J e f f e r s o n M e d i ca l C o l l e g e • T h o m a s J e f f e r s o n U n i v e r s i t y • S p r i n g 2 013
A New Backbone for Neurosurgical Education
Jeff at the Beach
Join JMC alumni for a reception and buffet supper down at the shore! Saturday, August 3, 2013 5:30 to 8:30 p.m. Womenâ€™s Civic Club of Stone Harbor 96th Street and the Beach, Stone Harbor, NJ 08247 $20 per person RSVP by July 26 to Allison Kowalski at 215-955-9100 or email firstname.lastname@example.org To register online, visit connect.jefferson.edu/JeffattheBeach Casual attire, flip-flops OK
6 Using Their Heads: Jefferson Neurosurgeons Develop Simulation Curriculum 11 Joint Effort: Researcher Seeks Genetic Causes of Hip Dysplasia 18 Global Reach: Jefferson Shares Expertise to Advance Global Health
Departments 2 DEAN’S COLUMN 4 FINDINGS KCC Reveals New Diagnostic and Prognostic Prostate Cancer Genetic Tests
14 FACULTY PROFILE
Warren Maley, MD: Transfixed by Transplants
16 DONOR SPOTLIGHT 25 ON CAMPUS 28 Alumnus Profile 10 Questions with… Charles J. Dunton, MD ’80
30 CLASS NOTES 34 IN MEMORIAM 37 BY THE NUMBERS Jefferson Alumni Bulletin Spring 2013 Volume 62, Number 2 Senior Vice President, Jefferson Foundation: Frederick Ruccius Vice President for Development and COO, Jefferson Foundation: Stephen T. Smith Editor: Gail Luciani Associate Editor: Karen L. Brooks Design: JeffGraphics Bulletin Committee William V. Harrer, MD ’62 Chair James Harrop, MD ’95 Cynthia Hill, MD ’87 Larry Kim, MD ’91 Phillip J. Marone, MD ’57, MS ’07 Joseph Sokolowski, MD ’62
THOMAS JEFFERSON UNIVERSITY
On the Cover: Jefferson neurosurgeons Ashwini Sharan, MD, and James Harrop, MD ’95, with a posterior cervical laminectomy model. Photo by Ed Cunicelli.
Quarterly magazine published continuously since 1922. Address correspondence to: Editor, Alumni Bulletin Jefferson Medical College of Thomas Jefferson University 925 Chestnut Street, Suite 110 Philadelphia, PA 19107-4216 215-955-7920 Fax: 215-503-5084 connect.jefferson.edu Alumni Relations: 215-955-7751 The Jefferson community and supporters are welcome to receive the Alumni Bulletin on a regular basis; please contact the address above. Postmaster: send address changes to the address above. ISSN-0021-5821 Copyright© Thomas Jefferson University. All Rights Reserved.
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The Dean’s Column International outreach has deep roots in our nation’s medical schools. Reaching beyond our borders has served to enrich the educational experiences of our students, promote scientific interchange among our faculties and disseminate the best in clinical acumen and cutting-edge medical technologies. At Jefferson, a welcome mat for foreign trainees has been our starting point. Students from across the globe come here to train as part of well-established inter-institutional relationships. During his days as dean, Joseph Gonnella, MD, championed ties between our medical college and several countries in Asia and Europe — from Japan and Malaysia to Italy. Four years ago, I added Israel to the mix, creating a formal link with the Technion-Israel Institute of Technology. This relationship has enabled medical students in their Faculty of Medicine to participate in elective rotations at Jefferson, and for the American ones, a route back to the United States for residency. Scientific and clinical exchange has been a big part of the picture. Our chairmen of radiation oncology and rehabilitation medicine have strong ties to China, as do other faculty in departments such as emergency medicine. In some instances, the international ties go beyond the academy, such as strategic alliances with transnational businesses that advance medical technology. Jefferson laboratory medicine experts in our pathology department are currently working with VelaDx in Singapore to innovate genetic diagnostic testing, a growth area for the
global market. They are also engaged with Roche in Switzerland, advising them on the launch of diagnostic laboratory services and FDA approval processes in the U.S. market. Earlier this year, we pioneered a new path for “top-down” seeding of collaborative interaction among scientists oceans apart. A generous estate gift from a grateful Jefferson patient, Herman Tolz, designated funds exclusively for collaborative projects between Jefferson and the Weizmann Institute of Science. Based upon joint proposals, a full-day symposium was held on the Weizmann campus in January, with Jefferson/ Weizmann pairs co-presenting their science and plans. The thematic focus was on systems and computational biology — forefront fields where both institutions excel. Nine research projects are now moving forward within this collaborative framework. This March, Jefferson received the Rabin Public Service Award from the Philadelphia-Israel Chamber of Commerce, recognizing, in part, this proactive seeding of scientific collaboration. Another dimension is global health — in this instance, first-world extending an arm to third-world. As but one example, a joint effort between our Department of Emergency Medicine and the Jefferson School of Population Health established the first post-residency Global Health Fellowship program for emergency physicians in Philadelphia. (Read about Masashi Rotte, MD, our first fellow, on page 15.) There is strong interest among our students in educational, service and
research activities that serve our own multicultural populations, as well as communities in developing nations. Many of them seek global health learning experiences and travel abroad to volunteer, alongside our faculty, in underserved communities. Studentrun JeffHEALTH has orchestrated volunteer projects in Rwanda, helping to improve nutritional habits and develop sustainable water resources. The diversity of Jefferson’s faculty, whose origins span the globe, helps catalyze our international outreach. On our journey to the Weizmann Institute, I stepped back at one point to marvel at the diverse face of our Jefferson scientific team, a mini-United Nations of sorts — hailing from Hungary, India, Holland, Italy, Ukraine and China, not to mention the United States — all assembled in the Middle East. Taking advantage of the gamut of global opportunities — whether through hosting trainees or promoting collaborative research, educational alliances or humanitarian clinical care, Jefferson is dedicated to an international perspective and preparing our students to help solve the global health challenges of the 21st century.
Mark L. Tykocinski, MD Anthony F. and Gertrude M. DePalma Dean Jefferson Medical College
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Highlights from Dean Tykocinskiâ€™s photo album taken during a visit to Israel in January 2013. Included are photos from a symposium at the Weizmann Institute of Science, as well as photos of Jefferson faculty interacting with Israeli scientists at Tel Aviv University.
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Findings KCC Reveals New Diagnostic and Prognostic Prostate Cancer Genetic Tests Researchers at the Kimmel Cancer Center at Jefferson (KCC) have developed potentially game-changing diagnostic and prognostic genetic tests shown to better predict prostate cancer survival outcomes and distinguish clinically relevant cancers. The team, led by Richard G. Pestell, MD, PhD, director of the KCC and chair of the Department of Cancer Biology at Jefferson, conducted a blinded, retrospective analysis of more than 350 patients as well as a mouse study. Using an oncogene-specific prostate cancer molecular signature, the researchers were able to separate men who died of prostate cancer from those who lived, and, more specifically, identified men who died on average after 30 months (recurrence-free survival). The diagnostic test distinguished patients with clinically relevant prostate cancer from normal prostate in men with elevated prostate-specific antigen (PSA) levels. The researchers worked with three oncogenes previously associated with poorer outcomes in prostate cancer: c-Myc , Ha-Ras and v-Src. The test, the researchers say, is superior to several previously published gene tests and to the Gleason Scale, which is a rating given to prostate cancer based upon its microscopic appearance and currently used to help evaluate the prognosis of men with the disease. Given the diversity of prostate cancer outcomes — some men live two years after diagnosis, others live for more
than 20 years — a new oncogenespecific signature like this could not only help better identify prostate cancer risk but also test targeted therapies by way of a new prostate cancer cell line. These studies describe the first isogenic prostate cancer cell lines that metastasize reliably in immune-competent mice. Previous studies were in immune-deficient mice. “This oncogene signature shows further value over current biomarkers of prediction and outcomes,” Pestell said. “Such a signature and cell line may also enable the identification of targets for therapies to better treat prostate cancer, which takes the lives of more than 27,000 men a year.” In breast cancer, the identification of tumor subsets with various gene signatures has improved clinical care for patients because of targeted therapies. The work here aims to identify gene patterns and subsequent tests in prostate cancer that could serve similar purposes. But to help develop such therapies, model systems that closely resemble human disease are required. To date, there have been several limitations with currently available cell lines. Although important transplantation experiments have been conducted using human prostate cancer cell lines in immune- deficient animals, the immune system plays an important role in prostate cancer onset and progression making it imperative to develop prostate cancer cell lines that can be studied in immune-competent animals.
Also, although the transgenic mouse has been an effective model to study the molecular basis of human cancers, the prostate cancer mouse models have long latency and often unpredictable metastasis. Here, the researchers succeeded in overcoming these issues. The oncogenespecific prostate cancer molecular signatures were recapitulated in human prostate cancer and validated in distinct populations of patients as a prognostic and diagnostic test. What’s more, the researchers demonstrated how the isogenic prostate cancer cell lines metastasized in immune-competent mice. “Identification of gene signatures in breast cancer has allowed for a deeper understanding of the disease, and this paper moves us steps closer to being able to follow a similar trajectory with prostate cancer. Today, such an understanding and a formidable testing ground for new therapies is lacking for this disease,” Pestell said. “With this new oncogene-specific prostate cancer molecular signature, we have a valuable prognostic and diagnostic resource that could help change the way we manage and treat prostate cancer.” Other researchers in the study include Xiaoming Ju, MD; Adam Ertel, PhD; Mathew Casimiro, PhD; Zuoren Yu, PhD; Hui Meng, PhD; Peter A. McCue, MD; Rhonda Walters, MD; and Paolo Fortina, MD, PhD.
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Prostate Cancer Diagnosis, Prognosis and Research Improvements 1. Diagnosis: Using the new oncogene-specific test, diagnosis of prostate cancer has been improved greatly over the previous method of the prostate-specific antigen (PSA) test.
Oncogenetic Test Accuracy
The PSA test measures the blood level of PSA, a protein that is produced by the prostate gland. However, studies have shown that the predictive value of a PSA test is approximately 30%.â€
The oncogenetic-specific test is superior to other tests because researchers can look for a signature of genes regulated in prostate cancer versus normal prostate.
2. Prognosis: The oncogenetic overexpression test has been able to give a more accurate prognosis than other
methods, like the Gleason Scale. Detecting the rate of expression, either high or low, in the c-Myc oncogene of the cancerous prostate has been proven to show a more accurate outcome of prostate cancer patients. High Expression - 25th percentile Survival outcomes are not good; average life expectancy is 30 months.
1 - Least Aggressive
5 - Most Aggressive
The Gleason Scale relies on a subjective view of the pathologist by grading the appearance of the prostate cancer tissue. The pathologist takes a sample of the tissue to look at its cellular makeup. A grade, from 1 to 5, is determined based on the appearance of the tissue. The higher grade indicates a more aggressive cancer and therefore a faster growth rate.
