News – Feb 2014

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Kaplan Joins Baptist Gastroenterology Associates

LOUISVILLE Mitchell Kaplan, MD, has joined Baptist Gastroenterology Associates, part of Baptist Medical Associates, Louisville. He is board-certified in gastroenterology.

Kaufman Joins Louisville Cardiology Group

LOUISVILLE Tara Kauffman, APRN, has joined the Louisville Cardiology Group (part of Baptist Health Medical Associates) as a nurse practititioner.

Williams Named Director of UK Center for Health Services Research

LEXINGTON Dr. Mark V. Williams, the new director for the University of Kentucky Center for Health Services Research, has a clear vision for the multidisciplinary research center: Applying research to optimize care.

Williams joins UK’s continued efforts on quality improvement and outcomes research. The Center for Health Services Research (CHSR) is focused on creating, testing, and scaling next-generation solutions to improve the efficiency and effectiveness of health care delivery and the overall health of people within Kentucky and beyond. A primary objective of the center is to accelerate the discovery of new knowledge concerning clinical effectiveness and cost-effectiveness of health care delivery, particularly in rural and limited-resource settings.

Health services and outcomes research is an evolving priority area for UK. With the recruitment of Williams and his research team, UK adds significant clinical informatics expertise and depth to the bio-medical informatics capacity already housed within the UK Center for Clinical and Translational Science.

Under Williams’s leadership, the CHSR will strive to translate research findings into improved decision-making in the clinics, conference rooms and administrative offices of UK HealthCare.

Williams brings to the Center a wealth of clinical and research expertise. He most recently served as the chief of the Division of Hospital Medicine at the Northwestern University Feinberg School of Medicine in Chicago. A graduate of the University of Florida and Emory University School of Medicine, Williams completed an internship and his residency in internal medicine at Massachusetts General Hospital. He also completed postdoctoral training at the General Medicine Faculty Development Fellowship Program of the University of North Carolina – Chapel Hill, the Woodruff Leadership Academy, the Harvard Palliative Care Education Program, the Advanced Training Program in Quality Improvement at the University of Utah, and obtained a Lean Certification from Simpler Consulting Inc.

Rinker Wins Award for Paper Highlighting New Post-Mastectomy Surgery Technique

LEXINGTON The American Society of Plastic Surgeons recently awarded UK HealthCare’s Dr. Brian Rinker a “Best Paper” designation for his contribution to Plastic and Reconstructive Surgery.

The “Best Paper” awards are determined by the number of views and downloads the articles receive. Rinker’s article, “The Use of Dermal Autograft as an Adjunct to Breast Reconstruction with Tissue Expanders,” highlighted a new and safer way to reconstruct breast cancer patients following a mastectomy. As a surgeon who specializes in breast reconstruction in UK’s Division of Plastic Surgery, Rinker frequently collaborates with the UK Markey Cancer Center’s surgical oncologists to provide a full spectrum of surgical care for mastectomy patients.

“The procedure introduced in the paper is a step forward in the care of breast cancer patients, as it produces an aesthetically pleasing reconstruction with a lower risk of infection and wound healing problems,” Rinker said. “UK is the only center in the region to offer the full range of breast reconstruction procedures, including microsurgical reconstruction, and this procedure is yet another option for our patients.”

The UK Markey Cancer Center is the only National Cancer Institute-designated cancer center in Kentucky. NCI-designated cancer centers are a major source of discovery and development of more effective approaches to cancer prevention, diagnosis and treatment.

Wilcock Appointed Associate Editor of the Journal of Neuroscience

LEXINGTON Donna Wilcock, assistant professor in the University of Kentucky College of Medicine Department of Physiology and the UK Sanders-Brown Center on Aging, has been invited to join the editorial board of The Journal of Neuroscience in 2014 as an associate editor in the Neurobiology of Disease section.

Bastos-Carvalho Receives Bayer Grant

LEXINGTON Ana Bastos-Carvalho, a visiting scholar in the Ambati research group in the Department of Ophthalmology and Visual Sciences at the University of Kentucky College of Medicine, received the Global Ophthalmology Research Award from Bayer HealthCare for her research, “Mechanisms of geographic atrophy expansion in age-related macular degeneration.” http://www.bayer-ophthalmology-awards.com/html/b-about-c.html

“We are studying age-related macular degeneration (AMD), the disease responsible for most cases of legal blindness in the American elderly population”, Bastos-Carvalho said. “The project awarded by Bayer focuses on unraveling how AMD progresses, which will hopefully lead to new therapies to stop the relentless and untreatable evolution of the disease.”

