Jeffrey Kirsch appointed Associate Dean for
Veterans and Clinical Affairs
Jeffrey R. Kirsch, MD, was appointed Associate Dean for
Veterans and Clinical Affairs in the OHSU School of Medicine,
effective December 1, 2009. Dr. Kirsch will continue to serve
as Professor and Chair in the
Department of Anesthesiology and
Perioperative Medicine (APOM).
The responsibilities of this new position include advising
the Dean on key issues related to the partnership between the
Portland Veterans Affairs Medical Center (VAMC) and the School
of Medicine. As noted in the recently issued Report
of the Blue Ribbon Panel on VA-Medical School Affiliations
(November 2009), the current focus nationwide on health care
reform and systemic change in delivery systems offers unique
opportunities to strengthen the VA-Medical School partnership.
Dr. Kirsch will also be involved in developing metrics that
help measure success and progress on specific clinical
initiatives.
"The importance of the school's relationship with the VAMC
cannot be overstated," said Dean Richardson. "I am confident
that Jeff is the right person to help manage the education,
research and clinical care aspects of this partnership and to
explore new ways to streamline, expand and strengthen the
relationship. Please join me in congratulating Jeff and
welcoming him to this leadership role."
"I am excited by this leadership role because my passion is
to support an environment where our patients receive the
absolute best care in the country while also being sure that
our clinical faculty are given the time and tools necessary to
continue development of innovative scholarship and education
excellence. OHSU is ideally positioned to assure that
excellence in education and research is focused on world-class
clinical care for Oregonians," said Dr. Kirsch.
Dr. Kirsch came to OHSU in December 2002 to assume the
position of Chair of APOM. His interest and dedication to
medical research and discovery has helped launch the
department into the top tier of national funding. Dr. Kirsch's
research interests include brain injury caused by stroke and
the role of opioids in neuroprotection. He earned his medical
degree from the University of Michigan Medical School and
completed his residency and a fellowship in neuro-surgical
anesthesiology and neuroscience critical care at Johns Hopkins
University Medical Center. Dr. Kirsch currently serves as a
member of the Anesthesiology ACGME Residency Review Committee
and is Chair of the FDA Anesthetic and Life
Support Drugs Advisory Committee. Dr. Kirsch was
previously Chair of the OHSU Quality Executive Committee and
Chair of the Professional Board.
November/December Paper of
the month The temple of the mind
The School of Medicine newsletter spotlights a recently
published faculty research paper in each issue. The goal is to
highlight the great research happening at OHSU and to share
this information across
departments, institutes and
disciplines. A list of all papers compiled by the OHSU Library
and published by OHSU faculty during the prior month (in this
case, two months since this is a double Nov/Dec issue) is also
provided here.
This month's featured paper was published in Nature: "X-ray
structure, symmetry and mechanism of an AMPA-subtype glutamate
receptor," by Alexander I. Sobolevsky, Michael P. Rosconi and
Eric Gouaux. Eric Gouaux, PhD, is a Senior Scientist at the Vollum
Institute and a Howard Hughes Medical Institute
Investigator.
The paper summary below was compiled by Associate Dean for
Basic Science Mary Stenzel-Poore and reviewed by Dean Mark
Richardson and Vice President/Senior Associate Dean for
Research Dan Dorsa.
A scientific team lead by Dr. Gouaux has solved the
structure of one of the most important receptors in the
brain the ionotropic glutamate receptor known as GluA2.
The importance of this work for understanding how this
receptor binds its ligands and opens and closes the ion
channel cannot be overstated. This structure will serve as a
template for the entire family of glutamate receptors.
Published in
the December 10 issue of Nature
(log-in may be required), the authors reported the
3-dimensional crystal structure of the AMPA-sensitive rat
GluA2 receptor. The group determined the structure of this
homo-tetrameric transmembrane spanning receptor at 3.6
Angstrom resolution in complex with a competitive antagonist
bound to the ligand binding site.
Their findings provide valuable insight into how this
receptor is configured on the cell's surface to bind
glutamate and trigger the opening of the ion channel. Their
studies tell us that the receptor is Y-shaped with three
parts the top with two symmetric prongs and just below
this is the ligand binding domain which controls the opening
of the ion channel, which itself is shaped like a Mayan
temple with 4-fold symmetry and a broad cytoplasmic base.
