Research Funds Soar
Sex, Lies, and Aggression
Emory Team Leads Transplant Network
Signs of the Times
Feeling with the Mind's Eye
Avert Bad Cholesterol
Y2K Brings New Heart
Clues to Immune Memory
Molecular Fingerprints
Traumatized as Child, Depressed as Adult?
Banner Year for Gifts
Vaccine Center Opens
CLH Redo Gets State OK

Moving Forward


FY99 was a very good year for Emory researchers. The Woodruff Health Sciences Center attracted $192.2 million in total research funding -- 24.5% more than the previous year. The center's total represents a record 93.4% of the $205.7 million brought in by university researchers.

The School of Medicine led the way with a 27% increase in funding totaling $142.8 million. Yerkes Primate Research Center was close behind with a 25% increase and a total of $23.2 million. The Rollins School of Public Health was up 19% with $24.6 million. Research also grew in the Nell Hodgson Woodruff School of Nursing, which saw a 129% jump to $1.27 million.

Nancy Wilkinson, director of the Office of Sponsored Programs, credits the increase to hard work by the faculty and a renewed emphasis on research driven by strategic planning. "We're trying to move the university forward through strategic planning, and those efforts are really beginning to show some results," she says. "We find ourselves in a world where there are more federal resources, and we've been successful in competing for them."

While the number of projects funded in FY99 was about the same, the average size of grants awarded increased significantly. The number of researchers funded for $1 million or more doubled from 20 to 40.

The federal government provides 75.9% of the university's total research funding. Most of that comes from the National Institutes of Health (NIH) to support biomedical research. Last year, Emory became the nation's fastest-rising recipient for NIH funds, based on grants awarded in FY98. The medical school rose six places to rank 24th with $79.9 million in total NIH funding, compared with 30th place and $65.1 million in FY97.

Will the upward trend in research funding continue? Wilkinson believes Emory may be at the saturation point for now. "Without the ability to grow faculty and until new facilities [the Whitehead Research Building, the Winship Cancer Institute building, and the new School of Nursing] come on line, we may not experience substantial changes," she says.

Research Funds Soar


How does the brain regulate complex social behaviors such as fear, affiliation, aggression, even sexual behavior? Conversely, how does social experience mold the developing brain? Thanks to a five-year, record-breaking grant of close to $20 million from the National Science Foundation (NSF), more than 60 Emory and other area researchers are beginning to ask and answer these basic questions.

The NSF grant enables Emory and its partners - Georgia State, Georgia Tech, and Atlanta University Center - to form a Center for Behavioral Neurosciences. It is the first large, interdisciplinary effort to address fundamental questions concerning behavior at the molecular, cellular, and systems levels in diverse species and at different stages of development.

One of five awards given to create new science and technology centers across the nation, the Atlanta grant was the only one presented in the life sciences. It is the largest grant ever to be received through Emory, based on dollars per year.

Tom Insel, former director of the Yerkes Regional Primate Center and director of the new center, cites the existing strong relationships between the universities as one factor in winning the NSF grant. The development of a biotechnology center between Emory and Georgia Tech was another. The third factor was the presence of Clark Atlanta University, Morris Brown, Morehouse, and Spelman colleges as partners. The center will encourage minority participation in science. As home to the highest density of minority colleges in the country, Atlanta is well positioned to address a national shortage of minorities in the sciences.

To fulfill its research component, the center is forming several "collaboratories" to combine teamwork and share laboratories at the partner institutions. One collaboratory, for example, will focus on the neuroscience basis of social behaviors such as fear and affiliation. A second collaboratory looks at agonistic (aggressive or defensive) and reproductive behaviors.

In technology transfer, scientists from different disciplines and universities will collaborate in fields such as imaging, molecular, cellular, systems, and behavioral research.

The educational component of the grant will furnish invaluable learning opportunities for Georgia faculty and students at all levels of the educational pipeline. The center will work with the Atlanta public schools to provide professional development for teachers of kindergarten through high school students, including research visits and internships in laboratories. Local schools can access instructional materials through LearnLink and the center's Science NET site as well as hands-on lab experiences on Georgia State's BioBus -- a 30-foot, traveling laboratory that enhances the science curriculum in Georgia.