In 2012, Bayer HealthCare launched the Global Ophthalmology Awards Program (GOAP) with the aim of advancing the scientific understanding and clinical management of retinal ophthalmic disorders. Bayer envisions the GOAP as a step toward making the dream of ophthalmology cures and improved treatments a reality.

Leadership Changes Announced by Cardiovascular Innovation Institute

LOUISVILLE Laman Gray, MD, a pioneer in heart disease research and the development and use of cardiovascular assist devices and artificial organs, has been named executive director of the Cardiovascular Innovation Institute. Gray will continue in his role as medical director of CII.

Roberto Bolli, MD, has been named the scientific director and Stuart Williams, PhD, has been named the director of bioficial organ research. The leadership positions were announced following a meeting of the CII Board of Directors.

In 2003 the University of Louisville and Jewish Hospital & St. Mary’s HealthCare partnered to create the CII, bringing together some of the finest minds in the field with the goal of improving the quality of life for patients with cardiovascular disease. The CII builds on the success of both organizations’ previous efforts to combat heart disease and heart failure through the development of novel treatments and therapies including adult stem cells, ventricular assist devices, artificial hearts and much more. The chair position of the CII board alternates annually between a designee of the Jewish Heritage Fund for Excellence and the University of Louisville.

Gray is internationally known as a leader in the fields of artificial hearts and circulatory support systems. He performed the first heart transplant in Kentucky in 1984. In 2001, his surgical team implanted the first fully implantable replacement heart, the AbioCor™. He served as director of University of Louisville School of Medicine’s Thoracic and Cardiovascular division for over 33 years. In 2008, he was awarded the University of Kentucky Medallion for Intellectual Achievement, which recognizes high intellectual achievement by Kentuckians.

Bolli is a leader in regenerative cardiology, the pioneering use of patient-derived cardiac stem cells to repair heart muscle damaged during a heart attack. He recently received the Research Achievement Award from the American Heart Association “for the profound and lasting impact of his extraordinary contributions to cardiovascular research.”

Williams joined the CII in 2007. His research interests have focused on medical devices, regenerative medicine and infection control. He developed and patented the first methods to use fat-derived stem cells for therapeutic use.

New Therapy at Jewish Hospital Helps Patients With Serious Stomach Disorder Linked to Diabetes

LOUISVILLE A new complication for the rapidly growing U.S. diabetes population[i] may be the significantly increased risk of gastroparesis,[ii] a serious digestive disorder which is estimated to affect five to 12 percent of the diabetes population.[iii] Jewish Hospital, part of KentuckyOne Health, is the only medical center in Louisville offering Medtronic Enterra® Therapy, the first and only FDA-approved* gastric electrical stimulation therapy indicated for use in the treatment of chronic, intractable (treatment-resistant) nausea and vomiting associated with gastroparesis of diabetic or unknown origin.

In patients with gastroparesis, a disorder in which food moves through the stomach more slowly than normal, the stomach muscles work poorly (or not at all), thus preventing the stomach from emptying properly.

Symptoms of gastroparesis include nausea and vomiting, and may include abdominal bloating and pain, lack of appetite and excessive weight loss. These symptoms prevent a person from eating normally and may lead to dehydration and malnutrition. Although there is no cure for gastroparesis, therapies like Medtronic Enterra Therapy may improve symptoms of chronic nausea and vomiting when conventional drug therapies are not effective or tolerated.

“Medtronic Enterra Therapy is an important part of the treatment landscape for my patients with gastroparesis,” said Thomas Abell, MD, director of the Jewish Hospital GI Motility Clinic and the Arthur M. Schoen, MD, chair in Gastroenterology at the University of Louisville. “Gastroparesis is difficult to manage, and given the enormity of the diabetes epidemic particularly in Kentucky additional therapeutic options to manage the symptoms associated with this disorder are critical.”

Jewish Hospital implanted its 100th temporary gastric electrical stimulation therapy device in December 2013. The temporary device is implanted first to be sure the therapy is effective before a permanent device is placed.

New UK Study Shows Potential for Targeting Aggressive Breast Cancers

LEXINGTON A new study led by University of Kentucky Markey Cancer Center researcher Peter Zhou shows that targeting Twist, a nuclear protein that is an accelerant of the epithelial-mesenchymal transition (EMT) program in human cells, may provide an effective approach for treating triple-negative breast cancer.

