The University of Chicago Medicine
Targeting lung cancer Imagine reaching deep into the lungs to detect and heal without surgery
ALSO INSIDE Collaboration expands options for patients with heart failure Imagine being awake while undergoing brain surgery
Expert help for kids who canâ€™t sleep: New at-home studies to diagnose sleep disorders
The University of Chicago Medicine and Biological Sciences has been at the forefront of medical care, research and teaching for more than 90 years. Located in historic Hyde Park on the South Side of Chicago, the University of Chicago Medicine and Biological Sciences includes: Patient Care: Bernard A. Mitchell Hospital (adult) Comer Children’s Hospital Duchossois Center for Advanced Medicine Numerous outpatient locations throughout the Chicago area
GREETINGS FROM THE FOREFRONT OF MEDICINE, Welcome to Imagine, our new quarterly magazine to keep you updated on all that’s happening at the University of Chicago Medicine. To be at the forefront of medicine requires the best minds working in collaboration, imagining and exploring the possibilities of curing and preventing disease. Our physicians and researchers go beyond “what if” and lead the way in making state-ofthe-art diagnoses and treatments available to patients throughout the Chicago area and different parts of the world. It’s an exciting time at the University of Chicago Medicine, as we will open a brand new hospital in less than a year. We imagined a setting where the patient always comes first, where world-class expertise and research give patients hope and where compassion is threaded through everything we do. This new 10-story hospital will transform the patient experience and serve as an inspiration as our physicians and researchers perform the most complex specialty care. It is truly at the forefront of care and discovery. In this issue of Imagine, you will read about how the University of Chicago Medicine is addressing the greatest health challenges in lung cancer, end-stage heart disease, brain tumors and children’s sleep problems. You will meet some extraordinary physicians and clinicians who are solving the problems of heart defibrillators, helping parents who have adopted overseas keep their children healthy, and even one who has written a play about community violence. And in each issue we’ll introduce you to our wonderful South Side community, where the arts, science, architecture, music and more are burgeoning. In this issue, we feature our long-time partner in scientific endeavors, the world-renowned Museum of Science and Industry. Being part of the prestigious University of Chicago means our physicians and researchers are collaborating with other scientists and researchers to imagine what is possible on behalf of our patients and community. We are proud to share our stories with you. Thank you for your support. We hope you enjoy learning more about us.
Teaching Programs: Pritzker School of Medicine Master’s and doctoral degree programs Postdoctoral programs Research: Medical and basic science units Among our many honors and acknowledgements: 12 Nobel laureates; ranked 10th of all U.S. medical schools; one of only 40 National Cancer Institute-designated comprehensive cancer centers; 21 adult and pediatric specialties ranked among the best in the country by U.S. News & World Report; ranked second in nation for National Institutes of Health grant support per researcher. University of Chicago Medicine and Biological Sciences Executive Leadership Kenneth S. Polonsky, MD, Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs for the University of Chicago Sharon O’Keefe, president of the University of Chicago Medical Center Richard Baron, MD, dean for clinical practice, chair of the University of Chicago Medicine Department of Radiology T. Conrad Gilliam, PhD, dean for research and graduate education, Biological Sciences Division Holly J. Humphrey, MD, dean for medical education, Pritzker School of Medicine Imagine is published quarterly by the University of Chicago Medicine. Editors: Ginny Lee-Herrmann Anna Madrzyk Email us at: email@example.com Design: Group Chicago Contributing writers: Laura Ramos Hegwer, Diane Kastiel, JoAnn Milivojevic, Rob Mitchum, Stephen Phillips, Anita Slomski and Mary Wroblewski Contributing photographers: Andrew Campbell, David Christopher, Megan Doherty, Bart Harris, Jean Lachat, Bruce Powell and Victor Powell Address: The University of Chicago Medicine 5841 S. Maryland Ave. Chicago, IL 60637
Kenneth S. Polonsky, MD
Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs for the University of Chicago
President of the University of Chicago Medical Center
Comer Children’s Hospital at the University of Chicago Medicine 5721 S. Maryland Ave. Chicago, IL 60637 Telephone: 1-773-702-1000 Appointments: 1-888-UCH-0200 Follow the University of Chicago Medicine on Twitter at twitter.com/UChicagoMed or visit our Facebook page at facebook.com/UChicagoMed. You can read more about our news and research at uchospitals.edu/news and at sciencelife.uchospitals.edu. This publication does not provide medical advice or treatment suggestions. If you have medical problems or concerns, contact a physician who will determine your treatment. Do not delay seeking medical advice because of something you read here. For urgent needs, call 911 right away.
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A Special Place for Kids
Adopted from Overseas
OUR ADOPTION CENTER PROVIDES EXPERTISE, SUPPORT FOR FAMILIES Bereket Rams and Larry Gray, MD
ast August, Chicagoans Patrick and Erin Rams traveled to Ethiopia to pick up their daughter, a beautiful little girl whose name means “blessing.” The first few weeks at home weren’t easy. Bereket was 4½ years old and didn’t speak any English. “Her world was flipped upside down,” Erin Rams said. Fortunately, the family found a doctor who not only understood but knew how to help. Medical Director Larry Gray, MD, and his team at the Adoption Center at the University of Chicago Medicine’s Comer Children’s Hospital are experts on the medical and emotional needs of children adopted from overseas. “It’s an amazing support system,” Patrick Rams said. The center provides its highly specialized care in a warm, child-friendly setting. Many children arrive with medical problems rarely seen in the U.S., such as extreme malnourishment. Gray recalls one child who had been here more than a year and had gained virtually no weight. “They called us, and we found the parasite others weren’t familiar with,” he said. “We take care of the medical issues, but it’s not a diseaseoriented or medical model,” Gray said. “That’s unusual in a medical center.” Indeed, the theme of a family’s first
By the Numbers
physicians ranked among the best of the best in Chicago magazine’s 2012 Top Doctors issue
visit is “Celebration.” Today, Bereket is thriving. In short order, she not only learned English but has blossomed into one of the most popular preschoolers in her class. Gray also provides pre-adoption consultations. He reviews medical records from the orphanage, counsels couples on relevant health issues and even gives them his phone number to take on their trip. “I have been humbled by the number of families who open up their homes to kids who have significant medical and developmental needs and are languishing in foreign orphanages,” Gray said. Chris and Sue Stepaniak’s little boy Jack, 2, was born with a rare bladder defect that will require a series of complex surgeries. When the Western Springs, Ill., couple brought him home from Russia in October, he weighed only 17 pounds. Now he is rocketing up the growth charts. “Not only has he learned to walk here, but now he walks around the house telling the dog off,” Gray said, grinning. For more information or to make an appointment, please visit adoption.uchicago.edu or call 1-888-UCH-0200.
