U UA Surgeons Perform Rare and Complex Organ Transplants Inside…

Winter 2007- 08
Volume 7, Issue 1
at the Arizona Health Sciences Center
2 Chairman’s
Message
UA Surgeons Perform Rare and
Complex Organ Transplants
3 New Treatments
for AAAs Study
U
Inside…
4 Less Invasive
Lung Surgery
5 Research on
Cancer Diagnosis
Delays
5 New Lung Surgery
Training Center
5 Vascular Suturing
Skills Workshop
6 Simulation
Curriculum in
Resident Training
7 Department
Welcomes Six
New Faculty
nder the leadership of a new chairman,
The University of Arizona Department of
Surgery is reaching new milestones and surgeons
are performing rare and complex procedures at
University Medical Center. A prime example is
the Transplant Program, which is offering new
hope to people suffering from organ failure.
First Combined Heart-Kidney Transplant
On Dec. 8, surgeons performed the first
simultaneous heart and kidney transplant
in Southern Arizona. After an earlier failed
heart transplant and resulting kidney failure,
41-year-old husband and father Ron Webb now
is recovering from the back-to-back dual-organ
transplant.
The cardiothoracic transplant team, led by
Raj K. Bose, MD, assistant professor of clinical
surgery, Section of Cardiovascular and Thoracic
Surgery, performed the heart transplant first.
8 Alumni Spotlight
– Rina Shinn, MD
9 ACS Reception
Hosted
10 Faculty Awards
& Publications
The Department of
Surgery at The University
of Arizona College of
Medicine is renowned for
its research, patient care
and academic achievement.
The department features
specialized sections
in cardiovascular and
thoracic surgery, surgical
research, general surgery
and trauma, surgical
oncology, neurosurgery,
plastic surgery, ENT,
transplantation, urology
and vascular surgery.
Dr. Rainer Gruessner, Department of Surgery chairman and chief
of Abdominal Transplantation, and Dr. Jack Copeland, chief of
Cardiovascular and Thoracic Surgery, check on Ron Webb, UMC’s
first patient to receive a simultaneous heart and kidney transplant.
A second surgical team, led by Rainer Gruessner,
MD, professor and chairman of the Department
of Surgery, performed the kidney transplant.
Webb’s heart damage was caused by a
virus when he was 28. After his previous heart
transplant failed, he developed kidney failure
because of the side effects of his immunosuppressive medications.
This life-saving operation was made even
more difficult because of the rejection suffered
from his first heart transplant, Dr. Bose says.
Rare En Bloc
Kidney
Transplant
William Diehl,
56, was given a
toddler’s kidneys
on Dec. 10 when the
surgical team carried
En bloc kidney transplantation
out a complex procedure
allows two pediatric kidneys
by transplanting the
to do the work of a single
adult organ.
child’s two kidneys
Illustration: Dave Cantrell,
connected only by the
AHSC Biomedical Communications
major blood vessels.
Diehl had been on dialysis for a year and a half
– ever since his kidneys failed due to polycystic
disease. Now, he no longer needs the tiring threetimes-a-week dialysis that dominated his life.
En bloc kidney transplantation, in which both
kidneys from a baby are transplanted into an adult
patient to do the work of a single adult kidney,
addresses organ shortage issues by
using organs that might not have
been used in the past, says Dr.
Gruessner. However, en bloc kidney
transplants are rare, according to the
United Network for Organ Sharing
(UNOS).
“The en block technique is more
challenging and there is a higher risk
of graft thrombosis due to build up
of blood clots. But, if we waited for
an adult kidney, it could have taken
many months,” Dr. Gruessner says.
More than 74,000 people in the
United States currently are on the
transplant list for a kidney. Each year,
about 6 percent of all patients on the waiting list die
before an organ becomes available.
Complex Positive Crossmatch Transplant
Wilma Burton’s son was more than willing to
donate one of his kidneys to his mother. However,
his mother was “sensitized,” meaning she had
developed harmful antibodies in her blood against
foreign tissue. A person can develop antibodies
through previous exposure to blood transfusions,
previous transplants, and from pregnancies. The
elevated levels of the antibodies make tissue
rejection almost certain.
CONTINUED ON PAGE 2
1
Chairman’s Message
Transplants
It truly has been an honor to serve as
the new Chairman of the Department of
Surgery at The University of Arizona
these past six months and I am proud of
the accomplishments of the department
showcased in this newsletter.
I accepted the position as chairman
because of the potential to build a preeminent surgical program in the Southwest.
My goal is to build on positive changes
instituted by my predecessors Drs. Hugo
Villar and Allan Hamilton. I am extremely
committed to establishing an outstanding academic department with continued
achievements in patient care, surgical
education and translational research.
I have been charged with substantially
expanding the size of the department
through recruitment of faculty across a
range of specialties. The generous support
of the College of Medicine, University
Medical Center and University Physicians Healthcare will allow us to build new
programs and expand existing ones.
We welcome six new faculty members
in this newsletter. I am delighted The
University of Arizona has been able to
recruit such outstanding physician leaders
to join our surgical team. We plan to hire a
total of 15-20 new faculty members across
all surgical specialties. The first phase of
recruitment will focus on general surgery,
trauma, transplantation and urology.
Beginning in 2009, we will start to rebuild
the Sections of Neurosurgery, ENT and
Plastic Surgery. Our recruitment efforts
will bring noted leaders in their fields who
will add to the existing nationally known
leaders already in the department.
Also, our residency programs now will
focus not only on solid clinical training,
but also on academic education through
basic or clinical research. We are working
in conjunction with Graduate Medical
Education to establish a MS/PhD program
starting at the end of this year. We will
send about 30
percent of our
residents after
the third year
into the labs,
focusing on the following research areas:
cardiovascular, oncology, trauma and
transplantation.
We also plan to increase the number
of residents in each of the residency
programs and build more fellowship
programs.
We also have created a Distinguished
Alumnus Award that will be presented
to a former resident who has emerged
as a leader in the field of surgery. The
award will be presented annually at the
surgery residency graduation.
Dr. Richard Carmona, the 17th U.S.
surgeon general, has been named professor of surgery. As many of you know,
Dr. Carmona has been affiliated with the
department since the 1980s. He kindly
has agreed to help create a board of
directors to assist with the department’s
development and strategic efforts.
The establishment of endowments
will be a priority and we will look to
alumni and friends of the department to
create endowed chairs across all surgical
specialties.
All these changes will help ensure
that the UA Department of Surgery will
provide the most innovative and comprehensive surgical care to all citizens
of Arizona and train the future leaders
in surgery.
Sincerely,
RAINER W. GRUESSNER, MD
Professor and Chairman,
UA Department of Surgery
Surgery is published semi-annually by the Arizona Health Sciences Center Office of Public Affairs,
P.O. Box 245066, Tucson, AZ 85724-5066 | (520) 626-7219 | Visit us online: www.surgery.arizona.edu
Editor: Jo Marie Gellerman | Production: Biomedical Communications
All contents © 2008 Arizona Board of Regents. All rights reserved. The UA is an EEO/AA - M/W/D/V Employer.
If you need this information in an accessible format (Braille, digital, tape or large print) please contact Jo Gellerman,
2(520) 626-7219.
CONT. FROM PAGE 1
Until recently, to be considered as a
live donor, blood and tissue type had to
be compatible with the recipient. UMC
surgeons now offer a procedure called
positive crossmatch transplant that allows
patients to receive a kidney from an
incompatible live donor.
Dr. Gruessner and his transplant team
were able to remove harmful antibodies
from Burton with a process called
plasmapheresis, a procedure similar to
dialysis that removes the plasma portion of
the blood where antibodies are located.
Once the antibodies against the blood
type of the live donor – Burton’s son –
decreased to very low levels, the kidney
transplant was able to take place and
Burton received her son’s special gift.