Low Expression - 75th percentile Outcomes are better, with some patients living as long as 20 years.
The oncogenetic overexpression signature test relies on the overexpression signature of the c-Myc oncogene found in prostate cancer patientsâ€™ DNA. The research revealed that high expression signatures result in a significantly worse outcome than those with lower expression.
3. Immune-Competent Mice: One of the primary finds from the research, which has opened the door to more accurate results, is the ability of the researchers to test immune-competent mice. Although important prostate cancer cell line research has been conducted on immune-deficient mice, the need for research on immune-competent mice was crucial since we know that the immune system plays a major role in the onset and progression of prostate cancer.
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Using Their Heads:
Jefferson Neurosurgeons Develop Simulation Curriculum By Karen L. Brooks
hen Ashwini Sharan, MD, started training neurosurgery residents at Jefferson, he sought a risk-free way to teach them the nuances involved in drilling through bone. So he attached balloons to the backs of a bunch of pig scapulae and instructed his trainees to drill through without popping them. “That was our first foray into simulation,” says Sharan, now director of the neurosurgery residency program. “We’ve come a long way since then.” Simulation has been a buzzword in healthcare training for the past decade, and Jefferson has proved a leader in the field with the Dr. and Mrs. Robert D. Rector Clinical Skills Center, which houses equipment that enables trainees to experience highly realistic simulations of medical Story Summary Simulation training has become routine in medical education, but most existing curricula and equipment do not incorporate neurosurgical procedures. Two Jefferson neurosurgeons have developed simulation models with both virtual and physical components that hone and measure trainees’ skills. Simulation training poses no risk to patients and helps compensate for decreased operating room exposure resulting from resident hour restrictions. The new simulation curriculum has been piloted through the Congress for Neurological Surgeons and will soon be used with Jefferson residents on campus.
events. But among the many exercises available there, none involves neurosurgery. So Sharan and his colleague James Harrop, MD ’95, both professors in the Department of Neurological Surgery, have spent the past several years building a simulation program specifically for neurosurgery residents. They initiated the effort to help translate the book knowledge learned in medical school into the technical proficiency needed to perform as a physician. For example, undergraduate students don’t often have the opportunity to assess the power differences among the many types of drills available in the operating room, which is why Sharan started having residents practice using them on animal bones. “It’s a fast transition from being a fourthyear student to a resident and suddenly being called a doctor,” Sharan says. “We’re looking to use simulation as a way to teach a high volume of information while also letting residents get used to all of our equipment quickly — because their first time on call, they are responsible for somebody’s life.”
Laying the foundation
To standardize core lessons for junior residents, about five years ago Sharan created what he called “Neurosurgery Foundations,” a comprehensive review of the skills they needed to master right away. The Foundations program was adopted nationally and is now known in graduate neurosurgery training programs as “Neurosurgery Boot Camp.” But even with boot camp, trainees lacked access to sophisticated, anatomically accurate models on which they could simulate procedures, and the Congress of
Neurological Surgeons, or CNS — a national organization seeking to advance neurosurgery education and technology — pushed its members to develop a formal simulation course. Sharan and Harrop both sit on CNS’ executive board, and Harrop serves as chair of the CNS simulation committee, so they eagerly accepted the challenge. Harrop began looking for existing simulators and found a few had already been developed for cranial and vascular procedures, but none for spine and spinal cord. “There were some computer simulation devices around, but we wanted to incorporate physical models. Virtual reality alone is just not sufficient — trainees want to use their hands, to feel what surgery is really like,” Harrop says. “I always paraphrase Jefferson’s former chairman of neurosurgery, Dr. William Buchheit, who would say, ‘The difference between being a good neurosurgeon and a great neurosurgeon is knowing how hard you can pull on something and get away with it.’” Harrop and Sharan approached a 3D modeling company in Germany called Phacon that they knew had previously made a brain model and asked if they could replicate a cervical spine. They provided Phacon with a CAT scan as its basis, and in return, Phacon shared with them dozens of options for material. The physicians took turns drilling to determine which felt most like human bone. “Every little detail, each ligament, had choices of various materials with different densities, and we went through every one to make sure we got what we wanted,” Sharan says. And they did — Phacon produced a cervical laminectomy surgery simulator that met their high standards.
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A resident practices drilling on a simulated skull base. Photo by Carl Cox.
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Photo by Carl Cox.
Although a No-Brainer, Simulation Has Limitations Even as advances in technology and equipment progress, simulation is not without its limitations. For one thing, surgery is often unpredictable, and simulators cannot impart the “emotional training” that takes place when the unexpected occurs. In time, Harrop hopes, science and technology will evolve to better mimic real life. “A problem is that when you are using a simulator, you can remain 100 percent dedicated to that task. That’s not reality. In the OR, there’s lots of background noise,” he says. “Surgeons have to be very good multitaskers — we must be able to listen and perform, keeping several balls in the air at all times.” He and Sharan are considering making residents wear headphones streaming distracting sounds during simulation training in the future to examine whether performance is compromised. Also, as with most medical equipment, simulation technology is expensive; physical models and virtual reality components can cost hundreds of thousands of dollars. There are bills in both the House and Senate that could lead to simulation funding, but Harrop and Sharan agree that it is daunting to think that residency programs may have to rely only on their own university resources to fund simulation curricula.
Since then, they have worked with Phacon to develop additional models and corresponding software components for many types of procedures. They introduced these tools at the CNS Annual Meeting in Washington, D.C., in 2011, where they spearheaded a full-day practical simulation course for neurosurgery residents, complete with computer-aided evaluation of skills demonstrated on the models. The course was repeated at the 2012 Annual Meeting in Chicago and will be part of the 2013 meeting in San Francisco this fall. “Simulation is the future of medical education and will be increasingly required as part of our training and certification,” says Ali Rezai, MD, president of the CNS and director of the Ohio State University Brain and Spine Institute. “Even after just one day of practice on simulators, residents show great improvement. Getting drills into their hands in an educational setting has a significant impact on their OR performances.”
Rezai refers to simulation as the future of medical education — but why? Harrop says it just makes sense. “Simulators put you in a crisis situation and force you to respond, and then the next time you are in a crisis, you will have had some exposure and be able to deal with it better. They don’t just teach technical skills but also introduce residents to bad situations with zero possible harm to a patient.” An ever-deepening nationwide focus on reducing medical errors and enhancing patient safety has placed increased emphasis on simulation training, as it has become less acceptable to have residents “practice” procedures for the first time on actual patients. “The neurosurgery training approach has traditionally been an apprenticeship model: see one, do one, teach one. But simulation is obviously safer. In many cases, real-world training is dangerous or even impossible,” Harrop says, explaining that while cadaver dissection provides a great educational foundation for undergraduate students, simulation technology makes more sense
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Ashwini Sharan, MD, fourth from left, and James Harrop, MD `95, far right, show Jefferson neurosurgery residents one of the models they helped design. Photo by Ed Cunicelli.
during post-graduate training. Previously, neurosurgery residents occasionally worked on cadavers, but they can be difficult to obtain and prepare. Some animal bodies are more affordable than humans and anatomically similar, but they can be associated with infection and disposal concerns. Simulation also helps compensate for restrictions on resident work hours; an 80-hour workweek has forced GME programs to make adjustments in order to deliver the same level of training as before the limitation was imposed 10 years ago. “Learning a surgical skill requires hours of repetition. You need to have experience, review experience, modify experience, re-create experience,” he says. “When I was a resident, I stayed in the operating room all day, then took care of other duties at night. I never went home, but everything got done. With hour restrictions nowadays, residents have much less exposure to the OR, and we have to supplement their education in the most efficient manner.” Many neurological procedures are performed infrequently, he adds, and simulation allows residents to establish a comfort level with situations seen only rarely in the clinic. Residents doing simulation exercises receive grades for their technical perfor-
mances as well as an exam, which gives physicians a way to evaluate their trainees objectively — something they have sought for some time. Harrop and Sharan are striving to formalize a standard scale by which all neurosurgery residents’ skills are measured. “Resident salaries are paid for by the U.S. government, and the taxpayers of America want to know: What kind of doctors are we paying for?” Sharan says. “These tools will help us answer that.”
Looking to expand
The duo is in the process of integrating the CNS simulation course into the curriculum for neurosurgery residents at Jefferson. And since virtually no validity studies in the neurosurgery simulation arena have been conducted, they are looking to other institutions to do the same. “We need to validate our skills assessment tools. Several other schools will be getting these models, and then we can compare results, looking for consistency,” Harrop says. He is building a Web platform so that residents can log onto a computer to access the academic portion of the program, then move onto a simulator for a performance test. As the program expands, score compilations would provide an overview
of potential deficiencies in training across the country. “Residency directors will be able to see where they need to spend more time with trainees,” says Harrop, who believes that obtaining a medical license might soon require meeting a proficiency score that can only be provided by simulationbased testing. Sharan agrees, predicting that “as soon as in the next five or 10 years, before residents are allowed to drill or sew or cut on the brain, they will have to log 20 or 50 or however many hours on a simulator,” he says. The Accreditation Council for Graduate Medical Education already mandates simulation training for some specialties, such as general surgery and obstetrics/gynecology. “This is evolving technology. Ultimately, I think virtual simulation will provide core knowledge for first-year residents, and then hands-on simulation will come in the second and third year,” Sharan says. “But that’s not for us to decide. The future of neurosurgery simulation really depends on the American Medical Association and its residency review committees. It’s up to us to show them why it works.”
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Save the Date
11th Annual Jefferson Awards Gala October 30, 2013 5:30 p.m. Reception 6:30 p.m. Dinner and program
Honorees: Award of Merit: Leonard and Jane Korman Achievement Award in Medicine: Roger B. Daniels, MD Grand Ballroom Hyatt at the Bellevue 200 S. Broad Street, Philadelphia For more information or to sponsor the event, contact Phyllis Nangle at email@example.com or 215-955-9136.
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Joint Effort: Researcher Seeks Genetic Causes of
By Karen L. Brooks
Just over 40 hours. After eight weeks of basic training, three weeks of technical training, 12 weeks of aeronautical training and more than a year of on-the-job training, thatâ€™s all that stood between Jo Ann Lidel and her certification as a boom operator for the U.S. Air Force.
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idel had been experiencing hip pain for some time and received a hip dysplasia diagnosis in her early 20s, but she never expected the condition to interfere with her career. She received a single hip reconstruction at 24 and planned to complete her training as soon as she recovered from surgery. The opportunity never came. “The military said my range of hip motion was too limited,” Lidel says, “and permanently disqualified me from flying.” Heartbroken, she was placed in a desk job and ultimately left the Air Force instead of re-enlisting and pursuing her dream of someday becoming a pilot.
