The Magazine of the Keck School of Medicine of USC | Summer 2011 Issue
KECK SCHOOL OF MEDICINE
Primary Care in the
Community New programs introduce students to community-based care
PA G E 1 4 - 1 6
Landmark study looks for genetic factors in Latino eye disease. PA G E 1 7 - 1 9
A New Normal
Support groups help patients, families deal with disease effects.
Shamie The new name for complex eye care in Beverly Hills.
Neda Shamie, MD
A leader in corneal transplantation techniques, Dr. Neda Shamie is an expert at managing the most complex corneal and ocular surface disorders, as well as complicated cataract surgeries.
Call today for a consultation (310) 601-3366
Associate Professor of Ophthalmology Medical Director, USC Doheny Eye Center, Beverly Hills
9033 Wilshire Blvd. (at Doheny Drive)
The Doctors of USC are faculty physicians at the Keck School of Medicine of USC, USC University Hospital and USC Norris Cancer Hospital.
USC Doheny Eye Center
SUMMER 2011 ISSUE
ON THE COVER 8
Putting Primary Care in the Community The Keck School of Medicine’s new community-based programs entice students to pursue careers in primary care Cover illustration: Medical students gain primary care experience at a variety of clinical settings throughout the Los Angeles area.
F E AT U R E S 14
Eye-Opening Research Landmark study reveals that Latinos have higher rates of eye disease
Adjusting to a New Normal Support groups help patients and families adjust to changes brought on by disease or treatment
Defending the Liver Researchers seek ways to protect the vital organ and to design new therapies
Ultimate Organization Scientists search for secrets of stem cell engineering, how the cells become feathers or bones
PROFILES 2 3 Anthony Senagore broadens services in colorectal surgery 2 4 Ashley Prosper aims to help people in tangible and important ways
D E PA R T M E N T S
Dean’s Message The Keck School of Medicine of USC builds healthy communities in many ways
In Brief Now in Beverly Hills; national cancer advisor; outstanding biomedical research; reaccreditation for residency program; and more
Keck in the News
Levan donates for scholarships; alumnus leaves bequest; and more A sampling of news coverage of the Keck School of Medicine 30
Where Can You Find The Doctors of USC?
Jane Brust Associate Senior Vice President for Health Sciences Public Relations & Marketing and Associate Dean
BOARD OF OVERSEERS
John E. Bryson, Chairman Edward P. Roski Jr., Vice Chairman Wallis Annenberg, Chairman, CEO and President Annenberg Foundation Peter K. Barker, Chairman of California JP Morgan Chase Gordon Binder, Managing Director Coastview Capital, LLC Eli Broad, Chairman and CEO Eli and Edythe L. Broad Foundation John E. Bryson, Chairman Emeritus Edison International Malcolm R. Currie, Chairman Emeritus Hughes Aircraft Company Kelly Day, Member The Rockefeller University Council Robert A. Day, Chairman W.M. Keck Foundation Helene V. Galen, Member USC Board of Trustees Elizabeth Garrett, Provost and Senior Vice President for Academic Affairs University of Southern California Stanley P. Gold, President and CEO Shamrock Holdings Inc. Ghada Irani Occidental Petroleum Corporation Howard B. Keck Jr., Director W.M. Keck Foundation Stephen M. Keck, Senior Vice President Trust Company of the West Kent Kresa, Chairman Emeritus Northrop Grumman Corp. John Kusmiersky, President The Brickstone Companies
J. Terrence Lanni, Chairman Emeritus MGM Mirage David Lee, Managing General Partner Clarity Partners James P. Lower, Partner Hanna & Morton, LLP Alfred E. Mann, Chairman and CEO Advanced Bionics Corp. Richard Merkin, President and CEO Heritage Provider Network Cecil L. Murray, Pastor (Retired) First AME Church C. L. Max Nikias, President University of Southern California Holly Robinson Peete, Co-Founder HollyRod Foundation Simon Ramo, Former Chairman KSOM Board of Overseers Edward P. Roski Jr., President and CEO Majestic Realty Co. Kathryn Sample University of Southern California Steven B. Sample, President Emeritus University of Southern California Steven Spielberg, Member USC Board of Trustees Wendy Stark, Editor Vanity Fair Gary L. Wilson, Chairman Manhattan Pacific Partners Selim K. Zilkha Zilkha Biomass Energy
Ina Fried Executive Director, Communications A S S I S TA N T E D I T O R
Sara Reeve ART DIRECTION
IE Design + Communications Hermosa Beach, CA CONTRIBUTING WRITERS
Ryan Ball, Martin Booe, Robin Heffler, Bob Kronemyer, Jon Nalick, Katie Neith, Alana Klein Prisco, Leslie Ridgeway, Carrie St. Michel, Imelda Valenzuela, Mary Ellen Zenka CONTRIBUTING PHOTOGRAPHERS
211 Photography, Ryan Ball, Jennifer Barberi, Philip Channing, Steve Cohn Photography, Patrick Davison, Pat Lassy, Carol Matthieu, Don Milici, Jon Nalick, Lisa Prosper, Ziva Santop, Van Urfalian, Bill Youngblood P H O T O S E R V I C E S C O O R D I N AT O R
Monica Padilla BUSINESS MANAGER
Elaine Sawitskas DISTRIBUTION
Eva Blaauw and Carol Matthieu !"#$%&"'(#()" is published twice a year by the Keck School of Medicine of the University of Southern California. Articles, artwork and photography may be reprinted only with permission. Please send all correspondence to: USC Health Sciences Public Relations & Marketing 1975 Zonal Ave., KAM 400 Los Angeles, CA 90033-9029 323-442-2830 firstname.lastname@example.org
Photo by Pat Davison
Carmen A. Puliafito, M.D., M.B.A., Dean
Message from the Dean
The concept of community is central to USC and the Trojan Family. Great universities are great – not in isolation – but within the communities they serve, local, national and global. At the Keck School of Medicine of USC, service to the community is a key part of our mission. CARMEN A. PULIAFITO, M.D., M.B.A.
Photo by Don Milici
Dean Keck School of Medicine of USC
This issue of Keck Medicine celebrates the opening of our clinical outpost on Los Angeles’ Westside, new programs to increase the experience of our medical students in the delivery of primary care, research that contributes to building healthy communities, and gifts devoted to the Keck School community. Inside the front cover of the magazine, you got a taste of the Westside marketing campaign that introduced the Doctors of USC Beverly Hills. Located at 9033 Wilshire Blvd. at Wetherly, our beautiful new office offers comprehensive diagnostic and treatment services initially focused on ophthalmology and urology/prostate cancer care. An on-site laboratory and pharmacy and valet parking are available for your convenience. You can see more details in our “In Brief” section. The new office in Beverly Hills is a part of the Keck School’s expansion of clinical services into the broader Los Angeles community beyond the USC Health Sciences Campus. A quick look at our standing feature on “Where are the Doctors of USC?” will acquaint you with our satellite locations in La Cañada and downtown Los Angeles. Watch for news of a coming location in Pasadena, as well. Wherever you live, your first contact for clinical care is often your primary care physician in the community. And the Keck School is increasing efforts to introduce our students to the challenges and rewards of community-based, primary care medicine. Our cover story highlights our Primary Care Community Medicine Program, which is being built with the support of a grant from the U.S. Health Resources and Services Administration. The program gives students a chance to see how doctors form longterm relationships with their patients while caring for a variety of health issues. One research program that already has had a major effect in the community is featured in our story “Eye-Opening Research.” The Los Angeles Latino Eye Study, which has been funded for more than a decade by the National Eye Institute, has benefitted more than 6,000 Latino adults whose vision was screened as part of the study. Results of the research are yielding lasting benefits nationwide from increased Medicare coverage of glaucoma screenings for Latinos and a visionscreening program launched by the American Academy of Ophthalmology. The eye study reflects community on a large scale. Read, too, about the value of community on a small scale, as support groups started by our physicians and staff members help our patients and their families adjust to life changes brought on by illness. And be sure to read about the gifts of generous Trojans Norman Levan – who pledged $8 million toward scholarships – and Carl Nemethi – who with his wife, Virginia, bequeathed $4.6 million to the Keck School. As always, we are grateful for the devotion of the loyal community that is the legacy of USC.
A Quick Look at news from the Keck School of Medicine and honors for Keck faculty, students and alumni.
Doctors of USC Opens New Location in Beverly Hills Ophthalmology and prostate cancer care among specialties offered to Westside patients
“This vital center brings the care and expertise of the Doctors of USC closer to Westside communities.”
The University of Southern California (USC) is bringing its world-class medical expertise in ophthalmology and urology/prostate cancer to Los Angeles’ Westside with the opening of the Doctors of USC Beverly Hills. The Doctors of USC Beverly Hills – affiliated with the Keck School of Medicine of USC – is located in suites 300 and 500 of the Archway Medical Plaza building, at 9033 Wilshire Blvd. at Wetherly. The new 14,195-square-foot location offers the latest treatments from top specialists in three key areas of medicine, said Keck School Dean Carmen A. Puliafito, M.D., M.B.A. “This vital center brings the care and expertise of the Doctors of USC closer to Westside communities,” said Puliafito, who is one of several physicians who sees patients at the new location. “The Doctors of USC Beverly Hills center is a dramatic demonstration of the Keck School of Medicine’s commitment to advancing the art and science of medicine for our local community. It is an extension of USC’s academic medical center, one of two such centers in Los Angeles.” For appointments, The Doctors of USC physician practice group is associated with the USC-owned please call: USC University Hospital and USC Norris Cancer Hospital. Neda Shamie, M.D., a leader in corneal transplantation, serves as medical Doheny Eye Center director of the USC Doheny Eye Center, affiliated with the top-ranked Doheny Eye 310-601-3366 Institute. Puliafito, an expert in macular degeneration, also sees patients at the USC USC Norris Westside Doheny Eye Center. Cancer Center Leading oncologist David Agus, M.D., sees patients in the USC Norris Westside 310-272-7640 Cancer Center, affiliated with the National Cancer Institute-designated USC Norris Comprehensive Cancer Center. Inderbir Gill, M.D., executive director, USC InstiUSC Institute tute of Urology, also sees patients at the new Beverly Hills location. of Urology The initial focus at The Doctors of USC Beverly Hills is on ophthalmology and 323-865-3700 urology/prostate cancer care, providing a complete range of sub-specialties to deliver comprehensive diagnostic and treatment services. Advanced care is offered through cutting-edge therapies and clinical trials, as well as continuing medical education for community physicians. The center features well-appointed patient exam and treatment rooms, an on-site laboratory and pharmacy, and valet parking. The USC Boardroom, the Trojan Hospitality Room and a medical education video conferencing center are also planned. For more information, see http://www.doctorsofusc.com/uscdocs/beverlyhills.
KECK MEDICINE | Summer 2011 Issue
Photo by Don Milici
By Leslie Ridgeway
C O N S I S T E N T LY O U T S T A N D I N G
Borok receives MERIT award
Jonathan M. Samet, M.D.
