Download Southwestern Medicine - 2012 Annual Review

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TEN THOUSAND & COUNTING
Numbered among UTSW’s more than 10,000 medical school graduates are some
of the world’s foremost scientists, distinguished physicians, and honored educators.
TEAM TLC
12
Helping multiple sclerosis patients adjust to the disease can be just as important as providing
the cutting-edge medical care for which UT Southwestern Medical Center is known.
UNLOCKING THE MYSTERIES OF STEM CELLS
18
Groundbreaking scientific discoveries are revolutionizing the way we understand how stem cells exist
at the interface of regenerative medicine and the biological basis of disease.
ELECTRIFYING MEDICINE
28
Whether it’s telemedicine, state-of-the-art electronic medical records, or robotic surgery,
UTSW continues to stay ahead of the technology curve to improve the quality of patient care.
TEAMWORK OFFERS NEW LIFE TO TRANSPLANT PATIENTS
36
Transplant patients are surrounded by a dedicated team that provides them with the compass to guide them
through their health crises and to support them long after they leave the hospital.
THE CLINICAL FRONTIER
46
HOW A NURSERY RHYME SAVES LIVES
46
FIGHTING CANCER WHILE PRESERVING FERTILITY
47
SOLVING THE SCID PUZZLE TO HELP SICK BABIES
48
LIVING WITHOUT PAIN
50
2012 ANNUAL REVIEW
51
HIGHLIGHTS OF THE YEAR
52
FINANCIAL STATEMENT
62
GIFT REPORT
65
Articles from Southwestern Medicine and other news and information from UT Southwestern are available online at www.utsouthwestern.edu.
N
umbered among those 10,000 graduates are some of the world’s foremost
scientists, distinguished physicians, and honored educators – men and
women who have far outpaced even the bold aspirations of the community
leaders who initially envisioned a medical school that Dallas could call its own.
“It is a remarkable achievement for an institution that granted its first degree
in 1944. The sheer number underscores the importance of UT Southwestern in
preparing physicians and physician-scientists who care for the people of Texas and
beyond,” said Dr. Daniel K. Podolsky, President of UT Southwestern.
Today, more than 300 current UT Southwestern faculty members are the product
of their own medical school, including more than 50 professors, three department
chairs, seven former chairmen, and one former dean and president. The alumni
range from Nobel Prize winners to astronauts, from politicians to biotech pioneers.
Their discoveries have changed the way medicine is practiced. Their decisions
have been etched into the history books. Their curiosity has charted unknown
territories from the microbial to the celestial.
“It is humbling to be part of a community comprised of so many who are
making a difference in the state of Texas and around the world,” Dr. Podolsky said.
“It’s an exciting milestone that conveys the true magnitude of our educational
mission and, through it, impacts the lives of untold numbers of patients cared for
by our more than 10,000 physician alumni.”
Inventory of accomplishments
The inventory of alumni accomplishments covers a broad swath of medical
and cultural achievements. The Medical School has educated physicians
desperately needed for World War II and researchers who defined Gulf War
syndrome. It produced the doctors who cared for John F. Kennedy in his final
moments and the physicians who rode aboard the space flights of which
he dreamed. It trained the minds behind the invention of Gatorade and the
Nobel-winning scientific discoveries that led to lifesaving statins.
UT Southwestern alumni have written many of the foundational textbooks
that educate the latest generations of doctors, along with the latest papers on the
cutting edge of stem cell and DNA research. They peer into the invisible realms
of molecular structures to battle heart disease and cancer and track the progression
of infectious diseases across entire populations. Yet, they still hold dear the skills
needed to coax a smile from a sickly child facing the toughest of futures.
“Among our graduates are those who make scientific advances that improve the
treatment and prevention of disease, as well as the teachers of the future generations of physicians and physician-scientists serving as members of our faculty and
the faculty of many other medical schools across the country,” Dr. Podolsky said.
For the purposes of primary care education, UT Southwestern is the highestranked medical school in Texas and No. 21 in the country (out of more than 140
medical schools) according to the most recent data by U.S. News & World Report.
In the same rankings, UT Southwestern also is listed among the top 25 medical
schools in the nation in research, one of only 10 medical schools in the country
in the top 25 for both the primary care and research categories.
UT Southwestern faculty, residents, and students annually provide direct care
to nearly 100,000 hospitalized patients and oversee approximately 2 million
outpatient visits. The broad range of patient care is backed by extraordinary
science – more than 200 labs spread across the Medical Center campus provide
the building blocks for future care. Funding from federal agencies, foundations,
companies, and private donors provides more than $400 million per year for
more than 3,500 research projects that engage, inspire, and attract the next
generation of students.
CLASS OF 1983
Dr. Francisco G. Cigarroa
In 2009, Dr. Cigarroa
became the 10th Chancellor of The University of
Texas System, one of the
largest public systems of
higher education in the
nation. President George
W. Bush appointed him
to serve as a member of
the President’s Committee
on the National Medal of
Science, and President
Barack Obama appointed
him to serve as a commissioner on the White House
Initiative on Educational
Excellence of Hispanic
Americans. Dr. Cigarroa is
the first Hispanic to head
a major public university
system in the country.
Today, the magnitude of
achievement embodied in
the UT Southwestern faculty
is stunning. It includes:
E Five Nobel laureates,
more than any other medical
center in the world.
E 19 members of the National
Academy of Sciences, the most
prestigious scientific society
in America.
E 18 members of the Institute
of Medicine, the medical
component of the NAS.
E 12 Howard Hughes Medical
Institute investigators.
E 15 members of the American
Academy of Arts and Sciences.
SOUTHWESTERN MEDICINE
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Team
Patients at UT Southwestern’s multiple sclerosis center receive
more than just cutting-edge medical care. They receive help in living
TLC
better lives while they battle their debilitating disease.
To t a l L i f e C a r e
B Y
D E B O R A H
WO R M S E R
Susan Sides adored helping patients as a nurse at
Children’s Medical Center Dallas. She held increasingly responsible positions there for more than 15
years after her first episode of multiple sclerosis and
even after a 2002 stroke, all that time presenting a
brave facade.
“I hid the MS from some of my co-workers and
tried to hide it from my daughter, who was 9 when
I had the stroke. I tried to act normal, but I wasn’t
OK. I was under a lot of stress,” recalled the 46-yearold Frisco, Texas, wife, mother, and health care
professional.
Mrs. Sides and many MS patients like her have
benefited greatly over the years from Dr. Elliot
Frohman’s decision to move Dallas in 1995 as Director of the new Multiple Sclerosis Program and
Clinical Center at UT Southwestern Medical Center.
Dr. Frohman, Professor of Neurology and Neurotherapeutics and of Ophthalmology, said colleagues
across the country wondered why the former chief
resident of neurology at Johns Hopkins Hospital
would put his promising research career on hold to
concentrate on patient care, which consumed his
time for the first four years of the clinic’s existence.
“It was very clear that this was a place that was
very serious about establishing a major center for
clinical care, for research, and for education,” he said,
explaining his conviction that UT Southwestern
would help turn his dream of a comprehensive-care,
clinical-research center into reality.
SOUTHWESTERN MEDICINE
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“MS is a progressive condition, and life is progressive.” — Registered Nurse Diana Logan with MS patient Susan Sides
“For patients who are on crutches or are
wheelchair bound, it is difficult to get to
multiple doctor appointments. Even when
the area is wheelchair accessible, it can be
too exhausting for patients with low energy.
We help them cut through those barriers by
having as much care as possible in one place,”
Mrs. Logan said.
A health passport
When patients arrive at the TLC clinic,
they receive a slip of paper that becomes their
global health passport. In addition to the MS
center’s social worker, nurse practitioner, and
physician assistants, the TLC clinic also offers
a physical therapist for gait assessments and a
registered dietitian for nutritional counseling.
Like everything about MS, even its nutritional
aspects are complex: Some MS patients deal with
obesity, while MS makes others dangerously
underweight, Mrs. Logan explained.
It’s Monday, 7:30 a.m., and the first thing
Mrs. Logan does for her TLC client is to listen.
Intensely.
She begins by asking: “What does this disease
keep you from doing? What bugs you the
most?” She then carefully follows a checklist
that asks about mobility, mood, memory
problems, energy level, etc., in order to get a
comprehensive view of the patient’s condition,
problems, and possible goals.
“It really doesn’t matter how smart I think
I am or how smart any of us think we are or
what we want the patient to do,” Mrs. Logan
said, echoing one of Dr. Frohman’s oft-quoted
treatment pearls. Often by the time she’s
finished her detailed assessment, she’s changed
her mind about what the goals should be.
“What is most important is that the TLC
goals are set by the patient,” she added.
Together, Mrs. Logan and her patients
brainstorm strategies to achieve those goals.
Next, the patient takes the global health
passport to another member of the team and
the process repeats. At the end of the day, the
patient has a fully signed passport, a printout
of goals and strategies, and an appointment in
three to four months.
“They are very compassionate, and they treat
me like I’m the only person they have to worry
about,” Mrs. Sides said. “TLC is totally brilliant
because it incorporates the four things that are
very important in your life when you have MS:
treating your symptoms, your emotions, your
diet, and your physical activity.”
SOUTHWESTERN MEDICINE
15
1
UT Southwestern forges ahead with new clinical and research
technologies designed to improve the quality of patient care.
The reach of UT Southwestern Medical Center’s technological advances in patient care can be seen in
the lives of patients who have been touched by them – in the operating rooms across the Medical Center or
in clinics beyond Dallas.
Decatur, a small town of about 6,000 people located 60 miles northwest of Dallas, is where patients like
Dana Clinesmith have virtual access to UT Southwestern doctors.
“To have this technology available in Decatur near my home is huge,” Mrs. Clinesmith said, staring at a
large flat-screen monitor displaying UT Southwestern genetics counselor Sara Pirzadeh-Miller in Fort Worth.
The Decatur city councilwoman and breast cancer patient recently had her risk for cancers that could be
passed down to her two sons assessed through a state-of-the art communication system now deployed by
UT Southwestern. It enables medical partners in four counties to conduct cancer screenings and make referrals.
“It will be a big relief for me to know that we could catch any hereditary cancer risk early,” Mrs. Clinesmith said.
Cancer genetics counselors at the Harold C. Simmons Comprehensive Cancer Center in Dallas and at
UT Southwestern’s Moncrief Cancer Institute in Fort Worth are now literally linked with disparate parts of North
Texas in a project spearheaded by Dr. David Euhus, Director of the Mary L. Brown Breast Cancer Genetics
and Risk Assessment Program.
By Alex Lyda
SOUTHWESTERN MEDICINE
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Whether it’s telemedicine, phone texting
to communicate with patients, state-of-the-art
medical records, or robotic surgery, UT Southwestern continues to stay ahead of the curve
when it comes to improving the quality of
care provided to patients.
The telemedicine video suites in Parker,
Wise, Hood, and Johnson counties offer secure,
high-speed computer technology connecting
genetics counselors with patients who might
otherwise never be seen.
While the set-up may look familiar, it should
not be confused with Skype, FaceTime, or other
popular ways to communicate via the Internet
– owing to the protection of private medical information. On one end, either in Dallas or Fort
Worth, is a Simmons Cancer Center genetics
counselor. On the other, at one of the dozens of
rural partners (usually a community hospital),
are a nurse and the patient.
“I’m pretty familiar with technology, but the
patient suite is very comfortable, even for those
who aren’t used to computers,” Mrs. Clinesmith
said. “The large monitors make it feel in many
ways like the doctor is in the room with you.”
Mrs. Clinesmith’s concern about the risk of
passing cancer to her sons isn’t unreasonable.