Published in Cancer Cell, the study found that the nuclear protein Twist acts similarly to a virus protein. Using protein purification, Zhou’s team identified that Twist interacted with a key nuclear transcription regulator BRD4. When many DNA viruses (such as papillomaviruses) enter into human “host” cells during infection, they hijack host cell machinery to replicate and synthesis their viral DNA and proteins. BRD4 is the virus’s favored molecule and is often seized by DNA papillomaviruses for gene transcription during replication and growth.

Twist uses a similar strategy to recruit BRD4 to the genomic regions that are regulated by Twist. Many of these genomic regions contain oncogenes, such as those of survival proteins, growth factors and molecules that enhance cell migration and invasion. By recruiting BRD4 to these genomic regions, Twist accelerates cell growth and invasion by “waking up” the expression of these oncogenes.

Additionally, the study showed that two BRD4 inhibitors, JQ1 and MS417, can specifically disrupt the interaction of Twist with BRD4, resulting in the suppression of invasion, stem cell-like characters and tumorigenicity of triple-negative breast cancer cells.

Jian Shi, a post-doctoral fellow at UK Markey Cancer Center, was the first author of this study, and other collaborators include UK Markey Cancer Center director Dr. Mark Evers and researchers Chi Wang and Haining Zhu. Previously, Zhou and his team have studied the role of the Snail complex — also known as the cellular “brake” in contrast to Twist’s accelerant — in the EMT program.

UK Gill Heart Institute, Whitesburg’s MCHC, ARH Cardiology Associates Join Forces to Provide Heart Care

WHITESBURG Letcher County community leaders and health care providers gathered in Whitesburg on Jan. 23 to celebrate a new partnership among Mountain Comprehensive Healthcare Corporation (MCHC), Appalachian Regional Healthcare (ARH), and UK HealthCare’s Gill Heart Institute.

Dena Sparkman, CCEO of Whitesburg ARH, welcomed more than 100 invited guests to the event held at the Pine Mountain Grill in Whitesburg. Remarks were provided by Joe Grossman, president and CEO of Appalachian Regional Healthcare; University of Kentucky Vice President for Health Affairs Dr. Michael Karpf; Mike Caudill, CEO at MCHC; Dr. Van Breeding, MCHC director of clinical affairs; and Dr. Susan Smyth, chief of cardiovascular medicine at the Gill Heart Institute.

Beginning earlier this month, ARH Cardiology Associates, in affiliation with UK Healthcare’s Gill Heart Institute, began offering cardiology services at MCHC in Whitesburg, allowing patients the ability to stay close to home for the highest quality and state-of-the art cardiovascular care.

ARH and UK HealthCare’s Gill Heart Institute joined forces last year in a collaboration aimed at improving access to UK’s expertise and resources offered by a regional academic medical center while maintaining the familiarity of community health care providers.

Mountain Comprehensive Health Corporation (MCHC), is a Federally Qualified Health Center designed to provide quality, affordable health care to the people of Letcher, Harlan, Perry, Owsley, and contiguous counties, and has been in operation since June 1971. MCHC is a non-profit Kentucky Corporation.

MCHC’s Central Office, Whitesburg Medical Clinic, Respiratory Clinic, and Wellness Center are located in Whitesburg. The Buckhorn and the Leatherwood/ Blackey Medical Clinics are located in Perry County, the Harlan Medical Clinic is in Harlan near the Harlan ARH Hospital, and the Owsley County Medical Clinic is located in Booneville. The Buckhorn, Leatherwood/Blackey and Owsley County Clinics each provide a Wellness Center for their patients. MCHC also operates 16 school-based clinics in Letcher and Perry counties.

UofL Named as One of Nine Centers in U.S. for Pulmonary Fibrosis Research

LOUISVILLE The University of Louisville is one of nine pilot sites selected by the Pulmonary Fibrosis Foundation (PFF) for its newly established Care Center Network and the PFF Patient Registry program. Rafael Perez, MD, director of the UofL Interstitial Lung Disease (ILD) program in the Division of Pulmonary, Critical Care & Sleep Disorders Medicine, will lead the UofL site.

Aimed at improving the health and quality of life of patients suffering from pulmonary fibrosis, the network and registry will help provide critical insights enabling the medical research community to develop more effective therapies, say UofL physicians involved in the initiative.

