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January 4, 2013

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Message from Paul Ramsey

Paul G. Ramsey

UW Medicine researchers make significant advances in 2012 

Dear Colleagues:

As we begin 2013, it is worthwhile to review what was accomplished at UW Medicine in 2012. While productive in all areas, the past year was especially noteworthy for research advances. A few of many significant research advances are briefly described below.

With major input and leadership from UW, an international team of researchers made significant progress toward compiling a comprehensive list of the working parts of the human genome. The ENCODE (ENCyclopedia Of DNA Elements) Project found that nearly 80 percent of the genome is biochemically John Stamatoyannopoulos2active—far more than previously thought. John A. Stamatoyannopoulos (photo, left), associate professor of genome sciences and medicine and director of the UW ENCODE Center, was senior author on seven of the 30 ENCODE papers published in September. The ENCODE project was cited in the December 20/27 2012 issue of Nature as one of the top science stories of the year. The insights from this project are helping researchers understand the links between genetics and disease.

Joshua Akey, associate professor of genome sciences, and his colleagues published research indicating that the expanding global population has enabled DNA errors to occur more rapidly and that rare variants occur so often that they contribute to common illness more than once thought. These findings may help scientists identify the genetic basis of diseases.

In cancer research, graduate students Mike Schmitt and Jessie Salk in the laboratory of Larry Loeb, professor of pathology and biochemistry, developed and tested an ingenious method to reduce the error rate in DNA sequencing. This method has major implications for targeting which cells are mutating and could lead to early diagnosis of cancer and a better treatment plan once researchers know which cells are resistant to chemotherapy.

Chuck MurryIn heart disease, UW researchers discovered that when human embryonic stem cells become heart cells, the DNA packaging alters as the cells differentiate, enabling researchers to pinpoint key regulators of heart development. The team, led by Charles Murry (photo, right), professor of pathology, bioengineering, and medicine; Randall Moon, professor of pharmacology; and John Stamatoyannopoulos, focused on the development of stem cells into heart muscle. Sharon Paige, a UW M.D. - Ph.D. student in Murry’s lab, was lead author.

Brian O’Roak, senior fellow in the Department of Genome Sciences, Jay Shendure, associate professor of genome sciences, and Evan Eichler, professor of genome sciences, provided important insights into genetic mutations that may impact autism. By uncovering new gene mutations that disrupt the function of proteins, the researchers discovered a pathway related to modifying chromatin—the tightly coiled spools of DNA in the cell—and to regulating genes in the brain and nervous system.

In prenatal studies, UW scientists successfully sequenced the genome of a baby in the womb without tapping its protective fluid sac. Jacob Kitzman and Matthew Snyder, both graduate students in genome sciences, led the study under the supervision of Jay Shendure. The tests are considered a safer substitute for the more invasive sampling of fluid from the uterus, a common procedure in obstetrical practice. CNN selected the UW researchers’ work as one of the top 10 science stories of 2012.

James MullinsIn HIV research, scientists used genetic sequencing to discover that the vaccine used in the RV144 HIV vaccine trial offered some protection against certain strains of HIV virus. This finding shows that a vaccine is possible. James Mullins (photo, left), professor of microbiology, medicine and laboratory medicine, leads one of the two laboratories that performed genetic analyses of the virus.

Comparing DNA from patients at the best and worst extremes of a health condition can reveal genes for resistance and susceptibility. This approach discovered rare variations in the DCTN4 gene among cystic fibrosis patients most prone to early, chronic airway infections. Mary J. Emond, research associate professor of biostatistics in the School of Public Health was first author of this report and Michael Bamshad, professor of pediatrics in the Division of Genetic Medicine, was senior author. Exome sequencing was performed by UW researchers in the laboratory of Debbie Nickerson, professor of genome sciences.

A team of UW Medicine researchers, in collaboration with scientists at the University of California, Berkeley, and the University of Munich, discovered a chemical that temporarily restores some vision to blind mice. The approach could eventually help those with retinitis pigmentosa, the most common inherited form of blindness, as well as those with age-related macular degeneration, the most common cause of acquired blindness in the developed world. Russ Van Gelder, UW chair and professor of ophthalmology, was a co-author on the study.

