Advance Research Digest - Summer 2015

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ADVANCING RESEARCH FROM LAB TO LIFE A Biannual Research Digest of the University of Tennessee Medical Center and UT Graduate School of Medicine

Collaborations Lead to Funded Research

On the Horizon:

Intraoperative Imaging with Fluoroscopy

Research Spotlight: Jonathan Wall, Ph.D.

Studies in Brief:

• Amyloidosis Research Supported • Resident Research Day • SBIR Grant Awarded • Cancer Center Participates in BCMB Course

Summer 2015

Wisdom for Your Life.


Spirit of Discovery‌


Observations

Table of Contents

This edition of Advance focuses on the involvement of students and residents in research and the achievements that are made by stimulating those young minds to ask questions and find answers. Having a scientific approach to medical care, whether it is at the basic level or at the systems level, is the foundation of offering the best system of care. It trains the physician to ask why, to pursue information, to have high standards and to not accept convention because ipse dixit. The Medical Center has recognized the seminal role that research in optimizing care and has incorporated a research effort in to its five year strategic plan. This, along with recruiting faculty who are interested in research in addition to being good physicians, will provide the platform for challenging the students and residents of the future and for transforming health care. Not all research is in the laboratory. In fact, not all residents and students should go to the laboratory. Frances Moore, MD, renowned Chairman of Surgery at the Peter Bent Brigham Hospital said that requiring all residents to go to the laboratory or to publish a certain number of papers, “has produced laboratory drones rather than scholars and trash rather than literature.” It’s the scholarly environment and the spirit of inquiry and the keeping the patients problems and welfare at the focus that is important. That and the unwillingness to accept what is dictum is what will ultimately produce doctors of medicine rather than practitioners and improved healthcare for all rather than patchwork bandages. The work that goes on at UTMC as exemplified in this issue provides scientific education for future doctors, solutions for our patients and strategies for our healthcare system.

In Brief: Fluroscopy as a Tool

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In Brief: Gerdau Supports Amyloidosis Research

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Featured Researcher: Jonathan Wall SBIR Grant Awarded 2015 Collmann Students

In Brief: 2015 Resident Research Day In Brief: Heidel Collaborates on NIH Grant In brief: Students Immersed in Cancer Center News

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Advance

Issue 10: Summer 2015 Publishers James Neutens, Ph.D. Mitch Goldman, M.D. Managing Editors Kristen Vandergriff, M.S. Rachel Echols Contributors Mitch Goldman, M.D. Photography Kandi Hodges Design Jerry Tracy/J Squared Graphics Advance is produced by the University of Tennessee Graduate School of Medicine. The mission of the digest is to spotlight research programs at the institution and explain how the work of our researchers impacts health care in East Tennessee and beyond. Institutional Review Board All research using human volunteers follows stringent federal regulations that require a review by an Institutional Review Board (IRB) before it is approved. The IRB committee is comprised of physicians, pharmacists, scientists, researchers and non-scientific community representatives. The members review research protocol to ensure protections are in place. Faculty from the UT Graduate School of Medicine influence medical care across the world by publishing and presenting. For a comprehensive list of publications and presentations, visit http://gsm.utmck.edu/scholars Contact Us Advance UT Graduate School of Medicine Kristen Vandergriff 1924 Alcoa Hwy., Box 93, Knoxville TN, 37920 Telephone: 865-305-9749 E-mail: klvandergriff@utmck.edu Web: http://gsm.utmck.edu

Mitchell H. Goldman, M.D.

Assistant Dean of Research University of Tennessee, Graduate School of Medicine

Wisdom for Your Life.

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FEATURED RESEARCHER »»»»»»

From Innovative Scientist

The rarer forms of amyloid disease are difficult to diagnose early because patients have a vast array of diverse symptoms, so the diseases are often unrecognized. At present there is no approved method in the US for imaging the disease in these patients, something that would aid in definitive diagnosis and assist doctors in monitoring patients with these devastating, often fatal disorders. To address this clinical problem, researcher Jonathan Wall, Ph.D. and his team in the Amyloidosis and Cancer Theranostics Program (ACTP) and Molecular Imaging and Translational Research Program (MITRP) have been developing new tools and techniques, through partnerships with

