UC Surgeon-Scientist Receives $1.5 Million Grant to Study Heart ...
UC Surgeon-Scientist Receives $1.5 Million Grant to Study Heart ...
UC Surgeon-Scientist Receives $1.5 Million Grant to Study Heart ...
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Winter 2005-2006<br />
<strong>UC</strong> <strong>Surgeon</strong>-<strong>Scientist</strong> <strong>Receives</strong> <strong>$1.5</strong> <strong>Million</strong><br />
<strong>Grant</strong> <strong>to</strong> <strong>Study</strong> <strong>Heart</strong> Enlargement/Failure<br />
<strong>Surgeon</strong>s at the University of Cincinnati<br />
College of Medicine have received <strong>$1.5</strong><br />
million <strong>to</strong> study the link between heart<br />
enlargement and heart failure. Shahab<br />
Akhter, M.D., Assistant Professor of<br />
Surgery in the Division of Cardiac Surgery,<br />
is principal investiga<strong>to</strong>r for the five-year<br />
study funded by the National Institutes of<br />
Health, National <strong>Heart</strong>, Lung and Blood<br />
Institute, and the Thoracic Surgery<br />
Foundation for Research & Education.<br />
Dr. Akhter believes that protein kinase C, a<br />
molecule that is activated when the heart<br />
becomes enlarged, “turns on” a specific<br />
enzyme that limits the heart’s ability <strong>to</strong><br />
respond <strong>to</strong> stress and pump efficiently. This<br />
can lead <strong>to</strong> poor heart function and, ultimately,<br />
heart failure.<br />
Dr. Akhter and his team will study the interaction<br />
between these signaling molecules<br />
in multiple lines of genetically engineered<br />
mice, each designed <strong>to</strong> express a specific<br />
kinase or kinase inhibi<strong>to</strong>r, in order <strong>to</strong><br />
identify new ways [see inside - “Akhter”]<br />
Dr. Shahab Akhter and Dr. Karyn Butler in their labs at the Cardiovascular Research Center.<br />
Trauma <strong>Surgeon</strong> Continues Innovative Cardiac Research<br />
Karyn Butler, M.D., F.A.C.S., F.C.C.M.,<br />
Associate Professor of Surgery, Division of<br />
Trauma and Critical Care, continues her<br />
research on hypertrophied hearts with support<br />
from a National Institutes of Health,<br />
Men<strong>to</strong>red Clinical <strong>Scientist</strong> (K08) Award.<br />
Cardiac chamber remodeling following<br />
myocardial infarction or in response <strong>to</strong><br />
hypertension may lead <strong>to</strong> left ventricular<br />
hypertrophy and cardiac failure. Preconditioning,<br />
or ischemic adaptation, repre-<br />
sents the intrinsic capacity of the heart <strong>to</strong><br />
protect itself from ischemic injury. The<br />
molecular basis of this phenomenon<br />
remains <strong>to</strong> be further characterized.<br />
Clinical and experimental studies indicate<br />
that hypertrophied hearts are more vulnerable<br />
<strong>to</strong> ischemic insult compared <strong>to</strong> nonhypertrophied<br />
hearts. In non-hypertrophied<br />
myocardium, cardiac preconditioning<br />
can attenuate ischemia/reperfusion<br />
induced contractile [see inside - “Butler”]
<strong>Surgeon</strong> Performs Region’s First Minimally Invasive<br />
Four-Arm Robotic-Assisted Gastric Bypass<br />
Calvin A. Selwyn, Jr., M.D., Assistant Professor of Surgery in<br />
the Division of Gastrointestinal and Endocrine Surgery, and<br />
Direc<strong>to</strong>r of Surgical Endoscopy and Laparoscopy, performed<br />
the Midwest's first minimally invasive gastric bypass procedure<br />
using a four-arm surgical robot on November 9, 2005. He is<br />
only the second surgeon in the world <strong>to</strong> do so. Dr. Selwyn’s<br />
technique allows self-assisted surgery that was once so complex<br />
that it required two surgeons <strong>to</strong> perform. He will be giving a<br />
presentation at the Pacific Rim Robotics Conference <strong>to</strong> be held<br />
in Anaheim, California in January 2006 <strong>to</strong> discuss this novel<br />
approach <strong>to</strong> bariatric surgery with some of the nation’s premiere<br />
robotic surgeons.<br />
Dr. Selwyn controls the four mechanical arms from an interactive<br />
console. Inserted in<strong>to</strong> the abdomen through several small<br />
tubes or “ports” without the need for a major incision, the arms<br />
function with the dexterity of human hands. The four-arm technology<br />
provides better depth perception and fine-motion control<br />
inside the abdomen than the three-arm approach, allowing the<br />
surgeon <strong>to</strong> operate with greater precision and control suturing<br />
techniques. “Robotic gastric bypass surgery minimizes complications<br />
common with open surgery, including hernias and pulmonary<br />
problems,” says Dr. Selwyn.<br />
“Akhter” (continued from front page)<br />
<strong>to</strong> prevent heart function deterioration. “If we can identify and<br />
block this molecular ‘cross-talk’ that contributes <strong>to</strong> heart failure,<br />
we can develop new, more precise therapies that reduce the incidence<br />
of disease and save more lives,” Dr. Akhter says.<br />
<strong>Heart</strong> disease is currently treated with a combination of drugs<br />
that reduce stress on the heart and improve blood flow. These<br />
include ACE (angiotensin-converting enzyme) inhibi<strong>to</strong>rs, which<br />
reduce blood pressure; beta-blockers, which block recep<strong>to</strong>rs <strong>to</strong><br />
slow the heartbeat and reduce muscle contractions; and diuretics,<br />
which help the body remove unneeded water and salt.<br />
“Beta-blockers and ACE inhibi<strong>to</strong>rs are effective in treating the<br />
symp<strong>to</strong>ms of heart failure, but clearly we need <strong>to</strong> do better. The<br />
average survival rate for someone with heart failure is just five<br />
years,” says Dr. Akhter.<br />
Dr. Calvin Selwyn at the controls of the daVinci robot system in the<br />
Surgical Simulation Labora<strong>to</strong>ry. (Pho<strong>to</strong> courtesy of Academic<br />
Health Center Public Relations/D. Davenport)<br />
Patients at the <strong>UC</strong> Center for Surgical Weight Loss undergo a<br />
rigorous presurgery evaluation that includes a review of dietary<br />
habits, exercise physiology, emotional counseling and physical<br />
examinations. Dr. Selwyn offers the robotic-assisted procedure<br />
<strong>to</strong> 30% of his patients. For more information, please call 513-<br />
475-7770.<br />
“Butler” (continued from front page)<br />
dysfunction. The preliminary data suggest that compensated<br />
