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82nd President of APS Gary C. Sieck |
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We are all deeply affected by our life experiences, training opportunities and career choices. In my case, my entire life has been greatly rewarded by crossing paths with truly outstanding individuals from different fields in science and medicine. My active involvement in the APS for more than 30 years, since my time as a graduate student in physiology and biophysics at the University of Nebraska Medical Center has been particularly rewarding. Foremost, I have gained a deep appreciation of the fundamental role of physiology and biomedical engineering in medicine. Indeed, it is my firm belief that physiology, biomedical engineering, and medicine are inextricably linked. One of my major goals as APS president will be to promote the teamwork that has existed between physiologists, physicians, and biomedical engineers. The Physiology InFocus program at next year’s Experimental Biology meeting will provide an opportunity to highlight the importance of the teamwork between physiologists, physicians and biomedical engineers. In other ways throughout the year, I will work with APS members to find ways to re-establish the preeminence of physiology as a foundation of medicine. Most of the founders of the APS were physicians who understood the role of science in advancing clinical practice and they based their research in core principles of engineering. However over the years, physicians and biomedical engineers have gravitated toward their own specialized meetings, and the dialogue and lines of communication between physiologists, physicians, and biomedical engineers have been strained. In the current environment of increasingly complex, collaborative scientific and medical research, we must bring more physicians and biomedical engineers back to the APS, back to the Experimental Biology meetings and back to reading and contributing to our journals. Clinical practice and biomedical engineering are closely aligned with physiology and, in many cases, physiologists, physicians, and biomedical engineers form three-way partnerships that have transformed medicine in the past, and is crucial for the future. There are so many clinical problems to address, from diagnosis of diseases to assessing prognosis and the effectiveness of therapies. Physiology plays a key role in every aspect of clinical practice. Biomedical engineering is a way of thinking, a way of approaching a problem and a way of working toward a solution. Biomedical engineers have provided the technologies that have transformed physiological science and medical practice. Indeed, I cannot think of any topic in physiology where research studies do not depend on technologies that utilize procedures or technologies that would not be considered biomedical engineering. We need to actively recruit both physicians and biomedical engineers to the APS, involve them in our meetings and encourage submission of their work to our journals. We can learn so much through our scientific interactions and I would like to involve our membership in reestablishing this dialogue. On the Shoulders of Giants At the University of Nebraska Medical Center, I learned physiology with first year medical students. I also took first year medical courses in pharmacology, biochemistry, and neuroanatomy. At the same time, I took rigorous courses in physical chemistry, computer programming (Fortran), advanced engineering mathematics, and analog circuit design. In the second year, I was the teaching assistant in the medical school physiology course and continued with advanced course work in systems physiology. These courses provided a solid foundation in physiology and the necessary quantitative skills. I still recall the emphasis placed on the work of Claude Bernard, the French physician and physiologist who is often considered the father of modern physiology. Bernard’s early work explored the physiologic role of the pancreas and glycogenic function of the liver, both of which contributed to an understanding of the pathophysiology of diabetes mellitus. Later, his use of the scientific method in medicine led to the discovery of the vasomotor system and its role in vasoconstriction. Bernard is best known for his formulation of the principle that the body’s internal milieu or environment is maintained, “La fixité du milieu intérieur est la condition de la vie libre. Fixation of the internal environment is the condition for free life.” There is little doubt that Bernard shaped the development of American physiology. The first president of the APS, Henry Pickering Bowditch (APS president for a total of six years in 1887, 1888, and 1891-1895) was one of Bernard’s students, as was Silas Weir Mitchell, the second APS president (1889 and 1890). Walter Cannon, the sixth APS president was also greatly affected by Bernard’s work, and extended it in formulating the fundamental physiological concept of homeostasis. We all stand on the shoulders of giants and what impressed me, probably because of my quantitative training, was the parallel between physiological homeostasis and feedback control systems employed in engineering. Since that time, I have had a natural affinity toward biomedical engineering, even before the discipline was widely recognized. I firmly believe that physiology and biomedical engineering have much in common, and that our partnership in many cases has truly transformed medicine and all of biomedical science. Partnerships in Physiology I am often asked, “What does a physiologist do?” I respond that in medicine we can essentially define two basic sciences: anatomy (which studies structure at all levels from molecules to the whole body); and physiology (which studies function at