take place from noon to 1 p.m. in Room 7364 of Scott Hall.

A Wayne State University School of Medicine assistant professor will be interviewed about dementia and other health problems among the Latino population by the nation’s largest private non-profit Spanish-language network of non-commercial telecommunications systems.

Hector Gonzalez, Ph.D., will be interviewed for the Hispanic Information and Telecommunications Network. With 12.7 million viewers, HITN claims to be the largest distributed Spanish-language cable network in the United States.

Dr. González, a clinical neuropsychologist and an assistant professor in the Department of Family Medicine and Public Health Sciences, has a joint appointment in the Institute of Gerontology.

He will be interviewed by telephone for the program “Diálago de Costa y Costa” (Dialog Coast to Coast). Conducted in Spanish, the interview came about, Dr. Gonzalez explained, because colleagues in the Hispanic Community Health Study/Study of Latinos recommended him to HITN.

“It seems there are very few Latinos with expertise on aging and dementia in the country,” Dr. Gonzalez said. “Because of the unacceptable dearth of Mexican-American clinicians and scholars, I got into this business to serve my community's health needs. I feel it is both an honor and an obligation to serve the community by providing the best information available in ways that makes sense and have lasting impact.”

Dr. Gonzalez noted that the prevalence of dementia among Latinos of Caribbean descent may be higher.

“Our own work with Mexican-Americans, like many of the good people of Detroit and Michigan, indicates the prevalence is no higher than among non-Latino whites,” he said. “One thing we do know is that chronic conditions, like diabetes and hypertension, are important risks for dementia among Mexican-Americans. By the way, it is important to remember that Mexican-Americans make up nearly 70 percent of all Latinos in the U.S.

“A lot of older adults are very concerned and fearful of dementia, and rightfully so,” Dr. Gonzalez added. “As a public health professional, I will stress the importance of controlling aforementioned risks for dementia. This is important, given there are no cures.”

The program is expected to air this month. HITN is available in the Detroit region via Dish Network channels 9401 and 843, and Directv 461.

Dr. Herbert C. Smitherman Jr., assistant dean of Community and Urban Health and assistant professor of the Department of Medicine for the Wayne State University School of Medicine, has been recommended by a Detroit congressman as the next U.S. surgeon general.

U.S. Rep. John Conyers has submitted a letter recommending Dr. Smitherman be named the highest health official in the nation to President-elect Barack Obama’s transition team.

“I was called on Nov. 5 by Congressman Conyers, who asked me if he could forward my name to the Obama-Biden transition team recommending me for U.S. surgeon general,” confirmed Smitherman, M.D., M.P.H., F.A.C.P. “I indicated that I was honored to be considered for such a recommendation by his office.”

Rep. Conyers followed up with a subsequent meeting with Dr. Smitherman, and then submitted the recommendation in writing to the Obama team.

Rep. Conyers wrote that his recommendation of Smitherman was inspired by his “personal and professional commitment to serving (his) community, state and nation.”

“Your integrity, academic excellence, health policy leadership, as well as your intellectual interests and career pursuits have supplemented your commitment to finding solutions for providing health care services to the uninsured and underinsured,” Rep. Conyers added in a letter to Dr. Smitherman.

The Conyers recommendation was quickly followed up by support from Gov. Jennifer Granholm.

Dr. Smitherman “is an informed and engaged advocate for affordable and preventative health care services and has been involved in crafting effective health policy in this state and sharing his experiences nationwide,” Gov. Granholm wrote to the Obama transition team. He has helped “lead the expansion of federally qualified health centers, including Health Centers Detroit, which he leads as president and CEO. He has also written a book (“Taking Care of the Uninsured: A Path to Reform”) that articulates a successful community health model for care of the uninsured and underinsured.”

Robert M. Mentzer Jr., M.D., dean of the School of Medicine and senior advisor to the president on Medical Affairs, said such national recognition speaks highly of Dr. Smitherman’s efforts and one of the school’s stated missions of providing care to the community.

“Dr. Smitherman not only exemplifies that part of our mission, he lives it daily,” said Dean Mentzer. “His work in the community on behalf of the School of Medicine shows that commitment and a focused effort can truly make a difference in providing health care for underserved populations. If he is appointed surgeon general, I can assure you that goal will remain at the top of his priority list.”

Dr. Smitherman, who this year received the School of Medicine’s Trailblazer Award for substantial contributions, courage, initiative, innovation, risk-taking and leadership, said that if he is offered the position he will accept, but maintain his Wayne State University appointment.