Arizona’s Only Comprehensive Program
UMC’s Transplant Program is the only
comprehensive solid-organ transplant
program in Arizona, offering heart, lung,
kidney, pancreas and liver transplantation
for children and adults.
On Feb. 5, the cardiothoracic (heart and
lung) transplant team performed its 1,000th
transplant with a new heart for 51-year-old
Michael Boudreaux.
The number of kidney transplants at
UMC is at an all-time high, with Wilma
Burton’s son becoming the 100th live
donor who underwent a laparoscopic
nephrectomy, a procedure that is becoming
the standard of care.
Pancreas transplantation also is growing
in strength with the number of transplants
quadrupling in 2007, compared to the
previous year.
Further, liver transplantation is being
revitalized by Dr. Gruessner and the
hiring of nationally known transplant
surgeon John Renz, MD, PhD. Referrals
for liver transplants from physicians in the
community continue to rise.
Exciting new programs in islet cell
and bowel transplantation are under
development.
“The Transplant Program is undergoing
dramatic changes, including a number of
new members of the transplant team,” says
Dr. Gruessner.
How to Refer Patients
For liver, kidney or pancreas transplant
consultations, please call (520) 694-6170.
For heart failure and heart transplantation
consultations, please call (520) 694-6299. O
Study Addresses New Treatments for
Abdominal Aortic Aneurysm
D
oes size matter? That is the question
UA Department of Surgery vascular
researchers aim to answer in the multicenter clinical trial, “Positive Impact
of Endovascular Options for Treating
Aneurysms Early.”
Over the past decade, revolutionary
changes have been made in the diagnosis
and treatment of abdominal aortic
aneurysms (AAAs). Minimally invasive
endovascular technologies, such as stent
grafts, have decreased length of stay and,
more importantly, improved outcomes
compared with conventional open
surgery.
Current guidelines recommend
treatment for aortic aneurysms when they
reach 5.5 cm in diameter, but were based
on clinical trials with open surgical repair
before the use of stents. New studies,
including the AAA Study in the Section
of Vascular Surgery, are under way that
are relevant to today’s management of
aneurysms with endovascular techniques.
AAA Study researchers are assessing
the safety and effectiveness of “watchful
waiting” compared to an endovascular
stent graft repair. The clinical trial
looks at patients with abdominal aortic
aneurysms 4-5 cm in diameter. Joseph
Mills, MD, professor and chief of the
Section of Vascular Surgery, is leading
the multi-center study at the UA. Also
participating in the UA study are vascular
surgeons John Hughes, MD, Kay
Goshima, MD, and Daniel Ihnat, MD.
An AAA forms when a bubble-like
swelling occurs in a portion of the aorta,
the major artery that carries blood from
the heart through the abdomen to the
lower body. As this “bubble” swells over
time, the artery wall can thin out and
rupture.
Ruptures can happen suddenly and
typically prove fatal. In fact, 50-75 percent
of people who suffer a ruptured AAA die
before making it to the hospital, and only
half of those who make it to the hospital
for emergency care survive the event.
“That’s why detecting these aneurysms
early and monitoring or repairing them is
crucial,” Dr. Mills says.
The traditional treatment option was
an open surgical repair, which requires
a surgeon to open the abdominal
cavity, clamp off the aorta and sew a
surgical graft in place to prevent an
aneurysm from rupturing. The newer
treatment option is minimally invasive
endovascular stent grafting. A woven
polyester tube (graft) covered by a metal
web (stent) is placed inside the diseased
vessel through a long catheter, without
surgically opening the body.
Open surgical repairs carry high
health risks for many older patients who
also may suffer from other significant
medical conditions, such as heart disease,
lung disease, diabetes or hypertension,
so doctors were hesitant to perform the
operation and followed the wait-and-see
approach on smaller aneurysms, says
Dr. Mills.
The AAA Study focuses on two groups:
one group receives an FDA-approved
stent graft and the other is placed into
a surveillance program, which includes
medical examinations, blood tests, CT
scans, magnetic resonance imaging
(MRI), or abdominal aorta ultrasound.
Participants will be followed by the
study doctor for a total of five years from
enrollment. This study is sponsored
by Medtronic Vascular, a subsidiary of
Medtronic, Inc., and the Cleveland Clinic
Foundation.
Aortic aneurysms – including thoracic
and abdominal aortic aneurysms – account
for nearly 15,000 deaths annually in this
country.
The AAA Study will be conducted at as
many as 70 U.S. hospitals and will include
as many as 1,000 patients nationwide.
For more information, contact:
Brenda Harrington, RN, (520) 626-4845,
[email protected]. O
More Vascular Clinical Research Studies
CREST – Carotid Revascularization
Endarterectomy vs. Stenting Trial
CREST is a randomized study
comparing the two available FDAapproved treatments for blockages in
the carotid arteries in the neck – carotid
endarterectomy versus carotid artery
stenting.
The carotid artery stenting only is
approved for patients who are considered
to be at high risk for complications from
carotid endarterectomy. Patients who are
enrolled in this study (and randomized
to the stenting group) can have the stent
even if they are not considered high risk.
PYTHAGORAS – Prospective Aneurysm
Trial: High Angle Aorfix™ Bifurcated
Stent Graft
This is a non-randomized study of the
new stent graft Aorfix™. Patients with
abdominal aortic aneurysms greater than
4.5 cm who qualify for an endovascular
repair may have one using the new stent
graft. It is
designed to be
more flexible
than currently
available stent
graphs.
SwirlGraft - A Post Market Clinical Study
to Compare the Performance of ePTFE
SwirlGraft™ with a Conventional ePTFE
Graft for Vascular Access Indications
This is a randomization study evaluating
the use of a newer type of vascular access
graft (SwirlGraft™) as compared with a
standard type of vascular access graft. The
product already is approved by the FDA,
but it has requested additional data on its
performance.
To find out more about these
studies, contact Brenda Harrington, RN,
(520) 626-4845, [email protected]. O
3
Vascular Disease Facts
Vascular Screening Can Prevent Deaths
from ‘Silent’ Disease
I
t is a silent killer. Thousands of people die each year from an aortic aneurysm, but
if caught early, it is highly treatable.
Non-cardiac vascular disease, including stroke from carotid artery disease,
peripheral arterial disease (PAD), and aortic aneurysms, causes as much death and
disability as heart disease and more than any cancer. It is called a “silent” disease
because it often is not symptomatic until a catastrophic event occurs, such as stroke
or aneurysm rupture.
Vascular surgeons at the UA Department of Surgery are nationally recognized
experts in the treatment of AAAs. They recommend high-risk individuals be screened
with simple tests.
“We now have available ultrasound and other screening technology designed to
find vascular disease before it becomes a major problem,” says Joseph Mills, MD,
professor and chief of vascular surgery. “Sudden death or major disability can occur
if certain vascular conditions are not identified and properly treated. The good news
is that most of these conditions can be discovered by using simple, painless, noninvasive tests that take just minutes to complete.”
Tests included a carotid artery ultrasound scan to look for blockages in the arteries
to the brain, an abdominal ultrasound to detect aortic aneurysms, and non-invasive
pressure tests to detect peripheral artery disease. The department held its annual free
screening event in September in the fourth-floor Vascular Clinic at UMC.
“Many people may have an aneurysm or peripheral vascular disease and not
know it until it is too late. These simple tests can save your life,” says Dr. Mills. O
Less Invasive Lung
Surgery Performed
at UMC
for early-stage lung cancer patients.
However, few surgeons in the nation are
trained to offer this operation.
