Archived News and Events - 2010
Cassada Introduces Non-Invasive Technique to Diagnose Venous Obstruction
Leg swelling can be a common cause for vascular surgical evaluation, and iliocaval obstruction due to May-Thurner Syndrome (MTS) can be difficult to diagnose.
At the University of Tennessee Graduate School of Medicine, David Cassada, MD, Associate Professor, Surgery's Division of Vascular/Transplant Surgery, in collaboration with Mitchell Goldman, MD, Chairman, and faculty and staff in the Department of Surgery and the Vascular Research Laboratory, developed a novel, non-invasive technique for the diagnosis of MTS, a compression of the left iliac vein by the right iliac artery. Using a simple blood pressure cuff and a duplex scanner, the velocity of outflow from the leg upon blood pressure cuff release was measured and compared to normal controls in the contralateral side. A decrease in outflow velocity correlated well with the diagnosis of MTS.
Traditionally, the condition has been indicated by exercise induced swelling, pain and fluid retention, most often in young females, and has been diagnosed using invasive procedures including CT and MRI scans, followed by a venogram to duplicate the results. The radiographic scans provided positive results less than 50 percent of the time, causing MTS to be under-diagnosed.
Once MTS is diagnosed, a stent is placed in the blockage. Dr. Cassada and his team have also found that measuring maximum venous outflow velocity through the tourniquet approach post-treatment is effective in determining its success.
This technique, previously described in an article by Michael Lebow, MD, Vascular Surgery Fellow Alumnus, has received significant professional acknowledgement. Dr. Cassada recently presented his abstract for this method, co-authored by Surgery Resident Matt Jones, to the Southern Association for Vascular Surgery, and his abstract for a similar technique to be used on the arm for the planning and treatment of conditions such as central venous stenosis and thoracic outlet syndrome has been accepted for poster competition at the Society for Vascular Surgery 2010 Vascular Annual Meeting in June.
"We have proven this technique works for the leg," said Dr. Cassada. "We are still in the process of proving it works for the arm. However, using this approach on the arm will affect more people worldwide because of dialysis. Veins are destroyed over time, and this will help us plan for treatment. Measuring venous outflow velocity, if we think the central vein is obstructed, can stop us from going into the operating room and doing something that won't work."
Posted: March 29, 2010
Professors Carlson, Hudson and McCoy Examine OMFS Board Candidates
University of Tennessee Graduate School of Medicine Oral and Maxillofacial Surgery Professors Eric Carlson, DMD, MD, FACS, Chairman; John W. Hudson, DDS; and J. Michael McCoy, DDS, examined eligible candidates for the American Board of Oral and Maxillofacial Surgery (ABOMS) in Dallas, Texas, in February. Of 86 examiners, these faculty-physicians were the only ones selected from Tennessee among four statewide OMFS programs. The objectives of the ABOMS are to elevate the standards of oral and maxillofacial surgery and to aid oral and maxillofacial surgeons in their efforts to provide optimum health care in the United States.
Posted: March 25, 2010
Susan G. Komen Foundation Awards Grant to Kestler and Bruker
University of Tennessee Graduate School of Medicine Assistant Professor Daniel Kestler, PhD, Human Immunology and Cancer Program (HICP), and Charles Bruker, MD, Pathology Resident, recently received notification of a three-year grant period totaling more than $575,000 in funds from the Susan G. Komen Foundation to develop an understanding of the Odontogenic Ameloblast associated protein (ODAM) expression in breast tumors as well as patients' humoral response to this protein. This study will provide the basis for the possible direct use of ODAM-based reagents in the assessment and treatment of breast cancers within the next decade.
ODAM is a protein that was first detected by Alan Solomon, MD, Director, HICP. It is produced within a rare calcifying epithelial odontogenic tumor and is the amyloid forming protein found with this tumor. Dr. Kestler, together with other HICP researchers, expressed recombinant ODAM and made antibodies to this protein. They found using immunohistochemical methods that ODAM was expressed within specific normal tissues, such as salivary gland and airway epithelium, and also within other epithelial cancers, including those of the breast, gastrointestinal tract and lung.
HICP investigators, along with Sabina Siddiqui, MD, Surgery Resident; Dr. Bruker; and Amber Patton, DO, Pathology Resident, immunohistochemically examined a significant number of slides for ODAM expression. These were breast cancer biopsies and resections identified through the University of Tennessee Cancer Center tumor registry and obtained from the Department of Pathology. This ODAM tumor expression was compared to patient staging and other reported clinicopathological data by Drs. Bruker and Siddiqui in conjunction with UT statisticians. The findings supported a relationship between ODAM expression and clinical stage as ODAM tumor-expression appears to correspond with better survival. These findings were recently presented at a national meeting and published in the American Surgeon.
HICP investigators had also observed and reported that late-stage breast cancer patients appear to possess anti-ODAM-specific serum antibody titers relative to normal females. This may support a possible relevant immunological response to ODAM in a portion of breast cancer patients. The proposed research will further investigate ODAM expression in breast tumors along with the presence of serum antibodies to ODAM in these patients in order to clarify any diagnostic, prognostic or possible therapeutic benefits of ODAM expression in tumor tissue or patient serum antibodies to ODAM.