Photo by Philip Channing
President Obama appoints Samet to advisory board President Barack Obama has appointed Keck School of Medicine of USC Professor Jonathan M. Samet, M.D., to a five-year term on the National Cancer Advisory Board. Samet serves as the Flora L. Thornton Chair of the Department of Preventive Medicine and director of the USC Institute for Global Health. “We are enormously proud of Dr. Samet and this well-deserved honor,” said Keck School Dean Carmen A. Puliafito, M.D., M.B.A. “Dr. Samet is an internationally respected leader in preventive medicine, and his contributions to the work of the National Cancer Advisory Board will be significant.” Members of the National Cancer Advisory Board meet several times a year to advise the U.S. Secretary of Health and Human Services and the director of the National Cancer Institute with respect to the activities of the Institute. The board’s work includes reviewing and recommending support grants and cooperative agreements, following scientific and peer review. “I am honored to be asked to join the National Cancer Advisory Board,” said Samet. “My appointment comes at a critical moment in cancer research as we attempt to realize the promise of genomics and molecular medicine. From my perspective, tobacco control research remains a high priority as well.” In a press release issued by The White House to announce several appointments including Samet’s, President Obama said, “These dedicated individuals bring a wealth of experience and talent to their new roles, and I am proud to have them serve in this Administration. I look forward to working with them in the months and years to come.”
In recognition of her outstanding work toward understanding mechanisms of lung injury and repair for more than 20 years, Zea Borok, M.D., professor of medicine and of biochemistry and molecular biology at the Keck School of Medicine of USC, has received a MERIT Award from the National Heart, Lung and Blood Institute (NHLBI), part of the National Institutes of Health. Borok is also chief of the division of pulmonary and critical care medicine at the Keck School. According to the award letter from the NHLBI, Borok was selected to receive funding for her “consistent outstanding contributions to biomedical science and to our Institute.” The overall objective of the NHLBI Method to Extend Research In Time (MERIT) Award program is to provide productive investigators with a history of exceptional talent, imagination and a record of preeminent scientific achievements the opportunity to continue making fundamental contributions of lasting scientific value.
The award provides long-term, stable support and is intended to foster continued creativity and lessen the administrative burdens associated with the preparation and submission of research grant applications.
NEW LOOK, NEW MESSAGE
CHLA celebrates 110 years of service, launches branding campaign I N C E L E B R AT I O N O F I T S 1 1 0 T H A N N I V E R S A R Y,
Children’s Hospital Los Angeles launched a re-branding initiative that includes a new look, new message and the return of the missing apostrophe in “Childrens,” which was left out due to a faulty typewriter key in 1901. The hospital also launched a city-wide ad campaign, including billboards, print, radio, bus wraps and other multimedia. “Children’s Hospital Los Angeles was the first children’s hospital in LA and shares a tremendous part of this city’s history,” said Richard Cordova, CEO of Children’s Hospital Los Angeles. It is one of America’s premier teaching hospitals, affiliated with the Keck School of Medicine of USC since 1932. “While we continue to celebrate the history that is the foundation of this great institution, we want to give Children’s Hospital Los Angeles a much bigger presence in the community to make sure our message is heard: the best care for your child is right here in your backyard,” Cordova said. The landmark non-profit institution, the only children’s hospital in the Western United States ranked among the nation’s top eight, is moving forward with a new logo featuring a symbolic butterfly to represent the incredible transformations that take place every day within its walls. The new logo also foreshadows the exciting changes happening throughout 2011 on the campus, located at Sunset Boulevard and Vermont, including the July opening of a new, state-of-the-art $636 million hospital building. Children’s Hospital Los Angeles also launched a new tagline that drives to the heartbeat of its mission: “We Treat Kids Better.” With top pediatric specialists, all faculty members of the Keck School in more than 100 subspecialties and related programs, Children’s Hospital Los Angeles is recognized for its ability to treat the toughest and most unusual cases, as well as its innovation in and improvement of existing treatment options through research. keck.usc.edu
Aiming to train a new generation of translational researchers, the Los Angeles Basin Clinical and Translational Science Institute (CTSI) has named its first nine scholars in its new pre- and postdoctoral training programs. Based at the Keck School of Medicine of USC, the CTSI received a $56.8 million grant from the National Institutes of Health in 2010 to accelerate the pace at which research discoveries are translated into clinical practice. The CTSI’s Center for Education, Training and Career Development has presented predoctoral TL1 and postdoctoral KL2 translational research training awards to young investigators highly motivated in acquiring the scientific competencies necessary to perform clinical and translational research in diverse populations with a multi-disciplinary, team-based approach. “The training programs of the CTSI have created new opportunities for faculty and students at USC and our CTSI partner institutions to learn how to carry out translational research,” said Jonathan Samet, M.D., the Flora L. Thornton Chair of the Department of Preventive Medicine at the Keck School and director of the CTSI’s Center for Education, Training and Career Development. “The first group of trainees are terrific and come from across the university and Children’s Hospital Los Angeles.” For pre-doctoral students, TL1 Research Training Awards support two years of mentored career development. Students have dual mentorship from their doctoral advisor and a translational research mentor. Awardees include Keck School students Tanya Alderete, a student in the Ph.D. program in Systems Biology and Disease; Jamaica Rettburg, Ph.D. student in Neuroscience; and Melissa Warden, Ph.D. student in Preventive Medicine/Molecular Epidemiology. Ian Holloway, a Ph.D. student in the School of Social Work, also received a TL1 award. KL2 Mentored Research Career Development Awards went to individuals who are in the early stages of their academic career. The three-year KL2 Program supports mentored research career development for individuals with health professional or research doctoral degrees. Keck School recipients of the KL2 awards are Kimberly Aldinger, Ph.D., postdoctoral fellow at the Zilkha Neurogenetic Institute (ZNI); Alex Balekian, M.D., assistant professor in the Department of Internal Medicine; William Mack, M.D., assistant professor of neurosurgery and director of the Neurovascular Research Laboratory at ZNI; and Kathleen Page, M.D., assistant professor in the Department of Internal Medicine. Robert Brown, M.D., senior research fellow in neuro-oncology at Children’s Hospital Los Angeles, also received a KL2 award. “Translational science is a relatively new discipline that emphasizes interdisciplinary research that progresses from discovery to application in human health,” said Thomas A. Buchanan, M.D., director of the CTSI and associate dean for clinical research at the Keck School. “The CTSI training program is designed to develop professionals who are used to working in teams and who are focused on creating new approaches to diagnosis and treatment of human disease. We want to create the new leaders of this field — people who can and will live and breathe translational science.”
KECK MEDICINE | Summer 2011 Issue
The maximum five-year institutional reaccreditation signals that the Keck School of Medicine/ LAC+USC Medical Center is among the elite training sites for residents in the United States.
Keck residency programs receive five-year reaccreditation By Sara Reeve The Keck School of Medicine/Los Angeles County+USC Medical Center residency programs received national recognition when the Accreditation Council for Graduate Medical Education (ACGME) bestowed another five-year reaccreditation — the longest cycle possible — upon the institution. “This accreditation signals that the Keck School of Medicine/LAC+USC Medical Center is among the elite training sites for residents in the United States,” said Keck School of Medicine Dean Carmen A. Puliafito, M.D., M.B.A. “I am proud of all the faculty, staff and residents who participated in this important process.” The institutional reaccreditation was achieved after a lengthy preparation by the Office for Graduate Medical Education, led by Lawrence Opas, M.D., associate dean for graduate medical education. A review document of more than 1,000 pages was assembled to demonstrate the institution’s compliance with ACGME requirements. A site visit took place in June 2010, and interviews were conducted with Keck School and LAC+USC administration, faculty leaders and 12 peer-selected residents from different programs. “It all boils down to teamwork,” said Opas. “From a supportive administration, to excellent program leaders, to brilliant residents, it’s not any one individual’s work — it’s a team effort.” Nearly 900 residents train in the 53 residency programs operating under the institutional umbrella of USC/LAC+USC Medical Center, which is one of the largest teaching hospitals in the country, admitting close to 40,000 patients each year. “Residents are the lifeblood of LAC+USC Medical Center,” said Glenn Ault, M.D., associate dean for clinical administration (LAC+USC Medical Center) at the Keck School. “This achievement reflects the outstanding commitment to graduate medical education at both the Keck School and LAC+USC Medical Center.”
Photo by Philip Channing
CTSI names first scholars in translational research training programs By Katie Neith
USC hospitals rank highly among those in L.A. metro area USC University Hospital ranked third among 44 hospitals in Los Angeles and Orange counties in a new survey published by U.S. News & World Report. The rankings are available online at www.usnews.com/hospitals. The new rankings recognize 622 hospitals in or near major U.S. cities with a record of high performance in key medical specialties, including 132 of the 152 hospitals already identified as the best in the nation. Children’s hospitals were excluded. USC University Hospital ranked third behind Ronald Reagan UCLA Medical Center (first) and Cedars-Sinai Medical Center (second). USC Norris Cancer Hospital ranked 21st in a four-way tie. “Our physicians, nurses and staff work tirelessly to give the best care to our patients, with a commitment to safety, excellence and continuous improvement,” said Mitch Creem, chief executive officer of USC University Hospital and
USC Norris Cancer Hospital. “Ranking so highly in these first-ever metro area rankings is an indication of the value our hospitals have to the community.” USC-affiliated Rancho Los Amigos National Rehabilitation Center also was ranked, at number seven. Los Angeles County+USC Medical Center was ranked 36th, in a nine-way tie. The new metro area rankings use existing data from the 2010-11 “Best Hospitals” rankings published in U.S. News last July. In those rankings, USC University Hospital ranked in six specialty areas: • Eighth in ophthalmology (USC Department of Ophthalmology at the Doheny Eye Institute) • 16th in urology • 20th in neurology and neurosurgery (up 25 spots from last year) • 28th in pulmonology • 29th in gynecology (up one spot from last year) • 31st in orthopaedics.
In a new U.S. News & World Report ranking, USC University Hospital ranked third in the Los Angeles metro area. According to U.S. News & World Report, the new metro area rankings are relevant to a much wider range of health care consumers. They are aimed primarily at consumers whose care may not demand the special expertise found only at a nationally ranked “Best Hospital.” Patients and their families will have a far better chance of finding a U.S. News-ranked hospital in their health insurance network and might not have to travel to get care at a high-performing hospital. To be ranked in its metro area, a hospital had to score in the top 25 percent among its peers in at least one of 16 medical specialties.
FIRST IN WORLD
New robotic surgery developed for kidney cancer By Ryan Ball
Photo by Carol Matthieu (top); Photo by Philip Channing (bottom)
U R O L O G I S T S AT U S C U N I V E R S I T Y H O S P I TA L
have developed a new method of robotic surgery for kidney cancer, which could help reduce organ damage. Previous techniques of kidney-sparing surgery (termed partial nephrectomy) require the kidney blood flow to be stopped by clamping the renal artery while the tumor is being removed. Stopping renal blood flow can affect kidney function negatively. USC’s novel robotic technique, called “zero-ischemia” partial nephrectomy, allows uninterrupted blood flow to the kidney during the entire operation. By removing only the tumor and saving the rest of the kidney without stopping its blood flow, the team of surgeons minimizes kidney damage, leading to superior kidney function. Pioneered by Inderbir S. Gill, M.D., professor, chairman and executive director of the USC Institute of Urology at the Keck School of Medicine of USC, this technique involves renal artery micro-dissection. “We use delicate robotic neurosurgical aneurysm micro-bulldog(s) to control specific, pre-terminal renal artery branches, which directly supply the tumor,” Gill says. “Thus, blood supply to the rest of the kidney stays untouched.”