“Few surgeons currently offer the
procedure because it’s difficult and
tudies have shown minimally invasive requires additional training with a steep
learning curve,” says Shari Meyerson,
lung surgery to be so successful
MD, assistant professor of surgery in the
that many surgeons are pushing for the
Section of Cardiovascular and Thoracic
procedure to be the standard of care
Surgery, who performs the
procedure at University Medical
Center. Dr. Meyerson is a noncardiac thoracic surgeon who
cares for patients with diseases
involving the lungs, airways,
esophagus and other structures
in the chest.
Traditional lung cancer
surgery is called a thoracotomy,
in which the surgeon cuts
through the muscles into the
chest and spreads open the ribs
to access the lungs. The incision
is large, and recovery is slow
and painful.
Minimally invasive
Dr. Shari Meyerson (right) trains a surgery resident to perform a
lung surgery, known as a
thoracoscopic lobectomy, a minimally invasive procedure to remove
S
lung cancer without opening the chest.
4
Certain conditions are associated with a
higher risk of vascular disease, including:
• Age – people older than 55 years of age
are at greater risk
• Hypertension
• High blood lipids (LDL or bad cholesterol)
• Smoking
• Diabetes
• Lack of exercise
• Family history of vascular disease
• Previous heart or leg problems
Carotid artery disease leads to stroke, which
remains the third-leading cause of death in
the United States with nearly 157,000 people
dying annually. A large proportion of strokes
are caused by plaque in the carotid arteries.
One in every 20 Americans over the age
of 50 has PAD. It affects 8 to 12 million
people in the U.S. Individuals with PAD
suffer a five-fold increased relative risk of a
cardiovascular ischemic event (heart attack
or stroke) and a total mortality rate that is
two to three fold greater than those without
PAD.
It is estimated that more than 1 million
people are living with undiagnosed AAA and
at least 95 percent of these individuals can
successfully be treated if the condition is
detected prior to rupture.
thoracoscopic lobectomy, is done
through two small incisions, one less
than one centimeter and the other two
to four centimeters and requires no rib
spreading. This reduces both the amount
of postoperative pain and the length of
hospital stay required. It is proven to
be as effective as traditional surgery in
removing cancer.
It is estimated that only about 10
percent of all lung cancer operations
nationwide are done with minimally
invasive techniques, but more than
half the patients who need the surgery
would qualify for the less invasive
procedure. Dr. Meyerson is establishing
a training program at the UA on
minimally invasive lung surgery so that
more surgeons can offer this life-saving
technique.
Dr. Meyerson also uses minimally
invasive procedures to ease the
discomfort and improve the quality of
life of patients who have been diagnosed
with advanced lung cancer that cannot
be removed by surgery. O
Research Examines Delays in
Cancer Diagnosis and Treatment
UA to be Training Center
for Lung Surgery
L
T
ess than 20 percent of lung cancer patients are diagnosed in
the early stages of disease. The later lung cancer is diagnosed,
the fewer the treatment options. Delays in diagnosing lung cancer
patients result in an overall survival rate of only 15 percent at five
years after diagnosis.
Research being conducted by Assistant Professor Shari Meyerson,
MD, Section of Cardiovascular and Thoracic Surgery, is looking at
whether barriers in the health-care system are creating delays in
diagnosis. Her study, “Navigating the System: A Pilot Study of the
Process of Obtaining a Diagnosis of Lung Cancer,” is investigating the
steps involved in obtaining a diagnosis of lung cancer.
She says data collected so far in her pilot study suggests a
significantly longer time to diagnosis from initial symptoms than
expected in both symptomatic and asymptomatic patients.
“This is a concern because the disease could progress significantly
in the time between the onset of symptoms and definitive treatment,”
Dr. Meyerson says.
“If a correlation between progression of disease stage and delay in
diagnosis can be confirmed in a larger study, interventions, including
public education about early treatment options, such as minimally
invasive approaches and the better prognosis of early-stage lung
cancers, could make a difference in patient outcomes.” O
Students Learn
Suturing Skills for
Tiny Vascular
Vessels
T
here’s the purse string, the
parachute, and the baseball
– these are some of the suturing
techniques UA surgery residents and
medical students are practicing on
small simulated blood vessels in a
workshop offered by the Section of
Vascular Surgery.
Considerable training is necessary
to master vascular suturing and
knot tying. Blood vessels are far less
forgiving than other tissues commonly
handled in general surgical practice.
The vessel wall is made up of three
he UA Department of Surgery is dedicated to
educating physicians and residents on new
technologies that will advance patient care. As a
result of the expertise of thoracic surgeon Shari
Meyerson, MD, and support from Covidien, the UA
Department of Surgery will be a national training site
for minimally invasive lung surgery. The UA will be
one of only a handful of academic medical centers in
the U.S. actively training surgeons to perform
the procedure.
Every two to four months, surgeons will come
to the department for the intensive one-day course.
The participants, specialists in cardiovascular and
thoracic surgery, will observe a live surgery as well as
practice in the cadaver lab
“The addition of this minimally invasive treatment
for lung cancer has been a tremendous step forward
for the treatment of the disease,” says Dr. Meyerson.
“We’re very excited about our ability to deliver the
most advanced surgical treatment for lung cancer
available anywhere in the world and to be part of the
select team to teach the technology of tomorrow.” O
layers, all of which
are delicate and easy
to traumatize. This is
even more the case
when the vessel is
diseased.
Historically, these
specialized skills have
been developed in
the operating room,
Dr. Luis León (far right) teaches surgery residents how to suture delicate blood
explains Luis R. León vessels in the Vascular Surgery Workshop.
Jr., MD, RVT, assistant
use of stents and other minimally
professor of clinical surgery and chief
invasive procedures for vascular
of vascular surgery at the Southern
conditions are providing little
Arizona Veterans Affairs Health Care
opportunity to perfect these skills
System. However, resident work-hour
when the need arises for open
limitations, increasing costs of operating
surgery.
room time and patient safety concerns
The Vascular Surgery Workshop
have led to an increased interest in
focuses on vascular suturing and
teaching these skills in a simulated
CONTINUED ON PAGE 6
environment. In addition, the growing
5
Suturing Skills
CONT. FROM PAGE 5
knot-tying techniques, types of
suture materials available and
needle choices conducive to
repairing vulnerable vessels, says
Kay R. Goshima, MD, assistant
professor of clinical surgery. The
instruction incorporates lectures and
hands-on practice using training
boxes, suture and prosthetic graft
material donated by several medical
companies. Prosthetic grafts are
mounted on a frame and cut in
different shapes, simulating as
close as possible real-life, human
body conditions. Then the residents
and students perform a vascular
anastomosis, reconnecting the
vessels, with end-to-end, end-toside anastomosis and interposition
vein grafts. After the four-hour
activity, which is held biannually
on Saturdays, the participants and
faculty discuss any remaining issues
and propose suggestions to further
improve the workshop.
Drs. Goshima and León organized
the workshop, first for residents
only, but after a couple of sessions
decided that
students in
the Surgery
Club could
benefit from
the training
as well.
Vascular
surgery
faculty
Joseph Mills, MD, and Daniel
Ihnat, MD, also serve as instructors.
For students, the workshop offers
early exposure to a different surgical
subspecialty that can help them
decide which career direction to
take in the future, says Dr. Goshima.
Residents learn these vascular
surgery techniques so when they
show up for their scheduled rotation
in our service, they are better
prepared, Dr. León adds. O
6
As part of his residency
training, surgery resident
Wynter Phoenix, MD,
practices laparoscopic skills
in the Arizona Simulation
Technology and Education
Center (ASTEC).
Hands-On, No-Risk Resident Training
T
he UA Department of Surgery is expanding in the area of minimally invasive
surgery. Residency programs in the department are moving to standardize the
curriculum for laparoscopic surgery in the simulation lab, which is a growing trend
nationally in medical training.