DDH can be difficult to study since genetics alone does not always trigger the disease. But regardless of environmental causes, genetic influence is strong. “You could say I was a little upset,” recalls 32-year-old Lidel, who had her other hip reconstructed at the Rothman Institute at Jefferson last year. In a normal hip joint, a cup-shaped socket called the acetabulum cleanly envelops the head of the femur. In Lidel’s case, developmental dysplasia of the hip, or DDH, prevented this socket from fully forming, and it ended up too short to cover the femur’s entire head, causing excessive wear and tear and easy dislocation. Patients with DDH often endure chronic pain, and many require hip reconstruction or replacement as young adults. George Feldman, PhD, DMD, assistant professor in the Department of Orthopaedic Surgery at JMC, aims to help people like Lidel by uncovering genetic mutations that cause their condition. DDH can be difficult to study since genetics alone does not always trigger the disease. Infants whose hips were stressed during a breech birth are particularly susceptible, as are those who came from a womb with low amniotic fluid. But
regardless of these environmental causes, Feldman says genetic influence is strong. “We see a high degree of similarity of inheritance between identical twins, as well as a 12-fold increase among first-degree relatives of those affected by the disorder. Clearly, this is evidence of genetic transmission,” he says. Feldman’s goal is to develop a genetic test for DDH to spare people from rude awakenings — such as Lidel’s — in adulthood. Most newborns are screened with a physical exam and ultrasound or X-ray, but these tests miss about 40 percent of cases of the disease, which progresses with age. Hips don’t fully calcify until about age 16, and X-rays don’t register cartilage very well. “I want to create a more reliable way to detect this in infants, because if we do so early enough, we can immobilize their hip joints so they don’t move around and interfere with continuing hip formation,” Feldman says. “Sometimes, as little as six weeks in a harness during a crucial period of development could save people a lifetime of agony from osteoarthritis, hip replacement and subsequent revision surgery.” Feldman sought a large family with a high incidence of DDH so that he could perform a genome-wide linkage analysis and determine which genetic variants affected members shared. Luckily, his mentor, Javad Parvizi, MD, director of clinical research at the Rothman Institute, had connections to the head of orthopaedic surgery at the University of Utah in Salt Lake City — a region in which DDH is prevalent. Through that connection, Feldman identified a family that not only met his needs but also happened to be planning a reunion involving four generations. And even better — its members were eager to help with his research. With their blessing, Feldman brought a team of residents, radiologists and nurses to the hotel where the reunion was taking place, and in a single day they obtained X-rays, cheek swabs, blood samples and medical questionnaires from 72 relatives. “My hypothesis was that DDH-affected individuals had a mutation that made them susceptible to the disease. Several in our pedigree had a questionable diagnosis, so we focused only on DNA from the most
These two radiographs show the difference between normal hip bones and hip dysplasia. In the bottom image, the affected hip shows a shallow socket and deformed femur head.
severely affected and discovered that they shared a set of variants located in a small region on chromosome 3,” Feldman says. “The chances of our result occurring by chance alone? About one in 1,000.” Of the more than 100 variants pinpointed, Feldman needed to determine which might actually cause DDH. He began by examining the nine known to cause changes in amino acids, the building blocks of proteins. Eight of those nine proved benign — which left him with one. “We honed in on that single variant in chromosome 3, which it turns out causes a defect in the function of a protein called
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George Feldman, PhD, DMD, works with a DNA sample in his laboratory. Photo by Sabina Pierce.
a chemokine receptor,” Feldman says. Chemokines transmit signals from outside a cell to inside a cell and affect cell migration and adhesion, and “there seems to be a screw-up in this case — some sort of faulty communication.” This communication breakdown showed Feldman exactly what he wanted to see, because chemokines are believed to affect the maturation of cartilage to bone. And that’s apparently the problem with DDH: cartilage doesn’t form into bone when it is supposed to. “We know this variant has roles that are both helpful and damaging in different
organ systems already, but we aren’t yet sure of its role in bone development,” Feldman says. He has since tested additional DNA samples from DDH patients and found that some have been positive for the mutation. Parvizi, who works closely with Feldman and performed Lidel’s second hip reconstruction, says these results could have a major impact on the field. “Knowing the genetic basis of dysplasia will allow us to diagnose the condition earlier and therefore deliver appropriate care earlier. Another immense benefit would be to be able to accurately diagnose the condition in adults
exhibiting symptoms, which in some circumstances is not a simple task,” he says. Feldman thinks any genetic test he ultimately develops will be a composite, because DDH-causing mutations could vary per family. He is currently studying other families, searching for additional variants that can aggravate the condition. “I am confident that one day we will develop a reliable test,” he says. “But first, we have a lot more proving to do.”
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Jefferson Faculty Warren Maley, MD Transfixed by Transplants
As a student at the University of Pittsburgh School of Medicine in the 1980s, Warren Maley was captivated by liver transplants. Thomas Starzl, MD, PhD, a pioneer in liver transplantation, headed the medical school’s program and was known for having helped pioneer cyclosporine, a drug that suppresses the body’s rejection of transplanted organs. With this dramatic development, transplantation became the treatment of choice for end-stage liver disease. And Maley became the first medical student to spend a month on Starzl’s service. “I was struck by the fact that people from all over the world were coming to see us for liver transplants,” says Maley. “I saw them in the outpatient clinic three weeks after surgery, and patients who had come in looking dilapidated and green were starting to look like normal human beings again. I was flabbergasted. I decided that this would be a good thing to do for the rest of my life — so I did.” Following medical school, Maley was a resident in general surgery then a transplant fellow at Johns Hopkins University in Baltimore. He joined the Hopkins staff after his fellowship, remaining for several years. “In the later part of that experience, I started to do live donor transplantation in adults,” he says. “We had been doing live donor liver transplants in kids since I was a fellow, but we started dividing livers and giving the right portion to the adult patient, which was very exciting at that time.” Today, Maley, professor of surgery, is the director of the Live Donor Liver Transplant Program at Jefferson. Q: Why did you come to Jefferson? A: I came in 2009 to develop live donor liver transplantation at Jefferson and because Charlie Yeo, chairman of surgery, invited me. We had been together at Johns Hopkins. He’s a phenomenal surgeon and a great mentor; it’s been wonderful working for him. Q: What kind of work are you doing in Bolivia? A: I’ve been doing liver transplants at the Clinica Incor in Santa Cruz, which is a city of about a million and a half people
in Bolivia. The physicians at the hospital call me at 8 in the morning to let me know when they have a donor. I pack my bags, take a flight to Miami at 3 p.m., fly from Miami to Santa Cruz and get there at 8 in the morning their time. We drive to the hospital, operate on the donor, then the recipient — it’s quite a long day. Q: How did you get involved in this work? A: I have a friend at duPont who was involved and he asked me to help. I went to Bolivia four times in 2012 to do liver transplants on both children and adults. We’re also training the local surgeons who are learning the procedures and are gearing up for their own program. It’s been difficult because some of the learning is figuring out what they need and how to get it. Q: Why do you do it? A: Liver transplantation patients get amazingly better. They go from being very sick people to reclaiming their lives. The concept that there are still places in the world where this surgery is not available is a problem. People shouldn’t die of liver disease for lack of funding. There are surgeons in Santa Cruz who are operating every day, and they are eager to learn to do these transplants but there’s no one to learn it from. To be in a position to help them is a wonderful pleasure. Liver transplantation is routine in this country, but in Santa Cruz, everyone — doctors, nurses, families — gets excited. It reminds me of the early 80s. It’s great to be involved, and I get a lot out of it. If they can become selfsufficient, that would be marvelous. Q: Would you recommend volunteering for projects like this to other surgeons? A: Absolutely. We don’t often think of the fact that we have abilities that are not readily available in other countries. So I would say be open to volunteer possibilities. — Gail Luciani
Photo by Sabina Pierce.
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Donor Spotlight Major Gift Establishes Jane and Leonard Korman Lung Center
“The Kormans’ gift will allow us to reach the next level of research and position Jefferson to be a nationally recognized lung center.” —Mark Tykocinski, MD, JMC Dean
cancer diagnosis is life-changing for both patients and their loved ones. Lung cancer survivor Jane Korman and her husband, Leonard, have drawn inspiration from their personal experience to help change the future for others facing similar diseases. Jane, cancer-free after receiving treatment at Jefferson, and Leonard, a University trustee since 1998, have provided support through the Jane and Leonard Korman Family Foundation to establish the Jefferson — Jane and Leonard Korman Lung Center. This partnership will allow Jefferson to better understand lung disease through innovative research and expanded clinical programs. “The Kormans’ gift will allow us to reach the next level of research and position Jefferson to be a nationally recognized lung center with leading programs in personalized medicine and care for lung disease patients. We are incredibly grateful,” says JMC Dean Mark L. Tykocinski, MD. With its primary focus on lung cancer, the Center will attack the leading cause of cancer death in the United States and worldwide. Because lung cancer often progresses stealthily, early diagnosis and improving treatment is vital.
Faculty at the Center will prioritize enhancing lung cancer care with a comprehensive program that will include evaluation and diagnosis through the lung cancer screening and nodule program, as well as through partnerships with the departments of surgery, medical oncology and radiation oncology. Non-cancerous pulmonary disease programs will also target conditions such as asthma and sarcoidosis, a regionally prevalent disease that triggers the formation of benign masses in the lungs. The Kormans’ generosity makes it possible for Jefferson to recruit three new faculty members, create two clinical and research programs and upgrade existing clinical and research facilities. They also established a fully funded professorship in pulmonary medicine, held by Gregory Kane, MD ’87, professor of medicine and interim chairman of the Department of Medicine.
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Mu Medical Student House Association Memorializes Jefferson Urologist with Scholarship and Lectureship Paul Zimskind, MD ’57, PhD, is remembered by former peers and students for his triumphs in the laboratory and charisma in the classroom. To honor his many achievements, the Mu Medical Student House Association has established the Paul Zimskind, MD ’57, PhD Scholarship Fund and the Paul Zimskind, MD ’57, PhD Memorial Lectureship in Urology at Jefferson. Last fall, Association President Michael LeWitt, MD ’74, sought a meaningful way to invest funds from the sale of a medical fraternity chapter house in Philadelphia. He decided that honoring Zimskind made sense, as the late urologist had served as president of the chapter as a JMC student and was involved in the initial purchase of its house on Clinton Street. “Dr. Zimskind was such an eminent researcher and teacher, it seemed natural to recognize him in some way,” LeWitt says. Zimskind, who completed both his internship and residency at Jefferson, became the Nathan Lewis Hatfield Professor of Urology and chairman of the department in 1967. At 36, he was one of the youngest professors to attain a departmental chairmanship, which he held until his sudden death in 1976 at age 44. His research accomplishments in urodynamics received international recognition. The Zimskind Scholarship will support as many as 10 JMC students per year, with preference given to students demonstrating high ethical standards and a commitment to community service. The Zimskind Lectureship will be an annual lecture within the Department of Urology.