Christopher MurrayChris Murray (photo, right), professor of global health, his colleagues in the Institute for Health Metrics and Evaluation, and colleagues worldwide provided groundbreaking knowledge about global health. The global team found that fewer people are dying worldwide but more are living with disability. Mental health disorders, pain, and injuries hinder people’s health, and obesity and high blood sugar are replacing lack of food as leading risks. The studies, published in a first-ever triple issue of The Lancet on December 15, have major implications for future policy decisions related to global health worldwide.

This brief list is by no means inclusive. UW Medicine is an exceptional home for research and I anticipate that 2013 will match and surpass 2012 in research advances. I offer my thanks to all UW Medicine researchers who make our community vibrant, extraordinary and highly successful in achieving our mission of improving health for all people.


PGRamsey Signature2


Paul G. Ramsey, M.D.
CEO, UW Medicine
Executive Vice President for Medical Affairs and
Dean of the School of Medicine,
University of Washington




UW Medicine faculty elected as fellows of the American Association for the Advancement of Science

Four UW Medicine researchers are among 702 new fellows of the American Association for the Advancement of Science (AAAS). Eleven UW scientists were elected in total. Election as a fellow of AAAS is an honor bestowed upon members by their peers. Fellows are recognized for meritorious efforts to advance science or its applications. The new fellows will receive a certificate and a blue and gold rosette as a symbol of their distinguished accomplishments at a ceremony at the Fellows Forum during the AAAS Annual Meeting in Boston, Feb. 16.

The UW Medicine AAAS fellows are:

Breck E. Byers, professor of medicine and genome sciences and former chair of the UW Department of Genetics, was selected for his contributions to cellular and molecular biology. He is noted for his work on the yeast cell cycle as a model for understanding cell division in a wide variety of organisms. Most significantly, he has pioneered work on how dividing cells split and transmit their genetic material during proliferation and during the creation of gametes, or reproductive cells. He also expanded the use of electron microscopy to capture fine details of cellular structures. He was one of the leaders in establishing the UW Department of Genome Sciences in 2001.

Trish DavisTrish Davis (photo, left), professor and acting chair of biochemistry, studies the molecular machines and motors that move chromosomes inside of cells. When operating with clockwork precision during cell division, they assure that chromosomes are evenly divided as the pairs are pulled apart. Errors can lead to birth defects, cancer, or cell death. Davis’ lab is working to understand the cell structures and activities that organize the accurate segregation of chromosomes during cell duplication, and the quality control measures that detect and correct mistakes. She is applying these findings to analyze the chromosome division abnormalities that occur in human cancer cells.

John Stamatoyannopoulos, associate professor of genome sciences, recently made several major contributions to Project ENCODE, an international effort to understand the regulatory elements of the human genome. He developed powerful techniques for mapping these complex control networks and is helping to uncover the operating instructions for the human genome. Through a greater understanding of the role of genome regulators generated in his lab, new ways of looking at the causes and progression of disease are likely to emerge.

Elton YoungElton “Ted” Young (photo right), professor of biochemistry and genome sciences (photo, right), studies the DNA and protein factors that control how yeast genes produce their products. His lab is interested in the genes that encode a family of enzymes involved in alcohol metabolism. Young and his team have identified the DNA sequences that mediate the expression of these genes. His discoveries have advanced knowledge about transcription regulation – how sections of the DNA code are transcribed to RNA. His group is making “designer” DNA binding proteins to target specific sequences in complex genomes and activate transcription.

For a complete listing of recently elected AAAS fellows, visit the AAAS website.

Read more in UW Today.  

Mild brain cooling after head injury prevents epileptic seizures in lab study

Raimondo Dambrusio2Mild cooling of the brain after a head injury prevents the later development of epileptic seizures, according to an animal study reported in December in the Annals of Neurology.

Epilepsy can result from genetics or brain damage. Traumatic head injury is the leading cause of acquired epilepsy in young adults. It is often difficult to manage with antiepileptic drugs. The mechanisms behind the onset of epileptic seizures after brain injury are not known. There is currently no treatment to cure it, prevent it, or even limit its severity.