Surgical residents now are required to spend time in the Arizona Simulation
Technology and Education Center (ASTEC) practicing the psychomotor skills
necessary for laparoscopic procedures. For General Surgery residents, simulation
offers the opportunity to become familiar with laparoscopic instruments and practice
new techniques in a no-risk environment. The simulation curriculum is divided into
three areas: basic equipment, technology and operative application laboratories,
says Herminio Ojeda, MD, assistant professor of clinical surgery. Dr. Ojeda tracks
each resident’s performance and confidence level throughout the four-to-six-week
training session.
“Using low-tech and high-tech simulation tools from wood blocks and rubber
bands to virtual reality simulators, residents develop the eye-hand coordination
skills needed for laparoscopic surgery,” Dr. Ojeda says.
First-year general surgery resident Wynter Phoenix, MD, says his time in ASTEC
was well spent. “The hands-on nature of ASTEC really helped in transitioning to
laparoscopic procedures in the operating room. Having time in the lab to try different
instruments and camera movements for the first time was a great opportunity for me
to practice and learn,” he says.
Mike Nguyen, MD, assistant professor of clinical surgery and director of
minimally invasive urologic surgery, has developed a one-on-one teaching/
mentorship program for urology residents using simulation to focus specifically on
core urologic laparoscopic procedures.
Dr. Nguyen uses a wide range of teaching tools, from watching videos of
procedures in the operating room to using simulated tissue and organ models
produced in ASTEC for hands-on practice with vascular injuries and partial removal
of a kidney.
“The ASTEC lab is an extremely valuable resource for resident teaching,” says
Dr. Nguyen. “Skills can be taught at the resident’s pace and errors in technique can
be identified and corrected in the lab before going to the actual operating room. This
way, time spent in live surgery is high yield for the resident and safe for the patient.”
Residents in the neurosurgery residency program practice their microsurgery
skills on simulated tissue under a special microscope with the mentorship of
neurosurgeon Allan Hamilton, MD, professor and ASTEC executive director. O
What’s Up in Surgery?
Department Welcomes New Faculty
Trauma, Critical Care and
Emergency Surgery
Peter M. Rhee, MD, MPH, has been
appointed chief of the Section of Trauma, Critical
Care and Emergency Surgery, and professor of
surgery. Dr. Rhee, who
once served as the
designated surgeon on
former President Clinton’s
China trip in 1998, provides
leadership and patient
care for Tucson’s only
Level 1 Trauma Center at
University Medical Center.
Dr. Rhee’s previous
experience involves some of the busiest trauma
centers in the country, including Harborview Medical
Center in Seattle and Washington Hospital Center
in Washington, D.C. He recently served in the U.S.
Navy as the director of the Navy Trauma Training
Center at Los Angeles County-University of Southern
California. He holds academic appointments as
professor of surgery and molecular cellular biology
at the Uniformed Services University of the Health
Sciences (USUHS) in Bethesda, Md., where he was
director of the Trauma Readiness and Research
Institute for Surgery, performing combat casualty care
research; and at the University of Southern California
Keck School of Medicine.
On the battlefield, Dr. Rhee was one of the first
trauma surgeons to be deployed to Camp Rhino,
Afghanistan, and recently started the first surgical
unit in Ramadi, Iraq. The recipient of numerous
awards and honors, including the Legion of Merit,
Defense Meritorious Service Medal and the Navy
Commendation Medal, Dr. Rhee serves as a
consultant to the Office of Naval Research, and
the Marine Corps Commandants War Fighting
Laboratory. Research interests include both
basic science and clinical research in the areas
of resuscitation, homeostasis, trauma training
and monitoring devices. He has more than 140
publications in refereed journals and 10 book
chapters.
He is a fellow of the American College of
Surgeons and Critical Care Medicine and has gained
national prominence from his committee work for
major medical organizations.
Dr. Rhee earned his medical degree in 1987
from the Uniformed Services University of the
Health Sciences F. Edward Hebert School of
Medicine. He received a master’s degree in public
health - health services, in 1995 from University of
Washington, Seattle, and a Diploma in the Medical
Care of Catastrophes in 1999 from the Society of
Apothecaries of London, UK.
Dr. Rhee completed his surgical internship at
Balboa Naval Hospital, San Diego, and residency in
general surgery at the University of California Irvine
Medical Center. He completed a fellowship in trauma
and critical care at Harborview Medical Center,
University of Washington, Seattle.
Transplantation
John F. Renz, MD, PhD, has joined the
department as professor of surgery and vice chief
of the Section of Transplantation. Dr. Renz comes
to the UA from Columbia University College of
Physicians and Surgeons,
where he served as surgical
director for the Liver
Transplantation Program at
the Center for Liver Disease
and Transplantation.
A highly skilled
transplant surgeon, Dr.
Renz was part of the first
surgical team ever to
perform a combined heart-liver transplant in the New
York region. Very few of these procedures have been
performed worldwide.
Dr. Renz is a pioneer in “extended criteria”
transplantation, or the use of organs that don’t meet
the usual criteria for transplantation due to various
health problems, but are still healthy enough for
a successful transplant. He proved that regular
and extended donor criteria (EDC) liver recipients
have equivalent survival rates, and EDC is able to
increase the access to liver transplantation.
In addition to liver transplantation, Dr. Renz
specializes in kidney and intestinal transplants.
Dr. Renz received his medical degree from
Jefferson Medical College, and his PhD in
biochemistry and molecular biology from Thomas
Jefferson University in Philadelphia. Both his
internship and residency were completed in general
surgery at the University of California, San Francisco.
He completed a fellowship in transplantation surgery
at the University of California, Los Angeles.
Dr. Renz’ research focuses on the development
of hepatocellular carcinoma, investigations into
expanded donor criteria allografts and experimental
therapies involving liver and intestinal transplantation
in adults and children. Clinical studies involve basic
mechanisms in liver transplantation.
A member of a dozen national and international
professional associations, Dr. Renz has published
more than 60 journal articles and book chapters.
Surgical Oncology
Julie Eileen Lang, MD, a fellowship-trained
breast surgical oncologist, has been appointed
assistant professor of surgery in the Section of
Surgical Oncology. Dr. Lang, who also is a member
of the Arizona Cancer Center, completed a breast
surgical oncology fellowship at the nationally
renowned MD Anderson Cancer Center in Houston.
Dr. Lang’s breast surgery practice focuses on
the full spectrum of malignant and benign breast
diseases, including breast masses, breast pain,
abnormal mammograms and breast cancer. She
also consults with high-risk patients, such as those
with a family history of breast cancer or prior breast
biopsies showing atypical findings. Additionally,
she will open a clinic for women with inflammatory
or locally advanced breast cancer at the Arizona
Cancer Center so that these patients can be treated
by a multidisciplinary team with extensive experience
with these diseases.
Specializing in skin sparing mastectomy and
immediate reconstruction, Dr. Lang employs surgical
techniques that optimize results both medically and
cosmetically for her breast surgery patients. She
is very enthusiastic about “oncoplastic” surgery,
techniques in which the surgeon plans a lumpectomy
and rearranges the local tissue to improve aesthetic
outcomes. She performs
ultrasound-guided minimally
invasive core needle biopsy
of suspicious breast lesions
and uses sentinel lymph
node biopsy, a minimally
invasive technique to check
to see if cancer has spread
to lymph nodes.
The co-author of
numerous publications, Dr. Lang’s research focuses
on circulating tumor cells and breast cancer stem
cells in an effort to find better targets for treatment for
all stages of breast cancer.
Dr. Lang completed her residency and a
postdoctoral cancer research fellowship at the
7
University of California, San Francisco. She received
her medical degree from the University of North
Carolina at Chapel Hill. She is the recipient of the
American Society of Clinical Oncology (ASCO)
Foundation Merit Award while at the MD Anderson
Cancer Center.
General Surgery
John B. Kettelle, MD, assistant professor
of clinical surgery, has joined the Section of General
Surgery, specializing in general and advanced
laparoscopic and endoscopic surgery for gallbladder
disease, hernias and the GI tract and in bariatric
surgery.
