Emory Woodruff Health Sciences Center
Update

Events:

April 26: Future Makers Lecture
April 27: 2nd Annual Greening Healthcare Conference

May 10: Book-signing: Charles Hatcher's All in the Timing

April 18, 2011
  Contents:  
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Plans for proton therapy center World's first peds nanomed center Carrying a vision through for Winship Health care reform in China and U.S. In brief
 
     
 

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Emory hosts international hand/tissue transplant meeting

Over the past month, the stars have aligned such that Emory has found itself more than once at the epicenter of activity and discussion surrounding hand transplantation. Just weeks after an Emory team performed the Southeast's first hand transplant in March, Emory Transplant Center physicians hosted the 10th meeting of the International Hand and Composite Tissue Allotransplantation Society in Atlanta this month. The scientific meeting included 150 of the world’s top surgeons and scientists in hand, face, and other tissue transplants.

Such transplants are used to to replace tissue defects that can’t be reconstructed, such as those created by traumatic injuries or congenital limb malformations. These transplants require special surgical skills to repair crushed or mangled bone, vessels, muscle, tendon, skin, and nerves. The multidisciplinary field encompasses immunology, issues of organ donation and procurement, prosthetics, regenerative medicine, and ethics.

  hand
  Hand transplant involves connection of numerous structures, including bones, tendons, nerves, vessels, and skin.
   

Hand and transplant surgeon Linda Cendales, who led the hand transplant at Emory last month, co-chaired the meeting’s local program organizing committee, along with Tom Pearson and Allan Kirk. Wright Caughman, Chris Larsen, and Susan Shows from the Georgia Research Alliance welcomed the international audience at an opening reception.

The meeting’s scientific sessions highlighted both clinical progress and basic scientific advances. A special closing session, moderated by Cendales and Holly Korschun, WHSC director of research communications, featured three journalists—Robert Basell of NBC News, Jonathan Serrie of Fox News, and Miriam Falco of CNN— discussing news coverage of hand and face transplants and considerations of patient and family privacy, ethics, and working with hospitals, research institutions, and PR professionals. Matthew Scott, who received the world’s longest surviving hand transplant 12 years ago, joined the journalists in a panel discussion.

hand_transplant_team
Transplant recipient Linda Lu (above center) is progressing well and is still in Atlanta undergoing rehabilitation at Emory. (Above L-R with Lu): surgeons Tom Pearson, Linda Cendales, Chris Larsen, and Allan Kirk.

Plans for proton therapy center in the works

 
  The gantry, or supporting structure, of
a proton therapy machine.

Emory Healthcare has signed a letter of intent with Advanced Particle Therapy of Minden, Nev., to explore development of a $200 million proton therapy center at Winship Cancer Institute. The center will be the first in the state.

Proton therapy involves the use of a controlled beam of protons to target tumors with precision unavailable in other radiation therapies. It is frequently used in the care of children diagnosed with cancer, as well as in adults who have small, well-defined tumors in the prostate, brain, head, neck, bladder, lungs, or spine.

Under the letter of intent, the facility will be staffed by Emory and funded by Advanced Particle Therapy, which will design, build, and own the center. Site selection for the approximately 100,000- square-foot facility is under way. Once operational, the center will be staffed by approximately 110 proton therapy-trained professionals, including radiation oncologists, medical physicists, radiation therapists, and medical support and administrative staff, and it will treat approximately 1,900 patients annually.

  walter_curran
  Walter Curran
   

The closest proton therapy facility to Georgia is at University of Florida in Jacksonville. There are only nine such centers in the United States, including ones at Massachusetts General Hospital, MD Anderson Cancer Center in Houston, and University of Pennsylvania.

"This is an exciting development in our ability to offer patients the widest possible array of treatment options," says Walter Curran, executive director of Winship. "We will work to expand this therapy's utility and access for patients through collaborative research projects with Georgia Tech and other institutions."