By current estimates, at least 5 percent of all
cancers are caused by a specific inherited syndrome, and approximately 10 percent of cancers
run in families. In many families, a pattern of
Dana Clinesmith, breast cancer patient
30
Dr. David Euhus, Professor of Surgery
cancer is obvious. In others, a pattern may not
be so easily identified because the families are
small or their health history is incomplete.
On the day Mrs. Clinesmith talked with Mrs.
Pirzadh-Miller, the UT Southwestern genetics
counselor, she learned how cancer can be inherited and was given a cancer-risk analysis with a
saliva sample.
Despite the prospect of additional radiation
treatments, she plans to open a bed and breakfast near Fort Worth with the help of her sons.
“I am about to start a new business that will
involve my sons, so they need to be healthy!”
Mrs. Clinesmith said.
Most of the telemedicine architecture is
housed in the new $22 million Fort Worth
facility that the Moncrief Cancer Institute
unveiled in November 2012.
The Moncrief Cancer Institute, under the
direction of Dr. Keith Argenbright, and the
Simmons Cancer Center have partnered with
other medical facilities and cancer organizations
to provide breast cancer screenings and diagnostics to reach underserved women in 15 outlying
counties. Included in their arsenal is a high-tech
mobile mammography unit that already has
been used to screen thousands of women.
“We’re using the latest in communications
technology and our mobile resources to reach
out to diverse, rural communities – especially
those that have limited access to health care
and are most in need of services,”
Dr. Argenbright said.
G
oing mobile
improves c linical
outcomes
The ability to connect with long-distance
patients also is taking place on a mobile and
wireless level, with devices that are as ubiquitous as the iPhone.
Dr. Sumeet Teotia, Assistant Professor of
Plastic Surgery, and Dr. Roshni Rao, Associate
Professor of Surgery, for example, have shown
that text follow-ups after breast cancer surgery
can improve clinical outcomes and can help
doctors intervene more quickly in the event
of post-operative complications.
A study led by Dr. Teotia and Dr. Rao involved more than 100 women who underwent
breast reconstruction after mastectomy. They
found that text messaging – as a medium of
post-operative communication between doctors
and patients – led to greater adherence to
medical advice and improved recovery times.
“Patients said that being able to communicate with their surgeon via text helped them
feel empowered as an advocate for their own
care,” Dr. Rao said. “And women who exchanged
texts with their surgeon made significantly
fewer clinic visits and phone calls.”
National studies have shown that if patients
are empowered with all the tools necessary
for them to make informed medical decisions,
they feel in charge of their health. Patients also
feel more in charge of their care if given the
opportunity to see and manage their medical
information online.
P
roviding instant
access to patient
medical records
From the patients’ perspective, the most
visible use of technology at UT Southwestern
is when they visit their physicians. Doctors
have electronic access to their patients’ medical
records – including radiology images, laboratory
reports, clinic notes, medications, discharge
papers, and summaries of previous visits in
the UT Southwestern Health System.
UT Southwestern University Hospitals and
Clinics all use electronic medical records, an
effort that began in 2002. This commitment
was driven by an anonymous donor, who challenged the university to develop an information technology infrastructure to improve the
quality of care. Additional donations, including
a $10 million endowment from Dallas philanthropists, helped UT Southwestern become the
first major medical center in the Dallas-Fort
Worth area to implement electronic medical
records across all of its clinical practice groups,
making patient care safer and more efficient.
Electronic health records (EHRs) are able
to pull together all of a patient’s information
– from the results of the last cholesterol check
with a primary care doctor to CT scans done by
an orthopaedic specialist – in one place that is
remotely accessible by physicians.
Such an amalgamation of health care information from institutions that may be separated
by geography or from doctors who are affiliated
with different hospitals is priceless for both the
doctor and patient, said Dr.
DuWayne Willett, Professor
of Internal Medicine and
Chief Medical Informatics Officer for UT Southwestern. He is in charge
of designing the implementation of EHRs across
campus.
An accurate patient
– Dr. Roshni Rao
history, preserved digitally,
allows doctors to avoid
ordering repetitive and unneeded tests, if the
results of previous ones can be summoned in
an instant, Dr. Willett said.
For instance, trends in a heart patient’s
blood pressure and cholesterol level, identified with the help of an electronic record that
moves with the patient, can allow the cardiologist or primary care physician to prescribe
preventive medications and lifestyle changes
to reduce the patient’s chance of developing a
heart attack.
“Patients said
that being able to
communicate with their
surgeon via text helped
them feel empowered.”
SOUTHWESTERN MEDICINE
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Dr. DuWayne Willett, Professor of Internal
Medicine and Chief Medical Informatics Officer
In 2009, as part of the American Recovery
and Reinvestment Act, the White House authorized nearly $1.2 billion in grants to help health
care providers begin using electronic health
records. In 2010, Congress approved new financial incentives for hospitals that use electronic
health records and imposed penalties that will
mean decreased Medicare reimbursements for
health care institutions that fail to use electronic
health records by 2015.
The comply-or-perish pressure to overhaul
the traditional paper health records system is
being met head-on by UT Southwestern in the
adoption of an EHR system called “Epic” that
is quickly becoming the industry leader.
Far from being a static platform, the EHR
system deployed by UT Southwestern can work
behind the scenes, when a person’s medical history may seem inactive or may have undergone
slight, subtle changes that can still have a big
impact on one’s health. Epic has the capability,
because of its innovative “rules logic,” to analyze developments and new information about
a person’s symptoms, condition, or treatment
along the continuum of care and offer recommendations that support clinical decisions,
Dr. Willett said. The EHR software also can be
configured to recommend treatment plans for
patients with a specific condition, based on
evidence that such measures have proved
effective for a majority of similar patients.
And because Epic is the market leader in
EHR software, UT Southwestern can query other
institutions in the network for key information
in the patient’s file in real time, Dr. Willett said,
eliminating the need for phoning from afar and
waiting on lab results to be faxed or mailed to
the receiving doctor.
32
Within UT Southwestern, the EHR’s secure
messaging system allows instantaneous routing
of results and other messages among all of a
patient’s caregivers, promoting the “team” care
of a patient that is so crucial in today’s complex medical environment. Clinicians receiving a secure message have instant access to the
breadth of a patient’s electronic health record
so they can locate pertinent information crucial
to a medical decision – even if the patient was
seen across campus earlier the same day. Radiology images also are viewable by the physician
online shortly after they are performed.
Dr. Willett is helping extend the reach of
UT Southwestern’s EHR by working with Dr.
Ronald Peshock, Assistant Dean for Informatics,
to enable it to be the basis of research protocols,
showing that the EHR not only is useful in the
clinic, but in identifying disease trends across
patient populations in a research setting.
Using Epic data drawn from more than 400
patients at Parkland and UT Southwestern-affiliated hospitals, Dr. David Gerber, an oncologist
and Assistant Professor of Internal Medicine, is
looking at trends involving the use of CT scanning for the early detection of lung cancer.
Additionally, more than 50,000 patients
have used the Medical Center’s MyChart system
to schedule appointments, refill prescriptions,
or ask questions of their health care providers
over an encrypted, secure Internet connection.
“We’ve surrounded all aspects of patient care
with information technology,” said Suresh
Gunasekaran, Associate Vice President for Health
System Information Resources. “And we’re
consistently investing in all aspects of information technology, from patient Internet access to
supply-chain automation to how doctors take
care of patients. Any way in which we can use
new technology to support our fight against
disease allows us to tailor our therapies and keep
track of our patients’ progress in real time.”
T
ouching patients'
lives with robotic
hardware
Surgery on the high-tech da Vinci robot
housed within UT Southwestern’s robotics
teaching lab can seem like child’s play – like
building a Lego castle on a video screen. While
moving tiny blocks, it is difficult to imagine
these are the same pincers that slice through
tissue, hold artery ends together so they can
be stitched, or trim cancer from healthy tissue
with granular precision in an operating room.
Future robotic surgeons receive their training
at the state-of-the-art SCMIS (Southwestern
Center for Minimally Invasive Surgery) teaching
lab, led by Dr. Daniel Scott, Professor of Surgery,
and Dr. Robert Rege, Chairman of Surgery at
UT Southwestern. Across the Medical Center
campus, four similar da Vinci robots loom
above patients every day.
For patients like Beth Nail, whose life literally was touched by a da Vinci, the curative
power of superior surgical acumen aided by the
best technology available is unforgettable.
The 53-year-old Allen, Texas, resident and
retired nurse suffers from diverticulitis, a
chronic condition where the bulging sacs of
the intestine’s inner lining become inflamed or
infected. One evening in late July, a particularly
nasty flare-up forced her to go the hospital.
Mrs. Nail had a routine chest X-ray, required to
rule out tuberculosis before an overnight stay.
The X-ray revealed a suspicious golf ball-size
mass in her lung, possibly cancer. Doctors said
it needed to be removed as soon as possible.
“After my initial shock, I looked into my
options and realized that a thoracotomy, or a
traditional open surgery on the lungs, can be
very involved and hard to recover from,” said
Mrs. Nail, who decided to look into the advantages of robotic surgery.
Mrs. Nail and patients like her, ultimately
were convinced to come to UT Southwestern
for their treatment because of its renowned
surgeons and the technological marvel that
robotic surgical machines represent.
“When I hurried to find the best place
for robotic surgery, I kept coming back to
UT Southwestern,” she said. “And the best man
for the job was Dr. Kemp Kernstine because he
had access to the latest robots.”
Dr. Kernstine is Chief of Thoracic Surgery
at UT Southwestern. “The advantages of
robotic surgery are precision, smaller incisions,
less pain, and quicker healing times,” he said.
The surgeons’ ability to access hidden crevices
is amplified by the robot while the overall
“surgical insult” to the patient is reduced.
UT Southwestern's
da Vinci surgical robot
SOUTHWESTERN MEDICINE
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Instead of eight weeks of recovery, Mrs.
Nail was up in five weeks. She fully was able
to return to her new job as a massage therapist
shortly thereafter. (Some patients, depending
on the complexity of the surgery, can be out in
as few as two days.) After following up with Dr.
Randall Hughes, Associate Professor of Internal
Medicine, Mrs. Nail was declared cancer-free.
“The robotics team got it all, and for that
they deserve their reputation as tops in their
field. But they took a very personal approach
with me, taking the time to literally draw out
what the robot was going to do and explaining in nontechnical terms how the procedure
would work,” she said.
T
he newest
radiation
technologies
In further defining the line between healthy
and diseased tissue, surgery is not the only area
in which improving technologies are tracing the
borders as precisely as possible.
Thanks to an unprecedented technological investment that UTSW is leading in North
Texas, certain hand-in-glove approaches that
blend surgery with radiation are increasingly
offering patients a more comprehensive way
of treating their diseases.
UT Southwestern is building a mecca for
the latest in disease-fighting technologies,
designed to take the fight against cancer to
the subatomic level.
The VERO – a highly advanced stereotactic
body radiation therapy (SBRT) device and the
only one of its kind in the Western Hemisphere
– started whirring and treating patients with
its ultraprecise radiation beam in 2012. SBRT
involves multiple beams focused on a targeted
area in a three-dimensional space, similar to
the “surround sound” of a home entertainment
system, where the viewer is centrally seated.
Dr. Robert Timmerman, Professor of Radiation Oncology and Neurological Surgery, is
using SBRT to study and treat lung cancer,
34
while building on data that show a certain
tumor-inhibiting compound developed at
UT Southwestern has a heightened effect when
combined with SBRT, but not with conventional
radiation treatment.
Researchers at UT Southwestern already
have shown that the compound bavituximab
not only will inhibit the development of blood
vessels supplying a tumor, but will attack the
tumor more aggressively following treatment
with the more potent form of SBRT radiation
offered via the VERO.
