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School of Medicine discoveries

February 2012 Archives

29
2012

Modern day revelations from ancient Egypt

Mummy CT

The University of Richmond’s resident mummy, Ti-Ameny-Net, on the CT table. In just minutes, the state-of-the-art scanner acquired 25,000 images with a head-to-heel scan.

It started with an email.

On a summer afternoon, Ann Fulcher, M.D., opened her inbox to find a message from University of Richmond student Caroline Cobert. The junior was part of a research project involving the University of Richmond’s resident mummy, Ti-Ameny-Net.

She’d sought out Radiology Chair Fulcher to ask if the Department could help in obtaining CT or x-ray images of the mummy?

Fulcher’s response? “Of course!”

“As recently as the 1970s, scientists performed mummy autopsies that entailed not only unwrapping the mummies but cutting through their bones and tissues,” said Fulcher, a member of the medical school’s Class of 1987 and now chairman and professor of the Department of Radiology. “But with today’s sophisticated CT scanners and software, we can study mummies without destroying them. These images let us electronically unwrap the mummy’s linen to reveal her skeleton.”

The 3,000-year-old mummy was packed up at UR, cushioned by small bean bags that acted as shock absorbers and driven not quite 10 miles to the MCV Campus. There she was placed in a 64-detector, all-purpose scanner that is usually used to answer a specific clinical question. For human patients, the radiation dose is kept to a minimum and a focused exam of a portion of the body provides physicians with information for diagnosis or treatment plans.

But in the case of Ti-Ameny, the hi-tech scanner provided a head-to-heel glimpse into the remote past and into the life of an ancient Egyptian woman. In a matter of seconds, the scanner delivered 25,000 images.

“I didn’t expect this level of preservation,” Fulcher said of the “exquisite” level of detail captured. “I could identify all the muscle groups because all her muscles were perfectly intact.”

Mummy CT

The CT images of the head were used to create a 3D rotational image that a forensic artist Joshua Harker used to render an image of how Ti-A may have looked in life.

Fulcher was able to determine that Ti-Ameny was probably about 30 years of age when she died, which would not have been considered unusually young in ancient Egypt. Fulcher spotted signs of scoliosis of the spine and associated degenerative change, but there was no evidence of trauma or of metabolic bone disease. Her teeth, however, appeared a bit unusual compared to modern-day standards.

“Ancient Egyptians added sand to grain in order to grind it more finely,” Fulcher said. “A portion of the sand remained in their flour and resulted in the grinding down of their teeth, in some cases to the pulp, but Ti-A showed overall good dental health.”

Ti-Ameny’s preserved body showed she had benefitted from good nutrition. This, combined with the unusual effort taken to preserve the body, could be evidence that Ti-Ameny was from an elite class, perhaps the priesthood or a royal family.

The CT scans also confirmed what is known about Egyptian mummification practices. The cribriform plate and sella – bones at the base of the skull and the back of the nose – had been broken to provide a route for accessing the brain and removing it.

Abdominal organs were also removed before preservation but, Fulcher pointed out, the heart was left in place. “They saw it as the seat of the soul.” And that’s where Fulcher found her most telling finding: signs of atherosclerosis, a common ailment of the time. The resulting heavy calcifications in the vessels of Ti-A’s heart are one likely cause of death.

Fulcher’s diagnosis was independently supported by a DNA analysis. While Ti-Ameny was on the MCV Campus, a bone marrow biopsy had been taken from the femur and pelvic bones. Analysis showed no indication of common and deadly infections like malaria or tuberculosis, but there was a clear correlation for hereditary coronary artery disease.

In February, Fulcher made the 10-mile trip to University of Richmond to share her findings in an unusual Grand Rounds. Together with her student research partner Caroline Colbert, they reviewed the CT results for a packed house that included physicians and staff from the MCV Campus as well as UR students, faculty and community members.

Colbert has translated her research study into a dual degree in biology and classical civilization. She’s now headed to England and a graduate program that will allow her to continue her work with mummies.

