Health Sciences Report (1997)

UNIVERSITY OF UTAH THE APROBABLE LIFE OF trio C FROM THE EDITOR On these wintry days when the white landscape blurs into the cloudy horizon, we welcome warmth. In hospital offices, clinics and patient rooms though, we frequently take it for granted. Only when a draft warns us of its impending absence do we talk about life- sustaining warmth. It's the same with feelings such as hope. Hope, the confidence- not certainty- that what we long for may happen, permeates the health sciences center. We can sense it every day in the hands of a nurse, the nod of a physical therapist, the eyes of a physician. But not until clinical vocabularies are exhausted do we often hear the word used in conversation. When hope seems most tenuous, we reach for it. Mario R. Capecchi, Ph. D., knows about hope. Despite discouragement from the National Institutes of Health, Capecchi remained confident that his experiments with gene targeting would prove successful. His perseverance paid off with the discovery of homologous recombination that has revolutionized mammalian biology. But there is an earlier chapter in the Capecchi story, a time when survival, not research, was the focus of his life. At four years of age, Capecchi was left homeless to wander through Italy. His mother had been imprisoned in a German concentration camp during World War II. For three years, he survived on the streets. A fourth year, he spent hospitalized for malnutrition. As Capecchi relates in this issue of the magazine, he lay naked on a hospital bed with no sheets or blankets, delirious from lack of food, yet every day, he plotted an escape. That hope kept him alive. Hope does the same for many patients today who are separated from their families by disease. But we are confident that, in the near future, we can offer them more than expressions of hope. At the University's transgenic and knockout mice facilities, also featured in this issue, researchers are working with laboratory animals to learn about some 4,000 human diseases known to be genetic. Many of these research projects have been described in previous issues of the magazine in " Research in Brief." That section, as well as several other regular features, will be included again this spring. We're expanding the magazine to three issues per year to better cover events and issues at the health sciences center. Vaclav Havel, playwright and president of the Czech Republic, has suggested that hope may not be the desire for something you want to happen, but " the certainty that something makes sense, regardless of how it turns out." At the University, we are working in labs, clinics, classrooms and offices towards a better understanding of health and disease with perseverance- and, of course, hope, c Susan Sample INTER 1997 HEALTH SCIENCES REPORT HEALTH SCIENCES REPORT UNIVERSITY OF UTAH Vol. 2 1 , No. 1 Published by the Office of Public Affairs, University of Utah Health Sciences Center, 50 North Medical Drive, Salt Lake City, Utah 84132. Telephone ( 801) 581- 7387. Health Sciences Report is mailed to faculty, staff, alumni and friends of the University of Utah School of Medicine; to the staffs of University Hospitals & Clinics, and Spencer S. Eccles Health Sciences Library; and to the faculties of the colleges of Pharmacy, Nursing and Health. Articles may be reprinted with permission. Editor: Susan Sample Editorial Consultant: Anne Brillinger Contributing Writer: Anne Brillinger Photographer: Brad Nelson, Medical Illustration Service This issue o/ Health Sciences Report is printed on recycled paper as part of a major recycling campaign at the University of Utah Health Sciences Center. Headlines. People Features Taking Aim in Gene Targeting 10 Knockout mice help researchers track the role defective genes play in disease causation. Against the Odds 16 Wandering homeless through Italy or discovering homologous recombination in his genetics lab, Mario Capecchi has persevered, proving that anything is possible. Gift of Health 23 The sesquicentennial campaign kicks off; other contributions fund a dermatology workshop, lectureship and cardiovascular research.NES HEALTH REASONS PROMPT JAMES PARKIN TO RESIGN AS SURGERY CHAIR, FPO HEAD Dames L. Parkin, M. D., resigned for health reasons as chair of both the Department of Surgery in the James t. Parkin, M. D. School of Medicine and the medical Faculty Practice Organization Dec. 1. He recently was diagnosed with multiple sclerosis. Parkin holds The Ross R. Anderson Presidential Endowed Chair of Surgery. In 1994, he was asked by his colleagues to head the new Faculty Practice Organization. A U of U faculty member since 1972, he led the division of head and neck surgery for 18 years before being named chief of surgery. He was named The C. Charles Hetzel, M. D., Professor of Surgery/ Otolaryngology in 1987. Parkin will serve as associate vice president for health sciences, a part- time position in which he will coordinate and direct the health sciences strategic planning effort. " As with most people, I have had plans for the future. My recent diagnosis of multiple sclerosis simply causes me to move up the timetable, to do now the things my wife, Bonnie, and I had planned to do later," said Parkin. " Jim Parkin picked up the standard of the medical school's founding fathers and carried it to new heights," said John M. Matsen, M. D., vice president for health sciences. " He is a peerless clinician, a