of only 40 National Cancer Institute-designated comprehensive cancer centers in the U.S.
Melissa Gilliam, MD, MPH, chief of family planning, professor of obstetrics/gynecology and pediatrics, and associate dean for diversity, was recognized for her work to prevent teen pregnancy and address the societal problems that contribute to it.
private inpatient rooms in our new hospital, opening in January 2013 adult and pediatric specialties ranked among the best in the nation by U.S. News & World Report
Getting Back in the Game
Orthopaedic surgeon specializes in minimally invasive surgery for sports injuries
ifty-two-year-old businessman and avid baseball player Laurence Cavanaugh wasn’t ready to hang up his glove after a dive for the ball led to a fractured shoulder and torn ligaments. “Fortunately,” said Cavanaugh, “it wasn’t my throwing arm.” Thankfully, his decision to see J. Martin Leland III, MD, sports medicine and orthopaedic surgeon at the University of Chicago Medicine, got him back on the field in relatively short order, after minimally invasive surgery to repair the damage from that great play. Leland, who practices in Hyde Park and in Matteson, Ill., specializes in the joints that are most commonly injured in
J. Martin Leland III, MD
sports — shoulders and knees. His first step was to recommend physical therapy for Cavanaugh, who lives in Crown Point, Ind. That helped the bone heal. The next step was to fix the problems in the joint. Leland repaired the tissues using an arthroscope, a slim instrument inserted into the joint through a small incision. Leland, who conducts ongoing research to find state-of-the-art treatments, is a sought-after educator and lecturer, offering his expertise to students, physicians and athletic trainers across Chicagoland. His practice includes some of the most complex sports medicine surgeries,
including multiligament knee reconstructions and proximal hamstring repairs. Leland’s experience and expertise also help patients quickly sort through the best treatment options — from the simple to the complex. Whether your sport is downhill skiing, golf, volleyball or baseball, chances are you can’t escape a few aches and pains. Of course, not all injuries require surgery. A lot can heal through time and nonsurgical treatments. “About 90 percent of my patients are nonoperative,” said Leland, former team physician for the Chicago Blackhawks. “My role is to help educate them on what’s going on in their body and how to continue being active without causing further damage.” Nearly all of Leland’s surgeries are arthroscopic. The small incisions significantly reduce pain and speed healing. Leland also works closely with physical therapists during rehabilitation. “I use very structured rehabilitation protocols and strength measurements to get patients to recover as quickly as possible,” he said. Most patients can expect to return to full activities in anywhere from two weeks to six months, depending on the extent of the injury, Leland said. As for Cavanaugh, he was happily back in center field just a few months after his surgery. To view videos about orthopaedic injury prevention and treatment, please go to uchospitals.edu/specialties/ orthopaedic-surgery/video.html. uchospitals.edu/physicians/j-martin-leland.html twitter.com/DrMartinLeland
To register for community events, please call 1-888-UCH-0200.
Living Well with Diabetes: Sunday Brunch with the Experts 11 a.m., Sunday, May 6 Duchossois Center for Advanced Medicine 5758 S. Maryland Ave., Chicago Kovler Diabetes Center’s sixth annual “Living Well with Diabetes” community event features Food Network chef Michael Digby, NBC 5 fitness expert Andrea Metcalf and diabetes experts from the University of Chicago Medicine. The free event includes a healthy brunch, food demonstration, Q&A and goodie bag. Cosponsored by the Urban Health Initiative. Seating is limited; register by May 1.
National Cancer Survivors Day Noon to 3 p.m., Sunday, June 3 Westin Hotel Wellington Ballroom 909 N. Michigan Ave., Chicago Join us for an afternoon of sharing, encouragement and family fun. Featured speakers are David H. Song, MD, MBA, chief of plastic and reconstructive surgery at the University of Chicago Medicine; fashion designer Barbara Bates, a breast cancer survivor; and master of ceremonies Mary Ann Childers. The free event includes music, refreshments and children’s activities. Register by May 31.
The University of Chicago Medicine
What Every Man Should Know About Testicular Cancer 6:30 to 7:30 p.m., Wednesday, June 6 Gilda’s Club Chicago 537 N. Wells St., Chicago Nine out of 10 cases of testicular cancer occur in men between the ages of 20 and 54, the American Cancer Society reports. Join Walter M. Stadler, MD, director of the Genitourinary Program at the University of Chicago Medicine and named one of Chicago magazine’s top doctors, for a discussion on early detection and treatment strategies for this highly curable malignancy.
<conversation> with the Dean Kenneth S. Polonsky, MD, is Dean of the Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs. He also is a leading diabetes researcher.
>> What’s new at the University of Chicago Medicine?
As we prepare for the opening of our new hospital in January 2013, we are transforming the patient experience to deliver compassionate, expert care with ease of access and state-of-the-art technology. It’s not only a magnificent facility, but a setting that provides support for our clinicians and staff to do their best work. And we have teams working on all the details of your visit, from additional parking we’re planning to new signage that will make it easy to get where you or your family need to be.