World's first center for pediatric nanomedicine

  gang_bao
  Gang Bao

Physicians and scientists from Emory, Children's Healthcare of Atlanta, and Georgia Tech are collaborating within a new Center for Pediatric Nanomedicine (CPN) to develop nanoparticles for use in diagnosing and treating pediatric diseases. The CPN is the first center of its kind in the world. Specific focus areas will include pediatric heart disease and thrombosis, infectious diseases, cancer, sickle cell disease, and cystic fibrosis.

The center is directed by Gang Bao, a professor in the joint Emory-Tech biomedical engineering department.

"Because nanoscale structures are compatible in size to the body's biomolecules, nanomedicine provides unprecedented opportunities for achieving better control of biological processes and drastic improvements in disease detection, therapy, and prevention," he says.

The CPN is part of the Emory-Children's Pediatric Research Center. The latter is led by Emory and Children's and includes collaborations with Georgia Tech and Morehouse School of Medicine. Emory and Georgia Tech already have several NIH-funded initiatives in nanomedicine, and discoveries made in these centers will be applied to research in pediatric diseases.


Carrying a vision through

 
  Fadlo Khuri

One in a series of profiles of people in the Woodruff Health Sciences Center

It's no secret that the Winship Cancer Institute went through a series of leadership and structural changes in recent years. What may be less recognized, says Winship Executive Director Walter Curran, are the many roles oncologist Fadlo Khuri has played in helping Winship through these changes and beyond. "Over the past decade, Fadlo has been the one constant, the one steady voice, the cornerstone of a Winship that he knew was possible and was determined to help build. We would not be where we are today if it had not been for Fadlo."

Khuri's changing positions at Emory illustrate how he has helped Winship evolve in its move toward National Cancer Institute designation.

 

Recruited from MD Anderson in 2002, Khuri served as Winship's chief medical officer until 2007. That same year he was named Roberto C. Goizueta Distinguished Chair in Cancer Research. He currently co-directs Winship's research program in developmental therapeutics with Haian Fu, whom Khuri calls Winship's "most valuable franchise player."

Winship's final push toward NCI-designation created more roles for Khuri.

First, the hematology and medical oncology group was elevated from a division in the Department of Medicine to a full-fledged department in the medical school. This shift was important in making Winship an umbrella or "matrix" organization integrating all cancer service lines, including radiation oncology, surgical oncology, diagnostic imaging, hematology and medical oncology, and pathology. Khuri, then division director, became chair of the new department.

Second, in response to suggestions from NCI, Winship reduced its number of deputy directors. From 2009 on, as Curran moved into the director role, there would be only one deputy director and that would be Khuri. The new role allowed Khuri to step back and look at the broader picture, providing Curran and others with constant evaluation and feedback about Winship's quality of patient care, clinical research, and compliance with NCI guidelines.

Big picture, yes, but Khuri's feet are very much on the ground. In addition to his administrative and research responsibilities, Khuri spends Wednesdays seeing his established as well as new patients, most of whom have been diagnosed with lung or head and neck cancer.

Over the past nine years, Khuri has been involved in recruiting more than 60 clinicians and researchers to Winship, an expansion critical for obtaining NCI status. He's proud of those recruits and even prouder of having helped so many faculty, both new and existing, embrace the dual citizenship in a departmental home and in Winship.

"It's become an easier sell," says Khuri, who is also a dual U.S. and Lebanese citizen. "Not only are cancer care and research becoming a team sport nationwide, but Emory and Winship leaders are working hard to create value in Winship membership, building a common culture in which accomplishments of the group are celebrated as much as accomplishments of individuals."


China-U.S. health reform experts discuss problems/solutions

china-conf
Among others, presenters included Shanlian Hu, William Roper, William Hsiao, Jeff Koplan, Ken Thorpe, Wright Caughman, and Assistant Secretary of State Howard Koh (the latter two not pictured).

More than 250 Chinese and U.S. health administrators and scholars from academic and government institutions gathered at Emory this month for the three-day Westlake Forum III, Healthcare Reform in China and the US: Similarities, Differences and Challenges. The third conference in the Westlake series and the first to be held in the United States, it was co-hosted by the Emory Global Health Institute (GHI), Zhejiang University School of Medicine, and the China Medical Board.

