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Archive for December, 2013

Dr. Wang’s research offers hope for family with history of cancer

by Vicky Cerino, UNMC public relations

 

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San Ming Wang. M.D. 

It’s not very often that those affected by breast cancer come face-to-face with researchers trying to find a cure for the disease.

Brandi Preston, 22, was one of five women who met in late summer with UNMC breast cancer researcher San Ming Wang, M.D.

Dr. Wang had just spoken about the latest in breast cancer research to the local members of Bright Pink, a support group chapter for those affected by familial breast cancer — those who carry a gene that can be passed down.

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Ben, Bailey and Brandi Preston (Photo courtesy Preston family) 

It was an emotional experience for Dr. Wang.

“I use DNA material from patients to study, but that was the first time I had direct contact with patients,” Dr. Wang said. “I learned from them all how psychologically stressful it is to have a breast cancer gene — like carrying a time bomb.

“I feel more pressure when I think about the patient,” he said. “It’s not so simple anymore to think of my research work as just science.”

Preston said meeting Dr. Wang was fascinating.

“He is doing so much amazing research,” Preston said. “It gives me a lot of hope for the future.”

Preston is facing a decision of whether or not to have a double mastectomy.

Preston’s mother carried the BRCA1 gene, as did her grandmother, great-grandmother and great- great grandmother. (Both her great-grandmother and great-great grandmother had breast and ovarian cancer.)

Preston’s mother was diagnosed with breast cancer on Thanksgiving of 2000. Before she passed away in 2005 at the age of 40, she asked Brandi to be tested for the BRCA gene when she turned 19.

The test came back positive. Preston’s brother also is positive for the BRCA I gene.

The gene requires extra vigilance. Every six months Preston has a breast exam, a yearly breast MRI, ovarian screening and a pap smear.

“Knowledge is power,” she said. “Now that I know I have this gene, I can do something about it. I can monitor.

“After each breast exam I say, ‘Whew, no cancer, I’m good for another six months.’ But why wait until I develop it? That’s why I’m thinking of having the double mastectomy.”

 

Dr. Vose to be president of American Society of Clinical Oncology

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Julie Vose, M.D. 

UNMC’s Julie Vose, M.D., has been elected president of the American Society of Clinical Oncology (ASCO) for a one-year term beginning in June 2015.

Dr. Vose will take office as president-elect during the ASCO annual meeting in Chicago in June 2014.

“ASCO is a very diverse and multifaceted organization with so much to offer its membership,” Dr. Vose said. “I am excited to serve the ASCO membership as president and to make a difference for oncology professionals and our patients.”

Dr. Vose cited the recent enhancements in the society’s educational offerings, quality improvement, and broadened advocacy as areas where her experience and training can add to the current ASCO activities, including CancerLinQ(TM), ASCO’s groundbreaking health information technology initiative to achieve higher quality, higher value cancer care with better outcomes for patients

Ken Cowan, M.D., Ph.D., director of the Fred & Pamela Buffett Cancer Center, called the election a great honor for Dr. Vose and UNMC.

“She is an internationally recognized leader in clinical trials in lymphoma,” he said. “As the leader of the largest organization of clinical oncologists, she will be able to have a major impact on the future directions of clinical research and clinical care in cancer.”

Dr. Vose’s election and involvement in ASCO and other national oncology organizations are a credit to UNMC as well as Dr. Vose, said James Armitage, M.D., the Joe Shapiro Professor of Internal Medicine in the UNMC Division of Oncology/Hematology.

“I’m incredibly proud of Julie and what she’s accomplished,” Dr. Armitage said. “This is the most visible and one of the most important oncology positions in the world. It reflects her excellence in clinical medicine and research.”

Dr. Vose is the Neumann M. and Mildred E. Harris Professorial Chair and chief of the oncology/hematology division in the UNMC Department of Internal Medicine, as well as the associate director of clinical research and co-chair of the lymphoma program at the Fred & Pamela Buffett Cancer Center. Since joining ASCO in 1991, she has served on the board of directors, as chair of the Cancer Education Committee and is the current chair-elect of the Integrated Media and Technology Committee, among other activities.

