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April 1, 2006 – May 31, 2006

May 26, 2006

Implanted Heart Sensor Reduces Hospital Visits for Heart Failure Patients

A new implantable device that monitors pressure in the heart and transmits readings to the physician via the Internet reduced hospitalizations by 41 percent for patients with heart failure, according to a study by USC researchers and others.

Uri Elkayam and Leslie Saxon, both professors of medicine in the division of cardiovascular medicine, participated in the multicenter heart failure study called Chronicle Offers Management to Patients with Advanced Signs and Symptoms (COMPASS) that examined both safety and efficacy of a new device from Medtronic called “The Chronicle.” Their results were presented earlier this year at the annual USC Heart Failure Symposium, which was attended by 500 people.
“The Chronicle is very similar in size to a pacemaker,” Elkayam said. “It contains a sensor for recording pressure in the right ventricle where it is placed. A coil antenna is implanted under the skin to transmit the pressure readings to a small device placed over the chest by the patient. The readings are downloaded to a computer and sent to the physician via the Internet.”

“This device is the future—and is likely to change the paradigm for treatment of heart failure,” he said.

The doctor can use the information to adjust the patient’s medications or change treatment, even when there are no outward symptoms. “It turns out that pressure change is key to detecting changes that occur just prior to a patient needing to be hospitalized for worsening of symptoms,” said Elkayam.

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Gynecologist Seeks Causes and Prevention of Pelvic Floor Dysfunction

By day, Begum Ozel is a gynecologist and surgeon, treating female patients at the USC Executive Health and Imaging Center downtown, at LAC+USC Medical Center, or in her clinic at the USC Norris Cancer Institute. She sees her share of standard gynecologic complaints: vaginal infections, bleeding, uterine fibroids.

By night—well, by afternoon, actually, and any other time she’s not seeing patients, Ozel is one of only a few few researchers looking into the biochemistry of connective tissue.

The link is Ozel’s specialty in female pelvic medicine and reconstructive surgery.

As an assistant professor of gynecology at the Keck School of Medicine, Ozel is studying the biochemical changes that lead to some of the most distressing problems found in older women: pelvic floor dysfunction, which is the loss of elasticity and strength the muscles and connective tissue in the lower pelvis leading to a host of problems.

For instance, pelvic floor dysfunction may result in the bladder or uterus slipping from their original positions and actually protruding into the vaginal canal (prolapse), or loss of control of either urine or bowels or both. And it’s not just childbirth that causes pelvic floor dysfunction—other factors like obesity or constant straining due to constipation are also culprits.

With the aging population and the obesity epidemic, Ozel knows that the number of patients affected by pelvic floor problems will only go up.

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Women’s Health Initiative Data Points to Risks, But Also Benefits of Hormone Therapy

Results released from the Women’s Health Initiative (WHI) trial clarifies estrogen’s role in protecting women from heart attacks.

A USC medical researcher encourages women and doctors not to dismiss hormone therapy as the research continues to sort out mixed results from the last few years.

“It remains an active area for women’s research—it’s a very unsettled area, and the trials to date show differing outcomes,” said Howard N. Hodis, director of the Atherosclerosis Research Unit in the Keck School of Medicine.

In the meantime, women can still find benefits from taking hormones, including the relief of menopausal symptoms, preserving bone density and reducing risk of diabetes, even if their long-term benefits and risks are still being clarified.

“Are there risks? Yes, like any other medication, but they’re not great enough to create panic and make everyone using hormones get off them,” he said.

An article published in the Feb. 13 issue of the Archives of Internal Medicine concludes that estrogen therapy does not appear to raise or reduce the risk of heart attack in healthy postmenopausal women overall, but it does appear to lower the risk of heart disease in women aged 50 to 59 years. These results are consistent with a previous trial conducted at USC and dozens of previous observational studies conducted over several decades, Hodis said.

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Successful Children’s Health Initiatives at Risk, USC Study Shows

Coalitions of county-based groups focused on providing health insurance to California’s uninsured children have had remarkable success, enrolling more than 88,000 children in the past five years, according to a new study by Michael Cousineau, associate professor of research in the division of community health.

The study, produced for the nonprofit California Endowment, warns that the success of these programs is threatened by estimated budgetary shortfalls of up to $126 million by 2007.

Cousineau and colleagues Gregory Stevens and Kyoko Rice monitored the number of children enrolled in Children’s Health Initiatives, or CHIs, that have formed in 17 counties so far. CHIs are being planned in 14 other counties.

A coalition of health insurance providers, government officials and child health advocates convened toward the goal of enrolling all children in health insurance in their counties; the CHIs aim to put children in Medi-Cal or the state’s Healthy Families insurance programs. When children are ineligible for those insurance plans—because of undocumented status or family income—CHIs create coverage through their own Healthy Kids program.