The Georgia Research Alliance, with a mandate to foster collaboration between research universities and the state, has committed matching funds to the neuroscience center. Support from the city and state also has been strong.

Sex, Lies, and Aggression




Emory's kidney transplant program is part of a National Institutes of Health nationwide network that will conduct clinical trials using new research strategies to improve organ transplantation. Emory transplant surgeon Christian Larsen will lead the nine kidney transplant research centers within the Collaborative Network for Clinical Research on Immune Tolerance.

The clinical researchers hope to induce immune tolerance and inhibit harmful immune responses while keeping protective ones intact. Their efforts promise to improve the success of transplants as well as treatments for autoimmune diseases such as type 1 diabetes, lupus, and arthritis.

More than 70 researchers and clinical specialists from 39 institutions in nine countries will work together in the new network. The seven-year initiative is funded by the National Institute of Allergy and Infectious Diseases, which contributed nearly $130 million to the effort; by the National Institute of Diabetes and Digestive and Kidney Diseases; and by the Juvenile Diabetes Foundation International, which contributed $14 million.

Larsen and Thomas Pearson co-lead Emory's program in kidney transplantation, which has gained international prominence for its groundbreaking research leading to new strategies to stop rejection of transplanted organs. In 1998, the NIH awarded physician-researchers in Emory's Center for Transplantation a five-year, $7.5 million grant to help establish true immune tolerance in patients receiving organ transplants.

Organ transplant patients are required to take lifelong daily regimens of immunosuppressant medicines. Unfortunately these same medicines make them highly susceptible to viral and bacterial infections as well as cancer, kidney failure, diabetes, and osteoporosis. The medicines are usually ineffective after about eight years. About 30% of patients experience episodes of organ rejection, requiring hospitalization and extra doses of immunosuppressants.

Emory Team Leads Transplant Network



Transplant surgeons Chris Larsen and Tom
Pearson lead Emory's transplant program.


After 27 years of operation, West Paces Medical Center (above) closed its doors December 10, when a study confirmed that the aging facility could no longer compete in the Atlanta market. The demise of the 292-bed, acute care facility on Howell Mill Road in northwest Atlanta came on the heels of declining patient volumes, exclusion from important managed care contracts, and declining reimbursements from insurers. Those factors plus the dire effects of the Balanced Budget Act "made it impossible for a facility of this age and operating cost to retain a competitive edge," says Thomas Gilbert, CEO.

Select, a long-term care facility, located within West Paces, remains open and is accepting patients until it can be relocated to another facility. The Greater Atlanta Sports Medicine Center, previously affiliated with West Paces also is open.

The decision to close West Paces was unrelated to the recent partnership of its owner, Columbia/HCA, with Emory last fall, Gilbert says. "The closing was a direct effect of today's health care market in metropolitan Atlanta and the financial challenges facing an aging facility with dwindling patient enrollment."

While Columbia/HCA had considered rebuilding the hospital two years ago, studies showed that the city had excess hospital beds. West Paces sits on leased property that can't accommodate a new facility, and land in the immediate area is expensive.

EHCA, LLC (the partnership between Emory and Columbia/HCA's Atlanta market) does not plan to close any of its other seven hospitals or five surgery centers, says Gilbert. "In fact, we see this as a move that will benefit those facilities by possibly increasing patient admissions and physician involvement and almost certainly giving those facilities access to some of the many excellent employees who worked at West Paces."

Emory is helping make the transition easier for more than 400 former employees of West Paces, who learned about job opportunities within Emory Healthcare at a recent job fair. A comprehensive resource center is also helping former employees find other employment, and an outside firm is providing career counseling and transition services.

Signs of the Times



New Emory signs went up at seven EHCA,
LLC hospitals over the past few months.
Other changes involving the EHCA, LLC
hospitals have included The Emory Clinic
Northlake's move to Emory Northlake
Regional Medical Center. In addition,
hospitalists (internists who serve as
physicians to inpatients) are now on
staff at a number of EHCA hospitals.


Until recently, scientists believed separate brain regions processed information gathered by the various senses. That view is now being challenged.

For the first time, researchers have verified that the part of the brain involved in processing the sense of sight is also necessary for the sense of touch. An Emory study has confirmed the role of the visual cortex in tactile (touch) perception.

