The WSU Physician Group has decided to purchase a building in Troy to house a proposed Ambulatory Surgery Center, said Robert Frank, M.D., in a letter to the School of Medicine community on Friday. Dr. Frank is dean of the WSU School of Medicine and chairman of the Board of Directors for the WSU Physician Group.

The action launches the University Physician Group's suburban strategy, which is designed to grow our clinical business and enable the continued support of the School of Medicine's missions. 

"While this action  may engender some uneasiness among our clinical affiliates, it is essential that University Physician Group expand and diversity its revenue base," Dr. Frank wrote. "We remain committed to our primary partner, the Detroit Medical Center , and we have taken special care to ensure that our strategies complement our partner's position rather competing with it. In fact, we are confident that our suburban strategy will benefit the DMC's bottom line as our business expands."

Dr. Frank reaffirmed the School's steadfast commitment to longtime clinical partners at the Detroit Medical Center and to the School's   mission of elevating the level of care, particularly for the underserved.

Watch for updates on this project in future issues of Prognosis.

:An excellent teacher of medical students and residents, Ralph brought his years of experience as a practicing pediatrician to the bedside and was recognized as Teacher of the Year. His "Cash's Corner" practice management seminars, which he taught with his wife, Barbara ("Bobbie"), were very popular with residents.

A gifted writer, Ralph wrote a medical advice column in the Detroit Free Press for several years. He also served as the chief of Pediatrics for many years at Sinai Hospital, in Detroit .

Ralph moved his private practice from Farmington Hills to the CHM Couzen's Building in the late 1970s. This practice, Medical Center Pediatrics, P.C. has grown to a large and successful pediatric practice.

"Ralph was a mentor and my friend, and we will miss him," wrote CHM President Herman Gray in a letter today. "Our heartfelt sympathy and prayers are extended to Bobbie and children Sandy, Howard, and Debbie."

Services will be held at 10:15 a.m., tomorrow, Oct. 27, at the Dorfman Funeral Chapel, 30440 W. 12 Mile Road , Farmington Hills, Mich. The Dorfman Chapel phone number is (248) 406-6000.

A new study published in the October issue of Nature Genetics has found evidence for a new genetic influence on multiple sclerosis using a computational strategy designed to find risk variants that differ strikingly in frequency across human populations. Omar Khan, M.D., a professor in the WSU Department of Neurology, participated in the study, which was a collaborative work with the Harvard Medical School, Massachusetts Institute of Technology and the University of California-San Francisco.

"This is the first time that a potential gene has been identified on a specific chromosome, which appears to be related to MS," Dr. Khan said. "The implications are huge."

The study compared genetic regions in African-American individuals with MS vs. healthy individuals used in a control group. Although a dozen centers participated in the study, WSU School of Medicine recruited nearly one-third of the patients for the study.

The new computational approach used showed greater power to detect weak factors contributing to disease risk than traditional methods. This method could be useful for identifying risk factors for other common diseases, such as lupus, end-stage renal disease and type 2 diabetes.

The study, "A whole-genome admixture scan finds a candidate locus for multiple sclerosis susceptibility," appeared with another study presenting a high-resolution map of a genetic region previously associated with MS susceptibility in Canadian and Finnish people who have MS. The authors of that study refined the boundaries for genetic association and found that the primary risk is associated with a class of genes involved in mediating immune reaction to foreign proteins that cells take up from their environment.

For more on these studies, please visit http://www.nature.com/ng/index.html.

Limited access to the driveway will be maintained throughout the repairs, at some times leaving only one late open. The Scott Hall parking circle will remain open throughout this time, but traffic congestion may occur. Please allow extra time when driving to this area.

In addition, the Detroit Medical Center also has hired crews to repair the concrete in the main drive of Harper University/Hutzel Women's hospitals. During the first phase of the work, which started Friday, the entrance drive will be closed from John R to the Center Deck, and accommodations will be made for two-way traffic in the exit drive.

Shuttle buses will stop at Karmanos Cancer Institute and the Harper Professional Building entrances only. Traffic for valet parking for both institutions will enter off John R, adjacent to the North Deck, and be routed through the fire lane parallel to John R.

Study led by Dr. Shankaran published in New England Journal of Medicine

Lowering an infant's body temperature to about 92 degrees Fahrenheit within the first six hours of life reduces the chances for disability and death among infants who failed to receive enough oxygen or blood to the brain during birth, according to a Wayne State University School of Medicine study published in tomorrow's New England Journal of Medicine .

The study involving 208 infants was led by Seetha Shankaran, M.D., WSU professor of pediatrics and division director of neonatal-perinatal medicine at Children's Hospital of Michigan and Hutzel Women's Hospital. The research was conducted through the 16-site Neonatal Research Network, part of the National Institute of Child Health and Human Development. The NICHD is one of the National Institutes of Health.

During the two-year study, researchers randomly enrolled qualifying infants from the NICHD neonatal sites. All infants had experienced oxygen deprivation during birth. Of the total 208 infants who took part in the study, 102 underwent the experimental cooling, or hypothermia, treatment, and 106 received standard care. Children's Hospital of Michigan and Hutzel Women's Hospital, combined, contributed findings from 34 cases to the study, the most of any site. CHM/Hutzel participants included some infants who were transferred immediately after birth to CHM from other Michigan hospitals.

