Mar

UNC Board of Governors endorses plan to expand medical education in North Carolina

tahughes — 2008-04-07T14:38:37Z

March 7, 2008

UNC Board of Governors Endorses Plan to Expand Medical Education in North Carolina

In an effort to address an expected shortage of doctors in North Carolina, the University of North Carolina Board of Governors today (March 7, 2008) endorsed a plan to expand medical education at the state's public medical schools.

The plan is based on a collaborative effort between the UNC-Chapel Hill School of Medicine and the Brody School of Medicine at East Carolina University. In addition, UNC-Chapel Hill will develop facilities in Charlotte and Asheville to accommodate students in the last two years of their medical education. UNC-Chapel Hill's expansion in Charlotte will involve a partnership with Carolinas Medical Center (CMC), as well as collaboration with the University of North Carolina at Charlotte in expanding research and related initiatives. The expansion in Asheville will involve Mission Hospital, the Mountain Area Health Education Center, and the Western North Carolina Health Network. ECU's Brody School of Medicine will work with AHEC to expand opportunities for its students to spend much of their third and fourth years in clinical placement in underserved areas.

This is a complex plan that will require more planning activities as each component is developed. The Board of Governors also will consider future requests for funding from the General Assembly. The cumulative cost of the plan is expected to be in the vicinity of $450 million-the bulk of which would provide new and/or renovated facilities-and would be phased in over the next 10 years.

"This is a milestone for our medical schools, as well as the people of North Carolina," said UNC President Erskine Bowles. "We have recognized for some time the threat of a physician shortage in our state. This coordinated plan for expansion positions us to better fulfill our mission to serve the medical needs of North Carolinians. I also applaud the leadership shown by our chancellors and the way our campuses have worked together to develop this joint plan."

The Joint Plan for Medical Education in North Carolina calls for:

UNC-Chapel Hill will expand its medical school enrollment from 160 to 230 first-year students on a phased basis, starting in 2009. Brody will expand its first-year medical school enrollment from the current 73 to 120 students in a phased process. The timeline for increasing enrollment will be determined by the fall of 2008.

UNC-Chapel Hill's additional 70 students will complete their third- and fourth-year rotations at either the CMC Charlotte campus (50) or Asheville campus (20), starting their regional placements in 2011. Brody's additional students will complete their third- and fourth-year clinical education at satellite training centers located in eastern North Carolina. Those sites will be identified by early 2009.

The plan also calls for a task force representing both public and private medical schools in the state, as well as the Carolinas Medical Center, AHEC, and the Sheps Center at UNC-Chapel Hill, to develop a plan for expanding the number of residencies or slots for graduate medical education in North Carolina and to seek more federal funding to support these residencies. Where a physician eventually decides to practice is highly correlated with where he or she completed a medical residency.

The North Carolina Institute of Medicine, the National Institute of Medicine and the Association of American Medical Colleges all predict a deficit of physicians by 2020, particularly in primary care. Already, fewer physicians are electing to go into primary care, and there are growing problems arising from imbalances in the geographic distribution of physicians. The predicted shortage is of particular concern in North Carolina, where the population is expected to grow 52 percent by 2030.

For more information, contact:
UNC General Administration: Alan Mabe (919) 962-4589
UNC Chapel Hill School of Medicine: Kevin FitzGerald (919) 966-9282
Brody School of Medicine: Dr. Nicholas Benson (252) 744 7400
UNC Charlotte: Joan Lorden (704) 687-2624
Carolinas Medical Center: Scott White (704) 355-3141
Mission Hospital: Merrill Gregory (828) 213-4806
AHEC: Tom Bacon (919) 966-4826

Doctors mentor Covenant Scholars about medical school

tahughes — 2008-04-07T14:38:37Z

March 5, 2008

Doctors mentor Covenant Scholars about medical school

Thursday (March 6)
5:30 p.m. to 6:30 p.m.
Lineberger Comprehensive Cancer Center, first floor conference room
West Drive off Manning Drive, Chapel Hill

Media representatives are invited to cover a class in which five of the top doctors at the University of North Carolina at Chapel Hill take time out of their clinic schedules to help low-income undergraduates decide whether medical school is right for them.

Concerned that students of lesser means have little or no access to mentoring and advice that comes easily to other students, the doctors have donated a minimum of an hour a month since October to advise interested Carolina Covenant Scholars about the ins and outs of preparing for and attending medical school, life as a doctor, other careers in health care and choosing the right career. Besides the class, some of the doctors also have Covenant Scholars shadow them in clinic.

