UTGSM The Scope E-Newsletter March 2012

Big things are happening at the Graduate School of Medicine, several of which are making quite an impact on our community. The UT Center for Advanced Medical Simulation has expanded and held its grand opening, inviting internal and external medical professionals as well as people in the community to tour the new facility and see the benefits simulation has on medical training and patient care. The efforts of its directors, Dr. Leonard Hines and Dr. Paul Huffstutter, are to be commended.

The GSM has also established its first endowed chair program, the Kelly L. Krahwinkel Chair in Oral and Maxillofacial Surgery. Congratulations to Dr. Eric Carlson in his efforts to endow the first chair at the GSM. Also, thank you to the family of Kelly Krahwinkel for their support of the Department's initiatives.

I would like to give special recognition to Martha Earl on her selection to the medical library leaders fellowship program. As one of five selected in the nation, she represents the true spirit of Preston Medical Library. I also want to recognize Dr. Ronald Lands for his leadership in narrative medicine, which I see as making medicine come to life. Also, thank you to Dr. Matthew Mancini and Susan Rawn for the leadership they are providing to local medical organizations - Dr. Mancini as the president of the Knoxville Academy of Medicine and Susan as the first president to the East Tennessee Chapter of the Society for Vascular Nursing.

In addition to leaders in the community, I want to recognize the Department of Family Medicine and its faculty and staff for establishing a Community Outreach Committee, which oversees new food and clothing pantries, and establishing programs to support health-related issues in the Knoxville area. As this issue of The Scope demonstrates, we have examples going on all around us that are making a difference to the communities we support.

James J. Neutens, PhD, FASHA
Dean

UTGSM Medical Simulation Center Open House

The UT Graduate School of Medicine held a grand opening event in its new medical simulation center, inviting faculty, staff and the community to tour the facility and participate in simulations. The UT Center for Advanced Medical Simulation is expected to enhance the quality of patient care and improve outcomes by advancing the medical skills of physicians and other healthcare professionals.

Physicians and staff said the new facility stands alongside the nation's best simulation centers for meeting the needs of practicing and aspiring medical professionals. Complete with lifelike adult and newborn mannequins that mimic humans, simulated operating, intensive care and endovascular suites and a host of other advanced training devices for medical and dental procedures, the center is equipped to help clinicians improve their skills and decision making capabilities.

UTGSM Center for Advanced Medical Simulation

"The new simulation center represents the changing paradigm in healthcare education and training," said Dr. Leonard Hines, Co-Director of the UT Center for Advanced Medical Simulation and an assistant professor with the UT Graduate School of Medicine. "Similar to training in the aviation industry, every member of the healthcare team has the opportunity to learn and master skills and to become familiar with advancing technology in a safe, risk-free environment, before accepting the challenge of patient care. In promoting safer and higher quality healthcare, the center becomes a valuable asset to the region's medical community and the patients served."

The new center is 6,500 square feet, significantly larger than the 400-square-foot original simulation center that opened in 2008. Already recognized as a regional asset for clinicians from a variety of hospitals and health systems in the Knoxville area, the newly renovated facility is expected to attract medical professionals from around the region and country for training.

"In addition to physicians, other healthcare providers such as nurses, therapists, physician assistants, EMTs and dentists learn techniques at the simulation center that can quickly be put into practice for their patients," said Dr. Paul Huffstutter, Co-Director of the simulation center and an assistant professor with the UT Graduate School of Medicine. "Our physicians and staff provide significant hands-on training, but we also step back to observe and capture video recordings of procedures from a control room, with immediate debriefing and critiquing sessions afterward, to optimize student learning."

In accordance with their role at the region's only academic medical center, staff members, including Melinda Klar, RN, Administrative Director, and Judy Roark, CST, Lab Coordinator and Skills Coach, employ a model by which they continually study their own training and teaching techniques as well as how others best learn. As a result, they can continually modify their training modules and methods to help those they teach maximize what they've learned on behalf of their patients.

"Not only will the UT Center for Advanced Medical Simulation make a great contribution to our educational programs here, but it also will provide excellent opportunities for physicians and other healthcare professionals in the region to update their skills and meet newer requirements for certification," said Dr. James J. Neutens, Dean of the UT Graduate School of Medicine. "Although the center revolves around providers of healthcare, the ultimate success story will be improved patient care and safety. We're delighted to open the new simulation center."

Eric Carlson, DMD, MD, Chair and Professor of Oral and Maxillofacial Surgery, recently introduced the Kelly L. Krahwinkel Endowed Chair in Oral and Maxillofacial Surgery. The endowment will support the department's initiative in oral/head and neck cancer diagnosis and surgical treatment, providing enhanced clinical integration in the UT Cancer Institute as well as supporting the department's academic mission in education and research.

Dr. Carlson said objectives of the endowment are to fund molecular research in oral/head and neck cancer as well as to provide clinical and administrative space in the new UT Cancer Institute, enhancing collaborations with clinicians in radiology, oncology and pathology. This collective wisdom will improve diagnosis and treatment planning as well as provide increased exposure and learning opportunities to fellows in Oral/Head and Neck Surgery.