ASCO’s board of directors is comprised of oncology leaders who are elected to positions reflecting various specialties within the oncology field.

 

Med Center Physicians Leading the Way in New Cardiology Specialty

Several decades ago someone like Taylor Harms wouldn’t be a second year medical student. Someone like Taylor Harms may very well have died as a child. Advances in medicine and surgery over the years mean people like him, born with congenital heart disease are growing up to be adults.

Harms has a perspective most of his medical school classmates won’t – the perspective of a patient. And not just any patient – one who’s had open heart surgery twice.

“I first learned about my condition when I was eight years old,” Harms says. “I went to the doctor with high blood pressure and it turned out I had a narrowed aorta.”

He had surgery to repair his aorta, the body’s main blood vessel when he was eight. Harms also had a bicuspid aortic valve – a condition where one of the heart’s valves develops only two leaflets instead of three. The stress on his heart also meant that its main pumping chamber was much larger than it should have been. By July, even though Harms was feeling fine, his blood pressure was going up. His condition had worsened.

“Blood was leaking back through that valve,” explained Shane Tsai, MD, cardiologist and congenital heart disease specialist. “Instead of being ejected into the body, the blood is falling back into the heart’s main pumping chamber.”

Harms would again need open heart surgery to remove the narrowed section of his aorta and to replace his aortic valve with a mechanical valve.

“We would prefer to get someone early in the stage of their disease,” says Kim Duncan, MD, cardiovascular surgeon at The Nebraska Medical Center. “We can do a procedure and preserve cardiac function for a much longer period of time.”

Dr. Duncan performed surgery on Harms in mid-July. He replaced the aortic valve with a mechanical valve they hope will last for decades. Dr. Duncan also replaced a portion of Harms’ aorta with a synthetic blood vessel.

Dr. Tsai says patients like Harms will become more common as medical advances continue.

“As medicine and surgery has gotten better, we have more survivors,” he says. “A few decades ago, 90% of these babies may not have survived into adulthood. We now expect that 85% of children born with these heart problems will survive into adulthood.”

But just because they live to be adults does not mean they are free from heart trouble. Dr. Tsai says that’s where the medical center’s program shows its importance.

“For the first time in the U.S. there are more adults than children living with congenital heart disease. There are over one million adults with these problems,” he says. “Unfortunately there are not a lot of specialized heart centers dealing with congenital heart disease.”

There are also few physicians who specialize in pediatric and adult congenital heart disease. Because of UNMC Physicians’ collaboration with Children’s Hospital and Medical Center, Dr. Tsai says med center physicians are uniquely positioned to care for these patients throughout their lives. Drs. Tsai and Duncan see pediatric patients at Children’s and adult patients at The Nebraska Medical Center.

“We see them when they’re babies and through adulthood,” he says. “We have different interventions and surgeries we can perform and we work together as a group to decide what is best for each patient.”

Taylor Harms is recovering quickly and just started his second year of medical school at UNMC. He’s already learned a lot about what it’s like to be a patient. He has a little bit of time to decide what specialty he’ll follow as an MD.

“I’m thinking maybe cancer,” Harms says. “I think cardiology may be a little too close.”

 

Eyeing new discoveries in Shanghai

by Tom O’Connor, UNMC public relations

 

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Shan Fan, M.D., and Carol Toris, Ph.D., of UNMC, with Tao Guo, M.D., associate professor of ophthalmology, Tenth People’s Hospital, Shanghai. 

SHANGHAI – Quan Dong Nguyen, M.D., is pumped.

The new chairman of ophthalmology and visual sciences, part of the UNMC delegation in China, is excited about the research that UNMC is doing with Tongji University and Tenth People’s Hospital in Shanghai.

The work, led by Carol Toris, Ph.D., professor of ophthalmology and visual sciences, is aimed at improving our understanding of glaucoma, the leading cause of irreversible blindness in the United States and worldwide. More than 60 million people in the world are living with glaucoma. It’s estimated that more than 80 million people will develop glaucoma by 2020.

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From left, UNMC’s Quan Dong Nguyen, M.D., UNMC’s Carol Toris, Ph.D., Fang Wang, M.D., chair of the department of ophthalmology at Tenth People’s Hospital, and UNMC’s Shan Fan, M.D.

