Mobile Vascular Lab Unit To Begin in Summer - Surgery - University ...

Endovascular Repair of Abdominal Aortic Aneurysm
More than 15,000 Americans die each year due
to ruptured abdominal aortic aneurysms (AAA).
AAA are caused by progressive weakening of the
aortic wall that causes a dilation or "ballooning"
of the vessel. The aneurysm will grow larger and
eventually rupture if not diagnosed and treated.
Major risk factors for
AAA include: (1) age
>60 years; (2) family
history of AAA; (3)
smoking; and (4) high
blood pressure. The risk
increases with age and is
much more common in
men than in women.
Surgery is usually required to repair an AAA, but
modern catheter-based technologies using
endovascular grafts have made treatment less
invasive in many cases. The combination of early
diagnosis and modern treatment can save countless
lives lost due to aneurysm rupture each year.
UC Surgeons Division of Vascular Surgery has
led the way in utilizing and teaching this minimally
invasive technique for AAA.
Surgical treatment of AAA has been performed
for almost 50 years and is a successful and
durable procedure. The diseased part of the aorta
is replaced with a Dacron or Teflon graft that is
carefully matched to the normal aorta and sewn
in place by the surgeon. While ultimately curative,
this operation requires a major abdominal
incision and general anesthesia, and hospital stay
averages 7-10 days. Even after uncomplicated
surgery, patients often require 1-2 months to
June - July, 2003
return to a full and normal life. Nevertheless,
more than 90% of patients make a full and permanent
recovery from surgery.
Recent advances in catheter-based technologies
over the past decade have led to exciting new
treatments for aortic aneurysms. Endovascular
grafting technology allows surgeons to repair the
AAA by delivering a graft through a small incision
in the groin. The endovascular method,
approved by the FDA in 1999, allows the graft to
be delivered via a catheter inserted in a groin
artery with x-ray guidance. The graft is then
expanded inside the aorta and held in place with
metallic hooks. The hospital stay is usually 1-2
days, and most patients can return to work or
normal daily activities in a week. Even patients
with serious medical problems, once thought to
be too sick or frail for AAA surgery, may have
their aneurysm repaired using an endovascular
graft. This can avoid the need for major open surgery
and eliminate the risk of fatal rupture if the
AAA was not treated at all. However, endovascular
grafting may not be possible in every case.
The Division of Vascular
Surgery has utilized
endovascular grafts to
repair AAA for over five
years and is nationally
recognized for educating
the vascular surgery
workforce in this and
other new and evolving
technologies.
For more information, call (513) 558-5367.
Mobile Vascular Lab Unit To Begin in Summer
UC Surgeons and the Division of Vascular Surgery announce plans for a Mobile Vascular Lab Unit to
begin this summer. Duplex studies of the carotid arteries to evaluate for stenosis, venous system to
rule out clot, in addition to non-invasive arterial vascular lab studies to assess blockages in the arteries
of the lower extremity, will be a few of the many evaluations offered. The mobility of these studies
will allow patients to be examined closer to their home or referring physician's office. Watch for
the Mobile Vascular Lab to make its first appearance at University Pointe! To schedule a visit by the
Mobile Vascular Lab in your area, please call (513) 558-5367.

Significant Gains in NIH Ranking
The Department of Surgery jumped from #28 in FY01 (and #31 in
FY00) to #15 in NIH grants ranking (based on research awards). The
total awards to UC Surgeons in FY02 was $4,088,546. The UC
College of Medicine is ranked 19/73 for public medical schools and
42/125 total public and private medical schools.
The UC Department of Surgery has surpassed not only Ohio State but
also Johns Hopkins, Vanderbilt, Columbia, Emory, and several other
prominent players in NIH ranking. This is an important indication
that UC Surgeons is being recognized nationally, and that its surgeons
and researchers are helping to shape the future of surgery and medicine.
The Department is poised with new recruits coming on board in
July to jump even higher in NIH ranking next year.
