Fw: UT Southwestern News Release Feb. 3, 2003 (3 releases included)

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Subject: UT Southwestern News Release Feb. 3, 2003 (3 releases included)

Media Contact: Roy Bode, 214-648-7500

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$10 MILLION SOLOMON GIFT ENDOWS GENERAL MEDICINE DIVISION,

LAUNCHES SPECIAL PROGRAM FOR CLINICAL SERVICES

AT UT SOUTHWESTERN

DALLAS - UT Southwestern Medical Center at Dallas will use a $10 million

gift from Mr. and Mrs. T. to help develop a model for

clinical service in general internal medicine, enabling physicians and staff

to center their attention on patients in a time when health care has become

increasingly impersonal and perplexing.

American medicine has been buffeted by massive change in the past decade. A

technology explosion, managed-care systems intended to control rising costs

and other developments have made obtaining medical attention more complex

for patients, Dr. Kern Wildenthal, UT Southwestern president, observed. In

addition, he pointed out, clinical programs at UT Southwestern have grown

dramatically since the 1980s, straining the institution's ability to handle

efficiently more than 400,000 referral outpatient visits last year while

caring for thousands more patients in affiliated hospitals.

, a Dallas businessman who is chairing UT Southwestern's Innovations

in Medicine capital campaign, said the contribution he and his wife, Gay,

are making will help highlight clinical service as an integral element of

the $450 million drive to advance research and treatment programs. The gift

will be made to Southwestern Medical Foundation from the T. and Gay

F. Fund of Communities Foundation of Texas and the T. and

Gay F. Advised Fund of The Dallas Foundation. " UT Southwestern's

increased focus on improving patient services will require a major

commitment of financial resources, " he said. " This new emphasis expands the

scope, relevance and purpose of the campaign. UT Southwestern is prepared to

make a commitment to revolutionize patient care with the help of private

philanthropy. " In all, he said, about $100 million will be required to fund

the clinical portion of the campaign.

" Since becoming chairman of the capital campaign, I have had an opportunity

to get an up close view of what UT Southwestern is doing, " he continued.

" Gay's and my personal commitment at this level is a testimony to what we

see as the importance of these efforts, their prospects for success and the

opportunity that presents itself at this time to us and others to help the

medical center achieve its goals. "

Wildenthal said the s' support will allow implementation of enhanced

services in UT Southwestern's general internal medicine division, whose

physicians see the largest number of patients at the medical center. The

division will be named the T. and Gay F. Division of General

Internal Medicine in recognition of the couple's support.

" The intent of the s is to enable general internal medicine to be a

proving ground to perfect a seamless system of clinical care, combining

exemplary patient-centered services with the latest technology and physician

expertise, " he explained. " Because this is a key issue for the entire

American health-care system, we hope our work will create a model for

improved doctor patient relations in other environments around the country. "

These are among the clinical initiatives that should simplify access of

patients to their doctors, expedite their care and allow their physicians to

provide more individual attention:

--Emphasizing a more patient-centered culture in which the quality of

clinical care and services matches UT Southwestern's world-class research

and teaching.

--Creating a streamlined appointment scheduling system, so patient visits to

various specialists can be coordinated easily.

--Implementing a new patient-friendly telephone system, so calls can be

completed without delay and frustration.

--Installing an electronic medical record system so all physicians involved

in a case can simultaneously access data while maintaining confidentiality.

--Enhancing customer-service training, performance measures, recognition and

incentives for staff.

--Making cutting-edge clinical treatment trials readily available to

patients, and facilitating enrollment and participation in them.

--Unifying management for all patient-related services so that

accountability is clear.

UT Southwestern drafted a detailed plan late last year after internal

studies, consultation with a panel of experts from other well-known American

medical centers, and site visits to other top clinics where both strengths

and weaknesses were evaluated. Implementation of its primary stages has

already begun.

" UT Southwestern has achieved an international reputation over the past two

decades, with recognized eminence in biomedical science, teaching and

clinical expertise, " said Dr. Willis C. Maddrey, executive vice president

for clinical affairs at UT Southwestern. " We now are focusing as well on the

quality of the patient experience. We are committed to ensuring that the

services and attention we give our patients is unsurpassed. "

Dr. D. McConnell, executive vice president for administration, added,

" Doctors and patients alike recognize that efficient, patient-friendly care

is not only more pleasant but also contributes to successful medical

outcomes. Together with the outstanding hospitals with which we are

affiliated, UT Southwestern will build an integrated clinical delivery

system that minimizes the bureaucracy of medicine and maximizes its

quality. "

, chairman of Austin Industries, leads a committee of more than 100

prominent civic and business leaders who have volunteered in UT

Southwestern's current capital campaign. A year ago, he and his wife

committed a lead gift of $1 million to the drive. " The more we learned about

UT Southwestern and its plans, the more we became convinced that there is a

unique opportunity at this point to achieve real breakthroughs both in the

quality of clinical service and in research, " said.

