“We now have a campus-wide, system and school strategic planning effort underway, which we can use to chart our collective course over the next three to five years in areas of common interest,” said E. Albert Reece, MD, PhD, MBA, Vice President for Medical Affairs, University of Maryland and John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. “It’s really a very exciting time, where we can sit together as partners with a joint vision to craft a course that will become a process by which we can achieve great things.”

Robert Chrencik, President and CEO of the University of Maryland Medical System (UMMS), joined Dean Reece for the strategic planning session, the first of its kind to be held at the School of Medicine. “It’s a privilege to be here,” Mr. Chrencik said, “Anything that brings the medical school and the medical system together to talk about the future is very important. Dr. Reece and I are huge believers in alignment and partnerships,” Mr. Chrencik adds, “so the strategic direction of the medical school is very important to the medical system.”

Dean Reece says the end result of these brainstorming sessions will be a document outlining strategy for the School of Medicine. “My hope is that department chairs, center and institute directors will look at this document when it’s done to see what we, as a school, would like to accomplish each year and use it as a guide to establish annual goals,” says Dean Reece. “Hopefully the medical system will also look at it and use it, as appropriate, as a guiding tool. Maybe we won’t accomplish 100%, but if we do 80% of it I’ll be very happy.”

The program is also intended to foster collaborations between junior and senior investigators and provide mentorship for new investigators in the art of grant writing and research. This year’s solicitation strongly encourages research proposals of a translational nature.

In order to be considered, a single-spaced proposal meeting the guidelines below must be submitted no later than January 15, 2010. The proposal should address the scientific merits of the proposed research and identify and justify specific NIH, NSF, or other federal programs that would be receptive of a full proposal that contains preliminary results obtained under the Seed Program. The number of awards will depend on the quality and quantity of proposals received, as well as the proposed budgets. The entire program is projected to award up to $500,000. The maximum grant size is $75K.

Individual investigators can be a participating PI on only one awarded proposal but can submit multiple proposals. The top-ranked proposal after peer review will be the one eligible for funding. Investigators can serve as a collaborator on an unlimited number of proposals. Past awardees remain eligible for this year’s competition.

Criteria

Eligibility: All full-time tenured or tenure track faculty members having primary academic appointments within the College of Agriculture and Natural Resources, Clark School of Engineering, College of Chemical and Life Sciences, College of Behavioral and Social Sciences, College of Computer, Mathematical and Physical Sciences, College of Information Studies, School of Public Health, and the College of Arts and Humanities at UMCP; and, the Schools of Medicine, Pharmacy, Nursing, and Dentistry at UMB are eligible.

This award program seeks to encourage groups of researchers (minimum of two faculty PI’s – one from each campus) to collaborate on new avenues of research that would not otherwise be explored by any one group alone. The research project must not overlap in focus with ongoing funded research in any of the participating laboratories and is expected to lead to applications for new external funding.

Expectations: Award recipients are expected to produce sufficient preliminary results so that within 12 months after expiration of the award, a proposal for external funding is submitted. Such a proposal is a desired outcome, but is not mandatory; however, expectations are that publication(s) or manuscript(s) will result from the funded work. Awardees will participate in future Progress Session(s) or other events that bridge campuses and bring researchers together. Recipients will remain faculty members of the participating school throughout the course of the grant, with any substitutions requiring approval in advance.

Conditions of the Award

1. Awards are made to principal investigators and are not transferable without prior approval by the Executive Vice Dean, UMB/SOM and Vice President for Research, UMCP.

2. Equipment purchased with these funds are property of UMB and UMCP and must remain should the PI leave his/her University.

3. A brief annual progress report and a final report (after 3 years) will be prepared.

4. Periodic surveys will require completion for interim progress or update on patent, invention,
creation of new companies, technology for commercialization, or other areas of interest to the schools

5. Three years after the project ends, the PI will be asked to file an update (part of final report) listing all presentations, published papers, and extramural funds that have resulted, in whole or in part, from the project. These should be sent to the Executive Vice Dean, UMB/SOM and Vice President for Research, UMCP upon request.

6. Funds should be budgeted for completion and exhausted at the end of one calendar year. Remaining or unspent funds are to be returned for subsequent competitions.

Transplant surgeons at the University of Maryland Medical Center have successfully completed a four-way kidney exchange involving eight patients from four states. The youngest recipient is a 10-year-old Catonsville, Md., boy, and the oldest a 74-year-old man from Virginia Beach, Va.

All four of the living donors had a kidney removed through a single incision through their navel, which speeds recovery and leaves virtually no scar. University of Maryland surgeons have performed more of these single-incision laparoscopic surgeries than any hospital in the country, but this is the first time that the technique has been used in a multiple kidney exchange. All of the donors and recipients are recovering well following the surgeries, which took place on Nov. 2 and Nov. 3, 2009, at the University of Maryland Medical Center.

Stephen T. Bartlett, M.D., surgeon-in-chief at the University of Maryland Medical Center and professor and chairman of surgery at the University of Maryland School of Medicine, who performed two of the transplants, says, “This large living donor kidney exchange requires extensive planning and coordination, but it provides great benefits to people with kidney failure who do not have a compatible living donor. We’ve been a national leader in kidney transplantation and laparoscopic donor kidney removal for many years, and our singular focus has always been on providing the highest quality care and the best outcomes for patients. This is yet another significant advance that will benefit patients from Maryland and throughout the country.”

Kidney exchanges, or swaps as they are sometimes called, allow living donors and their intended recipients to proceed with surgery, even if their blood and tissue types don’t match. They are paired with other donors and recipients who are incompatible with each other but are a match with others in the group. The patients are from Maryland, Virginia, Massachusetts and Florida. Two of the donors are female, and the other two donors and all of the recipients are male. There is one married couple, but the wife was not a match for her husband.

“Four people who otherwise would not have had matching donors now have lifesaving kidneys – from people they’ve never met. And this transplant chain was set in motion by a man who simply wanted to donate a kidney to someone in need,” says Matthew Cooper, M.D., director of kidney transplantation at the University of Maryland Medical Center and associate professor of surgery at the University of Maryland School of Medicine, who oversaw the series of surgeries.

Only a handful of hospitals in the country have performed large kidney transplant exchanges such as this one. The procedures, which took place over two days in four operating suites at the medical center, required extensive coordination and planning not only in the operating rooms, but also in the waiting rooms. Because the right to privacy for the donors and recipients is protected throughout the process, transplant coordinator Debbie Iacovino arranged separate waiting areas in different parts of the hospital for their families to ensure anonymity.

The kidney exchange started with a 59-year-old man from a suburb of Boston, Mass., who offered to donate a kidney to someone in need. His kidney was given to a Maryland man who was not a match with his intended donor, a woman who is also from Maryland. The woman was matched with a 10-year-boy from Catonsville whose kidneys were failing because of a congenital abnormality. A friend of the boy’s family, a 50-year-old lawyer from Catonsville, gave his kidney to a 64-year-old Florida man, whose wife was a donor for 74-year-old man from Virginia Beach, Va. The Virginia man’s son-in-law will be a “bridge” donor, who will give his kidney to a yet-undetermined recipient at a later date, which will allow the chain of transplants to continue.

Edward Behn, of Westborough, Mass., who started off the chain of transplants, says it didn’t matter to him who received his kidney. “Do your good turn,” he added, referring to the slogan, “Do a good turn daily,” used by the Boy Scouts of America, a group with whom he has been actively involved for many years.

About one third of patients who have a relative or friend willing to donate are not able to receive the kidney because of blood type or tissue-type incompatibility. Kidney exchanges increase the pool of donors and allow incompatible pairs to be matched with other pairs in the same situation.

Benjamin Philosophe, M.D., Ph.D., director of the Division of Transplantation at the University of Maryland Medical Center and associate professor of surgery at the University of Maryland School of Medicine, notes that patients who receive kidneys transplanted from living donors fare better than those who receive kidneys from deceased donors.

“There is a significant difference in outcomes with living-donor kidney transplants. There is also a severe shortage of kidneys from deceased donors, with people waiting three to five years to get a kidney. So, living donor transplants are often the best option for patients. With these types of kidney exchanges, we can dramatically increase the availability of donor kidneys and help many more people who need a transplant,” Dr. Philosophe says. More than 82,000 people waiting for kidneys are on the official list maintained by the United Network for Organ Sharing (UNOS). Last year, 16,517 received transplants – 5,967 from living donors.

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine, says, “Our physicians are always working to develop better and more innovative ways to help patients, and this four-way kidney exchange is another example of that diligence and excellent work. I congratulate Dr. Bartlett and the entire transplant team for this wonderful achievement.”

Jeffrey A. Rivest, president and chief executive officer of the University of Maryland Medical Center, notes, “The University of Maryland Medical Center has performed the largest number of minimally invasive kidney removals of any hospital in the world, starting in March 1996 and passing the 1,000 patient mark in 2005. These delicate, complicated surgeries demonstrate the tremendous expertise of our medical staff, nurses and technicians.”

“Providing anesthesia for patients undergoing transplantation is challenging because of the nature of the surgery and the medical condition of the patients. We work closely with our surgical colleagues to ensure the safest care and highest quality outcomes," says Peter Rock, M.D., chief of Anesthesiology at the University of Maryland Medical Center and professor and chairman of Anesthesiology at the University of Maryland School of Medicine. He adds, "We are excited to have played a key role in these kidney transplants in order to improve the lives of the kidney recipients."

In April 2009, University of Maryland surgeons began to remove donor kidneys through an opening in the navel, becoming the first hospital in Maryland and only the third hospital in the United States to use this approach. Since then, about 30 of these single-incision surgeries have been performed at the University of Maryland Medical Center. In the procedure, surgeons insert a camera and two instruments into the specially designed port in order to separate the kidney from its attachments in the abdomen. The kidney is removed through the same opening, which is covered with a tiny bandage. Donors are discharged within a day or two.

The University of Maryland School of Medicine Office of Policy and Planning has received more than $4.9 million in federal stimulus funding from the National Institutes of Health (NIH) to explore new strategies to address health disparities throughout the U.S.

One grant, for more than $2.4 million, will create a national Bioethics Research Center funded by the National Center on Minority Health and Health Disparities (NCMHD), part of the NIH. The Bioethics Research Center will implement innovative strategies to address ethical issues in research and examine the implications of these issues on health disparities within Maryland and throughout the U.S. The grant will enable the Center to train physicians and researchers in bioethics. The Center, funded by the American Recovery and Reinvestment Act (ARRA) of 2009, will also work to foster public trust in clinical trials and medical research among minority and rural communities across the nation.

The formation of the Bioethics Research Center was announced by Claudia R. Baquet, M.D., M.P.H., professor and associate dean for the Office of Policy and Planning and director of the Center for Health Disparities at the University of Maryland School of Medicine. She made the announcement at a news conference on November 9 at the Bel Alton High School Alumni Association Community Development Center in Charles County, located in southern Maryland. Dr. Baquet also announced a second ARRA grant for $2.5 million to fund a telemedicine study in rural Maryland.

Joining Dr. Baquet at the news conference were officials John Ruffin, Ph.D., director of the NCMHD; U.S. Senator Benjamin L. Cardin; U.S. Representative Steny Hoyer, whose district includes southern Maryland; and state Senator Thomas M. “Mac” Middleton, who represents Charles County.

“I am committed to ensuring that all Marylanders – regardless of economic status, racial or ethnic origin or place of residence – have equal access to quality health care and wellness information,” says Senator Cardin. “These two Recovery Act grants will help make that possible by funding new, innovative approaches that will help improve the overall health of individuals.”

Congressman Steny Hoyer said he was “pleased to join so many partners dedicated to the cause of improving public health and reducing health disparities in rural communities. When it comes to improving health outcomes, we know preventive care works. Telehome care is an important part of increasing access to critically-needed services, especially for rural populations and the elderly," he told reporters. "The Recovery Act’s investment in the Maryland Telehome Care Network will directly benefit southern Maryland’s communities with improved access and delivery of services, while working to promote economic recovery by preserving 12 jobs and creating 14 more.”

“Previous studies have identified barriers to participation in clinical trials for certain groups, and there is a need to increase public trust in research among African American, rural and other underserved communities,” says Dr. Baquet. “The lack of diversity in clinical research participation is an impediment to advancing new ways to prevent, diagnose and treat diseases. This issue contributes to health disparities in underserved communities. We are grateful for this NIH stimulus funding, which provides critical support for expanding the research and education we at the Office of Policy and Planning have developed over the past 12 years, in Maryland and across the nation.”

The new Bioethics Research Center, which includes a partnership between the School of Medicine and the Maryland Center at Bowie State University, will address the issue of clinical trial participation throughout the U.S., connecting the School of Medicine with key partners to reach out to primary care physicians, researchers, nurses, African Americans and others from minority groups and rural communities.

The Maryland Center at Bowie State will help to create summer training programs and fellowships for historically black colleges, universities and academic health centers across the country for the study of bioethics and clinical trial design issues. The grant also supports partnerships with media entities such as the Times Community Services/Newspapers and the National Newspaper Publishers Association. These media partners will train journalists in how to develop coverage of clinical trial issues.

The partnership will also include the Eastern Shore and Western Maryland Area Health Education Centers (AHECs) and the Maryland Academy of Family Physicians, which will work on
public education and physician and nurse continuing education in Maryland and across the U.S.

The NCMHD promotes minority health and leads, coordinates, supports, and assesses the NIH effort to reduce and ultimately eliminate health disparities. “Health disparities remain a public health challenge for the nation because of issues such as trust deficiency in health care, which has been a historical problem for racial and ethnic minorities, and access to medical care for rural and other underserved populations,” says Dr. Ruffin, NCMHD director. “Recovery Act funds have afforded us the opportunity to bring key community partners together who are committed to building the necessary infrastructure to tackle these issues to ultimately improve community health and eliminate these systemic barriers to health equity. The diversity of partners involved in these two projects reminds us of the complex nature of health disparities and the importance of engaging all sectors and disciplines in efforts to eliminate health disparities.”

In addition to the Bioethics Research Center, a $2.5 million stimulus grant to the Office of Policy and Planning from the NCMHD examines social determinants of health. It will fund state-of-the-art “telehealth” technologies in rural western and southern Maryland counties. The “telehome care” study confronts the issue of health outcomes for chronically ill rural residents who receive home care far from their physicians’ offices. It will allow doctors to closely track the progress of chronically ill patients undergoing home care. This grant will allow Dr. Baquet and co-investigator Shiraz I. Mishra, M.B.B.S., Ph.D., associate professor of family and community medicine at the University of Maryland School of Medicine, to study whether home telehealth care can close rural gaps in health care.

“Multiple factors serve as barriers to health care delivery for rural patients,” says Dr. Mishra. “These factors include distance to health care facilities, transportation problems, lack of access to primary care and specialty services, loss of health coverage and lack of timely access to new technologies. Telehome care has the potential to provide a cost-effective alternative for the provision of timely and quality care to rural underserved populations.”

“We hope this study finds that telehome care can provide an innovative and potentially cost-effective solution to the disparities in both health status and outcomes and access to quality specialty care for rural residents,” says Senator Middleton. “We’re looking for solutions to provide southern Maryland residents with the same quality of care and the same chance at long, healthy lives that patients in the rest of Maryland enjoy. I am proud to be part of this national partnership and effort on behalf of rural Maryland.”

The telehealth project is a collaborative effort between the School of Medicine, the AHECs on the Eastern Shore and in western Maryland, and the Office of Policy and Planning’s rural health care delivery partners, Garrett County Health Department Home Health Agency in western Maryland, and the Chesapeake Potomac Home Health Agency in southern Maryland.

The study will be implemented in rural western and southern Maryland counties among 250 patients with chronic health conditions such as diabetes, heart failure and hypertension. All the patients are receiving home health care through their local health departments. Patients will be assessed periodically to gather information such as their medication history, number of emergency visits, hospitalizations and quality of life. They each will receive a blood pressure cuff and a glucometer and will electronically transmit their data. During the monitoring period, the home care nurse will work with local physician oversight to provide clinical care. The home care nurse will contact the patient via telephone or in-person regarding any abnormal data.

“Like all the federal stimulus funding earned by the University of Maryland School of Medicine’s world-class researchers, these awards will foster the development of new ideas and hopefully uncover solutions that will impact human health for the better,” says E. Albert Reece, M.D., Ph.D., M.B.A., dean and John Z. and Akiko K. Bowers Distinguished Professor at the School of Medicine, and vice president of medical affairs for the University of Maryland. “Both of these grants recognize our school’s dedication to improving the health of minority patients in Maryland and around the globe.”

During the morning session, Dean E. Albert Reece, MD, PhD, MBA, gave an overview of the School of Medicine, and its rich history and success in patient care and research. Sheri Slezak, MD, an associate professor in the Department of Surgery, shared her perspective as both a teacher and a parent of a med school student (daughter Katie is in the class of 2012). Stephen Liggett, MD, Professor of Medicine, spoke of the exciting research being done at the school in such pioneering fields as genomics and personalized medicine. David Mallott, MD, Associate Dean of Medical Education, and Donna Parker, MD, Associate Dean for Student Affairs, filled parents in on just how hard medical school really is, but let the families know that help is available to their students whenever they need it, be it academic, physical or psychological.

Michael Grant, president of the Class of 2010, presented his view of medical school from a student perspective. “As you’ve already realized, the first year of medical school is many things,” he said. “It’s consistently challenging, it’s at times overwhelming, but it’s often exciting. Most of all, the first year is about setting up the foundation on which to build the rest of your medical career.”

The White Coat Ceremony

Following lunch was the event every first-year had been waiting for – the White Coat Ceremony. This tradition, which started at the School of Medicine in 1997, formally presents first-year students with their white coats, long the symbol of physicians and scientists. The coats are put on by School of Medicine faculty, to welcome their new colleagues to the profession of medicine.

“The White Coat Ceremony today symbolizes the beginning of your privileged journey into medicine,” said Dean Reece. “It is a lifelong journey of learning and healing….I charge you today to do the following: Walk well on this time-honored path. The white coat is just a symbol. What is most important is who is wearing it.”

After being "coated," students recited an oath acknowledging their acceptance of the obligations of the medical profession. They also add their signatures to the school's honor book, a leather-bound volume signed by all med students in their first year and their final year, in which they pledge to maintain integrity throughout their years in medicine.

The researchers hope their discovery will lead to the development of a new class of drugs to treat the condition, known as hyperkalemia, which is caused when patients can’t properly excrete excess potassium. If it is not treated promptly, it can cause fatal cardiac arrest.

“We are particularly excited about the translational potential of our basic science discovery,” says Paul A. Welling, M.D. professor of physiology at the University of Maryland School of Medicine. “Currently, there are no drugs that specifically target the molecular defect in kidney potassium retention. This new class of drugs will pave the way to allow damaged kidneys from long-standing high blood pressure, diabetes or heart disease to continue to properly excrete potassium in the urine, so that potentially fatal hyperkalemia can be prevented.” 

Potassium is critical for proper functioning of muscles, nerves and the heart. The kidney is the organ primarily responsible for eliminating excess potassium that accumulates in the blood stream. People at highest risk for abnormally high levels of potassium in the blood are those with kidney disease, because they cannot properly excrete the potassium through the urine. About 67 percent of cases of severe hyperkalemia are fatal if they are not caught and treated promptly.

A kidney gene called ROMK (Renal Outer Medullary K+ Channel) controls the levels of potassium excretion in the kidney. In people with kidney disease, the protein made by this gene no longer signals properly to ensure adequate excretion through the urine, so the potassium can build up in the blood. With funding from the National Institute of Diabetes and Digestive and Kidney Disease at the National Institutes of Health, Dr. Welling and his post doctorate fellow, Liang Fang, Ph.D. have discovered a new class of protein molecules responsible for this abnormal signaling. This new molecule has been shown to interact with the ROMK gene and inhibit the excretion of potassium, thus causing high blood levels.

“Our findings solve a mystery of how potassium excretion is turned off in response to dietary potassium deficiency and points to an underlying defect in kidney disease” says Dr. Fang. The name of this new adaptor protein is called ARH (Autosomal Recessive Hypercholesterolemia protein). The researchers hope that now that this pathway has been uncovered, it will lead to the development of new drugs that can prevent ARH from interacting with the ROMK gene. 

E. Albert Reece, MD, PhD, MBA, Vice President for Medical Affairs, University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine, says these findings change our basic understanding of how potassium balance is maintained in the body and are critical in the care of patients with kidney disease from conditions such as diabetes. “Dr. Welling’s discovery provides a completely new road map to develop therapeutic interventions for this relatively common, but very serious, complication of kidney disease,” he says. “This type of basic science research will translate into important clinical therapies for patient care in the future.”

Dr. Anthony Gaspari, professor and chair of the Department of Dermatology was highlighted in a special profile in the Top Doctors feature called "Saving Tree Man: A University of Maryland doc unravels the mystery of an Indonesian villager's bark-like skin."

The results of the Top Doctors cover story are based on a Baltimore Magazine survey of more than 2,000 randomly selected physicians in the Baltimore area -- including Baltimore City and the surrounding five counties -- asking where they would send a member of their family in each of 76 specialties.

Our winning faculty are listed below by specialty. All doctors who made the list are currently accepting new patients.

Alternative/Complementary Medicine: Brian Berman, MD, Professor of Family & Community Medicine and Director of the Center for Integrative Medicine

Cardiology: R. Michael Benitez, MD, Associate Professor of Medicine and Director of the Cardiology Fellowship Program

Family Practice: David L. Stewart, MD, Associate Professor and Chair of Family & Community Medicine

Gastroenterology/ Hepatology: Bruce Greenwald, MD, Professor of Medicine

Gynecology: Harry W. Johnson, Jr., MD, Associate Professor of Obstetrics, Gynecology & Reproductive Sciences

Maternal and Fetal Medicine: Lindsay Alger, MD, Professor of Obstetrics, Gynecology & Reproductive Sciences

Maternal and Fetal Medicine: Hugh Mighty, MD, Associate Professor and Chair of Obstetrics, Gynecology & Reproductive Sciences

Oral-Maxillofacial Surgery: Robert Ord, DDS, MD, FACS, Adjunct Faculty Member and Professor and Chair of the Division of Oral and Maxillofacial Surgery at the University of Maryland School of Denistry

Orthopaedics: Steven Ludwig, MD, Associate Professor of Orthopaedics

Pediatric Anesthesiology: Anne Savarase, MD, Assistant Professor of Anesthesiology

Pediatric Cardiology: Peter Gaskin, MBBS, Assistant Professor of Pediatrics

Pediatric Pulmonology: Anayansi Lasso-Pirot, Assistant Professor of Pediatrics

Pediatric Rheumatology: Stephen George, MD Clinical Assistant Professor of Pediatrics

Pediatric Surgery: Roger W. Voigt, MD, Professor of Surgery

Thoracic Surgery: Richard Battafarano, MD, PhD, Associate Professor of Surgery

Transplant Surgery: Stephen T. Bartlett, MD, Professor and Chair of Surgery

Trauma Surgery: Thomas M. Scalea, MD, Professor of Surgery and Director of the Program in Trauma

Researchers at the University of Maryland School of Medicine have joined with Sisters Network® Inc., a national African-American breast cancer survivorship organization, to produce a patient education video to help African-American women survive – and thrive – after being diagnosed with breast cancer.

The 30-minute educational video was produced to address the special challenges faced by African-American breast cancer survivors. It presents evidence-based guidelines developed by the Institute of Medicine in 2006 to help cancer survivors make a plan of follow-up care that promotes a healthy lifestyle and helps to prevent cancer recurrence.

The video was produced as part of a research study led by Renee Royak-Schaler, Ph.D., funded by Susan G. Komen for the Cure. A special screening of the video and reception will be held on Monday, Oct. 26, 2009, from 5:30 p.m. to 7:30 p.m. at the University of Maryland School of Medicine’s Health Sciences Facility II auditorium at 20 S. Penn St., in Baltimore.
 
“Developing feasible plans for self-care after breast cancer can be a daunting task, and this is particularly true for African-Americans, whose risk of recurrence and poor health outcomes is greater than for Caucasian patients. Many women don’t have a clear plan for follow-up care after their initial treatment, which can seriously affect their overall health and well-being,” says Dr. Royak-Schaler, an associate professor of epidemiology and preventive medicine.

Breast cancer deaths are 38 percent higher in African-American women than in white women. This disparity has been linked to lack of access to primary health care and being diagnosed at a later stage when the disease is less treatable. Many African-American women also have what is known as “triple-negative” breast cancer, which doesn’t respond as well to therapy.

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine, says, “Through this unique partnership with the Sisters Network, our researchers have produced a wonderful educational video that not only provides valuable information, but also empowers African-American breast cancer survivors to work with their doctors to take charge of their own follow-up care.”

"Sisters Network is pleased to collaborate with the University of Maryland School of Medicine to increase breast cancer survivorship awareness," said Karen Jackson, founder and chief executive officer of Sisters Network, Inc. "Women need to know that survivorship is not only about defeating cancer, but adopting a healthy, active lifestyle that hopefully will prevent the cancer from returning.”

The video features African-American breast cancer survivors talking about their experiences and interviews with two faculty members, Stacy D. Garrett-Ray, M.D., M.P.H., M.B.A., a family medicine physician and clinical assistant professor of family and community medicine, and Cynthia L. Drogula, M.D., a breast surgeon and assistant professor of surgery.

“It’s imperative that breast cancer survivors communicate with their doctors and understand what they need to do to take good care of themselves. Eating a healthy diet and exercising are very important. Taking part in a support group can also be very helpful in dealing with all the unique challenges of life after cancer,” says Dr. Garrett-Ray, who is also medical director of the Baltimore City Cancer Program at the University of Maryland Marlene and Stewart Greenebaum Cancer Center, which provides free cervical and breast cancer screening for uninsured women in Baltimore. “We hope that this video will prove to be a useful educational tool not only for African-American breast cancer survivors but also the doctors who care for them.”

E. Albert Reece, M.D., Ph.D., M.B.A., dean of the University of Maryland School of Medicine, was one of the leaders of academic medicine who gathered in Washington today to thank the Obama Administration, Congress and the American taxpayers for the much-needed medical research funding included in the American Recovery and Reinvestment Act (ARRA). Dean Reece is chair of the Council of Deans of the Association of American Medical Colleges (AAMC), which convened the medical leaders at a news conference at the National Press Club today.
 
The University of Maryland School of Medicine has received $40 million in stimulus funding so far, although most of the Recovery Act funding has yet to be awarded. The grants support work in cutting-edge fields such as personalized medicine — in which each patient’s care is tailored to their genetic make-up — organ transplantation, stem cell research, health disparities and gene therapy. In fiscal 2009, School of Medicine researchers brought in nearly $500 million in external research funding, most of it from the National Institutes of Health.

“The stimulus funds already awarded to the School of Medicine will support 30 jobs and top-tier research that brings hope to the patients who are waiting on our scientists to develop new cures and a better understanding of human health,” says Dean Reece, who also serves as Vice President for Medical Affairs at the University of Maryland, and the John Z. and Akiko K. Bowers Distinguished Professor at the School of Medicine.

“This preliminary ARRA funding has kept our research enterprise strong despite a constrained NIH budget,” adds Dean Reece. “Biomedical research is about investment, with the associated short- and long-term return on that investment. The long-term benefit includes bringing hope to patients with new cures and preventive tools to improve human health, and also serving as a major economic engine. In the short term, our research can rejuvenate the struggling economy by the creation of well-paying jobs and more.”

“The School of Medicine and its affiliated hospital system brought to the state of Maryland an economic impact of approximately $5 billion in fiscal 2009,” says Dean Reece. “The ARRA funds enable us to grow our economic footprint by recruiting new research scientists to explore exciting, growing fields such as stem cell research. The stimulus act also funds the networks of staff to support them. These innovative new projects explore cutting-edge ideas about the future of medicine and bring much-needed jobs to Maryland. We hope both the science and the jobs will last long after the stimulus dollars are spent.

"For this momentum that we’ve gained from the ARRA funds to blossom into cures that will save lives years down the road, we are dependent on a robust and sustained NIH support," Dean Reece continues. "We’re very excited about this 'shot in the arm,' but we need continued and consistent funding of biomedical research to achieve the greatest possible benefit for human health and the economy.”

The funds NIH provides to the University of Maryland School of Medicine support research that directly affects human health worldwide. Earlier this year, the School of Medicine founded its Center for Stem Cell Biology and Regenerative Medicine, recruiting renowned stem cell pioneer Curt Civin, M.D., as its first director. ARRA funds will help get the Center off the ground, including facilitating the recruitment of a young researcher dedicated to exploring the promise of stem cells for the treatment of cancer. Stem cell transplants already are used in pediatric oncology to treat leukemia, made possible by discoveries made in Dr. Civin’s lab using funding from the NIH.

“In pediatric oncology, stem cell research has led to cures,” says Dr. Civin. “The work being funded by the ARRA gives us the hope that stem cells could treat other cancers as well. The stimulus funding is a great start to get us going, but we’re dependent on continued strong funding of the NIH to sustain that momentum and to bring hope to cancer patients and their families.”

In August, funding from the National Institute of Allergy and Infectious Diseases, part of the NIH, enabled School of Medicine scientists to begin the first testing of the H1N1 vaccine in the U.S. as the government braced to protect the population from the 2009-2010 influenza season. School of Medicine faculty led nationwide trials of the vaccine in adults, seniors and children, and found the vaccine to be safe and effective. The American people began receiving the immunization in mid-October.

Also in August, University of Maryland School of Medicine researchers published a study showing new promise for personalized medicine to improve outcomes for cardiovascular disease patients. The NIH-funded study showed that a gene variant found in 30 percent of Americans makes heart disease patients unable to respond to the popular anti-clotting medication Plavix. A simple genetic screening test could identify patients for whom Plavix won’t work, allowing doctors to personalize each patient’s care based on personal genetic information. The study was made possible by a grant from the National Institute of General Medical Science, part of the NIH.

“The stimulus funds are a wonderful boost to research that means hope for so many patients and their families,” says Dean Reece. “But we need Congress to provide consistent strong funding for the NIH to make these cures possible and to achieve the added benefit of helping to revitalize the economy of Maryland and the entire U.S.”

The CVD study suggests that developing a broadly protective vaccine for malaria may be challenging because the parasite’s genetic makeup is so variable, constantly changing. If a vaccine targets only a single protein in the parasite, and there are many different versions of that protein, the parasite becomes a moving target for vaccine development.

Drug-resistant malaria has been a major barrier to treating the disease, and this CVD study suggests that “vaccine-resistant” malaria may also become a problem. The study is being published in the Oct. 14 issue of the journal Science Translational Medicine.

Scientists and health officials worldwide have made eradication of the disease a priority, with an effective and broadly protective vaccine a critical step toward that goal. Malaria — a parasite spread to humans through mosquito bites — is prevented by avoiding mosquito bites
using bed nets or by killing mosquitoes with insecticides.

The parasite is treatable using medications, although drug resistance is a relatively common problem. According to the World Health Organization, a child dies of malaria every 30 seconds. There are approximately 300 million malaria cases annually worldwide, resulting in more than one million deaths, most of them African children.

Certain regions within a key parasite protein — a protein targeted by some experimental malaria vaccines — seem to affect the human immune response more than others, and targeting those areas could help develop a better vaccine, according to the study led by Shannon Takala, Ph.D., assistant professor of Medicine at the University of Maryland School of Medicine and a research scientist in the CVD. The study was conducted in collaboration with researchers at the University of Bamako in Mali, West Africa, and at the Center for Bioinformatics and Computational Biology and Department of Biology at the University of Maryland, College Park.

“This brings us one step closer to being able to design a broadly protective malaria vaccine,” says Dr. Takala. “Though there are medications that are used to treat malaria, drug resistance is a recurring problem. An effective vaccine could help us eliminate malaria altogether, a public health goal that is attracting more global support than ever before.”

“In addition to its home campus in Baltimore, the University of Maryland School of Medicine employs hundreds of researchers in 23 countries around the globe,” says E. Albert Reece, M.D., Ph.D., M.B.A., dean of the School of Medicine, vice president for medical affairs of the University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor. “This study is an example of how our global footprint allows School of Medicine researchers to study diseases such as malaria in the very regions of the world in which they are devastating to the population.”

A research team of Malian and American scientists at the CVD’s outpost in Mali, West Africa, tested malaria parasites from 100 children in Mali over a three-year period. The children, who had not been vaccinated against the disease, all experienced repeated malaria infections during the three years. The CVD researchers, including Christopher Plowe, M.D., M.P.H., Howard Hughes Medical Institute investigator, professor of medicine and chief of the Malaria Section at the University of Maryland School of Medicine, looked at the genetic diversity in a surface protein of the Plasmodium falciparum — the AMA-1 protein — that is the target of some candidate malaria vaccines.

By tracking the changes in the AMA-1 protein each time a child became infected with malaria, researchers found a surprising amount of genetic diversity. Among more than 500 separate malaria infections the children experienced throughout the study, researchers found 214 distinct types of the AMA-1 protein. The scientists also found that the genetic differences in certain parts of the protein but not others corresponded to whether or not a child got sick the next time they were infected with malaria. It was easier for a child’s immune system to defend itself against illness in a subsequent infection if the protein in the second parasite was genetically similar to the parasite that caused their first illness.

Working with Michael P. Cummings, Ph.D., associate professor of biology at the University of Maryland, the researchers were able to track which variants of the AMA-1 protein were present in each infection and compare that data to the symptoms each child experienced during the infections.
 
“Applying a molecular evolutionary perspective to the study of the malaria parasite gave us new information about why it has been so challenging to develop an effective malaria vaccine,” says Dr. Cummings, who is affiliated with the University of Maryland’s Center for Bioinformatics and Computational Biology. “The genetic diversity we found in the AMA-1 protein was so high that it could potentially thwart the usefulness of any vaccine based on this protein.”

By narrowing their focus to those specific regions of the protein that are recognized as distinct by the immune response, the researchers were able to reduce the number of immunologically important AMA-1 types from 214 to just 25. By targeting those specific regions of the protein, scientists could possibly develop a more broadly protective malaria vaccine.

“The emergence of drug-resistant malaria was one of the main reasons eradication of the disease didn’t work when it was tried 50 years ago,” says senior author Dr. Plowe. “We want people to begin thinking now about the possibility that ‘vaccine-resistant malaria’ could be just as much of a problem for the new global eradication effort. We need to come up with ways to beat vaccine-resistant malaria before we start losing vaccines to resistance the way we have lost so many good drugs.”

The study was supported by grants from the National Institutes of Health and the United States Agency for International Development, as well as a seed grant from the University of Maryland.

For more information on the University of Maryland Center for Bioinformatics and Computational Biology, or to reach Dr. Michael Cummings, please contact Kelly Blake, Director of Communications, College of Chemical and Life Sciences, University of Maryland, at (301) 405-8203, or kellyb@umd.edu.

Renee Royak-Schaler, PhD, associate professor of Epidemiology and director of the Masters of Public Health Program was instrumental in securing this accreditation.  “This is an important and logical next step to address public health needs in Baltimore and throughout Maryland,” said Dr. Royak-Schaler.

Students can choose from two fields of concentration. There is an MPH concentration in epidemiology for students who desire quantitative research skills in epidemiologic study design and data analysis.  The other MPH concentration focuses on community and population health, which prepares students to apply conceptual and methodological approaches of both social and behavioral sciences to the practice and research of public health. Dr. Royak-Schaler says, “The curriculum provides critical training in examining and understanding the root causes of disparities in disease risk, access and utilization of preventive and health care services, and health outcomes.”

The Department of Epidemiology and Preventive Medicine has a close working relationship with many of the other professional schools on the University of Maryland, Baltimore campus. The department offers a variety of different joint degrees. There is a joint MD/MPH offered within the School of Medicine, as well as with other schools, such as: the School of Law (JD/MPH), the School of Social Work (MSW/MPH), the School of Pharmacy (PharmD/MPH), the School of Dentistry (DDS/MPH), and the School of Nursing (MS Nursing/MPH). Students are able to integrate their training in public health practice with training in the medical, pharmaceutical, nursing, dental, social work, legal and allied health professions.