The endowment is named for Kelly L. Krahwinkel who was diagnosed with a very aggressive variant of adenoid cystic carcinoma of the submandibular salivary gland and cervical lymph nodes in late 2007, which took her life only 13 months later. Her family, including husband Mark Spurlock and parents Dr. DJ and Lyda Krahwinkel, wished to provide a permanent legacy for Kelly while supporting and promoting the department's mission.

Read more from Dr. Carlson's personal statement regarding Kelly's courage in the face of her disease; why her family wishes to promote the institution's mission through the endowed chair; and how this impacts OMFS and its faculty.

For more information on contributing to the Kelly L. Krahwinkel Endowed Chair, contact the Office of Development or visit the Ways to Give page.

In light of ACGME's renewed focus on resident performance improvement efforts, "Residency Program Alert," a newsletter published by HCPro, Inc, featured the Internal Medicine Residency and its Monday Morning Quarterback meeting program as a model for other residency programs to follow. Monday Morning Quarterback meetings were initiated by Medicine faculty Mark Rasnake, MD, and Daphne Norwood, MD, in fall 2010 as a way for residents to identify issues related to safety and quality and recommend a plan of action to the department. Teams including a first-year resident, senior residents and a faculty mentor work together to identify safety issues and take action on issues they think they can improve.

"We incorporated ideas from the Institute for Healthcare Improvement and created a conference to bridge the gap between the resident's education and the hospital's quality and safety initiatives," Dr. Rasnake said. "We found that things discussed at a monthly morbidity and mortality conference would grow stale before the next meeting and needed changes would not be implemented. We thought a weekly meeting would help keep patient safety and quality on the front burner."

He and Dr. Norwood were correct. Dr. Rasnake said the program does not charge residents with brainstorming novel solutions. Instead, residents are instructed to take ideas instituted at other healthcare organizations and adapt best practices to the Graduate School of Medicine. Residents use a plan-do-study-act cycle to investigate improvement efforts. To date, recommendations have been made to improve insulin safety and the management of alcohol withdrawal, which are currently being discussed within hospital committees. Also, two residents have pending research presentations stemming from work done on the evaluation of syncope and on the reliability of point of care coagulation testing. Both of these projects are to be presented at national meetings by the residents.

Dr. Norwood said another positive outcome of the Monday Morning Quarterback meetings has been the communication between residents and institutional leadership, empowering residents to provide feedback and giving them a better understanding of how to effect change within a hospital.

For more information on the Monday Morning Quarterback meetings or the article published in the "Residency Program Alert," contact Dr. Rasnake.

Imaging Trial for Novel Liver Cancer Treatment Shows Promising Results

Radiology faculty are leading an investigation to improve imaging options available to patients who have undergone Selective Internal Radiation Therapy (SIRT), the latest treatment option available at the University of Tennessee Medical Center for those with inoperable hepatic tumors. SIRT is a non-surgical therapy that uses microscopic radioactive spheres, called SIR-Spheres®, to deliver radiation directly to the site of the liver tumor.

The procedure involves injecting billions of microscopic acrylic spheres (microspheres) containing the radioactive isotope Yttrium-90 into the liver tumor through the right or left hepatic artery. The microspheres lodge in the area of the tumor, where the radiation kills and slows the growth of the cancer cells. To optimize this treatment, the location of the microspheres is commonly imaged using a nuclear medicine SPECT scan. However, for technical reasons, SPECT is only capable of providing crude images of the Yttrium-90 isotope.

At the UT Graduate School of Medicine, Anastasia Balius, MD, Assistant Professor of Interventional Radiology, is leading a clinical trial with J. Mark McKinney, MD, Chair of Radiology, and Alexander Pasciak, PhD, Assistant Professor and Medical Physicist, to determine if PET/CT technology, considered the cutting-edge in oncology for its sensitivity to cancer, can be used to improve SIRT treatment by providing imaging which is superior to the traditional SPECT scan. Dr. Balius said, "Patients that come to the University of Tennessee Medical Center for SIRT have the opportunity to participate in exciting new PET/CT research that has the potential to improve SIR-Spheres® delivery and follow-up. We are one of a select few facilities in the nation participating in this type of investigation for advanced liver cancer."

At the forefront of PET/CT imaging equipment is the Siemens Biograph mCT PET/CT scanner, which the research team utilizes for this clinical trial. It is through an ongoing collaborative research relationship with Siemens, a global leader in medical imaging, that this technology is available at the UT Graduate School of Medicine.

While treatment with SIR-Spheres® is generally not regarded as a cure to liver cancer, it has been shown to shrink liver cancer more than chemotherapy alone.

"SIR-Spheres delivers more radiation targeted directly to tumors and spares more healthy tissue than would be possible using conventional external radiation," said Dr. J. Mark McKinney, Radiology Chair and Interventional Radiologist at the University of Tennessee Medical Center. "This new capability allows us to treat tumors in the liver regardless of the size or location with a precise, yet high dose of radiation. The treatment has been shown to shrink liver tumors and improve the quality of patients' lives."

