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The time Anna stayed up all night

Almost precisely a decade ago, a young Atlanta lawyer named Anna was returning to work, after being treated for an extraordinary sleep disorder. Her story has been told here at Emory and by national media outlets. Fast forward a decade to Idiopathic Hypersomnia Awareness Week 2018 (September 3-9), organized by Hypersomnolence Australia. What this post deals with is essentially the correction of a date at the tail end of Anna’s story, but one with long-term implications Read more

Mini-monsters of cardiac regeneration

Jinhu Wang’s lab is not producing giant monsters. They are making fish with fluorescent hearts. Lots of cool Read more

New tool in the fight for scarce donor organs

With so many men, women and children desperately awaiting a life-saving donor liver through traditional means – those donated by a deceased individual – transplant surgeons at Emory University Hospital looked for ways to improve the odds. transplantcenterlogo

Recently, Emory doctors were the first in Georgia to perform a rare “domino” liver transplant procedure – in effect saving two lives with one donor organ. The doctors had a opportunity to discuss the procedure at a media briefing held a few days ago.

The United Network for Organ Sharing (UNOS) says there are currently more than 16,000 Americans currently awaiting a liver transplant.

Domino liver transplant procedures are aptly named for the sequential, one-after-the-other nature of the process in which a viable liver from a deceased donor is transplanted into the first recipient, and the first recipient’s organ is then transplanted into a second recipient. The procedure is still extremely unusual, with fewer than 100 done in the United States since the first in 1996.

According to Stuart Knechtle, MD, professor of surgery in the Emory School of Medicine and director of the Emory liver transplant program, domino transplants are a rare but effective way of overcoming the national shortage of organs available for transplant. In most cases of domino liver transplants, one of the donated livers is transplanted from a patient with another type of disorder that does not affect the organ recipient.

“This successful domino liver transplant is something that simply does not start or end in a hospital operating room,” says Knechtle.

Liver recipient Bob Massie discusses his “miracle.”

Liver recipient Jean Handler discusses being “thankful and shocked.”

“This procedure, which saved two lives,” says Knechtle, “and will impact both families for many years to come, is the end result of a long chain of special events, starting with the decision by one person to donate the gift of life upon his untimely demise, which in turn allowed the recipient of that person’s organ to then donate hers to another patient.”

You can view the full briefing at this web site.

Posted on by Lance Skelly in Uncategorized Leave a comment

Jeff Koplan discusses H1N1 on panel

Experts on H1N1 influenza are collaborating all across the country to learn more about the virus and how to prevent its transmission. In a race against time, Emory studies are taking place in the lab and in human clinical trials to help find a vaccine that can be used in the near weeks to come.

Recently, Emory’s Jeff Koplan, MD, vice president for global health and past CDC director, participated in a Breakthroughs panel sponsored by Big Think, Pfizer and Discover to discuss the latest issues in pandemic and genomic science, fields that have not only made big headlines recently but also promise to be two of the most pressing topics in global science and medicine in coming years.

Jeffrey P. Koplan, MD, MPH

Jeffrey P. Koplan, MD, MPH

The panel focused on the real-time, round-the-clock scientific mission to understand the history, significance, and future of the new strain of flu that emerged suddenly this spring. Panelists included Koplan; Barry Bloom, Joan L. and Julius H. Jacobson Professor of Public Health at Harvard; Peter Palese, chairman of the microbiology department at Mt. Sinai Medical Center; and Michael Worobey, ecologist and evolutionary biologist at the University of Arizona.

View: Superbug – Are We Prepared for The Next Great Plague?


Emory began signing up several hundred interested volunteers several weeks ago for a clinical trial of the H1N1 vaccine along with the seasonal flu vaccine. About 170 adults have now been vaccinated in the trial, which will last about nine weeks and involve several vaccinations and blood tests. A clinical trial testing the H1N1 vaccine in children will begin at Emory and Children’s Healthcare of Atlanta in the next few days, followed by another adult clinical trial adding an adjuvant to the H1N1 vaccine.

In addition, a multi-pronged attack against the H1N1 virus by Emory researchers is using a new method of rapidly producing highly targeted monoclonal antibodies to develop a diagnostic test as well as a temporary therapy to stave off the H1N1 virus. The antibodies, which can be isolated from a small amount of the blood of humans infected with the virus, could be targeted against H1N1 and rapidly reproduced to detect or attack the virus.

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Biomaterials used for hips and knees

Orthopaedics is a constantly evolving subspecialty where medical technology and research drives the development of new products used for reconstruction of body parts, specifically for hip and knee replacements.