hypertrophied hearts exhibit enhanced ischemic <strong>to</strong>lerance after<br />
preconditioning compared <strong>to</strong> non-hypertrophied hearts. This<br />
observation suggests that the signaling pathways involved in<br />
adaptive hypertrophy may enhance ischemic <strong>to</strong>lerance.<br />
Dr. Butler has also observed that this relative preservation of<br />
ischemic adaptation in the hypertrophied heart is lost in a timedependent<br />
manner as the heart transitions from compensated<br />
hypertrophy <strong>to</strong> cardiac failure. Her labora<strong>to</strong>ry explores this<br />
clinically relevant problem by studying the response of hypertrophied<br />
rodent hearts <strong>to</strong> changes in myocardial blood flow. The<br />
goal of this research is <strong>to</strong> identify strategies that may improve<br />
cardiac function in patients with underlying heart disease who<br />
experience angina or “heart attack.”<br />
“It is a pleasure men<strong>to</strong>ring two such brilliant scientists.”<br />
“The current state of art in pharmacotherapy of heart failure, considering its epidemic nature in the world, is very disappointing.<br />
Recent reviews have emphasized that we are dealing with a highly complex, multifaceted disease, yet the<br />
pipeline of new and exciting breakthrough drugs and/or therapy is at a trickle. Theoretically, one reason slowing the<br />
development of effective breakthrough pharmaceuticals is that we still lack thorough understanding of the intricate<br />
biology of the heart and vasculature. I am convinced that the research proposed by Drs. Akhter and Butler will uncover<br />
substantial information that will assist in the eventual completion of this complicated puzzle.”<br />
Arnold Schwartz, Ph.D.<br />
Direc<strong>to</strong>r, Institute of Molecular Pharmacology and Biophysics
<strong>UC</strong> Researcher <strong>Receives</strong> NIH <strong>Grant</strong><br />
Susan E. Waltz, Ph.D., Associate Professor of Surgery in<br />
the Trauma, Sepsis and Inflammation Research Group, has<br />
received a 5-year continuation grant from the Department<br />
of Health and Human Services, National Institutes of<br />
Health, National Institute of Diabetes and Digestive and<br />
Kidney Diseases, for her project “Hepa<strong>to</strong>cyte Growth<br />
Fac<strong>to</strong>r-like Protein Recep<strong>to</strong>r” which will be effective from<br />
September 2005 <strong>to</strong> June 2010.<br />
Susan Waltz, PhD (far right, front row) and her research group.<br />
Harvard Chief of Surgery <strong>to</strong> Visit <strong>UC</strong><br />
Andrew L. Warshaw, M.D., W. Gerald Austen Professor of<br />
Surgery at Harvard Medical School and <strong>Surgeon</strong>-in-Chief and<br />
Chairman of the Department of Surgery at Massachusetts General<br />
Hospital, will serve as the Ninth Annual Altemeier Visiting<br />
Professor, January 17-18, 2006.<br />
Andrew L. Warshaw, M.D.<br />
Dr. Warshaw is a leading authority on<br />
the pancreas and has made important<br />
contributions <strong>to</strong> the diagnosis and treatment<br />
of pancreatic cancer and the<br />
pathogenesis and management of pancreatitis.<br />
Dr. Warshaw serves as a governor of the<br />
American College of <strong>Surgeon</strong>s, and<br />
president-elect of the Halsted Society.<br />
He is past-president of the Society of<br />
Surgery of the Alimentary Tract and the<br />
International Association of Pancrea<strong>to</strong>logy.<br />
On Tuesday, January 17, 2006, Dr. Warshaw will discuss<br />
“Advocacy For and By <strong>Surgeon</strong>s” at the 4:00 p.m. Surgical<br />
Seminar, and will speak on “Management of Pancreatic Cancer” at<br />
Surgical Grand Rounds on Wednesday, January 18, 2006, in the<br />
Surgical Amphitheater.<br />
Pediatric Surgery Chief Recognized<br />
for International Service<br />
Richard Azizkhan, M.D., Direc<strong>to</strong>r of the Division of<br />
Pediatric Surgery, has been awarded the R.K. Gandhi Gold<br />
Medal, the highest award of the Indian Association of<br />
Paediatric <strong>Surgeon</strong>s (IAPS). The medal was presented at<br />
the 2005 IAPS Congress in Bangalore, India. Dr. Azizkhan<br />
was recognized for his work creating international medical<br />
exchange programs and for his contributions as a clinical<br />
scientist, particularly for his work with hemangiomas and<br />
vascular malformations and airway reconstruction.<br />
Dr. Richard Azizkhan (left) receives the R.K. Gandhi Gold Medal<br />
Dr. Azizkhan has trained pediatric surgeons in countries<br />
around the world, including India, and he has established<br />
formal relationships with universities and hospitals in<br />
countries in Europe, the Middle East and Asia. More than<br />
300 medical, surgical and nursing professionals have come<br />
for training at Cincinnati Children's from Bosnia, China,<br />
Croatia, Egypt, Finland, Germany, Italy, Japan, Jordan,<br />
Kuwait, Russia, Ukraine and other countries.<br />
Pediatric <strong>Surgeon</strong> in 3rd Marathon<br />
Brad Warner, M.D.,<br />
Professor of Surgery,<br />
Division of Pediatric<br />
Surgery, ran in the<br />
Columbus Marathon in<br />
Columbus, Ohio, on<br />
Oc<strong>to</strong>ber 16, 2005.<br />
Dr. Warner finished the<br />
marathon in 4 hours and<br />
18 minutes, a personal<br />
best time for him.<br />
This was Dr. Warner’s<br />
third marathon run.<br />
Dr. Brad Warner runs in the<br />
Columbus Marathon
Vascular Surgery Advances Minimally Invasive Care<br />
Joseph S. Giglia, M.D., interim direc<strong>to</strong>r of the Division of<br />
Vascular Surgery, performed the first minimally invasive<br />
endovascular surgery in the Tristate <strong>to</strong> repair a thoracic aortic<br />
aneurysm using the GORE TAG Thoracic Endoprosthesis, the<br />
only FDA-approved device of its kind. The procedure, which<br />
eliminates the need for a major chest incision, is a major<br />
advance for patients who are not viable candidates for traditional<br />
open surgery because of advanced vascular disease and<br />
other health complications. The 70-year-old patient underwent<br />
the procedure on Oc<strong>to</strong>ber 31 and was released from University<br />
Hospital a week later.<br />
Dr. Joseph Giglia holds an endovascular graft.<br />
(Pho<strong>to</strong> courtesy of Academic Health Center Public Relations/D. Collins)<br />
Many patients who suffer from thoracic aortic aneurysms also<br />
have serious health problems that make traditional open surgery<br />