"The United States has much in common with China when it comes to issues of health care reform," says Jeff Koplan, Emory GHI director.

According to Shanlian Hu, a professor at Fudan University, China’s health care reform priorities include expanded coverage, equal access, improved benefits, improved care delivery systems, and containment of soaring medical costs.

Health care in China is highly decentralized, with a tiered system of coverage for urban and rural residents, Hu said. The government has a goal of complete coverage by 2020. Although 90% of citizens currently are covered, cost and accessibility vary considerably. Hospital stays are longer than in the United States, medical training is less rigorous, and access to high-quality care is limited. Like those in this country, China's public hospitals and providers struggle with economic and quality issues deriving from a fee-for-service reimbursement mechanism.

Yet health care costs in China are only 5.13% of the country’s GDP, compared with 17% in this country.

William Roper, dean of the University of North Carolina School of Medicine and CEO of the UNC Health System, said health care in the United States is a “paradox of excess and deprivation,” and Americans need to rethink some long-held assumptions.

"Americans believe they have the best health care system in the world, yet we spend more on medical care than any other country, we are the only rich democracy in which a substantial portion of citizens lack care, nurses are in short supply, quality and safety are not as high as they should be, and incentives for physicians are skewed toward specialization and expensive technical procedures," Roper said. "Political constraints and a lack of attention to international experience have resulted in a patchwork reform plan that offers thin coverage, with many remaining uninsured. Effective health care reform will require broad-based cooperation, and proposals must take cost control seriously," he added.

Harvard Professor William Hsiao noted that China has made significant progress in health care reform over the past seven years. In 2003, 75% of Chinese citizens were uninsured, whereas today China offers coverage on some level to 90%, with out-of-pocket payments continuing to decline. Problems persist, however, in lack of well-trained physicians and equipment, distorted prices, and profit motives of public hospitals and officials.

Ken Thorpe, chair of health policy and management in the Rollins School of Public Health, outlined the newly passed U.S. health reform law, which aims to expand and improve coverage, improve access to quality care, and control rising costs. Many of these improvements would likely be paid through Medicare reductions and increased taxes on higher-income households.

Other sessions in the three-day conference brought together Chinese and U.S. experts to discuss issues of professionalism, financing, integrated delivery systems, incentive structure, information technology, quality improvements, and comparative effectiveness.

     From the Executive VP

Wright Caughman
Wright Caughman  

Hand transplant is academic health sciences at its best

I like to think of the work we do here in Emory's Woodruff Health Sciences Center as academic health sciences at its best. To me that means that our key components are interdependent, and that success in one enhances the opportunity for success in another. One recent achievement—Emory's first hand transplant surgery—exemplifies one such instance in which our people and our missions converged to serve humanity by improving health. (See related story at left.)

When Orlando college student Linda Lu came to Emory to undergo rare hand transplant surgery, she may not have realized the full breadth of the team that would be supporting her complex surgery and long recovery. Lu, who lost her left hand to an autoimmune disease as an infant, underwent a 19-hour surgery at Emory University Hospital on March 12—a success by all measures thanks to the concerted efforts of faculty and staff throughout the Woodruff Health Sciences Center.

The surgical team was led by Linda Cendales, assistant professor of surgery in the School of Medicine and a member of the Emory Transplant Center faculty. Dr. Cendales was also on the team in Louisville that performed the first U.S. hand transplant in 1999. Her extraordinary accomplishment makes Emory one of just four institutions to have ever successfully performed this highly complex procedure.

But Dr. Cendales will be the first to tell you that she didn't achieve it alone. Her Vascularized Composite Allograft program, created in 2007 and sponsored by a Department of Defense grant, operates in partnership with the Atlanta Veterans Affairs Medical Center. (As you can imagine, the success of this surgery holds great promise for injured members of our nation's military.)

In addition to our great partners at the VA, the transplant team also included scores of Emory Healthcare staff, including multiple teams of surgeons, anesthesiologists, nurses, operating room staff, and rehabilitation staff.

