In Today’s Issue: 2017 Recycling THE CATALYST Guide
Nov. 3, 2017 MEDICAL UNIVERSITY of SOUTH CAROLINA Vol. 35, No. 24 Inside Palmetto tree, steel beam mark milestone Topping out ceremony for BRAIN CHANGES IN SPACE new children’s hospital features Lowcountry twist
BY HELEN ADAMS [email protected] 6 “Hoist that beam!” NASA funds As carpenter Mekiel Mitchell said those words on stage with MUSC Health CEO MUSC Patrick Cawley, M.D., the final steel beam research. for the MUSC Shawn Jenkins Children’s Hospital and Pearl Tourville Women's Pavilion was raised into position atop the 625,000 square–foot structure. INNOVATIONS IN For Mitchell, who volunteered to speak on NEUROSURGERY behalf of Robins and Morton construction workers at the topping out ceremony, it was a kind of homecoming. “This project is very dear to me, because the hospital that once stood here, I was actually born in,” he told a photo by Sarah Pack crowd of co–workers, MUSC employees and The blue beam, draped in an American flag and holding a Palmetto tree, rises local dignitaries. “I have a special affinity for over Charleston as workers prepare to complete the steel structure underlying the this particular project." MUSC Shawn Jenkins Children's Hospital and Pearl Tourville Women's Pavilion. 8 Topping out ceremonies mark the placement Patents of the last beam on top of a building during building the building. You feel the energy, Association for Minority Contractors. ultimately help its construction. There’s often a tree atop the the excitement, to see the completion coming Kylon Jerome Middleton, pastor of Mount patients. beam, based on an old Scandinavian religious soon for such a mind–blowing project to help Zion A.M.E. Church in Charleston, led the rite. Since this topping out was in Charleston, our women and children.” audience in a prayer, saying, “This is a place a palmetto tree rode this beam on its way to Later, Cawley, who also serves as vice where anything, everything, can become the top. president of health affairs, described some of possible.” The new hospital is scheduled to open in the hospital’s highlights while standing on New things have already become possible 2 Around Campus 2019. Shawn Jenkins, the co-founder and a temporary stage in what will become the for Mitchell, the carpenter who spoke at CEO of Benefitfocus who has donated $25 5 Meet Lori hospital’s lobby. the ceremony. “This is my first time in - million to help build the hospital, called it “It will include an expanded neonatal construction. You all have inspired me greatly. 12 New Medical surreal to see the project reach this milestone. intensive care unit, enhanced labor and You guys have inspired me so much that I - District “It was just a year ago, October 19, that the delivery services, an entire floor dedicated to began school at Trident Tech for construction. - first pile was driven, and now we’re putting the care of the children with cancer, a world- I’m very grateful and proud to be part of this the top beam on the structure,” Jenkins said class atrium, a world–class outdoor healing project.” THE CATALYST before the ceremony, still wearing a hard hat space and the most comprehensive pediatric Cawley said none of this would have been NLINE O from a lunch he shared with the construction heart center in South Carolina,” Cawley told possible without the generosity of donors such http://www. workers. the crowd. as the Jenkins, Tourville and Zucker families, musc.edu/ “I come out and visit the job site a lot – every The project has already won awards, all of whom have donated millions toward the catalyst week or every other week. It’s just inspiring including the project of the year for project. to be around the 600-something people the Southeast region from the National 2 THE CATALYST, Nov. 3, 2017
PEOPLE Around Campus EVENTS Holiday Festival of Lights Barry C. Gibney The Holiday Festival of Lights begins Barry C. Gibney, on Nov. 10 and is open every evening DO, has joined through Jan. 1 at James Island County the Division of Cardiothoracic Park. Visit Santa’s Village & Winter Surgery. Gibney Wonderland. It’s so much more than is an assistant just a driving tour. Park your car and visit professor of surgery Santa, explore the sand sculptures, roast and completed his marshmallows, ride the festival train, general surgery plus other activities. Sunday through training at Penn Thursday: 5:30 to 10 p.m., Friday and State Hershey and Saturday: 5:30 to 11 p.m., 1 to 15 guests: thoracic surgery training at Brigham and $20 per vehicle, $15 per vehicle Monday Women’s Hospital Harvard Medical through Thursday with a canned food School. His medical specialty is lung and donation to benefit the Lowcountry photo by Anne Thompson esophageal cancer and minimally invasive Food Bank. Present at the Oct. 12 MUSC Macaulay Museum of Dental History reded- thoracic surgery. ication were Susan Hoffius, curator; Drs. Staci N. Gaffos, SC Dental As- Women Scholars Initiative sociation; W. Lynn Campbell, SCDA; the Hon. Alexander Macaulay, son The 4th Women Scholars Initiative Jerry Mansfield of Dr. Neill Macaulay; Drs. Patricia Blanton, CDM former interim dean, (WSI) mentoring session for postdocs
Jerry Mansfield, and Theresa Gonzales, president of MUSC’s Waring Library Society. and staff scientists will feature MUSC’s Ph.D., RN, MUSC Bernadette P. Marriott, Ph.D., Tuesday, Nov. 21, from 4 to 5 p.m., Drug Health executive Mario Serafini Bruce Usher chief nursing Mario Serafini, Bruce Usher, Discovery Building, room 312. Marriott officer, has been M.D., associate M.D., professor will provide insight as a basic scientist elected to the professor, joined in the Division within a medical university setting who board of directors the staff of the of Cardiology, has successfully cultivated a career in of the Friends Department of has recently research and public policy. Space is of the National Anesthesia and been awarded a limited so RSVP to [email protected]. Institute of Nursing Perioperative Mastership in the Drinks and snacks will be provided. Research. Mansfield will serve a two- Medicine in American College year term beginning Jan. 1. Mansfield October. Originally of Physicians. Usher Charles Towne Landing joined MUSC in August 2016 where he from West joins a select few Volunteers are needed at the Charles was CNO at The Ohio State University Virginia, Serafini’s focus is on chronic bestowed with the Towne Landing State Historic Site. Learn Wexner Medical Center. The NINR’s pain management and cancer pain. ACP’s Masters designation. Masters to fire cannons, preserve the historic focus is improving the health and health He recently completed a fellowship in are selected on account of integrity, gardents, etc. Meet 10 a.m., at the Visitor care of Americans through the funding of palliative care medicine. positions of honor, eminence in practice Center, first Saturday of every month to nursing research and training. or in medical research. complete a volunteer orientation.
