discovery D E A N ’ S
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SPRING 2011
INSIDE THIS ISSUE
VOLUME 10, NUMBER 1
ShapingScience andMedicine
3 Partners for Discovery
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The influence of many medical school faculty members extends beyond the boundaries of the MCV Campus, particularly through their appointments to national research organizations and through the textbooks they author and edit. { }
Young Investigators
5 New Recruits
6 Research Notes
8 Anything is Possible
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Dean’s Discovery Initiative School of Medicine Development Office VCU’s Medical College of Virginia Campus P.O. Box 980022 Richmond, VA 23298-0022 A D D R ESS S E RV I C E R EQ U EST E D
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NONPROFIT ORGANIZATION U.S. POSTAGE PAID PERMIT NO. 869 RICHMOND VA
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The lists on this page represent a sample of our faculty’s contributions to science, clinical care and education. For an online list, please go to http://www.medschool.vcu.edu/community.
(continued from cover)
The medical school’s faculty has long been known for its mentoring and excellent teaching. This reputation has, in fact, been a drawing point for medical students and Ph.D. candidates. In the past three years, 52 faculty members have found a broader audience for disseminating knowledge through their textbooks, some of which have become widely adopted at other medical schools. Their service to national research organizations is also a point of pride
for the dean of the medical school, Jerome F. Strauss III, M.D., Ph.D. “These appointments are an acknowledgement by the medical and scientific communities of the contributions these individuals make to their respective areas of research and clinical expertise,” he says. “Our faculty members advise government agencies and major professional organizations. Their service in these advisory roles benefits the Commonwealth of Virginia, the nation and the world.”
ADVISORS
Faculty Holding Senior Advisory Positions with National Research Organizations Kellie J. Archer, Ph.D. associate professor of biostatistics Radiological Devices Panel of the FDA Medical Devices Advisory Committee
Harry D. Bear, M.D., Ph.D. professor and the Dr. Walter Lawrence Jr. Chair in Surgical Oncology National Surgical Adjuvant Breast and Bowel Program Foundation
James P. Bennett, Jr., M.D., Ph.D. professor of neurology and the Bemiss Chair Scientific Advisory Board, the American Parkinson Disease Association
David X. Cifu, M.D. department chair and the Herman Jacob Flax, M.D., Professor in Physical Medicine and Rehabilitation National director, U.S. Department of Veterans Affairs' PMR Program
PonJola Coney, M.D. professor of obstetrics and gynecology National Advisory Council, National Institute of Child Health and Human Development
William Dewey, Ph.D. professor and chair of pharmacology and toxicology National Council, National Institute on Drug Abuse President, Friends of NIDA
Danielle Dick, Ph.D. associate professor of psychiatry, psychology, and human and molecular genetics Committee Member, National Academy of Sciences Institute of Medicine’s “Committee on Twin Studies”
Michael Edmond, M.D., M.P.H., M.P.A. professor of internal medicine Advisory Committee, CDC's National Healthcare Safety Network
Paul B. Fisher, M.Ph., Ph.D. professor and chair of human and molecular genetics and the Thelma Newmeyer Corman Endowed Chair in Cancer Research Scientific Advisory Committee, Goldhirsh Foundation for Brain Tumor Research Scientific Advisory Board, International Institute of Anticancer Research, Athens, Greece
Andrea Ferreira-Gonzalez, Ph.D. professor of pathology Secretary of Health and Human Services’ Advisory Committee on Genetics, Health and Society
Chris Gennings, Ph.D. professor of biostatistics Chronic Hazard Advisory Panel (CHAP), the Consumer Product Safety Commission
Steven Grant, M.D. professor and Shirley Carter Olsson and Sture Gordon Olsson Chair in Oncology Research Chair, the NCI's Division of Cancer Treatment and Diagnosis Pharmacodynamic and Therapeutic Functional Working Group Co-chair, Signal Transduction Task Force of the NCI's Cancer Treatment and Evaluation Program's Investigational Drug Screening Committee
Michael Hagan, M.D., Ph.D. professor of radiation oncology
Anne-Marie Irani, M.D. professor of pediatrics and medicine and chair of the Division of Pediatric Allergy, Immunology Board of Directors, American Board of Allergy and Immunology Board of Directors, American Board of Medical Specialties Board of Directors, the American Academy of Allergy, Asthma and Immunology
Gundars Katlaps, M.D. assistant professor of cardiothoracic surgery Chair, Transplant Surgery Advisory Board of the Department of Veterans Affairs’ National Surgery Office
Susan Kornstein, M.D. professor of psychiatry • Advisory Committee on Research on Women’s Health for the NIH’s Office of Research on Women's Health
Alex Krist, M.D. associate professor of family medicine • Gastrointestinal Drugs Advisory Committee, Food and Drug Administration
Anton Kuzel, M.D. professor and the Harris-Mayo Chair in Family Medicine Board of Directors, North American Primary Care Research Group
Walter Lawrence, Jr., M.D. professor emeritus of surgery Death Review committee for the Prostate Lung Colorectal and Ovarian Screening Trial of the National Cancer Institute’s Division of Cancer Prevention
James Levenson, M.D. professor of psychiatry, medicine and surgery; vice chair of psychiatry; chairman of the Division of Consultation-Liaison Psychiatry
Lawrence B. Schwartz, M.D. professor of internal medicine and the Charles W. and Evelyn F. Thomas Chair in Rheumatology, Allergy and Immunology
Member, DSM-V Somatic Symptom Disorders Work Group
Board of Directors, Clinical Immunology Society Board of Directors, Co-Chair of Research, Asthma and Allergy Foundation of America
John E. Nestler, M.D. chair of internal medicine and the Dr. William Branch Porter Professor of Medicine Steering Committee, Specialized Cooperative Center Program in Reproduction and Infertility Research
Anand Pandurangi, M.D. professor and vice chair of psychiatry Member, Virginia State Board of Behavior Health and Developmental Services Chair, Mental Health Section, Indo-US and Global Health Care Summit, 2007-2011
John T. Povlishock, Ph.D. professor and chair of anatomy and neurobiology National Advisory Neurological Disorders and Stroke Council
Susan Roseff, M.D. professor of pathology Secretary of HHS Advisory Committee on Blood Safety and Availability
Bruce Rubin, M.D. chair of pediatrics and the Jessie Ball duPont Professor Board of Trustees, American Respiratory Care Foundation Advisory Committee on Blood Safety and Availability, Secretary of Health and Human Services Board of Medical Advisors, American Association for Respiratory Care
National Director of Radiation Oncology Services, Veterans Administration
Faculty Authors and Editors of Medical Texts of the Past Three Years Pasquale J. Accardo, M.D., and Barbara Y. Whitman, Ph.D. (Eds.), with Jennifer A. Accardo, M.D., Joann N. Bodurtha, M.D., M.P.H., Anne Farrell, Ph.D., Toni Goelz, P.T., Jill Morrow-Gorton, M.D., Gale B. Rice, Ph.D., Ginger Smith, M.Ed.