<strong>to</strong>o risky. Endovascular repair is very promising because<br />
it gives those high-risk patients a better chance for survival.<br />
The procedure requires only a few small incisions in the groin<br />
where a catheter is inserted. Guided by live X-ray images and<br />
a video screen, Dr. Giglia locates the aneurysm and threads the<br />
catheter through blood vessels <strong>to</strong> the exact location. He then<br />
deploys the GORE TAG Thoracic Endoprosthesis stent-graft <strong>to</strong><br />
patch the interior of the diseased artery. The stent-graft is held<br />
in place against the vessel walls once it expands <strong>to</strong> full size.<br />
Once in place, the stent-graft supports the weakened vessel<br />
walls and allows blood <strong>to</strong> continue flowing through the aorta<br />
without applying pressure <strong>to</strong> the aneurysm. Without a blood<br />
supply, the aneurysm is less likely <strong>to</strong> rupture and will begin <strong>to</strong><br />
shrink over time.<br />
Repairing the diseased artery from inside the body minimizes<br />
the complications associated with open surgery and gives more<br />
patients an option for survival. The procedure also takes a quarter<br />
of the time required for open surgery and minimizes blood<br />
loss. Endovascular grafts allow repair of the aneurysm without<br />
a major chest incision, with less risk for infection, a shorter<br />
hospital stay, and faster recovery time.<br />
As seen in the pho<strong>to</strong> at left, <strong>UC</strong> vascular surgeons are using an<br />
outsourced image processing service (Medical Metrix<br />
Solutions) for thoracic aortic aneurysm patients that decreases<br />
procedures, devices, and cost. It provides critical information<br />
using data from the patient's routine CT studies, and obviates<br />
the need for invasive angiogram prior <strong>to</strong> endovascular<br />
aneurysm repair. “It is a very powerful <strong>to</strong>ol that allows precise<br />
preoperative planning and assists with intraoperative management,”<br />
says Dr. Giglia.<br />
As noted in the previous newsletter, Dr. Giglia also was the<br />
first in the Tristate <strong>to</strong> perform a minimally invasive, laparoscopic-assisted<br />
bypass procedure <strong>to</strong> treat aor<strong>to</strong>iliac arterial<br />
occlusive disease. Only a handful of centers are performing<br />
this procedure nationally. <strong>UC</strong> vascular surgeons plan <strong>to</strong> perform<br />
the operation completely with laparoscopic instruments<br />
in the near future and eventually with a surgical robot.<br />
Vascular Surgery Fellowship Direc<strong>to</strong>r<br />
<strong>Receives</strong> Honors and Funding<br />
Amy B. Reed, M.D., Assistant Professor of Surgery in the<br />
Division of Vascular Surgery, was appointed <strong>to</strong> the Ohio<br />
Chapter ACS (American College of <strong>Surgeon</strong>s) Women’s<br />
Committee and Ohio Chapter ACS Representative <strong>to</strong><br />
Association of Women <strong>Surgeon</strong>s. Dr. Reed was invited speaker<br />
at <strong>UC</strong>’s AMWA (American Medical Women’s Association)<br />
Chapter on being a woman in vascular surgery, as well as invited<br />
speaker at Ohio/Northern Kentucky/Indiana Society for<br />
Vascular Ultrasound on “Treatment and Management of<br />
Venous Disease in 21st Century.”<br />
On September 23, 2005, Mr. Greg Wallace of Bos<strong>to</strong>n Scientific<br />
presented the Vascular Surgery Fellowship Program with a gift<br />
for continuing education in vascular surgery.<br />
Dr. Amy Reed accepts gift from Greg Wallace of Bos<strong>to</strong>n Scientific
Making Strides Walk is Held <strong>to</strong><br />
Benefit American Cancer Society<br />
The Breast Cancer and Environment research group teamed up<br />
with Kathleen Heppner-Goss, Ph.D., and her team for the<br />
recent Making Strides Walk <strong>to</strong> benefit research sponsored by<br />
the American Cancer Society. Dr. Goss, Assistant Professor of<br />
Surgery in the Epithelial Pathobiology Research Group,<br />
receives funding from the ACS for research in breast cancer.<br />
Participants in Making Strides Walk for American Cancer Society.<br />
Plastic <strong>Surgeon</strong> is Invited Faculty<br />
at “Mini Medical College” Course<br />
Anureet Bajaj, M.D., Assistant Professor of Surgery, Division<br />
of Plastic, Reconstructive and Hand Surgery, was an invited<br />
speaker at the <strong>UC</strong> College of Medicine “Mini Medical College”<br />
on Oc<strong>to</strong>ber 25, 2005. Her <strong>to</strong>pic, “Extreme Makeover Edition,”<br />
provided guidelines and expectations for people considering<br />
plastic surgery, and detailed advanced microsurgical procedures<br />
for breast reconstruction. Dr. Bajaj is the only surgeon in the<br />
region <strong>to</strong> perform these microsurgical procedures.<br />
Dr. Anureet Bajaj speaks at Mini Medical College.<br />
(Pho<strong>to</strong> by Dan Davenport, provided by University of Cincinnati<br />
College of Medicine Development and Alumni Affairs.)<br />
Division of Urology Hosts Symposium<br />
for Prostate Disease Specialists<br />
The <strong>UC</strong> Division of Urology hosted a symposium for the<br />
Prostate Cancer Working Group on Tuesday, December 6,<br />
2005, at the Marriott Kingsgate Conference Center.<br />
Speakers included Drs. William Barrett, radiation oncology;<br />
Bruce Bracken, urology; Ralph Buncher, environmental<br />
health; James Donovan, urology; Shuk-mei Ho, environmental<br />
health; Karen Knudsen, cell biology; Ying Wai Lam,<br />
environmental health; Alex Lentsch, surgical research;<br />
Leslie Oleksowicz, hema<strong>to</strong>logy and oncology; Patricia<br />
Revelo, pathology; and Edward Silberstein, nuclear medicine.<br />
For information on the next meeting of the Prostate Cancer<br />
Working Group, please call 513-558-0983.<br />
Dr. James Donovan addresses the Prostate Cancer Working Group.<br />
Plastic Surgery Chief Visits Paris<br />
<strong>to</strong> Test Improved Facelift Results<br />
John Kitzmiller,<br />
M.D., Chief of the<br />
Division of Plastic,<br />
Reconstructive and<br />
Hand Surgery, was<br />
in Paris in August<br />
with a team from<br />
Ethicon Endo-<br />
Surgery <strong>to</strong> study<br />
applications of the<br />
Harmonic scalpel<br />
<strong>to</strong> reduce recovery<br />
after facelifts.<br />
Dr. John Kitzmiller (far right) with<br />
Australian plastic surgeon Dr. Andrew<br />
Greensmith and assisting nurse in Paris.