Oak Ridge National Laboratory and Siemens, to effectively image amyloid in the body organs using radioactive proteins. The most important step in the development of this new technique is to perform a Phase I clinical trial with patients suffering from these disorders. Preparation for the clinical trial involves performing standard toxicology studies, manufacturing sufficient protein for the trial, and applying for approval from the Food and Drug Administration (FDA). The ACTP team, led by Jonathan Wall, Ph.D., has been awarded funding and support from the Science Moving towArds Research Translation and Therapy (SMARTT) Program to help make the clinical trial a reality. The SMARTT program, available through 2


to Healthcare Hero

Shawn Millsaps/Knoxville News Sentinel

the National Heart, Lung, and Blood Institute at the National Institutes of Health, is designed to accelerate translation of research from bench to bedside. To accomplish this mission, the SMARTT program provides regulatory support, manufacturing, and toxicology services to qualified projects. With support from the SMARTT program, the ACTP team, in collaboration with the MITRP and oncologists Ronald Lands, M.D., Associate Professor of Medicine, David Aljadir, M.D., and John Bell, M.D., Professor of Surgery, is applying to the FDA for approval of an imaging clinical trial using a novel amyloid-targeting agent called peptide p5+14. Also, SMARTT plans to provide more than 500 patient doses of the peptide

and may support important safety studies in preparation for the clinical trial at The University of Tennessee Medical Center. In addition to receiving the SMARTT grant, Dr. Wall has been named a 2015 Healthcare Hero for Innovation. The Greater Knoxville Business Journal’s Health Care Heroes is an annual celebration of individuals and organizations that have made significant contributions to the quality and availability of medical care in East Tennessee. More specifically, the innovation award that Dr. Wall received honors a company or individual primarily responsible for a scientific discovery or new process, device or service that can save lives or improve the quality of lives. 3


FEATURED RESEARCHER »»»»»»

Innovation in Regenerative Medicine Starts Here

The National Institutes of Health, the primary agency of the U.S. responsible for biomedical and health-related research, has awarded Steven Ripp, Ph.D., associate professor in the University of Tennessee Center for Environmental Biotechnology, and Stacy Stephenson, M.D., assistant professor and director of the UT Graduate School of Medicine Laboratory of Regenerative Medicine, a Small Business Innovation Research (SBIR) grant for a study to improve the tracking of stem cells used in regenerative medicine, a relatively new field of research. Regenerative medicine is a form of translational research, which means the

study starts in a laboratory setting with the potential to be used in patient care. Regenerative medicine involves stimulating the body’s own repair mechanisms using stem cells to functionally heal damaged tissues or organs. For the regenerative medicine field to effectively transition toward translational and clinical practice outcomes, a strong dependence on animal models will be required to fully understand the capabilities and complexities of stem cells. The study, “Expressing humanized bacterial luciferase in stem cells: Moving beyond firefly luciferase to expand the informational capacity of animal models for regenerative medicine,” is in response 4


light production in fireflies. This process occurs in specialized light-emitting organs, usually a firefly’s lower abdomen. When mixed with oxygen, an enzyme known as luciferase causes the organ to light up. By equipping the regenerative cells with the ability to constantly glow, the cells health and location can be tracked noninvasively. This is becoming a popular technique because it avoids the expense and technical skills required by more conventional imaging approaches such as magnetic resonance imaging (MRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), and computed tomography (CT). For the project, Graduate School of Medicine personnel will create a lentiviral delivery vector, transduce a stem cell line to enable continuous bioluminescence, implant the stem cell in the animal model, and visualize bioluminescence in vivo in the test subject. Viral vectors are commonly used to deliver genetic materials into cells, and lentivirus is a type of virus characterized by permanent integration of the genetic material into a cell’s DNA so that it may be expressed constantly and passed down as the cell divides.

to an NIH request for new techniques for non-invasive, long-term tracking of cell survivability, engraftment and migration following implantation. Assessing the fate of cells implanted into the body will allow for improved treatment effectiveness and an enhanced understanding of the potential risks of therapies. The approach to following implanted cells is similar to how fireflies light up. A chemical reaction called bioluminescence creates

Why this matters:

Funding for this grant will provide research on self-renewing stem cells that offer valuable therapeutic approach to heal previously irreparable tissues and organs. This approach will improve patient care and health.