The Catalyst is published bi- THE CATALYST monthly. Paid advertisements, which do not represent an endorsement by MUSC or the State of South Carolina, Editorial Office are handled by Island Publications MUSC Office of PublicAffairs & Inc., Moultrie News, 134 Columbus Media Relations, 135 Cannon St., Charleston, S.C., 843-958-7480 or Street, Suite 403C, Charleston, SC 843-937-7489. E-mail: advertising@ 29425. moultrienews.com. 843-792-4107 Fax: 843-792-6723
Editor: Cindy Abole [email protected] -===~Muse Medical University of South Carolina MUSC Public Safety Color Guard Video in Celebration of MUSC Veterans I Presentation of Lapel Pins to All Veterans 3 THE CATALYST, Nov. 3, 2017 Role of nurse practitioners in health care celebrated Nov. 12-18
BY PAULA BROOKS, DNP oncology, women’s health and emergency the country during NP week will help to of ART. Please pass out ribbons to your services. Working hand in hand with acquaint local citizens with the role of fellow NPs to promote MUSC NP and [email protected] other licensed health care professionals, NPs as providers of high-quality, cost- National Nurse Practitioner Week and ational Nurse Practitioner Week NPs improve the responsiveness and effective, personalized health care. It to give others an opportunity to ask what Nwill be celebrated this year Nov. efficiency of our health care system. will also highlight the value of choosing the gold ribbon means. 12 through 18. This special week offers In the United an NP as your partner in health. NP In addition to the gold ribbons, to a meaningful way to acknowledge States, the practice offers a unique combination celebrate National NP Week this year, and pay tribute to advanced practice NP workforce of nursing and health care treatment. there will be tables with information registered nurses (APRN) and the increased by Focusing not only on diagnosing and about NP practice in both the important contributions they make to more than 75 managing acute and chronic illnesses main hospital and lobby of ART, in the health of millions of Americans. It percent from like diabetes and high blood pressure, collaboration with the APP Best Practice also provides numerous opportunities to 2000 to 2011, NPs integrate health promotion, disease Center, APP Council and MUSC bring awareness to the NP role and the and presently, prevention, counseling and patient College of Nursing. exceptional care that NPs provide. there are education to help patients understand To learn more about NP Week and NP MUSC values the expertise that approximately their complete health picture. profession, visit aanp.org. To locate an APRNs bring to bear, and this 234,000 Here at MUSC, we believe in our NP in your community, go to npfinder. celebration affords us a great opportunity NPs, with NPs and are proud of the hard work com. Brooks to recognize them and say thank you. an additional they do every day. In celebration of 23,000 NP students graduating each year. National Nurse Practitioner week, we Additional facts about NPs: ABOUT NURSE PRACTITIONERS More than 1.02 billion visits are made are proud to recognize our NPs and An NP is an advanced practice to NPs annually. The growth rate in the again will be distributing gold ribbons q 22 states and the District of registered nurse who has completed profession has also been observed in for them to wear as recognition of their Columbia have granted full practice graduate level education, such as a the state. According to the most recent achievements. Inspired by similar efforts authority to NPs, giving patients master’s or doctoral degree. All NPs in data (May, 2016) from the United States conducted by other NP organizations, more direct access to the primary, South Carolina have been licensed by the Bureau of Labor Statistics, there were the campaign has proven extremely acute and specialty care services that South Carolina Board of Nursing, having 1,920 nurse practitioners employed in popular and was adopted by MUSC in NPs provide. completed the additional education and the state of South Carolina. 2016. q The federal government, through training. NPs have an expanded scope At MUSC, the role of the advanced Beginning Tuesday, Nov. 7, NPs can the Department of Veterans Affairs, of practice over the traditional registered practitioner is also growing. Currently, pick up a gold ribbon and wear them has approved the full scope of nurse role. An APRN can be a certified there are approximately 187 NPs in proudly during NP week. They are practice to NPs nationwide. registered nurse anesthetist (CRNA), a variety of APRN roles (NPs, CNM available either the director of APRNs q NPs provide a full range certified nurse midwife (CNM), a and CNS). In addition, there are 103 office, located at 245A North Tower of services, such as ordering, clinical nurse specialist (CNS) or a nurse CRNAs. Main Hospital, or in Kristy Smith’s performing and interpreting practitioner (NP). Events held in communities around office, located in office 1449, 1st floor diagnostic tests; diagnosing The first nurse practitioner training and treating acute and chronic program was developed in 1965 by conditions; prescribing medications Loretta Ford and Henry Silver, a nurse NursePractitioners: and treatments; and managing and a physician, respectively. Due to a overall patient care. shortage of physicians, state governments q NPs can prescribe medication sought innovative ways to meet the and other treatments in all 50 states growing demand for primary health 234,000 and the District of Columbia. q Patients whose primary care care services. Because the physician solutionsto strengthening shortage made it difficult to meet this providers are NPs have fewer demand, nurses began to take on the healthcare for America emergency room visits and shorter responsibility of providing primary care. NursePractitioners (NPs) are leadingthe charge,providing quality hospital stays, resulting in lower healthcare to millionsof Americans.In fact,an overwhelming Nursing leaders believed that nurses 64 percentof patientshave seen an NPfor their healthcare needs. out-of-pocket costs. were qualified to expand their roles and q Two out of three patients support meet the need. Out of that demand, the legislation for greater access to NP nurse practitioner profession grew to fill services. an important and vital role in America’s q NPs emphasize the health and health care system. well–being of the whole person in NPs specialize in many areas, including their approach, including helping acute care, gerontology, pediatric child patients make educated health care decisions and healthy lifestyle health, adult health, neonatal health, Am,,, ,, '< ··,,,,,,r AANP IJ\'U HSE PHACTITIO NEHS~ psychiatric mental health, family health, aanp.org choices. 