David Cifu, M.D., Cory Blake
Dictionary of Developmental Disabilities Terminology, 3rd Edition; Paul H. Brookes Publishing; 2011.
David Cifu, M.D., Deborah Caruso, M.D.
Bruce K. Shapiro, M.D., Pasquale J. Accardo, M.D. (Eds.)
Joan Serra Hoffman, Lyndee Knox, Robert Cohen, Ph.D. (Eds.)
Cardiovascular MRI in Practice, 2nd printing; Springer; 2008.
Neurogenetic Syndromes: Behavioral Issues and their Treatment; Paul H. Brookes Publishing; 2010.
Beyond Suppression: Global Perspectives on Youth Violence; Praeger; 2010.
Philip L. Glick, Marc A. Levitt, Michael G. Caty, Jeffrey H. Haynes, M.D., FACS, FAAP
Linda S. Costanzo, Ph.D.
Complications in Pediatric Surgery; Informa Healthcare; 2008.
Pasquale J. Accardo, M.D. (Ed.) Capute & Accardo’s Neurodevelopmental Disabilities in Infancy and Childhood, 3rd edition; Paul H. Brookes Publishing, 2008.
Overcoming Post-Deployment Syndrome: A Six-Step Mission to Health; Demos Publishing; 2011. Traumatic Brain Injury; Demos Publishing; 2010.
Physiology: Cases and Problems 3rd edition; Lippincott Williams & Wilkins; 2008.
Linda S. Costanzo, Ph.D.
David A. Gewirtz, Ph.D.; Shawn E. Holt, Ph.D., Steven Grant, M.D. Apoptosis, Senescence, and Cancer, 2nd edition; Humana Press, 2007.
John D. Grizzard, M.D., Robert Judd, Ph.D., Raymond Kim, M.D.
A. Bobby Chhabra, M.D., Jonathan E. Isaacs, M.D. Arthritis & Arthroplasty: the Hand, Wrist and Elbow; Elsevier; 2009.
Robert A. Adler, M.D. (Ed.)
Physiology 5th edition; Lippincott Williams & Wilkins, 2010.
Osteoporosis; Pathophysiology and Clinical Management, 2nd edition; Springer; 2010.
Michael J. DePalma, M.D. (Ed.)
Kent B. Crossley, Kimberly K. Jefferson, Ph.D., Gordon L. Archer, M.D., Vance G. Fowler Jr.
iSpine: Evidence-Based Interventional Spine Care; Demos Medical Publishing; 2011.
Staphylococci in Human Disease, 2nd edition; Wiley-Blackwell; 2009.
Lawrence M. Scheier, Ph.D., William Dewey, Ph.D. (Eds.)
Kenneth Kendler, M.D., Josef Parnas
The Complete Writing Guide to NIH Behavioral Science Grants; Oxford University Press; 2007.
Philosophical Issues in Psychiatry: Explanation, Phenomenology, and Nosology; The Johns Hopkins University Press; 2008.
Kenneth A. Ellenbogen, M.D., Mark A. Wood, M.D. (Eds.)
Robin M. Murray, Kenneth S. Kendler, M.D., Peter McGuffin, Simon Wessely, David J. Castle (Eds.)
Michael Molls, M.D., Peter Vaupel, Dr.Med., Carsten Nieder, M.D., Mitchell S. Anscher, M.D. (Eds.) The Impact of Tumor Biology on Cancer Treatment and Multidisciplinary Strategies; Springer; 2009.
David E. Wazer, Douglas W. Arthur, M.D., Frank A. Vicini (Eds.) Accelerated Partial Breast Irradiation: Techniques and Clinical Implementation, 2nd edition; Springer; 2009.
Stephen J. Bickston, M.D., AGAF, Richard S. Bloomfeld (Eds.) Handbook of Inflammatory Bowel Disease; Lippincott Williams & Wilkins; 2009.
Nooshin K. Brinster, M.D., Vincent Liu, MD, A. Hafeez Diwan, MD, Phillip H. McKee, MD Dermatopathology; W.B. Saunders Company; 2011.
David Chelmow, M.D. (Ed.) eMedicine: Obstetrics and Gynecology.
Cardiac Pacing & ICDs, 5th edition; Wiley; 2008.
Kenneth Ellenbogen, M.D., Angelo Auricchio, M.D., Ph.D. (Eds.) Pacing to Support the Failing Heart; Wiley; 2008.
