The findings appear in the March 1 issue of the Journal of Immunology.

“This could be a revolutionary means for Parkinson’s disease therapeutics,” said Howard Gendelman, M.D., chairman of the department of pharmacology and experimental neuroscience (PEN), who partnered with R. Lee Mosley, Ph.D., to lead the research. “It has been a long journey representing more than 10 years of hard work by our research team.”

UNMC researchers reversed the neurodegenerative effects of alpha synuclein by changing immune responses to it.

In mice with an experimental form of Parkinson’s disease, researchers found that the vaccine enabled T cells to migrate to the damaged area of the brain and triggered a neuroprotective response that reduced disease-linked reactions in the brain.

T cells are white blood cells that are key to immune response. They act like soldiers who search out and destroy the targeted invaders.

Other contributors:
Graduate students, Ashley Reynolds, Ph.D., David Stone and Jessica Hutter, contributed to the study.
 
 
Additional work is needed to determine how to safely translate the study results into a therapy for humans, Dr. Gendelman said.

Human studies are being conducted at the University of Alabama-Birmingham and within the next month at UNMC to determine if the immune deficits seen in mice also are present in humans with Parkinson’s disease. Such studies are required before vaccine trials are performed in humans, Dr. Gendelman said.

“Early results are encouraging,” said Dr. Mosley, an associate professor in the PEN department, who noted that the research could open new doors for treatment of Parkinson’s and other neurodegenerative disorders.

UNMC’s technology transfer company, UNeMed, has filed a patent application on the vaccine and soon will talk to commercial partners about bringing the vaccine to the clinical setting.

 
 
 
Date Published: Tuesday, March 2, 2010 

Chad Kimpel said it with a smile.

“I died. Multiple times.”

The 41 year old father of three from Farragut, IA first came to The Nebraska Medical Center on July 1, 2009. That was the day of the heart attack.

“My heart stopped before they got me on the life flight chopper to get here,” Kimpel recalled. “They shocked me and brought me back, but the doctor said I died several more times on the flight here. They kept bringing me back.”

Once at the medical center, Kimpel was diagnosed with heart failure. Treatments had him in and out of the hospital several times in the following months. When he returned to the medical center in January, his heart was working at just a fraction of its potential and his remaining arteries blocked. Kimpel’s cardiologists decided to place a stent in his artery.

A new type of heart pump allowed doctors to place the stents while Kimpel’s damaged heart continued to work. Instead of preparing for major heart surgery, Kimpel’s doctors placed the Impella 2.5 in his heart inside a cardiac catheterization lab at The Nebraska Medical Center. He was sedated, but awake during the procedure.

“The Impella acts almost like an artificial heart,” explained Ed O’Leary, MD, cardiologist at The Nebraska Medical Center. “Without this machine, his blood pressure would drop to dangerously low levels and he might not make it through the procedure.”

Dr. O’Leary inserted the Impella pump through the femoral artery in Kimpel’s left leg. He then guided it through his body into his heart. Once in place, the straw-sized pump assisted Kimpel’s heart by pulling blood out of the left ventricle and into the aorta. By keeping his blood flowing, the cardiology team was able to keep Kimpel’s blood pressure stable while placing the stents in his artery. Once the stents were placed, the Impella pump was removed and Kimpel’s heart was pumping blood through a newly cleared artery.

“Dr. O’Leary told me it was as close as I could get to having a new artery,” Kimpel said.

The Impella is designed to help the heart for short periods of time.

“There are machines that do the work of the heart,” Dr. O’Leary said. “Those bypass machines are used during open heart surgery. During those surgeries, the heart is stopped and the bypass machine does the work of the heart. Bypass surgery would have been very risky for Chad. With as weak as his heart was, it might have been very difficult to get his heart re-started after surgery.”

Instead of a long and risky open heart surgery, Kimpel’s angioplasty took only two hours. The Impella carried part of his heart’s workload for much of that time.

After the procedure, Kimpel was all smiles.

“I feel great,” he said with a laugh. “The technology is amazing. They put this little turbocharger in my heart and I feel great!”