4 THE CATALYST, Nov. 3, 2017 MUSC, SCSU team up to tackle health disparities BY HELEN ADAMS Dr. Marvella [email protected] Ford speaks with legislative aides about arvella Ford missed out on a fundamental part the need for health Mof childhood: having grandparents to spoil and disparities research. take care of her. They all died before she was born. “That’s a tremendous loss that you can never overcome. photo by Sarah Pack I grew up not having met or seen pictures of any of my grandparents,” she said. She couldn’t even find out how they died. “I was told that no one knew their causes of death. This lack of information about something so important made me decide to enter the field of health disparities research to try to better understand the reasons behind the racial and ethnic health disparities in this country.” Ford is now leading the effort to establish the South Carolina Cancer Disparities Research Center, designed to do exactly that. It’s funded by a $12.5 million grant from the National Cancer Institute. Half of the money goes to the MUSC Hollings Cancer Center and the other half to South Carolina State University. Ford is the glue that brings the two universities together in her roles as a professor in the MUSC College has multiple shared resources at the Hollings Cancer cancer. “We know that triple negative breast cancer is of Medicine’s Department of Public Health Sciences, Center, but SCSU hasn’t had one — until now. more prevalent in African-American women, but we a senior leader at the MUSC Hollings Cancer Center “This is specific to cancer research center grants,” Ford need to understand more about why,” Ford said. and the SmartState endowed chair in prostate cancer said. Having the shared resource will give SCSU a much SC CADRE will also help researchers study nuances disparities at SCSU. She’s leading the project with better shot at getting the federal government and other within the black community, including the health of Judith Salley-Guydon, chairwoman of the Department of funding sources to pay for its cancer research. That, she the Gullah living on the Sea Islands of South Carolina. Biological and Physical Sciences at SCSU. said, benefits both SCSU and MUSC. “It really allows “We’ve done some very preliminary work with 90 breast When it comes to cancer, “our state has glaring cancer MUSC investigators to partner with SCSU faculty, cancer survivors in South Carolina. Our work shows disparities geographically, socioeconomically, and in because they have access to funding resources we don’t that the prevalence of triple negative breast cancer seems terms of race,” Ford said. “With prostate cancer, the have, and vice versa, so multidirectional partnering can to be lower in Sea Islanders than in blacks without Sea death rate is three times higher for black men than it take place.” Island ancestry. We’re looking at biological contributors is for white men. The story is the same for women in to breast cancer outcomes. That’s the kind of study we’ll South Carolina with breast cancer. The mortality rate is INCREASING FOCUS ON THE HEALTH OF BLACK SOUTH be able to do.” much higher for black women than for white women.” CAROLINIANS Finding the answers to such questions may benefit The South Carolina Cancer Disparities Research The researchers will need good material to work with, people statewide, Ford said. “This is a cancer disparities Center, also known as SC CADRE, will be guided and the grant is designed to give them that. “We’re grant, but sometimes we forget disparities refer not only by the belief that race and circumstances should not establishing a new biorepository at South Carolina to racial and ethnic disparities but also to geographic keep people from enjoying as long and healthy a life as State and a clinical trials office in the Regional Medical and socioeconomic disparities. Our studies will include possible. SC CADRE’s goals include increasing SCSU’s Center in Orangeburg, where 62 percent of the patients multiple racial and ethnic groups with different levels of ability to do cancer research, conducting cutting-edge are African-American,” Ford said. education and income. We really want to improve cancer cancer disparities research, inspiring a new generation of Tissue samples taken from patients in the Regional outcomes for everyone in South Carolina.” researchers to focus on cancer disparities and getting the Medical Center’s Mabry Center for Cancer Care will general public more involved in cancer research. be taken to SCSU, cataloged and made available to LOWERING AGE LEVELS scientists. “We anticipate this new biorepository is going A third piece of the SC CADRE grant focuses on LAYING THE GROUNDWORK to be one of the most racially and ethnically diverse lowering the levels of AGEs, or advanced glycation end “This grant will help us build tremendous biorepositories in the country,” Ford said. “It should be products, in prostate cancer survivors. A big part of that infrastructure. The first piece is we’re developing a new in very high demand by other researchers and private may involve changing their diets, shifting away from biostatistics and quantitative methods shared resource at industries.” cooked meat to more fruits and vegetables. Researchers SCSU,” Ford said. One of the SC CADRE biorepository’s most will also look at whether exercise and medications can “Shared resource” is a common term in research. In important roles will be helping researchers identify lower AGE levels and improve people’s health. this case, it means a group of people who are experts differences in the biological pathways involved in “There is a big difference in levels of AGEs between in statistics and research methods who can help cancer diseases such as triple negative breast cancer, which has a blacks and whites,” Ford said. “Blacks actually have poorer prognosis than hormone-receptor positive breast researchers with data and computation. MUSC already See Cancer on page 11 5 THE CATALYST, Nov. 3, 2017
MEET LORI
ovizmbir8th et 5:30PM MUSCHorseshoe -~- · •· SalvationArmy CoastalBelle Singers Lori Tisdale, RN Dr.David Cole & Dr.Patrick Cawley Complimentary Department; How long at MUSC Nursing Professional Development; 8 years Cookies& HotChocolate
How are you changing what’s possible at MUSC I love being one of the first people to meet our new hires and explaining to them why MobileO n-siteM ammography MUSC needs their fresh eyes, enthusiasm and varied experiences to continue to improve our patient outcomes.