Emory has been on the forefront of investigating and using three materials for these replacements: ceramic on ceramic surfaces, metal on metal surfaces, or highly cross-linked polyethylene. These newer biomaterials can reduce wear rates by over 99 percent compared to previous materials, thus enhancing the life of the new hip or knee.

Adult reconstruction or hip and knee arthritis surgery delivers quality outcomes that make a dramatic improvement in a patient’s quality of life. At the first post-operative visit, patients are more comfortable, have less pain and are even more functional than before their surgery.

Orthopeadic surgeon James R. Roberson, MD, chairman, Department of Orthopaedics in Emory School of Medicine, and professor of orthopaedic surgery specializes in adult reconstructive surgery of the hip and knee.

Roberson has been involved in clinical research for more than 20 years to solve difficult problems of the arthritic hip and knee. He pioneered a minimally invasive surgery technique for knee replacement that allows him to use smaller incisions in certain patients who have uncomplicated conditions.

Visit Emory University Orthopaedics & Spine Center and Emory University Orthopaedics & Spine Hospital to learn more about orthopaedic services and watch a video about the hospital.

Posted on by Kathi Baker in Uncategorized Leave a comment

Pediatric liver disease on the rise

Miriam Vos, MD with patient.

Miriam Vos, MD with patient.

Miriam Vos, MD treats a growing number of children with nonalcoholic fatty liver disease. Yet little research has been conducted into the development of the illness. Nonalcoholic fatty liver disease in children, which often is associated with obesity, occurs when fat deposits itself in the liver. It eventually can lead to inflammation, cirrhosis and even liver failure.

In the hopes of preventing the disease in children, Vos, a pediatric hepatologist at Emory University School of Medicine

and Children’s Healthcare of Atlanta, is conducting research into the origins of this disorder in children. She suspects a diet high in sugar and too little exercise are tied to its onset.

In fact, a recent study led by Vos found that Americans are getting more than 10 percent of their daily calories from fructose, used mainly in sugar-sweetened beverages and processed foods.

The study analyzed the amount and sources of dietary fructose consumption among U.S. children and adults from 1988 to 1994. The researchers found that U.S. children and adults consumed 54.7 grams of fructose per day, an almost 50 percent increase from a national study sample conducted in 1977-1978.

Fructose occurs naturally in fruits and vegetables, however, it is added to many processed foods as table sugar (sucrose) and high-fructose corn syrup.

Vos has written a book aimed at helping children and their families shed pounds and achieve better nutrition through changes in lifestyle and diet.

To hear Vos’s own words about nonalcoholic fatty liver disease in children, listen to Emory University’s Sound Science podcast.

Posted on by Robin Tricoles in Uncategorized Leave a comment

Heated, targeted chemotherapy helps abdominal cancers

Cancer of the colon, ovaries, appendix or other organs within the abdomen often spreads to the lining of the abdominal cavity. Experts call this condition peritoneal surface malignancy. Until recently, treatment options for this form of cancer only provided relief from symptoms.

Emory University Hospital is one of a few facilities nationwide to utilize a new combination therapy to slow or prevent recurrence of this cancer. Hyperthermic intraperitoneal chemoperfusion (HIPEC) is a procedure done immediately following surgery that delivers heated chemotherapy directly into the abdominal cavity where it can penetrate cancerous tissue. Heat at 42 C (107 F) destroys cancer cells and enhances the power of chemotherapy.

The term “intraperitoneal” means that the treatment is delivered to the abdominal cavity. “Hyperthermic chemoperfusion” means that the solution containing chemotherapy is heated to a temperature greater than normal body temperature.

Charles Staley, MD, chief of surgical oncology at the Emory Winship Cancer Institute, says by bathing the abdomen with heated chemotherapy immediately following surgery doctors can administer a higher dose of medication than would normally be tolerated by a patient if given intravenously – the traditional way chemotherapy is administered.

During surgery, Staley removes all visible tumors throughout the abdomen, a procedure known as cytoreductive surgery. Following surgery, while still in the operating room, Staley administers the new treatment, which takes about two hours. Recent studies show improved prognosis in patients treated with HIPEC after the cytoreductive surgery.

Illustration of heated chemo therapy

Illustration of heated, targeted chemotherapy

Posted on by Vince Dollard in Uncategorized Leave a comment

New heart valve replacement option under study

A new option for heart valve replacement is under study at Emory University Hospital. Cardiologists at the Emory Heart & Vascular Center are conducting groundbreaking research to study a non-surgical treatment option for patients with severe aortic stenosis, a narrowing of the aortic valve opening that affects tens of thousands of people each year. It is most common among elderly patients over 70 years of age, but can surface earlier in life in those with rheumatic heart disease or congenital abnormalities of the valve. Patients often develop symptoms of chest pain, shortness of breath, fainting spells and heart failure.