The sessions draw from 12 to 40 students from the Covenant program, in which UNC covers all financial need for admitted students whose family’s incomes are at 200 percent of the federal poverty level or less. More than half the scholars are the first in their families to go to college.

Among 28 faculty mentors to the Covenant students campus-wide, the doctors work as a team, donating their mentor stipends of $1,000 each per semester to buy dinner for the scholars to enjoy during the classes, held from 5:30 p.m. to 6:30 p.m.

“We’re really motivated to give this class,” said Dr. Marion Couch, Ph.D., an associate professor in the medical school’s otolaryngology department, who heard about the Covenant on WUNC and recruited friends to the medical mentoring team. “It is very rewarding to be able to reach out to students and make an impact in their lives. I think that’s why we’re here.”

The doctors are:

Couch, a surgical oncologist who specializes in head, neck and thyroid surgery;
Dr. Bruce Cairns, distinguished associate professor of surgery and head of the N.C. Jaycee Burn Center at UNC Hospitals;
Dr. Lisa Carey, associate professor of medicine and specialist in medical hematology and oncology and breast care;
Dr. Matt Ewend, chief and program director of neurosurgery; and
Dr. Charles M. van der Horst, professor and specialist in infectious diseases including AIDS and fungal and viral infections.

Also a frequent speaker at the classes is Dr. Sam Jones, a clinical instructor in surgery.

“These are really some of the busiest physicians in the School of Medicine,” Couch said. “It’s marvelous that they are doing this, and boy, they have to move things to come to these meetings. Many of them have to go back to work after this.”

Visuals: Photos could best be sought after the class, from about 6:30 p.m. to 7:30 p.m., when students talk with the mentors. During class a Power Point is shown.

Parking: The eastern parking deck on Manning Drive is open to the public; other spots nearby may be available after 5 p.m. The western deck, across West Drive from the entrance to Lineberger, serves UNC Hospitals employees.

News Services contact: LJ Toler, (919) 962-8589; (919) 219-6374 on site.

Computer simulations point to key molecular basis of cystic fibrosis

tahughes — 2008-04-07T14:38:38Z

Computer simulations point to key molecular basis of cystic fibrosis
Monday, March 03, 2008
Researchers from the University of North Carolina at Chapel Hill have identified a key molecular mechanism that may account for the development of cystic fibrosis.

The findings, published Feb. 29 in the open-access on-line journal PLoS Computational Biology, add new knowledge to understanding the development of this fatal disease and may also point the way to new corrective treatments.

Cystic fibrosis (CF) is the most common inherited chronic disease affecting the lung and digestive system. In the United States, about 1 in 3,000 children is born with cystic fibrosis. It is caused by a defective gene that produces a misshapen form of a protein called cystic fibrosis transmembrane conductance regulator (CFTR). People with cystic fibrosis do not have enough CFTR for their cells to work normally because their bodies quickly destroy the mutant protein.

About 90 percent of CF cases are due to the deletion of an amino acid building block in CFTR, in a major domain of the protein called NBD1. Earlier experimental studies have shown that the mutant NBD1 without the amino acid Phe508 has an increased tendency to misfold resulting in the premature degradation of CFTR.

Protein folding is the process in which protein molecules assume their intricate three-dimensional shape. In CF, the molecular basis of this increased misfolding tendency has remained elusive, said senior study author Nikolay Dokholyan, Ph.D., assistant professor of biochemistry and biophysics at UNC’s School of Medicine.

“Understanding the molecular etiology of the disease is a key step to developing pharmaceutical strategies to fight this disease,” Dokholyan said.

Using sophisticated computer modeling techniques, the researchers performed extensive simulations of how normal and mutant NBD1 folded. Known as molecular dynamics simulations, these “virtual experiments” allowed researchers to view how atoms and molecules actually move according to known physical laws. When applied to the NBD1 protein, these simulations showed that the disease-causing mutant exhibits a higher misfolding tendency.

More importantly, by comparing the structures of the normal and the mutant NBD1 domains as they fold, the authors were able to determine critical pairs of amino acid residues that must come together for NBD1 to fold correctly. These interactions are modulators of CFTR folding, and hence, they are potential modulators of CF.

“Computer simulations approximate our understanding of natural phenomena. That our simulations correlated with known experimental studies is remarkable,” Dokholyan said. “More importantly, the molecular details of aberrant NBD1 folding provides guidance for the design of small molecule drugs to correct the most prevalent and pathogenic mutation in CFTR.”