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BY CINDY ABOLE To describe these symptoms, NASA coined the term visual impairment [email protected] intracranial pressure syndrome, or VIIP t’s been 55 years since NASA syndrome for short. The cause of VIIP Iastronaut John Glenn successfully syndrome is thought to be related to launched into space to complete three the redistribution of body fluid toward orbits aboard the Friendship 7 Mercury the head during long–term microgravity spacecraft, becoming the first American exposure; however, the exact cause is to orbit the Earth. The evolution of unknown. Given safety concerns and the spaceflight, advancements in science and potential impact to human exploration technologies and the progress of public- goals, NASA has made determining the private commercial partnerships with cause of VIIP syndrome and how to companies such as Space X and Blue resolve its effects a top priority. Horizons have strengthened NASA’s Roberts is an associate professor photo by Sarah Pack goals and the public’s confidence to of radiology in the Department of Dr. Donna Roberts, third from left, joins her MUSC research team: move forward in discovery and human Radiology and Radiological Sciences Dr. Marc Chimowitz, left to right, Davud Asemani, Dr. Michael exploration. at MUSC. Before attending medical Antonucci, Dr. Maria Vittoria Spampinato, Dr. Arindam Rano Chatterjee, More people today are poised to school at MUSC, she worked at NASA Corie Lynn and Judith Yost. Not pictured: Elizabeth O’ Quinn. explore space than ever before; those Headquarters in Washington, D.C. evaluated brain neuroplasticity, studying Roberts also saw evidence of brain who do will experience the effects Working with NASA’s Space Life the brain’s motor cortex before, during shifting and a narrowing of the space of microgravity on the human body. Sciences Division in the early 1990s, and after long-term bed rest. Results between the top of the brain and the Recognizing the need for data related to she was already aware of the challenges confirmed neuroplasticity in the inner table of the skull. She questioned those effects, MUSC neuroradiologist astronauts faced during long-duration brain occurred during bed rest, which if the same thing might be happening to Donna Roberts, M.D., conducted a spaceflights. She was concerned about correlated with functional outcomes of the astronauts during spaceflight. study titled “Effects of Spaceflight on the lack of data describing the adaptation the subjects. In further studies, Roberts acquired Astronaut Brain Structure as Indicated of the human brain to microgravity As Roberts evaluated the brain scans, brain MRI scans and related data on MRI,” the results of which were and proposed to NASA that magnetic she saw something unusual. She noted from NASA’s Lifetime Surveillance featured in the Nov. 2 issue of the New resonance imaging (MRI) be used to a “crowding” occurrence at the vertex, of Astronaut Health program for two England Journal of Medicine. investigate the anatomy of the brain or top of the brain, with narrowing groups of astronauts: 18 astronauts who “Exposure to the space environment following spaceflight. of the gyri and sulci, the bumps and had been in space for short periods of has permanent effects on humans that Roberts suspected subtle anatomical depressions in the brain that give it its time aboard the space shuttle and 16 we simply do not understand. What changes in the brains of astronauts folded appearance. This crowding was astronauts who had been in space for astronauts experience in space must be during spaceflight might be contributing worse for participants who were on longer periods of time, typically three mitigated to produce safer space travel to the development of VIIP syndrome, longer bed rest in the study. for the public,” said Roberts. based on her earlier work. From 2001 See Brain on page 7 While living and working in space to 2004, Roberts led a three-year NASA- can be exciting, space is a hostile funded bed–rest study, collaborating environment and presents many with other life sciences researchers at physiological and psychological the University of Texas Medical Branch challenges for the men and women of in Galveston. A South Carolina native, America’s space program. For example, Roberts had just completed a two– NASA astronauts have experienced year neuroradiology fellowship at the altered vision and increased pressure University of California, San Francisco. inside their heads during spaceflight For this study, she examined the brains aboard the International Space Station. and muscular responses of participants These conditions can be serious who stayed in bed for 90 days, during problems for astronauts, particularly if which time, they were required to keep they occur in low-earth orbit aboard the their heads continuously tilted in a International Space Station or far from downward position to simulate the Earth, such as on an exploration mission effects of microgravity. to Mars. Using functional MRI, Roberts 7 THE CATALYST, Nov. 3, 2017
Changesto the Brainin Participant 28 do to the human body? Could a human ISS Astronaut even survive that long in a reduced– Astronautsafter Postflight Spaceflight gravity environment? NASA astronaut Scott Kelly spent VIDEOS 340 days living and working aboard 11111 111111 the International Space Station, and Videol . Effacementof theC SFSpaces al the Vertexand Crowding and Compression oftne astronaut Peggy Whitson recently CorticalVeins . completed a 288–day mission in space. A parasagittalcine clip of an 155as tronaut (Participant32) wno h ad an upwardsh ift of the To date, the longest continuous time brainpostA ight showsrelated effacement of the cerebralsp inalfl uid (CSF)spaces al thever texand in space was 438 days, a record held by crowdingand compress ionof thecortical ve ins alongthe innertable of thesku ll (arrows)coursing Russian cosmonaut Valery Polyakov. throughthe vertex subarachnoid space and draininginto the super ior sagittalsinus . “We know these long–duration flights images provided take a big toll on the astronauts and Cine clip stills show a crowding of cosmonauts; however, we don’t know if the cortical veins and upward shift the adverse effects on the body continue of the brain postflight in astronauts to progress or if they stabilize after some from the International Space Station. time in space,” Roberts said. “These are the questions that we are interested in BRAIN Continued from Page Six would be. addressing, especially what happens to