surgeon of the first rank. He teaches by example, with sensitivity and caring. His intellect and the energy he pours into his research have propelled him to a position of international leadership in the field of hearing. " Jim also possesses a trait rare in academic physicians: he is a superb man-ager, willing and able to make the hard business decisions necessary to direct a large business enterprise like the University's clinical activities," added Matsen. Internationally recognized for his work with cochlear implants for the profoundly deaf, Parkin received his bachelor and medical degrees from the U of U. He earned a master of science degree in physiology and biophysics from the University of Washington, where he also served his medical intern-ship and residency in otolaryngology, r. PINCETL HEADS HOSPITAL INFORMATION RESOURCES Sierre S. Pincetl, M. D., joined the health sciences center as chief information officer and director of the Office of Information Resources for University Hospitals & Clinics, and the Faculty Practice Organization Systems last July. Pincetl also has a dual appointment as a faculty member in the departments of medical informatics and internal medicine at the School of Medicine. For seven years, he served as chief information officer and an associate professor of internal medicine at George Washington University. At the U of U, Pincetl is responsible for the IDX System ( the physicians' billing system), all centralized computing department applications in the hospital, hospital networks and data repository. Operations will be consolidated Pierre S. Pincetl, M. D. at a Research Park location, bringing together 94 information resources employees who are scattered across the health sciences campus. Pincetl graduated with a bachelor's degree from the University of Califor-nia, San Diego, and received his med-ical degree from George Washington University. He completed his residency at Harbor/ UCLA Medical Center and was a clinical and research fellow in medical informatics at Massachusetts General Hospital and Harvard School of Public Health, e U HOSPITAL EXPANDS NETWORK OF HEALTH CENTERS, CLINICS Three new health centers were added last summer to University Hospitals & Clinics burgeoning statewide network. Last July, the Park City Family Health and Emergency Center opened its doors, providing care 24 hours a day, seven days a week. It is staffed by 10 physicians and two nurse practition-ers who offer pediatrics, family practice and sports medicine, in addition to emergency care. The center includes a helispot and a covered ambulance entrance to handle trauma victims and other medical emergencies, such as strokes and heart attacks. At the other end of the state, the School of Medicine opened an office of the Division of Cardiology in St. George last July. The office is staffed by full-time U faculty cardiologists, who offer comprehensive cardiovascular diagnostic and treatment services. Robert B. Wray, M. D., associate chief of cardiology and professor of internal medicine, anchors the practice. Other faculty specialists visit the office to pro- Health Sciences Report Winter 1997 vide care for cardiac rhythm problems, heart failure, cholesterol reduction, congenital heart disease and genetically inherited disorders. Last August, the Women's Health & Breast Care Center opened at the Wasatch Health Center in Salt Lake City, offering comprehensive and coordinated women's health care at one location. The center provides annual checkups and radiology services rang-ing from screening mammography to stereotactic biopsy. All mammography services have been moved from University Hospital to the new center, which also operates a multidisciplinary tumor board to work with breast cancer patients to determine the most appropriate care regimen. The women's center is directed by Pamela F. Farrington, M. D., assistant professor of obstetrics and gynecology, and acting chief of the Division of General Obstetrics and Gynecology; Kathy Aoki, R. N., University Hospital women's and children's outpatient services; Wayne H. Smith, University Hospital radiology services; and Leslie Roberts, R. N., clinical nurse coordinator. Other members of the multidisci-plinary team that developed the center are: Edward W. Nelson, M. D., and Renato Saltz, M. D., surgery; Karen L. Miller, M. D., obstetrics and gynecology; B. J. Manaster, M. D., and Kathleen Murray, M. D., radiology; Saundra S. Buys, M. D., internal medicine; F. Marian Bishop, Ph. D., M. S. P. H., family and preventive medicine; and Gene Corapi, University Hospital adminis-tration. E NEURORADIOLOGY EXPERT NAMED DEPARTMENT CHAIR William W. Orrison, Jr., M. D., a recognized expert in neuroradio-logic imaging techniques, was named professor and chair of the Department of Radiology last August. Orrison, professor of radiology at the University of New Mexico, William W. Orrison, Jr., M. D. Albuquerque, will make regular visits to the Utah campus until he joins the faculty next April, with approval of the University's Board of Trustees. Since 1985, Orrison has been chief of the neuroradiology division, director of Magnetic Resonance Imaging ( MRI) and Magnetic Source Imaging ( MSI), and director of the neuroradiology fellowship program at New Mexico. He also has served as a member of the cancer center's medical and scientific staff, and as chief of neuroradiology at Albuquerque's Veterans Affairs facility, the New Mexico