In Memoriam:<br />
Dr. Arthur Evans<br />
Arthur Evans, M.D., the former<br />
direc<strong>to</strong>r of urology at <strong>UC</strong> for over<br />
20 years from the 1960's <strong>to</strong> the<br />
early 1980's, passed away on<br />
November 9, 2005.<br />
Dr. Evans received his urology<br />
training at the University of<br />
Cincinnati. He advanced the clinical<br />
and educational programs in<br />
the Division of Urology and<br />
Dr. Arthur Evans trained many urology residents<br />
and fellows who went on <strong>to</strong> successful<br />
careers in academic and private practice, including Dr.<br />
Thomas Bell, a long-time member of the Division who has<br />
served as Chief of the Division as well as Direc<strong>to</strong>r of the<br />
Urology Residency Program.<br />
When Dr. Evans was promoted <strong>to</strong> the emeritus professor level<br />
by then chairman Dr. Josef Fischer, it was remarked that Dr.<br />
Evans was a visionary and ahead of the times, and an early<br />
developer of the concept that the pharmaceutical industry<br />
could assist in the promotion of continuing medical education.<br />
It was also said that “Art” (as he was called by all of his residents)<br />
lived <strong>to</strong> teach.<br />
All three sons of Dr. Evans are <strong>UC</strong> College of Medicine graduates.<br />
His daughter is a graduate of <strong>UC</strong>, and his grandson,<br />
Blake Evans, is a second year medical student at <strong>UC</strong>.<br />
Dr. Arthur Evans (middle row, third from right) as a resident during<br />
the chairmanship of Dr. B. Noland Carter (front row, center). Others<br />
include Dr. Bruce MacMillan (middle row, far left), Dr. John Wulsin<br />
(middle row, second from left), Dr. Robert (Bud) Coith (<strong>to</strong>p row, third<br />
from left), and Dr. William Culbertson (<strong>to</strong>p row, far right). Pho<strong>to</strong> is<br />
on the grounds of old General Hospital in 1950.<br />
Trauma <strong>Surgeon</strong>, <strong>UC</strong> Medical Student<br />
Travel <strong>to</strong> Africa on Healthcare Mission<br />
As part of a group of 14 <strong>UC</strong> faculty and students led by<br />
Dr. Chris<strong>to</strong>pher Lewis of <strong>UC</strong>’s Department of Family<br />
Medicine, Kenneth Davis, Jr., M.D., Professor of<br />
Surgery in the Division of Trauma and Critical Care, and<br />
medical student (and future surgeon) Callisia Clarke<br />
traveled more than 10,000 miles in late Oc<strong>to</strong>ber <strong>to</strong> the<br />
remote village of Shirati in northern Tanzania, Africa, <strong>to</strong><br />
provide much-needed healthcare. Dr. Davis, assisted by<br />
Ms. Clarke, performed several tumor and gallbladder<br />
removals in the regional hospital.<br />
Callisia Clarke and Dr. Ken Davis examine a patient.<br />
Dr. Ken Davis and Callisia Clarke perform surgery in Tanzania.<br />
Society of Black Academic <strong>Surgeon</strong>s<br />
<strong>to</strong> Visit Cincinnati<br />
The 16th Annual Scientific Session of the Society of<br />
Black Academic <strong>Surgeon</strong>s (SBAS) will be held April 6-8,<br />
2006, in Cincinnati, Ohio. Kenneth Davis Jr., M.D., is<br />
2006 SBAS Planning Committee Chair, and Karyn<br />
Butler, M.D., is Co-Chair.