UC Matches First Female Vascular
Surgery Fellow
Amy B. Reed, M.D., Program Director of the University of
Cincinnati Vascular Surgery Fellowship, has successfully matched
UC's first female vascular surgery fellow, Catherine Caggianos,
M.D. Dr. Caggianos will begin the two-year clinical fellowship in
July 2004. The UC Division of Vascular Surgery's strong commitment
to state-of-the-art endovascular surgical training in addition to
complex open surgical techniques has allowed the Division to continue
to attract top candidates from across the country, while other top
programs in the country have gone unmatched.
More Vascular Surgery News:
Harold Davis, Ph.D., of the Vascular Surgery Division, presented a
poster entitled "The Role of the Cytoskeleton in Cellular Adhesion
Molecule Expression in Tumor Necrosis Factor-Stimulated
Endothelial Cells" at the Society for Vascular Medicine and Biology
meeting in Chicago on June 6-8, 2003. Other authors were Elizabeth
VandenBerg and John Edwards.
The Division of Vascular Surgery is also proud to announce that Amy
B. Reed, M.D., recently passed the American Board of Vascular
Surgery Certifying Examination and is now fully Board Certified in
Vascular Surgery.
Liver Transplant Program in Full Swing
The University of Cincinnati Liver Transplant Program has performed
more adult liver transplants in Cincinnati over the past six
months than the other four Ohio liver transplant programs combined.
As a result, many more patients have been removed from the waiting
list and returned to a normal life. UC Surgeons have performed more
than 50 liver transplants (with a 100% survival rate) since December
2002, twice the number of transplants ordinarily performed in a similar
time period.
This increase in transplant activity has occurred largely due to the
more aggressive recruitment of local and statewide organ donors
through the widespread use of "extended criteria donors." Whereas
organ donors with advanced age, certain types of infections, contain-
ing high degrees of fat, among other factors, were previously not considered
for liver donation, the new approach has enabled the acceptance
of these organ donors by minimizing the time the donor is without
blood flow as well as manipulating post-transplant immunosuppression
drugs. Nearly all liver donors are now deemed acceptable
for transplant, with very favorable results.
Under the direction of Steven M. Rudich,
M.D., Ph.D., Associate Professor of Surgery
and Director of Liver Transplant Services, the
liver transplant program has made great
strides forward. Within the next few months,
the UC Liver Transplant Program will resume
adult-to-adult live-donor liver transplants. In
this case, an exceptionally healthy relative
(usually) has approximately 60% of his/her
Steve Rudich, M.D., Ph.D.
liver removed, which is then given to the
recipient. The liver regenerates in both the donor and recipient. UC
Surgeons were the first in Ohio to offer live-donor transplants to
patients with liver disease.
In addition, more widespread use of donation after cardiac death
(DCD) organ donors will be realized through the use of extracorporeal
membrane oxygenation (ECMO), a technique that allows reoxygenation
and revitalization of organs after death. UC Surgeons are
one of only two groups in the world to use ECMO technology to prepare
livers from DCD organ donors for transplantation.
UC Surgeons are well on their way to creating the largest, most successful
and aggressive liver transplant program in Ohio. However,
only the selfless commitment of Ohioans makes this service possible.
In concert with LifeCenter, the UC Liver Transplant Program is working
to keep Ohioans free of the life-threatening complications of endstage
liver disease. For further information or to make a referral,
call (513) 558-3892.
More Transplant Surgery News:
Transplant Recipients May Be Prone to West Nile Virus
Encephalitis. Reuters and Medscape recently published the results
described in an abstract presented by Debby DeSalvo, M.D., a transplant
nephrology fellow in the UC Department of Internal Medicine,
and members of the UC Division of Transplantation at the American
Transplant Congress in June. Two transplant recipients at UC were
treated for West Nile Virus encephalitis during the past year; one
patient died after standard tests failed to reveal the diagnosis in time
for treatment, while the subsequent patient recovered fully after additional
tests revealed cerebral edema. This latter patient was taken off
immunosuppressants and put on a course of alpha interferon, an
experimental therapy; he recovered within days and is doing well 10
months later.