Hypoxic ischemic encephalopathy occurs when the brain fails to receive sufficient oxygen or sufficient blood before the infant is born. HIE may occur hours before birth, or, in some cases, during labor and delivery. The condition may result from a variety of causes. These include compression of the placenta, tearing of the placenta from the uterine wall before birth, compression of the umbilical cord and rupture of the uterus.

Standard care for HIE may involve placing the infant on a ventilator to assist breathing, monitoring blood pressure, providing fluids intravenously and other newborn intensive care supportive therapies.

The infants were cooled by placing them on a soft plastic blanket through which water circulates. The blanket's temperature is regulated by computer. For the study, the blankets were set at 5 degrees Celsius, or 41 degrees Fahrenheit. Each infant's temperature was lowered to 33.5 degrees Celsius, or 92.3 degrees Fahrenheit, as measured by a temperature probe placed in an infant's esophagus. The infants in the hypothermia group were enrolled within the first six hours of birth and remained on the cooled blanket for 72 hours. After 72 hours had passed, they were gradually warmed to a normal body temperature.

Infants in both the hypothermia group and the control group received standard newborn intensive care, including monitoring of vital signs, and were watched carefully for signs of organ dysfunction.

When the infants were examined at 18 to 22 months of age, 44 percent from the hypothermia group developed a moderate to severe disability or had died as compared to 62 percent in the control group. This is a statistically significant difference between groups.

“The experimental cooling of newborns to prevent death and injury from oxygen deprivation during birth is extremely promising,” said NICHD director Duane Alexander, M.D. “Yet it would be premature to institute the study results under any but the most carefully controlled and monitored circumstances.”

HIE is estimated to occur from 0.5 to 1 times per every 1,000 births. The study also indicates that 10 percent of infants with moderate HIE die, as do 60 percent of infants with severe HIE.

“Many, if not all, survivors of severe HIE are severely disabled,” Dr. Shankaran said.

Previous studies, conducted in laboratory animals, suggested that cooling the brain from 2 degrees Celsius to 5 degrees Celsius after HIE could reduce the chances for the death and disability that often result from HIE, the authors wrote.

Dr. Shankaran noted the study's results are statistically valid only when all of the infants in the study are considered together as one group. When possible outcomes were evaluated separately, the differences between each outcome in the two groups of infants were not statistically significant.

However, in terms of the number of infants affected, trends in these data indicated fewer infants in the hypothermia group died or experienced moderate or severe disability than was experienced by infants in the control group. For example, 24 infants in the hypothermia group died, as compared to 38 in the control group. Similarly, 15 infants in the hypothermia group experienced disabling cerebral palsy, compared to 19 infants in the control group. Five infants in the hypothermia group developed blindness as did nine in the control group. Infants in the hypothermia group also tended to score higher on measures of infant mental and physical development than infants in the control group.

Dr. Shankaran explained that it was not possible to recruit a large enough pool of infants to arrive at statistically significant measures for the differences in the various outcomes between the two groups. Because HIE occurs infrequently, it took three years to enroll a large enough number of infants to conduct the current study from the 16 participating NICHD Neonatal Research Network sites.

"A concern with any therapy that reduces mortality among infants at high risk of death and disability is the possibility of an increase in the number of infants who survive with disabilities,” the study authors wrote. “In our study there was no evidence of increased rates of moderate or severe disability at 18 to 22 months of age among infants treated with hypothermia.”

Side effects of the treatment consisted of hardening and drying of the skin where it came in contact with the cooling blanket, Dr. Shankaran said.

“Physicians need to exercise extreme caution in putting the study's results into practice,” said Rose Higgins, M.D., program scientist for the NICHD Neonatal Research Network and an author of the study. “Most newborn intensive care units probably don't have the resources to duplicate the carefully controlled conditions of the study.”

Dr. Higgins added that comparatively minor fluctuations in an infant's body temperature -- perhaps by as little as a few degrees – could potentially result in serious harm if not closely monitored by trained personnel.

During the 72 hours of the hypothermia treatment, personnel trained in life support and the use of the cooling blanket monitored all infants continuously. Fluctuations in the infant's temperature were compensated for immediately by adjustments to the cooling blanket.

Moreover, only full-term infants took part in the study, Dr. Higgins said. It is not known whether preterm infants with HIE would benefit or be harmed from hypothermia treatment.

Dr. Higgins said that the NICHD is currently advising the American Academy of Pediatrics on the development of practice recommendations for treating infants with HIE. Moreover, three ongoing studies of hypothermia treatment are expected to provide additional information on the most effective ways to carry out the treatment.

Dr. Higgins added that the NICHD Neonatal Research Network also will follow both groups of children until they reach the ages of six or seven, to learn if either group experiences any health problems or learning difficulties.

These events included the Pathfinders in Medicine Awards Gala and Mini Med School.