Center for Surgical Innovation (CSI) in the News<br />
Surgery in Space Symposium<br />
Mr. Charles Doarn (Executive Direc<strong>to</strong>r) and Dr. Timothy Broderick<br />
(Medical Direc<strong>to</strong>r) of the CSI served as co-chairs along with Canadian<br />
Astronaut, Dr. Dave Williams, in conducting the inaugural Surgery in<br />
Space Symposium. The symposium, held adjacent <strong>to</strong> the NASA<br />
Johnson Space Center, was funded by Mr. Doarn's 2004 Dean's<br />
Discovery Fund and his $20,000 grant from the US Army's<br />
Telemedicine and Advanced Technology Research Center (TATRC).<br />
Industrial sponsorship was provided by MD Robotics. The day-and-ahalf<br />
symposium brought <strong>to</strong>gether a wide range of individuals, including<br />
astronauts, researchers and explorers who shared their experiences<br />
and challenges of performing surgery in space and during groundbased<br />
research. Future surgical systems, battlefield surgery, and the<br />
extremes of Mt. Everest were presented. CSI personnel at the symposium<br />
included Mr. Doarn, Dr. Broderick, Ms. Elyssa Westrich, Mr.<br />
Brett Harnett and surgery resident, Dr. Thomas Husted.<br />
Participants at the Surgery in Space Symposium<br />
Outreach<br />
CSI worked closely with Dr. Joseph Buell of the Division of<br />
Transplantation <strong>to</strong> develop a unique, information-rich web site on<br />
laparoscopic liver surgery. Entitled Lapliver.com, this site contains<br />
valuable information for patients and physicians alike. Visit the site at<br />
www.lapliver.com.<br />
Courses<br />
The CSI continues <strong>to</strong> work closely with several divisions within<br />
Surgery <strong>to</strong> develop training courses, which are sponsor-specific or<br />
CME. In September, CSI worked with Dr. Buell and Transplantation<br />
<strong>to</strong> hold the second “Advances in Laparoscopic Hepatic Surgery<br />
Course” which was attended by 30 surgeons from around the world.<br />
The CSI also worked with Au<strong>to</strong>Suture (US Surgical) <strong>to</strong> conduct an<br />
industry-sponsored lab, entitled “Laparoscopic Skills & Intracorporeal<br />
Suturing.” Both courses involved didactic and labora<strong>to</strong>ry sessions.<br />
CSI works closely with AtriCure through unrestricted education grants<br />
<strong>to</strong> conduct didactic training entitled “Closed Chest Seminars on the<br />
Minimaze.” Courses are coordinated here at <strong>UC</strong> and at the Cleveland<br />
Clinic. The <strong>UC</strong> courses held each month are attended by more than 20<br />
surgeons each time. These courses include a telesurgery component.<br />
<strong>Grant</strong>s<br />
CSI faculty received several grant awards in the past several months:<br />
* Dr. Broderick's second extension on his intergovernmental personnel<br />
agreement (IPA) with the US Army's TATRC.<br />
* Dr. Wolf began a clinical trial with AtriCure on Res<strong>to</strong>re-SR II,<br />
“Thoracoscopically-Assisted Epicardial Bilateral Pulmonary Vein<br />
Isolation Using the AtriCure Bipolar System and Exclusion of the Left<br />
Atrial Appendage for the Treatment of Atrial Fibrillation.” Dr. Wolf is<br />
the Principal Investiga<strong>to</strong>r (PI) of this multi-center trial.<br />
* <strong>UC</strong> has developed and signed a joint use agreement (JUA) with the<br />
Cleveland Clinic Foundation (CCF) in support of the CCF's WCI /<br />
BRTT award from the State of Ohio <strong>to</strong> develop the Atrial Fibrillation<br />
Innovation Center (AFIC). With final approval from the <strong>UC</strong> Board of<br />
Trustees and the State Controlling Board, this effort began on<br />
December 1, 2005. CSI has a significant role in this effort, including<br />
research focused on minimally invasive surgery. In addition, Dr. Wolf<br />
is on the Board of Direc<strong>to</strong>rs of the AFIC.<br />
* CardioEnergetics received an award notice that its proposal,<br />
“Evaluation of Durable Muscle-Prosthetic Bond for Artificial Tendons<br />
in Animate Models” was approved by NIH. <strong>UC</strong> and CSI will serve as<br />
the research partner. Mr. Doarn will serve as the PI for the <strong>UC</strong> side.<br />
CSI's role is <strong>to</strong> provide animal and surgery support.<br />
Capabilities<br />
CSI has worked closely with the Emergency Department (ED) <strong>to</strong><br />
develop linkages between the ED and the OR. This permits real-time<br />
videoconferencing between the ED and the OR. Cameras installed in<br />
the ED trauma bays provide an opportunity for teaching and collaboration<br />
as patients are transferred <strong>to</strong> surgery. This system provides a<br />
unique opportunity for ED <strong>to</strong> follow up on patients that it transfers for<br />
surgical intervention. This is a tremendous collaborative teaching <strong>to</strong>ol.<br />
CSI <strong>to</strong> Co-Sponsor “Nanoscience” Seminar<br />
The <strong>UC</strong> Department of<br />
Biomedical Engineering,<br />
the Institute for Nanoscale<br />
Science and Technology,<br />
and the CSI will sponsor a<br />
half-day free seminar on<br />
“Nanoscale Science and<br />
Technology in Medicine”<br />
on Friday, January 20,<br />
2006, from 7:30 am -<br />
12:30 pm at the Kingsgate<br />
Conference Center in<br />
Cincinnati. For information,<br />
visit the website at<br />
http://www.eng.uc.edu/<br />
dept_biomed/seminar_<br />
registration/page1.htm<br />
and click on the black but<strong>to</strong>ns<br />
at the <strong>to</strong>p <strong>to</strong> access<br />
speaker information, a<br />
schedule, and registration.
Christ Hospital Opens Pelvic Floor<br />
Center with Division of Colon and<br />
Rectal Surgery<br />
The Christ Hospital Pelvic Floor Center, a new highly specialized<br />
center aimed at treating pelvic floor dysfunction,<br />
brings <strong>to</strong>gether the expertise of urogynecologists and colon<br />
and rectal surgeons (Drs. Janice Rafferty, Bradley Davis,<br />
and David O'Brien) who work <strong>to</strong>gether <strong>to</strong> find the best and<br />
most appropriate treatment for pelvic floor problems. These<br />
specialists have expertise in diagnosis and treatment of disorders<br />
of the bladder, vagina, anus, and rectum.<br />
The Christ Hospital Pelvic Floor Center, the only such<br />
advanced center in a wide area, offers evaluation and treatment<br />
of fecal incontinence, debilitating constipation, pelvic<br />