Interaction among the senses may be more common than generally thought, says lead author Krishnankutty (Krish) Sathian, associate professor of neurology and rehabilitation medicine.

In one task used in the study, a grooved object was impressed onto the fingertips of human volunteers. With their eyes closed or blindfolded, subjects tried to distinguish, via touch, the orientation of the grooves by the direction in which they ran along or across the fingertips. "They were 'visualizing with the mind's eye' the orientation of the grating on the fingertip, suggesting that visual imagery facilitiates this tactile task," Sathian says.

The Emory group then used positron emission tomography (PET) to show that a region of the cerebral cortex associated with sight is engaged when humans attempt to distinguish orientation via delicate touch.

The findings may help us understand not only how the brain normally processes sensory information but also how such processing is altered in conditions such as blindness, deafness, or numbness. Ultimately, the researchers hope the findings will help improve methods of communications for individuals with such disorders.

Feeling with Mind's Eye


The results of the first study to directly compare aggressive drug therapy for lowering cholesterol with angioplasty are in. Emory researchers and others in a national study have found that drug therapy is as good a treatment or better than angioplasty or usual care for preventing and delaying certain cardiac events in some patients with stable coronary artery disease.

The study, known as Atorvastatin Versus Revascularization Treatment (AVERT), enrolled 341 patients with stable coronary disease in 37 medical centers across North America and Europe. Participants were randomly assigned to receive either aggressive cholesterol-lowering therapy with the drug atorvastatin or to undergo balloon angioplasty and receive usual medical care. This usual care also may have included some form of cholesterol-lowering therapy.

Specifically, the AVERT participants who took 80 mg of atorvastatin daily reduced their low-density lipoprotein (bad) cholesterol by 46%. Thirteen percent of those receiving drug therapy experienced cardiac events (defined as cardiac arrest, nonfatal heart attack, stroke, bypass surgery, angioplasty, or cardiac death) compared with 21% who underwent angioplasty. The numbers show that participants receiving drug therapy had a 36% reduction in ischemic events during the 18-month study.

Additionally, the onset of cardiac events was significantly delayed in subjects receiving atorvastatin, compared with those in the angioplasty/usual care group.

Avert Bad Cholesterol


Are you Y2K compliant?" was the first thing Bryan Dunn asked when he arrived at Emory Hospital late New Year's Eve for his long-awaited heart transplant. He was kidding...sort of. He'd been joking for months that with his luck, he'd probably get a heart as the millennium clock turned to 2000.

He was right. Transplant surgeon David Vega began the operation on the 35-year-old at 10:30 pm New Year's Eve and finished about five hours later. "I wasn't too nervous about doing the transplant even though I know there was concern about Y2K issues at other centers," Vega said. "But the lights stayed on, and the heart bypass machine worked perfectly." The patient went home a week later.

Elsewhere in the health sciences center, it was also business as usual. Boring even, says Ron Palmich, who headed Emory's four-year, $10 million drive to become Y2K compliant. In this case, no news was the good news everyone hoped for.

Two dozen people manned Emory's Y2K emergency response center starting New Year's Eve but were sent home early on New Year's Day. Another 50 were on call in case of any emergency that might affect the hospital. Nothing happened.

Emory had been ready for Y2K since October 30, thanks to the efforts of almost 500 people, who spent from two hours to two months preparing for the date change. The concern was that anything driven by a computer chip might read the digits "00" as 1900 instead of 2000. It was hard to know if the fluke would affect computers, elevators, MRI devices, heart monitors, or other equipment and systems. So all equipment and systems were tested and components replaced when necessary to assure compliance. Contingency plans were fine-tuned.

Overall, the effort was enormous. More than 22,600 biomedical devices were tested, and in some cases, components and systems retested. One of the more challenging tasks was making sure that equipment and systems from outside vendors were up to par.

Emory and Crawford Long were prepared for Y2K because they always have a crisis response plan in place. If a power failure occurs, generators kick in almost immediately. Should the water supply stop, hospital cafeterias can switch to disposable plates; nurses can wash hands and patients with waterless soap; and stores of bottled water can be used for drinking and other purposes. Medications are also well stocked.