"We plan to verify the importance of ODAM expression in tumor tissue," Dr. Kestler said. "We also want to determine the relationship of patient anti-ODAM antibody reactivity to clinical data including disease stage, survival, recurrence and cancer status."
Dr. Kestler said his partnership with the Surgery and Pathology residency programs has presented an opportunity to apply medical and molecular perspectives to important biomedical research that often has been limited to basic or clinical science. "Through such collaboration, everyone and everything involved, scientists, clinicians and the work, are enriched and better for the interaction."
Dr. Bruker added, "This is translational research. It serves as the bridge between clinicians and the basic sciences. This type of research has been less common in the past, and discoveries have been made at the bench that physicians were not aware of. Translational research brings these results to the patient."
Posted: March 24, 2010
JAMA Publishes Poem by Preston Library's Donna Doyle
"Stroke," a poem by Donna Doyle, Consumer and Patient Health Information Specialist and Evening Supervisor in the University of Tennessee Graduate School of Medicine Preston Medical Library, was published in the February 24 issue of the Journal of the American Medical Association's Poetry and Medicine column. Doyle, also a creative writer, wrote the poem in response to her husband's June 2009 stroke. According to Poet's Market, JAMA receives approximately 750 poems per year and accepts only 7 percent.
In accepting the poem, JAMA's associate editor, Charlene Breedlove, stated in a letter, "The poem brilliantly defines some uses of the word stroke before delivering readers to its final and fateful likenesses. I know readers will appreciate, as I do, the subtle shaping of alternatives and the way the felt reality is finally delivered."
Doyle has worked for the University of Tennessee for 22 years and came to Preston Medical Library in September 2008 with an interest in the Consumer and Patient Health Information Service. She became a certified Consumer and Patient Health Information Specialist in December 2008 and said her goal is to actively and empathetically listen to every consumer. Doyle has received several awards for her poetry, and her manuscript, "Heading Home," was recently selected as a finalist in Finishing Line Press's New Women's Voices competition.
Read "Stroke" online or contact Donna Doyle for more information.
Published: March 22, 2010
GSM Research Seminar Discusses Molecular Imaging and Translational Research, March 23
Amy LeBlanc, DVM, Diplomate ACVIM, Assistant Professor and Director of Translational Research in the Department of Radiology, Director of Medical Oncology at the University of Tennessee College of Veterinary Medicine, will present "Molecular Imaging and Translational Research:
The DVM Perspective," at the UT Graduate School of Medicine Research Seminar to be held Tuesday, March 23, at noon in Morrison's Conference Center at the University of Tennessee Medical Center. Anyone interested in learning more about how PET/CT imaging studies benefit cancer patient care should make plans to attend.
Posted: March 22, 2010
Discover What Makes the GSM Unique in The Scope, Online Now
The University of Tennessee Graduate School of Medicine at the University of Tennessee Medical Center offers an array of programs for graduate medical and dental education that create an environment for learning unlike other regional medical centers throughout the nation. The March 2010 issue of The Scope E-Newsletter highlights these characteristics as well as the outstanding achievements of faculty, staff and residents for their cutting-edge research and leadership in national organizations.
Read the March 2010 issue of The Scope.
Posted: March 18, 2010
Register by March 22: CME-Certified Faculty Development Workshop, March 26
All University of Tennessee Graduate School of Medicine faculty are invited to attend the second annual Faculty Development Workshop, Friday, March 26, UT Conference Center, 8 a.m.–12 p.m., presented by the UT Graduate School of Medicine and Academy of Scholars Committee.
Faculty should register online by March 22. This workshop offers up to 4 CME credits through AMA and AAPA. Up to .4 CEUs also are available.
Two keynote presenters, Dr. Pamela Rowland of Dartmouth-Hitchcock Medical Center and Dr. Sheila Chauvin of Louisiana State University Health Science Center will address "Professionalism" and "Scholarly Research in Medical Education."
A nationally recognized communications expert, Dr. Rowland trained as a behavioral scientist and has more than 25 years of clinical experience at Brown, Tufts and Dartmouth medical schools. She evaluates faculty in clinical settings and has focused her research on physician-patient satisfaction, verbal examinations and interviewing skills.
Dr. Chavin, an equally experienced behavioral scientist, founded and directs the Academy for the Advancement of Educational Scholarship at LSU and also directs the Office of Medical Education and Research, which serves as a consulting group to faculty pursuing research projects.
For more information, visit www.tennessee.edu/cme/FacultyDevelopment2010 or call Communications and Outreach at 305-9190.
The University of Tennessee College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The UT College of Medicine designates this educational activity for a maximum of 4 AMA PRA Category 1 Credits.