The first author of the study is Adrian Serohijos, a graduate student in both the UNC School of Medicine’s molecular and cellular biophysics program, and in the UNC College of Arts and Sciences’ physics and astronomy department. Other co-authors include John Riordan, Ph.D., co-discoverer of the CFTR gene and professor of biochemistry and biophysics in the UNC School of Medicine; and postdoctoral research associate Tamas Hegedus, Ph.D., of the UNC Cystic Fibrosis Research Center.

The study was supported in part by grants from the Cystic Fibrosis Foundation, the National Institutes of Health, and the American Heart Association.

Note: Dokholyan can be reached at (919) 843-2513 or dokh@med.unc.edu. The paper can be found at http://www.ploscompbiol.org/doi/pcbi.1000008.

School of Medicine contact: Stephanie Crayton, (919) 966-2860, scrayton@med.unc.edu
News Services contact: Patric Lane, (919) 962-8596, patric_lane@unc.edu

UNC neurology professor appointed to national credentialing body

tahughes — 2008-04-07T14:38:38Z

People Brief
For immediate use: Wednesday, March 12, 2008

UNC neurology professor appointed to national credentialing body

Dr. James F. Howard Jr., distinguished professor of neuromuscular disease in the UNC School of Medicine’s neurology department, has been appointed to the Board of Directors of the American Board of Electrodiagnostic Medicine (ABEM).

The ABEM is an independent credentialing body in electrodiagnostic medicine for neurologists and physiatrists. Electrodiagnostic medicine is the study of diseases of nerves and muscles. Electrodiagnostic studies are used to diagnose diseases such as carpal tunnel syndrome, pinched back nerves and Lou Gehrig’s disease.

Howard will begin a four-year term in May.

Howard is also the section chief of the School of Medicine’s neuromuscular disorders division, and is an adjunct professor of clinical sciences (neurology) in the College of Veterinary Medicine at North Carolina State University.

The ABEM’s Web site is: http://www.abemexam.org.

School of Medicine contact: Stephanie Crayton, (919) 966-2860, scrayton@unch.unc.edu
News Services contact: Patric Lane, (919) 962-8596, patric_lane@unc.edu

American College of Surgeons establishes new Health Policy Institute at UNC

tahughes — 2008-04-07T14:38:38Z

For immediate use: Thursday, March 13, 2008

American College of Surgeons establishes new Health Policy Institute at UNC

The American College of Surgeons (ACS) has established a new Health Policy Institute, which will be based initially at the University of North Carolina at Chapel Hill.

Dr. George F. Sheldon, Zack D. Owens distinguished professor of surgery in UNC's School of Medicine and a former president of the ACS, was selected through a national search to be director of the institute. Thomas J. Ricketts, PhD, deputy director of UNC's Cecil G. Sheps Center for Health Policy Research, has been selected as administrative director.

"I am very excited about this collaboration between the American College of Surgeons and UNC," said Dr. Thomas R. Russell, executive director of the ACS. "Both George Sheldon and Tom Ricketts are nationally respected authorities, and the Sheps Center has a long and distinguished record in conducting health policy research. Basing the ACS Health Policy Institute at UNC will enable the ACS to begin our research much more quickly than if we built an entirely new program from scratch," he added.

Russell said the new institute will conduct research in many areas of health policy that promise to be increasingly important in the current health care environment. One example, he said, are surgeon workforce issues, such as how many surgeons will be needed in the future, in which specialties and where they will need to be based.

"Most experts who have studied the issue believe that we are going to have a shortage of surgeons in the not-too-distant future," Russell said. "We need to be able to address that, and the ACS Health Policy Institute will play a very important role in providing the data needed to guide policy decisions on this and many other issues."

Sheldon said some research dealing with issues related to the surgical workforce has already been conducted as a result of the collaboration between the ACS and UNC. These projects will be credited jointly and co-branded with the ACS, he said.

"The dynamics of health care are occurring at a time when both the scientific and the social aspects of health care are changing rapidly. Thus, the need exists for scholarly, well thought-out policies, based on the best evidence that can be generated. This collaboration should develop information and policy recommendations of use as we continue to participate constructively in health care reform," Sheldon said.

Ricketts said "there is growing pressure on physicians to document the work they do and to be as cost effective as possible.

"The Institute will help develop the data that can show what surgeons are doing well and where there may be ways to reduce costs. The institute will tackle the question of 'how many doctors do we need?' by examining the productivity of surgeons and their distribution. Congress is currently considering changes in how it supports medical education and we need good answers to support their decision making," Ricketts said.