Jefferson Receives Yitzhak Rabin Public Service Award On March 7, 2013, Richard Gozon, president, Thomas Jefferson University, and David McQuaid, FACHE, president, Thomas Jefferson University Hospitals, were honored by the Philadelphia-Israel Chamber of Commerce for their commitment to excellence in health care, their leadership in greater Philadelphia and their vision that includes Israeli partners. Jefferson was an early adopter of the Israeli pillcam and is active in initiatives that include ongoing collaborations with Israeli partners, clinical trials of Israeli technologies and joint ventures in Israel. Recent visits to Israel by Jefferson physicians and researchers have contributed to a strong bond and continuing partnership between the two entities.
Mark Tykocinski, MD, speaks at the Philadelphia-Israel Chamber event.
The Philadelphia-Israel Chamber is the leading facilitator of U.S.-Israel collaborations, making matches each year for dozens of Israeli companies in areas such as life sciences, clean technology, software and the internet.
18 Jefferson Medical College Alumni Bulletin
Jeffersonâ€™s Global Reach
This birdâ€™s eye view of Jefferson around the world shows the breadth of our international education, research, service, training and leadership activities. Faculty, students and alumni are working to advance global health in nations that span six continents. Africa
Egypt Ethiopia Kenya Liberia Libya Nigeria Rwanda Sierra Leone South Africa South Sudan
China Cook Islands India Israel Japan Malaysia Nepal South Korea Thailand Tibet Turkey
Costa Rica Dominican Republic Haiti Honduras Jamaica St. Lucia
Austria Finland France Germany Hungary Ireland Italy Poland Portugal Serbia Switzerland The Netherlands
South America Bolivia Brazil Columbia Peru
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Jefferson University Philadelphia, PA
Partnerships Humanitarian/Clinical Care Research Student and Training Activities
20 Jefferson Medical College Alumni Bulletin
Jefferson Shares Expertise to Advance Global Health By Gail Luciani
e inhabit a constantly changing world. From the exploding digital revolution in communications to the ebb and flow of transnational business, rapid and sometimes historic change is taking place on our planet. In this volatile environment, we may forget that many of the earth’s populations are dealing with these dizzying changes while still competing for clean water, arable land and basic health care. The issues are complex — population growth, loss of biodiversity, the spread of infectious disease, drought — and solutions must be comprehensive and wide ranging. Global health has been on the radar of medical professionals for many years, and collaborative research has helped deliver significant achievements — including a vaccine for meningitis A, a rapid test for detecting tuberculosis and a malaria drug for children.
But advancing global health in the 21st century requires more than sharing research and technological innovations across national borders. Improving and achieving equity in health for all people is at its heart, and it has become an area of growing interest for both medical students and the colleges that educate them. A Tradition of Global Learning
“At Jefferson, an increasing number of medical, population health and health professions students are seeking global health learning experiences,” says Janice Bogen, assistant vice president, international affairs. “Since 1997, 477 students have been partially funded for their study abroad experiences with Foerderer Award funds.” Bogen is a member of the Jefferson Global Health Initiative Committee, which formed in 2010. The committee includes representation from all schools, with members working to
promote the integration of global health into curricula today and perhaps leading to a Jefferson Global Health Center in the future. A center would build on Jefferson’s strong tradition of global learning. “Medical education is and should be an international experience,” says Joseph Gonnella, MD; distinguished professor of medicine; director, Center for Research in Medical Education and Health Care; and dean emeritus. “The sharing of medical knowledge is as old as the profession itself. From the earliest recorded history, medical education has been an international two-way bridge. We receive as much as we give in our global relationships.” Historically, Jefferson has signed contracts for collaborative research relationships in Korea, Italy, Japan, China and Argentina. Formal agreements with the Kimmel Cancer Center provide access to researchers who collaborate with scientists from institutions in Italy, Australia and Austria. In Japan, collaborative research with the Noguchi Medical Research Institute is improving medical care for patients around the world. In addition, Jefferson opened the Japan Center for Health Professions Education and Research in January 2012 to promote the exchange of training and research among Jefferson, the Japanese Association for the Development of Community Medicine and the Noguchi Medical Research Institute. Jefferson began a medical education venture in Malaysia in 1991 that was designed to improve education in the region and provide selected Malaysian students the opportunity to study at the medical college.
Harsh Sule, MD, left, oversees an ultrasound in Sierra Leone. Photo courtesy of Dr. Sule.
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In Israel, the Louis and Fannie Tolz Collaborative Research Project between the American Committee for the Weizmann Institute of Science in New York and Jefferson supports collaborative research in areas such as computational biology. Scientists from both institutions have met and shared ideas about prospective projects. In addition, American students studying medicine in Israel have an opportunity for elective rotations at Jefferson. In 2012, approximately 100 members of Jefferson’s faculty reported participating in conferences, scientific programs, medical meetings or lectures in a foreign country. And their peers in these countries come to Jefferson as well. “Jefferson sponsors a biannual symposium designed to foster interaction among global leaders in biomedical research,” says Bogen. “The event includes the presentation of the prestigious Lennox K. Black International Prize for Excellence in Medicine, which is a major contribution to Jefferson’s overall global presence.” Center and Department-Level Initiatives
The Center for Research in Medical Education and Health Care researchers are collaborating on a series of projects with the Regional Health Care System of EmiliaRomagna, Italy. According to Daniel Louis, center manager, current projects include development of models to predict risk of hospitalization for patients with chronic disease, analyses of the distribution and outcomes of surgical services for patients with cancer and analyses of intraregional variation in medical, surgical and pharmaceutical treatment. Many departments have active research collaborations with their peers across the globe; for example, the Department of Dermatology and Cutaneous Biology works
Jefferson faculty take time to visit an historic site during their trip to Israel. Photo courtesy of Dr. Zvi Grunwald.
with scientists in a host of countries including Finland, Germany and Hungary. “These collaborations relate to our ongoing work on molecular genetics of heritable skin diseases, with translational implications for diagnostics, genetic counseling, prenatal testing and development of novel molecular therapies,” says Jouni Uitto, MD, PhD, professor and department chair. The Department of Radiation Oncology has an active international fellowship program that provides training to medical students, radiation oncology residents, medical physics residents and fellows. “Our international program is extremely important. It brings new ideas, concepts and energy into the department and allows us to develop collaborative relationships with talented physicians, physicists and scientists throughout the world,” says Adam Dicker, MD, PhD, professor and chair of radiation oncology and professor of pharmacology and experimental therapeutics. John Melvin, MD, chair of the Department of Rehabilitation Medicine, oversees an international program that both hosts foreign visitors and encourages faculty to travel to international locations to provide advice, teaching and services.
“Our department disseminates information about medical rehabilitation to individual health professionals here on Jefferson’s campus and at international sites,” he says. “Through this two-way process, our faculty also has gained a broader understanding of how various health systems care for people with disabilities.” Melvin has met with governmental policy makers in several countries including China, where there is now a comprehensive plan for the development of rehabilitation centers throughout the country. Learning While Healing
Jefferson emergency department physicians have twice traveled to Sierra Leone to help improve the quality of health care and its delivery within the developing West African country. The team provided clinical care and helped train local healthcare workers to perform point-of-care ultrasound. Jefferson’s growing work in Sierra Leone provided the impetus for establishing the first post-residency Global Health Fellowship program for emergency physicians in Philadelphia, which began in July 2011. “Sustainable development requires improvements in local governing structures,
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“The sharing of medical knowledge is as old as the profession itself.” —Joseph Gonnella, MD
improvements in financing and improvements in education,” says Harsh Sule, MD, assistant professor of emergency medicine and director, international emergency medicine. “That’s why we decided to make our department’s focus not international emergency medicine, but rather the broader field of global health including the social determinants of health.” The program is a joint effort between the Jefferson Department of Emergency Medicine and the Jefferson School of Population Health. Learning opportunities in other countries are crucial to the study of medicine in the United States because students need to be aware of the breadth of disease. “We need to think about sending our students to other countries so that they will learn about some of the diseases we don’t often see here,” says Gonnella.
Students have that chance when they volunteer with JeffHEALTH, a model of student global education in Rwanda. The 7-year-old program encourages students who volunteer between their first and second year of medical school to learn approaches to care, education and research as well as methods of integrating primary care and public health. Students can also offer a range of services that meet community needs and work on specific programs developed with Rwanda partners such as HIV/AIDS education, malnutrition, clean water, income generation, family planning and prenatal care. “As an organization, JeffHEALTH seeks to build a Universitywide community of health professionals interested in working to advance health in African communities,” says faculty advisor James Plumb, MD ’74, professor in the
Department of Family and Community Medicine and director, Center for Urban Health. The program has been so successful that many medical students return for an elective in their fourth year. In addition, nursing, physical therapy, occupational therapy and population health student involvement underscores the importance of multidisciplinary education across borders. Geo-political borders may end in Philadelphia, but refugees from around the world arrive daily needing health care. The Center for Refugee Health operates out of Jefferson’s Department of Family and Community Medicine and is headed by Marc Altshuler, MD ’01. Each year, the center sees approximately 300 patients from more than 30 countries, including Iraq, Iran, Burma, Vietnam, Haiti, Nepal, Eritrea, Bhutan and the Congo. Rheumatic heart disease, not often seen in developed countries, is a common condition among refugees. A 19-year-old patient from Nepal arrived at the clinic weighing just 74 pounds, so weak her family had to help hold her up. “When I met her family, her father said to me ‘My family’s health is in your hands.’ She was seen in our center, then in cardiology, within 10 days,” Altshuler said. “Her heart valve was replaced at Jefferson and today she is doing well and living like a normal 21-year-old.” Impact Across Regions
True to a global interpretation of health care, Jefferson initiatives often cross borders in their execution and impact. Barry Goldberg, MD, who co-chairs the global health committee, pioneered the “Teach the Teachers” program at the Jefferson
JMC students work with children as part of a JeffHEALTH educational program in Rwanda. Photo courtesy of Dr. James Plumb.
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Ultrasound Research and Education Institute in 1990. The institute trains physicians worldwide in regional ultrasound education centers who then return to their respective countries to teach what they have learned to others. There are currently 37 training centers, and physicians from Central and Eastern Europe, sub-Saharan Africa, the Caribbean and Latin and South America have been trained through affiliate centers worldwide. True to its tradition of global learning, Jefferson has made contributions that range from the translation of its Scale of Empathy into 42 languages to a recent study that found that a re-sterilization and implantation strategy for explanted implantable cardioverter-defibrillators could have important humanitarian and economic effects for citizens of low- and middle-income nations. A renewed global health presence will build on Jefferson’s strengths of academics, clinical training and research excellence, contributing to the spread of equity in health for all people and the advancement of scientific knowledge resulting from global collaboration.
Masashi Rotte, MD, examining an infant in South Sudan. Photo courtesy of Dr. Rotte.