“It is a critical position, especially on the eve of president-elect Obama’s broad agenda for U.S. health care reform,” said Dr. Smitherman, 48. “My focus for the past 22 years here at Wayne State University has been twofold: that of creatively improving coverage and organizing delivery systems toward improved access to care for vulnerable populations and increasing the health status of my community. The U.S. Surgeon General role would be an opportunity to do this for my country.”

Dr. Smitherman has spent the past 22 years working with diverse communities in Detroit to develop urban-based primary-care delivery systems that integrate the health and social goals and concerns of the community. He has been successful establishing and working with best-practice models that have community participation and collaboration as the key element in creating sustainable primary care programs. Early results suggest that generating a sense of community ownership may lead to healthier communities overall.

Wayne State University School of Medicine students will have the opportunity to gain valuable insight into medical careers, loan repayment, and balancing resident and family obligations, along with free pizza, during the Wayne State University Medical Alumni Association’s annual Alumni-Student Career Evening on Jan. 7, 2009.

Now in its 11th year, the program will take place on the first floor of Scott Hall, beginning with registration at 4:30 p.m. and a pizza dinner from 5 to 6 p.m.

The dinner will be followed by three 30-minute sessions, beginning at 6:15 p.m., 6:50 p.m. and 7:25 p.m. Students will hear from physicians in various specialties as they rotate between the three sessions.

A dessert reception will follow the information sessions from 8 to 8:30 p.m. in the cafeteria for presenters, alumni and students, providing additional opportunity for students to ask more questions.

Students received invitations in their mailboxes the week of Nov. 17, as well as e-mail reminders weekly. The deadline to sign up for Career Evening is Dec. 24. Students may complete a registration form and email it to Lisa Ramos, assistant director of Medical Alumni Affairs, at lramos@med.wayne.edu. Students may also print out the form and drop it off at the Student Affairs Office in Room 1369 of Scott Hall.

The Wayne State University School of Medicine will participate in a trial comparing the effectiveness of two FDA-approved anti-seizure medications and how they are administered to patients before they arrive at hospitals.

The Rapid Anticonvulsant Medication Prior to Arrival Trial, or RAMPART, is sponsored by the National Institutes of Health. The purpose of the study is to determine whether Midazolam or Lorazepam are safer and more effective at stopping seizures when paramedics are called to treat a patient whose seizures aren’t stopping.

The study will be conducted on patients transported to and treated at Detroit Receiving and Sinai-Grace hospitals. Robert Welch, M.D., associate professor of the Department of Emergency Medicine, will oversee the study. Dr. Welch also serves as associate director of Clinical Research for the department, as well as principal investigator of the Wayne State University hub of the Neurological Emergencies Treatment Trials Network (NETT).

The network, funded by the National Institutes of Health, includes more than 100 emergency departments and Emergency Medical Services agencies in 17 major metropolitan areas. The organization was formed to conduct large trials to reduce the burden of injuries and illnesses affecting the brain, spinal cord and peripheral nervous system. The network, said Dr. Welch, explores the narrow window of opportunity that seems to exist in treating neurologic damage from a variety of conditions, ranging from stroke and traumatic brain injury to seizures and meningitis. The study of rapid interventions under study by NETT requires the assistance of paramedics treating patients in the field.

The seizures, called status epilepticus, create an emergency situation, Dr. Welch said. Estimates indicate that between 120,000 and 200,000 cases take place each year in the United States. As many as 55,000 people die from such seizures.

Complications of prolonged seizures, Dr. Welch explained, include impaired ventilation and aspiration into the lungs, which can result in pneumonia. Other problems include heart rhythm problems and direct injury to the nervous system.

“Optimal outcomes in patients, therefore depends on treatments that lead to rapid cessation of seizure,” Dr. Welch said. “In the pre-hospital setting, it can be difficult to treat this group of patients, particularly since starting an IV to administer medications can be very difficult.”

Dr. Welch said the study should begin by March 2009 and may continue for two years. Nationwide, the study may involve as many as patients, and Dr. Welch expects to oversee “one of the top enrolling sites.”

Area residents who suffer a seizure and are treated by Detroit EMS personnel may be enrolled in the RAMPART trial. Since the study will involve patients who are severely injured or severely affected and can’t make decisions for themselves, the research has been given exception from informed consent parameters.