Peter Block, MD

Peter Block, MD

Emory cardiologists, led by Peter Block, MD, FACC, professor of medicine, Emory School of Medicine, are performing percutaneous aortic valve replacement as part of a clinical trial, comparing this procedure with traditional, open-heart surgery or medical therapy in high-risk patients with aortic stenosis. It provides a new way for doctors to treat patients who are too ill or frail to endure the traditional surgical approach. So far, 115 people have participated in the phase II clinical trial.

In this new procedure, doctors create a small incision in the groin or chest wall and then feed a wire mesh valve through a catheter and place it where the new valve is needed. The standard therapy, which has been used to treat aortic stenosis for more than 30 years, is to remove the diseased valve through open-heart surgery.

Block says the results seen so far in this clinical trial show great promise for this procedure. He says this is especially important since tens of thousands of Americans are diagnosed with failing valves each year and that number is expected to increase substantially in the coming years as baby boomers pass the age of 70.

Posted on by Jennifer Johnson in Uncategorized 1 Comment

Strategies to target cancer stem cells

A story in last Friday’s New York Times highlights research on “cancer stem cells”: a fraction of cells in a tumor that are especially resistant to chemotherapy and resemble the body’s non-cancerous stem cells in their ability to renew themselves.

The story describes work by a team at the Broad Institute, who reported in the journal Cell that they had identified compounds that specifically kill cancer stem cells. The hope is that compounds such as these could be combined with conventional treatments to more effectively eliminate cancers.

However, scientists disagree on whether the phenomenon of cancer stem cells extends to different kinds of cancer and what is the best way to target them. Previously not much was known about how to attack these cells.

Work at Emory’s Winship Cancer Institute has been tracking how some biomarkers in cancer cells resemble or differ from those found in stem cells. These markers may help researchers home in on the cancer stem cells.

 

Anticancer therapy must target more than one type of cell. TIC means tumor initiating cell, DTC means differentiated tumor cell, and CPG means cancer progenitor

If "cancer stem cells" play the critical roles some scientists think they do, anticancer therapy must target more than one type of cell. In this figure from Van Meir + Hadjipanayis' review, TIC means tumor initiating cell, DTC means differentiated tumor cell, and CPG means cancer progenitor cells.Â

 

 

In a recent review, Emory brain cancer specialists Erwin Van Meir and Costas Hadjipanayis write:

The “cancer stem cell” hypothesis has invigorated the neuro-oncology field with a breath of fresh thinking that may end up shaking the foundation of old dogmas, such as the widely held belief that glioblastoma tumors are incurable because of infiltrative disease. If the infiltrated cells are in fact differentiated tumor cells, their dissemination beyond the surgical boundary may not be the primary cause of tumor recurrence.

Van Meir, the editor of a new book on brain cancer, adds this comment:

Clearly a lot more work needs to be done to understand the precise cause of glioblastoma recurrence after surgery and chemotherapy and how to prevent it.  The possibility of developing therapeutics that can specifically target the brain cancer stem cells is an exciting new development but will have to proceed with caution to spare normal stem cells in the brain. Developing new imaging tools that can track cancer stem cells in the brain of treated patients is also an important objective and some of the Emory investigators are evaluating the use of nanoparticles to this purpose.

A new faculty member at Winship, Tracy-Ann Read, recently published her research on a molecule that could be used to identify “tumor-propagating cells” in medulloblastoma, a form of brain cancer. She says:

Although cancer stem cells have been identified in many different types of cancer, it is becoming increasingly clear that the properties of these cells may vary greatly among the different tumor types. It is unlikely that one  therapeutic agent will be able to target the cancer stem cells in for example all types brain tumors. Hence  much work still needs to be done in terms of analyzing the properties of these cells in each tumor type and identifying the genes that are responsible for their unique ability to propagate the tumors. 

Winship’s director Brian Leyland-Jones has also reported at the San Antonio Breast Cancer Symposium that molecules that distinguish a hard-to-treat form of breast cancer resemble those that maintain stem cells.

Nice round-up from Nature’s stem cell blog editor Monya Baker

Posted on by Quinn Eastman in Cancer Leave a comment

Leverage universities for growth of metro Atlanta

Emory University President James W. Wagner, PhD

Emory University President James W. Wagner, PhD

In an Aug. 12 opinion piece published in The Atlanta Journal-Constitution, Emory University President James W. Wagner, PhD, says that if Atlanta is to move forward, it must recognize the important role that its colleges and universities play and put them front and center in public and private economic development plans.