In broadening its arsenal of radiation
oncology treatments, UT Southwestern is
considering the possibility of opening a stateof-the-art proton therapy center for North
Texas. Subject to future approval by the UT
System Board of Regents, the $220 million,
108,000-square-foot center would be funded
and owned by San Diego-based Advanced
Particle Therapy, and would be operated by
UT Southwestern physicians and staff.
It would feature five treatment vaults, as well
as laboratory space for researchers. The heart
of the new proton facility would be a particle
accelerator capable of speeding up protons to a
super-fast velocity – roughly 112,000 miles per
second or 60 percent of the speed of light.
As one of the most advanced radiation treatment technologies available, proton therapy
offers a more precise and aggressive approach to
destroying cancerous tumors than conventional
X-ray radiation. Proton therapy’s controlled
beam of protons can be deposited, because of
its heavier mass, on a specific target with less
collateral damage.
“A proton center here would offer patients in
the region access to the best possible treatment
options while providing us with an unparalleled
opportunity to study and apply this technology,” said Dr. Hak Choy, Chairman of Radiation
Oncology. “The precision of the proton beam
allows for unprecedented focus and intensity,
especially in kids where access can be anatomically much tighter.”
Claire Mendenhall, Director of Radiation Oncology Services;
Dr. Timothy Solberg, Professor of Radiation Oncology
P
and Radiology; and Dr. Hak Choy, Chairman of Radiation
rotecting future
generations,
near and far
Whether the healing touch is 100 miles away
or a mere 10 feet, UT Southwestern’s footprint
in technology applied to research and patient
care is growing with an intensity that points to
an even brighter future ahead.
But for patients facing an uncertain one,
caretakers can take heart in the simple wisdom
of patients themselves.
“I don’t let any preoccupations about the
future get in the way of doing the most I can
in a given day,” said Mrs. Clinesmith, who was
delighted to find she had not passed a genetic
risk for cancer to her sons.
As for Mrs. Nail, her new line of work has
proved physically demanding, but well within
her capability after her surgery.
“Being a massage therapist, sometimes
you have to put your whole weight into the
massage, to get deep into the tissue,” Mrs. Nail
said. “It turns out that I was able to do that
fairly quickly after robotic surgery.
Oncology, hold plans for the proposed proton center.
“That heavy machinery with a delicate touch
– and the people behind it – made a big difference.”
Dr. Choy holds the Nancy B. and Jake L. Hamon
Distinguished Chair in Therapeutic Oncology Research.
Dr. Kernstine holds the Robert Tucker Hayes Foundation Distinguished Chair in Cardiothoracic Surgery.
Dr. Timmerman holds the Effie Marie Cain
Distinguished Chair in Cancer Therapy Research.
Dr. Euhus holds the Marilyn R. Corrigan
Distinguished Chair in Breast Cancer Surgery.
Dr. Scott holds the Frank H. Kidd Jr., M.D.,
Distinguished Professorship in Surgery.
Dr. Rege holds the Hall and Mary Lucile Shannon
Distinguished Chair in Surgery.
SOUTHWESTERN MEDICINE
35
By Jan Jarvis and Lisa Warshaw
Carolyn Swann
“Our multidisciplinary team approach creates a close
relationship with patients, providing both cutting-edge
and patient-centered care to an increasing number of
transplant patients.”
- Carolyn Swann, Associate Vice President for Heart, Lung, and Vascular,
and Solid Organ Transplant Services
38
It was Dec. 26, and Randy Gideon was waking up from his bilateral lung transplant. Laid
up and heavily sedated in the intensive care
unit, the well-known Fort Worth architect was
surrounded by machines with tubes spilling
from his torso.
“When I came to, I had this ‘ah-ha’
conscious moment. I could breathe. I still
remember how unbelievable it felt to take a
deep breath,” Mr. Gideon said.
Just a few feet away, on the other side of
the glass window, the transplant team was
huddled. Transplant coordinator, pharmacist,
social worker, dietitian, physical therapist,
nurse, surgeon, and transplant physician
were all there discussing Mr. Gideon’s case –
just as they do for every transplant patient at
UT Southwestern Medical Center.
It takes a robust multidisciplinary team of
medical experts to save lives. In all, some 50
people envelop transplant recipients, providing the compass to guide them through their
health crises and to support them long after
they leave the hospital.
“As an academic medical center, we bring
advanced research to the bedside, benefiting
patients who come to our institution with few
remaining alternatives,” said Carolyn Swann,
Associate Vice President for Heart, Lung, and
Vascular, and Solid Organ Transplant Services.
“Our multidisciplinary team approach creates
a close relationship with patients, providing
both cutting-edge and patient-centered care to
an increasing number of transplant patients.”
UT Southwestern is nationally recognized
and repeatedly honored for its transplant
program, which is among the most comprehensive in the nation.
Its lung transplant program ranks among
the highest in one-year and three-year
survival rates after transplantation, according to the Scientific Registry of Transplant
Patients. UT Southwestern, which began its
lung transplantation program in 1990, has an
84 percent survival rate one year after surgery
and a 70 percent survival rate three years
after surgery.
And now, with established programs for
heart, lung, kidney, and liver, UT Southwestern is pushing the limits of medicine with the
recent approval for hand transplants.
Since its organ transplant program began,
hundreds of patients in end-stage organ
failure have received a second lease on life.
During their transplant journey, they are put
at the center of a world-class transplant team.
Financial coordinators help them wade
through the mountains of insurance-related
paperwork. Speech pathologists assist lungtransplant patients with re-learning to swallow
after surgery.
And then there are the team members
who work on the front lines with patients to
help ease the burden of undergoing a lifechanging surgery.
The Transplant Coordinator
The transplant coordinator is the person
who makes the call at 2 a.m. and says, “We
have an organ for you!”
Mr. Gideon nearly missed his call. His wife,
Beth, had mistakenly turned the phones on
vibrate. It was only when he heard the continuous hum of the vibration that he persuaded his
wife to check her phone. His Christmas gift had
arrived a day late.
A familiar voice was on the other end.
Although 20 minutes had passed, there was
still time for him to make it, Senior Transplant
Coordinator Melanie Alford assured him. The
couple would have to pack extra oxygen tanks
in their car just to make the drive from Fort
Worth to Dallas, but they would get there.
And Ms. Alford would be waiting to greet
them upon arrival.
Long before a transplant coordinator makes
the call announcing an organ has been located,
she already has established a special bond with
the recipient.
“From the moment we meet, we begin a
lifetime relationship,” Ms. Alford said. “We
spend long hours and long days with these
patients. It’s a labor of love.”
The transplant coordinator is the direct
point of contact, helping patients survive until
they get their organ. “Sadly, people on the waiting list can die, so we want to do everything we
can to keep that from happening,” said Laura
Restall, Senior Transplant Coordinator. The
bond strengthens when patients go home.
“We teach them how to live post-transplant,” Ms. Alford said. “Our goal is to help
patients recover as much health and vitality
as possible.”
Each patient leaves a lasting impression on
the transplant team.
“Before his transplant, there was one young
man who could barely walk across the room
without needing oxygen,” said Marcie Buford,
Senior Lung Transplant Coordinator.
“Then one day I saw him running down
the hallway. That’s when you know you’re
making a difference,” she said.
The Pharmacist
Transplant patients fight organ rejection
right from the start. Helping prevent infection and resist rejection is a balancing act that
falls in part to the pharmacists, who walk a
tightrope as patients deal with an onslaught
of medications. It takes a medicine cabinet
full of drugs to keep a person thriving
following a transplant.
“The first cup they take has 12 to 15 pills in
it,” said Dr. Sarah Wright, Transplant Pharmacist.
Lung transplant patient Randy Gideon
spends 30 minutes each week organizing his
pills into daily doses. Patients meet with the
pharmacists prior to hospital discharge to learn
what the pills look like, their purpose, dosage,
and when to take them.
“Teaching patients about their new meds is
one of my favorite things about my job,” Dr.
Wright said. “You see the panic on their face
when they’re confronted with all these pills, but
I’m able to help them become well-educated
and comfortable with their new medications.”
“We are a bridge over troubled waters. And when
the waters are the roughest, we pull out our bag
of tricks. Pick the day, we work miracles.”
- April Morgan, Transplant Social Worker
April Morgan
SOUTHWESTERN MEDICINE
39
It can get complex quickly. Pharmacists must
be aware of how all the medications interact, including over-the-counter and prescription drugs
that patients also may be taking. If a drug is not
covered by insurance, Dr. Wright will work in
conjunction with the physicians, coordinators,
and social workers to search for a less-expensive,
but equally effective alternative.
Pharmacists helped Mr. Gideon fine-tune the
dosage of the anti-rejection medication cyclosporine, which came in liquid form and must
be taken at specific times during the day. Taking
the liquid form limited his ability to go out in
public, but when he was switched to capsules,
his post-transplant life got easier.
“I still have to go out with a backpack full of
medicine, but I now can go out and watch my
son play baseball,” Mr. Gideon said.
The Social Worker
From conducting psychological assessments
to helping family members file medical-leave
paperwork, social workers are at the forefront
of patient advocacy. Need a place to stay close
“I had one patient who didn’t believe she would
ever walk again. But she did; little by little, she
got stronger.”
- Rebecca Parnell, Physical Therapist
to the hospital? Ask a social worker. Need help
with exorbitant medication costs? A social
worker can help with that, too.
“We are a bridge over troubled waters,”
said April Morgan, Transplant Social Worker.
“And when the waters are the roughest, we
pull out our bag of tricks. Pick the day, we
work miracles.”
Consider the potential liver transplant
patient who was turned down by other institutions because he was aggressive and combative.
In his most desperate moment, he turned to
UT Southwestern, where social workers proved
he deserved a second chance. He got it.
“Surgeons and physicians on the team carry
the weight of the responsibility,” Mrs. Morgan
said. “But to a family with no place to stay, no
food to eat, and a general lack of concrete resources, the care social workers provide means
just as much.”
“Surgeons and physicians carry the weight
of the responsibility on the team,” Mrs. Morgan said. “But to a family with no place to stay,
no food to eat, and a general lack of concrete
resources, the care social workers provide
means just as much.”
40
The Dietitian
What is the one food transplant patients
can’t eat?
Grapefruit. It interferes with the essential
anti-rejection medication.
For a transplant patient, a baked potato is a
healthy food choice. “It has half the potassium
a kidney patient needs for the day,” said Lynn
Henderson, Registered Dietitian.
Without a dietitian teaching patients how
to eat after a transplant, organ recipients can
easily make some dangerous choices.
Long before a transplant occurs, dietitians
are busy individualizing a nutrition plan and
helping recipients learn to make healthy
choices. When someone needs to lose or gain
weight, dieticians are there to help.
If a person’s body mass index (BMI) is too
high, a nutritionist can work with them to
lower it to an acceptable level in order to get
on the organ list.
“A lot of fat in the mid-section makes
surgery more difficult,” said Francis Dang,
Registered Dietitian.
An acceptable BMI for a lung transplant
patient is less than 30. For a heart and kidney
patient, it is less than 35. But it goes up to 40
for a liver patient. A normal BMI is between
18.5 and 24.9.
Post-transplant patients need to take dietary
precautions to counterbalance the side effects
of their medications. Increased blood pressure,
high cholesterol, and weight gain are among
the issues addressed by nutritionists.
“We help patients make better dietary
decisions,” Ms. Dang said.
Pulmonary fibrosis had ravaged Mr.
Gideon’s lungs, leaving him inactive and 40
pounds underweight. Dietitians counseled
him on weight gain measures he could take at
home, in conjunction with the exercise regimen prescribed by physical therapists.