Kenneth Ellenbogen, M.D., Bruce L. Wilkoff, MD, G. Neal Kay, MD, Chu Pak Lau
Joel J. Silverman, M.D. professor and chair of psychiatry Chairperson, American Psychiatry Association Workgroup on Psychiatric Evaluation of Adults APA Work Group on Initial Evaluation Guidelines
Jerome F. Strauss III, M.D., Ph.D. professor of obstetrics and gynecology, dean of the School of Medicine Board of Scientific Counselors, National Institute of Child Health and Human Development External Clinical Advisory Council, National Institute of Environmental Health Sciences Chair of the Board of Directors, Burroughs Wellcome Fund Co-Chair, Indo-U.S. Working Group on Reproductive Health
Richard Wenzel, M.D. professor of internal medicine • National Research Advisory Council, Department of Veterans Affairs
Steve Woolf, M.D., M.P.H. professor of family medicine Advisory Panel on Research, Association of American Medical Colleges Center for the Study of the Presidency and Congress’ Commission on U.S. Federal Leadership in Health and Medicine
Daniel Laskin, D.D.S., Omar A. Abubaker, D.M.D., Ph.D. (Eds.)
Joseph L. Izzo, M.D., Domenic Sica, M.D., Henry R. Black, M.D. (Eds.)
Decision Making in Oral and Maxillofacial Surgery; Quintessence Publishing; 2007.
Hypertension Primer, The Essentials of High Blood Pressure, 4th edition; Lippincott Williams & Wilkins; 2007.
Stephen J. Ferrando, M.D. (Author, Ed.), James L. Levenson, M.D., James A. Owen, M.D. (Eds.)
Jerome F. Strauss III, M.D., Ph.D., Robert L. Barbieri, M.D.
Clinical Manual of Psychopharmacology in the Medically Ill; American Psychiatric Publishing, Inc.; 2010.
Yen and Jaffe’s Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management, 6th edition; Saunders; 2009.
James L. Levenson, M.D. (Ed.)
Norbert Voelkel, M.D., Sharon Rounds
Textbook of Psychosomatic Medicine, 2nd edition; American Psychiatric Publishing, Inc.; 2010.
The Pulmonary Endothelium, Function in Health and Disease; Wiley; 2009.
Norbert Voelkel, M.D., William Macnee, M.B.Ch.B., M.D.
James Levenson, M.D., D.F. Gitlin, Cathy Crone, M.D. (Eds.) Psychiatric Clinics of North America: Psychosomatic Medicine; Elsevier; 2007.
Evanthia Diamanti-Kandarakis, M.D., Ph.D., E.; John E. Nestler, M.D., Dimitrios Panidis, M.D., Ph.D., Renato Pasquali, M.D. (Eds.) Insulin Resistance and Polycystic Ovarian Syndrome; Pathogenesis, Evaluation and Treatment; Springer; 2007.
Chronic Obstructive Lung Diseases 2; BC Decker, Inc.; 2008.
Colleen A. Thoma, Ph.D., Paul Wehman, Ph.D., with invited contributors Getting the Most Out of IEPs: An Educator’s Guide to the Student-Directed Approach; Paul H. Brookes Pub. Co.; 2010.
Paul Wehman, Ph.D., Marcia Datlow Smith, Ph.D., Carol Schall, Ph.D.
Janet P. Niemeier, Ph.D., ABPP, Robert Karol Overcoming Grief and Loss after Brain Injury; Oxford University Press; 2010.
Autism & the Transition to Adulthood: Success Beyond the Classroom; Paul H. Brookes Pub. Co.; 2009.
Janet P. Niemeier, Ph.D., ABPP, Robert Karol
Paul Wehman, Ph.D.
Therapists’ Guide to Overcoming Grief and Loss after Brain Injury; Oxford University Press; 2010.
Essentials of Transition Planning; Paul H. Brookes Pub. Co.; 2011.
Richard P. Wenzel, M.D., M.Sc., Gonzalo Bearman, M.D., M.P.H., Timothy F. Brewer, M.D., M.P.H., Jean-Paul Butzler, M.D., Ph.D. (Eds.)
Jonathan Flint, Ralph J. Greenspan, Kenneth S. Kendler, M.D.
J. V. (Ian) Nixon, M.D., Gerard P. Aurigemma, Ann F. Bolger, Michael H. Crawford, Gerald F. Fletcher, Gary S. Francis, Thomas C. Gerber, Welton M. Gersony, Peter Ott, Linda A. Pape, Nanette K. Wenger (Eds.)
How Genes Influence Behavior; Oxford University Press, 2010.
The AHA Clinical Cardiac Consult, 3rd edition; Lippincott Williams & Wilkins; 2010.
Guide to Infection Control in the Hospital, 4th Edition; International Society for Infectious Diseases; 2008.
Susan Kornstein, M.D., A. H. Clayton
Alice S. Pakurar, Ph.D., John W. Bigbee, Ph.D.
Shoei K. Stephen Huang, M.D., Mark A. Wood, M.D.
Psychiatric Clinics of North America: Women’s Mental Health; Elsevier; June 2010.
Catheter Ablation of Cardiac Arrhythmias, 2nd edition; Elsevier; 2010.
Essential Psychiatry 4th Edition; Cambridge University Press; 2008.
Clinical Cardiac Pacing, Defibrillation, and Resynchronization Therapy, 4th edition; Saunders; 2011.
Jeffrey S. Kreutzer, M.D., John DeLuca, Bruce Caplan (Eds.)
Digital Histology: An Interactive CD Atlas with Review Text, 2nd edition; Wiley, John & Sons, Inc.; 2009.
Adekunle M. Adesina, Tarik Tihan, Christine E. Fuller M.D., Tina Young Poussaint (Eds.)
Encyclopedia of Clinical Neuropsychology; Springer; 2011.
John M. Pellock, M.D., Blaise F.D. Bourgeois, M.D., and W. Edwin Dodson, M.D. (Eds.)
Atlas of Pediatric Brain Tumors; Springer; 2010.
Anton J. Kuzel, M.D., John D. Engel
Pediatric Epilepsy-Diagnosis and Therapy, 3rd edition; Demos Medical Publishing; 2007.
