------------------------------------------------------------ Newsbriefs ------------------------------------------------------------ Medical School dean emeritus recognized for lifelong efforts Throughout his 40-year career at the Johns Hopkins School of Medicine, Dean Emeritus Richard Ross has worked to preserve and protect academic medicine's inextricably linked missions of education, research and patient care. His lifelong effort was recognized last month by the Association of American Medical Colleges, which presented Dr. Ross with their 1994 Abraham Flexner Award for Distinguished Service to Medical Education. "This award represents for me a recognition by my peers of the accomplishments we all have achieved at Hopkins in the years I was dean," Dr. Ross said. "I personally am most proud of the fact that I was able to recruit such an outstanding faculty. This is important to me, because I believe the current faculty is directly descended from the hospital's original 1893 faculty. They recruited some of the best doctors in various fields who, in turn, recruited a subsequent group, who recruited the next group. So, I'm very pleased to have been able to continue that lineage of excellence. "And the quantitative measure of that success is the research funding we have been able to attract to Hopkins. When I became dean, Hopkins was something like seventh in National Institutes of Health grants to medical schools. When I retired, we were either first or very close to it," he said. "And this allowed us to continue to recruit top doctors and produce top research." Dr. Ross, who trained at Hopkins as an intern and resident, and was dean from 1975 through 1990, is considered an expert in coronary cineangiography, myocardial blood flow and myocardial performance as affected by coronary artery disease. He is the author and co-author of more than 150 articles and textbooks on various aspects of cardiovascular physiology and disease. "Our work is not by any means done, however, because the challenges continue in the changing health care environment," he said. "A premium is being placed on efficient and rapid care, shifting treatment more and more to outpatient clinics. This cuts into the teaching aspect of our mission. But my successor [Michael E. Johns] is working very hard to move education opportunities to these outpatient settings. "Hopkins is well positioned to take on the challenges we will face in the years ahead," he said. Public Health's Research Day showcases faculty projects Sharon Krag is well aware that the School of Public Health's mission is too often expressed in many, and often conflicting, languages. To try to bridge the gap between research and understanding, Dr. Krag, associate dean of research administration, organized the second annual School-wide Research Day on Nov. 10, a daylong event when young and seasoned faculty members showcase their most recent projects for colleagues and students. It is among the most important events on the school's academic calendar. "Interdisciplinary understanding often is limited by our vocabulary," Dr. Krag said. "But we have to stop to learn from each other, how to talk to each other. That challenge is a powerful thing that binds us all together. One of the school's greatest strengths is its interdisciplinary approach to tackling public health challenges." Several hundred students and faculty members packed into the East Wing Auditorium throughout the day to discuss work and discover common threads. The day was divided into three sessions: women's health was chaired by Carol Weisman, professor of health policy and management. The second session on molecular epidemiology was chaired by Gloria Petersen, associate professor of epidemiology. During the session, Lawrence Grossman, professor of biochemistry, presided over the liveliest question-and-answer period of the day. His topic concerned DNA repair as a biomarker in epidemiologic studies, and he served as referee between the epidemiologists and the biochemists. It was clear, he said, there was a communication problem. "You can see why we need these research days. We have to start sharing language and ideas," Dr. Grossman said. The third session on health care delivery, specifically patient outcomes research, was chaired by Judith Kasper, associate professor of health policy and management. One presenter, Donald Steinwachs, professor and chair of Health Policy and Management, discussed how outcomes research affects health policy. "We've entered a new generation of accountability," Dr. Steinwachs said. "Outcomes and quality information must be increasingly relevant to judge the performance of health care systems." "All new measures must consider diversity in health states," added Anne Riley, an assistant professor of health policy and management. "The goal is more than to just keep people alive. The best health status measures should be simple, universal, easily interpreted and applicable to a wide range of people." Dr. Krag was pleased both by the turnout for the event and by the quality and diversity of the presentations. "This event allowed us to recognize and reinforce our common threads of participation and cooperation," Dr. Krag said. "That's the powerful purpose for this day." ----------------------------------------------------------------- Hutchins determined to create world-class international services John J. Hutchins got his new position as Hopkins' first director of international services by making his prospective employers an offer they couldn't refuse. In his eight years as director of the International Center at the Cleveland Clinic Foundation, Hutchins built the annual volume of international business from $7 million to $70 million, said James Block, the hospital's president and chief executive officer. Hutchins, 53, invited himself to interview for a similar position at Hopkins, even though no such position existed there. But his offer to build Hopkins' international patient services into one of the finest in the world met receptive ears. Within the past year, Hopkins treated about 630 patients from 77 countries. The Cleveland Clinic Foundation treated that many international patients in a month. Part of the reason for the clinic's numbers is that they had aggressively courted international contacts and let it be known that the hospital was very accommodating to patients and their companions, Hutchins said. Hopkins, too, had been interested in attracting the business, but that had not been a priority. But it could have been, said Hutchins' boss in Cleveland, William Kaiser, who was a consultant to many U.S. hospitals, including Hopkins. Hutchins said that Dr. Kaiser told Hopkins administrators that they were losing a lot of revenue because their programs for attracting international patient services were underdeveloped and that the director of the program at Cleveland Clinic was about the only one who could straighten it out. That was John Hutchins. Although the seed was planted, the timing, for Hopkins, was not right. A year later, however, Hutchins was seriously entertaining offers from other hospitals, because Dr. Kaiser had retired and the new administration was not receptive to expanding its market share. As he mulled over offers from several other institutions, he asked himself a question. "If I were going to go to work somewhere else, should I go to where the offers are or should I go to the best hospital in America and offer my services," Hutchins recalled. "The best case scenario, I thought, was to go where the best doctors are, because ultimately that's the service the hospital is selling." So John Hutchins called Johns Hopkins and invited himself for an interview. He got the job. In his new position, Hutchins will be responsible for familiar duties such as foreign patient services, marketing programs and education. He will also assist patients and their representatives and will coordinate all aspects of admissions, in 36 languages, with the help of interpreters. Hutchins said he will draw on his 25 years of experience as a hospital administrator, including a five-year stint as a senior administrator at a 375-bed hospital in Taif, Saudi Arabia, to help him smoothly handle the diverse international patient population. "There is a lot of competition out there for these patients," Hutchins said. "Hopkins is the best hospital in the world, with the top doctors. We can and should get a larger percentage of them. That's my challenge." Researchers identify genetic alteration in prostate cancer Researchers at the Johns Hopkins Oncology Center and Department of Urology have identified a genetic alteration linked to prostate cancer that they believe is the most frequently occurring genetic error associated with the disease. Their findings were reported in the Nov. 21 issue of the Proceedings of the National Academy of Sciences. The investigators, led by William G. Nelson, assistant professor of oncology and urology, found the alteration-- hypermethylation of the glutathione S-transferase gene (GSTP1)-- in all of the human prostate cancer samples they studied. Methylation is a cellular punctuation mark control-ling the function of DNA in a cell. Too much methylation or abnormal patterns of it can markedly alter cell function. The researchers believe over-methylation of the GSTP1 inactivates it, which shuts down the cell's ability to manufacture an enzyme that detoxifies environmental carcinogens and protects against cancer. "Without the enzyme, prostate cells may be more vulnerable to carcinogens," Dr. Nelson said. Preliminary studies at Hopkins and elsewhere, involving men with noncancerous prostate tumors, have shown that some produce the enzyme while others do not. Researchers believe alteration of the gene at this stage, leading to its inactivation, may cause these benign prostate tumors to turn malignant. "If continued research confirms this hypothesis," Dr. Nelson said, "tests for the enzyme could serve as an early diagnostic marker for prostate cancer." Diagnosis may sideline athletes unnecessarily Some athletes who lose consciousness during or after physical exertion sometimes stop exercising, because they wrongly fear they may suffer sudden cardiac death. But according to a study done at Hopkins and the University of Michigan, many of these athletes have no underlying heart problems and can be successfully treated to prevent fainting. The researchers, led by Hugh Calkins, director of electrophysiology and associate professor of medicine at Hopkins, studied 17 boys, men and women who were involved in either competitive or non-competitive athletics. The participants, ranging in age from 11 to 45, all had a history of fainting during or just after exercise. "Our findings are important, because they demonstrate that athletes may lose consciousness due to vasodepressor syncope, which is a benign and often treatable condition," Dr. Calkins said. Following treatment with medication and an increase in salt intake, he said, they can resume their activities. But researchers point out that the vasodepressor syncope that occurs only during exercise may also reflect an underlying heart abnormality. It is important, therefore, to diagnose carefully those athletes who faint during exercise, because they may only have exercise-related vasodepressor syncope and not a potentially fatal heart abnormality.
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