" Gay and I decided to increase our support significantly because we believe

so strongly in what they are accomplishing. We are convinced that the

development of new models of patient-centered care coupled to the best of

modern technology will be important for the health care system nationally,

as well as for North Texas patients. "

A Dallas native, is a member of the boards of Belo, Hoblitzelle

Foundation and

Southwestern Medical Foundation. He has previously served as chairman of the

Dallas Citizens Council, Dallas Together Forum, Greater Dallas Chamber and

is involved in a number of other community organizations. A graduate of

Southern Methodist University and Harvard University, he was named to the

Texas Business Hall of Fame in 1996 and Texas Minority Business Advocate of

the Year in 1995.

Gay Ferguson , a homemaker, painter and interior designer, is an

ardent supporter of a variety of civic and religious organizations. An

honors graduate of UT Austin, she currently serves on the board of the

Dallas County Community College District Foundation and on the advisory

committee of the CONTACT Counseling and Crisis Line.

" The dedicated support of Bill and Gay in our campaign generally,

and for our initiative to enhance clinical care and service particularly,

will enable UT Southwestern to achieve a new standard of excellence, "

Wildenthal said. " Their foresight and the support of others who join them in

this effort will surely be seen by future generations as one of the most

lasting and significant contributions ever made to our community. "

###

Media Contact: Horton

214-648-3404

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(Sidebar to story)

UT SOUTHWESTERN'S GENERAL INTERNAL MEDICINE DIVISION

PROVIDES PRIMARY PATIENT CARE

DALLAS – Feb. 3, 2003 – The division of general internal medicine at UT

Southwestern Medical Center has a faculty of 37 physicians who last year

treated more than 62,000 patients for illnesses ranging from allergies to

heart disease.

Internists work as primary-care physicians who diagnose and treat virtually

all illnesses while referring complex cases to specialists. Common ailments

treated by internists include diabetes, hypertension and pneumonia.

" We're the traditional family doctor, excluding surgery and obstetrics, "

said Dr. W. , chief of general internal medicine. " We do a little

bit of everything. We're usually the first people that somebody calls when

they're sick. "

The division's faculty also are responsible for about half the teaching done

by the Department of Internal Medicine – the medical center's largest

department – which has 17 other divisions, including cardiology, infectious

diseases and hematology/oncology, said , holder of the S.T.

Family Distinguished Chair in Internal Medicine and the Eva A. Rosenthal

Professorship in Internal Medicine.

General internal medicine is the largest single clinical-care division at UT

Southwestern. Its outpatient facilities are located at the W. Aston

Ambulatory Care Center and at Parkland Memorial Hospital. Faculty members

also provide inpatient care and conduct consultations at Zale Lipshy

University Hospital, St. University Hospital and Parkland.

In addition, faculty clinicians at UT Southwestern also provide care to

patients at Children's Medical Center of Dallas, the Dallas Veterans Affairs

Medical Center, the UT Southwestern Moncrief Cancer Center in Fort Worth and

a number of other affiliated hospitals and clinics in Dallas, Fort Worth and

surrounding areas.

Internists make initial assessments of a patient's needs and arrange

appropriate medical care, said Dr. Ellwood , professor of internal medi

cine.

" Our job is to try to get the big picture and to coordinate care, " he said.

" Our patients may have multiple medical problems, so communication is key

with us, whether it be with other specialists, insurance providers or the

patients themselves. "

General internal medicine faculty physicians teach the physical diagnosis

courses for first- and second-year medical students at Southwestern Medical

School, said Dr. Al , associate dean for practice development, and

holder of the Tim and Toni Hartman Professorship in Medicine. They also

instruct third- and fourth-year students in general medicine in the wards

and clinics of Parkland.

" Preventive care is another main focus for doctors of internal medicine, "

said. They encourage patients to schedule regular check-ups, which

give health-care providers an opportunity to screen for diseases such as

cancer, and counsel the patients about diet and exercise.

" We are responsible for ensuring general preventive care, whether it be

making sure that patients are getting annual mammograms and Pap smears,

educating them about the symptoms of colon cancer, or monitoring cholesterol

levels, " said Dr. Leach, associate professor of internal medicine and

holder of the Irene Wadel and Atha Professorship of Internal

Medicine, in Honor of W. Burnside, M.D.

Physicians also conduct preoperative medical risk assessments to help

predict and prevent any complications of surgery or general anesthesia,

said.

The general internal medicine division's annual operating budget is about

$10 million. In addition to the faculty, the division employs 34 staff

members in its Aston clinic and 18 in its academic office.

UT Southwestern is re-naming the division as the T. and Gay

F. Division of General Internal Medicine, in recognition of the

's historic $10 million endowment gift.

With support provided by the gift, general internal medicine physicians and

staff will be the first to begin comprehensive implementation of UT

Southwestern's new initiative to provide patient-centered care and service.

###

Media Contact: Maier

214-648-3404

scott.maier@...

UT SOUTHWESTERN RESEARCHERS DEVELOPING NEW PROCEDURES

TO MAKE BONE-MARROW TRANSPLANTS SAFER

DALLAS – Feb. 4, 2003 – Researchers at UT Southwestern Medical Center at

Dallas are helping develop new procedures that may reduce infections and

diseases resulting from bone-marrow transplants.