Restoring Primary Care; Reframing Relationships and Redesigning Practice; Radcliffe Publishing; 2011.
Lei Xi, M.D., Tatiana V. Serebrovskaya (Eds.) Intermittent Hypoxia: From Molecular Mechanisms to Clinical Applications; Nova Science Pub, Inc.; 2010.
Robert K. Schneider, M.D., FACP, James L. Levenson, M.D. (Eds.) Psychiatry Essentials for Primary Care; American College of Physicians; 2007.
TEXTBOOKS discovery D E A N ’ S
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PARTNERS FOR DISCOVERY Jeffrey Kreutzer, PhD, ABPP, FACRM The Rosa Schwarz Cifu Professor in Cancer Rehabilitation in the Department of Physical Medicine and Rehabilitation Director, Virginia Commonwealth Traumatic Brain Injury Model System of Care 2010 recipient of the Distinguished Lifetime Contribution to Neuropsychology Award from the National Academy of Neuropsychology
by: Jill Adams People who sustain traumatic brain injury experience dramatic changes in their lives, as do their families. Jeffrey Kreutzer, Ph.D., who directs the medical school’s program in rehabilitation psychology and neuropsychology, knows how important it is to take time with patients and their families to address changes in physical abilities, psychological demeanor and daily living issues. “Medicine has done a great job at keeping these people alive,” Kreutzer says of people with brain injuries, whether from car accidents or gun shot wounds, neurodegenerative diseases or growing tumors. “But often, they are unable to work and they experience psychological disorders. A big part of what I do is to help them identify ways to get back to work and to lead emotionally healthy lives — lives worth living.” Now thanks to an endowed professorship in the medical school, Kreutzer has more time to help more people affected by brain injury. In 2009, Kreutzer was named to the Rosa Schwarz Cifu Professor in Cancer Rehabilitation in the Department of Physical Medicine and Rehabilitation. The endowed professorship guarantees Kreutzer the time to pursue work that goes beyond his patient care and teaching duties. In the past two years, he has used that allocation of time to focus on scholarly work and to share the programs he’s developed on the MCV Campus with the wider world. Kreutzer has just completed putting together the largest reference book ever compiled in the neuropsychology field. The Encyclopedia of Clinical Neuropsychology is a four-volume, 2,700-plus page tome that he hopes will become the go-to text in the field. In addition, he is spending time traveling and talking to others about some of the programs he’s developed in his nearly 30 years at VCU. The most recent is a family intervention program that helps families of brain-injured patients learn about brain injury and practice communication and problem-solving skills so that they can function in a healthy way. “Family members of brain-injured patients can feel quite lonely, even though they’re together,” Kreutzer says. “Our program helps them understand their feelings and stimulates ways to talk about them.” Kreutzer travels around the continent conducting trainings of the Brain Injury Family Intervention for health care professionals, as well as for patients and their families. The program combines education with counseling to address emotional, behavioral and cognitive changes that occur with brain injury. Earlier programs developed by Kreutzer and his VCU colleague Paul Wehman, Ph.D., include an employment program, which has since become the standard of care to help patients return to the workforce,
and a program to address depression, a too-common and debilitating outcome of brain injury. Kreutzer has received prestigious recognition from other organizations for his work in rehabilitation of brain-injured patients. Last fall the National Academy of Neuropsychology honored him with their Distinguished Lifetime Contribution to Neuropsychology Award. No one is happier to see Kreutzer benefitting from the endowed professorship than his department chair, David Cifu, M.D., who holds the Herman J. Flax, M.D. Professorship of PM&R. Together with his wife, brothers and father, Cifu set up the endowment to memorialize his mother, Rosa Schwarz Cifu, who was a cancer nurse for 30 years and received medical care at the VCU Medical Center. The motivation behind the endowment was to support a faculty member in rehabilitation, much the way his mother supported the recovery of so many patients. In fact, the PM&R department got its start in 1949, with the support of a gift from Bernard Baruch in honor of his father and Civil War surgeon Simon Baruch, M.D., making it one of the oldest departments in the country. “Patients with disability and pain can be helped to return to activity and productivity with compassionate medical services, therapeutic exercise, medications, education and training, health and life coaching, and psychologic support and care,” Cifu says. Psychologists like Kreutzer are a critical component of the interdisciplinary field of rehabilitation medicine. “Jeff Kreutzer is an internationally-recognized leader in research, teaching and clinical care," Cifu says. "I felt it was appropriate to provide dedicated funding so he could carve out time to teach people about his work.”
Young Investigators b y : J I L L A DA M S
Meet junior faculty members whose work is attracting recognition in their fields
Charles Chalfant, Ph.D., an associate professor of biochemistry and molecular biology, has built a high-profile research program around two recently identified players in inflammation. In recognition of his work, the American Society of Biochemistry and Molecular Biology has awarded Chalfant with the Aventi Young Investigator Award in Lipid Research. The award honors outstanding research contributions by young investigators with no more than 15 years of experience. Inflammation is a complex process that includes a whole host of biochemical and cell signaling processes, which interact in complex ways to coordinate the body’s response to injury. Chalfant’s work focuses on a lipid called ceramide-1-phosphate and the enzyme responsible for its synthesis, ceramide kinase. “The lipid itself and the enzyme were described in 1989,” Chalfant says, but only recently — and based in large part on his work — have their functions been revealed. Chalfant has systematically shown how key these molecules are in the inflammatory response. They stimulate a massive buildup of local hormones known as eicosanoids, which serve a wide range of functions including pain, fever, tissue growth, blood clotting and immune regulation. Chalfant’s research could lead eventually to novel treatments for inflammation. There’s certainly a need for alternatives to aspirin and ibuprofen, as the most recent ones, the COX-2 inhibitors, have been hampered by serious side effects. Chronic inflammation is also implicated in such diseases as arthritis, cancer, Alzheimer’s disease and asthma.