Initial data from the first 75 patients at USC indicate that patients undergoing the new technique may have superior surgical outcomes and better kidney function. Interest in the zero-ischemia technique is growing. In December 2010, a team from the Istituti Fisioterapici Ospitalieri in Rome visited USC to learn the technique and became the first to apply it in Europe. In March 2011, the USC Institute of Urology held the first Live Surgery Robotic Symposium to demonstrate the zeroischemia technique to a group of more than 50 national and international surgeons on the USC Health Sciences Campus. In addition, USC urologists were scheduled to present five papers on this novel technique at the American Urological Association meeting in Washington, D.C., in May. “Saving kidneys is very important for overall health and longevity,” Gill said. “This new possibility that even complex kidney tumors can be removed robotically without renal ischemia is very exciting.” Gill recently was named the first North American editor of European Urology. The highly influential publication has been published for more than 35 years and is read by more than 20,000 urologists around the world. keck.usc.edu
Inderbir S. Gill, M.D.
F E AT U R E
PUTTING PRIMARY CARE IN THE COMMUNITY
Medical student Veronica Ramirez conducts a community diagnosis to better understand patients she might see at the South Central Family Health Center.
The Keck School of Medicine’s new community-based programs entice students to pursue careers in primary care By Alana Klein Prisco
KECK MEDICINE | Summer 2011 Issue
Photo by Don Milici
Putting Primary Care in the Community
F E AT U R E
F E AT U R E
PUTTING PRIMARY CARE IN THE COMMUNITY
Before Veronica Ramirez, a second-year medical student at the Keck School of Medicine of USC, set foot in the South Central Family Health Center, she knew the residents of this community inside and out. She knew where they bought their groceries, where they went to church, where they could find an after-school program to keep their children off the gang-ridden streets and what health issues plagued their community.
“It was eye opening to see the whole patient picture – where these people come from and what barriers they face in their day-to-day lives to get the health care they need,” says Ramirez, who walked within a two-to-three-mile radius of the clinic, meticulously studying this particular community as part of the Keck School’s community diagnosis assignment. Designed for first-year medical students as part of the course on “Professionalism in the Practice of Medicine,” the project allows students to gain a better understanding of the prevalent urban health issues facing a distinct neighborhood in Los Angeles. The assignment motivated Ramirez to return to the South Central Family Health Center to shadow family medicine physicians on her own time. The community diagnosis assignment is only a small part of the Keck School’s many vibrant programs that demonstrate the value of primary care. Often referred to as the backbone of our health care system, primary care includes family medicine, general internal medicine and general pediatrics.
KECK MEDICINE | Summer 2011 Issue
O U T O F T H E H O S P I TA L , I N T O T H E C O M M U N I T Y
Now with the support of a $450,000 grant from the U.S. Health Resources and Services Administration, which is dedicated to improving access to health care services for underserved patient populations, the Keck School of Medicine is building an even stronger and more focused program to increase student exposure to community-based medicine. “This funding allows us to grow our curriculum outside the hospital and give students more than just a taste of community medicine,” says Jo Marie Reilly, M.D., associate professor of family medicine at the Keck School. The overall goal, she says, is “to have our students understand the value of primary care, its role in prevention and maintaining health in society, its ability to control health care costs and to support our students who are interested in pursuing a career in primary care.” The grant support has enabled a major shift in the Keck School curriculum, starting with the new Primary Care Community Medicine Program, which debuted in 2009 with nine programs. Designed to
F E AT U R E
9 NEW PROGRAMS
Introducing the Keck School of Medicine’s Nine New Programs that Expose Students to Community-Based Medicine Introduction to Community Medicine As part of the
Jo Marie Reilly, M.D., (in red suit) teaches medical students to conduct a physical exam.
introduce students to the challenges and rewards of community-based, primary care medicine, the program includes: • Primary Care Week, a week-long event that highlights and celebrates the importance of primary care; • the shadowing program, in which students shadow a primary care physician in a community clinic; • monthly Community Medicine and Public Health speaker series; • Choosing a Primary Care Career Connect and Select program, which provides students with a “go-to” community medicine physician.
Photo by Bill Youngblood
For a comprehensive list of Primary Care Community Medicine Program offerings, please see column at right. N U R T U R I N G S T U D E N T I N T E R E S T S While the program is still fairly new, it has already proven to be well received by students. The students of the class of 2014, who have completed their first year of medical school, rated the program a 4.8-5.0 on a five-point scale, revealing a high level of satisfaction with the program. “USC is a trailblazer in having a program like the Primary Care Community Medicine Program,” says Erin Quinn, Ph.D., professor of family medicine and co-director of the Primary Care Community Medicine Program. She points to the Introduction to Clinical Medicine course, which was created in the 1960s, as an early example of the school’s educational innovation. “It was one of the first programs in the country that taught students how to talk to patients, create a rapport with and understand the issues in their lives. It has been replicated across the country.” With the newer emphasis on community medicine, the Keck School continues its tradition of curriculum innovation. The Primary Care Week program, in particular, received rave reviews. “I was very impressed with the panelists invited to speak. They each offered a unique perspective, which is valuable to someone like me who is strongly considering going into family medicine,” Ramirez says. Even specialty-bound students benefited from the event. “I have always been interested in a surgical subspecialty, but Primary Care Week gave me a new appreciation for that field,” says Prem Tripathi, a second-year medical student who
well-established Introduction to Clinical Medicine, this new program enables students to spend a day observing physicians and their medical staff, conducting patient histories and physical examinations. This and the experience at the geriatric facility help students make connections that facilitate more shadowing and mentoring later. Introduction to Geriatric Medicine Also part of Introduction to Clinical Medicine, this program gives students exposure to community-based and geriatric care by spending a day in an assisted living facility, where they perform mental status exams and other assessments. Primary Care Community Medicine Shadowing Program
Students shadow a primary care provider in a community clinic, where they are exposed to community-based primary care for the first two years of medical school. They learn about the establishment of medical homes, chronic disease management and public health. Community-Based Selectives/Electives These courses provide fourth-year students with community clinic elective opportunities in community-ambulatory based pediatrics and the patient-centered medical home. Additionally, a family medicine sub-internship with the Keck School of Medicine-California Hospital Family Medicine Residency Program allows students to see the full spectrum of family medicine practiced in the community. Community Medicine and Public Health Speaker Series A
monthly lecture series provides students with interactive presentations on topics including community medicine, leadership and legislation. Primary Care Week A week-long event brings together several medical universities in the Los Angeles area to educate about, highlight and celebrate the importance of primary care within the institutions and community. Primary Care Student Website First - through fourth year medical students can visit primarycare.usc.edu to explore a career in primary care, research, summer and volunteer opportunities, and more. Choosing a Primary Care Career Connect and Select Program
This program provides students with a “go-to” community medicine physician for advice on career opportunities and lifestyle. Primary Care Community Medicine Student Coalition The coalition brings together student leaders with an interest in primary care and provides them with extra support and training.
PUTTING PRIMARY CARE IN THE COMMUNITY
Prioritizing Primary Care The need for primary care specialists is increasing dramatically, yet often the burden of tuition debt makes choosing a career in primary care a difficult one. Scholarship support provides relief from the burden of tuition debt making it easier for medical students to choose a career in primary care. Please contact the Keck School of Medicine Office of Development and Alumni Affairs to discuss establishing a named scholarship at 323-442-2358 or KeckDev@usc.edu. The need for primary care teaching and role modeling is critical. Alumni are invited to contact the Primary Care Community Medicine Office to offer shadowing opportunities at 323-442-1678 or email@example.com and the Introduction to Clinical Medicine Office for teaching opportunities at 323-442-2439 or firstname.lastname@example.org.
Michael Cousineau, Ph.D., says health care reform will increase the need for primary care physicians.
KECK MEDICINE | Summer 2011 Issue
feels a strong pull toward community medicine, despite his intention to specialize. He helped to form the John Snow Public Health Society, a student-run organization that raises awareness about the importance of public health and its relationship to clinical medicine. In addition, he volunteers at a Boyle Heights clinic, where he helped to start a program to prevent obesity. “No matter what I end up doing, I would like to focus a good proportion of my time helping indigent patient populations,” Tripathi says. “My parents came from a poor lifestyle in India to the U.S. to make something of themselves, and I was brought up with the notion that it’s important to give back.” Part of the Primary Care Community Medicine Program’s mission is to educate specialty-bound students about the importance of donating their time to patients in the community. “Specialists get insulated from that need unless we expose them to it,” says Kendra Gorlitsky, M.D., a professor of clinical medicine at the Keck School and a family practitioner, who also serves as a community preceptor for the program. “We are all members of the healing profession, and we all have a responsibility to help those people in the back of the line.” The community medicine program gives students a unique opportunity to see a diversity of health issues, particularly chronic conditions, such as diabetes and high blood pressure. “Students get to see how doctors form long-term relationships with their patients, instead of the touch-and-go patient experience they get in a hospital setting,” Reilly says. To ensure that students also get to form those relationships with patients, plans are under way to create an additional longitudinal program as part of the program, where students can follow the same patient panel in the same community clinic over their four years of training. “A student can meet a prepregnant woman, see her through her pregnancy, see her have the baby and then care for the baby,” Reilly says of the program, which will be piloted this fall. H E A LT H C A R E W O R K F O R C E I M B A L A N C E Despite the rewarding nature of community-based care, many students feel there are also disincentives. “The cost of medical education is a huge barrier to students, and primary care is not a highly paid specialty,” says Michael Cousineau, Ph.D., associate professor of research and director of the Center for Community Health Studies at the Keck School. However, efforts to address the significant inequities in compensation are under way, says Cousineau, who feels optimistic about the Obama administration’s touted commitment to breaking down these financial barriers for primary care doctors. He points to the health care reform bill, which would allocate $168 million for training more than 500 new primary care physicians by 2015 and $250 million toward boosting the supply of primary care providers in this country. Currently, there is a significant disproportion of specialists versus primary doctors in the workforce. According to the Association of American Medical Colleges, the U.S. had roughly 353,000 primary care doctors in 2009 compared to about 955,000 specialists. The association estimates that the country will need 45,000 more primary care doctors by 2020. “The bill attempts to reorganize the delivery of care with an emphasis on primary care and prevention,” Cousineau says. “By realizing the potential of our pre-doctoral training programs in helping meet the health care goals of the country, we are doing our part to reform how health care is delivered.” Additionally, he says there are many new loan repayment programs that could ease the financial burden. In many cases, these loan repayment programs require that students dedicate a certain number of years to an underserved area in order to have the majority of their loans paid off. Ultimately, faculty will lead by example.