Seizure patients in the study will receive one of two medicines from paramedics – Midazolam or Lorazepam -- and a placebo (saline with no medicine). Patients who are injected with Midazolam will receive the saline intravenously. Patients who receive a placebo injection will be given Lorazepam intravenously.

If patients are unconscious after they have been transported to the hospital and the seizure has subsided, a member of the study team will attempt to contact a family member. If patients later determine that they no longer wish to continue participating in the study after initial treatment, they may opt out.

For questions regarding the study, call the RAMPART trial hotline at 1-866-929-6388.

A Wayne State University School of Medicine professor has published research that could open the gateway for the exploration of new treatments for autism, schizophrenia and a host of other neurodegenerative diseases.

Alexander Gow, Ph.D., associate professor of the Center for Molecular Medicine and Genetics, the Carman and Ann Adams Department of Pediatrics and the Department of Neurology, published the paper, “Claudin 11 Stops the Leaks,” in the Dec. 1 issue of the Journal of Cell Biology.

The brain, for the most part, can be divided into gray and white areas. Neurons are located in the gray area, and the white parts are where the neurons send their axons – similar to electrical cables carrying messages – to communicate with other neurons or muscles.

The white parts of the brain are white, Dr. Gow explained, because a cell type called oligodendrocytes makes a cholesterol-rich membrane called myelin that coats the axons. The myelin’s function is to insulate the axons, much like a rubber coating on an electrical cable. In addition, the myelin speeds communication along axons and makes that communication much more reliable.

Axons come in varying sizes, but generally the smallest are in the brain and the largest outside the brain, such as the sciatic nerve running down the leg. Dr. Gow said scientists have studied larger axons for decades to describe how myelin performs its function and have developed “excellent mathematical models.” However, he said, the models fail when applied to small axons in the brain.

Gow’s study involved destroying a gene in mice that encodes a myelin protein called claudin 11. The protein is a member of a family of proteins that function throughout the body to generate barriers, much like walls in a house compartmentalize rooms. The research showed that claudin 11 serves as a barrier in myelin in the brain to stop electrical current from leaking out of axons as they communicate with other cells. Small axons, which have a thinner sheath of myelin, are the most susceptible to the absence of the barrier. The lack of the barrier can slow electrical communication twofold. Large axons can be affected, but only marginally, because of their thicker myelin coating.

To determine whether claudin 11 was required for myelin’s insulating propensity, Dr. Gow compared electrical recordings from the optic nerve of wild mice and claudin 11 “knockout mice” -- animals in which the protein was suppressed. While claudin 11 deficiency did not change the appearance of the myelin sheath, he found its lack slowed electrical signals in neurons with small axons -- the thinner the sheath, the greater the effect. The protein added to myelin’s electrical resistance and prevented the “leaking” of communication current.

“To explain the results in the knockout mice, we developed a novel computer model of myelinated axons,” Dr. Gow said. “This model is based on previous models, but includes new features. Our model can account for the results we obtain. In contrast, previously developed models cannot account for the data. Our computer model enables us to show that the function of claudin 11 is to increase the electrical resistance of thin myelin, which improves the speed of electrical communication for small neurons.”

One of the most important areas of the brain where small axons are located is the corpus callosum, a structure that serves to connect the left and right halves of the brain. That communication allows humans to process sensory information such as sight and hearing, and facilitates appropriate interactions with the environment.

Patients with schizophrenia and other affective disorders are thought to suffer from brain disconnect –- the different parts of the brain don’t communicate with each other. Dr. Gow said this can be interpreted as neurons not sending signals to different parts of the brain or signals being sent but arriving too late because of myelin defects that allow “leaking.”

While Dr. Gow said the significance of the research in terms of immediately combating disease and disorders is speculative at this point, the findings may explain some of the symptoms for a number of neurological diseases, including autism, schizophrenia and other disorders.

“Currently, affective disorders are believed to involve defects in neurotransmitter function in the brain,” he explained. “However, the claudin 11 story suggests additional possibilities, specifically that defects in myelin can contribute to or cause symptoms.”

He pointed out that structural defects in myelin have been observed in neurological diseases via magnetic resonance imaging studies. These patients have also been found to display decreases in the speed of neuron communication. Patients with multiple sclerosis exhibit thinned myelin coatings in axons.

The abnormal expression of myelin proteins has been found in autopsy specimens from those suffering from schizophrenia. A strong candidate gene for schizophrenia, called neuregulin, is thought to be involved in regulating myelin synthesis as well as neurotransmitters in the brain. Another gene that regulates myelin synthesis is implicated in genetic forms of schizophrenia.