Antonio Abbate, M.D., assistant professor of internal medicine, is interested in preventing the development of heart failure after heart attacks. Heart attacks cause injury to cardiac tissue and the body responds with an influx of immune cells and signaling molecules, which set the stage for healing. However, this inflammatory response also can create a second wave of injury. Abbate is investigating whether blunting the immune response might prevent the secondary damage of heart attacks, which results in a too-large, poorly pumping heart. He uses a drug that blocks the powerful immune mediator interleukin-1 and has found positive results in cell and animals studies. That was enough to test the drug – called anakinra and currently approved for rheumatoid arthritis – in a small clinical study. “The study was limited to 10 patients, but was very interesting,” Abbate says. Patients who received the drug had less cardiac enlargement at three months. Abbate plans to use the AHA grant to enroll more patients in his study.
Two medical school faculty members who are working to translate basic research into clinical medicine have received prestigious grant awards from the American Heart Association. The National Scientist Development Grant Program provides four years of support, about $300,000 total, to highly promising young scientists to help them build strong research programs and independent careers.
Fadi N. Salloum, Ph.D., assistant professor of internal medicine and physiology and biophysics, also studies the consequences of heart attack – specifically, the damage that can occur when the heart is reperfused with oxygenated blood. Reperfusion injury occurs, Salloum says, because the reintroduction of oxygen following ischemia causes a surge in free radicals, which can cause cells in the heart to die. “And what we know about heart muscle cells is that they poorly rejuvenate,” he says. Salloum is investigating a cell-signaling pathway thought to protect the heart through its generation of hydrogen sulfide, a molecule that plays an important role in biological processes. He can activate the pathway using drugs commonly prescribed for erectile dysfunction. In animal models of ischemia and reperfusion injury, the drug Cialis has produced excellent cardioprotective results. He is planning on testing the drug on cells obtained from heart failure patients following transplant. Salloum credits the VCU community for nurturing his work to this point. “The research environment is excellent, especially under the mentorship of Dr. Rakesh C. Kukreja, Virginia’s Scientist of the year in 2010,” Salloum says. At the Pauley Heart Center, clinicians, physician scientists and scientists all work together. “Ideas that start in the lab, when they show promise, have a good chance of being tested clinically.” Abbate agrees, saying he’s had lots of support in the form of internal funds and protected research time, as well as resources, community and expertise through the VCU Center for Clinical and Translational Research.
discovery D E A N ’ S
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by: JEN USCHER
David Chelmow, M.D. Taking the post as chair of the Department of Obstetrics and Gynecology was a good fit for Chelmow because of his broad interests. “I am a generalist in both my clinical practice and my research interests,” he says. “VCU's department is built around a large academic generalist group who provide great care and medical student and resident education.” The department also has strong clinical sections in all of the OB/GYN subspecialties. As a generalist, he feels he can work with each of the specialty sections to further grow their clinical services and expand their academic and research activities. Another goal is collaboration with other departments, for example creating a Continence and Pelvic Floor Center in collaboration with the Division of Urology. “This would give us the opportunity to conduct research together and offer even better multidisciplinary care,” he says. His research focuses on cesarean delivery techniques, particularly wound closure and the prevention of wound complications. Studies he conducted on using prophylactic antibiotics during cesarean delivery and on incision closure have contributed to widespread changes in practice. He is also the editor-in-chief of the eMedicine OB/GYN online textbook and has authored more than 65 peer-reviewed papers and review articles.
Unsong Oh, M.D. Oh joined the neurology department last summer after training for six years at the NIH as a clinical and research fellow. A graduate of VCU’s School of Medicine, he says he is pleased to be back on the MCV Campus. “The environment in our department is very supportive for physician-scientists,” he says. Oh examines inflammatory responses involved in multiple sclerosis and participates in clinical studies of therapies that modulate these responses. He recently received a K12 Career Development Award from the NIH to pursue a new research direction. “I’ll be investigating neurodegenerative mechanisms that may pertain to the secondary progressive phase of MS,” he says. In addition, Oh is developing a new center for comprehensive Multiple Sclerosis care on the MCV Campus that will give patients multidisciplinary care as well as the opportunity to enroll in trials of new therapies. He will submit the center for approval and affiliation with the National Multiple Sclerosis Society within the year.
Lindsay Sabik, Ph.D. The chance to be part of a large research university and a medical center that provides care for an underserved population is part of what drew Sabik to join the Department of Healthcare Policy and Research last September. Sabik investigates issues related to healthcare spending, the effects of a lack of insurance coverage and underserved populations. Because of those interests a home base at the VCU Medical Center, the largest safety net provider in the state, is a good fit. Her work has been published in a variety of peer-reviewed journals including Health Affairs and the American Journal of Public Health. Currently, she is working on a research project with Cathy J. Bradley, Ph.D., founding chair of the Department of Healthcare Policy and Research, looking at the effects of Medicaid caseload on safety net hospitals in Virginia. Sabik is also excited to be assisting in the development of new graduate programs in her department, including a Ph.D. in healthcare policy and research. “I look forward to teaching in the program and helping to shape it,” she says.
Samuel A. Taylor, Jr., M.D. Taylor arrived last September to join a growing sleep disorders program in the neurology department to study disorders that are associated with Parkinson’s Disease and other neurodegenerative conditions. Taylor is particularly interested in REM sleep behavior disorder, a sleep abnormality in which patients physically act out their dreams and may endanger themselves and their bed partners. People who have been diagnosed with the disorder are at greater risk for developing Parkinson’s or other neurodegenerative disorders. At the medical school’s new center for the research and treatment of Parkinson’s Disease and other movement disorders, Taylor will be participating in clinical studies and in the evaluation and treatment of sleep disorders. “We’ll be working to further characterize sleep disturbances in Parkinson’s Disease and other related conditions and to develop new therapies – including medications, procedures and other interventions — to improve patients’ overall sleep quality,” he says.
