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SPEEDING TOWARD DISCOVERY

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					           U               T                  O               R           O                   N                T            O




Medicine
VOLUME 1•ISSUE 2                                                                                                          JUNE 2003




  BRAIN WAVE              FASCINATING               TURNING               THIRD TIME               DRAWING              A LONG TAIL
  Jim Rutka’s interest       FACES                  THE TIDE               LUCKY?                 CONCLUSIONS              Janet Rossant
   in childhood brain    Denise Reid uses VR      U of T is attracting     A researcher’s          Art and medicine   believes that our furry
 tumours spans care,     therapeutically. Kevin       top minds          experiment is lost           combine to         friends may hold
research, and support      Kain takes a new         from the U.S.         in the Columbia           create powerful        the key to the
       for families.     approach to malaria.          Page 6                  disaster.           courtroom tools.      mysteries of life.
         Page 4                Page 5                                          Page 7                   Page 7                Page 8




                                                                                          SPEEDING
                                                                                          TOWARD
                                                                                         DISCOVERY
                                                                                              Aled Edwards and Cheryl Arrowsmith
                                                                                              are leading an innovative international
                                                                                                      project to characterize human
                                                                                                    proteins faster than ever before.
     Off to a                                                                            Around
     Good Start                                                                          the Faculty
           our last issue, Dean                                                                                                        • On March 5, the University of
     In    David Naylor introduced
     this publication by saying that
                                                  UPCOMING EVENTS

                                           • Faculty of Medicine alumni are
                                                                                                                                       Toronto and Faculty of Medicine
                                                                                                                                       celebrated the establishment of the
                                           invited to celebrate Homecoming on                                                          Chapnik, Freeman and Friedberg
     we wanted to share our pride          Saturday, October 4. Enjoy an Open                                                          Clinician Scientist Program in the
                                           House and luncheon at the Medical                                                           Department of Otolaryngology.
     and excitement with you.              Sciences Building. Don’t miss this                                                          Surrounded by friends, family and
     Judging from the response we          opportunity to catch up with old                                                            colleagues, Drs. Jerry Chapnik,
                                           friends and colleagues. For more                                                            Jeremy Freeman, and Jack Friedberg
     received, you are more than           information, please contact Macarena                                                        were presented with certificates
                                                                                         Dr. Michael Evans, course director of
     happy to share.                       Sierra at 416-946-8103 or e-mail              Mini-Med School and principal investigator
                                                                                                                                       for their generous contribution
                                           medicine.advancement@utoronto.ca.             in the Knowledge Transition Program,          at a reception in their honour.
        The inaugural UToronto             • Kick up your heels for a great cause!       is extremely pleased that Mini-Med            • The first issue of Ars Medica, a
                                                                                         School has proven so successful.
     Medicine was distributed to over      Saturday, October 18 marks the                                                              Mount Sinai-based publication,
                                           fourth annual Parkiepalooza at the            the fact that Mini-Med School offers          will be launched this fall. Ars Medica:
     24,000 people, including alumni,      Markham Fairgrounds. Proceeds from            a wonderfully accessible bridge               A Journal of Medicine, Health and
     donors and other stakeholders.        this dinner and dance go to Parkin-           between medical research and the              the Humanities will print previously
                                           son’s research at U of T’s Centre             information needs of the average              unpublished poetry, fiction, and
     Within a few weeks of publi-
                                           for Research in Neurodegenerative             health consumer. Plans are in the             creative non-fiction dealing with
     cation, we had many positive          Diseases. For more information,               works to start tailoring the program          illness, healing, and the art of
                                           contact Chris Hall at 905-725-1095.           to meet even more topical and urgent          medicine. If you are interested
     comments. Among them:
                                           • Planned Giving Donors can look              health information needs. Visit               in subscribing to, or writing for
     • “UToronto Medicine is an            forward to an appreciation event              www.mini-med.utoronto.ca to be                this new publication, visit
     excellent idea and great reading.     this fall. The Office of Advancement          kept up to date on developments.              www.mtsinai.on.ca/arsmedica.
                                           will be contacting supporters of our          • The Complete Canadian Health                • On April 9, U of T’s GRADitude
     You are to be congratulated.”         Planned Giving program at the end             Guide by Dr. June Engel has                   committee presented MEDS 0T3
     • “I thought the publication was      of the summer with further details.           become a national bestseller with             with the “Best New GRADitude
                                                                                         over 100,000 copies sold. Originally          Campaign” award for the class’
     extraordinarily good both visually
                                                     F A C U LT Y N E W S
     and in terms of content.”
                                           • President Birgeneau and Dean
     • “Great publication. Easy read       Naylor hosted a lunch in honour of
     that gives everyone a glimpse into    Dr. Keith Stewart on February 24.
                                           Stewart, the inaugural director of
     the great work of the Faculty.”       the R. Samuel McLaughlin Centre,
     • “A magnificent piece of             is charged with leading a team to
                                           advance the basic biomedical
     journalism/promotion, beautifully
                                           sciences of genetics and molecular
     laid out, informative and             biology. The knowledge produced
                                           by this powerhouse will be translated
     sophisticated imagery.”
                                           into new strategies for disease
        We are, of course, delighted       diagnosis, treatment, and prevention.
     to hear from you all. We are also     • The success of Mini-Med School              From left to right, Drs. Naylor, Friedberg,   contribution to the Faculty of
                                                                                         Freeman, Chapnik, and Dellandrea.
                                           just keeps on growing! Over 1,000                                                           Medicine. This year marks the first
     keen to keep the dialogue going.      people have now “graduated” from              published in 1993, the latest edition         time a medical class has participated
     Let us know what you think of         the School. Its popularity stems from         is the only all-Canadian health guide         in the GRADitude program. To date,
                                                                                         on the market. Over 1,000 medical             their gift totals over $84,000 and
     the magazine, and anything you        (from left) Mr. Christopher Wansbrough,
                                           chairman of the McLaughlin Foundation,        experts associated with the Faculty           will help support the CaRMS Travel
     find in it. Share your comments,      joins Dr. Stewart at his celebratory lunch.   provided Engel with their expertise           Bursary in addition to the Saturday
                                                                                                     during the writing of this        and St. Felix volunteer programs.
     pro or con, on what’s happening                                                                   guide. Available through
     in the Faculty.                                                                                     Key Porter Books, the
                                                                                                        Faculty of Medicine
        We are also proud to mention                                                                    receives 60 per cent
     that the magazine has already                                                                        of the profits made
                                                                                                                    on sales.
     won its first award – an Award
     of Excellence for editorial writing
     from the IABC Virtuoso Awards.
     We’re off to a good start.                                                                                                        Presenting the award, Mary Catherine
                                                                                                                                       Birgeneau is joined by GRADitude 2003
     JOANNE COLE,                                                                                                                      spokesperson Jack Wong (far left).
                                                                                                                                       Accepting on behalf of the graduating
     Executive Director, Office                                                                                                        class are co-presidents Prateek Lala
     of Advancement                                                                                                                    and Andrea Waddell.