“This accreditation represents the high quality of the program and enhances its national reputation for promoting the best standards of practice and research in public health and safety. It also assures that students are trained to have the utmost competence in the public health arena,” says E. Albert Reece, MD, PhD, MBA, Vice President for Medical Affairs, University of Maryland and Dean.  Dr. Reece says the accreditation offers another opportunity for University of Maryland graduates to enhance their professional mobility and employment opportunities in an increasingly competitive job market.

David J. Ramsay, DM, DPhil, President of the University of Maryland, Baltimore, adds “given the national shortage of professionals trained in public health, the University of Maryland MPH accreditation will attract additional students to this program in order to meet the growing demand for this expertise.”

The sessions are designed to be casual, informative presentations on health care issues that are important to the community, but they are not all fun and games. “We are not here just to entertain you, we are here to educate you,” Dean Reece told the audience. He encouraged participants not to get overwhelmed by the amount of information presented, but to focus on the issues that mean the most to them and their families and learn all they can about those areas. “This is something we believe we have an obligation to do,” added Dean Reece. “To the extent we can educate our neighbors about their lifestyles and making healthier choices, we can help them live longer, healthier lives.”

End-of-life issues, both legal and ethical, were the topic of the first night’s presentation, given by Henry Silverman, MD, MA, professor of Medicine, and Leslie Meltzer Henry, JD, MSc, PhD, an assistant professor at the University of Maryland School of Law. This subject generated quite a bit of discussion among participants, who asked anxious questions about who had the right to make such decisions for them if they were not able to speak for themselves. Participants learned about legal documents such as advanced directives and legal wills, and the legal steps needed to ensure their wishes are honored in the event of sudden tragedy. Dr. Silverman also presented actual case studies to help the audience better appreciate just how difficult making these decisions can be for both family and medical professionals when there are no directions in place.

"An endowed professorship is indicative of superior performance in the classroom, the laboratory and in the clinical setting," said Dean E. Albert Reece, MD, PhD, MBA of Dr. Sarkar’s honor. "In the world of academia, endowed professorships are a coveted and universally recognized accolade, signaling a colleague at the top of his or her field."

 “I am grateful to the University of Maryland School of Medicine for recognizing the value of the clinician scientist,” said Dr. Sarkar. I see this as a place where both clinical excellence and research success are valued and celebrated. This professorship was a key element in bringing me here, and I am very proud to receive this honor.”

The Barbara Baur Dunlap Professorship in Surgery was established in 2002 by Andrew Baur, chairman of Southwest Bank of St. Louis and a part-owner of the St. Louis Cardinals, who was a transplant patient of Dr. Bartlett’s. The professorship was named in honor of Mr. Baur’s sister, who donated the kidney that saved his life. “Gratitude is not a big enough word to describe my debt to Dr. Bartlett and this university,” said Baur. “This professorship given to the department in honor of my sister is small thanks for what you all have given to me. For the last 10 years, I’ve been able to enjoy time with friends, see my grandchildren grow up, and live a productive life. I am extremely appreciative of that.”

Dr. Emery was initially educated as a pharmacist before graduating from the University of Pittsburg School of Medicine in 1988. After completing a residency in otolaryngology at Louisiana State University Health Sciences Center, he completed a facial plastic and reconstructive surgery fellowship at UC Davis Medical Center in Sacramento, California. He was board certified in both otolaryngology and facial plastic and reconstructive surgery. Dr. Emery was recruited by past chair of the Department of Otorhinolaryngology, Douglas Mattox, MD, to be the first director of otolaryngology coverage in the R Adams Cowley Shock Trauma Center facial trauma rotation. Dr. Emery’s clinical interests also included snoring and sleep apnea surgery. Moreover, his devotion to clinical education resulted in him receiving the department’s coveted award for teaching excellence.

Thirty-five years after founding the University of Maryland School of Medicine's Center for Vaccine Development (CVD), Dr. Levine is known worldwide for his role in developing vaccines to prevent the spread of diseases such as cholera, typhoid fever, and Shigella dysentery. The CVD currently is working on an H1N1 vaccine, and evaluating one for malaria.

Other Highlights

• The national spotlight shone on the School of Medicine’s Center for Vaccine Development, which was one of only eight sites in the nation testing the H1N1 (swine flu) vaccine. Three faculty members were also named to the Maryland State H1N1 Influenza Board.
• Attracting national media attention was Dr. Michael Miller, whose study revealed the cardiovascular benefits of music; Dr. Stephen Liggett and Dr. Claire Fraser-Liggett, who cracked the genetic code for the common cold; and Dr. Johannes Bonatti, who performed one of the first robotic triple bypass surgeries in the nation. National coverage of these stories helped drive total media placements in print, broadcast and online outlets to an all-time high.
• School of Medicine researchers submitted 170 new patent applications and were awarded 40 patents for their work.
• High-profile faculty were recruited to leadership positions in the school, including Dr. Curt Civin, who leads the Center for Stem Cell Biology & Regenerative Medicine; Dr. Alan Faden, who leads the Anesthesiology Research (STAR) Organized Research Center; and Dr. Stephen Davis, who will chair the Department of Medicine.
• Four new joint degree programs were approved and began recruiting students. These new initiatives will allow those pursuing their MD to concurrently earn a Masters degree in Business Administration, Epidemiology, Clinical Research or Health Services Administration.
• The School of Medicine is making strides to increase diversity at all levels. Underrepresented groups accounted for 14 percent of medical students and 15 percent of graduate students.

Dean Reece is both optimistic and realistic about the School of Medicine’s future. Despite tough economic times, development of Health Sciences Facility III research building remains a priority, along with continued growth in research funding, and finding ways to leverage federal stimulus funds.

"We have confidence that our momentum will continue unabated despite the mountain of challenges we envision," Dean Reece said, as the strains of Marvin Gaye’s "Ain’t No Mountain High Enough" swelled in the background. "As the song says, there will be no mountain high enough to keep us from reaching our goals."

Surgical treatment for mitral valve disease includes either repairing the patient’s diseased valve or replacing it with a metal, mechanical valve or an animal tissue valve. The majority of those procedures are open-heart operations that require a major incision in the chest.

Now, after a six-year study, surgeons at the University of Maryland Medical Center in Baltimore conclude that minimally invasive mitral valve repair techniques, through only a two-inch incision in the right side of the chest, are safe, durable and effective. The results are published in the September 2009 Annals of Surgery.

“Our experience with 187 patients demonstrates that small-incision mitral valve surgery can be performed safely and effectively with a short hospital stay and a rapid recovery,” says lead author James S. Gammie, M.D., a cardiac surgeon at the University of Maryland Medical Center and associate professor of surgery at the University of Maryland School of Medicine.
 
The most common complications from mitral valve surgery are stroke, kidney failure and infections, none of which occurred among the 187 consecutive patients who received the minimally invasive procedure at the University of Maryland Medical Center, beginning in 2003. Echocardiograms taken just prior to discharge, which were read by cardiologists who did not know the method of mitral repair or surgical approach, showed that 99 percent of the repaired valves were working properly. The median hospital stay was four days. All patients survived the surgery and 2½ years later, 99 percent of the patients were still alive.
 
Mitral valve surgery was first performed in 1960, when surgeons replaced the diseased, native valve with an artificial valve. For the next 20 years, replacement with a metal or animal tissue valve was the gold standard. Dr. Gammie says no device is as good as a patient’s own valve. The metal valve tends to form blood clots, which can lead to a stroke, so patients must take a blood-thinning medication for the rest of their lives, with the risk of bleeding. The tissue valves are less likely to cause clots, but they last only 10-15 years. However, patients with a repaired valve can expect it to last for the rest of their lives.

Rates of mitral valve repair compared to valve replacement vary widely by institution and by surgeon. The repair rate among patients in this study was 96.7 percent for all small-incision mitral valve procedures and 100 percent for patients with mitral valve regurgitation (leakage of blood through the valve). This is well above the current national average of 60 percent repair for all mitral valve operations and 70 percent with procedures to correct pure mitral valve regurgitation.

While there has been widespread adoption of minimally invasive, patient-friendly techniques is most areas of surgery, there has been little data to prompt the routine use of these techniques in mitral valve surgery, especially in cases where the valve can be repaired.

“The small-incision approach fits with our emphasis on mitral valve repair rather than replacement,” says the study’s senior author, Bartley P. Griffith, M.D., chief of Cardiac Surgery at the University of Maryland Medical Center, professor of surgery and head of the Division of Cardiac Surgery at the University of Maryland School of Medicine. “We prefer to fix a broken mitral valve rather than replace it, because a repair lasts longer and rarely requires another operation down the road.”

He adds that because this surgery is more technically demanding than an open-heart repair, “We are uncertain if this approach is appropriate for hospitals that only occasionally perform mitral valve surgery or for surgeons who have not yet had a lot of experience with mitral valve repair."

“This minimally invasive approach to mitral valve repair exemplifies the commitment of our faculty physicians to provide the best care for their patients,” says E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine. “Very few surgeons across the United States perform this complex, small-incision procedure, yet the long term benefit to patients is unquestionably superior to valve replacement.”

“It is great to be in the company of so many people who are unlocking the science of healing, who are proud to able to care about one another and make the choices necessary to make our world a better place,” said Governor O’Malley. “I would like to recognize all of you for coming together here to do your part to help heal this world.” The three-day summit is being led in part by Curt Civin, MD, director of the Center for Stem Cell Biology & Regenerative Medicine, professor of Medicine and associate dean for Research at the University of Maryland School of Medicine.

Students from the School of Medicine were among the ambassadors who made themselves available to visitors to answer questions following the public symposium, called “Stem Cell Science and Medicine 101.”  E. Albert Reece, MD, PhD, MBA, Dean of the School of Medicine, welcomed the attendees, who included scientists from around the world, as well as medical personnel, local college and high school students, and members of the general public interested in this area of research. “Stem cell research is so important in our medical and scientific disciplines, because of its potential to do such a tremendous amount of good,” Dean Reece said. “I believe this meeting will have immediate as well as long-term implications within the field.”

The summit, which continues through September 23rd, is being sponsored, in part, by the University of Maryland, Baltimore (UMB). “Bioscience is one of the backbone economies of Maryland,” said David Ramsay, DM, DPhil, president of UMB. “Bio companies big and small are realizing that they have to harness not only what the universities are doing but what is coming out of NIH, the FDA and the other federal facilities that form the backbone of our life sciences industry.”

“This building is really transformational for the campus,” declared President Ramsay. “One of the problems with an institution like this is that students tend to affiliate only with their schools – they go to classes in the law school or medical school and then they go home. They rarely interact, but the marvelous thing about this center is that already you can see an effect. This is a place where the students and the faculty are gathering and mixing, and I think it’s going to make a huge difference in the identity of the campus.”

The campus center was built by the Whiting-Turner Contracting Company. Although they were confident they had crafted a great building, seeing it in operation has still been a great surprise. “Wow,” said Bob Kimmons, Whiting-Turner Division Vice President, of the center. “It has come to life and is truly a remarkable, remarkable building. It’s a dream come true for all of us who have worked for years to make this become a reality.”

Among those is David Hillman, CEO of the Southern Management Corporation and a member of the UMB Board of Trustees, whose $5 million gift transformed the quality of services the center is able to offer. “Your gift allowed us to make a good building excellent,” President Ramsay told Hillman. Amenities in the building include a state-of-the-art fitness facility, complete with a swimming pool, saunas and a running track, as well as an array of attractive conference/meeting spaces and healthy dining options.

Hillman could not be more pleased with the results. “It is so gratifying to see something that has been talked about and wished for, for such a long time, actually come into existence,” he said. “Southern Management is very proud to be a part of this campus center and what it is going to bring to the faculty and students at the University of Maryland.”

Andy York, who is studying at both the School of Pharmacy and the School of Law, spoke on behalf of the students at the ceremony. “The opening of the Southern Management Campus Center has transformed UMB,” he said. “For the first time we have a place where students from different schools and different programs can gather together to work, learn and play. And what a place it is! On behalf of the entire student body I promise today that we will cherish this new building and use it to its fullest.”

The consortium will work closely with several major military treatment centers and the
U.S. Army Institute of Surgical Research (USAISR) at Fort Sam Houston, Texas, to conduct multi-center clinical research studies relevant to the treatment and outcomes of severe orthopaedic trauma sustained on the battlefield. These studies will help establish treatment guidelines and facilitate the translation of new and emerging technologies into clinical practice.

“This clinical research network offers us a unique opportunity to investigate treatments for a variety of injuries common in military and civilian patients,” says Andrew N. Pollak, M.D., co-chair of the consortium and head of the division of orthopaedic traumatology at the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center and associate professor of orthopaedics at the University of Maryland School of Medicine. “We needed more funding to conduct definitive studies on severe wounds to the legs and arms. The results of this research will give us better insight into the best ways to treat severe, high-impact injuries to the limbs.”

Dr. Pollak, who served as chair of the American Academy of Orthopaedic Surgeons’ Extremity War Injury Project Team, will lead the orthopaedics studies at Shock Trauma as part of the new initiative. He has championed the need for increased funding for trauma research, citing the devastating extremity injuries suffered by U.S. soldiers in Iraq and Afghanistan. “There is a profound need for targeted medical research to help military surgeons find new limb-sparing techniques to save injured extremities, avoid amputations and preserve and restore the function of injured extremities,” he told the U.S. Senate Appropriations Subcommittee in 2007.

The Johns Hopkins Bloomberg School of Public Health will serve as the coordinating center for the consortium. The Orthopaedic Extremity Trauma Research Program (OETRP) of the Department of Defense has awarded the Bloomberg School of Public Health $18.4 million over five years to establish the consortium.

“The need for such a consortium is evident,” says Ellen MacKenzie, Ph.D., principal investigator and the Fred and Julie Soper Professor and Chair of the Bloomberg School’s Department of Health Policy and Management. “Eighty-two percent of all service members injured in Operation Iraqi Freedom and Operation Enduring Freedom sustain significant extremity trauma. Many sustain injuries to multiple limbs. The research to be conducted by the consortium will help us better understand what works and what doesn’t in treating these injuries and ensure that our service members are provided with the best care possible.”

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine, says, “The University of Maryland R Adams Cowley Shock Trauma Center is internationally recognized for its expertise in caring for the most critically injured patients and is a leader in trauma research. Our faculty members will play a very active role in this new consortium, working together with trauma specialists at other centers to develop innovative new therapies to treat traumatic limb injuries.”

Initial funding of the consortium will help establish the research network and provide resources to address some of the critical needs in acute clinical care identified by the military. These include the reconstruction of significant bone defects and the management of musculoskeletal infections. Over time, the consortium will expand and leverage its expertise to address many other priority topics relevant to the long-term management of severe extremity trauma, including the prevention of osteomyelitis, chronic pain and disability.

An important feature of the consortium will be its ability to expand the number of clinical
sites participating in any one study. More than 30 trauma centers across the country have pledged support for the consortium and are eager to participate in one or more of the studies.

“We are thrilled to be partnering with the consortium and the incredible team of investigators they have assembled,” says Joseph Wenke, Ph.D., of the USAISR. “Together we will develop the infrastructure critically needed to address some of the most pressing issues in orthopaedic trauma care. Without a large, multi-center effort such as this, many of these issues would never be solved.”

The other core clinical centers currently participating in the consortium are:  Boston University Medical Center; The Florida Orthopaedic Institute; Carolinas Medical Center; Denver Health and Hospital Authority; OrthoIndy and the Indiana Orthopaedic Hospital; Orthopaedic Associates of  Michigan; The Orthopaedic Trauma Institute at the University of California at San Francisco, San Francisco General Hospital; The University of Mississippi Medical Center; The University of Texas Southwestern Medical Center; The University of Washington Harborview Medical Center and Vanderbilt University Medical Center. 

“This is an event that many medical schools put on during the year,” explained E. Albert Reece, MD, PhD, MBA, Dean of the School of Medicine. “We believe that the more our representatives understand how medical education is conducted in this country, the better we will understand each other and be supportive of each other.”

Delegate Jim Mathias, a representative from Maryland’s Eastern Shore, attended the earlier session with his son Trevor, who is a pre-med student at UMBC and hopes to attend the School of Medicine after graduation. Having met many of our medical students when they came to Annapolis to promote the school, Delegate Mathias wanted to let them know their message is not being ignored. “I’m very proud that here in the state of Maryland we have the oldest public medical school in America,” said Delegate Mathias. “In this very difficult economic time, we want them to know that we are going to muster together to make the decisions that will continue to fund the school and all the good that they do.”

State senator Jim Robey, who represents Eastern Howard County, was excited to learn what medical students go through to become good doctors. “I also wanted a better understanding of how I – as a state senator serving on the budget and taxation committee – can be more understanding of the financing needs of institutions such as this.” His favorite part of the day was getting to talk with students about why they chose medicine. “They are here not for themselves but because they want to help other people and better this world.”

As they arrived, the participants were asked to don a white coat, the traditional garb of medicine. Then it was off to class, which started – as the first year of medical school does for all medical students here – in the Anatomy lab. Larry Anderson, PhD, a professor in the Department of Anatomy and Neurobiology, explained the importance of the 10-week anatomy course for first-year students and let the lawmakers  take a look at one of the cadavers used for study.

A new $11.2 million, five-year grant from the National Institutes of Health (NIH) will enable researchers at the University of Maryland School of Medicine in Baltimore and three other centers to improve the treatment of chronic heart failure. This multifaceted research program is the largest effort of its kind to focus on a basic question in heart failure: how can nutritional changes impact heart function to help patients with a failing heart?

The heart needs fuel to work properly. In a process called metabolism, chemical energy from food is transformed into the electrical energy that causes the heart to pump. Impaired metabolism is both a cause and effect of heart failure. Cell structures known as mitochondria are at the center of the process.

“Years of untreated high blood pressure or loss of cardiac tissue and scarring after a heart attack cause certain mitochondria to develop defects,” says William C. Stanley, Ph.D., professor of medicine and director of cardiovascular sciences at the University of Maryland School of Medicine, who is leading the research program. “Different substances from food affect the mitochondria in different ways. We want to improve those defective mitochondria and prevent the mitochondria from going bad when they are constantly under stress.”

Dr. Stanley and investigators at three other institutions, Case Western Reserve in Cleveland, Henry Ford Hospital in Detroit, and New York Medical College, have been collaborating for 10 years. Their work, funded with a previous NIH grant, has already produced 85 peer-reviewed journal publications and has provided many insights into the causes and results of heart failure.

Dr. Stanley and his team will investigate new dietary changes to prevent and treat heart failure. Their hypothesis is that the electrical abnormalities that lead to heart failure can be reversed by consumption of a diet low in carbohydrates and sugar, and high in polyunsaturated fat. “We want to figure out how to improve this transfer of energy so the function of the heart is maintained in the early stages of heart failure or even before heart failure has been established,” he says.

Dr. Stanley’s study builds on the group’s previous research, which showed that a low-carbohydrate/high-fat diet can prevent or reduce some of the most serious aspects of heart failure. In addition, they found that dietary supplementation with omega-3 polyunsaturated fatty acids prevents development of heart failure, and a high-sugar diet further accelerates development of heart failure. “We have observed that high-sugar diets are toxic in animal models of high blood pressure, which can lead to heart failure. We’ll try to learn why that is. We will also evaluate why polyunsaturated fatty acids from fish oils are protective to the heart in heart failure.”

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine, says, “Dr. Stanley’s research has the potential to advance a new model of treatment. An important aspect of heart failure treatment in the future may involve the targeting of changes in the way the heart receives its nourishment.”

“Therapy focused on improving cardiac energy metabolism could help the heart work smarter, not harder,” says Mandeep R. Mehra, M.B.B.S., professor of medicine, head of the Division of Cardiology at the University of Maryland School of Medicine and chief of cardiology at the University of Maryland Medical Center. “We believe this is a very important and promising area of research because it may be the key to simpler approaches, through the diet, to manage and even improve heart failure.”

The three other teams in this research program are studying related aspects of cardiac energy metabolism in heart failure. The Case Western Reserve team will design therapies to improve mitochondrial energy production, while investigators at Henry Ford Hospital will explore ways to reduce heart rate, a major regulator of energy utilization in heart failure. Researchers at New York Medical College will look at the relationship between altered energy metabolism and oxidative stress, which is the damage associated with unstable molecules called “free radicals.”

Each project will incorporate pre-clinical, animal models of heart failure to test approaches that can be translated into clinical treatments for humans. Heart failure affects nearly 5 million Americans. Five years after their initial diagnosis, fewer than 50 percent of heart failure patients are alive; at the 10-year mark, fewer than a quarter of patients survive. Risk factors that lead to heart failure include high blood pressure, a prior heart attack, abnormal heart valves and diabetes. In addition, a large number of patients have a form of heart failure called idiopathic cardiomyopathy, where no cause can be identified.
 
Heart failure develops when the heart is not able to pump enough blood to meet the body’s needs. The heart compensates for this loss in pumping capacity by growing larger, increasing muscle mass and pumping faster to increase the heart’s output. These changes typically occur over a long period of time, masking the problem. Eventually, the heart and the body cannot keep up with the demands, and the person begins to experience the fatigue and breathing problems that often are the first signs of the disease.

“Preserving these remaining beta cells would be very beneficial to patients. Studies have shown that when type 1 diabetes patients are still making some of their own insulin, their blood sugar levels are much easier to control and they require less insulin,” says Dr. Donner, medical director of the Joslin Diabetes Center at the University of Maryland Medical Center and associate professor of medicine at the University of Maryland School of Medicine. “If this therapy proves to be effective, it could potentially lead to fewer low blood sugar reactions and complications from diabetes in the future.”

The clinical trial, the Durable-Response Therapy Evaluation for Early or New-Onset Type 1 Diabetes, is called DEFEND-1. The study is sponsored by Tolerx, Inc., a Cambridge, Mass., company that is producing the drug in conjunction with GlaxoSmithKline. The study is also being funded by the Juvenile Diabetes Research Foundation.

“The DEFEND-1 study is among the first clinical trials to try to prevent insulin-producing beta cells in the pancreas from being destroyed by the immune system,” Dr. Donner says. Investigators hope to enroll a total of 240 young adults, age 18 to 35, who have been newly diagnosed with type 1 diabetes. University of Maryland researchers aim to recruit 10 patients.

The participants will be selected at random to receive eight days of otelixizumab infusions within 90 days of being diagnosed with type 1 diabetes. Two out of three people will receive the investigational drug, and the third person will receive a placebo. Neither the physicians nor the patients will know who is getting the drug. All of the participants will receive insulin injections and the usual standard of care for patients with type 1 diabetes. To evaluate the effectiveness of the treatment, researchers will measure C-peptide, a byproduct of the production of insulin in the blood which is a surrogate measure of beta cell function.

Dr. Donner adds, “All patients in the study will receive intensive diabetes management and free blood sugar testing supplies.”

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine, says, “Diabetes is a major public health problem affecting more than 170 million people around the world, and researchers at the University of Maryland School of Medicine are committed to finding better treatment options for patients. This study is an example of the innovative clinical research being conducted by our faculty members.”

Otelixizumab is a monoclonal antibody, which is being developed for the treatment of type 1
diabetes and other autoimmune diseases. It targets CD3, a T-lymphocyte receptor involved in normal cell signaling. Data suggest that the antibody works by blocking the function of effector T-cells, which mistakenly attack and destroy insulin-producing beta cells, while stimulating regulatory T-cells, which are believed to protect against effector T-cell damage.

Type 1 diabetes is one of the two major forms of diabetes. Previously known as juvenile diabetes or insulin-dependent diabetes, it accounts for 5 percent to 10 percent of the nearly 24 million people in the United States who have diabetes. Type 2 diabetes is by far the most common form. In type 2 diabetes, the body either doesn’t produce enough insulin or fails to use the insulin that it makes properly.

The University of Maryland Joslin Diabetes Center helps patients with both types of diabetes take charge of their own health and well-being, offering multidisciplinary care and individualized treatment programs. To get more information, people can visit the center’s Web site at http://www.umm.edu/joslindiabetes.

People who are interested in participating in the study should call (410) 328-6470. Additional information about the DEFEND-1 clinical trial is available at http://www.DefendAgainstDiabetes.com.

Researchers at the University of Maryland School of Medicine have identified a common gene variant carried by as many as a third of the general population that is believed to play a major role in determining why people do not respond to a popular anti-clotting medication, Plavix. If the medication doesn’t work, patients are at increased risk for subsequent heart attacks, strokes and other serious cardiovascular problems.

The results of the study, published in the Aug. 26, 2009, issue of the Journal of the American Medical Association (JAMA), confirm a previously reported link between people’s decreased response to Plavix, also known as clopidogrel, and common variations of the CYP2C19 gene. The study is the first to identify a common variant of this gene by using a sophisticated technique called a genome-wide association study to rapidly scan hundreds of thousands of genetic markers in the DNA of participants. More than 400 members of the Old Order Amish community in Pennsylvania took part in the study.

“By scanning the entire genome, we found compelling evidence that the CYP2C19 gene is a key determinant of how people respond to this medication,” says the lead author, Alan R. Shuldiner, M.D., professor of medicine and director of the Program in Genetics and Genomic Medicine at the
University of Maryland School of Medicine in Baltimore. “We didn’t detect any other common
gene variants that appear to be as significant as CYP2C19, but our research suggests that people’s response to clopidogrel is largely inherited and additional common and rare gene variants most likely are involved.”

Dr. Shuldiner says he will continue his research to search for these gene variants. “The more we know about how genes affect people’s response to medicines, the better able we are to develop effective new therapies and tailor treatment to an individual patient’s genetic make-up,” he says.

About 30 percent of the general population in the United States has the CYP2C19 variant identified in the study. Dr. Shuldiner says that it can be detected by a simple genetic test using DNA from blood or saliva. “If people have the gene variant, they might need to take a higher dose of clopidrogel or a different medication altogether,” he says, adding that more research is needed before such testing becomes routine.

Plavix is one of the world’s best-selling medications. It is used to prevent platelets from sticking together and causing blood clots in patients with cardiovascular disease who are at risk of having future heart attacks and strokes. (Platelets are fragments of bone marrow cells that help the blood to clot.) Despite its widespread use, up to 32 percent of people don’t respond to the therapy and as a result, experience serious cardiovascular events. Researchers don’t know the exact reason, but they believe that one important factor is the difference among individuals in their ability to metabolize the drug due to variation in the CYP2C19 gene.

“People who have this gene variant are less able to convert clopidrogel into its active form. They also have poorer platelet response to the medication and are at a 2.4-fold-higher risk of dying or having a serious cardiac event resulting from a blocked artery than those who don’t have the variant,” Dr. Shuldiner says.

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine, says, “Dr. Shuldiner is a nationally recognized leader in pharmacogenetics research, and the results of this study are very impressive and important, given the huge number of people with cardiovascular disease who depend on Plavix to prevent future heart attacks and strokes. This research significantly advances the science in this area and moves us forward in our quest to offer individualized treatments to our patients.”

Dr. Shuldiner and his colleagues analyzed the DNA of 429 healthy members of the Amish
community in Lancaster County, Pa. They gave the study participants Plavix for seven days and then looked at how their blood platelets responded. They also studied the participants’ DNA, searching for common gene variations. The researchers collaborated with investigators at the Sinai Center for Thrombosis Research in Baltimore, confirming their findings by studying a group of 227 people who received Plavix after having stents implanted to open blocked coronary arteries at Sinai Hospital.

Paul A. Gurbel, M.D., senior author of the study and director of the Sinai Center for Thrombosis Research, says that “patients with the CYP2C19 variant had a diminished platelet response to clopidogrel treatment and poorer cardiovascular outcomes.” Patients with the gene variant were more likely (20.9 percent vs. 10 percent) to have a heart attack or other serious cardiovascular event in the year following initiation of treatment.

In 2003, Dr. Gurbel and his colleagues at Sinai were the first to report that some people don’t respond to clopidogrel therapy. Two years later, they went on to demonstrate the important connection between this non-responsiveness and patients having adverse cardiovascular events.

“When we initially reported non-responsiveness to clopidogrel, the cause was unclear,” adds Dr. Gurbel. “Since then, this field has rapidly evolved as demonstrated in this important study. The results of the study lend support to genotyping and platelet function testing as potential future strategies for optimal antiplatelet drug selection in treating patients with cardiovascular disease.” This study is among the first to demonstrate in a single group of patients a link between a gene variant and responsiveness to clopidogrel that in turn is associated with outcomes after coronary stenting, he says.

Dr. Shuldiner says that about 30 percent of the Amish population has the CYP2C19 variant,
which is similar to the general population. He notes that by studying the Amish – a genetically homogenous people, most of whom are related – researchers were able to estimate that 70 percent of the variation in clopidogrel  response is due to genes and other shared factors among family members, such as their environment. In genetic research, 70 percent is considered extremely high “heritability,” he says.

The researchers estimate that the CYP2C19 variant accounts for 12 percent of the platelet response to the drug, and other factors, such as age, body mass index and cholesterol levels in the blood, account for another 10 percent. But, Dr. Shuldiner says most of the difference in response to the medicine remains unexplained. “Additional studies in larger populations will be necessary to find additional genes that influence response to clopidogrel,” Dr. Shuldiner says.

The research was funded in part by the National Institute of General Medical Sciences, which is part of the National Institutes of Health (NIH), and Sinai Hospital of Baltimore.

“This work was performed in a population that is superb for studying genetics, and the results were replicated in an unrelated and very different group in Baltimore,” says Rochelle M. Long, Ph.D., of the National Institute of General Medical Sciences and director of the National Institutes of Health Pharmacogenetics Research Network. “The results will be very useful in the future to help predict which drugs to use in which patients, for optimal effect and prevention of cardiovascular disease.”

Dr. Davis was recruited from Vanderbilt University School of Medicine in Tennessee. He will lead the University of Maryland School of Medicine’s largest department, with over 300 full-time faculty members of both physicians and scientists. He is an endocrinologist who has devoted his career to research and patient care, focusing on treating adults with diabetes and metabolic disorders, as well as studying the biological basis of certain diabetes-related complications.

“As a renowned physician-scientist, Dr. Davis will be most suited to provide excellent clinical and scientific leadership of the Department of Medicine here at the School of Medicine,” says E. Albert Reece, M.D., Ph.D., M.B.A., dean of the School of Medicine, vice president for medical affairs of the University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor. “During his 30-year career, Dr. Davis has balanced his award-winning diabetes research program with providing excellent patient care, while excelling at various leadership roles within his institution and in the international medical community at large. His career is the embodiment of the mission of the University of Maryland School of Medicine — to combine world class patient care with top-tier cutting-edge scientific research. We are very pleased that Dr. Davis will lead our Department of Medicine,” says Dean Reece.

“Dr. Davis has a distinguished reputation as a physician leader, educator and a scientist.  We look forward to working with him as he takes the helm of our largest department, caring for  patients with a full range of complex medical conditions,” says Jeffrey A. Rivest, president and CEO of the University of Maryland Medical Center. “In addition, with Dr. Davis’ expertise in diabetes, he will be a tremendous asset to the Joslin Diabetes Center, one of the most prominent programs within our Department of Medicine, which provides comprehensive care and education for people living with diabetes,” says Rivest.

The Department of Medicine at the University of Maryland School of Medicine was created at the school’s founding 202 years ago. Dr. Davis will be the 13th chairman to lead this nationally recognized department. The department is responsible for training 145 residents and 77 fellows. It has been very successful scientifically and currently receives almost $150 million in annual extramural research funding to support its comprehensive laboratory and clinical research programs.

The department includes 11 divisions and one specialized program: Cardiology; Endocrinology, Diabetes and Nutrition; Gastroenterology and Hepatology; General Internal Medicine; Geographic Medicine; Gerontology and Geriatric Medicine; Hematology/Oncology; Infectious Diseases; Nephrology; Pulmonary and Critical Care Medicine; Rheumatology and Clinical Immunology; and the Occupational Health Program. The Department of Medicine has a global reach, with research programs in many countries, and in regions such as South America and Africa.

A native of the United Kingdom, Dr. Davis earned his medical degree from London University and did his specialty training at the Royal College of Physicians. Dr. Davis joined Vanderbilt University School of Medicine in 1988. He was promoted to Director of the Division of Diabetes, Endocrinology and Metabolism, and professor of medicine, molecular physiology and biophysics. Most recently, he also served as associate director of the General Clinical Research Center at Vanderbilt, and for five years, ending in 2002, he was director of the Nashville Veterans Affairs/Juvenile Diabetes Foundation International Research and Training Center.

He has been recognized with many distinguished awards throughout his career, including the Novartis Award for Diabetes Research in 2000 — considered to be the highest honor in that field of research. He was named a Fellow of the American College of Physicians in 2009, a Fellow of the American College of Endocrinologists in 2008 and a Fellow of the Royal College of Physicians in 2001.

Dr. Davis currently leads research projects with extramural funding totaling $10 million.
His research focuses on the mechanisms that defend against a falling blood glucose level, a condition known as hypoglycemia. “Hypoglycemia is the complication of diabetes that patients fear most,” explains Dr. Davis. “Complications that can be associated with diabetes include blindness, kidney failure and even coma or death.” Some diabetics suffer from frequent episodes of hypoglycemia, even as often as several times each week. Dr. Davis’s laboratory has found areas in the brain that act to blunt the body’s ability to protect itself against hypoglycemia. Each episode of hypoglycemia triggers these areas of the brain to send out signals that make it more difficult for the body to defend itself against subsequent episodes of low glucose levels in the blood. Dr. Davis also has identified promising new treatments and interventions that counteract these mechanisms and stimulate the body’s ability to defend itself against hypoglycemia.    

Dr. Davis also explores the mechanisms that cause increased heart attacks and strokes in diabetic patients, most (65 percent) of whom die from such events. Dr. Davis is the author of more than 110 peer-reviewed articles and 50 textbook chapters and review articles.

“I am honored by the opportunity to take on this leadership role at the University of Maryland School of Medicine, an institution with a distinguished history, including being the first public medical school in the U.S.,” says Dr. Davis. “I want to thank Dean Reece for this great honor. I am also very pleased to be succeeding Dr. Frank Calia who has been an outstanding leader of this department, which has flourished on his watch. I hope to continue that momentum. I am looking forward to leading the Department of Medicine into a new, dynamic era of research and patient care defined by cutting-edge discoveries in emerging areas of science including genomics, stem cell biology and metabolic disorders.”

“Our goal is to offer our patients the finest care and most effective and innovative treatments, and recruiting such top-notch specialists and physician leaders as Dr. Davis enables us to fulfill our mission,” says Robert A. Chrencik, president and chief executive officer of the University of Maryland Medical System. “We believe that Dr. Davis is the right person to lead our Department of Medicine to even greater advances in patient care and research.”

Dr. Davis and his wife, Frances, have three sons — Ian, Stuart and Hugh. 

"Mini-Med School for Kids targets children from our underserved community in hopes of delivering key messages about important, and very relevant, health and lifestyle issues," explains Heather Graham Phelps, Manager of Public Relations in the School of Medicine's Office of Public Affairs. "It’s our intent to reach these kids while they are still young and healthy in order to instill valuable information about taking care of their bodies and making smarter health and lifestyle choices."

Things kicked off July 8 with a lesson from Dr. Yvette Rooks, Assistant Professor of Family Medicine, about the importance of eating well and exercising. The campers, many of whom have participated in previous sessions of Mini-Med School for Kids, impressed Dr. Rooks with their ready answers to her questions about nutrition.

Mini-Med School for Kids continued each Wednesday over the next five weeks. Dr. Mary Beth Bollinger, Associate Professor of Pediatrics, spoke with campers about allergies and asthma. Dr. Gina Perez, Assistant Professor of Psychiatry, tackled stress relief and anger management, with some help from Truman the Dragon, mascot of The Baltimore Times’ Kidsville newspaper. Dr. David Pumplin, Adjunct Professor of Anatomy and Neurobiology, got the kids moving with a presentation on the human body and how it works.  And Dr. Corrine Erickson educated them about skin care, particularly protecting themselves from the sun during these hot summer days.

The final session brought the campers to campus, where they had a hands-on session in the Department of Medical & Research Technology. McGruff the Crime Dog also paid the children a visit, during a presentation from the UMB Police about safety. Things ended with lunch, where the children were presented with graduation certificates for successfully participating in this year’s program.