Michigan Gov. Jennifer Granholm will be among the honorees at the Wayne State University School of Medicine's Pathfinders in Medicine Awards, this Saturday, October 8, at 6 p.m. at Ford Field.

Gov. Granholm plays a key role in ensuring that the state's vital health-care safety net remains viable despite economic hardships that threaten access to quality care. In 2004, she played a leading role in guiding the establishment of the Detroit Wayne County Health Authority. She also was instrumental in forming a temporary oversight committee that provided a $50 million infusion to bolster the Detroit Medical Center .

Established in 2000, the black-tie dinner honors outstanding vision and leadership in medicine, progressive scientific research and efforts that promote the availability of quality health care within the community. Amyre Makupson, a longtime Detroit anchor on UPN-50 and CBS-62, is mistress of ceremonies.

In addition to Gov. Granholm, This year's honorees include:

• Larry Fleischmann, M.D. , is past president of Children's Hospital of Michigan and a WSU professor of pediatrics and a pediatric nephrologist. Dr. Fleischmann founded Children's Hospital's Renal Dialysis and Transplant Program and was director of the Nephrology Service. A native of Saginaw who currently resides in St. Clair Shores , Dr. Fleischmann has received the March of Dimes Humanitarian of the Year Award and the National Kidney Foundation of Michigan Champion of Hope Award.
• Henry McKinnell, Ph.D., is chairman and CEO of Pfizer Inc., the world's largest research-based pharmaceutical company. He was appointed to the Presidential Advisory Council on HIV/AIDS by President George Bush and is the recipient of the United Nations Association of the United States of America 's Global Leadership Award and the Woodrow Wilson Institute for International Scholars Corporate Service Award.
• Tina Kelley, M.D. , (posthumously), a WSU School of Medicine resident dedicated to serving children who was killed in a car accident Feb. 4, excelled both academically and spiritually. She received her undergraduate degree from Michigan State University and her medical degree from Wayne State University School of Medicine. Dr. Kelley shared her many gifts with others through her volunteer endeavors. She was a youth interpreter for I Zandla, Hartford Memorial Baptist Church 's deaf ministry. This dedicated young woman was also a member of the Michigan State University Gospel Choir and the Just for Christ campus ministry, through which Dr. Kelley traveled on a mission to Jamaica .
• Roberto Romero, M.D. , leads the National Institutes of Health's Perinatology Research Branch at the WSU School of Medicine, which conducts studies into maternal and infant health and disease. A world renowned lecturer, Dr. Romero is one of the most prominent intellectual leaders in modern obstetrics. During the past 20 years, his work has focused on the prenatal diagnosis of congenital anomalies and the study of the mechanisms responsible for the onset of premature labor. Dr. Romero lives in Grosse Pointe.
• Ebony Rucker , a fourth-year student at the WSU School of Medicine, was born and raised in Detroit . She attended Detroit public schools until she received a scholarship to Cranbrook Kingswood in Bloomfield Hills which motivated her to attend college on the East Coast. Awaiting the arrival of twin siblings in the labor and delivery suite ignited her interest in a medical career. After receiving her bachelor's degree from Vassar College in Poughkeepsie , N.Y. , Ms. Rucker spent three years studying genetics at Harvard Medical School before applying to medical school. Since returning home, Ms. Rucker has been involved with numerous community endeavors including serving as a co-coordinator at the Cass Clinic and being involved with the Black Medical Association.
• Sophie Womack, M.D. , a Detroit resident, is the division chief of neonatology for Sinai-Grace Hospital , an assistant professor in the WSU Department of Pediatrics and a member of the Detroit Medical Center 's board of trustees. This physician and humanitarian tirelessly promotes children's health and safety through her volunteer efforts, including The Coalition Inc. – Circle of Hope, which she formed with her husband, Rev. Dr. Jimmy Womack. Dr. Womack has been honored with the “Caring for Children Angel Award” from Blue Cross and Blue Shield of Michigan and the “Image Award in Medicine” from the Women's Justice Center .

Proceeds from the event support the Pathfinders in Medicine Scholarship Fund, the Black Medical Association of Wayne State University Endowed Grant Fund and the Charles F. Whitten, M.D., Post-Baccalaureate Fund.

Previous Pathfinders in Medicine Award recipients include Barbara Anderson, M.D.; Thomas Batchelor, M.D.; Waldo Cain, M.D.; Julius Combs, M.D.; Ethelene Jones Crockett, M.D.; Walter Douglas; Mary Fisher; Cynthia Ford; Robert N. Frank, M.D.; Adnan Hammad, M.D.; Peter Karmanos, Jr.; Mark Kelley, M.D.; Kamran Moghissi, M.D.; Marjorie Peebles-Meyers, M.D.; Arthur Porter, M.D.; Altha Stewart, M.D.; Joan Stryker, M.D.; Natalia Tanner, M.D.; Vainutis Vaitkevicius, M.D.; Charles Vincent, M.D.; John Waller, Jr., Dr.P.H.; Charles Whitten, M.D.; and Charles Wright, M.D.

Tickets are $200 per person, of which $80 is tax deductible. For more information or to make a reservation, please contact Sue Helderop at (313) 993-4179 or sheldero@med.wayne.edu .