The multi-institutional research team used a rodent model of acquired epilepsy in which animals develop chronic spontaneous recurrent seizures—the hallmark of epilepsy—after a contusive head injury similar to that causing epilepsy in humans. The rats were randomized to either mock-cooling or cooling of the contused brain by no more than 2 Celsius degrees. This degree of cooling, the authors explained, is known to be safe and to decrease mortality of patients with head injury. The rats were then monitored for four months after injury and epilepsy was evaluated by intracranial EEG. The contused brain was cooled continuously with special headsets engineered to passively dissipate heat.

The investigators report that cooling by just 2 degrees Celsius for 5 weeks beginning 3 days after injury virtually abolished the later development of epileptic seizure activity. This effect persisted through the end of the study. The treatment induced no additional pathology or inflammation, and restored neuronal activity depressed by the injury.

“These findings demonstrate for the first time that prevention of epileptic seizures after traumatic brain injury is possible, and that epilepsy prophylaxis in patients could be achieved more easily than previously thought," said the lead author of the study, Raimondo D’Ambrosio (photo, upper left), UW associate professor of neurological surgery (photo, left). He added that a clinical trial is required to verify the findings in head injury patients.

In addition to D’Ambrosio, the research team from the UW included John W. Miller, professor of neurology and director of the UW Regional Epilepsy Center; Nancy R. Temkin, professor of neurological surgery and biostatistics; and Jeffrey G. Ojemann, professor of neurological surgery.

Read more in UW Today.



Clinical Care  

UW Medicine establishes new recognition program for service excellence

UW Medicine Recognition AwardUW Medicine is more than a health system. It is a collective of outstanding individuals working together to make UW Medicine the region’s healthcare system of choice for patients and families, and the workplace of choice for employees.

UW Medicine has established the UW Medicine Cares Award, a new program to formally recognize and celebrate the accomplishments and excellence of those in the UW Medicine community who consistently exemplify the UW Medicine Service Culture Guidelines. (Requires a UW NetID.) The guidelines are professional standards that ensure that anyone who encounters UW Medicine receives the same great care and service throughout the system. 

Each UW Medicine entity – Harborview Medical Center, Northwest Medical Center, Valley Medical Center, UW Medical Center, UW Neighborhood Clinics, UW Physicians and Airlift Northwest – will participate in the UW Medicine Cares Award program.

Anyone, including a member of the public, can nominate a healthcare professional, staff member or a team that has made a difference in patient care or the work environment. Employees can nominate a person or team outside of their own entity, as well. Within UW Medicine, nominations can be submitted online (links provided below), and each entity will manage its own nominations.

Each nomination will be approved by the nominee’s supervisor and the entity’s Human Resources before being added to the pool. Committees at each entity will review nominations twice yearly to select healthcare professionals, staff members and teams for the award.

Individual and team award recipients will receive a copy of the nomination, letter from UW Medicine CEO and Dean Paul Ramsey, a recognition certificate, lapel pin, and a professional photo, which will be displayed at the respective entities, on the entity’s intranet, and on the Patients Are First website. Individual recipients will also receive a gift from the University Book Store; team award recipients will be honored with a celebration in their department.

Patients, families, guests and others will be able to access a public nomination form on the UW Medicine website.

The first round of recipients will be selected and announced in late March.

To make a nomination or for more information, click on the appropriate entity link or contact your entity’s UW Medicine Cares Award representative listed below:

Airlift Northwest – Lori Joubert – ljoubert@airliftnw.org

Nominate someone at Airlift Northwest 

Harborview Medical Center – Monica Singh – ms5@uw.edu

Nominate someone at Harborview Medical Center

Northwest Hospital & Medical Center – Lorna Andrews – lorna.andrews@nwhsea.org

Nominate someone at Northwest Hospital 

UW Medical Center – Tara Brown – tarab34@uw.edu

Nominate someone at UW Medical Center

UW Medicine Shared Services – Tara Brown – tarab34@uw.edu

Nominate someone in UW Medicine Shared Services

UW Neighborhood Clinics – Jessica Davis – jdavis1@uwpn.org

Nominate someone at the UW Neighborhood Clinics

UW Physicians – Bonnie Sellen – bsellen@uwp.washington.edu

Nominate someone at UW Physicians

Valley Medical Center – Sue Churchill – sue_churchill@valleymed.org

Nominate someone at Valley Medical Center


HIV testing expands beyond high-risk groups 

The following is an excerpt from an article by Corinne Heinen, a family medicine physician at UW Neighborhood Belltown Clinic. She also provides HIV/AIDS care at Harborview’s Madison Clinic.