The Physical Therapist
“When I left the hospital, I was so weak
that stepping up a curb was almost unimaginable,” Mr. Gideon said.
Like many lung transplant recipients, Mr.
Gideon had lost every shred of strength and
stamina. Not surprisingly, lung transplant
patients often are apprehensive when they
start pulmonary rehabilitation.
Sometimes they come in using a wheelchair, said Rebecca Parnell, a Physical Therapist
who works with lung transplant recipients.
“They have that scared, deer-in-the-headlights look,” she said, “But when they leave,
they are already walking a mile.”
Mrs. Parnell is firm but gentle as she teaches
patients exercises to restore their range of motion, to increase their strength, and to improve
their balance. Their bodies are not used to any
activity after months of bed rest.
“The beautiful thing about the body is that
it adapts to stress,” Mrs. Parnell said. “My job is
to stress them at a safe level.”
Patients face a lot of peaks and valleys during their journey toward recovery, but if they
don’t give up, they will be able to accomplish
their goals.
“I had one patient who didn’t believe she
would ever walk again,” Mrs. Parnell said. “But
she did; little by little, she got stronger.”
Mr. Gideon hopes that with time and hard
work, he, too, will regain his strength.
“Transplant changes you physically and
emotionally and in lots of ways you don’t realize until you’re into it,” he said. “I was really
into fly fishing, and I hope to do it again. I’ve
just got to get my stamina back and feel like I
have the strength to stand in a river or ocean.”
Rebecca Parnell, Physical Therapist
SOUTHWESTERN MEDICINE
41
UTSW transplant programs offer hope
and the chance of a new life
Multidisciplinary transplant teams have
made the difference in hundreds of
patients’ lives. Whether monitoring the
condition of a donor heart that offers
the last chance for a dying patient or
offering an amputee the opportunity
to once again caress his child’s cheek,
UT Southwestern's teams continue to
provide the best in patient care so transplant recipients can lead healthier and
more productive lives.
Heart transplant patient Stephen Lund with Dr. Joseph Mishkin
HEART TRANSPLANT
Fighting to save a life
Stephen Lund arrived at UT Southwestern wearing a birthday
hat and holding a party horn. The celebratory occasion was the first
birthday of his new heart. The 62-year-old Tyler resident first came to
UT Southwestern when doctors in his area could no longer help him.
His case was too severe.
He urgently needed a heart transplant, but his organs were failing
one by one. Doctors couldn’t put him on the waiting list for a new heart
until his vitals showed improvement.
“Everything was shutting down,” Mr. Lund said. “People were counseling my wife and our three children. They were essentially planning
my funeral.”
But his UT Southwestern doctors wouldn’t give up. They placed a
temporary left ventricular assist device (LVAD) in Mr. Lund’s chest to
ease his ailing heart and to give his other organs a chance to recover.
42
Dr. Joseph Mishkin, Assistant Professor of Internal Medicine, stayed
up 40 hours straight to monitor Mr. Lund’s progress, hoping the LVAD
would turn the state of his organs around. It did. Mr. Lund was put on
the waiting list.
Three days later, the call came. There was a heart that matched Mr.
Lund’s specifications. The problem was the donor organ appeared overstressed and not viable. But Dr. Mishkin persisted. He chose to monitor
the organ, and his patience was rewarded. Its statistics improved, making it a viable option for his patient.
“They are all an amazing group of people,” Mr. Lund said of his UT
Southwestern caregivers. “Their knowledge and their medical ability
is unrivaled. But their personal care is just as important as, or more
important than, the other.”
Said Dr. Mishkin: “This was a group effort. The entire transplant
team was fighting to save this man’s life.”
Lisa Warshaw
KIDNEY TRANSPLANT
A stroke of luck
In 2001, an accident turned into a stroke of luck for Billy
Mark Munkres.
“When I went to the doctor, he did an X-ray of my ribs and told
me I didn’t have any broken bones,” said Mr. Munkres, then 35.
“But he saw something on the kidney – I had cancer.”
Mr. Munkres, who lives in Omaha, Texas, was referred to UT
Southwestern Medical Center, where his misfortune led to a lifesaving surgery to remove his kidney. If the accident had not occurred, his cancer might have progressed. The odds of discovering
that he had von Hippel-Lindau syndrome, a genetic disorder that
causes the abnormal growth of tumors, were even more remote.
Although he recovered quickly, Mr. Munkres was warned that
the disorder likely would lead to more tumors. After a decade of
monitoring, that prediction became reality. Only this time, Mr.
Munkres would need a transplant after the removal of his remain-
ing kidney. In October 2012, he became one of a growing number
of patients at UT Southwestern to undergo a kidney transplant from
a living donor. In Mr. Munkres' case, it was someone he had known
for years.
“It was such a blessing,” he said. “Most people wait five or
six years for a kidney, but I was really fortunate to have such a
good friend.”
In some ways, Mr. Munkres’ luck goes beyond friendship. At
UT Southwestern, he found a dynamic, nationally recognized
kidney transplant program. Since 2007, there have been more
than 200 kidney transplants performed at UT Southwestern.
Physicians from UT Southwestern performed the first kidney
transplant in Texas in 1964.
“We set the bar very high,” said Dr. Jason Schwartz, Associate
Professor of Surgery. “Our goal is to be the premier program in
the region.”
Jan Jarvis
“It was such a blessing.
Most people wait five or
six years for a kidney, but
I was really fortunate to
have such a good friend.”
- Billy Mark Munkres,
kidney transplant patient
SOUTHWESTERN MEDICINE
43
Dr. Juan Arenas (second from left) with a group of medical students
LIVER TRANSPLANT
Increasing the donor pool
While she waited for a liver transplant, Kelli Lee Yonker was
admitted to St. Paul University Hospital at least a dozen times in
10 months.
“I would black out,” she said. “Toxins would build up in my
body, and I just wouldn’t wake up.”
Twice, she got the call that a liver transplant was available, only
to learn that the organ was not a match.
As her weight plunged, the school librarian held onto her belief
that she eventually would get a transplant.
On Sept. 4, 2011, she did.
“I’ve been perfectly fine ever since, but I know I would not be here
if not for the wonderful nurses and doctors at UT Southwestern,” she
said. “They were so warm and welcoming.”
44
Since 2007, the UT Southwestern transplant team has performed
more than 80 liver transplants.
One of the immediate priorities is improving organ donations
so more lives can be saved, said Dr. Juan Arenas, Chief of Surgical
Transplantation.
“Nationally, the donor pool has become very stagnant in the last
10 years,” he said. “It remains fixed, which leads to high mortality.”
Still, the outlook is positive, Dr. Arenas said.
“With the careful selection of candidates, improvements in
immunosuppressants, and new treatments, liver transplantation is
now probably the best it has ever been,” he said.
The focus will continue to be on saving lives and giving patients
such as Mrs. Yonker a second chance.
“People who see me now cannot believe the difference,” she
said. “I am very, very lucky to have found the right liver transplant
surgeons to do such a good job.”
Jan Jarvis
HAND TRANSPLANT
A life-changing option
Hands grasp a steering wheel, fix dinner, screw in a light bulb, and
perform hundreds of tasks each day.
But when someone loses a hand to an accident or illness, that’s
not what they miss most. It’s the sense of touch, said Dr. Tae Chong,
Assistant Professor of Plastic Surgery and director of the reconstructive
transplant program at UT Southwestern.
“They want to feel their baby’s face or their spouse’s hand,” he said.
Through the UT Southwestern Reconstructive Hand Transplant
Program, amputees have the opportunity to do exactly that. The
program is the first in the region to offer transplantation to those who
have lost one or both hands below the elbow.
Worldwide, more than 70 hands have been transplanted on 50
patients. UT Southwestern has set the groundwork and is ready to
join the elite group of medical centers in this country that are dedicated
to providing amputees with a life-changing option.
Having already been successful with solid organ transplants,
UT Southwestern is poised to expand with this state-of-the-art hand
program, said Dr. Rod Rohrich, Chairman of Plastic Surgery.
“Hand transplantation is in the forefront of modern medicine due to
breakthroughs in technology and immunology,” he said.
The program also meets a growing need because of injuries that
occurred during the wars in Iraq and Afghanistan.
“We have vets returning with no arms or legs due to body armor,
which saves lives but not limbs,” Dr. Rohrich said.
Dr. Rohrich holds the Betty and Warren Woodward Chair in Plastic and
Reconstructive Surgery and the Crystal Charity Ball Distinguished Chair in
Plastic Surgery.
Jan Jarvis
When someone loses a hand to an accident
or illness, that’s not what they miss most. It’s the sense
of touch. “They want to feel their baby’s face or their
spouse’s hand.”
- Dr. Tae Chong, Assistant Professor of Plastic Surgery and director of the reconstructive
transplant program at UT Southwestern
Dr. Tae Chong demonstrates a color wheel to
match skin tones.
SOUTHWESTERN MEDICINE
45
THE CLINICAL FRONTIER
(special section)
How a nursery rhyme
saves lives
By Lisa Warshaw
When the school bell rang, Derrick Ephraim’s
heart stopped beating.
The 41-year-old middle school gym teacher
suffered a heart attack in 2011.
“You never know when it is coming,”
Mr. Ephraim said. “It just snuck up on me.
I’m young and active; cardiac arrest was far
from my thoughts.”
Co-workers called 911 and performed
cardiopulminary resuscitation (CPR) as they
waited for emergency personnel. Paramedics
eventually resuscitated Mr. Ephraim, thanks in
part to techniques pioneered at UT Southwestern Medical Center.
In fact, dramatically improved survival rates
for cardiac arrest victims throughout North
Texas can be credited in part for the research
led by UT Southwestern’s Dallas-Fort Worth
Center for Resuscitation Research – part of the
Resuscitation Outcomes Consortium (ROC).
Beginning in 2008, DFW-based emergency
responders have been trained to perform a
minimally interrupted chest compression
method of CPR. This method, which performs
compressions at a specific, constant rate,
significantly improves the chances of returning
a pulse to victims following cardiac arrest.
46
Dr. Ahamed Idris, Professor of Surgery
(specializing in Emergency Medicine) and
Internal Medicine at UT Southwestern,
set out to discover whether the rate of chest
compressions used by first responders affected
the outcome of resuscitation. He found out
it does.
The study’s findings pinpoint a sweet spot
for the number of chest compressions performed each minute on cardiac-arrest victims.
“Performing chest compressions too slow
or too fast yields a substantially lower chance
of restoring a heartbeat,” Dr. Idris said.
“Research indicates that a rate of 100 to 120
chest compressions per minute is exactly where
you need to be in order to increase survival.”
Today, Mr. Ephraim is among the many
whose lives have been saved thanks in part to
this research. By training its first responders
to maintain the proper rate of chest compressions, the city of Mesquite has seen a fourfold
increase in the survival rate over a five-year
period – from 3 percent in 2006 to 12 percent
in 2011.
The city of Carrollton saw a 340 percent
increase in survival rates – from 4 percent in
2006 to 14 percent in 2011. Dallas went from
3.9 percent in 2006 to 9.4 percent in 2011 – a
141 percent increase.
Area first responders were trained on the
chest compression method, and trained again.
“We kept training them until we saw the results
we wanted,” Dr. Idris said. “Today, the results
are outstanding. I’m thrilled.”
Some paramedics use a metronome to
keep the beat. Repeatedly singing the popular
children’s nursery rhyme, “Row, Row, Row
Your Boat,” also helps keep the rate of chest
compression in the recommended sweet spot,
Dr. Idris said.
The study tracked CPR efforts by rescue
units in DFW and nine other metropolitan
areas: Seattle, Portland, Ore., San Diego,
Dallas, Milwaukee, and Pittsburgh, in addition
to three Canadian cities: Vancouver, Toronto,
and Ottawa.