>> How does the new building reflect the commitment to
compassionate patient care? Many of our patients face complicated procedures and extended stays. The new hospital will have private rooms spacious enough for family members to comfortably spend the night. And the nights can be tranquil and quiet, thanks to blackout shades and a state-of-the-art communications system that does not rely on overhead paging. The building also will support very advanced technology for day-to-day care of patients with complex diseases.
>> What inspires you about the University of Chicago Medicine? Every day, I’m inspired by our brilliant, dedicated physi-
cians, researchers and care teams who collaborate to heal, to teach, to discover and to solve even the most difficult and challenging cases.
>> What makes you excited about
the future? We are ideally positioned to be among the leaders in translational research, and therefore patient care, as we translate basic discoveries made in the laboratory into bedside care. That means our patients often have access to innovative treatments before they are widely available.
>> Tell us about diabetes research at the University of
Chicago Medicine. The University of Chicago has a rich history of diabetes research dating back more than 100 years. Our groundbreaking work on the genetics of diabetes has received international recognition. We are at the forefront of customized diabetes diagnosis and treatment based on genetics, as well as research that may lead to novel therapies for this common disease.
IMAGINE THAT! Helping Your Fellow Rat Calling someone a rat is no compliment. Maybe it should be. A team of University of Chicago neuroscientists found rats show empathy for fellow rats in distress. In the study, published in Science, rats repeatedly acted to free fellow rats from a clear plastic tube. And they were equally likely to free their cage mates as they were to nudge open a tube filled with chocolate chips, a favorite treat. “This is the first evidence of helping behavior triggered by empathy in rats,” said Jean Decety, PhD. Secrets to Living to 100 People born in September, October or November have higher odds of cracking the century mark, a new study found. Seasonal differences in diet
and infection rates may be why. In past studies, researchers Leonid A. Gavrilov, PhD, and Natalia S. Gavrilova, PhD, of the University of Chicago’s Center on Aging, also found that chances for longevity are higher for people born to young mothers, those who have a slender or medium build at age 30 or who are farmers or spend their childhoods on a farm. Time to Try Diet, Exercise First Middle-aged adults recently diagnosed with diabetes and hypertension have time to learn how to control their high blood pressure without medication, but not too much time. The consequences of delaying effective hypertension treatment for up to a year were small — a two-day reduction in qualityadjusted life expectancy, University of Chicago Medicine researchers found. “Our results indicate that it’s OK to spend from six months
to a year, perhaps even longer, to make the difficult lifestyle changes that are necessary and will pay off in the long run,” said study author Neda Laiteerapong, MD. Finding a Fin-Limb Link University of Chicago professor Neil Shubin’s 2004 discovery of the fossil Tiktaalik roseae made National Geographic’s list of 10 projects “that have made the greatest difference in understanding the Earth” — out of 10,000 projects the magazine has funded to date. Tiktaalik, which has fishlike features with limb joints, provided the missing link between fish and the first animals that walked on land.
Read more at sciencelife.uchospitals.edu.
Leading the Fight Against Cancer Ranked #1 in Illinois and #14 in nation by U.S. News & World Report
More than 350 cancer clinical trials 210 University of Chicago laboratory and clinical scientists focusing their efforts on cancer
1 of only a few programs nationwide with NCI-sponsored Phase I, Phase II and Phase III clinical trials of anticancer drugs or procedures Highest overall rating from the American College of Surgeons Commission on Cancer uchospitals.edu/cancer
Robert Krull, left, and D. Kyle Hogarth, MD
The University of Chicago Medicine
Cancer Centers The University of Chicago Medicine’s leading-edge cancer care is available at multiple locations throughout Chicagoland.
for your lungs New technology allows doctors to reach deep into the lungs to diagnose lesions without a scalpel
For survivors of lung cancer, even a lingering cough from a cold can be a worrisome sign. Robert Krull, 67, knows that fear all too well. After surgeons at the University of Chicago Medicine removed cancer from Krull’s left lung in 2005, he gave up his two-pack-a-day AT THE FOREFRONT cigarette habit. The University of But his emphyChicago Medicine’s sema, family pulmonology program history of lung is ranked #1 in the cancer and the state by U.S. News & damage caused by World Report. 40 years of smoking left the Long Beach, Ind., lawyer at risk for recurrence. Two years after the surgery, a CT scan revealed an ominous mass on Krull’s right lung. “I was terrified at first and then angry that the cancer had come back when I thought I’d done everything right with my treatment,” Krull said. Krull’s pulmonologist, D. Kyle Hogarth, MD, also suspected cancer. But rather than have Krull undergo another extensive surgery to biopsy the mass, Hogarth, director of bronchoscopy and minimally invasive diagnostics at the University of Chicago Medicine, used a technology called electromagnetic navigation bronchoscopy to sample the abnormal tissue. Also known by its trade name, superDimension iLogic System, the high-tech device allows Hogarth to insert a scope through a patient’s mouth and maneuver it far into the lung to biopsy growths that previously required invasive measures to reach. The University of Chicago Medicine is a leader in electromagnetic navigation bronchoscopy in the Midwest, Hogarth said. In 2004, he was among the first
pulmonologists in Illinois to adopt superDimension. A pioneer of several noninvasive technologies to prevent, detect and treat lung cancer, Hogarth wants to give individuals at risk for the disease a fighting chance. “More people die from lung cancer every year than from breast, colon and prostate cancers combined because lung cancer is typically diagnosed too late,” said Hogarth, who codirects a University of Chicago Medicine clinic for people at risk of lung cancer and other malignancies. Hogarth leads a multidisciplinary team of specialists devoted to finding and treating lung cancer at its earliest stages, as well as reducing individuals’ risks of getting cancer. “We want the same early detection and vastly improved outcomes for patients with lung cancer that survivors of breast and colon cancers get from mammography and colonoscopy,” Hogarth said. Reaching lesions deep in the lung Until recently, the lungs’ complex and narrow branching system has made minimally invasive diagnosis and treatment of early-stage lung cancer challenging. More than 70 percent of cancerous lesions start in areas that are outside the direct view of a bronchoscope, a tube with a light and a camera that can inspect the airways for abnormalities and biopsy them. “I can go into the first and second branches of the upper lobe of the lung with conventional bronchoscopy, but then the airways narrow as they continue branching,” Hogarth said. Sometimes a biopsy is obtained by sticking a needle through the continued on page 9 chest wall into the lung.