    JUNE 2003                                                                                                                   U N I V E R S I T Y o f TO RO N TO

2
                  C O V E R S T O RY




T
                  here is something strangely beautiful
                  about the snaking ribbons of a pro-
                  tein model. Nicely framed, the image
                  might pass for modern art and attract
                  an appreciative audience of cognoscenti.
                     But of course, the real cognoscenti
aren’t interested in aesthetics. Protein models contain
information that will change the face of biomedical
research and ultimately, of medicine, in the years ahead.
The recent announcement of the Structural Genomics
Consortium, a three-year $95-million initiative led by
U of T scientist Aled Edwards, underlines the Faculty’s
leadership in this important new field.
    Proteins are molecules that act as messengers, regu-
lating the activities of cells by carrying out specific
chemical reactions. When disease occurs, it’s usually
because something has gone wrong in the chain of
events triggered by proteins. “There are other ways to
figure out which protein is interacting with which,”
says Edwards, “but they don’t tell you how. When you
determine the structure of the protein, you have a
three-dimensional picture at the atomic level, so that
you see how it interacts, and how you might be able to
modulate or change its activity.” A knowledge of protein




                                                             Speeding Toward
structure is especially important for pharmaceutical
researchers, who can use it to design targeted drugs.
    Aled Edwards has developed an international repu-
tation for his work in understanding protein structure.
After a PhD in neurochemistry at McGill University,
and four years doing research at Stanford, he served
on the faculty at McMaster University, then arrived
at U of T in 1997. Edwards was recently appointed
the Banbury Chair in Medical Research at the Bant-
ing and Best Department of Medical Research. His
colleague in the Consortium project, Cheryl Arrow-
                                                             Discovery
                                                             The $95-million Structural Genomics
smith, completed her PhD at U of T, also spent time
at Stanford, then came back to the University in the
early ’90s. They have been collaborating on research         Consortium will develop a faster way
projects since Edwards’ arrival, and co-founded
Affinium Pharmaceuticals, “a structure-guided drug
discovery company,” in 2000.
                                                             to determine protein structures
    Edwards and Arrowsmith have been using conven-
tional biochemical techniques to explore the ins and         genome project is complete, we know that there are          the first people ever to do something on this scale.”
outs of protein structure for several years. Edwards,        some 30,000 of these complex molecules to be char-              The project is funded by the Wellcome Trust,
for example, developed a model for the Epstein Barr          acterized. That’s why Edwards and Arrowsmith,               a British-based foundation that grants more than
virus protein in the early 1990s. When he did, it            together with Michael Sundstrom, a collaborator at          $2 billion a year to fund medical research, four Cana-
became clear that the virus was very similar to E2, a        the University of Oxford, are developing a new              dian research funding organizations (Ontario Research
protein from the papilloma virus. That realization           approach that will make the process faster and more         and Development Challenge Fund, Ontario Innova-
linked two major research fields and led to new under-       efficient. Explains Edwards: “We’re taking a tried and      tion Trust, Genome Canada and Canadian Institutes
standings about how both viruses act.                        true process that’s been developed in our labs and          of Health Research), and the global pharmaceutical
    Determining a protein structure is a slow and com-       we’re developing it into a highly parallel one.”            company GlaxoSmithKline. The Consortium will
plex process involving several delicate steps, from              The two sites of the Structural Genomics Consor-        be operated as a charity, and its discoveries will be in
manufacturing the protein and creating a crystal,            tium – at U of T and the University of Oxford – will        the public domain. Protein structures, Arrowsmith
to analyzing it using NMR spectroscopy or X-ray              each involve some 100 scientists. They will collaborate     explains, are at the very early stage of drug discovery.
crystallography. “Unlike gene sequencing, every step         to optimize the protein characterization process, then      By ensuring that the structures remain in the public
is complicated,” says Edwards. “You have to be a             each site will be responsible for applying it to a          domain, the Consortium will be helping to speed along
jack-of-all-trades across a spectrum of technologies.        group of proteins. In all, 350 proteins – selected in       the development of effective new pharmaceuticals.
That’s one of our strengths –                                                          large part for their relevance        Why is this international effort based at the Univer-
we’ve done every single step          “Unlike gene sequencing,                         to human diseases – will be       sity of Toronto? Edwards says the University and its
and know how to make the                                                               modeled in just three years.      affiliated hospital research institutes have invested heav-
right choices.”
                                       every step is complicated.                      That’s faster progress than has   ily in structural biology since early ’90s. “We had the
    The problem is that there         You have to be a jack-of-                        ever been made before. “It’s an   advantage of being among the first to do this stuff,” he
simply isn’t enough time to                                                            aggressive number,” Edwards       says, “and we’ve really worked hard to keep expanding.
tackle each protein one at a
                                          all-trades across a                          admits, “but it’s a reasonably    When the Wellcome Trust started looking for people
time. Now that the human              spectrum of technologies. ”                      aggressive number. We’ll be       to run this project, this was the logical place to look.”


F A C U LT Y O F M E D I C I N E                                                                        G R E AT M I N D S F O R A G R E AT F U T U R E

                                                                                                                                                                                       3
                                                                                    S U R G E RY




                                                               Brain Wave
                                                               For Jim Rutka, it’s not enough to use
                                                               his surgical skills to treat brain tumours:
                                                               he wants to prevent them

                                                                                                                          Recently they published an article in Nature Genetics
                                                                                                                          showing that a tumour suppressor gene, Human
                                                                                                                          Suppressor of Fused, is mutated in patients with medul-
                                                                                                                          loblastoma, a tumour that kills 30 per cent of the
                                                                                                                          children it affects. Now that the pathway has been
                                                                                                                          identified, the next step will be to develop ways to
                                                                                                                          overcome the genetic mutation and restore growth
                                                                                                                          control. Rutka hopes that will happen over the next
                                                                                                                          five years.
                                                                                                                              This work takes place in the context of the Arthur
                                                                                                                          and Sonia Labatt Brain Tumour Research Centre,
                                                                                                                          which Rutka counts as one his proudest accomplish-
                                                                                                                          ments. One of six such centres in North America,
                                                                                                                          it brings together scientists and clinicians interested
                                                                                                                          in brain tumour research from across Toronto. “We
                                                                                                                          have some outstanding investigators, both clinician
                                                                                                                          scientists and basic scientists, who are collaborating
                                                                                                                          effectively to devise new strategies to combat this
                                                                                                                          dreaded disease.”
                                                                                                                              Recognizing the heavy human, as well as the med-
                                                                                                                          ical, cost of brain tumours, Rutka championed the
                                                                                                                          founding of B.r.a.i.n.child in the early ’90s and con-
                                                                                                                          tinues to serve as its Medical and Scientific advisor.
                                                                                                                          The group, composed of families who are struggling
                                                                                                                          with a brain tumour diagnosis, provides support and
                                                                                                                          raises money for research – a total of close to $2 mil-
                                                                                                                          lion over ten years.
                                                                                                                              As a clinician, Rutka is also involved in a team that
                                                                                                                          treats intractable epilepsy – a condition that causes
                                                                                                                          some children to have more than 200 seizures a day
                                                                                                                          and cannot be controlled by medication. The team
                                                                                                                          works together to identify the portion of the brain
                                                                                                                          where the electrical abnormality arises, then excises it
                                                                                                                          surgically. “When the surgery is successful, the child
                                                                                                                          may be seizure-free and off medication,” he says.




