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The
Laboratory Report Winter 2012
A Publication of the Department of Pathology and Genomic Medicine
2
3
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5
6
Dr. Alberto Ayala Receives Award from MD Anderson
Dr. Suyang Hao Joins Department Faculty
Dr. Youli Zu Receives Grant from National Cancer Institute
New Diagnostic Test Offerings
In Focus: The Renal Pathology Team
Lab Stats: Methodist West Houston Hospital
Dr. Muthiah Kumaraswami Receives Grant From American Heart Association
Trainee Spotlight
Office of Academic Development to Hold Additional Seminars
Table of Contents
Methodist Pathology and Pharmacy Partner to Reduce Length of Stay
To register, visit texpath.org. The abstract submission deadline has passed.
To register, visit uscap.org. The abstract submission deadline has passed.
102nd Annual Meeting
Baltimore Convention
Center
Baltimore, Maryland
March 2-8, 2013
T he Methodist Hos-
pital System De-
partment of Pathol-
ogy and Genomic Medi-
cine is once again leading
medicine with the imple-
mentation of a new inter-
vention that significantly
reduces the length of hos-
pitalization for patients
with Gram-negative
bloodstream infections. The
new process combines rapid
identification of bacteria
using matrix-assisted laser desorption
ionization-time of flight (MALDI-TOF)
mass spectrometry and streamlined an-
timicrobial susceptibility testing, in con-
junction with near-real-time antimicrobial
stewardship practices.
This novel intervention was developed
here at Methodist by Dr. Katherine Perez,
a clinical specialist in the Pharmacy De-
partment, and members of the Clinical
Microbiology Laboratory, Pharmacy
Department, and the Center for Biostatis-
tics at The Methodist Hospital Research
Institute.
“This new method is as accurate as the
old method, and takes less than half the
time,” said Dr. James Musser, chair of the
Department of Pathology and Genomic
Medicine for the system and a co-
investigator on the study. “Time is espe-
cially important when infections become
systemic. Getting patients on the most
effective therapy as
quickly as possible is
critical.”
The collaborating team
conducted a clinical study
at Methodist to assess the
new intervention, and
confirmed that it signifi-
cantly improved the time
to optimal therapy and
decreased hospital length-
of-stay and costs. The re-
sults of the study were
published in an early
online release in Archives of Pathology and
Laboratory Medicine.
For more information on the interven-
tion, contact Pat Cernoch in the Clinical
Microbiology Laboratory at 713-441-0333.
For more information on the Express
Blood Culture Service offered by
Methodist Diagnostic Laboratories or to
subscribe to the service for your non-
Methodist hospital, contact Phuong
Nguyen at [email protected].
The
Laboratory Report View archive issues at methodisthealth.com/TheLaboratoryReport
Study investigators pose with the Bruker mass spectrometer. From left, Dr. William Musick, Dr. James Musser, Dr. Katherine Perez, Pat Cernoch, Dr. James Davis,
Dr. Geoffrey Land, Dr. Leif Peterson, and Dr. Randall Olsen.
The
LABORATORY REPORT
2
Dr. Suyang Hao Joins Department Faculty
T he Department’s Hematopathol-
ogy service added its newest fac-
ulty member on October 1st. Dr.
Suyang Hao comes to Methodist from the
Department of Pathology at the Univer-
sity of Massachusetts Medical School and
the UMass Memorial Medical Center in
Worcester, Massachusetts, where she was
an associate professor and director of the
Flow Cytometry Laboratory and Hemato-
pathology Fellowship Program.
“Dr. Hao brings an impressive range
and depth of experience to the Depart-
ment,” said Dr. James Musser, chair of
the Department of Pathology and Ge-
nomic Medicine for The Methodist Hos-
pital System. “Her contributions to our
patients and our academic programs will
be greatly appreciated.”
Dr. Hao received her M.D. degree in
1983 from the Tianjin Medical University
in Tianjin, China. She completed her pa-
thology residency at the University of
Kansas Medical Center in Kansas City,
Kansas, and a hematopathology fellow-
ship at the William Beaumont Hospital in
Royal Oak, Michigan. Dr. Hao joined the
Department of Pathology at the Univer-
sity of Massachusetts Medical School in
2003.
For more information on Dr. Hao, visit
methodisthealth.com/hao.
Suyang Hao, M.D.