Roberts compared these findings “The changes we have the human brain and brain function?” months, aboard the International Space with a similar medical syndrome seen may explain unusual Study co–author and Department Station. Roberts and her team then experienced by women called idiopathic of Radiology and Radiological Science compared the brain images of the two intracranial hypertension (IIH), which symptoms experienced by colleague Michael Antonucci, M.D., groups of astronauts. affects young, overweight women agreed. “This study is exciting in Roberts and study investigators who present with symptoms similar returning space station many ways, particularly as it lies at the evaluated the cerebrospinal fluid (CSF) to VIIP syndrome: blurry vision and astronauts and help identify intersection of two fascinating frontiers spaces at the top of the brain and high intracranial pressure with no of human exploration — space and the CSF–filled structures, called ventricles, known cause. A common treatment for key issues in the planning brain.” located at the center of the brain. In IIH is to perform a lumbar puncture, of longer-duration space “We have known for years that addition, the team paired the preflight whereby CSF is drained using a needle microgravity affects the body in and postflight MRI cine clips from high- placed in the lower back — a procedure exploration, including numerous ways,” he continued. resolution 3–D imaging of 12 astronauts performed by a neuroradiologist such as missions to Mars.” “However, this study represents the from long-duration flights and six Roberts. Presently, there is no protocol most comprehensive assessment of the astronauts from short–duration flights to perform a lumbar puncture in a Michael Antonucci, M.D. impact of prolonged space travel on the and looked for any displacement in brain microgravity environment. brain. The changes we have seen may structure. To further understand the results of explain unusual symptoms experienced Study results confirmed a narrowing the study, Roberts and the team plan to travel to and from Mars, along with the by returning space station astronauts and of the brain’s central sulcus, a groove in compare repeated postflight imaging of time spent on the surface, the Martian help identify key issues in the planning the cortex near the top of the brain that the brains of astronauts to determine expedition crew would be exposed to of longer–duration space exploration, separates the parietal and frontal lobes, if the changes are permanent or if they reduced gravity for at least three years, in 94 percent of the astronauts who will return to baseline following some according to Roberts. What would that See Brain on page 11 participated in long–duration flights time back on Earth. With NASA’s Mars and 18.8 percent of the astronauts on expedition mission set to launch in 2033, short-duration flights. Cine clips also there’s an urgency for researchers such showed an upward shift of the brain and as Roberts to collect more data about narrowing of the CSF spaces at the top astronauts and understand the basics of of the brain among the long-duration human space physiology. flight astronauts but not in the short- A journey to Mars can take three to six duration flight astronauts. months, at least. In order to reduce travel Her findings concluded that time between the Earth and Mars, the significant changes in brain structure two planets need to be aligned favorably, occur during long-duration space flight. which occurs approximately every two More importantly, the parts of the brain years. that are most affected — the frontal and During this two–year time period, parietal lobes — control movement of the crew members would remain on Mars, body and higher executive function. The carrying out exploration activities. longer an astronaut stayed in space, the The gravity on Mars is approximately worse the symptoms of VIIP syndrome one-third that of Earth. Considering 8 THE CATALYST, Nov. 3, 2017 Neurosurgeon proves necessity is the mother of invention
BY MIKIE HAYES “There was something, and there still [email protected] is, about making something myself. I’m a blacksmith now. I like making things Kitty Hawk had the Wright brothers. myself and seeing how far I can push it. Apple had Steve Jobs. There’s just something very intriguing MUSC has Bruce Frankel. about it.” Neurosurgeon, researcher, blacksmith, Not surprisingly, that driving curiosity speaker, inventor. A Renaissance man made its way into his work. with a keen power of observation and His first medical invention was a a lightning quick wit that could have cement tap. When he was a young just as easily landed him on late–night surgeon, he had a patient in Memphis TV, his domain is the operating room with a fracture in a bone that was very — where not only does he use his skill to osteoarthritic. He realized the screws he serve patients, he channels his boundless was going to insert into it weren’t going mental energy into innovation. to stay put. photo by Sarah Pack Whether he is placing screws in a “’This is terrible,’ I thought to myself. Dr. Bruce Frankel displays two of the patented surgical devices he spine, forging 160 layers of steel into ‘She’s going to get up, and the screws invented: the Everest Fenestrated Tap and the UST-5311. a Bowie knife or creating a way to see are going to rip out of her back.’ I would “I didn’t invent ultrasound,” he with that instrument and almost see into beneath a tumor, his brand of curiosity take a needle and inject the cement in explained, “but I made a device that is the future. I could tell where important doesn’t end with simply wondering the bone, but the bone was like Swiss an instrument that has ultrasound built blood vessels are before I saw them by how something might work better. He, cheese — it would squirt backward along into it so that I could use it as a probe, a eye.” like many inventors, is compelled to fix the needle and out another hole. So I curette or a scraper, but also so I could problems by creating unique solutions. thought, ‘Why don’t I make a disposable look at what I was doing simultaneously See Inventor on page 9 And he has 12 patents and 10 licenses tap that would prevent backflow of to show for it. cement that could be followed by screw Since the fifth grade, Frankel has been placement?’” figuring out better ways. When he runs There was, in fact, a whole body of into a problem, his mind immediately knowledge on how to cement them, but goes into high gear. none of it worked very well, so he set out “I get the idea to try something a to remedy that. And he came up with an different way, usually because there’s an idea that allowed him and other surgeons unmet need. So I’m always asking myself, to better cement them, giving patients ‘Why are you doing it that way?’ ‘Can a more robust and satisfying quality of this be done better?’” life. This concept skirted other existing Approaching things differently started patents and regulatory hurdles, had a early for Frankel. As a boy of about 10, number of patents issued and is still he decided to make his own skateboard. commercially available for use today. From scratch. He cut the platform out of It’s not just how something can be wood, stained it, got the individual parts done better that he grapples with but and put it together. “I guess it was I was also how to improve on something that’s in the fifth grade,” he recalled, “when inferior or possibly even dangerous. I went through a major bicycle- and Such was the case when he devised skateboard-making phase. a way to use a hand–held ultrasound- “Frankly,” he laughed, “they weren’t containing instrument to see within and very good. But I liked seeing how they around a tumor. held up under certain conditions. If I “I was doing surgery and couldn’t could skate around and the board didn’t see blood vessels behind the tumor crack in half, I was like, ‘Wow, I made no matter what I used, and that posed something robust enough that it could serious risks. So I thought, ‘I have to find withstand so and so,’ and I enjoyed being a better way of doing this.’” able to fix it when it broke.” Thinking outside the box paid off. Plus, he learned he could bring a He improved on an existing technology, project to fruition. taking it to a new and innovative place. 9 THE CATALYST, Nov. 3, 2017
INVENTOR Continued from Page Eight that’s important validation. surgeries. “I’m very mindful of the fact that if Frankel noticed during his surgical The device was unique enough that it I come up with an idea, I understand procedures, when he would tighten is used in a number of different surgical that I may see the utility, but when you the construct down, the curvature applications. For that invention, he see the market accept them, and you see of the rod would cause the top part received two patents, with others still other surgeons accept them, there’s a of the tall screws he was inserting to pending. pride. It’s thrilling to see that you really touch or overlap. When the screws are Not long after, he recognized there were onto something.” not placed properly, it puts stress on was still a need for a safer way to locate That possibility keeps his wheels the components. After the procedure, pilot holes in bone prior to performing turning, always asking, “What if?” Still, that could lead to loosening or other a pedicle screw implantation — a type of he doesn’t see how that makes him complications. But because of the bone screw that is implanted. He crafted particularly unique. device’s wave shape, several concave dips a small ultrasound device with a probe People have been asking that question in the rod allow screws to stay put and attached to the tip that could be used to for a very long time, he said. not touch when tightened. detect even the smallest bone breaches “You look back in history at the He has also worked with ZIAN on prior to the screw being inserted with surgeon–inventor type; there have several other devices, like an expandable the potential to greatly decrease the always been users and inventors,” he cage, which is used to reconstruct risk of injuring spinal nerves traveling explained, pointing to London surgeon vertebral bodies in complex spinal millimeters away. John Bradmore, who saved the day in the Dr. Bruce Frankel is co-director of surgery. This device has been issued two Interestingly, what is most exciting for early 1400s when Henry V was shot in the MUSC Spine Center. patents and is being actively licensed to him is not just how many other surgeons the head with an arrow, the tip of which lumbar spinal fusion surgeries where industry. are using his invention, but how they are lodged itself six inches into his face. degenerative spinal conditions, fractures, While revolutionary inventions such as taking it to the next level – beyond what Surgeons at that time would break the dislocations or tumors are present. these might conjure up images of state– Frankel had originally imagined. shaft of the arrow off wherever it was, so According to Frankel, who worked with of–the–art equipment lining the walls of “The ultrasound-based instrument — it didn’t show. If the person survived, the MUSC’s Zucker Institute for Applied an engineering lab, in reality, Frankel’s it’s a very versatile thing. The pedicle surgeon then would try to pull it out. Neurosciences to develop this device, it’s process is quite a bit less intimidating. screw system is only used in spine. But I “Accounts of the surgeon who devised a huge improvement over the standard At night and on weekends, he can be also use this ultrasound tool for pituitary the technique to be able to get the arrow rod that surgeons typically use in these See Inventor on page 11 surgery, as do other surgeons. They use out of the skull of the future king of it at quite a few famous institutions England shows that people have been around the country. Many places are doing this forever. It’s just part of being a seeing the value in it and making it human. You’re working with instruments safer for patients. Now, people are and creating things that didn’t exist – developing operations for patients with and seeing that you’re no different than cancer to more safely resect metastases any other human being. Whether it was that are growing in the spine. So people 500 years ago or 2,000 years ago, you’re are developing new operations around just doing what a human does.” it and building on it. It’s nice. I’m And earlier this year, his did it really thrilled by the versatility of that again. Frankel received notice that the particular device and how you use it with FDA had approved another device he different instruments you attach it to.” invented, a curved titanium rod he Building on his invention. For him, invented for use in minimally invasive 10 THE CATALYST, Nov. 3, 2017 Nature’s medicine: Part of process for greening MUSC