     L
                     ooking around Jim Rutka’s office at       took time off to complete a PhD in experimental
                     the Hospital for Sick Children, it’s      pathology at the University of California San Francisco.         “We deal with some very
                     not hard to imagine a famous cartoon      “It became clear to me that we still had many ques-
                     rabbit sauntering into the room, carrot   tions unanswered in neurosurgery,” he explains. “For
                                                                                                                               serious issues here, but you
                     in hand, and drawling, “Eh, what’s        example, why do patients get brain tumours, and why                can’t take yourself too
                     up, doc?”                                 do we still have relatively primitive treatments for
        The walls and table surfaces are covered with          them? Looking after patients is a very important part           seriously. It’s important to
     Warner Brothers cartoon collectibles and Rutka, an        of my career and practice, but it is not enough – I              maintain some balance,
     internationally-renowned neurosurgeon, is wearing         wanted to investigate the very fundamental aspects of
     an elegant Mickey Mouse watch. “We deal with some         these diseases.” After completing his residency, he                 and to have a sense
     very serious issues here,” he says, “but you can’t take   spent a year in Japan working with world-famous                         of humour.”
     yourself too seriously. It’s important to maintain some   neurosurgeon Dr. Kenichiro Sugita, learning more
     balance, and to have a sense of humour.”                  about microneurosurgical and molecular biological          “These are wonderful cases for everyone – the child,
        Faced with Bugs Bunny’s perennial question, Rutka      techniques and mastering the language. Despite offers      the parents and the treating team – but it requires a
     would have plenty to say. An accomplished clinician       from several American universities and the Mayo            formidable team-approach which fortunately we have
     with a busy practice focusing on the treatment of         Clinic, Rutka joined the staff at Sick Kids in 1990.       at the Hospital for Sick Children.” He also partici-
     childhood brain tumours and intractable epilepsy,            Today, he divides his time evenly between clinical      pated in some high-profile surgeries on international
     Rutka is also a renowned researcher, whose team has       practice and research. He has more than 150 peer-          patients, including the separation of Hira and Nida
     recently made major strides in understanding the          reviewed publications to his credit and works on           Jamal, conjoined twins from Pakistan who were
     genetic underpinnings of medulloblastoma, one of          the editorial boards of the Journal of Neurosurgery        joined at the head.
     the most common brain tumours.                            and Neurosurgery. He also serves as chair of the Divi-         Last year, Globe and Mail readers selected Jim Rutka
        Toronto-born Rutka completed a degree in chem-         sion of Neurosurgery and the Dan Family Chair of           one of Canada’s “Nation Builders” in the category of
     ical engineering at Princeton University and an MD        Neurosurgery.                                              science. “There are many caring medical professionals,”
     at Queens University. During his final year of medical       Rutka’s research focuses on the role of tumour          wrote one reader, “but Jim Rutka stands above them all
     school, he did an elective in neurosurgery at the         suppressor genes – genes that guard against cancer         for his ability to combine the consummate knowledge
     Hospital for Sick Children, and promptly fell in love     but can be inactivated by genetic mutation. His team       and skill of a surgeon, the analytical abilities of a
     with the field.                                           has established several brain tumour types in which        scientist, and the compassion and caring of a true
        During his residency training at U of T, Rutka         mutated tumour suppressor genes play a key role.           humanitarian.” Bugs couldn’t have put it better.


    JUNE 2003                                                                                                               U N I V E R S I T Y o f TO RO N TO

4
                                                                                        REHAB




                                                 Virtual Reality
                                               Produces Real
                                                Excitement
     et’s put it this way – maybe I didn’t get sand in my      building that are generating exciting
“L      pants, but boy, it was sure fun!”
    That’s the response Occupational Therapy profes-
                                                               research and learning opportunities.
                                                               Another is the Occupational Perfor-
sor Denise Reid got when she asked one of her young            mance Lab. It looks like a movie set
research subjects about his experience playing beach           with a large open area in the middle,
volleyball in her virtual reality lab at the new Reha-         and fully-functioning room settings
bilitation Sciences Building on University Avenue.             – a bedroom, bathroom, kitchen, liv-
    In the lab, a video camera captures upper body             ing room and home office – around
movement and integrates it into a virtual reality envi-        the perimeter. Primarily used to teach
ronment on a large screen in front of the participant.         OT students, it also serves as a show-
Without wearing, touching or holding anything, chil-           case for the latest adaptive devices.
dren with physical disabilities can now play volleyball,       “We want to make it available to the
catch some air on a snowboard or participate in other          community,” says Helene Polatajko,
new activities. Reid’s research focuses on the impact          chair of the Department of Occupa-
of this technology on feelings of self-efficacy. “A lot of     tional Therapy. “We envision commu-
these kids go through life not being able to do or             nity-based OTs and consumers coming
experience many things,” she says. “By providing               here.” It will also provide an ideal place for
them with an opportunity to do some of those things,           research on adaptability and adaptive devices.
we’re increasing their sense of what they can do.”                 Polatajko says lab space in the new facility
    Recently, Reid has started a new study looking at          has created a news sense of possibility for fac-
the role of VR in encouraging recovering stroke vic-           ulty members in all areas of rehabilitation science.
tims to become more active and involved. Although              “In our old building, we had six or seven researchers
the studies are not complete, she says the technology          crammed into one small lab,” she says. “Now we’ve got
has tremendous potential for practice.                         real potential to do exciting work – and we’re going
    Reid’s lab is just one of several in the newly-renovated   to live up to that potential.”




