Posts filed under ‘Research’
Paz reports on highlights of Medical Center’s fiscal year
Highlights from across all four parts of Penn State Milton S. Hershey Medical Center’s mission were at the center of this week’s annual public board of directors meeting. Dr. Harold L. Paz, CEO of Penn State Hershey Medical Center and Health System, Penn State’s senior vice president for health affairs, and dean, Penn State College of Medicine, addressed faculty, staff and community members. Paz discussed how new and expanded collaborations, growth in its clinical and research missions, and the presence of the first group of medical students in State College were all part of a successful 2011-12 fiscal year.
Read more about Dr. Paz’s presentation in this article >>
The presentation also included the following videos, each highlighting a key story from the past year:
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September 14, 2012 at 8:12 am pennstatemedicine Leave a comment
The lifecycle of a cancer
Imagine if various types of cancer were caused by a common, though currently unknown, virus. The implications for treatment options and methods of prevention could be enormous. The discovery of infectious agents, such as the human papillomavirus as the root cause of cervical cancer, opens the door to the idea that other viruses might be at work in the genesis of cancer development.
This theory is about to be tested further by Thomas P. Loughran, M.D., and his colleagues at Penn State Hershey Cancer Institute. But Loughran is no stranger to being at the forefront of cancer research.
The LGL discovery
As outlined in this previous Penn State Medicine article, Loughran, who is a professor of medicine at Penn State College of Medicine and director of the Cancer Institute, is responsible for the discovery of large granular lymphocyte (LGL) leukemia while he was an oncology fellow at the Fred Hutchinson Cancer Research Center in Washington. He has spent most of his career researching the development of the disease and establishing a treatment protocol, which has allowed many patients to live healthier and more productive lives. In 2003, he started an LGL leukemia registry to keep track of patient outcomes.
One of the most challenging aspects of LGL leukemia is getting an accurate diagnosis. Patients often present with chronic symptoms, such as joint pain, fevers, and immune system problems that can be misdiagnosed as rheumatoid arthritis (RA) or aplastic anemia.
“The diagnosis is clouded by the fact that the symptoms are not obvious,” Loughran says. “Patients can have morbidity with tiredness, shortness of breath, pain, and swelling of the joints. Ten to 30 percent have classic RA. This is a chronic disease, though, with a major complication being infections.”
A diagnosis of LGL leukemia is not difficult to come by if medical professionals know what to look for, which is an increased number of LGL cells that can be seen on a blood smear. But because this can easily be overlooked in basic blood tests, it often takes a recurrence of symptoms before an accurate diagnosis of LGL leukemia is reached. (more…)
Cardiovascular risks related to high dietary salt
According to the American Heart Association (AHA), cardiovascular disease is the number one cause of death in the United States in both men and women. Hypertension or high blood pressure, the most prevalent form of the disease, affects at least 34 percent of US adults and an estimated 18-20 percent of adolescents. Because hypertension plays a key role in the development of life-threatening heart disease, stroke, and other serious illnesses, biomedical researchers remain focused on understanding its causes, prevention, and treatment. Although many blood pressure-lowering medications are available, few patients with hypertension have well-controlled blood pressure. One reason for this is that a large component of blood pressure control is neurally mediated, and according to Sean Stocker, Ph.D., associate professor of cellular and molecular physiology at the College of Medicine.
“The key neural pathways and mechanisms that allow our sympathetic nervous system (SNS) to tightly regulate blood pressure are still not well defined,” Stocker said. A major factor in the brain’s control of blood pressure is dietary sodium intake. Understanding how the brain responds to plasma sodium levels is likely to be particularly important, because excess dietary salt intake is expected to pose a public health epidemic of hypertension in the coming years. The mechanism by which the brain senses and reacts to plasma sodium concentration is largely unknown, and how to control the process is a major therapeutic challenge for managing hypertension. (more…)
Today’s Research – Researchers study effects of manganese on brain
Researchers at Penn State College of Medicine are actively working in Hershey, with colleagues at Penn State, University Park and other Penn State campuses, and with colleagues at various institutions across the country to conduct groundbreaking research. Their discoveries continue to contribute to the advancement of health care on all levels.
College of Medicine scientists are researching the effects of the metal manganese on brain functions. This research builds on the results of an earlier, smaller-scale study that looked at welders. Research has indicated that environmental factors, including metals toxic to the neurological system, may play a role in the cause of neurobehavioral disorders. In a preliminary study, Xuemei Huang, M.D., Ph.D., and colleagues looked at a small group of welders and found an association between exposure to manganese-containing metal fumes and decreased motor performance on a test for dexterity/fine motor control in the welders.