Medscape also published the combined results of two separate
abstracts presented at the American Transplant Congress by Joseph
Buell, M.D., and Manish Gupta, M.D., showing that a history of
breast or prostate cancer is not necessarily a contraindication for solid
organ transplantation. Patients with stage I or II cancer do relatively
well, but a history of stage III breast or prostate cancer carries a very
poor prognosis.

Urology News
Chief Resident Nancy Kim, M.D., has been submitted for
the Pfizer Award for scholarship. She scored at the 92% level
with her peers in the nation on the last in-service exam. Nick
Meiers, M.D., will receive the TAP Industry award for allround
excellence. The Art Evans award will go to Marlou
Heiland, M.D., for her paper at the Ohio Urological Society.
********
The residents have chosen private community urologists
David Henning, M.D., and Courtney Persinger, M.D., to
be recipients of The Crystal Apple Award for their work in
the VAMC clinics and teaching cystoscopy and transrectal
ultrasonography of the prostate.
********
Thomas Bell, M.D., Chief of the Division of Urology, has
been appointed as Acting Chief of Surgery at the VAMC in
Dr. Bower's absence.
********
The VAMC approved the Division’s new LiebleFlarsheim
endosurgical table ($350,000).
********
The Division is putting together a proposal to bring robotic
surgery to Cincinnati’s VAMC in 10 years. Safwat Zaki,
M.D., is in charge of this endeavor in collaboration with
Creighton Wright, M.D.
********
R. Bruce Bracken, M.D., has recently lectured in
Singapore, Iowa, and Chicago.
****************
Recent Publications
Bommireddy R, Ormsby I, Yein M, Boivin GP, Babcock GF,
Doetschman T. Transforming growth factor beta-1 inhibits
Ca2+ calcineurin-mediated activation in thymocytes. J Immunol
170:3645-52, 2003.
Cuschieri J, Gourlay D, Jelacic S, et al. Endotoxin-induced
endothelial cell proinflammatory phenotypic differentiation
requires stress fiber polymerization. Shock 19:433-40, 2003.
Hess KA, Waltz SE, Chan EL, et al. The receptor tyrosine
kinase Ron is expressed in mouse reproductive tissues during
embryonic implantation and is important in trophoblast cell
function. Biology of Reproduction 68:1267-75, 2003.
Solomkin JS, Yellin AE, Rotstein OD, et al. Ertapenem vs.
piperacillin/tazobactam in treatment of complicated intraabdominal
infections: Results of a double-blind, randomized
comparative Phase III trial. Ann Surg 237:235-45, 2003.
Wen LT, Caldwell CC, Knowles AF. Poly(ADP-ribose) polymerase
activation and changes in Bax protein expression associated
with extracellular ATP-mediated apoptosis in human
embryonic kidney 293-P2X7 cells. Molec Pharmacol 63:706-
13, 2003.
Wilson SE, Solomkin JS, Le V, et al. A severity score for complicated
skin and soft tissue infections derived from Phase II
studies of linezolid. Am J Surg 185:369-75, 2003.
Timothy Broderick, M.D.
Charles Caldwell, Ph.D.
David Fischer, M.D.
New Faculty
Timothy A. Broderick, M.D., will join
the Department in early August as chief of
the Division of Gastrointestinal and
Endocrine Surgery. Dr. Broderick brings
exciting research and technology with
him. He is a NASA-funded researcher,
flying on the “vomit comet” this past June
to evaluate the use of surgical simulators
in microgravity.
Dr. Broderick specializes in advanced laparoscopic and robotic
procedures and is interested in the ongoing development of
telemedicine. He will also serve as the medical director of the
Interventional Technology Training Center scheduled to open in
summer 2004. In addition, Dr. Broderick serves as consulting
surgeon on telemedicine and robotics for NASA’s Medical
Informatics and Technology Applications Consortium (MITAC)
and as intergovernmental personnel for the US Army Telemedicine
& Advanced Technology Research Center (TATRC).
Dr. Broderick is a graduate of Xavier University and UC Medical
School. He completed his residency and has been on staff at the
Virginia Commonwealth University, Medical College of
Virginia.
