Moving forward
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Think small. A nanometer-sized particle is about the size of three or four atoms.
But the promise of these small, luminescent particles is large. These quantum dots are covered in a protective coating to keep them safe from the body’s enzymes and programmed with antibodies to find cancer cells that have matching antigens. Theoretically, they can tag hundreds or even thousands of different proteins.
But so far, the big promise of these small dots to detect cancers has been limited because clinicians have lacked the specific instructions for how to use them. That changed in May when Shuming Nie and colleagues at Emory and Georgia Tech published clinical protocols in Nature Protocols on how to prepare, process, and quantify these tiny particles. Now laboratory physicians have the information they need to track biomarkers in cells and tissues.
The technology is a variation of immunohistochemistry, the staining process commonly used by pathologists to identify proteins in a tissue section from a cancer patient. The scientists have developed detailed protocols for using the technology, including antibody conjugation, preparation of tissue specimens, multicolor quantum staining, image processing, and biomarker quantification. They also have developed bioinformatics and software for automated feature extraction and biomarker quantification.
This work, which took 12 investigators in five academic departments more than two years to complete, resolves "a major bottleneck" in the use of quantum dot probes for immunology and histology staining of cancer cells, according to Nie.
The new guidelines are available at www.natureprotocols.com.
The NIH stamp of approval
As the steward of medical research in the United States, the NIH has funded some of the world’s biggest scientific advances, with impressive results. In the 30 years between 1970 and 2000, for example, the life expectancy of the average American increased by six years, and the death rate from stroke and heart disease declined by more than 70% and 63%, respectively. NIH-sponsored research in the past decade has prevented 30,000 deaths from HIV/AIDS each year.
NIH designation marks efforts of the highest scientific integrity and premier research in the country. Emory has been the beneficiary of many such NIH designations—a Molecular Libraries Screening Center Network to explore proteins encoded in the genome, an Alzheimer’s Disease Research Center, three NIH nanotechnology designations in the past two years that focus on early cancer detection and DNA damage repair, a Center for AIDS Research, and Emory’s Collaborative Center for Parkinson’s Disease Environmental Research, to name a few. The most recent NIH designations for Emory came this spring with the naming of Emory’s HIV/AIDS clinical trials unit as a primary site nationally in both the AIDS Clinical Trials Group (ACTG) and the HIV Vaccine Trials Network (HVTN). And Emory is one of six new Centers of Excellence for Influenza Research and Surveillance.
What do the newest designations mean? For the clinical trials unit, it translates into more than $7 million over seven years and participation in a multi-site effort that includes HIV/AIDS clinical trials units on five continents. Many of the treatment guidelines now in place for HIV infection have been established through ACTG trials, and the HVTN is testing some of the more promising AIDS vaccines.
The new NIH designation for a flu center of excellence at Emory comes with a $32.8 million contract to help the United States prepare for a possible pandemic. Emory’s role will be to determine how flu viruses mutate to infect different species, a critical piece of knowledge in preparing for the possibility of a bird flu pandemic. Specifically, researchers will look at how human genes might be "silenced" to decrease or eliminate flu infections.
Georgia Assembly highlights
The 2007 Georgia General Assembly wrapped its session in April, passing a budget and legislation that has a major impact on health care in the state.
On the legislative front, Emory ethicist Kathy Kinlaw worked with legislators to create an important and improved advance directive statute for health care, House Bill 24. The new law combines the living will and durable power of attorney, making the advance directive more patient-friendly and easier to understand. It also gives clearer directions to health care professionals on the types of treatment and care that can be administered or withheld.
In the area of stem cell research, Senate Bill 148 establishes a network of banks for collection and storage of postnatal tissue and fluids in partnership with colleges and universities, hospitals, nonprofits, and private firms. The bank network, known as the Newborn Umbilical Cord Blood Bank, will make such tissue and fluid available for medical research. Beginning June 30, 2009, all physicians and hospitals must inform pregnant patients of the full range of options for donation of postnatal tissue and fluids no later than 30 days from the commencement of the patient’s third trimester of pregnancy or at the first consultation between the attending physician or the hospital.
