Clinical research interests include coronary thrombolysis in acute ischemia, the development of left ventricular assist pumps, and new PTCA and atherectomy devices. Quantitative arteriography to evaluate coronary restenosis and the progression of atherosclerosis is under investigation. Additionally, clinical research in cardiac imaging is being pursued with positron emission tomography and SPECT gamma imaging. Electrophysiology studies are evaluating new antiarrhythmic drugs, intelligent pacemaker cardioverters, implantable defibrillators and the effect of ablation procedures. Basic science research is underway in molecular and cell biology, particularly with regard to endothelial aspects of atherosclerosis and ischemic myocardial damage and repair.
Research opportunities include use of the Clinical Research Center at Hermann Hospital for metabolic studies. Basic research into the mechanisms of action of insulin and the regulation of cellular functions by calcium, clinical studies of bone and mineral metabolism (including collaborative research with NASA) ovulatory dysfunction and prevention f complications in patients with diabetes mellitus are ongoing. Epidemiologic research of diabetes is conducted in collaboration with faculty at The University of Texas School of Public Health. Clinical trials on bone disorders and osteoporosis are being conducted in collaboration with The Johnson Space Center.
The division has a number of basic and clinical research projects in progress. The factors which regulate fluid and electrolyte absorption in both the small intestine and colon are active interests. Clinical research interests involve studies examining the etiology and therapy of diarrhea, gastrointestinal motility including small bowel motility, and, ultrasound techniques in chronic liver disease. Also, investigational drug studies with inflammatory bowel disease, peptic ulcer disease and gastroesophageal influx are in progress.
Areas of expertise in research within the Division include hypertension, infectious diseases, geriatrics, and pharmacoepidemiology. Research efforts include studies of the pathophysiology of hypertension and lipid disorders and drug trials on new anti-hypertensive agents are conducted. In conjunction with the Division of Infectious Diseases, studies on the pathophysiology of gastrointestinal infections are ongoing. Clinical series of infections in organ transplant recipients and patients with AIDS have also been performed. A current study in geriatrics involves the evaluation of congestive heart failure in the elderly. Collaborative studies with the School of Public Health and the Food and Drug Administration are ongoing in pharmacoepidemiology. Many of the research activities of the Division are centered in the University Clinical Research Center, a center dedicated and staffed for outpatient clinical research, which has received NIH funding.
The major research activities include a multidisciplinary center for vascular and thrombosis research and diversified hematologic and oncologic research projects covering a wide scope of disciplines from molecular biology to clinical trials. Examples of these projects include the study of mediators of macrophage function, hormone receptors in breast cancer cells, and the efficacy of combined hyperthermia and hemotherapeutic agents in experimental animals. There is an active research program in clinical hyperthermia as well as innovative clinical research using positron imaging to diagnose and measure therapeutic response of solid tumors. The Center for Vascular and Thrombosis Research has focused on the investigation of fundamental and clinical aspects of thrombosis and vascular disorders. There are active collaborations between Hematology/Oncology investigators and those in the Department of Medicine, other departments and those in neighboring institutions including the MDACC, Rice University, and Baylor College of Medicine.
The Division, working with faculty colleagues at The University of Texas School of Public Health, has assembled a multidisciplinary research team to investigate the problem of enteric infection. The scope of activity includes the molecular biology of enteric infection, the etiology of acute diarrhea, the epidemiology of enteropathogens (reservoirs and modes of transmission) and the development of plans for control and prevention of diarrheal diseases. Other well developed research interests include the mechanisms and biology of antimicrobial resistance, polymorphonuclear leukocyte function, organ transplantation infectious diseases, fungal infections and the clinical aspects of surgical infections. Research centers have been developed by infectious disease faculty in Mexico, Egypt, Taiwan and Zambia. Students, residents and fellows are encouraged to participate in international field activities. The Center for Infectious Disease for molecular and epidemiologic research in infectious diseases was established with initial programs in enteric infectious diseases, hepatitis B and respiratory infections.