"We've formed a partnership with the School of Medicine that is really amazing," said Deborah Tyson, director of the camp. "The children go home and tell their parents about eating healthy, exercising, not using drugs or selling drugs, not smoking or drinking, and I hear back from the parents that they are so impressed by everything their children have learned. It's been so wonderful, and we hope to have the chance to do it again next year, because it is an excellent program."

The Summer Research Program was born from a conversation between Congressman Cummings and UMB president David J. Ramsay, DM, Phil, both of whom were seeking ways to inspire neighborhood students to pursue a college education. Now in its third year and growing bigger every summer, it gives students from the nearby Vivien T. Thomas Medical Arts Academy the chance to work side by side with mentors in their fields of interest from any of the University's professional schools, including medicine, nursing and law.

Many of the students work in laboratories at the School of Medicine, getting a peek into what a life in medicine might be like. Jordan Warnick, PhD, professor of Pharmacology and Experimental Therapeutics and Assistant Dean for Student Research at the School of Medicine, who oversees the Summer Research Program, hopes it will help these students take a step toward “a four-year school and even, after that, for them to come back here for graduate school and study medicine or physical therapy or pursue a research career.”

Some of the students expressed doubt that they could go so far, but Congressman Cummings urged them to toss aside their lack of confidence. “If there are people who are telling you that you can’t do this – and I don’t care who they are, your boyfriend or your mom or whoever – you have got to prove them wrong,” he advised the students.

The congressman shared the story of a school counselor who told him he would never amount to anything and how those words have stayed with him all these years, sometimes discouraging him but more often inspiring him to work harder (especially when the counselor had to come to him for legal representation years later). “Go for your dream,” he told the students. “If you pursue your dreams with everything you’ve got, even if you don’t succeed, you still succeed. You succeed because it’s not always about the end, it’s about the journey.”

Researchers at the University of Maryland Marlene and Stewart Greenebaum Cancer have found that head and neck cancer patients who test positive for the human papilloma virus (HPV) have much better survival rates than patients who don’t have the virus, according to a new study in the journal Cancer Prevention Research. The researchers also discovered that blacks in the study had a very low rate of HPV infection, and consequently worse survival, which may explain why African-American patients traditionally have had a poor prognosis for head and neck cancer.

"For the first time, we have evidence that the major difference in survival between black and white patients with head and neck cancer appears to be the rate of HPV infection. We found an astounding difference in prognosis between patients who are HPV-positive and those who are HPV-negative," says the study’s senior author, Kevin J. Cullen, M.D., director of the University of Maryland Marlene and Stewart Greenebaum Cancer Center and professor of medicine at the University of Maryland School of Medicine.

Scott Lippman, M.D., chairman of the Department of Thoracic Head and Neck Medical Oncology at the University of Texas M.D. Anderson Cancer Center, called the study 'practice-changing.' "Squamous cell carcinoma of the head and neck is one of the fastest growing cancers, and this study gives us a new way to assess prognosis for our patients," says Dr. Lippman, editor-in-chief of Cancer Prevention Research, which is published by the American Association for Cancer Research.

Dr. Cullen adds, "We need to analyze HPV routinely in specific patients with head and neck cancer, which we’re currently not doing. HPV-positive cancer is biologically a very different disease than HPV-negative cancer, and we need to take that into account as we’re planning future therapies. Those with HPV-negative disease may not be as well served with our current treatments combining chemotherapy and radiation."

The human papilloma virus is known to cause certain types of cancer and is a major risk factor for head and neck cancer, so researchers were surprised to find that patients with HPV infection had a better prognosis.

Only 4 percent of black patients with squamous cell carcinoma in the study were HPV-positive, compared with 34 percent of white patients. The median overall survival was more than three-fold higher for whites (70.6 months) than for blacks (20.9 months) who were treated with chemotherapy and radiation. Dr. Cullen says the survival rate at five years for HPV-positive patients was about 85 percent, compared to 35 percent for HPV-negative patients. Survival was similar for HPV-negative patients, regardless of race. The study’s findings confirm that HPV infection relates specifically to a type of head and neck cancer: cancer of the oropharynx, which include the tonsils, soft palate and base of the tongue.

"There is currently no consensus on why blacks fare worse with squamous cell carcinoma of the head and neck than whites," Dr. Cullen says, "but our findings provide the first clue that a critical reason may be biologic rather than related to issues of access to care, lack of insurance or attitudes of health care providers."

"Many researchers at the University of Maryland School of Medicine are conducting important studies relating to racial disparities in diagnosis and treatment," says E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine. "This groundbreaking study will have a significant impact on how doctors care for patients with head and neck cancer."

Cancer experts believe that head and neck cancer, particularly oropharyngeal cancer, is on the rise because of an increase in HPV infection in the oral cavity. Overall, about 25 percent of head
and neck cancers are tied to HPV infection, Dr. Cullen says. In comparison, HPV causes virtually
100 percent of cervical cancers, and a vaccine has been developed to help prevent this type of cancer by preventing HPV infection.

Researchers don’t yet understand why blacks have a lower rate of HPV infection in head and neck cancers than whites, Dr. Cullen says. There is some evidence that HPV transmission associated with oral cancer may be related to sexual practices, but he says there are probably a number of other factors involved, including possible differences in immunity and how the virus can become integrated into the cell’s DNA "that now we just don’t understand."

In the study, researchers analyzed data from about 200 patients who had been treated at the Greenebaum Cancer Center and then evaluated another group of 230 patients treated as part of a multi-center clinical trial.

The study was funded in part by the Maryland Cigarette Restitution Fund Program, which uses money from a legal settlement with big tobacco companies for cancer research and cancer screening,  education and prevention programs in Maryland. “This is really a wonderful example of how CRF-supported research can benefit Marylanders and all people who are battling cancer,” Dr. Cullen says. “We are very committed to helping the Cigarette Restitution Fund fulfill its mission of erasing racial disparities in diagnosis and care.”

The research was also funded by grants from Sanofi-Aventis U.S. and the Orokawa Foundation.

The University of Maryland Marlene and Stewart Greenebaum Cancer Center is a National Cancer Institute-designated cancer center. It offers a full range of treatments for all types of cancer and has a very active cancer research program. To learn more, go to www.umgcc.org.

[For more information about participating in clinical trials at the Center for Vaccine Development, please call 410-706-6156, or visit www.clinicaltrials.gov.]

The University of Maryland School of Medicine’s Center for Vaccine Development will lead one of the nation’s first studies of an experimental vaccine designed to prevent the 2009 H1N1 influenza virus. The Center for Vaccine Development is one of a nationwide network of Vaccine and Treatment Evaluation Units (VTEUs) funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH). The VTEUs are conducting the trial, which will recruit volunteers and test the vaccine beginning in August.

To view the entire news conference, click here. (Real Player is required.)

The clinical trial will enroll as many as 1,000 healthy adults and children at 10 centers nationwide to evaluate the safety of the vaccine and measure its ability to stimulate immune responses to the H1N1 virus. The research is a first step toward the U.S. government’s stated goal of developing a safe and effective vaccine against the H1N1 strain of influenza and making it available to the public before the flu season begins in the fall.

“The H1N1 flu outbreak has been declared a global pandemic by the World Health Organization and a public health emergency by the U.S. government,” says Karen L. Kotloff, M.D., professor of pediatrics, a lead investigator at the VTEU and a researcher in the Center for Vaccine Development at the University of Maryland School of Medicine. “This virus has the potential to cause significant illness with hospitalizations and deaths during the U.S. flu season this fall and winter. Vaccines have always been a vital tool for controlling influenza. The results of these studies will help to guide the optimal use of the H1N1 vaccines in the U.S. and elsewhere in the world.”

“Our Center for Vaccine Development has been home to one of the NIAID’s Vaccine and Treatment Evaluation Units for more than three decades,” says E. Albert Reece, M.D., Ph.D., M.B.A., dean of the University of Maryland School of Medicine.

“Our VTEU is now one of just eight in the country, and it is the only one in the mid-Atlantic region,” says Dean Reece, who also serves as Vice President for Medical Affairs, University of Maryland, and the John Z. and Akiko K. Bowers Distinguished Professor at the School of Medicine. “We’re very pleased the NIAID has chosen our top-tier researchers as leaders in the effort to stop the H1N1 pandemic before the 2009 influenza season begins.”

All participants in the trial will receive two doses of vaccine three weeks apart. The response after one dose versus two doses will be compared. The trial also will evaluate two strengths of the vaccine to determine which strength is required to stimulate an immune response that is most likely to protect people against the H1N1 flu. The vaccine will be tested in five different age groups. First, researchers will test the vaccine in healthy adult and elderly volunteers. If the vaccines are well tolerated in those groups, then the researchers will begin testing the vaccine in children. Ultimately, as many as 200 adults, 200 seniors and 600 children may be enrolled in the trials.

“The response to the vaccine may vary in different age groups,” Dr. Kotloff said. “This is because young people have not seen a flu virus like this one before. Older adults might have some immunity to the new H1N1 virus as a result of being exposed to similar flu viruses in the past. As a result, older adults might need fewer doses or a lower strength of the vaccine than younger individuals.”

In addition to involving Dr. Kotloff, the lead investigator, trials at the University of Maryland School of Medicine VTEU also will involve co-investigators Wilbur H. Chen, M.D., assistant professor of medicine, and Ina Stephens, M.D., assistant professor of pediatrics. Individuals will be able to volunteer for the trial at sites in Baltimore, Frederick and Annapolis. In Baltimore, the testing will take place at the University of Maryland Medical Center.

University of Maryland School of Medicine researchers also will participate in future studies of the vaccine that will be led by other members of the NIAID’s nationwide network of Vaccine and Treatment Evaluation Units. Those trials will examine important questions such as how the vaccine works in combination with the seasonal flu vaccine and whether including an adjuvant, which boosts the immune response to vaccines, can make the vaccine work better at lower doses.

The eight VTEU sites that will participate in these H1N1 vaccine trials include the University of Maryland School of Medicine as well as Baylor College of Medicine, Cincinnati Children’s Hospital Medical Center, Emory University, Saint Louis University, Seattle Group Health Cooperative, the University of Iowa, and Vanderbilt University. They will be joined by Children’s Mercy Hospital in Kansas City and Duke University Medical Center.

“Learning the responses of different age groups of people to the vaccine will not only tell
us the best way to use the vaccine in an individual, but we also learn ways to use the vaccine
supply most efficiently to protect the greatest number of people,” says Dr. Kotloff.

“The Center for Vaccine Development is an internationally known facility devoted to the use of vaccination to control of infectious diseases such as typhoid, measles, Hib meningitis, cholera, Shigella dysentery and malaria,” says Myron M. Levine, M.D., D.T.P.H., a professor of medicine, head of the Division of Geographic Medicine and director of the Center for Vaccine Development at the School of Medicine. “We’re delighted to play such a key role in the quest for an effective vaccine for this new, emerging strain of influenza.”

For more information about participating in clinical trials at the Center for Vaccine Development, please call 410-706-6156, or visit www.clinicaltrials.gov.

Dr. Faden was recruited from Georgetown University, where he developed a nationally renowned research program in brain injury and served in a variety of clinical, research and administrative roles, including as Dean of Research. He formerly held professorships in neuroscience, neurology, pharmacology and pediatrics. He will bring more than $7 million in research grants, including four major grants from the National Institutes of Health, as well as 15 members of his research team to the University of Maryland School of Medicine.

“Dr. Faden not only brings a national and international reputation as a research scientist, but he also will build bridges between basic science and clinical science,” says Dean Reece, who is also vice president for medical affairs at the University of Maryland. “Dr. Faden will actively lead the development of translational research as a two-way street. He will ensure that findings in the laboratory will eventually benefit patients, and challenges in patient care will inspire creative treatment approaches and new prevention techniques that will be tested in the laboratory,” adds Dr. Reece.

The new Shock, Trauma and Anesthesiology Organized Research Center is the only facility of its kind in the United States dedicated exclusively to the study of injury and its complications and prevention. It is a multidisciplinary research and educational center focusing on trauma, critical care and organ support, resuscitation, injury prevention, perioperative clinical outcomes and patient safety. The executive committee of the center will include leaders of the Program in Trauma, the Department of Anesthesiology and other disciplines.

According to Thomas M. Scalea, M.D., professor and director of the Program in Trauma at the School of Medicine and Physician-in-Chief of the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center, “All of us are excited about the launching of the new STAR Organized Research Center and about Dr. Faden in particular, and his ability to harness all the building blocks of research in trauma. We look forward to working with him,” says Dr. Scalea.

Peter Rock, M.D., M.B.A., professor and chair of the Department of Anesthesiology at the School of Medicine, says, “Dr. Faden is a world class scientist who has received continuous funding from the National Institutes of Health for years. His work in brain injury and brain trauma are areas we identified as important components of our program, so his research is a perfect fit. He also possesses many outstanding personal qualities, including being collaborative, collegial and energetic.”

“With Dr. Faden’s recruitment and the creation of the Shock, Trauma and Anesthesiology Organized Research Center, the School of Medicine has reaffirmed its longstanding commitment to the study and treatment of head injuries and trauma,” says Bruce E. Jarrell, M.D., professor and executive vice dean at the University of Maryland School of Medicine. “Medical understanding of these two areas is advancing rapidly, and Dr. Faden’s research will help propel that. The center will play a pivotal role in the future of head injury and trauma research and treatment, not just for civilians but for the military as well. We’re confident the STAR Center’s work will help the military to protect and treat its soldiers,” says Dr. Jarrell.

Dr. Faden began his research at the Walter Reed Army Institute of Research, with studies that addressed mechanisms of shock and cardiovascular regulation. “I have long been interested in brain and spinal cord regulation of the heart and blood vessels, which ultimately led to research related to shock and subsequently neurotrauma,” says Dr. Faden. “I chose neurology as a specialty because of the remarkable complexity of the brain and the fact that there were few effective treatments at that time. Working to develop new therapeutic approaches for clinical neuroscience has been a goal since residency training.”

Dr. Faden’s current research centers on delayed or secondary injury after brain or spinal cord trauma. He is trying to understand biochemical changes that lead to subsequent cell death and tissue destruction as well as how to block such damage. A recent focus has been directed to common pathways that link acute injury processes such as trauma or stroke and chronic neurodegenerative disorders like Alzheimer’s disease.

Dr. Faden underscores the increasing interest in traumatic brain injury as a consequence of the wars in Iraq and Afghanistan. “Early medical support in the field and use of body armor now enable soldiers to survive injuries that were lethal in previous wars. Because of that and the marked increase in blast-related trauma, the percentage of soldiers suffering head injury now exceeds 20 percent of those deployed to war zones.” At the same time, he notes that sports-related head injuries have become better recognized, with much improved clinical research on high school and college athletes who suffer brain trauma.

Dr. Faden says he looks forward to working with the leadership of Drs. Rock and Scalea, as well as current STAR Center investigators, “to build upon the existing strengths at the University of Maryland and by promoting collaborative research within the School of Medicine and across the schools and university campuses.”

Researchers at the Institute for Genome Sciences (IGS) at the University of Maryland School of Medicine have earned three new grants worth potentially more than $24.6 million to study the microbes that live in and on the human body and how they affect human health. The grants are part of an expansion of the Human Microbiome Project, a $140 million, five-year effort by the National Institutes of Health (NIH). The project’s expansion, which the NIH announced June 24, is partially funded by federal money allocated to stimulate the U.S. economy under the American Recovery and Reinvestment Act.

The grants to the University of Maryland School of Medicine will fund research on obesity and metabolic syndrome in the Old Order Amish, Crohn’s disease and bacterial vaginosis. The human microbiome refers to all of the genomes, or DNA, of the trillions of microorganisms that live on and in the human body. The Human Microbiome Project will investigate how the human microbiome affects the human genome.

“Now that the human genome has been sequenced, the human microbiome is the next great frontier for genomics. We’ve become a center of excellence for this new frontier, the study of the human microbiome,” says Claire Fraser-Liggett, Ph.D., a professor of medicine at the University of Maryland School of Medicine and director of the Institute for Genome Sciences.

“Now we have the tools to study these complex microbial communities that colonize every cavity and surface in the body. They are not just hitchhikers. They play a very important role in improving health by providing capabilities humans don’t have. There also is a growing association between important chronic diseases and potential shifts or changes in these microbial communities. This new field of study gives us an innovative approach to looking at complex diseases we know can’t be easily explained with a single mechanism,” adds Dr. Fraser-Liggett.

“Many of our researchers, including Dr. Fraser-Liggett, were involved with the sequencing of the human genome. These new grants keep the Institute at the cutting edge of this new frontier of genomics,” says E. Albert Reece, M.D., Ph.D., M.B.A., dean of the School of Medicine. “We hope this work will expand medicine’s understanding of conditions like Crohn’s disease and bacterial vaginosis, and one day lead to new treatments or diagnostic tools for these conditions,” says Dean Reece, who also is vice president for medical affairs of the University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor.

One of the grants is fully funded, but the other two will cover the beginning of projects that could each last as long as four years. After one year, the National Human Genome Research Institute (NHGRI), the part of the National Institutes of Health that is funding the Human Microbiome Project, will review the projects and decide whether to award the additional years. The Institute for Genome Sciences already has received funding from the Human Microbiome Project (HMP). In October 2008, IGS earned one of the project’s first grants, a $9.9 million award to run the Data Analysis and Coordination Center that forms the bioinformatics core of the project.

The new grants will fund pilot demonstration projects to sample the microbiomes of healthy volunteers and volunteers with specific diseases over the next year. The data will allow the researcher to study changes in the microbiome at particular body sites in both health and diseased states. Dr. Fraser-Liggett received two grants to study the microbes found in the digestive tract.

One grant, for $833,000 for one year, is to study Crohn’s disease in collaboration with researchers at Lawrence Berkeley National Laboratory in Berkeley, Calif., and Oak Ridge National Laboratory in Oak Ridge, Tenn. Another grant, for $1.02 million for the first year, and $12.3 million for the following three years, will fund Dr. Fraser-Liggett’s study of obesity and metabolic disorders in the Old Order Amish population in Lancaster, Pennsylvania. On that project she is collaborating with Alan R. Shuldiner, M.D., a professor of medicine at the University of Maryland School of Medicine. Dr. Shuldiner runs the Amish Research Clinic in Lancaster, which studies the genetics of the Amish.

A third grant goes to Jacques Ravel, Ph.D., an associate professor of microbiology and immunology at the School of Medicine and a researcher at the IGS, for the study of bacterial vaginosis. That project includes researchers at the University of Idaho. The grant is for $987,000 for the first year of a four-year planned project; the total four-year budget is $10.5 million.

About 25 to 30 percent of women have bacterial vaginosis at any point in time, and it is the most common vaginal infection that brings women of reproductive age to visit their primary care physician. In addition to causing discomfort, it has been associated with an increased risk of such problems as acquiring sexually transmitted infections and even pre-term delivery during pregnancy, according to Dr. Ravel.
“It’s a big problem that is very poorly understood,” he says. “Bacterial vaginosis is the result of changes in the microbiome in the vagina. We hope to identify the causes of the disruption of the microbiome, and we anticipate that a better understanding of bacterial vaginosis will ultimately result in more effective and personalized treatments.”

The NHGRI announced the grants as part of its nationwide expansion of the Human Microbiome Project. The project began in 2007 as a part of the NIH’s Roadmap for Medical Research. The expansion of the microbiome program will include pilot demonstration projects to study seven areas of the body: the digestive tract, the mouth, the skin, the nose, the vagina, the blood and the male urethra. The HMP expansion also will fund the sequencing of at least 400 microbial genomes. The sequencing of 500 other microbial genomes related to the human microbiome have already been completed or are in process.

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More information about the HMP is available at www.nihroadmap.nih.gov/hmp/ and www.hmpdacc.org.

An illustration showing the body sites that will be sampled as part of the Human Microbiome Project is available at: http://www.genome.gov/pressDisplay.cfm?photoID=20163.

A high resolution image of the bacteria, Entercoccus faecalis, a microbe that lives in the human gut, is available in color at www.genome.gov/pressDisplay.cfm?photoID=20023, or in black and white at www.genome.gov/pressDisplay.cfm?photoID=20024.

More information about NIH’s ARRA grant funding opportunities can be found at http://grants.nih.gov/recovery/. To track the progress of HHS activities funded through the ARRA, visit www.hhs.gov/recovery. To track all federal funds provided through the ARRA, visit www.recovery.gov.

"An endowed professorship is indicative of superior performance in the classroom, the laboratory and in the clinical setting," said Dean E. Albert Reece, MD, PhD, MBA when presenting Dr. Griffith with a medal to acknowledge his endowed professorship. "In the world of academia, endowed professorships are a coveted and universally recognized accolade, signaling a colleague at the top of his or her field."

This is certainly true of Dr. Griffith, whose clinical work focuses on treating patients with the most severe forms of heart and lung disease and whose research interests are concentrated on heart and lung transplantation and advancing the use of artificial organs. Dr. Griffith has published more than 500 papers and has been continuously funded by the National Institutes of Health as a principal research investigator since 1988. His research funding has paved the way for the development of an artificial lung and a pediatric heart pump, as well as a study to reduce muscle scarring after heart attacks.

"It's a pleasure for us as a family to be able to honor someone as distinguished as Dr. Griffith," said Mr. Hales, who came with his wife, son and daughter from their home in New York for the ceremony. "I've talked to a lot of thoracic surgeons, and every time I mention his name they say, 'He's the best in the world, you couldn't have a better doctor.' So on behalf of us and our children and our grandchildren, I want to thank you," he told Dr. Griffith. "You're a hell of a guy!"

Dr. Griffith thinks much the same of Mr. Hales. "You have been a wonderful example of a patient who takes very good care of himself," he said. "And what you are doing for this university truly can never be repaid. This will go a long way in establishing us as a center for continuous innovation and patient care."

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The Thomas E. and Alice Marie Hales Distinguished Professorship will be open-ended. The Hales Foundation has funded the first $2.5 million, and the Hales are allowing further contributions in order to enhance the value of this Distinguished Professorship.

All such donations should be sent directly to the University of Maryland Development Office:

Tierra Dorsey, Director of Development
University of Maryland School of Medicine
100 N. Greene Street, Suite 600
Baltimore, Maryland 21201
Telephone: (410) 706-2846
Facsimile: (410) 706-2995
Email:  tdorsey@som.umaryland.edu

Donations of any size will be acknowledged, and the Development Office will notify the Hales Foundation. 

The University of Maryland School of Medicine’s Institute for Genome Sciences (IGS) has been awarded $20 million from the National Institutes of Health to create a Genomic Sequencing Center for Infectious Diseases. The contract, the largest the Institute for Genome Sciences has earned since its founding two years ago, makes IGS a national hub for genetic information on infectious disease.

The Institute will use the funding to sequence and analyze the genomes of infectious organisms such as agents of bioterrorism and new or emerging diseases. Emerging diseases are defined as infections that cause a sudden outbreak, such as the 2009 H1N1 flu, SARS or foodborne illnesses. The genomic information can be used to develop new diagnostic and treatment tools to fight infectious diseases.

The National Institute of Allergy and Infectious Diseases (NIAID), which is part of the National Institutes of Health, awarded contracts to three institutions to create Genomic Sequencing Centers for Infectious Diseases (GSCID). “This project places the University of Maryland School of Medicine and IGS front and center in infectious disease research nationwide,” says Claire Fraser-Liggett, Ph.D., director of IGS and a professor of medicine at the University of Maryland School of Medicine. “Our work under this project could lead to new drugs, vaccines and diagnostic tools in the fight against infectious diseases, from emerging diseases such as 2009 H1N1 to agents of bioterrorism.”

The contract encourages collaboration between the IGS and outside clinicians or other scientists who have unusual or significant pathogen samples they would like to see sequenced and analyzed. Such scientists can propose projects to the IGS researchers and provide samples of the pathogens for sequencing. The contract will cover the cost of the sequencing and analysis at the IGS, and create a library of such information for sharing with researchers throughout the country. In return for proposing projects and providing samples, the outside researchers will gain access to the genomic information the IGS scientists discover.

“This new contract will encourage partnership between the world-class researchers at the Institute for Genome Sciences and other distinguished scientists across the country and in our own top-tier centers of excellence such as the Center for Vaccine Development and the Institute for Human Virology,” says E. Albert Reece, M.D., Ph.D., M.B.A., the John Z. and Akiko K. Bowers Distinguished Professor and Dean of the School of Medicine. “This is precisely the type of collaborative work we envisioned when we recruited Dr. Fraser-Liggett and her colleagues two years ago,” says Dean Reece, who also is vice president for medical affairs of the University of Maryland.

NIAID designed the program to allow research centers like the Institute for Genome Sciences to respond quickly and readily -- in a matter of weeks or even days -- in the event of a bioterrorist attack or an outbreak of a certain infectious agent. For example, if an outbreak of foodborne illness occurs, IGS scientists could quickly apply and gain approval for a project to sequence and analyze the genome sequence of that foodborne illness.

“With the help of the next-generation genomic sequencing equipment we have acquired at IGS, this contract will serve as a ready-made funding mechanism that could allow us to sequence as many as 500 to 600 DNA samples in five years,” says Dr. Fraser-Liggett. “We hope that by accelerating the process of sequencing and analyzing the DNA of these infectious diseases, we can also help speed scientists nationwide toward finding cures or vaccines for diseases that threaten lives in the U.S. and worldwide, such as pandemic influenza.”

"The academy is designed to recognize faculty members who demonstrate excellence in bedside, classroom and/or innovative medical education," said E. Albert Reece, MD, PhD, MBA, John Z. and Akiko K. Bowers Distinguished Professor and Dean of the School of Medicine. "Honorees are exemplary role models to students, embody the highest ideals of the medical profession and display uncommon commitment to students’ best interests," said Dean Reece.

This year's honorees are Bruce Jarrell, MD, Executive Vice Dean and professor of Surgergy, and Steven D. Munger, PhD, associate professor of Anatomy and Neurobiology. Dr. Jarrell is a gifted surgeon who specializes in kidney and liver transplantation and hepatobiliary surgery. In 1999, 2000, 2001 and 2003, he received the student council faculty teaching award.  In 2002, Dr. Jarrell received the "Golden Apple" award for best clinical faculty member.  Dr. Jarrell has set a continued emphasis on professionalism and mentorship among the education priorities.

Dr. Munger was the first assistant professor in the school to be Course Master for a major medical course and to ensure its quality he attends every lecture in the Neuroscience Course. Dr. Munger has served as course master, lecturer and laboratory director for Neuroscience since 2004 and routinely receives excellent student evaluations for both teaching and course management. He has instituted new electronic learning resources, including the use of the Medscope Forums for communications between students and faculty which has now been adopted by all basic science courses.

The names of Drs. Jarrell and Munger are displayed on the plaque at the Pass and Susel Medical Education Facility in Howard Hall which permanently recognizes of all inductees of the Pass and Susel Academy of Educational Excellence.

Researchers at the University of Maryland School of Medicine have found that an approved drug for treating rheumatoid arthritis reduces severe illness and death in mice exposed to the Influenza A virus. Their findings suggest that tempering the response of the body’s immune system to influenza infection may alleviate some of the more severe symptoms and even reduce mortality from this virus.

The scientists report in the June 1 edition of  The Journal of Immunology, which is now available online, that mice infected with the Influenza A virus responded favorably to a drug called Abatacept, which is commonly used to treat people with rheumatoid arthritis. The mice had been given “memory” T-cells, or white blood cells that have been primed to fight the invading virus as the result of previous exposure to Influenza A.

“We found that treating the mice with Abatacept minimized tissue damage caused by the immune response, but still enabled the body to rid itself of the virus. The mice didn’t become as sick, recovered much faster and had much less damage to the lungs, compared to mice that weren’t given the drug,” says Donna L. Farber, Ph.D., a  professor of surgery and microbiology and immunology at the University of Maryland School of Medicine and the study’s senior author.

“Moreover, treatment with Abatacept significantly improved survival for mice infected with a lethal dose of influenza virus,” Dr. Farber says. “The survival rate for the treated mice was 80 percent, compared to 50 percent for the mice that weren’t treated.”

She explains that the drug does not interrupt the immune system’s early, rapid attack in the lungs, which helps to kill the virus, but it prevents “memory” T-cells from overreacting, which produces multiple negative effects. “It’s this overactive immune response that can make you feel sick – and can also lead to pneumonia,” she says.

The study’s lead author, John R. Teijaro, a researcher in Dr. Farber’s lab, notes that tissue damage caused by this vigorous immune response – often most prevalent in young, healthy people – is thought to be the leading cause of death from pandemic strains of flu, such as the avian flu and the 1918 Spanish flu. It is also thought to be true of the early cases of H1N1 “swine” flu.

Dr. Farber says, “We believe that our findings are very significant because they provide a potential new treatment for infection by the influenza virus – one that would dampen the immune response, yet still preserve its protective effects.”

The researchers are now testing Abatacept in mice that have not previously been exposed to the flu virus, trying to determine how well they respond to the drug once they have become very sick. Instead of having “memory” T-cells, these mice have what are known as “naïve” T-cells, which have never been activated by being exposed to influenza previously. Depending on the results, Dr. Farber hopes to one day bring this promising new immunotherapy to the clinic for the benefit of patients.

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs, University of Maryland, and dean of the University of Maryland School of Medicine, says, “The results of this study are very promising. Influenza is a significant public health problem, affecting millions around
the world each year. We hope that this study – and Dr. Farber’s continuing research – will pave the way for identifying an effective treatment,” Dr. Reece says.

Abatacept, which is manufactured by Bristol-Myers Squibb and marketed under the name Orencia, is already approved by the U.S. Food and Drug Administration for treatment of rheumatoid arthritis. The drug is not approved for treating influenza.

The study, funded by the National Institutes of Health and Bristol-Myers Squibb, is available online http://www.jimmunol.org/cgi/content/full/182/11/6834. The Journal of Immunology is a peer-reviewed publication of the American Association of Immunologists.

There are three types of seasonal influenza, A, B and C, and a number of subtypes of Influenza A, including a new strain of the H1N1 virus, also known as the “swine flu,” which has recently emerged and caused illness and a number of deaths this year in Mexico, the United States and other countries around the world. Vaccination is the most effective way to prevent someone from getting the flu or having a serious case of the disease.  An antiviral drug, Tamiflu, can help to prevent the flu virus from spreading within the body if it is taken within 48 hours of the first symptoms.

Dr. Farber points out that an immunotherapy with a drug such as Abatacept would be effective against different strains of the virus because the target of the drug would be the immune system, not the virus itself. “We’re very excited about the potential of developing a new therapy, which possibly could be given to people even after they are very sick,” she says.

Learning must be a life-long process for the doctors of today advised keynote speaker Anthony Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases. "You will be witness to a constant and at times seemingly overwhelming evolution of technological advances," he warned the graduates. "You will feel, as I do, both exhilarated and intimidated. You will be learning the art of medicine while trying to keep up with the science of medicine, which will be advancing at breathtaking speed. The evolution of medicine will be beyond your control, but you must be a part of it if you are to evolve as well."

Dean E. Albert Reece, MD, PhD, MBA, is confident this class is ready for the challenges of  tomorrow. "Today we send you on your way," he said, "to a life's work of serving humanity and carrying on the healing tradition in new ways, in new environments, with new tools, exploring scientific puzzles with zeal and determination, while at the same time contributing to discoveries and cures."

Sampson Kyere is ready for those challenges now that he has earned his MD/PhD. "It's been a long eight years, and this is a very nice milestone to reach," he said of the graduation ceremony, where he was presented with the Student National Medical Association Service Award. This award is given to a graduating senior who has shown leadership in the Association (which has chapters in every U.S. medical school) and made outstanding contributions to the minority community. Kyere will stay at the University of Maryland for residencies in Internal Medicine and Diagnostic Radiology.

Also receiving an award at the ceremony was Zachary Kon, who was presented with the Faculty Gold Medal for Outstanding Qualifications for the Practice of Medicine. The medal is given to a graduate with outstanding scholarly accomplishments and those qualities of humanity and dedication most desirable in a physician. "It's a great feeling," he said of the day's activities. "But it's kind of sad, too. We're going to miss all our classmates who are leaving to go elsewhere. At the same time, we're very proud of them."

Pre-commencement celebrations were also held for students graduating from the School of Medicine who are not pursuing an M.D. These ceremonies included the Department of Medical and Research Technology, the Graduate Program in Life Sciences, the Masters in Genetic Counseling Program and the Department of Physical Therapy and Rehabilitation Science, where Dean Reece gave the keynote speech to the 62 graduates of the department's PhD, DPT (Doctor of Physical Therapy), DScPT (Doctor of Science in Physical Therapy) and TDPT (Transitional Doctor of Physical Therapy) programs.

No matter what aspect of medicine they will practice, all of the graduates would be wise to follow the advice Dr. Fauci gave during his speech. "The secret of the care of the patient is in caring for the patient," he said. "You will leave here today as professionals in a most noble field. You have been privileged, and with this privilege comes responsibility. May you carry this responsibility with pride."

"It is important that we set aside time during this very busy period to honor our very generous donors as well as our most accomplished students," said E. Albert Reece, MD, PhD, MBA, Vice President for Medical Affairs at the University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, School of Medicine. "This special celebration gives us an opportunity to appropriately acknowledge our scholarship and award recipients and the gracious donors who have made it possible for the School of Medicine to graduate the great physicians and scientists of tomorrow."

Judy Kopinski, President of the Class on 2009, spoke on behalf of her classmates when she said "I want to express our heartfelt thanks to each and every one of the donors and let them know that all the things you do for us and for the university have not gone unnoticed," she assured them. "You have given generously and freely of your resources and time, and your dedication and commitment to the school and your faith and hope in its students is a wonderful example of altruism, exemplifying the best that human nature has to offer."

Also honored at the brunch were the students with the top three capstone projects. The capstone project is a new requirement for graduation. It is a part of the fourth-year Area Health and Education Center (AHEC) rotation, during which students work in rural and underserved areas. For the capstone, students wrote on topics inspired by patients they met during these rotations. Jason O'Grady won first place for his essay about prison medicine. Ari Elman took second place for his essay on HIV partner notification and the physician's duty to warn. Third place went to Kathleen Sterling for her essay on healthcare for women veterans in the VA system.

All in all, the Class of 2009 received more than $1 million in grants and scholarships from generous donors, announced Dr. Donna Parker, Associate Dean for Student Affairs. She, too, acknowledged the donors who made this funding possible. "We'd like to thank all of you for paving the way for the continued education of the world-renowned clinicians and scientists that this institution produces."

Cancer specialists at the University of Maryland Marlene and Stewart Greenebaum Cancer Center in Baltimore are testing a new procedure to treat melanoma that has spread to the liver, targeting tumors with a dose of chemotherapy that is 10 times stronger than patients could otherwise tolerate.

The procedure is called percutaneous hepatic perfusion. Doctors use a specially designed delivery system with catheters and filters to make sure the cancer-fighting drug is applied only to the liver, thereby reducing the risk of damaging nearby organs and minimizing possible side effects for patients.

“This new procedure enables us to give patients extremely high doses of chemotherapy directly to the liver, where studies have shown it can be most effective in shrinking or eliminating tumors,” says H. Richard Alexander, Jr., M.D., a surgical oncologist at the Greenebaum Cancer Center who is one of the leaders of the Phase III clinical study. “Patients wouldn’t be able to tolerate this high-dose chemotherapy given intravenously to the entire body, but they generally tolerate this procedure quite well, with very few side effects.”

“Initial results have been promising. Half of the people in the Phase I study had their tumors shrink as a result of the treatment. In two people, the tumors disappeared altogether,” says Dr. Alexander, who is also a professor of surgery and associate chairman of clinical research in the Department of Surgery at the University of Maryland School of Medicine.
He says that although the study focuses on melanoma, this treatment might also be useful to treat other cancers that have spread to the liver, such as colon cancer or breast cancer.

Dr. Alexander was instrumental in researching and developing this new technique while he was a leader in clinical research at the National Cancer Institute (NCI).  He was deputy director of the NCI’s Center for Cancer Research when he joined the University of Maryland Greenebaum Cancer Center in 2006. The Greenebaum Cancer Center is part of the University of Maryland School of Medicine and the University of Maryland Medical Center.