The work by Dr. Ellen Vitetta, director of the Cancer Immunobiology Center,

and Dr. , director of the UT Southwestern Hematopoietic Cell

Transplant Program, is part of research at UT Southwestern designed to

identify the problem cells in a bone-marrow transplant and eliminate them

before the transplant is carried out.

The latest findings will appear in the Feb. 4 issue of the Proceedings of

the National Academy of Sciences and online at the journal's Web site.

In a bone-marrow transplant, the patient is treated with very high doses of

chemotherapy, with or without radiation, to destroy cancer cells. This

process also destroys the bone marrow, which is replaced with healthy marrow

cells obtained either from the patient beforehand (autologous) or from a

healthy donor (allogenic). Once transplanted, the donated bone-marrow cells

multiply and repopulate the patient's blood cells.

Allogenic stem cell transplants are preferred for many hematologic

malignancies or inherited disorders. But while this type of transplant often

has an anti-leukemic effect, the risk is graft-versus-host disease (GVHD),

where the donated immune system (the graft) begins to attack the recipient's

body (the host).

If the graft T cells (lymphocytes) are depleted prior to transplant, GVHD is

eliminated. However, there is no anti-leukemic effect, and the patients are

at-risk for infection.

" Graft-versus-host disease – when T cells are not eliminated and infections

when they are – causes significant morbidity and mortality in patients, "

said Vitetta, the study's senior author.

To combat this problem, Vitetta and are developing and refining an

in-vitro procedure to activate the donor T cells responsible for causing

GVHD. These activated T cells are then eliminated with an immunotoxin

against the cellular activation marker, CD25. This removes the cells

responsible for GVHD, but spares cells responsible for the anti-leukemic

activity and for fighting infections.

Immunotoxins are drugs created by linking an antibody to a portion of

bacterial or plant toxin to destroy cells expressing the molecule to which

the antibody binds.

" One of the major goals – the Holy Grail of bone-marrow transplantation – is

to separate graft-versus-host disease from graft-versus-leukemia, and we're

still not sure it can be done. But, what we've seen so far is very

encouraging. If this approach proves successful, it would make transplants a

lot safer and more widely utilized, " said .

In a recent clinical study in France, Vitetta's group showed the incidence

of GVHD was greatly reduced in patients who were infused with the treated

cells.

" What came out of the French trial is that this procedure is the way to go, "

Vitetta said. " Now, we're trying to refine our work and see how broadly it

can be applied. "

A study by will open soon at UT Southwestern involving both related

and unrelated bone-marrow transplant recipients. Instead of getting a full

complement of T cells from the donor, he said, patients will receive T cells

that have been selectively depleted of the allo-reactive T cells that

researchers believe cause graft-versus-host disease.

In addition to this work, Vitetta and are investigating whether T

cells that cause GVHD can be distinguished from T cells with anti-leukemia

activity. This is accomplished by generating clones of the two types of

receptors and sequencing them.

Their in-vitro research, featured in the Proceedings of the National Academy

of Sciences article, has shown there are separate donor T cells that respond

to the patient's normal cells and leukemia cells.

" The goal is to get rid of the T cells that cause damage and save the

beneficial ones, " Vitetta said. " Even though we're in the early days, both

in the clinical trials and in the laboratory research, this is very

encouraging.

" Importantly, it would really be the first time something like this has been

done entirely in-house, without companies. We make the immunotoxin, do all

the preclinical studies, file and get an IND (Investigational New Drug

Application) with the FDA, and do the clinical study, all on-site. We are

hoping this will be a flagship for future efforts in this and related

areas. "

Because a variety of disorders are treated with bone-marrow transplants, the

use of immunotoxins to eliminate harmful cells prior to the transplant could

have a significant impact in increasing transplant success rates and

reducing hospital time.

Bone-marrow transplants can benefit patients with several types of cancers,

including leukemia, lymphoma, myeloma or aplastic anemia. Occasionally,

those with certain genetic diseases of the blood (such as thalassemia,

sickle-cell disease and severe combined immunodeficiency) receive

transplants.

" If you can eliminate graft-versus-host disease but retain or even enhance

the other beneficial effects of T cells, this could be applied to a variety

of malignancies that are sensitive to donor T cells, " said. " It

could be utilized in patients who have greater degrees of mismatch and in

older patients. If this works out and makes transplants a lot safer, then I

know we're going to be doing a lot more transplants. "

Vitetta hopes to see the procedure expanded into different areas, such as

the treatment of breast, prostate and other cancers.

" I'd like to see this apply to all transplants and become standard-operating

procedure, " she said. " This could establish a new paradigm. "

The research was partially supported by a grant from the Leukemia

Association of North

Central Texas.

Other contributors to the Proceedings study included first author Dr.

Jaroslav Michalek and Dr. Petra Vaclavkova, postdoctoral research fellows;

H. Pasha Durrani, research technician; and L.E. Ruff and Dr. Douek at

the National Institutes of Health.

###

These news releases are available on our World Wide Web home page at

http://www.utsouthwestern.edu/home_pages/news/

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