The University of Tennessee Medical Center is the only site in East Tennessee offering SIR-Spheres® for the treatment of liver cancer. SIR-Spheres® is one of many options among a full array of treatments made available for patients with primary/metastatic liver disease. In addition to SIRT, other procedures to treat liver cancer include: surgery, radiofrequency ablative therapy, chemoembolization and stereotactic radiation therapy.

Katie Phillips, a fourth-year medical student at UT Health Science Center, expected the Narrative Medicine elective to teach her how to focus on learning the patients' stories – the obstacles they face and why they suffer from their ailments – to help her become a "stronger" doctor. What she did not foresee was how the rotation would also bring healing to her.

As the first student to participate in the one-month Internal Medicine elective facilitated by Ronald Lands, MD, Associate Professor, Phillips said she chose the course because she liked the relationship-building and continuity-of-care aspects of primary care and thought the goals of the narrative medicine rotation would help her to be a more well-rounded physician. Plus, she liked to read. She said she was surprised by the flexibility of the course as well as how much she learned about basic medicine.

Phillips's typical day included either making rounds with the housestaff team or attending hematology clinic with Dr. Lands in the morning. She spent her afternoons reading, usually short stories and poems related to medicine, and then discussing her reactions to what she read with Dr. Lands. Phillips said her responses were usually based on her own experiences, including the death of her father two years ago.

"Sometimes I would think what I read was terrible because of how I personally related to it," Phillips said. "I felt like I could be honest with Dr. Lands and say I didn't like it and he not take offense to it. I'm now much more able to discuss death and dying than before. I don't know if I would have grown so much if I hadn't experienced my own loss. Loss of a loved one changes who you are and how you view things. But, I also think it would be a great elective for any fourth-year medical student because it helps you reflect on difficult situations and how you may handle them in the future."

In addition to reading, Phillips spent time journaling each day on something that touched, inspired or surprised her. She said that one day when Dr. Lands was house staff, a patient passed, so she journaled about that experience.

"As a physician you see patients take their last breath," she said. "This rotation forces you to think and talk about things you may not have seen yet as a medical student, which helps for when you are the go-to person making decisions."

Dr. Lands then asked Phillips to turn her journal entry into a poem, which she did with the help of Donna Doyle, Preston Medical Library staff who assists with the narrative medicine course and has published several poems in the Journal of the American Medical Association.

"This was new to me," Phillips said. "I didn't know how to write a poem, so I Googled it. Donna gave me several prompts to turn what I wrote into a poem."

Phillips said she enjoyed the rotation and plans to continue incorporating narrative medicine into her professional life, especially the journaling because, "sometimes you need to get it out without talking."

Family Medicine Supports Community through Food and Clothing Pantries and Fundraisers

What began as Family Medicine's "Adopt a Family" program at Christmas-time has become an on-going project to provide food and clothing to University Family Physicians patients who are experiencing hardships. The Department of Family Medicine recently established a Community Outreach Committee to oversee new food and clothing pantries and determine families who may best benefit from these donations. The committee is also organizing activities to support local causes. In addition to organizing teams for runs and walks, they have established "Dress Down Fridays," which lets staff wear UFP tee shirts for a $1 donation that will support causes such as The American Heart Association's "Go Red for Women," March of Dimes, Alzheimer's Tennessee and the American Diabetes Association.

Kelly McDaniel, Administrative Director, said, "As a Family Medicine practice we see patients from all walks of life with many different health-related and social issues. Supporting local organizations is our way of also helping our patients, friends and families. The neat thing for me is to see how our staff has taken the initiative, time and organization to make these things happen with the fundraisers and in the creation of the food and clothing pantry. What started as a team building process has become so much more."

Sue Valicenti-Dosch, Co-Chair of the Community Outreach Committee with Lucky Morton, LPN, said the food and clothing pantries were founded after Christmas gifts were given to a patient and her family who had more than medical needs. She said the committee sees the pantries as another way for UFP staff to treat the "whole" patient. They have not yet established guidelines for providing assistance and have asked staff to recommend patients that may have needs.

Committee member Victoria Coy is spearheading donation efforts. Collection boxes are located in the UFP break room on the first floor of the GSM building. She has also been targeting community businesses, already receiving donations from Pilot on Asheville Highway where she also has collection boxes set up.

Coy said, "Right now we are collecting whatever we can just to get the pantry stocked. Then as we get more organized, we will hope to target seasonal items, like back-to-school supplies."

With Valincenti-Dosch, Morton and Coy, committee members are Kimberly Cook, Dr. Obaydah AbdurRaqeeb, Dr. Jennifer McHardy, Elizabeth Carroll, Carla Johnson, Melissa Mincey, LPN, Lynn Lowery, Kimberly Rose and Lisa Stephens.

For four weeks, UT Graduate School of Medicine physicians in Family Medicine and Surgery provided medical care and medical training in northern Ghana, located in West Africa. David Stockton, MD, MPH, Professor of Family Medicine, first joined a mission trip to the Baptist Medical Center in Nalerigu in 2007 and has returned several times. This year, Gregory Blake, MD, Professor and Chair; second-year residents Jonathan Laymance, MD, and Michael Martin, MD; and Hobart Akin, MD, Assistant Professor of Surgery, also participated in the medical mission.