D r. Alberto Ayala, deputy chief
of pathology for the Depart-
ment, has received the Distin-
guished Alumnus Award from The Uni-
versity of Texas MD Anderson Cancer
Center. He was presented with the pres-
tigious award at a ceremony and lecture
at MD Anderson on December 6th.
“The Department and the Hospital
System congratulate Dr. Ayala,” said Dr.
James Musser, chair of the Department of
Pathology and Genomic Medicine for the
System. “This level of recognition is re-
markable and a testament to his im-
mense career accomplishments.”
The Distinguished Alumnus Award
was established at MD Anderson in 1980
to recognize a prominent individual who
had trained at the Center and made
Dr. Alberto Ayala Receives Award from MD Anderson
distinguished contributions to their re-
spective field.
Dr. Ayala received his M.D. degree
from the University of Nuevo Leon
School of Medicine in Monterrey, Mexico
in 1960. He completed pathology resi-
dency at The University of Texas Medical
Branch at Galveston, and a fellowship at
MD Anderson where he joined the fac-
ulty in 1968. Dr. Ayala joined the pathol-
ogy department at Methodist in 2004.
For more information on Dr. Ayala,
visit methodisthealth.com/ayala.
Alberto G. Ayala, M.D.
The
LABORATORY REPORT
3
Dr. Youli Zu Receives Grant from National Cancer Institute
D r. Youli Zu, co-director of He-
matopathology for the Depart-
ment, has received a $1 million
R33 grant from the National Cancer In-
stitute (NCI) to develop and validate an
assay for the detection of circulating tu-
mor cells.
“Early detection of cancer and real-
time assessment of response to treatment
are critical in improving patient out-
comes,” said Dr. Zu. “This test will be a
great advance over the existing test, and
will allow for earlier detection and more
accurate results.”
The proposed assay will allow physi-
cians to detect circulating tumor cells in
one drop of patient blood and provide
results in seconds. The “one-drop, one-step”
V on Willebrand disease is the
most common hereditary coagu-
lation disorder. It is caused by a
deficiency and/or malfunctioning of von
Willebrand factor, a protein required for
platelet adhesion and hemostasis. The
Department of Pathology and Genomic
Medicine has recently brought three new
assays in-house to test for von Wille-
brand disease.
Von Willebrand Factor Collagen
Binding Assay
When tissue is damaged or wounded,
collagen is exposed to blood, and the von
Willebrand factor in blood adheres to the
collagen and pulls platelets from the
blood to start the hemostasis process.
This assay mimics this wound process to
determine the amount of and collagen
binding ability of von Willebrand factor.
In can be used to help differentiate type 1
from type 2 von Willebrand disease.
Von Willebrand Factor Immunofunc-
tional Activity Assay
The GP1b binding domain is responsi-
ble for facilitating the proper binding of
New Diagnostic Test Offerings:
platelets with von Willebrand factor. This
assay uses a monoclonal antibody to de-
termine if the GP1b binding domain is
functioning properly. This assay measures
the amount of and GP1 binding site func-
tion of von Willebrand factor in blood.
Von Willebrand Factor Multimer Assay
Normal von Willebrand factor is com-
posed of large protein polymers with
high molecular weight. This test is a
Western blot assay that evaluates
whether the patient is making these nor-
mal, large polymers.
The Methodist Hospital is the only pro-
vider of the multimer assay in Texas.
Combined, these assays establish Meth-
odist as having the most comprehensive
von Willebrand disease panel available in
the state.
For more information regarding von
Willebrand disease testing at Methodist,
contact Dr. Wayne Chandler at wlchan-
[email protected]. To subscribe to the von
Willebrand testing services for your non-
Methodist hospital, please contact
Phuong Nguyen at Methodist Diagnostic
Laboratories at [email protected].
Western blot multimer assay results showing absence of normal von
Willebrand polymers.
system that is only activated in the pres-
ence of tumor cells. The current assay is
both time and labor intensive, requiring
significantly more blood and several
preparation steps to isolate and stain the
tumor cells. Tumor cells can be lost dur-
ing these steps, reducing the accuracy of
the assay.
In addition to his responsibilities as co-
director of Hematopathology for the De-
partment, Dr. Zu is also the director of
the Cancer Pathology Laboratory at The
Methodist Hospital Research Institute
where the R33 grant is based.
For more information on Dr. Zu, visit
methodisthealth.com/Zu.