Delcath Systems, Inc., a medical technology company specializing in cancer treatment, makes the delivery system, which is being tested at the NCI, the Greenebaum Cancer Center and a number of other top cancer centers across the country. Melanoma patients with inoperable tumors in the liver are eligible to enroll in the study. Their cancer may begin in either the skin (cutaneous melanoma) or the eye (ocular melanoma).

“Once melanoma – in particular ocular melanoma – has spread to the liver, it can be very aggressive and extremely difficult to treat,” says Dr. Alexander. “Patients really don’t have a lot of options, so we’re very hopeful that this new targeted chemotherapy will prove to be effective.”

More than 62,000 people are diagnosed with melanoma each year in the United States. Ocular melanoma is much rarer, with about 2,500 new cases detected each year. The cancer is often lethal if it spreads to the liver, which is the most common site for it to metastasize.

Patients enrolled in the study are selected at random to receive either the new targeted treatment or an alternative therapy, such as intravenous or oral chemotherapy. However, those who receive the alternative therapy can opt to have the new procedure if the tumors do not respond to the alternative therapy and continue to grow.

Under the protocol, patients receive infusions of a chemotherapy drug, melphalan, for 30 minutes every four weeks. They can receive a total of four to six treatments. The procedure is performed in an operating room or interventional radiology suite while the patient is under an anesthetic. Doctors thread a catheter up through a major artery in the patient’s groin into the main artery that feeds the liver to deliver the chemotherapy. Another catheter is placed in the major vein behind the liver, and balloons on the catheter are inflated to direct all the blood flowing out of the liver into a filter. This filter system removes almost 90 percent of the chemotherapy from the blood, and the blood is then given back to the patient through a catheter placed in a large vein in the neck.

“This technique involves only a couple of small holes to place the catheters, so patients generally recover quickly and are released from the hospital in a day or two,” says Fred Moeslein, M.D., Ph.D., an interventional radiologist and an assistant professor of diagnostic radiology and nuclear medicine at the University of Maryland School of Medicine who performs the procedure. Side effects may include fatigue and lower red and white blood cell counts.

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs, University of Maryland, and dean of the University of Maryland School of Medicine, says, “This study is just one of a number of innovative clinical trials being conducted by University of Maryland School of Medicine researchers to develop effective new treatment options for patients facing very devastating diseases. We’re very pleased that Dr. Alexander is playing a leading role in testing this exciting new technology.”

Delcath hopes to have 96 patients participate in the multi-center study. About half of the patients already have been enrolled. For more information about the clinical trial, go to http://data.umms.org/scripts/trials/trial.cfm?ID=GCC0636. 

To learn more about the University of Maryland Marlene and Stewart Greenebaum Cancer Center, visit www.umgcc.org.

Co-hosted by the University of Maryland School of Medicine and the National Cancer Institute, the symposium looked back at the origins of research on human retroviruses, progress on combating the virus through a successful research enterprise, and obstacles that still need to be overcome in treatment and prevention for the global AIDS epidemic. The symposium was attended by the world’s leading HIV/AIDS researchers.

"Maryland – and Baltimore in particular – is at the epicenter of the HIV epidemic in the U.S.,” said E. Albert Reece, MD, PhD, MBA, Vice President for Medical Affairs, University of Maryland, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. “Fortunately, through the School of Medicine’s Institute of Human Virology, we are now having a direct and major impact on both the local and global AIDS epidemic."

Led by Dr. Gallo since 1996, IHV’s impact includes delivering life-saving medications to approximately a quarter-million HIV-infected patients in Africa. In addition, six separate clinics staffed by Institute professionals serve more than 4,000 patients in Baltimore.

The Gala - "Celebrating a Visionary's Quest for Discovery” – was held at the Baltimore Hilton. "We are honoring Dr. Gallo this weekend not only to celebrate one of our distinguished faculty members, but also to draw attention the continuing problem of HIV/AIDS around the world and, especially, here in Maryland," said Dean Reece.  There is no timeline yet for when a vaccine might be available. Finding one is still the "holy grail" of AIDS research, and Dr. Gallo will long be leading the way in the quest for a vaccine.

Gala guests included former Maryland Lt. Governor Kathleen Kennedy Townsend, as well as research colleagues from around the world. After Dean Reece presented Dr. Gallo with an autographed jersey from Brooks Robinson, Gallo's favorite player, the crowd of nearly 300 enjoyed a night of dinner and dancing.

HIV co-discoverers Drs. Robert C. Gallo, director of the Institute of Human Virology at the University of Maryland School of Medicine, and Luc A. Montagnier, president of the World Foundation for Medical Research and Prevention, held a join press conference to call on international organizations and governments to immediately implement six objectives to end the HIV/AIDS pandemic. They made the announcement at the National Press Club in Washington, DC.  Also speaking at the conference was Jeffrey S. Crowley, Director of the White House Office of National AIDS Policy.

"HIV and AIDS remain an unparalleled global health threat, and despite progress in treatment, could worsen unless determined action is taken," said Drs. Gallo and Montagnier. Hoping to take action against that, "we believe the recommendations we are making today will be key to reducing and ultimately minimizing the devastation of HIV and AIDS," said Drs. Gallo and Montagnier.

Global Call to Action:

1. Invest in medical infrastructure and educational outreach programs in U.S. communities most affected by the HIV/AIDS epidemic
2. Promote global development of HIV/AIDS treatment and control programs along with regional research institutions in developing countries
3. Cultivate and inspire young scientists in the field of human virology
4. Enhance HIV/AIDS education and prevention, especially in countries with high infection rates
5. Support cutting-edge vaccine research and the development of new effective therapies
6. Continue the focus on preventing mother-to-child HIV transmission

“Here we are, 25 years after discovering the cause of AIDS and we still have a major, public health HIV/AIDS crisis,” said Dr. Gallo. “Never in the history of mankind have we so quickly identified the cause of an epidemic, developed a test for it and begun to develop drug therapy, changing a once-deadly virus to a lifelong condition with proper medical intervention. It is important for governments and organizations from around the world to come together and combat this collective HIV/AIDS emergency.”

“President Obama is fully committed to the worldwide effort to combat HIV/AIDS, and is equally committed to the effort here at home, where we are facing a serious challenge, said Crowley. "With more than 56,000 new infections each year and more than 1.1 million people living with HIV/AIDS in the United States, we continue to have a very serious domestic epidemic. As part of the National HIV/AIDS Strategy development process, we will be developing strategies to lower HIV incidence, get all people living with HIV/AIDS into care, and address health disparities,” he vowed.

Dr. Gallo encouraged the media not to be so distracted by swine flu and natural disasters that they lose sight of the devastation HIV/AIDS is still causing. "Let's not forget that we have a known, deadly epidemic still going on," he said. "As one of my colleagues at the Institute of Human Virology pointed out, the tsunami killed about 175,000 people. Almost that many die every month from HIV and AIDs. Keep that in mind, that this is still killing a lot of people."

“Despite many advances in HIV research from the virus discovery to the antiretroviral therapy, the AIDS epidemic is still spreading and remains a major health problem in many countries,” said Dr. Montagnier.  “It is therefore of utmost importance to continue the research to find new ways of treatment and prevention for eradicating the virus infection.”

This global action coincides with the publishing of Dr. Gallo and his colleagues’ four key groundbreaking articles in Science magazine on May 4, 1984 Vol 224 (#4648). These four papers proved how the then-new, deadly virus was the cause of AIDS. This significant global contribution lead to the development of the HIV blood test, thereby diagnosing individuals and helping to control the pandemic, while paving the way for drug and vaccine research initiated at the National Cancer Institute (NCI). These reports followed publication by Dr. Montagnier and his co-workers, who showed the first existence of this new retrovirus and subsequently contributed to demonstrating its causative role in AIDS.”

Drs. Gallo and Montagnier are participating in a symposium, "25 Years After Discovering HIV as the Cause of AIDS," co-hosted by the University of Maryland School of Medicine and the National Cancer Institute.  The symposium, being held May 9-11, 2009, will look back at the origins of research on human retroviruses and the 25 years since proving HIV as the cause of AIDS, summarize the accomplishments of a successful research enterprise, and look forward to overcoming obstacles in treatment and prevention for the global AIDS epidemic. For more information, please visit http://www.gallo25.umaryland.edu/. 

“We set out with a very strong desire to push the boundaries of medicine for the benefit of mankind," said Dr. Fraser-Liggett, a professor of medicine and microbiology at the University of Maryland School of Medicine. In less than two years, the Institute for Genome Sciences has already garnered more than $100 million in research funding.

"This is a major milestone for all of us,” said Dean E. Albert Reece, MD, PhD, MBA, during a reception celebrating the Institute's move into BioPark II.  "I want to congratulate Claire for getting the Institute up and running so fast. What they have accomplished so far is nothing short of amazing."

In the months following her arrival, Dr. Fraser-Liggett worked alone, planning how she would build the Institute for Genome Sciences into the nation’s preeminent genome research facility. Joined by former colleagues from the Institute for Genomic Research (TIGR), her staff soon outgrew their temporary offices and labs around campus.

The Institute’s new home is in Building Two of  the UMB BioPark – a sophisticated 215,000 square foot facility located on the west side of the University of Maryland, Baltimore (UMB) campus. "We look forward to a very bright future here in our new home. And this truly does feel like home," said Dr. Fraser Liggett.

Dr. Fraser-Liggett says the Institute will continue to build research relationships with colleagues throughout the School of Medicine, the campus and the University of Maryland Medical Center. UMB President David Ramsey, DM, DPhil sees great promise in these partnerships. "Medicine has changed, science has changed, and one of the things that has most delighted me is the way that Claire is managing to break down rigid departmental silos and collaborate across the school."

For more on the Institute for Genome Sciences, visit their website.

John Paul Jones, born as John Paul in Scotland in 1747, is linked to the United States Navy's earliest traditions of heroism and victory. He first went to sea at age 13, became a captain at 21 and was a spectacularly successful officer during the American Revolution. Despite his naval prowess, Jones, the man who became the "Father of the U.S. Navy," experienced recurring health problems, beginning at age 26.

John Paul Jones is the subject of this year’s Historical Clinicopathological Conference (CPC), sponsored by the University of Maryland School of Medicine and the Veterans Affairs (VA) Maryland Health Care System in Baltimore. This conference is devoted to the modern medical diagnosis of disorders that affected prominent historical figures.

During the conference, naval historian Lori Lyn Bogle, Ph.D., associate professor of history at the United States Naval Academy in Annapolis, will trace Jones’ successes and failures. Jones died in 1792, at age 45.

Medical history and autopsy

“What is fascinating is that after he died, Jones’ body was stored in an alcohol-like substance. He was buried in an unmarked grave in Paris, and remarkably, the body was found,” says CPC presenter, Matthew R. Weir, M.D., who is responsible for analyzing what likely caused Jones to die. Dr. Weir is a professor of medicine at the University of Maryland School of Medicine and head of nephrology at the University of Maryland Medical Center. Dr. Weir says Jones’ preservation made it possible for an autopsy to be performed 113 years after Jones died.

Dr. Weir reviewed Jones’ medical records and the 1905 autopsy report. In 1792, officials said Jones died of “dropsy of the chest,” old medical terminology that may have referred to the accumulation of fluids in the lungs.

Early medical descriptions of Jones refer to severe, cyclical fever, and psychological highs and lows. At 33, he was almost blind, complaining of sore eyes. In one record, Jones told his doctor he felt like an old man. Jones traveled frequently to the West Indies. Dr. Weir says, “All of these fever-related illnesses could have been connected to anything from malaria or dengue fever, to bacteria or viruses. You name it, he had a lot going on as a young man.” The naval lifestyle may have contributed to his health problems: poor diet, cramped quarters, poor hygiene onboard ship and/or venereal disease.

By 1789, four years before his death, Jones was in rapid decline. “Poor health led him to turn down most social invitations. He had a poor appetite, yellowing of the skin, swelling of the legs and abdomen, a persistent cough and difficulty breathing,” says Dr. Weir.

Medical examiners at the autopsy concluded that Jones died from a type of kidney disease called interstitial nephritis, which is the description of a non-specific, inflammatory process in the kidneys. They also noted scarring in the lungs from pneumonia.

Final diagnosis

Dr. Weir considered a number of possibilities including infections, lead poisoning, autoimmune disorders, and tuberculosis. He then focused on common streptococcal (strep) infections, which can cause both pulmonary and kidney disease. Further, Dr. Weir says a different type of end-stage kidney disease, called glomerulonephritis, is more common than the interstitial variety. Dr. Weir’s final diagnosis: “John Paul Jones developed end-stage kidney failure as a result of viral or bacterial infection, which stimulated the development of a form of progressive glomerulonephritis. The interstitial nephritis was the end result of this progressive disease.  He also had pneumonia, an incidental finding not likely related to his kidney disease.” 

The achievements of John Paul Jones

While John Paul Jones is honored today for his numerous accomplishments, Dr. Bogle says he was not well accepted by other officers of his time because of his exaggerated sense of personal honor, over-the-top aggressiveness and what some said was a poor leadership style. “His need for fame and personal honor, not unusual for officers of his day, drove him to see his men as a means to achieve his personal goal,” says Dr. Bogle.

The high point for Jones during the Revolution was his victory over the HMS Serapis in 1779, which British admiral Horatio Nelson claimed was the greatest naval feat in history. Jones was praised in both Europe and the United States for his seamanship, dogged courage and determination. In 1781, the Continental Congress voted to give him “the thanks of the United States.” After the war, the Navy ceased to exist when Congress in 1785 auctioned off its last warship and sent home all its officers and men.

Jones, ever seeking to improve his craft, served briefly in Russia as an officer in the imperial fleet of Catherine the Great. He was known as a womanizer and left Russia in the wake of an apparently trumped-up rape charge by Russian officers and traveled to Paris, hoping without success to secure another naval commission.
 
President Theodore Roosevelt’s role

Dr. Bogle says the recognition that John Paul Jones had sought his entire life finally came to fruition in the early 20th century. The first step took place in 1900 when Augustus C. Buell, an engineer turned historian, wrote a two-volume biography titled John Paul Jones: Founder of the American Navy. “Buell referred to letters he had fabricated that would portray Jones with qualities that officers of the day would have tried to emulate. Buell later claimed he couldn’t remember his sources,” says Dr. Bogle.

The next step in creating Jones as father of the U.S. Navy, according to Dr. Bogle, was the discovery of Jones’ body in an abandoned Parisian cemetery. The find came just about the time that President Theodore Roosevelt was looking for a way to garner support for converting the U.S. Navy from a defense-only fleet to an offensive armada. Roosevelt, a naval historian, had previously dismissed Jones as a corsair, an officer who raided commerce. “Enshrining Jones as Father of the Navy provided the president with a useful means to convey the importance of the navy to America’s new extended responsibilities,” says Dr. Bogle.

As a result, the body of John Paul Jones was brought to the United States amid much fanfare, his remains were placed under the chapel at the U.S. Naval Academy where they repose today and the nation celebrated its new sea power mission.

“We believe these conferences are excellent teaching tools. They help give students a sense of history, show how medical science has evolved over the years and foster an appreciation for good patient diagnosis,” says E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs, University of Maryland, and dean, University of Maryland School of Medicine.

The Historical CPC is the brainchild of Philip A. Mackowiak, M.D., professor and vice chair of the Department of Medicine at the University of Maryland School of Medicine and director of medical care at the VA Maryland Health Care System.

The University of Maryland Medical Center in Baltimore is the first hospital in Maryland and only the third in the United States to perform a single-port, natural orifice kidney removal surgery through the navel for a living kidney donor. During the procedure, surgeons use a single opening in the navel (belly button) as they manipulate a camera and two laparoscopic instruments to separate the kidney from its attachments in the abdomen. The kidney is then removed through that same opening. Only a tiny bandage is required to close the navel, and there are no scars.

"This is the next advance in organ donation and we are pleased to be able to offer this procedure to patients who are doing a very altruistic thing by donating a kidney. It is another way we can say thanks to the very special people who are organ donors," says Rolf Barth, M.D., a transplant surgeon at the University of Maryland Medical Center and assistant professor of surgery at the University of Maryland School of Medicine. Dr. Barth led the surgical team as they performed the single-incision kidney removal on April 15, 2009. He adds, "Most kidney donors would qualify for this new approach."

Kristen McLoughlin, 22, of Madison Heights, Va., was the first kidney donor to undergo the single-port, kidney removal through the navel at the University of Maryland Medical Center. Ms. McLoughlin has high praise for this advance. "It’s neat. I came out of surgery with just a Band-Aid. It’s a breakthrough for future donors and will make it easier for them," she says.

Laparoscopic removal of donor kidneys, which University of Maryland Medical Center surgeons have performed since March 1996, has become the norm. That approach requires three or four tiny openings in the abdomen to insert a camera and instruments, and a four-inch incision to lift out the kidney. However, the new procedure, called single-incision laparoscopic surgery, accomplishes everything through a single opening in the belly button.

Single-incision laparoscopic kidney removal employs the same tools and techniques as conventional laparoscopic surgery and can be used in both men and women. The only difference is a specially-designed port that accommodates the tools.

"The single incision is the next step in promoting safe organ donation," says Benjamin Philosophe, M.D., Ph.D., director, division of transplantation at the University of Maryland Medical Center and associate professor of surgery at the University of Maryland School of Medicine, who participated in this landmark surgery. "The traditional laparoscopic approach has a long track record of minimal risk and quick recovery, but it is likely that the single-port technique will be even better since there is only one small incision."

Ms. McLoughlin donated her kidney to 54-year-old Cynthia Jacobson of Timonium, Md. Ms. Jacobson had been waiting for a kidney for a year and a half. She met Ms. McLoughlin through a Web-based organ donor matching service, matchingdonors.com.

Because of Ms. Jacobson’s polycystic kidney disease, her enlarged, diseased kidneys had to be removed. The University of Maryland Medical Center specializes in helping patients with Ms. Jacobson’s condition by removing the diseased kidneys just before the transplant, in one operation.

Andrew C. Kramer, M.D., urologist at the University of Maryland Medical Center and assistant professor of surgery at the University of Maryland School of Medicine, led the team that removed the kidneys. The transplant team was led by Eugene J. Schweitzer, M.D., transplant surgeon at the University of Maryland Medical Center and professor of surgery, University of Maryland School of Medicine.

Ms. McLoughlin says she began thinking about becoming an organ donor after her older sister was killed in a car accident more than three years ago. Some of her sister’s organs were donated after her death, and that started Ms. McLoughlin thinking about the idea of organ donation.

Ms. McLoughlin says that becoming an organ donor fits in with her work helping others that she’s been involved in during the past year after graduating from college. She is co-chair of a domestic violence coalition and a victim services coordinator in Lynchburg, Va., with the Crisis Line of Central Virginia, where she assists people who were victims of rape or sexual assault. She also teaches self-defense classes for college-age women and conducts courses at the local police academy about interviewing victims of sexual assault.

"The decision to use the single-port technique is consistent with the research and educational philosophy at the University of Maryland School of Medicine, which nurtures the quest for innovative ways to improve patient care," says E. Albert Reece, M.D., Ph.D., M.B.A., Vice President for Medical Affairs, University of Maryland; John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine.

"University of Maryland Medical Center surgeons have always been leaders in minimally invasive surgery," says Jeffrey A. Rivest, President and Chief Executive Officer of the University of Maryland Medical Center. "This procedure signals another step forward for our nationally acclaimed transplant program and elevates our efforts to provide the best surgical care while improving patient recovery."

Dr. Barth says that for donors like Kristen McLoughlin, who have already decided to give the gift of life and are willing to go through surgery to help a person in need, the possibility of coming through the surgery without scars is a secondary benefit.

Drinking alcohol is a known risk factor for many types of cancer, but studies also have shown that moderate alcohol consumption may actually decrease the risk of developing certain cancers, such as lymphoma. Now, researchers at the University of Maryland Marlene and Stewart Greenebaum Cancer Center have identified a molecular mechanism that helps to explain how alcohol protects against non-Hodgkin’s lymphoma, the most common form of lymphoma.

The scientists report in an online edition of the journal Blood that low-dose, chronic exposure to ethanol – regardless of whether the source is beer, wine or other types of alcoholic beverages – inhibits the activity of a protein called mTOR. That protein plays a key role in controlling important cellular processes, including the regulation of cell growth. The researchers found that the equivalent of several drinks a day resulted in “a striking inhibition of lymphoma growth” in mouse models.

“We’re not saying that people should have a couple of drinks a day to reduce their risk of developing lymphoma. But we believe that having a better understanding of this process may lead to more effective, targeted therapies to treat lymphoma and possibly prevent it. We hope to develop new compounds that will mimic the effect of alcohol, targeting the molecules that interact with this master regulatory molecule,” says Ronald B. Gartenhaus, M.D. , the study’s senior author.

Dr. Gartenhaus, an associate professor of medicine at the University of Maryland School of Medicine and a researcher at the University of Maryland Marlene and Stewart Greenebaum Cancer Center, is continuing his research into lymphoma development, searching for other molecules involved in mTOR inhibition. “We’re looking to develop very potent inhibitors of these molecules that will serve the same purpose as alcohol, only better,” he says.

The results of the study are available online in a First Edition of Blood, which is published by the American Society of Hematology. To see an abstract of this study, visit: http://bloodjournal.hematologylibrary.org/cgi/content/abstract/blood-2008-11-191783v1

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs, University of Maryland, and dean of the University of Maryland School of Medicine, says, “Lymphoma is a major hematological malignancy associated with considerable morbidity and mortality.  These findings significantly advance our understanding of how lymphomas develop and offer clues that may lead to the development of new therapies. The fact that Blood, the most cited peer-reviewed publication in the field, decided to publish these results underscores the importance of the findings.”

Lymphoma is a cancer that originates in the lymphocytes (a type of white blood cell) of the immune system. About 74,000 Americans are diagnosed with lymphoma each year. There are two major categories of lymphoma: Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Most non-Hodgkin’s lymphomas are B-cell lymphomas, but there are other lymphomas that arise from T cells or NK cells. Lymphomas can be slow-growing or aggressive, and more aggressive non-Hodgkin’s lymphomas usually are treated with chemotherapy and a biological therapy such as the monoclonal antibody Rituxan. On occasion, radiation therapy is also utilized. Bone marrow or stem cell transplantation may also be a treatment option.

Dr. Gartenhaus notes that a number of epidemiologic studies have found evidence that people who drink moderate amounts of alcohol – regardless of the beverage – have a decreased risk of having most types of non-Hodgkin’s lymphoma. But researchers had not been able to pinpoint the exact reason for this phenomenon. “We were able to demonstrate in our study that low-dose, chronic exposure to ethanol
disrupts the mTOR signaling pathway in lymphocytes, significantly inhibiting the growth of
lymphoma tumor cells. Our findings underscore the critical role of mTOR signaling in lymphoma,” Dr. Gartenhaus says.

mTOR, which stands for mammalian target of rapamycin, is known to be involved in the 
development of certain cancers, in particular those caused by a mutation in the PTEN gene. mTOR
inhibitors are used to help prevent rejection of transplanted organs, but because of the growing evidence of a link between mTOR and cancer, researchers are now studying mTOR inhibitors as possible cancer treatments.

Patrick R. Hagner, a graduate research assistant at the University of Maryland School of Medicine and the study’s lead author, says the study looked at the effect of alcohol on both breast cancer cells and lymphoma cells. “What we found is that the alcohol did not suppress the mTOR signaling pathway in breast cancer as it did in lymphoma, which was consistent with previously published clinical findings demonstrating a protective effect of moderate alcohol consumption on lymphoma development in contrast to the opposite effect for breast cancer,” he says.

The University of Maryland Marlene and Stewart Greenebaum Cancer Center, a National Cancer Institute-designated cancer center, is part of the University of Maryland School of Medicine and the University of Maryland Medical Center. The cancer center offers a full range of treatments for all types of cancer and has a very active cancer research program.

Curt I. Civin, MD, professor of pediatrics and director of the new Center for Stem Cell Biology and Regenerative Medicine at the University of Maryland School of Medicine, and Gary Fiskum, PhD, professor of anesthesiology, spoke at the free event, organized and sponsored by the Student Society for Stem Cell Research chapters at the University of Maryland, College Park and the Johns Hopkins University. Students designed the event to help other undergraduates understand the potential of the field and how expanded funding will bolster the field career opportunities for aspiring doctors and scientists.

The event was the brainchild of Josh Basile, a University of Maryland junior who suffered a spinal cord injury in a swimming accident at Bethany Beach, Del., in 2004. Josh, a quadriplegic, has spent the five years since his accident battling for better treatments. A key part of that battle, Josh believes, is advocating for the field of stem cell research so doctors can better help patients with devastating spinal cord injuries like his own.

“Stem cell therapies one day could make all the difference for paralyzed patients like me,” says Josh. “I want my fellow students who dream of being doctors and scientists to understand the potential of stem cells, and how increases in federal funding will impact the future of science and medicine. Getting the next generation of researchers excited about the field is critical to its success and to finding a cure for those of us who dream of walking again.”

Dr. Civin is known for discovering a way to isolate stem cells from other cells in the blood in 1984. He and Dr. Fiskum spoke on the future of stem cell research and what obstacles must be overcome before the promise of stem cells can be realized. "One of the hopes I had was that all the controversy about stem cell research would generate the heightened education, interest and knowledge of the general public in scientific research as a whole," said Dr. Civin. "And now this is happening."

After the doctors' presentations, the students explored the new stem cell exhibit at the Maryland Science Center, called “Cells — The Universe Inside Us.” Dr. Civin was a scientific advisor on that exhibit, as was Miriam Blitzer, PhD, a professor of pediatrics at the University of Maryland School of Medicine.

“The gala’s Hero Awards show just how many people it takes to save one life,” says Thomas Scalea, M.D., physician-in-chief at the R Adams Cowley Shock Trauma Center, and the Francis X. Kelly Professor of Trauma Surgery and the director of the Program in Trauma at the University of Maryland School of Medicine.

“These 97 heroes include emergency dispatchers, firefighters, EMS providers, Maryland State Police Aviation Command personnel, nurses, physicians, technicians and rehabilitation specialists. They all do amazing work, and the gala is our opportunity to acknowledge their medical expertise and tireless dedication to treating Maryland’s most critically injured patients,” says Dr. Scalea.

One of those patients is 18-year-old Robby Smith, whose story will be dramatically retold at the gala using photos, interviews and actual recordings of the conversations between the trauma center and paramedics in the field. While driving home on a winding road in December 2007, Smith swerved to miss an on-coming car, sending his vehicle into a split rail fence.

When Baltimore County paramedics arrived, they found the teenager impaled with a foot-long fence post sticking out of his throat.  Following the delicate efforts to extricate him from his car, a Maryland State Police Medevac team flew Smith to the UM Shock Trauma Center.  Physicians and nurses were astonished that Smith was awake and alert. They suspected that the sheer size of the post and the amount of pressure it was exerting on Smith’s body may have saved his life. Otherwise, they believed, he would almost certainly have bled to death.

Because of the precarious situation, for the first time ever, a paramedic had to come into the operating room holding the patient – it was too dangerous for him to let go. Several others on the medical team also had to cradle Smith, so the post would not move.  During a delicate surgery, the team used a special orthopaedic saw to remove the post. 

Smith required many units of blood, but he survived.  However, just a few days later, doctors had to amputate his arm. After many days of uncertainty, Smith began to improve. He was able to move to Kernan Orthopaedics and Rehabilitation Hospital just 36 days after the crash.  He has since graduated from Franklin High School and is pursuing a career in computer science.
 
“Fifty-four people will receive Hero Awards at the gala for their roles in saving Robby Smith. As his case shows, one person cannot do it alone; it takes a team of well-coordinated medical experts to save a trauma patient,” says John Spearman, former vice president of the Shock Trauma Center who is now senior vice president of external affairs for the University of Maryland Medical Center.

The second case to be highlighted at the gala is the story of Tony Damico, who collided with a tree while riding his bicycle on Crofton Parkway, possibly because of a seizure. The blow knocked him unconscious. Anne Arundel County paramedics who arrived on scene recognized that, with a head injury and increasing blood pressure, Damico was going into shock.

A Medevac helicopter team flew Damico to the UM Shock Trauma Center, where he was rushed into the operating room. Immediately, the surgeons saw that Damico’s spleen was severely injured and had to be removed. But they soon discovered another life-threatening problem: the Anne Arundel County man’s heart had ruptured. They quickly worked to rebuild his heart.

Damico spent nearly 200 days at Shock Trauma before he began intensive rehabilitation at Kernan Orthopaedics and Rehabilitation Hospital. His recovery was not easy; he had multiple setbacks and was readmitted to Shock Trauma for an infection in his lower leg. He also needed additional surgery to remove his gallbladder and reconstruct his abdomen. However, Damico continued to improve. Today, he is riding a new specialized bicycle and aspires to ride 30-40 miles a day, as he once did. 

“The perseverance of these trauma patients and their caregivers is truly inspiring. The gala gives us a chance to honor their courage and to thank the dedicated trauma doctors, nurses and other staff, as well as the thousands of emergency medical service providers throughout the state, who do everything they can to help these patients recover," says Jeffrey A. Rivest, president and chief executive officer of the University of Maryland Medical Center.

“The expertise of the Shock Trauma faculty, staff and their EMS partners is world-renowned. Marylanders should feel confident in the knowledge that our trauma center and EMS providers are simply the best,” adds E. Albert Reece, MD, PhD, MBA, vice president for medical affairs, University of Maryland, and dean, University of Maryland School of Medicine. Dr. Reece is also a member of the EMS board.

More than 1,700 people are expected to attend the gala, which will be held from 6:00 pm until midnight on April 25 at the Baltimore Convention Center.  Tickets are $350 per person and include cocktails, a seated dinner, live music and dancing. Funds raised at the gala benefit patient care services at Shock Trauma and will also be used to upgrade operating rooms and intensive care units.

Cardiac surgeons at the University of Maryland Medical Center in Baltimore have performed a rare triple bypass heart surgery using robotic assistance. This procedure, which does not require any large incisions, presents a durable alternative to open-heart surgery for patients with multiple blocked coronary arteries. With this minimally invasive procedure, patients can have a much shorter recovery time and return to their normal life much sooner.

The University of Maryland Medical Center is only the second place in the United States to have performed robot-assisted triple bypass and the first in the world to achieve the triple bypass using an advanced, minimally-invasive heart-lung machine. The medical center's first patient to benefit from robot-assisted triple bypass is 67-year-old Ronald A. Bress, from Cheektowaga, New York, near Buffalo, who had his surgery on March 31. He left the hospital four days later and was able to fly home just nine days later.

"The majority of patients who require bypass surgery have more than two blocked arteries going to the heart," says Johannes Bonatti, M.D., a cardiac surgeon at the University of Maryland Medical Center and professor of surgery at the University of Maryland School of Medicine who performed the pioneering surgery. "Our ability to bypass three vessels now means that many more patients can benefit from this minimally invasive, robot-assisted heart surgery."

With traditional open-heart surgery, in which the sternum or chest bone is cut open to reveal the heart, three or more bypasses are routine. People who undergo such open-heart surgery typically require two or three months to heal. They also face a higher risk of infection.

By contrast, robot-assisted surgery offers several key advantages over traditional open-heart procedures, including no need to split the chest open and no incisions: just three or four dime-sized openings to insert robotic tools and a camera. Recovery is usually a two-to-three week period with a quick return to normal activities, as well as reduced risk of infection and other complications.

Mr. Bress was seeking an alternative to open heart surgery when he learned about the innovative robot-assisted bypass approach offered at the University of Maryland Medical Center, where dozens of patients have had either single or double bypasses performed that way. He had gone into cardiac arrest while at a gym in the Buffalo area on March 16 and was rushed to a local hospital. Doctors there told him he needed open-heart surgery to bypass his blocked coronary arteries. He was aware of the long recovery that some of his friends had endured after traditional open-heart surgery. So Mr. Bress decided to do some research on the Internet, hoping for another option. He found information about robot-assisted heart surgery at the University of Maryland Medical Center's Web site and booked a flight to Baltimore.

"When I got to Baltimore, I was so impressed with Dr. Bonatti and everyone else on his team. I am grateful that I was able to avoid open-heart surgery. I feel good. I've been doing a lot of walking around the (Baltimore) Inner Harbor since I've been discharged. In fact, I have even walked from the hotel back to the hospital — about ten blocks," said Mr. Bress just nine days after his triple bypass.

His wife, Christine Bress, said, "This is an amazing place. They took excellent care of Ron and me, too, and they were always kind and respectful. I am so glad that he was a good candidate for this."

Dr. Bonatti is one of the world's most experienced surgeons in using the daVinci robot for heart surgery. The technique is sometimes referred to as "totally endoscopic coronary artery bypass" because there are no incisions. Until now, technical issues had limited robot-assisted bypass surgery to a maximum of two bypass grafts. The major impediment was a technical one — how to enable the robotic instruments to reach the underside of the heart.

Dr. Bonatti and his team have been working to overcome those barriers with improved techniques and new instruments that lift the heart up from the chest to provide access to blocked vessels on the back of the heart. Dr. Bonatti also uses a new type of heart-lung machine specially designed for use with robotic heart surgery, which is connected to the patient through an artery in the groin. A traditional heart-lung machine requires an opening in the chest.

"When the patient is on the heart-lung machine, and the heartbeat is stopped, we can sew extremely tight and accurate sutures with the robotic system. Research indicates that this technique adds to the longevity of the bypass, in contrast to other approaches in which the heart is kept beating," according to Dr. Bonatti.

Dr. Schimpff is a medical oncologist who was a leader in infectious diseases at the University of Maryland Marlene and Stewart Greenebaum Cancer Center. He also served as CEO of the University of Maryland Medical Center before retiring in 2004.

Dr. Schimpff’s book is a resource for the general public — not just health professionals — to understand upcoming medical developments. He interviewed about 150 medical leaders from across the country, asking them what each thought the major advances in medicine would be in the coming years. He took this data and distilled it down into a few megatrends, each representing a chapter in his book. Topics include genomics, stem cells, vaccines, medical devices, imaging, the operating room, the electronic medical record and complementary medicine.

"Genomic medicine is one of the most promising areas," says Dr. Schimpff. "In the coming years, we will see an improved ability to diagnose a disease and even to predict diseases to come later in life. Physicians will be able to select a drug based upon an individual patient’s personal way of responding to that drug, both in terms of greater effectiveness and in terms of reduced side effects."

Other medical megatrends explored in the book include:

• Vaccines to prevent cancer, heart disease and arthritis
• Increased use of robots for minimally invasive surgeries
• Drugs to attack specific, targeted areas of the body
• Stem cells to regenerate tissue lost to trauma or disease

The book is also an ideal primer on how information technology will be used to change the practice of medicine, and help people lead healthier lives.

Dr. Schimpff is already at work on a new book, which will be called, "Hospital of the Future," and is also a consultant for the Army on new facilities and technology.

"The Future of Medicine: Megatrends in Health Care That Will Improve Your Quality of Life" is available at Amazon, Barnes & Noble and leading book stores. For more information, go to: http://www.medicalmegatrends.com/.

So in 1992, when she moved from her home in Baltimore to a retirement community, Dr. Wadsworth decided to support this critical need in a big way. She wanted to establish an endowment, The Dr. Gladys E. Wadsworth Physical Therapy Research Fund, through a gift from her estate.

She recalled how much she appreciated the funding that she was awarded for her own research as a junior faculty member, which was made possible by a similar endowment established at the School of Medicine.

"That was an important factor in my work," said Dr. Wadsworth. "So I decided that my gifts will provide research grants to promising faculty who create and develop programs in the field of physical therapy."

But at the time, she was concerned for the health of two of her closest relatives. Specifically she wanted to find a way to ensure that her family members were provided for as long as possible during their lifetimes. How could she make this very significant gift to support future physical therapy research while also providing for her family?

For Dr. Wadsworth the answer came in the form of two gift annuity arrangements with our foundation. With part of her estate, she arranged for these annuities to provide lifetime distribution payments to her, and then to her relatives for the rest of their lives. By doing so, she assured financial support for her family without materially affecting her charitable plans for the department. Plus, she was able to claim an income tax deduction for a substantial amount of her gifts.