Working out of sparsely equipped operating, procedure and clinic rooms and using antiquated techniques, the physicians were able to treat patients for a variety of conditions including general wound care, skin grafts, suture of lacerations, abscess drainage, cesarean sections, exploration of tumors and more.

"We had to treat patients based on the ability to do physical diagnosis," Dr. Akin said. "We could take x-rays, but we had no other imaging equipment available. If a patient had abdominal pain, the only option was to open him up."

Dr. Laymance, who said he has a passion for mission work and has previously been to Brazil, Honduras and Costa Rica, said they were exposed to pathology rarely seen in the United States, including cases of mumps, leprosy and elephantiasis. He said he also enjoyed the opportunity to learn surgical technique, assisting Dr. Akin on cases including hernia repair and exploratory laparotomies with repair of bowel perforation due to typhoid.

Dr. Akin said his main goal during the trip was to train not only visiting residents but also local medical staff on surgical techniques as the staff at the hospital, including an obstetrics and gynecology physician and a pediatrician, had not been formally trained in surgery.

The GSM physicians noted the biggest hurdle in treating patients was the language barrier. Although many of the people speak English, there are about 100 dialects in Ghana. They also said one of the hardest things to see was the infant mortality, usually from malaria.

"Death is accepted there," Dr. Akin said. "You don't see grieving. The infant mortality may be as high as fifty percent."

Dr. Martin said, "The time in Ghana showed me how lucky we are to have our homes and health. It also helped me to realize I do have the training to know how to handle the patient that has an emergency, urgency or critical illness."

Baptist Medical Center was established more than 50 years ago and is the only hospital in the region. It has two full-time American physicians and is partially staffed by more than 150 volunteer practitioners each year. Dr. Stockton said UTGSM has a long history of faculty and resident physicians volunteering in Ghana. Jon Parham, DO, MPH, Associate Professor, Family Medicine is currently serving a two-week mission in Ghana through March 29.

Matt Pittman, MD, Anesthesiology Resident, recently won and donated a MacGrath® MAC video laryngoscope to the Department of Anesthesiology, valued at approximately $5,000. Dr. Pittman said he registered to win the pocket-sized camera at a vendor booth at the 2010 American Society of Anesthesiologists Annual Meeting and was surprised to receive notification of the award about a year later. He said he chose to donate the laryngoscope because he wants patients to be able to benefit from the technology, which he said is potentially life-saving, and he does not foresee many opportunities to use it following graduation based on his current plans.

Jerry Epps, MD, Chair, Anesthesiology, said, "Difficulty with tracheal intubation, particularly in patients with an unanticipated difficult airway, remains a frequent cause of anesthesia-related morbidity and mortality. A variety of special laryngoscope designs such as the McGrath® MAC have recently been employed to help deal with this problem. Dr. Pittman's generous donation has helped the Department of Anesthesiology to provide even safer care for our patients."

Matthew Mancini, MD, Associate Professor of Surgery, is serving as 2012 president to the Knoxville Academy of Medicine. He was inaugurated at a dinner honoring the KAM Executive Committee in February. KAM is a constituent of the Tennessee Medical Association, to which Dr. Mancini is chair on the Board of Trustees.

Dr. Mancini completed his General Surgery Residency at the UT Graduate School of Medicine in 1999, acting as Chief Resident from 1998-1999. Upon completion of his residency, Dr. Mancini joined Department of Surgery faculty.

Dustin Osborne, Assistant Professor, Radiology, has earned his PhD in Nuclear Engineering (Radiological Engineering) effective December 2011. His dissertation, "Characterization of a Small Animal SPECT Platform for use in Preclinical Translational Research," focused on the performance of SPECT to image I-125 and determine areas for improvement.

Dr. Osborne works in the Molecular Imaging and Translational Research Program (MITRP) area of Radiology as an imaging specialist and physicist providing technical expertise with regard to developing experiments, optimizing the conditions under which the experiments are performed, and analysis of data acquired from the imaging systems. Dr. Osborne also provides business development support to the MITRP, including driving collaborations and working to create an educational infrastructure within the group.

Jonathan Phipps also graduated with his PhD in December 2011 through the UT Comparative and Experimental Medicine Program, conducting research under the guidance of Jonathan Wall, PhD, Director of the Preclinical Diagnostic and Molecular Imaging Laboratory. His research, "Toward Personalized Medicine: The Potential Role of RNA Interference in Plasma Cell Dyscrasias," investigated the ability to apply a fairly novel method of gene regulation, RNA interference, to reduce protein burden in patients with amyloidosis and other plasma cell disorders. Dr. Phipps also developed and generated a virus-based delivery system which is used to deliver a modified version of interfering RNA to knock down the ability of cells to produce immunoglobulin components in a semi-permanent fashion. Dr. Phipps now works as a post-doctorate researcher in the Human Immunology and Cancer Program with Daniel Kestler, PhD, Assistant Professor, studying a protein called ODAM, which has been proposed as a biomarker in breast cancer.