New center at Silver Cross
The University of Chicago Medicine Comprehensive Cancer Center at Silver Cross Hospital opens by summer in New Lenox, Ill. The new $21.6 million, 20,000-square-foot outpatient cancer center, a joint venture between the University of Chicago Medicine and Silver Cross Hospital, will provide state-of-the-art chemotherapy and radiation therapy, as well as access to innovative clinical trials not usually found in a community setting. Patients can receive comprehensive cancer care for adult, gynecologic and pediatric cancers.
Gynecologic oncology cancer care is offered at the University of Chicago Health Specialists in Schererville, Ind.
Naperville — Palos Heights — Merrillville, Ind.
Compassionate and personalized pediatric cancer care from University of Chicago Medicine children’s cancer specialists is available at offices at Edward Hospital in Naperville, Ill., and in Palos Heights, Ill., and Merrillville, Ind.
University of Chicago Medicine physicians provide radiation oncology services at Sherman Hospital’s Cancer Care Center in Elgin, Ill.
Allen S. Anderson, MD, left, and Valluvan Jeevanandam, MD
Collaborating to fix a broken heart
Team offers hope to patients with advanced heart failure
On Christmas Eve 2009, Glenn Bovard and his wife were celebrating near their home in Valparaiso, Ind., when Bovard suffered a massive heart attack. Bovard, 64, is a resilient sort. In 1968, the truck he was driving in Vietnam hit a land mine. The explosion killed seven fellow U.S. soldiers. Bovard sustained widespread burns. In 1974, he began a 33-year career with the Indiana State Police. But this was the closest call yet for the retired trooper. He was rushed to nearby Porter Hospital, then transferred to the University of Chicago Medicine, where Valluvan Jeevanandam, MD, chief of cardiac and thoracic surgery, performed emergency Glenn Bovard surgery to implant a ventricular assist device (VAD) into his failing heart. The HeartMate® II consists of a tube IMAGINE
that runs between the heart’s left ventricle — the pumping capacity of which often is impaired in heart failure patients — and the aorta, from which blood is circulated around the body. Inside the tube, a rotor boosts the patient’s blood flow. The device is connected via a “driveline” that goes through the skin to a control unit that sits like a fanny pack on the patient’s waist. It is powered by two batteries secured under the patient’s arms. To stow the gear, which weighs around 7 pounds, Bovard bought two photographer’s jackets. The device offers a stopgap for patients awaiting transplantation. It also is a permanent therapy that some patients can live with for years. University of Chicago Medicine physicians implanted 58 VADs in 2011, among the highest number at any U.S. institution. The burgeoning VAD program complements the University of Chicago Medicine’s long-standing leadership in heart transplantation. Jeevanandam alone has performed approximately 1,200
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transplants. And under his aegis, the University of Chicago Medicine has helped pioneer “total transplant,” whereby — when possible — all of the diseased heart is removed and the full donor heart is implanted. This promotes improved heart performance and fewer complications compared to the standard procedure, in which the new heart is grafted onto parts of the diseased heart that are left intact. VADs and transplants take their place within a panoply of therapies for advanced congestive heart failure at the University of Chicago Medicine. Physicians credit the broad range of treatment options to a team approach to care and close collaboration between medicine and surgery. Indeed, Jeevanandam and his colleagues work tirelessly to prevent patients from needing a VAD or transplant in the first place. “With medical intervention, we often can prevent patients from needing those advanced therapies,” said Allen S. Anderson, MD, director of the Advanced Heart Failure Program. Surgically, the first step often is to try to repair or reconstruct the patient’s heart. “We don’t rush to the easiest therapy,” Jeevanandam said. “Doing a transplant or putting in a VAD can often be easier than reconstructing a heart, but preserving a patient’s own heart is almost always preferable, if possible.”