In addition, Dr. Wadsworth named the department as the last beneficiary in her will. By leaving the balance of her estate to the department, she would make certain that her endowment would continue to grow long after she was gone.

Today the principal of this endowment is over $568,000. This fund will produce critical income each year to seed promising new research that could eventually draw NIH grants or provide bridge funding for research-related expenses not covered by existing grants.

"Our research program is greatly bolstered by gifts like Dr. Wadsworth's," comments Mark W. Rogers, PT, PhD, FAPTA, vice chair for research and director of the PhD program in rehabilitation science. "They make it possible for us to pursue pioneering new avenues of discovery and maximize already meritorious projects with high potential to advance societal health."

Through her gifts, Dr. Wadsworth was not only able to provide lifetime income for herself and her family, she was able to nurture a more vibrant and robust research effort. Moreover, she will be remembered in a lasting and meaningful way through the enduring endowment created in her name.

For more information on how you can leave a legacy through your estate plans contact Karen McGuire at 410-706-8688 or kmcguire@som.umaryland.edu

Patients on a ventilator are usually thought to be too ill to be considered for a transplant. Doctors at the medical center say this new portable artificial lung offers promise for patients such as Mr. Forsyth, improving their chances of having a successful surgery.

The portable device is a simplified version of an ECMO machine, which employs a pump to circulate blood through an artificial lung and back to the bloodstream. It infuses the blood with oxygen and removes carbon dioxide, similar to healthy lungs. Previously, a person who was on the system had to remain lying down with large tubes placed in the neck and groin. But, doctors have modified the ECMO system so that a simple IV line is placed in the upper chest, allowing the patient to sit up, walk and remain active.

"We have been able to help Mr. Forsyth with a different approach. He is the first person in the United States, we believe, who is using this new, modified system to keep him alive as he waits for a lung transplant. Since he went on the machine on March 16th, he has been alert and has gradually grown stronger, even able to walk on a treadmill," says Aldo T. Iacono, M.D., medical director of the lung transplant program at the University of Maryland Medical Center and associate professor of medicine at the University of Maryland School of Medicine.

"It's a great alternative. Mr. Forsyth is not sedated or bedridden anymore and he is in better shape for undergoing a transplant," Dr. Iacono says. This mobility increases the chance that the patient will be in better physical condition for a lung transplant and may reduce the risk of infection and pneumonia. This new treatment may provide new hope for a better quality of life for thousands of patients awaiting a lung transplant.

Mr. Forsyth, a former truck driver who held a number of other jobs where he was exposed to substances that likely contributed to his emphysema, says, "I think this is the greatest thing because at this point I wouldn't be able to walk if it weren't for this machine."

Bartley P. Griffith, M.D., chief of cardiothoracic surgery at the University of Maryland Medical Center and professor of surgery at the University of Maryland School of Medicine, has been at the forefront of developing a small, portable artificial lung to help patients with severe lung disease. "This new approach may help us to further refine the technology to the point that patients can go home with an even smaller device. Eventually, we hope that some patients might be able to use this device indefinitely, even if they're not a candidate for a lung transplant," Dr. Griffith says.

Almost 2,000 people in the United States are on waiting lists today for a lung transplant, according to the United Network for Organ Sharing. Emphysema is the most common type of chronic obstructive pulmonary disease (COPD). COPD affects about 32 million people in the U.S.  and is the fourth-leading cause of death.

Rajabrata Sarkar, M.D., Ph.D., an expert in treating blood vessel disorders and a nationally known researcher in blood vessel growth and development, has joined the University of Maryland School of Medicine as professor of surgery and Head of the Division of Vascular Surgery. He also becomes Chief of Vascular Surgery at the University of Maryland Medical Center.
 
Dr. Sarkar comes from the University of California, San Francisco, where he was an associate professor of surgery with tenure and a vascular surgeon since 1999. He received his medical degree and a Ph.D. in physiology from the University of Michigan Medical School. He completed his surgical training at UCLA and was trained in vascular surgery at the University of Michigan.

“Dr. Sarkar has extensive scientific background and expertise in angiogenesis—the development and re-growth of blood vessels. He is working on new strategies to restore circulation to damaged or blocked blood vessels, which is important for the growing number of people who suffer from vascular disorders,” says Stephen T. Bartlett, M.D., Professor and Chairman of the Department of Surgery at the University of Maryland School of Medicine and Chief of Surgery at the University of Maryland Medical Center. “Dr. Sarkar is also an excellent clinician, and he will be a great resource for our patients who have vascular disease,” he adds.

“Dr. Sarkar is a top-tier researcher. He brings to the University of Maryland School of Medicine a very strong research program funded by the National Institutes of Health.  His work is likely to lead to the development of more effective treatments for vascular disease, which is a growing concern for millions of people,” says E. Albert Reece, M. D., Ph.D., M.B.A., Vice President for Medical Affairs, University of Maryland, and Dean, University of Maryland School of Medicine.

“Dr. Sarkar will lead a research laboratory at our Center for Vascular and Inflammatory Diseases, which is studying basic questions in vascular biology. His work will add an important dimension to the center’s expertise,” adds Dr. Reece.

Vascular disease is a term that includes a wide range of disorders that affect blood vessels all over the body, except the heart. These disorders include narrowed or blocked blood vessels in the legs, neck arteries supplying the brain, or the kidneys. Aneurysms, in which the wall of a blood vessel bulges or expands, also fall under the realm of vascular disease. Varicose veins, pulmonary embolism, deep vein thrombosis and blood clotting disorders are also treated by vascular disease specialists.

“With Dr. Sarkar’s leadership of our Vascular Surgery Program, we will be able to provide even more advanced, innovative care for patients with the full range of vascular problems,” says Jeffrey A. Rivest, President and CEO of the University of Maryland Medical Center.

“Our vascular specialists are national leaders in the minimally invasive repair of a variety of vascular disorders, including abdominal aortic aneurysms. With Dr. Sarkar’s expertise, energy and dedication, our patients will have additional access to the most advanced treatments and care,” adds Rivest.

Some people with blocked arteries are fortunate in that their bodies are naturally able to grow new vessels to allow the flow of blood in spite of the blockage. In the laboratory, Dr. Sarkar has been trying to understand how to initiate that process and grow new arteries in order to compensate for blocked ones. He is also studying how certain risk factors, including smoking, diabetes, high cholesterol, high blood pressure—all prevalent among Americans today— prohibit that growth of new vessels.
 
Another focus of his research is blood clots in veins—specifically how they resolve on their own and why, in many people, they fail to resolve, which leads to poor circulation. “We have identified key genes and proteins that help the body resolve clots, and we are targeting drug therapy to these genes with the goal of finding new treatments for the millions of people with deep vein thrombosis,” says Dr. Sarkar. 
 
Dr. Sarkar has also studied soldiers with vascular problems and tissue damage due to blast injuries, and he is investigating the use of gene therapy to turn on the growth of arteries and capillaries damaged by traumatic injuries. Such research would not only benefit patients with traumatic injuries, but also help people with poor blood flow due to hardening of the arteries. This research has the potential to change the way vascular disease is treated in the future.

“My goal is to expand the University of Maryland Division of Vascular Surgery’s activities in three specific areas,” says Dr. Sarkar. “The first is to increase minimally invasive treatment options for patients with blockages in the lower leg. The second goal is the development of a comprehensive program for treatment of life-threatening aortic aneurysms and aortic dissections, using minimally invasive endovascular techniques. The third area of focus will be to broaden the research activities of the division to identify key genes and proteins involved in vascular disease, develop innovative drug therapies and initiate novel clinical trials to help patients with vascular disease,” adds Dr. Sarkar.

Dr. Sarkar’s vascular research has been recognized with major national awards. He received the Lifetime Mentored Clinician Scientist Development Award from the National Heart, Lung and Blood Institute and the American Vascular Association in 2000. He also was honored by the Foundation for Accelerated Vascular Research in 2005 with the Wylie Scholar Award.

"You matched in 110 different programs, in 72 different hospitals and 24 different states," said Gina Perez, MD, Assistant Dean for Student Affairs. "We wish we could keep you all here, but many of you are going elsewhere."

Amir Abdel-Wahab matched to his first choice, Pitt, where he will specialize in Pediatrics. "So now I have to become a Steelers fan," he joked. "You'll need this," said Dr. David Mallott, associate dean of Medical Education, presenting him with a Steelers cap.

David Trotter is also headed out of Maryland. "I matched to the University of Chicago," revealed David, who will specialize in Emergency Medicine. "It's going to be a great experience, and I'm sure we're going to have a lot of fun." His mom Nadine, who lives in Michigan, is thrilled he will be now be closer to home and carrying on the family tradition. "His father was a family practitioner," she told us. "He passed last year, but I know he would have been so elated about this."

Patrick Hemmings' sister was elated to learn he and wife Margaret would still be in town when their first child is born this summer. "I matched at Hopkins Bayview Hospital, in Internal Medicine, Primary Care, which was my first choice," Patrick said. "I didn't know how I would feel today. It's almost like the day you get married – you wake up that day, and you know something wild is going to happen to you. It feels so good now that it's over. We can actually start making some plans."

Jonathan Mezrich and his wife Lisa are also happy they won't have to change their baby plans now that he's learned he'll be spending a preliminary year at Union Memorial Hospital before returning to the University of Maryland Medical Center to specialize in Radiology. "We're having a baby next month, so I am so excited we don't have to move out of Baltimore," said Lisa. "I'm very, very proud of him." Jonathan will be following in the footsteps of his father, Reuben, professor and chair of the Department of Diagnostic Radiology.

After more than an hour of fist pumping, shouts of joy and sighs of relief, all but one envelope had been handed out. As a reward for her patience, Sherese Phillips, the final student to receive her envelope, was given the bag into which each student had tossed a small monetary donation – money that is traditionally used for an after-Match celebration.

(See a gallery of images from this year's gala.)

"Our medical school embraces and touches the entire world in profound and practical ways," says E. Albert Reece, MD, PhD, MBA, Vice President for Medical Affairs, University of Maryland; the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. "Our presence around the globe is physical and constant and yields both the care of human suffering and the knowledge for treating and preventing diseases," he continues. "Our faculty carry the benefits of their extraordinary research back to the state of Maryland, where we provide our fellow citizens with the most advanced patient care anywhere in the world."

In a special investiture ceremony, 20 previously endowed chairs and professors received medals to recognize both their accomplishments and those of their donors. The front of the medal features the image of Dr. John Beale Davidge, a founder and the first dean of the school and the namesake of historic Davidge Hall. The back of the medal lists the four tenets of the School of Medicine's mission: education, research, patient care and service, as well as the official name of the endowed professorship.

After the investiture ceremony, the 600 guests took to the dance floor to swing to the big band sounds of Mood Swings, featuring alumnus Jack Vaeth, MD, Class of 1992. The gala raised more than $242,000 for the School of Medicine. "It is the generous support of sponsors and donors that has enabled the School of Medicine to raise funds to support outstanding research, innovative education and superb clinical care," acknowledged Mary Cain, Director of Special Events and Board Relations.

Endowed Professors and Chairs Receiving Medals at the Ceremony

• Stephen T. Bartlett, MD, the Barbara Baur Dunlap Professor in Transplantation Surgery
• Cynthia F. Bearer, MD, PhD, the Mary Gray Cobey Professor in Neonatology
• Maureen M. Black, PhD, the John A. Scholl, MD and Mary Louise Scholl, MD Professor in Pediatrics
• Frank M. Calia, MD, MACP, the Theodore E. Woodward Chair in Medicine
• Richard L. Eckert, PhD, MS, John F.B. Weaver Professor
• Howard M. Eisenberg, MD, the R.K. Thompson, MD Chair in Neurosurgery
• Anthony A. Gaspari, MD, the Albert Shapiro, MD Professor in Dermatology
• Myron M. Levine, MD, DTPH, Simon and Bessie Grollman Distinguished Professor
• Mandeep R. Mehra, MBBS, FACC, FACP, the Dr. Herbert Berger Professor in Medicine
• Reuben S. Mezrich, MD, PhD, FACR, the Dr. John M. Dennis Chair in Radiology
• Adrian Park, MD, FRCS(C), FACS, the Campbell and Jeanette Plugge Professor in Surgery
• Vincent D. Pellegrini, Jr, MD, the James Lawrence Kernan Professor and Chair in the Department of Orthopaedics
• Jean-Pierre Raufman, MD, the Moses Paulson, MD and Helen Golden Paulson Chair in the Division of Gastroenterology
• E. Albert Reece, MD, PhD, MBA, the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine
• Peter Rock, MD, MBA, the Dr. Martin A. Helrich Chair for Anesthesiology
• Mary M. Rodgers, PT, PhD, the George R. Hepburn Dynasplint Professor in Physical Therapy and Rehabilitation Science
• Thomas M. Scalea, MD, FACS, the Francis X. Kelly Professor of Trauma Surgery
• Michael T. Shipley, PhD, the Donald E. Wilson, MD, MACP Distinguished Professor
• Alan R. Shuldiner, MD, the John L. Whitehurst Professor of Medicine
• Susan D. Wolfsthal, MD, the Celeste Lauve Woodward, MD Professor in Humanism and Ethical Medical Practice

Scientists have begun to solve some of the mysteries of the common cold by putting together the pieces of the genetic codes for all the known strains of the human rhinovirus. Researchers at the University of Maryland School of Medicine in Baltimore and colleagues at the University of Wisconsin-Madison have completed the genomic sequences of the viruses and assembled them into a “family tree,” which shows how the viruses are related, with their commonalities and differences. The study was released on the online version of the journal Science (Science Express) at 2 p.m. EST on February 12.

The researchers say this work provides a powerful tool that may lead to the development of the first effective treatments against the common cold. “There has been no success in developing effective drugs to cure the common cold, which we believe is due to incomplete information about the genetic composition of all these strains,” says the study’s senior author, Stephen B. Liggett, M.D., professor of medicine and physiology at the University of Maryland School of Medicine and director of its Cardiopulmonary Genomics Program.

“We generally think of colds as a nuisance, but they can be debilitating in the very young and in older individuals, and can trigger asthma attacks at any age. Also, recent studies indicate that early rhinovirus infection in children can program their immune system to develop asthma by adolescence,” says Dr. Liggett, who is a pulmonologist and molecular geneticist.

Major Discoveries of the Study

The researchers found that human rhinoviruses are organized into about 15 small groups that come from distant ancestors. The discovery of these multiple groups explains why a “one drug fits all” approach for anti-viral agents does not work. But, says Dr. Liggett, “Perhaps several anti-viral drugs could be developed, targeted to specific genetic regions of certain groups. The choice of which drug to prescribe would be based on the genetic characteristics of a patient’s rhinovirus infection.”

Dr. Liggett adds that while anti-viral drugs seem to be the most likely to succeed, “the data gathered from these full genome sequences gives us an opportunity to reconsider vaccines as a possibility, particularly as we gather multiple-patient samples and sequence the entire genomes, to see how frequently they mutate during a cold season. That work is underway now.”

The researchers also found that the human rhinovirus skips a step when it makes its protein product, a shortcut that probably speeds up its ability to make a person feel sick soon after infection. “This is a new insight,” says co-investigator Claire M. Fraser-Liggett, Ph.D., director of the Institute for Genome Sciences and professor of medicine and microbiology at the University of Maryland School of Medicine. “We would not have had any sort of intuition about this had it not been revealed through genome analysis. Information that comes from this discovery might present a completely different approach in terms of therapy.”

The analysis shows that some human rhinoviruses result from the exchange of genetic material between two separate strains of the virus that infect the same person. Such a swap, known as recombination, was previously not thought possible in human rhinovirus. During cold season, when many different strains of rhinovirus may be causing infections, recombination could rapidly produce new strains.

Multiple mutations (as many as 800) were evident in virus samples taken recently from patients with colds, compared to older rhinovirus reference strains. Some viruses mutate by making slight changes in certain proteins to avoid being destroyed by antibodies from a person’s immune system. “Mutations were found in every area of the genome,” says Dr. Liggett.

The study’s lead author, Ann C. Palmenberg, Ph.D., professor of biochemistry and chair of the Institute for Molecular Virology at the University of Wisconsin-Madison, notes, “As we begin to accumulate additional samples from a large number of patients, it is likely that hotspots for mutation or recombination will become apparent, and other regions resistant to mutational change may emerge. This will provide clues as to how flexible the virus is as it responds to the human environment, important hints if you are designing new therapeutics.”

Study Background

Human rhinovirus infection is responsible for half of all asthma attacks and is a factor in bronchitis, sinusitis, middle ear infections and pneumonia. The coughs, sneezes and sniffles of colds impose a major health care burden in the United States—including visits to health care providers, cost of over-the-counter drugs for symptom relief, often-inappropriate antibiotic prescriptions and missed work days—with direct and indirect costs of about $60 billion annually.

Prior to the start of this project, the genomes of only a few dozen rhinoviruses had been sequenced from what was considered the reference library, a frozen collection of 99 different rhinovirus strains taken from patients over a span of more than two decades. During this team’s work, several other groups began to report the full genomes of some of these viruses, as well as some odd rhinovirus-like strains from relatively sick patients.
 
“It was clear to us that the spectrum of rhinoviruses out there was probably much greater than we realized. Further, we needed to develop a framework from which we could begin to figure out ways to combat these viruses and use their genetic signatures to predict how a specific virus would affect a patient,” says Dr. Fraser-Liggett.

The current study adds 80 new full genome sequences to the rhinovirus library and 10 more acquired recently from people with colds. Each sequence was modeled and compared to each other. Dr. Liggett says, “Now we can put together many pieces of the human rhinovirus puzzle to help us answer some fundamental questions: how these rhinoviruses might mutate as they spread from one person to another; which rhinoviruses are more associated with asthma exacerbations and why rhinovirus exposure in infancy may cause asthma later in life. With all this information at hand, we see strong potential for the development of the long-sought cure for the common cold, using modern genomic and molecular techniques.”

“With recent improvements in technology, including next-generation DNA sequencing tools, it has become easier to generate whole genome sequence information,” says Dr. Fraser-Liggett. “There is no reason any longer to focus on a very limited part of the rhinovirus molecule to learn what it’s doing, what the predominant strain is in a population, or to try to infer what the evolution of the entire molecule might be. Instead, by studying the complete genome sequence, we can answer multiple questions in parallel.”

Researchers from the J. Craig Venter Institute also contributed to this study. The University of Maryland School of Medicine funded this project.

                                                                          ###

Palmenberg AC, Spiro D, Kuzmickas R, Wang S, Djikeng A, Rathe JA, Fraser-Liggett CM, Liggett SB. “Sequencing and Analyses of All Known Human Rhinovirus Genomes Reveals Structure and Evolution.” Science. Published online ahead of print, February 12, 2009.

Physician leaders of the University of Maryland School of Medicine and the University of Maryland Medical Center have approved new policies to guide doctors, researchers, residents and students in their interactions with the pharmaceutical and medical device industry. The new policies, which have gone into effect at both institutions, mirror the recommendations made last year by the Association of American Medical Colleges (AAMC). The medical school and hospital are among the first 25 academic medical centers in the United States to pass such guidelines.

“These policies will serve as an important resource for our faculty as they navigate the increasingly complicated intersection of medicine and industry,” says E. Albert Reece, MD, PhD, MBA, Vice President for Medical Affairs, University of Maryland, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine.

“The health care industry is part of the medical community. We have to be engaged with
it, and there are appropriate ways to do that. These new, more comprehensive guidelines further ensure that we only support evidence-based practice and decision-making that is not subject to any potential or perceived influence from the pharmaceutical or medical device industries,” says Dean Reece.

The new policies are comprehensive, addressing such areas as gifts to individuals, distribution of pharmaceutical samples, access to patient care sites by pharmaceutical representatives and physician participation in industry-sponsored events. The policies were unanimously approved by the School of Medicine Council, a group of about 100 representatives from various departments of the school. They were also adopted by the Medical Staff Organization of the University of Maryland Medical Center, whose members are also on the faculty of the University of Maryland School of Medicine.

“These new policies will help us to maintain the confidence of our patients, ensuring that we are always acting in our patients’ best interest. The policies reflect ethical principles that are important in providing the highest quality of patient care and research,” says Reuben Mezrich, MD, PhD, president of the Medical Staff Organization. He adds that the new policies have received strong support from the medical staff. Dr. Mezrich also is professor and chair of the Department of Diagnostic Radiology and Nuclear Medicine at the School of Medicine.

A growing number of medical schools and academic medical centers are implementing similar policies to guide physicians in their dealings with industry, relationships that are both complicated and necessary. The policies create a consistent message and apply to students and faculty both on and off campus and at affiliate sites.

The program will be broadcast on FRONTLINE on February 3, 2009. It can also be viewed online at http://www.pbs.org/wgbh/pages/frontline/parkinsons/#.

Dr. Shulman, who is also co-director of the Parkinson's Disease and Movement Disorders Center at the University of Maryland Medical Center, is currently overseeing a multi-year study to determine if regular exercise can help people with Parkinson's improve their balance and walking.

During the show, viewers will see study participants walking on specialized treadmills at the Baltimore VA’s Geriatric Research, Education and Clinical Center, a gym facility with equipment for people who may have some physical limitations. Study participant Thomas Manning of Laurel also shares his personal story and how he feels the exercise has benefited him.

Dr. Lisa Shulman, M.D. is the principle investigator for the University of Maryland study. During the Frontline program, she observes, "Maybe there's been a cultural perspective that has embraced pharmaceutical and surgical approaches and has considered lifestyle changes soft and not worthy of study. But it's not at all hard for me to imagine that the results of a properly designed exercise program are going to be more effective than many of the medications we have now.”  The study is funded by a $750,000 grant from the Michael J. Fox Foundation.

My Father, My Brother and Me is by radio and TV producer Dave Iverson, who was diagnosed with Parkinson’s disease in 2002. Iverson’s father was diagnosed in 1971 and his brother learned he had the disease 20 years later.

"For me, Parkinson’s is a personal story, but the disease is much more than a family saga," says Iverson on the FRONTLINE website. "It’s the second most common neurological disorder there is, and it raises intriguing questions for science and our aging society."

“Parkinson’s patients tell us that when the disease begins to affect their ability to walk, their entire life is affected," says Dr. Shulman. "They have trouble with daily activities such as dressing, housekeeping, shopping and getting around their community. That’s why we are so interested in studying if exercise can help these patients improve their gait and balance, because it is so fundamental to their daily lives.”

For more information on the University of Maryland/Baltimore VA Medical Center trial on Parkinson’s disease and exercise, go to these sites:

http://www.umm.edu/news/releases/exercise_parkinsons.htm

http://www.umm.edu/parkinsons/ct_parkinsons.htm 

Dean Reece and more than 50 students and faculty members traveled to Annapolis January 15, 2009, to speak with members of the Maryland General Assembly about issues important to the University of Maryland School of Medicine. In face-to-face meetings with lawmakers, students discussed funding levels, the impact of physician shortages, and the need for new research facilities.

"Everybody seemed eager to talk with us and get our opinions," said Litty Smelter, a fourth-year student. Smelter and her fellow students urged the lawmakers to maintain current funding levels for the education of health professionals. Adequate funding is essential to preserve quality medical care, particularly for underserved populations. Dean Reece reinforced that message in his meetings with legislative leaders.

Legislators were honest – often brutally so – about the bleak economic outlook for Maryland, including a $1 billion deficit in a state budget that by law must be balanced. Yet most lawmakers remained receptive to what the students had to say.

Students asked for help to address physician shortages, particularly in the rural areas of Western and Southern Maryland and the Eastern Shore. "I want to see incentives to encourage us to come back and practice in rural areas, and to support potential medical students in those areas," said Mamta Jhaveri, a second-year student from Southern Maryland. Shetold the representativesthat many of her high school friends never considered medical school, not only because of the cost but because they had never seen someone from their area pursue that path.

Students also urged representatives to consider funding for Health Sciences Facility III, a new state-of-the-art building dedicated to biomedical research. Although the initial cost would be high, lawmakers were optimistic that the project would pay for itself through job creation, and new research funding.

Students and faculty were invited to the House and Senate chambers, where the School of Medicine was formally recognized. Dean Reece was honored with a proclamation for his service as chair of the Association of American Medical Colleges Council of Deans.

At the end of the day, the students felt good about their glimpse into government. “It's been a lot of fun,” said Smelter. "It's really interesting to see how government works and to feel that you're an important part of the legislative process."

The goal of the event was "to help new faculty find their place in our community of scholars, identify the resources they will need to be successful, map out a strategy for career development and promotion, and to identify one or more ways we hope they will 'give back' to our community through teaching and service," explained Nancy Lowitt, MD, MEd, Associate Dean for Professional Development and an Assistant Professor in the Department of Medicine.

Faculty selected one of three workshops based on their career track, and learned about critical resources available to support them, depending on whether they were clinician educators, clinical researchers, or basic science researchers. Each workshop featured two or three speakers from throughout the School of Medicine.

The information proved to be enlightening. "I gained an appreciation of the emphasis and encouragement of the institution for faculty – and subsequently institutional – advancement," said Anne Reicherter, who recently joined the Department of Physical Therapy and Rehabilitation Science as an Associate Professor.

After the workshops, new faculty members had an opportunity to gather information about faculty support services and resources through special exhibition tables set up in the MSTF Atrium.

The graduation ceremony was attended by UMB President David J. Ramsay, Dean E. Albert Reece, MD, PhD, MBA,  Alessio Fasano, MD, director of the University of Maryland center for Celiac Research, and the center's director of operations Pam King.

Celiac disease is a genetic disorder affecting children and adults. People with Celiac Disease are unable to eat foods that contain gluten, which is found in wheat and other grains. It is believed that one in every 100/150 Italians has celiac disease.

“This collaboration is really a prestigious initiative,” said Adriano Pucci, president of the Italian Celiac Society. "Professor Fasano is a native of our land, and we are honored to have him involved in our project," said Pucci. Also participating in the degree program is the University of Salerno, the University Politecnica delle Marche, and the Scuola Medica Salernitana Foundation.

Researchers at the University of Maryland School of Medicine have identified a common gene variant that appears to influence people’s risk of developing high blood pressure, according to the results of a study published online Dec. 29, 2008 in the Proceedings of the National Academy of Sciences (PNAS).

The STK39 gene is the first hypertension susceptibility gene to be uncovered through a new technique called a genome-wide association study and confirmed by data from several independent studies. Located on chromosome 2, the gene produces a protein that helps to regulate how the kidneys process salt, which plays a key role in determining blood pressure.

"This discovery has great potential for enhancing our ability to tailor treatments to the individual – what we call personalized medicine – and to more effectively manage patients with hypertension. We hope that it will lead to new therapies to combat this serious public health problem worldwide," says the senior author, Yen-Pei Christy Chang, Ph.D., an assistant professor of medicine and of epidemiology and preventive medicine at the University of Maryland School of Medicine.

But, Dr. Chang says, more research is needed. "Hypertension is a very complex condition, with numerous other genetic, environmental and lifestyle factors involved. The STK39 gene is only one important piece of the puzzle," she says. "We want to determine how people with different variations of this gene respond to diuretics and other medications, or to lifestyle changes, such as reducing the amount of salt in their diet. This information might help us discover the most effective way to control an individual patient’s blood pressure."

One in four Americans has elevated blood pressure, or hypertension, which can lead to death or result in complications, such as cardiovascular disease, stroke and end-stage kidney disease. Doctors consider the ideal systolic and diastolic blood pressure to be less than 120/80. (The numbers reflect the pressure of the blood against the arteries when the heart beats and is at rest.) When blood pressure is elevated, doctors recommend lifestyle changes or prescribe medications, such as diuretics, which force the kidneys to remove water from the body, in order to treat the condition. However, patients respond differently to treatments and finding the best treatment among all the possible ones for specific patients is still a "try and see" process, according to Dr. Chang.
 
Scientists believe multiple genes are involved in the most common form of high blood pressure called essential hypertension. But because so many factors affect blood pressure, including diet, exercise and stress levels, it has been difficult to pinpoint a specific gene or group of genes, says the lead author, Ying Wang, Ph.D., a researcher at the University of Maryland School of Medicine.

The University of Maryland researchers identified the link between the STK39 gene and blood pressure by analyzing the DNA of 542 members of the Old Order Amish community in Lancaster County, Pa., scanning approximately 100,000 genetic markers across the entire genome for variants known as single nucleotide polymorphisms, or SNPs, associated with systolic and diastolic blood pressure. The researchers found strong association "signals" with common variants of the serine/threonine kinase gene, or STK39, and confirmed their findings in another group of Amish people and in four other groups of Caucasians in the United States and Europe.

People with one particular variant showed slight increases in blood pressure compared to those with a more common form of the gene and were more likely to develop hypertension, researchers found. The researchers estimate that about 20 percent of Caucasians in the general population have this variant of the STK39 gene.

"With this new ‘scanning’ approach – the genome-wide association study – we are able to uncover genes that have previously eluded us. The field of complex disease genetics has undergone a revolution in terms of discovering new genes and understanding the genetic basis of common adult-onset diseases," says co-author Alan R. Shuldiner, M.D., professor of Medicine; head of the Division of Endocrinology, Diabetes and Nutrition; and director of the Program in Genetics and Genomic Medicine at the University of Maryland School of Medicine.

The study being published online in PNAS is titled, "Whole-genome association study identifies STK39 as a novel hypertension susceptibility gene." It will appear in the print edition of PNAS early next month.
The Amish are ideal for such studies because they are a genetically homogeneous people whose forefathers came to Pennsylvania from Europe in the mid-1700s and share a similar diet and rural lifestyle. Because many in the Amish community don’t have regular medical check-ups, they often don’t know they have high blood pressure or take medications for it, according to Dr. Chang. The Amish appear to have as much hypertension as other Caucasians. As a result of the study, some of the participants learned that they had hypertension and were able to start treatment.

The research, which was funded by the National Institutes of Health, is a spin-off project of another University of Maryland study – the Amish Family Diabetes study – looking for genes that may cause type 2 diabetes. Researchers at the School of Medicine already have identified a number of genes that may play a role in the development of this type of diabetes.

Since 1993, University of Maryland researchers, led by Dr. Shuldiner, have conducted more than a dozen studies of the Amish in Lancaster County, Pa., searching for genes that cause a variety of medical problems, including osteoporosis and obesity, as well as diabetes and hypertension. More than 4,000 members of the Amish community have participated in the studies.

For more information about the University of Maryland’s research with Lancaster County’s Amish community, visit: http://medschool.umaryland.edu/endocrinology/amish.asp.

Thomas A. Blanpied, Ph.D., assistant professor of physiology of the University of Maryland School of Medicine, has won the Presidential Early Career Award for Scientists and Engineers, known as PECASE. Dr. Blanpied was honored in a ceremony at the White House on Friday, Dec. 19. The award recognizes Dr. Blanpied for his work using high-resolution imaging to study synapses, the connections between neurons in the brain. Changes in the brain’s synapses play a key role in diseases like Alzheimer’s, schizophrenia, depression and addiction.

"An enormous number of people are affected by diseases caused by impaired synapses," says Dr. Blanpied. "To understand these conditions, we need to observe exactly how synapses are malfunctioning. This will help us to identify what causes the diseases and how better to treat them."
 
The PECASE Award is the U.S. government’s highest honor for scientists and engineers who are beginning their careers. PECASE winners receive a citation, a plaque and federal funding for their research for up to five years. Each year, nine federal departments recommend scientists and engineers for the honor. The National Institutes of Health, part of the U.S. Department of Health and Human Services, recommended Dr. Blanpied.

"Dr. Blanpied is really drilling down and pushing the limits of our ability to understand synaptic transmission," says Meredith Bond, Ph.D., professor and chair of the Department of Physiology at the University of Maryland School of Medicine. "He is one of the rising stars at this institution, in both physiology and neuroscience. This award is an honor for Dr. Blanpied, for the Department of Physiology and for the School of Medicine."

Dr. Blanpied and his research team are tracking the plasticity of the synapses; that is, how they change over time. Those changes affect how the synapses transmit signals between neurons, a process known as synaptic transmission. His technique of using state-of-the-art fluorescent microscopy allows Dr. Blanpied’s team to examine changes in just one synapse at a time. Traditional methods of studying synapses through biochemistry, molecular biology and genetics only provide images of large groups of synapses. Even for traditional light microscopes, synapses are so small that they can barely be measured accurately.

Dr. Blanpied is the second University of Maryland School of Medicine faculty member to win the PECASE honor in recent years. Steven D. Munger, Ph.D., associate professor of anatomy and neurobiology, received the award in 2004. "The fact that this is our second PECASE winner in several years speaks to the strength of the research that goes on here," says Dr. Bond.

Curt I. Civin, MD, a pioneer in cancer research who is known for developing a way to isolate stem cells from other blood cells, has joined the University of Maryland School of Medicine. Dr. Civin will become a professor of pediatrics in the Division of Hematology/Oncology, as well as associate dean for research and the founding director of the new University of Maryland School of Medicine Center for Stem Cell Biology and Regenerative Medicine.

Dr. Civin comes to the University of Maryland School of Medicine from the Johns Hopkins University School of Medicine, where he has served as a faculty member since 1979. Dr. Civin currently leads projects totaling $21.5 million in extramural research funding. He will bring to the School of Medicine his entire research team, including 15 postdoctoral fellows, graduate students and research technicians.

Dean E. Albert Reece, MD, PhD, MBA, who appointed Dr. Civin to his positions, says, "With the recruitment of Dr. Civin and the founding of the new Center for Stem Cell Biology and Regenerative Medicine, the University of Maryland steps into a leadership position in the burgeoning field of stem cell research and regenerative medicine." Dr. Reece is also Vice President for Medical Affairs, University of Maryland, and John Z. and Akiko K. Bowers Distinguished Professor of the School of Medicine.

"Research into stem cells and regenerative medicine will be a key frontier in medicine in the next two decades," Dean Reece says. "Adding Dr. Civin to our top-tier faculty and establishing the Center that he will direct will give us a tremendously influential position in the field of stem cell science."

Dr. Civin became well-known and earned the 1999 National Inventor of the Year Award for his groundbreaking scientific discovery in 1984 of a method for isolating stem cells from other blood cells, a critical step in studying them and for transplanting these cells into patients. Discoveries from his laboratory are used today in both clinical bone marrow stem-cell transplantation and leukemia diagnosis. Dr. Civin’s studies now focus on the genes expressed in stem cells. By understanding the inner mechanics of how stem cells work, he hopes to learn how to modify the key properties of stem cells in order to increase their therapeutic potential. In addition, his research includes learning how normal stem cells become cancerous.
 
"Dr. Civin is a nationally renowned physician-scientist who has made significant contributions both in terms of groundbreaking scientific research and the development of new treatments for patients," says Dean Reece. "He is the perfect fit to lead our new Center for Stem Cell Biology and Regenerative Medicine, where the dual goals are to advance scientific research and, ultimately, to apply those discoveries to patient care."

Dr. Civin envisions creation of a stem cell research initiative that will foster a broad range of interdisciplinary studies designed to understand and to directly affect human health and disease. Developing novel diagnostic methods, treatments and/or prevention for major human diseases can be a key, immediate part of each significant project.

His goals for the Center for Stem Cell Biology and Regenerative Medicine and for the field of stem cell biology are twofold. The Center will explore how to manipulate stem cells to allow for much better transplantation and transfusion therapies. Its scientists also will work to understand how stem cells contribute to diseases in order to develop ways to improve conventional treatment and prevention of these disorders.

"Our dream for the new Center is to make a significant impact on curing disease," says Dr. Civin. "That’s really what biomedical research is all about — providing better diagnoses, treatments and preventions."

Partnerships with other researchers within the University of Maryland School of Medicine will be critical to achieving the goals of the scientists at the Center for Stem Cell Biology and Regenerative Medicine. Those scientists will include the School of Medicine researchers who already are studying stem cell biology. The School of Medicine’s stem cell research encompasses more than $2 million in extramural funding annually, including several grants from the Maryland Stem Cell Research Fund.

"As I complete 30 years of wonderful experience at Johns Hopkins, I’m confident I will maintain my friendships and working relationships with colleagues there," says Dr. Civin. "I want this new Center and its work to have a global impact. To that end, I look forward to collaborating with colleagues at Johns Hopkins and at other prestigious Maryland institutions such as the National Cancer Institute and the rest of the National Institutes of Health, as well as other scientists around the globe."