organ prolapse causing bladder dysfunction, among others.<br />
This is the only center of its kind within a several-state<br />
radius. It offers unique evaluation and treatment capabilities<br />
<strong>to</strong> patients in Cincinnati and the surrounding region, including<br />
ultrasound evaluation of the anus and rectum, pelvic<br />
floor EMG, anal manometry, artificial bowel sphincter for<br />
those who need it, and pelvic floor reconstruction for fecal<br />
incontinence. Electromyography (EMG), the measurement<br />
of muscle activity, can be used <strong>to</strong> moni<strong>to</strong>r the pelvic floor<br />
muscles and provide visual and audible information <strong>to</strong><br />
patients as they learn <strong>to</strong> perform pelvic floor exercises<br />
(known as Kegels).<br />
Many people will experience problems with incontinence,<br />
bowel control, or pelvic pain. More often than not, individuals<br />
with these types of symp<strong>to</strong>ms are <strong>to</strong>o embarrassed <strong>to</strong> talk<br />
<strong>to</strong> their doc<strong>to</strong>r or seek help for many years before receiving<br />
any explanation for, or relief from, their disturbing symp<strong>to</strong>ms.<br />
These symp<strong>to</strong>ms could be directly related <strong>to</strong> what is<br />
called the pelvic floor.<br />
In the United States, millions of women and even men will<br />
experience some type of pelvic floor dysfunction. However,<br />
few women understand what is healthy and normal or immediately<br />
recognize signs and symp<strong>to</strong>ms that should be investigated<br />
further.<br />
For more information on the pelvic floor and symp<strong>to</strong>ms you<br />
may be experiencing, please call 513-585-4800 <strong>to</strong> speak with<br />
a specialist <strong>to</strong>day.<br />
Bradley Davis, M.D., was recently<br />
elected <strong>to</strong> the Hamil<strong>to</strong>n County<br />
American Cancer Society Advisory<br />
Board, and co-chairs the Colorectal<br />
Cancer Task Force Committee. He<br />
also is a member of the Speakers<br />
Bureau for the American Cancer<br />
Society, the Cincinnati Os<strong>to</strong>my<br />
Association (COA) and the Crohn’s<br />
Bradley Davis, MD Colitis Foundation (CCF). Dr. Davis<br />
has given lectures <strong>to</strong> the COA on “New<br />
Treatments for Colorectal Cancer” and <strong>to</strong> the CCF on<br />
“What's New in Inflamma<strong>to</strong>ry Bowel Disease.”<br />
<strong>Surgeon</strong> Sends Greetings from Iraq<br />
Robert Cavagnol, M.D., 2005 graduate of the general surgery<br />
residency training program, is currently serving in Fallujah,<br />
Iraq. Dr. Cavagnol recently received packages full of games,<br />
goodies, cigars, books, and more from the <strong>UC</strong> Department of<br />
Surgery, as well as a banner signed by numerous friends and<br />
colleagues. Dr. Cavagnol will return home in March <strong>to</strong> see his<br />
new family (wife Cindy is due Feb. 5th with their first boy).<br />
Dr. Rob Cavagnol in Fallujah with banner and packages.<br />
<strong>UC</strong> Pancreatic Disease Center <strong>to</strong> Hold<br />
Annual Symposium February 4, 2006<br />
The <strong>UC</strong> Pancreatic Disease Center will host the 5th Annual<br />
Symposium on Pancreatic Diseases February 4, 2006, at the<br />
Kingsgate Marriot Conference Center. Visit the website at<br />
www.ucpancreas.org for registration and more information.<br />
<strong>UC</strong> Surgery Alumni & Faculty Meet at ACS<br />
The Department of Surgery and the Mont Reid Surgical<br />
Society held its first annual joint dinner meeting at the 2005<br />
American College of <strong>Surgeon</strong>s (ACS) in San Francisco.<br />
(Left-right): Dr. Steve Albertson, Susie Fegelman, Dr. Elliott<br />
Fegelman, Dr. Edward Diekhoff, and Lisa Albertson at the ACS.
Dr. J. Wesley Alexander<br />
Dr. Anureet Bajaj<br />
Dr. Kathy Goss<br />
Awards and Achievements<br />
J. Wesley Alexander, M.D., Sc.D., Professor of Surgery in the Division of Transplantation, was<br />
awarded the second annual Distinguished Service Award by the Cincinnati Surgical Society on<br />
December 7, 2005.<br />
Anureet Bajaj, M.D., Assistant Professor of Surgery in the Division of Plastic, Reconstructive and<br />
Hand Surgery, passed the American Board of Plastic Surgery Oral Examination in November 2005.<br />
Kathleen Heppner Goss, Ph.D., Assistant Professor of Surgery in the Epithelial Pathobiology<br />
Research Group, was named as a YWCA of Greater Cincinnati Career Women of Achievement<br />
Rising Star at a luncheon on September 13, 2005.<br />
Wolfgang Stehr, M.D., surgery resident<br />
working in the labora<strong>to</strong>ry of Dr. Brad<br />
Warner, won the 3-minute oral presentation -<br />
Rosenkrantz Resident Research Award from<br />
the Surgical Section of the American<br />
Academy of Pediatrics in Washing<strong>to</strong>n, DC.<br />
His presentation, “STAT1 is an Inhibi<strong>to</strong>r of<br />
Adaptation after Massive Small Bowel<br />
Resection,” was accepted for publication.<br />
Brad W. Warner, M.D., Professor of<br />
Surgery, Division of Pediatric Surgery,<br />
served on the National Institutes of Health<br />
<strong>Study</strong> Section: NIDDK Special Emphasis<br />
Panel ZDK1 GRB-3(03) in August, 2005.<br />
Dr. Shahab Akhter Dr. Joshua Mammen Dr. Michael Nussbaum<br />
Dr. Shahab Akhter (Division of Cardiac Surgery) and Dr.<br />
Michael Nussbaum (Division of Gastrointestinal and Endocrine<br />
Surgery) were faculty inductees, and Dr. Joshua Mammen was<br />
resident inductee <strong>to</strong> Alpha Omega Alpha (AOA), the honorary<br />
medical society, at the AOA Annual Banquet on Friday, November<br />
18, 2005.<br />
Randall Wolf, M.D., and John B. Flege, Jr., M.D., Division of<br />
Cardiac Surgery, launched the new journal, INNOVATIONS:<br />
Technologies and Techniques in Cardiothoraic and Vascular<br />
Surgery (see right) on November 1, 2005. Dr. Wolf is co-edi<strong>to</strong>r and<br />
Dr. Flege is associate edi<strong>to</strong>r. The journal is the official publication<br />
of the International Society for Minimally Invasive Cardiothoracic<br />
Surgery (ISMIC), of which Dr. Wolf is President.<br />
(l-r) Wolfgang Stehr, MD, Nicole Bernal, MD, Kathryn<br />
Bernabe, MD, and Brad Warner, MD. The three are residents<br />
in Dr. Warner’s lab and had presentations at the American<br />
Academy of Pediatrics Surgical Section in Washing<strong>to</strong>n DC.