Photo by Don Milici
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“It’s our job as faculty to help students realize that it’s very possible to have a career in primary care and still pay off their loans. I am a living example of that. There are government resources out there,” Reilly says. D E M Y S T I F Y I N G P R I M A RY C A R E Students face other roadblocks in addition to the financial barriers, such as lack of exposure to primary care as practiced in the community. “Traditionally, third-year medical students see patients outside the hospital setting for only nine weeks out of their clerkship year and have few clinical, community-based opportunities in their first two years of medical school,” Reilly says. “That is not enough exposure considering that 90 percent of our nation’s health care is provided in community settings. “Students do not have as much exposure to primary care or to role models in the field who could nurture their interest in it, connect them to the community and show how them how this work can be done,” Reilly says. She points to the many shadowing opportunities through the Primary Care Community Medicine Program as an opportunity for students to get the hands-on education mentorship they need to make an informed decision about primary care. Ramirez took advantage of a shadowing opportunity over a four-week period last summer at the Community Memorial Hospital in Ventura. “I got to see first-hand the benefit of providing continuity of care to patients and the special doctor-patient relationship that results
from that. It was clear that primary care physicians do more than just treat people – they become a part of their patients’ lives,” Ramirez says. Some students simply have misinformation or misperceptions about primary care. “We just want students to understand that there are many ways to practice medicine,” says Quinn, adding that she has seen many students get dissuaded from exploring their interest in primary care. “They hear, ‘Oh, you’re so smart, you should become an orthopedic surgeon.’ That is a very damaging message. We should be nurturing whatever interest these students have.” She also believes it’s important to debunk the myth that being specialized implies that you know more. “The truth is, specialists know more about a very specific area, but primary care doctors can do 90 percent of what needs to be done,” she says. Primary care medicine has other perks, as well. Kendra Gorlitsky, M.D., who practices family medicine, says she finds her field “pretty glamorous if you like the idea of adventure.” She says she frequently travels to the developing world because these countries welcome the assistance of family physicians who can step into different situations quickly. Many students ask to accompany her on these service trips. “As far as I’m concerned, primary care is where the action is,” she says. “It’s for students who want to be at the front door, not upstairs in the master suite.” •
Community preceptor Kendra Gorlitsky, M.D., meets with medical students at the Keck School.
Photo by Don Milici
A D AY W I T H D R . K E N D R A G O R L I T S K Y
As a shadowing preceptor for the Primary Care Community Medicine Program, Kendra Gorlitsky, M.D., serves as both an educator and a trusted mentor to students. A typical day mentoring a student goes like this: First, the student observes the way she interacts with a patient. Then, she introduces the student to a subsequent patient, who is interviewed by the student in an adjacent examining room. After listening to the patient’s health concern and with the patient’s permission, the student does some of the physical exam, which Gorlitsky reviews and refines when she returns to the room. Gorlitsky then makes a diagnosis, and the student helps her construct a plan to help the patient address the health issues. The student then obtains resources for the patient. This may involve locating a safe walking program in the patient’s community, a swimming pool for an arthritic patient, a tutoring program for a teen falling behind in school, respite care for a family with a dependent elder or a 12-step program for a patient battling addiction. “The patients enjoy hearing my instruction to the students,” Gorlitsky says, adding that students offer “additional sympathetic ears and community services.”
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Thanks to participation in a research study, Margarita Tovar continues to see and enjoy the activities of her daily life.
Landmark study reveals that Latinos have higher rates of eye disease. Keck team now sets its sights on uncovering possible genetic risk factors By Carrie St. Michel
Tovar is referring to the Los Angeles Latino Eye Study (LALES) – the largest, most comprehensive study ever of eye disease and eye health among adult Latinos living in the United States. Set in the Southern California city of La Puente, this landmark research initiative has spanned more than a decade, producing a prodigious database that paints the clearest picture to date of ocular challenges unique to the Latino community. This unparalleled study, which currently is in its third phase, has resulted in sweeping impacts on the national, as well as the individual, level. At the national level, LALES results prompted Medicare to modify
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benefits to include coverage of glaucoma screenings for Latinos. In addition, the American Academy of Ophthalmology launched a vision-screening program designed specifically to combat undetected eye disease and visual impairment among Latinos. At an individual level, Margarita Tovar is representative of thousands who have benefitted from LALES. Having been with the study from its start, the 62-year-old Tovar has completed three extensive eye examinations. The most recent screening, she says, saved her eyesight. “I didn’t know how bad my glaucoma was,” Tovar notes. “I was laid off and don’t
Photos by Phillip Channing
“If I hadn’t opened the door,” explains Margarita Tovar, “I wouldn’t have been part of the study, and I could have lost my vision.”
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have insurance, so LALES referred me to an ophthalmologist at the [Los Angeles County+USC Medical Center] eye clinic. Otherwise, I wouldn’t have the glaucoma eye drops I need. The ophthalmologist is also monitoring the [age-related] macular degeneration that LALES diagnosed.” D E T E R M I N E D T O F I N D A N S W E R S Tovar and many others owe their preserved eyesight to the curiosity of Rohit Varma, M.D., M.P.H., professor of ophthalmology and preventive medicine at the Keck School of Medicine of USC and director of the Ocular Epidemiology Center at the Doheny Eye Institute at USC. The institute is ranked eighth in the nation in ophthalmology, according to the U.S. News & World Report best hospitals rankings. In the early 1990s, Varma was completing a glaucoma fellowship at Doheny. The majority of patients were Latino, and he quickly discovered no database existed to validate or refute his suspicion that this group had a high incidence of visual impairment and eye disease. As he recalls, “I remember thinking, ‘This is the fastestgrowing ethnic group in the U.S., and yet we have no idea what impact eye disease is having on their lives or what type of eye services should be in place.’” Determined to find answers, Varma applied for – and was awarded – a grant from the National Eye Institute (NEI), which is part of the National Institutes of Health (NIH). LALES was thus born, with Varma and Stanley Azen, Ph.D., Keck professor and co-director of biostatistics, Department of Preventive Medicine, as co-principal investigators. As a result of LALES and other groundbreaking ocular research, the Doheny Eye Institute currently receives the second-highest amount of NIH funding among ophthalmology programs nationwide.
With NEI funding in place, the knocking on doors – literally – began. Surveyors fanned out across the city of La Puente to find Latino adults, aged 40 and above, who were willing to participate in the study. La Puente was selected for its large Latino population (primarily of Mexican origin) and its proximity to LAC+USC (in the event urgent medical care was needed). A LALES clinic was opened in La Puente, and a team of Keck ophthalmologists and technicians launched the study’s first phase. From 1999 to 2003, free, comprehensive eye exams were given to 6,357 La Puente residents. These baseline assessments were designed to assess the prevalence of vision loss and the major, blinding eye diseases – cataract, glaucoma, diabetic retinopathy and age-related macular degeneration (AMD). The baseline study also assessed eye LALES I
disease from the perspectives of risk factors, impact on quality of life, eye-care utilization and barriers to care. The overarching LALES I finding was that – compared to any other ethnic group nationwide – Latinos have higher rates of developing visual impairment, blindness, diabetic retinopathy and cataracts. For Varma, however, the headline was this: “The most important finding was that 60 percent of their eye disease had gone undiagnosed. And that percentage rose significantly within specific disease categories.” In fact, 98 percent of AMD went undetected, as did 95 percent of diabetic retinopathy, 82 percent of glaucoma, 57 percent of cataracts and 19 percent of refractive error. Pointing to at least a partial explanation, Varma notes that only 57 percent of LALES participants had vision insurance. Another noteworthy finding was that one in five participants with diabetes was newly diagnosed during the LALES exam, and 23 percent of these individuals were found to have diabetic retinopathy. LALES II, which was again funded through an NEI grant, took place from 2004 through 2009 and involved reassessing nearly 80 percent of the study’s original participants. Findings included:
Rohit Varma, M.D., M.P.H., directs the largest, most comprehensive study ever of eye disease among adult Latinos living in the United States.
• Over the four years, 34 percent of diabetic participants developed diabetic retinopathy; of those who’d been diabetic for more than 15 years, 42 percent developed diabetic retinopathy. • Of those with diabetic retinopathy at the beginning of the study, 39 percent showed worsening of the disease four years later. • Participants who already had visual impairment, blindness or diabetic retinopathy in one eye at the study’s start, had very high rates of developing the condition in the other eye during the study. “These results underscore the importance of Latinos, especially those with diabetes, getting regular, dilated eye exams to monitor their health,” observes Varma. “Eye care professionals should closely monitor Latinos who have eye disease in one eye, because keck.usc.edu
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This art was created to represent the Los Angeles Latino Eye Study by Latino illustrator José Ramirez.
their quality of life can be dramatically impacted if they develop the condition in both eyes.” Roberta McKean-Cowdin, Ph.D., assistant professor of research in the Keck School’s Department of Preventive Medicine, concurs. In her role as LALES’ epidemiologist, McKean-Cowdin found, “A two-line loss [on an eye chart] is associated with a five-point loss in quality of life, and that significantly impacts areas such as independence and daily tasks like driving.” Based on these findings, she adds, “Screenings and treatment need to begin very early, because even small losses of vision have a big impact.” NEI-funded LALES III, which was launched last year and will continue through 2015, involves the third retesting of the study’s original participants to assess the progression of existing eye disease and to diagnose any new conditions. An added wrinkle this time around is determining if Latinos have a genetic predisposition to develop certain eye diseases. Toward that end, co-principal investigator Azen and his team – including Keck professor of preventive medicine James Gauderman, Ph.D., and Keck assistant professor of preventive medicine Paul Marjoram, Ph.D. – have the arduous task of merging complex genetic databases. While challenges come with the territory, so too does tremendous potential. “The beauty of big databases,” Azen says, “is that they open up opportunities for data mining, and that can lead to public health improvements that go beyond even the original aims of the study.” In addition to shepherding LALES III, Varma is heading a study in which some 9,000 Los Angelesarea preschool children – African American, Asian, Caucasian and Latino – were assessed for eye disease. Commenting on the soon-to-be-released results, Varma says, “This is very important data that will help inform how children’s vision screenings should be conducted.” LALES III
“Screenings and treatment need to begin very early, because even small losses of vision have a big impact.”
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PhotoIllustration by Mark Harmel by José Ramirez
L A L E S ’ L E G A C Y While the ultimate impact of LALES is still unfolding, La Puente Mayor David Argudo succinctly sums up the study’s impact thus far: “Their efforts have saved the eyesight of so many citizens in our community. Our heartfelt thanks go out to LALES.” •
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Uttam Sinha, M.D., left, walks with patient Blair Franks, who leads the Head and Neck Cancer Support Program.
Adjusting To A New Normal
A Photos by Philip Channing
Support groups lead the way in helping some patients and families deal with changes brought on by disease or medical treatment By Mary Ellen Zenka
Awkward conversations may occur after patients tell their friends and family that they have been diagnosed with a serious illness. Medical treatment can sometimes result in patients, and even their families, having to cope with a “new normal.” For some people, the situation can be overwhelming. The USC-owned hospitals offer options that may help. “There are a variety of approaches that can contribute unique and powerful avenues for support and comfort,” says Susan Waters, licensed clinical social worker and co-facilitator of the new Breast Cancer Support Program at USC Norris Cancer Hospital. “The support of loved ones can be extremely helpful. Some patients and families benefit from profes-
sional counseling, as well. And for many, the sense of belonging and understanding, which is shared by members of a support group, is invaluable. Each individual has to decide what is the best fit for him or her. A combination of several approaches may provide the best outcome.” When Blair Franks, 62, learned he had throat cancer several years ago, an enormity of emotions and questions took center stage in his life. Franks became aware that this type of cancer treatment would at least temporarily impair him and could possibly cause permanent, visible damage to his head and neck. Although he was treat-
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ADJUSTING TO A NEW NORMAL
“Most of all, our program celebrates life.” “By encouraging mentoring, we find that patients are led through this process by those with real life experience, and it gives them comfort,” Sinha adds. “Most of all, our program celebrates life. By maintaining a focus on that celebration, I really see my patients’ ability to cope and thrive increase.” BARIATRIC SURGERY SUPPORT For millions of Americans a trip to the doctor’s office means facing their obesity. Or not facing it. Martha Hynes, 56, understood that feeling for years and made a brave choice to make health her priority. She turned to Namir Katkhouda, M.D., chief, division of general and laparoscopic surgery at USC University Hospital, director of bariatric surgery and professor of medicine at the Keck School, to help her achieve a total change of lifestyle through gastric bypass surgery. Now 160 pounds lighter, Hynes credits her regular attendance at support group meetings for helping keep the weight off. Hynes admits she was initially uneasy with the idea of a public group meeting. “I am a private person, and so many issues surrounding weight are intimate and
Photos by Steve Cohn
From left are patient Martha Hynes, Debu Tripathy, M.D., and Namir Katkhouda, M.D.