The team’s prior study suggests that there is manganese accumulation in many other regions of the brain in welders who are showing no classic symptoms of overexposure, specifically in a part of the brain associated with smell. This suggests that at least some of the manganese is getting into the brain through inhalation. They also showed manganese in the areas of the brain associated with motor control, which correlates to the decreased motor control observed.
The initial study was supported by National Institute of Environmental Sciences, with additional support from the National Institute of Neurological Disorders and Stroke and the Penn State General Clinical Research Center (now the Penn State Clinical and Translational Science Institute), and results were published in the scientific journal Toxicological Sciences. The current study has received funding from the National Institute of Environmental Sciences.
Unraveling the mystery of a rare, virus-mediated neurological disease
From bench to bedside
Aron Lukacher, M.D., Ph.D.
Most adults in the United States are asymptomatic carriers of persistent viral infections, such as herpes simplex (cold sores) or varicella zoster (chicken pox). Exposed to such viruses at some point during childhood, our immune systems produced effective antibodies against the virus, which decreased viral titers and eliminated clinical signs of illness. Although persistent viruses remain in some tissues of our bodies, our immune systems keep the viruses in check, and we remain illness-free. For a small subset of people, however, their immune systems fail to control these latent viruses and they fall victim to disease.
Identifying people who are most vulnerable to viral re-activation is one of the major challenges facing physicians who treat patients with compromised immune systems.
Such patients include those with acquired immune deficiency syndrome (AIDS), those treated with cancer chemotherapy, and those receiving agents to prevent rejection of transplanted organs and to control autoimmune and inflammatory diseases. According to Aron Lukacher, M.D., Ph.D., professor and new chair of the Department of Microbiology and Immunology at Penn State College of Medicine, in recent years, major strides have been made in researchers’ understanding of immune responses to persistent viruses and the diverse strategies viruses use to evade immune detection. Ongoing research by many groups seeks to understand and overcome such strategies, so that patients who are often the most desperately ill can avoid falling victim to these viruses. Lukacher’s research focuses on the immunological mechanisms that control persistent viral infections and defining the pathways by which a certain class of viruses called polyomaviruses escape immune control to cause serious disease. (more…)
Physician lack of sleep: Can cognitive “overload” compromise care in a crisis?
For decades, lack of sleep and fatigue have been an unwelcome but accepted part of physician training and everyday medical practice. Medical students and residents are likely to work a full day and then be on call through the night, typically working a full 24-hour shift and getting very little uninterrupted sleep. Sleep researchers, however, have consistently shown that well-rested physicians commit fewer serious medical and diagnostic errors, compared to physicians working extended shifts (e.g., more than 24 hours). Increasing awareness of the negative impact and risks posed by physician sleep deprivation led the Accreditation Council for Graduate Medical Education in 2003 to place duty hour limits on resident physicians. Although the limits have been in place for nearly eight years, the debate about sleep deprivation, resident training, and hospital costs continues unabated.
A research study conducted by Jonathan Tomasko, M.D., research fellow in the Division of Minimally Invasive and Bariatric Surgery, along with Randy Haluck, M.D., ’91, R ’97, and Eric Pauli, ’04, M.D., Division of Minimally Invasive and Bariatric Surgery, sheds light on the duty limit debate. Tomasko explains, “We wanted to assess how sleep deprivation affects not only how well surgeons perform familiar techniques, but also their ability to learn something new and to deal with a mentally challenging task. It touches on clinical issues like dealing with errors, as well as the educational debate about duty hours.” (more…)
Understanding addiction: Using Animal Models to Answer the “Why, How, and Who”
Over the past decade, use of certain illicit drugs, including crack cocaine and methamphetamine, has shown sharp declines in the United States based on data from the Substance Abuse and Mental Health Services Administration (SAMHSA). But these encouraging data contradict other disturbing facts. Compared to 2002, use of marijuana and prescription pain relievers has jumped by approximately 20 percent and heroin use has shown an alarming 44 percent increase.
“Drug addiction persists as a major problem in the United States,” said Patricia Sue Grigson, Ph.D., professor, Department of Neural and Behavioral Sciences. “Drug use data does not reflect the devastating, long-term impact that drug addiction has on individuals and their families. This is why it is so important to continue to search for answers about why some people become addicted and others do not. Understanding and identifying risk factors for the development of addiction will lead to more effective prevention and treatment plans.”