Tatiana Perevozchikova, who was working as a Graduate Student in the Conformational Diseases and Therapeutics Research Program under the direction of Valerie Berthelier, PhD, received her doctorate in January. She studied "Structural Dynamics of Huntingtin Exon 1 Aggregation Studied By Small Angle Neutron Scattering" in collaboration with the Spallation Neutron Source at Oak Ridge National Laboratory. As a graduate student, Dr. Perevozchikova made several presentations at international meetings and won awards, including Best Research Presentation Prize from the National School on Neutron and X-ray Scattering. She is now a post-doctorate researcher for nSoft at the National Institute of Standards and Technology under the U.S. Department of Commerce in Maryland.

Martha Earl, MSLS, AHIP, Assistant Professor, Preston Medical Library, is participating in a one-year fellowship program to develop medical library leaders, jointly sponsored by the National Library of Medicine and the Association of Academic Health Sciences Libraries. She was one of five selected for the tenth fellowship class, which prepares leaders for director positions in academic health sciences libraries. Fellows are paired with mentors and will spend two one-week visits at their mentors' libraries. Fellows also participate in learning sessions and discussions with all current mentors and fellows, using a combination of in-person and virtual learning experiences.

Earl said, "The idea in participating in the fellowship is that I can learn new things in library leadership and bring those practical ideas back to put into practice here at UT. Sandy Oelschlegel [Preston Library Director] was very supportive and helpful with the application process."

Earl's goals for the program are to learn more about working within the university context to communicate the value of the library to administration; look at differences in services between her and her mentor's library; and learn more about fundraising, revenue generation and partnerships that leverage resources.

Fellows attended the Association of American Medical Colleges annual meeting in November 2011 where they participated in a leadership orientation and discussed trends in medical library leadership as well as trends in medicine and health sciences. Earl said that some of the leadership trends discussed included the value of true marketing, being at the table with leaders and having a voice; developing champions and telling your story to other leaders and people in the community; and knowing "what keeps your boss awake at night," such as trends for chief financial officers.

In April and August 2012, Earl will spend a total of two weeks at the Southern Illinois University School of Medicine Medical Library with her mentor, Connie Poole, who is the Associate Dean for Information Resources and Chair of Information and Communication Sciences.

Monthly, fellows participate in virtual learning sessions with topics including work force, e-science, revenue generation, diversity, and power and influence.

Other fellows and mentors selected are:

Shannon D. Jones
Associate Director, Research and Education
Tompkins-McCaw Library for the Health Sciences
Virginia Commonwealth University Libraries
Mentor: R. Kenny Marone
Director, Cushing/Whitney Medical Library
Associate University Librarian for School and Department Libraries
Yale University

Jennifer McKinnell
Head of Public Services
Health Sciences Library
McMaster University
Mentor: Cynthia Robinson
Director, George T. Harrell Health Sciences Library
Hershey Medical Center
Penn State College of Medicine

Douglas L. Varner
Senior Associate Director/Chief Biomedical Informationist
Dahlgren Memorial Library
Georgetown University Medical Center
Mentor: Evelyn B. Morgen
Director, Lyman Maynard Stowe Library
University of Connecticut Health Center

Jeffrey D. Williams
Assistant Director, Collections, Access & Clinical Services
Biomedical Library
University of California, San Diego
Mentor: A. James Bothmer
Associate Vice President for Health Sciences and
Director, Health Sciences Library
Creighton University

Susan Rawn, BSN, CCRP, RN, Research Coordinator in the Department of Surgery, was elected as President of the newly-formed East Tennessee Chapter of the Society for Vascular Nursing (SVN). The society's focus is advancing the care of persons living with vascular disease through excellence in clinical practice, education and research.

The East Tennessee Chapter, the first local chapter of SVN, will focus on volunteer efforts in community education events. To date, members have volunteered at Heartwise, a health fair at the Heart, Lung, Vascular Institute; Life Line Screenings; and Diabetes NOW!, filling in as needed with presentations, calcium scoring and more.

SVN will hold its annual conference in May, when the East Tennessee Chapter will be announced to the national organization. Also at the 2012 conference, Rawn, together with UT Medical Center vascular nurses Renee Black, MSN, Lauren Scarbro, RN, and Tammy Seay, RN, will present the findings of their study, "Retrospective Study of Rates of Infection among Dressings Used in Surgeries with Femoral Puncture," which led to the formation of the East Tennessee Chapter.

On forming the chapter, Rawn noted it would not have happened without the support of vascular surgeons Mitchell Goldman, MD, Assistant Dean of Research and Chair of Surgery; Scott Stevens, MD, Professor of Surgery and Director of Endovascular Surgery; Michael Freeman, MD, Professor, Chief of Vascular Surgery and Fellowship Program Director; and Alex Cantafio, MD, Assistant Professor. The chapter's inaugural executive committee also includes Seay as President-Elect; Ashley Dennis, RN, operating room nurse at UT Medical Center, as Secretary; and Meschel Wallace, RN, endovascular nurse at UT Medical Center, as Treasurer. The local chapter includes 26 members from the Knoxville area, all RNs with a range of specialties. For information on joining, contact Rawn at 865-305-9227.

