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February 10, 2006March 31, 2006

February 17, 2006

For New USC Dermatologist And Researcher, Love of Clinical Work Is More Than Skin Deep

Forget spider veins. Don’t even mention botox. And acne? Well…only if it’s a really bad case. For David Peng, assistant professor of clinical dermatology, dermatology isn’t about cosmetics. This Pasadena, Calif. native wants to work only on skin disease. The uglier the better.

Like the case of leprosy he treated a few weeks ago in his clinic at LAC+USC Medical Center. Or pustular psorasis. Or toxic epidermal necrolysis, a potentially deadly skin reaction to prescription drugs. “We just see some of the craziest diseases walk through the door” at LAC+USC Medical Center,” he said.

Even the dermatologic drama, however, was only part of what brought this multi-talented researcher to USC two years ago from his work as a melanoma researcher at UC San Diego. Rather, it was the opportunity to combine many of the things he loves: clinical work, teaching and epidemiologic research on skin diseases.

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March 10, 2006

Researchers Show How Genetic Changes Affect Lymphoma Survival

A multi-center, multi-national team of researchers, led by Joseph G. Hacia, assistant professor of biochemistry and molecular biology at the Institute for Genetic Medicine, has made unprecedented progress towards identifying molecular and genetic changes that have an impact on survival time in patients with mantle cell lymphoma.

The study was recently published in an online edition of the Proceedings of the National Academy of Sciences.

Mantle cell lymphomas are aggressive tumors that account for about six percent of all non-Hodgkin lymphoma cases in this country.

“In our paper, we took genomic approaches to characterize molecular changes frequently found in mantle cell lymphomas,” said Hacia.

“We recognize that mantle cell lymphoma is a blanket term for a number of highly related cancers that nonetheless have different clinical outcomes, such as time of survival after diagnosis,” he added. For instance, while the median survival for a patient with mantle cell lymphoma is three years, some individuals live for more than ten years after being diagnosed.

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Keck School of Medicine opens Center for Premature Infant Health

They are our most fragile citizens, these newborns whose weight is often measured in ounces and grams rather than pounds and kilograms. They no longer live in the warm, watery darkness of their mother’s womb, but instead are thrust into a world of metal and light and beeping, hissing, clattering sounds. They need help to breathe, to eat, to keep their tiny bodies warm. They need help—oftentimes a lot of help—to stay alive.

But what worries Jack Turman Jr., associate professor of biokinesiology and physical therapy at USC, is what happens afterward—after the tubes and the monitors have been removed and the round-the-clock care is no longer necessary. He worries about what happens when it is time for the baby to go about living the life for which it has been saved.
“In our effort to keep these babies alive, we often don’t think about—or even know—what we’re setting them up for down the road,” said Turman, who has a joint appointment in cell and neurobiology at the Keck School of Medicine.

But that reasoning is about to change, if Turman has anything to say about it. Turman has spent the past five years laying the groundwork for what is now one of the Keck School’s newest centers, the Center for Premature Infant Health and Development. Its goal is to create new strategies to help medically fragile infants and their families not just survive, but thrive.

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March 15, 2006

Tender Hearts: Learning That Your Baby Has A Congenital Heart Defect No Longer Means Certain Heartbreak. Thanks To Intricate Surgeries And Earlier Diagnoses, Most Tots With Broken Tickers Don’t Just Survive: They Thrive.

A generation ago, a baby born with such a severe set of heart problems would have had a slim chance of survival. But over the past quarter century, babies like Ryan have been given a good chance not only to survive, but to live normal lives, too.

“In the ’60s and ’70s, many of the complex forms of heart disease were fatal in infancy,” says Roberta Williams, chair of pediatrics at the Keck School of Medicine of USC and vice president for pediatrics and academic affairs at Childrens Hospital Los Angeles. “Now, the vast majority are reaching adult life, and most of them are quite healthy.”

While heart transplants are performed in some cases, they aren’t the norm, due to both a dearth of available donor hearts and the potential for organ rejection throughout the child’s life. Instead, surgical advances and improved care have made it possible to repair an infant’s own heart in the first days or weeks of life.

That’s good news, especially because congenital heart problems are the most common birth defects, occurring in about eight of every 1,000 live births. Many of those defects are relatively mild, but some, like Ryan’s, are life-threatening.

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The Maturing Heart: Lifelong Cardio Care

Children born with complex heart defects often continue to need specialized care as adults, and that can be hard to find, says Vaughn A. Starnes.

To fill this need, Starnes and his Keck School colleagues have started a clinic especially for adults with congenital heart disease. The new program will follow, evaluate and treat patients if they develop arrhythmias or other heart problems. Some patients will also need additional surgery.