Recent Presentations<br />
Bernabe KQ, Bernal NP, Stehr W, Erwin CR, Warner BW: “Resection-induced intestinal adaptation and the role for enteric smooth muscle:<br />
cause or effect?” American Academy of Pediatrics - Surgical Section, Oc<strong>to</strong>ber 8-11, 2005, Washing<strong>to</strong>n, DC.<br />
Bernal NP, Stehr W, Zhang Y, Profitt S, Erwin CR, Warner BW: “Combined pharmacotherapy that increases proliferation and decreases apop<strong>to</strong>sis<br />
optimally enhances intestinal adaptation.” American Academy of Pediatrics - Surgical Section, Oc<strong>to</strong>ber 8-11, 2005, Washing<strong>to</strong>n, DC.<br />
Billmire DA: “Cleft nasal repair: Timing and techniques.” 2005 Tri-State Craniofacial Conference, Indianapolis, IN, Oc<strong>to</strong>ber 7, 2005.<br />
Doarn CR: “Surgical innovation - robotics.” Topics in Cardiovascular Care: New Concepts and New Technologies. Hillcrest Hospital,<br />
Cleveland, OH, Oc<strong>to</strong>ber 2005.<br />
Doarn CR: “Integration of technology for medical care.” US Air Force. Theater Trauma Medical Requirements: Translating Expeditionary<br />
Medical Needs for Development and Incorporation of New Technology. Cincinnati, OH, Oc<strong>to</strong>ber 2005.<br />
Doarn CR: “Telemedicine and remote surgery.” 2nd Dialogue on National Research and Education Networks in Latin America - “Health<br />
Through the National Research and Education Networks” - Internet 2 broadcast. VTC from Cincinnati <strong>to</strong> Argentina, Oc<strong>to</strong>ber 2005.<br />
Doarn CR: “Surgical innovation.” Dual Admissions Program Workshop. University of Cincinnati, Oc<strong>to</strong>ber 2005.<br />
Doarn CR: “Telemedicine and remote surgery.” Dia Virtual CUDI de Institu<strong>to</strong>s Nacionales de Salud - Internet 2 Broadcast. VTC from Cincinnati<br />
<strong>to</strong> Mexico, September 2005.<br />
Harnett BM: “Advanced network opportunities for surgical tele-robotics.” Imaging the Possibilities Conference, Bradley University, Peoria, IL,<br />
Oc<strong>to</strong>ber 2005.<br />
Harnett BM: “Advanced network opportunities for surgical tele-robotics.” Fall 2005 Internet 2 Member Meeting, Philadelphia, PA.<br />
Huber N, Ben-David K, Johannigman JA: “Abdominal compartment syndrome after damage control laparo<strong>to</strong>my with bowel left in closed loop<br />
discontinuity.” ACS Committee on Trauma Section V Resident Competition, Detroit Trauma Symposium, November 11, 2005.<br />
Huffman L: “Early results from lung cancer screening using spiral CT of high-risk individuals.” Chest 2005 meeting, Montreal.<br />
Parvadia J, Vaikunth S, Marwan A, Harkness U, Maldonado A, Alaee D, Kalinowska B, Stehr W, Uzvolgyi E, Erwin C, Warner B,<br />
Crombleholme T: “Role of vascular endothelial growth fac<strong>to</strong>r (VEGF) in small bowel adaptation after resection: EGF is VEGF dependent for<br />
the adaptive response.” American Academy of Pediatrics - Surgical Section, Washing<strong>to</strong>n, DC, Oc<strong>to</strong>ber 8-11, 2005.<br />
Pritts TA: “Endpoints of shock resuscitation.” Surgical Grand Rounds, Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio,<br />
November, 2005.<br />
Reed AB: “Management of abdominal aortic aneurysms.” Medicine Grand Rounds, University of Cincinnati, September 8, 2005.<br />
Reed AB: “Vascular surgery in 21st Century.” Invited Speaker, Halsted Society, Cincinnati, OH, September 9, 2005.<br />
Reed AB: “Timing of repair of blunt traumatic thoracic aortic transections.” Midwest Vascular Surgery Society Meeting, September 15, 2005.<br />
Reed MF: “Inhibition of retinoblas<strong>to</strong>ma tumor suppressor activity by RNA interference in lung cancer lines deregulates growth.” Southern<br />
Thoracic Surgical Association 52nd Annual Meeting, Orlando, FL.<br />
Stehr W, Bernal NP, Bernabe KQ, Erwin CR, Warner BW: “STAT1 is an inhibi<strong>to</strong>r of adaptation after massive small bowel resection.” American<br />
Academy of Pediatrics - Surgical Section, Washing<strong>to</strong>n, DC, Oc<strong>to</strong>ber 8-11, 2005.<br />
Warner BW: “Surgical options for management of ulcerative colitis;” “Necrotizing enterocolitis;” “Surgical options for management of gastroesophageal<br />
reflux;” “Surgical options for management of short bowel syndrome;” and “Resection-induced intestinal adaptation.” Aspen<br />
Conference on Pediatric Gastrointestinal Disease - Pediatric Gastrointestinal Disease and Intestinal Transplantation, July 17-22, 2005.<br />
Warner BW: “Update on Children's Hospital.” Halsted Society, September 9, 2005, Cincinnati, OH.<br />
Wolf RK: “Emerging technologies/robotics” and “Future of surgical training and the field of surgery.” American College of <strong>Surgeon</strong>s, San<br />
Francisco, CA, Oc<strong>to</strong>ber 17, 2005.<br />
Wolf RK: “Surgical treatment of atrial fibrillation.” American <strong>Heart</strong> Association, November 13, 2005.<br />
Wolf RK: “AF ablation, future of surgery-The Center of Surgical Innovation at <strong>UC</strong>-biosurgery in space;” “New surgical technique for the cure<br />
of AF;” “How <strong>to</strong> train young cardiothoracic surgeon in Asia;” and “Evolution of a minimally invasive cardiothoracic practice.” Annual Meeting<br />
of the JATS, Oc<strong>to</strong>ber 2005.<br />
Wolf RK: “Is pulmonary vein isolation alone appropriate therapy for patients with paroxymal AF?” and “What is new in off pump minimally<br />
invasive coronary artery surgery?” 4th EACTS/ESTS Joint Meeting, September 30-Oc<strong>to</strong>ber 2005.