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Collmann Summer

balloon angioplasty. Additionally, MMPs are known to play a key role in inflammatory and cell proliferation pathways. Kyle’s research project has focused on analyzing inflammatory markers, such as chemokine ligands (CXCLs), proliferation markers MKI67 and PCNA, and MMP regulatory mechanisms in order to determine the effect of testosterone on the genetic expression of these mechanisms within the vessel wall in response to injury. This work could translate to a clearer understanding of the pathophysiological mechanisms underlying androgen deficiencymodulated intimal hyperplasia with the intent to improve clinical outcomes. Adrianna Eder graduated from the Brock Scholars Program at UT Chattanooga in May 2015 and is currently applying to medical school. She is performing research in the lab of Michael Karlstad, Ph.D. and is testing the hypothesis that steroid-induced insulin resistance will increase the proportion of genetically susceptible mice that advance to diabetes. Furthermore, an objective of her project is to determine if peripheral insulin resistance, determined by an insulin tolerance test, is the

Dr. Collmann initiated the I. Reid Collmann, M.D. Medical Student Education Fund to give students an opportunity similar to his own student research experience. The awareness of research’s impact on patient care is information that will build a solid foundation for the remainder of the student’s medical career. Kyle Boden is a rising M2 medical student at ETSU Quillen College of Medicine. This summer he worked with Deidra Mountain, PhD in the Vascular Research Lab in the Department of Surgery. His project aimed to elucidate the molecular mechanisms underlying the role of androgen deficiency “low T” in intimal hyperplasia development and restenosis. Specifically he has studied the effects of androgen deficiency and testosterone replacement therapy on extracellular matrix remodeling, inflammation, and vascular smooth muscle cell proliferation. Matrix metalloproteinases (MMPs), which are multi-domain proteins involved in matrix remodeling, are prime targets for evaluating the effects testosterone may have on cell-cell and cell-extracellular matrix interactions within the vessel wall following 6


Research Program early contributor to the increase in blood glucose

Jason Johnson is a rising M2 medical student at the University of Tennessee Health Science Center. This summer he worked in the research lab of Ralph Lydic, Ph.D. and Helen Baghdoyan, Ph.D. His work focused on the role of the satiety factor leptin and leptin receptors as modulators of pain. These ongoing studies are comparing the effects of the opiate buprenorphine on consciousness among normal weight mice, obese mice lacking leptin, and obese, diabetic mice lacking leptin receptors. Additionally, these studies tested the hypothesis of differential anti-nociceptive effects of buprenorphine between male and female mice. This research is clinically relevant for efforts to understand the mechanisms contributing to increased reports of pain that are associated with obesity. Emily Paulus is a rising M2 medical student at ETSU Quillen College of Medicine. This summer she worked in the research lab of Michael Karlstad, PhD in the Department of Surgery. Her project studied the effects of bacteria on wound healing in normal and diabetic mice. Treatment and vehicle groups were given two splinted excisional wounds dorsally, and the treatment groups were inoculated with either Pseudomonas aeruginosa, Staphylococcus aureus, or Methicillin-resistant Staphylococcus aureus. The rates of healing and the comparative histochemistries were evaluated using quantitative imaging analysis. The results of her work precede the murine in vivo implementation of an atmospheric plasma applicator that has been proven to destroy biofilm formation in vitro. Generally, biofilms found on diabetic patient wounds cannot be treated topically or systemically by antibiotics, which is why many patients must resort to amputation. The overall aim of this study is to demonstrate that the atmospheric plasma applicator will be an effective therapy for biofilm-compromised wounds, which could ultimately prevent the need for amputation due to diabetic complications.

levels and development of diabetes in genetically susceptible non-obese diabetic male mice. The applied mouse model is genetically predisposed to develop Type 1 diabetes mellitus (T1DM), making it an excellent model for surveying the mechanisms and development of steroidinduced insulin resistance and its relationship to T1DM. During the first 6 weeks of the study, the mice were administered corticosterone in their drinking water to induce diabetes, and the last 4 weeks of the study will determine if a washout of corticosterone will allow the mice to recover from corticosterone-induced hyperglycemia.