Minimally invasive procedures have potential
advantages over the traditional open surgery,
including less blood loss. Because laparoscopic
surgery requires only a
few small incisions, most
patients have a shorter
hospital stay and a faster
recovery.
Dr. Kettelle graduated
from the University of
California Davis School
of Medicine in 1997 and
completed his residency at
San Joaquin General Hospital in Stockton, Calif. After
finishing his residency, he stayed for an additional
year as a faculty member. Dr. Kettelle was in private
practice in Rhode Island prior to his fellowship training
in advanced laparoscopic and bariatric surgery at
The Central California Institute for Minimally Invasive
Surgery in Fresno, Calif.
Prior to medical school, Dr. Kettelle spent six
years in the U.S. Navy, where he served aboard the
fast-attack submarine USS William H. Bates.
Dr. Kettelle is a fellow of the American College of
Surgeons and a member of the Society of American
Gastrointestinal Endoscopic Surgeons.
Urology
Mike M. Nguyen, MD, has been named
director of Minimally Invasive Urologic Surgery
and assistant professor of clinical surgery in the
Section of Urology. Dr. Nguyen joined the UA after
completing a fellowship in
advanced laparoscopy at
the prestigious Glickman
Urological Institute at The
Cleveland Clinic Foundation.
Dr. Nguyen specializes
in advanced robotic and
laparoscopic procedures on
the prostate, bladder and
kidney for both malignant
8
and benign diseases.
Dr. Nguyen received his medical degree in 2000
from the University of California Davis School of
Medicine, where he also completed his internship and
residency training in urologic surgery.
A member of the Endourological Society, American
Association of Clinical Urologists and the American
Urologic Association, Dr. Nguyen has published
16 articles and his honors include the Society of
Laparoendoscopic Surgeons Outstanding Resident
Award. His clinical expertise is in performing advanced
robotic-assisted and laparoscopic urologic procedures
on the prostate, bladder and kidney for both malignant
and benign diseases.
His research interests include research on surgical
outcomes and on renal cancer.
Neurosurgery
Rein Anton, MD, PhD, has joined the
department as assistant professor of clinical surgery,
Section of Neurosurgery.
Dr. Anton’s clinical expertise includes complex
spine neurosurgery, including cervical/thoracic/lumbar
disorders, cervical and lumbar stenosis, cervical/
lumbar disc herniations and spinal cord tumors. Dr.
Anton also offers general neurosurgical intervention,
including treatment for benign and malignant brain
tumors.
He received his medical degree, summa cum
laude, from Tartu University, Estonia, where he also
completed his initial residency training in neurosurgery
and earned his PhD in biochemistry and molecular
biology. Dr. Anton completed
his postdoctoral research
in Uppsala, Sweden, and
at UCLA, on oncogenes
(genes that contribute to the
production of a cancer) and
genetically engineering cells
for neural transplantation.
Dr. Anton also completed a
general surgery internship
at UCLA and a neurosurgery residency at Loma Linda
University, Calif.
He is a member of the American Society for
Neural Therapy and Repair, Ludwig Puusep Society
for Neurologists and Neurosurgeons (Estonia) and
the American Association of Neurological Surgeons,
AANS/CNS Joint Section on Disorders of the Spine
and Peripheral Nerves.
Certified by the American Board of Neurological
Surgery, Dr. Anton has published more than 50
articles. His research interests include genetically
engineering cells for transplantation for Parkinson’s
and Huntington’s diseases, neuro-oncology, and the
functioning of oncogenes in brain tumors.
Alumni Spotlight
Greetings from Colorado
Balancing Motherhood
and Surgery
By Rina Shinn, MD
Class of ’97
When I finished
my residency 10
years ago, I came
out to the small
town of Pueblo,
Colo., about 150
miles south of
Denver. My brother,
who used to live in
Denver, campaigned for my move and the
town turned out to be an ideal place to live
and raise children.
Initially, the child-raising wasn’t the
primary concern, but the viability of a
small, single specialty practice was. I felt
ill-prepared to battle the ever-escalating
insurance/third-party provider demands
and games and felt practically lost to
comprehend the rapidly changing rules
and regulations of being a surgeon.
Then the children started to arrive. My
daughter, Freia, was born in 2000 and soon
followed my son, Baldur, in 2001. Most
recently, second son, Lodur, was born in
September. I found motherhood, especially
with a tiny infant, much harder to manage
than the residency. Even with every other
night of trauma call rotation, there was a
solid 10 to 12 hours when you can crash
and sleep, if you wanted to. With a couplehour interval feeding of a small infant,
however, the sleep-deprivation, lasting
three to four months and sometimes
longer, was truly torturous.
As the children grew in number and
size there were always more demands
for a mother in various capacities. I am
sure this is a similar dilemma all working
mothers face. And I had to learn the
ropes like all other mothers, without an
instruction manual. My husband (Stefan
Siegel) works at the Air Force Academy,
which requires a two-hour commute each
day, leaving me to be a single mom during
the daytime. One learns to develop a local
Department Hosts ACS Reception
The UA Department of Surgery hosted a reception in October for faculty and alumni at the Alumni
and Friends Reception during the Clinical Congress of the American College of Surgeons in New
Orleans. The reception was co-sponsored by Novartis and Karl Storz Endoscopy. More photos can
be seen on the Web site: www.opa.medicine.arizona.edu/surgery/acs07/.
ABOVE: Leigh Neumayer &
Dr. Hugo Villar
LEFT: Drs. Rainer Gruessner,
Amy Waer, Jennifer Tittensor &
Kimberly Peck
ABOVE: Dr. Angelika Gruessner,
Dr. Susan Horne, Ljubica Villar,
and Dr. Ana Grau
Dr. Martin Dresner
Drs. Charles Perry & Rod McKinley
LEFT: Drs. Herminio Ojeda & Luis León
network quickly when one has to maintain
a professional life and raise small children.
In 2002, I was given an opportunity
to take over a position of chief of surgery
at CMHIP, which is a remnant of an
old Colorado State
I found
Hospital. We have
motherhood, a 20-bed general
hospital, embedded
especially
in a state mental
with a tiny
health campus. Being
infant, was
a salaried surgeon
much harder made a great impact
in my family life and
to manage
I was able to balance
than the
my professional life
residency.
and motherhood much
better.
It’s truly a small world, and Andrea
Kaiser (class of ’98) came and took my
place in the old practice. She is married to
pediatrician Mark Schwartz and they have
two sons, Noah (almost 3 years old) and Eli
(15 months). Since last year, she has moved
into a bigger surgical group in Pueblo.
In the past few years, I have been
involved more with county and state
medical societies and been more politically
involved, realizing that the field of surgery,
as well as the entire medical profession, is
going through significant changes currently
and that all physicians need to be more
politically savvy than before.
We have just finished building an energyefficient passive solar house in town and
would love to hear from any alumni who
might pass through Colorado. O
Richard H. Carmona,
MD, MPH, 17th U.S.
Surgeon General
(2002-2006), is now
professor of surgery in
the UA Department of
Surgery. Dr. Carmona
has been affiliated with
the department since
1986. He will help the
department create a
board of directors to assist with development and
strategic efforts. Dr. Carmona also is distinguished
professor of public health at the UA Mel and Enid
Zuckerman College of Public Health, vice chairman
of Tucson-based Canyon Ranch, and president of
the non-profit Canyon Ranch Institute.