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May 19, 2006

Neurobiologist Jonah Chan Sees Glial Cells as Unsung Heroes of the Brain

When you think brain cells, you (usually) think neurons—the 100 billion or so cells that use electrical signals to send messages such as “catch the ball” or “hot.”

For Jonah Chan, assistant professor in the Department of Cell and Neurobiology at the Keck School of Medicine, the brain is more about glial cells, which make up the bulk of the brain. It is estimated there are up to 50 times more glial cells in the brain than neurons—making them the majority cells by far.

“The neurons get all the press,” said Chan, smiling. “Glial cells haven’t gotten the attention they deserve.”

Once considered passive bystanders in the neurotransmission processes, glia are gaining a new respect as the “glue” that makes nerve cells function. Glial cells, are responsible for providing the insulating sheath around axons called myelin, which helps in the efficient transmission of neuronal signals. Additionally, glia are now thought to have roles in information processing, synaptic plasticity, nervous system development and pathology.

“Neurons and glia share a mutual dependence in establishing a functional relationship that is controlled by the integration of complex molecular signals and pathways,” said Chan. “These reciprocal interactions are responsible for multiple processes, including cell survival, proliferation, cell-fate determination and differentiation.”

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All Eyes are on USC Research at Ophthalmology Conference

In 100 presentations of scientific papers and posters, scientists and physicians from the Keck School and USC’s Doheny Eye Institute described their advances in the field of ophthalmology at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO).
Thirteen of the 18 Keck School residents in ophthalmology presented, noted Alfredo Sadun, professor of ophthalmology and neurosurgery—the third highest number of residents from any medical school in the country.
At the event, held in Fort Lauderdale, Fla., April 30-May 4, almost a dozen of the presentations involved a unique cohort of Brazilian families afflicted with Leber’s Hereditary Optic Neuropathy (LHON)—a rare, hereditary condition that causes loss of central vision.
For reasons still not entirely known, not everyone who has the genes for LHON loses their sight, or even exhibits significant symptoms. The disease, which is passed from the mother through genes in the mitochondria, afflicts mostly males. The symptoms are sudden and irreversible: devastating loss of sight in one eye, followed by loss of sight in the other eye weeks or months later.
USC scientists are zeroing in on understanding more about the disease, said Sadun, thanks to this cohort of 332 individuals across seven generations living in rural Brazil. They have studied for the past six years.

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May 12, 2006

USC Alzheimer’s Disease Expert Calls for Improved Clinical Trials

Lon Schneider, professor of psychiatry, neurology and gerontology, was among the world’s leading physicians and scientists who participated in the ninth International Geneva/Springfield Symposium on the Advances in Alzheimer Therapy, held April 19-22 in Geneva, Switzerland.

The conference on Alzheimer’s disease treatment and dementia research included more than 100 sessions presented by 125 speakers during the four-day symposium. Nearly 900 specialists attended the international gathering.

Schneider’s presentation, which will be an article in Current Alzheimer’s Research, focused on the vale of current Alzheimer’s disease clinical trials and how they may be improved. Specifically, Schneider stated that trials are not relevant for development or clinical application. He proposed improving drug development by conducting small, short placebo-controlled trials to prove cognitive efficacy, as well as large, longer trials to demonstrate effectiveness and utility by using staging instruments and health-related quality of life to determine maintenance of their illness stage.

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May 9, 2006

Richmond Speaks at Chinese Symposium

Frances Richmond, director of the regulatory science program in the USC School of Pharmacy, was one of two U.S.-based speakers featured at the North American Pharmaceutical Market and Regulation meeting in Tianjin, China, in late April.

Richmond gave a keynote address titled “Regulation of Generic Drugs and Dietary Supplements in North America.” She also participated with Chinese industry representatives during the workshop portions of the meeting.

Sponsored by the Economic & Trade Commission and the Industry Commission of Tianjin, China, the goal of the meeting was to help transform the Chinese industry from a supplier of chemical commodities to the U.S. to a provider of finished goods.

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May 5, 2006

USC Researchers Link Asthma in Children to Highway Proximity

Young children who live near a major road are significantly more likely to have asthma than children who live further away, according to a study that appears in the May 1 issue of Environmental Health Perspectives.

The study found that children living within 75 meters (about 82 yards) of a major road had a 50 percent greater risk of exhibiting asthma symptoms in the past year than were children who lived more than 300 meters (about 328 yards) away.

Higher traffic volumes on the different roads were also related to increased rates of asthma.

“These findings are consistent with an emerging body of evidence that local traffic around homes and schools may be causing an increase in asthma,” said lead author Rob McConnell, professor of preventive medicine at the Keck School of Medicine. “This is a potentially important public health problem because many children live near major roads.”