                                                                                I N T E R N AT I O N A L




          The                                   S   hortly after he graduated from
                                                    medical school, Kevin Kain
                                                                                                  Kain had been planning to pursue
                                                                                              a residency in orthopedic surgery, a
                                                                                                                                           age of people with malaria die. The
                                                                                                                                           focus of Kain’s research is based on


        Enemy                                   and a group of friends drove from
                                                Cairo to Cape Town. What he saw
                                                on that 29,000 mile journey changed
                                                the course of his career, and may
                                                                                              reflection of his interest in sports and
                                                                                              his famous older sister’s career as
                                                                                              a professional dancer. But in Africa,
                                                                                              he came face to face with diseases that
                                                                                                                                           understanding humans’ natural ability
                                                                                                                                           to control malaria, and finding ways
                                                                                                                                           to enhance it.
                                                                                                                                               Kain and his team investigated

        Within                                  bring about a revolution in the
                                                treatment of malaria.
                                                                                              affect most of the world but had been
                                                                                              no part of his medical training and
                                                                                              were largely ignored by researchers in
                                                                                                                                           malaria at the cellular and molecular
                                                                                                                                           level using human cells in vitro.
                                                                                                                                           They discovered that macrophage
                                                                                              the West. “I realized,” he says, “that       cells, key components in the human
                                                                   While studying rates
                                                                     of malaria and drug
                                                                                              tropical medicine was something              immune response, are equipped
                                                                 resistance in rural New      I could get passionate about.”               with malaria receptors, and can
                                                                Guinea, Dr. Kevin Kain is         Indeed, Kain is nothing short            attract and “eat” the parasites. They
                                                                   joined by some of his
                                                                                              of passionate when he discusses his          also help to modulate the extreme
                                                                   enthusiastic patients.
                                                                                              research in malaria, which he calls          inflammatory response that sometimes
                                                                                              “one of the most important and most          causes death in patients. Further
                                                                                              neglected diseases in the world.” The        investigation of the molecular path-
                                                                                              traditional approach to malaria is to        ways turned up a previously unsus-
                                                                                              develop a drug that kills the parasite.      pected parallel with diabetes. Kain
                                                                                              But because the parasite is highly           is now preparing to launch clinical
                                                                                              evolved and complex, it quickly              trials using a common diabetes drug
                                                                                              develops drug resistance. As a result,       that has already been shown to
                                                                                              Kain says there’s more malaria than          control malaria in mice, and hopes
                                                                                              ever in the world today, and it’s more       to have results in three to four years.
                                                                                              drug resistant and more difficult                “We’re not there yet,” he says.
                                                                                              to prevent and manage.                       “In fact, we’ve got a long way to go.
                                                                                                  His approach is based on an evolu-       But we’ve got a very interesting idea
                                                                                              tionary perspective. Malaria and             that really bucks the dogma. Even if it
                                                                                              humans have evolved together because         doesn’t pan out, we’ve learned a lot
                                                                                              it is not in the interest of a parasite to   about the way people naturally
                                                                                              destroy its host. Only a small percent-      respond to malaria.”


F A C U LT Y O F M E D I C I N E                                                                           G R E AT M I N D S F O R A G R E AT F U T U R E

                                                                                                                                                                                     5
                                                                                    RECRUITMENT




                                                                  Turning the Tide
                                                                  U of T is attracting hot talent
                                                                  from south of the border