In 2012, the MUSC Annual Report, other health–promoting activities. happens within our walls. Ecotherapy titled “The Greening of MUSC,” Fast forward to November 2017, is a term that describes healing through MUSC described the recent trend at MUSC, and as we prepare to celebrate the interaction with nature. Research has Health which focused on sustainability, green first phase of the Charleston Medical found that patients in hospitals with a & Well-Being spaces and environmental conservation. District Greenway, it is evident that view of nature, a living plant in their Stories highlighted people and projects greening MUSC is an institutional rooms or interaction with hospital By Susan L. Johnson, dedicated to making MUSC a healthier priority that is having an impact far gardens, heal faster. One study reports Ph.D., MUSC Office of place to work and included the MUSC beyond the boundaries of our campus. that 95 percent of people who walk Arboretum, Porcher Medicinal Garden, Imagine MUSC 2020’s goal of Building through hospital gardens report a Health Promotion MUSC Urban Farm and MUSC Healthy Communities demonstrates therapeutic benefit from simply being boost. Sustainability, to name a few. A year our commitment to creating a culture in them. Contact with nature not only Spending time in nature also: later, in tribute to then-MUSC President of well-being on and off our campus, speeds patient healing, it also helps q Boosts the immune system Ray Greenberg, the Greenberg Greenway which focuses on policies, systems and an family members and hospital staff q Lowers blood pressure was dedicated, showcasing a series of environment that makes healthy living more effectively deal with the stress of q Reduces stress greenscapes that connect people with accessible for all. providing care. And that enables them q Improves mood places that support the environment The process of greening MUSC to serve their recovering loved ones and q Increases ability to focus, even in and ecology of our campus, provide has created not only a more visually patients better. children with ADHD opportunities for hands–on learning and appealing campus, but it also provides Benefits of a green campus extend q Accelerates recovery from surgery or create an inviting space for exercise and an extension to the healing work that beyond patients and visitors. Employees illness and students are no different than the q Increases energy levels average American, which means we q Improves sleep are all suffering from nature–deficit disorder, spending an estimated 93 No matter why nature influences our percent of our time either indoors or in well–being, the research shows that an enclosed vehicle. Negative effects can spending time in nature impacts our include diminished use of the senses, health in a positive manner. So take attention difficulties, higher rates of advantage of the wonderful green physical and emotional illnesses, a rising spaces, and think about taking your rate of myopia, child and adult obesity, next lunch break at the Urban Farm or vitamin D deficiency and many others. Medical District Greenway or by simply The good news is that just five minutes strolling through the arboretum that is of activity in natural areas resulted in the MUSC campus. And don’t forget improvements in self-esteem and mood, to come out and celebrate the Medical as well as increased focus and creativity. District Greenway on Nov. 20 at 11 a.m. the date Health care workers and students often For more information on greening work long hours and late shifts; getting at MUSC, visit www.musc.edu/ohp Going green through 2019 outdoors can improve circadian rhythms or email Susan Johnson. Ph.D., at and provide a much-needed energy [email protected]. It's only the beginning ...
Please plan to join the City of Charleston, MUSC , Roper Hospital, and the Ralph H. Johnson VA Medical Center to celebrate a kickoff event for the Charleston Medical District Greenway - Phase 1. More details to follow soon!
November 20, 2017 11:00 a.m. - 1:00 p.m.
If you are interested in supporting the Charleston Medical District Greenway, please contact the MUSC Office of Development at 843-792-4281.
U.S. O.pa rtm • nt MUSC ofV ete ransAffa ln Roper Medica l University Veterans Hc-alth of Sout h Carolina VAi Administration Hospital Ralph H. Johnson VAMedicalC~tct 11 THE CATALYST, Nov. 3, 2017
INVENTOR Continued from Page Nine I need to just focus on something else don’t care about patents. I care about my “I do look back and think, ‘That was a and not try to fix something. Sometimes patients. But in order to use a device on fun ride.’ I learned this and that, which found in his garage, tinkering with the it can be very taxing to have your mind a patient or get it into the clinic, I need gives me perspective. But it seems like supplies he’s bought at Lowe’s, designing continuously racing.” to interest companies in it. One of the it’s the next thing that really holds that prototypes. He genuinely enjoys the artistic process ways to interest companies is to build excitement for me.” Between his inventing, a busy surgical of making pattern–welded steel knives, value in it. You build value by having schedule and responsibilities that at any which he gives away to friends. It allows patents.” reeyde@mll$(;.edu time can include teaching, grant writing him to decompress. He welds the high– For him, that makes all the politics and research, it might seem like he’s on carbon and stainless steel — all 160 layers and red tape worthwhile, because being the job 24/7. Colleagues wonder if it’s — and forges it together. From the bolster in the operating room and inventing, RecyclesDay not actually a bit more, especially when to the tip, he handcrafts every single part he said, are the biggest thrills of his you add in the fact that Frankel and of the knife. And the etched artwork? professional life. his wife, a neurophysiologist at MUSC, His. Even the leather pocket sheath to “I love my patients. My greatest love 11.15.17 are so incredibly active in the lives and place it in — he sews it himself. is being a neurosurgeon. Using these activities of their five kids. And while he’s fortunate to have been instruments to help patients in the Sometimes, in fact, it takes hitting the granted so many patents, licenses and operating room is one of the most friendly skies for Frankel to find time to relicenses, he also said he’s had lots of thrilling things that I’ve experienced. take a mental break. failures. That just keeps him going back And writing about them, if I’ve used “Airplanes are great times for that. to the drawing board. And not for the it to reduce blood loss or increase the I’ll take whatever time is available,” he prestige — for the people who benefit strength of what I’m doing — that, to me, MuseHorseshoe said with a laugh. “We’re always getting from his work. is thrilling.” 