The Scope E-Newsletter March 2009

In these tumultuous times, attending to details is paramount. However, in doing so, it is easy to forget the big picture of UT Graduate School of Medicine. I would like to take a few moments to illustrate how we are continuing to take steps toward achieving our goal of national recognition in medical education.

As you know, last fall we initiated the Virtual Research Organization (VRO) with participation from existing faculty and staff as well as those in the UTK system who could assist us in this effort, including Eric Heidel for statistics. I am delighted to report the number of residents and faculty using the VRO for support is growing rapidly. The Graduate School of Medicine intranet, called the Pulse, explains how to use the VRO. Concomitantly, Dr. Lorraine Wallace and Dr. Bill Metheny created a research workshop specifically for our fellows with a base in the VRO.

On March 1, 2009, we took another step forward in reaching our goal by creating a new office entitled the "Office of Medical Education and Research," which will house the existing VRO and a new venture to enhance the teaching efforts of our faculty, fellows and residents. Dr. Lorraine Wallace has graciously agreed to serve as administrative director of this new office as well as continuing to share her knowledge and talent with all departments. She will work closely with Dr. Metheny who came to us with a strong background in faculty development. As you would expect, this office will work with the Academy of Scholars Committee, the Simulation Center and others to improve our educational efforts, including the creation of a Residents as Teachers Program. The kick-off for our faculty development component is on the morning of Friday, April 3, with two excellent guest speakers (see separate article in this issue of The Scope). I encourage anyone involved in teaching to attend this event.

A separate article in the future will detail the goals and objectives of the Office of Medical Education and Research and its location. It is important to understand that we are building this initiative with current resources, thereby requiring no new significant financial resources. I want to thank everyone involved for making personal sacrifices in order to contribute to our mission.

Although it may seem as if we are living under a dark cloud, keep in mind there are many "bright spots" in the Graduate School of Medicine and we are moving forward. If you would like to note a "Bright Spot," please contact Communications and Outreach or me, and we will place it in The Scope for everyone to enjoy.

James J. Neutens, PhD, FASHA
Dean

Valerie Berthelier, Assistant Professor and Director of the Conformational Diseases and Therapeutics Research lab, and George W. Kabalka, PhD, Robert H. Cole Distinguished Professor of Neuroscience, Director of Basic Science Research in Radiology, received patents from the U.S. Patent and Trademark Office (USPTO) for extraordinary medical research.

Dr. Berthelier developed new methods to study particular inherited neurological disorders, including Huntington’s disease. The invention will help researchers analyze specific proteins known to be associated with these devastating disorders and could lead to the development of new treatments or cures. Analogously to the situation in Alzheimer’s disease, in Huntington’s disease and seven other polyglutamine disorders, the disease protein forms insoluble protein aggregates that are toxic to neurons.

"Due to this development, we were able to identify a small number of promising compounds that affect protein aggregate formation," said Dr. Berthelier.

Dr. Kabalka’s patent addresses new methods for incorporating short-lived radioisotopes in molecules of use in nuclear medicine and biology. Short-lived radioisotopes are required by new nuclear medicine imaging techniques, such as positron emission tomography and single photon tomography.

"The methods described in the patent offer entirely new approaches to preparing radiopharmaceuticals for use in nuclear medicine imaging. The advantages of the new methodology are that the pharmaceutical precursors have shelf lives of years and can be used in radiopharmacy ‘kits’ that provide for simple purification of the final pharmaceutical product," said Dr. Kabalka.

Patents are awarded for unique technologies and ideas and serve to protect inventions that can benefit society. The process for receiving a patent is lengthy and difficult: fewer than 10 percent of the discoveries made at UT are eventually granted patents from the USPTO.

Drs. Berthelier and Kabalka are among 20 Knoxville-area UT researchers who were honored recently by the UT Research Foundation (UTRF) for receiving patents from the USPTO on discoveries that could transform the lives of people in Tennessee and the nation. The researchers achieved a total of 15 patents for their intellectual properties over the course of 2007 and 2008.

UTRF President and CEO Fred Tompkins says the scientists responsible for the research that makes it through this process are among the most innovative and dedicated individuals in the university system. "Awarded patents are an indication of the innovative people and programs at the university," Tompkins said.