Grigson uses an animal model to study the environmental, behavioral, and neurological underpinnings of addiction. “Humans and the rats in our studies have more in common than not,” she said. “For instance, about 17 percent of humans who try cocaine eventually become addicted; studies have shown the same percentage of rats that try cocaine also show addiction-like behavior.” (more…)
Today’s Research – Stems cells are potential source of cancer-fighting T cells
Researchers at Penn State College of Medicine are actively working in Hershey, with colleagues at Penn State, University Park and other Penn State campuses, and with colleagues at various institutions across the country to conduct groundbreaking research. Their discoveries continue to contribute to the advancement of health care on all levels.
Adult stem cells from mice converted to antigen-specific T cells—the immune cells that fight cancer tumor cells— show promise in cancer immunotherapy and may lead to a simpler, more efficient way to use the body’s immune system to fight cancer, according to College of Medicine researchers. Jianxsun Song, Ph.D., assistant professor of microbiology and immunology said, “Tumors grow in part because patients lack the kind of antigen-specific T cells needed to kill the cancer. An approach called adoptive T cell immunotherapy generates the T cells outside the body, which are then used inside the body to target cancer cells.” It is complex and expensive to expand T cell lines in the lab, so researchers have been searching for ways to simplify the process. Song and his team found a way to use induced pluripotent stem (iPS) cells, adult cells that are genetically changed to be stem cells.
By inserting DNA, researchers change the mouse iPS cells into immune cells and inject them into mice with tumors. After 50 days, 100 percent of the mice in the study were still alive, compared to 55 percent of control mice, which received tumor-reactive immune cells isolated from donors. Researchers reported their results and were featured as the cover story in a recent issue of the journal Cancer Research. Researchers are now studying how to use the process in human cells.
This study was funded through the Pennsylvania Department of Health using Tobacco Settlement Funds, the W.W. Smith Charitable Trust, and the Melanoma Research Foundation.
New education programs aim to better prepare students
In its usual tradition of education innovation, the Penn State College of Medicine has recently introduced a number of new or reconfigured programs. From dual-degree programs to an exciting new Physician Assistant Program, the College of Medicine is realigning its curriculum to better prepare future physicians, nurses, and researchers for the changing landscape of the biomedical research enterprise, and the health care arena where new discoveries are applied.
The new interdisciplinary graduate program, Biomedical Sciences (BMS), is a departure from the traditional graduate programs. “Up to a year ago, our graduate programs aligned with their basic science departments. We determined that this structure wasn’t meeting how we needed to train our students for the future,” says Michael F. Verderame, Ph.D., associate dean for graduate studies, professor of medicine, and director, Medical Student Research Project. “Students can build their own curriculum to address the work that they want to do.” The first class of students just completed their second semester in May.
Many of the new programs build on the tremendous strengths that Penn State has to offer to its students. One of those areas is its Department of Public Health Sciences, where faculty has been working for several years in developing the new Master of Public Health program. The first class included thirteen students. “The fact that we’re training the future generation to participate in the improvement of health in our nation is an important contribution,” says Verderame. Also in this department is a new Ph.D. program in biostatistics. That program targets a smaller number of students, who are expected to start with the next academic year. (more…)
Today’s Research – Results released for RAMPART, a national research trial
Researchers at Penn State College of Medicine are actively working in Hershey, with colleagues at Penn State, University Park and other Penn State campuses, and with colleagues at various institutions across the country to conduct groundbreaking research. Their discoveries continue to contribute to the advancement of health care on all levels.
RAMPART (Rapid Anticonvulsant Medications Prior to Arrival Trial) studied whether use of one FDA-approved seizure drug administered by EMS personnel as a shot is as effective as one administered intravenously. Patients treated by Life Lion EMS and who met the study criteria were part of the research, unless they opted out after community consultation by the Medical Center.
This is a federally-regulated procedure known as exception from informed consent, since patients are unable to opt-out of a research study during an emergency. Researchers found that midazolam, delivered as a shot into the muscle, is faster and more effective than IV drug lorazepam for prolonged seizures that last more than five minutes. Midazolam is delivered through use of an autoinjector, like an EpiPen, which is used to treat serious allergic reactions. Almost 73 percent of patients who received midazolam arrived at the hospital seizure-free compared to 63 percent who received the IV drug lorazepam. Among those admitted, both groups had similarly low rates of recurrent seizures.
The Medical Center was one of seventy-nine hospitals and thirty-three emergency medical services agencies that participated in the study nationwide. More than 4,000 paramedics and 893 patients were part of the study, which was sponsored by the National Institutes of Health. The site investigator for this study at Penn State Hershey was Christopher Vates, M.D. The study appears in the February 16, 2012 issue of The New England Journal of Medicine.