The research interests of the Division include the pathophysiologic basis of abnormal gas exchange in the lungs and peripheral tissues, the interrelationship between respiratory and cardiac function, the cellular and molecular mechanisms of sepsis, and factors involved in the activation of alveolar macrophages including the possible role of these cells in lung injury. The Division is also studying the influences of respiratory muscle function and ventilatory control on breathing and weaning from mechanical ventilation.
The Division of Renal Diseases & Hypertension maintains active research programs in both basic and clinical investigation. These research activities are designed to develop an understanding of transport mechanisms for water, electrolytes, and non-electrolytes. Recent research programs have focused on the role of the kidney in the regulation of homeostasis by investigation of the mechanisms of renal tubular acidosis in several experimental models. Such data have been improved diagnostic accuracy and classification of this disorder. In addition, several members of the division are developing research programs in the molecular biology of the kidney.
Major areas of investigative interest focus on the molecular biology and genetics underlying multisystem inflammatory rheumatic and autoimmune diseases, especially systemic lupus erythematosus, Sjogren s syndrome, polymyositis, scleroderma, rheumatoid arthritis and the spondyloarthropathies. HLA, T-cell receptor, and complement genes are under intensive study utilizing state-of-the-art molecular genetic technology. Numerous research opportunities exist for third year medical residents and fellows throughout all of the Divisions within our Department. Research activities include clinically-oriented research, basic research, including molecular biology and immunology, and the interested medical house officer is encouraged to participate. It is possible to obtain experience in a selected area of research during the third year of residency by using one of the elective periods. Since this exposure to research would be short, one may also consider devoting one full year to a research effort following the completion of the medical residency. This may be particularly relevant to one interested in General Medicine whose future career will include teaching, research, and service. Our programs are developed such that they may be individualized for senior medical residents, and we can make available an extra year of research training following the medical residency for serious and dedicated candidates.
In addition to the basic clinical research programs established in each division of the Department of Medicine, we are establishing two special research initiatives. One, the Institute of Molecular Medicine for the Prevention of Human Diseases will elucidate basic mechanisms responsible for human disease at the molecular level and will attempt to develop curative and preventive therapies based on a mechanistic understanding of selected human diseases in the area of infectious disease, cardiovascular, pulmonary, rheumatic connective tissue, endocrine and reproductive diseases, neuroscience, gastroenterology, medical genetics, hematology and solid tumor oncology and immunology. Resident scientists working at a molecular level are being recruited to work in 80,000 square feet of newly created research space. Funding for this institute come from UT funds and from private sources.
The second research initiative is a biotechnology, privately supported research facility linked to The University of Texas Medical School and its Department of Internal Medicine and led by Dr. Richard Dixon, previously the Director of Molecular Biology at Merck Sharp and Dohme Research Laboratories. This research effort will focus on the molecular biology and immunology of the endothelium, and it is located in approximately 26,000 square feet of newly created research space.
At the Medical School, a cyclotron facility exists and positron emission tomography (PET) studies of organ perfusion and metabolism are available. The School of Public Health is a special resource with well trained epidemiologists and is available to support training and participate in collaborative research. Individual faculty are interested in tutoring and supporting research development in the medical school for house officers. Collaborative research opportunities and laboratories of faculty in the basic science departments are available as well at this school.
Research training opportunities exist in all facilities of the Texas Medical Center and area schools, including Rice University and the University of Houston, as well as at nearby NASA. The diverse patient population in the teaching hospitals and the diversity of ethnic, worldwide origins and ages for the patients seen, provide substantial clinical research opportunities. The M.D. Anderson Cancer Center provides exposure to a foremost clinical care and research center in cancer. A MD/PhD program at the medical school would provide one interested in furthering his/her education this potential developmental possibility. International research and collaboration is possible and ongoing. Thus, state of the art facilities and unlimited possibilities exist for one to participate in discovering scientific bases of disease and generating new knowledge.