After decades of patching up Walter Zimmerman’s heart, doctors near his home in Cary, Ill., had reached the limits of what they could do for the retired plastics industry sales executive. Zimmerman was referred to the University of Chicago Medicine, where he received a VAD in November 2010. Beforehand, “my son came to me with tears in his eyes,” recalled Zimmerman, 73. “He said, ‘You don’t have to do this. You’ve been through an awful lot.’” “I said, ‘I’ve got to do it for you guys.’ ‘No, do it for yourself,’ he replied. ‘No difference,’ I said.” Zimmerman was back on his feet soon after VAD surgery. While Bovard, too, was happy with his VAD, it was determined that his next step, after his body recovered, would be a heart transplant. After consulting with Jeevanandam, he decided to proceed. He still chokes up recalling coming around following his transplant, last June. “I could feel the heart beat; it was amazing.” Today, Bovard wears a mask to safeguard against germs when he’s out, but he drives, does household chores and even has taken in a show in Chicago. The regimen of pills he must take daily to prevent his body from rejecting the organ is down from 32 to between 18 and 20. “Things are good and getting better,” he said. AT THE FOREFRONT
Four of the 11 heart-liver-kidney transplants performed in the U.S. were done at the University of Chicago Medicine. Zimmerman, too, is living life to the fullest, having been able to continue with the VAD rather than having a transplant. The physical encumbrance is “a small price to pay,” he said, for precious moments with his family. He has flown to California to see his grandchildren and doesn’t let the VAD cramp his style on the golf course, tying the batteries behind him so he can drive the ball. One thing Zimmerman can’t do anything about is his short game. But after he groused about it, the club pro couldn’t resist. “Well, you never could putt or chip,” he shot back. uchospitals.edu/specialties/heart/services/heart-failure
for your lungs
CONTINUED FROM PAGE 7
Multidisciplinary team strives to improve lung cancer outcomes In other cases, surgery is required to obtain a tissue sample. But superDimension’s navigation catheters allow Hogarth to safely maneuver a bronchoscope virtually anywhere in the lung. After receiving anesthesia for the outpatient procedure, Krull was positioned on an electromagnetic panel that functions as a sort of GPS, guiding the sensor-equipped scope toward the lesion. Hogarth tracked the scope’s exact location on a threedimensional road map of Krull’s lungs projected on a plasma screen. Even patients with the most challenging lung problems — advanced emphysema, those with only one lung or with severe heart disease — can have suspicious growths biopsied with superDimension. This technology will reduce the number of undiagnosed lesions, Hogarth said. If lung cancer is found, superDimension also can improve treatment. Hogarth uses the navigational scope, for example, to implant tiny metal tags around a tumor, allowing radiation oncologists to more precisely and safely aim the beam at only the cancerous tissue. When Krull woke from the 30-minute superDimension procedure, he found Hogarth grinning at him. Instead of cancer, Hogarth found what appeared to be a fungal infection in Krull’s lung, which was confirmed by a pathologist. “I was elated,” said Krull, who played golf the next day. Finding cancer early As of his last visit, Krull is cancerfree. Hogarth wants to increase the
chances of keeping him that way by checking his lungs annually for tiny lung cancers and premalignant lesions. These growths distort the tissues around them and make the airway thicker, changes that are invisible on a CT scan. The University of Chicago Medicine is one of
“This technology more than doubles the number of premalignant lesions we can detect.” D. KYLE HOGARTH, MD
the only hospitals in the Midwest that offers autofluorescence bronchoscopy to screen for precancerous changes in cells in individuals at risk for developing lung cancer. Autofluorescence bronchoscopy causes abnormal tissue to glow a different color than healthy tissue and “more than doubles the number of premalignant lesions we can detect,” Hogarth said. “Like a polyp in the colon, we can laser it out while we’re in there and potentially prevent cancer from developing.” Seven years after being treated for lung cancer, Krull says he feels and looks healthier than he has in a long time. “Friends mention that I don’t have a gray pallor since I stopped smoking, and I’m not afraid to buy green bananas,” Krull joked. And for Hogarth, there is no greater gratification than knowing that the more than 700 bronchoscopies he performs each year are “quite literally, helping to nip lung cancer in the bud.” uchospitals.edu/physicians/d-kyle-hogarth.html
getting kids to sleep Our children’s sleep specialists offer innovative, state-of-the-art care, including a new home sleep studies program
All too often, the sweet dreams of childhood are just a myth. Some children snore like little buzz saws. Others struggle to sleep at night, which makes them cranky all day. Expert diagnosis and treatment from the pediatric sleep specialists at the University of Chicago Medicine can help get children — and their weary parents — back on track to restful sleep. “A sleepless child is not the only one who is sleepless in the house,” said David Gozal, MD, chair of pediatrics and one of the world’s foremost experts on children’s sleep disorders. Along with providing comprehensive care for children with sleep disorders, physician-scientists and researchers at Comer Children’s Hospital at the University of Chicago Medicine are studying why sleep disorders occur and the best ways to treat them. That gives families access to innovative, state-of-the-art treatments often not available elsewhere. “We have extensive expertise, and we can offer a variety of diagnostic tools and treatments, many of which were developed here,” Gozal said. Sleep disorders are surprisingly common in kids, and can cause behavior, learning and health problems. Fifteen percent of preschoolers suffer from insomnia. Up to 4 percent have sleep apnea, an obstruction of the air passages that disrupts normal sleep patterns. For children with obesity, the rate is as high as 10 percent.
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University of Chicago Medicine children’s sleep specialists are pioneering a new program to make the diagnosis of sleep apnea easier on kids and more affordable for parents. Instead of spending the night in a sleep laboratory, your child can be monitored in the comfort of his own bed. The simple, lightweight device uses wireless technology, which makes it easy for parents to put it on and take it off their child. Data from the home sleep study is transmitted to University of Chicago Medicine board-certified pediatric sleep specialists for interpretation. If treatment is needed, our sleep specialists can work with your child’s primary physician to suggest the best course for follow-up care. “We want to offer families a test that is simple, not costly, that can be done at home and that will allow us to provide answers to their children’s sleep problems quickly,” said Hari Bandla, MD, chief of pediatric sleep medicine. Meanwhile, Gozal is leading a research team working on developing an even simpler test. Their work on a urine test to diagnose sleep apnea in children is supported by a grant from the National Institutes of Health. University of Chicago Medicine scientists also are aggressively exploring new treatments, including drugs aimed at making the standard treatment for sleep apnea — removal of the tonsils and adenoids — more successful. These new AT THE FOREFRONT
University of Chicago sleep scientists discovered rapid eye movement (REM) sleep in 1953. treatments might even allow some children to avoid surgery. Snoring is the primary symptom of obstructive sleep apnea, but only about 20 percent of children who snore have the disorder. The others may be simple snorers with stuffy noses or allergies. Regardless, snoring in children should not be taken lightly. “No child should snore,” Bandla said. “That is the message.” In most cases, the home sleep study will provide enough data to tell if a child’s snoring is caused by apnea. Children with
more complex sleep problems may need a more comprehensive overnight study in a hospital or clinic. Our children’s sleep specialists have the ability to analyze data from sleep studies that are conducted at the University of Chicago Medicine main campus in Hyde Park, the Institute of Sleep Medicine of DuPage Medical Group in Naperville, Ill., and Adventist Hinsdale Hospital in Hinsdale, Ill. Outpatient care by our pediatric sleep medicine specialists is available on the main campus and at our clinics in Westmont, Ill., Naperville, Ill., and Merrillville, Ind. “We understand parents have busy schedules,” Gozal said. That’s why our sleep medicine specialists work hard to minimize the number of return visits a family has to make, to streamline treatment plans and to work in collaboration with the child’s pediatrician, he said. For the most challenging cases, a multidisciplinary University of Chicago Medicine team may include a sleep specialist, ear, nose, and throat surgeon, craniofacial surgeon and orthodontist working together to treat the child. Behavioral therapy also is offered to families who need help establishing healthier daytime and nighttime routines. Our sleep experts also diagnose and treat many other disorders that disrupt kids’ sleep. These include bed-wetting, narcolepsy, parasomnias, period limb movement disorder, restless leg syndrome, sleepwalking, trouble falling asleep or awakening and teen sleep problems. It’s important to nip children’s sleep disorders in the bud, because they can have serious consequences. Kids who don’t get enough sleep may be crabby at home and struggle in school. Their parents are almost certainly frazzled. In a recent study, Gozal measured the sleep of more than 300 children ages 4 to 10. He found that children with disturbed sleep have a risk of obesity that’s up to four times higher than kids who get enough sleep. Long-term disrupted sleep is linked to obesity, diabetes and altered cardiovascular function in adults. “Our mandate is not only to make sure children are healthy, but to make sure they become healthy adults,” Gozal said.