Dr. Zu at The Methodist Hospital Research Institute
assay will use unique aptamer probes,
developed with Dr. Zu’s previous R43
grant from the NCI, that carry a reporter
The
LABORATORY REPORT
4
In Focus: The Renal Pathology Team
R enal pathology, or nephropathol-
ogy, is the subspecialty of anat-
omic pathology that focuses spe-
cifically on the study of diseases of kid-
ney tissue, including conditions related
to kidney transplant. These studies are
usually conducted on tissues obtained
through percutaneous renal biopsy. In
addition to light microscopy, renal pa-
thologists also use transmission electron
microscopy and immunofluorescence to
render a diagnosis.
The Department of Pathology and Ge-
nomic Medicine has a team of three anat-
omic pathologists with special training
and expertise in renal pathology. This team
Luan D. Truong, M.D.
Medical Director, Renal Pathology
Dr. Truong received his M.D. degree
from the Pennsylvania State University
College of Medicine in 1979. He com-
pleted pathology residency at Baylor Col-
lege of Medicine in Houston, and a renal
pathology fellowship at Columbia Uni-
versity in New York. His research aims to
better understand chronic tubulointersti-
tial injury using models of chronic ob-
structive nephropathy and ischemia-
reperfusion injury.
For more information on Dr. Truong,
visit methodisthealth.com/Truong.
Roberto Barrios, M.D.
Associate Medical Director, Renal Pathology
Dr. Barrios received his M.D. degree
from the Facultad de Medicina, Universi-
dad Nacional Autonoma de Mexico in
Mexico City in 1969. He then completed
pathology residency at the University
Hospitals of Cleveland and a renal pa-
thology fellowship at the Children’s Hos-
pital and National Heart Institute in Mex-
ico City. Dr. Barrios also completed a
pulmonary pathology fellowship at the
Lyman Duff Laboratory of McGill Uni-
versity and Royal Victoria Hospital in
Montreal, Quebec, Canada.
For more information on Dr. Barrios,
visit methodisthealth.com/Barrios.
provides invaluable
support to the ne-
phrology service
and transplant cen-
ter at Methodist, and
at other institutions
served by Methodist
Diagnostic Labora-
tories. The renal
pathology team also
provides outstanding
mentoring opportuni-
ties for the residents and fellows in the
Department of Pathology and Genomic
Medicine.
The renal pathology team: from left, Drs. Roberto Barrios, Luan Truong, and Lillian Gaber.
Lillian W. Gaber, M.D.
Associate Medical Director, Renal Pathology
Dr. Gaber received her medical degree
from the Ain Shams University School of
Medicine in Cairo, Egypt in 1976. She
completed residencies in anatomic and
clinical pathology at the New England
Deaconess Hospital in Boston, and a fel-
lowship in perinatal obstetrics and gyne-
cology pathology at the Brigham and
Women’s Hospital, also in Boston. Her
research investigates donor kidney biop-
sies at the cellular and molecular level to
determine suitability for transplantation,
changes following organ reperfusion, and
efficacy of immunosuppressive therapies.
For more information on Dr. Gaber,
visit methodisthealth.com/LillianWGaber. For more information on the renal pa-
thology service at Methodist, please con-
tact Dr. Luan Truong at [email protected].
Dr. Truong (right), and technologist Claire Haueter, review a kidney biopsy using the
transmission electron microscope.
Dr. Barrios (left) mentors resident, Dr. Jordan Roberts.
Dr. Gaber (center) consults on a kidney transplant patient with Dr. A. Osama Gaber (left)
and Dr. Samir Patel.
The
LABORATORY REPORT
5
“West Houston is growing fast and so is our hospital. Our team works hard to meet the challenges that new and grow-ing service lines bring. We like those chal-lenges; they energize us.”
Thu Ngo, M.D.
Lab Stats: Methodist West Houston Hospital Medical Director: Thu Ngo, M.D.
Dr. Ngo received his M.D. degree from
the Baylor College of Medicine in Hous-
ton in 1995. He completed a pathology
residency and fellowships in cytopathol-
ogy, hematopathology, and transfusion
medicine there as well. Dr. Ngo became
the medical director of Laboratory Ser-
vices at Methodist West Houston Hospi-
tal when the hospital opened in 2010.
Faculty: Lauri B. Campagna, M.D.
Dr. Campagna received her M.D. de-
gree in 1991 from the University of Colo-
rado School of Medicine in Denver. She
completed a residency in anatomic and
clinical pathology and a fellowship in
cytopathology at the Baylor College of
Medicine in Houston.