The founding of the University of Maryland Center for Stem Cell Biology and Regenerative Medicine comes at a potential turning point for the science of stem cell research. It is anticipated that President-Elect Barack Obama will repeal federal restrictions on stem cell research and open up NIH funding for the science. "We hope our new center will flourish under these anticipated less restrictive regulations for use of NIH funding in stem cell research," says Bruce E. Jarrell, MD, executive vice dean at the School of Medicine.

Dr. Civin agrees: "Repeal of the current funding restrictions not only will likely free up money for more stem cell projects. It also will allow researchers to spend more time concentrating on the science at hand, rather than concerning themselves with ensuring that projects funded by non-federal sources do not overlap with their currently restricted federal studies. It also will foster a global stem cell research community by removing boundaries between stem cell researchers in the U.S. and in countries where no such restrictions exist."

The quality of the University of Maryland School of Medicine’s faculty was a draw for Dr. Civin as he pondered joining the school. "I was so impressed by the recruitments the School of Medicine has made in recent years, from Dr. Robert Gallo, the co-discoverer of HIV, and his team at the Institute of Human Virology, to Dr. Claire Fraser-Liggett and her team at the University of Maryland Institute for Genome Sciences," Dr. Civin says. "I was encouraged by how happy these people were, and by the collaborative culture the school maintains for all its faculty members. I’m looking forward to working with my new colleagues."

The Department of Pediatrics faculty, which Dr. Civin joins as a professor, is eagerly anticipating his arrival, according to Steven Czinn, MD, chair of the Department of Pediatrics of the University of Maryland School of Medicine and director of the University of Maryland Hospital for Children at the University of Maryland Medical Center.

"Dr. Civin will be a tremendous asset to our department," says Dr. Czinn. "We’re certain he will energize our research program and help us find new treatments for children who desperately need them."

Dr. Civin also will become part of the University of Maryland Marlene and Stewart Greenebaum Cancer Center. The National Cancer Institute recently honored the Greenebaum Cancer Center with its distinguished designation —  one of only 64 such centers nationally— recognizing the Center’s high quality research and research-related patient care. "Dr. Civin has helped lead the field of stem cell biology, and his discoveries have had a critical impact on approaches to cancer with his contributions to the practice of bone marrow transplantation," says Kevin J. Cullen, MD, professor of medicine and director of the Greenebaum Cancer Center.

"More recently, his work is providing essential insights into the role of stem cells not just in leukemia and hematologic malignancies, but throughout the emerging field of regenerative medicine," Dr. Cullen says.

In his administrative position as associate dean for research, Dr. Civin will assist Dr. Jarrell, executive vice dean, in managing the Office of Research and Graduate Studies. Dr. Civin’s duties will include supporting the School of Medicine investigators and working to enhance the school’s research activities by promoting and managing a widely respected research enterprise.

"Dr. Civin will be a tremendous catalyst for creativity across the clinical and basic science departments, and core infrastructure," says Dr. Jarrell. "He is a proven leader and welcome collaborator who will enhance the University of Maryland’s already outstanding productivity."

Researchers at the University of Maryland School of Medicine in Baltimore have discovered a novel gene mutation among the Old Order Amish population that significantly reduces the level of triglycerides in the blood and appears to help prevent cardiovascular disease. The results of the study will be published in the Dec. 12, 2008 issue of the journal Science.

“We found that about 5 percent of the Amish have a gene mutation that speeds up the breakdown of triglycerides, which are fat particles in the blood associated with an increased risk of coronary artery disease,” says the lead investigator, Toni I. Pollin, Ph.D., an assistant professor of medicine at the University of Maryland School of Medicine. Carriers of the mutation have half the amount of apoC-III, a protein linked to triglycerides, than people without the gene variant.

Dr. Pollin says that those with this mutation of the APOC3 gene have higher levels of HDL-cholesterol, the so-called “good” cholesterol, and lower levels of LDL-cholesterol, the “bad” cholesterol. In addition, they have less arteriosclerosis (hardening of the arteries) – as measured by the amount of calcium in their coronary arteries. “Our findings suggest that having a lifelong deficiency of apoC-III helps to protect people from developing cardiovascular disease,” she says.
               
Triglycerides and cholesterol are lipids, or fats that circulate in the blood. ApoC-III is a protein that is bound to circulating lipids. It inhibits the breakdown of triglycerides so they stay in the blood longer. Elevated levels of apoC-III are associated with higher triglyceride levels.

“The discovery of this mutation may eventually help us to develop new therapies to lower triglycerides and prevent cardiovascular disease,” Dr. Pollin says. This is the first reported mutation within the human APOC3 gene that specifically blocks the production of apoC-III, causing individuals who carry a copy of the mutation to produce half the typical amount of the protein.

More than 800 members of the Old Order Amish community in Lancaster County, Pa., participated in the study, which was funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health. Researchers used a new approach called a genome-wide association study, or GWAS, to rapidly scan 500,000 markers in the DNA of the participants to find variations, or single nucleotide polymorphisms called SNPs, that are associated with triglyceride levels in the blood. This was followed by direct gene sequencing.
The GWAS technique is being used widely by scientists around the world to track down genes associated with many diseases.

As part of the study, participants drank a high-fat milkshake and then were closely monitored for the next six hours with blood tests as well as ultrasound tests of their brachial artery to determine how well their arteries were coping with the fatty meal. Some also were tested to determine if there were calcium deposits in their coronary arteries, which is a clear sign of cardiovascular disease. “What we found is that people who have the mutation are much less likely to have any calcification,” Dr. Pollin said.

Researchers believe the mutation was first introduced into the Amish community in Lancaster County by a person who was born in the mid-1700s.  This mutation appears to be rare or absent in the general population.
Alan R. Shuldiner, M.D., the study’s senior author, says, “The Old Order Amish are ideal for genetic research because they are a genetically homogenous people who trace their ancestry back 14 generations to a small group that came to Pennsylvania from Europe in the mid-1700s.”

Dr. Shuldiner is a professor of medicine; head of the Division of Endocrinology, Diabetes and Nutrition; and director of the Program in Genetics and Genomic Medicine at the University of Maryland School of Medicine.
The study is part of a larger University of Maryland research project, the Heredity and Phenotype Intervention (HAPI) Heart Study, which examined how genes and lifestyle factors influence the risk of developing cardiovascular disease.

Since 1993, Maryland researchers, led by Dr. Shuldiner, have conducted more than a dozen studies of the Amish, searching for genes that cause a variety of medical problems, such as type 2 diabetes, obesity, osteoporosis and high blood pressure. “We have uncovered a wealth of information in our studies of the Amish over the years, and much of what we have found is not only applicable to this unique population, but the general public as well,” Dr. Shuldiner says.

Other co-authors include: Coleen M. Damcott, Ph.D., an assistant professor of medicine; Haiqing Shen, Ph.D., an instructor of medicine; Richard B. Horenstein, M.D., J.D., an assistant professor of medicine; John C. McLenithan, Ph.D., an assistant professor of medicine; Braxton D. Mitchell, Jr., Ph.D., an assistant professor of medicine and of epidemiology and preventive
medicine; Michael Miller, M.D., an associate professor of medicine and of epidemiology and preventive medicine; and Jeffrey R. O’Connell, an assistant professor of medicine and of epidemiology and preventive medicine. Researchers from the University of Michigan School of Public Health and the Johns Hopkins University School of Medicine also contributed to the research.

For more information about the University of Maryland’s research with Lancaster County’s Old Order Amish community, visit: http://medschool.umaryland.edu/endocrinology/amish.asp.

Presenters during the symposium included faculty members Sergei Atamas, MD, PhD, Associate Professor of Medicine; Violeta Rus, MD, PhD, Associate Professor of Medicine; Charles Via, MD, Adjunct Professor of Medicine; Simeon Goldblum, MD, Professor of Medicine and Pathology and Jeffrey Hasday, MD, Professor of Medicine and Head of the Division of Pulmonary & Critical Care Medicine.

Myron Levine, MD, DTPH, Professor of Medicine, Epidemiology & Preventive Medicine, Microbiology & Immunology and Pediatrics, as well as Director of the Center for Vaccine Development, couldn't attend in person but sent his regards via video. "Your courage, tenacity and perseverence are truly inspiring," Dr. Levine told his colleague, who was clearly touched by the tribute.

Jan Thompson, President of the Arthritis Foundation's Maryland Chapter, was another colleague who came to praise the good doctor, who has a long history of volunteering with her organization. More so than the time he gives, though, "it's the humanity with which you do your work that really matters," she told Dr. Handwerger.

Anthony Rosen, MD, Professor of Medicine at Johns Hopkins University School of Medicine and Director of the Division of Rheumatology, who has collaborated with Dr. Handwerger on research for the Arthritis Foundation, agreed. "I am so much richer for having worked with him," he praised.

After "retiring" in 2006 as the nation's second-longest-serving medical school dean, Dr. Wilson is reprising his lifelong role as a medical educator as senior vice president for health sciences at Howard University. He is Dean Emeritus at the School of Medicine.

"An innovator in medical education both at the graduate and undergraduate levels," said Maryland School of Medicine Dean E. Albert Reece, M.D., PhD, MBA of his predecessor. Department of Medicine Chair Frank M. Calia, M.D., added "Donald Wilson, M.D. is the quintessential academician."

As the School of Medicine's dean for 15 years, Dr. Wilson was the first African American to hold that title at an accredited non-minority medical school and also was the medical school's first vice president for medical affairs. Prior to coming to Maryland, Dr. Wilson chaired the department of medicine at the State University of New York, Downstate Medical Center, College of Medicine in Brooklyn.

As an educator, it may be said that Dr. Wilson regards medical school as a full dress rehearsal for what students will encounter in the real-world of medicine. An early advocate of curriculum reform, he generated greater awareness of problem-based learning and advocated better integration of basic and clinical education. He also was an early adopter of new technology, requiring all first-year medical students to have laptops and making informatics part of the first-year curriculum.

Dr. Wilson's leadership was also key to Maryland's emergence as a leading national research institution. In the words of AAMC President Emeritus Jordan J. Cohen, M.D., "The school underwent a veritable transformation to become a true educational and research powerhouse." During Dr. Wilson's tenure, research grants quadrupled, pressing health issues such as AIDS and schizophrenia were tackled, and the school's research capacity was strengthened with the construction of two biomedical research buildings.

In the policy world, Dr. Wilson has served in numerous national and state positions, including chair of the National Advisory Council for Health Care Research and Quality. The National Institutes of Health also appointed Dr. Wilson several times to serve on agency committees, including a post on the Advisory Committee to the Director. His expertise in fiscal and political trends impacting medicine is widely sought, and when the state of Maryland Health Care Access and Cost Commission - which he chaired for nine years - merged with the Health Resources Planning Commission to become the Maryland Health Care Commission, legislation was passed specifically naming Dr. Wilson as chair.

His leadership has also touched the stage of academic medicine, as he peer-reviews post-M.D. training programs for the Accreditation Council for Graduate Medical Education on its Residency Review Committee for Internal Medicine. He also served on the Liaison Committee on Medical Education for 14 years. Within the AAMC, as a member of the Council of Deans and later as its chair, Dr. Wilson helped the council achieve its mission of improving the nation's medical schools. In 2003, Dr. Wilson was chair of the AAMC Executive Council, and today he serves on the Health Care Advisory Panel.

A native of Worcester, Massachusetts, Dr. Wilson earned his B.A. degree at Harvard Medical School and his M.D. degree at Tufts University School of Medicine, completing his internship and residency in Boston at St. Elizabeth's Hospital and the Veterans Administration Hospital, respectively. Dr. Wilson's lifelong commitment to diversity in medicine has been honored numerous times, including his receipt of the first AAMC Herbert W. Nickens Award for diversity in medicine in 2000.

Listening to your favorite music may be good for your cardiovascular system. Researchers at the University of Maryland School of Medicine in Baltimore have shown for the first time that the emotions aroused by joyful music have a healthy effect on blood vessel function.

Music, selected by study participants because it made them feel good and brought them a sense of joy, caused tissue in the inner lining of blood vessels to dilate (or expand) in order to increase blood flow. This healthy response matches what the same researchers found in a 2005 study of laughter. On the other hand, when study volunteers listened to music they perceived as stressful, their blood vessels narrowed, producing a potentially unhealthy response that reduces blood flow.

The results of the study, conducted at the University of Maryland Medical Center, were presented at the Scientific Sessions of the American Heart Association, on November 11, 2008, in New Orleans.

"We had previously demonstrated that positive emotions, such as laughter, were good for vascular health. So, a logical question was whether other emotions, such as those evoked by music, have a similar effect," says principal investigator Michael Miller, M.D., director of preventive cardiology at the University of Maryland Medical Center and associate professor of medicine at the University of Maryland School of Medicine. "We knew that individual people would react differently to different types of music, so in this study, we enabled participants to select music based upon their likes and dislikes."

Study Design

Ten healthy, non-smoking volunteers (70 percent male; average age 36 years) participated in all phases of the randomized study. There were four phases. In one, volunteers listened to music they selected that evoked joy. The volunteers brought recordings of their favorite music to the laboratory, or, if they did not own the music, the investigators acquired the recordings. Another phase included listening to a type of music that the volunteers said made them feel anxious. In a third session, audio tapes to promote relaxation were played, and in a fourth, participants were shown videotapes designed to induce laughter.

Each volunteer participated in each of the four phases, but the order in which each phase occurred was determined at random.

To minimize emotional desensitization, the volunteers were told to avoid listening to their favorite music for a minimum of two weeks. "The idea here was that when they listened to this music that they really enjoyed, they would get an extra boost of whatever emotion was being generated," says Dr. Miller.    

Prior to each phase of the study, the volunteers fasted overnight and were given a baseline test to measure what is known as flow-mediated dilation. This test can be used to determine how the endothelium (the lining of blood vessels) responds to a wide range of stimuli, from exercise to emotions to medications. The endothelium has a powerful effect on blood vessel tone and regulates blood flow, adjusts coagulation and blood thickening, and secretes chemicals and other substances in response to wounds, infections or irritation. It also plays an important role in the development of cardiovascular disease.

During the blood vessel dilation test, blood flow in the brachial artery, located in the upper arm, is restricted by a blood pressure cuff and released. An ultrasound device measures how well the blood vessel responds to the sudden increase in flow, with the result expressed as a percentage change in vessel diameter.

After the baseline test, each volunteer was exposed to the music or humorous video for 30 minutes. Additional dilation measurements were obtained throughout each phase to assess changes from baseline. Participants returned a minimum of one week later for the next phase. Sixteen measurements per person or a total of 160 dilation measurements were taken during the course of the study, which took six to eight months to complete.

Study Results

Compared to baseline, the average upper-arm blood vessel diameter increased 26 percent after the joyful music phase, while listening to music that caused anxiety narrowed blood vessels by six percent. "I was impressed with the highly significant differences both before and after listening to joyful music as well as between joyful and anxious music," says Dr. Miller.

During the laughter phase of the study, a 19 percent increase in dilation showed a significant trend. The relaxation phase increased dilation by 11 percent on average, a number that the investigators determined was not statistically significant.

Most of the participants in the study selected country music as their favorite to evoke joy, according to Dr. Miller, while they said "heavy metal" music made them feel anxious. "You can’t read into this too much, although you could argue that country music is light, spirited, a lot of love songs," says Dr. Miller, who enjoys rock, classical, jazz and country music. He says he could have selected 10 other individuals and the favorite could have been a different type of music.

Could other types of music produce similar positive effects on blood vessels? It’s possible, according to Dr. Miller. "The answer, in my opinion, is how an individual is ‘wired.’ We’re all wired differently; we all react differently. I enjoy country music, so I could appreciate why country music could cause that joyful response," he says.

Dr. Miller believes that a physiological reaction to the type of music is behind the formation of positive and negative blood vessel reaction. "We don’t understand why somebody may be drawn to certain classical music, for example. There are no words in that, and yet the rhythm, the melody and harmony, may all play a role in the emotional and cardiovascular response."

That physiological impact may also affect the activity of brain chemicals called endorphins. "The emotional component may be an endorphin-mediated effect," says Dr. Miller. "The active listening to music evokes such raw positive emotions likely in part due to the release of endorphins, part of that mind-heart connection that we yearn to learn so much more about.  Needless to say, these results were music to my ears, because they signal another preventive strategy that we may incorporate in our daily lives to promote heart health."

Dr. Miller’s funding sources include the American Heart Association, Veterans Administration and the National Institutes of Health.

"Positive Emotions and the Endothelium: Does Joyful Music Improve Vascular Health?" Miller M, Beach V, Mangano C, Vogel RA. Oral Presentation. American Heart Association Scientific Sessions, 11/11/2008.

"Dr. Regine has taken the Department of Radiation Oncology to new heights and achieved tremendous success in research, clinical care and training and mentoring," praised Dean E. Albert Reece, MD, PhD, MBA. "He brings a passion to his work that is matched by few and understands the importance of inspired and thoughtful leadership."

"The word that defines Dr. Regine is authentic," said Jeff Rivest, president and CEO of the University of Maryland Medical Center. "He is the epitome of an authentic leader and person. He's the real deal. What you see is what you get."

Dr. Regine, humbled by all the praise, declared himself the luckiest man on the planet that evening. He considered himself so because of his supportive family, friends and colleagues, most of whom were at the M&T Bank Pavilion in the Hippodrome Theater to celebrate this honor with him. Also on hand were many of the cancer survivors Dr. Regine has treated, whom he invited to take the stage with him. "I want to thank all of you for being our inspiration," he told them.

A big thank you also went out to the Foxmans from all of the evening's speakers. "Your generosity will have a generational impact on cancer patients," Mohan Suntha, MD, told Norty, Carol and the many other members of their family who attended. Dr. Suntha recently became the first Marlene and Stewart Greenebaum Endowed Professor of Radiation Oncology, and is also Vice Chair of the Department of Radiation Oncology. "I say this without a doubt because of the man you have decided to honor with your gift."

Dr. Suntha assisted Dean Reece with the presentation of Dr. Regine's endowed chairmanship medal and admitted Dr. Regine has been an inspiration as well as a colleague. "As a young chair, he could have focused on establishing his own presence, but from the day he arrived in Baltimore he has been a tireless champion of us, his faculty," praised Dr. Suntha. "We have collectively benefited from his fundamental belief that his success will ultimately be defined by us."

The AAMC Council of Deans strives for the continuing improvement of the nation’s medical schools. As an association of medical school deans, the council identifies issues affecting academic medicine and develops strategies to achieve the various missions of medical schools across the United States.

As chair of the Council of Deans, Dr. Reece will be an advocate for the AAMC and the nation’s medical schools, promote the advancement of institutional management, and support fellow deans in guiding individual schools toward excellence in medical education, research, and patient care.

During his tenure as chair, Dr. Reece plans to take an active role in the national health care debate. Dr. Reece says funding for research is even more important during tough economic times. “Biomedical research is a proven economic engine, and investment in this sector needs to be part of any economic stimulus package,” says Dr. Reece. Another priority will be to make the AAMC the nation’s authority on medical-school rankings.

The Association of American Medical Colleges is a not-for-profit association representing all 130 accredited U.S. and 17 accredited Canadian medical schools; nearly 400 major teaching hospitals and health systems, including 68 Department of Veterans Affairs medical centers; and nearly 90 academic and scientific societies. Through these institutions and organizations, the AAMC represents 125,000 faculty members, 70,000 medical students, and 104,000 resident physicians. Additional information about the AAMC and U.S. medical schools and teaching hospitals is available at www.aamc.org/newsroom.

During the morning session, Dean E. Albert Reece, MD, PhD, MBA, gave an overview of the School of Medicine, its rich history and its success in patient care and research. Sheri Slezak, MD, an associate professor in the Department of Surgery, shared her perspective as both a teacher and a parent of a med school student (daughter Katie is in the class of 2012). David Mallott, MD, Associate Dean of Medical Education, and Donna Parker, MD, Associate Dean for Student Affairs, let the families know that help is available to their students whenever they need it, be it academic, physical or psychological.

Judy Kopinski, president of the Class of 2009, presented her view of medical school from a student perspective. "I've worked harder than I ever thought I would or could," she admitted. "I have been through highs and lows, and through both I've had the opportunity to define myself and the type of doctor I am working to become."

After a luncheon for the families came the event first-year students have long been waiting for – the White Coat Ceremony. This tradition, which started at the School of Medicine in 1997, involves the presentation of traditional white coats, long the symbol of physicians and scientists, to students. The coats are put on the students by School of Medicine faculty, to welcome their new colleagues to the profession of medicine. After being "coated," students recited an oath acknowledging their acceptance of the obligations of the medical profession. They also added their signatures to the school's honor book, a leather-bound volume signed by all med students in their first year and their final year, in which they pledge to maintain integrity throughout their years in medicine.

For Lindsay Dancy, getting her white coat was the culmination of all the hard work she put in, first in getting into medical school and then in completing the nine-week Structure & Development (a.k.a. Anatomy) course that marks the students' first educational hurdle. She had special plans for where she would wear her new coat out in public for the first time. The students' next educational block is Introduction to Clinical Medicine, where they are given their first chance to work with real live people rather than cadavers, so "I'm going to put it on and go see patients," she said with a smile, already sounding like a doctor.

The doctors making the list are: 

• Stephen T. Bartlett, MD
• Brian Berman, MD
• R. Michael Benitez, MD
• Mary Beth Bollinger, DO
• John F. Caccamese, Jr., MD, DMD, FACS 
• Debra Counts, MD
• Peter Darwin, MD
• Raymond Flores, MD 
• Stephen George, MD 
• Neil J. Grossman, MD
• Nader Hanna, MD, FACS
• Harry W. Johnson, Jr., MD
• Benjamin Philosophe, MD, PhD 
• Neil B. Rosenshein, MD
• Thomas M. Scalea, MD
• Roger W. Voigt, MD

"For someone who's been here just a few years, I've been very impressed with the physicians, the staff, the quality of the care, and the incredible teaching and research that goes on here," said Steven Czinn, MD, who has been chair of the department since 2006. "I think this is an incredible opportunity to reconnect with all of the physicians we've trained over the last 60 years and make sure they appreciate the changes that have occurred and the fact that they're part of our extended family and we're here to help them take care of all the children of Maryland."

Governor Martin O'Malley, Mayor Sheila Dixon, the Maryland House of Representatives and the Maryland Senate all sent proclamations offering their congratulations, which were presented at a luncheon for past and present department faculty and residents. Lunch was followed by the Abraham H. Finkelstein, MD, lecture and the Ruth W. Baldwin, MD, lecture – both named for graduates of the School of Medicine – as well as other continuing education opportunities and tours of the department. A gala dinner for more than 200 capped off the celebration.

A book commemorating the 60th anniversary made its debut during the day's festivities. Entitled "Love, Concern and Excellence," it was put together by a committee of faculty members and staff in the department, at the suggestion of Dr. Czinn. "We had on our committee Drs. Misbah Khan, Prasanna Nair and Alice Heisler, all of whom have been in the department through much of this history, so we had detailed memories that were extremely valuable," explained Gail Olsen, RN, PhD, who oversaw the book project. Each section of the book concentrates on the milestones that took place from a pediatric perspective during the tenure of each of the department's six chairmen, from the first chair, Dr. Edmund Bradley, up to Dr. Czinn.

Even as his department celebrated the past, though, Dr. Czinn was looking toward the future. "Our first 60 years have been incredible and have given us a great platform to move in the direction we want to move in," he said. "We are ranked 23rd out of 100 departments of pediatrics nationally, and we're definitely looking to move into the top 20 – and hopefully even the top 10 – within the next five years."

This year’s award is for Dr. Simard’s work with Remedy Pharmaceuticals, which was established in 2004 to develop treatments based on his discoveries. Remedy is using Dr. Simard's research to create what it hopes will be a groundbreaking treatment for stroke, spinal cord and traumatic brain injury. "There's not much that can be done with injuries of that sort right now," Dr. Simard admits. "We think our discovery will open new therapeutic pathways and give victims of these debilitating and often fatal injuries options for a better quality of life."

Dean E. Albert Reece, MD, PhD, MBA, is confident that Dr. Simard's work can succeed.  "Dr. Simard is one of the university's most productive innovators and inventors, with 30 patents issued or pending," he said. "Thanks to the efforts of Dr. Simard, Remedy is finalizing a $22 million round of financing to fund a Phase II clinical trial, which is the next step in regulatory approval. Unfortunately, not much help is available now for patients with these types of injuries. Their hope lies with visionaries like Dr. Simard who work tirelessly at giving stroke victims the chance to be whole again."

Remedy Pharmaceuticals is now housed in the university's Bio Park 2, where Dr. Simard's award was announced at a breakfast in his honor. "We're very proud we've been able to build this bio park to allow people like Dr. Simard to develop their ideas and turn them into something of value in the marketplace," said David J. Ramsay, DM, DPhil, President of the University of Maryland, Baltimore.

Since 1996, the University has recognized three categories of excellence during its Founders Week: Teacher of the Year, Research Lecturer of the Year, and Public Servant of the Year. In 2006, the University added the Entrepreneur of the Year Award to honor a faculty member (or members) who show creativity and resolve in taking basic research from the lab to the marketplace. Two of the three Entrepreneur of the Year winners have been from the School of Medicine (Dr. Simard and 2006 honoree Alessio Fasano, MD, who helped establish Alba Therapeutics to move his celiac disease research from bench to bedside).

The center dedicated the new facilities with a ribbon-cutting on October 16. That same evening, more than two dozen grateful families were among the guests at a celebration at the Marriott Inner Harbor at Camden Yards.

“These families and children are at the heart of what we do at the Center for Advanced Fetal Care. Whether we are performing a routine ultrasound or a life-saving fetal transfusion, our team of physicians, sonographers, nurses and counselors is dedicated to doing all we can to help. We want to give these families the knowledge to make informed medical decisions about their child’s future,” says Christopher Harman, M.D. , director of the Center for Advanced Fetal Care at the University of Maryland Medical Center, and professor and vice chairman of obstetrics, gynecology and reproductive sciences at the University of Maryland School of Medicine.

The center offers an array of screening tools, including advanced imaging using 3D ultrasound, fetal MRI, fetal echocardiography and fetal biopsies. The center was the first in Maryland to offer fetoscopy, a procedure using a tiny fiberoptic camera to allow doctors to see the baby inside the uterus. This technology is used during fetal laser surgery for conditions such as twin-to-twin transfusion syndrome, a life-threatening imbalance of blood flow in some cases of identical twins.

The center also provides prenatal screening for all pregnant women, offering a unique, comprehensive risk assessment in the first trimester, using ultrasound, fetal blood flow monitoring and special blood tests to rule out potential pregnancy problems with a high degree of accuracy.

“Through our first trimester screening, we are able to get a very detailed look at the fetus and we can sort out many possible complications,” explains Ahmet Baschat, M.D., head of the section for fetal therapy at the University of Maryland Medical Center and an associate professor of obstetrics, gynecology and reproductive sciences at the University of Maryland School of Medicine.

He adds, “The majority of women do not get this important triage of risks in the first trimester of their pregnancies. In those cases where we do detect a possible problem with the baby, identifying those abnormalities early offers us the best opportunity for treatment.”

Staffed by world-renowned physicians and researchers, the Center for Advanced Fetal Care is also advancing the understanding of fetal growth and development through its research, such as investigating maternal blood serum markers to identify early signs of pre-eclampsia, a dangerous development of high blood pressure during pregnancy. Another research initiative involves testing a new non-invasive fetal monitor that may provide valuable information about changes in an unborn baby’s heartbeat and movement over an extended period of time.
 
The team also helps to manage maternal health conditions that may affect the pregnancy, such as diabetes or heart disease. The center’s staff has many years of expertise with multiple births for families expecting twins, triplets or more.

“The University of Maryland has been a leader in advancing the field of maternal/fetal medicine. The expansion of the Center for Advanced Fetal Care exemplifies our commitment to providing the best care possible for mothers, babies and families,” says Hugh Mighty, M.D., chairman and associate professor of obstetrics, gynecology and reproductive sciences at the University of Maryland School of Medicine. Dr. Mighty is also chief of obstetrics, gynecology and reproductive sciences at the University of Maryland Medical Center.

While the staff for the Center for Advanced Fetal Care has already moved into the new facilities, the expansion will continue over the next few months. A Feng Shui artist designed the new space with subdued lighting, calming colors and soft fabrics in order to provide a relaxing atmosphere for patients.

Among the grateful patients attending the October 16 evening celebration was Natalya Khazan, who was told she would have to abort one of her twins because the baby wasn’t growing properly. Khazan came to the University of Maryland Center for Advanced Fetal Care, where doctors worked to save both babies, who are now 18 months old. Khazan says, “Without the Center for Advanced Fetal Care, my children wouldn’t be here right now. Everyone there is truly wonderful.”

$9.9 Million, Five-Year Federal Grant to the University of Maryland School of Medicine Will Fund a Core Facility to Store and Analyze Genomic Information on the Microorganisms That Live in and on the Human Body

The human body is teeming with microbes — tiny microorganisms, trillions of them, living in every surface and cavity of the body. The genetic composition of these organisms is considered to be a critical new frontier in the field of genomics, and researchers at the University of Maryland School of Medicine’s Institute for Genome Sciences have been selected by the National Institutes of Health to play a central role.

The NIH has chosen Owen White, PhD, a professor of epidemiology and preventive medicine at the University of Maryland School of Medicine and a researcher at the University of Maryland Institute for Genome Sciences, to lead a $9.9 million project that forms the core of the Human Microbiome Project. That project is an initiative of the NIH’s National Human Genome Research Institute.

The Human Microbiome Project will engage scientists throughout the U.S. to sequence the genomes of 600 microbes that have been identified on the human body. It also funds work in refining the tools and technology used in this sequencing.

Dr. White, a bioinformatics expert, will spearhead the Human Microbiome Project Data Analysis and Coordination Center, a database system that will analyze, organize and disseminate the genomic information gathered at various sites as part of the Human Microbiome Project. All information in the Human Microbiome Project will be made available for free to U.S. investigators, just like the information gathered as part of the Human Genome Project. Scientists will access the information using the database Dr. White and his colleagues are developing at the University of Maryland Institute for Genome Sciences.

“Ease of access to the information gathered as part of the Human Microbiome Project is critical to accelerating the pace of scientific discovery,” says E. Albert Reece, MD, PhD, MBA, Vice President for Medical Affairs, University of Maryland, and John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. “We are honored that the NIH has entrusted such a crucial task to the University of Maryland Institute for Genome Sciences. For the institute to have received such a prestigious grant so early in its history recognizes the program’s strength and the skill of its researchers.”

Claire Fraser-Liggett, PhD, director of the University of Maryland Institute for Genome Sciences and a professor of medicine at the University of Maryland School of Medicine, says the institute already has a strong foothold in the field of metagenomics.

“The Data Analysis and Coordination Center will be a critical component of the Human Microbiome Project,” says Dr. Fraser-Liggett. “This award to Dr. White is a testament to his stature in the field of comparative genomics and bioinformatics, and will significantly add to the metagenomics research effort already underway within the University of Maryland Institute for Genome Sciences.”

“The Human Microbiome Project is the next generation of the human genome,” says Dr. White. “It is about studying the ecology of the organisms that are growing in association with the human body. Even healthy individuals have collections of bacteria in their mouths or on their skin that play a role in our health. There is already some research underway analyzing species of bacteria in healthy people versus unhealthy people. Studying the microbiome will enhance our overall understanding of human health.”

Dr. White and his colleagues will create a pipeline to funnel the information into their database from the Human Microbiome Project partner sites, as well as a data analysis system to organize the data accordingly. They will also establish a Web portal through which scientists can access the information, and a helpdesk that will make experts available to answer questions about the system. The project also will include community outreach such as training sessions and workshops to familiarize scientists with the bioinformatics system.

“The technology to sequence DNA has existed for a long time,” says Dr. White. “But we are still learning how to make use of the genetic information it generates.”

 “The volume of data is so large, a streamlined system is needed to perform processes such as finding all the genes and figuring out what they do,” Dr. White adds. “You can’t do that on your desktop; you need a huge computer infrastructure. That’s what we will create for the Human Microbiome Project.”

On Tuesday, Oct. 7, the NIH announced its first awards under the Human Microbiome Project. The $21.2 million in grants includes Dr. White’s $9.9 million grant and 10 others, averaging about $1 million each. The projects enter new territory in genomics known as metagenomics. Genomics typically focuses on the sequencing of the DNA of one microorganism at a time. But the advanced field of metagenomics allows scientists to analyze all the DNA in all the microbes in a sample. Many of the studies funded in this first round of the project are intended to improve the techniques and technology used to identify microbes and the location and significance of their genes, according to the NIH.

All the information uncovered will be stored in the database at the University of Maryland Institute for Genome Sciences, to be located in the institute’s new headquarters in the University of Maryland BioPark.

Dr. White has been with University of Maryland Institute for Genome Sciences since its founding in 2007. Like many of the 72 researchers who are now part of the institute, Dr. White was previously with The Institute for Genome Research, or TIGR, in Rockville. When that organization folded last year, its director, Dr. Fraser-Liggett, PhD, assumed a new role as director of the University of Maryland Institute for Genome Sciences, bringing many of her colleagues with her. 

 “This new core facility really helps confirm the University of Maryland Institute for Genome Sciences is a success,” says Dr. White. “The Human Microbiome Project is an exciting part of the genomics field that is really beginning to address very interesting health questions. Genomics is becoming more applied and having an impact on human disease. Being a part of this is genuinely very exciting for us.”

Cardiac surgeon Johannes Bonatti, M.D., who arrived at the University of Maryland Medical Center in July, has taken minimally invasive, heart bypass surgery to a new level. He performs what surgeons call "totally endoscopic coronary artery bypass" procedures. Using a surgical robot, Dr. Bonatti only needs to make four or five small holes the width of a dime to bypass blocked heart arteries. The operation accomplishes what conventional bypass surgery does, but without a large incision to open the chest.

Dr. Bonatti’s approach builds on robotic heart bypass procedures already being performed at the medical center. Those procedures, according to a University of Maryland study, provide faster patient recovery and fewer complications compared to conventional open-heart surgery. The study also found that using the robot is cost-effective. The results will appear in print in the October 2008 Annals of Surgery and are now available online.

Dr. Bonatti, director of coronary surgery and advanced coronary interventions at the University of Maryland Heart Center and professor of surgery at the University of Maryland School of Medicine, is among only a few surgeons around the world with experience in the totally endoscopic technique. He says his goal is to bring this patient-friendly heart bypass surgery into the mainstream, just as laparoscopic procedures are now the norm for gall bladder removal and other abdominal surgeries.

"This new endoscopic approach to bypass surgery reduces the trauma and recovery time for the patient, with many quality of life benefits," says Dr. Bonatti. "Patients can get back to their regular activities within two to three weeks. They have no scar. Best of all, the bypassed vessels stay open and healthy for a long time when we use the robotic surgery approach—that is our main goal."

First Baltimore Patient

Dr. Bonatti had performed more than 300 robot-assisted heart surgeries, including more than 250 bypass surgeries, before he moved to Baltimore from Innsbruck, Austria. His first patient at the University of Maryland Medical Center was 70-year-old Charles Pugh, an adjunct faculty member in the English department at Towson University, who needed surgery for two blocked coronary arteries. He also had other narrowed heart vessels that could be opened with angioplasty and kept open with stents.

Prof. Pugh approached the prospect of bypass surgery as something of a research project, reading everything he could find and visiting several hospitals to meet their top surgeons. He learned that most hospitals still use open heart surgery to do a bypass, with a large incision at the sternum to gain access to the heart and a 4-6 week post-surgery recovery.

Then he met Dr. Bonatti, who explained that in totally endoscopic coronary artery bypass procedures the surgeon uses a robot to hold slender tools and a video camera, which are inserted through tiny holes. With the robotic system, Dr. Bonatti can see the heart with 3-D detail and manipulate the tools to bypass blocked heart arteries with healthy arteries taken from the chest.

On July 24, 2008, Prof. Pugh underwent successful robot-assisted bypass surgery at the University of Maryland Medical Center. He went home after six days in the hospital. “I feel much better than before, when I walk up the four flights of stairs on campus,” he says.