And before the procedure even made it to the operating room, Yerkes National Primate Research Center was an invaluable collaborator in the preclinical work, helping develop the protocol for vascular composite transplantation. The Yerkes collaboration allowed our transplant team to study the behavior of these tissues after transplant, minimizing the process of rejection.

Our first hand transplant is an achievement for the entire Woodruff Health Sciences Center. We came together across missions, units, disciplines, and professions to achieve something few have ever done before, and we opened a new world of possibility to a young patient in need. We can all be proud of that.

Please let me know your thoughts and suggestions at evphafeedback@emory.edu.


In brief

New endowed chair named for Fray Marshall

fray_marshall  
Fray Marshall  

Friends and colleagues of Fray Marshall gathered last month to celebrate the establishment of the Fray Marshall Chair in Urology, which will be devoted to research. Marshall, who is the Ada Lee and Pete Correll Professor of Urology, came to Emory from Johns Hopkins in 1998 to chair urology following its evolution from a division in surgery to a full-fledged department. Marshall has expanded the department to international recognition for its faculty and research program. Read more.


Expanded coverage for cancer surveillance registry

 
Kevin Ward  

The Georgia Center for Cancer Statistics, headed by Kevin Ward (epidemiology, Rollins School of Public Health), received funding from the National Cancer Institute to expand its surveillance registry from metro Atlanta to all of Georgia. The additional funding will enhance the quality and timeliness of cancer surveillance data and support follow-up of patients.


Radiology's actual new name

The medical school's Department of Radiology has changed its name to the Department of Radiology and Imaging Sciences (not "Services," as previously reported).


Notable

 
Stephen Clements  
   
ann_critz  
Ann Critz  
   

Stephen Clements (cardiology, Emory University Hospital) and Ann Critz (chief of pediatrics, Emory University Hospital Midtown) each received one of this year's Second Century Awards for leadership and dedication. The auxiliaries at both hospitals also received awards this year.

 
James Curran  

James Curran (dean, Rollins School of Public Health) received the 2011 Ryan White Distinguished Leadership Award, established in 2009 by the Rural Center for AIDS/STD Prevention to recognize significant national contributions to this effort.

 
Mary Gullatte  

Mary Gullatte (associate chief nursing officer, Emory University Hospital Midtown) is president-elect of the Oncology Nursing Society.

 
Michael Kutner  

Michael Kutner (biostatistics, Rollins School of Public Health) received the 2011 Charles R. Hatcher Jr. Award. The award honors faculty from the Woodruff Health Sciences Center who, through their lifetime of work, exemplify excellence in public health.

 
Dane Peterson  

Dane Peterson (COO, Emory University Hospital Midtown) has been appointed chair of the public safety council of Central Atlanta Progress. Although public perception may still be playing catchup, Peterson notes that safety reports in recent years have shown that downtown is becoming one of the metro area's safest places to work, live, and visit. Read more in a recent article in Atlanta Business Chronicle.

 
Jean Rowe  

Jean Rowe (social worker, Winship Cancer Institute) was recognized as the Dennis Roth Neuro-Oncology Social Worker of the Year by the Association of Oncology Social Work. The award is sponsored by the National Brain Tumor Society.

red-cross

In response to the tsunami in Japan, staff in the Woodruff Health Sciences Center Admin Building raised more than $4,000 for Red Cross relief efforts. Staff were invited to wear jeans on March 18 in exchange for a $5 minimum donation, and WHSC matched the amount raised, for a grand total of $4,216.


Events

April 26: Future Makers Lecture. William Stead. 5 p.m., WHSCAB auditorium. More info.

April 27: 2nd Annual Greening Healthcare Conference. 8 a.m. to 1 p.m., School of Nursing auditorium. More info.

May 10: Charles Hatcher Jr. will sign copies of his book, All in the Timing: From Operating Room to Board Room, at 5 pm on the WHSCAB plaza.

Till June 30: The Life and Legacy of Robert W. Woodruff. Exhibit at Schatten Gallery, level 3, Robert W. Woodruff Library.