Since data collection began more than
six years ago, ROC's database has compiled
information from 175,000 patients, including
20,000 from the DFW region, which includes
eight cities, 31 hospitals, six trauma centers,
and more than 5,000 first responders.
“Our research outcomes may guide the
future training of first responders. The implications of this study are destined to have global
repercussions,” Dr. Idris said.
Fighting cancer while
preserving fertility
By Jan Jarvis
Camerine Day dreamed of having two
children with her husband, Matt, a high school
biology teacher.
But in a single October afternoon, those
dreams evaporated when a Pap test showed
something suspicious. A cone biopsy in December followed, and the results turned out
to be far worse than the personal trainer ever
imagined. She had cervical cancer.
“I was 24 years old and had just gotten married,” Mrs. Day said. “It was so depressing to be
told I’d never be able to have kids.”
After her physician insisted that a hysterectomy was her only option, she turned to her
grandparents for advice. They suggested she
contact UT Southwestern Medical Center
with the hope that gynecological oncologists
there could offer an alternative to a radical
hysterectomy that would end all chances of
her ever having a child.
“All I really wanted was someone to try,”
Mrs. Day said.
She found that someone in Dr. Siobhan
Kehoe, Assistant Professor of Obstetrics and
Gynecology. Dr. Kehoe is among a small
but growing number of physicians in the
U.S. who are blazing new frontiers in fertility
preservation. Advances in fertility-sparing
procedures are allowing physicians such as
Dr. Kehoe to treat cancer while enhancing
the patient’s quality of life.
UT Southwestern is among a handful of
medical institutions in the country offering
fertility-sparing techniques for gynecological
cancer patients such as Mrs. Day.
Each year, about 12,200 women in the U.S.
are diagnosed with cervical cancer, 42 percent
of them under the age of 45. Endometrial
cancer, which typically strikes older women,
also is being diagnosed in a growing number
of younger patients, who might benefit from
fertility-sparing procedures. Among the 47,000
women in the U.S. with endometrial cancer,
about 10 percent are of child-bearing age.
A month after her diagnosis with adenocarcinoma, Mrs. Day became the first patient
at UT Southwestern to undergo a radical trachelectomy, a delicate procedure that involves
the removal of the cervix while preserving
the uterus.
Before a trachelectomy is performed, the
lymph nodes in the pelvic area are removed to
determine if the cancer has spread. If cancer
is found, a hysterectomy must be performed.
Otherwise, the surgeon removes the cervix and
part of the vagina. The uterus is then attached
to what remains of the vagina. The cervix is
replaced with a cerclage, a type of suture placed
in the lower uterus to hold any future pregnancies in place.
“It’s a challenging procedure, but these
women are so young, and this procedure allows
them to have the cancer treated appropriately
while preserving their fertility,” Dr. Kehoe said.
Being diagnosed with cancer is a shock at
any age.
For young women who want to have a
family, the loss may be compounded by the
feeling that their purpose in life is gone, said
Dr. Jeff Kendall, Associate Professor of Psychiatry at the Harold C. Simmons Comprehensive
Cancer Center.
“It’s a challenging
procedure,
but these women
are so young, and
they want to preserve
their fertility.”
—Dr. Siobhan Kehoe
SOUTHWESTERN MEDICINE
47
THE CLINICAL FRONTIER
(special section)
“We originally wanted
two kids, but after
all this, if we get just
one I’ll be so happy.”
—Camerine Day
“Cancer changes their life goals and
dreams,” he said. “It forces them to go in a different direction.”
With fertility-preserving procedures, at least
one of the challenges they face as cancer survivors is removed, Dr. Kendall said. That doesn’t
mean they don’t grapple with the same fears
that other cancer patients do, he said.
“Their life is still changed by the diagnosis,”
Dr. Kendall said. “The difference is they don’t
have to realign their goal of having a family.”
Still, other fears arise, most commonly the
concern that the more fertility-sparing treatment will put them at a greater risk for cancer
later in life.
“Most young patients want to preserve their
fertility,” Dr. Kehoe said. “But they also want to
know they’re cured.”
It doesn’t have to be an either-or decision.
Radical trachelectomy has been shown to be
just as effective as a radical hysterectomy for
women with early-stage cancer. That should
help put some women’s minds at ease when
weighing the pros and cons of the treatment.
Mrs. Day, who has been given the green
light to try getting pregnant, said she’s just
grateful for the chance.
“We originally wanted two kids, but after
all this, if we get just one I’ll be so happy,”
she said.
Solving the SCID puzzle
to help sick babies
By Jan Jarvis
Photos of beautiful babies with chubby
cheeks and bright eyes fill the office of Dr.
Maite de la Morena, Associate Professor of
Pediatrics and Internal Medicine at UT Southwestern Medical Center.
But their robust appearance sometimes
defies reality. In some cases, these are children who appear healthy at birth, but then at
around three months, get an infection.
“They get sicker and sicker and never
recover,” said Dr. de la Morena, Director of the
Jeffrey Modell Primary Immunodeficiency Center at Children’s Medical Center Dallas.
For decades, parents have buried these babies without ever knowing the reason why.
But that sad scenario is changing. Today at
UT Southwestern, a multidisciplinary team of
physicians and researchers not only has the
answer to why these babies get so sick, but it
has the expertise to save their lives. With the
addition of a new statewide screening program,
48
these babies can be diagnosed and treated before they ever get sick.
The complex puzzle known as severe combined immunodeficiency, or SCID, is no longer
the mystery it was 40 years ago. Then the only
way to dodge death was to live in a sterile container as the so-called “bubble boy” did until
his death at age 12. UT Southwestern experts
now are able to offer hope to families facing
this difficult diagnosis.
Children born with SCID have little or no
immune system to fight off illness. The most
common type of SCID is caused by a gene
found on the X chromosome and affects only
males. The first sign that something is wrong
occurs when the baby develops a common
childhood illness.
Such was case with Carter Smith, who was
the picture of health until he got diarrhea
when he was 3 months old. Severe dehydration
and fever followed. After receiving intravenous
fluids for several days at a regional medical
center, Carter did not bounce back.
By the time he was referred to Children’s
Medical Center, Carter had pneumonia and was
a very sick little boy.
“We were afraid he was going to die,” said
Pete Smith, Carter’s father.
Within a day of Dr. de la Morena seeing
Carter, a blood test confirmed the diagnosis
of SCID.
Mr. Smith said they were lucky to find
Dr. de la Morena when they did. Since SCID is
rare, experts able to diagnose it quickly are
uncommon.
“We feel like it was the grace of God that we
ended up here,” he said.
To help the Smiths make the journey from
diagnosis to treatment and ultimate recovery took a team from various disciplines that
guided the family at every step.
“When we found out what Carter had, I
thought it was imminent death,” Mr. Smith
said. “I had no idea what to do next.”
What came next was a stem cell transplant,
in which cells were taken from the bone
marrow of Carter’s mother and introduced
into the baby. The expectation is that the new
cells will rebuild the immune system, said Dr.
Andrew Koh, Assistant Professor of Pediatrics
and Microbiology in the Harold C. Simmons
Comprehensive Cancer Center.
“This is the only true remedy for SCID,”
he said.
The disease affects only 1 in 125,000 children.
By the time a child is diagnosed, he’s often too
sick for a transplant, Dr. de la Morena said.
“If a child can get a transplant when
they’re still healthy, the chances of survival and
leading a normal life are very good,” she said.
The outlook for babies with SCID is
getting brighter.
In 2012, Texas added SCID to the list of
28 diseases that all newborns in the state are
screened for at birth. A baby with an abnormal
screening test is referred to a pediatric immunologist, which in the North Texas region
would most likely be Dr. de la Morena.
By screening babies at birth, SCID can be
diagnosed before 3 months of age, when a bone
marrow transplant promises the best chance
for survival, said Dr. Franklin Fuda, Assistant
Professor of Pathology.
“After three months, you have missed that
window of opportunity,” he said. “But if you
catch it at birth, you can treat these kids in a
timely fashion, and they do very well.”
Carter was fortunate. He’s now a healthy
little boy who celebrated his fifth birthday in
October 2012.
“He’s a real success story, and a lot of it has
to do with the doctors who treated him,” Mr.
Smith said. “It was a team effort to find the
solution. I can’t say enough about this group.”
SOUTHWESTERN MEDICINE
49
THE CLINICAL FRONTIER
(special section)
Living without pain
By Russell Rian
“Pain management
has multiple goals,
but I think it really
depends on the
patient’s goal.”
—Dr. Carl Noe
50
The true toll of chronic pain isn’t revealed in
the numbers alone – 100 million adults in the
U.S. suffer from it at an estimated cost of $635
billion. The real impact comes individually,
revealed perhaps in a gasp and a grimace.
So while the pain management field continually evolves with new treatments, therapies,
and medicines, any strategy must be centered
on the patient, said Dr. Carl Noe, Director of
UT Southwestern’s Eugene McDermott Center
for Pain Management.
“Pain management has multiple goals, but
I think it really depends on the patient’s goal,”
said Dr. Noe, Professor of Anesthesiology and
Pain Management. “How the pain affects the
individual, and his or her life and livelihood, is
critical. If your small finger on a nondominant
hand hurts, that’s not the same as if you’re a
violinist, and that pain is disabling. So we tailor
treatments to the individual’s goals.”
The McDermott Center uses the latest
scientific advances and procedures to diagnose,
locate, and treat everything from back pain
to abdominal pain, foot pain to headaches.
The Center covers adult and pediatric pain
management, cancer pain management,
and interventional therapies such as minimally
invasive procedures for back pain and other
pain syndromes.
While the list of chronic and acute pains
is formidable, so is the Center’s arsenal to
quell them.
Minimally invasive options can involve painspecific nerve-block agents applied to joints
and nerves, or fully implantable, programmable
drug pumps for chronic pain that help reduce
site infections and promote independence.
Minimally invasive surgeries are done routinely in order to remove scar tissue – a process
called lysis of adhesion – and to alleviate pain
in people with back or neck problems. Other
procedures include pulse radiofrequency, which
heats and destroys nerve endings to interrupt pain messaging signals to the brain, and
vertebroplasty, a surgical cement injected into
injured or fractured spines.
Interdisciplinary programs for back pain,
chronic pain, and medication reduction have
been developed over the past two years. They
include medical pain management, behavioral
medicine, and physical therapy.
The majority of treatments at the Center are
for back pain, arthritis, headaches, and cancerrelated pain. But what sets the McDermott
Center for Pain Management apart is the
forceful combination of therapy and unique
research that provides access to the latest
techniques and technologies.
“There’s nothing like our Center,” said
Dr. Noe, who has been the author or co-author
of numerous publications in the field.
For some, pain management was often a
temporary fix to a chronic problem. But Texas
Instruments co-founder Eugene McDermott
and his family envisioned something better.
Mr. McDermott showed appreciation of
the pain management field early on with
contributions to sponsor visiting professorships, student scholarships and lectures, and
underwriting anesthesia research and the
development of monitoring equipment in
the field of anesthesiology.
“The critical contributions of the McDermotts cannot be understated. The research
and care they have underwritten have had a
substantial and tangible effect in alleviating
the pain and suffering of thousands who have
found relief at the Center over the years,”
said Dr. Charles Whitten, Chairman of Anesthesiology and Pain Management.
The McDermott Center for Pain Management was among the first facilities of its kind to
launch a coordinated attack on chronic pain by
joining multiple disciplines from the Departments of Anesthesiology and Pain Management, Physical Medicine and Rehabilitation,
and Psychiatry. It has evolved into the longest
running interdisciplinary program in the DallasFort Worth area, as well as the region’s only
endowed pain management center.