Corrine HeinenDon’t be surprised if your doctor suggests HIV testing during a routine office visit. Since 2006, the Centers for Disease Control and Prevention has recommended screening in primary care, even for patients not in high-risk groups. Everyone ages 13-64 who has ever been sexually active should be tested at least once. Women should be tested during pregnancy. Before starting a new relationship, I recommend to my patients that they get a screen for sexually transmitted infections and ask the same of their prospective partner. 

Screening involves a simple blood test for antibodies to HIV, but it takes from three weeks to three months for this test to turn positive after a patient has been infected. If a person is concerned about being sick with HIV for the first time, another specific blood test can be used for this diagnosis.

In the United States, 1.1 million people are infected with HIV, about 20 percent of whom are unaware of their status. Getting these people diagnosed and into care is crucial to decreasing the rate of new infections, which has remained stable at about 40,000 cases each year.

HIV is spread through such body fluids as blood, semen, vaginal fluids, anal fluids and breast milk. After being infected, some people will have no symptoms for years. Others may experience fever, sore throat, swollen neck glands and a rash within two to four weeks. Because these symptoms are similar to mononucleosis and other viral illnesses, HIV is often overlooked as a potential cause. It is extremely important to figure out who is having early infection, as it is estimated that almost half of infections are transmitted by people at this early stage of disease when their viral load (the amount of virus in the blood) can be astronomically high.

When I began caring for HIV patients in the 1990s, screening focused on high-risk groups: gay men, intravenous drug users and people with multiple sex partners. Due to the lack of effective treatments, a positive diagnosis came with a difficult prognosis. Today, even though the virus is more widely present in the general population, the good news is that powerful antiretroviral medications are available that can suppress virus levels in the bloodstream. When taken daily, exactly as prescribed, these drugs can often slow significantly or prevent the progression to AIDS.

Read the entire article in the Journal magazine. 


Education and Training 

Academic medicine has major economic impact on the state and the nation

A report released last week from the Association of American Medical Colleges shows that its member medical schools, teaching hospitals and healthcare systems had a combined economic impact of more than $587 billion in the United States in 2011. The firm Tripp Umbach conducted the economic measurements and analysis.

The AAMC is a not-for-profit association representing 133 accredited medical schools and 255 major teaching hospitals and health systems in the United States, including Department of Veterans Affairs medical centers.

Washington was among the 25 states with the highest economic impact from academic medicine, which encompasses three interwoven missions:  training physicians and biomedical scientists, conducting research, and providing patient care.

UW Medicine is one of the largest members of the AAMC in the country. UW Medicine includes four hospitals (UW Medical Center, Harborview Medical Center, Northwest Hospital, and Valley Medical Center), the University of Washington School of Medicine;  UW Physicians, which is the largest physician practice plan in the northwest; UW Neighborhood Clinics; and Airlift Northwest. UW Medicine also shares in the ownership and governance of the Seattle Cancer Care Alliance and Children’s University Medical Group.

The total business volume economic impact of AAMC members in the state of Washington was $5,745,608,783, an amount that placed Washington 25th among the states.  New York, California, Pennsylvania, Massachusetts and Texas had the highest total business volume impact.

Visit The Economic Impact of AAMC-member Medical Schools and Teaching Hospitals to read the full report.

Read more in UW Today.


Training Xchange puts UW research advances into practitioners' hands

Allison and Pavel 2UW Training Xchange is on a mission to put more new therapies, tools, and process improvements into the hands of healthcare practitioners and other professionals for the benefit of millions of people. Life-saving advances continually emerge from faculty labs and clinics at the University of Washington, which is one of the nation’s largest recipients of federal research funding for biomedical science.