Arizona Surgery Club officers Christine Poach,
Mina Shin & Andrew Hopper
Rifat Latifi, MD, (left), Section of Trauma
and Emergency Services, talks with the
Prime Minister of Albania, Dr. Salih Berisha,
center, and Deputy Minister of Health of
Albania, Arben Ivanaj, Oct. 22, 2007. As
professor of clinical surgery and associate
director of the Arizona Telemedicine
Program, Telesurgery and International
Affairs, Dr. Latifi has been successful in
developing telemedicine links to seven
hospitals in various parts of Kosova. The
program, funded by a U.S. Department of
State Bureau of Educational and Cultural
Affairs grant, aims to improve the delivery of
medical services in the Balkan countries.
9
Awards & Recognition
Tucson’s Best Doctors – Copeland,
Hamilton, Mills, Villar
Four surgeons from the UA Department of
Surgery are included among the 2007-2008 Best
Doctors in America. The database includes about
40,000 U.S. physicians in more than 40 specialties
and 400 subspecialties of medicine who represent
the top 3 to 5 percent of specialists in the country.
University Medical Center Ranks Among
America’s Best Hospitals 2007
UMC is ranked among the nation’s premier
hospitals in U.S.News & World Report’s
18th annual guide to “America’s Best
Hospitals.” This year UMC is ranked
among the top 50 hospitals in the
following medical specialties:
• Heart and Heart Surgery
• Cancer
• Geriatrics
• Respiratory Disorders
Jack Copeland, MD, Section of Cardiovascular
and Thoracic Surgery, has been appointed
Visiting Professor and Faculty Member, School of
Cardiovascular Science at the University of Verona
Medical School, Verona, Italy.
Luis R. León, MD, Section of Vascular Surgery,
was a nominated finalist for the 2007 Frank
Brown Berry Prize in Federal Medicine (U.S.
Medicine - The Voice of Federal Medicine.
August 2007; Vol.43: No. 8). Dr. Leon also was
awarded the International Society for Vascular
Surgery (ISVS) Scholarship – Milan, Italy.
Michael Moulton, MD, Section of Cardiothoracic
Surgery, received the 2007 Special Recognition
Award from the Southern Arizona Chapter
Association of Perioperative Registered Nurses
at their annual meeting in September.
Juan Martin Valdivia-Valdivia, MD,
neurosurgery resident, received the annual
John Green Award for Resident Research of the
Arizona Neurosurgical Society 2007. This paper
has been selected to be presented at the American
Association of Neurological Surgeons Meeting in
Chicago in 2008.
Hugo Villar, MD, Section of Surgical Oncology,
has been named to a two-year term as chair of
the International Relations Committee for the
American College of Surgeons. Dr. Villar also
was named the Distinguished Latin American
Surgeon in the United States for 2007 by the
Federation of Latin American Surgeons (FELAC –
Federation Latino Americana de Curugia).
Outstanding Teaching Awards
The UA Department of Surgery was awarded
the UA College of Medicine “Outstanding
Achievement in Teaching by a Clerkship or
Elective in the Clinical Sciences Award.” This
10
award is nominated and selected by the college’s
medical students. Surgery resident Albert Chi,
MD, received the “Houseofficer Educator of the
Year Award.”
Publications
Emil S, Duong ST. Antibiotic therapy
and interval appendectomy for perforated
appendicitis in children: a selective approach.
Am Surg 2007 Sep;73(9):917-22.
Gruessner RWG,
Benedetti E (editors).
Living Donor Organ
Transplantation. 1st
Edition. McGraw-Hill,
New York, Jan 2008.
Gruessner RW,
Sutherland DE,
Kandaswamy R,
Gruessner AC, Over
500 solitary pancreas
transplants in nonnuremic patients with brittle
diabetes mellitus. Transplantation 2008 Jan
15;85(1):42-7.
Sturdevant ML and Gruessner RWG: Critical
Care Problems in Kidney Transplant Recipients.
In: Intensive Care Medicine. 6th Edition. Editors:
Irwin RSI and Rippe JM. Wolters Kluwer
Lippincott Williams & Wilkins, Philadelphia,
2008.
Gonzales JA, Hughes JD, León LR. Probable
zoonotic aortitis due to group C Streptococcal
infection. J Vasc Surg 2007 Nov;46 (5):1039-1043.
Ihnat DM, Duong ST, Taylor Z, León LR, Mills
JL, Echeverri J, Arslan B. Contemporary outcomes
after superficial femoral artery angioplasty and
stenting”: the influence of TASC classification and
runoff score. Journal of Vascular Surgery: (in press).
Coons SJ, Chongpison Y, Wendel CS, Grant M,
Krouse RS. Overall quality of life and difficulty
paying for ostomy supplies in the VA ostomy
health-related quality of life study: An exploratory
analysis. Med Care 2007 Sept; 45:891-5.
Mitchell KA, Rawl SM, Schmidt CM, Grant M,
Ko CY, Baldwin CM, Wendel C, Krouse RS.
Demographic, Clinical, and Quality of Life
Variables Related to Embarrassment in Veterans
Living With an Intestinal Stoma. J Wound Ostomy
Continence Nurs 2007 Sept/Oct; 34(5):524-532.
Jain S, McGory ML, Ko CY, Sverdlik A, Tomlinson
JS, Wendel CS , Coons SJ, Rawl SM , Schmidt CM,
Grant M, McCorkle R, Mohler MJ, Baldwin CM,
Krouse RS. Comorbidities play a larger role in
predicting quality of life compared to having an
ostomy. Am J Surg 2007 Dec;194(6):774-779.
Alberts DS, Einspahr JG, Krouse RS, Prasad A,
Ranger-Moore J, Hamilton P, Ismail A, Lance
P, Goldschmid S, Hess LM, Yozwiak M, Bartels
HG, Bartels PH. Karyometry of the colonic
mucosa. Cancer Epidemiol Biomarkers Prev 2007
Dec;16(12):2704-2716.
Julie E. Lang, MD, and Henry M. Kuerer, MD,
PhD, Breast Ductal Secretions: Clinical Features,
Potential Uses, and Possible Applications, Cancer
Control, Oct 2007.
R Latifi, RS Weinstein, JM Porter, M Ziemba,
D Judkins, D Ridings, R Nassi, T Valenzuela,
M Holcomb, F Leyva. Telemedicine and
Telepresence for Trauma and Emergency Care
Management, Scandinavian Journal of Surgery 96:
281–289, 2007.
“Current Practices and Principles on Telemedicine
and E-Health,” Rifat Latifi, editor, published by
IOS, Amsterdam.
Labropoulos N, Ayuste B, León LR. Renovascular
disease among patients referred for renal duplex
ultrasonography. J Vasc Surg 2007 Oct; 46 (4):
731-737.
Labropoulos N, León LR, Gonzalez-Fajardo
JA, Mansour AM, Kang SS. Non-atherosclerotic
pathology of the neck vessels: prevalence and
flow patterns. Vascular and Endovascular Surgery
2007 Oct/Nov; (41) 5: 417-427.
León LR, Psalms SB. A diagnostic dilemma:
does peri stent-graft air after thoracic aortic
endografting necessarily imply infection? Vascular
and Endovascular Surgery 2007 Oct/Nov; (41) 5:
433-439.
León LR, Mills JL Sr., Psalms SB, Kasher J, Kim J,
Ihnat DM. Aortic paraprosthetic-colonic fistulae:
review of the literature. Eur J Vasc Endovasc Surg
2007 Dec; 34 (6):682-692.
León LR, Hughes JD, Psalms SB. Guerra R,
Biswas A, Prasad A, Krouse RS. Portomesenteric
reconstruction during Whipple procedures:
review and report of a case. Vascular and
Endovascular Surgery 2007 Dec;41(6).
León LR, Mills JL. Invited commentary on:
Bandyk DF. Surveillance after lower extremity
arterial bypass. Pers Vasc Surg Endovasc Ther 2007
Dec; 19 (4).
León LR, Psalms SB, Ihnat DM, Mills JL
Sr. Vascular Images: Aortic graft-colonic
paraprosthetic fistula. Journal of Vascular Surgery
2007: in press.