Jefferson’s First Global Health Fellow In 2011, Masashi Rotte, MD, was selected as Jefferson’s first Global Health Fellow, a post-residency program that is a joint effort between the Department of Emergency Medicine and the School of Population Health. Through the fellowship, Rotte is earning a Master’s of Public Health and completing field training in St. Lucia, South Sudan and Sierra Leone. The fellowship was inspired by a trip to Sierra Leone by the program’s now-directors, Bon Kun, MD, and Harsh Sule, MD. Sierra Leone has grim records of population health, with an average life expectancy of 49, total health expenditure of 3.5 percent of the gross domestic product and one doctor per 50,000 people — the equivalent of having 29 doctors to treat all of Philadelphia. Rotte’s first overseas stint in the fellowship was through the International Medical Corps to St. Lucia, where he worked in a small hospital that serves the indigenous population, giving lectures and providing bedside training. In summer 2012, he went to South Sudan through the Corps again and worked for six weeks in a refugee camp, followed by six weeks in a rural town. This past February, he traveled to Sierra Leone through the U.S.-based NGO Global Action Foundation and Sierra Leone-based Wellbody Alliance. Besides seeing common worldwide health issues like skin infections, abscesses and pneumonia, Rotte tackles conditions specific to the developing world, such as malaria, parasitic infections and fecal-oral infections from unclean drinking water. Since these developing countries don’t have separate emergency departments, Rotte invests his time teaching local physicians how to quickly diagnose and treat people. “I’m trying to teach them some of the concepts we have here — to quickly triage, diagnose and treat patients,” he says. “The goal is to educate people and improve what they do with what they have. For instance, you can’t go in and teach them how to use a CAT machine because they don’t have one. You make do.” After the fellowship, Rotte hopes to continue a career in academic emergency medicine or with an NGO. He says his long-term hope for his missions to developing countries is not to do some doctoring and then leave: It’s to teach the healthcare providers to do a better job with what they have. “It’s the difference between giving a man a fish and teaching a man to fish,” he says. “My goal is to give them education and experience.”
Kenichiro Hasumi, MD, with Joseph Gonnella, MD, and Takami Sato, MD, PhD, at Dr. Sato’s investiture as the K. Hasumi Professor of Medical Oncology.
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One by One: Three Stories of Service Michele Meltzer, MD, clinical associate professor, Department of Medicine, has volunteered in East Africa, promoting rheumatology education. “There is a shortage of rheumatologists internationally, which is especially severe in East Africa, with about three rheumatologists for 18 million or more people. Because of lack of expertise in rheumatology, documenting epidemiology of musculoskeletal disease is difficult. Some people with infectious diseases that are uncommon in the developed world, such as tuberculosis, can develop arthritis. That is why there needs to be a partnership with local physicians. Since I treat chronic diseases, I can give advice, but I’m not like surgeon who can come in and perform surgeries and make an immediate impact. Our goal is to ensure training in diagnosis and treatment of rheumatic diseases. “Once I attended a rheumatology clinic in Nairobi. I saw a young boy, six or seven years old, who lived seven hours by bus from the hospital. When he was five years old, he had been brought to the hospital. Therapy that was consistent with how we would have treated him in the U.S. was recommended for his rheumatoid arthritis. But the family was poor and unable to come back to the clinic for the therapy. By the time I saw him, he had arthritis everywhere. He couldn’t stand, he couldn’t dress himself. He was 100 percent disabled. It broke my heart. He will never even be able to feed himself. His father was with him and was attentive and kind, but he could not provide the proper care the child needed. We have to educate the physicians and healthcare professionals even in outlying rural areas, so they know when to refer these patients and treat them.
“My personal goal is to develop an online program where we can teach students and physicians in Africa and they can consult with us. They have internet access, even in the remote areas, so this is doable.” Stuart Weiner, MD, professor and director, Division of Reproductive Imaging, Department of Obstetrics and Gynecology, has volunteered in Nepal, Liberia, Ethiopia and the Cook Islands to provide obstetric and gynecological care. “The first time I went to Nepal, I joined six doctors and three nurses from all over the world on a three-week trek into the Himalayas. We had 56 sherpas, guides and cooks on the trail with us. A few weeks before we were due to arrive in a village, we sent out runners with notices so people could come out of the hills to see us. We would go from village to village, set up a clinic for two to three days until we’d seen everybody. We went into one village and there was an entire field with 500 people who had camped out waiting for us. It was thrilling. “In Liberia, whatever the patient needs has to be provided by the family, even food. Medications and surgical equipment are scarce. The electricity goes out often, so they don’t bother to put anyone on a ventilator. I completed one surgery by the light of our cell phones. Surgery has to be paid for up front. I did one operation where the family paid the minimum, but we ran out of suture material at the end. With the belly still open, the hospital refused to send any more. One of the surgeons yelled ‘I’ll pay for it, get it up here.’ “I do this because, first, I want to, one at a time, help patients. Second, I want to educate care providers in other countries. I’ve realized through my decades of being a teacher that there is a wonderfully magnifying effect on everyone when you teach.”
Villagers in Nepal watch for visiting physicians. Photo courtesy of Dr. Weiner.
Deborah Witt, MD, assistant professor, Department of Family and Community Medicine, has volunteered in Jamaica, Haiti and Kenya, providing medical and non-medical aid. “In the mountains of Jamaica, we see hypertension, diabetes and arthritis. In Haiti, there are a lot of mental health concerns. All of the places have different forms of depression, because they just don’t have much. Hunger is profound. When you’re hungry and don’t eat right, you become ill, so we see stomach issues as well. In Kenya, a 16-year-old girl came to the clinic. She had four children, and her oldest was 6 years old. Her determination to get to the clinic and get help was impressive. We gave her things for her babies, mainly food and supplies. “We think we are going to help people and build homes, but really they help us. They help us to see the disparities in health care and to see what the desperate needs are. They have so little. When we come back to the United States, we are on fire and passionate about going back and doing better. The students get a great opportunity to practice medicine and see how they can be culturally sensitive. Some of the residents that have come with me are now in New Zealand, Hawaii and Ethiopia. I feel like I contributed to that.” — Elizabeth Seasholtz If you have a global humanitarian story that you would like to share, please send it to firstname.lastname@example.org and it will be posted on the JMC community website.
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People Entwistle Appointed Surgical Director of Cardiac Transplantation
John Entwistle III, MD, PhD, has joined the Division of Cardiothoracic Surgery as surgical director of cardiac transplantation and mechanical circulatory support. He has also been named associate professor of surgery at JMC. Entwistle previously served as associate professor of cardiothoracic surgery at Drexel University College of Medicine.
Reeves Joins Jefferson Heart Institute Faculty
Gordon R. Reeves, MD, has joined the Division of Cardiology as a member of the Advanced Heart Failure and Cardiac Transplant Team at the Jefferson Heart Institute. He has also been named assistant professor of medicine at JMC. Reeves has been with Jefferson since 2008 as a fellow in cardiovascular medicine and then as a fellow in advanced heart failure and cardiac transplant. He holds a master’s degree in physical therapy and worked as a physical therapist prior to attending medical school.
Hurwitz Joins Department of Radiation Oncology
Mark Hurwitz, MD, has been named vice chair for quality, safety and performance excellence and director of thermal oncology of the Department of Radiation Oncology. Hurwitz is a widely recognized leader in the fields of thermal medicine and genitourinary oncology and previously served as director of regional program
development for radiation oncology at the Dana-Farber/Brigham and Women’s Cancer Center. Hurwitz is the first to hold these new positions as part of Jefferson’s efforts to continue its strong focus on quality assurance and patient safety in radiation oncology and other disciplines and expand upon promising treatment techniques.
Cristofanilli Named Breast Care Center Director
Massimo Cristofanilli, MD, has been appointed director of the Jefferson Breast Care Center. With more than 25 years of clinical, basic science and educational experience, Cristofanilli will also serve as deputy director of translational research at the KCC. Prior to joining Jefferson, he served as chairman of medical oncology and head of the Inflammatory Breast Cancer Clinic at Fox Chase Cancer Center. Cristofanilli is a widely recognized leader in the translational research and treatment of inflammatory breast cancer, the rare and aggressive form of breast cancer in which cancer cells block lymph vessels in the skin of the breast. He also has expertise in the development of novel diagnostic and prognostic markers in primary and metastatic breast cancer.
Headlines Meditation, Art Therapy Reduce Anxiety
A study from the Jefferson-Myrna Brind Center of Integrative Medicine combined creative art therapy with a Mindfulness-
based Stress Reduction program for women with breast cancer and showed changes in brain activity associated with lower stress and anxiety after the eight-week program. Lead author Daniel Monti, MD, Brind Center director, says, “Our goal was to observe possible mechanisms for the observed psychosocial effects of Mindfulness-based Art Therapy by evaluating the cerebral blood flow changes associated with an MBAT intervention in comparison with a control of equal time and attention. This type of expressive art and meditation program has never before been studied for physiological impact and the correlation of that impact to improvements in stress and anxiety.” Improvements in anxiety levels and changes in cerebral blood flow suggest that the program helps mediate emotional responses in breast cancer patients. The study appeared in the December 2012 issue of Stress and Health.
Pathways Drive Metastatic Prostate Cancer
Led by Karen E. Knudsen, PhD, deputy director for basic science at the KCC, researchers have discovered that elevated levels of Cyclin D1b could function as a novel biomarker of lethal metastatic disease in prostate cancer patients, according to a pre-clinical study published Dec. 21, 2012, in the Journal of Clinical Investigation. The group found that Cyclin D1b, a variant of the cell cycle regulator Cyclin D1a, functions independently of the cell cycle to promote metastasis in both early and late stage prostate cancer. Cyclin
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D1b regulates a large gene network, the researchers discovered, which was shown to cooperate with androgen receptor (AR) signaling to fuel metastatic progression in multiple models of prostate cancer. “Identification of AR-driven pathways that mediate metastatic progression represents a significant leap forward in our attempts to effectively manage prostate cancer progression,” Knudsen says.
these new drugs with radiation has been limited. Here, we have put together a road map to help overcome obstacles and speed the development of new pipeline drugs with radiation,” Lawrence says. “These guidelines explicitly explain how much evidence is needed to go forward from the lab into the clinic, and furthermore how to design the clinical trials in humans.”
New Guidelines Help Expedite Cancer Drugs
A study led by William B. Young, MD, a neurologist at the Jefferson Headache Center, shows that patients with migraines suffer social stigma similar to the stigma experienced by patients with epilepsy. The study, which appeared on Jan. 16, 2013, in the online journal PLOS ONE, is one of the first to examine the social cost of this frequently debilitating and misunderstood illness. The authors conclude that the high level of stigma for chronic migraine sufferers is due to the impact of migraine on the study subjects’ work lives: Chronic migraine has a bigger impact on the work of migraine patients than epilepsy has on the work of epilepsy patients. “I don’t think people realize that it is not unusual for people with migraine to have severe headaches every day — to be so disabled that they are unable to work,” Young said. “This is what causes the stigma — the fact that people with severe migraine may not be able to work.”