ed successfully by Uttam Sinha, M.D., chief and residency program director in the Department of Otolaryngology - Head and Neck Surgery at the Keck School of Medicine of USC, Franks thought his long-term recovery would be aided if he could connect with others facing similar issues and challenges. One year into Franks’ recovery, the Head and Neck Cancer Support Program was founded by Sinha and his staff, and today, Franks is the volunteer at its helm. “Head and neck cancers are called the cancers of the lonely,” says Franks. “People often retreat to their homes because these cancers, and their treatments, affect how people project themselves to the world. They often will remain disfigured, and may have either short- or long-term difficulties with eating and speaking. As a result, many patients isolate themselves.” Five years later, Sinha continues to recognize the profound impact this support has on his patients. “This group gives an opportunity for me and many of my colleagues to treat our patients’ health as a whole, not just treat their cancer,” says Sinha. “We discuss many subjects pertaining to a patient’s psycho-social health, and we frequently have speakers such as nutritionists or speech therapists to help people adjust to the challenges.” The group meets monthly with 20-40 people in attendance. Patients are encouraged to attend before their treatment even begins and to keep attending long after their treatment is complete. According to Sinha, there is a kind of mentoring atmosphere whereby those who are much further along in their treatment and recovery help to guide the others who have just been diagnosed.
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The Bariatric Support Group practices exercise to help maintain their weight loss.
Groups for Patients and Families For information on the Bariatric Support Group at USC University Hospital, call 323-442-6868. For information on the Head and Neck Surgery Group at USC Norris Cancer Hospital, call 323-442-5790.
personal. I spent a long time soul searching to decide how I was going to make my surgery a success,” says Hynes. “I started attending the Bariatric Support Group one month after my surgery. The reassuring staff allowed my trust to build over time, and they didn’t make me talk until I was ready. Each month about 30 people participate, and we really help each other.” Katkhouda encourages all his patients to attend, even those who have not yet had surgery. Support is given by guest speakers, who discuss pertinent topics such as exercise, vitamin support, nutrition, psychology and motivation. According to Katkhouda, “The support group makes patients feel comfortable and keeps them motivated. They realize they are not alone with their weight challenge. They can exchange views and share tips and experiences. This is a life-changing operation, and I want to follow these people for life. By attending the group each month, patients stay connected to our staff and have long-term success. It is also a key component of long-term weight loss.” The USC Norris Cancer Hospital recently launched a program, consistent with the mission of the USC Norris Comprehensive Cancer Center, aimed at saving lives through patient support and advocacy. Breast cancer patient attendees
B R E A S T C A N C E R S UPPORT
benefit from information about treatment innovations, psychosocial support and creative paths to healing. “It is a variation of support groups in the more traditional manner,” social worker Waters says, explaining the approach. The group, which is co-facilitated by Michele Prince, licensed clinical social worker, “offers a series of workshops that focus on a specific topic or theme each time. One session may present a lecture by a medical expert, while others offer experiential participation, such as art therapy, creative writing and HealthRHYTHMS drumming.” Co-leader of Women’s Breast Health and professor of medicine at the Keck School, Debu Tripathy, M.D., sees many advantages for patients who attend support groups. “People often go through steps that are similar to grieving when they receive a cancer diagnosis. Many don’t feel a support group is right for them, but we really encourage them to attend and discover for themselves what type of activities work for them. Over time, patients are able to tailor an approach that meets their needs. Our education and therapies help patients cope with all the changes in their lives, both temporary and permanent,” he says. •
The USC Norris Cancer Hospital Social Services Department offers a variety of support groups and programs for patients and their families. All groups are free. For information, call 323-865-3150. • Bladder Cancer Educational and Support Group • Breast Cancer Support Program • Colorectal Cancer Support Group • J-Pouch Support Group • Look Good … Feel Better • Patient/Family Navigation Program • Prostate Cancer Educational Forum • Prostate Cancer Support Group – For Men Only • Prostate – Significant Others • Yoga
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Neil Kaplowitz, M.D., leads studies to understand and prevent or treat liver diseases.
Defending the Liver Researchers seek ways to protect the vital organ at the cellular and genetic levels and to design new therapies By Robin Heffler
Acetaminophen, commonly known by the brand name of Tylenol, is the most widely used drug for pain and fever in the world. It’s also the No. 1 cause of acute liver failure in the United States, prompting Neil Kaplowitz, M.D., an international expert on the origins and development of drug- and alcohol-related liver disease, to study what triggers this failure and how it can be prevented.
“Previously, it was thought that when taken at high doses and for long periods of time, such toxins were just overwhelming poisons,” says Kaplowitz, professor of medicine at the Keck School of Medicine of USC, chief of the division of gastrointestinal and liver disease, and director of the USC Research Center for Liver Diseases. “Instead, we found that they activate a signaling mechanism built into liver cells, which then disrupts the mitochondria, the energy-producing factories that are needed for cells to survive. By either inhibiting or knocking out the signaling mechanism, we can prevent cells from dying.” The liver is a vital major organ, and its primary
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function is to filter the blood coming from the gastrointestinal tract. The liver also detoxifies chemicals, metabolizes drugs and makes a variety of proteins important for blood clotting and other functions. Based on his team’s breakthrough findings, Kaplowitz and other researchers in his laboratory are working to identify therapeutic agents that can block the signaling activation and then test those agents in humans with acute and chronic liver injury. Since 1994, Kaplowitz has served as director of the Research Center for Liver Diseases, one of only four such centers nation-
ONE OF FOUR IN THE NATION
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wide that receive ongoing grants from the National Institute of Diabetes and Digestive and Kidney Diseases. The centers are charged with conducting basic research to understand liver-disease processes and translational research – investigations that seek to bridge basic research and human testing of potential treatments. At USC, the research center provides technical and administrative resources, educational enrichment, and oversight of pilot-study feasibility for the work of 50 researchers. According to the National Center for Health Statistics and the American Liver Foundation, over 26,000 people in the United States die each year from chronic liver disease and cirrhosis, and approximately 3.5 million people in the U.S. are chronically infected with the hepatitis C virus. Keck School researchers who are members of the Research Center for Liver Diseases have made important contributions in the areas of fatty-liver disease, acute and chronic viral hepatitis, cirrhosis and liver cancer. Their research has yielded key findings about cell and molecular biology in normal liver functions and how diseases of the liver disturb these functions. A significant area of research conducted by Kaplowitz’s team is how alcohol damages the liver, focusing on understanding the role of the endoplasmic reticulum (ER), the cell structure that produces and folds proteins in liver cells. The proper folding of proteins during their synthesis in the ER is essential for healthy liver function. “We found that alcohol puts overwhelming stress on the ER,” Kaplowitz says. “When the ER is unable to cope with this stress, fat can accumulate, or inflammation and cell death can occur, which can lead to liver disease or worsen other underlying causes of liver injury,” he says. His team has been studying the inhibition of that stress through use of a commonly available dietary supplement known as betaine. Numerous liver-disease studies also have been conducted through the research center by Shelly Lu, M.D., a prominent mentee of Kaplowitz two decades ago and today a Keck professor of medicine. For many years, a strong focus of Lu’s research has been the regulation of glutathione, a molecule that protects against oxidative stress – damage done to the body when oxygen combines with other chemical elements in cells, leading to the development of many diseases. In the liver, glutathione also helps to eliminate toxins.
Photos by Don Milici
C O P I N G W I T H S T RESS ON CELLS
“We’re now looking at a lot of chronic liver disease processes where glutathione synthesis is abnormal, and trying to understand the mechanism to correct it,” she says. In other research, she is examining the production of SAM-e, a compound manufactured in all human cells and which regulates critical cellular processes. She focuses on the enzyme that makes SAM-e, and the genes – MAT1A and MAT2A – that produce the enzyme. “When people have liver cancer, the MAT1A gene is often silenced while the MAT2A gene is activated,” says Lu, noting that liver cancer currently has a very poor prognosis, ranking as the fifth most common cancer and the third leading cause of cancer death worldwide. “These changes are important as they favor cancer growth. We’re looking at how these genes are controlled and what we can do to change them and thereby treat the cancer.” Lu’s team’s work has created a foundation for SAM-e being used to treat liver cancer and other liver conditions. “We are on the verge of clinical trials of SAM-e for preventing recurrence of liver cancer after initial treatment,” she says. Another research center member, James Ou, Ph.D., professor of molecular microbiology and immunology, and his laboratory colleagues study hepatitis B virus (HBV) and hepatitis C virus (HCV), two major causes of hepatitis and other severe liver diseases, including cirrhosis and cancer. Together, these viruses are responsible for 80 percent of all liver cancers. In the U.S., there are 1.2 million HBV carriers and nearly 4 million HCV carriers. Ou and his team have found that when the viruses infect liver cells, the viruses disrupt the ability of the liver cells to function normally, opening the door for changes that lead to malignancy, even in the absence of hepatitis symptoms or inflammation. In addition, he says, these two viruses frequently establish a persistent infection, which the patient’s immune system cannot remove. Ou’s laboratory discovered that this is because the viruses can turn the mechanism usually responsible for fighting infections into a means to reproduce the viruses. “By continuing to understand how the viruses battle with the immune system,” Ou says, “we will be able to design therapies to treat patients and eventually defeat the virus.” • VERGE OF CLINICAL TRIALS
Shelly Lu, M.D., and James Ou, Ph.D.
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(Pictured) Cheng-Ming Chuong, M.D., Ph.D., says feathers make a good model for studying stem cells.