Many UW researchers publish journal articles about their new findings and proven methods, but often their readers don’t know how to adopt them. Faculty and graduate students do not have time to set up and promote training programs. To address the innovation adoption gap, the UW is expanding its Training Xchange initiative to enable researchers to transmit their innovations to healthcare workers and other professionals locally and far beyond the Northwest.

“The UW is one of the nation’s leading centers for health, medical, and bioengineering research, and we’d like to see as many research advances out in the world making lives better for people, rather than sitting on a bookshelf. Training others in their use is a way to do this,” said Paul Ciechanowski, UW associate professor of psychiatry and behavioral sciences and director of the Training Xchange. Ciechanowski developed the initiative with Richard Veith, chair of the UW Department of Psychiatry and Behavioral Sciences.

Their team created a training infrastructure that helps university researchers translate evidence-based information and methods from their labs and clinics into formats designed for wider dissemination. Offerings include a range of in-person and online training products through which trainees gain tangible skills and practical knowledge they can put to work immediately.

“Combining our faculty’s expertise with the experience and platform of Training Xchange is a great way to bridge the gap between research and practice,” Veith said.

One major initiative called TEAMcare brings a proven UW faculty intervention to medical clinics. It integrates mental health and medical services for people diagnosed with both depression and diabetes or coronary heart disease. TEAMcare results in better treatment that can save lives. A group led by Wayne Katon, UW professor of psychiatry and behavioral sciences, developed TEAMcare with assistance from Training Xchange. Success in promotion and early adoption has earned the UW a $1 million award from the Centers for Medicare and Medicaid Services to expand the program as part of an $18 million national initiative to foster the widespread implementation of TEAMcare.

Read more in UW Today.

Photo: Paul Ciechanowski, director of Training Xchange, with Allison Waddell, program manager, in front of the Center for Commercialization sign.

UW Medicine Advancement launches website to recognize honorary chairs and professorships

UW Medicine Advancement has launched a new website that celebrates the accomplishments of physicians, researchers and educators who hold honorary chairs and professorships. These faculty members inspire donors whose generosity creates and funds these positions to advance UW Medicine’s work. To review the stories behind the creation of these funds, visit UW Medicine Advancement’s new, enhanced website.

For more information, contact UW Medicine Advancement at 206.543.5686 or writemed@uw.edu.


WWAMI Regional News  

Research takes Jocelyn Krebs, Alaska WWAMI educator and scientist, on a personal journey  

Jocelyn Krebs and SonJocelyn Krebs, professor of biology at the University of Alaska Anchorage (UAA) and affiliate professor of molecular biochemistry in the Alaska WWAMI medical education program, arrived at UAA in 2000 with a research focus in epigenetics, the control of development through ‘traffic signals’ that determine which genes get turned on, or off, in a precisely choreographed process, one so complex that there can be mishaps, with resulting birth defects or cancer.  At UAA, she met another researcher and Alaska WWAMI faculty member, Tim Hinterberger. Utilizing Hinterberger's colony of frogs, Krebs and a graduate student collaborated on the study of a gene called Williams Syndrome Transcription Factor (WSTF).

Initially, Krebs was interested in WSTF’s role as a chromatin remodeling complex, but soon became interested in the disease known as Williams syndrome. 

Krebs, who is principal investigator of the Alaska INBRE (IdeA Network of Biomedical Research Excellence), had no idea how intimately she would understand the disease, scientifically and personally. Three years into her work with WSTF her first son Rhys was diagnosed with Williams syndrome at age 19 months. Williams syndrome, caused by 25-30 genes missing on chromosome No. 7, occurs in 1 out of 8,000 births.  Of course she knew the genetic basis for the syndrome and much more.

At first, Krebs worried about Rhys developmentally. She knew that Williams syndrome could result in a smaller brain, with under- and over-developed areas. People with the syndrome may be gifted in language and music, and extremely friendly. They may also have elastin insufficiency, which makes blood vessels stiff;  high blood calcium levels which can lead to seizures­­­­; and other conditions.  Krebs does not dwell on the negative.   