Regional Federal Medical Center. The neuroimaging center that Orrison has directed at New Mexico has become a national referral center. The MSI facility is the only one in the world capable of handling pediatric complex epilepsy, learning disabilities and a wide variety of neuropsychiatric disorders. Orrison earned his medical degree from the University of Kansas School of Medicine, then completed an intern-ship and six- year residency ( three each in neurology and radiology) at the University of Wisconsin, Madison. After a neuroradiology fellowship at Ulleval Hospital, Oslo, Norway, he returned to the Madison campus to complete a second neuroradiology fellowship. Orrison is the author of hundreds of professional papers, book chapters and three books. Functional Brain Imaging, published last year, is considered the foremost text on the subject. He also has held editorial positions on scientific publications and is a member of numerous professional organizations, e NEW ADMINISTRATOR JOINS U HOSPITAL TEAM Madeline C. Buelt, R. N., M. S. N., director of patient care and associ-ate hospital director at the University of Nebraska Medical Center ( UNMC), was named associate administrator for University of Utah Hospital last January. She replaced acting administrator Faye Lincoln, R. N., B. S. N., M. B. A., who returned to her position as director of the hospital's Alternative Care Services. At Utah, Buelt oversees hospital inpatient services, including critical care, pre- hospital, transplant, maternal/ child, medical/ surgical and psychiatry; rehabilitation; and hotel services. Buelt had served as a UNMC administrator since 1992, overseeing the oncology service, surgical services, pain management and the Lied Trans-plant Center. She developed a home health care program; integrated acute, chronic and behavioral pain programs into a comprehensive service; and directed development of an in vitro fertilization program. Buelt also consolidated primary care services within the UNMC hospital and family medicine department; integrated inpatient, outpatient and anesthesia services into a single department; and incorporated an off- site surgical center into the main hospital to cut costs. A1980 graduate of the University of Nebraska College of Nursing, Buelt received a master of science degree in nursing in 1984. She served on the faculty of Methodist College of Nursing and Allied Health in Omaha from 1981- 86, and was a public health nurse in Nebraska prior to that. She has worked in public health in Sao Paulo, Brazil, and was a volunteer consultant in Moscow, Russia, b Health Sciences Report Winter 1997 AHEC AWARDED $ 2.1 MILLION The Utah Area Health Education Centers ( AHEC) program was awarded a three- year, $ 2.1 million grant from the Health Resources and Services Administration, U. S. Depart-ment of Health and Human Services, last August. Created on the recommendation of Gov. Mike Leavitt's Health Policy Commission, AHEC received start- up funding of $ 300,000 in 1995 from the Utah State Legislature to bolster health-care services in rural and underserved areas of Utah. Since then, a program office has been established at the University health sciences center to coordinate systems and support from educational institutions, the Utah Department of Health and interested professional organizations. Last spring, Central Utah AHEC, the first of four planned regional centers, opened at Snow College in Ephraim. The program serves Juab, Millard, Sanpete, Sevier, Wayne and Piute counties. It helps coordinate and sup-plement existing programs, recruit young people to health careers, train health- professions students on site, support existing professionals through continuing education courses and promote cooperation with community providers, educators, hospitals and gov-ernments to meet their specific needs. Some 22 percent of Utah's popula-tion lives in rural areas, and 26 of the state's 29 counties are designated in whole or in part as health professionals shortage areas, according to Michael K. Magill, M. D., Utah AHEC program director. A lack of sufficient health- care providers- ranging from physicians to nurses to dentists to pharmacists- threatens the viability of hospitals and clinics. Since these are major employers in rural areas, the hospitals and clinics are keys to attracting and retaining other businesses and visitors to the areas, said Magill, professor and chair of the U of U medical school's Department of Family and Preventive Medicine. Although the governor's 1996 budget recommended continued support for AHEC and an increase for the planned regional centers, funding was not appropriated. " We've enjoyed tremendous state support, but we're concerned about continued state sup-port for future centers," said Magill. " We may not be able to open the AHEC planned for northern Utah." Federal funding for AHEC is limited, according to Magill. Eleven states com-peted for the three grants awarded this year. States can receive up to nine years of federal funding, but it's determined largely by a demonstrated commitment of support from state and local sources. " By 2004- 05, Utah AHEC will cost the state approximately $ 1.5 million annually- a modest price to solve a very big problem: the lack of support to health professional shortage areas," said Magill. " Over this first decade of start- up, every dollar of state general revenues is expected to attract nearly two dollars from