School Notes: School of Medicine
May/June 2007

Hands-on science program for local students

Some of the students working with cadavers in the School of Medicine's anatomy lab are not enrolled in the medical school; they're high school students from Hill Regional Career High School, a magnet school close to campus, who are participating in Yale's Anatomy Teaching Program. Career High attracts students from New Haven and its suburbs who are interested in careers in health, business, or computer technology. Yale's partnership with the school has enabled these students to take advantage of Yale's resources. Y

ale students and faculty instruct and mentor Career High pupils in a number of settings. In the medical careers class, Yale public health students come to Career High to speak about medical career options during the first semester, and the high school students complete an internship at Yale in the second semester. The university donated a research-quality electron microscope to the high school to help Career students understand molecular structures; it also recommended the types of equipment that would be most appropriate for a certified nurse's aide room set up to look like a clinic. Another learning opportunity is offered to advanced biology students who come to Yale twice a month after school to work with medical students who help them with course material.

Chinese herbal remedy works against kidney disease in mice

A compound found in the Chinese herbal medicine Lei Gong Teng has been shown to be effective in the treatment of polycystic kidney disease (PKD), a disorder in which genetic mutations lead to the formation of cysts that impair kidney function. The compound, triptolide, binds to a calcium channel that is implicated in PKD. In a study conducted by Craig M. Crews, associate professor of chemistry, pharmacology, and molecular, cellular, and developmental biology, and Stefan Somlo, C. N. H. Long Professor of Medicine (nephrology) and professor of genetics, the triptolide reined in the rogue calcium channel in mice and appeared to mitigate the symptoms of PKD. "Our research shows that triptolide . . . markedly decreases cyst formation in a mouse model of this most common genetic lethal kidney disease," Crews said. The findings were reported in the March Proceedings of the National Academy of Sciences.

Yale researchers cited for top breakthroughs

The work of two Yale faculty members and an alumnus has been noted by the journal Science in its listing of the top ten scientific breakthroughs of 2006.

The journal cited genomic studies of agerelated macular degeneration (AMD) led by Josephine J. Hoh, associate professor of epidemiology and ophthalmology and visual science, (along with other studies) as representing significant progress against the disease -- the most common cause of blindness in people over the age of 50.

Haifan Lin, professor of cell biology and director of the Yale Stem Cell Center, was one of four scientists who contributed to breakthroughs in the understanding of small RNA molecules known as Piwi-interacting RNAs, or piRNAs. Lin's lab first discovered Piwi/ Argonaute genes, which are essential for the self-renewal of stem cells, in 1998. But it was not understood how these genes play a role in stem cell division until last year, when Lin's group showed that Piwi/Argonaute proteins bind to piRNAs.

Jonathan Rothberg ’91PhD is the founder and chair of the board of 454 Life Sciences, a Branford, Connecticut, company that created technology for the rapid sequencing of genomes. Two of the labs on the top-ten list used this technology, and Stem Cell Center director Lin is using it in his work. Rothberg and collaborators in Europe analyzed DNA from a 38,000-year-old Neanderthal fossil and found that the difference between the human and Neanderthal genome is just one base pair in 2,000.

The virtual patient: simulation in medical education

Training through simulation -- whether by "standardized patients," mannequins, or virtual computer technology -- has become an increasingly accepted methodology in medical education. Medical schools, including Yale, are devoting significant resources to expose students to these training opportunities. Standardized patients -- actors who play the roles of patients to teach interviewing skills -- are integrated into all four years of medical school. Yale now has an array of human patient simulators, or mannequins, for students to "treat," as well as a simulation laboratory equipped with computers that allow students to practice everything from suturing techniques to performing a colonoscopy.

Instructors say these simulation tools are useful for both teaching and assessment. Students can practice and make mistakes without harming real patients; these tools can simulate unusual cases students wouldn't often see in practice; and they are ideal for comparative evaluations of clinical skills because each student faces identical patient challenges.

Last June, Leigh Evans, director of healthcare simulation for the section of emergency medicine in the Department of Surgery, launched a program using high-fidelity human patient simulators for third-year medical students during their surgery rotations. The lifelike polymer figures are computerized and programmable, so they can simulate just about any condition that occurs in the human body. The simulators can talk and breathe, their vital signs can change, and they can even "die," although Evans, an assistant professor, says she's never made a simulator do that because she worries it would be too traumatic for the students. The major advantage a simulator has over actors is that you can create a medical emergency or practice such procedures as intubation that you wouldn't perform on a real person.