Charles C. Caldwell, Ph.D., joined the
Department on May 1 as an Assistant
Professor in the Trauma, Sepsis and
Inflammation Research Group. A graduate
of the University of California, San Diego,
he pursued graduate coursework in protein
chemistry at San Diego State University
and postdoctoral studies in Biochemistry
and Immunopharmacology at the NIH.
Dr. Caldwell's research interests center around the immunomodulation
of T cells during infections. His future studies will
continue to employ the translation of structure-function receptor
chemistry to in vivo biochemistry with therapeutic applications.
David R. Fischer, M.D., joined the
Department on July 1 as an Assistant
Professor in the Division of Gastrointestinal
and Endocrine Surgery. Dr.
Fischer graduated summa cum laude from
the University of Toledo and received his
medical degree from the University of
Cincinnati College of Medicine.
Dr. Fischer completed surgical residency and a research fellowship
in the UC Department of Surgery, winning several research
awards. He will specialize in general surgery including laparoscopic
GI, endocrine and bariatric surgery. Dr. Fischer will see
patients at the Medical Arts Building and The Christ Hospital.

Scott Frame Memorial Lecture Held
The Division of Trauma and Critical Care recently hosted Dr. Rao
Ivatury as visiting professor for the Scott Frame Memorial
Lectureship. Dr. Ivatury is the Director of Trauma and Critical
Care at the University of Virginia and nationally recognized for
his work in trauma. The lectureship was expanded to include a
Grand Rounds presentation hosted jointly by the Departments of
Surgery and Emergency Medicine. This year also marked the first
Frame Resident Award in recognition of the resident physician
who best embodies Dr. Frame's vision for collaboration between
the Departments. The winners were Dr. Robert Cavagnol and Dr.
William Hinckley, who were presented with a plaque by Mrs.
Joyce Frame as well as the Fifth Edition of the Pre-Hospital Life
Support Manual edited by (and dedicated to) Dr. Frame.
Left to right: Jay Johannigman, M.D., Chief of the Division of Trauma and
Critical Care; Rao Ivatury, M.D.; Mrs. Scott Frame; W. Brian Gibler, M.D.,
Chairman, Department of Emergency Medicine; and Andra Blomkalns, M.D.,
Emergency Medicine associate residency director.
Dr. Ivatury also joined faculty from the two Departments in the
first Frame Memorial EMS Lecture Series on topics pertaining to
pre-hospital care, disaster preparedness and trauma. The conference
was attended by over 100 firefighters and paramedics. The
Division of Trauma and Critical Care looks forward to continuing
this educational event on a yearly basis.
Grace Mak, M.D., at the Ohio Chapter, American College of Surgeons
Plastic Surgery News
Faculty and residents of the Division of Plastic Surgery presented
the following abstracts at the Ohio Valley Society of Plastic
Surgeons Meeting, May 29-31, 2003: "Management of Cleft Lip
from A to Z" (David A. Billmire, MD); "The Skin Sciences
Institute: A Collaborative Model for Research in Aesthetic Surgery"
(W. John Kitzmiller, MD); "Mandibular Distraction Can Reverse
Cardiovascular Structural Changes in Patients with Severe
Micrognathia and Obstructive Sleep Apnea Syndrome" (John J.
Bulger, MD); "Growth Hormone Secretion Normalization after
Mandibular Distraction" (David Passaretti, MD, and Christopher
B. Gordon, MD), voted Runner-up for Best Clinical Paper; and
"Growth Arrest and Skeletal Deformities in the Pediatric Burned
Hand and Upper Extremity" (Allison E. Wilt, MD).
********
The faculty and residents of the Division of Plastic Surgery are
proud to announce that Rian Maercks, MD, a 2003 Duke Medical
School graduate, begins his residency here in the 3 + 3 integrated
program. Our own Thad O'Neill, MD, will begin his plastic surgery
residency starting in 2004 in the 5 + 2 independent program. Both
were highly sought after in the Match. We welcome them both to
our Division.