Not only do patents benefit the university through external funding, but they also have the potential to stimulate economic development through the generation of licensing revenues, which can be the basis for starting new companies.

In addition to Drs. Berthelier and Kabalka, 11 researchers from UT Knoxville and seven researchers from the UT Institute of Agriculture were honored by UTRF.

UTRF helps inventors at UT turn their ideas and discoveries into products and services that benefit society. In addition to supporting the university research enterprise and commercializing the resulting inventions, UTRF also supports entrepreneurship as well as state and regional economic development efforts. UTRF serves all seven of the UT campuses and institutes across the state. For more information, visit http://utrf.tennessee.edu.

Brittany Beasley, UT Genetics Center Molecular Laboratory Technologist trainee, passed the National Credentialing Agency national certification examination in molecular genetics. Successful certification will lead to state licensure as a medical technologist specialist. Beasley has been a trainee in the Genetics Center for two years.

The Preston Medical Library Consumer and Patient Health Information Service (CAPHIS) began in 1989 with a $5,000 grant from the Tennessee State Library and Archives (TSLA). The grant funded the beginning of the service working with Knox County Public Library. This grant was the first ever given by TSLA to a medical library.

Check The Scope each month for more interesting facts about CAPHIS leading to its 20th celebration in October.

Faculty
Leon Baltrucki, MD, Assistant Professor, Pathology
Julie Jeter, MD, Assistant Professor, Family Practice
Yitong Fu, MD, PhD, Assistant Professor, Radiology

Fellow
Andres Guerra, DMD, Oral and Maxillofacial Surgery

The UT Graduate School of Medicine Genetics Center laboratories are the first in the region to offer two new tests: Warfarin Mutation Panel and KRAS Mutation Analysis. The Warfarin Mutation Panel analyzes DNA variations to determine sensitivity to Warfarin treatment. The KRAS Mutation Analysis analyzes DNA variation in colorectal tumor cells that identifies tumors that will be resistant to EGFR (epidermal growth factor receptor) monoclonal antibody-based treatments.

Also in the Genetics Center, the Cytogenetics Laboratory is the only regional laboratory qualified to provide cytogenetic analysis for protocols that define the diagnosis and treatment of childhood leukemia. Carmen Lozzio, MD, FACMG, Professor of Medical Genetics and Director of the Cytogenetics Laboratory; and Terri Ryan, Laboratory Supervisor, attended the Children's Oncology Workshop, Feb. 13-14, in St. Louis, to represent the Genetics Center in a meeting of laboratories certified to provide cytogenetic analysis.

To refer a patient to the Genetics Center for testing, call 305-9449.

Annual performance evaluation summary forms are due to the Office of Faculty and Staff Affairs March 27. Performance evaluations are a time for supervisors and employees to meet to review job performance from the previous year, clarify future expectations and discuss departmental goals. While several forms are available as resources to the evaluation process, only the summary form must be submitted to the Office of Faculty and Staff Affairs. This form will be forwarded to the employee personnel file in the Human Resources office.

To access forms online, go to http://www.utmem.edu/hr/Compensation/performance.htm.

For additional information, contact Carol Houser at 305-6482.

Watch newsstands this month for the fourth issue in a four-part series of Frontiers magazine focusing on our mission of education, research, patient care and public service to learn more about how our physicians go beyond expectations to serve the community.

You’ll find articles about how John Eaddy, MD, has spent 50+ years managing—and helping others learn to manage—diabetes and how Preston Medical Library is helping community libraries become reliable sources of medical information for their patrons and rural doctors.

You’ll read how the Graduate School of Medicine sends physicians into the community to provide medical support for high school sports teams, and you’ll be pleased to learn that some of our surgeons are taking their skills to the stars to share their expertise. Be sure to watch for this exceptional issue of Frontiers this month.

Frontiers is a quarterly publication for alumni and friends, produced by UT Medical Center and UT Graduate School of Medicine.

Want to get Frontiers in the mail?

To be added to the Frontiers mailing list, visit http://gsm.utmck.edu/news/frontiers.cfm to complete the online form.

To request a previous issue of Frontiers in the mail, contact the Communications and Outreach office at 305-9190.