If it seems like a huge leap of imagination to use chicken feathers as a way to regenerate vital organs in humans, and perhaps even to re-grow lost limbs or treat alopecia (hair loss) … well, that’s because it is. But it’s a leap that Cheng-Ming Chuong, M.D., Ph.D., has made with a degree of success that has won him international acclaim in the scientific community. Chuong directs the Laboratory of Tissue Development and Engineering in the Department of Pathology at the Keck School of Medicine and is principal investigator of the National Institutes of Health (NIH) training grant in developmental biology for the Health Sciences Campus. Recently, Chuong was elected to the prestigious Academia Sinica, Taiwan’s equivalent to the National Academy of Sciences. He holds the Distinguished Research Chair of National Taiwan University and is honorary director of the Research Center for Developmental Biology and Regenerative Medicine there. Helping people regenerate livers or grow new fingers may be the ultimate goals, but Chuong’s focus is on the principles of morphogenesis, the study of how cells are assembled into functional forms. In other words, how do stem cells know what to do? Whether it’s feathers or bones, the stem cells are fundamentally the same, Chuong says. “But the way they organize themselves is one of nature’s great mysteries. Scientists can make a bone cell, but they can’t engineer the shape of a bone.” In the era of regenerative medicine, “the next major breakthrough is to know how to mold stem cells into organs with specific sizes and shapes,” he says. Chuong and his team were the first to identify feather stem cells and to develop novel ways to modify their gene expression. “The results lead us to further develop the concept of topobiology,” or “how the simple changes of the configuration of cell groups can give rise to complex organ forms,” Chuong explains. “Feathers work as our ‘Rosetta Stone’ for understanding the language of morphogenesis.” Feathers provide a great model because, unlike skeletons, they regenerate in the course of a bird’s life span. For example, one cycle may produce downy feathers for warmth, another strong feathers for flying. The ability to regenerate different organ forms to accommodate to
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different physiological needs, from seasonal changes to puberty, pregnancy and aging, led him to propose in Nature the concept of “macro-environmental regulation” of stem cells. “The concept can even explain alopecia of middle aged men,” he says with a grin, “and we may have hit a new clue for treatment.” In the last few years, his team has published six papers and commentaries in the prestigious journals Nature and Science. He received the 2007 Associates Award for Creativity in Research, the highest honor the USC faculty can bestow on its members for distinguished intellectual and artistic achievements. Chuong’s curiosity has led him to another track to search for the origin of feathers. He interacts with Chinese scientists who discovered feathered dinosaur and Mesozoic bird fossils in Northern China. He visited the fossil sites and learned to crack rocks with paleontologists. “It is like opening a book that nobody has opened for 120 million years,” he says enthusiastically. His contribution is more on the experimental side, on how to mold stem cells to form chicken teeth, feathered scales, different proto-feather forms, thus linking studies on feathered dinosaurs with current stem cell concepts. “Darwin solved the question of ‘why?’ We’re working on the question of ‘how?’” he says. For each research project Chuong assembles a multiple-discipline team. “USC is great in this aspect, as it provides a large spectrum of collaborators from different schools,” Chuong says. Among them, robot engineering professor Wei Min Shen, Ph.D. “We have developed a digital hormone theory that can describe both robot swarming behavior and self-organization of stem cells,” Chuong says. He also collaborates with USC professor of surgery Warren Garner, M.D., director of the USC Burn Center, who pointed out the need to regenerate skin with hairs and sweat glands. In studying hairs, Chuong applied his work on self-organization learned from the study of feather pattern formation. The work is in press in Tissue Engineering, and the team has been awarded a new five-year NIH grant to continue. The breakthroughs in skin and hair regeneration may profoundly change the outlook for burn victims in the future. •
Photo by Philip Channing
Scientists search for secrets of stem cell engineering, how the cells become feathers or bones By Martin Booe
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Broadening Services in Colorectal Surgery
By Bob Kronemyer
W H E N A N T H O N Y S E N A G O R E , M . D . , S TA R T E D
Photo by Philip Channing
practicing medicine in the early 1980s, he was hard pressed to find surgeons who performed both surgery and endoscopy. “I really enjoyed endoscopy, so I was intrigued by the fact that colorectal surgeons performed colonoscopies, as well as surgery, for their patients,” he recalls. He also enjoyed being able to mix major surgery, such as for colon cancer, with minor procedures, such as for hemorrhoids. Variety is still an important part of his professional life. As chief of the division of colorectal surgery at the Keck School of Medicine since last July, Senagore and his colleagues treat a wide range of conditions, ranging from inflammatory bowel disease — which causes chronic inflammation of the digestive tract — to pelvic floor disorder — which can cause loss of bowel or urinary control, chronic pelvic pain, constipation and sexual dysfunction. A goal of Senagore’s work is to save or improve patients’ lives with as little discomfort as possible. For example, a colonoscopy is a short preventive procedure that allows physicians to look inside the large intestine for early warning signs of colon or rectal cancer. The procedure is usually conducted with pain medication and a mild sedative. In randomized clinical trials, screening for colorectal cancer has proven to decrease mortality. He also performs minimally invasive surgery, which generally involves less pain and quicker recovery than open surgery. Senagore performs less-invasive, laparoscopic procedures for bowel resection, in which a diseased part of the intestine is removed; pelvic pouch, in which an internal pouch is created to replace parts of the colon damaged by ulcerative colitis; and rectal cancer. Although these procedures have yet to evolve to outpatient status, the length of hospital stay has dramatically decreased from up to nine days to as little as two to three days. Senagore is committed to broadening the services offered by the division of colorectal surgery at USC – which also schedules colonoscopy screenings – and expanding the university’s presence in the Los Angeles market. Through education, marketing and networking with other physicians and large health care groups,
“we’ve started a conversation around value-based medical care delivery,” says Senagore, who earned an M.B.A. at the University of Phoenix. “Better quality outcome is actually less expensive health care in the long run.” Besides his busy clinical schedule, Senagore is involved in several areas of research, including evaluating bowel recovery after surgery. He investigates how the gastrointestinal tract can be helped to recover sooner, so that patients can be fed earlier and return home more quickly while maintaining nutrition. Senagore’s team is also working with USC’s medical oncology department to find better predictors for treatment response to radiation, chemotherapy and surgery. Senagore hails from Michigan, where he has deep roots. He grew up in Detroit and earned his medical degree from Michigan State University in East Lansing. Prior to his appointment at USC, he served as vice president and chief academic officer at the forerunner of Spectrum Health in Grand Rapids, Mich. He also had experience as a staff surgeon in colorectal surgery at the Cleveland Clinic. But Senagore does not miss the inclement weather of the Midwest and doubts he’ll be returning anytime soon. Fortunately, his wife, Patricia, is able to mostly telecommute for her position as an associate professor of pathology at Michigan State University. The couple has two grown children. The balmy weather of Southern California is conducive to Senagore’s love of golf, too. “Hopefully, my score will improve since I’m able to play year-round here,” he quips. •
Anthony Senagore, M.D., uses less invasive surgical procedures that reduce the length of a patient’s hospital stay.
To make an appointment with physicians in the division of colorectal surgery, please call 323-865-3690.
WHEN A WOMAN COLLAPSED IN HER GLENDALE CHURCH,
Ashley Prosper, carries the flag for the Keck School of Medicine during the procession for the inauguration of USC President C. L. Max Nikias, Ph.D.
then 5-year-old Ashley Prosper watched, utterly rapt, as a physician in the congregation rushed forward and rendered aid that no one else could provide. The incident may well have planted the seed of desire to be a doctor when she grew up, Prosper says, noting, “My curiosity about medicine was definitely piqued.” By high school, Prosper realized that medicine represented a practical application of math and science – her favorite subjects – that helped people in tangible and important ways. She devoted herself then to becoming a physician. Now, at 25, she has achieved exactly that, graduating in May 2011 from the Keck School of Medicine of USC and setting her sights on a career in interventional
radiology. Prosper learned in March that she matched with her first choice positions of residencies. After a preliminary year of internal medicine at Huntington Memorial Hospital, she will be performing her residency at the Los Angeles County+USC Medical Center’s Department of Radiology. The former Miss USC and co-president of her class for the last four years says that she is thrilled to be a practicing physician – “one of those compassionate people with useful skills who can help people at a moment’s notice.” 24
KECK MEDICINE | Summer 2011 Issue
Prosper says that USC provided her with a unique opportunity to fulfill her dream because its instructors were not only brilliant, but also approachable and happy to teach. For example, she recalls her third-year cardiothoracic surgery rotation, during which she mentioned her interest in seeing a transplant surgery to her attending physician, Ismael Nuño, M.D., assistant professor of cardiothoracic surgery at the Keck School. “I had a burning desire to see a transplant surgery, so I asked if there was any way I could see it. So he got a number where he could reach me and a while later, at 11 p.m., I got a call. He said, ‘Can you meet me in the O.R. in two hours? We’re going to procure the lungs,’” she says. Just hours later, she was not only observing, but actively assisting in the operation and holding the lungs that would go on to save a patient’s life, she adds. “That’s an experience I’ll never forget, and it was amazing to me that I could just ask a faculty member and he made it happen. That’s true of all of the faculty here. They’re really supportive. They want us to learn, and they’re encouraging of our curiosity,” she says. Prosper also got a chance to perform award-winning research that compared the efficacy of conventional CT versus cardiac MRI scans in spotting signs of a heart attack. Her study showed that conventional CT scans, which are commonly discounted as a source of reliable information on the presence of damage from a heart attack, proved to be frequently helpful at showing precisely that. Prosper praised USC for offering an environment in which patients who are uninsured and patients with some of the best health insurance available are all able to receive care by the same outstanding clinical faculty working at both Los Angeles County+USC Medical Center and at the university-owned USC University Hospital. Looking back at her experience, she says, “Keck is an amazing place to be a medical student. I am so happy to have had the opportunity to obtain my medical education in such a dynamic, diverse environment where faculty love to teach, patients are willing to allow us to learn from their cases, and the administration is determined to make the process as smooth as possible.” •
Photo by Lisa Prosper
Helping People in Tangible and Important Ways By Jon Nalick
W FORMER CHAIR, CURRENT SUPPORT
Photo by Jon Nalick
USC alum Norman Levan pledges $8 million in Keck School scholarships By Ryan Ball
When dermatologist Norman Levan, M.D., was enrolled in the medical school at USC, tuition was a mere $400 a year. During a recent visit with Henri Ford, M.D., vice dean of medical education for the Keck School of Medicine of USC and chief of surgery at USC-affiliated Children’s Hospital Los Angeles, Levan was reminded that the average medical student is now paying $50,000 annually. Levan last year gave $2 million to endow the Norman E. Levan Chair for Medical Ethics at the Keck School, to which he plans to give another $2 million. He also pledged $8 million in scholarships for Keck students. The gift will greatly lighten the load for many future Keck students. “Thanks to you, we can actually lower the level of indebtedness they’re going to experience,” said Ford. “We cannot afford to just turn our backs on medical education. My concern is if we do that, then there won’t be anybody to take care of me when I get a little older.” Ford thanked Levan, a former chair of the Department of Dermatology at USC, for his continued support of the Keck School and its students, noting, “You make my job easier.” Levan said he personally reads essays of students applying for scholarships. He said that literacy and clarity are two qualities he looks for. He also prefers students Ford thanked Levan, with a background in the humanities rather than the sciences. a former chair of the Department of “They have more stringent ideas about what ethics are,” he explained. Dermatology at In 2007, Levan donated $6 million to USC to establish the USC Norman USC, for his Levan Institute for Humanities and Ethics to provide a forum in which students continued support can explore different modes of thinking and responding to the world. of the Keck School and its students, While Levan’s commitment to USC and the Keck School of Medicine are exnoting, “You make traordinary, so too is his dedication to his chosen profession. Though he certainly my job easier.” doesn’t need the money, the 95-year-old continues to see patients once a week at his practice in Bakersfield, Calif. He has cared for three generations of some families and said he continues to learn and grow as a physician. “On Monday I saw a case that I never saw before in my life,” he said. “As a matter of fact, the largest dermatology textbook doesn’t mention it.” keck.usc.edu
Keck School of Medicine Vice Dean Henri Ford, M.D., left, thanks alumnus Norman Levan, M.D., for his support for medical education.
