Medical Devices Fall Short for Children

"Innovation in medicine is driven by need, but also by the market," said Dr. Michael R. Harrison, the director emeritus of the Fetal Treatment Center and the director of the Pediatric Device Consortium, both at the University of California, San Francisco. "Big markets have lots of folks developing devices, but small markets like the pediatrics market don't."

Lung Cancer Systems Genetics Expands Map of Drug Discovery

In the journal Nature Communications, lead author  Il-Jin Kim, Ph.D., (pictured left) Director of Applied Genomics in the UCSF Thoracic Oncology Lab, Thoracic Oncology Program Leader, David M. Jablons, M.D., (pictured right) and others, demonstrate the value of mining vast gene expression networks to expand the pool of therapeutic targets in lung cancer. This could lead to the discovery of  novel druggable targets specific to lung adenocarcinoma, sparing normal lung tissue, and to anti-cancer drugs with minimal side toxicity yet with high tumor killing efficacy. 

Awards Announced for 26th Annual J. Engelbert Dunphy Resident Research Symposium

The annual 26th Annual J. Engelbert Dunphy Resident Research Symposium was held on April 5, 2013. The award for "Best Abstract" went to Robert Bell, MD with runners-up Jessica Beard, MD, MPH and Randi Smith, MD MPH.  Xiaoti Xu, MD received the award  for "Best Quick Shot".  Jack Harbell, MD and Cristina O'Donohue, MD received Honorable Mention certificates for their presentations.

16th Annual Maurice Galante Lecture Featuring Malcolm Gladwell (Watch Online)

The 16th Annual Maurice Galante Lecture took place on Febuary 22, 2013 and featured Malcolm Gladwell. The video of the lecture can be watched online.

Malcolm Gladwell has been a staff writer with The New Yorker magazine since 1996. His 1999 profile of Ron Popeil won a National Magazine Award, and in 2005 he was named one of Time Magazine's 100 Most Influential People. He is the author of four books, "The Tipping Point: How Little Things Make a Big Difference," (2000), "Blink: The Power of Thinking Without Thinking" (2005), and "Outliers: The Story of Success" (2008) all of which were number one New York Times bestsellers. His latest book, "What the Dog Saw" (2009) is a compilation of stories published in The New Yorker. 

From 1987 to 1996, he was a reporter with the Washington Post, where he covered business, science, and then served as the newspaper's New York City bureau chief. He graduated from the University of Toronto, Trinity College, with a degree in history. He was born in England, grew up in rural Ontario, and now lives in New York City.

Alden H. Harken, M.D. Receives Lifetime Achievement Award from Society of University Surgeons (SUS)

Alden H. Harken, M.D. was recently honored with the 2012 Lifetime Achievement Award from the Society of University Surgeons (SUS). Dr. Harken is  Chief of the  UCSF-East Bay Surgery Program, and   Chief of Surgery and Chair of the Surgery Department at Alameda Health System's (AHS). Over the course of his career, His contributions to the field of cardiac electrophysiology include influential early work around mapping and surgical ablation for ventricular tachyarrhythmias. Dr. Harken's work in this area helped our understanding of the pathophysiology of ventricular tachycardia and shaped today's methods of ablative treatment of ischemic ventricular tachycardia. According to SUS, "Dr. Harken's energy, insight, enthusiasm and innovative work have created a legacy that will influence the treatment of cardiac arrhythmias for many years to come. He has clearly been a pioneer in the field, and has been a true role model for his colleagues in the SUS and AAS." *

*Excerpts above from news release for Alameda Health System's (AHS)

JAMA Article Highlights Critical Need for Surgeons to Address Smoking Cessation with Patients

A recent Viewpoint article  in JAMA, co-authored by  John Maa, M.D., Assistant Professor of Surgery at UCSF, highlighted the importance of smoking cessation before surgery, a conversation that both improves surgical outcomes and creates a teachable moment in the life of the patient:

"Elective surgery offers a powerful opportunity for physicians to help smokers quit, yet 25% to 30% of patients smoke perioperatively, and approximately 10 million patients who smoke undergo surgical procedures annually. Approximately 42% of all surgeons and 70% of anesthesiologists do not routinely counsel patients to stop smoking before an operation or do not refer them to appropriate cessation services........Perioperative smoking is linked to surgical complications including wound infection, respiratory failure, cardiac arrest, myocardial infarction, prolonged hospital stay, stroke, sepsis, shock, and anastomotic leak."