                                    endy Levinson and her




     W                              husband Jim Shaw lived
                                    in a pleasant neighbour-
                                    hood minutes from the
                                    campus of the University
                                    of Chicago. Still, Levin-
     son never walked home alone after dark. In Toronto, she
     lets her teenage daughter stay out late and take the sub-
     way home. “In Chicago, I felt constantly vigilant about
     safety,” she says. “Here I don’t have that same sense.”
         That’s just one difference that Levinson and Shaw
     have noticed since they took up appointments at U of T
     in 2001. Levinson is vice-chair of the Department of
     Medicine at the University of Toronto, and Shaw is an
     associate professor in the Division of Dermatology.
         A few years ago, media and policy makers alike
     worried that Canada was losing its best minds to
     American universities and hospitals. Higher salaries
     and more research funding proved a magnet for talent.
     Now there are signs that trend may be reversing itself.
     In fact, Levinson herself has helped recruit several
     new faculty members from the U.S. While an increase
     in government research funding is helping, U of T’s
     unique environment for academic medicine is a pow-
     erful attraction.
         Levinson grew up in Toronto and attended U of T
     as an undergraduate. After completing her MD at
     McMaster and post-graduate training at McGill, she
     moved to Portland, Oregon to set up a practice. In
     1997, she became Chief of General Internal Medicine
     and Geriatrics at the University of Chicago. Two years
     ago, she and Shaw, a Seattle native, were contemplating
     a move to be closer to their aging parents. When she
     contacted Elliott Philipson, chair of the Department
     of Medicine at U of T, he created a “really great
     opportunity” for both of them.                                                      who is currently a senior research     global health research at St. Mike’s and U of T,” says
         Shaw, an American, was com-
     fortable with the move. A change
                                                “There’s strength in                     physician in the Center for Out-
                                                                                         comes and Effectiveness Research
                                                                                                                                Lavery. “He reminded me of just how impressive the
                                                                                                                                capacity is here and the rich intellectual resources that
     in regulations meant that his spe-        terms of the richness                     of the Agency of Healthcare            will be at my disposal.”
     cialty accreditation was accepted
     in Canada, and he was already
                                                  of the faculty                         Research and Quality. Although
                                                                                         she grew up in New York City,
                                                                                                                                   Lavery is also intrigued by the opportunity to com-
                                                                                                                                bine his interests in international health with research
     familiar with the city. “I love           and the potential for                     Bierman’s mother is Canadian           into inner city populations at the Centre for Inner City
     Toronto,” he says. “There’s good                                                    and as a child, she spent her          Health Research at St. Michael’s Hospital, for which
     infrastructure, ethnic diversity,
                                                 collaborations.”                        summers in Montreal. At U of T,        Wendy Levinson is also currently the acting director.
     and it’s a friendly city.”                                   she will be the first Ontario Women’s Health Coun-            He recognizes that Canadian government grants may
         While research grants are generally much larger in       cil Chair in Women’s Health.                                  not be as lavish as at the NIH, but is encouraged by
     the U.S., Levinson points out that they usually include          Bierman says U of T is the right environment to           the enormous opportunities to build research collab-
     salary support. At U of T, academic physicians are more      pursue her interests in health policy and outcomes            orations at U of T and the openness to innovative
     likely to have protected time for their research pursuits.   research. “There’s strength in terms of the richness of       approaches to research partnerships and funding.
     “As a researcher in the U.S., you have as much time to       the faculty and the potential for collaborations,” she           Lavery and his wife and two daughters are also glad
     devote to your research as you bring in in grants,” she      says. “I have cross-disciplinary interests and it’s a great   to be returning to Canada for personal reasons. “Liv-