León LR, Psalms SB, Ihnat DM, Becker GJ, Mills
JL Sr. Endovascular iliac aneurysm exclusion
when hypogastric artery flow preservation is
crucial: a novel approach. Vascular: in press.
León LR, Ojeda H, León CR, Mills JL Sr., Psalms
SB, Villar H. The journey of a foreign-trained
physician to a U.S. residency: Controversies
surrounding their migration. Journal of the
American College of Surgeons 2007: in press.
León LR, Psalms SB, Walters JL. Diabetic foot
infections in the elderly: primary amputation
vs. “foot- sparing surgery”. A case report.
International Wound Journal: in press.
León LR, Psalms SB, Mills JL, Taylor Z.
Degenerative aneurysms of the superficial
femoral artery. European Journal of Vascular and
Endovascular Surgery: in press.
León LR, Psalms SB, Labropoulos N, Mills
JL. Mycotic aneurysms affecting the upper
extremities. European Journal of Vascular and
Endovascular Surgery: in press.
Labropoulos N, Bekelis K, León LR. Natural
history of deep vein thrombosis in unusual sites
of the lower extremity. Journal of Vascular Surgery:
in press.
León LR, Rodriguez HE, Labropoulos N, Littooy
FN, Psalms SB. Aortitis and bacterial endocarditis.
Vascular: in press.
Melissa L. Meas, Lisa Davidson, Grace-Davis
Gorman, Paul F. McDonagh, Bruce M. Coull and
Leslie S. Ritter. Evaluation of Sample Fixation
and Comparison of LDS-751 or anti-CD45 for
Leukocyte Identification in Mouse Whole Blood
Using Flow Cytometry. J Immunological Methods
319: 79-86, 2007.
DuBose JJ, Inaba K, Shiflett A, Trankiem C,
Teixeira PG, Salim A, Rhee P, Demetriades D,
Belzberg H. Measurable outcomes of quality
improvement in the trauma intensive care unit:
the impact of a daily quality rounding checklist.
J Trauma. 2008 Jan;64(1):22-7; discussion 27-9.
Diaz JJ Jr, Cullinane DC, Altman DT, Bokhari
F, Cheng JS, Como J, Gunter O, Holevar M,
Jerome R, Kurek SJ Jr, Lorenzo M, Mejia V,
Miglietta M, O’Neill PJ, Rhee P, Sing R, Streib E,
Vaslef S; EAST Practice Management Guideline
Committee. Practice management guidelines for
the screening of thoracolumbar spine fracture.
J Trauma. 2007 Sept;63(3):709-18.
Yanar H, Demetriades D, Hatzizacharia P,
Nomoto S, Salim A, Inaba K, Rhee P, Chan LS.
Pedestrians injured by automobiles: risk factors
for cervical spine injuries. J Am Coll Surg. 2007
Dec;205(6):794-9. Epub 2007 Sept 17.
Dokken B and McDonagh P. Role of Innate
Immune Dysregulation in Diabetic Heart Failure.
In: Immune Dysfunction and Immunotherapy in
Heart Disease. Watson and Larson ed. BlackwellFutura, 2007.
Oncel D, Demetriades D, Gruen P, Salim A,
Inaba K, Rhee P, Browder T, Nomoto S, Chan
L. Brain lobectomy for severe head injuries
is not a hopeless procedure. J Trauma. 2007.
Nov;63(5):1010-3.
Katie Finnerty, Ji-Eun Choi, Alexandria Lau,
Grace Davis Gorman, Conrad Diven, Norma
Seaver, William Linak, Mark Witten and Paul
McDonagh. Instillation of Coal Ash Particulate
Matter and Lipopolysaccharide Produces a
Systemic Inflammatory Response in Mice. Journal
of Toxicology and Environmental Health, Part A. 70:
1957-1966, Dec 2007.
Salim A, Ottochian M, Gertz RJ, Brown C,
Inaba K, Teixeira PG, Rhee P, Demetriades D.
Intraabdominal injury is common in blunt trauma
patients who sustain spinal cord injury. Am Surg.
2007 Oct;73(10):1035-8.
Mills JL, Duong ST, León LR, Goshima KR,
Wendel CS, Ihnat DM, Chavez L, Zimmerman
H, Pike SL. The effect of EVAR and serial
surveillance contrast CT scans on long-term renal
function. Journal of Vascular Surgery: in press.
Rhee P, Inaba K. Coagulopathy in Trauma. Current
Surgical Therapy. Cameron ed: in press.
Rhee P, Holcomb J, Jenkins D. Military Trauma.
Trauma. Mattox, Moore, Feliciano eds: in press.
Martin M, Rhee P. Nonoperative management of
blunt and penetrating abdominal injuries. Current
Therapy in Trauma and Surgical Critical Care,
Asensio and Trunkey eds: in press
Teixeira PG, Inaba K, Hadjizacharia P, Brown
C, Salim A, Rhee P, Browder T, Noguchi TT,
Demetriades D. Preventable or potentially
preventable mortality at a mature trauma center.
J Trauma. 2007 Dec;63(6):1338-46; discussion
1346-7.
Rhee P, Hadjizacharia P, Trankiem C, Chan
L, Salim A, Brown C, Green D, Inaba K, Law
J, Demetriades D. What happened to total
parenteral nutrition? The disappearance of its
use in a trauma intensive care unit. J Trauma.
2007 Dec;63(6):1215-22.
Salim A, Hadjizacharia P, Brown C, Inaba K,
Teixeira PG, Chan L, Rhee P, Demetriades
D. Significance of troponin elevation after
severe traumatic brain injury. J Trauma. 2008
Jan;64(1):46-52.
Teixeira PG, Inaba K, Salim A, Brown C, Rhee P,
Browder T, Belzberg H, Demetriades D. Retained
foreign bodies after emergent trauma surgery:
incidence after 2526 cavitary explorations. Am
Surg. 2007 Oct;73(10):1031-4.
Inaba K, Teixeira PG, David JS, Brown C, Salim
A, Rhee P, Browder T, Dubose J, Demetriades
D. Computed tomographic brain density
measurement as a predictor of elevated
intracranial pressure in blunt head trauma.
Am Surg. 2007 Oct; 73(10):1023-6.
Salim A, Martin M, Brown C, Inaba K, Browder
T, Rhee P, Teixeira PG, Demetriades D. The
presence of the adult respiratory distress
syndrome does not worsen mortality or discharge
disability in blunt trauma patients with severe
traumatic brain injury. Injury. 2008 Jan;39(1):30-5.
Epub 2007 Oct 24.
Gigena M, Villar HV, Knowles NG, Cunningham
JT, Outwater EK, León LR. A rare occurrence of
antegrade intussusception after remote Whipple
and Puestow procedures due to pancreas
divisum. World J Gastroenterol. 2007 Nov 28;13(44):
5954-5956.
Witte, MH, M Bernas: Silver bullets and shotguns
in lymphedema research. Lymphology 40:1-2, 2007.
Dellinger, MT, RJ Hunter, MJ Bernas, MH
Witte, RP Erickson: Chy-3 mice are Vegfc
haploinsufficient and exhibit defective dermal
superficial to deep lymphatic transition and
dermal lymphatic hypoplasia. Develop. Dynamics
236:2346-2355, 2007.
Witte M, K Jones, M Bernas, CL Witte: Landmarks
and advances in translational lymphology. In:
Cancer Metastasis and the Lymphovascular System:
Basis for Rational Therapy. Chapter 1, Leong SPL
(Ed.), Springer US, 2007, pp. 1-16.
Leong, SL, MH Witte: Future perspectives and
unanswered questions on cancer metastasis and
the lymphovascular system. In: Cancer Metastasis
and the Lymphovascular System: Basis for Rational
Therapy. Chapter 21, Leong SPL (Ed.), Springer
US, 2007, pp. 293-296.