********
On September 19-20, 2003, the Division will celebrate Dr. Henry
Neale’s 29 years of service to the Department as well as the 25th
Anniversary of the Division of Plastic Surgery Residency Program.
The festivities will include a golf outing on Friday at Traditions Golf
Course and a reception immediately following at the Club House.
On Saturday morning an educational forum will be held in the
Surgical Amphitheater and a black-tie dinner will be held that
evening. Program information will be forthcoming.
********
Henry W. Neale, MD, and W. John Kitzmiller, MD, attended the
American Association of Plastic Surgeons Meeting on May 4-7,
2003, in Baltimore. Dr. Kitzmiller was inducted as a new member
of this prestigious association.
Burn Division Presents at ABA
Members of the Burn Division and Shriners Burns Hospital
were prominent at the American Burn Association Annual
Meeting in Miami Beach on April 1-4, 2003, making 10 oral
and 15 poster presentations.
Ohio Chapter, American College of
Surgeons Meeting Held in Cincinnati
The 48th Annual Meeting of the Ohio Chapter, American College
of Surgeons was held in Cincinnati on May 8-10, 2003, at the
Marriott Kingsgate Conference Center and was a great success.
John Howington, MD, FACS, Chief of the Division of Thoracic
Surgery, served as the Program Chair. Jeff Lyons, M.D., won 3rd
place for Resident Research Presentations. Pictured at left in front of
her poster presentation is Grace Mak, M.D., a surgical resident who
is currently doing research in the laboratories of the Epithelial
Pathobiology Research Group at The Vontz Center.

Department Welcomes New Interns
The Department held a Welcome Reception for new interns at the Cincinnati Country Club on June 17, 2003. We had another excellent
match and welcome the new interns to our Department.
Jocelyn Logan-Collins
Northwestern University
General Surgery
Sunil Sinha
New York University
Oral Surgery
Colin Martin
Wayne State University
General Surgery
Rodney Stigall
University of Louisville
Oral Surgery
Benjamin McIntyre
Univ. of South Carolina
General Surgery
Rian Maercks
Duke University
Plastic Surgery
Left to right: Jocelyn Logan-Collins, M.D.; Henry W. Neale, M.D.;
Joan Matthews, M.D.; and Darragh Collins.
Thomas Shin
University of Michigan
General Surgery
CINCINNATI SURGICAL SOCIETY MEETING HELD
UC Surgeons participated at the Cincinnati Surgical Society meeting held Wednesday, May 21, 2003. Andrew Knott, M.D.,
won Second Place in the Cincinnati Surgical Resident Essay Contest with his paper entitled “Smooth Muscle Overexpression of
Insulin-like Growth Factor-1 Results in a Novel Adaptive Response to Small Bowel Resection.”
Robert H. Bower, M.D., completed his year as President of the Society in June.
Janice Taylor
Ohio State University
General Surgery
Rebecca Roedersheimer
University of Cincinnati
Urology
Gwen Roesel
Ryan Thomas
Loyola University
General Surgery
University of Cincinnati
Urology
Left to right: Howard Bellamah, M.D.; John B.
Flege, Jr., M.D.; and Henry W. Neale, M.D.

Inaugural Research Retreat Is Great Success
About forty Department of Surgery faculty, residents, staff, and students attended a research retreat on May 31, 2003 at the Mill Race Lodge
in Winton Woods. The retreat was comprised of morning and afternoon sessions with slide and poster presentations of ongoing departmental
research efforts. The main objective of the retreat was to exchange ideas and initiate collaborations in a very informal, comfortable setting.
Dr. Kathleen H. Goss served as program director, and responses from attendees indicated that the event was a great success. The
Department looks forward to making this an annual event to foster interactions among basic and clinical researchers.
Cardiothoracic Surgery News
Shahab Akhter, M.D., and Michael F. Reed, M.D., recently passed
the American Board of Thoracic Surgery Certifying Examination
and are now fully Board Certified in Thoracic Surgery.