Preparing for the 21st century brought out some of the finest teamwork Palmich has ever witnessed. But it's not over yet. The Y2K team remains vigilent, watching for glitches that haven't shown themselves yet. Palmich doesn't expect much to turn up.

Y2K Brings New Heart


One of the key features of our immune system is its ability to remember and respond to invading organisms, even years after an acute infection. Viruses can trigger two types of long-term memory: humoral memory, in which B cells produce anti-bodies to prevent infection, and cellular immunity, in which T cells kill virus-infected cells.

Although the existence of immune memory has been recognized and documented for more than 2,000 years, scientists only recently have been able to visually distinguish which T lymphocytes become memory cells. They have done so by developing a new method of permanently marking T cells.

Emory immunologist Joshy Jacob and Nobel laureate David Baltimore developed a method of irreversibly tagging T lymphocytes with a cell surface protein in genetically engineered mice. Jacob calls the protein they used a "reporter gene." It is found in the human placenta but not in mice.

"In these mice, we can visualize memory T cells, follow their fate in vivo, and study their normal physiology," Jacob says.

The research, published in June in Nature, has far-reaching implications for vaccine development, transplantation, and the treatment of autoimmune diseases. "The key to designing good vaccines is understanding how immune memory works," Jacob says. "And the key to understanding how memory works is to have the ability to map and follow these memory cells in animals. The basic science that will come out of this will give us important clues as to what is important for the generation and maintenance of immune memory."

Clues to Immune Memory




In DNA microarray facilities, scientists are using a new technology that places them at the forefront of genetic research in the basic and clinical sciences. The new chip technology allows researchers to assess changes in the expression of thousands of genes simultaneously. Sequences from as many as 18,000 genes currently can be placed on a single chip. Soon, scientists expect to array 30,000 per chip.

Emory pharmacologist Scott Hemby, who directs a microarray facility at the Emory Vaccine Center, likens the technology to the ability to conduct thousands of experiments simultaneously. "Until now, assessing genetic changes has been equivalent to reading one word or sentence in a book and trying to decipher what the book is about," Hemby says. "Genomics gives us the ability to read a whole chapter and have a much better understanding of the entire book."

The new DNA microarray facility at the vaccine center serves as the core for a group of Georgia institutions that includes the Medical College of Georgia, Georgia State University, Georgia Institute of Technology, and the University of Georgia. The chip technology will also be made available to other state colleges and universities. Scientists in the Emory School of Medicine's division of molecular medicine also are using DNA chip technology to study genetic changes in mitochondrial diseases and aging, while investigators in the departments of pathology and urology are assessing genetic changes during intestinal inflammation and cancer. An Emory DNA sequencing core facility at the Atlanta VA Medical Center provides microarray technology services to other medical school investigators.

The chip technology, which draws on genetic sequencing information from the Human Genome Project, arrays complementary DNA (cDNA) representative of specific genes on a small chip. Scientists then probe the chip with RNA or DNA to compare diseased and normal tissue. RNA that matches genetic sequences arrayed on the chip will fluoresce when read by a special laser scanner.

Examining changes in the expression of multiple genes should reveal a "molecular fingerprint" of a disease. From that fingerprint, scientists will have a greatly enhanced ability to conduct basic genetic research, provide more accurate disease diagnosis and prognosis, and develop new drugs that target the genetic basis of disease.

Molecular Fingerprints


A large team of neuroscientists at Emory's School of Medicine has been awarded a five-year, $13 million grant from the National Institute of Mental Health to help establish the Emory Conte Center for the Neuroscience of Mental Disorders.

Investigators from Emory, Yale, and Princeton will work at the center under the leadership of Charles Nemeroff, chair of psychiatry and behavioral sciences. They will conduct eight projects based on the stress-diathesis model of mood disorders, put forth by Nemeroff in the June 1998 issue of Scientific American. The theory holds that depression experienced in adulthood is associated in many patients with aberrant brain chemistry altered in childhood by early life stress. The theory is based on rodent, primate, and human research conducted largely by the Emory team.

Traumatized as Child, Depressed as Adult?


In the 1970s John Bostwick was a resident, training at Emory under plastic surgeons Maurice Jurkiewicz and William Hamm (pictured right). A pioneer in plastic surgery, Hamm helped develop a procedure for skin grafts in the 1930s that is still used to treat burn victims today. Now, close to three decades later, Bostwick heads the division of plastic surgery and holds a chair named in his mentor's honor.