More than 5,000 children ages 5 to 7 were involved in the study, which was an expansion of the Children’s Health Study currently underway in 13 southern California communities. The researchers determined how far each participating child lived from a major road—a freeway, large highway or a feeder road to a highway.

“These results suggest that living in residential areas with high traffic-related pollution significantly increases the risk of childhood asthma,” said David A. Schwartz, director of the National Institute of Environmental Health Sciences (NIEHS), the primary agency that funded the study. “Children with no parental history of asthma who had long-term exposure or early-life exposure to these pollutants were among the most susceptible.”

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April 21, 2006

USC Scientists Identify Promising Avenue of Breast Cancer Research

Keck School of Medicine researchers have proposed a novel hypothesis for breast carcinogenesis that could spark new ideas for prevention.

Their examination of the role of lipid peroxidation in the epidemiology and prevention of breast cancer, published in Cancer Epidemiology, Biomarkers and Prevention last December, is “stimulating quite a bit of research, because it is one of the first new ways of looking at breast cancer in a while,” said Manuela Gago-Dominguez, assistant professor of research in the Department of Preventive Medicine.

In previous research, Gago-Dominguez and colleagues reported a novel pathway for renal cell cancer, the most common type of kidney cancer. Although scientists had recognized for a long time that obesity and hypertension increased the risk of developing renal cell cancer, no one had yet identified why they caused the disease. Gago-Dominguez and colleagues noted that a process called lipid peroxidation—the oxidation of fatty acids such as omega 3 fatty acids—is increased in the blood of patients who are obese and hypertensive and is an important cause of renal cancer in laboratory studies.

During the course of this investigation, Gago-Dominguez and Keck colleagues Esteban Castelao, Malcolm Pike, Alex Sevanian and Robert Haile noted that certain risk factors for renal cell cancer—including pre-menopausal obesity, pregnancy-related preeclampsia (high blood pressure in pregnancy), increased parity, and removal of the ovaries—were actually protective factors for breast cancer. On the other hand, certain protective factors for renal cell cancer—such as alcohol intake and oral contraceptives—actually increased breast cancer risk.

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April 7, 2006

New ZNI Researcher Probes Big Mysteries at the Smallest of Scales

The spectrometer in the basement of the Zilkha Neurogenetic Institute is enormous, a giant silver cylinder requiring a ladder to the top to place specimens inside. Multiple metallic tubes connect underneath, giving the impression of a sort of scientific brewery. The science it produces, however, is extraordinarily minute—providing a glimpse of the structure and action of proteins, the molecular machines inside cells.

This is the high-tech world of researcher Tobias Ulmer, assistant professor of biochemistry and molecular biology at the Keck School of Medicine. The German-born scientist uses nuclear magnetic resonance (NMR) spectroscopy to illuminate the three-dimensional structures of proteins and their dynamics at atomic resolution.

Ulmer came to USC only five months ago from the National Institutes of Health in Bethesda, Md., setting up the heavy equipment that will help him unravel some of the cellular mysteries of neurodegenerative diseases like Parkinson’s and Alzheimer’s.

“The aggregation of degradation products of the amyloid β-protein (Aβ) in neurons is a pivotal event in Alzheimer’s pathogenesis.” he said. “The aggregation products are toxic to the cells, leading to the loss of certain brain functions.”

Ulmer tries to understand how those aggregates are formed inside the cell and “figure out the specific interactions that stabilize the aggregated, disease state of Aβ versus the healthy state. If we understand the formation of the first type of aggregates to be formed, soluble oligomeric assemblies, we’ll be able to understand how to stop the formation of the entire range of disease-causing aggregates with drugs.”

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April 3, 2006

Pharmacy School Offers Diabetes Challenge: The Program Strives for Better Health Among Patients While Saving Health-care Dollars and Lowering Absenteeism

USC will offer the Diabetes Ten City Challenge, a proven diabetes self-management program, to employees and dependents covered through the university’s self-insured medical benefit, known as the USC Network Medical Plan, beginning June 1.

The patient-centered program teaches diabetics how to take charge of their diabetes by using the resources of their health-care team, with the pharmacist as the central, most easily accessible professional available to guide the patient.

Through regular appointments, the pharmacist coaches the patient on disease management issues and ensures that the patient is maintaining contact with team physicians, nutritionists and diabetes educators.

As an incentive, the USC Network Medical Plan will waive co-pays on prescription medications and diabetes monitoring supplies for all diabetic employees/dependents who enroll in the challenge.

“The Ten City Challenge takes care of diabetic patients in a smart, collaborative way, building on the knowledge and skills of physicians, pharmacists, diabetes educators and the patients themselves,” said Edith Mirzaian, coordinator of the Ten City Challenge-USC Program.

The goal of the program is to improve patient health, which also may result in saving health-care dollars and reducing absenteeism in the workplace.

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