********
Michael F. Reed, M.D., presented a paper entitled “The Impact of
Barrett’s Esophagus on Outcomes for Adenocarcinoma” at the
Western Thoracic Surgical Association annual meeting in Carlsbad,
California, on June 20, 2003.
********
Walter H. Merrill, M.D., Chief of the Section of Cardiothoracic
Surgery, has been chairing the UC Anesthesia Search Committee for
the new Chairman of Anesthesia.
********
Robert Osterday, PA-C, has joined the Section of Cardiothoracic
Surgery as a Physician Assistant. Bob received a B.S. Degree in
Biology from Wright State University and an AS-Physician
Assistant degree from Kettering College of Medical Arts in Dayton,
Ohio. He most recently served as a Physician Assistant at The
Jewish Hospital of Cincinnati.
********
The Lung Cancer Screening Trial (John Howington, M.D.,
Principal Investigator) has enrolled more than 100 patients, well on
the way to an ultimate goal of 500 patients. To refer a patient, call
Tonya Mohn at (513) 584-7698. For more information on the trial,
call Brandon Kleykamp at (513) 584-3183.
Shahab Akhter, M.D. Michael F. Reed, M.D.
Walter H. Merrill, M.D.
Robert Osterday, PA-C

Resident Research Awards Presented
The Department of Surgery faculty and residents presented research
awards at Final Grand Rounds on Wednesday, June 25, 2003.
Department of Surgery Resident Research Award:
First Place: Joshua Mammen, MD ("Regulation of MAPKs During
Post-Ischemic Stress in Model Intestinal Epithelia")
Finalists: Drs. Steve Allen, Russell J. Juno, and Konstantin Umanskiy
Max Zinninger Award (nomination and voting by faculty):
First Place: Timothy Pritts, MD, PhD
Finalists: Drs. Robert Cavagnol, David Fischer, Eric Hungness,
Thomas Husted, and Thaddeus O'Neill
Josef E. Fischer, M.D. Award (nomination/vote of fellow residents):
First Place: David Fischer, MD
Finalists: Drs. Robert Cavagnol, Gyu Gang, Prakash Pandalai, and
Timothy Pritts
Other Resident Awards:
Society of Laparoendoscopic Surgeons Resident Achievement
Award: Jonathan F. Finks, MD.
Department of Surgery Best Teaching Resident Award (as voted
by medical students during 3rd year Surgery Clerkship):
First Place: David Fischer, MD
Finalists: Drs. Lauren Archer, Robert Cavagnol, and Timothy Pritts
Arnold P. Gold Foundation Award for Humanism and Excellence
in Teaching (voted by 3rd & 4th year medical students as their best
role models): David Fischer, MD, and Timothy Pritts, MD, PhD.
Presented at New Student Clinician Ceremony on July 2nd.
Jeff Lyons, MD, won 3rd place at the Ohio Chapter ACS meeting for
Resident Research Presentations.
Chief Residents, 2003-2004, left to right: Thaddeus O'Neill, MD; David
O’Brien, MD; Eric Hungness, MD; and Gyu Gang, MD.
Final Grand Rounds, June 25, 2003, in the Surgical Amphitheater
Josh Mammen, MD
Jeff Matthews, MD, and Dave
Fischer, MD
Bob Bower, MD, Tim Pritts, MD,
PhD, and Jeff Matthews, MD
Jeff Matthews, MD, and Jonathan
F. Finks, MD
New Chief Residents Honored
The new Chiefs were honored at Final Grand Rounds
on June 25, 2003. They are pictured at left.

Surgical Grand Rounds Schedule
Formal Grand Rounds will resume in September. A schedule will appear in the next newsletter.
The Farewell to Chiefs Dinner was held on Saturday, June 21, 2003, at the Queen City Club. Graduating
chief residents were also honored at Surgical Grand Rounds on June 25, 2003.
Graduating Chief Residents 2002-2003, left to right: Jonathan Finks, MD; David Fischer, MD; Joseph
Kim, MD; Timothy Pritts, MD, PhD; and Lawrence Stern, MD.
June - July, 2003