RESEARCH NOTES Patent Spotlight The School of Medicine was responsible for 80 invention disclosures last year, more than half of VCU’s total invention disclosures and more than any other school or college at the university. Such creativity is fueled in part by research grants from external organizations — last year, the School of Medicine attracted its highest-ever level of funding from the National Institutes of Health. In addition, the medical school accounts for 51 percent of the university’s sponsored research awards. Naturally, inventive people stand behind the numbers and one of those is Kevin Ward, M.D., professor and director of research in the Department of Emergency Medicine and director of VCURES, the VCU Reanimation Engineering Science Center. Over the last decade, Ward has led all faculty by making 65 invention disclosures, applying for 121 patents and licensing 13 inventions to outside companies. Two of his inventions are in the FDA approval process and should be on the market this year. Moreover, these inventions are lifesavers that will affect the wellbeing of patients across the country and around the world, including U.S. military personnel in combat. Some provide non-invasive — and safer — means of measuring the body’s vital functions including intra-cranial pressure, heart venous blood pressure and the level of oxygen reaching internal organs. Often the inventions carry the names of multiple faculty members, as Ward is known for reaching across disciplines to stimulate collaboration. On one invention, Ward coordinated the ingenuity of VCU faculty in chemical engineering, anesthesiology, chemistry, emergency medicine and biochemistry. Another drew on the talents of a cardiologist, an anesthesiologist, a physiologist, a trauma surgeon and others. Ward truly believes inventing is best played as a team sport. For these achievements, Ward was presented last fall with VCU’s Billy Martin Innovation Award, the ultimate accolade for inventiveness at the research university.
$8-MILLION NIH EXTENSION Gregory A. Buck, Ph.D., professor of microbiology & immunology and director of the VCU Center for the Study of Biological Complexity VCU has won an $8-million NIH extension for its work on how microorganisms found in the vagina influence health and disease in women. The work, begun in 2009 under Buck, will be funded for an additional three years and is part of a larger nationwide study of how the human microbiome (microbes found in and on the body) affects health and disease. “We are uncovering associations that were previously unknown and unexpected but may have important implications for women’s health,” Buck said. Fifteen studies competed for extensions; VCU’s program was one of eight to win funding. Recent developments in the interrelationship between the genetic makeup of microbes and the genetic makeup of their hosts will enhance the project’s goal of improving women’s health. The research is supported by an $8-million grant from NIH. HELP FOR PREECLAMPSIA Scott Walsh, Ph.D., professor of obstetrics & gynecology and physiology & biophysics In as many as 10 percent of pregnancies, women can suffer from preeclampsia, a condition commonly associated with high blood pressure, swelling and loss of protein in the urine. At times misdiagnosed, the condition is a leading cause worldwide of sickness and death in mothers and babies. Walsh and his team have announced two important findings that might explain some of the disorder’s symptoms. They connected an increased level of an enzyme called MMP-1 in the blood vessels of pregnant women suffering from preeclampsia with the swelling and protein loss in urine that are typically associated with the condition. Additionally, an interaction between MMP-1 and a receptor called PAR-1 – which is also elevated in women with preeclampsia – results in constricted blood vessels. "Here was a totally new and novel explanation for the high blood pressure that women have in preeclampsia," Walsh said.
ETHICS OF DONOR RECRUITMENT Laura Siminoff, Ph.D., professor and chair of social and behavioral health, and the Theresa A. Thomas Memorial Foundation Chair in Cancer Prevention and Control at the VCU Massey Cancer Center Siminoff will lead a two-year study on the ethical, legal and social issues of organ donor recruitment and consent. She and her team will coordinate with the National Disease Research Interchange in Philadelphia, which is engaged in a national study to understand how genetic variation may control gene activity and its relationship to disease. The national project will establish a tissue bank with three biospecimen sources sites, each with its own tissue recruitment. Siminoff, a nationally recognized expert on health communication and decision making in organ and tissue donation, has been charged with evaluating the consent process toward developing one that maximizes the biobank's diversity and is sensitive to the cultural and ethical requirements of biobank donors. The research is supported by a $283,000-grant from the NIH. MAPPING THE DEAF BRAIN Alex Meredith, Ph.D., professor of anatomy & neurobiology Deaf individuals have supranormal peripheral vision and visual motion-detection. To find where this occurs in the brain, congenitally deaf cats were evaluated attempting to perform these visual tasks while selected parts of their brain were deactivated. Researchers found that when the auditory cortex was deactivated, the deaf cats lost their supranormal abilities. Thus, the auditory parts of the deaf brain had been reorganized to perform specific visual functions – a phenomenon that is termed cross-modal plasticity. Meredith was part of an international research team that included the Centre for Brain and Mind at the University of Western Ontario in Canada and the Medical University in Hannover, Germany. They hope their findings lead to a new generation of cochlear implants that take advantage of cross-modal plasticity in human brains. Read more in the October 10 issue of Nature Neuroscience. The research was supported by the Canadian Institutes of Health Research. PROMISING TOOL FOR FIGHTING KIDNEY CANCER Paul Dent, Ph.D., professor of neurosurgery and the Universal Corporation distinguished professor in cancer cell signaling at the VCU Massey Cancer Center, and Paul B. Fisher, M.Ph., Ph.D., professor and chair of human & DENT FISHER molecular genetics, director of the VCU Institute of Molecular Medicine and the Thelma Newmeyer Corman Endowed Chair in Cancer Research at the VCU Massey Cancer Center A novel virus-based gene therapy kills metastatic kidney cancer cells by combining the use of FDA-approved Sorafenib (Nexavar) and a gene-altered adenovirus. The adenovirus is normally one that infects the upper respiratory system but which is genetically altered to cause kidney cancer cells – and normal cells protecting the kidneys – to produce a cancer-killing protein. In mice, the protein not only stopped the growth of cancer cells at the kidney but once it had entered the blood stream also stopped the growth of a distant tumor not infected with the altered adenovirus, a process called toxic 'bystander' effect. “Adenoviral gene therapies are still very new, but they represent a potentially powerful tool in the fight against cancer,” says Fisher. He and Dent will be working next on moving the research from the laboratory to clinical trials and investigating whether the therapy may be useful in other cancers. Read more in the December 2010 issue of Cancer Biology and Therapy.