Business Survival Skills for Physicians, a series designed to assist physicians who plan to go into private practice, will continue March 25, with "Personal and Practice Insurance II." The session will be led by Heath Hildreth from Hildreth Agency from 12-1 p.m. in Wood Auditorium. Lunch will be provided to residents.

On April 8, Kim Friar from University Physicians Association will lead "Billing and Collections" from 12-1 p.m. in Wood Auditorium.

While senior residents are strongly encouraged to attend the entire annual series, all residents and fellows are welcome. For more information or for a complete schedule, contact the Graduate Medical and Dental Education office at 305-9339 or gme@utmck.edu. Series dates are subject to change.

The Graduate School of Medicine's employee site, the Pulse, has a new look and fresh content. The Pulse aims to keep faculty, residents and staff informed with the news and events concerning the campus, college and university. Each academic department and service office has its own section for posting and sharing materials specific to the needs of its area and function.

To access the Pulse from a campus computer, go to http://pulse/. Bookmark this link from your workstation to visit often.

Check the Event Calendar each month for all campus events at http://pulse/calendar.cfm.

Faculty, staff, residents and fellows who need access to the Pulse should contact the Graduate School of Medicine HelpDesk at gsmhelpdesk@utmck.edu.

The UT Graduate School of Medicine is in the process of updating our disaster plan, which is an organized method by which we ensure the safety of our employees in the event of an emergency. Will Wallace, Compliance Officer, is leading the effort, and Mark Smith, Environmental, Health & Safety, UT Knoxville, will provide training later this spring. Watch for complete information about the plan and training schedule in the next Scope.

Medical device manufacturer Medtronic joins several pharmaceutical companies planning to disclose U.S. consulting fees, royalties or honoraria of $5,000 or more made to physicians, including consulting agreements. Medtronic's disclosure will begin in March 2011 for payments made in 2010, and data will be published on the company's web site. Market indicators predict more companies will join Medtronic in an effort to maintain grant and payment transparency. For the full announcement from Medtronic, visit http://wwwp.medtronic.com/
Newsroom/NewsReleaseDetails.do?itemId=1204043372937
&lang=en_US.

The Institute of Medicine recently made recommendations to adjust resident work hours by setting the maximum number of hours a resident can work without time for sleep to 16, increasing the required number of days off, and setting stricter moonlighting restrictions. In a Hematology/Oncology Today article, William Law, Jr., MD, FACE, FACP, Clinical Professor of Medicine and Chief of Endocrinology, discussed the impacts these new requirements would have on the Graduate School of Medicine, residents and the community.

Dr. Law said smaller training programs should be given greater flexibility.

"Large programs with 20- to 30-plus residents a year have sufficient manpower to accommodate unanticipated increases in workforce demand created by resident illnesses, pregnancies and post-partum absences," he said.

"Smaller programs are more likely to lack the financial resources to hire hospitalists to do this work at 400 percent of the residents' salaries," Dr. Law said. "Since it is well established that the single most accurate determinant of where a physician ultimately practices is where he completed his residency training, such rigid limits could conceivably force such programs to close their doors, thus depriving the smaller communities of the source of many of their practicing physicians."

Dr. Law also said restrictions on moonlighting could discourage residents from training in traditionally lower-compensated medical professions because residents use moonlighting to pay off large student loans.

"The inclusion of all moonlighting hours, not just in-house institutional hours, in the 80-hour total may have the de facto effect of severely restricting their freedom to earn a living while in training, which may, in turn, further discourage residents from entering traditionally lower-compensated fields, such as family practice, general internal medicine, and pediatrics," Law said. "This is not a desirable development from a societal standpoint."

To read the article published in Hematology/Oncology Today online, visit www.hemonctoday.com/article.aspx?rid=36881.

To view the report published by IOM, visit http://www.iom.edu/CMS/3809/48553/60449.aspx.

For more information on current resident duty hours, visit the Accreditation Council for Graduate Medical Education web site at www.acgme.org.