C O L L A B O R AT I O N
Keck School builds community partnerships By Imelda Valenzuela
The Keck School of Medicine of USC and the Eisenhower Medical Center in the Palm Desert community of Rancho Mirage celebrated their new partnership with a reception hosted by Keck School Dean Carmen A. Puliafito, M.D., M.B.A., and Eisenhower President and Chief Executive Officer G. Aubrey Serfling at the Rancho Las Palmas Resort and Spa. More than 75 guests attended the reception, including administrators and faculty from both the Keck School and Eisenhower, friends and alumni of the Keck School, and several Palm Desert community members. Puliafito gave a speech focused on personalized medicine and community-based medical education, the core of the collaboration between the Keck School and Eisenhower. “What we are seeing is a change in the way medical students are being educated with community-based medical education,” Puliafito said. “That
is, having medical students, interns and residents work at community hospitals that have created a teaching environment. This is really going to help the way in which we deliver health care in a smart way,” he said, noting that the Keck School and Eisenhower are building an educational alliance “at every level.” Puliafito also emphasized the growing trend in personalized medicine. “We’ve come to understand that different disease processes, in very distinctive ways, vary from person to person and between groups of patients,” he said. “This is important because as we scientifically discover what’s unique about different diseases, we can develop targeted therapies for patients and treat them without a high degree of toxicity.” He stated that more personalized and specific medical treatments will be developed over the next 25 years. Additional strategic community educational alliances are under way for the Keck School in Pasadena, Newport Beach, Santa Barbara and La Jolla.
Celebrating a new partnership between the Keck School of Medicine and the Eisenhower Medical Center in Rancho Mirage are USC Board of Trustees honorary member Helene Galen and Keck School Dean Carmen A. Puliafito, M.D., M.B.A.
Alumnus and wife bequeath $4.6 million to Keck School
U S C D I G N I TA R I E S G AT H E R TO VIEW LIVE SURGERY
USC Trustee Harlyne J. Norris, seated, and members of the USC Norris Advisory Board were invited to a symposium on robotic partial nephrectomy on March 4. Sponsored by the USC Institute of Urology, more than 60 participants watched live surgery and enjoyed hands-on experience with the da Vinci Simulator.
Carl Nemethi, M.D., a Keck School of Medicine of USC Class of 1938 graduate and former USC football player, was a quiet philanthropist who, with his wife, Virginia, recently left behind a legacy of $4.6 million to the Keck School in the form of an estate gift. Nemethi was 98 when he passed away late last year, and his wife was 94 when she died in 2006. The couple married a year after Nemethi graduated from the Keck School and remained married for 67 years. According to longtime family friend, Doug Trewhitt, the very religious and highly social couple “never had a shortage of fun in their lives.” They made their home in Beverly Hills, where they were longtime residents. Nemethi served as an Army flight surgeon in World War II and, upon returning to Los Angeles, specialized in hand injuries and surgery, since many of his patients worked at nearby manufacturing plants where hand injuries were common. Nemethi opened several clinics and was instrumental in opening the first emergency room at California Lutheran Hospital. “Carl practiced medicine into his eighties,” Trewhitt said. “He was very ethical and very dedicated to medicine. He wanted the best for the world.” For more information on making a planned gift, contact Clara Driscoll at email@example.com or 323-442-1346.
KECK MEDICINE | Summer 2011 Issue
Carl Nemethi, M.D.; Virginia Nemethi
Photo by Pat Lassy (top); Photo Ryan Ball (left)
By Imelda Valenzuela
W H AT ’ S U P D O C ?
Photo by Jennifer Barberie (left)
USC Associates hear about Keck School Milestones By Imelda Valenzuela Seventy USC Associates gathered at the Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research at USC for “What’s Up Doc?” part of the USC Associates’ Distinguished Speaker Series. The USC Associates is the university’s premier academic support group. Keck School Dean Carmen A. Puliafito, M.D., “We want to expose more M.B.A., left, and alumnus Mitchell Lew, M.D., people in the community and in a Chairman-level Associate and president-elect of the Associates group to all of the the USC Alumni Association. exciting, new things happening on the Health Sciences Campus, which is why we brought back ‘What’s Up Doc,’” said Jane Popovich, president of the USC Associates Board of Directors. The event marked the first time in more than 10 years that an Associates’ meeting occurred on the Health Sciences Campus. “This has been by far one of the best events, with the most questions and the most interest I’ve seen. People are interested in medicine because medicine affects our daily lives.” Keck School of Medicine Dean Carmen A. Puliafito, M.D., M.B.A., provided an overview of milestones and highlights at the campus, including the 2009 purchase of USC University Hospital and USC Norris Cancer Hospital, Keck School faculty recruitment and research, the opening of the Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research at USC, and Keck School student programs, such as the M.D./M.B.A. degree program jointly offered by the Keck School and the USC Marshall School of Business. “It’s a very exciting time for USC medicine,” Puliafito said. “We’re all very proud of the tremendous progress that USC has made over the last 20 years, and here at the medical school, we’re poised to become, as USC President Max Nikias puts it, ‘part of the undisputed elite’ of U.S. universities.” Martin Pera, Ph.D., director of the stem cell research center, noted the center’s 12 research groups, 100 staff members and four labs. Pera’s presentation spanned the range of activities in the stem cell research center, including embryonic research and tissue regeneration and repair. Michael Kahn, Ph.D., co-director of the USC Center for Molecular Pathways and Drug Discovery, professor of biochemistry and molecular biology, provost’s professor of medicine and pharmacy, and co-leader of the USC GI-Oncology program, discussed a promising new drug entering clinical trial. In preclinical studies, the drug has shown the potential to benefit patients suffering from several diseases and conditions, including cancers, degenerative diseases and fibrotic disorders. “We believe that this class of molecules safely targets an extremely fundamental cell biological switch. We are very excited about the broad potential to treat a wide array of diseases even beyond cancer, based upon our preclinical results to date,” Kahn said. Lisa Werth, a first-year medical student, expressed her gratitude for a USC Associates scholarship. “Thanks to the Associates program, I was able to shift my focus away from the financial stresses of medical school and instead focus on what I really want to do with my medical career,” she said.
Development leader rejoins USC to helm Health Sciences fundraising After a national search, William (Bill) Watson has been named vice president for Health Sciences Campus development at the University of Southern California. In this role, he overWilliam (Bill) Watson sees development functions for the Keck School of Medicine of USC, USC University Hospital and USC Norris Cancer Hospital. Watson is a recognized leader in medical and hospital development. He most recently served as senior vice president and chief development officer at Saint John’s Health Center and John Wayne Cancer Institute in Santa Monica, Calif. At Saint John’s, he led a successful campaign to raise $300 million for a 275,000-square-foot diagnostic and treatment center and was instrumental in campaign planning to expand the health center campus for a variety of programs and services, including additional patient resources, education and wellness programs, a translation science center, a conference center and senior housing. Prior to Saint John’s, Watson served as chief development officer at the Keck School of Medicine, where he managed the Board of Overseers and raised money for the Zilkha Neurogenetic Institute, USC Norris Comprehensive Cancer Center, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, and the Keck School, as well as other health sciences priorities. He previously served as director of development and external relations for the USC Norris Comprehensive Cancer Center. “I am delighted Bill Watson has returned to USC and joined our team,” said Al Checcio, senior vice president for university advancement. “Having such a talented fundraiser and manager overseeing our efforts gives us a tremendous advantage at this stage of our campaign planning. I’m confident he will make immediate and long-lasting contributions toward our ambitious goals.” Watson said, “I’m excited to be back at USC. The university has taken great strides in the past few years to advance the mission of the Health Sciences campus, and I’m eager to address the challenge of taking USC’s recent success even further.” Watson is a graduate of Fresno State University.
The USC Associates is open to all alumni, parents and friends of the university. For more information on membership, visit www.usc.edu/associates or call 213-740-8722. keck.usc.edu
• SCHOLARSHIP BENEFIT
Dinner showcases music and medicine By Imelda Valenzuela
An inspiring evening showcasing the medical, as well as musical, talents of students at the Keck School of Medicine of USC was celebrated at the Medical Faculty Family and Friends and Salerni Collegium Annual Scholarship Dinner at the Jonathan Club in downtown Los Angeles on March 5. The Medical Faculty Family and Friends and Salerni Collegium are organizations of the Keck School of Medicine, sharing the mission to raise money for medical student scholarships. The evening opened with a surprise duet performed by Dean Emeritus of the Keck School of Medicine Allen Mathies, M.D., and Keck School second-year student Morgan Cross. Fourth-year medical student and pianist Matt Greenberg provided piano music during dinner, and third-year medical student Kimberly DeQuattro sang a musical selection from the opera “Carmen.” Chorda Tympani, a mixed voice, a cappella singing group and service organization comprised of Keck School students, provided additional entertainment. The medical talent of the students was apparent through the announcement of 12 student scholarships representing $95,000 in scholarship funds, as presented by Dean Carmen A. Puliafito, M.D., M.B.A., and Donna Elliott, M.D., associate dean for student affairs. A total of $79,000, some of which will be dedicated to future medical student scholarships, was raised that evening. Honorees for the evening included Donald I. Feinstein, M.D., emeritus professor of medicine in the Jane Anne Nohl Division of Hematology at the Keck School and emeritus chief of medicine at USC University Hospital and USC Norris Cancer Hospital, and his wife, Jackie; and Steve Giannotta, M.D., professor and chair of the Department of Neurosurgery at the Keck School, and his wife, Sharon. The evening was capped off with a live auction featuring the dean’s Dodgers box seat tickets, master chorale concert tickets at the Walt Disney Concert Hall, jewelry and a Hawaiian vacation. For more information on making a donation for scholarships, contact Sandra Campione at firstname.lastname@example.org 626-457-4219.
Honorees Don Feinstein, M.D., and his wife, Jackie, left, and Steve Giannotta, M.D., and his wife, Sharon, flank Dean Carmen A. Puliafito, M.D., M.B.A., and his wife, Janet Pine, M.D. 28
KECK MEDICINE | Summer 2011 Issue
Photo by Sara Reeve (left); Photos by 211 Photography (right)
M I N I M E D I C A L S C H O O L D AY
More than 100 parents of current medical students learned first-hand about the experiences of their children at the Second Annual Mini Medical School, sponsored by the Parents Association of the Keck School of Medicine of USC. Board members are, from left, George Stoneman, M.D., class of 1965, president; Barbara House, parent of 2008 graduate; Jeanie Riddell, parent of 2011 graduate; and John Reid, parent of 2005 graduate. The free organization is open to all parents of Keck medical students. For more information, contact Connie Wagner, 626-457-4076 or email@example.com.
Medical student a capella group Chorda Tympani performs at the 2011 annual scholarship dinner of Salerni Collegium and USC Medical Faculty Family & Friends of the Keck School of Medicine.
Keck in the News from the market. Samet was also quoted by two stories in the Wall Street Journal, USA Today, Bloomberg News, Los Angeles Times, San Francisco Chronicle and an Associated Press story in the Washington Post.
Photos this page: Don Milici
Photos by Don Milici
NBC News San Francisco affiliate KNTV-TV interviewed Jaimie Davis on ways to get kids to eat vegetables, noting that she is affiliated with the USC Childhood Obesity Research Center. The Los Angeles Times quoted her about common sources of sugar in children’s diets and the mandate to add nutrition labels to packages of raw meat. Fox News, EFE (Spain) and KNBC-TV featured research by Davis, Michael Goran and colleagues, which found that Latinos are genetically predisposed to have increased liver fat when they consume sugar. Los Angeles Times quoted James Ou about boceprivir, a new drug that offers breakthroughs in the treatment of hepatitis C. KABC TV News interviewed Steven Richeimer of the USC Pain Center about research that shows that emotional pain – like when someone breaks up with you – can show up in the brain during an MRI. The New York Times quoted Jonathan Samet, who chairs the Tobacco Products Scientific Advisory Committee to the Food and Drug Administration, about the committee’s report stating that there would be a public health benefit to removing menthol cigarettes
Los Angeles Times quoted Edward Newton about a California budget plan to shift emergency funds. MSNBC interviewed David Quinn about biomarkers associated with prostate cancer risk. MyHealthNewsDaily also quoted him. Los Angeles Times quoted Donna Spruijt-Metz about the health impact of excess abdominal fat. U.S. News & World Report, Time, United Press International and CBS News cited a new study published by Heather Volk and a team of researchers from Children’s Hospital Los Angeles and the Keck School of Medicine, which found that children born to women living within about a thousand feet from a freeway are twice as likely to have autism. The story was also covered by the Los Angeles Times, WebMD, Medical News Today, CTV (Canada) and Asian News International (India), among others.