Researchers from the translational research program of the National Cancer Institute and the Radiation Therapy Oncology Therapy Group have developed new guidelines to help fast-track the clinical development of targeted cancer drugs in combination with radiation therapy. The guidelines, published in the Journal of the National Cancer Institute with lead author Yaacov Richard Lawrence, MRCP, adjunct assistant professor in Jefferson’s Department of Radiation Oncology and director of the Center for Translational Research in Radiation Oncology at Sheba Medical Center in Israel, offer steps in the preclinical and early phase clinical trial process to get well-studied and novel targeted agents into the clinic more quickly. Over the last decade, molecular agents that target cellular survival and growth have been developed but alone have had modest effect on improved survival. Combining them with radiation therapy, however, has the potential to improve cure rates. “There is very promising laboratory data out there, but the clinical development of
Migraines Cause Social Stigma
Interventions Increase Colorectal Cancer Screening Rates Ronald E. Myers, PhD, director of the Division of Population Science in the
Department of Medical Oncology, and researchers from the KCC have discovered that patients are much more likely to get screened for colorectal cancer if urged by a mailing or a phone call. The team performed a randomized, controlled trial to test the impact of a new preferencebased navigation intervention — as opposed to standard mailing or usual care — on screening rates. A third of patients received a “tailored” phone call to encourage them to perform their preferred screening test (colonoscopy vs. at-home blood stool test), plus a mailing of preferred information; another third were sent information on colonoscopy and a stool blood test kit; and the last third received no intervention. Patients who received a phone call and/or mailing were almost three times as likely to undergo screening six months later compared to those who had no intervention. The study was published in the January 2013 issue of Cancer Epidemiology, Biomarkers and Prevention.
Medical Frontiers Patient-Centered Practice Receives National Recognition
Jefferson Medical Care-South Philadelphia, a primary care practice, has received accreditation from the National Committee for Quality Assurance as a Patient-Centered Medical Home, showing its commitment to evidence-based, patient-centered care that focuses on coordinated and long-term collaborative patient-physician partnerships.
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Anatomy of an Upgrade:
Jefferson Opens High-Tech Dissecting Facility Over time, the structure of the human body hasn’t changed much — but technology certainly has. To ensure that students have access to the most state-of-the-art tools when learning anatomy, Jefferson unveiled a brand-new dissecting facility at the beginning of this academic year. The 32,200-square-foot facility includes six separate dissecting rooms equipped with high-definition monitors that allow students to explore the complex architecture of the human body in a modern way. Activity from any one of the rooms can be streamed into the others for a shared learning experience, and computers at each dissecting table are loaded with anatomical education and reference software. Located on the second floor of Jefferson Alumni Hall, the facility’s multi-room layout provides significant advantage over the previous facility on the building’s fifth floor, where all dissections were performed in a large, open space. This resulted in faculty members “getting pulled in all directions,” according to Richard R. Schmidt, PhD, vice chair of educational development in the Department of Pathology, Anatomy and Cell Biology. Now, professors are assigned to individual rooms, enabling them to focus on the same group of students for the duration of a class. “As you can imagine, the new layout also keeps things a lot quieter. Instead of some 150 students in the same room, we now have 40 or less,” Schmidt says. Additional features include enhanced storage, freezer and instrument cleaning facilities; improved air circulation; a new embalming room; and a pro-section room for filming dissections. Forty-six dissections can take place simultaneously. “I’ve enjoyed watching students’ reactions,” Schmidt says. “Our newest students never had an opportunity to work in our old facility, but I’ve seen some very wide eyes from third- and fourth-year students when they walk into the space for the first time.”
Students perform dissections in the new facility. Photos by Sabina Pierce.
Schmidt says cadaver dissection experience remains essential during undergraduate medical education, regardless of ongoing developments in simulation technology. In fact, although two influential medical schools — Harvard and the University of California, San Francisco — began scaling back general anatomy instruction several years ago, both have since reversed that decision. “In today’s world, there are efforts to teach anatomy without dissection by using things like pro-section, computerized models and simulation. But there is really no substitute for actual dissection,” he says. “Dissection is the foundation for simulation and all other learning. If you have never been exposed to
anatomy through dissection, you won’t get as much out of simulation.” And by using human cadavers, students learn more than just anatomy, according to Susan Rattner, MD, associate dean for undergraduate medical education. “While anatomy simulation technologies continue to evolve, we are teaching about respect and appreciation for life as much as we are teaching about the human form,” she says. “The new dissection facility offers a positive environment that launches students in their studies while valuing everyone involved — students, faculty and the donors themselves.” — Karen L. Brooks
28 Jefferson Medical College Alumni Bulletin
10 Questions with...Charles J. Dunton, MD ’80 Charles Dunton believes that at some point in your life you should give back. After beginning his OBGYN residency at Lankenau Medical Center Dunton decided he wanted to care for seriously ill women-specifically, women with cancer. He finished his residency and completed an oncology fellowship at the University of Pennsylvania. He decided to give even more when the Society of Gynecologic Oncologists contacted him last year with an offer to join a volunteer effort to teach in Honduras through the organization Health Volunteers Overseas, or HVO. “The idea of teaching local healthcare providers, rather than just
seeing patients, made a lot of sense to me,” Dunton says. During his week-long trip to Honduras this past August, Dunton was impressed with the high level of knowledge the healthcare providers had but surprised by their inability to deliver the best medicine because of social constraints. “They don’t have the screenings we have, so you see a lot of advanced cancers,” he says. “We had to go back in time, think how we treated patients 30 to 40 years ago, and make do with what we had.” With about 2.1 million women at risk, it’s estimated there are more than 3,300 cases of cervical cancer in Honduras,
representing 40 percent of cancer in the nation. If the United States experienced similar rates, we would see more than 150,000 cases of cervical each year. Instead, due to screening and treatment, there are only about 12,000 U.S. cases annually. Since returning home, Dunton has remained involved with the Honduran physicians he met, talking to them via Skype in a monthly tumor board. He also hosted a Honduran physician who came in April to observe him at Lankenau, where he’s now director of gynecologic oncology. Dunton says HVO is constantly in need of healthcare professionals in all fields to train their counterparts in foreign countries.
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Photo by Sabina Pierce.
Dunton answers 10 questions about his career. 1. W hat don’t people know about your field that you wish they did? The importance of HPV (human papillomavirus) vaccines in prevention of cervical cancer. There needs to be more widespread use. 2. W hat advice would you give to your 25-year-old self? Make sure to study basics well so you don’t have to relearn them. 3. I f you weren’t a physician, what would you be? A writer.
4. W hat is your biggest pet peeve? People who get on the elevator without letting you off first.
8. W hat is the proudest moment in your career? Graduation from JMC with my parents.
5. W hat’s on your bucket list? To write a book and visit Sweden — I’ve always wanted to visit Scandinavia.
9. W hat is the most adventurous thing you have ever done? Sailed the Caribbean during medical school with five other 1980 graduates.
6. If you had a theme song, what would it be? “Mr. Bad Example” by Warren Zevon. 7. D escribe yourself in three words. Dedicated, funny, family man. I have a son and a daughter, McCrea and Brittany.
hat gets you out of bed in the 10. W morning? The mortgage and tuition payments! — Elizabeth Seasholtz
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George Tibbens reports he is “still kicking at 91 years old — but not too high, because life is becoming difficult” at his age. Tibbens lives in Washington, Pa.
Philip Dunn retired from practice in 1993 but remains active living on his farm in Huntingdon, Pa. He has been married to his wife, Dorothy, for 65 years.
Irwin M. Potash continues to practice occupational medicine at the Airport and Port of Miami medical clinics he established in 1965 but stopped practicing trauma surgery in 1987. Potash plays golf and tennis and goes to gym regularly. He has been married to his wife, Linda, for 57 years, and says he hopes to attend his 60th reunion this fall. Robert J. Rubin has been retired for more than 12 years and enjoys fishing, reading and attending concerts. He lives in Watchung, N.J., and is looking forward to his 60th reunion.
John W. Holdcraft writes that he is proud of his daughter, Suzanne Holdcraft, MD ’83, and granddaughter, Emily Sherrad, who is in her second year at JMC, making it three generations at Jefferson. Holdcraft is still playing golf at 93 and lives in Mickleton, N.J.
Richard E. Eshbach reports that he and his wife are selling their home in Greece and plan to move back to Doylestown, Pa., area. Morren J. Greenburg is still practicing family medicine in the office and works part time in corporate health. He lives in Hermitage, Pa.
Charles McDowell is a clinical professor of orthopaedic and plastic (hand) surgery at the Medical College of Virginia. He also teaches and does reconstructive surgery for patients with cervical spinal cord and brain injuries at the McGuire Veterans Administration Hospital in Richmond, Va.
Henry Gelband is professor and vice chair of pediatrics at the University of Miami School of Medicine. He stays busy keeping up with his three sons and four grandchildren and participating in outdoor activities. Gelband lives in Key Biscayne, Fla. Robert C. Nuss recently retired after 40 years with the University of Florida College of Medicine, where he served as dean of the regional campus in Jacksonville for 10 years. He remains active serving on the Florida Board of Medicine and enjoys fishing and woodworking.
Dale C. Brentlinger retired from practicing internal medicine in June 2012. He writes that he is looking forward to attending reunion weekend in October. Robert M. Davis is continuing his work in Ghana, where he is helping to build a fish processing plant. His home is in York, Pa.
Robert E. McBride retired in 2004 from Pathology Consultants Inc., which he founded with his brother and consisted of 23 pathologists at the time of his retirement. McBride lives in Valparaiso, Ind.
Stanton I. Moldovan and his wife, Cheryl, visited Carl Stanitski, MD ’67, last summer in Charleston,
S.C. The Moldovans live in Houston and are planning to build a second home on Kiawah Island in South Carolina. Anthony M. Padula was the recipient of the 2012 Cristol Award from the Philadelphia County Medical Society. The award recognizes dedication in furthering and enhancing the educational, scientific and charitable goals of organized medicine. He is also a member of the Pennsylvania delegation to the American Medical Association. He lives in Philadelphia. Don Weiser is still doing research at Midwest Institute for Clinical Research in Indianapolis, Ind., where he lives. James Sumerson retired from practicing otolaryngology in July 2011. He enjoys reading, traveling, playing his guitar and banjo and spending winters in Puerto Rico. He lives in Cherry Hill, N.J.
Thomas J. Gal retired four years ago from the University of Virginia as a professor of anesthesiology and says he is enjoying the freedom and flexibility that comes with emeritus professor status. Gal is busy overseeing the restoration of his ’69 BMW 2002, which he calls his “oldest child.” He is eagerly anticipating a return to Philadelphia in October to visit his JMC classmates at their 45th reunion. William J. Dennis is practicing pediatrics at a more leisurely pace at Valley Pediatrics in Warminster, Pa. Dennis enjoys teaching medical students as well as spending time with his grandchildren.
Vincent T. Randazzo retired in January 2012 after practicing internal medicine for 36 years. He and his wife, Phyllis, often visit their daughter Chrissy and grandson in Cherry Hill, N.J., and travel frequently to Colorado to visit their daughter Paula and other two grandchildren. He looks forward to seeing his classmates again at their 45th medical school reunion in 2014.
James G. McBride lives in Bethlehem, Pa., and works four days a week but is taking time to pursue a second career in music.