“We’re approaching the time where we have some 20-year-olds and 25-year-olds coming back in need of other care,” he explains. “It was important for us to have a program to take care of these individuals as they get older.”

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March 17, 2006

Trauma Study Shows Obese Children Fare Worse Than Lean Peers

Adding more weight to the alarm surrounding the growing childhood obesity epidemic, a study by USC trauma experts found obese children and adolescents have more complications and require longer stays in the intensive care unit than their lean counterparts.

The study, “The Impact of Obesity on Severely Injured Children and Adolescents,” which appeared in the Journal of Pediatric Surgery in January, followed outcomes for more than 300 child and adolescent trauma patients who were admitted to the intensive care unit at LAC+USC Medical Center from 1998 to 2003. Injury patterns were similar, except obese patients had less severe head injuries. Although there was no difference in mortality among the lean and obese youth, obese youngsters had almost double the complications (41 percent versus, 22 percent) as their lean counterparts. In addition, obese patients required longer ICU stays after severe trauma.

“We were surprised, because we did not think obesity would have the same poor effects on outcome in children as our previous studies showed in obese adults,” said Carlos Brown, deputy director of the Navy Trauma Training Center at LAC+USC and lead author of the study. “The results are significant, given that obesity is just as big a problem across the country in children, and we’re starting to see more obese children in the trauma unit.”

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ZNI Scientist Seeks How Brain Makes Connections

In the black-and-white video image playing on Le Ma’s computer, small tentacles grow quickly outward, branching like tree limbs from a central white sphere. Some of the wispy lines contract and disappear, some stretch and swell and connect with other branches.

The time-lapse light microscope video is over in less than 10 seconds. What it shows—the intricate, dynamic formation of connections between brain cells—occurs throughout the development and still goes on in our brain for a lifetime.

From his lab in the Zilkha Neurogenetic Institute, Le Ma, assistant professor of cell and neurobiology at the Keck School of Medicine, is breaking new ground in the quest to understand just how the brain works.

His research is focused on understanding what triggers the network-building that goes on in billions of nerve cells in the developing brain.

“We know how a computer works and how individual building blocks are connected to form circuits,” said the young researcher, who came to USC six months ago from Stanford University. “What we don’t know is how individual nerve cells make thousands of connections to establish the complex networks in the brain. These connections are established during embryonic development and any misregulation could fail to form functional circuits and ultimately lead to early childhood diseases such as mental retardation.”

In addition, he said, while the connections in a computer, once built, remain essentially the same, the brain has the remarkable ability to “remodel” the connections even after the networks are established. “Such ability appears to be diminished over time in the central nervous system, contributing to the great medical challenge in adult nerve regeneration,” he said. “If we could learn how to trigger that remodeling, or better yet, how to direct it, it could have enormous medical implications.”

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March 21, 2006

Study Challenges Rush To Medicate Early Episodes Of Schizophrenia

The finding could pave the way for researchers to identify the large number of schizophrenia patients who do not need drugs, says Assistant Professor John Bola.
A USC review of published research has found no evidence that early episodes of schizophrenia without medication result in long-term harm for patients, casting doubt on the practice to immediately medicate for a year.

“The question is whether we should rush to treat early episodes with anti-psychotics, often before a clear diagnosis has become evident,” wrote John Bola in his study slated for publication in the April edition of Schizophrenia Bulletin.

Bola said the findings are important because the drugs used to treat schizophrenia can have serious side effects in nearly half of patients, from severe weight gain and restlessness to involuntary movement and adult-onset diabetes.

The controversial findings could clear the way for researchers to identify the large number of patients who do not need the drugs for their conditions to improve, said Bola, an assistant professor in the USC School of Social Work.

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March 24, 2006

USC Surgeon Helps Dancers Recover From Pitfalls Of Their Profession

With 28 bones, five nerves, two major arteries and countless muscles, the foot is a very complex structure.  Now consider the beating it takes day in and day out and then add the additional pressure an athlete places on it. Better yet, add the enormous stress and pounding that comes from a professional ballet dancer.   You can see why Timothy Charlton, assistant professor of orthopaedic surgery at the Keck School of Medicine of USC, is in high demand.

Charlton, who came to USC from Cornell’s Hospital For Special Surgery in New York six months ago with a specialty in foot and ankle orthopaedics, has worked with major ballet companies like the American Ballet Theater. With his mentor, William Hamilton, Charlton helped their dancers deal with pains, stresses and complex injuries in their feet and ankles. He is working with a podiatrist to design a new toe shoe that would reduce the stress.