Why this matters:

Research is the force behind advances in medicine. By participating in research during medical school, students are empowered to remain on the cutting edge of an evolving field while discovering new information and developing state of the art treatment methods leading to the improvement of the lives of their patients. Without research, the understanding of disease processes would remain stagnant and treatment options would fail to progress. 7


IN BRIEF »»»»»» Intraoperative Imaging with Fluoroscopy is a Useful Tool to Achieve Negative Margins After a Wire-Guided Partial Mastectomy Shannon Beierle, M.D., Research Resident in the Department of Surgery, along with advisor James McLoughlin, M.D. presented at the Tennessee Chapter meeting of the American College of Surgeons in August on intraoperative imaging with fluoroscopy. Fluoroscopy is a type of medical imaging that shows a continuous X-ray image on a monitor, much like an X-ray movie. During a fluoroscopy procedure, an X-ray beam is passed through the body. For this study, fluoroscopy was used to supplement mammography in order to identify the location of the clip and wire in a supine patient. The goal of this study was to transition young surgeons and residents to a negative margin rate consistent with senior surgeons. Negative margins indicate that no cancer cells are seen at the outer edge of the tissue that was removed. Positive margins indicate that cancer cell come to the edge of the removed tissue and more surgery is usually required. Over a 3 year period 217 patients underwent wire-guided partial mastectomy and approximately half were completed with fluoroscopic assistance. The rate of needing to return to the operating room for positive margins was equivalent between the two

groups although the size of the tissue removed was larger for the group where fluoroscopy was used. When looking at surgeon experience, the average time in practice was only 4.3 years for the surgeons using fluoroscopy as compared to 20.3 years for the surgeons who did not use fluoroscopy. Also, in concordance with current literature there was a much higher rate of needing to return to the operating room if the tumor was ductal carcinoma In situ or lobular carcinoma than for invasive ductal carcinoma. The research found that wire-guided partial mastectomies present an operative challenge to achieve negative margin rates. Intraoperative fluoroscopy does augment surgical planning and may be a bridge for young surgeons to achieve negative margin rates below national average and equivalent to experienced surgeons. The technology was limited by tumor subtype. Dr. Beierle worked with James Lewis, M.D., Elena Stewart, B.S., John Bell, M.D., and James McLoughlin, M.D. as part of her research presentation. Dr. James McLoughlin presented the data at the International Breast Cancer in Birmingham, United Kingdom on August 3rd, 2015.

Why this matters:

Finding an alternative to wire-guided partial mastectomies allows young surgeons to achieve a negative margin closer to that of an experienced surgeon. 8


IN BRIEF »»»»»»

Gerdau Knoxville Supports Amyloidosis Research

Dr. Jonathan Wall of the University of Tennessee Graduate School of Medicine (front row) accepts a $1,500 donation from Gerdau from John Miller, the company’s vice president and general manager. Also present for the check presentation are (second row, from left) Gerdau employees Ron Fritz, Don Clark, Wesley Mills, Eric Smith, Damien Rose and Gwen Reichel.

Representatives of steel recycler Gerdau’s Knoxville mill recently donated $1,500 to the University of Tennessee Graduate School of Medicine in memory of Arlan Piepho, former Gerdau Knoxville vice president and general manager. The donation, raised through the company’s third annual golf tournament held in Piepho’s honor, supports the Amyloidosis and Cancer Theranostics Program’s research team, seeking to find better treatments for primary amyloidosis, a rare and devastating disease that took Piepho’s life at age 63. “We cannot make a difference in the lives of amyloidosis patients without support from companies like Gerdau,” said Jonathan Wall, PhD, director of the Amyloidosis and Cancer Theranostics Program. “These funds

will help us to find new ways to diagnose and treat the disease.” The golf tournament was held at Egwani Farms Golf Course in Rockford and drew 44 participants. Participants included Gerdau employees, their invited guests, doctors and researchers involved in amyloidosis cases. “While health and wellness is one of the key pillars of the Gerdau’s social responsibility program, raising funds for Dr. Wall’s amyloidosis research is particularly meaningful to our team,” said Johnny Miller, vice president and general manager of Gerdau’s Knoxville steel mill. “We are honored to provide this support in Arlan Piepho’s memory.” For more information, visit http://www.gerdau.com/northamerica.

Why this matters:

Funding from outside companies can develop research for rare diseases that otherwise would not receive as much attention from the medical field. 9


IN BRIEF »»»»»»

Resident Research Day

Second place was awarded to Radiology Resident Austin Bourgeois, M.D. for his research “Improved Tumor Targeting in Liver-Directed Therapy with a Novel Antireflux Catheter.” Tied for third place was Urology Resident Kyle Basham, M.D. and Oral and Maxillofacial Surgery Resident Kipp Slocum, D.DS. Dr. Basham presented “Does Intravenous Acetaminophen Improve Percutaneous Nephrolithotomy Outcomes?” and Dr. Slocum presented “Odontogenic AmeloblastAssociated Protein Expression in Oral Squamous Cell Carcinoma of the Tongue.” First place for Case Report was Radiology Resident Chad Hruska, M.D. with “GIST Masquerading as a Solid Pseudopapillary Tumor of the Pancreas: Implications of Tyrosine Kinase Inhibitor (TKI) Therapy in Child-Bearing Women.”