Dr. Whitten holds the Margaret Milam
McDermott Distinguished Chair in Anesthesiology
and Pain Management.
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HIGHLIGHTS OF THE YEAR
42 62
FINANCIAL STATEMENT
44 65
GIFT REPORT
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H I G H L I G H T S
of the year
FA L L
2011
QUICK USE OF
DEFIBRILLATOR
MAKES DIFFERENCE
Paramedics who deliver
defibrillator shocks within
three minutes of arriving at the
scene of a cardiac arrest can
boost survival rates in some
cases, a clinical study involving
UT Southwestern emergency
physicians revealed.
More people with a potentially fatal abnormal heart
rhythm called ventricular fibrillation survive when paramedics
perform cardiopulmonary
resuscitation while setting up
defibrillator machines, then
deliver electrical shocks within
three minutes of arrival.
The real-world findings
involved Dr. Ahamed Idris,
Professor of Emergency Medicine and Internal Medicine, and
were reported in The New
England Journal of Medicine. Dr.
Idris heads the Dallas-Fort
Worth arm of the Resuscitation
Outcomes Consortium, funded
by the National Institutes of
THE WORK OF DRS. AHAMED IDRIS AND LYNN
ROPPOLO, ASSOCIATE PROFESSOR OF
SURGERY, IS ELEVATING FIRST-RESPONSE
CARE FOR CARDIAC ARRESTS.
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Health. The consortium is a
$120 million joint U.S. - Canadian series of clinical trials
aimed at identifying the best
on-scene practices for traumas
and cardiac-arrest cases. The
Dallas-Fort Worth arm has the
highest participation in the
U.S., with about 4,500 people
enrolled annually.
Dr. Idris, a pioneer in
resuscitation research, has
helped revolutionize the list of
critical steps that paramedics
should take within a few
minutes.
RESEARCHERS SHOW
NUMEROUS MUTATIONS
led to a key
step in cancer
development
called anchorage-independent growth,
meaning cells
piled up on
top of each
DR. JERRY SHAY
other rather
than aligning neatly.
The groundbreaking investigation was selected by the
Faculty of 1000 – an international group of leading scientists
and researchers – to be recognized in the top 2 percent of
published articles in biology
and medicine.
LEAD TO COLON CANCER
UT Southwestern scientists
reported there are at least 70
genetic mutations involved in
the formation of colon cancer,
far more than previously
thought.
The researchers, led by Dr.
Jerry Shay, Professor of Cell
Biology, suggest a new approach
to colon cancer treatments –
targeting multiple genes and
pathways simultaneously.
Current cancer treatments target
just one or two known cancerdriver genes. While patients
may get transient tumor burden
reduction, tumor growth almost
always returns.
UTSW’s research contradicts
previous thinking that only a
few mutated genes are important in the development of
cancerous tumors. Under the
old model, scientists believed
there were 151 candidate genes
and that mutations in just
eight to 15 of them would lead
to cancer.
According to the investigation at UT Southwestern,
mutations to these candidate
genes play significant roles in
cancer development. Inactivating the function of any of
these tumor-suppressing genes
COMPOUND KILLS
DANGEROUS
INFLUENZA STRAIN
A compound tested by scientists at UT Southwestern destroys several viruses, including
the deadly Spanish flu that
killed an estimated 30 million
people in the worldwide pandemic of 1918.
This compound – which acts
by increasing the levels of a
human anti-viral protein –
potentially could be developed
into a new drug to combat the
flu, a virus that tends to mutate
into strains resistant to antiinfluenza drugs.
Dr. Beatriz Fontoura,
Professor of
Cell Biology,
said that while
current drugs
act on the
virus, investigators at UTSW
were working
to uplift a
DR. BEATRIZ
host/human
FONTOURA
anti-viral
response at the cellular level. In
cell testing done in New York,
the compound successfully
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HIGH HOPES POUR
INTO CLEMENTS
UNIVERSITY HOSPITAL
I n a special onsite ceremony, the
CONSTRUCTION OF THE WILLIAM P. CLEMENTS JR. UNIVERSITY HOSPITAL IS CHANGING THE
NORTH CAMPUS SKYLINE.
knocked out three types of
influenza as well as a smallpoxrelated virus and an animal
virus.
The compound is among
others that the research team is
testing that induce an infectionfighting human protein called
REDD1. The scientists discovered the protein is a key human
barrier for infection. In all, the
UT Southwestern-led research
team tested 200,000 compounds
for those that would inhibit flu
virus infection. A total of 71
were identified.
According to the National
Institutes of Health, influenza
hospitalizes more than 200,000
people in the U.S. each year,
with about 36,000 fatalities
related to the illness.
Worldwide, flu kills about
500,000 people annually.
hopes and aspirations of 1,000
UT Southwestern employees,
donors, and community
supporters were poured into the
foundation of the new University
Hospital, an $800 million stateof-the-art facility slated to open
in late 2014.
October’s foundation-laying
event commemorated a key
milestone for the construction
of the new facility, which began
in March 2011 with site preparation. The 12-floor, 460-bed
hospital is an essential step in
UT Southwestern’s strategy to
become one of the nation’s top
10 comprehensive academic
medical centers.
By late winter, UT Southwestern leaders had announced
that the new building on a
32-acre site on the southwest
side of Harry Hines Boulevard
between Mockingbird Lane and
Inwood Road will be named the
William P. Clements Jr. University Hospital. The name honors
legendary Texas Gov. William P.
Clements Jr., who died in
May 2011, in recognition of his
2009 gift of $100 million to the
Southwestern Medical Foundation, the largest single gift for
the benefit of UT Southwestern
in the institution’s history.
UTSW President Dr. Daniel K.
Podolsky said the Medical
Center was deeply honored by
Mr. Clements’ confidence,
shown through the unrestricted
gift, and “proud to name the
new hospital in commemoration of a true Texas giant,
certain that it will have the
transformational effect he
envisioned.”
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WINTER 2011-2012
ZALE LIPSHY’S
PATIENT CARE GETS
NATIONAL PRAISE
UT Southwestern was the
nation’s only academic medical
center to win two major patient
satisfaction awards – the Patient
Voice Award and the Summit
Award for inpatient services –
from Press Ganey, a national
consulting firm specializing in
health care performance.
Both awards recognized
outstanding care provided to
patients at Zale Lipshy University Hospital. Executive Vice
President for Health System
Affairs Dr. Bruce Meyer said that
the findings – through patient
feedback – reflect the consistent
excellence UTSW strives to
deliver to patients through its
team-care approach.
Press Ganey selected Patient
Voice Award winners based on
federal data that measures
patient satisfaction in areas such
as communication with doctors
and nurses, responsiveness of
hospital staff, pain management, cleanliness, and
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quietness. Winning hospitals
had to score an overall rating in
the 90th percentile or higher.
For the Summit Award,
UT Southwestern won for its
inpatient services by ranking in
at least the 95th percentile every
three months for three consecutive years. The consulting firm
evaluated data from August
2008 through July 2011. Only
37 Summit Awards were presented out of more than 1,000
eligible hospitals.
CAMPUS CROWD
CELEBRATES 5TH
NOBEL LAUREATE
The UT Southwestern
community enthusiastically
shared in a mid-December
celebration of Dr. Bruce A.
Beutler’s triumphant return
home with the 2011 Nobel Prize
in Physiology or Medicine for
his 1990s research that
identified the mammalian
receptor for innate immunity,
the body’s first response to
invasion by bacteria and other
pathogens. Dr. Beutler is the
fifth UTSW faculty member so
honored.
“We welcome Bruce back not
UT SOUTHWESTERN MEDICAL SCHOOL DEAN DR. GREG FITZ (LEFT) AND UTSW PRESIDENT DR.
DANIEL K. PODOLSKY (RIGHT) HELPED WELCOME NOBEL LAUREATE DR. BRUCE BEUTLER BACK
TO CAMPUS AFTER HIS 2011 RECOGNITION IN SWEDEN.
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for the work he has done in the
past, as proud as we are of that,
but for the work we know he’s
going to do in the future,”
UT Southwestern President Dr.
Daniel K. Podolsky said to the
crowd of campus leaders, faculty
members, staff, and community
supporters gathered in the Tom
and Lula Gooch Auditorium.
The honor, Dr. Podolsky said, “is
especially satisfying because it
recognizes groundbreaking work
which was done right here at
UT Southwestern as a member
of our faculty.”
Dr. Beutler completed his
internship and residency in
neurology at UTSW and served
on the Internal Medicine faculty
and was a Howard Hughes
Medical Institute Investigator
from 1986 to 2000. He returned
to campus in September 2011 as
Director of the Center for the
Genetics of Host Defense.
Dr. Beutler said his trip to
Sweden to accept the honor was
humbling at times. “I went to
the Nobel museum, and there I
saw my name juxtaposed with
all the scientific greats of the
last century … It was a little
hard for me to believe.”
Dr. Michael Brown and Dr.
Joseph Goldstein, who won
UT Southwestern’s first Nobel
Prize in 1985 for their discovery
of the basic mechanisms of
cholesterol metabolism, were
among those who spoke at the
event. Dr. Brown ruefully recalled the many times he tried
to talk Dr. Beutler out of the
work because of its immense
difficulty. “And even after he
made his enormous discovery,
I didn’t realize the importance
of it … A true discovery comes
as a surprise, and it does take
a while to appreciate the broad
significance of it. And there’s
no question that his discovery
has that impact.”
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SPRING
2012
DIAGNOSTIC TEST
COULD REVOLUTIONIZE
BRAIN-TUMOR CARE
Researchers
at UT Southwestern led by
Dr. Elizabeth
Maher, Associate Professor
of Internal
Medicine and
Neurology and DR. ELIZABETH
NeurotheraMAHER
peutics, developed the first
clinical application of a new
imaging technique to diagnose
brain tumors. The test could
preclude the need for surgery
in patients whose tumors are
located in areas of the brain
too dangerous to biopsy.
This new magnetic resonance
spectroscopy technique provides
a definitive diagnosis of cancer
based on imaging of a protein
associated with a mutated gene
found in 80 percent of low- and
intermediate-grade gliomas.
Presence of the mutation also
means a better prognosis.
Dr. Maher said the finding,
reported in Nature Medicine, “is a
major breakthrough for brain
tumor patients” and is the only
direct metabolic consequence of
a genetic mutation in a cancer
cell that can be identified
through noninvasive imaging.
MANGELSDORF’S WORK
GARNERS PRESTIGIOUS
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worldwide for outstanding
contributions in endocrinology
and diabetes research.
In announcing the award,
Karolinska Institutet officials
said the UTSW Chairman of
Pharmacology’s “work on
nuclear receptors led to
landmark discoveries of how
regulatory pathways govern
cholesterol, lipid, and bile acid
homeostasis. He defined crucial
signal-transduction networks in
their entirety.”
Nuclear
receptors are
proteins that
turn genes on
and off, serving
as sensors that
protect human
cells against
elevated levels
DR. DAVID
of lipids. Dr.
MANGELSDORF
Mangelsdorf
and his laboratory team have
identified several new
molecules, or ligands, that
activate so-called orphan
nuclear receptors whose
biological functions previously
had remained unknown.
Dr. Daniel K. Podolsky,
President of UT Southwestern,
said the international honor
“recognizes excellence in
scientific discovery and the
fruits of Dr. Mangelsdorf’s
determination to unlock
mysteries surrounding human
metabolism. This research holds
important implications for the
treatment of several diseases.”
INTERNATIONAL HONOR
Director of
the Eugene
McDermott
Center for
Human Growth
and Development, Dr.