11am-2pm pinballed from one place to another with Patents, he said, are just a necessary He has a couple of new things coming our jobs, so if there’s some downtime, evil. down the pike soon. But for now, he it’s a wonderful thing. I find it very “The business side of this, I am lousy said, he’s in a quiet period. Presented by MUSC Sustainability & Recycling soothing. Also, the blacksmithing is at it. I only have an interest in them Will that last? Food Trucks • Local Vendors • Games • Prizes & More! invaluable when my mind is rushing, and in order to get these ideas to market. I “No,” he admitted. ~Go IOXCAR IITTY'S Continued from Page Four Green [j'),g CANCER BRAIN Continued from Page Seven higher levels of AGEs even before cancer diagnosis. They’re linked with poorer prognosis and worse including missions to Mars. outcomes in prostate cancer. The idea is, if we can drive Roberts hopes to continue to collect long-term down the level of AGEs, we can make more equitable follow–up data on the astronauts already being health outcomes for blacks and whites, and it may help studied. In addition, she is participating in a new reduce disparity in prostate cancer survival rates.” bed–rest study in Cologne, Germany, collaborating with Racheal Seidler, Ph.D., of the University of Florida and the German Space Agency. The study BUY-IN FROM THE PUBLIC Ford said all of her team’s work is guided by input simulates astronauts living aboard the International from the public. “We have community input at every Space Station, while being exposed to higher levels step. Even in putting the grant together we went to our of carbon dioxide. CO2 scrubbers aboard the advisory board at the cancer center to get their input in International Space Station clean and filter the air how to proceed with developing the grant.” systems throughout the spacecraft, but some CO2 The SC CADRE researchers created a community remains. Roberts will evaluate the blood flow to engagement panel. “It’s important to have the input the brain, brain structure and other changes among of the public, especially when we’re designing clinical study subjects. trials. They can tell us about how the trial might be With her team’s hard work and dedication, perceived in the community. And when it comes to the Roberts hopes to establish MUSC as the go– end points that we think are most important, they may to institution for further studies in clinical have other ideas we can learn from.” neuroimaging related to space exploration. Part of getting that community input involves letting people know that the researchers understand where Study authors: they’re coming from, in terms of the burden of cancer Donna R. Roberts, M.D.; Moritz H. in local communities. “We hear the pain. We feel Albrecht, M.D.; Heather R. Collins, the pain,” Ford said. “I want people to know we are Ph.D.; Davud Asemani, Ph.D.; A. doing everything we can to conduct research to reduce Rano Chatterjee, M.D.; M. Vittoria disparities in South Carolina.” Spampinato, M.D.; Xun Zhu, Ph.D.; Marc I. Chimowitz, MBChB; and Michael U. Antonucci, M.D. 12 THE CATALYST, Nov. 3, 2017 Tactical Urbanism: Reclaiming Doughty Street for new Medical District Greenway Staff Report while the road is being painted green, electric signage indicating new travel With the Charleston Medical District routes for vehicles is being placed Greenway kickoff event quickly near the space (Nov. 3) and trees and approaching, employees will start to see furniture are being delivered and some major changes to Doughty Street, positioned (beginning Nov. 10). beginning this week. These changes Many exciting changes and new will affect the stretch of road that runs additions are expected in the area over from Doughty at Ehrhardt Street to the the next several weeks. The street will be images provided intersection of Doughty, President and painted green to denote the long-term intention to remove the asphalt. Mature Artist renderings of the new Charleston Medical District Greenway will Jonathan Lucas streets, which meet in feature a variety of trees, outdoor furniture and areas for relaxation. front of the Public Safety building. and hearty oak and bald cypress trees As of Monday, Nov. 6, this section will find new homes in large planters to offer fun and unique fare. lawn chairs and inaccessible to cars. of Doughty Street will close forever to along the greenway, beautifying the area. As the greenway is gradually brought to As time moves on and more permanent vehicular traffic, thus launching a new With the hope that people will begin to life, new landscaping promises to mirror projects are implemented to take the era of use for this space in the heart of utilize the space, new outdoor furniture the wonderful esthetic improvements greenway to its final phases, hopefully the Charleston Medical District. As a will offer numerous spots for respite and that are already evident around MUSC families looking for a nice place to walk result, it is important to be mindful of fellowship. Food trucks will be able to campus. It’s been said that Doughty and relax at MUSC, Roper or the VA, changing pedestrian patterns, especially park at one end of the greenway regularly Street is “going green through 2019,” and will come to consider this space a place it’s only the beginning. Before long, the of healing, community and sustainability. area will be completely transformed. For more information about the long- “Tactical urbanism” is a relatively new term planning efforts involving this part term that might be most familiar to of campus and the entire Charleston people who live in large metro areas such Medical District, please watch this as New York City, Chicago or Boston. It video: https://vimeo.com/239653080/ refers to reclaiming a road or abandoned e67f58e2d5. property quickly and inexpensively and Please plan to join MUSC, the city of creating a temporary public space that Charleston, Roper Hospital and the can be used in a new way for a variety of Ralph H. Johnson VA Medical Center at activities. The idea is to reclaim urban the kickoff event to celebrate the launch spaces swiftly, with more permanent of Phase I of the Charleston Medical changes coming in the future. Perhaps District Greenway. The event will take the best known example is NYC’s Times place on Monday, Nov. 20, from 11 a.m. Square, when literally overnight, it to 1 p.m., at the intersection of Doughty, became home to hundreds of folding President and Jonathan Lucas streets.