     says. “If you write a grant and get 50 per cent of your      university to pursue them.” Like Shaw, she and her            ing in the U.S. was a wonderful experience for all
     salary funded, then you can negotiate to have 50 per         family are enthusiastic about the city. “We just fell in      of us and we really grew to love the people,” he says.
     cent of your time available to do research.” She and         love with Toronto.”                                           “But we also discovered that we really are Canadian
     Shaw also believe that teaching is valued more highly            Jim Lavery, a U of T-trained bioethicist, is another      and are very committed to having our daughters grow
     at U of T. “Taking teaching seriously is viewed as a         new recruit. He is returning to Canada to take up             up in Canada with an appreciation of the values that
     worthwhile endeavour here,” Shaw says.                       a position in the new Centre for Global Health                make this such a great country.”
         When it comes to salaries, Levinson says it’s diffi-     Research at St. Michael’s Hospital after three years at          Has U of T’s Faculty of Medicine succeeded in
     cult to make direct comparisons because costs vary.          the National Institutes of Health in Washington,              reversing the “brain drain”? It’s probably too early to
     “In the U.S. you pay for health care, private schools        where his work has focused on the ethics and regula-          say, but for some Americans and expatriate Canadians,
     and malpractice insurance. It’s hard to translate dollars    tion of research in developing countries. “Art Slutsky        Arlene Bierman sums it up well. “There are lots of
     into lifestyle.”                                             (VP Research, St. Michael’s Hospital) really made it          great colleagues and lots of resources here. This is
         One of Levinson’s new recruits is Arlene Bierman,        clear to me that there is a strong commitment to              where I feel I can contribute and grow.”


    JUNE 2003                                                                                                                     U N I V E R S I T Y o f TO RO N TO

6
                                                                                RESEARCH




                                    Third time
                                        lucky?
           February 1, 2003, millions       parallel interest in mind/body interac-
On         of people around the world
watched as the space shuttle Columbia
                                            tions in immunity. Studying immuno-
                                            logical serum levels in a group of
broke into pieces shortly after it          healthy individuals over a 24-hour
re-entered the Earth’s atmosphere.          period, he turned up a surprising result.
Seven astronauts were lost. Like            “Lo and behold, it turns out that there
everyone else, Dr. Reg Gorczynski, a        are circadian changes in some serum
U of T professor of immunology and          factors,” Gorcyznski says. With further
surgery, was deeply saddened by the         investigation, he established a strong       logical serum factors were related         Gorcyznski’s hypothesis is confirmed
human tragedy. But unlike most,             link between the immune system and           to dramatic changes in sleep physi-        by simulation data produced on Earth.
Gorczynski lost something else of           the sleep/wake cycle.                        ology, but the data was flawed.            “We still don’t have a hard and fast
value – data from an experiment that           Sleep disruption is a serious prob-          His next chance came with the           answer, but it looks as if the effect is
went into space with the Columbia.          lem for astronauts, so Gorczynski and        Columbia. This time, the experiment        really quite enormous,” he says. If con-
    Gorzynski trained as a biochemist       a colleague proposed an experiment           used bone cells in vitro. By now, he       firmed, this finding could be significant
and immunologist, then completed an         that involved collecting serum factors       knew that the same serum factors were      for the treatment of osteoporosis and
MD. Most of his research for the past       from astronauts during the Shuttle-          also implicated in bone loss, so there     other clinical conditions where bone
30 years has focused on immunoregu-         Mir mission in 1997. Unfortunately,          was an added hypothesis: that bone         loss is significant. Will he get a chance
lation as it relates to tumour biology      when the Mir craft collided with a           loss in space is not just a result of      to repeat the experiment? Gorcyznski
and parasitology, and most recently,        cargo vessel, the experiment refriger-       microgravity – as scientists have always   believes the shuttle will fly again, and
organ rejection in transplantation.         ator was put out of action. The samples      believed – but also of sleep disruption.   that his experiment could be among
    Several years ago, he developed a       showed that changes in immuno-                  Although the experiment was lost,       the first selected to go into space.




