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| Lorenzo
Klein |
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Home
Institution
Medizinische Hochschule Hannover
Host
Institutions
1) University of Colorado Health Sciences Center Denver, Colorado (research);
Mentor: Norbert Voelkel, MD Division of Pulmonary Medicine & Critical
Care Pulmonary Hypertension Center
2) Vanderbilt University Medical Center Nashville, Tennessee (clinical)
E-Mail
lorenzo.klein@web.de
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Research
Topic
see Abstract |
Personal
Reactions to the U.S. Experience
Going to the US and enjoying the opportunity to get an insight into the
way work is organized in the medical field is priceless. It gave me ideas
for my own career decisions and it stimulates me to at least try to change
things at home.
Thinking about my own future as a clinician / researcher I know now that
it is not all working hours, payment, or career options, that I need to
worry about. If only we had structures and a mentality in Germany that would
encourage me to invest time and effort into working as a doctor, instead
of making frustration and destroying motivation the major driving forces.
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Greatest
Difficulties Encountered
Abbreviations of clinical terminology. |
Most
humorous incident
Being called "Loretta" for some totally unknown reason by my fellow colleagues
during the MDI meeting. |
Helpful
Hints for Future Students
Do not be ashamed of asking for, or even demanding, if it is a reasonable
thing you are asking for. Nobody will find out who you are AND what you
want unless you say it or ask for it! And this is NOT considered rude or
demanding, but simply normal. |
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Reserch
at One of The World's Leading Centers For Pulmonary Medicine
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| Denver, with
the University of Colorado Health Sciences Center's (UCHSC) Division of
Pulmonary Medicine and the nearby National Jewish Hospital (NJH), hosts
the biggest and most renowned center for the investigation and treatment
of pulmonary disease in the United States. During my time at UCHSC I was
assigned to the Pulmonary Hypertension Center, lead by Norbert F. Voelkel,
M.D., and Mark W. Geraci, M.D. |
| As my time
in Denver was limited to just about four months, and my research performed
in Germany could not be directly continued here, it seemed to my mentors
more appropriate for me to use the opportunity to get an insight into as
many aspects of the research on pulmonary disease as possible. Needless
to say, the most thorough insight I got was into the progress of understanding
primary pulmonary hypertension and the new treatment approaches for it. |
| This poorly
understood, not uncommon but often fatal condition is one of the main focuses
of the Pulmonary Hypertension Center. An increasing emphasis though is now
being put on the investigation of Chronic Obstructive Pulmonary Disease
(COPD). With a growing number of long-time smokers now reaching the main
manifestation age of 60 years and above, COPD is becoming one of the major
public health issues in the not so distant future. Already, awareness is
being raised in public campaigns about this condition, caused in the vast
majority by nicotine abuse, and which for a long time was given minor importance
compared to other nicotine related diseases, such as myocardial infarction
or stroke. While campaigns will hopefully prevent younger people from reaching
the level of manifest COPD by simply avoiding tobacco, more efforts must
be undertaken to find a way to understand and treat patients with COPD.
I was able to appreciate these two goals of the researchers at UCHSC and
the NJH during my time in Denver. Although I did not conduct my own project,
I profited a lot from joining and following all aspects of pulmonary research
in Denver, in the labs as well as on the wards. |
| To give just
a few ideas of how intense and diverse the research efforts in Denver are,
here are some recent publications from various groups at UCHSC: |
Pulmonary
Hypertension:
Geraci MW, Gao B, Shepherd DC, Moore MD, Westcott JY, Fagan KA, Alger LA;
Tuder RM, Voelkel NF. Pulmonary prostacyclin synthase overexpression in
transgenic mice protects against development of hypoxic pulmonary hypertension.
J Clin Invest. 1999 Jun; 103(11):1509-15. The pathophysiological correlate
to prostacyclin treatment in PH - until now the only effective option -
was developped at UCHSC.
Geraci MW, Gao B, Hoshikawa Y, Yeager ME, Tuder RM, Voelkel NF. Genomic
approaches to research in pulmonary hypertension. Respir Res. 2001;2(4):210-5.
Review. An excellent review of all new aspects of research in PH. |
COPD:
Voelkel NF. COPD: Working towards a greater understanding. Introduction.
Chest. 2000 May;117(5 Suppl. 2):325S. This supplement to Chest containts
excellent reviews on progress and future challenges in research and treatment
of COPD, it's impacts on community health care costs. Also it provides interesting
aspects on how differently still the problem of cigarette smoking is approached
in Europe compared to the US.
Kasahara Y, Tuder RM, Taraseviciene-Stewart L, Le Cras TD, Abman S, Hirth
PK, Waltenberger J, Voelkel NF. Inhibition of VEGF receptors causes lung
cell apoptosis and emphysema. J Clin Invest. 2000 Dec;106(11):1311-9. Recent
discoveries on the pathobiology of COPD leading to the conclusion that there
is only one way to fight COPD, to "create new lung tissue" (NF Voelkel).
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