For her part, Fulcher couldn’t be more pleased with the collaboration. “This shows how you can combine arts and science to bring history to life.”

On display
An exhibition featuring Fulcher and Colbert’s research is on display at the Lora Robins Gallery of Design from Nature at the University of Richmond. “Ti-Ameny Net: an Ancient Mummy, an Egyptian Woman, and Modern Science” runs through November 16, 2012. For information, please visit the museum’s website.

12
2012

Jennifer Harvey: Medical student by day, NCAA volleyball player by night

When first-year student Jennifer Harvey enrolled in the medical school last fall, she also stepped onto the VCU women’s volleyball team.

She’s believed to be the first person at VCU to try juggling the responsibilities of both a Division I athlete and medical student. Her accomplishment is featured in the December issue of VCU Athletics’ Ram Report.

Jennifer Harvey

Despite four years away from the game, first-year medical student Jennifer Harvey joined the VCU Volleyball team last fall.
Photo courtesy of VCU Athletics

Student athletes are given five years to compete in four seasons of any given sport. During her undergraduate studies at Virginia Tech, she played soccer, accumulating 44 career points and being named Academic All-America in 2010.

Though Harvey had used up her four years of soccer eligibility, as long as she was in college this year, she was eligible to play any other sport during the 2011-12 academic year. She chose volleyball, which she starred in at Cave Spring High School.

VCU Volleyball Coach James Finley said “It was great having somebody with that kind of commitment and that kind of work ethic because that’s such a great influence on our team as a whole, academically and athletically.”

Her medical school schedule forced her to miss certain practices and games, but Harvey always showed up ready to play as often as she could. She appeared in eight matches for the Rams and averaged 1.46 digs per set, a reasonable mark given her limited playing time.

“She absolutely shocked us that her skill level was as high as it was because it was like she’s been playing for three years,” Finley said. “She just has such a natural ability to read and know where the ball’s going to go and she’s a phenomenal athlete.”

The volleyball season ended with the team posting an 8-6 record in conference play. Read the full story of how Harvey handled the responsibilities of her fall schedule in the Ram Report.

04
2012

Students host policy panel and workshops for regional peers, pre-med students

More than 110 medical and pre-medical college students visited the MCV Campus on February 4 for the regional meeting of the Student National Medical Association. The VCU Chapter of the SNMA hosted the meeting, putting together a program that drew participants from around Virginia, Maryland and Washington, D.C.

Audra Stone

First-year student Audra Stone speaks with pre-medical and medical students from D.C., Virginia and Maryland.

To maximize the day’s potential, the medical student organizers packed opportunities into the daylong program. In the morning, medical students headed into clinical workshop sessions where they tried their hand at techniques in a variety of specialties including innovative robotic surgery, anesthesiology and cardiology. Meanwhile, pre-med students benefited from individualized advising sessions on applying to medical school.

“This unique experience gave students the chance to interact one-on-one with inspiring physicians from the VCU Medical Center,” said Maria Stevens, a second-year student in the VCU School of Medicine. “Having the opportunity to help organize this event as well as be a participant in the sessions was an extremely rewarding and unforgettable learning experience.”

The afternoon’s policy panel was a reflection of the SNMA’s goal to address the needs of medically underserved communities as well as increase the number of underrepresented minorities in medicine. Organizers invited physicians to sit side-by-side with elected representatives and discuss current topics like health disparities in minority populations and the impact the Affordable Care Act could have in Virginia and America at large.

Health policy panel

Rep. Bobby Scott, Sheldon Retchin, M.D., Del. Jennifer McClellan, Jack Lanier, Dr.PH., and Sheryl Garland, M.H.A., answer questions from medical students during the health policy panel.

The Richmond Times-Dispatch reported that panelist Del. Jennifer McClellan encouraged physicians to make their voices heard. “How many doctors do you think come to the committee meetings and talk to their legislators on a regular basis?” the representative of the 71st House of Delegates District was reported as asking. “You have public policies that are being made by people about health care who don’t fully understand the impact of what they are doing.”