Hamm, who died of heart failure at age 96, left a $1.5 million endowment to fund the chair, bringing his contributions to Emory full circle. As clinical professor emeritus of surgery at Emory and a private practice plastic surgeon, Hamm was the first general surgeon in the country to receive full training in general surgery and then go on to complete extensive training in plastic surgery. He spent his Emory career of more than 60 years helping adults with cancer of the face, mouth, and jaw, as well as children born with congenital deformities.

The Hamm gift is just one of many generous signs of support given to the Woodruff Health Sciences Center in the 1998-1999 academic year. The Woodruff family of foundations presented the center with more than $50 million, honoring an earlier pledge. Other foundations supporting health sciences included the National Foundation for the Centers for Disease Control and Prevention and the O. Wayne Rollins Foundation. The estate of Reunette Harris supported scholarships and research with more than $19 million.

Corporate and individual support for the entire university was $233.9 million, with the health sciences center receiving 42% of that grand total.

Banner Year for Gifts



A $1.5 million endowment honors
plastic surgeon William Hamm.


Crippling afflictions like smallpox and polio are no longer a threat in this country because vaccines were developed to prevent them. But in many areas of the world, a number of devastating diseases remain for which there are no effective restraints.

A group of the nation's most respected immunologists and virologists hope to change that, working at Emory in one of the largest centers ever created to forge new vaccine strategies. Emory dedicated its new Vaccine Research Center Building in October, with a commitment to eliminate or control deadly infectious diseases that plague millions around the globe.

"The idea of the vaccine center is to create new technologies that will make our most challenging problems such as AIDS, malaria, tuberculosis, influenza, and respiratory viruses a thing of the past," says Rafi Ahmed, director of the center and the Georgia Research Alliance's Eminent Scholar in Vaccine Research.

The new 75,000-square-foot building adjoins the main building of Yerkes Regional Primate Center, adjacent to the Emory campus. Four levels house investigators in 23 state-of-the-art laboratories, contemporary offices, and meeting facilities. It also functions as an interdisciplinary "center without walls" for investigators throughout the health sciences center and for collaborative scientists at the CDC, the Carter Center, and nearby academic institutions. For more information about the center, see www.emory.edu/WHSC/Yerkes/current.

Vaccine Center Opens



Emory's Vaccine Research Center Building
houses investigators searching for
vaccines to eliminate or control
deadly infectious diseases.


Emory has cleared a major hurdle in plans for a $270 million redevelopment of Crawford Long Hospital. The Georgia Department of Community Health approved certificates of need late last year, clearing the way for construction to start on the midtown Atlanta hospital.
CLH Redo Gets State OK

By summer 2002, outpatient services now spread out over 14 acres will be consolidated in a 22-story, glass-and-stone building. Sixteen of those stories will house physician offices, while a 500,000-square-foot diagnostic and treatment center will occupy the six lower floors. Most inpatient rooms will remain in the Peachtree building. All outpatient diagnostics and testing areas, along with labor and delivery suites, will be in the new facility.

While the improvements won't add beds or expand most services, they are expected to help Crawford Long increase market share in tertiary care, such as cardiac surgery and women's services. More flexible operating rooms, an expanded emergency department, a women's center that combines labor and delivery services, and a new parking deck are expected to improve patient access and convenience.

Already under construction is the Pine Street parking deck, which began in mid-November, with completion expected by fall 2000. The 12-level, 1,150-car parking facility is an important piece of the master plan for the area, according to Emory Hospitals CEO John Henry. The deck will provide a convenient, safe, enclosed link to the hospital from the Civic Center MARTA station.

Groundbreaking for the medical office building will be this spring, with a projected opening of March 2002. The treatment facility is scheduled to open about six months later.

In this Issue


From the Director  /  Letters

The Grady Crunch

The Healing Fields

Getting into the Act

Moving Forward  /  Noteworthy

Grady's Crisis is America's

Dig It!

 

 


Copyright © Emory University, 2000. All Rights Reserved.
Send comments to the Editors.
Web version by Jaime Henriquez.