Dr. Campagna spent ten years in com-
munity hospital pathology, including as
the hospital chief of staff at the Medical
Center of Mckinney in McKinney, Texas.
She then held the appointment of assis-
tant professor of surgical pathology at
The University of Texas Southwestern
Medical Center in Dallas before joining
the laboratory at Methodist West Hous-
ton Hospital in 2011.
Pictures from top: Dr. Ngo in the Core Laboratory; Dr. Campagna in the Histology Laboratory; Melody Peeples processing hematopathology specimens; Ericka Bonnee logging in specimens;
and Joy Nunez loading the coagulation analyzer.
“It‟s been wonderful to return to Hous-ton and The Methodist Hospital System. The Katy area is vibrant and growing; it‟s a great place to be.”
Lauri B. Campagna, M.D.
Director: Melody Peeples, B.S., M.Ed.
Ms. Peeples received her master of edu-
cation (higher education administration
and supervision) from the University of
Houston and her bachelor of science
(medical technology) from Eastern Illi-
nois University. In addition to being the
director of laboratory services at Meth-
odist West Houston Hospital, she is also
the director of respiratory care.
“With expansion of our cardiovascular surgery program, opening of another medi-cal/surgical unit, and the addition of beds in our Family Birthing Center and NICU, the belief of „build it and they will come‟ is being fulfilled. Our team has successfully met each challenge with enthu-siasm and demonstration of our ICARE values.”
Melody Peeples, B.S., M.Ed.
Staff:
The laboratory currently employs 22
staff members that include laboratory
technicians, medical technologists, histol-
ogy assistants, and laboratory service
center representatives. These employees
work together to adapt to the fast-
growing environment of Methodist West
Houston Hospital. They are the A-team
of West Houston.
“It‟s always changing, but that is good; it keeps you on your toes.”
Joy Nunez, MT Q.A. Specialist and ICARE Award Recipient
“This is a nice place to work. We all work well together.”
Ericka Bonnee Laboratory Service Center Representative
The
LABORATORY REPORT
6
Trainee Spotlight:
Jian Chen, M.D., Ph.D. PGY4 Resident
D r. Jian Chen, PGY4 clinical pathology resident, is the recipient of the Department’s
Trainee Leadership and Innovation Award for the 4th quarter of 2012. He re-
ceived the award for initiating and conducting a stem cell donation study with Dr.
Christopher Leveque that resulted in a Fenwal Award from the American Association of
Blood Banks. Dr. Chen will also be presenting a poster on partial e antibody at the Texas
Society of Pathologists’ 92nd Annual Meeting in Austin in January.
Dr. Chen received his medical degree from the Shandong Medical University in China and
his Ph.D. in molecular and cellular pathology from the University of Alabama at Birming-
ham. He completed a blood banking/transfusion medicine fellowship at Methodist last year. Jian Chen, M.D., Ph.D.
Dr. Muthiah Kumaraswami Receives Grant from American Heart Association
D r. Muthiah Kumaras-
wami, an investigator
in the Department’s
Center for Molecular and Trans-
lational Human Infectious Dis-
eases Research, has received a 4-
year Scientist Development
Grant from the American Heart
Association to study the effect of
gene regulation on virulence in
group A Streptococcus.
“These bacteria cause a wide
range of infections, and some
can be very serious,” said Dr.
Kumaraswami. “Understanding
why some Streptococcus infec-
tions are more severe than others
is important, and will help us
develop more effective treatments.”
Group A Streptococcus causes a broad
range of clinical manifestations, from
mild pharyngitis and impetigo to
life threatening flesh-eating dis-
ease and toxic shock syndrome.
Post-infection sequelae can also
include acute rheumatic heart
disease, the leading cause of
cardiovascular morbidity and
mortality in young people in
developing countries.
In the proposed studies, Dr.
Kumaraswami will use genetic,
biochemical, biophysical, and
crystallographic methods to
elucidate the role of growth-
phase-specific secreted small
peptides as potential intercellu-
lar signals in the gene regulation
of Streptococcus virulence.
For more information on Dr. Kumaras-
wami, visit methodisthealth.com/
Kumaraswami.
Dr. Kumaraswami (right), with Senior Research Technician Nishanth Makthal, in their laboratory at The Methodist Hospital Research Institute.
Office of Academic Development to Hold Additional Seminars
T he Office of Academic Devel-
opment (OAD) in the Depart-
ment of Pathology and Ge-
nomic Medicine has scheduled its
seminars and workshops for 2013.