                                                                                T E AC H I N G




                                      Drawing Conclusions
                                                                                         year, professional Master’s degree         tration and animation. Inspired by a
                                                                                         (MScBMC). Students are required to         speaker at an Association of Medical
                                                                                         have a rare combined skill set of fine     Illustrators’ meeting in the U.S.
                                                                                         art, design theory, science, technol-      almost 20 years ago, Lax pioneered
                                                                                         ogy, and communications.                   the field in Toronto.
                                                                                            Historically, medical illustrators          The discipline has blossomed in
                                                                                         drew what the eye could see, isolating     recent years. As Lax says, “We have
                                                                                         important structures key to medical        become a very visual society.” Visual
                                                                                         conditions or procedures. They still do,   evidence is key in the courtroom since
                                                                                         but according to Dr. Linda Wilson-         medical terminology alone may not be
                                                                                         Pauwels, professor and director            meaningful, and x-rays and MRIs are
                                                                                         BMC, they also help to visualize the       not readily interpreted by a judge and
                                                                                         invisible. “We draw what you can’t         jury. Illustrators have become educators
                                                                                         see,” she says, “– hypotheses at the       of the courtroom. And as lawyers
                                                                                         cellular level, imagining what might       themselves become used to using visual
                                                                                         go on, based on empirical data.”           demonstrative evidence, the demand
                                                                                            One course in the program, Med-         for medical-legal illustration grows.
                                                                                         ical Legal Visualization, teaches com-         Artists can be held legally respon-
                                                                                         munication for a very specific audience    sible for their artwork, so accuracy is
                                              urors and judges often struggle to         – a judge and jury. Professor Leila        paramount. From the initial sketch to
             This graphic depicts how a
            medical-legal illustrator can
               clarify advanced medical
                                            J understand complex medical issues in
                                            a court of law. Fortunately, graduates of
                                                                                         Lax, who created and now teaches the
                                                                                         course, advocates better medical
                                                                                                                                    the final product, medical-legal illus-
                                                                                                                                    trators seek professional guidance
                      concepts to a jury.
            The illustration was created    U of T’s unique program in Biomedical        understanding to support better legal      from medical specialists.
                to show two MRI planes      Communications are trained to use            decisions. Using the most up-to-date           Teresa McLaren, one of Professor
                    that cut through the
                     ventricular system.
                                            art in the service of justice.               software, she teaches illustration and     Lax’s talented students, entered BMC
                                                U of T is the only place in Canada       animation based on real legal evidence     with a degree in human nutrition. The
                                            where you can learn the highly special-      – MRIs, x-rays, and doctors’ charts.       program has given her the tools and
                                            ized skills required of a medical illus-     Professor Lax also takes advantage of      training to rely on art as a means of full-
                                            trator. This small division within the       eLearning pedagogic techniques.            time employment. “Before, I identified
                                            Department of Surgery accepts only              Before 1985, there was no formal-       myself as a scientist,” says McLaren.
                                            eight students annually into its two-        ized profession of medical-legal illus-    “Now I identify myself as an artist.”


F A C U LT Y O F M E D I C I N E                                                                    G R E AT M I N D S F O R A G R E AT F U T U R E

                                                                                                                                                                                  7
                       G R E AT M I N D S




                         is, as Janet Rossant points out, a




     It                  small miracle. Life begins with a
                         single cell. Somehow, the cell dif-
                         ferentiates itself, growing into an
                         unimaginably complex organism.
                         Mouse or human, the process of
     embryonic development is a fascinating puzzle.
         That puzzle has fascinated Rossant since she
     was an undergraduate student at Oxford University
     in the 1970s, and still drives her research at the
     Samuel Lunenfeld Research Institute of Mount
     Sinai Hospital.
         Rossant’s first mentor at Oxford, Sir John Gurdon,
     inspired her passionate interest in developmental biol-
     ogy. Gurdon used frogs in his experiments, but
     Rossant chose something closer to humans – mice.
     As a graduate student, she worked with Richard
     Gardner – one of the first scientists to genetically alter
     a mouse – at Cambridge University. After complet-
     ing post-doctoral research with Gardner, Rossant
     married a Canadian and took up a faculty position at
     Brock University. She moved to Toronto in 1985 after