Kimpel will have close follow up care with his cardiology team at the medical center. A carefully designed diet and exercise plan awaits him back home in Iowa.

“I’ve always been in good shape and kind of a health food nut,” he said. “But I’ll have to be extra careful about salt, and about doing too much exercise.”

The Impella was approved by the FDA in June of 2008.

Dr. Ed O’Leary (right) places the Impella 2.5 into the left femoral artery
of angioplasty patient Chad Kimpel

For the second year in a row, The Nebraska Medical Center has received the American Stroke Association’s Get With The GuidelinesSM–Stroke Gold Performance Achievement Award. The award recognizes the medical center’s commitment and success in implementing a higher standard of stroke care by ensuring that stroke patients receive treatment for at least 24 months according to nationally accepted standards and recommendations.

The Nebraska Medical Center will be recognized by the American Stroke Association in an advertisement in the July 21 “America’s Best Hospitals” issue of US News & World Report.

“This accomplishment signifies that The Nebraska Medical Center has consistently committed to and successfully implemented accepted standards, or guidelines, to improve quality patient care,” said Pierre Fayad, M.D., Director of the Stroke Center at The Nebraska Medical Center and Reynolds Centennial Professor & Chairman of Neurological Sciences at UNMC. “Rapid assessment, treatment and intensive acute care is vital for stroke patients to help them gain back as much of their lives as possible and prevent complications.”

View video: watch?v=bSPJ5oJI6to&feature=player_embedded

To receive the Get With The Guidelines-Stroke Gold Performance Achievement Award, The Nebraska Medical Center demonstrated 85 percent adherence in the Get With The Guidelines–Stroke key measures for 24 or more consecutive months. These include aggressive use of medications like tPA, antithrombotics, anticoagulation therapy, DVT prophylaxis, cholesterol-reducing drugs, and smoking cessation.

Dr. Fayad adds that the Get With The Guidelines-Stroke program addresses the important element of time. “With a stroke, time lost is brain lost,” said Dr. Fayad. The Nebraska Medical Center has developed a comprehensive system for rapid diagnosis and treatment of stroke patients admitted through the emergency department or transferred from other hospitals. The medical center ensures the prompt availability and coordination of medical professionals, personnel and equipment 24 hours a day, seven days a week. Highlights of its expertise include: rapid brain and blood vessel imaging; neurologists, neurosurgeons, emergency physicians, radiologists and pharmacists available to conduct acute patient evaluations; and use of clot-busting medications and interventional clot removal techniques when appropriate.

“The American Stroke Association commends The Nebraska Medical Center for its success in implementing standards of care and protocols,” said Lee H. Schwamm, M.D., Chair of the national Get With the Guidelines Steering Committee and Vice-Chair of the Neurology department and director of acute stroke services at Massachusetts General Hospital in Boston. “The full implementation of acute care and secondary prevention recommendations and guidelines is a critical step in saving the lives and improving outcomes of stroke patients.”

Get With The Guidelines–Stroke uses the “teachable moment,” the time soon after a patient has had a stroke, when they are most likely to listen to and follow their healthcare professionals’ guidance. Studies demonstrate that patients who are taught how to manage their risk factors while still in the hospital reduce their risk of a second heart attack or stroke. Through Get With The Guidelines–Stroke, customized patient education materials are made available at the point of discharge, based on patients’ individual risk profiles. The take-away materials are written in an easy-to-understand format and are available in English and Spanish. In addition, the Get With The Guidelines Patient Management Tool* provides access to up-to-date cardiovascular and stroke science at the point of care.

According to the American Stroke Association, each year approximately 795,000 people suffer a stroke — 610,000 are first attacks and 185,000 are recurrent. Every 40 seconds, someone in the United States is suffering from a stroke. This deadly condition accounts for 1 out of every 18 deaths in the United States. The number of acute ischemic stroke patients eligible for treatment is expected to grow over the next decade due to increasing stroke incidence and a large aging population.