Other speakers included PonJola Coney, M.D., senior associate dean for faculty affairs in the medical school and director of the Center on Health Disparities; Sheryl Garland, M.H.A., VCU Health System vice president of health policy and community relations; Jack Lanier, M.H.A., Dr.PH., CEO of the Richmond Behavioral Health Authority; Sheldon Retchin, M.D., CEO of the VCU Health System; and Virginia Rep. Robert C. “Bobby” Scott, D-3rd. Wally Smith, M.D., the science director of the Center on Health Disparities, moderated the panel.

VCU medical students

VCU medical students during the lunch meet-and-greet with pre-medical and medical students from D.C., Virginia, and Maryland.

“The unlimited support of senior administrators and staff in helping us execute this event strongly affirms the university’s overall commitment to increasing the diversity of medical students here at the VCU School of Medicine,” said second-year student Priscilla Mpasi, who serves as president of the VCU chapter of the SNMA.

Mpasi’s impression of the day was that “it reflects the commitment of our local chapter to uphold the mission of the SNMA to develop clinically excellent, culturally competent and socially conscious physicians through programming that focuses on academic enrichment, clinical skill development and education on important health care policies.”

Read the Richmond Times-Dispatch’s coverage of the daylong program.

Photos courtesy of Tu Nguyen, second-year med student, and Mohamed Abbamin, legislative assistant to Congressman Scott.

03
2012

VA Chief draws attention to polytrauma rehabilitation

Richmond’s McGuire Veterans Affairs Medical Center has built the reputation as the VA system’s premiere program for treating polytrauma patients, those soldiers who come from the battlefield with multiple disabling injuries including traumatic brain injury.

VA tour

From left to right: Director of the Richmond VA Medical Center Charles E. Sepich, U.S. Secretary of Veterans Affairs Eric K. Shinseki, Virginia Rep. Robert C. “Bobby” Scott, D-3rd, Dean of Medicine Jerome F. Strauss, III, M.D., Ph.D., and network director of the region’s Veterans Integrated Service Network Daniel F. Hoffman.

The polytrauma unit at McGuire tests approaches for these difficult to treat patients and then shares what works throughout the VA system. On February 3, Eric K. Shinseki, the U.S. Secretary of Veterans Affairs, visited McGuire for a first-hand view of the work.

Visits like this do a tremendous amount for patients’ recovery, according to Shane McNamee, M.D., who is medical director of McGuire’s Polytrauma Rehabilitation Center. “The patients are buoyed by seeing their senior leadership on site, caring about them as individuals.”

McNamee led Shinseki on a tour that included meeting patients and test driving a backhoe simulator that prepares patients for real-world jobs. As an assistive technology Center of Excellence, the McGuire VA is among the first to get new equipment that is useful in rehabilitation.

McGuire is one of few VA medical centers in the country that treat active duty service members in addition to veterans. Because of that, they see a large number of patients with recent, acute injuries. Shinseki told the Richmond Times-Dispatch that seeing the service members’ hard won improvement made him proud of the VA’s work.

Like many of the VA’s physicians, McNamee holds a joint appointment in the medical school. Now an assistant professor of physical medicine and rehabilitation, he also completed his housestaff training on the MCV Campus.

The medical school’s longstanding partnership with the nearby McGuire VA was spotlighted by the Jan. 11 visit of First Lady Michelle Obama when she came to Richmond to announce the Joining Forces initiative.

Dean of Medicine Jerry Strauss, M.D., Ph.D., toured the unit with Shinseki and was reminded of the importance of the VA’s relationship to the medical school and its faculty. “When we visited the unit, we met a number of polytrauma patients who are working hard on their recovery. They have earned our country’s gratitude, and I was impressed to see the team approach to world-class care that the polytrauma program provides for our service men and women.”

Photo courtesy of the McGuire Veterans Affairs Medical Center

LINKS:
Read the Richmond Times-Dispatch coverage of Shinseki’s visit.