“It’s all about aqueous humor dynamics,” Dr. Nguyen said. Glaucoma can occur when the optic nerve is damaged, and frequently this is associated with high intraocular pressure.

That’s where aqueous humor dynamics come into play. To maintain intraocular pressure at a steady level requires a fine balance between the production, circulation and drainage of ocular aqueous humor.

Dr. Toris is one of the leading experts in the world on aqueous humor dynamics — Google the term and Dr. Toris’ name is the first to appear.

Working with Tongji University and Tenth People’s Hospital researchers led by Tao Guo, M.D., Dr. Toris, along with Shan Fan, M.D., assistant professor of ophthalmology and visual sciences and also with UNMC’s delegation to Shanghai, measure fluid flow in the eyes of volunteers.

They have studied healthy Caucasian adults, an ethnic group that is prone to a certain type of glaucoma. Now in collaboration with Tenth People’s Hospital they are studying healthy Chinese adults, an ethnic group that is prone to a different kind of glaucoma.

The team will compare data to identify differences that may help explain why people may get a particular kind of glaucoma. These findings should help determine the best treatments for the particular type of glaucoma.

“With a population of 1.35 billion, China is a fertile environment for finding research subjects,” Dr. Nguyen said.

“It’s a great collaboration,” Dr. Nguyen proclaimed. “To have all these patients done on Chinese soil is indicative of how well the project is going.”

In the next two years, Dr. Nguyen said that the Truhlsen Eye Institute at UNMC, and Tongji University and Tenth People’s Hospital hope to combine forces on several other projects, expanding to other areas of significant concerns for visual loss such as age-related macular degeneration, diabetic retinopathy, and uveitis and ocular inflammation.

 

UNMC designated one of three national endoscopic surgery testing centers

by Tom O’Connor

 
oleynikovThe University of Nebraska Medical Center is one of the first three centers in the country to be designated as a testing center for the Fundamentals of Endoscopic Surgery (FES) program.

The program is a comprehensive educational and assessment tool designed to teach and evaluate the fundamental knowledge, clinical judgment and technical skills required for basic gastrointestinal endoscopic surgery. It also teaches fundamentals of endoscopic surgery in a consistent, scientifically accepted format and to test cognitive and technical skills, while improving the quality of patient care.

“Being able to use flexible endoscopy for upper GI procedures and colonoscopies is a very important skill for surgeons,” said Dmitry Oleynikov, M.D., the Joseph and Richard Still Endowed Professor of Surgery. “Just like you have to pass a driving test to be able to drive a car, the testing center will allow us to make sure that surgeons are proficient in endoscopic procedures.”

The UNMC center was made possible in part by a donation from Paul Hodgson, M.D., establishing the Paul E. Hodgson, M.D. Innovations in Surgical Technology Fund through the University of Nebraska Foundation. Dr. Hodgson, former chairman of the UNMC Department of Surgery, died Aug. 28 at the age of 91.

Dr. Hodgson’s fund paid for half of the equipment and materials needed for the testing center. The other half of the funding will come from the Alton K. Wong, M.D., Distinguished Professorship held by pediatric surgeon Ken Azarow, M.D.

The testing center equipment is located in the Dr. Wayne and Eileen Ryan Surgical Simulation Suite in the Sorrell Center.

“Under the guidance of our chairman, Dr. David W. Mercer, and his unequivocal support of educational efforts, the department of surgery is on the path to becoming a regional and national leader in surgical education,” said Chandra Are, M.B.B.S., vice chair for education and associate professor, surgical oncology.

“Obtaining the designation as a testing center for the FES program is another milestone in satisfying the vision of our department to become an educational powerhouse.”

Being designated as a FES testing center culminates a lengthy certification process for UNMC, Dr. Oleynikov said, and is indicative of how UNMC “has become a leader in education in the region.”

Through world-class research and patient care, UNMC generates breakthroughs that make life better for people throughout Nebraska and beyond. Its education programs train more health professionals than any other institution in the state. Learn more at unmc.edu.

 

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