This structural information allows new and important
interpretations of studies that have been performed over the
past two decades on the pharmacology and functional outcomes
of receptor activation among this family of
receptors.
Knowing the architecture of this receptor will help
scientists understand the structure of other members of this
ionotropic receptor family and, most importantly, will
define the molecular underpinnings of receptor activation
and dysfunction in the setting of neurodegeneration and
chronic disease states such as Alzheimer's and epilepsy.
Click here for the summary by Nature News and here
for the Oregonian article.
Pictured: Ribbon diagram of the GluA2 structure with
each subunit in a different color (from Nature).
AAMC President visits OHSU,
calls for transformational change in academic
medicine
Darrell Kirch,
MD, President of the Association of American Medical
Colleges (AAMC), spoke about health care reform and the
role academic health centers can play in catalyzing
transformational change in the 21st century.
Speaking to nearly 300 students, faculty, staff and guests
at the OHSU auditorium, Dr. Kirch cautioned that while
President Obama may soon sign a health care reform bill, there
will still be fundamental work needed to improve our nation's
health care system. He emphasized the "culture" of academic
medicine the good and the not-so-good and noted that he
observed a current cultural inertia that may be inhibiting
progress toward improving our health care
system.
He expanded on the
themes of an address he made to the 2007 AAMC annual
conference in which he said, "The dilemma for academic
medicine may very well be that while higher education and
health care have held fast to their traditional
individualistic culture, the world has fundamentally
changed."
In an age of complex science, he argued that the necessary
focus in academic medicine on collaboration between
individuals and groups to solve complex problems will depend
on building better connections between departments, and
between the clinical and academic enterprise.
Referring to the process as "heavy-lifting," Dr. Kirch said
that changing the culture in academic medicine will require
courage, including a rethinking about traits of good leaders.
Instead of relying on a candidate's curriculum vitae as the
primary source of qualification, he urged academic medicine to
also consider a candidate's emotional intelligence, a capacity
to be trusted and an ability to build coalitions. "The
institutions that will show us all the way in the next few
years will be the places with the highest level of shared
courage," he said.
Looking forward, the possibilities are exciting for
academic medicine, he said. For example, the AAMC supported
legislation that would advance health system change by
establishing federal Healthcare
Innovation Zones, or HIZs. This legislation would support
partnerships between academic health centers and their
communities to test innovative approaches to health care
delivery.
Dr. Kirch said he saw OHSU and Oregon as having many of the
necessary "pre-conditions" needed to successfully establish an
HIZ and/or lead the country in academic and clinical
innovation in other ways. The pre-conditions included, for
instance, a state with only one academic health center
(precluding competition between institutions), a state that
has a history of health care innovation, an engaged community,
and the fact that OHSU is already making progress at
transformational change, such as clinical integration.
During his (first) visit to OHSU, Dr. Kirch also met with
the Executive Leadership Team, and with School of Medicine
leadership, including the dean, associate deans and
chairs.
Pictured: Dr. Kirch in the OHSU auditorium
addressing the audience and with Walt Meihoff, MD,
Class of 1959, President, School of Medicine Alumni
Association after the lecture.
From the Archives: West
portrait by Dotter
This pencil portrait of
E.S. West, MD, PhD, is more than just a lovely sketch of a
prominent former faculty member of the School of Medicine. It
is also an example of the wonderful artistic skills of another
prominent faculty member: Charles Dotter, MD.
Edward Staunton West (1896-1988) chaired the Department of
Biochemistry at the Medical School from 1934 to 1966. With
Wilbert Todd, PhD, he wrote a Textbook of
Biochemistry which quickly became the standard text; it
went through four editions from 1951 to 1966. West was one of
the original PIs on the grant for the Oregon Regional Primate
Research Center, longtime chair of the admissions committee,
and originator of the campus' noontime horseshoe
matches.
Charles Theodore Dotter (1920-1985) was chair of the
Department of Diagnostic Radiology at the medical school from
1952 until his death in 1985, and is widely considered the
father of interventional radiology.