Every health care provider who gives prenatal care will now be required to test patients for HIV except in cases where the woman refuses testing, based on House Bill 429. Physicians also are required to refer HIV-positive women to counseling services and appropriate medical care providers.
A recommendation of last year’s Joint Comprehensive State Trauma Services Study Committee resulted in the introduction and passage of Senate Bill 60 that establishes the Georgia Trauma Care Network Commission. This commission will create a state trauma network, which will distribute funds designated for trauma care and is the first step in the development of a sustainable statewide trauma system for the citizens of Georgia. Lt. Governor Casey Cagle has appointed Emory emergency medicine physician Leon Haley to serve on the commission.
With several bills carrying over to next year’s session, the legislative debate is certain to continue on Georgia’s Certificate of Need (CoN) program. The intent of the CoN program is to insure appropriate access to health care for rural and urban populations, control investments in hospitals and health care facilities, and promote quality health care for all Georgia citizens. The debate concerns legislation that would grant an out-of-state specialty hospital an exemption from the CoN process. Emory Healthcare favors retaining the current CoN program with some modifications to streamline the process but opposes exemptions or the creation of special categories to guarantee an exemption. The CoN Program should continue to fulfill its purpose, while improving laws to correspond with Georgia’s health care market needs and supporting consistency in administering those laws. —Linda Womack
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Bluffton University bus crash, Grady responds
Atlanta. March 2, 2007. 5:40 am. A chartered bus carrying an Ohio college baseball team en route to Florida overturns on an exit ramp off I-75 and crashes to the interstate below. Eric Ossmann, director of emergency medical services for Grady Hospital, is called to the scene as primary triage officer. Six years of responding to crises for Grady—car wrecks, a workplace shooting, a plane crash—fail to blunt the impact of the tragedy for Ossmann. The accident claims the lives of four students, the bus driver, and his wife, and one week later, a fifth student, who dies at Grady.
"I’ve seen a lot of bad stuff in my career, but this overturned bus was awful," Ossmann says.
At the scene, he found some of the victims were ejected once the bus hit the overpass barrier, followed by more who were thrown when the bus landed on the highway below. With the help of paramedics working at the accident site, Ossmann sent the 16 most critically injured via ambulance to Grady and two other metro Atlanta hospitals. He put another 14 "walking wounded" on a MARTA bus bound for Grady, supervised by a paramedic.
At 6 am, the staff at Grady was in the midst of a shift change, but many stayed late to help with the incoming injuries. They knew the drill. They formed a line to receive the Bluffton University players getting off the bus. They assessed injuries first, then walked each student to a decontamination room to shower off fuel and dirt from the accident.
They also cleared the radiology holding area so that the students could stay together. "The decision to put the students in a private area really allowed the psychologic healing to begin," says Alexander Isakov, associate director of Grady EMS. "What was remarkable about the Bluffton players is they worked as a team throughout the healing process." Chaplains and social service personnel were available to talk with concerned families, who started pouring in by late morning.
To the media camped outside the hospital’s doors, Ossmann and Leon Haley, chief of Grady’s emergency department, gave regular updates. As players were discharged, they gave first-hand details to the reporters about the terrifying accident. The last patient, Tim Berta, age 22 at the time of the accident, left Grady in late April to continue rehabilitation in Ohio.
"Terrible events like this show the value of a hospital like Grady," says Isakov. —Kay Torrance
Emory Midtown
With a prime location in the heart of downtown Atlanta and adjacent to key education and business partners, the Emory Midtown campus brings unprecedented opportunities for Emory’s health sciences. WHSC CEO Michael Johns describes Emory Midtown as "a footprint for one of the most vital urban environments in any major city." Adding to the significant health care presence of Emory Crawford Long Hospital and the Predictive Health Institute’s Center for Health Discovery and Well-Being, Emory envisions a campus with retail and living space, cultural venues, and educational areas.