Study Results

Before Dr. Bonatti moved to Baltimore, surgeons at the University of Maryland Medical Center had performed more than 100 robot-assisted bypass surgeries that required a two-inch incision between the ribs on the left side of the chest—still a minimally invasive approach compared to conventional bypass. (Dr. Bonatti eliminates the ribcage incision.) University of Maryland researchers compared those cases with a matched group of 100 patients who had the traditional "open" bypass surgery with a sternotomy, a surgical incision through the sternum.

In addition to a shorter hospital stay, faster patient recovery, fewer complications and a better chance that the new bypass vessels will stay open, the researchers found that robotic heart bypass surgery makes good economic sense for hospitals.

Study co-author Bartley P. Griffith, M.D., head of cardiac surgery at the University of Maryland Medical Center and professor of surgery at the University of Maryland School of Medicine, says the surgical robot increases the cost of each bypass case by about $8,000. "Those additional expenses, which are due to equipment and supplies, are offset by a shorter hospital stay, reduced need for transfusions and fewer post-surgical complications that would require a patient to be re-admitted to the hospital. The cost savings are especially significant with high risk patients who have lung or kidney disease or other health problems," says Dr. Griffith.

The average hospital stay for the patients with the minimally invasive surgery was about four days, compared to seven days for the traditional bypass operation; however the difference was even greater among patients considered to be at high risk. In that group, the average stay was five days with robotic surgery compared to 12 days with the traditional technique. The complication rate for those who had the robotic bypass was also much lower, with 88 percent of patients free of complications after having the minimally invasive surgery compared to 66 percent of those with the "open" operation.

The patients in the study were followed for up one year after their surgery. Using a CT angiography scan, the researchers found that those who had the robotic bypass were much less likely to have narrowing or clots in the bypass graft than those with the traditional bypass surgery. The grafted vessels of more than 99 percent of the patients who had robotically-assisted bypass surgery were still open and functioning well compared to about 80 percent of those who had the "open" operation.

The reason for the difference is that for patients who need multiple bypasses, surgeons can easily access two internal mammary arteries to use as the new bypass vessels rather than taking a section of vein from another part of the body.  In traditional bypass operations, only one internal mammary artery is used while other bypasses are performed using a vein. The long-term success of the bypass, or patency of the target vessel, is superior with an internal mammary artery versus a vein.  

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Poston RS, Tran R, Collins M, Reynolds M, Connerney I, Reicher B, Zimrin D, Griffith BP, Bartlett ST. "Comparison of  Economic and Patient Outcomes With Minimally Invasive Versus Traditional Off-Pump Coronary Artery Bypass Grafting Techniques." Annals of Surgery 2008;248.4. Published online ahead of print, August 25, 2008.

Topics this year included autism, genetics, celiac disease, violence intervention & anger management, brain disorders and colds & flu. On the final evening, participants were treated to a nutrition and fitness presentation from best-selling author Pamela Peeke, MD, MPH, a clinical assistant professor in the Department of Family & Community Medicine. Dr. Peeke, who is also chief medical consultant on Nutrition and Fitness for the Discovery Health Channel, showed clips from her Discovery special Fit to Live, which is based on her book of the same name. She had the audience in stitches with her stories about the differences between how men and women approach exercise.

This year's Mini Med School was the most successful ever, with nearly 300 students attending each week. Offered as a public service by the University of Maryland School of Medicine, Mini-Med School is a series of tuition-free classes designed to help Baltimore residents improve their health and well being. Mini-Med School lectures are presented by faculty physicians and are open to everyone. The sessions are designed to be casual, fun and informative presentations on health care issues that are important to the community. The majority of attendees came from West Baltimore neighborhoods near the School of Medicine, but some came from as far away as Harford and Cecil counties. They ranged in age from 8 to 80.

Plans are already underway for next year's Mini Med School, which will start in September 2009. Visit the Mini Med website next spring for more information.

Dr. Mehra is also the current president of ISHLT. The society brings together a wide range of transplant specialists including cardiologists, cardiopulmonary surgeons, basic scientists, ethicists and nurses. ISHLT promotes educational programs, scientific exchange and develops guideline statements in addition to its sponsorship of the journal.

The School of Medicine currently ranks 19th out of all 129 medical schools in the country in direct grants and contract expenditures. The School of Medicine jumped up to 7th place when compared to all 76 public U.S. medical schools. The school's total revenue, which includes grants, tuition, state funding, faculty practice revenue and philanthropic gifts, was $734.5 million. Its economic impact on the state of Maryland was an impressive $1.5 billion, or a $24 return for every $1 of state investment.

Despite stiff competition for federal funding, grants and contracts to the School of Medicine increased an astounding 9.7 percent in fiscal year 2007 to 2008.  Much of the credit for this achievement goes to a 19 percent increase in the number of grant requests submitted. The dean remarked that the quality of these requests has also improved, thanks to new training initiatives for faculty and fellows.

Despite uncertainty in the U.S. economy, philanthropic gifts to the School of Medicine also increased dramatically. Private gifts to the school increased 6.7 percent, to $49.1 million, and endowments have increased 5.7 percent to $173.8 million. "This is something important," said Dean Reece. "I'm very excited for our faculty, who have been able to secure these funds during this difficult time."

Another high point was a 10.7 percent increase in revenue for the Clincal Practice Plan, which collected more than $194 million. Dean Reece said University Physicians, Inc., is operating more efficiently than ever, with a net collection rate of 99 percent.

The State of the School Address was also an opportunity to look back on an historic year of discovery, success and national recognition for the accomplishments of faculty, staff and students.  For example, the Marlene and Stewart Greenebaum Cancer Center earned the prestigious NCI Cancer Center designation, one of only 64 centers in the U.S. to do so.  Faculty members at the University of Maryland Center for Vaccine Development received important research awards.  Christopher Plowe, MD, PhD, professor and chief of the maleria section, was named a 2007 Howard Hughes Medical Institute Investigator. Kirsten Lyke, MD, assistant professor of medicine, and Miriam Laufer, PhD, assistant professor of pediatrics, each received the Doris Duke Clinical Scientist Development award. Jonas Nelson, Class of 2010, became the School of Medicine's first recipient of the Doris Duke Student Award -  one of only 60 students in the country selected for this honor. 

Among the Other Highlights:

• Thanks to the hard work of faculty and staff, the School of Medicine won a successful eight-year reaccreditation Liaison Committee on Medical Education (LCME).

• The University of Maryland School of Medicine now has a presence in 23 countries around the globe, thanks in large part to its Center for Vaccine Development and Institute of Human Virology.

• The School of Medicine established a new organized research center for Trauma and Anesthesiology Research.

• The Graduate Program in Life Sciences (GPILS) boasted 42 new NIH grant proposals from its trainees: 26 from students and 16 from postdoctoral fellows.

• National media coverage of the School of Medicine increased 85 percent. The total number of story placements increased 55 percent, while print and wire service placements increased 150 percent.

• The total workforce at the School of Medicine continues to grow, increasing 3 percent over the past year. That workforce is a loyal one, with the retention rate for our faculty holding steady at more than 90 percent.

"The Society recognizes individuals who have demonstrated a special, long-term commitment to the School of Medicine," said E. Albert Reece, MD, PhD, MBA, Vice President for Medical Affairs, University of Maryland and John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. "It promotes the philanthropy that has helped the School of Medicine advance in medical discovery and educate thousands of physicians, allied health professionals and scientists."

The Society is named in honor of Frank C. Bressler, MD, who graduated from the School of Medicine in 1885. The Baltimore surgeon left a $1.2 million bequest to the school upon his death in 1935. This tremendous gift, which came during the dark days of the Great Depression, enabled the school to expand during a critical time. Today the Bressler Research Building houses numerous faculty laboratories, as well as the offices of the dean.

Dr. Mordecai P. Blaustein, MD, professor of physiology and medicine at the University of Maryland School of Medicine, has been honored as a recipient of the prestigious Novartis Award for Hypertension Research.

Dr. Blaustein received the award, one of the highest honors in the hypertension research field, at the annual conference of the American Heart Association's Council for High Blood Pressure Research in Atlanta, Ga., on Friday, September 19.

The award recognizes Dr. Blaustein’s groundbreaking discoveries exploring the biological mechanisms by which salt raises blood pressure. "It’s been well-documented that if you retain too much salt, your blood pressure goes up," Dr. Blaustein says. "Most people are interested only in why we retain too much salt, but my research helps to explain how. This could lead to new treatments for high blood pressure, and even new methods of predicting which patients will be prone to high blood pressure."

"Dr. Blaustein is being honored for basic science studies demonstrating how excess salt intake causes high blood pressure," said L. Gabriel Navar, Ph.D., chair of the American Heart Association's Council for High Blood Pressure Research and professor and chair of the Department of Physiology at Tulane University School of Medicine. "His studies demonstrated for the first time the release of an endogenous digitalis-like compound. This compound, called ouabain (WA-bane), inhibits the sodium-transporting membranes and leads to increases in calcium inside the cells, which causes contractions of the blood vessels, leading to increased blood pressure."
 
During more than 40 years of work, Dr. Blaustein and his colleagues have made important basic science discoveries to explain the link between salt and hypertension. These include a hormone that originates in the body that is very similar to a plant compound called ouabain. Dr. Blaustein and his colleagues call it endogenous ouabain because it is identical to the plant compound but is endogenous to the human body. A second factor is the sodium pump, a protein that controls the amount of sodium in cells and that is regulated by ouabain. The third factor is the sodium-calcium exchanger, which Dr. Blaustein discovered.  Dr. Blaustein has determined how these three factors interact and cause the contraction of blood vessels that lead to salt-dependent hypertension.

Dr. Blaustein’s laboratory at the University of Maryland School of Medicine is examining how to manipulate these factors to prevent blood pressure elevation. With collaborators in the U.S., Italy and Japan, Dr. Blaustein also is working to predict which patients will be prone to high blood pressure, with hopes of treating them proactively.

Since he began his work four decades ago, Dr. Blaustein has steadily built the case for his hypothesis, even in the face of skepticism from some colleagues. He has answered criticism with solid scientific evidence and has watched other laboratories worldwide corroborate his findings over the past four decades.

"Dr. Blaustein’s research has helped set the stage for our current understanding of the role of sodium in blood pressure regulation," says Meredith Bond, PhD, professor and chair of the Department of Physiology at the University of Maryland School of Medicine. "Despite the resistance that he has faced from some in the field of blood pressure regulation, his extraordinary scientific contributions over the past 40 years demonstrate the scientific heights that can be scaled as a result of a combination of dedication, passion, persistence, intellect and drive."

The Novartis Award for Hypertension Research has been presented to outstanding scientists in the field each year since 1966, when the American Heart Association first began to recognize the relevance of hypertension to heart health.

An uncommonly used surgical procedure that bypasses a narrowed aortic valve, rather than replacing it, effectively restores blood flow from the heart to the rest of the body and gives high-risk patients a safe alternative to conventional valve surgery. That is the finding of a study conducted at the University of Maryland Medical Center in Baltimore. The researchers conclude that the procedure, called aortic valve bypass, is an important treatment option for high-risk elderly patients with a narrowed aortic valve, a condition called aortic stenosis.

The bypass procedure can be performed in a minimally invasive way without stopping the heart. Many of the patients in the study had previously been considered too frail to benefit from surgery. The study will appear in the September 30, 2008 print issue of Circulation and is now online.

“Because of the possible risks associated with aortic valve replacement in the elderly, almost 60 percent of patients with symptoms related to aortic stenosis are never referred to surgery,” says the study’s principal investigator, James S. Gammie, M.D., associate professor of surgery at the University of Maryland School of Medicine and cardiac surgeon at the University of Maryland Medical Center.

Survival for these patients without surgery is poor; only 20 percent are alive three years after diagnosis. “But our research and five years of experience with the bypass procedure suggests there is a group of patients, typically considered inoperable because they are at the upper level of the risk spectrum, who could benefit from aortic valve bypass,” says Dr. Gammie. 

The aortic valve controls the flow of blood from the heart’s main pumping chamber, the left ventricle, to the aorta, the artery that supplies blood to the rest of the body. In aortic stenosis, calcium deposits narrow the valve and impair the heart’s ability to pump blood. Aortic stenosis is the most common heart valve disease of the elderly in the United States. More than 50,000 people in the United States require surgery for aortic stenosis each year.

During conventional valve replacement, the surgeon opens the chest, stops the heart for about 90 minutes, opens the aorta just above the aortic valve, cuts out the old valve and sews in a new one. While valve replacement has benefited millions of patients with good outcomes, in elderly patients, particularly those with other health conditions, the death rate can exceed 10 percent.
 
The Bypass Procedure

In order to bypass the narrowed aortic valve, surgeons at the University of Maryland Medical Center have refined a procedure, originally called an apicoaortic conduit, which was developed in the 1970s and initially used for children. During the procedure, most of the blood flow from the heart is diverted through a tube containing a standard replacement valve that is placed near the apex of the left ventricle, the pointed tip at the bottom of the heart, to the aorta, the main blood vessel at the back of the chest.

The surgeons work through an incision between two ribs on the left side of the chest. During the first cases, a large incision was needed. However, the procedure was modified this year, so that only a small, three-inch opening between the ribs is required. “We are excited because for the first time we can surgically treat a narrowed aortic valve through a minimally-invasive approach with the heart beating, compared to the traditional breastbone-splitting approach,” says Dr. Gammie.

Study Details

Between 2003 and 2007, the surgeons treated 31 high-risk aortic stenosis patients with aortic valve bypass surgery. Many of the patients also had other conditions ranging from chronic obstructive pulmonary disease to kidney disease, or had a history of heart attack or diabetes. The average age was 81, and nearly half had been refused conventional surgery. Early in the series, four of the 31 patients did not survive the procedure, yet there were no deaths among the most recent 16 consecutive patients.

The procedure was as effective as conventional aortic valve replacement surgery at relieving the obstruction of blood leaving the heart. Stroke and kidney problems were uncommon. Because the impaired aortic valve was left in place, some blood flow continued through that valve. But postsurgical blood flow measurements indicated that in most patients, approximately 70 percent of cardiac output flowed through the new bypass.

The study results suggest that continued improvements in technology and surgical technique may warrant extending aortic valve bypass surgery to moderate-risk patients with aortic stenosis. In addition to the 31 patients who received an aortic valve bypass, the University of Maryland Medical Center performed 438 other aortic valve procedures during the same time period.

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Gammie JS, Krowsoski LS, Brown JM, Odonkor PN, Young CA, Santos MJ, Gottdiener JS, Griffith BP. Aortic Valve Bypass Surgery: Mid-term Clinical Outcomes in a High-Risk Aortic Stenosis Population. Circulation. Published online ahead of print, September 15, 2008.

"This event summarizes in a very tactile/tangible way the vitality of our graduate programs. The pool of nominees for each award was intensely competitive," said Tom McHugh, Program Manager for GPILS. "Our Awards Committee did an outstanding job weighing the merits of each nominee, and Dr. Achsah Keegan provided outstanding leadership as chair of this committee."

The following were awarded during the ceremony:

• Dean E. Albert Reece, MD, PhD, MBA, presented the Postdoctoral Scholar award, which went to Joseph Mauban, PhD, from the Department of Physiology.
• Executive Vice Dean Bruce Jarrell, MD, presented Thomas Abrams, PhD, Associate Professor in the Department of Pharmacology & Experimental Therapeutics, with an award for Outstanding Achievement in Graduate Education.
• Angela Brodie, PhD, Professor in the Department of Pharmacology & Experimental Therapeutics, used money from her 2006 Kettering Award to establish an award for graduate students in Pharmacology, which this year went to Tamara Blutstein.
• Kathleen Reinecke from the Graduate Program in Biochemistry & Molecular Biology received the Recognition of Service award.
• Shayna Rich from Epidemiology was the PhD Scholar this year, while Xiao-Ling Li, MD, PhD was recognized for the best PhD Thesis Project.
• John Teijaro from the Program in Microbiology and Immunology was given the Elaine Miye Otani Memorial Award. The Otani Award was established in remembrance of Elaine Miye Otani, a graduate student whose life was tragically cut short when she was only 26. It is given annually to a graduate student in GPILS of outstanding character who demonstrates superior academic performance and who shows outstanding promise as an independent investigator.
• The Teacher of the Year award went to Martin Flajnik, PhD, Professor of Microbiology and Immunology.

Lisa M. Shulman, MD, has been named the first recipient of the Eugenia Brin Professorship in Parkinson’s Disease and Movement Disorders at the University of Maryland School of Medicine. The professorship is the result of a generous $1.5 million gift from Eugenia Brin, Michael Brin, PhD, and their son, Google co-founder Sergey Brin. Dr. Shulman, a professor of neurology at the School of Medicine and a researcher in the University of Maryland Parkinson’s Disease and Movement Disorders Center, will be invested in her new position in a ceremony Tuesday, September 16, at the School of Medicine campus in Baltimore.

The Brins know first-hand the challenges Parkinson’s patients face. Mrs. Brin is a Parkinson’s patient herself, and for years she has been treated at the University of Maryland Parkinson’s Disease and Movement Disorders Center."Parkinson’s has touched me and my family very personally," says Mrs. Brin.

"By supporting research into new treatments and diagnostic tools, we hope to help other patients like me, and possibly even find a cure," Mrs. Brin continues. "I have seen the research and the clinical work that goes on in the Movement Disorders Center. I decided to endow this professorship to help the faculty there continue their extraordinary work."

The new endowed professorship will support Dr. Shulman’s studies at the University of Maryland Parkinson’s Disease and Movement Disorders Center. Dr. Shulman, also a neurologist at the University of Maryland Medical Center, uses data collection and analysis to examine how to maximize the quality of life Parkinson’s patients experience. As an endowment, the Brins’ gift will support such research at the School of Medicine in perpetuity. The original amount of the gift will be invested, and the return on that investment will go to support Parkinson’s research conducted by Dr. Shulman and, subsequently, other faculty members in this area of research.

"The Brins’ gift will support the groundbreaking discoveries at the University of Maryland Parkinson’s Disease and Movement Disorders Center long into the future, creating hope for patients like Mrs. Brin and their families. Academic medicine relies on the generosity of donors such as the Brins in order to make the scientific advances that can change and save lives," says E. Albert Reece, MD, PhD, MBA, Vice President for Medical Affairs, University of Maryland, and John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine.
 
Dr. Shulman will use the funds to support the infrastructure and personnel required to maintain and grow the comprehensive database the Center has compiled, including information collected over the past five years on more than 1,000 Parkinson’s patients. "We hope to begin the collection of genetic samples from our patients," Dr. Shulman said. "The combination of large comprehensive datasets and exciting new methods of genetic analysis is one of the most powerful new avenues of medical discovery. We’re trying to learn how health care can promote adaptation to a chronic condition, and help our patients feel confident and in control."

The gift was a natural step for the Brins. Mrs. Brin, an analyst at the NASA Goddard Space Flight Center, says she particularly respects Dr. Shulman as a fellow female scientist. The family feels loyalty toward the University of Maryland as well. Dr. Brin is a professor of mathematics at the University of Maryland, College Park, and both sons, Sergey and Sam, attended the University of Maryland, College Park. Sam Brin, 21, is a senior there now. "We have strong ties to the institution. That is one of the reasons we are making this gift," Mrs. Brin says.

Both students and staff took the time to speak one-on-one with Dean Reece as well as to catch up with each other. "We need to get some ice cream in our office," someone in the crowd was overheard saying. "I've seen everyone I've been trying to reach all week here today."

There was even an ice-cream expert on hand. Bryan Soronson, administrator for the Department of Neurology, is a gourmet ice-cream taster. A large group gathered as he shared his expertise, educating the crowd on the differences between various brands, the history of ice cream, and the meaning of ice-cream terms (what makes an ice cream "light," what is kosher ice cream, etc.).

“Dr. Griffith saved my life,” says Mr. Hales, who underwent a successful double lung transplant last November at the University of Maryland Medical Center. The Hales created the professorship out of gratitude to Dr. Griffith for his skill and compassion in treating Mr. Hales. Dr. Griffith specializes in treating patients with the most severe heart and lung diseases.

“I was really at the point where I was not going to make it,” says Mr. Hales, the former Chairman and CEO of U.S.B. Holding Co. Inc., and its wholly owned subsidiary, Union State Bank.

“My gift is intended to draw attention to the quality of care I received from Dr. Griffith and the entire medical and surgical team at the University of Maryland,” Mr. Hales continues. “This professorship at the School of Medicine will support research to advance the field of thoracic surgery to the benefit of future patients.”

Before his transplant, Mr. Hales’ lungs had suffered from pulmonary fibrosis, a disease with unknown causes that results in scarring of the lung. As the lung tissue scars, it loses its ability to transfer oxygen into the bloodstream. There is no current treatment for the condition, other than transplant.

“The Hales’ gift will help advance the field of heart and lung transplantation by supporting even more cutting-edge science at the University of Maryland School of Medicine,” says E. Albert Reece, MD, PhD, MBA, vice president for medical affairs, University of Maryland, and The John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. “The School of Medicine is an established leader in cardiovascular research, and this gift will enhance that important scientific work.”

“The Hales’ gift places us a giant step closer to improving transplantation science to better assist patients with severe heart and lung conditions,” says Dr. Griffith. “I am grateful to them for their generosity and for this honor.”

Prior to Dr. Griffith’s arrival at the University of Maryland, he served as vice chairman of the Department of Surgery at the University of Pittsburgh School of Medicine, where he was also chief of Cardiothoracic Surgery and the Henry T. Bahnson Professor of Surgery.

Dr. Griffith was also the creator and director of the new internationally recognized McGowan Center for Artificial Organ Development, now known as the McGowan Institute for Regenerative Medicine, in Pittsburgh.

Dr. Griffith’s clinical work focuses on treating patients with the most severe forms of heart and lung disease. His research interests are concentrated on heart and lung transplantation and advancing use of artificial organs. He is internationally respected for his contributions to the field and has been continuously funded by the National Institutes of Health as a principal research investigator since 1988. His research funding includes the development of an artificial lung, a pediatric size heart pump, and a study to reduce muscle scar after heart attacks.

Dr. Griffith received his medical degree from Jefferson Medical College and completed a surgery internship and also a general and cardiothoracic surgery residency at the University of Pittsburgh School of Medicine Health Center Hospitals. He has published more than 500 articles and book chapters, has lectured at professional meetings nationally and internationally and is the recipient of numerous honors and awards, including induction into the Royal College of Surgeons, Edinburgh, Scotland.

The University of Maryland School of Medicine faculty surgeons have long been leaders in transplant surgery and related research. To describe the surgeons’ innovations in transplant surgery as “cutting edge” is becoming less of a play on words and more of an accurate characterization, as minimally invasive transplant techniques continue to evolve.

Dr. Stephen T. Bartlett, chairman of the Department of Surgery and The Barbara Baur Dunlap Professor of Transplant Surgery at the University of Maryland School of Medicine, was recruited to the University of Maryland in 1991 from the University of California to develop a major clinical and research transplant program. Under his leadership, the program’s achievements include Maryland’s first simultaneous kidney and pancreas transplant and the state’s first successful pancreas-alone transplant.

The increase in kidney transplants is due in large measure to major advancements made by the University of Maryland School of Medicine’s faculty surgeons in laparoscopic organ removal from living donors. “We were the second center in the U.S. to perform laparoscopic organ removal from living donors, and our work popularized the procedure,” said Dr. Bartlett. “Of the live organ transplants, 98 percent of the removals are done laparoscopically.” According to Dr. Bartlett, the greatest challenge in organ transplantation is the shortage of donors.

The Thomas E. and Alice Marie Hales Distinguished Professorship will be open-ended. The Hales Foundation will fund the first $2.5 million. The Hales are allowing further contributions in order to enhance the value of this Distinguished Professorship.

All such donations should be sent directly to the University of Maryland Development Office.

Tierra Dorsey, Director of Development
University of Maryland School of Medicine
100 N. Greene Street, Suite 600
Baltimore, Maryland 21201
Telephone: (410) 706-2846
Facsimile: (410) 706-2995
Email: tdorsey@som.umaryland.edu

All donations of any size will be acknowledged and the Development Office will notify the Hales Foundation.                                  

"Our results strongly suggest that the increased risk of obesity due to genetic susceptibility can be blunted through physical activity," the authors conclude. "These findings emphasize the important role of physical activity in public health efforts to combat obesity, particularly in genetically susceptible individuals." The results of the study were published in the Sept. 8, 2008 issue of the Archives of Internal Medicine.

Soren Snitker, M.D., Ph.D., the senior author and an assistant professor of medicine and pediatrics at the University of Maryland School of Medicine, says, "Our study shows that a high level of physical activity can ‘level the playing field,’ equalizing the risk of obesity between those who have copies of the FTO gene variant and those who don’t."

The FTO gene recently has been linked to obesity and increased body mass index, or BMI, in several large-scale studies. More than half of all people of European descent have one or two copies of a variation of this gene, British scientists reported last year. Individuals with two copies of the gene variant are on average seven pounds heavier and 67 percent more likely to be obese than those who don’t have it.

University of Maryland researchers found this same link between variations of the FTO gene and increased risk of obesity in their study of 704 Amish men and women. But, in examining the gene in this unique group of people with a similar genetic background and active lifestyle, the researchers also found that high levels of physical activity helped to counteract the gene’s effects.

"Having multiple copies of FTO gene variants had no effect on body weight for people who were the most physically active, regardless of whether they were men or women. But in less active people, the association between the gene and increased BMI was significant," says Evadnie Rampersaud, Ph.D., the lead author and a former postdoctoral fellow at the University of Maryland School of Medicine who is now at the University of Miami Institute for Human Genomics. "This provides evidence that the negative effects of the FTO variants on increasing body weight can be moderated by physical activity."

Dr. Snitker, of the University of Maryland School of Medicine, says the FTO gene is likely only one of a number of genes linked to obesity and notes that the effect of these genes may have changed over time. "Some of the genes shown to cause obesity in our modern environment may not have had this effect a few centuries ago when most people’s lives were similar to that of present-day Amish farmers," he says. He adds that environmental and lifestyle factors, such as a high-fat diet and lack of exercise, also may serve as triggers for obesity in genetically susceptible people.

"We are just starting to unravel these complex interactions between genomics and environment. It’s really a new age of discovery," Dr. Snitker says. "One day, we hope to be able to provide a personally optimized prescription to prevent or treat obesity in people based on their individual genetic makeup."

In this study, which was funded by the National Institutes of Health (NIH), the researchers examined dozens of variations in the FTO gene. They gauged the participants’ physical activity level with the help of a device worn on the hip called an accelerometer, which measures body movement. "We were able to get objective measurements of physical activity over seven consecutive 24-hour periods using this device, and that is a real strength of our study," says Dr. Rampersaud.

Participants were classified as having "high activity" or "low activity" levels. The more active people used 900 more kilocalories, or units of energy, a day, which translates into three to four hours of moderately intensive activity, such as brisk walking, housecleaning or gardening. Despite an active lifestyle, 54 percent of the men in the study were considered overweight (BMI over 25) and 10.1 percent were obese (BMI over 30). Sixty-three percent of the women were overweight, and 30 percent were considered obese. The mean BMI was slightly higher in women (27.8) than in men (25.7).

These figures are in line with previous University of Maryland studies that showed that  the Amish are as obese as other Caucasians in the United States. The earlier research also found that the Amish have half the incidence of Type 2 diabetes, as well as favorable cholesterol levels, despite a diet high in fat and cholesterol, although the reasons for this remain unclear.

The Old Order Amish are considered ideal for genetic research because they are a genetically homogenous people who trace their ancestry back 14 generations to a small group that came to Pennsylvania from Europe in the mid-1700s. They don’t drive cars or have electricity in their homes, eschewing many of the trappings of modern life. Most Amish men are farmers or work in physically demanding occupations such as blacksmithing or carpentry. Women are homemakers who work without the aid of modern appliances and often care for many children.

University of Maryland School of Medicine researchers, led by Alan R. Shuldiner, M.D.,  have conducted more than a dozen studies of the Amish in Lancaster County, Pa. since 1993, looking at various medical problems, such as diabetes, obesity, osteoporosis and high blood pressure. The latest research is an offshoot of a larger NIH-funded study, the Heredity and Phenotype Intervention (HAPI) Heart Study, examining how genes and lifestyle factors influence the Amish people’s risk of developing cardiovascular disease.

Among the co-authors of the FTO gene study are Dr. Shuldiner, who is a professor of medicine, head of the Division of Endocrinology, Diabetes and Nutrition, and director of the Program in Genetics and Genomic Medicine at the School of Medicine; Toni I. Pollin, Ph.D., an assistant professor of medicine; and Braxton D. Mitchell, Ph.D., a professor of medicine.

More than 300 students – a mix of both Mini-Med alumni and newcomers – enjoyed lively and informative presentations by Dr. Alessio Fasano and Dr. Carnell Cooper, during the first week's session. Dr. Fasano – a professor in the Department of Pediatrics and director of the Center for Celiac Research and the Mucosal Biology Research Center – spoke about irritable bowel syndrome (IBS) and celiac disease. Dr. Cooper, associate professor in the Department of Surgery, tackled the difficult issue of violence prevention.

Although celiac disease was once thought to be exclusive to European countries and people of European origin in the United States, new diagnostic tests have proven that it exists in populations around the world, including African-Americans. Dr. Fasano detailed the symptoms of the disease, including weight loss, abdominal pain, chronic fatigue, weakness, malnutrition and other gastrointestinal problems. He urged those who are showing symptoms or who have a genetic predisposition to the disease to be tested. Celiac disease can only be treated with a gluten-free diet, which is very difficult to follow. Dr. Fasano and his colleagues at the University of Maryland Center for Celiac Research are dedicated to learning the cause of celiac disease, identifying new medications, and, ultimately, finding a cure.

Unfortunately, there are also no medications to treat the problem of violence in our society, which has been growing at an alarming rate. As a surgeon at the R Adams Cowley Shock Trauma Center, Dr. Cooper has seen more than his fair share. He's fighting back with the Violence Intervention program, which strives to prevent violence among Baltimore City's most at-risk populations through research into the causes of violence and the development of intervention programs. The Mini Med school audience was eager to hear all about the program long after his presentation was over, so Dr. Cooper stayed to answer parents' questions about how to protect their children from a violent future.

Mini Med School will continue every Wednesday through October 1, 2008 from 6-8pm in the MSTF auditorium at 685 W. Baltimore Street. Topics include Autism, Genetics, Brain Disorders and a Nutrition and Fitness presentation from best-selling author Dr. Pamela Peeke. Classes are free, and all are welcome. Those who attend four of the five classes will receive a Mini-Med School diploma. See the Mini Med website for more information.

The University of Maryland Marlene and Stewart Greenebaum Cancer Center has been selected as a National Cancer Institute (NCI)-designated cancer center, a distinction shared by only 63 other centers across the country.

Kevin J. Cullen, M.D., director of the University of Maryland Marlene and Stewart Greenebaum Cancer Center

The NCI bestows this special designation on the nation’s top cancer centers in recognition of their scientific excellence and outstanding patient care. NCI-designated centers are selected through a highly competitive, peer-reviewed process, made even more competitive in the wake of recent NCI funding cutbacks.

“This is a tremendous honor and achievement for all who work in the cancer center and share a vision to defeat cancer. It’s also a tribute to our tireless supporters inside and outside of the cancer center who embrace this vision and have made this day possible,” says Kevin J. Cullen, M.D., director of the University of Maryland Marlene and Stewart Greenebaum Cancer Center and professor of medicine and pharmacology and experimental therapeutics at the University of Maryland School of Medicine.

• Watch a Q & A with Dr. Cullen about the NCI designation
• View the News Conference
• See video featuring Dr. Cullen discussing the NCI designation

The University of Maryland Greenebaum Cancer Center, located in Baltimore, is part of both the University of Maryland Medical Center and the University of Maryland School of Medicine. All of the center’s researchers and physicians are on the faculty of the medical school and other professional schools at the University of Maryland, Baltimore.

E. Albert Reece, M.D., Ph.D., M.B.A., vice president of medical affairs, University of Maryland, and dean of the University of Maryland School of Medicine

“E. Albert Reece, M.D., Ph.D., M.B.A., vice president of medical affairs, University of  Maryland, and dean of the University of Maryland School of Medicine, praised the cancer center’s commitment to research. “The cancer center has an outstanding basic science and clinical research program, with some of the best scientific minds in the country working to unravel the mysteries of cancer,” Dr. Reece says. “I believe this well-deserved recognition will pave the way for major breakthroughs in cancer research that will benefit patients everywhere.”

A researcher at the cancer center, Angela H. Brodie, Ph.D., a professor of pharmacology and experimental therapeutics at the University of Maryland School of Medicine, already has made a major contribution to the treatment of breast cancer with the discovery and development of a new class of drugs called aromatase inhibitors, which are used worldwide.

Jeffrey A. Rivest, president and chief executive officer of the University of Maryland Medical Center, says, “We are extremely proud that the National Cancer Institute has accorded this special status to the Marlene and Stewart Greenebaum Cancer Center. This designation will enhance our ability to provide excellent care for our patients and conduct clinical trials that provide cutting-edge cancer treatments to patients long before they are widely available,” he says.

Dr. Cullen notes that the Greenebaum Cancer Center cares for patients throughout Maryland and the region but has a unique commitment to minorities and underserved communities. “African-Americans represent more than 40 percent of our patients, and nearly half of them take part in clinical trials. Nationally, less than 2 percent of African-American cancer patients participate in clinical trials,” he says.

Jeffrey Rivest, President and CEO, University of Maryland Medical Center

“African-Americans, here and elsewhere, have a much higher death rate from cancer than white patients with the same disease, and we need to look at the underlying reasons. Their participation in clinical trials provides us with valuable information to better understand cancer in this community and to develop effective treatments,” Dr. Cullen says. “Our commitment to addressing health disparities among minorities sets us apart from many other cancer centers.”

He also cites the center’s close working relationship with the University of Maryland School of Medicine’s Institute of Human Virology, with researchers collaborating on ways to prevent and treat cancers which are increasingly prevalent in people who are HIV-positive and those with AIDS.
 
“The rise in HIV-related cancers is a growing public health concern in the United States and worldwide. Those infected with HIV have a much higher risk of developing cancer,” says Robert C. Gallo, M.D., the institute’s director and a professor of medicine and microbiology and immunology at the School of Medicine, who co-discovered that the HIV virus caused AIDS. “The NCI recognizes the enormity of the problem, and with its continued support, we will be able to significantly expand our research with the cancer center on HIV-related malignancies and in other areas, such as cancer vaccine development.”

The NCI recognizes centers in two categories – cancer centers and comprehensive cancer centers. The Marlene and Stewart Greenebaum Cancer Center was approved as a designated cancer center. The main difference is that comprehensive centers have epidemiological research programs. There are 41 NCI-designated comprehensive cancer centers and 23 designated cancer centers in the United States, including the Greenebaum Cancer Center. All of the centers are funded through the P30 Cancer Center Support Grant, and as part of the designation, the GreenebaumCancer Center will receive up to $3 million in NCI funding over the next three years. The designation also will open the door to grants and NCI-funded cancer studies offered only to designated centers and may help to generate additional funding from other public and private sources.

The process of applying for and receiving NCI designation often takes many years. Dr. Cullen, a head-and-neck cancer specialist who was recruited from Georgetown University in 2004,  has spearheaded the Greenebaum Cancer Center’s efforts to seek the designation.

Since then, he has recruited more than 40 top clinicians and researchers, significantly expanded the cancer center’s research and clinical programs, and overseen efforts to rebuild laboratory facilities and modernize inpatient rooms – with support from the Maryland Cigarette Restitution Fund Program. Total research funding for the cancer center has nearly doubled since 2002, to $48.1 million, with $14.4 million from the NCI. In June 2005, the cancer center opened a new, state-of-the-art outpatient area, the Roslyn and Leonard Stoler Pavilion, designed to promote multidisciplinary patient care.

The cancer center has comprehensive programs to treat all types of cancer and is a major referral center for patients throughout Maryland and the region. Recently, it has been recognized as one of the top 50 cancer centers in the United States by U.S. News and World Report. It is named for real estate developer and businessman Stewart Greenebaum and his wife, Marlene, a breast cancer survivor. They called the NCI designation “perhaps the most important event” in the center’s history.