Every week the news media cover stories from the Keck School of Medicine of USC. Here is a sampling of coverage. For complete listings see www.usc.edu/uscnews/usc_in_the_news/.
and colleagues. The invention has allowed some blind patients to see again. IndiaWest reported that Humayun has been elected to the National Academy of Engineering, adding that this election is one of the highest professional distinctions accorded to engineers. Money Morning quoted Humayun regarding the use of microchip technology in ophthalmology. Savannah Morning News quoted Andrea Hricko on research about the effects of port pollution on minority communities. The Long Beach Post quoted Hricko about her research on poor air quality near freeways. La Opinion featured a program launched by Anne Peters and colleagues, which uses cell phone text messages to educate low-income diabetic patients awaiting an appointment at one of the city’s public clinics. The Huffington Post cited Peters regarding the average length of time diabetic patients have the condition before they are diagnosed.
WTVQ News quoted Thomas Lee about using flash photography to detect possible eye problems in children. Time featured research by Richard Bergman and colleagues, who found a new way to measure percent body fat that can account for different ethnicities. New Scientist, AOL News, Reuters, MX (Australia), The Globe and Mail (Canada), El Mercurio (Chile), Fox News Boston affiliate WFXT-TV, MyHealthNewsDaily, RedOrbit, SmartPlanet also featured the research. Science Channel’s “Innovation Nation” and Popular Mechanics featured the artificial retina developed at the USC Doheny Eye Institute by Mark Humayun
Qilong Ying Groundbreaking research led by Qilong Ying was selected as one of Science magazine’s top 10 Breakthroughs of 2010. Ying and colleagues successfully created the first “knockout” rats — animals that are genetically modified to lack one or more genes — through embryonic stem cell-based gene targeting. The development of knockout rats will have a significant impact on biomedical research. The Boston Globe and Physorg.com highlighted the work.
Where can you find The Doctors of USC? 1-800-USC-CARE
New locations are now open in La Cañada and Beverly Hills THE DOCTORS OF U S C B E V E R LY H I L L S
THE DOCTORS OF USC LA CAÑADA
THE DOCTORS OF USC DOWNTOWN
DOHENY EYE INSTITUTE
9033 Wilshire Blvd. Beverly Hills, CA 90211
1751 Foothill Blvd., Suite 3 La Canada, CA 91011
333 South Hope Street, Suite C-145 Los Angeles, CA 90071
1450 San Pablo Street Los Angeles, CA 90033
The Doctors of USC Beverly Hills satellite is home to the USC Doheny Eye Center, offering comprehensive ophthalmology care, and the USC Norris Westside Cancer Center, offering expert care in diagnosis and treatment. Advanced care in urology/prostate cancer is offered through cutting-edge therapies and clinical trials, as well as continuing medical education for community physicians.
The Doctors of USC now offer their world-class care to the local community of La Cañada Flintridge through the Doctors of USC La Cañada satellite location. Primary care services include internal medicine. The office is conveniently located on Foothill Boulevard near the end of the 2 freeway.
The Doctors of USC Downtown offers general and specialty medical care for people who live or work in the downtown Los Angeles area. Services include internal medicine, women’s health, gerontology, dermatology and imaging. The center features an Executive Health Program with comprehensive, highly personalized disease detection and prevention exams. It also houses the USC Faculty/Staff Health Center.
H E A LT H C A R E C O N S U LT A T I O N CENTERS I & II
1510 San Pablo Street (HCC I) & 1520 San Pablo Street (HCC II) Los Angeles, CA 90033 5
The Doheny Eye Institute is recognized as a world leader in basic and clinical vision research and advanced patient care. Faculty physicians from the Keck School of Medicine of USC provide outpatient services for a variety of vision-related conditions. Additional locations include: Arcadia, (626) 446-2122 Beverly Hills, (310) 601-3366 Fountain Valley, (714) 628-2966 Pasadena, (626) 395- 0778 Rancho Mirage, (760) 325-2069 Riverside, (951) 788-1231
Private practice offices for many USC faculty physicians are located at Healthcare Consultation Centers (HCC) I & II adjacent to USC University Hospital. These facilities give patients easy access to family medicine, gynecology, urology, orthopaedics, psychiatry, cardiothoracic surgery, head and neck surgery, otolaryngology, and neurology and neurosurgery. HCC I features an outpatient pharmacy. HCC II features the CardioVascular Thoracic Institute and diagnostic imaging, including MRI, PET and CT.
USC UNIVERSITY H O S P I TA L
LAC+USC MEDICAL CENTER
1500 San Pablo Street Los Angeles, CA 90033
1200 North State Street Los Angeles, CA 90033
USC NORRIS COMPREHENSIVE CANCER CENTER A N D H O S P I TA L
CHILDREN’S H O S P I TA L LOS ANGELES
4650 Sunset Boulevard Los Angeles, CA 90027
1441 Eastlake Avenue Los Angeles, CA 90033 6
USC University Hospital is a private, 411-bed referral, teaching and research hospital staffed by faculty of the Keck School of Medicine of USC. The hospital offers some of the most sophisticated services available, including neurointerventional radiology, interventional cardiology and the da Vinci robot. Surgical specialties include organ transplantation and neurosurgery, as well as cardiothoracic, esophageal, orthopaedic, and plastic and reconstructive surgeries.
A partner of the Keck School of Medicine of USC since 1885, LAC+USC Medical Center is among the largest teaching hospitals in the country. Staffed by faculty of the Keck School of Medicine of USC and more than 1,000 medical residents and students, LAC+USC serves 39,000 inpatients and 1 million outpatients annually. Among its specialized facilities are a state-of-the-art burn center, neonatal intensive care unit, trauma service and HIV/AIDS outpatient center.
USC Norris Comprehensive Cancer Center is one of only 40 centers in the United States designated as “comprehensive” by the National Cancer Institute. USC Norris clinical researchers are leaders in the development of novel therapies for the disease. The USC Norris Cancer Hospital offers advanced treatments in an intimate setting.
Photo of Wong by Van Urfalian
Photos 2, 3, 4, 5 and 7 by Jon Nalick; 6 and 8 by Pat Davison; 9 courtesy of Children’s Hospital Los Angeles
The Doctors of USC are among the nation’s leaders in innovative clinical care, research and education of future physicians. They are more than 500 physicians who are faculty members of the Keck School of Medicine of USC. The Doctors of USC provide care in a wide range of medical specialties from the most complex diagnoses and treatments to primary care for the entire family. The Doctors of USC practice in numerous locations throughout Los Angeles and Southern California, including the locations featured below.
To learn more, or to make an appointment, call The Doctors of USC at 1-800-USC-CARE.
Children’s Hospital Los Angeles is a 317-bed nonprofit hospital serving patients from newborn to age 18. Staffed by faculty of the Keck School of Medicine of USC, Children’s Hospital has become a pioneer in family-centered care and is ranked among the top 10 pediatric facilities in the nation. The research program has made significant contributions to children’s health care worldwide.
Michael K. Wong, M.D., Ph.D., professor of medicine, Keck School of Medicine, and head of the Solid Tumors Section and director of the melanoma program, USC Norris Comprehensive Cancer Center and Hospital
Spotlight 1. University Kidney Research Organization (UKRO) honors Keck School of Medicine Dean Carmen A. Puliafito, M.D., M.B.A., right, along with UKRO spokesperson and Grammy Award winning singer/songwriter Natalie Cole, and Fresenius Medical Care CEO Ben J. Lipps. 2. Former Massachusetts Governor and one-time presidential candidate Michael Dukakis discusses health care reform with students in a Health Policy class taught by Keck School of Medicine Professor Michael Cousineau, Ph.D. 3. Keck School Dean Carmen A. Puliafito, M.D., M.B.A., right, poses with actor-comedian Martin Short, an honoree at the 14th Annual Unforgettable Evening in Beverly Hills. The starstudded event raises funds for the Women’s Cancer Research Fund (WCRF), a program of the Entertainment Industry Foundation. The USC Norris Comprehensive Cancer Center is one of the primary beneficiaries. Norris Cancer Center Advisory Board members Marion Laurie and Quinn Ezralow are among the WCRF founders. 4. On Match Day, Keck School student Chris Yurko hugs it out with a pal after finding out he will be going to Duke University for a radiology residency. 5. Television journalist Huell Howser, left, interviews epilepsy patient Nathan Jones as Christi Heck, M.D., associate professor of neurology, center right, and 16-year-old epilepsy patient Emily Evans, center, and her mother Kristin, in red, look on at the USC Comprehensive Epilepsy Center.
Continuing Medical Education 19th Annual Educational Meeting: A Midsummer Nights’ Wheeze DATE: July 8-10, 2011 LOCATION: Hyatt Regency Hotel, Huntington Beach, CA FEES: $195-CSAAI member; $295-Non-member; $125-Allied Health Professional CREDIT: 11.5 *&*%+,*%-./"0123%4%-2"'(/56& 54th Annual USC Refresher Course in Medicine and Current Clinical Issues in Women’s Health DATE: August 1-5, 2011
KECK MEDICINE | 2008 Summer Issue 2011 Issue
Hyatt Regency Hotel, Kaanapali Beach, Maui, HI $795-MD/DO; $625-RN/Allied Health CREDIT: 28 *&*%+,*%-./"0123%4%-2"'(/56& LOCATION: FEES:
Multimodality Treatment of Brain Cancer: Current Concepts and Recent Advances DATE: September 24, 2011 LOCATION: Los Angeles Marriott Hotel-Downtown, Los Angeles, CA FEES: To be determined CREDIT: To be determined
Perinatal Medicine 2012 February 27 - March 1, 2012 LOCATION: Hyatt Regency Maui, Kaanapali Beach, Maui, HI FEES: To be determined CREDIT: To be determined DATE:
Contact the USC Continuing Medical Education Office at: TELEPHONE: 323-442-2555 or 800-USC-1119 EMAIL: firstname.lastname@example.org REGISTER: www.peopleware.net/0128
Photo 1 courtesy of UKRO; Photo 2 by Ziva Santop/Steve Cohn Photography; Photo 3 by Steve Cohn; Photo 4 & 5 by Ryan Ball
Joyous events mark the life of the expanding USC academic medical center.
My legacy is ending cancer Arlene Ray is a survivor. Decades after overcoming a struggle with breast cancer, she faced a diagnosis of lymphoma and turned to the experts at USC Norris. They helped her beat back the diseaseâ€” and they inspired her with their innovative research and unparalleled clinical care. Today, she has dedicated her philanthropy to helping USC Norris researchers pioneer new frontiers of discovery to end cancer once and for all. To learn more about charitable gift planning to benefit the USC Norris Comprehensive Cancer Center, please contact the Office of Development at 323.442.1531 or by email at email@example.com.
What will your legacy be?
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