In addition, the ACS Health Policy Institute has received requests for collaborative projects from other highly respected research institutes, including the Institute for Health Policy Change and the American Association of Medical Colleges (AAMC) Workforce Center.

"We expect that the research program of the ACS Health Policy Institute will be productive fairly rapidly, because of these relationships and our access to this unique expertise," Sheldon said.

The new institute will be headquartered in the Sheps Center until a new building to house the College's Washington, D.C., staff is completed, in 2010. At that time the institute's headquarters will relocate to Washington, but much of its work will remain based at UNC, according to Russell.

"The American College of Surgeons is the largest organization of surgeons in the world and has an international presence with chapters in over fifty countries," Sheldon said. "The siting of the ACS Health Policy Institute in a collaborative venture with a respected and established health policy center, such as the Sheps Center, is an innovative approach."

School of Medicine contact: Stephanie Crayton, (919) 966-2860 or scrayton@unch.unc.edu
News Services contact: Clinton Colmenares, (919) 843-1991 or clinton_colmenares@unc.edu
American College of Surgeons contact: Sally Garneski, (312) 202-6409 or sgarneski@facs.org

For the paper trail of life on Mars or other planets, find cellulose

thughes — 2008-04-11T18:32:59Z

For the paper trail of life on Mars or other planets, find cellulose

Monday, March 31, 2008

Looking for evidence of life on Mars or other planets? Finding cellulose microfibers would be the next best thing to a close encounter, according to new research from the University of North Carolina at Chapel Hill. The cover story for the April issue of the journal Astrobiology, the new research also pushes back the earliest direct evidence of biological material on Earth by about 200 million years.

Cellulose is the tough, resilient substance best-known as the major structural component of plant matter. It is one of the most abundant biological materials on Earth, with plants, algae and bacteria generating an estimated 100 gigatons each year. Prehistoric forms of cellulose were made by cyanobacteria, the blue-green algae and bacteria still found in almost every conceivable habitat on land and in the oceans, which is known to have been present on Earth 2.8 billion years ago.

Jack D. Griffith, Ph.D., Kenan Distinguished Professor of microbiology and immunology at the UNC School of Medicine, found cellulose microfibers in samples he took from pristine ancient salt deposits deep beneath the New Mexico high desert.

“The age of the cellulose microfibers we describe in the study is estimated to be 253 million years old. It makes these the oldest native macromolecules to date to have been directly isolated, visualized and examined biochemically,” said Griffith, who is also a virology professor at the UNC Lineberger Comprehensive Cancer Center.

Until now, the oldest evidence of biological material from fragments of ancient protein – found in Tyrannosaurus Rex dinosaur fossils – was dated at 68 million years.

According to Griffith, the most primitive life forms likely developed means of polymerizing glucose – the energy currency of all known carbon-based life forms – into cellulose as a structural molecule. “Cellulose is like the bacteria’s house, the biofilm surrounding them. Plants adopted cellulose as their structural entity, and insects changed cellulose slightly to make kitin of which their exoskeletons are formed,” he said.

Griffith’s study took him to the U.S. Department of Energy’s Waste Isolation Pilot Plant (WIPP), the world’s first underground repository licensed to safely and permanently dispose of radioactive waste left over from nuclear weapons research and production, which is located near Carlsbad, N.M.

The waste is placed more than 2,000 feet below the surface in rooms excavated from the salt deposits that were laid more than 200 million years ago. The site was chosen to hold the waste because salt is somewhat plastic and will flow to seal any cracks that develop.

The salt samples Griffith retrieved from the WIPP were studied in his transmission electron microscopy lab at the Lineberger Comprehensive Cancer Center. In examining the content of fluid “inclusions”, or microscopic bubbles, in the salt and in solid halite (“rock salt”) crystals, he and his team found abundant cellulose microfibers that were “remarkably intact.”

Their examination clearly revealed the cellulose was in the form of microfibers as small as five nanometers in diameter, as well as composite ropes and mats. “The cellulose we isolated from the ancient salt deposits is very much like real, modern day cellulose: it looks like cellulose, behaves like cellulose, it’s chopped up by the same enzymes that cut modern day cellulose and it’s very intact,” Griffith said.

As to evidence of ancient DNA, Griffith said it was observed, but in much lesser amounts than cellulose.