Martin C. Burke, DO
Improving Pacemaker Safety Cardiologist develops mathematical model to reduce the risk from heart-device wires Pacemakers and implantable cardioverter-defibrillators (ICDs) can be lifesavers. But sometimes the “wiring” that connects them to the heart needs to be removed to treat dangerous infections and other complications, such as when a wire in the heart fails to function normally. Making sure your physician knows when to remove these “leads” when there is an infection or before they fail is key. Researchers at the University of Chicago Medicine have developed a mathematical tool to help physicians do just that. Now they are turning it into a mobile app that physicians will be able to use when patients come in to have the battery on their pacemaker or ICD replaced. The tool was developed by a team of physicians led by Martin C. Burke, DO, interim chief of cardiology and director of the Heart Rhythm Center, who presented their findings at the recent American Heart Association meeting in Orlando, Fla. By helping predict lead problems before they occur, the tool may allow more patients to benefit from these heart devices, Burke said. “Approximately 60 percent of patients who are currently eligible to receive an ICD don’t get this therapy,” Burke said. “A major reason is the perceived risk of wire complications.” This includes many younger patients, such as those in their 50s, who delay getting an ICD because of concerns about what will happen to the leads over time. “With this model, patients and their doctors will feel more comfortable knowing that we are able to address problems before they happen,” Burke said. “Knowing when to extract or not based on safety to the patient is the most attractive piece of this research.” When leads have problems, University of Chicago Medicine physicians can remove them using state-of-the-art laser techniques. Due to their extensive expertise, University of Chicago Medicine heart rhythm physicians were the first in the country to test a promising new type of ICD that does not use leads in the heart. uchospitals.edu/physicians/martin-burke.html
To find out if a home sleep study is right for your child, please call 1-888-UCH-0200. Visit uchicagokidshospital.org/home-sleep to learn more.
Patient awake, talking
as surgeon removes lemon-size tumor from her brain
Anna Litchfield and Maciej S. Lesniak, MD
Surgery can be a daunting experience for anyone, though thanks to general anesthesia, it’s not typically a memorable one. That’s not so for patients who go through an awake craniotomy — a unique procedure that allows surgeons to react based on feedback from the patient during removal of a brain tumor. “I remember them waking me up, using a flashlight and talking to me,” said Anna Litchfield, 50, who was operated on in August by Maciej S. Lesniak, MD, director of neurosurgical oncology at the
At the Forefront of Medicine®
Early 1900s IMAGINE
University of Chicago Medicine. “I remember Dr. Lesniak saying, ‘Anna, are you OK?’ and I remember saying, ‘Great, Dr. L!’” Awake craniotomies typically are used to remove tumors nestled close to functional areas of the brain. As the surgeon carefully removes the tumor, a neurologist monitors the patient to minimize damage to critical parts of the brain. “When tumors are in what we call eloquent, functional areas, the margin of error is a millimeter,” Lesniak said.
Surgeon proves blood loss causes most cases of surgical shock, leading to the widespread use of blood transfusions during surgery.
A cardiac surgeon performs the first heart transplant, on a dog.
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First hormone therapy for cancer. The 75-year-old prostate cancer patient lives another 13 years. Today, hormone therapy is used to treat several types of cancer, including breast cancer.
He and his team perform one of the highest numbers of awake craniotomies in the Chicago area — more than 30 each year. Each surgery utilizes an interdisciplinary, experienced team of neurosurgeons, neurologists, anesthesiologists and operating room nurses. “Dr. Lesniak showed me very quickly that he not only understood me as a patient, but also supported my journey,” Litchfield said. “I decided if there’s anybody on this planet I would literally let in my head, it would be him.” For most of the procedure, the patient is in a state of “twilight” anesthesia, similar to what is used for dental procedures. The procedure can last up to eight hours. “Often I find my role is to distract the patient,” said Leo Towle, PhD, professor of neurology, surgery and pediatrics. “We talk about their kids, their hobbies.” The conversation is more than small talk. Throughout the surgery, the neurologist runs tests to make sure there is no loss of function. “They’re under the drapes asking them questions, showing them cards, asking them to count back, and I listen,” Lesniak said. “It’s like music: When there’s a note or something that sounds off, I know that we are approaching a critical area.” The lemon-size tumor on the right side of Litchfield’s brain was invading into the motor cortex, so it was important to monitor her ability to move the limbs on the left side of her body. When the team observed muscle weakness, the surgery was immediately stopped. Litchfield, a teacher from Lake Forest, Ill., experienced some neurological deficits after surgery, but has seen full recovery of normal function after rehabilitation. In a procedure where the surgical team could not continually test the patient, the damage could have been permanent, Lesniak said.