Faculty
Upinder Dhand, MD, Professor, Medicine
James McLoughlin, MD, Associate Professor, Surgery

Staff
Andrea Clark, Laboratory Assistant, Family Medicine
Laura May Ewing, Senior Lab Technologist, Family Medicine
Brandie Miracle, Administrative Coordinator, Anesthesiology
Angela Jordan, LPN, License Practical Nurse, Obstetrics and Gynecology
Ashley Hull, Administrative Support Assistant, Pathology
Amanda Wilson, Faculty Affairs Coordinator, Dean's Office

A new research digest, Advance, spotlights research programs at the UT Graduate School of Medicine and explains how the work of the institution's researchers impacts healthcare in Tennessee and beyond.

The second issue of Advance includes features on efforts to ensure healthier babies and moms; a new peptide, p5, developed at the Graduate School of Medicine that visualizes plaque in the brain; and breakthroughs in Huntington's disease and Type 2 diabetes. Also featured are regenerative medicine; dental forensics; clinical trials; and other research news.

Advance is available under Research on the GSM website and in hard copy. To request copies, contact the office of Continuing Education and Professional Development at 865-305-9190.

The UT Graduate School of Medicine and Academy of Scholars Committee will hold Resident and Fellow Research Day on Wednesday, May 23. Residents and fellows are invited to submit abstracts via The Pulse, due April 15. Submission guidelines have been updated and should be reviewed on The Pulse prior to submission.

The 2011-2012 Business Course for Residents series will hold its final session Thursday, April 19, at noon in Morrison's Conference Center, hosted by Christy Bailey with University Physician's Association who will discuss billing and collections.

The series has covered several topics designed to prepare physicians and dentists for careers in private practice, hospital or academic settings, including, for the first time, "Changes in Healthcare," presented by Michael Stahl, PhD, Director of the Physician Executive MBA Program and Distinguished Professor of Management in the College of Business at UT Knoxville. Also recently presented was "Credentialing," by Shirley Lett with UPA.

More information and previous business courses are on The Pulse.

Visit www.tennessee.edu/cme for details about these and more upcoming certified continuing education activities presented by the UT Graduate School of Medicine.

Second Tuesday: Internal Medicine Grand Rounds, Morrison's Conference Center, 8-9 a.m.

Every Wednesday: Tumor Board Series, Morrison's Conference Center, 7:00-8:30 a.m.

Every Thursday: Pulmonary Tumor Board Series, Cancer Institute Conference Room, 7-8 a.m.

Every Thursday: Surgery Grand Rounds, Morrison's Conference Center, 7-8 a.m.

Every Friday: Breast Cancer Tumor Board Series, Cancer Institute Conference Room, 7:00-8:30 a.m.

April 9: Head and Neck Tumor Board Series, Cancer Institute Conference Room, 12-1 p.m.

April 16: Neurology/Neurosurgery Quarterly Case Conference, Morrison's Conference Center, 7-8 a.m.

April 23: Head and Neck Tumor Board Series, Cancer Institute Conference Room, 12-1 p.m.

May 7: Head and Neck Tumor Board Series, Cancer Institute Conference Room, 12-1 p.m.

May 8: Internal Medicine Grand Rounds, Morrison's Conference Center, 8-9 a.m.

May 21: Head and Neck Tumor Board Series, Cancer Institute Conference Room, 12-1 p.m.

Visit Continuing Education and Professional Development Upcoming Courses or contact CEPD for more information.

A course offered by the University of Tennessee, Knoxville Center for Executive Education in the UT College of Business is certified for CME and CDE credits.

Lean for Healthcare is a multi-day course offered March 26-30, August 6-10 and November 5-9, at the Haslam Business Building on the UTK campus. This course uses the concept of lean processes traditionally practiced in the manufacturing industry but applied now to improving efficiencies and eliminating waste in healthcare. Each Lean for Healthcare course is approved for 34.5 AMA and AGD credits.

The course is appropriate for healthcare professionals, including physicians, nurses, pharmacists and others as well as healthcare executives and those who impact medical and financial decisions in an organization.

For more information, visit Lean for Healthcare or contact the Center for Executive Education at 865-974-0460.

Lean for Healthcare is jointly sponsored by the University of Tennessee College of Business Center for Executive Education and the UT Graduate School of Medicine, Knoxville.

The UT Graduate School of Medicine presented the Eighth Annual Hematology Conference: An Update on Selected ASH Topics, on January 21, and leading discussions were Thomas Habermann, MD, Mayo Clinic; Michael Keating, MB, BS, MD Anderson Cancer Center; Craig Kitchens, MD, University of Florida; and Rami Komrokji, MD, H. Lee Moffitt Cancer Center. Wahid Hanna, MD, professor, UT Graduate School of Medicine, directed the educational activity.