all levels). Most other sciences have stemmed from these two basic sciences. This is certainly true for physiology in America. In a collaborative effort that involved the great comparative physiologist C. Richard Taylor and the renowned functional anatomist Ewald Weibel, they proposed the exciting concept of symmorphosis or optimization of biological design. Their original concept was proposed in the context of evolution of the respiratory system. Put simply, they proposed that in evolution, no structure is formed or maintained other than that which is required to satisfy functional demands. In a complex system, the capacity of each component should be optimally matched. I would suggest that we can extend the concept of symmorphosis to the evolution of modern academic medical centers, where the capacities for basic science discovery, translational research and clinical practice must be matched. Toward this end, we must work in teams combining the expertise and insight of physiologists and other basic scientists, physicians providing direction in areas of clinical need and biomedical engineers providing transformative technologies and process improvements. During my entire career, I have worked closely with many clinical colleagues in promoting basic, translational, and clinical research relevant to pulmonary, cardiovascular, and neuromuscular diseases. I have also worked closely with biomedical engineers, developing new technologies to promote basic discovery and enhancing a quantitative approach to improve the process of discovery. During my PhD research, I had the opportunity to move to UCLA where I was exposed to a completely new academic environment. After finishing my PhD, I stayed on at UCLA, initially as a postdoctoral fellow supported by a Public Health Service/NIH award and later as a faculty member in the Department of Anatomy and Cell Biology. I wasn’t an anatomist, so I had to learn gross anatomy just hours ahead of the medical students I was “teaching.” This exposure to a new discipline was extremely rewarding for me and I continued to teach anatomy for a number of years always including my physiological inclination toward function. My career path then passed through the City of Hope where I joined the faculty in the Division of Pulmonary and Critical Care Medicine. There I worked side by side with academic physicians exploring potential therapies designed to ameliorate the symptoms of chronic obstructive pulmonary diseases. Pulmonary diseases such as asthma, emphysema and tuberculosis affect millions of people around the world. I became part of a team working toward a common goal. There are many such teams of physiologists and physicians working together with biomedical engineers to address a variety of important clinical problems. These include: cardiovascular disease, the leading cause of morbidity and mortality in the United States and around the world; diabetes, which is reaching epidemic proportions and affects millions of people worldwide; cancer, a tragedy that impacts millions; neurodegenerative diseases that dim the quality of life in our twilight years. The list goes on and on, but overall an understanding of physiology is the essential foundation. After the City of Hope and UCLA, my career path took me to the University of Southern California where I joined the faculty in the Department of Biomedical Engineering. Here, the close affinity between biomedical engineering and physiology was again obvious. My graduate studies in physiology had provided a sound foundation in mathematics and quantitative science, and I had previously worked closely with biomedical engineers, so I felt at home in this department. In my opinion, biomedical engineering represents an approach to problem solving—the biomedical problems are often presented by physiologists and clinicians, but the solution involves a systematic engineering approach. Physiologists explore functional complexity ranging from protein-protein interactions inside the cell, to cell-cell interactions within tissue, to the organization and function of organ systems and the interactions across systems. We may call this systems biology, but it is physiology to the core. Biomedical engineering provides the tools for exploring and solving physiological complexity. Clinical practice relies on the insight provided by pathophysiological discoveries and constantly identifies needs for new technologies or process improvement that require biomedical engineering. At the Mayo Clinic, I’ve been able to continue my partnerships with physicians and biomedical engineers. Early on, the Mayo brothers recognized that modern medicine is built on teamwork between physicians, scientists, and engineers. Physiologists and other basic scientists strive to answer fundamental questions about biological processes involved in disease. By understanding disease at its molecular and cellular level, the basic discoveries of scientists provide the path for designing new therapies to treat disease. It is not difficult for basic scientists to interact with clinicians. I have had the privilege to work with many physician scientists, working as a team in my laboratory. We talk to each other and they keep me focused on clinically relevant issues, things that will have importance to real patients. Our collaborative research is often translational in nature, building on basic discoveries, but we always have our eye on the ball in terms of how our research will ultimately impact patients. Disruptive Events and New Opportunities Over the years at Mayo, I have assumed more and more administrative responsibilities. In these administrative roles, I have gained key insight into the important issues facing clinical practice, especially those related to access and reimbursements for medical care. There are major