Sites were selected because of their expertise in pulmonary fibrosis patient care and research. In the network with UofL are the University of California, San Francisco, University of Chicago, University of Michigan, National Jewish Health, University of Pittsburgh, Vanderbilt University, University of Washington and Yale University.

The PFF Care Center Network will provide a standardized, multidisciplinary approach to patient care. This model of comprehensive patient care will help identify and establish best practices, determine the impact of specific interventions, and improve the quality of life of patients. The Care Center Network will incrementally expand to eventually include 40 medical centers by 2015.

The PFF Patient Registry is planned to be the largest database of PF patient records with the furthest demographic reach in the country. It will provide data essential for improving the understanding of the epidemiology, incidence, prevalence, natural history, and other clinical characteristics of P F. The registry will use consistent data-gathering methodology so that the information obtained will be useful to all clinicians and researchers seeking to better understand the disease and develop new therapies for PF.

All the pilot sites of the Care Center Network will participate in the Patient Registry. A principal investigator at each network site will work with a team of allied health professionals to enroll PF patients into the Registry. The Duke Clinical Research Institute at Duke University will host and maintain and oversee implementation of the PFF Patient Registry.

Patients needing treatment for pulmonary fibrosis should contact Perez at University of Louisville Physicians, 502-813-6500. For more information about the PFF, visit www.pulmonaryfibrosis.org.

Exhaled Breath May Help Identify Early Lung Cancer

LOUISVILLE AND ORLANDO, FL Specific compounds found in exhaled breath may help diagnose lung cancer in its early stages, according to a study released at the 50th Annual Meeting of The Society of Thoracic Surgeons.

The discovery was made when Associate Professor of Cardiovascular and Thoracic Surgery Michael Bousamra, MD, and other researchers from the University of Louisville examined patients with suspicious lung lesions.

Using a silicone microprocessor developed at UofL and a mass spectrometer, the researchers tested exhaled breath for specific volatile organic compounds (VOCs) known as carbonyls from patients with suspected lung cancer detected on computed tomography scans. The researchers then matched their findings with pathologic and clinical results.

“Although the data are preliminary, we found that patients with an elevation of three or four cancer-specific carbonyl compounds was predictive of lung cancer in 95 percent of patients with a pulmonary nodule or mass,” Bousamra said. “Conversely, the absence of elevated VOC levels was predictive of a benign mass in 80 percent of patients.”

The researchers found that elevated carbonyl concentrations returned to normal following complete resection – surgical removal – in patients who had a malignant nodule.

“Instead of sending patients for invasive biopsy procedures when a suspicious lung mass is identified, our study suggests that exhaled breath could identify which patients may be directed for an immediate intraoperative biopsy and resection,” Bousamra said.

The silicone microprocessor used in the study was developed at the University of Louisville. It was coated with an amino-oxy compound that binds to carbonyl compounds in exhaled breath.

UofL Epidemiologist Uncovers New Genes Linked to Abdominal Fat

LOUISVILLE Excess abdominal fat can be a precursor to diseases such as cardiovascular disease, type 2 diabetes, and cancer. A person’s measure of belly fat is reflected in the ratio of waist circumference to hip circumference, and it is estimated that genetics account for about 30-60 percent of waist-to-hip ratio (WHR). Kira Taylor, PhD, MS, assistant professor, University of Louisville School of Public Health and Information Sciences, and her research team have identified five new genes associated with increased WHR, potentially moving science a step closer to developing a medication to treat obesity or obesity-related diseases.

The researchers recently published their findings in Human Molecular Genetics.

The team conducted an analysis of more than 57,000 people of European descent, and searched for genes that increase risk of high waist-to-hip ratio, independent of overall obesity. They investigated over 50,000 genetic variants in 2,000 genes thought to be involved in cardiovascular or metabolic traits.

Their analysis identified three new genes associated with increased WHR in both men and women, and discovered two new genes that appear to affect WHR in women only. Of the latter, one gene, SHC1, appears to interact with 17 other proteins known to have involvement in obesity, and is highly expressed in fat tissue. In addition, the genetic variant the team discovered in SHC1 is linked to another variant that causes an amino acid change in the protein, possibly changing the function or expression of the protein.

Prior research has found that mice lacking the SHC1 protein are leaner, suggesting this molecule may have a role in metabolic imbalance and premature cell deterioration by supplying too much nutrition for normal growth and development.

Additional evidence finds SHC1 activates the insulin receptor, triggering multiple signaling events that affect fat cell growth.

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