Read more in the January 2011 issue of the American Journal of Pathology.
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WHY PATIENTS AVOID CANCER SCREENINGS Resa M. Jones, M.P.H., Ph.D., assistant professor of epidemiology and community health and Massey Cancer Center member researcher
THWARTING BIRTH DEFECTS Michael A. McVoy, Ph.D., and Stuart P. Adler, M.D., both professors of pediatrics and microbiology & immunology Infection by the cytomegalovirus (CMV) is the leading cause of congenital mental retardation and non-genetic hearing loss in the United States. McVoy and Adler will work in conjunction with San Diego-based Vical, Inc., to prepare and evaluate CMV vaccines for human use. Previous studies by McVoy and Adler have identified CMV antigens that could be used for a vaccine to prevent CMV infection. A safe and highly effective CMV vaccine would be used for nearly all women of child bearing age, and its use would be even more widespread than the vaccine introduced in 2006 for preventing infection by the human papillomavirus (HPV), a primary cause of cervical cancer. ADLER
Research is supported by a grant of almost $4 million from NIH’s National Institute of Allergy and Infectious Disease. EVALUATING DELIVERY OF HEALTH CARE TO THE UNINSURED Wally R. Smith, M.D., professor of medicine, vice chair for research for the Division of General Internal Medicine, and scientific director of the VCU Center on Health Disparities Virginia Coordinated Care could prove to be a nationally replicable model of effective delivery of primary care and hospital services to eligible lowincome patients likely to be newly insured by recent health care reform. Organized in 2000, VCC is a joint effort of the VCU Health System and primary care physicians in the community. VCC was founded to both improve the health of the uninsured and eliminate unnecessary emergency department use by providing geographically close and more timely access to primary care for those in zip codes surrounding the VCU Health System. As part of a broader national evaluation, a study to evaluate VCC will compare VCC’s health delivery to the traditional safety net system. “We believe our work will provide policy makers and other health systems across the country with evidence and templates for better care for the uninsured and newly insured poor.” Smith said. The research is supported by a $1.2-million grant from U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality. PSYCHIATRY PAPER HIGHLIGHTED FOR RAPIDLY INCREASING CITATIONS John M. "Jack" Hettema, M.D., Ph.D., associate professor of psychiatry and member of the Virginia Institute for Psychiatric and Behavioral Genetics
A recent study suggested a reason why patients avoid cancer screenings: too many options. Presented with more than one method of screening for colorectal cancer, patients cited greater confusion over which one to undergo and settled the matter by choosing none of them, the study found. At least four kinds of colorectal cancer screening tests – of varying preparations, potential discomforts and costs – have been recommended, and some expert panels are recommending more options. Jones found that patients presented with more than one option were 1.6 times more likely to be confused compared to those presented with just one option, and nearly twice as likely to not follow screening recommendations. Jones will next examine various factors that might be contributing to the confusion over and ultimate rejection of colorectal cancer screening. It is important to develop an effective education strategy because, while colorectal cancer is the second leading cause of cancer death, it is far more likely to be curable when detected early. Read more in the November 2010 issue of Cancer Epidemiology, Biomarkers & Prevention. GOING HOME WITH AN ARTIFICIAL HEART Vigneshwar Kasirajan, M.D., professor and chair of cardiothoracic surgery and director of the Pauley Heart Center heart transplantation program Receiving an artificial heart used to mean being tied to a 418-pound console, but not any more. The School of Medicine has been chosen the lead institution for a 30center national clinical trial of a 13-pound Freedom® driver that fits in a backpack and allows a patient to recuperate and rehabilitate at home while awaiting a donor heart. The VCU Medical Center is leading the FDA-approved Investigational Device Exemption clinical study of the first U.S. portable driver, which powers SynCardia’s Total Artificial Heart. Kasirajan is principal investigator for the clinical trial that is designed to demonstrate whether the Freedom driver is suitable for stable artificial heart patients to safely use at home or in a step-down medical facility. Without a portable device, patients can wait months or even a year in a hospital for a suitable donor heart for transplant. The VCU Medical Center is the most active total artificial heart center in the U.S. MISSED OPPORTUNITY TO SAVE LIVES John M. Quillin, Ph.D., assistant professor of human & molecular genetics
In the world of scientific journals, citing another researcher’s study is a visible illustration of how scientists build on each others' work, according to Thomson Reuters ScienceWatch Essential Science Indicators. As it tracks these citings, Thomson Reuters pays particular attention to what it calls Fast Moving Fronts, those articles whose rates of citations are increasing most rapidly. Earlier this year, Thomson Reuters reported that a 2006 paper by Hettema was at the top of the group of publications in the Psychiatry/Psychology field that saw a rapid increase in citations from June to August 2010.
to the same cancers.
Hettema’s study examined genetic factors relating to the relationship between neurotic personality traits and clinical depression and anxiety disorders. His conclusion, based on the studies of 9,000 sets of twins, was that genetic factors of depression and anxiety substantially overlap risk factors for neurotic personality traits. Hettema said that the study could aid in the identification of genes that contribute to psychiatric disorders. “I was quite fortunate to have landed at Virginia Commonwealth University for my medical training,” he told ScienceWatch, “as that exposed me to their world-renown psychiatric genetics research program.”