A birthplace of modern chemotherapy. A University of Chicago doctor uses nitrogen mustard — the active agent in the mustard gas used as a weapon in World War I — to treat leukemia and lymphoma.
University of Chicago studies conducted in two Chicago suburbs lead to the fluoridation of water — and fewer cavities — nationwide.
The next big thing in brain cancer treatment might be very, very small
rain cancer is among the most difficult malignancies to treat. Physician-scientists at the University of Chicago Medicine are researching innovative ways to make treatment easier. Maciej S. Lesniak, MD, director of neuro-oncology research at the University of Chicago Medicine, is collaborating with scientists at the University of Chicago’s Center for Nanoscale Materials and the Materials Science Division at Argonne National Laboratory on a novel therapy that uses magnetic nanoparticles to destroy cancer cells. And Bakhtiar Yamini, MD, assistant professor of surgery at the University of Chicago Medicine, collaborated with a Nebraska biotechnology company to design a nanoparticle “shell” capable of selectively targeting therapeutics to brain tumor cells. Lesniak recently was awarded a five-year, $3 million grant from the National Institutes of Health to begin testing the nanomagnetic therapy in animal models. “There have been advances in therapy for brain cancer, but they haven’t been significant enough to make a tremendous difference in terms of extending life,” Lesniak said. Lesniak and his team are at the forefront of research with a total of $13 million in NIH grants to study brain tumor treatments, including gene therapy, immunotherapy and neural stem cells. The nanomedicine technique developed by the University of Chicago Medicine and Argonne scientists uses magnetic
Donald F. Steiner, MD, discovers the proinsulin molecule, paving the way for the first synthetic insulin.
microdiscs so tiny that calling them “microscopic” would be an exaggeration. Antibodies attached to the microdiscs are capable of recognizing brain cancer cells. Once the discs reach their targets, a weak magnetic field — about the same strength as a refrigerator magnet — is applied to the cancer cells. The discs start to rotate, which severely disrupts the cell functions. The cancer cells self-destruct. In theory, this therapy is potentially less toxic than the standard weapons to treat brain cancer, such as radiation and chemotherapy, which work by damaging cancer cells’ DNA but also harm healthy cells. “The great thing about this approach is it changes the mindset from trying to use pharmaceutical agents to do something to a cell to actually damaging the cell in a mechanical fashion,” Lesniak said. Yamini’s NIH-funded research with nanoparticles, meanwhile, essentially tags the particles so physicians will be able to monitor their path in the desired area of the brain by MRI. “People have previously used both targeting and image guidance in the treatment of other cancers, but bringing these two strategies together in one vehicle is something that would be really useful,” Yamini said. If testing of the nanoparticle delivery system is successful in animal models, the next step is a clinical trial for dogs with brain tumors whose owners decide to volunteer their sick pets in order to receive a leading-edge treatment.
A doctor-patient relationship inspired one of the largest donations ever pledged to the University of Chicago Medicine. The Matthew and Carolyn Bucksbaum Family Foundation is giving $42 million to the University of Chicago to create a unique program to improve doctor-patient communication. The Bucksbaums’ longtime physician, Mark Siegler, MD, will lead the initiative. “Our doctor, Mark Siegler, showed us what good doctoring involved, and it was just as much about compassion and communication as his outstanding clinical competence,” Carolyn “Kay” Bucksbaum said. “In Dr. Siegler, I have had a doctor who is interested in my husband and me as persons, not just diseases, although we’ve confronted him with a few of them. I have so valued that. A special mark of Dr. Siegler’s character is his extreme kindness and interest in what makes us tick.” The Bucksbaum Institute for Clinical Excellence will train medical students, junior faculty members and senior clinicians to serve as role models and mentors in communication and shared decision making. According to a 2001 study by the Commonwealth Fund, one in five U.S. adults had trouble communicating with doctors and one in 10 felt they had been treated disrespectfully during a recent health care visit. Kay Bucksbaum hopes the Bucksbaum Institute will address this problem by becoming a clinical and teaching model nationwide, emulated by other academic medical centers. “This is a transformative gift, the kind that has an impact sustained over generations,” said Holly J. Humphrey, MD, dean for medical education at the University of Chicago Pritzker School of Medicine.
Janet Rowley, MD, identifies the first chromosomal abnormality in leukemia, leading to the recognition of the genetic basis of cancer. In 2009, Rowley receives the Presidential Medal of Freedom, the highest civilian honor bestowed in the U.S.
World’s first successful living-donor liver transplant.
First successful heart-liver-kidney transplant.
Bruce A. Beutler, MD, a 1981 graduate of the Pritzker School of Medicine, wins the Nobel Prize, becoming one of 87 Nobel laureates associated with the University of Chicago.