Mark your calendars for these 2009 Continuing Medical and Dental Education events, sponsored by the UT Graduate School of Medicine:

April 3, 2009: Faculty Development Workshop: Teaching, UT Visitors' Center

April 14, 2009: Internal Medicine Grand Rounds: Sickle Cell, Part 2, Morrison's Conference Center

April 20, 2009: Neurology/Neurosurgery Case Conference: Traumatic Brain Injury, Morrison's Conference Center

April 29, 2009: John E. Sullivan, D.D.S. Endowed Lecture, Wood Auditorium

May 12, 2009: Internal Medicine Grand Rounds: NASH (Non Alcoholic Steatohepatitis), Morrison's Conference Center

June 9, 2009: Internal Medicine Grand Rounds: The Role of EUS in GI Malignancies, Morrison's Conference Center

July 20, 2009: Neurology/Neurosurgery Case Conference: Neurological Infectious Diseases, Morrison's Conference Center

October 19, 2009: Neurology/Neurosurgery Case Conference: Neurological Emergencies, Morrison's Conference Center

Registration is open for the April 3 Faculty Development Workshop, designed for UT Graduate School of Medicine faculty and volunteer faculty by our Academy of Scholars Committee. The free CME workshop will be held at the UT Visitors' Center Friday, April 3, 7:30 a.m.-1:30 p.m., and continental breakfast and box lunch will be served.

Up to 4.5 CME credits through AMA and AAPA are available to participants. Up to .4 CEUs also are available. The event is funded through the Dean's Fund.

This teaching-focused workshop welcomes guest speakers Patrick Alguire, MD, American College of Physicians, who will present Teaching in the Office, and Martin Eason, MD, James H. Quillen College of Medicine, who will discuss Teaching with Simulation. Additional topics include Giving Feedback, The Challenging Student, Teaching in the OR, and Bedside Teaching.

To register for the April 3 Faculty Development Workshop, call Communications and Outreach at 305-9190 by March 31. To register by e-mail, send your name, department and phone number to CME@utmck.edu by March 31.

The UT Visitors' Center is located on Neyland Drive. From UT Graduate School of Medicine, travel U.S. 129 North (Alcoa Highway) to Knoxville; take the Neyland Drive exit; turn right onto Neyland Drive (158 N); and turn left into the UT Visitors' Center parking lot.

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 University of Tennessee College of Medicine designates this educational activity for a maximum of 4.5 AMA PRA Category 1 Credits^TM.

No other CDE lecture in the region offers two divergent topics with one important goal: educate dental professionals to improve oral surgery outcomes.

The 2009 John E. Sullivan, D.D.S. Endowed Lecture: Growth Factor Use in Surgical Techniques and Technology-Driven Treatment in Dental Implant Techniques, April 29, Wood Auditorium, UT Medical Center, will closely examine options for oral surgery, including the use of rhBMP-2 (recombinant human bone morphogenetic protein-2) growth factor with surgical techniques and the use of technology, such as cone beam CT (CBCT) and CAD/CAM in dental implant techniques. Oral and maxillofacial surgeons, prosthodontists and dentists will benefit from this lecture.

Expert speakers include Alan S. Herford, DDS, MD, Chair and Program Director, Oral and Maxillofacial Surgery, Loma Linda University, and Stanley E. Rye, DDS, Atlanta prosthodontist.

This CDE lecture will offer up to four hours credit through Academy of General Dentistry, and CEUs also are available. AGD credit is accepted by the Tennessee Board of Dentistry for re-licensure credit. Participants licensed outside of Tennessee should check with their licensing board.

The event is sponsored by the UT Graduate School of Medicine and Oral and Maxillofacial Surgery and is directed by Eric Carlson, DMD, MD. Register today at www.tennessee.edu/cme/Sullivan2009. Call 305-9190 for more information.

Earn CME credits by attending the CME-certified grand rounds this year. The UT Graduate School of Medicine presents these sessions with Internal Medicine and the University of Tennessee Medical Center Brain and Spine Institute.

The Neurology/Neurosurgery Quarterly Case Conference series is intended for physicians and allied health professionals who provide care for patients with neurological and neurosurgical diagnoses. The Brain and Spine Institute and UT Graduate School of Medicine offer the following remaining 2009 sessions:

These sessions are held in Morrison's Conference Center, 7-8 a.m. Questions can be directed to the Institute at 305-8046.