foundation, private or other federal sources, with the goal of becoming self- sustaining," he added, n ADASHI NAMED NEW CHAIR OF OBSTETRICS- GYNECOLOGY Eli Y. Adashi, M. D., co- editor of the premiere 2,399- page textbook Reproductive Endocrinology, Surgery and Technology joined the Utah medical school faculty last fall as chair of the Department of Obstetrics and Gynecology. Adashi had been acting chair of the obstetrics and gynecology department at the University of Maryland, where he had been a faculty member for 15 years. Last summer, he was listed by American Health as one of the best doctors in America. Adashi specializes in reproductive endocrinology and has been an examiner for the certifying board for 10 years. He has participated on eight study sections or selection committees of the National Institutes of Health, in Eli Y. Adashi, M. D. addition to holding numerous editorial positions on scientific journals. He is the author or co- editor of more than 480 scientific papers. A graduate of Sackler School of Medicine in Israel, Adashi completed postgraduate training at Tufts Univer-sity, Johns Hopkins University and the University of California, San Diego. In addition to his research, publica-tions and patient care, Adashi has been a faculty preceptor and counselor for medical students, and directed the obstetrics and gynecology residency program at Maryland, r. RESEARCHERS DISCOVER GENE FOR COGNITIVE TRAIT Ateam of researchers led by a U of U molecular geneticist reported in the July 12 issue of Cell the first finding of the molecular basis for a specific human cognitive trait: impaired cogni-tive development. Mark T. Keating, M. D., associate professor of human genetics and cardi-ology at the School of Medicine, and an investigator for the Howard Hughes Medical Institute, led the team that discovered the gene Lim- kinase, which encodes an intracellular signaling molecule. The deletion of this gene causes impaired spatial cognition. The research focused on individuals with Williams syndrome who have great difficulty visualizing an object as a set of parts and constructing a replica of that object with its parts, such as a checkerboard consisting of four cubes. 4 Health Sciences Report Winter 1997 Investigators identified individuals who had only some of the features of Williams syndrome, which can include mental retardation as well as strength in language and auditory memory, and musical ability. Researchers found that these individuals have smaller dele-tions on chromosome 7 than those with the complete syndrome. The loss of one copy of Lim- kinase led to impaired cognition in the disorder. Studies also demonstrated that this gene is switched on in cells that are precursors for neu-rons in the brain essential for cognitive development. Collaborating with Keating's research team were Colleen Morris, M. D., a human geneticist at the University of Nevada, Las Vegas, and Carolyn Mervis, Ph. D., a cognitive neuroscientist at Emory University, E CONSTRUCTION BEGINS ON HUNTSMAN INSTITUTE Construction began Oct. 24 on the Huntsman Cancer Institute ( HCI) building, located east of University Hospital, and is scheduled to continue through 1998. The six- story building will house the institute's interdisciplinary work in genetics and cancer treatment and research, which temporarily has been conducted at other campus locations and in Research Park. HCI is focusing on cancers of the breast, prostate, lung, colon and pancreas, and already has created the High Risk Breast Cancer Clinic. Construction is being funded by a combination of sources, including $ 23 million from the Huntsman Cancer Foundation, bonds, University and state funds, for a total of $ 48 million. HCI is supported by $ 100 million in pledges from the Jon M. Huntsman family and another $ 51 million in gifts attracted by the Huntsmans and other donors, e Spencer F. Ecdes spoke at the 25th anniversary celebration of the dedication of the health sciences library named in memory of his father, Spencer S. Ecdes. ECCLES LIBRARY CELEBRATES DEDICATION ANNIVERSARY David P. Gardner, University of Utah president emeritus, delivered the keynote address Oct. 4 at the 25th anniversary celebration of the dedication of the Spencer S. Eccles Health Sciences Library. The Eccles library is the repository for the Elizabeth Fuhriman Gardner Prize, an annual award established in 1992 by friends and family of the late Mrs. David P. Gardner to honor out-standing women in the health sciences. Also presenting remarks at the celebration were: Arthur K. Smith, U of U president; Spencer F. Eccles, chairman and chief executive officer, First Security Corporation; and Wayne J. Peay, library director. For many years, the library consisted of one room at the Salt Lake County General Hospital and one room in the main University Library. In 1967, the collection was consolidated on the B level of the new U medical center. Priscilla M. Mayden, who began her 17- year career as medical library direc-tor that same year, was instrumental in securing funds to help build the Eccles library. The National Library of Medicine provided a $ 1.3 million construction grant, which was matched with funds from the bequest of the late Spencer S. Eccles and an additional gift from his family. Since then, the family of his son, Spencer F. Eccles, has provided significant financial help. Annually, 250,000 people walk through the library's doors; twice that numbe