Each year, the conference provides updates derived from the speakers' expertise and presentations at the international conference of the American Society of Hematology. The eighth annual conference was approved for 5 AMA, ACPE and AAPA credits and.5 CEUs.

For more information about continuing education activities, visit www.tennessee.edu/cme.

A capacity crowd attended the Eighth Annual Diabetes Regional Conference in March. Attendees learned from regional and national experts in the fields of endocrinology, podiatry, family medicine, pharmacy, obstetrics/gynecology, health literacy and more, who focused their presentations on trends and treatments of diabetes mellitus.

The conference was approved for AMA, AAPA, AAFP, ACPE credits, as well as CEUs. It was presented by the UT Graduate School of Medicine and Department of Family Medicine, Knoxville.

Poster Presentation
Joshua Arnold, MD
"Smooth Muscle Cell Polymeric Transfection Is An Efficient Alternative to Traditional methods of Experimental Gene Therapy"
Co-authors: Deidra Mountain, PhD, Michael Freeman, MD, Stacey Kirkpatrick, Scott Stevens, MD, Mitchell Goldman, MD, Oscar Grandas, MD

2012 Annual Scientific Meeting of the Southeastern Surgical Congress, Birmingham, Alabama, February 11-14

Oral Presentation
Keith Gray, MD
"Predictors and Effect of Blood Transfusion on Morbidity following Pancreaticoduodenectomy"

Poster Presentation
Michelle Fillion, MD
"Intraoperative Marking Technique Facilities Second-Stage Ablation of Occult Hepatic Tumors"
Contributors: Keith Gray, MD, John Bell, MD, James Lewis, MD

Poster Presentation
Richard Laine, MD
"A Review of False Positive Findings on 131I Whole Body Scans in Thyroid Cancer with Case Examples"
Co-author: Karen Wells, MD

Southern Association for Vascular Surgery Annual Meeting, Scottsdale, Arizona, January 18-21

Poster Presentation
Joshua Arnold, MD
"Establishing Polymeric Transfection as a Non-Viral, Non-Toxic Method for Gene Therapy in the Prevention of Vascular Disease"
Co-authors: Deidra Mountain, PhD, Michael Freeman, MD, Stacy Kirkpatrick, Scott Stevens, MD, Mitchell Goldman, MD, Oscar Grandas, MD

Daniel Alterman, MD
"Contemporary Outcomes of Vertebral Artery Injury - A Ten Year Single Center Experience"
Co-authors: Eric Heidel, Brian Daley, MD, Scott Stevens, MD, Oscar Grandas, MD, Mitchell Goldman, MD, Michael Freeman, MD

Poster Presentations
Camille Blackledge, MD
"Unique Technique for Repair of Bilateral Parastomal Hernias without Ostomy Resiting"
Co-authors: Gregory Mancini, MD, Melissa Phillips, MD

Hien Le, MD
"Retromuscular Preperitoneal Repair of Recurrent Hernia through the Linea Similunaris after Kidney Transplantation"
Co-authors: Gregory Mancini, MD, Melissa Phillips, MD

Poster Presentation
Valerie Sams, MD
"Effect of Local Anesthetic on Microorganisms in a Murine Model of Surgical Site Infections"
Co-authors: Christy Lawson, MD, Patricia Coan, DVM, David Bemis, PhD, Kim Newkirk, DVM, Michael Karlstad, PhD, Jamison Norwood, BS, Brian Daley, MD

Pediatric Research Day at Le Bonheur Children's Hospital, Memphis, Tennessee, November 16, 2011

Poster Presentations
TJ Nobles
"Cross Sectional Analysis of Sports Concussion in Adolescent Athletes"
Contributors: Thomas Terrell, MD, Jamie Yeager, Brianna Rader, Eric Heidel, Kenneth Bielak, MD, Robert Cantu, MD, Jeffrey Barth, PhD, Robert Bostick, MD, Daniel Laskowitz, MD, Ellen Bennett, PhD

North American Primary Care Research Group Conference, Banff, Canada, November 12-16

Oral Presentation
Amy Keenum, DO
"Generic Medications for Me but Brand Name Medications for You"

Poster Presentation
Amy Keenum, DO
"How do Young Women Understand the Terms 'Opioids' and 'Narcotics'?"
Contributors: Obaydah AbdurRaqueeb, MD, Luke Chesney, MD, Lorraine Wallace, PhD

8th International Melanoma Congress of The Society of Melanoma Research & 5th Annual Meeting of Interdisciplinary Melanoma/Skin Cancer Centres, Tampa, FL, November 9-12, 2011

Oral Presentation
James Lewis, MD
"Advances in Surgery and Regional Therapy for Melanoma"

Oral Presentation
Jane White, PhD
"Hospital Malnutrition: Raising Awareness and Revising the Approach"
This presentation was simulcast to Columbus, Ohio; Baltimore, Maryland; New York, New York; Chicago, Illinois; Houston, Texas; San Francisco, California; Los Angeles, California; Seattle, Washington; Las Vegas, Nevada; San Diego, California

Tennessee Chapter of the American College of Physicians Scientific Meeting, Nashville, Tennessee, October 13-15, 2011

Oral Presentation
Eric Edwards, MD
"A 59 year old with Mental Status Changes"
Contributors : Mark Rasnake, MD, Daphne Norwood, MD
Dr. Edwards was one of three residents state-wide chosen to present during "Doctor's Dilemma."

