It is important to note that in addition to the assignment of a scientific mentor, each trainee in our program has a clinical preceptor assigned. The role of this clinical preceptor is to aid trainees in elating their basic science efforts to the clinical arena and to provide academic and career counseling.
The recent addition of a clinical epidemiology program has been a significant benefit to our training program. Our trainees utilize epidemiological and biostatistical resources available through this program. Injury surveillance and epidemiology efforts are directed at blunt and penetrating trauma in the Dallas metroplex under the supervision of Paul Pepe, M.D., Director of Emergency Medical Services at UT Southwestern Medical Center and Parkland Hospital, Dallas.
George Buchanan, M.D., Professor, Department of Pediatrics
Dr. Buchanan’s research interests include the development of improved means of diagnosing and treating patients with hereditary blood coagulation disorders; the epidemiology and pathophysiology of childhood anemias, including iron deficiency, hereditary spherocytosi, and Diamond-Blackfan anemia; the management of immune thrombocytopenia (ITP) during childhood, emphasizing outcome measures other than platelet count (e.g., bleeding signs and symptoms, cost of therapy, and quality of life); the prevention and treatment of complications of sickle cell disease; and vascular complications following splenectomy.
Christopher Yu-Hua Lu, M.D., Professor of Medicine
Ischemic acute kidney injury (AKI - previously called "acute renal failure" or "acute tubular necrosis") confronts the physician with major clinical problems, and the scientist with fundamental unsolved questions. The physician is confronted a disease with no accepted treatment other than supportive care. Although there is often some renal recovery, the acute mortality and morbidity remains high, and the long-term problems include progressive chronic kidney disease and longterm mortality.
The scientist is confronted by a disease where the underlying pathophysiology is not understood. Although it is now recognized that the initial insult to the kidney is exacerbated by a maladaptive inflammatory response, how injury is translated into inflammation remains a fundament unsolved problem.
The overall goal of our laboratory is elucidating this unsolved problem in the hope this will lead to more effective therapies. To this end, we use in vivo models of ischemic AKI in mice, and in vitro model systems to perform detailed studies of proinflammatory genes activated by renal ischemia/ reperfusion. We have found that molecules, normally residing within healthy cells, are released into the extracellular space when renal cells are injured by ischemia in vivo and in vitro.
These molecules elicit activate proinflammatory genes. We are also translating this bench research into the clinic by studying clinically indicated pre-transplant renal biopsies; these biopsy studies will determine if the genes associated with the inflammatory response to ischemia in mice also are activated in man.
In addition to addressing fundamental questions, these clinical studies may predict the course and guide therapy of renal transplant recipients. Ischemic AKI inevitably occurs during the process of renal transplantation – the donor hypotension, cold storage, and the transplant surgery. The inflammatory response to this allograft ischemia will include recipient leukocytes that should exacerbate allograft rejection Thus, our studies will also help us understand allograft rejection.
Joseph Minei, M.D., Professor of Surgery
Dr. Minei’s research interests include the development of trauma systems and the use of evidence-based medicine to develop clinical practice guidelines.
Paul E. Pepe, M.D., Professor, Department of Surgery
Renown for a grass-roots, street-wise style in planning, implementing, and overseeing a systems approach to saving lives, both operationally and through clinical trials, his programs have resulted in some of the highest cardiac arrest and trauma survival rates worldwide.
In addition to the Chain of Survival publication, he is known for his original measurements of physiological mechanisms (e.g., Auto-PEEP), intrepid clinical concepts (e.g., deferred rescue breaths in CPR), and groundbreaking clinical trials (e.g., deferred IV fluids for trauma). Published years ago by Dr. Pepe and colleagues, these studies are now part of mainstream medical practice and research.
Many of his numerous studies, injury prevention programs, and media interactions have consistently affected public policy and legislation. Helping to set national priorities for cardiac and trauma resuscitation research, the NIH now has formally designated his EM program as a federally funded resuscitation research center set to conduct 10 clinical trials over the next 5-10 years.
Robert Rege, M.D., Professor, Department of Surgery
In recent years, Dr. Rege has been a leader in development of advanced laparoscopic surgery, including laparoscopic hernia repair, Nissen fundoplication, esophagomyotomy, colectomy, and splenectomy. Dr. Rege maintained an active basic research program to study the pathogenesis of gallstones, which has been continuously funded via external sources since its inception in 1983.