Maurice Galante, M.D., Legendary Surgeon and Renaissance Man, Dies

Dr. Maurice Galante, whose professional career at UCSF spanned an incredible 44 years (1945-1989), passed away on February 5, 2013. Dr. Galante was born in Rhodes in 1919 and came to the United States alone to receive his undergraduate and medical education. He entered his residency training in general surgery at UCSF in 1945. He subsequently became a member of the Department of Surgery faculty. As a faculty member at UCSF, Dr. Galante was celebrated as a master surgeon and for his varied interests in medical ethics, music and the arts. His reputation with patients was legendary and his grateful patients helped him and the Department of Surgery establish the Galante Lecture Program, The Galante Research Program and the Maurice Galante Distinguished Professorship.

Rogers Urges Caution on New Medical Device to Treat GERD

A recent study in the New England Journal of Medicine touts a new medical device for the treatment of  Gastroesophageal Reflux Disease (GERD) as an alternative to standard therapy, long-term proton-pump inhibitors or Nissen Fundoplication. The new treatment is a surgical procedure in which a small band of magnetic beads is surgically implanted  to augment the lower esophageal sphincter, the valve between the esophagus and stomach. 

But Stanley J. Rogers, M.D., Associate Professor of Surgery at UCSF, Chief of Minimally Invasive Surgery, and Chief of Bariatric Surgery, expressed concern about its use, telling CBS/KCBS News Healthwatch that the device  was essentially untested except for the small study cited above. He cautioned that the beads were a foreign object and where the device was placed could potentially cause serious complications including infection, perforation and abdominal sepsis, leading to ultimate removal. He emphasized that long-term data was needed to demonstrate its safety and effectiveness. 

Ventricular Assist Device (VAD) Serves as Bridge to Heart Transplant While Candidate Loses Required Weight

Suitulaga "Sugi" Hunkin has been overweight most of his life. He attributes that to his love of food and his Samoan ancestry.  Because of his size, he also had trouble breathing and experienced irregular heartbeat - symptoms his doctors diagnosed as heart disease called cardiomyopathy, which usually leads to heart failure...........He needed heart transplantation surgery to replace his failing heart, but before that could happen, he needed to lose at least 100 pounds.  "If a patient is very obese, he bears a lot of risks and complications, inter-operatively as well as post-operatively," said  Georg Wieselthaler. M.D., Professor of Surgery of UC San Francisco's Division of Adult Cardiothoracic Surgery, and director and surgical chief of the UCSF Cardiac Transplantation and Mechanical Circulatory Support. "And therefore it's absolutely favorable for patients to try and have a body mass index of below 35 before going into a complex operation."

Hunkin chose UCSF to help him with his heart failure. Its pioneering Cardiothoracic Surgery program, now led by Scot H. Merrick, M.D., was established 50 years ago by chair Leon Goldman, MD, and Benson Roe, M.D. The Heart and Lung Transplant Program has historically had high one-year survival outcomes among academic surgery programs nationally. To help Hunkin stay alive, Wieselthaler installed a ventricular assist device (VAD), a mechanical device that helps a failing heart pump blood. The VAD allowed Hunkin stay alive, but it did not help him lose weight.   *Excerpt above adapted from UCSF News

Il-Jin Kim Awarded Grant to Investigate Novel Genetic Profiles in Mesothelioma

The Mesothelioma Applied   Research Foundation (MARF), a leading national funder of research for this disease, has awarded Il-Jin Kim, Ph.D.,  Assistant Professor and  Director of Applied Genomics in the  Thoracic Oncology Laboratory, a grant to study Novel fusion and tumor-specific isoform candidates in malignant pleural mesothelioma (MPM), an aggressive and highly lethal cancer, with the ultimate goal of identifying therapeutic targets. The research focuses on a class of patient who lack the three most common genetic deletions (CDKN2A, NF2, and BAP1). Studying the unique genetic profile of this so-called triple-negative (TN) MPM patient population may reveal unique genetic characteristics and oncogenic fusions contributing to MPM development. The goal would be to target the aberrant cancer-inducting activity in this small group of patients with novel therapies. This is a similar approach to the identification of the EML4-ALK fusion genes in non-small cell lung cancer patients, leading to the novel therapy crizotinib, an example of 21st century precision medicine.