issues facing the future of healthcare, not least of which are the rising costs of medical care. The financial problems we face today in medicine are only the tip of the iceberg. The demographic changes that will follow the aging of the baby boomers will place an enormous strain on medical resources and the cost of healthcare. Undoubtedly, the rising costs of healthcare will impact the funds available for biomedical research. We are truly in the midst of what may be termed a major disruptive event with the severe depression, downturn of the financial markets, a decrease in asset values and greatly reduced liquidity. Because of past and present leadership, the financial condition of the APS is still very sound, but our investments have been affected. The important activities of the APS in education and membership support must and will continue. However, because of the financial situation we will need to be prudent and prioritize areas of support. Out of disruptive events come opportunities, and this is true today. We have new national leadership, and the Obama administration has reacted with a major stimulus bill that includes substantial support for biomedical research through the NIH, NSF, and VA. There will be a bolus of $10 billion for the NIH alone and the only downside is that the funds will need to be spent across a two-year period. During the previous administration, there were real reductions in NIH funding, and this presented a real threat to our membership, especially younger physicians and scientists. The stimulus funds may help to stem this threat at least in the short term. However, the APS must work together with FASEB and other societies to influence future funding decisions that affect our research and clinical practice. Public engagement and education are critical to our success. The APS has always been a leader in publishing biomedical research, since the establishment of the American Journal of Physiology in 1898 under the leadership of William Townsend Porter. As editor of the Journal of Applied Physiology, and as a member of the editorial boards for leading journals in physiology and medicine, I know firsthand how important it is to maintain the quality and excellence of our journals and our scientific meetings. The misplaced emphasis on journal impact factor does not promote quality and excellence in scientific publication. Unfortunately, the impact factor is widely abused as a surrogate of the quality of scientific publications. The APS should take a more active role in this debate and promote better metrics of scientific quality that are focused on the individual investigator and the value of the scientific discovery. The recent debate on public access has also posed a real threat to our journals and to the peer review process. I am proud that the APS was a founding member of the DC Principles Coalition, a group that proposed reasonable alternatives to immediate open access that preserved the essential funding models of scientific publications without cost shifting to investigators. Physiology Training and Communication Physiology is important in our daily lives and in advancing medical discoveries. These essential facts must be communicated more effectively. Just this week, scientists, physicians and engineers throughout Rochester participated in a highly successful community science fair involving students from second grade through high school. Our community also has a math-science partnership that promotes educational programs in the public schools. Our labs provide opportunities throughout the year for mentoring high school students in science and engineering projects, and each summer, more than 200 students work in our labs, gaining valuable research experience that will hopefully shape their career choices. I am proud that the APS has been a leader in educational activities. We have a truly outstanding K-12 education program, and we need to consider other programs to feed the pipeline for future physiologists. Such programs might include summer undergraduate research fellowships in physiology funded by the APS. The APS has supported opportunities for high school and middle school science teachers to work in physiology labs during the summer, and we need to consider other programs to promote physiology education in middle and high schools. We also need to continue to promote physiology in undergraduate curricula. Through a variety of activities, we will encourage students to consider careers in physiology. These young physiologists will keep our society strong and vibrant into the future. In conclusion, I want to offer my sincere thanks and grateful appreciation to the outgoing president, Irving Zucker, for all his contributions to the APS. I look forward to working with APS members and staff in furthering and expanding our goals and ensuring investment in a strong future for the society. I invite the suggestions and contributions of the entire membership in helping us achieve our goals. 1. Olmsted, J. M. D. and Olmsted, E. H. Claude Bernard and the Experimental Method in Medicine. New York: Henry Schuman 1952. 2. Taylor, C.R. and Weibel, E.R. “Design of the mammalian respiratory system. I. Problem and strategy.” Respir Physiol. 44(1):1–10, 1981. 3. Virtanen, R. Claude Bernard and His Place in the History of Ideas. University of Nebraska Press, 1960. 4. Weibel, E.R., Taylor, C.R. and Hoppeler, H. “The concept of symmorphosis: a testable hypothesis of structure-function relationship.” Proc Natl Acad Sci USA. 88(22): 10357–10361, 1991. |
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Introducing Gary C. Sieck |
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Gary C. Sieck is a Professor and Chair of the Department of
Physiology & Biomedical Engineering at the Mayo Clinic College of Medicine.