Archival Photograph Files, Special Collections Research Center, University of Chicago Library
Doriane C. Miller, MD, never expected to become a
Get to know our wonderful South Side
he University of Chicago Medicine campus is located in Hyde Park, a vibrant and historic city neighborhood just a 10-minute drive along the lakefront from downtown Chicago. One of our close neighbors is the world-renowned Museum of Science and Industry. “I grew up going to the museum and always loved visiting it,” said David Meltzer, MD, PhD, associate professor of medicine, who served on the advisory board for YOU! The Experience, a 15,000-square-foot exhibit that explores the human mind, body and spirit. “Serving on the advisory board, I was so impressed with the pool of expertise the museum has to draw on, and how carefully they think about their mission and how to best realize it,” Meltzer said. “They really think about the audiences they want to reach and try to understand what will engage them.” University of Chicago Booth School of Business faculty members Nicholas Epley, PhD, and Reid Hastie, PhD, worked with
THE MUSEUM OF SCIENCE AND INDUSTRY 400,000 square feet of exhibit space makes it the largest science center in the Western Hemisphere Only remaining building from the 1893 World’s Columbian Exposition 1.4 million visits each year
museum staff on principles of psychological science featured in the Your Mind section of YOU! The Experience. And several days a week, visitors to the exhibit get a chance to participate in psychology experiments conducted by Epley’s team of behavioral scientists. “We thought this might be an interesting educational experience for museum visitors,” Epley said. To listen to a podcast on Epley’s research into intuition and decision making, please visit msichicago.org/online-science/podcast/nicholas-epley. For more information on the museum, visit msichicago.org
STUDENTS GIVE BACK TO IMPROVE COMMUNITY HEALTH Residents of several city neighborhoods have been vaccinated against the flu this season, thanks to students at the University of Chicago Pritzker School of Medicine. Under physician supervision, first- and second-year students administered more than 500 flu vaccines to community members during flu vaccine drives in Chicago’s Chinatown and Little Village neighborhoods and on the city’s South Side. Pritzker students gained an appreciation for Chicago’s diverse neighborhoods and immigrant populations and had the chance to talk with community members in Spanish and Chinese.
Pritzker School of Medicine student David Bluhm immunizes a young soccer player at the ¡Gol…A Tú Salud! Health Fair.
Along with giving flu shots, the future physicians took blood pressure readings and administered glucose screenings at the Chinatown Health Fair. Students also participated in Community Prostate Awareness Day on the South Side, giving free PSA tests to screen for prostate cancer.
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playwright. At a brainstorming session with community members on Chicago’s South Side, everyone loved the idea of tackling the issue of teen depression through drama. But no one knew how to write a play. So Miller, an associate professor of medicine and director of the Center for Community Health and Vitality, did some research on playwriting techniques. Then, one evening she just started to write. By early morning, she had written half the play. “It Shoudda Been Me,” a unique collaboration between the University of Chicago Medicine and eta Creative Arts Foundation’s Showfolk Cultural Enrichment Series for Youth, runs through June 15. Doriane C. Miller The play is about a 15-year-old top student whose grades plummet within months after his best friend is killed in a drive-by shooting. The storyline illustrates the need to recognize signs of depression among youth and seek out options for healing, Miller said. Miller drew on what she has heard from young patients who have been exposed to street violence. These teens often act nonchalantly, she said, but “many of these young people exhibited symptoms of anxiety and depression, not unlike people exposed to war.”
Performances of “It Shoudda Been Me” are at 10 a.m. and noon select weekdays at eta Creative Arts Foundation Inc., 7558 S. South Chicago Ave. For ticket information, visit etacreativearts.org.
curing breast cancer Michelle McBride supports research so other women will be spared the tough decisions she faced
Michelle McBride admits she’s “driven.” “I’m always trying to raise a little more money,” said McBride, vice president of the Noreen Fraser Foundation, a nonprofit dedicated to supporting research into women’s cancers. For McBride, it’s personal. On Dec. 11, 2011, she turned 39 years and 24 days old. It’s not a milestone most of us would mark, but for McBride, of Glencoe, Ill., it held special significance. Both her mother and grandmother had died young, and McBride had, on that day, lived longer than her mom had. “When your mother dies young, it’s natural to assume you’ll die young too — especially when your grandmother also died early,” explained McBride. “My husband and I were up until midnight; I turned to the clock and said, ‘I made it.’” For McBride, a mother of three, it had been an arduous journey. Sensitized to her familial risk of cancer by watching her mother succumb to the disease at 39 and the knowledge that her grandmother had died of it at 44, she underwent a test in 2006 that found a particular genetic mutation. It meant her odds of getting breast cancer were 87 percent. She stood a 27 percent chance of developing ovarian cancer. “I cried,” she recalled. “I was sad my mother didn’t have the chance to learn what I had about our genetic makeup and to do something that could have prevented her death.” McBride, a former attorney, embarked on a course of screening and self-education that culminated in her decision — in her mid-30s and without any indication of cancer — to have her breasts and ovaries removed. She documented her experiences in a series of moving online journal entries. “I am trying to break a pattern that is woven into my genetic fiber,” she wrote after deciding on the mastectomy.
Michelle McBride with her daughters London, 7, and Lola, 4
McBride consulted widely about the best place for treatment. All roads led to the University of Chicago Medicine. “I knew the university had a stellar program,” she said. But conferring with luminaries during an American Association for Cancer Research meeting “sealed the deal.” “Hands-down, they said, ‘Go to the University of Chicago.’” McBride registered as a patient with Olufunmilayo I. Olopade, MD, an international leader in breast cancer research. McBride’s mastectomy and subsequent breast reconstruction were performed by Nora Jaskowiak, MD, and David H. Song, MD, MBA, respectively. “They’re remarkable,” she Olufunmilayo I. Olopade, MD said. “They worked so well together, and listened to me every step of the way.” Today, McBride draws upon her experiences for inspiration in her role at the Noreen Fraser Foundation. Philanthropy is especially important amid shrinking science budgets, she said.
“We’re making such strides in research that it’s imperative to continue supporting groundbreaking work.” One project the foundation supports — through a $150,000 grant — is Olopade’s pioneering 4,000-patient study of triple-negative breast cancer, a virulent cancer that disproportionately strikes women of African descent. “Their funding is vital,” said Olopade. “We want to prevent breast cancer through better risk assessment, improved guidance on lifestyle changes, new therapies and less-invasive procedures. “Our hope is that one day women like Michelle will be spared the tough decisions she faced.” For information on how to support cancer research at the University of Chicago Medicine, please contact Amanda Nunnink at firstname.lastname@example.org. To learn more about the Noreen Fraser Foundation, visit noreenfraserfoundation.org.
Support Comer Children’s Hospital at the University of Chicago Medicine through the House of Dreams Charity Raffle. Enter at houseofdreamsraffle.org for the chance to win a house or $1 million in cash.
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