The UT Graduate School of Medicine and Academy of Scholars Committee held Resident and Fellow Research Day on Wednesday, May 27, where selected resident and fellow physicians presented their original research or case study in five-minute oral presentations. A total of 40 abstracts were originally submitted for consideration and a group of reviewers selected 21 abstracts for presentation. Reviewers included Valerie Berthelier, Ph.D., Michael Karlstad, Ph.D., Ronald Lands, M.D., Dustin Osborne, Ph.D., Teresa Stephens, Ph.D., and Wesley White, M.D. The 2015 judges panel included Inga Himelright, M.D., Leonard Hines, M.D., Paul Huffstutter, M.D., Stephen Kennel, Ph.D., and Jonathan Wall, Ph.D. Vascular Fellow Ryan Buckley, M.D. received first place in Original Research for “A Poly-Herbal Dietary Supplement, Zyflamend, Inhibits Matrix Metalloproteinase Expression and Attenuates Intimal Hyperplasia in a Rodent Model of Vascular Disease.”

Why this matters:

Resident Research Day provides residents and fellows the opportunity to present new research and creates a competitive environment to generate original research material.

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IN BRIEF »»»»»»

Eric Heidel, Ph.D. Collaborates on Grant to Increase STEMM Interest to Youth in Rural Counties

Starting this fall, a new project will allow nearly every sophomore student in Campbell and Union counties to spend several weeks exploring career options in science, technology, engineering, math and medical science (STEMM). The program will engage students in activities that help them learn more about strengths and interests and explore potential barriers they may encounter in attending college as well as career options in STEMM fields. This project is made possible by a new five-year $963,000 Science Education Partnership award to UT from the National Institutes of Health. Possibilities in Postsecondary Education and Science—also known as PIPES—will aim to reduce perceived educational barriers, promote college awareness, raise knowledge of critical public health needs, and introduce STEMM-related career opportunities to students at Campbell County Comprehensive High School, Jellico High School and Union County High School, which are all located in rural areas of Appalachia.

A total of 44 percent of the state’s population lives in Appalachia, where 74 percent of adults have a high school diploma or less. In addition to student support, the project includes workshops for parents on how their children can apply to college, financial aid options and college myths. Students who come to UT in the summer will visit research labs on and off campus. They will meet with faculty and representatives in private industry as well as current undergraduate students who are enrolled in various STEMM majors. In his role as Co-PI, Eric Heidel, Ph.D. Department of Surgery, will have students shadowing him for a week at a time. This experience will give the students in this program exposure to real research and STEM type work environments. Dr. Heidel will also give classroom demonstrations on research methods and statistics. In addition to his work with students, Dr. Heidel will also be conducting the statistical analysis for the entirety of the grant project.

Why this matters:

Bridge programs between local schools and higher education give students opportunities to grow in their field of interest without barriers.

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IN BRIEF »»»»»»

From Bench to Bedside and Beyond A partnership between UT and UTMC

most [from] in my college career.’ It’s not often that you get to hear that from an undergraduate from one of your classes.” Thanks to a combination of efforts from UTMC and UT’s campuses, this course became a reality last spring, creating a unique relationship between both campuses. Professors and physicians from UT Veterinary School, School of Public Health, and Departments of Microbiology, Biochemistry Cellular and Molecular Biology, and Nutrition, taught the basics of cancers, chemotherapy, animal models, nutrition, and the epidemiology of cancer. In the second half of the class, Dr. John Bell, Director of UT’s Cancer Institute, allowed these students to shadow a diverse group of cancer healthcare providers. Students engaged with physicians, nurses, caseworkers, and healthcare providers in the fields of medical ethics, pathology, chemotherapy, pastoral care, palliative care, surgery, and social work. This type of “experiential learning” will stick with the students long after they have forgotten much of the book knowledge that so most of our classes focus on. The success of this class was a combination of small class size, a chance to experience the “real world” of cancer healthcare, and a willingness on both sides of the river to cooperate. Clearly everyone’s efforts have paid dividends in these student’s lives. Hopefully other classes at UT will provide this kind of learning and provide a transformative experience for these students.