“These seminars can be very help-
ful to trainees and junior faculty,”
said Dr. Kathryn Stockbauer, man-
ager of the OAD. “It gives them the
information they need to „jump start‟
their academic development and
really get moving with their pro-
jects.”
The OAD will hold 2 one-hour seminars
in the first quarter of 2013. These
seminars will cover research creden-
tialing, ARAF/IRB submissions, and
study design (Jan. 15), and scientific
writing and presentations (Mar. 12).
A more interactive workshop on
manuscript development will be held
in April. That workshop will last
approximately 2 hours, and attendees
will bring actual manuscripts in
preparation to further develop with
the instructor.
For more information on the OAD,
visit methodisthealth.com/OAD.
Dr. Stockbauer leading a scientific writing seminar with trainees in 2011.
The
LABORATORY REPORT
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Cagle PT, Myers J. Precision medicine for lung cancer: role of the surgical pathologist. Arch Pathol Lab Med. 2012 Oct;136(10):1186-9.
Choi E, Lewis AL, Takei H, Ro JY. Leptomeningeal carcinomatosis as initial presentation in adenocarcinoma of lung with signet ring
cell features: an autopsy case report. Int J Clin Exp Pathol. 2012;5(9):972-6.
Chow KK, Naik S, Kakarla S, Brawley VS, Shaffer DR, Yi Z, Rainusso N, Wu MF, Liu H, Kew Y, Grossman RG, Powell S, Lee D, Ah-
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Flores AR, Jewell BE, Fittipaldi N, Beres SB, Musser JM. Human disease isolates of serotype M4 and M22 group A Streptococcus lack
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Khan KA, Smith DA, Thrall MJ. Only a small fraction of high-grade cervical lesions are discovered after an interpretation of atypical
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Continued page 8
RECENT PUBLICATIONS
7
The
LABORATORY REPORT
Ping Wang, Ph.D. Claudia P. Molina, M.D.
Seema Mullick, M.D.
Thu Ngo, M.D.
Steven Shen, M.D., Ph.D.
Paul Sumby, Ph.D.
The Laboratory Report is a publication
of The Methodist Hospital System
Department of Pathology and
Genomic Medicine.
Treviño J, Liu Z, Cao TN, Ramirez-Peña E, Sumby P. RivR is a negative regulator of virulence factor expression in the group A Strep-
tococcus. Infect Immun. 2012 Nov 12. [Epub ahead of print]
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Orazi A, Zu Y, Bhagat G, Wang HY, Dunphy CH, O' Neill S, Hsi ED, Zhao XF, Choi WW, Zhao X, van Krieken JH, Huang Q, Ai W,
Ponzoni MA, Ferreri AJ, Kahl BS, Winter JN, Go RS, Dirnhofer S, Piris MA, Møller MB, Wu L, Medeiros LJ, Young KH. Patients with
diffuse large B cell lymphoma of germinal center origin with BCL2 translocations have poor outcome, irrespective of MYC status: a
report from an International DLBCL rituximab-CHOP Consortium Program Study. Haematologica. 2012 Aug 28. [Epub ahead of print]
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Xu-Monette ZY, Wu L, Visco C, Tai YC, Tzankov A, Liu WM, Montes-Moreno S, Dybkær K, Chiu A, Orazi A, Zu Y, Bhagat G, Rich-
ards KL, Hsi ED, Zhao XF, Choi WW, Zhao X, van Krieken JH, Huang Q, Huh J, Ai W, Ponzoni M, Ferreri AJ, Zhou F, Kahl BS, Win-
ter JN, Xu W, Li J, Go RS, Li Y, Piris MA, Møller MB, Miranda RN, Abruzzo LV, Medeiros LJ, Young KH. Mutational profile and prog-
nostic significance of TP53 in diffuse large B-cell lymphoma patients treated with R-CHOP: report from an International DLBCL Ri-
tuximab-CHOP Consortium Program Study. Blood. 2012 Nov 8;120(19):3986-96.
RECENT PUBLICATIONS continued
8
Editor-in-Chief
April A. Ewton, M.D.
The Laboratory Report
Editorial Committee
Hazel L. Awalt, M.D.
Christopher Leveque, M.D.
The Methodist Hospital
Clare Rose, M.B.A.
Manuel Hinojosa, M.H.A. Editorial Coordinator
Philip Randall
Department Chair
James M. Musser, M.D., Ph.D.