In his Vision 2012 speech in May, Johns unveiled a mixed-use project for Emory Midtown that will start at the corner of Peachtree and Linden. The site, still in the planning phase, will include parking, retail, approximately 200,000 square feet of research space, and an additional 100,000 square feet of clinical space, potentially topped by housing.
Planners hope to work with adjacent property owners over the next decade to develop open spaces, such as a large quad and a park that spans the interstate. "This could all make for one of the most spectacular environments for education, research, health care, and urban living anywhere," says Johns.
Found in translation
Travelers unaware of the meaning of certain gestures in foreign countries can quickly get into trouble. Now researchers at the Yerkes National Primate Research Center are trying to interpret how gestures are used in the culture of great apes and just how that use fits into language development.
As reported in the April 30 edition of Proceedings of the National Academy of Sciences, researchers Amy Pollick and Frans de Waal have found that chimpanzees and bonobos use gestures more flexibly than facial or vocal expressions to communicate. Both species use facial and vocal signals similarly—for example, a scream for victims of intimidation, threat, or attack. But the way the 34 chimps and 13 bonobos in the study used gestures was more complicated. A single gesture could communicate different messages depending on its social context. For example, in the hundreds of hours of videotape they observed, the researchers found that a male chimpanzee using an extended arm and open hand could be begging for food, asking a female for sex, or even attempting to reconcile with another male after a fight.
The finding supports a theory that human language began with the development of gestures. Gestures are evolutionarily younger than facial expressions and vocalizations, as shown by their presence in apes and humans but not in monkeys. This ability to learn gestures distinguishes the great apes (chimpanzees, bonobos, orangutans, and gorillas) from monkeys, according to deWaal. "A gesture that occurs in bonobos and chimpanzees as well as humans likely was present in the last common ancestor," says Pollick.
Milestones
Funded
by a $10 million grant from the National Institute of Aging,
researchers at Yerkes are comparing changes in humans (normal aging humans,
humans with Alzheimer’s, and humans with mild cognitive impairment)
with changes that occur in nonhuman primates, including chimpanzees and
rhesus macaques. The goal of the five-year study, the first to use chimpanzees,
is to identify ways to diagnose aging-related disorders earlier to increase
chances for effective treatment.
Generous
gifts: In a record-breaking year, the WHSC raised more
than $420 million in gifts and commitments for buildings, programs, and
scholarships. The grand total reflects $240 million from the Woodruff Foundation
for a new clinic building, $50 million from the Rollins family for a new
public health building, more than $20 million for faculty research and global
health programs, $9 million for renovations to the WHSC administration building
(also from the Woodruff Foundation), more than $4 million for student scholarships,
$3 million for predictive health programs, and more than $2.5 million for
neuroscience-related programs. In all, donors have funded 12 new endowed
chairs. Former Georgia Pacific Chairman and CEO Pete Correll and his wife,
Ada Lee, have pledged $2.5 million through the Correll Foundation to the
School of Medicine for support of scholarships, faculty research, and teaching. Andrew McKelvey, founder of Monster.com has donated 115,000 shares of Monster stock, valued at more than $5.4 million, to support the Emory Transplant Center. And the estate of J.B. Fuqua has pledged a $3 million gift to expand treatment for late-life depression for elderly people living in rural and medically underserved regions of Georgia.
With
the University’s acquistion of a new high-performance
computer cluster, Emory has significantly enhanced its computational resources,
accelerating the pace of scientific discovery in fields from chemistry and
neurology to genetics and pharmacology. The new cluster, which became operational
in June, places Emory on the list of the world’s most powerful supercomputing
sites and allows researchers to pursue unprecedented studies, for example,
the digital imaging of breast cancer and the effect of anesthesia on the
central nervous system.
The
National Institute of Mental Health has awarded the medical
school a $3.6 million grant to test schizophrenic patients for a recently
discovered variation in the human genome. Led by chair of Human Genetics
Stephen Warren, the project will screen 500 schizophrenic patients and 500
people without schizophrenia for the variation, known as copy number variation,
or CNV.Copyright © Emory University, 2007. All Rights Reserved