Mitchell Goldman, M.D., Assistant Dean of Research at UT Graduate School of Medicine (GSM), initiated the Cancer Community of Scholars in 2013 that brought together faculty from GSM and the UT Knoxville campuses to coalesce around cancer collaborations. One of the first efforts that was initiated was an undergraduate class entitled Cancer Biology: From Bench to Bedside and Beyond. This small upper level class was half didactic learning and half shadowing of a variety of cancer healthcare workers at the UT Cancer Institute. Tim Sparer, Ph.D., Associate Professor in the Department of Microbiology at the University of Tennessee, is the faculty member responsible for initiating the cancer biology course. Ten students from UT were selected to participate over the period of one semester to engage in shadowing opportunities with medical professionals. Dr. Sparer has heard many positive comments from students: “’this class is quite possibly the class [that] I have learned the

Why this matters:

Positive experiences between UT students and medical professionals at UTMC help create interest in future programs, bringing both institutions together for better learning opportunities. 12


News»

Excellence and Leadership in Clinical Research: Craig Towers, M.D., Professor, Obstetrics and Gynecology

Dr. Dhand currently serves as a board member to ISAM, and he will continue in that role until he takes over his new responsibilities in 2017. Dr. Dhand joined ISAM in 1995 and has been a board member for the past four years. The organization, founded in 1970 to further research in medicine including health effects of inhaled aerosols and pulmonary drug delivery, has over 300 members from countries all over the world, including North and South America, Europe, Asia and Australia.

Dr. Osborne Chairs Preclinical Imaging Task Force

Dustin Osborne, PhD, Associate Professor, Molecular Imaging and Translational Research Program, has been appointed as Chair of the Center for Molecular Imaging Innovation and Translation’s (CMIIT) Preclinical Imaging Task Force. This task force is comprised of experts in the field of preclinical imaging and charged with creating best practices guidelines based on how to design and conduct preclinical imaging experiments; to serve as consultants on preclinical imaging issues; to develop resources for training MI lab specialists; to encourage the development of standards for image formats and management, and to develop standard protocols for imaging database management and methods.

Dr. Towers is considered the leading researcher in his department, and many residents ask for his guidance for their research projects. He has contributed to residents’ scholarly activity, and many of their projects have been accepted for publication and presentation. One of Dr. Towers’s most distinguishing research skills is the ability to identify a clinical question, design a clinical trial to answer the question, and structure a trial that is not only easy to understand but also can be completed in a timely manner. He currently has four Physicians Medical Education and Research Foundation-funded projects and more than 15 Internal Review Board trials in progress, all involving resident physicians. Larry Kilgore, M.D., Interim Chair of Obstetrics and Gynecology said, “Dr. Towers is an extremely valuable member of our department as an educator and researcher. His clinical and research expertise provide leadership for our department, including faculty, staff and residents. It is with great pleasure that I recommend him for this year’s award.”

Research Staff Win SNMMI Awards

Shelley Acuff, Clinical Research Leader, won the Society of Nuclear Medicine and Molecular Imaging Lab Professional Award from the Education and Research Foundation for Nuclear Medicine and Molecular Imaging. This award is designed to recognize developments in innovative techniques and practices by molecular imaging laboratory professionals. She was granted this award for her previous and ongoing work in molecular imaging, including patient assessments of anxiety during imaging, Post-therapy Y90 microsphere imaging, and the development of new protocols for PET/CT imaging using continuous bed motion imaging technology. Acuff and Alan Stuckey, Preclinical Research Leader, also received their third consecutive travel awards to the SNMMI conference for their presented works.

Dr. Rajiv Dhand Elected as PresidentElect to International Society for Aerosols in Medicine At the recent 20th Congress of the International Society of Aerosols in Medicine (ISAM), Rajiv Dhand, M.D., Chair of Medicine and Associate Dean for Clinical Affairs, was elected to a two-year term as president from 2017-2019.

Your Chance to Advance The people at the UT Graduate School of Medicine would be happy to discuss our research programs and how your support can help advance healthcare. For information about philanthropic giving to the UT Graduate School of Medicine Office of Research, please contact the development office at 865-305-6611 or development@utmck.edu. If you would like more information about any research programs described in this issue of Advance, please contact the UT Graduate School of Medicine’s Research Coordinator, Kristen Vandergriff, at 865-305-9749 or visit online: http://gsm.utmck.edu/research/main.cfm.

Thank you. 13


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