Five to ten percent of cancers have a hereditary component and relatives warned in time have a better chance of remaining healthy. Though one fifth of a group of 43 dying patients studied by Quillin and his team qualified for genetic testing, none had such tests performed. Quillin also reported that patients had only a limited knowledge of genetic testing and that none of the patients had been counseled about it despite its potential benefit to their relatives. Genetic testing is most warranted for persons who develop cancer younger than age 50, have multiple cancers or who have relatives who had suffered from similar cancers.
Read more from the paper, “A population-based twin study of the relationship between neuroticism and internalizing disorders,” in the May 2006 issue of American Journal of Psychiatry.
Read more in the October 2011 issue of the Journal of Genetic Counseling.
Most terminally ill cancer patients eligible for testing that might have revealed a genetic susceptibility to cancer never received such testing. The genetic testing might have benefited relatives interested in learning if their own genetic structure showed susceptibilities
Fourth-year M.D. Student’s F Global Health Interest Takes Her to Kenya
FOURTH-YEAR MEDICAL STUDENT ESTHER JOHNSTON HAS TRAVELED TO NAIROBI FOR A FOUR-MONTH STINT DEVELOPING A PANDEMIC INFLUENZA SURVEILLANCE PROGRAM. SERVICE AND PUBLIC HEALTH HAVE BEEN IMPORTANT TO JOHNSTON THROUGHOUT HER ADULT LIFE. BECAUSE OF THAT FOCUS, SHE IS THE RECIPIENT OF THE HARRY AND ZACKIA SHAIA SCHOLARSHIP, A FOURYEAR SCHOLARSHIP AWARDED TO INCOMING MEDICAL STUDENTS WITH A DEMONSTRATED COMMITMENT TO THE COMMUNITY.
by A N N A W O O D ourth-year medical student Esther Johnston already has 10 years experience working abroad. Now she’s on another journey. In January, Johnston traveled to Nairobi, Kenya for a four-month stint developing a pandemic influenza surveillance program. Last May, the Centers for Disease Control and Prevention awarded Johnston a Hubert Global Health Fellowship. Each year since 1999, the fellowship has provided a limited number of students with the opportunity to gain public health knowledge in a global setting. Through these experiences, students establish relationships with, and receive training from, recognized experts from CDC and other national and international health agencies. While in Kenya, Johnston will collect specimens from throughout the country. Her work will include data collection and analysis, monitoring and evaluation of the project. Prior to 1994, Africa’s surveillance system for assessing the impact of influenza was unreliable and inaccurate. To address the issue, the Kenyan Ministry of Health and the U.S. Department of Health and Human Services created an International Emerging Infections Program office in Nairobi. “Getting the right medicines and the right expertise to patients who need it requires an understanding of where and what the problem is,” explained Johnston. “If we don’t perform surveillance in enough different locales then we could miss the emergence of a new and possibly more dangerous virus.” With 10 surveillance sites, Johnston’s team will work to understand the pattern of Kenya’s seasonal influenza so that appropriate prevention strategies can be designed. Studies have shown that different populations respond to vaccines in different ways, and so Johnston also will study vaccine use in Kenya during her stay. Because most vaccines for influenza are tested and approved outside Africa, that population could possibly be receiving ineffectual vaccines. As an undergraduate at UC San Diego, Johnston was drawn to global health. Each summer during college, she traveled to Ensenada, Mexico to work with a free primary care clinic. Those first trips sparked her awareness of the vast health disparities among peoples and were the beginning of many expeditions abroad. “Over the last 10 years I’ve traveled from Mexico to Charlottesville to Richmond, Guatemala, Ecuador, and Nicaragua, I’ve realized that every time I cross borders my eyes open a little more to the incredible diversity of the human experience,” said Johnston. That realization prompted Johnston to take a year off from medical school to obtain her Master’s in Public Health at Johns Hopkins University. During that time, she concentrated her work in humanitarian assistance and refugee issues as well as infectious disease. In fact, Johnston’s capstone project involved one of the refugee camps she may be working with in Kenya. She expects that in her trip, “I’ll be relying heavily on that education in monitoring and evaluation, epidemiology and biostatistics.” Isaac Wood, M.D., senior associate dean for medical education and student affairs, says that “Esther is truly a remarkable medical student who epitomizes all the qualities we seek in our graduates. Her commitment to international humanitarian causes sets the bar for all students. Esther truly upholds the dignity of human beings and their rights to have access to and receive medical care.” VCU’s School of Medicine has had a track record of students accepted into the CDC-Hubert Global Health Fellowship. Most recently, the Class of 2010’s Benita Panigrahi traveled to Gaborone, Botswana with the CDC in 2009-2010. She worked for an ongoing project on the implementation of quality assurance of rapid HIV testing. The Class of 2009’s Claire Rezba received the fellowship as well.
DEAN’S DISCOVERY REPORT | Volume 10, Number 1 The Dean’s Discovery Report is published twice a year by Virginia Commonwealth University’s School of Medicine on the Medical College of Virginia Campus. Reader comments and suggestions are welcome; please call (800) 332-8813 or (804) 828-4800, e-mail MedAlum@vcu.edu or write to P.O. Box 980022, Richmond, VA 23298-0022. The Dean’s Discovery Initiative provides an opportunity for donors to transform the research environment in the School of Medicine. Through philanthropy, alumni and friends can support the school's research endeavor in ways that traditional funding sources do not. Dean: Jerome F. Strauss III, M.D., Ph.D. Produced by the School of Medicine’s Alumni and Development Office: Associate Dean for Development, Tom Holland; Editor, Erin Lucero. Contributing Writers: Jill Adams, Brooke C. Stoddard, Jen Uscher and Anna Wood Photographers: Allen Jones, Tom Kojcsich, Mark Mitchell Photography, Stygar Group and VCU Creative Services Graphic Design: Zeigler|Dacus © Virginia Commonwealth University, 2011.
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