Ahmad SA, Lowy AM, Wray CJ, D’Alessio D, Choe KA, James<br />
LE, Gelrud A, Matthews JB, Rilo HLR. Fac<strong>to</strong>rs associated with<br />
insulin and narcotic independence after islet au<strong>to</strong>transplantation<br />
in patients with severe chronic pancreatitis. J Am Coll Surg<br />
201:680–687, 2005.<br />
Bernal NP, Stehr W, Zhang Y, Profitt S, Erwin CR, Warner BW.<br />
Evidence for active Wnt signaling during postresection intestinal<br />
adaptation. J Pediatr Surg 40:1025-1029, 2005.<br />
Guo J, Sheng G, Warner BW. Epidermal growth fac<strong>to</strong>r-induced<br />
rapid retinoblas<strong>to</strong>ma phosphorylation at Ser780 and Ser795 is<br />
mediated by ERK1/2 in small intestine epithelial cells. J Biol<br />
Chem 280:35992-35998, 2005.<br />
Ignacio RC, Falcone RA Jr, Warner BW. Necrotizing fasciitis:<br />
a rare complication of neonatal necrotizing enterocolitis. J<br />
Pediatr Surg 40:1805-1807, 2005.<br />
Kim ES, Warner BW. Unexpected finding during inguinal hernia<br />
repair in a girl. Surgery 138:954-955, 2005.<br />
Merrell RC, Doarn CR. Disasters - how can telemedicine help?<br />
[Edi<strong>to</strong>rial] Telemed and E Health 11(5):511-512, 2005.<br />
Piasecki J, Lied A, Billmire D, Ludwig M, Bentz M. Congenital<br />
melanocytic nevus and the internet: an evaluation of available<br />
web-based resources. J Craniofacial Surgery 16:894-895, 2005.<br />
Prasad V, Boivin GP, Miller ML, Liu LH, Erwin CR, Warner<br />
BW, Shull GE. Haploinsufficiency of Atp2a2, encoding the<br />
sarco(endo)plasmic reticulum Ca2+-ATPase isoform 2 Ca2+<br />
<strong>UC</strong> Cancer Center’s first appendiceal cancer research benefit<br />
-- “A Night of Silence and Singing” -- generated more<br />
than $7,500 for local cancer research. Proceeds from the<br />
event go directly <strong>to</strong> the research efforts of Andrew Lowy,<br />
Recent Publications<br />
pump, predisposes mice <strong>to</strong> squamous cell tumors via a novel<br />
mode of cancer susceptibility. Cancer Res 65:8655-8661, 2005.<br />
Pritts SD, Fischer DR, Pritts TA. Managing morbid obesity:<br />
new options improve outcomes. J Fam Pract 54s:1-4, 2005.<br />
Pritts TA, Knight D, Davis BR, Porembka D, Cuschieri J.<br />
Accidental self-inflicted nail gun injury <strong>to</strong> the heart. Injury<br />
Extra 36:517-519, 2005.<br />
Pritts TA. Surgical simulation: time <strong>to</strong> practice how we play.<br />
RAS-ACS News, Summer 2005.<br />
Reed AB. Timing of repair of blunt traumatic thoracic aortic<br />
transections. J Vasc Surg, in press.<br />
Robb BW, Reed MF. Congenital diaphragmatic hernia presenting<br />
as splenic rupture in an adult. Ann Thorac Surg, in press.<br />
Speich JE, Cagle YD, Rafiq A, Merrell RC, Doarn CR,<br />
Broderick TJ. Evaluation of surgical skills in microgravity using<br />
force sensing. Medical Engineering & Physics 27:687-693,<br />
2005.<br />
Stehr W, Mercer TI, Bernal NP, Erwin CR, Warner BW.<br />
Opposing roles for p21(waf1/cip1) and p27(kip1) in enterocyte<br />
differentiation, proliferation, and migration. Surgery 138:187-<br />
194, 2005.<br />
Warner BW, Warner BB. Role of epidermal growth fac<strong>to</strong>r in the<br />
pathogenesis of neonatal necrotizing enterocolitis. Semin<br />
Pediatr Surg 14:175-180, 2005.<br />
“A Night of Silence and Singing” Raises Money for Cancer Research<br />
Cancer survivor Traci Wansack (center) and restaurant owners<br />
Vi<strong>to</strong> and Mary Ciepiel.<br />
M.D., direc<strong>to</strong>r of the Division of Surgical Oncology, and<br />
his team. More than 70 attendees were on hand for dinner<br />
and a silent auction at the event, held Saturday, Oct. 22,<br />
2005, at Vi<strong>to</strong>'s Café in Ft. Thomas, Kentucky.<br />
Dr. Andrew Lowy and wife Dr. Haydee Ojeda-Fournier with<br />
other participants at the benefit.
Surgical Grand Rounds Schedule<br />
January 11, 2006 Amod Sarnaik, M.D. (Chief Resident): “Controversies in Gastric Cancer”<br />
January 18, 2006 Altemeier Visiting Professor, Andrew L. Warshaw, M.D. (W. Gerald Austen Professor of<br />
Surgery, Harvard Medical School, and Chairman, Department of Surgery, Massachusetts<br />
General Hospital): “Surgical Management of Pancreatic Cancer”<br />
January 25, 2006 Shahab Akhter, M.D. (Cardiac Surgery): “On-Pump Versus Off-Pump Coronary Artery<br />
Bypass Surgery: Is There An Advantage <strong>to</strong> Avoiding Cardiopulmonary Bypass?”<br />
February 1, 2006 Colorectal Surgery<br />
February 8, 2006 Transplant Surgery<br />
February 15, 2006 Guest Speaker (Urology), Kevin T. McVary, M.D., Associate Professor of Surgery,<br />
Department of Urology, Northwestern University<br />
February 22, 2006 Kfir Ben-David, M.D. (Chief Resident)<br />
March 1, 2006 McDonough Visiting Professor, Ajit K. Sachdeva, M.D. (Direc<strong>to</strong>r, Division of Education,<br />
American College of <strong>Surgeon</strong>s)<br />
March 8, 2006 Russell Juno, M.D. (Chief Resident)<br />
March 15, 2006 Karyn Butler, M.D. (Trauma & Critical Care)<br />
March 22, 2006 Plastic Surgery<br />
March 29, 2006 Fischer Visiting Professor, Julie A. Freischlag, M.D. (William Stewart Halsted Professor<br />
and Chairman, Department of Surgery, Johns Hopkins University School of Medicine)<br />
The University <strong>Surgeon</strong> is published quarterly by <strong>UC</strong> <strong>Surgeon</strong>s, Inc.<br />
Written by Steve Wiesner, 558-4207, steve.wiesner@uc.edu<br />
Edited by Elizabeth Pierce, 558-1321, elizabeth.pierce@uc.edu<br />
Winter 2005-2006