This sketch hung for many years in the office of the
Biochemistry chair until it was donated to the archives by
Richard T. Jones, MD, PhD, in June 2006. Richard Theodore
Jones (1929-2008) was chair of the department from 1966-1993
and Acting President of University of Oregon Health Sciences
Center, 1977-1978.
Contributed by Sara Piasecki, Head, OHSU
Historical Collections & Archives.
Dean Richardson, Dr.
Saultz testify in Salem about workforce shortages, primary
care
On November 18, Dean Richardson testified in Salem before
the House Business & Labor Subcommittee for Workforce
Development about the critical need to support and fund health
care education. His testimony focused on improving outreach to
undergraduate and high school students to encourage them to
enter and appropriately prepare for health care careers,
on reducing student indebtedness, and on retaining more
physicians for Oregon by expanding and regionalizing Graduate
Medical Education (GME) capacity.
Dean Richardson highlighted the historic opportunity to
expand support for health care education within the context of
reform, noting that successful health care reform depends on a
robust and well-trained workforce. He said that as part of
reform, OHSU was interested in focusing on parallel curricular
reforms and introducing new delivery models that support
coordinated care in which providers work at the "top of their
licenses."
The day before, on November 17, John Saultz, MD, Chair of
the Department
of Family Medicine, testified before the House Health
Committee on behalf of the Oregon Academy of Family Physicians
about ways to more effectively deliver primary care to people.
This testimony was formally included in OHSU's follow-up to
the Workforce Development Subcommittee to reinforce the goal
of transforming primary care. Dr. Saultz noted the extensive
body of evidence showing robust primary care systems improve
the health of the public and deliver care at a lower cost than
other models.
Eight Weeks in Tanzania
MD students experience lessons in global health 
As the pediatric outreach clinic in the Langast Maasai
village drew to a hot and dusty close, second-year med student
Michelle Bar realized that she, three student colleagues and a
single physician had assessed and treated 250 children in a
mere two days. "This is probably the only opportunity for
treatment that these kids will get this year," she reflected.
Along with fellow students Hailey Allen and Lindsay Braun,
Bar spent eight weeks in July and August on OB/GYN, pediatric
and surgical rotations at Mt. Meru hospital in Arusha, a town
of 270,000 people in northeast Tanzania. Their trip was
sponsored in part by the OHSU
Global Health Center and the R. Bradley Sack International
Scholarship Fund.
"We learned to rely much more on the physical exam since
there was no imaging equipment other than an x-ray machine and
an ultrasound device in the hospital," said Bar. Although they
felt the need to learn Swahili for "I am not a doctor" as
early as the second day, all three students found themselves
fully participating in deliveries and surgical procedures, and
seeing diseases that they had only heard about in classroom
courses.
The challenges of physical diagnosis, limited treatment
options and different standards of ongoing care made some
aspects of their experience difficult to get used to. "But it
was a confidence booster, and helped me further define my
career choice," said Bar.
Pictured: l to r Lindsay Braun, Hailey Allen and
Michelle Bar in Tanzania.
FACULTY SPOTLIGHT:
Dr. Melanie Gillingham Scouting the frontiers of childhood
metabolic disorder
Since October 2003,
approximately 80 Alaska Native infants have been identified
with carnitine palmitoyltransferase 1A (CPT1A) deficiency;
previously only 30 published cases were known worldwide.
A child with CPT1A deficiency is unable to metabolize
stored fat efficiently enough to nourish the brain and nervous
system. When no ingested food is available such as during a
bout of stomach flu or similar episodes of involuntary fasting
the child is in danger of losing consciousness, damaging the
brain or nervous system, and even dying. The condition is
caused by a genetic mutation that hinders this crucial liver
enzyme's ability to perform its usual fat-oxidation duty. The
version identified in Alaska differs from the "classic"
deficiency; it reduces the enzyme's activity to about 20
percent of normal, rather than practically zero.
While the importance of researching this population is
clear, the process is daunting. Dr. Melanie Gillingham, PhD,
Assistant Professor in the Department of Molecular &
Medical Genetics, decided the best approach was to bring the
children and families to OHSU. Dr. Gillingham was awarded
$30,000 in pilot project funding from the Oregon
Clinical and Translational Research Institute (OCTRI).