Poster Presentations
Andrew Dake, MD
"Etanercept Accelerated Pulmonary Nodulosis in Rheumatoid Arthritis"
Contributor: Mark Rasnake, MD

Eric Edwards, MD
"Acute Psychosis in a Patient with Cushing's Disease"
Contributors: Mark Rasnake, MD, Daphne Norwood, MD

Benjamin Helms, DO
"Syncope with a Paralyzing Result"
Contributor: Daniel Ely, MD

Adrienne Netterville, MD
"Infected Left Atrial Myxoma: A Rare Cause of Bacteremia with a Common Pathogen"
Contributor: Mark Rasnake, MD

32nd Forum for the Behavioral Sciences in Family Medicine, Chicago, Illinois, September 22-25, 2011

Oral Presentation
Edwin Rogers, PhD
"Psychiatry Rotation with an Integrated Care Component: Direct Experience with Health Behavior Change"
Contributors: Brian Bonnyman, MD, Suzanne Bailey, PsyD

Poster Presentation
Solomon Lee, DO
"Improving Quality of Cytology Diagnosis: Splenic Fine Needle Aspirations and Core Biopsies, Our 16 Years Experience"
Co-authors: Stuart Van Meter MD, J Mark McKinney MD, Laurentia Nodit MD

Oral Presentation
Keith Gray, MD
"Gastrointestinal Reflux Disease (GERD)"

Dhand R, Dolovich M, Chipps B, Myers TR, Restrepo R, Farrar JR.
The role of nebulized therapy in the management of COPD: evidence and recommendations.
COPD. 2012 Feb;9(1):58-72
PMID: 22292598

Siddiqui S, Heidel RE, Angel CA, Kennedy AP Jr.
Pyloromyotomy: randomized control trial of laparoscopic vs open technique.
J Pediatr Surg. 2012 Jan;47(1):93-8.
PMID: 22244399

Aligeti VR, South HL, Hirsh JB, Wortham DC
Aorto-Right Atrial Fistula Following Transseptal Catheterization and Catheter Ablation for Atrial Fibrillation.
J Cardiovasc Electrophysiol. 2012 Jan 11. [Epub ahead of print]
PMID: 22235776

Pokorny E, Hecht S, Sura PA, Leblanc AK, Phillips J, Conklin GA, Haifley KA, Newkirk K
Magnetic Resonance Imaging of Canine Mast Cell Tumors.
Vet Radiol Ultrasound. 2011 Dec 4. [Epub ahead of print]
PMID: 22136427

Hopko DR, Armento ME, Robertson SM, Ryba MM, Carvalho JP, Colman LK, Mullane C, Gawrysiak M, Bell JL, McNulty JK, Lejuez CW
Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: randomized trial.
J Consult Clin Psychol. 2011 Dec;79(6):834-49. Epub 2011 Oct 10.
PMID: 21988544

Wall JS, Richey T, Stuckey A, Donnell R, Oosterhof A, van Kuppevelt TH, Smits NC, Kennel SJ
SPECT imaging of peripheral amyloid in mice by targeting hyper-sulfated heparan sulfate proteoglycans with specific scFv antibodies.
Nucl Med Biol. 2012 Jan;39(1):65-75. Epub 2011 Sep 29.
PMID: 21958847

South H, Bains J, Hirsh J
Unusual complication of pacemaker implantation/revision: Secondary endocarditis due to fracture and embolization of an introducer sheath.
Catheter Cardiovasc Interv. 2012 Feb 1;79(2):339-43. Epub 2011 Jul 22.
PMID: 21786401

Kabalka GW, Shaikh AL, Barth RF, Huo T, Yang W, Gordnier PM, Chandra S.
Boronated unnatural cyclic amino acids as potential delivery agents for neutron capture therapy.
Appl Radiat Isot. 2011 Dec;69(12):1778-81. Epub 2011 Mar 31.
PMID: 21481596

Sams VG, Lawson CM, Shibli AB, Taylor DA, Branca PR
Severe Tracheobronchomalacia after Prolonged Intubation of Multitrauma Patient
Case Reports in Surgery 2011; 2011: Article ID 627012
PMID: 21481596

Blevins DW, Yao ML, Yong L, Kabalka GW
Iron trichloride promoted hydrolysis of potassium organotrifluoroborates.
Tetrahedron Letters 2011 Dec 7; 52(49):6534-6536

Quinn, M, Yao, M, Yong, L, Kabalka, GW
Boron Trihalide Mediated Haloallylation of Aryl Aldehydes and its Application to the Preparation of (E) – 1, 3-Dienes
Synthesis. 2011:3815-3820.

Fish L, Duncan LD, Gray K, Bell J, Lewis J
Primary Cutaneous Melanoma Arising in a Long-Standing Irradiated Keloid
Case Reports in Surgery 2012; 2012: Article ID 165319