Anthony J. Calabrese continues to practice gastroenterology in Annapolis, Md. He plays the clarinet and saxophone and is part of an 18-piece band. He enjoys spending time with his grandchildren. Robert E. Steward practices general surgery at Clearfield Hospital in Clearfield, Pa.
Paul and Deborah Bialas continue to practice internal medicine in Warren, Pa. Their daughter Nicole Harrison, MD ’02, has joined their practice, and their daughter Bridget Flickinger, MD ’05, works in in emergency medicine in State College, Pa.
Joseph R. Berger lives in Lexington, Ky., with his wife, Sandy. He writes that his oldest son has completed a plastic surgery residency at Stanford; his middle son is a federal prosecutor in Miami; and his youngest daughter is trying to break into theatre in New York.
SPRING 2013 31
William J. Gibbons practices internal medicine at Holy Redeemer Hospital in Meadowbrook, Pa. He lives in Southampton, Pa.
Larry R. Glazerman recently relocated back to the Philadelphia area for a position at Main Line Health’s Lankenau Hospital in the obstetrics and gynecology department.
Marc Zubrow is vice president for telemedicine with the University of Maryland Medical System. He lives in Wilmington, Del.
Harry Chaikin has sold his Brigantine, N.J., primary care internal medicine practice to Atlantic Care Health System. He reports that he is a happy employee without many of the business worries that previously kept him up at night and says he enjoys caring for his patients now more than ever. Carol A. Love says that at age 66, she is enjoying working three half days per week. Love lives in Penn Valley, Pa. Patricia Petrozza recently received the Distinguished Faculty Award at Wake Forest School of Medicine, where she is associate dean for graduate medical education and professor of neuroanesthesiology. She lives in Statesville, N.C.
Kathleen Quadro reports that she enjoys working in urgent care. She lives in Carmichael, Calif.
Rudolph T. DePersia Jr. practices internal medicine in Woodbury, N.J., and lives in Haddonfield, N.J.
Alumni Association President’s Message It was on my bucket list. Visit the Holy Land. Then one day in the endoscopy unit, our usual anesthesiologist was replaced by a cheerful man with an interesting accent. I learned he was from Israel and introduced myself. I asked, “Dr. Grunwald, could you please show me a trail of breadcrumbs to follow so I can visit Israel and leave safely?” He said, “I can do better. I’ll take you there myself!” And a new friendship was born. Dr. Zvi Grunwald is probably the most optimistic person I know. Even when a patient’s oxygen saturation starts to fall, he quips, “No problem. No one is holding a gun to your head. We can fix this.” I guess when you grow up in Israel, every day that you don’t hear sirens is a good day. Zvi and his wife, Hava, planned the trip of a lifetime to Israel for 20 Jeff physicians and some of their family members. We started at the Mount of Olives. Now I know where Judgment Day will take place. A lot of people ask to be buried there so they will be first in line. Personally, I prefer to be in the back. That way, when the Lord gets tired, I’m hoping he’ll say, “OK, just go in the door to heaven.” Our tour guide, Naftali Shoshany, actually had a PhD in tourism. He was an expert in archeology, geography, history, theology, philosophy, congeniality and then some. At each stop, he gave the entire history of
the site from the Jewish, Christian and Muslim perspectives. CME lectures given on the bus were peppered throughout the trip. We learned about Jeff Joseph’s fascinating research with the artificial pancreas just before we floated on the Dead Sea. We placed our petitions in the Wall of Lamentations and later we were updated on celiac disease by Jay DiMarino. After a tour of the simulation center in Tel Aviv, Charlie Yeo informed us of recent advances in pancreas surgery. The “Consult Guys” Geno Merli and Howard Weitz tried to stump us, but we all felt renewed when we were “baptized” in the River Jordan. We dined under the stars with “Abraham and Isaac” and broke bread at a kibbutz. One very special night, we feasted on a waterfront dock then shimmied the night away with a belly dancer while floating on a boat on the Sea of Galilee! We had our picture taken in the “trenches” of the Golan Heights, so we could send it back to the dean and tell him we felt at home. As a Catholic, I found that tracing the footsteps of Jesus as we walked the Via Dolorosa (Latin for “Way of Grief”), the path to the Crucifixion, was a moving experience. It was a powerful feeling when I stood at the foot of the cross, but the life-changing moment came when I placed my hands on the stone where His body lay, when it was taken from the cross and prepared for burial. Our final day included crossing the border into Jordan. We visited Petra, the home of Indiana Jones’ Temple of Doom. I was definitely “Petra-fied” when I was riding that camel! This special experience was made exceptional because Zvi, our Jeff colleague, was our Israeli travel agent. Equally memorable was the result of the experience. While visiting this birthplace of religion for much of mankind, 40 friends from Jefferson became a family. What’s that, you say … a Jefferson Travel Club? Count me in!
Marianne T. Ritchie, MD ’80 President, JMC Alumni Association
32 Jefferson Medical College Alumni Bulletin
Annual Alumni Winter Meeting
Richard Greco is senior partner of the Georgia Institute for Plastic Surgery in Savannah, Ga.
Judith J. Dennis reports that after 20 years working the emergency department night shift, she is now the owner and medical director of the Roswell Urgent Care Center in Roswell, Ga.
Fellow Alumni, One day my friend and classmate Lou Broad, MD ’74, called me and asked, “Do you want to meet at the Jefferson Alumni Ski Meeting this year? It’s at Whistler.” “Sounds great,” I said. “But what is a Jefferson ski meeting?” He told me he had been on a few of these annual meetings and they were great! Educational, lots of fun and a relaxed opportunity to interact with some very interesting and bright Jefferson colleagues. The course is titled “What Every Health Professional Should Know” with a goal of giving all specialties nuggets they can use in their practice. A chance to catch up with my old friends, ski and pick up some pearls while earning CME – this seemed too good an opportunity to pass up. I immediately answered, “Sure!” That was 10 years ago, and I’ve attended every one since then. We’ve been to Deer Valley, Big Sky, Snowmass and next year will be at the Ritz-Carlton Northstar (Tahoe). The organizers consistently identify magnificent properties that are five-star, ski-in/ski-out, with tremendous discounts on room rates, lift tickets, rentals and spa. I’ve skied with a bunch of great people including a few deans, snowboarded with Dick Schmidt from anatomy and learned a fair amount every year that I can use in my GI practice. Every year the course features a broad spectrum of interesting topics covered by experts in their field. For instance, besides covering heart disease from prevention to transplant and diagnosis and management of headaches, some highlights of the last few years were high altitude sickness, avalanche safety, “The Gross Clinic” and the story behind its sale, Dean Tykocinski’s vision for Jefferson’s future and the annual and highly spirited “Raft Debate.” Besides learning together, there is ample opportunity for socializing with our colleagues and families, culminating with a big night out, when we take over a local restaurant and share an excellent culinary experience. I would personally recommend this course to anyone who likes to ski and/or ride and/or would just like to connect with their Jefferson roots! Even if you don’t ski, this meeting is always in a beautiful setting in a great resort, with lots of outdoor and indoor activities available.
Ed Share, MD ’74
Michael Yao has been named senior vice president of clinical affairs and national medical director for Golden Living, a family of companies providing services including rehabilitation, home care, assisted living, nursing care, pharmacy and hospice care. Yao lives in Pittsburgh and has served in a variety of capacities with Golden Living for the past 10 years.
Craig G. Richman has been promoted to medical director of the Meadows Palliative Care Center near State College, Pa. His promotion occurred just after he had brain surgery, which was performed by James Evans, MD, of Jefferson’s Department of Neurological Surgery. He lives in Chalfont, Pa., and says he feels blessed with his improved health, loving family and support from Jefferson.
Spyros G. Mezitis is an assistant professor of clinical medicine/ endrocrinology at Weill Medical College of Cornell Medical Center in New York City. He also is a consulting endocrinologist at New York Presbyterian Hospital in Manhattan.
Douglas T. Corwin married Lucy Northrop in June 2012. The couple lives in Washington, Pa. Mark H. Schutta recently was honored with an endowed chair and promoted as the G. Clayton
SPRING 2013 33
Kyle Associate Professor of Medicine at the Hospital of the University of Pennsylvania, where he also serves as medical director of the Penn Rodebaugh Diabetes Center. Schutta and his wife, Eunkyung Kauh, MD ’96, PhD, live a few blocks from Jefferson’s campus with their 6-year-old son, Benjamin.
Mahesh Krishnan is vice president of clinical research for DaVita Healthcare Partners and lives with his wife and children in McLean, Va. Suken Shah was recently appointed division chief of the Spine and Scoliosis Center at Nemours/A.I. duPont Hospital for Children in Wilmington, Del., and has been promoted to associate professor of orthopaedic surgery and pediatrics at JMC. Shah lives in Greenville, Del.
Christopher C. Cooke is in his 11th year as a partner with Orthopedic Associates of Lancaster in Lancaster, Pa., the practice his father, Albert J. Cooke, MD ’64, founded 40 years ago. Cooke has been named chief of orthopaedics at Lancaster General Hospital.
Alicia Sanchez and Ignacio Echenique recently moved to Chicago after finishing their residencies at Brown University. Echenique has started an infectious disease fellowship at Northwestern, while Sanchez now works at Northwestern Urgent Care. They look forward to keeping in touch with alumni in the area.
Thea and John Dalfino welcomed their fourth child, Evora Rose, on Sept. 8, 2012. The family lives in Rensselaer, N.Y.
Bryan D. O’Connell is working in general internal medicine at Abington Memorial Hospital in Abington, Pa.
A Luscious Collection of Philadelphia’s Favorite Recipes
Deborah K. Witt was recently recognized for her work by Pennsylvania Governor Tom Corbett at a Black History Month event in Harrisburg. Witt, assistant professor of family and community medicine at JMC, is CFO and medical director of Glory Unlimited Evangelistic Ministries International and organizes volunteer medical teams to travel abroad to provide medical services to underserved communities including Montego Bay, Jamaica; Kenya, Africa; and Croix-des-Bouquets, Haiti. She lives in Wilmington, Del.
From the Women’s Board of Thomas Jefferson University Hospital
Copies now available. Order yours today. Fill out an order form or order online by visiting our website at: www.JeffersonHospital.org/womensboard
Jonathan Harris writes that he enjoys his general internal medicine practice in Bronx, N.Y. He resides in Rye Brook, N.Y., with his wife and two children.
At the Table
Send us your personal and professional updates for the Bulletin’s Class Notes! Contact Toni Agnes at 215-955-7751 or email@example.com. Mail to: Toni Agnes The Jefferson Foundation 925 Chestnut St., Suite 110 Philadelphia, PA 19107
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34 Jefferson Medical College Alumni Bulletin
George W. Hager Jr., 94, of Cherry Hill, N.J., died Feb. 28, 2012. Hager served as a U.S. Army Captain during World War II and was a recipient of the Silver Star, the Bronze Star and the Purple Heart. He was a psychiatrist with Cooper Medical Center and in private practice. He served on the Haddonfield, N.J., school board for 15 years. Hager is survived by his wife, Ingrid, and two children, George W. Hager III, MD ’72, and Bethanne Weibling.