                                                                  A Long Tail
     establishing a collaboration with Alan Bernstein, a
     Canadian biologist who was exploring the use of
     retroviruses to genetically manipulate embryos. Bern-
     stein recruited her to the newly-formed Lunenfeld
     Research Institute, where she has been ever since.
     “The Lunenfeld has grown considerably in that
     time,” says Rossant, “but it’s managed to maintain a
                                                                  During 30 years of research on mouse
     collegial spirit. It’s a good place to do science.”
         Beyond the fundamental fascination of embry-             embryos, Janet Rossant has explored the
     onic development, Rossant says it’s important to
     understand the process of cell differentiation for two       mysteries at the heart of life itself
     reasons – because it helps us understand when devel-
     opment goes wrong and produces birth defects and
     genetic syndromes, and because                                                        generate random mutations           bioengineers, ethicists, lawyers and others with an
     it offers insights into pregnancy             “If science is not                      in mice, then screen them for       interest in this promising but controversial area.
     disorders such as pre-term labour,                                                    symptoms of human diseases.             Rossant is honoured to hold one of U of T’s five
     pre-eclampsia and placental insuf-         creative, it will never                        This work has led Rossant       Tanenbaum Chairs in Molecular Medicine, the
     ficiency. Working at Mt. Sinai,
     with its large program in high-
                                                    leap forward.”                         to an interest in stem cell
                                                                                           research. Her team uses embry-
                                                                                                                               result of an unprecedented $10 million donation
                                                                                                                               from renowned philanthropist Anne Tanenbaum.
     risk pregnancy, has fostered her interest in clinical        onic stem cells – cells that are capable of developing       Rossant has received many honours in her career,
     issues. “We don’t have the answers,” she says, “but          into a wide variety of different cells in the fully-devel-   including her recent naming as a “foreign honorary
     we have some clues – and it’s an area where there’s a        oped animal – to create mutant mice. But of course,          member” in the American Academy of Arts and Sci-
     real need for better clinical interventions.”                the medical community is fascinated by the possi-            ences. But she says the Tanenbaum Chair is unique.
         Rossant and her team focus most of their work on         bility that these cells could also be used to graft into     “This has special meaning because the Tanenbaums
     the early stages of embryo patterning – the process          humans for therapeutic purposes – to re-grow nerve           have been enormously strong supporters of the Uni-
     by which the body develops from head to tail – and           cells after a spinal injury, for example. “We’re not         versity and our hospital.”
     the genes involved in the process. One way of explor-        currently working with human cells,” says Rossant,               Rossant says that women in science have come a
     ing the role of genes is to cause random mutations,          “although that’s certainly a possibility in the future.      long way since the days of Rosalind Franklin, the
     then watch what happens as the animal develops. If           We hope the kinds of things we’re doing in the               researcher whose contribution to cracking the double
     the resulting mouse shows symptoms of a disease              mouse will transfer to the human system and allow            helix code was not recognized for many years. But the
     or condition like diabetes, hypertension or osteo-           us to manipulate cells for therapeutic use.” Rossant         small number of women choosing science as a career
     porosis, the researchers have an important clue to           is a member of the Canadian Stem Cell Network,               is still a concern. “It’s a very competitive area,” she says,
     which genes are involved. Rossant leads the Centre           a CIHR-supported National Centre of Excellence               “but somehow, we have to make sure that there are no
     for Modeling Human Disease, where researchers                that includes basic scientists like her, clinicians,         systemic reasons for women to take themselves out.”
                                                                                                                                   What does it take to make significant contri-
                                                                                                                               butions to science, as Rossant has throughout her
                      UToronto Medicine • Volume 1 Issue 2        Published by the Faculty of Medicine,
                      Executive Editor: Joanne Cole               University of Toronto
                                                                                                                               career? The ability to mix experience and intuition,
                      Editor: Pat Morden                          Phone: 416-978-5715 Fax: 416-946-7722                        then make a ‘leap of faith’ that pulls together dis-
                      Associate Editor: Jennifer Little           E-mail: medicine.advancement@utoronto.ca                     parate pieces of information into a coherent and
                      Design: Ireland + Associates                Canadian Publications Mail Product                           testable hypothesis. “The fun part,” she says, “comes
                      Illustration: Teresa McLaren                Sales Agreement No. 40786012
                                                                                                                               during the creative sessions where you’re reading and
                      Photography: Laura Arsiè, Steve Frost,
                                                                  GREAT MINDS FOR                                              thinking and developing new hypotheses. If science
                      John Hryniuk, Camelia Linta,
                      Jamie Thompson                              A GREAT FUTURE                                               is not creative, it will never leap forward.”


    JUNE 2003                                                                                                                      U N I V E R S I T Y o f TO RO N TO

8

				
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