The Graduate School of Medicine and Internal Medicine offer a monthly CME-certified series, which focuses on the broad topics managed by Internal Medicine physicians to provide a diverse educational opportunity. The series is intended for primary care and internal medicine physicians and surgeons, and sessions are held in Morrison's Conference Center, 8-9 a.m.

Sessions remaining in the 2008-2009 academic year include these:

Questions about the Internal Medicine grand rounds can be directed to 305-9340.

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 each educational activity for a maximum of 1 AMA PRA Category 1 Credit^TM.

Through publications and invited presentations, Graduate School of Medicine researchers and physicians share findings with their peers, making an impact on patient care worldwide.

Brian J. Daley, MD, FACS, Professor of Surgery, was a Visiting Professor at York Hospital in York, Pa., Feb. 27. He lectured in grand rounds on "Perioperative Anticoagulation," delivered the basic science core lecture on "Hemostasis" and participated in mock orals for the surgery residents.

Stanley Kurek, DO, FACS, Associate Professor of Surgery, made recommendations as part of a national expert panel on field triage. These recommendations were published in an article, "Guidelines for Field Triage of Injured Patients Recommendations of the National Expert Panel on Field Triage" in the Jan. 23 Morbidity and Mortality Weekly Report. To read the article online, go to http://www.cdc.gov
/mmwr/preview/mmwrhtml/rr5801a1.htm.

Diabetes Patient Education Symposium, American Diabetes Association, Knoxville, Tenn., Feb. 28

Oral Presentation
John Eaddy, MD
"Secrets for Living Well and Long with Diabetes"

American Society for Parenteral and Enteral Nutrition Clinical Nutrition Week, New Orleans, Jan. 30

Symposium
Brian Daley, MD, FACS
"Surgery and Short Bowel Syndrome"

Eastern Association for the Surgery of Trauma 22nd Scientific Assembly, Orlando, Fla., Jan. 13-17

Stanley Kurek, DO, FACS
"EAST Leadership Development Workshop Part Three: A Formula for Success as a Division Chief"

Oral Presentation
Khanjan Nagarsheth, MD, Stanley Kurek, DO, FACS
"Ultrasound Detection of Pneumothorax Compared to Chest Xray and CT Scan"

Stanley CB, Berthelier V
Unraveling the Polyglutamine Aggregation Pathway in Huntington's Disease by Small-Angle Neutron Scattering.
Biophysical Journal, 2009 Feb; 96(3):218a-219a.

Zite NB, Wallace LS
Do instructions for over-the-counter pre-coital female contraceptives promote "perfect use"?
Contraception. 2009 Mar;79(3):211-5. Epub 2008 Nov 17.
PMID: 19185675 [PubMed - in process]
Related Articles

Venero CV, Thompson PD
Managing statin myopathy.
Endocrinol Metab Clin North Am. 2009 Mar;38(1):121-36.
PMID: 19217515 [PubMed - in process]
Related Articles

Brewer ME Jr, Strnad BT, Daley BJ, Currier RP, Klein FA, Mobley JD, Kim ED
Percutaneous Embolization for the Management of Grade 5 Renal Trauma in Hemodynamically Unstable Patients: Initial Experience.
J Urol. 2009 Feb 20. [Epub ahead of print]
PMID: 19233429 [PubMed - as supplied by publisher]
Related Articles

Yao ML, Reddy MS, Zeng W, Hall K, Walfish I, Kabalka GW
Identification of a boron-containing intermediate in the boron tribromide mediated aryl propargyl ether cleavage reaction.
J Org Chem. 2009 Feb 6;74(3):1385-7.
PMID: 19093827 [PubMed - in process]
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White WM, Mobley JD 3rd, Doggweiler R, Dobmeyer-Dittrich C, Klein FA
Incidence and Predictors of Complications With Sacral Neuromodulation.
Urology. 2009 Feb 3. [Epub ahead of print]
PMID: 19193415 [PubMed - as supplied by publisher]
Related Articles
Devoe JE, Wallace LS, Fryer GE Jr
Patient age influences perceptions about health care communication.
Fam Med. 2009 Feb;41(2):126-33.
PMID: 19184691