The stroke center at The Nebraska Medical Center has also achieved recognitions from other organizations. The Nebraska Medical Center was Nebraska’s first and continues to be Omaha’s only stroke center to receive the “Gold Seal of Approval” from the Joint Commission for its dedication to the prevention and management of stroke. Dr. Fayad was also named the National American Heart Association Physician of the Year in 2009. He serves as the chairman of the American Stroke Association Advisory Committee.

by Tom O’Connor, UNMC public relations

 
(EDITOR’S NOTE: The following story originally appeared in the Fall 2009 edition of UNMC Discover.

 Julia Bridge, M.D., has a unique skill set that makes her a true Sherlock Holmes in the pathology world.

She specializes in analyzing bone and soft tissue tumors, and she’s one of the best in the world.

A professor of pathology and microbiology at UNMC, Dr. Bridge will be honored next year by Memorial Sloan-Kettering Cancer Center (MSKCC) in New York for her contributions to advance knowledge of human cancer. She will receive the prestigious Fred W. Stewart Award, which honors a top pathologist each year.

“Cancer cytogenetics is one of the foundations of our growing understanding of human cancer that is driving improved diagnosis and therapy,” said Marc Ladanyi, M.D., chief of MSKCC’s Molecular Diagnostics Service in the department of pathology. “Through her career-long effort in this area, Dr. Bridge has not only put UNMC on the map, she has made it a world capital in this field.”

There are more than 100 different types of bone and soft tissue cancers and many types exhibit overlapping clinical, radiographic and microscopic features, so making the correct diagnosis is challenging.

New genetic findings — at least 40 of which have been discovered by Dr. Bridge and her laboratory team — allow pathologists to more precisely identify and classify these tumors.

“Once we know the exact type of cancer, the clinician can provide the most appropriate therapy with the highest chance of delivering a successful outcome,” she said.

One tumor-specific genetic change identified by Dr. Bridge’s team is the 12;22 rearrangement in clear cell sarcoma.

“Cancer cytogenetics is one of the foundations of our growing understanding of human cancer that is driving improved diagnosis and therapy. … Dr. Bridge has not only put UNMC on the map, she has made it a world capital in this field.”-Marc Ladanyi, M.D.
 

This cancer may appear clinically and microscopically identical to the deadly skin cancer malignant melanoma. Recognition of this molecular marker has become fundamental in differentiating it from malignant melanoma.

Dr. Bridge’s team tries to identify additional markers of diagnostic and prognostic importance and develop more rational classification schemes that will impact clinical management and therapy election.

“We’re looking at the underlying genetic changes and the molecular consequences of those changes,” she said. “Many tumors have a characteristic genetic change that is exclusive to that tumor.

“Once we recognize this change, it’s like a domino effect. We can then specifically target these genes as well as other genes further down the pathway.”
 
 
Date Published: Thursday, December 31, 2009

by Vicky Cerino, UNMC public relations

Julie Vose, M.D., has been elected to the board of directors of the American Society of Clinical Oncology (ASCO).

Dr. Vose, the Neumann M. and Mildred E. Harris Professorial Chair and chief of section of hematology/oncology, begins her four-year term in June.

 ASCO — the world’s leading professional organization — represents physicians who treat people with cancer. It also sets the standard for patient care worldwide and leads the way in clinical research to improve the prevention, diagnosis and treatment of cancer.

“This is a very exciting opportunity for UNMC to be involved in setting national health care standards and policies in hematology and oncology,” said Dr. Vose, one of the country’s leading experts on lymphoma. “It will give us a voice and a seat at the table with other oncology leaders from around the country and world to improve oncology clinical care, research, and education.”

Dr. Vose’s election to the board is a testimony to her expertise and international recognition in clinical oncology, said Lynell Klassen, M.D., professor and chairman of the UNMC Department of Internal Medicine.

“It reflects what she’s done,” he said. “To be elected at this level by a group of peers is truly noteworthy.”

Dr. Vose is principal investigator or co-investigator of two National Cancer Institute grants and other clinical research grants totaling more than $6 million. She has authored or co-authored 240 manuscripts, 40 book chapters and 230 abstracts and has given more than 400 lectures and presentations internationally.

Date Published: Thursday, January 7, 2010