Patients with multiple sclerosis display neuronal loss and myelin abnormalities. In the disease’s advanced stages, much of the myelin damage is repaired, but the myelin is too thin. For small axons, this is equivalent to losing claudin 11. Multiple sclerosis patients, Dr. Gow said, can exhibit symptoms of schizophrenia, suggesting that thin myelin could be a contributing factor.

“While our study doesn’t suggest any treatments at this stage, it does suggest new directions of research that should be looked at in schizophrenia and other neurodegenerative diseases,” Dr. Gow said.

The Wayne State University School of Medicine Department of Anatomy and Cell Biology will present a seminar at noon Dec. 10.

Kwaku Nantwi, Ph.D., an assistant professor in the department, will present “Adenosine Receptors and Functional Recovery in Spinal Cord Injury.”

The seminar will take place in Room 8366 of Scott Hall.

The associate chair of the Wayne State University School of Medicine’s Department of Neurology played a key role in creating new guidelines developed to assist in the evaluation of patients who may suffer from neuropathy.

Richard A. Lewis M.D., professor and associate chair of Neurology for the School of Medicine, said the guidelines, adopted by the American Academy of Neurology (AAN), will aid clinicians in evaluating patients, and provide a more efficient and complete evaluation.

The guidelines were published in the Dec. 3, 2008, online issue of Neurology, the medical journal of the American Academy of Neurology.

“The group of clinicians involved in this study represents some of the most outstanding investigators in clinical peripheral nerve disease,” Dr. Lewis said. “As the lead author on the skin biopsy section, I was honored to work with three outstanding investigators who lead the field in the use of skin biopsy for clinical and research purposes.”

Dr. Lewis said he and his co-authors performed a comprehensive analysis of all available scientific studies on neuropathy to develop the guidelines.

The study recommends physicians consider a set of tests that measure the action of nerves that control sweating, heart rate and blood pressure. Skin biopsy may also be useful to diagnose loss of nerve fibers, according to the AAN.

Dr. Lewis praised two of his colleagues, noting that “some of the most unique uses of skin biopsy in investigating peripheral nerve disease are being pioneered at Wayne State in the laboratories of Drs. Michael Shy and Jun Li.”

Jun Li, M.D., Ph.D., is an associate professor of Neurology. Michael Shy, M.D., is a professor of Neurology and member of the Center for Molecular Medicine and Genetics at the School of Medicine.

The new guidelines, according to the AAN, indicate a combination of blood tests and other assessments appear to be “most helpful” for tracing the cause of neuropathy, also known as neuritis or distal symmetric polyneuropathy. The nerve disorder affects one in 50 people in the general population and one in 12 over the age of 55, according to the AAN. Symptoms include numbness, tingling or pain, often starting in the feet and moving to the hands. The most common cause is diabetes, although heredity, alcohol abuse, poor nutrition and autoimmune processes can have an effect.

The report was supported and funded by the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation.

Dr. Lewis’s co-authors include J.D. England, M.D. (chair); G.S. Gronseth, M.D.; G. Franklin, M.D.; G.T. Carter, M.D.; J. Kinsella, M.D.; J.A. Cohen, M.D.; ,A.K. Asbury, M.D.; K. Szigeti, M.D., Ph.D.; J.R. Lupski, M.D., Ph.D.; N. Latov, M.D.; P.A. Low, M.D.; M.A. Fisher, M.D.; D.N. Herrmann, M.D.; J.F. Howard Jr., M.D.; G. Lauria, M.D.; R.G. Miller, M.D.; M. Polydefkis, M.D., M.H.S.; and A.J. Sumner, M.D.

The Wayne State University School of Medicine Department of Anatomy and Cell Biology will present a seminar by William M. Armstead, Ph.D., speaking on “Age and Sex Dependent Mechanisms in Pediatric Traumatic Brain Injury,” on Dec. 3.

Dr. Armstead is a research associate professor in the Department of Anesthesiology and Critical Care at the University of Pennsylvania.

The seminar begins at noon in Room 8366 of Scott Hall.

The Wayne State University School of Medicine Department of Psychiatry and Behavioral Neurosciences will present “The Pregnant Psychiatrist: A Resident’s Perspective” during chairman’s grand rounds Dec. 3.

Sunita Muranjan, M.D., will present the topic at 1 p.m. in the John D. Dingell VA Medical Center Auditorium.