OCTRI also provides support for pediatric nurses.
Dr. Gillingham's first family arrived in spring 2009. The
"arrival" proved nearly as challenging as the science. Most
affected families live in very remote areas in Alaska. Dr.
Gillingham became an authority on small prop plane services
and their weekly schedules at village landing strips, as well
as Anchorage hotels, to put up families until their flight to
Oregon.
The science requires keeping a three-year-old from eating
for 18 hours (with appropriate safety precautions). Dr.
Gillingham brings in entire families not just because an older
sibling makes a great "control group" (for non-invasive scans
of liver fat), but also because family members are an
essential part of the team that distracts the child as the
hours of fasting wear on. This clinical work includes the
medical supervision of David Koeller, MD, Professor,
Department of Pediatrics.
Dr. Gillingham intends for this study and its pilot grant
to catalyze broader studies funded by tribal, state, national
and/or international entities, and a registry of affected
children. This will involve a collaborative effort with tribal
elders, doctors and the State Health Department. In fact, the
State Health Department has already created an educational
video featuring Dr. Koeller to distribute to families and
providers. "But the first entity you have to report to is the
tribe," explained Dr. Gillingham. "We'll work with them to get
word out to the population."
Dr. Gillingham processes blood samples while one of her
mentors, OCTRI Education Program Director Cindy Morris, PhD,
MPH, looks on.
Division of Biomedical Engineering
is part of $10 million innovative cancer consortium
Owen McCarty, PhD, Assistant Professor, Division of
Biomedical Engineering in the Department of Science and
Engineering, is part of a new consortium of scientists and
engineers awarded $10 million by the National Cancer Institute
to take a nontraditional approach to understanding cancer
metastasis.
Led by the Scripps Research Institute, the consortium is
dubbed the 4DB Center
and brings together oncologists and pathologists at Scripps
Clinic, the University of California San Diego Moore Cancer
Center, and Billings Clinic (Montana) with physicists and
biologists at Scripps Research Institute, applied
mathematicians and engineers at the Viterbi School of
Engineering, University of Southern California, and biomedical
engineers at the OHSU School of Medicine.
The NCI announced the $10 million, five-year grant on
October 26, as part of an initiative to launch 12 Physical
SciencesOncology Centers around the country.
"Physical scientists think in terms of time, space,
pressure, heat, and evolution in ways that we hope will lead
to new understandings of the multitude of forces that govern
cancer and with that understanding, we hope to develop new
and innovative methods of arresting tumor growth and
metastasis," said NCI Director John E. Niederhuber,
MD.
The goal of Dr. McCarty's team is to characterize the size,
mechanical and ultrastructural properties of individual cancer
cells across time, space and disease stages. Together, the 4DB
team hopes to generate a comprehensive portrait of cancer
cells including their numbers, physical properties, and gene
expression profiles, as they act through space in the body
as well as time over the course of the disease's
progression.
Steven L. Jacques, PhD, Professor, and Kevin Phillips, PhD,
post-doctoral researcher, both in the Departments of
Dermatology and Biomedical Engineering, are part of the team
and will focus on developing novel optical imaging tools for
the study. This will be the first time that such a study has
been conducted. Until recently, the technology was not
available to make these types of observations about cancer
cells without frequent biopsies from patients.
Dr. McCarty has a joint appointment in the Department of
Cell & Developmental Biology.
Local alums gather to celebrate
the holidays 
The chill of December did not deter 200 people from
attending the School of Medicine Alumni Association Holiday
gathering.
Alumni and guests talked with President Joe Robertson and
Dean Mark Richardson, shared news with classmates and caught
with up advances in their fields from colleagues and faculty
members. Current students also joined the alumni
guests.
In a letter to the alumni, Dean Richardson said, "No one
else knows us as well as you our former students and
residents who through the years have spent countless hours in
the class room and the library, the lab and the clinic. These
experiences fundamentally transform us as individuals, and we
carry our alma mater wherever our subsequent careers take us.
The Alumni Association takes a leadership role in making sure
these transformational experiences are not forgotten, and are
passed from generation to generation."
"We were pleased to offer this celebration to our alumni
this year and very glad to see the great turnout," said Walt
Meihoff, MD, Class of 1959, President of the Alumni
Association.
