School Notes: School of Medicine
November/December 2007

Help for children with heart defects

A tissue engineering project developed by two Yale physician-scientists could aid children born with serious medical defects, such as hearts with only two chambers.

Traditional treatment options for these children -- molding the child's own tissue into new vessels to be used as grafts, Gore-Tex grafts, and biological grafts from animals -- have been problematic. But now, Christopher K. Breuer, assistant professor of surgery and pediatrics, and Toshiharu Shinoka, associate professor and director of pediatric cardiovascular surgery at Yale-New Haven Children's Hospital, have developed a way to coax cells to grow blood vessels that can be used to repair or replace faulty vessels.

The engineered blood vessels, which are grown from stem cells taken from a patient's own bone marrow, aren't prone to the inflammation or rejection that can affect transplanted tissue. The process has been used successfully in 47 children in Japan. Shinoka and Breuer are now awaiting word on their application to the U.S. Food and Drug Administration to conduct clinical trials of their grafts at Yale.

Seed money yields a bumper crop of biotech companies

Fiscal Year 2007 was a banner year for biotech startups that sprang from intellectual property developed by researchers at the Yale School of Medicine. Six new companies received financing, and a seventh closed on funding shortly after the end of the fiscal year. In addition, existing bioscience companies in the New Haven area secured more than $400 million in new financing.

Jon Soderstrom, managing director of Yale's Office of Cooperative Research, attributes this year's success to a strong investment climate as well as the fact that many of the new startups address the unmet therapeutic needs of a large segment of the population. One example is Optherion, Inc., a new company that will leverage recent discoveries in the genetic causes of age-related macular degeneration (AMD) to offer more effective, longer-lasting therapies.

Three of the startups were founded in whole or in part with financing from Elm Street Ventures, a seed capital fund started with Yale's help two years ago. All but one of the seven new companies are headquartered in New Haven. "That's a critical aspect," Soderstrom said, "that these companies end up in New Haven and bolster the local economy."

Roughly 80 percent of ventures based on Yale intellectual property come from the medical school.

The road less traveled

Students who want to be doctors don't expect to work bankers' hours, but a growing number are turning away from primary care medicine and choosing so-called lifestyle specialties that allow them to maintain more balance between their work and personal lives.

At medical schools across the country, specialties such as emergency medicine, radiology, ophthalmology, anesthesia, and dermatology -- or E-ROAD, as these specialties are collectively called -- are becoming increasingly popular, either because they don't involve responding to a lot of nighttime emergencies or because the physicians work set shifts. 

At the Yale School of Medicine, the number of students choosing the E-ROAD rose from 17 in 1997 to 34 this year. What worries health administrators about this trend is that as the number of E-ROAD doctors goes up, the number of primary care physicians, or those trained in general internal medicine, family practice, and pediatrics, is dropping. At Yale, the number of graduates specializing in these areas dipped from 36 in 1997 to 22 in 2007.

Suggestions on how to reverse this trend nationally have included offering tuition debt forgiveness to students who choose to become primary care physicians.