William Francis Dowdell, 89, died Aug. 5, 2008, in Parma, Ohio. After completing his internship, he served as a captain in the U.S. Army from 1946 to 1948. Following service, he completed a residency in internal medicine at Crile VA Hospital and a fellowship in rheumatology at City Hospital, both in Cleveland, Ohio. He was in private practice from 1953 until his retirement in 1989. He is survived by his wife, Ann; four children; and 12 grandchildren. John T. (Jack) McGeehan, 93, of West Brandywine, Pa., died Dec. 22, 2011. McGeehan served as a U.S. Army physician in Austria at the end of World War II, then practiced general surgery and subsequently radiology in St. Mary’s, Pa., for many years. He also was a radiologist at Geisinger Medical Center in Danville, Pa. In his retirement, he enjoyed watching the Philadelphia Phillies, painting and traveling as much as possible. McGeehan is survived by two sisters, one brother, four sons, three daughters, six grandchildren and three great-grandchildren.
His wife, Elizabeth (Betty), and younger brother, William, preceded him in death.
Charles William Korbonits, 91, of West Chester, Pa., died Jan. 7, 2013, at Chester County Hospital. Korbonits was an obstetrician/ gynecologist in West Chester for 40 years, retiring in 1992. He was on staff at the Chester County Hospital as well as Memorial Hospital and was the first president of the Chester County Cancer Society. He enjoyed traveling with his wife, June, and loved trivia and history. In addition to June, he is survived by his children, Bill, Patricia, David and Robert; eight grandchildren; and four greatgrandchildren. He was preceded in death by his sister, Lillian.
John Riggs Evans, 93, of Santa Ana, Calif., died Dec. 8, 2012. Evans moved to Southern California in 1951 for a residency at Harbor UCLA General Hospital in Torrance, Calif. In 1957, he established an internal medicine practice in Orange, Calif., where he continued to work until his retirement in 1993. Evans is survived by his wife of 62 years, Ruth; five children, Barbara Openshaw, John Robert Evans, MD ’82, Richard Evans, MD ’84, Carol Day and Michael Evans; 19 grandchildren; and one great-grandchild.
Harold J. Reinhard, 88, of Russell, Pa., died Jan. 13, 2013, of Merkel cell carcinoma. Reinard served his internship at St. Vincent’s Hospital in Bridgeport,
Conn., and his psychiatric residency at Warren State Hospital in Warren, Pa. He held various positions at Warren State Hospital, ultimately serving as superintendent from 1970 to 1981. Reinhard was on the boards of many medical societies and associations and was an adjunct associate professor of psychiatry at the University of Pittsburgh. The American Psychiatric Association honored him with its Life Distinguished Fellow Award. In 1981, Reinhard moved with his family to Green Bay, Wisc., and entered private practice. He was on the staff of four hospitals in Green Bay and was director of adult psychiatric services at Bellin Psychiatric Center. After retiring in 1991, he returned to Russell, Pa., and served on the Mental Health and Mental Retardation Advisory Board for the Department of Human Services. He is survived by five children, Sheila, Ellen, Kerry, Jerome and Michael; nine grandchildren; three great-grandchildren; and numerous nieces and nephews. He was preceded in death by his wife, Eileen; his youngest son, Mark; and two brothers. Dean C. Shore, 82, of Morristown, N.J., died Jan. 31, 2011. Shore joined the U.S. Air Force in 1954 and was stationed in Chester, England. He began his private medical practice in Morristown in 1958 and retired in 1995. He is survived by his wife of 50 years, Julie; and two sons.
Allan W. Lazar, 80, of Teaneck, N.J., died Aug. 23, 2012. He spent the first half of his career as a
pathologist on the faculty of the University of Chicago and Columbia College of Physicians and Surgeons, where he spearheaded groundbreaking cancer research programs. He also served as a pro bono adjunct professor at Fairleigh Dickinson University Dental School. Later, he founded a successful diagnostic pathology laboratory in Englewood, N.J. He shifted his focus to bariatric medicine in the second half of his professional career. Lazar is survived by his wife, Edna; and nine children.
Irving M. Melnick, 81, of Naples, Fla., died Nov. 28, 2012. After completing his residency in urology, Melnick settled in Danville, Va., in private practice for 30 years. He also served for several years as president of the medical staff of the Danville Regional Medical Center and subsequently sat on its board of directors. He is survived by his wife of 56 years, Elaine; and four children.
David Michael Perlmutter, 43, died suddenly on June 5, 2012. Perlmutter was an interventional radiologist at Virginia Radiology Associates and also worked at Prince William and Fauqiuer Hospitals. He is survived by his wife of 17 years, Lori Suzanne Snyder, MD ’95; two sons, Grant Alexander and Max Evan; and his parents, Phyllis Perlmutter and Paul Perlmutter, MD. Perlmutter’s father-in-law was also a JMC graduate, Joseph Snyder, MD ’62.
SPRING 2013 35
James Hunter, MD ’53 Renowned Hand Surgeon James M. Hunter, MD ’53, distinguished professor of orthopaedic surgery at JMC, died of heart failure Jan. 29, 2013, at age 88. Hunter worked at Jefferson for about 50 years, focusing on surgery of the hand and upper extremity as well as the previously untapped science and practice of hand therapy. In the late 1950s and early 1960s, he developed the first artificial tendon for use in reconstructing hands. The device, the Hunter Tendon Prosthesis, is named for him. He was awarded the first fellowship in hand surgery by Columbia University in 1959 and was instrumental in the creation of the “bible” of hand surgery and therapy, Rehabilitation of the Hand and Upper Extremity, now in its sixth edition. Hunter was a founding member of the Hand Rehabilitation Foundation of Philadelphia and the “Philadelphia Meeting,” where hand surgeons from around the world gathered and under which Hunter mentored some 150 fellows in hand surgery and 8,000 hand surgeons and therapists. In 1995, the Congresses of the International Federation of Societies for Surgery of the Hand bestowed its highest honor on Hunter, naming him one of its “pioneers of hand surgery” at the Sixth International Congress Helsinki, Finland. His longtime friend and colleague, Phillip Marone, MD ’57, MS ’07, said Hunter helped train him at Jefferson in the 1950s. Marone, associate dean of alumni relations at Jefferson, remembers Hunter as “the ultimate physician, clinician, educator and researcher.” “I miss him as a teacher, mentor and colleague and a great person,” Marone said. “He was the nicest person you would ever run into.” Hunter was an avid sailor and a musician. He played the upright bass with jazz artists around Philadelphia and was in a jazz band known as the Red Peppers, featuring other area physicians. He also played the tuba. He is survived by his wife, Margaret; two sons, Gary and Jeffrey; a daughter, Kimberly; three grandchildren; and a sister. He was predeceased by his first wife, Carolyn.
36 Jefferson Medical College Alumni Bulletin
continued Leonard Apt, MD ’45 Expert in Childhood Blindness Leonard Apt, 90, of Los Angeles, died Feb. 1, 2013, after a brief illness. Apt was professor emeritus of ophthalmology and founding chief of the Division of Pediatric Ophthalmology and Strabismus at the David Geffen School of Medicine at the University of California, Los Angeles. He trained in pediatrics, pathology and ophthalmology at Harvard, the University of Cincinnati and the National Institutes of Health. Apt devoted his career to preventing blindness in children. As the first physician certified by both the American Board of Pediatrics and the American Board of Ophthalmology, he joined the UCLA faculty in 1961. The co-founder of the UCLA Center to Prevent Childhood Blindness, he invented diagnostic tests (the Apt Test is now used worldwide in newborns) and surgical instruments and identified new diseases. Together with longtime collaborator Sherwin Isenberg, MD, Apt identified povidone-iodine as a safe topical antimicrobial agent. Prior to their research, no previous studies provided a standard for sterilizing the surface of the eye before surgery. Known commercially as Betadine, the eye drop is now used throughout the world to prepare patients for eye surgery and prevent infection. Apt and Isenberg also demonstrated that Betadine was safer, cheaper and more effective than silver nitrate or antibiotics in preventing eye disease in newborns. To honor Apt’s accomplishments, the American Academy of Pediatrics created an annual lecture in his name. He is survived by two nephews and was preceded in death by three sisters.
Elliott Mancall, MD Neurology Professor at JMC Elliott Mancall, MD, 85, emeritus professor of neurology, died Jan. 2, 2013. Mancall received his MD from the University of Pennsylvania and trained at Hartford Hospital in Connecticut, the Neurological Institute of New York at Columbia Presbyterian Medical Center and Massachusetts General Hospital. A Fulbright Scholar, he also worked as clinical clerk at the National Hospital for Nervous Diseases, Queen Square, London. Mancall became an associate professor at JMC in 1964 and a year later joined Hahnemann Medical College as a professor of medicine. In 1976, he became founding chair of the neurology department at Hahnemann, a position he held for 18 years. He then returned to Jefferson and from 1997 to 2003 served as interim chair of neurology. He became emeritus professor in 2005 but continued to teach medical students and neurology residents. Mancall’s research included neurological complications of chronic alcoholism and malnutrition and neurological manifestations of systemic malignancy. With his colleagues, he described progressive multifocal leukoencephalopathy (PML) as a complication of chronic lymphatic leukemia and Hodgkin’s disease. PML was later found to be present in other diseases as well, including AIDS and immunodeficiency disorders. He also described central pontine myelinolysis, a disease affecting the myelin sheath, the insulating cover of nerve cells, in the pons segment of the brain, induced by alcoholism, malnutrition and electrolyte imbalance. Recognition of these conditions has saved many lives. Mancall is survived by his wife of 59 years, Jacqueline Mancall, PhD; two sons, Peter C. Mancall, PhD, and Andrew Mancall, MD; and four grandchildren.
By Numbers Work and Stress May brings warmer days and, for many Americans, the promise of a slower pace as summer approaches. For those who do not experience a summer lull, May is themed “Revise Your Work Schedule Month.” Many studies have shown that the workplace is the greatest source of stress for adults in the United States — and that work-related stress has escalated steadily over the past few decades. Here are some figures pertaining to work and stress.
Americans who consider work the top source of stress in their lives:
2 in 3
Percentage of workers reporting “extreme” stress levels:
Number of Americans who miss work each day because of stress:
Average company cost due to stressrelated absenteeism:
per employee per year
Average length of professional leave for stress and its associated disorders:
Percentage more spent on health care by stressed employees than non-stressed employees:
Top 5 workplace stressors: Salary Unrealistic expectations
Lack of opportunity for growth/advancement Job insecurity
Sources: The American Psychological Association; the American Institute of Stress; and the National Institutes of Mental Health.
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Thomas Jefferson University's quarterly magazine for the medical college published continuously since 1922.
Published on May 1, 2013
Thomas Jefferson University's quarterly magazine for the medical college published continuously since 1922.