Teen Liver Transplant Recipient to Honor Donor at 2013 Rose Parade

Three years ago, Alfonso Garcia was diagnosed with Wilson's disease and was in desperate need of a liver transplant. George Becker, who signed up to be an organ donor on his driver's license when he was 16, ended up being the right match. Garcia's UCSF medical team - which included transplant surgeon Ryutaro Hirose, MD (pictured first); Philip Rosenthal, MD (pictured second), medical director of the Pediatric Liver Transplant Program; Emily Perito, MD, a clinical fellow in pediatrics and gastroenterology; and nurse practitioner Susan Diaz, MSN - performed a successful transplant.Since receiving the liver transplant, Garcia has made it a mission to spread the word about the value of organ donation by sharing the memory of his hero, George Becker, who died after a bad sinus infection spread to his brain. As part of that mission, Garcia was selected by UCSF and the California Transplant Donor Network to ride on the Donate Life "Journeys of the Heart" float at the 2013 Tournament of Roses Parade in Pasadena, Calif., on Tuesday, Jan. 1., in honor of Becker. The float will bear a florograph of Becker - a portrait made of flowers.

UCSF Vascular Surgeon advocates discussing medical challenges associated with space tourism

The world may be on the brink of a vast new frontier of tourism - and that could raise a few odd, and at this point unanswerable, questions for doctors. Space tourism is on the cusp of becoming a real possibility for people who don't have the health and fitness of a NASA astronaut, and aerospace medicine experts including Dr. Marlene Grenon, M.D., C.M., of the UCSF Division of Vascular and Endovascular Surgery, believe that now is the time to think about medical guidelines. There's a wealth of information about the effects of space travel on government astronauts - from the symptoms of space sickness to the long-term repercussions of lengthy stays at the International Space Station. But the effects on the average person with imperfect health are unknown. In a paper published in the British Medical Journal, Dr. Grenon and colleagues provide background in the field of space medicine for non-experts and clinicians.

CFCF Awards New Research Grant to Dr. Eric Nakakura to Study Resistance to mTOR Inhibition in Pancreatic Neuroendocrine Tumors

Eric Nakakura, M.D., Ph.D. has been awarded the 2012 Caring for Carcinoid Foundation-AACR Grant for Carcinoid Tumor and Pancreatic Neuroendocrine Tumor Research. Dr. Nakakura will receive $250,000 over two years to understand why some patients develop resistance to mTOR inhibiting drugs like everolimus. In particular, he will focus on INK128, a new mTOR inhibitor to see if it can overcome this resistance in mouse models of pancreatic neuroendocrine cancer. He will also evaluate the utility of (68)GA-DOTATOC PET-CT to monitor tumor response to mTOR inhibiting therapies like everolimus and INK128. 

Bariatric Surgery May Improve Chances for Successful Organ Transplantation

"Bariatric surgery has been widely accepted in the medical field, but now we're trying to apply it to specific patient groups," said Matthew Y.C. Lin, M.D., a gastrointestinal surgeon, a former surgical fellow*, and now an Assistant Professor of Surgery at UCSF. In a pilot study of 26 morbidly obese patients waiting for a kidney or liver transplant, Dr. Lin and colleagues in the UCSF Bariatric Surgery Program found laproscopic sleeve gastrectomy, a procedure that removes most of the stomach and reshapes it into a small tube or sleeve, significantly improved the chances of undergoing successful organ transplantation. "The reason why physicians are skittish about bariatric surgery for organ transplant is that these patients have more medical comorbities," said Lin, who is the lead author of the study. "But our study shows that it is safe to proceed."

* Fellowship in Minimally Invasive Surgery generously underwritten by Foundation for Surgical Fellowships.

East Bay Toddler in Waiting Game For a Combined Liver-Kidney Transplant at UCSF

21-month old Matthew Ouimet was born with primary hyperoxaluria Type I, a rare liver condition that causes buildup of oxalates in the body which damages the kidney. Matthew first experienced renal failure at 4 months old. On both the kidney and liver transplant waiting lists, he now undergoes four-hour dialysis sessions six days a week at UCSF Medical Center, attended by Julius Heilman, R.N. (pictured left), patient care manager of the pediatric dialysis unit and the UCSF Pediatric Transplant team. "The waiting list for a liver is based on how ill you are," explains Dr. Paul Brakeman (pictured right), a pediatric nephrologist and Medical Director of the Pediatric Dialysis Unit UCSF. "The more ill you are, the more points you get, the more likely you are to get an organ. Matthew's lab tests look good because he has a functioning liver. He just doesn't have the gene that removes the oxalates from his system."