Posted: March 18, 2010
CEM Research Symposium Joins with Center for Public Health; Abstract Titles Due March 26
The University of Tennessee Comparative and Experimental Medicine program and the Center for Public Health are jointly offering the Comparative and Experimental Medicine and Public Health Research Symposium scheduled June 14-15 on the UT Agriculture Campus in the Plant Biotechnology Building. Graduate students, postdoctoral researchers, resident physicians and assistant professors of research with research interests in human or animal health should submit research titles by 5 p.m., March 26, and submit abstracts by 5 p.m., April 12.
In addition to bringing together biomedical, veterinary and public health investigators to collaborate on ideas, the Symposium will feature keynote presentations by Dr. Steve Blair, Professor, Division of Health Aspects of Physical Activity, Department of Exercise Science, University of South Carolina; Dr. Arnold Caplan, Professor of Biology and Director of the Skeletal Research Center, Case Western Reserve University; and Sam Venable, Knoxville News Sentinel Columnist.
Learn more about the Comparative and Experimental and Public Health Research Symposium.
The Comparative and Experimental and Public Health Research Symposium is sponsored by the University of Tennessee College of Veterinary Medicine, Center for Public Health, UT Graduate School of Medicine, Tennessee Agricultural Research, the UT Graduate School and the UT Knoxville Office of Research.
Posted: March 15, 2010
Graduate School of Medicine Offers CME-Certified Grand Rounds, Quarterly Case Conferences
The weekly University of Tennessee Graduate School of Medicine Surgery Grand Rounds, held Thursdays, 7-8 a.m., in Morrison's Conference Center, offer up to 1 CME credit per session. Surgery Grand Rounds include the John W. Whittington, MD Visiting Lectureship series, bringing specialists from across the country to the Graduate School of Medicine. Whittington lectures will be held during regularly scheduled Grand Rounds times and will be offered several times each year. On March 11, Vikram Prabhu, MD, Associate Professor, Neurological Surgery, Loyola University, will present, "Update on Management of Pineal Tumors."
Other CME-certified grand rounds include the Internal Medicine Grand Rounds, held the second Tuesday of each month, 8-9 a.m., Morrison's Conference Center. Each session offers up to 1 CME credit. The next meeting, April 13, will discuss medical complications of pregnancy.
Neurology/Neurosurgery Quarterly Case Conferences, presented by the Brain and Spine Institute, also are CME-certified and are held the third Monday of the first month of each quarter. They offer up to 1 CME credit per session and are held 7-8 a.m., Morrison's Conference Center. Stroke will be the topic of the April 19 meeting.
Visit Continuing Medical and Dental Education Courses to see a listing of all CME-certified grand rounds and quarterly case conferences.
Posted: March 10, 2010
Kendrick Publishes Nursing Education Book on Diabetes in Pregnancy
Jo Kendrick, MSN, RNC, CDE, Clinical Instructor, Perinatal Diabetes Program in Obstetrics and Gynecology's Division of Maternal-Fetal Medicine, recently published Diabetes in Pregnancy, 4th Edition, a continuing nursing education training module offered by the March of Dimes. The module provides perinatal nurses with up-to-date information to guide comprehensive nursing care and education of women with pregestational and gestational diabetes during the perinatal period. In her book, Kendrick covers nursing assessments; treatments including medical nutrition therapy, pharmacologic therapy and exercise; and management of acute complications.
Posetd: March 4, 2010
Gerard and Carlson Advance Oral Cancer Research Through Retrospective Study
While breast cancer research has led to advancements in treatment options and increased survival rates over the past 15 years, oral cancer research has made little progress. Oral cancers, represented by squamous cell carcinoma, are the tenth most common cancers in the United States, and even higher in East Tennessee due to smoking and other social habits such as the use of smokeless tobacco.
David Gerard, PhD, Professor of Oral and Maxillofacial Surgery and Director of Research; and Eric Carlson, DMD, MD, FACS, Professor and Chairman of the Department of Oral and Maxillofacial Surgery at the University of Tennessee Graduate School of Medicine, want to improve the survivability associated with oral cancer by being able to predict a cancer's biologic behavior with subsequent targeted therapy. They have designed a study in an attempt to identify a "genetic signature" for oral cancers that behave in different ways. After two pilot studies, the investigators discovered that oral squamous cell carcinoma may behave in one of three ways: the cancer remains isolated to the oral cavity without regional lymph node or distant metastatic spread despite the potential for bone invasion; the cancer spreads quickly to regional lymph nodes in the neck; or the cancer spreads to the lymph nodes in the neck as well as distant organs.
Using evidence collected from more than 200 operated cases of oral cancer with long-term follow-up of patients, the investigators will examine the genetic profile of these cancers and look for mutations in patients who had a recurrence of their cancer. Their goal is to identify genetic profiles of cancers that will permit surgical procedures and adjuvant therapy based on a predicted biologic behavior of the cancer.
"The integration of effort of clinicians and basic science researchers presents an exciting opportunity to make clinically meaningful conclusions in translational research performed in an academic medical center," Dr. Carlson said. "My hope is that my work with Dr. Gerard will one day result in my ability to more effectively manage cancer patients in my surgical practice."
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