Hobbs leads
investigations
DR. HELEN
that focus on
HOBBS
identifying
genetic factors that contribute
to variations in the levels of
cholesterol in the blood,
especially low-density
lipoprotein (LDL) cholesterol.
Elevated levels of LDL increase
the risk of a heart attack.
Since 1999 Dr. Hobbs has
led the Dallas Heart Study, a
longitudinal, multiethnic,
population-based study of risk
factors underlying cardiovascular disease. The study, funded
by the Donald W. Reynolds
Foundation, involves thousands
of participants.
Collaborating with Dr.
Jonathan Cohen, Professor of
Internal Medicine, Dr. Hobbs
identified people with a genetic
mutation that kept them from
making normal amounts of the
PCSK9 protein. Those with the
mutation have a 28 percent
reduction in LDL cholesterol
levels and an 88 percent reduction in risk of coronary heart
disease over a 15-year period
compared to those without
the mutation.
OLSON WINS PASSANO
AWARD FOR SEMINAL
HEART RESEARCH
Dr. David Mangelsdorf received
CHOLESTEROL METABOLISM
the 2012 Rolf Luft Award for
research that has advanced
understanding of nuclear
receptor pathways. The annual
recognition from the Karolinska
Institutet, the prestigious
medical university in Sweden
that is also home to the Nobel
Assembly, honors one scientist
HOBBS 1ST GOTTO PRIZE
INVESTIGATIONS EARN
Dr. Helen Hobbs, who studies
the genetics of cholesterol
metabolism, won the inaugural
Antonio M. Gotto Jr. Prize in
Atherosclerosis Research from the
International Atherosclerosis
Society.
Chairman of Molecular Biology
Dr. Eric Olson won the 2012
Passano Award for identifying
major genetic pathways that
control the development of the
heart and other muscles.
Passano Foundation officials
noted that Dr. Olson’s discoveries at the interface of developmental biology and medicine
SOUTHWESTERN MEDICINE
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“have profoundly influenced our
understanding
of the mechanisms responsible for development and
dysfunction of
DR. ERIC OLSON
the heart.” The
recognition honors U.S.-based
research that leads to real-world
applications in clinical
medicine.
Discoveries in Dr. Olson’s
laboratory have “unveiled the
molecular underpinnings of
congenital and acquired diseases
of the heart and established a
foundation for the advancement
of new cardiovascular therapeutics,” said Dr. Joseph
Goldstein, Chairman of Molecular Genetics and co-winner of
the 1985 Nobel Prize in Physiology or Medicine.
Twenty-three Passano Award
recipients have gone on to win
the Nobel Prize, including three
who have regental professorships at UTSW: Dr. Goldstein;
his co-winner, Dr. Michael
Brown, Director of the Erik
Jonsson Center for Research in
Molecular Genetics and Human
Disease; and Dr. Alfred Gilman,
Regental Professor Emeritus of
Pharmacology who shared the
1994 Nobel Prize in Physiology
or Medicine.
NAS RECOGNIZES
MOLECULAR BIOLOGY
CONTRIBUTIONS OF CHEN
Dr. Zhijian
“James” Chen,
Professor of
Molecular
Biology, was
recognized with
the National
Academy of
Sciences Award
in Molecular
Biology.
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DR. Zhijian
“James” Chen
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NAS officials noted that Dr.
Chen was “honored for two
contributions important for
cancer and immunity: discovering an unsuspected component in a central signaling pathway and identifying an unprecedented role for a subcellular
organelle in fighting viral
infection.”
Dr. Daniel K. Podolsky,
President of UTSW, said Dr.
Chen “has applied powerful
techniques of molecular biology
to understand the fundamental
mechanisms of cell response to
viral infections.”
The Howard Hughes Institute
Investigator’s research focuses
on cellular signaling in the
immune system, particularly the
protein ubiquitin, so named
because it is ubiquitously, or
universally, found in all cells.
Dr. Chen’s discoveries noted by
the NAS are important for
understanding the fundamental
mechanisms of cancer and
immunity, and they identify
potential new targets for the
development of drugs to fight
infection by common viruses
such as hepatitis C, West Nile,
and influenza.
TAMEST SELECTS
SCHERER FOR
O’DONNELL AWARD
Dr. Philipp Scherer, Director of
the Touchstone Center for
Diabetes Treatment, received The
Academy of Medicine, Engineering and Science of Texas’ 2012
Edith and Peter O’Donnell Award
in medicine.
Dr. Scherer received the
award based in part on his
research into fat-derived hormones that control sensitivity
to insulin. The blood levels of
adiponectin – a protein he discovered in 1994 – decline as a
person gains weight, which
offers potential as a good
predictor of diabetes, heart
disease, and
cancer risk.
The
selection committee cited
Dr. Scherer’s
research on
fat cells called
adipocytes. The
DR. Philipp
group also
Scherer
noted Dr.
Scherer’s discovery of how fat
cells communicate with other
tissues and regulate the release
of their hormones. Adiponectin,
for instance, is secreted almost
reciprocally with another fatderived hormone, leptin. Dr.
Scherer in 2007 demonstrated
that excess adiponectin in mice
can prompt fat tissue to expand
in a healthy, non-inflamed way,
thereby generating the “world’s
fattest healthy mice” resistant to
development of diabetes.
INVESTIGATORS
MOVE TO UNLOCK
CLOCK COMPLEX
UT Southwestern researchers
continue to take major steps
toward understanding the
cellular clock, mapping for the
first time the atomic-level
architecture of a key component
of the timekeeper that governs
the body’s daily rhythms.
The daily, or
circadian,
cycles guided
by the body’s
clocks affect
our ability to
get a good
night’s sleep,
how fast we
DR. JOSEPH
recover from
TAKAHASHI
jet lag, and
even the best time to give
cancer treatments, said Dr.
Joseph Takahashi, Chairman of
Neuroscience and a pioneer in
the study of circadian rhythms.
Understanding the structure
of the cellular clock could lead
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to better treatments for insomnia, diabetes, and cancer.
Mapping the 3-D structure of
the key component in the cellular clock – called the CLOCK:
BMAL1 transcriptional activator
complex – will have a great
impact on the study of circadian
rhythms and in other areas like
toxicology and the growth of
nerve cells, in which proteins in
the same family play central
roles, Dr. Takahashi said.
SUMMER
2012
SCIENTISTS RECEIVE PRC
DISTINGUISHED AWARDS
The President’s Research Council
presented its 2012 Distinguished
Young Researcher Awards to a
pair of outstanding UT Southwestern investigators. The recipients – Dr. Arun Radhakrishnan,
Assistant Professor of Molecular
Genetics, and Dr. Puneeth
Iyengar, Assistant Professor of
Radiation Oncology – each
received a $65,000 award.
Dr. Radhakrishnan is
studying how cholesterolsensing membrane proteins
measure the concentration of
cholesterol in endoplasmic
reticulum (ER) membranes.
Using purified ER membranes,
he and his research team have
shown that these sensors
respond in a switch-like fashion
to small changes in membrane
cholesterol to regulate
cholesterol levels in cells.
Dr. Radhakrishnan, who
joined the faculty in 2011, was
previously a faculty member at
Weill Cornell Medical College
and a postdoctoral Fellow at
UTSW. He earned his doctorate
degree from Stanford University
after graduating from the University of California, Berkeley.
Dr. Iyengar, a faculty member
since 2010, is studying cachexia
– the massive loss of fat and
muscle – that is found in many
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about and advancing medical
research at UT Southwestern.
THREE SCHOOLS
CONFER 452 DEGREES
Diplomas were received by
DR. ARUN
DR. PUNEETH
RADHAKRISHNAN
IYENGAR
disease states, including cancer,
infectious disease, liver disease,
and heart failure. He said understanding of the condition may
add to the knowledge of the
mechanisms leading to obesity,
the opposite condition to
cachexia.
Dr. Iyengar earned his
doctorate and medical degrees
from Albert Einstein College of
Medicine and a Bachelor of
Science from Massachusetts
Institute of Technology.
The Distinguished Young
Researcher Award is presented
annually by the PRC, which is
made up of community leaders
227 UT Southwestern Medical
School students and 122
UT Southwestern Graduate
School of Biomedical Sciences
students in June commencement ceremonies.
In mid-December 2011, 103
students graduated from the
UT Southwestern School of
Health Professions. The
graduates included students
from physical therapy, physician assistant studies, clinical
nutrition, medical laboratory
sciences, prosthetics-orthotics,
and radiation therapy.
U.S. Sen. Kay Bailey Hutchison delivered the keynote address to the Medical School
graduates and guests. The
school’s 68th commencement
ceremony included the confer-
UT SOUTHWESTERN MEDICAL SCHOOL’S SUMMER COMMENCEMENT IN JUNE INCLUDED A NOTED
MILESTONE – CONFERENCE OF THE SCHOOL’S 10,000TH DEGREE.
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A TEAM OF MORE THAN 50 PHYSICIANS, NURSES, AND OTHER CLINICAL SPECIALISTS COLLABORATED IN THE FLAWLESS DELIVERY AND CARE OF
THE JONES QUINTUPLETS, BORN AT ST. PAUL UNIVERSITY HOSPITAL.
ence of the school’s 10,000th
degree. Since its establishment
in 1943, UTSW has now conferred 10,164 medical degrees.
Southwestern Medical Foundation’s Ho Din Award, the top
honor for a graduating medical
student, was presented to Dr.
Thomas Heyne.
The Graduate School’s address was delivered by Nobel
Laureate Dr. Bruce A. Beutler,
Director of the Center for the
Genetics of Host Defense. Dr.
Tina Han received the Nominata
Award, given to the outstanding
Graduate School student.
[See story ….. Page 2]
BIRTH OF QUINTS
DEMONSTRATES
DEDICATED CARE
One of the nation’s first set of
2012 quintuplets – three boys
and two girls – were born
August 9 at UT Southwestern’s
St. Paul University Hospital to
missionaries Carrie and Gavin
Jones.
A specially trained multidisciplinary delivery team of
more than 50 UTSW specialists,
nurses, technicians, and thera-
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pists – including dedicated units
for each infant – managed the
successful births, delivered in
less than five minutes. The five
infants – Will Edward, David
Stephen, Marcie Jane, Seth Jared,
and Grace Elise – were cared for
in St. Paul’s Neonatal Intensive
Care Unit for months before
they reached weight, post-birth
age, and health markers.
Dr. Patricia Santiago-Munoz,
Associate Professor of Obstetrics
and Gynecology, delivered the
infants. She said the births went
as expected, thanks to Mrs.
Jones’ strong spirit and months
of coordination on the part of
the medical team, which
included a specially designated
“CODE 5” alert when the time
came. The babies’ 27-week
weight at birth ranged from 1
pound, 12 ounces to 2 pounds,
11 ounces, said Dr. Gary
Burgess, Medical Director of the
NICU, who oversaw care for the
five children.
Mr. and Mr. Jones, along with
their 8-year-old son, Isaac, serve
as missionaries in the South
Pacific nation of Papua New
Guinea, north of Australia.
APPOINTMENTS
FOR
2011-2012
The following individuals were
appointed to endowed positions
or to major leadership positions
at UT Southwestern during the
past fiscal year.
■ Dr. Hunt Batjer, Chairman
of Neurological Surgery, and to
the Lois C.A. and Darwin E.
Smith Distinguished Chair in
Neurological Surgery.
■ Dr. Perry Bickel, Chief of
Endocrinology, and to the J.D.
and Maggie E. Wilson Distinguished Chair in Biomedical
Research.
■ Dr. Preston Blomquist, to
the Dr. W. Maxwell Thomas
Chair in Ophthalmology
■ Dr. Stephen Cannon, to the
Patricia A. Smith Distinguished
Chair in Neuromuscular Disease
Research, in Honor of Gil Wolfe,
M.D.