Pictured right: Festive shots from the holiday
party.
And justice for all! AMSA
District X delegates converge on OHSU
Dean Mark Richardson
and Associate Dean Tana Grady-Weliky welcomed over 175
students from the American Medical Student Association (AMSA)
District X conference to OHSU over the December 4 weekend.
Keynote speaker Martin Donohoe, MD, Adjunct Associate
Professor in Community Health at Portland State University,
discussed "Do Something: Activism 101 for Medical Students and
Physicians," arguing that speaking up for those who had no
voice was an integral part of the physician's charge. School
of Medicine alumna Kavita Patel, MD, MS, Director of Policy
for the White House Office of Public Engagement and
Intergovernmental Affairs, closed the conference with a timely
behind-the-scenes look at the national health care reform
debate. In between, delegates selected from 29 breakouts on
subjects ranging from Surgical Skills Workshops to Creating
International Health Experiences, attended an exhibit fair,
rode the Portland Aerial Tram and sampled Portland night life.
Conference leadership was provided by Kate Menninger, MS3,
Leela Rao, MS2, Anne Siler, MS2 and an organizing committee of
37 School of Medicine students. "We were very happy with the
way everything turned out " said Lee Shapley, MS2, AMSA
District X Chapter President. "The strong program and
interactive sessions gave delegates a great opportunity to
make professional connections that can last a
lifetime."
Pictured: Dr. Donohoe discusses activism in medicine
during his keynote address.
Aging research A
collaborative study with OHSU and Mirabella
In early 2007, OHSU set out to collaborate with a
continuing care retirement community developer to build a new
community in South Waterfront, one block from the Center for
Health & Healing. Mirabella 
answered the
call.
The 325-foot building rising in South Waterfront symbolizes
a revolution in retirement urban high-rise design, resort
style amenities, comprehensive healthcare services, and most
importantly, collaboration with OHSU on the latest aging
technologies and research.
The goal of Mirabella and OHSU's collaboration is to create
brand-new health innovations to serve the needs of seniors.
Research will focus on physical, social, cognitive,
psychological, environmental and other dimensions of aging
with the intended result of greater independence and improved
care practices.
Among Mirabella's future residents are Frank Parker, MD,
Professor of Dermatology, and his wife, Karen Parker.
Dr. Parker currently works at CHH where he is watching
construction progress from his office window. The Parkers are
looking forward to Mirabella's completion in late summer of
2010 and the availability of programs, activities, outings and
continuing education at their fingertips day or
night.
Similarly, Mirabella will offer new dining options in the
South Waterfront three of its four restaurants are on the
24th floor, which provides views of the river, mountains and
downtown Portland.
For more information about Mirabella and OHSU's
collaboration or to schedule a tour, call (503)
245-4742.
HONORS, APPOINTMENTS AND ANNOUNCEMENTS
Dr. Bardana receives
national honor
Emil J. "Bud" Bardana
Jr., MD, Professor, Department of Medicine in the Division of
Allergy and Clinical Immunology, received the American College
of Allergy, Asthma & Immunology's Gold Headed Cane Award
for 2009.
Awarded to only one physician in the country each year, Dr.
Bardana was chosen for this honor by the fellows of the
College for demonstrating the highest standards of scientific
excellence and integrity while serving as a Fellow of the
College for at least 20 years.
Dr. Bardana has been a faculty member in the School of
Medicine since 1971. His research has catalyzed widespread
interest in air quality health issues, and led to his
co-authorship of the textbooks Occupational Asthma and Indoor
Air Pollution and Health, as well as over 200 other published
works.
Click
here to read more.
Pictured: Dr. Bardana (l) receives the 2009 Gold Headed
Cane Award from Sami L. Bahna, MD, DrPH, President of ACAAI,
in November.
American College of Physicians
honors Drs. Bagby and Cooney
The American College of Physicians selected Grover C.
Bagby, MD, and Thomas G. Cooney, MD, as 2010
Masters.
The titles are awarded each year by the ACP after a
meticulous selection process. The ACP named just 50 doctors
from around the world as Masters for 2010. According to the
ACP, Masters are selected based on "personal character,
positions of honor, contributions toward furthering the
purposes of the ACP, eminence in practice or in medical
research, or other attainments in science or in the art of
medicine. The Master must be distinguished by the excellence
and significance of his or her contributions to the field of
medicine."'