Wagner notes that colleges and universities like Emory create the human capital needed to advance the economic, social and cultural lifeblood of a community.

“Work in the area of sustainable development creates an opportunity for the production of new ideas that can be applied as far away as a remote village in Africa or as close as the crowded corridors of metro Atlanta,” says Wagner.

“Whether the goal is creating world-class facilities for the research and treatment of cancer in Atlanta or a healthier economic climate through sustainable development on another continent, America’s most successful communities have come to rely heavily on their universities and colleges to sustain economic and social progress.”

Visit AJC.com to read Wagner’s opinion piece on the impact that Emory and other colleges and universities have on the communities they serve and how they can help move the region and state forward.

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Childhood cancer treatment may raise diabetes risk

Cancer survivors who got radiation treatments as children have nearly twice the risk of developing diabetes as adults. That’s according to a study led by Emory and Children’s Healthcare of Atlanta pediatric oncologist Lillian R. Meacham, MD.

Lillian Meacham, MD

Lillian Meacham, MD

The study, published in the August 10/24 issue of Archives of Internal Medicine, compared rates of diabetes in nearly 8,600 childhood cancer survivors diagnosed between 1970 and 1986, and nearly 3,000 of their siblings who did not have cancer.

Children who were treated with total body radiation or abdominal radiation to fight off cancer appear to have higher diabetes risks later in life, regardless of whether they exercise regularly or maintain a normal weight.

After adjusting for other risk factors, including body mass index – a ratio of height and weight – Meacham and team found that childhood cancer survivors overall were 1.8 times more likely to have diabetes.

And the more radiation that was used, the greater the diabetes risk. For those treated with total body radiation — a treatment often used before bone marrow transplants to treat childhood leukemia — the diabetes risk was more than seven times greater.

More study is needed to understand how radiation could promote diabetes in cancer survivors, notes Meacham.

She says it is imperative that clinicians recognize this risk, screen for diabetes and pre-diabetes when appropriate, and approach survivors with aggressive risk-reducing strategies.

Meacham is a professor of pediatrics in the Emory School of Medicine and medical director of the Cancer Survivor Program with the AFLAC Cancer Center and Blood Disorders Services, Children’s Healthcare of Atlanta.

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Remembering Grace Crum Rollins

Grace Crum Rollins

Grace Crum Rollins

She was quiet and small in stature but firm in her beliefs. Grace Crum Rollins made good on her late husband’s promise of helping construct a building to house Emory’s School of Public Health. In 1994, the Grace Crum Rollins Building became the permanent home for the school that Emory named for her extraordinary family.

Mrs. Rollins, whose generosity led the Rollins School of Public Health to become one of the nation’s premier schools in its field, died on August 8 at age 98.

Dean James Curran says, “Essentially, the school would not be what it is today without her family. Our faculty, students, and alumni are part of her legacy.”

Grace Crum married O. Wayne Rollins during the Depression. They worked hard, lived simply, and never bought anything on credit. When Wayne was hospitalized for an appendectomy, Grace knitted to pay his bill.

Years later, Forbes magazine would count him among the nation’s greatest business leaders. In what is considered one of the first leveraged buyouts, Wayne bought Orkin Exterminating in 1964. The family’s business grew to encompass oil and gas services, security systems, and real estate.

Also in 1964, Wayne and Grace moved to Atlanta with their sons Randall and Gary. The couple became involved at Emory through the Candler School of Theology and Wayne’s role as a university trustee. With a lead gift to the School of Medicine, they enabled construction of the O. Wayne Rollins Research Center, doubling Emory’s laboratory space. Upon learning that the School of Public Health needed a building, Wayne volunteered his support but died unexpectedly in 1991. Less than a year after his death, Grace and her sons fulfilled his promise by contributing $10 million for construction.

The Rollins attend an Emory event

Wayne and Grace Rollins attend an Emory event

Other gifts followed, including a $50 million lead gift through the O. Wayne Rollins Foundation for a second public health building. The Claudia Nance Rollins Building, which is named for Wayne’s mother, will open in 2010 and more than double the physical size of the school.

The idea of creating the first public health building appealed to Wayne Rollins’ entrepreneurial spirit. With just 20 faculty and 500 graduates, it was a risky endeavor, Curran says.

“Mrs. Rollins kept that commitment” notes Curran. “Today the school has 200 faculty and more than 5,000 alumni in 90 countries.”

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