■ Dr. Diego Castrillon, to the
John H. Childers, M.D. Professorship in Pathology.
■ Dr. David Chason, to the
M.R. & E. Hudson Foundation
Professorship in Radiology, in
Honor of Edward E. Christensen, M.D.
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■ Arnim Dontes, Executive
Vice President for Business
Affairs.
■ Dr. David Farrar, to the
J. Wayne Streilein, M.D.,
Professorship in Immunology.
■ Dr. Andrew Feranchak, to
the Willis C. Maddrey, M.D.,
Professorship in Liver Disease.
■ Dr. Kevin Gill, to the Aaron
A. Hofmann, M.D., and Suzanne
Hofmann Distinguished Chair
in Orthopaedic Surgery in Honor of Richard E. Jones, M.D.
■ Dr. Frederick Grinnell, to
the Robert McLemore Professorship in Medical Science.
■ Dr. Donald Hilgemann, to
the Floyd C. Rector Jr., M.D,
Professorship in Acid-Base
Regulation.
■ Randy Jones, Associate Vice
President and Chief Administrative Officer for Ambulatory
Care.
■ Dr. David Karp, to the
Fredye Factor Chair in Rheumatoid Arthritis Research.
■ Dr. Kemp Kernstine, Chief
of Thoracic Surgery.
■ Dr. Makoto Kuro-o, to the
Frederic C. Bartter Professorship
in Vitamin D Research.
■ Dr. Jayanthi Lea, to the
Patricia Duniven Fletcher
Distinguished Professorship in
Gynecological Oncology.
■ Dr. Robert Lenkinski, to the
Charles A. and Elizabeth Ann
Sanders Chair in Translational
Research, and the Jan and Bob
Pickens Distinguished Professorship in Medical Science, in
Memory of Jerry Knight Rymer
and Annette Brannon Rymer
and Mr. and Mrs. W.L. Pickens
■ Dr. Beth Levine, to the
Charles Cameron Sprague
Distinguished Chair in
Biomedical Science.
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■ Dr. Chris Madden, Associate Vice President for Parkland
Health & Hospital System
Affairs.
■ Dr. James Malter, Chairman of Pathology.
■ Dr. Darren McGuire, to the
Dallas Heart Ball Chair for
Research on Heart Disease in
Women.
■ Dr. David Scott Miller, to
the Amy and Vernon E. Faulconer Distinguished Chair in
Medical Science.
■ Dr. R. Tyler Miller, to the
John S. Fordtran, M.D., Professorship in Calcium Research
■ Dr. Chandra Mohan, to the
McGee Foundation Chair in
Arthritis Research.
■ Dr. Ivan Pedrosa, to the
Jack Reynolds, M.D., Chair in
Radiology.
■ Dr. Margaret Phillips, to
the Beatrice and Miguel Elias
Distinguished Chair in Biomedical Science.
■ Dr. Vanessa Rogers, to the
Norman F. Gant, Jr., M.D. Chair
in Obstetrics and Gynecology.
■ Dr. Michael Rosen, Chairman of the Department
of Biophysics.
■ Dr. Theodora Ross, to the
H. Ben and Isabelle T. Decherd
Chair in Internal Medicine, in
Honor of Henry M. Winans Sr.,
M.D., and the Jeanne Ann Plitt
Professorship in Breast Cancer
Research.
■ Dr. Anne Satterthwaite, to
the Peggy Chavellier Professorship for Arthritis Research and
Treatment.
■ Dr. Sandra Schmid,
Chairman of Cell Biology, and
to the Cecil H. Green Distinguished Chair in Cellular and
Molecular Biology.
■ Dr. Amer Shakil, to the
Perry E. Gross, M.D., Distinguished Chair in Family
Medicine, the Stanley Gilbert,
M.D., Professorship in Family
Practice, and the Dr. Bill Ross
Professorship in Family Practice.
■ Dr. Jeanne Sheffield, to the
Alvin “Bud” Brekken Professorship in Obstetrics and
Gynecology.
■ Dr. Xiankai Sun, to the Dr.
Jack Krohmer Professorship in
Radiation Physics.
■ Carolyn Swann, Associate
Vice President for Heart, Lung,
and Vascular, and Solid Organ
Transplant Services at University
Hospitals & Clinics.
■ Dr. Stan Taylor, Associate
Vice President and Chief
Medical Officer for Ambulatory
Care at the University Clinics.
■ Dr. Carlos Timaran, to the
G. Patrick Clagett Professorship
in Vascular Surgery.
■ Dr. Jose Torrealba, to the
Drs. George and Anne Race
Distinguished Professorship of
Pathology.
■ Dr. Steven Vernino, to the
Dr. Bob and Jean Smith Foundation Distinguished Chair in
Neuromuscular Disease
Research.
■ Dr. John Warner, Chief
Executive Officer for University
Hospitals.
■ Dr. Steven Wolf, to the
Golden Charity Guild Charles R.
Baxter, M.D. Chair.
■ Dr. Jeffrey Zigman, to the
Mr. and Mrs. Bruce G. Brookshire Professorship in Medicine,
and the Diana and Richard C.
Strauss Professorship in
Biomedical Research.
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H
MAJOR GIFTS
IN 2011-2012
Philanthropists continued to
demonstrate their commitment
to UT Southwestern in 20112012, providing support for a
variety of research, clinical, and
educational programs.
Major new pledges and gifts
received in the fiscal year 20112012 included:
■ $8,400,000 from an
anonymous donor to support
research programs at UT Southwestern.
■ $6,000,000 from Lyda Hill
to establish the Lyda Hill
Endowment for Systems Biology.
■ $3,000,000 from Mr. and
Mrs. Howard M. Meyers to Southwestern Medical Foundation
to support the construction of
UT Southwestern’s new William
P. Clements Jr. University
Hospital.
■ $1,525,000 from Jimmie C.
LaFollette, through a bequest to
Southwestern Medical Foundation, in support of research
into intracranial hemorrhagic
stroke, macular degeneration,
glaucoma, and non-Hodgkin
lymphoma at UT Southwestern.
■ $1,390,000 from proceeds
of the 2011 Sweetheart Ball to
Southwestern Medical Foundation in support of heart
research at UT Southwestern.
■ $1,000,000 from The
Dedman Foundation to Southwestern Medical Foundation to
support the construction of
UT Southwestern’s new
William P. Clements Jr.
University Hospital.
■ $1,000,000 from the Roger
Horchow family to Southwestern Medical Foundation
to support the construction of
UTSW’s new William P.
Clements Jr. University Hospital.
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■ $1,000,000 from the Lowe
Foundation to Southwestern
Medical Foundation to establish
the Erma Lowe Center for
Alzheimer's Disease Research.
■ $1,000,000 from the estate
of Shirley Pollock, through a
bequest to Southwestern Medical Foundation, to support the
Lawrence S. Pollock Jr. Center
for Intestinal Cancer Research.
■ $1,000,000 from the estate
of Patricia A. Smith to establish
the Patricia A. Smith Distinguished Chair in Neuromuscular
Disease Research, in Honor of
Gil Wolfe, M.D.
■ $407,352 from the estate of
Patricia Alford Box, through a
bequest to Southwestern Medical Foundation, to support
UT Southwestern research of
chronic lymphocytic leukemia.
■ $400,000 from the
Hartwell Foundation to provide
individual and collaborative
biomedical research fellowships
for promising early-career
investigators at UTSW.
■ $400,000 from the Lupe
Murchison Foundation to
Southwestern Medical Foundation to support Alzheimer's
disease research under the
direction of Dr. Joachim Herz.
■ $350,000 from Yukie Niwa,
M.D., Ph.D., to support research
of rheumatic diseases under the
direction of Dr. Joel D. Taurog.
■ $332,195 from the Howard
Hughes Medical Institute to
support flow cytometry
technology.
■ $300,000 from the National
Multiple Sclerosis Society to
support continuing education
and clinical programs for
multiple sclerosis.
■ $250,000 from the International Mental Health Research
Organization to support the
2011 IMHRO Rising Star.
Generous contributions and
pledges of $100,000 to $249,999
were received from a number of
additional donors, including the
following new commitments
from:
■ An anonymous donor to
support research on microRNAbased anti-cancer therapeutics
under the direction of Dr.
Joshua Mendell.
■ An anonymous donor to
support lung cancer programs in
honor of Drs. Hak Choy, J.
Michael DiMaio, Jonathan E.
Dowell, and David A. Pistenmaa.
■ An anonymous donor to
Southwestern Medical Foundation to provide unrestricted
support for UT Southwestern.
■ The Cain Foundation to
support a fellowship in urology.
■ The Canary Foundation to
support lung cancer research.
■ The David M. Crowley
Foundation to support peripheral nerve and pain management research and activities in
the David M. Crowley Research
and Rehabilitation Laboratory.
■ Dr. and Mrs. Adi F. Gazdar
to Southwestern Medical
Foundation to establish the Adi
Gazdar, M.D., Annual Lectureship in Translational Medicine,
and the Adi and Celia Gazdar
Fund in Translational Cancer
Research.
■ Mr. and Mrs. Mark Gibson,
through The Melchizedek Fund
of Communities Foundation of
Texas, to Southwestern Medical
Foundation to support research,
education, and clinical care
programs at UT Southwestern.
■ David C. Haley to support
diabetes research.
■ Mr. and Mrs. G. Houston
Hall to Southwestern Medical
Foundation to support the
construction of UT Southwestern’s new William P.
Clements Jr. University Hospital.
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■ Mr. and Mrs. J. Davis
Hamlin to Southwestern
Medical Foundation to support
education, research, and clinical
care programs at UT Southwestern, in honor of Dr. and
Mrs. Kern Wildenthal and Dr.
Amy Phelan.
■ The Hoblitzelle Foundation
to Southwestern Medical Foundation to endow the Ron Anderson, M.D., Professorship in
Clinical Care and Education at
Parkland Memorial Hospital.
■ Mr. and Mrs. Peter M. Holt
to support corneal research.
■ The Dixie S. Jones Foundation Testamentary Trust to support the care and/or treatment
of children under the age of 18.
■ The Mary Kay Foundation
to support breast cancer
research.
■ Once Upon a Time… to
endow the Nadine and Tom
Craddick Professorship in
Medical Education and to
Southwestern Medical
Foundation to support
education, research, and
clinical care programs at
UT Southwestern.
■ The Charles Y.C. Pak
Foundation to support
metabolic kidney disease
research and to establish the
John S. Fordtran, M.D.,
Professorship in Calcium
Research.
■ The Perkins-Prothro
Foundation to Southwestern
Medical Foundation to support
the construction of UT Southwestern’s new William P.
Clements Jr. University Hospital.
■ Pfizer Inc. to support the
2012 Pfizer Fellows in the
Medical Scientist Training
Program at UT Southwestern.
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■ The Vin and Caren Prothro
Foundation to Southwestern
Medical Foundation to support
the construction of UT Southwestern’s new William P.
Clements Jr. University Hospital.
■ Bette Claire Schuttler,
through a bequest to Southwestern Medical Foundation,
for research into cancer and
Alzheimer’s disease.
■ James Cleo Thompson Jr.,
through a bequest to Southwestern Medical Foundation, to
establish a fund for bladder
cancer research under the
direction of Dr. Ganesh Raj.
■ Mr. and Mrs. Gifford O.
Touchstone to support diabetes
research under the direction of
Dr. Roger Unger.
■ The Ivor and Mildred Wold
Charitable Fund to Southwestern Medical Foundation to
support the Mildred Wyatt
and Ivor P. Wold Center for
Geriatric Care.
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