Click here to read the OHSU
media release.
Dr. Halvorson recognized with Palliative
Care Award
Stephanie Halvorson, MD, Assistant Professor, Department of
Medicine, Hospital Medicine, received the 2009 Virginia I.
Sznewajs Faculty Excellence in Palliative Care Award in
recognition of her outstanding work caring for patients with
life-threatening illnesses.
"The care of loved ones in the final days creates lasting
memories for a family," said Dr. Halvorson. "The Sznewajs
family knows this all too well, and I am very humbled to be
recognized in this way."
"The Sznewjas family created this award to recognize the
outstanding system-wide palliative care Ginny Sznewjas
received as an OHSU patient over an 18 month period," said
Mary Denise Smith, RN, CNS, ACHPN, Palliative Care Clinical
Nurse Specialist.
The daughter of a Minnesotan pastor, Dr. Halvorson used to
accompany her father on some of his hospital visits. "As a
hospitalist who is often confronted with patients at the end
of life, I now see how much I draw on those experiences," she
said.
Click
here to read more.
Medical Research Foundation announces 2009 award
winners
Eric Gouaux, PhD, Senior Scientist at the Vollum Institute
and Howard Hughes Medical Institute Investigator, received the
Medical Research Foundation's Discovery Award for 2009 at a
November 10 reception in Portland. The MRF's annual awards
recognize scientific leadership and innovation, and Dr. Gouaux
was honored for his pioneering work in the structural biology
of membrane proteins (see related article above).
The MRF also recognized David and Lynn Frohnmayer for their
commitment to advancing knowledge of Fanconi anemia, and
presented the Richard T. Jones New Investigator Award to
Joseph W. Thornton, PhD, at the University of Oregon.
Dr. Jones, for whom this award is named, served as Chair of
the Department of Biochemistry in the OHSU School of Medicine
from 1996-1993, and as acting president of OHSU for 14 months
during 1977-1978.
Click here to read the OHSU media
release.
Dr. Seropian is
president-elect of Society for Simulation in
Healthcare
Michael Seropian, MD, Associate Professor in the Department
of Anesthesiology and Perioperative Medicine (APOM), was
elected president-elect of the Society for Simulation in
Healthcare (SSH). Dr. Seropian's term begins in January and he
will transition to SSH president in 2011.
Dr. Seropian currently serves as treasurer of SSH and has
been a board member for four years. His work has helped place
OHSU and Oregon as national leaders for providing simulation
education. In 2003, he co-founded and designed the OHSU
Simulation and Clinical Learning Center as a collaboration
between the Schools of Medicine and Nursing. He was the
co-director of the Center until April 2006. Today he is the
medical director of OHSU Simulation and director of the OHSU
Anesthesia Simulation Service. He served as chair of the
Oregon Simulation Alliance (OSA) and is a member of the
American Society of Anesthesiologists simulation education
committee. Dr. Seropian has been at OHSU since 1998.
Congratulations! Two administrators awarded FACMPE
designation
Sally Rogers, administrator in the Department of
Neurosurgery, and Benjamin Cox, administrator in the
Department of Family Medicine, recently completed and received
a Fellowship distinction from the American College of Medical
Practice Executives Medical Group Management Association.
According to the MGMA, the Fellow in the American College
of Medical Practice Executives (FACMPE) demonstrates an
individual's willingness to embrace greater challenges and
drive practice performance to new levels. Click
here for more information.
Welcome New Faculty
A warm welcome to new faculty (listed in alphabetical
order):
- Kimberly A. Humann, MD, Assistant Professor,
Psychiatry
- Christina M. Joseph, MPAS, PA-C, Instructor, Surgery,
Pediatric Surgery
- Stacy L. Parker, MMS, PA-C, Instructor, Anesthesiology
& Perioperative Medicine
- Ajay Wanchu, MD, Associate Professor, Provisional,
Medicine, Arthritis & Rheumatic Diseases
- Susan S. Woods, MD, MPH, Assistant Professor, Medicine,
General Internal Medicine & Geriatrics