He is also a Professor of Anesthesiology and Director of the Biomedical
Engineering Program. Administratively, he is the Deputy Director for
Research and Vice Dean for Research at the Mayo Clinic. Sieck was born and raised in Seward, NE and attended the Univ. of Nebraska where he received a BS degree in Zoology in 1971. He then received a PhD in Physiology and Biophysics from the Univ. of Nebraska Medical Center in 1976 under the direction of Judith Ramaley. In 1973 he went to UCLA where he conducted a significant part of his PhD thesis research in the Brain Research Institute under the guidance of Anna Taylor. He then stayed at the UCLA School of Medicine as a postdoctoral fellow. In 1979, he was appointed as a Research Assistant Professor in the Department of Anatomy and Cell Biology at UCLA. In 1981, he moved to the City of Hope National Medical Center in Duarte, CA and was appointed as a Research Scientist in the Department of Respiratory Diseases, but he retained a faculty appointment at UCLA. In 1987, Sieck joined the faculty in the Department of Biomedical Engineering at the Univ. of Southern California where he stayed until 1990, when he joined the Mayo Clinic staff. Since 2002 he has chaired the Department of Physiology & Biomedical Engineering, where he directs the Cellular Imaging and Physiology Laboratory. He is currently Deputy Director for Research at Mayo Clinic, Vice Dean for Research and Vice Chair of the Research Committee. For more than 30 years, Sieck has focused on neural control of respiratory muscles. In particular, he and his colleagues are exploring the basis for plasticity and remodeling of neuromotor control of respiratory muscles during development and in association with pulmonary diseases, spinal cord injury, and mechanical ventilation. His studies have shown that phrenic motoneurons exert direct trophic influences over contractile protein expression and metabolic enzyme activities of diaphragm muscle fibers. Conversely, trophic influences emanating from muscle fibers affect structural and functional remodeling of phrenic motoneurons. Such plasticity is also the basis for skeletal muscle adaptations to exercise and inactivity, as well as the remarkable remodeling of neuromotor control associated with pre- and postnatal development. In all of his studies, Sieck is using state-of-the-art cellular and molecular techniques, many developed in his laboratory. He is using real-time confocal microscopy to image changes in intracellular calcium in response to stimulation, and uses confocal microscopy and three-dimensional reconstruction to evaluate structural remodeling and localize protein expression. Sieck and his colleagues are using laser capture microdissection and single cell RT-PCR techniques to examine changes in phrenic motor neuron mRNA expression. His group has also developed quantitative electrophoretic techniques to explore changes in contractile protein expression in single muscle fibers and the relationship between contractile protein content and both mechanical and energetic properties of muscle fibers. In particular, he has examined the expression of different isoforms of myosin heavy chain, which form cross-bridges with actin during force generation and contraction, and are the site of ATP hydrolysis. Thus, plasticity in the essential linkages between structure, intracellular calcium regulation, mechanical and energetic properties of muscle fibers is being comprehensively explored. In 2004 he received the Joseph R. Rodarte Award for Scientific Distinction from the American Thoracic Society. In 2007, he was recognized as a Mayo Distinguished Investigator, and he was elected as a member of the College of Fellows of the American Institute for Medical and Biological Engineering (AIMBE). Sieck has published 231 original peer-reviewed papers, 14 invited reviews, 29 book chapters, 24 editorials and commentaries, and more than 450 published abstracts. He has also presented more than 90 invited lectures throughout the world. Sieck has been very active in educational activities. He has served as thesis advisor for 11 PhD students, has mentored seven visiting graduate students, 45 postdoctoral fellows, 10 junior faculty members and 20 visiting scientists, as well as numerous undergraduate and high school students. Since 2001, he has directed Mayo Graduate School’s Biomedical Engineering Program. He is also a member of the school’s Education Committee. Sieck earned the Mayo Research Educator Award from 2001 to 2004, and in 2006, he received the Dean’s Recognition Award. In addition to his service activities at Mayo, Sieck has served on many editorial boards, including the Journal of Applied Physiology, American Journal of Respiratory, Critical Care Medicine, Respiratory Physiology and Neurobiology, Acta Physiologica Sinica (China), Anasthesiologie, Intensivmedizin, Notfall-medizin, Schmerztherapie (Germany) and Journal of Anesthesiology and Intensive Care (Kazakstan). From 1999 to 2005, he served as the editor-in-chief of the Journal of Applied Physiology. His service also includes membership on NIH study sections (Respiratory and Applied Physiology [RAP] 1991-1994; Sensory Motor Integration [SMI] 2001-2005, and Native American Research Centers for Health [NARCH] chair 2004-2005, Cardiovascular, Lung & Blood Training Grants 2006-present), Special Emphasis Panels (Biological and Physiological Sciences 1993 and 1996, Skeletal Muscle Biology 2004, Bioengineering Research 2006, and Physiology and Pathobiology of Organ Systems 2006), Program Project grant site visits and review panels, and special ad hoc review panels. Sieck was also a member of the Veterans Administration Merit Review Board for Respiration from 1998-2001, and he has served as a reviewer for the NSF, Department of Defense, and other funding agencies. Within APS, Sieck has served in many roles. He is a member of the APS Respiration Section, in which he has served on the Program Committee (1996-2004) and Scientific Advisory Committee (1999-2005). He was chair of the APS Respiration Section in 2005 until he was elected to the APS Council, serving from 2005 to 2008. He also served as chair of the Respiratory Structure and Function Assembly of the American Thoracic Society (ATS) from 1996 to 1998, as a member of the ATS Scientific Conference Program Committee (1993-1995), Long-Range Planning Committee (1995-1998), Scientific Advisory Committee (1998-2002), Program and Budget Committee (1999-2003), and Publications Committee (2005-present). Sieck was also a member of the American Thoracic Society Board of Directors from 1996 to 1998. He was also a member of the National Council of the American Lung Association from 1997 to 2000. |
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