The following were published in: Progress
in Lymphology. Proc. 20th Int’l. Congress of
Lymphology, Salvador, Brazil. Andrade M, MH
Witte (Eds.), Lymphology 39(Suppl), 2007:
Hunter, R, M Witte, M Dellinger, B Kriederman,
R Zeigler, C Suri, N Gale, G Yancopoulos:
The generalized hypo-dysplastic lymphaticlymphedema phenotype of angiopoietin-2
knockout mice persists throughout adulthood
and is fully rescued by angiopoietin-1 knock-in.
Lymphology 39(Suppl):28-30, 2007.
Noon, A, R Hunter, B Kriederman, M Witte,
M Bernas, M Rennels, S Enerback, N Miura,
R Erickson, C Witte: Foxc2 gene insufficiency
and imbalance in the genesis of the distinctive
lymphatic and ocular phenotype of
lymphedema-distichiasis syndrome. Lymphology
39(Suppl):31-34, 2007.
Dellinger, MT, RJ Hunter, MJ Bernas, RP Erickson,
MH Witte: Lymphatic phenotype of Chy-3 mice.
Lymphology 39(Suppl):62-65, 2007.
Jones, KA, MH Witte: Cancer and the lymphatic
system. Lymphology 39(Suppl):136-140, 2007.
Richards, G, M Bernas, R Hunter, B Kaylor, A
Gmitro, MH Witte: Rhodamine-base optical
imaging of the murine lymphatic system.
Lymphology 39(Suppl): 164-165, 2007.
BonHomme, KP, WH Williams, MH Witte:
Muscle hypertrophy and inflammation in the
lymphedematous upper extremities of women
following treatment for breast cancer. Lymphology
39(Suppl): 298-303, 2007.
Suri C, MH Witte: Lymphedema syndromes. In:
Lang, F. (ed). Encyclopedia of Molecular Mechanisms
of Disease. Springer, Berlin Heidelberg New York
(in press).
Witte MH, P Crown, M Bernas, CL Witte:
Lessons learned from ignorance: The curriculum
on medical (and other) ignorance. In: Virtues of
Ignorance: Complexity, Sustainability, and the Limits
of Knowledge. William Vitek and Wes Jackson,
editors, University Press, University of Kentucky
(in press).
Witte MH, MJ Bernas, KA Northup, CL
Witte: Molecular lymphology and genetics
of lymphedema-angiodysplasia syndromes.
In: Textbook of Lymphology, Földi M, E Földi, S
Kubik (Eds), Urban & Fischer Verlag, München,
Germany, (in press).
Ramos, R, JB Hoying, MH Witte, WD Stamer:
Schlemms’ canal endothelia, lymphatic or blood
vascular? J. Glaucoma 16:391-405, 2007.
11
The University of Arizona
Department of Surgery
PO Box 245066
Tucson AZ 85724-5066
Presentations
“The effect of EVAR and serial surveillance
contrast CT scans on long-term renal function,”
Duong ST
ST, Mills JL
JL, Goshima KR
KR, León
LR, Ihnat DM, Taylor Z, Chavez L, Pike SL,
Zimmerman H. Abstract Book. Forum, Western
Vascular Society 22nd Annual Meeting and 14th
Annual Resident, Kona, Hawaii, Sept 2007.
Intern
International Virtual e-Hospital: The Balkans
Projec
Project”; “Amazon Virtual Medical Team:
Telem
Telemedicine in the jungle of Peru and Brazil.”
Latifi, R. Distinguished Speaker, “Global Forum
on Tel
Telemedicine: Connecting the World through
Partnerships.” First Annual ATA/TATRC MidYear Meeting, Las Vegas, Sept 2007.
Latifi, R. Key Speaker, “Telemedicine and
Telepresence for Trauma and Emergency Care
Management: Ready for Prime Time.” Surgical
Rainer Gruessner, “The Uremic Diabetic: LD
kidney followed by PAK is preferred to a DD SPK Grand Rounds. Billings Clinic, Mont. Oct 2007.
– PRO.” International Pancreas & Islet Transplant Latifi, R. Key Speaker, Second Intensive Balkan
Association, Joint Conference Minneapolis, Sept
Telemedicine and e-Health Seminar: A Three-Day
2007.
Workshop on Current Principles and Practices of
Rainer Gruessner, “Transplantation of Extrarenal Telemedicine and e-Health, Albania, Oct 2007.
Abdominal Organs,” Grand Rounds - University “The Journey of a Foreign-trained Physician to a
of New Mexico Health Sciences Center, Nov 2007. U.S. Residency”; and “Cervical Cancer in Peru,”
León LR. New Orleans, 93rd American College
“High velocity penetrating wounds to the
of
Surgeons Annual Clinical Congress: Latin
neck: lessons learned from the battlefields in
American Day, Oct 2007.
Afghanistan and Iraq,” presentor – Hwang P,
invited discussant, Surgical Forum, American
College of Surgeons 93rd Annual Clinical
Congress, New Orleans, Oct 2007.
“Percutaneous stenting of the superficial femoral
artery,” Ihnat DM, Arslan B, Taylor Z, León LR,
Goshima KR, Duong ST, Mills JL. Abstract Book.
Forum, Western Vascular Society 22nd Annual
Meeting and 14th Annual Resident, Kona,
Hawaii, Sept 2007.
Latifi, R. Invited Faculty, First Annual ATA
Mid-Year Meeting, Las Vegas, Sept 2007: “The
“The risks of celiac artery coverage during
endoluminal repair of acute and chronic thoracic
aortic pathology,” León LR, Mills JL, Morasch
MM, Jordan W, Kovacs ME, Becker GJ, Arslan
B, Dake MD, Katzen BT. Abstract Book, First
European Congress of the International Society
for Vascular Surgery, Milan, Italy, Oct 2007.
Abstract Book. 34th Annual VEITH symposium,
1st Poster Session, New York, Nov 14-18, 2007.
New York, New York, VEITH symposium, poster
presentation, Nov 2007.
NONPROFIT ORG
US POSTAGE PAID
TUCSON AZ
PERMIT NO. 190
“Is irreversible shock truly irreversible?” Shultz
C, Zheng C, Sailhamer E, Rhee P, Spaniolas
K, Velmahos G, De Moya M, Alam H, Surgical
Forum, 93rd Annual Clinical Congress of ACS, New
Orleans, Oct 2007.
“RANTES and E2F1 Chemokines mediate
Neuronal Apoptosis in Intractable Epilepsy,” Juan
Martin Valdivia-Valdivia, Martin Weinand, Milan
Fiala, presented at the Arizona Neurosurgical
Society Meeting, Oct 2007.
Ojeda H. “Perspectives in Bariatric Surgery”
and “Development of New Devices in Surgery,”
Annual Navajo Surgical Society Meeting in
Flagstaff, Nov 2007.
“From genes to man: The past, present and future
of lymphology and the ISL,” Marlys H. Witte,
Ceremonial Opening Lecture; “Heme/Lymph
vasculogenesis, angiogenesis, angiotumorigenesis,
and tumor angiogenesis: need for a terminology
adjustment,” Marlys H. Witte, Michael Dellinger,
Michael Bernas, Invited Lecturer, Session on
Lymphangiogenesis; “Genetics for lymphologists,”
and “The lymphatic system and cancer:
Historical, biological and clinical perspectives.”
Marlys H. Witte, Invited Lecture, Session on
Oncolymphology and Sentinel Node. 21st
International Congress of Lymphology, Shanghai,
China, Sept 2007:
“Groin Wound Complications Involving Vascular
Grafts: The Importance Of Debridement And
Sartorius Flap Coverage,” Hannah Zimmerman,
Joseph Mills, presented at the Western Vascular
Society, Kona, Hawaii, Sept 2007. O