“The dancer’s feet are the equivalent of a musician’s hands,” he said. “Women dancers get more injuries, mostly because they dance en pointe. But men get laboral tears in their hips, and an arabesque can cause huge back injuries. Dancing is extremely athletic, but it’s anaerobic, more like sprinting, where you get short periods of explosive activity that can be very difficult on the body.”

Interestingly, most of the people in Charlton’s practice are not dancers but “people who were athletic several years ago and now time has caught up and things are starting to break down.”  In fact, while most consider the knees the most vulnerable joint in aging weekend athletes, Charlton noted that “the feet take just as much force as the knee or the hip. It’s the same amount of weight going through each, and sometimes the smaller surface area or the angle of the forces in the foot or ankle can magnify the stress significantly.”

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USC Craniofacial Researchers Identify Gene Implicated In Human And Animal Birth Defects

Craniofacial researchers have developed an animal model that explains how skull malformations occur and how they might be prevented.  Birth defects of the face and skull are relatively common in humans, striking one in 500 to 1,000 babies. Defects can include cleft lip or palate, congenitally missing teeth and severe malformations of the skull.

A group led by Yang Chai, chair of the division of craniofacial sciences and therapeutics in the USC School of Dentistry, has identified the genetic factor leading to malformation of the forehead and frontal part of the skull. The discovery was published online Dec. 20 by the journal Development.

Children with frontal bone defects lack vital protection for their brain. They also may develop bulging, irregularly shaped heads.   Chai’s group focused on a gene called transforming growth factor-beta. TGF-beta is known to play an important role in human and animal development.

To study the gene’s effect on the skull, the researchers deleted TGF-beta in mouse embryos, but only in the cranial neural crest cells that build facial bone and cartilage. “If you knock out this gene in every single cell in the body, the embryos die very early. That doesn’t help us figure out the role the gene plays in cranial development,” Chai said.

The rest of the embryo’s cells were allowed to retain the gene and grew normally.  Mice born from the treated embryos carried severe craniofacial defects, including cleft palate and skull malformations.  The results showed that TGF-beta is necessary for proper development of frontal bones.

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March 31, 2006

USC Study Warns Of Link Between Antipsychotic Drugs And Diabetes
A new study that found the annual number of children prescribed antipsychotic drugs jumped fivefold between 1995 and 2002 to an estimated 2.5 million children, is giving new urgency to the work of Marilyn Ader, associate professor of physiology and biophysics at the Keck School of Medicine.

Ader, along with her colleague Richard Bergman, chair of physiology and biophysics at the Keck School and the Keck Chair in Medicine, studied two of the six medications in this class of drugs. Their study, published in the February 2005 issue of the journal Diabetes, noted that these drugs can have serious side effects.

In their six-week study, animals given the antipsychotic drugs “virtually doubled their body fat, becoming obese in a short period of time,” said Ader. In addition, the researchers found the functioning of the pancreas was severely impaired.
“When obesity impairs the ability of insulin to lower the blood sugar [‘insulin resistance”], a normal, healthy pancreas will sense that the insulin isn’t working, and compensate by releasing more insulin. It’s a normal function, called compensatory hyperinsulinemia,” said Ader.

However, in the animals that became obese and insulin resistant after receiving certain antipsychotic medications, “we were surprised to find that they were unable to release more insulin. Their pancreatic secretory function was seriously impaired,” she said. Since reduced secretory function of the pancreas presages type 2 (adult-type) diabetes, the findings of Ader’s group provide an important clue to the link between antipsychotic drugs and the development of diabetes.

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Study Shows Self-Esteem Falters Among ‘Fat’ Chinese Teens

Chinese teens who think of themselves as fat, even if they are normal or underweight, are at a greater risk for depression and school-related stress, a new USC study has found.

Girls who said they were overweight reported an overall grade point average of 3.06 versus 3.20 for other girls, according to the study of nearly 7,000 middle- and high-school students in seven Chinese cities.  Boys who felt obese reported being more prone to rudeness and losing their temper. The study appears in the March issue of the American Journal of Health Behavior.

“Thin as the ideal body type is a relatively new standard in China, a trend fueled by increased wealth and media exposure to Western lifestyle,” said lead author Bin Xie, an assistant research professor in the USC School of Social Work.  Weight perception may trump actual body weight in predicting negative psychological effects, Xie said.

“The major point here is that misperception has an important impact on academic performance and a person’s psychological experience,” Xie said.

In another study, published in the March edition of Preventive Medicine, Xie found that Chinese youth’s unhappiness with their weight was significantly related to Western media exposure, leading some girls to adopt such unhealthy behaviors as smoking or drinking.

“The studies underscore the importance children place on body image,” Xie said.

The data for the two studies came from an ongoing longitudinal health promotion study of Chinese adolescents in seven large cities on the Chinese mainland.

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