“So in looking for evidence of life on Mars, for bacteria or higher plants that existed on Mars or other planets in the solar system, then looking for cellulose in salt deposits is probably a very good way to go. Cellulose appears to be highly stable and more resistant to ionizing radiation than DNA. And if it is relatively resistant to harsh conditions such as those found in space, it may provide the ideal ‘paper trail’ in the search for life on other planets.”

Co-authors along with Griffith include Smaranda Willcox, research analyst, Lineberger Comprehensive Cancer Center; Dennis W. Powers, Ph.D., geology and geological engineering department, University of Mississippi; Roger Nelson, U.S. Department of Energy, Carlsbad, N.M.; and Bonnie Baxter, Ph.D., biology department, Westminster College, Salt Lake City, Utah.

The study was supported in part by grants from the National Institute of Environmental Health Sciences and the National Institute of General Medical Sciences .

Note: Griffith can be reached at (919) 966-8563, (919) 966-2151 or jdg@med.unc.edu.

School of Medicine contact: Les Lang (919) 843-9687, llang@med.unc.edu
Lineberger Comprehensive Cancer Center contact: Dianne Shaw, (919) 966-7834, dgs@med.unc.edu
News Services contact: Patric Lane, (919) 962-8596, patric_lane@unc.edu

Lawrence Marks appointed chair of radiation oncology at UNC School of Medicine

thughes — 2008-04-28T12:24:17Z

March 27, 2008

Lawrence Marks appointed chair of radiation oncology at UNC School of Medicine

Dr. Lawrence Marks has been appointed chair of the department of radiation oncology at the University of North Carolina at Chapel Hill School of Medicine, effective March 31. He succeeds Dr. Carolyn I. Sartor, professor of radiation oncology.

Regarded as one of the country’s top breast cancer specialists, Marks comes to UNC from Duke University, where he had been a member of the radiation oncology faculty since 1989.

“Larry Marks is a nationally renowned radiation oncologist who brings to UNC strong research accomplishments, with particular interests in clinical trials in breast and lung cancer, as well as in enhancing our understanding of the mechanisms behind radiation-related lung injury,” said Dr. William L. Roper, dean of the UNC School of Medicine and chief executive officer of UNC Health Care.

“Dr. Marks is well respected for his clinical skills in treating patients with breast and lung cancer,” Roper said. “He has been a collaborator with UNC faculty members over the years in research projects, and we welcome his new leadership for this outstanding department.”

Marks said he was excited to be joining the UNC faculty for several reasons, including the new North Carolina Cancer Hospital, which is currently under construction, and the newly established University Cancer Research Fund.

“This is an exciting time to be at UNC,” Marks said. “The new facility is a wonderful opportunity to provide a patient-friendly, state-of-the-art cancer care experience. And with the state’s deep commitment to the University Cancer Research Fund, there is a mandate here to expand UNC’s already excellent cancer research program.”

Marks’ clinical and research interests include three-dimensional and conformal radiation treatment planning, breast cancer and lung cancer.

“We use computer tools to try to make our treatments better by making them more accurate, and by better protecting non-target normal tissues,” Marks explained. “I am particularly interested in radiation effects on lung function. At Duke I headed a clinical study looking at the local and whole organ effects of therapeutic radiation. I plan to continue this line of research at UNC.”

Marks was already well known to his colleagues at UNC long before he applied for and was offered the chair’s position. In 2001, he was the lead author of a lung cancer study that included UNC’s Dr. Mark Socinski and Dr. Julian Rosenman as co-authors.

A native of Brooklyn, N.Y., Marks earned his medical degree at the University of Rochester School of Medicine in 1985 and the completed his residency training in radiation oncology at Massachusetts General Hospital in Boston from 1986 to 1989.

At Duke, Marks compiled an impressive record as both an award-winning teacher and a highly productive researcher. In 2004, he was awarded Duke’s Master Clinician Teacher Award. In 2003 he was a finalist for the national Parker J. Palmer “Courage to Teach” Award, given by the Accreditation Council for Graduate Medical Education. In 2001 the residents in radiation oncology at Duke honored Marks with their Teacher of the Year Award. He is also the author of more than 140 research articles in refereed publications.

Marks has been recognized for his clinical excellence as well with a listing in Castle Connolly’s “America’s Top Doctors” directory. In addition, both Redbook and Good Housekeeping magazines identified him as one of the country’s top doctors for breast cancer.

Note: A photo of Marks is available at: http://www.unchealthcare.org/site/newsroom/images/markslarry.jpg

Media contact: Dianne Shaw, 919-966-7834 or dgs@med.unc.edu