Rhys, now four years old, is a delightful little boy who” is doing great,” according to his mother.  “My son loves the outdoors. We take him on little hikes. We joke that he’s a little botanist. He loves looking at leaves and trees.”  She doesn’t worry now about what he might not do, or achieve.  He recently started putting two and three word sentences together, her favorite ‘Put Frey down!’ Frey is his 9-month-old brother.

Krebs continues her research on WSTF, and has recently published a paper, Williams Syndrome Transcription Factor is critical for neural crest cell function in Xenopus laevis

Jane Shelby, director of the first-year Alaska WWAMI program said, “Dr. Krebs’s experience and discoveries as a medical researcher, and her personal journey with her son, are inspirational to graduate students and medical students, and we are very fortunate to have her associated with the Alaska WWAMI program.” 

Versions of this article appeared in the Anchorage Daily News and in the UAA Green and Gold News.  

Photo: Jocelyn Krebs and her son Rhys at age one. 


Upcoming Events

The following events may be of interest to the UW Medicine community:    

Science in Medicine Lecture, Jan. 14

No gain, no pain: Turning TRPVI ion channels to respond to noxious stimuli, 1 to 2 p.m., UW Health Sciences Building, Room T-733. Sharona Gordon, associate professor of physiology and biophysics, will discuss multi-modal TRPVI ion changes that detect painful signals including heat, acid, inflammatory molecules and capsaicin, the pungent abstract from hot chili peppers. Gordon will discuss how regulation of TRPVI by the membrane in which it is embedded alters the gain of pain receptors to enhance or suppress the pain response.  The lecture will be televised at several other locations. For more information, contact somevent@u.washington.edu or 206.221.5807.

GME Grand Rounds for Residents and Fellows, Jan. 17

Sharing Difficult Information with Patients and Families: Handling Conversations with Truth and Grace, 5:30 to 7 p.m., UW Health Sciences Building, Turner Conference Room, E202. Anthony Back, UW professor of medicine in the Division of Oncology and expert in end-of-life communication between physicians and patients will discuss the importance of showing patients basic courtesy and respect by acknowledging their situation and saying goodbye with dignity. Back focuses his teaching on building resident and fellow confidence and communication skills as they work with patients who are about to die.  The event is open to residents, fellows and the Graduate Medical Education community. A light dinner will be served at 5:30 p.m. Registration is required. Contact Shawn Banta at sbanta@uw.edu or 206.616.8286 for more information.

Future Faculty Fellows Workshop, Jan. 30 – 31

The Future Faculty Fellows Program (FFFP)  prepares postdoctoral scientists for successful careers that combine research, service, mentoring, and teaching.  The two-day Future Faculty Fellows Workshop, Jan. 30 – 31 at South Lake Union, will provide participants with teaching, communication, and job-seeking skills.  The free workshop is open to any postdoctoral fellow in a biology-related field in his or her second year or beyond.   Fellows  rom the UW and  affiliated research institutions: the Fred Hutchinson Cancer Research Center, Institute for Systems Biology, Seattle Biomedical Research Institute and Seattle Children’s Research Institute, may apply. Apply for the two-day workshop online. (UW NetID required. If you do not have a UW NetID, please email fffp@uw.edu to request one.) Applications are due by Friday, January 11, at 5 p.m.   Questions may be directed to Mark Bothwell, director of the Future Faculty Fellows Program, at fffp@uw.edu.

Paul Ramsey’s annual address to the UW Medicine community, Feb. 7, 2013

Paul Ramsey, CEO, UW Medicine, executive vice president for medical affairs and dean of the School of Medicine, University of Washington, will review progress at UW Medicine over the past year and cover challenges and opportunities for the upcoming year. The address will be held in Hogness Auditorium in the UW Health Sciences Building, 4 to 5 p.m. A reception will follow in the Health Sciences Lobby. The address will be recorded and available starting the next day on the UW Medicine website for those who cannot attend. For more information, contact Julie Monteith at jspiro@uw.edu or 206.543.7718.

Continuing Medical Education 

Visit Continuing Medical Education for information on upcoming classes.



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