“What makes this news so exciting is that while the official recognition is to the center, in truth, the recognition is to all of you,” the Greenebaums said in a letter to the cancer center staff.  “Your extraordinary cutting-edge contributions, while already known to many, are now officially recognized. It is your brilliance and compassion to your fellow man that has earned you this great honor. We are both proud and humbled to have our names associated with all of you.”

For more information about the cancer center, go to www.umgcc.org.

Read the Full Story here.

Researchers from the University of Maryland School of Medicine have found that the risk of stroke among young women increases the more they smoke. That is the key finding in a study to be published in the August 14 edition of Stroke: Journal of the American Heart Association.

"We studied the risk of stroke for women under age 50 and we found that the more cigarettes they smoked, the more likely they were to have a stroke," says John Cole, M.D., M.S., assistant professor of neurology at the University of Maryland School of Medicine. "Among women who smoked 40 or more cigarettes a day, the stroke risk increased more than nine times over that of a non-smoker. But we found that any smoking at all more than doubles the risk of stroke."

This study is one of the first to examine the relationship between higher rates of smoking and ischemic strokes, those caused by a blockage in the brain, in an ethnically-diverse group of young women. It is part of the University of Maryland’s on-going Stroke Prevention in Young Women initiative, in which researchers are looking at genetic and non-genetic risk factors for stoke.

"This new study shows how behavior can greatly influence a woman’s risk for stroke. It also emphasizes the importance of getting younger women to stop smoking or never to start," adds Dr. Cole, who is also a neurologist and stroke specialist at the University of Maryland Medical Center and a clinical research scientist at the Baltimore Veterans Affairs Medical Center.

In their analysis, the Maryland researchers obtained the smoking history of a group of more than 400 African-American and Caucasian women between the ages of 15 and 49 who had suffered an ischemic stroke. After face-to-face interviews, the researchers classified the women into three groups: current smokers, former smokers and never smokers, defined as women who had not smoked more than 100 cigarettes in their lifetime. Former smokers had smoked more than 100 cigarettes, or five packs, in their lifetime but had not smoked in the month prior to their stroke.

The team compared the smoking rates to a control group of women with similar age, race and ethnicity who had not suffered a stroke. Former smokers and “never” smokers showed no difference in their risk of stroke compared to each other; however, the number of cigarettes smoked by the current smokers revealed a significant dose-related increase in risk:

• 1 – 10 cigarettes per day = 2.2 times increased stroke risk
• 11 – 20 cigarettes per day =  2.5 times increased stroke risk
• 21-39 cigarettes per day =  4.3 times increased stroke risk
• 40 or more cigarettes per day = 9.1 times increased stroke risk

Almost 120,000 women and 105,000 men in the United States under the age of 45 have suffered a stroke, which is the nation’s leading cause of disability and third leading cause of death.
"While strokes in younger people are rare, they can have a significant effect on people’s lives and can leave them with difficulties with speech, vision, balance and thinking. So it’s very important that we find ways to reduce the risk of stroke, and, as our study shows, smoking cessation is an important step," says Dr. Cole.

Smoking causes the walls of the arteries to thicken and become less elastic, which can lead to plaque and fat accumulations inside the vessel.  If this plaque breaks off, it can travel in the blood stream to the brain causing a clot, resulting in a stroke. Smoking also makes the blood more "sticky" and likely to clot.

According to previous research, stroke risk decreases significantly two years after smoking cessation and reaches the level of nonsmokers by five years after quitting. The benefits also appear to be greater the earlier in life a person quits, particularly for a person under age 35, although stopping smoking has health benefits at any age.

The Centers for Disease Control reports that more than 20 percent of young women between the ages of 18-44 described themselves as smokers. The Maryland team also found a large prevalence of smoking among African-Americans in both the stroke group and the control group.

The researchers plan to conduct a similar study for stroke and smoking in younger men.

"I want to thank you for participating. You truly are special," a proud Congressman Cummings told the high-schoolers during his inspiring keynote speech at a luncheon in their honor. "This is about looking at your life at an early point and understanding with a keen sense of maturity that the things that you do now and in the next five to ten years will affect you until you die. Even if you live to be 110 years old, your choices now will affect every single aspect of your life. You are on a journey to success. And when I look at you, it just makes me feel so good."

The Summer Research Program was born from a conversation between Congressman Cummings and UMB president David J. Ramsay, DM, Phil, both of whom were seeking ways to inspire neighborhood students to pursue a college education. "Vivien T. Thomas students can apply for these research positions and then come here for the summer to work," explains Jordan Warnick, PhD, who heads this program and is also a professor in the Department of Pharmacology and Experimental Therapeutics and Assistant Dean for Student Education & Research at the School of Medicine. "We find places for them based on the mentors we have and the students' interests, so they don't get just any job – we try to match the position with what they want to do."

Some of this year's students were placed in laboratories at the School of Medicine, where they had the opportunity to study such diseases as cancer, HIV and asthma, but others took advantage of opportunities at the Schools of Nursing and Social Work and at the Center for School Mental Health in the Department of Psychiatry at the School of Medicine. "The School of Medicine is always interested in students who want to do research," says Dr. Warnick. "But I'm well aware that not everyone wants to be a physician. I'm here to open these high school students' eyes to something, regardless of whether it's pharmacy or poetry or nursing or social work – whatever they have a glint in their eye about. I want them to flourish in this environment. We try to dispel some of the things they've heard, that they have to be this or that to get into this school. All you have to do is complete the required prerequisite courses."

The Summer Research Program is funded by the Office of the President at UMB. For more information on student research opportunities at the university, visit the Office of Student Research.

In an effort to improve the overall health of school children, professionals from across the United States will attend the eighth annual School Health Interdisciplinary Program (SHIP), to be held August 4-7, 2008 at Turf Valley Resort and Conference Center in Ellicott City, MD. Participants will include educators, family members, faith-based representatives, drop-out prevention specialists, pupil personnel workers, safe and drug free school coordinators, physicians, school nurses, psychologists, nurse practitioners, social workers, nutritionists, counselors and health educators. The program is a partnership of the University of Maryland School of Medicine Department of Psychiatry’s Center for School Mental Health, the Department of Health and Mental Hygiene’s Center for Maternal and Child Health, the Maryland State Department of Education, the Department of Juvenile Services, and state organizations.

SHIP provides intensive training on all components of school health programs, including health education and mental health services. Some workshop sessions will include: the teenage brain, defiant youth, teen drivers, internet safety, violence prevention, teen pregnancy prevention, gang awareness, nutrition, physical education, family and community involvement, staff wellness, school environment, and other vital topics. The four-day conference will update participants on current issues and trends and help them build leadership and problem solving skills. A panel discussion by local students will offer perspectives on how adults can successfully intervene in children’s lives.

Among those scheduled to speak at the conference are: John Colmers, Secretary of the Maryland Department of Health and Mental Hygiene; Donald DeVore, Secretary of the Maryland Department of Juvenile Services; JoAnne Carter, Deputy State Superintendent of the Maryland State Department of Education, along with keynote speakers: Andres’ Alonso, CEO of Baltimore City Public Schools, Faye Calhoun, former Deputy Director for the National Institute of Alcohol Abuse & Alcoholism, Michelle Gourdine, former Deputy Secretary for Public Health Services for the Maryland Department of Health and Mental Hygiene, Frank Kros, President of the Upside Down Organization and Executive Vice President of the Children’s Guild in Maryland.  The opening conference day will feature, the Singing Sensations Youth Choir, directed by Dr. Hollie Hood-Mincey.
 
A complete list of the workshops topics can be found at http://csmh.umaryland.edu

Partial funding for this project is provided by the Title V Maternal and Child Health Block Grant Program from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, through the Maryland Department of Health and Mental Hygiene, Family Health Administration, Center for Maternal and Child Health, the Maryland State Department of Education and the Maryland Department of Juvenile Services.

Doctors at the University of Maryland Center for Advanced Fetal Care are testing a new fetal monitor that may provide valuable information about changes in an unborn baby’s heartbeat and movement over an extended period of time. The device, about the size of an iPod, measures the electrical impulse of the fetus’ heartbeat on the mother’s skin, detected with electrodes similar to an electrocardiogram (EKG). The system then uses special software to separate the maternal and fetal heartbeats. The monitor can collect data on fetal heartbeat and uterine activity for nearly 24 hours, much longer than ultrasound, which is generally used for a maximum of two hours.

"This device, called the Monica AN24, allows us to see changes in uterine contractions and fetal heartbeat and movement throughout the day and night, rather than just a snapshot of what’s going on at one particular time," explains Ahmet Baschat, M.D., a maternal-fetal medicine specialist at the University of Maryland Medical Center. "Ultrasound-based monitoring is limited because you can use it only for a short period, and, if the baby moves out of optimal position, the sound waves can’t bounce back and won’t provide the information we need."

By collecting data for an extended period, researchers want to see if they can spot earlier signs that the fetus is at risk or the patient may go into preterm labor. The device may be helpful for mothers who have medical conditions such as diabetes or autoimmune diseases. It may also provide crucial information in patients with poor fetal growth or problems with the placenta, which may require early medical intervention.

"With some high-risk conditions, the baby’s health may decline over time, which you may not pick up if you’re only monitoring for an hour or so with ultrasound," says Dr. Baschat, who is also an associate professor of obstetrics, gynecology and reproductive sciences at the University of Maryland School of Medicine.

The new device also appears to be extremely safe, since it simply monitors what is already occurring. During a monitoring session, four or five patches are placed on the mother’s belly. These patches contain the electrodes that pick up the fetal and maternal heartbeats, just like an EKG for heart monitoring. The electrodes are connected by wires to the small monitor that stores the data.

With ultrasound, a technician uses a wand to send sound waves, which are energy, into the uterus. The bounce-back of those waves is used to monitor the baby. However, doctors do not know if there are any effects of long-term exposure to ultrasound energy.

The Monica system provides an accurate measurement of the fetal heart rate and the strength of uterine contraction compared to ultrasound-based systems, which provide only an approximation. The new device also gives maternal-fetal medicine specialists a significant amount of data on fetal health, which they can analyze to look for changes or early signs of problems.

"Right now, we do not know if there’s a benefit to having all this information, but it’s one of the things we are hoping to find out. We want to know how we can use this data to help women with high-risk pregnancies to deliver healthy babies," says Dr. Baschat.

Currently, researchers at the University of Maryland Center for Advanced Fetal Care are using the device for women with high-risk pregnancies who are in the hospital with conditions such as pre-term labor and preeclampsia. The team also uses it during patient appointments at their clinic. However, because the device is lightweight and portable, developers hope the monitor can be used outside the hospital, to provide information about fetal movement and heart rate under real world conditions. Mobile technology could send the information to the hospital through wireless or Bluetooth systems.

The University of Maryland Medical Center team has been using the device for several months and plans to test it on 200 patients.  The Medical Center is the only academic hospital in the United States testing the system.

The University of Maryland Center for Advanced Fetal Care is a leader in patient care and research in perinatology, the care of the unborn child. The specialists in high-risk pregnancies provide state-of-the-art care for diagnosing and treating complex pregnancies, including multiples like twins and triplets, genetic conditions and problems of fetal development. Treatments include transfusions, gene therapy, shunts and fetal laser surgery for conditions such as twin-to-twin transfusion syndrome, a complex disorder involving an unequal blood exchange between identical twins. Researchers at the Center for Advanced Fetal Care have a wide range of interests, such as examining biomarkers in a mother’s blood in the first weeks of pregnancy as a possible predictor for subsequent preeclampsia.

A new study from researchers at the Center for Celiac Research at the University of Maryland School of Medicine answers a fundamental question relating to the cause of celiac disease and, possibly, other autoimmune disorders such as Type I diabetes and multiple sclerosis.

People with celiac disease must not eat foods containing gluten, a protein found in wheat. For them, gluten triggers an autoimmune response in which the immune system attacks the body, leading to a wide spectrum of serious health problems.

The new study, published in the July 2008 issue of the journal Gastroenterology, identifies the key gluten receptor in the intestine that opens the gateway through which gluten enters the body and triggers a faulty immune response in celiac patients.

The receptor, called CXCR3, is critical to the early stages of the faulty immune response. Pinpointing it could help doctors treat celiac disease more effectively, according to Alessio Fasano, M.D., professor of Pediatrics, Medicine and Physiology of the University of Maryland School of Medicine and medical director of the Center for Celiac Research.

"This is a scientific question that had never been answered before," Dr. Fasano says. "It is not only significant in the basic science of autoimmune disorders such as celiac disease, but in therapeutic approaches for the future. This opens a new scientific paradigm for the study of immunity.

There are three key components of celiac disease, according to Dr. Fasano. One is genes, and researchers have already identified a number of genes that seem common among celiac patients, but none that are consistently found in all patients.

The second component is the environmental trigger that leads to the autoimmune attack. Triggers have remained elusive for all autoimmune diseases except celiac disease, in which gluten is the undisputable trigger.

The third component is a leaky gut, wherein the barrier of the intestine becomes permeable enough to allow in the offending antigen — in this case, gluten, to come through.

Researchers at the Center for Celiac Research found that gliadin, the component of gluten that proves problematic for celiac patients, binds to the receptor called CXCR3.

This interaction between gliadin and CXCR3 triggers the release of a human protein called zonulin, which opens up the intestinal barrier to make it more permeable. In healthy patients, this effect is temporary. In celiac patients, the effect is long-term, and the results can be devastating.

The findings may be significant for other autoimmune disorders as well, Dr. Fasano says. The same process may occur in patients with Type I diabetes and multiple sclerosis, in which the intestines are the port of entry or the pathway through which the offending antigens in these and other autoimmune disorders get into the body, he explains.
 

"For the first time, we have evidence of how the foreign antigen gains access to the body, causing the autoimmune response," according to Dr. Fasano, who is also a pediatric gastroenterologist at the University of Maryland Medical Center. "Further study is needed, but this could allow us to intervene before the zonulin is either released or activated, preventing the immune response altogether."

Johannes Bonatti, M.D., a heart surgeon recognized as one of the world’s most experienced in minimally invasive coronary operations using the DaVinci robot, has joined the Department of Surgery at the University of Maryland. He will be a professor of surgery at the University of Maryland School of Medicine and a cardiac surgeon at the University of Maryland Medical Center as of July 15, 2008.

His recruitment further builds on the University of Maryland’s expertise in minimally invasive heart procedures, enabling patients to recover much faster with fewer side effects compared to traditional operations with a large incision.

Dr. Bonatti has performed more than 300 robotic heart surgeries; most were completely endoscopic—without even a small incision. Instead, patients needed only four or five small holes in which instruments were inserted, depending on the type of operation. In endoscopic procedures, surgeons use tiny robotic instruments and a video camera to perform the operations. Only a few surgeons world-wide have experience in performing a completely endoscopic heart bypass operation.

Of the 300 robotic operations that Dr. Bonatti has performed, 240 were coronary artery bypass operations; among those were 30 double artery bypass operations. With the minimally invasive endoscopic technique, patients can return to usual activities and light exercise and after about two weeks instead of spending 2-3 months recovering after traditional bypass surgery.

“We are very fortunate that Dr. Bonatti has decided to join us. He will strengthen our leadership in performing complex operations in a minimally invasive way. With his arrival, we truly have the world’s dream team of experienced and skilled surgeons who offer our patients a minimally invasive approach to a wide range of operations,” says Stephen T. Bartlett, M.D., professor and chairman of the Department of Surgery at the University of Maryland School of Medicine and chief of surgery at the University of Maryland Medical Center. 

Bartley Griffith, M.D., professor and head of the Division of Cardiac Surgery at the University of Maryland, says, “Our patients will benefit from Dr. Bonatti’s extraordinary expertise in endoscopic heart surgery. He is clearly an innovator and he will complement our superb team with his skills in minimally invasive coronary bypass procedures. This fits well into our goal to offer minimally invasive procedures in all types of cardiac surgery.”

“I am looking forward to moving my program from Austria to the United States and, in particular, to the University of Maryland,” says Dr. Bonatti. “The medical center team is already familiar and working with the DaVinci robot system. We will have more resources here and greater opportunities to bring the use of the DaVinci robot into the mainstream of heart surgery.”

Dr. Bonatti adds, “My primary goal in performing heart bypass operations with the DaVinci robot is to have a perfect graft—so that the vessel will stay open and functioning for many years. Using the robot, we can perform the surgery in a very precise way without opening the chest. It is the same operation on the inside as the traditional bypass—but without the long recovery time and scar.”

Dr. Bonatti has been an attending cardiac surgeon and associate professor of surgery at Innsbruck University Hospital in Austria since 1998.  He has also worked as director of the Heart Surgery Research Laboratory at Innsbruck Medical University for the past six years.

Dr. Bonatti graduated from Innsbruck University Medical School in 1986 and performed a variety of clerkships and internships in Austria and in South Korea. He did part of his surgical residency at the Medical College of Virginia in Richmond in 1989.

He started a program in minimally invasive cardiac surgery in Innsbruck in 2001 and has participated in FDA-sponsored studies of the robotic approach to coronary artery bypass surgery. Dr. Bonatti also organized a series of workshops in which cardiac surgeons and interventional cardiologists develop common strategies for the treatment of coronary artery disease.

He has served as a visiting surgeon in many countries and has trained surgeons at hospitals in Germany, the Czech Republic, Greece, Turkey, India and Australia in the use of the DaVinci robot for heart surgery.

Dr. Bonatti was a member of the Austrian Freestyle Ski National Team from 1979-1981, and later, as an emergency physician, he combined his skiing experience and his medical skills to provide helicopter rescue of injured skiers in the Alps.

"During 2007, our bicentennial year, the Office of Public Affairs hosted a special version of our Mini-Med School community outreach program," explained Heather Graham Phelps, Manager of Public Relations in the School of Medicine's Office of Public Affairs. "We geared it towards children and called it Mini-Med School for Kids. Last year’s program was such a success we decided to make it an annual event.

"Mini-Med School for Kids targets children from our underserved community in hopes of delivering key messages about important, and very relevant, health and lifestyle issues," Phelps continued. "It’s our intent to reach these kids while they are still young and healthy in order to instill valuable information about taking care of their bodies and making smarter health and lifestyle choices."

Things kicked off July 9 with a lesson for the older campers about sexually transmitted infections and HIV. It was led by Ligia Peralta, MD, Associate Professor of Pediatrics and Chief of the Division of Adolescent Medicine. There was some giggling, blushing and hiding of faces during her matter-of-fact presentation, but by the end the campers were comfortable enough to ask her important questions about how they can protect themselves from these illnesses. They also proved, through a fast-paced game of Medical ‘Jeopardy’, that they had indeed been paying attention and absorbing the material, despite its sensitive nature.

Mini-Med School for Kids continued each Wednesday over the next five weeks, covering such topics as diabetes, obesity and nutrition; stress relief and anger management; asthma; smoking, drug & alcohol abuse and addictions; and heart health and exercise. It ended August 13 with a visit to the medical school, where the campers had a lesson in Anatomy from Ron Wade, director of the State Anatomy Board and the Anatomical Services Division at the School of Medicine. They were also treated to a spoken word performance by David Ross of PHAT (Promoting Healthy Alternatives for Teens).

"We've formed a partnership with the School of Medicine that is really amazing," said Deborah Tyson, director of the camp. "The children wrote letters to camp benefactors about what they like most about camp, and every one of them talked about Mini Med School. They go home and tell their parents about eating healthy, exercising, not using drugs or selling drugs, not smoking or drinking, and I hear back from the parents that they are so impressed by everything their children have learned. It's been so wonderful, and we hope to have the chance to do it again next year, because it is an excellent program."

Minorities and residents of some rural areas in Maryland are participating at lower than expected rates in federally funded cancer treatment clinical trials, which may suggest growing racial, ethnic and geographic disparities in cancer treatment.

That’s according to a new study led by Claudia R. Baquet, M.D., M.P.H., a professor of medicine and associate dean for policy and planning at the University of Maryland School of Medicine and director of the school’s Center for Health Disparities Research and Outreach.

The study, which looked at 2,240 Maryland cancer patients enrolled in National Cancer Institute (NCI)-sponsored clinical trials from 1999 to 2002, will be published in the July 10, 2008, issue of the Journal of Clinical Oncology. Dr. Baquet’s co-authors are Gary L. Ellison, Ph.D., M.P.H. , an epidemiologist in the Office of Policy and Planning and an instructor of the School of Medicine, and Shiraz I. Mishra M.B.B.S., Ph.D., an associate professor of the School of Medicine and deputy director for evaluation and outcomes in the Office of Policy and Planning.

The percentage of Maryland patients participating in NCI-funded cancer treatment clinical trials rose one percent over the four-year period, to 2.9 percent in 2002, but the percentage of African-American participants fell an estimated 8.9 percent per year, according to the study. 

"Low representation of African-Americans, other minorities and rural patients in cancer clinical trials could contribute to health disparities. Without adequate diversity, it may be difficult to generalize about trial results because you don’t know whether new treatments or preventive strategies have comparable effects among patients from diverse racial or ethnic groups," Dr. Baquet explains.

The study’s results are particularly significant because the African-American community shows disproportionately high rates for certain cancers, according to Dr. Baquet. These include colon cancer, aggressive forms of breast cancer and prostate cancer.

This is the first study to focus on Maryland’s patient participation rates in cancer treatment clinical trials funded by the NCI, which is part of the National Institutes of Health. It looked at clinical trials funded by NCI’s Clinical Trials Cooperative Group Program, which are offered at cancer centers, community hospitals and oncology practices. The study did not include NCI-sponsored treatment trials initiated by individual investigators or those funded by private industry.

Other findings of the study, which was funded by the NCI and the NIH National Center for Minority Health and Health Disparities, include:

• Some rural areas of the state, specifically Allegany and Washington counties in Western Maryland and St. Mary’s County in Southern Maryland, had lower-than-expected rates of participation in the NCI-sponsored clinical trials.

• Baltimore City, Prince George’s County and Howard County also had lower rates of participation than expected.

• Montgomery County had a significantly higher-than-expected participation rate. Baltimore County and Anne Arundel County also had higher rates than had been anticipated. Participation in trials on the Eastern Shore met researchers’ expectations.

• Pediatric and adolescent patients, white patients, female patients (for sex-specific tumors) and patients with private health insurance had higher-than-expected rates of participation.

Dr. Baquet notes that the University of Maryland School of Medicine’s Center for Health Disparities Research and Outreach has developed intensive, multi-level programs to help increase minority and rural participation in clinical trials on Maryland’s Eastern Shore.

The Center for Health Disparities Research and Outreach at the School of Medicine, funded by NIH’s National Center for Minority Health and Health Disparities, strives to help close the health care gaps between the races. Its Maryland Community Cancer Clinical Trial Program on the Eastern Shore of Maryland works to get minorities and residents of rural areas more involved in clinical trials.

"This program is part of the center’s efforts, in partnership with Dr. Mary DeShields at the Eastern Shore Cancer Research Network, to increase diversity in clinical trials, cancer clinical trials in particular," Dr. Baquet says. "We will continue to monitor cancer patients’ participation in clinical trials in Maryland, expand our community-based clinical trials educational efforts and provide continuing education for physicians and other health care professionals providing care to African-American, rural and other underserved communities," she adds.

In 2004, Drs. Baquet and DeShields received the first and only National Best Practice Award from the U.S. Department of Health and Human Services for increasing rural cancer patient participation in clinical trials on the Eastern Shore.

It was this connection that brought University of Maryland School of Medicine physicians to BWI Thurgood Marshall Airport on June 26^th, 2008 to begin a two day conference on Innovations in the Surgical Environment.

Surgeons and pilots learned from each other in a series of lectures and demonstrations held in an aircraft hanger. The power of state-of-the-art technology was apparent in the cockpits of a Navy F/A-18 Hornet jet fighter and a Maryland State Police Dauphine II helicopter. After touring these aircraft, as well as a Bell 412 helicopter used by Maryland Express Care, attendees were treated to a keynote speech from NASA Astronaut Dave Williams, a former emergency room physician who has conducted space flight experiments focusing on the effects of microgravity on the brain and nervous systems.

The conference is the brainchild of Adrian Park, MD, FRCS (C), FACS, professor and Vice Chair of the Department of Surgery and head of the division of General Surgery. Dr. Park says there is much that surgeons can learn from pilots, but a surgeon’s job is no less complicated. “Their system of briefing and debriefing is one that has had great impact on their performance and we can learn from that. But the machines that we perform in and operate on are different. No matter how technologically advanced a Hornet is, it still doesn’t hold a candle to the complexities of the pancreas.”

While there are many surgical innovations to pursue, Dr. Park and his team are focusing on four main pillars: surgical visualization, smart imaging, informatics, and ergonomics/ human factors research. "Our lack of knowledge in these fields is outstanding," said Dr. Park, who believes collaboration and knowledge sharing will improve surgical training and promote research. "Hopefully this is our breakout year, where we really spur the broader community," he adds. "Not just with the whiz bang stuff, but to get them to really collaborate on substantive issues. We're defining those issues and hopefully bringing the folks together to cross-pollinate and create real interdisciplinary, collaborative research."

In addition to the U.S. Navy and the Maryland State Police Aviation Administration, conference participants included the University of Maryland Center for Medical Simulation for Skill Acquisition (MASTRI), The U.S. Army and Maryland Express Care.

This year's five honorees were Larry Anderson, PhD, Professor of Anatomy and Neurobiology; Miriam Blitzer, PhD, Professor of Pediatrics, Obstetrics and Biochemistry & Molecular Biology; Frank Calia, MD, Theodore E. Woodward Professor and Chair of the Department of Medicine, as well as Professor Emeritus of Medicine, Microbiology & Immunology; Michael Donnenberg, MD, Professor of Medicine and Microbiology & Immunology; and Jordan Warnick, PhD, Professor of Pharmacology & Experimental Therapeutics and Assistant Dean for Student Education & Research. The inductees, who were selected by their peers for this distinction, were presented with plaques of recognition and a monetary award by Drs. Pass and Susel. Two new members will be inducted into the Academy every year.

"The School of Medicine has had few ways to recognize the select few who truly excel at pedagogy and cherish the opportunity to teach, mentor and mold the next generation of physicians, scientists and allied health professionals," said E. Albert Reece, MD, PhD, MBA, John Z. and Akiko K. Bowers Distinguished Professor and Dean of the School of Medicine. "The academy is designed to recognize faculty members who demonstrate excellence in bedside, classroom and/or innovative medical and graduate education. Honorees are exemplary role models to students, embody the highest ideals of the medical profession and display uncommon commitment to students’ best interests."

Dr. Susel believes the Academy of  Educational Excellence will make a difference for decades to come. "As important as the teaching facility is, it would not be complete without the participation of the outstanding teachers in the medical school. The five inductees today have demonstrated their special teaching abilities in being selected for this award. We honor and salute them and thank the medical school for allowing us to endow this program."

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"It is recognized as one of the highest tributes that an institution can bestow on its most distinguished faculty," said E. Albert Reece, MD, PhD, MBA, vice president for medical affairs, and the the John Z. and Akiko K. Bowers Distinguished Professor and Dean. "It provides a faculty member with an enduring source to sustain his or her research and teaching efforts and is indicative of superior performance in the classroom, the laboratory and the clinical setting."

"I'm proud to describe myself as a faculty member of the School of Medicine," Dr. Suntha said in accepting his professorship. "And I’m equally proud to describe myself as a member of the medical center. Together they provide me with many opportunities to work with incredibly talented faculty who have pushed me to consider goals that I would have never dreamed possible."

The Greenebaums, who have long been crusaders in the fight against cancer, were only too happy to support Dr. Suntha. "I never say this, but he would be genuinely irreplaceable," said Mr. Greenebaum. "What makes him so extraordinary is the rarest kind of brilliance. A brilliance that resides as much in the heart as in the head, a brilliance that shines as brightly as his smile, and that's saying something. His enthusiasm for life is present in the research lab as well as the treatment room, bringing hope and comfort even to those who know their chances are slim. It's a brilliance that embraces and inspires everyone around him."

One of those he inspired is Frank Calia, MD, Theodore E. Woodward Professor and Chair of the Department of Medicine. Dr. Calia once served as the Interim Chair of the Department of Radiation Oncology and credits Suntha with helping him succeed in that position. "Mohan Suntha is the whole package," he proclaimed at the investiture ceremony. "He's a terrific physician, a skilled teacher and a productive investigator. Marlene and Stewart Greenebaum have done a wonderful thing, recognizing and honoring a respected member of this institution. Let's hope that all subsequent Greenebaum professors live up to the Suntha standard."

A team of trauma specialists from the University of Maryland R Adams Cowley Shock Trauma Center has returned from China after 10 days of helping to treat victims of the devastating earthquake that occurred on May 12.

The team of physicians and nurses was the first officially invited United States medical team to assist the Chinese following the earthquake. The Chinese Ambassador to the U.S., Zhou Wenzhong, had invited the team.

With a primary mission as consultants, the team worked with doctors at West China Hospital in Chengdu, Sichuan Province, located about 50 miles from the epicenter of the quake. It is considered one of China's leading facilities for trauma care.

The hospital has been serving many of the most critically injured patients. At the hospital, the U.S. team gave lectures on treating traumatic injuries as well as helping to treat patients.

"It was an opportunity each of us will remember for the rest of our lives." said Thomas M. Scalea, MD, physician in chief of Shock Trauma and professor of surgery at the University of Maryland School of Medicine who led the team.

The University of Maryland Shock Trauma Center is a world leader in brain and spinal cord trauma and crush injuries. In addition to Scalea, the team members included Thomas Grissom, MD, a specialist in critical care and anesthesiology; Geoffrey Sheinfeld, MD, a specialist in critical care and nephrology; Karen Karash, RN, a neurotrauma critical care nurse; and Peter Hu, chief technologist responsible for telemedicine consultations conducted during the trip.

Sheinfeld said that the team achieved three goals for their consulting trip: to build relationships that last, to learn how the Chinese handle disasters, and to do some training on techniques they routinely apply at Shock Trauma nearly 7,700 times a year. "We saw similar injury cases, like those we have here, but on a much greater scale."

The magnitude-7.9 quake killed nearly 70,000 in Central China. The Chengdu hospital treated 3,000 patients in the first three weeks after the earthquake, Scalea said.

He said when the team arrived, they found "a group of unbelievably committed doctors and nurses who had been slugging it out for a month without a rest every day in the ICU or in the operating room or throughout the hospital." He continued, "I think each of us found there were far more similarities with Shock Trauma in Baltimore than differences though."

The team fit in quickly, said Scalea. "I was absolutely shocked that at the end of day one, we felt that we were part of the team. What was fantastic was this was synergistic in a way you don't often see. After a day the cooperation was seamless. It felt just like being home, just going to work."

He said the team was especially impressed with how China as a whole had responded to the disaster, with doctors flying in by helicopters, providing their own food and clothing for a period of time, then being replaced by others in rapid order. "I don't care how many drills you do, you're not prepared fully to go live until you go live."

The hospital itself, said Scalea, had some damaged windows and chunks of plaster missing from walls. There was also concern during the trip that more of the earthen dams in the region might break from additional rains.

As the team was leaving Baltimore June 6, E. Albert Reece, MD, PhD, MBA, dean of the School of Medicine, said that one of several missions of the School is community outreach. "And we consider the community as the world." Reece said the School is currently working in 23 difference countries worldwide. "We are honored that the Chinese actually saw fit to invite us. I have no doubt our time will be effective."

Scalea said on his June 18 return, "We believe we have grown from a local to a national to an international resource." He said the current mission of Shock Trauma includes "training the next generation and the ability to go anywhere in the world."

Since 2004, Shock Trauma has been building relationships with members of the Ministry of Health of the People's Republic of China and several trauma hospitals in China. These include Shanghai East Hospital, People's Hospital and Peking Union Hospital. Shock Trauma co-hosted an international conference in Shanghai with the Chinese Emergency Medicine & Trauma Associations in 2007 that brought together experts to discuss advanced trauma and critical care.

Shock Trauma, located at the University of Maryland Medical Center, cares for about 7,700 critically injured people each year and, in partnership with the University of Maryland School of Medicine's Program in Trauma, serves as the core of the state's EMS/trauma system.

Stroke survivors who have lost the use of an arm because of a stroke will soon have access to an in-home exercise device to help activate new brain pathways to improve arm function. A grant from the National Institutes of Health (NIH) will enable further refinement of the patented device, to be called Tailwind, which was developed at the University of Maryland School of Medicine. Tailwind will be available to recovering stroke patients this fall.

Clinical studies show that Tailwind improves arm movement in stroke survivors who have been paralyzed for months, even years, after a stroke. Through a licensing partnership with the School of Medicine, Baltimore-based medical device company Encore Path will market the invention in a compact, retractable and portable design. The U.S. Food and Drug Administration has designated Tailwind as an exercise device for stroke patients. The $120,000 Small Business Innovation Research grant, from the National Institute of Neurological Disorders and Stroke, is awarded to both the School of Medicine and Encore Path.

University of Maryland co-inventors Jill Whitall, Ph.D., a professor in the Department of Physical Therapy and Rehabilitation Science, and Sandra A. McCombe Waller, P.T., Ph.D., an assistant professor in the same department, created Tailwind through research they conducted in the late 1990s at the School of Medicine. The earlier version of their device was called BATRAC, an acronym that stands for the type of physical therapy it promotes: bilateral arm training with rhythmic auditory cueing.

In 2004, Drs. Whitall and McCombe Waller published a study in The Journal of the American Medical Association, which showed that using the device helped patients who had suffered a stroke at least six months earlier. After six weeks of using the device three times a week, stroke survivors who improved their ability to use and control their muscles and movements also demonstrated a re-organization of the brain indicating that a healthy part of the brain took over the function of damaged parts. “There seems to be some benefit of improved motor function in a significant portion of the people we have tested some years after their stroke,” says Dr. Whitall.  “This NIH grant will enable us to advance Tailwind to help patients aim for specific goals in their recovery in the privacy of their homes.”  

So far, the device has been tested only in patients six or more months after their first stroke. Drs. McCombe Waller and Whitall have received funding to test the upgraded device in the sub-acute hospital setting, with patients who recently had a stroke.

The NIH grant will enable Encore Path to create additional software that will allow therapists to measure patient progress. “What I find truly exciting is that we have a tremendous partnering opportunity with the University of Maryland to invent, develop and research practical and cost-effective rehabilitation technologies that will advance the recovery of stroke survivors everywhere," says Encore Path CEO Kristen Appel. See www.encorepath.com.

The National Stroke Association says there are six million stroke survivors in the United States. Stroke is the third leading cause of death, and the number one cause of adult disability.

"Working with students and colleagues from different professions, schools and programs on campus has been very special to me," said Plaut. "One of the best things about being here is I felt like a perpetual student, always having the opportunity to learn something new, to develop my teaching and to face new challenges."

The challenges were many during Plaut's years at the school, 30 of which were spent in Student Affairs. "Mike is always behind the scenes in a very humble, no-publicity way, gathering information and putting the right spin on it so we can interpret it correctly," said Bruce Jarrell, MD, Vice Dean for Research and Academic Affairs and a professor in the Department of Surgery. "He knows more about the policies of this school and the history of them and how they've been applied than anybody in this institution. And of course that's really important to us, because we need to deal with students in a consistent fashion, and he's been the lynchpin for our being able to do that."

Dean E. Albert Reece, MD, PhD, MBA echoed Jarrell's praise. "In order for a school of our size to function as effectively as it does, it requires key people in important roles to function independently and effectively," he said. "Mike epitomizes such a person, one who actually sees things that need to occur and does them independently without being told to do them."

“We are going to miss Mike Plaut a lot,” said Anthony F. Lehman M.D., M.S.P.H, Chair of the Department of Psychiatry, which helped organize the event. “If you have a problem, you can always go to him and he will do whatever he can do to help. He has always been loyal to the Department of Psychiatry and to the School of Medicine.”

In addition to his high-level participation in school affairs, Plaut has also been very active in teaching and is remembered well by generations of medical students for his subject matter: courses on sexual dysfunction and on setting boundaries between physicians and patients. "All those medical students Mike has embarrassed, appal